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Quantitative MR Analysis for the Assessment of Carotid Atherosclerosis

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Multi-Modality Atherosclerosis Imaging and Diagnosis

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Abstract

In recent years in vivo carotid black blood MRI (bb-MRI) has evolved to be a promising method for imaging atherosclerotic disease of the cervical arteries. Advantages such as noninvasiveness, lack of radiation exposure, excellent soft tissue contrast, accuracy, and reproducibility have contributed to its acceptance. Recent developments of bb-MRI enable to reliably identify and quantify plaque components and to detect features of the vulnerable plaque, such as a thin or ruptured fibrous cap, large necrotic core, intraplaque hemorrhage, macrophage infiltration, and neovascularization. In addition, carotid bb-MRI allows evaluating mechanical forces and the biological activity of atherosclerotic plaques. The ability to quantitatively evaluate a variety of these markers paves the way for a broad application of carotid bb-MRI and permits studies aimed at understanding atherosclerotic disease development, treatment studies, and patient risk stratification. This book chapter will discuss the capabilities of bb-MRI for quantitative assessment of the composition and morphology of atherosclerotic lesions. Technical requirements, such as hardware, software, and sequence considerations will be discussed. Studies, which evaluated the accuracy and reproducibility of carotid bb-MRI, will be shown. In addition, clinical studies will be shown which used bb-MRI to compare symptomatic and asymptomatic plaques, to study the natural history of atherosclerosis, and to evaluate the effect of anti-atherosclerotic drugs on the regression/progression of atherosclerosis.

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Abbreviations

bb-MRI:

Black-blood magnetic resonance imaging

CNR:

Contrast-to-noise ratio

DCE:

Dynamic contrast enhanced

DIR:

Double inversion recovery

FC:

Fibrous cap

ICC:

Intraclass correlation coefficient

IOSB:

Inflow/outflow saturation band

IPH:

Intraplaque hemorrhage

IS:

Inflow saturation

LR/NC:

Lipid-rich/necrotic core

MACE:

Major cardiovascular or cerebrovascular event

MP-RAGE:

Magnetization-prepared rapid acquisition gradient echo

MSDE:

Motion-sensitized driven equilibrium

NWI:

Normalized wall index

PWS:

Plaque wall stress

REX-DIR:

Rapid extended coverage double inversion recovery

SNR:

Signal-to-noise ratio

TI:

Time of inversion

TOF:

Time of flight

USPIO:

Ultrasmall superparamagnetic iron oxide

WSS:

Wall shear stress

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Authors and Affiliations

  1. Department of Clinical Radiology, University of Munich, Pettenkoferstr. 8a, 80336, München, Germany

    Andreas Schindler & Tobias Saam

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  1. Andreas Schindler
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  2. Tobias Saam
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Correspondence to Tobias Saam .

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Editors and Affiliations

  1. Department of Radiology, A.O.U Cagliari - Polo di Monserrato, Bivio per Sestu, Italy

    Luca Saba

  2. Instituto Superior Técnico Institute for Systems and Robotics, Lisboa, Portugal

    João Miguel Sanches

  3. Hospital de Santa Maria, Lisboa, Portugal

    Luís Mendes Pedro

  4. Stroke Research and Monitoring Division, AtheroPoint(TM) LLC, Roseville, California, USA

    Jasjit S. Suri

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Schindler, A., Saam, T. (2014). Quantitative MR Analysis for the Assessment of Carotid Atherosclerosis. In: Saba, L., Sanches, J., Pedro, L., Suri, J. (eds) Multi-Modality Atherosclerosis Imaging and Diagnosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7425-8_4

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