Dilatation, Proliferation, and Abnormal Anastomosis of Lenticulostriate Arteries on Whole-Brain Vessel Wall Imaging as a Predictor of Hemorrhage in Patients with Moyamoya Disease

In this study, we explored distinct branching pattern of lenticulostriate arteries (LSAs) in moyamoya disease (MMD) and identified collateral features of hemorrhagic MMD, using whole-brain vessel wall imaging (WB-VWI). Results showed that patients with MMD more frequently presented with dilated and proliferated LSA branches than patients with atherosclerotic moyamoya syndrome. In patients with MMD, type 3 LSA pattern (dilatation and proliferation of LSA branches with abnormal anastomosis) was associated with hemorrhagic events and vanished middle cerebral artery. These findings suggest that WB-VWI can provide complementary information of abnormal moyamoya vessels and facilitate to predict hemorrhage in MMD.