Quiet diffusion‐weighted head scanning: Initial clinical evaluation in ischemic stroke patients at 1.5T

PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.