Clinical implications of vessel wall imaging-State-of-the-art review

Area of Science:

• Radiology
• Neuroimaging
• Vascular Medicine

Background:

• Arterial wall diseases, including atherosclerosis, dissections, vasculitis, and occlusions, can cause significant neurovascular events like stroke.
• Luminal imaging is insufficient for assessing the full extent of arterial wall pathology.
• Vessel wall MRI provides direct visualization of arterial wall pathology, aiding clinical diagnosis and management.

Purpose of the Study:

• To review the importance and clinical applications of carotid and intracranial vessel wall MRI in neurovascular pathologies.
• To discuss recent advancements, including carotid Plaque-RADS risk scoring and intracranial vasculopathy differentiation.
• To cover technical requirements for vessel wall MRI and future diagnostic approaches.

Main Methods:

• Review of current literature on vessel wall MRI techniques and applications.
• Discussion of diagnostic criteria and risk stratification tools.
• Exploration of emerging technologies and future directions in neurovascular imaging.

Main Results:

• Vessel wall MRI is superior to luminal imaging for diagnosing arterial wall diseases.
• Carotid and intracranial vessel wall MRI are vital for assessing pathologies like atherosclerosis, dissections, and vasculitis.
• Recent developments enhance risk stratification and differentiation of neurovascular conditions.

Conclusions:

• Vessel wall MRI is essential for accurate diagnosis and management of carotid and intracranial arterial diseases.
• Advancements in vessel wall MRI are improving stroke risk assessment and etiological classification.
• Future developments promise further refinement in diagnosing and managing neurovascular pathologies.