title: Vessel wall MRI to differentiate between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis: preliminary results.
abstract: OBJECTIVE
  Prospective differentiation between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis can be challenging. We hypothesized that high-resolution vessel wall MRI would demonstrate arterial wall enhancement in central nervous system vasculitis but not in reversible cerebral vasoconstriction syndrome.
  
  
  METHODS
  We identified all patients with multifocal segmental narrowing of large intracranial arteries who had high-resolution vessel wall MRI and follow-up angiography at our institute over a 4-year period and performed a detailed chart review.
  
  
  RESULTS
  Three patients lacked arterial wall enhancement, and these all had reversal of arterial narrowing within 3 months. Four patients demonstrated arterial wall enhancement, and these had persistent or progressive arterial narrowing at a median follow-up of 17 months (range, 6-36 months) with final diagnoses of central nervous system vasculitis (3) and cocaine vasculopathy (1).
  
  
  CONCLUSIONS
  Preliminary results suggest that high-resolution contrast-enhanced vessel wall MRI may enable differentiation between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis.
authors.affiliation: Division of Neuroradiology, Toronto Western Hospital and the University of Toronto, Toronto, Ontario, Canada.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Mandell
authors.forename: Charles C
authors.initials: CC
authors.lastname: Matouk
authors.forename: Richard I
authors.initials: RI
authors.lastname: Farb
authors.forename: Timo
authors.initials: T
authors.lastname: Krings
authors.forename: Ronit
authors.initials: R
authors.lastname: Agid
authors.forename: Karel
authors.initials: K
authors.lastname: terBrugge
authors.forename: Robert A
authors.initials: RA
authors.lastname: Willinsky
authors.forename: Richard H
authors.initials: RH
authors.lastname: Swartz
authors.forename: Frank L
authors.initials: FL
authors.lastname: Silver
authors.forename: David J
authors.initials: DJ
authors.lastname: Mikulis
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D002539:Cerebral Arterial Diseases / Q000175:diagnosis*; D002536:Cerebral Arteries / Q000473:pathology*; D019970:Cocaine-Related Disorders / Q000150:complications; D003251:Constriction, Pathologic / Q000473:pathology; D016208:Databases, Factual; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020293:Vasculitis, Central Nervous System / Q000139:chemically induced / Q000175:diagnosis*; D014661:Vasoconstriction; D055815:Young Adult