The Diagnostic Value Of High-resolution Magnetic Resonance Vessel Wall Imaging In Primary Angiitis Of The Central Nervous System

Objective:By analyzing the imaging characteristics of primary angiitis of the central nervous system(PACNS)in high-resolution magnetic resonance vessel wall imaging(HR-VWI),and comparing with MRA,the diagnostic value of HR-VWI in PACNS was explored.Method:We retrospectively analyzed 18 PACNS patients in the Department of Neurology,the first hospital of Jilin University from January 2015 to December 2019.All patients were examined by T1 WI,T2WI,MRA and HR-VWI(non-enhancement and enhancement)sequence of 3.0T MR.We recorded the general information of patients including age,gender,clinical symptoms,laboratory examination,and imaging data including the involved vessels,lesion sites and image manifestations of each sequence.All the results were analyzed by two experienced neuroradiologist and neurologist.All data were analyzed by spss21.0 statistical software.Measurement data were shown by average value ± standard deviation or median with quartile according to its normality.Enumeration data were shown by percentage.Chi square test was used for comparison between the two groups.P<0.05 means there is statistical significance.Results:A total of 18 patients with 162 vessels were included in this study,which included bilateral anterior,middle and posterior cerebral arteries,bilateral vertebral arteries and basilar arteries.HR-VWI(non-enhancement and enhancement)showed a total of 47 large and medium size vessels were involved(29.0%),24 of which were anterior circulation(14.8%),23 of which were posterior circulation(14.2%).The wall of the involved vessels showed uniform thickness with enhancement.MRA showed only 23 large and medium size vessels were involved(14.2%),16 of which were anterior circulation(9.9%),7 of which were posterior circulation(4.3%).The involved vessels showed stenosis of vascular lumen.The 23 vessels that were abnormal in MRA were also abnormal in HR-VWI.The positive rate of HR-VWI was higher than MRA.The difference was statistically significant.Conclusion:HR-VWI can directly show the condition of vessel wall,which is of great value for the diagnosis of PACNS.The main manifestations are diffuse,uniform,centripetal thickening with enhancement of the involved vessel wall.Compared with traditional vascular imaging methods,such as MRA,HR-VWI has a higher positive rate of abnormal vessels and no ionizing radiation,which can provide more comprehensive information for the diagnosis of PACNS.Therefore,when we suspect PACNS,HR-VWI should be performed in time.