Multi-sequence whole-brain intracranial vessel wall imaging at 7.0 tesla

BackgroundT2-weighted (T2w) intracranial vessel wall imaging (IVWI) provides good contrast to differentiate intracranial vasculopathies and discriminate various important plaque components. However, the strong cerebrospinal fluid (CSF) signal in T2w images interferes with depicting the intracranial vessel wall. In this study, we propose a T2-prepared sequence for whole-brain IVWI at 3T with CSF suppression.MethodsA preparation module that combines T2 preparation and inversion recovery (T2IR) was used to suppress the CSF signal and was incorporated into the commercial three-dimensional (3D) turbo spin echo sequence-Sampling Perfection with Application optimized Contrast using different flip angle Evolution (SPACE). This new technique (hereafter called T2IR-SPACE) was evaluated on nine healthy volunteers and compared with two other commonly used 3D T2-weighted sequences: T2w-SPACE and FLAIR-SPACE (FLAIR: fluid-attenuated inversion recovery). The signal-to-noise ratios (SNRs) of the vessel wall (VW) and CSF and contrast-to-noise ratios (CNRs) between them were measured and compared among these three T2-weighted sequences. Subjective wall visualization of the three T2-weighted sequences was scored blindly and independently by two radiologists using a four-point scale followed by inter-rater reproducibility analysis. A pilot study of four stroke patients was performed to preliminarily evaluate the diagnostic value of this new sequence, which was compared with two conventional T2-weighted sequences.ResultsT2IR-SPACE had the highest CNR (11.01 ± 6.75) compared with FLAIR-SPACE (4.49 ± 3.15; p < 0.001) and T2w-SPACE (−56.16 ± 18.58; p < 0.001). The subjective wall visualization score of T2IR-SPACE was higher than those of FLAIR-SPACE and T2w-SPACE (T2IR-SPACE: 2.35 ± 0.59; FLAIR-SPACE: 0.52 ± 0.54; T2w-SPACE: 1.67 ± 0.58); the two radiologists’ scores showed excellent agreement (ICC = 0.883).ConclusionThe T2IR preparation module markedly suppressed the CSF signal without much SNR loss of the other tissues (i.e., vessel wall, white matter, and gray matter) compared with the IR pulse. Our results suggest that T2IR-SPACE is a potential alternative T2-weighted sequence for assessing intracranial vascular diseases.

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Whole-brain intracranial vessel wall imaging at 3 Tesla using cerebrospinal fluid-attenuated T1-weighted 3D turbo spin echo

Magnetic Resonance in Medicine ◽

10.1002/mrm.26201 ◽

2016 ◽

Vol 77 (3) ◽

pp. 1142-1150 ◽

Cited By ~ 39

Author(s):

Zhaoyang Fan ◽

Qi Yang ◽

Zixin Deng ◽

Yuxia Li ◽

Xiaoming Bi ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Vessel Wall ◽

Spin Echo ◽

Vessel Wall Imaging ◽

3 Tesla ◽

Turbo Spin Echo ◽

Whole Brain ◽

Turbo Spin ◽

Intracranial Vessel ◽

Wall Imaging

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Current uses of intracranial vessel wall imaging for clinical practice: a high-resolution MR technique recently available

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20200044 ◽

2020 ◽

Vol 78 (10) ◽

pp. 642-650

Author(s):

Felipe Torres PACHECO ◽

Luiz Celso Hygino da CRUZ JUNIOR ◽

Igor Gomes PADILHA ◽

Renato Hoffmann NUNES ◽

Antônio Carlos Martins MAIA JUNIOR ◽

...

Keyword(s):

Clinical Practice ◽

Vessel Wall ◽

Vascular Diseases ◽

Vascular Wall ◽

Vessel Wall Imaging ◽

Clinical Settings ◽

Direct Evaluation ◽

Intracranial Vessel ◽

Indirect Evaluation ◽

Wall Imaging

ABSTRACT Intracranial vessel wall imaging plays an increasing role in diagnosing intracranial vascular diseases. With the growing demand and subsequent increased use of this technique in clinical practice, radiologists and neurologists should be aware of the choices in imaging parameters and how they affect image quality, clinical indications, methods of assessment, and limitations in the interpretation of these images. Due to the improvement of the MRI techniques, the possibility of accurate and direct evaluation of the abnormalities in the arterial vascular wall (vessel wall imaging) has evolved, adding substantial data to diagnosis when compared to the indirect evaluation based on conventional flow analyses. Herein, the authors proposed a comprehensive approach of this technique reinforcing appropriated clinical settings to better use intracranial vessel wall imaging.

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