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<meta name="DC.Title" content="Temporal Changes on Postgadolinium MR Vessel Wall Imaging Captures Enhancement Kinetics of Intracranial Atherosclerotic Plaques and Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8370" />
<meta name="DC.Date" content="2024-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2024 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Analysis of vessel wall contrast kinetics (ie, wash-in/washout) is a promising method for the diagnosis and risk-stratification of intracranial atherosclerotic disease plaque (ICAD-P) and the intracranial aneurysm walls (IA-W). We used black-blood MR imaging or MR vessel wall imaging to evaluate the temporal relationship of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws compared with normal anatomic reference structures.

MATERIALS AND METHODS: Patients with ICAD-Ps or IAs who underwent MR vessel wall imaging with precontrast, early postcontrast (5–15 minutes), and delayed postcontrast (20–30 minutes) 3D T1-weighted TSE sequences were retrospectively studied. ROIs of a standardized diameter (2 mm) were used to measure the signal intensities of the cavernous sinus, pituitary infundibulum, temporalis muscle, and choroid plexus. Point ROIs were used for ICAD-Ps and IA-Ws. All ROI signal intensities were normalized to white matter signal intensity obtained using ROIs of 10-mm diameter. Measurements were acquired on precontrast, early postcontrast, and delayed postcontrast 3D T1 TSE sequences for each patient.

View this table:

Table 1: 
MR-VWI parameters for ICAD-Ps and IAs



RESULTS: Ten patients with 17 symptomatic ICAD-Ps and 30 patients with 34 IA-Ws were included and demonstrated persisting contrast uptake ( P  &lt; .001) of 7.21% and 10.54% beyond the early phase (5–15 minutes postcontrast) and in the delayed phase (20–30 minutes postcontrast) on postcontrast MR vessel wall imaging. However, normal anatomic reference structures including the pituitary infundibulum and cavernous sinus demonstrated a paradoxical contrast washout in the delayed phase. In both ICAD-Ps and IA-Ws, the greatest percentage of quantitative enhancement (&gt;70%–90%) occurred in the early phase of postcontrast imaging, consistent with the rapid contrast uptake kinetics of neurovascular pathology.

CONCLUSIONS: Using standard MR vessel wall imaging techniques, our results demonstrate the effects of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws with extended accumulating enhancement into the delayed phase (&gt; 15 minutes) as opposed to normal anatomic reference structures that conversely exhibit decreasing enhancement. Because these relative differences are used to assess qualitative patterns of ICAD-P and IA-W enhancement, our findings highlight the importance of standardizing acquisition time points and MR vessel wall imaging protocols to interpret pathologic enhancement for the risk stratification of cerebrovascular pathologies.

AWE
:   aneurysm wall enhancement
IA
:   intracranial aneurysm
IA-W
:   intracranial aneurysm wall
ICAD
:   intracranial atherosclerotic disease
ICAD-P
:   intracranial atherosclerotic disease plaque
K trans
:   volume transfer constant
SI
:   signal intensity
VWI
:   vessel wall imaging" />
<meta name="DC.Contributor" content="Abhinav Patel" />
<meta name="DC.Contributor" content="Ramez N. Abdalla" />
<meta name="DC.Contributor" content="Sammy Allaw" />
<meta name="DC.Contributor" content="Donald R. Cantrell" />
<meta name="DC.Contributor" content="Ali Shaibani" />
<meta name="DC.Contributor" content="Frances Caprio" />
<meta name="DC.Contributor" content="David M. Hasan" />
<meta name="DC.Contributor" content="Ali Alaraj" />
<meta name="DC.Contributor" content="Sean P. Polster" />
<meta name="DC.Contributor" content="Timothy J. Carroll" />
<meta name="DC.Contributor" content="Sameer A. Ansari" />
<meta name="article:published_time" content="2024-09-01" />
<meta name="article:section" content="Neurovascular/Stroke Imaging" />
<meta name="citation_title" content="Temporal Changes on Postgadolinium MR Vessel Wall Imaging Captures Enhancement Kinetics of Intracranial Atherosclerotic Plaques and Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Analysis of vessel wall contrast kinetics (ie, wash-in/washout) is a promising method for the diagnosis and risk-stratification of intracranial atherosclerotic disease plaque (ICAD-P) and the intracranial aneurysm walls (IA-W). We used black-blood MR imaging or MR vessel wall imaging to evaluate the temporal relationship of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws compared with normal anatomic reference structures.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Patients with ICAD-Ps or IAs who underwent MR vessel wall imaging with precontrast, early postcontrast (5–15 minutes), and delayed postcontrast (20–30 minutes) 3D T1-weighted TSE sequences were retrospectively studied. ROIs of a standardized diameter (2 mm) were used to measure the signal intensities of the cavernous sinus, pituitary infundibulum, temporalis muscle, and choroid plexus. Point ROIs were used for ICAD-Ps and IA-Ws. All ROI signal intensities were normalized to white matter signal intensity obtained using ROIs of 10-mm diameter. Measurements were acquired on precontrast, early postcontrast, and delayed postcontrast 3D T1 TSE sequences for each patient.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Ten patients with 17 symptomatic ICAD-Ps and 30 patients with 34 IA-Ws were included and demonstrated persisting contrast uptake (&lt;i&gt;P &lt;/i&gt;&amp;lt; .001) of 7.21% and 10.54% beyond the early phase (5–15 minutes postcontrast) and in the delayed phase (20–30 minutes postcontrast) on postcontrast MR vessel wall imaging. However, normal anatomic reference structures including the pituitary infundibulum and cavernous sinus demonstrated a paradoxical contrast washout in the delayed phase. In both ICAD-Ps and IA-Ws, the greatest percentage of quantitative enhancement (&amp;gt;70%–90%) occurred in the early phase of postcontrast imaging, consistent with the rapid contrast uptake kinetics of neurovascular pathology.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Using standard MR vessel wall imaging techniques, our results demonstrate the effects of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws with extended accumulating enhancement into the delayed phase (&amp;gt; 15 minutes) as opposed to normal anatomic reference structures that conversely exhibit decreasing enhancement. Because these relative differences are used to assess qualitative patterns of ICAD-P and IA-W enhancement, our findings highlight the importance of standardizing acquisition time points and MR vessel wall imaging protocols to interpret pathologic enhancement for the risk stratification of cerebrovascular pathologies.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2024/09/01" />
<meta name="citation_mjid" content="ajnr;45/9/1206" />
<meta name="citation_id" content="45/9/1206" />
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<meta name="citation_doi" content="10.3174/ajnr.A8370" />
<meta name="citation_pmid" content="39054289" />
<meta name="citation_volume" content="45" />
<meta name="citation_issue" content="9" />
<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Neurovascular/Stroke Imaging" />
<meta name="citation_firstpage" content="1206" />
<meta name="citation_lastpage" content="1213" />
<meta name="citation_author" content="Abhinav Patel" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author" content="Ramez N. Abdalla" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author_institution" content="bDepartment of Radiology (R.N.A.), Ain Shams University, Cairo, Egypt" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-2611-2097" />
<meta name="citation_author" content="Sammy Allaw" />
<meta name="citation_author_institution" content="cDepartment of Radiology (S.A., T.J.C.), University of Chicago, Chicago, Illinois" />
<meta name="citation_author" content="Donald R. Cantrell" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author_institution" content="dDepartment of Neurology (D.R.C., A.S., F.C., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author" content="Ali Shaibani" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author_institution" content="dDepartment of Neurology (D.R.C., A.S., F.C., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author_institution" content="eDepartment of Neurological Surgery (A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-9901-2903" />
<meta name="citation_author" content="Frances Caprio" />
<meta name="citation_author_institution" content="dDepartment of Neurology (D.R.C., A.S., F.C., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author" content="David M. Hasan" />
<meta name="citation_author_institution" content="fDepartment of Neurological Surgery (D.M.H.), Duke University School of Medicine, Durham, North Carolina" />
<meta name="citation_author" content="Ali Alaraj" />
<meta name="citation_author_institution" content="hDepartment of Neurosurgery, College of Medicine (A.A.), University of Illinois at Chicago, Chicago, Illinois" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-1491-4634" />
<meta name="citation_author" content="Sean P. Polster" />
<meta name="citation_author_institution" content="gDepartment of Neurological Surgery (S.P.P.), University of Chicago Pritzker School of Medicine, Chicago, Illinois" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-3229-5021" />
<meta name="citation_author" content="Timothy J. Carroll" />
<meta name="citation_author_institution" content="cDepartment of Radiology (S.A., T.J.C.), University of Chicago, Chicago, Illinois" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-2113-6284" />
<meta name="citation_author" content="Sameer A. Ansari" />
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<meta name="citation_author_institution" content="dDepartment of Neurology (D.R.C., A.S., F.C., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author_institution" content="eDepartment of Neurological Surgery (A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-8176-4616" />
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<meta name="twitter:title" content="Temporal Changes on Postgadolinium MR Vessel Wall Imaging Captures Enhancement Kinetics of Intracranial Atherosclerotic Plaques and Aneurysms" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Analysis of vessel wall contrast kinetics (ie, wash-in/washout) is a promising method for the diagnosis and risk-stratification of intracranial atherosclerotic disease plaque (ICAD-P) and the intracranial aneurysm walls (IA-W). We used black-blood MR imaging or MR vessel wall imaging to evaluate the temporal relationship of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws compared with normal anatomic reference structures.

MATERIALS AND METHODS: Patients with ICAD-Ps or IAs who underwent MR vessel wall imaging with precontrast, early postcontrast (5–15 minutes), and delayed postcontrast (20–30 minutes) 3D T1-weighted TSE sequences were retrospectively studied. ROIs of a standardized diameter (2 mm) were used to measure the signal intensities of the cavernous sinus, pituitary infundibulum, temporalis muscle, and choroid plexus. Point ROIs were used for ICAD-Ps and IA-Ws. All ROI signal intensities were normalized to white matter signal intensity obtained using ROIs of 10-mm diameter. Measurements were acquired on precontrast, early postcontrast, and delayed postcontrast 3D T1 TSE sequences for each patient.

View this table:

Table 1: 
MR-VWI parameters for ICAD-Ps and IAs



RESULTS: Ten patients with 17 symptomatic ICAD-Ps and 30 patients with 34 IA-Ws were included and demonstrated persisting contrast uptake ( P  &lt; .001) of 7.21% and 10.54% beyond the early phase (5–15 minutes postcontrast) and in the delayed phase (20–30 minutes postcontrast) on postcontrast MR vessel wall imaging. However, normal anatomic reference structures including the pituitary infundibulum and cavernous sinus demonstrated a paradoxical contrast washout in the delayed phase. In both ICAD-Ps and IA-Ws, the greatest percentage of quantitative enhancement (&gt;70%–90%) occurred in the early phase of postcontrast imaging, consistent with the rapid contrast uptake kinetics of neurovascular pathology.

CONCLUSIONS: Using standard MR vessel wall imaging techniques, our results demonstrate the effects of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws with extended accumulating enhancement into the delayed phase (&gt; 15 minutes) as opposed to normal anatomic reference structures that conversely exhibit decreasing enhancement. Because these relative differences are used to assess qualitative patterns of ICAD-P and IA-W enhancement, our findings highlight the importance of standardizing acquisition time points and MR vessel wall imaging protocols to interpret pathologic enhancement for the risk stratification of cerebrovascular pathologies.

AWE
:   aneurysm wall enhancement
IA
:   intracranial aneurysm
IA-W
:   intracranial aneurysm wall
ICAD
:   intracranial atherosclerotic disease
ICAD-P
:   intracranial atherosclerotic disease plaque
K trans
:   volume transfer constant
SI
:   signal intensity
VWI
:   vessel wall imaging" />
<meta name="og-title" property="og:title" content="Temporal Changes on Postgadolinium MR Vessel Wall Imaging Captures Enhancement Kinetics of Intracranial Atherosclerotic Plaques and Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/45/9/1206" />
<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: Analysis of vessel wall contrast kinetics (ie, wash-in/washout) is a promising method for the diagnosis and risk-stratification of intracranial atherosclerotic disease plaque (ICAD-P) and the intracranial aneurysm walls (IA-W). We used black-blood MR imaging or MR vessel wall imaging to evaluate the temporal relationship of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws compared with normal anatomic reference structures.

MATERIALS AND METHODS: Patients with ICAD-Ps or IAs who underwent MR vessel wall imaging with precontrast, early postcontrast (5–15 minutes), and delayed postcontrast (20–30 minutes) 3D T1-weighted TSE sequences were retrospectively studied. ROIs of a standardized diameter (2 mm) were used to measure the signal intensities of the cavernous sinus, pituitary infundibulum, temporalis muscle, and choroid plexus. Point ROIs were used for ICAD-Ps and IA-Ws. All ROI signal intensities were normalized to white matter signal intensity obtained using ROIs of 10-mm diameter. Measurements were acquired on precontrast, early postcontrast, and delayed postcontrast 3D T1 TSE sequences for each patient.

View this table:

Table 1: 
MR-VWI parameters for ICAD-Ps and IAs



RESULTS: Ten patients with 17 symptomatic ICAD-Ps and 30 patients with 34 IA-Ws were included and demonstrated persisting contrast uptake ( P  &lt; .001) of 7.21% and 10.54% beyond the early phase (5–15 minutes postcontrast) and in the delayed phase (20–30 minutes postcontrast) on postcontrast MR vessel wall imaging. However, normal anatomic reference structures including the pituitary infundibulum and cavernous sinus demonstrated a paradoxical contrast washout in the delayed phase. In both ICAD-Ps and IA-Ws, the greatest percentage of quantitative enhancement (&gt;70%–90%) occurred in the early phase of postcontrast imaging, consistent with the rapid contrast uptake kinetics of neurovascular pathology.

CONCLUSIONS: Using standard MR vessel wall imaging techniques, our results demonstrate the effects of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws with extended accumulating enhancement into the delayed phase (&gt; 15 minutes) as opposed to normal anatomic reference structures that conversely exhibit decreasing enhancement. Because these relative differences are used to assess qualitative patterns of ICAD-P and IA-W enhancement, our findings highlight the importance of standardizing acquisition time points and MR vessel wall imaging protocols to interpret pathologic enhancement for the risk stratification of cerebrovascular pathologies.

AWE
:   aneurysm wall enhancement
IA
:   intracranial aneurysm
IA-W
:   intracranial aneurysm wall
ICAD
:   intracranial atherosclerotic disease
ICAD-P
:   intracranial atherosclerotic disease plaque
K trans
:   volume transfer constant
SI
:   signal intensity
VWI
:   vessel wall imaging" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node110096--5" data-node-nid="110096" id="top-node-110096--6790025165" data-pisa="ajnr;45/9/1206" data-pisa-master="ajnr;ajnr.A8370" data-apath="/ajnr/45/9/1206.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">Neurovascular/Stroke Imaging</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Temporal Changes on Postgadolinium MR Vessel Wall Imaging Captures Enhancement Kinetics of Intracranial Atherosclerotic Plaques and Aneurysms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Abhinav Patel</span>, <span class="highwire-citation-author" data-delta="1">Ramez N. Abdalla</span>, <span class="highwire-citation-author" data-delta="2">Sammy Allaw</span>, <span class="highwire-citation-author" data-delta="3">Donald R. Cantrell</span>, <span class="highwire-citation-author" data-delta="4">Ali Shaibani</span>, <span class="highwire-citation-author" data-delta="5">Frances Caprio</span>, <span class="highwire-citation-author" data-delta="6">David M. Hasan</span>, <span class="highwire-citation-author" data-delta="7">Ali Alaraj</span>, <span class="highwire-citation-author" data-delta="8">Sean P. Polster</span>, <span class="highwire-citation-author" data-delta="9">Timothy J. Carroll</span> and <span class="highwire-citation-author" data-delta="10">Sameer 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">September 2024,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1206-1213; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8370 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-110096--6790025165" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Abhinav Patel </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, 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=Abhinav%2BPatel%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=Patel%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 last"><a href="/search/author1%3AAbhinav%2BPatel%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Ramez N. Abdalla </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (R.N.A.), Ain Shams University, Cairo, Egypt</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=Ramez%2BN.%2BAbdalla%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=Abdalla%20RN&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%3ARamez%2BN.%2BAbdalla%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/0000-0003-2611-2097" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Ramez N. Abdalla</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Sammy Allaw </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (S.A., T.J.C.), University of Chicago, 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=Sammy%2BAllaw%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=Allaw%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 last"><a href="/search/author1%3ASammy%2BAllaw%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Donald R. Cantrell </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neurology (D.R.C., A.S., F.C., S.A.A.), Northwestern University Feinberg School of Medicine, 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=Donald%2BR.%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%20DR&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 last"><a href="/search/author1%3ADonald%2BR.%2BCantrell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Ali Shaibani </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neurology (D.R.C., A.S., F.C., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neurological Surgery (A.S., S.A.A.), Northwestern University Feinberg School of Medicine, 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=Ali%2BShaibani%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=Shaibani%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%3AAli%2BShaibani%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/0000-0002-9901-2903" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Ali Shaibani</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Frances Caprio </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neurology (D.R.C., A.S., F.C., S.A.A.), Northwestern University Feinberg School of Medicine, 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=Frances%2BCaprio%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=Caprio%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 last"><a href="/search/author1%3AFrances%2BCaprio%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">David M. Hasan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Neurological Surgery (D.M.H.), Duke University School of Medicine, Durham, North Carolina</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=David%2BM.%2BHasan%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=Hasan%20DM&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 last"><a href="/search/author1%3ADavid%2BM.%2BHasan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">Ali Alaraj </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>h</span>Department of Neurosurgery, College of Medicine (A.A.), University of Illinois at Chicago, 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=Ali%2BAlaraj%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=Alaraj%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%3AAli%2BAlaraj%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/0000-0002-1491-4634" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Ali Alaraj</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">Sean P. 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Ansari </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology, (A.P., R.N.A., D.R.C., A.S., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neurology (D.R.C., A.S., F.C., S.A.A.), Northwestern University Feinberg School of Medicine, Chicago, Illinois</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neurological Surgery (A.S., S.A.A.), Northwestern University Feinberg School of Medicine, 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=Sameer%2BA.%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%20SA&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%3ASameer%2BA.%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="https://orcid.org/0000-0001-8176-4616" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Sameer A. 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We used black-blood MR imaging or MR vessel wall imaging to evaluate the temporal relationship of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws compared with normal anatomic reference structures.</p></div><div id="sec-2" class="subsection"><p id="p-3"><strong>MATERIALS AND METHODS:</strong> Patients with ICAD-Ps or IAs who underwent MR vessel wall imaging with precontrast, early postcontrast (5–15 minutes), and delayed postcontrast (20–30 minutes) 3D T1-weighted TSE sequences were retrospectively studied. ROIs of a standardized diameter (2 mm) were used to measure the signal intensities of the cavernous sinus, pituitary infundibulum, temporalis muscle, and choroid plexus. Point ROIs were used for ICAD-Ps and IA-Ws. All ROI signal intensities were normalized to white matter signal intensity obtained using ROIs of 10-mm diameter. Measurements were acquired on precontrast, early postcontrast, and delayed postcontrast 3D T1 TSE sequences for each patient.</p><div id="T1" class="table pos-float"><div class="table-inline table-callout-links"><div class="callout"><span>View this table:</span><ul class="callout-links"><li class="view-inline first"><a href="" class="table-expand-inline" data-table-url="/highwire/markup/110117/expansion?postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed&amp;table-expand-inline=1" data-icon-position="" data-hide-link-title="0">View inline</a></li><li class="view-popup last"><a href="/highwire/markup/110117/expansion?width=1000&amp;height=500&amp;iframe=true&amp;postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed" class="colorbox colorbox-load table-expand-popup" rel="gallery-fragment-tables" data-icon-position="" data-hide-link-title="0">View popup</a></li></ul></div></div><div class="table-caption"><span class="table-label">Table 1:</span> <p id="p-4" class="first-child">MR-VWI parameters for ICAD-Ps and IAs</p><div class="sb-div caption-clear"></div></div></div></div><div id="sec-3" class="subsection"><p id="p-6"><strong>RESULTS:</strong> Ten patients with 17 symptomatic ICAD-Ps and 30 patients with 34 IA-Ws were included and demonstrated persisting contrast uptake (<em>P </em>&lt; .001) of 7.21% and 10.54% beyond the early phase (5–15 minutes postcontrast) and in the delayed phase (20–30 minutes postcontrast) on postcontrast MR vessel wall imaging. However, normal anatomic reference structures including the pituitary infundibulum and cavernous sinus demonstrated a paradoxical contrast washout in the delayed phase. In both ICAD-Ps and IA-Ws, the greatest percentage of quantitative enhancement (&gt;70%–90%) occurred in the early phase of postcontrast imaging, consistent with the rapid contrast uptake kinetics of neurovascular pathology.</p></div><div id="sec-4" class="subsection"><p id="p-7"><strong>CONCLUSIONS:</strong> Using standard MR vessel wall imaging techniques, our results demonstrate the effects of gadolinium contrast uptake kinetics in ICAD-Ps and IA-Ws with extended accumulating enhancement into the delayed phase (&gt; 15 minutes) as opposed to normal anatomic reference structures that conversely exhibit decreasing enhancement. Because these relative differences are used to assess qualitative patterns of ICAD-P and IA-W enhancement, our findings highlight the importance of standardizing acquisition time points and MR vessel wall imaging protocols to interpret pathologic enhancement for the risk stratification of cerebrovascular pathologies.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">AWE<span class="def-item-dt-sep"></span></dt><dd>aneurysm wall enhancement<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">IA<span class="def-item-dt-sep"></span></dt><dd>intracranial aneurysm<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">IA-W<span class="def-item-dt-sep"></span></dt><dd>intracranial aneurysm wall<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">ICAD-P<span class="def-item-dt-sep"></span></dt><dd>intracranial atherosclerotic disease plaque<span class="def-item-dd-sep"></span></dd><dt id="def-item-6"><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-7">SI<span class="def-item-dt-sep"></span></dt><dd>signal intensity<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">VWI<span class="def-item-dt-sep"></span></dt><dd>vessel wall imaging</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2024 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/45/9/1206.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. 45</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 9 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Sep 2024 </div></div>
      
      
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      <div class="highwire-cite-title">Temporal Changes on Postgadolinium MR Vessel Wall Imaging Captures Enhancement Kinetics of Intracranial Atherosclerotic Plaques and Aneurysms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Abhinav</span> <span class="nlm-surname">Patel</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Ramez N.</span> <span class="nlm-surname">Abdalla</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Sammy</span> <span class="nlm-surname">Allaw</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Donald R.</span> <span class="nlm-surname">Cantrell</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Ali</span> <span class="nlm-surname">Shaibani</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Frances</span> <span class="nlm-surname">Caprio</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">David M.</span> <span class="nlm-surname">Hasan</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Ali</span> <span class="nlm-surname">Alaraj</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Sean P.</span> <span class="nlm-surname">Polster</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Timothy J.</span> <span class="nlm-surname">Carroll</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Sameer A.</span> <span class="nlm-surname">Ansari</span></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">Sep 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1206-1213; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8370 </span></div>
  
  
  
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      <div class="highwire-cite-title">Temporal Changes on Postgadolinium MR Vessel Wall Imaging Captures Enhancement Kinetics of Intracranial Atherosclerotic Plaques and Aneurysms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Abhinav</span> <span class="nlm-surname">Patel</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Ramez N.</span> <span class="nlm-surname">Abdalla</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Sammy</span> <span class="nlm-surname">Allaw</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Donald R.</span> <span class="nlm-surname">Cantrell</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Ali</span> <span class="nlm-surname">Shaibani</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Frances</span> <span class="nlm-surname">Caprio</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">David M.</span> <span class="nlm-surname">Hasan</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Ali</span> <span class="nlm-surname">Alaraj</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Sean P.</span> <span class="nlm-surname">Polster</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Timothy J.</span> <span class="nlm-surname">Carroll</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Sameer A.</span> <span class="nlm-surname">Ansari</span></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">Sep 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1206-1213; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8370 </span></div>
  
  
  
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