Journal article
High resolution 7T MR imaging in characterizing culprit intracranial atherosclerotic plaques
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, Vol.31(1), pp.24-31
02/2025
DOI: 10.1177/15910199221145760
PMID: 36573263
Abstract
Current imaging modalities underestimate the severity of intracranial atherosclerotic disease (ICAD). High resolution vessel wall imaging (HR-VWI) MRI is a powerful tool in characterizing plaques. We aim to show that HR-VWI MRI is more accurate at detecting and characterizing intracranial plaques compared to digital subtraction angiography (DSA), time-of-flight (TOF) MRA, and computed tomography angiogram (CTA).
Patients with symptomatic ICAD prospectively underwent 7T HR-VWI. We calculated: degree of stenosis, plaque burden (PB), and remodeling index (RI). The sensitivity of detecting a culprit plaque for each modality as well as the correlations between different variables were analyzed. Interobserver agreement on the determination of a culprit plaque on every imaging modality was evaluated.
A total of 44 patients underwent HR-VWI. Thirty-four patients had CTA, 18 TOF-MRA, and 18 DSA. The sensitivity of plaque detection was 88% for DSA, 78% for TOF-MRA, and 76% for CTA. There's significant positive correlation between PB and degree of stenosis on HR-VWI MRI (p < 0.001), but not between PB and degree of stenosis in DSA (p = 0.168), TOF-MRA (p = 0.144), and CTA (p = 0.253). RI had a significant negative correlation with degree of stenosis on HR-VWI MRI (p = 0.003), but not on DSA (p = 0.783), TOF-MRA (p = 0.405), or CTA (p = 0.751). The best inter-rater agreement for culprit plaque detection was with HR-VWI (p = 0.001).
The degree of stenosis measured by intra-luminal techniques does not fully reflect the true extent of ICAD. HR-VWI is a more accurate tool in characterizing atherosclerotic plaques and may be the default imaging modality in clinical practice.
Details
- Title: Subtitle
- High resolution 7T MR imaging in characterizing culprit intracranial atherosclerotic plaques
- Creators
- Rami Fakih - Department of Neurology, 21782The University of Iowa Hospitals and Clinics, Iowa City, IA, USAAlberto Varon Miller - Department of Neurology, 21654University of Connecticut Health Center, Farmington, CT, USAAshrita Raghuram - University of IowaSebastian Sanchez - University of IowaJacob M Miller - University of IowaSedat Kandemirli - University of IowaChengcheng Zhu - Department of Radiology, 7284University of Washington, Seattle, WA, USAAmir Shaban - University of IowaEnrique C Leira - University of IowaEdgar A Samaniego - Department of Radiology, 21782The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, Vol.31(1), pp.24-31
- DOI
- 10.1177/15910199221145760
- PMID
- 36573263
- NLM abbreviation
- Interv Neuroradiol
- ISSN
- 1591-0199
- eISSN
- 2385-2011
- Grant note
- name: NIH, award: 1S10RR028821-01
- Language
- English
- Electronic publication date
- 12/26/2022
- Date published
- 02/2025
- Academic Unit
- Neurology; Radiology; Epidemiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984353409802771
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