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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleAdult Brain
Open Access

Image-Quality Assessment of 3D Intracranial Vessel Wall MRI Using DANTE or DANTE-CAIPI for Blood Suppression and Imaging Acceleration

B. Sannananja, C. Zhu, C.G. Colip, A. Somasundaram, M. Ibrahim, T. Khrisat and M. Mossa-Basha
American Journal of Neuroradiology June 2022, 43 (6) 837-843; DOI: https://doi.org/10.3174/ajnr.A7531
B. Sannananja
aFrom the Department of Radiology (B.S., A.S.), Emory University, Atlanta, Georgia
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C. Zhu
bDepartment of Radiology (C.Z., M.M.-B.), University of Washington, Seattle, Washington
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C.G. Colip
cKaiser Permanente Northwest (C.G.C.), Portland, OR;
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A. Somasundaram
aFrom the Department of Radiology (B.S., A.S.), Emory University, Atlanta, Georgia
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M. Ibrahim
dDepartment of Radiology (M.I.), University of Kansas, Lawrence, Kansas
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T. Khrisat
eDepartment of Surgery (T.K.), Lincoln Medical Center, New York, New York
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M. Mossa-Basha
bDepartment of Radiology (C.Z., M.M.-B.), University of Washington, Seattle, Washington
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  • FIG 1.
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    FIG 1.

    Quantitative measurement technique. Manual ROIs were drawn on representative images tracing the interface between the wall and lumen (luminal contour) and between the wall and surrounding tissues (outer wall contour). Total area of the vessel (area within the outer contour), luminal area (area within the inner contour), mean signal intensity, and SD were recorded for each patient. Sum indicates the sum of signal intensities within the selected region; Min, minimum; Max, maximum.

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    FIG 2.

    When we compare sagittal T1-SPACE precontrast (A) and sagittal T1-SPACE postcontrast (B), there are multiple focal enhancing lesions seen along the cortical surface (small arrows) on postcontrast IVW. On T1-DANTE-CAIPI-SPACE (C), the cortically based enhancing lesions disappear. The enhancing foci represent nonsuppression of blood signal in small cortical veins.

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    FIG 3.

    Sagittal T1-SPACE precontrast (A) shows a normal right M1 MCA segment without wall thickening. Sagittal T1-SPACE postcontrast (B) shows eccentric wall enhancement along the posterior, superior, and inferior walls of the M1 MCA (arrowhead) and the right V4 vertebral artery (short arrow) as well as nonsuppression of luminal signal in the right petrous ICA (long arrow) and the transverse sinus (thick arrow). Sagittal T1-DANTE-SPACE (C) shows the normal wall appearance of the right M1 MCA and V4 vertebral artery segments, similar to precontrast acquisition, and suppression of the venous signal.

Tables

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    Table 1:

    Pulse sequence acquisition parameters

    3D T1-SPACEDANTE-CAIPI-T1-SPACEDANTE-T1-SPACE
    TR/TE (ms)1000/11.01000/11.01000/11.0
    In-plane resolution (mm)0.56 × 0.560.56 × 0.560.56 × 0.56
    Section thickness (mm)0.560.560.56
    Flip angleVariableVariableVariable
    FOV (mm)180 × 180180 × 180180 × 180
    Parallel imaging factor222
    Averages111
    Scan time (min)8:085:118:47
    DANTENoYesYes
    CAIPINoYesNo
    • View popup
    Table 2:

    Patient demographics

    CharacteristicsCohort
    Age (age group) (median)22–80 years, median age, 53 years
    Sex (%)
        Male34 (38.2%)
        Female55 (61.8%)
    Clinical indication for IVW MR imaging
        Intracranial atherosclerotic disease33
        Aneurysm postcoiling/Pipeline stent/clipping31
        Vasculitis11
        Moyamoya disease/syndrome3
        Aneurysm4
        CADASIL2
        Radiation vasculopathy1
        Cryptogenic stroke4
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    Table 3:

    SPACE versus DANTE-CAIPI-SPACE (average score of 2 reviewers)a

    SPACEDANTE-CAIPI-SPACEP Value
    Qualitative measurements
        Image quality2.5 (2–3)2 (1.5–2.5)<.001
        SNR1.5 (1–2)2 (2–2.5)<.001
        Artifacts3.5 (3–4)3 (2–3)<.001
        Art. blood suppression3 (2.5–3.5)1.25 (1–1.5)<.001
        Lesion2 (1.5–2.5)1.5 (1–2)<.001
        Ven. blood suppression3 (2–3.375)1.5 (1.125–2)<.001
        Motion1 (0–2)0 (0–0.5)<.001
    Quantitative measurement
        Lumen area (mm2)7.9 (5.5–10.3)7.6 (4.8–11.0).45
        Wall area (mm2)12.6 (9.9–16.3)12.4 (10.1–14.6).04
        Lumen CR0.33 (0.26–0.43)0.37 (0.27–0.48).003
        Wall lumen CR2.3 (1.9–2.6)1.9 (1.7–2.5)<.001
    • Note:—Art. indicates arterial; Ven., venous; CR, contrast ratio.

    • ↵a Values are expressed as median (interquartile range).

    • View popup
    Table 4:

    SPACE versus DANTE-SPACE (average score of 2 reviewers)a

    SPACEDANTE-SPACEP Value
    Qualitative measurements
        Image quality2.5 (2–3)2 (1.5–2.5)<.001
        SNR2 (2–2.5)2 (1.5–2.5)<.001
        Artifacts3.5 (3–4)2.5 (2–3)<.001
        Art. blood suppression3 (2.625–3.5)1.5 (1–1.875)<.001
        Lesion2.5 (2–3)1.75 (1–2)<.001
        Ven. blood suppression3 (2–3)2 (1.5–2)<.001
        Motion0.5 (0–2.75)0.75 (0–2).50
    Quantitative measurement
        Lumen area (mm2)5.9 (4.5–8.4)6.8 (4.9–8.4).66
        Wall area (mm2)14.4 (9.9–18.2)14.1 (10.9–20.1).09
        Lumen CR0.33 (0.26–0.55)0.35 (0.26–0.53).22
        Wall lumen CR2.2 (1.8–2.4)2.2 (1.9–2.6).46
    • Note:—Art. indicates arterial; Ven., venous; CR, contrast ratio.

    • ↵a Values are expressed as median (interquartile range).

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American Journal of Neuroradiology: 43 (6)
American Journal of Neuroradiology
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1 Jun 2022
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B. Sannananja, C. Zhu, C.G. Colip, A. Somasundaram, M. Ibrahim, T. Khrisat, M. Mossa-Basha
Image-Quality Assessment of 3D Intracranial Vessel Wall MRI Using DANTE or DANTE-CAIPI for Blood Suppression and Imaging Acceleration
American Journal of Neuroradiology Jun 2022, 43 (6) 837-843; DOI: 10.3174/ajnr.A7531

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Image Quality of 3D Intracranial Vessel MRI
B. Sannananja, C. Zhu, C.G. Colip, A. Somasundaram, M. Ibrahim, T. Khrisat, M. Mossa-Basha
American Journal of Neuroradiology Jun 2022, 43 (6) 837-843; DOI: 10.3174/ajnr.A7531
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