Background
Prompt diagnosis of vessel pathology and appropriate treatment of moyamoya vasculopathy
(MMV) are essential to improve long-term prognosis. The aims of our study were to
explore the diagnostic value of ultra–high-field (UHF) magnetic resonance imaging
at 7.0 T in MMV patients and to compare the applicability of two different 7.0 T vessel
imaging modalities to 3.0 T magnetic resonance angiography (MRA) and digital subtraction
angiography (DSA).
Methods
In a World Health Organization-registered and prospective imaging trial, patients
were investigated at 7.0 T magnetization-prepared rapid-acquisition gradient echo
(MPRAGE)-MRA and time-of-flight (TOF)-MRA, 3.0 T TOF-MRA, and by DSA.
Results
Six patients were included in our study and evaluated for MMV. 3.0 T TOF-MRA and 7.0 T
MPRAGE-MRA were able to depict the complete major vascular tree and confirmed MMV-specific
steno-occlusions of major intracranial arteries, as previously identified by DSA.
7.0 T TOF-MRA was limited to visualization of the circle of Willis as well as the
internal carotid artery only. Donor vessels for bypass surgery (i.e., branches of
superficial temporal artery) could be sufficiently visualized with all magnetic resonance
modalities.
Conclusions
Our results indicate that a specific 7.0 T vascular imaging protocol yields diagnostic
information about vessel pathology in MMV that approximates conventional DSA. 7.0 T
MPRAGE was superior to 7.0 T TOF-MRA due to shorter scanning times and better brain
coverage. To date, however, limited availability of 7.0 T technology in medical facilities
as well as technical and procedural constraints excludes a fair amount of patients
from the clinical 7.0 T imaging process.
Key Words
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Article info
Publication history
Published online: April 01, 2016
Accepted:
January 29,
2016
Received in revised form:
January 20,
2016
Received:
November 13,
2015
Footnotes
Conflict of interest: Thoralf Niendorf is founder and CEO of MRI.TOOLS GmbH, Berlin, Germany, and received speaker honoraria from Siemens Healthcare. Jens Wuerfel is CEO of the Medical Image Analysis Center (MIAC AG), Basel, Swizerland. He received research grants from Novartis and Biogen, and speaker honoraria from Bayer, Novartis, Teva, and Biogen. He served for advisory boards for Novartis and Biogen. He is supported by the German Ministry of Science (BMBF/KKNMS) and the German Ministry of Economy (BMWi). Apart from the scanner, no other resources of Siemens Healthcare, MRI.TOOLS GmbH, and MIAC AG were used, and the companies had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.041
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
