Key result
Optimized MPRAGE improves carotid blood-muscle contrast by ~0.19 over standard acquisition.
Why the study?
Commonly used clinical MPRAGE protocols suffer from inconsistent blood suppression, limiting reliable detection of intraplaque hemorrhage in carotid artery imaging.
Does optimizing 3D MPRAGE with a wideband inversion pulse and a 50-mm magnet center shift toward the heart improve blood suppression, tissue contrast, and intraplaque hemorrhage detection in patients with carotid artery disease?
Observational (n=21)
Single-blind
No
Does optimizing 3D MPRAGE with a wideband inversion pulse and a 50-mm magnet center shift toward the heart improve blood suppression, tissue contrast, and intraplaque hemorrhage detection in patients with carotid artery disease?
Optimizing 3D carotid MPRAGE with a wideband inversion pulse and a 50-mm table shift toward the heart significantly improves luminal blood suppression and contrast-to-noise ratio, enhancing visualization of the carotid vessel wall and detection of high-risk intraplaque hemorrhage.
Answers are grounded in this paper and cite their sources.
May aid IPH visualization on carotid MRI; leaves open whether gains improve risk stratification or outcomes.
PURPOSE: This study aims to optimize the Magnetization Prepared Rapid Acquisition Gradient Echo (MPRAGE) technique to improve the accuracy of intraplaque hemorrhage (IPH) detection in carotid diseases and enhance reliability for clinical use, addressing the challenge of inconsistent blood suppression observed in commonly used clinical protocols. METHODS: Bloch equation simulations were used to evaluate the effects of inversion time and flip angle on blood suppression and tissue contrast. The optimized parameters were implemented on a clinical 3 T scanner and tested in four subjects. Quantitative measures included blood-muscle contrast and contrast-to-noise ratios (CNR) for lumen-wall and lumen-IPH. Imaging was performed in 21 patients with carotid artery disease, two MPRAGE acquisitions were performed per patient: (1) at the magnet isocenter with the standard IR pulse, and (2) at a 50-mm shifted position toward the heart with the wideband IR pulse. Qualitative image quality was evaluated independently by two neuroradiologists using a predefined 4-point scale (1 = poor, 4 = excellent) for blood suppression, vessel wall clarity, motion artifacts, and IPH visualization, in addition to quantitative SNR and CNR measurements. RESULTS: The optimized MPRAGE sequence demonstrated significantly improved blood suppression, with blood-muscle contrast increasing from 0.42 ± 0.08 to 0.61 ± 0.07 (p = 0.002). Lumen-wall CNR increased from 15.2 ± 3.4 to 22.8 ± 4.1 (p = 0.01), and lumen-IPH CNR increased from 18.7 ± 5.2 to 26.3 ± 6.0 (p = 0.004). These improvements enhanced vessel wall delineation and IPH conspicuity. CONCLUSION: Optimization of MPRAGE parameters enhances blood suppression and contrast, providing improved visualization of the carotid vessel wall and more reliable detection of IPH. This approach may increase the diagnostic accuracy of carotid plaque imaging.
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Roberts et al. (2025) conducted an observational in Carotid artery disease (n=21). Optimized 3D MPRAGE with wideband IR pulse and 50-mm magnet center shift toward the heart vs. Standard 3D MPRAGE with standard 1.1 kHz IR pulse at the magnet isocenter was evaluated on Blood-muscle contrast (p=0.002). Optimized MPRAGE with a wideband IR pulse and 50-mm shift improved blood-muscle contrast from 0.42 to 0.61 (p=0.002) and lumen-IPH CNR from 18.7 to 26.3 (p=0.004) in carotid artery disease.
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