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

Stroke ◽  
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.

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

2021 ◽  
Author(s):  
Konstanze Viktoria Guggenberger ◽  
Giulia Dalla Torre ◽  
Ute Ludwig ◽  
Patrick Vogel ◽  
Andreas Max Weng ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Spin Echo ◽  
Cerebral Arteries ◽  
Vasa Vasorum ◽  
Elderly Subjects ◽  
Black Blood ◽  
Large Artery ◽  
Isotropic Resolution ◽  
Spin Echo Sequence ◽  
Longitudinal Extension

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.

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

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.

scholarly journals Effect of black blood MR image quality on vessel wall segmentation

2001 ◽  
Vol 46 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Jonathan B. Thomas ◽  
Brian K. Rutt ◽  
Hanif M. Ladak ◽  
David A. Steinman
Keyword(s):  
Image Quality ◽  
Vessel Wall ◽  
Black Blood ◽  
Mr Image

scholarly journals Wave-controlled aliasing in parallel imaging magnetization-prepared gradient echo (wave-CAIPI MPRAGE) accelerates speed for pediatric brain MRI with comparable diagnostic performance

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Younghee Yim ◽  
Mi Sun Chung ◽  
Su Yeong Kim ◽  
Na Mi Lee ◽  
Jun Soo Byun ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Image Quality ◽  
Parallel Imaging ◽  
Reliable Method ◽  
Pediatric Patients ◽  
Motion Artifacts ◽  
Gradient Echo ◽  
Post Contrast ◽  
Scan Time ◽  
Intracranial Lesions

AbstractWe aimed to compare accelerated post-contrast magnetization-prepared rapid gradient-echo (MPRAGE) using wave-controlled aliasing in parallel imaging (wave-CAIPI) with conventional MPRAGE as a reliable method to diagnose intracranial lesions in pediatric patients. A total of 23 consecutive pediatric patients who underwent post-contrast wave-CAIPI and conventional MPRAGE (scan time: 2 min 39 s vs. 5 min 46 s) were retrospectively evaluated. Two radiologists independently assessed each image for the presence of intracranial lesions. Quantitative [contrast-to-noise ratio (CNR), contrast rate (CR), and signal-to-noise ratio (SNR)] and qualitative parameters (overall image quality, gray-white matter differentiation, demarcation of basal ganglia and sulci, and motion artifacts) were also surveyed. Wave-CAIPI MPRAGE and conventional MPRAGE detected enhancing and non-enhancing intracranial lesions with 100% agreement. Although wave-CAIPI MPRAGE had a lower SNR (all p < 0.05) and overall image quality (overall analysis, p = 0.02) compared to conventional MPRAGE, other quantitative (CNR and CR) and qualitative parameters (gray-white differentiation, demarcation of basal ganglia and sulci, and motion artifacts) were comparable in the pooled analysis and between both observers (all p > 0.05). Wave-CAIPI MPRAGE was a reliable method for diagnosing intracranial lesions in pediatric patients as conventional MPRAGE at half the scan time.

scholarly journals Ultra-high resolution, 3-dimensional magnetic resonance imaging of the atherosclerotic vessel wall at clinical 7T

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0241779
Author(s):  
Martin J. Willemink ◽  
Bram F. Coolen ◽  
Hadrien Dyvorne ◽  
Philip M. Robson ◽  
Ilda Bander ◽  
...  
Keyword(s):  
High Resolution ◽  
Image Quality ◽  
Spatial Resolution ◽  
Vessel Wall ◽  
High Field ◽  
High Spatial Resolution ◽  
Black Blood ◽  
Lower Field ◽  
Plaque Area ◽  
Field Strengths

Accurate quantification and characterization of atherosclerotic plaques with MRI requires high spatial resolution acquisitions with excellent image quality. The intrinsically better signal-to-noise ratio (SNR) at high-field clinical 7T compared to the widely employed lower field strengths of 1.5 and 3T may yield significant improvements to vascular MRI. However, 7T atherosclerosis imaging also presents specific challenges, related to local transmit coils and B1 field inhomogeneities, which may overshadow these theoretical gains. We present the development and evaluation of 3D, black-blood, ultra-high resolution vascular MRI on clinical high-field 7T in comparison lower-field 3T. These protocols were applied for in vivo imaging of atherosclerotic rabbits, which are often used for development, testing, and validation of translatable cardiovascular MR protocols. Eight atherosclerotic New Zealand White rabbits were imaged on clinical 7T and 3T MRI scanners using 3D, isotropic, high (0.63 mm3) and ultra-high (0.43 mm3) spatial resolution, black-blood MR sequences with extensive spatial coverage. Following imaging, rabbits were sacrificed for validation using fluorescence imaging and histology. Image quality parameters such as SNR and contrast-to-noise ratio (CNR), as well as morphological and functional plaque measurements (plaque area and permeability) were evaluated at both field strengths. Using the same or comparable imaging parameters, SNR and CNR were in general higher at 7T compared to 3T, with a median (interquartiles) SNR gain of +40.3 (35.3–80.1)%, and a median CNR gain of +68.1 (38.5–95.2)%. Morphological and functional parameters, such as vessel wall area and permeability, were reliably acquired at 7T and correlated significantly with corresponding, widely validated 3T vessel wall MRI measurements. In conclusion, we successfully developed 3D, black-blood, ultra-high spatial resolution vessel wall MRI protocols on a 7T clinical scanner. 7T imaging was in general superior to 3T with respect to image quality, and comparable in terms of plaque area and permeability measurements.

scholarly journals Clinical Significance of Intraluminal Contrast Enhancement in Patients with Spontaneous Cervical Artery Dissection: A Black-Blood MRI Study

2017 ◽  
Vol 189 (07) ◽  
pp. 624-631 ◽  
Author(s):  
Eva Coppenrath ◽  
Olga Lenz ◽  
Nora Sommer ◽  
Nina Lummel ◽  
Jennifer Linn ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Contrast Enhancement ◽  
Vessel Wall ◽  
Thrombus Formation ◽  
Brain Mri ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Black Blood ◽  
Post Contrast ◽  
Cervical Artery

Purpose Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD). Methods 33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2*w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries. Presence/absence of iCE, vessel occlusion and vessel wall hematoma (hyperintense in T1w pre-contrast) were analysed by two radiologists in consensus decision. Results 44 of 132 analysed vessels had a vessel wall hematoma, consistent with sCAD. In 17 of 44 dissected vessels an acute ischemic stroke was found. 16 of 17 (94.1 %) vessels ipsilateral to ischemic stroke demonstrated iCE, compared to 9 of 44 (20.4 %) dissected vessels without stroke (P< 0.001). The presence/absence of iCE resulted in a sensitivity, specificity, positive and negative predictive value and accuracy for ischemic stroke of 0.94, 0.67, 0.64, 0.95, and 0.77, respectively, and an odds ratio of 32.0. Conclusion iCE, which is suggestive of intraluminal thrombus formation, is strongly correlated with ischemic symptoms in patients with sCAD. Key points  Citation Format

scholarly journals Surveillance of abdominal aortic aneurysm using accelerated 3D non-contrast black-blood cardiovascular magnetic resonance with compressed sensing (CS-DANTE-SPACE)

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Chengcheng Zhu ◽  
Lizhen Cao ◽  
Zhaoying Wen ◽  
Sinyeob Ahn ◽  
Esther Raithel ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Abdominal Aortic Aneurysm ◽  
Magnetic Resonance ◽  
Image Quality ◽  
Aortic Aneurysm ◽  
Compressed Sensing ◽  
Contrast Ratio ◽  
Black Blood ◽  
Scan Time ◽  
Abdominal Aortic

Abstract Background 3D non-contrast high-resolution black-blood cardiovascular magnetic resonance (CMR) (DANTE-SPACE) has been used for surveillance of abdominal aortic aneurysm (AAA) and validated against computed tomography (CT) angiography. However, it requires a long scan time of more than 7 min. We sought to develop an accelerated sequence applying compressed sensing (CS-DANTE-SPACE) and validate it in AAA patients undergoing surveillance. Methods Thirty-eight AAA patients (all males, 73 ± 6 years) under clinical surveillance were recruited for this study. All patients were scanned with DANTE-SPACE (scan time 7:10 min) and CS-DANTE-SPACE (scan time 4:12 min, a reduction of 41.4%). Nine 9 patients were scanned more than 2 times. In total, 50 pairs of images were available for comparison. Two radiologists independently evaluated the image quality on a 1–4 scale, and measured the maximal diameter of AAA, the intra-luminal thrombus (ILT) and lumen area, ILT-to-muscle signal intensity ratio, and the ILT-to-lumen contrast ratio. The sharpness of the aneurysm inner/outer boundaries was quantified. Results CS-DANTE-SPACE achieved comparable image quality compared with DANTE-SPACE (3.15 ± 0.67 vs. 3.03 ± 0.64, p = 0.06). There was excellent agreement between results from the two sequences for diameter/area and ILT ratio measurements (ICCs> 0.85), and for quantifying growth rate (3.3 ± 3.1 vs. 3.3 ± 3.4 mm/year, ICC = 0.95.) CS-DANTE-SPACE showed a higher ILT-to-lumen contrast ratio (p = 0.01) and higher sharpness than DANTE-SPACE (p = 0.002). Both sequences had excellent inter-reader reproducibility for quantitative measurements (ICC > 0.88). Conclusion CS-DANTE-SPACE can reduce scan time while maintaining image quality for AAA imaging. It is a promising tool for the surveillance of patients with AAA disease in the clinical setting.

Vessel wall imaging with advanced flow suppression in the characterization of intracranial aneurysms following flow diversion with Pipeline embolization device

2022 ◽  
pp. neurintsurg-2021-018086
Author(s):  
Eytan Raz ◽  
Adam Goldman-Yassen ◽  
Anna Derman ◽  
Ahrya Derakhshani ◽  
John Grinstead ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Flow Diverter ◽  
Black Blood ◽  
Gadolinium Enhancement ◽  
Parent Vessel ◽  
Post Contrast ◽  
Conventional Mri ◽  
Aneurysm Wall ◽  
Pattern Distribution ◽  
Aneurysm Occlusion

BackgroundHigh-resolution vessel wall MRI (VWI) is increasingly used to characterize intramural disorders of the intracranial vasculature unseen by conventional arteriography.ObjectiveTo evaluate the use of VWI for surveillance of flow diverter (FD) treated aneurysms.Materials and methodsRetrospective study of 28 aneurysms (in 21 patients) treated with a FD (mean 57 years; 14 female). All examinations included VWI and a contemporaneously obtained digital subtraction angiogram. Multiplanar pre- and post-gadolinium 3D, variable flip-angle T1 black-blood VWI was obtained using delay alternating nutation for tailored excitation (DANTE) at 3T. 3D time-of-flight MR angiography (MRA) was also carried out. Images were assessed for in-stent stenosis, aneurysm occlusion, presence and pattern/distribution of aneurysmal or parent vessel gadolinium enhancement.ResultsThe VWI-MRI was performed on average at 361±259 days after the intervention. Follow-up DSA was performed at 338±254 days postintervention. Good or excellent black-blood angiographic quality was recorded in 22/28 (79%) pre-contrast and 21/28 (75%) post-contrast VWI, with no cases excluded for image quality. Aneurysm enhancement was noted in 24/28 (85.7%) aneurysms, including in 79% of angiographically occluded aneurysms and 100% of angiographically non-occluded aneurysms. Enhancement of the stented parent-vessel wall occurred significantly more often when aneurysm enhancement was present (92% vs 33%, p=0.049).ConclusionAdvanced VWI produces excellent depiction of FD-treated aneurysms, with robust evaluation of the parent vessel and aneurysm wall to an extent not achievable with conventional MRI/MRA. Gadolinium enhancement may, however, continue even after enduring catheter angiographic occlusion, confounding interpretation, and requiring cognizance of this potentially prolonged effect in such patients.

scholarly journals Pre-contrast T1-weighted imaging of the spinal cord may be unnecessary in patients with multiple sclerosis

2021 ◽  
Author(s):  
Isabelle Riederer ◽  
Mark Mühlau ◽  
Claus Zimmer ◽  
Magaly Gutbrod-Fernandez ◽  
Nico Sollmann ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Image Quality ◽  
Detection Rate ◽  
List Type ◽  
Diagnostic Confidence ◽  
Post Contrast ◽  
Scan Time ◽  
Spinal Mri

Abstract Objectives Multiple sclerosis (MS) is an inflammatory disease frequently involving the spinal cord, which can be assessed by magnetic resonance imaging (MRI). Here, we hypothesize that pre-contrast T1-w imaging does not add diagnostic value to routine spinal MRI for the follow-up of patients with MS. Methods 3-T MRI scans including pre- and post-contrast T1-w as well as T2-w images of 265 consecutive patients (mean age: 40 ± 13 years, 169 women) with (suspected) MS were analyzed retrospectively. Images were assessed in two separate reading sessions, first excluding and second including pre-contrast T1-w images. Two independent neuroradiologists rated the number of contrast-enhancing (ce) lesions as well as diagnostic confidence (1 = unlikely to 5 = very high), overall image quality, and artifacts. Results were compared using Wilcoxon matched-pairs signed-rank tests and weighted Cohen’s kappa (κ). Results Fifty-six ce lesions were found in 43 patients. There were no significant differences in diagnostic confidence between both readings for both readers (reader 1: p = 0.058; reader 2: p = 0.317). Inter-rater concordance was both moderate regarding artifacts (κ = 0.418) and overall image quality (κ = 0.504). Thirty-one black holes were found in 25 patients with high diagnostic confidence (reader 1: 4.04 ± 0.81; reader 2: 3.80 ± 0.92) and substantial inter-rater concordance (κ = 0.700). Conclusions Availability of pre-contrast T1-w images did not significantly increase diagnostic confidence or detection rate of ce lesions in the spinal cord in patients with MS. Thus, pre-contrast T1-w sequences might be omitted in routine spinal MRI for follow-up exams, however not in special unclear clinical situations in which certainty on contrast enhancement is required. Key Points Availability of pre-contrast T1-w images does not increase diagnostic confidence or detection rate of contrast-enhancing lesions in the spinal cord of MS patients. Excluding pre-contrast T1-w sequences reduces scan time, thus providing more time for other sequences or increasing the patients’ compliance.

scholarly journals Cardiac involvement in COVID-19 patients: mid-term follow up by cardiovascular magnetic resonance

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hui Wang ◽  
Ruili Li ◽  
Zhen Zhou ◽  
Hong Jiang ◽  
Zixu Yan ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Involvement ◽  
Global Longitudinal Strain ◽  
Cine Imaging ◽  
Black Blood ◽  
Healthy Controls ◽  
Term Outcome ◽  
Post Contrast

Abstract Background Coronavirus disease 2019 (COVID-19) induces myocardial injury, either direct myocarditis or indirect injury due to systemic inflammatory response. Myocardial involvement has been proved to be one of the primary manifestations of COVID-19 infection, according to laboratory test, autopsy, and cardiovascular magnetic resonance (CMR). However, the middle-term outcome of cardiac involvement after the patients were discharged from the hospital is yet unknown. The present study aimed to evaluate mid-term cardiac sequelae in recovered COVID-19 patients by CMR Methods A total of 47 recovered COVID-19 patients were prospectively recruited and underwent CMR examination. The CMR protocol consisted of black blood fat-suppressed T2 weighted imaging, T2 star mapping, left ventricle (LV) cine imaging, pre- and post-contrast T1 mapping, and late gadolinium enhancement (LGE). LGE were assessed in mixed both recovered COVID-19 patients and healthy controls. The LV and right ventricle (RV) function and LV mass were assessed and compared with healthy controls. Results A total of 44 recovered COVID-19 patients and 31 healthy controls were studied. LGE was found in 13 (30%) of COVID-19 patients. All LGE lesions were located in the mid myocardium and/or sub-epicardium with a scattered distribution. Further analysis showed that LGE-positive patients had significantly decreased LV peak global circumferential strain (GCS), RV peak GCS, RV peak global longitudinal strain (GLS) as compared to non-LGE patients (p < 0.05), while no difference was found between the non-LGE patients and healthy controls. Conclusion Myocardium injury existed in 30% of COVID-19 patients. These patients have depressed LV GCS and peak RV strains at the 3-month follow-up. CMR can monitor the COVID-19-induced myocarditis progression, and CMR strain analysis is a sensitive tool to evaluate the recovery of LV and RV dysfunction.

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