Simultaneous time of flight-MRA and T2* imaging for cerebrovascular MRI
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PAEDIATRIC NEURORADIOLOGY
Simultaneous time of flight-MRA and T2* imaging for cerebrovascular MRI Bryan A. Lanzman 1 & Yuhao Huang 2 & Edward H. Lee 1,3 & Michael Iv 1 & Michael E. Moseley 1 & Samantha J. Holdsworth 4,5 & Kristen W. Yeom 1,6 Received: 19 April 2020 / Accepted: 13 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose 3D multi-echo gradient-recalled echo (ME-GRE) can simultaneously generate time-of-flight magnetic resonance angiography (pTOF) in addition to T2*-based susceptibility-weighted images (SWI). We assessed the clinical performance of pTOF generated from a 3D ME-GRE acquisition compared with conventional TOF-MRA (cTOF). Methods Eighty consecutive children were retrospectively identified who obtained 3D ME-GRE alongside cTOF. Two blinded readers independently assessed pTOF derived from 3D ME-GRE and compared them with cTOF. A 5-point Likert scale was used to rank lesion conspicuity and to assess for diagnostic confidence. Results Across 80 pediatric neurovascular pathologies, a similar number of lesions were reported on pTOF and cTOF (43–40%, respectively, p > 0.05). Rating of lesion conspicuity was higher with cTOF (4.5 ± 1.0) as compared with pTOF (4.0 ± 0.7), but this was not significantly different (p = 0.06). Diagnostic confidence was rated higher with cTOF (4.8 ± 0.5) than that of pTOF (3.7 ± 0.6; p < 0.001). Overall, the inter-rater agreement between two readers for lesion count on pTOF was classified as almost perfect (κ = 0.98, 96% CI 0.8–1.0). Conclusions In this study, TOF-MRA simultaneously generated in addition to SWI from 3D MR-GRE can serve as a diagnostic adjunct, particularly for proximal vessel disease and when conventional TOF-MRA images are absent. Keywords Multi-echo gradient-recalled Echo . Time-of-flight magnetic resonance angiography . MRI . Neurovascular . Pediatric
BAL and YH are co-first authors. SJH and KWY are co-senior authors. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00234-020-02499-5) contains supplementary material, which is available to authorized users. * Kristen W. Yeom [email protected] 1
Department of Radiology, Stanford University, Stanford, CA, USA
2
Department of Neurosurgery, Stanford University, Stanford, CA, USA
3
Department of Electrical Engineering, Stanford University, Stanford, CA, USA
4
Mātai Medical Research Institute, Gisborne-Tairāwhiti, Gisborne, New Zealand
5
Department of Anatomy and Medical Imaging & Centre for Brain Research, The University of Auckland, Auckland, New Zealand
6
Lucile Packard Children’s Hospital, Palo Alto, CA, USA
Introduction Gradient recalled echo (GRE) MRI techniques have wide applications in clinical MRI due to their scan speed and anatomic characterization. Two such routine uses of GRE-based methods are T2*-based 2D/3D GRE for highlighting tissues prone to magnetic susceptibility effects such as hemorrhage, mineralization, or deoxygenated blood, and a 3D time-offlight magnetic resonance angiography (TOF-MRA) for
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