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<meta name="DC.Title" content="Quantifying Intracranial Plaque Permeability with Dynamic Contrast-Enhanced MRI: A Pilot Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4998" />
<meta name="DC.Date" content="2017-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2017 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Intracranial atherosclerotic disease plaque hyperintensity and/or gadolinium contrast enhancement have been studied as imaging biomarkers of acutely symptomatic ischemic presentations using single static MR imaging measurements. However, the value in modeling the dynamics of intracranial plaque permeability has yet to be evaluated. The purpose of this study was to use dynamic contrast-enhanced MR imaging to quantify the contrast permeability of intracranial atherosclerotic disease plaques in symptomatic patients and to compare these parameters against existing markers of plaque volatility using black-blood MR imaging pulse sequences.

MATERIALS AND METHODS: We performed a prospective study of contrast uptake dynamics in the major intracranial vessels proximal and immediately distal to the circle of Willis using dynamic contrast-enhanced MR imaging, specifically in patients with symptomatic intracranial atherosclerotic disease. Using the Modified Tofts model, we extracted the volume transfer constant ( K trans) and fractional plasma volume (Vp) parameters from plaque-enhancement curves. Using regression analyses, we compared these parameters against time from symptom onset as well as intraplaque hyperintensity and postcontrast enhancement derived from T1 SPACE, a black-blood MR vessel wall imaging sequence.

RESULTS: We completed analysis in 10 patients presenting with symptomatic intracranial atherosclerotic disease. K trans and Vp measurements were higher in plaques versus healthy white matter and similar or less than values in the choroid plexus. Only K trans correlated significantly with time from symptom onset ( P = .02). Dynamic contrast-enhanced MR imaging parameters were not found to correlate significantly with intraplaque enhancement or intraplaque hyperintensity ( P = .4 and P = .17, respectively).

CONCLUSIONS: Elevated K trans and Vp values found in intracranial atherosclerotic disease plaques versus healthy white matter suggest that dynamic contrast-enhanced MR imaging is a feasible technique for studying vessel wall and plaque characteristics in the proximal intracranial vasculature. Significant correlations between K trans and symptom onset, which were not observed on T1 SPACE–derived metrics, suggest that K trans may be an independent imaging biomarker of acute and symptom-associated pathologic changes in intracranial atherosclerotic disease plaques.

BBMRI
:   black-blood MRI
DCE
:   dynamic contrast-enhanced
GRE
:   gradient recalled-echo
ICAD
:   intracranial atherosclerotic disease
IPE
:   intraplaque enhancement
IPH
:   intraplaque hyperintensity
K trans
:   volume transfer constant
NAWM
:   normal-appearing white matter
SPACE
:   sampling perfection with application-optimized contrasts by using different flip angle evolution
SI
:   signal intensity
VL
:   extracellular extravascular space
Vp
:   fractional plasma volume" />
<meta name="DC.Contributor" content="P. Vakil" />
<meta name="DC.Contributor" content="A.H. Elmokadem" />
<meta name="DC.Contributor" content="F.H. Syed" />
<meta name="DC.Contributor" content="C.G. Cantrell" />
<meta name="DC.Contributor" content="F.H. Dehkordi" />
<meta name="DC.Contributor" content="T.J. Carroll" />
<meta name="DC.Contributor" content="S.A. Ansari" />
<meta name="article:published_time" content="2017-02-01" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="Quantifying Intracranial Plaque Permeability with Dynamic Contrast-Enhanced MRI: A Pilot Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Intracranial atherosclerotic disease plaque hyperintensity and/or gadolinium contrast enhancement have been studied as imaging biomarkers of acutely symptomatic ischemic presentations using single static MR imaging measurements. However, the value in modeling the dynamics of intracranial plaque permeability has yet to be evaluated. The purpose of this study was to use dynamic contrast-enhanced MR imaging to quantify the contrast permeability of intracranial atherosclerotic disease plaques in symptomatic patients and to compare these parameters against existing markers of plaque volatility using black-blood MR imaging pulse sequences.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We performed a prospective study of contrast uptake dynamics in the major intracranial vessels proximal and immediately distal to the circle of Willis using dynamic contrast-enhanced MR imaging, specifically in patients with symptomatic intracranial atherosclerotic disease. Using the Modified Tofts model, we extracted the volume transfer constant (&lt;i&gt;K&lt;/i&gt;&lt;sup&gt;trans&lt;/sup&gt;) and fractional plasma volume (V&lt;sub&gt;p&lt;/sub&gt;) parameters from plaque-enhancement curves. Using regression analyses, we compared these parameters against time from symptom onset as well as intraplaque hyperintensity and postcontrast enhancement derived from T1 SPACE, a black-blood MR vessel wall imaging sequence.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;We completed analysis in 10 patients presenting with symptomatic intracranial atherosclerotic disease. &lt;i&gt;K&lt;/i&gt;&lt;sup&gt;trans&lt;/sup&gt; and V&lt;sub&gt;p&lt;/sub&gt; measurements were higher in plaques versus healthy white matter and similar or less than values in the choroid plexus. Only &lt;i&gt;K&lt;/i&gt;&lt;sup&gt;trans&lt;/sup&gt; correlated significantly with time from symptom onset (&lt;i&gt;P&lt;/i&gt; = .02). Dynamic contrast-enhanced MR imaging parameters were not found to correlate significantly with intraplaque enhancement or intraplaque hyperintensity (&lt;i&gt;P&lt;/i&gt; = .4 and &lt;i&gt;P&lt;/i&gt; = .17, respectively).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Elevated &lt;i&gt;K&lt;/i&gt;&lt;sup&gt;trans&lt;/sup&gt; and V&lt;sub&gt;p&lt;/sub&gt; values found in intracranial atherosclerotic disease plaques versus healthy white matter suggest that dynamic contrast-enhanced MR imaging is a feasible technique for studying vessel wall and plaque characteristics in the proximal intracranial vasculature. Significant correlations between &lt;i&gt;K&lt;/i&gt;&lt;sup&gt;trans&lt;/sup&gt; and symptom onset, which were not observed on T1 SPACE–derived metrics, suggest that &lt;i&gt;K&lt;/i&gt;&lt;sup&gt;trans&lt;/sup&gt; may be an independent imaging biomarker of acute and symptom-associated pathologic changes in intracranial atherosclerotic disease plaques.&lt;/p&gt;" />
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<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A4998" />
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<meta name="citation_author" content="P. Vakil" />
<meta name="citation_author_institution" content="aFrom the College of Medicine (P.V.), University of Illinois, Chicago, Illinois" />
<meta name="citation_author_institution" content="bDepartments of Radiology (P.V., A.H.E., F.S., C.G.C., T.J.C., S.A.A.)" />
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<meta name="twitter:title" content="Quantifying Intracranial Plaque Permeability with Dynamic Contrast-Enhanced MRI: A Pilot Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Intracranial atherosclerotic disease plaque hyperintensity and/or gadolinium contrast enhancement have been studied as imaging biomarkers of acutely symptomatic ischemic presentations using single static MR imaging measurements. However, the value in modeling the dynamics of intracranial plaque permeability has yet to be evaluated. The purpose of this study was to use dynamic contrast-enhanced MR imaging to quantify the contrast permeability of intracranial atherosclerotic disease plaques in symptomatic patients and to compare these parameters against existing markers of plaque volatility using black-blood MR imaging pulse sequences.

MATERIALS AND METHODS: We performed a prospective study of contrast uptake dynamics in the major intracranial vessels proximal and immediately distal to the circle of Willis using dynamic contrast-enhanced MR imaging, specifically in patients with symptomatic intracranial atherosclerotic disease. Using the Modified Tofts model, we extracted the volume transfer constant ( K trans) and fractional plasma volume (Vp) parameters from plaque-enhancement curves. Using regression analyses, we compared these parameters against time from symptom onset as well as intraplaque hyperintensity and postcontrast enhancement derived from T1 SPACE, a black-blood MR vessel wall imaging sequence.

RESULTS: We completed analysis in 10 patients presenting with symptomatic intracranial atherosclerotic disease. K trans and Vp measurements were higher in plaques versus healthy white matter and similar or less than values in the choroid plexus. Only K trans correlated significantly with time from symptom onset ( P = .02). Dynamic contrast-enhanced MR imaging parameters were not found to correlate significantly with intraplaque enhancement or intraplaque hyperintensity ( P = .4 and P = .17, respectively).

CONCLUSIONS: Elevated K trans and Vp values found in intracranial atherosclerotic disease plaques versus healthy white matter suggest that dynamic contrast-enhanced MR imaging is a feasible technique for studying vessel wall and plaque characteristics in the proximal intracranial vasculature. Significant correlations between K trans and symptom onset, which were not observed on T1 SPACE–derived metrics, suggest that K trans may be an independent imaging biomarker of acute and symptom-associated pathologic changes in intracranial atherosclerotic disease plaques.

BBMRI
:   black-blood MRI
DCE
:   dynamic contrast-enhanced
GRE
:   gradient recalled-echo
ICAD
:   intracranial atherosclerotic disease
IPE
:   intraplaque enhancement
IPH
:   intraplaque hyperintensity
K trans
:   volume transfer constant
NAWM
:   normal-appearing white matter
SPACE
:   sampling perfection with application-optimized contrasts by using different flip angle evolution
SI
:   signal intensity
VL
:   extracellular extravascular space
Vp
:   fractional plasma volume" />
<meta name="og-title" property="og:title" content="Quantifying Intracranial Plaque Permeability with Dynamic Contrast-Enhanced MRI: A Pilot Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/38/2/243" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Intracranial atherosclerotic disease plaque hyperintensity and/or gadolinium contrast enhancement have been studied as imaging biomarkers of acutely symptomatic ischemic presentations using single static MR imaging measurements. However, the value in modeling the dynamics of intracranial plaque permeability has yet to be evaluated. The purpose of this study was to use dynamic contrast-enhanced MR imaging to quantify the contrast permeability of intracranial atherosclerotic disease plaques in symptomatic patients and to compare these parameters against existing markers of plaque volatility using black-blood MR imaging pulse sequences.

MATERIALS AND METHODS: We performed a prospective study of contrast uptake dynamics in the major intracranial vessels proximal and immediately distal to the circle of Willis using dynamic contrast-enhanced MR imaging, specifically in patients with symptomatic intracranial atherosclerotic disease. Using the Modified Tofts model, we extracted the volume transfer constant ( K trans) and fractional plasma volume (Vp) parameters from plaque-enhancement curves. Using regression analyses, we compared these parameters against time from symptom onset as well as intraplaque hyperintensity and postcontrast enhancement derived from T1 SPACE, a black-blood MR vessel wall imaging sequence.

RESULTS: We completed analysis in 10 patients presenting with symptomatic intracranial atherosclerotic disease. K trans and Vp measurements were higher in plaques versus healthy white matter and similar or less than values in the choroid plexus. Only K trans correlated significantly with time from symptom onset ( P = .02). Dynamic contrast-enhanced MR imaging parameters were not found to correlate significantly with intraplaque enhancement or intraplaque hyperintensity ( P = .4 and P = .17, respectively).

CONCLUSIONS: Elevated K trans and Vp values found in intracranial atherosclerotic disease plaques versus healthy white matter suggest that dynamic contrast-enhanced MR imaging is a feasible technique for studying vessel wall and plaque characteristics in the proximal intracranial vasculature. Significant correlations between K trans and symptom onset, which were not observed on T1 SPACE–derived metrics, suggest that K trans may be an independent imaging biomarker of acute and symptom-associated pathologic changes in intracranial atherosclerotic disease plaques.

BBMRI
:   black-blood MRI
DCE
:   dynamic contrast-enhanced
GRE
:   gradient recalled-echo
ICAD
:   intracranial atherosclerotic disease
IPE
:   intraplaque enhancement
IPH
:   intraplaque hyperintensity
K trans
:   volume transfer constant
NAWM
:   normal-appearing white matter
SPACE
:   sampling perfection with application-optimized contrasts by using different flip angle evolution
SI
:   signal intensity
VL
:   extracellular extravascular space
Vp
:   fractional plasma volume" />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">ADULT BRAIN</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Quantifying Intracranial Plaque Permeability with Dynamic Contrast-Enhanced MRI: A Pilot Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P. Vakil</span>, <span class="highwire-citation-author" data-delta="1">A.H. Elmokadem</span>, <span class="highwire-citation-author" data-delta="2">F.H. Syed</span>, <span class="highwire-citation-author" data-delta="3">C.G. Cantrell</span>, <span class="highwire-citation-author" data-delta="4">F.H. Dehkordi</span>, <span class="highwire-citation-author" data-delta="5">T.J. Carroll</span> and <span class="highwire-citation-author" data-delta="6">S.A. Ansari</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">243-249; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4998 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14656--61858691829" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">P. Vakil </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the College of Medicine (P.V.), University of Illinois, Chicago, Illinois</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (P.V., A.H.E., F.S., C.G.C., T.J.C., S.A.A.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Biomedical Engineering (P.V., C.G.C., T.J.C.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BVakil%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vakil%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BVakil%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3862-2185" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Vakil</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A.H. Elmokadem </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (P.V., A.H.E., F.S., C.G.C., T.J.C., S.A.A.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.H.%2BElmokadem%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Elmokadem%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.H.%2BElmokadem%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5119-9548" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.H. Elmokadem</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">F.H. Syed </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (P.V., A.H.E., F.S., C.G.C., T.J.C., S.A.A.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.H.%2BSyed%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Syed%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.H.%2BSyed%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9048-2538" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.H. Syed</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">C.G. Cantrell </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (P.V., A.H.E., F.S., C.G.C., T.J.C., S.A.A.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Biomedical Engineering (P.V., C.G.C., T.J.C.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.G.%2BCantrell%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Cantrell%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.G.%2BCantrell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0559-8681" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.G. Cantrell</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">F.H. Dehkordi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Economics and Decision Sciences (F.H.D.), Western Illinois University, Macomb, Illinois.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.H.%2BDehkordi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Dehkordi%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.H.%2BDehkordi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-0990-2436" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.H. Dehkordi</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">T.J. Carroll </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (P.V., A.H.E., F.S., C.G.C., T.J.C., S.A.A.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Biomedical Engineering (P.V., C.G.C., T.J.C.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.J.%2BCarroll%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Carroll%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.J.%2BCarroll%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-5149-8377" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T.J. 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Ansari </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Radiology (P.V., A.H.E., F.S., C.G.C., T.J.C., S.A.A.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Neurology and Neurological Surgery (S.A.A.), Northwestern University, Chicago, Illinois</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.A.%2BAnsari%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ansari%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.A.%2BAnsari%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-8176-4616" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.A. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-2"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-3"><strong>BACKGROUND AND PURPOSE:</strong> Intracranial atherosclerotic disease plaque hyperintensity and/or gadolinium contrast enhancement have been studied as imaging biomarkers of acutely symptomatic ischemic presentations using single static MR imaging measurements. However, the value in modeling the dynamics of intracranial plaque permeability has yet to be evaluated. The purpose of this study was to use dynamic contrast-enhanced MR imaging to quantify the contrast permeability of intracranial atherosclerotic disease plaques in symptomatic patients and to compare these parameters against existing markers of plaque volatility using black-blood MR imaging pulse sequences.</p></div><div id="sec-2" class="subsection"><p id="p-4"><strong>MATERIALS AND METHODS:</strong> We performed a prospective study of contrast uptake dynamics in the major intracranial vessels proximal and immediately distal to the circle of Willis using dynamic contrast-enhanced MR imaging, specifically in patients with symptomatic intracranial atherosclerotic disease. Using the Modified Tofts model, we extracted the volume transfer constant (<em>K</em><sup>trans</sup>) and fractional plasma volume (V<sub>p</sub>) parameters from plaque-enhancement curves. Using regression analyses, we compared these parameters against time from symptom onset as well as intraplaque hyperintensity and postcontrast enhancement derived from T1 SPACE, a black-blood MR vessel wall imaging sequence.</p></div><div id="sec-3" class="subsection"><p id="p-5"><strong>RESULTS:</strong> We completed analysis in 10 patients presenting with symptomatic intracranial atherosclerotic disease. <em>K</em><sup>trans</sup> and V<sub>p</sub> measurements were higher in plaques versus healthy white matter and similar or less than values in the choroid plexus. Only <em>K</em><sup>trans</sup> correlated significantly with time from symptom onset (<em>P</em> = .02). Dynamic contrast-enhanced MR imaging parameters were not found to correlate significantly with intraplaque enhancement or intraplaque hyperintensity (<em>P</em> = .4 and <em>P</em> = .17, respectively).</p></div><div id="sec-4" class="subsection"><p id="p-6"><strong>CONCLUSIONS:</strong> Elevated <em>K</em><sup>trans</sup> and V<sub>p</sub> values found in intracranial atherosclerotic disease plaques versus healthy white matter suggest that dynamic contrast-enhanced MR imaging is a feasible technique for studying vessel wall and plaque characteristics in the proximal intracranial vasculature. Significant correlations between <em>K</em><sup>trans</sup> and symptom onset, which were not observed on T1 SPACE–derived metrics, suggest that <em>K</em><sup>trans</sup> may be an independent imaging biomarker of acute and symptom-associated pathologic changes in intracranial atherosclerotic disease plaques.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">BBMRI<span class="def-item-dt-sep"></span></dt><dd>black-blood MRI<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">DCE<span class="def-item-dt-sep"></span></dt><dd>dynamic contrast-enhanced<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">GRE<span class="def-item-dt-sep"></span></dt><dd>gradient recalled-echo<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">ICAD<span class="def-item-dt-sep"></span></dt><dd>intracranial atherosclerotic disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">IPE<span class="def-item-dt-sep"></span></dt><dd>intraplaque enhancement<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">IPH<span class="def-item-dt-sep"></span></dt><dd>intraplaque hyperintensity<span class="def-item-dd-sep"></span></dd><dt id="def-item-7"><em>K</em><sup>trans</sup><span class="def-item-dt-sep"></span></dt><dd>volume transfer constant<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">NAWM<span class="def-item-dt-sep"></span></dt><dd>normal-appearing white matter<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">SPACE<span class="def-item-dt-sep"></span></dt><dd>sampling perfection with application-optimized contrasts by using different flip angle evolution<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">SI<span class="def-item-dt-sep"></span></dt><dd>signal intensity<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">V<sub>L</sub><span class="def-item-dt-sep"></span></dt><dd>extracellular extravascular space<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">V<sub>p</sub><span class="def-item-dt-sep"></span></dt><dd>fractional plasma volume</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2017 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/38/2/243.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 38</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2017 </div></div>
      
      
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