• Neurosurgery · Nov 2022

    Intracranial Artery Morphology in Pediatric Moya Moya Disease and Moya Moya Syndrome.

    • Vivek S Yedavalli, Jennifer L Quon, Elizabeth Tong, Eric K van Staalduinen, Pauline Mouches, Lily H Kim, Gary K Steinberg, Gerald A Grant, Kristen W Yeom, and Nils D Forkert.
    • Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
    • Neurosurgery. 2022 Nov 1; 91 (5): 710716710-716.

    BackgroundMoya Moya disease (MMD) and Moya Moya syndrome (MMS) are cerebrovascular disorders, which affect the internal carotid arteries (ICAs). Diagnosis and surveillance of MMD/MMS in children mostly rely on qualitative evaluation of vascular imaging, especially MR angiography (MRA).ObjectiveTo quantitatively characterize arterial differences in pediatric patients with MMD/MMS compared with normal controls.MethodsMRA data sets from 17 presurgery MMD/MMS (10M/7F, mean age = 10.0 years) patients were retrospectively collected and compared with MRA data sets of 98 children with normal vessel morphology (49 male patients; mean age = 10.6 years). Using a level set segmentation method with anisotropic energy weights, the cerebral arteries were automatically extracted and used to compute the radius of the ICA, middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and basilar artery (BA). Moreover, the density and the average radius of all arteries in the MCA, ACA, and PCA flow territories were quantified.ResultsStatistical analysis revealed significant differences comparing children with MMD/MMS and those with normal vasculature ( P < .001), whereas post hoc analyses identified significantly smaller radii of the ICA, MCA-M1, MCA-M2, and ACA ( P < .001) in the MMD/MMS group. No significant differences were found for the radii of the PCA and BA or any artery density and average artery radius measurement in the flow territories ( P > .05).ConclusionHis study describes the results of an automatic approach for quantitative characterization of the cerebrovascular system in patients with MMD/MMS with promising preliminary results for quantitative surveillance in pediatric MMD/MMS management.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

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