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van Ooijen I, Annink K, Benders M, Dudink J, Alderliesten T, Groenendaal F, Tataranno M, Lequin M, Hoogduin J, Visser F, Raaijmakers A, Klomp D, Wiegers E, Wijnen J, van der Aa N. Introduction of ultra-high-field MR brain imaging in infants: vital parameters, temperature and comfort. NEUROIMAGE. REPORTS 2023; 3:100175. [PMID: 38357432 PMCID: PMC10865273 DOI: 10.1016/j.ynirp.2023.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 02/16/2024]
Abstract
Background Brain MRI in infants at ultra-high-field scanners might improve diagnostic quality, but safety should be evaluated first. In our previous study, we reported simulated specific absorption rates and acoustic noise data at 7 Tesla. Methods In this study, we included twenty infants between term-equivalent age and three months of age. The infants were scanned on a 7 Tesla MRI directly after their clinically indicated 3 Tesla brain MRI scan. Vital parameters, temperature, and comfort were monitored throughout the process. Brain temperature was estimated during the MRI scans using proton MR spectroscopy. Results We found no significant differences in vital parameters, temperature, and comfort during and after 7 Tesla MRI scans, compared to 3 Tesla MRI scans. Conclusions These data confirm our hypothesis that scanning infants at 7 Tesla MRI appears to be safe and we identified no additional risks from scanning at 3 Tesla MRI.
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Affiliation(s)
- I.M. van Ooijen
- Department of Neonatology, University Medical Center Utrecht, Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
- Centre for Image Sciences, High Field MR Research, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - K.V. Annink
- Department of Neonatology, University Medical Center Utrecht, Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - M.J.N.L. Benders
- Department of Neonatology, University Medical Center Utrecht, Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - J. Dudink
- Department of Neonatology, University Medical Center Utrecht, Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - T. Alderliesten
- Department of Neonatology, University Medical Center Utrecht, Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - F. Groenendaal
- Department of Neonatology, University Medical Center Utrecht, Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - M.L. Tataranno
- Department of Neonatology, University Medical Center Utrecht, Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - M.H. Lequin
- Departement of Radiology, Division of Imaging and Oncology, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - J.M. Hoogduin
- Centre for Image Sciences, High Field MR Research, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - F. Visser
- Centre for Image Sciences, High Field MR Research, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - A.J.E. Raaijmakers
- Centre for Image Sciences, High Field MR Research, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - D.W.J. Klomp
- Centre for Image Sciences, High Field MR Research, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - E.C. Wiegers
- Centre for Image Sciences, High Field MR Research, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - J.P. Wijnen
- Centre for Image Sciences, High Field MR Research, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - N.E. van der Aa
- Department of Neonatology, University Medical Center Utrecht, Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
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2
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Clément J, Tomi-Tricot R, Malik SJ, Webb A, Hajnal JV, Ipek Ö. Towards an integrated neonatal brain and cardiac examination capability at 7 T: electromagnetic field simulations and early phantom experiments using an 8-channel dipole array. MAGMA (NEW YORK, N.Y.) 2022; 35:765-778. [PMID: 34997396 PMCID: PMC9463228 DOI: 10.1007/s10334-021-00988-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Neonatal brain and cardiac imaging would benefit from the increased signal-to-noise ratio levels at 7 T compared to lower field. Optimal performance might be achieved using purpose designed RF coil arrays. In this study, we introduce an 8-channel dipole array and investigate, using simulations, its RF performances for neonatal applications at 7 T. METHODS The 8-channel dipole array was designed and evaluated for neonatal brain/cardiac configurations in terms of SAR efficiency (ratio between transmit-field and maximum specific-absorption-rate level) using adjusted dielectric properties for neonate. A birdcage coil operating in circularly polarized mode was simulated for comparison. Validation of the simulation model was performed on phantom for the coil array. RESULTS The 8-channel dipole array demonstrated up to 46% higher SAR efficiency levels compared to the birdcage coil in neonatal configurations, as the specific-absorption-rate levels were alleviated. An averaged normalized root-mean-square-error of 6.7% was found between measured and simulated transmit field maps on phantom. CONCLUSION The 8-channel dipole array design integrated for neonatal brain and cardiac MR was successfully demonstrated, in simulation with coverage of the baby and increased SAR efficiency levels compared to the birdcage. We conclude that the 8Tx-dipole array promises safe operating procedures for MR imaging of neonatal brain and heart at 7 T.
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Affiliation(s)
- Jérémie Clément
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | | | - Shaihan J Malik
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Centre for the Developing Brain, King's College London, London, UK
| | - Andrew Webb
- Department of Radiology, C. J Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - Joseph V Hajnal
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Centre for the Developing Brain, King's College London, London, UK
| | - Özlem Ipek
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
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3
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Fiber tracing and microstructural characterization among audiovisual integration brain regions in neonates compared with young adults. Neuroimage 2022; 254:119141. [PMID: 35342006 DOI: 10.1016/j.neuroimage.2022.119141] [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: 06/09/2021] [Revised: 02/23/2022] [Accepted: 03/21/2022] [Indexed: 11/23/2022] Open
Abstract
Audiovisual integration has been related with cognitive-processing and behavioral advantages, as well as with various socio-cognitive disorders. While some studies have identified brain regions instantiating this ability shortly after birth, little is known about the structural pathways connecting them. The goal of the present study was to reconstruct fiber tracts linking AVI regions in the newborn in-vivo brain and assess their adult-likeness by comparing them with analogous fiber tracts of young adults. We performed probabilistic tractography and compared connective probabilities between a sample of term-born neonates (N = 311; the Developing Human Connectome Project (dHCP, http://www.developingconnectome.org) and young adults (N = 311 The Human Connectome Project; https://www.humanconnectome.org/) by means of a classification algorithm. Furthermore, we computed Dice coefficients to assess between-group spatial similarity of the reconstructed fibers and used diffusion metrics to characterize neonates' AVI brain network in terms of microstructural properties, interhemispheric differences and the association with perinatal covariates and biological sex. Overall, our results indicate that the AVI fiber bundles were successfully reconstructed in a vast majority of neonates, similarly to adults. Connective probability distributional similarities and spatial overlaps of AVI fibers between the two groups differed across the reconstructed fibers. There was a rank-order correspondence of the fibers' connective strengths across the groups. Additionally, the study revealed patterns of diffusion metrics in line with early white matter developmental trajectories and a developmental advantage for females. Altogether, these findings deliver evidence of meaningful structural connections among AVI regions in the newborn in-vivo brain.
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4
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Verschuur AS, Boswinkel V, Tax CM, Osch JA, Nijholt IM, Slump CH, Vries LS, Wezel‐Meijler G, Leemans A, Boomsma MF. Improved neonatal brain MRI segmentation by interpolation of motion corrupted slices. J Neuroimaging 2022; 32:480-492. [PMID: 35253956 PMCID: PMC9314603 DOI: 10.1111/jon.12985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Anouk S. Verschuur
- Department of Radiology Isala Zwolle The Netherlands
- Image Sciences Institute University Medical Center Utrecht Utrecht The Netherlands
| | - Vivian Boswinkel
- Women and Children's Hospital Isala Zwolle The Netherlands
- UMC Utrecht Brain Center Utrecht University Utrecht The Netherlands
| | - Chantal M.W. Tax
- Image Sciences Institute University Medical Center Utrecht Utrecht The Netherlands
- Cardiff University Brain Research Imaging Centre Cardiff UK
| | | | | | - Cornelis H. Slump
- Department of Robotics and Mechatronics University of Twente Enschede The Netherlands
| | - Linda S. Vries
- Department of Neonatology Wilhelmina Children's Hospital Utrecht The Netherlands
| | | | - Alexander Leemans
- Image Sciences Institute University Medical Center Utrecht Utrecht The Netherlands
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5
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Wolfer N, Wang-Leandro A, Beckmann KM, Richter H, Dennler M. Intracranial Lesion Detection and Artifact Characterization: Comparative Study of Susceptibility and T2 *-Weighted Imaging in Dogs and Cats. Front Vet Sci 2021; 8:779515. [PMID: 34966811 PMCID: PMC8710604 DOI: 10.3389/fvets.2021.779515] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/10/2021] [Indexed: 12/28/2022] Open
Abstract
Susceptibility-weighted imaging (SWI), an MRI sequence for the detection of hemorrhage, allows differentiation of paramagnetic and diamagnetic substances based on tissue magnetic susceptibility differences. The three aims of this retrospective study included a comparison of the number of areas of signal void (ASV) between SWI and T2*-weighted imaging (T2*WI), differentiation of hemorrhage and calcification, and investigation of image deterioration by artifacts. Two hundred twelve brain MRIs, 160 dogs and 52 cats, were included. The sequences were randomized and evaluated for presence/absence and numbers of ASV and extent of artifacts causing image deterioration by a single, blinded observer. In cases with a CT scan differentiation of paramagnetic (hemorrhagic) and diamagnetic (calcification) lesions was made, SWI was performed to test correct assignment using the Hounsfield Units. Non-parametric tests were performed to compare both sequences regarding detection of ASV and the effect of artifacts on image quality. The presence of ASV was found in 37 SWI sequences and 34 T2*WI sequences with a significant increase in ASV only in dogs >5 and ≤ 15 kg in SWI. The remaining weight categories showed no significance. CT examination was available in 11 cases in which 81 ASV were found. With the use of phase images, 77 were classified as paramagnetic and none as diamagnetic. A classification was not possible in four cases. At the level of the frontal sinus, significantly more severe artifacts occurred in cats and dogs (dogs, p < 0.001; cats, p = 0.001) in SWI. The frontal sinus artifact was significantly less severe in brachycephalic than non-brachycephalic dogs in both sequences (SWI, p < 0.001; T2*WI, p < 0.001). In conclusion, with the advantages of better detection of ASV in SWI compared with T2*WI and the opportunity to differentiate between paramagnetic and diamagnetic origin in most cases, SWI is generally recommended for dogs. Frontal sinus conformation appears to be a limiting factor in image interpretation.
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Affiliation(s)
- Nadja Wolfer
- Clinic for Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Adriano Wang-Leandro
- Clinic for Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Katrin M Beckmann
- Section of Neurology and Neurosurgery, Small Animal Clinic, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Henning Richter
- Clinic for Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Matthias Dennler
- Clinic for Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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6
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Li N, Zheng H, Xu G, Gui T, Yin Q, Chen Q, Lee J, Xin Y, Zhang S, He Q, Zhang X, Liu X, Zheng H, Wang D, Li Y. Simultaneous Head and Spine MR Imaging in Children Using a Dedicated Multichannel Receiver System at 3T. IEEE Trans Biomed Eng 2021; 68:3659-3670. [PMID: 34014817 DOI: 10.1109/tbme.2021.3082149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this work was to enable simultaneous head and spine Magnetic Resonance imaging (MRI) in children at 3T by using a dedicated multichannel radiofrequency coil array system. METHODS A 24-channel head and spine pediatric coil system was developed and constructed. The coils performance was compared with a commercially available 24-channel adult head-neck coil and a spine coil (1-4 spine of 16-channel were selected). Signal-to-noise ratio (SNR) and parallel imaging capability were quantitatively evaluated by phantom studies and in vivo imaging experiments. With Institutional Review Board and Ethics Committee approval, the designed coil was used to acquire head and spine images on 27 children in clinical settings. RESULTS The pediatric coil provided substantial SNR improvements with an increase of 32 % to 40 % in the brain region and up to a two-fold increase in the surface. SNR increased by at least 18 % in the spine region. The coil enabled higher resolution and a faster imaging speed, owing to significantly improved SNR. Extensive coverage of the coil enabled high-quality fast imaging from head-neck to the whole spine. Good image quality with an average score 4.63 out of 5 was achieved using the developed pediatric coil in clinical studies. CONCLUSION Simultaneous head and spine MRI with superior performance have been successfully acquired in children subjects at 3T using the dedicated 24-channel head and spine pediatric coil system. SIGNIFICANCE The 24-channel pediatric coil system potentially can enhance pediatric head and spine MRI in clinical research and diagnosis.
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7
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York V, Sultan N, Thapa M, Chaturvedi A. Musculoskeletal MRI in Infants: Technical Considerations, Pitfalls and Optimization Strategies. Semin Roentgenol 2021; 56:277-287. [PMID: 34281680 DOI: 10.1053/j.ro.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Vincent York
- Department of Radiology, Rochester General Hospital, Rochester, NY.
| | - Nadia Sultan
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY
| | - Mahesh Thapa
- Department of Radiology, University of Washington, Seattle, WA
| | - Apeksha Chaturvedi
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY
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8
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Machado-Rivas F, Jaimes C, Kirsch JE, Gee MS. Image-quality optimization and artifact reduction in fetal magnetic resonance imaging. Pediatr Radiol 2020; 50:1830-1838. [PMID: 33252752 DOI: 10.1007/s00247-020-04672-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/09/2020] [Accepted: 03/31/2020] [Indexed: 11/28/2022]
Abstract
Fetal MRI allows for earlier and better detection of complex congenital anomalies. However, its diagnostic utility is often limited by technical barriers that introduce artifacts and reduce image quality. The main determinants of fetal MR image quality are speed of acquisition, spatial resolution and signal-to-noise ratio (SNR). Imaging optimization is a challenge because a change to improve one scan parameter often leads to worsening of another. Moreover, the recent introduction of fetal MRI on 3-tesla (T) scanners to achieve better SNR can amplify some technical issues. Motion, banding artifacts and aliasing artifacts impact the quality of fetal acquisitions at any field strength. High specific absorption rate (SAR) and artifacts from inhomogeneities in the radiofrequency field are important limitations of high-field-strength imaging. We discuss technical barriers that impact image quality and are important limitations to prenatal MRI diagnosis, and propose solutions to improve image quality and reduce artifacts.
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Affiliation(s)
- Fedel Machado-Rivas
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Camilo Jaimes
- Department of Radiology, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Boston Children's Hospital, Boston, MA, USA
| | - John E Kirsch
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA. .,Department of Radiology, Harvard Medical School, Boston, MA, USA.
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9
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Tokatly Latzer I, Orbach R, Ben-Sira L, Mezad-Koursh D, Bachar Zipori A, Roth J, Constantini S, Fattal-Valevski A, Lubetzky R. The Clinical Utility of Inpatient Brain Magnetic Resonance Imaging in Children. J Child Neurol 2020; 35:744-752. [PMID: 32517554 DOI: 10.1177/0883073820931264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The clinical applicability and yield of brain magnetic resonance imaging (MRI) in the setting of an inpatient pediatric department has not been investigated. The authors performed a retrospective chart review of nontraumatic/nonneurosurgical children who underwent brain MRI during their hospitalization in a general pediatric department over a 5-year period. Of the 331 children who underwent brain MRI, 148 (45%) had abnormal findings. High-risk headaches and focal seizures were significantly correlated with findings on brain MRI. Diagnostic and therapeutic yields were most significant in acute demyelinating events, acute cerebrovascular disorders, high-risk headaches when supported by neurologic and ophthalmologic findings, focal seizures with evidence of multifocal epileptic activity on an electroencephalogram and ophthalmic complaints when accompanied by cranial nerve palsy and optic nerve impairment. Since the contributions of a brain MRI in hospitalized children is pivotal in specific clinical situations, a judicious decision-making process should be done before its scheduling, in order to optimize clinical care.
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Affiliation(s)
- Itay Tokatly Latzer
- Pediatric Neurology Institute, 108403Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, 26745Tel-Aviv University, Israel
| | - Rotem Orbach
- Pediatric Neurology Institute, 108403Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, 26745Tel-Aviv University, Israel
| | - Liat Ben-Sira
- Sackler School of Medicine, 26745Tel-Aviv University, Israel.,Pediatric Radiology Unit, 108403Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Daphna Mezad-Koursh
- Sackler School of Medicine, 26745Tel-Aviv University, Israel.,Pediatric Ophthalmology Unit, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Anat Bachar Zipori
- Sackler School of Medicine, 26745Tel-Aviv University, Israel.,Pediatric Ophthalmology Unit, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Jonathan Roth
- Sackler School of Medicine, 26745Tel-Aviv University, Israel.,Department of Pediatric Neurosurgery and 108403Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Shlomi Constantini
- Sackler School of Medicine, 26745Tel-Aviv University, Israel.,Department of Pediatric Neurosurgery and 108403Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Aviva Fattal-Valevski
- Pediatric Neurology Institute, 108403Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, 26745Tel-Aviv University, Israel.,These authors have contributed equally to this work
| | - Ronit Lubetzky
- Sackler School of Medicine, 26745Tel-Aviv University, Israel.,Department of Pediatrics, 108403Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.,These authors have contributed equally to this work
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10
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Annink KV, van der Aa NE, Dudink J, Alderliesten T, Groenendaal F, Lequin M, Jansen FE, Rhebergen KS, Luijten P, Hendrikse J, Hoogduin HJM, Huijing ER, Versteeg E, Visser F, Raaijmakers AJE, Wiegers EC, Klomp DWJ, Wijnen JP, Benders MJNL. Introduction of Ultra-High-Field MR Imaging in Infants: Preparations and Feasibility. AJNR Am J Neuroradiol 2020; 41:1532-1537. [PMID: 32732273 DOI: 10.3174/ajnr.a6702] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/19/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral MR imaging in infants is usually performed with a field strength of up to 3T. In adults, a growing number of studies have shown added diagnostic value of 7T MR imaging. 7T MR imaging might be of additional value in infants with unexplained seizures, for example. The aim of this study was to investigate the feasibility of 7T MR imaging in infants. We provide information about the safety preparations and show the first MR images of infants at 7T. MATERIALS AND METHODS Specific absorption rate levels during 7T were simulated in Sim4life using infant and adult models. A newly developed acoustic hood was used to guarantee hearing protection. Acoustic noise damping of this hood was measured and compared with the 3T Nordell hood and no hood. In this prospective pilot study, clinically stable infants, between term-equivalent age and the corrected age of 3 months, underwent 7T MR imaging immediately after their standard 3T MR imaging. The 7T scan protocols were developed and optimized while scanning this cohort. RESULTS Global and peak specific absorption rate levels in the infant model in the centered position and 50-mm feet direction did not exceed the levels in the adult model. Hearing protection was guaranteed with the new hood. Twelve infants were scanned. No MR imaging-related adverse events occurred. It was feasible to obtain good-quality imaging at 7T for MRA, MRV, SWI, single-shot T2WI, and MR spectroscopy. T1WI had lower quality at 7T. CONCLUSIONS 7T MR imaging is feasible in infants, and good-quality scans could be obtained.
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Affiliation(s)
- K V Annink
- From the Departments of Neonatology (K.V.A., N.E.v.d.A., J.D., T.A., F.G., M.J.N.L.B.), and Paediatric Neurology (F.E.J.), University Medical Center Utrecht Brain Center
| | - N E van der Aa
- From the Departments of Neonatology (K.V.A., N.E.v.d.A., J.D., T.A., F.G., M.J.N.L.B.), and Paediatric Neurology (F.E.J.), University Medical Center Utrecht Brain Center
| | - J Dudink
- From the Departments of Neonatology (K.V.A., N.E.v.d.A., J.D., T.A., F.G., M.J.N.L.B.), and Paediatric Neurology (F.E.J.), University Medical Center Utrecht Brain Center
| | - T Alderliesten
- From the Departments of Neonatology (K.V.A., N.E.v.d.A., J.D., T.A., F.G., M.J.N.L.B.), and Paediatric Neurology (F.E.J.), University Medical Center Utrecht Brain Center
| | - F Groenendaal
- From the Departments of Neonatology (K.V.A., N.E.v.d.A., J.D., T.A., F.G., M.J.N.L.B.), and Paediatric Neurology (F.E.J.), University Medical Center Utrecht Brain Center
| | - M Lequin
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - F E Jansen
- From the Departments of Neonatology (K.V.A., N.E.v.d.A., J.D., T.A., F.G., M.J.N.L.B.), and Paediatric Neurology (F.E.J.), University Medical Center Utrecht Brain Center
| | - K S Rhebergen
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - P Luijten
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - J Hendrikse
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - H J M Hoogduin
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - E R Huijing
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - E Versteeg
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - F Visser
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - A J E Raaijmakers
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - E C Wiegers
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - D W J Klomp
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - J P Wijnen
- the Departments of Radiology (M.L., P.L., J.H., H.J.M.H., E.R.H., E.V., F.V., A.J.E.R., E.C.W., D.W.J.K., J.P.W.), and Otorhinolaryngology and Head and Neck Surgery (K.S.R.), University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - M J N L Benders
- From the Departments of Neonatology (K.V.A., N.E.v.d.A., J.D., T.A., F.G., M.J.N.L.B.), and Paediatric Neurology (F.E.J.), University Medical Center Utrecht Brain Center
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11
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Annink KV, Groenendaal F, Cohen D, van der Aa NE, Alderliesten T, Dudink J, Benders MJNL, Wijnen JP. Brain temperature of infants with neonatal encephalopathy following perinatal asphyxia calculated using magnetic resonance spectroscopy. Pediatr Res 2020; 88:279-284. [PMID: 31896129 DOI: 10.1038/s41390-019-0739-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/10/2019] [Accepted: 12/15/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Little is known about brain temperature of neonates during MRI. Brain temperature can be estimated non-invasively with proton Magnetic Resonance Spectroscopy (1H-MRS), but the most accurate 1H-MRS method has not yet been determined. The primary aim was to estimate brain temperature using 1H-MRS in infants with neonatal encephalopathy (NE) following perinatal asphyxia. The secondary aim was to compare brain temperature during MRI with rectal temperatures before and after MRI. METHODS In this retrospective study, brain temperature in 36 (near-)term infants with NE was estimated using short (36 ms) and long (288 ms) echo time (TE) 1H-MRS. Brain temperature was calculated using two different formulas: formula of Wu et al. and a formula based on phantom calibration. The methods were compared. Rectal temperatures were collected <3 hours before and after MRI. RESULTS Brain temperatures calculated with the formula of Wu et al. and the calibrated formula were similar as well as brain temperatures derived from short and long TE 1H-MRS. Rectal temperature did not differ before and after MRI. CONCLUSIONS Brain temperature can be measured using 1H-MRS in daily clinical practice using the formula of Wu et al. with both short and long TE 1H-MRS. Brain temperature remained within physiological range during MRI.
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Affiliation(s)
- Kim V Annink
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Floris Groenendaal
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Daan Cohen
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Niek E van der Aa
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Thomas Alderliesten
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Jannie P Wijnen
- Department of Radiology, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands.
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12
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Paquette N, Gajawelli N, Lepore N. Structural neuroimaging. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:251-264. [PMID: 32977882 DOI: 10.1016/b978-0-444-64148-9.00018-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Characterizing the neuroanatomical correlates of brain development is essential in understanding brain-behavior relationships and neurodevelopmental disorders. Advances in brain MRI acquisition protocols and image processing techniques have made it possible to detect and track with great precision anatomical brain development and pediatric neurologic disorders. In this chapter, we provide a brief overview of the modern neuroimaging techniques for pediatric brain development and review key normal brain development studies. Characteristic disorders affecting neurodevelopment in childhood, such as prematurity, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), epilepsy, and brain cancer, and key neuroanatomical findings are described and then reviewed. Large datasets of typically developing children and children with various neurodevelopmental conditions are now being acquired to help provide the biomarkers of such impairments. While there are still several challenges in imaging brain structures specific to the pediatric populations, such as subject cooperation and tissues contrast variability, considerable imaging research is now being devoted to solving these problems and improving pediatric data analysis.
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Affiliation(s)
- Natacha Paquette
- CIBORG Lab, Department of Radiology, Children's Hospital of Los Angeles and University of Southern California, Los Angeles, CA, United States
| | - Niharika Gajawelli
- CIBORG Lab, Department of Radiology, Children's Hospital of Los Angeles and University of Southern California, Los Angeles, CA, United States
| | - Natasha Lepore
- CIBORG Lab, Department of Radiology, Children's Hospital of Los Angeles and University of Southern California, Los Angeles, CA, United States.
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13
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Fumagalli M, Cinnante CM, Calloni SF, Sorrentino G, Gorla I, Plevani L, Pesenti N, Sirgiovanni I, Mosca F, Triulzi F. Clinical safety of 3-T brain magnetic resonance imaging in newborns. Pediatr Radiol 2018; 48:992-998. [PMID: 29594440 DOI: 10.1007/s00247-018-4105-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/21/2018] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The effects and potential hazards of brain magnetic resonance imaging (MRI) at 3 T in newborns are debated. OBJECTIVE Assess the impact of 3-T MRI in newborns on body temperature and physiological parameters. MATERIAL AND METHODS Forty-nine newborns, born preterm and at term, underwent 3-T brain MRI at term-corrected age. Rectal and skin temperature, oxygen saturation and heart rate were recorded before, during and after the scan. RESULTS A statistically significant increase in skin temperature of 0.6 °C was observed at the end of the MRI scan (P<0.01). There was no significant changes in rectal temperature, heart rate or oxygen saturation. CONCLUSION Core temperature, heart rate and oxygen saturation in newborns were not affected by 3-T brain MR scanning.
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Affiliation(s)
- Monica Fumagalli
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Claudia Maria Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Gabriele Sorrentino
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Ilaria Gorla
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Laura Plevani
- Nursing coordinator S.I.T.R.A. Basic Education Sector-Neonatology and Neonatal Intensive Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Pesenti
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Ida Sirgiovanni
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Fabio Mosca
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Fabio Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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14
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Hua CH, Uh J, Krasin MJ, Lucas JT, Tinkle CL, Acharya S, Smith HL, Kadbi M, Merchant TE. Clinical Implementation of Magnetic Resonance Imaging Systems for Simulation and Planning of Pediatric Radiation Therapy. J Med Imaging Radiat Sci 2018; 49:153-163. [DOI: 10.1016/j.jmir.2018.02.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/31/2018] [Accepted: 02/20/2018] [Indexed: 01/10/2023]
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15
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Kim MO, Hong T, Kim DH. Fast B1+ mapping using three consecutive RF pulses and balanced gradients for improved bSSFP imaging. Magn Reson Imaging 2018; 46:40-46. [DOI: 10.1016/j.mri.2017.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 10/27/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
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16
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Chou Z, Paquette N, Ganesh B, Wang Y, Ceschin R, Nelson MD, Macyszyn L, Gaonkar B, Panigrahy A, Lepore N. Bayesian automated cortical segmentation for neonatal MRI. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2017; 10572. [PMID: 31178619 DOI: 10.1117/12.2285217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Several attempts have been made in the past few years to develop and implement an automated segmentation of neonatal brain structural MRI. However, accurate automated MRI segmentation remains challenging in this population because of the low signal-to-noise ratio, large partial volume effects and inter-individual anatomical variability of the neonatal brain. In this paper, we propose a learning method for segmenting the whole brain cortical grey matter on neonatal T2-weighted images. We trained our algorithm using a neonatal dataset composed of 3 full-term and 4 preterm infants scanned at term equivalent age. Our segmentation pipeline combines the FAST algorithm from the FSL library software and a Bayesian segmentation approach to create a threshold matrix that minimizes the error of mislabeling brain tissue types. Our method shows promising results with our pilot training set. In both preterm and full-term neonates, automated Bayesian segmentation generates a smoother and more consistent parcellation compared to FAST, while successfully removing the subcortical structure and cleaning the edges of the cortical grey matter. This method show promising refinement of the FAST segmentation by considerably reducing manual input and editing required from the user, and further improving reliability and processing time of neonatal MR images. Further improvement will include a larger dataset of training images acquired from different manufacturers.
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Affiliation(s)
- Zane Chou
- CIBORG laboratory, Department of Radiology, Children's Hospital of Los Angeles, CA, USA.,Viterbi School of Engineering, University of Southern California, CA, USA
| | - Natacha Paquette
- CIBORG laboratory, Department of Radiology, Children's Hospital of Los Angeles, CA, USA
| | - Bhavana Ganesh
- CIBORG laboratory, Department of Radiology, Children's Hospital of Los Angeles, CA, USA.,Viterbi School of Engineering, University of Southern California, CA, USA
| | - Yalin Wang
- Department of Radiology, Children's Hospital of Pittsburgh UPMC, Pittsburgh, PA, USA
| | - Rafael Ceschin
- Department of Radiology, Children's Hospital of Los Angeles, CA, USA
| | - Marvin D Nelson
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Neurosurgery, University of California Los Angeles, CA, USA
| | - Luke Macyszyn
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Bilwaj Gaonkar
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Ashok Panigrahy
- CIBORG laboratory, Department of Radiology, Children's Hospital of Los Angeles, CA, USA.,Department of Radiology, Children's Hospital of Los Angeles, CA, USA
| | - Natasha Lepore
- CIBORG laboratory, Department of Radiology, Children's Hospital of Los Angeles, CA, USA.,Viterbi School of Engineering, University of Southern California, CA, USA
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17
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Rossi A, Martinetti C, Morana G, Severino M, Tortora D. Diagnostic Approach to Pediatric Spine Disorders. Magn Reson Imaging Clin N Am 2017; 24:621-44. [PMID: 27417404 DOI: 10.1016/j.mric.2016.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Understanding the developmental features of the pediatric spine and spinal cord, including embryologic steps and subsequent growth of the osteocartilaginous spine and contents is necessary for interpretation of the pathologic events that may affect the pediatric spine. MR imaging plays a crucial role in the diagnostic evaluation of patients suspected of harboring spinal abnormalities, whereas computed tomography and ultrasonography play a more limited, complementary role. This article discusses the embryologic and developmental anatomy features of the spine and spinal cord, together with some technical points and pitfalls, and the most common indications for pediatric spinal MR imaging.
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Affiliation(s)
- Andrea Rossi
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy.
| | - Carola Martinetti
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Giovanni Morana
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Mariasavina Severino
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Domenico Tortora
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
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18
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Brainstem shape is affected by clinical course in the neonatal intensive care unit. NEUROIMAGE-CLINICAL 2017; 15:62-70. [PMID: 28491493 PMCID: PMC5412108 DOI: 10.1016/j.nicl.2017.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/28/2017] [Accepted: 04/11/2017] [Indexed: 11/24/2022]
Abstract
The brainstem, critical for motor function, autonomic regulation, and many neurocognitive functions, undergoes rapid development from the third trimester. Accordingly, we hypothesized it would be vulnerable to insult during this period, and that a difficult clinical course in the neonatal intensive care unit (NICU) would affect development, and be reflected through atypical shape. Our study population consisted of 66 neonates - all inpatients from the NICU at Victoria Hospital, London Health Sciences Centre, ON, Canada, of which 45 entered the final analysis. The cohort varied in gestational age (GA) and ranged from neurologically healthy to severely brain-injured. Structural MRI was used to quantify brainstem shape at term-equivalent age. From these images, brainstems were semi-automatically segmented and co-registered across subjects. The anterior-posterior dimensions on a sagittal maximum intensity projection were used as the basis for shape comparison. Factor analysis was used to summarize variation in shape and in clinical course to determine three shape factors and three clinical factors, and their relationship assessed using correlation. A factor driven by low GA and associated complications correlated with alterations in the posterior medulla, while a factor driven by complications independent of GA correlated with alterations in the midbrain. Additionally, single clinical measures most representative of their respective clinical factor (days in NICU; days on ventilation) predicted the changes. Thus, different clinical courses in the NICU may have different effects on the shape of the brainstem, and may mediate some of the distinct neurodevelopmental profiles observed in premature and brain-injured neonates.
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19
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Hwang JY, Yoon HK, Lee JH, Yoon HM, Jung AY, Cho YA, Lee JS, Yoon CH. Cranial Nerve Disorders in Children: MR Imaging Findings. Radiographics 2017; 36:1178-94. [PMID: 27399242 DOI: 10.1148/rg.2016150163] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cranial nerve disorders are uncommon disease conditions encountered in pediatric patients, and can be categorized as congenital, inflammatory, traumatic, or tumorous conditions that involve the cranial nerve itself or propagation of the disorder from adjacent organs. However, determination of the normal course, as well as abnormalities, of cranial nerves in pediatric patients is challenging because of the small caliber of the cranial nerve, as well as the small intracranial and skull base structures. With the help of recently developed magnetic resonance (MR) imaging techniques that provide higher spatial resolution and fast imaging techniques including three-dimensional MR images with or without the use of gadolinium contrast agent, radiologists can more easily diagnose disease conditions that involve the small cranial nerves, such as the oculomotor, abducens, facial, and hypoglossal nerves, as well as normal radiologic anatomy, even in very young children. If cranial nerve involvement is suspected, careful evaluation of the cranial nerves should include specific MR imaging protocols. Localization is an important consideration in cranial nerve imaging, and should cover entire pathways and target organs as much as possible. Therefore, radiologists should be familiar not only with the various diseases that cause cranial nerve dysfunction, and the entire course of each cranial nerve including the intra-axial nuclei and fibers, but also the technical considerations for optimal imaging of pediatric cranial nerves. In this article, we briefly review normal cranial nerve anatomy and imaging findings of various pediatric cranial nerve dysfunctions, as well as the technical considerations of pediatric cranial nerve imaging. Online supplemental material is available for this article. (©)RSNA, 2016.
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Affiliation(s)
- Jae-Yeon Hwang
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hye-Kyung Yoon
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jeong Hyun Lee
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hee Mang Yoon
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Ah Young Jung
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Young Ah Cho
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jin Seong Lee
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Chong Hyun Yoon
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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20
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Weisstanner C, Gruber GM, Brugger PC, Mitter C, Diogo MC, Kasprian G, Prayer D. Fetal MRI at 3T-ready for routine use? Br J Radiol 2017; 90:20160362. [PMID: 27768394 PMCID: PMC5605013 DOI: 10.1259/bjr.20160362] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Fetal MR now plays an important role in the clinical work-up of pregnant females. It is performed mainly at 1.5 T. However, the desire to obtain a more precise fetal depiction or the fact that some institutions have access only to a 3.0 T scanner has resulted in a growing interest in performing fetal MR at 3.0 T. The aim of this article was to provide a reference for the use of 3.0 T MRI as a prenatal diagnostic method.
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Affiliation(s)
- Christian Weisstanner
- 1 Division of Neuro- and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
- 2 Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Gerlinde M Gruber
- 3 Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Peter C Brugger
- 3 Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Christan Mitter
- 1 Division of Neuro- and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Mariana C Diogo
- 4 Neuroradiology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Gregor Kasprian
- 1 Division of Neuro- and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Daniela Prayer
- 1 Division of Neuro- and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
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21
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Shelmerdine SC, Roebuck DJ, Towbin AJ, McHugh K. MRI of paediatric liver tumours: How we review and report. Cancer Imaging 2016; 16:21. [PMID: 27526937 PMCID: PMC4986178 DOI: 10.1186/s40644-016-0083-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/09/2016] [Indexed: 12/12/2022] Open
Abstract
Liver tumours are fortunately rare in children. Benign tumours such as haemangiomas and cystic mesenchymal hamartomas are typically seen in infancy, often before 6 months of age. After that age, malignant hepatic tumours increase in frequency. The differentiation of a malignant from benign lesion on imaging can often negate the need for biopsy. Ultrasound is currently the main screening tool for suspected liver pathology, and is ideally suited for evaluation of hepatic lesions in children due to their generally small size. With increasing research, public awareness and parental anxiety regarding radiation dosage from CT imaging, MRI is now unquestionably the modality of choice for further characterisation of hepatic mass lesions. Nevertheless the cost, length of imaging time and perceived complexity of a paediatric liver MR study can be intimidating to the general radiologist and referring clinician. This article outlines standard MR sequences utilised, reasons for their utilisation, types of mixed hepatocyte specific/extracellular contrast agents employed and imaging features that aid the interpretation of paediatric liver lesions. The two commonest paediatric liver malignancies, namely hepatoblastoma and hepatocellular carcinoma are described. Differentiation of primary hepatic malignancies with metastatic disease and mimickers of malignancy such as focal nodular hyperplasia (FNH) and hepatic adenomas are also featured in this review.. Imaging should aim to clarify the presence of a lesion, the likelihood of malignancy and potential for complete surgical resection. Reviewing and reporting the studies should address these issues in a systematic fashion whilst also commenting upon background liver parenchymal appearances. Clinical information and adequate patient preparation prior to MR imaging studies help enhance the diagnostic yield.
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Affiliation(s)
- Susan C Shelmerdine
- Department of Diagnostic Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
| | - Derek J Roebuck
- Department of Interventional Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Alexander J Towbin
- Department of Pediatric Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kieran McHugh
- Department of Diagnostic Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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22
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Ho ML, Patton AC, DeLone DR, Kim H, Gilbertson JR, Felmlee J, Watson RE. Brain Injury in the Preterm and Term Neonate. CURRENT RADIOLOGY REPORTS 2016. [DOI: 10.1007/s40134-016-0161-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Varga-Szemes A, Kiss P, Rab A, Suranyi P, Lenkey Z, Simor T, Bryant RG, Elgavish GA. In Vitro Longitudinal Relaxivity Profile of Gd(ABE-DTTA), an Investigational Magnetic Resonance Imaging Contrast Agent. PLoS One 2016; 11:e0149260. [PMID: 26872055 PMCID: PMC4752229 DOI: 10.1371/journal.pone.0149260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/30/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose MRI contrast agents (CA) whose contrast enhancement remains relatively high even at the higher end of the magnetic field strength range would be desirable. The purpose of this work was to demonstrate such a desired magnetic field dependency of the longitudinal relaxivity for an experimental MRI CA, Gd(ABE-DTTA). Materials and Methods The relaxivity of 0.5mM and 1mM Gd(ABE-DTTA) was measured by Nuclear Magnetic Relaxation Dispersion (NMRD) in the range of 0.0002 to 1T. Two MRI and five NMR instruments were used to cover the range between 1.5 to 20T. Parallel measurement of a Gd-DTPA sample was performed throughout as reference. All measurements were carried out at 37°C and pH 7.4. Results The relaxivity values of 0.5mM and 1mM Gd(ABE-DTTA) measured at 1.5, 3, and 7T, within the presently clinically relevant magnetic field range, were 15.3, 11.8, 12.4 s-1mM-1 and 18.1, 16.7, and 13.5 s-1mM-1, respectively. The control 4 mM Gd-DTPA relaxivities at the same magnetic fields were 3.6, 3.3, and 3.0 s-1mM-1, respectively. Conclusions The longitudinal relaxivity of Gd(ABE-DTTA) measured within the presently clinically relevant field range is three to five times higher than that of most commercially available agents. Thus, Gd(ABE-DTTA) could be a practical choice at any field strength currently used in clinical imaging including those at the higher end.
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Affiliation(s)
- Akos Varga-Szemes
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, United States of America.,Elgavish Paramagnetics Inc., Birmingham, AL, United States of America
| | - Pal Kiss
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, United States of America.,Elgavish Paramagnetics Inc., Birmingham, AL, United States of America
| | - Andras Rab
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, United States of America.,Elgavish Paramagnetics Inc., Birmingham, AL, United States of America
| | - Pal Suranyi
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, United States of America.,Elgavish Paramagnetics Inc., Birmingham, AL, United States of America
| | - Zsofia Lenkey
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, United States of America.,Elgavish Paramagnetics Inc., Birmingham, AL, United States of America.,Heart Institute, Medical School, University of Pecs, Pecs, Hungary
| | - Tamas Simor
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, United States of America.,Elgavish Paramagnetics Inc., Birmingham, AL, United States of America.,Heart Institute, Medical School, University of Pecs, Pecs, Hungary
| | - Robert G Bryant
- Department of Chemistry, University of Virginia, Charlottesville, VA, United States of America
| | - Gabriel A Elgavish
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, United States of America.,Elgavish Paramagnetics Inc., Birmingham, AL, United States of America
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Abstract
Radiological imaging is extremely valuable as a diagnostic tool in the pediatric population, but it comes with a number of distinct challenges as compared to the imaging of adults. This is because of the following: It requires dedicated imaging protocols to acquire the images, there is need for sedation or general anesthesia for longer procedures such as MRI, specific training is required for the healthcare personnel involved, thorough knowledge and expertise should be applied for evaluating the images, and most importantly, it requires consideration for radiation exposure if ionizing radiation is being used. One of the challenges for clinical care personnel is to gain the child's trust and co-operation before and throughout the duration of an examination, which can prove to be difficult in children who may be ill and have pain. This is important to acquire quality images and prevent repeat examinations. Even with a quality examination, the accurate interpretation of images requires a thorough knowledge of the intricate and dynamic face of anatomy and specific pathological presentations in children. The increased radiation sensitivity of growing organs and children's longer expected life spans make them more susceptible to the harmful effects of radiation. Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose. In order to prevent the harmful effects of ionizing radiation, As Low As Reasonably Achievable (ALARA) principle should be strictly followed. This article seeks to draw attention to various challenges of pediatric imaging and the ways to overcome them.
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Affiliation(s)
- Brij Bhushan Thukral
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Balassy C, Roberts D, Miller SF. Safety and efficacy of gadoteric acid in pediatric magnetic resonance imaging: overview of clinical trials and post-marketing studies. Pediatr Radiol 2015; 45:1831-41. [PMID: 26045036 DOI: 10.1007/s00247-015-3394-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 08/03/2014] [Accepted: 05/14/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Gadoteric acid is a paramagnetic gadolinium macrocyclic contrast agent approved for use in MRI of cerebral and spinal lesions and for body imaging. OBJECTIVE To investigate the safety and efficacy of gadoteric acid in children by extensively reviewing clinical and post-marketing observational studies. MATERIALS AND METHODS Data were collected from 3,810 children (ages 3 days to 17 years) investigated in seven clinical trials of central nervous system (CNS) imaging (n = 141) and six post-marketing observational studies of CNS, musculoskeletal and whole-body MR imaging (n = 3,669). Of these, 3,569 children were 2-17 years of age and 241 were younger than 2 years. Gadoteric acid was generally administered at a dose of 0.1 mmol/kg. We evaluated image quality, lesion detection and border delineation, and the safety of gadoteric acid. We also reviewed post-marketing pharmacovigilance experience. RESULTS Consistent with findings in adults, gadoteric acid was effective in children for improving image quality compared with T1-W unenhanced sequences, providing diagnostic improvement, and often influencing the therapeutic approach, resulting in treatment modifications. In studies assessing neurological tumors, gadoteric acid improved border delineation, internal morphology and contrast enhancement compared to unenhanced MR imaging. Gadoteric acid has a well-established safety profile. Among all studies, a total of 10 children experienced 20 adverse events, 7 of which were thought to be related to gadoteric acid. No serious adverse events were reported in any study. Post-marketing pharmacovigilance experience did not find any specific safety concern. CONCLUSION Gadoteric acid was associated with improved lesion detection and delineation and is an effective and well-tolerated contrast agent for use in children.
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Affiliation(s)
- Csilla Balassy
- Department of Radiology, Division of General and Pediatric Radiology, Medical University of Vienna, Vienna General Hospital, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Donna Roberts
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
| | - Stephen F Miller
- Department of Radiology, LeBonheur Children's Hospital, Memphis, TN, USA
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Paediatric acute mastoiditis, then and now: is it more of a problem now? The Journal of Laryngology & Otology 2015; 129:955-9. [DOI: 10.1017/s0022215115002078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Acute mastoiditis is a significant cause of morbidity in the paediatric population. This paper reviews our experience with this condition over the last 10 years and compares it with historical data from Alder Hey Children's Hospital, Liverpool, UK.Method:A retrospective case note review of patients who presented between 2003 and 2012 was performed.Results:Forty-six patients with acute mastoiditis were identified. Imaging with computed tomography and magnetic resonance imaging was carried out in 14 cases (30.4 per cent). Intracranial complications were identified in six patients (13.0 per cent), one of whom required neurosurgical intervention. In 27 cases (58.7 per cent), a surgical procedure was performed. Data from 1995 to 2000 revealed similar rates of imaging (30.0 per cent), but significantly lower rates of surgical intervention (23 per cent). A lower rate of intracranial complications (4.8 per cent) in the historical cohort did not prove to be statistically significant (p = 0.419).Conclusion:The numbers of paediatric patients presenting with acute mastoiditis appears essentially unchanged. Improvement in imaging technology and aids to interpretation may explain the apparent increase of intracranial complications.
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Shalish M, Dykstein N, Friedlander-Barenboim S, Ben-David E, Gomori JM, Chaushu S. Influence of common fixed retainers on the diagnostic quality of cranial magnetic resonance images. Am J Orthod Dentofacial Orthop 2015; 147:604-9. [PMID: 25919106 DOI: 10.1016/j.ajodo.2014.11.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/01/2014] [Accepted: 11/01/2014] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Orthodontists are often asked to remove fixed retainers before magnetic resonance imaging (MRI). This study was undertaken to assess the effects of 2 commonly used fixed retainers on MRI distortion and whether they should be removed. METHODS MRI scans were performed on a dry skull with Twistflex (Dentaurum, Ispringen, Germany) and Ortho Flex Tech (Reliance Orthodontic Products, Itasca, Ill) retainers. Two neuroradiologists independently ranked the distortions. The influence of the fixed retainers' alloys, their distance to the area of diagnosis, location, strength of the magnetic field, and the spin-echo sequence were examined. Statistical analysis included kappa and Pearson chi-square tests. RESULTS Ortho Flex Tech retainers caused no distortion. Twistflex retainers caused distortion in 46% of the tests in areas close to the retainer (tongue and jaws). Maxillary fixed retainers and the combination of maxillary and mandibular fixed retainers further increased the distortion. Greater distortion was observed with 3-T magnetic fields and T1-weighted spin-echo sequences. CONCLUSIONS Removal of the Ortho Flex Tech retainer is unnecessary before MRI. Removal of the Twistflex should be considered if the MRI scans are performed to diagnose areas close to the fixed retainers, when 3-T magnetic fields and T1-weighted sequences are used, and when both maxillary and mandibular fixed retainers are present.
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Affiliation(s)
- Miriam Shalish
- Clinical lecturer and director, Postgraduate Program, Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
| | - Nimrod Dykstein
- Clinical instructor, Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Silvina Friedlander-Barenboim
- Head, Oral & Maxillofacial Radiology Unit, Oral Medicine Department, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Eliel Ben-David
- Clinical instructor, Department of Radiology, Hadassah Medical Center, Jerusalem, Israel
| | - John Moshe Gomori
- Professor and head, Neuroradiology Unit, Department of Radiology, Hadassah Medical Center, Jerusalem, Israel
| | - Stella Chaushu
- Associate professor and chair, Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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Tocchio S, Kline-Fath B, Kanal E, Schmithorst VJ, Panigrahy A. MRI evaluation and safety in the developing brain. Semin Perinatol 2015; 39:73-104. [PMID: 25743582 PMCID: PMC4380813 DOI: 10.1053/j.semperi.2015.01.002] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Magnetic resonance imaging (MRI) evaluation of the developing brain has dramatically increased over the last decade. Faster acquisitions and the development of advanced MRI sequences, such as magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), perfusion imaging, functional MR imaging (fMRI), and susceptibility-weighted imaging (SWI), as well as the use of higher magnetic field strengths has made MRI an invaluable tool for detailed evaluation of the developing brain. This article will provide an overview of the use and challenges associated with 1.5-T and 3-T static magnetic fields for evaluation of the developing brain. This review will also summarize the advantages, clinical challenges, and safety concerns specifically related to MRI in the fetus and newborn, including the implications of increased magnetic field strength, logistics related to transporting and monitoring of neonates during scanning, and sedation considerations, and a discussion of current technologies such as MRI conditional neonatal incubators and dedicated small-foot print neonatal intensive care unit (NICU) scanners.
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Affiliation(s)
- Shannon Tocchio
- Pediatric Imaging Research Center, Department of Radiology Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Beth Kline-Fath
- Department of Radiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Emanuel Kanal
- Director, Magnetic Resonance Services; Professor of Neuroradiology; Department of Radiology, University of Pittsburgh Medical Center (UPMC)
| | - Vincent J. Schmithorst
- Pediatric Imaging Research Center, Department of Radiology Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ashok Panigrahy
- Pediatric Imaging Research Center, Department of Radiology Children׳s Hospital of Pittsburgh of UPMC, University of Pittsburgh Medical Center, Pittsburgh, PA.
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Practical planning to maintain premature infants' safety during magnetic resonance imaging: a systematic review. Adv Neonatal Care 2015; 15:23-37; quiz E1-2. [PMID: 25626980 DOI: 10.1097/anc.0000000000000142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) makes a significant contribution to diagnose brain injury in premature infants and is a diagnostic procedure that requires the infant to be taken out of the controlled environment established for growth and development. To ensure safe procedures for these vulnerable patients, practical planning and surveillance are paramount. PURPOSE This systematic review summarizes and evaluates the literature reporting on practical planning to maintain required safety for premature infants undergoing MRI. METHODS Literature identified through various search strategies was screened, abstracted, appraised, and synthesized through a descriptive analysis. Thirteen research studies, 2 quality improvement projects, and 10 other documents, including practice guidelines, general reviews and articles, a book chapter, and an editorial article, were retained for in-depth review. CONCLUSIONS Various procedures and equipment to ensure the safety of premature infants during MRI have been developed and tested. Although the results are promising and increasingly consistent, our review suggests that more research is needed before conclusive recommendations for the use of magnetic resonance-compatible incubators, the "feed-and-sleep" approach to avoid sedation, or the specific noise-cancelling ear protection for the premature infants' safety during MRI can be established.
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30
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Nguyen KL, Khan SN, Moriarty JM, Mohajer K, Renella P, Satou G, Ayad I, Patel S, Boechat MI, Finn JP. High-field MR imaging in pediatric congenital heart disease: initial results. Pediatr Radiol 2015; 45:42-54. [PMID: 25086500 PMCID: PMC4281382 DOI: 10.1007/s00247-014-3093-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 06/03/2014] [Accepted: 06/16/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Comprehensive assessment of pediatric congenital heart disease (CHD) at any field strength mandates evaluation of both vascular and dynamic cardiac anatomy for which diagnostic quality contrast-enhanced magnetic resonance angiography (CEMRA) and cardiac cine are crucial. OBJECTIVE To determine whether high-resolution (HR) CEMRA and steady-state free precession (SSFP) cine can be performed reliably at 3.0 T in children with CHD and to compare the image quality to similar techniques performed at 1.5 T. MATERIALS AND METHODS Twenty-eight patients with a median age of 5 months and average weight 9.0 ± 7.8 kg with suspected or known CHD were evaluated at 3.0 T. SSFP cine (n = 86 series) and HR-CEMRA (n = 414 named vascular segments) were performed and images were scored for image quality and artifacts. The findings were compared to those of 28 patients with CHD of similar weight who were evaluated at 1.5 T. RESULTS Overall image quality on HR-CEMRA was rated as excellent or good in 96% (397/414) of vascular segments at 3.0 T (k = 0.49) and in 94% (349/371) of vascular segments at 1.5 T (k = 0.36). Overall image quality of SSFP was rated excellent or good in 91% (78/86) of cine series at 3.0 T (k = 0.55) and in 81% (87/108) at 1.5 T (k = 0.47). Off-resonance artifact was common at both field strengths, varied over the cardiac cycle and was more prevalent at 3.0 T. At 3.0 T, off-resonance dark band artifact on SSFP cine was absent in 3% (3/86), mild in 69% (59/86), moderate in 27% (23/86) and severe in 1% (1/86) of images; at 1.5 T, dark band artifact was absent in 16% (17/108), mild in 69% (75/108), moderate in 12% (13/108) and severe in 3% (3/108) of cine images. The signal-to-noise ratio and contrast-to-noise ratio of both SSFP cine and HR-CEMRA images were significantly higher at 3.0 T than at 1.5 T (P < 0.001). CONCLUSION Signal-to-noise ratio and contrast-to-noise ratio of high-resolution contrast-enhanced magnetic resonance angiography and SSFP cine were higher at 3.0 T than at 1.5 T. Artifacts on SSFP cine were cardiac phase specific and more prevalent at 3.0 T such that frequency-tuning was required in one-third of exams. In neonates, high spatial resolution CEMRA was highly reliable in defining extracardiac vascular anatomy.
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Affiliation(s)
- Kim-Lien Nguyen
- Division of Cardiology, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - Sarah N. Khan
- Department of Radiological Sciences, University of California at Los Angeles, Peter V. Ueberroth Bldg., Ste. 3371, 10945 Le Conte Ave., Los Angeles, CA 90095-7206 USA
| | - John M. Moriarty
- Department of Radiological Sciences, University of California at Los Angeles, Peter V. Ueberroth Bldg., Ste. 3371, 10945 Le Conte Ave., Los Angeles, CA 90095-7206 USA
| | - Kiyarash Mohajer
- Department of Radiological Sciences, University of California at Los Angeles, Peter V. Ueberroth Bldg., Ste. 3371, 10945 Le Conte Ave., Los Angeles, CA 90095-7206 USA
| | - Pierangelo Renella
- Department of Radiological Sciences, University of California at Los Angeles, Peter V. Ueberroth Bldg., Ste. 3371, 10945 Le Conte Ave., Los Angeles, CA 90095-7206 USA
| | - Gary Satou
- Division of Pediatric Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - Ihab Ayad
- Department of Anesthesia, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - Swati Patel
- Department of Anesthesia, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - M. Ines Boechat
- Department of Radiological Sciences, University of California at Los Angeles, Peter V. Ueberroth Bldg., Ste. 3371, 10945 Le Conte Ave., Los Angeles, CA 90095-7206 USA
| | - J. Paul Finn
- Department of Radiological Sciences, University of California at Los Angeles, Peter V. Ueberroth Bldg., Ste. 3371, 10945 Le Conte Ave., Los Angeles, CA 90095-7206 USA
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Kang LH, Kim DE, Lee SY. Fast B1 mapping based on interleaved-three-flip-angle (ITFA) excitation. Med Phys 2013; 40:112301. [PMID: 24320457 DOI: 10.1118/1.4824151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Fast B1 mapping based on short-TR sequences is prone to T1-induced errors. The purpose of this study is to develop a novel fast B1 mapping method that is less prone to T1-induced errors. METHODS The authors acquired three gradient echoes by applying three RF pulses of different flip angles in an interleaved manner. The new method, named interleaved-three-flip-angle (ITFA) method, employs a short TR for fast scan. Since the pixel intensity of the gradient echo images is dependent on both B1 and T1, the authors could compute a B1 map from the three gradient echo images with excluding the T1-effects. The authors simulated the proposed B1 mapping method for various T1 values, and they found optimal flip angles for ITFA experiments for a given repetition time. To evaluate the B1 mapping performance, the authors made a human-brain-mimicking phantom that had six compartments with different T1 and T2. The authors performed B1 mapping experiments at 3T on the phantom and a volunteer using the ITFA method, the actual flip angle imaging (AFI) method, and the double angle method (DAM), and then, the authors compared the B1 mapping results. RESULTS Using a birdcage coil as a transceiver at 3T, the authors performed ITFA scans of the phantom and a volunteer with TR of 60 ms and the nominal flips angles of (25°, 70°, 80°). The authors also performed AFI scans with TR1/TR2 of 30/150 ms and the nominal flip angle of 60°. In both the phantom and human head imaging performed with the same scan times for ITFA and AFI, ITFA showed smaller average B1 errors than AFI when they were compared to DAM. CONCLUSIONS ITFA excitations made it possible to reduce the T1-effects on B1 mapping of the human-brain-mimicking phantom and the human brain at 3T. The authors expect the ITFA method can be used for B1 shimming once the optimal flip angles have been predetermined for the target imaging region and for the preferred TR.
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Affiliation(s)
- Lae Hoon Kang
- Department of Biomedical Engineering, Kyung Hee University, 1 Seochun, Yongin-si, Gyeonggi-do 446-701, South Korea
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Görgülü S, Ayyildiz S, Kamburoglu K, Gökçe S, Ozen T. Effect of orthodontic brackets and different wires on radiofrequency heating and magnetic field interactions during 3-T MRI. Dentomaxillofac Radiol 2013; 43:20130356. [PMID: 24257741 DOI: 10.1259/dmfr.20130356] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the heating and magnetic field interactions of fixed orthodontic appliances with different wires and ligaments in a 3-T MRI environment and to estimate the safety of these orthodontic materials. METHODS 40 non-carious extracted human maxillary teeth were embedded in polyvinyl chloride boxes, and orthodontic brackets were bonded. Nickel-titanium and stainless steel arch wires, and elastic and stainless steel ligaments were used to obtain four experimental groups in total. Specimens were evaluated at 3 T for radiofrequency heating and magnetic field interactions. Radiofrequency heating was evaluated by placing specimens in a cylindrical plastic container filled with isotonic solution and measuring changes in temperature after T1 weighted axial sequencing and after completion of all sequences. Translational attraction and torque values of specimens were also evaluated. One-way ANOVA test was used to compare continuous variables of temperature change. Significance was set at p < 0.05. RESULTS None of the groups exhibited excessive heating (highest temperature change: <3.04 °C), with the maximum increase in temperature observed at the end of the T1 weighted axial sequence. Magnetic field interactions changed depending on the material used. Although the brackets presented minor interactions that would not cause movement in situ, nickel-titanium and stainless steel wires presented great interactions that may pose a risk for the patient. CONCLUSIONS The temperature changes of the specimens were considered to be within acceptable ranges. With regard to magnetic field interactions, brackets can be considered "MR safe"; however, it would be safe to replace the wires before MRI.
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Affiliation(s)
- S Görgülü
- Department of Orthodontics, Dental Health Sciences Center, Gulhane Military Medical Academy, Ankara, Turkey
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Abstract
Many assumptions are made when imaging children. In particular a judgement is made regarding how safe or unsafe each imaging modality is, using relatively arbitrary definitions and distinctions, due to the lack of robust scientific data. Here, the latest evidence is reviewed, particularly regarding the medical exposure to ionizing radiation (X-rays and CT) and MRI in childhood. The best evidence currently available suggests a small but convincing risk of cumulative low-dose ionizing radiation in children. Given our predictions for the children imaged today, it seems reasonable to pursue non-ionizing-based techniques wherever possible, although there is emerging evidence that MRI and ultrasound may have hitherto unknown effects. As our knowledge base expands, we must continually review our practice in light of the latest scientific data.
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Affiliation(s)
| | - Alvhild Alette Bj⊘rkum
- Departments of Biomedical Laboratory
Sciences and Chemical Engineering, Faculty of Engineering, Bergen University
College, Bergen, Norway
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Abstract
Magnetic resonance imaging (MRI) is rich in diagnostic information but requires optimization for use in children. The main problems are motion artifacts and poor signal-to-noise ratio (SNR). SNR is proportional to voxel volume, which must therefore not be too small, however, usually needs to be reduced compared to adult imaging to account for the finer anatomy of the child. The use of multi-channel coils with element sizes appropriate for the anatomy of interest ensures optimal baseline SNR. Longer acquisition time increases SNR (with a square-root factor), but the flip-side is that this allows more motion artifacts. Attention to patient preparation and to techniques for motion artifact reduction is therefore crucial, and the most important principles are discussed. Low SNR may in part be compensated by optimizing the image contrast by weighting (tissue and lesions T1 and T2 may differ from adults) and by using contrast agents. It is also powerful to combine different image contrasts during postprocessing. The basic principles are discussed, followed by an example scan protocol.
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Affiliation(s)
- Øystein E Olsen
- Radiology Department, Great Ormond Street Hospital for
Children NHS Foundation Trust, London, UK
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35
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Bhargava R, Hahn G, Hirsch W, Kim MJ, Mentzel HJ, Olsen ØE, Stokland E, Triulzi F, Vazquez E. Contrast-enhanced magnetic resonance imaging in pediatric patients: review and recommendations for current practice. MAGNETIC RESONANCE INSIGHTS 2013; 6:95-111. [PMID: 25114547 PMCID: PMC4089734 DOI: 10.4137/mri.s12561] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Magnetic resonance imaging (MRI), frequently with contrast enhancement, is the preferred imaging modality for many indications in children. Practice varies widely between centers, reflecting the rapid pace of change and the need for further research. Guide-line changes, for example on contrast-medium choice, require continued practice reappraisal. This article reviews recent developments in pediatric contrast-enhanced MRI and offers recommendations on current best practice. Nine leading pediatric radiologists from internationally recognized radiology centers convened at a consensus meeting in Bordeaux, France, to discuss applications of contrast-enhanced MRI across a range of indications in children. Review of the literature indicated that few published data provide guidance on best practice in pediatric MRI. Discussion among the experts concluded that MRI is preferred over ionizing-radiation modalities for many indications, with advantages in safety and efficacy. Awareness of age-specific adaptations in MRI technique can optimize image quality. Gadolinium-based contrast media are recommended for enhancing imaging quality. The choice of most appropriate contrast medium should be based on criteria of safety, tolerability, and efficacy, characterized in age-specific clinical trials and personal experience.
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Affiliation(s)
- Ravi Bhargava
- Division of Pediatric Radiology, Department of Radiology and Diagnostic Imaging, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Gabriele Hahn
- Institut und Poliklinik für Radiologische Diagnostik, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Wolfgang Hirsch
- Department of Paediatric Radiology, University of Leipzig, Germany
| | - Myung-Joon Kim
- Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Øystein E. Olsen
- Radiology Department, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Eira Stokland
- Department of Paediatric Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fabio Triulzi
- Department of Radiology and Neuroradiology, Ospedale Vittore Buzzi Pediatric Hospital, Milan, Italy
| | - Elida Vazquez
- Radiology Department, Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain
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Inoue Y, Yoneyama M, Nakamura M, Ozaki S, Ito K, Hiura M. [Carotid plaque assessment using inversion recovery T1 weighted-3 dimensions variable refocus flip angle turbo spin echo sampling perfection with application optimized contrast using different angle evolutions black blood imaging]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2013; 68:880-8. [PMID: 22821162 DOI: 10.6009/jjrt.2012_jsrt_68.7.880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Vulnerable plaque can be attributed to induction of ischemic symptoms and magnetic resonance imaging of carotid artery is valuable to detect the plaque. Magnetization prepared rapid acquisition with gradient echo (MPRAGE) method could detect hemorrhagic vulnerable plaque as high intensity signal; however, blood flow is not sufficiently masked by this method. The contrast for plaque in T<inf>1</inf> weighted image (T<inf>1</inf>WI) could not be obtained sufficiently with black blood image (BBI) by sampling perfection with application optimized contrast using different angle evolutions (SPACE) method as turbo spin echo (TSE). In addition, an appearance of artifact by slow flow is a problem. Considering these controversial situations in plaque imaging, we examined the modified BBI inversion recovery (IR)-SPACE in which IR was added for SPACE method so that the contrast for plaque in T<inf>1</inf>WI was optimized. We investigated the application of this method in plaque imaging. As a result of phantom imaging, the contrast for plaque in T<inf>1</inf>WI was definitely obtained by choosing an appropriate inversion time (TI) for the corresponding repetition time. In clinical cases, blood flow was sufficiently masked by IR-SPACE method and the plaque imaging was clearly obtained in clinical cases to the same extent as MPRAGE method. Since BBI with IR-SPACE method was derived from both IR pulse and flow void effect, this method could obtain the blood flow masking effect definitely. The present study suggested that SPACE method might be applicable to estimate properties of carotid artery plaque.
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Abstract
Magnetic resonance (MR) imaging is an effective and noninvasive modality for evaluating hepatobiliary pathologic conditions. This article provides an up-to-date review of anatomy, indications, and imaging goals and protocols, including patient preparation, pulse sequences, and contrast agents used in pediatric MR hepatobiliary imaging. This article also highlights some of the common MR features of pediatric liver pathologic conditions, including tumors, congenital biliary ductal plate malformations, trauma, fibrosis, and infection.
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Bosemani T, Verschuuren SI, Poretti A, Huisman TAGM. Pitfalls in susceptibility-weighted imaging of the pediatric brain. J Neuroimaging 2013; 24:221-5. [PMID: 24015797 DOI: 10.1111/jon.12051] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 05/19/2013] [Accepted: 05/21/2013] [Indexed: 12/01/2022] Open
Abstract
Susceptibility-weighted imaging (SWI) is a recently developed high resolution 3-dimensional gradient-echo pulse sequence that accentuates the magnetic susceptibility of blood, calcium, and nonheme iron. The clinical applications of SWI in pediatric neuroimaging have significantly expanded recently. Potential pitfalls related to blood oxygenation, blood flow, magnetic field strength, and misinterpretation of localization as well as possible mimickers may be misleading and affect the correct interpretation of SWI images. Familiarity with these potential diagnostic pitfalls is important to prevent misdiagnosis and will further enhance the ability of SWI in becoming a robust and reliable technique.
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Affiliation(s)
- Thangamadhan Bosemani
- Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
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Pannek K, Guzzetta A, Colditz PB, Rose SE. Diffusion MRI of the neonate brain: acquisition, processing and analysis techniques. Pediatr Radiol 2012; 42:1169-82. [PMID: 22903761 DOI: 10.1007/s00247-012-2427-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/05/2012] [Accepted: 03/11/2012] [Indexed: 12/13/2022]
Abstract
Diffusion MRI (dMRI) is a popular noninvasive imaging modality for the investigation of the neonate brain. It enables the assessment of white matter integrity, and is particularly suited for studying white matter maturation in the preterm and term neonate brain. Diffusion tractography allows the delineation of white matter pathways and assessment of connectivity in vivo. In this review, we address the challenges of performing and analysing neonate dMRI. Of particular importance in dMRI analysis is adequate data preprocessing to reduce image distortions inherent to the acquisition technique, as well as artefacts caused by head movement. We present a summary of techniques that should be used in the preprocessing of neonate dMRI data, and demonstrate the effect of these important correction steps. Furthermore, we give an overview of available analysis techniques, ranging from voxel-based analysis of anisotropy metrics including tract-based spatial statistics (TBSS) to recently developed methods of statistical analysis addressing issues of resolving complex white matter architecture. We highlight the importance of resolving crossing fibres for tractography and outline several tractography-based techniques, including connectivity-based segmentation, the connectome and tractography mapping. These techniques provide powerful tools for the investigation of brain development and maturation.
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Affiliation(s)
- Kerstin Pannek
- Centre for Clinical Research, The University of Queensland, Brisbane, Australia
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Arthurs OJ, Edwards A, Austin T, Graves MJ, Lomas DJ. The challenges of neonatal magnetic resonance imaging. Pediatr Radiol 2012; 42:1183-94. [PMID: 22886375 DOI: 10.1007/s00247-012-2430-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 04/27/2012] [Accepted: 05/06/2012] [Indexed: 12/29/2022]
Abstract
Improved neonatal survival rates and antenatal diagnostic imaging is generating a growing demand for postnatal MRI examinations. Neonatal brain MRI is now becoming standard clinical care in many settings, but with the exception of some research centres, the technique has not been optimised for imaging neonates and small children. Here, we review some of the challenges involved in neonatal MRI, including recent advances in overall MR practicality and nursing practice, to address some of the ways in which the MR experience could be made more neonate-friendly.
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Affiliation(s)
- Owen J Arthurs
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
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41
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Prabhakaran V, Nair VA, Austin BP, La C, Gallagher TA, Wu Y, McLaren DG, Xu G, Turski P, Rowley H. Current status and future perspectives of magnetic resonance high-field imaging: a summary. Neuroimaging Clin N Am 2012; 22:373-97, xii. [PMID: 22548938 DOI: 10.1016/j.nic.2012.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There are several magnetic resonance (MR) imaging techniques that benefit from high-field MR imaging. This article describes a range of novel techniques that are currently being used clinically or will be used in the future for clinical purposes as they gain popularity. These techniques include functional MR imaging, diffusion tensor imaging, cortical thickness assessment, arterial spin labeling perfusion, white matter hyperintensity lesion assessment, and advanced MR angiography.
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Affiliation(s)
- Vivek Prabhakaran
- Division of Neuroradiology, Department of Radiology, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792-3252, USA.
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Hillenbrand CM, Reykowski A. MR Imaging of the Newborn: a technical perspective. Magn Reson Imaging Clin N Am 2012; 20:63-79. [PMID: 22118593 DOI: 10.1016/j.mric.2011.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article discusses neonatal magnetic resonance (MR) imaging and reviews equipment and procedures for MR-related transport, sedation, monitoring, and scanning. MR is gaining importance in the diagnosis and clinical management of critically ill, and often very low birth weight infants, so research is ongoing to make transport and examination safer and imaging more successful. Efforts are focused on integration of dedicated neonate MR scanners in neonatal intensive care units, improvements in incubator technology and handling, and more efficient use of scan/sedation time by choosing dedicated neonate coil arrays that improve the signal-to-noise-ratio and facilitate the choice of modern imaging techniques.
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Affiliation(s)
- Claudia M Hillenbrand
- Division of Translational Imaging Research, Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, TN 38105, USA
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Dahmoush HM, Vossough A, Roberts TPL. Pediatric high-field magnetic resonance imaging. Neuroimaging Clin N Am 2012; 22:297-313, xi. [PMID: 22548934 DOI: 10.1016/j.nic.2012.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
High-field 3 T magnetic resonance (MR) imaging provides greater signal-to-noise ratio (SNR) compared with 1.5 T systems. Various MR imaging clinical applications in children can benefit from improvements resulting from this increased SNR. High-resolution imaging of the brain, arterial spin labeling perfusion imaging, diffusion imaging, MR spectroscopy, and imaging of small anatomic parts are some areas in which these improvements can increase our clinical diagnostic capabilities. However, challenges inherent to 3 T imaging become more relevant in children. The use of 3 T imaging in children has allowed better diagnostic efficacy in neuroimaging, but certain technique modifications may be required for optimal imaging.
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Affiliation(s)
- Hisham M Dahmoush
- Neuroradiology Section, Department of Radiology, Children's Hospital of Philadelphia, Wood 2115, 324 South 34th Street, Philadelphia, PA 19104, USA
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Darge K, Anupindi SA, Jaramillo D. MR imaging of the abdomen and pelvis in infants, children, and adolescents. Radiology 2011; 261:12-29. [PMID: 21931139 DOI: 10.1148/radiol.11101922] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Recent developments in magnetic resonance (MR) imaging have profoundly changed the investigation of abdominal and pelvic disease in pediatrics. Motion reduction techniques, such periodically rotated overlapping parallel lines with enhanced reconstruction, or PROPELLER, have resulted in reliable imaging with quiet breathing. Faster imaging sequences minimize artifact and allow for more efficient studies. Diffusion-weighted imaging has become increasingly important in the evaluation of neoplastic disease, depicting disease with increased cellularity and helping to differentiate benign from malignant masses. MR enterography helps visualize intra- and extraluminal bowel pathologic conditions. MR cholangiopancreatography can depict congenital and acquired causes of pancreatic and biliary abnormalities. MR urography is an effective technique for a one-stop-shop evaluation of structural urinary tract abnormality and renal function. Three-dimensional acquisitions allow volumetric display of structures from multiple angles. Specialized techniques allow quantification of iron and fat in the viscera in children with hemolytic anemia and obesity, respectively. This article covers current techniques and strategies to perform and optimize MR imaging of the abdomen and pelvis in infants, children, and adolescents and describes important practical applications.
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Affiliation(s)
- Kassa Darge
- Department of Radiology, The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA 19104, USA.
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Li X, Welch EB, Arlinghaus LR, Chakravarthy AB, Xu L, Farley J, Loveless ME, Mayer IA, Kelley MC, Meszoely IM, Means-Powell JA, Abramson VG, Grau AM, Gore JC, Yankeelov TE. A novel AIF tracking method and comparison of DCE-MRI parameters using individual and population-based AIFs in human breast cancer. Phys Med Biol 2011; 56:5753-69. [PMID: 21841212 DOI: 10.1088/0031-9155/56/17/018] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Quantitative analysis of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) data requires the accurate determination of the arterial input function (AIF). A novel method for obtaining the AIF is presented here and pharmacokinetic parameters derived from individual and population-based AIFs are then compared. A Philips 3.0 T Achieva MR scanner was used to obtain 20 DCE-MRI data sets from ten breast cancer patients prior to and after one cycle of chemotherapy. Using a semi-automated method to estimate the AIF from the axillary artery, we obtain the AIF for each patient, AIF(ind), and compute a population-averaged AIF, AIF(pop). The extended standard model is used to estimate the physiological parameters using the two types of AIFs. The mean concordance correlation coefficient (CCC) for the AIFs segmented manually and by the proposed AIF tracking approach is 0.96, indicating accurate and automatic tracking of an AIF in DCE-MRI data of the breast is possible. Regarding the kinetic parameters, the CCC values for K(trans), v(p) and v(e) as estimated by AIF(ind) and AIF(pop) are 0.65, 0.74 and 0.31, respectively, based on the region of interest analysis. The average CCC values for the voxel-by-voxel analysis are 0.76, 0.84 and 0.68 for K(trans), v(p) and v(e), respectively. This work indicates that K(trans) and v(p) show good agreement between AIF(pop) and AIF(ind) while there is a weak agreement on v(e).
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Affiliation(s)
- Xia Li
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
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Smyser CD, Snyder AZ, Neil JJ. Functional connectivity MRI in infants: exploration of the functional organization of the developing brain. Neuroimage 2011; 56:1437-52. [PMID: 21376813 PMCID: PMC3089442 DOI: 10.1016/j.neuroimage.2011.02.073] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/22/2011] [Accepted: 02/27/2011] [Indexed: 12/15/2022] Open
Abstract
Advanced neuroimaging techniques have been increasingly applied to the study of preterm and term infants in an effort to further define the functional cerebral architecture of the developing brain. Despite improved understanding of the complex relationship between structure and function obtained through these investigations, significant questions remain regarding the nature, location, and timing of the maturational changes which occur during early development. Functional connectivity magnetic resonance imaging (fcMRI) utilizes spontaneous, low frequency (< 0.1 Hz), coherent fluctuations in blood oxygen level dependent (BOLD) signal to identify networks of functional cerebral connections. Due to the intrinsic characteristics of its image acquisition and analysis, fcMRI offers a novel neuroimaging approach well suited to investigation of infants. Recently, this methodology has been successfully applied to examine neonatal populations, defining normative patterns of large-scale neural network development in the maturing brain. The resting-state networks (RSNs) identified in these studies reflect the evolving cerebral structural architecture, presumably driven by varied genetic and environmental influences. Principal features of these investigations and their role in characterization of the tenets of neural network development during this critical developmental period are highlighted in this review. Despite these successes, optimal methods for fcMRI data acquisition and analysis for this population have not yet been defined. Further, appropriate schemes for interpretation and translation of fcMRI results remain unknown, a matter of increasing importance as functional neuroimaging findings are progressively applied in the clinical arena. Notwithstanding these concerns, fcMRI provides insight into the earliest forms of cerebral connectivity and therefore holds great promise for future neurodevelopmental investigations.
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Affiliation(s)
- Christopher D Smyser
- Department of Neurology, Washington University, Saint Louis, MO 63110-1093, USA.
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Arthurs OJ, Gallagher FA. Functional and molecular imaging with MRI: potential applications in paediatric radiology. Pediatr Radiol 2011; 41:185-98. [PMID: 20972674 DOI: 10.1007/s00247-010-1842-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2010] [Revised: 07/29/2010] [Accepted: 08/25/2010] [Indexed: 01/17/2023]
Abstract
MRI is a very versatile tool for noninvasive imaging and it is particularly attractive as an imaging technique in paediatric patients given the absence of ionizing radiation. Recent advances in the field of MRI have enabled tissue function to be probed noninvasively, and increasingly MRI is being used to assess cellular and molecular processes. For example, dynamic contrast-enhanced MRI has been used to assess tissue vascularity, diffusion-weighted imaging can quantify molecular movements of water in tissue compartments and MR spectroscopy provides a quantitative assessment of metabolite levels. A number of targeted contrast agents have been developed that bind specifically to receptors on the vascular endothelium or cell surface and there are several MR methods for labelling cells and tracking cellular movements. Hyperpolarization techniques have the capability of massively increasing the sensitivity of MRI and these have been used to image tissue pH, successful response to drug treatment as well as imaging the microstructure of the lungs. Although there are many challenges to be overcome before these techniques can be translated into routine paediatric imaging, they could potentially be used to aid diagnosis, predict disease outcome, target biopsies and determine treatment response noninvasively.
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Affiliation(s)
- Owen J Arthurs
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Teaching Hospitals NHS Foundation Trust, University of Cambridge, Box 218, Level 5, Hills Road, Cambridge, CB2 0QQ, UK
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Outcome-related metabolomic patterns from 1H/31P NMR after mild hypothermia treatments of oxygen-glucose deprivation in a neonatal brain slice model of asphyxia. J Cereb Blood Flow Metab 2011; 31:547-59. [PMID: 20717124 PMCID: PMC3010526 DOI: 10.1038/jcbfm.2010.125] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Human clinical trials using 72 hours of mild hypothermia (32°C-34°C) after neonatal asphyxia have found substantially improved neurologic outcomes. As temperature changes differently modulate numerous metabolite fluxes and concentrations, we hypothesized that (1)H/(31)P nuclear magnetic resonance (NMR) spectroscopy of intracellular metabolites can distinguish different insults, treatments, and recovery stages. Three groups of superfused neonatal rat brain slices underwent 45 minutes oxygen-glucose deprivation (OGD) and then were: treated for 3 hours with mild hypothermia (32°C) that began with OGD, or similarly treated with hypothermia after a 15-minute delay, or not treated (normothermic control group, 37°C). Hypothermia was followed by 3 hours of normothermic recovery. Slices collected at different predetermined times were processed, respectively, for 14.1 Tesla NMR analysis, enzyme-linked immunosorbent assay (ELISA) cell-death quantification, and superoxide production. Forty-nine NMR-observable metabolites underwent a multivariate analysis. Separated clustering in scores plots was found for treatment and outcome groups. Final ATP (adenosine triphosphate) levels, severely decreased at normothermia, were restored equally by immediate and delayed hypothermia. Cell death was decreased by immediate hypothermia, but was equally substantially greater with normothermia and delayed hypothermia. Potentially important biomarkers in the (1)H spectra included PCr-(1)H (phosphocreatine in the (1)H spectrum), ATP-(1)H (adenosine triphosphate in the (1)H spectrum), and ADP-(1)H (adenosine diphosphate in the (1)H spectrum). The findings suggest a potential role for metabolomic monitoring during therapeutic hypothermia.
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Moriarty JM, Finn JP, Fonseca CG. Contrast agents used in cardiovascular magnetic resonance imaging: current issues and future directions. Am J Cardiovasc Drugs 2010; 10:227-37. [PMID: 20653329 DOI: 10.2165/11539370-000000000-00000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Cardiovascular MRI is being increasingly used in the evaluation of ischemic heart disease, cardiac masses, complex congenital heart disease, and morphologic evaluation of the vascular anatomy throughout the body. Many and varied contrast media may be used to increase the sensitivity and specificity of detecting and evaluating various pathologies, and a knowledge of the different mechanisms of action, distributions and safety profiles of these agents is required for safe and effective imaging. This article reviews the currently available magnetic resonance (MR) contrast media, discusses the risks and benefits, and gives illustrated examples of current clinical applications in cardiovascular disease. A literature search covered the period 1990 to the present with the use of multiple databases including MEDLINE, PUBMED, SciSearch and Google Medical. All identified studies containing information relevant to the topic of cardiovascular MRI and cardiovascular MR contrast agents and their uses and properties were evaluated. Evaluation was limited to studies in English. The conclusions were that the use of contrast agents vastly increases the diagnostic yield, sensitivity and specificity of cardiovascular MRI in the non-invasive diagnosis of the full breadth of cardiovascular pathology. The use of contrast MRI for investigating ischemic heart disease, cardiac masses, and congenital heart disease and in angiography is now well established, and the referring physician, cardiologist, or radiologist requires an in-depth knowledge of the safety profiles and correct dosing of commonly prescribed contrast agents. As the number of MR contrast agents on the market continues to increase, knowledge of the basic mechanism of action is vital for keeping abreast of how new and emerging agents will affect clinical practice in the future.
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Affiliation(s)
- John M Moriarty
- Diagnostic Cardiovascular Imaging, Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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