RT Journal Article
SR Electronic
T1 Imaging Assessments and Clinical Significance of Brain Frailty in Moyamoya Disease
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A8232
A1 Wang, Liuxian
A1 Lyu, Jinhao
A1 Han, Dongshan
A1 Bian, Xiangbing
A1 Zhang, Dekang
A1 Wang, Hui
A1 Hao, Fangbin
A1 Duan, Lian
A1 Ma, Lin
A1 Lou, Xin
YR 2024
UL http://www.ajnr.org/content/early/2024/05/23/ajnr.A8232.abstract
AB BACKGROUND AND PURPOSE: Imaging assessment of brain frailty in ischemic stroke has been extensively studied, while the correlation between brain frailty and Moyamoya disease remains obscure. This study aimed to investigate the imaging characteristics of brain frailty and its clinical applications in Moyamoya disease.MATERIALS AND METHODS: This study included 60 patients with Moyamoya disease (107 hemispheres). All patients were divided into stroke and nonstroke groups based on clinical symptoms and imaging findings. The modified brain frailty score was adapted to consider 4 imaging signs: white matter hyperintensity, enlargement of perivascular space, old vascular lesions, and cerebral microbleed. The relative CBF of the MCA territory was quantified using pseudocontinuous arterial-spin labeling. Surgical outcome after revascularization surgery was defined by the Matsushima grade.RESULTS: The relative CBF of the MCA territory decreased as the modified brain frailty score and periventricular white matter hyperintensity grades increased (ρ = −0.22, P = .02; ρ = −0.27, P = .005). Clinically, the modified brain frailty score could identify patients with Moyamoya disease with stroke (OR = 2.00, P = .02). Although the modified brain frailty score showed no predictive value for surgical outcome, basal ganglia enlargement of the perivascular space had a significant correlation with the postoperative Matsushima grade (OR = 1.29, P = .03).CONCLUSIONS: The modified brain frailty score could reflect a cerebral perfusion deficit and clinical symptoms of Moyamoya disease, and its component basal ganglia enlargement of perivascular space may be a promising marker to predict surgical outcome and thus aid future clinical decision-making.CMBcerebral microbleedEDASencephaloduroarteriosynangiosisEPVSenlargement of the perivascular spaceMMDMoyamoya diseasePCAposterior cerebral arterypCASLpseudocontinuous arterial-spin labelingPVSperivascular spacerCBFmcarelative CBF of the MCAWMHwhite matter hyperintensity