Relaxation-Enhanced Angiography Without Contrast and Triggering (REACT) for Fast Imaging of Extracranial Arteries in Acute Ischemic Stroke at 3â¯T.
Clin Neuroradiol
; 31(3): 815-826, 2021 Sep.
Article
em En
| MEDLINE
| ID: mdl-33026511
ABSTRACT
PURPOSE:
To evaluate a novel flow-independent 3D isotropic REACT sequence compared with CE-MRA for the imaging of extracranial arteries in acute ischemic stroke (AIS).METHODS:
This was a retrospective study of 35 patients who underwent a stroke protocol at 3â¯T including REACT (fixed scan time 246â¯min) and CE-MRA of the extracranial arteries. Three radiologists evaluated scans regarding vessel delineation, signal, and contrast and assessed overall image noise and artifacts using 5-point scales (5 excellent delineation/no artifacts). Apparent signal- and contrast-to-noise ratios (aSNR/aCNR) were measured for the common carotid artery (CCA), internal carotid artery (ICA, C1 segment), and vertebral artery (V2 segment). Two radiologists graded the degree of proximal ICA stenosis.RESULTS:
Compared to REACT, CE-MRA showed better delineation for the CCA and ICA (C1 and C2 segments) (median 5, range 2-5 vs. 4, range 3-5; Pâ¯< 0.05). For the ICA (C1 and C2 segments), REACT provided a higher signal (5, range 3-5; Pâ¯< 0.05/4.5, range 3-5; Pâ¯> 0.05 vs. 4, range 2-5) and contrast (5, range 3-5 vs. 4, range 2-5; Pâ¯> 0.05) than CE-MRA. The remaining segments of the blood-supplying vessels showed equal medians. There was no significant difference regarding artifacts, whereas REACT provided significantly lower image noise (4, range 3-5 vs. 4 range 2-5; Pâ¯< 0.05) with a higher aSNR (Pâ¯< 0.05) and aCNR (Pâ¯< 0.05) for all vessels combined. For clinically relevant (≥50%) ICA stenosis, REACT achieved a detection sensitivity of 93.75% and a specificity of 100%.CONCLUSION:
Given its fast acquisition, comparable image quality to CE-MRA and high sensitivity and specificity for the detection of ICA stenosis, REACT was proven to be a clinically applicable method to assess extracranial arteries in AIS.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
/
Acidente Vascular Cerebral
/
AVC Isquêmico
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article