Assessment of Arterial Wall Enhancement for Differentiation of Parent Artery Disease from Small Artery Disease: Comparison between Histogram Analysis and Visual Analysis on 3-Dimensional Contrast-Enhanced T1-Weighted Turbo Spin Echo MR Images at 3T

• Published in: Korean journal of radiology Vol. 18; no. 2; pp. 383 - 391
• Main Authors: Jang, Jinhee, Kim, Tae-Won, Hwang, Eo-Jin, Choi, Hyun Seok, Koo, Jaseong, Shin, Yong Sam, Jung, So-Lyung, Ahn, Kook-Jin, Kim, Bum-soo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.03.2017; 대한영상의학회
• Subjects: Aged; Aged, 80 and over; Area Under Curve; Atherosclerosis; Constriction, Pathologic - pathology; Diabetes; Female; Humans; Hypertension; Image Enhancement; Imaging, Three-Dimensional; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical records; Middle Aged; Middle Cerebral Artery - diagnostic imaging; Middle Cerebral Artery - physiology; Myocardial Infarction - diagnosis; Neurointervention; Patients; Quantitative analysis; Retrospective Studies; ROC Curve; Stroke; Tertiary Care Centers; Vein & artery diseases; 방사선과학; Germany; 3T MRI; Small vessel disease; Acute ischemic stroke; Parent artery disease; Histogram analysis; Middle cerebral artery; Vessel wall imaging; Enhancement
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2017.18.2.383

The purpose of this study was to compare the histogram analysis and visual scores in 3T MRI assessment of middle cerebral arterial wall enhancement in patients with acute stroke, for the differentiation of parent artery disease (PAD) from small artery disease (SAD). Among the 82 consecutive patients in a tertiary hospital for one year, 25 patients with acute infarcts in middle cerebral artery (MCA) territory were included in this study including 15 patients with PAD and 10 patients with SAD. Three-dimensional contrast-enhanced T1-weighted turbo spin echo MR images with black-blood preparation at 3T were analyzed both qualitatively and quantitatively. The degree of MCA stenosis, and visual and histogram assessments on MCA wall enhancement were evaluated. A statistical analysis was performed to compare diagnostic accuracy between qualitative and quantitative metrics. The degree of stenosis, visual enhancement score, geometric mean (GM), and the 90th percentile (90P) value from the histogram analysis were significantly higher in PAD than in SAD ( = 0.006 for stenosis, < 0.001 for others). The receiver operating characteristic curve area of GM and 90P were 1 (95% confidence interval [CI], 0.86-1.00). A histogram analysis of a relevant arterial wall enhancement allows differentiation between PAD and SAD in patients with acute stroke within the MCA territory.