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London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 397 213 Vascular imaging Collateral Vascularity on TOF MR Angiography Can Estimate Cerebrovascular Dynamics in Cases with Cerebral Main Artery Occlusion? K. Igase1, I. Matsubara2, M. Arai3, J Goishi4, K. Sadamoto5 Department of Neurosurgery, Washokai Sadamoto Hospital, Matsuyama, JAPAN1, Department of Neurosurgery, Washokai Sadamoto Hospital, Matsuyama, JAPAN2, Department of Neurosurgery, Washokai Sadamoto Hospital, Matsuyama, JAPAN3, Department of Neurosurgery, Washokai Sada-moto Hospital, Matsuyama, JAPAN4, Department of Neurosurgery, Washokai Sadamoto Hospital, Matsuyama, JAPAN5 (Introduction) In cases with a cerebral artery occlusion the residual cerebral blood flow (CBF) is crucial factor for a decision-making of their individual treatment. In order to measure the residu-al CBF or cerebrovascular reactivity (CVR) either single photon-emission computed tomography (SPECT) or positron-emission tomography (PET) is generally used, however, few hospitals possess such equipment because of its high value and necessity of shielding. Therefore, we have evaluated a simple way to estimate the state of cerebrovascular circulation using collateral vascularity on 3D time-of-flight (TOF) - MR Angiography (MRA) and confirmed the correlation with basic parameters on CBF analysis. (Methods) Twelve cases suspected to have an occlusion of middle cerebral artery on TOF-MRA were collected (Fig.1). All cases underwent a quantitative CBF examination which was consisted of resting CBF, CBF after acetazolamide administration, and CVR. TOF-MRA was performed with 3T MRI (SIGNA HDxt: GE healthcare) and CBF analysis with Infinia3 (GE healthcare). Collateral vas-cularity was evaluated rating the visualization on 3-points scale (0-2) about both middle meningeal artery (MMA) and superficial temporal artery (STA). (Results) Resting CBF on lesion side did not reveal a close correlation with the vascularity of STA (R2=0.19), however a considerable close correlation with that of MMA (R2=0.23). Meanwhile, CBF on lesion side after acetazolamide administration had a strong correlation with the vascularity of MMA (R2=0.43), but not STA (R2=0.02), moreover CVR on lesion side was also closely correlated with the vascularity of MMA (R2=0.35), but not STA (R2=0.04). (Discussion) This study has shown that collateral vascularity on TOF-MRA seems to reflect cerebro-vascular dynamics, and this method might be a simple way to estimate the residual CBF and CVR in case with cerebral main artery occlusion. 214 Vascular imaging Leptomeningeal High Signal Intensity and Moyamoya Vessels on MR Imaging in Patients with Atherosclerotic Moyamoya Syndrome K.D. Joo1, W.S. Kim2, M.J. Bae3, M.H. Choi4, J.S. Han5, J.M. Jung6, H.J. Yang7, J.H. Lee8 Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medi-cine, Gangneung, SOUTH KOREA1, Department of Family Medicine, Seoul Asan Hospital, Asan Medical Center, University of Ulsan College of Medicine, Seoul, SOUTH KOREA2, Department of Family Medicine, Seoul Asan Hospital, Asan Medical Center, University of Ulsan College of Med-icine, Seoul, SOUTH KOREA3, Department of Family Medicine, Seoul Asan Hospital, Asan Medi-cal Center, University of Ulsan College of Medicine, Seoul, SOUTH KOREA4, Department of Fam-ily Medicine, Seoul Asan Hospital, Asan Medical Center, University of Ulsan College of Medicine, Seoul, SOUTH KOREA5, Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, SOUTH KOREA6, Department of Family Medicine, Gang-neung Asan Hospital, University of Ulsan College of Medicine, Gangneung, SOUTH KOREA7, De-partment of Diagnostic Radiology, Gangneung Asan Hospital, University of Ulsan College of Medi-cine, Gangneung, SOUTH KOREA8 Background and aims: Leptomeningeal high signal intensity (LMHI: ivy sign) has been reported on unenhanced fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) imaging in patients with moyamoya disease. However, the LMHI in moyamoya syndrome associated athero-sclerosis has not been investigated. We investigated the clinical utility of LMHI and additional basal ganglia moyamoya vessels on MR imaging in patients with moyamoya syndrome associated with atherosclerotic occlusion of the middle cerebral artery (MCA). Methods: We retrospectively analyzed 12 consecutive patients ( 5 males and 6 females) who had unilateral (n=11) or bilateral (n=1) steno-occlusive lesions in the MCA with basal moyamoya ves-sels demonstrated by conventional angiography. Patients ranged in age from 34 to 69 years (mean age, 51.8 years). All patients underwent 3.0-T MR imaging and three-dimensional time-of-flight MR angiography. The grade of LMHI on FLAIR images was classified as “absent,” “minimal,” “moder-ate,” or “marked.” The visibility of moyamoya vessels (MMV) on T2-weighted images was graded according to a 4-point scale (none, slight, moderate, or marked). Results: The degree of LMHI were grade 0 in 5 patients (38%), grade 1 in 6 patients (46%), grade 2 in 1 patient (8%) out of 13 hemispheres. LMHI was most frequently and prominently seen in the frontal and parietal lobes. The MMV was seen only one patient out of 12 hemispheres (8%). Conclusions: LMHI on FLAIR images is not prominent and MMV on T2-weighted images is not obvious in the basal ganglia. These findings suggest that LMHI and MMV are not useful sign in MR imaging for the diagnosis of moyamoya syndrome associated with atherosclerotic occlusion of the MCA.


Karger_ESC London_2013
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