Intracranial atherosclerosis is a common cause of ischemic stroke. Variability in protocol/pulse sequence design of intracranial vessel wall MR imaging (VWI) has led to different imaging endpoints to detect and characterize atherosclerosis. We systematically reviewed the literature to identify VWI investigations studying atherosclerosis to identify commonly reported imaging endpoints. The most common imaging endpoints using T1-weighting included wall enhancement, thickening, plaque quadrant in cross-section, and stenosis; on T2-weighting, intraplaque T2 signal intensity and wall thickening were common endpoints. Establishing diagnostically accurate imaging endpoints to validate as atherosclerosis biomarkers are critical to understand where efforts for technique optimization should be directed.
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