ISMRM 24th Annual Meeting & Exhibition • 07-13 May 2016 • Singapore

Combined Educational & Scientific Session: Neurovascular: Hemorrhage

Skill Level: Intermediate

Organizers: Greg Zaharachuk, M.D., Ph.D. & Toshiaki Taoka, M.D., Ph.D.

Thursday 12 May 2016

This course will explore the utility of MRI in the setting of brain hemorrhage. Specifically the breadth of MR changes seen in routine clinical practice will be described, as well as the value of mutiparametric MR in better assessing the extent of changes and subsequent prognosis.

Target Audience
This course will describe the spectrum of the MR changes seen in hemorrhage which will benefit both physicists and clinicians involved in their evaluation and care of patients with hemorrhage.

Educational Objectives
Upon completion of this course, participants should be able to:

  • Select an MR protocol that can be used to classify the spectrum of MR appearances in acute TBI;
  • Illustrate and distinguish the different categories of MR appearances in TBI; and
  • Hypothesize mechanisms underlying the MR appearances in TBI.

Moderator: Toshiaki Taoka
Approach to Intracranial Hemorrhage.
Jalal B. Andre1
1Radiology, University of Washington, Seattle, WA, United States
Intracranial hemorrhage (ICH) has been traditionally classified as intra- versus extra-axial in location, and can arise from a variety of etiologies.  This talk will focus on the importance of location, timing, and source of hemorrhage through a case-based exploration of ICH and associated complications as they pertain to the following locations: 1) Intraventricular 2) Intraparenchymal 3) Subarachnoid 4) Subdural 5) Epidural

Multi-contrast joint intra- and extracranial artery wall imaging – a feasibility study
Lei Zhang1, Jun Wu2, Lijie Ren3, Tingting Wang2, Xin Liu1, and Yiu-Cho Chung1
1Paul C. Lauterbur Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academic of Sciences, Shenzhen, China, People's Republic of, 2Neurology, Peking University Shenzhen Hospital, Shenzhen, China, People's Republic of, 3Neurology, Shenzhen Second People’s Hospital, Shenzhen, China, People's Republic of
In this study, we evaluated multi-contrast three dimensional (3D) high resolution black blood vessel wall imaging technique for joint intra- and extracranial artery wall imaging in 8 stroke patients. The new techniques covered both the intra- and extracranial segments in one scan. T1w, T2w scans were performed. MPRAGE was included when hemmorrhage was suspected. 8 plaques were identified.  Two of them had high signal in all three sequences, suggestive of intraplaque hemorrhage. The 3D multi-contrast large coverage black blood techniques would be a promising tool to the study on the association between atherosclerotic plaques and ischemic stroke.

A multiple comparison between 3T intracranial vessel wall sequences
Arjen Lindenholz1, Anita Harteveld1, Jeroen Siero1, Jaco Zwanenburg1, and Jeroen Hendrikse1
1Medical Imaging, UMC Utrecht, Utrecht, Netherlands
In this study we optimized high resolution magnetic resonance vessel wall imaging regarding scan duration signal-to-noise (SNR) and contrast-to-noise (CNR). We compared the SNRs and CNRs two clinically used intracranial vessel wall sequences with 5 variants with various trade-offs between scan time, resolution and contrast between vessel wall and cerebrospinal fluid (CSF). Compared to the clinically used sequences, we developed a sequence which was considerably faster and had comparable or higher SNRs and CNRs that resulted in a good visibility of the intracranial vessel wall.  

Neurovascular Imaging Techniques
Kevin M Johnson1
1Medical Physics, University of Wisconsin - Madison, WI, United States
This overview talk discusses current imaging techniques used for the evaluation of patients at risk for or following hemorrhage. In particular, it provides insight into the state of imaging techniques used to image vascular origins and the growing abilities to correlate vascular structure interactions.

The performances evaluation of 32-channel coil system for extracranial and intracranial artery wall imaging at 3T
Xiaoqing Hu1, Lei Zhang1, Xiao Chen1, Xiaoliang Zhang2,3, Xin Liu1, Hairong Zheng1, Yiu-Cho Chung1, and Ye Li1
1Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, CAS, Shenzhen, China, People's Republic of, 2Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States, 3UCSF/UC Berkeley Joint Graduate Group in Bioengineering, San Francisco, CA, United States
Atherosclerosis is a major cause of ischemic stroke. The high resolution magnetic resonance imaging (MRI) of vessel wall can detect nonstenotic atherosclerotic plaque missed by luminal angiography. To develop a multi-channel radiofrequency (RF) coil system with high spatial resolution and large longitudinal coverage for the intracranial and extracranial arteries vessel wall imaging in one setting. The high resolution images with 0.6 mm3 are obtained with the proposed “24+8” channel coil system from a patient in vivo.

Vessel wall thickness measurements of the circle of Willis using 7.0T MRI
Anita A. Harteveld1, Anja G. van der Kolk1, Nerissa P. Denswil2, Jeroen C.W. Siero1, Hugo J. Kuijf3, Aryan Vink4, Wim G.M. Spliet4, Peter R. Luijten1, Mat J. Daemen2, Jaco J.M. Zwanenburg1,3, and Jeroen Hendrikse1
1Radiology, University Medical Center Utrecht, Utrecht, Netherlands, 2Pathology, Academic Medical Center, Amsterdam, Netherlands, 3Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands, 4Pathology, University Medical Center Utrecht, Utrecht, Netherlands
In the last decade, several MRI sequences have been developed for direct visualization of the intracranial vessel wall. Although much is known about vessel wall (intima-media) thickness of extracranial arteries, less is known about the intracranial arterial vessel wall. In the current study, vessel wall thickness of major intracranial arteries was measured in ex vivo samples of the circle of Willis, using 7T MRI and histological validation, to ultimately provide a reference guide for normal intracranial vessel wall thickness. The results show that ultrahigh-resolution MRI at 7T enables accurate measurement of vessel wall thickness in ex vivoCoW specimens.

Adjournment & Meet the Teachers

The International Society for Magnetic Resonance in Medicine is accredited by the Accreditation Council for
Continuing Medical Education to provide continuing medical education for physicians.