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Campbell GJ, Sneag DB, Queler SC, Lin Y, Li Q, Tan ET. Quantitative double echo steady state T2 mapping of upper extremity peripheral nerves and muscles. Front Neurol 2024; 15:1359033. [PMID: 38426170 PMCID: PMC10902120 DOI: 10.3389/fneur.2024.1359033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction T2 mapping can characterize peripheral neuropathy and muscle denervation due to axonal damage. Three-dimensional double echo steady-state (DESS) can simultaneously provide 3D qualitative information and T2 maps with equivalent spatial resolution. However, insufficient signal-to-noise ratio may bias DESS-T2 values. Deep learning reconstruction (DLR) techniques can reduce noise, and hence may improve quantitation of high-resolution DESS-T2. This study aims to (i) evaluate the effect of DLR methods on DESS-T2 values, and (ii) to evaluate the feasibility of using DESS-T2 maps to differentiate abnormal from normal nerves and muscles in the upper extremities, with abnormality as determined by electromyography. Methods and results Analysis of images from 25 subjects found that DLR decreased DESS-T2 values in abnormal muscles (DLR = 37.71 ± 9.11 msec, standard reconstruction = 38.56 ± 9.44 msec, p = 0.005) and normal muscles (DLR: 27.18 ± 6.34 msec, standard reconstruction: 27.58 ± 6.34 msec, p < 0.001) consistent with a noise reduction bias. Mean DESS-T2, both with and without DLR, was higher in abnormal nerves (abnormal = 75.99 ± 38.21 msec, normal = 35.10 ± 9.78 msec, p < 0.001) and muscles (abnormal = 37.71 ± 9.11 msec, normal = 27.18 ± 6.34 msec, p < 0.001). A higher DESS-T2 in muscle was associated with electromyography motor unit recruitment (p < 0.001). Discussion These results suggest that quantitative DESS-T2 is improved by DLR and can differentiate the nerves and muscles involved in peripheral neuropathies from those uninvolved.
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Affiliation(s)
- Gracyn J. Campbell
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
| | - Darryl B. Sneag
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
| | - Sophie C. Queler
- College of Medicine, Downstate Health Sciences University, Brooklyn, NY, United States
| | - Yenpo Lin
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Qian Li
- Biostatistics Core, Hospital for Special Surgery, New York, NY, United States
| | - Ek T. Tan
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
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Jiang M, Song X, Zhang H, Tao X, Yang G, Wang Y, Liu Y, Zhou H, Sun J, Li Y. The combination of T2-mapping value of lacrimal gland and clinical indicators can improve the stage prediction of Graves' ophthalmopathy compared to clinical activity scores. Endocrine 2022; 78:321-328. [PMID: 35997966 DOI: 10.1007/s12020-022-03167-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/06/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To explore radiological changes of the lacrimal gland (LG) in Graves' ophthalmopathy (GO) and whether a combination of MRI parameters and clinical indicators would be more effective in predicting individual clinical manifestation of GO compared to clinical activity scores (CAS) assessment. METHODS A total of 28 patients with GO (56 eyes) and 14 healthy controls (HCs) (28 eyes) were enrolled between July 2020 and July 2021. Patients were classified into the active GO group (CAS ≥ 3) and the inactive GO group (CAS < 3). MRI data and clinical data of LG were collected. The diagnostic performance of MRI parameters and models was assessed by receiver operating characteristic curve analysis. Logistic regression predictive models for staging GO were compared. RESULTS LG in GO groups had significantly higher Ktrans, Ve, IAUC, ADC, and T2-mapping values (p = 0.006, p < 0.001, p < 0.001, p = 0.048, and p = 0.001, respectively), and significant lower Kep and Vp values (p < 0.001 and p < 0.001 respectively). There were statistically significant differences in T2-mapping value (p < 0.001), the proportion of mild or no obvious redness of conjunctiva (p < 0.001), and the proportion of swelling of caruncle or plica (p < 0.001) between inactive and active groups. In MRI based logistic regression model, the T2-mapping value was an independent risk factor (AUC = 0.832). When combining MRI and clinical indicators, T2-mapping value and age resulted in independent risk factors (AUC = 0.928). Swelling of eyelids, redness of the conjunctiva, swelling of the conjunctiva, swelling of caruncle or plica, and spontaneous retrobulbar pain could be replaced by other objective indicators (AUC = 0.937, 0.852, 0.876, 0.896, and 0.891, respectively). CONCLUSION There were significant differences in MRI quantitative parameters of LG between HCs and GO patients. The combination of the T2-mapping value of LG and clinical indicators improved the stage prediction of Graves' ophthalmopathy compared to CAS, thus providing a new idea for enhancing the objectification level of GO data collection.
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Affiliation(s)
- Mengda Jiang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Xuefei Song
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Haiyang Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Gongxin Yang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China
| | - Yishi Wang
- Philips Healthcare, Beijing, 100600, China
| | - Yuting Liu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Huifang Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Jing Sun
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China.
| | - Yinwei Li
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China.
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Chen J, Qin Z, Zeng X, Zhong Y, Deng M, Lan B, Fan B. Applicative value of T2 mapping in evaluating lumbosacral nerve root injury induced by lumbosacral disc herniation. Acta Radiol 2022; 64:1526-1532. [PMID: 36171736 DOI: 10.1177/02841851221128377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To alleviate the damage caused by nerve root entrapment mediated by lumbosacral disc herniation (LDH), an imaging method that allows quantitative evaluation of the lumbosacral nerve injury is necessary. PURPOSE To investigate the diagnostic value of magnetic resonance (MR) T2 mapping in nerve root injury caused by LDH. MATERIAL AND METHODS A total of 70 patients with unilateral sciatic nerve pain and 35 healthy volunteers were divided into three groups: LDH with nerve root entrapment; LDH without nerve root entrapment; and 35 healthy volunteers. All participants underwent 3.0-T MR with T1-weighted (T1W) imaging, T2-weighted (T2W) imaging, and T2-mapping images. T2 was measured and observed with the left and right nerve roots of the L4-S1 segments in healthy volunteers; the differences between the three groups were compared. T2 and the relaxation rate of nerve root injury were analyzed. RESULTS T2 showed significant differences among the three groups (F = 89.494; P = 0.000), receiver operating characteristic curve revealed that the T2 relaxation threshold was 79 ms, the area under curve (AUC) area was 0.86, sensitivity was 0.77, and specificity was 0.74; the T2 relaxation rate was 1.06, the AUC area was 0.88, sensitivity was 0.74, and specificity was 0.85. CONCLUSION T2 mapping could quantitatively evaluate the nerve root injury with lumbar disc degeneration. Hence, it can be used for the clinical evaluation of nerve root entrapment caused by LDH.
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Affiliation(s)
- Jingcong Chen
- Department of Radiology, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Ziliang Qin
- Interventional Room, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Xiangling Zeng
- Department of Radiology, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Yu Zhong
- Department of Radiology, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Ming Deng
- Interventional Room, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Bowen Lan
- Department of Radiology, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Bing Fan
- Department of radiology, 159384Jiangxi Provincial People's Hospital, Nanchang, PR China
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Martín-Noguerol T, Montesinos P, Hassankhani A, Bencardino DA, Barousse R, Luna A. Technical Update on MR Neurography. Semin Musculoskelet Radiol 2022; 26:93-104. [PMID: 35609571 DOI: 10.1055/s-0042-1742753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Imaging evaluation of peripheral nerves (PNs) is challenging. Magnetic resonance imaging (MRI) and ultrasonography are the modalities of choice in the imaging assessment of PNs. Both conventional MRI pulse sequences and advanced techniques have important roles. Routine MR sequences are the workhorse, with the main goal to provide superb anatomical definition and identify focal or diffuse nerve T2 signal abnormalities. Selective techniques, such as three-dimensional (3D) cranial nerve imaging (CRANI) or 3D NerveVIEW, allow for a more detailed evaluation of normal and pathologic states. These conventional pulse sequences have a limited role in the comprehensive assessment of pathophysiologic and ultrastructural abnormalities of PNs. Advanced functional MR neurography sequences, such as diffusion tensor imaging tractography or T2 mapping, provide useful and robust quantitative parameters that can be useful in the assessment of PNs on a microscopic level. This article offers an overview of various technical parameters, pulse sequences, and protocols available in the imaging of PNs and provides tips on avoiding potential pitfalls.
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Affiliation(s)
| | | | - Alvand Hassankhani
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | | | - Rafael Barousse
- Peripheral Nerve and Plexus Department, Centro Rossi, Buenos Aires, Argentina
| | - Antonio Luna
- MRI Unit, Radiology Department, HT Médica, Jaén, Spain
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Wang H, Li K, Wang Q, Liu X, Zhao X, Zhong Z, Gu C, Li R. Magnetic Resonance Neurography for Evaluation of Dorsal Root Ganglion Morphology. World Neurosurg 2021; 154:e54-e60. [PMID: 34224889 DOI: 10.1016/j.wneu.2021.06.123] [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: 06/05/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND In this study, the morphologic characteristics and anatomic position of the dorsal root ganglion (DRG) were measured and analyzed in healthy people using magnetic resonance neurography (MRN), which provided an anatomical reference for minimally invasive spinal surgery. METHODS From January 2018 to December 2019, 20 healthy adult volunteers (10 male and 10 female volunteers between 20 and 65 years old) were scanned and imaged by 3.0 T magnetic resonance imaging combined with neuroimaging technology. Here, the position of the DRG was located, and the shape and size of the DRG, as well as its distance to the upper pedicle, were measured. RESULTS All volunteers provided satisfactory MRN scans of the L1-S1 lumbar DRG. According to the spatial position of the DRG, the morphology of the DRG can be divided into the intervertebral foramen type (81.01%), intraspinal type (16.01%), extraforaminal type (0.8%), and mixed type (2.0%). CONCLUSIONS The intervertebral foramen type and Intraspinal type were observed to be the main distribution forms of lumbar DRG. Due to the downward movement of lumbar segments, the position of the DRG was noted to gradually move to the spinal canal while its volume gradually increased. In addition, the distance from the upper pedicle was found to decrease gradually. MRN imaging can clearly show the shape, location, and adjacent relationship of the DRG, providing effective imaging guidance for the minimally invasive lumbar techniques.
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Affiliation(s)
- Hongwei Wang
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China.
| | - Kaixiang Li
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Qingyun Wang
- Department of Radiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Xiaoqiang Liu
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Xiangjun Zhao
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Zhanghua Zhong
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Changwei Gu
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Ruibing Li
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
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Preisner F, Behnisch R, Foesleitner O, Schwarz D, Wehrstein M, Meredig H, Friedmann-Bette B, Heiland S, Bendszus M, Kronlage M. Reliability and reproducibility of sciatic nerve magnetization transfer imaging and T2 relaxometry. Eur Radiol 2021; 31:9120-9130. [PMID: 34104997 PMCID: PMC8589742 DOI: 10.1007/s00330-021-08072-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/08/2021] [Accepted: 05/11/2021] [Indexed: 12/19/2022]
Abstract
Objectives To assess the interreader and test-retest reliability of magnetization transfer imaging (MTI) and T2 relaxometry in sciatic nerve MR neurography (MRN). Materials and methods In this prospective study, 21 healthy volunteers were examined three times on separate days by a standardized MRN protocol at 3 Tesla, consisting of an MTI sequence, a multi-echo T2 relaxometry sequence, and a high-resolution T2-weighted sequence. Magnetization transfer ratio (MTR), T2 relaxation time, and proton spin density (PSD) of the sciatic nerve were assessed by two independent observers, and both interreader and test-retest reliability for all readout parameters were reported by intraclass correlation coefficients (ICCs) and standard error of measurement (SEM). Results For the sciatic nerve, overall mean ± standard deviation MTR was 26.75 ± 3.5%, T2 was 64.54 ± 8.2 ms, and PSD was 340.93 ± 78.8. ICCs ranged between 0.81 (MTR) and 0.94 (PSD) for interreader reliability and between 0.75 (MTR) and 0.94 (PSD) for test-retest reliability. SEM for interreader reliability was 1.7% for MTR, 2.67 ms for T2, and 21.3 for PSD. SEM for test-retest reliability was 1.7% for MTR, 2.66 ms for T2, and 20.1 for PSD. Conclusions MTI and T2 relaxometry of the sciatic nerve are reliable and reproducible. The values of measurement imprecision reported here may serve as a guide for correct interpretation of quantitative MRN biomarkers in future studies. Key Points • Magnetization transfer imaging (MTI) and T2 relaxometry of the sciatic nerve are reliable and reproducible. • The imprecision that is unavoidably associated with different scans or different readers can be estimated by the here presented SEM values for the biomarkers T2, PSD, and MTR. • These values may serve as a guide for correct interpretation of quantitative MRN biomarkers in future studies and possible clinical applications. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08072-9.
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Affiliation(s)
- Fabian Preisner
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Olivia Foesleitner
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Daniel Schwarz
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Michaela Wehrstein
- Department of Sports Medicine (Internal Medicine VII), Medical Clinic, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Hagen Meredig
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Birgit Friedmann-Bette
- Department of Sports Medicine (Internal Medicine VII), Medical Clinic, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Moritz Kronlage
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
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Felisaz PF, Belatti E, Deligianni X, Bergsland N, Santini F, Paoletti M, Solazzo F, Germani G, Cortese A, Vegezzi E, Bieri O, Bastianello S, Pichiecchio A. Variable echo time imaging for detecting the short T2* components of the sciatic nerve: a validation study. MAGMA (NEW YORK, N.Y.) 2021; 34:411-419. [PMID: 32964300 PMCID: PMC8154754 DOI: 10.1007/s10334-020-00886-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 12/02/2022]
Abstract
OBJECTIVE The aim of this study was to develop and validate an MRI protocol based on a variable echo time (vTE) sensitive to the short T2* components of the sciatic nerve. MATERIALS AND METHODS 15 healthy subjects (M/F: 9/6; age: 21-62) were scanned at 3T targeting the sciatic nerve at the thigh bilaterally, using a dual echo variable echo time (vTE) sequence (based on a spoiled gradient echo acquisition) with echo times of 0.98/5.37 ms. Apparent T2* (aT2*) values of the sciatic nerves were calculated with a mono-exponential fit and used for data comparison. RESULTS There were no significant differences in aT2* related to side, sex, age, and BMI, even though small differences for side were reported. Good-to-excellent repeatability and reproducibility were found for geometry of ROIs (Dice indices: intra-rater 0.68-0.7; inter-rater 0.70-0.72) and the related aT2* measures (intra-inter reader ICC 0.95-0.97; 0.66-0.85) from two different operators. Side-related signal-to-noise-ratio non-significant differences were reported, while contrast-to-noise-ratio measures were excellent both for side and echo. DISCUSSION Our study introduces a novel MR sequence sensitive to the short T2* components of the sciatic nerve and may be used for the study of peripheral nerve disorders.
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Affiliation(s)
- Paolo Florent Felisaz
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
- Department of Radiology, Desio Hospital, ASST Monza, Desio, Italy
| | - Eugenio Belatti
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Xeni Deligianni
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland.
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Francesco Santini
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Matteo Paoletti
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Francesca Solazzo
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Giancarlo Germani
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Andrea Cortese
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
- Department for Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology, London, UK
| | - Elisa Vegezzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
| | - Oliver Bieri
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Stefano Bastianello
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
| | - Anna Pichiecchio
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
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Hu H, Chen HH, Chen W, Wu Q, Chen L, Zhu H, Shi HB, Xu XQ, Wu FY. Thyroid-Associated Ophthalmopathy: Preliminary Study Using T2 Mapping to Characterize Intraorbital Optic Nerve Changes Before Dysthyroid Optic Neuropathy. Endocr Pract 2021; 27:191-197. [PMID: 33630733 DOI: 10.1016/j.eprac.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/25/2020] [Accepted: 09/15/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the performance of T2 mapping in detecting intraorbital optic nerve (ON) changes in patients with thyroid-associated ophthalmopathy (TAO) before the onset of dysthyroid optic neuropathy (DON). METHODS Thirty-five patients with TAO and without DON (21 active, 14 inactive) and 21 healthy controls (HCs) were enrolled. Magnetic resonance imaging-derived parameters of T2 relaxation time (T2RT) at the intraorbital ON, extraocular muscle (EOM), orbital fat, exophthalmos, summed thickness of EOMs, orbital fat thickness, and clinical variables were compared. Correlations between T2RT at the ON and other variables were assessed. RESULTS Patients with TAO showed significantly higher T2RTs at the intraorbital ON than HCs (P < .001). Patients with active TAO had significantly higher T2RTs than those with inactive TAO and HCs (P < .001). Differences between patients with inactive TAO and HCs were insignificant (P > .05/3). T2RT at the intraorbital ON was positively correlated with clinical activity score, modified NOSPECS score, T2RT at EOM, exophthalmos, and summed thickness of EOMs in the TAO group (P ≤ .003) and negatively correlated with visual acuity (P = .033) and visual field indices (P = .030) in patients with active TAO. A T2RT cutoff of 82.9 ms for the intraorbital ON distinguished active TAO and healthy eyes optimally (area under the curve, 0.800; sensitivity, 85.7%; specificity, 64.3%). CONCLUSION T2RT detects disturbance in the intraorbital ON in patients with TAO, especially active TAO, before DON develops. T2 mapping has a potential for noninvasive evaluation of ON changes in patients with TAO.
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Affiliation(s)
- Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huan-Huan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wen Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qian Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hai-Bin Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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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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Van der Cruyssen F, Peeters F, Croonenborghs TM, Fransen J, Renton T, Politis C, Casselman J, Jacobs R. A systematic review on diagnostic test accuracy of magnetic resonance neurography versus clinical neurosensory assessment for post-traumatic trigeminal neuropathy in patients reporting neurosensory disturbance. Dentomaxillofac Radiol 2020; 50:20200103. [PMID: 32401614 PMCID: PMC7780836 DOI: 10.1259/dmfr.20200103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To perform a systematic review of published studies on diagnostic accuracy of magnetic resonance neurography (MRN) vs clinical neurosensory testing (NST) for post-traumatic trigeminal neuropathy (PTTN) in patients reporting neurosensory disturbances (NSD). METHODS Human studies except case reports, reviews, systematic reviews and meta-analyses were included. PubMed, Embase, Web of Science and Cochrane Library were consulted. Risk of bias assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Predetermined data extraction parameters were noted and summarized. RESULTS 8 studies met eligibility criteria of which 7 were retrospective, representing 444 subjects. Most studies were at high risk of bias with low applicability concerns. Populations and objectives were divergent with a large variation in timing (3 days-17 years post injury) and parameters (multiple coil designs, fat suppression techniques, additional contrast agent) of MRI acquisition. T2 weighted 3 T imaging with short echo times (2.2-100 ms) and fat suppression was applied in seven studies, techniques varied. Determination of sensitivity and specificity could not be performed due to the methodological variation between studies and lacking comparative data between index and reference tests. Based on limited data, PTTN correlated reasonably well between clinical assessment, intraoperative findings and MRN abnormalities (k = 0.57). Increased signal intensity correlated with persistency of neurosensory disturbances in one study. Intra- (ICC 0.914-0.927) and interobserver (k = 0.70-0.891) MRN variability was considered good to excellent. One retrospective study showed substantial impact of MRN on clinical decision making in one-third of patients. CONCLUSION Currently, there is insufficient scientific knowledge to support or refute the use of MRN. Based on limited data, MRN seems promising and reliable in detection and grading of PTTN. Methodological issues underline the importance for prospective blinded studies with standardization of signal intensity calculation and rigorous reporting of MRI acquisition parameters.
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Affiliation(s)
- Frederic Van der Cruyssen
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Frederik Peeters
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Tomas-Marijn Croonenborghs
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Jasper Fransen
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Tara Renton
- Department of Oral Surgery, King's College London Dental Institute, London, United Kingdom
| | - Constantinus Politis
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Jan Casselman
- Department of Radiology, AZ St-Jan Brugge-Oostende, Bruges, Belgium.,Department of Radiology, AZ St-Augustinus, Antwerp, Belgium
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium.,Department of Oral Health Sciences and Department of Dentistry, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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