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Updated: Jan 4, 2026
A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage
Published on: July 28, 2018
High-Resolution MRI Vessel Wall Imaging in Acute Aneurysmal Subarachnoid Hemorrhage : Spatiotemporal Pattern and
Charlie Chia-Tsong Hsu1,2, Suradech Suthiphosuwan1, Thien Huynh1,3
1Division of Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Canada.
Purpose:
The spatiotemporal pattern of vessel wall changes was investigated on two time point magnetic resonance images (MRI) in patients with aneurysmal subarachnoid hemorrhages (aSAH) and its association with clinicoradiologic severity score and delayed cerebral ischemia (DCI) was analyzed.
Methods:
A total of 32 prospectively enrolled patients with aSAH (mean age 56.94 years; 9 male and 23 female) underwent vessel wall imaging (VWI) MRI. Of the patients 20 completed two time point MRIs early and late during the admission, 10 patients only had early MRI and 2 patients only had late MRI. Timing of early MRI had a mean of 2.5 days (range 1-6 days) and late MRI had a mean of 10.5 days (range 7-16 days) from time of admission. Spatiotemporal pattern of vessel wall enhancement (VWE), vasospasm, diffusion-weighted imaging (DWI) lesion burden (grade 0-III) and infarcts were analyzed against the clinicoradiologic severity score (high-risk: vasograde red and yellow, low-risk: vasograde green) and DCI.
Results:
On the early MRI, mild VWE alone was significantly more frequent in the high-risk group (36.7% versus 20.0%; P = 0.024). On the late MRI, vasospasm was significantly more frequent in the high-risk group (27.2% versus 4.5%; P = 0.022). Vasospasm infrequently showed mild VWE (6.67% on early MRI and 9.09% on late MRI). Both mild VWE alone on early MRI and on late MRI were significantly associated with development of DCI during the admission (P = 0.034 and P = 0.035, respectively).
Conclusion:
Mild VWE on early MRI and vasospasm on late MRI were significantly more prevalent in high-risk and DCI patients suggesting VWI might enable imaging of early neuroinflammatory changes which are part of the pathomechanism of vasospasm and DCI.
Insights
Vessel wall enhancement on early MRI and vasospasm on late MRI in aneurysmal subarachnoid hemorrhage patients are linked to higher risk and delayed cerebral ischemia. Vessel wall imaging may detect early neuroinflammation.
Area of Science:
- Neuroimaging
- Vascular Neurology
- Radiology
Background:
- Aneurysmal subarachnoid hemorrhage (aSAH) poses significant risks, including delayed cerebral ischemia (DCI).
- Understanding the spatiotemporal evolution of vessel wall changes post-aSAH is crucial for predicting outcomes.
- Vessel wall imaging (VWI) offers a potential tool to visualize these changes.
Purpose of the Study:
- To investigate the spatiotemporal pattern of vessel wall changes using serial MRI in aSAH patients.
- To analyze the association of these changes with clinicoradiologic severity and DCI.
- To explore the potential of VWI in identifying early neuroinflammatory processes.
Main Methods:
- 32 aSAH patients underwent serial VWI MRI (early and late).
- Vessel wall enhancement (VWE), vasospasm, and diffusion-weighted imaging (DWI) lesions were assessed.
- Findings were correlated with clinicoradiologic severity scores and DCI development.
Main Results:
- Mild VWE on early MRI was more frequent in high-risk patients (36.7% vs. 20.0%, P=0.024).
- Vasospasm on late MRI was significantly more common in high-risk patients (27.2% vs. 4.5%, P=0.022).
- Mild VWE (early and late MRI) was significantly associated with DCI development (P=0.034 and P=0.035).
Conclusions:
- Mild VWE on early MRI and vasospasm on late MRI are prevalent in high-risk and DCI patients.
- VWI may detect early neuroinflammatory changes contributing to vasospasm and DCI.
- Serial VWI could enhance the understanding and management of aSAH complications.
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