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.
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