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Quantification of intracranial arterial stenotic degree evaluated by high-resolution vessel wall imaging and time-of-flight MR angiography: reproducibility, and diagnostic agreement with DSA

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The purpose of this study was to compare the reproducibility and diagnostic agreement of high-resolution vessel wall imaging (HR-VWI) and time-of-flight magnetic resonance angiography (TOF-MRA) with digital subtraction angiography (DSA) to evaluate intracranial arterial stenosis.

Methods

We retrospectively enrolled patients who underwent HR-VWI and TOF-MRA with suspected intracranial artery disease and had DSA results from our institutional imaging database. Two neuroradiologists separately and independently evaluated anonymous image data for the stenotic lesions. DSA was analyzed by two neurointerventionalists and it served as a standard criterion. The reproducibility of these two MR techniques was determined by the intraclass correlation coefficients (ICCs). The diagnostic agreement to DSA was assessed by the concordance correlation coefficients (CCCs).

Results

A total of 246 lesions from 106 individuals were analyzed for stenotic degrees. The total intra-observer and inter-observer reproducibility of HR-VWI was excellent for identifying stenosis and better than of TOF-MRA. The overall concordance of HR-VWI with DSA was excellent with CCC = 0.932, whereas TOF-MRA was 0.694. In addition, HR-VWI could provide additional vessel wall information.

Conclusions

HR-VWI has more advantages over TOF-MRA, such as better reproducibilities and diagnostic agreements with DSA to analyze intracranial arterial stenosis. It provides additional information that helps in clinical diagnosis and management.

Key Points

• High-resolution vessel wall imaging can assess intracranial arterial stenosis with a better reproducibility than TOF-MRA and has a higher diagnostic agreement with DSA.

• High-resolution vessel wall imaging had a higher diagnostic agreement with DSA compared with TOF-MRA.

• Apart from evaluating vascular stenosis, HR-VWI provided additional vessel wall information to help in clinical diagnosis.

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Abbreviations

CCC:

Concordance correlation coefficient

DSA:

Digital subtraction angiography

HR-VWI:

High-resolution vessel wall imaging

ICAD:

Intracranial atherosclerosis disease

ICAS:

Intracranial atherosclerotic stenosis

ICC:

Intraclass correlation coefficient

IPH:

Intra-plaque hemorrhage

IR-SPACE:

Inversion-recovery sampling perfection with application-optimized contrasts using different flip angle evolution

TOF-MRA:

Time-of-flight MR angiography

WASID:

Warfarin-Aspirin Symptomatic Intracranial Disease

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Acknowledgements

The authors thank Song Liu, MD, Department of Radiology, Tianjin Huanhu Hospital and Jian Wang, MD, of Department of Radiology, Tianjin First Central Hospital for image acquisition, and Jinxia Zhu, senior collaboration research scientist, for her professional proof-reading of the entire manuscript.

Funding

This work was supported in part by the National Natural Science Foundation of China (NSFC) (grant number 81871342) and in part by the Spring plan of Tianjin First Central Hospital (grant number 2019CM05).

Author information

Author notes

  1. Yan Gong and Chen Cao contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, 300192, China

    Yan Gong, Chen Cao, Ying Zou & Xiudi Lu

  2. Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, 300100, China

    Yan Gong

  3. Department of Radiology, Tianjin Huanhu Hospital, Key Laboratory for Cerebral Artery and Neural Degeneration of Tianjin, Tianjin, 300350, China

    Chen Cao

  4. Department of Radiology, Tianjin First Central Hospital, School of Medical, Nankai University, Tianjin, 300192, China

    Yu Guo, Wen Shen & Shuang Xia

  5. Department of Neurosurgery, Tianjin First Central Hospital, School of Medical, Nankai University, Tianjin, 300192, China

    Binge Chang & Zhiguo Sheng

  6. Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China

    Ying Zou & Xiudi Lu

  7. School of Medicine, Nankai University, Tianjin, 300071, China

    Jiahua Xing

Authors
  1. Yan Gong
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Correspondence to Shuang Xia.

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The scientific guarantor of this publication is Shuang Xia.

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Gong, Y., Cao, C., Guo, Y. et al. Quantification of intracranial arterial stenotic degree evaluated by high-resolution vessel wall imaging and time-of-flight MR angiography: reproducibility, and diagnostic agreement with DSA. Eur Radiol 31, 5479–5489 (2021). https://doi.org/10.1007/s00330-021-07719-x

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