{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T04:09:50Z","timestamp":1754194190899,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T00:00:00Z","timestamp":1597795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Diffusion\u2010weighted imaging (DWI) is common for evaluating pediatric musculoskeletal lesions, but suffers from geometric distortion and intense acoustic noise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the performance of a near\u2010silent and distortion\u2010free DWI sequence (DW\u2010SD) relative to standard echo\u2010planar DWI (DW\u2010EPI) in pediatric extremity MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective validation study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Thirty\u2010nine children referred for extremity MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>DW\u2010EPI and DW\u2010SD, based on a rotating ultrafast sequence modified with sinusoidal diffusion preparation gradients, at 3T.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>DW\u2010SD image quality (S<jats:sub>anat<\/jats:sub>) was assessed from 0 (nondiagnostic) to 5 (outstanding) and comparative image quality (S<jats:sub>comp<\/jats:sub>) (from \u20132 = DW\u2010EPI more delineated to +2 = DW\u2010SD more delineated, 0 = same). ADC measured by DW\u2010SD and DW\u2010EPI were compared in bone marrow, muscle, and lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Wilcoxon ran<jats:italic>k\u2010<\/jats:italic>sum test and confidence interval of proportions (CIOP) were calculated for S<jats:sub>comp<\/jats:sub>, Student's <jats:italic>t<\/jats:italic>\u2010test, coefficient of variation (COV), and Bland\u2013Altman analysis for ADC values, and intraclass correlation coefficient (ICC) for interreader agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>DW\u2010SD and DW\u2010EPI ADC values for bone marrow, muscle, and lesions were not significantly different (<jats:italic>P<\/jats:italic> = 0.3, <jats:italic>P<\/jats:italic> = 0.2, and <jats:italic>P<\/jats:italic> = 0.27, respectively) and had an overall ADC COV of 14.8% (95% confidence interval: 12.3%, 16.9%) and no significant proportional bias on Bland\u2013Altman analysis. S<jats:sub>anat<\/jats:sub> CIOP was rated diagnostic or better (score of 3, 4, or 5) in 72\u201398% of cases for bone marrow, muscle, and soft tissues. DW\u2010SD was equivalent to or preferred over DW\u2010EPI in muscles and soft tissues, with CIOP 86\u201393% and 93%, respectively. Lesions were equally visualized on DW\u2010SD and DW\u2010EPI in 40\u201351%, with DW\u2010SD preferred in 44\u201356% of cases. DW\u2010SD was rated significantly better than DW\u2010EPI across all comparative variables that included bone marrow, muscle, soft tissue, cartilage, and lesions (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Readers had moderate to near\u2010perfect (ICC range = 0.45\u20130.85).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>DW\u2010SD of the extremities provided similar ADC values and improved image quality compared with conventional DW\u2010EPI.<\/jats:p><jats:p><jats:bold>Level of Evidence<\/jats:bold> 2<\/jats:p><jats:p><jats:bold>Technical Efficacy Stage<\/jats:bold> 2<\/jats:p><jats:p>J. MAGN. RESON. IMAGING 2021;53:504\u2013513.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27330","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T11:43:58Z","timestamp":1598615038000},"page":"504-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["<scp>Near\u2010Silent<\/scp> and <scp>Distortion\u2010Free<\/scp> Diffusion <scp>MRI<\/scp> in Pediatric Musculoskeletal Disorders: Comparison With Echo Planar Imaging Diffusion"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9980-8859","authenticated-orcid":false,"given":"Jesse K.","family":"Sandberg","sequence":"first","affiliation":[{"name":"Department of Radiology Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria A.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali B.","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianmin","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxin","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University  Stanford California USA"},{"name":"Department of Electrical Engineering Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Sandino","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Menini","sequence":"additional","affiliation":[{"name":"Application Science Lab, GE Healthcare  Menlo Park California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Hargreaves","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreyas","family":"Vasanawala","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,19]]},"reference":[{"issue":"5","key":"e_1_2_6_2_1","first-page":"740","article-title":"Diffusion\u2010weighted imaging in musculoskeletal radiology\u2010clinical applications and future directions","volume":"5","author":"Bhojwani 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