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Chen T, Liu S, Jiang Y, Wu W, Li J, Li K, Guo D. High-resolution vessel wall imaging for quantitatively and qualitatively evaluating in-stent stenosis of intracranial aneurysms. Front Neurol 2024; 15:1381438. [PMID: 38784915 PMCID: PMC11112073 DOI: 10.3389/fneur.2024.1381438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024] Open
Abstract
Background It is critical to accurately and noninvasively evaluate the stented parent artery of intracranial aneurysms (IAs) with endovascular treatment. Objective To investigate high-resolution vessel wall imaging (HR-VWI) for quantitative and qualitative evaluation of in-stent stenosis (ISS) in IAs treated with stent placement (SP). Methods Fifty-five patients (58 aneurysms) underwent HR-VWI, contrast-enhanced (CE)-HR-VWI, CE-MR angiography (MRA), time-of-flight (TOF)-MRA, and digital subtraction angiography (DSA) six months after SP, and the reliability of quantitative stent lumen measurements was evaluated by intraclass correlation coefficient (ICC) analysis. Agreement and correlation of quantitative evaluation were estimated by comparing the four MR imaging modalities with DSA. The diagnostic performance for >0%, ≥25%, and ≥50% of ISS degrees and overall diagnostic accuracy for the ISS degrees of the four MR imaging modalities were calculated to qualitative evaluation. Results The reliability of CE-HR-VWI and HR-VWI for ISS quantitative measurements was excellent (ICC 0.955-0.989). The agreement and correlation of CE-HR-VWI, HR-VWI versus DSA for ISS quantitative measurements were better than those of CE-MRA and TOF-MRA (p < 0.05). The diagnostic performance for distinguishing the degree of ISS >0%, ≥25%, and ≥50% by CE-HR-VWI and HR-VWI was superior to CE-MRA and TOF-MRA, and their overall diagnostic accuracy was 96.55 and 94.83%, respectively. HR-VWI and CE-HR-VWI were not statistically significant in the quantitative and qualitative evaluation of ISS performance (p > 0.05). Conclusion HR-VWI and CE-HR-VWI have similar performance and value in the quantitative and qualitative evaluation of ISS, and HR-VWI without contrast media could be used as an ideal long-term follow-up approach after SP treatment for IAs.
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Affiliation(s)
- Ting Chen
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shushu Liu
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Medical Imaging, People’s Hospital of Fengjie, Chongqing, China
| | - Yongxiang Jiang
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Wu
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiali Li
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kunhua Li
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dajing Guo
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Cai X, Sun J, Jin A, Jing J, Wang S, Mei L, Meng X, Li S, Wei T, Wang Y, Pan Y. Association of insulin resistance with intra- and extra-cranial atherosclerotic burden in the nondiabetic community population. Neurobiol Dis 2023; 186:106268. [PMID: 37625526 DOI: 10.1016/j.nbd.2023.106268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023] Open
Abstract
AIMS Few population-based studies have investigated the association between insulin resistance and atherosclerotic burden in intra- and extra-cranial arteries. The purpose of this study is to explore the relationship between insulin resistance and intra- and extra-cranial atherosclerotic burden in community-based nondiabetic participants. METHODS This is a cross-sectional analysis from a population-based prospective cohort-PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study in China. The homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices (ISI0-120) were stratified by the quartiles, respectively. The atherosclerotic presence of plaques and burden was evaluated by high-resolution MRI. Binary or ordinal logistic regression was performed to assess the association between HOMA-IR or ISI0-120 and the presence and burden of atherosclerosis. RESULTS Among the 2754 participants, the mean age was 60.9 ± 6.6 years, and 1296 (47.1%) were males. Compared with the lowest quartile of HOMR-IR, the highest quartile of HOMA-IR (indicating a higher level of insulin resistance) was associated with an increased presence of plaques (OR:1.54, 95% CI:1.14-2.08), and atherosclerotic burden (OR:1.53, 95%CI:1.14-2.07) in intracranial arteries. Meanwhile, we observed a similar relationship between HOMA-IR and the presence or burden in extracranial atherosclerosis. The first (indicating a higher level of insulin resistance) quartiles of ISI0-120 were associated with the intracranial plaques (Q1, OR:1.56, 95%CI:1.16-2.11) and atherosclerotic burden (Q1, OR:1.57, 95%CI:1.17-2.12), but not extracranial plaques or atherosclerotic burden, compared with the fourth quartile of ISI0-120. CONCLUSIONS Insulin resistance was associated with an increased intra-and extra-cranial atherosclerotic burden in the nondiabetic elderly Chinese population.
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Affiliation(s)
- Xueli Cai
- Department of Neurology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Jingping Sun
- Department of Neurology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Aoming Jin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Suying Wang
- Department of Neurology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China
| | - Lerong Mei
- Department of Neurology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Shan Li
- Department of Neurology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China
| | - Tiemin Wei
- Department of Cardiology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
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Jia Y, Liu X, Zhang L, Kong X, Chen S, Zhang L, Wang J, Shu S, Liu J, Fu X, Liu D, Wang J, Shi H. Integrated head and neck imaging of symptomatic patients with stroke using simultaneous non-contrast cardiovascular magnetic resonance angiography and intraplaque hemorrhage imaging as compared with digital subtraction angiography. J Cardiovasc Magn Reson 2022; 24:19. [PMID: 35307027 PMCID: PMC8935695 DOI: 10.1186/s12968-022-00849-1] [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: 07/06/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Both stenosis rate and intraplaque hemorrhage (IPH) are important predictors of stroke risk. Simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) cardiovascular magnetic resonance (CMR) imaging can detect both stenosis rate and IPH. We aimed to evaluate consistency between SNAP and digital subtraction angiography (DSA) to assess symptomatic patients with stroke and explore the performance of SNAP to identify IPH and the clinical factors associated with IPH. METHODS Eighty-one symptomatic patients with stroke, admitted to Wuhan Union Hospital who underwent CMR high-resolution vessel wall imaging (HR-VWI) and SNAP, were retrospectively identified. For patients who received interventional therapy, the imaging functions of SNAP and HR-VWI were compared with DSA. The diameters of the intracranial and carotid vessels were measured, and stenotic vessels were identified. The consistency of SNAP and HR-VWI in identifying IPH was also examined, and the correlations between IPH and clinical factors were analyzed. RESULTS SNAP was more consistent with DSA than HR-VWI in measuring vascular stenosis (intraclass correlation coefficient [ICC]SNAP-DSA = 0.917, ICC HR-VWI-DSA = 0.878). Regarding the diameter measurements of each intracranial and carotid vessel segment, SNAP was superior or similar to HR-VWI, and both were consistent with DSA in the measurement of major intracranial vascular segments. HR-VWI and SNAP exhibited acceptable agreement in identifying IPH (Kappa = 0.839, 95% confidence interval [CI]: 0.704-0.974). Patients who underwent interventional therapy had a higher plaque burden (P < 0.001). Patients with IPH had lower levels of high-density lipoprotein cholesterol (HDL) (P = 0.038) and higher levels of blood glucose (P = 0.007) and cystatin C (P = 0.040). CONCLUSIONS CMR SNAP is consistent with DSA in measuring vessel diameters and identifying atherosclerosis stenosis in each intracranial and carotid vessel segment. SNAP is also a potential alternative to HR-VWI in identifying stenosis and IPH.
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Affiliation(s)
- Yuxi Jia
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Lan Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xiangchuang Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Shuo Chen
- Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Haidian District, Beijing, China
| | - Lei Zhang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiazheng Wang
- Clinical & Technical Solutions, Philips Healthcare, Beijing, China
| | - Shenglei Shu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jia Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xiaona Fu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Dingxi Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jing Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
| | - Heshui Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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Yang W, Wasserman B, Yang H, Liu L, Orman G, Intrapiromkul J, Trout H, Qiao Y. Characterization of Restenosis following Carotid Endarterectomy Using Contrast-Enhanced Vessel Wall MR Imaging. AJNR Am J Neuroradiol 2022; 43:422-428. [PMID: 35177544 PMCID: PMC8910800 DOI: 10.3174/ajnr.a7423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 12/09/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Restenosis is an important determinant of the long-term efficacy of carotid endarterectomy. Our aim was to assess the role of high-resolution vessel wall MR imaging for characterizing restenosis after carotid endarterectomy. MATERIALS AND METHODS Patients who underwent vessel wall MR imaging after carotid endarterectomy were included in this study. Restenotic lesions were classified as myointimal hyperplasia or recurrent atherosclerotic plaques based on MR imaging features of lesion compositions. Imaging characteristics of myointimal hyperplasia were compared with those of normal post-carotid endarterectomy and recurrent plaque groups. Recurrent plaques were matched with primary plaques by categories of stenosis, and differences in plaque features were compared between the 2 groups. RESULTS Twenty-two recurrent lesions from 18 patients (14 unilateral and 4 bilateral) were classified as myointimal hyperplasia or recurrent plaque. Myointimal hyperplasia showed no difference in enhancement compared with normal post-carotid endarterectomy vessels (5 unilateral) but showed stronger enhancement than recurrent plaques (80.10% [SD, 42.42%] versus 56.74% [SD, 46.54%], P = .042). A multivariate logistic regression model of plaque-feature detection in recurrent plaques compared with primary plaques adjusted for maximum wall thickness revealed that recurrent plaques were longer (OR, 4.27; 95% CI, 1.32-13.85; P = .015) and more likely to involve a flow divider and side walls (OR, 6.96; 95% CI, 1.37-35.28; P = .019). Recurrent plaques had a higher prevalence of intraplaque hemorrhage (61.5% versus 30.8%, P = .048) by a χ2 test, but compositional differences were not significant in the multivariate model. CONCLUSIONS Vessel wall MR imaging can distinguish recurrent plaques from myointimal hyperplasia and reveal features that may differ between primary and recurrent plaques, highlighting its value for evaluating patients with carotid restenosis.
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Affiliation(s)
- W. Yang
- From The Russell H. Morgan Department of Radiology and Radiological Sciences (W.Y., B.A.W., L.L., J.I., Y.Q.), The Johns Hopkins Hospital, Baltimore, Maryland
| | - B.A. Wasserman
- From The Russell H. Morgan Department of Radiology and Radiological Sciences (W.Y., B.A.W., L.L., J.I., Y.Q.), The Johns Hopkins Hospital, Baltimore, Maryland
| | - H. Yang
- Department of Radiology (H.Y.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - L. Liu
- From The Russell H. Morgan Department of Radiology and Radiological Sciences (W.Y., B.A.W., L.L., J.I., Y.Q.), The Johns Hopkins Hospital, Baltimore, Maryland
| | - G. Orman
- Department of Radiology (G.O.), Texas Children's Hospital, Houston, Texas
| | - J. Intrapiromkul
- From The Russell H. Morgan Department of Radiology and Radiological Sciences (W.Y., B.A.W., L.L., J.I., Y.Q.), The Johns Hopkins Hospital, Baltimore, Maryland
| | - H.H. Trout
- Department of Surgery (H.H.T.), Suburban Hospital, Bethesda, Maryland
| | - Y. Qiao
- From The Russell H. Morgan Department of Radiology and Radiological Sciences (W.Y., B.A.W., L.L., J.I., Y.Q.), The Johns Hopkins Hospital, Baltimore, Maryland
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Wang J, Zhang S, Lu J, Qi P, Hu S, Yang X, Chen K, Wang D. High-Resolution MR for Follow-Up of Intracranial Steno-Occlusive Disease Treated by Endovascular Treatment. Front Neurol 2022; 12:706645. [PMID: 35002907 PMCID: PMC8740140 DOI: 10.3389/fneur.2021.706645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Purpose: An endovascular recanalization is an alternative option for symptomatic intracranial atherosclerotic steno-occlusive disease (ICAD). Accurate non-invasive alternatives to digital subtraction angiography (DSA) for follow-up imaging after endovascular treatment are desirable. We aimed to evaluate the image quality and diagnostic performance of high-resolution magnetic imaging in follow-up using DSA as a reference. Materials and Methods: From January 2017 to June 2021, data from 35 patients with 40 intracranial steno-occlusive lesions who underwent endovascular recanalization and received high-resolution magnetic resonance (HR-MR) follow-up were retrospectively collected in our prospective database. Studies were evaluated for the quality of visualization of the vessel lumen, restenosis rate, and accuracy of high-resolution magnetic resonance (HR-MR) with DSA used as the reference standard. Intraclass correlation coefficient (ICC) analyses were performed to assess the agreement between the two different readers. Results: In total, 40 intracranial steno-occlusive lesions in 35 patients, with 34 lesions undergoing balloon angioplasty [including 16 drug-coated balloons (DCBs)] and 8 lesions undergoing stenting were enrolled. The median age was 63.6 years (IQR 58.5-70.0 years), and the mean imaging follow-up time was 9.5 months (IQR 4.8-12.5 months). The median degrees of preprocedural and residual stenosis were 85.0% (IQR 75.0-99.0%) and 32.8% (IQR 15.0-50.0%), respectively. Intracranial periprocedural complications occurred in 1 (3.6%) patient. In the case of a stainless-steel stent (n = 1), there was a signal drop at the level of the vessel, which did not allow evaluation of the vessel lumen. However, this was visible in the case of nitinol stents (n = 7) and angioplasty (n = 34). The overall restenosis rate was 25.8% (n = 9). The DCB subgroup showed a lower rate of restenosis than the percutaneous transluminal angioplasty (PTA) subgroup [5.3% (2/13) vs. 35.7% (5/14)]. Conclusion: High-resolution magnetic resonance may be a reliable non-invasive method for demonstrating the vessel lumen and diagnostic follow-up after endovascular recanalization for ICAD. Compared with MR angiography (MRA), HR-MR showed a higher inter-reader agreement and could provide more information after endovascular recanalization, such as enhancement of the vessel wall.
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Affiliation(s)
- Junjie Wang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Shun Zhang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Jun Lu
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Peng Qi
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Shen Hu
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ximeng Yang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Kunpeng Chen
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Daming Wang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Wan M, Yan L, Xu Z, Hou Z, Kang K, Cui R, Yu Y, Song J, Hui F, Wang Y, Miao Z, Lou X, Ma N. Symptomatic and Asymptomatic Chronic Carotid Artery Occlusion on High-Resolution MR Vessel Wall Imaging. AJNR Am J Neuroradiol 2022; 43:110-116. [PMID: 34857516 PMCID: PMC8757554 DOI: 10.3174/ajnr.a7365] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/28/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Chronic carotid artery occlusion remains a poorly understood risk factor for subsequent stroke, and potential revascularization is dependent on understanding the anatomy and nature of the occlusion. Luminal imaging cannot assess the nature of an occlusion, so the internal structure of the occlusion must be inferred. The present study examines the signal characteristics of symptomatic and asymptomatic carotid occlusion that may point to management differentiation. MATERIALS AND METHODS We prospectively recruited patients who were diagnosed with chronic carotid artery occlusion defined as longer than 4 weeks and confirmed by DSA. All patients underwent high-resolution MR vessel wall imaging examinations after enrollment. Baseline characteristics, vessel wall imaging features, and DSA features were collected and evaluated. The vessel wall imaging features included segment involvement, signal intensity, contrast enhancement, and vessel wall thickness. The symptomatic and asymptomatic chronic carotid artery occlusions were compared. RESULTS A total of 44 patients with 48 lesions were included in this study from February 2020 to December 2020. Of the 48 lesions, 35 (72.9%) were symptomatic and 13 (27.1%) were asymptomatic. There was no difference in baseline and DSA features. On vessel wall imaging, C1 and C2 were the most commonly involved segments (91.7% and 68.8%, respectively). Compared with symptomatic lesions, asymptomatic lesions were more often isointense (69.2%) in the distal segment (P = .03). Both groups had diffuse wall thickening (80% and 100%). CONCLUSIONS Signal characteristics between those with symptomatic and asymptomatic carotid artery occlusions differ in a statistically significant fashion, indicating a different structure of the occlusion.
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Affiliation(s)
- M. Wan
- From the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.),China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China,Department of Neurology (M.W.), Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, China
| | - L. Yan
- From the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.),China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
| | - Z. Xu
- Department of Neurology (Z.X.), The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China
| | - Z. Hou
- From the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.),China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
| | - K. Kang
- Neurology (K.K., Y.W.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China,China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
| | - R. Cui
- From the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.),China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
| | - Y. Yu
- From the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.),China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
| | - J. Song
- From the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.),China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
| | - F.K. Hui
- Department of Radiology and Radiological Sciences (F.K.H.), Johns Hopkins Hospital, Baltimore, Maryland
| | - Y. Wang
- Neurology (K.K., Y.W.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China,China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
| | - Z. Miao
- From the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.),China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
| | - X. Lou
- Department of Radiology (X.L.), Chinese PLA General Hospital, Beijing, China
| | - N. Ma
- From the Department of Interventional Neuroradiology (M.W., L.Y., Z.H., R.C., Y.Y., J.S., Z.M., N.M.),China National Clinical Research Center for Neurological Diseases (M.W., L.Y., Z.H., K.K., R.C., Y.Y., J.S., Y.W., Z.M., N.M.), Beijing, China
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Cao X, Tang Y, Pan L, Yang J, Wu Y, Geng D, Zhang J. Assessment of carotid atherosclerotic plaque using 3D motion-sensitized driven-equilibrium prepared rapid gradient echo: a comparative study. Quant Imaging Med Surg 2021; 11:2744-2755. [PMID: 34079738 DOI: 10.21037/qims-20-869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background 3D motion-sensitized driven-equilibrium prepared rapid gradient echo (MERGE) can characterize carotid atherosclerotic plaque morphology and composition. The present study aimed to evaluate its performance by comparing it with reference images and assessing the inter-reader agreement. Methods Eighty-four patients were prospectively recruited and scanned with 3D MERGE. Two trained magnetic resonance imaging (MRI) readers measured and calculated the maximum wall thickness (WT), maximum vessel diameter, total vessel area, lumen area, wall area, normalized wall index, plaque volume, intraplaque hemorrhage (IPH) volume, and calcification volume independently. IPH, calcification, mixed calcification, and ulceration were identified. The intraclass correlation coefficient (ICC) with 95% confidence interval (CI) was used to assess the inter-reader agreement. MERGE performance was assessed in terms of sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, kappa value (κ), and the results of the Bland-Altman analysis and compared with reference images. Results MERGE showed excellent inter-reader agreement (All ICCs >0.90). MERGE and simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) showed excellent agreement in detecting IPH (κ=0.938) and measuring IPH volume (ICC =0.995; 95% CI: 0.991-0.997). MERGE and computed tomography angiography (CTA) showed strong consistency in detecting calcification (κ=0.814) and mixed calcification (κ=0.972), and in measuring calcification volume (ICC =0.996; 95% CI: 0.993-0.997). MERGE and digital subtraction angiography (DSA) showed relatively strong consistency in identifying ulceration (κ=0.737). Conclusions MERGE showed excellent performance in identifying and measuring IPH and calcification in carotid atherosclerotic plaques. Therefore, MERGE can be a promising imaging approach in atherosclerotic-vulnerable plaque.
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Affiliation(s)
- Xin Cao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Ye Tang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Pan
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jinming Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yifan Wu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Jun Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
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8
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Abstract
Magnetic resonance (MR) imaging is a crucial tool for evaluation of the skull base, enabling characterization of complex anatomy by utilizing multiple image contrasts. Recent technical MR advances have greatly enhanced radiologists' capability to diagnose skull base pathology and help direct management. In this paper, we will summarize cutting-edge clinical and emerging research MR techniques for the skull base, including high-resolution, phase-contrast, diffusion, perfusion, vascular, zero echo-time, elastography, spectroscopy, chemical exchange saturation transfer, PET/MR, ultra-high-field, and 3D visualization. For each imaging technique, we provide a high-level summary of underlying technical principles accompanied by relevant literature review and clinical imaging examples.
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Affiliation(s)
- Claudia F Kirsch
- Division Chief, Neuroradiology, Professor of Neuroradiology and Otolaryngology, Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, Manhasset, NY
| | - Mai-Lan Ho
- Associate Professor of Radiology, Director of Research, Department of Radiology, Director, Advanced Neuroimaging Core, Chair, Asian Pacific American Network, Secretary, Association for Staff and Faculty Women, Nationwide Children's Hospital and The Ohio State University, Columbus, OH; Division Chief, Neuroradiology, Professor of Neuroradiology and Otolaryngology, Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, Manhasset, NY.
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9
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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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