Original Article
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World J Radiol. May 28, 2014; 6(5): 192-202
Published online May 28, 2014. doi: 10.4329/wjr.v6.i5.192
Atherosclerosis imaging using 3D black blood TSE SPACE vs 2D TSE
Stephanie K Wong, Motunrayo Mobolaji-Iawal, Leron Arama, Joy Cambe, Sylvia Biso, Nadia Alie, Zahi A Fayad, Venkatesh Mani
Stephanie K Wong, Motunrayo Mobolaji-Iawal, Leron Arama, Joy Cambe, Sylvia Biso, Nadia Alie, Zahi A Fayad, Venkatesh Mani, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States
Stephanie K Wong, Motunrayo Mobolaji-Iawal, Zahi A Fayad, Venkatesh Mani, Department of Radiology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States
Zahi A Fayad, Zena and Michael A Wiener Cardiovascular Institute, Department of Medicine, Marie-Josée and Henry R, Kravis Cardiovascular Health Center, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States
Author contributions: Wong SK made substantial contributions to data analysis and interpretation, performed the statistical analysis, wrote the manuscript draft, and revised it critically according the suggestions of the other authors; Mobolaji-Iawal M, Cambe J, Biso S and Alie N made substantial contributions to data analysis, interpretation, finding the pictures, and helped draft the manuscript; Arama L participated in the design of the study and made substantial contribution to data analysis; Fayad ZA made substantial contribution to study conception and design, and critically revised the manuscript draft for important intellectual content; Mani V made substantial contributions to the study conception and design, participated in data acquisition, critically revised the manuscript draft for important intellectual content, and gave final approval of the version to be published; all the authors read and approved the final manuscript.
Supported by NIH NHLBI R01HL71021 (Fayad ZA); and Siemens Medical Solutions
Correspondence to: Venkatesh Mani, PhD, Assistant Professor, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mt. Sinai, One Gustave L, Levy Place, Box 1234, New York, NY 10029, United States. venkatesh.mani@mssm.edu
Telephone: +1-212-8248454 Fax: +1-646-5379689
Received: December 21, 2013
Revised: January 30, 2014
Accepted: April 17, 2014
Published online: May 28, 2014
Processing time: 158 Days and 7.9 Hours
Abstract

AIM: To compare 3D Black Blood turbo spin echo (TSE) sampling perfection with application-optimized contrast using different flip angle evolution (SPACE) vs 2D TSE in evaluating atherosclerotic plaques in multiple vascular territories.

METHODS: The carotid, aortic, and femoral arterial walls of 16 patients at risk for cardiovascular or atherosclerotic disease were studied using both 3D black blood magnetic resonance imaging SPACE and conventional 2D multi-contrast TSE sequences using a consolidated imaging approach in the same imaging session. Qualitative and quantitative analyses were performed on the images. Agreement of morphometric measurements between the two imaging sequences was assessed using a two-sample t-test, calculation of the intra-class correlation coefficient and by the method of linear regression and Bland-Altman analyses.

RESULTS: No statistically significant qualitative differences were found between the 3D SPACE and 2D TSE techniques for images of the carotids and aorta. For images of the femoral arteries, however, there were statistically significant differences in all four qualitative scores between the two techniques. Using the current approach, 3D SPACE is suboptimal for femoral imaging. However, this may be due to coils not being optimized for femoral imaging. Quantitatively, in our study, higher mean total vessel area measurements for the 3D SPACE technique across all three vascular beds were observed. No significant differences in lumen area for both the right and left carotids were observed between the two techniques. Overall, a significant-correlation existed between measures obtained between the two approaches.

CONCLUSION: Qualitative and quantitative measurements between 3D SPACE and 2D TSE techniques are comparable. 3D-SPACE may be a feasible approach in the evaluation of cardiovascular patients.

Keywords: Atherosclerosis, Carotid artery plaque, Aorta, Femoral artery, Magnetic resonance imaging

Core tip: The traditional approach to atherosclerotic plaque imaging using magnetic resonance (MR) is the two-dimensional (2D) multi-contrast turbo spin echo technique. However, 3D black blood MR imaging is becoming the preferred methodology for evaluating plaque burden non-invasively. Comparing imaging results obtained using both 3D sampling Perfection with application-optimized contrast using different flip angle evolution (SPACE) and conventional 2D multi-contrast TSE sequences in evaluating vascular territories showed good agreement in both qualitative and quantitative measurements between the two techniques. 3D SPACE technique is a promising and potentially feasible approach for the evaluation of multiple vascular beds in patients at risk for cardiovascular disease.