• Investigative Magnetic Resonance Imaging
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• v.23 no.3
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• pp.210-219
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• 2019

Purpose: The purpose of this study was to investigate if double inversion recovery (DIR) imaging can have a role in the evaluation of brain ischemia, compared with diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) imaging. Materials and Methods: Sixty-seven patients within 48 hours of onset, underwent MRI scans with FLAIR, DWI with b-value of 0 (B0) and $1000s/mm^2$, and DIR sequences. Patients were categorized into four groups: within three hours, three to six hours, six to 24 hours, and 24 to 48 hours after onset. Lesion-to-normal ratio (LNR) value was calculated and compared among all sequences within each group, by the Friedman test and conducted among all groups, for each sequence by the Kruskal-Wallis test. In qualitative assessment, signal intensity changes of DIR, B0, and FLAIR based on similarity with DWI and image quality of each sequence, were graded on a 3-point scale, respectively. Scores for detectability of lesions were compared by the McNemar's test. Results: LNR values from DWI were higher than DIR, but not statistically significant in all groups (P > 0.05). LNR values of DIR were significantly higher than FLAIR within 24 hours of onset (P < 0.05). LNR values were significantly different between, before, and after six hours onset time for DIR (P = 0.016), B0 (P = 0.008), and FLAIR (P = 0.018) but not for DWI (P = 0.051). Qualitative analysis demonstrated that detectability of DIR was higher, compared to that of FLAIR within 4.5 hours and six hours of onset (P < 0.05). Also, the DWI quality score was lower than that of DIR, particularly relative to infratentorial lesions. Conclusion: DIR provides higher detectability of hyperacute brain ischemia than B0 and FLAIR, and does not suffer from susceptibility artifact, unlike DWI. So, DIR can be used to replace evaluation of the FLAIR-DWI mismatch.

• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.991-998
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• 2021

The purpose of this study is to investigate the image quality of the SE-EPI and SSH-TSE technique for MR DWI. Datum were analyzed for 35 PACS transmission datum(Normal part: 12 males, 13 females, Cerebral Infarction: 10(5males and 5females), and average age 68±7.32), randomly selected patients who underwent MRDWI tests. The equipment used was Ingenia CX 3.0T, SSH_TSE and SE-EPI pulse sequence and 32 Ch. head coil were used for data acquisition. Image evaluation was performed on the paired t-test and Wilcoxon tests, and was considered significant when the p value was 0.05 or less. As a result of quantitative analysis of SNR for DWI images, the mean and standard deviation values of 4 parts (WM, GM, BG, Cerebellum) in ADC (s/mm2), Diffusion b=0, 1000 images were higher in SE-EPI techniques(ADC: 120.50 ± 40, b=0: 54.50 ± 35.91, b=1000: 91.61 ± 36.63) than in SSH-TSE techniques(ADC: 99.69 ± 31.10, b=0: 43.52 ± 25.00 , b=1000: 60.74 ± 24.85)(p<0.05). The CNR values for GM-WM, BG-WM sites were also higher in SE-EPI technique (ADC: 116.08 ± 43.30, b=0:27.23 ± 09.10, b=1000: 78.50 ± 16.56) than in SSH-TSE(ADC: 101.08 ± 36.81, b=0: 23.96 ± 07.79 , b=1000: 74.30 ± 14.22). As a visual evaluation of observers, ghost artifact, magnetic susceptibility artifacts and overall image quality for SE-TSE and SSH-TSE all yielded high results from SSH-TSE techniques(ADC:3.6 ± 0.1, 2.8 ± 0.2, b=0: 4.3 ± 0.3, 3.4 ± 0.1 b=1000: 4.3 ± 0.2, 3.5 ± 0.2, p=0.000). In conclusion, the SE-EPI technique obtained an superiority in SNR and CNR measurements using SSH-TSE, SE-EPI. In the qualitative analysis, the SSH-TSE pulse sequence was obtained a high result according to the pulse sequence characteristics.