Assessment of carotid atherosclerotic disease using three-dimensional cardiovascular magnetic resonance vessel wall imaging: comparison with digital subtraction angiography

Purpose After stent-assisted treatment for intracranial diseases, three-dimensional time-of-flight magnetic resonance angiography is a noninvasive follow-up method, but susceptibility artifacts prevent accurate evaluations of stented arteries. Sampling perfection with application-optimized contrast using different flip angle evolution (SPACE) sequence often used for vessel wall imaging is less susceptible to susceptibility artifacts, since it is a spin-echo sequence. Hence, we evaluated the feasibility of black-blood magnetic resonance angiography generated from vessel wall imaging data obtained using the SPACE sequence in the depiction of stented arteries by comparing with three-dimensional time-of-flight magnetic resonance angiography and digital subtraction angiography. Methods Our study group comprised 11 consecutive patients. For both three-dimensional time-of-flight magnetic resonance angiography and black-blood magnetic resonance angiography, the contrast ratio obtained from the stented artery and the normal artery proximal to the stent were calculated. And the depiction of stented arteries was visually evaluated. Additionally, the relative diameter index obtained from the stented artery and the normal artery proximal to the stent were calculated for three-dimensional time-of-flight magnetic resonance angiography, black-blood magnetic resonance angiography and digital subtraction angiography. Results The contrast ratio of the stented artery was significantly lower than that of the normal artery on three-dimensional time-of-flight magnetic resonance angiography, but no significant difference was seen using black-blood magnetic resonance angiography. Regarding both the diameter index and the visual assessment score, black-blood magnetic resonance angiography was significantly better than three-dimensional time-of-flight magnetic resonance angiography. On black-blood magnetic resonance angiography, the diameter index was equal to that of digital subtraction angiography, and the flow signal was homogeneous and continuous in most the cases.

Download Full-text

Magnetic resonance vessel wall imaging in intracranial atherosclerotic disease simulating vasculitis

Neurology India ◽

10.4103/0028-3886.258031 ◽

2019 ◽

Vol 67 (2) ◽

pp. 588

Author(s):

PN Sylaja ◽

K Arun ◽

Chinmay Nagesh ◽

C Kesavadas ◽

SapnaE Sreedharan

Keyword(s):

Magnetic Resonance ◽

Vessel Wall ◽

Vessel Wall Imaging ◽

Atherosclerotic Disease ◽

Intracranial Atherosclerotic Disease ◽

Wall Imaging

Download Full-text

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

Advances in Clinical Radiology ◽

10.1016/j.yacr.2019.05.005 ◽

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

Download Full-text

Practical Value of Three-dimensional High Resolution Magnetic Resonance Vessel Wall Imaging in Identifying Suspicious Intracranial Vertebrobasilar Dissecting Aneurysms

10.21203/rs.2.11922/v1 ◽

2019 ◽

Author(s):

Xianjin Zhu ◽

Hancheng Qiu ◽

Ferdinand K Hui ◽

Yiqun Zhang ◽

Yun-e Liu ◽

...

Keyword(s):

Magnetic Resonance ◽

High Resolution ◽

Vessel Wall ◽

Three Dimensional ◽

Vessel Wall Imaging ◽

Catheter Angiography ◽

Double Lumen ◽

Post Contrast ◽

Dissecting Aneurysms ◽

Wall Imaging

Abstract Background: Direct evidence of intimal flaps, double lumen and intramural haematomas (IMH) is difficult to detect on conventional angiography in most intracranial vertebrobasilar dissecting aneurysms (VBDAs). Our purpose was to assess the value of three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR VWI) for identifying VBDAs. Methods: Between August 2013 and January 2016, consecutive patients with suspicious VBDAs were prospectively enrolled to undergo catheter angiography and VWI (pre- and post-contrast). The lesion was diagnosed as definite VBDA when presenting direct signs of dissection; as possible when only presenting indirect signs; and as segmental ectasia when there was local dilation and wall thickness similar to adjacent normal artery’s without mural thrombosis. Results: Twenty-one patients with 27 lesions suspicious for VBDAs were finally included. Based on findings of VWI and catheter angiography, definite VBDA was diagnosed in 25 and 7 lesions (92.6%, vs 25.9%, p = 0.000), respectively; possible VBDA in 0 and 20 (0 vs 74.1%), respectively; and segmental ectasia in 2 and 0 (7.4% vs 0%), respectively. On VWI and catheter angiography, intimal flap was detected in 21 and 7 lesions (77.8% vs 25.9%, p=0.001), respectively; double lumen sign in 18 and 7 (66.7% vs 25.9%, p=0.003), respectively; and IMH sign in 14 and 0 (51.9% vs 0), respectively. Conclusions: 3D HRMR VWI was superior to catheter angiography in achieving definite diagnosis of intracranial VBDAs with higher rate of detection of direct dissection signs; and allowed a promising way to differentiate between VBDA and segmental ectasia.

Download Full-text

Disparate trends of atherosclerotic plaque evolution in stroke patients under 18-month follow-up: a 3D whole-brain magnetic resonance vessel wall imaging study

The Neuroradiology Journal ◽

10.1177/19714009211026920 ◽

2021 ◽

pp. 197140092110269

Author(s):

Jiayu Xiao ◽

Shlee S Song ◽

Konrad H Schlick ◽

Shuang Xia ◽

Tao Jiang ◽

...

Keyword(s):

Magnetic Resonance ◽

Vessel Wall ◽

Morphological Changes ◽

Contrast Ratio ◽

Vessel Wall Imaging ◽

Atherosclerotic Disease ◽

Stroke Recurrence ◽

Intracranial Atherosclerotic Disease ◽

Maximum Wall Thickness ◽

Wall Imaging

Purpose The trend of atherosclerotic plaque feature evolution is unclear in stroke patients with and without recurrence. We aimed to use three-dimensional whole-brain magnetic resonance vessel wall imaging to quantify the morphological changes of causative lesions during medical therapy in patients with symptomatic intracranial atherosclerotic disease. Methods Patients with acute ischemic stroke attributed to intracranial atherosclerotic disease were retrospectively enrolled if they underwent both baseline and follow-up magnetic resonance vessel wall imaging. The morphological features of the causative plaque, including plaque volume, peak normalized wall index, maximum wall thickness, degree of stenosis, pre-contrast plaque-wall contrast ratio, and post-contrast plaque enhancement ratio, were quantified and compared between the non-recurrent and recurrent groups (defined as the recurrence of a vascular event within 18 months of stroke). Results Twenty-nine patients were included in the final analysis. No significant differences were found in plaque features in the baseline scan between the non-recurrent ( n = 22) and recurrent groups ( n = 7). The changes in maximum wall thickness (–13.32% vs. 8.93%, P = 0.026), plaque-wall contrast ratio (–0.82% vs. 3.42%, P = 0.005) and plaque enhancement ratio (–11.03% vs. 9.75%, P = 0.019) were significantly different between the non-recurrent and recurrent groups. Univariable logistic regression showed that the increase in plaque-wall contrast ratio (odds ratio 3.22, 95% confidence interval 1.55–9.98, P = 0.003) was related to stroke recurrence. Conclusion Morphological changes of plaque features on magnetic resonance vessel wall imaging demonstrated distinct trends in symptomatic intracranial atherosclerotic disease patients with and without stroke recurrence.

Download Full-text

Association between homocysteine and multivascular atherosclerosis in stroke-related vascular beds determined by three-dimensional magnetic resonance vessel wall imaging

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2019.08.076 ◽

2019 ◽

Vol 70 ◽

pp. 72-78

Author(s):

Wei Dai ◽

Dongye Li ◽

Ying Cai ◽

Enchao Qiu ◽

Jingwei Xu ◽

...

Keyword(s):

Magnetic Resonance ◽

Vessel Wall ◽

Three Dimensional ◽

Vessel Wall Imaging ◽

Vascular Beds ◽

Wall Imaging

Download Full-text

Practical Value of Three-dimensional High Resolution Magnetic Resonance Vessel Wall Imaging in Identifying Suspicious Intracranial Vertebrobasilar Dissecting Aneurysms

10.21203/rs.2.11922/v3 ◽

2020 ◽

Author(s):

Xianjin Zhu ◽

Hancheng Qiu ◽

Ferdinand K Hui ◽

Yiqun Zhang ◽

Yun-e Liu ◽

...

Keyword(s):

Magnetic Resonance ◽

High Resolution ◽

Vessel Wall ◽

Three Dimensional ◽

Vessel Wall Imaging ◽

Definite Diagnosis ◽

Catheter Angiography ◽

Double Lumen ◽

Dissecting Aneurysms ◽

Wall Imaging

Abstract Background: Direct evidence of intimal flaps, double lumen and intramural haematomas (IMH) is difficult to detect on conventional angiography in most intracranial vertebrobasilar dissecting aneurysms (VBDAs). Our purpose was to assess the value of three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR VWI) for identifying VBDAs. Methods: Between August 2013 and January 2016, consecutive patients with suspicious VBDAs were prospectively enrolled to undergo catheter angiography and VWI (pre- and post-contrast). The lesion was diagnosed as definite VBDA when presenting direct signs of dissection; as possible when only presenting indirect signs; and as segmental ectasia when there was local dilation and wall thickness similar to adjacent normal artery’s without mural thrombosis. Results: Twenty-one patients with 27 lesions suspicious for VBDAs were finally included. Based on findings of VWI and catheter angiography, definite VBDA was diagnosed in 25 and 7 lesions (92.6%, vs 25.9%, p = 0.000), respectively; possible VBDA in 0 and 20 (0 vs 74.1%), respectively; and segmental ectasia in 2 and 0 (7.4% vs 0%), respectively. On VWI and catheter angiography, intimal flap was detected in 21 and 7 lesions (77.8% vs 25.9%, p=0.001), respectively; double lumen sign in 18 and 7 (66.7% vs 25.9%, p=0.003), respectively; and IMH sign in 14 and 0 (51.9% vs 0), respectively. Conclusions: 3D HRMR VWI could detect direct dissection signs more frequently than catheter angiography. This may help obtain definite diagnosis of intracranial VBDAs, and allow accurate differentiation between dissecting aneurysm and segmental ectasia as well. Further prospective study with larger sample was required to investigate the superiority of HRMR VWI for definite diagnosis of intracranial VBDAs than catheter angiography

Download Full-text