Inter- and intraobserver reliability of five MRI sequences in the evaluation of the final volume of cerebral infarct.
J. Magn. Reson. Imaging. 2009-06-01; 29(6): 1280-1284
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1. J Magn Reson Imaging. 2009 Jun;29(6):1280-4. doi: 10.1002/jmri.21779.
Inter- and intraobserver reliability of five MRI sequences in the evaluation of
the final volume of cerebral infarct.
Sibon I(1), Ménégon P, Orgogozo JM, Asselineau J, Rouanet F, Renou P, Tourdias T,
Pachai C, Chêne G, Dousset V.
(1)CHU Bordeaux, Department of Clinical Neurosciences, Bordeaux, France.
PURPOSE: To evaluate the reproducibility of fluid attenuated inversion recovery
(FLAIR) and four other magnetic resonance imaging (MRI) sequences in the
quantitative assessment of final cerebral infarct volume.
MATERIALS AND METHODS: FLAIR, T1-3D, magnetization transfer ratio (MTR)-map,
diffusion-weighted trace (DWI)-trace, and apparent diffusion coefficient
(ADC)-map, were acquired and measured in 33 patients 30-45 days after onset of a
first-ever ischemic stroke. The infarct area was visually detected and manually
delineated two times by two readers separately after images and sequences
randomization. The reliability was assessed by using an intraclass correlation
coefficient (ICC) and its two-sided 95% confidence interval (95% CI).
RESULTS: DWI-trace had the best reliability, with an ICC of 0.96 (95% CI =
0.93-0.98). FLAIR had an ICC of 0.86 (95% CI = 0.73-0.93), and a much higher
volume. T1-3D, MTR-map and ADC-map had lower reliability or excessive volume
values equal to 0 in comparison to DWI-trace.
CONCLUSION: DWI-trace performed within 30th and 45th day following onset of acute
ischemic stroke was the most reliable sequence for final infarct volume
quantification. This sequence should be added to FLAIR evaluation to strengthen
the statistical results of the pharmacological trials and reduce their
PMID: 19472382 [Indexed for MEDLINE]