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Echo planar perfusion imaging with high spatial and temporal resolution: methodology and clinical aspects.
European Radiology
|April 2, 1999
Summary
Optimized echo-planar imaging (EPI) enhances dynamic susceptibility contrast MRI (DSC-MRI) for detecting brain conditions. Time-to-peak maps show high sensitivity for identifying at-risk areas in cerebrovascular disease and tumors.
Area of Science:
- Neuroradiology
- Medical Imaging
- Neuroscience
Background:
- Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) is crucial for assessing cerebral perfusion.
- Optimizing echo-planar imaging (EPI) techniques can improve spatial and temporal resolution in DSC-MRI.
- Understanding the advantages and limitations of calculated parameter images is essential for accurate diagnosis.
Purpose of the Study:
- To analyze the specific advantages and limitations of calculated parameter images derived from an optimized EPI technique in DSC-MRI.
- To evaluate the utility of different parameter images (MSR, delta SR, Tp, SInt) in detecting various cerebrovascular and brain tumor conditions.
Main Methods:
- Performed DSC-MRI on 12 patients with cerebrovascular disease and 13 with brain tumors.
- Developed an EPI sequence with 0.68s temporal resolution for three slices (128x128 matrix).
- Calculated pixelwise parameter images: Maximum Signal Reduction (MSR), maximum signal difference (delta SR), time-to-peak (Tp), and integral of signal-intensity-time curve until Tp (SInt).
Main Results:
- MSR maps excelled in detecting acute infarctions; delta SR maps were superior for delineating vasogenic brain edema.
- Time-to-peak (Tp) maps demonstrated high sensitivity (90%) for detecting post-stenotic malperfused areas.
- Hyperperfused brain tumors (>1 cm diameter) were detected with >90% sensitivity.
- A 128x128 matrix size was sufficient; further increases did not improve spatial resolution due to vascularization and susceptibility effects.
Conclusions:
- Optimized EPI-based DSC-MRI provides valuable insights into cerebral perfusion.
- Time-to-peak (Tp) maps are particularly advantageous for identifying "areas at risk" in cerebrovascular disease due to improved temporal resolution.
- Different parameter images have distinct clinical utilities, aiding in the diagnosis of specific neurological conditions.