ESR Essentials: diffusion-weighted MRI-practice recommendations by the European Society for Magnetic Resonance in Medicine and Biology.

IF 4.7 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Marco Palombo, Benedetta Bodini, Francesco Grussu, Denis Le Bihan, Markus Nilsson, Raquel Perez-Lopez, Edwin H G Oei, Ivo G Schoots, Marion Smits, Ileana O Jelescu
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引用次数: 0

Abstract

Diffusion-weighted imaging (DWI) offers critical insights into tissue microstructure through the assessment of water molecule random displacements and plays a central role in the assessment of neoplastic and non-neoplastic diseases. To successfully implement and use DWI in clinical practice, guidelines for acquisition, interpretation of image contrast and of artefacts should be followed, taking the disease process and body part into account. We recommend covering a b-value range of 0-1000 s/mm2 in the brain (along at least six directions for white matter), and 50-800 s/mm2 in the body. Available acquisition acceleration options should be used to reduce repetition time (TR), echo time (TE), and echo-planar imaging (EPI) distortions, while considering the penalty in signal-to-noise ratio (SNR) and image sharpness. DW images and the apparent diffusion coefficient (ADC) map should be read jointly for the clinical interpretation. Areas of slower diffusion are hyperintense on DW images and hypointense on the ADC map, and vice versa. Magnetic susceptibility distortions and signal drop-outs or pile-ups are particularly pronounced at air-tissue or metal-tissue interfaces and may obscure areas of interest or hinder the co-localisation with structural scans. By following these guidelines and recommendations, radiologists and imaging professionals can enhance diagnostic accuracy, reduce variability, and maximise the clinical value of DWI across diverse applications. KEY POINTS: This article provides an overview of DWI principles, clinical applications, potential pitfalls, and emerging advances, alongside expert recommendations for optimal implementation. We provide key considerations tailored to specific applications (neuro and whole-body imaging), including protocol optimisation, adherence to established guidelines, and quality assurance measures to minimise artefacts and ensure reproducibility. By following the guidelines and recommendations summarised in this work, radiologists and imaging professionals can enhance diagnostic accuracy, reduce variability, and maximise the clinical value of DWI across diverse applications.

ESR要点:欧洲医学和生物学磁共振学会的弥散加权mri实践建议。
扩散加权成像(DWI)通过评估水分子的随机位移提供了对组织微观结构的关键见解,在评估肿瘤和非肿瘤疾病中起着核心作用。为了在临床实践中成功实施和使用DWI,应遵循采集、图像对比度解释和伪影指南,同时考虑到疾病过程和身体部位。我们建议在大脑中覆盖0-1000 s/mm2的b值范围(至少沿着白质的六个方向),在身体中覆盖50-800 s/mm2。应该使用可用的采集加速选项来减少重复时间(TR)、回波时间(TE)和回波平面成像(EPI)失真,同时考虑到信噪比(SNR)和图像清晰度的损失。DW图像应与表观扩散系数(ADC)图联合阅读,以便临床解释。扩散较慢的区域在DW图像上呈高强度,在ADC地图上呈低强度,反之亦然。在空气组织或金属组织界面处,磁化率失真和信号脱落或堆积尤其明显,可能会模糊感兴趣的区域或阻碍结构扫描的共定位。通过遵循这些指南和建议,放射科医生和成像专业人员可以提高诊断准确性,减少变异性,并在各种应用中最大化DWI的临床价值。重点:本文概述了DWI原理、临床应用、潜在缺陷和新兴进展,以及专家对最佳实施的建议。我们提供针对特定应用(神经和全身成像)的关键考虑因素,包括方案优化、遵守既定指南和质量保证措施,以最大限度地减少伪影并确保可重复性。通过遵循本工作总结的指南和建议,放射科医生和成像专业人员可以提高诊断准确性,减少变异性,并在不同的应用中最大化DWI的临床价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Radiology
European Radiology 医学-核医学
CiteScore
11.60
自引率
8.50%
发文量
874
审稿时长
2-4 weeks
期刊介绍: European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
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