Mahmud Mossa-Basha1, Dean K Shibata2, Danial K Hallam2, Adam de Havenon2, Daniel S Hippe2, Kyra J Becker2, David L Tirschwell2, Thomas Hatsukami2, Niranjan Balu2, Chun Yuan2. 1. From the Department of Radiology (M.M.-B., D.K.S., D.K.H., D.S.H., N.B., C.Y.), Department of Neurology (K.J.B., D.L.T.), and Department of Surgery (T.H.), University of Washington, Seattle; and Department of Neurology, University of Utah, Salt Lake City (A.D.H.). mmossab@uw.edu. 2. From the Department of Radiology (M.M.-B., D.K.S., D.K.H., D.S.H., N.B., C.Y.), Department of Neurology (K.J.B., D.L.T.), and Department of Surgery (T.H.), University of Washington, Seattle; and Department of Neurology, University of Utah, Salt Lake City (A.D.H.).
Abstract
BACKGROUND AND PURPOSE: Our goal is to determine the added value of intracranial vessel wall magnetic resonance imaging (IVWI) in differentiating nonocclusive vasculopathies compared with luminal imaging alone. METHODS: We retrospectively reviewed images from patients with both luminal and IVWI to identify cases with clinically defined intracranial vasculopathies: atherosclerosis (intracranial atherosclerotic disease), reversible cerebral vasoconstriction syndrome, and inflammatory vasculopathy. Two neuroradiologists blinded to clinical data reviewed the luminal imaging of defined luminal stenoses/irregularities and evaluated the pattern of involvement to make a presumed diagnosis with diagnostic confidence. Six weeks later, the 2 raters rereviewed the luminal imaging in addition to IVWI for the pattern of wall involvement, presence and pattern of postcontrast enhancement, and presumed diagnosis and confidence. Analysis was performed on per-lesion and per-patient bases. RESULTS: Thirty intracranial atherosclerotic disease, 12 inflammatory vasculopathies, and 12 reversible cerebral vasoconstriction syndrome patients with 201 lesions (90 intracranial atherosclerotic disease, 64 reversible cerebral vasoconstriction syndrome, and 47 inflammatory vasculopathy lesions) were included. For both per-lesion and per-patient analyses, there was significant diagnostic accuracy improvement with luminal imaging+IVWI when compared with luminal imaging alone (per-lesion: 88.8% versus 36.1%; P<0.001 and per-patient: 96.3% versus 43.5%; P<0.001, respectively). There was substantial interrater diagnostic agreement for luminal imaging+IVWI (κ=0.72) and only slight agreement for luminal imaging (κ=0.04). Although there was a significant correlation for both luminal and IVWI pattern of wall involvement with diagnosis, there was a stronger correlation for IVWI finding of lesion eccentricity and intracranial atherosclerotic disease diagnosis than for luminal imaging (κ=0.69 versus 0.18; P<0.001). CONCLUSIONS: IVWI can significantly improve the differentiation of nonocclusive intracranial vasculopathies when combined with traditional luminal imaging modalities.
BACKGROUND AND PURPOSE: Our goal is to determine the added value of intracranial vessel wall magnetic resonance imaging (IVWI) in differentiating nonocclusive vasculopathies compared with luminal imaging alone. METHODS: We retrospectively reviewed images from patients with both luminal and IVWI to identify cases with clinically defined intracranial vasculopathies: atherosclerosis (intracranial atherosclerotic disease), reversible cerebral vasoconstriction syndrome, and inflammatory vasculopathy. Two neuroradiologists blinded to clinical data reviewed the luminal imaging of defined luminal stenoses/irregularities and evaluated the pattern of involvement to make a presumed diagnosis with diagnostic confidence. Six weeks later, the 2 raters rereviewed the luminal imaging in addition to IVWI for the pattern of wall involvement, presence and pattern of postcontrast enhancement, and presumed diagnosis and confidence. Analysis was performed on per-lesion and per-patient bases. RESULTS: Thirty intracranial atherosclerotic disease, 12 inflammatory vasculopathies, and 12 reversible cerebral vasoconstriction syndromepatients with 201 lesions (90 intracranial atherosclerotic disease, 64 reversible cerebral vasoconstriction syndrome, and 47 inflammatory vasculopathy lesions) were included. For both per-lesion and per-patient analyses, there was significant diagnostic accuracy improvement with luminal imaging+IVWI when compared with luminal imaging alone (per-lesion: 88.8% versus 36.1%; P<0.001 and per-patient: 96.3% versus 43.5%; P<0.001, respectively). There was substantial interrater diagnostic agreement for luminal imaging+IVWI (κ=0.72) and only slight agreement for luminal imaging (κ=0.04). Although there was a significant correlation for both luminal and IVWI pattern of wall involvement with diagnosis, there was a stronger correlation for IVWI finding of lesion eccentricity and intracranial atherosclerotic disease diagnosis than for luminal imaging (κ=0.69 versus 0.18; P<0.001). CONCLUSIONS: IVWI can significantly improve the differentiation of nonocclusive intracranial vasculopathies when combined with traditional luminal imaging modalities.
Authors: Daniel M Mandell; Charles C Matouk; Richard I Farb; Timo Krings; Ronit Agid; Karel terBrugge; Robert A Willinsky; Richard H Swartz; Frank L Silver; David J Mikulis Journal: Stroke Date: 2011-12-08 Impact factor: 7.914
Authors: Ricardo J Komotar; Christopher P Kellner; Daniel M Raper; Dorothea Strozyk; Randall T Higashida; Philip M Meyers Journal: World J Radiol Date: 2010-05-28
Authors: R H Swartz; S S Bhuta; R I Farb; R Agid; R A Willinsky; K G Terbrugge; J Butany; B A Wasserman; D M Johnstone; F L Silver; D J Mikulis Journal: Neurology Date: 2009-02-17 Impact factor: 9.910
Authors: E C Obusez; F Hui; R A Hajj-Ali; R Cerejo; L H Calabrese; T Hammad; S E Jones Journal: AJNR Am J Neuroradiol Date: 2014-04-10 Impact factor: 3.825
Authors: Mikael Mazighi; Julien Labreuche; Fernando Gongora-Rivera; Charles Duyckaerts; Jean-Jacques Hauw; Pierre Amarenco Journal: Stroke Date: 2008-02-28 Impact factor: 7.914
Authors: Adam de Havenon; Chun Yuan; David Tirschwell; Thomas Hatsukami; Yoshimi Anzai; Kyra Becker; Ali Sultan-Qurraie; Mahmud Mossa-Basha Journal: Case Rep Radiol Date: 2015-08-06
Authors: Antoine Kimmoun; Elisabeth Baux; Vincent Das; Nicolas Terzi; Patrice Talec; Pierre Asfar; Stephan Ehrmann; Guillaume Geri; Steven Grange; Nadia Anguel; Alexandre Demoule; Anne Sophie Moreau; Elie Azoulay; Jean-Pierre Quenot; Julie Boisramé-Helms; Guillaume Louis; Romain Sonneville; Nicolas Girerd; Nicolas Ducrocq; Nelly Agrinier; Denis Wahl; Xavier Puéchal; Bruno Levy Journal: Crit Care Date: 2016-01-26 Impact factor: 9.097
Authors: J D Schaafsma; S Rawal; J M Coutinho; J Rasheedi; D J Mikulis; C Jaigobin; F L Silver; D M Mandell Journal: AJNR Am J Neuroradiol Date: 2019-09-05 Impact factor: 3.825
Authors: Jason Brett Hartman; Hiroko Watase; Jie Sun; Daniel S Hippe; Louis Kim; Michael Levitt; Laligam Sekhar; Niranjan Balu; Thomas Hatsukami; Chun Yuan; Mahmud Mossa-Basha Journal: Br J Radiol Date: 2019-01-30 Impact factor: 3.039
Authors: Felicia C Chow; Andrew Callen; Victor Arechiga; David Saloner; Jared Narvid; Priscilla Y Hsue Journal: AIDS Date: 2022-01-01 Impact factor: 4.177
Authors: Jae W Song; Brianna F Moon; Morgan P Burke; Srikant Kamesh Iyer; Mark A Elliott; Haochang Shou; Steven R Messé; Scott E Kasner; Laurie A Loevner; Mitchell D Schnall; John E Kirsch; Walter R Witschey; Zhaoyang Fan Journal: J Neuroimaging Date: 2020-05-11 Impact factor: 2.486
Authors: Mahmud Mossa-Basha; Hiroko Watase; Jie Sun; Dean K Shibata; Daniel S Hippe; Niranjan Balu; Thomas Hatsukami; Chun Yuan Journal: Br J Radiol Date: 2019-02-26 Impact factor: 3.039
Authors: Basar Sarikaya; Charles Colip; William D Hwang; Daniel S Hippe; Chengcheng Zhu; Jie Sun; Niranjan Balu; Chun Yuan; Mahmud Mossa-Basha Journal: Br J Radiol Date: 2020-11-18 Impact factor: 3.039
Authors: Nathan Arnett; Athanasios Pavlou; Morgan P Burke; Brett L Cucchiara; Rennie L Rhee; Jae W Song Journal: Neuroradiology Date: 2021-05-03 Impact factor: 2.804
Authors: Maximilian Patzig; Robert Forbrig; Clemens Küpper; Ozan Eren; Tobias Saam; Lars Kellert; Thomas Liebig; Florian Schöberl Journal: J Neurol Date: 2021-07-08 Impact factor: 4.849