Diagnostic Value of Contrast-Enhanced Vessel Wall Imaging in the Evaluation of Various Intracranial Non-Vascular Pathologies: A Single Center Experience

INTRODUCTION: Vessel Wall Imaging (VWI) is a relatively novel magnetic resonance imaging (MRI) technique primarily aimed at diagnosing vascular pathologies. In this study, we aimed to evaluate the diagnostic value of contrast-enhanced (CE) VWI in identifying various intracranial non-vascular pathologies.
METHODS: This retrospective study was approved by our institutional ethics committee with approval number 2022-05/17 on March 11, 2022. We retrospectively evaluated cranial CE-MRI, including the VWI sequence, of 189 patients (76 females and 113 males) who were referred to our radiology department for brain imaging for various reasons. MRI examinations were performed using a 3 Tesla unit. A single observer evaluated anonymized cranial MRI images without CE-VWI in addition to the relevant clinical information in a random order. The same observer interpreted the CE-VWI with relevant clinical information six weeks later. The findings, which could only be visualized on VWI in the second session, were noted.
RESULTS: In 10 patients of our study cohort (5.3%), VWI demonstrated pathological signal alterations or contrast enhancement (e.g., post-status frontal lobe pial enhancement in a patient with autoimmune epilepsy, contrast enhancement in the hippocampus in a diffusion-negative hyper-acute ischemic stroke patient, and optic disc enhancement in a patient with intracranial hypertension) that apparently reflected underlying clinical disorders, which otherwise could not be visualized on conventional MRI.
DISCUSSION AND CONCLUSION: CE-VWI might serve as a valuable adjunct for the diagnosis of various parenchymal or meningeal intracranial diseases, yet further, more comprehensive studies are needed to reveal the true potential of VWI.