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U.S. and Chinese researchers work to standardize MR stroke protocols with 3-D model

por John W. Mitchell, Senior Correspondent | April 24, 2017
Cardiology MRI
A U.S. team of neurologists and bioengineers has teamed up with doctors in China to test a new application of a 10-year old vessel-wall MR test to get a better take on intracranial atherosclerotic disease (ICAD).

The new MR method produces a 3-D printed phantom of a stenotic intracranial artery that highlights the vessels and plaque associated with stroke. Also known as high-resolution MR (HRMRI), the new protocol helps overcome some long-standing problems in strokes diagnosis and research. This includes the lack of existence of a common image standard to allow information sharing between research sites.

"The motivation (for the research) is to enable multi-center studies that will study the relationship between atherosclerotic plaque components and risk of stroke in patients with intracranial stenosis," Dr. Tanya N. Turan, associate professor of neurology and director of the Stroke Center at the Medical University of South Carolina (MUSC) told HCB News. "Without standardization using a phantom, multicenter studies are almost impossible."
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MUSC developed the 3-D model, HRMRI method in collaboration with bioengineers at the University of Massachusetts and reached out to colleagues in China to help with the research. The team's study results have recently been published in the Journal of NeuroInterventional Surgery.

"The leading cause of death in China is stroke, and intracranial stenosis is probably the most common cause of stroke there. So they have many patients with the disease," explained Turan. "Our Chinese collaborators are also leaders in the field in intracranial HRMRI research. So, they have a lot of good ideas."

She added that it is not known why the Chinese have a higher prevalence of the intracranial atherosclerosis that causes stroke. However, she said ICAD is a widespread health problem throughout the world and the leading cause of stroke.

HRMRI has been used to study the plaque components in vessels in the brain for more than ten years. It has the potential to clarify the underlying pathology of ICAD as well as to gauge patient risk and inform clinical trials for new therapies. However, progress has been stymied by the lack of standardization in high-resolution MR protocols, which hinders research collaboration.

"HRMRI may also be used in the future to identify patients at particularly high risk of stroke, which could provide an opportunity to guide treatment," said Turan. "HRMRI plaque features may also be used as surrogate endpoints or biomarkers to assess novel therapies for stroke prevention."

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