INTRODUCTION: We attempted to determine the most appropriate combination of magnetic resonance (MR) images that can accurately detect and discriminate between asymptomatic infarction and deep white matter hyperintensity (DWMH); these lesions have different clinical implications and are occasionally confused. MATERIALS AND METHODS: We performed an observer performance analysis using cerebral MR images of 45 individuals with or without asymptomatic small white matter infarction and/or mild DWMH who participated in a physical checkup program at four institutions. Six observers interpreted whether infarction and/or DWMH existed in combinations of two or three image types of the T1-weighted images (T1WI), T2-weighted images (T2WI), and fluid-attenuated inversion recovery (FLAIR) images. The observers' performance was evaluated with a receiver operating characteristic (ROC) analysis. RESULTS: The averaged area under the ROC curve (Az) for detecting a infarction was significantly larger in the combination of all the three image types (0.95) than that in any combinations of the two image types (T1WI and FLAIR images, 0.87; T2WI and FLAIR images, 0.85; T1WI and T2WI, 0.86). The Az for detecting DWMH was significantly smaller in the combination of T1WI and T2WI (0.79) than that in other image combinations (T1WI and FLAIR, 0.89; T2WI and FLAIR, 0.91; T1WI, T2WI, and FLAIR, 0.90). CONCLUSION: The combination of T1WI, T2WI, and FLAIR images is required to accurately detect both small white matter infarction and mild DWMH.
INTRODUCTION: We attempted to determine the most appropriate combination of magnetic resonance (MR) images that can accurately detect and discriminate between asymptomatic infarction and deep white matter hyperintensity (DWMH); these lesions have different clinical implications and are occasionally confused. MATERIALS AND METHODS: We performed an observer performance analysis using cerebral MR images of 45 individuals with or without asymptomatic small white matter infarction and/or mild DWMH who participated in a physical checkup program at four institutions. Six observers interpreted whether infarction and/or DWMH existed in combinations of two or three image types of the T1-weighted images (T1WI), T2-weighted images (T2WI), and fluid-attenuated inversion recovery (FLAIR) images. The observers' performance was evaluated with a receiver operating characteristic (ROC) analysis. RESULTS: The averaged area under the ROC curve (Az) for detecting a infarction was significantly larger in the combination of all the three image types (0.95) than that in any combinations of the two image types (T1WI and FLAIR images, 0.87; T2WI and FLAIR images, 0.85; T1WI and T2WI, 0.86). The Az for detecting DWMH was significantly smaller in the combination of T1WI and T2WI (0.79) than that in other image combinations (T1WI and FLAIR, 0.89; T2WI and FLAIR, 0.91; T1WI, T2WI, and FLAIR, 0.90). CONCLUSION: The combination of T1WI, T2WI, and FLAIR images is required to accurately detect both small white matter infarction and mild DWMH.
Authors: Wiesje M van der Flier; Elizabeth C W van Straaten; Frederik Barkhof; Ana Verdelho; Sofia Madureira; Leonardo Pantoni; Domenico Inzitari; Timo Erkinjuntti; Militta Crisby; Gunhild Waldemar; Reinhold Schmidt; Franz Fazekas; Philip Scheltens Journal: Stroke Date: 2005-09-01 Impact factor: 7.914
Authors: F E de Leeuw; J C de Groot; E Achten; M Oudkerk; L M Ramos; R Heijboer; A Hofman; J Jolles; J van Gijn; M M Breteler Journal: J Neurol Neurosurg Psychiatry Date: 2001-01 Impact factor: 10.154
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Authors: Sarah E Vermeer; Tom Den Heijer; Peter J Koudstaal; Matthijs Oudkerk; Albert Hofman; Monique M B Breteler Journal: Stroke Date: 2003-02 Impact factor: 7.914
Authors: Sarah E Vermeer; Monika Hollander; Ewoud J van Dijk; Albert Hofman; Peter J Koudstaal; Monique M B Breteler Journal: Stroke Date: 2003-04-10 Impact factor: 7.914
Authors: Ralph Weber; Christian Weimar; Isabel Wanke; Claudia Möller-Hartmann; Elke R Gizewski; Jon Blatchford; Karin Hermansson; Andrew M Demchuk; Michael Forsting; Ralph L Sacco; Jeffrey L Saver; Steven Warach; Hans Christoph Diener; Anke Diehl Journal: Stroke Date: 2012-01-19 Impact factor: 7.914
Authors: Robert I Liem; Jingxia Liu; Mae O Gordon; Bruce A Vendt; Robert C McKinstry; Michael A Kraut; John J Strouse; William S Ball; Michael R DeBaun Journal: J Child Neurol Date: 2013-12-05 Impact factor: 1.987