Magnetic resonance vessel wall imaging in cerebrovascular diseases

Neurosurg Focus. 2019 Dec 13;47(6):E4. doi: 10.3171/2019.9.FOCUS19599.


Cerebrovascular diseases manifest as abnormalities of and disruption to the intracranial vasculature and its capacity to carry blood to the brain. However, the pathogenesis of many cerebrovascular diseases begins in the vessel wall. Traditional luminal and perfusion imaging techniques do not provide adequate information regarding the differentiation, onset, or progression of disease. Intracranial high-resolution MR vessel wall imaging (VWI) has emerged as an invaluable technique for understanding and evaluating cerebrovascular diseases. The location and pattern of contrast enhancement in intracranial VWI provides new insight into the inflammatory etiology of cerebrovascular diseases and has potential to permit earlier diagnosis and treatment. In this report, technical considerations of VWI are discussed and current applications of VWI in vascular malformations, blunt cerebrovascular injury/dissection, and steno-occlusive cerebrovascular vasculopathies are reviewed.

Keywords: intracranial vessel wall imaging; cerebral aneurysm; endothelial inflammation; vasospasm; intracranial atherosclerosis; moyamoya.

Publication types

  • Review

MeSH terms

  • Aortic Dissection / diagnostic imaging
  • Artifacts
  • Cerebral Arteries / diagnostic imaging*
  • Cerebral Arteries / injuries
  • Cerebrovascular Circulation
  • Cerebrovascular Disorders / diagnostic imaging*
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Arteriosclerosis / diagnostic imaging
  • Intracranial Arteriovenous Malformations / diagnostic imaging
  • Magnetic Resonance Angiography / methods*
  • Moyamoya Disease / diagnostic imaging
  • Neuroimaging / methods*
  • Vasculitis, Central Nervous System / diagnostic imaging
  • Vasoconstriction
  • Vasospasm, Intracranial / diagnostic imaging
  • Wounds, Nonpenetrating / diagnostic imaging