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Simultaneous time of flight-MRA and T2* imaging for cerebrovascular MRI

  • Paediatric Neuroradiology
  • Published:
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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.

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Author notes

  1. SJH and KWY are co-senior authors.

Authors and Affiliations

  1. Department of Radiology, Stanford University, Stanford, CA, USA

    Bryan A. Lanzman, Edward H. Lee, Michael Iv, Michael E. Moseley & Kristen W. Yeom

  2. Department of Neurosurgery, Stanford University, Stanford, CA, USA

    Yuhao Huang

  3. Department of Electrical Engineering, Stanford University, Stanford, CA, USA

    Edward H. Lee

  4. Mātai Medical Research Institute, Gisborne-Tairāwhiti, Gisborne, New Zealand

    Samantha J. Holdsworth

  5. Department of Anatomy and Medical Imaging & Centre for Brain Research, The University of Auckland, Auckland, New Zealand

    Samantha J. Holdsworth

  6. Lucile Packard Children’s Hospital, Palo Alto, CA, USA

    Kristen W. Yeom

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  1. Bryan A. Lanzman
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  2. Yuhao Huang
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Correspondence to Kristen W. Yeom.

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Disclosures

Preliminary results from this article was presented at the American Society of Neuroradiology 2016 Annual Meeting, May 21-26, Washington, DC. Funding support was provided by ASNR Comparative Effectiveness Grant and NIH grant 1R21HD08380301A1.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Stanford University Institutional Review Board in the Research Compliance Office (RCO). The study protocol number is 44683.

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As the study was entirely retrospective in nature, informed consent for subjects in this study were not required.

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BAL and YH are co-first authors.

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Lanzman, B.A., Huang, Y., Lee, E.H. et al. Simultaneous time of flight-MRA and T2* imaging for cerebrovascular MRI. Neuroradiology 63, 243–251 (2021). https://doi.org/10.1007/s00234-020-02499-5

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  • DOI: https://doi.org/10.1007/s00234-020-02499-5

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