{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T15:05:39Z","timestamp":1782572739325,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21AG072244"],"award-info":[{"award-number":["R21AG072244"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN268201700001I"],"award-info":[{"award-number":["HHSN268201700001I"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN268201700002I"],"award-info":[{"award-number":["HHSN268201700002I"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN268201700003I"],"award-info":[{"award-number":["HHSN268201700003I"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN268201700004I"],"award-info":[{"award-number":["HHSN268201700004I"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN268201700005I"],"award-info":[{"award-number":["HHSN268201700005I"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL105930"],"award-info":[{"award-number":["R01HL105930"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Intracranial vessel tortuosity is a key component of dolichoectasia and has been associated with atherosclerosis and adverse neurologic outcomes. However, the evaluation of tortuosity is mainly a descriptive assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare the performance of three automated tortuosity metrics (angle metric [AM], distance metric [DM], and distance\u2010to\u2010axis metric [DTA]) for detection of dolichoectasia and presence of segment\u2010specific plaques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Observational, cross\u2010sectional metric assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>1899 adults from the general population; mean age\u2009=\u200976\u2009years, female\u2009=\u200959%, and black\u2009=\u200929%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3\u2010T, three\u2010dimensional (3D) time\u2010of\u2010flight MRA and 3D vessel wall MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Tortuosity metrics and mean luminal area were quantified for designated segments of the internal carotid artery, middle cerebral artery, anterior cerebral artery, posterior cerebral artery, vertebral artery, and entire length of basilar artery (BA). Qualitative interpretations of\u00a0BA dolichoectasia were assessed based on Smoker's visual criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Descriptive statistics (2\u2010sample <jats:italic>t<\/jats:italic>\u2010tests, Pearson chi\u2010square tests) for group comparisons. Receiver operating characteristics area under the curve (AUC) for detection of BA dolichoectasia or segment\u2010specific plaque. Model inputs included 1) tortuosity metrics, 2) mean luminal area, and 3) demographics (age, race, and sex).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Qualitative dolichoectasia was identified in 336 (18%) participants, and atherosclerotic plaques were detected in 192 (10%) participants. AM\u2010, DM\u2010, and DTA\u2010calculated tortuosity were good individual discriminators of basilar dolichoectasia (AUCs: 0.76, 0.74, and 0.75, respectively), with model performance improving with the mean lumen area: (AUCs: 0.88, 0.87, and 0.87, respectively). Combined characteristics (tortuosity and mean luminal area) identified plaques with better performance in the anterior (AUCs ranging from 0.66 to 0.78) than posterior (AUCs ranging from 0.54 to 0.65) circulation, with all models improving by the addition of demographics (AUCs ranging from 0.62 to 0.84).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Quantitative vessel tortuosity metrics yield good diagnostic accuracy for the detection of dolichoectasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>1<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy Stage<\/jats:title><jats:p>2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.28923","type":"journal-article","created":{"date-parts":[[2023,7,29]],"date-time":"2023-07-29T05:03:35Z","timestamp":1690607015000},"page":"1612-1619","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Detection of Dolichoectasia and Atherosclerosis by Automated <scp>MRA<\/scp> Tortuosity Metrics in a Population\u2010Based Study"],"prefix":"10.1002","volume":"59","author":[{"given":"Shang","family":"Zhou","sequence":"first","affiliation":[{"name":"The Russell H. Morgan Department of Radiology and Radiological Sciences The Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Qiao","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology and Radiological Sciences The Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwei","family":"Zhou","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology and Radiological Sciences The Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A.","family":"Wasserman","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology and Radiological Sciences The Johns Hopkins University  Baltimore Maryland USA"},{"name":"Department of Radiology The University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8433-5147","authenticated-orcid":false,"given":"Melissa C.","family":"Caughey","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of North Carolina and North Carolina State University  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20447"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/str.50.suppl_1.TMP52"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr253"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.120.315692"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11647"},{"key":"e_1_2_8_7_1","first-page":"55","article-title":"High\u2010resolution computed tomography of the basilar artery: 1. 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