| ID | 114896 |
| Title Alternative | Reliability of DWI and FLAIR for diagnosis of sporadic CJD
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| Author |
Fujita, Koji
The University of Tokushima
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Harada, Masafumi
The University of Tokushima
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Sasaki, Makoto
Iwate Medical University
Yuasa, Tatsuhiko
Kamagaya General Hospital
Sakai, Kenji
Kanazawa University
Hamaguchi, Tsuyoshi
Kanazawa University
Sanjo, Nobuo
Tokyo Medical and Dental University
Shiga, Yusei
Aoba Neurosurgical Clinic
Satoh, Katsuya
Nagasaki University
Atarashi, Ryuichiro
Nagasaki University
Shirabe, Susumu
Nagasaki University
Nagata, Ken
Research Institute for Brain and Blood Vessels
Maeda, Tetsuya
Research Institute for Brain and Blood Vessels
Murayama, Shigeo
Tokyo Metropolitan Institute of Gerontology
Izumi, Yuishin
The University of Tokushima
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Kaji, Ryuji
The University of Tokushima
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Yamada, Masahito
Kanazawa University
Mizusawa, Hidehiro
Tokyo Medical and Dental University
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| Content Type |
Journal Article
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| Description | Objectives: To assess the utility of the display standardisation of diffusion-weighted MRI (DWI) and to compare the effectiveness of DWI and fluid-attenuated inversion recovery (FLAIR) MRI for the diagnosis of sporadic Creutzfeldte–Jakob disease (sCJD).
Design: A reliability and agreement study. Setting: Thirteen MRI observers comprising eight neurologists and five radiologists at two universities in Japan. Participants: Data of 1.5-Tesla DWI and FLAIR were obtained from 29 patients with sCJD and 13 controls. Outcome measures: Standardisation of DWI display was performed utilising b0 imaging. The observers participated in standardised DWI, variable DWI (the display adjustment was observer dependent) and FLAIR sessions. The observers independently assessed each MRI for CJD-related lesions, that is, hyperintensity in the cerebral cortex or striatum, using a continuous rating scale. Performance was evaluated by the area under the receiver operating characteristics curve (AUC). Results: The mean AUC values were 0.84 (95% CI 0.81 to 0.87) for standardised DWI, 0.85 (95% CI 0.82 to 0.88) for variable DWI and 0.68 (95% CI 0.63 to 0.72) for FLAIR, demonstrating the superiority of DWI (p<0.05). There was a trend for higher intraclass correlations of standardised DWI (0.74, 95% CI 0.66 to 0.83) and variable DWI (0.72, 95% CI 0.62 to 0.81) than that of FLAIR (0.63, 95% CI 0.53 to 0.74), although the differences were not statistically significant. Conclusions: Standardised DWI is as reliable as variable DWI, and the two DWI displays are superior to FLAIR for the diagnosis of sCJD. The authors propose that hyperintensity in the cerebral cortex or striatum on 1.5-Tesla DWI but not FLAIR can be a reliable diagnostic marker for sCJD. |
| Journal Title |
BMJ Open
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| ISSN | 20446055
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| Publisher | BMJ Publishing Group
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| Volume | 2
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| Issue | 1
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| Start Page | e000649
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| Published Date | 2012-01-30
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| Rights | This final article is available for use under the terms of the Creative Commons Attribution Non-Commercial 2.0 Licence(https://creativecommons.org/licenses/by-nc/2.0/); see http://bmjopen.bmj.com
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| EDB ID | |
| DOI (Published Version) | |
| URL ( Publisher's Version ) | |
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| language |
eng
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| TextVersion |
Publisher
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| departments |
Medical Sciences
University Hospital
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