Mazzacane Federico, Mazzoleni Valentina, Scola Elisa, Mancini Sara, Lombardo Ivano, Busto Giorgio, Rognone Elisa, Pichiecchio Anna, Padovani Alessandro, Morotti Andrea, Fainardi Enrico
Department of Emergency Neurology and Stroke Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy.
Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
Diagnostics (Basel). 2022 Jan 20;12(2):258. doi: 10.3390/diagnostics12020258.
Cerebrovascular diseases are a leading cause of disability and death worldwide. The definition of stroke etiology is mandatory to predict outcome and guide therapeutic decisions. The diagnosis of pathological processes involving intracranial arteries is especially challenging, and the visualization of intracranial arteries' vessel walls is not possible with routine imaging techniques. Vessel wall magnetic resonance imaging (VW-MRI) uses high-resolution, multiparametric MRI sequences to directly visualize intracranial arteries walls and their pathological alterations, allowing a better characterization of their pathology. VW-MRI demonstrated a wide range of clinical applications in acute cerebrovascular disease. Above all, it can be of great utility in the differential diagnosis of atherosclerotic and non-atherosclerotic intracranial vasculopathies. Additionally, it can be useful in the risk stratification of intracranial atherosclerotic lesions and to assess the risk of rupture of intracranial aneurysms. Recent advances in MRI technology made it more available, but larger studies are still needed to maximize its use in daily clinical practice.
脑血管疾病是全球致残和致死的主要原因。明确卒中病因对于预测预后和指导治疗决策至关重要。诊断涉及颅内动脉的病理过程极具挑战性，常规成像技术无法实现颅内动脉血管壁的可视化。血管壁磁共振成像（VW-MRI）利用高分辨率、多参数MRI序列直接观察颅内动脉血管壁及其病理改变，从而更好地对其病变特征进行描述。VW-MRI在急性脑血管疾病中展现出广泛的临床应用。最重要的是，它在鉴别动脉粥样硬化性和非动脉粥样硬化性颅内血管病变方面具有很大价值。此外，它还可用于颅内动脉粥样硬化病变的风险分层以及评估颅内动脉瘤破裂风险。MRI技术的最新进展使其应用更为广泛，但仍需开展更大规模的研究以在日常临床实践中充分发挥其作用。
