Intracranial Vessel Wall Imaging at 7.0-T MRI

Background And Purpose: Conventional imaging methods cannot depict the vessel wall of intracranial arteries at sufficient resolutions. This hampers the evaluation of intracranial arterial disease. The aim of the present study was to develop a high-resolution MRI method to image intracranial vessel wall.

Methods: We developed a volumetric (3-dimensional) turbo spin-echo (TSE) sequence for intracranial vessel wall imaging at 7.0-T MRI. Inversion recovery was used to null cerebrospinal fluid to increase contrast with the vessel wall. Magnetization preparation was applied before inversion to improve signal-to-noise ratio. Seven healthy volunteers and 35 patients with ischemic stroke or transient ischemic attack underwent imaging to test the magnetization preparation inversion recovery TSE sequence. Gadolinium-based contrast agent (Gadobutrol, 0.1 mL/kg) was administered to assess possible lesion enhancement in the patients.

Results: The walls of intracranial arterial vessels could be visualized in all volunteers and patients with good contrast between wall, blood, and cerebrospinal fluid. The quality of the vessel wall depiction was independent of the vessel orientation relative to the plane of acquisition. In 21 of the 35 patients, a total number of 52 intracranial vessel wall lesions were identified. Eleven of the 52 lesions showed enhancement after contrast administration. Only 14 of the 52 lesions resulted in stenosis of the arterial lumen.

Conclusions: Intracranial vessel wall and its pathology can be depicted with the magnetization preparation inversion recovery TSE sequence at 7.0 T. The magnetization preparation inversion recovery TSE sequence will make it possible to study the role of intracranial arterial wall pathology in ischemic stroke. Clinical Trial Registration Information- URL: http://www.trialregister.nl/trialreg/index.asp. Unique identifier: NTR2119.