Utility of black-blood MRI sequences in the study of vascular pathology of the CNS

Abstract

Cerebrovascular diseases are diseases of the central nervous system caused by alterations in the intracranial blood circulation involving an insufficient supply of oxygen to the brain parenchyma. In order to carry out a valid analysis of the vessel wall in recent years, magnetic resonance imaging of the vascular wall has become widespread. (VWMRI, vessel wall magnetic resonance imaging), which has proven to be an effective method with which to characterise pathologies involving the vessel wall and in detecting low-grade stenosis that may evade angiography. VWMRI is based on the use of ‘black blood’ sequences, i.e. sequences in which the blood signal inside the vessels is suppressed. Contrast medium is often used for this type of study, because it allows any inflammatory changes in the vessel walls to be highlighted. In the past, the main methods for studying intracranial vessels were digital subtraction angiography, i.e. DSA, and CT angiography. Magnetic resonance imaging has proved to be a valid alternative to these methods for detecting stenotic lesions without using ionising radiation, being able to characterise these types of lesions and having the ability to detect lesions that are not stenotic.