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FIG 3. Serial MRA images in a patient receiving hydroxyurea. Images show progressive improvement in vascular patency.
A and B, Examination 2. One year after beginning therapy, an 8-mm severe stenosis is present in the left ICA, with a large left posterior communicating (PCOM) artery. Also present is a 10-mm stenosis in the proximal right A-1 segment of the ACA, as well as proximal segmental stenoses in both middle cerebral arteries (MCAs) (11 mm, right M-1; 9 mm, left M-1). Small moyamoya collaterals are present near the right A-1 and M-1 segments.
C and D, Examination 3. Eight months later, with the MRA examination further optimized for rapid flow, the left ICA stenosis has nearly resolved, with only a 5-mm region of tapering involving the supraclinoid segment. Stenoses involving the left M-1, right A-1, and right M-1 segments had decreased to 7, 3, and 3 mm, respectively. A short 2-mm proximal stenosis is present in the left A-1 segment. Moyamoya vasculopathy was unchanged.
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