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<meta name="DC.Title" content="High-Resolution MRI for Evaluation of the Possibility of Successful Recanalization in Symptomatic Chronic ICA Occlusion: A Retrospective Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A7576" />
<meta name="DC.Date" content="2022-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Accurate radiologic evaluation of the possibility of successful recanalization in symptomatic chronic ICA occlusion remains challenging. This study aimed to investigate the high-resolution MR imaging characteristics of symptomatic chronic ICA occlusion and their association with successful recanalization.

MATERIALS AND METHODS: Consecutive patients with symptomatic chronic ICA occlusion who underwent balloon dilation plus stent implantation were identified retrospectively and divided into 2 groups: a successful recanalization group and an unsuccessful recanalization group. Clinical and high-resolution MR imaging characteristics were compared between the groups. Univariate and multivariate analyses were used to identify the characteristics associated with successful recanalization.

RESULTS: A total of 114 patients were included in the study. High-resolution MR imaging characteristics independently associated with unsuccessful recanalization were longer lesion length (OR, 0.41; 95% CI, 0.36–0.55; P = .009) and larger calcification volume (OR, 0.56; 95% CI, 0.37–0.68; P = .002) for proximal occlusion and reversed distal ICA flow at the level of ophthalmic segment or above (OR, 0.14; 95% CI, 0.08–0.48; P = .001). Reversed distal ICA flow at the level of the petrous segment or below (OR, 4.07; 95% CI, 1.65–8.38; P = .001) and lumen area (OR, 1.13; 95% CI, 1.04–1.61; P = .002) for distal occlusion were risk factors of successful recanalization.

CONCLUSIONS: In symptomatic chronic ICA occlusion, lesion length and calcification volume (for proximal occlusion), the level of reversed distal ICA flow, and the lumen area (for distal occlusion) appear to be predictors of successful recanalization. High-resolution MR imaging can evaluate chronic ICA occlusion and help in clinical decision-making.

CE
:   contrast-enhanced
CICAO
:   chronic ICA occlusion
HR
:   high-resolution
IPH
:   intraplaque hemorrhage
NSA
:   number of signals averaged" />
<meta name="DC.Contributor" content="M. Tang" />
<meta name="DC.Contributor" content="X. Yan" />
<meta name="DC.Contributor" content="J. Gao" />
<meta name="DC.Contributor" content="L. Li" />
<meta name="DC.Contributor" content="X. Zhe" />
<meta name="DC.Contributor" content="Xin Zhang" />
<meta name="DC.Contributor" content="F. Jiang" />
<meta name="DC.Contributor" content="J. Hu" />
<meta name="DC.Contributor" content="N. Ma" />
<meta name="DC.Contributor" content="K. Ai" />
<meta name="DC.Contributor" content="Xiaoling Zhang" />
<meta name="article:published_time" content="2022-08-01" />
<meta name="article:section" content="Extracranial Vascular" />
<meta name="citation_title" content="High-Resolution MRI for Evaluation of the Possibility of Successful Recanalization in Symptomatic Chronic ICA Occlusion: A Retrospective Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Accurate radiologic evaluation of the possibility of successful recanalization in symptomatic chronic ICA occlusion remains challenging. This study aimed to investigate the high-resolution MR imaging characteristics of symptomatic chronic ICA occlusion and their association with successful recanalization.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Consecutive patients with symptomatic chronic ICA occlusion who underwent balloon dilation plus stent implantation were identified retrospectively and divided into 2 groups: a successful recanalization group and an unsuccessful recanalization group. Clinical and high-resolution MR imaging characteristics were compared between the groups. Univariate and multivariate analyses were used to identify the characteristics associated with successful recanalization.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;A total of 114 patients were included in the study. High-resolution MR imaging characteristics independently associated with unsuccessful recanalization were longer lesion length (OR, 0.41; 95% CI, 0.36–0.55; &lt;i&gt;P&lt;/i&gt; = .009) and larger calcification volume (OR, 0.56; 95% CI, 0.37–0.68; &lt;i&gt;P&lt;/i&gt; = .002) for proximal occlusion and reversed distal ICA flow at the level of ophthalmic segment or above (OR, 0.14; 95% CI, 0.08–0.48; &lt;i&gt;P&lt;/i&gt; = .001). Reversed distal ICA flow at the level of the petrous segment or below (OR, 4.07; 95% CI, 1.65–8.38; &lt;i&gt;P&lt;/i&gt; = .001) and lumen area (OR, 1.13; 95% CI, 1.04–1.61; &lt;i&gt;P&lt;/i&gt; = .002) for distal occlusion were risk factors of successful recanalization.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In symptomatic chronic ICA occlusion, lesion length and calcification volume (for proximal occlusion), the level of reversed distal ICA flow, and the lumen area (for distal occlusion) appear to be predictors of successful recanalization. High-resolution MR imaging can evaluate chronic ICA occlusion and help in clinical decision-making.&lt;/p&gt;" />
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<meta name="twitter:title" content="High-Resolution MRI for Evaluation of the Possibility of Successful Recanalization in Symptomatic Chronic ICA Occlusion: A Retrospective Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Accurate radiologic evaluation of the possibility of successful recanalization in symptomatic chronic ICA occlusion remains challenging. This study aimed to investigate the high-resolution MR imaging characteristics of symptomatic chronic ICA occlusion and their association with successful recanalization.

MATERIALS AND METHODS: Consecutive patients with symptomatic chronic ICA occlusion who underwent balloon dilation plus stent implantation were identified retrospectively and divided into 2 groups: a successful recanalization group and an unsuccessful recanalization group. Clinical and high-resolution MR imaging characteristics were compared between the groups. Univariate and multivariate analyses were used to identify the characteristics associated with successful recanalization.

RESULTS: A total of 114 patients were included in the study. High-resolution MR imaging characteristics independently associated with unsuccessful recanalization were longer lesion length (OR, 0.41; 95% CI, 0.36–0.55; P = .009) and larger calcification volume (OR, 0.56; 95% CI, 0.37–0.68; P = .002) for proximal occlusion and reversed distal ICA flow at the level of ophthalmic segment or above (OR, 0.14; 95% CI, 0.08–0.48; P = .001). Reversed distal ICA flow at the level of the petrous segment or below (OR, 4.07; 95% CI, 1.65–8.38; P = .001) and lumen area (OR, 1.13; 95% CI, 1.04–1.61; P = .002) for distal occlusion were risk factors of successful recanalization.

CONCLUSIONS: In symptomatic chronic ICA occlusion, lesion length and calcification volume (for proximal occlusion), the level of reversed distal ICA flow, and the lumen area (for distal occlusion) appear to be predictors of successful recanalization. High-resolution MR imaging can evaluate chronic ICA occlusion and help in clinical decision-making.

CE
:   contrast-enhanced
CICAO
:   chronic ICA occlusion
HR
:   high-resolution
IPH
:   intraplaque hemorrhage
NSA
:   number of signals averaged" />
<meta name="og-title" property="og:title" content="High-Resolution MRI for Evaluation of the Possibility of Successful Recanalization in Symptomatic Chronic ICA Occlusion: A Retrospective Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/43/8/1164" />
<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: Accurate radiologic evaluation of the possibility of successful recanalization in symptomatic chronic ICA occlusion remains challenging. This study aimed to investigate the high-resolution MR imaging characteristics of symptomatic chronic ICA occlusion and their association with successful recanalization.

MATERIALS AND METHODS: Consecutive patients with symptomatic chronic ICA occlusion who underwent balloon dilation plus stent implantation were identified retrospectively and divided into 2 groups: a successful recanalization group and an unsuccessful recanalization group. Clinical and high-resolution MR imaging characteristics were compared between the groups. Univariate and multivariate analyses were used to identify the characteristics associated with successful recanalization.

RESULTS: A total of 114 patients were included in the study. High-resolution MR imaging characteristics independently associated with unsuccessful recanalization were longer lesion length (OR, 0.41; 95% CI, 0.36–0.55; P = .009) and larger calcification volume (OR, 0.56; 95% CI, 0.37–0.68; P = .002) for proximal occlusion and reversed distal ICA flow at the level of ophthalmic segment or above (OR, 0.14; 95% CI, 0.08–0.48; P = .001). Reversed distal ICA flow at the level of the petrous segment or below (OR, 4.07; 95% CI, 1.65–8.38; P = .001) and lumen area (OR, 1.13; 95% CI, 1.04–1.61; P = .002) for distal occlusion were risk factors of successful recanalization.

CONCLUSIONS: In symptomatic chronic ICA occlusion, lesion length and calcification volume (for proximal occlusion), the level of reversed distal ICA flow, and the lumen area (for distal occlusion) appear to be predictors of successful recanalization. High-resolution MR imaging can evaluate chronic ICA occlusion and help in clinical decision-making.

CE
:   contrast-enhanced
CICAO
:   chronic ICA occlusion
HR
:   high-resolution
IPH
:   intraplaque hemorrhage
NSA
:   number of signals averaged" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node98302--5" data-node-nid="98302" id="top-node-98302--62106822192" data-pisa="ajnr;43/8/1164" data-pisa-master="ajnr;ajnr.A7576" data-apath="/ajnr/43/8/1164.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <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">Extracranial Vascular</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">High-Resolution MRI for Evaluation of the Possibility of Successful Recanalization in Symptomatic Chronic ICA Occlusion: A Retrospective Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M. Tang</span>, <span class="highwire-citation-author" data-delta="1">X. Yan</span>, <span class="highwire-citation-author" data-delta="2">J. Gao</span>, <span class="highwire-citation-author" data-delta="3">L. Li</span>, <span class="highwire-citation-author" data-delta="4">X. Zhe</span>, <span class="highwire-citation-author" data-delta="5">Xin Zhang</span>, <span class="highwire-citation-author" data-delta="6">F. Jiang</span>, <span class="highwire-citation-author" data-delta="7">J. Hu</span>, <span class="highwire-citation-author" data-delta="8">N. Ma</span>, <span class="highwire-citation-author" data-delta="9">K. Ai</span> and <span class="highwire-citation-author" data-delta="10">Xiaoling Zhang</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">August 2022,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">43 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1164-1171; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A7576 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-98302--62106822192" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M. Tang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of MRI (M.T., X.Y., J.G., L.L., X. Zhe., X. Zhang., N.M., X. Zhang)</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=M.%2BTang%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=Tang%20M&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%3AM.%2BTang%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="https://orcid.org/0000-0002-4070-7110" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Tang</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">X. Yan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of MRI (M.T., X.Y., J.G., L.L., X. Zhe., X. Zhang., N.M., X. Zhang)</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=X.%2BYan%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=Yan%20X&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%3AX.%2BYan%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="https://orcid.org/0000-0002-5539-8330" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. Yan</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">J. Gao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of MRI (M.T., X.Y., J.G., L.L., X. Zhe., X. Zhang., N.M., X. Zhang)</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=J.%2BGao%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=Gao%20J&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%3AJ.%2BGao%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="https://orcid.org/0000-0002-0218-5438" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Gao</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">L. Li </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of MRI (M.T., X.Y., J.G., L.L., X. Zhe., X. Zhang., N.M., X. Zhang)</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=L.%2BLi%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=Li%20L&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%3AL.%2BLi%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="https://orcid.org/0000-0001-7169-9531" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Li</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">X. Zhe </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of MRI (M.T., X.Y., J.G., L.L., X. Zhe., X. Zhang., N.M., X. Zhang)</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=X.%2BZhe%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=Zhe%20X&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%3AX.%2BZhe%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="https://orcid.org/0000-0003-4946-1302" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. Zhe</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Xin Zhang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of MRI (M.T., X.Y., J.G., L.L., X. Zhe., X. Zhang., N.M., X. Zhang)</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=Xin%2BZhang%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=Zhang%20X&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%3AXin%2BZhang%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="https://orcid.org/0000-0002-5308-9489" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Xin Zhang</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">F. Jiang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (F.J., J.H.), Shaanxi Provincial People’s Hospital, Beilin District, Xi'an City, Shaanxi Province, China</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.%2BJiang%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=Jiang%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.%2BJiang%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="https://orcid.org/0000-0001-6672-2960" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. Jiang</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">J. Hu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (F.J., J.H.), Shaanxi Provincial People’s Hospital, Beilin District, Xi'an City, Shaanxi Province, China</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=J.%2BHu%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=Hu%20J&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%3AJ.%2BHu%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="https://orcid.org/0000-0001-9805-5365" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Hu</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">N. Ma </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of MRI (M.T., X.Y., J.G., L.L., X. Zhe., X. Zhang., N.M., X. Zhang)</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=N.%2BMa%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=Ma%20N&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%3AN.%2BMa%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="https://orcid.org/0000-0003-0700-7638" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N. Ma</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">K. Ai </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Clinical Science (K.A.), Philips Healthcare, Xìan, China</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=K.%2BAi%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=Ai%20K&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%3AK.%2BAi%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="https://orcid.org/0000-0002-0807-3584" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. Ai</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">Xiaoling Zhang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of MRI (M.T., X.Y., J.G., L.L., X. Zhe., X. Zhang., N.M., X. Zhang)</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=Xiaoling%2BZhang%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=Zhang%20X&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%3AXiaoling%2BZhang%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="https://orcid.org/0000-0001-9200-8832" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Xiaoling Zhang</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-43.8.1164.1" data-doi="10.1161/01.STR.0000135024.54608.3f"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Flaherty</span>  <span class="cit-name-given-names">ML</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Flemming</span>  <span class="cit-name-given-names">KD</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">McClelland</span>  <span class="cit-name-given-names">R</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span 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