Preoperative and Postoperative MRA

  • Takeshi Mikami
  • Satoshi Iihoshi
  • Kiyohiro Houkin


Magnetic resonance angiography (MRA) has opened the door to noninvasive evaluation of the intracranial major arteries. The contemporary MRA can clearly disclose the major intracranial arteries and has become an indispensable modality for the management of cerebrovascular stroke. Based on this dramatic technical evolution, since 1994 new diagnostic guidelines for moyamoya disease have included good MRA as the definitive diagnostic technique for moyamoya disease [1, 2, 3, 4]. Nowadays, MRA can be an alternative to conventional angiography in moyamoya disease, and has been acknowledged as a reliable diagnostic tool with high sensitivity and specificity as a result of the remarkable development of MR imaging technology [5, 6, 7, 8, 9, 10, 11, 12, 13]. Moreover, MRA is useful not only for the diagnosis but also for follow-up of moyamoya disease in a noninvasive way.


Internal Carotid Artery Middle Cerebral Artery Magnetic Resonance Angiography Anterior Cerebral Artery Moyamoya Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Fukui M (1997) Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (‘moyamoya’ disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Clin Neurol Neurosurg 99 Suppl 2:S238–240PubMedGoogle Scholar
  2. 2.
    Numaguchi Y, Gonzalez CF, Davis PC et al (1997) Moyamoya disease in the United States. Clin Neurol Neurosurg 99 Suppl 2:S26–30PubMedCrossRefGoogle Scholar
  3. 3.
    Houkin K, Aoki T, Takahashi A et al (1994) Diagnosis of moyamoya disease with magnetic resonance angiography. Stroke 25:2159–2164PubMedCrossRefGoogle Scholar
  4. 4.
    Yamada I, Matsushima Y, Suzuki S (1992) Moyamoya disease: diagnosis with three-dimensional time-of-flight MR angiography. Radiology 184:773–778PubMedGoogle Scholar
  5. 5.
    Yamada I, Suzuki S, Matsushima Y (1995) Moyamoya disease: comparison of assessment with MR angiography and MR imaging versus conventional angiography. Radiology 196:211–218PubMedGoogle Scholar
  6. 6.
    Kikuchi M, Asato M, Sugahara S (1996) Evaluation of surgically formed collateral circulation in moyamoya disease with 3D-CT angiography: comparison with MR angiography and X-ray angiography. Neuropediatrics 27:45–49PubMedCrossRefGoogle Scholar
  7. 7.
    Hasuo K, Mihara F, Matsushima T (1998) MRI and MR angiography in moyamoya disease. J Magn Reson Imaging 8:762–766PubMedCrossRefGoogle Scholar
  8. 8.
    Shirane R, Mikawa S, Ebina T (1999) A case of adult moyamoya disease showing progressive angiopathy on cerebral angiography. Clin Neurol Neurosurg 101:210–214PubMedCrossRefGoogle Scholar
  9. 9.
    Takanashi JI, Sugita K, Niimi H (1998) Evaluation of magnetic resonance angiography with selective maximum intensity projection in patients with childhood moyamoya disease. Eur J Paediatr Neurol 2:83–89PubMedCrossRefGoogle Scholar
  10. 10.
    Aoki S, Yoshikawa T, Hori M et al (2000) Two-dimensional thick-slice MR digital subtraction angiography for assessment of cerebrovascular occlusive diseases. Eur Radiol 10:1858–1864PubMedCrossRefGoogle Scholar
  11. 11.
    Thibaud C, Garnier-Viarouge MP, De Kersaint-Gilly A et al (2001) Moyamoya disease: importance of the MRI-MRA combination and difficulties in management and follow-up in 7 cases. J Neuroradiol 28:84–91PubMedGoogle Scholar
  12. 12.
    Yamada I, Nakagawa T, Matsushima Y et al (2001) High-resolution turbo magnetic resonance angiography for diagnosis of moyamoya disease. Stroke 32:1825–1831PubMedCrossRefGoogle Scholar
  13. 13.
    Kuroda S, Houkin K (2008) Moyamoya disease: current concepts and future perspectives. Lancet Neurol 11:1056–1066CrossRefGoogle Scholar
  14. 14.
    Fukui M (1997) Current state of study on moyamoya disease in Japan. Surg Neurol 47:138–143PubMedCrossRefGoogle Scholar
  15. 15.
    Houkin K (2001) Magnetic resonance image (MRI) and CT scan diagosis. In: Ikezaki K, Loftus CM (eds) Moyamoya disease. AANS, Rolling Meadows, ILGoogle Scholar
  16. 16.
    Houkin K, Tanaka N, Takahashi A et al (1994) Familial occurrence of moyamoya disease. Magnetic resonance angiography as a screening test for high-risk subjects. Childs Nerv Syst 10:421–425PubMedCrossRefGoogle Scholar
  17. 17.
    Anderson CM, Saloner D, Tsuruda JS et al (1990) Artifacts in maximum-intensity-projection display of MR angiograms. AJR Am J Roentgenol 154:623–629PubMedGoogle Scholar
  18. 18.
    Creasy JL, Price RR, Presbrey T et al (1990) Gadolinium-enhanced MR angiography. Radiology 175:280–283PubMedGoogle Scholar
  19. 19.
    Marchal G, Bosmans H, Van Fraeyenhoven L et al (1990) Intracranial vascular lesions: optimization and clinical evaluation of three-dimensional time-of-flight MR angiography. Radiology 175:443–448PubMedGoogle Scholar
  20. 20.
    Motomiya M, Karino T (1984) Flow patterns in the human carotid artery bifurcation. Stroke 15:50–56PubMedCrossRefGoogle Scholar
  21. 21.
    Ruggieri PM, Laub GA, Masaryk TJ et al (1989) Intracranial circulation: pulse-sequence considerations in three-dimensional (volume) MR angiography. Radiology 171:785–791PubMedGoogle Scholar
  22. 22.
    Suzuki J, Takaku A (1969) Cerebrovascular “moyamoya” disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol 20:288–299PubMedCrossRefGoogle Scholar
  23. 23.
    Suzuki J, Kodama N (1983) Moyamoya disease – a review. Stroke 14:104–109PubMedCrossRefGoogle Scholar
  24. 24.
    Suzuki J, Kodama N (1971) Cerebrovascular “Moyamoya” disease. 2. Collateral routes to forebrain via ethmoid sinus and superior nasal meatus. Angiology 22:223–236PubMedCrossRefGoogle Scholar
  25. 25.
    Houkin K, Nakayama N, Kuroda S et al (2005) Novel magnetic resonance angiography stage grading for moyamoya disease. Cerebrovasc Dis 20:347–354PubMedCrossRefGoogle Scholar
  26. 26.
    Asfora WT, West M, McClarty B (1993) Angiography of encephalomyosynangiosis and superficial temporal artery to middle cerebral artery anastomosis in moyamoya disease. Am J Neuroradiol 14:29–30PubMedGoogle Scholar
  27. 27.
    Eller TW, Pasternak JF (1987) Revascularization for moyamoya disease: five-year follow-up. Surg Neurol 28:463–467PubMedCrossRefGoogle Scholar
  28. 28.
    Houkin K, Kamiyama H, Abe H et al (1996) Surgical therapy for adult moyamoya disease. Can surgical revascularization prevent the recurrence of intracerebral hemorrhage? Stroke 27:1342–1346PubMedCrossRefGoogle Scholar
  29. 29.
    Kinugasa K, Mandai S, Kamata I et al (1993) Surgical treatment of moyamoya disease: operative technique for encephalo-duro-arterio-myo-synangiosis, its follow-up, clinical results, and angiograms. Neurosurgery 32:527–531PubMedCrossRefGoogle Scholar
  30. 30.
    Matsushima T, Inoue T, Suzuki SO et al (1992) Surgical treatment of moyamoya disease in pediatric patients – comparison between the results of indirect and direct revascularization procedures. Neurosurgery 31:401–405PubMedCrossRefGoogle Scholar
  31. 31.
    Sakamoto H, Kitano S, Yasui T et al (1997) Direct extracranial—intracranial bypass for children with moyamoya disease. Clin Neurol Neurosurg 99 Suppl 2:S128–133PubMedGoogle Scholar
  32. 32.
    Suzuki R, Matsushima Y, Takada Y et al (1989) Changes in cerebral hemodynamics following encephalo-duro-arterio-synangiosis (EDAS) in young patients with moyamoya disease. Surg Neurol 31:343–349PubMedCrossRefGoogle Scholar
  33. 33.
    Aoki T, Matsuzawa H, Houkin K et al (1993) Usefulness and limitation of MR imaging and MR angiography in diagnosis of juvenile moyamoya disease. No Shinkei Geka 21:305–311PubMedGoogle Scholar
  34. 34.
    Yamada I, Matsushima Y, Suzuki S (1992) Moyamoya disease: diagnosis with three-dimensional time-of-flight MR angiography. Radiology 184:773–778PubMedGoogle Scholar
  35. 35.
    Houkin K, Nakayama N, Kuroda S et al (2004) How does angiogenesis develop in pediatric moyamoya disease after surgery? A prospective study with MR angiography. Childs Nerv Syst 20:734–741PubMedGoogle Scholar
  36. 36.
    Takahashi A, Sawamura Y, Houkin K et al (1993) The cerebrospinal fluid in patients with moyamoya disease (spontaneous occlusion of the circle of Willis) contains high level of basic fibroblast growth factor. Neurosci Lett 160:214–216PubMedCrossRefGoogle Scholar
  37. 37.
    Yoshimoto T, Houkin K, Takahashi A et al (1996) Angiogenic factors in moyamoya disease. Stroke 27:2160–2165PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2010

Authors and Affiliations

  • Takeshi Mikami
    • 1
  • Satoshi Iihoshi
    • 1
  • Kiyohiro Houkin
    • 1
  1. 1.Department of NeurosurgerySapporo Medical UniversitySapporoJapan

Personalised recommendations