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Updated: Mar 27, 2026

Longitudinal In Vivo Imaging of the Cerebrovasculature: Relevance to CNS Diseases
Published on: December 6, 2016
Vessel wall imaging for intracranial vascular disease evaluation
Mahmud Mossa-Basha1, Matthew Alexander2, Santhosh Gaddikeri1
1Department of Radiology, University of Washington, Seattle, Washington, USA.
Insights
Intracranial vessel wall MRI offers direct visualization of vessel wall changes, improving diagnosis of vasculopathies. This advanced imaging technique aids in better patient outcomes by identifying disease beyond lumen narrowing.
Area of Science:
- Neuroradiology
- Neuroimaging
- Vascular Imaging
Background:
- Accurate diagnosis of intracranial vasculopathies is crucial to prevent morbidity from delayed or incorrect treatment.
- Conventional imaging methods assess only the vessel lumen, limiting evaluation of the vessel wall itself.
Purpose of the Study:
- To review intracranial vessel wall magnetic resonance imaging (MRI) techniques.
- To discuss applications and imaging findings of various intracranial vasculopathies.
- To highlight the relevance for neurointerventionalists, neurologists, and neuroradiologists.
Main Methods:
- Literature search of MEDLINE, PubMed, and Google for English publications.
- Keywords used: 'intracranial vessel wall imaging', 'intracranial vessel wall', and 'intracranial vessel wall MRI'.
Main Results:
- Vessel wall MRI allows direct characterization of pathological vessel wall changes.
- Extracranial vessel wall imaging has proven effective in assessing atherosclerotic plaque and stroke risk.
- Intracranial vessel wall MRI techniques offer potential for improved diagnostic accuracy.
Conclusions:
- Intracranial vessel wall MRI techniques represent an advancement over conventional luminal imaging.
- These techniques can enhance diagnostic accuracy and potentially improve patient outcomes in managing intracranial vasculopathies.
Abstract:
Accurate and timely diagnosis of intracranial vasculopathies is important owing to the significant risk of morbidity with delayed and/or incorrect diagnosis both from the disease process and inappropriate therapies. Conventional luminal imaging techniques for analysis of intracranial vasculopathies are limited to evaluation of changes in the vessel lumen. Vessel wall MRI techniques can allow direct characterization of pathologic changes of the vessel wall. These techniques may improve diagnostic accuracy and improve patient outcomes. Extracranial carotid vessel wall imaging has been extensively investigated in patients with atherosclerotic disease and has been shown to accurately assess plaque composition and identify vulnerable plaque characteristics that may predict stroke risk beyond luminal stenosis alone. This review provides a brief history of vessel wall MRI, an overview of the intracranial vessel wall MRI techniques, its applications, and imaging findings of various intracranial vasculopathies pertinent to the neurointerventionalist, neurologist, and neuroradiologist. We searched MEDLINE, PubMed, and Google for English publications containing any of the following terms: 'intracranial vessel wall imaging', 'intracranial vessel wall', and 'intracranial vessel wall MRI'.
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