The pathogenesis of many strokes originates in the vessel wall. Despite this, most traditional imaging focuses on the vascular lumen. Vessel-wall magnetic resonance imaging (VWMRI) is useful for establishing the etiology of intracranial stenosis. It also provides information regarding atherosclerotic plaque composition and thus plaque vulnerability, which is an indication of its potential to cause a stroke. In this review we focus on the characteristics of VWMRI findings in various arteriopathies related to intracranial artery stenosis, and discuss the clinical implications of these findings.

Citations

• Intracranial Atherosclerotic Stenosis
  Jeong Yoon Song, Sun U. Kwon
  Cerebrovascular Diseases Extra.2025; 15(1): 62.     CrossRef
• The Role of High-Resolution Magnetic Resonance Imaging in Cerebrovascular Disease: A Narrative Review
  Xiaohui Li, Chengfang Liu, Lin Zhu, Meng Wang, Yukai Liu, Shuo Li, Qiwen Deng, Junshan Zhou
  Brain Sciences.2023; 13(4): 677.     CrossRef
• Acute Stroke Caused by Large Vessel Vasculitis in a Patient with Systemic Lupus Erythematosus
  Min A Lee, Byoung Wook Hwang, Dong Kun Lee, Chang Ju Lee, Ju Hye Kim, Seong Hwan Ahn
  Journal of Neurosonology and Neuroimaging.2022; 14(1): 51.     CrossRef
• Vessel Wall Magnetic Resonance Imaging in Cerebrovascular Diseases
  Federico Mazzacane, Valentina Mazzoleni, Elisa Scola, Sara Mancini, Ivano Lombardo, Giorgio Busto, Elisa Rognone, Anna Pichiecchio, Alessandro Padovani, Andrea Morotti, Enrico Fainardi
  Diagnostics.2022; 12(2): 258.     CrossRef

Background: Moyamoya disease is characterized by a progressive stenosis or occlusion of the intracranial internal carotid artery and/or the proximal portion of the anterior cerebral artery and middle cerebral artery. Whether the onset time was childhood or adulthood, the bony carotid canal diameter might be different, but reflects the size of internal carotid artery passing through the bony carotid canal. In this study, we aimed to identify the relationship between bony carotid canal diameter and clinical manifestation. Methods: 146 consecutive patients diagnosed with moyamoya disease by brain imaging studies were included. We measured the diameter of a transverse portion of bony carotid canal on bone window of a brain computed tomography(CT) image. Patients were divided into two groups, ischemic or hemorrhagic stroke according to clinical manifestation. As a result, 115 patients were included. The Suzuki stage was used as criteria for disease progression. Results: Bony carotid canal diameter was 3.6 ± 0.5 (right) and 3.6 ± 0.4 (left) in the hemorrhagic stroke group, and 3.7 ± 0.4 (right) and 3.6 ± 0.4 (left) in the ischemic stroke group. The bony carotid canal diameter of the moyamoya vessels (3.6 mm) was smaller than the diameter of non-moyamoya vessels (3.8 mm), significantly (p = 0.042). However, there was no difference in the collateral patterns and clinical manifestation in a comparison of both groups. Conclusions: In our study, there was no significant difference of clinical manifestations and collateral patterns depend on the bony carotid canal diameter in patients with moyamoya disease. These findings suggest that the clinical presentations of moyamoya disease are not related to the onset time of the disease.