Original Research

Quantitative Susceptibility Mapping for Characterization of Intraplaque Hemorrhage and Calcification in Carotid Atherosclerotic Disease

Chaoyue Wang MSc

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

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Yue Zhang MS,

Yue Zhang MS

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

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Jingwen Du MS,

Jingwen Du MS

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

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István N. Huszár MD,

István N. Huszár MD

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

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Saifeng Liu PhD,

Saifeng Liu PhD

Magnetic Resonance Imaging Institute for Biomedical Research, Bingham Farms, Michigan, USA

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Yongsheng Chen PhD,

Yongsheng Chen PhD

orcid.org/0000-0001-7114-5731

Magnetic Resonance Imaging Institute for Biomedical Research, Bingham Farms, Michigan, USA

Department of Radiology, Wayne State University, Detroit, Michigan, USA

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Sagar Buch PhD,

Sagar Buch PhD

Center for Functional and Metabolic Mapping, Robarts' Research Institute, Western University, London, Ontario, Canada

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Fang Wu MD,

Fang Wu MD

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

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Yuehong Liu MS,

Yuehong Liu MS

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

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Mark Jenkinson PhD,

Mark Jenkinson PhD

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

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Charlie Chia-Tsong Hsu PhD,

Charlie Chia-Tsong Hsu PhD

Gold Coast University Hospital, Southport, Queensland, Australia

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Zhaoyang Fan PhD,

Zhaoyang Fan PhD

Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA

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E. Mark Haacke PhD,

E. Mark Haacke PhD

Magnetic Resonance Imaging Institute for Biomedical Research, Bingham Farms, Michigan, USA

Department of Radiology, Wayne State University, Detroit, Michigan, USA

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Qi Yang MD, PhD,

Corresponding Author

Qi Yang MD, PhD

[email protected]

orcid.org/0000-0002-5773-0456

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA

Address reprints requests to: Q. Yang, MD, PhD, Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. E-mail: [email protected]Search for more papers by this author

Chaoyue Wang MSc,

Chaoyue Wang MSc

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

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Yue Zhang MS,

Yue Zhang MS

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

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Jingwen Du MS,

Jingwen Du MS

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

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István N. Huszár MD,

István N. Huszár MD

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

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Saifeng Liu PhD,

Saifeng Liu PhD

Magnetic Resonance Imaging Institute for Biomedical Research, Bingham Farms, Michigan, USA

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Yongsheng Chen PhD,

Yongsheng Chen PhD

orcid.org/0000-0001-7114-5731

Magnetic Resonance Imaging Institute for Biomedical Research, Bingham Farms, Michigan, USA

Department of Radiology, Wayne State University, Detroit, Michigan, USA

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Sagar Buch PhD,

Sagar Buch PhD

Center for Functional and Metabolic Mapping, Robarts' Research Institute, Western University, London, Ontario, Canada

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Fang Wu MD,

Fang Wu MD

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

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Yuehong Liu MS,

Yuehong Liu MS

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

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Mark Jenkinson PhD,

Mark Jenkinson PhD

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

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Charlie Chia-Tsong Hsu PhD,

Charlie Chia-Tsong Hsu PhD

Gold Coast University Hospital, Southport, Queensland, Australia

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Zhaoyang Fan PhD,

Zhaoyang Fan PhD

Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA

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E. Mark Haacke PhD,

E. Mark Haacke PhD

Magnetic Resonance Imaging Institute for Biomedical Research, Bingham Farms, Michigan, USA

Department of Radiology, Wayne State University, Detroit, Michigan, USA

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Qi Yang MD, PhD,

Corresponding Author

Qi Yang MD, PhD

[email protected]

orcid.org/0000-0002-5773-0456

Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China

Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA

First published: 10 February 2020

https://doi.org/10.1002/jmri.27064

Citations: 16

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Abstract

Background

Carotid artery intraplaque hemorrhage (IPH), an unstable component of atherosclerosis, is associated with an increased risk of stroke.

Purpose

To investigate quantitative susceptibility mapping (QSM) as a tool for the evaluation of IPH and calcification in vivo.

Study Type

Prospective.

Population

Ten healthy volunteers and 15 patients.

Field Strength/Sequence

3.0T Susceptibility-weighted imaging (SWI), magnetization-prepared rapid acquisition with gradient echo (MP-RAGE), T₁-weighted sampling perfection with application of optimized contrasts using different flip angle evolution (T₁-SPACE), T₂-weighted turbo spin-echo (T₂WI), and time-of-flight (TOF) sequences.

Assessment

The vessel wall area of the carotid artery was measured with QSM and compared with T₁-SPACE on healthy volunteers. Four radiologists, blinded to clinical history and patient identity, determined the presence and area of IPH on MP-RAGE and QSM, as well as the area of calcification on T₁-SPACE and QSM.

Statistical Tests

Bland–Altman analysis, Pearson correlation coefficients, linear regression analyses were performed to evaluate the concordance of area measurements. Cohen's kappa (κ) was analyzed to determine the agreement between IPH detections. The paired t-test was used to compare the group differences.

Results

In 423 matched slices, 20.1% (85/423) and 19.6% (83/423) were detected to have IPH on MP-RAGE and QSM, respectively. IPH detection by QSM and MP-RAGE showed good agreement (κ = 0.822, P < 0.001) between the two methods. There was no significant difference in IPH area measurements between QSM and MP-RAGE (7.28 mm² ± 6.41 vs. 7.16 mm² ± 5.99, P = 0.575). There was no significant difference in calcification area measurement between QSM and T₁-SPACE (3.51 mm² ± 1.78 vs. 3.41 mm² ± 2.02, P = 0.783).

Data Conclusion

QSM is a novel imaging tool for the identification of IPH in patients with carotid atherosclerosis and enables differentiation of IPH and calcification.

Evidence Level

Technical Efficacy

Stage 1 J. Magn. Reson. Imaging 2020;52:534–541.

Supporting Information

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Citing Literature

Volume52, Issue2

August 2020

Pages 534-541

Quantitative Susceptibility Mapping for Characterization of Intraplaque Hemorrhage and Calcification in Carotid Atherosclerotic Disease

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Evidence Level

Technical Efficacy

Supporting Information

REFERENCES

Citing Literature

References

Information

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Quantitative Susceptibility Mapping for Characterization of Intraplaque Hemorrhage and Calcification in Carotid Atherosclerotic Disease

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Evidence Level

Technical Efficacy

Supporting Information

REFERENCES

Citing Literature

References

Related

Information