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Shi C, Liang D, Wang H, Zhu Y. High efficiency free-breathing 3D thoracic aorta vessel wall imaging using self-gating image reconstruction. Magn Reson Imaging 2024; 107:80-87. [PMID: 38237694 DOI: 10.1016/j.mri.2024.01.009] [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: 09/21/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE To improve the scan efficiency of thoracic aorta vessel wall imaging using a self-gating (SG)-based motion correction scheme. MATERIALS AND METHODS A slab-selective variable-flip-angle 3D turbo spin-echo (SPACE) sequence was modified to acquire SG signals and imaging data. Cartesian sampling with a tiny golden-step spiral profile ordering was used to obtain the imaging data during the systolic period, and then the image data were subsequently corrected based on the SG signals and binned to different respiratory cycles. Finally, respiratory artifacts were estimated from image-based registration of 3D undersampled respiratory bins that were reconstructed with L1 iterative self-consistent parallel imaging reconstruction (SPIRiT). This method was evaluated in 11 healthy volunteers and compared against conventional diaphragmatic navigator-gated acquisition to assess the feasibility of the proposed framework. RESULTS Results showed that the proposed method achieved image quality comparable to that of conventional diaphragmatic navigator-gated acquisition with an average scan time of 4 min. The sharpness of the vessel wall and the definition of the liver boundary were in good agreement with the navigator-gated acquisition, which took approximately above 8.5 min depend on the respiratory rate. Further valuation of this technique in patients will be conducted to determine its clinical use.
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Affiliation(s)
- Caiyun Shi
- School of Biomedical Engineering, The Fourth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
| | - Dong Liang
- Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Science, Shenzhen, Guangdong, China; Medical AI Research Centre, Shenzhen Institutes of Advanced Technology, Chinese Academy of Science, Shenzhen, Guangdong, China
| | - Haifeng Wang
- Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Science, Shenzhen, Guangdong, China
| | - Yanjie Zhu
- Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Science, Shenzhen, Guangdong, China.
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Hosadurg N, Kramer CM. Magnetic Resonance Imaging Techniques in Peripheral Arterial Disease. Adv Wound Care (New Rochelle) 2023; 12:611-625. [PMID: 37058352 PMCID: PMC10468560 DOI: 10.1089/wound.2022.0161] [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: 02/02/2023] [Accepted: 04/12/2023] [Indexed: 04/15/2023] Open
Abstract
Significance: Peripheral arterial disease (PAD) leads to a significant burden of morbidity and impaired quality of life globally. Diabetes is a significant risk factor accelerating the development of PAD with an associated increase in the risk of chronic wounds, tissue, and limb loss. Various magnetic resonance imaging (MRI) techniques are being increasingly acknowledged as useful methods of accurately assessing PAD. Recent Advances: Conventionally utilized MRI techniques for assessing macrovascular disease have included contrast enhanced magnetic resonance angiography (MRA), noncontrast time of flight MRA, and phase contrast MRI, but have significant limitations. In recent years, novel noncontrast MRI methods assessing skeletal muscle perfusion and metabolism such as arterial spin labeling (ASL), blood-oxygen-level dependent (BOLD) imaging, and chemical exchange saturation transfer (CEST) have emerged. Critical Issues: Conventional non-MRI (such as ankle-brachial index, arterial duplex ultrasonography, and computed tomographic angiography) and MRI based modalities image the macrovasculature. The underlying mechanisms of PAD that result in clinical manifestations are, however, complex, and imaging modalities that can assess the interaction between impaired blood flow, microvascular tissue perfusion, and muscular metabolism are necessary. Future Directions: Further development and clinical validation of noncontrast MRI methods assessing skeletal muscle perfusion and metabolism, such as ASL, BOLD, CEST, intravoxel incoherent motion microperfusion, and techniques that assess plaque composition, are advancing this field. These modalities can provide useful prognostic data and help in reliable surveillance of outcomes after interventions.
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Affiliation(s)
- Nisha Hosadurg
- Department of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Christopher M. Kramer
- Department of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia, USA
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Wang X, Nai YH, Gan J, Lian CPL, Ryan FK, Tan FSL, Chan DYS, Ng JJ, Lo ZJ, Chong TT, Hausenloy DJ. Multi-Modality Imaging of Atheromatous Plaques in Peripheral Arterial Disease: Integrating Molecular and Imaging Markers. Int J Mol Sci 2023; 24:11123. [PMID: 37446302 DOI: 10.3390/ijms241311123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Peripheral artery disease (PAD) is a common and debilitating condition characterized by the narrowing of the limb arteries, primarily due to atherosclerosis. Non-invasive multi-modality imaging approaches using computed tomography (CT), magnetic resonance imaging (MRI), and nuclear imaging have emerged as valuable tools for assessing PAD atheromatous plaques and vessel walls. This review provides an overview of these different imaging techniques, their advantages, limitations, and recent advancements. In addition, this review highlights the importance of molecular markers, including those related to inflammation, endothelial dysfunction, and oxidative stress, in PAD pathophysiology. The potential of integrating molecular and imaging markers for an improved understanding of PAD is also discussed. Despite the promise of this integrative approach, there remain several challenges, including technical limitations in imaging modalities and the need for novel molecular marker discovery and validation. Addressing these challenges and embracing future directions in the field will be essential for maximizing the potential of molecular and imaging markers for improving PAD patient outcomes.
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Affiliation(s)
- Xiaomeng Wang
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
| | - Ying-Hwey Nai
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
| | - Julian Gan
- Siemens Healthineers, Singapore 348615, Singapore
| | - Cheryl Pei Ling Lian
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Fraser Kirwan Ryan
- Infocomm Technology Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Forest Su Lim Tan
- Infocomm Technology Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Dexter Yak Seng Chan
- Department of General Surgery, Khoo Teck Puat Hospital, Singapore 768828, Singapore
| | - Jun Jie Ng
- Division of Vascular and Endovascular Surgery, Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore 119074, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Zhiwen Joseph Lo
- Vascular Surgery Service, Department of Surgery, Woodlands Health, Singapore 258499, Singapore
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Tze Tec Chong
- Department of Vascular Surgery, Singapore General Hospital, Singapore 168752, Singapore
- Surgical Academic Clinical Programme, Singapore General Hospital, Singapore 169608, Singapore
- Vascular SingHealth Duke-NUS Disease Centre, Singapore 168752, Singapore
| | - Derek John Hausenloy
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
- National Heart Research Institute Singapore, National Heart Centre, Singapore 169609, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore 117597, Singapore
- The Hatter Cardiovascular Institute, University College London, London WC1E 6HX, UK
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Tachikawa Y, Hamano H, Yoshikai H, Ikeda K, Maki Y, Hirata K, Takahashi Y, Matake K. Three-dimensional multicontrast blood imaging with a single acquisition: Simultaneous non-contrast-enhanced MRA and vessel wall imaging in the thoracic aorta. Magn Reson Med 2022; 88:617-632. [PMID: 35436368 DOI: 10.1002/mrm.29217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/22/2022] [Accepted: 02/13/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate MRA and vessel wall imaging (VWI) image quality in the thoracic aorta using a novel method named BRIDGE (bright and dark blood images with multishot gradient-echo EPI). METHODS The BRIDGE method consists of 3D multishot gradient-echo EPI acquisition using pulse gating, navigator gating, and magnetization preparation with a T2 -preparation pulse and a nonselective inversion-recovery pulse. The BRIDGE and conventional methods (noncontrast MRA based on 3D turbo-field-echo [TFE] and VWI based on 3D turbo spin echo with variable refocusing flip angle [VRFA-TSE]) were performed in 10 healthy volunteers and 10 patients. The SNR, contrast-to-noise ratio (CNR), and sharpness in the thoracic aorta were compared for MRA evaluation. The values of SNRlumen , SNRwall , CNRwall-lumen , contrast ratio (CR)lumen-muscle , coefficient of variation, sharpness, lumen area, and wall area in the thoracic aorta were compared for VWI evaluation. Two radiologists independently performed qualitative image-analysis assessments. RESULTS When MRA and VWI were acquired, the acquisition time was 26.6% to 27.8% shorter with BRIDGE than the conventional method. In the MRA evaluation, BRIDGE and TFE methods were comparable. In the VWI evaluation, BRIDGE was superior to the VRFA-TSE method in blood suppression and evaluation of the ascending aorta. Because the blood signal suppression of BRIDGE is based on the T1 value of blood, the blood signal can be suppressed more uniformly than with the VRFA-TSE method, regardless of age, blood flow velocity, or vascular anatomy. CONCLUSION The BRIDGE method can provide both MRA, to assess vascular anatomy and luminal changes, and VWI, to assess the vessel wall and detect vulnerable plaques, in a single scan.
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Affiliation(s)
- Yoshihiko Tachikawa
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | | | - Hikaru Yoshikai
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | - Kento Ikeda
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | - Yasunori Maki
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | - Kazuhide Hirata
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | | | - Kunishige Matake
- Department of Radiology, Karatsu Red Cross Hospital, Saga, Japan
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Ozaki S, Okamoto S, Shinohara N. 3D T2-Weighted Sampling Perfection with Application-Optimized Contrasts Using Different Flip Angle Evolutions (SPACE) and 3D Time-of-Flight (TOF) MR Angiography Fusion Imaging for Occluded Intracranial Arteries. JOURNAL OF NEUROENDOVASCULAR THERAPY 2022; 16:452-457. [PMID: 37502793 PMCID: PMC10370984 DOI: 10.5797/jnet.oa.2021-0102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/24/2022] [Indexed: 07/29/2023]
Abstract
Objective Determining the course of occluded vessels in advance will increase the success rate and safety of mechanical thrombectomy (MT). Herein, we evaluate the usefulness of MR fusion images created via 3D T2-weighted sampling perfection with application-optimized contrasts using different flip angle evolutions (T2-SPACE) and 3D time-of-flight (TOF)-MRA for visualization of occluded vessels in patients with acute ischemic stroke (AIS) before MT. Methods We enrolled 26 patients with AIS caused by intracranial large vessel occlusion who presented at our hospital and underwent MRI with fusion images unaffected by motion artifacts in our study. All patients underwent T2-SPACE and TOF-MRA followed by MT. We created fusion images of the T2-SPACE and TOF-MRA by combining a translucent image of the occluded artery produced by the flow void effect in T2-SPACE with the same vessel in a TOF-MRA image. Fusion images were compared with post-recanalization angiography and post-recanalization MRA, respectively, and the degree of agreement in depiction of M1 runs and M2 branching beyond the occlusion on three levels was assessed. Imaging evaluations were performed independently by two endovascular specialists. Results The interobserver agreement of the MRI findings about the concordance of the occluded vessel's run was excellent (kappa was 0.87 [confidence interval: 0.61-1.12]). In all, 21 patients (80.8%) had excellent imaging, four (15.4%) had fair imaging, and one (3.8%) had a divided opinion of the rating between excellent and fair imaging. No cases were judged to be poorly drawn. Even if there was a localized signal loss, its distal portion could be delineated, so it did not affect the estimation of the entire vessel run, and we found that the anatomical structures of the occluded vessels were distinctly visible in the fusion images. Conclusion We demonstrated that MR fusion images derived using T2-SPACE and MRA methodologies could determine the courses of occluded vessels prior to MT performed for AIS. Fusion MR imaging may have potential as a preoperative test for ensuring effective and safe MT procedures.
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Affiliation(s)
- Saya Ozaki
- Department of Neurosurgery, Ehime University School of Medicine, Toon, Ehime, Japan
- Department of Regeneration of Community Medicine, Ehime University School of Medicine, Toon, Ehime, Japan
| | - Shigetaka Okamoto
- Department of Neurosurgery, HITO Medical Center, Shikokuchuo, Ehime, Japan
| | - Naoki Shinohara
- Department of Neurosurgery, HITO Medical Center, Shikokuchuo, Ehime, Japan
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Space-Occupying Lesions of the Inner Ear Are Easily Misdiagnosed as Endolymphatic Hydrops in a Perilymph-Enhanced Sequence Without the Assistance of a Heavily T2-Weighted Sequence. J Comput Assist Tomogr 2022; 46:830-835. [PMID: 35675691 DOI: 10.1097/rct.0000000000001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the study was to explore the value of T2-sampling perfection with application-optimized contrasts by using different flip angle evolutions (T2-SPACE) in identifying space-occupying lesions of the inner ear. METHODS We collected the T2-SPACE and 3-dimensional inversion-recovery sequence with real reconstruction (3D-real IR) images of 220 patients with inner ear symptoms, including 15 patients with inner ear space-occupying lesions. With T2-SPACE images hidden, a senior and junior radiologist made a diagnosis for all patients using only the 3D-real IR images. After 4 weeks the images were shuffled, and T2-SPACE images were made available to the 2 radiologists in addition to 3D-real IR to reconsider the diagnosis for all patients. RESULTS With the SPACE images hidden, the correct diagnosis rate of the space-occupying lesions was 8/15 (53.3%) for the senior radiologist, whereas it was only 2/15 (13.3%) for the junior radiologist. Without the SPACE images hidden, the correct diagnosis rate of the space-occupying lesions was 15/15 (100.0%) for the senior radiologist, whereas it was 13/15 (86.7%) for the junior radiologist. Of the 15 patients, 7 had only vestibular space-occupying lesions, 2 had only cochlear space-occupying lesions, and 6 had both. No semicircular canal space-occupying lesion was observed. CONCLUSIONS T2-SPACE can help identify space-occupying lesions of the inner ear that tend to be misdiagnosed as endolymphatic hydrops on 3D-real IR. The senior radiologist had a higher rate for the identification of space-occupying lesions than the junior radiologist when using only 3D-real IR, although the senior radiologist detection rate was still only 53.3%. With the addition of T2-SPACE, both the junior and senior radiologist achieved a high detection rate, which increased to 86.7% and 100%, respectively.
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Ning Z, Zhang N, Qiao H, Han H, Shen R, Yang D, Chen S, Zhao X. Free-Breathing Three-Dimensional Isotropic-Resolution MR sequence for simultaneous vessel wall imaging of bilateral renal arteries and abdominal aorta: Feasibility and reproducibility. Med Phys 2021; 49:854-864. [PMID: 34967464 DOI: 10.1002/mp.15436] [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] [Received: 05/27/2021] [Revised: 11/03/2021] [Accepted: 12/28/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Many diseases can simultaneously involve renal arteries and the adjacent abdominal aorta. The study proposed a free-breathing three-dimensional (3D) isotropic-resolution MR sequence for simultaneous vessel wall imaging of bilateral renal arteries and adjacent abdominal aorta. METHODS A respiratory triggered isotropic-resolution sequence which combined the improved motion-sensitized driven-equilibrium (iMSDE) preparation with the spoiled gradient recalled (SPGR) readout (iMSDE-SPGR) was proposed for simultaneous vessel wall imaging of renal arteries and abdominal aorta. The proposed iMSDE-SPGR sequence was optimized by positioning spatial saturation pulses (i.e. REST slabs) elaborately to further alleviate respiratory and gastrointestinal motion artifacts and selecting appropriate first-order gradient moment (m1 ) of the iMSDE preparation. Thirteen healthy subjects and thirteen patients with renal artery stenosis (RAS) underwent simultaneous vessel wall imaging with the optimized iMSDE-SPGR sequence at 3.0T. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and morphology of renal arterial wall and aortic wall were measured. Reproducibility of intra-observer, inter-observer and scan-rescan (n = 13 healthy subjects) in measuring SNR, CNR and morphology was evaluated. For the reproducibility test, the agreement was determined using intraclass correlation coefficients (ICC) and the differences were compared using paired-t test or non-parametric Wilcoxon test when appropriate. Bland-Altman plots were used to calculate the bias between observers and between scans. RESULTS The proposed iMSDE-SPGR sequence was feasible for simultaneous vessel wall imaging both in the healthy subjects and the patients. The sequence showed good to excellent inter-observer (ICC:0.615-0.999), excellent intra-observer (ICC:0.801-0.998) and scan-rescan (ICC:0.768-0.998) reproducibility in measuring morphology, SNR and CNR. There were no significant differences in SNR, CNR and morphology measurements between observers and between scans (all P>0.05). Bland-Altman plots showed small bias in assessing SNR, CNR and morphology. DATA CONCLUSION The proposed free-breathing 3D isotropic-resolution iMSDE-SPGR technique is feasible and reproducible for simultaneous vessel wall imaging of bilateral renal arteries and adjacent abdominal aorta. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Zihan Ning
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Beijing, 100029, China
| | - Huiyu Qiao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Hualu Han
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Rui Shen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Dandan Yang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Shuo Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, 100084, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
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Yang Y, Li Z, Liu Q, Guo Y, Mei Y, Lyu J, Zhao M, Feng Y, Xie G. Carotid arterial wall MRI of apolipoprotein e-deficient mouse at 7 T using DANTE-prepared variable-flip-angle rapid acquisition with relaxation enhancement. Magn Reson Imaging 2021; 86:1-9. [PMID: 34688846 DOI: 10.1016/j.mri.2021.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/20/2021] [Accepted: 10/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To optimize a sequence combining the delay alternating with nutation for tailored excitation (DANTE) preparative module with the variable-flip-angle rapid acquisition with relaxation enhancement (VF-RARE) sequence (DANTE-VF-RARE) and to investigate its feasibility for vessel wall imaging in Apolipoprotein E-Deficient (ApoE-/-) mouse at 7 Tesla (T). MATERIALS AND METHODS Specific T1/T2 values were used for producing a sharper vessel wall in the variable-flip-angle optimization scheme. The DANTE RF pulse flip angle and pulse train length were optimized for maximizing the wall-lumen contrast. ApoE-/- (fed high fat diet for 20/40/ 60 weeks, n = 9/4/4) and wild-type mice (controls, n = 3) were imaged at 7 T using VF-RARE, DANTE-VF-RARE, time-of-flight (TOF) angiography, and multi-slice T1-weighted 2D RARE coupled with inflow outflow saturation bands (IOSB-RARE). Wall-lumen contrast-to-noise-ratio efficiency (CNReff), lumen area (LA), and wall area (WA) were compared between DANTE-VF-RARE and 2D IOSB-RARE sequences. Additionally, linear regression analysis was conducted between MR measurements and histomorphometric planimetry results. RESULTS Residual blood signal was observed in the four out of eighteen carotids on VF-RARE images, whereas it was significantly suppressed on DANTE-VF-RARE images. Compared with IOSB-RARE, DANTE-VF-RARE offered significantly improved CNReff (P < 0.001). The LA and WA were both comparable (P = 0.085 and 0.112, respectively) and showed excellent agreement between DANTE-VF-RARE and IOSB-RARE (ICC = 0.96 and 0.95, respectively). The luminal stenosis identified by DANTE-VF-RARE was in consistent with the results of TOF. Strong correlations were found between MR measurements and histopathological analysis for both WA (DANTE-VF-RARE: r = 0.92, slope = 0.94, P < 0.001; IOSB-RARE: r = 0.93, slope = 0.94, P < 0.001) and LA (DANTE-VF-RARE: r = 0.82, slope = 0.54, P < 0.001; IOSB-RARE: r = 0.78, slope = 0.50, P < 0.001). CONCLUSION DANTE-VF-RARE achieves effective blood signal suppression and is a feasible approach for the 3D carotid arterial wall imaging of ApoE-/- mouse at 7 T.
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Affiliation(s)
- Yuanbo Yang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhonghao Li
- Department of Pathophysiology, Key Lab for Shock and Microcirculation Research of Guangdong, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Qiang Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yihao Guo
- MR Collaboration, Siemens Healthcare Ltd., Guangzhou, China
| | - Yingjie Mei
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China; Philips Healthcare, Guangzhou, China
| | - Jian Lyu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Ming Zhao
- Department of Pathophysiology, Key Lab for Shock and Microcirculation Research of Guangdong, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China.
| | - Guoxi Xie
- Department of Biomedical Engineering, The Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou, China.
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Coolen BF, Schoormans J, Gilbert G, Kooreman ES, de Winter N, Viessmann O, Zwanenburg JJM, Majoie CBLM, Strijkers GJ, Nederveen AJ, Siero JCW. Double delay alternating with nutation for tailored excitation facilitates banding-free isotropic high-resolution intracranial vessel wall imaging. NMR IN BIOMEDICINE 2021; 34:e4567. [PMID: 34076305 PMCID: PMC8459252 DOI: 10.1002/nbm.4567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/26/2021] [Accepted: 05/15/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to evaluate the use of a double delay alternating with nutation for tailored excitation (D-DANTE)-prepared sequence for banding-free isotropic high-resolution intracranial vessel wall imaging (IC-VWI) and to compare its performance with regular DANTE in terms of signal-to-noise ratio (SNR) as well as cerebrospinal fluid (CSF) and blood suppression efficiency. To this end, a D-DANTE-prepared 3D turbo spin echo sequence was implemented by interleaving two separate DANTE pulse trains with different RF phase-cycling schemes, but keeping all other DANTE parameters unchanged, including the total number of pulses and total preparation time. This achieved a reduction of the banding distance compared with regular DANTE enabling banding-free imaging up to higher resolutions. Bloch simulations assuming static vessel wall and flowing CSF spins were performed to compare DANTE and D-DANTE in terms of SNR and vessel wall/CSF contrast. Similar image quality measures were assessed from measurements on 13 healthy middle-aged volunteers. Both simulation and in vivo results showed that D-DANTE had only slightly lower vessel wall/CSF and vessel wall/blood contrast-to-noise ratio values compared with regular DANTE, which originated from a 10%-15% reduction in vessel wall SNR but not from reduced CSF or blood suppression efficiency. As anticipated, IC-VWI acquisitions showed that D-DANTE can successfully remove banding artifacts compared with regular DANTE with equal scan time or DANTE preparation length. Moreover, application was demonstrated in a patient with an intracranial aneurysm, indicating improved robustness to slow flow artifacts compared with clinically available 3D turbo spin echo scans. In conclusion, D-DANTE provides banding artifact-free IC-VWI up to higher isotropic resolutions compared with regular DANTE. This allows for a more flexible choice of DANTE preparation parameters in high-resolution IC-VWI protocols.
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Affiliation(s)
- Bram F. Coolen
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
| | - Jasper Schoormans
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
| | | | - Ernst S. Kooreman
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
- Department of Radiation OncologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Naomi de Winter
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
| | - Olivia Viessmann
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Harvard Medical SchoolMassachusetts General HospitalCharlestownMassachusettsUSA
| | - Jaco J. M. Zwanenburg
- Department of Radiology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | | | - Gustav J. Strijkers
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
| | - Aart J. Nederveen
- Department of Radiology & Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
| | - Jeroen C. W. Siero
- Department of Radiology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Spinoza Centre for NeuroimagingAmsterdamThe Netherlands
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Detection and Prediction of Peripheral Arterial Plaque Using Vessel Wall MR in Patients with Diabetes. BIOMED RESEARCH INTERNATIONAL 2021. [PMID: 31638151 PMCID: PMC8088372 DOI: 10.1155/2021/5585846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objectives To evaluate the predictive performance of a newly developed delay alternating with nutation for tailored excitation (DANTE) pulse sequence for detecting lower extremity artery wall morphology and distribution in patients with peripheral artery disease (PAD) with diabetes. Methods Seventy-four PAD patients diagnosed according to 2011 WHO criteria were enrolled, who has diabetic diagnosis by 1999 WHO diabetes criteria. All patients received sequential DANTE, T2WI, DANTE-enhance, and CE-MRA scans. The images consisted of three parts: the iliac artery (segment 1), femoral artery (segment 2), and popliteal artery (segment 3). Regions of interest (ROIs) were drawn on vessels, muscle, and background, and multiple imaging metrics compared between modalities, including image quality score, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). In the images with a score greater than 2, the lumen area (LA), total vessel area (TVA), and vessel thickness (VT) can be identified using semiautomatic image analysis vessel morphology parameters. Results All 222 arterial segments were successfully analyzed from 71 patients, after exclusion of three subjects with poor image quality (IQ < 2) in segment 3. There were 54 diabetic and 17 nondiabetic patients. Quantitative analysis shows that the CNR difference between diabetic patients and nondiabetic patients was statistically significant for the same segment, while there was no significant difference among the three segments of SNR and CNR. There were a total of 54 diabetics with plaque distribution data, which showed that LA of segments 1 and 2 was higher than that of segment 3. The VWI of segments 1 and 2 was lower than segment 3. Diabetic was associated with vascular WT 3 and WA3, which increased by 0.23 and 0.83 units on average compared without diabetic foot, respectively. Diabetic foot was associated with vascular WT 3, which increased by 0.37 units on average compared without diabetic foot. The incidence of segment 3 plaques was higher than that of segment 1. The incidence of the left and right plaques was different. Conclusions MR imaging using the DANTE and multicontrast sequence could evaluate plaque morphology, and distribution of lower extremities and the occurrence of diabetic foot development are closely related; it may predict occurrence of PAD with diabetic foot.
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Wang L, Deng W, Liang J, Zhuang W, Feng H, Zhuang G, Liu D, Chen H. Loan sharking: changing patterns in, and challenging perceptions of, an abuse of deprivation. JOURNAL OF PUBLIC HEALTH (OXFORD, ENGLAND) 2021; 43:e62-e68. [PMID: 31638151 PMCID: PMC8088372 DOI: 10.1093/pubmed/fdz090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/02/2019] [Accepted: 07/10/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND Illegal high interest lending or 'loan sharking' exploits the vulnerable and has profound negative impacts on individuals and communities. The 2008 UK financial crash and subsequent austerity programme coupled with changes in the consumer credit market have fuelled an increase in predatory lending. METHODS The study is a descriptive analysis of demographic, financial, health and behavioural data on 753 victims (2011-2017). A review of the causative factors and potential political, economic and public health responses is analysed. RESULTS Most victims were female but males were considerably more indebted. Illegal loans are largely taken out for routine living expenses and over 70% of victims reported other serious debts. Victims are disproportionately poor, unemployed and on benefits but fewer than half have had financial or benefits advice. Despite 90% reporting they would not borrow illegally again, 30% had previously done so from the same shark and over half considered them a friend. CONCLUSIONS The increase in loan sharking has coincided with the withdrawal of traditional sub-prime lenders and local welfare assistance schemes, and the low penetration of Credit Unions in many areas. Conventional perceptions of loan sharks and their relationships with victims are largely incorrect. A range of coordinated financial, political and social interventions is required.
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Affiliation(s)
- Li Wang
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Wei Deng
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Jianke Liang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Weizhao Zhuang
- Invasive Technology Department, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Huigang Feng
- Invasive Technology Department, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Gaoming Zhuang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Dexiang Liu
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Hanwei Chen
- Invasive Technology Department, Guangzhou Panyu Central Hospital, Guangzhou, China
- Invasive Technology Department, The First Affiliated Hospital, Jinan University, Guangzhou, China
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Ozaki S, Okamoto S, Shinohara N. A proposed method for outlining occluded intracranial artery using 3D T2-weighted sampling perfection with application optimized contrasts using different flip angle evolution (SPACE). Acta Radiol Open 2021; 10:20584601211003233. [PMID: 33815831 PMCID: PMC7995312 DOI: 10.1177/20584601211003233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 11/25/2022] Open
Abstract
High-resolution vessel wall imaging techniques have been developed for clinical use in various types of intracranial artery disease. Numerous studies have described techniques for evaluating remodeling patterns and plaque character, but few have reported a method for outlining obstructed vessels in intracranial artery occlusion. The course of the vessel affects the success of recanalization and can cause complications in mechanical thrombectomy for acute ischemic stroke. We propose imaging with 3D T2-weighted sampling perfection with application optimized contrasts using different flip angle evolution (SPACE) as a useful tool for describing the course of an occluded artery in ischemic stroke due to intracranial artery occlusion.
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Affiliation(s)
- Saya Ozaki
- Department of Neurosurgery, Ehime University Graduate School of Medicine, Ehime, Japan.,Department of Regeneration of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
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Ning Z, Chen S, Sun H, Shen R, Qiao H, Han H, Yang D, Zhao X. Evaluating renal arterial wall by non-enhanced 2D and 3D free-breathing black-blood techniques: Initial experience. Magn Reson Imaging 2021; 79:5-12. [PMID: 33677024 DOI: 10.1016/j.mri.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate the feasibility and reproducibility of 2D and 3D black-blood sequences in measuring morphology of renal arterial wall. METHODS The 2D and 3D imaging sequences used variable-refocusing-flip-angle and constant-low-refocusing-flip-angle turbo spin echo (TSE) readout respectively, with delicately selected black-blood scheme and respiratory motion trigger for free-breathing imaging. Fourteen healthy subjects and three patients with Takayasu arteritis underwent renal artery wall imaging with 3D double inversion recovery (DIR) TSE and 2D Variable Flip Angle-TSE (VFA-TSE) black-blood sequences at 3.0 T. Four healthy subjects were randomly selected for scan-rescan reproducibility experiments. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and morphology of arterial wall were measured and compared using paired-t-test or Wilcoxon signed-rank test between 2D and 3D sequences. The inter-observer, intra-observer and scan-rescan agreements of above measurements were determined using intraclass correlation coefficient (ICC). RESULTS The 2D and 3D imaging sequences showed similar morphological measurements (lumen area, wall area, mean wall thickness and maximum wall thickness) of renal arterial wall (all P > 0.05) and excellent agreement (ICC: 0.853-0.954). Compared to 2D imaging, 3D imaging exhibited significantly lower SNRlumen (P < 0.01) and SNRwall (P = 0.037), similar contrast-to-noise ratio (CNR) (P = 0.285), and higher CNR efficiency (CNReff) (P < 0.01). Both 2D and 3D imaging showed good to excellent inter-observer (ICC: 0.723-0.997), intra-observer (ICC: 0.749-0.996) and scan-rescan (ICC: 0.710-0.992) reproducibility in measuring renal arterial wall morphology, SNR and CNR, respectively. CONCLUSIONS Both high-resolution free-breathing 2D VFA-TSE and 3D DIR TSE black-blood sequences are feasible and reproducible in high-resolution renal arterial wall imaging. The 2D imaging has high SNR, whereas 3D imaging has high imaging efficiency.
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Affiliation(s)
- Zihan Ning
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | - Shuo Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | - Hao Sun
- Department of Radiology, Peking Union Medical College Hospital, Beijing 100005, China
| | - Rui Shen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | - Huiyu Qiao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | - Hualu Han
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | - Dandan Yang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China.
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Wu Y, Li F, Wang Y, Hu T, Xiao L. High-Resolution Vessel Wall Magnetic Resonance Imaging of the Middle Cerebral Artery: Comparison of 3D CUBE T1-Weighted Sequence with and without Fat Suppression. Med Sci Monit 2020; 26:e928931. [PMID: 33159730 PMCID: PMC7657061 DOI: 10.12659/msm.928931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Fat suppression is an important technique in magnetic resonance imaging (MRI). Comprehensive and quantitative assessment of the influence of fat suppression (FS) on T1-weighted imaging of intracranial vessel wall imaging is needed. In this study, we compared the three-dimensional (3D) variable-flip-angle turbo-spin-echo (CUBE) T1-weighted sequence with and without FS to investigate the differences between the 2 sequences in imaging of the middle cerebral artery (MCA) vessel walls. Material/Methods A 3D CUBE T1-weighted sequence with and without FS by 3.0T MRI was used to obtain intracranial vessel wall images of 105 MCA stenosis patients. The image signal intensity, signal-to-noise ratio, and contrast-to-noise ratio were calculated and compared. Two observers evaluated the image quality of the 2 sequences twice, and interobserver and intraobserver consistency were determined. Differences between the 2 sequences in the area of lumen and plaque were compared. Results The signal intensity, signal-to-noise ratio, and contrast-to-noise ratio of the 3D CUBE T1-weighted sequence without FS were higher, whereas the noise level was lower. In terms of subjective scores, the 3D CUBE T1-weighted sequence without FS performed better. No significant difference was observed in the measurement of the vascular lumen area between the 2 sequences, although there were statistically significant differences in the measurement of plaque area (i.e., the measurement obtained with 3D CUBE T1-weighted sequence without FS was larger). Conclusions 3D CUBE T1-weighted sequence without FS performed better for MCA vessel walls imaging than 3D CUBE T1-weighted sequence with FS.
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Affiliation(s)
- Yejun Wu
- The Fourth Affiliated Hospital of China Medical University, China Medical University, Shengyang, Liaoning, China (mainland)
| | - Fangbing Li
- The Fourth Affiliated Hospital of China Medical University, China Medical University, Shengyang, Liaoning, China (mainland)
| | - Yilin Wang
- The Fourth Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China (mainland)
| | - Tianxiang Hu
- The Fourth Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China (mainland)
| | - Liang Xiao
- The Fourth Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China (mainland)
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Inui S, Yamamoto A, Sakurai K. [Imaging diagnosis of intracranial artery dissections: visualization of the vessel walls on high-resolution vessel wall imaging]. Rinsho Shinkeigaku 2020; 60:573-580. [PMID: 32779599 DOI: 10.5692/clinicalneurol.cn-001447] [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] [Indexed: 06/11/2023]
Abstract
MRI is a non-invasive imaging modality with a high contrast resolution useful in diagnosing intracranial artery dissections. However, conventional MRI techniques, including time-of-flight MR angiography or basi-parallel anatomical scanning provide only limited information because they focus on imaging findings rather than the vessel walls. A newly devised MRI technique, high-resolution vessel wall imaging (HRVWI), enables direct visualization of vessel wall and therefore more accurate diagnosis. With increasing use of HRVWI, physicians need to understand the clinical indications, MR sequences for assessment, optimization of acquisition parameters, and limitations in the interpretation of images. For precise interpretation of images, physicians should be aware of the pathological condition of intracranial artery dissection and its radiological findings. In this review, we provide an overview and principles of MRI assessment used for intracranial artery dissection paying special attention to its pathological findings and radiological presentations on HRVWI.
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Affiliation(s)
- Shohei Inui
- Department of Radiology, Graduate School of Medicine, The University of Tokyo
| | - Asako Yamamoto
- Department of Radiology, Teikyo University School of Medicine
| | - Keita Sakurai
- Department of Radiology, National Center for Geriatrics and Gerontology
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Deep-learning-based image quality enhancement of compressed sensing magnetic resonance imaging of vessel wall: comparison of self-supervised and unsupervised approaches. Sci Rep 2020; 10:13950. [PMID: 32811848 PMCID: PMC7434911 DOI: 10.1038/s41598-020-69932-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/14/2020] [Indexed: 01/01/2023] Open
Abstract
While high-resolution proton density-weighted magnetic resonance imaging (MRI) of intracranial vessel walls is significant for a precise diagnosis of intracranial artery disease, its long acquisition time is a clinical burden. Compressed sensing MRI is a prospective technology with acceleration factors that could potentially reduce the scan time. However, high acceleration factors result in degraded image quality. Although recent advances in deep-learning-based image restoration algorithms can alleviate this problem, clinical image pairs used in deep learning training typically do not align pixel-wise. Therefore, in this study, two different deep-learning-based denoising algorithms-self-supervised learning and unsupervised learning-are proposed; these algorithms are applicable to clinical datasets that are not aligned pixel-wise. The two approaches are compared quantitatively and qualitatively. Both methods produced promising results in terms of image denoising and visual grading. While the image noise and signal-to-noise ratio of self-supervised learning were superior to those of unsupervised learning, unsupervised learning was preferable over self-supervised learning in terms of radiomic feature reproducibility.
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Park CJ, Cha J, Ahn SS, Choi HS, Kim YD, Nam HS, Heo JH, Lee SK. Contrast-Enhanced High-Resolution Intracranial Vessel Wall MRI with Compressed Sensing: Comparison with Conventional T1 Volumetric Isotropic Turbo Spin Echo Acquisition Sequence. Korean J Radiol 2020; 21:1334-1344. [PMID: 32767865 PMCID: PMC7689147 DOI: 10.3348/kjr.2020.0128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/08/2020] [Accepted: 04/25/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Compressed sensing (CS) has gained wide interest since it accelerates MRI acquisition. We aimed to compare the 3D post-contrast T1-weighted volumetric isotropic turbo spin echo acquisition (VISTA) with CS (VISTA-CS) and without CS (VISTA-nonCS) in intracranial vessel wall MRIs (VW-MRI). MATERIALS AND METHODS From April 2017 to July 2018, 72 patients who underwent VW-MRI, including both VISTA-CS and VISTA-nonCS, were retrospectively enrolled. Wall and lumen volumes, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured from normal and lesion sites. Two neuroradiologists independently evaluated overall image quality and degree of normal and lesion wall delineation with a four-point scale (scores ≥ 3 defined as acceptable). RESULTS Scan coverage was increased in VISTA-CS to cover both anterior and posterior circulations with a slightly shorter scan time compared to VISTA-nonCS (approximately 7 minutes vs. 8 minutes). Wall and lumen volumes were not significantly different with VISTA-CS or VISTA-nonCS (interclass correlation coefficient = 0.964-0.997). SNR was or trended towards significantly higher values in VISTA-CS than in VISTA-nonCS. At normal sites, CNR was not significantly different between two sequences (p = 0.907), whereas VISTA-CS provided lower CNR in lesion sites compared with VISTA-nonCS (p = 0.003). Subjective wall delineation was superior with VISTA-nonCS than with VISTA-CS (p = 0.019), although overall image quality did not differ (p = 0.297). The proportions of images with acceptable quality were not significantly different between VISTA-CS (83.3-97.8%) and VISTA-nonCS (75-100%). CONCLUSION CS may be useful for intracranial VW-MRI as it allows for larger scan coverage with slightly shorter scan time without compromising image quality.
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Affiliation(s)
- Chae Jung Park
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jihoon Cha
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Seok Choi
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Suk Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hoe Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Koo Lee
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
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Dai X, Lei Y, Zhang Y, Qiu RLJ, Wang T, Dresser SA, Curran WJ, Patel P, Liu T, Yang X. Automatic multi-catheter detection using deeply supervised convolutional neural network in MRI-guided HDR prostate brachytherapy. Med Phys 2020; 47:4115-4124. [PMID: 32484573 DOI: 10.1002/mp.14307] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/19/2020] [Accepted: 05/24/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE High-dose-rate (HDR) brachytherapy is an established technique to be used as monotherapy option or focal boost in conjunction with external beam radiation therapy (EBRT) for treating prostate cancer. Radiation source path reconstruction is a critical procedure in HDR treatment planning. Manually identifying the source path is labor intensive and time inefficient. In recent years, magnetic resonance imaging (MRI) has become a valuable imaging modality for image-guided HDR prostate brachytherapy due to its superb soft-tissue contrast for target delineation and normal tissue contouring. The purpose of this study is to investigate a deep-learning-based method to automatically reconstruct multiple catheters in MRI for prostate cancer HDR brachytherapy treatment planning. METHODS Attention gated U-Net incorporated with total variation (TV) regularization model was developed for multi-catheter segmentation in MRI. The attention gates were used to improve the accuracy of identifying small catheter points, while TV regularization was adopted to encode the natural spatial continuity of catheters into the model. The model was trained using the binary catheter annotation images offered by experienced physicists as ground truth paired with original MRI images. After the network was trained, MR images of a new prostate cancer patient receiving HDR brachytherapy were fed into the model to predict the locations and shapes of all the catheters. Quantitative assessments of our proposed method were based on catheter shaft and tip errors compared to the ground truth. RESULTS Our method detected 299 catheters from 20 patients receiving HDR prostate brachytherapy with a catheter tip error of 0.37 ± 1.68 mm and a catheter shaft error of 0.93 ± 0.50 mm. For detection of catheter tips, our method resulted in 87% of the catheter tips within an error of less than ± 2.0 mm, and more than 71% of the tips can be localized within an absolute error of no >1.0 mm. For catheter shaft localization, 97% of catheters were detected with an error of <2.0 mm, while 63% were within 1.0 mm. CONCLUSIONS In this study, we proposed a novel multi-catheter detection method to precisely localize the tips and shafts of catheters in three-dimensional MRI images of HDR prostate brachytherapy. It paves the way for elevating the quality and outcome of MRI-guided HDR prostate brachytherapy.
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Affiliation(s)
- Xianjin Dai
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Yang Lei
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Yupei Zhang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Richard L J Qiu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Tonghe Wang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Sean A Dresser
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Walter J Curran
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Pretesh Patel
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Tian Liu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30332, USA
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Han Y, Zhu Z, Guan M, Yang D, Wang W, Li C, Chen H, Zhao X. Diabetes-specific characteristics of atherosclerotic plaques in femoral arteries determined by three-dimensional magnetic resonance vessel wall imaging. Diabetes Metab Res Rev 2020; 36:e3201. [PMID: 31278827 DOI: 10.1002/dmrr.3201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/28/2019] [Accepted: 07/03/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study aimed to investigate the characteristics of femoral atherosclerotic plaques in patients with diabetes mellitus (DM) compared with those without DM using three-dimensional magnetic resonance vessel wall imaging. METHODS Lower extremity atherosclerotic disease patients with and without DM (age ≥ 50 year-old) were recruited and underwent three-dimensional magnetic resonance imaging for femoral arteries. The femoral arteries were divided into common femoral artery (CFA), proximal of superficial femoral artery (pSFA), adductor canal (AC), and popliteal artery (PA) segments. The characteristics of femoral artery atherosclerotic plaques were compared between patients with and without DM. RESULTS Forty-eight patients with DM (69.5 ± 8.2 years; 26 males) and 50 patients without DM (71.9 ± 5.7 years; 28 males) were included. Significant differences were found in maximum wall thickness in CFA and AC segments, eccentricity index in AC segment, prevalence of plaque in CFA, pSFA and AC segments, stenosis and prevalence of calcification in pSFA, AC and PA segments, prevalence of lipid-rich necrotic core (LRNC) in all segments, and prevalence of intraplaque haemorrhage in PA segment between patients with and without DM (all P < .05). After adjusted for confounding factors of age, gender, hyperlipidemia, coronary artery disease, and statin use, the differences in eccentricity index, stenosis and prevalence of plaque, calcification and LRNC in pSFA and AC segments, and stenosis and prevalence of LRNC in PA segment remained statistically significant between patients with and without DM (all P < .05). CONCLUSIONS Patients with DM have significantly larger plaque burden, higher prevalence of plaques, and more complex plaque compositions in femoral arteries than those without DM.
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Affiliation(s)
- Yongjun Han
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Zhu Zhu
- Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Maobin Guan
- Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Dandan Yang
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Wei Wang
- Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Cheng Li
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
- Center of Stroke, Beijing Institute of Brain Disorders, Beijing, China
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Suh CH, Jung SC, Lee HB, Cho SJ. High-Resolution Magnetic Resonance Imaging Using Compressed Sensing for Intracranial and Extracranial Arteries: Comparison with Conventional Parallel Imaging. Korean J Radiol 2019; 20:487-497. [PMID: 30799580 PMCID: PMC6389811 DOI: 10.3348/kjr.2018.0424] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 09/17/2018] [Indexed: 12/25/2022] Open
Abstract
Objective To compare conventional sensitivity encoding (SENSE) to compressed sensing plus SENSE (CS) for high-resolution magnetic resonance imaging (HR-MRI) of intracranial and extracranial arteries. Materials and Methods HR-MRI was performed in 14 healthy volunteers. Three-dimensional T1-weighted imaging (T1WI) and proton density-weighted imaging (PD) were acquired using CS or SENSE under the same total acceleration factors (AFt)-5.5, 6.8, and 9.7 for T1WI and 3.2, 4.0, and 5.8 for PD-to achieve reduced scanning times in comparison with the original imaging sequence (SENSE T1WI, AFt 3.5; SENSE PD, AFt 2.0) using the 3-tesla system. Two neuroradiologists measured signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and used visual scoring systems to assess image quality. Acceptable imaging was defined as a visual score ≥ 2. Repeated measures analysis of variance and Cochran's Q test were performed. Results CS yielded better image quality and vessel delineation than SENSE in T1WI with AFt of 5.5, 6.8, and 9.7, and in PD with AFt of 5.8 (p < 0.05). CS T1WI with AFt of 5.5 and CS PD with AFt of 3.2 and 4.0 did not differ significantly from original imaging (p > 0.05). SNR and CNR in CS were higher than they were in SENSE, but lower than they were in the original images (p < 0.05). CS yielded higher proportions of acceptable imaging than SENSE (CS T1WI with AFt of 6.8 and PD with AFt of 5.8; p < 0.0167). Conclusion CS is superior to SENSE, and may be a reliable acceleration method for vessel HR-MRI using AFt of 5.5 for T1WI, and 3.2 and 4.0 for PD.
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Affiliation(s)
- Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Chai Jung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - Ho Beom Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Se Jin Cho
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Dronkers CEA, Klok FA, van Langevelde K, Šrámek A, van Haren GR, Huisman MV, de Roos A, Kroft LJM. Diagnosing Recurrent DVT of the Leg by Two Different Non-Contrast-Enhanced Magnetic Resonance Direct Thrombus Imaging Techniques: A Pilot Study. TH OPEN 2019; 3:e37-e44. [PMID: 31249980 PMCID: PMC6524903 DOI: 10.1055/s-0039-1678683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 01/02/2019] [Indexed: 11/12/2022] Open
Abstract
Introduction
Magnetic resonance direct thrombus imaging (MRDTI) is a promising technique to improve the diagnostic management of patients with a suspected ipsilateral recurrent deep vein thrombosis (DVT) by direct visualization of a thrombus. Another magnetic resonance imaging (MRI) technique, T1-weighted turbo spin-echo spectral attenuated inversion recovery (TSE-SPAIR), has the potential to image a thrombus directly with a high spatial resolution as well. The main aim of this pilot study was to investigate if adding the TSE-SPAIR sequence to an MRDTI sequence performed in patients with suspected recurrent DVT may increase the diagnostic confidence of expert MRDTI readers.
Methods
Fifteen patients with suspected acute recurrent DVT were included in this study. The TSE-SPAIR sequence was scanned directly after the MRDTI scan but not used to guide clinical decision making, and both scans were adjudicated post hoc two times separately by three independent expert MRDTI readers. Diagnostic confidence was scored on a 4-point Likert scale: (1) poor (definite diagnosis impossible), (2) fair (evaluation of major findings possible), (3) good (definite diagnosis possible), and (4) excellent (exact diagnosis possible).
Results
The diagnostic confidence of expert readers increased when adding the TSE-SPAIR sequence on top of the MRDTI sequence from “good” (median, 3.0; interquartile range [IQR], 2.66–3.0) to “excellent” (median, 3.67; IQR 3.33–3.67;
p
= 0.001). Evaluation of the scans in the reversed order 5 months after initial reading showed similar results. Diagnostic accuracy for proximal DVT of both scan techniques was good.
Conclusion
The extra TSE-SPAIR sequence may help increase diagnostic confidence of radiologists in cases of uncertain diagnosis in patients with suspected ipsilateral recurrent DVT.
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Affiliation(s)
- Charlotte E A Dronkers
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Frederikus A Klok
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Kirsten van Langevelde
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Radiology, HAGA Teaching Hospital, The Hague, The Netherlands
| | - Alexandr Šrámek
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Guido R van Haren
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Menno V Huisman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lucia J M Kroft
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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22
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Han Y, Guan M, Zhu Z, Li D, Chen H, Yuan C, Li C, Wang W, Zhao X. Assessment of longitudinal distribution of subclinical atherosclerosis in femoral arteries by three-dimensional cardiovascular magnetic resonance vessel wall imaging. J Cardiovasc Magn Reson 2018; 20:60. [PMID: 30173671 PMCID: PMC6120082 DOI: 10.1186/s12968-018-0482-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 07/20/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Lower extremity peripheral artery disease has become a significant health burden worldwide. Since the treatment strategies can be different if atherosclerotic disease involves different femoral artery segments, it is important to assess plaque distribution among different segments of femoral arteries. We sought to investigate the longitudinal distribution of subclinical femoral artery atherosclerosis in asymptomatic elderly adults using cardiovascular magnetic resonance (CMR) vessel wall imaging. METHODS Asymptomatic elderly subjects underwent three-dimensional (3D) CMR vessel wall imaging for femoral arteries. The 3D motion sensitized-driven equilibrium prepared rapid gradient-echo (3D-MERGE) sequence was acquired from the common femoral artery to the popliteal artery. The femoral artery was divided into 4 segments: common femoral artery (CFA), proximal superficial femoral artery (pSFA), adductor canal (AC) segment of femoral artery, and popliteal artery (PA). The morphological characteristics including lumen area, wall area, maximum and minimum wall thickness, normalized wall index (NWI = wall area / [lumen area + wall area] × 100%), and eccentricity index ([maximum wall thickness - minimum wall thickness] / maximum wall thickness), luminal stenosis, and presence of atherosclerotic plaque were evaluated and compared between bilateral sides and among different femoral artery segments in each side of femoral artery. The associations between ankle-brachial index (ABI) and cardiovascular risk factors and femoral artery plaque characteristics were also determined. RESULTS Of 107 recruited subjects (71.9 ± 5.6 years; 48 males), 70 (65.4%) were found to have femoral artery plaques. The atherosclerotic plaques were most frequently found in PA (41.1%) and CFA (40.2%) segments, followed by pSFA (31.8%) and AC (23.4%) segments (p = 0.002). Similarly, PA and CFA segments showed significantly greater maximum wall thickness and eccentricity index compared with pSFA and AC segments (all p < 0.001). Significant differences can be found in NWI among four segments of femoral arteries (p < 0.001) and PA showed the highest NWI (54.8%), followed by AC (54.3%), pSFA (52.4%) and CFA (45.9%) segments. Compared with right femoral artery, left femoral artery had significant smaller lumen area and greater NWI in most of segments (p < 0.002). There were no significant differences in ABI between subjects with and without atherosclerotic plaques (p = 0.161). The presence of subclinical atherosclerotic plaque in femoral arteries was significantly associated with cardiovascular risk factors including age (odds ratio [OR], 1.133; 95% confidence interval [CI], 1.048-1.224, p = 0.002), male gender (OR, 3.914; 95% CI, 1.612-9.501, p = 0.003), and hypertension (OR, 4.000; 95% CI, 1.700-9.411, p = 0.001), respectively. CONCLUSIONS Subclinical femoral artery atherosclerosis is prevalent in the elderly population, particularly in the left femoral artery and segments of CFA and PA, and is associated with age, male gender and hypertension. Our findings suggest that, for screening subclinical atherosclerosis, more attention needs to be paid to the specific side and segments of femoral arteries, particularly older individuals and those with these cardiovascular disease risk factors.
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Affiliation(s)
- Yongjun Han
- Center for Brain Disorders Research, Capital Medical University and Beijing Institute of Brain Disorders, Beijing, China
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Maobin Guan
- Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Zhu Zhu
- Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Dongye Li
- Center for Brain Disorders Research, Capital Medical University and Beijing Institute of Brain Disorders, Beijing, China
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Chun Yuan
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
- Department of Radiology, University of Washington, Seattle, USA
| | - Cheng Li
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Wei Wang
- Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
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23
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Tianfang Y, Liang X, Yukui W, Qingtang L, Liqun J, Geng X. Feasibility of High-Resolution 3-Dimensional Sampling Perfection with Application-Optimized Contrast Using Different Flip Angle Evolution Imaging for the Preoperative Detection of Parasinus Meningioma: A Pilot Study Compared with Contrast-Enhanced Magnetic Resonance Venography. World Neurosurg 2018; 119:e623-e630. [PMID: 30077750 DOI: 10.1016/j.wneu.2018.07.223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To prospectively evaluate the diagnostic value of 3.0 Tesla magnetic resonance 3-dimensional sampling perfection with application-optimized contrast using different flip angle evolution (3D-SPACE) in the detection of sinus wall invasion and sinus patency in parasinus meningiomas. METHODS In this study, 28 patients with suspected meningiomas adjacent to the venous sinus underwent conventional magnetic resonance imaging, contrast-enhanced magnetic resonance venography, and 3D-SPACE scans. We collected patient charts and surgical reports for demographic details, histologic analysis, and neurologic performance preoperatively and postoperatively. Images obtained by each technique were assessed independently by 2 neurosurgeons for characteristics of sinus infiltration, wall invasion, lumen patency, and collateral veins. RESULTS The blood flow signal inside the lumen and collateral veins were depressed and presented as black, contrasting well with the sinus wall on 3D-SPACE imaging. When the curved-planar reconstruction images were combined, it was intuitive and accurate to detect the extent of sinus wall invasion by meningioma and also to detect lumen patency. An intratumoral "false lumen" was shown to maintain the blood flow inside the sinus at a totally invaded lesion. Moreover, collateral veins enveloped in a meningioma with their confluence points of the venous sinus were easily observed on 3D-SPACE images. CONCLUSION With an integrative presentation of parasinus meningioma, wall invasion, lumen patency, and collateral veins, high-resolution 3D-SPACE imaging provides a reliable technique to accurately assess venous sinus invasion preoperatively.
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Affiliation(s)
- Yan Tianfang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xu Liang
- Department of Neurosurgery, Beijing Haidian Hospital, Beijing, China
| | - Wei Yukui
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lin Qingtang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jiao Liqun
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xu Geng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
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24
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Helyar VG, Gupta Y, Blakeway L, Charles-Edwards G, Katsanos K, Karunanithy N. Depiction of lower limb venous anatomy in patients undergoing interventional deep venous reconstruction-the role of balanced steady state free precession MRI. Br J Radiol 2017; 91:20170005. [PMID: 29076743 DOI: 10.1259/bjr.20170005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study evaluates the use of balanced steady-state free precession MRI (bSSFP-MRI) in the diagnostic work-up of patients undergoing interventional deep venous reconstruction (I-DVR). Intravenous digital subtraction angiography (IVDSA) was used as the gold-standard for comparison to assess disease extent and severity. METHODS A retrospective comparison of bSSFP-MRI to IVDSA was performed in all patients undergoing both examinations for treatment planning prior to I-DVR. The severity of disease in each venous segment was graded by two board-certified radiologists working independently, according to a predetermined classification system. RESULTS In total, 44 patients (225 venous segments) fulfilled the inclusion criteria. A total of 156 abnormal venous segments were diagnosed using bSSFP-MRI compared with 151 using IVDSA. The prevalence of disease was higher in the iliac and femoral segments (range, 79.6-88.6%). Overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the diagnostic ratio for bSSFP-MRI were 99.3%, 91.9%, 12.3, 0.007 and 1700, respectively. CONCLUSION This study supports the use of non-contrast balanced SSFP-MRI in the assessment of the deep veins of the lower limb prior to I-DVR. The technique offers an accurate, fast and non-invasive alternative to IVDSA. Advances in Knowledge: Although balanced SSFP-MRI is commonly used in cardiac imaging, its use elsewhere is limited and its use in evaluating the deep veins prior to interventional reconstruction is not described. Our study demonstrates the usefulness of this technique in the work-up of patients awaiting interventional venous reconstruction compared with the current gold standard.
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Affiliation(s)
- Vincent G Helyar
- 1 Department of Radiology, Hampshire Hospitals NHS Foundation Trust , Basingstoke , UK
| | - Yuri Gupta
- 2 Department of Radiology, Guy's & St Thomas' NHS Foundation Trust , London , UK.,3 Department of Radiology, Brighton and Sussex University Hospitals NHS Trust , Brighton , UK
| | - Lyndall Blakeway
- 4 Department of Medical Physics, Guy's & St Thomas' NHS Foundation Trust , London , UK
| | - Geoff Charles-Edwards
- 4 Department of Medical Physics, Guy's & St Thomas' NHS Foundation Trust , London , UK
| | - Konstantinos Katsanos
- 5 Department of Radiology, School of Medicine, University Hospital of Patras , Patras , Greece
| | - Narayan Karunanithy
- 2 Department of Radiology, Guy's & St Thomas' NHS Foundation Trust , London , UK
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25
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Coolen BF, Calcagno C, van Ooij P, Fayad ZA, Strijkers GJ, Nederveen AJ. Vessel wall characterization using quantitative MRI: what's in a number? MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:201-222. [PMID: 28808823 PMCID: PMC5813061 DOI: 10.1007/s10334-017-0644-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 07/04/2017] [Accepted: 07/18/2017] [Indexed: 12/15/2022]
Abstract
The past decade has witnessed the rapid development of new MRI technology for vessel wall imaging. Today, with advances in MRI hardware and pulse sequences, quantitative MRI of the vessel wall represents a real alternative to conventional qualitative imaging, which is hindered by significant intra- and inter-observer variability. Quantitative MRI can measure several important morphological and functional characteristics of the vessel wall. This review provides a detailed introduction to novel quantitative MRI methods for measuring vessel wall dimensions, plaque composition and permeability, endothelial shear stress and wall stiffness. Together, these methods show the versatility of non-invasive quantitative MRI for probing vascular disease at several stages. These quantitative MRI biomarkers can play an important role in the context of both treatment response monitoring and risk prediction. Given the rapid developments in scan acceleration techniques and novel image reconstruction, we foresee the possibility of integrating the acquisition of multiple quantitative vessel wall parameters within a single scan session.
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Affiliation(s)
- Bram F Coolen
- Department of Biomedical Engineering and Physics, Academic Medical Center, PO BOX 22660, 1100 DD, Amsterdam, The Netherlands. .,Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
| | - Claudia Calcagno
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Academic Medical Center, PO BOX 22660, 1100 DD, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
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26
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Pruzan AN, Kaufman AE, Calcagno C, Zhou Y, Fayad ZA, Mani V. Feasibility of imaging superficial palmar arch using micro-ultrasound, 7T and 3T magnetic resonance imaging. World J Radiol 2017; 9:79-84. [PMID: 28298968 PMCID: PMC5334505 DOI: 10.4329/wjr.v9.i2.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 12/17/2016] [Accepted: 01/14/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To demonstrate feasibility of vessel wall imaging of the superficial palmar arch using high frequency micro-ultrasound, 7T and 3T magnetic resonance imaging (MRI).
METHODS Four subjects (ages 22-50 years) were scanned on a micro-ultrasound system with a 45-MHz transducer (Vevo 2100, VisualSonics). Subjects’ hands were then imaged on a 3T clinical MR scanner (Siemens Biograph MMR) using an 8-channel special purpose phased array carotid coil. Lastly, subjects’ hands were imaged on a 7T clinical MR scanner (Siemens Magnetom 7T Whole Body Scanner) using a custom built 8-channel transmit receive carotid coil. All three imaging modalities were subjectively analyzed for image quality and visualization of the vessel wall.
RESULTS Results of this very preliminary study indicated that vessel wall imaging of the superficial palmar arch was feasible with a whole body 7T and 3T MRI in comparison with micro-ultrasound. Subjective analysis of image quality (1-5 scale, 1: poorest, 5: best) from B mode, ultrasound, 3T SPACE MRI and 7T SPACE MRI indicated that the image quality obtained at 7T was superior to both 3T MRI and micro-ultrasound. The 3D SPACE sequence at both 7T and 3T MRI with isotropic voxels allowed for multi-planar reformatting of images and allowed for less operator dependent results as compared to high frequency micro-ultrasound imaging. Although quantitative analysis revealed that there was no significant difference between the three methods, the 7T Tesla trended to have better visibility of the vessel and its wall.
CONCLUSION Imaging of smaller arteries at the 7T is feasible for evaluating atherosclerosis burden and may be of clinical relevance in multiple diseases.
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27
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Xie G, Chen H, He X, Liang J, Deng W, He Z, Ye Y, Yang Q, Bi X, Liu X, Li D, Fan Z. Black-blood thrombus imaging (BTI): a contrast-free cardiovascular magnetic resonance approach for the diagnosis of non-acute deep vein thrombosis. J Cardiovasc Magn Reson 2017; 19:4. [PMID: 28095878 PMCID: PMC5242043 DOI: 10.1186/s12968-016-0320-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/23/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Deep vein thrombosis (DVT) is a common but elusive illness that can result in long-term disability or death. Accurate detection of thrombosis and assessment of its size and distribution are critical for treatment decision-making. In the present study, we sought to develop and evaluate a cardiovascular magnetic resonance (CMR) black-blood thrombus imaging (BTI) technique, based on delay alternating with nutation for tailored excitation black-blood preparation and variable flip angle turbo-spin-echo readout, for the diagnosis of non-acute DVT. METHODS: This prospective study was approved by institutional review board and informed consent obtained from all subjects. BTI was first conducted in 11 healthy subjects for parameter optimization and then conducted in 18 non-acute DVT patients to evaluate its diagnostic performance. Two clinically used CMR techniques, contrast-enhanced CMR venography (CE-MRV) and three dimensional magnetization prepared rapid acquisition gradient echo (MPRAGE), were also conducted in all patients for comparison. All images obtained from patients were analyzed on a per-segment basis. Using the consensus diagnosis of CE-MRV as the reference, the sensitivity (SE), specificity (SP), positive and negative predictive values (PPV and NPV), and accuracy (ACC) of BTI and MPRAGE as well as their diagnostic agreement with CE-MRV were calculated. Besides, diagnostic confidence and interreader diagnostic agreement were evaluated for all three techniques. RESULTS BTI with optimized parameters effectively nulled the venous blood flow signal and allowed directly visualizing the thrombus within the black-blood lumen. Higher SE (90.4% vs 67.6%), SP (99.0% vs. 97.4%), PPV (95.4% vs. 85.6%), NPV (97.8% vs 92.9%) and ACC (97.4% vs. 91.8%) were obtained by BTI in comparison with MPRAGE. Good diagnostic confidence and excellent diagnostic and interreader agreements were achieved by BTI, which were superior to MPRAGE on detecting the chronic thrombus. CONCLUSION BTI allows direct visualization of non-acute DVT within the dark venous lumen and has the potential to be a reliable diagnostic tool without the use of contrast medium.
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Affiliation(s)
- Guoxi Xie
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, CAS, Guangdong, 518055 China
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Pacific Theatres Building, Suite 800, 8700 Beverly Blvd, Los Angeles, CA 90048 USA
| | - Hanwei Chen
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong 511400 China
| | - Xueping He
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong 511400 China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405 China
| | - Jianke Liang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong 511400 China
| | - Wei Deng
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong 511400 China
| | - Zhuonan He
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong 511400 China
| | - Yufeng Ye
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong 511400 China
| | - Qi Yang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Pacific Theatres Building, Suite 800, 8700 Beverly Blvd, Los Angeles, CA 90048 USA
- Department of Radiology, Xuanwu Hospital, Beijing, 100053 China
| | - Xiaoming Bi
- MR R&D, Siemens Healthcare, Los Angeles, CA 90048 USA
| | - Xin Liu
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, CAS, Guangdong, 518055 China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Pacific Theatres Building, Suite 800, 8700 Beverly Blvd, Los Angeles, CA 90048 USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Pacific Theatres Building, Suite 800, 8700 Beverly Blvd, Los Angeles, CA 90048 USA
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28
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Zhang N, Zhang L, Yang Q, Pei A, Tong X, Chung YC, Liu X. A fast screening protocol for carotid plaques imaging using 3D multi-contrast MRI without contrast agent. Magn Reson Imaging 2016; 39:89-97. [PMID: 27989914 DOI: 10.1016/j.mri.2016.10.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 10/26/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To implement a fast (~15min) MRI protocol for carotid plaque screening using 3D multi-contrast MRI sequences without contrast agent on a 3Tesla MRI scanner. MATERIALS AND METHODS 7 healthy volunteers and 25 patients with clinically confirmed transient ischemic attack or suspected cerebrovascular ischemia were included in this study. The proposed protocol, including 3D T1-weighted and T2-weighted SPACE (variable-flip-angle 3D turbo spin echo), and T1-weighted magnetization prepared rapid acquisition gradient echo (MPRAGE) was performed first and was followed by 2D T1-weighted and T2-weighted turbo spin echo, and post-contrast T1-weighted SPACE sequences. Image quality, number of plaques, and vessel wall thicknesses measured at the intersection of the plaques were evaluated and compared between sequences. RESULTS Average examination time of the proposed protocol was 14.6min. The average image quality scores of 3D T1-weighted, T2-weighted SPACE, and T1-weighted magnetization prepared rapid acquisition gradient echo were 3.69, 3.75, and 3.48, respectively. There was no significant difference in detecting the number of plaques and vulnerable plaques using pre-contrast 3D images with or without post-contrast T1-weighted SPACE. The 3D SPACE and 2D turbo spin echo sequences had excellent agreement (R=0.96 for T1-weighted and 0.98 for T2-weighted, p<0.001) regarding vessel wall thickness measurements. CONCLUSION The proposed protocol demonstrated the feasibility of attaining carotid plaque screening within a 15-minute scan, which provided sufficient anatomical coverage and critical diagnostic information. This protocol offers the potential for rapid and reliable screening for carotid plaques without contrast agent.
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Affiliation(s)
- Na Zhang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology of Chinese Academy of Sciences, Shenzhen Key Laboratory for MRI, Shenzhen, China; Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Lei Zhang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology of Chinese Academy of Sciences, Shenzhen Key Laboratory for MRI, Shenzhen, China
| | - Qi Yang
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Anqi Pei
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiaoxin Tong
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yiu-Cho Chung
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology of Chinese Academy of Sciences, Shenzhen Key Laboratory for MRI, Shenzhen, China
| | - Xin Liu
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology of Chinese Academy of Sciences, Shenzhen Key Laboratory for MRI, Shenzhen, China.
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Reference Values for Cardiac and Aortic Magnetic Resonance Imaging in Healthy, Young Caucasian Adults. PLoS One 2016; 11:e0164480. [PMID: 27732640 PMCID: PMC5061387 DOI: 10.1371/journal.pone.0164480] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/26/2016] [Indexed: 12/04/2022] Open
Abstract
Background Reference values for morphological and functional parameters of the cardiovascular system in early life are relevant since they may help to identify young adults who fall outside the physiological range of arterial and cardiac ageing. This study provides age and sex specific reference values for aortic wall characteristics, cardiac function parameters and aortic pulse wave velocity (PWV) in a population-based sample of healthy, young adults using magnetic resonance (MR) imaging. Materials and Methods In 131 randomly selected healthy, young adults aged between 25 and 35 years (mean age 31.8 years, 63 men) of the general-population based Atherosclerosis-Monitoring-and-Biomarker-measurements-In-The-YOuNg (AMBITYON) study, descending thoracic aortic dimensions and wall thickness, thoracic aortic PWV and cardiac function parameters were measured using a 3.0T MR-system. Age and sex specific reference values were generated using dedicated software. Differences in reference values between two age groups (25–30 and 30–35 years) and both sexes were tested. Results Aortic diameters and areas were higher in the older age group (all p<0.007). Moreover, aortic dimensions, left ventricular mass, left and right ventricular volumes and cardiac output were lower in women than in men (all p<0.001). For mean and maximum aortic wall thickness, left and right ejection fraction and aortic PWV we did not observe a significant age or sex effect. Conclusion This study provides age and sex specific reference values for cardiovascular MR parameters in healthy, young Caucasian adults. These may aid in MR guided pre-clinical identification of young adults who fall outside the physiological range of arterial and cardiac ageing.
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Abstract
PURPOSE To test and validate magnetic resonance imaging (MRI) sequences for peripheral artery lesion characterization and relate the MRI characteristics to the amount of force required for a guidewire to puncture peripheral chronic total occlusions (CTOs) as a surrogate for immediate failure of endovascular therapy. METHODS Diseased superficial femoral, popliteal, and tibial artery segments containing 55 atherosclerotic lesions were excised from the amputated limbs of 7 patients with critical limb ischemia. The lesions were imaged at high resolution (75 μm3 voxels) with T2-weighted (T2W) and ultrashort echo time (UTE) sequences on a 7-T MR scanner. The MR images (n=15) were validated with micro-computed tomography and histology. CTOs (n=40) were classified by their MR signal characteristics as "soft" (signals indicating fat, thrombus, microchannels, or loose fibrous tissue), "hard" (collagen and/or speckled calcium signals), or "calcified" (calcified nodule signals). A 2-kg load cell advanced the back end of a 0.035-inch stiff guidewire at a fixed displacement rate (0.05 mm/s) through the CTOs, and the forces required to cross each lesion were measured. RESULTS T2W images showed fat as hyperintense and hardened tissue as hypointense. Calcium and thrombus appeared as a signal void in conventional MRI sequences but were easily identified in UTE images (thrombus was hyperintense and calcium hypointense). MRI accurately differentiated "hard," "soft," and "calcified" CTOs based on associated guidewire puncture force. The guidewire could not enter "calcified" CTOs (n=6) at all. "Hard" CTOs (n=9) required a significantly higher (p<0.001) puncture force of 1.71±0.51 N vs 0.43±0.36 N for "soft" CTOs (n=25). CONCLUSION MRI characteristics of PAD lesions correlate with guidewire puncture forces, an important aspect of crossability. Future work will determine if clinical MR scanners can be used to predict success in peripheral vascular interventions.
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Affiliation(s)
- Trisha Roy
- 1 Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 Division of Vascular Surgery, Department of Surgery, University of Toronto, Ontario, Canada
| | - Garry Liu
- 1 Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,3 Department of Medical Biophysics, University of Toronto, Ontario, Canada
| | - Noor Shaikh
- 4 Division of Engineering Science, University of Toronto, Ontario, Canada
| | - Andrew D Dueck
- 1 Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 Division of Vascular Surgery, Department of Surgery, University of Toronto, Ontario, Canada
| | - Graham A Wright
- 1 Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,3 Department of Medical Biophysics, University of Toronto, Ontario, Canada
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Zhang Q, Zhang Z, Yang J, Sun Q, Luo Y, Shan T, Zhang H, Han J, Liang C, Pan W, Gu C, Mao G, Xu R. CBCT-based 3D MRA and angiographic image fusion and MRA image navigation for neuro interventions. Medicine (Baltimore) 2016; 95:e4358. [PMID: 27512846 PMCID: PMC4985301 DOI: 10.1097/md.0000000000004358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Digital subtracted angiography (DSA) remains the gold standard for diagnosis of cerebral vascular diseases and provides intraprocedural guidance. This practice involves extensive usage of x-ray and iodinated contrast medium, which can induce side effects. In this study, we examined the accuracy of 3-dimensional (3D) registration of magnetic resonance angiography (MRA) and DSA imaging for cerebral vessels, and tested the feasibility of using preprocedural MRA for real-time guidance during endovascular procedures.Twenty-three patients with suspected intracranial arterial lesions were enrolled. The contrast medium-enhanced 3D DSA of target vessels were acquired in 19 patients during endovascular procedures, and the images were registered with preprocedural MRA for fusion accuracy evaluation. Low-dose noncontrasted 3D angiography of the skull was performed in the other 4 patients, and registered with the MRA. The MRA was overlaid afterwards with 2D live fluoroscopy to guide endovascular procedures.The 3D registration of the MRA and angiography demonstrated a high accuracy for vessel lesion visualization in all 19 patients examined. Moreover, MRA of the intracranial vessels, registered to the noncontrasted 3D angiography in the 4 patients, provided real-time 3D roadmap to successfully guide the endovascular procedures. Radiation dose to patients and contrast medium usage were shown to be significantly reduced.Three-dimensional MRA and angiography fusion can accurately generate cerebral vasculature images to guide endovascular procedures. The use of the fusion technology could enhance clinical workflow while minimizing contrast medium usage and radiation dose, and hence lowering procedure risks and increasing treatment safety.
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Affiliation(s)
- Qiang Zhang
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
| | - Zhiqiang Zhang
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
| | | | - Qi Sun
- Siemens Ltd. China, Healthcare Sector
| | - Yongchun Luo
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
| | - Tonghui Shan
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
| | - Hao Zhang
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
| | | | - Chunyang Liang
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
| | - Wenlong Pan
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
| | - Chuanqi Gu
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
| | - Gengsheng Mao
- General Hospital of Chinese People's Armed Police Forces, Beijing, China
| | - Ruxiang Xu
- Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing
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32
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Aw-Zoretic J, Collins JD. Considerations for Imaging the Inferior Vena Cava (IVC) with/without IVC Filters. Semin Intervent Radiol 2016; 33:109-21. [PMID: 27247480 DOI: 10.1055/s-0036-1583207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Deep venous thrombosis (DVT), thrombosis of the inferior vena cava, and pulmonary embolism (PE) constitute a continuum that includes venous thromboembolic (VTE) disease. VTE is the third most common cardiovascular disorder that affects all races, ethnicities, gender, and ages. VTE predominantly affects the elderly population, exponentially increasing in incidence with increasing age. Venous thromboembolism is not only a singular event but a chronic disease and has been found to have a rate of recurrence approaching 40% among all patients after 10 years. Whether symptomatic or asymptomatic, once thromboembolism is suspected, objective methods are required for the accurate and confirmatory presence of a thrombus with imaging as the next step in the diagnostic algorithm. Imaging also allows for the determination of the extent of clot burden, clot propagation, occlusive versus nonocclusive thrombus, acute versus chronic thrombus, or in some cases thrombus recurrence versus thrombophlebitis. Vena caval filter placement is, in some instances, required to prevent a significant subsequent VTE event. Placement of these therapeutic devices paradoxically promotes thrombus formation, and other sequelae may arise from the placement of inferior vena cava filters. In this article, the authors provide an overview of available techniques for imaging the vena cava with or without a filter and discuss advantages and drawbacks for each.
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Affiliation(s)
- Jessie Aw-Zoretic
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jeremy D Collins
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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33
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Qiao H, He Q, Chen Z, Xu D, Huang L, He L, Jiang L, Li R, Luo J, Yuan C, Zhao X. Identification of early atherosclerotic lesions in carotid arteries with quantitative characteristics measured by 3D MRI. J Magn Reson Imaging 2016; 44:1270-1276. [PMID: 27079951 DOI: 10.1002/jmri.25264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/21/2016] [Accepted: 03/22/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To evaluate the usefulness of quantitative characteristics of morphology and signal intensity of arterial wall measured by 3D multicontrast magnetic resonance vessel wall imaging (MRVWI) in identification of carotid early atherosclerosis (CEAS). MATERIALS AND METHODS In all, 61 older subjects (mean age 71.8 ± 5.6 years old; 25 males) without cardiovascular symptoms in the last 6 months were recruited. The carotid arteries without advanced plaque features on 3.0T MRI were included for analysis. Ultrasound imaging was used as a reference to identify CEAS. The morphological parameters including lumen area (LA), wall area (WA), wall thickness (WT), and normalized wall index (NWI = WA/[WA+LA] × 100%) and the signal intensity on 3.0T MR T2 -weighted images (T2 SI) of the carotid arterial wall were measured. Three regression models were built to identify CEAS with the following parameters: Model 1 with both morphological and T2 SI parameters; Model 2 with T2 SI parameters; and Model 3 with morphological parameters. All models were adjusted for age and sex. Area under the curve (AUC) was calculated to validate models. RESULTS Of the 86 carotid arteries without advanced plaques, 47 (54.7%) were found to have early plaques determined by ultrasound. Among three regression models, Model 1 showed the highest AUC values in identifying CEAS (left: AUC = 0.856, P < 0.001; right: AUC = 0.867, P < 0.001), followed by Model 2 (left: AUC = 0.843, P < 0.001; right: AUC = 0.798, P = 0.001), and Model 3 (left: AUC = 0.790, P = 0.002; right: AUC = 0.806, P < 0.001). CONCLUSION The combination of morphology and normalized T2 SI of arterial wall measured by MRVWI is more effective than each characteristic alone in identification of CEAS. J. Magn. Reson. Imaging 2016;44:1270-1276.
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Affiliation(s)
- Huiyu Qiao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Qiong He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Zhensen Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Dongxiang Xu
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Lingyun Huang
- Clinical Sites Research Program, Philips Research China, Shanghai, China
| | - Le He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Li Jiang
- Philips Healthcare (Suzhou), Jiangsu, China
| | - Rui Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Jianwen Luo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Chun Yuan
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.,Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
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Eikendal ALM, Blomberg BA, Haaring C, Saam T, van der Geest RJ, Visser F, Bots ML, den Ruijter HM, Hoefer IE, Leiner T. 3D black blood VISTA vessel wall cardiovascular magnetic resonance of the thoracic aorta wall in young, healthy adults: reproducibility and implications for efficacy trial sample sizes: a cross-sectional study. J Cardiovasc Magn Reson 2016; 18:20. [PMID: 27075677 PMCID: PMC4831203 DOI: 10.1186/s12968-016-0237-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/22/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Pre-clinical detection of atherosclerosis enables personalized preventive strategies in asymptomatic individuals. Cardiovascular magnetic resonance (CMR) has evolved as an attractive imaging modality for studying atherosclerosis in vivo. Yet, the majority of aortic CMR studies and proposed sequences to date have been performed at 1.5 tesla using 2D BB techniques and a slice thickness of 4-5 mm. Here, we evaluate for the first time the reproducibility of an isotropic, T1-weighted, three-dimensional, black-blood, CMR VISTA sequence (3D-T1-BB-VISTA) for quantification of aortic wall characteristics in healthy, young adults. METHODS In 20 healthy, young adults (10 males, mean age 31.3 years) of the AMBITYON cohort study the descending thoracic aorta was imaged with a 3.0 T MR system using the 3D-T1-BB-VISTA sequence. The inter-scan, inter-rater and intra-rater reproducibility of aortic lumen, total vessel and wall area and mean and maximum wall thickness was evaluated using Bland-Altman analyses and Intraclass Correlation Coefficients (ICC). Based on these findings, sample sizes for detecting differences in aortic wall characteristics between groups were calculated. RESULTS For each studied parameter, the inter-scan, inter-rater and intra-rater reproducibility was excellent as indicated by narrow limits of agreement and high ICCs (ranging from 0.76 to 0.99). Sample sizes required to detect a 5% difference in aortic wall characteristics between two groups were 203, 126, 136, 68 and 153 per group for lumen area, total vessel area and vessel wall area and for mean and maximum vessel wall thickness, respectively. CONCLUSION The 3D-T1-BB-VISTA sequence provides excellent reproducibility for quantification of aortic wall characteristics and can detect small differences between groups with reasonable sample sizes. Hence, it may be a valuable tool for assessment of the subtle vascular wall changes of early atherosclerosis in asymptomatic populations.
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Affiliation(s)
- Anouk L. M. Eikendal
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Björn A. Blomberg
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Cees Haaring
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Tobias Saam
- />Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich, Germany
| | - Rob J. van der Geest
- />Division of Image Processing, Department of Radiology, 1-C2S Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Fredy Visser
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- />Philips Healthcare, Veenpluis 4-6, 5684PC Best, The Netherlands
| | - Michiel L. Bots
- />Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Hester M. den Ruijter
- />Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Imo E. Hoefer
- />Laboratory of Clinical Chemistry and Hematology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Tim Leiner
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Abstract
There has been significant progress made in 3-dimensional (3D) carotid plaque MR imaging techniques in recent years. Three-dimensional plaque imaging clearly represents the future in clinical use. With effective flow-suppression techniques, choices of different contrast weighting acquisitions, and time-efficient imaging approaches, 3D plaque imaging offers flexible imaging plane and view angle analysis, large coverage, multivascular beds capability, and even can be used in fast screening.
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Affiliation(s)
- Chun Yuan
- Vascular Imaging Lab, Department of Radiology, Bio-Molecular Imaging Center, University of Washington, Box 358050, 850 Republican Street, Seattle, WA 98109-4714, USA.
| | - Dennis L Parker
- Department of Radiology, Imaging & Neurosciences Center, Utah Center for Advanced Imaging Research (UCAIR), University of Utah, 729 Arapeen Drive, Salt Lake City, UT 84108, USA
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Xie G, Zhang N, Xie Y, Nguyen C, Deng Z, Bi X, Fan Z, Liu X, Li D, Fan Z. DANTE-prepared three-dimensional FLASH: A fast isotropic-resolution MR approach to morphological evaluation of the peripheral arterial wall at 3 Tesla. J Magn Reson Imaging 2015; 43:343-51. [PMID: 26139414 DOI: 10.1002/jmri.24986] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/11/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND To develop and assess a sequence using DANTE dark-blood preparation combined with FLASH readout (DANTE-FLASH) for rapid isotropic-resolution three-dimensional (3D) peripheral vessel wall imaging at 3 Tesla (T). METHODS Numerical simulations were first conducted to optimize imaging parameters for maximizing the wall-lumen contrast. The sequence, implemented at 3T, was then assessed in the bilateral superficial femoral arteries of eight healthy volunteers and three patients who were undergoing non-contrast-enhanced MRA due to known peripheral artery disease. Conventional 2D dark-blood turbo spin echo (DB-TSE) was performed as a reference in all subjects. Image quality on a 5-point scale, apparent wall signal-to-noise ratio, apparent wall-lumen contrast-to-noise ratio, wall thickness, wall area and lumen area were assessed or measured in all healthy subjects. Additionally, the agreement in the depiction of wall thickening or luminal stenosis between DANTE-FLASH and DB-TSE, or MRA was assessed using a 4-point scale in the patient study. RESULTS DANTE-FLASH allowed for a 30-cm-long coverage within 4 min, whereas DB-TSE took approximately 7 min for a 9-cm-long coverage. Good image quality was obtained by DANTE-FLASH (score > 3). The wall thickness, wall area, and lumen area were all comparable (t-test; P = 0.334, 0.224 and 0.136) and showed excellent agreement between DANTE-FLASH and DB-TSE (intra-class correlation = 0.81, 0.85, and 0.98). The atherosclerotic plaques and luminal stenosis identified by DANTE-FLASH were in accordance with the findings by 2D DB-TSE or MRA. CONCLUSION DANTE-FLASH is a 3D dark-blood MR sequence allowing for rapid isotropic-resolution imaging of the peripheral vessel wall at 3T.
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Affiliation(s)
- Guoxi Xie
- Shenzhen Key Lab for MRI, BCMIIS, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, China.,Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, China
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Christopher Nguyen
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Zixin Deng
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Xiaoming Bi
- MR R&D, Siemens Healthcare, Los Angeles, California, USA
| | - Zhanming Fan
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, China
| | - Xin Liu
- Shenzhen Key Lab for MRI, BCMIIS, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA
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Abstract
Magnetic resonance imaging is a powerful, noninvasive imaging technique with exquisite sensitivity to soft tissue composition. Magnetic resonance imaging is primary tool for brain tumor diagnosis, evaluation of drug response assessment, and clinical monitoring of the patient during the course of their disease. The flexibility of magnetic resonance imaging pulse sequence design allows for a variety of image contrasts to be acquired, including information about magnetic resonance-specific tissue characteristics, molecular dynamics, microstructural organization, vascular composition, and biochemical status. The current review highlights recent advancements and novel approaches in MR characterization of brain tumors.
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Three-Dimensional Black-Blood T1-Weighted Turbo Spin-Echo Techniques for the Diagnosis of Deep Vein Thrombosis in Comparison With Contrast-Enhanced Magnetic Resonance Imaging. Invest Radiol 2015; 50:401-8. [DOI: 10.1097/rli.0000000000000142] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nunthayanon K, Honda EI, Shimazaki K, Ohmori H, Inoue-Arai MS, Kurabayashi T, Ono T. Use of an advanced 3-T MRI movie to investigate articulation. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:684-94. [PMID: 25956219 DOI: 10.1016/j.oooo.2015.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 02/20/2015] [Accepted: 03/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To develop a magnetic resonance imaging (MRI) movie to reveal the dynamic movement of articulators and teeth. STUDY DESIGN Five healthy females with normal occlusion participated in this study. Various concentrations of MRI contrast media (ferric ammonium citrate [FAC]) were tested for visualization of teeth, according to facial markers and with the use of a gel. Custom-made circuitry was connected to synchronize pronunciation of fricative sounds (/asa/) with scans. Three gradient echo sequences (True fast imaging with steady state precession [true FISP], FISP, and fast low angle shot [FLASH]) with a segmented cine were tested with the use of repetition times (TRs) of 9 ms and 31.5 ms. The MRI movie images were superimposed over the boundaries of teeth. The images produced during pronunciation, using the two different TRs (9 ms and 31 ms), were compared to assess the position of the lips and the tongue. RESULTS Images obtained using the FLASH sequence, with a TR of 9 ms or 31.5 ms, can be used for diagnostic purposes. A TR of 9 ms, with 161 continuous images acquired, produced the highest-quality images of teeth, with few artifacts present. Pronunciation of the consonant "s" was clearly discernable. CONCLUSIONS Our 3-T MRI movie system, with a temporal resolution less than 9 ms, can provide detailed information pertaining to variations in speech or oropharyngeal function.
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Affiliation(s)
- Kulthida Nunthayanon
- Graduate student, Graduate School, Orthodontic Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan; Lecturer, Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand.
| | - Ei-ichi Honda
- Professor, Graduate School, Oral and Maxillofacial Radiology, University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima, 770-8504, Japan; Lecturer, Graduate School, Oral and Maxillofacial Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Kazuo Shimazaki
- Assistant professor, Graduate School, Orthodontic Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroko Ohmori
- Staff, Graduate School, Orthodontic Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Maristela Sayuri Inoue-Arai
- Lecturer, Maxillofacial Orthognathics, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Tohru Kurabayashi
- Professor, Graduate School, Oral and Maxillofacial Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Takashi Ono
- Professor, Graduate School, Orthodontic Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, 113-8549, Tokyo, Japan
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Wong SK, Mobolaji-Iawal M, Arama L, Cambe J, Biso S, Alie N, Fayad ZA, Mani V. Atherosclerosis imaging using 3D black blood TSE SPACE vs 2D TSE. World J Radiol 2014; 6:192-202. [PMID: 24876923 PMCID: PMC4037545 DOI: 10.4329/wjr.v6.i5.192] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 01/30/2014] [Accepted: 04/19/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare 3D Black Blood turbo spin echo (TSE) sampling perfection with application-optimized contrast using different flip angle evolution (SPACE) vs 2D TSE in evaluating atherosclerotic plaques in multiple vascular territories.
METHODS: The carotid, aortic, and femoral arterial walls of 16 patients at risk for cardiovascular or atherosclerotic disease were studied using both 3D black blood magnetic resonance imaging SPACE and conventional 2D multi-contrast TSE sequences using a consolidated imaging approach in the same imaging session. Qualitative and quantitative analyses were performed on the images. Agreement of morphometric measurements between the two imaging sequences was assessed using a two-sample t-test, calculation of the intra-class correlation coefficient and by the method of linear regression and Bland-Altman analyses.
RESULTS: No statistically significant qualitative differences were found between the 3D SPACE and 2D TSE techniques for images of the carotids and aorta. For images of the femoral arteries, however, there were statistically significant differences in all four qualitative scores between the two techniques. Using the current approach, 3D SPACE is suboptimal for femoral imaging. However, this may be due to coils not being optimized for femoral imaging. Quantitatively, in our study, higher mean total vessel area measurements for the 3D SPACE technique across all three vascular beds were observed. No significant differences in lumen area for both the right and left carotids were observed between the two techniques. Overall, a significant-correlation existed between measures obtained between the two approaches.
CONCLUSION: Qualitative and quantitative measurements between 3D SPACE and 2D TSE techniques are comparable. 3D-SPACE may be a feasible approach in the evaluation of cardiovascular patients.
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Bloch LØ, Hansen AYKG, Pedersen SF, Honge JL, Kim WY, Hansen ESS. Imaging of carotid artery vessel wall edema using T2-weighted cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2014; 16:22. [PMID: 24593873 PMCID: PMC3973999 DOI: 10.1186/1532-429x-16-22] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 02/10/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Atherothrombosis remains a major health problem in the western world, and carotid atherosclerosis is an important contributor to embolic ischemic strokes. It remains a clinical challenge to identify rupture-prone atherosclerotic plaques before clinical events occur. Inflammation, endothelial injury and angiogenesis are features of vulnerable plaques and may all be associated with plaque edema. Therefore, vessel wall edema, which can be detected by 2D T2-weighted cardiovascular magnetic resonance (CMR), may be used as a dynamic marker of disease activity in the atherosclerotic plaque. However, 2D imaging is limited by low spatial resolution in the slice-select direction compared to 3D imaging techniques. We sought to investigate the ability of novel 3D techniques to detect edema induced in porcine carotid arteries by acute balloon injury compared to conventional 2D T2-weighted black-blood CMR. METHODS Edema was induced unilaterally by balloon overstretch injury in the carotid artery of nine pigs. Between one to seven hours (average four hours) post injury, CMR was performed using 2D T2-weighted short-tau inversion recovery (T2-STIR), 3D volumetric isotropic turbo spin echo acquisition (VISTA) and 3D T2 prepared gradient-echo (T2prep-GE). The CMR images were compared in terms of signal-to-noise ratio (SNR) and contrast-to-noise (CNR) ratio. Furthermore, the presence of vessel wall injury was validated macroscopically by means of Evans Blue dye that only enters the injured vessel wall. RESULTS All three imaging sequences classified the carotid arteries correctly compared to Evans Blue and all sequences demonstrated a significant increase in SNR of the injured compared to the non-injured carotid vessel wall (T2-STIR, p = 0.002; VISTA, p = 0.004; and T2prep-GE, p = 0.003). There was no significant difference between sequences regarding SNR and CNR. CONCLUSION The novel 3D imaging sequences VISTA and T2prep-GE perform comparably to conventional 2D T2-STIR in terms of detecting vessel wall edema. The improved spatial coverage of these 3D sequences may facilitate visualization of vessel wall edema to enable detection and monitoring of vulnerable carotid atherosclerotic plaques.
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Affiliation(s)
- Lars Ølgaard Bloch
- Department of Cardiology, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Anne Yoon Krogh Grøndal Hansen
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Steen Fjord Pedersen
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Jesper Langhoff Honge
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Won Yong Kim
- Department of Cardiology, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Esben Søvsø Szocska Hansen
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
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42
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Mugler JP. Optimized three‐dimensional fast‐spin‐echo MRI. J Magn Reson Imaging 2014; 39:745-67. [PMID: 24399498 DOI: 10.1002/jmri.24542] [Citation(s) in RCA: 238] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- John P. Mugler
- Department of Radiology and Medical ImagingUniversity of Virginia School of MedicineCharlottesville Virginia USA
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Mihai G, Varghese J, Lu B, Zhu H, Simonetti OP, Rajagopalan S. Reproducibility of thoracic and abdominal aortic wall measurements with three-dimensional, variable flip angle (SPACE) MRI. J Magn Reson Imaging 2013; 41:202-12. [DOI: 10.1002/jmri.24545] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 11/15/2013] [Indexed: 11/06/2022] Open
Affiliation(s)
- Georgeta Mihai
- Department of Radiology; The Ohio State University; Columbus Ohio USA
| | - Juliet Varghese
- The Dorothy M. Davis Heart and Lung Research Institute and the Division of Cardiovascular Medicine, The Ohio State University; Columbus Ohio USA
| | - Bo Lu
- College of Public Health; The Ohio State University; Columbus Ohio USA
| | - Hong Zhu
- Department of Clinical Sciences Division of Biostatistics; University of Texas, Southwestern Medical Center; Dallas Texas USA
| | - Orlando P. Simonetti
- Department of Radiology; The Ohio State University; Columbus Ohio USA
- The Dorothy M. Davis Heart and Lung Research Institute and the Division of Cardiovascular Medicine, The Ohio State University; Columbus Ohio USA
| | - Sanjay Rajagopalan
- The Dorothy M. Davis Heart and Lung Research Institute and the Division of Cardiovascular Medicine, The Ohio State University; Columbus Ohio USA
- Department of Medicine Division of Cardiology; The University of Maryland; Baltimore Maryland USA
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Langham MC, Li C, Englund EK, Chirico EN, Mohler ER, Floyd TF, Wehrli FW. Vessel-wall imaging and quantification of flow-mediated dilation using water-selective 3D SSFP-echo. J Cardiovasc Magn Reson 2013; 15:100. [PMID: 24172037 PMCID: PMC3819508 DOI: 10.1186/1532-429x-15-100] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 10/16/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND To introduce a new, efficient method for vessel-wall imaging of carotid and peripheral arteries by means of a flow-sensitive 3D water-selective SSFP-echo pulse sequence. METHODS Periodic applications of RF pulses will generate two transverse steady states, immediately after and before an RF pulse; the latter being referred to as the SSFP-echo. The SSFP-echo signal for water protons in blood is spoiled as a result of moving spins losing phase coherence in the presence of a gradient pulse along the flow direction. Bloch equation simulations were performed over a wide range of velocities to evaluate the flow sensitivity of the SSFP-echo signal. Vessel walls of carotid and femoral and popliteal arteries were imaged at 3 T. In two patients with peripheral artery disease the femoral arteries were imaged bilaterally to demonstrate method's potential to visualize atherosclerotic plaques. The method was also evaluated as a means to measure femoral artery flow-mediated dilation (FMD) in response to cuff-induced ischemia in four subjects. RESULTS The SSFP-echo pulse sequence, which does not have a dedicated blood signal suppression preparation, achieved low blood signal permitting discrimination of the carotid and peripheral arterial walls with in-plane spatial resolution ranging from 0.5 to 0.69 mm and slice thickness of 2 to 3 mm, i.e. comparable to conventional 2D vessel-wall imaging techniques. The results of the simulations were in good agreement with analytical solution and observations for both vascular territories examined. Scan time ranged from 2.5 to 5 s per slice yielding a contrast-to-noise ratio between the vessel wall and lumen from 3.5 to 17. Mean femoral FMD in the four subjects was 9%, in good qualitative agreement with literature values. CONCLUSIONS Water-selective 3D SSFP-echo pulse sequence is a potential alternative to 2D vessel-wall imaging. The proposed method is fast, robust, applicable to a wide range of flow velocities, and straightforward to implement.
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Affiliation(s)
- Michael C Langham
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Cheng Li
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Erin K Englund
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Erica N Chirico
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Emile R Mohler
- Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Thomas F Floyd
- Departments of Anesthesiology, Medical Center, Stony Brook University, Stony Brook, USA
| | - Felix W Wehrli
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, USA
- Radiologic Science, Biochemistry and Biophysics, Medical Center, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Chi J, Chiu B, Cao Y, Liu X, Wang J, Balu N, Yuan C, Xu J. Assessment of femoral artery atherosclerosis at the adductor canal using 3D black-blood MRI. Clin Radiol 2013; 68:e213-21. [DOI: 10.1016/j.crad.2012.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 12/03/2012] [Accepted: 12/07/2012] [Indexed: 10/27/2022]
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Yuan C, Wang J, Balu N. High-field atherosclerotic plaque magnetic resonance imaging. Neuroimaging Clin N Am 2012; 22:271-84, xi. [PMID: 22548932 DOI: 10.1016/j.nic.2012.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Manifestations of atherosclerotic plaque in different arterial beds range from perfusion deficits to overt ischemia such as stroke and myocardial infarction. Atherosclerotic plaque composition is associated with its propensity to rupture and cause vascular events. Magnetic resonance (MR) imaging of atherosclerotic plaque using clinical 1.5 T scanners can detect plaque composition. Plaque MR imaging at higher field strengths offers both opportunities and challenges to improving the high spatial resolution and contrast required for this type of imaging. This article summarizes the technological requirements required for high-field plaque MR imaging and its application in detecting plaque components.
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Affiliation(s)
- Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA 98109, USA.
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Peripheral arterial wall imaging using contrast-enhanced, susceptibility-weighted phase imaging. J Comput Assist Tomogr 2012; 36:77-82. [PMID: 22261774 DOI: 10.1097/rct.0b013e3182388cdf] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To demonstrate improved delineation of peripheral arterial wall in susceptibility-weighted imaging (SWI) phase images by using gadolinium contrast agent. MATERIALS AND METHODS Superficial femoral arteries were imaged using high-resolution SWI in 11 healthy volunteers before and after injection of gadopentetate dimeglumine. Two postcontrast scans started 1 minute and 11 minutes after injection, respectively. Eight of the 11 volunteers also underwent double-inversion recovery turbo-spin-echo (TSE) scans. The same resolution and matrix size were used between SWI and TSE studies, and TSE locations were matched to SWI images. Arterial lumen-wall phase difference and phase contrast-to-noise ratio were measured and compared between precontrast and postcontrast SWI measurements. The lumen and wall areas measured on both TSE and matching SWI images were analyzed for agreement. Two other volunteers participated in a double-echo gradient-echo study. Results were compared to SWI. RESULTS By injecting gadolinium contrast agent, phase difference changed by 54.5% and -1.6%, and phase contrast-to-noise ratio changed by 85.7% and 27.0% for the first and second postcontrast scans, respectively. Morphological measurements showed insignificant difference between TSE and SWIs based on paired t tests; good agreements in Bland-Altman plots were achieved. The double-echo gradient-echo study had similar phase measurements as SWI. CONCLUSION Contrast-enhanced phase imaging improves arterial wall delineation in SWI of peripheral arterial wall. Contrast-enhanced SWI is a promising vessel wall imaging technique.
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Abstract
The association between gadolinium-based contrast agents and neprogenic systemic fibrosis has helped propel noncontrast angiography techniques to center stage in the MR evaluation of vascular disease, especially in individuals with intrinsic renal diseases. Although balanced steady-state free precession, phase contrast, and time-of-flight sequences are currently being revisited and improved, new noncontrast angiographic methods have been created and are under development: ECG-gated 3D partial-Fourier fast spin echo (FSE) and 3D variable flip angle FSE (SPACE). All of these are attempts to develop noncontrast methods that offer equal or superior vascular diagnosis as compared with contrast-enhanced MR angiography.
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Chiu B, Sun J, Zhao X, Wang J, Balu N, Chi J, Xu J, Yuan C, Kerwin WS. Fast plaque burden assessment of the femoral artery using 3D black-blood MRI and automated segmentation. Med Phys 2011; 38:5370-84. [PMID: 21992357 DOI: 10.1118/1.3633899] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Vessel wall imaging techniques have been introduced to assess the burden of peripheral arterial disease (PAD) in terms of vessel wall thickness, area or volume. Recent advances in a 3D black-blood MRI sequence known as the 3D motion-sensitized driven equilibrium (MSDE) prepared rapid gradient echo sequence (3D MERGE) have allowed the acquisition of vessel wall images with up to 50 cm coverage, facilitating noninvasive and detailed assessment of PAD. This work introduces an algorithm that combines 2D slice-based segmentation and 3D user editing to allow for efficient plaque burden analysis of the femoral artery images acquired using 3D MERGE. METHODS The 2D slice-based segmentation approach is based on propagating segmentation results of contiguous 2D slices. The 3D image volume was then reformatted using the curved planar reformation (CPR) technique. User editing of the segmented contours was performed on the CPR views taken at different angles. The method was evaluated on six femoral artery images. Vessel wall thickness and area obtained before and after editing on the CPR views were assessed by comparison with manual segmentation. Difference between semiautomatically and manually segmented contours were compared with the difference of the corresponding measurements between two repeated manual segmentations. RESULTS The root-mean-square (RMS) errors of the mean wall thickness (t(mean)) and the wall area (WA) of the edited contours were 0.35 mm and 7.1 mm(2), respectively, which are close to the RMS difference between two repeated manual segmentations (RMSE: 0.33 mm in t(mean), 6.6 mm(2) in WA). The time required for the entire semiautomated segmentation process was only 1%-2% of the time required for manual segmentation. CONCLUSIONS The difference between the boundaries generated by the proposed algorithm and the manually segmented boundary is close to the difference between repeated manual segmentations. The proposed method provides accurate plaque burden measurements, while considerably reducing the analysis time compared to manual review.
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Affiliation(s)
- Bernard Chiu
- Department of Electronic Engineering, City University of Hong Kong, Hong Kong.
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Fan Z, Zuehlsdorff S, Liu X, Li D. Prospective self-gating for swallowing motion: a feasibility study in carotid artery wall MRI using three-dimensional variable-flip-angle turbo spin-echo. Magn Reson Med 2011; 67:490-8. [PMID: 22161627 DOI: 10.1002/mrm.23295] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 09/15/2011] [Accepted: 10/18/2011] [Indexed: 11/05/2022]
Abstract
Three-dimensional black-blood MRI is a promising noninvasive imaging technique for the assessment of atherosclerotic carotid artery disease. However, this technique is inherently susceptible to motion. In particular, swallowing can result in considerable wall motion at the carotid bifurcations, which may induce drastic image degradation or substantial overestimation of wall thickness. Self-gating techniques have previously been shown to be capable of resolving and compensating for cardiac or respiratory motion during MRI. This work presents a self-gating-based prospective motion gating scheme that is combined with a three-dimensional variable-flip-angle turbo spin-echo sequence (SPACE) for detecting swallowing motion. Self-gating signal readouts along the superior-inferior direction during each repetition time period are used to derive the projection profiles of the imaging volume. Based on cross-correlation analysis between the projection profiles and the corresponding reference profiles, swallowing motion can be detected and the motion-contaminated data will subsequently be discarded and reacquired in the next repetition time. The self-gated SPACE sequence was validated on eight healthy volunteers and two patients and, when compared with the conventional SPACE sequence, proved to be more resistant to swallowing motion and significantly improved image quality as well as the sharpness of carotid artery wall boundaries.
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Affiliation(s)
- Zhaoyang Fan
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
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