Motion-insensitive carotid intraplaque hemorrhage imaging using 3D inversion recovery preparation stack of stars
Seong-Eun Kim1,2, John A Roberts1,2, Laura B Eisenmenger2
1Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.
Insights
A new "Stack of Stars" (SOS) MRI sequence improves carotid intraplaque hemorrhage (IPH) detection by reducing motion and flow artifacts. This advanced imaging technique offers higher image quality and reliability for stroke risk assessment.
Area of Science:
- Medical Imaging
- Radiology
- Cardiovascular Imaging
Background:
- Carotid artery imaging is crucial for stroke risk assessment.
- Detecting intraplaque hemorrhage (IPH) in carotid arteries is diagnostically challenging.
- Standard 3D MPRAGE sequences can be limited by motion and flow artifacts.
Purpose of the Study:
- To develop and evaluate an improved 3D carotid MPRAGE sequence for enhanced IPH detection.
- To investigate the efficacy of a radial-based "Stack of Stars" (SOS) sequence with inversion recovery preparation.
- To hypothesize that SOS would reduce motion sensitivity and improve flow suppression.
Main Methods:
- 31 patients with carotid disease underwent 3T MRI using both 3D IR-prep Cartesian and SOS sequences.
- Image quality, motion, and flow artifacts were compared between the two sequences.
- Interrater reliability was assessed using Kappa analysis.
Main Results:
- The SOS sequence demonstrated significantly higher image quality (3.74 vs. 3.11, P < 0.001).
- SOS acquisition resulted in less motion (19.4% vs. 45.2%, P < 0.002) and flow artifact (27.4% vs. 41.9%, P < 0.089).
- Excellent interrater reliability was achieved with SOS (kappa = 0.89), surpassing Cartesian (kappa = 0.84).
Conclusions:
- The SOS MPRAGE sequence offers significant advantages over Cartesian MPRAGE for carotid IPH detection.
- Reduced artifacts and high reliability make SOS a valuable tool for clinical management.
- This improved sequence aids in more accurate stroke risk assessment.
Purpose:
Carotid artery imaging is important in the clinical management of patients at risk for stroke. Carotid intraplaque hemorrhage (IPH) presents an important diagnostic challenge. 3D magnetization prepared rapid acquisition gradient echo (MPRAGE) has been shown to accurately image carotid IPH; however, this sequence can be limited due to motion- and flow-related artifact. The purpose of this work was to develop and evaluate an improved 3D carotid MPRAGE sequence for IPH detection. We hypothesized that a radial-based k-space trajectory sequence such as "Stack of Stars" (SOS) incorporated with inversion recovery preparation would offer reduced motion sensitivity and more robust flow suppression by oversampling of central k-space.
Materials And Methods:
A total of 31 patients with carotid disease (62 carotid arteries) were imaged at 3T magnetic resonance imaging (MRI) with 3D IR-prep Cartesian and SOS sequences. Image quality was determined between SOS and Cartesian MPRAGE in 62 carotid arteries using t-tests and multivariable linear regression. Kappa analysis was used to determine interrater reliability.
Results:
In all, 25 among 62 carotid plaques had carotid IPH by consensus from the reviewers on SOS compared to 24 on Cartesian sequence. Image quality was significantly higher with SOS compared to Cartesian (mean 3.74 vs. 3.11, P < 0.001). SOS acquisition yielded sharper image features with less motion (19.4% vs. 45.2%, P < 0.002) and flow artifact (27.4% vs. 41.9%, P < 0.089). There was also excellent interrater reliability with SOS (kappa = 0.89), higher than that of Cartesian (kappa = 0.84).
Conclusion:
By minimizing flow and motion artifacts and retaining high interrater reliability, the SOS MPRAGE has important advantages over Cartesian MPRAGE in carotid IPH detection.
Level Of Evidence:
1 J. Magn. Reson. Imaging 2017;45:410-417.
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