Comparison of TGSE-BLADE DWI, RESOLVE DWI, and SS-EPI DWI in healthy volunteers and patients after cerebral aneurysm clipping

Diffusion-weighted magnetic resonance imaging is prone to have susceptibility artifacts in an inhomogeneous magnetic field. We compared distortion and artifacts among three diffusion acquisition techniques (single-shot echo-planar imaging [SS-EPI DWI], readout-segmented EPI [RESOLVE DWI], and 2D turbo gradient- and spin-echo diffusion-weighted imaging with non-Cartesian BLADE trajectory [TGSE-BLADE DWI]) in healthy volunteers and in patients with a cerebral aneurysm clip. Seventeen healthy volunteers and 20 patients who had undergone surgical cerebral aneurysm clipping were prospectively enrolled. SS-EPI DWI, RESOLVE DWI, and TGSE-BLADE DWI of the brain were performed using 3 T scanners. Distortion was the least in TGSE-BLADE DWI, and lower in RESOLVE DWI than SS-EPI DWI near air-bone interfaces in healthy volunteers (P < 0.001). Length of clip-induced artifact and distortion near the metal clip were the least in TGSE-BLADE DWI, and lower in RESOLVE DWI than SS-EPI DWI (P < 0.01). Image quality scores for geometric distortion, susceptibility artifacts, and overall image quality in both healthy volunteers and patients were the best in TGSE-BLADE DWI, and better in RESOLVE DWI than SS-EPI DWI (P < 0.001). Among the three DWI sequences, image quality was the best in TGSE-BLADE DWI in terms of distortion and artifacts, in both healthy volunteers and patients with an aneurysm clip.