Impact of Endothelial Shear Stress on the Bilateral Progression of Unilateral Moyamoya Disease

Autor: Young Jin Ryu, Chul-Ho Sohn, Woo Jin Lee, Keun Hwa Jung, Kap Soo Han, Seul-Ki Jeong, Sanghyuk Lee
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
030204 cardiovascular system & hematology
Magnetic resonance angiography
Cohort Studies
Young Adult
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Moyamoya disease
Child
Retrospective Studies
Tomography
Emission-Computed
Single-Photon
Advanced and Specialized Nursing
medicine.diagnostic_test
Receiver operating characteristic
business.industry
Area under the curve
Brain
Infant
Magnetic resonance imaging
Retrospective cohort study
Middle Aged
medicine.disease
Magnetic Resonance Imaging
ROC Curve
Child
Preschool
Angiography
Disease Progression
Cardiology
Female
Endothelium
Vascular
Stress
Mechanical
Neurology (clinical)
Moyamoya Disease
Cardiology and Cardiovascular Medicine
business
Carotid Artery
Internal
Magnetic Resonance Angiography
030217 neurology & neurosurgery
Follow-Up Studies
Cerebral angiography
Zdroj: Stroke. 51:775-783
ISSN: 1524-4628
0039-2499
DOI: 10.1161/strokeaha.119.028117
Popis: Background and Purpose— In unilateral moyamoya disease, altered endothelial shear stress on the intact-side terminal internal carotid artery might trigger the progression to bilateral disease. We analyzed the endothelial shear stress parameters of the normally appearing terminal internal carotid artery in unilateral moyamoya disease and its association with the progression to bilateral disease. Methods— This retrospective cohort study included patients diagnosed with unilateral moyamoya disease by cerebral angiography and followed-up with regular magnetic resonance imaging/magnetic resonance angiography evaluations for >1 year. Endothelial shear stress parameters acquired were mean and maximum signal intensity gradients (SIG) and SIG SD at the vessel boundary in time-of-flight sequences in initial brain magnetic resonance imaging/magnetic resonance angiography. Contralateral disease progression defined as the detection of newly developed vessel steno-occlusion with an magnetic resonance angiography steno-occlusive stage of ≥2, in the previously intact side of the brain on follow-up magnetic resonance imaging/magnetic resonance angiography evaluation. Results— Among 146 patients (66 males [45.2%] and 80 females [54.8%]; 76 pediatric [52.1%]), contralateral disease progression was detected in 43 patients (29.5%) after a mean follow-up of 4.3±2.4 years. Multivariate analysis showed that SIG SD was significantly associated with this progression (odds ratio, 13.001 [95% CI, 1.764−95.794], P =0.012). In receiver operating characteristic curve analysis, SIG SD predicted the contralateral progression with area under the curve values of 0.803 (95% CI, 0.726−0.880, P Conclusions— Increased spatial variability of the endothelial shear stress around the normally appearing terminal internal carotid artery, as measured by SIG SD in time-of-flight sequences, may predict the contralateral progression of unilateral moyamoya disease.
Databáze: OpenAIRE
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