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Radiation-induced Arteritis: Thickened Wall with Prominent Enhancement on Cranial MR Images—Report of Five Cases and Comparison with 18 Cases of Moyamoya Disease¹

¹ From the Department of Radiology, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyoku, Tokyo 113-8655, Japan (S.A., N.H., O.A., I.S., K.N., K.O.); and Department of Radiology, Yamanashi Medical University, Yamanashi, Japan (K.I., T.O., T.A.). From the 2000 RSNA scientific assembly. Received April 24, 2001; revision requested May 25; revision received September 19; accepted November 12. Address correspondence to S.A. (e-mail: saoki-dis@h.u-tokyo.ac.jp).

View larger version (92K): [in a new window]   Figure 1a. Radiation-induced arteritis in a 15-year-old girl (patient 2) who had undergone irradiation with a conventional method at 10 years of age because of suprasellar germinoma. (a) Superior-inferior time-of-flight MR angiographic image (33/6.9; 20° flip angle) shows bilateral distal ICA occlusion (arrows). (b) Coronal precontrast T1-weighted spin-echo MR image (500/11) shows the isointense thickened wall (arrows) of each distal ICA. (c) Coronal postcontrast T1-weighted spin-echo MR image (500/11) shows ring enhancement (arrows) of the wall of each distal ICA.

View larger version (147K): [in a new window]   Figure 1b. Radiation-induced arteritis in a 15-year-old girl (patient 2) who had undergone irradiation with a conventional method at 10 years of age because of suprasellar germinoma. (a) Superior-inferior time-of-flight MR angiographic image (33/6.9; 20° flip angle) shows bilateral distal ICA occlusion (arrows). (b) Coronal precontrast T1-weighted spin-echo MR image (500/11) shows the isointense thickened wall (arrows) of each distal ICA. (c) Coronal postcontrast T1-weighted spin-echo MR image (500/11) shows ring enhancement (arrows) of the wall of each distal ICA.

View larger version (162K): [in a new window]   Figure 1c. Radiation-induced arteritis in a 15-year-old girl (patient 2) who had undergone irradiation with a conventional method at 10 years of age because of suprasellar germinoma. (a) Superior-inferior time-of-flight MR angiographic image (33/6.9; 20° flip angle) shows bilateral distal ICA occlusion (arrows). (b) Coronal precontrast T1-weighted spin-echo MR image (500/11) shows the isointense thickened wall (arrows) of each distal ICA. (c) Coronal postcontrast T1-weighted spin-echo MR image (500/11) shows ring enhancement (arrows) of the wall of each distal ICA.

View larger version (147K): [in a new window]   Figure 2a. Radiation-induced arteritis in a 27-year-old woman (patient 3) who had undergone gamma-knife irradiation at 25 years of age because of a large right basal ganglial arteriovenous malformation. (a) Conventional angiogram of the right common carotid artery (Towne view) shows right distal ICA occlusion (arrow). (b) Transverse precontrast T1-weighted spin-echo MR image (600/14) shows the isointense thickened wall (arrow) of the right distal ICA. (c) Transverse contrast-enhanced T1-weighted spin-echo MR image (600/14) shows intense ring enhancement (arrow) of the distal ICA wall.

View larger version (185K): [in a new window]   Figure 2b. Radiation-induced arteritis in a 27-year-old woman (patient 3) who had undergone gamma-knife irradiation at 25 years of age because of a large right basal ganglial arteriovenous malformation. (a) Conventional angiogram of the right common carotid artery (Towne view) shows right distal ICA occlusion (arrow). (b) Transverse precontrast T1-weighted spin-echo MR image (600/14) shows the isointense thickened wall (arrow) of the right distal ICA. (c) Transverse contrast-enhanced T1-weighted spin-echo MR image (600/14) shows intense ring enhancement (arrow) of the distal ICA wall.

View larger version (161K): [in a new window]   Figure 2c. Radiation-induced arteritis in a 27-year-old woman (patient 3) who had undergone gamma-knife irradiation at 25 years of age because of a large right basal ganglial arteriovenous malformation. (a) Conventional angiogram of the right common carotid artery (Towne view) shows right distal ICA occlusion (arrow). (b) Transverse precontrast T1-weighted spin-echo MR image (600/14) shows the isointense thickened wall (arrow) of the right distal ICA. (c) Transverse contrast-enhanced T1-weighted spin-echo MR image (600/14) shows intense ring enhancement (arrow) of the distal ICA wall.

View larger version (167K): [in a new window]   Figure 3a. MR images show idiopathic moyamoya disease in a 15-year-old boy. (a) Transverse precontrast intermediate-weighted spin-echo MR images (fast spin echo, 3,200/14) show narrowing of both distal ICAs (arrows) and MCAs (arrowheads). Moyamoya vessels also were seen. (b) Transverse contrast-enhanced T1-weighted spin-echo MR images (500/9) show no definite enhancement of the narrowed arteries (arrows).

View larger version (130K): [in a new window]   Figure 3b. MR images show idiopathic moyamoya disease in a 15-year-old boy. (a) Transverse precontrast intermediate-weighted spin-echo MR images (fast spin echo, 3,200/14) show narrowing of both distal ICAs (arrows) and MCAs (arrowheads). Moyamoya vessels also were seen. (b) Transverse contrast-enhanced T1-weighted spin-echo MR images (500/9) show no definite enhancement of the narrowed arteries (arrows).