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Guimarães J, de Almeida J, Mendes PL, Ferreira MJ, Gonçalves L. Advancements in non-invasive imaging of atherosclerosis: Future perspectives. J Clin Lipidol 2024; 18:e142-e152. [PMID: 38142178 DOI: 10.1016/j.jacl.2023.11.008] [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: 07/23/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 12/25/2023]
Abstract
Atherosclerosis is a chronic inflammatory disease characterized by the buildup of plaques in arterial walls, leading to cardiovascular diseases and high morbidity and mortality rates worldwide. Non-invasive imaging techniques play a crucial role in evaluating patients with suspected or established atherosclerosis. However, there is a growing body of evidence suggesting the need to visualize the underlying processes of plaque progression and rupture to enhance risk stratification. This review explores recent advancements in non-invasive assessment of atherosclerosis, focusing on computed tomography, magnetic resonance imaging, and nuclear imaging. These advancements provide valuable insights into the assessment and management of atherosclerosis, potentially leading to better risk stratification and improved patient outcomes.
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Affiliation(s)
- Joana Guimarães
- Cardiology Department, Coimbra's Hospital and University Center, Praceta Mota Pinto, 3000-561 Coimbra, Portugal.
| | - José de Almeida
- Cardiology Department, Coimbra's Hospital and University Center, Praceta Mota Pinto, 3000-561 Coimbra, Portugal
| | - Paulo Lázaro Mendes
- Cardiology Department, Coimbra's Hospital and University Center, Praceta Mota Pinto, 3000-561 Coimbra, Portugal
| | - Maria João Ferreira
- Cardiology Department, Coimbra's Hospital and University Center, Praceta Mota Pinto, 3000-561 Coimbra, Portugal; Faculty of Medicine, Coimbra's University, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Lino Gonçalves
- Cardiology Department, Coimbra's Hospital and University Center, Praceta Mota Pinto, 3000-561 Coimbra, Portugal; Faculty of Medicine, Coimbra's University, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
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2
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Kim DJ, Lee HJ, Baik J, Hwang MJ, Miyoshi M, Kang Y. Improved Blood Suppression of Motion-Sensitized Driven Equilibrium in High-Resolution Whole-Brain Vessel Wall Imaging: Comparison of Contrast-Enhanced 3D T1-Weighted FSE with Motion-Sensitized Driven Equilibrium and Delay Alternating with Nutation for Tailored Excitation. AJNR Am J Neuroradiol 2022; 43:1713-1718. [PMID: 36265890 DOI: 10.3174/ajnr.a7678] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/15/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE High-resolution vessel wall MR imaging is prone to slow-flow artifacts, particularly when gadolinium shortens the T1 relaxation time of blood. This study aimed to determine the optimal preparation pulses for contrast-enhanced high-resolution vessel wall MR imaging. MATERIALS AND METHODS Fifty patients who underwent both motion-sensitized driven equilibrium and delay alternating with nutation for tailored excitation (DANTE) preparation pulses with contrast-enhanced 3D-T1-FSE were retrospectively included. Qualitative analysis was performed using a 4-grade visual scoring system for black-blood performance in the small-sized intracranial vessels, overall image quality, severity of artifacts, and the degree of blood suppression in all cortical veins as well as transverse sinuses. Quantitative analysis of the M1 segment of the MCA was also performed. RESULTS The qualitative analysis revealed that motion-sensitized driven equilibrium demonstrated a significantly higher black-blood score than DANTE in contrast-enhanced 3D-T1-FSE of the A3 segment (3.90 versus 3.58, P < .001); M3 (3.72 versus 3.26, P = .004); P2 to P3 (3.86 versus 3.64, P = .017); the internal cerebral vein (3.72 versus 2.32, P < .001); and overall cortical veins (3.30 versus 2.74, P < .001); and transverse sinuses (2.82 versus 2.38, P < .001). SNRlumen, contrast-to noise ratiowall-lumen, and SNRwall in the M1 vessel were not significantly different between the 2 preparation pulses (all, P > .05). CONCLUSIONS Motion-sensitized driven equilibrium demonstrated improved blood suppression on contrast-enhanced 3D-T1-FSE in the small intracranial arteries and veins compared with DANTE. Motion-sensitized driven equilibrium is a useful preparation pulse for high-resolution vessel wall MR imaging to decrease venous contamination and suppress slow-flow artifacts when using contrast enhancement.
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Affiliation(s)
- D J Kim
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - H-J Lee
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - J Baik
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.,Department of Radiology (J.B.), Good Gang-An Hospital, Busan, South Korea
| | - M J Hwang
- GE Healthcare Korea (M.J.H.), Seoul, South Korea
| | - M Miyoshi
- GE Healthcare Japan (M.M.), Tokyo, Japan
| | - Y Kang
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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3
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Willemink MJ, Coolen BF, Dyvorne H, Robson PM, Bander I, Ishino S, Pruzan A, Sridhar A, Zhang B, Balchandani P, Mani V, Strijkers GJ, Nederveen AJ, Leiner T, Fayad ZA, Mulder WJM, Calcagno C. Ultra-high resolution, 3-dimensional magnetic resonance imaging of the atherosclerotic vessel wall at clinical 7T. PLoS One 2020; 15:e0241779. [PMID: 33315867 PMCID: PMC7735577 DOI: 10.1371/journal.pone.0241779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
Accurate quantification and characterization of atherosclerotic plaques with MRI requires high spatial resolution acquisitions with excellent image quality. The intrinsically better signal-to-noise ratio (SNR) at high-field clinical 7T compared to the widely employed lower field strengths of 1.5 and 3T may yield significant improvements to vascular MRI. However, 7T atherosclerosis imaging also presents specific challenges, related to local transmit coils and B1 field inhomogeneities, which may overshadow these theoretical gains. We present the development and evaluation of 3D, black-blood, ultra-high resolution vascular MRI on clinical high-field 7T in comparison lower-field 3T. These protocols were applied for in vivo imaging of atherosclerotic rabbits, which are often used for development, testing, and validation of translatable cardiovascular MR protocols. Eight atherosclerotic New Zealand White rabbits were imaged on clinical 7T and 3T MRI scanners using 3D, isotropic, high (0.63 mm3) and ultra-high (0.43 mm3) spatial resolution, black-blood MR sequences with extensive spatial coverage. Following imaging, rabbits were sacrificed for validation using fluorescence imaging and histology. Image quality parameters such as SNR and contrast-to-noise ratio (CNR), as well as morphological and functional plaque measurements (plaque area and permeability) were evaluated at both field strengths. Using the same or comparable imaging parameters, SNR and CNR were in general higher at 7T compared to 3T, with a median (interquartiles) SNR gain of +40.3 (35.3-80.1)%, and a median CNR gain of +68.1 (38.5-95.2)%. Morphological and functional parameters, such as vessel wall area and permeability, were reliably acquired at 7T and correlated significantly with corresponding, widely validated 3T vessel wall MRI measurements. In conclusion, we successfully developed 3D, black-blood, ultra-high spatial resolution vessel wall MRI protocols on a 7T clinical scanner. 7T imaging was in general superior to 3T with respect to image quality, and comparable in terms of plaque area and permeability measurements.
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Affiliation(s)
- Martin J. Willemink
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Radiology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Bram F. Coolen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hadrien Dyvorne
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Philip M. Robson
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Ilda Bander
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Seigo Ishino
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Alison Pruzan
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Arthi Sridhar
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Bei Zhang
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Venkatesh Mani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Gustav J. Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Aart J. Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Zahi A. Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Willem J. M. Mulder
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Medical Biochemistry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Claudia Calcagno
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- * E-mail:
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Schmitter S, Adriany G, Waks M, Moeller S, Aristova M, Vali A, Auerbach EJ, Van de Moortele PF, Ugurbil K, Schnell S. Bilateral Multiband 4D Flow MRI of the Carotid Arteries at 7T. Magn Reson Med 2020; 84:1947-1960. [PMID: 32187742 DOI: 10.1002/mrm.28256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/31/2020] [Accepted: 02/24/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Simultaneous multislab (SMSb) 4D flow MRI was developed and implemented at 7T for accelerated acquisition of the 3D blood velocity vector field in both carotid bifurcations. METHODS SMSb was applied to 4D flow to acquire blood velocities in both carotid bifurcations in sagittal orientation using a local transmit/receive coil at 7T. B 1 + transmit efficiency was optimized by B 1 + shimming. SMSb 4D flow was obtained in 8 healthy subjects in single-band (SB) and multiband (MB) fashion. Additionally, MB data were retrospectively undersampled to simulate GRAPPA R = 2 (MB2_GRAPPA2), and both SB datasets were added to form an artificial MB dataset (SumSB). The band separation performance was quantified by signal leakage. Peak velocity and total flow values were calculated and compared to SB via intraclass correlation analysis (ICC). RESULTS Clean slab separation was achieved yielding a mean signal leakage of 13% above the mean SB noise level. Mean total flow for MB2, SumSB, and MB_GRAPPA2 deviated less than 9% from the SB values. Peak velocities averaged over all vessels and subjects were 0.48 ± 0.11 m/s for SB, 0.47 ± 0.12 m/s for SumSB, 0.50 ± 0.13 m/s for MB2, and 0.53 ± 0.13 m/s for MB2_GRAPPA2. ICC revealed excellent absolute agreement and consistency of total flow for all methods compared to SB2. Peak velocity showed good to excellent agreement and consistency for SumSB and MB2 and MB2_GRAPPA2 method showed poor to excellent agreement and good to excellent consistency. CONCLUSION Simultaneous multislab 4D Flow MRI allows accurate quantification of total flow and peak velocity while reducing scan times.
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Affiliation(s)
- Sebastian Schmitter
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA.,Physikalisch-Technische Bundesanstalt, Braunschweig and Berlin, Germany
| | - Gregor Adriany
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Matt Waks
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Steen Moeller
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Maria Aristova
- McCormick School of Engineering, Northwestern University, Evanston, USA.,Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Alireza Vali
- Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Edward J Auerbach
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | | | - Kamil Ugurbil
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Susanne Schnell
- Feinberg School of Medicine, Northwestern University, Chicago, USA
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5
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Ruytenberg T, Webb A, Zivkovic I. A flexible five-channel shielded-coaxial-cable (SCC) transceive neck coil for high-resolution carotid imaging at 7T. Magn Reson Med 2020; 84:1672-1677. [PMID: 32052472 PMCID: PMC7317455 DOI: 10.1002/mrm.28215] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/10/2020] [Accepted: 01/25/2020] [Indexed: 11/13/2022]
Abstract
Purpose Imaging the carotid arteries at 7T ideally requires a flexible multichannel array that allows B1‐shimming and conforms to different neck sizes. The major challenge is to minimize coupling between closely spaced coils and to make the coupling relatively insensitive to loading conditions. Methods We have designed a five‐channel flexible transceive array composed of shielded‐coaxial‐cable coils placed on the anterior part of the neck and conforming to the anatomy. In vivo imaging of the carotid arteries in three subjects has been performed. Results The measured noise correlation matrices show the decoupling level between the individual elements to be −12.5 dB and better. Anatomical localizer imaging of the carotids shows both carotids in every subject well visualized after B1‐shimming. In vivo black‐blood, carotid images were acquired with very high in‐plane spatial resolution (0.25 × 0.25 mm2) with clear depiction of the vessel walls. Conclusions The flexibility of the proposed coil has been demonstrated by imaging subjects with different neck circumferences. To the best of our knowledge, the in‐plane resolution of 0.25 × 0.25 mm2 is the highest reported at 7T.
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Affiliation(s)
- Thomas Ruytenberg
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Andrew Webb
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Carle Foundation Hospital, Urbana, IL, USA
| | - Irena Zivkovic
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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Wüst RCI, Calcagno C, Daal MRR, Nederveen AJ, Coolen BF, Strijkers GJ. Emerging Magnetic Resonance Imaging Techniques for Atherosclerosis Imaging. Arterioscler Thromb Vasc Biol 2020; 39:841-849. [PMID: 30917678 DOI: 10.1161/atvbaha.118.311756] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Atherosclerosis is a prevalent disease affecting a large portion of the population at one point in their lives. There is an unmet need for noninvasive diagnostics to identify and characterize at-risk plaque phenotypes noninvasively and in vivo, to improve the stratification of patients with cardiovascular disease, and for treatment evaluation. Magnetic resonance imaging is uniquely positioned to address these diagnostic needs. However, currently available magnetic resonance imaging methods for vessel wall imaging lack sufficient discriminative and predictive power to guide the individual patient needs. To address this challenge, physicists are pushing the boundaries of magnetic resonance atherosclerosis imaging to increase image resolution, provide improved quantitative evaluation of plaque constituents, and obtain readouts of disease activity such as inflammation. Here, we review some of these important developments, with specific focus on emerging applications using high-field magnetic resonance imaging, the use of quantitative relaxation parameter mapping for improved plaque characterization, and novel 19F magnetic resonance imaging technology to image plaque inflammation.
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Affiliation(s)
- Rob C I Wüst
- From the Biomedical Engineering and Physics (R.C.I.W., M.R.R.D., B.F.C., G.J.S.), Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Claudia Calcagno
- Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (C.C., G.J.S.)
| | - Mariah R R Daal
- From the Biomedical Engineering and Physics (R.C.I.W., M.R.R.D., B.F.C., G.J.S.), Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Aart J Nederveen
- Radiology and Nuclear Medicine (A.J.N.), Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Bram F Coolen
- From the Biomedical Engineering and Physics (R.C.I.W., M.R.R.D., B.F.C., G.J.S.), Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Gustav J Strijkers
- From the Biomedical Engineering and Physics (R.C.I.W., M.R.R.D., B.F.C., G.J.S.), Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, the Netherlands.,Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (C.C., G.J.S.)
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