title: Improved cerebrospinal fluid suppression for intracranial vessel wall MRI.
abstract: To develop and assess a three-dimensional (3D) high resolution black blood MRI (BBMRI) method for evaluation of intracranial vessels with improved cerebrospinal fluid (CSF) suppression.
  
  
  
  The anti-driven-equilibrium (ADE) pulse was incorporated into a variable flip-angle TSE-based 3D BBMRI to improve CSF suppression. ADE-BBMRI was optimized in 8 participants and compared with BBMRI, with acquired 0.5 mm isotropic resolution and scan time of 5.4 min at 3 Tesla. Contrast-enhanced ADE-BBMRI protocol was implemented in nine patients with intracranial atherosclerosis. Signal and morphological measurements were compared between ADE-BBMRI and BBMRI, as well as pre- and postcontrast ADE-BBMRI. Reliability was assessed by intraclass correlations (ICC).
  
  
  
  ADE-BBMRI effectively suppressed the surrounding CSF signal of intracranial vessels, with a 36-44% reduction compared with BBMRI. ADE-BBMRI also reduced the overall wall signal by 8-8.5%, but provided a significant improvement in wall-to-CSF contrast-to-noise ratio over BBMRI (middle cerebral artery, 5.93 ± 0.59 versus 3.95 ± 1.67, P < 0.01; basilar artery, 3.8 ± 1.76 versus 1.34 ± 0.54, P = 0.01, respectively). No differences were noted in morphological measurements between ADE-BBMRI and BBMRI (lumen area, 6.35 ± 2.87 versus 6.32 ± 2.84 mm(2) ; wall area, 1.28 ± 0.52 versus 1.27 ± 0.53 mm(2) ; mean wall thickness, 0.93 ± 0.30 versus 0.93 ± 0.32 mm; maximum wall thickness, 1.27 ± 0.33 versus 1.28 ± 0.36 mm, all P > 0.05). Contrast enhanced ADE-BBMRI improved the plaque delineation by the increased wall signal, wall-to-CSF and wall-to-blood contrast-to-noise ratio. ICC ranged from 0.54 to 0.95.
  
  
  
  The 3D ADE-BBMRI provides excellent blood and CSF suppression, and accurate measurements of intracranial vessels at 0.5 mm isotropic resolution in 5 min. Its clinical application may provide insight into stroke risk. J. Magn. Reson. Imaging 2016;44:665-672.
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Yang
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, Maryland, USA.|Department of Radiology, Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Zhang
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, Maryland, USA.|F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.
authors.forename: Qin
authors.initials: Q
authors.lastname: Qin
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Wasserman
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Ye
authors.initials: Y
authors.lastname: Qiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016477:Artifacts; D002533:Cerebral Angiography / Q000379:methods; D002536:Cerebral Arteries / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D002555:Cerebrospinal Fluid / Q000166:cytology / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D013382:Subtraction Technique
keywords: 3D; MRI; intracranial; isotropic; vessel wall