Subacute Vessel Wall Imaging at 7-T MRI in Post-thrombectomy Stroke Patients

Overview

Journal Neuroradiology

Specialties Neurology
Radiology

Date 2019 Jun 27

PMID 31240344

Citations 3

Authors

My Truong

Karin Markenroth Bloch

Mads Andersen

Gunnar Andsberg

Johannes Toger

Johan Wasselius

Affiliations

Soon will be listed here.

Abstract

Purpose: Reports from 3-T vessel wall MRI imaging have shown contrast enhancement following thrombectomy for acute stroke, suggesting potential intimal damage. Comparisons have shown higher SNR and more lesions detected by vessel wall imaging when using 7 T compared with 3 T. The aim of this study was to investigate the vessel walls after stent retriever thrombectomy using high-resolution vessel wall imaging at 7 T.

Methods: Seven patients with acute stroke caused by occlusion of the distal internal carotid artery (T-occlusion), or proximal medial cerebral artery, and treated by stent retriever thrombectomy with complete recanalization were included and examined by 7-T MRI within 2 days. The MRI protocol included a high-resolution black blood sequence with prospective motion correction (iMOCO), acquired before and after contrast injection. Flow measurements were performed in the treated and untreated M1 segments.

Results: All subjects completed the MRI examination. Image quality was independently rated as excellent by two neuroradiologists for all cases, and the level of motion artifacts did not impair diagnostic quality, despite severe motion in some cases. Contrast enhancement correlated with the deployment location of the stent retrievers. Flow data showed complete restoration of flow after treatment.

Conclusion: Vessel wall imaging with prospective motion correction can be performed in patients following thrombectomy with excellent imaging quality at 7 T. We show that vessel wall contrast enhancement is the normal post-operative state and corresponds to the deployment location of the stent retriever.

Citing Articles

A high resolution scanning electron microscopy analysis of intracranial thrombi embedded along the stent retrievers.

Dumitriu LaGrange D, Bernava G, Reymond P, Wanke I, Vargas M, Machi P Sci Rep. 2022; 12(1):8027.

PMID: 35577906 PMC: 9110407. DOI: 10.1038/s41598-022-11830-4.

Accuracy investigations for volumetric head-motion navigators with and without EPI at 7 T.

Andersen M, Laustsen M, Boer V Magn Reson Med. 2022; 88(3):1198-1211.

PMID: 35576128 PMC: 9325528. DOI: 10.1002/mrm.29296.

High-resolution vessel wall imaging after mechanical thrombectomy.

Al Kasab S, Bathla G, Varon A, Roa J, Sabotin R, Raghuram A Neuroradiol J. 2021; 34(6):593-599.

PMID: 34014780 PMC: 8649198. DOI: 10.1177/19714009211017782.

References

van der Kolk A, Hendrikse J, Brundel M, Biessels G, Smit E, Visser F . Multi-sequence whole-brain intracranial vessel wall imaging at 7.0 tesla. Eur Radiol. 2013; 23(11):2996-3004. DOI: 10.1007/s00330-013-2905-z. View

Heiberg E, Sjogren J, Ugander M, Carlsson M, Engblom H, Arheden H . Design and validation of Segment--freely available software for cardiovascular image analysis. BMC Med Imaging. 2010; 10:1. PMC: 2822815. DOI: 10.1186/1471-2342-10-1. View

Mozaffarian D, Benjamin E, Go A, Arnett D, Blaha M, Cushman M . Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2015; 133(4):e38-360. DOI: 10.1161/CIR.0000000000000350. View

Gallichan D, Marques J, Gruetter R . Retrospective correction of involuntary microscopic head movement using highly accelerated fat image navigators (3D FatNavs) at 7T. Magn Reson Med. 2015; 75(3):1030-9. DOI: 10.1002/mrm.25670. View

Viessmann O, Li L, Benjamin P, Jezzard P . T2-Weighted intracranial vessel wall imaging at 7 Tesla using a DANTE-prepared variable flip angle turbo spin echo readout (DANTE-SPACE). Magn Reson Med. 2016; 77(2):655-663. PMC: 5298018. DOI: 10.1002/mrm.26152. View

Berkhemer O, Fransen P, Beumer D, van den Berg L, Lingsma H, Yoo A . A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2014; 372(1):11-20. DOI: 10.1056/NEJMoa1411587. View

Goyal M, Demchuk A, Menon B, Eesa M, Rempel J, Thornton J . Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015; 372(11):1019-30. DOI: 10.1056/NEJMoa1414905. View

Campbell B, Mitchell P, Kleinig T, Dewey H, Churilov L, Yassi N . Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015; 372(11):1009-18. DOI: 10.1056/NEJMoa1414792. View

De Cocker L, Lindenholz A, Zwanenburg J, van der Kolk A, Zwartbol M, Luijten P . Clinical vascular imaging in the brain at 7T. Neuroimage. 2016; 168:452-458. PMC: 5862656. DOI: 10.1016/j.neuroimage.2016.11.044. View

10.

Mandell D, Mossa-Basha M, Qiao Y, Hess C, Hui F, Matouk C . Intracranial Vessel Wall MRI: Principles and Expert Consensus Recommendations of the American Society of Neuroradiology. AJNR Am J Neuroradiol. 2016; 38(2):218-229. PMC: 7963837. DOI: 10.3174/ajnr.A4893. View

11.

Harteveld A, van der Kolk A, van der Worp H, Dieleman N, Zwanenburg J, Luijten P . Detecting Intracranial Vessel Wall Lesions With 7T-Magnetic Resonance Imaging: Patients With Posterior Circulation Ischemia Versus Healthy Controls. Stroke. 2017; 48(9):2601-2604. DOI: 10.1161/STROKEAHA.117.017868. View

12.

Jovin T, Chamorro A, Cobo E, de Miquel M, Molina C, Rovira A . Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015; 372(24):2296-306. DOI: 10.1056/NEJMoa1503780. View

13.

Dieleman N, van der Kolk A, Zwanenburg J, Harteveld A, Biessels G, Luijten P . Imaging intracranial vessel wall pathology with magnetic resonance imaging: current prospects and future directions. Circulation. 2014; 130(2):192-201. DOI: 10.1161/CIRCULATIONAHA.113.006919. View

14.

van Ooij P, Zwanenburg J, Visser F, Majoie C, VanBavel E, Hendrikse J . Quantification and visualization of flow in the Circle of Willis: time-resolved three-dimensional phase contrast MRI at 7 T compared with 3 T. Magn Reson Med. 2012; 69(3):868-76. DOI: 10.1002/mrm.24317. View

15.

Tisdall M, Hess A, Reuter M, Meintjes E, Fischl B, van der Kouwe A . Volumetric navigators for prospective motion correction and selective reacquisition in neuroanatomical MRI. Magn Reson Med. 2012; 68(2):389-99. PMC: 3320676. DOI: 10.1002/mrm.23228. View

16.

Harteveld A, van der Kolk A, van der Worp H, Dieleman N, Siero J, Kuijf H . High-resolution intracranial vessel wall MRI in an elderly asymptomatic population: comparison of 3T and 7T. Eur Radiol. 2016; 27(4):1585-1595. PMC: 5334422. DOI: 10.1007/s00330-016-4483-3. View

17.

Saver J, Goyal M, Bonafe A, Diener H, Levy E, Pereira V . Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015; 372(24):2285-95. DOI: 10.1056/NEJMoa1415061. View

18.

Seo W, Oh K, Suh S, Seol H . Clinical Significance of Wall Changes After Recanalization Therapy in Acute Stroke: High-Resolution Vessel Wall Imaging. Stroke. 2017; 48(4):1077-1080. DOI: 10.1161/STROKEAHA.116.015429. View

19.

Bodle J, Feldmann E, Swartz R, Rumboldt Z, Brown T, Turan T . High-resolution magnetic resonance imaging: an emerging tool for evaluating intracranial arterial disease. Stroke. 2012; 44(1):287-92. PMC: 3556720. DOI: 10.1161/STROKEAHA.112.664680. View

20.

Feigin V, Norrving B, Mensah G . Global Burden of Stroke. Circ Res. 2017; 120(3):439-448. DOI: 10.1161/CIRCRESAHA.116.308413. View