MR imaging features of vessel walls at the beginning of the middle cerebral artery in patients with moyamoya disease: a follow up study / 中华神经医学杂志

ABSTRACT

Objective To investigate the MR imaging features and changes of arterial walls at the beginning of the middle cerebral artery in patients with moyamoya disease during the natural course.Methods Nineteen patients with moyamoya disease,admitted to our hospital from January 2014 to December 2015,were chosen prospectively in the study.The MR imaging manifestations and clinical symptoms of the initial vascular walls of the unilateral middle cerebral artery in each patient were observed.Results Two patients were classified as Suzuki grading Ⅱ,9 were classified as Suzuki grading Ⅲ,and 8 were classified as Suzuki grading Ⅳ.The maximum cross-sectional area of patients with moyamoya disease was (5.7±1.4) mm2,and the maximum thickness was (0.9±0.2) mm;15 patients showed wall non-enhancement,two showed wall slight enhancement,and two showed wall obvious enhancement.Concentric thickening was noted in 17 patients and eccentric thickening in two.Two patients with Suzuki grading Ⅲ presented concentric thickening and slight enhancement;two patients with Suzuki grading Ⅲ presented concentric thickening and obvious enhancement;one patient with Suzuki grading Ⅱ and one with Suzuki grading Ⅳ presented eccentric thickening and non-enhancement;one patient with Suzuki grading Ⅱ,5 with Suzuki grading Ⅲ and 7 with Suzuki grading Ⅳ presented concentric thickening and non-enhancement.After the follow up for a median time of 38.7 months,the maximum cross-sectional area was (5.5±1.2) mm2 and the maximum thickness was (1.0±0.3) mm,which showed no significant differences as compared with those at admission (P＞0.05).Two patients with Suzuki grading Ⅱ progressed to Suzuki grading Ⅲ (the vessel wall developed from non-enhancement to slight or obvious enhancement).No obvious differences in Suzuki grading,enhancement or thickening styles were noted in the other patients during the follow up.Six patients had recurrent cerebral ischemia during follow-up,4 were with wall enhancement,and two were with wall non-enhancement.Conclusions Patients with moyamoya disease at Suzuki grading Ⅱ-Ⅳ commonly present concentric thickening without enhancement.Moyamoya disease progresses slowly,a few patients with moyamoya disease may present enhancement when it is in progress,and patients with wall enhancement are more likely to have recurrent attack of cerebral ischemia.