scholarly journals Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Zhang Shi ◽  
Xia Tian ◽  
Bing Tian ◽  
Zakaria Meddings ◽  
Xuefeng Zhang ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Artery Dissection ◽  
Black Blood ◽  
Type I ◽  
Imaging Features ◽  
Intracranial Artery ◽  
Intracranial Artery Dissection ◽  
Complementary Value

Abstract Background Intracranial artery dissection (IAD) often causes headache and cerebral vascular ischemic events. The imaging characteristics of IAD remain unclear. This study aims to characterize the appearance of culprit and non-culprit IAD using high-resolution cardiovascular magnetic resonance imaging (hrCMR) and quantify the incremental value of hrCMR in identifying higher risk lesions. Methods Imaging data from patients who underwent intervention examination or treatment using digital subtraction angiography (DSA) and hrCMR using a 3 T CMR system within 30 days after the onset of neurological symptoms were collected. The CMR protocol included diffusion-weighted imaging (DWI), black blood T1-, T2- and contrast-enhanced T1-weighted sequences. Lesions were classified as culprit and non-culprit according to imaging findings and patient clinical presentations. Univariate and multivariate analyses were performed to assess the difference between culprit and non-culprit lesions and complementary value of hrCMR in identifying higher risk lesions. Results In total, 75 patients were included in this study. According to the morphology, lesions could be classified into five types: Type I, classical dissection (n = 50); Type II, fusiform aneurysm (n = 1); Type III, long dissected aneurysm (n = 3); Type IV, dolichoectatic dissecting aneurysm (n = 9) and Type V, saccular aneurysm (n = 12). Regression analyses showed that age and hypertension were both associated with culprit lesions (age: OR, 0.83; 95% CI 0.75–0.92; p < 0.001 and hypertension: OR, 66.62; 95% CI 5.91–751.11; p = 0.001). Hematoma identified by hrCMR was significantly associated with culprit lesions (OR, 16.80; 95% CI 1.01–280.81; p = 0.037). Moreover, 17 cases (16 lesions were judged to be culprit) were diagnosed as IAD but not visible in DSA and 15 were Type I lesion. Conclusion hrCMR is helpful in visualizing and characterizing IAD. It provides a significant complementary value over DSA for the diagnosis of IAD.

Magnetic resonance vessel wall imaging predicts morphological deterioration in unruptured intracranial artery dissection

2020 ◽  
Vol 29 (9) ◽  
pp. 105006
Author(s):  
Yukishige Hashimoto ◽  
Toshinori Matsushige ◽  
Koji Shimonaga ◽  
Hiroki Takahashi ◽  
Tatsuya Mizoue ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vessel Wall ◽  
Vessel Wall Imaging ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Intracranial Artery Dissection ◽  
Wall Imaging

scholarly journals Accelerated high-resolution free-breathing 3D whole-heart T2-prepared black-blood and bright-blood cardiovascular magnetic resonance

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Teresa Correia ◽  
Giulia Ginami ◽  
Imran Rashid ◽  
Giovanna Nordio ◽  
Reza Hajhosseiny ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Healthy Subjects ◽  
Free Breathing ◽  
Black Blood ◽  
Contrast Injection ◽  
Post Contrast ◽  
Whole Heart ◽  
Bright Blood

Abstract Background The free-breathing 3D whole-heart T2-prepared Bright-blood and black-blOOd phase SensiTive inversion recovery (BOOST) cardiovascular magnetic resonance (CMR) sequence was recently proposed for simultaneous bright-blood coronary CMR angiography and black-blood late gadolinium enhancement (LGE) imaging. This sequence enables simultaneous visualization of cardiac anatomy, coronary arteries and fibrosis. However, high-resolution (< 1.4 × 1.4 × 1.4 mm3) fully-sampled BOOST requires long acquisition times of ~ 20 min. Methods In this work, we propose to extend a highly efficient respiratory-resolved motion-corrected reconstruction framework (XD-ORCCA) to T2-prepared BOOST to enable high-resolution 3D whole-heart coronary CMR angiography and black-blood LGE in a clinically feasible scan time. Twelve healthy subjects were imaged without contrast injection (pre-contrast BOOST) and 10 patients with suspected cardiovascular disease were imaged after contrast injection (post-contrast BOOST). A quantitative analysis software was used to compare accelerated pre-contrast BOOST against the fully-sampled counterpart (vessel sharpness and length of the left and right coronary arteries). Moreover, three cardiologists performed diagnostic image quality scoring for clinical 2D LGE and both bright- and black-blood 3D BOOST imaging using a 4-point scale (1–4, non-diagnostic–fully diagnostic). A two one-sided test of equivalence (TOST) was performed to compare the pre-contrast BOOST images. Nonparametric TOST was performed to compare post-contrast BOOST image quality scores. Results The proposed method produces images from 3.8 × accelerated non-contrast-enhanced BOOST acquisitions with comparable vessel length and sharpness to those obtained from fully- sampled scans in healthy subjects. Moreover, in terms of visual grading, the 3D BOOST LGE datasets (median 4) and the clinical 2D counterpart (median 3.5) were found to be statistically equivalent (p < 0.05). In addition, bright-blood BOOST images allowed for visualization of the proximal and middle left anterior descending and right coronary sections with high diagnostic quality (mean score > 3.5). Conclusions The proposed framework provides high‐resolution 3D whole-heart BOOST images from a single free-breathing acquisition in ~ 7 min.

scholarly journals M2 segment dissection of middle cerebral artery diagnosed using high-resolution magnetic resonance imaging

2017 ◽  
Vol 45 (6) ◽  
pp. 1802-1804
Author(s):  
Xiaoyan Song ◽  
Haiyan Lv ◽  
Jianjun Tang ◽  
Qing Zhang ◽  
Qiaoshu Wang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Imaging Technique ◽  
Intramural Hematoma ◽  
Artery Dissection ◽  
Resonance Imaging ◽  
Intracranial Artery Dissection

Middle cerebral artery (MCA) dissection is a rare cause of ischemic stroke, especially in the M2 or M3 segments. Diagnosis of intracranial artery dissection remains challenging. We herein report a case of M2 segment dissection of the MCA with typical features of an intimal flap and intramural hematoma diagnosed using high-resolution 3T magnetic resonance imaging. This imaging technique might be a more effective noninvasive method by which to diagnose M2 segment dissection of the MCA than either computed tomography angiography or digital subtraction angiography.

Quantitative Analysis Using High-Resolution 3T MRI in Acute Intracranial Artery Dissection

2016 ◽  
Vol 26 (6) ◽  
pp. 612-617 ◽  
Author(s):  
Seung Chai Jung ◽  
Ho Sung Kim ◽  
Choong-Gon Choi ◽  
Sang Joon Kim ◽  
Deok Hee Lee ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
High Resolution ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
3T Mri ◽  
Intracranial Artery Dissection

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.

Abstract WMP71: Moyamoya-atherosclerosis Syndrome: Clinical and High-resolution Magnetic Resonance Imaging Features

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Lian Duan ◽  
Wei-Hai Xu ◽  
Cong Han
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Moyamoya Disease ◽  
Treatment Strategies ◽  
Diagnostic Process ◽  
Imaging Features ◽  
Intracranial Atherosclerosis ◽  
Resonance Imaging

Introduction: The diagnosis in the patients with angiographic moyamoya findings and atherogenic risk factors is challenging. In this study, we try to incorporate high-resolution magnetic resonance imaging (HRMRI) into the diagnostic process of intracranial atherosclerosis associated moyamoya syndrome. Methods: From March 2013 to March 2014, HRMRI was consecutively performed on adult patients with angiographic moyamoya. The patients were classified as moyamoya - plaques (MMD-P) if a plaque could be identified or as moyamoya - no plaques (MMD-NP) if a plaque could not be identified. The angiography, HRMRI findings and atherogenic risk factors of these patients were analyzed. Results: Fifty-one patients (mean age 39±9, 20 males) were enrolled. On traditional angiography, probable intracranial atherosclerosis was identified in 5 patients, no definite diagnosis in 12 patients, and moyamoya disease in 34 patients. On HRMRI, 15 out of 32 patients with risk factors and 4 out of 19 patients without risk factors were found to have plaques and were diagnosed as MMD-P, while the other 32 patients were diagnosed as MMD-NP. The MMD-P patients were more likely to be older and male and were less likely to have cerebral hemorrhage and a history of disease progression. Conclusions: Our study suggests that HRMRI can help diagnose intracranial atherosclerosis more accurately in moyamoya disease patients with atherogenic risk factors. The distinct clinical features between MMD-P and MMD-NP patients suggest different underlying pathophysiology and therefore potentially different treatment strategies.

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