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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleAdult Brain
Open Access

Cortical Distribution of Fragile Periventricular Anastomotic Collateral Vessels in Moyamoya Disease: An Exploratory Cross-Sectional Study of Japanese Patients with Moyamoya Disease

A. Miyakoshi, T. Funaki, Y. Fushimi, T. Nakae, M. Okawa, T. Kikuchi, H. Kataoka, K. Yoshida, Y. Mineharu, M. Matsuhashi, E. Nakatani and S. Miyamoto
American Journal of Neuroradiology December 2020, 41 (12) 2243-2249; DOI: https://doi.org/10.3174/ajnr.A6861
A. Miyakoshi
aFrom the Department of Neurosurgery (A.M., T.F., M.O., T.K., H.K., K.Y., Y.M., S.M.)
dDepartment of Neurosurgery (A.M.)
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T. Funaki
aFrom the Department of Neurosurgery (A.M., T.F., M.O., T.K., H.K., K.Y., Y.M., S.M.)
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Y. Fushimi
bDiagnostic Imaging and Nuclear Medicine (Y.F.)
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T. Nakae
fDepartment of Neurosurgery (T.N.), Shiga General Hospital, Shiga, Japan
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M. Okawa
aFrom the Department of Neurosurgery (A.M., T.F., M.O., T.K., H.K., K.Y., Y.M., S.M.)
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T. Kikuchi
aFrom the Department of Neurosurgery (A.M., T.F., M.O., T.K., H.K., K.Y., Y.M., S.M.)
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H. Kataoka
aFrom the Department of Neurosurgery (A.M., T.F., M.O., T.K., H.K., K.Y., Y.M., S.M.)
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K. Yoshida
aFrom the Department of Neurosurgery (A.M., T.F., M.O., T.K., H.K., K.Y., Y.M., S.M.)
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Y. Mineharu
aFrom the Department of Neurosurgery (A.M., T.F., M.O., T.K., H.K., K.Y., Y.M., S.M.)
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M. Matsuhashi
cEpilepsy, Movement Disorders and Physiology (M.M.), Kyoto University Graduate School of Medicine, Kyoto, Japan
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E. Nakatani
eDivision of Statistical Analysis (E.N.), Shizuoka General Hospital, Shizuoka, Japan
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S. Miyamoto
aFrom the Department of Neurosurgery (A.M., T.F., M.O., T.K., H.K., K.Y., Y.M., S.M.)
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Figures

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  • FIG 1.
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    FIG 1.

    Schematic illustration showing a coronal plane of the left cerebral hemisphere and 3 subtypes of collateral anastomoses: lenticulostriate, thalamic, and choroidal anastomoses. A indicates artery; Med, medullary; Subepend, subependymal; TGA, thalamogeniculate artery; TPA, thalamoperforating artery; TTA, thalamotuberal artery. Reprinted with permission from Funaki et al.18

  • FIG 2.
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    FIG 2.

    Flowchart for patient inclusion. Asterisk indicates that the patients have the anastomoses for which signals could be identified all the way from the origin to the cerebral cortex without interruption on MR angiography.

  • FIG 3.
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    FIG 3.

    Cortical distributions for each type of collateral depicted on a standard brain surface model (A, All types; B, Lenticulostriate anastomosis; C, Thalamic anastomosis; D, Choroidal anastomosis). Each dot shows the point of anastomosis outflow to the cortex (blue dot, lenticulostriate anastomosis; black dot, thalamic anastomosis; red dot, choroidal anastomosis). Unfilled circles represent outflow on the insular cortex. Pale dots represent outflow located in a sulcus. CS indicates central sulcus.

  • FIG 4.
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    FIG 4.

    Cortical distributions of each type of collateral depicted on a standard brain surface model. Each dot shows the point where each anastomosis outflowed to the cortex (blue dot, lenticulostriate anastomosis; black dot, thalamic anastomosis; red dot, choroidal anastomosis). White circles (circles without fill) show dots located on the insular cortex. A, All dots are depicted on a brain surface model. B, The view from the medial surface of a 3D brain surface model. Dots were extracted that exist within 15 mm from the midline.

  • FIG 5.
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    FIG 5.

    Mediolateral (x-coordinate) distribution of outflow to the cortex for each type of anastomosis. The value for the midline of images is 181, and the value for the lateral edge of images is 361. Values for x-coordinates are shown as density estimations. The asterisk indicates P < .001.

  • FIG 6.
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    FIG 6.

    Posteroanterior (y-coordinate) distribution of outflow to the cortex for each type of anastomosis. The value for the posterior edge of images is 1, and the value for the frontal edge of images is 395. Values for y-coordinates are shown as density estimations. The asterisk indicates P < .001.

  • FIG 7.
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    FIG 7.

    Caudocranial (z-coordinate) distribution of outflow to the cortex for each type of anastomosis. The value for the caudal edge of images is 1, and the value for the cranial edge of images is 345. Values for z-coordinates are shown as density estimations.

Tables

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  • Patient characteristics

    Included Patients with Moyamoya Disease (n = 46)
    Median age (range) (yr)28.5 (3–56)
    Male sex (No.) (%)14 (30.4)
    Clinical presentation (No.) (%)
     Ischemic symptoms28 (60.9)
     Hemorrhagic symptoms11 (23.9)
     Other symptoms7 (15.2)
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American Journal of Neuroradiology: 41 (12)
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Vol. 41, Issue 12
1 Dec 2020
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Cite this article
A. Miyakoshi, T. Funaki, Y. Fushimi, T. Nakae, M. Okawa, T. Kikuchi, H. Kataoka, K. Yoshida, Y. Mineharu, M. Matsuhashi, E. Nakatani, S. Miyamoto
Cortical Distribution of Fragile Periventricular Anastomotic Collateral Vessels in Moyamoya Disease: An Exploratory Cross-Sectional Study of Japanese Patients with Moyamoya Disease
American Journal of Neuroradiology Dec 2020, 41 (12) 2243-2249; DOI: 10.3174/ajnr.A6861

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Cortical Distribution of Fragile Periventricular Anastomotic Collateral Vessels in Moyamoya Disease: An Exploratory Cross-Sectional Study of Japanese Patients with Moyamoya Disease
A. Miyakoshi, T. Funaki, Y. Fushimi, T. Nakae, M. Okawa, T. Kikuchi, H. Kataoka, K. Yoshida, Y. Mineharu, M. Matsuhashi, E. Nakatani, S. Miyamoto
American Journal of Neuroradiology Dec 2020, 41 (12) 2243-2249; DOI: 10.3174/ajnr.A6861
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