MRI strain imaging of the carotid artery: present limitations and future challenges.
Rupture of atherosclerotic plaques in the carotid artery is a main cause of stroke. Current diagnostics are not sufficient to identify all rupture-prone plaques, and studies have shown that biomechanical factors improve current plaque risk assessment. Strain imaging may be a valuable contribution to this risk assessment. MRI is a versatile imaging technique that offers various methods that are capable of measuring tissue strain. In this review, MR imaging techniques with displacement (DENSE), velocity (PC MRI), or strain (SENC) encoding protocols are discussed, together with post-processing techniques based on time-resolved MRI data. Although several MRI techniques are being developed to improve time-resolved MR imaging, current technical limitations related to spatial and temporal resolutions render MRI strain imaging currently unfit for carotid plaque strain evaluation. A novel approach using non-rigid image registration of MR images to determine strain in carotid arteries based on black blood cine MRI is proposed in this review. This and other post-processing techniques based on time-resolved MRI data may provide a good estimate of plaque strain, but are also dependent on the spatial and temporal resolution of the MR images. However, they seem to be the most promising approach for MRI based plaque strain analysis in the near future.
Department of Radiology, Academic Medical Center Amsterdam, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: a.j.nederveen@amc.uva.nl.
Aart J
AJ
Nederveen
Center for Biomedical and Healthcare Engineering, Ecole Nationale Supérieure des Mines de Saint-Étienne, France.
Stéphane
S
Avril
Department of Biomedical Engineering, Erasmus MC Rotterdam, The Netherlands.
Lambert
L
Speelman
D002339:Carotid Arteries / Q000473:pathology / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D058226:Plaque, Atherosclerotic / Q000473:pathology* / Q000503:physiopathology*; D018570:Risk Assessment / Q000379:methods; D013314:Stress, Mechanical
Carotid artery plaque; Cine MRI; Non-rigid image registration; Phase contrast MRI; Strain