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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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Zun Z, Shin T. Velocity-selective excitation: Principles and applications. NMR IN BIOMEDICINE 2023; 36:e4820. [PMID: 35994473 PMCID: PMC9845137 DOI: 10.1002/nbm.4820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/12/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Velocity-selective (VS) excitation is a relatively new type of excitation that can be useful for generating image contrast based on spin's motion. This review aims to explain the principles of VS excitation and their utilization for clinical applications. We first review the generalized excitation k-space formalism, which reveals a Fourier relationship between sequence parameters and excitation profiles for spins with arbitrary spatial location, off-resonance, and velocity. Based on the k-space framework, we analyze practical VS excitation pulse sequences that yield sinusoidal or sinc-shaped velocity profiles. Then we demonstrate how these two types of VS excitation can be used as magnetization preparation for clinical applications, including saturation- or inversion-based arterial spin labeling and black- or bright-blood angiography. We also discuss practical considerations and issues for each application, including the determination of design parameters and the effects of MR system errors, such as magnetic field offsets and eddy currents.
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Affiliation(s)
- Zungho Zun
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Taehoon Shin
- Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul, South Korea
- Graduate Program in Smart Factory, Ewha Womans University, Seoul, South Korea
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
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Cao X, Tang Y, Pan L, Yang J, Wu Y, Geng D, Zhang J. Assessment of carotid atherosclerotic plaque using 3D motion-sensitized driven-equilibrium prepared rapid gradient echo: a comparative study. Quant Imaging Med Surg 2021; 11:2744-2755. [PMID: 34079738 DOI: 10.21037/qims-20-869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background 3D motion-sensitized driven-equilibrium prepared rapid gradient echo (MERGE) can characterize carotid atherosclerotic plaque morphology and composition. The present study aimed to evaluate its performance by comparing it with reference images and assessing the inter-reader agreement. Methods Eighty-four patients were prospectively recruited and scanned with 3D MERGE. Two trained magnetic resonance imaging (MRI) readers measured and calculated the maximum wall thickness (WT), maximum vessel diameter, total vessel area, lumen area, wall area, normalized wall index, plaque volume, intraplaque hemorrhage (IPH) volume, and calcification volume independently. IPH, calcification, mixed calcification, and ulceration were identified. The intraclass correlation coefficient (ICC) with 95% confidence interval (CI) was used to assess the inter-reader agreement. MERGE performance was assessed in terms of sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, kappa value (κ), and the results of the Bland-Altman analysis and compared with reference images. Results MERGE showed excellent inter-reader agreement (All ICCs >0.90). MERGE and simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) showed excellent agreement in detecting IPH (κ=0.938) and measuring IPH volume (ICC =0.995; 95% CI: 0.991-0.997). MERGE and computed tomography angiography (CTA) showed strong consistency in detecting calcification (κ=0.814) and mixed calcification (κ=0.972), and in measuring calcification volume (ICC =0.996; 95% CI: 0.993-0.997). MERGE and digital subtraction angiography (DSA) showed relatively strong consistency in identifying ulceration (κ=0.737). Conclusions MERGE showed excellent performance in identifying and measuring IPH and calcification in carotid atherosclerotic plaques. Therefore, MERGE can be a promising imaging approach in atherosclerotic-vulnerable plaque.
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Affiliation(s)
- Xin Cao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Ye Tang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Pan
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jinming Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yifan Wu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Jun Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
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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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Henningsson M, Malik S, Botnar R, Castellanos D, Hussain T, Leiner T. Black-Blood Contrast in Cardiovascular MRI. J Magn Reson Imaging 2020; 55:61-80. [PMID: 33078512 PMCID: PMC9292502 DOI: 10.1002/jmri.27399] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022] Open
Abstract
MRI is a versatile technique that offers many different options for tissue contrast, including suppressing the blood signal, so‐called black‐blood contrast. This contrast mechanism is extremely useful to visualize the vessel wall with high conspicuity or for characterization of tissue adjacent to the blood pool. In this review we cover the physics of black‐blood contrast and different techniques to achieve blood suppression, from methods intrinsic to the imaging readout to magnetization preparation pulses that can be combined with arbitrary readouts, including flow‐dependent and flow‐independent techniques. We emphasize the technical challenges of black‐blood contrast that can depend on flow and motion conditions, additional contrast weighting mechanisms (T1, T2, etc.), magnetic properties of the tissue, and spatial coverage. Finally, we describe specific implementations of black‐blood contrast for different vascular beds.
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Affiliation(s)
- Markus Henningsson
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Shaihan Malik
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Rene Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Daniel Castellanos
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Pediatric Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, The Netherlands
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Wang Y, Liu X, Haraldsson H, Zhu C, Ballweber M, Gasper W, Hatsukami T, Saloner D. Quantitative measurement of atheroma burden: reproducibility in serial studies of atherosclerotic femoral arteries. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 33:855-863. [PMID: 32297164 DOI: 10.1007/s10334-020-00843-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/18/2020] [Accepted: 04/03/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aims to evaluate the reproducibility of measures of plaque morphology in serially acquired black-blood MRI of untreated atherosclerotic femoral arteries. MATERIALS AND METHODS MR studies was obtained from 42 timepoints, on 12 patients with known femoral artery atherosclerosis. Images with a 3D isotropic FLASH with DANTE-prepared black blood contrast (DASH) at a 3-T scanner were acquired at baseline, within 1 week, and at 1 month. Six of the patients were scanned additionally at 6 months. Inter-scan and inter-observer variations of arterial area/volume measurements were evaluated. RESULTS Measurement of vessel area, lumen area, wall area and wall volume showed inter-scan intraclass correlation coefficients (ICC) ranging from 0.92 to 0.97 for 3 scans, 0.91-0.97 for 4 scans, and inter-observer ICCs of 0.89-0.96. Among 3 scans, the coefficients of variance (CV) for the vessel area, lumen area, wall area and wall volume were 4.1%, 6.5%, 7.5%, and 4.4%. CVs among 4 scans ranged from 4.4% to 7.9%, and interobserver CVs ranged from 6.1% to 11.8% for the different area/volume measurements. CONCLUSION DASH MRI is useful for quantifying atherosclerotic vessel area and volume of femoral arteries with low variability among serial repeated scans and between observers.
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Affiliation(s)
- Yuting Wang
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 2006 Xiyuan Avenue, Chengdu, 611731, China. .,Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
| | - Xinke Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.,Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Henrik Haraldsson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Chengcheng Zhu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Megan Ballweber
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Warren Gasper
- Division of Vascular and Endovascular Surgery, University of California, San Francisco, CA, USA
| | - Thomas Hatsukami
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Effects of Colchicine on Atherosclerotic Plaque Stabilization: a Multimodality Imaging Study in an Animal Model. J Cardiovasc Transl Res 2020; 14:150-160. [PMID: 32140929 DOI: 10.1007/s12265-020-09974-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 02/14/2020] [Indexed: 02/07/2023]
Abstract
Colchicine demonstrated clinical benefits in the treatment of stable coronary artery disease. Our aim was to evaluate the effects of colchicine on atherosclerotic plaque stabilization. Atherosclerosis was induced in the abdominal aorta of 20 rabbits with high-cholesterol diet and balloon endothelial denudation. Rabbits were randomized to receive either colchicine or placebo. All animals underwent MRI, 18F-FDG PET/CT, optical coherence tomography (OCT), and histology. Similar progression of atherosclerotic burden was observed in the two groups as relative increase of normalized wall index (NWI). Maximum 18F-FDG standardized uptake value (meanSUVmax) decreased after colchicine treatment, while it increased in the placebo group with a trend toward significance. Animals with higher levels of cholesterol showed significant differences in favor to colchicine group, both as NWI at the end of the protocol and as relative increase in meanSUVmax. Colchicine may stabilize atherosclerotic plaque by reducing inflammatory activity and plaque burden, without altering macrophage infiltration or plaque typology.
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Shi F, Yang Q, Guo X, Qureshi TA, Tian Z, Miao H, Dey D, Li D, Fan Z. Intracranial Vessel Wall Segmentation Using Convolutional Neural Networks. IEEE Trans Biomed Eng 2019; 66:2840-2847. [PMID: 30716027 DOI: 10.1109/tbme.2019.2896972] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To develop an automated vessel wall segmentation method using convolutional neural networks to facilitate the quantification on magnetic resonance (MR) vessel wall images of patients with intracranial atherosclerotic disease (ICAD). METHODS Vessel wall images of 56 subjects were acquired with our recently developed whole-brain three-dimensional (3-D) MR vessel wall imaging (VWI) technique. An intracranial vessel analysis (IVA) framework was presented to extract, straighten, and resample the interested vessel segment into 2-D slices. A U-net-like fully convolutional networks (FCN) method was proposed for automated vessel wall segmentation by hierarchical extraction of low- and high-order convolutional features. RESULTS The network was trained and validated on 1160 slices and tested on 545 slices. The proposed segmentation method demonstrated satisfactory agreement with manual segmentations with Dice coefficient of 0.89 for the lumen and 0.77 for the vessel wall. The method was further applied to a clinical study of additional 12 symptomatic and 12 asymptomatic patients with >50% ICAD stenosis at the middle cerebral artery (MCA). Normalized wall index at the focal MCA ICAD lesions was found significantly larger in symptomatic patients compared to asymptomatic patients. CONCLUSION We have presented an automated vessel wall segmentation method based on FCN as well as the IVA framework for 3-D intracranial MR VWI. SIGNIFICANCE This approach would make large-scale quantitative plaque analysis more realistic and promote the adoption of MR VWI in ICAD management.
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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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Kerwin WS, Miller Z, Yuan C. Imaging of the high-risk carotid plaque: magnetic resonance imaging. Semin Vasc Surg 2017; 30:54-61. [PMID: 28818259 DOI: 10.1053/j.semvascsurg.2017.04.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The emergence of the concept of high-risk atherosclerotic plaque has led to considerable interest in noninvasive imaging techniques to identify high-risk features before clinical sequelae. For plaques in the carotid arteries, magnetic resonance imaging has undergone considerable histologic validation to link imaging features to indicators of plaque instability, including plaque burden, intraplaque hemorrhage, fibrous cap disruption, lipid rich necrotic core, and calcification. Recently introduced imaging technologies, especially those focused on three-dimensional imaging sequences, are now poised for integration into the clinical workup of patients with suspected carotid atherosclerosis. The purpose of this article is to review the carotid plaque magnetic resonance imaging techniques that are most ready for integration into the clinic.
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Affiliation(s)
- William S Kerwin
- University of Washington Vascular Imaging Lab, Department of Radiology, 850 Republican Street, Seattle, WA 98109
| | - Zach Miller
- University of Washington Vascular Imaging Lab, Department of Radiology, 850 Republican Street, Seattle, WA 98109
| | - Chun Yuan
- University of Washington Vascular Imaging Lab, Department of Radiology, 850 Republican Street, Seattle, WA 98109.
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Chen Z, Liu AF, Chen H, Yuan C, He L, Zhu Y, Guan M, Jiang WJ, Zhao X. Evaluation of basilar artery atherosclerotic plaque distribution by 3D MR vessel wall imaging. J Magn Reson Imaging 2016; 44:1592-1599. [PMID: 27249041 DOI: 10.1002/jmri.25296] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/13/2016] [Accepted: 04/13/2016] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Basilar artery (BA) atherosclerosis is an important cause of perforator stroke in the brainstem due to plaque involvement of the perforator ostia in BA dorsal or lateral walls. Therefore, to acquire information on plaque distribution is important to better understand and prevent the perforator stroke. This study aimed to comprehensively evaluate BA plaque distribution with 3D magnetic resonance imaging (MRI) vessel wall imaging. MATERIALS AND METHODS Consecutive patients with cerebrovascular symptoms and stenosis or irregular luminal surface of BA were recruited and underwent BA 3D proton density-weighted volume isotropic turbo spin echo acquisition (VISTA) imaging at 3T. The cross-sectional and longitudinal distribution of BA plaque were analyzed with a custom-developed tool. RESULTS In all, 85 BA plaques were detected in 61 recruited patients. For cross-sectional distribution, the prevalence of plaque involvement in the ventral, left, dorsal, and right quadrant of BA wall was 74.1%, 70.6%, 67.1%, and 62.4%, respectively. Of the 85 plaques, 17.7% involved one quadrant and 82.3% involved two or more quadrants. The most severe plaque region was more commonly situated at lateral walls (66.1%) as compared to ventral (23.2%, P < 0.001) and dorsal walls (10.6%, P < 0.001). Longitudinally, plaques were more frequently found to occur at BA segment distal than proximal to anterior inferior cerebellar artery (AICA) (63.5% vs. 36.5%). CONCLUSION Taking advantage of 3D MR vessel wall imaging, BA plaques were found to more likely affect lateral walls and form in BA distal to AICA, where most perforators originate, suggesting that it might be useful to characterize BA plaque distribution before aggressive treatment for prevention of perforator stroke. J. Magn. Reson. Imaging 2016;44:1592-1599.
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Affiliation(s)
- Zhensen Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Ao-Fei Liu
- New Era Stroke Care and Research Institute, General Hospital of the PLA Rocket Force, 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, Washington, USA
| | - Le He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Yandong Zhu
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Maobin Guan
- Department of Radiology, Yangzhou First People's Hospital, Yangzhou, China
| | - Wei-Jian Jiang
- New Era Stroke Care and Research Institute, General Hospital of the PLA Rocket Force, Beijing, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
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13
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Fully automatic prostate segmentation from transrectal ultrasound images based on radial bas-relief initialization and slice-based propagation. Comput Biol Med 2016; 74:74-90. [PMID: 27208705 DOI: 10.1016/j.compbiomed.2016.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 05/03/2016] [Accepted: 05/05/2016] [Indexed: 11/22/2022]
Abstract
Prostate segmentation from transrectal ultrasound (TRUS) images plays an important role in the diagnosis and treatment planning of prostate cancer. In this paper, a fully automatic slice-based segmentation method was developed to segment TRUS prostate images. The initial prostate contour was determined using a novel method based on the radial bas-relief (RBR) method, and a false edge removal algorithm proposed here in. 2D slice-based propagation was used in which the contour on each image slice was deformed using a level-set evolution model, which was driven by edge-based and region-based energy fields generated by dyadic wavelet transform. The optimized contour on an image slice propagated to the adjacent slice, and subsequently deformed using the level-set model. The propagation continued until all image slices were segmented. To determine the initial slice where the propagation began, the initial prostate contour was deformed individually on each transverse image. A method was developed to self-assess the accuracy of the deformed contour based on the average image intensity inside and outside of the contour. The transverse image on which highest accuracy was attained was chosen to be the initial slice for the propagation process. Evaluation was performed for 336 transverse images from 15 prostates that include images acquired at mid-gland, base and apex regions of the prostates. The average mean absolute difference (MAD) between algorithm and manual segmentations was 0.79±0.26mm, which is comparable to results produced by previously published semi-automatic segmentation methods. Statistical evaluation shows that accurate segmentation was not only obtained at the mid-gland, but also at the base and apex regions.
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14
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Ukwatta E, Yuan J, Qiu W, Rajchl M, Chiu B, Fenster A. Joint segmentation of lumen and outer wall from femoral artery MR images: Towards 3D imaging measurements of peripheral arterial disease. Med Image Anal 2015; 26:120-32. [PMID: 26387053 DOI: 10.1016/j.media.2015.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 08/17/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
Abstract
Three-dimensional (3D) measurements of peripheral arterial disease (PAD) plaque burden extracted from fast black-blood magnetic resonance (MR) images have shown to be more predictive of clinical outcomes than PAD stenosis measurements. To this end, accurate segmentation of the femoral artery lumen and outer wall is required for generating volumetric measurements of PAD plaque burden. Here, we propose a semi-automated algorithm to jointly segment the femoral artery lumen and outer wall surfaces from 3D black-blood MR images, which are reoriented and reconstructed along the medial axis of the femoral artery to obtain improved spatial coherence between slices of the long, thin femoral artery and to reduce computation time. The developed segmentation algorithm enforces two priors in a global optimization manner: the spatial consistency between the adjacent 2D slices and the anatomical region order between the femoral artery lumen and outer wall surfaces. The formulated combinatorial optimization problem for segmentation is solved globally and exactly by means of convex relaxation using a coupled continuous max-flow (CCMF) model, which is a dual formulation to the convex relaxed optimization problem. In addition, the CCMF model directly derives an efficient duality-based algorithm based on the modern multiplier augmented optimization scheme, which has been implemented on a GPU for fast computation. The computed segmentations from the developed algorithm were compared to manual delineations from experts using 20 black-blood MR images. The developed algorithm yielded both high accuracy (Dice similarity coefficients ≥ 87% for both the lumen and outer wall surfaces) and high reproducibility (intra-class correlation coefficient of 0.95 for generating vessel wall area), while outperforming the state-of-the-art method in terms of computational time by a factor of ≈ 20.
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Affiliation(s)
- Eranga Ukwatta
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA; Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
| | - Jing Yuan
- Robarts Research Institute, Western University, London, ON, Canada; Biomedical Engineering Graduate Program, Western University, London, ON, Canada
| | - Wu Qiu
- Robarts Research Institute, Western University, London, ON, Canada; Biomedical Engineering Graduate Program, Western University, London, ON, Canada
| | - Martin Rajchl
- Department of Computing, Imperial College London, London, UK
| | - Bernard Chiu
- Department of Electronic Engineering, City University of Hong Kong, Hong Kong
| | - Aaron Fenster
- Robarts Research Institute, Western University, London, ON, Canada; Biomedical Engineering Graduate Program, Western University, London, ON, Canada
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15
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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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16
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Chen W, Xu J, Chiu B. Fast segmentation of the femoral arteries from 3D MR images: A tool for rapid assessment of peripheral arterial disease. Med Phys 2015; 42:2431-48. [DOI: 10.1118/1.4916803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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17
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Ukwatta E, Yuan J, Qiu W, Rajchl M, Chiu B, Shavakh S, Xu J, Fenster A. Joint segmentation of 3D femoral lumen and outer wall surfaces from MR images. ACTA ACUST UNITED AC 2014; 16:534-41. [PMID: 24505708 DOI: 10.1007/978-3-642-40811-3_67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Abstract
We propose a novel algorithm to jointly delineate the femoral artery lumen and outer wall surfaces from 3D black-blood MR images, while enforcing the spatial consistency of the reoriented MR slices along the medial axis of the femoral artery. We demonstrate that the resulting optimization problem of the proposed segmentation can be solved globally and exactly by means of convex relaxation, for which we introduce a novel coupled continuous max-flow (CCOMF) model based on an Ishikawa-type flow configuration and show its duality to the studied convex relaxed optimization problem. Using the proposed CCMF model, the exactness and globalness of its dual convex relaxation problem is proven. Experiment results demonstrate that the proposed method yielded high accuracy (i.e. Dice similarity coefficient > 85%) for both the lumen and outer wall and high reproducibility (intra-class correlation coefficient of 0.95) for generating vessel wall area. The proposed method outperformed the previous method, in terms of computation time, by a factor of pproximately 20.
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Affiliation(s)
- Eranga Ukwatta
- Robarts Research Institute, Western University, London, ON, Canada.
| | - Jing Yuan
- Robarts Research Institute, Western University, London, ON, Canada
| | - Wu Qiu
- Robarts Research Institute, Western University, London, ON, Canada
| | - Martin Rajchl
- Robarts Research Institute, Western University, London, ON, Canada
| | - Bernard Chiu
- Department of Electronic Engineering, City University of Hong Kong, Hong Kong
| | - Shadi Shavakh
- Robarts Research Institute, Western University, London, ON, Canada
| | - Jianrong Xu
- Renji Hospital, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Aaron Fenster
- Robarts Research Institute, Western University, London, ON, Canada
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18
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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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Chiu B, Ukwatta E, Shavakh S, Fenster A. Quantification and visualization of carotid segmentation accuracy and precision using a 2D standardized carotid map. Phys Med Biol 2013; 58:3671-703. [DOI: 10.1088/0031-9155/58/11/3671] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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20
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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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21
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Pollak AW, Kramer CM. MRI in Lower Extremity Peripheral Arterial Disease: Recent Advancements. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013; 6:55-60. [PMID: 23336015 PMCID: PMC3547388 DOI: 10.1007/s12410-012-9175-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Evaluation of peripheral arterial disease by cardiovascular magnetic resonance imaging continues to develop. Of the clinical diagnostics tests currently available, magnetic resonance angiography is well established as one of the preferred techniques for determining areas of arterial occlusive disease affecting the lower extremities. Despite this, there have been new developments in non-gadolinium based contrast-enhanced studies as well as testing done at higher field strength scanners. In the research arena, magnetic resonance spectroscopy, calf muscle perfusion imaging and atherosclerotic plaque evaluation all have made significant advancements over the last year. These techniques are gaining traction as surrogate endpoints in clinical trials of novel therapeutics aimed at alleviating symptoms in patients with peripheral arterial disease.
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Affiliation(s)
- Amy W. Pollak
- Department of Medicine, Cardiovascular Imaging Center, University of Virginia Health System, University of Virginia, Charlottesville, VA
| | - Christopher M. Kramer
- Department of Medicine, Cardiovascular Imaging Center, University of Virginia Health System, University of Virginia, Charlottesville, VA
- Department of Radiology, Cardiovascular Imaging Center, University of Virginia Health System, University of Virginia, Charlottesville, VA
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