High-resolution MRI vessel wall imaging in varicella zoster virus vasculopathy.
Contrast-enhanced vessel wall imaging high-resolution MRI (HRMR) has revealed vessel wall thickening and enhancement in multiple intracranial vasculopathies, including varicella zoster virus (VZV) vasculopathy. We retrospectively reviewed a database of patients with virologically-verified VZV vasculopathy, who underwent initial and follow-up HRMR between April 2011 and May 2014. Six patients were identified. Baseline demographic and clinical characteristics were collected, including stroke risk factors, history of VZV-related disorders, neurological presentation, course and antiviral treatment. Initial HRMR in patients with VZV vasculopathy demonstrated various patterns of stenosis, vessel wall thickening and enhancement, predominantly in terminal internal carotid artery segments and the M1 segment of the middle cerebral arteries. Follow-up HRMR showed improvement of stenosis, with reduced vessel wall thickening and enhancement at multiple times after treatment. HRMR has the potential to assist in diagnosis and treatment of VZV vasculopathy.
Department of Neuroradiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
Esteban
E
Cheng-Ching
Department of Neuroradiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
Stephen
S
Jones
Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Ferdinand K
FK
Hui
Department of Neurology, Wright State University, Dayton, OH, USA.
Shumei
S
Man
Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Microbiology and Immunology, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: don.gilden@ucdenver.edu.
Don
D
Gilden
Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
Adarsh
A
Bhimraj
Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Ken
K
Uchino
D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000209:etiology / Q000473:pathology*; D002539:Cerebral Arterial Diseases / Q000209:etiology / Q000473:pathology*; D005260:Female; D006562:Herpes Zoster / Q000150:complications*; D014645:Herpesvirus 3, Human / Q000472:pathogenicity*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D012189:Retrospective Studies
Angiography; High-resolution; MRI; Treatment; Varicella zoster virus; Vasculopathy