Zedde Marialuisa, Sette Massimo Del, Quatrale Rocco, Causin Francesco, Pascarella Rosario
Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia, 42122, Italy.
Neurology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.
Neurol Sci. 2025 Jul 16. doi: 10.1007/s10072-025-08366-6.
Vessel Wall Imaging (VWI) is a Magnetic Resonance (MR) technique whose employment is more and more frequent for investigating intracranial arterial diseases. This is mainly due to its potential to see beyond the arterial luminal stenosis giving information on the arterial walls. This promising role could help to distinguish among several causes of intracranial arteriopathies (atherosclerosis, vasculitis, Moyamoya, etc.) and to predict the instability of plaques and aneurysms.
In this review, the main technical issues and potential source of misinterpretation of VWI were analyzed and the data provided by the literature on pathological validation of these findings were critically proposed, in order to better define the limitations and the future potential of this method.
Only in isolated cases the main findings of VWI were validated against histopathology and in several diseases, there is not a pathological validation of the interpretation of abnormal findings of VWI technique.
The lack of a pathological substrate underlying wall contrast enhancement and wall thickening (two of the most characterizing aspects of this technique) makes difficult to rely only on this technique for drawing a conclusive diagnosis.
血管壁成像（VWI）是一种磁共振（MR）技术，在颅内动脉疾病研究中的应用越来越频繁。这主要是因为它有潜力超越动脉管腔狭窄，提供有关动脉壁的信息。这一有前景的作用有助于区分颅内动脉病变的多种病因（动脉粥样硬化、血管炎、烟雾病等），并预测斑块和动脉瘤的不稳定性。
在本综述中，分析了VWI的主要技术问题和潜在的误解来源，并批判性地提出了文献中关于这些发现病理验证的数据，以便更好地界定该方法的局限性和未来潜力。
仅在个别情况下，VWI的主要发现通过组织病理学得到验证，并且在几种疾病中，VWI技术异常发现的解释没有病理验证。
缺乏壁对比增强和壁增厚（该技术最具特征的两个方面）的病理基础，使得仅依靠该技术做出确定性诊断变得困难。
