Details

Autor(en) / Beteiligte

• Mehan, Jr, William A
• González, R Gilberto
• Buchbinder, Bradley R
• Chen, John W
• Copen, William A
• Gupta, Rajiv
• Hirsch, Joshua A
• Hunter, George J
• Hunter, Scott
• Johnson, Jason M
• Kelly, Hillary R
• Larvie, Mykol
• Lev, Michael H
• Pomerantz, Stuart R
• Rapalino, Otto
• Rincon, Sandra
• Romero, Javier M
• Schaefer, Pamela W
• Shah, Vinil
• Kassubek, Jan

Titel

Optimal brain MRI protocol for new neurological complaint

Ist Teil von

• PloS one, 2014-10, Vol.9 (10), p.e110803-e110803

Ort / Verlag

United States: Public Library of Science

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• Patients with neurologic complaints are imaged with MRI protocols that may include many pulse sequences. It has not been documented which sequences are essential. We assessed the diagnostic accuracy of a limited number of sequences in patients with new neurologic complaints. 996 consecutive brain MRI studies from patients with new neurological complaints were divided into 2 groups. In group 1, reviewers used a 3-sequence set that included sagittal T1-weighted, axial T2-weighted fluid-attenuated inversion recovery, and axial diffusion-weighted images. Subsequently, another group of studies were reviewed using axial susceptibility-weighted images in addition to the 3 sequences. The reference standard was the study's official report. Discrepancies between the limited sequence review and the reference standard including Level I findings (that may require immediate change in patient management) were identified. There were 84 major findings in 497 studies in group 1 with 21 not identified in the limited sequence evaluations: 12 enhancing lesions and 3 vascular abnormalities identified on MR angiography. The 3-sequence set did not reveal microhemorrhagic foci in 15 of 19 studies. There were 117 major findings in 499 studies in group 2 with 19 not identified on the 4-sequence set: 17 enhancing lesions and 2 vascular lesions identified on angiography. All 87 Level I findings were identified using limited sequence (56 acute infarcts, 16 hemorrhages, and 15 mass lesions). A 4-pulse sequence brain MRI study is sufficient to evaluate patients with a new neurological complaint except when contrast or angiography is indicated.