Research Article

Reliability and Value of 3D Sequential QUantitative T₁-T₂-T₂* MAppings (SQUMA) MR Multi-Parametric Imaging in Characterizing Carotid Artery Atherosclerosis

Huiyu Qiao PhD

orcid.org/0000-0003-2688-6893

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

School of Medicine, Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China

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Qiansu Yang BS,

Qiansu Yang BS

Center of Medicine Clinical Research, Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Beijing, China

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Ran Huo PhD,

Ran Huo PhD

orcid.org/0000-0003-3749-0253

Department of Radiology, Peking University Third Hospital, Beijing, China

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Hualu Han PhD,

Hualu Han PhD

orcid.org/0000-0002-4144-5722

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

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Zihan Ning BS,

Zihan Ning BS

orcid.org/0000-0002-9692-1976

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

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Rui Shen MS,

Rui Shen MS

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

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Xiaowei Song MD, PhD,

Xiaowei Song MD, PhD

Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

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Huijun Chen PhD,

Huijun Chen PhD

orcid.org/0000-0003-1158-5510

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

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Shuo Chen PhD,

Corresponding Author

Shuo Chen PhD

[email protected]

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

Address reprint requests to: S.C. or X.Z., Haidian District, 100084 Beijing, China. E-mail: [email protected] or [email protected]

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Xihai Zhao MD, PhD,

Corresponding Author

Xihai Zhao MD, PhD

[email protected]

orcid.org/0000-0001-8953-0566

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

Address reprint requests to: S.C. or X.Z., Haidian District, 100084 Beijing, China. E-mail: [email protected] or [email protected]

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Huiyu Qiao PhD,

Huiyu Qiao PhD

orcid.org/0000-0003-2688-6893

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

School of Medicine, Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China

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Qiansu Yang BS,

Qiansu Yang BS

Center of Medicine Clinical Research, Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Beijing, China

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Ran Huo PhD,

Ran Huo PhD

orcid.org/0000-0003-3749-0253

Department of Radiology, Peking University Third Hospital, Beijing, China

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Hualu Han PhD,

Hualu Han PhD

orcid.org/0000-0002-4144-5722

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

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Zihan Ning BS,

Zihan Ning BS

orcid.org/0000-0002-9692-1976

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

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Rui Shen MS,

Rui Shen MS

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

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Xiaowei Song MD, PhD,

Xiaowei Song MD, PhD

Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

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Huijun Chen PhD,

Huijun Chen PhD

orcid.org/0000-0003-1158-5510

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

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Shuo Chen PhD,

Corresponding Author

Shuo Chen PhD

[email protected]

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

Address reprint requests to: S.C. or X.Z., Haidian District, 100084 Beijing, China. E-mail: [email protected] or [email protected]

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Xihai Zhao MD, PhD,

Corresponding Author

Xihai Zhao MD, PhD

[email protected]

orcid.org/0000-0001-8953-0566

Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China

Address reprint requests to: S.C. or X.Z., Haidian District, 100084 Beijing, China. E-mail: [email protected] or [email protected]

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First published: 29 September 2022

https://doi.org/10.1002/jmri.28445

Shuo Chen and Xihai Zhao contributed equally to this study.

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Abstract

Background

T₁, T₂, and T₂* mappings are seldom performed in a single examination, and their values in evaluating symptomatic atherosclerosis are lacking.

Purpose

To perform three-dimensional (3D) quantitative T₁, T₂, and T₂* mappings (SQUMA) multi-parametric imaging for carotid vessel wall and evaluate its reliability and value in assessing carotid atherosclerosis.

Study Type

Prospective.

Subjects

Eight healthy subjects and 20 patients with symptomatic carotid atherosclerosis.

Field Strength/Sequence

3 T, SQUMA imaging T₁-, T₂-, and T₂*-mapping, multi-contrast vessel wall imaging including T₁- and T₂-weighted, time-of-flight, and SNAP sequences.

Assessment

SQUMA was acquired in all subjects and multi-contrast images were acquired in healthy subjects. T₁, T₂, and T₂* values and lumen area (LA), wall area (WA), mean wall thickness (MeanWT), and normalized wall index (NWI) of carotid arteries were measured. SQUMA and multi-contrast measurements were compared in healthy subjects and differences in SQUMA measurements between healthy subjects and patients were assessed. The discriminative value of SQUMA measurements for symptomatic vessel was determined.

Statistical Tests

Paired t or Wilcoxon signed-rank test, independent t or Mann–Whitney U test, area under the receiver operating characteristic curve (AUC), intraclass correlation coefficients, and Bland–Altman plots. Statistically significant level, P < 0.05.

Results

There were no significant differences in LA (P = 0.340), WA (P = 0.317), MeanWT (P = 0.088), and NWI (P = 0.091) of carotid arteries between SQUMA and multi-contrast vessel wall images. The values of T₂ (50.9 ± 2.9 msec vs. 44.5 ± 4.2 msec), T₂* (28.2 ± 4.3 msec vs. 24.7 ± 2.6 msec), WA (23.7 ± 4.6 mm² vs. 36.2 ± 7.7 mm²), MeanWT (0.99 ± 0.05 mm vs. 1.50 ± 0.28 mm), and NWI (40.7 ± 3.0% vs. 53.8 ± 5.4%) of carotid arteries in healthy subjects were significantly different from those in atherosclerotic patients. The combination of quantitative T₁, T₂, and T₂* values and MeanWT showed greatest AUC (0.81; 95% CI: 0.65–0.92) in discriminating symptomatic vessels.

Data Conclusion

Carotid MR 3D quantitative multi-parametric imaging of SQUMA enables acquisition of T₁, T₂, and T₂* maps, reliably measuring carotid morphology and discriminating carotid symptomatic atherosclerosis.

Level of Evidence

Technical Efficacy

Stage 2

Supporting Information

References

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Volume57, Issue5

May 2023

Pages 1376-1389

Reliability and Value of 3D Sequential QUantitative T₁-T₂-T₂* MAppings (SQUMA) MR Multi-Parametric Imaging in Characterizing Carotid Artery Atherosclerosis

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Level of Evidence

Technical Efficacy

Supporting Information

References

References

Information

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Reliability and Value of 3D Sequential QUantitative T1-T2-T2* MAppings (SQUMA) MR Multi-Parametric Imaging in Characterizing Carotid Artery Atherosclerosis

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Level of Evidence

Technical Efficacy

Supporting Information

References

References

Related

Information

Reliability and Value of 3D Sequential QUantitative T₁-T₂-T₂* MAppings (SQUMA) MR Multi-Parametric Imaging in Characterizing Carotid Artery Atherosclerosis