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Liao W, Shi G, Lv Y, Liu L, Tang X, Jin Y, Ning Z, Zhao X, Li X, Chen Z. Accurate and robust segmentation of cerebral vasculature on four-dimensional arterial spin labeling magnetic resonance angiography using machine-learning approach. Magn Reson Imaging 2024; 110:86-95. [PMID: 38631533 DOI: 10.1016/j.mri.2024.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/13/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
Segmentation of cerebral vasculature on MR vascular images is of great significance for clinical application and research. However, the existing cerebrovascular segmentation approaches are limited due to insufficient image contrast and complicated algorithms. This study aims to explore the potential of the emerging four-dimensional arterial spin labeling magnetic resonance angiography (4D ASL-MRA) technique for fast and accurate cerebrovascular segmentation with a simple machine-learning approach. Nine temporal features were extracted from the intensity-time signal of each voxel, and eight spatial features from the neighboring voxels. Then, the unsupervised outlier detection algorithm, i.e. Isolation Forest, is used for segmentation of the vascular voxels based on the extracted features. The total length of the centerlines of the intracranial arterial vasculature, the dice similarity coefficient (DSC), and the average Hausdorff Distance (AVGHD) on the cross-sections of small- to large-sized vessels were calculated to evaluate the performance of the segmentation approach on 4D ASL-MRA of 18 subjects. Experiments show that the temporal information on 4D ASL-MRA can largely improve the segmentation performance. In addition, the proposed segmentation approach outperforms the traditional methods that were performed on the 3D image (i.e. the temporal average intensity projection of 4D ASL-MRA) and the previously proposed frame-wise approach. In conclusion, this study demonstrates that accurate and robust segmentation of cerebral vasculature is achievable on 4D ASL-MRA by using a simple machine-learning approach with appropriate features.
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Affiliation(s)
- Weibin Liao
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Gen Shi
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Yi Lv
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Lixin Liu
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China
| | - Xihe Tang
- Department of Neurosurgery, Aviation General Hospital of China Medical University, Beijing 100012, China
| | - Yongjian Jin
- Department of Neurosurgery, Aviation General Hospital of China Medical University, Beijing 100012, China
| | - Zihan Ning
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Xuesong Li
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing 100081, China.
| | - Zhensen Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Beijing 200433, China.
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Konta N, Shibukawa S, Horie T, Niwa T, Obara M, Okazaki T, Kawamura Y, Miyati T. Turbo spin-echo-based enhanced acceleration-selective arterial spin labeling without electrocardiography or peripheral pulse unit triggering and contrast enhancement for lower extremity MRA. Magn Reson Imaging 2024; 110:43-50. [PMID: 38604346 DOI: 10.1016/j.mri.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/28/2024] [Accepted: 04/07/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE Lower extremity magnetic resonance angiography (MRA) without electrocardiography (ECG) or peripheral pulse unit (PPU) triggering and contrast enhancement is beneficial for diagnosing peripheral arterial disease (PAD) while avoiding synchronization failure and nephrogenic systemic fibrosis. This study aimed to compare the diagnostic performance of turbo spin-echo-based enhanced acceleration-selective arterial spin labeling (eAccASL) (TSE-Acc) of the lower extremities with that of turbo field-echo-based eAccASL (TFE-Acc) and triggered angiography non-contrast enhanced (TRANCE). METHODS Nine healthy volunteers and a patient with PAD were examined on a 3.0 Tesla magnetic resonance imaging (MRI) system. The artery-to-muscle signal intensity ratio (SIR) and contrast-to-noise ratio (CNR) were calculated. The arterial visibility (1: poor, 4: excellent) and artifact contamination (1: severe, 4: no) were independently assessed by two radiologists. Phase-contrast MRI and digital subtraction angiography were referenced in a patient with PAD. Friedman's test and a post-hoc test according to the Bonferroni-adjusted Wilcoxon signed-rank test were used for the SIR, CNR, and visual assessment. p < 0.05 was considered statistically significant. RESULTS No significant differences in nearly all the SIRs were observed among the three MRA methods. Higher CNRs were observed with TSE-Acc than those with TFE-Acc (anterior tibial artery, p = 0.014; peroneal artery, p = 0.029; and posterior tibial artery, p = 0.014) in distal arterial segments; however, no significant differences were observed upon comparison with TRANCE (all p > 0.05). The arterial visibility scores exhibited similar trends as the CNRs. The artifact contamination scores with TSE-Acc were significantly lower (but within an acceptable level) compared to those with TFE-Acc. In the patient with PAD, the sluggish peripheral arteries were better visualized using TSE-Acc than those using TFE-Acc, and the collateral and stenosis arteries were better visualized using TSE-Acc than those using TRANCE. CONCLUSION Peripheral arterial visualization was better with TSE-Acc than that with TFE-Acc in lower extremity MRA without ECG or PPU triggering and contrast enhancement, which was comparable with TRANCE as the reference standard. Furthermore, TSE-Acc may propose satisfactory diagnostic performance for diagnosing PAD in patients with arrhythmia and chronic kidney disease.
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Affiliation(s)
- Natsuo Konta
- Department of Radiology, Tokai University Hospital, Kanagawa, Japan; Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan.
| | - Shuhei Shibukawa
- Department of Radiological Technology, Juntendo University, Tokyo, Japan
| | - Tomohiko Horie
- Department of Radiology, Tokai University Hospital, Kanagawa, Japan
| | - Tetsu Niwa
- Department of Diagnostic Radiology, Tokai University School of Medicine, Kanagawa, Japan
| | | | - Takashi Okazaki
- Department of Diagnostic Radiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Yui Kawamura
- Department of Diagnostic Radiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Toshiaki Miyati
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan
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Yogi A, Ito J, Ishikawa K, Heianna J, Sakugawa S, Aguni N, Obara M, Maeda H, Nishie A. The effect of arterial spin labeling MR angiography (ASL-MRA) in visualizing the branches of external carotid artery. Sci Rep 2024; 14:4490. [PMID: 38396152 PMCID: PMC10891102 DOI: 10.1038/s41598-024-55018-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 02/19/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to assess the performance of arterial-spin labeling MRA (ASL-MRA) for visualizing the external carotid artery (ECA) branches in comparison with time-of-flight MRA (TOF-MRA) and CT angiography (CTA). We retrospectively selected 31 consecutive patients, who underwent both MRAs and CTA, prior to the intra-arterial chemoradiotherapy (IACRT) for head and neck cancer. Four patients underwent IACRT bilaterally, so we analyzed 35 ECAs. Pseudo-continuous, three-dimensional ASL using a turbo field echo sequence was acquired. For the TOF-MRA and CTA, clinically used parameters were applied. Two observers evaluated each ECA branch with reference to the angiogram at the IACRT, using five-point scale, in consensus. Friedman test for multiple comparisons was applied. ASL-MRA and CTA better visualized the superior thyroid, lingual, facial, submental, transverse facial, and internal maxillary arteries (IMAs) better than TOF-MRA (p < 0.05). In addition, CTA was superior to ASL-MRA in visualizing only submental artery among these arteries (p = 0.0005). Alternatively, the ASL-MRA was superior for visualizing the middle meningeal artery (MMA) and IMA, compared to the CTA (p = 0.0001 and 0.0007, respectively). ASL-MRA was superior to the TOF-MRA and similar to the CTA in visualizing most of ECA branches. Furthermore, ASL-MRA can better visualize the periphery of MMA and IMA than CTA.
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Affiliation(s)
- Akira Yogi
- Department of Radiology, University of the Ryukyus Hospital, 207 Uehara, Nishihara-Cho, , Nakagami-Gun, Okinawa, 903-0125, Japan.
| | - Junji Ito
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan
| | - Kazuki Ishikawa
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan
| | - Joichi Heianna
- Department of Radiology, University of the Ryukyus Hospital, 207 Uehara, Nishihara-Cho, , Nakagami-Gun, Okinawa, 903-0125, Japan
- Department of Radiology, Nanbu Tokushukai Hospital, 171-1 Hokama Yaese-Cho, Shimajiri-Gun, Okinawa, 901-0493, Japan
| | - Satoshi Sakugawa
- Department of Radiology, University of the Ryukyus Hospital, 207 Uehara, Nishihara-Cho, , Nakagami-Gun, Okinawa, 903-0125, Japan
| | - Narihisa Aguni
- Department of Radiology, University of the Ryukyus Hospital, 207 Uehara, Nishihara-Cho, , Nakagami-Gun, Okinawa, 903-0125, Japan
| | - Makoto Obara
- Philips Japan Healthcare, 13-37, Kohnan 2-Chome, Minato-Ku, Tokyo, Japan
| | - Hiroyuki Maeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan
| | - Akihiro Nishie
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan
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Togao O, Obara M, Yamashita K, Kikuchi K, Wada T, Murazaki H, Arimura K, Nishimura A, Horie N, van de Ven K, Van Cauteren M, Ishigami K. Arterial Spin Labeling-Based MR Angiography for Cerebrovascular Diseases: Principles and Clinical Applications. J Magn Reson Imaging 2023. [PMID: 37937684 DOI: 10.1002/jmri.29119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023] Open
Abstract
Arterial spin labeling (ASL) is a noninvasive imaging technique that labels the proton spins in arterial blood and uses them as endogenous tracers. Brain perfusion imaging with ASL is becoming increasingly common in clinical practice, and clinical applications of ASL for intracranial magnetic resonance angiography (MRA) have also been demonstrated. Unlike computed tomography (CT) angiography and cerebral angiography, ASL-based MRA does not require contrast agents. ASL-based MRA overcomes most of the disadvantages of time-of-flight (TOF) MRA. Several schemes have been developed for ASL-based MRA; the most common method has been pulsed ASL, but more recently pseudo-continuous ASL, which provides a higher signal-to-noise ratio (SNR), has been used more frequently. New methods that have been developed include direct intracranial labeling methods such as velocity-selective ASL and acceleration-selective ASL. MRA using an extremely short echo time (eg, silent MRA) or ultrashort echo-time (TE) MRA can suppress metal susceptibility artifacts and is ideal for patients with a metallic device implanted in a cerebral vessel. Vessel-selective 4D ASL MRA can provide digital subtraction angiography (DSA)-like images. This review highlights the principles, clinical applications, and characteristics of various ASL-based MRA techniques. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Osamu Togao
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuhiro Wada
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroo Murazaki
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | | | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Zhang X, Lei Y, Su J, Gao C, Li Y, Feng R, Xia D, Gao P, Gu Y, Mao Y. Individualised evaluation based on pathophysiology for moyamoya vasculopathy: application in surgical revascularisation. Stroke Vasc Neurol 2023:svn-2023-002464. [PMID: 37640496 DOI: 10.1136/svn-2023-002464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/26/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Although bypass surgery is an effective treatment for moyamoya vasculopathy (MMV), the incidence of postoperative complications is still high. This study aims to introduce a novel evaluating system based on individualised pathophysiology of MMV, and to assess its clinical significance. METHODS This multicentre, prospective study enrolled adult patients with MMV from Huashan Hospital, Fudan University and National Center for Neurological Disorders, China between March 2021 and February 2022. Multimodal neuroimages containing structural and functional information were used to evaluate personalised disease severity and fused to localise the surgical field, avoid invalid regions and propose alternative recipient arteries. The recipient artery was further selected intraoperatively by assessing regional haemodynamic and electrophysiological information. The preanastomosis and postanastomosis data were compared with assist with the postoperative management. Patients who received such tailored revascularisations were included in the novel group and the others were included in the traditional group. The 30-day surgical outcomes and intermediate long-term follow-up were compared. RESULTS Totally 375 patients (145 patients in the novel group and 230 patients in the traditional group) were included. The overall complication rate was significantly lower in the novel group (p˂0.001). In detail, both the rates of postoperative infarction (p=0.009) and hyperperfusion syndrome (p=0.010) were significantly lower. The functional outcomes trended to be more favourable in the novel group, though not significantly (p=0.260). Notably, the proportion of good functional status was higher in the novel group (p=0.009). Interestingly, the preoperative statuses of perfusion and metabolism around the bypass area were significantly correlated with the occurrence of postoperative complications (P˂0.0001). CONCLUSIONS This novel evaluating system helps to identify appropriate surgical field and recipient arteries during bypass surgery for MMV to achieve better haemodynamic remodelling and pathophysiological improvement, which results in more favourable clinical outcomes.
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Affiliation(s)
- Xin Zhang
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
| | - Yu Lei
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
| | - Jiabin Su
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
| | - Chao Gao
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
| | - Yanjiang Li
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
| | - Rui Feng
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
| | - Ding Xia
- Department of Radiology, Huashan Hospital Fudan University, Shanghai, China
| | - Peng Gao
- Department of Radiology, Huashan Hospital Fudan University, Shanghai, China
| | - Yuxiang Gu
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
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Lindner T, Bolar DS, Achten E, Barkhof F, Bastos-Leite AJ, Detre JA, Golay X, Günther M, Wang DJJ, Haller S, Ingala S, Jäger HR, Jahng GH, Juttukonda MR, Keil VC, Kimura H, Ho ML, Lequin M, Lou X, Petr J, Pinter N, Pizzini FB, Smits M, Sokolska M, Zaharchuk G, Mutsaerts HJMM. Current state and guidance on arterial spin labeling perfusion MRI in clinical neuroimaging. Magn Reson Med 2023; 89:2024-2047. [PMID: 36695294 PMCID: PMC10914350 DOI: 10.1002/mrm.29572] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 01/26/2023]
Abstract
This article focuses on clinical applications of arterial spin labeling (ASL) and is part of a wider effort from the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group to update and expand on the recommendations provided in the 2015 ASL consensus paper. Although the 2015 consensus paper provided general guidelines for clinical applications of ASL MRI, there was a lack of guidance on disease-specific parameters. Since that time, the clinical availability and clinical demand for ASL MRI has increased. This position paper provides guidance on using ASL in specific clinical scenarios, including acute ischemic stroke and steno-occlusive disease, arteriovenous malformations and fistulas, brain tumors, neurodegenerative disease, seizures/epilepsy, and pediatric neuroradiology applications, focusing on disease-specific considerations for sequence optimization and interpretation. We present several neuroradiological applications in which ASL provides unique information essential for making the diagnosis. This guidance is intended for anyone interested in using ASL in a routine clinical setting (i.e., on a single-subject basis rather than in cohort studies) building on the previous ASL consensus review.
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Affiliation(s)
- Thomas Lindner
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Divya S. Bolar
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Eric Achten
- Department of Radiology and Nuclear Medicine, Ghent University, Ghent, Belgium
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, UK
| | | | - John A. Detre
- Department of Neurology, University of Pennsylvania, Philadelphia PA USA
| | - Xavier Golay
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Matthias Günther
- (1) University Bremen, Germany; (2) Fraunhofer MEVIS, Bremen, Germany; (3) mediri GmbH, Heidelberg, Germany
| | - Danny JJ Wang
- Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles CA USA
| | - Sven Haller
- (1) CIMC - Centre d’Imagerie Médicale de Cornavin, Place de Cornavin 18, 1201 Genève 1201 Genève (2) Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (3) Faculty of Medicine of the University of Geneva, Switzerland. Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, P. R. China
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Hans R Jäger
- UCL Queen Square Institute of Neuroradiology, University College London, London, UK
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Meher R. Juttukonda
- (1) Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown MA USA (2) Department of Radiology, Harvard Medical School, Boston MA USA
| | - Vera C. Keil
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical sciences, University of Fukui, Fukui, JAPAN
| | - Mai-Lan Ho
- Nationwide Children’s Hospital and The Ohio State University, Columbus, OH, USA
| | - Maarten Lequin
- Division Imaging & Oncology, Department of Radiology & Nuclear Medicine | University Medical Center Utrecht & Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Xin Lou
- Department of Radiology, Chinese PLA General Hospital, Beijing, China
| | - Jan Petr
- (1) Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany (2) Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Nandor Pinter
- Dent Neurologic Institute, Buffalo, NY, USA. University at Buffalo Neurosurgery, Buffalo, NY, USA
| | - Francesca B. Pizzini
- Radiology Institute, Dept. of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Marion Smits
- (1) Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands (2) The Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Magdalena Sokolska
- Department of Medical Physics and Biomedical Engineering University College London Hospitals NHS Foundation Trust, UK
| | | | - Henk JMM Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Wang Z, Ji C, Han Q, Wang Z, Huang Y. Data-Independent Acquisition-Based Serum Proteomic Profiling of Adult Moyamoya Disease Patients Reveals the Potential Pathogenesis of Vascular Changes. J Mol Neurosci 2022; 72:2473-85. [PMID: 36520382 DOI: 10.1007/s12031-022-02092-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
Moyamoya disease (MMD) is a chronic cerebrovascular disease with unknown etiology. The pathogenesis of vascular changes remains unclear. Ischemic and hemorrhagic adult MMD patients and healthy volunteers were enrolled to collect serum for data-independent acquisition (DIA)-based proteomic analysis and ELISA validation. DIA serum proteomic revealed that apolipoprotein C-I (APOC1), apolipoprotein D (APOD), and apolipoprotein A-IV (APOA4) were decreased. The reductases glutathione S-transferase omega-1 (GSTO1) and peptidyl-prolyl cis-trans isomerase A (PPIA) were upregulated, and ADAMTS-like protein 4 (ADAMTSL4) was downregulated in both ischemic and hemorrhagic MMD. Afamin (AFM) and transforming growth factor-beta-induced protein ig-h3 (TGFBI) increased in ischemic patients but decreased in hemorrhagic patients. Serum ELISA results confirmed that APOA4, APOC1, and APOD were decreased compared to controls. Then, we retrospectively analyzed biochemical indexes of 200 MMD patients. A total of 54 enrolled MMD patients showed decreased total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-c). APOA4, APOC1, and APOD were vital factors in the HDL decrease in MMD patients. Lipoprotein dysfunction in MMD patients is involved in MMD. Intimal thickening by enhanced adhesion, middle layer vascular smooth muscle cell migration, and decreased lipid antioxidant function represented by HDL are potential pathogeneses of vascular changes in MMD.
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Liu S, Fan D, Zang F, Gu N, Yin Y, Ge X, Zhang L, Chen X, Zhang Z, Xie C. Collateral circulation detected by arterial spin labeling predicts outcome in acute ischemic stroke. Acta Neurol Scand 2022; 146:635-642. [PMID: 36062837 DOI: 10.1111/ane.13694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/16/2022] [Accepted: 08/14/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Robust collateral circulation is strongly associated with good outcomes in acute ischemic stroke (AIS). AIMS To determine whether collateral circulation detected by arterial spin labeling (ASL) magnetic resonance imaging could predict good clinical outcome in AIS patients with 90 days follow-up. MATERIALS AND METHODS Total 58 AIS patients with anterior circulation stroke were recruited. Collateral circulation was defined as arterial transit artifact in ASL images. Modified Rankin Scale (mRS), the Barthel Index, and National Institutes of Health Stroke Scale (NIHSS) were employed to evaluate neurological function for the baseline and 90 days follow-up. The percent changes of these scores were also calculated, respectively. Finally, a support vector classifier model of machine learning and receiver operating characteristic curve were employed to estimate the power of ASL collaterals (ASLcs) predicting the clinical outcome. RESULTS Patients with ASLcs represented higher rate of good outcome (83.30% vs. 31.25%, p < .001) and lower follow-up mRS scores (p < .001), when compared to patients without ASLcs. There were significant differences for percent changes of mRS scores and NIHSS scores between these two groups. Further, the presence of ASLcs could predict good clinical outcome (OR, 1.54; 95% CI, 1.10-2.16), even after controlling for baseline NIHSS scores. The SVC model incorporating baseline NIHSS scores and ASLcs had significant predictive effect (accuracy, 79.3%; AUC, 0.806) on clinical prognosis for AIS patients. DISCUSSION We targeted on the non-invasive assessment of collateral circulation using ASL technique and found that patients with ASLcs were more likely to have a good clinical outcome after AIS. This finding is of guiding significance for treatment selection and prognostic prediction. CONCLUSIONS Early ASLcs assessment provides a good powerful tool to predict clinical outcome for AIS patients with 90 days follow-up.
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Affiliation(s)
- Sangni Liu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Dandan Fan
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Feifei Zang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Nan Gu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yun Yin
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xiao Ge
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ling Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xiang Chen
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhengsheng Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Neuropsychiatric Institute, Affiliated ZhongDa Hospital, Southeast University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Neuropsychiatric Institute, Affiliated ZhongDa Hospital, Southeast University, Nanjing, China.,The Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, China
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Fukushima Y, Fushimi Y, Funaki T, Sakata A, Hinoda T, Nakajima S, Sakamoto R, Yoshida K, Miyamoto S, Nakamoto Y. Evaluation of moyamoya disease in CT angiography using ultra-high-resolution computed tomography: Application of deep learning reconstruction. Eur J Radiol 2022; 151:110294. [DOI: 10.1016/j.ejrad.2022.110294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/09/2022] [Accepted: 04/02/2022] [Indexed: 02/04/2023]
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10
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Okada T, Fujimoto K, Fushimi Y, Akasaka T, Thuy DHD, Shima A, Sawamoto N, Oishi N, Zhang Z, Funaki T, Nakamoto Y, Murai T, Miyamoto S, Takahashi R, Isa T. Neuroimaging at 7 Tesla: a pictorial narrative review. Quant Imaging Med Surg 2022; 12:3406-3435. [PMID: 35655840 PMCID: PMC9131333 DOI: 10.21037/qims-21-969] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/05/2022] [Indexed: 01/26/2024]
Abstract
Neuroimaging using the 7-Tesla (7T) human magnetic resonance (MR) system is rapidly gaining popularity after being approved for clinical use in the European Union and the USA. This trend is the same for functional MR imaging (MRI). The primary advantages of 7T over lower magnetic fields are its higher signal-to-noise and contrast-to-noise ratios, which provide high-resolution acquisitions and better contrast, making it easier to detect lesions and structural changes in brain disorders. Another advantage is the capability to measure a greater number of neurochemicals by virtue of the increased spectral resolution. Many structural and functional studies using 7T have been conducted to visualize details in the white matter and layers of the cortex and hippocampus, the subnucleus or regions of the putamen, the globus pallidus, thalamus and substantia nigra, and in small structures, such as the subthalamic nucleus, habenula, perforating arteries, and the perivascular space, that are difficult to observe at lower magnetic field strengths. The target disorders for 7T neuroimaging range from tumoral diseases to vascular, neurodegenerative, and psychiatric disorders, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, epilepsy, major depressive disorder, and schizophrenia. MR spectroscopy has also been used for research because of its increased chemical shift that separates overlapping peaks and resolves neurochemicals more effectively at 7T than a lower magnetic field. This paper presents a narrative review of these topics and an illustrative presentation of images obtained at 7T. We expect 7T neuroimaging to provide a new imaging biomarker of various brain disorders.
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Affiliation(s)
- Tomohisa Okada
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Fujimoto
- Department of Real World Data Research and Development, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Thai Akasaka
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Dinh H. D. Thuy
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Shima
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobukatsu Sawamoto
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoya Oishi
- Medial Innovation Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Zhilin Zhang
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Funaki
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tadashi Isa
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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11
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Wang M, Ma Y, Chen F, Zhou F, Zhang J, Zhang B. Acceleration of pCASL-Based Cerebral 4D MR Angiography Using Compressed SENSE: A Comparison With SENSE. Front Neurol 2022; 13:796271. [PMID: 35386411 PMCID: PMC8977489 DOI: 10.3389/fneur.2022.796271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 02/22/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives The objectives of this study were to accelerate the non-contrast-enhanced four-dimensional magnetic resonance angiography (4D MRA) based on pseudocontinuous arterial spin labeling combined with the Keyhole and View-sharing (4D-PACK) procedure using the Compressed SENSE (C-SENSE) and to improve intracranial vasculopathy evaluations for clinical purposes. Methods 4D-PACK acquisition with different C-SENSE and SENSE acceleration factors was performed on 29 healthy volunteers and six patients by means of a 3.0 T MR system. Two radiologists used a 4-grade scale to qualitatively assess the vessel visualization of the middle cerebral artery (MCA) and used a 5-grade scale to qualitatively examine the image quality of 4D-PACK axial source images. Interobserver agreement was assessed by determining the weighted kappa statistic. The contrast-to-noise ratio (CNR) and arterial transmit time (ATT) were calculated in four segments of the MCA. The repeated measures one-way ANOVA for CNR and the Friedman test for source images and vessel visualization were used to analyse the differences in five sequences. Results (1) At the M4 segment, C-SENSE5 acquisition (scores, 2.72 ± 0.53) and C-SENSE6.5 (scores, 2.55 ± 0.57) provided similar vessel visualization compared with SENSE4.5 (scores, 2.72 ± 0.46); however, C-SENSE8 (scores, 1.79 ± 0.49) and C-SENSE10 (scores, 1.52 ± 0.51) had lower scores (P < 0.050). (2) The source image quality of C-SENSE5 (scores, 4.55 ± 0.51), C-SENSE6.5 (scores, 4.03 ± 0.33), and C-SENSE8 (scores, 3.48 ± 0.51) acquisition was higher than that of SENSE4.5 (scores, 3.07 ± 0.26) (P < 0.001). (3) CNRs of different MCA segments for C-SENSE5 and C-SENSE6.5 acquisitions were not significantly different compared with that of SENSE4.5 acquisition. However, the CNRs were significantly lower for C-SENSE8 (M1: 45.85 ± 13.91, M2: 27.08 ± 9.92, M4: 7.93 ± 4.49) and C-SENSE10 (M1: 37.94 ± 9.92, M2: 23.51 ± 9.0, M4: 6.78 ± 4.12) than for SENSE4.5 (M1: 55.49 ± 13.39, M2: 36.94 ± 11.02, M4: 10.18 ± 5.15) in each corresponding segment (P < 0.050). ATTs in all MCA segments within different accelerating C-SENSE factors were obviously correlated with SENSE4.5. Conclusion C-SENSE6.5 acquisition could be used to evaluate both the intracranial macrovascular and distal arteries, which could reduce the acquisition time by 18% (5 min 5 s) compared with SENSE4.5. Moreover, C-SENSE8 acquisition (37% acceleration, 3 min 54 s) could be used for routine screening and clinical diagnosis of intracranial macrovascular disease with balanced image quality.
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Affiliation(s)
- Maoxue Wang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yiming Ma
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Fei Chen
- Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - Fei Zhou
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | | | - Bing Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Institute of Brain Science, Nanjing University, Nanjing, China
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12
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Abstract
Dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL) are techniques used to evaluate brain perfusion using MRI. DSC requires dynamic image acquisition with a rapid administration of gadolinium-based contrast agent. In contrast, ASL obtains brain perfusion information using magnetically labeled blood water as an endogenous tracer. For the evaluation of brain perfusion in pediatric neurological diseases, ASL has a significant advantage compared to DSC, CT, and single-photon emission CT/positron emission tomography because of the lack of radiation exposure and contrast agent administration. However, in ASL, optimization of several parameters, including the type of labeling, image acquisition, background suppression, and postlabeling delay, is required, because they have a significant effect on the quantification of cerebral blood flow (CBF).In this article, we first review recent technical developments of ASL and age-dependent physiological characteristics in pediatric brain perfusion. We then review the clinical implementation of ASL in pediatric neurological diseases, including vascular diseases, brain tumors, acute encephalopathy with biphasic seizure and late reduced diffusion (AESD), and migraine. In moyamoya disease, ASL can be used for brain perfusion and vessel assessment in pre- and post-treatment. In arteriovenous malformations, ASL is sensitive to detect small degrees of shunt. Furthermore, in vascular diseases, the implementation of ASL-based time-resolved MR angiography is described. In neoplasms, ASL-derived CBF has a high diagnostic accuracy for differentiation between low- and high-grade pediatric brain tumors. In AESD and migraine, ASL may allow for accurate early diagnosis and provide pathophysiological information.
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Affiliation(s)
- Mika Kitajima
- Department of Medical Imaging Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan,Corresponding author: 4-24-1, Kuhonji, Chuo-ku, Kumamoto, Kumamoto 862-0976, Japan. Phone: +81-373-5483, Fax: +81-373-5519, E-mail:
| | - Hiroyuki Uetani
- Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
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13
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Wang M, Wang Y, Zhang W, Zhao X, Yang Y, Zhang B. Preoperative Collateral Perfusion Using Arterial Spin Labeling: A Predictor of Surgical Collaterals in Moyamoya Angiopathy. Front Neurosci 2022; 16:839485. [PMID: 35368266 PMCID: PMC8964430 DOI: 10.3389/fnins.2022.839485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/25/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Various degrees of surgical collateral circulation are often found in moyamoya angiopathy (MMA) patients after revascularization. Little is known about arterial spin labeling (ASL) that affects surgical collateral circulation. This study aimed to investigate the effect of ASL on surgical collaterals in patients with MMA after combined bypass surgery. Methods MMA patients with complete radiological and clinical information, who had undergone combined bypass, were enrolled in this study. Surgical collaterals were classified as good or poor based on the Matsushima standard. Cerebral perfusion on ASL was quantitatively analyzed as relative cerebral blood flow (rCBF). The qualitative collateral score was calculated using a four-grade scale. Univariable and multivariable logistic regressions were performed to identify the predictors for surgical collaterals after combined bypass. Results In total, 66 hemispheres of 61 patients (47 years old ± 8.66) were prospectively included (29 and 37 hemispheres with good and poor surgical collaterals, respectively). The presurgical collateral score was significantly lower in patients with good surgical collaterals (13.72 scores ± 7.83) than in those with poor surgical collaterals (19.16 scores ± 6.65, P = 0.005). The presurgical rCBF and modified Rankin scale (mRS) scores were not significantly different between the two groups (PrCBF = 0.639, PmRS = 0.590). The collateral score was significantly elevated (good: 13.72 scores ± 7.83 vs. 20.79 scores ± 6.65, P < 0.001; poor: 19.16 scores ± 6.65 vs. 22.84 scores ± 5.06, P < 0.001), and the mRS was reduced (good: 1.66 scores ± 1.14 vs. 0.52 scores ± 0.83, P < 0.001; poor: 1.49 scores ± 0.90 vs. 0.62 scores ± 0.76, P < 0.001) in patients after revascularization. Multivariable logistic regression showed that preoperative collateral scores [odds ratio (OR): 0.791; 95% confidence interval (CI): 0.695, 0.900; P < 0.001], age (OR: 0.181; 95% CI: 0.039, 0.854; P = 0.031), sex (OR: 0.154; 95% CI: 0.035, 0.676; P = 0.013), and hypertension (OR: 0.167; 95% CI: 0.038, 0.736; P = 0.018) were predictors of surgical collaterals after combined revascularization. Conclusion The preoperative collateral score based on ASL could be a predictor for surgical collaterals in patients with MMA after combined bypass surgery. Combined with age, sex, and hypertension, it may have a better predictive effect.
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Affiliation(s)
- Maoxue Wang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yi Wang
- Department of Neurosurgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Wen Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | | | - Yongbo Yang
- Department of Neurosurgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- *Correspondence: Yongbo Yang,
| | - Bing Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Institute of Brain Science, Nanjing University, Nanjing, China
- Bing Zhang,
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14
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Togao O, Obara M, Kikuchi K, Helle M, Arimura K, Nishimura A, Wada T, Murazaki H, Van Cauteren M, Hiwatashi A, Ishigami K. Vessel-Selective 4D-MRA Using Superselective Pseudocontinuous Arterial Spin-Labeling with Keyhole and View-Sharing for Visualizing Intracranial Dural AVFs. AJNR Am J Neuroradiol 2022; 43:368-375. [PMID: 35241425 PMCID: PMC8910818 DOI: 10.3174/ajnr.a7426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/11/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE An accurate assessment of the hemodynamics of an intracranial dural AVF is necessary for treatment planning. We aimed to investigate the utility of 4D-MRA based on superselective pseudocontinuous arterial spin-labeling with CENTRA-keyhole and view-sharing (4D-S-PACK) for the vessel-selective visualization of intracranial dural AVFs. MATERIALS AND METHODS We retrospectively analyzed the images of 21 patients (12 men and 9 women; mean age, 62.2 [SD,19.2] years) with intracranial dural AVFs, each of whom was imaged with DSA, 4D-S-PACK, and nonselective 4D-MRA based on pseudocontinuous arterial spin-labeling combined with CENTRA-keyhole and view-sharing (4D-PACK). The shunt location, venous drainage patterns, feeding artery identification, and Borden classification were evaluated by 2 observers using both MRA methods on separate occasions. Vessel selectivity was evaluated on 4D-S-PACK. RESULTS Shunt locations were correctly evaluated in all 21 patients by both observers on both MRA methods. With 4D-S-PACK, observers 1 and 2 detected 76 (80.0%, P < .001) and 73 (76.8%, P < .001) feeding arteries of the 95 feeding arteries identified on DSA but only 39 (41.1%) and 46 (48.4%) feeding arteries with nonselective 4D-PACK, respectively. Both observers correctly identified 10 of the 11 patients with cortical venous reflux confirmed by DSA with both 4D-S-PACK and 4D-PACK (sensitivity = 90.9%, specificity = 90.9% for each method), and they made accurate Borden classifications in 20 of the 21 patients (95.2%) on both MRA methods. Of the 84 vessel territories examined, vessel selectivity was graded 3 or 4 in 73 (91.2%) and 66 (88.0%) territories by observers 1 and 2, respectively. CONCLUSIONS 4D-S-PACK is useful for the identification of feeding arteries and accurate classifications of intracranial dural AVFs and can be a useful noninvasive clinical tool.
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Affiliation(s)
- O. Togao
- From the Departments of Molecular Imaging & Diagnosis (O.T.)
| | - M. Obara
- Philips Japan (M.O., M.V.C.), Tokyo, Japan
| | | | - M. Helle
- Philips Research (M.H.), Hamburg, Germany
| | - K. Arimura
- Neurosurgery (K.A., A.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A. Nishimura
- Neurosurgery (K.A., A.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T. Wada
- Division of Radiology (T.W., H.M.), Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - H. Murazaki
- Division of Radiology (T.W., H.M.), Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
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15
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Zhang X, Xiao W, Zhang Q, Xia D, Gao P, Su J, Yang H, Gao X, Ni W, Lei Y, Gu Y. Progression in Moyamoya Disease: Clinical Feature, Neuroimaging Evaluation and Treatment. Curr Neuropharmacol 2021; 20:292-308. [PMID: 34279201 PMCID: PMC9413783 DOI: 10.2174/1570159x19666210716114016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/08/2021] [Accepted: 07/09/2021] [Indexed: 11/22/2022] Open
Abstract
Moyamoya disease (MMD) is a chronic cerebrovascular disease characterized by progressive stenosis of the arteries of the circle of Willis, with the formation of collateral vascular network at the base of the brain. Its clinical manifestations are complicated. Numerous studies have attempted to clarify the clinical features of MMD, including its epidemiology, genetic characteristics, and pathophysiology. With the development of neuroimaging techniques, various neuroimaging modalities with different advantages have deepened the understanding of MMD in terms of structural, functional, spatial, and temporal dimensions. At present, the main treatment for MMD focuses on neurological protection, cerebral blood flow reconstruction, and neurological rehabilitation, such as pharmacological treatment, surgical revascularization, and cognitive rehabilitation. In this review, we discuss recent progress in understanding the clinical features, in the neuroimaging evaluation and treatment of MMD.
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Affiliation(s)
- Xin Zhang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China
| | - Weiping Xiao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China
| | - Qing Zhang
- Department of Nursing, Huashan Hospital North, Fudan University, China
| | - Ding Xia
- Department of Radiology, Huashan Hospital North, Fudan University, China
| | - Peng Gao
- Department of Radiology, Huashan Hospital North, Fudan University, China
| | - Jiabin Su
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China
| | - Heng Yang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China
| | - Xinjie Gao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China
| | - Wei Ni
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China
| | - Yu Lei
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China
| | - Yuxiang Gu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China
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16
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Shibukawa S, Saito M, Niwa T, Obara M, Konta N, Hara T, Okazaki T, Nomura T. Optimized enhanced acceleration selective arterial spin labeling (eAccASL) for non-gated and non-enhanced MR angiography of the hands. Magn Reson Imaging 2021; 78:1-6. [PMID: 33486082 DOI: 10.1016/j.mri.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/13/2020] [Accepted: 01/16/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Enhanced acceleration selective arterial spin labeling (eAccASL) was introduced as non-enhanced and non-gated magnetic resonance angiography (MRA). This technique has not been applied to hand MRA. The objective of this study was to optimize the eAccASL for MRA of the hands and to investigate the factors for MRA visibility of the hands. METHODS Twenty healthy volunteers were examined on a 1.5 T MR system. To evaluate arterial visualization, we compared four different acceleration-encoding (AENC) values (i.e., 0.12, 0.29, 0.58, and 0.87 m/s2). Image quality score regarding the MRA depiction of the proximal artery (range, 0-10), the distal artery (0-5), and venous contamination (0-5) was evaluated by three radiologists. We measured the peak to peak arterial blood flow velocity (Vpp) measured by phase contrast cine MRI and hand temperature as the factors for arterial visualization. Qualitative scores were compared with Friedman's tests. Spearman's correlation of qualitative scores with Vpp and hand temperature was performed to analyze influencing factors. RESULTS For the distal arterial depiction, scores at AENC 0.12 (median, 9.0) and AENC 0.29 (8.0) were significantly better (both P < 0.0001) than those at AENC 0.87 (5.5). For the proximal arterial depiction, scores at AENC 0.12 (2.25) and AENC 0.29 (2.0) were significantly better (P < 0.001 and P < 0.01, respectively) than those at AENC 0.87 (1.5). Conversely, venous contamination scores at AENC 0.12 (3.0) and AENC 0.29 (3.0) were significantly worse (both P < 0.0001) than those at AENC 0.87 (4.0). There were significantly negative correlations between venous contamination and Vpp at AENC 0.12 (ρ = -0.56, P = 0.01), and 0.29 (ρ = -0.68, P = 0.001), whereas hand temperatures were not significantly correlated with scores (all P > 0.05). CONCLUSION eAccASL MRA of the hands was optimized by using low AENC values (0.12-0.29 m/s2). Venous contamination may increase with elevation of arterial blood flow.
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Affiliation(s)
- Shuhei Shibukawa
- Department of Radiology, Tokai University Hospital, Isehara, Kanagawa, Japan.
| | - Misaki Saito
- Department of Radiology, Tokai University Hospital, Isehara, Kanagawa, Japan
| | - Tetsu Niwa
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | | | - Natsuo Konta
- Department of Radiology, Tokai University Hospital, Isehara, Kanagawa, Japan
| | - Takuya Hara
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Takashi Okazaki
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Takakiyo Nomura
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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17
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Franklin SL, Bones IK, Harteveld AA, Hirschler L, van Stralen M, Qin Q, de Boer A, Hoogduin JM, Bos C, van Osch MJP, Schmid S. Multi-organ comparison of flow-based arterial spin labeling techniques: Spatially non-selective labeling for cerebral and renal perfusion imaging. Magn Reson Med 2020; 85:2580-2594. [PMID: 33251644 PMCID: PMC7898485 DOI: 10.1002/mrm.28603] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/21/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022]
Abstract
Purpose Flow‐based arterial spin labeling (ASL) techniques provide a transit‐time insensitive alternative to the more conventional spatially selective ASL techniques. However, it is not clear which flow‐based ASL technique performs best and also, how these techniques perform outside the brain (taking into account eg, flow‐dynamics, field‐inhomogeneity, and organ motion). In the current study we aimed to compare 4 flow‐based ASL techniques (ie, velocity selective ASL, acceleration selective ASL, multiple velocity selective saturation ASL, and velocity selective inversion prepared ASL [VSI‐ASL]) to the current spatially selective reference techniques in brain (ie, pseudo‐continuous ASL [pCASL]) and kidney (ie, pCASL and flow alternating inversion recovery [FAIR]). Methods Brain (n = 5) and kidney (n = 6) scans were performed in healthy subjects at 3T. Perfusion‐weighted signal (PWS) maps were generated and ASL techniques were compared based on temporal SNR (tSNR), sensitivity to perfusion changes using a visual stimulus (brain) and robustness to respiratory motion by comparing scans acquired in paced‐breathing and free‐breathing (kidney). Results In brain, all flow‐based ASL techniques showed similar tSNR as pCASL, but only VSI‐ASL showed similar sensitivity to perfusion changes. In kidney, all flow‐based ASL techniques had comparable tSNR, although all lower than FAIR. In addition, VSI‐ASL showed a sensitivity to B1‐inhomogeneity. All ASL techniques were relatively robust to respiratory motion. Conclusion In both brain and kidney, flow‐based ASL techniques provide a planning‐free and transit‐time insensitive alternative to spatially selective ASL techniques. VSI‐ASL shows the most potential overall, showing similar performance as the golden standard pCASL in brain. However, in kidney, a reduction of B1‐sensitivity of VSI‐ASL is necessary to match the performance of FAIR.
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Affiliation(s)
- Suzanne L Franklin
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Isabell K Bones
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anita A Harteveld
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lydiane Hirschler
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Marijn van Stralen
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anneloes de Boer
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes M Hoogduin
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Clemens Bos
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Sophie Schmid
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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18
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Fu Q, Liu DX, Zhang XY, Deng XB, Zheng CS. Pointwise encoding time reduction with radial acquisition in subtraction-based magnetic resonance angiography to assess saccular unruptured intracranial aneurysms at 3 Tesla. Neuroradiology 2020; 63:189-199. [PMID: 32794074 DOI: 10.1007/s00234-020-02512-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/02/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the clinical utility of pointwise encoding time reduction with radial acquisition in subtraction-based magnetic resonance angiography (PETRA-MRA) and time-of-flight magnetic resonance angiography (TOF-MRA) to evaluate saccular unruptured intracranial aneurysms (UIAs). METHODS A total of 49 patients with 54 TOF-MRA-identified saccular UIAs were enrolled. The morphologic parameters, contrast-to-noise-ratios (CNRs), and sharpness of aneurysms were measured using PETRA-MRA and TOF-MRA. Two radiologists independently evaluated subjective image scores, focusing on aneurysm signal homogeneities and sharpness depictions using a 4-point scale: 4, excellent; 3, good; 2, poor; 1, not assessable. PETRA-MRA and TOF-MRA acoustic noises were measured. RESULTS All aneurysms were detected with PETRA-MRA. The morphologic parameters of 15 patients evaluated with PETRA-MRA were more closely correlated with those receiving computed tomography angiography over those receiving TOF-MRA. No significant differences between PETRA-MRA and TOF-MRA parameters were seen in the 54 UIAs (p > 0.10), excluding those with inflow angles (p < 0.05). In four patients with inflow angles on PETRA-MRA, the angles were more closely related to those of digital subtraction angiography than those of TOF-MRA. CNRs between TOF-MRA and PETRA-MRA were comparable (p = 0.068), and PETRA-MRA sharpness values and subjective image scores were significantly higher than those of TOF-MRA (p < 0.001). Inter-observer agreements were excellent for both PETRA-MRA and TOF-MRA (intraclass correlation coefficients were 0.90 and 0.97, respectively). The acoustic noise levels of PETRA-MRA were much lower than those of TOF-MRA (59 vs.73 dB, p < 0.01). CONCLUSIONS PETRA-MRA, with better visualization of aneurysms and lower acoustic noise levels than TOF-MRA, showed a superior diagnostic performance for depicting saccular UIAs.
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Affiliation(s)
- Qing Fu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Ding-Xi Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Xiao-Yong Zhang
- MR Collaborations, Siemens Healthcare Ltd, Shenzhen, 518000, People's Republic of China
| | - Xian-Bo Deng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Chuan-Sheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, People's Republic of China. .,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China.
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Togao O, Obara M, Helle M, Yamashita K, Kikuchi K, Momosaka D, Kikuchi Y, Nishimura A, Arimura K, Wada T, Murazaki H, Iihara K, Van Cauteren M, Hiwatashi A. Vessel-selective 4D-MR angiography using super-selective pseudo-continuous arterial spin labeling may be a useful tool for assessing brain AVM hemodynamics. Eur Radiol 2020; 30:6452-6463. [PMID: 32696254 DOI: 10.1007/s00330-020-07057-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/04/2020] [Accepted: 06/30/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the usefulness of 4D-MR angiography based on super-selective pseudo-continuous ASL combined with keyhole and view-sharing (4D-S-PACK) for vessel-selective visualization and to examine the ability of this technique to visualize brain arteriovenous malformations (AVMs). METHODS In this retrospective study, 15 patients (ten men and five women, mean age 44.0 ± 16.9 years) with brain AVMs were enrolled. All patients were imaged with 4D-PACK (non-selective), 4D-S-PACK, and digital subtraction angiography (DSA). Observers evaluated vessel selectivity, identification of feeding arteries and venous drainage patterns, visualization scores, and contrast-to-noise ratio (CNR) for each AVM component. Measurements were compared between the MR methods. RESULTS Vessel selectivity was graded 4 in 43/45 (95.6%, observer 1) and 42/45 (93.3%, observer 2) territories and graded 3 in two (observer 1) and three (observer 2) territories. The sensitivity and specificity for identification of feeding arteries for both observers was 88.9% and 100% on 4D-PACK, and 100% and 100% on 4D-S-PACK, respectively. For venous drainage, the sensitivity and specificity was 100% on both methods for observer 1. The sensitivity and specificity for observer 2 was 94.4% and 83.3% on 4D-PACK, and 94.4% and 91.7% on 4D-S-PACK, respectively. The CNRs at the timepoint of 1600 ms were slightly lower in 4D-S-PACK than in 4D-PACK for all AVM components (Feeding artery, p = .02; nidus, p = .001; and draining artery, p = .02). The visualization scores for both observers were not significantly different between 4D-PACK and 4D-S-PACK for all components. CONCLUSIONS 4D-S-PACK could be a useful non-invasive clinical tool for assessing hemodynamics in brain AVMs. KEY POINTS • The 4D-MR angiography based on super-selective pseudo-continuous arterial spin labeling combined with CENTRA-keyhole and view-sharing (4D-S-PACK) enabled excellent vessel selectivity. • The 4D-S-PACK enabled the perfect identification of feeding arteries of brain arteriovenous malformation (AVM). • 4D-S-PACK could be a non-invasive clinical tool for assessing hemodynamics in brain AVMs.
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Affiliation(s)
- Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Makoto Obara
- Philips Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | | | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Daichi Momosaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshitomo Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tatsuhiro Wada
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroo Murazaki
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Iihara
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Marc Van Cauteren
- Philips Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | - Akio Hiwatashi
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
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20
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Hou K, Li G, Guo Y, Xu B, Xu K, Yu J. Angiographic study of the transdural collaterals at the anterior cranial fossa in patients with Moyamoya disease. Int J Med Sci 2020; 17:1974-1983. [PMID: 32788876 PMCID: PMC7415394 DOI: 10.7150/ijms.48308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/12/2020] [Indexed: 01/31/2023] Open
Abstract
Unlike its parietal, temporal, and occipital counterparts, the frontal lobe has a broad basal surface directly facing the anterior cranial fossa dura mater which could permit establishment of transdural collaterals (TDCs) with the frontal lobe. Studies on the TDCs from the anterior cranial fossa in moyamoya disease (MMD) are scarce and inadequately investigated. A retrospective study of 100 hemispheres in 50 patients who were diagnosed with MMD by catheter angiography between January 2015 and June 2019 was performed in our institution. TDCs through the anterior ethmoid artery (AEA) or posterior ethmoid artery (PEA) were divided into 3 types respectively based on their respective angioarchitecture. Furthermore, we also studied TDCs to the temporal, parietal, and occipital lobes and collaterals from the posterior circulation to the territory of the anterior cerebral artery. TDCs through the AEA and PEA were identified in 89 (89/100, 89%) and 73 (73/100, 73%) of the hemispheres. The vascularization state of the frontal lobe was good in 89 (89/100, 89%) hemispheres. Rete mirabile and TDCs through the PEA were statistically different among patients with different Suzuki stages. No statistical difference was noted in TDCs through the AEA, frontal TDCs from other sources, and the vascularization state of the frontal lobe with regard to different Suzuki stages. TDCs through the AEA and PEA at the anterior cranial fossa play a very important role in compensating the ischemic frontal lobe. The frontal lobe could be well compensated in most of the patients with TDCs at the anterior cranial fossa.
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Affiliation(s)
- Kun Hou
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China
| | - Guichen Li
- Department of Neurology, The First Hospital of Jilin University, Changchun, 130021, China
| | - Yunbao Guo
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China
| | - Baofeng Xu
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China
| | - Kan Xu
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China
| | - Jinlu Yu
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China
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Abstract
In the 1980’s some of the earliest studies of arterial spin labeling (ASL) MRI have demonstrated its ability to generate MR angiography (MRA) images. Thanks to many technical improvements, ASL has been successfully moving its position from the realm of research into the clinical area, albeit more known as perfusion imaging than as MRA. For MRA imaging, other techniques such as time-of-flight, phase contrast MRA and contrast-enhanced (CE) MRA are more popular choices for clinical applications. In the last decade, however, ASL-MRA has been experiencing a remarkable revival, especially because of its non-invasive nature, i.e. the fact that it does not rely on the use of contrast agent. Very importantly, there are additional benefits of using ASL for MRA. For example, its higher flexibility to achieve both high spatial and temporal resolution than CE dynamic MRA, and the capability of vessel specific visualization, in which the vascular tree arising from a selected artery can be exclusively visualized. In this article, the implementation and recent developments of ASL-based MRA are discussed; not only focusing on the basic sequences based upon pulsed ASL or pseudo-continuous ASL, but also including more recent labeling approaches, such as vessel-selective labeling, velocity-selective ASL, vessel-encoded ASL and time-encoded ASL. Although these ASL techniques have been already utilized in perfusion imaging and their usefulness has been suggested by many studies, some additional considerations should be made when employing them for MRA, since there is something more than the difference of the spatial resolution of the readout sequence. Moreover, extensive discussion is included on what readout sequence to use, especially by highlighting how to achieve high spatial resolution while keeping scan-time reasonable such that the ASL-MRA sequence can easily be included into a clinical examination.
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Affiliation(s)
- Yuriko Suzuki
- Institute of Biomedical Engineering, University of Oxford
| | - Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital
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22
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Shang S, Ye J, Dou W, Luo X, Qu J, Zhu Q, Zhang H, Wu J. Validation of Zero TE-MRA in the Characterization of Cerebrovascular Diseases: A Feasibility Study. AJNR Am J Neuroradiol 2019; 40:1484-1490. [PMID: 31467242 DOI: 10.3174/ajnr.a6173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/02/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Zero TE-MRA is less sensitive to field heterogeneity, complex flow, and acquisition noise. This study aimed to prospectively validate the feasibility of zero TE-MRA for cerebrovascular diseases assessment, compared with TOF-MRA. MATERIALS AND METHODS Seventy patients suspected of having cerebrovascular disorders were recruited. Sound levels were estimated for each MRA subjectively and objectively in different modes. MRA image quality was estimated by 2 neuroradiologists. The degree of stenosis (grades 0-4) and the z-diameter of aneurysms (tiny group ≤3 mm and large group >3 mm) were measured for further quantitative analysis. CTA was used as the criterion standard. RESULTS Zero TE-MRA achieved significantly lower subjective perception and objective noise reduction (37.53%). Zero TE-MRA images showed higher signal homogeneity (3.29 ± 0.59 versus 3.04 ± 0.43) and quality of venous signal suppression (3.67 ± 0.47 versus 2.75 ± 0.46). The intermodality agreement was higher for zero TE-MRA than for TOF-MRA (zero TE, 0.90; TOF, 0.81) in the grading of stenosis. Zero TE-MRA had a higher correlation than TOF-MRA (zero TE, 0.84; TOF, 0.74) in the tiny group and a higher consistency with CTA (intraclass correlation coefficient, 0.83; intercept, -0.5084-1.1794; slope -0.4952 to -0.2093) than TOF-MRA (intraclass correlation coefficient, 0.64; intercept, 0.7000-2.6133; slope -1.0344 to -0.1923). Zero TE-MRA and TOF-MRA were comparable in the large group. Zero TE-MRA had more accurate details than TOF-MRA of AVM and Moyamoya lesions. CONCLUSIONS Compared with TOF-MRA, zero TE-MRA achieved more robust performance in depicting cerebrovascular diseases. Therefore, zero TE-MRA was shown to be a promising MRA technique for further routine application in the clinic in patients with cerebrovascular diseases.
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Affiliation(s)
- S Shang
- From the Department of Radiology (S.S., J.Y., X.L., Q.Z., H.Z., J.W.), Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - J Ye
- From the Department of Radiology (S.S., J.Y., X.L., Q.Z., H.Z., J.W.), Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - W Dou
- MR Research China (W.D., J.Q.), GE Healthcare, Beijing China
| | - X Luo
- From the Department of Radiology (S.S., J.Y., X.L., Q.Z., H.Z., J.W.), Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - J Qu
- MR Research China (W.D., J.Q.), GE Healthcare, Beijing China
| | - Q Zhu
- From the Department of Radiology (S.S., J.Y., X.L., Q.Z., H.Z., J.W.), Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - H Zhang
- From the Department of Radiology (S.S., J.Y., X.L., Q.Z., H.Z., J.W.), Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - J Wu
- From the Department of Radiology (S.S., J.Y., X.L., Q.Z., H.Z., J.W.), Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
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23
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Togao O, Hiwatashi A, Yamashita K, Momosaka D, Obara M, Nishimura A, Arimura K, Hata N, Iihara K, Van Cauteren M, Honda H. Acceleration-selective arterial spin labeling MR angiography for visualization of brain arteriovenous malformations. Neuroradiology 2019; 61:979-989. [PMID: 31016367 DOI: 10.1007/s00234-019-02217-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/11/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate the performance of acceleration-selective arterial spin labeling (AccASL) MR angiography in the visualization of brain arteriovenous malformations (AVMs) in comparison with digital subtraction angiography (DSA) and time-of-flight (TOF) MR angiography. METHODS Twenty-one patients with brain AVM (mean age 31.1 ± 18.6 years; 11 males, 10 females) underwent TOF and AccASL MR angiography and DSA. Two neuroradiologists conducted an observer study for detection, nidus size, eloquence, venous drainage pattern, and Spetzler-Martin (SM) grade. The evaluations included the visualization of each AVM component with reference to DSA and assessments of contrast-to-noise ratio (CNR). The kappa statistic, repeated measures analysis of variance, Wilcoxon matched pairs test, and paired t test were used. RESULTS Both observers detected more AVMs with AccASL (95.2%, 90.5% for Observers 1 and 2) than with TOF (76.2% and 71.4%, respectively). The inter-modality agreement between AccASL and DSA was almost perfect for the eloquence, venous drainage pattern, and SM grade for Observer 1 and moderate for the venous drainage pattern and substantial for the eloquence and SM grade for Observer 2. The visualization scores were higher with AccASL than with TOF for the feeding artery (AccASL, 4.5 ± 1.0 vs. TOF, 3.9 ± 1.5, p = 0.0214), nidus (4.6 ± 1.1 vs. 3.2 ± 1.5, p = 0.0006), and draining vein (4.6 ± 1.0 vs. 2.2 ± 1.1, p < 0.0001), respectively. The CNRs in the nidus were higher in AccASL than in TOF (29.9 ± 16.7 vs. 20.8 ± 16.5, p = 0.0002), as in the draining vein (23.2 ± 13.0 vs. 12.6 ± 12.0, p = 0.0010), respectively. CONCLUSIONS AccASL better visualized brain AVMs compared with TOF and was useful for grading without the use of contrast agents.
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Affiliation(s)
- Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Akio Hiwatashi
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Daichi Momosaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Makoto Obara
- Philips Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Nobuhiro Hata
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Iihara
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
| | - Marc Van Cauteren
- Philips Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan
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Akamine Y, Obara M, Togao O, Shibukawa S, Yoneyama M, Okuaki T, Van Cauteren M. Robust visualization of middle cerebral artery main trunk by enhanced acceleration-selective arterial spin labeling (eAccASL) for intracranial MRA. Magn Reson Med 2018; 81:3185-3191. [DOI: 10.1002/mrm.27603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/16/2022]
Affiliation(s)
| | | | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Shuhei Shibukawa
- Department of Radiology; Tokai University Hospital; Kanagawa Japan
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Wei N, Zhang Z, An J, Weng D, Zhuo Y. Improved visualization of superficial temporal artery using segmented time-of-flight MR angiography with venous suppression at 7T. Neuroradiology 2018; 60:1243-1246. [PMID: 30244414 DOI: 10.1007/s00234-018-2099-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/09/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the quality of time-of-flight MR angiography (TOF-MRA) with venous suppression at 7T on imaging superficial temporal artery (STA). METHODS A recently developed segmented TOF technique with reduced specific absorption rate (SAR) of venous suppression (VS) module was employed to achieve high-resolution arterial angiography without the contamination of venous signal. Images of segmented TOF with VS at 7T, TOF without VS at 7T, and TOF with VS at 3T were collected on 17 healthy volunteers. The number of STA branches and their local contrast achieved by the three methods were quantified and compared using paired t test. RESULTS Segmented TOF with VS at 7T successfully suppressed venous signal without reducing the contrast of arterial angiography. The numbers of STA branches in 7T images were significantly higher than that in 3T images (5.79 vs. 4.50, p < 0.001). The contrast of 7T segmented TOF was significantly higher than 3T TOF (7.21 vs. 5.56, p = 0.006). CONCLUSION Segmented TOF with VS at 7T displayed more branches of STA, while eliminating the signal of superficial temporal vein (STV). The improved visualization of STA will potentially facilitate the pre-operative assessment of STA in STA-MCA bypass surgery.
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Affiliation(s)
- Ning Wei
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Zihao Zhang
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Jing An
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, 518057, China
| | - Dehe Weng
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, 518057, China
| | - Yan Zhuo
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
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Togao O, Hiwatashi A, Obara M, Yamashita K, Momosaka D, Nishimura A, Arimura K, Hata N, Yoshimoto K, Iihara K, Van Cauteren M, Honda H. 4D ASL-based MR angiography for visualization of distal arteries and leptomeningeal collateral vessels in moyamoya disease: a comparison of techniques. Eur Radiol 2018; 28:4871-81. [PMID: 29737389 DOI: 10.1007/s00330-018-5462-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/13/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To evaluate the performance of four-dimensional pseudo-continuous arterial spin labeling (4D-pCASL)-based angiography using CENTRA-keyhole and view sharing (4D-PACK) in the visualization of flow dynamics in distal cerebral arteries and leptomeningeal anastomosis (LMA) collaterals in moyamoya disease in comparison with contrast inherent inflow-enhanced multiphase angiography (CINEMA), with reference to digital subtraction angiography (DSA). METHODS Thirty-two cerebral hemispheres from 19 patients with moyamoya disease (mean age, 29.7 ± 19.6 years; five males, 14 females) underwent both 4D-MR angiography and DSA. Qualitative evaluations included the visualization of anterograde middle cerebral artery (MCA) flow and retrograde flow via LMA collaterals with reference to DSA. Quantitative evaluations included assessments of the contrast-to-noise ratio (CNR) on these vessels. The linear mixed-effect model was used to compare the 4D-PACK and CINEMA methods. RESULTS The vessel visualization scores were significantly higher with 4D-PACK than with CINEMA in the visualization of anterograde flow for both Observer 1 (CINEMA, 3.53 ± 1.39; 4D-PACK, 4.53 ± 0.80; p < 0.0001) and Observer 2 (CINEMA, 3.50±1.39; 4D-PACK, 4.31 ± 0.86; p = 0.0009). The scores were higher with 4D-PACK than with CINEMA in the visualization of retrograde flow for both Observer 1 (CINEMA, 3.44 ± 1.05; 4D-PACK, 4.47 ± 0.88; p < 0.0001) and Observer 2 (CINEMA, 3.19 ± 1.20; 4D-PACK, 4.38 ± 0.91; p < 0.0001). The maximum CNR in the anterograde flow was higher in 4D-PACK (40.1 ± 16.1, p = 0.0001) than in CINEMA (27.0 ± 16.6). The maximum CNR in the retrograde flow was higher in 4D-PACK (36.1 ± 10.0, p < 0.0001) than in CINEMA (15.4 ± 8.0). CONCLUSIONS The 4D-PACK provided better visualization and higher CNRs in distal cerebral arteries and LMA collaterals compared with CINEMA in patients with this disease. KEY POINTS • The 4D-PACK enables good visualization of distal cerebral arteries in moyamoya disease. • The 4D-PACK enables direct visualization of leptomeningeal collateral vessels in moyamoya disease. • Vessel visualization by 4D-PACK can be useful in assessing cerebral hemodynamics.
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