Zhou Yijun, Zhai Yuanren, Zhao Shihai, Xue Ke, Yang Yuxin, Sun Gan, Xu Zhengyu, Li Mingli, Ni Jun, Zhang Dong, Wang Yining, Feng Feng
Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Cardiovasc Diagn Ther. 2025 Jun 30;15(3):624-634. doi: 10.21037/cdt-2025-6. Epub 2025 Jun 25.
Time-of-flight magnetic resonance angiography (TOF MRA) is a widely recognized noninvasive diagnostic tool of moyamoya angiopathy (MMA). 3.0 T TOF MRA may lack the precision needed to evaluate collaterals in MMA, whereas 5.0 T TOF MRA may enable better visualization of collateral vessels. This study compared the efficacy of 5.0 T and 3.0 T TOF MRA in assessing collateral circulation in patients with MMA.
A total of 21 patients diagnosed with MMA [male 11; mean age: 35 years (range, 18-57 years)] was included in this study. Qualitative assessments encompassed imaging of the terminal internal carotid arteries (ICAs), distal middle cerebral arteries (MCAs), moyamoya vessels (MMVs), and leptomeningeal anastomosis (LMA) collaterals, using digital subtraction angiography (DSA) as a reference. A semi-quantitative grading system was employed with both 5.0 T and 3.0 T MRI to assess MMV visibility and LMA collaterals, using MMV area scores and leptomeningeal system scores.
The 5.0 T TOF MRA showed better scores for visualization of distal MCAs, MMVs, and LMA collaterals than 3.0 T TOF MRA (P<0.05 for both observers). The 5.0 T TOF MRA demonstrated superior detection capabilities. It showed higher MMV area scores, indicating better visibility of MMVs (z=4.41, P<0.001), and higher leptomeningeal system scores (z=3.72, P<0.001) compared to 3.0 T MRA.
The 5.0 T TOF MRA demonstrates potential as an assessment tool for MMA, providing enhanced visualization of abnormal vascular networks.
时间飞跃磁共振血管造影（TOF MRA）是一种广泛认可的烟雾病血管病变（MMA）无创诊断工具。3.0T TOF MRA可能缺乏评估MMA侧支循环所需的精度，而5.0T TOF MRA可能能更好地显示侧支血管。本研究比较了5.0T和3.0T TOF MRA在评估MMA患者侧支循环方面的效果。
本研究共纳入21例诊断为MMA的患者[男性11例；平均年龄：35岁（范围18 - 57岁）]。定性评估包括对颈内动脉终末段（ICA）、大脑中动脉远端（MCA）、烟雾血管（MMV）和软脑膜吻合支（LMA）侧支进行成像，以数字减影血管造影（DSA）作为参考。采用半定量分级系统，通过MMV面积评分和软脑膜系统评分，对5.0T和3.0T MRI的MMV可视性和LMA侧支进行评估。
5.0T TOF MRA在显示MCA远端、MMV和LMA侧支方面的评分高于3.0T TOF MRA（两位观察者的P值均<0.05）。5.0T TOF MRA显示出更强检测能力。与3.0T MRA相比，其MMV面积评分更高，表明MMV可视性更好（z = 4.41，P<0.001）；软脑膜系统评分也更高（z = 3.72，P<0.001）。
5.0T TOF MRA作为MMA评估工具具有潜力，能增强对异常血管网络的可视化。
