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<meta name="DC.Title" content="High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3909" />
<meta name="DC.Date" content="2014-04-10" />
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<meta name="DC.Description" content="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" />
<meta name="DC.Contributor" content="E.C. Obusez" />
<meta name="DC.Contributor" content="F. Hui" />
<meta name="DC.Contributor" content="R.A. Hajj-ali" />
<meta name="DC.Contributor" content="R. Cerejo" />
<meta name="DC.Contributor" content="L.H. Calabrese" />
<meta name="DC.Contributor" content="T. Hammad" />
<meta name="DC.Contributor" content="S.E. Jones" />
<meta name="article:published_time" content="2014-04-10" />
<meta name="article:section" content="BRAIN" />
<meta name="citation_title" content="High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_author" content="E.C. Obusez" />
<meta name="citation_author_institution" content="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." />
<meta name="citation_author" content="F. Hui" />
<meta name="citation_author_institution" content="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." />
<meta name="citation_author" content="R.A. Hajj-ali" />
<meta name="citation_author_institution" content="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." />
<meta name="citation_author" content="R. Cerejo" />
<meta name="citation_author_institution" content="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." />
<meta name="citation_author" content="L.H. Calabrese" />
<meta name="citation_author_institution" content="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." />
<meta name="citation_author" content="T. Hammad" />
<meta name="citation_author_institution" content="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." />
<meta name="citation_author" content="S.E. Jones" />
<meta name="citation_author_institution" content="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." />
<meta name="twitter:title" content="High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="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" />
<meta name="og-title" property="og:title" content="High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2014/04/10/ajnr.A3909" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="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" />
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      <h1 class="highwire-cite-title" id="page-title">High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">E.C. Obusez</span>, <span class="highwire-citation-author" data-delta="1">F. Hui</span>, <span class="highwire-citation-author" data-delta="2">R.A. Hajj-ali</span>, <span class="highwire-citation-author" data-delta="3">R. Cerejo</span>, <span class="highwire-citation-author" data-delta="4">L.H. Calabrese</span>, <span class="highwire-citation-author" data-delta="5">T. Hammad</span> and <span class="highwire-citation-author" data-delta="6">S.E. Jones</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">April 2014,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3909 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-50608--61707811104" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">E.C. Obusez </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>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.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.C.%2BObusez%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Obusez%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AE.C.%2BObusez%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">F. Hui </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>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.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BHui%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hui%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AF.%2BHui%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">R.A. Hajj-ali </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>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.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.A.%2BHajj-ali%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hajj-ali%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.A.%2BHajj-ali%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">R. Cerejo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>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.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BCerejo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Cerejo%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2BCerejo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">L.H. Calabrese </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>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.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.H.%2BCalabrese%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Calabrese%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.H.%2BCalabrese%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">T. Hammad </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>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.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BHammad%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hammad%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.%2BHammad%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">S.E. 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