Intracranial Vessel Wall MRI in Clinical Practice: Technical Considerations, Current and Emerging Applications, Clinical Pearls and Pitfalls

M.C. Pinho, J.T. Hall, J.C. Cross, T. Shang, A.J. Madhuranthakam, and W.A. Moore and M. Hagiwara

View Article on Neurographics Website

Date of Activity Release: Apr. 1, 2018
Date of Activity Expiration: Apr. 1, 2021

Target Audience:
Intended for neuroradiologists and neuroradiology trainees with varying degrees of experience.

Learning Objective:
Understand the technical requirements and clinical implementation details of intracranial vessel wall MR imaging, recognize normal findings and the imaging appearances of common disease processes, and identify imaging pitfalls and current limitations.

Despite considerable advancements in imaging techniques, patients with stroke or intracranial hemorrhage may lack a specific diagnosis, even after an extensive diagnostic evaluation. One of the main underlying reasons for this shortcoming is that neurovascular imaging approaches have traditionally focused on the vessel lumen. Luminal imaging lacks both sensitivity and specificity in many clinical scenarios because luminal compromise may occur at advanced stages of disease and frequently does not offer insights about the underlying pathologic process. Most of the disease processes originate in the vessel wall, which has previously been technically difficult to image. MR imaging is an ideal technique for vessel wall imaging due to its versatility and exquisite soft-tissue contrast. Due to recent progress in imaging techniques, the translation of intracranial vessel wall MR imaging from research applications to routine clinical practice has become possible. The goal of this article was to familiarize readers with the technical underpinnings, normal findings, and current clinical applications of intracranial vessel wall MR imaging as well as to discuss limitations, pitfalls, and future perspectives for this exciting new imaging tool.

Commercial Support
No commercial support was received for this activity.

Credit Designation Statement

The American Society of Neuroradiology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Neuroradiology designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Physician Participation:
Each participant will review the corresponding Neurographics article located at Upon completion, each physician will complete and pass a post-test with a score of at least 80% to receive a CME certificate.

All individuals in control of content have disclosed the following relevant financial relationships. All of these relationships were treated as a conflict of interest, and have been resolved (C7 SCS 6.1-6.2, 6.5)

Authors have no relevant financial relationships.





Barton Branstetter 

Editor in Chief

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Adam Flanders

Deputy Editor

Royalties, Lippincott Williams and Wilkins

Robert Quencer 

Consulting Editor

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Associate Editor

Non-remunerative position, AUR6

Meng Law

Associate Editor

Stockholder, Clinical Imaging

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Associate Editor

Grant, Atherysys, Inc.; Royalties, Thieme Medical Publishers

Scott Faro

Associate Editor

None, N/A

Tina Young Poussaint

Associate Editor

None, N/A

Dheeraj Ghandi

Associate Editor

Grant, Arstasis, Axera Inc.; Consultant, Covidien, EV3

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