Head and Neck CTA Combined With Multimodal MRI to Assess the Risk of Cerebrovascular Disease
Conditions: Cerebrovascular Disease
Sponsor: Tang-Du Hospital

Version number / Version date: The first version 1.0 / April 15,20
Plan ID: 2018LCYJ005
The Second Affiliated Hospital of Air Force Medical University
Science and Technology Innovation Development Fund
Study Protocol
Protocol Title: Integrated image strategy of head and neck CTA
combined with multimodal MRI to assess the risk of
cerebrovascular disease
Principal Institute: Tang Du Hospital
The Second Affiliated Hospital of Air Force Medical University

Study Protocol
Objects:
Patients with suspected carotid artery stenosis who received CTA
examination were selected from the outpatient department of neurology
and ward of our hospital
1. Inclusion criteria: No neurological symptoms associated with carotid
artery stenosis or tia (50 people in each group, 25 men and 25 women).
Mild stenosis group: CTA indicated carotid artery stenosis < 30%;
Moderate stenosis group: CTA indicated 30-69% carotid stenosis;
Severe stenosis group: CTA indicated carotid artery stenosis ≥70%;
Healthy control group: Suspected stiff artery stenosis was examined by
CTA without definite stenosis;
No definite stenosis was observed via MRA and/or transcranial Doppler
(TCD);
2. Exclusion criteria :1) Dementia, MMSE score < 21;
2) Previous symptoms of carotid artery stenosis or transient ischemic
attack;
3) Other craniocerebral lesions, such as craniocerebral trauma, tumor,
inflammation,
macrovascular
complications
(cerebral
infarction
or
cerebral softening foci);
4) Contraindications for MRI examination;
5) Have recently taken psychoactive drugs or hormones.

3. Lifestyle assessment: Subjects' intake of staple food (grams per day),
smoking status (cigarettes per day), drinking status (two days), tea
drinking habits, exercise status (frequency/week, duration/time), nap and
night sleep status (duration, whether or not they snored) were collected in
the last three months.
4. Clinically relevant information collection: age, sex, years of education,
blood lipids (plasma total cholesterol, triglycerides), blood pressure,
blood glucose (fasting blood glucose, glycosylated hemoglobin), body
mass index (BMI), waist-to-hip ratio (WHR), and medication status
(medication name, frequency, dosage/time, use method).
Cognitive assessment:
1. Montrier Cognitive Assessment Scale (MoCA) was used to evaluate
the cognitive function of the subjects in different dimensions;
2. California Word Learning Scale (CVLT) test, Wisconsin (WCST) card
test and Stroop word test were used to observe the subjects' memory
ability and executive ability.
Neuroimaging examination:
Equipment: GE Discovery MR750 3.0T superconducting MRI, using
8-channel phased array head coil.
1) Conventional sequences: T2WI, FLAIR and DWI sequences to

exclude other organic lesions.
2) 3D BRAVO sequence: TE = 3.2 ms, TR=8.2 ms, TI= 450 ms, FA)=12°,
FOV=256 ×256 mm2, matrix =256 ×256, layer thickness =1 mm, layer
number = 188. Scanning time: 4 minutes and 10 seconds
3) 3D-Pcasl: TR 4632ms,TE 10.5ms,Arms 8, Points 512, PLD (Post
Label Delay) 1525ms, layer thickness 4mm, layer spacing 0mm, a total of
72 cross-section images covered the whole brain.
4) RS-fmri: EPI sequence was used, TR 2000 ms; TE 30 ms; Turn Angle
90, layer thickness 4mm, no layer spacing; The matrix is 64 × 64, 180
time points are collected, and the scanning time is 7min.
5) DKI: Se-ss-dt-epi sequence was adopted. 3 B values (0, 1000, 2000
s/mm2) 10 b0 images, 25 diffusion gradient directions,TR/TE =
5800/77ms, FOV =256 × 256 mm2, matrix =128 × 128, layer thickness
=2 mm, FA = 90°, layer number =48, In-plane spatial resolution = 2 × 2
mm2. Scanning time is 5 minutes and 54 seconds
QSM
The data analysis
1. 3D-ASL data analysis: Perfusion weighted images obtained by
3D-ASL sequence scanning were passed
Reprocessing
software
included
in
GE's
MR
device
generates
CEREBRAL blood flow (CBF). Of CBF figure like into the line from the

line after the principle, by using SPM8 (http://www.filion.ucl.ac.uk)
software based on voxel method (VBA) analysis. Each perfusion map
was registered to the Montreal Neurologic Institute (MNI) standard brain
space for intergroup comparisons. After spatial standardization, the image
was resamped as 2 mm isotropic voxels, and a 6 mm half-height
full-width (FWHM) Gaussian kernel was used for spatial smoothing to
improve the image signal-to-noise ratio (SNR).
2. Rs-fmri data analysis: Data Processing using Data Processing Assistant
for
Resting
State
fMRI
Adcanced
Edition
(DPARSFA,
http://www.restfmri.net/forum/DPARSF)
software
for
image
preprocessing, including removal of top 10 point layer correction, head of
nmo correction, time, space, standardized point, head of nmo correction
(3 mm), and then the Data smoothing (FWHM) = 8 mm, to linear drift,
Covariates (6 head motor parameters, average white matter signal,
average whole brain signal, and average cerebrospinal fluid signal) were
removed, and low-frequency filtering was performed (0.01 ~ 0.08Hz).
WFU Pick Atlas Tool Version 3.0 software was used to select
hippocampal regions of both cerebral hemispheres as seed points on the
automatic anatomical marking template.