Predictors of improvement for patients with CNS vasculitis stenoses: A high-resolution vessel wall MRI follow-up study

Purpose: To investigate the predictors of the improvement for patients with isolated intracranial vasculitis ste-noses using high-resolution vessel wall magnetic resonance imaging (HR VW-MRI). Methods: We retrospectively reviewed data from consecutive patients with confirmed intracranial vasculitis under the same conventional conservative treatment based on a prospectively established HR VW-MRI database between December 2016 and December 2020. According to the changes between the degree of stenosis at baseline compared to follow-up MR angiography, the patients were divided into an improvement group and a non-improvement group. A multivariate analysis was performed to identify the predictive factors associated with the improvement of stenoses secondary to intracranial vasculitis. Results: Overall, 41 patients (mean age 32.0 +/- 10.1 years, 16 females) with isolated intracranial vasculitis ste-noses were included (41.5 % [17/41] in the improvement group, and 58.5 % [24/41] were in the non -improvement group). The degree of wall enhancement on follow-up imaging was significantly reduced compared with that on the baseline imaging in the improvement group (P = 0.004). The multivariate analysis showed that the degree of enhancement (OR, 0.219, 95 % CI, 0.054 to 0.881; P = 0.033) at baseline was an independent predictive factor associated with the improvement in the intracranial vasculitis stenoses. Conclusions: In patients with isolated intracranial vasculitis stenoses, the less enhancement the vessel wall was, the more likely the degree of stenosis would be reduced by conventional conservative therapy.

Automated summary

This study aimed to investigate the predictors of improvement in patients with isolated intracranial vasculitis stenoses using high-resolution vessel wall magnetic resonance imaging (HR VW-MRI). The degree of wall enhancement at baseline was found to be an independent predictive factor associated with the improvement in intracranial vasculitis stenoses. Therefore, a lower degree of wall enhancement is more likely to result in reduced stenosis in patients undergoing conventional conservative therapy.