TY - JOUR T1 - Clinical Application of Readout-Segmented− Echo-Planar Imaging for Diffusion-Weighted Imaging in Pediatric Brain JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1274 LP - 1279 DO - 10.3174/ajnr.A2481 VL - 32 IS - 7 AU - S.J. Holdsworth AU - K. Yeom AU - S. Skare AU - A.J. Gentles AU - P.D. Barnes AU - R. Bammer Y1 - 2011/08/01 UR - http://www.ajnr.org/content/32/7/1274.abstract N2 - BACKGROUND AND PURPOSE: RS-EPI has been suggested as an alternative approach to EPI for high-resolution DWI with reduced distortions. To determine whether RS-EPI is a useful approach for routine clinical use, we implemented GRAPPA-accelerated RS-EPI DWI at our pediatric hospital and graded the images alongside standard accelerated (ASSET) EPI DWI used routinely for clinical studies. MATERIALS AND METHODS: GRAPPA-accelerated RS-EPI DWIs and ASSET EPI DWIs were acquired on 35 pediatric patients using a 3T system in 35 pediatric patients. The images were graded alongside each other by using a 7-point Likert scale as follows: 1, nondiagnostic; 2, poor; 3, acceptable; 4, standard; 5, above average; 6, good; and 7, outstanding. RESULTS: The following were the average scores for EPI and RS-EPI, respectively: resolution, 3.5/5.2; distortion level, 2.9/6.0; SNR, 3.4/4.1; lesion conspicuity, 3.3/5.9; and diagnostic confidence, 3.2/6.0. Overall, the RS-EPI had significantly improved diagnostic confidence and more reliably defined the extent and structure of several lesions. Although ASSET EPI scans had better SNR per scanning time, the higher spatial resolution as well as reduced blurring and distortions on RS-EPI scans helped to better reveal important anatomic details at the cortical-subcortical levels, brain stem, temporal and inferior frontal lobes, skull base, sinonasal cavity, cranial nerves, and orbits. CONCLUSIONS: This work shows the importance of both resolution and decreased distortions in the clinics, which can be accomplished by a combination of parallel imaging and alternative k-space trajectories such as RS-EPI. ASSETarray spatial sensitivity encoding techniqueDTIdiffusion tensor imagingDWIdiffusion-weighted imagingEPIecho-planar imagingFSEfast spin-echoGRAPPAgeneralized autocalibrating partially parallel acquisitionPROPELLERperiodically rotated overlapping parallel lines with enhanced reconstructionRS-EPIreadout-segmented−echo-planar imagingSNRsignal intensity–to-noise ratioTEminminimum TE ER -