Acta Neurochirurgica

, Volume 154, Issue 12, pp 2151–2157 | Cite as

Outer-diameter narrowing of the internal carotid and middle cerebral arteries in moyamoya disease detected on 3D constructive interference in steady-state MR image: is arterial constrictive remodeling a major pathogenesis?

  • Yasuyuki Kaku
  • Motohiro MoriokaEmail author
  • Yuki Ohmori
  • Takayuki Kawano
  • Yutaka Kai
  • Hirofumi Fukuoka
  • Toshinori Hirai
  • Yasuyuki Yamashita
  • Jun-ichi Kuratsu
Clinical Article



To obtain information on affected vessels in moyamoya disease (MMD), we analyzed the vascular morphological characteristics of MMD using three-dimensional (3D) constructive interference in steady-state (CISS) magnetic resonance imaging (MRI).


The population of this 3D-CISS MRI study consisted of 51 patients with MMD: 16 patients with atherosclerotic middle cerebral artery (MCA) stenosis or occlusion, 42 MRI control patients, and 28 control digital subtraction angiography (DSA) patients. We measured the outer diameters of the terminal portion of the internal carotid artery (ICA) and the proximal portion of the MCA (M1 portion). We evaluated the inner diameter as the relative value (%) obtained from magnified DSA images and analyzed these data.


The outer diameters of the ICA and M1 portions were significantly smaller in the MMD group than in the other two groups, while the M1 outer diameter of the atherosclerosis group was not significantly different compared to the control (ICA: MMD, 2.61 ± 0.46 mm vs. control, 4.04 ± 0.50 mm and M1: MMD, 1.92 ± 0.43 mm vs. control, 3.34 ± 0.54 mm vs. atherosclerosis, 3.45 ± 0.56 mm). Furthermore, in MMD patients, the outer diameter was unrelated to the progression of the luminal stenosis grade estimated by DSA.


This is the first report that the outer diameters of both the ICA and M1 decrease in MMD patients. Our findings suggest that the vascular constrictive changes of the affected arteries are an important phenomenon reflecting MMD pathology.


3D-CISS Moyamoya disease MRI Outer diameter 


Conflicts of interest


Grant support

This work was supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Sports, Science and Culture of Japan.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Yasuyuki Kaku
    • 1
  • Motohiro Morioka
    • 3
    Email author
  • Yuki Ohmori
    • 1
  • Takayuki Kawano
    • 1
  • Yutaka Kai
    • 1
  • Hirofumi Fukuoka
    • 2
  • Toshinori Hirai
    • 2
  • Yasuyuki Yamashita
    • 2
  • Jun-ichi Kuratsu
    • 1
  1. 1.Department of Neurosurgery, School of MedicineKumamoto UniversityKumamotoJapan
  2. 2.Department of Diagnostic Radiology, School of MedicineKumamoto UniversityKumamotoJapan
  3. 3.Department of Neurosurgery, School of MedicineKurume UniversityKurumeJapan

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