Validation of choroidal anastomosis on high-resolution magnetic resonance imaging as an imaging biomarker in hemorrhagic moyamoya disease View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-01-14

AUTHORS

Fang Wu, Cong Han, Yuehong Liu, Zhiwen Liu, Xiaoxu Yang, Ye Wu, Jingwen Du, Yu Wu, Luca Saba, Qian Zhang, Zhaoyang Fan, Debiao Li, Lian Duan, Qi Yang

ABSTRACT

ObjectivesThis study aimed to investigate the association between dilation and proliferation and anastomosis of perforating arteries, and intracranial hemorrhage in moyamoya disease (MMD) patients, using high-resolution magnetic resonance imaging (HRMRI).MethodsAdult patients with MMD at advanced stages were prospectively enrolled and underwent HRMRI exams. Dilation and proliferation of the lenticulostriate artery (LSA), medullary artery, and anterior or posterior choroidal arteries (AChA or PChA) were assessed. Abnormal anastomoses were identified between (1) the LSA and the medullary or insular arteries; (2) the thalamo-geniculate, thalamo-tuberal, or thalamo-perforating arteries and the medullary or insular arteries; and (3) the AChA or PChA and the medullary or insular arteries. The association between these variables and hemorrhagic events was calculated using univariate and multivariate analyses.ResultsFifty patients (14 men; mean age, 35.4 ± 9.7 years) were finally analyzed, including 17 hemorrhagic patients and 33 non-hemorrhagic patients. The inter-rater agreement for the qualitative evaluation of perforating arteries was good. Dilation and proliferation of the AChA or PChA (88.2% versus 54.5%, p = 0.027), and choroidal anastomosis (64.7% versus 18.2%, p = 0.002) were more frequently observed in patients with hemorrhage. Multivariate logistic regression showed that choroidal anastomosis remained significantly associated with hemorrhage (odds ratio = 5.95, 95% confidence interval = 1.21–29.25, p = 0.028).ConclusionsChoroidal anastomosis is independently associated with hemorrhagic events in adult patients with MMD at advanced stages. HRMRI can provide detailed information on both the anatomies and abnormal collaterals in MMD, which facilitates risk estimates of bleeding in MMD.Key Points• High-resolution magnetic resonance imaging allows for the evaluation of perforating arteries in patients with moyamoya disease.• Choroidal anastomosis is associated with hemorrhagic events in patients with moyamoya disease.• High-resolution magnetic resonance imaging might facilitate further grading and classification of moyamoya vessels. More... »

PAGES

4548-4556

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-020-07479-0

DOI

http://dx.doi.org/10.1007/s00330-020-07479-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1134579059

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33447859


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44 choroidal artery
45 classification
46 collaterals
47 detailed information
48 dilation
49 disease
50 disease patients
51 estimates
52 evaluation
53 events
54 exam
55 grading
56 hemorrhage
57 hemorrhagic events
58 hemorrhagic moyamoya disease
59 hemorrhagic patients
60 high-resolution magnetic resonance
61 high-resolution magnetic resonance imaging
62 imaging
63 information
64 insular arteries
65 inter-rater agreement
66 intracranial hemorrhage
67 lenticulostriate arteries
68 logistic regression
69 magnetic resonance
70 magnetic resonance imaging
71 medullary arteries
72 moyamoya disease
73 moyamoya disease patients
74 moyamoya vessels
75 multivariate logistic regression
76 non-hemorrhagic patients
77 patients
78 posterior choroidal artery
79 proliferation
80 qualitative evaluation
81 regression
82 resonance
83 resonance imaging
84 risk estimates
85 stage
86 study
87 thalamo
88 univariate
89 validation
90 variables
91 vessels
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