title: Characteristics of Diffusional Kurtosis in Chronic Ischemia of Adult Moyamoya Disease: Comparing Diffusional Kurtosis and Diffusion Tensor Imaging.
abstract: Detecting microstructural changes due to chronic ischemia potentially enables early identification of patients at risk of cognitive impairment. In this study, diffusional kurtosis imaging and diffusion tensor imaging were used to investigate whether the former provides additional information regarding microstructural changes in the gray and white matter of adult patients with Moyamoya disease.
  
  
  
  MR imaging (diffusional kurtosis imaging and DTI) was performed in 23 adult patients with Moyamoya disease and 23 age-matched controls. Three parameters were extracted from diffusional kurtosis imaging (mean kurtosis, axial kurtosis, and radial kurtosis), and 4, from DTI (fractional anisotropy, radial diffusivity, mean diffusivity, and axial diffusivity). Voxelwise analysis for these parameters was performed in the normal-appearing brain parenchyma. The association of these parameters with neuropsychological performance was also evaluated.
  
  
  
  Voxelwise analysis revealed the greatest differences in fractional anisotropy, followed, in order, by radial diffusivity, mean diffusivity, and mean kurtosis. In patients, diffusional kurtosis imaging parameters were decreased in the dorsal deep white matter such as the corona radiata and superior longitudinal fasciculus (P < .01), including areas without DTI abnormality. Superior longitudinal fasciculus fiber-crossing areas showed weak correlations between diffusional kurtosis imaging and DTI parameters compared with tissues with a single-fiber direction (eg, the corpus callosum). Diffusional kurtosis imaging parameters were associated with general intelligence and frontal lobe performance.
  
  
  
  Although DTI revealed extensive white matter changes, diffusional kurtosis imaging additionally demonstrated microstructural changes in ischemia-prone deep white matter with abundant fiber crossings. Thus, diffusional kurtosis imaging may be a useful adjunct for detecting subtle chronic ischemic injuries.
authors.affiliation: From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.) kazumata@med.hokudai.ac.jp.
authors.forename: K
authors.identifier: 0000-0001-7409-9515
authors.initials: K
authors.lastname: Kazumata
authors.affiliation: Radiobiology and Medical Engineering (K.K.T.).
authors.forename: K K
authors.identifier: 0000-0002-9072-4509
authors.initials: KK
authors.lastname: Tha
authors.affiliation: Psychiatry (H.N.).
authors.forename: H
authors.identifier: 0000-0003-0700-6600
authors.initials: H
authors.lastname: Narita
authors.affiliation: Biostatistics (Y.M.I.), Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Y M
authors.identifier: 0000-0001-5073-0827
authors.initials: YM
authors.lastname: Ito
authors.affiliation: From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.).
authors.forename: H
authors.identifier: 0000-0003-2910-4711
authors.initials: H
authors.lastname: Shichinohe
authors.affiliation: From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.).
authors.forename: M
authors.identifier: 0000-0002-8032-7198
authors.initials: M
authors.lastname: Ito
authors.affiliation: From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.).
authors.forename: H
authors.identifier: 0000-0001-6567-8136
authors.initials: H
authors.lastname: Uchino
authors.affiliation: From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.).
authors.forename: T
authors.identifier: 0000-0001-5082-1761
authors.initials: T
authors.lastname: Abumiya
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D002908:Chronic Disease; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000150:complications / Q000000981:diagnostic imaging*