Work

Imaging Inflammation in Cerebrovascular Disease

Year: 2015

Type: article

Abstract: C urrently, diagnosis of intracranial large vessel patholo- gies is based on luminal appearance using angiographic studies either noninvasively with magnetic resonance (MR) or computed tomography or invasively with catheter angiography.However, exciting new methodologies are in development that allow imaging beyond the lumen to characterize the disease process of the vessel wall.1,2 Inflammation has been implicated in large artery cerebrovascular lesions, having a role in the progression of symptomatic intracranial atherosclerosis, 3 growth and rupture of brain aneurysms, 4 delayed cerebral ischemia after subarachnoid hemorrhage, 5 and rupture risk of brain arteriovenous malformations.6 Imaging the spatial distribution, severity, and temporal changes in cerebrovascular inflammation may offer insight into the clinical diagnosis and treatment decisions in the near future.Substantial challenges remain for the development of high-resolution, specific, and sensitive techniques to quantify patterns of inflammation in large intracranial arteries.This review serves to highlight developments in vascular wall imaging and molecular imaging techniques to better elucidate the predictive value of vascular inflammation in the progression of cerebrovascular disease. MethodsWe conducted searches using PubMed and Google Scholar for relevant articles published since 1980 in English.We used search words, such as cerebral arteries or cerebrovasculature, inflammation, or imaging, combined with subject heading search words representing different pathological conditions or imaging modalities, such as magnetic resonance imaging (MRI), molecular imaging, positron emission tomography (PET), ultrasound, vessel wall imaging, intracranial atherosclerosis, intracranial aneurysm, angitis, vasculitis, Moyamoya disease, giant cell arteritis, or ultrasmall superparamagnetic iron oxide (USPIO).The first search was performed in January 2015 and the last in May 2015.Articles were screened by title and abstract, and if relevant, the article was reviewed in its entirety.Because of restrictions in Stroke on the publication of Topical Reviews, final discretion of selected references was determined by the authors.

Source: Stroke

DOI: 10.1161/strokeaha.115.008229