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Correlation of angiography and MR imaging in cerebral vasculitis

H J Cloft1, C D Phillips, J E Dix

  • 1Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.

Insights

Cerebral angiography is more reliable than MR imaging for diagnosing primary angiitis of the central nervous system (PACNS). Angiography is recommended for suspected PACNS, even with normal MR findings.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Imaging

Background:

  • Primary angiitis of the central nervous system (PACNS) is a rare condition affecting blood vessels in the brain.
  • Accurate diagnosis is crucial for timely treatment and improved patient outcomes.

Purpose of the Study:

  • To compare the diagnostic utility of MR imaging and cerebral angiography in patients with PACNS.
  • To determine the relative roles of these imaging modalities in diagnosing PACNS.

Main Methods:

  • Retrospective analysis of MR imaging and cerebral angiography in 9 patients diagnosed with PACNS.
  • Assessment of vascular territory involvement (anterior, middle, posterior cerebral arteries, posterior fossa).

Main Results:

  • All patients exhibited angiographic evidence of vasculitis in multiple vascular territories.
  • MR imaging findings varied from normal to abnormal; one patient had a completely normal MR.
  • 17 out of 50 (34%) affected vascular territories appeared normal on MR imaging despite angiographic evidence of vasculitis.

Conclusions:

  • MR imaging is less sensitive than cerebral angiography for detecting PACNS.
  • Cerebral angiography remains the gold standard for diagnosing PACNS when clinical suspicion is high.
  • Angiography is indicated irrespective of MR imaging results in suspected PACNS cases.
Abstract

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