Two-dimensional T2*-weighted multi-shot echo-planar imaging to detect cerebral microbleeds in neurocognitive disorders: A time-efficient alternative to susceptibility weighted angiography

Purpose: To evaluate the effectiveness of ultra-fast two-dimensional (2D) T2*-weighted multi-shot echo-planar imaging (MS-EPI) for the detection of cerebral microbleeds (CMB) in cognitive disorders.

Methods: Sixty-eight patients referred for neuroimaging to investigate cognitive disorders underwent 3 T MR imaging, with both 2D T2*-weighted MS-EPI and susceptibility-weighted angiography (SWAN). Microbleeds were separately assessed on 2D T2*-weighted MS-EPI and SWAN by 2 raters. Intermodality and interobserver (n = 2 raters) agreement was calculated using the Cohen's kappa.

Results: In assessing the number of microbleeds across five categories (0, 1, 2-4, 5-10, >10), interobserver agreement reached 0.95 for SWAN and 0.90 for 2D MS-EPI. When considering the consensus evaluation, intermodality agreement stood at 0.75. Using the consensus evaluation, motion artifacts were significantly less frequent for 2D MS-EPI (p = 0.001).

Conclusion: This study suggests that the ultra-fast 2D MS-EPI sequence holds promise as an effective alternative to the SWAN sequence for detecting microbleeds in patients with neurocognitive disorders, particularly in those who are unable of remaining still during long scans.