Diagnosing intracranial vasculitis: the roles of MR and angiography.
OBJECTIVE
To describe our experience with MR and angiography in diagnosing intracranial vasculitis and to test the hypothesis that MR can be used to screen for patients unlikely to have vasculitis.


METHODS
Ninety-two patients who had angiography with "exclude vasculitis" as the indication or who had angiography and a clinical diagnosis of vasculitis were identified. Angiograms of all 92 patients and the MRs of the 70 patients who had both studies were reviewed.


RESULTS
Eleven patients had intracranial vasculitis. Angiography showed characteristic changes in 8. MR, performed in 9 of 11 vasculitis cases, was significantly abnormal in all 9. Among 70 patients who had both studies, 19 had MR that was completely normal or showed only incidental findings. None of these 19 was diagnosed with vasculitis. The diagnostic yield of angiography performed to exclude vasculitis was only 6%.


CONCLUSIONS
Evaluation for intracranial vasculitis should include MR. A negative MR excludes intracranial vasculitis more definitively than does a negative angiogram and makes the likelihood of finding vasculitis with angiography negligible.
Harris
K G
KG
Department of Radiology, University of Iowa College of Medicine, Iowa City 52242-1077.
Tran
D D
DD
Sickels
W J
WJ
Cornell
S H
SH
Yuh
W T
WT
D000293:Adolescent; D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis; D016893:Carotid Stenosis / Q000175:diagnosis; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014657:Vasculitis / Q000175:diagnosis*