The high-resolution vessel wall imaging (HR-VWI) is a millimetric technique that demonstrates vessel wall inflammation, which can occur simultaneously with leptomeningitis. Encephalic infarction may be observed in less than 50% of the cases.11 Choudhary N, Vyas S, Modi M, et al. MR vessel wall imaging in tubercular meningitis. Neuroradiology 2021;63(10):1627–1634, 22 Pacheco FT, Cruz Junior LCHD, Padilha IG, et al. Current uses of intracranial vessel wall imaging for clinical practice: a high-resolution MR technique recently available. Arq Neuropsiquiatr 2020;78(10):642–650, 33 Mont’Alverne Filho FE, Machado LdosR, Lucato LT, Leite CC. The role of 3D volumetric MR sequences in diagnosing intraventricular neurocysticercosis: preliminar results. Arq Neuropsiquiatr 2011;69(01):74–78
A 42-year-old man with neurocysticercosis, presented headache and visual blurring. Magnetic resonance imaging (MRI) and HR-VWI scans were performed, as demonstrated in ►Figures 1 and 2, respectively. The findings contribute to the pathophysiology of the disease, by demonstrating concentric and irregular wall enhancement (vasculitis). The degree of vessel involvement correlates with the severity of disease stage,11 Choudhary N, Vyas S, Modi M, et al. MR vessel wall imaging in tubercular meningitis. Neuroradiology 2021;63(10):1627–1634 and was demonstrated in other infections, such as syphilis,44 Feitoza LM, Stucchi RSB, Reis F. Neurosyphilis vasculitis manifesting as ischemic stroke. Rev Soc Bras Med Trop 2020;53: e20190546 and tuberculosis,11 Choudhary N, Vyas S, Modi M, et al. MR vessel wall imaging in tubercular meningitis. Neuroradiology 2021;63(10):1627–1634,55 Feitoza LM, Jarry VM, Ramos MC, Reis F. High-Resolution Vessel Wall MRI as a Complementary Investigation for CNS Tuberculosis. Can J Neurol Sci 2021;48(05):717–718 but not in neurocysticercosis.
Axial Fast Imaging Employing Steady-state Acquisition (FIESTA) images (A and B): cystic lesions in the subarachnoid space. Axial T1 post-contrast (C and D): a nodular lesion with peripheral contrast enhancement in the left calcarine region (arrow) and leptomeningeal enhancement (arrowhead). The MIP axial TOF MRA and DWI images (E and F) showed no significant abnormalities. Abbreviations: DWI, Diffusion-weighted imaging; MIP, Maximum Intensity Projection; MRA, Magnetic Resonance Angiography; TOF, Time-Of-Flight.
References
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1Choudhary N, Vyas S, Modi M, et al. MR vessel wall imaging in tubercular meningitis. Neuroradiology 2021;63(10):1627–1634
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2Pacheco FT, Cruz Junior LCHD, Padilha IG, et al. Current uses of intracranial vessel wall imaging for clinical practice: a high-resolution MR technique recently available. Arq Neuropsiquiatr 2020;78(10):642–650
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3Mont’Alverne Filho FE, Machado LdosR, Lucato LT, Leite CC. The role of 3D volumetric MR sequences in diagnosing intraventricular neurocysticercosis: preliminar results. Arq Neuropsiquiatr 2011;69(01):74–78
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4Feitoza LM, Stucchi RSB, Reis F. Neurosyphilis vasculitis manifesting as ischemic stroke. Rev Soc Bras Med Trop 2020;53: e20190546
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5Feitoza LM, Jarry VM, Ramos MC, Reis F. High-Resolution Vessel Wall MRI as a Complementary Investigation for CNS Tuberculosis. Can J Neurol Sci 2021;48(05):717–718
Publication Dates
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Publication in this collection
21 Nov 2022 -
Date of issue
July 2022
History
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Received
17 Jan 2022 -
Accepted
07 Mar 2022