Three-dimensional intra- and extracranial arterial vessel wall joint imaging in patients with cerebrovascular disease

Abstract Purpose To evaluate the clinical performance of a newly developed three-dimensional (3D) intra- and extracranial arterial vessel wall joint imaging technique at 3 Tesla using T1-weighted 3D variable-flip-angle turbo spin-echo sequence with improved cerebrospinal fluid suppression in patients with cerebrovascular disease Materials and Methods 122 consecutive patients (mean age 45.96 ± 12.16 years) with clinically confirmed cerebrovascular symptoms were imaged using a 3D intra- and extracranial arterial vessel wall joint imaging sequence with and without contrast enhancement on a 3 T MR system. The number of plaques and culprit plaques were evaluated. The image quality score, percent stenosis, remodeling ratio, and plaque burden were measured and compared between intracranial and carotid arterial plaques, and between non-culprit and culprit plaques. Results Except for 23 patients, there were 322 plaques (111 culprit plaques) detected in 96 patients with large artery atherosclerosis. Of the plaques, 278 (96 culprit plaques) and 44 (15 culprit plaques) plaques were identified in intracranial and extracranial arteries, respectively. Image quality did not differ significantly between pre- and post-contrast vessel wall magnetic resonance images. There were also no significant differences in the percent stenosis, remodeling ratio, and plaque burden between intracranial and carotid arteries, and between non-culprit and culprit plaques. The enhancement rate of culprit plaques was significantly higher than that of non-culprit plaques. Conclusions The described joint imaging is a promising vessel wall magnetic resonance imaging method for comprehensive diagnosis of cerebrovascular symptoms and investigation of etiology. The imaging technique is a potentially valuable means to optimize treatment.