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Wang D, Krishnamoorthy G, Ooi MB, Pipe JG. Spiral inflow MRA with sliding-slice localized quadratic encoding. Magn Reson Med 2023; 90:1818-1829. [PMID: 37415416 DOI: 10.1002/mrm.29770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/27/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE This work proposes a 2D/3D hybrid inflow MRA technique for fast scanning and high SNR and contrast-to-noise (CNR) efficiencies. METHODS Localized quadratic (LQ) encoding was combined with a sliding-slice spiral acquisition. Inflow MRAs around the circle of Willis and the carotid bifurcations were collected on four healthy volunteers. Spiral images were deblurred without or with water-fat separation for sliding-slice LQ (ssLQ) out-of-phase (OP) and Dixon inflow MRAs, respectively. Results were compared to multiple overlapping thin slab acquisitions (MOTSA) and 2D OP inflow MRAs. Noise data were also acquired with RF and gradients turned off to compute maps of SNR and SNR efficiency. Quantitative assessment of relative contrast, CNR, and CNR efficiency for flow were performed in regions of interest. RESULTS The sliding-slice spiral technique alone reduces scan time by 10% to 40% compared with a standard spiral acquisition scheme. The proposed spiral ssLQ OP achieves 50% higher scan speed than the spiral MOTSA with comparable SNR and CNR efficiencies, which are ∼100% higher than the Cartesian MOTSA for intracranial inflow MRAs. Spiral ssLQ Dixon inflow MRA provides better visibility for vessels around the fat compared to spiral ssLQ OP inflow MRA, with a trade-off of scan speed. Spiral ssLQ MRA with thinner slice thickness is two to five times faster than the 2D Cartesian inflow neck MRA around the carotid bifurcations, while also achieving higher SNR efficiency. CONCLUSION The proposed spiral ssLQ is a fast and flexible MRA method with improved SNR and CNR efficiencies over traditional Cartesian inflow MRAs.
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Affiliation(s)
- Dinghui Wang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Guruprasad Krishnamoorthy
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
- Philips Healthcare, Gainesville, Florida, USA
| | | | - James G Pipe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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2
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Koktzoglou I, Huang R, Ong AL, Aouad PJ, Walker MT, Edelman RR. High spatial resolution whole-neck MR angiography using thin-slab stack-of-stars quiescent interval slice-selective acquisition. Magn Reson Med 2020; 84:3316-3324. [PMID: 32521094 DOI: 10.1002/mrm.28339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To report a 3D multi-echo thin-slab stack-of-stars (tsSOS) quiescent-interval slice-selective (QISS) strategy for high-resolution magnetic resonance angiography (MRA) of the entire neck in under seven minutes. METHODS The neck arteries of eight subjects were imaged at 3 Tesla. Multi-echo 3D tsSOS QISS using a FLASH readout was compared with 3D tsSOS FLASH, 2D QISS, 2D TOF, and 3D TOF. A root-mean-square (RMS) combination of echo time images was tested. Evaluation metrics included arterial signal-to-noise ratio (SNR), arterial-to-muscle contrast-to-noise ratio (CNR), and image quality. RESULTS 3D multi-echo tsSOS QISS using a RMS combination of echo time images increased SNR and CNR by 60% and 63% with respect to the reconstruction obtained with the shortest echo time. 3D tsSOS QISS showed superior CNR with respect to 3D tsSOS FLASH imaging, and more than 3-fold higher SNR and CNR with respect to 2D radial QISS when normalized for voxel size. 3D tsSOS QISS provided good to excellent image quality that exceeded the image quality of 2D QISS, 2D TOF, and 3D TOF (P < .05). CONCLUSION Whole-neck high-resolution nonenhanced MRA is feasible using 3D tsSOS QISS, and produced image quality that exceeded those of competing nonenhanced MRA protocols at 3 Tesla.
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Affiliation(s)
- Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Rong Huang
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Archie L Ong
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.,Department of Neurology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Pascale J Aouad
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew T Walker
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Robert R Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Ludwig DR, Shetty AS, Broncano J, Bhalla S, Raptis CA. Magnetic Resonance Angiography of the Thoracic Vasculature: Technique and Applications. J Magn Reson Imaging 2020; 52:325-347. [PMID: 32061029 DOI: 10.1002/jmri.27067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/05/2020] [Accepted: 01/07/2020] [Indexed: 12/12/2022] Open
Abstract
Magnetic resonance angiography (MRA) is a powerful clinical tool for evaluation of the thoracic vasculature. MRA can be performed on nearly any magnetic resonance imaging (MRI) scanner, and provides images of high diagnostic quality without the use of ionizing radiation. While computed tomographic angiography (CTA) is preferred in the evaluation of hemodynamically unstable patients, MRA represents an important tool for evaluation of the thoracic vasculature in stable patients. Contrast-enhanced MRA is generally performed unless there is a specific contraindication, as it shortens the duration of the exam and provides images of higher diagnostic quality than noncontrast MRA. However, intravenous contrast is often not required to obtain a diagnostic evaluation for most clinical indications. Indeed, a variety of noncontrast MRA techniques are used for thoracic imaging, often in conjunction with contrast-enhanced MRA, each of which has a differing degree of reliance on flowing blood to produce the desired vascular signal. In this article we review contrast-enhanced MRA, with a focus on contrast agents, methods of bolus timing, and considerations in imaging acquisition. Next, we cover the mechanism of contrast, strengths, and weaknesses of various noncontrast MRA techniques. Finally, we present an approach to protocol development and review representative protocols used at our institution for a variety of thoracic applications. Further attention will be devoted to additional techniques employed to address specific clinical questions, such as delayed contrast-enhanced imaging, provocative maneuvers, electrocardiogram and respiratory gating, and phase-contrast imaging. The purpose of this article is to review basic techniques and methodology in thoracic MRA, discuss an approach to protocol development, and illustrate commonly encountered pathology on thoracic MRA examinations. Level of Evidence 5 Technical Efficacy Stage 3.
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Affiliation(s)
- Daniel R Ludwig
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Anup S Shetty
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jordi Broncano
- Cardiothoracic Imaging Section, Health Time, Hospital de la Cruz Roja and San Juan de Dios, Cordoba, Spain
| | - Sanjeev Bhalla
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Constantine A Raptis
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
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Bastiaansen JAM, van Heeswijk RB, Stuber M, Piccini D. Noncontrast free-breathing respiratory self-navigated coronary artery cardiovascular magnetic resonance angiography at 3 T using lipid insensitive binomial off-resonant excitation (LIBRE). J Cardiovasc Magn Reson 2019; 21:38. [PMID: 31291957 PMCID: PMC6621993 DOI: 10.1186/s12968-019-0543-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/20/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Robust and homogeneous lipid suppression is mandatory for coronary artery cardiovascular magnetic resonance (CMR) imaging since the coronary arteries are commonly embedded in epicardial fat. However, effective large volume lipid suppression becomes more challenging when performing radial whole-heart coronary artery CMR for respiratory self-navigation and the problem may even be exacerbated at increasing magnetic field strengths. Incomplete fat suppression not only hinders a correct visualization of the coronary vessels and generates image artifacts, but may also affect advanced motion correction methods. The aim of this study was to evaluate a recently reported lipid insensitive CMR method when applied to a noncontrast self-navigated coronary artery CMR acquisitions at 3 T, and to compare it to more conventional fat suppression techniques. METHODS Lipid insensitive binomial off resonant excitation (LIBRE) radiofrequency excitation pulses were included into a self-navigated 3D radial GRE coronary artery CMR sequence at 3 T. LIBRE was compared against a conventional CHESS fat saturation (FS) and a binomial 1-180°-1 water excitation (WE) pulse. First, fat suppression of all techniques was numerically characterized using Matlab and experimentally validated in phantoms and in legs of human volunteers. Subsequently, free-breathing self-navigated coronary artery CMR was performed using the LIBRE pulse as well as FS and WE in ten healthy subjects. Myocardial, arterial and chest fat signal-to-noise ratios (SNR), as well as coronary vessel conspicuity were quantitatively compared among those scans. RESULTS The results obtained in the simulations were confirmed by the experimental validations as LIBRE enabled near complete fat suppression for 3D radial imaging in vitro and in vivo. For self-navigated whole-heart coronary artery CMR at 3 T, fat SNR was significantly attenuated using LIBRE compared with conventional FS. LIBRE increased the right coronary artery (RCA) vessel sharpness significantly (37 ± 9% (LIBRE) vs. 29 ± 8% (FS) and 30 ± 8% (WE), both p < 0.05) and led to a significant increase in the measured RCA vessel length to (83 ± 31 mm (LIBRE) vs. 56 ± 12 mm (FS) and 59 ± 27 (WE) p < 0.05). CONCLUSIONS Applied to a respiratory self-navigated noncontrast 3D radial whole-heart sequence, LIBRE enables robust large volume fat suppression and significantly improves coronary artery image quality at 3 T compared to the use of conventional FS and WE.
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Affiliation(s)
- Jessica A. M. Bastiaansen
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ruud B. van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Biomedical Imaging, Lausanne, Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Advanced clinical imaging technology, Siemens Healthcare AG, Lausanne, Switzerland
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Usefulness of IDEAL T2 imaging for homogeneous fat suppression and reducing susceptibility artefacts in brachial plexus MRI at 3.0 T. Radiol Med 2015; 121:45-53. [DOI: 10.1007/s11547-015-0576-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
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6
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Fat-subtracted three-dimensional time-of-flight MR angiography of the neck by use of fat-only images with the two-point Dixon technique. Radiol Phys Technol 2015; 8:193-9. [PMID: 25577234 DOI: 10.1007/s12194-015-0307-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/27/2014] [Accepted: 01/05/2015] [Indexed: 10/24/2022]
Abstract
For improvement of three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) image quality in the neck, fat-subtracted MRA by use of the two-point Dixon technique was compared with conventional fat-suppressed MRA techniques. Three different types of neck 3D-TOF-MRA were obtained [minimum echo time (TE) (1.9 ms), opposed-phase TE (3.4 ms), and chemical shift selective fat suppression (CHESS) (TE = 1.9 ms)] on five volunteers at 3.0 T. MRA was obtained with subtraction of fat-only images (produced by a two-point Dixon sequence) from minimum-TE MRA images, and compared with other fat-suppressed MRA images. Fat-subtracted MRA demonstrated uniform fat suppression compared with other techniques. The mean vessel-to-fat contrast in fat-subtracted MRA was significantly higher (p < 0.01) than in other MRA images (minimum-TE: 0.137 ± 0.086, opposed-phase TE: 0.268 ± 0.102, CHESS: 0.307 ± 0.052, fat-subtracted: 0.965 ± 0.101). The mean vessel-to-muscle contrast in opposed-phase TE MRA was significantly lower (p < 0.01) than in other MRA images (minimum-TE: 0.526 ± 0.036, opposed-phase TE: 0.419 ± 0.188, CHESS: 0.511 ± 0.023, fat-subtracted: 0.573 ± 0.016). Fat-subtracted MRA by use of the two-point Dixon technique improves the image quality of neck MRA. This technique would be a useful method for MRA, especially in areas with inhomogeneous magnetic fields, such as the neck.
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Ye Y, Wu Z, Lewis NA, Fan Q, Haacke EM. Retrobulbar magnetic resonance angiography using binomial off-resonant rectangular (BORR) pulse. Magn Reson Med 2014; 74:1050-6. [PMID: 25311332 DOI: 10.1002/mrm.25498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 09/23/2014] [Accepted: 09/26/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE Applying a newly developed binomial off-resonant rectangular (BORR) pulse method for high resolution three-dimensional MR angiography (MRA) on retrobulbar ocular vessels, which has not been possible with routine MRA due to background fatty tissues. METHODS BORR pulse was implemented in a gradient echo sequence by replacing the original excitation pulse, and were optimized for robust orbital fat suppression. Several other MRA methods, with or without fat suppression, were also compared, including time-of-flight, contrast enhanced MRA, and hybrid of opposite-contrast MRA. Nine healthy subjects participated with written informed consents. To reduce eye motion, the subjects were instructed to casually stare at a projected cross during each MRA scan. Major vessels were evaluated by three independent radiologists using a 4-point scale. RESULTS The BORR method yielded the best MRA results for retrobulbar vessels without contrast enhancement, significantly superior than other MRA methods. BORR results had significantly higher visibility scores than all other methods for small vessels. CONCLUSION We have successfully revealed orbital vessels in retrobulbar space for the first time using MRA, by using the BORR pulse method. With a clear depiction of the vasculature without the need for contrast enhancement, our method has the potential to provide important diagnostic information for ocular vascular diseases.
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Affiliation(s)
- Yongquan Ye
- MR Research Facility, Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Zhen Wu
- Department of Radiology, Wayne State University Detroit, Michigan, USA
| | - Nicholas A Lewis
- Department of Radiology, Wayne State University Detroit, Michigan, USA
| | - Qingxia Fan
- Eye clinical and vision research division, He Eye Hospital, Shenyang, Liaoning, China
| | - E Mark Haacke
- MR Research Facility, Department of Radiology, Wayne State University, Detroit, Michigan, USA
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Eggers H, Börnert P. Chemical shift encoding-based water-fat separation methods. J Magn Reson Imaging 2014; 40:251-68. [PMID: 24446249 DOI: 10.1002/jmri.24568] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 12/12/2013] [Indexed: 12/13/2022] Open
Abstract
The suppression of signal from fat constitutes a basic requirement in many applications of magnetic resonance imaging. To date, this is predominantly achieved during data acquisition, using fat saturation, inversion recovery, or water excitation methods. Postponing the separation of signal from water and fat until image reconstruction holds the promise of resolving some of the problems associated with these methods, such as failure in the presence of field inhomogeneities or contrast agents. In this article, methods are reviewed that rely on the difference in chemical shift between the hydrogen atoms in water and fat to perform such a retrospective separation. The basic principle underlying these so-called Dixon methods is introduced, and some fundamental implementations of the required chemical shift encoding in the acquisition and the subsequent water-fat separation in the reconstruction are described. Practical issues, such as the selection of key parameters and the appearance of typical artifacts, are illustrated, and a broad range of applications is demonstrated, including abdominal, cardiovascular, and musculoskeletal imaging. Finally, advantages and disadvantages of these Dixon methods are summarized, and emerging opportunities arising from the availability of information on the amount and distribution of fat are discussed.
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Li XH, Zhu J, Zhang XM, Ji YF, Chen TW, Huang XH, Yang L, Zeng NL. Abdominal MRI at 3.0 T: LAVA-flex compared with conventional fat suppression T1-weighted images. J Magn Reson Imaging 2013; 40:58-66. [PMID: 24222639 DOI: 10.1002/jmri.24329] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 07/10/2013] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xing Hui Li
- Sichuan Key Laboratory of Medical Imaging; Department of Radiology; Affiliated Hospital of North Sichuan Medical College; Nanchong China
| | - Jiang Zhu
- Sichuan Key Laboratory of Medical Imaging; Department of Radiology; Affiliated Hospital of North Sichuan Medical College; Nanchong China
| | - Xiao Ming Zhang
- Sichuan Key Laboratory of Medical Imaging; Department of Radiology; Affiliated Hospital of North Sichuan Medical College; Nanchong China
| | - Yi Fan Ji
- Sichuan Key Laboratory of Medical Imaging; Department of Radiology; Affiliated Hospital of North Sichuan Medical College; Nanchong China
| | - Tian Wu Chen
- Sichuan Key Laboratory of Medical Imaging; Department of Radiology; Affiliated Hospital of North Sichuan Medical College; Nanchong China
| | - Xiao Hua Huang
- Sichuan Key Laboratory of Medical Imaging; Department of Radiology; Affiliated Hospital of North Sichuan Medical College; Nanchong China
| | - Lin Yang
- Sichuan Key Laboratory of Medical Imaging; Department of Radiology; Affiliated Hospital of North Sichuan Medical College; Nanchong China
| | - Nan Lin Zeng
- Sichuan Key Laboratory of Medical Imaging; Department of Radiology; Affiliated Hospital of North Sichuan Medical College; Nanchong China
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Ho KY, Hu HH, Keyak JH, Colletti PM, Powers CM. Measuring bone mineral density with fat-water MRI: comparison with computed tomography. J Magn Reson Imaging 2012; 37:237-42. [DOI: 10.1002/jmri.23749] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 06/04/2012] [Indexed: 11/10/2022] Open
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The Role of 3 Tesla MRA in the Detection of Intracranial Aneurysms. Int J Vasc Med 2012; 2012:792834. [PMID: 22292121 PMCID: PMC3265088 DOI: 10.1155/2012/792834] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Accepted: 10/09/2011] [Indexed: 12/01/2022] Open
Abstract
Intracranial aneurysms constitute a common pathological entity, affecting approximately 1–8% of the general population. Their early detection is essential for their prompt treatment. Digital subtraction angiography is considered the imaging method of choice. However, other noninvasive methodologies such as CTA and MRA have been employed in the investigation of patients with suspected aneurysms. MRA is a noninvasive angiographic modality requiring no radiation exposure. However, its sensitivity and diagnostic accuracy were initially inadequate. Several MRA techniques have been developed for overcoming all these drawbacks and for improving its sensitivity. 3D TOF MRA and contrast-enhanced MRA are the most commonly employed techniques. The introduction of 3 T magnetic field further increased MRA's sensitivity, allowing detection of aneurysms smaller than 3 mm. The development of newer MRA techniques may provide valuable information regarding the flow characteristics of an aneurysm. Meticulous knowledge of MRA's limitations and pitfalls is of paramount importance for avoiding any erroneous interpretation of its findings.
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HORI M, KIM T, ONISHI H, NAKAMOTO A, TSUBOYAMA T, TATSUMI M, TOMIYAMA N. Ovarian Masses: MR Imaging with T1-weighted 3-dimensional Gradient-echo IDEAL Water-fat Separation Sequence at 3T. Magn Reson Med Sci 2012; 11:117-27. [DOI: 10.2463/mrms.11.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Gadolinium-Enhanced Liver Magnetic Resonance Imaging Using a 2-Point Dixon Fat-Water Separation Technique. J Comput Assist Tomogr 2011; 35:96-101. [DOI: 10.1097/rct.0b013e3181f3d57e] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Springer F, Machann J, Claussen CD, Schick F, Schwenzer NF. Liver fat content determined by magnetic resonance imaging and spectroscopy. World J Gastroenterol 2010; 16:1560-6. [PMID: 20355234 PMCID: PMC2848364 DOI: 10.3748/wjg.v16.i13.1560] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatic steatosis as the most prevalent liver disorder can either be related to alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD). In both conditions, hepatocytes excessively accumulate fat-containing vacuoles within their cytoplasm, which is the key histological feature. In contrast to ALD, NAFLD is commonly associated with metabolic syndrome, obesity and insulin resistance. To determine increased liver fat content, liver biopsy is currently considered the gold standard. Besides the invasive technique, various other non-invasive techniques have been developed, such as ultrasound, computed tomography (CT), magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) based methods. Among these techniques, ultrasound and CT provide only qualitative information about hepatic steatosis, whereas MRS- or MRI-based methods are able to determine even small amounts of fat accurately. These non-invasive magnetic resonance techniques have already proven their great potential, especially in longitudinal and cross-sectional studies regarding various metabolic conditions and medical treatment regimens. In this review, the most common, non-invasive MRS/MRI techniques for assessment of intrahepatic lipid content are described with their inherent advantages and limitations.
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