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European Radiology
Erschienen in:

08.05.2018 | Neuro

4D ASL-based MR angiography for visualization of distal arteries and leptomeningeal collateral vessels in moyamoya disease: a comparison of techniques

verfasst von: Osamu Togao, Akio Hiwatashi, Makoto Obara, Koji Yamashita, Daichi Momosaka, Ataru Nishimura, Koichi Arimura, Nobuhiro Hata, Koji Yoshimoto, Koji Iihara, Marc Van Cauteren, Hiroshi Honda

Erschienen in: European Radiology | Ausgabe 11/2018

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Abstract

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.

Key Points

• The 4D-PACK enables good visualization of distal cerebral arteries in moyamoya disease.
• The 4D-PACK enables direct visualization of leptomeningeal collateral vessels in moyamoya disease.
• Vessel visualization by 4D-PACK can be useful in assessing cerebral hemodynamics.
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Metadaten
Titel
4D ASL-based MR angiography for visualization of distal arteries and leptomeningeal collateral vessels in moyamoya disease: a comparison of techniques
verfasst von
Osamu Togao
Akio Hiwatashi
Makoto Obara
Koji Yamashita
Daichi Momosaka
Ataru Nishimura
Koichi Arimura
Nobuhiro Hata
Koji Yoshimoto
Koji Iihara
Marc Van Cauteren
Hiroshi Honda
Publikationsdatum
08.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 11/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5462-7

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