Study On The Combination With High-resolution MRI And PCASL In The Research Of Unilateral Moyamoya Disease

Objective:To discuss the applicative value of combined use of 3.0T high-resolution MRI and 3D-p CASL in diagnosis and evaluation of unilateral moyamoya disease.Material and Methods: The clinical data of patients who diagnosed unilateral moyamoya disease during March 2013 to March 2015 at the Second Affiliated Hospital of Nanchang University were reviewed. Eleven patients met inclusion criteria: unilateral moyamoya was diagnosed by digital subtraction angiography. All the patients performed HR-MRI and 3D-p CASL to evaluate the obturation in affected side of middle cerebral artery and bilateral cerebral perfusion. We seperated these patients into 2groups: the infarction group and the noninfarction group. The infarction patients showed ischemic stroke station in affected side while the noninfarction group didn’t show ischemic stroke. Finally, we’ve learnt the obturation in affected side of middle cerebral by HR-MRI and assessed the perfusion value in bilateral basal ganglia area, cortex area and cerebral white matter by 3D-p CASL which conclude CBF, the mirror side CBF and r CBF. We then compared the obturation of cerebral artery and the difference in CBF and r CBF of bilateral brain tissue between both group, we also compared the CBF in affected side and the mirror side.Results: In all patients studied, 7 of which are female, the others are male. The average age of them are 32.27±10.50 years old. All the patients showed unilateral MCA flow voids disappeared by MRI plain scan and 3D TOF-MRA, while MCA vessels could be clearly visualized and showed high-grade stenosis on HR-MRI and that results were consistent with DSA. In the infarction group, we found the CBF and r CBF in bilateral basal ganglia area, cortex area and cerebral white matter were signifiicantly lower than the noninfarction group; furthermore, the affected side also showed significant lower in CBF level compared to the mirror side in the infarction group, but the comparison in the noninfarction group appeared no significant difference.Conclusion:1. 3.0T HR-MRI could give us a better indication of lumen and structure of middle cerebral artery in unilateral moyamoya disease while 3D TOF-MRA tend to overestimate the occlusion of middle cerebral artery. 2. The cerebral perfusion in the unilateral moyamoya disease could be evaluated by 3D-p CASL, and 3D-p CASL could be used in the clinical evaluating and following-up in unilateral moyamoya disease.