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Quiet Diffusion-weighted MR Imaging of the Brain for Pediatric Patients with Moyamoya Disease
Satoshi Nakajima1, Yasutaka Fushimi1, Takeshi Funaki2
1Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine.
Purpose:
Diffusion-weighted MRI (DWI) is an essential sequence for evaluating pediatric patients with moyamoya disease (MMD); however, acoustic noise associated with DWI may lead to motion artifact. Compared with conventional DWI (cDWI), quiet DWI (qDWI) is considered less noisy and able to keep children more relaxed and stable. This study aimed to evaluate the suitability of qDWI compared with cDWI for pediatric patients with MMD.
Methods:
In this observational study, MR examinations of the brain were performed either with or without sedation in pediatric patients with MMD between September 2017 and August 2018. Three neuroradiologists independently evaluated the images for artifacts and restricted diffusion in the brain. The differences between qDWI and cDWI were compared statistically using a chi-square test.
Results:
One-hundred and six MR scans of 56 patients with MMD (38 scans of 15 sedated patients: 6 boys and 9 girls; mean age, 5.2 years; range, 1-9 years; and 68 scans of 42 unsedated patients: 19 boys and 23 girls; mean age, 10.7 years; range, 7-16 years) were evaluated. MR examinations were performed either with or without sedation (except in one patient). In sedated patients, no artifact other than susceptibility was observed on qDWI, whereas four artifacts were observed on cDWI (P = .04). One patient awoke from sedation during cDWI scanning, while no patient awoke from sedation during qDWI acquisition. For unsedated patients, three scans showed artifacts on qDWI, whereas two scans showed artifacts on cDWI (P = .65). Regarding restricted diffusion, qDWI revealed three cases, while two cases were found on cDWI (P = .66).
Conclusion:
qDWI induced fewer artifacts compared with cDWI in sedated patients, and similar frequencies of artifacts were induced by qDWI and by cDWI in unsedated patients. qDWI showed restricted diffusion comparable to cDWI.
Insights
Quiet diffusion-weighted MRI (qDWI) reduces artifacts in sedated pediatric moyamoya disease (MMD) patients compared to conventional DWI (cDWI). qDWI demonstrates comparable restricted diffusion detection to cDWI in both sedated and unsedated MMD patients.
Area of Science:
- Radiology
- Pediatric Neurology
- Neuroimaging
Background:
- Diffusion-weighted MRI (DWI) is crucial for moyamoya disease (MMD) evaluation in children.
- Acoustic noise from conventional DWI (cDWI) can cause motion artifacts in pediatric patients.
- Quiet DWI (qDWI) offers a less noisy alternative, potentially improving patient cooperation.
Purpose of the Study:
- To compare the effectiveness of qDWI versus cDWI in pediatric MMD patients.
- To assess artifact incidence and restricted diffusion detection between qDWI and cDWI.
- To evaluate the impact of sedation on image quality with qDWI and cDWI.
Main Methods:
- Observational study of pediatric MMD patients undergoing brain MRI (September 2017 - August 2018).
- MR examinations performed with or without sedation.
- Independent neuroradiologist evaluation of image artifacts and restricted diffusion.
- Statistical comparison of qDWI and cDWI using chi-square test.
Main Results:
- qDWI showed significantly fewer artifacts than cDWI in sedated patients (P = .04).
- No sedated patients awoke during qDWI, while one awoke during cDWI.
- Artifact frequencies were similar between qDWI and cDWI in unsedated patients (P = .65).
- Restricted diffusion detection was comparable between qDWI and cDWI (P = .66).
Conclusions:
- qDWI is superior to cDWI in reducing artifacts in sedated pediatric MMD patients.
- qDWI provides comparable restricted diffusion assessment to cDWI.
- qDWI may enhance image quality and patient comfort in pediatric MMD neuroimaging.
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