Role of Vessel Wall MRI in Differentiaition Between Intracranial Atherosclerotic Disease and Vasculitis as Causes of Ischemic Stroke

February 28, 2026 updated by: Mahmoud Abdelbaset Mahmoud Mohamed, Assiut University

Role of Vessel Wall MRI in Differentiaition Between Intrcranial Atherosclerotic Disease and Vasculitis as Causes of Ischemic Stroke

This work aims to clarify the diagnostic ability of vessel wall MRI to differentiate between intracranial atherosclerotic disease and vasculitis as causes of ischemic stroke, thereby guiding appropriate treatment and improving patient outcomes.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Intracranial arterial diseases, such as intracranial atherosclerotic disease (ICAD) and vasculitis, are major contributors to ischemic stroke globally. Differentiating these conditions, which is critical for effective clinical management given their distinct pathogenic mechanisms and therapeutic requirements. Traditional imaging modalities, including magnetic resonance angiography (MRA), computed tomography angiography (CTA), and digital subtraction angiography (DSA), predominantly assess the arterial lumen, detecting stenosis or occlusion. While valuable for identifying luminal abnormalities, these techniques often fail to characterize the vessel wall pathology, a key limitation in distinguishing between ICAD and vasculitis. Both conditions can manifest with similar clinical presentations of ischemic stroke, rendering diagnosis challenging with conventional methods.

Vessel wall magnetic MRI has emerged as an effective diagnostic tool. This non-invasive technique directly visualizes and characterizes the intracranial arterial wall, providing detailed information on wall thickening patterns, contrast enhancement characteristics, and plaque morphology. Current strategies show ability of vessel wall MRI to differentiate Intracranial atherosclerotic disease, typically presenting with eccentric wall thickening and eccentric enhancement if the atherosclerotic plaque is active and no enhancement if the atherosclerotic plaque is inactive, from vasculitis, which often exhibits circumferential wall thickening and enhancement.

The rationale for utilizing vessel wall magnetic resonance imaging stems from the need to move beyond mere luminal assessment to a more granular, tissue-level understanding of cerebrovascular disease. This advanced characterization facilitates precise diagnosis, guides appropriate treatment decisions-such as antiplatelet therapy for intracranial atherosclerotic disease versus immunosuppression for vasculitis-and ultimately aims to improve patient outcomes following ischemic stroke.

Study Type

Interventional

Enrollment (Estimated)

46

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients with ischemic stroke within 2 weeks from onset detected by magnetic resonance imaging (MRI) and have intracranial artery stenosis seen in magnetic resonance angiography (MRA).

Exclusion Criteria:

  • Contraindications for MRI such as claustrophobia, heart pacemaker and ferromagnetic implants.

    • Contraindications for contrast as patients with renal impairment.
    • Patients in which the misaligned images or distortions due to motion artifacts made the interpretation of the MRI unreliable.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: No Arms have been specified for this study.
Device: MRI
Vessel wall MRI in differentiation between intracranial atherosclerotic disease and vasculitis as causes of ischemic stroke

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Role of vessel wall MRI in differentiation between intracranial atherosclerotic disease and vasculitis as causes of ischemic stroke by detection of eccentric or circumferential arterial wall thickening and pattern of postcontrast enhancement.
Time Frame: Baseline

Vessel wall MR sequences including T1 pre and post contrast in order to differentiate between intracranial atherosclerotic plaque and vasculitis and to assess atherosclerotic plaque activity by detection of eccentric or circumferential arterial wall thickening and pattern of postcontrast enhancement.

According to previous studies, if there is enhancing eccenteric arterial wall thickening, it considered active athrosclerotic plaque, if there is non enhancing eccenteric aretrial wall thickening, it considered inactive atherosclerotic plaque.

If there is enhancing circumferential arterial wall thickening, it considered vasculitis
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

March 1, 2026

Primary Completion (Estimated)

March 1, 2027

Study Completion (Estimated)

April 1, 2027

Study Registration Dates

First Submitted

February 20, 2026

First Submitted That Met QC Criteria

February 28, 2026

First Posted (Actual)

March 4, 2026

Study Record Updates

Last Update Posted (Actual)

March 4, 2026

Last Update Submitted That Met QC Criteria

February 28, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Vessel wall MRI

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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