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Potential of fluid-attenuated inversion recovery diffusion-weighted imaging in patients with acute cerebral
Ryosuke Fujii1, Yuma Mochizuki2, Wakaba Koide2
1Department of Radiology Technology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Chuo-ku, Hamamatsu-shi, Shizuoka, 430-8558, Japan. chan.05228@outlook.jp.
Abstract:
Although the utility of magnetic resonance imaging (MRI) in the diagnosis and treatment planning of acute cerebral infarction is well established, MRI acquisition times are longer than those for computed tomography, suggesting the need for improved MRI imaging efficiency. Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR), integral to stroke protocols, are crucial for estimating the onset time of cerebral infarction. FLAIR DWI (F-DWI), which incorporates a long TI inversion recovery pulse into DWI, allows for the simultaneous acquisition of DWI and b0 FLAIR, significantly reducing imaging time. However, the impact of a long TI IR pulse on DWI remains unclear. Therefore, this study evaluated the utility of F-DWI and assessed its potential for reducing imaging time in patients with acute cerebral infarction. Qualitative image quality assessments (noise, distortion, artifacts, and overall image quality) of conventional DWI (C-DWI) and F-DWI were independently performed by two radiologists. Visual assessments included the presence of cerebral infarction, DWI/FLAIR mismatch, intraarterial sign, and FLAIR artifacts. The qualitative assessments were comparable between C-DWI and F-DWI. On visual assessment, F-DWI successfully detected acute cerebral infarction, indicating its potential diagnostic value. Furthermore, b0 FLAIR allowed the assessment of intraarterial sign and DWI/FLAIR mismatch, potentially obviating the need for c-FLAIR. Thus, F-DWI may contribute to shortening the time to treatment initiation for acute cerebral infarction.
Insights
FLAIR Diffusion-Weighted Imaging (F-DWI) offers comparable image quality to conventional DWI for acute cerebral infarction detection. This technique may reduce MRI scan times, potentially accelerating treatment initiation for stroke patients.
Area of Science:
- Radiology
- Neuroimaging
- Medical Imaging
Background:
- Magnetic Resonance Imaging (MRI) is vital for diagnosing acute cerebral infarction but suffers from long acquisition times.
- Diffusion-Weighted Imaging (DWI) and FLAIR are crucial for stroke diagnosis and onset time estimation.
- Improving MRI efficiency is necessary to reduce delays in acute stroke treatment.
Purpose of the Study:
- To evaluate the diagnostic utility of FLAIR DWI (F-DWI) in acute cerebral infarction.
- To assess the potential of F-DWI to reduce overall MRI imaging time.
- To compare the image quality and diagnostic performance of F-DWI against conventional DWI (C-DWI).
Main Methods:
- F-DWI was implemented, incorporating a long TI inversion recovery pulse into DWI for simultaneous acquisition of DWI and b0 FLAIR.
- Two radiologists performed qualitative image quality assessments (noise, distortion, artifacts, overall quality) on both C-DWI and F-DWI.
- Visual assessments included detection of cerebral infarction, DWI/FLAIR mismatch, intraarterial sign, and FLAIR artifacts.
Main Results:
- Qualitative assessments showed comparable image quality between C-DWI and F-DWI.
- F-DWI successfully detected acute cerebral infarction, demonstrating diagnostic value.
- The b0 FLAIR component allowed assessment of intraarterial sign and DWI/FLAIR mismatch, potentially replacing c-FLAIR.
Conclusions:
- F-DWI provides comparable diagnostic utility to C-DWI for acute cerebral infarction.
- F-DWI has the potential to significantly reduce MRI acquisition time.
- This technique may expedite treatment initiation for patients with acute cerebral infarction.
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