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Updated: Jul 1, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Imaging of intracranial arterial disease: a comparison between MRI and unenhanced CT
Carlo Lucci1, Ina Rissanen2, Richard A P Takx1
1Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands.
Insights
Intracranial arterial disease assessment differs between CT-detected calcifications and MRI-detected vessel wall lesions. While lesion numbers correlate with calcification severity, their distributions vary, suggesting a combined imaging approach is necessary.
Area of Science:
- Neuroimaging
- Vascular Neurology
- Radiology
Background:
- Intracranial arterial disease is often assessed using unenhanced CT for arterial calcifications and MRI for vessel wall lesions.
- The comparative pathology depicted by these imaging modalities remains unclear.
- This study investigates the relationship between these findings in patients with cerebrovascular disease history.
Purpose of the Study:
- To compare the presence and distribution of arterial calcifications on CT and vessel wall lesions on MRI.
- To determine if these imaging findings are interchangeable in evaluating intracranial arterial disease.
- To assess the association between vessel wall lesions and arterial calcifications.
Main Methods:
- Analysis of CT and 7 Tesla MRI data from 78 patients with stroke or TIA.
- Visual assessment of vessel wall lesions and arterial calcifications in intracranial arteries.
- Evaluation focused on the intracranial internal carotid artery (iICA) and vertebral arteries (VA).
Main Results:
- 69% of patients showed at least one imaging finding.
- The iICA and VA demonstrated both calcifications and vessel wall lesions.
- A significant association was found between the number of vessel wall lesions and iICA calcification severity (p=0.013).
Conclusions:
- Vessel wall lesion counts increase with intracranial internal carotid artery calcification severity.
- Significant differences exist in the distribution of vessel wall lesions (MRI) versus arterial calcifications (CT).
- A combined imaging approach is recommended for comprehensive assessment of intracranial arterial disease.
Background And Purpose:
Arterial calcifications on unenhanced CT scans and vessel wall lesions on MRI are often used interchangeably to portray intracranial arterial disease. However, the extent of pathology depicted with each technique is unclear. We investigated the presence and distribution of these two imaging findings in patients with a history of cerebrovascular disease.
Materials And Methods:
We analyzed CT and MRI data from 78 patients admitted for stroke or TIA at our institution. Vessel wall lesions were assessed on 7 T MRI sequences, while arterial calcifications were assessed on CT scans. The number of vessel wall lesions, severity of intracranial internal carotid artery (iICA) calcifications, and overall presence and distribution of the two imaging findings were visually assessed in the intracranial arteries.
Results:
At least one vessel wall lesion or arterial calcification was assessed in 69 (88%) patients. Only the iICA and vertebral arteries (VA) showed a substantial number of both calcifications and vessel wall lesions. The other vessels showed almost exclusively vessel wall lesions. The number of vessel wall lesions was associated with the severity of iICA calcification (p = 0.013).
Conclusions:
The number of vessel wall lesions increases with the severity of iICA calcifications. Nonetheless, the distribution of vessel wall lesions on MRI and arterial calcifications on CT shows remarkable differences. These findings support the need for a combined approach to examine intracranial arterial disease.
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