Abstract
Objectives
This study evaluated the utility of three-dimensional (3D), black-blood (BB), contrast-enhanced, magnetic resonance imaging (MRI) for the detection of intraluminal thrombi in acute stroke patients.
Methods
Forty-seven patients with acute stroke involving the anterior circulation underwent MRI examination within 6 h of clinical onset. Cerebral angiography was used as the reference standard. In a blinded manner, two neuroradiologists interpreted the following three data sets: (1) diffusion-weighted imaging (DWI) + 3D BB contrast-enhanced MRI; (2) DWI + susceptibility weighted imaging (SWI); (3) DWI + 3D BB contrast-enhanced MRI + SWI.
Results
Of these patients, 47 had clots in the middle cerebral artery and four had clots in the anterior cerebral artery. For both observers, the area under the curve (Az) for data sets 1 and 3, which included 3D BB contrast-enhanced MRI, was significantly greater than it was for data set 2, which did not include 3D BB contrast-enhanced MR imaging (observer 1, 0.988 vs 0.904, p = 0.001; observer 2, 0.988 vs 0.894, p = 0.000).
Conclusions
Three-dimensional BB contrast-enhanced MRI improves detection of intraluminal thrombi compared to conventional MRI methods in patients with acute ischaemic stroke.
Key Points
• BB contrast-enhanced MRI helps clinicians to assess the intraluminal clot
• BB contrast-enhanced MRI improves detection of intraluminal thrombi
• BB contrast-enhanced MRI for clot detection has a higher sensitivity
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Change history
19 November 2018
The original version of this article, published on 19 March 2018, unfortunately contained a mistake. In the section “MR examination,” the contrast medium Gadoterate meglumine was incorrectly named Gadodiamide.
19 November 2018
The original version of this article, published on 19 March 2018, unfortunately contained a mistake. In the section ���MR examination,��� the contrast medium Gadoterate meglumine was incorrectly named Gadodiamide.
Abbreviations
- ASPECT:
-
Alberta Stroke Program Early CT Score
- BB:
-
Black blood
- iMSDE:
-
Improved motion-sensitised driven-equilibrium
- VISTA:
-
Volumetric isotropic turbo spin-echo acquisition
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Funding
This study has received funding by Guerbet.
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The scientific guarantor of this publication is Hyo Sung Kwak.
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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
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No complex statistical methods were necessary for this paper.
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Written informed consent was waived by the Institutional Review Board.
Methodology
• prospective
• diagnostic or prognostic study
• performed at one institution
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Jang, W., Kwak, H.S., Chung, G.H. et al. Three-dimensional black-blood contrast-enhanced MRI improves detection of intraluminal thrombi in patients with acute ischaemic stroke. Eur Radiol 28, 3840–3847 (2018). https://doi.org/10.1007/s00330-018-5323-4
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DOI: https://doi.org/10.1007/s00330-018-5323-4