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This review discusses the 3 key MRI sequences for ARIA monitoring and standardized imaging protocols and provides imaging recommendations for 3 key patient scenarios. All patients on anti-amyloid immunotherapy should have T2* gradient-recalled echo (to evaluate for ARIA-H), 2D or 3D T2 FLAIR (to evaluate for ARIA-E), and DWI (to differentiate ARIA-E from acute ischemia). Patient imaging scenarios are 1) baseline dementia diagnosis/treatment enrollment evaluation, 2) asymptomatic ARIA monitoring, and 3) evaluation of the symptomatic patient on anti-amyloid immunotherapy.

A DSA-based flow quantification tool (AneurysmFlow) was used to measure blood flow vectors and velocities after contrast injection. Complex flow patterns were shown to be common in ruptured aneurysms and those with daughter sacs. Lowest mean aneurysm flow amplitude in the dome and daughter sacs indicated pathophysiologic changes linked to rupture. Also, hypertension, bifurcation location, and irregular shape of unruptured aneurysm were found to be independent rupture risk factors.