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Truong M, Lennartsson F, Bibic A, Sundius L, Persson A, Siemund R, In’t Zandt R, Goncalves I, Wassélius J. Classifications of atherosclerotic plaque components with T1 and T2* mapping in 11.7 T MRI. Eur J Radiol Open 2021; 8:100323. [PMID: 33532518 PMCID: PMC7822939 DOI: 10.1016/j.ejro.2021.100323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/21/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND AIMS Histopathology is the gold standard for analysis of atherosclerotic plaques but has drawbacks due to the destructive nature of the method. Ex vivo MRI is a non-destructive method to image whole plaques. Our aim was to use quantitative high field ex vivo MRI to classify plaque components, with histology as gold standard. METHODS Surgically resected carotid plaques from 12 patients with recent TIA or stroke were imaged at 11.7 T MRI. Quantitative T1/T2* mapping sequences and qualitative T1/T2* gradient echo sequences with voxel size of 30 × 30 × 60 μm3 were obtained prior to histological preparation, sectioning and staining for lipids, inflammation, hemorrhage, and fibrous tissue. Regions of interest (ROI) were selected based on the histological staining at multiple levels matched between histology and MRI. The MRI parameters of each ROI were then analyzed with quadratic discriminant analysis (QDA) for classification. RESULTS A total of 965 ROIs, at 70 levels matched between histology and MRI, were registered based on histological staining. In the nine plaques where three or more plaque components were possible to co-localize with MRI, the mean degree of misclassification by QDA was 16.5 %. One of the plaques contained mostly fibrous tissue and lipids and had no misclassifications, and two plaques mostly contained fibrous tissue. QDA generally showed good classification for fibrous tissue and lipids, whereas plaques with hemorrhage and inflammation had more misclassifications. CONCLUSION 11.7 T ex vivo high field MRI shows good visual agreement with histology in carotid plaques. T1/T2* maps analyzed with QDA is a promising non-destructive method to classify plaque components, but with a higher degree of misclassifications in plaques with hemorrhage or inflammation.
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Key Words
- 11.7 T MRI
- 11.7T, 11.7 Tesla
- 3T, 3 Tesla
- Atherosclerosis
- BSA, bovine serum albumin
- CI, confidence interval
- CTA, computed tomography angiography
- Carotid plaque
- Classification
- FA, flip angle
- FOV, field of view
- GE3D, gradient echo three dimensional
- HRP, horse radish peroxidase
- ICA, internal carotid artery
- IPH, intra-plaque hemorrhage
- LRNC, lipid rich necrotic core
- MRI, magnetic resonance imaging
- OCT, optimal cutting temperature
- Plaque components
- RF, radio frequency
- ROI, region of interest
- SD, standard deviation
- T1 maps
- T1w, T1 weighted
- T2*maps
- T2*w, T2 star weighted
- TBS, tris-buffered saline
- TE, echo time
- TIA, transient ischemic attack
- TR, repetition time
- ms, millisecond
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Affiliation(s)
- My Truong
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Medical Imaging Department, Neuroradiology, 22185, Lund, Sweden
| | - Finn Lennartsson
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Medical Imaging Department, Neuroradiology, 22185, Lund, Sweden
| | - Adnan Bibic
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, F. M. Kirby Center, 707 North Broadway, Baltimore, MD, 21 205, USA
| | - Lena Sundius
- Clinical Sciences Malmö, Lund University, Jan Waldenströmsg 35, 91-12, Skåne University Hospital, 20502, Malmö, Sweden
| | - Ana Persson
- Clinical Sciences Malmö, Lund University, Jan Waldenströmsg 35, 91-12, Skåne University Hospital, 20502, Malmö, Sweden
| | - Roger Siemund
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Medical Imaging Department, Neuroradiology, 22185, Lund, Sweden
| | - René In’t Zandt
- Lund University Bioimaging Centre, Lund University, Klinikgatan 32, BMC D11, SE-221 84, Lund, Sweden
| | - Isabel Goncalves
- Cardiology, Skåne University Hospital, Sweden
- Clinical Sciences Malmö, Lund University, Jan Waldenströmsg 35, 91-12, Skåne University Hospital, 20502, Malmö, Sweden
| | - Johan Wassélius
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Medical Imaging Department, Neuroradiology, 22185, Lund, Sweden
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Al-Bachari S, Parkes LM, Vidyasagar R, Hanby MF, Tharaken V, Leroi I, Emsley HCA. Arterial spin labelling reveals prolonged arterial arrival time in idiopathic Parkinson's disease. Neuroimage Clin 2014; 6:1-8. [PMID: 25379411 PMCID: PMC4215519 DOI: 10.1016/j.nicl.2014.07.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/24/2014] [Accepted: 07/29/2014] [Indexed: 12/30/2022]
Abstract
Idiopathic Parkinson's disease (IPD) is the second most common neurodegenerative disease, yet effective disease modifying treatments are still lacking. Neurodegeneration involves multiple interacting pathological pathways. The extent to which neurovascular mechanisms are involved is not well defined in IPD. We aimed to determine whether novel magnetic resonance imaging (MRI) techniques, including arterial spin labelling (ASL) quantification of cerebral perfusion, can reveal altered neurovascular status (NVS) in IPD. Fourteen participants with IPD (mean ± SD age 65.1 ± 5.9 years) and 14 age and cardiovascular risk factor matched control participants (mean ± SD age 64.6 ± 4.2 years) underwent a 3T MRI scan protocol. ASL images were collected before, during and after a 6 minute hypercapnic challenge. FLAIR images were used to determine white matter lesion score. Quantitative images of cerebral blood flow (CBF) and arterial arrival time (AAT) were calculated from the ASL data both at rest and during hypercapnia. Cerebrovascular reactivity (CVR) images were calculated, depicting the change in CBF and AAT relative to the change in end-tidal CO2. A significant (p = 0.005) increase in whole brain averaged baseline AAT was observed in IPD participants (mean ± SD age 1532 ± 138 ms) compared to controls (mean ± SD age 1335 ± 165 ms). Voxel-wise analysis revealed this to be widespread across the brain. However, there were no statistically significant differences in white matter lesion score, CBF, or CVR between patients and controls. Regional CBF, but not AAT, in the IPD group was found to correlate positively with Montreal cognitive assessment (MoCA) scores. These findings provide further evidence of alterations in NVS in IPD. Investigation of neurovascular status (NVS) in IPD using arterial spin labelling Diffuse prolonged arterial arrival time in IPD compared to controls Reduced regional CBF in the IPD group correlated with cognitive impairment. Clinical evidence of altered NVS in IPD warrants further research.
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Key Words
- 3T, 3 Tesla
- AAT, arterial arrival time
- AD, Alzheimer’s disease
- ASL, arterial spin labelling
- Arterial arrival time
- Arterial spin labelling
- CBF, cerebral blood flow
- CO2, carbon dioxide
- CV, cerebrovascular
- CVD, cerebrovascular disease
- CVR, cerebrovascular reactivity
- CVRAAT, cerebrovascular reactivity measures of arterial arrival time
- CVRCBF, cerebrovascular reactivity measures of cerebral blood flow
- Cerebral blood flow
- Cerebrovascular reactivity
- DS, digit span
- DSST, digit symbol substitution test
- DWMH, deep white matter hyperintensity
- EPI, echo planar imaging
- ETCO2, end-tidal carbon dioxide
- FAS, (verbal) fluency assessment scale
- FLAIR, fluid attenuation inversion recovery
- FWE, family-wise error
- HAM-D, Hamilton depression rating scale
- IPD, idiopathic Parkinson's disease
- Idiopathic Parkinson's disease
- L-dopa, levodopa
- LARS, Lille apathy rating scale
- LEDD, levodopa equivalent daily dose
- MCI, mild cognitive impairment
- MRI, magnetic resonance imaging
- MoCA
- MoCA, Montreal cognitive assessment
- NPI, neuropsychiatric inventory
- NVU, Neurovascular unit
- O2−, oxygen
- PET, positron emission tomography
- PIGD, Postural instability and gait disorder
- PL, parietal lobe
- PVH, periventricular hyperintensity
- ROI, region of interest
- SPECT, single positron emission computed tomography
- SPM, statistical parametric mapping
- STAR, signal targeting with alternating radiofrequency
- TD, tremor dominant
- TE, echo time
- TI, inversion time
- TL, temporal lobe
- TMT-B, trail making test B
- TR, repetition time
- UKPDS BB, United Kingdom Parkinson's Disease Society Brain Bank
- UPDRS, Unified Parkinson's disease Rating Scale
- WAIS-R, Wechsler adult intelligence scale-revised
- WML, white matter lesion
- fMRI, functional magnetic resonance imaging
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Affiliation(s)
- Sarah Al-Bachari
- Department of Neurology, Royal Preston Hospital, Preston, UK ; Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Laura M Parkes
- Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Rishma Vidyasagar
- Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Martha F Hanby
- Department of Neurology, Royal Preston Hospital, Preston, UK
| | - Vivek Tharaken
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - Iracema Leroi
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - Hedley C A Emsley
- Department of Neurology, Royal Preston Hospital, Preston, UK ; School of Medicine, University of Manchester, UK
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