Accurate and timely diagnosis of intracranial vasculopathies is important owing to the significant risk of morbidity with delayed and/or incorrect diagnosis both from the disease process and inappropriate therapies. Conventional luminal imaging techniques for analysis of intracranial vasculopathies are limited to evaluation of changes in the vessel lumen. Vessel wall MRI techniques can allow direct characterization of pathologic changes of the vessel wall. These techniques may improve diagnostic accuracy and improve patient outcomes. Extracranial carotid vessel wall imaging has been extensively investigated in patients with atherosclerotic disease and has been shown to accurately assess plaque composition and identify vulnerable plaque characteristics that may predict stroke risk beyond luminal stenosis alone. This review provides a brief history of vessel wall MRI, an overview of the intracranial vessel wall MRI techniques, its applications, and imaging findings of various intracranial vasculopathies pertinent to the neurointerventionalist, neurologist, and neuroradiologist. We searched MEDLINE, PubMed, and Google for English publications containing any of the following terms: ‘intracranial vessel wall imaging’, ‘intracranial vessel wall’, and ‘intracranial vessel wall MRI’.
- Vessel Wall
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Contributors MM-B: wrote, reviewed, supervised, directed and submitted the manuscript. MA: wrote portions of the manuscript and performed critical review. SG: performed critical review, edited and composed the figure of the manuscript. CY, DG: performed critical review, edited and directed portions of the manuscript.
Funding Research support from NIH 1R56NS092207-01 grant.
Competing interests None declared.
Ethics approval Institutional review board.
Provenance and peer review Not commissioned; externally peer reviewed.