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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Comparative magnetic resonance imaging at 1.5 and 3 Tesla for the evaluation of traumatic microbleeds
Rainer Scheid1, Derek V Ott, Henrik Roth
1Day Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany. scheid@cbs.mpg.de
Abstract:
Traumatic microbleeds (TMBs) can be regarded as a radiological marker of diffuse axonal injury (DAI). We sought to investigate the impact of the field strengths on the depiction of TMBs by T2*-weighted gradient echo magnetic resonance imaging (MRI). By the use of comparative MRI of 14 patients (age range, 22-62 years) on 1.5- and a 3 T (Tesla) systems at a median time interval of 61 months after traumatic brain injury (TBI), we found 239 (range 0.5-48.5, median 7.5) TMBs at 1.5 T, and 470 (range 2-118, median 18.5) TMBs at 3 T, respectively (p=0.001). However, in all but one patients MRI at 1.5 T also clearly showed TMBs. A significant negative correlation between the number of TMBs and the time interval TBI-MRI was observed, which was weaker for the imaging at 3 T (r(s)=-0.798; p=0.001; and r(s)=-0.649; p=0.012, respectively). In conclusion, T2*-weighted gradient-echo MRI at 3 T is superior as compared to MRI at 1.5 T for the detection of TMBs. Nevertheless, in clinical practice, MRI at 1.5 T seems to be sufficient for this purpose. MRI at 3 T may be appropriate if there is a strong clinical suspicion of DAI, despite unremarkable routine MRI, and possibly also if evidence of DAI is sought after a long interval from trauma.
Insights
Three Tesla (3T) MRI detects more traumatic microbleeds (TMBs) than 1.5 Tesla (1.5T) MRI, aiding diffuse axonal injury (DAI) diagnosis. While 1.5T is sufficient for clinical use, 3T offers superior detection, especially in complex cases.
Area of Science:
- Radiology
- Neuroimaging
- Medical Physics
Background:
- Traumatic microbleeds (TMBs) are key radiological markers for diffuse axonal injury (DAI) following traumatic brain injury (TBI).
- Assessing the impact of magnetic field strength on TMB detection is crucial for optimizing neuroimaging protocols.
Purpose of the Study:
- To compare the efficacy of 1.5 Tesla (1.5T) and 3 Tesla (3T) T2*-weighted gradient echo magnetic resonance imaging (MRI) in depicting TMBs.
- To evaluate the influence of time elapsed since TBI on TMB detection rates at different field strengths.
Main Methods:
- Comparative MRI analysis of 14 TBI patients (age 22-62) using both 1.5T and 3T systems.
- T2*-weighted gradient echo sequences were employed for imaging.
- Statistical analysis including correlation and significance testing was performed.
Main Results:
- 3T MRI identified significantly more TMBs (median 18.5) than 1.5T MRI (median 7.5) (p=0.001).
- A significant negative correlation between TMB count and time since TBI was observed, which was weaker at 3T.
- TMBs were visualized on 1.5T MRI in all but one patient.
Conclusions:
- 3T MRI demonstrates superior sensitivity for detecting TMBs compared to 1.5T MRI.
- 1.5T MRI remains clinically sufficient for TMB detection in routine practice.
- 3T MRI is recommended for suspected DAI with unremarkable initial MRI or when seeking evidence long after trauma.
