AUTHOR=Lucci Carlo , Rissanen Ina , Takx Richard A. P. , van der Kolk Anja G. , Harteveld Anita A. , Dankbaar Jan W. , Geerlings Mirjam I. , de Jong Pim A. , Hendrikse Jeroen TITLE=Imaging of intracranial arterial disease: a comparison between MRI and unenhanced CT JOURNAL=Frontiers in Radiology VOLUME=4 YEAR=2024 URL=https://www.frontiersin.org/journals/radiology/articles/10.3389/fradi.2024.1338418 DOI=10.3389/fradi.2024.1338418 ISSN=2673-8740 ABSTRACT=Background and purpose

Arterial calcifications on unenhanced CT scans and vessel wall lesions on MRI are often used interchangeably to portray intracranial arterial disease. However, the extent of pathology depicted with each technique is unclear. We investigated the presence and distribution of these two imaging findings in patients with a history of cerebrovascular disease.

Materials and methods

We analyzed CT and MRI data from 78 patients admitted for stroke or TIA at our institution. Vessel wall lesions were assessed on 7 T MRI sequences, while arterial calcifications were assessed on CT scans. The number of vessel wall lesions, severity of intracranial internal carotid artery (iICA) calcifications, and overall presence and distribution of the two imaging findings were visually assessed in the intracranial arteries.

Results

At least one vessel wall lesion or arterial calcification was assessed in 69 (88%) patients. Only the iICA and vertebral arteries (VA) showed a substantial number of both calcifications and vessel wall lesions. The other vessels showed almost exclusively vessel wall lesions. The number of vessel wall lesions was associated with the severity of iICA calcification (p = 0.013).

Conclusions

The number of vessel wall lesions increases with the severity of iICA calcifications. Nonetheless, the distribution of vessel wall lesions on MRI and arterial calcifications on CT shows remarkable differences. These findings support the need for a combined approach to examine intracranial arterial disease.