NEURORADIOLOGY / ORIGINAL PAPER
Magnetic resonance vessel wall imaging is superior to MRA in assessing the extent of vascular involvement in patients with moyamoya disease
1
Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
2
Government Medical College and Hospital (GMCH), Chandigarh, India
Submission date: 2025-06-13
Final revision date: 2025-08-04
Acceptance date: 2025-08-21
Publication date: 2025-12-10
Corresponding author
Saameer Vyas
Division of Neuroimaging and Interventional Neuroradiology, Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Division of Neuroimaging and Interventional Neuroradiology, Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Pol J Radiol, 2025; 90: 602-610
KEYWORDS
TOPICS
ABSTRACT
Purpose:
To compare the effectiveness of time-of-flight (TOF) magnetic resonance angiography (MRA) and magnetic resonance (MR) vessel wall imaging (VWI) in assessing the degree of vascular involvement in patients with moyamoya disease (MMD).
Material and methods:
This was a single-time observational study carried out on patients with MMD before any surgical interventions. In addition to routine magnetic resonance imaging sequences, TOF MRA and VWI were performed. A total of 11 vascular segments (bilateral supraclinoid and terminal internal carotid arteries [ICA], anterior cerebral arteries [ACA], middle cerebral arteries [MCA], posterior cerebral arteries [PCA], and the distal basilar artery) were assessed in each patient for steno-occlusive changes on TOF MRA, and the presence of vessel wall thickening and enhancement on high-resolution VWI. Comparative analysis between the TOF MRA and VWI findings was conducted.
Results:
A total of 40 cases were included, out of which 39 patients presented with infarcts, predominantly in multi-territorial distribution and only one patient presented with intracerebral hemorrhage. 440 vascular segments were assessed on TOF MRA and VWI, out of which TOF MRA revealed 38.8% stenotic (n = 171) and 30.2% (n = 133) occluded vascular segments. VWI revealed concentric vessel wall thickening in 97.5% of cases, with vessel wall contrast enhancement detected in 306 segments (69.54%). On comparison of TOF MRA and VWI findings, 69.09% of segments were abnormal on TOF MRA, while VWI detected 81.4% abnormal segments; notably, 11.8% of segments labeled normal on TOF MRA exhibited abnormal vessel wall traits on VWI.
Conclusions:
This study highlights the valuable role of VWI as an important diagnostic tool and its superiority to TOF MRA for evaluating the extent of vascular involvement in patients with MMD.
To compare the effectiveness of time-of-flight (TOF) magnetic resonance angiography (MRA) and magnetic resonance (MR) vessel wall imaging (VWI) in assessing the degree of vascular involvement in patients with moyamoya disease (MMD).
Material and methods:
This was a single-time observational study carried out on patients with MMD before any surgical interventions. In addition to routine magnetic resonance imaging sequences, TOF MRA and VWI were performed. A total of 11 vascular segments (bilateral supraclinoid and terminal internal carotid arteries [ICA], anterior cerebral arteries [ACA], middle cerebral arteries [MCA], posterior cerebral arteries [PCA], and the distal basilar artery) were assessed in each patient for steno-occlusive changes on TOF MRA, and the presence of vessel wall thickening and enhancement on high-resolution VWI. Comparative analysis between the TOF MRA and VWI findings was conducted.
Results:
A total of 40 cases were included, out of which 39 patients presented with infarcts, predominantly in multi-territorial distribution and only one patient presented with intracerebral hemorrhage. 440 vascular segments were assessed on TOF MRA and VWI, out of which TOF MRA revealed 38.8% stenotic (n = 171) and 30.2% (n = 133) occluded vascular segments. VWI revealed concentric vessel wall thickening in 97.5% of cases, with vessel wall contrast enhancement detected in 306 segments (69.54%). On comparison of TOF MRA and VWI findings, 69.09% of segments were abnormal on TOF MRA, while VWI detected 81.4% abnormal segments; notably, 11.8% of segments labeled normal on TOF MRA exhibited abnormal vessel wall traits on VWI.
Conclusions:
This study highlights the valuable role of VWI as an important diagnostic tool and its superiority to TOF MRA for evaluating the extent of vascular involvement in patients with MMD.
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| ISSN: | 1899-0967 |
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