title: Motion-insensitive carotid intraplaque hemorrhage imaging using 3D inversion recovery preparation stack of stars (IR-prep SOS) technique.
abstract: Carotid artery imaging is important in the clinical management of patients at risk for stroke. Carotid intraplaque hemorrhage (IPH) presents an important diagnostic challenge. 3D magnetization prepared rapid acquisition gradient echo (MPRAGE) has been shown to accurately image carotid IPH; however, this sequence can be limited due to motion- and flow-related artifact. The purpose of this work was to develop and evaluate an improved 3D carotid MPRAGE sequence for IPH detection. We hypothesized that a radial-based k-space trajectory sequence such as "Stack of Stars" (SOS) incorporated with inversion recovery preparation would offer reduced motion sensitivity and more robust flow suppression by oversampling of central k-space.
  
  
  
  A total of 31 patients with carotid disease (62 carotid arteries) were imaged at 3T magnetic resonance imaging (MRI) with 3D IR-prep Cartesian and SOS sequences. Image quality was determined between SOS and Cartesian MPRAGE in 62 carotid arteries using t-tests and multivariable linear regression. Kappa analysis was used to determine interrater reliability.
  
  
  
  In all, 25 among 62 carotid plaques had carotid IPH by consensus from the reviewers on SOS compared to 24 on Cartesian sequence. Image quality was significantly higher with SOS compared to Cartesian (mean 3.74 vs. 3.11, P < 0.001). SOS acquisition yielded sharper image features with less motion (19.4% vs. 45.2%, P < 0.002) and flow artifact (27.4% vs. 41.9%, P < 0.089). There was also excellent interrater reliability with SOS (kappa = 0.89), higher than that of Cartesian (kappa = 0.84).
  
  
  
  By minimizing flow and motion artifacts and retaining high interrater reliability, the SOS MPRAGE has important advantages over Cartesian MPRAGE in carotid IPH detection.
  
  
  
  1 J. Magn. Reson. Imaging 2017;45:410-417.
authors.affiliation: Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.|Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Seong-Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.|Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Roberts
authors.affiliation: Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Eisenmenger
authors.affiliation: Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Booth W
authors.initials: BW
authors.lastname: Aldred
authors.affiliation: Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Osama
authors.initials: O
authors.lastname: Jamil
authors.affiliation: Siemens Healthcare, Salt Lake City, Utah, USA.
authors.forename: Bradley D
authors.initials: BD
authors.lastname: Bolster
authors.affiliation: Siemens Healthcare, Salt Lake City, Utah, USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Bi
authors.affiliation: Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.|Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Parker
authors.affiliation: Department of Surgery, University of Utah, Salt Lake City, Utah, USA.|Department of Veterans Affairs, VASLCHCS, Salt Lake City, Utah, USA.
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Treiman
authors.affiliation: Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.|Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
authors.forename: J Scott
authors.initials: JS
authors.lastname: McNally
mesh_terms: D000368:Aged; D016477:Artifacts; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging*; 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; D009038:Motion; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted
keywords: IPH; MPRAGE; SOS; carotid plaque; flow suppression; stroke