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Koori N, Kamekawa H, Naito T, Takatsu Y, Fuse H, Miyakawa S, Yasue K, Takahashi M, Kurata K. Carotid and aortic plaque imaging using 3D gradient-echo imaging and the three-point Dixon method with improved motion-sensitized driven-equilibrium (iMSDE). Magn Reson Imaging 2024; 111:202-209. [PMID: 38547936 DOI: 10.1016/j.mri.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 05/24/2024]
Abstract
BACKGROUND We devised a method that combines the 3D-Dixon-gradientecho (GRE) method with an improved motion-sensitized driven-equilibrium (iMSDE) to suppress blood flow signals. PURPOSE The purpose of this study was to evaluate the effectiveness of the new method we developed plaque imaging method (3D-Dixon-GRE with the iMSDE method). STUDY TYPE Retrospective cohort. POPULATION Thirty-nine patients who underwent cervical plaque imaging. FIELD STRENGTH/SEQUENCE 3.0 T/3D-GRE. ASSESSMENT Signal intensities of the common carotid artery, aorta, plaque, muscle, and subcutaneous fat were measured through the VISTA and the 3D-Dixon-GRE with iMSDE methods, and each contrast was calculated. STATISTICAL TEST Used the Mann Whitney U test. P-values below 0.05 were considered statistically significant. RESULTS Plaque and muscle contrast estimated through the VISTA method and 3D-Dixon-GRE with iMSDE method was 1.60 ± 0.96 and 2.04 ± 1.06, respectively, (P < 0.05). The contrast between the flow (common carotid artery and Aorta) and muscle according to the VISTA method and 3D-Dixon-GRE with iMSDE method was 0.24 ± 0.11 and 0.40 ± 0.12, respectively (P < 0.001). Finally, the mean contrast for subcutaneous fat and muscle at six locations was 3.05 ± 1.25 and 0.81 ± 0.23 for the VISTA method and 3D-Dixon-GRE with the iMSDE method, respectively (P < 0.001). DATA CONCLUSION Compared to the conventional method (VISTA), the 3D-Dixon-GRE with iMSDE method is preferable in relation to the fat suppression effect, but it is disadvantageous regarding blood flow signal suppression. Therefore, the 3D-Dixon-GRE with the iMSDE method could be considered useful for plaque imaging.
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Affiliation(s)
- Norikazu Koori
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences 4669-2 Ami, Ibaraki 300-03, Japan; Division of Health Sciences, Kanazawa University Graduate School of Medical Sciences, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan.
| | - Hiroki Kamekawa
- Department of Radiology, Komaki City Hospital, 1-20 Jyoubushi, Komaki, Aichi 485-8520, Japan
| | - Takehiro Naito
- Department of Neurosurgery, Komaki City Hospital, 1-20 Jyoubushi, Komaki, Aichi 485-8520, Japan
| | - Yasuo Takatsu
- Division of Health Sciences, Kanazawa University Graduate School of Medical Sciences, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan; School of Medical Sciences, Fujita Health University, Molecular Imaging, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Hiraku Fuse
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences 4669-2 Ami, Ibaraki 300-03, Japan
| | - Shin Miyakawa
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences 4669-2 Ami, Ibaraki 300-03, Japan
| | - Kenji Yasue
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences 4669-2 Ami, Ibaraki 300-03, Japan
| | - Masato Takahashi
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences 4669-2 Ami, Ibaraki 300-03, Japan
| | - Kazuma Kurata
- Department of Radiology, Komaki City Hospital, 1-20 Jyoubushi, Komaki, Aichi 485-8520, Japan
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Li X, Zhang J, Zhang J, Wang L, Tian J, Tang H, Mossa-Basha M, Zhao B, Wan J, Xu J, Zhou Y, Sun B, Zhao H, Zhu C. Optimizing timing for quantification of intracranial aneurysm enhancement: a multi-phase contrast-enhanced vessel wall MRI study. Eur Radiol 2024:10.1007/s00330-024-10827-z. [PMID: 38856782 DOI: 10.1007/s00330-024-10827-z] [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: 01/04/2024] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVES Aneurysm wall enhancement (AWE) on high-resolution contrast-enhanced vessel wall MRI (VWMRI) is an emerging biomarker for intracranial aneurysms (IAs) stability. Quantification methods of AWE in the literature, however, are variable. We aimed to determine the optimal post-contrast timing to quantify AWE in both saccular and fusiform IAs. MATERIALS AND METHODS Consecutive patients with unruptured IAs were prospectively recruited. VWMRI was acquired on 1 pre-contrast and 4 consecutive post-contrast phases (each phase was 9 min). Signal intensity values of cerebrospinal fluid (CSF) and aneurysm wall on pre- and 4 post-contrast phases were measured to determine the aneurysm wall enhancement index (WEI). AWE was also qualitatively analyzed on post-contrast images using previous grading criteria. The dynamic changes of AWE grade and WEI were analyzed for both saccular and fusiform IAs. RESULTS Thirty-four patients with 42 IAs (27 saccular IAs and 15 fusiform IAs) were included. The changes in AWE grade occurred in 8 (30%) saccular IAs and 6 (40%) in fusiform IAs during the 4 post-contrast phases. The WEI of fusiform IAs decreased 22.0% over time after contrast enhancement (p = 0.009), while the WEI of saccular IAs kept constant during the 4 post-contrast phases (p > 0.05). CONCLUSIONS When performing quantitative analysis of AWE, acquiring post-contrast VWMRI immediately after contrast injection achieves the strongest AWE for fusiform IAs. While the AWE degree is stable for 36 min after contrast injection for saccular IAs. CLINICAL RELEVANCE STATEMENT The standardization of imaging protocols and analysis methods for AWE will be helpful for imaging surveillance and further treatment decisions of patients with unruptured IAs. KEY POINTS Imaging protocols and measurements of intracranial aneurysm wall enhancement are reported heterogeneously. Aneurysm wall enhancement for fusiform intracranial aneurysms (IAs) is strongest immediately post-contrast, and stable for 36 min for saccular IAs. Future multi-center studies should investigate aneurysm wall enhancement as an emerging marker of aneurysm growth and rupture.
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Affiliation(s)
- Xiao Li
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianjian Zhang
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jin Zhang
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lingling Wang
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaqi Tian
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Tang
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Bing Zhao
- Department of Neurosurgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieqing Wan
- Department of Neurosurgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianrong Xu
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Beibei Sun
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Huilin Zhao
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, WA, USA.
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Tachikawa Y, Maki Y, Ikeda K, Yoshikai H, Toyonari N, Hamano H, Chiwata N, Suzuyama K, Takahashi Y. Flow independent black blood imaging with a large FOV from the neck to the aortic arch: A feasibility study at 3 tesla. Magn Reson Imaging 2024; 108:77-85. [PMID: 38331052 DOI: 10.1016/j.mri.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/03/2024] [Accepted: 02/03/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE To investigate the feasibility of obtaining black-blood imaging with a large FOV from the neck to the aortic arch at 3 T using a newly modified Relaxation-Enhanced Angiography without Contrast and Triggering for Black-Blood Imaging (REACT-BB). MATERIALS AND METHODS REACT-BB provides black-blood images by adjusting the inversion time (TI) in REACT to the null point of blood. The optimal TI for REACT-BB was investigated in 10 healthy volunteers with TI varied from 200 ms to 1400 ms. Contrast ratios were calculated between muscle and three branch arteries of the aortic arch. Additionally, a comparison between REACT-BB and MPRAGE involved evaluating the depiction of high-intensity plaques in 222 patients with stroke or transient ischemic attack. Measurements included plaque-to-muscle signal intensity ratios (PMR), plaque volumes, and carotid artery stenosis rates in 60 patients with high-intensity plaques in carotid arteries. RESULTS REACT-BB with TI = 850 ms produced the black-blood image with the best contrast between blood and background tissues. REACT-BB outperformed MPRAGE in depicting high-intensity plaques in the aortic arch (55.4% vs 45.5%) and exhibited superior overall image quality in visual assessment (3.31 ± 0.70 vs 2.89 ± 0.73; p < 0.05). Although the PMR of REACT-BB was significantly lower than MPRAGE (2.227 ± 0.601 vs 2.285 ± 0.662; P < 0.05), a strong positive correlation existed between REACT-BB and MPRAGE (ρ = 0.935; P < 0.05), and all high-intensity plaques that MPRAGE detected were clearly detected by REACT-BB. CONCLUSION REACT-BB provides black-blood images with uniformly suppressed fat and blood signals over a large FOV from the neck to the aortic arch with comparable or better high-signal plaque depiction than MPRAGE.
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Affiliation(s)
- Yoshihiko Tachikawa
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847-8588, Japan.
| | - Yasunori Maki
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847-8588, Japan
| | - Kento Ikeda
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847-8588, Japan
| | - Hikaru Yoshikai
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847-8588, Japan
| | - Nobuyuki Toyonari
- Department of Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto 862-0962, Japan
| | - Hiroshi Hamano
- Philips Japan, Philips Building, 2-13-37 Kohnan, Minato-ku, Tokyo 108-8507, Japan
| | - Naoya Chiwata
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847-8588, Japan
| | - Kenji Suzuyama
- Department of Neurosurgery, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847-8588, Japan
| | - Yukihiko Takahashi
- Department of Radiology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847-8588, Japan
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Charles JH, Desai S, Jean Paul A, Hassan A. Multimodal imaging approach for the diagnosis of intracranial atherosclerotic disease (ICAD): Basic principles, current and future perspectives. Interv Neuroradiol 2024; 30:105-119. [PMID: 36262087 PMCID: PMC10956456 DOI: 10.1177/15910199221133170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 09/29/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To review the different imaging modalities utilized in the diagnosis of Intracranial Atherosclerotic Disease (ICAD) including their latest development and relevance in management of ICAD. METHODS A review of the literature was conducted through a search in google scholar, PubMed/Medline, EMBASE, Scopus, clinical trials.gov and the Cochrane Library. Search terms included, "imaging modalities in ICAD," "ICAD diagnostic," "Neuroimaging of ICAD," "Evaluation of ICAD". A summary and comparison of each modality's basic principles, advantages and disadvantages were included. RESULTS A total of 144 articles were identified and reviewed. The most common imaging used in ICAD diagnoses were DSA, CTA, MRA and TCD. They all had proven accuracy, their own benefits, and limitations. Newer modalities such as VWI, IVUS, OCT, PWI and CFD provide more detailed information regarding the vessel walls, plaque characteristics, and flow dynamics, which play a tremendous role in treatment guidance. In certain clinical scenarios, using more than one modality has been shown to be helpful in ICAD identification. The rapidly evolving software related to imaging studies, such as virtual histology, are very promising for the diagnostic and management of ICAD. CONCLUSIONS ICAD is a common cause of recurrent ischemic stroke. Its management can be both medical and/or procedural. Many different imaging modalities are used in its diagnosis. In certain clinical scenario, a combination of two more modalities can be critical in the management of ICAD. We expect that continuous development of imaging technique will lead to individualized and less invasive management with adequate outcome.
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Affiliation(s)
| | - Sohum Desai
- Department of Endovascular Surgical Neuroradiology, Valley Baptist Medical Center, Harlingen, Texas, USA
| | - Axler Jean Paul
- School of Medicine, State University of Haiti, Port Au Prince, Haiti
| | - Ameer Hassan
- Department of Endovascular Surgical Neuroradiology, Valley Baptist Medical Center, Harlingen, Texas, USA
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Suzuki Y, Toma N, Inoue K, Ichikawa T, Nishikawa H, Miura Y, Fujimoto M, Yasuda R, Maeda M, Suzuki H. Evaluation of Intra-Aneurysmal Residual Blood Flow with the iMSDE T1-Black Blood Imaging after Flow Diverter Treatment. JOURNAL OF NEUROENDOVASCULAR THERAPY 2023; 17:159-166. [PMID: 37609573 PMCID: PMC10442175 DOI: 10.5797/jnet.oa.2023-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/25/2023] [Indexed: 08/24/2023]
Abstract
Objective We aimed to evaluate the efficacy of the "improved motion-sensitized driven-equilibrium (iMSDE)"-prepared T1-weighted black blood (T1-BB) MRI for monitoring treatment effect with a flow diverter (FD) for cerebral aneurysms. Methods Following the exclusion of concomitant coiling and retreatment cases from 60 consecutive cases of cerebral aneurysms treated with FDs at our institution, 32 with imaging data were included in the analysis. Detectability of residual blood flow within the aneurysms was validated as follows: 1) comparison of MRI sequences (iMSDE-prepared T1-BB images, T1-weighted images [ T1WI], and time-of-flight [ TOF]-MRA) in cases of incompletely occluded aneurysms and 2) comparison of angiography and MRI sequences in the same period. Results 1) The probability of diagnosing intra-aneurysmal blood flow was significantly higher with iMSDE-prepared T1-BB (iMSDE-prepared T1-BB vs. T1WI, p <0.001; iMSDE-prepared T1-BB vs. TOF-MRA, p <0.001). 2) The diagnostic accuracy of residual aneurysmal blood flow was significantly higher with iMSDE-prepared T1-BB than that with T1WI (p = 0.032). Furthermore, in cases of incomplete occlusion, the probability of detecting intra-aneurysmal blood flow was significantly higher with iMSDE-prepared T1-BB (iMSDE-prepared T1-BB vs. T1WI, p <0.001; iMSDE-prepared T1-BB vs. TOF-MRA, p = 0.023). Conclusion Our results demonstrated that iMSDE-prepared T1-BB could help distinguish between blood flow and thrombus within the aneurysms after FD treatment, especially in the early stages of FD treatment.
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Affiliation(s)
- Yume Suzuki
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Naoki Toma
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Katsuhiro Inoue
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Tomonori Ichikawa
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hirofumi Nishikawa
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yoichi Miura
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masashi Fujimoto
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Ryuta Yasuda
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masayuki Maeda
- Department of Neuroradiology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hidenori Suzuki
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Zun Z, Shin T. Velocity-selective excitation: Principles and applications. NMR IN BIOMEDICINE 2023; 36:e4820. [PMID: 35994473 PMCID: PMC9845137 DOI: 10.1002/nbm.4820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/12/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Velocity-selective (VS) excitation is a relatively new type of excitation that can be useful for generating image contrast based on spin's motion. This review aims to explain the principles of VS excitation and their utilization for clinical applications. We first review the generalized excitation k-space formalism, which reveals a Fourier relationship between sequence parameters and excitation profiles for spins with arbitrary spatial location, off-resonance, and velocity. Based on the k-space framework, we analyze practical VS excitation pulse sequences that yield sinusoidal or sinc-shaped velocity profiles. Then we demonstrate how these two types of VS excitation can be used as magnetization preparation for clinical applications, including saturation- or inversion-based arterial spin labeling and black- or bright-blood angiography. We also discuss practical considerations and issues for each application, including the determination of design parameters and the effects of MR system errors, such as magnetic field offsets and eddy currents.
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Affiliation(s)
- Zungho Zun
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Taehoon Shin
- Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul, South Korea
- Graduate Program in Smart Factory, Ewha Womans University, Seoul, South Korea
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
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Jun C, Shuhua L, Xue Z, Chunqing B, Mingli H. Application of motion-sensitized driven equilibrium based black blood 3D TSE sequence in the detection of brain metastases. Magn Reson Imaging 2022; 93:145-148. [PMID: 35981693 DOI: 10.1016/j.mri.2022.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/18/2022] [Accepted: 08/09/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To investigate the value of contrast-enhanced motion-sensitized driven equilibrium (MSDE) based black blood three-dimensional (3D) turbo spin echo (TSE) sequence in the detection of brain metastases compared with 3D Turbo Field Echo (TFE) sequence. MATERIAL AND METHODS 53 patients with suspected brain metastases were included in this study between November 2021 and February 2022. Contrast-enhanced cranial 3D TFE and MSDE-based 3D black blood TSE MR imaging were performed for each patient. Two senior neuroradiologists independently evaluated all contrast-enhanced 3D TFE and 3D black blood TSE images to detect brain metastases. The images were divided into two groups: the TFE group and the black blood TSE group. Agreement between the two reviewers for detection of the brain metastases in each group was performed using the kappa test. The two reviewers determined the final result for brain metastasis in the two groups by consensus. A paired t-test was performed for the final detection of brain metastases between the black blood TSE group and the TFE group. RESULTS There was a very good agreement between the two reviewers for the TSE group (kappa = 0.823) and a good agreement for the TFE group (kappa = 0.663). There was a statistical difference in the detection of small cortical and subcortical metastases between the TFE and the black blood TSE groups (t = 5.039, P = 0.000 < 0.05). There was no statistical difference in the detection of small supratentorial deep lesions and subtentorial lesions between the two groups. CONCLUSION Compared with conventional 3D TFE sequence, MSDE-based black blood 3D TSE sequence was superior for visualizing small brain metastases, especially small cortical and subcortical metastases.
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Affiliation(s)
- Chen Jun
- Department of MR, Liaocheng People's Hospital, Liaocheng, Shandong Province 252000, China.
| | - Li Shuhua
- Department of MR, Liaocheng People's Hospital, Liaocheng, Shandong Province 252000, China
| | - Zhang Xue
- Department of MR, Liaocheng People's Hospital, Liaocheng, Shandong Province 252000, China
| | - Bu Chunqing
- Department of MR, Liaocheng People's Hospital, Liaocheng, Shandong Province 252000, China
| | - He Mingli
- Department of MR, Liaocheng People's Hospital, Liaocheng, Shandong Province 252000, China
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Tachikawa Y, Hamano H, Yoshikai H, Ikeda K, Maki Y, Hirata K, Takahashi Y, Matake K. Three-dimensional multicontrast blood imaging with a single acquisition: Simultaneous non-contrast-enhanced MRA and vessel wall imaging in the thoracic aorta. Magn Reson Med 2022; 88:617-632. [PMID: 35436368 DOI: 10.1002/mrm.29217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/22/2022] [Accepted: 02/13/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate MRA and vessel wall imaging (VWI) image quality in the thoracic aorta using a novel method named BRIDGE (bright and dark blood images with multishot gradient-echo EPI). METHODS The BRIDGE method consists of 3D multishot gradient-echo EPI acquisition using pulse gating, navigator gating, and magnetization preparation with a T2 -preparation pulse and a nonselective inversion-recovery pulse. The BRIDGE and conventional methods (noncontrast MRA based on 3D turbo-field-echo [TFE] and VWI based on 3D turbo spin echo with variable refocusing flip angle [VRFA-TSE]) were performed in 10 healthy volunteers and 10 patients. The SNR, contrast-to-noise ratio (CNR), and sharpness in the thoracic aorta were compared for MRA evaluation. The values of SNRlumen , SNRwall , CNRwall-lumen , contrast ratio (CR)lumen-muscle , coefficient of variation, sharpness, lumen area, and wall area in the thoracic aorta were compared for VWI evaluation. Two radiologists independently performed qualitative image-analysis assessments. RESULTS When MRA and VWI were acquired, the acquisition time was 26.6% to 27.8% shorter with BRIDGE than the conventional method. In the MRA evaluation, BRIDGE and TFE methods were comparable. In the VWI evaluation, BRIDGE was superior to the VRFA-TSE method in blood suppression and evaluation of the ascending aorta. Because the blood signal suppression of BRIDGE is based on the T1 value of blood, the blood signal can be suppressed more uniformly than with the VRFA-TSE method, regardless of age, blood flow velocity, or vascular anatomy. CONCLUSION The BRIDGE method can provide both MRA, to assess vascular anatomy and luminal changes, and VWI, to assess the vessel wall and detect vulnerable plaques, in a single scan.
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Affiliation(s)
- Yoshihiko Tachikawa
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | | | - Hikaru Yoshikai
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | - Kento Ikeda
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | - Yasunori Maki
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | - Kazuhide Hirata
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, Saga, Japan
| | | | - Kunishige Matake
- Department of Radiology, Karatsu Red Cross Hospital, Saga, Japan
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Peng F, Liu L, Niu H, Feng X, Zhang H, He X, Xia J, Xu B, Bai X, Li Z, Sui B, Liu A. Comparisons between cross-section and long-axis-section in the quantification of aneurysmal wall enhancement of fusiform intracranial aneurysms in identifying aneurysmal symptoms. Front Neurol 2022; 13:945526. [PMID: 35959406 PMCID: PMC9361002 DOI: 10.3389/fneur.2022.945526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background To investigate the quantification of aneurysmal wall enhancement (AWE) in fusiform intracranial aneurysms (FIAs) and to compare AWE parameters based on different sections of FIAs in identifying aneurysm symptoms. Methods Consecutive patients were prospectively recruited from February 2017 to November 2019. Aneurysm-related symptoms were defined as sentinel headache and oculomotor nerve palsy. All patients underwent high resolution magnetic resonance imaging (HR-MRI) protocol, including both pre and post-contrast imaging. CRstalk (signal intensity of FIAs' wall divided by pituitary infundibulum) was evaluated both in the cross-section (CRstalk−cross) and the long-axis section (CRstalk−long) of FIAs. Aneurysm characteristics include the maximal diameter of the cross-section (Dmax), the maximal length of the long-axis section (Lmax), location, type, and mural thrombus. The performance of parameters for differentiating symptomatic and asymptomatic FIAs was obtained and compared by a receiver operating characteristic (ROC) curve. Results Forty-three FIAs were found in 43 patients. Eighteen (41.9%) patients who presented with aneurysmal symptoms were classified in the symptomatic group. In univariate analysis, male sex (P = 0.133), age (P = 0.013), FIAs type (P = 0.167), mural thrombus (P = 0.130), Lmax (P = 0.066), CRstalk−cross (P = 0.027), and CRstalk−long (P = 0.055) tended to be associated with aneurysmal symptoms. In the cross-section model of multivariate analysis, male (P = 0.038), age (P = 0.018), and CRstalk−cross (P = 0.048) were independently associated with aneurysmal symptoms. In the long-axis section model of multivariate analysis, male (P = 0.040), age (P = 0.010), CRstalk−long (P = 0.046), and Lmax (P = 0.019) were independently associated with aneurysmal symptoms. In the combination model of multivariate analysis, male (P = 0.027), age (P = 0.011), CRstalk−cross (P = 0.030), and Lmax (P = 0.020) were independently associated with aneurysmal symptoms. CRstalk−cross has the highest accuracy in predicting aneurysmal symptoms (AUC = 0.701). The combination of CRstalk−cross and Lmax exhibited the highest performance in discriminating symptomatic from asymptomatic FIAs (AUC = 0.780). Conclusion Aneurysmal wall enhancement is associated with symptomatic FIAs. CRstalk−cross and Lmax were independent risk factors for aneurysmal symptoms. The combination of these two factors may improve the predictive performance of aneurysmal symptoms and may also help to stratify the instability of FIAs in future studies.
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Affiliation(s)
- Fei Peng
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lang Liu
- Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hao Niu
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xin Feng
- Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hong Zhang
- Operating Room, Heze Municipal Hospital, Heze, China
| | - Xiaoxin He
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiaxiang Xia
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Boya Xu
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoyan Bai
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhiye Li
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China
- *Correspondence: Binbin Sui
| | - Aihua Liu
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, China
- Aihua Liu
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10
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Han M, Choi JW, Jung WS, Lee JS. Isolated posterior inferior cerebellar artery dissection with ischaemic stroke: evaluating the radiological features and diagnostic feasibility of high-resolution vessel wall imaging. Clin Radiol 2022; 77:584-591. [PMID: 35676104 DOI: 10.1016/j.crad.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 05/06/2022] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the radiological features of isolated posterior inferior cerebellar artery dissection (PICAD) and the feasibility of using high-resolution vessel-wall imaging (HR-VWI) for diagnosing PICAD. MATERIALS AND METHODS Three hundred and nine patients with arterial dissection involving the posterior cerebral circulation, who underwent HR-VWI between March 2012 and July 2019 were reviewed retrospectively. Among them, 44 patients (14.2%) were diagnosed with isolated PICAD in consensus among a neuroradiologist, a neurointerventionist, and a neurologist. Two neuroradiologists reviewed the vessel wall images independently for evidence of dissection (dissection flap, outer diameter enlargement on T2-weighted imaging [WI], mural haematoma). Diagnostic confidence was also scored on a five-point scale. Intra- and interobserver agreement for diagnosing PICAD and detecting evidence of dissection were evaluated. RESULTS Dissection flaps were seen on T2WI in all cases (100%) and on contrast-enhanced T1WI in 34 patients (79.1%). Outer diameter enlargement of the steno-occlusive lesions on angiography was detected in most cases (97.7%). A mural haematoma was detected on three-dimensional (3D) contrast-enhanced motion-sensitised driven-equilibrium T1WI in 97.1% of the cases. The mean diagnostic confidence score derived by two neuroradiologists was 4.72. The two reviewers showed substantial to almost perfect agreement (weighted kappa coefficient: 0.62-0.97). CONCLUSION Use of HR-VWI as a diagnostic tool for PICAD is feasible, and a dissection flap with outer wall enlargement on HR-T2WI allows confident dissection diagnosis. The present data suggest that PICAD might be considered as a stroke aetiology in patients with unexplained ischaemic stroke in the PICA territory, and that PICA evaluation with HR-VWI is both necessary and feasible.
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Affiliation(s)
- M Han
- Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, Republic of Korea; Department of Radiology, Graduate School of Kangwon National University, Chuncheon, Republic of Korea
| | - J W Choi
- Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, Republic of Korea.
| | - W S Jung
- Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, Republic of Korea; Department of Radiology, Graduate School of Kangwon National University, Chuncheon, Republic of Korea
| | - J S Lee
- Department of Neurology, Ajou University School of Medicine, Ajou University Hospital, Suwon, Republic of Korea
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11
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Sannananja B, Zhu C, Colip CG, Somasundaram A, Ibrahim M, Khrisat T, Mossa-Basha M. Image-Quality Assessment of 3D Intracranial Vessel Wall MRI Using DANTE or DANTE-CAIPI for Blood Suppression and Imaging Acceleration. AJNR Am J Neuroradiol 2022; 43:837-843. [PMID: 35618420 DOI: 10.3174/ajnr.a7531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/13/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE 3D intracranial vessel wall MRI techniques are time consuming and prone to artifacts, especially flow artifacts. Our aim was to compare the image quality of accelerated and flow-suppressed 3D intracranial vessel wall MR imaging techniques relative to conventional acquisitions. MATERIALS AND METHODS Consecutive patients undergoing MR imaging had conventional postcontrast 3D T1-sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) and either postcontrast delay alternating with nutation for tailored excitation (DANTE) flow-suppressed or DANTE-controlled aliasing in parallel imaging results in higher acceleration (CAIPI) flow-suppressed and accelerated T1-SPACE sequences performed. The sequences were evaluated using 4- or 5-point Likert scales for overall image quality, SNR, extent/severity of artifacts, motion, blood suppression, sharpness, and lesion assessment. Quantitative assessment of lumen and wall-to-lumen contrast ratios was performed. RESULTS Eighty-nine patients were included. T1-DANTE-SPACE had significantly better qualitative ratings relative to T1-SPACE for image quality, SNR, artifact impact, arterial and venous suppression, and lesion assessment (P < .001 for each, respectively), with the exception of motion (P = .16). T1-DANTE-CAIPI-SPACE had significantly better image quality, lesion assessment, arterial and venous blood suppression, less artifact impact, and less motion compared with T1-SPACE (P < .001 for each, respectively). The SNR was higher with T1-SPACE compared with T1-DANTE-CAIPI-SPACE (P < .001). T1-DANTE-CAIPI-SPACE showed significantly worse lumen (P = .005) and wall-to-lumen contrast ratios (P = .001) compared with T1-SPACE, without a significant difference between T1-SPACE and T1-DANTE-SPACE. T1-DANTE-CAIPI-SPACE scan time was 5:11 minutes compared with 8:08 and 8:41 minutes for conventional T1-SPACE and T1-DANTE-SPACE, respectively. CONCLUSIONS Accelerated postcontrast T1-DANTE-CAIPI-SPACE had fewer image artifacts, less motion, improved blood suppression, and a shorter scan time, but lower qualitative and quantitative SNR ratings relative to conventional T1-SPACE intracranial vessel wall MR imaging. Postcontrast T1-DANTE-SPACE had superior SNR, blood suppression, higher image quality, and fewer image artifacts, but slightly longer scan times relative to T1-SPACE.
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Affiliation(s)
- B Sannananja
- From the Department of Radiology (B.S., A.S.), Emory University, Atlanta, Georgia
| | - C Zhu
- Department of Radiology (C.Z., M.M.-B.), University of Washington, Seattle, Washington
| | - C G Colip
- Kaiser Permanente Northwest (C.G.C.), Portland, OR
| | - A Somasundaram
- From the Department of Radiology (B.S., A.S.), Emory University, Atlanta, Georgia
| | - M Ibrahim
- Department of Radiology (M.I.), University of Kansas, Lawrence, Kansas
| | - T Khrisat
- Department of Surgery (T.K.), Lincoln Medical Center, New York, New York
| | - M Mossa-Basha
- Department of Radiology (C.Z., M.M.-B.), University of Washington, Seattle, Washington
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12
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Zhai SJ, Jia L, Kukun HJ, Wang YL, Wang H, Ding S, Jia WX. Predictive power of high-resolution vessel wall magnetic resonance imaging in ischemic stroke. Am J Transl Res 2022; 14:664-671. [PMID: 35173884 PMCID: PMC8829603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/25/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Intracranial atherosclerotic disease (ICAD) is a key contributor to ischemic stroke and has a high recurrence rate. This study aimed to investigate the function of high-resolution vessel wall MRI (HR-VW-MRI) and evaluate plaque characteristics in patients with ICAD. METHODS A consecutive series of patients with ICAD who underwent HR-VW-MRI were enrolled, and imaging measurements were acquired. Baseline clinical characteristics were identified. Telephone follow-up was conducted every three months. The endpoint events were the first onset or recurrence of ischemic stroke and new clinical vascular events. Patients were divided into groups with or without events according to whether the endpoint event occurred. RESULTS A total of 70 patients (mean age = 57.6 years old) were enrolled. The median follow-up duration was 182 days. During the follow-up, 10 patients developed ischemic stroke, experienced endpoint events, and were found with 44 plaques in the artery area. A total of 169 plaques were further found in 70 patients. There were significant differences in EI, HST1, surface features, and WA reference between the two groups (P < 0.05). Logistic analysis showed that grade 2 enhancements, stenosis degree ≥ 50%, HST1, and surface features were independent prognostic factors of the onset of stroke, caused by ICAD. CONCLUSION This prospective study demonstrates that HR-VW-MRI can identify atherosclerotic plaques in the cerebral artery and high-risk plaques, which may contribute to the prevention of ICAD and guide clinical treatment.
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Affiliation(s)
- Shu-Jia Zhai
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054, China
| | - Lin Jia
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054, China
| | - Han-Jiaerbieke Kukun
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054, China
| | - Yun-Ling Wang
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054, China
| | - Hong Wang
- Department of Radiology, The Second Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830063, China
| | - Shuang Ding
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054, China
| | - Wen-Xiao Jia
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054, China
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13
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Ning Z, Zhang N, Qiao H, Han H, Shen R, Yang D, Chen S, Zhao X. Free-Breathing Three-Dimensional Isotropic-Resolution MR sequence for simultaneous vessel wall imaging of bilateral renal arteries and abdominal aorta: Feasibility and reproducibility. Med Phys 2021; 49:854-864. [PMID: 34967464 DOI: 10.1002/mp.15436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/03/2021] [Accepted: 12/28/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Many diseases can simultaneously involve renal arteries and the adjacent abdominal aorta. The study proposed a free-breathing three-dimensional (3D) isotropic-resolution MR sequence for simultaneous vessel wall imaging of bilateral renal arteries and adjacent abdominal aorta. METHODS A respiratory triggered isotropic-resolution sequence which combined the improved motion-sensitized driven-equilibrium (iMSDE) preparation with the spoiled gradient recalled (SPGR) readout (iMSDE-SPGR) was proposed for simultaneous vessel wall imaging of renal arteries and abdominal aorta. The proposed iMSDE-SPGR sequence was optimized by positioning spatial saturation pulses (i.e. REST slabs) elaborately to further alleviate respiratory and gastrointestinal motion artifacts and selecting appropriate first-order gradient moment (m1 ) of the iMSDE preparation. Thirteen healthy subjects and thirteen patients with renal artery stenosis (RAS) underwent simultaneous vessel wall imaging with the optimized iMSDE-SPGR sequence at 3.0T. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and morphology of renal arterial wall and aortic wall were measured. Reproducibility of intra-observer, inter-observer and scan-rescan (n = 13 healthy subjects) in measuring SNR, CNR and morphology was evaluated. For the reproducibility test, the agreement was determined using intraclass correlation coefficients (ICC) and the differences were compared using paired-t test or non-parametric Wilcoxon test when appropriate. Bland-Altman plots were used to calculate the bias between observers and between scans. RESULTS The proposed iMSDE-SPGR sequence was feasible for simultaneous vessel wall imaging both in the healthy subjects and the patients. The sequence showed good to excellent inter-observer (ICC:0.615-0.999), excellent intra-observer (ICC:0.801-0.998) and scan-rescan (ICC:0.768-0.998) reproducibility in measuring morphology, SNR and CNR. There were no significant differences in SNR, CNR and morphology measurements between observers and between scans (all P>0.05). Bland-Altman plots showed small bias in assessing SNR, CNR and morphology. DATA CONCLUSION The proposed free-breathing 3D isotropic-resolution iMSDE-SPGR technique is feasible and reproducible for simultaneous vessel wall imaging of bilateral renal arteries and adjacent abdominal aorta. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Zihan Ning
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Beijing, 100029, China
| | - Huiyu Qiao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Hualu Han
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Rui Shen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Dandan Yang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Shuo Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, 100084, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, 100084, China
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14
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Mossa-Basha M, Zhu C, Wu L. Vessel Wall MR Imaging in the Pediatric Head and Neck. Magn Reson Imaging Clin N Am 2021; 29:595-604. [PMID: 34717847 DOI: 10.1016/j.mric.2021.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Vessel wall MR imaging (VWI) is a technique that progressively has gained traction in clinical diagnostic applications for evaluation of intracranial and extracranial vasculopathies, with increasing use in pediatric populations. The technique has shown promise in detection, differentiation, and characterization of both inflammatory and noninflammatory vasculopathies. In this article, optimal techniques for intracranial and extracranial VWI as well as applications and value for pediatric vascular disease evaluation are discussed.
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Affiliation(s)
- Mahmud Mossa-Basha
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA.
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, 325 9th Avenue, Seattle, WA 98104, USA
| | - Lei Wu
- Department of Radiology, University of Washington, 1660 South Columbian Way, Seattle, WA 98108, USA
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15
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Feng J, Liu X, Zhang Z, Wu Y, Li Z, Zhang Q, Jiang Y, You W, Liu P, Wang Y, Mossa-Basha M, Saloner D, Li Y, Zhu C. Comparison of 7 T and 3 T vessel wall MRI for the evaluation of intracranial aneurysm wall. Eur Radiol 2021; 32:2384-2392. [PMID: 34643780 DOI: 10.1007/s00330-021-08331-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/28/2021] [Accepted: 09/15/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To compare the visibility of intracranial aneurysm wall and thickness quantification between 7 and 3 T vessel wall imaging and evaluate the association between aneurysm size and wall thickness. METHODS Twenty-nine patients with 29 unruptured intracranial aneurysms were prospectively recruited for 3D T1-weighted vessel wall MRI at both 3 T and 7 T with 0.53 mm (3 T) and 0.4 mm (7 T) isotropic resolution, respectively. Two neuroradiologists independently evaluated wall visibility (0-5 Likert scale), quantified the apparent wall thickness (AWT) using a semi-automated full-width-half-maximum method, calculated wall sharpness, and measured the wall-to-lumen contrast ratio (CRwall/lumen). RESULTS Twenty-four patients with 24 aneurysms were included in this study. 7 T achieved significantly better aneurysm wall visibility than 3 T (3.6 ± 1.1 vs 2.7 ± 0.8, p = 0.003). AWT measured on 3 T and 7 T had a good correlation (averaged r = 0.63 ± 0.19). However, AWT on 3 T was 15% thicker than that on 7 T (0.52 ± 0.07 mm vs 0.45 ± 0.05 mm, p < 0.001). Wall sharpness on 7 T was 57% higher than that on 3 T (1.95 ± 0.32 mm-1 vs 1.24 ± 0.15 mm-1, p < 0.001). CRwall/lumen on 3 T and 7 T was comparable (p = 0.424). AWT on 7 T was positively correlated with aneurysm size (saccular: r = 0.58, q = 0.046; fusiform: r = 0.67, q = 0.049). CONCLUSIONS 7 T provides better visualization of intracranial aneurysm wall with higher sharpness than 3 T. 3 T overestimates the wall thickness relative to 7 T. Aneurysm wall thickness is positively correlated with aneurysm size. 7 T MRI is a promising tool to evaluate aneurysm wall in vivo. KEY POINTS • 7 T provides better visualization of intracranial aneurysm wall with higher sharpness than 3 T. • 3 T overestimates the wall thickness comparing with 7 T. • Aneurysm wall thickness is positively correlated with aneurysm size.
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Affiliation(s)
- Junqiang Feng
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xinke Liu
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zihao Zhang
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing, 100101, China. .,University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing, 100049, China. .,CAS Center for Excellence in Brain Science and Intelligence Technology, Beijing, 100049, China.
| | - Yue Wu
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing, 100101, China.,University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing, 100049, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Beijing, 100049, China
| | - Zhixin Li
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Beijing, 100101, China.,University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing, 100049, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Beijing, 100049, China
| | - Qiang Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Yuhua Jiang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei You
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Liu
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yan Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | | | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Youxiang Li
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, WA, USA
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16
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Sun B, Wang L, Li X, Zhang J, Zhang J, Liu X, Wu H, Mossa-Basha M, Xu J, Zhao B, Zhao H, Zhou Y, Zhu C. Intracranial Atherosclerotic Plaque Characteristics and Burden Associated With Recurrent Acute Stroke: A 3D Quantitative Vessel Wall MRI Study. Front Aging Neurosci 2021; 13:706544. [PMID: 34393761 PMCID: PMC8355600 DOI: 10.3389/fnagi.2021.706544] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Intracranial atherosclerotic disease (ICAD) tends to affect multiple arterial segments, and previous studies rarely performed a comprehensive plaque analysis of the entire circle of Willis for the evaluation of recurrent stroke risk. We aimed to investigate the features of circle of Willis ICAD on 3D magnetic resonance vessel wall imaging (MR-VWI) and their relationships with recurrent acute stroke. Methods: Patients with either acute ischemic stroke (within 4 weeks after stroke) or chronic ischemic stroke (after 3 months of stroke) due to intracranial atherosclerotic plaque underwent 3D contrast-enhanced MR-VWI covering major cerebral arteries. Participants were divided into three groups: first-time acute stroke, recurrent acute stroke, and chronic stroke. Culprit plaque (defined as the only lesion or the most stenotic lesion when multiple plaques were present within the same vascular territory of the stroke) and non-culprit plaque characteristics, including total plaque number, plaque thickness, plaque area, plaque burden (calculated as plaque area divided by outer wall area), enhancement ratio (ER), eccentricity, and stenosis, were measured and compared across the three groups. Associations between plaque characteristics and recurrent acute stroke were investigated by multivariate analysis. Results: A total of 176 participants (aged 61 ± 10 years, 109 men) with 702 intracranial plaques were included in this study. There were 80 patients with first-time acute stroke, 42 patients with recurrent acute stroke, and 54 patients with chronic stroke. More intracranial plaques were found per patient in the recurrent acute stroke group than in the first-time acute stroke or chronic stroke group (5.19 ± 1.90 vs. 3.71 ± 1.96 and 3.46 ± 1.33, p < 0.001). Patients in the recurrent acute stroke group had greater culprit plaque burden (p < 0.001) and higher culprit ER (p < 0.001) than the other two groups. After adjustment of clinical demographic factors, in multivariate analysis, coronary artery disease (CAD) (odds ratio, OR = 4.61; p = 0.035), total plaque number (OR = 1.54; p = 0.003), culprit plaque ER (OR = 2.50; p = 0.036), and culprit plaque burden (OR per 10% increment = 2.44; p = 0.010) were all independently associated with recurrent acute stroke compared to the first-time acute stroke. Conclusion: Increased intracranial atherosclerotic plaque number, higher culprit plaque ER, greater culprit plaque burden, and CAD are independently associated with recurrent acute stroke.
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Affiliation(s)
- Beibei Sun
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Lingling Wang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiao Li
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jin Zhang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jianjian Zhang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaosheng Liu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Hengqu Wu
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Bing Zhao
- Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Huilin Zhao
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yan Zhou
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, WA, United States
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17
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Detection and Prediction of Peripheral Arterial Plaque Using Vessel Wall MR in Patients with Diabetes. BIOMED RESEARCH INTERNATIONAL 2021. [PMID: 31638151 PMCID: PMC8088372 DOI: 10.1155/2021/5585846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objectives To evaluate the predictive performance of a newly developed delay alternating with nutation for tailored excitation (DANTE) pulse sequence for detecting lower extremity artery wall morphology and distribution in patients with peripheral artery disease (PAD) with diabetes. Methods Seventy-four PAD patients diagnosed according to 2011 WHO criteria were enrolled, who has diabetic diagnosis by 1999 WHO diabetes criteria. All patients received sequential DANTE, T2WI, DANTE-enhance, and CE-MRA scans. The images consisted of three parts: the iliac artery (segment 1), femoral artery (segment 2), and popliteal artery (segment 3). Regions of interest (ROIs) were drawn on vessels, muscle, and background, and multiple imaging metrics compared between modalities, including image quality score, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). In the images with a score greater than 2, the lumen area (LA), total vessel area (TVA), and vessel thickness (VT) can be identified using semiautomatic image analysis vessel morphology parameters. Results All 222 arterial segments were successfully analyzed from 71 patients, after exclusion of three subjects with poor image quality (IQ < 2) in segment 3. There were 54 diabetic and 17 nondiabetic patients. Quantitative analysis shows that the CNR difference between diabetic patients and nondiabetic patients was statistically significant for the same segment, while there was no significant difference among the three segments of SNR and CNR. There were a total of 54 diabetics with plaque distribution data, which showed that LA of segments 1 and 2 was higher than that of segment 3. The VWI of segments 1 and 2 was lower than segment 3. Diabetic was associated with vascular WT 3 and WA3, which increased by 0.23 and 0.83 units on average compared without diabetic foot, respectively. Diabetic foot was associated with vascular WT 3, which increased by 0.37 units on average compared without diabetic foot. The incidence of segment 3 plaques was higher than that of segment 1. The incidence of the left and right plaques was different. Conclusions MR imaging using the DANTE and multicontrast sequence could evaluate plaque morphology, and distribution of lower extremities and the occurrence of diabetic foot development are closely related; it may predict occurrence of PAD with diabetic foot.
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Wang L, Deng W, Liang J, Zhuang W, Feng H, Zhuang G, Liu D, Chen H. Loan sharking: changing patterns in, and challenging perceptions of, an abuse of deprivation. JOURNAL OF PUBLIC HEALTH (OXFORD, ENGLAND) 2021; 43:e62-e68. [PMID: 31638151 PMCID: PMC8088372 DOI: 10.1093/pubmed/fdz090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/02/2019] [Accepted: 07/10/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND Illegal high interest lending or 'loan sharking' exploits the vulnerable and has profound negative impacts on individuals and communities. The 2008 UK financial crash and subsequent austerity programme coupled with changes in the consumer credit market have fuelled an increase in predatory lending. METHODS The study is a descriptive analysis of demographic, financial, health and behavioural data on 753 victims (2011-2017). A review of the causative factors and potential political, economic and public health responses is analysed. RESULTS Most victims were female but males were considerably more indebted. Illegal loans are largely taken out for routine living expenses and over 70% of victims reported other serious debts. Victims are disproportionately poor, unemployed and on benefits but fewer than half have had financial or benefits advice. Despite 90% reporting they would not borrow illegally again, 30% had previously done so from the same shark and over half considered them a friend. CONCLUSIONS The increase in loan sharking has coincided with the withdrawal of traditional sub-prime lenders and local welfare assistance schemes, and the low penetration of Credit Unions in many areas. Conventional perceptions of loan sharks and their relationships with victims are largely incorrect. A range of coordinated financial, political and social interventions is required.
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Affiliation(s)
- Li Wang
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Wei Deng
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Jianke Liang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Weizhao Zhuang
- Invasive Technology Department, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Huigang Feng
- Invasive Technology Department, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Gaoming Zhuang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Dexiang Liu
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Hanwei Chen
- Invasive Technology Department, Guangzhou Panyu Central Hospital, Guangzhou, China
- Invasive Technology Department, The First Affiliated Hospital, Jinan University, Guangzhou, China
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Wang HW, Wu C, Xue Z, Shu XJ, Sun ZH. A Supplemental Technique for Preoperative Evaluation of Giant Intracranial Aneurysm. J Neurol Surg A Cent Eur Neurosurg 2021; 82:424-429. [PMID: 33583010 DOI: 10.1055/s-0040-1721006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Preoperative planning mainly relies on digital subtraction angiography (DSA) and computed tomography angiography. However, neither technique can reveal thrombi in giant intracranial aneurysms (GIAs). In this study, we aimed to reconstruct the circulating and noncirculating parts of GIAs with the time-of-flight (TOF) and motion-sensitized driven-equilibrium (MSDE) sequences with 3D Slicer to reveal an integrated presentation of GIAs, compare its accuracy, and validate the usefulness for preoperative planning. MATERIAL AND METHODS Patients with GIAs who were treated with microsurgery in our department were included in this study. Both the TOF and MSDE sequence data for each patient were loaded into 3D Slicer for reconstruction and segmentation. The parameters measured by 3D Slicer were compared with those measured by DSA. RESULTS The mean diameter for all GIAs was 28.7 ± 1.5 mm (range, 25.9-31.9 mm). The mean diameter for all GIAs measured by DSA and 3D Slicer was 24.46 ± 5.25 and 28.66 ± 1.48 mm, respectively (t = 4.948, p < 0.01). When only the nonthrombotic GIAs were included, the mean diameter measured by DSA and 3D Slicer was 28.69 ± 2.03 and 28.97 ± 1.79 mm, respectively (t = 1.023, p = 0.323). The mean aneurysmal volume was 8,292.6 ± 1,175.1 mm3 and the mean thrombotic volume was 3,590.0 ± 1,003.7 mm3. CONCLUSION The MSDE sequence brings diagnostic benefits as a comparison to other MRI sequences. Reconstruction of GIAs with 3D Slicer is a low-cost, dependable, and useful supplemental technique for surgical planning.
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Affiliation(s)
- Hua-Wei Wang
- Chinese PLA General Hospital, Neurosurgery, Beijing, China
| | - Chen Wu
- Chinese PLA General Hospital, Neurosurgery, Beijing, China
| | - Zhe Xue
- Chinese PLA General Hospital, Neurosurgery, Beijing, China
| | - Xu-Jun Shu
- Chinese PLA General Hospital, Neurosurgery, Beijing, China
| | - Zheng-Hui Sun
- Chinese PLA General Hospital, Neurosurgery, Beijing, China
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20
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Settecase F, Rayz VL. Advanced vascular imaging techniques. HANDBOOK OF CLINICAL NEUROLOGY 2021; 176:81-105. [DOI: 10.1016/b978-0-444-64034-5.00016-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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21
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Fu Q, Wang Y, Zhang Y, Zhang Y, Guo X, Xu H, Yao Z, Wang M, Levitt MR, Mossa-Basha M, Zhu J, Cheng J, Guan S, Zhu C. Qualitative and Quantitative Wall Enhancement on Magnetic Resonance Imaging Is Associated With Symptoms of Unruptured Intracranial Aneurysms. Stroke 2021; 52:213-222. [PMID: 33349014 PMCID: PMC7770055 DOI: 10.1161/strokeaha.120.029685] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Aneurysmal wall enhancement (AWE) on vessel wall magnetic resonance imaging (VW-MRI) has been described as a new imaging biomarker of unstable unruptured intracranial aneurysms (UIAs). Previous studies of symptomatic UIAs are limited due to small sample sizes and lack of AWE quantification. Our study aims to investigate whether qualitative and quantitative assessment of AWE can differentiate symptomatic and asymptomatic UIAs. METHODS Consecutive patients with UIAs were prospectively recruited for vessel wall magnetic resonance imaging at 3T from October 2014 to October 2019. UIAs were categorized as symptomatic if presenting with sentinel headache or oculomotor nerve palsy directly related to the aneurysm. Evaluation of wall enhancement included enhancement pattern (0=none, 1=focal, and 2=circumferential) and quantitative wall enhancement index (WEI). Univariate and multivariate analyses were used to identify the parameters associated with symptoms. RESULTS Two hundred sixty-seven patients with 341 UIAs (93 symptomatic and 248 asymptomatic) were included in this study. Symptomatic UIAs more frequently showed circumferential AWE than asymptomatic UIAs (66.7% versus 17.3%, P<0.001), as well as higher WEI (median [interquartile range], 1.3 [1.0-1.9] versus 0.3 [0.1-0.9], P<0.001). In multivariate analysis, both AWE pattern and WEI were independent factors associated with symptoms (odds ratio=2.03 across AWE patterns [95% CI, 1.21-3.39], P=0.01; odds ratio=3.32 for WEI [95% CI, 1.51-7.26], P=0.003). The combination of AWE pattern and WEI had an area under the curve of 0.91 to identify symptomatic UIAs, with a sensitivity of 95.7% and a specificity of 73.4%. CONCLUSIONS In a large cohort of UIAs with vessel wall magnetic resonance imaging, both AWE pattern and WEI were independently associated with aneurysm-related symptoms. The qualitative and quantitative features of AWE can potentially be used to identify unstable intracranial aneurysms.
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Affiliation(s)
- Qichang Fu
- Department of Magnetic Resonance, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuting Wang
- Department of Radiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yi Zhang
- Department of Magnetic Resonance, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinbin Guo
- Department of Interventional Neuroradiology, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Haowen Xu
- Department of Interventional Neuroradiology, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhiqiang Yao
- Department of Interventional Neuroradiology, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Meng Wang
- Department of Neurological Surgery, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Michael R. Levitt
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
- Department of Radiology, University of Washington, Seattle, WA, USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | | | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd., Beijing, China
| | - Jingliang Cheng
- Department of Magnetic Resonance, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Sheng Guan
- Department of Interventional Neuroradiology, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, WA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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22
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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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Zhu C, Wang X, Eisenmenger L, Shi Z, Degnan A, Tian B, Liu Q, Hess C, Saloner D, Lu J. Wall enhancement on black-blood MRI is independently associated with symptomatic status of unruptured intracranial saccular aneurysm. Eur Radiol 2020; 30:6413-6420. [PMID: 32666320 DOI: 10.1007/s00330-020-07063-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/19/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aims to investigate whether aneurysm wall enhancement (AWE) is independently associated with symptomatic status of unruptured intracranial aneurysms (UIAs). METHODS One hundred thirty-nine consecutive patients (67 male, mean age 58 ± 11 years) with 79 symptomatic and 87 asymptomatic UIAs were imaged using black-blood MRI pre- and post-gadolinium contrast administration and 3D DSA. Symptoms related to aneurysms were identified including cranial nerve deficits and headache. AWE grade and area were characterized, and aneurysm size was measured on DSA. Multivariate binary logistic regression analysis was used to identify factors associated with symptoms. Further subgroup analysis was performed for aneurysms size < 10 mm. RESULTS Symptomatic UIAs had significantly larger aneurysm size (11.2 ± 6.2 mm vs. 6.4 ± 3.3 mm), enhancement grade (1.3 ± 0.6 vs. 0.4 ± 0.6), enhancement area (2.0 ± 0.9 vs. 0.4 ± 0.7), and higher prevalence of thick enhancement (39% vs. 3%) compared with asymptomatic UIAs, all p < 0.001. In multivariate analysis, only AWE area (odds ratio [OR] 6.9, 95% confidence interval [4.0, 11.7]) was independently associated with symptoms. AWE area had an area under curve (AUC) value of 0.888, with 72.2% sensitivity and 92.0% specificity for symptoms, which was superior to aneurysm size (AUC of 0.771, with 75.9% sensitivity and 65.5% specificity). In the subgroup analysis of aneurysms smaller than 10 mm (n = 118), AWE area (OR, 7.0, p < 0.001) remained the only independent risk factor associated with symptoms. CONCLUSIONS Larger AWE area is independently associated with symptomatic UIAs, which may provide additional value to guide UIA management and improve patient outcomes. KEY POINTS • Symptomatic intracranial aneurysms are larger and more often demonstrate significant wall enhancement than asymptomatic aneurysms. • Larger wall enhancement area is independently associated with symptomatic intracranial aneurysm.
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Affiliation(s)
- Chengcheng Zhu
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Xinrui Wang
- Department of Radiology, Changhai Hospital, Shanghai, China.,Department of Radiology, General Hospital of Northern Theatre Command, Shenyang, China
| | | | - Zhang Shi
- Department of Radiology, Changhai Hospital, Shanghai, China
| | - Andrew Degnan
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bing Tian
- Department of Radiology, Changhai Hospital, Shanghai, China
| | - Qi Liu
- Department of Radiology, Changhai Hospital, Shanghai, China
| | - Christopher Hess
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - David Saloner
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Jianping Lu
- Department of Radiology, Changhai Hospital, Shanghai, China.
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Liu X, Zhang Z, Zhu C, Feng J, Liu P, Kong Q, Zhang X, Zhang Q, Jin H, Ge H, Jiang Y, Saloner D, Li Y. Wall enhancement of intracranial saccular and fusiform aneurysms may differ in intensity and extension: a pilot study using 7-T high-resolution black-blood MRI. Eur Radiol 2019; 30:301-307. [PMID: 31218429 DOI: 10.1007/s00330-019-06275-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/18/2019] [Accepted: 05/14/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate and compare wall enhancement patterns in saccular and fusiform intracranial aneurysms using high-resolution black-blood MRI at 7 T. METHODS Thirty-one patients with 32 unruptured intracranial aneurysms (21 saccular and 11 fusiform) underwent 7-T black-blood MRI. Aneurysm wall enhancement (AWE) was categorized as follows: no wall enhancement (NWE), focal wall enhancement (FWE), and uniform wall enhancement (UWE). The degree of enhancement was scored as follows: 0 (no enhancement), 1 (signal intensity (SI) of the aneurysm wall less than that of the pituitary infundibulum), and 2 (equal to that of the pituitary infundibulum). The chi-squared test was used to compare the AWE pattern and degree between saccular and fusiform aneurysms. RESULTS In saccular aneurysms, 12/21 (57%) enhanced. Of these, 9 showed FWE (5 grade 1 and 4 grade 2), and 3 showed UWE (2 grade 1 and 1 grade 2). In fusiform aneurysms, 11/11 (100%) enhanced. Of these, 1 showed FWE and 10 showed UWE. All fusiform aneurysms had grade-2 enhancement. Fusiform aneurysms had more extensive and higher SI AWE than saccular aneurysms (p < 0.01) despite having a similar size (6.9 ± 3.0 mm vs. 8.0 ± 2.9, p = 0.23). For saccular aneurysm, larger aneurysm size was correlated with higher degree of enhancement with Pearson's r = 0.64 (p = 0.002). CONCLUSION Intracranial fusiform aneurysms had enhancement of higher SI and that covered a more extensive area than saccular aneurysms, which might indicate differences in vessel wall pathology. KEY POINTS • Intracranial aneurysm wall enhancement can be reliably characterized by 7-T black-blood MRI. • AWE in intracranial fusiform aneurysms presents over a larger surface area and with greater signal intensity as compared with that in saccular aneurysms, which might indicate differences in pathology. • Stronger signal intensity of AWE correlates with the aneurysm size in saccular aneurysms.
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Affiliation(s)
- Xinke Liu
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zihao Zhang
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,The Innovation Center of Excellence on Brain Science, Chinese Academy of Sciences, Beijing, China
| | - Chengcheng Zhu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Junqiang Feng
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Liu
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qingle Kong
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Xianchang Zhang
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Qiang Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Hengwei Jin
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huijian Ge
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuhua Jiang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Youxiang Li
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Zhu C, Wang X, Eisenmenger L, Tian B, Liu Q, Degnan AJ, Hess C, Saloner D, Lu J. Surveillance of Unruptured Intracranial Saccular Aneurysms Using Noncontrast 3D-Black-Blood MRI: Comparison of 3D-TOF and Contrast-Enhanced MRA with 3D-DSA. AJNR Am J Neuroradiol 2019; 40:960-966. [PMID: 31122914 DOI: 10.3174/ajnr.a6080] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/15/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE Patients with unruptured intracranial aneurysms routinely undergo surveillance imaging to monitor growth. Angiography is the criterion standard for aneurysm diagnosis, but it is invasive. This study aimed to evaluate the accuracy and reproducibility of a 3D noncontrast black-blood MR imaging technique for unruptured intracranial aneurysm measurement in comparison with 3D-TOF and contrast-enhanced MRA, using 3D rotational angiography as a reference standard. MATERIALS AND METHODS Sixty-four patients (57.3 ± 10.9 years of age, 41 women) with 68 saccular unruptured intracranial aneurysms were recruited. Patients underwent 3T MR imaging with 3D-TOF-MRA, 3D black-blood MR imaging, and contrast-enhanced MRA, and they underwent 3D rotational angiography within 2 weeks. The neck, width, and height of the unruptured intracranial aneurysms were measured by 2 radiologists independently on 3D rotational angiography and 3 MR imaging sequences. The accuracy and reproducibility were evaluated by Bland-Altman plots, the coefficient of variance, and the intraclass correlation coefficient. RESULTS 3D black-blood MR imaging demonstrates the best agreement with DSA, with the smallest limits of agreement and measurement error (coefficients of variance range, 5.87%-7.04%). 3D-TOF-MRA had the largest limits of agreement and measurement error (coefficients of variance range, 12.73%-15.78%). The average coefficient of variance was 6.26% for 3D black-blood MR imaging, 7.03% for contrast-enhanced MRA, and 15.54% for TOF-MRA. No bias was found among 3 MR imaging sequences compared with 3D rotational angiography. All 3 MR imaging sequences had excellent interreader agreement (intraclass correlation coefficient, >0.95). 3D black-blood MR imaging performed the best for patients with intraluminal thrombus (n = 10). CONCLUSIONS 3D black-blood MR imaging achieves better accuracy for aneurysm size measurements compared with 3D-TOF, using 3D rotational angiography as a criterion standard. This noncontrast technique is promising for surveillance of unruptured intracranial aneurysms.
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Affiliation(s)
- C Zhu
- From the Department of Radiology and Biomedical Imaging (C.Z., L.E., C.H., D.S.), University of California, San Francisco, San Francisco, California
| | - X Wang
- Department of Radiology (X.W., B.T., Q.L., J.L.), Changhai Hospital, Shanghai, China.,Department of Radiology (X.W.), General Hospital of Northern Military Command, Liaoning, China
| | - L Eisenmenger
- From the Department of Radiology and Biomedical Imaging (C.Z., L.E., C.H., D.S.), University of California, San Francisco, San Francisco, California
| | - B Tian
- Department of Radiology (X.W., B.T., Q.L., J.L.), Changhai Hospital, Shanghai, China
| | - Q Liu
- Department of Radiology (X.W., B.T., Q.L., J.L.), Changhai Hospital, Shanghai, China
| | - A J Degnan
- Department of Radiology (A.J.D.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - C Hess
- From the Department of Radiology and Biomedical Imaging (C.Z., L.E., C.H., D.S.), University of California, San Francisco, San Francisco, California
| | - D Saloner
- From the Department of Radiology and Biomedical Imaging (C.Z., L.E., C.H., D.S.), University of California, San Francisco, San Francisco, California
| | - J Lu
- Department of Radiology (X.W., B.T., Q.L., J.L.), Changhai Hospital, Shanghai, China
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Intracranial Aneurysm Wall Enhancement Associated with Aneurysm Rupture: A Systematic Review and Meta-analysis. Acad Radiol 2019; 26:664-673. [PMID: 29908979 DOI: 10.1016/j.acra.2018.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 12/20/2022]
Abstract
RATIONALE AND OBJECTIVES Aneurysm wall enhancement (AWE) on magnetic resonance vessel wall imaging has been proposed as an imaging marker of aneurysm wall inflammation and instability. We performed a systematic review and meta-analysis to summarize the association between AWE and aneurysm rupture. MATERIALS AND METHODS We performed a comprehensive literature search of studies evaluating the association between AWE and aneurysm rupture. We abstracted the following study data: study design, patient demographics, aneurysm characteristics, MRI protocols, and AWE assessment. We performed meta-analysis using a random-effects model. Study heterogeneity was assessed by using the Cochrane Q and I2 statistic, and publication bias was examined by using the Begg-Mazumdar test. RESULTS Five studies with 492 subjects met eligibility for systematic review. We found a significant positive overall association between AWE and aneurysm rupture, with an odds ratio (OR) of 34.26 (95% confidence interval [CI] 10.20-115.07, p < 0.001). No significant heterogeneity (Q = 5.38, p = 0.25; I2 = 26%) or publication bias (p = 1.000) was present. In the separate analysis of circumferential AWE and aneurysm rupture, we identified marked heterogeneity across studies (Q = 21.23, p < 0.001; I2 = 86%). Further subgroup analysis considering the effect of aneurysm size showed that the strength of association between circumferential AWE and aneurysm rupture was significant in small aneurysms (<7 mm), with an OR of 26.12 (95% CI 6.11-111.75, p < 0.001), but limited in large aneurysms (OR = 0.56, 95% CI [0.21, 1.44], p = 0.23). CONCLUSION AWE on magnetic resonance vessel wall imaging is significantly and independently associated with aneurysm rupture and may become a promising imaging marker to predict aneurysm behavior and identify high-risk aneurysms.
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Hori M, Fujita S. Risk Assessment of Intracranial Aneurysms with MRI. Acad Radiol 2019; 26:674-675. [PMID: 30733062 DOI: 10.1016/j.acra.2019.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 10/27/2022]
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Milotta G, Ginami G, Cruz G, Neji R, Prieto C, Botnar RM. Simultaneous 3D whole-heart bright-blood and black blood imaging for cardiovascular anatomy and wall assessment with interleaved T 2 prep-IR. Magn Reson Med 2019; 82:312-325. [PMID: 30896049 DOI: 10.1002/mrm.27734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To develop a motion-corrected 3D flow-insensitive imaging approach interleaved T2 prepared-inversion recovery (iT2 prep-IR) for simultaneous lumen and wall visualization of the great thoracic vessels and cardiac structures. METHODS A 3D flow-insensitive approach for simultaneous cardiovascular lumen and wall visualization (iT2 prep) has been previously proposed. This approach requires subject-dependent weighted subtraction to completely null the arterial blood signal in the black-blood volume. Here, we propose an (T2 prep-IR) approach to improve wall visualization and remove need for weighted subtraction. The proposed sequence is based on the acquisition and direct subtraction of 2 interleaved 3D whole-heart data sets acquired with and without T2 prep-IR preparation. Image navigators are acquired before data acquisition to enable 2D translational and 3D non-rigid motion correction allowing 100% respiratory scan efficiency. The proposed approach was evaluated in 10 healthy subjects and compared with the conventional 2D double inversion recovery (DIR) sequence and the 3D iT2 prep sequence. Additionally, 5 patients with congenital heart disease were acquired to test the clinical feasibility of the proposed approach. RESULTS The proposed iT2 prep-IR sequence showed improved blood nulling compared to both DIR and iT2 prep techniques in terms of SNR (SNRblood = 6.9, 12.2, and 18.2, respectively) and contrast-to-noise-ratio (CNRmyoc-blood = 28.4, 15.4, and 15.3, respectively). No statistical difference was observed between iT2 prep-IR, iT2 prep and DIR atrial and ventricular wall thickness quantification. CONCLUSION The proposed interleaved T2 prep-IR sequence enables the simultaneous lumen and wall visualization of cardiac structures and shows promising results in terms of SNR, CNR, and wall thickness measurement.
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Affiliation(s)
- Giorgia Milotta
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Giulia Ginami
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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Henningsson M, Zahr RA, Dyer A, Greil GF, Burkhardt B, Tandon A, Hussain T. Feasibility of 3D black-blood variable refocusing angle fast spin echo cardiovascular magnetic resonance for visualization of the whole heart and great vessels in congenital heart disease. J Cardiovasc Magn Reson 2018; 20:76. [PMID: 30474554 PMCID: PMC6260764 DOI: 10.1186/s12968-018-0508-1] [Citation(s) in RCA: 11] [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: 07/06/2018] [Accepted: 11/14/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Volumetric black-blood cardiovascular magnetic resonance (CMR) has been hampered by long scan times and flow sensitivity. The purpose of this study was to assess the feasibility of black-blood, electrocardiogram (ECG)-triggered and respiratory-navigated 3D fast spin echo (3D FSE) for the visualization of the whole heart and great vessels. METHODS The implemented 3D FSE technique used slice-selective excitation and non-selective refocusing pulses with variable flip angles to achieve constant echo signal for tissue with T1 (880 ms) and T2 (40 ms) similar to the vessel wall. Ten healthy subjects and 21 patients with congenital heart disease (CHD) underwent 3D FSE and conventional 3D balanced steady-state free precession (bSSFP). The sequences were compared in terms of ability to perform segmental assessment, local signal-to-noise ratio (SNRl) and local contrast-to-noise ratio (CNRl). RESULTS In both healthy subjects and patients with CHD, 3D FSE showed superior pulmonary vein but inferior coronary artery origin visualisation compared to 3D bSFFP. However, in patients with CHD the combination of 3D bSSFP and 3D FSE whole-heart imaging improves the success rate of cardiac morphological diagnosis to 100% compared to either technique in isolation (3D FSE, 23.8% success rate, 3D bSSFP, 5% success rate). In the healthy subjects SNRl for 3D bSSFP was greater than for 3D FSE (30.1 ± 7.3 vs 20.9 ± 5.3; P = 0.002) whereas the CNRl was comparable (17.3 ± 5.6 vs 17.4 ± 4.9; P = 0.91) between the two scans. CONCLUSIONS The feasibility of 3D FSE for whole-heart black-blood CMR imaging has been demonstrated. Due to their high success rate for segmental assessment, the combination of 3D bSSFP and 3D FSE may be an attractive alternative to gadolinium contrast enhanced morphological CMR in patients with CHD.
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Affiliation(s)
- Markus Henningsson
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Riad Abou Zahr
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Adrian Dyer
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Gerald F. Greil
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Barbara Burkhardt
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Animesh Tandon
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Tarique Hussain
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
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Significance of hyperintense arteries on Gd-enhanced 3D T1W black-blood imaging in acute stroke. Eur Radiol 2018; 29:1329-1337. [PMID: 30088068 DOI: 10.1007/s00330-018-5669-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/18/2018] [Accepted: 07/13/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To elucidate the pathogenesis of hyperintense arteries on Gd-enhanced 3D T1W BB FSE and their clinical significance in acute middle cerebral artery (MCA) stroke. METHODS We retrospectively reviewed 20 patients with MCA infarction. We measured the contrast-to-noise ratio between hyperintense artery and adjacent grey matter on T2-FLAIR and Gd-enhanced 3D T1W BB FSE and compared them by using Student's t test. The agreement of positive hyperintense artery between T2 FLAIR and Gd-enhanced 3D T1WI BB FSE was estimated with intraclass correlation coefficient. Our cohort was dichotomised into two groups depending on hyperintense artery scores, and clinical data were compared between two groups by using Student's t test and chi-square test. RESULTS The contrast between hyperintense artery and grey matter on Gd-enhanced 3D T1W BB FSE was significantly higher than that on T2-FLAIR (2.27 ± 1.65 versus 0.94 ± 0.86, p = 0.01). Overall, agreement of hyperintense arteries on T2-FLAIR and Gd-enhanced 3D T1W BB FSE was excellent (ρ = 0.76, p < 0.01). Patients with higher hyperintense artery scores had higher perfusion deficits that those with lower hyperintense artery scores (196.7 ± 41.4 vs 100.1 ± 130.1, p = 0.03). CONCLUSION Hyperintense arteries on Gd-enhanced 3D T1W BB FSE in acute MCA stroke may be associated with slow collateral flows. Their territories corresponded to those of FLAIR, but had a better contrast. The patients with hyperintense arteries in a wider territory showed larger perfusion deficit than those with hyperintense arteries in a narrower territory. KEY POINTS • Hyperintense arteries on Gd-enhanced 3D T1W BB FSE are slow collateral flows. • Hyperintense arteries on Gd-enhanced 3D T1W BB FSE are well matched with FLAIR hyperintense vessels. • Hyperintense arteries are associated with perfusion deficit in stroke patients.
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Wall enhancement of intracranial unruptured aneurysm is associated with increased rupture risk and traditional risk factors. Eur Radiol 2018; 28:5019-5026. [PMID: 29872913 DOI: 10.1007/s00330-018-5522-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 04/24/2018] [Accepted: 05/03/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Aneurysm wall enhancement (AWE) on MRI has been considered an imaging marker to indicate active aneurysm inflammation, but no prospective studies have assessed the ability of AWE to predict rupture risk or growth. We aim to study the association of AWE with traditional risk factors and the estimated rupture risk. METHODS Seventy-seven patients (mean age, 58.4 ± 10.8 years; 57% female) with 88 asymptomatic intracranial saccular aneurysms underwent both 3-T high-resolution MRI and three-dimensional (3D) rotational digital subtraction angiography (DSA). Geometric and morphologic parameters were measured on DSA, and the degree of AWE on MRI was graded. One- and 5-year rupture risks of aneurysms were estimated using the UCAS and PHASES calculator. Parameters associated with AWE were analyzed using uni- and multivariate logistic regression. RESULTS Non-internal carotid artery location (OR 3.4, 95% CI 1.6-7.1) and aneurysm size (OR 1.9, 95% CI 1.3-2.7) were independently associated with AWE (p < 0.05). Aneurysms with AWE had significantly higher estimated rupture risk (1 and 5 year, 1.9% and 5.8%) than aneurysms without AWE (0.5% and 2.1%) (p < 0.001). Stronger and larger areas of AWE were correlated with the aneurysm size, size ratio and estimated rupture risk (R2 ≥ 0.30) (p < 0.01). CONCLUSIONS Prospective assessment of asymptomatic intracranial aneurysms with MRI suggests that AWE is associated with traditional risk factors and estimated short- and medium-term rupture risk. KEY POINTS • AWE independently associates with aneurysm location and size. • Aneurysms with AWE have higher rupture risk than aneurysms without AWE. • Stronger and larger areas of AWE correlated with the aneurysm size, size ratio and rupture risk.
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Zhu C, Tian X, Degnan AJ, Shi Z, Zhang X, Chen L, Teng Z, Saloner D, Lu J, Liu Q. Clinical Significance of Intraplaque Hemorrhage in Low- and High-Grade Basilar Artery Stenosis on High-Resolution MRI. AJNR Am J Neuroradiol 2018; 39:1286-1292. [PMID: 29794236 DOI: 10.3174/ajnr.a5676] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/29/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intraplaque hemorrhage within intracranial atherosclerotic plaques identified by high-resolution MR imaging has been studied as a potential marker of stroke risk. However, previous studies only examined intracranial arteries with high-grade stenosis (degree of stenosis, >50%). This study aimed to ascertain the clinical relevance of intraplaque hemorrhage in patients with low- and high-grade stenotic basilar artery plaques. MATERIALS AND METHODS Patients with basilar artery stenosis (n = 126; mean age, 62 ± 10 years; 66 symptomatic and 60 asymptomatic) underwent high-resolution MR imaging. The relationship between imaging findings (intraplaque hemorrhage, contrast enhancement, degree of stenosis, minimal lumen area, and plaque burden) and symptoms was analyzed. RESULTS Intraplaque hemorrhage was identified in 22 patients (17.5%), including 21 (31.8%) symptomatic patients and 1 (1.7%) asymptomatic patient. Multivariate analysis showed that intraplaque hemorrhage was the strongest independent marker of symptomatic status (odds ratio, 27.5; 95% CI, 3.4-221.5; P = .002). Contrast enhancement was also independently associated with symptomatic status (odds ratio, 9.9; 95% CI, 1.5-23.6; P = .016). Stenosis, minimal lumen area, and plaque burden were not correlated with symptoms (P > .05). Intraplaque hemorrhage was present in both low- and high-grade stenotic basilar arteries (11.3% versus 16.3%, P = .63). Diagnostic performance values of intraplaque hemorrhage for patients with acute/subacute symptomatic stroke were the following: specificity, 98.3%; sensitivity, 31.8%; positive predictive value, 95.5%; and negative predictive value, 56.7%. CONCLUSIONS Intraplaque hemorrhage is present in both low- and high-grade stenotic basilar artery plaques and is independently associated with symptomatic stroke status. Intraplaque hemorrhage may identify high-risk plaque and provide new insight into the management of patient with stroke without significant stenosis.
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Affiliation(s)
- C Zhu
- From the Department of Radiology and Biomedical Imaging (C.Z., D.S.), University of California, San Francisco, San Francisco, California
| | - X Tian
- Department of Radiology (X.T., Z.S., X.Z., L.C., J.L., Q.L.), Changhai Hospital, Shanghai, China
| | - A J Degnan
- Department of Radiology (A.J.D.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Z Shi
- Department of Radiology (X.T., Z.S., X.Z., L.C., J.L., Q.L.), Changhai Hospital, Shanghai, China
| | - X Zhang
- Department of Radiology (X.T., Z.S., X.Z., L.C., J.L., Q.L.), Changhai Hospital, Shanghai, China
| | - L Chen
- Department of Radiology (X.T., Z.S., X.Z., L.C., J.L., Q.L.), Changhai Hospital, Shanghai, China
| | - Z Teng
- Department of Radiology (Z.T.), University of Cambridge, Cambridge, UK
| | - D Saloner
- From the Department of Radiology and Biomedical Imaging (C.Z., D.S.), University of California, San Francisco, San Francisco, California
| | - J Lu
- Department of Radiology (X.T., Z.S., X.Z., L.C., J.L., Q.L.), Changhai Hospital, Shanghai, China
| | - Q Liu
- Department of Radiology (X.T., Z.S., X.Z., L.C., J.L., Q.L.), Changhai Hospital, Shanghai, China
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Lehman VT, Brinjikji W, Mossa-Basha M, Lanzino G, Rabinstein AA, Kallmes DF, Huston J. Conventional and high-resolution vessel wall MRI of intracranial aneurysms: current concepts and new horizons. J Neurosurg 2018; 128:969-981. [DOI: 10.3171/2016.12.jns162262] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intracranial aneurysms are heterogeneous in histopathology and imaging appearance. The biological behavior of different types of aneurysms is now known to depend on the structure and physiology of the aneurysm wall itself in addition to intraluminal flow and other luminal features. Aneurysm wall structure and imaging markers of physiology such as aneurysm wall enhancement have been assessed in many prior investigations using conventional-resolution MRI. Recently, high-resolution vessel wall imaging (HR-VWI) techniques with MRI have been introduced. Reports of findings on high-resolution imaging have already emerged for many types of aneurysms demonstrating detailed characterization of wall enhancement, thickness, and components, but many questions remain unexplored. This review discusses the key HR-VWI literature to date. Aneurysm wall findings on conventional-resolution MRI are also discussed as these may help one understand the potential utility and findings on HR-VWI for various aneurysm types. The authors have illustrated these points with several examples demonstrating both features already described in the literature and novel cases demonstrating the potential for future clinical and research applications.
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Affiliation(s)
| | | | - Mahmud Mossa-Basha
- 2Department of Radiology, University of Washington Medical Center, Seattle, Washington
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Tan HW, Chen X, Maingard J, Barras CD, Logan C, Thijs V, Kok HK, Lee MJ, Chandra RV, Brooks M, Asadi H. Intracranial Vessel Wall Imaging with Magnetic Resonance Imaging: Current Techniques and Applications. World Neurosurg 2018; 112:186-198. [PMID: 29360586 DOI: 10.1016/j.wneu.2018.01.083] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 01/05/2018] [Accepted: 01/11/2018] [Indexed: 11/19/2022]
Abstract
Vessel wall magnetic resonance imaging (VW-MRI) is a modern imaging technique with expanding applications in the characterization of intracranial vessel wall pathology. VW-MRI provides added diagnostic capacity compared with conventional luminal imaging methods. This review explores the principles of VW-MRI and typical imaging features of various vessel wall pathologies, such as atherosclerosis, dissection, and vasculitis. Radiologists should be familiar with this important imaging technique, given its increasing use and future relevance to everyday practice.
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Affiliation(s)
- Haur Wey Tan
- Department of Radiology, Austin Hospital, Melbourne, Australia.
| | - Xiao Chen
- Department of Radiology, Austin Hospital, Melbourne, Australia
| | - Julian Maingard
- Department of Radiology, Austin Hospital, Melbourne, Australia; Department of Interventional Neuroradiology Service, Austin Hospital, Melbourne, Australia; Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, Victoria, Australia
| | - Christen D Barras
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, United Kingdom; The South Australian Health and Medical Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Vincent Thijs
- Department of Neurology, Austin Health, Heidelberg, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
| | - Hong Kuan Kok
- Department of Interventional Radiology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Michael J Lee
- Department of Radiology, Beaumont Hospital, Dublin, Ireland; Interventional Radiology Service, Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons Ireland, Dublin, Ireland
| | - Ronil V Chandra
- Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, Australia; Department of Imaging, Monash University, Melbourne, Victoria, Australia
| | - Mark Brooks
- Department of Interventional Neuroradiology Service, Austin Hospital, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia; Department of Radiology, Interventional Neuroradiology Service, St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Hamed Asadi
- Department of Interventional Neuroradiology Service, Austin Hospital, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia; Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, Victoria, Australia
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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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High-resolution vessel wall MRI for the evaluation of intracranial atherosclerotic disease. Neuroradiology 2017; 59:1193-1202. [PMID: 28942481 DOI: 10.1007/s00234-017-1925-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 09/11/2017] [Indexed: 01/23/2023]
Abstract
High-resolution vessel wall MRI (vwMRI) of the intracranial arteries is an emerging diagnostic imaging technique with the goal of evaluating vascular pathology. vwMRI sequences have high spatial resolution and directly image the vessel wall by suppressing blood signal. With vwMRI, it is possible to identify distinct morphologic and enhancement patterns of atherosclerosis that can provide important information about stroke etiology and recurrence risk. We present a review of vwMRI research in relation to intracranial atherosclerosis, with a focus on the relationship between ischemic stroke and atherosclerotic plaque T1 post-contrast enhancement or plaque/vessel wall morphology. The goal of this review is to provide readers with the most current understanding of the reliability, incidence, and importance of specific vwMRI findings in intracranial atherosclerosis, to guide their interpretation of vwMRI research, and help inform clinical interpretation of vwMRI. We will also provide a translational perspective on the existing vwMRI literature and insight into future vwMRI research questions and objectives. With increased use of high field strength MRI, powerful gradients, and improved pulse sequences, vwMRI will become standard-of-care in the diagnosis and prognosis of patients with cerebrovascular disease, making a firm grasp of its strengths and weakness important for neuroimagers.
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Yuan J, Usman A, Reid SA, King KF, Patterson AJ, Gillard JH, Graves MJ. Three-dimensional black-blood multi-contrast carotid imaging using compressed sensing: a repeatability study. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:183-190. [PMID: 28653214 PMCID: PMC5813054 DOI: 10.1007/s10334-017-0640-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 06/09/2017] [Accepted: 06/16/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this work is to evaluate the repeatability of a compressed sensing (CS) accelerated multi-contrast carotid protocol at 3 T. MATERIALS AND METHODS Twelve volunteers and eight patients with carotid disease were scanned on a 3 T MRI scanner using a CS accelerated 3-D black-blood multi-contrast protocol which comprises T 1w, T 2w and PDw without CS, and with a CS factor of 1.5 and 2.0. The volunteers were scanned twice, the lumen/wall area and wall thickness were measured for each scan. Eight patients were scanned once, the inter/intra-observer reproducibility of the measurements was calculated. RESULTS In the repeated volunteer scans, the interclass correlation coefficient (ICC) for the wall area measurement using a CS factor of 1.5 in PDw, T 1w and T 2w were 0.95, 0.81, and 0.97, respectively. The ICC for lumen area measurement using a CS factor of 1.5 in PDw, T 1w and T 2w were 0.96, 0.92, and 0.96, respectively. In patients, the ICC for inter/intra-observer measurements of lumen/wall area, and wall thickness were all above 0.81 in all sequences. CONCLUSION The results show a CS accelerated 3-D black-blood multi-contrast protocol is a robust and reproducible method for carotid imaging. Future protocol design could use CS to reduce the scanning time.
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Affiliation(s)
- Jianmin Yuan
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK.
| | - Ammara Usman
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK
| | | | | | - Andrew J Patterson
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jonathan H Gillard
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Cervantes B, Kirschke JS, Klupp E, Kooijman H, Börnert P, Haase A, Rummeny EJ, Karampinos DC. Orthogonally combined motion- and diffusion-sensitized driven equilibrium (OC-MDSDE) preparation for vessel signal suppression in 3D turbo spin echo imaging of peripheral nerves in the extremities. Magn Reson Med 2017; 79:407-415. [DOI: 10.1002/mrm.26660] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Barbara Cervantes
- Department of Diagnostic and Interventional Radiology; Technische Universität München; Munich Germany
| | - Jan S. Kirschke
- Department of Neuroradiology; Technische Universität München; Munich Germany
| | - Elizabeth Klupp
- Department of Neuroradiology; Technische Universität München; Munich Germany
| | | | | | - Axel Haase
- Institute of Medical Engineering; Technische Universität München; Garching Germany
| | - Ernst J. Rummeny
- Department of Diagnostic and Interventional Radiology; Technische Universität München; Munich Germany
| | - Dimitrios C. Karampinos
- Department of Diagnostic and Interventional Radiology; Technische Universität München; Munich Germany
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Added Value of 3D Proton-Density Weighted Images in Diagnosis of Intracranial Arterial Dissection. PLoS One 2016; 11:e0166929. [PMID: 27880798 PMCID: PMC5120794 DOI: 10.1371/journal.pone.0166929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 11/07/2016] [Indexed: 11/19/2022] Open
Abstract
Background An early and reliable diagnosis of intracranial arterial dissection is important to reduce the risk of neurological complication. The purpose of this study was to assess the clinical usefulness of three-dimensional high-resolution MRI (3D-HR-MRI) including pre- and post-contrast T1-weighted volumetric isotropic turbo spin echo acquisition with improved motion-sensitized driven equilibrium preparation (3D-iMSDE-T1) and proton-density weighted image (3D-PD) in detecting dissection and to evaluate the added value of 3D-PD in diagnosing intracranial arterial dissection. Methods We retrospectively recruited patients who underwent 3D-HR-MRI with clinical suspicion of arterial dissection. Among them, we selected patients who were diagnosed with definite dissection according to the Spontaneous Cervicocephalic Arterial Dissections Study criteria. For each patient, the presence of intimal flap, intramural hematoma, and vessel dilatation were evaluated independently by two neuroradiologists on each sequence. Interobserver agreement was assessed. Results Seventeen patients (mean age: 41 ± 10 [SD] years; 13 men) were diagnosed with definite dissection. The intimal flaps were more frequently detected on 3D-PD (88.2%, 15/17) than on 3D-iMSDE-T1 (29.4%, 5/17), and post-contrast 3D-iMSDE-T1 (35.3%, 6/17; P = 0.006 and P = 0.004, respectively). No significant difference was found in the detection rate of intramural hematomas (59–71%) and vascular dilatations (47%) on each sequence. Interobserver agreement for detection of dissection findings showed almost perfect agreement (k = 0.84–1.00), except for detection of intimal flaps on pre-contrast 3D-iMSDE-T1 (k = 0.62). After addition of 3D-PD to pre- and post-contrast 3D-iMSDE-T1, more patients were diagnosed with definite dissection with the initial MRI (88.2% vs. 47.1%; P = 0.039). Conclusions The intimal flap might be better visualized on the 3D-PD sequence than the 3D-iMSDE-T1 sequences, allowing diagnosis of definite dissection without follow-up imaging.
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Pennell DJ, Baksi AJ, Prasad SK, Mohiaddin RH, Alpendurada F, Babu-Narayan SV, Schneider JE, Firmin DN. Review of Journal of Cardiovascular Magnetic Resonance 2015. J Cardiovasc Magn Reson 2016; 18:86. [PMID: 27846914 PMCID: PMC5111217 DOI: 10.1186/s12968-016-0305-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/02/2016] [Indexed: 12/14/2022] Open
Abstract
There were 116 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2015, which is a 14 % increase on the 102 articles published in 2014. The quality of the submissions continues to increase. The 2015 JCMR Impact Factor (which is published in June 2016) rose to 5.75 from 4.72 for 2014 (as published in June 2015), which is the highest impact factor ever recorded for JCMR. The 2015 impact factor means that the JCMR papers that were published in 2013 and 2014 were cited on average 5.75 times in 2015. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is <25 % and has been falling because the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality papers to JCMR for publication.
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Affiliation(s)
- D. J. Pennell
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - A. J. Baksi
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - S. K. Prasad
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - R. H. Mohiaddin
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - F. Alpendurada
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - S. V. Babu-Narayan
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - J. E. Schneider
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
| | - D. N. Firmin
- Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, SW 3 6NP UK
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Zhu C, Haraldsson H, Tian B, Meisel K, Ko N, Lawton M, Grinstead J, Ahn S, Laub G, Hess C, Saloner D. High resolution imaging of the intracranial vessel wall at 3 and 7 T using 3D fast spin echo MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:559-70. [DOI: 10.1007/s10334-016-0531-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/27/2016] [Accepted: 02/01/2016] [Indexed: 11/29/2022]
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Mossa-Basha M, Alexander M, Gaddikeri S, Yuan C, Gandhi D. Vessel wall imaging for intracranial vascular disease evaluation. J Neurointerv Surg 2016; 8:1154-1159. [PMID: 26769729 DOI: 10.1136/neurintsurg-2015-012127] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 12/19/2015] [Indexed: 11/04/2022]
Abstract
Accurate and timely diagnosis of intracranial vasculopathies is important owing to the significant risk of morbidity with delayed and/or incorrect diagnosis both from the disease process and inappropriate therapies. Conventional luminal imaging techniques for analysis of intracranial vasculopathies are limited to evaluation of changes in the vessel lumen. Vessel wall MRI techniques can allow direct characterization of pathologic changes of the vessel wall. These techniques may improve diagnostic accuracy and improve patient outcomes. Extracranial carotid vessel wall imaging has been extensively investigated in patients with atherosclerotic disease and has been shown to accurately assess plaque composition and identify vulnerable plaque characteristics that may predict stroke risk beyond luminal stenosis alone. This review provides a brief history of vessel wall MRI, an overview of the intracranial vessel wall MRI techniques, its applications, and imaging findings of various intracranial vasculopathies pertinent to the neurointerventionalist, neurologist, and neuroradiologist. We searched MEDLINE, PubMed, and Google for English publications containing any of the following terms: 'intracranial vessel wall imaging', 'intracranial vessel wall', and 'intracranial vessel wall MRI'.
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Affiliation(s)
- Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Matthew Alexander
- Department of Radiology, University of California-San Francisco, San Francisco, California, USA
| | - Santhosh Gaddikeri
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Dheeraj Gandhi
- Department of Radiology, Neurosurgery and Neurology, University of Maryland, Baltimore, Maryland, USA
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Pennell DJ, Baksi AJ, Prasad SK, Raphael CE, Kilner PJ, Mohiaddin RH, Alpendurada F, Babu-Narayan SV, Schneider J, Firmin DN. Review of Journal of Cardiovascular Magnetic Resonance 2014. J Cardiovasc Magn Reson 2015; 17:99. [PMID: 26589839 PMCID: PMC4654908 DOI: 10.1186/s12968-015-0203-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 11/08/2015] [Indexed: 01/19/2023] Open
Abstract
There were 102 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2014, which is a 6% decrease on the 109 articles published in 2013. The quality of the submissions continues to increase. The 2013 JCMR Impact Factor (which is published in June 2014) fell to 4.72 from 5.11 for 2012 (as published in June 2013). The 2013 impact factor means that the JCMR papers that were published in 2011 and 2012 were cited on average 4.72 times in 2013. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is <25% and has been falling because the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality papers to JCMR for publication.
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Affiliation(s)
- D J Pennell
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - A J Baksi
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - S K Prasad
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - C E Raphael
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - P J Kilner
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - R H Mohiaddin
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - F Alpendurada
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - S V Babu-Narayan
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - J Schneider
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
| | - D N Firmin
- Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust & Imperial College, Sydney Street, London, SW 3 6NP, UK.
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Abstract
There has been significant progress made in 3-dimensional (3D) carotid plaque MR imaging techniques in recent years. Three-dimensional plaque imaging clearly represents the future in clinical use. With effective flow-suppression techniques, choices of different contrast weighting acquisitions, and time-efficient imaging approaches, 3D plaque imaging offers flexible imaging plane and view angle analysis, large coverage, multivascular beds capability, and even can be used in fast screening.
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Affiliation(s)
- Chun Yuan
- Vascular Imaging Lab, Department of Radiology, Bio-Molecular Imaging Center, University of Washington, Box 358050, 850 Republican Street, Seattle, WA 98109-4714, USA.
| | - Dennis L Parker
- Department of Radiology, Imaging & Neurosciences Center, Utah Center for Advanced Imaging Research (UCAIR), University of Utah, 729 Arapeen Drive, Salt Lake City, UT 84108, USA
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Choi YJ, Jung SC, Lee DH. Vessel Wall Imaging of the Intracranial and Cervical Carotid Arteries. J Stroke 2015; 17:238-55. [PMID: 26437991 PMCID: PMC4635720 DOI: 10.5853/jos.2015.17.3.238] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 08/19/2015] [Accepted: 08/31/2015] [Indexed: 12/05/2022] Open
Abstract
Vessel wall imaging can depict the morphologies of atherosclerotic plaques, arterial walls, and surrounding structures in the intracranial and cervical carotid arteries beyond the simple luminal changes that can be observed with traditional luminal evaluation. Differentiating vulnerable from stable plaques and characterizing atherosclerotic plaques are vital parts of the early diagnosis, prevention, and treatment of stroke and the neurological adverse effects of atherosclerosis. Various techniques for vessel wall imaging have been developed and introduced to differentiate and analyze atherosclerotic plaques in the cervical carotid artery. High-resolution magnetic resonance imaging (HR-MRI) is the most important and popular vessel wall imaging technique for directly evaluating the vascular wall and intracranial artery disease. Intracranial artery atherosclerosis, dissection, moyamoya disease, vasculitis, and reversible cerebral vasoconstriction syndrome can also be diagnosed and differentiated by using HR-MRI. Here, we review the radiologic features of intracranial artery disease and cervical carotid artery atherosclerosis on HR-MRI and various other vessel wall imaging techniques (e.g., ultrasound, computed tomography, magnetic resonance, and positron emission tomography-computed tomography).
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Affiliation(s)
- Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Chai Jung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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46
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Scan-Rescan Reproducibility of High Resolution Magnetic Resonance Imaging of Atherosclerotic Plaque in the Middle Cerebral Artery. PLoS One 2015; 10:e0134913. [PMID: 26247869 PMCID: PMC4527831 DOI: 10.1371/journal.pone.0134913] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 07/16/2015] [Indexed: 11/30/2022] Open
Abstract
Purpose To evaluate the scan-rescan reproducibility of high-resolution magnetic resonance imaging (MRI) of middle cerebral artery (MCA) plaque, and calculate the number of subjects needed for future longitudinal clinical studies. Material and Methods Twenty two patients with MCA plaque were scanned twice by a T2-weighted fast-spin-echo sequence at 3T. Areas and volumes of MCA lumen, total vessel and plaque were quantified and compared between two repeated scans. Agreement and measurement error was quantified by intraclass correlation coefficient (ICC) and coefficient of variance (CV) as defined by standard deviation (SD) of pair wise difference / mean. Sample size needed to detect 5% to 20% changes in area/volume was calculated using 80% power and 5% significance level. Results There was no significant different between the area and volume measurements of two repeated scans (p>0.05) with good agreement (ICC range 0.97–0.98 for area and 0.99 for volume). Relatively small measurement errors were observed with CVs range 6.1%-11.8% for area quantification and 4.9%-8.0% for volume quantification. Volume measurements tended to have 19.7% to 32.2% smaller CVs compared with area measurements. Sample size calculation showed a group of 47 patients was sufficient to detect 5% to 10% changes in MCA area/volume. Conclusion High resolution MRI is feasible for quantifying intracranial plaque area and volume in longitudinal clinical studies with low scan-rescan variability. Volume measurement tends to be more reproducible compared with area measurements.
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Xie Y, Yang Q, Xie G, Pang J, Fan Z, Li D. Improved black-blood imaging using DANTE-SPACE for simultaneous carotid and intracranial vessel wall evaluation. Magn Reson Med 2015; 75:2286-94. [PMID: 26152900 DOI: 10.1002/mrm.25785] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 11/10/2022]
Abstract
PURPOSE The purpose of this study was to develop a three-dimensional black blood imaging method for simultaneously evaluating the carotid and intracranial arterial vessel walls with high spatial resolution and excellent blood suppression with and without contrast enhancement. METHODS The delay alternating with nutation for tailored excitation (DANTE) preparation module was incorporated into three-dimensional variable flip angle turbo spin echo (SPACE) sequence to improve blood signal suppression. Simulations and phantom studies were performed to quantify image contrast variations induced by DANTE. DANTE-SPACE, SPACE, and two-dimensional turbo spin echo were compared for apparent signal-to-noise ratio, contrast-to-noise ratio, and morphometric measurements in 14 healthy subjects. Preliminary clinical validation was performed in six symptomatic patients. RESULTS Apparent residual luminal blood was observed in five (pre-contrast) and nine (post-contrast) subjects with SPACE and only two (post-contrast) subjects with DANTE-SPACE. DANTE-SPACE showed 31% (pre-contrast) and 100% (post-contrast) improvement in wall-to-blood contrast-to-noise ratio over SPACE. Vessel wall area measured from SPACE was significantly larger than that from DANTE-SPACE due to possible residual blood signal contamination. DANTE-SPACE showed the potential to detect vessel wall dissection and identify plaque components in patients. CONCLUSION DANTE-SPACE significantly improved arterial and venous blood suppression compared with SPACE. Simultaneous high-resolution carotid and intracranial vessel wall imaging to potentially identify plaque components was feasible with a scan time under 6 min. Magn Reson Med 75:2286-2294, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Qi Yang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guoxi Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Shenzhen Key Lab for MRI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jianing Pang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
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