Vessel Wall and Lumen Features in North American Moyamoya Patients
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ORIGINAL ARTICLE
Vessel Wall and Lumen Features in North American Moyamoya Patients Petrice M. Cogswell1 Manus J. Donahue2
· Sarah K. Lants2 · L. Taylor Davis2 · Meher R. Juttukonda2 · Matthew R. Fusco2,3 ·
Received: 30 May 2019 / Accepted: 16 July 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Purpose To apply intracranial vessel wall imaging (VWI) to determine changes in vessel wall characteristics between North American moyamoya patients and controls, as well as with standard clinical measures of moyamoya disease severity. Methods North American moyamoya patients and controls underwent intracranial 3.0 T VWI. Moyamoya patients also underwent digital subtraction angiography (DSA), from which modified Suzuki scores (mSS) were calculated. Lumen and outer vessel wall diameters of the supraclinoid internal carotid arteries (ICAs) and basilar artery on VWI were measured by two readers from which wall thickness was calculated. Controls and moyamoya patients were compared in logistic regression using disease category (moyamoya or none) as the dependent variable and wall thickness, age, gender, and side as the explanatory variables (significance: two-sided p < 0.05). In moyamoya patients, regression was performed with mSS as the dependent variable and wall thickness, age, gender, and side as the explanatory variables. Analyses were repeated for each lumen diameter and outer vessel wall diameter in place of wall thickness. Results Patients with moyamoya (n = 23, gender = 3/20 male/female; age = 43 ± 12 years) and controls (n = 23, gender = 3/20 male/female, age = 43 ± 13 years) were included. Moyamoya patients showed a significantly smaller ICA lumen and outer vessel wall diameter compared to controls (p < 0.05) but no significant change in vessel wall thickness. Similarly, ICA lumen and outer vessel wall diameters decreased with increasing mSS (p < 0.05). Conclusion Findings suggest decreased ICA lumen and outer vessel wall diameters, but no significant difference in wall thickness, between patients and controls. Lumen and outer vessel wall diameters also decreased with disease severity.
Keywords MRI · Vessel wall imaging · Vascular imaging · Moyamoya disease
Introduction Moyamoya disease is characterized by idiopathic progressive narrowing of the supraclinoid internal carotid arteries (ICAs) with development of collateral vessels [1, 2]. A similar vascular phenotype is seen in moyamoya syndrome, which arises secondary to processes, such as sickle cell disease, Down syndrome, atherosclerosis and radiation therapy. The pathophysiology of moyamoya changes remains unknown, and prognosis is variable. Although di Petrice M. Cogswell
[email protected] 1
Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
2
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
3
Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
agnosis and grading of moyamoya is convention
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