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Journal Article

Sensitivity of diffusion-weighted STEAM MRI and EPI-DWI to infratentorial ischemic stroke.

MPS-Authors
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Merboldt,  K. D.
Biomedical NMR Research GmbH, MPI for biophysical chemistry, Max Planck Society;

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Frahm,  J.
Biomedical NMR Research GmbH, MPI for biophysical chemistry, Max Planck Society;

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2346399.pdf
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Supplementary Material (public)

2346399_Suppl.DOC
(Supplementary material), 77KB

Citation

Khalil, A. A., Hohenhaus, M., Kunze, C., Schmidt, W., Brunecker, P., Villringer, K., et al. (2016). Sensitivity of diffusion-weighted STEAM MRI and EPI-DWI to infratentorial ischemic stroke. PLOS ONE, 11(8): e0161416. doi:10.1371/journal.pone.0161416.


Cite as: http://hdl.handle.net/11858/00-001M-0000-002B-5D74-8
Abstract
Objectives To assess the sensitivity of stimulated echo acquisition mode diffusion weighted imaging (STEAM-DWI) to ischemic stroke in comparison to echo-planar imaging diffusion weighted imaging (EPI-DWI) in the infratentorial compartment. Methods Fifty-seven patients presenting with clinical features of infratentorial stroke underwent STEAM-DWI, high-resolution EPI-DWI (HR-DWI, 2.5 mm slice thickness) and low-resolution EPI-DWI (LR-DWI, 5 mm slice thickness). Four readers assessed the presence of ischemic lesions and artifacts. Agreement between sequences and interobserver agreement on the presence of ischemia were calculated. The sensitivities of the DWI sequences were calculated in 45 patients with a confirmed diagnosis of infratentorial stroke. Results Median time from symptom onset to imaging was 24 hours. STEAM-DWI agreed with LR-DWI in 89.5% of cases (kappa = 0.72, p<0.0001) and with HR-DWI in 89.5% of cases (kappa = 0.68, p<0.0001). STEAM-DWI showed fewer intraparenchymal artifacts (1/57) than HR-DWI (44/57) and LR-DWI (41/57). Ischemia was visible in 87% of cases for LR-DWI, 93% of cases for HR-DWI, and 89% of cases for STEAM-DWI. Interobserver agreement was good for STEAM-DWI (kappa = 0.62, p<0.0001). Conclusions Compared to the best currently available MR sequence for detecting ischemia (HR-DWI), STEAM-DWI shows fewer artifacts and a similar sensitivity to infratentorial stroke.