Carotid plaque high-resolution MRI at 3 T: evaluation of a new imaging score for symptomatic plaque assessment

Purpose

To assess the sensitivity and specificity of intra-plaque hemorrhage (IPH), large lipid-rich necrotic core (LR-NC) and ulceration or cap rupture (UCR) for symptomatic carotid plaque characterization and to evaluate a new imaging score [Hemorrhage, Ulceration or cap rupture, Lipid-rich necrotic Core (HULC) score based on the sum of presence/absence of IPH, UCR and LR-NC; range 0–3] for assessment of recently symptomatic carotid plaques.

Material and methods

Twenty-seven recently symptomatic (< 8 weeks) and 36 asymptomatic patients with a carotid plaque thicker than 2 mm were prospectively imaged on a 3-T magnetic resonance (MR) system using high-resolution, multi-contrast MR sequences. Prior to analysis, all images were reviewed to assess image quality of each sequence. Sensitivity and specificity of IPH, LR-NC, UCR and HULC scores were calculated.

Results

Fifty-one patients were analyzed (26 symptomatic carotids and 67 asymptomatic carotids) after exclusion of studies with poor image quality. Sensitivity and specificity for symptomatic carotid plaque was, respectively, 46.1% and 97% for IPH, 84.6% and 73.1% for UCR and 80.7% and 76.1% for LR-NC. A HULC score of 2 or more showed a sensitivity of 73% and a specificity of 92.5%.

Conclusion

At 3 T, intra-plaque hemorrhage is the most specific criterion to characterize symptomatic carotid plaque. The HULC score offers the best compromise between sensitivity and specificity.     

An intravascular loopless monopole antenna for vessel wall MR imaging at 3.0 T

The purpose of this study was to develop a novel intravascular loopless monopole antenna (ILMA) design specifically for imaging of small vessel walls. The ILMA consisted of an unshielded, low-friction guide wire and a tuning/matching box. The material of the guide wire was nitinol and it was coated with polyurethane. Because the guide wire was unshielded, it could be made thinner than the coaxial cable-based loopless intravascular antenna design. The material of the box was aluminum. In this study, the diameter of the guide wire was 0.5 mm and the length was 58.7 mm. The ILMA was used as a receiving antenna and body coil for transmission. To verify the feasibility of the ILMA, in vitro and in vivo experiments were performed on a 3.0-T magnetic resonance (MR) scanner. In vitro tests using the ILMA indicated that the proposed design could be used to image target vessel walls with a spatial resolution of 313 μm at the frequency coding direction and more than 100 mm of longitudinal coverage. In vivo tests demonstrated that the images showed the vessel walls clearly by using the ILMA and also indicated that the ILMA could be used for small vessels. The proposed antenna may therefore be utilized to promote MR-based diagnoses and therapeutic solutions for cardiovascular atherosclerotic diseases.     

Nonlinear ultrasonic imaging method for closed cracks using subtraction of responses at different external loads

To improve the selectivity of closed cracks for objects other than cracks in ultrasonic imaging, we propose an extension of a novel imaging method, namely, subharmonic phased array for crack evaluation (SPACE) as well as another approach using the subtraction of responses at different external loads. By applying external static or dynamic loads to closed cracks, the contact state in the cracks varies, resulting in an intensity change of responses at cracks. In contrast, objects other than cracks are independent of external load. Therefore, only cracks can be extracted by subtracting responses at different loads. In this study, we performed fundamental experiments on a closed fatigue crack formed in an aluminum alloy compact tension (CT) specimen using the proposed method. We examined the static load dependence of SPACE images and the dynamic load dependence of linear phased array (PA) images by simulating the external loads with a servohydraulic fatigue testing machine. By subtracting the images at different external loads, we show that this method is useful in extracting only the intensity change of responses related to closed cracks, while canceling the responses of objects other than cracks.     

A 32-channel coil system for MR vessel wall imaging of intracranial and extracranial arteries at 3T

PurposeTo develop a RF coil system for joint imaging of intracranial and extracranial arterial vessel wall at 3T.Materials and methodThe coil system consists of a 24-channel head coil combined with an 8-channel carotid coil. It is compared with a standard coil configuration (12-channel head coil + 4-channel neck coil + 8-channel carotid coil) for SNR and g-factors in phantoms and healthy volunteers. The clinical relevance of the proposed coil system is also evaluated in patients.ResultsIn phantom experiments, the SNR of the proposed coil system is 53% higher than the maximum SNR of the standard coil configuration at the center of the phantom which usually corresponds to the intracranial region of the head. The g-factors of the proposed coil system in the sagittal plane are lower than the standard coil configuration (by 10.8% and 26.6% for R = 2 and 4 respectively) in the same experiment. In healthy volunteer experiments, 55% of the pixels have SNR above 100 for the proposed coil system, which is 33% more than that of the standard coil configuration. The maximum g-factors in the standard configuration are higher than those from the new coil design by 12% at R = 2 and up to 36% at R = 4 in the sagittal plane. In patients, in-vivo intracranial and extracranial arterial wall images at an isotropic spatial resolution of 0.6 mm can be acquired using the proposed coil system. Plaques are well depicted from the images.ConclusionsThe performance of the proposed coil set is superior to the standard coil configuration, providing high SNR, low g-factor and good spatial coverage needed for simultaneous high resolution imaging of intracranial and extracranial arterial walls. Images acquired in 7.6 min using the proposed coil system can achieve an isotropic spatial resolution of 0.6 mm and can be used to depict plaques on the intracranial and extracranial arterial walls in patients.     

An optimized 3D inversion recovery prepared fast spoiled gradient recalled sequence for carotid plaque hemorrhage imaging at 3.0 T

An optimized 3D inversion recovery prepared fast spoiled gradient recalled sequence (IR FSPGR) on a 3-T scanner for carotid plaque imaging is described. It offers clear blood and fat signal suppression at the carotid artery bifurcation and highlights the regions of carotid plaque affected by hemorrhage at 3 T with high contrast and contrast-to-noise ratio compared with other sequences. It can potentially be used to replace the more traditional noncontrast T₁-weighted 2D black-blood imaging for hemorrhage detection and offers additional benefits of high-resolution 3D volumetric visualization.     

IDATEN and G‐SITENNO: GUI‐assisted software for coherent X‐ray diffraction imaging experiments and data analyses at SACLA

Using our custom‐made diffraction apparatus KOTOBUKI‐1 and two multiport CCD detectors, cryogenic coherent X‐ray diffraction imaging experiments have been undertaken at the SPring‐8 Angstrom Compact free electron LAser (SACLA) facility. To efficiently perform experiments and data processing, two software suites with user‐friendly graphical user interfaces have been developed. The first is a program suite named IDATEN, which was developed to easily conduct four procedures during experiments: aligning KOTOBUKI‐1, loading a flash‐cooled sample into the cryogenic goniometer stage inside the vacuum chamber of KOTOBUKI‐1, adjusting the sample position with respect to the X‐ray beam using a pair of telescopes, and collecting diffraction data by raster scanning the sample with X‐ray pulses. Named G‐SITENNO, the other suite is an automated version of the original SITENNO suite, which was designed for processing diffraction data. These user‐friendly software suites are now indispensable for collecting a large number of diffraction patterns and for processing the diffraction patterns immediately after collecting data within a limited beam time.     

Combination of integrated dynamic shimming and readout-segmented echo planar imaging for diffusion weighted MRI of the head and neck region at 3 Tesla

PurposeTo evaluate the performance of combined integrated slice-by-slice shimming and readout-segmented EPI (irsEPI) for diffusion-weighted MR imaging (DWI) of the neck at 3 Tesla.MethodsThis study was approved by the local ethics committee. An anthropometric phantom of the head/neck region incorporating compartments with different diffusivities was constructed. In vivo measurements were performed in 10 healthy volunteers. DWI of the phantom and volunteers was performed on a 3 Tesla MR scanner using single shot EPI (sEPI), a prototype single shot EPI with integrated slice-by-slice shimming (iEPI), readout segmented EPI (rsEPI) and a prototype readout segmented EPI with integrated shimming irsEPI. Apparent diffusion coefficients (ADC) and spatial distortions of phantom compartments were quantified. For phantom and volunteer measurements, the presence of geometric distortions, signal losses, ghosting artifacts as well as overall image quality were visually assessed on a 4-point scale by two radiologists in consensus. In addition, failure of fat saturation was assessed in volunteer data.ResultsQuantification of ADC within the phantom compartments was comparable using the different EPI techniques without significant variations. Using irsEPI, spatial distortions in phase-encoding direction were markedly reduced compared to iEPI, rsEPI and especially sEPI. irsEPI yielded significantly better overall image quality compared to sEPI, iEPI and rsEPI in phantom data as well as volunteer measurements. Markedly reduced geometric distortions and signal loss as well as better fat saturation were observed using irsEPI.ConclusionThe use of irsEPI significantly improves image quality and reduces artifacts caused by magnetic field inhomogeneities in EPI based DWI of the head/neck at 3 Tesla.