Comparions of the diagnostic value of CT, MRI and DSA for Moyamoya disease

Aim: To compare the diagnostic value of computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiography(DSA) in Moyamoya disease.Methods:The CT, MRI and DSA materials of 153 patients with Moyamoya disease were retrospectively analysed. In these patients, 83 had plain CT scan, 30 had postcontrast CT scan, and 25 had computed tomographic angiography (CTA); 135 had precontrast MRI scan with SE sequence, 130 had 3D time of fly magnetic resonance angiography (3D TOF MRA); 113 had DSA.Results: A trtal of 38 cases of infarction and 33 cases of hemorrhage were found in the 83 patients with plain CT scan, and slightly high density Moyamoya vessels were found in the thalamus basal ganglia region and the suprasalle cistern in 3 of 83 cases. In the 135 patients with precontrast MRI scan, 108 cases of infarction and 38 cases of hemorrhage were demonstrated, respectively.The positive diagnostic rate of plain CT, CTA and precontrast CT for Moyamoya disease diagnosis was 3.6%(3/83), 92%(23/25) and 93.3%(28/30), respectively . The positive diagnostic rate of precontrast MRI scan and 3D TOF MRA was 95.6%(129/135) and 100% (135/135), respectively. The positive diagnostic rate of DSA was 100%(113/113). The positive rate of CTA, MRA and DSA for demonstrating collateral vessels from external carotid artery was 24%(6/25), 27.7%(36/130), and 35.4%(40/113), respectively. Compared with DSA, CTA and MRA demonstrated fewer Moyamoya vessels and often overestimated the stenosis of cerebral arteries. Conclusion: DSA is the best radiological method to diagnose moyamoya disease, but it has invasiveness. Postcontrast CT, CTA, precontrast MRI and MRA are important methods for the diagnosis of Moyamoya disease, but plain CT is difficult to make the diagnosis.