期刊
EUROPEAN RADIOLOGY
卷 28, 期 11, 页码 4871-4881出版社
SPRINGER
DOI: 10.1007/s00330-018-5462-7
关键词
Magnetic resonance imaging; Magnetic resonance angiography; Moyamoya disease; Collateral circulation; Cerebrovascular disorders
资金
- JSPS KAKENHI grant [JP 17K10410]
Objectives To evaluate the performance of four-dimensional pseudo-continuous arterial spin labeling (4D-pCASL)-based angiography using CENTRA-keyhole and view sharing (4D-PACK) in the visualization of flow dynamics in distal cerebral arteries and leptomeningeal anastomosis (LMA) collaterals in moyamoya disease in comparison with contrast inherent inflow-enhanced multiphase angiography (CINEMA), with reference to digital subtraction angiography (DSA). Methods Thirty-two cerebral hemispheres from 19 patients with moyamoya disease (mean age, 29.7 +/- 19.6 years; five males, 14 females) underwent both 4D-MR angiography and DSA. Qualitative evaluations included the visualization of anterograde middle cerebral artery (MCA) flow and retrograde flow via LMA collaterals with reference to DSA. Quantitative evaluations included assessments of the contrast-to-noise ratio (CNR) on these vessels. The linear mixed-effect model was used to compare the 4D-PACK and CINEMA methods. Results The vessel visualization scores were significantly higher with 4D-PACK than with CINEMA in the visualization of anterograde flow for both Observer 1 (CINEMA, 3.53 +/- 1.39; 4D-PACK, 4.53 +/- 0.80; p < 0.0001) and Observer 2 (CINEMA, 3.50 +/- 1.39; 4D-PACK, 4.31 +/- 0.86; p = 0.0009). The scores were higher with 4D-PACK than with CINEMA in the visualization of retrograde flow for both Observer 1 (CINEMA, 3.44 +/- 1.05; 4D-PACK, 4.47 +/- 0.88; p < 0.0001) and Observer 2 (CINEMA, 3.19 +/- 1.20; 4D-PACK, 4.38 +/- 0.91; p < 0.0001). The maximum CNR in the anterograde flow was higher in 4D-PACK (40.1 +/- 16.1, p = 0.0001) than in CINEMA (27.0 +/- 16.6). The maximum CNR in the retrograde flow was higher in 4D-PACK (36.1 +/- 10.0, p < 0.0001) than in CINEMA (15.4 +/- 8.0). Conclusions The 4D-PACK provided better visualization and higher CNRs in distal cerebral arteries and LMA collaterals compared with CINEMA in patients with this disease.
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