Value of high-resolution magnetic resonance imaging in differential diagnoses of moyamoya disease and vasculitis-related moyamoya syndrome

Abstract

Objective To explore the clinical application value of high-resolution magnetic resonance imaging (HR-MRI) in the differential diagnoses of moyamoya disease (MMD) and vasculitis-related moyamoya syndrome (V-MMS). Methods A prospective study of clinical data of 22 patients with MMD and 24 patients with V-MMS, admitted to our hospital from January 2014 to September 2016, was performed. HR-MRI and 3D-time of flight-magnetic resonance angiography (3D-TOF-MRA) were performed in all the patients. The proximal middle cerebral artery performance on HR-MRI was recorded: the max-vessel area, min-vessel area, max-lumen area, min-lumen area, wall max-thickness, styles of stenosis of the proximal middle cerebral artery lumen (eccentric stenosis or concentric stenosis), and wall enhancement or not. Results The max-vessel area, min-vessel area, and wall max-thickness of the V-MMS group were significantly larger than those in the MMD group (P<0.05). As compared with patients from MMD group, those from V-MMS group displayed higher distinct and concentric enhancement in the proximal portion of middle cerebral artery (M1 portion) and perforator vessels in basal ganglia region and small vessels in meninges or groove, with statistically significant differences (P<0.05). The sensitivity, specificity and accuracy of M1 portion wall distinct enhancement in diagnosing V-MMS were 75.0% (18/24), 86.4% (19/22), and 80.4% (37/46). The sensitivity, specificity and accuracy of M1 portion wall distinct enhancement combined with perforator vessels in basal ganglia region or small vessels in meningeal or groove in diagnosing V-MMS were 63.6% (15/24), 90.9% (20/22), and 76.1% (35/46). The sensitivity, specificity and accuracy of M1 portion wall distinct enhancement combined with perforator vessels in basal ganglia region or small vessels in meningeal or groove in diagnosing V-MMS were 63.6% (15/24), 90.9% (20/22), and 76.1% (35/46). Conclusion HR-MRI is a good tool in the differential diagnoses of MMD and V-MMS. Key words: Moyamoya disease; Vasculitis-related moyamoya syndrome; High-resolution magnetic resonance imaging