Document Detail


Diffusion-weighted MRI in acute stroke within the first 6 hours: 1.5 or 3.0 Tesla?
MedLine Citation:
PMID:  20463287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To compare the sensitivity and specificity of 1.5-T and 3.0-T diffusion-weighted MRI (DWI) to detect hyperacute ischemic stroke lesions. METHODS: We blindly reviewed the DWI of 135 acute stroke patients and 34 controls performed at 1.5 T (n = 108) or 3.0 T (n = 61). The stroke patients all had subsequently proved carotid territory ischemic stroke and were imaged within the first 6 hours after stroke onset. Four readers (2 neuroradiologists and 2 stroke neurologists) blinded to clinical data and magnetic field strength recorded the presence of ischemic lesions on DWI and apparent diffusion coefficient (ADC) maps if necessary. Sensitivity, specificity, and false-negative rates were computed. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and DWI contrasts were calculated at both field strengths. RESULTS: The accuracy of DWI in stroke diagnosis was superior at 1.5 T (98.8%) than at 3.0 T (90.9%, p = 0.03). The sensitivity decreased from 99.1% at 1.5 T to 92.5% at 3.0 T (p = 0.06) and the specificity from 97.8% to 84.1% (p = 0.002). ADC map readings did not improve accuracy, sensitivity, or specificity. The false-negative rate was 0.6% at 1.5 T and 6.1% at 3.0 T. Type of readers, stroke severity, and type of the coil did not affect diagnosis value. SNR and CNR were significantly higher at 3 T (p < 0.0001) but DWI contrast was lower (p = 0.04). CONCLUSIONS: Blind reading by 4 experts of a large series of images shows that 1.5-T diffusion-weighted MRI (DWI) is better than 3.0-T DWI for the imaging of hyperacute stroke during the therapeutic window of thrombolysis.
Authors:
C Rosso; A Drier; D Lacroix; G Mutlu; C Pires; S Lehéricy; Y Samson; D Dormont
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-05-12
Journal Detail:
Title:  Neurology     Volume:  74     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-07-19     Revised Date:  2010-09-01    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1946-53     Citation Subset:  AIM; IM    
Affiliation:
AP-HP, Urgences Cérébro-Vasculaires, Université Pierre et Marie Curie, Paris VI, Hôpital Pitié-Salpêtrière, Paris, France. charlotte.rosso@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Diffusion Magnetic Resonance Imaging / methods*,  standards*
Humans
Middle Aged
Prospective Studies
Retrospective Studies
Stroke / diagnosis*,  therapy
Time Factors
Comments/Corrections
Comment In:
Neurology. 2010 Jun 15;74(24):1936-7   [PMID:  20484683 ]
J Neurol. 2010 Sep;257(9):1587-9   [PMID:  20706844 ]

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