Abstract
Spontaneous occlusion of the circle of Willis, i.e., moyamoya disease (MMD), is a clinical disease entity angiographically characterized by progressive and bilateral stenosis of the carotid bifurcation, with a hazy collateral network at the base or convexity of the brain. Although the importance of computed tomography (CT) and conventional magnetic resonance (MR) imaging in diagnosing MMD has already been determined, conventional arteriography is still regarded as necessary for definitive diagnosis. Magnetic resonance angiography (MR-A) is a very recent vascular imaging technique which allows noninvasive and direct imaging of vessels without the use of contrast medium. We present four pediatric cases of MMD, evaluated by conventional angiography, CT, MR imaging, and MR-A. Our data demonstrate thatMR-A is successful both in allowing detection of occlusive disease of the basal portion of the internal carotid artery and large branch basal cerebral vessels and demonstrating the collateral vessels at the base of the brain. As a noninvasive procedure, MR-A promises to become a valuable alternative to classical angiography in the diagnosis of MMD.
Similar content being viewed by others
References
Aoki T, Matsuzawa H, Houkin K, Kamiyama H, Abe H, Miyasaka K, Saito H (1993) Usefulness and limitation of MR imaging and MR angiography in diagnosis of juvenile moya moya disease. No Shinkei Geka 21: 305–311
Chang KH, Yi JG, Han MH, Kim IO (1990) MR imaging findings of moyamoya disease. J Korean Med Sci 5: 85–90
Creasy JL, Price RR, Presbrey T, Goins D, Partain CL, Kessler RM (1990) Gadolinium-enhanced MR angiography. Radiology 175: 280–283
Demaerel P, Wilms G, Casteels Van Daele M, Marchal G, Van-Fraeyenhoven L, Bosmans H, Casaer P, Baert AL, (1990), Moyamoya. Diagnostic par IRM et angiographie RMN. J Radiol 71:119–123
Edelman RR, Mattle HP, Atkinson DJ, Hoogewoud HM (1990) MR angiography. AJR 154: 937–946
Edelman RR, Mattle HP, Reilly GV, Wentz KU, Liu C, Zhao B (1990) Magnetic resonance imaging of flow dynamics in the circle of Willis. Stroke 21: 56–65
Fujisawa I, Asato R, Mishimura K, Kogashi K, Itoh K, Noma S, Sagoh T, Minami S, Nakano Y, Yonekawa Y (1987) Moyamoya disease. MR imaging. Radiology 164: 103–105
Gordon N, Isler W (1989) Childhood moyamoya disease. Develop Med Child Neurol 31: 98–107
Hankey GJ, Warlow CP, Sellar RJ, (1990) Cerebral angiographic risk in mild cerebrovascular disease. Stroke 21: 209–222
Heiserman JE, Drayer BP, Keller PJ, Fram EK (1992) Intracranial vascular stenosis and occlusion: evaluation with three-dimensional time-of-flight MR angiography. Radiology 185: 667–673
Kurlemann G, Bongartz G, Krings W, Palm DG (1991) Asymptomatic moya-moya syndrome. Diagnosis by EEG and magnetic resonance angiography. Monatsschr Kinderheilkd 139: 235–238
Kurokawa T, Tomita S, Ueda K, Narazaki O, Hanai T, Hasuo K, Matsushima T, Kitamura K (1985) Prognosis of occlusive disease ofthe circle of Willis (moyamoya disease) in children. Pediatr Neurol 1: 274–277
Kuwabara Y, Ichiya Y, Otsuka M, Tahara T, Gunasekera R, Hasuo K, Masuda K, Matsushima T, Fukui M (1990) Cerebral hemodynamic change in the child and the adult with moyamoya disease. Stroke 21: 272–277
Laub GA, Kaiser WA (1989) MR angiography with gradient motion refocusing. J Comput Assist Tomogr 12: 377–382
Marchal G, Bosmans H, Van Fraeyenhoven L, Wilms G, Van Hecke P, Plets C, Baert AL (1990) Intracranial vascular lesions: optimization and clinical evaluation of three-dimensional time-of-flight MR angiography. Radiology 175: 443–448
Masaryk TJ, Modic MT, Ross JS, Ruggieri PM, Laub GA (1989) Intracranial circulation: preliminary clinical results with three-dimensional (volume) MR angiography. Radiology 171: 793–799
Matsushima Y, Aoyagi M, Niimi Y, Masaoka H, Ohno K (1990) Symptoms and their pattern of progression in childhood moyamoya disease. Brain Dev 12: 784–789
Nishimoto A (1979) Moyamoya disease. Neurol Med Chir 19: 221–228
Ohashi K, Fernandez Ulloa M, Hall LC (1992) SPECT, magnetic resonance and angiographic features in a moyamoya patient before and after external-tointernal carotid artery by pass. J Nucl Med 33: 1692–1695
Rolak LA, Rokey R (1986) Magnetic resonance imaging in moyamoya disease. J Clin Neurol 1: 67–70
Ross JS, Masaryk TJ, Modic MT, Harik SI Wiznitzer M, Selman WR (1989) Magnetic resonance angiography of the extracranial carotid arteries and intracranial vessels: a review. Neurology 39: 1369–1376
Sato K, Shimoji T (1992) Moyamoya disease. In: Raimondi AJ, Choux M, Di Rocco C (eds) Cerebrovascular diseases in children. Springer. New York Berlin Heidelberg, pp 227–243
Sato S, Shibuya H, Matsushima Y, Suzuki S (1988) Analysis of the angiographic findings in cases of childhood moyamoya. Neuroradiology 30: 111–119
Sato H, Sato N, Tamaki N, Matsumoto S (1990) Chronic low-perfusion state in children with moyamoya disease following revascularization. Child's Nerv Syst 6: 166–171
Sunaga Y, Fujinaga T, Ohtsuka T (1992) MRI findings of moyamoya disease in children. No To Hattatsu 24: 375–379
Suzuki J, Takaku A (1969) Cerebrovascular moyamoya disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol 20: 288–299
Suzuki J, Kodama N (1983) Moyamoya disease. A review. Stroke 14: 104–109
Takahashi M, Miyauchi T, Kowada M (1980) Computed tomography of moyamoya disease: demonstration of occluted arteries and collateral vessels as important diagnostic signs. Radiology 134: 671–676
Takeuchi S, Tanaka R, Ishii R, Tsuchida T, Kobayashi K, Arai H (1985) Cerebral hemodynamics in patients with moyamoya disease. A study of regional cerebral blood flow by the 133Xe inhalation method. Surg Neurol 23: 468–474
Yamada I, Matsushima Y, Suzuki S, (1992) Moyamoya disease: diagnosis with three-dimensional time-of-flight MR angiography. Radiology 184: 773–778
Zimmerman RA, Bogdan A, Bilaniuk LT (1992) Pediatric MR angiography of the central nervous system. Riv Neuroradiol 5 [Suppl 1]: 121–126
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Battistella, P.A., Carollo, C., Pellegrino, P.A. et al. Magnetic resonance angiography in moyamoya disease. Child's Nerv Syst 11, 329–334 (1995). https://doi.org/10.1007/BF00301664
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00301664