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Evaluation of the Cerebral Vessels

  • Robert A. WillinskyEmail author
Chapter

Abstract

Evaluation of the cerebral vessels traditionally demonstrates the lumen of the vessel (the so-called luminogram). The methods include computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA). All three methods can evaluate the veins, but CT venography (CTV) and MR venography (MRV) are traditionally done separately from CTA and MRA. In the last decade, dynamic 3D CTA and MRA techniques can be done that provide a hemodynamic evaluation of both the arteries and the veins. These dynamic 3D techniques give a great overview of the cerebral circulation but lack spatial resolution. DSA remains the “gold standard” in the evaluation of the arteries and the hemodynamics. We believe the gadolinium-enhanced MRV is now the “gold standard” in the evaluation of the venous system.

Keywords

Cerebral arteries Cerebral veins Imaging Cerebrovascular diseases Computed tomography angiography Magnetic resonance angiography Digital subtraction angiography Vasculitis Amyloid Reversible cerebral vasoconstriction syndrome 

Suggested Reading

  1. Agid R, Andersson T, Almqvist H, Willinsky RA, Lee SK, terBrugge KG, Farb RI, Söderman M (2010) Negative CT angiography findings in patients with spontaneous subarachnoid hemorrhage: when is digital subtraction angiography still needed? AJNR Am J Neuroradiol 31(4):696–705CrossRefPubMedGoogle Scholar
  2. Castro Caldas A, Silva C, Albuquerque L, Pimentel J, Silva V, Ferro JM (2015) Cerebral amyloid angiopathy associated with inflammation: report of 3 cases and systematic review. J Stroke Cerebrovasc Dis 24(9):2039–2048CrossRefPubMedGoogle Scholar
  3. Ducros A (2012) Reversible cerebral vasoconstriction syndrome. Lancet Neurol 11:906–917CrossRefPubMedGoogle Scholar
  4. Farb RI, Agid R, Willinsky RA, Johnstone DM, Terbrugge KG (2009) Cranial dural arteriovenous fistula: diagnosis and classification with time-resolved MR angiography at 3T. AJNR Am J Neuroradiol 30(8):1546–1551CrossRefPubMedGoogle Scholar
  5. Mandell DM, Matouk CC, Farb RI, Krings T, Agid R, terBrugge K, Willinsky RA, Swartz RH, Silver FL, Mikulis DJ (2012) Vessel wall MRI to differentiate between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis: preliminary results. Stroke 43(3):860–862CrossRefPubMedGoogle Scholar
  6. Martucci M, Sarria S, Toledo M, Coscojuela P, Vert C, Siurana S, Auger C, Rovira A (2014) Cerebral amyloid angiopathy-related inflammation: imaging findings and clinical outcome. Neuroradiology 56(4):283–289CrossRefPubMedGoogle Scholar
  7. Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D (2015a) Reversible cerebral vasoconstriction syndrome, part 1: epidemiology, pathogenesis, and clinical course. AJNR Am J Neuroradiol 36(8):1392–1399CrossRefPubMedGoogle Scholar
  8. Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D (2015b) Reversible cerebral vasoconstriction syndrome, part 2: diagnostic work-Up, imaging evaluation, and differential diagnosis. AJNR Am J Neuroradiol 36(9):1580–1588CrossRefPubMedGoogle Scholar
  9. Moussaddy A, Levy A, Strbian D, Sundararajan S, Berthelet F, Lanthier S (2015) Inflammatory cerebral amyloid angiopathy, amyloid-β-related angiitis, and primary angiitis of the central nervous system: similarities and differences. Stroke 46(9):e210–e213CrossRefPubMedGoogle Scholar
  10. Skarpathiotakis M, Mandell DM, Swartz RH, Tomlinson G, Mikulis DJ (2013) Intracranial atherosclerotic plaque enhancement in patients with ischemic stroke. AJNR Am J Neuroradiol 34(2):299–304CrossRefPubMedGoogle Scholar
  11. Willems PW, Brouwer PA, Barfett JJ, terBrugge KG, Krings T (2011) Detection and classification of cranial dural arteriovenous fistulas using 4D-CT angiography: initial experience. AJNR Am J Neuroradiol 32:49–53PubMedGoogle Scholar
  12. Yamada M (2015) Cerebral amyloid angiopathy: emerging concepts. J Stroke 17(1):17–30CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Joint Department of Medical ImagingToronto Western Hospital, University Health Network and Mount Sinai Hospital, University of TorontoTorontoCanada

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