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Rapid High-resolution, Self-registered, Dual Lumen-contrast MRI Method for Vessel-wall Assessment in Peripheral Artery Disease:: A Preliminary Investigation.

Authors :
Langham MC
Desjardins B
Englund EK
Mohler ER 3rd
Floyd TF
Wehrli FW
Source :
Academic radiology [Acad Radiol] 2016 Apr; Vol. 23 (4), pp. 457-67. Date of Electronic Publication: 2016 Feb 22.
Publication Year :
2016

Abstract

Rationale and Objectives: Contrast-enhanced angiographic evaluation by magnetic resonance imaging (MRI) and computed tomography (CT) is the reference standard for assessing peripheral artery disease (PAD). However, because PAD and diabetes often coexist, the prevalence of renal insufficiency is a major challenge to contrast-based angiography. The objective of this work is to describe and demonstrate a new application of three-dimensional double-echo steady-state (3D DESS) as a noncontrast vascular MRI method for evaluating peripheral atherosclerosis at 3 Tesla (3T).<br />Materials and Methods: A water-selective 3D DESS pulse sequence was designed to simultaneously collect two steady-state free-precession signals (free induction decay and Echo) yielding "black blood" (BB) and "gray blood" (GB) images. For completeness Bloch equation, simulations were performed to characterize DESS signals of various tissues including blood at different velocities and to assess two healthy subjects for the purpose of pulse sequence optimization. Exploratory studies were performed as an add-on protocol to an existing study involving patients with PAD. To evaluate the method's specificity for detecting calcification, images from select patients were compared against CT angiography.<br />Results: Simulations agreed qualitatively with in vivo images supporting DESS' potential for generating distinct lumen contrast (GB vs BB). Lesions representing calcium were easily identifiable on the basis of signal void occurring on both image types and were confirmed by CT angiography. Further, BB allowed visualization of stent restenosis, and data suggest its ability to visualize acute thrombus by virtue of T2 weighting.<br />Conclusion: Preliminary investigation and results suggest noncontrast 3D DESS to have the potential to improve diagnosis of PAD patients by providing detailed structural assessment of vessel-wall architecture.<br /> (Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1878-4046
Volume :
23
Issue :
4
Database :
MEDLINE
Journal :
Academic radiology
Publication Type :
Academic Journal
Accession number :
26916248
Full Text :
https://doi.org/10.1016/j.acra.2015.12.015