DSA Features Of Moyamoya Disease

Objective: To analyze the characteristics of moyamoya disease of Digital Substract Angiology(DSA) examination.Methods: Classify all the Moyamoya disease patients confirmed by DSA resault (include Internal carotid arteries and vertebral artery angiology) in the past ten years (from 1th May 1999 to 1th May 2009), in the second affiliated hospital of Dalian Medical University, by morphological basis, as stenosis and occllusion positions in intracranial vascular, and the morphologics features of moyamoya vascular, then analyse the morpho- logical characteristics.Results:1. Internal carotid artery system: 6 of the 46 internal carotid arteries were occluded, 23 were stenosised; occlusion and stenosis sites were mainly located in intracranial segment of internal carotid arteries(C1 and C2, specially). 24 begining of ophthalmic arteries were stenosised. 12 of the 46 anterior cerebral arteries stenosised, 2 anterior cerebral arteries were occluded. 19 middle cerebral arteries stenosised, 18 occluded, all of the occlusion and stenosis occurred in the M1 segment.2. Vertebral-basilar artery system: all the 23 patients were found have no vertebral artery stenosis or occlusion. 3 of 23 were found that the whole basilar artery stenosised. Besides, 1 vertebral-basilar were found a large lumen, and irregular wall. 4 of 46 posterior cerebral arteries were found slender, and 4 begining of the vescular stenosised.3. Moyamoya vessels: 35 of the 46 internal carotid artery angiographies show moyamoya vessels. All of the moyamoya vessels were located at the basal ganglia area. No vertebral artery angiography moyamoya network.4. Collateral circulation: all cases show various forms of collateral circulation, comped the blood supply. In which, there were 21 cases of leptomeningeal anastomosis extension, 18 cases Willis ring, 9 cases moyamoya vessels, 4 cases of subdural ansa.Conclusion: Moyamoya disease is characterized by a progressive brain artery stenosis, occlusion, and with extensive collaterals formed. Its pathological changes mainly affect the internal carotid artery system, the most common one was middle cerebral artery and ophthalmic artery, followed by the ministry of internal carotid artery siphon. Vertebral-basilar artery system involving less. The most important collaterals were cortical leptoment ingeal anastomosis and circle of Willis. Moyamoya vessels and transdual anastomosis can also play a role in the compensatory blood supply.