Comparative The High Resolution Magnetic Resonance Imaging Features Of Ischemic Moyamoya Disease And Hemorrhagic Moyamoya Disease

Objective:To investigate the differences of high-resolution magnetic resonance imaging(HR-MRI)features between ischemic and hemorrhagic moyamoya disease,and to analyze its clinical relevance to stroke.Methods:Seventy-six patients confirmed moyamoya disease in our hospital from September 2017 to December 2018 in the Department of Neurology and Neurosurgery were enrolled in this study.All patients underwent digital subtraction angiography(DSA)and bilateral middle cerebral artery high-resolution magnetic resonance(HR-MRI)examination.Patients were staged according to DSA and observed high-resolution magnetic resonance imaging of the bilateral proximal middle cerebral artery,including vessel wall eccentric and concentric patterns.The wall enhancement was divided into 3 grades: grade 0(no enhancement),grades1(light enhancement)and grade 2(significant enhancement).Results:Of the 78 patients with moyamoya disease included in this study,50 cases(64.10%)had ischemic moyamoya disease,infarction was mainly distributed in frontal and parietal lobe;28 cases(35.90%)had hemorrhagic moyamoya disease,and hemorrhage was mainly located in brain lobe and striatum.The high-resolution magnetic resonance features of the bilateral middle cerebral artery wall in patients with moyamoya disease are characterized with vessel wall concentric patterns(78.85%)and smaller vessel lumens.As for ischemic moyamoya disease patients,grade 1 enhancements and grade 2 enhancements are more common(71.00%),while hemorrhagic moyamoya disease patients mainly do not have enhancement(78.57%),the difference was statistically significant(χ2 = 36.467,P < 0.001).We found 24 patients with acute infarction in all the ischemic moyamoya disease patients,16 patients(66.67%)had grade 2 enhancement,7 patients(29.17%)had grade 1 enhancement and 1 patients(4.16%)did not have any enhancement of corresponding vessels.Statistical analysis showed that the incidence of lesions with grade 2 enhancement in patients may be associated with acute cerebral infarction(odds ratio = 56.0;95% confidence interval: 6.6-475.5;P<0.001).Conclusion:The high-resolution magnetic resonance features of moyamoya disease is characterized with vessel wall concentric patterns and smaller vessel lumens.The characteristics of high-resolution magnetic resonance imaging of ischemic and hemorrhagic moyamoya disease are different: As for ischemic moyamoya disease patients,grade 1 enhancements and grade 2 enhancements are more common,while hemorrhagic moyamoya disease patients mainly show grade 0 enhancement.Grade 2 enhancement in patients with ischemic moyamoya disease is significantly associated with acute cerebral infarction.