The contribution of vessel wall magnetic resonance imaging to the diagnosis of primary and secondary central nervous system vasculitis

Background: To describe high-resolution brain vessel wall MRI (VW-MRI) patterns and morphological brain findings in central nervous system (CNS) vasculitis patients. Methods: Fourteen patients with confirmed CNS Vasculitis from two tertiary centers underwent VW-MRI using a 3T scanner. The images wer...

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Detalles Bibliográficos
Autores: D'Aniello, Serena, Rustici, Arianna, Gramegna, Laura Ludovica, Godi, Claudia, Piccolo, Laura, Gentile, Mauro, Zini, Andrea, Carrozzi, Alessandro, Lodi, Raffaele, Tonon, Caterina, Dall'Olio, Massimo, Simonetti, Luigi, Chieffo, Raffaella, Anzalone, Nicoletta, Cirillo, Luigi
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/70160
Acceso en línea:http://hdl.handle.net/10230/70160
http://dx.doi.org/10.3390/diagnostics14090927
Access Level:acceso abierto
Palabra clave:MRI
VWI
Cerebral vasculitis
Magnetic resonance
Vessel wall
Descripción
Sumario:Background: To describe high-resolution brain vessel wall MRI (VW-MRI) patterns and morphological brain findings in central nervous system (CNS) vasculitis patients. Methods: Fourteen patients with confirmed CNS Vasculitis from two tertiary centers underwent VW-MRI using a 3T scanner. The images were reviewed by two neuroradiologists to assess vessel wall enhancement characteristics and locations. Results: Fourteen patients were included (six females; average age 48 ± 19 years). Diagnoses included primary CNS vasculitis (PCNSV) in six patients and secondary CNS vasculitis (SCNSV) in eight, half of which were infection-related. Thirteen patients showed vessel wall enhancement, which was intense in eleven patients (84.6%) and concentric in twelve (92.3%), affecting the anterior circulation in nine patients (69.2%), posterior in two patients (15.4%), and both circulations in two patients (15.4%). The enhancement patterns were similar across different CNS vasculitis types. DWI changes corresponded with areas of vessel wall enhancement in 77% of patients. Conclusions: CNS vasculitis is often associated with intense, concentric vessel wall enhancement in VW-MRI, especially in the anterior circulation. The consistent presence of DWI alterations in affected territories suggests a possible link to microembolization or hypoperfusion. These imaging findings complement parenchymal brain MRI and MRA/DSA data, potentially increasing the possibility of a clinical diagnosis of CNS vasculitis.