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Focal time-to-peak changes on perfusion MRI in children with Moyamoya disease: correlation with conventional angiography

 Hyun Seok Choi  ;  Dong-Seok Kim  ;  Seung-Koo Lee  ;  Eun Soo Kim  ;  Jinna Kim  ;  Kyu-Won Shim 
 Acta Radiologica, Vol.52(6) : 675-679, 2011 
Journal Title
 Acta Radiologica 
Issue Date
BACKGROUND: Moyamoya disease is a chronic progressive steno-occlusion of the distal internal carotid arteries with unknown etiology. As the classical presentation of childhood Moyamoya disease is ischemic stroke, cerebral hemodynamic evaluation is important for patient selection for surgery to prevent recurrent ischemic attacks. Perfusion MR imaging has been applied to evaluate cerebral hemodynamics. PURPOSE: To correlate the 'basal time-to-peak preservation sign', 'auto-synangiosis sign', and 'posterior involvement sign' on time-to-peak map of perfusion MRI with catheter angiography. MATERIAL AND METHODS: Thirty-four children (6.91 ± 3.08 years) with Moyamoya disease who underwent both perfusion-weighted MRI and catheter angiography were enrolled in this study. Given catheter angiography as a reference standard, basal time-to-peak preservation sign, auto-synangiosis sign, and posterior involvement sign were evaluated on time-to-peak maps. RESULTS: The basal time-to-peak preservation sign was accurate for the diagnosis of childhood Moyamoya disease; both sensitivity and specificity were 100%. The auto-synangiosis sign showed lower sensitivity (65%), however, with an acceptable specificity (98%). The posterior involvement sign showed lower sensitivity (61%) but had an acceptable specificity (96%). CONCLUSION: The basal time-to-peak preservation sign may be a universal finding in childhood Moyamoya disease. The auto-synangiosis and posterior involvement sign may be useful in determining transdural collateral status and posterior circulation involvement in childhood Moyamoya disease.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김동석(Kim, Dong Seok) ; 김은수(Kim, Eun Soo) ; 김진아(Kim, Jinna) ; 심규원(Shim, Kyu Won) ; 이승구(Lee, Seung Koo) ; 최현석(Choi, Hyun Seok)
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