Nora Navina Kammer MD, Presenter: Nothing to Disclose

Eva Maria Coppenrath MD, Abstract Co-Author: Nothing to Disclose

Karla Maria Treitl MD, Abstract Co-Author: Nothing to Disclose

Hendrik Kooijman, Abstract Co-Author: Employee, Koninklijke Philips NV

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Tobias Saam MD, Abstract Co-Author: Research Grant, Diamed Medizintechnik GmbH Research Grant, Bayer AG

2D-T1w black-blood sequences are used in atherosclerotic plaque imaging and for the assessment of inflammatory changes of intracranial vessels. However, sequences are limited due to long acquisition times which limits the number of acquired slices and thus the coverage (coverage often 3 cm or less). Aim of the study was to evaluate a commercially not available gadolinium-enhanced isotropic 3D-whole-brain-black-blood T1w-TSE sequence with variable flip angles (T1w-VISTA) for the diagnosis of intra- and extracranial vasculitis.

We prospectively included 26 patients with suspected vasculitis, 3 patients with Sickle-cell disease and 15 tumor patients without any evidence of vascular disease. All patients received a standardized protocol (T1w pre- and post contrast, TOF, DIFF, T2, FLAIR) and a T1w 3D-BB-VISTA sequence pre- and post contrast (resolution=0.8 mm3 isotropic, scan time 4:43 minutes). Left and right arteries of the anterior and posterior circulation (176 segments) and right/left temporal artery (88 segments) were evaluated for the presence of stenosis, wall thickening (eccentric/concentric) and contrast enhancement of the vessel wall (3-point Likert scale).

6 out of 104 arterial segments in patients with suspected intracranial vasculitis (3x right/1x left middle cerebral artery, 1x right and left vertebral artery) and 6 out of 88 temporal arteries showed focal circumferential, concentric wall thickening, luminal narrowing and strong contrast enhancement These findings were found in 8 distinct patients in which vasculitis was clinically confirmed. One patient with sickle-cell disease presented with a stenosis and concentric wall thickening without contrast enhancement. None of the 60 arterial segments of the tumor patients showed vasculitis like lesions but 6 segments (distal vertebral artery) showed an eccentric wall thickening and none to moderate contrast enhancement due to atherosclerotic plaques.

Whole-brain-black-blood MRI is feasible in less than 5 minutes scan time and allows to accurately diagnosing CNS vasculitis and Horton's disease. Future studies will be necessary to evaluate the utility of this sequence for other vascular pathologies, such as arterial dissection and atherosclerosis.

Whole-brain-black-blood MRI is a relevant additional tool for diagnosing and monitoring cranial vasculitis.

Kammer, N, Coppenrath, E, Treitl, K, Kooijman, H, Reiser, M, Saam, T, Whole Brain 3D-T1w-Black-Blood 3T-MRI for the Diagnosis of Intracranial CNS Vasculitis and Horton's Disease: A Pilot Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011558.html