The Application Of MRA And DSC-pwi In Patients With Moya-moya Disease

Objective:To evaluate the clinical value of magnetic resonance angiography(MRA)on abnormal vessels in Moya-moya disease,and to evaluate the value of Dynamic susceptibility contrast—perfusion weighted imaging(DSC-PWI)in quantitative analysis of perfusion in Moya-moya disease.Methods: 22 cases of Moya-moya disease diagnosed by DSA between July2017 and March 2018 in the first affiliated Hospital of Nanchang University were collected.T1 WI,T2WI,DWI,MRA and DSA were performed for all patients.All the patients were defined according Moya-moya disease criterion without cerebral infarction(including acute,sub-acute and chronic infarction).According to the results of DSA,all patients were divided into two groups: 9 patients in unilateral Moya-moya disease group and 13 patients in bilateral Moya-moya disease group.Finally,by comparing the MRA results with the clinical DSA results,we know the difference between them.And by DSC-PWI in both groups,we obtain rCBV,rCBF,rTTP,rMTT in the white matter of bilateral frontal lobe,temporal lobe and basal ganglia.To compare the difference of rCBV,rCBF,rTTP,rMTT in the white matter of frontal lobe,temporal lobe and basal ganglia between the affected and the mirror side in the unilateral Moya-moya disease group.And to compare the difference of rCBV,rCBF,rTTP,rMTT in the white matter of frontal lobe,temporal lobe and basal ganglia between the severe vascular stenosis side and the mirror side in the bilateral Moya-moya disease group,so as to determine the clinical treatment plan.Results: The sensitivity of MRA of 22 patients with Moya-moya in displaying stenosis vessels and peripheral collateral circulation are 90.90%,77.27%.In the unilateral Moya-moya disease group,the rCBF(49.250±7.401,56.532±7.247,115.484±18.477)in the white matter of the affected frontal lobe,temporal lobe and basal ganglia was significantly lower than that(58.376±9.217,67.528±9.253,137.193±17.993)in the healthy side,and the difference was statistically significant(P<0.05).The rCBV(148.936±34.943,179.262±49.494,259.507±55.886)in the white matter of the affected frontal lobe,temporal lobe and basal ganglia washigher than that(111.736±35.151,131.899±44.564,199.437±62.601)in the healthy side,and the difference was statistically significant(P<0.05).The rTTP(29.754±1.570,29.587±1.262,28.347±1.396)in the white matter of the affected frontal lobe,temporal lobe and basal ganglia was longer than that(27.821±1.138,28.172±1.136,26.581±0.949)in the healthy side,and the difference was statistically significant(P<0.05).The rMTT(128.441±28.606)in the white matter of the affected temporal lobe was longer than that(103.977±13.264)in the healthy side,and the difference was statistically significant(P<0.05).There was no significant difference in the MTT in the white matter of the frontal lobe and basal ganglia between the affected side(121.992±23.740,86.851±6.785)and the healthy side(103.783±13.267,82.786±14.582)(P>0.05).In the bilateral Moya-moya disease group,rCBF(41.954±7.906,46.552±11.477,128.391±31.671)in the white matter of the frontal lobe,temporal lobe and basal ganglia in the severe vascular stenosis side was significantly lower than that(52.861±7.439,57.734±13.103,155.491±34.500)in the mirror side,and the difference was statistically significant(P<0.05).The rCBV(165.521±46.973,178.926±51.966,273.130±64.159)in the white matter of the frontal lobe,temporal lobe and basal ganglia in the severe vascular stenosis side was higher than that(125.621±43.369,126.080±41.885,216.451±59.699)in the mirror side,and the difference was statistically significant(P<0.05).The rTTP(38.088±6.925,39.469±9.025,34.634±7.172)in the white matter of the frontal lobe,temporal lobe and basal ganglia in the severe vascular stenosis side was longer than that(32.189±7.425,32.407±8.35,28.668±5.699)in the mirror side,and the difference was statistically significant(P<0.05).There was no significant difference in the rMTT in the white matter of the frontal lobe,temporal lobe and basal ganglia between the severe vascular stenosis side(126.758±27.780,136.833±52.600,83.600±12.375)and the mirror side(115.774±11.56,115.683±19.565,84.794±17.121)(P>0.05).Conclusions: 1.MRA can be used as a safe and noninvasive method to determine the responsible vessels of Moya-moya disease.2.PWI can better reflect the basic situation of whole brain perfusion in the patients with Moya-moya disease and provide help for the determination of the clinical treatment plan.