In this selected retrospective case series of patients evaluated for suspected inflammatory intracranial vasculopathy, 3T HR-VWI commonly demonstrated concentric vessel wall enhancement and provided descriptive longitudinal information regarding enhancement evolution.
Vessel wall enhancement (VWE) was present in all 19 patients, with a purely concentric pattern predominating.
The middle cerebral artery and internal carotid artery were the most commonly involved vessels.
VWE grade decreased in the majority of patients on follow-up HR-VWI.
Maximum wall thickness decreased in nearly all patients with paired examinations on follow-up.
The study cohort was predominantly female with a middle-aged demographic and variable follow-up duration.
The authors explicitly caution that findings should not be interpreted as evidence of diagnostic performance.
This research examined a specialized MRI technique called high-resolution vessel wall imaging (HR-VWI), performed at 3 Tesla field strength, in 19 patients who were suspected of having inflammatory disease affecting the blood vessels of the brain. The MRI scans allowed doctors to look closely at the walls of intracranial arteries — something not easily visible on standard brain MRI. At baseline, all 19 patients showed abnormal enhancement (brightening with contrast dye) of their vessel walls, and in most cases this enhancement appeared in a ring-like, or 'concentric,' pattern around the vessel. The arteries most commonly affected were the middle cerebral artery and internal carotid artery, which are major vessels supplying the brain. Among the 17 patients who had repeat MRI scans over a follow-up period ranging from about two weeks to over 11 years (median roughly 13 months), the majority showed improvement: vessel wall enhancement decreased in 13 of 17 patients, and vessel wall thickness decreased in 16 of 17 patients. No patients showed worsening of enhancement on follow-up. These longitudinal changes suggest that HR-VWI can track disease activity over time in patients with suspected inflammatory brain vessel disease. This research suggests that 3T HR-VWI may be a useful tool for monitoring changes in the walls of brain arteries in patients suspected of having inflammatory vasculopathy. However, the authors emphasize that because this was a small, retrospective descriptive study without a control group, the findings cannot be used to draw conclusions about how accurate or reliable this technique is for diagnosing the condition. Larger, prospective studies with standardized diagnostic criteria would be needed to establish the clinical value of this imaging approach.
Basar Y, Orman M, Ozdemir Gultekin T, Karaarslan E, Islak C. (2026). High-Resolution 3T Intracranial Vessel Wall MRI in Patients Evaluated for Suspected Inflammatory Intracranial Vasculopathy: Morphologic and Follow-Up Findings from a Retrospective Case Series.. Tomography (Ann Arbor, Mich.). https://doi.org/10.3390/tomography12080116