Comparison Between TOF and SWAN Sequences in the Detection of Arterial Occlusion in Acute Ischemic Stroke Using MRI (TOF-SWAN)

Lille Catholic University

Status: Completed

Conditions: Angiography; Diagnosis; Stroke, Acute; Magnetic Resonance Imaging

Treatments: Diagnostic Test: Magnetic resonance imaging

Study type: Observational

Funder types: Other

Identifiers

NCT03645902

TOF-SWAN

Details and patient eligibility

About

Optimizing the MRI protocol in acute ischemic stroke remains a challenging issue. In this field, susceptibility-weighted sequences have proved their superiority over T2. Besides the strengthened susceptibility effect, enhanced susceptibility-weighted angiography (eSWAN) sequence provides also a time-of-flight (TOF) effect, allowing the exploration of the intracranial arterial circulation. The objective of this study is to compare eSWAN and 3D TOF, considered as the reference, in the detection of arterial occlusion in acute stroke.

Full description

Patients who undergo MRI for suspected acute stroke with an acute ischemic lesion on diffusion-weighted imaging (DWI) will be prospectively included in this study.eSWAN and TOF images will be analyzed under double-blind conditions by a junior radiologist and a senior neuroradiologist for the detection of arterial occlusion. eSWAN images will be assessed in order to estimate the inter-observer agreement. After a consensus, eSWAN and TOF data will be compared to calculate inter-modality agreement.

Enrollment: 34 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• clinical symptoms compatible with acute stroke;
• time range between symptoms and magnetic resonance imaging less than 4 h 30
• presence of at least one acute ischemic lesion on the diffusion-weighted images (DWI).

Exclusion criteria

• MR contraindications;
• negative DWI;
• differential diagnosis;
• incomplete acquisition of the full magnetic resonance imaging protocol or technical issues leading to uninterpretable eSWAN and/or TOF sequences (e.g.motion artifacts).

Trial design

34 participants in 1 patient group

Acute stroke patients

Description:

MRI examinations will be performed on a 3 T GE MR750 W scanner. Two readers, an experienced neuroradiologist (8 years of experience in neuroradiology) and a junior radiologist (3 years of experience in general radiology) will independently analyze eSWAN and TOF images in random order, looking for arterial occlusions. Analysis will be based on a 2-point-scale: arterial occlusion, based on a local signal loss, or acceptable permeability.

Treatment:

Diagnostic Test: Magnetic resonance imaging