J Korean Radiol Soc.
1995 Dec;33(6):979-985.
Moyamoya Disease: Difference of MR Findings between Children and Adults
Abstract
- PURPOSE
To evaluate whether there are any differences in MR findings between
the childhood and the adult moyamoya disease.
MATERIALS AND METHODS
We compared the brain MR findings in 22 children (13
boys and 9 girls, 2-18 years of age) who had moyamoya disease with 15 adult
patients (7 men and 8 women, 19-55 years of age). The MR findings were classified
as parenchymal-(infarctions and intracranial hemorrhages) and vascular abnormalities
(intracranial vascular patency and moyamoya vessels). The difference in each of these
MR findings was analyzed using Chi-squaretest and Fisher's
exact test (two-tailed). Out of 22 children, two children with normal MR finding
were excluded from the statistical analysis. Moyamoya diseases were diagnosed
angiographically in all adult patients. In children, they were diagnosed by MR
imaging, MR angiography(6), and/or conventional cerebral angiography(18).
RESULTS
In children, cerebral infarctions were observed in 20 of 22 patients
(91%) (cortex 86%, periventricular white matter/centrum semiovale 32%, basal
ganglia 10%). In two patients, there was no parenchymal abnormality. Intra-cranial
hemorrhages were not demonstrated in any patients. In adults, intra-cranial
hemorrhages(intracerebral hematoma, intraventricular hemorrhage,
alone or combined) were demonstrated in 10 of 15 patients(67%). Cerebral
infarctions with or without intracranial hemorrhage were detected in 10 of 15
patients(67%)(cortex 40%, periventricular white matter/centrum semiovale
53%, basal ganglia 20%). The difference in parenchymal abnormalities between
the childhood and the adult moyamoya disease was statistically significant (p=0.
000164). There was no significant difference between the two groups with regard
to the occlusive changes of the internal carotid and middle cerebral arteries or to
moyamoya vessels(p> 0.01 ).
CONCLUSION
This study could prove the fact that the principal clinical symptoms
in the childhood moyamoya disease were due to cerebral infarction and
those in the adult cases were due to infarction and intracranial hemorrhage. In addition,
cortical infarction was more prevalent in children and infarction in
periventricular white matter/centrum semivoale and basal ganglia was more frequentin
adults. There was no significant difference in vascular abnormalities between the two groups.