A 3-Minute Ultrafast MRI and MRA Protocol for Screening of Acute Ischemic Stroke

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology Pub Date : 2025-03-01 DOI:10.1016/j.jacr.2025.01.002

Maria Camila Cortes-Albornoz MD , Bryan Clifford PhD , Wei-Ching Lo PhD , Seonghwan Yee PhD , Brooks P. Applewhite MD , Azadeh Tabari MD , Claire White-Dzuro BA , Stephen F. Cauley PhD , Pamela W. Schaefer MD , Otto Rapalino MD , Michael H. Lev MD , Berkin Bilgic , Thorsten Feiweier , Susie Y. Huang MD, PhD , John M. Conklin MD , Min Lang MD, MSc

{"title":"A 3-Minute Ultrafast MRI and MRA Protocol for Screening of Acute Ischemic Stroke","authors":"Maria Camila Cortes-Albornoz MD , Bryan Clifford PhD , Wei-Ching Lo PhD , Seonghwan Yee PhD , Brooks P. Applewhite MD , Azadeh Tabari MD , Claire White-Dzuro BA , Stephen F. Cauley PhD , Pamela W. Schaefer MD , Otto Rapalino MD , Michael H. Lev MD , Berkin Bilgic , Thorsten Feiweier , Susie Y. Huang MD, PhD , John M. Conklin MD , Min Lang MD, MSc","doi":"10.1016/j.jacr.2025.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic performance of a 3-min ultrafast brain MRI and MRA protocol for screening of acute ischemic stroke.</div></div><div><h3>Methods</h3><div>This study involved 67 adult patients who underwent ultrafast and reference MRI and MRA scans from September 2023 to June 2024 for stroke evaluation. Two readers independently assessed the ultrafast and reference MRI and MRA images in a masked and randomized manner for acute and chronic infarct and hemorrhage as well as large-vessel occlusion and severe stenosis. A 3-point Likert scale was used to evaluate diagnostic quality of the ultrafast sequences and Cohen’s κ was used to assess interrater agreement.</div></div><div><h3>Results</h3><div>The ultrafast MRI and MRA protocol showed high diagnostic quality, with 98% of sequences rated as diagnostic. Raters showed perfect agreement in identifying acute infarcts, aneurysms, and vascular occlusions using both ultrafast and reference protocols and near-perfect agreement (>95%) for detecting acute hemorrhage and severe stenosis. For chronic conditions such as chronic infarction and chronic hemorrhage, there was substantial agreement with κ values ranging from 0.73 to 0.76.</div></div><div><h3>Discussion</h3><div>The screening ultrafast MRI and MRA protocol can effectively identify acute ischemic stroke and intracranial large-vessel occlusion with high diagnostic accuracy while significantly reducing acquisition time, making it suitable for initial stroke triage. Evaluation for chronic pathologies on the ultrafast protocol is inferior compared with standard MRI and MRA imaging.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 3","pages":"Pages 366-375"},"PeriodicalIF":4.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American College of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S154614402500002X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To evaluate the diagnostic performance of a 3-min ultrafast brain MRI and MRA protocol for screening of acute ischemic stroke.

Methods

This study involved 67 adult patients who underwent ultrafast and reference MRI and MRA scans from September 2023 to June 2024 for stroke evaluation. Two readers independently assessed the ultrafast and reference MRI and MRA images in a masked and randomized manner for acute and chronic infarct and hemorrhage as well as large-vessel occlusion and severe stenosis. A 3-point Likert scale was used to evaluate diagnostic quality of the ultrafast sequences and Cohen’s κ was used to assess interrater agreement.

Results

The ultrafast MRI and MRA protocol showed high diagnostic quality, with 98% of sequences rated as diagnostic. Raters showed perfect agreement in identifying acute infarcts, aneurysms, and vascular occlusions using both ultrafast and reference protocols and near-perfect agreement (>95%) for detecting acute hemorrhage and severe stenosis. For chronic conditions such as chronic infarction and chronic hemorrhage, there was substantial agreement with κ values ranging from 0.73 to 0.76.

Discussion

The screening ultrafast MRI and MRA protocol can effectively identify acute ischemic stroke and intracranial large-vessel occlusion with high diagnostic accuracy while significantly reducing acquisition time, making it suitable for initial stroke triage. Evaluation for chronic pathologies on the ultrafast protocol is inferior compared with standard MRI and MRA imaging.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

6.30

自引率

8.90%

发文量

312

审稿时长

34 days

期刊介绍： The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.