Findings of CNS vasculitis on CTA include multifocal vessel wall narrowing and dilatation with considerable overlap with other nonvasculitis cerebral vascular diseases and sensitivity is limited to resolution [99]. CTV Head There is no relevant literature to support the use of CTV head in the initial imaging for suspected CNS vasculitis. MRA Head MRA head offers a noninvasive and radiation free examination of the intracranial vessels. As stated above in the arteriography and CTA head sections, specificity of vascular luminal imaging is limited by considerable overlap with other cerebrovascular disease, such as atherosclerosis and reversible cerebral vasoconstriction syndrome, and sensitivity is limited to resolution as vasculitis can involve small distal arteries below native resolution of MRA [99]. In a recent retrospective comparison of time-of-flight MRA to DSA, time-of-flight MRA was abnormal in 81% of patients with angiographic findings of vasculitis and normal in 100% of patients with a normal angiogram. Although postcontrast imaging is utilized in vessel wall imaging MRI brain protocols and MRA is typically included in the imaging protocol, no relevant literature supports the use of postcontrast MRA in the initial imaging for suspected CNS vasculitis. MRI Head Perfusion There is no relevant literature to support the use of MRI head perfusion in the initial imaging for suspected CNS vasculitis. CVD-Aneurysm, Vascular Malformation, and SAH MRI Head MRI head is a useful examination in the evaluation of CNS vasculitis given its superior soft-tissue characteristics of the brain parenchyma and vessel walls. Multiple infarcts of variable ages are identified on MRI in up to 50% of patients with CNS vasculitis [99,101]. Other findings of primary CNS vasculitis include mass lesions, meningeal enhancement, and hemorrhage in 5%, 8%, and 9% of cases, respectively [99,101].
Cerebrovascular Diseases Aneurysm Vascular Malformation and Subarachnoid Hemorrhage PCAs. Findings of CNS vasculitis on CTA include multifocal vessel wall narrowing and dilatation with considerable overlap with other nonvasculitis cerebral vascular diseases and sensitivity is limited to resolution [99]. CTV Head There is no relevant literature to support the use of CTV head in the initial imaging for suspected CNS vasculitis. MRA Head MRA head offers a noninvasive and radiation free examination of the intracranial vessels. As stated above in the arteriography and CTA head sections, specificity of vascular luminal imaging is limited by considerable overlap with other cerebrovascular disease, such as atherosclerosis and reversible cerebral vasoconstriction syndrome, and sensitivity is limited to resolution as vasculitis can involve small distal arteries below native resolution of MRA [99]. In a recent retrospective comparison of time-of-flight MRA to DSA, time-of-flight MRA was abnormal in 81% of patients with angiographic findings of vasculitis and normal in 100% of patients with a normal angiogram. Although postcontrast imaging is utilized in vessel wall imaging MRI brain protocols and MRA is typically included in the imaging protocol, no relevant literature supports the use of postcontrast MRA in the initial imaging for suspected CNS vasculitis. MRI Head Perfusion There is no relevant literature to support the use of MRI head perfusion in the initial imaging for suspected CNS vasculitis. CVD-Aneurysm, Vascular Malformation, and SAH MRI Head MRI head is a useful examination in the evaluation of CNS vasculitis given its superior soft-tissue characteristics of the brain parenchyma and vessel walls. Multiple infarcts of variable ages are identified on MRI in up to 50% of patients with CNS vasculitis [99,101]. Other findings of primary CNS vasculitis include mass lesions, meningeal enhancement, and hemorrhage in 5%, 8%, and 9% of cases, respectively [99,101].