Magnetic resonance imaging in the evaluation of the pathologies affecting large intracranial arteries

Our aim is to describe the utility of magnetic resonance imaging (MRI) in the evaluation of pathologies affecting large intracranial arteries.

We performed a prospective and observational study from 2018 to 2020 using 1.5 T MRI. Our study included 75 patients who were referred for MRI brain with clinical features of stroke or having tumors/infection involving large intracranial arteries (vertebral, basilar, and internal carotid arteries) on initial MRI. Correlation of MRI diagnosis was done with final diagnosis.

Atherothrombosis was the most common pathology involving all the intracranial large arteries and was most commonly seen in elderly male patients. The second most common pathology involving the internal carotid, vertebral, and basilar arteries was tumors, dissection, and aneurysms, respectively. The most common artery involved by atherothrombosis, tumor, and infection/inflammation was internal carotid artery, whereas it was basilar artery and vertebral artery in cases of aneurysm and dissection, respectively.

MRI is an extremely useful modality to study large intracranial arteries. It is useful to demonstrate the site of abnormality, vessel lumen and caliber, vessel wall changes, and perivascular areas. This can help in arriving at correct diagnosis and thereby guide appropriate timely management.