Correlation between Clinical Presentations and Hemodynamic Parameters Measured by Dynamic Susceptibility Contrast Magnetic Resonance Imaging in Adult Patients with Moyamoya Disease

J Stroke Cerebrovasc Dis. 2017 Dec;26(12):2814-2820. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.057. Epub 2017 Aug 1.


Background: The examination of cerebral hemodynamics is indispensable for the clinical management of patients with moyamoya disease (MMD). In this study, we examined the correlation between clinical presentations and hemodynamic parameters measured by dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) in adult patients with MMD.

Methods: One hundred fifty-seven hemispheres in 122 adult patients with MMD were examined by DSC-MRI to measure the regional relative cerebral blood volume (CBV) and relative mean transit time (MTT). The patients were divided into 4 groups based on their clinical presentations: a nonsymptomatic (NS), hemorrhagic (H), infarction (I), and transient ischemic attack (T) group. The regional CBV and MTT values were compared among the 4 groups.

Results: The relative value of CBV was significantly higher in groups T and I than in the NS group (P < .01). The CBV of group H was higher than that of the NS group only in the frontal lobe cortex. There were no significant statistical differences among the 3 symptomatic groups. Prolongation of the MTT in comparison with the cerebellum (MTT delay) was significantly higher in groups T and I than in the NS group in all regions of the cerebral cortex (P < .05). The MTT delay was significantly lower in group H than in group T in the frontal lobe and the Rolandic area (P < .05).

Conclusions: Hemodynamic factors measured by DSC-MRI reflected the variable clinical presentations of patients with MMD. DSC-MRI is a useful modality for evaluating the clinical conditions of individual adult patients with MMD.

Keywords: DSC-MRI; Moyamoya disease; cerebral hemodynamics; clinical presentation.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Blood Flow Velocity
  • Brain Infarction / diagnostic imaging
  • Brain Infarction / physiopathology
  • Cerebrovascular Circulation*
  • Contrast Media / administration & dosage*
  • Female
  • Gadolinium DTPA / administration & dosage*
  • Hemodynamics*
  • Humans
  • Intracranial Hemorrhages / diagnostic imaging
  • Intracranial Hemorrhages / physiopathology
  • Ischemic Attack, Transient / diagnostic imaging
  • Ischemic Attack, Transient / physiopathology
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Moyamoya Disease / diagnostic imaging*
  • Moyamoya Disease / physiopathology*
  • Predictive Value of Tests
  • Prognosis
  • Regional Blood Flow
  • Young Adult


  • Contrast Media
  • gadodiamide
  • Gadolinium DTPA