Vasa vasorum of proximal cerebral arteries after dural crossing — potential imaging confounder in diagnosing intracranial vasculitis in elderly subjects on black-blood MRI

Abstract Objectives Vessel wall enhancement (VWE) may be commonly seen on MRI images of asymptomatic subjects. This study aimed to characterize the VWE of the proximal internal carotid (ICA) and vertebral arteries (VA) in a non-vasculitic elderly patient cohort. Methods Cranial MRI scans at 3 Tesla were performed in 43 patients (aged ≥ 50 years) with known malignancy for exclusion of cerebral metastases. For vessel wall imaging (VWI), a high-resolution compressed-sensing black-blood 3D T1-weighted fast (turbo) spin echo sequence (T1 CS-SPACE prototype) was applied post gadolinium with an isotropic resolution of 0.55 mm. Bilateral proximal intradural ICA and VA segments were evaluated for presence, morphology, and longitudinal extension of VWE. Results Concentric VWE of the proximal intradural ICA was found in 13 (30%) patients, and of the proximal intradural VA in 39 (91%) patients. Mean longitudinal extension of VWE after dural entry was 13 mm in the VA and 2 mm in the ICA. In 14 of 39 patients (36%) with proximal intradural VWE, morphology of VWE was suggestive of the mere presence of vasa vasorum. In 25 patients (64 %), morphology indicated atherosclerotic lesions in addition to vasa vasorum. Conclusions Vasa vasorum may account for concentric VWE within the proximal 2 mm of the ICA and 13 mm of the VA after dural entry in elderly subjects. Concentric VWE in these locations should not be confused with large artery vasculitis. Distal to these segments, VWE may be more likely related to pathologic conditions such as vasculitis. Key Points • Vasa vasorum may account for concentric VWE within the proximal 2 mm of the ICA and 13 mm of the VA after dural entry in non-vasculitic elderly people. • Concentric enhancement within the proximal 2 mm of the intradural ICA and within the proximal 13 mm of the intradural VA portions should not be misinterpreted as vasculitis. • Distal of this, VWE is likely related to pathologic conditions, in case of concentric VWE suggestive of vasculitis.

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Abstract WP125: Accelerated 3d Isotropic High-resolution Multi-contrast Intracranial Vessel Wall MRI For Large Artery Stroke Evaluation

Stroke ◽

10.1161/str.48.suppl_1.wp125 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Niranjan Balu ◽

Zechen Zhou ◽

Mahmud Mossa-basha ◽

Chun Yuan

Keyword(s):

Image Quality ◽

Vessel Wall ◽

Complex Geometry ◽

Plaque Morphology ◽

Black Blood ◽

Large Artery ◽

Step Method ◽

Post Contrast ◽

Isotropic Resolution ◽

Scan Time

Introduction: Intracranial large-artery atherosclerotic disease (ICAD) is a leading cause of death and morbidity worldwide. Vessel Wall Imaging (VWI) has potential to stratify disease beyond current angiographic methods by identifying plaque morphology and components directly. Plaque component identification requires a multi-contrast black-blood protocol. High isotropic resolution is also required due to small vessels and their complex geometry and therefore typical ICAD VWI protocols require long scan times. Aim: To develop a 3D 0.5 mm isotropic multi-contrast ICAD VWI with scan time of less than 30 minutes. Methods: Experiments were carried out on a Philips Ingenia 3T scanner with 32 channel head coil. Acceleration by K-space undersampling using CUSTOM method and compressed sensing reconstruction using STEP method [1] was used to reduce scan times. The following protocol was optimized on phantoms and volunteers: Survey scan was followed by 3D TOF, T1 weighted VISTA, PD weighted DANTE [2] VISTA, SNAP [3]. After single dose gadolinium contrast injection a post-contrast T1 weighted VISTA is obtained. Protocol parameters were optimized such that total scan time is 25 mins with all scans (except survey) being 0.5mm isotropic. Results: CUSTOM acceleration factors of 4X to 5X provided good image quality. Representative image quality (pre-contrast) is shown in figure 1. Total scan time for the multi-contrast protocol was 30 minutes including patient setup time. Studies on ICAD patients are ongoing with the optimized protocol. Conclusions: Multi-contrast 3D 0.5mm isotropic resolution MRI protocol was developed to scan ICAD patients within 30 minute scan time. Acceleration tailored for VWI allowed reducing scan times from 2 hours to less than 30 minutes thereby providing a clinically usable ICAD VWI multi-contrast protocol. References: [1] Zhou Z et al, MRM 2016, [2] Li L et al, MRM 2012, [3] Wang et al, MRM 2013.

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Reproducibility of left ventricular mass measurement using a half-Fourier black-blood single-shot fast spin-echo sequence within a single breath hold: Comparison with a conventional multiple breath-hold segmented gradient echo technique in patients

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.10006 ◽

2002 ◽

Vol 15 (6) ◽

pp. 654-660 ◽

Cited By ~ 8

Author(s):

Olivier Vignaux ◽

Denis Duboc ◽

Joel Coste ◽

Christophe Argaud ◽

Pierre Carlier ◽

...

Keyword(s):

Mass Measurement ◽

Spin Echo ◽

Left Ventricular ◽

Fast Spin Echo ◽

Breath Hold ◽

Black Blood ◽

Single Shot ◽

Single Breath ◽

Single Breath Hold ◽

Spin Echo Sequence

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Quantitative analysis of unruptured intracranial aneurysm wall thickness and enhancement using 7T high resolution, black blood magnetic resonance imaging

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2021-017688 ◽

2021 ◽

pp. neurintsurg-2021-017688

Author(s):

Xinke Liu ◽

Junqiang Feng ◽

Zhixin Li ◽

Zihao Zhang ◽

Qiang Zhang ◽

...

Keyword(s):

Intracranial Aneurysm ◽

Wall Thickness ◽

Signal Intensity ◽

Spin Echo ◽

Fast Spin Echo ◽

Black Blood ◽

Post Contrast ◽

Isotropic Resolution ◽

Aneurysm Size ◽

Aneurysm Wall

BackgroundThis study was performed to quantify intracranial aneurysm wall thickness (AWT) and enhancement using 7T MRI, and their relationship with aneurysm size and type.Methods27 patients with 29 intracranial aneurysms were included. Three-dimensional T1 weighted pre‐ and post-contrast fast spin echo with 0.4 mm isotropic resolution was used. AWT was defined as the full width at half maximum on profiles of signal intensity across the aneurysm wall on pre-contrast images. Enhancement ratio (ER) was defined as the signal intensity of the aneurysm wall over that of the brain parenchyma. The relationships between AWT, ER, and aneurysm size and type were investigated.Results7T MRI revealed large variations in AWT (range 0.11–1.24 mm). Large aneurysms (>7 mm) had thicker walls than small aneurysms (≤7 mm) (0.49±0.05 vs 0.41±0.05 mm, p<0.001). AWT was similar between saccular and fusiform aneurysms (p=0.546). Within each aneurysm, a thicker aneurysm wall was associated with increased enhancement in 28 of 29 aneurysms (average r=0.65, p<0.05). Thicker walls were observed in enhanced segments (ER >1) than in non-enhanced segments (0.53±0.09 vs 0.38±0.07 mm, p<0.001).ConclusionImproved image quality at 7T allowed quantification of intracranial AWT and enhancement. A thicker aneurysm wall was observed in larger aneurysms and was associated with stronger enhancement.

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