RETURNMRI and N-Isopropyl(I-123)p-Iodoamphetamine SPECT Findings in Cases of Moyamoya Disease
Yuji Suto, Biray E. Caner*, Terumi Kato and Yoshio Ohta
Department of Radiology, Faculty of Medicine, Tottori University, Yonago 683, Japan and *Department of Nuclear Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
Six patients with moyamoya disease underwent magnetic resonance imaging (MRI), and in 4 of 6 cases, MRI findings were compared with N-isopropyl (I-123)p-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) brain scans to determine if there was a correlation between the morphology, as seen on MRI, and cerebral perfusion and/or metabolic changes detected by IMP-SPECT. MRI clearly revealed abnormalities secondary to moyamoya disease: nonvisualization of a signal void flow sign in the arteries, moyamoya vessels, and cerebral atrophy. All the perfusion abnormalities of the cortex, except a small one, observed on MR images were also detected on IMP-SPECT images, but small white matter abnormalities demonstrated on MR images could not be revealed by IMP-SPECT. Interestingly, in 2 patients, 2 additional cortical defects that were not observed on the IMP-SPECT images but not on the MR images may reflect mild ischemia and/or certain metabolic abnormalities that lead to low tracer accumulation. Overall, IMP-SPECT and MRI may play complementary roles in the evaluation of this disease.
Key words: magnetic resonance imaging; moyamoya disease; N-isopropyl (I-123)p-iodoamphetamine