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European Radiology

, Volume 28, Issue 9, pp 3840–3847 | Cite as

Three-dimensional black-blood contrast-enhanced MRI improves detection of intraluminal thrombi in patients with acute ischaemic stroke

  • Won Jang
  • Hyo Sung Kwak
  • Gyung Ho Chung
  • Seung Bae Hwang
Head and Neck

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

Keywords

Magnetic resonance imaging Stroke Thrombosis Brain Cerebral arteries 

Abbreviations

ASPECT

Alberta Stroke Program Early CT Score

BB

Black blood

iMSDE

Improved motion-sensitised driven-equilibrium

VISTA

Volumetric isotropic turbo spin-echo acquisition

Notes

Funding

This study has received funding by Guerbet.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Hyo Sung Kwak.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

• prospective

• diagnostic or prognostic study

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Radiology and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University HospitalJeonju-siRepublic of Korea

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