MRI Quantitative T2* Mapping to Predict Dominant Composition of In Vitro Thrombus

Fellows’ Journal Club

Thirty-five thrombus analogs of different compositions were scanned with an MR imaging quantitative T2* mapping sequence. Two radiologists, blinded to thrombus composition, measured the thrombus-T2* relaxation time twice, at an interval of 2 weeks. Quantitative histologic evaluations of red blood cell content were performed. Inter- and intraobserver reproducibility of the thrombus-T2* relaxation time was assessed by calculating intraclass correlation coefficients. MR imaging quantitative T2* mapping can reliably identify the thrombus red blood cell content in vitro. This fast, easy-to-use sequence could be implemented in routine practice.

Abstract

BACKGROUND AND PURPOSE

MR images of 3D-CISS analog thrombi
A, MR images of 3D-CISS analog thrombi. B, MR images of coregistered T2 mapping and 3D-CISS analog thrombus. Thrombi were manually contoured and analyzed in their largest surface, with the support of multiplanar reconstruction. Thrombi were identified by their localization in the matrix to allow comparison with histologic data. C, Macroscopic view of floating thrombi. D, Matrix of agarose gel with holes filled with physiologic serum. Ar indicates surface; Av, mean T2* relaxation time; E-T, SD.

MR imaging quantitative T2* mapping, which provides information about thrombus composition and specifically the red blood cell content, may be obtained in the setting of acute ischemic stroke before treatment. This could be useful to adapt the endovascular strategy. We aimed to analyze the red blood cell content of in vitro thrombi in relation to the thrombus-T2* relaxation time.

MATERIALS AND METHODS

Thirty-five thrombus analogs of different compositions were scanned with an MR imaging quantitative T2* mapping sequence. Two radiologists, blinded to thrombus composition, measured the thrombus-T2* relaxation time twice at an interval of 2 weeks. Quantitative histologic evaluations of red blood cell content were performed. Inter- and intraobserver reproducibility of the thrombus-T2* relaxation time was assessed by calculating intraclass correlation coefficients. Finally, a Spearman product moment correlation between the thrombus-T2* relaxation time and red blood cell content was performed.

RESULTS

The median thrombus-T2* relaxation time was 78.5 ms (range, 16–268 ms; interquartile range, 60.5 ms). The median red blood cell content was 55% (range, 0%–100%; interquartile range, 75%). Inter- and intraobserver reproducibility of the thrombus-T2* relaxation time was excellent (>0.9). The Spearman rank correlation test found a significant inverse correlation between thrombus-T2* relaxation time and red blood cell content (ρ = −0.834, P < .001).

CONCLUSIONS

MR imaging quantitative T2* mapping can reliably identify the thrombus red blood cell content in vitro. This fast, easy-to-use sequence could be implemented in routine practice to predict stroke etiology and adapt devices or techniques for endovascular treatment of acute ischemic stroke.

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MRI Quantitative T2* Mapping to Predict Dominant Composition of In Vitro Thrombus
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Jeffrey Ross
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