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Gemmete JJ. Vessel Wall Characterization Using Quantitative MR Imaging. Neuroimaging Clin N Am 2024; 34:281-292. [PMID: 38604712 DOI: 10.1016/j.nic.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
MR imaging's exceptional capabilities in vascular imaging stem from its ability to visualize and quantify vessel wall features, such as plaque burden, composition, and biomechanical properties. The application of advanced MR imaging techniques, including two-dimensional and three-dimensional black-blood MR imaging, T1 and T2 relaxometry, diffusion-weighted imaging, and dynamic contrast-enhanced MR imaging, wall shear stress, and arterial stiffness, empowers clinicians and researchers to explore the intricacies of vascular diseases. This array of techniques provides comprehensive insights into the development and progression of vascular pathologies, facilitating earlier diagnosis, targeted treatment, and improved patient outcomes in the management of vascular health.
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Affiliation(s)
- Joseph J Gemmete
- Department of Radiology, Michigan Medicine, 1500 East Medican Center Drive, UH B1D 328, Ann Arbor, MI 48109.
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2
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Zeng W, Weng C, Yuan D, Wang T, Huang B, Zhao J, Xia C, Li Z, Wang J. Multimodality magnetic resonance evaluating the effect of enhanced physical exercise on the growth rate, flow haemodynamics, aneurysm wall and ventricular-aortic coupling of patients with small abdominal aortic aneurysms (AAA MOVE trial): a study protocol for an open-label randomised controlled trial. BMJ Open 2024; 14:e080073. [PMID: 38355193 PMCID: PMC10868247 DOI: 10.1136/bmjopen-2023-080073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION The best lifestyle for small abdominal aortic aneurysms (sAAA) is essential for its conservative management. Physical exercise can improve the cardiopulmonary function of the patients, but it remains unclear which specific type of exercise is most beneficial for individuals with sAAA. The current study was designed to investigate the effect of physician-guided enhanced physical exercise programme on the aorto-cardiac haemodynamic environment, aneurysm sac wall, cardiac function and growth rate of sAAA by multimodality MRI. METHODS AND ANALYSIS AAA MOVE study is a prospective, parallel, equivalence, randomised controlled trial. Eligible individuals will be recruited if they are diagnosed with sAAA (focal dilation of abdominal aorta with maximum diameter <5 cm), without contraindication for MRI scanning, or severe heart failure, or uncontrolled arrhythmia. Participants will be randomly allocated to intervention group (physician-guided enhanced physical exercise programme: mainly aerobic training) and control group (standard clinical care) separately in a 1:1 ratio. The primary outcome is 12-month growth rate of sAAA. The first set of secondary outcomes involve multimodality MRI parameters covering flow haemodynamics, aortic wall inflammation and cardiac function. The other secondary outcome (safety end point) is a composite of exercise-related injury, aneurysm rupture and aneurysm intervention. Follow-up will be conducted at 6 and 12 months after intervention. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee on Biomedical Research of West China Hospital (approval number: 2023-783) on 16 June 2023. Main findings from the trial will be disseminated through presentations at conferences, peer-reviewed publications and directly pushed to smartphone of participants. TRIAL REGISTRATION NUMBER ChiCTR2300073334.
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Affiliation(s)
- Wen Zeng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chengxin Weng
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ding Yuan
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tiehao Wang
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bin Huang
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jichun Zhao
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenlin Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiarong Wang
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Munoz C, Fotaki A, Hua A, Hajhosseiny R, Kunze KP, Ismail TF, Neji R, Pushparajah K, Botnar RM, Prieto C. Simultaneous Highly Efficient Contrast-Free Lumen and Vessel Wall MR Imaging for Anatomical Assessment of Aortic Disease. J Magn Reson Imaging 2023; 58:1110-1122. [PMID: 36757267 PMCID: PMC10946808 DOI: 10.1002/jmri.28613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Bright-blood lumen and black-blood vessel wall imaging are required for the comprehensive assessment of aortic disease. These images are usually acquired separately, resulting in long examinations and potential misregistration between images. PURPOSE To characterize the performance of an accelerated and respiratory motion-compensated three-dimensional (3D) cardiac MRI technique for simultaneous contrast-free aortic lumen and vessel wall imaging with an interleaved T2 and inversion recovery prepared sequence (iT2Prep-BOOST). STUDY TYPE Prospective. POPULATION A total of 30 consecutive patients with aortopathy referred for a clinically indicated cardiac MRI examination (9 females, mean age ± standard deviation: 32 ± 12 years). FIELD STRENGTH/SEQUENCE 1.5-T; bright-blood MR angiography (diaphragmatic navigator-gated T2-prepared 3D balanced steady-state free precession [bSSFP], T2Prep-bSSFP), breath-held black-blood two-dimensional (2D) half acquisition single-shot turbo spin echo (HASTE), and 3D bSSFP iT2Prep-BOOST. ASSESSMENT iT2Prep-BOOST bright-blood images were compared to T2prep-bSSFP images in terms of aortic vessel dimensions, lumen-to-myocardium contrast ratio (CR), and image quality (diagnostic confidence, vessel sharpness and presence of artifacts, assessed by three cardiologists on a 4-point scale, 1: nondiagnostic to 4: excellent). The iT2Prep-BOOST black-blood images were compared to 2D HASTE images for quantification of wall thickness. A visual comparison between computed tomography (CT) and iT2Prep-BOOST was performed in a patient with chronic aortic dissection. STATISTICAL TESTS Paired t-tests, Wilcoxon signed-rank tests, intraclass correlation coefficient (ICC), Bland-Altman analysis. A P value < 0.05 was considered statistically significant. RESULTS Bright-blood iT2Prep-BOOST resulted in significantly improved image quality (mean ± standard deviation 3.8 ± 0.5 vs. 3.3 ± 0.8) and CR (2.9 ± 0.8 vs. 1.8 ± 0.5) compared with T2Prep-bSSFP, with a shorter scan time (7.8 ± 1.7 minutes vs. 12.9 ± 3.4 minutes) while providing a complementary 3D black-blood image. Aortic lumen diameter and vessel wall thickness measurements in bright-blood and black-blood images were in good agreement with T2Prep-bSSFP and HASTE images (<0.02 cm and <0.005 cm bias, respectively) and good intrareader (ICC > 0.96) and interreader (ICC > 0.94) agreement was observed for all measurements. DATA CONCLUSION iT2Prep-BOOST might enable time-efficient simultaneous bright- and black-blood aortic imaging, with improved image quality compared to T2Prep-bSSFP and HASTE imaging, and comparable measurements for aortic wall and lumen dimensions. EVIDENCE LEVEL 2. TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Camila Munoz
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Anastasia Fotaki
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Alina Hua
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Reza Hajhosseiny
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Karl P. Kunze
- MR Research CollaborationsSiemens Healthcare LimitedFrimleyUK
| | - Tevfik F. Ismail
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
- MR Research CollaborationsSiemens Healthcare LimitedFrimleyUK
| | - Kuberan Pushparajah
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - René M. Botnar
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
- Escuela de Ingeniería, Pontificia Universidad Católica de ChileSantiagoChile
- Instituto de Ingeniería Biológica y Médica, Pontificia Universidad Católica de ChileSantiagoChile
- Millenium Institute for Intelligent Healthcare Engineering iHEALTHSantiagoChile
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
- Escuela de Ingeniería, Pontificia Universidad Católica de ChileSantiagoChile
- Instituto de Ingeniería Biológica y Médica, Pontificia Universidad Católica de ChileSantiagoChile
- Millenium Institute for Intelligent Healthcare Engineering iHEALTHSantiagoChile
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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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Ververs FA, Eikendal ALM, Kofink D, Nuboer R, Westenberg JJM, Hovenkamp GT, Kemps JJ, Coenen ICJ, Daems JJN, Claus LR, Ju Y, Wulffraat NM, van der Ent CK, Monaco C, Boes M, Leiner T, Grotenhuis HB, Schipper HS. Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease. J Am Heart Assoc 2022; 11:e024675. [PMID: 35861840 PMCID: PMC9707823 DOI: 10.1161/jaha.122.024675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Adolescents with chronic disease are often exposed to inflammatory, metabolic, and hemodynamic risk factors for early atherosclerosis. Since postmortem studies have shown that atherogenesis starts in the aorta, the CDACD (Cardiovascular Disease in Adolescents with Chronic Disease) study investigated preclinical aortic atherosclerosis in these adolescents.
Methods and Results
The cross‐sectional CDACD study enrolled 114 adolescents 12 to 18 years old with chronic disorders including juvenile idiopathic arthritis, cystic fibrosis, obesity, corrected coarctation of the aorta, and healthy controls with a corrected atrial septal defect. Cardiovascular magnetic resonance was used to assess aortic pulse wave velocity and aortic wall thickness, as established aortic measures of preclinical atherosclerosis. Cardiovascular magnetic resonance showed a higher aortic pulse wave velocity, which reflects aortic stiffness, and higher aortic wall thickness in all adolescent chronic disease groups, compared with controls (
P
<0.05). Age (β=0.253), heart rate (β=0.236), systolic blood pressure (β=−0.264), and diastolic blood pressure (β=0.365) were identified as significant predictors for aortic pulse wave velocity, using multivariable linear regression analysis. Aortic wall thickness was predicted by body mass index (β=0.248) and fasting glucose (β=0.242), next to aortic lumen area (β=0.340). Carotid intima‐media thickness was assessed using ultrasonography, and was only higher in adolescents with coarctation of the aorta, compared with controls (
P
<0.001).
Conclusions
Adolescents with chronic disease showed enhanced aortic stiffness and wall thickness compared with controls. The enhanced aortic pulse wave velocity and aortic wall thickness in adolescents with chronic disease could indicate accelerated atherogenesis. Our findings underscore the importance of the aorta for assessment of early atherosclerosis, and the need for tailored cardiovascular follow‐up of children with chronic disease.
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Affiliation(s)
- Francesca A. Ververs
- Center for Translational Immunology University Medical Center Utrecht Utrecht the Netherlands
| | - Anouk L. M. Eikendal
- Department of Radiology University Medical Center Utrecht Utrecht the Netherlands
| | - Daniel Kofink
- Department of Cardiology University Medical Center Utrecht Utrecht the Netherlands
| | - Roos Nuboer
- Department of Pediatrics Meander Medical Center Amersfoort Amersfoort the Netherlands
| | | | - Gijs T. Hovenkamp
- Department of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Jitske J.A. Kemps
- Department of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Iris C. J. Coenen
- Department of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Joëlle J. N. Daems
- Department of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Laura R. Claus
- Department of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Yillie Ju
- Department of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Nico M. Wulffraat
- Department of Pediatric Immunology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
- Rare Immunodeficiency, Autoinflammatory and Autoimmune European Reference Network Utrecht the Netherlands
| | - Cornelis K. van der Ent
- Department of Pediatric Pulmonology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Claudia Monaco
- Kennedy Institute of RheumatologyUniversity of Oxford Oxford UK
| | - Marianne Boes
- Center for Translational Immunology University Medical Center Utrecht Utrecht the Netherlands
- Department of Pediatric Immunology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Tim Leiner
- Department of Radiology University Medical Center Utrecht Utrecht the Netherlands
- Department of Radiology Mayo Clinic Rochester MN
| | - Heynric B. Grotenhuis
- Department of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
| | - Henk S. Schipper
- Center for Translational Immunology University Medical Center Utrecht Utrecht the Netherlands
- Department of Pediatric Cardiology Wilhelmina Children’s HospitalUniversity Medical Center Utrecht Utrecht the Netherlands
- Kennedy Institute of RheumatologyUniversity of Oxford Oxford UK
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Matsumoto K, Yokota H, Yoda T, Ebata R, Mukai H, Masuda Y, Uno T. Reproducibility between three-dimensional turbo spin-echo and two-dimensional dual inversion recovery turbo spin-echo for coronary vessel wall imaging in Kawasaki disease. Sci Rep 2022; 12:6835. [PMID: 35478214 PMCID: PMC9046194 DOI: 10.1038/s41598-022-10951-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 04/11/2022] [Indexed: 12/02/2022] Open
Abstract
Magnetic resonance vessel wall imaging is desirable for evaluating Kawasaki disease (KD)-associated coronary arterial lesions. To evaluate the reproducibility of three-dimensional turbo spin-echo (3D-TSE) and two-dimensional dual inversion-recovery turbo spin-echo (2D-DIR-TSE) for coronary vessel wall imaging in KD. Ten patients were prospectively enrolled. Coronary vessel wall imaging with axial-slice orientation 3D-TSE and 2D-DIR-TSE were acquired for cross-sectional images in aneurysmal and normal regions. Lumen area (LA), wall area (WA), and normalized wall index (NWI) of cross-sectional images were measured in both regions. Reproducibility between 3D-TSE and 2D-DIR-TSE was evaluated via intraclass correlation coefficients (ICCs) and Bland–Altman plots. 48 points (aneurysmal, 27; normal, 21) were evaluated. There were high ICCs between 3D-TSE and 2D-DIR-TSE in LA (0.95) and WA (0.95). In aneurysmal regions, 95% limits of agreement were LA, WA, and NWI of − 29.9 to 30.4 mm2, − 18.8 to 15.0 mm2, and − 0.22 to 0.20, respectively. In normal regions, the 95% limits of agreement were LA, WA, and NWI of − 4.44 to 4.38 mm2, − 3.51 to 4.30 mm2, and − 0.14 to 0.16, respectively. No fixed and proportional biases between 3D-TSE and 2D-DIR-TSE images in aneurysmal and normal regions were noted. 3D-TSE was reproducible with conventional 2D-DIR-TSE for coronary vessel wall assessment on KD.
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Affiliation(s)
- Koji Matsumoto
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba, Japan.
| | - Hajime Yokota
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takafumi Yoda
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba, Japan
| | - Ryota Ebata
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroki Mukai
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba, Japan
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Edelman RR, Leloudas N, Pang J, Koktzoglou I. Dark blood cardiovascular magnetic resonance of the heart, great vessels, and lungs using electrocardiographic-gated three-dimensional unbalanced steady-state free precession. J Cardiovasc Magn Reson 2021; 23:127. [PMID: 34724939 PMCID: PMC8559409 DOI: 10.1186/s12968-021-00808-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recently, we reported a novel neuroimaging technique, unbalanced T1 Relaxation-Enhanced Steady-State (uT1RESS), which uses a tailored 3D unbalanced steady-state free precession (3D uSSFP) acquisition to suppress the blood pool signal while minimizing bulk motion sensitivity. In the present work, we hypothesized that 3D uSSFP might also be useful for dark blood imaging of the chest. To test the feasibility of this approach, we performed a pilot study in healthy subjects and patients undergoing cardiovascular magnetic resonance (CMR). MAIN BODY The study was approved by the hospital institutional review board. Thirty-one adult subjects were imaged at 1.5 T, including 5 healthy adult subjects and 26 patients (44 to 86 years, 10 female) undergoing a clinically indicated CMR. Breath-holding was used in 29 subjects and navigator gating in 2 subjects. For breath-hold acquisitions, the 3D uSSFP pulse sequence used a high sampling bandwidth, asymmetric readout, and single-shot along the phase-encoding direction, while 3 shots were acquired for navigator-gated scans. To minimize signal dephasing from bulk motion, electrocardiographic (ECG) gating was used to synchronize the data acquisition to the diastolic phase of the cardiac cycle. To further reduce motion sensitivity, the moment of the dephasing gradient was set to one-fifth of the moment of the readout gradient. Image quality using 3D uSSFP was good-to-excellent in all subjects. The blood pool signal in the thoracic aorta was uniformly suppressed with sharp delineation of the aortic wall including two cases of ascending aortic aneurysm and two cases of aortic dissection. Compared with variable flip angle 3D turbo spin-echo, 3D uSSFP showed improved aortic wall sharpness. It was also more efficient, permitting the acquisition of 24 slices in each breath-hold versus 16 slices with 3D turbo spin-echo and a single slice with dual inversion 2D turbo spin-echo. In addition, lung and mediastinal lesions appeared highly conspicuous compared with the low blood pool signals within the heart and blood vessels. In two subjects, navigator-gated 3D uSSFP provided excellent delineation of cardiac morphology in double oblique multiplanar reformations. CONCLUSION In this pilot study, we have demonstrated the feasibility of using ECG-gated 3D uSSFP for dark blood imaging of the heart, great vessels, and lungs. Further study will be required to fully optimize the technique and to assess clinical utility.
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Affiliation(s)
- Robert R. Edelman
- Department of Radiology, Northshore University HealthSystem, Evanston, IL USA
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
- Walgreen Building, G534, 2650 Ridge Avenue, Evanston, IL 60201 USA
| | - Nondas Leloudas
- Department of Radiology, Northshore University HealthSystem, Evanston, IL USA
| | - Jianing Pang
- Siemens Medical Solutions USA Inc., Chicago, IL USA
| | - Ioannis Koktzoglou
- Department of Radiology, Northshore University HealthSystem, Evanston, IL USA
- Radiology, Pritzker School of Medicine, University of Chicago, Chicago, IL USA
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Usefulness of rapid MR angiography using two-point Dixon for evaluating carotid and aortic plaques. Neuroradiology 2021; 64:693-702. [PMID: 34559244 DOI: 10.1007/s00234-021-02812-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Recently, various magnetic resonance imaging (MRI) modalities have been developed to easily detect carotid and aortic plaques, but these techniques are time-consuming and vulnerable to motion artifacts. We investigated the utility of a gradient echo MRI technique known as liver acquisition with volume acceleration flexible (LAVA-Flex) to detect carotid and aortic atherosclerotic plaques. METHODS Ten patients who underwent carotid endarterectomy (CEA) were assessed regarding the correspondence between LAVA-Flex findings and the histopathology of excised carotid plaques. In addition, 47 patients with cryptogenic ischemic stroke underwent LAVA-Flex and transesophageal echocardiography (TEE) for detection of embolic sources in the thoracic aorta. We analyzed the relationship between the thickness of the aortic plaque measured by TEE and the presence of high-intensity lesions on LAVA-Flex. RESULTS Nine of 10 patients (90.0%) who underwent CEA showed a high-intensity carotid lesion on LAVA-Flex, which corresponded pathologically to plaques containing large lipid cores and hemorrhage. Twenty-four (51.1%) of 47 cryptogenic stroke patients showed a high-intensity lesion in the thoracic aorta on LAVA-Flex; of these, 21 (87.5%) also demonstrated a large plaque (thickness ≥4 mm) on TEE. Twenty-two (95.7%) of 23 patients without a high-intensity lesion on LAVA-Flex demonstrated no large plaque on TEE. LAVA-Flex had a sensitivity of 95.5% and a specificity of 88.0% in patients with large plaques. CONCLUSION This study showed that LAVA-Flex successfully detected carotid and aortic plaques. This imaging technique may be useful to rapidly diagnose and evaluate carotid and aortic plaques, which are critical risk factors for aortogenic stroke.
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Subramaniam DR, Gutmark E, Andersen N, Nielsen D, Mortensen K, Gravholt C, Backeljauw P, Gutmark-Little I. Influence of Material Model and Aortic Root Motion in Finite Element Analysis of Two Exemplary Cases of Proximal Aortic Dissection. J Biomech Eng 2021; 143:1086152. [PMID: 32793953 DOI: 10.1115/1.4048084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Indexed: 01/25/2023]
Abstract
The risk of type-A dissection is increased in subjects with connective tissue disorders and dilatation of the proximal aorta. The location and extents of vessel wall tears in these patients could be potentially missed during prospective imaging studies. The objective of this study is to estimate the distribution of systolic wall stress in two exemplary cases of proximal dissection using finite element analysis (FEA) and evaluate the sensitivity of the distribution to the choice of anisotropic material model and root motion. FEA was performed for predissection aortas, without prior knowledge of the origin and extents of vessel wall tear. The stress distribution was evaluated along the wall tear in the postdissection aortas. The stress distribution was compared for the Fung and Holzapfel models with and without root motion. For the subject with spiral dissection, peak stress coincided with the origin of the tear in the sinotubular junction. For the case with root dissection, maximum stress was obtained at the distal end of the tear. The FEA predicted tear pressure was 20% higher for the subject with root dissection as compared to the case with spiral dissection. The predicted tear pressure was higher (9-11%) for root motions up to 10 mm. The Holzapfel model predicted a tear pressure that was lower (8-15%) than the Fung model. The FEA results showed that both material response and root motion could potentially influence the predicted dissection pressure of the proximal aorta at least for conditions tested in this study.
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Affiliation(s)
| | - Ephraim Gutmark
- Department of Aerospace Engineering and Engineering Mechanics, University of Cincinnati, Cincinnati, OH 45221-0070
| | - Niels Andersen
- Department of Cardiology, Aalborg University Hospital, Aalborg 9100, Denmark
| | - Dorte Nielsen
- Department of Cardiology, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Kristian Mortensen
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London WC1N 3JH, UK
| | - Claus Gravholt
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Philippe Backeljauw
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229
| | - Iris Gutmark-Little
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229
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Leiner T, Bogaert J, Friedrich MG, Mohiaddin R, Muthurangu V, Myerson S, Powell AJ, Raman SV, Pennell DJ. SCMR Position Paper (2020) on clinical indications for cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2020; 22:76. [PMID: 33161900 PMCID: PMC7649060 DOI: 10.1186/s12968-020-00682-4] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/18/2020] [Indexed: 12/22/2022] Open
Abstract
The Society for Cardiovascular Magnetic Resonance (SCMR) last published its comprehensive expert panel report of clinical indications for CMR in 2004. This new Consensus Panel report brings those indications up to date for 2020 and includes the very substantial increase in scanning techniques, clinical applicability and adoption of CMR worldwide. We have used a nearly identical grading system for indications as in 2004 to ensure comparability with the previous report but have added the presence of randomized controlled trials as evidence for level 1 indications. In addition to the text, tables of the consensus indication levels are included for rapid assimilation and illustrative figures of some key techniques are provided.
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Affiliation(s)
- Tim Leiner
- Department of Radiology, E.01.132, Utrecht University Medical Center, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands.
| | - Jan Bogaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Catholic University Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Matthias G Friedrich
- Departments of Medicine and Diagnostic Radiology, McGill University, 1001 Decarie Blvd., Montreal, QC, H4A 3J1, Canada
| | - Raad Mohiaddin
- Department of Radiology, Royal Brompton Hospital, Sydney Street, Chelsea, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, South Kensington Campus, London, SW7 2AZ, UK
| | - Vivek Muthurangu
- Centre for Cardiovascular Imaging, Science & Great Ormond Street Hospital for Children, UCL Institute of Cardiovascular, Great Ormond Street, London, WC1N 3JH, UK
| | - Saul Myerson
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Farley, 2nd Floor, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, 300 Longwood Avenue, Farley, 2nd Floor, Boston, MA, 02115, USA
| | - Subha V Raman
- Krannert Institute of Cardiology, Indiana University School of Medicine, 340 West 10th Street, Fairbanks Hall, Suite 6200, Indianapolis, IN, 46202-3082, USA
| | - Dudley J Pennell
- Royal Brompton Hospital, Sydney Street, Chelsea, London, SW3 6NP, UK
- Imperial College, South Kensington Campus, London, SW7 2AZ, UK
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11
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Henningsson M, Malik S, Botnar R, Castellanos D, Hussain T, Leiner T. Black-Blood Contrast in Cardiovascular MRI. J Magn Reson Imaging 2020; 55:61-80. [PMID: 33078512 PMCID: PMC9292502 DOI: 10.1002/jmri.27399] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022] Open
Abstract
MRI is a versatile technique that offers many different options for tissue contrast, including suppressing the blood signal, so‐called black‐blood contrast. This contrast mechanism is extremely useful to visualize the vessel wall with high conspicuity or for characterization of tissue adjacent to the blood pool. In this review we cover the physics of black‐blood contrast and different techniques to achieve blood suppression, from methods intrinsic to the imaging readout to magnetization preparation pulses that can be combined with arbitrary readouts, including flow‐dependent and flow‐independent techniques. We emphasize the technical challenges of black‐blood contrast that can depend on flow and motion conditions, additional contrast weighting mechanisms (T1, T2, etc.), magnetic properties of the tissue, and spatial coverage. Finally, we describe specific implementations of black‐blood contrast for different vascular beds.
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Affiliation(s)
- Markus Henningsson
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Shaihan Malik
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Rene Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Daniel Castellanos
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Pediatric Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, The Netherlands
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12
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Weinrich JM, Avanesov M, Lenz A, Tahir E, Henes FO, Schoennagel BP, Rybczinsky M, Adam G, von Kodolitsch Y, Bannas P. Reliability of non-contrast magnetic resonance angiography-derived aortic diameters in Marfan patients: comparison of inner vs. outer vessel wall measurements. Int J Cardiovasc Imaging 2020; 36:1533-1542. [PMID: 32314122 PMCID: PMC7381445 DOI: 10.1007/s10554-020-01850-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/10/2020] [Indexed: 02/05/2023]
Abstract
Aortic diameter measurements play a crucial role for the indication of aortic root surgery in Marfan patients. However, for magnetic resonance angiography (MRA)-derived measurements, there is no consensus on whether the aortic wall should be included or excluded in the aortic diameter. The purpose of this retrospective study was to compare the reliability of non-contrast bright blood MRA aortic inner-to-inner and outer-to-outer edge measurements in patients with Marfan syndrome. Forty Marfan patients underwent ECG-gated balanced steady-state free-precession MRA of the aorta at 1.5 T. Two readers independently performed inner and outer measurements at different aortic levels. They rated the image quality of the delineation of both inner and outer vessel wall edges on a four-point scale. MRA-derived diameters of the sinuses of Valsalva were compared with echocardiography-derived diameters. Aortic vessel wall delineation score was rated higher at all levels for inner than for outer vessel walls (p < 0.001). Inter- and intraobserver variances of aortic measurements were smaller for inner-to-inner measurements at the sinuses of Valsalva, sinotubular junction and ascending aorta (p < 0.03). There was a difference of 1.1 ± 2.3 mm for inner MRA measurements (p = 0.014) and 6.9 ± 3.1 mm for outer MRA measurements (p < 0.001) when compared to echocardiographic leading-edge measurements. Inner-to-inner vessel wall diameter measurements in non-contrast bright blood MRA provide more reliable diameters when compared to outer-to-outer vessel wall measurements of the aortic root. Therefore, we propose to rely on inner rather than outer aortic wall measurements in non-contrast-MRA when monitoring aortic diameters in patients with Marfan syndrome.
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Affiliation(s)
- Julius Matthias Weinrich
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Maxim Avanesov
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Alexander Lenz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Enver Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Frank-Oliver Henes
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Bjoern Philip Schoennagel
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Meike Rybczinsky
- Department of General and Interventional Cardiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Yskert von Kodolitsch
- Department of General and Interventional Cardiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Bannas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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13
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Li Y, Chen Q, Wei Z, Zhang L, Tie C, Zhu Y, Jia S, Xia J, Liang D, He Q, Zhang X, Liu X, Zhang B, Zheng H. One-Stop MR Neurovascular Vessel Wall Imaging With a 48-Channel Coil System at 3 T. IEEE Trans Biomed Eng 2019; 67:2317-2327. [PMID: 31831406 DOI: 10.1109/tbme.2019.2959030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The purpose of this article was to build a radio frequency (RF) coil system to achieve high vessel wall image quality with coverage extending from the aortic arch to the intracranial vessels. METHODS A 48-channel coil system was built and characterized at a 3 tesla (T) Magnetic Resonance Imaging (MRI) scanner (uMR 790, Shanghai United Imaging Healthcare, Shanghai, China). The coil's performance was compared with a commercially available 36-channel coil system. By human studies, signal-to-noise ratio (SNR) units were evaluated and g-factors were calculated in the transverse planes of the brain and neck regions. RESULTS The SNR was increased by at least 28% in the brain region and up to fourfold in the neck region. The average g-factor with the acceleration factor, R = 3, was lowered by 21% in the transverse plane of the neck region. Intracranial and carotid arterial wall images with an isotropic spatial resolution of 0.63 mm were acquired within 7.7 minutes and thoracic aorta wall images with an isotropic spatial resolution of 1.1 mm were acquired within 2.7 minutes with the 48-channel coil system. The vessel wall can be more clearly visualized with the 48-channel coil system compared with the 36-channel coil system. CONCLUSION A 48-channel coil system was developed and demonstrated superior performance for vessel wall imaging at the intracranial and cervical carotid arteries compared with a commercial 36-channel coil. SIGNIFICANCE The 48-channel coil system is potentially useful for clinical diagnostics, especially when attempting to diagnose ischemic stroke.
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14
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Sommer NN, Pons Lucas R, Coppenrath E, Kooijman H, Galiè F, Hesse N, Sommer WH, Treitl KM, Saam T, Froelich MF. Contrast-enhanced modified 3D T1-weighted TSE black-blood imaging can improve detection of infectious and neoplastic meningitis. Eur Radiol 2019; 30:866-876. [PMID: 31691123 DOI: 10.1007/s00330-019-06475-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/30/2019] [Accepted: 09/20/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To evaluate the diagnostic value of a contrast-enhanced 3D T1-weighted-modified volumetric isotropic turbo spin-echo acquisition sequence (T1-mVISTA) in comparison with a conventional 3D T1-weighted magnetization-prepared rapid gradient-echo (T1-MP-RAGE) sequence for the detection of meningeal enhancement in patients with meningitis. METHODS Thirty patients (infectious meningitis, n = 12; neoplastic meningitis, n = 18) and 45 matched controls were enrolled in this retrospective case-control study. Sets of randomly selected T1-mVISTA and T1-MP-RAGE images (both with 0.8-mm isotropic resolution) were read separately 4 weeks apart. Image quality, leptomeningeal and dural enhancement, grading of visual contrast enhancement, and diagnostic confidence were compared using the Kruskal-Wallis rank sum test. RESULTS Image quality was rated to be good to excellent in 75 out of 75 cases (100%) for T1-mVISTA and 74 out of 75 cases (98.7%) for T1-MP-RAGE. T1-mVISTA detected significantly more patients with leptomeningeal enhancement (p = 0.006) compared with T1-MP-RAGE (86.7 vs. 50.0%, p < 0.001), each with specificity of 100%. Similarly, sensitivity of T1-mVISTA for the detection of dural and/or leptomeningeal enhancement was also significantly higher compared with that of T1-MP-RAGE (96.7 vs. 80.0%, p = 0.025) without significant differences regarding specificity (97.8 vs. 95.6%, p = 0.317). No significant differences were found for dural enhancement alone. Diagnostic confidence in T1-mVISTA was significantly higher (p = 0.01). Visual contrast enhancement was tendentially higher in T1-mVISTA. CONCLUSIONS T1-mVISTA may be an adequate and probably better alternative to T1-MP-RAGE for detection of leptomeningeal diseases. KEY POINTS • Black-blood T1-mVISTA showed a significant higher sensitivity for the detection of leptomeningeal enhancement compared with MP-RAGE without losses regarding specificity. • Diagnostic confidence was assessed significantly higher in T1-mVISTA. • T1-mVISTA should be considered a supplement or an alternative to T1-MP-RAGE in patients with suspected leptomeningeal diseases.
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Affiliation(s)
- Nora Navina Sommer
- Department of Radiology, Ludwig-Maximilians-University Hospital, Ziemssenstr. 1, 80336, Munich, Germany.
| | - Romina Pons Lucas
- Department of Radiology, Ludwig-Maximilians-University Hospital, Ziemssenstr. 1, 80336, Munich, Germany
| | - Eva Coppenrath
- Department of Radiology, Ludwig-Maximilians-University Hospital, Ziemssenstr. 1, 80336, Munich, Germany
| | | | - Franziska Galiè
- Department of Radiology, Ludwig-Maximilians-University Hospital, Ziemssenstr. 1, 80336, Munich, Germany
| | - Nina Hesse
- Department of Radiology, Ludwig-Maximilians-University Hospital, Ziemssenstr. 1, 80336, Munich, Germany
| | - Wieland H Sommer
- Department of Radiology, Ludwig-Maximilians-University Hospital, Ziemssenstr. 1, 80336, Munich, Germany
| | - Karla M Treitl
- Department of Radiology, Ludwig-Maximilians-University Hospital, Ziemssenstr. 1, 80336, Munich, Germany.,German Center for Cardiovascular Disease Research (DZHK e. V.), Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Tobias Saam
- Radiologisches Zentrum Rosenheim, Stollstr. 6, 83022, Rosenheim, Germany
| | - Matthias F Froelich
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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15
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Maurus S, Sommer NN, Kooijman H, Coppenrath E, Witt M, Schulze-Koops H, Czihal M, Hoffmann U, Saam T, Treitl KM. 3D black-blood 3T-MRI for the diagnosis of abdominal large vessel vasculitis. Eur Radiol 2019; 30:1041-1044. [PMID: 31529250 DOI: 10.1007/s00330-019-06432-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/27/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To assess the value of a T1-3D black-blood turbo spin echo (TSE) sequence for the diagnosis of abdominal large vessel vasculitis (LVV). MATERIALS AND METHODS The study included 20 patients with abdominal LVV and 17 controls, who underwent a 3T-MRI scan using a modified T1-3D volumetric isotropic TSE acquisition and a segmented T1-3D turbo field echo sequence (T1-mVISTA/T1-eTHRIVE). Two radiologists independently analyzed the aorta for concentric contrast enhancement, concentric wall thickening, image quality, and flow artifact intensity (CCE/CWT/IQ/FAI; 4-point scales). The mean aortic wall thickness (MAWT) in post-contrast T1-mVISTA was compared between patients and controls. RESULTS IQ of T1-mVISTA was rated good to excellent in 91.5% of 282 evaluated vessel segments with no or minor FAI present in 85.5%. The inter-observer reproducibility for the identification of CCE/CWT on T1-mVISTA was 0.92 and 0.93 (p < 0.001). The distribution of segmental inflammation in T1-mVISTA significantly correlated with T1-eTHRIVE (CCE, κ = 0.768; CWT, κ = 0.715; p < 0.001), resulting in a sensitivity, specificity, and positive predictive value of 100%, 81.3%, and 83.3%. The MAWT significantly differed between patients and controls (3.29 ± 0.81 vs. 2.24 ± 0.45 mm; p < 0.001). CONCLUSIONS T1-mVISTA enables the evaluation of the MAWT and allows the detection of abdominal LVV. KEY POINTS • 3D T1w-mVISTA accurately depicted the large abdominal vessels. • 3D T1w-mVISTA enables accurate measurements of the abdominal aortic wall thickness. • 3D T1w-mVISTA is useful for the detection of abdominal LVV.
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Affiliation(s)
- Stefan Maurus
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
| | - Nora N Sommer
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | | | - Eva Coppenrath
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Matthias Witt
- Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Michael Czihal
- Division of Vascular Medicine, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Ulrich Hoffmann
- Division of Vascular Medicine, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Saam
- Radiologisches Zentrum Rosenheim, Rosenheim, Germany
| | - Karla M Treitl
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,German Center for Cardiovascular Disease Research (DZHK e. V.), Munich, Germany
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16
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Dai W, Li D, Cai Y, Qiu E, Xu J, Li J, Wang Y, Guo Y, Li Y, Jiang B, Zhang Y, Ge J, Yao C, Zhang R, Liu G, Yao G, Cai J, Zhao X. Association between homocysteine and multivascular atherosclerosis in stroke-related vascular beds determined by three-dimensional magnetic resonance vessel wall imaging. J Clin Neurosci 2019; 70:72-78. [PMID: 31447358 DOI: 10.1016/j.jocn.2019.08.076] [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: 07/01/2019] [Accepted: 08/08/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atherosclerosis in stroke-related vascular beds is the major cause of stroke. Studies demonstrated that multivascular atherosclerosis is prevalent in stroke patients and those with multivascular plaques had higher risk of recurrent stroke. OBJECTIVES This study investigated the relationship between homocysteine and multivascular atherosclerosis in stroke-related vascular beds using magnetic resonance imaging. METHODS Patients with recent ischemic cerebrovascular symptoms were enrolled and underwent three-dimensional magnetic resonance vessel wall imaging for intracranial arteries, extracranial carotid arteries and aortic arch. Traditional risk factors and homocysteine were measured. Presence of multivascular plaques defined as plaques in at least two stroke-related vascular beds on magnetic resonance imaging was determined. The relationship between homocysteine and characteristics of multivascular plaques was determined. RESULTS Of 49 enrolled patients (mean age: 56.3 ± 13.8 years; 35 males), 23 had multivascular plaques. Homocysteine (odds ratio, 1.17; 95% confidence interval, 1.02-1.34; p = 0.022) and age (odds ratio, 1.71; 95% confidence interval, 1.22-2.41; p = 0.002) were significantly associated with presence of multivascular plaques. The adjusted associations remained significant (both p < 0.05). In discriminating presence of multivascular plaques, the area-under-the-curve of age, homocysteine and combination of them was 0.79, 0.70 and 0.87 respectively. CONCLUSIONS Homocysteine is independently associated with stroke-related multivascular plaques and combination of age and homocysteine has stronger predictive value.
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Affiliation(s)
- Wei Dai
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; Department of Neurology, Chinese PLA General Hospital & Medical School of Chinese PLA, Beijing 100853, China
| | - Dongye Li
- Center for Brain Disorders Research, Capital Medical University and Beijing Institute for Brain Disorders, Beijing 100069, China
| | - Ying Cai
- Department of Radiology, Taizhou People's Hospital, Taizhou 225300, China
| | - Enchao Qiu
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Jingwei Xu
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Jing Li
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Yunxia Wang
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Yueqi Guo
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Yifan Li
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Bo Jiang
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Yunyan Zhang
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Junling Ge
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Cunshan Yao
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Runhua Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Gaifen Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Guoen Yao
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China.
| | - Jianming Cai
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100069, China.
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17
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Manning WJ. Journal of Cardiovascular Magnetic Resonance 2017. J Cardiovasc Magn Reson 2018; 20:89. [PMID: 30593280 PMCID: PMC6309095 DOI: 10.1186/s12968-018-0518-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 02/07/2023] Open
Abstract
There were 106 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2017, including 92 original research papers, 3 reviews, 9 technical notes, and 1 Position paper, 1 erratum and 1 correction. The volume was similar to 2016 despite an increase in manuscript submissions to 405 and thus reflects a slight decrease in the acceptance rate to 26.7%. The quality of the submissions continues to be high. The 2017 JCMR Impact Factor (which is published in June 2018) was minimally lower at 5.46 (vs. 5.71 for 2016; as published in June 2017), which is the second highest impact factor ever recorded for JCMR. The 2017 impact factor means that an average, each JCMR paper that were published in 2015 and 2016 was cited 5.46 times in 2017.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in continuus fashion and in the chronologic order of acceptance, with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or theme, so that readers can view areas of interest in a single article in relation to each other and other contemporary JCMR articles. In this publication, the manuscripts are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought within the journal. In addition, I have elected to use this format to convey information regarding the editorial process to the readership.I hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your very best, high quality manuscripts to JCMR for consideration. I thank our very dedicated Associate Editors, Guest Editors, and Reviewers for their efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the forefront journal of our field. And finally, I thank you for entrusting me with the editorship of the JCMR as I begin my 3rd year as your editor-in-chief. It has been a tremendous learning experience for me and the opportunity to review manuscripts that reflect the best in our field remains a great joy and highlight of my week!
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Affiliation(s)
- Warren J Manning
- Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
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18
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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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Li D, Dai W, Cai Y, Han Y, Yao G, Chen H, Yuan C, Xiao L, Zhao X. Atherosclerosis in stroke-related vascular beds and stroke risk: A 3-D MR vessel wall imaging study. Ann Clin Transl Neurol 2018; 5:1599-1610. [PMID: 30564625 PMCID: PMC6292191 DOI: 10.1002/acn3.673] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/07/2018] [Accepted: 09/23/2018] [Indexed: 11/10/2022] Open
Abstract
Objectives To investigate the characteristics of atherosclerotic plaques in stroke-related vascular beds and their relationship with stroke using three-dimensional magnetic resonance (MR) vessel wall imaging. Methods Fifty-two symptomatic patients (mean age: 56.3 ± 13.4 years; 38 males) were enrolled and underwent MR vessel wall imaging for stroke-related vascular beds including intracranial and extracranial carotid arteries and aortic arch and routine MR imaging for brain. The maximum wall thickness (Max WT) and luminal stenosis of each plaque were measured. The presence/absence of atherosclerotic plaque, intraplaque hemorrhage (IPH), and severe stenosis (stenosis >50%) at each vascular bed and acute ischemic lesion (AIL) were determined. The correlation between Max WT of each vascular bed and AIL was analyzed. Results Of 52 patients, 24 (46.2%) had AILs, and 30 (57.7%), 34 (65.4%), and 11 (21.2%) had plaques in intracranial artery, extracranial carotid artery, and aortic arch, respectively. The prevalence of IPH and severe stenosis was 25% and 26.9% for intracranial arteries, 13.5% and 9.6% for extracranial carotid artery, and 3.8% and 0% for aortic arch, respectively. In discriminating AIL, Max WT of intracranial artery had the highest area-under-the-curve (AUC = 0.84), followed by extracranial carotid artery (AUC = 0.83) and aortic arch (AUC = 0.78) after adjusted for confounding factors. The AUC of Max WT combined three stroked-related vascular beds reached 0.87. Conclusion Extracranial carotid arteries have the highest prevalence of plaques and intraplaque hemorrhage and severe stenosis are most frequently seen in intracranial arteries in Asian symptomatic patients. The Max WT combined three stroke-related vascular beds show stronger predictive value for AIL than each vascular bed alone.
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Affiliation(s)
- Dongye Li
- Center for Brain Disorders Research Capital Medical University and Beijing Institute of Brain Disorders Beijing China.,Center for Biomedical Imaging Research Department of Biomedical Engineering Tsinghua University School of Medicine Beijing China
| | - Wei Dai
- Department of Neurology The First Affiliated Hospital of the PLA General Hospital Beijing China
| | - Ying Cai
- Department of Radiology Taizhou People's Hospital Taizhou China
| | - Yongjun Han
- Center for Brain Disorders Research Capital Medical University and Beijing Institute of Brain Disorders Beijing China
| | - Guoen Yao
- Department of Neurology The First Affiliated Hospital of the PLA General Hospital Beijing China
| | - Huijun Chen
- Center for Biomedical Imaging Research Department of Biomedical Engineering Tsinghua University School of Medicine Beijing China
| | - Chun Yuan
- Center for Biomedical Imaging Research Department of Biomedical Engineering Tsinghua University School of Medicine Beijing China.,Department of Radiology University of Washington Seattle Washington
| | - Lei Xiao
- Department of Neurology Beijing Fengtai Hospital of Integrated Traditional and Western Medicine Beijing China
| | - Xihai Zhao
- Center for Biomedical Imaging Research Department of Biomedical Engineering Tsinghua University School of Medicine Beijing China.,Center of Stroke Beijing Institute for Brain Disorders Beijing China
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20
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Gerbrand Zoet GA, Anna Sverrisdóttir AK, Anouk Eikendal ALM, Arie Franx A, Tim Leiner T, Bas van Rijn BB. MRI-derived aortic characteristics after pregnancy: The AMBITYON study. Pregnancy Hypertens 2018; 13:46-50. [PMID: 30177070 DOI: 10.1016/j.preghy.2018.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/26/2018] [Accepted: 04/28/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Pregnancy and pregnancy complications have been associated with increased arterial stiffness even at young age. In this study we assessed the impact of parity on CMR-derived aortic characteristics as early markers of atherosclerosis and arterial stiffness in healthy women between 25 and 35 years. STUDY DESIGN We studied 68 women who participated in the AMBITYON study, a prospective population-based cohort study for assessment of atherosclerotic burden by MRI and traditional CVD risk factors in healthy, young adults. Of these women, 40 (58.8%) were nulliparous, 13 (19.1%) were primiparous and 15 (22.1%) were multiparous. MAIN OUTCOME MEASURES Descending thoracic aortic wall thickness (AWT) and pulse wave velocity (PWV) were measured using 3.0T CMR. RESULTS AWT measurements were similar between nulliparous women and primi- or multiparous women (1.6 mm ± 0.2 mm vs. 1.6 mm ± 0.2 mm; p = 0.79). Correction for age and systolic blood pressure did not change these results. Applying percentile based cut-off values showed a non-significant increase in AWT in parous women. PWV measurements did not differ between nulliparous women and parous women (4.5 m/s ± 0.7 m/s vs. 4.5 m/s ± 0.8 m/s; p = 0.78). Correction for age and systolic blood pressure did not influence these results. Using percentile based cut-off values, showed an increasing likelihood of higher PWV-values in parous women, although not statistically significant. CONCLUSIONS Direct measurement of aortic AWT and PWV by CMR showed no difference between nulliparous and parous women, probably indicating limited effect of pregnancy on arterial stiffness and early markers of atherosclerosis. TRIAL REGISTRATION Netherlands Trial Register (NTR) number: 4742.
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Affiliation(s)
- G A Gerbrand Zoet
- Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, Lundlaan 6, PO Box 85090, 3508 AB Utrecht, The Netherlands.
| | - A K Anna Sverrisdóttir
- Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, Lundlaan 6, PO Box 85090, 3508 AB Utrecht, The Netherlands
| | - A L M Anouk Eikendal
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - A Arie Franx
- Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, Lundlaan 6, PO Box 85090, 3508 AB Utrecht, The Netherlands
| | - T Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - B B Bas van Rijn
- Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, Lundlaan 6, PO Box 85090, 3508 AB Utrecht, The Netherlands; Academic Unit of Human Development and Health, University of Southampton, Princess Anne Hospital, Coxford Road, Southampton SO16 5YA, United Kingdom
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21
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Eikendal ALM, Bots ML, Gohar A, Lutgens E, Hoefer IE, den Ruijter HM, Leiner T. Circulating levels of P-selectin and E-selectin relate to cardiovascular magnetic resonance-derived aortic characteristics in young adults from the general population, a cross-sectional study. J Cardiovasc Magn Reson 2018; 20:54. [PMID: 30068374 PMCID: PMC6090925 DOI: 10.1186/s12968-018-0473-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 06/26/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Although endothelial cell adhesion molecules (CAMs) are postulated to play a key role in early atherosclerosis, studies on endothelial CAMs are mainly pertained to middle-aged populations and populations with an unfavourable cardiovascular risk burden. Therefore, this study evaluated whether circulating endothelial CAMs are related to cardiovascular magnetic resonance imaging (CMR) derived indicators of arterial wall alterations in a random sample of young adults from the general population. METHODS This cross-sectional study is part of the general-population-based Atherosclerosis-Monitoring-and-Biomarker-measurements-In-The-YOuNg (AMBITYON) cohort study. In 131 adults (age: 25-35 years), demography, anthropometry and a lipid spectrum was acquired. Thoracic aortic wall area, wall thickness and pulse wave velocity (PWV) were measured using a 3 T CMR-system. From stored blood samples, four CAMs (E-selectin, P-selectin, vascular CAM-1 and intercellular CAM-1) were measured using dedicated methods. Linear mixed-effects regression analysis was used to evaluate the relation of these CAMs with the selected aortic characteristics. RESULTS Of the studied endothelial CAMs, P-selectin related to natural logarithm transformed aortic wall thickness (β = 0.18 mm/(μg/ml), [95% confidence interval: 0.04, 0.31], p = 0.01) whereas E-selectin related to natural logarithm transformed aortic PWV (β = 3.01 (m/s)/(μg/ml), [95% confidence interval: 0.08, 5.95], p = 0.04). Of note, VCAM-1 and ICAM-1 did not relate to the selected aortic characteristics. CONCLUSIONS In young adults from the general population, circulating P-selectin and E-selectin levels appear positively related to CMR-derived aortic wall thickness and PWV, possibly pointing towards atherogenic inflammatory arterial wall alterations inflicted by these CAMs already in young adulthood. TRIAL REGISTRATION Netherlands National Trial Register (NTR): NTR4742 , Registered 18 August 2014, retrospectively registered.
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Affiliation(s)
- Anouk L. M. Eikendal
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Michiel L. Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Aisha Gohar
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Esther Lutgens
- Department of Medical Biochemistry, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Imo E. Hoefer
- Laboratory of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hester M. den Ruijter
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
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22
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Zhang N, Zhang F, Deng Z, Yang Q, Diniz MA, Song SS, Schlick KH, Marcel Maya M, Gonzalez N, Li D, Zheng H, Liu X, Fan Z. 3D whole-brain vessel wall cardiovascular magnetic resonance imaging: a study on the reliability in the quantification of intracranial vessel dimensions. J Cardiovasc Magn Reson 2018; 20:39. [PMID: 29898736 PMCID: PMC6000985 DOI: 10.1186/s12968-018-0453-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 04/12/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND One of the potentially important applications of three-dimensional (3D) intracranial vessel wall (IVW) cardiovascular magnetic resonance (CMR) is to monitor disease progression and regression via quantitative measurement of IVW morphology during medical management or drug development. However, a prerequisite for this application is to validate that IVW morphologic measurements based on the modality are reliable. In this study we performed comprehensive reliability analysis for the recently proposed whole-brain IVW CMR technique. METHODS Thirty-four healthy subjects and 10 patients with known intracranial atherosclerotic disease underwent repeat whole-brain IVW CMR scans. In 19 of the 34 subjects, two-dimensional (2D) turbo spin-echo (TSE) scan was performed to serve as a reference for the assessment of vessel dimensions. Lumen and wall volume, normalized wall index, mean and maximum wall thickness were measured in both 3D and 2D IVW CMR images. Scan-rescan, intra-observer, and inter-observer reproducibility of 3D IVW CMR in the quantification of IVW or plaque dimensions were respectively assessed in volunteers and patients as well as for different healthy subjectsub-groups (i.e. < 50 and ≥ 50 years). The agreement in vessel wall and lumen measurements between the 3D technique and the 2D TSE method was also investigated. In addition, the sample size required for future longitudinal clinical studies was calculated. RESULTS The intra-class correlation coefficient (ICC) and Bland-Altman plots indicated excellent reproducibility and inter-method agreement for all morphologic measurements (All ICCs > 0.75). In addition, all ICCs of patients were equal to or higher than that of healthy subjects except maximum wall thickness. In volunteers, all ICCs of the age group of ≥50 years were equal to or higher than that of the age group of < 50 years. Normalized wall index and mean and maximum wall thickness were significantly larger in the age group of ≥50 years. To detect 5% - 20% difference between placebo and treatment groups, normalized wall index requires the smallest sample size while lumen volume requires the highest sample size. CONCLUSIONS Whole-brain 3D IVW CMR is a reliable imaging method for the quantification of intracranial vessel dimensions and could potentially be useful for monitoring plaque progression and regression.
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Affiliation(s)
- Na Zhang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Ave., Shenzhen University Town, Shenzhen, 518055 China
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA 90048 USA
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Fan Zhang
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA 90048 USA
| | - Zixin Deng
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA 90048 USA
- Department of Bioengineering, University of California, Los Angeles, CA USA
| | - Qi Yang
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA 90048 USA
| | - Marcio A. Diniz
- Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Shlee S. Song
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Konrad H. Schlick
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - M. Marcel Maya
- Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Nestor Gonzalez
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA 90048 USA
- Department of Bioengineering, University of California, Los Angeles, CA USA
- Department of Medicine, University of California, Los Angeles, CA USA
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Ave., Shenzhen University Town, Shenzhen, 518055 China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Ave., Shenzhen University Town, Shenzhen, 518055 China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA 90048 USA
- Department of Medicine, University of California, Los Angeles, CA USA
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Manning WJ. Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston. J Cardiovasc Magn Reson 2017; 19:108. [PMID: 29284487 PMCID: PMC5747150 DOI: 10.1186/s12968-017-0423-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023] Open
Abstract
The Journal of Cardiovascular Magnetic Resonance (JCMR) is the official publication of the Society for Cardiovascular Magnetic Resonance (SCMR). In 2016, the JCMR published 93 manuscripts, including 80 research papers, 6 reviews, 5 technical notes, 1 protocol, and 1 case report. The number of manuscripts published was similar to 2015 though with a 12% increase in manuscript submissions to an all-time high of 369. This reflects a decrease in the overall acceptance rate to <25% (excluding solicited reviews). The quality of submissions to JCMR continues to be high. The 2016 JCMR Impact Factor (which is published in June 2016 by Thomson Reuters) was steady at 5.601 (vs. 5.71 for 2015; as published in June 2016), which is the second highest impact factor ever recorded for JCMR. The 2016 impact factor means that the JCMR papers that were published in 2014 and 2015 were on-average cited 5.71 times in 2016.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in the order that they are accepted with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes with previously published JCMR papers to guide continuity of thought in the journal. In addition, I have elected to open this publication with information for the readership regarding the transition of the JCMR editorial office to the Beth Israel Deaconess Medical Center, Boston and the editorial process.Though there is an author publication charge (APC) associated with open-access to cover the publisher's expenses, this format provides a much wider distribution/availability of the author's work and greater manuscript citation. For SCMR members, there is a substantial discount in the APC. I hope that you will continue to send your high quality manuscripts to JCMR for consideration. Importantly, I also ask that you consider referencing recent JCMR publications in your submissions to the JCMR and elsewhere as these contribute to our impact factor. I also thank our dedicated Associate Editors, Guest Editors, and reviewers for their many efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the leading publication in our field.
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Affiliation(s)
- Warren J Manning
- From the Journal of Cardiovascular Magnetic Resonance Editorial Office and the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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24
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Coolen BF, Calcagno C, van Ooij P, Fayad ZA, Strijkers GJ, Nederveen AJ. Vessel wall characterization using quantitative MRI: what's in a number? MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:201-222. [PMID: 28808823 PMCID: PMC5813061 DOI: 10.1007/s10334-017-0644-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 07/04/2017] [Accepted: 07/18/2017] [Indexed: 12/15/2022]
Abstract
The past decade has witnessed the rapid development of new MRI technology for vessel wall imaging. Today, with advances in MRI hardware and pulse sequences, quantitative MRI of the vessel wall represents a real alternative to conventional qualitative imaging, which is hindered by significant intra- and inter-observer variability. Quantitative MRI can measure several important morphological and functional characteristics of the vessel wall. This review provides a detailed introduction to novel quantitative MRI methods for measuring vessel wall dimensions, plaque composition and permeability, endothelial shear stress and wall stiffness. Together, these methods show the versatility of non-invasive quantitative MRI for probing vascular disease at several stages. These quantitative MRI biomarkers can play an important role in the context of both treatment response monitoring and risk prediction. Given the rapid developments in scan acceleration techniques and novel image reconstruction, we foresee the possibility of integrating the acquisition of multiple quantitative vessel wall parameters within a single scan session.
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Affiliation(s)
- Bram F Coolen
- Department of Biomedical Engineering and Physics, Academic Medical Center, PO BOX 22660, 1100 DD, Amsterdam, The Netherlands. .,Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
| | - Claudia Calcagno
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pim van Ooij
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gustav J Strijkers
- Department of Biomedical Engineering and Physics, Academic Medical Center, PO BOX 22660, 1100 DD, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
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Eikendal ALM, den Ruijter HM, Haaring C, Saam T, van der Geest RJ, Westenberg JJM, Bots ML, Hoefer IE, Leiner T. Sex, body mass index, and blood pressure are related to aortic characteristics in healthy, young adults using magnetic resonance vessel wall imaging: the AMBITYON study. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:173-182. [PMID: 28569376 PMCID: PMC5813077 DOI: 10.1007/s10334-017-0626-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 12/31/2022]
Abstract
Objectives More detailed evaluation of atherosclerosis and its key determinants in young individuals is warranted to improve knowledge on the pathophysiology of its development and progression. This study evaluated associations of magnetic resonance imaging (MRI)-derived aortic wall area, wall thickness, and pulse wave velocity (PWV) with cardiovascular risk factors in asymptomatic, young adults. Materials and methods In 124 adults (age: 25–35 years) from the general population-based Atherosclerosis Monitoring and Biomarker Measurements in the Young study, demography, anthropometry, and blood samples were collected. The studied MRI-parameters were measured using a 3.0T MRI system. Relations between cardiovascular risk factors and aortic characteristics were assessed using multivariable linear regression analyses. Results Mean age was 31.8 years, 47.6% was male. Aortic wall area was positively associated with age [β = 0.01, (95% confidence interval (CI) 2.00 × 10−3, 0.02), p = 0.01] and BMI [β = 0.01, (0.01, 0.02), p = 0.003] and negatively associated with sex (reference: men) [β = −0.06, (−0.11, −0.01), p = 0.02]. Natural logarithm transformed (ln) aortic wall thickness was positively associated with BMI [β = 0.01, (1.00 × 10−3, 0.02), p = 0.02]. Ln aortic PWV was positively associated with 10 mmHg increment of SBP [β = 0.06, (0.03, 0.09), p < 0.001] and DBP [β = 0.06, (0.02, 0.09), p = 0.006]. No relations were observed for smoking and lipids. Conclusions Already in early adulthood, aortic wall geometry and stiffness vary by age, sex, BMI, and blood pressure.
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Affiliation(s)
- Anouk L M Eikendal
- Department of Radiology (E01.132), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Hester M den Ruijter
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Cees Haaring
- Department of Radiology (E01.132), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Tobias Saam
- Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377, Munich, Germany
| | - Rob J van der Geest
- Division of Image Processing, Department of Radiology, 1-C2S Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Jos J M Westenberg
- Division of Image Processing, Department of Radiology, 1-C2S Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Imo E Hoefer
- Laboratory of Clinical Chemistry and Hematology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Tim Leiner
- Department of Radiology (E01.132), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Zhou C, Qiao H, He L, Yuan C, Chen H, Zhang Q, Li R, Wang W, Du F, Li C, Zhao X. Characterization of atherosclerotic disease in thoracic aorta: A 3D, multicontrast vessel wall imaging study. Eur J Radiol 2016; 85:2030-2035. [DOI: 10.1016/j.ejrad.2016.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/01/2016] [Accepted: 09/10/2016] [Indexed: 01/25/2023]
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27
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Reference Values for Cardiac and Aortic Magnetic Resonance Imaging in Healthy, Young Caucasian Adults. PLoS One 2016; 11:e0164480. [PMID: 27732640 PMCID: PMC5061387 DOI: 10.1371/journal.pone.0164480] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/26/2016] [Indexed: 12/04/2022] Open
Abstract
Background Reference values for morphological and functional parameters of the cardiovascular system in early life are relevant since they may help to identify young adults who fall outside the physiological range of arterial and cardiac ageing. This study provides age and sex specific reference values for aortic wall characteristics, cardiac function parameters and aortic pulse wave velocity (PWV) in a population-based sample of healthy, young adults using magnetic resonance (MR) imaging. Materials and Methods In 131 randomly selected healthy, young adults aged between 25 and 35 years (mean age 31.8 years, 63 men) of the general-population based Atherosclerosis-Monitoring-and-Biomarker-measurements-In-The-YOuNg (AMBITYON) study, descending thoracic aortic dimensions and wall thickness, thoracic aortic PWV and cardiac function parameters were measured using a 3.0T MR-system. Age and sex specific reference values were generated using dedicated software. Differences in reference values between two age groups (25–30 and 30–35 years) and both sexes were tested. Results Aortic diameters and areas were higher in the older age group (all p<0.007). Moreover, aortic dimensions, left ventricular mass, left and right ventricular volumes and cardiac output were lower in women than in men (all p<0.001). For mean and maximum aortic wall thickness, left and right ejection fraction and aortic PWV we did not observe a significant age or sex effect. Conclusion This study provides age and sex specific reference values for cardiovascular MR parameters in healthy, young Caucasian adults. These may aid in MR guided pre-clinical identification of young adults who fall outside the physiological range of arterial and cardiac ageing.
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