Imaging of the extracranial internal carotid artery in acute ischemic stroke: assessment of stenosis, plaques, and image quality using relaxation-enhanced angiography without contrast and triggering (REACT).
Acute ischemic stroke (AIS)
contrast-enhanced magnetic resonance angiography (CE-MRA)
extracranial arteries
relaxation-enhanced angiography without contrast and triggering (REACT)
Journal
Quantitative imaging in medicine and surgery
ISSN: 2223-4292
Titre abrégé: Quant Imaging Med Surg
Pays: China
ID NLM: 101577942
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
19
11
2021
accepted:
22
03
2022
entrez:
5
7
2022
pubmed:
6
7
2022
medline:
6
7
2022
Statut:
ppublish
Résumé
In stroke magnetic resonance imaging (MRI), contrast-enhanced magnetic resonance angiography (CE-MRA) is the clinical standard to depict extracranial arteries but native MRA techniques are of increased interest to facilitate clinical practice. The purpose of this study was to assess the detection of extracranial internal carotid artery (ICA) stenosis and plaques as well as the image quality of cervical carotid arteries between a novel flow-independent relaxation-enhanced angiography without contrast and triggering (REACT) sequence and CE-MRA in acute ischemic stroke (AIS). In this retrospective, single-center study, 105 consecutive patients (65.27±18.74 years, 63 males) were included, who received a standard stroke protocol at 3T in clinical routine including Compressed SENSE (CS) accelerated (factor 4) 3D isotropic REACT (fixed scan time: 02:46 min) and CS accelerated (factor 6) 3D isotropic CE-MRA. Three radiologists independently assessed scans for the presence of extracranial ICA stenosis and plaques (including hyper-/hypointense signal) with concomitant diagnostic confidence using 3-point scales (3= excellent). Vessel quality, artifacts, and image noise of extracranial carotid arteries were subjectively scored on 5-point scales (5= excellent/none). Wilcoxon tests were used for statistical comparison. Considering CE-MRA as the standard of reference, REACT provided a sensitivity of 89.8% and specificity of 95.2% for any and of 93.5% and 95.8% for clinically relevant (≥50%) extracranial ICA stenosis and yielded a to CE-MRA comparable diagnostic confidence [mean ± standard deviation (SD), median (interquartile range): 2.8±0.5, 3 (3-3) Without the use of gadolinium-based contrast agents or triggering, REACT provides a high sensitivity and specificity for extracranial ICA stenosis and a potential improved depiction of adjacent plaques while yielding to CE-MRA comparable vessel quality in a large patient cohort with AIS.
Sections du résumé
Background
UNASSIGNED
In stroke magnetic resonance imaging (MRI), contrast-enhanced magnetic resonance angiography (CE-MRA) is the clinical standard to depict extracranial arteries but native MRA techniques are of increased interest to facilitate clinical practice. The purpose of this study was to assess the detection of extracranial internal carotid artery (ICA) stenosis and plaques as well as the image quality of cervical carotid arteries between a novel flow-independent relaxation-enhanced angiography without contrast and triggering (REACT) sequence and CE-MRA in acute ischemic stroke (AIS).
Methods
UNASSIGNED
In this retrospective, single-center study, 105 consecutive patients (65.27±18.74 years, 63 males) were included, who received a standard stroke protocol at 3T in clinical routine including Compressed SENSE (CS) accelerated (factor 4) 3D isotropic REACT (fixed scan time: 02:46 min) and CS accelerated (factor 6) 3D isotropic CE-MRA. Three radiologists independently assessed scans for the presence of extracranial ICA stenosis and plaques (including hyper-/hypointense signal) with concomitant diagnostic confidence using 3-point scales (3= excellent). Vessel quality, artifacts, and image noise of extracranial carotid arteries were subjectively scored on 5-point scales (5= excellent/none). Wilcoxon tests were used for statistical comparison.
Results
UNASSIGNED
Considering CE-MRA as the standard of reference, REACT provided a sensitivity of 89.8% and specificity of 95.2% for any and of 93.5% and 95.8% for clinically relevant (≥50%) extracranial ICA stenosis and yielded a to CE-MRA comparable diagnostic confidence [mean ± standard deviation (SD), median (interquartile range): 2.8±0.5, 3 (3-3)
Conclusions
UNASSIGNED
Without the use of gadolinium-based contrast agents or triggering, REACT provides a high sensitivity and specificity for extracranial ICA stenosis and a potential improved depiction of adjacent plaques while yielding to CE-MRA comparable vessel quality in a large patient cohort with AIS.
Identifiants
pubmed: 35782261
doi: 10.21037/qims-21-1122
pii: qims-12-07-3640
pmc: PMC9246733
doi:
Types de publication
Journal Article
Langues
eng
Pagination
3640-3654Informations de copyright
2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-21-1122/coif). SL, NA, and RJG report that they received research support from Philips Healthcare. JPG and JB are on the speaker’s bureau of Siemens Healthineers. JPG reports that he received payment for expert testimony from Siemens Healthineers. DM, JB, and LP are on the speaker’s bureau of Philips Healthcare. KW is an employee of Philips Healthcare and reports that he holds stock of Philips Healthcare. The other authors have no conflicts of interest to declare.
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