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European Radiology

, Volume 28, Issue 11, pp 4890–4899 | Cite as

Correlation-based perfusion mapping using time-resolved MR angiography: A feasibility study for patients with suspicions of steno-occlusive craniocervical arteries

  • Yoonho Nam
  • Jinhee Jang
  • Sonya Youngju Park
  • Hyun Seok Choi
  • So-Lyung Jung
  • Kook-Jin Ahn
  • Bum-soo Kim
Neuro

Abstract

Purpose

To explore the feasibility of using correlation-based time-delay (CTD) maps produced from time-resolved MR angiography (TRMRA) to diagnose perfusion abnormalities in patients suspected to have steno-occlusive lesions in the craniocervical arteries.

Materials and methods

Twenty-seven patients who were suspected to have steno-occlusive lesions in the craniocervical arteries underwent both TRMRA and brain single-photon emission computed tomography (SPECT). TRMRA was performed on the supra-aortic area after intravenous injection of a 0.03 mmol/kg gadolinium-based contrast agent. Time-to-peak (TTP) maps and CTD maps of the brain were automatically generated from TRMRA data, and their quality was assessed. Detection of perfusion abnormalities was compared between CTD maps and the time-series maximal intensity projection (MIP) images from TRMRA and TTP maps. Correlation coefficients between quantitative changes in SPECT and parametric maps for the abnormal perfusion areas were calculated.

Results

The CTD maps were of significantly superior quality than TTP maps (p < 0.01). For perfusion abnormality detection, CTD maps (kappa 0.84, 95% confidence interval [CI] 0.67-1.00) showed better agreement with SPECT than TTP maps (0.66, 0.46-0.85). For perfusion deficit detection, CTD maps showed higher accuracy (85.2%, 95% CI 66.3-95.8) than MIP images (66.7%, 46-83.5), with marginal significance (p = 0.07). In abnormal perfusion areas, correlation coefficients between SPECT and CTD (r = 0.74, 95% CI 0.34-0.91) were higher than those between SPECT and TTP (r = 0.66, 0.20-0.88).

Conclusion

CTD maps generated from TRMRA were of high quality and offered good diagnostic performance for detecting perfusion abnormalities associated with steno-occlusive arterial lesions in the craniocervical area.

Key Points

• Generation of perfusion parametric maps from time-resolved MR angiography is clinically useful.

• Correlation-based delay maps can be used to detect perfusion abnormalities associated with steno-occlusive craniocervical arteries.

• Estimation of correlation-based delay is robust for low signal-to-noise 4D MR data.

Keywords

Magnetic resonance angiography Perfusion Stenosis Computer-assisted image processing Comparative study 

Abbreviations

ASPECT

Alberta Stroke Program Early CT score

CI

Confidence interval

CTD

Correlation-based time delay

DSA

Digital subtraction cerebral angiography

GBCA

Gadolinium-based contrast agent

HR-CEMRA

High-resolution contrast-enhanced MR angiography

ICA

Internal carotid artery

ICC

Intra-class coefficients

IQR

Interquartile range

MCA

Middle cerebral artery

MIP

Maximal intensity projection

ROI

Region of interest

SNR

Signal-to-noise ratio

TRMRA

Time-resolved, multiphasic MR angiography

TTP

Time to peak

TWIST

Time-resolved angiography with stochastic trajectories

Notes

Funding

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03033829).

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Bum-soo Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• cross-sectional study

• performed at one institution

Supplementary material

330_2018_5468_MOESM1_ESM.docx (38 kb)
ESM 1 (DOCX 37.6 kb)

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Radiology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulKorea

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