All Articles

Cerebrovascular Disease: Achieving Clarity

William Jones, MD

William Jones, MD

Computed tomographic (CT) and magnetic resonance imaging (MRI) techniques have been used in recent years to evaluate cerebrovascular disease and to document structural abnormalities and functional impairments that occur in the brain and cerebral vasculature of aging patients.

In a review of techniques for neuroimaging of cerebrovascular disease, researchers at Weill Cornell Medical College identified several newer techniques that provide physicians greater clarity in the workup of these diseases in aging patients. These include higher resolution CT angiography (CTA) and MR angiography (MRA), as well as perfusion and diffusion tensor imaging techniques.


At Scottsdale Medical Imaging (SMIL), radiologists regularly employ angiographic studies, CTA or MRA, which look specifically at the vessels themselves, when it comes to cerebrovascular disease, says William Jones, MD, a neuroradiologist at SMIL.

MRA doesn’t require contrast, which can be an advantage, but patients must remain motionless. The SMIL advantage, Jones says, is that 3-Tesla MRA produces extremely high resolution for diagnosing cerebral ischemia and other brain disorders.

“We have a number of 3-Tesla magnets in our system, and MRAs, in particular, are much better at 3T versus a much smaller field strength like the 1.5 T,” Jones says. “When there is some question, we can send patients to the 3-Tesla magnet and get a higher resolution study looking for very small aneurysms or small vascular irregularity.”

In addition, with MR, SMIL radiologists use diffusion-weighted imaging on every case. Diffusion tensor imaging (DTI) is another MR technique that allows direct in vivo examination of the tissue microstructure; however, Jones says, it is generally reserved for academic studies mapping the location, orientation and directionally dependent properties (anisotropy) of the brain’s white matter tracts for studies of white matter disorders.

If MRA is not possible, CTA is used, which requires contrast and radiation. However, SMIL uses a low-dose protocol to minimize the exposure.

“With contrast, you can see if one part of the brain is being poorly perfused compared to another part of the brain, which is very helpful in determining the next phase of treatment,” Jones says. “We are always looking at new areas of imaging to improve and incorporate into our practice to improve detection and subsequent treatment.” •

Gupta A, Nair S, Schweitzer A, et al. Neuroimaging of Cerebrovascular Disease in the Aging Brain.
Aging and Disease. 2012;3(5):414-425.

We would like to thank you for your review and support of The SMIL Radiology Report by sponsoring your 2018 membership to the Phoenix Fine Dining Group. Your membership invites you to experience the exceptional food and distinctive personality of 30 top-tier Valley restaurants all at great savings; restaurants such as Talavera, Bistro 24, T Cook's and Roka Akor.

To receive your 2018 membership card please complete the form below. You will receive your card by mail - please allow 4 to 6 weeks (your information will not be published or shared with any other organization).

To learn more about Phoenix Fine Dining Group and Preferred Restaurants visit

    Name (required)

    Title (required)

    Speciality (required)

    Name of your practice (required)

    Address (required)

    City, State, Zip (required)


    Please rate how useful this article was to you


    What topics would you like to see covered in upcoming
    editions of the SMIL Radiology Report? (required)

    Other comments suggestions you would like to share with the SMIL Radiology Report team?