High resolution imaging of the intracranial vessel wall at 3 and 7 T using 3D fast spin echo MRI

High resolution MRI of the intracranial vessel wall provides important insights in the assessment of intracranial vascular disease. This study aims to refine high resolution 3D MRI techniques for intracranial vessel wall imaging at both 3 and 7 T using customized flip angle train design, and to explore their comparative abilities. 11 patients with intracranial artery disease (four atherosclerotic plaques, six aneurysms and one reversible cerebral vasoconstriction syndrome) were imaged at 3 and 7 T with a 3D T (1)-weighted fast-spin-echo sequence (SPACE) both pre and post Gd contrast injection. Wall to lumen contrast ratio (CRwall-lumen), contrast enhancement ratio (ER) and the sharpness of the vessel wall were quantified. Two experienced radiologists evaluated the image quality on a 0-5 scale. Both 3 and 7 T achieved good image quality with high resolution (nominal 0.5 mm isotropic) and whole brain coverage. The CRwall-lumen and the ER measurements were comparable (p > 0.05). The 7 T images were significantly sharper (sharpness: 2.69 +/- 0.50 vs. 1.88 +/- 0.53 mm(-1), p < 0.001) with higher image quality (reader 1 score: 3.5 +/- 1.1 vs. 2.4 +/- 1.1, p = 0.002) compared to 3 T. 3D T (1)-weighted SPACE can be used for intracranial vessel wall evaluation at both 3 and 7 T. 7 T provides significantly better image quality and improves the confidence of diagnosis.