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Research ArticleBRAIN

High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

E.C. Obusez, F. Hui, R.A. Hajj-ali, R. Cerejo, L.H. Calabrese, T. Hammad and S.E. Jones
American Journal of Neuroradiology April 2014, DOI: https://doi.org/10.3174/ajnr.A3909
E.C. Obusez
From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute; Cerebrovascular Center (F.H.); Department of Neurology (R.A.H., R.C.), Neurological Institute; and Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio.
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F. Hui
From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute; Cerebrovascular Center (F.H.); Department of Neurology (R.A.H., R.C.), Neurological Institute; and Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio.
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R.A. Hajj-ali
From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute; Cerebrovascular Center (F.H.); Department of Neurology (R.A.H., R.C.), Neurological Institute; and Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio.
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R. Cerejo
From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute; Cerebrovascular Center (F.H.); Department of Neurology (R.A.H., R.C.), Neurological Institute; and Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio.
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L.H. Calabrese
From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute; Cerebrovascular Center (F.H.); Department of Neurology (R.A.H., R.C.), Neurological Institute; and Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio.
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T. Hammad
From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute; Cerebrovascular Center (F.H.); Department of Neurology (R.A.H., R.C.), Neurological Institute; and Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio.
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S.E. Jones
From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute; Cerebrovascular Center (F.H.); Department of Neurology (R.A.H., R.C.), Neurological Institute; and Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio.
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Abstract

BACKGROUND AND PURPOSE: High-resolution MR imaging is an emerging tool for evaluating intracranial artery disease. It has an advantage of defining vessel wall characteristics of intracranial vascular diseases. We investigated high-resolution MR imaging arterial wall characteristics of CNS vasculitis and reversible cerebral vasoconstriction syndrome to determine wall pattern changes during a follow-up period.

MATERIALS AND METHODS: We retrospectively reviewed 3T-high-resolution MR imaging vessel wall studies performed on 26 patients with a confirmed diagnosis of CNS vasculitis and reversible cerebral vasoconstriction syndrome during a follow-up period. Vessel wall imaging protocol included black-blood contrast-enhanced T1-weighted sequences with fat suppression and a saturation band, and time-of-flight MRA of the circle of Willis. Vessel wall characteristics including enhancement, wall thickening, and lumen narrowing were collected.

RESULTS: Thirteen patients with CNS vasculitis and 13 patients with reversible cerebral vasoconstriction syndrome were included. In the CNS vasculitis group, 9 patients showed smooth, concentric wall enhancement and thickening; 3 patients had smooth, eccentric wall enhancement and thickening; and 1 patient was without wall enhancement and thickening. Six of 13 patients had follow-up imaging; 4 patients showed stable smooth, concentric enhancement and thickening; and 2 patients had resoluton of initial imaging findings. In the reversible cerebral vasoconstriction syndrome group, 10 patients showed diffuse, uniform wall thickening with negligible-to-mild enhancement. Nine patients had follow-up imaging, with 8 patients showing complete resolution of the initial findings.

CONCLUSIONS: Postgadolinium 3T-high-resolution MR imaging appears to be a feasible tool in differentiating vessel wall patterns of CNS vasculitis and reversible cerebral vasoconstriction syndrome changes during a follow-up period.

Abbreviations

HRMRI
high-resolution MR imaging
RCVS
reversible cerebral vasoconstriction syndrome
  • © 2014 American Society of Neuroradiology
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High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis
E.C. Obusez, F. Hui, R.A. Hajj-ali, R. Cerejo, L.H. Calabrese, T. Hammad, S.E. Jones
American Journal of Neuroradiology Apr 2014, DOI: 10.3174/ajnr.A3909

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High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis
E.C. Obusez, F. Hui, R.A. Hajj-ali, R. Cerejo, L.H. Calabrese, T. Hammad, S.E. Jones
American Journal of Neuroradiology Apr 2014, DOI: 10.3174/ajnr.A3909
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