Cerebral hemodynamics in Moyamoya disease: correlation between perfusion-weighted MR imaging and cerebral angiography.
OBJECTIVE
In Moyamoya disease, the relationship between cerebral hemodynamics and angiographic findings has not been fully evaluated. The purpose of this study is to evaluate hemodynamics in Moyamoya disease with perfusion-weighted MR imaging (PWI) and cerebral angiography.


METHODS
Twenty patients with Moyamoya disease were the subjects. Mean transit time (MTT) derived from PWI was calculated in the medial frontal lobes, the posterior frontal lobes, the occipital lobes, and the basal ganglia. From the angiographies, we classified the degrees of internal carotid artery (ICA) and posterior cerebral artery (PCA) stenoses as well as the degrees of Moyamoya vessels and leptomeningeal anastomosis (LMA). MTT in each region was compared with the angiographic findings.


RESULTS
MTT positively correlated with the degree of ICA stenosis in the medial frontal (P < .01), posterior frontal (P < .001), and occipital (P < .001) lobes, as well as in the basal ganglia (P < .001). MTT correlated with the degree of PCA stenosis in the medial frontal (P < .001), posterior frontal (P < .001), and occipital (P < .001) lobes, as well as in the basal ganglia (P < .001). MTT correlated with the degree of Moyamoya vessels in the medial frontal (P < .05) and posterior frontal (P < .01) lobes. A multivariate analysis revealed that ICA and PCA stenoses and Moyamoya vessels were independent factors that prolonged MTT.


CONCLUSIONS
Both ICA and PCA stenoses may influence overall cerebral perfusion in Moyamoya disease. The development of Moyamoya vessels may indicate hemodynamic impairment.
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Maidashi, Fukuoka, Japan.
O
O
Togao
F
F
Mihara
T
T
Yoshiura
A
A
Tanaka
T
T
Noguchi
Y
Y
Kuwabara
K
K
Kaneko
T
T
Matsushima
H
H
Honda
D000293:Adolescent; D000328:Adult; D001479:Basal Ganglia / Q000098:blood supply; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002343:Carotid Artery, Internal / Q000503:physiopathology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology; D002533:Cerebral Angiography; D002540:Cerebral Cortex / Q000098:blood supply; D002648:Child; D002675:Child, Preschool; D003097:Collateral Circulation / Q000502:physiology; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008578:Meninges / Q000098:blood supply; D008875:Middle Aged; D009072:Moyamoya Disease / Q000175:diagnosis* / Q000503:physiopathology; D020769:Posterior Cerebral Artery / Q000503:physiopathology; D013223:Statistics as Topic