Survey of the American Society of Neuroradiology Membership on the Use and Value of Intracranial Vessel Wall MRI

Abstract

BACKGROUND AND PURPOSE: Intracranial vessel wall MR imaging is an emerging technique for intracranial vasculopathy assessment. Our aim was to investigate intracranial vessel wall MR imaging use by the American Society of Neuroradiology (ASNR) members at their home institutions, including indications and barriers to implementation. MATERIALS AND METHODS:The ASNR Vessel Wall Imaging Study Group survey on vessel wall MR imaging use, frequency, applications, MR imaging systems and field strength used, protocol development approaches, vendor engagement, reasons for not using vessel wall MR imaging, ordering-provider interest, and impact on clinical care, was distributed to the ASNR membership between April 2 and August 30, 2019.RESULTS: There were 532 responses; 79 were excluded due to nonresponse and 42 due to redundant institutional responses, leaving 411 responses. Fifty-two percent indicated that their institution performs vessel wall MR imaging, with 71.5% performed at least 1-2 times/ month, most frequently on 3T MR imaging, and 87.7% using 3D sequences. Protocols most commonly included were T1-weighted preand postcontrast and TOF-MRA; 60.6% had limited contributions from vendors or were still in protocol development. Vasculopathy differentiation (94.4%), cryptogenic stroke (41.3%), aneurysm (38.0%), and atherosclerosis (37.6%) evaluation were the most common indications. For those not performing vessel wall MR imaging, interpretation (53.1%) or technical (46.4%) expertise, knowledge of applications (50.5%), or limitations of clinician (56.7%) or radiologist (49.0%) interest were the most common reasons. If technical/expertise obstacles were overcome, 56.4% of those not performing vessel wall MR imaging indicated that they would perform it. Ordering providers most frequently inquiring about vessel wall MR imaging were from stroke neurology (56.5%) and neurosurgery (25.1%), while 34.3% indicated that no providers had inquired.CONCLUSIONS: More than 50% of neuroradiology groups use vessel wall MR imaging for intracranial vasculopathy characterization and differentiation, emphasizing the need for additional technical and educational support, especially as clinical vessel wall MR imaging implementation continues to grow.

Survey of the American Society of Neuroradiology Membership on the Use and Value of Extracranial Carotid Vessel Wall MRI

“…This study is the extracranial portion of a survey administered, for which the intracranial portion had previously been published. 4 The survey was discussed at ASNR Vessel Wall Imaging Study Group meetings and developed through input by multiple Study Group members. Through an iterative review process, the final survey was developed on the SurveyMonkey (https://www.…”

Comprehensive imaging analysis of intracranial atherosclerosis

“…The most common application of HR-MRI is for vasculopathy differentiation (93.9%), ICAD characterization for symptomatic plaques (40.5%), and cryptogenic stroke assessment (40.9%). 25 ICAD has distinctive imaging characteristics on HR-MRI relative to other intracranial vasculopathies, specifically inflammatory vasculopathies, reversible cerebral vasoconstriction syndrome, and Moyamoya disease. On multicontrast HR-MRI, ICAD typically appears as eccentric lesions, outwardly remodeled, that have heterogeneous, intermediate, or a significant degree of post-contrast enhancement, and have a juxta luminal T2-weighted hyperintense signal (fibrous cap) with a deeper hypointense signal (lipid-rich necrotic core).…”

Editorial: Cerebrovascular imaging—From micro- to macroscopic scales

“…Vessel wall imaging is a hot topic with increasing research and clinical translation interests (Mossa-Basha et al, 2022 ) in the past decade and we include seven articles in this Research Topic. However, most of current studies were cross-sectional with limited sample sizes.…”