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Updated: Jun 3, 2025
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Two-dimensional T2*-weighted multi-shot echo-planar imaging to detect cerebral microbleeds in neurocognitive
Aïmane Patel1, Emmanuel Gerardin2, Julie Poujol3
1Department of Radiology, Rouen University Hospital, Rouen, Normandy, France.
Purpose:
To evaluate the effectiveness of ultra-fast two-dimensional (2D) T2*-weighted multi-shot echo-planar imaging (MS-EPI) for the detection of cerebral microbleeds (CMB) in cognitive disorders.
Methods:
Sixty-eight patients referred for neuroimaging to investigate cognitive disorders underwent 3 T MR imaging, with both 2D T2*-weighted MS-EPI and susceptibility-weighted angiography (SWAN). Microbleeds were separately assessed on 2D T2*-weighted MS-EPI and SWAN by 2 raters. Intermodality and interobserver (n = 2 raters) agreement was calculated using the Cohen's kappa.
Results:
In assessing the number of microbleeds across five categories (0, 1, 2-4, 5-10, >10), interobserver agreement reached 0.95 for SWAN and 0.90 for 2D MS-EPI. When considering the consensus evaluation, intermodality agreement stood at 0.75. Using the consensus evaluation, motion artifacts were significantly less frequent for 2D MS-EPI (p = 0.001).
Conclusion:
This study suggests that the ultra-fast 2D MS-EPI sequence holds promise as an effective alternative to the SWAN sequence for detecting microbleeds in patients with neurocognitive disorders, particularly in those who are unable of remaining still during long scans.
Insights
Ultra-fast 2D T2*-weighted multi-shot echo-planar imaging (MS-EPI) effectively detects cerebral microbleeds (CMB) in cognitive disorders. This method shows promise as an alternative to SWAN, especially for patients with motion artifacts.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- Cerebral microbleeds (CMB) are associated with cognitive disorders.
- Accurate detection of CMB is crucial for diagnosis and management.
- Existing imaging sequences may be limited by scan time and motion artifacts.
Purpose of the Study:
- To evaluate the effectiveness of ultra-fast 2D T2*-weighted multi-shot echo-planar imaging (MS-EPI) for detecting cerebral microbleeds (CMB).
- To compare the performance of 2D MS-EPI with susceptibility-weighted angiography (SWAN) in patients with cognitive disorders.
Main Methods:
- Sixty-eight patients with cognitive disorders underwent 3T MRI using both 2D T2*-weighted MS-EPI and SWAN sequences.
- Two raters independently assessed microbleeds on both imaging modalities.
- Intermodality and interobserver agreement were calculated using Cohen's kappa.
Main Results:
- High interobserver agreement was observed for both SWAN (0.95) and 2D MS-EPI (0.90).
- Intermodality agreement between SWAN and 2D MS-EPI was 0.75.
- 2D MS-EPI demonstrated significantly fewer motion artifacts compared to SWAN (p=0.001).
Conclusions:
- Ultra-fast 2D MS-EPI is a promising sequence for detecting CMB in neurocognitive disorders.
- It offers an effective alternative to SWAN, particularly for patients unable to remain still.
- This technique may improve diagnostic accuracy and patient tolerance in neuroimaging.
