Article Figures & Data
Figures
- Fig 1.
Schematic illustrations of deeply seated collateral networks are shown in coronal (A) and sagittal (B) MR imaging views. Six pathways of collateral vessels according to perfusing territories can be divided into collateral networks to cortical vessels (remote, type a and b) and to major trunk vessels (local, types c–f). Anastomoses between striate arteries or choroidal arteries and cortical arteries directly or via medullary arteries (a); septal transcallosal anastomoses between choroidal arteries with pericallosal arteries (b); anastomoses between choroidal arteries or the posterior communicating artery and thalamostriate arteries (c); intrastriatal anastomosis among striatal arteries (d); intrathalamic anastomosis among thalamic arteries (e); and focal Moyamoya vessels in the basal cistern (f).
- Fig 2.
Case 1. Selective right internal carotid angiography (anteroposterior, A; lateral view, B) shows anastomotic connections to cortical arteries from the anterior choroidal artery (black arrowheads, type b) as well as from thalamostriate arteries (white arrows, type a). Collateral networks are excellently visualized in MIP from TOF-MRA with slab thickness of 20 mm (white arrows and black arrowheads) (C). Transcallosal connections to cortical arteries (white arrowheads) not detected by DSA are poorly visualized on MPRAGE (D).
- Fig 3.
Case 8. Selective right internal carotid angiography (anteroposterior, A; right 45°oblique view, B) shows anastomosis between the posterior communicating artery and the thalamostriate arteries (arrows, type c). MIP from TOF-MRA (C) demonstrates this anastomosis clearly as well as connection with the anterior choroidal artery (asterisk). The latter anastomosis could neither be detected in DSA nor visualized by MIP from MPRAGE (D).
- Fig 4.
Case 5. Selective right internal carotid angiography (right 45° oblique, A; left 45° oblique view, B) shows intrastriatal anastomoses among thalamostriate arteries running through the periventricular space (arrows, type d). MIP from TOF-MRA (C) excellently demonstrates these networks as well as focal connections among Moyamoya vessels in the basal cistern (asterisk, type f). MIP from MPRAGE (D) moderately depicts the network; however, basal Moyamoya vessels are poorly visualized.
- Fig 5.
Case 6. Selective left vertebral angiography (anteroposterior, A; lateral view, B) shows no marked anastomosis. The MIP from TOF-MRA (C) demonstrates excellent visualization of inner thalamic anastomosis among posterior thalamostriate arteries (white arrows, type e), whereas the visualization is only moderate on MIP from MPRAGE (D).
- Fig 6.
Case 10. Selective right vertebral angiography (anteroposterior, A; lateral view, B) shows a tiny, barely visible anastomosis (black arrows) between the posterior thalamostriate artery and a medullary-cortical artery. MIP from TOF-MRA (C) and MIP from MPRAGE (D) do not delineate the anastomosis. The white arrow (C) indicates the supposed anatomic location of the anastomosis.
Tables
Comparison of 7T MRA and DSA regarding the number of detected collateral networks and image quality for anastomoses to major trunk vessels and collateral pathways to cortical vessels
Type Connecting Vessels in Collateral Networks DSA TOF-MRA MPRAGE Collateral networks connecting to cortical arteries a Striate/choroidal arteries and medullary-cortical arteries 11 16 8 b Striate/choroidal arteries and the pericallosal arteries 7 9 4 Total 18 25 12 Image quality (n = 18)a (mean) (SEM) (range) 4.0 (0.26, 3–5) 4.8 (0.10, 3–5) 2.4 (0.35, 1–5) Collateral networks connecting to major trunk vessels c Choroidal arteries or PcomA and thalamostriate arteries 21 19 9 d Intrastriatal arteries 21 22 16 e Intrathalamic arteries 8 8 6 f Moyamoya vessels in the basal cistern 32 32 30 Total 82 81 61 Image quality (n = 82)a (mean) (SEM) (range) 4.6 (0.07, 2–5) 4.4 (0.12, 3–5) 2.7 (0.13, 1–5) Note:—PcomA indicates posterior communicating artery.
↵a Image quality was evaluated in collateral networks detected by DSA as a clinical standard using a 5-point scale.
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