Unlike extracranial vasa vasorum, intracranial vasa vasorum are rare and develop with age, predominantly on the proximal portions of the intracranial arteries. Advanced contrast material-enhanced imaging techniques can help detect and even grade intracranial vasa vasorum, which may provide new insights into our ability to diagnose and assess the risk of intracranial vascular lesions such as atherosclerosis, aneurysms, dissections and vasculitis.
In a Review and Commentary in the June issue of Radiology (RSNA.org/Radiology), Anthony Portanova, B.S., of the University of Rochester, N.Y., and colleagues review the published literature on intracranial vasa vasorum and interpret the findings in a radiologic context. The authors offer radiologists a concise framework for analyzing diseases of the intracranial arteries on the basis of the presence or absence of vasa vasorum.
The unique structure and environment of intracranial arteries may explain their relative lack of vasa vasorum, according to the authors. This distinctive feature of intracranial arteries may serve as an important diagnostic characteristic on imaging studies, since vasa vasorum signal the presence of a variety of vascular pathologic processes and can be detected by using contrast-enhanced imaging techniques.
“Contrast-enhanced imaging modalities, including MR imaging, CT, and ultrasound, can depict vasa vasorum by showing wall enhancement, which enables the identification and characterization of intracranial vasculopathies such as atherosclerosis, aneurysms, dissections, and vasculitis that would not be achievable with conventional angiography,” the authors write.
Diffusion-weighted MR imaging is emerging as an important tool in the evaluation of gastrointestinal tract tumors and inflammatory disorders and is used to depict complications and monitor tumors and inflammatory bowel disorders to assess response to treatment.
In an article in the May-June issue of RadioGraphics (RSNA.org/RadioGraphics). Rakesh Sinha, M.B.B.S., M.D., F.R.C.R., F.I.C.R., of Warwick Hospital, South Warwickshire NHS Foundation Trust, England, and colleagues review the technique, indications and imaging findings of diffusion-weighted imaging and its role in depicting disease processes that affect the gastrointestinal tract. The authors also discuss artifacts and an approach to image optimization with examples of pitfalls of interpreting diffusion-weighted images of the bowel.
“Complications, such as a malignant change, abscess, and fistula, may also be depicted, and it is particularly useful in assessing gastrointestinal tract conditions in patients with contraindications to the use of intravenous contrast material,” the authors write. “Quantitative measurements of signal intensity at diffusion-weighted imaging may help differentiate actively inflamed bowel from normal bowel, and ADC values provide useful information about disease activity and response to treatment.”
An Invited Commentary on Dr. Sinha’s article by Aliya Qayyum, M.B.B.S., M.R.C.P., F.R.C.R., also appears in the issue.
The Journal Highlights section in the April issue of RSNA News incorrectly identified the journal in the citation for the study, “Breast Reconstruction: Review of Surgical Methods and Spectrum of Imaging Findings.” The journal is RadioGraphics.
The Radiology in Public Focus section in that issue incorrectly identified the page numbers in the citation for the study, “Body CT Scanning in Young Adults: Examination Indications, Patient Outcomes and Risk of Radiation-induced Cancer.” The page numbers are 460-469.
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