Dongye Li1, Huilin Zhao2, Xiaoyi Chen1,3, Shuo Chen3, Huiyu Qiao3, Le He3, Rui Li3, Jianrong Xu2, Chun Yuan3,4, Xihai Zhao5,6. 1. Centre for Brain Disorders Research, Capital Medical University and Beijing Institute for Brain Disorders, Beijing, China. 2. Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 3. Centre for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, Haidian District, 100084, China. 4. Department of Radiology, University of Washington, Seattle, WA, USA. 5. Centre for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, Haidian District, 100084, China. xihaizhao@tsinghua.edu.cn. 6. Centre of Stroke, Beijing Institute for Brain Disorders, Beijing, China. xihaizhao@tsinghua.edu.cn.
Abstract
OBJECTIVES: To investigate the usefulness of Simultaneous Non-contrast Angiography and intraPlaque haemorrhage (SNAP) imaging in characterising carotid intraplaque haemorrhage (IPH) compared with magnetisation-prepared rapid acquisition gradient-echo (MP-RAGE) sequence. METHODS: Fifty-four symptomatic patients (mean age: 63.1 ± 5.7 years, 38 males) with carotid atherosclerosis were recruited and underwent carotid MR imaging. The presence and area of IPH on SNAP and MP-RAGE images were determined. The agreement in identifying IPH and its area between SNAP and MP-RAGE was analysed. RESULTS: Of 1368 slices with acceptable image quality in 54 patients, 13% and 22.6% were found to have IPH on MP-RAGE and SNAP images, respectively. There was moderate agreement between MP-RAGE and SNAP sequences in identifying IPH (κ = 0.511, p = 0.029). The area of IPH on SNAP images was significantly larger than that on MP-RAGE images (17.9 ± 18.2 mm2 vs. 9.2 ± 10.5 mm2, p < 0.001). For IPHs detected by SNAP imaging, the area of IPHs also detected by the MP-RAGE sequence was significantly larger than that of IPHs not detected by the MP-RAGE sequence (17.9 ± 19.2 mm2 vs. 6.4 ± 6.2 mm2, p < 0.001). CONCLUSION: Compared with the MP-RAGE sequence, SNAP imaging detects more IPHs, particularly for smaller IPHs, suggesting that SNAP imaging might be a more sensitive tool for identification of carotid haemorrhagic plaques. KEY POINTS: • Moderate agreement was found between SNAP and MP-RAGE in identification of IPH • SNAP imaging might be a more sensitive tool to detect carotid IPHs • Compared with the MP-RAGE sequence, SNAP imaging can detect carotid IPHs with smaller size • SNAP imaging can help clinicians to optimise the treatment strategy.
OBJECTIVES: To investigate the usefulness of Simultaneous Non-contrast Angiography and intraPlaque haemorrhage (SNAP) imaging in characterising carotid intraplaque haemorrhage (IPH) compared with magnetisation-prepared rapid acquisition gradient-echo (MP-RAGE) sequence. METHODS: Fifty-four symptomatic patients (mean age: 63.1 ± 5.7 years, 38 males) with carotid atherosclerosis were recruited and underwent carotid MR imaging. The presence and area of IPH on SNAP and MP-RAGE images were determined. The agreement in identifying IPH and its area between SNAP and MP-RAGE was analysed. RESULTS: Of 1368 slices with acceptable image quality in 54 patients, 13% and 22.6% were found to have IPH on MP-RAGE and SNAP images, respectively. There was moderate agreement between MP-RAGE and SNAP sequences in identifying IPH (κ = 0.511, p = 0.029). The area of IPH on SNAP images was significantly larger than that on MP-RAGE images (17.9 ± 18.2 mm2 vs. 9.2 ± 10.5 mm2, p < 0.001). For IPHs detected by SNAP imaging, the area of IPHs also detected by the MP-RAGE sequence was significantly larger than that of IPHs not detected by the MP-RAGE sequence (17.9 ± 19.2 mm2 vs. 6.4 ± 6.2 mm2, p < 0.001). CONCLUSION: Compared with the MP-RAGE sequence, SNAP imaging detects more IPHs, particularly for smaller IPHs, suggesting that SNAP imaging might be a more sensitive tool for identification of carotid haemorrhagic plaques. KEY POINTS: • Moderate agreement was found between SNAP and MP-RAGE in identification of IPH • SNAP imaging might be a more sensitive tool to detect carotid IPHs • Compared with the MP-RAGE sequence, SNAP imaging can detect carotid IPHs with smaller size • SNAP imaging can help clinicians to optimise the treatment strategy.
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