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  Diagnostic value of diffusion-weighted STEAM-MRI in ischemic stroke

Müller, S. J., Khadhraoui, E., Kube, J. M. V., Langer, P., Riedel, C. H., Voit, D., et al. (2021). Diagnostic value of diffusion-weighted STEAM-MRI in ischemic stroke. European Journal of Radiology, 139: 109677, pp. 109677. doi:10.1016/j.ejrad.2021.109677.

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Müller, S. J., Author
Khadhraoui, E., Author
Kube, J. M. V., Author
Langer, P., Author
Riedel, C. H., Author
Voit, D.1, Author
Ernst, M., Author
Frahm, J.1, Author           
Affiliations:
1Research Group of Biomedical NMR, MPI for Biophysical Chemistry, Max Planck Society, ou_578633              

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Free keywords: STEAM, stroke, DWI, susceptibility, artifacts
 Abstract: Introduction: Diffusion-weighted imaging in stimulated echo acquisition mode (STEAM-DWI) is an interesting alternative with less susceptibility artifacts compared to the most commonly used diffusion-weighted echo-planar imaging (EPI-DWI). Sensitivity and specificity of a novel STEAM-DWI, described by Merrem et al. 2017 [1], were assessed in patients with ischemic stroke. Methods: EPI- and STEAM-DWIs were performed in patients with suspected subacute stroke between 01 July 2019 and 30 June 2020 using 3-T MRI. Three neuroradiologists independently and separately rated STEAM-DWI images with respect to (i) signs of an acute/subacute stroke, (ii) the number, size and localization of infarctions and, (iii) the presence of artifacts. Results: In 55 (23 right, 23 left, 9 both hemispheres) of 85 patients a subacute stroke was confirmed using EPI- DWI. The cerebral vascular territories were affected as follows: anterior cerebral artery 8 %, middle cerebral artery 48 %, posterior cerebral artery 27 %, brainstem 7 %, cerebellum 10 %. In 53 of 55 (96 %) cases the stroke was detected by usage of STEAM-DWI, in 35 of 37 patients microembolic events were noticed (95 %). Results showed a sensitivity and specificity of 100 % (70/70) for major infarcts (>9 mm2 in-plane) and a sensitivity of up to 94 % (121/129) for detecting subacute microembolic lesions. No susceptibility artifacts were noticed in STEAM-DWI. Conclusion: Compared to standard EPI-DWI, STEAM-DWI offers a more robust alternative for diagnosing subacute strokes in areas affected by susceptibility artifacts.

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Language(s): eng - English
 Dates: 2021-062021
 Publication Status: Published in print
 Pages: -
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 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1016/j.ejrad.2021.109677
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Title: European Journal of Radiology
Source Genre: Journal
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Publ. Info: Elsevier
Pages: 7 Volume / Issue: 139 Sequence Number: 109677 Start / End Page: 109677 Identifier: ISSN: 0720048X