Usefulness and limitation of 3-dimensional time of Flight Magnetic Resonance Angiography in the diagnosis of moyamoya disease

J Korean Neurol Assoc > Volume 15(3); 1997 > Article

Journal of the Korean Neurological Association 1997;15(3): 481-487.

모야모야병의 진단에 있어서 삼차원 TOF 자기공명혈관촬영의 유용성 및 한계

송홍기, 이병철, 김승현

한림대학교 의대 신경과, 한양의대 신경과

Usefulness and limitation of 3-dimensional time of Flight Magnetic Resonance Angiography in the diagnosis of moyamoya disease

Hong-Ki Song, Byung-Chul Lee, Seung-Hyun Kim

Department of Neurology College of Medicine, Hallym University and Hanyang University

Abstract

Objective : To evaluate clinical usefulness of magnetic resonance angiogra phy(MRA) in the diagnosis of moyamoya disease. Subjects and Methods : 14 moyamoya patients were included in this study. The machine was a Magnetom 63SP(Siemens) with a static magnetic field of 1.5T. MRA was performed by 3 dimensional time of flight(3D-TOF) method. Upon a total of 28 sides, the degree of stenotic process at the supraclinoid portion of internal carotid artery and the proximal portions of anterior cerebral artery and middle cerebral artery, and the number of moyamoya vessels(MMV) as well as presence of leptomeningeal anastomosis or transdural collaterals were evaluated. The findings of MRA were compared with those of contrast angiography(CA). Results : 1) The degree of stenotic process : Among 28 sides, all but one were abnormal in both MRA and CA. Findings of MRA in the degree of stenosis were exactly correlated with those of CA in 24 sides(89.9%, 24/27) and the degree of stenosis was overestimated by MRA in 3 sides. 2) MMV : MRA visualized MMV in 19 of 27(70.3%) hemispheres, while CA showed basal MMV in 25(93.791) hemispheres. MRA underestimated the number of MMV in 9 hemispheres. 3) Of a total of 29 large leptomeningeal or transdural collateral vessels demonstrated by CA, 15(51.7%) were identified by MRA. Conclusion : MRA is considered to be an excellent screening test for the diagnosis of moyamoya disease. However, further studies with another methods or higher field strength machines should be necessary for enhancing diagnostic accuracy, since MRA in this study poorly visualized small-sized arteries such as MMV and other collateral circulations compared to CA.