Intracranial Vessel Wall MR Imaging: From Bench to Bedside

Abstract

Intracranial vessel wall MR Imaging is an emerging MRI-technique that has gained an increasing popularity in the last decade because of its potential applications in a variety of intracranial vascular diseases. However, intracranial vessel wall MRI has not been systematically applied in clinical setting yet. In this thesis, the clinical translation has been made from research to clinical practice.

First, we describe how intracranial vessel wall MRI should be used and how the images should be interpreted. Second, we show with clinical-epidemiological studies the additional value of this MRI-technique. We show that vessel wall lesions, detected with intracranial vessel wall MRI, are associated with several cardiovascular risk factors and with damage of the brain parenchyma itself. Furthermore, we assess with ultra-high resolution (7 tesla) MRI possible vessel wall damage after intra-arterial thrombectomy (IAT). The results suggest reactive changes of the vessel wall after IAT which should be taken into consideration during follow-up MRI of the vessel wall.

Ultimately, we think that intracranial vessel wall MRI has the strong potential to be implemented in the workup and follow-up of patients with cerebrovascular disease, in risk management, and in diagnosing other vasculopathies, using it as non-invasive diagnostic tool to guide preventive and therapeutic decision-making.