RT Journal Article
SR Electronic
T1 Maximum AmbiGuity Distance for Phase Imaging in Detection of Traumatic Cerebral Microbleeds: An Improvement over Current Imaging Practice
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 2027
OP 2033
DO 10.3174/ajnr.A6774
VO 41
IS 11
A1 K. Nael
A1 J.C. Dagher
A1 M.E. Downs
A1 M.S. Fine
A1 E. Brokaw
A1 D. Millward
YR 2020
UL http://www.ajnr.org/content/41/11/2027.abstract
AB BACKGROUND AND PURPOSE: Developed using a rigorous mathematic framework, Maximum AmbiGuity distance for Phase Imaging (MAGPI) is a promising phase-imaging technique that provides optimal phase SNR and reduced susceptibility artifacts. We aimed to test the potential of MAGPI over routinely used SWI in the detection of traumatic cerebral microbleeds in athletes diagnosed with mild traumatic brain injury.MATERIALS AND METHODS: In this prospective study, 10 athletes (18–22 years of age, 3 women/7 men) diagnosed with mild traumatic brain injury were enrolled. Brain MRIs were performed using 3T MR imaging at 2 days, 2 weeks, and 2 months after head trauma. The imaging protocol included whole-brain T1 MPRAGE, T2 FLAIR, conventional SWI, and the MAGPI multiecho sequence. Phase images from MAGPI were put through a previously described SWI process to generate MAGPI-SWI. Conventional and MAGPI-SWI were assessed independently by a board-certified neuroradiologist for the presence of contusions and cerebral microbleeds. All participants had routine neuropsychological assessment and Visuo-Motor Tests.RESULTS: At initial assessment, 4 of the participants had visuo-motor performance indicative of mild traumatic brain injury, and 4 participants had a Post-Concussion Symptom Scale score of >21, a threshold that has been used to define moderate impairment. Cerebral microbleeds were identified in 6 participants on MAGPI-SWI, 4 of whom had evidence of concurrent contusions on FLAIR imaging. None of these cerebral microbleeds were identified confidently on conventional SWI due to substantial distortion and susceptibility artifacts.CONCLUSIONS: Optimal phase unwrapping with reduced susceptibility in MAGPI-SWI can clarify small microbleeds that can go undetected with routinely used conventional SWI.CMBcerebral microbleedsImPACTImmediate Post-Concussion Assessment and Cognitive TestingMAGPIMaximum AmbiGuity distance for Phase ImagingmTBImild traumatic brain injuryPCSSPost-Concussion Symptom ScaleVMTVisuo-Motor Test