• Jinnan Wang, Maobin Guan, Kiyofumi Yamada, Daniel S Hippe, William S Kerwin, Chun Yuan, Peter Börnert, and Xihai Zhao.
• Clinical Sites Research Program, Philips Research North America, Briarcliff Manor, New York, United States of America.
• Plos One. 2016 Jan 1; 11 (2): e0149130.

ObjectivesSimultaneous Non-contrast Angiography and intraPlaque hemorrhage (SNAP) technique was recently proposed for joint MRA and intraplaque hemorrhage (IPH) imaging. The purpose of this study is to validate SNAP's MRA performance in patients with suspected intracranial artery disease.MethodsSNAP and time-of-flight (TOF) techniques with matched field of view and resolution were applied on 15 patients with suspected intracranial artery disease. Both techniques were evaluated based on their detection of luminal stenosis of bilateral middle cerebral arteries (MCA) and the delineation of smallest visible branches (SVB) of the MCA. Statistical analysis was conducted on the artery level.ResultsThe SNAP MRA was found to provide similar stenosis detection performance when compared with TOF (Cohen's κ 0.79; 95% Confidence Interval: 0.56-0.99). For the SVB comparison, SNAP was found to provide significantly better small artery delineation than TOF (p = 0.017). Inter-reader reproducibility for both measurements on SNAP was over 0.7. SNAP also detected IPH lesions on 13% of the patients.ConclusionsThe SNAP technique's MRA performance was optimized and compared against TOF for intracranial artery atherosclerosis imaging and was found to provide comparable stenosis detection accuracy. Along with its IPH detection capability, SNAP holds the potential to become a first-line screening tool for high risk intracranial atherosclerosis disease evaluation.

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