Vessel Wall and Lumen Features in North American Moyamoya Patients

Clin Neuroradiol. 2020 Sep;30(3):545-552. doi: 10.1007/s00062-019-00819-8. Epub 2019 Aug 6.

Abstract

Purpose: To apply intracranial vessel wall imaging (VWI) to determine changes in vessel wall characteristics between North American moyamoya patients and controls, as well as with standard clinical measures of moyamoya disease severity.

Methods: North American moyamoya patients and controls underwent intracranial 3.0 T VWI. Moyamoya patients also underwent digital subtraction angiography (DSA), from which modified Suzuki scores (mSS) were calculated. Lumen and outer vessel wall diameters of the supraclinoid internal carotid arteries (ICAs) and basilar artery on VWI were measured by two readers from which wall thickness was calculated. Controls and moyamoya patients were compared in logistic regression using disease category (moyamoya or none) as the dependent variable and wall thickness, age, gender, and side as the explanatory variables (significance: two-sided p < 0.05). In moyamoya patients, regression was performed with mSS as the dependent variable and wall thickness, age, gender, and side as the explanatory variables. Analyses were repeated for each lumen diameter and outer vessel wall diameter in place of wall thickness.

Results: Patients with moyamoya (n = 23, gender = 3/20 male/female; age = 43 ± 12 years) and controls (n = 23, gender = 3/20 male/female, age = 43 ± 13 years) were included. Moyamoya patients showed a significantly smaller ICA lumen and outer vessel wall diameter compared to controls (p < 0.05) but no significant change in vessel wall thickness. Similarly, ICA lumen and outer vessel wall diameters decreased with increasing mSS (p < 0.05).

Conclusion: Findings suggest decreased ICA lumen and outer vessel wall diameters, but no significant difference in wall thickness, between patients and controls. Lumen and outer vessel wall diameters also decreased with disease severity.

Keywords: MRI; Moyamoya disease; Vascular imaging; Vessel wall imaging.

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction
  • Basilar Artery / diagnostic imaging*
  • Carotid Artery, Internal / diagnostic imaging*
  • Case-Control Studies
  • Cerebral Angiography
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Moyamoya Disease / diagnostic imaging*
  • Severity of Illness Index
  • United States

Supplementary concepts

  • Moyamoya disease 1