Reliability and Value of 3D Sequential QUantitative T1‐T2‐T2* MAppings (SQUMA) MR Multi‐Parametric Imaging in Characterizing Carotid Artery Atherosclerosis. Issue 5 (29th September 2022)

• Record Type: Journal Article
• Authors: Qiao, Huiyu; Yang, Qiansu; Huo, Ran; Han, Hualu; Ning, Zihan; Shen, Rui; Song, Xiaowei; Chen, Huijun; Chen, Shuo; Zhao, Xihai
• Is Part Of: Journal of magnetic resonance imaging. Volume 57:Issue 5(2023)
• Page Start: 1376
• Page End: 1389
• Publication Date: 2022-09-29
• Subjects: carotid artery -- atherosclerosis -- multi‐parametric imaging -- morphology; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.28445
• Languages: English
• ISSNs: 1053-1807

Abstract

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 mm 2 vs. 36.2 ± 7.7 mm 2 ), 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: 2 Technical Efficacy: Stage 2