High resolution 3T MRI for the assessment of cervical and superficial cranial arteries in giant cell arteritis

Abstract

A new high-resolution MR protocol for the combined assessment of neurovascular arterial anatomy and subsequent evaluation of inflammatory disease in cranial vessels walls has been investigated. First-pass contrast-enhanced MR angiography (CE-MRA) in combination with parallel imaging at high field permits the depiction of the neurovascular geometry with large coverage, including the aortic arch, supraaortic vessels, and almost the entire head, with high, submillimeter detail. Utilizing the remaining contrast agent, postcontrast T(1)-weighted turbo spin-echo (TSE) imaging was used to generate late enhancement images of the vessel walls to assess the morphology and potential inflammatory changes in cranial arteries with high in-plane (195 x 260 microm(2)) spatial resolution. As a result, a combined analysis of neurovascular arterial anatomy as well as cranial vessel wall inflammations could be achieved in less than 45 minutes in all studies. The feasibility and clinical value for the diagnosis of rheumatologic diseases and simultaneous arteriosclerotic involvement was demonstrated in seven patients with suspected giant cell arteritis (GCA). Excellent CE-MRA image quality could be achieved and even vascular geometry of small superficial cranial arteries could be successfully visualized using single dose (0.1 mmol/kg) contrast agent administration and a dedicated phased-array head and neck coil at 3T.