Abstract 205: Longitudinal Study of Intracranial Atherosclerosis Using 3D High Resolution MRI Imaging

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Xuefeng Zhang ◽  
Huan Yang ◽  
Mona Shahriari ◽  
Li Liu ◽  
Yiyi Zhang ◽  
...  
Keyword(s):  
High Resolution ◽  
Wall Thickness ◽  
Vessel Wall ◽  
Time Interval ◽  
Black Blood ◽  
Plaque Progression ◽  
Intracranial Atherosclerotic Disease ◽  
Maximum Wall Thickness ◽  
The Mean

Hypothesis: The progression of asymptomatic intracranial atherosclerotic disease (ICAD) remains relatively unknown. We sought to determine whether the progression of ICAD over 24 months can be quantitatively detected using 3D high-resolution vessel wall MRI. Methods: 28 participants with identified ICAD (14 male; mean age, 80.1±4.94 years, ranges, 71 to 89) were enrolled from Atherosclerosis Risk in Communities Study. The baseline MRI exams were performed on a 3T Siemens scanner that included 3D time-of-flight MRA and 3D black blood MRI (BBMRI) (e.g., acquired resolution: TOF, 0.55 x 0.5 x 0.5 mm 3 ; BBMRI, 0.5 mm 3 ) for identifying atherosclerosis in major intracranial arteries. The follow-up MRI exams were repeated to determine the progression of ICAD. The mean time interval between two scans was 2.65±1.48 years. Three trained readers independently measured the degree of stenosis, plaque thickness, and normalized wall index for both normal wall and identified plaques in both visits. Plaque progression was defined by plaque showing > 2 measurement error of increase in plaque thickness. Reliability was assessed by intraclass correlations (ICC). Results: Inter- and intra-reader reliability for MRI measurements ranged from fair to excellent (ICC, 0.58-0.82). The mean coefficient of variation was 10% for mean wall thickness, 13% for maximum wall thickness and 12% for normalized wall index. Of the 28 participants with ICAD identified at baseline, 18 of 28 participants (64%) had either new plaques or evidence of plaque progression. A total of 152 and 163 plaques were identified at baseline and follow-up, respectively. Among 152 plaques, 45 (30%) progressed, and mean, maximum wall thickness, stenosis and normalized wall index increased 36%, 28%, 27% and 14%, respectively (Table 1). Conclusion: 3D High-resolution vessel wall MRI is reliable tool for measuring changes in ICAD plaque and provides insight into the natural history of ICAD progression in general population.

Abstract WMP48: 3D MR Vessel Wall Imaging Reveals Plaque-Specific Responses to Medical Therapy in Patients With Symptomatic Intracranial Atherosclerotic Disease: Initial Experience

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jiayu Xiao ◽  
Huijuan Miao ◽  
Song Shlee ◽  
Konrad Schlick ◽  
Tao Jiang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Medical Therapy ◽  
Wall Thickness ◽  
Vessel Wall ◽  
Plaque Volume ◽  
Post Contrast ◽  
Intracranial Atherosclerotic Disease ◽  
Maximum Wall Thickness ◽  
Wall Imaging

Introduction: Intracranial atherosclerotic disease (ICAD) is a common cause of ischemic stroke worldwide and carries a high rate of recurrence. Follow-up of symptomatic ICAD routinely relies on assessment of lumen stenosis. Magnetic resonance vessel wall imaging (MR-VWI) has recently demonstrated the potential to reliably quantify plaque features. This work presents our experience in using serial MR-VWI to quantify the morphological changes of culprit lesions in response to medical therapy in patients with symptomatic ICAD. Methods: Twenty-four patients (4 females; age 46.75±14.05 years) with acute ischemic stroke secondary to ICAD underwent baseline (1-44 days after onset) and follow-up (3-15 months after baseline) 3D whole-brain MR-VWI, which was used to acquire pre- and post-contrast images. Quantitative plaque features, including plaque volume, peak normalized wall index (pNWI), maximum wall thickness, stenosis degree, pre-contrast plaque-wall contrast ratio (CR), and post-contrast plaque enhancement ratio (ER), were derived from both baseline and follow-up MR-VWI scans. Patients with 18-month clinical follow-up were divided into progression and non-progression groups depending on whether major vascular events (stroke, TIA, death) occurred. Results: Seventeen patients were categorized into the non-progression group and 4 into the progression group. Maximum wall thickness (P=0.047), CR (P=0.020) and ER (P=0.012) showed significant decreases in the non-progression group. In the progression group, all 4 patients showed an increase in pNWI, stenosis degree and CR; plaque volume, maximum wall thickness and ER increased in three patients. Typical cases are shown in Figure. Conclusions: Quantitative assessment of lesion-specific responses to medical therapy is clinically feasible with serial MR-VWI. The changes of plaque over time may be useful for ischemic stroke risk stratification with implications for ICAD medical management.

Association of residual stenosis after balloon angioplasty with vessel wall geometries in intracranial atherosclerosis

2021 ◽  
pp. neurintsurg-2021-017997
Author(s):  
Zhikai Hou ◽  
Zhe Zhang ◽  
Long Yan ◽  
Jidong You ◽  
Min Wan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
High Resolution ◽  
Wall Thickness ◽  
Balloon Angioplasty ◽  
Vessel Wall ◽  
Perioperative Complications ◽  
Residual Stenosis ◽  
Wall Area ◽  
Intracranial Atherosclerotic Disease ◽  
Remodeling Index

BackgroundPercutaneous transluminal balloon angioplasty (PTBA) may be an alternative treatment for patients with symptomatic intracranial atherosclerotic disease (ICAD) refractory to medical treatment. This study aimed to investigate the association of vessel wall geometric characteristics on high-resolution magnetic resonance vessel wall imaging (MR-VWI) with low residual stenosis in patients with ICAD after PTBA.MethodsPatients with symptomatic ICAD who underwent PTBA were prospectively and consecutively enrolled. High-resolution MR-VWI was performed before the PTBA. Vessel wall geometries of the target artery, including normalized wall index (NWI: wall area/vessel area × 100%), normalized wall thickness index (NWTI: mean wall thickness/vessel radius × 100%), and remodeling index (RI) were evaluated. Low residual stenosis was defined as postprocedural stenosis degree ≤50%. Perioperative complications including symptomatic ischemic stroke/intracranial hemorrhage, death, and arterial dissection were recorded. The baseline characteristics, vessel wall geometries, and perioperative complications were compared between the patients with low residual stenosis and high residual stenosis.ResultsAmong 60 patients prospectively enrolled, low residual stenosis was achieved in 46 participants (77%). Three patients (5%) suffered from symptomatic ischemic stroke within 30 days. Multivariable logistic regression showed that a lower NWI and lower NWTI were associated with low residual stenosis after PTBA (adjusted OR 0.57, 95% CI 0.35 to 0.94, p=0.027; and adjusted OR 0.88, 95% CI 0.80 to 0.98, p=0.015).ConclusionsLower NWI and NWTI of the target artery on high-resolution MR-VWI were associated with low residual stenosis in patients with ICAD after PTBA.

scholarly journals High-Resolution Black-Blood MRI of the Carotid Vessel Wall Using Phased-Array Coils at 1.5 and 3 Tesla1

2005 ◽  
Vol 12 (12) ◽  
pp. 1521-1526 ◽  
Author(s):  
SeshaSailaja Anumula ◽  
Hee Kwon Song ◽  
Alexander C. Wright ◽  
Felix W. Wehrli
Keyword(s):  
High Resolution ◽  
Vessel Wall ◽  
Phased Array ◽  
Black Blood ◽  
Black Blood Mri ◽  
Carotid Vessel Wall ◽  
Phased Array Coils ◽  
Array Coils ◽  
Carotid Vessel

scholarly journals Evaluation of a dedicated dual phased-array surface coil using a black-blood FSE sequence for high resolution MRI of the carotid vessel wall

2002 ◽  
Vol 15 (3) ◽  
pp. 344-351 ◽  
Author(s):  
Mohamed Ouhlous ◽  
Franck Lethimonnier ◽  
Diederik W.J. Dippel ◽  
Marc R.H.M. van Sambeek ◽  
Lambertus C.J. van Heerebeek ◽  
...  
Keyword(s):  
High Resolution ◽  
Vessel Wall ◽  
Phased Array ◽  
Surface Coil ◽  
Black Blood ◽  
High Resolution Mri ◽  
Carotid Vessel Wall ◽  
Carotid Vessel

scholarly journals Black blood vessel wall MRI to identify vulnerable atherosclerotic plaque in a non-stenotic intracranial vertebral artery as a cause of acute ischaemia

2020 ◽  
Vol 6 (4) ◽  
pp. 20200061
Author(s):  
Sundip Dhanvant Udani ◽  
Pervinder Bhogal
Keyword(s):  
Vertebral Artery ◽  
Atherosclerotic Plaque ◽  
Vessel Wall ◽  
Black Blood ◽  
Vulnerable Atherosclerotic Plaque ◽  
Acute Ischaemia ◽  
Neurological Sequelae ◽  
Intracranial Atherosclerotic Disease ◽  
Coronary Syndromes ◽  
Neuroimaging Techniques

Conventional neuroimaging techniques for investigating the cause of stroke are mainly centred on investigating luminal stenosis. The pathophysiology of intracranial atherosclerotic disease (ICAD) and stroke is complex and extends beyond just vessel narrowing. The concept of the vulnerable atherosclerotic plaque, that can result in acute coronary syndromes, has been well described in the cardiac literature 1,2 although this concept is less well accepted among stroke physicians. We describe a case of a 61-year-old male with acute neurological sequelae from a non-stenotic atherosclerotic plaque of the intracranial vertebral artery. This case report describes the additional use of vessel wall MRI techniques to aid the radiologist in identifying such vulnerable lesions and therefore helping to tailor management and prevent further clinical deterioration.

scholarly journals High-resolution black-blood contrast-enhancedT1weighted images for the diagnosis and follow-up of intracranial arteritis

2010 ◽  
Vol 83 (993) ◽  
pp. e182-e184 ◽  
Author(s):  
T Saam ◽  
M Habs ◽  
O Pollatos ◽  
C Cyran ◽  
T Pfefferkorn ◽  
...  
Keyword(s):  
High Resolution ◽  
Black Blood

Human Carotid Atherosclerotic Plaque Growth Function and Progression Simulation Using Meshless GFD and Statistical Methods Based on Multi-Year In Vivo MRI

2008 ◽  
Author(s):  
Chun Yang ◽  
Joseph D. Petruccelli ◽  
Zhongzhao Teng ◽  
Chun Yuan ◽  
Gador Canton ◽  
...  
Keyword(s):  
Atherosclerotic Plaque ◽  
Wall Thickness ◽  
Vessel Wall ◽  
Plaque Rupture ◽  
Patient Specific ◽  
Tracking Data ◽  
Plaque Progression ◽  
Vessel Wall Thickness ◽  
Plaque Growth

Atherosclerotic plaque rupture and progression have been the focus of intensive investigations in recent years. The mechanisms governing plaque progression and rupture process are not well understood. Using computational models based on patient-specific multi-year in vivo MRI data, our recent results indicated that 18 out of 21 patients studied showed significant negative correlation between plaque progression measured by vessel wall thickness increase (WTI) and plaque wall (structural) stress (PWS) [1]. In this paper, a computational procedure based on meshless generalized finite difference (MGFD) method and serial magnetic resonance imaging (MRI) data was introduced to simulate plaque progression. Participating patients were scanned three times (T1, T2, and T3, at intervals of approximately 18 months) to obtain plaque progression data. Vessel wall thickness (WT) changes were used as the measure for plaque progression. Starting from T2 plaque geometry, plaque progression was simulated by solving the solid model and adjusting wall thickness using plaque growth functions iteratively until time T3 is reached. Numerically simulated plaque progression showed very good agreement with actual plaque geometry at T3 given by MRI data. We believe this is the first time plaque progression simulation results based on multi-year patient-tracking data are reported. Multi-year tracking data and MRI-based progression simulation add time dimension to plaque vulnerability assessment and will improve prediction accuracy.

High-Resolution Magnetic Resonance Vessel Wall Imaging in Intracranial Atherosclerotic Disease

2019 ◽  
Vol 1 ◽  
pp. 193-214
Author(s):  
Ramez N. Abdalla ◽  
Donald R. Cantrell ◽  
Alireza Vali ◽  
Michael C. Hurley ◽  
Ali Shaibani ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
High Resolution ◽  
Vessel Wall ◽  
Vessel Wall Imaging ◽  
Atherosclerotic Disease ◽  
Intracranial Atherosclerotic Disease ◽  
Wall Imaging
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