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Suzuki Y, Koktzoglou I, Li Z, Jezzard P, Okell T. Improved visualization of intracranial distal arteries with multiple 2D slice dynamic ASL-MRA and super-resolution convolutional neural network. Magn Reson Med 2024. [PMID: 39155401 DOI: 10.1002/mrm.30245] [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: 05/01/2024] [Revised: 07/08/2024] [Accepted: 07/24/2024] [Indexed: 08/20/2024]
Abstract
PURPOSE To develop a novel framework to improve the visualization of distal arteries in arterial spin labeling (ASL) dynamic MRA. METHODS The attenuation of ASL blood signal due to the repetitive application of excitation RF pulses was minimized by splitting the acquisition volume into multiple thin 2D (M2D) slices, thereby reducing the exposure of the arterial blood magnetization to RF pulses while it flows within the brain. To improve the degraded vessel visualization in the slice direction due to the limited minimum achievable 2D slice thickness, a super-resolution (SR) convolutional neural network (CNN) was trained by using 3D time-of-flight (TOF)-MRA images from a large public dataset. And then, we applied domain transfer from 3D TOF-MRA to M2D ASL-MRA, while avoiding acquiring a large number of ASL-MRA data required for CNN training. RESULTS Compared to the conventional 3D ASL-MRA, far more distal arteries were visualized with higher signal intensity by using M2D ASL-MRA. In general, however, the vessel visualization with a conventional interpolation was prone to be blurry and unclear due to the limited spatial resolution in the slice direction, particularly in small vessels. Application of CNN-based SR transferred from 3D TOF-MRA to M2D ASL-MRA successfully addressed such a limitation and achieved clearer visualization of small vessels than conventional interpolation. CONCLUSION This study demonstrated that the proposed framework provides improved visualization of distal arteries in later dynamic phases, which will particularly benefit the application of this approach in patients with cerebrovascular disease who have slow blood flow.
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Affiliation(s)
- Yuriko Suzuki
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, USA
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Ziyu Li
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Peter Jezzard
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Thomas Okell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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2
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Zhang Y, Zhu H, Cao T, Zhang L, Chang Y, Liang S, Ma C, Liang F, Song Y, Zhang J, Li C, Jiang C. Rupture-Related Features of Cerebral Arteriovenous Malformations and Their Utility in Predicting Hemorrhage. Stroke 2024; 55:1339-1348. [PMID: 38511314 DOI: 10.1161/strokeaha.123.045456] [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: 10/07/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Evaluating rupture risk in cerebral arteriovenous malformations currently lacks quantitative hemodynamic and angioarchitectural features necessary for predicting subsequent hemorrhage. We aimed to derive rupture-related hemodynamic and angioarchitectural features of arteriovenous malformations and construct an ensemble model for predicting subsequent hemorrhage. METHODS This retrospective study included 3 data sets, as follows: training and test data sets comprising consecutive patients with untreated cerebral arteriovenous malformations who were admitted from January 2015 to June 2022 and a validation data set comprising patients with unruptured arteriovenous malformations who received conservative treatment between January 2009 and December 2014. We extracted rupture-related features and developed logistic regression (clinical features), decision tree (hemodynamic features), and support vector machine (angioarchitectural features) models. These 3 models were combined into an ensemble model using a weighted soft-voting strategy. The performance of the models in discriminating ruptured arteriovenous malformations and predicting subsequent hemorrhage was evaluated with confusion matrix-related metrics in the test and validation data sets. RESULTS A total of 896 patients (mean±SD age, 28±14 years; 404 women) were evaluated, with 632, 158, and 106 patients in the training, test, and validation data sets, respectively. From the training set, 9 clinical, 10 hemodynamic, and 2912 pixel-based angioarchitectural features were extracted. A logistic regression model was built using 4 selected clinical features (age, nidus size, location, and venous aneurysm), whereas a decision-tree model was constructed from 4 hemodynamic features (outflow time, stasis index, cerebral blood flow, and outflow volume ratio). A support vector machine model was designed using 5 pixel-based angioarchitectural features. In the validation data set, the accuracy, sensitivity, specificity, and area under the curve of the ensemble model for predicting subsequent hemorrhages were 0.840, 0.889, 0.823, and 0.911, respectively. CONCLUSIONS The ensemble model incorporating clinical, hemodynamic, and angioarchitectural features showed favorable performance in predicting subsequent hemorrhage of cerebral arteriovenous malformations.
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Affiliation(s)
- Yupeng Zhang
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Haoyu Zhu
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Tingliang Cao
- Department of Neurosurgery, Kaifeng Central Hospital, Henan, China (T.C.)
| | - Longhui Zhang
- Department of Neurology, Beijing Tiantan Hospital (L.Z.), Capital Medical University, China
| | - Yuzhou Chang
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Shikai Liang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, China (S.L., C.M.)
| | - Chao Ma
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, China (S.L., C.M.)
| | - Fei Liang
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China (F.L.)
| | - Yuqi Song
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Jiarui Zhang
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
| | - Changxuan Li
- Department of Neurosurgery, The First Affiliated Hospital of Hainan Medical University, Hainan, China (C.L.)
| | - Chuhan Jiang
- Department of Neurosurgery, Beijing Neurosurgical Institute (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
- Department of Neurosurgery, Beijing Tiantan Hospital (Y.Z., H.Z., Y.C., Y.S., J.Z., C.J.), Capital Medical University, China
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3
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Togao O, Obara M, Yamashita K, Kikuchi K, Wada T, Murazaki H, Arimura K, Nishimura A, Horie N, van de Ven K, Van Cauteren M, Ishigami K. Arterial Spin Labeling-Based MR Angiography for Cerebrovascular Diseases: Principles and Clinical Applications. J Magn Reson Imaging 2023. [PMID: 37937684 DOI: 10.1002/jmri.29119] [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: 07/17/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023] Open
Abstract
Arterial spin labeling (ASL) is a noninvasive imaging technique that labels the proton spins in arterial blood and uses them as endogenous tracers. Brain perfusion imaging with ASL is becoming increasingly common in clinical practice, and clinical applications of ASL for intracranial magnetic resonance angiography (MRA) have also been demonstrated. Unlike computed tomography (CT) angiography and cerebral angiography, ASL-based MRA does not require contrast agents. ASL-based MRA overcomes most of the disadvantages of time-of-flight (TOF) MRA. Several schemes have been developed for ASL-based MRA; the most common method has been pulsed ASL, but more recently pseudo-continuous ASL, which provides a higher signal-to-noise ratio (SNR), has been used more frequently. New methods that have been developed include direct intracranial labeling methods such as velocity-selective ASL and acceleration-selective ASL. MRA using an extremely short echo time (eg, silent MRA) or ultrashort echo-time (TE) MRA can suppress metal susceptibility artifacts and is ideal for patients with a metallic device implanted in a cerebral vessel. Vessel-selective 4D ASL MRA can provide digital subtraction angiography (DSA)-like images. This review highlights the principles, clinical applications, and characteristics of various ASL-based MRA techniques. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Osamu Togao
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuhiro Wada
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroo Murazaki
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | | | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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4
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Woods JG, Schauman SS, Chiew M, Chappell MA, Okell TW. Time-encoded pseudo-continuous arterial spin labeling: Increasing SNR in ASL dynamic angiography. Magn Reson Med 2023; 89:1323-1341. [PMID: 36255158 PMCID: PMC10091734 DOI: 10.1002/mrm.29491] [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: 04/05/2022] [Revised: 08/28/2022] [Accepted: 09/23/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE Dynamic angiography using arterial spin labeling (ASL) can provide detailed hemodynamic information. However, the long time-resolved readouts require small flip angles to preserve ASL signal for later timepoints, limiting SNR. By using time-encoded ASL to generate temporal information, the readout can be shortened. Here, the SNR improvements from using larger flip angles, made possible by the shorter readout, are quantitatively investigated. METHODS The SNR of a conventional protocol with nine Look-Locker readouts and a 4 × $$ \times $$ 3 time-encoded protocol with three Look-Locker readouts (giving nine matched timepoints) were compared using simulations and in vivo data. Both protocols were compared using readouts with constant flip angles (CFAs) and variable flip angles (VFAs), where the VFA scheme was designed to produce a consistent ASL signal across readouts. Optimization of the background suppression to minimize physiological noise across readouts was also explored. RESULTS The time-encoded protocol increased in vivo SNR by 103% and 96% when using CFAs or VFAs, respectively. Use of VFAs improved SNR compared with CFAs by 25% and 21% for the conventional and time-encoded protocols, respectively. The VFA scheme also removed signal discontinuities in the time-encoded data. Preliminary data suggest that optimizing the background suppression could improve in vivo SNR by a further 16%. CONCLUSIONS Time encoding can be used to generate additional temporal information in ASL angiography. This enables the use of larger flip angles, which can double the SNR compared with a non-time-encoded protocol. The shortened time-encoded readout can also lead to improved background suppression, reducing physiological noise and further improving SNR.
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Affiliation(s)
- Joseph G Woods
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
| | - S Sophie Schauman
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom.,Department of Radiology, Stanford University, Stanford, California, USA
| | - Mark Chiew
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
| | - Michael A Chappell
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom.,Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Thomas W Okell
- Wellcome Centre for Integrated Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
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5
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Hernandez‐Garcia L, Aramendía‐Vidaurreta V, Bolar DS, Dai W, Fernández‐Seara MA, Guo J, Madhuranthakam AJ, Mutsaerts H, Petr J, Qin Q, Schollenberger J, Suzuki Y, Taso M, Thomas DL, van Osch MJP, Woods J, Zhao MY, Yan L, Wang Z, Zhao L, Okell TW. Recent Technical Developments in ASL: A Review of the State of the Art. Magn Reson Med 2022; 88:2021-2042. [PMID: 35983963 PMCID: PMC9420802 DOI: 10.1002/mrm.29381] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/31/2022] [Accepted: 06/18/2022] [Indexed: 12/11/2022]
Abstract
This review article provides an overview of a range of recent technical developments in advanced arterial spin labeling (ASL) methods that have been developed or adopted by the community since the publication of a previous ASL consensus paper by Alsop et al. It is part of a series of review/recommendation papers from the International Society for Magnetic Resonance in Medicine Perfusion Study Group. Here, we focus on advancements in readouts and trajectories, image reconstruction, noise reduction, partial volume correction, quantification of nonperfusion parameters, fMRI, fingerprinting, vessel selective ASL, angiography, deep learning, and ultrahigh field ASL. We aim to provide a high level of understanding of these new approaches and some guidance for their implementation, with the goal of facilitating the adoption of such advances by research groups and by MRI vendors. Topics outside the scope of this article that are reviewed at length in separate articles include velocity selective ASL, multiple-timepoint ASL, body ASL, and clinical ASL recommendations.
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Affiliation(s)
| | | | - Divya S. Bolar
- Center for Functional Magnetic Resonance Imaging, Department of RadiologyUniversity of California at San DiegoSan DiegoCaliforniaUSA
| | - Weiying Dai
- Department of Computer ScienceState University of New York at BinghamtonBinghamtonNYUSA
| | | | - Jia Guo
- Department of BioengineeringUniversity of California RiversideRiversideCaliforniaUSA
| | | | - Henk Mutsaerts
- Department of Radiology & Nuclear MedicineAmsterdam University Medical Center, Amsterdam NeuroscienceAmsterdamThe Netherlands
| | - Jan Petr
- Helmholtz‐Zentrum Dresden‐RossendorfInstitute of Radiopharmaceutical Cancer ResearchDresdenGermany
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Yuriko Suzuki
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Manuel Taso
- Division of MRI research, RadiologyBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMassachusettsUSA
| | - David L. Thomas
- Department of Brain Repair and RehabilitationUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Matthias J. P. van Osch
- C.J. Gorter Center for high field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Joseph Woods
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Department of RadiologyUniversity of CaliforniaLa JollaCaliforniaUSA
| | - Moss Y. Zhao
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Lirong Yan
- Department of Radiology, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Ze Wang
- Department of Diagnostic Radiology and Nuclear MedicineUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Li Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument ScienceZhejiang UniversityZhejiangPeople's Republic of China
| | - Thomas W. Okell
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
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6
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Togao O, Obara M, Kikuchi K, Helle M, Arimura K, Nishimura A, Wada T, Murazaki H, Van Cauteren M, Hiwatashi A, Ishigami K. Vessel-Selective 4D-MRA Using Superselective Pseudocontinuous Arterial Spin-Labeling with Keyhole and View-Sharing for Visualizing Intracranial Dural AVFs. AJNR Am J Neuroradiol 2022; 43:368-375. [PMID: 35241425 PMCID: PMC8910818 DOI: 10.3174/ajnr.a7426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/11/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE An accurate assessment of the hemodynamics of an intracranial dural AVF is necessary for treatment planning. We aimed to investigate the utility of 4D-MRA based on superselective pseudocontinuous arterial spin-labeling with CENTRA-keyhole and view-sharing (4D-S-PACK) for the vessel-selective visualization of intracranial dural AVFs. MATERIALS AND METHODS We retrospectively analyzed the images of 21 patients (12 men and 9 women; mean age, 62.2 [SD,19.2] years) with intracranial dural AVFs, each of whom was imaged with DSA, 4D-S-PACK, and nonselective 4D-MRA based on pseudocontinuous arterial spin-labeling combined with CENTRA-keyhole and view-sharing (4D-PACK). The shunt location, venous drainage patterns, feeding artery identification, and Borden classification were evaluated by 2 observers using both MRA methods on separate occasions. Vessel selectivity was evaluated on 4D-S-PACK. RESULTS Shunt locations were correctly evaluated in all 21 patients by both observers on both MRA methods. With 4D-S-PACK, observers 1 and 2 detected 76 (80.0%, P < .001) and 73 (76.8%, P < .001) feeding arteries of the 95 feeding arteries identified on DSA but only 39 (41.1%) and 46 (48.4%) feeding arteries with nonselective 4D-PACK, respectively. Both observers correctly identified 10 of the 11 patients with cortical venous reflux confirmed by DSA with both 4D-S-PACK and 4D-PACK (sensitivity = 90.9%, specificity = 90.9% for each method), and they made accurate Borden classifications in 20 of the 21 patients (95.2%) on both MRA methods. Of the 84 vessel territories examined, vessel selectivity was graded 3 or 4 in 73 (91.2%) and 66 (88.0%) territories by observers 1 and 2, respectively. CONCLUSIONS 4D-S-PACK is useful for the identification of feeding arteries and accurate classifications of intracranial dural AVFs and can be a useful noninvasive clinical tool.
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Affiliation(s)
- O. Togao
- From the Departments of Molecular Imaging & Diagnosis (O.T.)
| | - M. Obara
- Philips Japan (M.O., M.V.C.), Tokyo, Japan
| | | | - M. Helle
- Philips Research (M.H.), Hamburg, Germany
| | - K. Arimura
- Neurosurgery (K.A., A.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A. Nishimura
- Neurosurgery (K.A., A.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T. Wada
- Division of Radiology (T.W., H.M.), Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - H. Murazaki
- Division of Radiology (T.W., H.M.), Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
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7
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Ledbetter LN, Burns J, Shih RY, Ajam AA, Brown MD, Chakraborty S, Davis MA, Ducruet AF, Hunt CH, Lacy ME, Lee RK, Pannell JS, Pollock JM, Powers WJ, Setzen G, Shaines MD, Utukuri PS, Wang LL, Corey AS. ACR Appropriateness Criteria® Cerebrovascular Diseases-Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage. J Am Coll Radiol 2021; 18:S283-S304. [PMID: 34794589 DOI: 10.1016/j.jacr.2021.08.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 08/26/2021] [Indexed: 11/22/2022]
Abstract
Cerebrovascular disease is a broad topic. This document focuses on the imaging recommendations for the varied clinical scenarios involving intracranial aneurysms, vascular malformations, and vasculitis, which all carry high risk of morbidity and mortality. Additional imaging recommendations regarding complications of these conditions, including subarachnoid hemorrhage and vasospasm, are also covered. While each variant presentation has unique imaging recommendations, the major focus of this document is neurovascular imaging techniques. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Luke N Ledbetter
- Director, Head and Neck Imaging, University of California Los Angeles, Los Angeles, California.
| | - Judah Burns
- Panel Chair and Program Director, Diagnostic Radiology Residency Program, Montefiore Medical Center, Bronx, New York
| | - Robert Y Shih
- Panel Vice-Chair, Uniformed Services University, Bethesda, Maryland
| | - Amna A Ajam
- Ohio State University, Columbus, Ohio; Chief of Neuroradiology & MRI at WRNMMC; and Associate Chief of Neuroradiology for AIRP
| | - Michael D Brown
- Michigan State University, East Lansing, Michigan, American College of Emergency Physicians
| | - Santanu Chakraborty
- Ottawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada, Canadian Association of Radiologists
| | - Melissa A Davis
- Director of Quality, Radiology, Emory University, Atlanta, Georgia; ACR YPS Communications Liaison
| | - Andrew F Ducruet
- Barrow Neurological Institute, Phoenix, Arizona, Neurosurgery expert
| | | | - Mary E Lacy
- University of New Mexico, Albuquerque, New Mexico, American College of Physicians
| | - Ryan K Lee
- Chair, Department of Radiology, Einstein Healthcare Network, Philadelphia, Pennsylvania
| | - Jeffrey S Pannell
- University of California San Diego Medical Center, San Diego, California
| | | | - William J Powers
- University of North Carolina School of Medicine, Chapel Hill, North Carolina; American Academy of Neurology; Chair, Writing Group, American Heart Association/American Stroke Association Guidelines for the Early Management of Patients with Acute Ischemic Stroke, 2016-2019
| | - Gavin Setzen
- Albany ENT & Allergy Services, PC, Albany, New York; American Academy of Otolaryngology-Head and Neck Surgery; President, Albany ENT & Allergy Services, PC
| | - Matthew D Shaines
- Associate Chief, Hospital Medicine, Albert Einstein College of Medicine Montefiore Medical Center, Bronx, New York; Internal medicine physician
| | - Pallavi S Utukuri
- Clinical Site Director, Department of Radiology, Allen Hospital, New York Presbyterian, New York, New York; and Columbia University Medical Center, New York, New York
| | - Lily L Wang
- University of Cincinnati Medical Center, Cincinnati, Ohio
| | - Amanda S Corey
- Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia
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8
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Wu CX, Zang ZX, Hong T, Dong MQ, Shan Y, Zhao ZL, Hou CB, Lu J. Signal intensity ratio of draining vein on silent MR angiography as an indicator of high-flow arteriovenous shunt in brain arteriovenous malformation. Eur Radiol 2021; 31:9252-9261. [PMID: 34263361 PMCID: PMC8589750 DOI: 10.1007/s00330-021-08170-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/26/2021] [Accepted: 06/25/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate whether the signal intensity ratio (rSI) of the draining vein on silent MR angiography is correlated with arteriovenous (A-V) transit time on digital subtraction angiography (DSA), thereby identifying high-flow A-V shunt in brain arteriovenous malformation (BAVM), and to analyze whether the rSI and the characteristic of draining veins on silent MRA are associated with hemorrhage presentation. METHODS Eighty-one draining veins of 46 participants with BAVM (mean age 33.2 ± 16.9 years) who underwent silent MRA and DSA were evaluated retrospectively. The correlation between the rSI of the draining vein on silent MRA and A-V transit time on DSA was examined. The AUC-ROC was obtained to evaluate the performance of the rSI in determining the presence of high-flow A-V shunt. The characteristics of draining veins with the maximum rSI (rSImax) were further compared between the hemorrhagic and non-hemorrhagic untreated BAVM. RESULTS The rSI of each draining vein on silent MRA was significantly correlated with A-V transit time from DSA (r = -0.81, p < .001). The AUC-ROC was 0.89 for using the rSI to determine the presence of high-flow A-V shunt. A cut-off rSI value of 1.09 yielded a sensitivity of 82.4% and a specificity of 82.8%. The draining vein with rSImax and no ectasia was significantly more observed in the hemorrhagic group (p = 0.045). CONCLUSIONS The rSI of the draining vein on silent MRA is significantly correlated with A-V transit time on DSA, and it can be used as an indicator of high-flow A-V shunt in BAVM. KEY POINTS • The signal intensity ratio (rSI) of the draining vein on silent MRA significantly correlated with arteriovenous (A-V) transit time of brain arteriovenous malformation (BAVM) on digital subtraction angiography (DSA). • The area under the receiver operating characteristic curve (AUC) was 0.89 for using the rSI of draining veins to determine high-flow A-V shunt. • Draining veins with maximum rSI and no ectasia were significantly more observed in the hemorrhagic group of BAVM (p = 0.045).
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Affiliation(s)
- Chun-Xue Wu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 45# Changchun Street, Xicheng District, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Zhen-Xiang Zang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 45# Changchun Street, Xicheng District, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Tao Hong
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Meng-Qi Dong
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yi Shan
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 45# Changchun Street, Xicheng District, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Zhi-Lian Zhao
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 45# Changchun Street, Xicheng District, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Cheng-Bei Hou
- Center for Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 45# Changchun Street, Xicheng District, Beijing, China. .,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
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Togao O, Obara M, Helle M, Yamashita K, Kikuchi K, Momosaka D, Kikuchi Y, Nishimura A, Arimura K, Wada T, Murazaki H, Iihara K, Van Cauteren M, Hiwatashi A. Vessel-selective 4D-MR angiography using super-selective pseudo-continuous arterial spin labeling may be a useful tool for assessing brain AVM hemodynamics. Eur Radiol 2020; 30:6452-6463. [PMID: 32696254 DOI: 10.1007/s00330-020-07057-4] [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: 01/14/2020] [Revised: 04/04/2020] [Accepted: 06/30/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the usefulness of 4D-MR angiography based on super-selective pseudo-continuous ASL combined with keyhole and view-sharing (4D-S-PACK) for vessel-selective visualization and to examine the ability of this technique to visualize brain arteriovenous malformations (AVMs). METHODS In this retrospective study, 15 patients (ten men and five women, mean age 44.0 ± 16.9 years) with brain AVMs were enrolled. All patients were imaged with 4D-PACK (non-selective), 4D-S-PACK, and digital subtraction angiography (DSA). Observers evaluated vessel selectivity, identification of feeding arteries and venous drainage patterns, visualization scores, and contrast-to-noise ratio (CNR) for each AVM component. Measurements were compared between the MR methods. RESULTS Vessel selectivity was graded 4 in 43/45 (95.6%, observer 1) and 42/45 (93.3%, observer 2) territories and graded 3 in two (observer 1) and three (observer 2) territories. The sensitivity and specificity for identification of feeding arteries for both observers was 88.9% and 100% on 4D-PACK, and 100% and 100% on 4D-S-PACK, respectively. For venous drainage, the sensitivity and specificity was 100% on both methods for observer 1. The sensitivity and specificity for observer 2 was 94.4% and 83.3% on 4D-PACK, and 94.4% and 91.7% on 4D-S-PACK, respectively. The CNRs at the timepoint of 1600 ms were slightly lower in 4D-S-PACK than in 4D-PACK for all AVM components (Feeding artery, p = .02; nidus, p = .001; and draining artery, p = .02). The visualization scores for both observers were not significantly different between 4D-PACK and 4D-S-PACK for all components. CONCLUSIONS 4D-S-PACK could be a useful non-invasive clinical tool for assessing hemodynamics in brain AVMs. KEY POINTS • The 4D-MR angiography based on super-selective pseudo-continuous arterial spin labeling combined with CENTRA-keyhole and view-sharing (4D-S-PACK) enabled excellent vessel selectivity. • The 4D-S-PACK enabled the perfect identification of feeding arteries of brain arteriovenous malformation (AVM). • 4D-S-PACK could be a non-invasive clinical tool for assessing hemodynamics in brain AVMs.
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Affiliation(s)
- Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Makoto Obara
- Philips Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | | | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Daichi Momosaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshitomo Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tatsuhiro Wada
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroo Murazaki
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Iihara
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Marc Van Cauteren
- Philips Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | - Akio Hiwatashi
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
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10
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Ramachandran S, Mukherjee D, Delf J, Bown MJ, Kandiyil N. A comparison of arterial spin labelling with catheter angiography in evaluating arteriovenous malformations: a systematic review. Br J Radiol 2020; 93:20190830. [PMID: 32208976 PMCID: PMC10993222 DOI: 10.1259/bjr.20190830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare the performance of arterial spin labelling (ASL) in evaluating arteriovenous malformations (AVMs) against the current gold standard of catheter angiography. METHODS We systematically reviewed the published literature using EMBASE and Medline. We included studies that compared ASL to catheter angiography in the assessment of AVMs in three outcome domains: detection, angioarchitectural and haemodynamic features. RESULTS From 314 unique citations, 19 studies representing 289 patients with intracranial AVMs met our inclusion criteria. We did not pool data due to marked heterogeneity in study outcome measures. Seven studies showed high diagnostic performance of ASL in identifying arterial feeders, with sensitivity ranging from 84.6 to 100% and specificity ranging from 93.3 to 100%. Six studies showed strong ability in detecting arteriovenous shunting, with sensitivity ranging from 91.7 to 100% and specificity ranging from 90 to 100%. Seven studies demonstrated that ASL could identify nidal location and size as well as catheter angiography, while five studies showed relatively poorer performance in delineating venous drainage. Two studies showed 100% sensitivity of ASL in the identification of residual or obliterated AVMs following stereotactic radiosurgery. CONCLUSIONS Despite limitations in the current evidence base and technical challenges, this review suggests that ASL has a promising role in the work-up and post-treatment follow-up of AVMs. Larger scale prospective studies assessing the diagnostic performance of ASL are warranted. ADVANCES IN KNOWLEDGE ASL demonstrates overall validity in the evaluation of intracranial AVMs.
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Affiliation(s)
- Sanjeev Ramachandran
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
- University of Leicester,
Leicester, United Kingdom
| | - Deyashini Mukherjee
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
- University of Leicester,
Leicester, United Kingdom
| | - Jonathan Delf
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
| | - Matthew James Bown
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
- University of Leicester,
Leicester, United Kingdom
| | - Neghal Kandiyil
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
- University of Leicester,
Leicester, United Kingdom
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Silent MRA: arterial spin labeling magnetic resonant angiography with ultra-short time echo assessing cerebral arteriovenous malformation. Neuroradiology 2020; 62:455-461. [PMID: 31898767 DOI: 10.1007/s00234-019-02345-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE MR angiography using the silent MR angiography algorithm (silent MRA), which combines arterial spin labeling and an ultrashort time echo, has not been used for the evaluation of cerebral arteriovenous malformations (CAVMs). We aimed to determine the usefulness of silent MRA for the evaluation of CAVMs. METHODS Twenty-nine CAVMs of 28 consecutive patients diagnosed by 4D CT angiography or digital subtraction angiography, who underwent both time-of-flight (TOF) MRA and silent MRA, were enrolled. Two observers independently assessed the TOF-MRA and silent MRA images of CAVMs. Micro AVM was defined as AVM with a nidus diameter less than 10 mm. The detection rate, visualization of the components, and accuracy of Spetzler-Martin grade were evaluated with statistical software R. RESULTS For all 29 CAVMs, 23 (79%) lesions were detected for TOF-MRA and all for silent MRA. Of 10 micro AVMs, only 4 (40%) lesions were detectable on TOF-MRA and all (100%) on silent MRA. The visibility of the nidus and drainer was significantly better for silent MRA than TOF-MRA (p < 0.001), while there was no significant difference in the feeder between the two sequences. The accuracy rates of the Spetzler-Martin grade for the TOF and silent MRA were 38% (11/29) and 79.3% (23/29), respectively (p < 0.001). CONCLUSIONS Silent MRA is useful for evaluating CAVM components and detecting micro AVM.
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13
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Togao O, Hiwatashi A, Yamashita K, Momosaka D, Obara M, Nishimura A, Arimura K, Hata N, Iihara K, Van Cauteren M, Honda H. Acceleration-selective arterial spin labeling MR angiography for visualization of brain arteriovenous malformations. Neuroradiology 2019; 61:979-989. [PMID: 31016367 DOI: 10.1007/s00234-019-02217-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/11/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate the performance of acceleration-selective arterial spin labeling (AccASL) MR angiography in the visualization of brain arteriovenous malformations (AVMs) in comparison with digital subtraction angiography (DSA) and time-of-flight (TOF) MR angiography. METHODS Twenty-one patients with brain AVM (mean age 31.1 ± 18.6 years; 11 males, 10 females) underwent TOF and AccASL MR angiography and DSA. Two neuroradiologists conducted an observer study for detection, nidus size, eloquence, venous drainage pattern, and Spetzler-Martin (SM) grade. The evaluations included the visualization of each AVM component with reference to DSA and assessments of contrast-to-noise ratio (CNR). The kappa statistic, repeated measures analysis of variance, Wilcoxon matched pairs test, and paired t test were used. RESULTS Both observers detected more AVMs with AccASL (95.2%, 90.5% for Observers 1 and 2) than with TOF (76.2% and 71.4%, respectively). The inter-modality agreement between AccASL and DSA was almost perfect for the eloquence, venous drainage pattern, and SM grade for Observer 1 and moderate for the venous drainage pattern and substantial for the eloquence and SM grade for Observer 2. The visualization scores were higher with AccASL than with TOF for the feeding artery (AccASL, 4.5 ± 1.0 vs. TOF, 3.9 ± 1.5, p = 0.0214), nidus (4.6 ± 1.1 vs. 3.2 ± 1.5, p = 0.0006), and draining vein (4.6 ± 1.0 vs. 2.2 ± 1.1, p < 0.0001), respectively. The CNRs in the nidus were higher in AccASL than in TOF (29.9 ± 16.7 vs. 20.8 ± 16.5, p = 0.0002), as in the draining vein (23.2 ± 13.0 vs. 12.6 ± 12.0, p = 0.0010), respectively. CONCLUSIONS AccASL better visualized brain AVMs compared with TOF and was useful for grading without the use of contrast agents.
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Affiliation(s)
- Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Akio Hiwatashi
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Daichi Momosaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Makoto Obara
- Philips Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Nobuhiro Hata
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Iihara
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Marc Van Cauteren
- Philips Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
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Lin Z, Zhang X, Guo L, Wang K, Jiang Y, Hu X, Huang Y, Wei J, Ma S, Liu Y, Zhu L, Zhuo Z, Liu J, Wang X. Clinical feasibility study of 3D intracranial magnetic resonance angiography using compressed sensing. J Magn Reson Imaging 2019; 50:1843-1851. [PMID: 30980468 DOI: 10.1002/jmri.26752] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 04/02/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Compressed sensing (CS) has been widely used to improve the speed of MRI, but the feasibility of application in 3D intracranial MR angiography (MRA) needs to be evaluated in clinical practice. PURPOSE To evaluate the clinical feasibility of CS-MRA in comparison with conventional 3D-MRA (Con-MRA). STUDY TYPE Retrospective. SUBJECTS Forty-nine consecutive patients with suspected intracranial arterial disease. FIELD STRENGTH/SEQUENCE 3T MRI. 3D time-of-flight (TOF) MRA using a CS algorithm and conventional 3D TOF MRA scan. ASSESSMENT Three radiologists (4, 11, and 12 years of experience in neuroradiology) independently assessed the image quality, vascular lesions, and variations of intracranial arteries of both CS-MRA and Con-MRA, respectively. STATISTICAL TESTS The Kendall W test was performed to assess the interobserver agreement of image quality and intracranial arterial stenosis. A nonparametric test (Wilcoxon test) was used for comparison of the image quality and definition of the external carotid artery (ECA). Weighted kappa analysis was performed for the interstudy agreement of intracranial arterial stenosis. The aneurysm, decreased branches, congenital hypoplasia, absence, and variant branching of intracranial arteries were observed and evaluated for interobserver agreement and interstudy agreement by kappa analysis. Paired-t-tests for signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were conducted. RESULTS Image quality is better for CS-MRA compared with Con-MRA with significance (Z = -3.710 to -2.673, with P < 0.01). The interstudy agreement of lesion and variation of intracranial arteries assessment for each observer was excellent. The SNR and CNR were significantly higher in CS-MRA compared with Con-MRA (P < 0.001). The definition of ECA of CS-MRA was significantly better (Z = -4.9, P < 0.001). DATA CONCLUSION CS-MRA showed significantly higher image quality with less blur, comparable image diagnostic performance of intracranial arteries, and better display of ECA than Con-MRA. LEVEL OF EVIDENCE 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:1843-1851.
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Affiliation(s)
- Zhiyong Lin
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Xiaodong Zhang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Li Guo
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Ke Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Yuan Jiang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Xiaoyu Hu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Yong Huang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Juan Wei
- Philips Research China, Shanghai, China
| | - Shuai Ma
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Yi Liu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Lina Zhu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | | | - Jing Liu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Xiaoying Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
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15
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Edelman RR, Koktzoglou I. Noncontrast MR angiography: An update. J Magn Reson Imaging 2019; 49:355-373. [PMID: 30566270 PMCID: PMC6330154 DOI: 10.1002/jmri.26288] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/24/2018] [Accepted: 07/26/2018] [Indexed: 12/12/2022] Open
Abstract
Both computed tomography (CT) angiography (CTA) and contrast-enhanced MR angiography (CEMRA) have proven to be useful and accurate cross-sectional imaging modalities over a wide range of vascular territories and vascular disorders. A key advantage of MRA is that, unlike CTA, it can be performed without the administration of a contrast agent. In this review article we consider the motivations for using noncontrast MRA, potential contrast mechanisms, imaging techniques, advantages, and drawbacks with respect to CTA and CEMRA, and the level of evidence for using the various MRA techniques. In addition, we explore new developments that promise to expand the reliability and range of clinical applications for noncontrast MRA, along with functional MRA capabilities not available with CTA or CEMRA. Level of Evidence: 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:355-373.
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Affiliation(s)
- Robert R. Edelman
- Radiology, Northshore University HealthSystem, Evanston, IL
- Radiology, Northwestern Memorial Hospital, Chicago, IL
| | - Ioannis Koktzoglou
- Radiology, Northshore University HealthSystem, Evanston, IL
- Radiology, University of Chicago Pritzker School of Medicine, Chicago, IL
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16
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Non contrast, Pseudo-Continuous Arterial Spin Labeling and Accelerated 3-Dimensional Radial Acquisition Intracranial 3-Dimensional Magnetic Resonance Angiography for the Detection and Classification of Intracranial Arteriovenous Shunts. Invest Radiol 2018; 53:80-86. [PMID: 28937545 DOI: 10.1097/rli.0000000000000411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this study was to assess the sensitivity and specificity of pseudo-continuous arterial spin labeling (PCASL) magnetic resonance angiography (MRA) with 3-dimensional (3D) radial acquisition for the detection of intracranial arteriovenous (AV) shunts. MATERIALS AND METHODS A total of 32 patients who underwent PCASL-MRA, clinical magnetic resonance imaging (MRI)/MRA exam, and digital subtraction angiography (DSA) were included in this retrospective analysis. Twelve patients presented with AV shunts. Among these were 8 patients with AV malformations (AVM) and 4 patients with AV fistulas (AVF). The clinical MRI/MRA included 3D time-of-flight MRA in all cases and time-resolved, contrast-enhanced MRA in 9 cases (6 cases with AV shunting). Research MRI and clinical MRI were independently evaluated by 2 neuroradiologists blinded to patient history. A third radiologist evaluated DSA imaging. A diagnostic confidence score was used for the presence of abnormalities associated with AV shunting (1-5). The AVMs were characterized using the Spetzler-Martin scale, whereas AVFs were characterized using the Borden classification. κ Statistics were applied to assess intermodality agreement. RESULTS Compared with clinical MRA, noncontrast PCASL-MRA with 3D radial acquisition yielded excellent sensitivity and specificity for the detection of intracranial AV shunts (reader 1: 100%/100%, clinical MRA: 91.7%, 94.4%; reader 2: 91.7%/100%, clinical MRA: 91.7%/100%). Diagnostic confidence was 4.8/4.66 with PCASL-MRA and 4.25/4.66 with clinical MRA. For AVM characterization with PCASL-MRA, intermodality agreement with DSA showed κ values of 0.43 and 0.6 for readers 1 and 2, respectively. For AVF characterization, intermodality agreement showed κ values of 0.56 for both readers. CONCLUSION Noncontrast PCASL-MRA with 3D radial acquisition is a potential tool for the detection and characterization of intracranial AV shunts with a sensitivity and specificity equivalent or higher than routine clinical MRA.
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17
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Lin A, Rawal S, Agid R, Mandell DM. Cerebrovascular Imaging: Which Test is Best? Neurosurgery 2017; 83:5-18. [DOI: 10.1093/neuros/nyx325] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 05/12/2017] [Indexed: 11/12/2022] Open
Abstract
Abstract
Optimal diagnosis and characterization of cerebrovascular disease requires selection of the appropriate imaging exam for each clinical situation. In this review, we focus on intracranial arterial disease and discuss the techniques in current clinical use for imaging the blood vessel lumen and blood vessel wall, and for mapping cerebral hemodynamic impairment at the tissue level. We then discuss specific strategies for imaging intracranial aneurysms, arteriovenous malformations, dural arterial venous fistulas, and arterial steno-occlusive disease.
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Affiliation(s)
- Amy Lin
- Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital and the University of Toronto, Toronto, Ontario, Canada
| | - Sapna Rawal
- Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital and the University of Toronto, Toronto, Ontario, Canada
| | - Ronit Agid
- Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital and the University of Toronto, Toronto, Ontario, Canada
| | - Daniel M Mandell
- Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital and the University of Toronto, Toronto, Ontario, Canada
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18
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Zhou Z, Han F, Yu S, Yu D, Rapacchi S, Song HK, Wang DJJ, Hu P, Yan L. Accelerated noncontrast-enhanced 4-dimensional intracranial MR angiography using golden-angle stack-of-stars trajectory and compressed sensing with magnitude subtraction. Magn Reson Med 2017; 79:867-878. [PMID: 28480537 DOI: 10.1002/mrm.26747] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/12/2017] [Accepted: 04/14/2017] [Indexed: 11/10/2022]
Abstract
PURPOSE To evaluate the feasibility and performance of compressed sensing (CS) with magnitude subtraction regularization in accelerating non-contrast-enhanced dynamic intracranial MR angiography (NCE-dMRA). METHODS A CS algorithm was introduced in NCE-dMRA by exploiting the sparsity of the magnitude difference of the control and label images. The NCE-dMRA data were acquired using golden-angle stack-of-stars trajectory on six healthy volunteers and one patient with arteriovenous fistula. Images were reconstructed using (i) the proposed magnitude-subtraction CS (MS-CS); (ii) complex-subtraction CS; (iii) independent CS; and (iv) view-sharing with k-space weighted image contrast (KWIC). The dMRA image quality was compared across the four reconstruction strategies. The proposed MS-CS method was further compared with KWIC for temporal fidelity of depicting dynamic flow. RESULTS The proposed MS-CS method was able to reconstruct NCE-dMRA images with detailed vascular structures and clean background. It provided better subjective image quality than the other two CS strategies (P < 0.05). Compared with KWIC, MS-CS showed similar image quality, but reduced temporal blurring in delineating the fine distal arteries. CONCLUSIONS The MS-CS method is a promising CS technique for accelerating NCE-dMRA acquisition without compromising image quality and temporal fidelity. Magn Reson Med 79:867-878, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Ziwu Zhou
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Fei Han
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Songlin Yu
- Department of Neurology, University of California, Los Angeles, California, USA.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dandan Yu
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Stanislas Rapacchi
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Hee Kwon Song
- Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA
| | - Danny J J Wang
- Laboratory of Functional MRI Technology, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Peng Hu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Lirong Yan
- Laboratory of Functional MRI Technology, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Lang S, Gölitz P, Struffert T, Rösch J, Rössler K, Kowarschik M, Strother C, Doerfler A. 4D DSA for Dynamic Visualization of Cerebral Vasculature: A Single-Center Experience in 26 Cases. AJNR Am J Neuroradiol 2017; 38:1169-1176. [PMID: 28408632 DOI: 10.3174/ajnr.a5161] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/23/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE 4D DSA allows acquisition of time-resolved 3D reconstructions of cerebral vessels by using C-arm conebeam CT systems. The aim of our study was to evaluate this new method by qualitative and quantitative means. MATERIALS AND METHODS 2D and 4D DSA datasets were acquired in patients presenting with AVMs, dural arteriovenous fistulas, and cerebral aneurysms. 4D DSA was compared with 2D DSA in a consensus reading of qualitative and quantitative parameters of AVMs (eg, location, feeder, associated aneurysms, nidus size, drainage, Martin-Spetzler Score), dural arteriovenous fistulas (eg, fistulous point, main feeder, diameter of the main feeder, drainage), and cerebral aneurysms (location, neck configuration, aneurysmal size). Identifiability of perforators and diameters of the injection vessel (ICA, vertebral artery) were analyzed in 2D and 4D DSA. Correlation coefficients and a paired t test were calculated for quantitative parameters. The effective patient dose of the 4D DSA protocol was evaluated with an anthropomorphic phantom. RESULTS In 26 patients, datasets were acquired successfully (AVM = 10, cerebral aneurysm = 10, dural arteriovenous fistula = 6). Qualitative and quantitative evaluations of 4D DSA in AVMs (nidus size: r = 0.99, P = .001), dural arteriovenous fistulas (diameter of the main feeder: r = 0.954, P = .03), and cerebral aneurysms (aneurysmal size: r = 1, P = .001) revealed nearly complete accordance with 2D DSA. Perforators were comparably visualized with 4D DSA. Measurement of the diameter of the injection vessel in 4D DSA was equivalent to that in 2D DSA (P = .039). The effective patient dose of 4D DSA was 1.2 mSv. CONCLUSIONS 4D DSA is feasible for imaging of AVMs, dural arteriovenous fistulas, and cerebral aneurysms. 4D DSA offers reliable visualization of the cerebral vasculature and may improve the understanding and treatment of AVMs and dural arteriovenous fistulas. The number of 2D DSA acquisitions required for an examination may be reduced through 4D DSA.
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Affiliation(s)
- S Lang
- From the Departments of Neuroradiology (S.L., P.G., T.S., J.R., A.D.)
| | - P Gölitz
- From the Departments of Neuroradiology (S.L., P.G., T.S., J.R., A.D.)
| | - T Struffert
- From the Departments of Neuroradiology (S.L., P.G., T.S., J.R., A.D.)
| | - J Rösch
- From the Departments of Neuroradiology (S.L., P.G., T.S., J.R., A.D.)
| | - K Rössler
- Neurosurgery (K.R.), University of Erlangen-Nuremberg, Erlangen, Germany
| | - M Kowarschik
- Angiography & Interventional X-Ray Systems (M.K.), Siemens Healthcare GmbH, Forchheim, Germany
| | - C Strother
- Department of Radiology (C.S.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - A Doerfler
- From the Departments of Neuroradiology (S.L., P.G., T.S., J.R., A.D.)
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Ozyurt O, Dincer A, Erdem Yildiz M, Peker S, Yilmaz M, Sengoz M, Ozturk C. Integration of arterial spin labeling into stereotactic radiosurgery planning of cerebral arteriovenous malformations. J Magn Reson Imaging 2017; 46:1718-1727. [DOI: 10.1002/jmri.25690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/13/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Onur Ozyurt
- Bogazici University; Institute of Biomedical Engineering; Istanbul Turkey
- Acibadem University; Neuroradiology Research Center; Istanbul Turkey
| | - Alp Dincer
- Acibadem University; Neuroradiology Research Center; Istanbul Turkey
- Acibadem University; Department of Radiology, School of Medicine; Istanbul Turkey
| | - Mehmet Erdem Yildiz
- Acibadem University; Neuroradiology Research Center; Istanbul Turkey
- Acibadem University; Department of Radiology, School of Medicine; Istanbul Turkey
| | - Selcuk Peker
- Acibadem University; Department of Neurosurgery, School of Medicine; Istanbul Turkey
| | - Meltem Yilmaz
- Acibadem Kozyatagi Hospital; Department of Radiation Oncology, School of Medicine; Istanbul Turkey
| | - Meric Sengoz
- Acibadem Kozyatagi Hospital; Department of Radiation Oncology, School of Medicine; Istanbul Turkey
| | - Cengizhan Ozturk
- Bogazici University; Institute of Biomedical Engineering; Istanbul Turkey
- Bogazici University; Center for Life Sciences and Technologies; Istanbul Turkey
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21
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Koktzoglou I, Walker MT, Meyer JR, Murphy IG, Edelman RR. Nonenhanced hybridized arterial spin labeled magnetic resonance angiography of the extracranial carotid arteries using a fast low angle shot readout at 3 Tesla. J Cardiovasc Magn Reson 2016; 18:18. [PMID: 27067840 PMCID: PMC4828773 DOI: 10.1186/s12968-016-0238-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate ungated nonenhanced hybridized arterial spin labeling (hASL) magnetic resonance angiography (MRA) of the extracranial carotid arteries using a fast low angle shot (FLASH) readout at 3 Tesla. METHODS In this retrospective, institutional review board-approved and HIPAA-compliant study, we evaluated the image quality (4-point scale) of nonenhanced hASL MRA using a FLASH readout with respect to contrast-enhanced MRA (CEMRA) in 37 patients presenting with neurologic symptoms. Two certified neuroradiologists independently evaluated 407 arterial segments (11 per patient) for image quality. The presence of vascular pathology was determined by consensus reading. Gwet's AC1 was used to assess inter-rater agreement in image quality scores, and image quality scores were correlated with age and body mass index. Objective measurements of arterial lumen area and sharpness in the carotid arteries were compared to values obtained with CEMRA. Comparisons were also made with conventional nonenhanced 2D time-of-flight (TOF) MRA. RESULTS CEMRA provided the best image quality, while nonenhanced hASL FLASH MRA provided image quality that exceeded 2D TOF at the carotid bifurcation and in the internal and external carotid arteries. All nine vascular abnormalities of the carotid and intracranial arteries detected by CEMRA were depicted with hASL MRA, with no false positives. Inter-rater agreement of image quality scores was highest for CEMRA (AC1 = 0.87), followed by hASL (AC1 = 0.61) and TOF (AC1 = 0.43) (P < 0.001, all comparisons). With respect to CEMRA, agreement in cross-sectional lumen area was significantly better with hASL than TOF in the common carotid artery (intraclass correlation (ICC) = 0.90 versus 0.66; P < 0.05) and at the carotid bifurcation (ICC = 0.87 versus 0.54; P < 0.05). Nonenhanced hASL MRA provided superior arterial sharpness with respect to CEMRA and 2D TOF (P < 0.001). CONCLUSION Although inferior to CEMRA in terms of image quality and inter-rater agreement, hASL FLASH MRA offers an alternative to 2D TOF for the nonenhanced evaluation of the extracranial carotid arteries at 3 Tesla. Compared with 2D TOF, nonenhanced hASL FLASH MRA provides improved quantification of arterial cross-sectional area, vessel sharpness, inter-rater agreement and image quality.
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Affiliation(s)
- Ioannis Koktzoglou
- />Department of Radiology, NorthShore University HealthSystem, Evanston, USA
- />University of Chicago Pritzker School of Medicine, Chicago, USA
| | - Matthew T. Walker
- />Department of Radiology, NorthShore University HealthSystem, Evanston, USA
- />University of Chicago Pritzker School of Medicine, Chicago, USA
| | - Joel R. Meyer
- />Department of Radiology, NorthShore University HealthSystem, Evanston, USA
- />University of Chicago Pritzker School of Medicine, Chicago, USA
| | - Ian G. Murphy
- />Department of Radiology, NorthShore University HealthSystem, Evanston, USA
- />Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Robert R. Edelman
- />Department of Radiology, NorthShore University HealthSystem, Evanston, USA
- />Northwestern University Feinberg School of Medicine, Chicago, USA
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22
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Fujima N, Osanai T, Shimizu Y, Yoshida A, Harada T, Nakayama N, Kudo K, Houkin K, Shirato H. Utility of noncontrast-enhanced time-resolved four-dimensional MR angiography with a vessel-selective technique for intracranial arteriovenous malformations. J Magn Reson Imaging 2016; 44:834-45. [PMID: 26970348 DOI: 10.1002/jmri.25222] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/23/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To evaluate the utility of a vessel-selective four-dimensional (4D) magnetic resonance angiography (MRA) technique for the evaluation of intracranial arteriovenous malformations (AVMs). MATERIALS AND METHODS Twelve AVM patients were evaluated retrospectively. Time-of-flight (TOF) MRA, nonvessel-selective 4D-MRA (NS-4D-MRA), and vessel-selective 4D-MRA (VS-4D-MRA) were performed using a 3T MR unit in all patients, and used to identify feeding arteries and draining veins and measure nidus size. The diagnostic accuracy of the three techniques was compared using digital subtraction angiography (DSA). If a multifeeder was observed, the percentage of blood flow of each feeding artery to the entire nidus was evaluated and compared to the DSA findings using the "error value," defined as the degree of overestimation of the blood flow. All imaging findings were assessed by two neuroradiologists. RESULTS In both raters, the detectability of feeding arteries by VS-4D-MRA (12 and 11 patients) was significantly higher than those of TOF-MRA (7 and 6 patients) and NS-4D-MRA (8 and 7 patients) (P < 0.016). The detectability of drainer veins by TOF-MRA (10 and 10 patients) was significantly higher than that of VS-4D-MRA (7 and 6 patients). In the percentage of the blood flow of each feed artery to the entire nidus, the DSA findings (error value; 27.1 ± 5.7) indicated overestimations of the blood flow compared to the VS-4D-MRA (error value; 7.1 ± 3.9) (P < 0.001). CONCLUSION VS-4D-MRA was shown to be a useful technique for the evaluation of intracranial AVMs, especially for detecting feed arteries and estimating details of the nidus structure. J. MAGN. RESON. IMAGING 2016;44:834-845.
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Affiliation(s)
- Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
| | - Toshiya Osanai
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yukie Shimizu
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Atsushi Yoshida
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Taisuke Harada
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Naoki Nakayama
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kohsuke Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Kiyohiro Houkin
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroki Shirato
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Global Station for Quantum Medical Science and Engineering, Global Institution for collaborative research and education, Sapporo, Japan
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23
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Wojak JC, Abruzzo TA, Bello JA, Blackham KA, Hirsch JA, Jayaraman MV, Dariushnia SR, Meyers PM, Midia M, Russell EJ, Walker TG, Nikolic B. Quality Improvement Guidelines for Adult Diagnostic Cervicocerebral Angiography: Update Cooperative Study between the Society of Interventional Radiology (SIR), American Society of Neuroradiology (ASNR), and Society of NeuroInterventional Surgery (SNIS). J Vasc Interv Radiol 2015; 26:1596-608. [DOI: 10.1016/j.jvir.2015.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/07/2015] [Accepted: 07/07/2015] [Indexed: 12/19/2022] Open
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24
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Proisy M, Bruneau B, Rozel C, Tréguier C, Chouklati K, Riffaud L, Darnault P, Ferré JC. Arterial spin labeling in clinical pediatric imaging. Diagn Interv Imaging 2015; 97:151-8. [PMID: 26456912 DOI: 10.1016/j.diii.2015.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 10/22/2022]
Abstract
Arterial spin labeling (ASL) perfusion-weighted magnetic resonance imaging is the only approach that enables direct and non-invasive quantitative measurement of cerebral blood flow in the brain regions without administration of contrast material and without radiation. ASL is thus a promising perfusion imaging method for assessing cerebral blood flow in the pediatric population. Concerning newborns, there are current limitations because of their smaller brain size and lower brain perfusion. This article reviews and illustrates the use of ASL in pediatric clinical practice and discusses emerging cerebral perfusion imaging applications for children due to the highly convenient implementation of the ASL sequence.
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Affiliation(s)
- M Proisy
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France; Inserm VisAGeS unité/projet U746, UMR 6074, Irisa, université Rennes 1, 35043 Rennes cedex, France.
| | - B Bruneau
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - C Rozel
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - C Tréguier
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - K Chouklati
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - L Riffaud
- Department of Pediatric Neurosurgery, CHU de Rennes, 2, rue Henri-Le-Guillou, 35033 Rennes cedex 9, France
| | - P Darnault
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - J-C Ferré
- Inserm VisAGeS unité/projet U746, UMR 6074, Irisa, université Rennes 1, 35043 Rennes cedex, France; Department of Radiology, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France
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25
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Interest of HYPR flow dynamic MRA for characterization of cerebral arteriovenous malformations: comparison with TRICKS MRA and catheter DSA. Eur Radiol 2015; 25:3230-7. [DOI: 10.1007/s00330-015-3745-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 03/04/2015] [Accepted: 03/26/2015] [Indexed: 10/23/2022]
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26
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Raoult H, Bannier E, Maurel P, Neyton C, Ferré JC, Schmitt P, Barillot C, Gauvrit JY. Hemodynamic Quantification in Brain Arteriovenous Malformations With Time-Resolved Spin-Labeled Magnetic Resonance Angiography. Stroke 2014; 45:2461-4. [DOI: 10.1161/strokeaha.114.006080] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hélène Raoult
- From the CHU Rennes, Department of Neuroradiology, Rennes, France (H.R., J.-C.F., J.-Y.G.); Unité VISAGES U746 INSERM-INRIA, IRISA UMR CNRS 6074, University of Rennes, Rennes, France (H.R., E.B., P.M., C.N., J.-C.F., C.B., J.-Y.G); and MR Application & Workflow Development, Siemens AG, Healthcare Sector, Erlangen, Germany (P.S.)
| | - Elise Bannier
- From the CHU Rennes, Department of Neuroradiology, Rennes, France (H.R., J.-C.F., J.-Y.G.); Unité VISAGES U746 INSERM-INRIA, IRISA UMR CNRS 6074, University of Rennes, Rennes, France (H.R., E.B., P.M., C.N., J.-C.F., C.B., J.-Y.G); and MR Application & Workflow Development, Siemens AG, Healthcare Sector, Erlangen, Germany (P.S.)
| | - Pierre Maurel
- From the CHU Rennes, Department of Neuroradiology, Rennes, France (H.R., J.-C.F., J.-Y.G.); Unité VISAGES U746 INSERM-INRIA, IRISA UMR CNRS 6074, University of Rennes, Rennes, France (H.R., E.B., P.M., C.N., J.-C.F., C.B., J.-Y.G); and MR Application & Workflow Development, Siemens AG, Healthcare Sector, Erlangen, Germany (P.S.)
| | - Clément Neyton
- From the CHU Rennes, Department of Neuroradiology, Rennes, France (H.R., J.-C.F., J.-Y.G.); Unité VISAGES U746 INSERM-INRIA, IRISA UMR CNRS 6074, University of Rennes, Rennes, France (H.R., E.B., P.M., C.N., J.-C.F., C.B., J.-Y.G); and MR Application & Workflow Development, Siemens AG, Healthcare Sector, Erlangen, Germany (P.S.)
| | - Jean-Christophe Ferré
- From the CHU Rennes, Department of Neuroradiology, Rennes, France (H.R., J.-C.F., J.-Y.G.); Unité VISAGES U746 INSERM-INRIA, IRISA UMR CNRS 6074, University of Rennes, Rennes, France (H.R., E.B., P.M., C.N., J.-C.F., C.B., J.-Y.G); and MR Application & Workflow Development, Siemens AG, Healthcare Sector, Erlangen, Germany (P.S.)
| | - Peter Schmitt
- From the CHU Rennes, Department of Neuroradiology, Rennes, France (H.R., J.-C.F., J.-Y.G.); Unité VISAGES U746 INSERM-INRIA, IRISA UMR CNRS 6074, University of Rennes, Rennes, France (H.R., E.B., P.M., C.N., J.-C.F., C.B., J.-Y.G); and MR Application & Workflow Development, Siemens AG, Healthcare Sector, Erlangen, Germany (P.S.)
| | - Christian Barillot
- From the CHU Rennes, Department of Neuroradiology, Rennes, France (H.R., J.-C.F., J.-Y.G.); Unité VISAGES U746 INSERM-INRIA, IRISA UMR CNRS 6074, University of Rennes, Rennes, France (H.R., E.B., P.M., C.N., J.-C.F., C.B., J.-Y.G); and MR Application & Workflow Development, Siemens AG, Healthcare Sector, Erlangen, Germany (P.S.)
| | - Jean-Yves Gauvrit
- From the CHU Rennes, Department of Neuroradiology, Rennes, France (H.R., J.-C.F., J.-Y.G.); Unité VISAGES U746 INSERM-INRIA, IRISA UMR CNRS 6074, University of Rennes, Rennes, France (H.R., E.B., P.M., C.N., J.-C.F., C.B., J.-Y.G); and MR Application & Workflow Development, Siemens AG, Healthcare Sector, Erlangen, Germany (P.S.)
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