title: Quiet diffusion-weighted head scanning: Initial clinical evaluation in ischemic stroke patients at 1.5T.
abstract: To compare the quality and diagnostic value of routine single-shot, echo-planar imaging, diffusion-weighted imaging (ss-EPI-DWI) to those of quiet readout segmented EPI-DWI (q-DWI) in magnetic resonance imaging (MRI) of acute stroke.
  
  
  
  Twenty-six patients with acute stroke underwent a 1.5T MRI including diffusion-weighted ss-EPI and q-DWI. The two sequences were protocolled to have identical spatial resolution and spatial coverage. q-DWI was tested with (regular q-DWI) and without (fast q-DWI) averaging in 13 patients each. The acoustic noise generated by each sequence was measured. Quantitative and qualitative assessments regarding signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), lesion conspicuity, level of artifacts, overall image quality as well as diagnostic content were performed.
  
  
  
  SNR and CNR values of the q-DWI scans were considerably higher than those of ss-EPI DWI (P ≤ 0.0078). No statistical difference was found for lesion conspicuity (P ≥ 0.125). Statistical differences were found for level of artifacts (P ≥ 0.0078) and overall image quality (P ≥ 0.002). Both were evaluated better in the ss-EPI DWI than in the regular and fast q-DWI. Apart from one fast q-DWI patient, radiologists voted the images to have the same diagnostic content, with upper 90% confidence limits of 0.238 for regular q-DWI and 0.429 for fast q-DWI.
  
  
  
  If the acoustic burden is critical to the patient, q-DWI is an equivalent quiet alternative to ss-EPI DWI for use in stroke patients. J. Magn. Reson. Imaging 2016;44:1238-1243.
authors.affiliation: Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany. julie.roesch@uk-erlangen.de.
authors.forename: Julie
authors.initials: J
authors.lastname: Rösch
authors.affiliation: Magnetic Resonance, Siemens Healthcare, Erlangen, Germany.|Research Center for Magnetic-Resonance-Bavaria, Wuerzburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Ott
authors.affiliation: Magnetic Resonance, Siemens Healthcare, Erlangen, Germany.|Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Bjoern
authors.initials: B
authors.lastname: Heismann
authors.affiliation: Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Arnd
authors.initials: A
authors.lastname: Doerfler
authors.affiliation: Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Engelhorn
authors.affiliation: Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Sembritzki
authors.affiliation: Magnetic Resonance, Siemens Healthcare, Erlangen, Germany.
authors.forename: David M
authors.initials: DM
authors.lastname: Grodzki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009622:Noise / Q000517:prevention & control*; D010865:Pilot Projects; D015203:Reproducibility of Results; D050794:STAT1 Transcription Factor; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D020521:Stroke / Q000000981:diagnostic imaging*
chemical_list: D050794:STAT1 Transcription Factor
keywords: DWI; EPI; RESOLVE; acoustic noise; diffusion-weighted imaging; quiet; readout segmented; silent