MY CONTENT

In this retrospective review of children with SWS, the most prevalent lesions at the first MRI were subarachnoid varicose network and transmedullary veins. The dilated venous channels are an early compensatory mechanism, preceding abnormal pial contrast enhancement, atrophy, and calcification.

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.