Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine.
Department of Neurosurgery, Kyoto University Graduate School of Medicine.
Magn Reson Med Sci. 2022 Oct 1;21(4):583-591. doi: 10.2463/mrms.mp.2020-0174. Epub 2021 Jul 30.
Diffusion-weighted MRI (DWI) is an essential sequence for evaluating pediatric patients with moyamoya disease (MMD); however, acoustic noise associated with DWI may lead to motion artifact. Compared with conventional DWI (cDWI), quiet DWI (qDWI) is considered less noisy and able to keep children more relaxed and stable. This study aimed to evaluate the suitability of qDWI compared with cDWI for pediatric patients with MMD.
In this observational study, MR examinations of the brain were performed either with or without sedation in pediatric patients with MMD between September 2017 and August 2018. Three neuroradiologists independently evaluated the images for artifacts and restricted diffusion in the brain. The differences between qDWI and cDWI were compared statistically using a chi-square test.
One-hundred and six MR scans of 56 patients with MMD (38 scans of 15 sedated patients: 6 boys and 9 girls; mean age, 5.2 years; range, 1-9 years; and 68 scans of 42 unsedated patients: 19 boys and 23 girls; mean age, 10.7 years; range, 7-16 years) were evaluated. MR examinations were performed either with or without sedation (except in one patient). In sedated patients, no artifact other than susceptibility was observed on qDWI, whereas four artifacts were observed on cDWI (P = .04). One patient awoke from sedation during cDWI scanning, while no patient awoke from sedation during qDWI acquisition. For unsedated patients, three scans showed artifacts on qDWI, whereas two scans showed artifacts on cDWI (P = .65). Regarding restricted diffusion, qDWI revealed three cases, while two cases were found on cDWI (P = .66).
qDWI induced fewer artifacts compared with cDWI in sedated patients, and similar frequencies of artifacts were induced by qDWI and by cDWI in unsedated patients. qDWI showed restricted diffusion comparable to cDWI.
弥散加权磁共振成像（DWI）是评估儿童烟雾病（MMD）患者的基本序列；然而，与 DWI 相关的声音噪音可能会导致运动伪影。与常规 DWI（cDWI）相比，安静 DWI（qDWI）被认为噪音较小，能使儿童更加放松和稳定。本研究旨在评估 qDWI 对 MMD 患儿的适用性。
在 2017 年 9 月至 2018 年 8 月期间，对患有 MMD 的儿科患者进行了脑磁共振检查，检查时或不镇静。三位神经放射科医生独立评估了图像中的伪影和脑内受限扩散。使用卡方检验对 qDWI 和 cDWI 之间的差异进行统计学比较。
共评估了 56 例 MMD 患儿的 106 次磁共振扫描（镇静组 38 次，包括 6 名男孩和 9 名女孩，平均年龄 5.2 岁，范围 1-9 岁；未镇静组 68 次，包括 19 名男孩和 23 名女孩，平均年龄 10.7 岁，范围 7-16 岁）。除一名患者外，所有患者的磁共振检查均在镇静或不镇静下进行。在镇静组患者中，qDWI 上除了磁敏感伪影外没有观察到其他伪影，而 cDWI 上观察到 4 个伪影（P =.04）。一名患者在 cDWI 扫描过程中从镇静中醒来，而在 qDWI 采集过程中没有患者从镇静中醒来。对于未镇静组患者，qDWI 上有 3 个扫描显示伪影，而 cDWI 上有 2 个扫描显示伪影（P =.65）。关于受限扩散，qDWI 显示 3 例，cDWI 显示 2 例（P =.66）。
qDWI 引起的伪影比 cDWI 少，qDWI 和 cDWI 在未镇静患者中引起的伪影频率相似。qDWI 显示的受限扩散与 cDWI 相似。
