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Zhang Y, Cao J, Qiao C, Gao B, Du W, Lin L, Liu N, Song Q, Miao Y. Fast imaging of lenticulostriate arteries by high-resolution black-blood T1-weighted imaging with variable flip angles and acceleration by compressed sensitivity encoding. Magn Reson Imaging 2024; 110:51-56. [PMID: 38458551 DOI: 10.1016/j.mri.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 02/24/2024] [Accepted: 03/04/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE We investigated the feasibility of using compressed sensitivity encoding (CS-SENSE) to accelerate high-resolution black-blood T1-weighted imaging with variable flip angles (T1WI-VFA) for efficient visualization and characterization of lenticulostriate arteries (LSAs) on a 3.0 T MR scanner. MATERIALS AND METHODS Twenty-five healthy volunteers and 18 patients with the cerebrovascular disease were prospectively enrolled. Healthy volunteers underwent T1WI-VFA sequences with different acceleration factors (AFs), including conventional sensitivity encoding (SENSE) AF = 3 and CS-SENSE AF = 3, 4, 5, and 6 (SENSE3, CS3, CS4, CS5, CS6, respectively) at 3 Tesla MRI scanner. Objective evaluation (contrast ratio and number, length, and branches of LSAs) and subjective evaluation (overall image quality and LSA visualization scores) were used to assess image quality and LSA visualization. Comparisons were performed among the 5 sequences to select the best AF. All patients underwent both T1WI-VFA with the optimal AF and digital subtraction angiography (DSA) examination, and the number of LSAs observed by T1WI-VFA was compared with that by DSA. RESULTS Pair-wise comparisons among CS3, CS4, and SENSE3 revealed no significant differences in both objective measurements and subjective evaluation (all P > 0.05). In patients, there was no significant difference in LSA counts on the same side between T1WI-VFA with CS4 and DSA (3, 3-4 and 3, 3-3, P = 0.243). CONCLUSIONS CS3 provided better LSA visualization but a longer scan duration compared to CS4. And, CS4 strikes a good balance between LSA visualization and acquisition time, which is recommended for routine clinical use.
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Affiliation(s)
- Yukun Zhang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Jiajun Cao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Chen Qiao
- Department of Intervention, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Bingbing Gao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Wei Du
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing 100000, China
| | - Na Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Yanwei Miao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China.
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de Nys CM, Liang ES, Prior M, Woodruff MA, Novak JI, Murphy AR, Li Z, Winter CD, Allenby MC. Time-of-Flight MRA of Intracranial Aneurysms with Interval Surveillance, Clinical Segmentation and Annotations. Sci Data 2024; 11:555. [PMID: 38816429 PMCID: PMC11139857 DOI: 10.1038/s41597-024-03397-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 05/21/2024] [Indexed: 06/01/2024] Open
Abstract
Intracranial aneurysms (IAs) are present in 2-6% of the global population and can be catastrophic upon rupture with a mortality rate of 30-50%. IAs are commonly detected through time-of-flight magnetic resonance angiography (TOF-MRA), however, this data is rarely available for research and training purposes. The provision of imaging resources such as TOF-MRA images is imperative to develop new strategies for IA detection, rupture prediction, and surgical training. To support efforts in addressing data availability bottlenecks, we provide an open-access TOF-MRA dataset comprising 63 patients, of which 24 underwent interval surveillance imaging by TOF-MRA. Patient scans were evaluated by a neuroradiologist, providing aneurysm and vessel segmentations, clinical annotations, 3D models, in addition to 3D Slicer software environments containing all this data for each patient. This dataset is the first to provide interval surveillance imaging for supporting the understanding of IA growth and stability. This dataset will support computational and experimental research into IA dynamics and assist surgical and radiology training in IA treatment.
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Affiliation(s)
- Chloe M de Nys
- School of Chemical Engineering, The University of Queensland, Brisbane, Australia
- Herston Biofabrication Institute, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Ee Shern Liang
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Medical Imaging, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Marita Prior
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Medical Imaging, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Maria A Woodruff
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
| | - James I Novak
- Herston Biofabrication Institute, The Royal Brisbane and Women's Hospital, Brisbane, Australia
- School of Architecture, Design and Planning, The University of Queensland, Brisbane, Australia
| | - Ashley R Murphy
- School of Chemical Engineering, The University of Queensland, Brisbane, Australia
| | - Zhiyong Li
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
| | - Craig D Winter
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
- Kenneth G Jaimieson Department of Neurosurgery, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Mark C Allenby
- School of Chemical Engineering, The University of Queensland, Brisbane, Australia.
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Li J, Bian Y, Wu F, Fan Z, Zhang C, Zhao X, Ji X, Yang Q. Association of Morphology of Lenticulostriate Arteries and Proximal Plaque Characteristics With Single Subcortical Infarction: A Whole-Brain High-Resolution Vessel Wall Imaging Study. J Am Heart Assoc 2024; 13:e032856. [PMID: 38726896 PMCID: PMC11179825 DOI: 10.1161/jaha.123.032856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/15/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND We aimed to investigate the association of characteristics of lenticulostriate artery (LSA) morphology and parental atheromatous disease (PAD) with single subcortical infarction (SSI) and to explore whether the LSA morphology is correlated with proximal plaque features in asymptomatic PAD. METHODS AND RESULTS Patients with acute SSI were prospectively enrolled and classified as large- and small-SSI groups. The clinical data and imaging features of LSA morphology (branches, length, dilation, and tortuosity) and middle cerebral artery plaques (normalized wall index, remodeling index, enhancement degree, and hyperintense plaques) were evaluated. Logistic regression was performed to determine the association of large SSIs with morphologic features of LSAs and plaques. The Spearman correlation between the morphologic characteristics of LSAs and plaque features in asymptomatic PAD was analyzed. Of the 121 patients recruited with symptomatic PAD, 102 had coexisting asymptomatic contralateral PAD. The mean length of LSAs (odds ratio, 0.84 [95% CI, 0.73-0.95]; P=0.007), mean tortuosity of LSAs (odds ratio, 1.13 [95% CI, 1.05-1.22]; P=0.002), dilated LSAs (odds ratio, 22.59 [95% CI, 2.46-207.74]; P=0.006), and normalized wall index (odds ratio, 1.08 [95% CI, 1.01-1.15]; P=0.022) were significantly associated with large SSIs. Moreover, the normalized wall index was negatively correlated with the mean length of LSAs (r=-0.348, P<0.001), and the remodeling index was negatively correlated with the mean tortuosity of LSAs (r=-0.348, P<0.001) in asymptomatic PAD. CONCLUSIONS Our findings suggest that mean length of LSAs, mean tortuosity of LSAs, dilated LSAs, and normalized wall index are associated with large SSIs. Moreover, plaque features in asymptomatic PAD are correlated with morphologic features of LSAs.
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Affiliation(s)
- Jin Li
- Department of Radiology Beijing Chaoyang Hospital, Capital Medical University Beijing China
| | - Yueyan Bian
- Department of Radiology Beijing Chaoyang Hospital, Capital Medical University Beijing China
| | - Fang Wu
- Department of Radiology Xuanwu Hospital, Capital Medical University Beijing China
| | - Zhaoyang Fan
- Department of Radiology, Keck School of Medicine University of Southern California Los Angeles CA USA
| | - Chen Zhang
- MR Research Collaboration, Siemens Healthineers Beijing China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering Tsinghua University School of Medicine Beijing China
| | - Xunming Ji
- Department of Neurology Xuanwu Hospital, Capital Medical University Beijing China
- Beijing Institute of Brain Disorders, Capital Medical University Beijing China
| | - Qi Yang
- Department of Radiology Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Key Lab of Medical Engineering for Cardiovascular Disease Ministry of Education Beijing China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine Beijing China
- Laboratory for Clinical Medicine Capital Medical University Beijing China
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Zhou L, Wu H, Zhou H. Correlation Between Cognitive Impairment and Lenticulostriate Arteries: A Clinical and Radiomics Analysis. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01060-7. [PMID: 38429561 DOI: 10.1007/s10278-024-01060-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/19/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
Lenticulostriate arteries (LSA) are potentially valuable for studying vascular cognitive impairment. This study aims to investigate correlations between cognitive impairment and LSA through clinical and radiomics features analysis. We retrospectively included 102 patients (mean age 62.5±10.3 years, 60 males), including 58 with mild cognitive impairment (MCI) and 44 with moderate or severe cognitive impairment (MSCI). The MRI images of these patients were subjected to z-score preprocessing, manual regions of interest (ROI) outlining, feature extraction (pyradiomics), feature selection [max-relevance and min-redundancy (mRMR), least absolute shrinkage and selection operator (LASSO), and univariate analysis], model construction (multivariate logistic regression), and evaluation [receiver operating characteristic curve (ROC), decision curve analysis (DCA), and calibration curves (CC)]. In the training dataset (71 patients, 44 MCI) and the test dataset (31 patients, 17 MCI), the area under curve (AUC) of the combined model (training 0.88 [95% CI 0.78, 0.97], test 0.76 [95% CI 0.6, 0.93]) was better than that of the clinical model and the radiomics model. The DCA results demonstrated the highest net yield of the combined model relative to the clinical and radiomics models. In addition, we found that LSA total vessel count (0.79 [95% CI 0.08, 1.59], P = 0.038) and wavelet.HLH_glcm_MCC (-1.2 [95% CI -2.2, -0.4], P = 0.008) were independent predictors of MCI. The model that combines clinical and radiomics features of LSA can predict MCI. Besides, LSA vascular parameters may serve as imaging biomarkers of cognitive impairment.
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Affiliation(s)
- Langtao Zhou
- Department of Radiology of the First Affiliated Hospital, University of South China, Hengyang, 421001, China
- School of Cyberspace Security, Guangzhou University, Guangzhou, 510006, China
| | - Huiting Wu
- Department of Radiology of the First Affiliated Hospital, University of South China, Hengyang, 421001, China.
| | - Hong Zhou
- Department of Radiology of the First Affiliated Hospital, University of South China, Hengyang, 421001, China.
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Bai X, Fan P, Li Z, Mossa-Basha M, Ju Y, Zhao X, Kong Q, Pei X, Zhang X, Sui B, Zhu C. Evaluating Middle Cerebral Artery Plaque Characteristics and Lenticulostriate Artery Morphology Associated With Subcortical Infarctions at 7T MRI. J Magn Reson Imaging 2024; 59:1045-1055. [PMID: 37259904 DOI: 10.1002/jmri.28839] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Lenticulostriate artery (LSA) obstruction is a potential cause of subcortical infarcts. However, MRI LSA evaluation at 3T is challenging. PURPOSE To investigate middle cerebral artery (MCA) plaque characteristics and LSA morphology associated with subcortical infarctions in LSA territories using 7-T vessel wall MRI (VW-MRI) and time-of-flight MR angiography (TOF-MRA). STUDY TYPE Prospective. POPULATION Sixty patients with 80 MCA atherosclerotic plaques (37 culprit and 43 non-culprit). FIELD STRENGTH/SEQUENCE 7-T with 3D TOF-MRA and T1-weighted 3D sampling perfection with application-optimized contrast using different flip angle evolutions (SPACE) sequences. ASSESSMENT Plaque distribution (superior, inferior, ventral, or dorsal walls), LSA origin involvement, LSA morphology (numbers of stems, branches, and length), and plaque characteristics (normalized wall index, maximal wall thickness, plaque length, remodeling index, intraplaque hemorrhage, and plaque surface morphology (regular or irregular)) were assessed. STATISTICAL TESTS Least absolute shrinkage and selection operator regression, generalized estimating equations regression, receiver operating characteristic curve, independent t-test, Mann-Whitney U test, Chi-square test, Fisher's exact test, and intra-class coefficient. A P value <0.05 was considered statistically significant. RESULTS Plaque irregular surface, superior wall plaque, longer plaque length, LSA origin involvement, fewer LSA stems, and shorter total and average lengths of LSAs were significantly associated with culprit plaques. Multivariable logistic analysis confirmed that LSA origin involvement (OR, 28.51; 95% CI, 6.34-181.02) and plaque irregular surface (OR, 8.32; 95% CI, 1.41-64.73) were independent predictors in differentiating culprit from non-culprit plaques. A combination of LSA origin involvement and plaque irregular surface (area under curve = 0.92; [95% CI, 0.86-0.98]) showed good performance in identifying culprit plaques, with sensitivity and specificity of 86.5% and 86.0%, respectively. DATA CONCLUSION 7-T VW-MRI and TOF-MRA can demonstrate plaque involvement with LSA origins. MCA plaque characteristics derived from 7-T VW-MRI showed good diagnostic accuracy in determining the occurrence of subcortical infarctions. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Xiaoyan Bai
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Pingping Fan
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhiye Li
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Mahmud Mossa-Basha
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Yi Ju
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qingle Kong
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Xun Pei
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Zhang
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Binbin Sui
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, Washington, USA
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Meng Y, Magigi MC, Song Y, Zhao W, Zheng M, Sun L, Yin H, Wang W, Zhang J, Han J. Plaque features of the middle cerebral artery are associated with periprocedural complications of intracranial angioplasty and stenting. Neuroradiology 2024; 66:109-116. [PMID: 37953353 DOI: 10.1007/s00234-023-03244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/29/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE The identification of plaque features in the middle cerebral artery (MCA) may help minimize periprocedural complications and select patients suitable for percutaneous transluminal angioplasty and stenting (PTAS). However, relevant research is lacking. METHODS We retrospectively included patients with symptomatic MCA stenosis who received PTAS. All patients underwent intracranial vessel wall MRI (VWMRI) before surgery. Periprocedural complications (PC) included ischemic and hemorrhagic stroke within 30 days. Stenosis location, MCA shape, plaque eccentricity and distribution, plaque thickness and length, and enhancement ratio were compared between patients with and without PC. RESULTS Sixty-six patients were included in the study, of which 12.1% (8/66) had PC. Of the eight patients with PC, seven (87.5%) had superior wall plaques. In the non-PC group (n = 58), nine (17%) patients had superior wall plaques. Compared with patients without PC, those with PC had more frequent superior wall plaques (17% vs 87.5%, p < 0.001) and s-shaped MCAs (19% vs 50%, p = 0.071), different stenosis locations (p = 0.012), thicker plaques (1.58 [1.35, 2.00] vs 1.98 [1.73, 2.43], p = 0.038), and less frequent inferior wall plaques (79.2% vs 12.5%, p < 0.001). Multivariate analysis showed that only the presence of superior wall plaques (OR = 41.54 [2.31, 747.54]) was independently associated with PC. CONCLUSION MCA plaque features were highly correlated with PC in patients with symptomatic MCA stenosis who underwent PTAS.
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Affiliation(s)
- Yao Meng
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Miyengi Cosmas Magigi
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Yun Song
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Wei Zhao
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Meimei Zheng
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Lili Sun
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Hao Yin
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Wei Wang
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Jun Zhang
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Ju Han
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China.
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Huang P, Chen K, Liu C, Zhen Z, Zhang R. Visualizing Cerebral Small Vessel Degeneration During Aging and Diseases Using Magnetic Resonance Imaging. J Magn Reson Imaging 2023; 58:1323-1337. [PMID: 37052571 DOI: 10.1002/jmri.28736] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Cerebral small vessel disease is a major contributor to brain disorders in older adults. It is associated with a much higher risk of stroke and dementia. Due to a lack of clinical and fluid biomarkers, diagnosing and grading small vessel disease are highly dependent on magnetic resonance imaging. In the past, researchers mostly used brain parenchymal imaging markers to represent small vessel damage, but the relationships between these surrogate markers and small vessel pathologies are complex. Recent progress in high-resolution magnetic resonance imaging methods, including time-of-flight MR angiography, phase-contrast MR angiography, black blood vessel wall imaging, susceptibility-weighted imaging, and contrast-enhanced methods, allow for direct visualization of cerebral small vessel structures. They could be powerful tools for understanding aging-related small vessel degeneration and improving disease diagnosis and treatment. This article will review progress in these imaging techniques and their application in aging and disease studies. Some challenges and future directions are also discussed. EVIDENCE LEVEL: 4. TECHNICAL EFFICACY: 3.
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Affiliation(s)
- Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kang Chen
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chen Liu
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhiming Zhen
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ruiting Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Zhang Z, Kong Q, Zhang Y, Zhu W, Wei N, Xu Y, Suo Y, Meng X, Liebig P, Zhang Z, Wang Y, Jing J. Improved characterization of lenticulostriate arteries using compressed sensing time-of-flight at 7T. Eur Radiol 2023; 33:6939-6947. [PMID: 37062772 DOI: 10.1007/s00330-023-09629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 01/22/2023] [Accepted: 02/17/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVES To evaluate the feasibility of 0.2-mm isotropic lenticulostriate arteries (LSAs) imaging using compressed sensing time-of-flight (CS TOF) at around 10 min on 7T, and compare the delineation and characterization of LSAs using conventional TOF and CS TOF. METHODS Thirty healthy volunteers were examined with CS TOF and conventional TOF at 7T for around 10 min each. CS TOF was optimized to achieve 0.2-mm isotropic LSA imaging. The numbers of LSA stems and branches were counted and compared on a vascular skeleton. The length and distance were measured and compared on the most prominent branch in each hemisphere. Another patient with intracranial artery stenosis was studied to compare LSA delineation in CS TOF and digital subtraction angiography (DSA). RESULTS The number of stems visualized with CS TOF was significantly higher than with conventional TOF in both left (p = 0.002, ICC = 0.884) and right (p < 0.001, ICC = 0.938) hemispheres. The number of branches visualized by conventional TOF was significantly lower than that by CS TOF in both left (p < 0.001, ICC = 0.893) and right (p < 0.001, ICC = 0.896) hemispheres. The lengths were statistically higher in CS TOF than in conventional TOF (left: p < 0.001, ICC = 0.868; right: p < 0.001, ICC = 0.876). CONCLUSIONS The high-resolution CS TOF improves the delineation and characterization of LSAs over conventional TOF. High-resolution LSA imaging using CS TOF can be a promising tool for clinical research and applications in patients with neurologic diseases. KEY POINTS • 0.2-mm isotropic LSA imaging for around 10 min using CS TOF at 7T is feasible. • More stems and branches of LSAs with longer lengths can be delineated with CS TOF than with conventional TOF at the same scan time. • High-resolution CS TOF can be a promising tool for research and applications on LSA.
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Affiliation(s)
- Zhe Zhang
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Qingle Kong
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Yingkui Zhang
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Wanlin Zhu
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Ning Wei
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuyuan Xu
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yue Suo
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xia Meng
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | - Zihao Zhang
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yongjun Wang
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Jing
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, No 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Zhang Y, Chang P, Liu N, Jiang Y, Chu Y, Du W, Lin L, Gao B, Li Y, Qu M, Yang C, Miao Y. Correlation between lenticulostriate arteries and white matter microstructure changes in patients with cerebral small vessel disease. Front Neurosci 2023; 17:1202538. [PMID: 37817799 PMCID: PMC10560852 DOI: 10.3389/fnins.2023.1202538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/05/2023] [Indexed: 10/12/2023] Open
Abstract
To explore the correlation between the number of lenticulostriate arteries (LSAs) and the white matter features in cerebral small vessel diseases (CSVD) by 3T magnetic resonance imaging (MRI). Seventy-one patients with diagnoses of CSVD were prospectively enrolled to undergo 3T MRI examination, including high-resolution vascular wall imaging (VWI) and diffusion tensor imaging (DTI). The LSAs were observed and counted on VWI, and the patients were divided into three groups according to the LSA counts. The presence of white matter hyperintensities (WMHs), lacunes, cerebral microbleeds (CMBs), and enlarged perivascular spaces (EPVS) was assessed in each patient, and a composite CSVD score was calculated. Periventricular and deep white matter hyperintensity (PVWMH, DWMH) volume ratios were obtained based on automatic segmentation. Fractional anisotropy (FA) and mean diffusivity (MD) were processed by using tract-based spatial statistics (TBSS) analysis. These parameters were compared among the three groups. Correlations between the LSA counts and white matter features were also analyzed. There were differences in WMHs (P = 0.001), CMBs (P < 0.001), EPVS (P = 0.017), composite CSVD scores (P < 0.001), PVWMH volume ratios (P = 0.001), DWMH volume ratios (P < 0.001), global FA (P = 0.001), and global MD (P = 0.002) among the three groups. There were correlations between the LSA counts and WMHs (r = -0.45, P < 0.001), CMBs (r = -0.44, P < 0.001), EPVS (r = -0.28, P = 0.020), the composite CSVD score (r = -0.52, P < 0.001), DWMH volume ratio (r = -0.47, P < 0.001), PWMH volume ratio (r = -0.34, P = 0.004), global FA (r = 0.36, P = 0.002), and global MD (r = -0.33, P = 0.005). Diabetes mellitus (OR 3.36, 95% CI 1.06-10.63; P = 0.039) and increased DWMH volume ratios (OR 1.04, 95% CI 1.00-1.08; P = 0.048) were independent risk factors for a decrease in LSA counts. TBSS analysis showed differences among the three groups in global FA and MD after adjusting for age and sex (P < 0.05). The LSA counts was associated with white matter microstructure changes in CSVD and has the potential to represent the extent of subcortical microvascular damage in CSVD patients.
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Affiliation(s)
- Yukun Zhang
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Peipei Chang
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Na Liu
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Yuhan Jiang
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Ying Chu
- Department of Neurology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Wei Du
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | | | - Bingbing Gao
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Yuan Li
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Mingrui Qu
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Chao Yang
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - YanWei Miao
- Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
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Li Y, Feng Q, Wang C, Zhang X, Wan L, Han T. Exploration of the etiology of single small subcortical infarctions using high-resolution vessel wall MRI. Front Neurol 2023; 14:1179730. [PMID: 37360343 PMCID: PMC10289301 DOI: 10.3389/fneur.2023.1179730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/09/2023] [Indexed: 06/28/2023] Open
Abstract
Objective We aimed to explore imaging indicators for diagnosing the etiology of single small subcortical infarctions (SSI) using high-resolution vessel wall imaging (HR-VWI). Methods Patients with acute isolated subcortical cerebral infarction were prospectively enrolled and classified as having large artery atherosclerosis (LAA), stroke of undetermined etiology (SUD), or small artery disease (SAD). The infarct information, the cerebral small vessel disease (CSVD) score, morphological characteristics of the lenticulostriate arteries (LSAs), and plaque characteristics were compared between the three groups. Results Seventy seven patients were enrolled (30 LAA, 28 SUD, and 19 SAD). The total CSVD score of the LAA (P = 0.001) and SUD groups (P = 0.017) was significantly lower than that of the SAD group. The number and total length of LSA branches in the LAA and SUD groups were shorter than in the SAD group. Moreover, the total length laterality index (LI) of the LSAs in the LAA and SUD groups was greater than in the SAD group. The total CSVD score and LI of total length were independent predictors for the SUD and LAA groups. The remodeling index of the SUD group was significantly higher than that of the LAA group (P = 0.002); positive remodeling was dominant in the SUD group (60.7%), whereas remodeling in the LAA group was primarily non-positive (83.3%). Conclusions SSI with and without plaques on the carrier artery may have different modes of pathogenesis. Patients with plaques may also have a coexisting mechanism of atherosclerosis.
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Affiliation(s)
- Yutian Li
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin University, Tianjin, China
- Department of Radiology, Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Quanzhi Feng
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin University, Tianjin, China
| | - Congcong Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | | | - Liang Wan
- Medical College, Tianjin University, Tianjin, China
| | - Tong Han
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin, China
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Shi Z, Zhao X, Zhu S, Miao X, Zhang Y, Han S, Wang B, Zhang B, Ye X, Dai Y, Chen C, Rao S, Lin J, Zeng M, Wang H. Time-of-Flight Intracranial MRA at 3 T versus 5 T versus 7 T: Visualization of Distal Small Cerebral Arteries. Radiology 2023; 306:207-217. [PMID: 36040333 DOI: 10.1148/radiol.220114] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Three-dimensional (3D) time-of-flight (TOF) MR angiography (MRA) at 7 T has been reported to have high image quality for visualizing small perforating vessels. However, B1 inhomogeneity and more physiologic considerations limit its applications. Angiography at 5 T may provide another choice for intracranial vascular imaging. Purpose To evaluate the image quality and cerebrovascular visualization of 5-T 3D TOF MRA for visualizing intracranial small branch arteries. Materials and Methods Participants (healthy volunteers or participants with a history of ischemic stroke undergoing intracranial CT angiography or MRA for identifying steno-occlusive disease) were prospectively included from September 2021 to November 2021. Each participant underwent 3-T, 5-T, and 7-T 3D TOF MRA with use of customized MR protocols within 48 hours. Radiologist scoring from 0 (invisible) to 3 (excellent) and quantitative assessment were obtained to evaluate the image quality. The Friedman test was used for comparison of characteristics derived from 3 T, 5 T, and 7 T. Results A total of 12 participants (mean age ± SD, 38 years ± 9; nine men) were included. Visualizations of the distal arteries and small vessels at 5-T TOF MRA were significantly higher than those at 3 T (median score: 3.0 vs 2.0, all P < .001 for distal segments and lenticulostriate artery; median score: 2.0 vs 0, P < .001 for pontine artery). The total length of small vessel branches detected at 5 T was larger than that at 3 T (5.1 m ± 0.7 vs 1.9 m ± 0.4; P < .001). However, there was no evidence of a significant difference compared with 7 T in either the depiction of distal segments and small vessel branches (average median score, 2.5; all P > .05) or the quantitative measurements (total length, 5.6 m ± 0.5; P = .41). Conclusion Three-dimensional time-of-flight MR angiography at 5 T presented the capability to provide superior visualization of distal large arteries and small vessel branches (in terms of subjective and quantitative assessment) to 3 T and had image quality similar to 7 T. © RSNA, 2022 Online supplemental material is available for this article. An earlier incorrect version appeared online. This article was corrected on September 14, 2022.
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Affiliation(s)
- Zhang Shi
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Xueying Zhao
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Shuo Zhu
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Xiyin Miao
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Yunfei Zhang
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Shihong Han
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Bei Wang
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Boyu Zhang
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Xiaodan Ye
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Yongming Dai
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Caizhong Chen
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Shengxiang Rao
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Jiang Lin
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - Mengsu Zeng
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
| | - He Wang
- From the Departments of Radiology (Z.S., S.Z., X.M., X.Y., C.C., S.R., J.L., M.Z.) and Neurology (H.W.), Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai, China (Z.S., S.Z., Y.Z., X.Y., C.C., S.R., J.L., M.Z.); Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (X.Z., B.W., B.Z., H.W.); Central Research Institute, United Imaging Healthcare, Shanghai, China (Y.Z., Y.D.); Shanghai United Imaging Healthcare, Shanghai, China (S.H.)
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Yan Y, Jiang S, Yang T, Yuan Y, Wang C, Deng Q, Wu T, Tang L, Wu S, Sun J, Wu B. Lenticulostriate artery length and middle cerebral artery plaque as predictors of early neurological deterioration in single subcortical infarction. Int J Stroke 2023; 18:95-101. [PMID: 35120419 DOI: 10.1177/17474930221081639] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Early neurological deterioration (END) is not a rare phenomenon in single subcortical infarction (SSI; traditionally known as lacunar infarction) patients. Predictors of END in SSI patients are uncertain. AIMS We aimed to investigate the association between infarct lesion characteristics, penetrating artery morphology, carrier artery plaque features and END using whole-brain vessel-wall imaging. METHODS We prospectively collected data from SSI patients without stenosis of the corresponding carrier artery. The infarct lesion size and location, lenticulostriate artery (LSA) morphological characteristics, and features of the middle cerebral artery (MCA) plaques involving M1 segment adjacent to LSA origin on the symptomatic side were compared between patients with or without END. RESULTS A total of 74 participants were enrolled, of whom 23 cases (31.1%) showed END. Multivariable logistic regression analysis adjusted for baseline National Institutes of Health Stroke Scale score and axial maximal diameter of infarct lesion revealed that the patients with MCA plaques adjacent to the LSA origin were more likely to develop END (odds ratio (OR) = 3.87, 95% confidence interval (CI) = 1.21-12.33), while with longer average length of LSAs were less likely to occur END (OR = 0.21, 95% CI = 0.05-0.92). CONCLUSION MCA plaques located adjacent to the LSA origin and average length of LSAs on the symptomatic side were independent predictors of END in SSI patients. This finding might provide new insights into the mechanisms of the neurological progression in SSI and facilitate therapeutic interventions.
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Affiliation(s)
- Yuying Yan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Shuai Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Tang Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Ye Yuan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Changyi Wang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qiao Deng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Wu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Lu Tang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Simiao Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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Li S, Ni J, Fan X, Yao M, Feng F, Li D, Qu J, Zhu Y, Zhou L, Peng B. Study protocol of Branch Atheromatous Disease-related stroke (BAD-study): a multicenter prospective cohort study. BMC Neurol 2022; 22:458. [PMID: 36494618 PMCID: PMC9733351 DOI: 10.1186/s12883-022-02976-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/08/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As a meaningful subtype of ischemic stroke in Asians, Branch atheromatous disease (BAD)-related stroke is associated with high early neurological deterioration (END) and disability, but is understudied and without recommended therapy. The mechanism of END still remains unclear. Branch atheromatous disease-related stroke study (BAD-study) therefore aims to investigate demographic, clinical and radiological features, and prognosis of BAD-related stroke in Chinese patients. METHODS/DESIGN BAD-study is a nationwide, multicenter, consecutive, prospective, observational cohort study enrolling patients aged 18-80 years with BAD-related stroke within 72 h after symptom onset. Initial clinical data, laboratory tests, and imaging data are collected via structured case report form, and follow-ups will be performed at 7 days, 30 days, 90 days, 6 months and 12 months after enrollment. The primary outcome is the score on modified Rankin Scale at 90-day follow-up with single-blinded assessment. Secondary outcomes include END within 7 days, and National institute of health stroke scale score, Barthel index, cerebrovascular events, major bleeding complications, and all-cause mortality during 90-day follow-up. Characteristics of penetrating and parent artery will be assessed by high-resolution magnetic resonance imaging combined with other imaging techniques. DISCUSSION BAD-study can provide demographic, clinical, radiological, and prognostic characteristics of BAD-related stroke, and thereby potentially figure out the vascular mechanism of early neurological deterioration and optimize therapy strategy with the aid of advanced imaging technique. Baseline data and evidence will also be generated for randomized controlled trials on BAD-related stroke in the future.
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Affiliation(s)
- Shengde Li
- grid.506261.60000 0001 0706 7839Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China ,grid.413106.10000 0000 9889 6335State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jun Ni
- grid.506261.60000 0001 0706 7839Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China ,grid.413106.10000 0000 9889 6335State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xiaoyuan Fan
- grid.413106.10000 0000 9889 6335Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Ming Yao
- grid.506261.60000 0001 0706 7839Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China ,grid.413106.10000 0000 9889 6335State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Feng Feng
- grid.413106.10000 0000 9889 6335Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Dongxue Li
- grid.413106.10000 0000 9889 6335Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jianxun Qu
- Research Scientist, Siemens Healthineers, Beijing, China
| | - Yicheng Zhu
- grid.506261.60000 0001 0706 7839Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China ,grid.413106.10000 0000 9889 6335State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Lixin Zhou
- grid.506261.60000 0001 0706 7839Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China ,grid.413106.10000 0000 9889 6335State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Bin Peng
- grid.506261.60000 0001 0706 7839Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China ,grid.413106.10000 0000 9889 6335State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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d’Annunzio A, Arboix A, García-Eroles L, Sánchez-López MJ. Vertigo in Acute Stroke Is a Predictor of Brain Location but Is Not Related to Early Outcome: The Experience of Sagrat Cor Hospital of Barcelona Stroke Registry. Biomedicines 2022; 10:2830. [PMID: 36359352 PMCID: PMC9687911 DOI: 10.3390/biomedicines10112830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Vertigo is an uncommon symptom among acute stroke victims. Knowledge about the clinical profile, the brain location, and the early outcome in stroke patients with cerebrovascular diseases and vertigo remains limited. OBJECTIVES In this study, the effects of vertigo on cerebral topography and early prognosis in cerebrovascular diseases were investigated. METHODS A comparative analysis in terms of demographics, risk factors, clinical characteristics, stroke subtypes, cerebral and vascular topography, and early outcome was performed between patients with presence or absence of vertigo on a sample of 3743 consecutive acute stroke patients available from a 24-year ongoing single-center hospital-based stroke registry. RESULTS Vertigo was present in 147 patients (3.9%). Multiple logistic regression analysis showed that variables independently associated with vertigo were: location in the cerebellum (OR 5.59, CI 95% 3.24-9.64), nausea or vomiting (OR 4.48, CI 95% 2.95-6.82), medulla (OR 2.87, CI 95% 1.31-6.30), pons (OR 2.39, CI 95% 1.26-4.51), basilar artery (OR 2.36, CI 95% 1.33-4.17), ataxia (OR 2.33, CI 95% 1.41-3.85), and headache (OR 2.31, CI 95% 1.53-3.49). CONCLUSION The study confirmed that the presence of vertigo was not related with increased in-hospital mortality or poor prognosis at hospital discharge. Vertigo is mainly related to non-lacunar vertebrobasilar stroke with topographic localization in the cerebellum and/or brainstem.
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Affiliation(s)
- Angela d’Annunzio
- Department of Neurology, Hospital Universitari Sagrat Cor, Quirónsalud, Universitat de Barcelona, 08029 Barcelona, Catalunya, Spain
| | - Adrià Arboix
- Department of Neurology, Hospital Universitari Sagrat Cor, Quirónsalud, Universitat de Barcelona, 08029 Barcelona, Catalunya, Spain
| | - Luís García-Eroles
- Department of Neurology, Hospital Universitari Sagrat Cor, Quirónsalud, Universitat de Barcelona, 08029 Barcelona, Catalunya, Spain
| | - María-José Sánchez-López
- Medical Library, Hospital Universitari Sagrat Cor, Quirónsalud, Universitat de Barcelona, 08029 Barcelona, Catalunya, Spain
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15
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Xu J, Rajah GB, Zhang H, Han C, Shen X, Li B, Zou Z, Zhao W, Ren C, Liu G, Ding Y, Yang Q, Li S, Ji X. Imaging features of adult moyamoya disease patients with anterior intracerebral hemorrhage based on high-resolution magnetic resonance imaging. J Cereb Blood Flow Metab 2022; 42:2123-2133. [PMID: 35765819 PMCID: PMC9580173 DOI: 10.1177/0271678x221111082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to identify the high-resolution magnetic resonance imaging (HRMRI) features of moyamoya disease (MMD) patients with anterior intracerebral hemorrhage (ICH) and attempted to reveal potential mechanisms of anterior ICH. Eligible adult MMD patients were consecutively included, and the morphological features of lenticulostriate arteries (LSAs), vessel wall structure of terminal internal carotid artery (ICA) and periventricular anastomosis were evaluated by HRMRI. 78 MMD patients containing 21 patients with anterior ICH, 31 ischemic patients and 26 asymptomatic patients were included. The mean value of total length of LSAs in anterior ICH group (90.79 ± 37.00 mm) was distinctively lower (p < 0.001) compared with either ischemic group (138.04 ± 46.01 mm) or asymptomatic group (170.50 ± 39.18 mm). Lumen area of terminal ICA was significantly larger (p < 0.001) in hemorrhagic group (4.33 ± 2.02 mm2) compared with ischemic group (2.29 ± 1.17 mm2) or asymptomatic group (3.00 ± 1.34 mm2). Multivariate analysis revealed the total length of LSAs (OR 0.689, 95%CI, 0.565-0.840; p < 0.001) and lumen area of terminal ICA (OR 2.085, 95%, 1.214-3.582; p = 0.008) were significantly associated with anterior ICH. Coexistence of reduced LSAs and relatively preserved lumen area of terminal ICA with an AUC of 0.901 (95%CI, 0.812-0.990) could be a potential predictor of anterior ICH in MMD patients.
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Affiliation(s)
- Jiali Xu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Gary B Rajah
- Department of Neurosurgery, Munson Medical Center, Traverse City, MI, USA
| | - Houdi Zhang
- Department of Neurosurgery, the 307th Hospital of the Chinese People's Liberation Army, The Fifth Medical Center of Chinese PLA General Hospital, Academy of Military Medical Science, Beijing, China
| | - Cong Han
- Department of Neurosurgery, the 307th Hospital of the Chinese People's Liberation Army, The Fifth Medical Center of Chinese PLA General Hospital, Academy of Military Medical Science, Beijing, China
| | - Xuxuan Shen
- 307 Clinical College of Anhui Medical University, Hefei, China
| | - Bin Li
- Department of Neurosurgery, the 307th Hospital of the Chinese People's Liberation Army, The Fifth Medical Center of Chinese PLA General Hospital, Academy of Military Medical Science, Beijing, China
| | - Zhengxing Zou
- Department of Neurosurgery, the 307th Hospital of the Chinese People's Liberation Army, The Fifth Medical Center of Chinese PLA General Hospital, Academy of Military Medical Science, Beijing, China
| | - Wenbo Zhao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Changhong Ren
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guiyou Liu
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Yuchuan Ding
- Department of Neurosurgery, Wayne State University, Detroit, MI, USA
| | - Qi Yang
- Department of Radiology, Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Sijie Li
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xunming Ji
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
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16
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Jiang S, Cui JY, Yan YY, Yang T, Tao WD, Wu B. Association of compromised cerebral perfusion with lenticulostriate artery impairments in the subacute phase of branch atheromatous disease. Ther Adv Neurol Disord 2022; 15:17562864221109746. [PMID: 35813607 PMCID: PMC9260584 DOI: 10.1177/17562864221109746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/09/2022] [Indexed: 02/05/2023] Open
Abstract
Background Purpose: Whether altered cerebral perfusion is associated with the pathogenesis of
single subcortical infarctions (SSIs) in the lenticulostriate artery (LSA)
territory remains unclear. Objective: We aimed to assess whether cerebral perfusion abnormalities are related to
LSA impairments in the subacute phase of SSIs and then to examine their
correlations with etiological subtypes of SSIs. Methods: A total of 110 patients with acute SSIs in the LSA territory were
prospectively recruited between July 2017 and October 2021, and they
underwent magnetic resonance perfusion-weighted imaging (PWI) and
whole-brain vessel-wall imaging (VWI) within 7 days of stroke onset. Based
on VWI, patients were assigned to one of two SSI subtypes: branch
atheromatous disease (BAD, n = 78, 70.9%) or lacunar
infarction related to cerebral small vessel disease (CSVD-related LI,
n = 32, 29.1%). Perfusion maps and LSA morphology were
also quantitatively assessed. Results: Based on PWI, 22 patients (20%) had hypoperfusion and 88 (80%) showed normal
perfusion. Compared with normal individuals, patients with hypoperfusion
showed shorter average LSA length (23.48 ± 4.81 mm versus
25.47 ± 3.74 mm, p = 0.037). Compared with patients with
CSVD-related LI, patients with BAD had significantly lower relative cerebral
blood flow [0.95 (IQR 0.81–1.12) versus 1.04 (IQR
0.92–1.22); p = 0.036] and cerebral blood volume [0.95 (IQR
0.84–1.15) versus 1.14 (IQR 0.97–1.27);
p = 0.020] after adjusting for hypertension, number of LSA
branches, and infarct volume. Conclusion: Compromised cerebral perfusion is associated with impairments in the LSA and
with BAD pathogenesis. Perfusion magnetic resonance imaging can provide
important insights into acute SSI pathophysiology, and it may be useful for
determining the clinical significance of perfusion abnormalities in BAD
occurrence.
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Affiliation(s)
- Shuai Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing-Yu Cui
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu-Ying Yan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Tang Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Wen-Dan Tao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu 610041, Sichuan, China
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17
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Xu YY, Jing J, Zhang YJ, Wang AX, Li ZX, Liu LP, Zhao XQ, Wang YL, Li H, Meng X, Wang YJ. Prognosis and antiplatelet therapy of small single subcortical infarcts in penetrating artery territory: a post hoc analysis of the Third China National Stroke Registry. BMJ Neurol Open 2022; 4:e000267. [PMID: 35463388 PMCID: PMC8984046 DOI: 10.1136/bmjno-2022-000267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/19/2022] [Indexed: 12/04/2022] Open
Abstract
Background Small single subcortical infarction (SSSI) may be classified as parent artery disease-related or only branch involved according to the stenosis of parent artery. The study aimed to evaluate short-term and long-term prognoses and the effectiveness of antiplatelet therapy in SSSI. Methods We prospectively enrolled 2890 patients with SSSI from the Third China National Stroke Registry (CNSR-III) database from August 2015 to March 2018. We assessed clinical outcomes and antiplatelet treatment effects in patients with SSSI with and without parent artery stenosis (PAS) identified by magnetic resonance angiography. Results Among 2890 patients with SSSI in the perforator territory of the middle cerebral artery and the basilar artery, there were 680 (23.53%) patients with PAS and 2210 (76.47%) patients without PAS, respectively. After adjusting for potential confounders, the PAS group had a greater initial stroke severity (OR 1.262, 95% CI 1.058 to 1.505; p=0.0097) and a higher risk of ischaemic stroke recurrence at 3 months (OR 2.266, 95% CI 1.631 to 3.149; p<0.0001) and 1 year (OR 2.054, 95% CI 1.561 to 2.702; p<0.0001), as well as composite vascular events at 3 months (OR 2.306, 95% CI 1.674 to 3.178; p<0.0001) and 1 year (OR 1.983, 95% CI 1.530 to 2.570; p<0.0001), compared with the non-PAS group. In both groups, dual antiplatelet therapy was not superior to single antiplatelet therapy in preventing stroke recurrence, composite vascular events and disability. Conclusion PAS related to significantly higher rates of short-term and long-term stroke recurrence and composite vascular events, suggesting heterogeneous mechanisms in SSSI subgroups. The effectiveness of antiplatelet therapy for SSSI needs further investigation.
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Affiliation(s)
- Yu-Yuan Xu
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Jing
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yi-Jun Zhang
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - An-Xin Wang
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zi-Xiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Li-Ping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing-Quan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yi-Long Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hao Li
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xia Meng
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong-Jun Wang
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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18
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Yang X, Wu F, Liu Y, Duan J, Fisher M, Ji X, Meng R, Zhang H, Fan Z, Yang Q. Diagnostic performance of MR black-blood thrombus imaging for cerebral venous thrombosis in real-world clinical practice. Eur Radiol 2022; 32:2041-2049. [PMID: 34542696 DOI: 10.1007/s00330-021-08286-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/24/2021] [Accepted: 08/19/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVES MR black-blood thrombus imaging (BTI) has been developed for the detection of cerebral venous thrombosis (CVT). Yet, there is a lack of real-world data to verifying its clinical performance. This study aims to evaluate the performance of BTI in diagnosing and staging CVT in a 5-year period. METHODS Patients suspected of CVT were enrolled between 2014 and 2019. Patients with or without BTI scans were classified into group A and group B, respectively. The prevalence of correct diagnosis of CVT and patients with evaluable clot age were compared. The diagnostic performance of BTI including sensitivity, specificity, and specific staging information was further analyzed. RESULTS Two hundred and twenty-one of the 308 patients suspected of CVT were eligible in the current study (114 in group A and 97 in group B), with 125 diagnosed by multidisciplinary teams to have CVTs (56 in group A, 69 in group B). The rate of correct diagnosis of CVT was higher in group A than that in group B (94.7% vs 60.8%, p < 0.001, x2 = 36.517) after adding BTI images. The percent of patients with evaluable staged segments between the two groups were 96.4% and 33.9%, respectively (x2 = 48.191, p < 0.001). BTI showed a sensitivity of 96.4% and 87.9% in the detection of CVT on per-patient and per-segment level, respectively. Up to 98.1% of all thrombosed segments could be staged by BTI and 59.6% of them were matched with clinical staging. CONCLUSIONS In the actual clinical practice, BTI improves diagnostic confidence and has an excellent performance in confirming and staging CVT. KEY POINTS • Black-blood thrombus imaging has good diagnostic performance in detecting cerebral venous thrombosis compared to traditional imaging methods with strong evidence in the actual clinical setting. • BTI helps clinicians to diagnose CVT with more accuracy and confidence, which can be served as a promising imaging examination. • BTI can also provide additional information of different thrombus ages objectively, the valuable reference for clinical strategy.
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Affiliation(s)
- Xiaoxu Yang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongti Nanlu, Chaoyang District, Beijing, 100020, China
- Department of Radiology, Xuanwu Hospital, Beijing, China
| | - Fang Wu
- Department of Radiology, Xuanwu Hospital, Beijing, China
| | - Yuehong Liu
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongti Nanlu, Chaoyang District, Beijing, 100020, China
| | - Jiangang Duan
- Department of Emergency, Xuanwu Hospital, Beijing, China
| | - Marc Fisher
- Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Xunming Ji
- Department of Neurosurgery, Xuanwu Hospital, Beijing, China
| | - Ran Meng
- Department of Neurology, Xuanwu Hospital, Beijing, China
| | - Huibo Zhang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongti Nanlu, Chaoyang District, Beijing, 100020, China
| | - Zhaoyang Fan
- Radiology and Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
| | - Qi Yang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongti Nanlu, Chaoyang District, Beijing, 100020, China.
- Beijing Laboratory for Cardiovascular Precision Medicine, Beijing, China.
- Key Laboratory of Medical Engineering for Cardiovascular Disease, Ministry of Education, Beijing, China.
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19
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Evaluation of clinical relevance and underlying pathology for hemodynamic compromise in acute small subcortical infarction using MRI-based neuroimaging markers. Biomed J 2022; 46:100529. [PMID: 35367449 DOI: 10.1016/j.bj.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/12/2022] [Accepted: 03/23/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hemodynamic compromise has been observed in patients with acute small subcortical infarction (SSI), and it may play a critical role in the development of early neurological deterioration (END). This study aimed to evaluate the clinical relevance and underlying pathology of hemodynamic compromise in SSI using MRI-based neuroimaging markers. METHODS We retrospectively analyzed data and imaging of previous prospective studies. Patients with acute SSI in penetrating artery territories were recruited, all of whom underwent perfusion MRI within 24 h of stroke onset. We examined the relationships among perfusion defects and neuroimaging markers of small vessel disease, including white matter hyperintensities, cerebral microbleeds, enlarged perivascular spaces (EPVSs) and lacunes. RESULTS One hundred and seven patients were recruited, of whom 21 (19.6%) had END and 55 (51.4%) had visible perfusion defects. Patients with perfusion defects were associated with a higher rate of END (34.5% vs. 3.8%; p < 0.001), higher initial National Institutes of Health Stroke Scale scores (5.4 vs. 3.4, p < 0.001), higher rate of branch atheromatous disease (61.8% vs. 34.6%, p = 0.005) and higher rate of poor outcome at 3 months (40.0% vs. 5.4%; p = 0.005). In multiple logistic regression, perfusion defects were significantly associated with basal ganglia EPVS scores (adjusted odds ratio [aOR]: 3.93; 95% confidence interval [CI]: 1.76-8.77; p = 0.001) and branch atheromatous disease (aOR: 2.64; 95% CI: 1.06-6.60; p = 0.037). CONCLUSION Hemodynamic compromise in acute SSI was highly related to the development of END, basal ganglia EPVS and branch atheromatous disease, suggesting the correlation with underlying pathologies of hypertensive arteriopathy and atherosclerosis.
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20
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The Potential Impact of Neuroimaging and Translational Research on the Clinical Management of Lacunar Stroke. Int J Mol Sci 2022; 23:ijms23031497. [PMID: 35163423 PMCID: PMC8835925 DOI: 10.3390/ijms23031497] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 12/21/2022] Open
Abstract
Lacunar infarcts represent one of the most frequent subtypes of ischemic strokes and may represent the first recognizable manifestation of a progressive disease of the small perforating arteries, capillaries, and venules of the brain, defined as cerebral small vessel disease. The pathophysiological mechanisms leading to a perforating artery occlusion are multiple and still not completely defined, due to spatial resolution issues in neuroimaging, sparsity of pathological studies, and lack of valid experimental models. Recent advances in the endovascular treatment of large vessel occlusion may have diverted attention from the management of patients with small vessel occlusions, often excluded from clinical trials of acute therapy and secondary prevention. However, patients with a lacunar stroke benefit from early diagnosis, reperfusion therapy, and secondary prevention measures. In addition, there are new developments in the knowledge of this entity that suggest potential benefits of thrombolysis in an extended time window in selected patients, as well as novel therapeutic approaches targeting different pathophysiological mechanisms involved in small vessel disease. This review offers a comprehensive update in lacunar stroke pathophysiology and clinical perspective for managing lacunar strokes, in light of the latest insights from imaging and translational studies.
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21
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Bykanov AE, Pitskhelauri DI, Batalov AI, Young R, Trube MA, Holodny AI, Pronin IN, Zagidullin T. Sensitivity of three-dimensional time-of-flight 3.0 T magnetic resonance angiography in visualizing the number and course of lenticulostriate arteries in patients with insular gliomas. BRAIN & SPINE 2021; 2:100856. [PMID: 36248136 PMCID: PMC9560693 DOI: 10.1016/j.bas.2021.100856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 05/26/2023]
Abstract
Background Neurosurgical resection of insular gliomas is complicated by the possibility of iatrogenic injury to the lenticulostriate arteries (LSAs) and is associated with devastating neurological complications, hence the need to accurately assess the number of LSAs and their relationship to the tumor preoperatively. Methods The study included 24 patients with insular gliomas who underwent preoperative 3D-TOF MRA to visualize LSAs. The agreement of preoperative magnetic resonance imaging with intraoperative data in terms of the number of LSAs and their invasion by the tumor was assessed using the Kendall rank correlation coefficient and Cohen's Kappa with linear weighting. Agreement between experts performing image analysis was estimated using Cohen's Kappa with linear weighting. Results The number of LSAs arising from the M1 segment varied from 0 to 9 (mean 4.3 ± 0.37) as determined by 3D-TOF MRA and 2-6 (mean 4.25 ± 0.25) as determined intraoperatively, κ = 0.51 (95% CI: 0.25-0.76) and τ = 0.64 (p < 0.001). LSAs were encased by the tumor in 11 patients (confirmed intraoperatively in 9 patients). LSAs were displaced medially in 8 patients (confirmed intraoperatively in 8 patients). The tumor partially involved the LSAs and displaced them in 5 patients (confirmed intraoperatively in 7 patients), κ = 0.87 (95% CI: 0.70-1), τ = 0.93 (p < 0.001). 3D-TOF MRA demonstrated high sensitivity (100%, 95% CI: 0.63-1) and high specificity (86.67%, 95% CI: 0.58-0.98) in determining the LSA-tumor interface. Conclusions 3D-TOF MRA at 3T demonstrated sensitivity in determining the LSA-tumor interface and the number of LSAs in patients with insular gliomas.
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Affiliation(s)
| | | | - Artem I. Batalov
- Neuroradiology (A.I.B., I.N.P.) N.N, Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Robert Young
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY, 10065, USA
| | - Maxim A. Trube
- Peoples' Friendship University of Russia, Faculty of Medicine, Moscow, Russia
| | - Andrei I. Holodny
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY, 10065, USA
- Department of Neuroscience, Weill-Cornell Graduate School of the Medical Sciences, 1300 York Ave, New York, NY, 10065, USA
| | - Igor N. Pronin
- Neuroradiology (A.I.B., I.N.P.) N.N, Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia
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22
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Wei N, Zhang X, An J, Zhuo Y, Zhang Z. A Processing Pipeline for Quantifying Lenticulostriate Artery Vascular Volume in Subcortical Nuclei. Front Neurol 2021; 12:700476. [PMID: 34484103 PMCID: PMC8415791 DOI: 10.3389/fneur.2021.700476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/08/2021] [Indexed: 11/23/2022] Open
Abstract
Lenticulostriate arteries (LSAs) supply blood to the basal ganglia region. Its lesion causes lacunar stroke and resulting neurological syndromes. However, due to its small caliber and large individual variance, the evaluation of LSAs was limited to descriptive and objective measurements. In this study, we aimed to develop a post-processing method to quantify LSAs in subcortical regions and compare their vascular volume to conventional LSA measurements. A processing pipeline was designed to extract subcortical areas in individual spaces while screening out vessels. The vascular volume of LSAs in the subcortical region was calculated from time-of-flight-magnetic resonance angiography (TOF-MRA) at 7 Tesla. The reproducibility was tested to be good for the vascular volume (n = 5, ICCA = 0.84). Comparing the results to conventional measurements, the vascular volume was significantly correlated with the number of branches (r = 0.402, p < 0.001) and the length (r = 0.246, p = 0.032) of LSAs. By applying the method to a group of healthy volunteers (n = 40), we found that most LSAs crossing through the putamen which thereby has the highest vascular density among subcortical nuclei. In general, we proposed a semi-automated processing pipeline for quantifying the vascular volume of LSAs in subcortical regions. The novel method was tested to be robust and provided reasonable results. This method revealed spatial relationships among the perforating arteries and basal ganglia. The vascular volume can be used to evaluated blood supply of subcortical regions, benefiting the radiologic evaluation of neurodegenerative diseases caused by small vascular lesions.
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Affiliation(s)
- Ning Wei
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | - Jing An
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Yan Zhuo
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Zihao Zhang
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
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23
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Jiang S, Cao T, Yan Y, Yang T, Yuan Y, Deng Q, Wu T, Sun J, Wu S, Hao ZL, Anderson CS, Wu B. Lenticulostriate artery combined with neuroimaging markers of cerebral small vessel disease differentiate the pathogenesis of recent subcortical infarction. J Cereb Blood Flow Metab 2021; 41:2105-2115. [PMID: 33563077 PMCID: PMC8327122 DOI: 10.1177/0271678x21992622] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recent subcortical infarction (RSI) in the lenticulostriate artery (LSA) territory with a non-stenotic middle cerebral artery is a heterogeneous entity. We aimed to investigate the role of LSA combined with neuroimaging markers of cerebral small vessel disease (CSVD) in differentiating the pathogenic subtypes of RSI by whole-brain vessel-wall magnetic resonance imaging (WB-VWI). Fifty-two RSI patients without relevant middle cerebral artery (MCA) stenosis on magnetic resonance angiography were prospectively enrolled. RSI was dichotomized as branch atheromatous disease (BAD; a culprit plaque located adjacent to the LSA origin) (n = 34) and CSVD-related lacunar infarction (CSVD-related LI; without plaque or plaque located distal to the LSA origin) (n = 18). Logistic regression analysis showed lacunes (odds ratio [OR] 9.68, 95% confidence interval [CI] 1.71-54.72; P = 0.010) and smaller number of LSA branches (OR 0.59, 95% CI 0.36-0.96; P = 0.034) were associated with of BAD, whereas severe deep white matter hyperintensities (DWMH) (OR 0.11, 95% CI 0.02-0.71; P = 0.021) was associated with CSVD-related LI. In conclusion, the LSA branches combined with lacunes and severe DWMH may delineate subtypes of SSI. The WB-VWI technique could be a credible tool for delineating the heterogeneous entity of SSI in the LSA territory.
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Affiliation(s)
- Shuai Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.,Department of Neurology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Tian Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuying Yan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Tang Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Ye Yuan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiao Deng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Wu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Simiao Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Zi-Long Hao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Craig S Anderson
- The George Institute China at Peking University Health Science Center, Beijing, China.,The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, Australia
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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Visualization of lenticulostriate artery by intracranial dark-blood vessel wall imaging and its relationships with lacunar infarction in basal ganglia: a retrospective study. Eur Radiol 2021; 31:5629-5639. [PMID: 33566147 DOI: 10.1007/s00330-020-07642-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/22/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES There is close relationship between lenticulostriate arteries (LSAs) and lacunar infarctions (LIs) of the basal ganglia. The study aims to visualize the LSAs using high-resolution vessel wall imaging (VWI) on 3T system and explore the correlation between LSAs and LIs. METHODS Fifty-six patients with LIs in basal ganglia, and 44 age-matched control patients were enrolled and analyzed retrospectively. The raw VWI images were reformatted into coronal slices in minimum intensity projection for further observation of LSAs. The risk factors of LIs in basal ganglia were analyzed by univariate and multivariate logistic regression. The correlation and linear regression analysis between the LSAs and LIs, ipsilateral MCA-M1 plaques were investigated. RESULTS The total number (p < 0.01) and length (p < 0.01) of LSAs were statistically different between basal ganglias with and without LIs. The total number of LSAs and ipsilateral MCA-M1 plaques were independently related to LIs in basal ganglias. The mean length of LSAs were negatively correlated with number (r = - 0.33, p = 0.002) and volume (r = - 0.37, p = 0.001) of LIs. Age, drinking history, and mean length of LSAs were associated with LI occurrence in basal ganglia, and mean length of LSAs was correlated with larger volume of LIs. CONCLUSIONS Number of LSA reduction and ipsilateral MCA-M1 plaques were associated with the presence of LIs in basal ganglias. Age increasing, drinking history, and shorter LSAs were correlated with the increasing of LIs. KEY POINTS • Patients with LIs tend to have shorter LSAs. • The characteristics of LSAs and ipsilateral MCA-M1 plaques are associated with LIs in basal ganglias. • Age, drinking history, and mean length of LSAs are correlated with LI features in basal ganglias.
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Wu F, Han C, Liu Y, Liu Z, Yang X, Wu Y, Du J, Wu Y, Saba L, Zhang Q, Fan Z, Li D, Duan L, Yang Q. Validation of choroidal anastomosis on high-resolution magnetic resonance imaging as an imaging biomarker in hemorrhagic moyamoya disease. Eur Radiol 2021; 31:4548-4556. [PMID: 33447859 DOI: 10.1007/s00330-020-07479-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 10/11/2020] [Accepted: 11/05/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study aimed to investigate the association between dilation and proliferation and anastomosis of perforating arteries, and intracranial hemorrhage in moyamoya disease (MMD) patients, using high-resolution magnetic resonance imaging (HRMRI). METHODS Adult patients with MMD at advanced stages were prospectively enrolled and underwent HRMRI exams. Dilation and proliferation of the lenticulostriate artery (LSA), medullary artery, and anterior or posterior choroidal arteries (AChA or PChA) were assessed. Abnormal anastomoses were identified between (1) the LSA and the medullary or insular arteries; (2) the thalamo-geniculate, thalamo-tuberal, or thalamo-perforating arteries and the medullary or insular arteries; and (3) the AChA or PChA and the medullary or insular arteries. The association between these variables and hemorrhagic events was calculated using univariate and multivariate analyses. RESULTS Fifty patients (14 men; mean age, 35.4 ± 9.7 years) were finally analyzed, including 17 hemorrhagic patients and 33 non-hemorrhagic patients. The inter-rater agreement for the qualitative evaluation of perforating arteries was good. Dilation and proliferation of the AChA or PChA (88.2% versus 54.5%, p = 0.027), and choroidal anastomosis (64.7% versus 18.2%, p = 0.002) were more frequently observed in patients with hemorrhage. Multivariate logistic regression showed that choroidal anastomosis remained significantly associated with hemorrhage (odds ratio = 5.95, 95% confidence interval = 1.21-29.25, p = 0.028). CONCLUSIONS Choroidal anastomosis is independently associated with hemorrhagic events in adult patients with MMD at advanced stages. HRMRI can provide detailed information on both the anatomies and abnormal collaterals in MMD, which facilitates risk estimates of bleeding in MMD. KEY POINTS • High-resolution magnetic resonance imaging allows for the evaluation of perforating arteries in patients with moyamoya disease. • Choroidal anastomosis is associated with hemorrhagic events in patients with moyamoya disease. • High-resolution magnetic resonance imaging might facilitate further grading and classification of moyamoya vessels.
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Affiliation(s)
- Fang Wu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Cong Han
- Department of Neurosurgery, the Fifth Medical Centre of PLA General Hospital, Beijing, China
| | - Yuehong Liu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhiwen Liu
- Department of Neurosurgery, the General Hospital of Central Theater Command, Wuhan, Hubei, China
| | - Xiaoxu Yang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ye Wu
- Department of Radiology, Aerospace Center Hospital, Beijing, China
| | - Jingwen Du
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu Wu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Qian Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, and Departments of Medicine and Bioengineering, University of California, Los Angeles, CA, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, and Departments of Medicine and Bioengineering, University of California, Los Angeles, CA, USA
| | - Lian Duan
- Department of Neurosurgery, the Fifth Medical Centre of PLA General Hospital, Beijing, China.
| | - Qi Yang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
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Shao Q, Li Q, Wu Q, Li T, Li L, Chang K. Comparison of 3D T1-SPACE and DSA in evaluation of intracranial in-stent restenosis. Br J Radiol 2020; 94:20190950. [PMID: 33259233 DOI: 10.1259/bjr.20190950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE In-stent restenosis (ISR) after stenting for intracranial stenosis is a significant issue. This study aimed to evaluate the usefulness of the 3D T1-SPACE technique in the follow-up of patients after stent implantation. METHODS Fifteen patients with intracranial arterial stenosis were prospectively enrolled 6-8 months after stenting. Digital subtraction angiography (DSA) and 3D T1-SPACE imaging were performed to evaluate the degree of stenosis and the enhancement of the vessel wall. Bland-Altman plots were used to assess the agreement between the two imaging methods, and the Pearson correlation coefficient was calculated as a measure of the linear correlation. RESULTS Eight Enterprise stents and seven Wingspan stents were used in 15 patients. The follow-up DSA after 6-8 months showed that the degree of stenosis was 40% (range, 30-72%), and ISR occurred in 4 of 15 (26.7%) lesions. The degree of stenosis assessed using the 3D T1-SPACE imaging technique was 35% (range, 30-75%). All four patients with ISR demonstrated significant enhancement. The Pearson correlation coefficient between the two methods was 0.959 (p < 0.05), and the Bland-Altman plot showed that all data points were within the consistency limits ([Formula: see text] ± 1.96 s). CONCLUSION As a non-invasive imaging modality, 3D T1-SPACE showed great consistency with DSA in measuring the degree of stenosis after intracranial stenting. It may be used as an optional method for detecting ISR. ADVANCES IN KNOWLEDGE This study evaluated the usefulness of 3D T1-SPACE technique in the follow-up of patients after stent implantation, which could be used as an optional and non-invasive method in detection of in-stent restenosis.
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Affiliation(s)
- Qiuji Shao
- Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Qiang Li
- Department of Radiology, Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Qiaowei Wu
- Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Tianxiao Li
- Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Li Li
- Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Kaitao Chang
- Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
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Jiang S, Yan Y, Yang T, Zhu Q, Wang C, Bai X, Hao Z, Zhang S, Yang Q, Fan Z, Sun J, Wu B. Plaque Distribution Correlates With Morphology of Lenticulostriate Arteries in Single Subcortical Infarctions. Stroke 2020; 51:2801-2809. [PMID: 32757756 PMCID: PMC7447184 DOI: 10.1161/strokeaha.120.030215] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Supplemental Digital Content is available in the text. Background and Purpose: We aimed to use novel whole-brain vessel-wall magnetic resonance imaging (WB-VWI) to investigate the association between plaque distribution of middle cerebral artery (MCA) and morphological changes of the lenticulostriate arteries (LSAs) in single subcortical infarctions. Methods: Forty single subcortical infarction patients with no relevant MCA disease on magnetic resonance angiography were prospectively enrolled. Plaque location in the MCA was dichotomized as proximal (located adjacent to the LSA origin) or distal (located distal to the LSA origin) on whole-brain vessel-wall magnetic resonance imaging. The MCAs with proximal plaques were divided into the symptomatic and asymptomatic side, and asymptomatic side MCAs without proximal plaques were the control group. The morphological characteristics of the LSAs and features of proximal plaques were analyzed. Results: A total of 71 MCAs in 40 patients were analyzed (31 on the symptomatic side, 22 on the asymptomatic side, and 18 in the control group). Superior-wall plaques of MCAs were observed more frequently on the symptomatic side than the asymptomatic side (45.2% versus 9.1%, P=0.005). The wall area index, plaque burden, and remodeling index did not differ significantly between the symptomatic and asymptomatic side. The number of LSA branches was smaller (P=0.011) in the symptomatic side (5.48±1.88) compared with the control group (6.83±1.92). The symptomatic side exhibited shorter average length of the LSAs (23.23±3.44 versus 25.75±3.76 mm, P=0.025) and shorter average distance of the LSAs (16.47±3.11 versus 21.53±4.76 mm, P<0.001) compared with the asymptomatic side. Conclusions: Superiorly distributed MCA plaques at the LSA origin are closely associated with morphological changes of the LSA in symptomatic MCAs, suggesting that the distribution, rather than the inherent features of plaques, determines the occurrence of single subcortical infarctions. Our findings provide insight into the etiologic mechanism of branch atheromatous disease in single subcortical infarctions.
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Affiliation(s)
- Shuai Jiang
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China.,Department of Neurology, The Third People's Hospital of Chengdu, China (S.J.)
| | - Yuying Yan
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China
| | - Tang Yang
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China
| | - Qiange Zhu
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China
| | - Changyi Wang
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China
| | - Xueling Bai
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China
| | - Zilong Hao
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China
| | - Shihong Zhang
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China
| | - Qi Yang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China (Q.Y.)
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA (Z.F.)
| | - Jiayu Sun
- Radiology (J.S.), West China Hospital, Sichuan University, Chengdu, China
| | - Bo Wu
- Departments of Neurology (S.J., Y.Y., T.Y., Q.Z., C.W., X.B., Z.H., S.Z., B.W.), West China Hospital, Sichuan University, Chengdu, China
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Guan M, Lin J, Huang S, Leng X, Shi C, Qiao H, Wang X, Huang L. High-Degree Middle Cerebral Artery Stenosis : Can Advanced 3D DSA-MRI Fusion Imaging Better Illustrate Plaques and Perforators? Clin Neuroradiol 2020; 31:51-59. [PMID: 32617602 PMCID: PMC7943526 DOI: 10.1007/s00062-020-00927-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/10/2020] [Indexed: 11/24/2022]
Abstract
Purpose Endovascular treatment in severe middle cerebral artery (MCA) stenosis is controversial owing to high rates of periprocedural complications, especially occlusion of the lenticulostriate arteries (LSA). The characteristics of LSAs and the spatial relationships between MCA plaques and LSAs using the fusion of three-dimensional (3D) digital subtraction angiography (DSA) and magnetic resonance imaging (3D DSA-MRI fusion) were investigated. Methods We retrospectively analyzed data from 32 ischemic stroke or transient ischemic attack patients with severe MCA stenosis, who underwent MRI and DSA within 2 weeks after symptom onset. The patients were divided into culprit and non-culprit MCA stenosis groups. The 3D DSA-MRI fusion was performed on dedicated workstations, which allowed automated overlays of the target vessels. The characteristics of LSAs, plaque distribution and lesion patterns, and their relationships were evaluated. Results The 3D DSA-MRI fusion image was able to illustrate the spatial relationships between MCA plaques and LSA orifices. Of 42 LSA stems in 32 patients, 10 had MCA plaque over the LSA orifice and were all found in the culprit MCA stenosis group. Over half (51.9%) of the LSA stems in patients with culprit MCA stenosis originated from the stenotic MCA segment. The MCA plaque-LSA orifice spatial relationships were classified into four types, which were significantly different between the two groups (p = 0.016). Conclusion The 3D DSA-MRI fusion technique enables visualization of the LSA orifice and MCA plaque and their spatial relationships. This classification of the type of spatial relationships can provide insights into the pathogenesis of MCA stroke and useful guides for treatment strategies.
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Affiliation(s)
- Min Guan
- Department of Neurology, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, 510630, Guangzhou, China
| | - Jia'xing Lin
- Department of Neurology, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, 510630, Guangzhou, China
| | - Sheng'ming Huang
- Department of Neurology, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, 510630, Guangzhou, China
| | - Xin'yi Leng
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong Shatin, Hong Kong, SAR, China
| | - Chang'zheng Shi
- Medical Imaging Center, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Hong'yu Qiao
- Department of Neurology, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, 510630, Guangzhou, China
| | - Xiang'yu Wang
- Department of Neurosurgery, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Li'an Huang
- Department of Neurology, The First Affiliated Hospital, Jinan University, NO.613 the West of Huangpu street, 510630, Guangzhou, China.
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Huizinga N, Keil F, Birkhold A, Kowarschik M, Tritt S, Berkefeld J. 4D Flat Panel Conebeam CTA for In Vivo Imaging of the Microvasculature of the Human Cortex with a Novel Software Prototype. AJNR Am J Neuroradiol 2020; 41:976-979. [PMID: 32439643 DOI: 10.3174/ajnr.a6574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/28/2020] [Indexed: 11/07/2022]
Abstract
It was the aim of our pilot study to investigate whether time-resolved flat panel conebeam CTA is able to demonstrate small cortical vessels in vivo. In 8 patients with small AVMs, time-resolved coronal MPRs of the vasculature of the frontal cortex were recalculated from 3D rotational angiography datasets with the use of a novel software prototype. 4D flat panel conebeam CTA demonstrated the course of the cortical arteries with small perpendicular side branches to the underlying cortex. Pial arterial and venous networks could also be identified, corresponding to findings in injection specimens. Reasonable image quality was achieved in 6 of 8 cases. In this small study, in vivo display of the cortical microvasculature with 4D flat panel conebeam CTA was feasible and superior to other angiographic imaging modalities.
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Affiliation(s)
- N Huizinga
- From the Institute of Neuroradiology (N.H., F.K., J.B.), University Hospital of Frankfurt, Frankfurt, Germany
| | - F Keil
- From the Institute of Neuroradiology (N.H., F.K., J.B.), University Hospital of Frankfurt, Frankfurt, Germany
| | - A Birkhold
- Siemens Healthcare GmbH (A.B., M.K.), Forchheim, Germany
| | - M Kowarschik
- Siemens Healthcare GmbH (A.B., M.K.), Forchheim, Germany
| | - S Tritt
- Helios Dr. Horst Schmidt Kliniken Wiesbaden (S.T.), Wiesbaden, Germany
| | - J Berkefeld
- From the Institute of Neuroradiology (N.H., F.K., J.B.), University Hospital of Frankfurt, Frankfurt, Germany
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30
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Liu F, Chen C, Hong L, Shen H, Cao W, Dong Q, Yang X, Guo M, Li Y, Xiao Y, Cheng X, Li G. Lenticulostriate arteries appearance before thrombectomy predicts good outcome in acute middle cerebral artery occlusion. BMC Neurol 2020; 20:139. [PMID: 32299387 PMCID: PMC7161229 DOI: 10.1186/s12883-020-01716-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 04/02/2020] [Indexed: 12/27/2022] Open
Abstract
Background Endovascular therapy is widely used in acute large vessel occlusion. This study investigated whether imaging of lateral lenticulostriate arteries (LSAs) before thrombectomy would potentially be helpful for predicting prognosis of patients with acute M1 segment of middle cerebral artery occlusion (MCAO). Methods 59 consecutive patients with acute M1 segment of MCAO treated with mechanical thrombectomy at two comprehensive stroke centers were analyzed. Patients were categorized into LSA+ (appearing of lateral LSAs) and LSA- (sparing of lateral LSAs) group according to preprocedural digital substraction angiography (DSA). Baseline data and clinical outcomes were compared. A good clinical outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months. The association between clinical and imaging parameters and functional outcome was evaluated with logistic regression analysis. Results LSA+ was shown in 36 patients (61%). LSA+ group had a significantly higher proportion of good outcome (72.2% vs. 8.7%, OR 27.3,95% CI 5.38–138.4, P < 0.001), lower risk of symptomatic intracranial haemorrhages (sICH) (8.3% vs. 47.8%,OR 0.10,95% CI 0.02–0.42, P = 0.001) and lower mortality in hospital (5.6% vs. 34.8%, OR 0.11,95% CI 0.02–0.58, P < 0.004) compared with LSA- group. Patients in LSA+ group had lower baseline NIHSS score(P < 0.01) and NIHSS score at 14 days(P < 0.01) and smaller infarct core volume (P = 0.016) on computed tomography perfusion imaging (CTP) compared to the LSA- group. Multivariate logistic regression analysis showed that a small infarct core volume (OR 6.74,95% CI 1.148–39.569, P = 0.035) and LSA+(OR 22.114,95% CI 3.339–146.470, P = 0.001) were associated with a good clinical outcome. Conclusions Our data suggest that appearance of lateral LSAs before mechanical thrombectomy would be potentially helpful for predicting favorable prognosis of patients with acute M1 segment of MCAO.
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Affiliation(s)
- Feifeng Liu
- Department of Neurology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Chen Chen
- Department of Neurology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Lan Hong
- Department of Neurology, Shanghai huashan hospital, Fudan University, Shanghai, China
| | - Hao Shen
- Department of Neurology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Wenjie Cao
- Department of Neurology, Shanghai huashan hospital, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology, Shanghai huashan hospital, Fudan University, Shanghai, China
| | - Xinyi Yang
- Department of Neurology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Mengruo Guo
- Department of Neurology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Ying Li
- Department of Neurology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Yaping Xiao
- Department of Neurology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Xin Cheng
- Department of Neurology, Shanghai huashan hospital, Fudan University, Shanghai, China
| | - Gang Li
- Department of Neurology, Shanghai East Hospital, Tongji University, Shanghai, China.
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Ling C, Fang X, Kong Q, Sun Y, Wang B, Zhuo Y, An J, Zhang W, Wang Z, Zhang Z, Yuan Y. Lenticulostriate Arteries and Basal Ganglia Changes in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy, a High-Field MRI Study. Front Neurol 2019; 10:870. [PMID: 31447773 PMCID: PMC6696621 DOI: 10.3389/fneur.2019.00870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/26/2019] [Indexed: 01/18/2023] Open
Abstract
Background and Purpose: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) mainly affects the cerebral small arteries. We aimed to analyze changes in the lenticulostriate arteries (LSAs) and the basal ganglia in patients with CADASIL using high-field magnetic resonance imaging (7.0-T MRI). Methods: We examined 46 patients with CADASIL and 46 sex- and age-matched healthy individuals using 7.0-T MRI. The number and length of the LSAs, and the proportion of discontinuous LSAs were compared between the two groups. The Mini-Mental State Examination score, the modified Rankin Scale, the Barthel Index, and the MRI lesion load of the basal ganglia were also examined in patients with CADASIL. We analyzed the association between LSA measurements and the basal ganglia lesion load, as well as the association between LSA measurements and clinical phenotypes in this patient group. Results: We observed a decrease in the number of LSA branches (t = −2.591, P = 0.011), and an increase in the proportion of discontinuous LSAs (z = −1.991, P = 0.047) in patients with CADASIL when compared with healthy controls. However, there was no significant difference in the total length of LSAs between CADASIL patients and healthy individuals (t = −0.412, P = 0.682). There was a positive association between the number of LSA branches and the Mini-Mental State Examination scores of CADASIL patients after adjusting for age and educational level (β = 0.438; 95% CI: 0.093, 0.782; P = 0.014). However, there was no association between LSA measurements and the basal ganglia lesion load among CADASIL patients. Conclusions: 7.0-T MRI provides a promising and non-invasive method for the study of small artery damage in CADASIL. The abnormalities of small arteries may be related to some clinical symptoms of CADASIL patients such as cognitive impairment. The lack of association between LSA measurements and the basal ganglia lesion load among the patients suggests that changes in the basal ganglia due to CADASIL are caused by mechanisms other than anatomic narrowing of the vessel lumen.
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Affiliation(s)
- Chen Ling
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Xiaojing Fang
- Department of Neurology, Peking University First Hospital, Beijing, China.,Department of Neurology, Peking University International Hospital, Beijing, China
| | - Qingle Kong
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Yunchuang Sun
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Bo Wang
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Yan Zhuo
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jing An
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Zihao Zhang
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing, China
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Characterization of lenticulostriate arteries with high resolution black-blood T1-weighted turbo spin echo with variable flip angles at 3 and 7 Tesla. Neuroimage 2019; 199:184-193. [PMID: 31158475 DOI: 10.1016/j.neuroimage.2019.05.065] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/30/2019] [Accepted: 05/25/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The lenticulostriate arteries (LSAs) with small diameters of a few hundred microns take origin directly from the high flow middle cerebral artery (MCA), making them especially susceptible to damage (e.g. by hypertension). This study aims to present high resolution (isotropic ∼0.5 mm), black blood MRI for the visualization and characterization of LSAs at both 3 T and 7 T. MATERIALS AND METHODS T1-weighted 3D turbo spin-echo with variable flip angles (T1w TSE-VFA) sequences were optimized for the visualization of LSAs by performing extended phase graph (EPG) simulations. Twenty healthy volunteers (15 under 35 years old, 5 over 60 years old) were imaged with the T1w TSE-VFA sequences at both 3 T and 7 T. Contrast-to-noise ratio (CNR) was quantified, and LSAs were manually segmented using ITK-SNAP. Automated Reeb graph shape analysis was performed to extract features including vessel length and tortuosity. All quantitative metrics were compared between the two field strengths and two age groups using ANOVA. RESULTS LSAs can be clearly delineated using optimized 3D T1w TSE-VFA at 3 T and 7 T, and a greater number of LSA branches can be detected compared to those by time-of-flight MR angiography (TOF MRA) at 7 T. The CNR of LSAs was comparable between 7 T and 3 T. T1w TSE-VFA showed significantly higher CNR than TOF MRA at the stem portion of the LSAs branching off the medial middle cerebral artery. The mean vessel length and tortuosity were greater on TOF MRA compared to TSE-VFA. The number of detected LSAs by both TSE-VFA and TOF MRA was significantly reduced in aged subjects, while the mean vessel length measured on 7 T TSE-VFA showed significant difference between the two age groups. CONCLUSION The high-resolution black-blood 3D T1w TSE-VFA sequence offers a new method for the visualization and quantification of LSAs at both 3 T and 7 T, which may be applied for a number of pathological conditions related to the damage of LSAs.
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Wu F, Zhang Q, Dong K, Duan J, Yang X, Wu Y, Zhang L, Li D, Fan Z, Yang Q. Whole-brain magnetic resonance imaging of plaque burden and lenticulostriate arteries in patients with different types of stroke. Ther Adv Neurol Disord 2019; 12:1756286419833295. [PMID: 30833987 PMCID: PMC6393832 DOI: 10.1177/1756286419833295] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/11/2018] [Indexed: 12/21/2022] Open
Abstract
Background Large-vessel atherosclerotic disease is an important pathogenesis of deep-perforator infarction (DPI). However, altered vessel walls of intracranial large arteries and distribution of small arteries in DPI are unclear because of the limited resolution of current imaging techniques. In this study the intracranial plaque burden and lenticulostriate artery (LSA) distribution in patients with recent DPI and non-DPI using whole-brain vessel-wall imaging (WB-VWI) were investigated. Methods A total of 44 patients with recent DPI (23 patients) or non-DPI (21 patients) due to intracranial atherosclerotic disease were prospectively enrolled. WB-VWI was performed in all the patients using a three-dimensional T1-weighted vessel-wall magnetic resonance technique. Hemispheres with DPI and non-DPI were considered as the DPI group and non-DPI group, respectively. Hemispheres without a history of stroke were the control group. The intracranial plaque burden was compared between the DPI and non-DPI groups. The number and length of visualized LSA branches among DPI, non-DPI, and control groups were also evaluated. Results A total of 77 hemispheres were analyzed (23 in the DPI group, 21 in the non-DPI group, and 33 in the control group). Plaque burden was lower (p = 0.047) in the DPI group (82.0 ± 45.9 mm3) compared with the non-DPI group (130.9 ± 90.3 mm3). There was a significant reduction (p = 0.002) in length of visualized LSA branches in the DPI group (74.1 ± 21.7 mm) compared with the control group (104.6 ± 33.3 mm). Conclusions WB-VWI enables the combination of vessel-wall and LSA imaging in one image setting, which can provide information about plaque burden and LSA distribution.
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Affiliation(s)
- Fang Wu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qian Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kai Dong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jiangang Duan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaoxu Yang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ye Wu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ling Zhang
- Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA, and Departments of Medicine and Bioengineering, University of California, Los Angeles, CA, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA, and Departments of Medicine and Bioengineering, University of California, Los Angeles, CA, USA
| | - Qi Yang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
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