1.Clinical Value of 1.5-T Non-contrast Whole-heart Magnetic Resonance Coronary Angiography in Evaluating the Severity of Coronary Stenosis.
Lu LIN ; Xiao-Na ZHANG ; Hong LEI ; Liang WANG ; Zhu-Jun SHEN ; Wei CHEN ; Zhen-Jie WANG ; Zheng-Yu JIN ; Yi-Ning WANG
Acta Academiae Medicinae Sinicae 2021;43(3):406-413
		                        		
		                        			
		                        			Objective To evaluate the diagnostic performance of 1.5-T non-contrast free-breathing whole-heart magnetic resonance coronary angiography(MRCA)for≥50% and≥70% coronary artery stenosis in coronary artery disease(CAD).Methods Forty-one patients clinically scheduled for invasive coronary angiography(ICA)underwent 1.5-T non-contrast free-breathing whole-heart MRCA.The diagnostic performance for≥50% and≥70% stenosis was evaluated and compared using ICA as a reference standard.Results MRCA was completed in all the 41 patients with the total acquisition time of(10.1 ± 2.2)min.The sensitivity,specificity,and accuracy of MRCA for≥50% and≥70% stenosis were 100%(95%
		                        		
		                        		
		                        		
		                        			Coronary Angiography
		                        			;
		                        		
		                        			Coronary Stenosis/diagnostic imaging*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			;
		                        		
		                        			Magnetic Resonance Spectroscopy
		                        			;
		                        		
		                        			Predictive Value of Tests
		                        			;
		                        		
		                        			Sensitivity and Specificity
		                        			
		                        		
		                        	
2.Characteristics of high-resolution magnetic resonance vessel wall imaging of cervicocerebral artery dissection and the influential factors of vascular recanalization.
Jielin OU ; Weihua LIAO ; Shuai YANG
Journal of Central South University(Medical Sciences) 2021;46(5):467-474
		                        		
		                        			OBJECTIVES:
		                        			Cervicocerebral artery dissection (CAD) is one of the important causes for ischemic stroke in young and middle-aged people. CAD is dangerous and untimely diagnosis and treatment are likely to result in severe disability. Early diagnosis and timely intervention can greatly improve the prognosis of patients. This study was to investigate the imaging features of CAD on high-resolution magnetic resonance vessel wall imaging (HRMR-VWI) and to analyze the influential factors of vascular recanalization.
		                        		
		                        			METHODS:
		                        			A total of 19 CAD patients with both baseline HRMR-VWI and follow-up data of vascular imaging in the period from April 2017 to December 2019 in Department of Radiology, Xiangya Hospital, Central South University were retrospectively analyzed. The diseased vessels were divided into a recovery group and a unrecovered group. After treatment, diseased vessels with no residual arterial dissection and no residual stenosis in the lumen were included in the recovery group. Diseased vessels with stenosis, occlusion or residual dissection were included in the unrecovered group. Diseased vessels were divided into a ischemic stroke group and a non-ischemic stroke group according to the presence or absence of ischemic stroke in the area supplied by the diseased vessels. Differences in clinical data and HRMR-VWI imaging findings were compared between the groups.
		                        		
		                        			RESULTS:
		                        			A total of 26 vessels were involved, including 14 (53.8%) internal carotid artery extracranial segment, 8 (30.8%) vertebral artery extracranial segment, 3 (11.5%) vertebral artery intracranial segment, and 1 (3.9%) basilar artery. Ischemic stroke occurred in 16 diseased vascular supply areas. Intramural hematoma was all observed in the baseline HMR-VWI of the affected vessels. There were 18 vessels (69.2%) in the recovery group and 8 vessels (30.8%) in the unrecovered group. Compared with the vessels in the recovery group, the vessels in the unrecovered group were mostly found in the intracranial segment (
		                        		
		                        			CONCLUSIONS
		                        			Intramural hematoma is a common imaging manifestation of CAD and can be shown clearly and accurately on HRMR-VWI. Recanalization rate of CAD is high, and the recanalization of CAD in intracranial segment is slower than that of CAD in extracranial segment, which can prolong the review time.
		                        		
		                        		
		                        		
		                        			Basilar Artery
		                        			;
		                        		
		                        			Dissection
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Magnetic Resonance Spectroscopy
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Stroke
		                        			
		                        		
		                        	
3.Susceptibility vessel sign in subacute stroke patients with large vessel occlusion.
Guo Yong REN ; Xue Mei WU ; Ying LI ; Jie Yu LI ; Wei Ping SUN ; Yi Ning HUANG
Journal of Peking University(Health Sciences) 2021;53(6):1133-1138
		                        		
		                        			OBJECTIVE:
		                        			To investigate the presentation of susceptibility vessel sign (SVS) in subacute stroke patients with large vessel occlusion.
		                        		
		                        			METHODS:
		                        			We collected consecutive stroke patients who were admitted to Peking University First Hospital from December 2017 to August 2019 retrospectively. Those who had intracranial large vessel occlusion and received sensitivity weighted imaging (SWI) within 3 to 14 days after stroke onset were included in our analysis. The diagnosis of large vessel occlusion was based on magnetic resonance angiography (MRA), CT angiography (CTA) or digital subtraction angiography (DSA). The demographic information, clinical characteristics and imaging results were obtained from medical record. The occurrence rates of SVS sign were compared between stroke patients with cardioembolism (CE) and large artery atherosclerosis (LAA). In the sensitivity analysis, we performed a subgroup analysis in those patients who received SWI within 7 to 14 days after stroke onset. We also compared the occurrence rate of SVS sign between the patients with and without atrial fibrillation.
		                        		
		                        			RESULTS:
		                        			A total of 51 patients, 19 females and 32 males, with an average age of (63.04±11.23) years were analyzed in this study. Compared with LAA group, the patients in CE group were older and more likely to have an atrial fibrillation (P < 0.05). There were no significant differences between the CE group and LAA group in gender, hypertension, diabetes, coronary heart disease, hyperlipidemia, smoking, or National Institute of Health stroke scale(NIHSS) score at admission. SVS sign was found in 30 patients. Of whom, 3 were in CE group and 27 in LAA group. The occurrence rate of SVS sign was higher in the LAA group than in the CE group significantly (65.9% vs. 30.0%, P=0.039). The subgroup analysis showed that, in the patients who received SWI examination within 7 to 14 days after stroke onset, the differences between the two groups were still statistically significant (0 vs. 72.7%, P=0.006). Another sensitivity analysis showed that, the rate of SVS in the patients with atrial fibrillation was significantly lower than those patients without atrial fibrillation (25% vs. 65.1%, P=0.043).
		                        		
		                        			CONCLUSION
		                        			In subacute stroke patients, the occurrence rate of SVS sign in CE group was lower than that of LAA group. The significance of SVS sign in the differentiation of stroke subtype needs further validation.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Arteries
		                        			;
		                        		
		                        			Atherosclerosis
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Stroke/diagnostic imaging*
		                        			
		                        		
		                        	
4.Gadolinium angiography of inner ear in patients with sudden deafness and its clinical analysis.
Yong Ping HAN ; Jun Yi ZHANG ; Lei LIU ; Cai Feng LIANG ; Guo Hua MIAO ; Zheng Bang XU ; Lei WU ; Xue Qin DU ; Wen Jie FAN ; Ying XING ; Li Sheng YU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(7):746-750
		                        		
		                        			
		                        			Objective: To observe the gadolinium imaging findings of inner ear in patients with sudden deafness and to analyze its clinical features. Methods: From November 2017 to July 2020, 21 patients with sudden deafness in the People's Hospital of Dongsheng District, Ordos City were selected as the research objects, including 14 males and 7 females, aged 36-76 years, with a median age of 50 years. The course of disease was 1-19 days, with an average of 5.5 days. The patients received audiology tests, laboratory examination, and intravenous gadolinium angiography, each of whom was scanned twice by 3D-FLAIR sequence: once before intravenous gadolinium injection, and once again 4.5-6.0 h after intravenous gadolinium injection. The following corresponding clinical treatment was given. The imaging manifestations and clinical features were observed. Results: Among 21 cases of sudden deafness in acute stage, the signal intensity of 11 cases was significantly higher than that of the contralateral ear, and 2 cases had vestibular labyrinthine hydrops. In laboratory examination, only 2 cases of total deafness had increased WBC count and faster erythrocyte sedimentation rate, and the rest had no abnormality. The hearing types of 21 patients with sudden deafness were: total deafness in 8 cases, flat decline in 10 cases, low frequency decline in 1 case, high frequency decline in 2 cases. The total effective rate was 57% (12/21). The hearing types of 11 patients with abnormal gadolinium angiography were total deafness in 5 cases, flat decline in 5 cases and high frequency decline in 1 case. The total effective rate was 64% (7/11). Conclusion: Gadolinium angiography is abnormal in some patients with sudden deafness, and the permeability of blood labyrinth barrier may be increased, which is worthy of further study.
		                        		
		                        		
		                        		
		                        			Angiography
		                        			;
		                        		
		                        			Deafness
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Gadolinium
		                        			;
		                        		
		                        			Hearing Loss, Sudden/diagnostic imaging*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Vestibule, Labyrinth
		                        			
		                        		
		                        	
5.Alpha Stent for Coiling of Unruptured, Wide-Necked, Distal Internal Carotid Artery Aneurysms: Safety and Effectiveness at 6 Months
Yunsun SONG ; Jae Jon SHEEN ; Joong Goo KIM ; Sang Hun LEE ; Su Hee CHO ; Jung Cheol PARK ; Choong Gon CHOI ; Deok Hee LEE
Korean Journal of Radiology 2020;21(2):228-235
		                        		
		                        			
		                        			magnetic resonance angiography assessment. The primary safety endpoint was the absence of serious adverse events (SAEs) up to 6 months from the procedure.RESULTS: The primary effectiveness endpoint was observed in 94.4% (51/54) aneurysms. In one patient with technical failure, the stent could not be deployed because of parent artery tortuosity; therefore, a different type of stent was used. Of the 53 aneurysms treated with the Alpha stent, complete occlusion was achieved in 64.1% (34/53) cases, and near-complete occlusion was achieved in 32.0% (17/53) cases by the 6-month follow-up. Two cases (3.7%) required retreatment because of major recurrence. In 4% (2/50) patients, SAEs, i.e., retinal artery thromboembolism and corona radiata lacunar infarction, were reported after the procedure.CONCLUSION: For endovascular treatment of unruptured, wide-necked, distal ICA aneurysms, coil embolization using the newly developed Alpha stent showed excellent procedural and mid-term clinical follow-up results in terms of effectiveness and safety.]]>
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aneurysm
		                        			;
		                        		
		                        			Arteries
		                        			;
		                        		
		                        			Carotid Artery, Internal
		                        			;
		                        		
		                        			Embolization, Therapeutic
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			;
		                        		
		                        			Parents
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Recurrence
		                        			;
		                        		
		                        			Retinal Artery
		                        			;
		                        		
		                        			Retreatment
		                        			;
		                        		
		                        			Stents
		                        			;
		                        		
		                        			Stroke, Lacunar
		                        			;
		                        		
		                        			Thromboembolism
		                        			
		                        		
		                        	
6.Progress in the role of high resolution magnetic resonance imaging technology in the risk assessment of intracranial aneurysm rupture.
Bingzhong GUO ; Yifeng LI ; Weixi JIANG ; Shun YANG ; Buyan LI ; Dun YUAN
Journal of Central South University(Medical Sciences) 2020;45(12):1476-1482
		                        		
		                        			
		                        			The traditional classification, diagnosis, and treatment of intracranial aneurysms are based on the characteristics of their vascular lumen. However, in the past few years, some advances in MRI technology with high-resolution imaging can assess the pathology of intracranial vascular walls. Compared with traditional methods of computed tomography angiography, magnetic resonance angiograhpy, and digital subtraction angiography, high resolution magnetic resonance imaging technology can help us to newly understand the disease by directly evaluating the characteristics of vascular wall, such as aneurysm wall thickness, inflammation, enhancement, permeability and hemodynamics. At present, high-resolution magnetic resonance imaging is increasingly used in clinic to assess the rupture risk of intracranial aneurysms, which is of great significance for guiding the diagnosis and treatment of intracranial aneurysms.
		                        		
		                        		
		                        		
		                        			Aneurysm, Ruptured/diagnostic imaging*
		                        			;
		                        		
		                        			Cerebral Angiography
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Intracranial Aneurysm/diagnostic imaging*
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Risk Assessment
		                        			;
		                        		
		                        			Technology
		                        			
		                        		
		                        	
7.Feasibility of Non-contrast-enhanced Coronary Magnetic Resonance Angiography at 3.0T.
Jing-Wen DAI ; Jian CAO ; Lu LIN ; Xiao LI ; Yi-Ning WANG ; Zheng-Yu JIN
Acta Academiae Medicinae Sinicae 2020;42(2):216-221
		                        		
		                        			
		                        			To evaluate the feasibility of non-contrast-enhanced magnetic resonance angiography (NCE-MRA) on a 3.0T scanner. Totally 36 volunteers and 24 patients with clinically suspected coronary artery disease underwent NCE-MRA. The quality of the NCE-MRA images was graded for each segment on a four-point scale. The subjects were divided into two groups according to image quality. The age,body mass index (BMI),heart rate,end-expiratory diaphragm displacement,and respiratory diaphragm motion amplitude were evaluated and compared. The average image quality score of every segment was above 2 points. The proximal and middle segments of left anterior descending artery had significantly higher quality scores than the distal segments (=0.000) and the proximal segment of left circumflex coronary artery had significantly higher quality scores than the distal segments (=0.000),the proximal segment of right coronary artery also had a significant higher quality score than its distal segment (=0.001). The image quality was good in 38 subjects (64.4%). The heart rate [(66.35±9.39) beat/min (75.32±11.67) beat/min] (=0.002) and the body mass index [(24.72±3.33) kg/m (27.82±3.61) kg/m ] (=0.002) were significantly different between the good image quality group and the poor image quality group. The end-expiratory diaphragm displacement in good image quality group was (4.43±2.07)mm,which was significantly lower than that in poor image quality group [(9.26±7.62)mm](=0.013). The respiratory diaphragm motion amplitude [(21.35±6.02) mm] in good image quality group was significantly lower than that in poor image quality group [(30.68±14.20)mm](=0.012). NCE-MRA on 3.0T is a feasible tool for visualization of the proximal and middle segments of coronary arteries,and the image quality can be optimized by controlling heart rate and respiration in the future.
		                        		
		                        		
		                        		
		                        			Contrast Media
		                        			;
		                        		
		                        			Coronary Angiography
		                        			;
		                        		
		                        			Coronary Artery Disease
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			Coronary Vessels
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			Feasibility Studies
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			
		                        		
		                        	
8.Evaluation of Tumor Blood Flow Using Alternate Ascending/Descending Directional Navigation in Primary Brain Tumors: A Comparison Study with Dynamic Susceptibility Contrast Magnetic Resonance Imaging
Hyeree PARK ; Joonhyuk LEE ; Sung Hong PARK ; Seung Hong CHOI
Korean Journal of Radiology 2019;20(2):275-282
		                        		
		                        			
		                        			OBJECTIVE: Alternate ascending/descending directional navigation (ALADDIN) is a novel arterial spin labeling technique that does not require a separate spin preparation pulse. We sought to compare the normalized cerebral blood flow (nCBF) values obtained by ALADDIN and dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging (MRI) in patients with primary brain tumors. MATERIALS AND METHODS: Sixteen patients with primary brain tumors underwent MRI scans including contrast-enhanced T1-weighted imaging, DSC perfusion MRI, and ALADDIN. The nCBF values of normal gray matter (GM) and tumor areas were measured by both DSC perfusion MRI and ALADDIN, which were compared by the Wilcoxon signed rank test. Subgroup analyses according to pathology were performed with the Wilcoxon signed rank test. RESULTS: Higher mean nCBF values of GM regions in the bilateral frontal lobe, temporal lobe, and caudate were detected by ALADDIN than by DSC perfusion MRI (p <0.05). In terms of the mean or median nCBF values and the mean of the top 10% nCBF values from tumors, DSC perfusion MRI and ALADDIN did not statistically significantly differ either overall or in each tumor group. CONCLUSION: ALADDIN tended to detect higher nCBF values in normal GM, as well as higher perfusion portions of primary brain tumors, than did DSC perfusion MRI. We believe that the high perfusion signal on ALADDIN can be beneficial in lesion detection and characterization.
		                        		
		                        		
		                        		
		                        			Brain Neoplasms
		                        			;
		                        		
		                        			Cerebrovascular Circulation
		                        			;
		                        		
		                        			Frontal Lobe
		                        			;
		                        		
		                        			Glioma
		                        			;
		                        		
		                        			Gray Matter
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Pathology
		                        			;
		                        		
		                        			Perfusion
		                        			;
		                        		
		                        			Temporal Lobe
		                        			
		                        		
		                        	
9.Accelerated Time-of-Flight Magnetic Resonance Angiography with Sparse Undersampling and Iterative Reconstruction for the Evaluation of Intracranial Arteries
Hehan TANG ; Na HU ; Yuan YUAN ; Chunchao XIA ; Xiumin LIU ; Panli ZUO ; Aurelien F STALDER ; Michaela SCHMIDT ; Xiaoyue ZHOU ; Bin SONG ; Jiayu SUN
Korean Journal of Radiology 2019;20(2):265-274
		                        		
		                        			
		                        			OBJECTIVE: To compare the image quality of three-dimensional time-of-flight (TOF) magnetic resonance angiography (MRA) with sparse undersampling and iterative reconstruction (sparse TOF) with that of conventional TOF MRA. MATERIALS AND METHODS: This study included 56 patients who had undergone sparse TOF MRA for intracranial artery evaluation on a 3T MR scanner. Conventional TOF MRA scans were also acquired from 29 patients with matched acquisition times and another 27 patients with matched scanning parameters. The image quality was scored using a five-point scale based on the delineation of arterial vessel segments, artifacts, overall vessel visualization, and overall image quality by two radiologists independently, and the data were analyzed using the non-parametric Wilcoxon signed-rank test. Contrast ratios (CRs) of vessels were compared using the paired t test. Interobserver agreement was calculated using the kappa test. RESULTS: Compared with conventional TOF at the same spatial resolution, sparse TOF with an acceleration factor of 3.5 could reduce acquisition time by 40% and showed comparable image quality. In addition, when compared with conventional TOF with the same acquisition time, sparse TOF with an acceleration factor of 5 could also achieve higher spatial resolution, better delineation of vessel segments, fewer artifacts, higher image quality, and a higher CR (p < 0.05). Good-to-excellent interobserver agreement (κ: 0.65–1.00) was obtained between the two radiologists. CONCLUSION: Compared with conventional TOF, sparse TOF can achieve equivalent image quality in a reduced duration. Furthermore, using the same acquisition time, sparse TOF could improve the delineation of vessels and decrease image artifacts.
		                        		
		                        		
		                        		
		                        			Acceleration
		                        			;
		                        		
		                        			Arteries
		                        			;
		                        		
		                        			Artifacts
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			
		                        		
		                        	
10.Oculomotor nerve palsy associated with internal carotid artery: case reports
Journal of the Korean Society of Emergency Medicine 2019;30(2):198-204
		                        		
		                        			
		                        			Oculomotor nerve palsy limits the specific direction eyeball movement, and represents diplopia, mydriasis, and ptosis. The vascular-associated etiologies of oculomotor nerve palsy are the microvascular ischemia due to hypertension or diabetes, or compression of the nerve by the aneurysm. For the aneurysm, if not treated properly, it may result in mortality or severe neurological impairment. Thorough history taking, physical examinations, and proper imaging modality are needed to make an accurate diagnosis. A 76-year-old female with decreased mentality and anisocoria presented at our emergency department. An 83-year-old female presented with right ptosis and lateral-side deviated of the right eyeball. No definite lesion was noted on the initial non-contrast brain computed tomography (CT) and magnetic resonance imaging diffusion. An aneurysm was detected on CT angiography taken several hours later in the former patient. For the latter patient, a giant aneurysm was detected on magnetic resonance angiography that had been performed at another hospital 4 days earlier. These two patients underwent transfemoral cerebral angiography with coiling. They were discharged with no neurological sequelae.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Aneurysm
		                        			;
		                        		
		                        			Angiography
		                        			;
		                        		
		                        			Anisocoria
		                        			;
		                        		
		                        			Brain
		                        			;
		                        		
		                        			Carotid Artery, Internal
		                        			;
		                        		
		                        			Cerebral Angiography
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Diffusion
		                        			;
		                        		
		                        			Diplopia
		                        			;
		                        		
		                        			Emergency Service, Hospital
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hypertension
		                        			;
		                        		
		                        			Ischemia
		                        			;
		                        		
		                        			Magnetic Resonance Angiography
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Mortality
		                        			;
		                        		
		                        			Mydriasis
		                        			;
		                        		
		                        			Oculomotor Nerve Diseases
		                        			;
		                        		
		                        			Oculomotor Nerve
		                        			;
		                        		
		                        			Physical Examination
		                        			
		                        		
		                        	
            
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