Mingming Lu1,2, Hongtao Zhang3, Cong Han4, Jianming Cai5, Dongqing Liu3, Xu Liu3, Lichen Zhang3, Peng Peng1, Fei Yuan1, Shitong Liu3, Fugeng Sheng3, Yuan Liu3, Yao He2, Xihai Zhao6, Qian Zhang7, Heguan Fu7. 1. Department of Radiology, Pingjin Hospital, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China. 2. State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, Institute of Geriatrics, The Second Medical Center, Chinese PLA General Hospital, Beijing, China. 3. Department of Radiology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100853, China. 4. Department of Neurosurgery, Chinese PLA General Hospital, Beijing, 100853, China. hc82225@x126.com. 5. Department of Radiology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100853, China. beili12345@sina.cn. 6. Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China. 7. Department of Neurosurgery, Chinese PLA General Hospital, Beijing, 100853, China.
Abstract
BACKGROUND AND PURPOSE: This study aimed to investigate the enhancement characteristics of vessel wall in patients with moyamoya disease (MMD) using 3D high-resolution magnetic resonance (MR) imaging and their relationship with initial and recurrent intracranial hemorrhage. METHODS: Consecutive patients with MMD were retrospectively analyzed and classified as intracranial hemorrhagic and non-hemorrhagic groups according to the CT or MR images. The clinical features and vessel wall characteristics were compared between the two groups. Logistic regression was performed to relate the vessel wall characteristics to the initial hemorrhage in MMD patients. Patients in hemorrhagic group were followed up after surgery to evaluate the relationship between vessel wall characteristics and recurrent hemorrhage. RESULTS: A total of 507 MMD patients including 79 hemorrhagic and 428 non-hemorrhagic MMD patients were recruited in the study. We found that hemorrhagic group had more patients with vessel wall enhancements (40.5% vs. 25.7%, p = 0.009) and more eccentric enhanced lesions (17.7% vs. 6.5%, p = 0.001) compared to those in non-hemorrhage group and vessel wall enhancements were independently associated with ipsilateral initial hemorrhage after adjusted for clinical factors (OR = 1.99, CI 1.20-3.28, p = 0.007). Furthermore, three recurrent intracranial hemorrhagic episodes in the present study were all observed in MMD patients with vessel wall enhancement during the long-term follow-up after surgery. CONCLUSIONS: Wall enhancement of intracranial vessels was significantly associated with intracranial hemorrhage in MMD patients. Our findings suggest that vessel wall enhancement may serve as a marker of intracranial hemorrhage.
BACKGROUND AND PURPOSE: This study aimed to investigate the enhancement characteristics of vessel wall in patients with moyamoya disease (MMD) using 3D high-resolution magnetic resonance (MR) imaging and their relationship with initial and recurrent intracranial hemorrhage. METHODS: Consecutive patients with MMD were retrospectively analyzed and classified as intracranial hemorrhagic and non-hemorrhagic groups according to the CT or MR images. The clinical features and vessel wall characteristics were compared between the two groups. Logistic regression was performed to relate the vessel wall characteristics to the initial hemorrhage in MMD patients. Patients in hemorrhagic group were followed up after surgery to evaluate the relationship between vessel wall characteristics and recurrent hemorrhage. RESULTS: A total of 507 MMD patients including 79 hemorrhagic and 428 non-hemorrhagic MMD patients were recruited in the study. We found that hemorrhagic group had more patients with vessel wall enhancements (40.5% vs. 25.7%, p = 0.009) and more eccentric enhanced lesions (17.7% vs. 6.5%, p = 0.001) compared to those in non-hemorrhage group and vessel wall enhancements were independently associated with ipsilateral initial hemorrhage after adjusted for clinical factors (OR = 1.99, CI 1.20-3.28, p = 0.007). Furthermore, three recurrent intracranial hemorrhagic episodes in the present study were all observed in MMD patients with vessel wall enhancement during the long-term follow-up after surgery. CONCLUSIONS: Wall enhancement of intracranial vessels was significantly associated with intracranial hemorrhage in MMD patients. Our findings suggest that vessel wall enhancement may serve as a marker of intracranial hemorrhage.
Authors: Nadeem I Khan; Ali A Saherwala; Mo Chen; Sepand Salehian; Hisham Salahuddin; Babu G Welch; Marco C Pinho; Ty Shang Journal: Cerebrovasc Dis Extra Date: 2019-12-12