Diagnostic value of diffusion-weighted STEAM-MRI in ischemic stroke

Müller, Sebastian Johannes; Khadhraoui, Eya; Kube, Julia My Van; Langer, Philip; Riedel, Christian; Voit, Dirk; Ernst, Marielle; Frahm, Jens

doi:10.1016/j.ejrad.2021.109677

Cited by 3 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hence, in cases where air artifacts completely distort EPI DWI, a more confident diagnosis using STEAM DWI is possible. Previous studies [ 5 , 12 ] found STEAM detection rates in stroke patients to be slightly worse than those for EPI DWI, mainly due to a lower signal-to-noise ratio, resulting in poorer detection of microembolisms. The present work reveals a superiority of STEAM DWI in the detection of acute or subacute strokes in patients with postoperative air artifacts using a new version of this sequence.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Comparison of EPI DWI and STEAM DWI in Early Postoperative MRI Controls After Resection of Tumors of the Central Nervous System

Müller

Khadhraoui

Voit³

et al. 2023

Clin Neuroradiol

Self Cite

View full text Add to dashboard Cite

Purpose Diffusion-weighted imaging (DWI) is important for differentiating residual tumor and subacute infarctions in early postoperative magnetic resonance imaging (MRI) of central nervous system (CNS) tumors. In cases of pneumocephalus and especially in the presence of intraventricular trapped air, conventional echo-planar imaging (EPI) DWI is distorted by susceptibility artifacts. The performance and robustness of a newly developed DWI sequence using the stimulated echo acquisition mode (STEAM) was evaluated in patients after neurosurgical operations with early postoperative MRI. Methods We compared EPI and STEAM DWI of 43 patients who received 3‑Tesla MRI within 72 h after a neurosurgical operation between 1 October 2019 and 30 September 2021. We analyzed susceptibility artifacts originating from air and blood and whether these artifacts compromised the detection of ischemic changes after surgery. The DWI sequences were (i) visually rated and (ii) volumetrically analyzed. Results In 28 of 43 patients, we found severe and diagnostically relevant artifacts in EPI DWI, but none in STEAM DWI. In these cases, in which artifacts were caused by intracranial air, they led to a worse detection of ischemic lesions and thus to a possible failed diagnosis or lack of judgment using EPI DWI. Additionally, volumetric analysis demonstrated a 14% smaller infarct volume detected with EPI DWI. No significant differences in visual rating and volumetric analysis were detected among the patients without severe artifacts. Conclusion The newly developed version of STEAM DWI with highly undersampled radial encodings is superior to EPI DWI in patients with postoperative pneumocephalus.

show abstract

Section: Discussionmentioning

confidence: 96%

“…The new versions of STEAM DWI are now used routinely in our neuroradiologic institute in Göttingen. In a previous study [ 5 ] the capability of STEAM DWI for detecting subacute infarctions was evaluated and showed similar sensitivity and specificity as EPI DWI, but fewer artifacts.…”

Section: Introductionmentioning

confidence: 99%

Comparison of EPI DWI and STEAM DWI in Early Postoperative MRI Controls After Resection of Tumors of the Central Nervous System

Müller

Khadhraoui

Voit³

et al. 2023

Clin Neuroradiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…DWI in stimulated echo acquisition mode (STEAM-DWI), compared to echo-planar imaging DWI (EPI-DWI), has greater sensitivity for ischemic stroke (Khalil et al, 2016), with fewer susceptibility artifacts. This provides a reliable alternative for stroke diagnosis in the regions affected by susceptibility artifacts (Müller et al, 2021). DWI-BLADE (PROPELLER) sequences also eliminate susceptibility artifacts (Fries et al, 2009).…”

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

Applications of Magnetic Resonance Imaging in Stroke for Multidimensional Assessment

Wang,

Liu

2023

AI and IoT-Based Technologies for Precision Medicine

View full text Add to dashboard Cite

Stroke remains a leading cause of disability and death worldwide. Accurate diagnosis of stroke is vital for guiding treatment decisions and predicting outcomes. Different types of strokes have distinct pathological processes, but they share many common symptoms with other brain disorders. Differential diagnosis of stroke is important but challenging; with non-invasive nature, diverse sequences, and high spatiotemporal resolution, it enables multidimensional assessment of stroke. It can detect hemodynamic and structural changes in intracranial arteries, and the metabolic state of relevant brain regions. MRI can differentiate between ischemic stroke, hemorrhagic stroke, and other intracranial vascular lesions. To improve diagnostic accuracy, numerous methods and algorithms have been proposed towards precise diagnosis. This chapter first briefly introduces the concept of structural MRI and its role in precise diagnosis of stroke.

show abstract

“…With its ability to probe water molecular diffusion at the microscopic scale, DWI has become a powerful non‐invasive technique to characterize microenvironment and infer tissue microstructures 1 . The ADC quantitatively describes the mobility of water molecules in tissues 2 and has been found useful for characterizing a variety of diseases such as stroke 3–6 and cancer 7–9 . In complex biological tissues, it has been increasingly recognized that ADC not only depends on diffusion encoding direction and b ‐values, but also varies with the diffusion time (Δ) 2,10–13 .…”

Section: Introductionmentioning

confidence: 99%

Time‐dependent diffusion MRI using multiple stimulated echoes

Dan

Sun

Luo

et al. 2023

Magnetic Resonance in Med

View full text Add to dashboard Cite

Purpose To develop a time‐efficient pulse sequence that acquires multiple diffusion‐weighted images with distinct diffusion times in a single shot by using multiple stimulated echoes (mSTE) with variable flip angles (VFA). Methods The proposed diffusion‐weighted mSTE with VFA (DW‐mSTE‐VFA) sequence begins with two 90° RF pulses that straddle a diffusion gradient lobe (GD) to excite and restore one half of the magnetization into the longitudinal axis. The restored longitudinal magnetization was successively re‐excited by a series of RF pulses with VFA, each followed by another GD, to generate a set of stimulated echoes. Each of the multiple stimulated echoes was acquired with an EPI echo train. As such, the train of multiple stimulated echoes produced a set of diffusion‐weighted images with varying diffusion times in a single shot. This technique was experimentally demonstrated on a diffusion phantom, a fruit, and healthy human brain and prostate at 3 T. Results In the phantom experiment, the mean ADC measured at different diffusion times using DW‐mSTE‐VFA were highly consistent (r = 0.999) with those from a commercial spin‐echo diffusion‐weighted EPI sequence. In the fruit and brain experiments, DW‐mSTE‐VFA exhibited similar diffusion‐time dependence to a standard diffusion‐weighted stimulated echo sequence. The ADC showed significant time dependence in the human brain (p = 0.003 in both white matter and gray matter) and prostate tissues (p = 0.003 in both peripheral zone and central gland). Conclusion DW‐mSTE‐VFA offers a time‐efficient tool for investigating the diffusion‐time dependency in diffusion MRI studies.

show abstract

Diagnostic value of diffusion-weighted STEAM-MRI in ischemic stroke

Cited by 3 publications

References 15 publications

Comparison of EPI DWI and STEAM DWI in Early Postoperative MRI Controls After Resection of Tumors of the Central Nervous System

Comparison of EPI DWI and STEAM DWI in Early Postoperative MRI Controls After Resection of Tumors of the Central Nervous System

Applications of Magnetic Resonance Imaging in Stroke for Multidimensional Assessment

Time‐dependent diffusion MRI using multiple stimulated echoes

Contact Info

Product

Resources

About