Vessel Wall MRI Added to MR Angiography in the Evaluation of Suspected Vasculopathies

Abstract

METHODS: Ninety-three consecutive subjects with a clinical history of suspected vasculopathy imaged with both VWI and 3D-TOF-MRAs were retrospectively reviewed. The 3D-TOF-MRAs were reviewed by two independent neuroradiologists classifying arterial segments as normal or abnormal based on caliber changes. Following a 2-week wash-out period, the 3D-TOF-MRAs with VWI together were re-evaluated for caliber changes and/or vessel wall enhancement. A third neuroradiologist served as consensus. Significance was assessed by McNemar's test. RESULTS:Forty-two subjects with VWI and 3D-TOF-MRAs met the inclusion criteria. By 3D-TOF-MRA alone, 12.3% (95% confidence interval [CI], 10.7-15.1) of the arterial segments were identified as abnormal compared to 20.8% (95% CI, 18.2-23.4) by VWI and 3D-TOF-MRA together (P < .0001). CONCLUSIONS: 3D-TOF-MRA and VWI together identifies a higher number of abnormal vessel segments than 3D-TOF-MRA alone and may provide a more accurate assessment of disease burden.

Intracranial vascular imaging detects arterial wall abnormalities in persons with treated HIV infection

“…1). This finding is in line with studies from the general population that have demonstrated superiority of VW-MRI in the detection of nonstenotic ICAD [7,9,10]. As MRA and CTA primarily capture luminal deficits, ICAD may go undetected on these imaging modalities, especially if atherosclerotic vessels have undergone 'positive remodeling' that does not affect the caliber of the vessel.…”

“…VW-MRI complements traditional vessel imaging techniques [e.g. computed tomography angiography (CTA), magnetic resonance angiography (MRA)], which may miss nonstenotic intracranial atherosclerotic lesions [7]. In addition, when combined with luminal imaging, VW-MRI may facilitate differentiation of ICAD from other causes of intracranial arterial disease based on enhancement characteristics [8].…”

Impact of Vessel Wall MR Imaging in the Work-Up for Ischemic Stroke

“…Many studies have shown that VW-MR imaging provides supplemental anatomic information to existing lumenbased imaging techniques. 1,2 Yet, the diagnostic utility of VW-MR imaging in the work-up of ischemic stroke still remains investigative, and questions remain about whether it provides diagnostic information that ultimately improves patient outcomes.…”

COVID-19 associated intracranial vasculopathy–MRI vessel wall imaging as adjunct to emergent CT angiography—a case report

“…Stroke mediated through large- and small-vessel inflammatory vasculopathies are reported neurovascular complications of COVID-19 [ 3 , 4 ]. The putative mechanism of COVID-19-associated vasculitis is SARS-CoV-2 endothelial cell tropism leading to either primary virus- or secondary immune-mediated endothelial dysfunction, as opposed to direct central nervous system infection and dissemination [ 7 ]. In keeping with prior reports underpinning this purported mechanism, SARS-CoV-2 RNA was detected in the serum, but not the cerebrospinal fluid of the patient whose case is reported here within [ 8 ].…”