Experiences using 3-tesla magnetic resonance imaging in the treatment of Moyamoya disease

Abstract

To introduce our initial experiences using 3-tesla (3T) magnetic resonance (MR) imaging in the treatment of moyamoya disease (MMD). 3T MR imaging was used to study 63 consecutive patients with MMD. Evaluation of regional cerebral blood flow (rCBF) was performed with 123IMP-SPECT or 15O 2 gas steady-state PET. T2-weighted gradient-echo imaging was used to study the incidence of asymptomatic cerebral microbleeds (MBs) in the 63 patients. Preoperative targeting of a recipient artery in 12 recent operations for STA-MCA anastomosis on 9 patients was performed as follows. The MR angiography (MRA) and rCBF data sets were registered with the MPRAGE data set through the coregistration function of the SPM2 software in order to obtain a fusion of all images. In the fusion images of the MRA and rCBF images, we selected the cortical artery with the largest diameter as the target recipient artery from the candidates located on or near the cortex where the rCBF was markedly decreased. Asymptomatic MBs were found in 25 (40%) of the 63 patients and a successful bypass to the target was achieved in all 12 operations. Conclusion. Use of 3T MR imaging provides new types of information for the treatment of MMD. © 2008 Springer-Verlag.