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MR VWI in patients with symptomatic intracranial atherosclerotic disease plaques and aneurysms showed contrast accumulation beyond the early-phase (5–15 min) into the delayed phase (20–30 min). This nonspecific enhancement may indicate focal inflammation, neoangiogenesis, and/or increased permeability. The authors advocate postcontrast imaging soon after contrast administration to optimize diagnostic accuracy.

This study prospectively evaluated the diagnostic accuracy of an optimized CT lumbar spine protocol as a potential alternative to MRI in assessing suspected neural compression. CT accurately identified all cases requiring urgent decompression. CT had 97% sensitivity, specificity, and positive and negative predictive values in detecting disc pathology in patients presenting with symptoms suggestive of acute neural compression compared with MRI.