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<meta name="DC.Title" content="Optimal Fat Suppression in Head and Neck MRI: Comparison of Multipoint Dixon with 2 Different Fat-Suppression Techniques, Spectral Presaturation and Inversion Recovery, and STIR" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5483" />
<meta name="DC.Date" content="2018-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2018 by American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Uniform complete fat suppression is essential for identification and characterization of most head and pathology. Our aim was to compare the multipoint Dixon turbo spin-echo fat-suppression technique with 2 different fat-suppression techniques, including a hybrid spectral presaturation with inversion recovery technique and an inversion recovery STIR technique, in head and neck fat-suppression MR imaging.

MATERIALS AND METHODS: Head and neck MR imaging datasets of 72 consecutive patients were retrospectively reviewed. All patients were divided into 2 groups based on the type of fat-suppression techniques used (group A : STIR and spectral presaturation with inversion recovery gadolinium-T1WI; group B : multipoint Dixon T2 TSE and multipoint Dixon gadolinium-T1WI TSE). Objective and subjective image quality and scan acquisition times were assessed and compared between multipoint Dixon T2 TSE versus STIR and multipoint Dixon gadolinium-T1WI TSE versus spectral presaturation with inversion recovery gadolinium-T1WI using the Mann-Whitney U test.

RESULTS: A total of 64 patients were enrolled in the study (group A, n = 33 and group B, n = 31). Signal intensity ratios were significantly higher for multipoint Dixon T2 and gadolinium-T1WI techniques compared with STIR ( P &lt; .001) and spectral presaturation with inversion recovery gadolinium-T1WI ( P &lt; .001), respectively. Two independent blinded readers revealed that multipoint Dixon T2 and gadolinium-T1WI techniques had significantly higher overall image quality ( P = .022 and P &lt; .001) and fat-suppression grades ( P &lt; .013 and P &lt; .001 across 3 different regions) than STIR and spectral presaturation with inversion recovery gadolinium-T1WI, respectively. The scan acquisition time was relatively short for the multipoint Dixon technique (2 minutes versus 4 minutes 56 seconds for the T2-weighted sequence and 2 minutes versus 3 minutes for the gadolinium-T1WI sequence).

CONCLUSIONS: The multipoint Dixon technique offers better image quality and uniform fat suppression at a shorter scan time compared with STIR and spectral presaturation with inversion recovery gadolinium-T1WI techniques.

AP
:   anteroposterior
CHESS
:   chemical shift selective suppression
FS
:   fat suppression
Gad-T1WI
:   gadolinium-T1WI
mDixon
:   multipoint Dixon
SPIR
:   spectral presaturation with inversion recovery" />
<meta name="DC.Contributor" content="S. Gaddikeri" />
<meta name="DC.Contributor" content="M. Mossa-Basha" />
<meta name="DC.Contributor" content="J.B. Andre" />
<meta name="DC.Contributor" content="D.S. Hippe" />
<meta name="DC.Contributor" content="Y. Anzai" />
<meta name="article:published_time" content="2018-02-01" />
<meta name="article:section" content="Head &amp;amp; Neck" />
<meta name="citation_title" content="Optimal Fat Suppression in Head and Neck MRI: Comparison of Multipoint Dixon with 2 Different Fat-Suppression Techniques, Spectral Presaturation and Inversion Recovery, and STIR" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Uniform complete fat suppression is essential for identification and characterization of most head and pathology. Our aim was to compare the multipoint Dixon turbo spin-echo fat-suppression technique with 2 different fat-suppression techniques, including a hybrid spectral presaturation with inversion recovery technique and an inversion recovery STIR technique, in head and neck fat-suppression MR imaging.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Head and neck MR imaging datasets of 72 consecutive patients were retrospectively reviewed. All patients were divided into 2 groups based on the type of fat-suppression techniques used (group &lt;i&gt;A&lt;/i&gt;: STIR and spectral presaturation with inversion recovery gadolinium-T1WI; group &lt;i&gt;B&lt;/i&gt;: multipoint Dixon T2 TSE and multipoint Dixon gadolinium-T1WI TSE). Objective and subjective image quality and scan acquisition times were assessed and compared between multipoint Dixon T2 TSE versus STIR and multipoint Dixon gadolinium-T1WI TSE versus spectral presaturation with inversion recovery gadolinium-T1WI using the Mann-Whitney &lt;i&gt;U&lt;/i&gt; test.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;A total of 64 patients were enrolled in the study (group A, &lt;i&gt;n&lt;/i&gt; = 33 and group B, &lt;i&gt;n&lt;/i&gt; = 31). Signal intensity ratios were significantly higher for multipoint Dixon T2 and gadolinium-T1WI techniques compared with STIR (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001) and spectral presaturation with inversion recovery gadolinium-T1WI (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001), respectively. Two independent blinded readers revealed that multipoint Dixon T2 and gadolinium-T1WI techniques had significantly higher overall image quality (&lt;i&gt;P&lt;/i&gt; = .022 and &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) and fat-suppression grades (&lt;i&gt;P&lt;/i&gt; &amp;lt; .013 and &lt;i&gt;P&lt;/i&gt; &amp;lt; .001 across 3 different regions) than STIR and spectral presaturation with inversion recovery gadolinium-T1WI, respectively. The scan acquisition time was relatively short for the multipoint Dixon technique (2 minutes versus 4 minutes 56 seconds for the T2-weighted sequence and 2 minutes versus 3 minutes for the gadolinium-T1WI sequence).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The multipoint Dixon technique offers better image quality and uniform fat suppression at a shorter scan time compared with STIR and spectral presaturation with inversion recovery gadolinium-T1WI techniques.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="twitter:title" content="Optimal Fat Suppression in Head and Neck MRI: Comparison of Multipoint Dixon with 2 Different Fat-Suppression Techniques, Spectral Presaturation and Inversion Recovery, and STIR" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/39/2.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Uniform complete fat suppression is essential for identification and characterization of most head and pathology. Our aim was to compare the multipoint Dixon turbo spin-echo fat-suppression technique with 2 different fat-suppression techniques, including a hybrid spectral presaturation with inversion recovery technique and an inversion recovery STIR technique, in head and neck fat-suppression MR imaging.

MATERIALS AND METHODS: Head and neck MR imaging datasets of 72 consecutive patients were retrospectively reviewed. All patients were divided into 2 groups based on the type of fat-suppression techniques used (group A : STIR and spectral presaturation with inversion recovery gadolinium-T1WI; group B : multipoint Dixon T2 TSE and multipoint Dixon gadolinium-T1WI TSE). Objective and subjective image quality and scan acquisition times were assessed and compared between multipoint Dixon T2 TSE versus STIR and multipoint Dixon gadolinium-T1WI TSE versus spectral presaturation with inversion recovery gadolinium-T1WI using the Mann-Whitney U test.

RESULTS: A total of 64 patients were enrolled in the study (group A, n = 33 and group B, n = 31). Signal intensity ratios were significantly higher for multipoint Dixon T2 and gadolinium-T1WI techniques compared with STIR ( P &lt; .001) and spectral presaturation with inversion recovery gadolinium-T1WI ( P &lt; .001), respectively. Two independent blinded readers revealed that multipoint Dixon T2 and gadolinium-T1WI techniques had significantly higher overall image quality ( P = .022 and P &lt; .001) and fat-suppression grades ( P &lt; .013 and P &lt; .001 across 3 different regions) than STIR and spectral presaturation with inversion recovery gadolinium-T1WI, respectively. The scan acquisition time was relatively short for the multipoint Dixon technique (2 minutes versus 4 minutes 56 seconds for the T2-weighted sequence and 2 minutes versus 3 minutes for the gadolinium-T1WI sequence).

CONCLUSIONS: The multipoint Dixon technique offers better image quality and uniform fat suppression at a shorter scan time compared with STIR and spectral presaturation with inversion recovery gadolinium-T1WI techniques.

AP
:   anteroposterior
CHESS
:   chemical shift selective suppression
FS
:   fat suppression
Gad-T1WI
:   gadolinium-T1WI
mDixon
:   multipoint Dixon
SPIR
:   spectral presaturation with inversion recovery" />
<meta name="og-title" property="og:title" content="Optimal Fat Suppression in Head and Neck MRI: Comparison of Multipoint Dixon with 2 Different Fat-Suppression Techniques, Spectral Presaturation and Inversion Recovery, and STIR" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/2/362" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Uniform complete fat suppression is essential for identification and characterization of most head and pathology. Our aim was to compare the multipoint Dixon turbo spin-echo fat-suppression technique with 2 different fat-suppression techniques, including a hybrid spectral presaturation with inversion recovery technique and an inversion recovery STIR technique, in head and neck fat-suppression MR imaging.

MATERIALS AND METHODS: Head and neck MR imaging datasets of 72 consecutive patients were retrospectively reviewed. All patients were divided into 2 groups based on the type of fat-suppression techniques used (group A : STIR and spectral presaturation with inversion recovery gadolinium-T1WI; group B : multipoint Dixon T2 TSE and multipoint Dixon gadolinium-T1WI TSE). Objective and subjective image quality and scan acquisition times were assessed and compared between multipoint Dixon T2 TSE versus STIR and multipoint Dixon gadolinium-T1WI TSE versus spectral presaturation with inversion recovery gadolinium-T1WI using the Mann-Whitney U test.

RESULTS: A total of 64 patients were enrolled in the study (group A, n = 33 and group B, n = 31). Signal intensity ratios were significantly higher for multipoint Dixon T2 and gadolinium-T1WI techniques compared with STIR ( P &lt; .001) and spectral presaturation with inversion recovery gadolinium-T1WI ( P &lt; .001), respectively. Two independent blinded readers revealed that multipoint Dixon T2 and gadolinium-T1WI techniques had significantly higher overall image quality ( P = .022 and P &lt; .001) and fat-suppression grades ( P &lt; .013 and P &lt; .001 across 3 different regions) than STIR and spectral presaturation with inversion recovery gadolinium-T1WI, respectively. The scan acquisition time was relatively short for the multipoint Dixon technique (2 minutes versus 4 minutes 56 seconds for the T2-weighted sequence and 2 minutes versus 3 minutes for the gadolinium-T1WI sequence).

CONCLUSIONS: The multipoint Dixon technique offers better image quality and uniform fat suppression at a shorter scan time compared with STIR and spectral presaturation with inversion recovery gadolinium-T1WI techniques.

AP
:   anteroposterior
CHESS
:   chemical shift selective suppression
FS
:   fat suppression
Gad-T1WI
:   gadolinium-T1WI
mDixon
:   multipoint Dixon
SPIR
:   spectral presaturation with inversion recovery" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node58361--5" data-node-nid="58361" id="top-node-58361--654074141" data-pisa="ajnr;39/2/362" data-pisa-master="ajnr;ajnr.A5483" data-apath="/ajnr/39/2/362.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Head &amp; Neck</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Optimal Fat Suppression in Head and Neck MRI: Comparison of Multipoint Dixon with 2 Different Fat-Suppression Techniques, Spectral Presaturation and Inversion Recovery, and STIR</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Gaddikeri</span>, <span class="highwire-citation-author" data-delta="1">M. Mossa-Basha</span>, <span class="highwire-citation-author" data-delta="2">J.B. Andre</span>, <span class="highwire-citation-author" data-delta="3">D.S. Hippe</span> and <span class="highwire-citation-author" data-delta="4">Y. Anzai</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">362-368; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5483 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-58361--654074141" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Gaddikeri </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroradiology (S.G.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (S.G.), Rush University Medical Center, Chicago, Illinois</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BGaddikeri%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gaddikeri%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BGaddikeri%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4226-5563" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Gaddikeri</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. Mossa-Basha </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Departments of Neuroradiology (M.M.-B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BMossa-Basha%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mossa-Basha%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BMossa-Basha%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-7798-8158" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Mossa-Basha</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">J.B. Andre </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neuroradiology (J.B.A.), University of Washington Medical Center, Seattle, Washington</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.B.%2BAndre%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Andre%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.B.%2BAndre%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-0896-183X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.B. Andre</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">D.S. Hippe </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Radiology (D.S.H.), University of Washington, Seattle, Washington</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.S.%2BHippe%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hippe%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.S.%2BHippe%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-2427-4404" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.S. Hippe</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Y. Anzai </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Radiology (Y.A.), University of Utah Health Center, Salt Lake City, Utah.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.%2BAnzai%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Anzai%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AY.%2BAnzai%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-2988-7445" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y. Anzai</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-39.2.362.1" data-doi="10.1148/rg.341135130"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 39</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2018 </div></div>
      
      
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      <div class="highwire-cite-title">Optimal Fat Suppression in Head and Neck MRI: Comparison of Multipoint Dixon with 2 Different Fat-Suppression Techniques, Spectral Presaturation and Inversion Recovery, and STIR</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Gaddikeri</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Mossa-Basha</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">J.B.</span> <span class="nlm-surname">Andre</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">D.S.</span> <span class="nlm-surname">Hippe</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Anzai</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">362-368; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5483 </span></div>
  
  
  
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      <div class="highwire-cite-title">Optimal Fat Suppression in Head and Neck MRI: Comparison of Multipoint Dixon with 2 Different Fat-Suppression Techniques, Spectral Presaturation and Inversion Recovery, and STIR</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Gaddikeri</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Mossa-Basha</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">J.B.</span> <span class="nlm-surname">Andre</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">D.S.</span> <span class="nlm-surname">Hippe</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Anzai</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">362-368; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5483 </span></div>
  
  
  
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