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Wu G, Zhu C, Wang H, Fu D, Lu X, Cao C, Zhang X, Zhu J, Huang L, Mossa-Basha M, Xia S. Co-existing intracranial and extracranial carotid atherosclerosis predicts large-artery atherosclerosis stroke recurrence: a single-center prospective study utilizing combined head-and-neck vessel wall imaging. Eur Radiol 2023; 33:6970-6980. [PMID: 37081300 PMCID: PMC10527495 DOI: 10.1007/s00330-023-09654-5] [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: 09/04/2022] [Revised: 01/15/2023] [Accepted: 03/09/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES Intracranial and extracranial plaque features on high-resolution vessel wall imaging (HR-VWI) are associated with large-artery atherosclerosis (LAA) stroke recurrence. However, most studies have focused on a single vascular bed, and the prognostic value of combined intracranial and extracranial plaque features has yet to be studied. This study aimed to investigate the roles of plaque features, plaque number, and co-existing atherosclerosis in predicting stroke recurrence, utilizing combined head-and-neck HR-VWI. METHODS From September 2016 to March 2020, participants with acute LAA ischemic strokes were prospectively enrolled and underwent combined head-and-neck HR-VWI. The participants were followed for stroke recurrence for at least 12 months or until a subsequent event occurred. The imaging features at baseline, including conventional and histogram plaque features, plaque number, and co-existing atherosclerosis, were evaluated. Univariable Cox regression analysis and the least absolute shrinkage and selection operator (lasso) method were used for variable screening. Multivariable Cox regression analyses were used to determine the independent risk factors of stroke recurrence. RESULTS A total of 97 participants (59 ± 12 years, 63 men) were followed for a median of 30.9 months, and 21 participants experienced recurrent strokes. Multivariable Cox analysis identified co-existing intracranial high signal on T1-weighted fat-suppressed images (HST1) and extracranial carotid atherosclerosis (HR, 6.12; 95% CI, 2.52-14.82; p = 0.001) as an independent imaging predictor of stroke recurrence. CONCLUSION Co-existing intracranial HST1 and extracranial carotid atherosclerosis independently predicted LAA stroke recurrence. Combined head-and-neck HR-VWI is a promising technique for atherosclerosis imaging. CLINICAL RELEVANCE STATEMENT This prospective study using combined head-and-neck HR-VWI highlighted the necessity of both intracranial culprit plaque evaluation and multi-vascular bed assessment, adding value to the prediction of stroke recurrence. KEY POINTS • This study highlighted the necessity of both intracranial culprit plaque evaluation and multi-vascular bed assessment, adding value to the prediction of stroke recurrence. • This prospective study using combined head-and-neck HR-VWI found co-existing intracranial HST1 and extracranial carotid atherosclerosis to be independent predictors of stroke recurrence.
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Affiliation(s)
- Gemuer Wu
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin, 300192, China
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, 325 9Th Ave, Seattle, WA, 98104, USA
| | - Huiying Wang
- The School of Medicine, Nankai University, 94 Weijin Road, Tianjin, 300071, China
| | - Dingwei Fu
- Department of Radiology, The Second Affiliated Hospital of Wannan Medical College, 10 Kangfu Road, Jinghu District, Wuhu, 241000, China
| | - Xiudi Lu
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
| | - Chen Cao
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | | | - Jinxia Zhu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Lixiang Huang
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin, 300192, China
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, 325 9Th Ave, Seattle, WA, 98104, USA
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin, 300192, China.
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Hu Q, Fang Z, Ge J, Li H. Nanotechnology for Cardiovascular Diseases. Innovation (N Y) 2022; 3:100214. [PMID: 35243468 PMCID: PMC8866095 DOI: 10.1016/j.xinn.2022.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/30/2022] [Accepted: 01/30/2022] [Indexed: 11/23/2022] Open
Abstract
Cardiovascular diseases have become the major killers in today's world, among which coronary artery diseases (CADs) make the greatest contributions to morbidity and mortality. Although state-of-the-art technologies have increased our knowledge of the cardiovascular system, the current diagnosis and treatment modalities for CADs still have limitations. As an emerging cross-disciplinary approach, nanotechnology has shown great potential for clinical use. In this review, recent advances in nanotechnology in the diagnosis of CADs will first be elucidated. Both the sensitivity and specificity of biosensors for biomarker detection and molecular imaging strategies, such as magnetic resonance imaging, optical imaging, nuclear scintigraphy, and multimodal imaging strategies, have been greatly increased with the assistance of nanomaterials. Second, various nanomaterials, such as liposomes, polymers (PLGA), inorganic nanoparticles (AuNPs, MnO2, etc.), natural nanoparticles (HDL, HA), and biomimetic nanoparticles (cell-membrane coating) will be discussed as engineered as drug (chemicals, proteins, peptides, and nucleic acids) carriers targeting pathological sites based on their optimal physicochemical properties and surface modification potential. Finally, some of these nanomaterials themselves are regarded as pharmaceuticals for the treatment of atherosclerosis because of their intrinsic antioxidative/anti-inflammatory and photoelectric/photothermal characteristics in a complex plaque microenvironment. In summary, novel nanotechnology-based research in the process of clinical transformation could continue to expand the horizon of nanoscale technologies in the diagnosis and therapy of CADs in the foreseeable future. Nanotechnology represents new viable approaches for diagnosis and treatment of cardiovascular diseases, the leading cause of morbidity and mortality worldwide Nanotechnology-assisted biosensing and molecular imaging can improve the sensitivity and specificity in the diagnosis of cardiovascular diseases Nanomaterials enable targeted drug delivery or directly exert therapeutic action for cardiovascular system, based on their physicochemical properties and surface modification
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Zhou P, Wang Y, Sun J, Yu Y, Mossa-Basha M, Zhu C. Assessment of Therapeutic Response to Statin Therapy in Patients With Intracranial or Extracranial Carotid Atherosclerosis by Vessel Wall MRI: A Systematic Review and Updated Meta-Analysis. Front Cardiovasc Med 2021; 8:742935. [PMID: 34778404 PMCID: PMC8578267 DOI: 10.3389/fcvm.2021.742935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Statin therapy is an essential component of cardiovascular preventive care. In recent years, various vessel wall MRI (VW-MRI) techniques have been used to monitor atherosclerosis progression or regression in patients with extracranial or intracranial large-artery atherosclerosis. We aimed to perform a systematic review and meta-analysis on the effects of statin therapy on plaque evolution as assessed by VW-MRI. Materials and Methods: Prospective studies investigating carotid and intracranial atherosclerotic plaques in patients on statin therapy monitored by serial VW-MRI were systematically identified in the literature. The plaque burden and lipid-rich necrotic core (LRNC) volume of carotid plaque and the imaging features of intracranial plaques were extracted and summarized. For studies investigating carotid artery wall volume and LRNC volume, combined estimates were derived by meta-analysis. Results: The study identified 21 studies of carotid plaque and two studies of intracranial plaque. While 16 studies investigating carotid plaques that included 780 patients by High-resolution VW-MRI were included in the meta-analysis. There was no significant change in carotid wall volume from baseline to 12 months. A significant change in LRNC volume was observed at > 12 months compared with baseline (Effect = −10.69, 95% CI = −19.11, −2.28, P < 0.01), while no significant change in LRNC volume at 3–6 months or 7–12 months after statin therapy initiation in 6 studies. Increases in fibrous tissue and calcium and reduction in neovascularization density of the plaque were seen in 2/3 studies (including 48/59 patients), 1/3 studies (including 17/54 patients), and 2/2 studies (including 71 patients) after statin therapy, respectively. Two studies with 257 patients in intracranial atherosclerosis showed that statins could effectively decrease wall volume and plaque enhancement volume. Conclusions: Collective data indicated that statins could potentially stabilize carotid plaques by significantly reducing LRNC with 1 year of therapy as shown on serial carotid VW-MRI. There was no significant decrease in wall volume, which nonetheless indicated that plaque composition changes might be more sensitive to response monitoring than wall volume. It is likely that more sensitive, clinically relevant, and preferably quantitative indicators of therapeutic effects on intracranial vessel plaque morphology will be developed in the future.
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Affiliation(s)
- Pengyu Zhou
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuting Wang
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jie Sun
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Yannan Yu
- Internal Medicine Department, University of Massachusetts Memorial Medical Center, Worcester, MA, United States
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, WA, United States
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Mossa-Basha M, Zhu C, Wu L. Vessel Wall MR Imaging in the Pediatric Head and Neck. Magn Reson Imaging Clin N Am 2021; 29:595-604. [PMID: 34717847 DOI: 10.1016/j.mric.2021.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Vessel wall MR imaging (VWI) is a technique that progressively has gained traction in clinical diagnostic applications for evaluation of intracranial and extracranial vasculopathies, with increasing use in pediatric populations. The technique has shown promise in detection, differentiation, and characterization of both inflammatory and noninflammatory vasculopathies. In this article, optimal techniques for intracranial and extracranial VWI as well as applications and value for pediatric vascular disease evaluation are discussed.
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Affiliation(s)
- Mahmud Mossa-Basha
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA.
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, 325 9th Avenue, Seattle, WA 98104, USA
| | - Lei Wu
- Department of Radiology, University of Washington, 1660 South Columbian Way, Seattle, WA 98108, USA
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Guggenberger K, Krafft AJ, Ludwig U, Raithel E, Forman C, Meckel S, Hennig J, Bley TA, Vogel P. Intracranial vessel wall imaging framework - Data acquisition, processing, and visualization. Magn Reson Imaging 2021; 83:114-124. [PMID: 34403760 DOI: 10.1016/j.mri.2021.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 07/09/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Assessment of vessel walls is an integral part in diagnosis and disease monitoring of vascular diseases such as vasculitis. Vessel wall imaging (VWI), in particular of intracranial arteries, is the domain of Magnetic Resonance Imaging (MRI) - but still remains a challenge. The tortuous anatomy of intracranial arteries and the need for high resolution within clinically acceptable scan times require special technical conditions regarding the hardware and software environments. MATERIALS AND METHODS In this work a dedicated framework for intracranial VWI is presented offering an optimized, black-blood 3D T1-weighted post-contrast Compressed Sensing (CS)-accelerated MRI sequence prototype combined with dedicated 3D-GUI supported post-processing tool for the CPR visualization of tortuous arbitrary vessel structures. RESULTS Using CS accelerated MRI sequence, the scanning time for high-resolution 3D black-blood CS-space data could be reduced to under 10 min. These data are adequate for a further processing to extract straightened visualizations (curved planar reformats - CPR). First patient data sets could be acquired in clinical environment. CONCLUSION A highly versatile framework for VWI visualization was demonstrated utilizing a post-processing tool to extract CPR reformats from high-resolution 3D black-blood CS-SPACE data, enabling simplified and optimized assessment of intracranial arteries in intracranial vascular disorders, especially in suspected intracranial vasculitis, by stretching their tortuous course. The processing time from about 15-20 min per patient (data acquisition and further processing) allows the integration into clinical routine.
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Affiliation(s)
- Konstanze Guggenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Axel J Krafft
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ute Ludwig
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | | | - Stephan Meckel
- Department of Neuroradiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Hennig
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thorsten A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Patrick Vogel
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany; Department of Experimental Physics 5 (Biophysics), University of Würzburg, Würzburg, Germany.
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Guggenberger K, Krafft AJ, Ludwig U, Vogel P, Elsheik S, Raithel E, Forman C, Dovi-Akué P, Urbach H, Bley T, Meckel S. High-resolution Compressed-sensing T1 Black-blood MRI : A New Multipurpose Sequence in Vascular Neuroimaging? Clin Neuroradiol 2019; 31:207-216. [PMID: 31853612 DOI: 10.1007/s00062-019-00867-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 12/04/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE In vasculopathies of the central nervous system, reliable and timely diagnosis is important against the background of significant morbidity and sequelae in cases of incorrect diagnosis or delayed treatment. Magnetic resonance imaging (MRI) plays a major role in the detection and monitoring of intracranial and extracranial vascular pathologies of different etiologies, in particular for evaluation of the vessel wall in addition to luminal information, thus allowing differentiation between various vasculopathies. Compressed-sensing black-blood MRI combines high image quality with relatively short acquisition time and offers promising potential in the context of neurovascular vessel wall imaging in clinical routine. This case review gives an overview of its application in the diagnosis of various intracranial and extracranial entities. METHODS An optimized high-resolution compressed-sensing black-blood 3D T1-weighted fast (turbo) spin echo technique (T1 CS-SPACE prototype) precontrast and postcontrast application at 3T was used for the evaluation of various vascular conditions in neuroradiology. RESULTS In this article seven cases of intracranial and extracranial arterial and venous vasculopathies with representative imaging findings in high-resolution compressed-sensing black-blood MRI are presented. CONCLUSION High-resolution 3D T1 CS-SPACE black-blood MRI is capable of imaging various vascular entities in high detail with whole head coverage and low susceptibility for motion artifacts and within acceptable scan times. It represents a highly versatile, non-invasive technique for the visualization and differentiation of a wide variety of neurovascular arterial and venous disorders.
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Affiliation(s)
- Konstanze Guggenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.
| | - Axel Joachim Krafft
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Freiburg, Germany
| | - Ute Ludwig
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Freiburg, Germany
| | - Patrick Vogel
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Samer Elsheik
- Department of Neuroradiology, Medical Center-University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany
| | | | | | - Philippe Dovi-Akué
- Department of Neuroradiology, Medical Center-University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Center-University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany
| | - Thorsten Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - Stephan Meckel
- Department of Neuroradiology, Medical Center-University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany
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Zhu C, Wang X, Eisenmenger L, Tian B, Liu Q, Degnan AJ, Hess C, Saloner D, Lu J. Surveillance of Unruptured Intracranial Saccular Aneurysms Using Noncontrast 3D-Black-Blood MRI: Comparison of 3D-TOF and Contrast-Enhanced MRA with 3D-DSA. AJNR Am J Neuroradiol 2019; 40:960-966. [PMID: 31122914 DOI: 10.3174/ajnr.a6080] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/15/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE Patients with unruptured intracranial aneurysms routinely undergo surveillance imaging to monitor growth. Angiography is the criterion standard for aneurysm diagnosis, but it is invasive. This study aimed to evaluate the accuracy and reproducibility of a 3D noncontrast black-blood MR imaging technique for unruptured intracranial aneurysm measurement in comparison with 3D-TOF and contrast-enhanced MRA, using 3D rotational angiography as a reference standard. MATERIALS AND METHODS Sixty-four patients (57.3 ± 10.9 years of age, 41 women) with 68 saccular unruptured intracranial aneurysms were recruited. Patients underwent 3T MR imaging with 3D-TOF-MRA, 3D black-blood MR imaging, and contrast-enhanced MRA, and they underwent 3D rotational angiography within 2 weeks. The neck, width, and height of the unruptured intracranial aneurysms were measured by 2 radiologists independently on 3D rotational angiography and 3 MR imaging sequences. The accuracy and reproducibility were evaluated by Bland-Altman plots, the coefficient of variance, and the intraclass correlation coefficient. RESULTS 3D black-blood MR imaging demonstrates the best agreement with DSA, with the smallest limits of agreement and measurement error (coefficients of variance range, 5.87%-7.04%). 3D-TOF-MRA had the largest limits of agreement and measurement error (coefficients of variance range, 12.73%-15.78%). The average coefficient of variance was 6.26% for 3D black-blood MR imaging, 7.03% for contrast-enhanced MRA, and 15.54% for TOF-MRA. No bias was found among 3 MR imaging sequences compared with 3D rotational angiography. All 3 MR imaging sequences had excellent interreader agreement (intraclass correlation coefficient, >0.95). 3D black-blood MR imaging performed the best for patients with intraluminal thrombus (n = 10). CONCLUSIONS 3D black-blood MR imaging achieves better accuracy for aneurysm size measurements compared with 3D-TOF, using 3D rotational angiography as a criterion standard. This noncontrast technique is promising for surveillance of unruptured intracranial aneurysms.
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Affiliation(s)
- C Zhu
- From the Department of Radiology and Biomedical Imaging (C.Z., L.E., C.H., D.S.), University of California, San Francisco, San Francisco, California
| | - X Wang
- Department of Radiology (X.W., B.T., Q.L., J.L.), Changhai Hospital, Shanghai, China.,Department of Radiology (X.W.), General Hospital of Northern Military Command, Liaoning, China
| | - L Eisenmenger
- From the Department of Radiology and Biomedical Imaging (C.Z., L.E., C.H., D.S.), University of California, San Francisco, San Francisco, California
| | - B Tian
- Department of Radiology (X.W., B.T., Q.L., J.L.), Changhai Hospital, Shanghai, China
| | - Q Liu
- Department of Radiology (X.W., B.T., Q.L., J.L.), Changhai Hospital, Shanghai, China
| | - A J Degnan
- Department of Radiology (A.J.D.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - C Hess
- From the Department of Radiology and Biomedical Imaging (C.Z., L.E., C.H., D.S.), University of California, San Francisco, San Francisco, California
| | - D Saloner
- From the Department of Radiology and Biomedical Imaging (C.Z., L.E., C.H., D.S.), University of California, San Francisco, San Francisco, California
| | - J Lu
- Department of Radiology (X.W., B.T., Q.L., J.L.), Changhai Hospital, Shanghai, China
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Cattaneo M, Wyttenbach R, Corti R, Staub D, Gallino A. The Growing Field of Imaging of Atherosclerosis in Peripheral Arteries. Angiology 2018; 70:20-34. [PMID: 29783854 DOI: 10.1177/0003319718776122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In the past decades, peripheral arteries have represented a model for the comprehension of atherosclerosis as well as for the development of new diagnostic imaging modalities and therapeutic strategies. Peripheral arteries may represent a window to study atherosclerosis. Pathology has prominently contributed to move the clinical and research attention from the arterial lumen stenosis and angiography to morphological and functional imaging techniques. Evidence from large and prospective cohort or randomized controlled studies is still modest. Nevertheless, several emerging imaging investigations represent a potential tool for a comprehensive "in vivo" evaluation of the entire natural history of peripheral atherosclerosis. This constitutes a demanding assignment, as it would be desirable to obtain both single-lesion focused and extensive arterial system views to achieve the most accurate prognostic information. Our narrative review rests upon the fundamental pathological evidence, summarizing the rapidly growing field of imaging of atherosclerosis in peripheral arteries and presenting a selection of both currently available and emerging imaging techniques.
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Affiliation(s)
- Mattia Cattaneo
- 1 Cardiovascular Medicine Department, Ospedale Regionale di Bellinzona e Valli, San Giovanni, Bellinzona, Switzerland
| | - Rolf Wyttenbach
- 2 Radiology Department, Ospedale Regionale di Bellinzona e Valli, San Giovanni, Bellinzona, Switzerland.,3 University of Bern, Bern, Switzerland
| | - Roberto Corti
- 4 Cardiology Department, HerzKlinik Hirslanden, Zurich, Switzerland
| | - Daniel Staub
- 5 Angiology Department, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Augusto Gallino
- 1 Cardiovascular Medicine Department, Ospedale Regionale di Bellinzona e Valli, San Giovanni, Bellinzona, Switzerland.,6 University of Zurich, Zurich, Switzerland
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Zhu C, Tian B, Chen L, Eisenmenger L, Raithel E, Forman C, Ahn S, Laub G, Liu Q, Lu J, Liu J, Hess C, Saloner D. Accelerated whole brain intracranial vessel wall imaging using black blood fast spin echo with compressed sensing (CS-SPACE). MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:457-467. [PMID: 29209856 DOI: 10.1007/s10334-017-0667-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 11/16/2017] [Accepted: 11/22/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Develop and optimize an accelerated, high-resolution (0.5 mm isotropic) 3D black blood MRI technique to reduce scan time for whole-brain intracranial vessel wall imaging. MATERIALS AND METHODS A 3D accelerated T1-weighted fast-spin-echo prototype sequence using compressed sensing (CS-SPACE) was developed at 3T. Both the acquisition [echo train length (ETL), under-sampling factor] and reconstruction parameters (regularization parameter, number of iterations) were first optimized in 5 healthy volunteers. Ten patients with a variety of intracranial vascular disease presentations (aneurysm, atherosclerosis, dissection, vasculitis) were imaged with SPACE and optimized CS-SPACE, pre and post Gd contrast. Lumen/wall area, wall-to-lumen contrast ratio (CR), enhancement ratio (ER), sharpness, and qualitative scores (1-4) by two radiologists were recorded. RESULTS The optimized CS-SPACE protocol has ETL 60, 20% k-space under-sampling, 0.002 regularization factor with 20 iterations. In patient studies, CS-SPACE and conventional SPACE had comparable image scores both pre- (3.35 ± 0.85 vs. 3.54 ± 0.65, p = 0.13) and post-contrast (3.72 ± 0.58 vs. 3.53 ± 0.57, p = 0.15), but the CS-SPACE acquisition was 37% faster (6:48 vs. 10:50). CS-SPACE agreed with SPACE for lumen/wall area, ER measurements and sharpness, but marginally reduced the CR. CONCLUSION In the evaluation of intracranial vascular disease, CS-SPACE provides a substantial reduction in scan time compared to conventional T1-weighted SPACE while maintaining good image quality.
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Affiliation(s)
- Chengcheng Zhu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA, USA.
| | - Bing Tian
- Department of Radiology, Changhai Hospital, Shanghai, China
| | - Luguang Chen
- Department of Radiology, Changhai Hospital, Shanghai, China
| | - Laura Eisenmenger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | | | | | | | | | - Qi Liu
- Department of Radiology, Changhai Hospital, Shanghai, China
| | - Jianping Lu
- Department of Radiology, Changhai Hospital, Shanghai, China.
| | - Jing Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Christopher Hess
- Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA, USA
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Shinohara Y, Sakamoto M, Kuya K, Kishimoto J, Yamashita E, Fujii S, Kurosaki M, Ogawa T. Carotid Plaque Evaluation Using Gemstone Spectral Imaging: Comparison with Magnetic Resonance Angiography. J Stroke Cerebrovasc Dis 2017; 26:1535-1540. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.02.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/31/2017] [Accepted: 02/22/2017] [Indexed: 10/19/2022] Open
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Wang Y, Seguro F, Kao E, Zhang Y, Faraji F, Zhu C, Haraldsson H, Hope M, Saloner D, Liu J. Segmentation of lumen and outer wall of abdominal aortic aneurysms from 3D black-blood MRI with a registration based geodesic active contour model. Med Image Anal 2017; 40:1-10. [PMID: 28549310 DOI: 10.1016/j.media.2017.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 05/05/2017] [Accepted: 05/12/2017] [Indexed: 11/24/2022]
Abstract
Segmentation of the geometric morphology of abdominal aortic aneurysm is important for interventional planning. However, the segmentation of both the lumen and the outer wall of aneurysm in magnetic resonance (MR) image remains challenging. This study proposes a registration based segmentation methodology for efficiently segmenting MR images of abdominal aortic aneurysms. The proposed methodology first registers the contrast enhanced MR angiography (CE-MRA) and black-blood MR images, and then uses the Hough transform and geometric active contours to extract the vessel lumen by delineating the inner vessel wall directly from the CE-MRA. The proposed registration based geometric active contour is applied to black-blood MR images to generate the outer wall contour. The inner and outer vessel wall are then fused presenting the complete vessel lumen and wall segmentation. The results obtained from 19 cases showed that the proposed registration based geometric active contour model was efficient and comparable to manual segmentation and provided a high segmentation accuracy with an average Dice value reaching 89.79%.
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Affiliation(s)
- Yan Wang
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States.
| | - Florent Seguro
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - Evan Kao
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States; University of California, Berkeley; San Francisco, United States
| | - Yue Zhang
- Veterans Affairs Medical Center, San Francisco, United States
| | - Farshid Faraji
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - Chengcheng Zhu
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - Henrik Haraldsson
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - Michael Hope
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - David Saloner
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States; Veterans Affairs Medical Center, San Francisco, United States
| | - Jing Liu
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
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12
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Non-contrast 3D black blood MRI for abdominal aortic aneurysm surveillance: comparison with CT angiography. Eur Radiol 2016; 27:1787-1794. [PMID: 27553926 PMCID: PMC5323367 DOI: 10.1007/s00330-016-4559-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 08/04/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Management of abdominal aortic aneurysms (AAAs) is based on diameter. CT angiography (CTA) is commonly used, but requires radiation and iodinated contrast. Non-contrast MRI is an appealing alternative that may allow better characterization of intraluminal thrombus (ILT). This study aims to 1) validate non-contrast MRI for measuring AAA diameter, and 2) to assess ILT with CTA and MRI. METHOD 28 patients with AAAs (diameter 50.7 ± 12.3 mm) underwent CTA and non-contrast MRI. MRI was acquired at 3 T using 1) a conventional 3D gradient echo (GRE) sequence and 2) a 3D T1-weighted black blood fast-spin-echo sequence. Two radiologists independently measured the AAA diameter. The ratio of signal of ILT and adjacent psoas muscle (ILTr = signalILT/signalMuscle) was quantified. RESULTS Strong agreement between CTA and non-contrast MRI was shown for AAA diameter (intra-class coefficient > 0.99). Both approaches had excellent inter-observer reproducibility (ICC > 0.99). ILT appeared homogenous on CTA, whereas MRI revealed compositional variations. Patients with AAAs ≥5.5 cm and <5.5 cm had a variety of distributions of old/fresh ILT types. CONCLUSIONS Non-contrast 3D black blood MRI provides accurate and reproducible AAA diameter measurements as validated by CTA. It also provides unique information about ILT composition, which may be linked with elevated risk for disease progression. KEY POINTS • Non-contrast MRI is an appealing alternative to CTA for AAA management. • Non-contrast MRI can accurately measure AAA diameters compared to CTA. • MRI affords unique characterization of intraluminal thrombus composition.
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13
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Hu X, Zhang L, Zhang X, Zhu H, Chen X, Zhang Y, Chung YC, Liu X, Zheng H, Li Y. An 8-channel RF coil array for carotid artery MR imaging in humans at 3 T. Med Phys 2016; 43:1897. [DOI: 10.1118/1.4944500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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14
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Zhu C, Haraldsson H, Tian B, Meisel K, Ko N, Lawton M, Grinstead J, Ahn S, Laub G, Hess C, Saloner D. High resolution imaging of the intracranial vessel wall at 3 and 7 T using 3D fast spin echo MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:559-70. [DOI: 10.1007/s10334-016-0531-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/27/2016] [Accepted: 02/01/2016] [Indexed: 11/29/2022]
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15
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Speelman L, Teng Z, Nederveen AJ, van der Lugt A, Gillard JH. MRI-based biomechanical parameters for carotid artery plaque vulnerability assessment. Thromb Haemost 2016; 115:493-500. [PMID: 26791734 DOI: 10.1160/th15-09-0712] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/13/2015] [Indexed: 12/18/2022]
Abstract
Carotid atherosclerotic plaques are a major cause of ischaemic stroke. The biomechanical environment to which the arterial wall and plaque is subjected to plays an important role in the initiation, progression and rupture of carotid plaques. MRI is frequently used to characterize the morphology of a carotid plaque, but new developments in MRI enable more functional assessment of carotid plaques. In this review, MRI based biomechanical parameters are evaluated on their current status, clinical applicability, and future developments. Blood flow related biomechanical parameters, including endothelial wall shear stress and oscillatory shear index, have been shown to be related to plaque formation. Deriving these parameters directly from MRI flow measurements is feasible and has great potential for future carotid plaque development prediction. Blood pressure induced stresses in a plaque may exceed the tissue strength, potentially leading to plaque rupture. Multi-contrast MRI based stress calculations in combination with tissue strength assessment based on MRI inflammation imaging may provide a plaque stress-strength balance that can be used to assess the plaque rupture risk potential. Direct plaque strain analysis based on dynamic MRI is already able to identify local plaque displacement during the cardiac cycle. However, clinical evidence linking MRI strain to plaque vulnerability is still lacking. MRI based biomechanical parameters may lead to improved assessment of carotid plaque development and rupture risk. However, better MRI systems and faster sequences are required to improve the spatial and temporal resolution, as well as increase the image contrast and signal-to-noise ratio.
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Affiliation(s)
- Lambert Speelman
- Dr. Lambert Speelman, Department of Biomedical Engineering, Ee 23.38B, P.O Box 2040, 3000 CA Rotterdam, the Netherlands, Tel.: +31 10 70 44039, Fax: +31 10 70 44720, E-mail:
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