Usefulness of Different Imaging Methods in the Diagnosis of Cerebral Vasculopathy

Assessment of cerebral vasculopathies is challenging and can be facilitated by a comprehensive understanding of the available imaging methods and their utility. There are several angiographic techniques that can image the vessel lumen, each with unique advantages and disadvantages. Bolus-based angiographic methods such as CTA and CE-MRA require careful timing of a contrast bolus to enhance arterial conspicuity while minimizing venous enhancement. Non-contrast MRA techniques such as TOF and PC-MRA do not require contrast and are useful for showing arteries with high spatial resolution and little to no venous contamination. While digital subtraction angiography (DSA) remains the gold standard of angio-graphic techniques due to its exquisite spatial resolution, it is invasive and usually not the initial study of choice. In contrast to techniques that rely on depiction of the lumen, VW-MRI offers a non-invasive means of assessing vessel wall pathology and provide further characterization. In general, brain MRI offers relatively high sensitivity for the diagnosis of vasculitis and is useful in differentiating various non-inflammatory vasculopathies.

Automated summary

Assessment of cerebral vasculopathies can be challenging, but a comprehensive understanding of different imaging methods can facilitate the process. There are various angiographic techniques with unique advantages and disadvantages, such as bolus-based methods that enhance arterial depiction and non-contrast techniques that show high-resolution arteries. MRI can assess vessel wall pathology and aid in diagnosing vasculitis and non-inflammatory vasculopathies.