Comparison of diffusion weighted imaging b0 with T2*-weighted gradient echo or susceptibility weighted imaging for intracranial hemorrhage detection after reperfusion therapy for ischemic stroke.

Autor: Luijten SPR; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. s.luijten@erasmusmc.nl.; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands. s.luijten@erasmusmc.nl., van der Ende NAM; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands., Cornelissen SAP; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands., Kluijtmans L; Department of Radiology, Isala Hospital, Zwolle, The Netherlands., van Hattem A; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands., Lycklama A Nijeholt G; Department of Radiology, Haaglanden Medisch Centrum, Hague, The Netherlands., Postma AA; Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands., Bokkers RPH; Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Thomassen L; Department of Neurology, Haukeland University Hospital, Bergen, Norway., Waje-Andreassen U; Department of Neurology, Haukeland University Hospital, Bergen, Norway., Logallo N; Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway., Bracard S; Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nancy, Nancy, France., Gory B; Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nancy, Nancy, France., Roozenbeek B; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands., Dippel DWJ; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands., van der Lugt A; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Neuroradiology [Neuroradiology] 2023 Nov; Vol. 65 (11), pp. 1649-1655. Date of Electronic Publication: 2023 Jun 29.
DOI: 10.1007/s00234-023-03180-3
Abstrakt: Purpose: Diffusion-weighted imaging (DWI) b0 may be able to substitute T2*-weighted gradient echo (GRE) or susceptibility-weighted imaging (SWI) in case of comparable detection of intracranial hemorrhage (ICH), thereby reducing MRI examination time. We evaluated the diagnostic accuracy of DWI b0 compared to T2*GRE or SWI for detection of ICH after reperfusion therapy for ischemic stroke.
Methods: We pooled 300 follow-up MRI scans acquired within 1 week after reperfusion therapy. Six neuroradiologists each rated DWI images (b0 and b1000; b0 as index test) of 100 patients and, after a minimum of 4 weeks, T2*GRE or SWI images (reference standard) paired with DWI images of the same patients. Readers assessed the presence of ICH (yes/no) and type of ICH according to the Heidelberg Bleeding Classification. We determined the sensitivity and specificity of DWI b0 for detection of any ICH, and the sensitivity for detection of hemorrhagic infarction (HI1 & HI2) and parenchymal hematoma (PH1 & PH2).
Results: We analyzed 277 scans of ischemic stroke patients with complete image series and sufficient image quality (median age 65 years [interquartile range, 54-75], 158 [57%] men). For detection of any ICH on DWI b0, the sensitivity was 62% (95% CI: 50-76) and specificity 96% (95% CI: 93-99). The sensitivity of DWI b0 was 52% (95% CI: 28-68) for detection of hemorrhagic infarction and 84% (95% CI: 70-92) for parenchymal hematoma.
Conclusion: DWI b0 is inferior for detection of ICH compared to T2*GRE/SWI, especially for smaller and more subtle hemorrhages. Follow-up MRI protocols should include T2*GRE/SWI for detection of ICH after reperfusion therapy.
(© 2023. The Author(s).)
Databáze: MEDLINE
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