High resolution 3D diffusion cardiovascular magnetic resonance of carotid vessel wall to detect lipid core without contrast media

Journal of Cardiovascular Magnetic Resonance

Technical Notes

Zhaoyang Fan¹  Yibin Xie²  Christopher Nguyen²  Debiao Li²  Zhaoqi Zhang³  Wei Yu³  Tianjing Zhang⁴  Jing An⁴  Xiaoming Bi⁵ 

[1]Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA

[2]Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA

[3]Department of Bioengineering, University of California, Los Angeles, CA, USA

[4]Department of Radiology, Anzhen Hospital, Capital Medical University, Beijing, China

[5]MR Collaborations NE Asia, Siemens Healthcare, Beijing, China

[6]MR R&D, Siemens Healthcare, Los Angeles, CA, USA

关键词: Atherosclerosis;    Carotid;    Vessel wall;    Diffusion-weighted imaging;    Lipid core;    ADC;    Plaque characterization;    Cardiovascular magnetic resonance;   

DOI  :  10.1186/s12968-014-0067-z

 received in 2014-04-19, accepted in 2014-08-12,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundWithout the need of contrast media, diffusion-weighted imaging (DWI) has shown great promise for accurate detection of lipid-rich necrotic core (LRNC), a well-known feature of vulnerable plaques. However, limited resolution and poor image quality in vivo with conventional single-shot diffusion-weighted echo planar imaging (SS-DWEPI) has hindered its clinical application. The aim of this work is to develop a diffusion-prepared turbo-spin-echo (DP-TSE) technique for carotid plaque characterization with 3D high resolution and improved image quality.MethodsUnlike SS-DWEPI where the diffusion encoding is integrated in the EPI framework, DP-TSE uses a diffusion encoding module separated from the TSE framework, allowing for segmented acquisition without the sensitivity to phase errors. The interleaved, motion-compensated sequence was designed to enable 3D black-blood DWI of carotid arteries with sub-millimeter resolution. The sequence was tested on 12 healthy subjects and compared with SS-DWEPI for image quality, vessel wall visibility, and vessel wall thickness measurements. A pilot study was performed on 6 patients with carotid plaques using this sequence and compared with conventional contrast-enhanced multi-contrast 2D TSE as the reference.ResultsDP-TSE demonstrated advantages over SS-DWEPI for resolution and image quality. In the healthy subjects, vessel wall visibility was significantly higher with diffusion-prepared TSE (p < 0.001). Vessel wall thicknesses measured from diffusion-prepared TSE were on average 35% thinner than those from the EPI images due to less distortion and partial volume effect (p < 0.001). ADC measurements of healthy carotid vessel wall are 1.53 ± 0.23 × 10−3 mm2/s. In patients the mean ADC measurements in the LRNC area were significantly lower (0.60 ± 0.16×10−3 mm2/s) than those of the fibrous plaque tissue (1.27 ± 0.29 × 10−3 mm2/s, p < 0.01).ConclusionsDiffusion-prepared CMR allows, for the first time, 3D DWI of the carotid arterial wall in vivo with high spatial resolution and improved image quality over SS-DWEPI. It can potentially detect LRNC without the use of contrast agents, allowing plaque characterization in patients with renal insufficiency.

【 授权许可】

Unknown   
© Xie et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.