VW-MR imaging to evaluate vascular disease activity. MR angiogram demonstrates a saccular aneurysm at the tip of the basilar artery (A) and a saccular aneurysm at the right posterior communicating artery origin (C). Coronal contrast-enhanced T1-weighted VW-MR imaging shows no enhancement of the basilar artery aneurysm wall (B, arrow) but intense enhancement of the posterior communicating artery aneurysm wall (D, arrow). Axial T2-weighted FLAIR image (E, arrow) demonstrates a hematoma centered around the enhancing aneurysm, consistent with the preliminary research studies, suggesting that symptomatic and ruptured aneurysms have wall enhancement much more commonly than asymptomatic saccular aneurysms.