Utility of minimum intensity projection images based on three-dimensional CUBE T1 weighted imaging for evaluating middle cerebral artery stenosis

Abstract

Objective: This study investigated the diagnostic performance of MinIP images based on three-dimensional variable-flip-angle turbo spin echo T1 weighted imaging (3D CUBE T1WI) from high-resolution vessel wall magnetic resonance imaging for detecting middle cerebral artery (MCA) stenosis. Methods: A total of 63 consecutive patients were included in this study. MinIP images were reconstructed using 3D CUBE T1WI as the source images. The degree and length of MCA stenosis were measured on MinIP images and were compared with digital subtraction angiography (DSA) as the reference standard. Results: The intra- and interobserver agreement for both the rate and length of MCA stenosis were excellent for the MinIP images. There was also excellent agreement in the degree of MCA stenosis calculated using MinIP images and DSA. MinIP images had a high sensitivity, specificity for diagnosing MCA stenosis. There was a good correlation between the two methods for measuring the rate and length of MCA stenosis. Conclusion: MinIP images based on 3D CUBE T1WI are highly consistent with DSA for evaluating the degree and length of MCA stenosis. Advances in knowledge: MinIP images can be produced as a derivative from vessel wall imaging and implemented as an adjunct to vessel wall imaging without extra acquisition time.