E1223. Fibromuscular Dysplasia: A Primer for the Neuroradiologist
  1. Thomas Marini; University of Rochester
  2. James Loftus; University of Rochester
  3. Yu Zhao; University of Rochester
  4. Edward Lin; University of Rochester
  5. Anthony Portanova; University of Rochester
  6. Jeevak Almast; University of Rochester
  7. Shehanaz Ellika; University of Rochester
Fibromuscular dysplasia (FMD) is an arterial disease affecting the major craniocervical arterial vasculature in up to 70% of cases. Recognizing the various imaging manifestations of FMD is essential, as complications of this disease process can lead to serious morbidity and mortality.

Educational Goals / Teaching Points
This presentation will review the spectrum of imaging modalities available for imaging FMD, the imaging manifestations of different forms of FMD, and its differential diagnosis. In addition, the viewer will learn to recognize the complications of FMD

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
CTA, MRA, and vessel wall imaging are sensitive non-invasive imaging studies to detect FMD & its complications. While the most common manifestation of FMD is luminal irregularity in a string of beads pattern (type I), less common findings include long segment tubular stenosis (type II), and eccentric outpouching secondary to periadventitial fibroplasia (type III). The differential diagnosis includes other vasculopathies, arterial “standing waves,” and atherosclerotic disease.

FMD has a classic appearance on imaging in the craniocervical vasculature, although variations do exist and are important for the neuroradiologist to recognize. Knowledge of the various imaging appearances of FMD facilitate proper identification of this disease, which has potential to result in serious complications including ischemic stroke, subarachnoid hemorrhage, dissection, aneurysm/pseudoaneurysm, and carotid-cavernous fistula.