The value of b0 images obtained from diffusion-weighted echo planar sequences for the detection of intracranial hemorrhage compared with GRE sequence

AbstractPurposeOur aim was to evaluate the clinical utility of b0EPI images obtained from diffusion sequence for the detection of the intracranial hemorrhagic lesions, especially acute intracerebral bleeds thereby shorten the scan time particularly in the critical acute cases of stroke.Materials and methodsAmong all consecutive MR brain studies performed in our department last year, we retrospectively selected those who followed the following criteria: (1) clinically suspected or radiographically confirmed acute infarction or hemorrhage. (2) MRI imaging including DWI and T2∗ images. Sensitivity of hemorrhage detection, conspicuity of lesions, and diagnostic certainty were compared between the b0EPI and GRE sequences.ResultsThere were 77 hemorrhagic lesions with a variety of pathogeneses in various locations. 76/77 (98.7%) of these lesions were hemorrhagic (hypointense) on the GRE sequences, whereas 61 (79.2%) were characterized as hemorrhagic on b0EPI images, and 16 (20.8%) were not detected. The overall difference in hemorrhage conspicuity/diagnostic certainty between GRE and b0EPI sequences was statistically significant (P<.05).Conclusionb0EPI sequence, although shorter in acquisition time, was inferior to GRE imaging in the detection of acute and chronic intracerebral hemorrhage

Diffusion-weighted MR imaging and ADC measurement in normal prostate, benign prostatic hyperplasia and prostate carcinoma

Purpose: Our aim was to investigate the diffusion-weighted Imaging (DWI) appearance and apparent diffusion coefficient (ADC) values of normal prostatic gland, prostate carcinoma (PCa) and benign prostate hyperplasia (BPH) and to determine the utility of DWI in their characterization. Materials and methods: During a period of 16 months, 40 consecutive patients, with elevated PSA level and 12 healthy volunteers with no clinical symptoms or history of prostate disease were prospectively evaluated with DWI of the prostate. MRI was performed using a 1.5T MR scanner equipped with a pelvic phased array coil. For anatomical imaging, T2W FSE in the three orthogonal planes, and T1WI in axial plane were obtained. DWI with b values of 0, 300, 500 and 800 s/mm2 were performed in axial plane. The results were confirmed by TRUS-guided biopsy or prostatectomy. Results: Patients ranged in age from 45 to 85 years (mean 66.6 ± 7.9 year). Twenty patients were confirmed to have BPH, whereas 20 patients had PCa. The mean and SD of ADC values for the peripheral zone (PZ), central gland (CG), BPH nodules and PCa were 1.839 ± 0.233, 1.469 ± 0.239, 1.359 ± 0.201 and 0.87 ± 0.13 respectively. The mean ADC value of PCa was significantly lower than that of CG, PZ, and BPH nodule, with p value <0.05. Conclusion: DW MR imaging characteristics and ADC values can differentiate PCa and BPH. DWI with ADC may be used as a complementary method to conventional MRI in diagnosis of PCa and BPH

Predicting grade of cerebral gliomas using Myo-inositol/Creatine ratio

Purpose: Our aim was to determine the diagnostic accuracy of MI/Cr ratio in determining the grade of glioma. Materials and methods: Twenty-two patients (14 males and 8 females), ranging in age from 15–63 years (mean 34.4 years) were prospectively recruited for this study. All had a brain tumor recently diagnosed by MRI and had received no previous treatment, except for steroids. They were referred for MRS examination before surgical biopsy and/or resection or radiotherapy. Ratios for MI/Cr, Cho/Cr, and Cho/NAA were obtained for each lesion and compared with the grade of the lesion. Results: The levels of MI/Cr were higher (2.14 ± 1.4) in patients with low-grade astrocytoma, and lower in patients with anaplastic astrocytoma (0.39 ± 0.11) and GBM (0.025 ± 0.06). 21 out of the 22 patients were correctly classified using MI/Cr ratio, one patient was misdiagnosed as high grade glioma and the biopsy revealed grade II glioma. The diagnostic accuracy, sensitivity and specificity of MI/Cr ratio for the grading of glioma was 95.4%, 100%, and 92.8%, respectively. Conclusion: MRS has proven to be an important complementary tool saving the patient from unnecessary biopsy taking when it is conclusive thus altering the treatment planning. This study had demonstrated that MI level and MI/Cr ratio are important in presurgical grading of brain tumors