Added Value of Vessel Wall Magnetic Resonance Imaging for Differentiation of Nonocclusive Intracranial Vasculopathies

BACKGROUND AND PURPOSE—Our goal is to determine the added value of intracranial vessel wall magnetic resonance imaging (IVWI) in differentiating nonocclusive vasculopathies compared with luminal imaging alone. METHODS—We retrospectively reviewed images from patients with both luminal and IVWI to ide...

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Bibliographic Details
Published in:Stroke (1970) 2017-11, Vol.48 (11), p.3026-3033
Main Authors: Mossa-Basha, Mahmud, Shibata, Dean K, Hallam, Danial K, de Havenon, Adam, Hippe, Daniel S, Becker, Kyra J, Tirschwell, David L, Hatsukami, Thomas, Balu, Niranjan, Yuan, Chun
Format: Article
Language:English
Subjects:
Adult
Female
Humans
Intracranial Arteriosclerosis - diagnostic imaging
Magnetic Resonance Angiography - methods
Male
Middle Aged
Retrospective Studies
Vasculitis, Central Nervous System - diagnostic imaging
Vasospasm, Intracranial - diagnostic imaging
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Summary:BACKGROUND AND PURPOSE—Our goal is to determine the added value of intracranial vessel wall magnetic resonance imaging (IVWI) in differentiating nonocclusive vasculopathies compared with luminal imaging alone. METHODS—We retrospectively reviewed images from patients with both luminal and IVWI to identify cases with clinically defined intracranial vasculopathiesatherosclerosis (intracranial atherosclerotic disease), reversible cerebral vasoconstriction syndrome, and inflammatory vasculopathy. Two neuroradiologists blinded to clinical data reviewed the luminal imaging of defined luminal stenoses/irregularities and evaluated the pattern of involvement to make a presumed diagnosis with diagnostic confidence. Six weeks later, the 2 raters rereviewed the luminal imaging in addition to IVWI for the pattern of wall involvement, presence and pattern of postcontrast enhancement, and presumed diagnosis and confidence. Analysis was performed on per-lesion and per-patient bases. RESULTS—Thirty intracranial atherosclerotic disease, 12 inflammatory vasculopathies, and 12 reversible cerebral vasoconstriction syndrome patients with 201 lesions (90 intracranial atherosclerotic disease, 64 reversible cerebral vasoconstriction syndrome, and 47 inflammatory vasculopathy lesions) were included. For both per-lesion and per-patient analyses, there was significant diagnostic accuracy improvement with luminal imaging+IVWI when compared with luminal imaging alone (per-lesion88.8% versus 36.1%; P
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.117.018227