Application Of 3D T1-SPACE Mr Vessel Wall Imaging In Cerebrovascular Disease

Objective: Our aim was to determine the characteristic of enhancement pattern of intracranial atherosclerotic plaque and the relationship with newly onset of stroke by using three-dimensional T1-SPACE high-resolution MR vessel wall imaging.Methods: 3D T1-SPACE MR images were retrospectively reviewed in patients with ischemic stroke and intracranial vascular stenosis. Patients were assigned into three groups: acute group(group A), subacute group(group B),and the chronic group(group C) according to the time since the onset of infarction. 3D T1 SPACE sequence was performed on a 3T MR imaging system(Magnetom Verio, Siemens healthcare,Erlangen,Germany)together with a 32-channel coils. Each identified plaque was classified as symptomatic plaque or asymptomatic plaque according to the locations of plaque and lesions responsible for clinical symptoms. Contrast enhancement extent was categorized into 3 grades on 3D T1-SPACE MR images. The relationship between the presence and enhancement extent of plaque and the ischemic stroke was investigated.Results: Fourteen of 35 stroke patients were studied during the acute phase, 10 of 35 patients in the subacute phase, and 11 patients in the chronic phase. In acute phase, symptomatic atherosclerotic plaques in the stroke territory demonstrated strong enhancement compared with asymptomatic plaques(p<0.01). In the subgroup analysis,the extent of plaque enhancement decreased during repeated examination.Conclusions: Our study proved that the extent of enhancement of the atherosclerotic plaque was associated with onset of ischemic stroke. In the acute phase, enhancement of the plaque exists and in the chronic phase enhancement decreased. These findings suggest enhancement pattern of intracranial atherosclerotic plaque may be used as a new imaging biomarker.Purpose Early detection of cerebral venous thrombosis(CVT) is currently a clinical challenge. We proposed a three-dimensional T1-SPACE high-resolution black-blood(BB) thrombus MR imaging technique for detection of CVT.Methods BB MR imaging was performed on 23 patients with proven CVT and 24 patients with negative CVT confirmed by conventional imaging techniques. Patients were divided into 2 groups based on the duration of clinical onset: ≤7 days(group 1) and between 7 and 30 days(group 2). Signal/noise ratio was calculated for the detected thrombus, and contrast/noise ratio was measured between thrombus and lumen and also between thrombus and brain tissue.Results In 23 patients with proven CVT, BB MR imaging correctly identified 113 of 116 segments with a sensitivity of 97.4%.Thrombus signal/noise ratio was 153±57 and 261±95 for group 1(n=10) and group 2(n=13), respectively(P<0.01).Thrombus to lumen contrast/noise ratio was 149±57 and 256±94 for group 1 and group 2, respectively. Thrombus to brain tissue contrast/noise ratio was 41±36 and 120±63(P<0.01), respectively.Conclusions The current findings support that T1-SPACE high-resolution black-blood MR imaging allows selective visualization of thrombus as opposed to indirect detection of venous flow perturbation and can be used as a promising first-line diagnostic imaging tool.