title: Adult moyamoya-atherosclerosis syndrome: Clinical and vessel wall imaging features.
abstract: BACKGROUND
  We sought to incorporate high-resolution magnetic resonance imaging (HRMRI) into the diagnostic process of intracranial atherosclerosis associated moyamoya syndrome in adult patients.
  
  
  METHODS
  From March 2013 to March 2014, HRMRI was consecutively performed on adult patients with angiographic moyamoya. The patients were classified as moyamoya - plaques (MMD-P) if a plaque could be identified or as moyamoya - no plaques (MMD-NP) if a plaque could not be identified. The angiography, HRMRI findings and atherogenic risk factors of these patients were analyzed.
  
  
  RESULTS
  Fifty-one patients (mean age 39±9, 20 males) were enrolled. On traditional angiography, probable intracranial atherosclerosis was identified in 5 patients, no definite diagnosis in 12 patients, and moyamoya disease in 34 patients. On HRMRI, 15 out of 32 patients with risk factors and 4 out of 19 patients without risk factors were found to have plaques and were diagnosed as MMD-P, while the other 32 patients were diagnosed as MMD-NP. The MMD-P patients were more likely to be older (P=0.033) and male (P=0.0353) and were less likely to have cerebral hemorrhage (P=0.0066) and a history of disease progression (P=0.0012).
  
  
  CONCLUSIONS
  Our study suggests that HRMRI can help diagnose intracranial atherosclerosis more accurately in moyamoya disease patients with atherogenic risk factors. The distinct clinical features between MMD-P and MMD-NP patients suggest different underlying pathophysiology and therefore potentially different treatment strategies.
authors.affiliation: Department of Neurosurgery, 307 Hospital, PLA, Beijing, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Han
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Ming-Li
authors.initials: ML
authors.lastname: Li
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yu-Yuan
authors.initials: YY
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, 307 Hospital, PLA, Beijing, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Ye
authors.affiliation: Department of Neurosurgery, 307 Hospital, PLA, Beijing, China.
authors.forename: Chen-Fan
authors.initials: CF
authors.lastname: Xie
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, 307 Hospital, PLA, Beijing, China. Electronic address: duanlian307@sina.com.
authors.forename: Lian
authors.initials: L
authors.lastname: Duan
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: xuwh@pumch.cn.
authors.forename: Wei-Hai
authors.initials: WH
authors.lastname: Xu
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging*; D001808:Blood Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: Diagnosis; Magnetic resonance imaging; Moyamoya disease; Stroke