High field carotid vessel wall imaging: A study on reproducibility

Kröner, E.S.J.; Westenberg, Jos J.M.; Geest, Rob J. van der; Brouwer, Niels J.; Doornbos, Joost; Kooi, M. Eline; Wall, E. E. van der; Lamb, Hildo J.; Siebelink, Hmj

doi:10.1016/j.ejrad.2012.11.028

Cited by 10 publications

(9 citation statements)

References 26 publications

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“…However, the limitations in current MRI diagnosis should be overcome with technological developments such as surface coil design and stronger magnetic fields. 16,17 Our results have limitations inherent in the retrospective design of the study. First, it is possible that the elevated ER ratios that we found in symptomatic patients could be the result, rather than the cause, of ischemic events.…”

Section: Discussionmentioning

confidence: 97%

The association between expansive arterial remodeling detected by high-resolution MRI in carotid artery stenosis and clinical presentation

Yoshida

Fukumitsu

Kurosaki

et al. 2015

JNS

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OBJECT The purpose of the present study was to investigate the association between carotid artery (CA) expansive remodeling (ER) and symptoms of cerebral ischemia. METHODS One hundred twenty-two consecutive CAs scheduled for CA endarterectomy (CEA) or CA stent placement (CAS) were retrospectively studied. After excluding 22 CAs (2 were contraindicated for MRI, 8 had near-occlusion, 6 had poor image quality, and 6 had restenosis after CEA or CAS), there were 100 CAs (100 patients) included in the final analysis. The study included 50 symptomatic patients (mean age 73.6 ± 8.9 years, 6 women, mean stenosis 68.5% ± 21.3%) and 50 asymptomatic patients (mean age 72.0 ± 5.9 years, 5 women, mean stenosis 79.4% ± 8.85%). Expansive remodeling was defined as enlargement of the internal carotid artery (ICA) with outward plaque growth. The ER ratio was calculated by dividing the maximum distance between the lumen and the outer borders of the plaque perpendicular to the axis of the ICA by the maximal luminal diameter of the distal ICA at a region unaffected by atherosclerosis using long-axis, high-resolution MRI. RESULTS The ER ratio of the atherosclerotic CA was significantly greater than that of normal physiological expansion (carotid bulb; p < 0.01). The ER ratio of symptomatic CA stenosis (median 1.94, interquartile range [IQR] 1.58–2.23) was significantly greater than that of asymptomatic CA stenosis (median 1.52, IQR 1.34–1.81; p = 0.0001). When the cutoff value of the ER ratio was set to 1.88, the sensitivity and specificity to detect symptoms were 0.6 and 0.78, respectively. The ER ratio of symptomatic patients was consistently high regardless of the degree of stenosis. CONCLUSIONS There was a significant correlation between ER ratio and ischemic symptoms. The ER ratio might be a potential indicator of vulnerable plaque, which requires further validation by prospective observational study of asymptomatic patients.

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Section: Discussionmentioning

confidence: 97%

The association between expansive arterial remodeling detected by high-resolution MRI in carotid artery stenosis and clinical presentation

Yoshida

Fukumitsu

Kurosaki

et al. 2015

JNS

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“…A more recent population-based study has reported considerably lower reproducibility in wall volume, normalized wall index, and mean wall thickness for a 3D IVW CMR sequence [ 25 ]. One of major possible reasons for the better performance of the whole-brain IVW CMR sequence in our study is that two repeat scans were in the same imaging session in healthy volunteers or days apart in patients.. Clearly this same-session investigation strategy for healthy subjects only reveals the scan-rescan repeatability instead of the true longitudinal repeatability of a technique, but has commonly been used in many previous studies [ 26 , 28 , 29 ]. Nevertheless, our findings suggest the possibility for reliable serial examination of IVW using the 3D whole-brain IVW CMR technique as previous carotid studies did [ 26 , 29 , 30 ].…”

Section: Discussionmentioning

confidence: 98%

“…Confidence intervals for the overall ICC were calculated by bootstrap taking in account the correlation between segments in the same patient. An ICC value of less than 0.4 was considered poor agreement, a value of 0.4–0.75 was considered good agreement, and a value of 0.75 or greater was considered excellent agreement [ 26 ]. Bland-Altman analysis was also used to determine the scan-rescan, intra-, and inter-observer reproducibility of 3D IVW CMR as well as inter-method agreement between 3D IVW CMR and 2D TSE in quantifying vessel dimensions for volunteers.…”

Section: Methodsmentioning

confidence: 99%

3D whole-brain vessel wall cardiovascular magnetic resonance imaging: a study on the reliability in the quantification of intracranial vessel dimensions

Zhang

Deng

et al. 2018

Journal of Cardiovascular Magnetic Resonance

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BackgroundOne of the potentially important applications of three-dimensional (3D) intracranial vessel wall (IVW) cardiovascular magnetic resonance (CMR) is to monitor disease progression and regression via quantitative measurement of IVW morphology during medical management or drug development. However, a prerequisite for this application is to validate that IVW morphologic measurements based on the modality are reliable. In this study we performed comprehensive reliability analysis for the recently proposed whole-brain IVW CMR technique.MethodsThirty-four healthy subjects and 10 patients with known intracranial atherosclerotic disease underwent repeat whole-brain IVW CMR scans. In 19 of the 34 subjects, two-dimensional (2D) turbo spin-echo (TSE) scan was performed to serve as a reference for the assessment of vessel dimensions. Lumen and wall volume, normalized wall index, mean and maximum wall thickness were measured in both 3D and 2D IVW CMR images. Scan-rescan, intra-observer, and inter-observer reproducibility of 3D IVW CMR in the quantification of IVW or plaque dimensions were respectively assessed in volunteers and patients as well as for different healthy subjectsub-groups (i.e. < 50 and ≥ 50 years). The agreement in vessel wall and lumen measurements between the 3D technique and the 2D TSE method was also investigated. In addition, the sample size required for future longitudinal clinical studies was calculated.ResultsThe intra-class correlation coefficient (ICC) and Bland-Altman plots indicated excellent reproducibility and inter-method agreement for all morphologic measurements (All ICCs > 0.75). In addition, all ICCs of patients were equal to or higher than that of healthy subjects except maximum wall thickness. In volunteers, all ICCs of the age group of ≥50 years were equal to or higher than that of the age group of < 50 years. Normalized wall index and mean and maximum wall thickness were significantly larger in the age group of ≥50 years. To detect 5% - 20% difference between placebo and treatment groups, normalized wall index requires the smallest sample size while lumen volume requires the highest sample size.ConclusionsWhole-brain 3D IVW CMR is a reliable imaging method for the quantification of intracranial vessel dimensions and could potentially be useful for monitoring plaque progression and regression.Electronic supplementary materialThe online version of this article (10.1186/s12968-018-0453-z) contains supplementary material, which is available to authorized users.

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“…Multi-contrast MRI has been used widely in assessing plaque components and vulnerability [ 2 , 3 , 12 , 26 – 34 ]. Originally this was performed at 1.5 T [ 2 , 26 – 30 ], however the studies are now more commonly performed at 3 T due to the superior signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) [ 31 – 33 , 35 – 37 ]. In addition, the development of 3-D sequences allows for larger coverage, better through-plane resolution, higher scanning efficiency, less motion artefact and more precise plaque segmentation [ 3 , 12 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional black-blood multi-contrast carotid imaging using compressed sensing: a repeatability study

Yuan

Usman

Reid

et al. 2017

Magn Reson Mater Phy

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ObjectiveThe purpose of this work is to evaluate the repeatability of a compressed sensing (CS) accelerated multi-contrast carotid protocol at 3 T.Materials and methodsTwelve volunteers and eight patients with carotid disease were scanned on a 3 T MRI scanner using a CS accelerated 3-D black-blood multi-contrast protocol which comprises T 1w, T 2w and PDw without CS, and with a CS factor of 1.5 and 2.0. The volunteers were scanned twice, the lumen/wall area and wall thickness were measured for each scan. Eight patients were scanned once, the inter/intra-observer reproducibility of the measurements was calculated.ResultsIn the repeated volunteer scans, the interclass correlation coefficient (ICC) for the wall area measurement using a CS factor of 1.5 in PDw, T 1w and T 2w were 0.95, 0.81, and 0.97, respectively. The ICC for lumen area measurement using a CS factor of 1.5 in PDw, T 1w and T 2w were 0.96, 0.92, and 0.96, respectively. In patients, the ICC for inter/intra-observer measurements of lumen/wall area, and wall thickness were all above 0.81 in all sequences.ConclusionThe results show a CS accelerated 3-D black-blood multi-contrast protocol is a robust and reproducible method for carotid imaging. Future protocol design could use CS to reduce the scanning time.

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High field carotid vessel wall imaging: A study on reproducibility

Cited by 10 publications

References 26 publications

The association between expansive arterial remodeling detected by high-resolution MRI in carotid artery stenosis and clinical presentation

The association between expansive arterial remodeling detected by high-resolution MRI in carotid artery stenosis and clinical presentation

3D whole-brain vessel wall cardiovascular magnetic resonance imaging: a study on the reliability in the quantification of intracranial vessel dimensions

Three-dimensional black-blood multi-contrast carotid imaging using compressed sensing: a repeatability study

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