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Diffusion-weighted imaging with dual-echo echo-planar imaging for better sensitivity to acute stroke.

S J Holdsworth1, K W Yeom2, M U Antonucci2

  • 1From the Department of Radiology (S.J.H., K.W.Y., M.U.A., J.R., M.A., M.S., N.J.F., R.B., M.E.M., G.Z.), Stanford University, Stanford, California sholdsworth@stanford.edu.

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Parallel imaging-enhanced dual-echo diffusion-weighted imaging improves lesion detection in stroke patients. The longer echo time (TE) in echo 2 significantly enhances lesion conspicuity, while echo 1 provides better signal-to-noise ratio apparent diffusion coefficient maps.

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Area of Science:

  • Magnetic Resonance Imaging
  • Neuroradiology
  • Medical Imaging Techniques

Background:

  • Parallel imaging accelerates echo-planar imaging (EPI) acquisition by reducing echo time (TE).
  • This acceleration allows for dual-echo acquisitions, capturing images at both short and long TEs within a single diffusion-preparation period.

Purpose of the Study:

  • To investigate the utility of a parallel imaging-enhanced dual-echo EPI sequence.
  • To improve lesion conspicuity in diffusion-weighted imaging (DWI) for stroke evaluation.

Main Methods:

  • Acquired parallel imaging-enhanced dual-echo DWI data in 50 patients suspected of stroke at 1.5T.
  • Utilized dual-echo EPI with TE1 = 48 ms and TE2 = 105 ms.
  • Neuroradiologists graded lesion conspicuity, diagnostic confidence, and image quality, comparing with routine DWI.

Main Results:

  • Both echo 1 and echo 2 DWIs were rated superior to the reference DWI.
  • Echo 2 demonstrated superior sensitivity for detecting acute infarcts, unanimously favored over echo 1 and reference DWI.
  • Echo 1 offered better overall image quality and higher SNR ADC maps for infarct specificity.

Conclusions:

  • Parallel imaging-enhanced dual-echo DWI is effective for evaluating lesions with restricted diffusion.
  • The longer TE of echo 2 significantly enhances lesion conspicuity.
  • Echo 1 provides valuable ADC maps for specificity, and relaxivity maps may offer complementary information.