Asymptomatic microbleeds in moyamoya disease: T2*-weighted gradient-echo magnetic resonance imaging study

Ken-Ichiro Kikuta M.D., Ph.D. 1 , Yasushi Takagi M.D., Ph.D. 1 , Kazuhiko Nozaki M.D., Ph.D. 1 , Takashi Hanakawa M.D., Ph.D. 1 , Tsutomu Okada M.D. 1 , Nobuhro Mikuni M.D., Ph.D. 1 , Yukio Miki M.D., Ph.D. 1 , Yasutaka Fushimi M.D. 1 , Akira Yamamoto M.D. 1 , Keisuke Yamada M.D., Ph.D. 1 , Hidenao Fukuyama M.D., Ph.D. 1 and Nobuo Hashimoto M.D., Ph.D. 1
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  • 1 Departments of Neurosurgery, Nuclear Medicine and Diagnostic Radiology, and Emergency Medicine, Kyoto University Graduate School of Medicine; Human Brain Research Center, Kyoto University School of Medicine, Kyoto, Japan
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Object. The aim of this study was to investigate the incidence of asymptomatic microbleeds (MBs) in patients with moyamoya disease (MMD) by using a 3-tesla magnetic resonance (MR) imaging unit.

Methods. Data on 63 patients hospitalized with MMD between 1999 and 2004 were retrospectively examined to determine the incidence of asymptomatic MBs. Gradient-echo T2*-weighted MR imaging studies obtained using 3- and 1.5-tesla units were available in 25 patients. These patients consisted of five men and 20 women, ranging in age from 17 to 66 years (mean age 41 ± 14 years). Ischemic MMD was diagnosed in 18 patients, and hemorrhagic MMD in seven. The incidence of MBs was also evaluated using the same 3-tesla MR imaging unit in 34 healthy volunteers including seven men and 27 women, ranging in age from 18 to 71 years (mean age 33 ± 12 years). Using the 3-tesla MR unit, asymptomatic MBs were demonstrated in 11 patients (44%); they were detected in seven patients (28%) by using the 1.5-tesla unit. In the 3-tesla MR studies in healthy individuals, MBs were found in two patients (5.8%). Based on 3-tesla MR studies, the incidence of MBs was significantly higher in patients with MMD compared with that in healthy individuals. Asymptomatic MBs were demonstrated in eight (44%) of 18 patients with ischemic MMD and three (43%) of seven patients with hemorrhagic MMD.

Conclusions. Microbleeds are significantly more common in patients with MMD than in healthy individuals regardless of the disease type. The evaluation of MBs with T2*-weighted 3-tesla MR imaging might contribute to the treatment of MMD.

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Contributor Notes

Address reprint requests to: Ken-ichiro Kikuta, M.D., Ph.D., Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606–8507, Japan. email: kikuta@kuhp.kyoto-u.ac.jp.
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