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Fan Q, Tan Z, Su W, Li Q, Jin D, Du Y, Zhang L, Wu S. Efficacy, safety and mechanism of Simiaoyongan decoction in the treatment of carotid atherosclerotic plaque: a randomized, double-blind, placebo-controlled clinical trial protocol. BMC Complement Med Ther 2024; 24:277. [PMID: 39039498 PMCID: PMC11265120 DOI: 10.1186/s12906-024-04555-6] [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: 06/25/2023] [Accepted: 06/17/2024] [Indexed: 07/24/2024] Open
Abstract
INTRODUCTION Chronic inflammation is the major pathological feature of Atherosclerosis(As). Inflammation may accelerate plaque to develop, which is a key factor resulting in the thinning of the fibrous cap and the vulnerable rupture of plaque. Presently, clinical treatments are still lacking. It is necessary to find a safe and effective treatment for As inflammation. Simiaoyongan Decoction (SMYA) has potential anti-inflammatory and plaque protection effects. This protocol aims to evaluate the efficacy, safety, and mechanism of SMYA for patients with carotid atherosclerotic plaque. METHODS/DESIGN The assessment of SMYA clinical trial is designed as a randomized, double-blind, placebo-controlled study. The sample size is 86 cases in total, with 43 participants in the intervention group and the control group respectively. The intervention group takes SMYA, while the control group takes SMYA placebo. The medication lasts for 14 days every 10 weeks, with a total of 50 weeks. We will use carotid artery high resolution magnetic resonance imaging (HR-MRI) to measure plaque. The plaque minimum fiber cap thickness (PMFCT) is adopted as the primary outcome. The secondary outcomes include plaque fiber cap volume, volume percentage of fiber cap, lipid-rich necrotic core (LRNC) volume, volume percentage of LRNC, internal bleeding volume of plaque, internal bleeding volume percentage of plaque, plaque calcification volume, volume percentage of plaque calcification, lumen stenosis rate, average and a maximum of vessel wall thickness, vessel wall volume, total vessel wall load, carotid atherosclerosis score, hs-CRP, IL-1β and IL-6, the level of lipid profiles and blood glucose, blood pressure, and body weight. DISCUSSION We anticipate that patients with As plaque will be improved from SMYA by inhibiting inflammation to enhance plaque stability. This study analyzes plaque by using HR-MRI to evaluate the clinical efficacy and safety of SMYA. Moreover, we conduct transcriptome analysis, proteomic analysis, and metagenomic analysis of blood and stool of participants to study the mechanism of SMYA against As plaque. This is the first prospective TCM trial to observe and treat As plaque by inhibiting inflammatory reaction directly. If successful, the finding will be valuable in the treatment of As plaque and drug development, especially in the "statin era". TRIAL REGISTRATION NUMBER This trial is registered on Chinese Clinical Trials.gov with number ChiCTR2000039062 on October 15, 2020 ( http://www.chictr.org.cn ).
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Affiliation(s)
- QinHua Fan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - ZhongJian Tan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - WenQuan Su
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - QingXiao Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dian Jin
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - YaWei Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - LiPing Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - ShengXian Wu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
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Marks K, Ahn SJ, Rai N, Anfray A, Iadecola C, Anrather J. A minimally invasive thrombotic stroke model to study circadian rhythm in awake mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.10.598243. [PMID: 38915621 PMCID: PMC11195071 DOI: 10.1101/2024.06.10.598243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Experimental stroke models in rodents are essential for mechanistic studies and therapeutic development. However, these models have several limitations negatively impacting their translational relevance. Here we aimed to develop a minimally invasive thrombotic stroke model through magnetic particle delivery that does not require craniotomy, is amenable to reperfusion therapy, can be combined with in vivo imaging modalities, and can be performed in awake mice. We found that the model results in reproducible cortical infarcts within the middle cerebral artery (MCA) with cytologic and immune changes similar to that observed with more invasive distal MCA occlusion models. Importantly, the injury produced by the model was ameliorated by tissue plasminogen activator (tPA) administration. We also show that MCA occlusion in awake animals results in bigger ischemic lesions independent of day/night cycle. Magnetic particle delivery had no overt effects on physiologic parameters and systemic immune biomarkers. In conclusion, we developed a novel stroke model in mice that fulfills many requirements for modeling human stroke.
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Shen M, Gao P, Chen S, Zhao X, Li R, Du W, Yuan C, Hatsukami T, Sui B. Differences in distribution and features of carotid and middle cerebral artery plaque in patients with pial infarction and perforating artery infarction: A 3D vessel wall imaging study. Eur J Radiol 2023; 167:111045. [PMID: 37586303 DOI: 10.1016/j.ejrad.2023.111045] [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: 03/20/2023] [Revised: 05/31/2023] [Accepted: 08/12/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE Atherosclerotic plaques of carotid artery (CA) and middle cerebral artery (MCA) are important causes of acute ischemic stroke (AIS). This study was designed to jointly assess the plaque distribution and features of CA and MCA in AIS patients with pial infarction (PI) and perforating artery infarction (PAI), and to investigate the associations between plaque characteristics and ischemic infarction patterns. METHODS Imaging data of sixty-five patients from a cross-sectional study were reviewed. All the patients had acute infarction in the MCA territory on diffusion weighted imaging (DWI) and underwent CA and MCA vessel wall imaging (VWI). The CA and MCA plaque presence and high-risk features on the ipsilateral side of infarction were analyzed. The brain infarction lesions were divided into PI group vs. non-PI group, and PAI group vs. non-PAI group. Different plaque distribution types and plaque features were compared in each two groups, and their associations were investigated using binary logistic regression. RESULTS Sixty-five patients (mean age, 54.6 ± 10.1 years; 61 men) were included. The CA high-risk plaque (OR: 5.683 [1.409-22.929], P = 0.015) and MCA plaque presence (OR: 3.949 [1.397-11.162], P = 0.010) were significantly associated with PI. MCA plaques that involved the orifice of the perforating arteries were significantly associated with PAI (OR: 15.167 [1.851-124.257], P = 0.011). CONCLUSION CA and MCA plaques show distinct distribution and high-risk features in patients with PI and PAI. Combined intracranial and extracranial arteries imaging should be considered for the evaluation of the symptomatic ischemic patients.
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Affiliation(s)
- Mi Shen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peiyi Gao
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Neurosurgical Institute, Beijing, China.
| | - Shuo Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Rui Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Wanliang Du
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 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, WA, USA
| | - Thomas Hatsukami
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Binbin Sui
- Beijing Neurosurgical Institute, Beijing, China; Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.
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Fernández-Serra R, Martínez-Alonso E, Alcázar A, Chioua M, Marco-Contelles J, Martínez-Murillo R, Ramos M, Guinea GV, González-Nieto D. Postischemic Neuroprotection of Aminoethoxydiphenyl Borate Associates Shortening of Peri-Infarct Depolarizations. Int J Mol Sci 2022; 23:ijms23137449. [PMID: 35806455 PMCID: PMC9266990 DOI: 10.3390/ijms23137449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/29/2022] [Accepted: 07/03/2022] [Indexed: 11/28/2022] Open
Abstract
Brain stroke is a highly prevalent pathology and a main cause of disability among older adults. If not promptly treated with recanalization therapies, primary and secondary mechanisms of injury contribute to an increase in the lesion, enhancing neurological deficits. Targeting excitotoxicity and oxidative stress are very promising approaches, but only a few compounds have reached the clinic with relatively good positive outcomes. The exploration of novel targets might overcome the lack of clinical translation of previous efficient preclinical neuroprotective treatments. In this study, we examined the neuroprotective properties of 2-aminoethoxydiphenyl borate (2-APB), a molecule that interferes with intracellular calcium dynamics by the antagonization of several channels and receptors. In a permanent model of cerebral ischemia, we showed that 2-APB reduces the extent of the damage and preserves the functionality of the cortical territory, as evaluated by somatosensory evoked potentials (SSEPs). While in this permanent ischemia model, the neuroprotective effect exerted by the antioxidant scavenger cholesteronitrone F2 was associated with a reduction in reactive oxygen species (ROS) and better neuronal survival in the penumbra, 2-APB did not modify the inflammatory response or decrease the content of ROS and was mostly associated with a shortening of peri-infarct depolarizations, which translated into better cerebral blood perfusion in the penumbra. Our study highlights the potential of 2-APB to target spreading depolarization events and their associated inverse hemodynamic changes, which mainly contribute to extension of the area of lesion in cerebrovascular pathologies.
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Affiliation(s)
- Rocío Fernández-Serra
- Center for Biomedical Technology, Universidad Politécnica de Madrid, 28223 Madrid, Spain; (R.F.-S.); (M.R.); (G.V.G.)
- Departamento de Tecnología Fotónica y Bioingeniería, ETSI Telecomunicaciones, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Departamento de Ciencia de Materiales, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Silk Biomed SL, 28260 Madrid, Spain
| | - Emma Martínez-Alonso
- Department of Research, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (E.M.-A.); (A.A.)
| | - Alberto Alcázar
- Department of Research, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (E.M.-A.); (A.A.)
| | - Mourad Chioua
- Laboratory of Medicinal Chemistry, Institute of General Organic Chemistry (CSIC), 28006 Madrid, Spain; (M.C.); (J.M.-C.)
| | - José Marco-Contelles
- Laboratory of Medicinal Chemistry, Institute of General Organic Chemistry (CSIC), 28006 Madrid, Spain; (M.C.); (J.M.-C.)
| | | | - Milagros Ramos
- Center for Biomedical Technology, Universidad Politécnica de Madrid, 28223 Madrid, Spain; (R.F.-S.); (M.R.); (G.V.G.)
- Departamento de Tecnología Fotónica y Bioingeniería, ETSI Telecomunicaciones, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - Gustavo V. Guinea
- Center for Biomedical Technology, Universidad Politécnica de Madrid, 28223 Madrid, Spain; (R.F.-S.); (M.R.); (G.V.G.)
- Departamento de Ciencia de Materiales, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Silk Biomed SL, 28260 Madrid, Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
- Biomaterials and Regenerative Medicine Group, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Daniel González-Nieto
- Center for Biomedical Technology, Universidad Politécnica de Madrid, 28223 Madrid, Spain; (R.F.-S.); (M.R.); (G.V.G.)
- Departamento de Tecnología Fotónica y Bioingeniería, ETSI Telecomunicaciones, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Silk Biomed SL, 28260 Madrid, Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-910679280
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Truong M, Håkansson C, HaileMichael M, Svensson J, Lätt J, Markenroth Bloch K, Siemund R, Gonçalves I, Wassélius J. The potential role of T2*-weighted multi-echo data image combination as an imaging marker for intraplaque hemorrhage in carotid plaque imaging. BMC Med Imaging 2021; 21:121. [PMID: 34380454 PMCID: PMC8356411 DOI: 10.1186/s12880-021-00652-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/14/2021] [Indexed: 01/14/2023] Open
Abstract
Background Carotid atherosclerotic plaques with intraplaque hemorrhage (IPH) are associated with elevated stroke risk. IPH is predominantly imaged based on paramagnetic properties of the upstream hemoglobin degradation product methemoglobin. This is an explorative observational study to test the feasibility of a spoiled gradient echo based T2* weighted MRI sequence (3D MEDIC) for carotid plaque imaging, and to compare signs suggestive of the downstream degradation product hemosiderin on 3D MEDIC with signs of methemoglobin on a T1wBB sequence.
Methods Patients with recent TIA or stroke were selected based on the presence on non-calcified plaque components on CTA to promote an enriched prevalence of IPH in the material. Patients (n = 42) underwent 3T MRI with 3D MEDIC and 2D turbo spin echo T1w black blood (T1wBB). Images were independently evaluated by two neuroradiologists and Cohens Kappa was used for inter-reader agreement for each sequence. Results The technical feasibility for 3D MEDIC, was 34/42 patients (81%). Non-calcified plaque components with susceptibility effect without simultaneous T1-shortening—a combination suggestive of hemosiderin, was seen in 13/34 of the plaques. An equally large group display elevated T1w signal in combination with signal loss on 3D MEDIC, a combination suggestive of both hemosiderin and methemoglobin. Cohen’s kappa for inter-reader agreement was 0.64 (CI 0.345–0.925) for 3D MEDIC and 0.94 (CI 0.81–1.00) for T1wBB. Conclusions 3D MEDIC shows signal loss, without elevated T1w signal on T1wBB, in non-calcified tissue in many plaques in this group of patients. If further studies, including histological verification, confirm that the 3D MEDIC susceptibility effect is indeed caused by hemosiderin, 3D MEDIC could aid in the detection of IPH, beyond elevation of T1w signal.
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Affiliation(s)
- My Truong
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Claes Håkansson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Makda HaileMichael
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Jonas Svensson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Medical Radiation Physics, Department of Translational Medicine, Lund University , Lund, Sweden
| | - Jimmy Lätt
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | | | - Roger Siemund
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Isabel Gonçalves
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö , Sweden
| | - Johan Wassélius
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden. .,Department of Clinical Sciences, Lund University, Lund, Sweden. .,Department of Radiology, Skåne University Hospital, 221 85, Lund, Sweden.
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Sun Y, Xu L, Jiang Y, Ma M, Wang XY, Xing Y. Significance of high resolution MRI in the identification of carotid plaque. Exp Ther Med 2020; 20:3653-3660. [PMID: 32855717 PMCID: PMC7444342 DOI: 10.3892/etm.2020.9091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/01/2020] [Indexed: 11/25/2022] Open
Abstract
The stability of carotid artery plaque serves a key role in the occurrence of stroke. The present study was based on the recruitment of patients with acute ischemic cerebrovascular disease. High-resolution magnetic resonance imaging (HR-MRI) was used to identify the nature of carotid artery plaque, and the results were then used to manage the high-risk group of stroke. The patients were divided equally into a symptomatic group (36 cases) and an asymptomatic group (36 cases). According to the degree of carotid artery stenosis, the patients were divided into mild, moderate and severe stenosis groups, each group comprising 12 patients, and HR-MRI was performed. The proportion of patients with vulnerable plaque in the symptomatic group was higher compared with that in the asymptomatic group (P<0.05). The more severe the stenosis, the higher the proportion of vulnerable plaque that was identified (P<0.05). Compared with carotid ultrasound, HR-MRI was indicated to have the capability to both identify and quantify the different components in the plaque, allowing an assessment of its properties. In conclusion, the present study demonstrated that carotid HR-MRI is able to distinguish and quantify the different components of plaque, which may prove to be helpful for the hierarchical management of a population at high risk of stroke.
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Affiliation(s)
- Yong Sun
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Lei Xu
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Yan Jiang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Ming Ma
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Xin-Yi Wang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Ying Xing
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
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Wu J, Xin J, Yang X, Sun J, Xu D, Zheng N, Yuan C. Deep morphology aided diagnosis network for segmentation of carotid artery vessel wall and diagnosis of carotid atherosclerosis on black-blood vessel wall MRI. Med Phys 2019; 46:5544-5561. [PMID: 31356693 DOI: 10.1002/mp.13739] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/14/2019] [Accepted: 07/11/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Early detection of carotid atherosclerosis on the vessel wall (VW) magnetic resonance imaging (MRI) (VW-MRI) images can prevent the progression of cardiovascular disease. However, the manual inspection process of the VW-MRI images is cumbersome and has low reproducibility. Therefore in this paper, by using the convolutional neural networks (CNNs), we develop a deep morphology aided diagnosis (DeepMAD) network for automated segmentation of the VW of carotid artery and for automated diagnosis of the carotid atherosclerosis with the black-blood (BB) VW-MRI (i.e., the T1-weighted MRI) in a slice-by-slice manner. METHODS The proposed DeepMAD network consists of a segmentation subnetwork and a diagnosis subnetwork for performing the segmentation and diagnosis tasks on the BB-VW-MRI images, where the manual labeled lumen area, the manual labeled outer wall area and the manual labeled lesion Types based on the modified American Heart Association (AHA) criteria are used as the ground-truth. Specifically, a deep U-shape CNN with a weighted fusion layer is designed as the segmentation subnetwork, where the lumen area and the outer wall area can be simultaneously segmented under the supervision of the triple Dice loss to provide the vessel wall map as morphological information. Then, the image stream from the BB-VWMRI image and the morphology stream from the obtained vessel wall map are extracted from two deep CNNs and combined to obtain the diagnosis results of atherosclerosis in the diagnosis subnetwork. In addition, the triple input set is formed by three carotid regions of interest (ROIs) from three consecutive slices of the MRI sequence and input to the DeepMAD network, where the first and last slices used as additional adjacent slices to provide 2.5D spatial information along the carotid artery centerline for the intermediate slice, which is the target slice for segmentation and diagnosis in the study. RESULTS Compared to other existing methods, the DeepMAD network can achieve promising segmentation performances (0.9594 Dice for the lumen and 0.9657 Dice for the outer wall) and better diagnosis Accuracy of the carotid atherosclerosis (0.9503 AUC and 0.8916 Accuracy) in the test dataset (including invisible subjects) from same source as the training dataset. In addition, the trained DeepMAD model can be successfully transferred to another test dataset for segmentation and diagnosis tasks with remarkable performance (0.9475 Dice for the lumen and 0.9542 Dice for the outer wall, 0. 9227 AUC and 0.8679 Accuracy for diagnosis). CONCLUSIONS Even without the intervention of reviewers required for previous works, the proposed DeepMAD network automatically segments the lumen and the outer wall together and diagnoses the carotid atherosclerosis with high performances. The DeepMAD network can be used in clinical trials to help radiologists get rid of tedious reading tasks, such as screening review to separate the normal carotid from the atherosclerotic arteries and outlining the vessel wall contours.
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Affiliation(s)
- Jiayi Wu
- Institute of Artificial Intelligence and Robotics, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Jingmin Xin
- Institute of Artificial Intelligence and Robotics, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| | - Jie Sun
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Dongxiang Xu
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Nanning Zheng
- Institute of Artificial Intelligence and Robotics, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA, USA
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Yuan J, Patterson AJ, Ruetten PPR, Reid SA, Gillard JH, Graves MJ. A Comparison of Black-blood T 2 Mapping Sequences for Carotid Vessel Wall Imaging at 3T: An Assessment of Accuracy and Repeatability. Magn Reson Med Sci 2018. [PMID: 29515084 PMCID: PMC6326764 DOI: 10.2463/mrms.mp.2017-0141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Purpose: This study is to compare the accuracy of four different black-blood T2 mapping sequences in carotid vessel wall. Methods: Four different black-blood T2 mapping sequences were developed and tested through phantom experiments and 17 healthy volunteers. The four sequences were: 1) double inversion-recovery (DIR) prepared 2D multi-echo spin-echo (MESE); 2) DIR-prepared 2D multi-echo fast spin-echo (MEFSE); 3) improved motion-sensitized driven-equilibrium (iMSDE) prepared 3D FSE and 4) iMSDE prepared 3D fast spoiled gradient echo (FSPGR). The concordance correlation coefficient and Bland–Altman statistics were used to compare the sequences with a gold-standard 2D MESE, without blood suppression in phantom studies. The volunteers were scanned twice to test the repeatability. Mean and standard deviation of vessel wall T2, signal-to-noise (SNR), the coefficient of variance and interclass coefficient (ICC) of the two scans were compared. Results: The phantom study demonstrated that T2 measurements had high concordance with respect to the gold-standard (all r values >0.9). In the volunteer study, the DIR 2D MEFSE had significantly higher T2 values than the other three sequences (P < 0.01). There was no difference in T2 measurements obtained using the other three sequences (P > 0.05). iMSDE 3D FSE had the highest SNR (P < 0.05) compared with the other three sequences. The 2D DIR MESE has the highest repeatability (ICC: 0.96, [95% CI: 0.88–0.99]). Conclusion: Although accurate T2 measurements can be achieved in phantom by the four sequences, in vivo vessel wall T2 quantification shows significant differences. The in vivo images can be influenced by multiple factors including black-blood preparation and acquisition method. Therefore, a careful choice of acquisition methods and analysis of the confounding factors are required for accurate in vivo carotid vessel wall T2 measurements. From the settings in this study, the iMSDE prepared 3D FSE is preferred for the future volunteer/patient scans.
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Affiliation(s)
- Jianmin Yuan
- Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital
| | - Andrew J Patterson
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust
| | - Pascal P R Ruetten
- Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital
| | | | - Jonathan H Gillard
- Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Level 5, Box 218, Addenbrooke's Hospital.,Department of Radiology, Cambridge University Hospitals NHS Foundation Trust
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Xu X, Geng H, Zhang Q, Yu J, Chu Y, Dong G, Wu J. Investigation of 3D reduced field of view carotid atherosclerotic plaque imaging. Magn Reson Imaging 2017; 49:10-15. [PMID: 28958875 DOI: 10.1016/j.mri.2017.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/19/2017] [Accepted: 09/23/2017] [Indexed: 11/25/2022]
Abstract
To investigate the feasibility of using CUBE based reduced field of view imaging in atherosclerotic plaque imaging. Twenty-four patients were enrolled in this prospective study (13 males, 11 females, age 63±10). All patients underwent MRI exams consisting of 3D TOF, MPRAGE, iMSDE, DANTE, full FOV and reduced FOV CUBE imaging; 18 patients under went contrast enhanced imaging. The resulting images from different imaging sequences were assessed in terms of blood suppression, SNR, motion artifacts and vascular clarity. Reduced field of view CUBE outperformed MPRAGE, iMSDE and full FOV CUBE in blood suppression (P<0.05); outperformed MPRAGE, iMSDE and DANTE in SNR(P<005); outperformed MPRAGE and iMSDE in motion artifacts (P<005); outperformed MPRAGE and iMSDE in vascular clarity (P<0.05). The identifications of hemorrhage and calcification components were consistent between full FOV CUBE and reduced FOV CUBE (P<0.05). Overall, CUBE combined with reduced field of view imaging would be a promising method in atherosclerotic plaque imaging.
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Affiliation(s)
- Xueyan Xu
- Weifang People's Hospital, Weifang, Shandong, China
| | - Hai Geng
- Weifang People's Hospital, Weifang, Shandong, China
| | - Qiang Zhang
- Weifang People's Hospital, Weifang, Shandong, China
| | - Jianmin Yu
- Weifang People's Hospital, Weifang, Shandong, China
| | - Yujing Chu
- Weifang People's Hospital, Weifang, Shandong, China
| | - Guang Dong
- Weifang People's Hospital, Weifang, Shandong, China
| | - Jun Wu
- Weifang People's Hospital, Weifang, Shandong, China.
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Xia J, Yin A, Li Z, Liu X, Peng X, Xie N. Quantitative Analysis of Lipid-Rich Necrotic Core in Carotid Atherosclerotic Plaques by In Vivo Magnetic Resonance Imaging and Clinical Outcomes. Med Sci Monit 2017; 23:2745-2750. [PMID: 28584227 PMCID: PMC5470833 DOI: 10.12659/msm.901864] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to explore the accuracy of in vivo magnetic resonance imaging (MRI) in the quantitative evaluation of lipid-rich necrotic core (LRNC) in carotid atherosclerotic plaques compared with histopathology, and to assess the association of LRNC size with cerebral ischemia symptoms. Material/Methods Thirty patients were enrolled and 19 patients (16 men and 3 women) were analyzed. All the patients were submitted to MRI on a Siemens Avanto (1.5-Tesla) device before carotid endarterectomy (CEA). The scanning protocol included three-dimensional time of flight (3D TOF), T1-weighted image (T1WI), T2-weighted image (T2WI), turbo spin-echo T2-weighted (T2-TSE), and contrast-enhanced T1-weighted image. MRI images were reviewed for quantitative measurements of LRNC areas. LRNC specimens were collected for histology. Percentages of LRNC area to total vessel area were assessed to determine the association of MRI with histological findings. Results There were 151 pairs of matched MRI and pathological sections. LRNC area percentages (LRNC area/vessel area) measured by MRI and histology were 20.6±9.0% and 18.7±9.5%, respectively (r=0.69, p<0.001). Twelve out of 19 patients had symptoms (S-group; 3 had recent stroke, 3 had a recent stroke and a history of transient ischemic attack (TIA), and 6 had TIA); the remaining 7 subjects showed no symptoms (NS-group). LRNC area percentages in the S- and NS-groups were 22.2±5.8% and 12.6±10.7%, respectively (p<0.05). Conclusions MRI can quantitatively measure LRNC in carotid atherosclerotic plaques, and may be useful in predicting the rupture risk of plaques. These findings provide a basis for imaging use in individualized treatment plan.
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Affiliation(s)
- Jun Xia
- Department of Radiology, Shenzhen No.2 People's Hospital (the First Affiliated Hospital of Shenzhen University), Shenzhen, Guangdong, China (mainland)
| | - Anyu Yin
- Department of Radiology, Shenzhen No.2 People's Hospital (the First Affiliated Hospital of Shenzhen University), Shenzhen, Guangdong, China (mainland)
| | - Zhenzhou Li
- Department of Ultrasound, Shenzhen No. 2 People's Hospital (the First Affiliated Hospital of Shenzhen University), Shenzhen, Guangdong, China (mainland)
| | - Xin Liu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China (mainland)
| | - Xianghong Peng
- Core Laboratory, Shenzhen No. 2 People's Hospital (the First Affiliated Hospital of Shenzhen University), Shenzhen, Guangdong, China (mainland)
| | - Ni Xie
- Core Laboratory, Shenzhen No. 2 People's Hospital (the First Affiliated Hospital of Shenzhen University), Shenzhen, Guangdong, China (mainland)
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11
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Three-dimensional black-blood T 2 mapping with compressed sensing and data-driven parallel imaging in the carotid artery. Magn Reson Imaging 2017; 37:62-69. [DOI: 10.1016/j.mri.2016.11.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 11/18/2016] [Accepted: 11/20/2016] [Indexed: 11/22/2022]
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12
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崔 园, 陈 潇, 马 露, 卢 明, 姚 国, 杨 家, 赵 锡, 蔡 剑. [Magnetic resonance imaging characteristics of unilateral versus bilateral intraplaque hemorrhage in patients with carotid atherosclerotic plaques]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2016; 37:517-521. [PMID: 28446406 PMCID: PMC6744101 DOI: 10.3969/j.issn.1673-4254.2017.04.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the difference in the vulnerability of carotid atherosclerotic plaques in patients with unilateral and bilateral intraplaque hemorrhage (IPH). METHODS A retrospective analysis was conducted among 44 patients with unilateral IPH (30 cases) or bilateral IPH (14 cases) in the carotid plaques detected by magnetic resonance imaging (MRI) in our hospital between December, 2009 and December, 2012. The age, maximum wall thickness and incidence of fibrous cap rupture were compared between the two groups. RESULTS Compared with those with unilateral IPH, the patients with bilateral IPHs had a significantly younger age (66.6∓9.4 years vs 73.7∓9.0 years, P=0.027), a significantly greater maximum plaque thickness (6.3∓1.9 mm vs 5.0∓1.3 mm, P=0.035) and a higher incidence of ulcers (50% vs 13.3%, P=0.025). Logistic regression analysis revealed a significant association between bilateral IPHs and the occurrence of ulcer with an odd ratio (OR) of 6.5 (95% confidence interval [CI]: 1.5-28.7, P=0.014). After adjustment for gender in Model 1, bilateral IPHs were still significantly associated with presence of ulcer (OR=5.7, 95%CI: 1.1-29.2, P=0.036). But after adjustment for age (P=0.131) or maximum plaque thickness (P=0.139) in model 2, no significant correlation was found between bilateral IPHs and the presence of ulcer. CONCLUSION Compared with patients with unilateral IPH, those with bilateral IPHs are at a younger age and have a greater plaque burden and a higher incidence of fibrous cap rupture, suggesting a greater vulnerability of the carotid plaques in patients with bilateral IPHs.
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Affiliation(s)
- 园园 崔
- 中国人民解放军总医院放射科,北京 100853Department of Radiology, General Hospital of PLA, Beijing 100853, China
| | - 潇祎 陈
- 清华大学生物医学影像研究中心,北京 100084Center for Biomedical Imaging Research, Tsinghua University, Beijing 100084, China
- 首都医科大学北京脑重大疾病研究院,北京 100069Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China
| | - 露 马
- 中国人民解放军总医院放射科,北京 100853Department of Radiology, General Hospital of PLA, Beijing 100853, China
| | - 明明 卢
- 中国人民解放军总医院放射科,北京 100853Department of Radiology, General Hospital of PLA, Beijing 100853, China
| | - 国恩 姚
- 解放军总医院第一附属医院神经内科,北京 100048Department of Neurology, First Affiliated Hospital of General Hospital of PLA, Beijing 100048, China
| | - 家斐 杨
- 解放军总医院第一附属医院放射科,北京 100048Department of Radiology, First Affiliated Hospital of General Hospital of PLA, Beijing 100048, China
| | - 锡海 赵
- 清华大学生物医学影像研究中心,北京 100084Center for Biomedical Imaging Research, Tsinghua University, Beijing 100084, China
| | - 剑鸣 蔡
- 中国人民解放军总医院放射科,北京 100853Department of Radiology, General Hospital of PLA, Beijing 100853, China
- 解放军总医院第一附属医院放射科,北京 100048Department of Radiology, First Affiliated Hospital of General Hospital of PLA, Beijing 100048, China
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Abstract
Plaque imaging by MR imaging provides a wealth of information on the characteristics of individual plaque that may reveal vulnerability to rupture, likelihood of progression, or optimal treatment strategy. T1-weighted and T2-weighted images among other options reveal plaque morphology and composition. Dynamic contrast-enhanced-MR imaging reveals plaque activity. To extract this information, image processing tools are needed. Numerous approaches for analyzing such images have been developed, validated against histologic gold standards, and used in clinical studies. These efforts are summarized in this article.
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Affiliation(s)
- Huijun Chen
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Room No. 109, Haidian District, Beijing, China
| | - Qiang Zhang
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Room No. 120, Haidian District, Beijing, China
| | - William Kerwin
- Department of Radiology, School of Medicine, University of Washington, 850 Republican Street, Seattle, WA 98109, USA.
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14
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Sadat U, Jaffer FA, van Zandvoort MAMJ, Nicholls SJ, Ribatti D, Gillard JH. Inflammation and neovascularization intertwined in atherosclerosis: imaging of structural and molecular imaging targets. Circulation 2014; 130:786-94. [PMID: 25156914 DOI: 10.1161/circulationaha.114.010369] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Umar Sadat
- From the Cambridge Vascular Unit (U.S.) and University Department of Radiology (U.S., J.H.G.), Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom; Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, MA (F.A.J.); Advanced Microscopy Unit, Department of Genetics and Cell Biology-Molecular Cell Biology, Maastricht University, Maastricht, The Netherlands (M.A.M.J.v.Z.); Institute for Molecular Cardiovascular Research, Aachen University, Aachen, Germany (M.A.M.J.v.Z.); South Australian Health and Medical Research Institute and Heart Foundation Heart Health, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia (S.J.N.); Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy (D.R.); and National Cancer Institute "Giovanni Paolo II," Bari, Italy (D.R.).
| | - Farouc A Jaffer
- From the Cambridge Vascular Unit (U.S.) and University Department of Radiology (U.S., J.H.G.), Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom; Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, MA (F.A.J.); Advanced Microscopy Unit, Department of Genetics and Cell Biology-Molecular Cell Biology, Maastricht University, Maastricht, The Netherlands (M.A.M.J.v.Z.); Institute for Molecular Cardiovascular Research, Aachen University, Aachen, Germany (M.A.M.J.v.Z.); South Australian Health and Medical Research Institute and Heart Foundation Heart Health, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia (S.J.N.); Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy (D.R.); and National Cancer Institute "Giovanni Paolo II," Bari, Italy (D.R.)
| | - Marc A M J van Zandvoort
- From the Cambridge Vascular Unit (U.S.) and University Department of Radiology (U.S., J.H.G.), Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom; Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, MA (F.A.J.); Advanced Microscopy Unit, Department of Genetics and Cell Biology-Molecular Cell Biology, Maastricht University, Maastricht, The Netherlands (M.A.M.J.v.Z.); Institute for Molecular Cardiovascular Research, Aachen University, Aachen, Germany (M.A.M.J.v.Z.); South Australian Health and Medical Research Institute and Heart Foundation Heart Health, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia (S.J.N.); Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy (D.R.); and National Cancer Institute "Giovanni Paolo II," Bari, Italy (D.R.)
| | - Stephen J Nicholls
- From the Cambridge Vascular Unit (U.S.) and University Department of Radiology (U.S., J.H.G.), Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom; Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, MA (F.A.J.); Advanced Microscopy Unit, Department of Genetics and Cell Biology-Molecular Cell Biology, Maastricht University, Maastricht, The Netherlands (M.A.M.J.v.Z.); Institute for Molecular Cardiovascular Research, Aachen University, Aachen, Germany (M.A.M.J.v.Z.); South Australian Health and Medical Research Institute and Heart Foundation Heart Health, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia (S.J.N.); Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy (D.R.); and National Cancer Institute "Giovanni Paolo II," Bari, Italy (D.R.)
| | - Domenico Ribatti
- From the Cambridge Vascular Unit (U.S.) and University Department of Radiology (U.S., J.H.G.), Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom; Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, MA (F.A.J.); Advanced Microscopy Unit, Department of Genetics and Cell Biology-Molecular Cell Biology, Maastricht University, Maastricht, The Netherlands (M.A.M.J.v.Z.); Institute for Molecular Cardiovascular Research, Aachen University, Aachen, Germany (M.A.M.J.v.Z.); South Australian Health and Medical Research Institute and Heart Foundation Heart Health, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia (S.J.N.); Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy (D.R.); and National Cancer Institute "Giovanni Paolo II," Bari, Italy (D.R.)
| | - Jonathan H Gillard
- From the Cambridge Vascular Unit (U.S.) and University Department of Radiology (U.S., J.H.G.), Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom; Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, MA (F.A.J.); Advanced Microscopy Unit, Department of Genetics and Cell Biology-Molecular Cell Biology, Maastricht University, Maastricht, The Netherlands (M.A.M.J.v.Z.); Institute for Molecular Cardiovascular Research, Aachen University, Aachen, Germany (M.A.M.J.v.Z.); South Australian Health and Medical Research Institute and Heart Foundation Heart Health, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia (S.J.N.); Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy (D.R.); and National Cancer Institute "Giovanni Paolo II," Bari, Italy (D.R.)
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15
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Fan Z, Yu W, Xie Y, Dong L, Yang L, Wang Z, Conte AH, Bi X, An J, Zhang T, Laub G, Shah PK, Zhang Z, Li D. Multi-contrast atherosclerosis characterization (MATCH) of carotid plaque with a single 5-min scan: technical development and clinical feasibility. J Cardiovasc Magn Reson 2014; 16:53. [PMID: 25184808 PMCID: PMC4222690 DOI: 10.1186/s12968-014-0053-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 07/08/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Multi-contrast weighted imaging is a commonly used cardiovascular magnetic resonance (CMR) protocol for characterization of carotid plaque composition. However, this approach is limited in several aspects including low slice resolution, long scan time, image mis-registration, and complex image interpretation. In this work, a 3D CMR technique, named Multi-contrast Atherosclerosis Characterization (MATCH), was developed to mitigate the above limitations. METHODS MATCH employs a 3D spoiled segmented fast low angle shot readout to acquire data with three different contrast weightings in an interleaved fashion. The inherently co-registered image sets, hyper T1-weighting, gray blood, and T2-weighting, are used to detect intra-plaque hemorrhage (IPH), calcification (CA), lipid-rich necrotic core (LRNC), and loose-matrix (LM). The MATCH sequence was optimized by computer simulations and testing on four healthy volunteers and then evaluated in a pilot study of six patients with carotid plaque, using the conventional multi-contrast protocol as a reference. RESULTS On MATCH images, the major plaque components were easy to identify. Spatial co-registration between the three image sets with MATCH was particularly helpful for the reviewer to discern co-existent components in an image and appreciate their spatial relation. Based on Cohen's kappa tests, moderate to excellent agreement in the image-based or artery-based component detection between the two protocols was obtained for LRNC, IPH, CA, and LM, respectively. Compared with the conventional multi-contrast protocol, the MATCH protocol yield significantly higher signal contrast ratio for IPH (3.1±1.3 vs. 0.4±0.3, p<0.001) and CA (1.6±1.5 vs. 0.7±0.6, p=0.012) with respect to the vessel wall. CONCLUSIONS To the best of our knowledge, the proposed MATCH sequence is the first 3D CMR technique that acquires spatially co-registered multi-contrast image sets in a single scan for characterization of carotid plaque composition. Our pilot clinical study suggests that the MATCH-based protocol may outperform the conventional multi-contrast protocol in several respects. With further technical improvements and large-scale clinical validation, MATCH has the potential to become a CMR method for assessing the risk of plaque disruption in a clinical workup.
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Affiliation(s)
- Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Wei Yu
- Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Li Dong
- Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lixin Yang
- Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhanhong Wang
- Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | | | - Xiaoming Bi
- MR R&D, Siemens Healthcare, Los Angeles, CA, USA
| | - Jing An
- MR Collaborations NE Asia, Siemens Healthcare, Beijing, China
| | - Tianjing Zhang
- MR Collaborations NE Asia, Siemens Healthcare, Beijing, China
| | - Gerhard Laub
- MR R&D, Siemens Healthcare, Los Angeles, CA, USA
| | - Prediman Krishan Shah
- Oppenheimer Atherosclerosis Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Atherosclerosis Prevention and Management Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Zhaoqi Zhang
- Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
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