title: High-resolution intracranial vessel wall imaging: imaging beyond the lumen.
abstract: Accurate and timely diagnosis of intracranial vasculopathies is important due to significant risk of morbidity with delayed and/or incorrect diagnosis both from the disease process as well as inappropriate therapies. Conventional vascular imaging techniques for analysis of intracranial vascular disease provide limited information since they only identify changes to the vessel lumen. New advanced MR intracranial vessel wall imaging (IVW) techniques can allow direct characterisation of the vessel wall. These techniques can advance diagnostic accuracy and may potentially improve patient outcomes by better guided treatment decisions in comparison to previously available invasive and non-invasive techniques. While neuroradiological expertise is invaluable in accurate examination interpretation, clinician familiarity with the application and findings of the various vasculopathies on IVW can help guide diagnostic and therapeutic decision-making. This review article provides a brief overview of the technical aspects of IVW and discusses the IVW findings of various intracranial vasculopathies, differentiating characteristics and indications for when this technique can be beneficial in patient management.
authors.affiliation: Department of Radiology, University of Washington, Seattle, Washington, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Alexander
authors.affiliation: Department of Radiology, University of Washington, Seattle, Washington, USA.
authors.forename: Chun
authors.initials: C
authors.lastname: Yuan
authors.affiliation: Department of Radiology, University of Washington, Seattle, Washington, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Rutman
authors.affiliation: Department of Neurology, University of Washington, Seattle, Washington, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Tirschwell
authors.affiliation: Department of Radiology, University of Washington, Seattle, Washington, USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: Palagallo
authors.affiliation: Department of Radiology, Neurology and Neurosurgery, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Gandhi
authors.affiliation: Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
authors.forename: Laligam N
authors.initials: LN
authors.lastname: Sekhar
authors.affiliation: Department of Radiology, University of Washington, Seattle, Washington, USA.
authors.forename: Mahmud
authors.initials: M
authors.lastname: Mossa-Basha
mesh_terms: D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography; D009131:Muscle, Smooth, Vascular / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity
keywords: ARTERIAL DISSECTION; CEREBROVASCULAR DISEASE; MRA; MRI; STROKE