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Purpose <p>Various clinical classifications of Moyamoya angiopathy (MMA) have different characteristics of collateral compensation. Advancements in 5&#xa0;T MRI have made it possible to non-invasively assess vascular collateralization using 4-dimensional MR angiography (4DMRA). The objective of this study is to analyze collateral compensation in MMA patients using 4DMRA and determine variations among different clinical classifications.</p> Materials and Methods <p>Collateral compensation of posterior cerebral artery (PCA) to anterior circulation was evaluated using 4DMRA at 5&#xa0;T MRI. After adjusting for confounding factors, multivariate analyses were conducted to compare the distribution of PCA collateral compensation among patients with different clinical classifications of MMA.</p> Results <p>85 MMA patients were enrolled in the study. Among the 158 hemispheres evaluated, 100 were asymptomatic, 7 were hemorrhagic, 50 were ischemic, and 1 had a combination of hemorrhagic and ischemic stroke. Multivariate logistic regression analysis revealed a statistically significant difference in total PCA collateral compensation scores between asymptomatic and ischemic hemispheres (<i>P</i> &lt; 0.001, 95% CI [0.614, 0.839]). Subgroup analysis revealed a clear distinction between asymptomatic hemispheres and ischemic hemispheres (<i>P</i> = 0.001, 95% CI [0.193, 0.677]) in terms of PCA compensation to middle cerebral artery through the parieto-occipital branch. However, no notable differences were observed in other compensation pathways.</p> Conclusion <p>The collateral compensation of PCA to the anterior circulation in MMA patients, assessed by 4DMRA at 5&#xa0;T MRI, is significantly associated with ischemic MMA. The parieto-occipital branch may be the most important compensatory pathway. 4DMRA can potentially serve as a valuable tool for evaluating the risk of ischemic stroke in patients with MMA.</p>

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Correlation between collateral compensation of the posterior cerebral artery on 5 T magnetic resonance imaging and clinical classifications in patients with Moyamoya angiopathy

  • 期刊论文

  • 发表日期：

    2025年4月16日

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  • Guangsong Han,
  • Xiaoyuan Fan,
  • Yuehui Hong,
  • Ming Yao,
  • Lixin Zhou,
  • Yicheng Zhu,
  • Feng Feng,
  • Jun Ni

摘要

Purpose

Various clinical classifications of Moyamoya angiopathy (MMA) have different characteristics of collateral compensation. Advancements in 5 T MRI have made it possible to non-invasively assess vascular collateralization using 4-dimensional MR angiography (4DMRA). The objective of this study is to analyze collateral compensation in MMA patients using 4DMRA and determine variations among different clinical classifications.

Materials and Methods

Collateral compensation of posterior cerebral artery (PCA) to anterior circulation was evaluated using 4DMRA at 5 T MRI. After adjusting for confounding factors, multivariate analyses were conducted to compare the distribution of PCA collateral compensation among patients with different clinical classifications of MMA.

Results

85 MMA patients were enrolled in the study. Among the 158 hemispheres evaluated, 100 were asymptomatic, 7 were hemorrhagic, 50 were ischemic, and 1 had a combination of hemorrhagic and ischemic stroke. Multivariate logistic regression analysis revealed a statistically significant difference in total PCA collateral compensation scores between asymptomatic and ischemic hemispheres (P < 0.001, 95% CI [0.614, 0.839]). Subgroup analysis revealed a clear distinction between asymptomatic hemispheres and ischemic hemispheres (P = 0.001, 95% CI [0.193, 0.677]) in terms of PCA compensation to middle cerebral artery through the parieto-occipital branch. However, no notable differences were observed in other compensation pathways.

Conclusion

The collateral compensation of PCA to the anterior circulation in MMA patients, assessed by 4DMRA at 5 T MRI, is significantly associated with ischemic MMA. The parieto-occipital branch may be the most important compensatory pathway. 4DMRA can potentially serve as a valuable tool for evaluating the risk of ischemic stroke in patients with MMA.