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Eajazi A, Weinschenk C, Chhabra A. Imaging Biomarkers of Peripheral Nerves: Focus on Magnetic Resonance Neurography and Ultrasonography. Semin Musculoskelet Radiol 2024; 28:92-102. [PMID: 38330973 DOI: 10.1055/s-0043-1776427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Peripheral neuropathy is a prevalent and debilitating condition affecting millions of individuals globally. Magnetic resonance neurography (MRN) and ultrasonography (US) are noninvasive methods offering comprehensive visualization of peripheral nerves, using anatomical and functional imaging biomarkers to ensure accurate evaluation. For optimized MRN, superior and high-resolution two-dimensional and three-dimensional imaging protocols are essential. The anatomical MRN and US imaging markers include quantitative measures of nerve and fascicular size and signal, and qualitative markers of course and morphology. Among them, quantitative markers of T2-signal intensity ratio are sensitive to nerve edema-like signal changes, and the T1-mapping technique reveals nerve and muscle tissue fatty and fibrous compositional alterations.The functional markers are derived from physiologic properties of nerves, such as diffusion characteristics or blood flow. They include apparent diffusion coefficient from diffusion-weighted imaging and fractional anisotropy and tractography from diffusion tensor imaging to delve into peripheral nerve microstructure and integrity. Peripheral nerve perfusion using dynamic contrast-enhanced magnetic resonance imaging estimates perfusion parameters, offering insights into nerve health and neuropathies involving edema, inflammation, demyelination, and microvascular alterations in conditions like type 2 diabetes, linking nerve conduction pathophysiology to vascular permeability alterations.Imaging biomarkers thus play a pivotal role in the diagnosis, prognosis, and monitoring of nerve pathologies, thereby ensuring comprehensive assessment and elevating patient care. These biomarkers provide valuable insights into nerve structure, function, and pathophysiology, contributing to the accurate diagnosis and management planning for peripheral neuropathy.
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Affiliation(s)
- Alireza Eajazi
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
| | - Cindy Weinschenk
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
| | - Avneesh Chhabra
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas
- Department of Radiology & Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Texas
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Sollmann N, Schandelmaier P, Weidlich D, Stelter J, Joseph GB, Börner C, Schramm S, Beer M, Zimmer C, Landgraf MN, Heinen F, Karampinos DC, Baum T, Bonfert MV. Headache frequency and neck pain are associated with trapezius muscle T2 in tension-type headache among young adults. J Headache Pain 2023; 24:84. [PMID: 37438700 DOI: 10.1186/s10194-023-01626-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Tension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is commonly associated with primary headaches and the trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons of the brainstem, thus conceptualizes the emergence of headache in relation to neck pain. However, no objective biomarkers exist for the myofascial involvement in primary headaches. This study aimed to investigate the involvement of the trapezius muscles in primary headache disorders by quantitative magnetic resonance imaging (MRI), and to explore associations between muscle T2 values and headache frequency and neck pain. METHODS This cohort study prospectively enrolled fifty participants (41 females, age range 20-31 years): 16 subjects with TTH only (TTH-), 12 with mixed-type TTH plus migraine (TTH+), and 22 healthy controls (HC). The participants completed fat-suppressed T2-prepared three-dimensional turbo spin-echo MRI, a headache diary (over 30 days prior to MRI), manual palpation (two weeks before MRI), and evaluation of neck pain (on the day of MRI). The bilateral trapezius muscles were manually segmented, followed by muscle T2 extraction. Associations between muscle T2 and the presence of neck pain as well as the number of days with headache (considering the 30 days prior to imaging using the headache calendar) were analyzed using regression models (adjusting for age, sex, and body mass index). RESULTS The TTH+ group demonstrated the highest muscle T2 values (right side: 31.4 ± 1.2 ms, left side: 31.4 ± 0.8 ms) as compared to the TTH- group or HC group (p < 0.001). Muscle T2 was significantly associated with the number of headache days (β-coefficient: 2.04, p = 0.04) and the presence of neck pain (odds ratio: 2.26, p = 0.04). With muscle T2 as the predictor, the area under the curve for differentiating between HC and the TTH+ group was 0.82. CONCLUSIONS Increased T2 of trapezius muscles may represent an objective imaging biomarker for myofascial involvement in primary headache disorders, which could help to improve patient phenotyping and therapy evaluation. Pathophysiologically, the increased muscle T2 values could be interpreted as a surrogate of neurogenic inflammation and peripheral sensitization within myofascial tissues.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
| | - Paul Schandelmaier
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jonathan Stelter
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Corinna Börner
- Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Severin Schramm
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Mirjam N Landgraf
- Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Florian Heinen
- Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Michaela V Bonfert
- Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
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Multi-echo in steady-state acquisition improves MRI image quality and lumbosacral radiculopathy diagnosis efficacy compared with T2 fast spin-echo sequence. Neuroradiology 2023; 65:969-977. [PMID: 36862186 DOI: 10.1007/s00234-023-03130-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/05/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE This study compares the performance of a 4-min multi-echo in steady-state acquisition (MENSA) with a 6-min fast spin echo with variable flip angle (CUBE) protocol for the assessment of lumbosacral plexus nerve root lesions. METHODS Seventy-two subjects underwent MENSA and CUBE sequences on a 3.0-T MRI scanner. Two musculoskeletal radiologists independently assessed the images for quality and diagnostic capability. A qualitative assessment scoring system for image quality and quantitative nerve signal-to-noise ratio (SNR) and iliac vein and muscle contrast-to-noise ratios (CNR) was applied. Using surgical reports as the reference, sensitivity, specificity, accuracy, and area under the receiver operating characteristic curves (AUC) were evaluated. Intraclass correlation coefficients (ICC) and weighted kappa were used to calculate reliability. RESULTS MENSA image quality rating (3.679 ± 0.47) was higher than for CUBE images (3.038 ± 0.68), and MENSA showed higher mean nerve root SNR (36.935 ± 8.33 vs. 27.777 ± 7.41), iliac vein CNR (24.678 ± 6.63 vs. 5.210 ± 3.93), and muscle CNR (19.414 ± 6.07 vs. 13.531 ± 0.65) than CUBE (P < 0.05). Weighted kappa and ICC values indicated good reliability. Sensitivity, specificity, and accuracy of diagnosis based on MENSA images were 96.23%, 89.47%, and 94.44%, respectively, and AUC was 0.929, compared with 92.45%, 84.21%, 90.28%, and 0.883 for CUBE images. The two correlated ROC curves were not significantly different. Weighted kappa values for intraobserver (0.758) and interobserver (0.768-0.818) reliability were substantial to perfect. CONCLUSION A time-efficient 4-min MENSA protocol exhibits superior image quality and high vascular contrast with the potential to produce high-resolution lumbosacral nerve root images.
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Quantification and Proximal-to-Distal Distribution Pattern of Tibial Nerve Lesions in Relapsing-Remitting Multiple Sclerosis : Assessment by MR Neurography. Clin Neuroradiol 2022; 33:383-392. [PMID: 36264352 DOI: 10.1007/s00062-022-01219-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/14/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Recent studies suggest an involvement of the peripheral nervous system (PNS) in multiple sclerosis (MS). Here, we characterize the proximal-to-distal distribution pattern of peripheral nerve lesions in relapsing-remitting MS (RRMS) by quantitative magnetic resonance neurography (MRN). METHODS A total of 35 patients with RRMS were prospectively included and underwent detailed neurologic and electrophysiologic examinations. Additionally, 30 age- and sex-matched healthy controls were recruited. 3T MRN with anatomical coverage from the proximal thigh down to the tibiotalar joint was conducted using dual-echo 2‑dimensional relaxometry sequences with spectral fat saturation. Quantification of PNS involvement was performed by evaluating microstructural (proton spin density (ρ), T2-relaxation time (T2app)), and morphometric (cross-sectional area, CSA) MRN markers in every axial slice. RESULTS In patients with RRMS, tibial nerve lesions at the thigh and the lower leg were characterized by a decrease in T2app and an increase in ρ compared to controls (T2app thigh: p < 0.0001, T2app lower leg: p = 0.0040; ρ thigh: p < 0.0001; ρ lower leg: p = 0.0098). An additional increase in nerve CSA was only detectable at the thigh, while the semi-quantitative marker T2w-signal was not altered in RRMS in both locations. A slight proximal-to-distal gradient was observed for T2app and T2-signal, but not for ρ. CONCLUSION PNS involvement in RRMS is characterized by a decrease in T2app and an increase in ρ, occurring with proximal predominance at the thigh and the lower leg. Our results indicate microstructural alterations in the extracellular matrix of peripheral nerves in RRMS and may contribute to a better understanding of the pathophysiologic relevance of PNS involvement.
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Jana S, Sutton M, Mollayeva T, Chan V, Colantonio A, Escobar MD. Application of multiple testing procedures for identifying relevant comorbidities, from a large set, in traumatic brain injury for research applications utilizing big health-administrative data. Front Big Data 2022; 5:793606. [PMID: 36247970 PMCID: PMC9563390 DOI: 10.3389/fdata.2022.793606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Multiple testing procedures (MTP) are gaining increasing popularity in various fields of biostatistics, especially in statistical genetics. However, in injury surveillance research utilizing the growing amount and complexity of health-administrative data encoded in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10), few studies involve MTP and discuss their applications and challenges. Objective We aimed to apply MTP in the population-wide context of comorbidity preceding traumatic brain injury (TBI), one of the most disabling injuries, to find a subset of comorbidity that can be targeted in primary injury prevention. Methods In total, 2,600 ICD-10 codes were used to assess the associations between TBI and comorbidity, with 235,003 TBI patients, on a matched data set of patients without TBI. McNemar tests were conducted on each 2,600 ICD-10 code, and appropriate multiple testing adjustments were applied using the Benjamini-Yekutieli procedure. To study the magnitude and direction of associations, odds ratios with 95% confidence intervals were constructed. Results Benjamini-Yekutieli procedure captured 684 ICD-10 codes, out of 2,600, as codes positively associated with a TBI event, reducing the effective number of codes for subsequent analysis and comprehension. Conclusion Our results illustrate the utility of MTP for data mining and dimension reduction in TBI research utilizing big health-administrative data to support injury surveillance research and generate ideas for injury prevention.
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Affiliation(s)
- Sayantee Jana
- Department of Mathematics, Indian Institute of Technology, Hyderabad, India
- *Correspondence: Sayantee Jana
| | | | - Tatyana Mollayeva
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- KITE Research Institute Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Vincy Chan
- KITE Research Institute Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Angela Colantonio
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- KITE Research Institute Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- ICES (fomerly Institute for Clinical Evaluative Sciences), Toronto, ON, Canada
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Sollmann N, Schandelmaier P, Weidlich D, Börner C, Urban G, Lang M, Zimmer C, Karampinos DC, Landgraf MN, Heinen F, Baum T, Bonfert MV. Patients with episodic migraine show increased T2 values of the trapezius muscles - an investigation by quantitative high-resolution magnetic resonance imaging. Cephalalgia 2021; 41:934-942. [PMID: 33615841 PMCID: PMC8217886 DOI: 10.1177/0333102421996374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Neck pain is frequent in patients with migraine. Likewise, evidence for inflammatory processes in the trapezius muscles is accumulating. However, non-invasive and objectively assessable correlates are missing in vivo. Methods Twenty-one subjects with episodic migraine (mean age: 24.6 ± 3.1 years, 18 females) and 22 controls (mean age: 23.0 ± 2.2 years, 17 females) without any history of headache prospectively underwent physical examination and quantitative magnetic resonance imaging of the trapezius muscles. A T2‐prepared turbo spin-echo sequence was acquired for manual segmentation of the trapezius muscles and extraction of mean T2 values. Results There were no statistically significant differences regarding age, sex, body mass index, or number of myofascial trigger points (mTrPs) between groups. All patients with migraine presented with mTrPs in the trapezius muscles. T2 of the entire trapezius muscles was significantly higher in the migraine group when compared to controls (31.1 ± 0.8 ms vs. 30.1 ± 1.1 ms; p = 0.002). Conclusions Elevated T2 values of the trapezius muscles may indicate subtle inflammatory processes within musculature among patients with migraine because T2 increase is likely to stem from edematous changes. Future work may validate this finding in larger cohorts, but muscle T2 might have potential to develop into a viable in vivo biomarker for muscular affection in migraine.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Paul Schandelmaier
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, LMU - University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Corinna Börner
- Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, LMU - University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Giada Urban
- Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, LMU - University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Magdalena Lang
- Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, LMU - University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, LMU - University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, LMU - University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Michaela V Bonfert
- Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, LMU - University Hospital, Ludwig Maximilian University, Munich, Germany
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Ge YX, Hu SD, Wang Z, Guan RP, Zhou XY, Gao QZ, Yan G. Feasibility and reproducibility of T2 mapping and DWI for identifying malignant lymph nodes in rectal cancer. Eur Radiol 2020; 31:3347-3354. [PMID: 33185752 DOI: 10.1007/s00330-020-07359-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 08/27/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the diagnostic value and reproducibility of T2 mapping versus apparent diffusion coefficients (ADC) for identifying malignant lymph nodes in patients with non-mucinous rectal adenocarcinoma. METHODS High-resolution magnetic resonance imaging, diffusion-weighted imaging, and T2 mapping were performed on patients with suspected metastatic lymph nodes in the mesorectum or around the superior rectal artery with a short-axis diameter of 4-10 mm. The T2 and ADC values of pathology-confirmed metastatic versus non-metastatic lymph nodes were compared using the independent-samples t test and receiver operating characteristic curves. Intra- and inter-observer reproducibility were tested. The cutoff value for T2 relaxation time was determined. RESULTS In total, 67 lymph nodes underwent histological analysis, with 24 in the non-metastatic and 43 in the metastatic groups. Intra- and inter-observer agreements for T2 values were 0.999 and 0.998, respectively, which were higher than the ADC values of 0.924 and 0.844, respectively. The mean T2 and ADC values for metastatic lymph nodes (65 ± 7.8 ms and 1.17 ± 0.16 × 10-3 mm2/s, respectively) were significantly lower than for benign lymph nodes(83 ± 5.7 ms and 1.29 ± 0.15 × 10-3 mm2/s, respectively). T2 values had a higher AUC value of 0.990 than the AUC value for ADC of 0.729. With a cutoff value of 77 ms, sensitivity and specificity for T2 values were 95% and 96%, respectively. CONCLUSIONS T2 mapping had higher diagnostic efficacy and reproducibility than ADC and may be useful in differentiating metastatic from non-metastatic lymph nodes in rectal cancer. KEY POINTS • Mean T2 values were significantly shorter for malignant versus benign LNs in patients with non-mucinous rectal adenocarcinoma. • The diagnostic efficacy and reproducibility of T2 values were excellent and superior to ADC values.
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Affiliation(s)
- Yu-Xi Ge
- Department of Radiology, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, Jiangsu, China
| | - Shu-Dong Hu
- Department of Radiology, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, Jiangsu, China
| | - Zi Wang
- Department of Radiology, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, Jiangsu, China
| | - Rong-Ping Guan
- Department of Radiology, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, Jiangsu, China
| | - Xin-Yi Zhou
- Department of Pathology, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, Jiangsu, China
| | - Qi-Zhong Gao
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, 214000, Jiangsu, China.
| | - Gen Yan
- Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, 556 Shengguang Road, Xiamen, 361021, Fujian, China.
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Jende JME, Kender Z, Rother C, Alvarez-Ramos L, Groener JB, Pham M, Morgenstern J, Oikonomou D, Hahn A, Juerchott A, Kollmer J, Heiland S, Kopf S, Nawroth PP, Bendszus M, Kurz FT. Diabetic Polyneuropathy Is Associated With Pathomorphological Changes in Human Dorsal Root Ganglia: A Study Using 3T MR Neurography. Front Neurosci 2020; 14:570744. [PMID: 33100960 PMCID: PMC7546893 DOI: 10.3389/fnins.2020.570744] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022] Open
Abstract
Diabetic neuropathy (DPN) is one of the most severe and yet most poorly understood complications of diabetes mellitus. In vivo imaging of dorsal root ganglia (DRG), a key structure for the understanding of DPN, has been restricted to animal studies. These have shown a correlation of decreased DRG volume with neuropathic symptom severity. Our objective was to investigate correlations of DRG morphology and signal characteristics at 3 Tesla (3T) magnetic resonance neurography (MRN) with clinical and serological data in diabetic patients with and without DPN. In this cross-sectional study, participants underwent 3T MRN of both L5 DRG using an isotropic 3D T2-weighted, fat-suppressed sequence with subsequent segmentation of DRG volume and analysis of normalized signal properties. Overall, 55 diabetes patients (66 ± 9 years; 32 men; 30 with DPN) took part in this study. DRG volume was smaller in patients with severe DPN when compared to patients with mild or moderate DPN (134.7 ± 21.86 vs 170.1 ± 49.22; p = 0.040). In DPN patients, DRG volume was negatively correlated with the neuropathy disability score (r = −0.43; 95%CI = −0.66 to −0.14; p = 0.02), a measure of neuropathy severity. DRG volume showed negative correlations with triglycerides (r = −0.40; 95%CI = −0.57 to −0.19; p = 0.006), and LDL cholesterol (r = −0.33; 95%CI = −0.51 to −0.11; p = 0.04). There was a strong positive correlation of normalized MR signal intensity (SI) with the neuropathy symptom score in the subgroup of patients with painful DPN (r = 0.80; 95%CI = 0.46 to 0.93; p = 0.005). DRG SI was positively correlated with HbA1c levels (r = 0.30; 95%CI = 0.09 to 0.50; p = 0.03) and the triglyceride/HDL ratio (r = 0.40; 95%CI = 0.19 to 0.57; p = 0.007). In this first in vivo study, we found DRG morphological degeneration and signal increase in correlation with neuropathy severity. This elucidates the potential importance of MR-based DRG assessments in studying structural and functional changes in DPN.
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Affiliation(s)
- Johann M E Jende
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Rother
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Lucia Alvarez-Ramos
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Jan B Groener
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany.,German Center of Diabetes Research, München-Neuherberg, Germany.,Medicover Neuroendokrinologie, Munich, Germany
| | - Mirko Pham
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.,Department of Neuroradiology, Würzburg University Hospital, Würzburg, Germany
| | - Jakob Morgenstern
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Dimitrios Oikonomou
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Artur Hahn
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jennifer Kollmer
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.,Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany.,German Center of Diabetes Research, München-Neuherberg, Germany
| | - Peter P Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany.,German Center of Diabetes Research, München-Neuherberg, Germany.,Joint Institute for Diabetes and Cancer at Helmholtz-Zentrum Munich and Heidelberg University, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix T Kurz
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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Yiannakas MC, Schneider T, Yoneyama M, Aforlabi-Logoh I, Prados F, Ciccarelli O, Wheeler-Kingshott CAM. Magnetisation transfer ratio combined with magnetic resonance neurography is feasible in the proximal lumbar plexus using healthy volunteers at 3T. Sci Rep 2020; 10:14568. [PMID: 32884016 PMCID: PMC7471697 DOI: 10.1038/s41598-020-71570-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/14/2020] [Indexed: 12/30/2022] Open
Abstract
Magnetic resonance neurography (MRN) has been used extensively to study pathological conditions affecting the peripheral nervous system (PNS). However, tissue damage is assessed qualitatively with little information regarding the underlying pathophysiological processes involved. Magnetisation transfer ratio (MTR) is a quantitative magnetic resonance imaging method which is sensitive to tissue macromolecular content and may therefore have an important role in the study of pathologies affecting the PNS. This study explored the feasibility of obtaining reliable MTR measurements in the proximal lumbar plexus of healthy volunteers using MRN to identify and segment each lumbar segment (L2-L5) and regions (preganglionic, ganglionic and postganglionic). Reproducibility of the MTR measurements and of the segmentation method were assessed from repeated measurements (scan-rescan), and from the reanalysis of images (intra- and inter-rater assessment), by calculating the coefficient of variation (COV). In all segments combined (L2-L5), mean (± SD) MTR was 30.5 (± 2.4). Scan-rescan, intra- and inter-rater COV values were 3.2%, 4.4% and 5.3%, respectively. One-way analysis of variance revealed a statistically significant difference in MTR between the preganglionic and postganglionic regions in all lumbar segments. This pilot study in healthy volunteers demonstrates the feasibility of obtaining reliable MTR measurements in the proximal lumbar plexus, opening up the possibility of studying a broad spectrum of neurological conditions in vivo.
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Affiliation(s)
- Marios C Yiannakas
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, Queen Square House, Queen Square, London, WC1N 3BG, UK.
| | | | | | - Innocent Aforlabi-Logoh
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, Queen Square House, Queen Square, London, WC1N 3BG, UK
| | - Ferran Prados
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, Queen Square House, Queen Square, London, WC1N 3BG, UK
- Centre for Medical Image Computing, Medical Physics and Biomedical Engineering Department, University College London, London, UK
- e-Health Centre, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Olga Ciccarelli
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, Queen Square House, Queen Square, London, WC1N 3BG, UK
| | - Claudia A M Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, Queen Square House, Queen Square, London, WC1N 3BG, UK
- Brain MRI 3T Research Centre, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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10
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Sollmann N, Cervantes B, Klupp E, Weidlich D, Makowski MR, Kirschke JS, Hu HH, Karampinos DC. Magnetic resonance neurography of the lumbosacral plexus at 3 Tesla - CSF-suppressed imaging with submillimeter resolution by a three-dimensional turbo spin echo sequence. Magn Reson Imaging 2020; 71:132-139. [PMID: 32553857 DOI: 10.1016/j.mri.2020.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE To investigate magnetic resonance neurography (MRN) of the lumbosacral plexus (LSP) with cerebrospinal fluid (CSF) suppression by using submillimeter resolution for three-dimensional (3D) turbo spin echo (TSE) imaging. MATERIALS AND METHODS Using extended phase graph (EPG) analysis, the signal response of CSF was simulated considering dephasing from coherent motion for frequency-encoding voxel sizes ranging from 0.3 to 1.3 mm and for CSF velocities ranging from 0 to 4 cm/s. In-vivo MRN included 3D TSE data with frequency encoding parallel to the feet/head axis from 15 healthy adults (mean age: 28.5 ± 3.8 years, 5 females; acquisition voxel size: 2 × 2 × 2 mm3) and 16 pediatric patients (mean age: 6.7 ± 4.1 years, 7 females; acquisition voxel size: 0.7 × 0.7 × 1.4 mm3) acquired at 3 Tesla. Five of the adults were scanned repetitively with changing acquisition voxel sizes (1 × 2 × 2 mm3, 0.7 × 2× 2 mm3, and 0.5 × 2 × 2 mm3). Measurements of the bilateral ganglion of the L5 nerve root, averaged between sides, as well as the CSF in the thecal sac were obtained for all included subjects and compared between adults and pediatric patients and between voxel sizes, using a CSF-to-nerve signal ratio (CSFNR). RESULTS According to simulations, the CSF signal is reduced along the echo train for moving spins. Specifically, it can be reduced by over 90% compared to the maximum simulated signal for flow velocities above 2 cm/s, and could be most effectively suppressed by considering a frequency-encoding voxel size of 0.8 mm or less. For in-vivo measurements, mean CSFNR was 1.52 ± 0.22 for adults and 0.10 ± 0.03 for pediatric patients (p < .0001). Differences in CSFNR were significant between measurements using a voxel size of 2 × 2 × 2 mm3 and measurements in data with reduced voxel sizes (p ≤ .0012), with submillimeter resolution (particularly 0.5 × 2 × 2 mm3) providing highest CSF suppression. CONCLUSIONS Applying frequency-encoding voxel sizes in submillimeter range for 3D TSE imaging with frequency encoding parallel to the feet/head axis may considerably improve MRN of LSP pathology in adults in the future because of favorable CSF suppression.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Barbara Cervantes
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Elisabeth Klupp
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Houchun H Hu
- Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA; Hyperfine Research, Guilford, CT, USA
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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11
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Sollmann N, Weidlich D, Klupp E, Cervantes B, Ganter C, Zimmer C, Rummeny EJ, Baum T, Kirschke JS, Karampinos DC. T2 mapping of the distal sciatic nerve in healthy subjects and patients suffering from lumbar disc herniation with nerve compression. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 33:713-724. [PMID: 32048099 PMCID: PMC7502059 DOI: 10.1007/s10334-020-00832-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/22/2019] [Accepted: 01/28/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To measure T2 values for magnetic resonance neurography (MRN) of the healthy distal sciatic nerve and compare those to T2 changes in patients with nerve compression. MATERIALS AND METHODS Twenty-one healthy subjects and five patients with sciatica due to disc herniation underwent MRN using a T2-prepared turbo spin echo (TSE) sequence of the distal sciatic nerve bilaterally. Six and one of those healthy subjects further underwent a commonly used multi-echo spin-echo (MESE) sequence and magnetic resonance spectroscopy (MRS), respectively. RESULTS T2 values derived from the T2-prepared TSE sequence were 44.6 ± 3.0 ms (left) and 44.5 ± 2.6 ms (right) in healthy subjects and showed good inter-reader reliability. In patients, T2 values of 61.5 ± 6.2 ms (affected side) versus 43.3 ± 2.4 ms (unaffected side) were obtained. T2 values of MRS were in good agreement with measurements from the T2-prepared TSE, but not with those of the MESE sequence. DISCUSSION A T2-prepared TSE sequence enables precise determination of T2 values of the distal sciatic nerve in agreement with MRS. A MESE sequence tends to overestimate nerve T2 compared to T2 from MRS due to the influence of residual fat on T2 quantification. Our approach may enable to quantitatively assess direct nerve affection related to nerve compression.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Elisabeth Klupp
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Barbara Cervantes
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Carl Ganter
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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12
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Where do patients with MRI-confirmed single-level radiculopathy experience pain, and what is the clinical interpretability of these pain patterns? A cross-sectional diagnostic accuracy study. Chiropr Man Therap 2019; 27:50. [PMID: 31608144 PMCID: PMC6778979 DOI: 10.1186/s12998-019-0273-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 07/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Clinicians nominate the distribution of leg pain as being important in diagnosing nerve root involvement. This study aimed to identify: (i) common unisegmental radicular pain patterns and whether they were dermatomal, and (ii) whether these radicular pain patterns assisted clinician discrimination of the nerve root level involved. Methods A cross-sectional diagnostic accuracy study of adult patients with radicular leg pain at a hospital in Denmark. All patients had positive neurological signs (average 2.8 signs - hypoalgesia, diminished reflexes, muscle weakness, positive Straight Leg Raise test).Part 1 (pain patterns) was a secondary analysis of baseline pain pattern data collected during a clinical trial. The pain charts of 93 patients with an MRI and clinically confirmed single-level disc herniation with nerve root compression were digitised and layered to form a composite picture of the radicular patterns for the L5 and S1 nerve roots, which were then compared to published dermatomes.In Part 2 (clinical utility) we prospectively measured the discriminative ability of the identified pain patterns. The accuracy was calculated of three groups of six clinicians at classifying the nerve root affected in a randomized sequence of 53 patients, when not shown, briefly shown or continuously shown the composite pain patterns. In each group were two chiropractors, two medical doctors and two physiotherapists. Results There was a wide overlap in pain patterns from compromised L5 and S1 nerve roots but some distinguishing features. These pain patterns had approximately 50 to 80% overlap with published dermatomes. Clinicians were unable to determine with any accuracy above chance whether an individual pain drawing was from a person with a compromised L5 or S1 nerve root, and use of the composite pain drawings did not improve that accuracy. Conclusions While pain distribution may be an indication of radiculopathy, pain patterns from L5 or S1 nerve root compression only approximated those of sensory dermatomes, and level-specific knowledge about radicular pain patterns did not assist clinicians' diagnostic accuracy of the nerve root impinged. These results indicate that, on their own, pain patterns provide very limited additional diagnostic information about which individual nerve root is affected.
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13
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Vietti Violi N, Hilbert T, Bastiaansen JAM, Knebel JF, Ledoux JB, Stemmer A, Meuli R, Kober T, Schmidt S. Patient respiratory-triggered quantitative T 2 mapping in the pancreas. J Magn Reson Imaging 2019; 50:410-416. [PMID: 30637852 PMCID: PMC6766866 DOI: 10.1002/jmri.26612] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/21/2018] [Accepted: 11/26/2018] [Indexed: 02/06/2023] Open
Abstract
Background Long acquisition times and motion sensitivity limit T2 mapping in the abdomen. Accelerated mapping at 3 T may allow for quantitative assessment of diffuse pancreatic disease in patients during free‐breathing. Purpose To test the feasibility of respiratory‐triggered quantitative T2 analysis in the pancreas and correlate T2‐values with age, body mass index, pancreatic location, main pancreatic duct dilatation, and underlying pathology. Study Type Retrospective single‐center pilot study. Population Eighty‐eight adults. Field Strength/Sequence Ten‐fold accelerated multiecho‐spin‐echo 3 T MRI sequence to quantify T2 at 3 T. Assessment Two radiologists independently delineated three regions of interest inside the pancreatic head, body, and tail for each acquisition. Means and standard deviations for T2 values in these regions were determined. T2‐value variation with demographic data, intraparenchymal location, pancreatic duct dilation, and underlying pancreatic disease was assessed. Statistical Tests Interreader reliability was determined by calculating the interclass coefficient (ICCs). T2 values were compared for different pancreatic locations by analysis of variance (ANOVA). Interpatient associations between T2 values and demographical, clinical, and radiological data were calculated (ANOVA). Results The accelerated T2 mapping sequence was successfully performed in all participants (mean acquisition time, 2:48 ± 0:43 min). Low T2 value variability was observed across all patients (intersubject) (head: 60.2 ± 8.3 msec, body: 63.9 ± 11.5 msec, tail: 66.8 ± 16.4 msec). Interreader agreement was good (ICC, 0.82, 95% confidence interval: 0.77–0.86). T2‐values differed significantly depending on age (P < 0.001), location (P < 0.001), main pancreatic duct dilatation (P < 0.001), and diffuse pancreatic disease (P < 0.03). Data Conclusion The feasibility of accelerated T2 mapping at 3 T in moving abdominal organs was demonstrated in the pancreas, since T2 values were stable and reproducible. In the pancreatic parenchyma, T2‐values were significantly dependent on demographic and clinical parameters. Level of Evidence: 4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:410–416.
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Affiliation(s)
- Naïk Vietti Violi
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Tom Hilbert
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare, Switzerland.,LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Jessica A M Bastiaansen
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jean-Francois Knebel
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Laboratory for investigative neurophysiology (The LINE), Department of Radiology and Department of Clinical Neurosciences, University hospital center and University of Lausanne, Lausanne, Switzerland
| | - Jean-Baptiste Ledoux
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | | | - Reto Meuli
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Tobias Kober
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare, Switzerland.,LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sabine Schmidt
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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14
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Hiwatashi A, Togao O, Yamashita K, Kikuchi K, Momosaka D, Nakatake H, Yamasaki R, Ogata H, Yoneyama M, Kira JI, Honda H. Lumbar plexus in patients with chronic inflammatory demyelinating polyradiculoneuropathy: evaluation with simultaneous T 2 mapping and neurography method with SHINKEI. Br J Radiol 2018; 91:20180501. [PMID: 30160180 DOI: 10.1259/bjr.20180501] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE: To evaluate the usefulness of simultaneous T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (SHINKEI) in the lumbar plexus to distinguish patients with chronic inflammatory demyelinating polyneuropathy (CIDP) from healthy controls. METHODS: Our institutional review boards approved this retrospective study, and written informed consent was waived. 10 patients with CIDP from 2015 to 2017 were studied along with 5 healthy controls on a 3 T scanner. The T2 relaxation time and the size of the dorsal root ganglia and nerves of the lumbar plexus at L3-S1 were measured. Statistical analyses were performed with the Mann-Whitney U test and a receiver operating characteristics analysis. RESULTS: The T2 relaxation times of the dorsal root ganglia and the nerves of the lumbar plexus were longer in the CIDP patients (133.34 ± 41.36 and 130.40 ± 47.78 ms) compared to the healthy controls (114.69 ± 24.90 and 83.72 ± 17.51 ms, p = 0.0265 and p < 0.0001, respectively). The sizes of the nerves were larger in the CIDP patients (6.19 ± 2.28 mm) compared to the controls (4.54 ± 0.86 mm, p < 0.0001). However, there was no significant difference between the sizes of the ganglia in the CIDP patients and the controls. The receiver operating characteristics analysis revealed that the T2 relaxation time of the nerves was best at distinguishing the CIDP patients from the controls (Az = 0.848). CONCLUSION: Patients with CIDP could be distinguished from healthy controls using simultaneous T2 mapping and neurography with SHINKEI in the lumbar plexus. ADVANCES IN KNOWLEDGE: Patients with CIDP could be distinguished from healthy controls using simultaneous T2 mapping and neurography with SHINKEI in the lumbar plexus.
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Affiliation(s)
- Akio Hiwatashi
- 1 Departments of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Osamu Togao
- 2 Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Koji Yamashita
- 2 Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Kazufumi Kikuchi
- 2 Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Daichi Momosaka
- 2 Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Hiroshi Nakatake
- 2 Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Ryo Yamasaki
- 3 Neurology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Hidenori Ogata
- 3 Neurology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | | | - Jun-Ichi Kira
- 3 Neurology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Hiroshi Honda
- 2 Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
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