Neuroimaging in Moyamoya angiopathy: Updated review.

Moyamoya angiopathy (MMA) is a rare condition characterized by steno-occlusion of terminal portions of the internal carotid arteries and/or their proximal branches with the formation of collateral vessels network (moyamoya vessels). These changes result in chronic ischemia of the brain parenchyma with subsequent serious cerebrovascular accidents. The prognosis of MMA could be dramatically improved if the diagnosis and assessment are prompt and accurate. It is also crucial to define the indications, optimal timing, volume, and tactics of revascularization surgery, as well as longitudinal observation after treatment. It is therefore necessary to use strict criteria for decision making, including radiological criteria. In today's world, neuroimaging is a valuable diagnostic tool that continually evolves and provides us with more and more information about structural and functional changes in different pathological conditions. However, due to MMA's rarity, its neuroimaging can be challenging. The purpose of this review is to summarize a contemporary knowledge regarding neuroimaging in patients with MMA and to discuss the main difficulties associated with visualizing this condition.