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Reliability of fast magnetic resonance imaging for acute ischemic stroke patients using a 1.5-T scanner

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Abstract

Objectives

To determine whether fast scanned MRI using a 1.5-T scanner is a reliable method for the detection and characterization of acute ischemic stroke in comparison with conventional MRI.

Methods

From May 2015 to June 2016, 862 patients (FLAIR, n = 482; GRE, n = 380; MRA, n = 190) were prospectively enrolled in the study, with informed consent and under institutional review board approval. The patients underwent both fast (EPI-FLAIR, ETL-FLAIR, TR-FLAIR, EPI-GRE, parallel-GRE, fast CE-MRA) and conventional MRI (FLAIR, GRE, time-of-flight MRA, fast CE-MRA). Two neuroradiologists independently assessed agreements in acute and chronic ischemic hyperintensity, hyperintense vessels (FLAIR), microbleeds, susceptibility vessel signs, hemorrhagic transformation (GRE), stenosis (MRA), and image quality (all MRI), between fast and conventional MRI. Agreements between fast and conventional MRI were evaluated by generalized estimating equations. Z-scores were used for comparisons of the percentage agreement among fast FLAIR sequences and fast GRE sequences and between conventional and fast MRA.

Results

Agreements of more than 80% were achieved between fast and conventional MRI (ETL-FLAIR, 96%; TR-FLAIR, 97%; EPI-GRE, 96%; parallel-GRE, 98%; fast CE-MRA, 86%). ETL- and TR-FLAIR were significantly superior to EPI-FLAIR in the detection of acute ischemic hyperintensity and hyperintense vessels, while parallel-GRE was significantly superior to EPI-GRE in the detection of susceptibility vessel sign (p value < 0.05 for all). There were no significant differences in the other scores and image qualities (p value > 0.05).

Conclusions

Fast MRI at 1.5 T is a reliable method for the detection and characterization of acute ischemic stroke in comparison with conventional MRI.

Key Points

• Fast MRI at 1.5 T may achieve a high intermethod reliability in the detection and characterization of acute ischemic stroke with a reduction in scan time in comparison with conventional MRI.

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Abbreviations

CT:

Computed tomography

DWI:

Diffusion-weighted imaging

EPI:

Echo-planar imaging

EPI-FLAIR:

FLAIR using echo-planar imaging

EPI-GRE:

GRE using echo-planar imaging

ETL-FLAIR:

FLAIR with increased echo train length

Fast CE-MRA:

Contrast-enhanced MRA with increased acceleration factor and slice thickness

FLAIR:

Fluid-attenuated inversion recovery

GRE:

Gradient echo T2*-weighted imaging

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

Parallel-GRE:

GRE with increased acceleration factor

PWI:

Perfusion-weighted imaging

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Funding

This study has received funding by the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (HI12C1847).

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Authors and Affiliations

  1. Department of Radiology, Chung-Ang University Hospital, Seoul, South Korea

    Mi Sun Chung

  2. Department of Radiology, Soonchunhyang University Bucheon Hospital, Wonmi-gu, Bucheon, South Korea

    Ji Ye Lee

  3. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Song pa-gu, Seoul, 138-736, South Korea

    Seung Chai Jung, Woo Hyun Shim, Ji Eun Park, Ho Sung Kim, Choong Gon Choi, Sang Joon Kim & Deok Hee Lee

  4. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Seunghee Baek

  5. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Sang-Beom Jeon, Dong-Wha Kang, Sun U. Kwon & Jong S. Kim

Authors
  1. Mi Sun Chung
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  2. Ji Ye Lee
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  3. Seung Chai Jung
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  4. Seunghee Baek
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  5. Woo Hyun Shim
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  7. Ho Sung Kim
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  8. Choong Gon Choi
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  9. Sang Joon Kim
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  10. Deok Hee Lee
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  11. Sang-Beom Jeon
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  12. Dong-Wha Kang
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  13. Sun U. Kwon
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  14. Jong S. Kim
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Corresponding author

Correspondence to Seung Chai Jung.

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Guarantor

The scientific guarantor of this publication is Sang Joon Kim.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

One of the authors (S Baek) has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Prospective

• Diagnostic study

• Performed at one institution

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Chung, M.S., Lee, J.Y., Jung, S.C. et al. Reliability of fast magnetic resonance imaging for acute ischemic stroke patients using a 1.5-T scanner. Eur Radiol 29, 2641–2650 (2019). https://doi.org/10.1007/s00330-018-5812-5

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  • DOI: https://doi.org/10.1007/s00330-018-5812-5

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