title: Diffusion-weighted imaging with navigated interleaved echo-planar imaging and a conventional gradient system.
abstract: OBJECTIVE
  To demonstrate the technical feasibility and precision of a navigated diffusion-weighted (DW) MR imaging method with interleaved echo-planar imaging and test its diagnostic sensitivity for detection of ischemic stroke.
  
  
  METHODS
  Apparent diffusion coefficient (ADC) measurements were performed in phantoms, and six healthy adult volunteers were examined to determine intrasubject (precision) and intersubject (reference range) variations in absolute ADC and relative ADC (rADC) measurements. DW imaging maps and lesion rADC values were also obtained in 34 consecutive stroke patients to evaluate the sensitivity and reliability of DW-interleaved echo-planar imaging for detection of ischemic brain damage.
  
  
  RESULTS
  Phantom and volunteer ADC values were in excellent agreement with published data. The intrasubject variation of rADC was 6.2%. The ADC precision ranged from 6.5% in the subcortical white matter in the frontal lobe to 12.9% in the head of the caudate nucleus. Interleaved echo-planar imaging enabled rapid acquisition of high-quality images of the entire brain without substantial artifacts. Within the 1st week, the sensitivity of DW-interleaved echo-planar imaging for detection of acute infarction was 90% (18 of 20 true-positive studies) and independent of lesion location.
  
  
  CONCLUSIONS
  DW-interleaved echo-planar imaging with phase navigation and cardiac triggering is robust, reliable, and fast. With high sensitivity for detection of early ischemic infarction, it is useful for examining stroke patients by using MR systems with conventional gradient hardware.
authors.affiliation: Magnetic Resonance Institute, University of Graz, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Bammer
authors.forename: R
authors.initials: R
authors.lastname: Stollberger
authors.forename: M
authors.initials: M
authors.lastname: Augustin
authors.forename: J
authors.initials: J
authors.lastname: Simbrunner
authors.forename: H
authors.initials: H
authors.lastname: Offenbacher
authors.forename: H
authors.initials: H
authors.lastname: Kooijman
authors.forename: S
authors.initials: S
authors.lastname: Ropele
authors.forename: P
authors.initials: P
authors.lastname: Kapeller
authors.forename: P
authors.initials: P
authors.lastname: Wach
authors.forename: F
authors.initials: F
authors.lastname: Ebner
authors.forename: F
authors.initials: F
authors.lastname: Fazekas
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000033:anatomy & histology* / Q000473:pathology; D002421:Caudate Nucleus / Q000033:anatomy & histology; D002544:Cerebral Infarction / Q000175:diagnosis; D002555:Cerebrospinal Fluid; D003337:Corpus Callosum / Q000033:anatomy & histology; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D005625:Frontal Lobe / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000033:anatomy & histology; D019047:Phantoms, Imaging; D012680:Sensitivity and Specificity