Article
Magnetic resonance imaging of collateral networks in moyamoya angiopathy at 7 Tesla
Search Medline for
Authors
-
Bixia Chen
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Deutschland
-
Toshinori Matsushige
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Deutschland
-
Markus Krämer
- Klinik für Neurochirurgie, Alfried Krupp Krankenhaus, Essen, Deutschland
-
Marc Schlamann
- Zentrum für Radiologie, Abteilung für Neuroradiologie, Universitätsklinikum Giessen, Justus-Liebig-Universität Giessen, Giessen, Deutschland
-
Mark E. Ladd
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Germany; Medizinische Physik in der Radiologie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
-
Ulrich Sure
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
-
Karsten H. Wrede
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Deutschland
| Published: | June 9, 2017 |
|---|
Outline
Text
Objective: Collateral networks in Moyamoya angiopathy (MMA) have a complex angioarchitecture difficult to comprehend in conventional examinations. This prospective study aimed to delineate deeply seated collateral networks (DSCNs) and evaluate their morphologic patterns by 7 Tesla (T) magnetic resonance angiography (MRA) in comparison with the current gold standard conventional digital subtraction angiography (DSA).
Methods: Ten patients suffering from MMA underwent 7T TOF MRA with 0.22 × 0.22 × 0.41 mm3 resolution and MPRAGE with 0.7 × 0.7 × 0.7 mm3 resolution, additional to the standard clinical workup with conventional DSA. Four experienced raters analyzed the images in consensus reading. Classification of DSCNs was according to location and connecting vessels. Presence of DSCNs and image quality for DSA, TOF MRA and MPRAGE were rated on a five-point scale. Delineation of collateral networks was analyzed by the McNemar test. Image quality was compared using Wilcoxon signed-rank tests. Statistical analysis was carried out with the STATA software package (Stata/MP 14.2 for Linux 64-bit).
Results: All examinations were successfully performed without occurrence of adverse events. The study group comprised 3 male and 7 female patients. The mean age was 34 years (range: 21 – 58 years). DSCNs were classified into 2 major categories (connection to cortical vessels and connection to major trunk vessels) with a total of 6 pathways. Seventy DSCNs were detected in DSA, 79 in TOF MRA, and 54 in MPRAGE, respectively. All collateral networks detected in DSA were excellently delineated in TOF MRA and 54 of 70 (77.1%) in MPRAGE. Nine anastomoses were identified by MRA (TOF: n = 9, MPRAGE: n = 3) not visible in DSA. Detection of DSCNs was significantly better in TOF MRA than in DSA and MPRAGE (p < 0.01). The mean overall image quality was 4.83 in DSA, 4.92 in TOF MRA and 4.75 in MPRAGE, respectively. Overall image quality showed comparable results for DSA and TOF MRA (p = 1.0); however, both were better than MPRAGE (p < 0.0001).
Conclusion: Delineation of submillimeter vessels in DSCNs in MMA is feasible with excellent image quality using 7T MRA. Visualization by 7T TOF MRA was superior to conventional DSA and 7T MPRAGE. The presented 7T TOF MRA protocol is very promising for further morphological and pathophysiological MMA research especially for submillimeter collateral networks.
