TY - JOUR
T1 - Interobserver Reliability on Intravoxel Incoherent Motion Imaging in Patients with Acute Ischemic Stroke
AU - Yamashita, Koji
AU - Kamei, R.
AU - Sugimori, H.
AU - Kuwashiro, T.
AU - Tokunaga, S.
AU - Kawamata, K.
AU - Furuya, K.
AU - Harada, S.
AU - Maehara, J.
AU - Okada, Y.
AU - Noguchi, T.
N1 - Funding Information:
Received November 10, 2021; accepted after revision February 11, 2022. From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.), Cerebrovascular Medicine and Neurology (H.S., T.K., Y.O.), Neuroendovascular Therapy (S.T.), Clinical Research Institute, and Medical Technology (K.K.), Division of Radiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. This work was supported by Nishikawa Medical Foundation, and the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number 22K07657. Please address correspondence to Koji Yamashita, MD, PhD, Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-0065 Japan; e-mail: yamakou@radiol.med.kyushu-u.ac.jp
Publisher Copyright:
© 2022 American Society of Neuroradiology. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - BACKGROUND AND PURPOSE: Noninvasive perfusion-weighted imaging with short scanning time could be advantageous in order to determine presumed penumbral regions and subsequent treatment strategy for acute ischemic stroke (AIS). Our aim was to evaluate interobserver agreement and the clinical utility of intravoxel incoherent motion MR imaging in patients with acute ischemic stroke. MATERIALS AND METHODS: We retrospectively studied 29 patients with AIS (17 men, 12 women; mean age, 75.2 [SD, 12.0 ] years; median, 77 years). Each patient underwent intravoxel incoherent motion MR imaging using a 1.5T MR imaging scanner. Diffusion-sensitizing gradients were applied sequentially in the x, y, and z directions with 6 different b-values (0, 50, 100, 150, 200, and 1000 seconds/mm2). From the intravoxel incoherent motion MR imaging data, diffusion coefficient, perfusion fraction, and pseudodiffusion coefficient maps were obtained using a 2-step fitting algorithm based on the Levenberg-Marquardt method. The presence of decreases in the intravoxel incoherent motion perfusion fraction and pseudodiffusion coefficient values compared with the contralateral normal-appearing brain was graded on a 2-point scale by 2 independent neuroradiologists. Interobserver agreement on the rating scale was evaluated using the k statistic. Clinical characteristics of patients with a nondecreased intravoxel incoherent motion perfusion fraction and/or pseudodiffusion coefficient rated by the 2 observers were also assessed. RESULTS: Interobserver agreement was shown for the intravoxel incoherent motion perfusion fraction (k = 0.854) and pseudodiffusion coefficient (k = 0.789) maps, which indicated almost perfect and substantial agreement, respectively. Patients with a nondecreased intravoxel incoherent motion perfusion fraction tended to show recanalization of the occluded intracranial arteries more frequently than patients with a decreased intravoxel incoherent motion perfusion fraction. CONCLUSIONS: Intravoxel incoherent motion MR imaging could be performed in < 1 minute in addition to routine DWI. Intravoxel incoherent motion parameters noninvasively provide feasible, qualitative perfusion-related information for assessing patients with acute ischemic stroke.
AB - BACKGROUND AND PURPOSE: Noninvasive perfusion-weighted imaging with short scanning time could be advantageous in order to determine presumed penumbral regions and subsequent treatment strategy for acute ischemic stroke (AIS). Our aim was to evaluate interobserver agreement and the clinical utility of intravoxel incoherent motion MR imaging in patients with acute ischemic stroke. MATERIALS AND METHODS: We retrospectively studied 29 patients with AIS (17 men, 12 women; mean age, 75.2 [SD, 12.0 ] years; median, 77 years). Each patient underwent intravoxel incoherent motion MR imaging using a 1.5T MR imaging scanner. Diffusion-sensitizing gradients were applied sequentially in the x, y, and z directions with 6 different b-values (0, 50, 100, 150, 200, and 1000 seconds/mm2). From the intravoxel incoherent motion MR imaging data, diffusion coefficient, perfusion fraction, and pseudodiffusion coefficient maps were obtained using a 2-step fitting algorithm based on the Levenberg-Marquardt method. The presence of decreases in the intravoxel incoherent motion perfusion fraction and pseudodiffusion coefficient values compared with the contralateral normal-appearing brain was graded on a 2-point scale by 2 independent neuroradiologists. Interobserver agreement on the rating scale was evaluated using the k statistic. Clinical characteristics of patients with a nondecreased intravoxel incoherent motion perfusion fraction and/or pseudodiffusion coefficient rated by the 2 observers were also assessed. RESULTS: Interobserver agreement was shown for the intravoxel incoherent motion perfusion fraction (k = 0.854) and pseudodiffusion coefficient (k = 0.789) maps, which indicated almost perfect and substantial agreement, respectively. Patients with a nondecreased intravoxel incoherent motion perfusion fraction tended to show recanalization of the occluded intracranial arteries more frequently than patients with a decreased intravoxel incoherent motion perfusion fraction. CONCLUSIONS: Intravoxel incoherent motion MR imaging could be performed in < 1 minute in addition to routine DWI. Intravoxel incoherent motion parameters noninvasively provide feasible, qualitative perfusion-related information for assessing patients with acute ischemic stroke.
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U2 - 10.3174/ajnr.A7486
DO - 10.3174/ajnr.A7486
M3 - Article
C2 - 35450854
AN - SCOPUS:85130005460
SN - 0195-6108
VL - 43
SP - 696
EP - 700
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 5
ER -