Advantages of high b-value diffusion-weighted imaging to diagnose pseudo-responses in patients with recurrent glioma after bevacizumab treatment

Background

The diagnosis of pseudo-responses after bevacizumab treatment is difficult. Because diffusion-weighted imaging (DWI) is associated with cell density, it may facilitate the differentiation between true- and pseudo-responses. Furthermore, as high b-value DWI is even more sensitive to diffusion, it has been reported to be diagnostically useful in various clinical settings.

Materials and methods

Between September 2008 and May 2011, 10 patients (5 males, 5 females; age range 6–65 years) with recurrent glioma were treated with bevacizumab. All underwent pre- and post-treatment MRI including T2- or FLAIR imaging, post-gadolinium contrast T1-weighted imaging, and DWI with b-1000 and b-4000. Response rates were evaluated by MacDonald- and by response assessment in neuro-oncology working group (RANO) criteria. We also assessed the response rate by calculating the size of high intensity areas using high b-value diffusion-weighted criteria. Prognostic factors were evaluated using Kaplan–Meier survival curves (log-rank test).

Results

It was easier to identify pseudo-responses with RANO- than MacDonald criteria, however the reduction of edema by bevacizumab rendered the early diagnosis of tumor progression difficult by RANO criteria. In some patients with recurrent glioma treated with bevacizumab, high b-value diffusion-weighted criteria did, while MacDonald- and RANO criteria did not identify pseudo-responses at an early point after the start of therapy.

Discussion and conclusion

High b-value DWI reflects cell density more accurately than regular b-value DWI. Our findings suggest that in patients with recurrent glioma, high b-value diffusion-weighted criteria are useful for the differentiation between pseudo- and true responses to treatment with bevacizumab.     

Preoperative histological grading of meningiomas using apparent diffusion coefficient at 3T MRI

Purpose

We assessed whether a high b-value DWI at b = 4000 s/mm² would discriminate the histopathological differentiation of the tumor grade of meningiomas, and also focused on the relationship between radiologic features and the tumor grade.

Materials and methods

We acquired DWI at 3T with b = 1000 and b = 4000 s/mm² in 77 patients (42, 31 and 4 patients were WHO grades I (G1), II (G2), and III (G3), respectively). The apparent diffusion coefficient (ADC) was measured by placing multiple regions of interest (ROIs) on ADC maps. The ADC values of each tumor were determined preoperatively from several ROIs, and expressed as the minimum (ADC_MIN), mean (ADC_MEAN), and maximum absolute values (ADC_MAX). We evaluated the relationship between ADCs and histological findings, and assessed the radiologic features such as tumor location, tumor size, presence/absence of peritumoral edema, shape of the tumor, presence/absence of bone destruction or hyperplasia, status of contrast enhancement, presence/absence of calcification and cyst.

Results

ADCs of the meningiomas were inversely correlated with the histological grade of meningiomas. According to results of the discriminant analysis, the apparent log likelihood value was greatest for ADC_MIN at b = 4000. Furthermore, only the ADC_MIN value at b = 4000 was significantly correlated with the histological grade of meningiomas when we performed a multiple logistic regression analysis to identify the significant independent factors such as shape of tumor, presence/absence of bone destruction, status of contrast enhancement, presence/absence of cyst and ADC_MIN at b = 4000.

Conclusion

A meningioma with a low ADC_MIN at a high b-value might imply a high-grade meningioma.     

Application of contrast agents in the evaluation of stroke: Conventional MR and echo-planar MR imaging

The availability of new therapeutic interventions, including neuroprotective agents and endovascular thrombolysis, has given new hope to patients suffering an acute stroke. Early intervention remains a key factor in the effectiveness of these new and traditional treatments. More importantly, the capability to assess the viability and reversibility of the ischemic tissue became essential for better delineation and differentiation of infarcted versus ischemic tissue and patient management. Abnormal MR imaging (MRI) findings during acute stroke usually reflect the underlying pathophysiologic changes, which can be classified into three sequential stages: (a) hypoperfusion, (b) cellular dysfunction and (c) breakdown of the blood-brain barrier. The first stage is a kinetic phenomenon (not biologic) and, therefore, can be detected immediately. Contrast agents accentuate the abnormal flow kinetics and facilitate the early diagnosis of ischemia using either conventional MRI or newly developed echo-planar perfusion imaging (EPPI). The demonstration of abnormal arterial or parenchymal enhancement on conventional MRI during acute stroke provides the earliest sign of vascular occlusion/stenosis. EPPI, in contrast, provides information related to microcirculation (< 100 microns) and tissue reserve (cerebral blood volume) that cannot be obtained by conventional angiography and is directly related to the target end-organ. Further information obtained from both contrast MRI and EPPI may have a predictive value in the clinical outcome of acute stroke patients.     

High b-value diffusion-weighted MR imaging of normal brain at 3T

Introduction

The purpose of this study was to determine the normative apparent diffusion coefficient (ADC) values at 3 T using high b-value (3000 s/mm²) diffusion-weighted images (DWI) and compare the signal characteristics of the high b value with standard b-value (1000 s/mm²) DWI.

Methods

Institutional review board approval was obtained for this prospective study which included 20 volunteers (10 M, 10 F, mean age: 38.7 ± 14.9) without any known clinical disease or radiological findings. All brain examinations were performed with 3 T MR by using similar parameters of b1000 and b3000 DWI sequences. DWI and ADC maps were obtained. Signal intensity, noise, signal to noise ratio (SNR), contrast to noise (CNR), contrast ratio (CR), and ADC values of bilateral posterior limb of internal capsule, frontal white matter, parietal gray matter, pons, thalamus, splenium of corpus callosum were measured on b1000 and b3000 DW images.

Results

In all anatomic locations, MR signal intensity, SNR and ADC values of b3000 images were significantly lower than MR signal intensity, SNR and ADC values of b1000 images (p < 0.001). The CNR and CR values at the posterior limb of internal capsule and pons were significantly increased on b3000 images (p < 0.001) and decreased in the other regions measured.

Conclusion

The ADC values calculated from standard b-value DWI were significantly higher than those calculated from high b-value DWI. These results agree with the previous studies. In the regions where CNR values increase with high b value, b3000 DWI images may provide additional clinical information.     

Histological correlation of 7 T multi-parametric MRI performed in ex-vivo Achilles tendon

Introduction

The goal of this in vitro validation study was to investigate the feasibility of biochemical MRI techniques, such as sodium imaging, T₂ mapping, fast imaging with steady state precession (FISP), and reversed FISP (PSIF), as potential markers for collagen, glycosaminoglycan and water content in the Achilles tendon.

Materials and methods

Five fresh cadaver ankles acquired from a local anatomy department were used in the study. To acquire a sodium signal from the Achilles tendon, a 3D-gradient-echo sequence, optimized for sodium imaging, was used with TE = 7.71 ms and TR = 17 ms. The T₂ relaxation times were obtained using a multi-echo, spin-echo technique with a repetition time (TR) of 1200 ms and six echo times. A 3D, partially balanced, steady-state gradient echo pulse sequence was used to acquire FISP and PSIF images, with TR/TE = 6.96/2.46 ms. MRI parameters were correlated with each other, as well as with histologically assessed glycosaminoglycan and water content in cadaver Achilles tendons.

Results

The highest relevant Pearson correlation coefficient was found between sodium SNR and glycosaminoglycan content (r = 0.71, p = 0.007). Relatively high correlation was found between the PSIF signal and T₂ values (r = 0.51, p = 0.036), and between the FISP signal and T₂ values (r = 0.56, p = 0.047). Other correlations were found to be below the moderate level.

Conclusion

This study demonstrated the feasibility of progressive biochemical MRI methods for the imaging of the AT. A GAG-specific, contrast-free method (sodium imaging), as well as collagen- and water-sensitive methods (T₂ mapping, FISP, PSIF), may be used in fast-relaxing tissues, such as tendons, in reasonable scan times.     

Effect of gadolinium chelate contrast agents on diffusion weighted MR imaging of the liver, spleen, pancreas and kidney at 3 T

Purpose

To retrospectively test the null hypotheses that the qualitative appearance of DWI and the signal intensity values in DWI and corresponding ADC values of the liver, spleen, pancreas and kidneys are identical before and after the administration of gadolinium.

Materials and methods

Following IRB approval, DWI was acquired in 50 patients (25 male; mean age 54.9 years) prior to and after contrast administration, using single-shot echo planar imaging with b-values of 50 s/mm² and 800 s/mm² at 3 T. Binomial analysis was used to determine which image set was more significantly preferred in conveying the diffusion information. Pre- and post-gadolinium DWI and ADC values of corresponding regions of each organ were analyzed using standardized signal intensity measurements.

Results

Pre-contrast DWI images of the liver, spleen, and pancreas were preferred 52%, 49%, and 58%, respectively, with none of the differences being statistically significant. DWI of the kidneys was preferred on pre-contrast images in 83% (p < 0.001). In the liver and spleen, contrast caused a significant increase in the post-contrast DWI signal intensity values at b = 50 (p < 0.02) and b = 800 (p < 0.05) but had no statistically significant effect on the ADC value (p > 0.40). Pancreatic DWI signal intensity and ADC values pre- and post-contrast were also not significantly different (p = 0.489). In the renal parenchyma, significant decrease in the values of DWI at b = 50 (p < 0.01) and b = 800 (p < 0.01) as well as ADC (p < 0.02) was demonstrated following gadolinium administration.

Conclusion

Intravenous gadolinium administration does not make a statistically significant difference in the qualitative appearance or ADC measurements of the liver, spleen, or pancreas when comparing pre-contrast to post-contrast DWI. In the kidneys, however, ADC values are significantly lower post-contrast with the pre-contrast diffusion weighted images also being qualitatively preferred.     

Investigation of mechanisms underlying transient T2 normalization in longitudinal studies of ischemic stroke

PURPOSE: To determine if the phenomenon of transient normalization of T2 relaxation in the subacute stage of ischemic stroke is associated with either magnetic susceptibility effects secondary to hemorrhage or changes in tissue water content. MATERIALS and METHODS: We utilized a rat model of transient, focal, cerebral ischemia. The possibility of hemorrhage was evaluated with T2*-weighted (T2*W) imaging and histology. Changes in water content were assessed by brain wet-to-dry weight. RESULTS: Susceptibility effects were not evident in T2*W images, and neither red blood cells nor unchelated Fe(III) was found in hematoxylin and eosin (H-E)- or Prussian Blue-stained sections, respectively. However, between the peak of T2 contrast and the point of transient T2 normalization, water content consistently decreased by an average of 3%. CONCLUSION: Transient T2 normalization is associated with normalization of water content and can occur without evidence of hemorrhage.     

定量磁敏感加权成像在急性缺血性脑卒中的应用进展

磁敏感加权成像(SWI)对显示静脉、血液成分、钙化、铁沉积等非常敏感,已广泛应用于脑血管病的诊断。近年来,定量SWI对急性缺血性脑卒中进行早期诊断及评估成为热点。SWI优势在于显示急性缺血性脑卒中血栓、不对称显著皮质静脉征、不对称深髓质静脉以及对急性缺血性脑卒中后血氧饱和度变化的判断,进而指导临床治疗及提示预后。主要综述定量磁敏感加权成像在急性缺血性脑卒中的应用。     

磁敏感加权成像突出血管征对急性缺血性卒中缺血半暗带的评估价值

目的探讨磁敏感加权成像(SWI)上的突出血管征(PVS)对急性缺血性卒中(AIS)病人缺血半暗带的评估价值。方法连续选取32例发病9 h以内大血管严重狭窄或闭塞脑梗死溶栓分级(TICI)为0~1级并完成多模态MRI检查的病人,其中男23例,女9例,中位年龄59岁。用ASPECTS评分对扩散加权成像(DWI)、SWI及平均通过时间(MTT)异常区域进行评分。将DWI正常/SWI异常和SWI异常>DWI异常的区域定义为缺血半暗带区域。采用Wilcoxon符号秩和检验分别比较大脑半球、基底节区域的PVS与MTT评分的差异;采用Spearman相关分析评估DWI-PVS与DWI-MTT、m DWI-PVS与m DWI-MTT的相关性。结果 DWI-PVS与DWI-MTT呈正相关(r=0.433,P=0.013),m DWI-PVS与m DWI-MTT明显正相关(r=0.502,P=0.003);PVS与MTT对大脑半球评分差异无统计学意义(P=0.395),对基底节区域的评分的差异有统计学意义(P=0.029)。结论对于大血管严重狭窄或闭塞的AIS病人,PVS可以用于缺血半暗带评估且对大脑半球区域缺血半暗带的判断更准确。     

Lymphomas and glioblastomas: differences in the apparent diffusion coefficient evaluated with high b-value diffusion-weighted magnetic resonance imaging at 3T

Background and purpose

As the usefulness of the apparent diffusion coefficient (ADC) obtained from diffusion-weighted images (DWI) for the differential diagnosis between glioblastoma and primary central nervous system lymphoma is controversial, we assessed whether high b-value DWI at b 4000 s/mm² could discriminate between glioblastoma and lymphoma. We also compared the power of high- and standard b-value (b-4000, b-1000) imaging on a 3-Tesla (3 T) magnetic resonance (MR) instrument.

Materials and methods

This study was approved by our Institutional Review Board. We acquired DWI at 3 T with b = 1000 and b = 4000 s/mm² in 10 patients with lymphoma and 14 patients with glioblastoma. The ADC was measured by placing multiple regions of interest (ROI) on ADC maps of the site of enhanced lesions on contrast-enhanced T1-weighted MR images. We avoided hemorrhagic and cystic lesions by using T1-, T2-, FLAIR-, and T2* MR images. The ADC values of each tumor were determined preoperatively from several ROI and expressed as the minimum-, mean-, and maximum ADC value (ADC_MIN, ADC_MEAN, ADC_MAX). We evaluated the relationship between ADCs and histological information including tumor cellularity.

Results

All ADC values were statistically associated with tumor cellularity. ADC_MIN at b-4000 was associated with tumor cellularity more significantly than ADC_MIN at b-1000. All ADC values were lower for lymphoma than glioblastoma and the statistical difference was larger at b = 4000- than b = 1000 s/mm². According to the results of discriminant analysis, the log likelihood was greatest for ADC_MIN at b = 4000. At a cut-off value of ADC_MIN = 0.500 × 10⁻³ mm²/s at b-4000 it was possible to differentiate between lymphoma and glioblastoma (sensitivity 90.9%, specificity 91.7%).

Conclusions

Calculating the ADC value is useful for distinguishing lymphoma from glioblastoma. The lowest degree of overlapping and a better inverse correspondence with tumor cellularity were obtained with ADC_MIN at b-4000 s/mm² at 3 T MRI.     

Dynamic pelvic floor MR imaging at 3 T in patients with clinical signs of urinary incontinence-preliminary results

To prospectively evaluate feasibility, image quality and diagnostic accuracy of dynamic MR imaging the pelvic floor at 3.0 T in patients with urinary incontinence and to compare these results with those of MRI performed at 1.5 T. Ten patients with the diagnosis of urinary incontinence (clinical symptoms, clinical examination, pelvic ultrasound) were examined with a dynamic balanced FFE (B-FFE) sequence at 1.5 T and 3.0 T on the same day in a randomized order. Spatial (1.5 × 1.5 × 8 mm) and temporal (0.44 s) resolution at 3.0 T were comparable to the 1.5-T B-FFE sequence. Two radiologists assessed visual signal to noise (three-point scale), artefact level (five-point scale) and final MR diagnoses with regard to pelvic floor weakness (independent analysis). The diagnoses obtained at 1.5-T field strength and the results of the clinical tests served as standard of reference. In addition, ROI-based quantitative measurements were performed to assess different tissue contrasts at both field strengths. Data were analyzed for statistical differences by using the Wilcoxon's matched pairs test and the marginal homogeneity test. Visual signal to noise was rated higher at 3.0 T for all ten studies by both radiologists. With regard to artefact level, there was no statistically significant difference between the studies obtained at 3.0 T as compared to the corresponding 1.5-T studies (marginal homogeneity test: p = 0.18 for reviewer 1 and 0.41 for reviewer 2). Mean artefact level was rated minor to moderate by both reviewers for both field strengths (excellent interobserver agreement with Kendall-W value of 0.973). Except for a higher tissue contrast between fat and urethra at 1.5 T, there were no statistically significant differences between tissue contrast at 1.5 T as compared to 3.0 T (Wilcoxon's test). Final MR diagnoses regarding pelvic floor weakness did not differ between 3.0-T and 1.5-T field strength and correlated well with the results of the clinical tests. Dynamic pelvic floor MR imaging is feasible at 3.0 T. Our preliminary data indicate that evaluation of pelvic floor disease seems to be possible with 3.0 T equally well as compared to 1.5 T.     

3D-CUBE T1和SWI对急性缺血性脑卒中动脉血栓诊断的临床价值

目的探讨3D-CUBE T₁与SWI对急性缺血性脑卒中(AIS)责任动脉血栓的临床价值。方法选取AIS(0～7天)患者71例,行DWI、MRA、SWI和矢状位3D-CUBE T₁全脑扫描,并对SWI原始图像进行最小强度投影(MinIP)的轴位重建。3D-CUBE T₁原始图像采用MIP重组出轴位、冠状位、矢状位、斜位和曲面重建。采用Χ²检验比较AIS的SWI的动脉磁敏感征(SVS)和3D CUBE T₁的高信号血管征(CUBE vascular hyperintensity, CVH)责任动脉血栓阳性率,分析上述2种成像方法对责任动脉血栓的检出率。结果 71例AIS患者的超急性期8例、急性期42例和亚急性早期21例。在71例AIS患者中有74根责任血管,SWI显示45根SVS征,其中MCA 35根、ICA 0根、ACA 2根、PCA 4根、VA 3根、BA 1根。3D CUBE T₁显示有67根CVS征,其中MCA 34根、ICA 12根、ACA 2根、P...     

人工智能在急性缺血性脑卒中成像中的应用进展

人工智能(AI)技术可采用多种算法模拟人类认知和信息处理过程,与CT和MRI相结合可用于急性缺血性脑卒中成像,包括梗死灶的检测、影像分割、头颈大血管闭塞的检测和病人预后预测等。采用AI技术分析或构建模型有助于临床医师对脑卒中病人的尽早诊疗、及时干预和随访评估。概述AI的概念,并就其在急性缺血性脑卒中病人CT平扫、CT血管成像(CTA)、CT灌注成像(CTP)、MRI中的应用进展进行综述。     

L X-ray fluorescence cross sections experimentally determined for elements with 45<Z<50 at 9 keV

Experimental determination of L fluorescence cross-sections for elements with 45<Z<50 have been determined at 9 keV using Synchrotron radiation. This work is part of an investigation we did at low energies in the same group of elements. The individual L X-ray photons, Ll, Lα, Lβ_I, Lβ_II, Lγ_Ι and Lγ_ΙΙ produced in the target were measured using a Si(Li) detector. The experimental set-up provided a low background by using linearly polarized monoenergetic photon beam, improving the signal-to-noise ratio. The experimental cross sections obtained in this work were compared with data calculated using coefficients from Scofield (1973), Krause et al., (1978), Krause (1979) and Scofield and Puri et al. (1993, 1995)     

缺血性中风患者急性期DWI影像ADC值与中医证候的关系探讨

目的:通过观察缺血性中风患者急性期扩散加权成像(DWI)ADC值的变化,对照其中医证候变化,探究二者的相关性。方法:选择符合纳入标准的缺血性中风急性期患者60例,按中医证候标准分为风、火热、痰、瘀、气虚、阴虚阳亢六大证候,观察发病6～48 h及10 d时的证候变化。同时分别于发病6～48 h及10 d时检查ADC值,并与证候值的变化比较,进行统计学处理。结果:各证候的ADC值在发病6～48 h内组间比较差异无统计学意义;发病10 d时均明显升高,与发病6～48 h比较差异有统计学意义(P<0.05),组间比较风证和火热证的ADC值升高明显,较其他证候差异有统计学意义(P<0.05)。结论:中医证候的演变与ADC值有相关性,并且风证和火热证的ADC值变化较其他证候差异有统计学意义,可把ADC值升高明显者作为风证、火热证辨证的客观参考指标之一。因此,DWI影像ADC值的变化可以作为中医证候诊断的客观辅助指标和手段。     

Analysis of diffusion tensor imaging metrics for gliomas grading at 3 T

Objectives

To assess the diagnostic accuracy of axial diffusivity (AD), radial diffusivity (RD), apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values derived from DTI for grading of glial tumors, and to estimate the correlation between DTI parameters and tumor grades.

Methods

Seventy-eight patients with glial tumors underwent DTI. AD, RD, ADC and FA values of tumor, peritumoral edema and contralateral normal-appearing white matter (NAWM) and AD, RD, ADC and FA ratios: lowest average AD, RD, ADC and FA values in tumor or peritumoral edema to AD, RD, ADC and FA of NAWM were calculated.DTI parameters and tumor grades were analyzed statistically and with Pearson correlation. Receiver operating characteristic (ROC) curve analysis was also performed.

Results

The differences in ADC, AD and RD tumor values, and ADC and RD tumor ratios were statistically significant between grades II and III, grades II and IV, and between grades II and III–IV. The AD tumor ratio differed significantly among all tumor grades.Tumor ADC, AD, RD and glial tumor grades were strongly correlated. In the ROC curve analysis, the area under the curve (AUC) of the parameter tumor ADC was the largest for distinguishing grade II from grades III to IV (98.5%), grade II from grade IV (98.9%) and grade II from grade III (97.0%).

Conclusion

ADC, RD and AD are useful DTI parameters for differentiation between low- and high-grade gliomas with a diagnostic accuracy of more than 90%. Our study revealed a good inverse correlation between ADC, RD, AD and WHO grades II–IV astrocytic tumors.     

Reproducibility of high-resolution MRI for the middle cerebral artery plaque at 3 T

Purpose

To assess the reproducibility of HR-MRI for the identification of MCA atherosclerotic plaque components and quantification of stenosis.

Materials and methods

Seventy-three consecutive subjects who initially had ischemic stroke or asymptomatic MCA stenosis (>50%) were enrolled in the study. All subjects were scanned using 3.0 T MRI. Two independent readers reviewed all images and one reader reevaluated all images four weeks later. The tissue components of plaques were analyzed qualitatively and the vessels were quantitative measured.

Results

HR-MRI displayed the artery wall and lumen clearly. The intra-observer reproducibility was excellent for the identification of plaques (kappa [κ] = 0.96; 95% CI: 0.83–1.04) and contrast enhancement (κ = 0.89; 0.78–0.95); it was substantial for intra-plaque hemorrhage (κ = 0.79; 0.57–0.96) and the fibrous cap (κ = 0.65; 0.42–0.86). The inter-observer reproducibility was excellent for plaques (κ = 0.92; 0.73–1.06), substantial for contrast enhancement (κ = 0.80; 0.65–0.93), intra-plaque hemorrhage (κ = 0.68; 0.47–0.92) and moderate for the fibrous cap (κ = 0.58; 0.44–0.79). Both intra-observer and inter-observer reproducibility were excellent for quantitative vessel, lumen and wall measurements with intraclass correlation coefficients ranging from 0.91 to 0.97 and 0.87 to 0.96, respectively. However, vessel and wall areas and the intervals defined by the Bland–Altman plots were wide in comparison to the mean.

Conclusions

The identification of MCA atherosclerotic plaque components and the quantification of vessel and lumen measurements are reproducible. The reproducibility is overall acceptable. HR-MRI may provide a useful tool for clinical risk evaluation in MCA atherosclerosis.     

Delayed-enhancement magnetic resonance imaging at 3.0 T using 0.15 mmol/kg of contrast agent for the assessment of chronic myocardial infarction

Objective

A recent international, multicenter, double-blinded, randomized trial shows delayed-enhanced magnetic resonance imaging (DE-MRI) using contrast doses of ≥0.2 mmol/kg is effective in the detection and assessment of myocardial infarction (MI), and 0.1 mmol/kg is not enough; intermediate doses between 0.1 and 0.2 mmol/kg have not been tested. The aim of this study was to prospectively test the performance of DE-MRI using 0.15 mmol/kg of contrast agent for the detection of MI.

Materials and methods

A total of 31 consecutive patients with chronic MI underwent DE-MRI at 3.0 T using both 0.15 mmol/kg and 0.2 mmol/kg of contrast agent in random order and on separate days. Infarction segment and infarction size were compared on DE-MRI images using a 17-segment model. Bland–Altman analysis was used to analyze correlation and agreement between global infarct sizes.

Results

DE-MRI showed enhanced myocardium in all the 31 patients with chronic MI. There was no significant difference between the 0.15 mmol/kg and 0.2 mmol/kg images in all 31 patients based on the infarction segment (7.87 ± 2.72 vs. 7.81 ± 2.64, respectively; p = 0.33). There was no significant difference between the infarction size obtained from 0.15 mmol/kg acquisition and that from 0.2 mmol/kg acquisition (16.3 ± 7.8% vs. 16.4 ± 7.9%, respectively; p = 0.87). A strong correlation between the infarction size obtained from 0.15 mmol/kg acquisition and that from 0.2 mmol/kg acquisition was indicated through Bland–Altman analysis.

Conclusion

DE-MRI at 3.0 T using 0.15 mmol/kg of contrast agent is effective for the assessment of MI.