Chen Qian, Qi Rongfeng, Cheng Xiaoqing, Zhou Changsheng, Luo Song, Ni Ling, Huang Wei
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Vasa. 2014 Jul;43(4):278-83. doi: 10.1024/0301-1526/a000363.
To evaluate the value of time-of-flight MR angiography (TOF MRA) for the assessment of extracranial-intracranial (EC-IC) bypass in Moyamoya disease in comparison with computed tomography angiography (CTA).
A consecutive series of 23 patients with Moyamoya disease were analyzed retrospectively. Twenty three patients underwent 25 procedures of extracranial-intracranial bypass. Cranial CTA was performed within one week after the surgery to assess bypass patency. Then TOF MRA was scanned within 24 h after CTA on a 3T MRI system. Using 5-point scales (0 = poor to 4 = excellent), two radiologists rated the image quality and vessel integrity of bypass for three segments (extracranial, trepanation, intracranial).
Image quality was high in both CTA and TOF MRA (mean quality score 3.84 ± 0.37 and 3.8 ± 0.41), without statistical difference (p = 0.66). Mean scores of TOF MRA with respect to bypass visualization were higher than CTA in the intracranial segment (p = 0.026). No significant difference of bypass visualization regarding the extracranial and trepanation segments was found between TOF MRA and CTA (p = 0.66 and p = 0.34, respectively). For the trepanation segment, TOF MRA showed pseudo lesions in 2 of all 25 cases.
3T TOF MRA, a non-contrast technique not exposing the patients to radiation, proved to be at least equal to CTA for the assessment of EC-IC bypass, and even superior to CTA with respect to the intracranial segment. In addition, readers should be aware of a potential overestimation showing focal pseudo lesions of the bypass at the trepanation segment in TOF MRA.
为评估时间飞跃磁共振血管造影（TOF MRA）与计算机断层血管造影（CTA）相比，在烟雾病颅外-颅内（EC-IC）搭桥评估中的价值。
回顾性分析连续23例烟雾病患者。23例患者接受了25次颅外-颅内搭桥手术。术后1周内行头颅CTA以评估搭桥通畅情况。然后在CTA后24小时内在3T MRI系统上进行TOF MRA扫描。两名放射科医生使用5分制（0 =差至4 =优）对搭桥三个节段（颅外、颅骨切开、颅内）的图像质量和血管完整性进行评分。
CTA和TOF MRA的图像质量均较高（平均质量评分分别为3.84±0.37和3.8±0.41），无统计学差异（p = 0.66）。TOF MRA在颅内节段的搭桥可视化平均评分高于CTA（p = 0.026）。TOF MRA和CTA在颅外和颅骨切开节段的搭桥可视化方面无显著差异（分别为p = 0.66和p = 0.34）。对于颅骨切开节段，25例中有2例在TOF MRA上显示假病变。
3T TOF MRA是一种无需造影剂且不使患者暴露于辐射的技术，在评估EC-IC搭桥方面至少与CTA相当，在颅内节段甚至优于CTA。此外，读者应注意TOF MRA在颅骨切开节段可能会高估搭桥的局灶性假病变。
