[Neuroimaging of cerebral vasculitis]

Area of Science:

• Neurology
• Radiology
• Immunology

Background:

• Cerebral vasculitis presents diverse origins and lacks specific clinical or imaging markers.
• Central nervous system (CNS) vasculitis can mimic other neurological conditions, complicating diagnosis and treatment.
• Accurate diagnosis of cerebral vasculitis is challenging, necessitating a comprehensive approach.

Purpose of the Study:

• To review the current diagnostic strategies for cerebral vasculitis.
• To present key imaging findings associated with cerebral vasculitis.
• To discuss differential diagnoses in radiological imaging of cerebral vasculitis.

Main Methods:

• Magnetic resonance imaging (MRI) and MR angiography (MRA) are primary radiological tools.
• Digital subtraction angiography (DSA) is used for evaluating medium-sized vessels when initial imaging is inconclusive.
• Brain or leptomeningeal biopsy is essential for diagnosing small vessel vasculitis, which is not detectable by vascular imaging.

Main Results:

• MRI and MRA assess parenchymal damage and detect vessel wall abnormalities.
• DSA aids in identifying changes in medium-sized cerebral arteries.
• Biopsy remains the gold standard for small vessel cerebral vasculitis diagnosis.

Conclusions:

• A multi-modal diagnostic approach combining advanced imaging and biopsy is crucial for cerebral vasculitis.
• Understanding imaging findings and differential diagnoses is key for effective management of CNS vasculitis.
• Early and accurate diagnosis of cerebral vasculitis improves patient outcomes by enabling timely and appropriate treatment.