3分钟超快MRI和MRA方案筛选急性缺血性脑卒中

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

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引用次数: 0

摘要

目的评价3 min超快脑MRI和MRA方案对急性缺血性脑卒中的诊断价值。方法本研究纳入67例成年患者，于2023年9月至2024年6月进行了超快和参考MRI和MRA扫描，以评估卒中。两位读者独立评估了急性和慢性梗死和出血以及大血管闭塞和严重狭窄的超快和参考MRI和MRA图像，以一种隐蔽和随机的方式。采用3点Likert量表评估超快序列的诊断质量，采用Cohen’s κ评估判读器一致性。结果超快MRI和MRA方案具有较高的诊断质量，98%的序列可诊断。评分者在识别急性梗死、动脉瘤和血管闭塞方面表现出完美的一致性，在检测急性出血和严重狭窄方面表现出近乎完美的一致性（95%）。对于慢性疾病，如慢性梗死和慢性出血，κ值在0.73至0.76之间有很大的一致性。筛选超快MRI和MRA方案可以有效识别急性缺血性卒中和颅内大血管闭塞，诊断准确率高，同时显著缩短采集时间，适合卒中初始分诊。与标准MRI和MRA成像相比，超快方案对慢性病理的评价较差。

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

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.

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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.