Evaluation of image quality in carotid and cerebrovascular disease: a comparative study between subtraction and routine computed tomography angiography

Zhao, Di; Wan, Yong; Wang, Guokun; Wang, Haibo; Liang, Hongwei; Zhou, Huacheng; Gao, Li; Zhang, Jinling

doi:10.1111/echo.13326

Echocardiography

2016

DOI: 10.1111/echo.13326

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Evaluation of image quality in carotid and cerebrovascular disease: a comparative study between subtraction and routine computed tomography angiography

Di Zhao

Yong Wan

Guokun Wang

et al.

Abstract: Review of SCTA images is an effective means to remove bone close to vessels as seen on routine CTA and has good image quality and diagnostic accuracy. SCTA is superior to routine CTA in the visualization and diagnostic accuracy of adjacent skull base part of the ICA and decreases reading time for carotid and cerebrovascular arterial imaging.

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Cited by 3 publications

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References 16 publications

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“…Imaging of the cerebral vasculature plays a pivotal role in the initial diagnosis of cerebrovascular disorders, such as steno-occlusive arterial disease, cerebral an-eurysm, AVM, and Moyamoya disease, in addition to treatment decisions and follow-up evaluation. 1,2 Although patients suspected of having cerebrovascular disease are best diagnosed with DSA or CTA due to their superior angiogram quality, 3,4 these protocols place patients at risk of ionizing radiation and contrastinduced renal insufficiency.…”

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confidence: 99%

Validation of Zero TE–MRA in the Characterization of Cerebrovascular Diseases: A Feasibility Study

Shang

Dou³

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Zero TE-MRA is less sensitive to field heterogeneity, complex flow, and acquisition noise. This study aimed to prospectively validate the feasibility of zero TE-MRA for cerebrovascular diseases assessment, compared with TOF-MRA. MATERIALS AND METHODS: Seventy patients suspected of having cerebrovascular disorders were recruited. Sound levels were estimated for each MRA subjectively and objectively in different modes. MRA image quality was estimated by 2 neuroradiologists. The degree of stenosis (grades 0-4) and the z-diameter of aneurysms (tiny group Յ3 mm and large group Ͼ3 mm) were measured for further quantitative analysis. CTA was used as the criterion standard. RESULTS: Zero TE-MRA achieved significantly lower subjective perception and objective noise reduction (37.53%). Zero TE-MRA images showed higher signal homogeneity (3.29 Ϯ 0.59 versus 3.04 Ϯ 0.43) and quality of venous signal suppression (3.67 Ϯ 0.47 versus 2.75 Ϯ 0.46). The intermodality agreement was higher for zero TE-MRA than for TOF-MRA (zero TE, 0.90; TOF, 0.81) in the grading of stenosis. Zero TE-MRA had a higher correlation than TOF-MRA (zero TE, 0.84; TOF, 0.74) in the tiny group and a higher consistency with CTA (intraclass correlation coefficient, 0.83; intercept, Ϫ0.5084-1.1794; slope Ϫ0.4952 to Ϫ0.2093) than TOF-MRA (intraclass correlation coefficient, 0.64; intercept, 0.7000-2.6133; slope Ϫ1.0344 to Ϫ0.1923). Zero TE-MRA and TOF-MRA were comparable in the large group. Zero TE-MRA had more accurate details than TOF-MRA of AVM and Moyamoya lesions. CONCLUSIONS: Compared with TOF-MRA, zero TE-MRA achieved more robust performance in depicting cerebrovascular diseases. Therefore, zero TE-MRA was shown to be a promising MRA technique for further routine application in the clinic in patients with cerebrovascular diseases. ABBREVIATIONS: ASL ϭ arterial spin-labeling; AVM ϭ arteriovenous malformation; MRA ϭ magnetic resonance angiography; CTA ϭ computed tomography angiography; CE ϭ contrast-enhanced; TOF ϭ time-of-flight; zTE ϭ zero echo time; MIP ϭ maximum intensity projection; VR ϭ volume rendering; MCA ϭ middle cerebral artery; ICA ϭ internal carotid artery

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mentioning

confidence: 99%

Validation of Zero TE–MRA in the Characterization of Cerebrovascular Diseases: A Feasibility Study

Shang

Dou³

et al. 2019

AJNR Am J Neuroradiol

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Antineuroinflammation of Minocycline in Stroke

Chen

Cai

2017

The Neurologist

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Accumulating research substantiates the statement that inflammation plays an important role in the development of stroke. Both proinflammatory and anti-inflammatory mediators are involved in the pathogenesis of stroke, an imbalance of which leads to inflammation. Anti-inflammation is a kind of hopeful strategy for the prevention and treatment of stroke. Substantial studies have demonstrated that minocycline, a second-generation semisynthetic antibiotic belonging to the tetracycline family, can inhibit neuroinflammation, inflammatory mediators and microglia activation, and improve neurological outcome. Experimental and clinical data have found the preclinical and clinical potential of minocycline in the treatment of stroke due to its anti-inflammation properties and anti-inflammation-induced pathogeneses, including antioxidative stress, antiapoptosis, inhibiting leukocyte migration and microglial activation, and decreasing matrix metalloproteinases activity. Hence, it suggests a great future for minocycline in the therapeutics of stroke that diminish the inflammatory progress of stroke.

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Dual Energy Computed Tomography of Internal Carotid Artery: A Modified Dual-Energy Algorithm for Calcified Plaque Removal, Compared With Digital Subtraction Angiography

Yong-an

et al. 2021

Front. Neurol.

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Background: Atherosclerotic disease of the internal carotid artery (ICA) is a common reason for ischemic stroke. Computed tomography angiography (CTA) is a common tool for evaluation of internal carotid artery (ICA) stenosis. However, blooming artifacts caused by calcified plaques might lead to overestimation of the stenosis grade. Furthermore, the intracranial ICA is more vulnerable to calcification than other ICA segments. The proposed technique, dual-energy computed tomography (DECT) with a modified three-material decomposition algorithm may facilitate the removal of calcified plaques and thus increase diagnostic accuracy.Objectives: The objective of the study is to assess the accuracy of the modified three-material decomposition algorithm for grading intracranial ICA stenosis after calcified plaque removal, with digital subtraction angiography (DSA) used as a reference standard.Materials and Methods: In total, 41 patients underwent DECT angiography and DSA. The three-material decomposition DECT algorithm for calcium removal was applied. We evaluated 64 instances of calcified stenosis using conventional CTA, the previous non-modified calcium removal DECT technique, the modified DECT algorithm, and DSA. The correlation coefficient (r2) between the results generated by the modified algorithm and DSA was also calculated.Results: The virtual non-calcium images (VNCa) produced by the previous non-modified calcium removal algorithm were named VNCa 1, and those produced by the modified algorithm were named VNCa 2. The assigned degree of stenosis of VNCa 1 (mean stenosis: 39.33 ± 19.76%) differed significantly from that of conventional CTA images (mean stenosis: 59.03 ± 25.96%; P = 0.001), DSA (13.19 ± 17.12%, P < 0.001). VNCa 1 also significantly differed from VNCa 2 (mean stenosis: 15.35 ± 18.70%, P < 0.001). In addition, there was a significant difference between the degree of stenosis of VNCa 2 and conventional CTA images (P < 0.001). No significant differences were observed between VNCa 2 and DSA (P = 0.076). The correlation coefficient (r2) between the stenosis degree of the VNCa 2 and DSA images was 0.991.Conclusions: The proposed DECT with a modified three-material decomposition algorithm for calcium removal has high sensitivity for the detection of relevant stenoses, and its results were more strongly correlated with DSA than with those of conventional CTA or the previous non-modified algorithm. Further, it overcomes CTA's previous problem of overestimating the degree of stenosis because of blooming artifacts caused by calcified plaques. It is useful to account for calcified plaques while evaluating carotid stenosis.

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Evaluation of image quality in carotid and cerebrovascular disease: a comparative study between subtraction and routine computed tomography angiography

Cited by 3 publications

References 16 publications

Validation of Zero TE–MRA in the Characterization of Cerebrovascular Diseases: A Feasibility Study

Validation of Zero TE–MRA in the Characterization of Cerebrovascular Diseases: A Feasibility Study

Antineuroinflammation of Minocycline in Stroke

Dual Energy Computed Tomography of Internal Carotid Artery: A Modified Dual-Energy Algorithm for Calcified Plaque Removal, Compared With Digital Subtraction Angiography

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