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Liu D, Zhu D, Qin Q. Direct angiographic comparison of different velocity-selective saturation, inversion, and DANTE labeling modules on cerebral arteries. Magn Reson Med 2024; 92:761-771. [PMID: 38523590 PMCID: PMC11142876 DOI: 10.1002/mrm.30085] [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: 12/01/2023] [Revised: 02/07/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE This study evaluated the velocity-selective (VS) MRA with different VS labeling modules, including double refocused hyperbolic tangent, eight-segment B1-insensitive rotation, delay alternating with nutation for tailored excitation, Fourier transform-based VS saturation, and Fourier transform-based inversion. METHODS These five VS labeling modules were evaluated first through Bloch simulations, and then using VSMRA directly on various cerebral arteries of healthy subjects. The relative signal ratios from arterial ROIs and surrounding tissues as well as relative arteria-tissue contrast ratios of different methods were compared. RESULTS Double refocused hyperbolic tangent and eight-segment B1-insensitive rotation showed very similar labeling effects. Delay alternating with nutation for tailored excitation yielded high arterial signal but with residual tissue signal due to the spatial banding effect. Fourier transform-based VS saturation with half the time of other techniques serves as an efficient nonsubtractive VSMRA method, but the remaining tissue signal still obscured some small distal arteries that were delineated by other subtraction-based VSMRA, allowing more complete cancelation of static tissue. Fourier transform-based inversion produced the highest arterial signal in VSMRA with minimal tissue background. CONCLUSION This is the first study that angiographically compared five different VS labeling modules. Their labeling characteristics on arteries and tissue and implications for VSMRA and VS arterial spin labeling are discussed.
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Affiliation(s)
- Dapeng Liu
- Department of Radiology and Radiological Science; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Dan Zhu
- Department of Radiology and Radiological Science; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Qin Qin
- Department of Radiology and Radiological Science; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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de Buck MHS, Jezzard P, Hess AT. An extended phase graph-based framework for DANTE-SPACE simulations including physiological, temporal, and spatial variations. Magn Reson Med 2024; 92:332-345. [PMID: 38469983 DOI: 10.1002/mrm.30071] [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: 10/13/2023] [Revised: 01/18/2024] [Accepted: 02/09/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE The delay alternating with nutation for tailored excitation (DANTE)-sampling perfection with application-optimized contrasts (SPACE) sequence facilitates 3D intracranial vessel wall imaging with simultaneous suppression of blood and CSF. However, the achieved image contrast depends closely on the selected sequence parameters, and the clinical use of the sequence is limited in vivo by observed signal variations in the vessel wall, CSF, and blood. This paper introduces a comprehensive DANTE-SPACE simulation framework, with the aim of providing a better understanding of the underlying contrast mechanisms and facilitating improved parameter selection and contrast optimization. METHODS An extended phase graph formalism was developed for efficient spin ensemble simulation of the DANTE-SPACE sequence. Physiological processes such as pulsatile flow velocity variation, varying flow directions, intravoxel velocity variation, diffusion, andB 1 + $$ {\mathrm{B}}_1^{+} $$ effects were included in the framework to represent the mechanisms behind the achieved signal levels accurately. RESULTS Intravoxel velocity variation improved temporal stability and robustness against small velocity changes. Time-varying pulsatile velocity variation affected CSF simulations, introducing periods of near-zero velocity and partial rephasing. Inclusion of diffusion effects was found to substantially reduce the CSF signal. Blood flow trajectory variations had minor effects, butB 1 + $$ {\mathrm{B}}_1^{+} $$ differences along the trajectory reduced DANTE efficiency in low-B 1 + $$ {\mathrm{B}}_1^{+} $$ areas. Introducing low-velocity pulsatility of both CSF and vessel wall helped explain the in vivo observed signal heterogeneity in both tissue types. CONCLUSION The presented simulation framework facilitates a more comprehensive optimization of DANTE-SPACE sequence parameters. Furthermore, the simulation framework helps to explain observed contrasts in acquired data.
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Affiliation(s)
- Matthijs H S de Buck
- Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Spinoza Centre for Neuroimaging, Amsterdam, The Netherlands
| | - Peter Jezzard
- Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Aaron T Hess
- Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Liao L, Chen J, Liu Z, Liang S, Qin L, Lin X, Pan S, Tan M, Huang L, Ruan Q, Huang Z, Shi C, Xie G. Direct abdominal vein thrombus imaging (DATI): a contrast-free black-blood MR technique for the diagnosis of abdominal vein thrombosis. Abdom Radiol (NY) 2024:10.1007/s00261-024-04335-3. [PMID: 38780634 DOI: 10.1007/s00261-024-04335-3] [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: 02/25/2024] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES To develop and evaluate a direct abdominal vein thrombus imaging (DATI) technique, based on a respiratory navigating SPACE sequence with DANTE black-blood preparation, for diagnosing abdominal vein thrombosis (AVT) without the use of exogenous contrast agents. METHODS We prospectively enrolled 10 healthy subjects and 28 suspected AVT patients who underwent DATI scans on 3.0 T MRI. Contrast-enhanced CT venography (CTV) was also conducted on the suspected AVT patients for comparison. All images were analyzed by two blinded radiologists who independently evaluated randomized images and gave image quality and diagnostic confidence scores (1-poor, 4-excellent) for DATI and CTV. The accuracy (ACC), sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) of CTV were calculated using CTV as a standard reference. The diagnostic agreement between DATI and CTV as well as the interobserver agreement were conducted using Cohen κ test. RESULTS The patient study demonstrated that DATI can provide adequate thrombus signal intensity and the contrast between the thrombus to dark venous lumen for the diagnosis of AVT. It offers good to excellent image quality (reader1/reader2: 3.50 ± 0.64/3.42 ± 0.63, κ = 0.872) and diagnostic confidence (reader1/reader2: 3.71 ± 0.53/3.78 ± 0.42, κ = 0.804) for the diagnosis of AVT. Taking CTV as a reference, DATI has high accuracy (96.6%), SE (91.5%), SP (98.0%), PPV (92.3%), and NPV (97.8%). DATA CONCLUSION DATI can provide good to excellent image quality, effective venous blood signal suppression, and definitive thrombus detection for the diagnosis of AVT without the use of exogenous contrast agents.
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Affiliation(s)
- Liping Liao
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Jiayuan Chen
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Zeping Liu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, #A2-607, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou, 511436, Guangdong, People's Republic of China
| | - Shengyuan Liang
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Lei Qin
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Xinmei Lin
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Shengzhang Pan
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Mingxia Tan
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Lanbin Huang
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Qizeng Ruan
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China
| | - Zehe Huang
- Department of Radiology, The First People's Hospital of Qinzhou, Qinnan District, Mingyang Road, Qinzhou, 535000, Guangxi, People's Republic of China.
| | - Caiyun Shi
- School of Biomedical Engineering, The Fourth Affiliated Hospital, Guangzhou Medical University, Guangdong, People's Republic of China.
| | - Guoxi Xie
- School of Biomedical Engineering, The Fourth Affiliated Hospital, Guangzhou Medical University, Guangdong, People's Republic of China
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Gemmete JJ. Vessel Wall Characterization Using Quantitative MR Imaging. Neuroimaging Clin N Am 2024; 34:281-292. [PMID: 38604712 DOI: 10.1016/j.nic.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
MR imaging's exceptional capabilities in vascular imaging stem from its ability to visualize and quantify vessel wall features, such as plaque burden, composition, and biomechanical properties. The application of advanced MR imaging techniques, including two-dimensional and three-dimensional black-blood MR imaging, T1 and T2 relaxometry, diffusion-weighted imaging, and dynamic contrast-enhanced MR imaging, wall shear stress, and arterial stiffness, empowers clinicians and researchers to explore the intricacies of vascular diseases. This array of techniques provides comprehensive insights into the development and progression of vascular pathologies, facilitating earlier diagnosis, targeted treatment, and improved patient outcomes in the management of vascular health.
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Affiliation(s)
- Joseph J Gemmete
- Department of Radiology, Michigan Medicine, 1500 East Medican Center Drive, UH B1D 328, Ann Arbor, MI 48109.
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Yang H, Huang G, Li X, Wu M, Zhou W, Yin X, Zhang M, Chen Z. High-resolution magnetic resonance vessel wall imaging provides new insights into Moyamoya disease. Front Neurosci 2024; 18:1375645. [PMID: 38665292 PMCID: PMC11043609 DOI: 10.3389/fnins.2024.1375645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/13/2024] [Indexed: 04/28/2024] Open
Abstract
Moyamoya disease (MMD) is a rare condition that affects the blood vessels of the central nervous system. This cerebrovascular disease is characterized by progressive narrowing and blockage of the internal carotid, middle cerebral, and anterior cerebral arteries, which results in the formation of a compensatory fragile vascular network. Currently, digital subtraction angiography (DSA) is considered the gold standard in diagnosing MMD. However, this diagnostic technique is invasive and may not be suitable for all patients. Hence, non-invasive imaging methods such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are often used. However, these methods may have less reliable diagnostic results. Therefore, High-Resolution Magnetic Resonance Vessel Wall Imaging (HR-VWI) has emerged as the most accurate method for observing and analyzing arterial wall structure. It enhances the resolution of arterial walls and enables quantitative and qualitative analysis of plaque, facilitating the identification of atherosclerotic lesions, vascular entrapment, myofibrillar dysplasia, moyamoya vasculopathy, and other related conditions. Consequently, HR-VWI provides a new and more reliable evaluation criterion for diagnosing vascular lesions in patients with Moyamoya disease.
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Affiliation(s)
- Hui Yang
- Department of Neurology, Clinical Medical School of Jiujiang University, Jiujiang, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
- School of Basic Medicine, Jiujiang University, Jiujiang, China
| | - Guilan Huang
- Department of Neurology, Clinical Medical School of Jiujiang University, Jiujiang, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
| | - Xi Li
- Department of Neurology, University of California Irvine Medical Center, Irvine, CA, United States
| | - Moxin Wu
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
| | - Weixin Zhou
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
| | - Xiaoping Yin
- Department of Neurology, Clinical Medical School of Jiujiang University, Jiujiang, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
| | - Manqing Zhang
- School of Basic Medicine, Jiujiang University, Jiujiang, China
| | - Zhiying Chen
- Department of Neurology, Clinical Medical School of Jiujiang University, Jiujiang, China
- Jiujiang Clinical Precision Medicine Research Center, Jiujiang, China
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Tagawa H, Fushimi Y, Funaki T, Nakajima S, Sakata A, Okuchi S, Hinoda T, Grinstead J, Ahn S, Hidaka Y, Yoshida K, Miyamoto S, Nakamoto Y. Vessel wall MRI in moyamoya disease: arterial wall enhancement varies depending on age, arteries, and disease progression. Eur Radiol 2024; 34:2183-2194. [PMID: 37798407 DOI: 10.1007/s00330-023-10251-9] [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: 12/07/2022] [Revised: 07/19/2023] [Accepted: 08/08/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE To investigate the relationship of followings for patients with moyamoya disease (MMD): arterial wall enhancement on vessel wall MRI (VW-MRI), cross-sectional area (CSA), time-of-flight MR angiography (MRA), age, locations from intracranial internal carotid artery (ICA) to proximal middle cerebral artery (MCA), disease progression, and transient ischemic attack (TIA). METHODS Patients who underwent VW-MRI between October 2018 and December 2020 were enrolled in this retrospective study. We measured arterial wall enhancement (enhancement ratio, ER) and CSA at five sections of ICA and MCA. Also, we scored MRA findings. Multiple linear regression (MLR) analysis was performed to explore the associations between ER, age, MRA score, CSA, history of TIA, and surgical revascularization. RESULTS We investigated 102 sides of 51 patients with MMD (35 women, 16 men, mean age 31 years ± 18 [standard deviation]). ER for MRA score 2 (signal discontinuity) was higher than ER for other scores in sections D (end of ICA) and E (proximal MCA) on MLR analysis. ER in section E was significantly higher in patients for MRA score 2 with TIA history than without. ER significantly increased as CSA increased in section E, which suggests ER becomes less in decreased CSA due to negative remodeling. CONCLUSION Arterial wall enhancement in MMD varies by age, location, and disease progression. Arterial wall enhancement may be stronger in the progressive stage of MMD. Arterial wall enhancement increases with history of TIA at proximal MCA, which may indicate the progression of the disease. CLINICAL RELEVANCE STATEMENT Arterial wall enhancement in moyamoya disease varies by age, location of arteries, and disease progression, and arterial wall enhancement may be used as an imaging biomarker of moyamoya disease. KEY POINTS It has not been clarified what arterial wall enhancement in moyamoya disease represents. Arterial wall enhancement in moyamoya disease varies by age, location of arteries, and disease progression. Arterial wall enhancement in moyamoya disease increases as the disease progresses.
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Affiliation(s)
- Hiroshi Tagawa
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Takeshi Funaki
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Sachi Okuchi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takuya Hinoda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | | | - Sinyeob Ahn
- Siemens Healthineers, San Francisco, CA, USA
| | - Yu Hidaka
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Nie Y, Lu N, Liao L, Liu Z, Gu A, Huang X, Tie C, Liu H, Huang Z, Xie G. Black-Blood Magnetization Prepared 2 Rapid Acquisition Gradient Echoes: A Fast and Three-Dimensional MR Black-Blood T 1 Mapping Technique for Quantitative Assessment of Atherosclerosis and Venous Thrombosis. J Magn Reson Imaging 2023. [PMID: 38009385 DOI: 10.1002/jmri.29156] [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: 08/28/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Blood flow signals may be a confounder in quantifying T1 values of plaque or thrombus and how to realize black-blood T1 mapping remains a challenge task. PURPOSE To develop a fast and three-dimensional black-blood T1 mapping technique for quantitative assessment of atherosclerosis and venous thrombosis. STUDY TYPE Sequence development and optimization via phantoms and volunteers as well as pilot prospective. PHANTOM AND SUBJECTS Numerical simulations, a standard phantom, 8 healthy volunteers (mean age, 22 ± 1 years; 5 males), and 19 patients (mean age, 57 ± 14 years; 13 males) with atherosclerosis or venous thrombosis. FIELD STRENGTH/SEQUENCE 3T/inversion recovery spin-echo sequence (IR-SE), magnetization prepared 2 rapid acquisition gradient echoes (MP2RAGE), and black-blood prepared MP2RAGE (BB-MP2RAGE). ASSESSMENT The black-blood preparation (i.e., delay alternating with nutation for tailored excitation, DANTE) was incorporated into MP2RAGE for black-blood T1 mapping. The BB-MP2RAGE was optimized numerically based on the Bloch equation, and then the phantom study was performed to verify the accuracy of T1 mapping by BB-MP2RAGE against IR-SE and MP2RAGE. Preliminary clinical validation was prospectively performed to assess the flow suppression effect and its potential application in plaque and thrombosis identification. STATISTICAL TESTS Pearson correlation test, Bland-Altman analysis, paired t-test, and intraclass correlation coefficient. A P value <0.05 indicates a statistically significant difference. RESULTS Phantom experiments showed comparable accuracy of T1 maps by BB-MP2RAGE with IR-SE and MP2RAGE (all r2 > 0.99); Compared to MP2RAGE, BB-MP2RAGE effectively nulled the blood flow signals, and had a significant improvement in contrast-to-noise ratio between static tissue and blood (250.5 ± 66.6 vs. 91.9 ± 35.9). BB-MP2RAGE can quantify plaque or thrombus T1 relaxation time with blood flow signal suppression. DATA CONCLUSION Accurate T1 mapping with sufficient blood flow suppression was achieved by BB-MP2RAGE. BB-MP2RAGE has the potential to quantitatively characterize atherosclerosis and venous thrombosis. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Yuhui Nie
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Na Lu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Liping Liao
- Department of Radiology, The First People's Hospital of Qinzhou, Qinzhou, China
| | - Zeping Liu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Anyan Gu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xin Huang
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Changjun Tie
- Paul C. Lauterbur Imaging Center, Shenzhen Institutes Advanced Technology, Shenzhen, Guangdong, China
| | - Hongyan Liu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zehe Huang
- Department of Radiology, The First People's Hospital of Qinzhou, Qinzhou, China
| | - Guoxi Xie
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
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de Buck MHS, Jezzard P, Frost R, Randell C, Hurst K, Choudhury RP, Robson MD, Biasiolli L. 10-channel phased-array coil for carotid wall MRI at 3T. PLoS One 2023; 18:e0288529. [PMID: 37556496 PMCID: PMC10411804 DOI: 10.1371/journal.pone.0288529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/27/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Accurate assessment of plaque accumulation near the carotid bifurcation is important for the effective prevention and treatment of stroke. However, vessel and plaque delineation using MRI can be limited by low contrast-to-noise ratio (CNR) and long acquisition times. In this work, a 10-channel phased-array receive coil design for bilateral imaging of the carotid bifurcation using 3T MRI is proposed. METHODS The proposed 10-channel receive coil was compared to a commercial 4-channel receive coil configuration using data acquired from phantoms and healthy volunteers (N = 9). The relative performance of the coils was assessed, by comparing signal-to-noise ratio (SNR), noise correlation, g-factor noise amplification, and the CNR between vessel wall and lumen using black-blood sequences. Patient data were acquired from 12 atherosclerotic carotid artery disease patients. RESULTS The 10-channel coil consistently provided substantially increased SNR in phantoms (+77 ± 27%) and improved CNR in healthy carotid arteries (+62 ± 11%), or reduced g-factor noise amplification. Patient data showed excellent delineation of atherosclerotic plaque along the length of the carotid bifurcation using the 10-channel coil. CONCLUSIONS The proposed 10-channel coil design allows for improved visualization of the carotid arteries and the carotid bifurcation and increased parallel imaging acceleration factors relative to a commercial 4-channel coil design.
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Affiliation(s)
- Matthijs H. S. de Buck
- Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Peter Jezzard
- Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Robert Frost
- Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States of America
- Department of Radiology, Harvard Medical School, Boston, MA, United States of America
| | | | - Katherine Hurst
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Robin P. Choudhury
- Acute Vascular Imaging Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Matthew D. Robson
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Perspectum, Gemini One, John Smith Drive, Oxford, United Kingdom
| | - Luca Biasiolli
- Acute Vascular Imaging Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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Peret A, Romero-Sanchez G, Dabiri M, McNally JS, Johnson KM, Mossa-Basha M, Eisenmenger LB. MR Angiography of Extracranial Carotid Disease. Magn Reson Imaging Clin N Am 2023; 31:395-411. [PMID: 37414468 DOI: 10.1016/j.mric.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Magnetic resonance angiography sequences, such as time-of-flight and contrast-enhanced angiography, provide clear depiction of vessel lumen, traditionally used to evaluate carotid pathologic conditions such as stenosis, dissection, and occlusion; however, atherosclerotic plaques with a similar degree of stenosis may vary tremendously from a histopathological standpoint. MR vessel wall imaging is a promising noninvasive method to evaluate the content of the vessel wall at high spatial resolution. This is particularly interesting in the case of atherosclerosis as vessel wall imaging can identify higher risk, vulnerable plaques as well as has potential applications in the evaluation of other carotid pathologic conditions.
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Affiliation(s)
- Anthony Peret
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53705, USA
| | - Griselda Romero-Sanchez
- Department of Radiology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Avenida Vasco de Quiroga No.15, Colonia Belisario Domínguez Sección XVI, Delegación Tlalpan C.P.14080, Ciudad de México, Mexico City, Mexico
| | - Mona Dabiri
- Radiology Department, Children's Medical Center, Tehran University of Medical Science, No 63, Gharib Avenue, Keshavarz Blv, Tehran 1419733151, Iran
| | - Joseph Scott McNally
- Department of Radiology, University of Utah, 50 N Medical Dr, Salt Lake City, UT 84132, USA
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53705, USA
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA
| | - Laura B Eisenmenger
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53705, USA.
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10
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Xie S, Ran Y, Wang X, Zhang Y, Fu Q, Ren Y, Liu J, Teng Z, Cheng J. Diagnostic potential of routine brain MRI and high-resolution, multi-contrast vessel wall imaging in the detection of internal carotid artery dissection. Front Neurol 2023; 14:1165453. [PMID: 37251240 PMCID: PMC10213939 DOI: 10.3389/fneur.2023.1165453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/14/2023] [Indexed: 05/31/2023] Open
Abstract
Objective Cervical artery dissection (CAD) is one of the major causes of stroke and most commonly occurs at the site of the extracranial internal carotid artery (ICA). This study aimed to assess the value of routine brain MRI, clinical information, and high-resolution, multi-contrast vessel wall MR imaging (hrVWI) for the timely detection of ICA dissection. Methods A total of 105 patients with CAD and 105 without CAD were recruited for this study. The lesion type in the patients was determined based on images from different modalities, including brain MRI, magnetic resonance angiography (MRA), computed tomography angiography (CTA), digital subtraction angiography (DSA), ultrasonography, and hrVWI and clinical information. Each lesion was reviewed to determine the type following a stepwise procedure by referring to (1) brain MRI only; (2) brain MRI and clinical information; (3) hrVWI only; and (4) hrVWI, CTA, DSA, and clinical information. Results Typical clinical presentations of patients with potential CAD include headache, neck pain, and/or Horner's syndrome. Representative imaging signs in the brain MRI included a crescentic or circular iso- or hyperintensity around the lumen, a curvilinear and isointense line crossing the lumen, or aneurysmal vessel dilation. Based on brain MRI alone, 54.3% (57/105) of the patients with CAD were correctly classified, and the accuracy increased to 73.3% (77/105) when clinical information was combined (P < 0.001) with high specificity and low sensitivity. Further analysis showed that hrVWI had the superior capability in detecting CAD, with a sensitivity and a specificity of 95.1% and 97.0%, respectively. Conclusion The combination of brain MRI and clinical information could be used for the diagnosis of CAD; however, hrVWI should be sought for uncertain cases.
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Affiliation(s)
- Shanshan Xie
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuncai Ran
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qichang Fu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanan Ren
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Juanfang Liu
- Department of Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhongzhao Teng
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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11
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Kim DJ, Lee HJ, Baik J, Hwang MJ, Miyoshi M, Kang Y. Improved Blood Suppression of Motion-Sensitized Driven Equilibrium in High-Resolution Whole-Brain Vessel Wall Imaging: Comparison of Contrast-Enhanced 3D T1-Weighted FSE with Motion-Sensitized Driven Equilibrium and Delay Alternating with Nutation for Tailored Excitation. AJNR Am J Neuroradiol 2022; 43:1713-1718. [PMID: 36265890 DOI: 10.3174/ajnr.a7678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/15/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE High-resolution vessel wall MR imaging is prone to slow-flow artifacts, particularly when gadolinium shortens the T1 relaxation time of blood. This study aimed to determine the optimal preparation pulses for contrast-enhanced high-resolution vessel wall MR imaging. MATERIALS AND METHODS Fifty patients who underwent both motion-sensitized driven equilibrium and delay alternating with nutation for tailored excitation (DANTE) preparation pulses with contrast-enhanced 3D-T1-FSE were retrospectively included. Qualitative analysis was performed using a 4-grade visual scoring system for black-blood performance in the small-sized intracranial vessels, overall image quality, severity of artifacts, and the degree of blood suppression in all cortical veins as well as transverse sinuses. Quantitative analysis of the M1 segment of the MCA was also performed. RESULTS The qualitative analysis revealed that motion-sensitized driven equilibrium demonstrated a significantly higher black-blood score than DANTE in contrast-enhanced 3D-T1-FSE of the A3 segment (3.90 versus 3.58, P < .001); M3 (3.72 versus 3.26, P = .004); P2 to P3 (3.86 versus 3.64, P = .017); the internal cerebral vein (3.72 versus 2.32, P < .001); and overall cortical veins (3.30 versus 2.74, P < .001); and transverse sinuses (2.82 versus 2.38, P < .001). SNRlumen, contrast-to noise ratiowall-lumen, and SNRwall in the M1 vessel were not significantly different between the 2 preparation pulses (all, P > .05). CONCLUSIONS Motion-sensitized driven equilibrium demonstrated improved blood suppression on contrast-enhanced 3D-T1-FSE in the small intracranial arteries and veins compared with DANTE. Motion-sensitized driven equilibrium is a useful preparation pulse for high-resolution vessel wall MR imaging to decrease venous contamination and suppress slow-flow artifacts when using contrast enhancement.
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Affiliation(s)
- D J Kim
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - H-J Lee
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - J Baik
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.,Department of Radiology (J.B.), Good Gang-An Hospital, Busan, South Korea
| | - M J Hwang
- GE Healthcare Korea (M.J.H.), Seoul, South Korea
| | - M Miyoshi
- GE Healthcare Japan (M.M.), Tokyo, Japan
| | - Y Kang
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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12
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Visualisation of lenticulostriate arteries using contrast-enhanced time-of-flight magnetic resonance angiography at 7 Tesla. Sci Rep 2022; 12:20306. [PMID: 36434036 PMCID: PMC9700841 DOI: 10.1038/s41598-022-24832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
7 Tesla-field-strength (7 T) Magnetic Resonance Imaging allows the small perforating arteries in the brain to be visualised, and this modality may allow visualisation of the arterial pathology in cerebral small vessel disease. Most studies have used standard Time-of-Flight (ToF) Magnetic Resonance Angiography (MRA). Whether the use of contrast enhancement improves perforating artery visualisation at 7 T remains unclear. In a prospective study, we compared standard ToF MRA with contrast-enhanced (CE) ToF MRA at 7 T for the visualisation of the lenticulostriate arteries (LSAs). Ten patients with symptomatic lacunar stroke were recruited (mean age, SD, 64 ± 9.9 years). Visualisation was assessed using a visual rating scale administered by two independent expert readers and length of the LSAs visible. Visualisation of the LSAs was improved with CE ToF MRA. The mean Visibility and Sharpness Score was higher for CE ToF MRA over standard ToF MRA (2.55 ± 0.64 vs. 1.75 ± 0.68; P = 0.0008). The mean length of LSA visualised was significantly longer with CE ToF MRA compared to standard ToF MRA (24.4 ± 4.5 vs. 21.9 ± 4.0 mm; P = 0.01). CE ToF MRA offers improved visualisation of the LSAs over standard ToF MRA. The addition of contrast may improve the ability to visualise cerebral small vessel disease arterial pathology.
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Abstract
Vessel wall MR imaging (VW-MRI) has been introduced into clinical practice and applied to a variety of diseases, and its usefulness has been reported. High-resolution VW-MRI is essential in the diagnostic workup and provides more information than other routine MR imaging protocols. VW-MRI is useful in assessing lesion location, morphology, and severity. Additional information, such as vessel wall enhancement, which is useful in the differential diagnosis of atherosclerotic disease and vasculitis could be assessed by this special imaging technique. This review describes the VW-MRI technique and its clinical applications in arterial disease, venous disease, vasculitis, and leptomeningeal disease.
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14
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Mazzacane F, Mazzoleni V, Scola E, Mancini S, Lombardo I, Busto G, Rognone E, Pichiecchio A, Padovani A, Morotti A, Fainardi E. Vessel Wall Magnetic Resonance Imaging in Cerebrovascular Diseases. Diagnostics (Basel) 2022; 12:diagnostics12020258. [PMID: 35204348 PMCID: PMC8871392 DOI: 10.3390/diagnostics12020258] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 01/27/2023] Open
Abstract
Cerebrovascular diseases are a leading cause of disability and death worldwide. The definition of stroke etiology is mandatory to predict outcome and guide therapeutic decisions. The diagnosis of pathological processes involving intracranial arteries is especially challenging, and the visualization of intracranial arteries’ vessel walls is not possible with routine imaging techniques. Vessel wall magnetic resonance imaging (VW-MRI) uses high-resolution, multiparametric MRI sequences to directly visualize intracranial arteries walls and their pathological alterations, allowing a better characterization of their pathology. VW-MRI demonstrated a wide range of clinical applications in acute cerebrovascular disease. Above all, it can be of great utility in the differential diagnosis of atherosclerotic and non-atherosclerotic intracranial vasculopathies. Additionally, it can be useful in the risk stratification of intracranial atherosclerotic lesions and to assess the risk of rupture of intracranial aneurysms. Recent advances in MRI technology made it more available, but larger studies are still needed to maximize its use in daily clinical practice.
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Affiliation(s)
- Federico Mazzacane
- Department of Emergency Neurology and Stroke Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy;
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Valentina Mazzoleni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy; (V.M.); (A.P.)
- Neurology Unit, Department of Neurological Sciences and Vision, ASST-Spedali Civili, 25123 Brescia, Italy;
| | - Elisa Scola
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy; (E.S.); (S.M.); (I.L.); (G.B.)
| | - Sara Mancini
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy; (E.S.); (S.M.); (I.L.); (G.B.)
| | - Ivano Lombardo
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy; (E.S.); (S.M.); (I.L.); (G.B.)
| | - Giorgio Busto
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy; (E.S.); (S.M.); (I.L.); (G.B.)
| | - Elisa Rognone
- Department of Neuroradiology, IRCCS Mondino Foundation, 27100 Pavia, Italy;
| | - Anna Pichiecchio
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
- Department of Neuroradiology, IRCCS Mondino Foundation, 27100 Pavia, Italy;
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy; (V.M.); (A.P.)
- Neurology Unit, Department of Neurological Sciences and Vision, ASST-Spedali Civili, 25123 Brescia, Italy;
| | - Andrea Morotti
- Neurology Unit, Department of Neurological Sciences and Vision, ASST-Spedali Civili, 25123 Brescia, Italy;
| | - Enrico Fainardi
- Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
- Correspondence:
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15
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Li L, Law C, Marrett S, Chai Y, Huber L, Jezzard P, Bandettini P. Quantification of cerebral blood volume changes caused by visual stimulation at 3 T using DANTE-prepared dual-echo EPI. Magn Reson Med 2021; 87:1846-1862. [PMID: 34817081 DOI: 10.1002/mrm.29099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/07/2021] [Accepted: 11/05/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE We investigate the influence of moving blood-attenuation effects when using "delay alternating with nutation for tailored excitation" (DANTE) pulses in conjunction with blood oxygen level dependent (BOLD) of functional MRI (fMRI) at 3 T. Based on the effects of including DANTE pulses, we propose quantification of cerebral blood volume (CBV) changes following functional stimulation. METHODS Eighteen volunteers in total underwent fMRI scans at 3 T. Seven volunteers were scanned to investigate the effects of DANTE pulses on the fMRI signal. CBV changes in response to visual stimulation were quantified in 11 volunteers using a DANTE-prepared dual-echo EPI sequence. RESULTS The inflow effects from flowing blood in arteries and draining vein effects from flowing blood in large veins can be suppressed by use of a DANTE preparation module. Using DANTE-prepared dual-echo EPI, we quantitatively measured intravascular-weighted microvascular CBV changes of 25.4%, 29.8%, and 32.6% evoked by 1, 5, and 10 Hz visual stimulation, respectively. The extravascular fraction (∆S/S)extra at TE = 30 ms in total BOLD signal was determined to be 64.8 ± 3.4%, which is in line with previous extravascular component estimation at 3 T. Results show that the microvascular CBV changes are linearly dependent on total BOLD changes at TE = 30 ms with a slope of 0.113, and this relation is independent of stimulation frequency and subject. CONCLUSION The DANTE preparation pulses can be incorporated into a standard EPI fMRI sequence for the purpose of minimizing inflow effects and reducing draining veins effects in large vessels. Additionally, the DANTE-prepared dual-echo EPI sequence is a promising fast imaging tool for quantification of intravascular-weighted CBV change in the microvascular space at 3 T.
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Affiliation(s)
- Linqing Li
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Christine Law
- Systems Neuroscience and Pain Lab, Stanford University, Stanford, California, USA
| | - Sean Marrett
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Yuhui Chai
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Laurentius Huber
- MR-Methods Group, MBIC, FPN, Maastricht University, Maastricht, Netherlands
| | - Peter Jezzard
- Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Peter Bandettini
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Edelman RR, Leloudas N, Pang J, Koktzoglou I. Dark blood cardiovascular magnetic resonance of the heart, great vessels, and lungs using electrocardiographic-gated three-dimensional unbalanced steady-state free precession. J Cardiovasc Magn Reson 2021; 23:127. [PMID: 34724939 PMCID: PMC8559409 DOI: 10.1186/s12968-021-00808-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recently, we reported a novel neuroimaging technique, unbalanced T1 Relaxation-Enhanced Steady-State (uT1RESS), which uses a tailored 3D unbalanced steady-state free precession (3D uSSFP) acquisition to suppress the blood pool signal while minimizing bulk motion sensitivity. In the present work, we hypothesized that 3D uSSFP might also be useful for dark blood imaging of the chest. To test the feasibility of this approach, we performed a pilot study in healthy subjects and patients undergoing cardiovascular magnetic resonance (CMR). MAIN BODY The study was approved by the hospital institutional review board. Thirty-one adult subjects were imaged at 1.5 T, including 5 healthy adult subjects and 26 patients (44 to 86 years, 10 female) undergoing a clinically indicated CMR. Breath-holding was used in 29 subjects and navigator gating in 2 subjects. For breath-hold acquisitions, the 3D uSSFP pulse sequence used a high sampling bandwidth, asymmetric readout, and single-shot along the phase-encoding direction, while 3 shots were acquired for navigator-gated scans. To minimize signal dephasing from bulk motion, electrocardiographic (ECG) gating was used to synchronize the data acquisition to the diastolic phase of the cardiac cycle. To further reduce motion sensitivity, the moment of the dephasing gradient was set to one-fifth of the moment of the readout gradient. Image quality using 3D uSSFP was good-to-excellent in all subjects. The blood pool signal in the thoracic aorta was uniformly suppressed with sharp delineation of the aortic wall including two cases of ascending aortic aneurysm and two cases of aortic dissection. Compared with variable flip angle 3D turbo spin-echo, 3D uSSFP showed improved aortic wall sharpness. It was also more efficient, permitting the acquisition of 24 slices in each breath-hold versus 16 slices with 3D turbo spin-echo and a single slice with dual inversion 2D turbo spin-echo. In addition, lung and mediastinal lesions appeared highly conspicuous compared with the low blood pool signals within the heart and blood vessels. In two subjects, navigator-gated 3D uSSFP provided excellent delineation of cardiac morphology in double oblique multiplanar reformations. CONCLUSION In this pilot study, we have demonstrated the feasibility of using ECG-gated 3D uSSFP for dark blood imaging of the heart, great vessels, and lungs. Further study will be required to fully optimize the technique and to assess clinical utility.
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Affiliation(s)
- Robert R. Edelman
- Department of Radiology, Northshore University HealthSystem, Evanston, IL USA
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
- Walgreen Building, G534, 2650 Ridge Avenue, Evanston, IL 60201 USA
| | - Nondas Leloudas
- Department of Radiology, Northshore University HealthSystem, Evanston, IL USA
| | - Jianing Pang
- Siemens Medical Solutions USA Inc., Chicago, IL USA
| | - Ioannis Koktzoglou
- Department of Radiology, Northshore University HealthSystem, Evanston, IL USA
- Radiology, Pritzker School of Medicine, University of Chicago, Chicago, IL USA
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17
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Yang Y, Li Z, Liu Q, Guo Y, Mei Y, Lyu J, Zhao M, Feng Y, Xie G. Carotid arterial wall MRI of apolipoprotein e-deficient mouse at 7 T using DANTE-prepared variable-flip-angle rapid acquisition with relaxation enhancement. Magn Reson Imaging 2021; 86:1-9. [PMID: 34688846 DOI: 10.1016/j.mri.2021.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/20/2021] [Accepted: 10/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To optimize a sequence combining the delay alternating with nutation for tailored excitation (DANTE) preparative module with the variable-flip-angle rapid acquisition with relaxation enhancement (VF-RARE) sequence (DANTE-VF-RARE) and to investigate its feasibility for vessel wall imaging in Apolipoprotein E-Deficient (ApoE-/-) mouse at 7 Tesla (T). MATERIALS AND METHODS Specific T1/T2 values were used for producing a sharper vessel wall in the variable-flip-angle optimization scheme. The DANTE RF pulse flip angle and pulse train length were optimized for maximizing the wall-lumen contrast. ApoE-/- (fed high fat diet for 20/40/ 60 weeks, n = 9/4/4) and wild-type mice (controls, n = 3) were imaged at 7 T using VF-RARE, DANTE-VF-RARE, time-of-flight (TOF) angiography, and multi-slice T1-weighted 2D RARE coupled with inflow outflow saturation bands (IOSB-RARE). Wall-lumen contrast-to-noise-ratio efficiency (CNReff), lumen area (LA), and wall area (WA) were compared between DANTE-VF-RARE and 2D IOSB-RARE sequences. Additionally, linear regression analysis was conducted between MR measurements and histomorphometric planimetry results. RESULTS Residual blood signal was observed in the four out of eighteen carotids on VF-RARE images, whereas it was significantly suppressed on DANTE-VF-RARE images. Compared with IOSB-RARE, DANTE-VF-RARE offered significantly improved CNReff (P < 0.001). The LA and WA were both comparable (P = 0.085 and 0.112, respectively) and showed excellent agreement between DANTE-VF-RARE and IOSB-RARE (ICC = 0.96 and 0.95, respectively). The luminal stenosis identified by DANTE-VF-RARE was in consistent with the results of TOF. Strong correlations were found between MR measurements and histopathological analysis for both WA (DANTE-VF-RARE: r = 0.92, slope = 0.94, P < 0.001; IOSB-RARE: r = 0.93, slope = 0.94, P < 0.001) and LA (DANTE-VF-RARE: r = 0.82, slope = 0.54, P < 0.001; IOSB-RARE: r = 0.78, slope = 0.50, P < 0.001). CONCLUSION DANTE-VF-RARE achieves effective blood signal suppression and is a feasible approach for the 3D carotid arterial wall imaging of ApoE-/- mouse at 7 T.
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Affiliation(s)
- Yuanbo Yang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhonghao Li
- Department of Pathophysiology, Key Lab for Shock and Microcirculation Research of Guangdong, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Qiang Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yihao Guo
- MR Collaboration, Siemens Healthcare Ltd., Guangzhou, China
| | - Yingjie Mei
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China; Philips Healthcare, Guangzhou, China
| | - Jian Lyu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Ming Zhao
- Department of Pathophysiology, Key Lab for Shock and Microcirculation Research of Guangdong, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China.
| | - Guoxi Xie
- Department of Biomedical Engineering, The Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou, China.
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Coolen BF, Schoormans J, Gilbert G, Kooreman ES, de Winter N, Viessmann O, Zwanenburg JJM, Majoie CBLM, Strijkers GJ, Nederveen AJ, Siero JCW. Double delay alternating with nutation for tailored excitation facilitates banding-free isotropic high-resolution intracranial vessel wall imaging. NMR IN BIOMEDICINE 2021; 34:e4567. [PMID: 34076305 PMCID: PMC8459252 DOI: 10.1002/nbm.4567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/26/2021] [Accepted: 05/15/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to evaluate the use of a double delay alternating with nutation for tailored excitation (D-DANTE)-prepared sequence for banding-free isotropic high-resolution intracranial vessel wall imaging (IC-VWI) and to compare its performance with regular DANTE in terms of signal-to-noise ratio (SNR) as well as cerebrospinal fluid (CSF) and blood suppression efficiency. To this end, a D-DANTE-prepared 3D turbo spin echo sequence was implemented by interleaving two separate DANTE pulse trains with different RF phase-cycling schemes, but keeping all other DANTE parameters unchanged, including the total number of pulses and total preparation time. This achieved a reduction of the banding distance compared with regular DANTE enabling banding-free imaging up to higher resolutions. Bloch simulations assuming static vessel wall and flowing CSF spins were performed to compare DANTE and D-DANTE in terms of SNR and vessel wall/CSF contrast. Similar image quality measures were assessed from measurements on 13 healthy middle-aged volunteers. Both simulation and in vivo results showed that D-DANTE had only slightly lower vessel wall/CSF and vessel wall/blood contrast-to-noise ratio values compared with regular DANTE, which originated from a 10%-15% reduction in vessel wall SNR but not from reduced CSF or blood suppression efficiency. As anticipated, IC-VWI acquisitions showed that D-DANTE can successfully remove banding artifacts compared with regular DANTE with equal scan time or DANTE preparation length. Moreover, application was demonstrated in a patient with an intracranial aneurysm, indicating improved robustness to slow flow artifacts compared with clinically available 3D turbo spin echo scans. In conclusion, D-DANTE provides banding artifact-free IC-VWI up to higher isotropic resolutions compared with regular DANTE. This allows for a more flexible choice of DANTE preparation parameters in high-resolution IC-VWI protocols.
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Affiliation(s)
- Bram F. Coolen
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
| | - Jasper Schoormans
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
| | | | - Ernst S. Kooreman
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
- Department of Radiation OncologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Naomi de Winter
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
| | - Olivia Viessmann
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Harvard Medical SchoolMassachusetts General HospitalCharlestownMassachusettsUSA
| | - Jaco J. M. Zwanenburg
- Department of Radiology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | | | - Gustav J. Strijkers
- Department of Biomedical Engineering & PhysicsAmsterdam UMCAmsterdamThe Netherlands
| | - Aart J. Nederveen
- Department of Radiology & Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
| | - Jeroen C. W. Siero
- Department of Radiology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Spinoza Centre for NeuroimagingAmsterdamThe Netherlands
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Pravdivtseva MS, Gaidzik F, Berg P, Hoffman C, Rivera-Rivera LA, Medero R, Bodart L, Roldan-Alzate A, Speidel MA, Johnson KM, Wieben O, Jansen O, Hövener JB, Larsen N. Pseudo-Enhancement in Intracranial Aneurysms on Black-Blood MRI: Effects of Flow Rate, Spatial Resolution, and Additional Flow Suppression. J Magn Reson Imaging 2021; 54:888-901. [PMID: 33694334 PMCID: PMC8403769 DOI: 10.1002/jmri.27587] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Vessel-wall enhancement (VWE) on black-blood MRI (BB MRI) has been proposed as an imaging marker for a higher risk of rupture and associated with wall inflammation. Whether VWE is causally linked to inflammation or rather induced by flow phenomena has been a subject of debate. PURPOSE To study the effects of slow flow, spatial resolution, and motion-sensitized driven equilibrium (MSDE) preparation on signal intensities in BB MRI of patient-specific aneurysm flow models. STUDY TYPE Prospective. SUBJECTS/FLOW ANEURYSM MODEL/VIRTUAL VESSELS Aneurysm flow models based on 3D rotational angiography datasets of three patients with intracranial aneurysms were 3D printed and perfused at two different flow rates, with and without Gd-containing contrast agent. FIELD STRENGTH/SEQUENCE Variable refocusing flip angle 3D fast-spin echo sequence at 3 T with and without MSDE with three voxel sizes ((0.5 mm)3 , (0.7 mm)3 , and (0.9 mm)3 ); time-resolved with phase-contrast velocity-encoding 3D spoiled gradient echo sequence (4D flow MRI). ASSESSMENT Three independent observers performed a qualitative visual assessment of flow patterns and signal enhancement. Quantitative analysis included voxel-wise evaluation of signal intensities and magnitude velocity distributions in the aneurysm. STATISTICAL TESTS Kruskal-Wallis test, potential regressions. RESULTS A hyperintense signal in the lumen and adjacent to the aneurysm walls on BB MRI was colocalized with slow flow. Signal intensities increased by a factor of 2.56 ± 0.68 (P < 0.01) after administering Gd contrast. After Gd contrast administration, the signal was suppressed most in conjunction with high flows and with MSDE (2.41 ± 2.07 for slow flow without MSDE, and 0.87 ± 0.99 for high flow with MSDE). A clear result was not achieved by modifying the spatial resolution . DATA CONCLUSIONS Slow-flow phenomena contribute substantially to aneurysm enhancement and vary with MRI parameters. This should be considered in the clinical setting when assessing VWE in patients with an unruptured aneurysm. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Mariya S. Pravdivtseva
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University,Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Franziska Gaidzik
- Lab. of Fluid Dynamics and Technical Flows, Forschungscampus STIMULATE, University of Magdeburg, Magdeburg, Germany
| | - Philipp Berg
- Lab. of Fluid Dynamics and Technical Flows, Forschungscampus STIMULATE, University of Magdeburg, Magdeburg, Germany
| | - Carson Hoffman
- Department of Medical Physics and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Madison, WI, United States
| | - Leonardo A. Rivera-Rivera
- Department of Medical Physics and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Madison, WI, United States
| | - Rafael Medero
- Department of Mechanical Engineering and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Madison, WI, United States
| | - Lindsay Bodart
- Department of Medical Physics and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Madison, WI, United States
| | - Alejandro Roldan-Alzate
- Department of Mechanical Engineering and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Madison, WI, United States
| | - Michael A. Speidel
- Department of Medical Physics and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Madison, WI, United States
| | - Kevin M. Johnson
- Department of Medical Physics and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Madison, WI, United States
| | - Oliver Wieben
- Department of Medical Physics and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Madison, WI, United States
| | - Olav Jansen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University
| | - Naomi Larsen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
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20
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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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21
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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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22
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Vranic JE, Hartman JB, Mossa-Basha M. High-Resolution Magnetic Resonance Vessel Wall Imaging for the Evaluation of Intracranial Vascular Pathology. Neuroimaging Clin N Am 2021; 31:223-233. [PMID: 33902876 DOI: 10.1016/j.nic.2021.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Intracranial vessel wall imaging (IVWI) is an advanced MR imaging technique that allows for direct visualization of the walls of intracranial blood vessels and detection of subtle pathologic vessel wall changes before they become apparent on conventional luminal imaging. When performed correctly, IVWI can increase diagnostic confidence, aid in the differentiation of intracranial vasculopathies, and assist in patient risk stratification and prognostication. This review covers the essential technical underpinnings of IVWI and presents emerging clinical research highlighting its utility for the evaluation of multiple intracranial vascular pathologies.
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Affiliation(s)
- Justin E Vranic
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Gray 2, Room 273A, 55 Fruit Street, Boston, MA 02114, USA.
| | - Jason B Hartman
- Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Box 357115, Seattle, WA 98195, USA
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Box 357115, Seattle, WA 98195, USA
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23
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杨 渊, 李 忠, 刘 蔷, 谢 国, 冯 衍. [Carotid artery wall imaging using 7.0T magnetic resonance imaging with threedimensional DANTE-prepared FLASH in ApoE -/- mice]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:216-222. [PMID: 33624594 PMCID: PMC7905245 DOI: 10.12122/j.issn.1673-4254.2021.02.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the feasibility of three-dimensional (3D) vessel wall imaging of carotid atherosclerotic plaques in ApoE-/- mice using 7.0T magnetic resonance imaging (MRI) with delays alternating with nutations for tailored excitation (DANTE)-prepared fast low-angle shot (DANTE-FLASH) technique. OBJECTIVE Numerical simulations were performed for optimizing imaging parameters to maximize the wall-lumen contrast. Six ApoE-/- and three wild-type mice were scanned using a 7.0T MRI scanner with DANTE-FLASH and multi-slice 2D RARE coupled with inflow outflow saturation bands (2D-IOSBRARE). The wall signal-to-noise ratio (SNRwall), lumen SNR (SNRlumen), wall-lumen contrast-to-noise ratio (CNR), lumen area (LA), and wall area (WA) were compared between DANTE- FLASH and 2D-IOSB-RARE sequences. Linear regression analysis was performed to assess the correlation between the MRI measurements and histopathological measurements of LA and WA. OBJECTIVE Based on the simulation results, a flip angle of 15° and a train length of 150 were implemented in the live imaging study. Compared with 2D-IOSB-RARE, DANTE-FLASH provided a slightly reduced CNR (P < 0.001) but much improved slice resolution. The LA and WA measurements from the DANTE-FLASH and 2D-IOSB- RARE showed excellent agreement based on ICC analysis (LA: ICC=0.94, P < 0.001; WA: ICC=0.93, P < 0.001) and Bland-Altman plots. Strong correlations were observed between the MRI and histopathological measurements for both LA (P < 0.0001) and WA (P < 0.0001). OBJECTIVE As a 3D black-blood MR sequence, DANTE-FLASH provides isotropic high spatial resolution to allow reliable visualization and quantitative evaluation of the arteriosclerotic lesions within the carotid artery of ApoE-/- mice using a 7.0T MRI scanner.
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Affiliation(s)
- 渊博 杨
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- 南方医科大学广东省医学图像处理重点实验室,广东 广州 510515Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou 510515, China
| | - 忠豪 李
- 南方医科大学基础医学院//广东省病理生理教研室//广东省休克与微循环研究重点实验室,广东 广州 510515Department of Pathophysiology//Key Lab for Shock and Microcirculation Research of Guangdong Province//School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - 蔷 刘
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- 南方医科大学广东省医学图像处理重点实验室,广东 广州 510515Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou 510515, China
| | - 国喜 谢
- 广州医科大学基础学院,第六附属医院,生物医学工程系,广东 广州 511436Department of Biomedical Engineering, Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou 511436, China
| | - 衍秋 冯
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- 南方医科大学广东省医学图像处理重点实验室,广东 广州 510515Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou 510515, China
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24
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Mao H, Guan X, Peng K, Cai Y, Yang J, He X, Chen H, Zhang X, Bi X, Liu X, Li D, Fan Z, Deng Z, Xie G. Time-efficient and contrast-free magnetic resonance imaging approach to the diagnosis of deep vein thrombosis on black-blood gradient-echo sequence: a pilot study. Quant Imaging Med Surg 2021; 11:276-289. [PMID: 33392028 DOI: 10.21037/qims-19-761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Black-blood thrombus imaging (BTI) has shown to be advantageous for the diagnosis of deep vein thrombosis (DVT). However, previous techniques using fast spin echo have a high specific absorption rate. As DANTE (delay alternating with nutation for tailored excitation) black-blood preparation can suppress blood flows over a broad range of velocities, we hypothesized that a DANTE black-blood preparation combined with a fast low-angle shot (FLASH) gradient-echo readout-DANTE-FLASH could be used to diagnose DVT. Methods Eleven healthy volunteers and 30 suspected DVT patients were recruited to undergo DANTE-FLASH and magnetic resonance direct thrombus imaging (MRDTI). The suspected DVT patients were also examined by ultrasound (US). For the segment level, a total of 1,066 venous vessel segments were analyzed. Using US and MRDTI as the references, the sensitivity (SE), specificity (SP), positive and negative predictive values (PPV and NPV), and accuracy (ACC) of DANTE-FLASH were calculated. To quantitatively compare image quality between DANTE-FLASH and MRDTI, image signal-to-noise ratio (SNR), apparent contrast-to-noise ratio (CNR) between muscle and the venous lumen, and the apparent CNR between the thrombus and venous lumen were measured. Additionally, diagnostic confidence, image quality, and clot burden were also evaluated. Results Using the consensus results of US and MRDTI as a standard reference, the diagnostic SE, SP, PPV, NPV, and ACC of DANTE-FLASH for the 2 readers were 97.0% and 93.2%, 99.0% and 98.2%, 93.4% and 87.9%, 99.6% and 99.0%, and 98.8% and 97.6%, respectively. According to the image quantitative analysis results, DANTE-FLASH demonstrated higher image SNR and CNR than MRDTI. The image quality and diagnostic confidence scores of DANTE-FLASH were higher than MRDTI (3.66±0.44 vs. 3.52±0.52, P<0.001, and 3.84±0.36 vs. 3.76±0.41, P<0.001). There was excellent agreement between DANTE-FLASH and MRDTI on clot burden evaluation. Conclusions DANTE-FLASH provided better image quality than MRDTI and accurately detected thrombi. It may, therefore, serve as a safe and convenient alternative for the diagnosis of DVT.
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Affiliation(s)
- Huan Mao
- Department of Biomedical Engineering, The Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou, China
| | - Xiuhong Guan
- Department of Biomedical Engineering, The Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou, China
| | - Kewen Peng
- Department of Radiology, Nanshan People's Hospital, Shenzhen, China
| | - Yanjun Cai
- Department of Biomedical Engineering, The Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou, China
| | - Jing Yang
- Department of Biomedical Engineering, The Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou, China
| | - Xueping He
- Department of Radiology, Panyu Central Hospital, Guangzhou, China
| | - Hanwei Chen
- Department of Radiology, Panyu Central Hospital, Guangzhou, China
| | - Xiaoyong Zhang
- MR Collaborations, Siemens Healthcare Ltd., Shenzhen, China
| | - Xiaoming Bi
- MR R&D, Siemens Healthineers, Los Angeles, CA, USA
| | - Xin Liu
- Paul C. Lauterbur Biomedical Imaging Center, Shenzhen Institutes of Advanced Technology, Shenzhen, China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Zhixian Deng
- Department of Biomedical Engineering, The Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou, China
| | - Guoxi Xie
- Department of Biomedical Engineering, The Sixth Affiliated Hospital, School of Basic Sciences, Guangzhou Medical University, Guangzhou, China
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25
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Oshima S, Fushimi Y, Okada T, Nakajima S, Yokota Y, Shima A, Grinstead J, Ahn S, Sawamoto N, Takahashi R, Nakamoto Y. Neuromelanin-Sensitive Magnetic Resonance Imaging Using DANTE Pulse. Mov Disord 2020; 36:874-882. [PMID: 33314293 PMCID: PMC8247273 DOI: 10.1002/mds.28417] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/14/2020] [Accepted: 11/16/2020] [Indexed: 12/22/2022] Open
Abstract
Background Neuromelanin‐sensitive magnetic resonance imaging techniques have been developed but currently require relatively long scan times. The aim of this study was to assess the ability of black‐blood delay alternating with nutation for tailored excitation‐prepared T1‐weighted variable flip angle turbo spin echo (DANTE T1‐SPACE), which provides relatively high resolution with a short scan time, to visualize neuromelanin in the substantia nigra pars compacta (SNpc). Methods Participants comprised 49 healthy controls and 25 patients with Parkinson's disease (PD). Contrast ratios of SNpc and hyperintense SNpc areas, which show pixels brighter than thresholds, were assessed between DANTE T1‐SPACE and T1‐SPACE in healthy controls. To evaluate the diagnostic ability of DANTE T1‐SPACE, the contrast ratios and hyperintense areas were compared between healthy and PD groups, and receiver operating characteristic analyses were performed. We also compared areas under the curve (AUCs) between DANTE T1‐SPACE and the previously reported gradient echo neuromelanin (GRE‐NM) imaging. Each analysis was performed using original images in native space and images transformed into Montreal Neurological Institute space. Values of P < 0.05 were considered significant. Results DANTE T1‐SPACE showed significantly higher contrast ratios and larger hyperintense areas than T1‐SPACE. On DANTE T1‐SPACE, healthy controls showed significantly higher contrast ratios and larger hyperintense areas than patients with PD. Hyperintense areas in native space analysis achieved the best AUC (0.94). DANTE T1‐SPACE showed AUCs as high as those of GRE‐NM. Conclusions DANTE T1‐SPACE successfully visualized neuromelanin of the SNpc and showed potential for evaluating PD. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society ![]()
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Affiliation(s)
- Sonoko Oshima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohisa Okada
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Yokota
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Shima
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Sinyeob Ahn
- Siemens Healthineers, San Francisco, California, USA
| | - Nobukatsu Sawamoto
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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26
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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: 27] [Impact Index Per Article: 6.8] [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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27
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Kassem M, Florea A, Mottaghy FM, van Oostenbrugge R, Kooi ME. Magnetic resonance imaging of carotid plaques: current status and clinical perspectives. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1266. [PMID: 33178798 PMCID: PMC7607136 DOI: 10.21037/atm-2020-cass-16] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Rupture of a vulnerable carotid plaque is one of the leading causes of stroke. Carotid magnetic resonance imaging (MRI) is able to visualize all the main hallmarks of plaque vulnerability. Various MRI sequences have been developed in the last two decades to quantify carotid plaque burden and composition. Often, a combination of multiple sequences is used. These MRI techniques have been extensively validated with histological analysis of carotid endarterectomy specimens. High agreement between the MRI and histological measures of plaque burden, intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), fibrous cap (FC) status, inflammation and neovascularization has been demonstrated. Novel MRI sequences allow to generate three-dimensional isotropic images with a large longitudinal coverage. Other new sequences can acquire multiple contrasts using a single sequence leading to a tremendous reduction in scan time. IPH can be easily identified as a hyperintense signal in the bulk of the plaque on strongly T1-weighted images, such as magnetization-prepared rapid acquisition gradient echo images, acquired within a few minutes with a standard neurovascular coil. Carotid MRI can also be used to evaluate treatment effects. Several meta-analyses have demonstrated a strong predictive value of IPH, LRNC, thinning or rupture of the FC for ischemic cerebrovascular events. Recently, in a large meta-analysis based on individual patient data of asymptomatic and symptomatic individuals with carotid artery stenosis, it was shown that IPH on MRI is an independent risk predictor for stroke, stronger than any known clinical risk parameter. Expert recommendations on carotid plaque MRI protocols have recently been described in a white paper. The present review provides an overview of the current status and applications of carotid plaque MR imaging and its future potential in daily clinical practice.
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Affiliation(s)
- Mohamed Kassem
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Alexandru Florea
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Robert van Oostenbrugge
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,Department of Neurology, MUMC+, Maastricht, The Netherlands
| | - M Eline Kooi
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
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Bapst B, Amegnizin JL, Vignaud A, Kauv P, Maraval A, Kalsoum E, Tuilier T, Benaissa A, Brugières P, Leclerc X, Hodel J. Post-contrast 3D T1-weighted TSE MR sequences (SPACE, CUBE, VISTA/BRAINVIEW, isoFSE, 3D MVOX): Technical aspects and clinical applications. J Neuroradiol 2020; 47:358-368. [DOI: 10.1016/j.neurad.2020.01.085] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 12/11/2019] [Accepted: 01/19/2020] [Indexed: 11/25/2022]
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Fushimi Y, Nakajima S. Editorial for “Quantitative Susceptibility Mapping for Characterization of Intraplaque Hemorrhage and Calcification in Carotid Atherosclerotic Disease”. J Magn Reson Imaging 2020; 52:542-543. [DOI: 10.1002/jmri.27089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear MedicineKyoto University Graduate School of Medicine Kyoto Japan
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Frost R, Biasiolli L, Li L, Hurst K, Alkhalil M, Choudhury RP, Robson MD, Hess AT, Jezzard P. Navigator-based reacquisition and estimation of motion-corrupted data: Application to multi-echo spin echo for carotid wall MRI. Magn Reson Med 2020; 83:2026-2041. [PMID: 31697862 PMCID: PMC7065122 DOI: 10.1002/mrm.28063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To assess whether artifacts in multi-slice multi-echo spin echo neck imaging, thought to be caused by brief motion events such as swallowing, can be corrected by reacquiring corrupted central k-space data and estimating the remainder with parallel imaging. METHODS A single phase-encode line (ky = 0, phase-encode direction anteroposterior) navigator echo was used to identify motion-corrupted data and guide the online reacquisition. If motion corruption was detected in the 7 central k-space lines, they were replaced with reacquired data. Subsequently, GRAPPA reconstruction was trained on the updated central portion of k-space and then used to estimate the remaining motion-corrupted k-space data from surrounding uncorrupted data. Similar compressed sensing-based approaches have been used previously to compensate for respiration in cardiac imaging. The g-factor noise amplification was calculated for the parallel imaging reconstruction of data acquired with a 10-channel neck coil. The method was assessed in scans with 9 volunteers and 12 patients. RESULTS The g-factor analysis showed that GRAPPA reconstruction of 2 adjacent motion-corrupted lines causes high noise amplification; therefore, the number of 2-line estimations should be limited. In volunteer scans, median ghosting reduction of 24% was achieved with 2 adjacent motion-corrupted lines correction, and image quality was improved in 2 patient scans that had motion corruption close to the center of k-space. CONCLUSION Motion-corrupted echo-trains can be identified with a navigator echo. Combined reacquisition and parallel imaging estimation reduced motion artifacts in multi-slice MESE when there were brief motion events, especially when motion corruption was close to the center of k-space.
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Affiliation(s)
- Robert Frost
- Wellcome Centre for Integrative NeuroimagingFMRIB DivisionNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalCharlestownMassachusetts
- Department of RadiologyHarvard Medical SchoolBostonMassachusetts
| | - Luca Biasiolli
- Oxford Centre for Clinical Magnetic Resonance ResearchDivision of Cardiovascular MedicineRadcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Acute Vascular Imaging CentreDivision of Cardiovascular MedicineRadcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
| | - Linqing Li
- Laboratory of Brain and CognitionNational Institute of Mental HealthBethesdaMaryland
| | - Katherine Hurst
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUnited Kingdom
| | - Mohammad Alkhalil
- Acute Vascular Imaging CentreDivision of Cardiovascular MedicineRadcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
| | - Robin P. Choudhury
- Acute Vascular Imaging CentreDivision of Cardiovascular MedicineRadcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
| | - Matthew D. Robson
- Oxford Centre for Clinical Magnetic Resonance ResearchDivision of Cardiovascular MedicineRadcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
| | - Aaron T. Hess
- Oxford Centre for Clinical Magnetic Resonance ResearchDivision of Cardiovascular MedicineRadcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
| | - Peter Jezzard
- Wellcome Centre for Integrative NeuroimagingFMRIB DivisionNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
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31
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Qiao H, Cai Y, Huang M, Liu Y, Zhang Q, Huang L, Chen H, Yuan C, Zhao X. Quantitative assessment of carotid artery atherosclerosis by three-dimensional magnetic resonance and two-dimensional ultrasound imaging: a comparison study. Quant Imaging Med Surg 2020; 10:1021-1032. [PMID: 32489926 DOI: 10.21037/qims-19-818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background It has been proven that magnetic resonance (MR) and ultrasound imaging are useful tools in the quantification of carotid atherosclerotic plaques. However, there are only a few pieces of evidence to illustrate the links of quantitative measurements of carotid plaques between MR and ultrasound imaging. This study looked to compare the quantitative measurements of carotid plaques and investigate their relationship between three-dimensional (3D) MR vessel wall imaging and two-dimensional (2D) ultrasound imaging. Methods Seventy-five asymptomatic elderly subjects (mean age: 73.3±5.7 years; 45 males) with carotid atherosclerotic plaques diagnosed by both ultrasound and MR imaging were included in this study. The plaque size, including the maximum wall thickness (Max WT), plaque length, and plaque area, was measured by 3D MR and ultrasound imaging on longitudinal and cross-sectional views. The quantitative assessments of carotid plaque size were compared and correlated between 3D MR and 2D ultrasound imaging. Results In total, the quantitative measurements of 101 plaques on longitudinal views or 44 plaques on cross-sectional views of both MR and ultrasound imaging were compared. The Max WT of the plaques (longitudinal: 2.9±0.8 vs. 2.4±0.9 mm; cross-sectional: 3.2±1.1 vs. 2.6±0.7 mm) and plaque areas (longitudinal: 24.3±13.4 vs. 17.0±12.7 mm2; cross-sectional: 24.9±24.6 vs. 16.8±13.3 mm2) measured by MR imaging were found to be significantly higher than those measured by ultrasound imaging (all P<0.001). Moderate to strong correlations were found in Max WT, plaque area, plaque length between 3D MR and ultrasound imaging. Conclusions The quantitative measurements of carotid plaques using 3D MR and 2D ultrasound are significantly correlated. The plaque area and Max WT measured by 3D MR imaging are more significant than these parameters measured by 2D ultrasound imaging, which might be explained by the resolution of MR imaging and the workflow of measurements.
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Affiliation(s)
- Huiyu Qiao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | - Ying Cai
- Department of Radiology, Taizhou People's Hospital, Taizhou 225400, China
| | - Manwei Huang
- Department of Ultrasound, China Meitan General Hospital, Beijing 100028, China
| | - Yang Liu
- Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou 225009, China
| | - Qiang Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | | | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
| | - Chun Yuan
- Department of Radiology, University of Washington, Washington, Seattle, USA
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China
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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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Alkhalil M. A promising tool to tackle the risk of cerebral vascular disease, the emergence of novel carotid wall imaging. Brain Circ 2020; 6:81-86. [PMID: 33033777 PMCID: PMC7511918 DOI: 10.4103/bc.bc_65_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/24/2020] [Accepted: 03/25/2020] [Indexed: 11/24/2022] Open
Abstract
Stroke is a heterogeneous vascular disease. Carotid artery atherosclerosis is associated with almost one-quarter of ischemic strokes. Moreover, a large percentage of preventable strokes are currently attributed to carotid atherosclerosis. Over the past three decades, the management of carotid artery disease has evolved. The benefits of carotid revascularization alongside medical therapy have early been recognized. Nonetheless, the debate regarding the optimal strategy is still ongoing, particularly in patients with asymptomatic carotid artery disease. One of the challenges is the use of luminal stenosis to quantify the severity of the carotid artery disease and to guide decision-making regarding invasive revascularization. Characterizing carotid atherosclerotic plaque is a promising tool to identify vulnerable plaque. Certain features such as large lipid core have already been linked to acute vascular events, not only at the plaque level but also to predict systemic cardiovascular events. Recently, a quantitative T2 mapping magnetic resonance imaging technique was developed and validated against histology. The ability to accurately quantify plaque lipid content using this technique opens several new opportunities. In this review articles, we will discuss the current challenges in the management of carotid artery disease and the future roles of T2 mapping to aid therapeutic options. These roles may include how to determine the mode of invasive carotid revascularization in symptomatic patients. Moreover, there may be a rational to use T2 mapping as a risk stratification tool in asymptomatic patients with carotid artery stenosis. It may also provide an opportunity to stage atherosclerosis and identify patients with coronary atherosclerosis who may benefit maximally from intensive lipid interventions.
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Affiliation(s)
- Mohammad Alkhalil
- Department of Cardiology, Royal Victoria Hospital, Belfast, UK
- Department of Cardiology, Toronto General Hospital, Toronto, Canada
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Wang Z, Lu M, Liu W, Zheng T, Li D, Yu W, Fan Z. Assessment of carotid atherosclerotic disease using three-dimensional cardiovascular magnetic resonance vessel wall imaging: comparison with digital subtraction angiography. J Cardiovasc Magn Reson 2020; 22:18. [PMID: 32131854 PMCID: PMC7057661 DOI: 10.1186/s12968-020-0604-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 02/05/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A three-dimensional (3D) cardiovascular magnetic resonance (CMR) vessel wall imaging (VWI) technique based on 3D T1 weighted (T1w) Sampling Perfection with Application-optimized Contrast using different flip angle Evolutions (SPACE) has recently been used as a promising CMR imaging modality for evaluating extra-cranial and intra-cranial vessel walls. However, this technique is yet to be validated against the current diagnostic imaging standard. We therefore aimed to evaluate the diagnostic performance of 3D CMR VWI in characterizing carotid disease using intra-arterial digital subtraction angiography (DSA) as a reference. METHODS Consecutive patients with at least unilateral > 50% carotid stenosis on ultrasound were scheduled to undergo interventional therapy were invited to participate. The following metrics were measured using 3D CMR VWI and DSA: lumen diameter of the common carotid artery (CCA) and segments C1-C7, stenosis diameter, reference diameter, lesion length, stenosis degree, and ulceration. We assessed the diagnostic sensitivity, specificity, accuracy, and receiver operating characteristic (ROC) curve of 3D CMR VWI, and used Cohen's kappa, the intraclass correlation coefficient (ICC), and Bland-Altman analyses to assess the diagnostic agreement between 3D CMR VWI and DSA. RESULTS The ICC (all ICCs ≥0.96) and Bland-Altman plots indicated excellent inter-reader agreement in all individual morphologic measurements by 3D CMR VWI. Excellent agreement in all individual morphologic measurements were also found between 3D CMR VWI and DSA. In addition, 3D CMR VWI had high sensitivity (98.4, 97.4, 80.0, 100.0%), specificity (100.0, 94.5, 99.1, 98.0%), and Cohen's kappa (0.99, 0.89, 0.84, 0.96) for detecting stenosis > 50%, stenosis > 70%, ulceration, and total occlusion, respectively, using DSA as the standard. The AUC of 3D CMR VWI for predicting stenosis > 50 and > 70% were 0.998 and 0.999, respectively. CONCLUSIONS The 3D CMR VWI technique enables accurate diagnosis and luminal feature assessment of carotid artery atherosclerosis, suggesting that this imaging modality may be useful for routine imaging workups and provide comprehensive information for both the vessel wall and lumen.
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Affiliation(s)
- Zhenjia Wang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Beijing, 100029 China
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No. 23, Back Road of Art Gallery, Beijing, 100010 China
| | - Mi Lu
- Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029 China
| | - Wen Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Beijing, 100029 China
| | - Tiejin Zheng
- Department of Neurosurgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029 China
| | - Debiao Li
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA 90048 USA
- Department of Bioengineering, University of California, Los Angeles, CA USA
| | - Wei Yu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Beijing, 100029 China
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA 90048 USA
- Department of Bioengineering, University of California, Los Angeles, CA USA
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Wang G, Yang X, Duan J, Zhang N, Maya MM, Xie Y, Bi X, Ji X, Li D, Yang Q, Fan Z. Cerebral Venous Thrombosis: MR Black-Blood Thrombus Imaging with Enhanced Blood Signal Suppression. AJNR Am J Neuroradiol 2019; 40:1725-1730. [PMID: 31558501 DOI: 10.3174/ajnr.a6212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/29/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The residual blood flow artifact is a critical confounder for MR black-blood thrombus imaging of cerebral venous sinus thrombosis. This study aimed to conduct a validation of a new MR black-blood thrombus imaging technique with enhanced blood signal suppression. MATERIALS AND METHODS Twenty-six participants (13 volunteers and 13 patients) underwent conventional imaging methods followed by 2 randomized black-blood thrombus imaging scans, with a preoptimized delay alternating with nutation for tailored excitation (DANTE) preparation switched on and off, respectively. The signal intensity of residual blood, thrombus, brain parenchyma, normal lumen, and noise on black-blood thrombus images were measured. The thrombus volume, SNR of residual blood, and contrast-to-noise ratio for residual blood versus normal lumen, thrombus versus residual blood, and brain parenchyma versus normal lumen were compared between the 2 black-blood thrombus imaging techniques. Segmental diagnosis of venous sinus thrombosis was evaluated for each black-blood thrombus imaging technique using a combination of conventional imaging techniques as a reference. RESULTS In the volunteer group, the SNR of residual blood (11.3 ± 2.9 versus 54.0 ± 23.4, P < .001) and residual blood-to-normal lumen contrast-to-noise ratio (7.5 ± 3.4 versus 49.2 ± 23.3, P < .001) were significantly reduced using the DANTE preparation. In the patient group, the SNR of residual blood (16.4 ± 8.0 versus 75.0 ± 35.1, P = .002) and residual blood-to-normal lumen contrast-to-noise ratio (12.4 ± 7.8 versus 68.8 ± 35.4, P = .002) were also significantly lower on DANTE-prepared black-blood thrombus imaging. The new black-blood thrombus imaging technique provided higher thrombus-to-residual blood contrast-to-noise ratio, significantly lower thrombus volume, and substantially improved diagnostic specificity and agreement with conventional imaging methods. CONCLUSIONS DANTE-prepared black-blood thrombus imaging is a reliable MR imaging technique for diagnosing cerebral venous sinus thrombosis.
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Affiliation(s)
- G Wang
- From the Department of Biomedical Sciences (G.W., N.Z., Y.X., D.L., Q.Y., Z.F.), Biomedical Imaging Research Institute
- Department of Radiology (G.W.), The First Affiliated Hospital of China Medical University, Shenyang, China
| | - X Yang
- Radiology (X.Y., Q.Y.) Xuanwu Hospital, Capital Medical University, Beijing, China
| | - J Duan
- Departments of Emergency (J.D., X.J.)
| | - N Zhang
- Paul C. Lauterbur Research Center for Biomedical Imaging (N.Z.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - M M Maya
- Department of Imaging (M.M.M.), Cedars-Sinai Medical Center, Los Angeles, California
| | - Y Xie
- From the Department of Biomedical Sciences (G.W., N.Z., Y.X., D.L., Q.Y., Z.F.), Biomedical Imaging Research Institute
| | - X Bi
- MR R&D (X.B., D.L.), Siemens Healthineers, Los Angeles, California
| | - X Ji
- Departments of Emergency (J.D., X.J.)
| | - D Li
- From the Department of Biomedical Sciences (G.W., N.Z., Y.X., D.L., Q.Y., Z.F.), Biomedical Imaging Research Institute
- MR R&D (X.B., D.L.), Siemens Healthineers, Los Angeles, California
- Departments of Medicine (D.L., Z.F.)
| | - Q Yang
- From the Department of Biomedical Sciences (G.W., N.Z., Y.X., D.L., Q.Y., Z.F.), Biomedical Imaging Research Institute
- Radiology (X.Y., Q.Y.) Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Z Fan
- From the Department of Biomedical Sciences (G.W., N.Z., Y.X., D.L., Q.Y., Z.F.), Biomedical Imaging Research Institute
- Departments of Medicine (D.L., Z.F.)
- Bioengineering (Z.F.), University of California, Los Angeles, California
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Cho S, Choi Y, Chung S, Lee J, Baek J. High-resolution MRI using compressed sensing-sensitivity encoding (CS-SENSE) for patients with suspected neurovascular compression syndrome: comparison with the conventional SENSE parallel acquisition technique. Clin Radiol 2019; 74:817.e9-817.e14. [DOI: 10.1016/j.crad.2019.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/27/2019] [Indexed: 11/25/2022]
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de Havenon A, Muhina HJ, Parker DL, McNally JS, Alexander MD. Effect of Time Elapsed since Gadolinium Administration on Atherosclerotic Plaque Enhancement in Clinical Vessel Wall MR Imaging Studies. AJNR Am J Neuroradiol 2019; 40:1709-1711. [PMID: 31515211 DOI: 10.3174/ajnr.a6191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/17/2019] [Indexed: 11/07/2022]
Abstract
Vessel wall MR imaging is a useful tool for the evaluation of intracranial atherosclerotic disease. Enhancement can be particularly instructive. This study investigated the impact of the duration between contrast administration and image acquisition. The cohort with the longest duration had the greatest increase in signal intensity change. When using vessel wall MR imaging to assess intracranial atherosclerotic disease, protocols should be designed to maximize the duration between contrast administration and image acquisition to best demonstrate enhancement.
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Affiliation(s)
| | - H J Muhina
- the School of Medicine(H.J.M.), University of Utah, Salt Lake City, Utah
| | - D L Parker
- From the Departments of Radiology and Imaging Sciences (M.D.A., D.L.P., J.S.M.)
| | - J S McNally
- From the Departments of Radiology and Imaging Sciences (M.D.A., D.L.P., J.S.M.)
| | - M D Alexander
- From the Departments of Radiology and Imaging Sciences (M.D.A., D.L.P., J.S.M.) .,Neurosurgery (M.D.A.)
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Cho SJ, Jung SC, Suh CH, Lee JB, Kim D. High-resolution magnetic resonance imaging of intracranial vessel walls: Comparison of 3D T1-weighted turbo spin echo with or without DANTE or iMSDE. PLoS One 2019; 14:e0220603. [PMID: 31386679 PMCID: PMC6684065 DOI: 10.1371/journal.pone.0220603] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 07/21/2019] [Indexed: 12/01/2022] Open
Abstract
Background The black-blood (BB) technique was developed to suppress the signal from blood and cerebrospinal fluid (CSF) to provide improved depiction of vessel walls. Purpose The aim was to compare three-dimensional turbo spin echo T1-weighted imaging (3D TSE T1WI) with or without two BB techniques (delay alternating with nutation for tailored excitation [DANTE], and improved motion-sensitized driven equilibrium [iMSDE]) for high-resolution magnetic resonance imaging (HR-MRI) of the vessel walls of intracranial arteries. Study type Prospective. Population Fourteen healthy volunteers who underwent 3D T1WI for examination of intracranial vessel walls. Field strength/Sequence 3 Tesla, 3D TSE T1WI (SPACE and BrainVIEW) and BB (DANTE and iMSDE). Assessment SPACE with or without DANTE, and BrainVIEW with or without iMSDE, were acquired in each subject. Two neuroradiologists independently assessed image quality, vessel wall delineation, BB effect, CSF, and acceptability using visual scoring systems, and measured signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in vessel walls, lumen, and CSF, while blinded to the presence and type of BB technique used. Statistical tests Repeated measures ANOVA or Friedman tests were performed for the comparisons, followed by Bonferroni correction. Results The 3T T1WI sequences without BB are significantly superior in vessel wall delineation (P = 0.001). Black CSF scores were lower in SPACE with DANTE than SPACE without DANTE, and in BrainVIEW without iMSDE than SPACE without DANTE (P < 0.001). However, there were no significant differences in BB effect, image quality, and acceptability between the four 3D T1WI sequences (p > .05). The SNRVessel wall, CNRWall-Lumen, and CNRWall-CSF were higher (all p < .001) on SPACE with and without DANTE than on BrainVIEW with and without iMSDE. SNRLumen were higher (all p < .001) on BrainVIEW with and without iMSDE than on SPACE with and without DANTE. SNRCSF was higher (all p < .001) on BrainVIEW with iMSDE than on SPACE with DANTE. Data conclusion Both 3D TSE T1WI sequences were acceptable for intracranial vessel wall evaluation, with or without BB techniques. Therefore, BB techniques may not necessarily be required with 3D TSE T1WI with a long ETL and TR (below 1160 ms).
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Affiliation(s)
- Se Jin Cho
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Republic of Korea
| | - Seung Chai Jung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Republic of Korea
- * E-mail:
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Republic of Korea
| | - Jung Bin Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Republic of Korea
| | - Donghyun Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Republic of Korea
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Joint intracranial and carotid vessel wall imaging in 5 minutes using compressed sensing accelerated DANTE-SPACE. Eur Radiol 2019; 30:119-127. [DOI: 10.1007/s00330-019-06366-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/22/2019] [Accepted: 07/10/2019] [Indexed: 11/25/2022]
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40
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Kim D, Heo YJ, Jeong HW, Baek JW, Han JY, Lee JY, Jin SC, Baek HJ. Usefulness of the Delay Alternating with Nutation for Tailored Excitation Pulse with T1-Weighted Sampling Perfection with Application-Optimized Contrasts Using Different Flip Angle Evolution in the Detection of Cerebral Metastases: Comparison with MPRAGE Imaging. AJNR Am J Neuroradiol 2019; 40:1469-1475. [PMID: 31371358 DOI: 10.3174/ajnr.a6158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/27/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Contrast-enhanced T1-weighted sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) with the delay alternating with nutation for tailored excitation (DANTE) pulse could suppress the blood flow signal and provide a higher contrast-to-noise ratio of enhancing lesion-to-brain parenchyma than the MPRAGE sequence. The purpose of our study was to evaluate the usefulness of SPACE with DANTE compared with MPRAGE for detecting brain metastases. MATERIALS AND METHODS Seventy-one patients who underwent contrast-enhanced SPACE with DANTE and MPRAGE sequences and who were suspected of having metastatic lesions were included. Two neuroradiologists determined the number of enhancing lesions, and diagnostic performance was evaluated using figure of merit, sensitivity, positive predictive value, interobserver agreement, and reading time. Contrast-to-noise ratiolesion/parenchyma and contrast-to-noise ratiowhite matter/gray matter were also assessed. RESULTS SPACE with DANTE (observer one, 328; observer two, 324) revealed significantly more small (<5 mm) enhancing lesions than MPRAGE (observer one, 175; observer two, 150) (P < 0.001 for observer 1, P ≤ .0001 for observer 2). Furthermore, SPACE with DANTE showed significantly higher figure of merit and sensitivity and shorter reading time than MPRAGE for both observers. The mean contrast-to-noise ratiolesion/parenchyma of SPACE with DANTE (52.3 ± 43.1) was significantly higher than that of MPRAGE (17.5 ± 19.3) (P ≤ .0001), but the mean contrast-to-noise ratiowhite matter/gray matter of SPACE with DANTE (-0.65 ± 1.39) was significantly lower than that of MPRAGE (3.08 ± 1.39) (P ≤ .0001). CONCLUSIONS Compared with MPRAGE, SPACE with DANTE significantly improves the detection of brain metastases.
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Affiliation(s)
- D Kim
- From the Departments of Radiology (D.K., Y.J.H., H.W.J., J.W.B., J.-Y.H.)
| | - Y J Heo
- From the Departments of Radiology (D.K., Y.J.H., H.W.J., J.W.B., J.-Y.H.)
| | - H W Jeong
- From the Departments of Radiology (D.K., Y.J.H., H.W.J., J.W.B., J.-Y.H.)
| | - J W Baek
- From the Departments of Radiology (D.K., Y.J.H., H.W.J., J.W.B., J.-Y.H.)
| | - J-Y Han
- From the Departments of Radiology (D.K., Y.J.H., H.W.J., J.W.B., J.-Y.H.)
| | - J Y Lee
- Internal Medicine (J.Y.L.), Inje University Busan Paik Hospital, Busan, Korea
| | - S-C Jin
- Department of Neurosurgery (S.-C.J.), Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - H J Baek
- Department of Radiology (H.J.B.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
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Alexander MD, de Havenon A, Kim SE, Parker DL, McNally JS. Assessment of quantitative methods for enhancement measurement on vessel wall magnetic resonance imaging evaluation of intracranial atherosclerosis. Neuroradiology 2019; 61:643-650. [PMID: 30675639 DOI: 10.1007/s00234-019-02167-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/11/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Quantitative measures of vessel wall magnetic resonance imaging (vwMRI) for the evaluation of intracranial atherosclerotic disease (ICAD) offers standardization not available with previously used qualitative approaches that may be difficult to replicate. METHODS vwMRI studies performed to evaluate ICAD that had caused a stroke were analyzed. Two blinded reviewers qualitatively rated culprit lesions for the presence of enhancement on T1 delay alternating with nutation for tailored excitation (DANTE) SPACE images. At least 3 months later, quantitative analysis was performed of the same images, comparing lesion enhancement to reference structures. Cohen's kappa and intraclass correlation coefficients were calculated to assess agreement. Ratios of enhancement of lesions to references were compared to qualitative ratings. RESULTS Studies from 54 patients met inclusion criteria. A mean of 49 (90.7%) lesions were qualitatively rated as enhancing, with good inter-rater agreement (κ = 0.783). Among reference structure candidates, low infundibulum demonstrated the highest inter-rater agreement on pre- and post-contrast imaging. The ratio of percentage increase in plaque signal following contrast to the same measure in low infundibulum demonstrated the highest agreement with qualitative assessment, with highest agreement seen with a ratio of 0.8 set as a threshold (κ = 0.675). CONCLUSION Quantitative metrics can yield objective data to better standardize techniques and acceptance of vwMRI evaluation of ICAD. The low infundibulum had the highest inter-rater agreement on both pre- and post-contrast images and is best suited as a normally enhancing reference structure. Such quantitative techniques should be implemented in future research of vwMRI for the evaluation of ICAD.
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Affiliation(s)
- Matthew D Alexander
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA. .,Department of Neurosurgery, University of Utah, 30 North 1900 East, Room 1A071, Salt Lake City, UT, 84132, USA.
| | - Adam de Havenon
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Seong-Eun Kim
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Dennis L Parker
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Joseph S McNally
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
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Komatsu K, Takagi Y, Ishii A, Kikuchi T, Yamao Y, Fushimi Y, Grinstead J, Ahn S, Miyamoto S. Ruptured intranidal aneurysm of an arteriovenous malformation diagnosed by delay alternating with nutation for tailored excitation (DANTE)-prepared contrast-enhanced magnetic resonance imaging. Acta Neurochir (Wien) 2018; 160:2435-2438. [PMID: 30367252 DOI: 10.1007/s00701-018-3713-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022]
Abstract
This case report describes the usefulness of delay alternating with nutation for tailored excitation (DANTE)-prepared, contrast-enhanced magnetic resonance imaging (CE-MRI) for detecting the rupture site of an arteriovenous malformation (AVM). A ruptured intranidal aneurysm was confirmed histopathologically. Accurate non-invasive information about the possible rupture site of an AVM is critical for optimal treatment and evaluation. Vessel wall enhancement visualized by DANTE-prepared CE-MRI may be a useful tool for providing information about changes in inflammatory status and vulnerability to further developments.
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Chen H, He X, Xie G, Liang J, Ye Y, Deng W, He Z, Liu D, Li D, Liu X, Fan Z. Cardiovascular magnetic resonance black-blood thrombus imaging for the diagnosis of acute deep vein thrombosis at 1.5 Tesla. J Cardiovasc Magn Reson 2018; 20:42. [PMID: 29936910 PMCID: PMC6016134 DOI: 10.1186/s12968-018-0459-6] [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: 11/30/2017] [Accepted: 05/16/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The aim was to investigate the feasibility of a cardiovascular magnetic resonance (CMR) black-blood thrombus imaging (BBTI) technique, based on delay alternating with nutation for tailored excitation black-blood preparation and a variable flip angle turbo-spin-echo readout, for the diagnosis of acute deep vein thrombosis (DVT) at 1.5 T. METHODS BBTI was conducted in 15 healthy subjects and 30 acute DVT patients. Contrast-enhanced CMR venography (CE-CMRV) was conducted for comparison and only performed in the patients. Apparent contrast-to-noise ratios between the thrombus and the muscle/lumen were calculated to determine whether BBTI could provide an adequate thrombus signal for diagnosis. Two blinded readers assessed the randomized BBTI images from all participants and made independent decisions on the presence or absence of thrombus at the segment level. Images obtained by CE-CMRV were also randomized and assessed by the two readers. Using the consensus CE-CMRV as a reference, the sensitivity, specificity, positive and negative predictive values, and accuracy of BBTI, as well as its diagnostic agreement with CE-CMRV, were calculated. Additionally, diagnostic confidence and interobserver diagnostic agreement were evaluated. RESULTS The thrombi in the acute phase exhibited iso- or hyperintense signals on the BBTI images. All the healthy subjects were correctly identified from the participants based on the segment level. The diagnostic confidence of BBTI was comparable to that of CE-CMRV (3.69 ± 0.52 vs. 3.70 ± 0.47). High overall sensitivity (95.2%), SP (98.6%), positive predictive value (96.0%), negative predictive value (98.3%), and accuracy (97.7%), as well as excellent diagnostic and interobserver agreements, were achieved using BBTI. CONCLUSION BBTI is a reliable, contrast-free technique for the diagnosis of acute DVT at 1.5 T.
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Affiliation(s)
- Hanwei Chen
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
- Medical Imaging Institute of Panyu, Guangzhou, 511400 Guangdong China
| | - Xueping He
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
- Medical Imaging Institute of Panyu, Guangzhou, 511400 Guangdong China
| | - Guoxi Xie
- The Sixth Affiliated Hospital, Guangzhou Medical University, Xinzao, Panyu District, Qingyuan, 511518 Guangdong China
- Department of Biomedical Engineering of Basic Medical School, Guangzhou Medical University, Guangzhou, 511436 Guangdong China
| | - Jianke Liang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Yufeng Ye
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Wei Deng
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Zhuonan He
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Dexiang Liu
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048 USA
| | - Xin Liu
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055 Guangdong China
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048 USA
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Li L, Li N, An L, Shen J. A novel approach to probing in vivo metabolite relaxation: Linear quantification of spatially modulated magnetization. Magn Reson Med 2018; 79:2491-2499. [PMID: 28940581 PMCID: PMC5821591 DOI: 10.1002/mrm.26941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 08/16/2017] [Accepted: 08/31/2017] [Indexed: 11/08/2022]
Abstract
PURPOSE Conventional sequences for metabolite transverse relaxation quantification all generally measure signal changes at different echo times (TEs). However, quantification results obtained via these conventional methods can be very different and are highly dependent on the type of sequence being applied. TE-dependent effects such as diffusion, macromolecule baseline, and J-coupling modulation contribute significantly to these differences. Here, we propose a novel technique-multiple flip angle pulse-driven ratio of longitudinal steady states (MARzss)-for preparing magnetization with T2 /T1 weighting. Using premeasured T1 values, T2 values for metabolites can thereby be determined. The measurement procedure does not require varying TE and is TE independent; T2 , diffusion, and J-coupling effects induced by the readout sequence are cancelled. METHOD Longitudinal steady states at different flip angles were prepared with trains of radio frequency pulses interspersed with field gradients. The resulting spatially modulated longitudinal magnetization was acquired with a PRESS readout module. A new linear equation for quantification of MARzss was derived from Bloch equations. RESULTS By implementing this readout-independent method, T2 measurement of brain metabolites at 7T was demonstrated through Bloch simulations, phantom, and in vivo experiments. CONCLUSIONS The proposed MARzss technique can be used to largely avoid multi-TE associated interference, including diffusion, macromolecules, and J modulation. This MARzss technology, which is uniquely insensitive to readout sequence type and TE, is a promising technique for more accurately probing in vivo metabolite relaxation. Magn Reson Med 79:2491-2499, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Linqing Li
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Ningzhi Li
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Li An
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Jun Shen
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Yuan J, Patterson AJ, Ruetten PPR, Reid SA, Gillard JH, Graves MJ. A Comparison of Black-blood T 2 Mapping Sequences for Carotid Vessel Wall Imaging at 3T: An Assessment of Accuracy and Repeatability. Magn Reson Med Sci 2018. [PMID: 29515084 PMCID: PMC6326764 DOI: 10.2463/mrms.mp.2017-0141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Purpose: This study is to compare the accuracy of four different black-blood T2 mapping sequences in carotid vessel wall. Methods: Four different black-blood T2 mapping sequences were developed and tested through phantom experiments and 17 healthy volunteers. The four sequences were: 1) double inversion-recovery (DIR) prepared 2D multi-echo spin-echo (MESE); 2) DIR-prepared 2D multi-echo fast spin-echo (MEFSE); 3) improved motion-sensitized driven-equilibrium (iMSDE) prepared 3D FSE and 4) iMSDE prepared 3D fast spoiled gradient echo (FSPGR). The concordance correlation coefficient and Bland–Altman statistics were used to compare the sequences with a gold-standard 2D MESE, without blood suppression in phantom studies. The volunteers were scanned twice to test the repeatability. Mean and standard deviation of vessel wall T2, signal-to-noise (SNR), the coefficient of variance and interclass coefficient (ICC) of the two scans were compared. Results: The phantom study demonstrated that T2 measurements had high concordance with respect to the gold-standard (all r values >0.9). In the volunteer study, the DIR 2D MEFSE had significantly higher T2 values than the other three sequences (P < 0.01). There was no difference in T2 measurements obtained using the other three sequences (P > 0.05). iMSDE 3D FSE had the highest SNR (P < 0.05) compared with the other three sequences. The 2D DIR MESE has the highest repeatability (ICC: 0.96, [95% CI: 0.88–0.99]). Conclusion: Although accurate T2 measurements can be achieved in phantom by the four sequences, in vivo vessel wall T2 quantification shows significant differences. The in vivo images can be influenced by multiple factors including black-blood preparation and acquisition method. Therefore, a careful choice of acquisition methods and analysis of the confounding factors are required for accurate in vivo carotid vessel wall T2 measurements. From the settings in this study, the iMSDE prepared 3D FSE is preferred for the future volunteer/patient scans.
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Affiliation(s)
- Jianmin Yuan
- Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital
| | - Andrew J Patterson
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust
| | - Pascal P R Ruetten
- Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital
| | | | - Jonathan H Gillard
- Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital.,Department of Radiology, Cambridge University Hospitals NHS Foundation Trust
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46
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Saba L, Yuan C, Hatsukami TS, Balu N, Qiao Y, DeMarco JK, Saam T, Moody AR, Li D, Matouk CC, Johnson MH, Jäger HR, Mossa-Basha M, Kooi ME, Fan Z, Saloner D, Wintermark M, Mikulis DJ, Wasserman BA. Carotid Artery Wall Imaging: Perspective and Guidelines from the ASNR Vessel Wall Imaging Study Group and Expert Consensus Recommendations of the American Society of Neuroradiology. AJNR Am J Neuroradiol 2018; 39:E9-E31. [PMID: 29326139 DOI: 10.3174/ajnr.a5488] [Citation(s) in RCA: 176] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Identification of carotid artery atherosclerosis is conventionally based on measurements of luminal stenosis and surface irregularities using in vivo imaging techniques including sonography, CT and MR angiography, and digital subtraction angiography. However, histopathologic studies demonstrate considerable differences between plaques with identical degrees of stenosis and indicate that certain plaque features are associated with increased risk for ischemic events. The ability to look beyond the lumen using highly developed vessel wall imaging methods to identify plaque vulnerable to disruption has prompted an active debate as to whether a paradigm shift is needed to move away from relying on measurements of luminal stenosis for gauging the risk of ischemic injury. Further evaluation in randomized clinical trials will help to better define the exact role of plaque imaging in clinical decision-making. However, current carotid vessel wall imaging techniques can be informative. The goal of this article is to present the perspective of the ASNR Vessel Wall Imaging Study Group as it relates to the current status of arterial wall imaging in carotid artery disease.
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Affiliation(s)
- L Saba
- From the Department of Medical Imaging (L.S.), University of Cagliari, Cagliari, Italy
| | - C Yuan
- Departments of Radiology (C.Y., N.B., M.M.-B.)
| | - T S Hatsukami
- Surgery (T.S.H.), University of Washington, Seattle, Washington
| | - N Balu
- Departments of Radiology (C.Y., N.B., M.M.-B.)
| | - Y Qiao
- The Russell H. Morgan Department of Radiology and Radiological Sciences (Y.Q., B.A.W.), Johns Hopkins Hospital, Baltimore, Maryland
| | - J K DeMarco
- Department of Radiology (J.K.D.), Walter Reed National Military Medical Center, Bethesda, Maryland
| | - T Saam
- Department of Radiology (T.S.), Ludwig-Maximilian University Hospital, Munich, Germany
| | - A R Moody
- Department of Medical Imaging (A.R.M.), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - D Li
- Biomedical Imaging Research Institute (D.L., Z.F.), Cedars-Sinai Medical Center, Los Angeles, California
| | - C C Matouk
- Departments of Neurosurgery, Neurovascular and Stroke Programs (C.C.M., M.H.J.).,Radiology and Biomedical Imaging (C.C.M., M.H.J.)
| | - M H Johnson
- Departments of Neurosurgery, Neurovascular and Stroke Programs (C.C.M., M.H.J.).,Radiology and Biomedical Imaging (C.C.M., M.H.J.).,Surgery (M.H.J.), Yale University School of Medicine, New Haven, Connecticut
| | - H R Jäger
- Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, University College London Institute of Neurology, London, UK
| | | | - M E Kooi
- Department of Radiology (M.E.K.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Z Fan
- Biomedical Imaging Research Institute (D.L., Z.F.), Cedars-Sinai Medical Center, Los Angeles, California
| | - D Saloner
- Department of Radiology and Biomedical Imaging (D.S.), University of California, San Francisco, California
| | - M Wintermark
- Department of Radiology (M.W.), Neuroradiology Division, Stanford University, Stanford, California
| | - D J Mikulis
- Division of Neuroradiology (D.J.M.), Department of Medical Imaging, University Health Network
| | - B A Wasserman
- The Russell H. Morgan Department of Radiology and Radiological Sciences (Y.Q., B.A.W.), Johns Hopkins Hospital, Baltimore, Maryland
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47
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The development and optimisation of 3D black-blood R2* mapping of the carotid artery wall. Magn Reson Imaging 2017; 44:104-110. [DOI: 10.1016/j.mri.2017.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/05/2017] [Accepted: 08/30/2017] [Indexed: 11/22/2022]
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48
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Cai Y, He L, Yuan C, Chen H, Zhang Q, Li R, Li C, Zhao X. Atherosclerotic plaque features and distribution in bilateral carotid arteries of asymptomatic elderly population: A 3D multicontrast MR vessel wall imaging study. Eur J Radiol 2017; 96:6-11. [DOI: 10.1016/j.ejrad.2017.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 07/28/2017] [Accepted: 09/08/2017] [Indexed: 11/27/2022]
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49
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Xu X, Geng H, Zhang Q, Yu J, Chu Y, Dong G, Wu J. Investigation of 3D reduced field of view carotid atherosclerotic plaque imaging. Magn Reson Imaging 2017; 49:10-15. [PMID: 28958875 DOI: 10.1016/j.mri.2017.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/19/2017] [Accepted: 09/23/2017] [Indexed: 11/25/2022]
Abstract
To investigate the feasibility of using CUBE based reduced field of view imaging in atherosclerotic plaque imaging. Twenty-four patients were enrolled in this prospective study (13 males, 11 females, age 63±10). All patients underwent MRI exams consisting of 3D TOF, MPRAGE, iMSDE, DANTE, full FOV and reduced FOV CUBE imaging; 18 patients under went contrast enhanced imaging. The resulting images from different imaging sequences were assessed in terms of blood suppression, SNR, motion artifacts and vascular clarity. Reduced field of view CUBE outperformed MPRAGE, iMSDE and full FOV CUBE in blood suppression (P<0.05); outperformed MPRAGE, iMSDE and DANTE in SNR(P<005); outperformed MPRAGE and iMSDE in motion artifacts (P<005); outperformed MPRAGE and iMSDE in vascular clarity (P<0.05). The identifications of hemorrhage and calcification components were consistent between full FOV CUBE and reduced FOV CUBE (P<0.05). Overall, CUBE combined with reduced field of view imaging would be a promising method in atherosclerotic plaque imaging.
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Affiliation(s)
- Xueyan Xu
- Weifang People's Hospital, Weifang, Shandong, China
| | - Hai Geng
- Weifang People's Hospital, Weifang, Shandong, China
| | - Qiang Zhang
- Weifang People's Hospital, Weifang, Shandong, China
| | - Jianmin Yu
- Weifang People's Hospital, Weifang, Shandong, China
| | - Yujing Chu
- Weifang People's Hospital, Weifang, Shandong, China
| | - Guang Dong
- Weifang People's Hospital, Weifang, Shandong, China
| | - Jun Wu
- Weifang People's Hospital, Weifang, Shandong, China.
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50
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Chung MS, Jung SC, Kim SO, Kim HS, Choi CG, Kim SJ, Kwon SU, Kang DW, Kim JS. Intracranial Artery Steno-Occlusion: Diagnosis by Using Two-dimensional Spatially Selective Radiofrequency Excitation Pulse MR Imaging. Radiology 2017; 284:834-843. [DOI: 10.1148/radiol.2017161490] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mi Sun Chung
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
| | - Seung Chai Jung
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
| | - Seon-Ok Kim
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
| | - Ho Sung Kim
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
| | - Choong Gon Choi
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
| | - Sang Joon Kim
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
| | - Sun U. Kwon
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
| | - Dong-Wha Kang
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
| | - Jong S. Kim
- From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul 138-736, Korea
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