title: Black blood MRI in suspected large artery primary angiitis of the central nervous system.
abstract: OBJECTIVE
  Single case reports suggest that black blood MRI (T1-weighted fat and blood suppressed sequences with and without contrast injection; BB-MRI) may visualize intracranial vessel wall contrast enhancement (CE) in primary angiitis of the central nervous system (PACNS). In this single-center observational pilot study we prospectively investigated the value of BB-MRI in the diagnosis of large artery PACNS.
  
  
  METHODS
  Patients with suspected large artery PACNS received a standardized diagnostic program including BB-MRI. Vessel wall CE was graded (grade 0-2) by two experienced readers blinded to clinical data and correlated to the final diagnosis.
  
  
  RESULTS
  Four of 12 included patients received a final diagnosis of PACNS. All of them showed moderate (grade 1) to strong (grade 2) vessel wall CE at the sites of stenosis. A moderate (grade 1) vessel wall CE grade was also observed in 6 of the remaining 8 patients in whom alternative diagnoses were made: arteriosclerotic disease (n = 4), intracranial dissection (n = 1), and Moyamoya disease (n = 1).
  
  
  CONCLUSIONS
  Our pilot study demonstrates that vessel wall CE is a frequent finding in PACNS and its mimics. Larger trials will be necessary to evaluate the utility of BB-MRI in the diagnostic workup of PACNS.
authors.affiliation: Department of Neurology, University of Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pfefferkorn
authors.forename: Jennifer
authors.initials: J
authors.lastname: Linn
authors.forename: Maximilian
authors.initials: M
authors.lastname: Habs
authors.forename: Christina
authors.initials: C
authors.lastname: Opherk
authors.forename: Clemens
authors.initials: C
authors.lastname: Cyran
authors.forename: Caroline
authors.initials: C
authors.lastname: Ottomeyer
authors.forename: Andreas
authors.initials: A
authors.lastname: Straube
authors.forename: Martin
authors.initials: M
authors.lastname: Dichgans
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.forename: Tobias
authors.initials: T
authors.lastname: Saam
mesh_terms: D000328:Adult; D000465:Algorithms; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D020293:Vasculitis, Central Nervous System / Q000473:pathology*