Abstract
High-resolution magnetic resonance vessel wall imaging (VWI) permits direct visualization of intracranial arterial wall pathology, providing diagnostic and prognostic information that is complementary to conventional imaging techniques. We highlight the most recent studies that have advanced the clinical application of VWI. VWI aids in distinguishing and diagnosing intracranial atherosclerotic disease (ICAD), intracranial dissections, central nervous system vasculitis, reversible cerebral vasoconstriction syndrome, and moyamoya disease. VWI may help predict recurrent stroke in ICAD, treatment effects in vasculitis, and disease progression in moyamoya. VWI also identifies ruptured intracranial aneurysms and may predict stability of unruptured aneurysms. Implementing VWI as an adjunctive imaging technique may permit earlier and noninvasive discrimination of rare vasculopathies. However the prognostic utility of VWI for more common cerebrovascular pathologies requires further validation.
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