Improved cerebrospinal fluid suppression for intracranial vessel wall MRI

• Published in: Journal of magnetic resonance imaging Vol. 44; no. 3; pp. 665 - 672
• Main Authors: Yang, Huan, Zhang, Xuefeng, Qin, Qin, Liu, Li, Wasserman, Bruce A., Qiao, Ye
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.09.2016; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Aged, 80 and over; Algorithms; Cerebral Angiography - methods; Cerebral Arteries - anatomy & histology; Cerebral Arteries - diagnostic imaging; Cerebrospinal Fluid - cytology; Cerebrospinal Fluid - diagnostic imaging; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; intracranial; isotropic; Magnetic Resonance Angiography - methods; Magnetic resonance imaging; Male; Middle Aged; MRI; Reproducibility of Results; Sensitivity and Specificity; Signal Processing, Computer-Assisted; Subtraction Technique; vessel wall; vessel wall; 3D; intracranial; MRI; isotropic
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.25211

Purpose To develop and assess a three‐dimensional (3D) high resolution black blood MRI (BBMRI) method for evaluation of intracranial vessels with improved cerebrospinal fluid (CSF) suppression. Materials and Methods The anti‐driven‐equilibrium (ADE) pulse was incorporated into a variable flip‐angle TSE‐based 3D BBMRI to improve CSF suppression. ADE‐BBMRI was optimized in 8 participants and compared with BBMRI, with acquired 0.5 mm isotropic resolution and scan time of 5.4 min at 3 Tesla. Contrast‐enhanced ADE‐BBMRI protocol was implemented in nine patients with intracranial atherosclerosis. Signal and morphological measurements were compared between ADE‐BBMRI and BBMRI, as well as pre‐ and postcontrast ADE‐BBMRI. Reliability was assessed by intraclass correlations (ICC). Results ADE‐BBMRI effectively suppressed the surrounding CSF signal of intracranial vessels, with a 36–44% reduction compared with BBMRI. ADE‐BBMRI also reduced the overall wall signal by 8–8.5%, but provided a significant improvement in wall‐to‐CSF contrast‐to‐noise ratio over BBMRI (middle cerebral artery, 5.93 ± 0.59 versus 3.95 ± 1.67, P < 0.01; basilar artery, 3.8 ± 1.76 versus 1.34 ± 0.54, P = 0.01, respectively). No differences were noted in morphological measurements between ADE‐BBMRI and BBMRI (lumen area, 6.35 ± 2.87 versus 6.32 ± 2.84 mm2; wall area, 1.28 ± 0.52 versus 1.27 ± 0.53 mm2; mean wall thickness, 0.93 ± 0.30 versus 0.93 ± 0.32 mm; maximum wall thickness, 1.27 ± 0.33 versus 1.28 ± 0.36 mm, all P > 0.05). Contrast enhanced ADE‐BBMRI improved the plaque delineation by the increased wall signal, wall‐to‐CSF and wall‐to‐blood contrast‐to‐noise ratio. ICC ranged from 0.54 to 0.95. Conclusion The 3D ADE‐BBMRI provides excellent blood and CSF suppression, and accurate measurements of intracranial vessels at 0.5 mm isotropic resolution in 5 min. Its clinical application may provide insight into stroke risk. J. Magn. Reson. Imaging 2016;44:665–672.