Specific Shrinkage of Carotid Forks in Moyamoya Disease: A Novel Key Finding for Diagnosis
| Autor: | Kyo Noguchi, Emiko Hori, Naoki Akioka, Yukio Horie, Satoshi Kuroda, Manabu Nishikata, Masaki Koh, Daina Kashiwazaki, Kimiko Umemura, Naoya Kuwayama |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty diagnosis carotid fork three-dimensional constructive interference in steady state medicine.artery Internal medicine Anterior cerebral artery Basilar artery Medicine Humans Carotid Stenosis Moyamoya disease Child Arterial stenosis business.industry outer diameter medicine.disease Surgery Stenosis Middle cerebral artery Cardiology Etiology Female Original Article Neurology (clinical) Internal carotid artery Moyamoya Disease business |
| Zdroj: | Neurologia medico-chirurgica |
| ISSN: | 1349-8029 |
| Popis: | This study was aimed to analyze the outer diameter of the involved arteries in moyamoya disease, using three-dimensional (3D) constructive interference in steady state (CISS) and direct surgical inspection. Radiological evaluation was performed in 64 patients with moyamoya disease. As the controls, six patients with severe middle cerebral artery (MCA) stenosis and 17 healthy subjects were also recruited. On 3D-CISS, the outer diameter was quantified in the supraclinoid portion of internal carotid artery (C1), the horizontal portions of MCA (M1) and anterior cerebral artery (A1), and basilar artery. The involved carotid fork was directly observed during surgery in another series of three adult patients with moyamoya disease. In 53 adult patients with moyamoya disease, the outer diameters of C1, M1, and A1 segments were 2.3 ± 0.7 mm, 1.3 ± 0.5 mm, and 1.0 ± 0.4 mm in the involved side (n = 91), being significantly smaller than the control (n = 17), severe M1 stenosis (n = 6), and non-involved side in moyamoya disease (n = 15, P < 0.01). There were significant correlations between Suzuki's angiographical stage and the outer diameters of C1, M1, and A1 (P < 0.001). The laterality ratio of C1 and M1 was significantly smaller in unilateral moyamoya disease (n = 20) than the controls and severe MCA stenosis (P < 0.01). Direct observations revealed a marked decrease in the outer diameter of the carotid fork (n = 3). These findings strongly suggest specific shrinkage of the involved arteries in moyamoya disease, which may provide essential information to distinguish moyamoya disease from other intracranial arterial stenosis and shed light on the etiology and novel diagnosis cue of moyamoya disease. |
| Databáze: | OpenAIRE |
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