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High-resolution intracranial vessel wall imaging: imaging beyond the lumen
  1. Matthew D Alexander1,
  2. Chun Yuan1,
  3. Aaron Rutman1,
  4. David L Tirschwell2,
  5. Gerald Palagallo1,
  6. Dheeraj Gandhi3,
  7. Laligam N Sekhar4,
  8. Mahmud Mossa-Basha1
  1. 1Department of Radiology, University of Washington, Seattle, Washington, USA
  2. 2Department of Neurology, University of Washington, Seattle, Washington, USA
  3. 3Department of Radiology, Neurology and Neurosurgery, University of Maryland, Baltimore, Maryland, USA
  4. 4Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Mahmud Mossa-Basha, Department of Radiology, University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195, USA; mmossab{at}


Accurate and timely diagnosis of intracranial vasculopathies is important due to significant risk of morbidity with delayed and/or incorrect diagnosis both from the disease process as well as inappropriate therapies. Conventional vascular imaging techniques for analysis of intracranial vascular disease provide limited information since they only identify changes to the vessel lumen. New advanced MR intracranial vessel wall imaging (IVW) techniques can allow direct characterisation of the vessel wall. These techniques can advance diagnostic accuracy and may potentially improve patient outcomes by better guided treatment decisions in comparison to previously available invasive and non-invasive techniques. While neuroradiological expertise is invaluable in accurate examination interpretation, clinician familiarity with the application and findings of the various vasculopathies on IVW can help guide diagnostic and therapeutic decision-making. This review article provides a brief overview of the technical aspects of IVW and discusses the IVW findings of various intracranial vasculopathies, differentiating characteristics and indications for when this technique can be beneficial in patient management.

  • MRA
  • MRI

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