scholarly journals Comparison of time-of-flight MR angiography and intracranial vessel wall MRI for luminal measurements relative to CT angiography

2020 ◽  
pp. 20200743
Author(s):  
Basar Sarikaya ◽  
Charles Colip ◽  
William D Hwang ◽  
Daniel S Hippe ◽  
Chengcheng Zhu ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Measurement Accuracy ◽  
Random Order ◽  
Concordance Correlation ◽  
Tof Mra ◽  
Intracranial Vessel ◽  
Significant Bias ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Made In

Objective: To assess whether intracranial vessel wall (IVW) MRI luminal measurements are more accurate than non-contrast 3D-TOF-MRA measurements for intracranial atherosclerotic stenosis, relative to CTA. Methods: Consecutive patients with non-calcified intracranial atherosclerotic stenosis seen on CTA, who had non-contrast 3D-TOF-MRA and IVW performed between 1 January 2013 and 20 April 2014 were selected, and images with stenosis were pre-selected by a single independent rater. The pre-selected CTA, MRA, and IVW (T1-weighted) images were then reviewed by two independent raters blinded to the other measurements in random order. Measurements were made in a plane perpendicular to the lumen on each modality. MRA and IVW measurements were compared to CTA, to determine which more accurately matched the degree of stenosis. Results: 18 patients with 33 intracranial atherosclerotic stenoses were included. Relative to CTA, IVW had 40% less variance than MRA (p = .004). IVW had a significantly higher concordance correlation coefficient (CCC) relative to CTA than MRA (.87 vs .68, p = .002). IVW and MRA did not have significant bias relative to CTA, however, 8/33 lesions showed >20% overestimation of the degree of stenosis on MRA, compared to 1/33 for IVW. CCC between raters were 0.84 (95% CI 0.67–0.93) for CTA, 0.83 (0.67–0.93) for TOF-MRA, and 0.85 (0.71–0.94) for IVW. For stenosis >50% sensitivity was 82% for IVW and 64% for MRA, while specificity was 73% for both. Conclusion: IVW provides more accurate stenosis measurements than MRA when compared to CTA. Advances in knowledge: Considering higher stenosis measurement accuracy of IVW, it can be more reliably used for quantitative evaluation relative to MRA.

Visualization of the lenticulostriate arteries at 3T using black-blood T1-weighted intracranial vessel wall imaging: comparison with 7T TOF-MRA

2018 ◽  
Vol 29 (3) ◽  
pp. 1452-1459 ◽  
Author(s):  
Zihao Zhang ◽  
Zhaoyang Fan ◽  
Qingle Kong ◽  
Jiayu Xiao ◽  
Fang Wu ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Vessel Wall Imaging ◽  
Black Blood ◽  
Lenticulostriate Arteries ◽  
Tof Mra ◽  
Intracranial Vessel ◽  
Wall Imaging

scholarly journals Bench-Top Comparison of Three Different Types of Stents Used for Treatment of Intracranial Atherosclerotic Stenosis

2020 ◽  
Vol 15 (3) ◽  
pp. 117-125
Author(s):  
Jung-soo Park ◽  
Hyo Sung Kwak ◽  
Jin-Woo Kim
Keyword(s):  
Kinetic Energy ◽  
Vessel Wall ◽  
Mechanical Characteristics ◽  
Bending Stiffness ◽  
Bending Test ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Different Types ◽  
Wall Apposition ◽  
Curved Vessels

Purpose: Four key bench-top tests, including trackability, conformability, wall-apposition, and bending stiffness, were performed to understand the mechanical characteristics in 3 different types of stents applicable for treatment of intracranial atherosclerotic stenosis: Balloon-expandable D<sup>+</sup>Storm, Pro-Kinetic Energy, and self-expandable Wingspan stents.Materials and Methods: Trackability was assessed by measuring the tracking forces of each stent with its delivery systems. Conformability and wall apposition were quantified and analyzed using curved vessel models. A 3-point bending test was employed to evaluate bending stiffness.Results: D<sup>+</sup>Storm showed the lowest tracking forces while the conformability of the Wingspan stent was superior to that of the tested stents. Pro-Kinetic Energy and D<sup>+</sup>Storm had better wall apposition in curved vessels than the Wingspan stent. Bending stiffness of the Wingspan stent was notably lower, whereas no significant differences were found between D<sup>+</sup>Storm and Energy. Pro-Kinetic Energy and D<sup>+</sup>Storm not only indicated lower gap ratios between the struts and the vessel wall but also maintained good wall apposition even in the curved model.Conclusion: These bench-top measurements may provide clinicians with useful information in regard to selecting suitable stents for treatment of intracranial atherosclerotic stenosis.

Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 264-274
Author(s):  
Dagmar Krajíčková ◽  
Antonín Krajina ◽  
Miroslav Lojík ◽  
Martina Mulačová ◽  
Martin Vališ
Keyword(s):  
Death Rate ◽  
Long Term Outcomes ◽  
Single Centre ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Angioplasty And Stenting ◽  
Aggressive Medical Management ◽  
Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

Intracranial Vessel Wall MRI in a Rabbit Elastase Aneurysm Model

2019 ◽  
Author(s):  
James Ho ◽  
Nakisa Sadeghi ◽  
Ilana Galex ◽  
Nathan Davis ◽  
Sofia Cabello ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Intracranial Vessel ◽  
Aneurysm Model

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

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.

Symptomatic and asymptomatic intracranial atherosclerotic stenosis: 3 years’ prospective study

2020 ◽  
Vol 267 (6) ◽  
pp. 1687-1698 ◽  
Author(s):  
Urs Fischer ◽  
Kety Hsieh-Meister ◽  
Frauke Kellner-Weldon ◽  
Aikaterini Galimanis ◽  
Xin Yan ◽  
...  
Keyword(s):  
Prospective Study ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis

scholarly journals Complex wall modeling for hemodynamic simulations of intracranial aneurysms based on histologic images

2021 ◽  
Vol 16 (4) ◽  
pp. 597-607
Author(s):  
Annika Niemann ◽  
Samuel Voß ◽  
Riikka Tulamo ◽  
Simon Weigand ◽  
Bernhard Preim ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Geometric Model ◽  
Image Data ◽  
Outer Wall ◽  
3D Models ◽  
Patient Specific ◽  
Intracranial Vessel ◽  
Hemodynamic Simulations

Abstract Purpose For the evaluation and rupture risk assessment of intracranial aneurysms, clinical, morphological and hemodynamic parameters are analyzed. The reliability of intracranial hemodynamic simulations strongly depends on the underlying models. Due to the missing information about the intracranial vessel wall, the patient-specific wall thickness is often neglected as well as the specific physiological and pathological properties of the vessel wall. Methods In this work, we present a model for structural simulations with patient-specific wall thickness including different tissue types based on postmortem histologic image data. Images of histologic 2D slices from intracranial aneurysms were manually segmented in nine tissue classes. After virtual inflation, they were combined into 3D models. This approach yields multiple 3D models of the inner and outer wall and different tissue parts as a prerequisite for subsequent simulations. Result We presented a pipeline to generate 3D models of aneurysms with respect to the different tissue textures occurring in the wall. First experiments show that including the variance of the tissue in the structural simulation affect the simulation result. Especially at the interfaces between neighboring tissue classes, the larger influence of stiffer components on the stability equilibrium became obvious. Conclusion The presented approach enables the creation of a geometric model with differentiated wall tissue. This information can be used for different applications, like hemodynamic simulations, to increase the modeling accuracy.

Abstract WMP55: Vessel Wall Characteristics using High Resolution Magnetic Resonance Imaging in Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Russell Cerejo ◽  
Seby John ◽  
Tariq Hammad ◽  
Emmanuel C. Obusez ◽  
Rula Hajj-ali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Central Nervous System ◽  
Vessel Wall ◽  
Clinical Presentation ◽  
Wall Thickening ◽  
Resonance Imaging ◽  
Cns Vasculitis ◽  
Cerebral Vasoconstriction ◽  
Intracranial Vessel ◽  
Vessel Stenosis

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) and central nervous system (CNS) vasculitis often have similar initial clinical presentation, laboratory findings and imaging features creating a diagnostic dilemma. High-resolution-3-Tesla Magnetic Resonance Imaging with Gadolinium contrast (HR-MRI) is a non-invasive method to look at intracranial vessel wall characteristics. Methods: A retrospective analysis of all patients with a diagnosis of RCVS or CNS vasculitis that underwent HR-MRI at our institution was performed. Inclusion criteria for RCVS were clinical presentation, no aneurysmal subarachnoid hemorrhage, normal cerebrospinal fluid and reversible multifocal intracranial vessel stenosis whereas criteria for CNS vasculitis were cases with positive brain biopsy or typical clinical presentation, course and laboratory markers with rheumatology and stroke neurology agreement in diagnosis. Demographics, clinical presentation, laboratory testing, imaging studies and outcomes were collected. Results: Eleven patients with RCVS [10 (90.9%) females, mean age 45.2] and 8 with CNS vasculitis [6 primary CNS vasculitis, 6 (75%) males, mean age 43.5] were included in the study. No abnormal vessel wall enhancement or thickening was seen in any of the RCVS patients in areas of vessel stenosis. Six (75%) of CNS vasculitis patients had vessel wall thickening or enhancement (p=0.001 for comparison to RCVS) and the remaining 2 patients had HR-MRI performed 6 and 10 years after diagnosis and chronic treatment. All RCVS patients who had follow up HR-MRI demonstrated resolution of the multifocal stenosis. Two out of 4 CNS vasculitis patients with subsequent HR-MRI imaging had decrease in vessel wall thickening and enhancement after immunosuppressive therapy. Conclusion: In acute stages of presentation, HR-MRI may be useful in differentiating RCVS from CNS vasculitis. It may also be useful in following the disease course to look for resolution of intracranial vessel stenosis in RCVS or treatment response in vasculitis. Further studies are needed to confirm the utility of HR-MRI in diagnosis and disease progression in RCVS and vasculitis.

Abstract 1122‐000172: High Resolution Vessel Wall Imaging and Cerebrovascular Plaques: Comparison with DSA, MRA, and CTA

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Rami Fakih ◽  
Alberto Miller ◽  
Ashrita Raghuram ◽  
Sebastian Herrera ◽  
Sedat Kandemirli ◽  
...  
Keyword(s):  
Vessel Wall ◽  
The Other ◽  
Imaging Modalities ◽  
Plaque Burden ◽  
Rater Agreement ◽  
Cross Sectional ◽  
Tof Mra ◽  
Plaque Detection ◽  
Wall Imaging

Introduction : Current imaging modalities might underestimate the presence and severity of intracranial atherosclerosis (ICAD). High resolution vessel wall imaging (HR‐VWI) MRI emerged as a powerful tool to diagnose plaques not detected on routine imaging. We aim to compare different imaging modalities (HR‐VWI MRI; digital subtraction angiogram (DSA); Time‐of‐flight (TOF) MRA; and CTA) in the identification and characterization of intracranial atherosclerotic culprit plaques. Methods : Patients diagnosed with ICAD were prospectively imaged with HR‐VWI MRI. Culprit plaques were identified based on the likelihood of causing the stroke. Using cross‐sectional images of intracranial vessels, regions of interest (ROI) were delineated. Then, diameters and ROI areas were measured for the purpose of calculating the following variables: degree of stenosis (DS) at the plaque level, plaque burden (PB), and remodeling index (RI). Additional imaging modalities (DSA, TOF MRA, and CTA) were identified retrospectively for each patient. The sensitivity of detecting a culprit plaque as well as the correlations between the different variables were analyzed for each modality. Linear regression analysis was used to determine the association of DS with PB and RI. Interobserver agreement on the determination of a culprit plaque on every imaging modality was evaluated. Results : A total of 44 patients who underwent HR‐VWI had ICAD and were included in the final analysis. Of those, 34 had CTA, 18 had TOF‐MRA, and 18 had DSA. Using HR‐VWI as gold standard, the sensitivity for culprit plaque detection was 88% for DSA, 78% for TOF MRA, and 76% for CTA. We found no difference between the DS in all four modalities using measured cross‐sectional diameters, but difference was found when measuring ROI areas to calculate DS. There was a significant positive correlation between PB and DS on HR‐VWI MRI (p<0.001), but not on the DSA (p = 0.168), MRA (p = 0.144), or CTA (p = 0.253), and a significant negative correlation between RI and DS on HR‐VWI MRI (p = 0.003), but not on DSA (p = 0.783), MRA (p = 0.405), or CTA (p = 0.751). PB and RI predicted the degrees of stenosis on HR‐VWI, but not on the other modalities. There was good inter‐rater agreement for culprit plaque detection on HR‐VWI (k = 0.48, p = 0.001), but no agreement was found on the other modalities. Conclusions : HR‐VWI MRI can locate otherwise undetectable plaques on conventional imaging through the ability to measure plaque burden, an essential component for characterization of plaques severity and a strong predictor of stenosis. HR‐VWI also showed more accurate measurements of degree of stenosis through measurement of ROI areas, and had good inter‐rater agreement for accurate plaque detection, compared to DSA, MRA, and CTA.

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