Variable impact of CSF flow suppression on quantitative 3.0T intracranial vessel wall measurements
Cogswell, Petrice M; Siero, Jeroen C W; Lants, Sarah K; Waddle, Spencer; Davis, L Taylor; Gilbert, Guillaume; Hendrikse, Jeroen; Donahue, Manus J
(2018) Journal of Magnetic Resonance Imaging, volume 48, issue 4, pp. 1120 - 1128
(Article)
Abstract
BACKGROUND: Flow suppression techniques have been developed for intracranial (IC) vessel wall imaging (VWI) and optimized using simulations; however, simulation results may not translate in vivo. PURPOSE: To evaluate experimentally how IC vessel wall and lumen measurements change in identical subjects when evaluated using the most commonly available blood and
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cerebrospinal fluid (CSF) flow suppression modules and VWI sequences. STUDY TYPE: Prospective. POPULATION/SUBJECTS: Healthy adults (n = 13; age = 37 ± 15 years) were enrolled. FIELD STRENGTH/SEQUENCE: A 3.0T 3D T 1 /proton density (PD)-weighted turbo-spin-echo (TSE) acquisition with post-readout anti-driven equilibrium module, with and without Delay-Alternating-with-Nutation-for-Tailored-Excitation (DANTE) was applied. DANTE flip angle (8-12°) and TSE refocusing angle (sweep = 40-120° or 50-120°) were varied. ASSESSMENT: Basilar artery and internal carotid artery (ICA) wall thicknesses, CSF signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and signal ratio (SR) were assessed. Measurements were made by two readers (radiology resident and board-certified neuroradiologist). STATISTICAL TESTS: A Wilcoxon signed-rank test was applied with corrected two-sided P < 0.05 required for significance (critical P = 0.008, 0.005, and 0.05 for SNR/CNR, SR, and wall thickness, respectively). RESULTS: A TSE pulse sweep = 40-120° and sweep = 50-120° provided similar (P = 0.55) CSF suppression. Addition of the DANTE preparation reduced CSF SNR from 17.4 to 6.7, thereby providing significant (P < 0.008) improvement in CSF suppression. The DANTE preparation also resulted in a significant (P < 0.008) reduction in vessel wall SNR, but variable vessel wall to CSF CNR improvement (P = 0.87). There was a trend for a difference in blood SNR with vs. without DANTE (P = 0.05). The outer vessel wall diameter and wall thickness values were lower (P < 0.05) with (basilar artery 4.45 mm, 0.81 mm, respectively) vs. without (basilar artery 4.88 mm, 0.97 mm, respectively) DANTE 8°. DATA CONCLUSION: IC VWI with TSE sweep = 40-120° and with DANTE flip angle = 8° provides the best CSF suppression and CNR of the approaches evaluated. However, improvements are heterogeneous, likely owing to intersubject vessel pulsatility and CSF flow variations, which can lead to variable flow suppression efficacy in these velocity-dependent modules. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;48:1120-1128.
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Keywords: CSF, DANTE, intracranial stenosis, vessel wall imaging, Protons, Prospective Studies, Humans, Middle Aged, Male, Young Adult, Computer Simulation, Image Processing, Computer-Assisted/methods, Adult, Female, Image Interpretation, Computer-Assisted/methods, Imaging, Three-Dimensional, Image Enhancement/methods, Carotid Artery, Internal/diagnostic imaging, Cerebrospinal Fluid/metabolism, Signal-To-Noise Ratio, Magnetic Resonance Angiography, Cerebrovascular Circulation, Brain/blood supply, Basilar Artery/diagnostic imaging, Contrast Media, Radiology, Radiology Nuclear Medicine and imaging, Research Support, Non-U.S. Gov't, Journal Article, Research Support, N.I.H., Extramural
ISSN: 1053-1807
Publisher: John Wiley and Sons Inc.
Note: Funding Information: Southeastern affiliate; contract grant number: 14GRNT20150004; Contract grant sponsor: AHA National affiliate; contract grant number: 14CSA20380466 Funding Information: Contract grant sponsor: NIH/NINDS; contract grant numbers: 1R01NS07882801A1; 1R01NS097763; Contract grant sponsor: NIH/NINR; contract grant number: 1R01NR01507901; Contract grant sponsor: AHA Publisher Copyright: © 2018 International Society for Magnetic Resonance in Medicine
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