To address many of the deficiencies in optical neuroimaging technologies such as poor spatial resolution, time-consuming reconstruction, low penetration depth, and contact-based measurement, a novel, noncontact, time-resolved laser speckle contrast imaging (TR-LSCI) technique has been developed for continuous, fast, and high-resolution 2D mapping of cerebral blood flow (CBF) at different depths of the head. TR-LSCI illuminates the head with picosecond-pulsed, coherent, widefield near-infrared light and synchronizes a newly developed, high-resolution, gated single-photon avalanche diode camera (SwissSPAD2) to capture CBF maps at different depths. By selectively collecting diffuse photons with longer pathlengths through the head, TR-LSCI reduces partial volume artifacts from the overlying tissues, thus improving the accuracy of CBF measurement in the deep brain. CBF map reconstruction was dramatically expedited by incorporating highly parallelized computation. The performance of TR-LSCI was evaluated using head-simulating phantoms with known properties and in-vivo rodents with varied hemodynamic challenges to the brain. Results from these pilot studies demonstrated that TR-LSCI enabled mapping CBF variations at different depths with a sampling rate of up to 1 Hz and spatial resolutions ranging from tens of micrometers on the head surface to 1-2 millimeters in the deep brain. With additional improvements and validation in larger populations against established methods, we anticipate offering a noncontact, fast, high-resolution, portable, and affordable brain imager for fundamental neuroscience research in animals and for translational studies in humans.
Artificial intelligence (AI)-assisted PET imaging is emerging as a promising tool for the diagnosis of Parkinson’s disease (PD). We aim to systematically review the diagnostic accuracy of AI-assisted PET in detecting PD. The Ovid MEDLINE, Ovid Embase, Web of Science, and IEEE Xplore databases were systematically searched for related studies that developed an AI algorithm in PET imaging for diagnostic performance from PD and were published by August 17, 2023. Binary diagnostic accuracy data were extracted for meta-analysis to derive outcomes of interest: area under the curve (AUC). 23 eligible studies provided sufficient data to construct contingency tables that allowed the calculation of diagnostic accuracy. Specifically, 11 studies were identified that distinguished PD from normal control, with a pooled AUC of 0.96 (95% CI: 0.94–0.97) for presynaptic dopamine (DA) and 0.90 (95% CI: 0.87–0.93) for glucose metabolism ( 18 F-FDG). 13 studies were identified that distinguished PD from the atypical parkinsonism (AP), with a pooled AUC of 0.93 (95% CI: 0.91 − 0.95) for presynaptic DA, 0.79 (95% CI: 0.75–0.82) for postsynaptic DA, and 0.97 (95% CI: 0.96–0.99) for 18 F-FDG. Acceptable diagnostic performance of PD with AI algorithms-assisted PET imaging was highlighted across the subgroups. More rigorous reporting standards that take into account the unique challenges of AI research could improve future studies.
BACKGROUND AND PURPOSE: The circle of Willis (COW) is a crucial mechanism for cerebral collateral circulation. This proof-of-concept study aims to develop and assess an analysis method to characterize the hemodynamics of the arterial segments in the COW by using arterial spin-labeling (ASL) based non-contrast-enhanced dynamic MR angiography (dMRA). MATERIALS AND METHODS: The developed analysis method uses a graph model, bootstrap strategy, and ensemble learning methodologies to determine the time curve shift from ASL dMRA to estimate the flow direction within the COW. The performance of the method was assessed on 52 subjects, by using the flow direction, either antegrade or retrograde, derived from 3D phase-contrast MR imaging as the reference. RESULTS: A total of 340 arterial segments in the COW were evaluated, among which 30 (8.8%) had retrograde flow according to 3D phase-contrast MRI. The ASL dMRA-based flow direction estimation has an accuracy, sensitivity, and specificity of 95.47%, 80%, and 96.34%, respectively. CONCLUSIONS: Using ASL dMRA and the developed image analysis method to estimate the flow direction in COW is feasible. This study provides a new method to assess the hemodynamics of the COW, which could be useful for the diagnosis and study of cerebrovascular diseases.
OBJECTIVE: Evaluate the efficacy, safety, and patient satisfaction of transradial access (TRA) compared with conventional transfemoral access (TFA) for diagnostic cerebral angiography in elderly patients (>= 65 years of age). METHODS: We performed a retrospective review of patients receiving cerebral angiography via TRA or TFA between October 2020 and December 2021 at 3 institutions. Basic patient characteristics, angiographic data, postoperative complications, and patient satisfaction were collected for analysis. RESULTS: Of the 357 enrolled elderly patients, 175 were performed through TRA and 182 were performed through TFA. There was no significant difference in mean fluoroscopy time (8.6 +/- 3.8 minutes vs. 9.1 +/- 3.1 minutes; P = 0.103) and radiation exposure (47.7 +/- 10.8 Gy-cm(2) vs. 49.8 +/- 11.3 Gy-cm(2); P = 0.068) between the TRA and TFA groups. However, the TRA group had a shorter procedural time (54.7 +/- 6.2 minutes vs. 61.1 +/- 5.6 minutes; P < 0.001) and less contrast agent (83.2 +/- 28.1 mL vs. 100.1 +/- 26.2 mL; P < 0.001) than the TFA group. In terms of safety, the incidence of minor vascular access complications in the TRA group was lower than that in the TFA group (1.7% vs. 8.8%; P = 0.003). The incidence of serious complications and neurologic complications in the TRA group was also lower, although the difference was not statistically significant. Overall patient satisfaction was higher in the TRA group than that in the TFA group. CONCLUSIONS: TRA was an efficient and safe alternative to conventional TFA in elderly patients who underwent diagnostic cerebral angiography and who underwent TRA were more satisfied. Findings supported the radial-first strategy for cerebral angiography in elderly populations.
Background Three‐dimensional (3D) intracranial vessel wall (IVW) magnetic resonance imaging can reliably image intracranial atherosclerotic disease (ICAD). However, an integrated, streamlined, and optimized workflow for IVW analysis to provide qualitative and quantitative measurements is lacking. Purpose To propose and evaluate an image analysis pipeline (MOCHA) that can register multicontrast and multitime point 3D IVW for multiplanar review and quantitative plaque characterization. Study type Retrospective. Population A total of 11 subjects with ICAD (68 ± 10 years old, 6 males). Field Strength/Sequence A 3.0 T, 3D time‐of‐flight gradient echo sequence and T1‐ and proton density‐weighted fast spin echo sequences. Assessment Each participant underwent two IVW sessions within 2 weeks. Scan and rescan IVW images were preprocessed using MOCHA. The presence of atherosclerotic lesions was identified in different intracranial arterial segments by two readers (GC and JS, 12 years of vascular MR imaging experience each) following an established review protocol to reach consensus on each of the reviews. For all locations with identified plaques, plaque length, lumen and vessel wall areas, maximum and mean wall thickness values, normalized wall index and contrast enhancement ratio were measured. Statistical Tests Percent agreement and Cohen's κ were used to test scan–rescan reproducibility of detecting plaques using MOCHA. Intraclass correlation coefficient (ICC) and Bland–Altman analysis were used to evaluate scan–rescan reproducibility for plaque morphologic and enhancement measurements. Results In 150 paired intracranial vessel segments, the overall agreement in plaque detection was 92.7% ( κ = 0.822). The ICCs (all ICCs > 0.90) and Bland–Altman plots (no bias observed) indicated excellent scan–rescan reproducibility for all morphologic and enhancement measurements. Data Conclusion Findings from this study demonstrate that MOCHA provides high scan–rescan reproducibility for identification and quantification of atherosclerosis along multiple intracranial arterial segments and highlight its potential use in characterizing plaque composition and monitoring plaque development. Evidence Level 4 Technical Efficacy Stage 2
BACKGROUND:Alterations in cerebral vasculature are instrumental in affecting cognition. Current studies mainly focus on proximal large arteries and small vessels, while disregarding morphology and blood flow of the arteries between them (medium-to-large arteries). METHODS:In this prospective study, two types of non-contrast enhanced magnetic resonance angiography (NCE-MRA) techniques, simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) and 3D Time-of-flight (TOF), were used to measure vascular morphologic features in medium-to-large intracranial arteries. Grey matter (GM) tissue level perfusion was assessed with arterial spin labeling (ASL) MRI. Twenty-seven subjects at high cardiovascular risk underwent baseline and 12-month follow-up MRI to compare the relationship between morphological features measured by NCE MRA, GM CBF by ASL MRI, and cognitive function measured by the Montreal Cognitive Assessment (MoCA). RESULTS:Changes in both global medium-to-large arteries and posterior cerebral (PCA) distal artery length and branch numbers, measured on SNAP MRA, were significantly associated with alterations in MoCA scores (P < 0.01), after adjusting for clinical confounding factors, total brain volume, and total white matter lesion (WML) volume. There were no associations between MoCA scores and vascular features on TOF MRA or ASL GM CBF. CONCLUSIONS:Alterations in vascular features of distal medium-to-large arteries may be more sensitive for detecting potential changes in cognition than cerebral blood flow alterations at the parenchymal level captured by perfusion ASL. Hemodynamic information from distal medium-to-large arteries provides an additional tool to advance understanding of the vascular contributions to cognitive function.
The purpose of this study was to investigate the prevalence of alveolar bone dehiscence and fenestration of Class I individuals with normality patterns in the anterior region using cone-beam computed tomography (CBCT). A total of 4715 retrospective cases from January 2018 to December 2020 in the Orthodontic Department of xxx Hospital were screened. Sixty-one cases were Class I individuals with normality patterns in the anterior region. Their incidence of dehiscence and fenestration in the anterior teeth region was studied and statistically analyzed. Dehiscence was found in 27.46% of the evaluated anterior teeth and fenestration was found in 26.91% of anterior teeth. Severe dehiscences and fenestrations mainly occurred in mandibular canines and maxillary canines, respectively. Alveolar bone defects were present in 100% of patients, while one patient had alveolar bone defects in 91.67% of the anterior teeth. Dehiscence was found in 27.46% of the anterior teeth of Class I individuals with normality patterns, while fenestration was found in 26.91% of them. Alveolar bone defects were present in 100% of patients. Alveolar bone dehiscence and fenestration were normal and common in our sample, indicating that they are more likely to be physiological rather than pathological defects. Orthodontists should be aware of the presence and severity of these defects before treatment in order to avoid both possible complications and overtreatment.
Developing novel risk markers for vascular contributions to cognitive impairment and dementia is important. This study aimed to extract total length, branch number and average tortuosity of intracranial distal arteries (A2, M2, P2 and more distal) from non-contrast enhanced magnetic resonance angiography (NCE-MRA) images, and explore their associations with global cognition. In 29 subjects (aged 40–90 years) with carotid atherosclerotic disease, the 3 intracranial vascular features on two NCE-MRA techniques (i.e. time of flight, TOF and simultaneous non-contrast angiography and intraplaque hemorrhage, SNAP) were extracted using a custom-developed software named iCafe. Arterial spin labeling (ASL) and phase contrast (PC) cerebral blood flow (CBF) were measured as references. Linear regression was performed to study their associations with global cognition, measured with the Montreal Cognitive Assessment (MoCA). Intracranial artery length and number of branches on NCE-MRA, ASL CBF and PC CBF were found to be positively associated with MoCA scores ( P < 0.01). The associations remained significant for artery length and number of branches on NCE-MRA after adjusting for clinical covariates and white matter hyperintensity volume. Further adjustment of confounding factors of ASL CBF or PC CBF did not abolish the significant association for artery length and number of branches on TOF. Our findings suggest that intracranial vascular features, including artery length and number of branches, on NCE-MRA may be useful markers of cerebrovascular health and provide added information over conventional brain blood flow measurements in individuals with cognitive impairment.
In order to solve the problem of identification and verification of topological relationship between feeder and distribution transformer in distribution network, an identification method of the feeder-transformer connection relationship in distribution network based on fault outage information inversion is proposed. Firstly, the identification model of feeder-transformer connection relationship is established through the single fault outage information set. Then, through the identification model of feeder-transformer connection relationship, the feeder fault standard outage information set and feeder fault real-time outage information set are established. Finally, the distribution transformer fault connection information set and distribution transformer missing connection information set are determined by the difference set between the feeder fault standard outage information set and feeder fault real-time outage information set. The example analysis shows that this method can identify the feeder-transformer relationship of distribution network based on the topology information and real-time fault alarm information of DMS. The method is simple and reliable, can better meet the actual needs of the site, and has good promotion value.
OBJECTIVES:Non-stenotic plaques have been observed in intracranial arteries but are less understood compared to those in coronary and carotid arteries. We sought to compare plaque distribution and morphology between stenotic and non-stenotic intracranial plaques with MR vessel wall imaging (VWI) and quantitative image analysis. MATERIALS AND METHODS:Twenty-four patients with intracranial arterial stenosis or luminal irregularity on clinical imaging were scanned with a multi-contrast VWI protocol. Plaques were detected as focal wall thickening on co-registered multiplanar reformats of multi-contrast VWI, with assessment of the location and morphology. TOF-MRA was independently reviewed for any appreciable stenosis using the WAISD criteria. RESULTS:Across 504 arterial segments, a total of 80 plaques were detected, including 23 (29%) with stenosis on TOF-MRA, 56 (70%) without, and 1 (1%) not covered by TOF-MRA. Plaques involving the ICA were more likely to be non-stenotic than those involving other segments (80% versus 55%, p = 0.030) whereas the basilar artery (40%) and PCA (33%) had the lowest proportions of non-stenotic plaques. Maximum wall thickness, indicative of plaque burden, correlated poorly with degree of stenosis (p = 0.10) and overlapped substantially between stenotic and non-stenotic plaques (1.9 [1.5, 2.4] versus 2.0 [1.5, 2.2] mm, p = 0.074). CONCLUSIONS:Intracranial plaques without appreciable stenosis on TOF-MRA represent a large proportion of lesions throughout arterial segments but disproportionately affect the ICA. Morphological characterization of plaques with and without stenosis shows that luminal stenosis is a poor indicator of the underlying burden of intracranial atherosclerosis.
In clinical procedures of angioplasty (i.e., open clogged coronary arteries), devices such as balloons and stents need to be placed and expanded in arteries under the guidance of X-ray fluoroscopy. Due to the limitation of X-ray dose, the resulting images are often noisy. To check the correct placement of these devices, typically multiple motion-compensated frames are averaged to enhance the view. Therefore, device tracking is a necessary procedure for this purpose. Even though angioplasty devices are designed to have radiopaque markers for the ease of tracking, current methods struggle to deliver satisfactory results due to the small marker size and complex scenes in angioplasty. In this paper, we propose an end-to-end deep learning framework for single stent tracking, which consists of three hierarchical modules: a U-Net for landmark detection, a ResNet for stent proposal and feature extraction, and a graph convolutional neural network for stent tracking that temporally aggregates both spatial information and appearance features. The experiments show that our method performs significantly better in detection compared with the state-of-the-art point-based tracking models. In addition, its fast inference speed satisfies clinical requirements.
Objective To investigate the relationship between the decrease of plasma oxidized low-density lipoprotein (oxLDL) levels and clinical outcomes in patients with acute atherosclerosis-related ischemic stroke. Methods We recruited acute ischemic stroke patients within 3 days of onset consecutively. Plasma oxLDL levels were measured on the second day after admission and before discharge (10-14 days after stroke onset). Initial stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) scores, and infarct volume was measured using diffusion-weighted imaging (DWI) by the ITK-SNAP software. Clinical outcomes were evaluated by DWI volumes in the acute phase, neurological improvement at discharge, and favorable functional prognosis at 90 days. Logistic regression was performed to evaluate the association between oxLDL level decrease and clinical outcomes. Results 207 patients were enrolled in this study. Compared with the mild decrease of the oxLDL level group, patients with a significant decrease of the oxLDL level group were more likely to have a higher ratio of neurological improvement at discharge (55.07% vs. 14.49%, p < 0.01) and favorable functional prognosis at 90 days (91.30% vs. 55.07%, p < 0.01). In multivariable logistic regression, the degree of oxLDL level decrease was related to neurological improvement at discharge and favorable functional prognosis at 90 days (p < 0.01). Patients with significant decrease were more likely to have neurological improvement at discharge (OR = 7.92, 95% CI, 3.14-19.98, and p < 0.01) and favorable functional prognosis at 90 days (OR = 7.46, 95% CI, 2.40-23.23, and p < 0.01) compared to patients with mild decrease of oxLDL level. The DWI volumes in patients with different oxLDL level decrease groups had no statistical difference (p = 0.41), and the Spearman's rho between oxLDL level decrease and DWI infarct volumes was -0.03, but no statistical difference (p = 0.72). Conclusions The degree of oxLDL level decrease is related to neurological improvement at discharge and favorable functional prognosis at 90 days for patients with acute atherosclerosis-related ischemic stroke, but not with infarct volume in the acute phase.
Background An artificial intelligence vessel segmentation tool, Fully Automated and Robust Analysis Technique for Popliteal Artery Evaluation (FRAPPE), was used to analyze a large databank of popliteal arteries imaged through the OAI (Osteoarthritis Initiative) to study the impact of atherosclerosis risk factors on vessel dimensions and characterize remodeling patterns. Methods and Results Magnetic resonance images from 4668 subjects contributing 9189 popliteal arteries were analyzed using FRAPPE. Age ranged from 45 to 79 years (median, 61), and 58% were women. Mean lumen diameter, mean outer wall diameter, and mean wall thickness (MWT) were measured per artery. Their median values were 5.8 mm (interquartile range, 5.2–6.5 mm), 7.3 mm (interquartile range, 6.7–8.1 mm), and 0.78 mm (interquartile range, 0.73–0.84 mm) respectively. MWT was associated with multiple cardiovascular risk factors, with age (4.2% increase in MWT per 10‐year increase in age; 95% CI, 3.9%–4.5%) and sex (8.6% higher MWT in men than women; 95% CI, 7.7%–9.3%) being predominant. On average, lumen and outer wall diameters increased with increasing MWT until the thickness was 0.92 mm for men and 0.84 mm for women. After this point, lumen diameter decreased steadily, more rapidly in men than women (−7.9% versus −6.1% per 25% increase in MWT; P<0.001), with little change in outer wall diameter. Conclusions FRAPPE has enabled the analysis of the large OAI knee magnetic resonance imaging data set, successfully showing that popliteal atherosclerosis is predominantly associated with age and sex. The average vessel remodeling pattern consisted of an early phase of compensatory enlargement, followed by a negative remodeling, which is more pronounced in men.
Image quality assessment (IQA) of carotid vessel walls from magnetic resonance imaging (MRI) is critical to accurate diagnosis and prevention of stroke. However, most existing solutions for IQA are either manual or based only on holistic information. The low efficiency and accuracy of these methods hampers the transition of vessel wall imaging into clinical use. In this paper, we propose an IQA framework which assesses image quality using local features from multiple patches close to the target region in the image. Following criterion for target-oriented medical imaging quality assessment, we highlight the patch covering the artery detected by a neural network built on YOLOv2 and set the weights for other patches based on the human visual system both in training and testing. Finally, the image score is determined by a weighted average of patch scores. This method proved able to identify and quantify image quality using MRI datasets of different sequences with over 82% sensitivity and 90% specificity for four sequences (3D-MERGE, T1, T2, TOF) separately tasked with binary classification. Our proposed system shows the method's advantages on accuracy, efficiency, and adaptability in clinical use.
Comprehensive quantification of intracranial artery features may help to assess and understand regional variations of blood supply during early brain development and aging. We analyzed vasculature features of 27 healthy infants during natural sleep, 13 infants at 7-months (7.3 ± 1.0 month), and 14 infants at 12-months (11.7 ± 0.4 month), and 13 older healthy, awake adults (62.8 ± 8.7 years) to investigate age-related vascular differences as a preliminary study of vascular changes associated with brain development. 3D time-of-flight (TOF) magnetic resonance angiography (MRA) acquisitions were processed in iCafe, a technique to quantify arterial features ( http://icafe.clatfd.cn ), to characterize intracranial vasculature. Overall, adult subjects were found to have increased ACA length, tortuosity, and vasculature density compared to both 7-month-old and 12-month-old infants, as well as MCA length compared to 7-month-old infants. No brain laterality differences were observed for any vascular measures in either infant or adult age groups. Reduced skull and brain sharpness, indicative of increased head motion and brain/vascular pulsation, respectively, were observed in infants but not correlated with length, tortuosity, or vasculature density measures. Quantitative analysis of TOF MRA using iCafe may provide an objective approach for systematic study of infant brain vascular development and for clinical assessment of adult and pediatric brain vascular diseases.
Dietary sodium and potassium intake are associated with stroke, but the potential mechanisms are unclear. We aimed to study the association between sodium and potassium intake and subclinical cerebrovascular health in hypertensive older males using multimodal magnetic resonance imaging. A total of 189 hypertensive male subjects without previous cardiovascular or cerebrovascular disease were included. Daily urinary sodium and potassium excretion were estimated from a fasting spot urine sample using a formula approach. A dedicated cerebrovascular health imaging protocol including vessel wall imaging, angiography, arterial spin labeling imaging and T2-weighted fluid-attenuated inversion recovery imaging was performed to study intracranial atherosclerosis, vascular rarefaction (defined as fewer discernible vessels on angiography), brain perfusion and small vessel disease, respectively. The mean age was 64.9 (± 7.2) years. The average daily urinary and potassium excretion was 4.7 (± 1.4) g/L and 2.1 (± 0.5) g/L, respectively. Increased urinary sodium excretion was associated with decreased cerebral blood flow and elevated urinary potassium excretion was associated with reduced prevalence of intracranial plaque. The associations remained significant after adjusting for covariates, even including blood pressure control. Quadratic regression analysis indicated a marginally significant U-shaped association between urinary sodium intake and white matter hyperintensity, which lost significance in fully adjusted models. No significant association of urinary sodium and potassium excretion with other cerebrovascular health measures was noted. We concluded that in hypertensive older males without overt cardiovascular disease, increased sodium intake and reduced potassium intake are associated with impaired subclinical cerebrovascular health.
PURPOSE:To explore feasibility of using the vessel length on time-of-flight (TOF) or simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) MRA as an imaging biomarker for brain blood flow, by using arterial spin labeling (ASL) perfusion imaging and 3D phase contrast (PC) quantitative flow imaging as references. METHODS:In a population of thirty subjects with carotid atherosclerotic disease, the visible intracranial arteries on TOF and SNAP were semi-automatically traced and the total length of the distal segments was calculated with a dedicated software named iCafe. ASL blood flow was calculated automatically using the recommended hemodynamic model. PC blood flow was obtained by generating cross-sectional arterial images and semi-automatically drawing the lumen contours. Pearson correlation coefficients were used to assess the associations between the different whole-brain or hemispheric blood flow measurements. RESULTS:Under the imaging protocol used in this study, TOF vessel length was larger than SNAP vessel length (P < 0.001). Both whole-brain TOF and SNAP vessel length showed a correlation with whole brain ASL and 3D PC blood flow measurements, and the correlation coefficients were higher for SNAP vessel length (TOF vs ASL: R = 0.554, P = 0.002; SNAP vs ASL: R = 0.711, P < 0.001; TOF vs 3D PC: R = 0.358, P = 0.052; SNAP vs 3D PC: R = 0.425, P = 0.019). Similar correlation results were observed for the hemispheric measurements. Hemispheric asymmetry index of SNAP vessel length also showed a significant correlation with hemispheric asymmetry index of ASL cerebral blood flow (R = 0.770, P < 0.001). CONCLUSION:The results suggest that length of the visible intracranial arteries on TOF or SNAP MRA can serve as a potential imaging marker for brain blood flow.
Objectives: To investigate the relationship between change of plasma oxidized low-density lipoprotein (oxLDL) level and clinical outcomes in patients with acute atherosclerosis related ischemic stroke. Methods: We recruited acute ischemic stroke patients within 3 days after onset consecutively. Plasma oxLDL level were measured on the second day after admission and before discharge. Initial stroke severity was assessed by the National Institutes of Health Stroke Scale(NIHSS) scores, and infarct volume was measured using diffusion weighted imaging (DWI) by ITK-SNAP software. Clinical outcomes were evaluated by neurological improvement at discharge and favorable functional prognosis at 90 days. Results: 207 patients were enrolled into this study. Compared with mild change of oxLDL level group, patients with significant change oxLDL level group were more likely to have higher ratio of neurological improvement at discharge(55.07% vs 14.49%) and favorable functional prognosis at 90 days(91.30% vs 55.07%). The DWI volumes in patients with different oxLDL level change groups were no statistical difference. In multivariable logistic regression, the degree of oxLDL level change was related with neurological improvement at discharge and favorable functional prognosis at 90 days. Compared to patients with mild change of oxLDL level, patients with significant change were more likely to have neurological improvement at discharge(OR=7.21,95%, 3.09-16.80, p <0.01) and favorable functional prognosis at 90 days (OR=6.67, 95%CI, 2.15-20.73, p <0.01). Conclusions: The degree of oxLDL level change is related to the neurological improvement at discharge and favorable functional prognosis at 90 days for patients with acute atherosclerosis related ischemic stroke, but not with infarct volume.
PURPOSE:To develop and evaluate a domain adaptive and fully automated review workflow (lesion assessment through tracklet evaluation, LATTE) for assessment of atherosclerotic disease in 3D carotid MR vessel wall imaging (MR VWI). METHODS:VWI of 279 subjects with carotid atherosclerosis were used to develop LATTE, mainly convolutional neural network (CNN)-based domain adaptive lesion classification after image quality assessment and artery of interest localization. Heterogeneity in test sets from various sites usually causes inferior CNN performance. With our novel unsupervised domain adaptation (DA), LATTE was designed to accurately classify arteries into normal arteries and early and advanced lesions without additional annotations on new datasets. VWI of 271 subjects from four datasets (eight sites) with slightly different imaging parameters/signal patterns were collected to assess the effectiveness of DA of LATTE using the area under the receiver operating characteristic curve (AUC) on all lesions and advanced lesions before and after DA. RESULTS:LATTE had good performance with advanced/all lesion classification, with the AUC of >0.88/0.83, significant improvements from >0.82/0.80 if without DA. CONCLUSIONS:LATTE can locate target arteries and distinguish carotid atherosclerotic lesions with consistently improved performance with DA on new datasets. It may be useful for carotid atherosclerosis detection and assessment on various clinical sites.