Diagnosing intracranial vasculitis: the roles of MR and angiography

• Published in: American journal of neuroradiology : AJNR Vol. 15; no. 2; pp. 317 - 330
• Main Authors: Harris, KG, Tran, DD, Sickels, WJ, Cornell, SH, Yuh, WT
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.02.1994; American Society of Neuroradiology
• Subjects: 550900 > Pathology; Adolescent; Adult; Aged; BASIC BIOLOGICAL SCIENCES; Biological and medical sciences; BIOMEDICAL RADIOGRAPHY; BLOOD VESSELS; BODY; BRAIN; Brain Ischemia - diagnosis; CARDIOVASCULAR SYSTEM; Carotid Stenosis - diagnosis; CENTRAL NERVOUS SYSTEM; Cerebral Angiography; Cerebrovascular Disorders - diagnosis; COMPARATIVE EVALUATIONS; Diagnosis, Differential; DIAGNOSTIC TECHNIQUES; DISEASES; EVALUATION; Female; Humans; Intracranial Embolism and Thrombosis - diagnosis; MAGNETIC RESONANCE; Magnetic Resonance Imaging; Male; Medical sciences; MEDICINE; Middle Aged; NERVOUS SYSTEM; Neurology; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; RADIOLOGY AND NUCLEAR MEDICINE; RESONANCE 550602 > Medicine > External Radiation in Diagnostics > (1980-); Retrospective Studies; VASCULAR DISEASES; Vascular diseases and vascular malformations of the nervous system; Vasculitis - diagnosis; Human; Intracranial; Nervous system diseases; Angiography; Radiodiagnosis; Cardiovascular disease; Exploration; Nuclear magnetic resonance imaging; Cerebral disorder; Vascular disease; Vasculitis; Central nervous system disease; Diagnosis
• ISSN: 0195-6108; 1936-959X

To describe our experience with MR and angiography in diagnosing intracranial vasculitis and to test the hypothesis that MR can be used to screen for patients unlikely to have vasculitis. Ninety-two patients who had angiography with "exclude vasculitis" as the indication or who had angiography and a clinical diagnosis of vasculitis were identified. Angiograms of all 92 patients and the MRs of the 70 patients who had both studies were reviewed. Eleven patients had intracranial vasculitis. Angiography showed characteristic changes in 8. MR, performed in 9 of 11 vasculitis cases, was significantly abnormal in all 9. Among 70 patients who had both studies, 19 had MR that was completely normal or showed only incidental findings. None of these 19 was diagnosed with vasculitis. The diagnostic yield of angiography performed to exclude vasculitis was only 6%. Evaluation for intracranial vasculitis should include MR. A negative MR excludes intracranial vasculitis more definitively than does a negative angiogram and makes the likelihood of finding vasculitis with angiography negligible.