ISMRM & SMRT Annual Meeting • 15-20 May 2021
Vessel Walls, Flow & Angiography in Stroke Imaging
|Concurrent 6||17:00 - 18:00|
||High-Resolution Vessel Wall Imaging: Association of Plaque with Morphological Changes of Lenticulostriate Arteries in SSIs
Hui Wang1, Xianchang Zhang2, Quanzhi Feng1, Yutian Li1, Jinli Li1, Yujun Wang3, Guangzhao Yang3, Qingle Kong2, Zihao Zhang4, and Tong Han1
1Radiology, Tianjin Huanhu Hospital, Tianjin, China, 2MR Collaboration, Siemens Healthcare Lid., Beijing, China, 3Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, China, 4State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
This study evaluated the association between plaque existence and lenticulostriate artery (LSA) morphology using high-resolution vessel wall imaging (HR-VWI) in patients with lenticulostriate infarction and non-stenotic middle cerebral artery (MCA). Patients were divided into plaque and non-plaque groups based on the plaque presence in the MCA-M1 segment of the infarcted hemisphere. Atheromatous plaque was found in 52.8% of patients, and the laterality index of the LSA and total length were higher in the plaque group. These findings suggest that HR-VWI may help distinguish branch from non-branch atheromatous small vessel disease.
||Quantification of hemodynamics of cerebral arteriovenous malformations after stereotactic radiosurgery using 4D Flow MRI
Shanmukha Srinivas1, Tara Retson1, Aaron Simon2, Marc Alley3, Shreyas Vasanawala3, Jona Hattangadi-Gluth2, Albert Hsiao1, and Nikdokht Farid1
1Department of Radiology, University of California San Diego, San Diego, CA, United States, 2Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, CA, United States, 3Department of Radiology, Stanford University, Stanford, CA, United States
This study evaluated the use of 4D flow MRI to assess hemodynamic changes to cerebral arteriovenous malformations after stereotactic radiosurgery (SRS). As a comparison, structural changes of AVMs were measured on T2W single shot fast spin echo (SSFSE) and time-of-flight (TOF) angiography. Hemodynamic changes, including reduction in feeding arterial flow and draining venous flow, preceded structural changes including arterial circumference and nidus volume for large arteriovenous malformations. This study demonstrated the potential utility of 4D flow MRI as a robust tool to supplement existing imaging techniques and measure early treatment response after stereotactic radiosurgery (SRS).
||Generating virtual brains for MRI-based 3D cerebral blood flow simulations
Tamás I. Józsa1, Jan Petr2, Alle Meije Wink3, Frederik Barkhof3, Henk J. M. M. Mutsaerts3, and Stephen J. Payne1
1Department of Engineering Science, University of Oxford, Oxford, United Kingdom, 2Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany, 3Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
Human brain perfusion simulations have been limited to less than five patient-specific cases. We propose a pipeline based on MRI to overcome this limitation. Computational geometry is adjusted using T1-weighted MRI, and the perfusion model parameters are tuned based on arterial spin labeling perfusion MRI. A cohort of 75 patients is used to demonstrate that the pipeline is suitable to generate virtual patients with statistically accurate and precise cerebral blood flow maps. Our findings encourage future studies on in silico clinical trials using similar virtual cohorts to improve ischaemic stroke interventions.
||Measuring pulse wave velocity in the cerebral arterial tree using 4D flow MRI
Cecilia Björnfot1, Anders Garpebring1, Sara Qvarlander1, Jan Malm2, Anders Eklund1, and Anders Wåhlin1,3
1Department of Radiation Sciences, Umeå University, Umeå, Sweden, 2Department of Clinical Sciences, Umeå University, Umeå, Sweden, 3Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
Age-related arterial wall hardening could be detrimental to brain function via several pathways. A consequence of vessel wall hardening is the increased velocity at which the cardiac-induced pulse wave travels. Previously, pulse wave velocity in the aorta and extracranial arteries have been linked to brain pathology. However, there's a lack of “target-organ” measurements. Here we present a 4D flow MRI method to estimate pulse wave velocity in the cerebral arterial tree. The method is shown to be stable in an internal consistency test, and of sufficient sensitivity to robustly detect age-related increases in intracranial pulse wave velocity.
||Integration of high-resolution ultra-high-field 7T magnetic resonance vessel neuroimaging into clinical routine: preliminary results
Piotr Radojewski1, Arun Joseph2,3,4, Gabriele Bonnano2,3,4, Tom Hilbert5,6,7, Tobias Kober5,7,8, Jan Gralla1, Roland Wiest1, and Pasquale Mordasini1
1Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Inselspital,, Bern, Switzerland, 22. Advanced Clinical Imaging Technology, Siemens Healthcare AG, Bern, Switzerland, 33. Translational Imaging Center, Sitem-Insel, Bern, Switzerland, 44. Departments of Radiology and Biomedical Research, University of Bern, Bern, Switzerland, 55. Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland, 66. Department of Radiology, , Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, 77. LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland, 86. Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
MRI-based vessel imaging has two goals, the anatomico-morphological depiction and vessel wall imaging, including delineation of contrast enhancement within the vessel wall. We performed sequence implementation and optimization in healthy volunteers to establish a dedicated 7T MRI protocol for vessel imaging at 7T. We implemented MPRAGE, T2 TSE, SWI, and ToF for anatomico-morphological vessel-delineation and optimized T1 SPACE and T1 SE for vessel wall delineation.
||Cerebrovascular dual-venc 4D flow MRI: Assessment of arterial pulsatility and resistance measures in intracranial atherosclerotic disease
Jackson Moore1, Maria Aristova1, Ramez Abdalla1, Ann Ragin1, Eric Russell1, Fan Caprio2, Michael Hurley1, Susanne Schnell3, Sameer A. Ansari1, and Michael Markl1
1Radiology, Northwestern University, Chicago, IL, United States, 2Neurology, Northwestern University, Chicago, IL, United States, 3Universitaet Greifswald, Greifswald, Germany
Intracranial atherosclerotic disease (ICAD) is a known risk factor for ischemic stroke. There is a need to develop quantitative imaging biomarkers to identify patients who may not respond to medical management. Here, the pulsatility index (PI) and resistivity index (RI) are derived from 4D flow MRI using a semi-automated vessel identification and segmentation workflow for 7 subjects with severe ICAD. Initial results show significant asymmetries (PI: 0.89 ± 0.2 vs 1.06 ± 0.1, p = 0.04; RI: 0.92 ± 0.1 vs 1.03 ± 0.07, p = 0.009) for affected vessels as well as contralateral hemisphere changes compared to controls.
||Reproducibility of quantitative measures of intracranial arterial geometry: dependence on sequence and scanner platform differences
Niranjan Balu1, Wenjin Liu1, Zhensen Chen1, Anders Gould1, Dan S Hippe1, Li Chen1, Binbin Sui2, Mi Shen2, Peiyi Gao2, Thomas S Hatsukami1, and Chun Yuan1
1Radiology, University of Washington, Seattle, WA, United States, 2Beijing Tiantan Hospital, Beijing, China
Distal intracranial artery length measurement on TOF-MRA is a biomarker of age-related vascular changes but its measurement reproducibility in multi-center setting is unknown. We studied the dependence of measurement reproducibility on protocol and scanner platform variation. Reproducibility increased with increasing superior-inferior TOF-MRA coverage and consistency of imaging parameters. After correcting for these factors, high reproducibility was achieved between Philips 3T and Siemens 3T scanner platforms suggesting feasibility of quantitative intracranial vessel length measurements for multi-platform serial MRI studies.
||Preliminary study on plaque characteristics of intracranial artery atherosclerotic stroke in young adults
Ling Li1, Xiao Ling Zhang1, Min Tang1, Xue jiao Yan1, Nian E Ma1, Xiao Yan Lei1, Xin Zhang1, Juan Li1, and Kai Ai2
1Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China, 2Philips Healthcare, Xi'an, China
The aim of this study was to investigate plaque characteristics and clinical risk factors of intracranial atherosclerotic stroke in young adults. The vessel wall characteristics of plaque and clinical data were compared between young and old patients. Our results showed that maximum vessel wall thickness, narrowest vascular area and vessel wall area of young patients were significantly lower than those of old patients, while the number of young patients with plaque positive remodeling was higher. In addition, the number of young people suffering from hyperhomocysteinemia was significantly higher than that of old patients, while suffering from hypertension was significantly lower.
||Ultrahigh Resolution 3T Clinical Black-blood Angiography: A new imaging biomarker of aneurysm occlusion following endovascular therapy
Adam E. Goldman-Yassen1, Eytan Raz2, Anna Derman2, Ahrya Derakhshani3, and Seena Dehkharghani2,4
1Department of Radiology, Children's Healthcare of Atlanta, Atlanta, GA, United States, 2Department of Radiology, New York University Langone Medical Center, New York, NY, United States, 3Department of Radiology, UCLA Health, Los Angeles, CA, United States, 4Department of Neurology, New York University Langone Medical Center, New York, NY, United States
High-resolution black-blood vessel wall imaging optimized with robust flow suppression offers reproducible, reliable, and non-invasive longitudinal evaluation of flow diversion treated aneurysms, with superior overall classification accuracy relative to conventional TOF or dynamic MRA. Aneurysm and parent vessel enhancement may persist even after angiographic occlusion during the healing phase of obliterated aneurysm.
||Material investigation for in vitro aneurysm flow model that mimics the arterial vessel and examining the flow in rigid wall model using 4D Flow MRI
Isil Unal1, Duygu Dengiz2, Eckhard Quandt2, Mona Salehi Ravesh1, Jan-Bernd Hövener3, Mariya Pravdivtseva1, and Olav Jansen1
1Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany, Kiel, Germany, 2Institute for Materials Science, Faculty of Engineering, University of Kiel, Germany., Kiel, Germany, 3Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Kiel, Germany
Blood flow , which is one of the factors leading to aneurysm rupture, can be measured in vivo by 4D flow MRI. In this study, the flow in 3D printed, patient-derived models was measured in vitro. Elastic modulus of materials were investigated to mimic the real brain arteries.
||The application of High-Resolution Vessel Wall MRI(HR-VW-MRI) in determining the stability of intracranial MCA and BA plaques
Hongwei Zhou1, Derui Kong1, and Tianjing Zhang2
1The First Hospital of JiLin University, Changchun City,Jilin Province, China, 2Philips healthcare, Guangzhou City,Guangdong Province, China
The stability of intracranial of the middle cerebral artery(MCA) and basilar artery( BA) plaques related to the stroke events is a crucial issue. However, the discrimination of the plaque’s stability could be rather challenging. Compared with traditional imaging methods such as CTA, MRA or DSA, high-resolution vessel wall MR imaging(HR-VW-MRI) method could demonstrate the abnormality of the vessel wall .It could also potentially evaluate the stability of the intracranial artery. This study aims to compare HR-VW-MRI’s characteristic features of MCA plaque with BA plaque, and to figure out the relationship between plaques’ imaging features with the stroke events.
||Significant lower WSS and higher OSI on enhanced wall area of intracranial aneurysm
Mingzhu Fu1, Shuo Chen1, Miaoqi Zhang1, and Rui Li1
1Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
we studied the relationship between aneurysm wall enhancement and distribution of hemodynamic parameters including WSS and OSI on aneurysm wall from pixel-wise perspective based on the self-control of aneurysm. Statistics indicated that enhanced wall area of intracranial aneurysm had significant lower WSS and higher OSI.
||Silent MR Angiography for the Depiction of cerebral arteriovenous Malformations: A Comparison of Techniques
Chunxue Wu1, Mengqi Dong1, Tao Hong2, Hongqi Zhang1, and Jie Lu1
1Xuanwu Hospital Capital Medical University, Beijing, China, firstname.lastname@example.org, Beijing, China
Digital subtraction angiography (DSA) is the golden standard of radiological technique for diagnosis and treatment evaluation of cerebral arteriovenous malformations (CAVMs). However, DSA is invasive and ionizing radiative. Silent MRA, which combines arterial spin labeling (ASL) and an ultrashort time echo (UTE), is used for CAVM structure visualization. The silent MRA is superior to TOF-MRA and enables the same Spetzler-Martin classification of cerebral AVM as that at DSA.
||Comparisons of high-resolution intracranial vessel wall MRI findings in different types of middle cerebral artery territory infarction
So Yeon Won1, Jihoon Cha1, Hyun Seok Choi1, Young Dae Kim2, Hyo Suk Nam2, Ji Hoe Heo2, and Seung-Koo Lee1
1Radiology, Severance Hospital, Seoul, Korea, Republic of, 2Neurology, Severance Hospital, Seoul, Korea, Republic of
Our object is the evaluation of spatial relationship of MCA plaque and perforator in different types of MCA infarction using VW-MRI. We included 34 patients with acute MCA infarction and divided into 3 groups according to infarction pattern. We evaluated location relationship between perforators and plaques. Wall area, stenosis degree and plaque enhancement were calculated. There was difference in relationship between plaque and perforator, location and characteristics of plaque in different types of MCA infarction. In patients with BOD, the plaque margin was closer to perforator orifice with less stenosis and enhancement than patients with artery to artery embolism.
||Application of 3D vessel wall high-resolution MR(3D VW-MR) imaging in Primary Angiitis of the Central Nervous System
Hongwei Zhou1, Derui Kong1, and Tianjing Zhang2
1The First Hospital of JiLin University, Changchun City,Jilin Province, China, 2Philips healthcare, Guangzhou City,Guangdong Province, China
Primary angiitis of the central nervous system(PACNS) is a kind of rare disease,but the clinical diagnosis is difficult. Recently, high-resolution HR-3D-VW-MRI(3-dimensional vessel wall MR imaging) method has been used to evaluate cerebral vessels because it could directly show the vessel wall as well the lumen;thus it can assist in differentiating various types of vasculopathy. The purpose of our study was to summarize the typical imaging performance of PACNS and evaluate the value of 3D- VW-MRI sequence in demonstrating the detailed information in detection, diagnosis, evaluation, and follow-up for PACNS.
||Application Value of High-resolution Vessel Wall Imaging for Quantitative Analysis of Lipid-rich Necrotic
Mengjiao Wei1, Yang Gao1, Qiong Wu1, Shaoyu Wang2, and Huapeng Zhang2
1Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China, 2MR Scientific Marketing, Siemens Healthineers, Shanghai, China
This study investigated the feasibility and accuracy of the maximum wall thickness(MWT), the lipid-rich necrotic core percentage(%LRNC) and the carotid atherosclerosis (CAS) score to predict stroke and diagnose vulnerable plaques. Our results showed that quantitative lipid-rich necrotic core can effectively diagnose vulnerable plaques and predict the risk of stroke, in addition, the CAS score can simply grade carotid artery plaques and provide a basis for clinical diagnosis and treatment.
||Evaluation of registration accuracy for cerebral vessel on pre- and postcontrast T1 black blood images by Elastix
Wei Qiu1, Hanyu Wei1, Shuo Chen1, and Rui Li1
1Center for Biomedical Image Research, Department of Medicine, Tsinghua University, Beijing, China
Image registration plays a prominent role in medical image processing pipeline1. It’s of interest to assess pre-post variation for registered vessels on black blood MR images. In this research, Elastix tool was applied to register pre-contrast T1 and post-contrast T1 black blood images, use our own methods to actually and accurately evaluate the accuracy of the registration, and achieved promising quantitative results. The study suggests that Elastix performs good registration accuracy of the two images, and can be directly used for automatic image processing, so as to more conveniently serve clinical applications.
||The Impact of Acceleration Factors of Compressed Sensing on the Image Quality of 3D-TOF-MRA for Cervical Vessels
Haonan Zhang1, Qingwei Song1, Jiazheng Wang2, Peng Sun2, Renwang Wang1, Nan Zhang1, and Ailian Liu1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, 2PHILIPS——Philips Healthcare, beijing, China
Traditional 3D-TOF Magnetic Resonance Angiography (MRA) in carotid imaging needs a relatively long scan time and is prone to be disturbed by motion artifacts such as vascular pulsation, respiratory movement, and some other physiological factors. A combination of compressed sensing (CS) can achieve high acceleration factors and thus lead to a significant reduction of scan time. Here, we investigated the impact of acceleration factors of compressed sensing on the image quality of 3D-TOF-MRA for cervical vessels. CS acceleration factor of 6 is recommended for clinical 3D-TOF carotid MRA to achieve an optimal balance between imaging time and image quality.
||Investigation into the Cerebrovascular Effects of Gender Affirming Therapy in Transgender Men using TOF-MRA and pCASL
Samantha Cote1, Reihaneh Forouhandehpour1, Etienne Croteau1, Diane Rottembourg2, Jean-Francois Lepage2, and Kevin Whittingstall3
1Département de médecine nucléaire et radiobiologie, Université de Sherbrooke, Sherbrooke, QC, Canada, 2Département de pédiatrie, Université de Sherbrooke, Sherbrooke, QC, Canada, 3Département de radiologie diagnostique, Université de Sherbrooke, Sherbrooke, QC, Canada
We investigated if gender affirming hormonal therapy (GAHT) in young transgender men receiving testosterone (T) impacts cerebrovascular function and structure using pseudo-continuous arterial spin labelling (pCASL) and time of flight magnetic resonance angiography (TOF). We observed decreases in CBF and arterial vessel diameter. These results suggest an association between increased serum T and decreases in CBF which may be related to changes in cerebrovascular morphology.
||Type and Time of Dialysis Are Independent Indicators for Carotid Atherosclerosis in End-stage Renal Disease Patients on Dialysis
Yuze Li1, Chunmiao Chen2, Yajie Wang1, Jie Li2, Xiaoli Sun2, Shuiwei Xia2, Lie Jin2, Yani Ye2, Jiansong Ji2, and Huijun Chen1
1Center for Biomedical Imaging Research, Medical School, Tsinghua University, Beijing, China, 2The Central Hospital of Zhejiang Lishui, Lishui, China
In this work, the vessel wall characteristics of carotid artery was measured on T1w, T2w and SNAP images in end-stage renal disease patients on dialysis. Totally, 94 patients were included. The time on dialysis was significantly and positively correlated with the mean wall area (p=0.012), normalized wall index (p=0.006), maximal wall thickness (p=0.005) and mean wall thickness (p=0.010). The presence of plaque was found to be significantly and independently associated with the dialysis type (p=0.047) and time on dialysis (p=0.032).
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