Vasa vasorum of proximal cerebral arteries after dural crossing - potential imaging confounder in diagnosing intracranial vasculitis in elderly subjects on black-blood MRI

Please always quote using this URN: urn:nbn:de:bvb:20-opus-266524
  • Objectives Vessel wall enhancement (VWE) may be commonly seen on MRI images of asymptomatic subjects. This study aimed to characterize the VWE of the proximal internal carotid (ICA) and vertebral arteries (VA) in a non-vasculitic elderly patient cohort. Methods Cranial MRI scans at 3 Tesla were performed in 43 patients (aged ≥ 50 years) with known malignancy for exclusion of cerebral metastases. For vessel wall imaging (VWI), a high-resolution compressed-sensing black-blood 3D T1-weighted fast (turbo) spin echo sequence (T1 CS-SPACEObjectives Vessel wall enhancement (VWE) may be commonly seen on MRI images of asymptomatic subjects. This study aimed to characterize the VWE of the proximal internal carotid (ICA) and vertebral arteries (VA) in a non-vasculitic elderly patient cohort. Methods Cranial MRI scans at 3 Tesla were performed in 43 patients (aged ≥ 50 years) with known malignancy for exclusion of cerebral metastases. For vessel wall imaging (VWI), a high-resolution compressed-sensing black-blood 3D T1-weighted fast (turbo) spin echo sequence (T1 CS-SPACE prototype) was applied post gadolinium with an isotropic resolution of 0.55 mm. Bilateral proximal intradural ICA and VA segments were evaluated for presence, morphology, and longitudinal extension of VWE. Results Concentric VWE of the proximal intradural ICA was found in 13 (30%) patients, and of the proximal intradural VA in 39 (91%) patients. Mean longitudinal extension of VWE after dural entry was 13 mm in the VA and 2 mm in the ICA. In 14 of 39 patients (36%) with proximal intradural VWE, morphology of VWE was suggestive of the mere presence of vasa vasorum. In 25 patients (64 %), morphology indicated atherosclerotic lesions in addition to vasa vasorum. Conclusions Vasa vasorum may account for concentric VWE within the proximal 2 mm of the ICA and 13 mm of the VA after dural entry in elderly subjects. Concentric VWE in these locations should not be confused with large artery vasculitis. Distal to these segments, VWE may be more likely related to pathologic conditions such as vasculitis.show moreshow less

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Metadaten
Author: Konstanze Viktoria Guggenberger, Giulia Dalla Torre, Ute Ludwig, Patrick Vogel, Andreas Max Weng, Marius Lothar Vogt, Matthias Fröhlich, Marc Schmalzing, Esther Raithel, Christoph Forman, Horst Urbach, Stephan Meckel, Thorsten Alexander Bley
URN:urn:nbn:de:bvb:20-opus-266524
Document Type:Journal article
Faculties:Fakultät für Physik und Astronomie / Physikalisches Institut
Medizinische Fakultät / Institut für diagnostische und interventionelle Neuroradiologie (ehem. Abteilung für Neuroradiologie)
Language:English
Parent Title (English):European Radiology
ISSN:1432-1084
Year of Completion:2022
Volume:32
Issue:2
Pagenumber:1276–1284
Source:European Radiology 2022, 32(2):1276–1284. DOI: 10.1007/s00330-021-08181-5
DOI:https://doi.org/10.1007/s00330-021-08181-5
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=34347156
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:Atherosclerosis, intracranial arteries; large artery vasculitis; magnetic resonance imaging; vasa vasorum; vertebral artery
Release Date:2022/08/03
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International