Magnetic Resonance Angiography with Black Blood as Routine for Evaluate Cerebrovascular Disease (P3.213)

Objective: To present a series of cases with clinical/radiological correlation in cerebrovascular disease (CD) that undergo a study of vessels wall, beyond the lumen, with Intracranial black-blood MRA. Background: New advanced techniques of vessels wall imaging in intracranial magnetic resonance angiography (MRA) may allow the direct characterization of the vascular wall with better evaluation of CD. Design/Methods: This single-blind study included patients under investigation for cerebrovascular diseases at BP Hospital, Sao Paulo, Brazil. The MRA patterns of intracranial vessel wall abnormalities were correlated with primary vascular insult and were assessed by one only radiologist using a 3 Tesla device, in sagittal T1-weighted SPACE sequence before and after gadolinium administration (black-blood technique). Results: 46 patients (60% men), the mean age was 57 years. Abnormalities in intracranial vessel wall was positive in 82,2% of patients, with 37,8%, 21,6%, and 2,7% for acute stroke, vessel stenosis, and TIA, respectively. The MR angiography with black-blood anatomical findings correlated extensively with the etiology and share a significant association with neurological deficits. Conclusions: Cerebral vascular disease evaluation is traditionally done through the study of luminal changes on vessels, which shows abnormality only when lumen is affected, without explain other pathological situations as non-stenotic plaque or elucidade disease activity. Black-blood provide a vessel wall analysis allowing an morphologic evaluation of atherosclerotic plaque, identifying disease activity and differential diagnoses in intracranial vascular stenoses. An evaluation of cerebrovascular disease traditionally done through vessel lumen study is limited to the identification of lumen stenosis, generating poor information about disease activity, instability or etiology. With the analysis of the vessel-wall with black-blood technique, it was possible a more sensitive evaluation in relation to the activity, severity and instability of the vascular insult, futhermore assisting diagnosis according to the patterns of enhancement in vessel wall. Study Supported by: Not applicable Disclosure: Dr. Teixeira has nothing to disclose. Dr. Siqueira Campos has nothing to disclose. Dr. Guimaraes de Queiroz has nothing to disclose. Dr. Ferreira Lima has nothing to disclose. Dr. Marussi has nothing to disclose. Dr. Baeta has nothing to disclose.