The Use of Pointwise Encoding Time Reduction With Radial Acquisition MRA to Assess Middle Cerebral Artery Stenosis Pre- and Post-stent Angioplasty: Comparison With 3D Time-of-Flight MRA and DSA

Zhang, Feifei; Ran, Yuncai; Zhu, Ming; Xiaowen, Lei; Niu, Junxia; Wang, Xiao; Zhang, Yong; Li, Shu-Jian; Zhu, Jinxia; Mossa‐Basha, Mahmud; Cheng, Jingliang; Zhu, Chengcheng

doi:10.3389/fcvm.2021.739332

Cited by 5 publications

(5 citation statements)

References 32 publications

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“…ASL, another subtraction-based imaging acquisition method, is most commonly used as an MRA equivalent of x-ray digital subtraction angiography (DSA) for perfusion imaging of the brain but is also capable of imaging the extracranial carotid arteries. New developments in ASL imaging, such as 3D pointwise encoding time reduction MRA (PETRA-MRA), are in closer agreement with DSA when compared to TOF-MRA in the evaluation of intracranial stenosis [ 37 ]. Additionally, PETRA-MRA is notable for its superior image of intracranial stenosis both pre- and post-operatively when compared to TOF-MRA.…”

Section: Resultsmentioning

confidence: 99%

Radiation Dose Reduction Opportunities in Vascular Imaging

et al. 2022

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Computed tomography angiography (CTA) has been the gold standard imaging modality for vascular imaging due to a variety of factors, including the widespread availability of computed tomography (CT) scanners, the ease and speed of image acquisition, and the high sensitivity of CTA for vascular pathology. However, the radiation dose experienced by the patient during imaging has long been a concern of this image acquisition method. Advancements in CT image acquisition techniques in combination with advancements in non-ionizing radiation imaging techniques including magnetic resonance angiography (MRA) and contrast-enhanced ultrasound (CEUS) present growing opportunities to reduce total radiation dose to patients. This review provides an overview of advancements in imaging technology and acquisition techniques that are helping to minimize radiation dose associated with vascular imaging.

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Section: Resultsmentioning

confidence: 99%

Radiation Dose Reduction Opportunities in Vascular Imaging

et al. 2022

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“…Shang et al revealed that zero TE-MRA (a technique comparable to PETRA-MRA) had excellent image quality and performance in depicting cerebrovascular diseases ( 8 ). Zhang et al also reported that PETRA-MRA had higher image quality and agreement with DSA in measuring the degree of stenosis of the middle cerebral artery than TOF-MRA ( 13 ). Our study agrees well with these previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, as an ultrashort echo time sequence, PETRA-MRA is less sensitive to turbulent or slow flow artifacts and attenuates acoustic noise, resulting in good signal-to-noise ratio (SNR) of the flowing lumen and signal homogeneity ( 8 – 10 ). PETRA-MRA has been used in the evaluation of intracranial aneurysms ( 11 , 12 ) but very few studies applied such a technique in the assessment of intracranial stenosis ( 13 ). No study has compared PETRA-MRA with TOF-MRA and CTA directly in the same cohort, using DSA as a reference standard.…”

Section: Introductionmentioning

confidence: 99%

Use of PETRA-MRA to assess intracranial arterial stenosis: Comparison with TOF-MRA, CTA, and DSA

et al. 2023

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Background and purposeNon-invasive and accurate assessment of intracranial arterial stenosis (ICAS) is important for the evaluation of intracranial atherosclerotic disease. This study aimed to evaluate the performance of 3D pointwise encoding time reduction magnetic resonance angiography (PETRA-MRA) and compare its performance with that of 3D time-of-flight (TOF) MRA and computed tomography angiography (CTA), using digital subtraction angiography (DSA) as the reference standard in measuring the degree of stenosis and lesion length.Materials and methodsThis single-center, prospective study included a total of 52 patients (mean age 57 ± 11 years, 27 men, 25 women) with 90 intracranial arterial stenoses who underwent PETRA-MRA, TOF-MRA, CTA, and DSA within 1 month. The degree of stenosis and lesion length were measured independently by two radiologists on these four datasets. The degree of stenosis was classified according to DSA measurement. Severe stenosis was defined as a single lesion with >70% diameter stenosis. The smaller artery stenosis referred to the stenosis, which occurred at the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery, except for the first segment of them. The continuous variables were compared using paired t-test or Wilcoxon signed rank test. The intraclass correlation coefficients (ICCs) were used to assess the agreement between MRAs/CTA and DSA as well as inter-reader variabilities. The ICC value >0.80 indicated excellent agreement. The agreement of data was assessed further by Bland–Altman analysis and Spearman's correlation coefficients. When the difference between MRAs/CTA and DSA was statistically significant in the degree of stenosis, the measurement of MRAs/CTA was larger than that of DSA, which referred to the overestimation of MRAs/CTA for the degree of stenosis.ResultsThe four imaging methods exhibited excellent inter-reader agreement [intraclass correlation coefficients (ICCs) > 0.80]. PETRA-MRA was more consistent with DSA than with TOF-MRA and CTA in measuring the degree of stenosis (ICC = 0.94 vs. 0.79 and 0.89) and lesion length (ICC = 0.99 vs. 0.97 and 0.73). PETRA-MRA obtained the highest specificity and positive predictive value (PPV) than TOF-MRA and CTA for detecting stenosis of >50% and stenosis of >75%. TOF-MRA and CTA overestimated considerably the degree of stenosis compared with DSA (63.0% ± 15.8% and 61.0% ± 18.6% vs. 54.0% ± 18.6%, P < 0.01, respectively), whereas PETRA-MRA did not overestimate (P = 0.13). The degree of stenosis acquired on PETRA-MRA was also more consistent with that on DSA than with that on TOF-MRA and CTA in severe stenosis (ICC = 0.78 vs. 0.30 and 0.57) and smaller artery stenosis (ICC = 0.95 vs. 0.70 and 0.80). In anterior artery circulation stenosis, PETRA-MRA also achieved a little bigger ICC than TOF-MRA and CTA in measuring the degree of stenosis (0.93 vs. 0.78 and 0.88). In posterior artery circulation stenosis, PETRA-MRA had a bigger ICC than TOF-MRA (0.94 vs. 0.71) and a comparable ICC to CTA (0.94 vs. 0.91) in measuring the degree of stenosis.ConclusionPETRA-MRA is more accurate than TOF-MRA and CTA for the evaluation of intracranial stenosis and lesion length when using DSA as a reference standard. PETRA-MRA is a promising non-invasive tool for ICAS assessment.

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“…It has attracted significant attention in recent years because of its ability to significantly reduce metal artifacts. [1][2][3] In this study, the aneurysm occlusion status was evaluated using PETRA-MRA in 11 of the 12 patients after SAC. In nine cases, PETRA-MRA and DSA findings were compared.…”

Section: Discussionmentioning

confidence: 99%

“…Pointwise encoding time reduction with radial acquisition (PETRA)-MRA is a noninvasive imaging method characterized by an ultrashort echo time (TE) and has been attracting attention in recent years because it considerably reduces metal artifacts. [1][2][3] PETRA-MRA has the potential for postoperative evaluation of aneurysms and visualization of blood flow in stents. Therefore, this study aimed to evaluate the effectiveness of PETRA-MRA for follow-up imaging after SAC.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of PETRA-MRA for Postoperative Follow-Up of Stent-Assisted Coil Embolization of Cerebral Aneurysms

Ebiko

Wakabayashi

Okada

et al. 2023

NOUSHINKEI KEKKANNAI TIRYOU

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Objective Image evaluation after stent-assisted coil embolization (SAC) for a cerebral aneurysm is difficult with conventional MRA or CTA because of metal artifacts. Pointwise encoding time reduction with radial acquisition (PETRA)-MRA is a noninvasive imaging examination that can reduce metal artifacts. This study aimed to examine whether PETRA-MRA can be used as a follow-up imaging after SAC. Methods Twelve patients (eight women and four men; mean age, 66.9 ± 13.2 years) underwent SAC for unruptured aneurysms and were retrospectively evaluated using time-of-flight (TOF)- and PETRA-MRA data from the same follow-up session. Two neurosurgeons independently compared the aneurysm occlusion status and flow visualization score in the stented parent artery (4-point scale, where 4 points represented excellent visualization) between TOF- and PETRA-MRA images. If DSA was performed within 3 months before or after PETRA-MRA, the aneurysm assessment was compared between MRA and DSA. The interobserver agreement for each MRA was evaluated. Results Nine of the 12 patients underwent DSA within 3 months before and after TOF- and PETRA-MRA. The aneurysm occlusion status on DSA was more consistent with PETRA-MRA (eight of nine cases) than with TOF-MRA (one of nine cases; P = 0.023). The median visualization score of the stented parent artery was significantly higher for PETRA-MRA (4 [interquartile range {IQR} 3–4]) than for TOF-MRA (1 [IQR 1–1], P = 0.003). The interobserver agreement for evaluation of the aneurysm occlusion status and visualization score of the parent artery for PETRA-MRA were excellent (κ = 0.98 and 0.93, respectively). In one case, PETRA-MRA was able to detect aneurysm recurrence, leading to subsequent retreatment. Conclusion PETRA-MRA is a noninvasive examination that can be used to evaluate the occlusion status of aneurysms after SAC and visualize the stented parent artery. PETRA-MRA is useful for repeated follow-up examinations after SAC.

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The Use of Pointwise Encoding Time Reduction With Radial Acquisition MRA to Assess Middle Cerebral Artery Stenosis Pre- and Post-stent Angioplasty: Comparison With 3D Time-of-Flight MRA and DSA

Cited by 5 publications

References 32 publications

Radiation Dose Reduction Opportunities in Vascular Imaging

Radiation Dose Reduction Opportunities in Vascular Imaging

Use of PETRA-MRA to assess intracranial arterial stenosis: Comparison with TOF-MRA, CTA, and DSA

Usefulness of PETRA-MRA for Postoperative Follow-Up of Stent-Assisted Coil Embolization of Cerebral Aneurysms

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