High-resolution vessel wall MRI for the evaluation of intracranial atherosclerotic disease
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High-resolution vessel wall MRI (vwMRI) of the intracranial arteries is an emerging diagnostic imaging technique with the goal of evaluating vascular pathology. vwMRI sequences have high spatial resolution and directly image the vessel wall by suppressing blood signal. With vwMRI, it is possible to identify distinct morphologic and enhancement patterns of atherosclerosis that can provide important information about stroke etiology and recurrence risk. We present a review of vwMRI research in relation to intracranial atherosclerosis, with a focus on the relationship between ischemic stroke and atherosclerotic plaque T1 post-contrast enhancement or plaque/vessel wall morphology. The goal of this review is to provide readers with the most current understanding of the reliability, incidence, and importance of specific vwMRI findings in intracranial atherosclerosis, to guide their interpretation of vwMRI research, and help inform clinical interpretation of vwMRI. We will also provide a translational perspective on the existing vwMRI literature and insight into future vwMRI research questions and objectives. With increased use of high field strength MRI, powerful gradients, and improved pulse sequences, vwMRI will become standard-of-care in the diagnosis and prognosis of patients with cerebrovascular disease, making a firm grasp of its strengths and weakness important for neuroimagers.
KeywordsHigh-resolution MRI Vessel wall MRI Intracranial atherosclerosis Ischemic stroke
Computed tomography angiography
Delay alternating with nutation for tailored excitation
Internal carotid artery
Vessel wall MRI
Middle cerebral artery
Magnetization-prepared rapid gradient-echo
Magnetic resonance angiography
Motion sensitized driven equilibrium
Transient ischemic attack
Variable refocusing flip angle
Compliance with ethical standards
The study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number KL2TR001065 (AdH).
Conflict of interest
The authors declare that they have no conflict of interest.
The manuscript does not contain clinical studies or patient data.
Statement of informed consent was not applicable since the manuscript does not contain any patient data.
- 7.Gao T, Yu W, Liu C. Mechanisms of ischemic stroke in patients with intracranial atherosclerosis: a high-resolution magnetic resonance imaging study. Exp Ther Med. [Internet]. 2014 [cited 2015 Jan 27]; Available from: http://www.spandidos-publications.com/10.3892/etm.2014.1600.
- 11.de Havenon A, Chung L, Park M, Mossa-Basha M. Intracranial vessel wall MRI: a review of current indications and future applications. Neurovascular Imaging. 2016;2.Google Scholar
- 12.de Havenon A, Yuan C, Tirschwell D, Hatsukami T, Anzai Y, Becker K et al (2015) Nonstenotic culprit plaque: the utility of high-resolution vessel wall MRI of intracranial vessels after ischemic stroke. Case Rep Radiol 2015:e356582Google Scholar
- 17.Mandell DM, Mossa-Basha M, Qiao Y, Hess CP, Hui F, Matouk C, et al. Intracranial vessel wall MRI: principles and expert consensus recommendations of the American Society of Neuroradiology. Am J Neuroradiol [Internet]. 2016 [cited 2016 Aug 7]; Available from: http://www.ajnr.org/content/early/2016/07/28/ajnr.A4893.
- 23.Wang J, Helle M, Zhou Z, Börnert P, Hatsukami TS, Yuan C. Joint blood and cerebrospinal fluid suppression for intracranial vessel wall MRI. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med. 2015.Google Scholar
- 24.Zhu C, Graves MJ, Yuan J, Sadat U, Gillard JH, Patterson AJ (2014) Optimization of improved motion-sensitized driven-equilibrium (iMSDE) blood suppression for carotid artery wall imaging. J Cardiovasc Magn Reson Off J Soc Cardiovasc Magn Reson 16:61Google Scholar
- 29.Varma N, Hinojar R, D’Cruz D, Arroyo Ucar E, Indermuehle A, Peel S et al (2014) Coronary vessel wall contrast enhancement imaging as a potential direct marker of coronary involvement: integration of findings from CAD and SLE patients. JACC Cardiovasc Imaging 7:762–770CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Hilgendorf I, Swirski FK, Robbins CS. Monocyte fate in atherosclerosis. Arterioscler Thromb Vasc Biol. 2014;ATVBAHA.114.303565.Google Scholar
- 44.Vakil P, Elmokadem AH, Syed FH, Cantrell CG, Dehkordi FH, Carroll TJ, et al. Quantifying intracranial plaque permeability with dynamic contrast-enhanced MRI: a pilot study. Am J Neuroradiol. [Internet]. 2016 [cited 2017 Aug 20]; Available from: http://www.ajnr.org/content/early/2016/11/17/ajnr.A4998.
- 47.Stary HC, Chandler AB, Dinsmore RE, Fuster V, Glagov S, Insull W et al (1995) A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis a report from the committee on vascular lesions of the council on arteriosclerosis. Am Heart Assoc Circ 92:1355–1374Google Scholar
- 50.Chen Z, Liu A-F, Chen H, Yuan C, He L, Zhu Y, et al. Evaluation of basilar artery atherosclerotic plaque distribution by 3D MR vessel wall imaging. J Magn Reson Imaging. 2016.Google Scholar
- 55.Isoda K, Arakawa K, Kamezawa Y, Nishizawa K, Nishikawa K, Shibuya T et al (2001) Effect of coronary risk factors on arterial compensatory enlargement in Japanese middle-aged patients with de novo single-vessel disease—an intravascular ultrasound study. Clin Cardiol 24:443–450CrossRefPubMedGoogle Scholar
- 57.Zhao D-L, Deng G, Xie B, Ju S, Yang M, Chen X-H et al (2015) High-resolution MRI of the vessel wall in patients with symptomatic atherosclerotic stenosis of the middle cerebral artery. J Clin Neurosci Off J Neurosurg Soc Australas 22:700–704Google Scholar
- 67.Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ (Buddy), Culebras A, et al. An updated definition of stroke for the 21st century a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44:2064–89Google Scholar