Reduced blood flow artifact in intraplaque hemorrhage imaging using CineMPRAGE

Mendes, Jason; Parker, Dennis L.; Kim, Seong Eun; Treiman, Gerald S.

doi:10.1002/mrm.24354

Cited by 14 publications

(13 citation statements)

References 26 publications

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“…9, 28–31 Since patients at our institution underwent imaging with neurovascular rather than surface coils, issues of coil sensitivity related to magnetic field inhomogeneity were not an issue. Experienced neuroradiologists (range of experience, 15 to 40 years) and a cardiothoracic radiologist with subspecialty and academic expertise in vascular biology imaging (A.R.M., experience, 27 years), routinely report the presence of IPH on the clinically acquired 3D T1-weighted GRE imaging acquisition.…”

Section: Methodsmentioning

confidence: 99%

Age-Specific Sex Differences in Magnetic Resonance Imaging-Depicted Carotid Intraplaque Hemorrhage

Singh

Moody

Zhang

et al. 2017

Stroke

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Background and Purpose Stroke rates are higher in males compared to females in the fourth through seventh decades of life, and higher rates may result from differences in carotid intraplaque hemorrhage (IPH), an unstable atherosclerotic plaque component. We report age-specific sex differences in the presence of MRI depicted carotid IPH. Methods Patients (n=1115) underwent MRI for carotid IPH between 2005 and 2014. Low-grade carotid stenosis patients (n=906) without prior endarterectomy were eligible for this cross-sectional study. Results Of the 906 patients included (mean age ± SD in years, 66.98 +/− 15.15), 63 (6.95%) had carotid IPH. In males and females, carotid IPH was present in 11.43% (48/420) and 3.09% (15/486), respectively (p<0.0001). Multivariable logistic regression analysis confirmed greater odds of carotid IPH in males for all ages: 45 to 54 (OR=45.45, 95% CI 3.43 to 500), 55 to 64 years (OR=21.74, 95% CI 3.21 to 142.86), 65 to 74 years (OR=10.42, 95% CI 2.91 to 37.04), and ≥75 years (OR=5.00, 95% CI 2.31 to 10.75). Male sex modified the effect of age on the presence of carotid IPH (β= 0.074, SE=0.036, p=0.0411). Conclusions Males have greater age-specific odds of MRI depicted carotid IPH compared to females. With increasing age post-menopause, the odds of carotid IPH in females becomes closer to that of males. Delayed onset of carotid IPH in females, an unstable plaque component, may partly explain differential stroke rates between sexes and further studies are warranted.

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Section: Methodsmentioning

confidence: 99%

Age-Specific Sex Differences in Magnetic Resonance Imaging-Depicted Carotid Intraplaque Hemorrhage

Singh

Moody

Zhang

et al. 2017

Stroke

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“…A limitation of this study is that motion and flow artifact were not completely eradicated with the SOS modification; however, a further decrease or elimination of these artifacts may be accomplished with cardiac‐gating and postprocessing in a manner similar to the cineMPRAGE technique . Another limitation of this study was the lack of a true gold standard for IPH, although in previous research we found that Cartesian MPRAGE signal highly correlates with IPH on histology .…”

Section: Discussionmentioning

confidence: 92%

Motion-insensitive carotid intraplaque hemorrhage imaging using 3D inversion recovery preparation stack of stars (IR-prep SOS) technique

Kim

Roberts

Eisenmenger

et al. 2016

J. Magn. Reson. Imaging

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Purpose-Carotid artery imaging is important in the clinical management of patients at risk for stroke. Carotid intraplaque hemorrhage (IPH) presents an important diagnostic challenge. 3D magnetization prepared rapid acquisition gradient echo (MPRAGE) has been shown to accurately image carotid IPH; however, this sequence can be limited due to motion-and flow-related artifact. The purpose of this work was to develop and evaluate an improved 3D carotid MPRAGE sequence for IPH detection. We hypothesized that a radial-based k-space trajectory sequence such as "Stack of Stars" (SOS) incorporated with inversion recovery preparation would offer reduced motion sensitivity and more robust flow suppression by oversampling of central k-space.Materials and Methods-A total of 31 patients with carotid disease (62 carotid arteries) were imaged at 3T magnetic resonance imaging (MRI) with 3D IR-prep Cartesian and SOS sequences. Image quality was determined between SOS and Cartesian MPRAGE in 62 carotid arteries using t-tests and multivariable linear regression. Kappa analysis was used to determine interrater reliability.Results-In all, 25 among 62 carotid plaques had carotid IPH by consensus from the reviewers on SOS compared to 24 on Cartesian sequence. Image quality was significantly higher with SOS compared to Cartesian (mean 3.74 vs. 3.11, P < 0.001). SOS acquisition yielded sharper image features with less motion (19.4% vs. 45.2%, P < 0.002) and flow artifact (27.4% vs. 41.9%, P < 0.089). There was also excellent interrater reliability with SOS (kappa = 0.89), higher than that of Cartesian (kappa = 0.84). *Address reprint requests to: S.-E.K., Utah Center for Advanced Imaging Research, 729 Arapeen Dr., Salt Lake City, UT, 84108. sekim@ucair.med.utah.edu. The basic premise of the MPRAGE sequence is that tissue with long T 1 relaxation times (blood and muscle) can be differentiated from tissue with short T 1 relaxation times (hemorrhage and fat) using nonselective inversion recovery preparation. Hemorrhage can be further delineated from fat by the addition of fat saturation to the sequence. The inversion time is selected to minimize the signal from flowing blood and other tissues to allow for maximum hemorrhage contrast. HHS Public AccessAlthough promising, MPRAGE accuracy can be limited by patient motion and flow-related artifact. Higher-resolution 3D MPRAGE requires long scan times to compensate for reduced signal-to-noise ratio (SNR), increasing the likelihood of motion artifacts and nondiagnostic studies. A previous study found that over one-third of MPRAGE exams exhibit motion artifacts. 11 Elimination of motion artifact will improve IPH detection and better assess IPH location relative to surface disruption. A motion-robust 3D radial and Cartesian hybrid sequence such as 3D "Stack of Stars" (SOS) has been used to acquire volumetric k-space data, where radial sampling is performed in-plane (along ky and kx) and Cartesian sampling is used along the slice dimension (kz). 12 Compared with conventional Cartesian sampl...

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“…We have recently developed the ability to limit cardiac pulsation and flow artifact in the MPRAGE sequence, by applying cardiac gating and post‐processing to create a cineMPRAGE . The cineMPRAGE sequence may reduce or eliminate artifact related to motion and flow, and may significantly improve interobserver agreement.…”

Section: Discussionmentioning

confidence: 99%

“…We have recently developed the ability to limit cardiac pulsation and flow artifact in the MPRAGE sequence, by applying cardiac gating and post-processing to create a cineMPRAGE. 33 The cineMPRAGE sequence may reduce or eliminate artifact related to motion and flow, and may significantly improve interobserver agreement. Additional methods such as the slab-selective phase-sensitive inversion-recovery (SPI) or simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) sequences may also play a role by identifying flow related signal artifact and separating this from intraplaque hemorrhage.…”

Section: Discussionmentioning

confidence: 99%