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Ueda T, Yamamoto K, Yazawa N, Tozawa I, Ikedo M, Yui M, Nagata H, Nomura M, Ozawa Y, Ohno Y. Efficacy of compressed sensing and deep learning reconstruction for adult female pelvic MRI at 1.5 T. Eur Radiol Exp 2024; 8:103. [PMID: 39254920 DOI: 10.1186/s41747-024-00506-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/22/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND We aimed to determine the capabilities of compressed sensing (CS) and deep learning reconstruction (DLR) with those of conventional parallel imaging (PI) for improving image quality while reducing examination time on female pelvic 1.5-T magnetic resonance imaging (MRI). METHODS Fifty-two consecutive female patients with various pelvic diseases underwent MRI with T1- and T2-weighted sequences using CS and PI. All CS data was reconstructed with and without DLR. Signal-to-noise ratio (SNR) of muscle and contrast-to-noise ratio (CNR) between fat tissue and iliac muscle on T1-weighted images (T1WI) and between myometrium and straight muscle on T2-weighted images (T2WI) were determined through region-of-interest measurements. Overall image quality (OIQ) and diagnostic confidence level (DCL) were evaluated on 5-point scales. SNRs and CNRs were compared using Tukey's test, and qualitative indexes using the Wilcoxon signed-rank test. RESULTS SNRs of T1WI and T2WI obtained using CS with DLR were higher than those using CS without DLR or conventional PI (p < 0.010). CNRs of T1WI and T2WI obtained using CS with DLR were higher than those using CS without DLR or conventional PI (p < 0.003). OIQ of T1WI and T2WI obtained using CS with DLR were higher than that using CS without DLR or conventional PI (p < 0.001). DCL of T2WI obtained using CS with DLR was higher than that using conventional PI or CS without DLR (p < 0.001). CONCLUSION CS with DLR provided better image quality and shorter examination time than those obtainable with PI for female pelvic 1.5-T MRI. RELEVANCE STATEMENT CS with DLR can be considered effective for attaining better image quality and shorter examination time for female pelvic MRI at 1.5 T compared with those obtainable with PI. KEY POINTS Patients underwent MRI with T1- and T2-weighted sequences using CS and PI. All CS data was reconstructed with and without DLR. CS with DLR allowed for examination times significantly shorter than those of PI and provided significantly higher signal- and CNRs, as well as OIQ.
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Affiliation(s)
- Takahiro Ueda
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Japan.
| | | | | | - Ikki Tozawa
- Department of Radiology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Masato Ikedo
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masao Yui
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroyuki Nagata
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masahiko Nomura
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoshiyuki Ozawa
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoshiharu Ohno
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Japan
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan
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Leal LM, Vasques GMB, Sasahara THDC, Vulcano LC, Machado MRF, Minto BW. Approach to the humerus and femur of the paca (Cuniculus paca, Linnaeus 1766). Anat Histol Embryol 2021; 50:931-939. [PMID: 34499362 DOI: 10.1111/ahe.12736] [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: 05/11/2021] [Revised: 07/20/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022]
Abstract
The paca (Cuniculus paca, Linnaeus 1766) is a rodent species, typical of tropical regions. It is important that in addition to its commercial value as a protein source, it can be used as a scientific scope. The objective of this study was to describe the morphology of the thigh and the arm of the paca by anatomical and imaging methodology with radiography (X-ray), computed tomography (CAT scan) and magnetic resonance imaging (MRI) to determine the surgical approach of the bones of these regions. It was concluded that the imaging study through X-ray, CAT scan and MRI are reliable methods for anatomical description of wild animals that have little known about their morphology. Finally, similarly to dogs, it was determined that lateral access is the best approach to the femoral diaphysis and the medial access is the best approach to the humerus diaphysis of the paca.
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Affiliation(s)
| | | | | | - Luiz Carlos Vulcano
- Department of Veterinary Surgery and Animal Reproduction, Universidade Estadual Paulista, Botucatu, Brazil
| | | | - Bruno Watanabe Minto
- Department of Veterinary Clinical and Surgery, Universidade Estadual Paulista, Jaboticabal, Brazil
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Xiao BH, Wáng YXJ. Different tissue types display different signal intensities on b = 0 images and the implications of this for intravoxel incoherent motion analysis: Examples from liver MRI. NMR IN BIOMEDICINE 2021; 34:e4522. [PMID: 33851487 DOI: 10.1002/nbm.4522] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Ben-Heng Xiao
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
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Li Q, Dhyani M, Grajo JR, Sirlin C, Samir AE. Current status of imaging in nonalcoholic fatty liver disease. World J Hepatol 2018; 10:530-542. [PMID: 30190781 PMCID: PMC6120999 DOI: 10.4254/wjh.v10.i8.530] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 06/25/2018] [Accepted: 06/28/2018] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common diffuse liver disease, with a worldwide prevalence of 20% to 46%. NAFLD can be subdivided into simple steatosis and nonalcoholic steatohepatitis. Most cases of simple steatosis are non-progressive, whereas nonalcoholic steatohepatitis may result in chronic liver injury and progressive fibrosis in a significant minority. Effective risk stratification and management of NAFLD requires evaluation of hepatic parenchymal fat, fibrosis, and inflammation. Liver biopsy remains the current gold standard; however, non-invasive imaging methods are rapidly evolving and may replace biopsy in some circumstances. These methods include well-established techniques, such as conventional ultrasonography, computed tomography, and magnetic resonance imaging and newer imaging technologies, such as ultrasound elastography, quantitative ultrasound techniques, magnetic resonance elastography, and magnetic resonance-based fat quantitation techniques. The aim of this article is to review the current status of imaging methods for NAFLD risk stratification and management, including their diagnostic accuracy, limitations, and practical applicability.
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Affiliation(s)
- Qian Li
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Manish Dhyani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Radiology, Lahey Hospital and Medical Center, 41 Burlington Mall Road, Burlington, MA 01805, United States
| | - Joseph R Grajo
- Department of Radiology, Division of Abdominal Imaging, University of Florida College of Medicine, Gainesville, FL 32610, United States
| | - Claude Sirlin
- Altman Clinical Translational Research Institute, University of California, San Diego, CA 92103, United States
| | - Anthony E Samir
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
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Donato H, França M, Candelária I, Caseiro-Alves F. Liver MRI: From basic protocol to advanced techniques. Eur J Radiol 2017; 93:30-39. [PMID: 28668428 DOI: 10.1016/j.ejrad.2017.05.028] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 02/07/2023]
Abstract
Liver MR is a well-established modality with multiparametric capabilities. However, to take advantage of its full capacity, it is mandatory to master the technique and optimize imaging protocols, apply advanced imaging concepts and understand the use of different contrast media. Physiologic artefacts although inherent to upper abdominal studies can be minimized using triggering techniques and new strategies for motion control. For standardization, the liver MR protocol should include motion-resistant T2-w sequences, in-op phase GRE T1 and T2-w fast spin echo sequences with fat suppression. Diffusion-weighted imaging (DWI) is mandatory, especially for detection of sub-centimetre metastases. Contrast-enhanced MR is the cornerstone of liver MR, especially for lesion characterization. Although extracellular agents are the most extensively used contrast agents, hepatobiliary contrast media can provide an extra-layer of functional diagnostic information adding to the diagnostic value of liver MR. The use of high field strength (3T) increases SNR but is more challenging especially concerning artefact control. Quantitative MR belongs to the new and evolving field of radiomics where the use of emerging biomarkers such as perfusion or DWI can derive new information regarding disease detection, prognostication and evaluation of tumour response. This information can overcome some of the limitations of current tests, especially when using vascular disruptive agents for oncologic treatment assessment. MR is, today, a robust, mature, multiparametric imaging modality where clinical applications have greatly expanded from morphology to advanced imaging. This new concept should be acknowledged by all those involved in producing high quality, high-end liver MR studies.
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Affiliation(s)
- Henrique Donato
- Imaging Department, Faculty of Medicine of Coimbra, University Centre Hospitals of Coimbra (CHUC), Portugal.
| | - Manuela França
- Imaging Department, Centro Hospitalar do Porto, Portugal.
| | - Isabel Candelária
- Imaging Department, Faculty of Medicine of Coimbra, University Centre Hospitals of Coimbra (CHUC), Portugal.
| | - Filipe Caseiro-Alves
- Imaging Department, Faculty of Medicine of Coimbra, University Centre Hospitals of Coimbra (CHUC), Portugal.
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Critical analysis of the major and ancillary imaging features of LI-RADS on 127 proven HCCs evaluated with functional and morphological MRI: Lights and shadows. Oncotarget 2017; 8:51224-51237. [PMID: 28881643 PMCID: PMC5584244 DOI: 10.18632/oncotarget.17227] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/22/2017] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To report a critical analysis of major and ancillary MR imaging features in assessment of HCC. METHODS Retrospectively we evaluated 70 cirrhotic patients with 173 nodules, which were subjected to MR study at 0 time (MR0), after 3 (MR3) and 6 months (MR6) using two different contrast media. EOB-GD-DTPA was injected at MR0 and MR6, while Gd-BT-DO3A at MR3. Three expert hepatic radiologists reviewed all images, recording, according to LI-RADS, the size, the presence and quality of arterial-phase hyperenhancement, washout and capsule appearance, threshold growth. Additionally, we recorded signal intensity (SI) on T2-W images, on DWI, on apparent diffusion coefficient (ADC) maps and SI on T1-W images of EOB-GD-BPTA hepatospecific phase. Median value of ADC and of Intravoxel incoherent motion related parameters were assessed. RESULTS 127 HCCs and 24 dysplastic nodules were assessed. Hypervascular on arterial phase was found in 84 HCCs, washout appearance in 124, capsule appearance in 111, hypointensity on hepatospecific phase in 127, hyperintensity on T2-W sequences and restricted diffusion in 107. Hyper vascular on arterial phase was found in 17 dysplastic nodules, wash-out appearance in 2, hypointensity on hepatospecific phase in 7 while no dysplastic nodules showed capsule appearance, hyperintensity on T2-W and restricted diffusion. Highest accuracy was obtained by washout appearance and hypointense signal on hepatospecific phase (97% and 95%). CONCLUSIONS Hypointensity on hepatospecific phase and washout appearance are the most relevant diagnostic sign for differentiating low-risk from high-risk HCC nodules. The capsule appearance, T2-W hyperintensity and restricted diffusion have high positive predictive value.
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Tsurusaki M, Sofue K, Murakami T. Current evidence for the diagnostic value of gadoxetic acid-enhanced magnetic resonance imaging for liver metastasis. Hepatol Res 2016; 46:853-61. [PMID: 26750497 DOI: 10.1111/hepr.12646] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 12/25/2015] [Accepted: 12/31/2015] [Indexed: 02/08/2023]
Abstract
A variety of imaging techniques, including ultrasonography (US), multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and positron emission tomography combined with CT scan (PET/CT), are available for diagnosis and treatment planning in liver metastasis. Contrast-enhanced MDCT is a relatively non-invasive, widely available and standardized method for hepatic work-up. Gadoxetic acid (gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid; EOB Primovist®]) is a recently developed liver-specific hepatobiliary MR contrast agent that offers both dynamic imaging as well as liver-specific static hepatocyte imaging, referred to as the hepatobiliary phase. Following contrast injection, this technique reveals dynamic vascular phases (arterial, portal venous and delayed phases), in addition to the hepatobiliary phase upon uptake by functional hepatocytes. The overall sensitivity of gadoxetic acid-enhanced MRI was significantly higher than that of contrast-enhanced CT. Specifically, the higher sensitivity of gadoxetic acid-enhanced MRI was observed in lesions smaller than 1 cm in diameter. Gadoxetic acid-enhanced MRI is considered an extremely useful tool for the diagnosis of liver metastases. Future studies will focus on diagnostic algorithms involving combinations of modalities such as MRI, MDCT and/or (18) F-fluorodeoxyglucose PET/CT, which may impact the treatment plan for these patients.
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Affiliation(s)
| | - Keitaro Sofue
- Department of Radiology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Takamichi Murakami
- Department of Radiology, Kinki University Faculty of Medicine, Osaka, Japan
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Agostini A, Kircher MF, Do R, Borgheresi A, Monti S, Giovagnoni A, Mannelli L. Magnetic Resonance Imaging of the Liver (Including Biliary Contrast Agents) Part 1: Technical Considerations and Contrast Materials. Semin Roentgenol 2016; 51:308-316. [PMID: 27743567 DOI: 10.1053/j.ro.2016.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- A Agostini
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Radiology, School of Radiology, Universita' Politecnica delle Marche Ancona, Italy
| | - M F Kircher
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - R Do
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - A Borgheresi
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Radiology, School of Radiology, Universita' degli Studi di Firenze Firenze, Italy
| | | | - A Giovagnoni
- Department of Radiology, School of Radiology, Universita' Politecnica delle Marche Ancona, Italy
| | - L Mannelli
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY.
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Sousa MSC, Ramalho M, Herédia V, Matos AP, Palas J, Jeon YH, Afonso D, Semelka RC. Perilesional enhancement of liver cavernous hemangiomas in magnetic resonance imaging. ACTA ACUST UNITED AC 2016; 39:722-30. [PMID: 24531350 DOI: 10.1007/s00261-014-0100-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate on magnetic resonance imaging (MRI) the occurrence rate of temporal perilesional parenchymal enhancement (PPE) associated with hepatic hemangiomas in a large consecutive series and to determine which aspects are associated with this observation. MATERIALS AND METHODS Institutional review board approved this retrospective study. A computerized search of the MRI database was performed for consecutive patients between January 2008 and January 2012. The study population included 513 liver hemangiomas in 224 patients (104 males and 120 females; mean age of 55.2 ± 13.5 years; age range 24-89 years). Two readers independently reviewed the frequency of PPE, size, speed of enhancement and location of each hemangioma. Marginal models with generalized estimating equation were used. Wald test was applied to verify if the model coefficients were significant. RESULTS 80/513 (15.6%) hemangiomas showed PPE. The incidence of PPE was significantly higher (p < 0.05) in hemangiomas with Type1 speed of enhancement (51/80, 63.8%) than in those with Type2 or Type3. 66/80 (82.5%) hemangiomas with PPE were subcapsular (p < 0.05). Conversely, the majority (280/433, 64.7%) of hemangiomas without PPE were deep in location (p < 0.001). Lesser proportion of hemangiomas with PPE was located in segment IVa (p < 0.05). CONCLUSION PPE is not uncommonly seen along with hepatic hemangiomas. This appearance is most frequently observed in rapidly enhancing small lesions with a subcapsular location.
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Affiliation(s)
- Marta S C Sousa
- Department of Radiology, Hospital Garcia de Orta, 2801-951, Almada, Portugal
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Tsurusaki M, Sofue K, Isoda H, Okada M, Kitajima K, Murakami T. Comparison of gadoxetic acid-enhanced magnetic resonance imaging and contrast-enhanced computed tomography with histopathological examinations for the identification of hepatocellular carcinoma: a multicenter phase III study. J Gastroenterol 2016; 51:71-9. [PMID: 26130441 DOI: 10.1007/s00535-015-1097-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 04/08/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has an important role in preoperative evaluation of hepatocellular carcinoma (HCC). However, no studies have prospectively performed intraindividual comparison of gadoxetic acid-enhanced 3T MRI and multidetector-row computed tomography (MDCT) with histopathological examination for the detection of HCCs. We prospectively compared the efficacies of gadoxetic acid-enhanced MRI and multiphasic contrast-enhanced MDCT with that of histopathological examination, used as a reference standard, for the detection of HCC in surgical candidates. METHODS The study was approved by the institutional review boards at each of four centers. Patients scheduled to undergo multiphasic CT, gadoxetic acid-enhanced MRI, and liver surgery were prospectively included in this study. The diagnostic abilities of MRI and CT were evaluated and compared on the basis of sensitivity and positive predictive value for detection of and differentiation between HCCs and benign lesions. RESULTS Fifty-four patients with 83 histopathologically confirmed HCCs were included in the study. Combined interpretation of the dynamic and hepatobiliary phases of gadoxetic acid-enhanced MRI showed statistically higher sensitivity for lesion detection (83 %) than did interpretation of multiphasic MDCT images (70 %; p < 0.001). The mean area under each alternative free-response receiver operating characteristics curve was significantly higher for MR images (0.927) than for CT images (0.864, p < 0.01). CONCLUSIONS The sensitivity for preoperative detection of HCCs was higher for gadoxetic acid-enhanced MRI than for multiphasic MDCT imaging.
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Affiliation(s)
| | - Keitaro Sofue
- National Cancer Center Hospital-Diagnostic Radiology, 5-1-1, Tsukiji, Chuo-ku, Tokyo, Tokyo, 104-0045, Japan
- Kobe University Graduate School of Medicine-Radiology, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Masahiro Okada
- Faculty of Medicine-Radiology, Kinki University, Osakasayama, Osaka, Japan
| | - Kazuhiro Kitajima
- Kobe University Graduate School of Medicine-Radiology, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
- Department of Raiology, Dokkyo Medical School, Mibu, Tochigi, Japan
| | - Takamichi Murakami
- Faculty of Medicine-Radiology, Kinki University, Osakasayama, Osaka, Japan
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Yoon JH, Lee JM, Yu MH, Kim EJ, Han JK, Choi BI. Fat-suppressed, three-dimensional T1-weighted imaging using high-acceleration parallel acquisition and a dual-echo Dixon technique for gadoxetic acid-enhanced liver MRI at 3 T. Acta Radiol 2015; 56:1454-62. [PMID: 25480475 DOI: 10.1177/0284185114561038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 11/01/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Parallel imaging (PI) techniques are used for overcoming lower spatial and time resolution for magnetic resonance imaging (MRI). There is clinical need to overcome inevitable noise by decreased voxel size and signal-to-noise issue by using high-acceleration factor (AF). PURPOSE To determine whether the combination of a modified Dixon three-dimensional (3D) T1-weighted (T1W) gradient echo technique (mDixon-3D-GRE) and high-acceleration ([HA], AF = 5) PI can provide breath-hold (BH) T1W imaging with better image quality than conventional fat-suppressed 3D-T1W-GRE (SPAIR-3D-GRE) for Gd-EOB-DTPA-enhanced liver MR. MATERIAL AND METHODS This retrospective study was approved by our institutional review board and informed consent was waived. There were 138 patients who underwent Gd-EOB-DTPA-enhanced liver MR at 3 T using either standard SPAIR-3D-GRE sequences with an AF of 2.6 (n = 68, Standard group) or mDixon-3D-GRE with an AF of 5 (n = 70, HA group). In the HA group, hepatobiliary phase was obtained three times using HA-mDixon-3D-GRE (AF = 5), HA-SPAIR-3D-GRE (AF = 5), and standard-SPAIR-3D-GRE (AF = 2.6). Image noise, quality, and anatomic depiction of dynamic phase were compared between standard and HA groups, and those of hepatobiliary phase were compared among the three image sets in HA group. RESULTS As for dynamic imaging, the HA-mDixon-3D-GRE images showed better anatomic details and overall image quality than standard-SPAIR-3D-GRE sequence (arterial phase: 3.56 ± 0.63 vs. 2.66 ± 0.69, P < 0.001). In the intra-individual comparison, HA-mDixon-3D-GRE provided better orang depiction and overall image quality than standard-SPAIR-3D-GRE (3.99 ± 0.75 vs. 3.0 ± 0.72, P < 0.001) and better fat suppression and significantly less noise than HA-SPAIR-3D-GRE (4.76 ± 0.43 vs. 3.71 ± 0.54, P < 0.001). CONCLUSION The combined use of mDixon-3D-GRE sequence and high-acceleration PI provided better quality BH-T1W imaging compared with conventional SPAIR-3D-GRE for Gd-EOB-DTPA-enhanced liver MRI.
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Affiliation(s)
- Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Radiation Medicine Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mi Hye Yu
- Konkuk University Hospital, Seoul, Republic of Korea
| | - Eun Ju Kim
- Philips Healthcare Korea, Seoul, Republic of Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Radiation Medicine Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Byung Ihn Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Radiation Medicine Seoul National University College of Medicine, Seoul, Republic of Korea
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Kawahara S, Isoda H, Ohno T, Furuta A, Togashi K. Non-contrast-enhanced hepatic MR arteriography with balanced steady-state free-precession and time spatial labeling inversion pulse: optimization of the inversion time at 3 Tesla. Acta Radiol Open 2015; 4:2058460115616427. [PMID: 26668756 PMCID: PMC4668994 DOI: 10.1177/2058460115616427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 10/16/2015] [Accepted: 10/17/2015] [Indexed: 11/15/2022] Open
Abstract
Background A 3 Tesla (3 T) magnetic resonance (MR) scanner is a promising tool for upper abdominal angiography. However, no report has focused on the contrast behavior of non-contrast-enhanced hepatic MR arteriography at 3 T. Purpose To establish the optimal inversion time (TI) for favorable selective visualization of the hepatic arteries on non-contrast-enhanced MR arteriography with time spatial labeling inversion pulse (Time-SLIP) at 3 T. Material and Methods Twenty-five healthy volunteers were examined using respiratory-triggered three-dimensional balanced steady-state free-precession combined with Time-SLIP. According to the difference in the TI, five image groups (A, B, C, D, and E, from 1200 to 2000 ms, increasing at 200-ms intervals) were performed and compared to detect the optimal TI for hepatic artery visualization. The relative Cv-l (vessel-to-liver contrast) was quantified. For qualitative evaluation, the vessel visualization quality and order of the depicted hepatic artery branches were evaluated. Results In group C (TI of 1600 ms), the Cv-l showed the highest probably due to a favorable balance between the hepatic vessel signal and signal recovery of the surrounding tissue. Regarding qualitative assessment, in group C, the mean image quality score of all hepatic arteries and mean maximal visible order of the hepatic artery branches were the highest. However, there was no significant difference between these results. Conclusion Non-contrast-enhanced hepatic MR arteriography with Time-SLIP at 3 T enabled the selective visualization of hepatic arteries at a TI of 1600 ms with an optimal balance between Cv-l and peripheral hepatic artery visualization.
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Affiliation(s)
- Seiya Kawahara
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tsuyoshi Ohno
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihiro Furuta
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Matos AP, Velloni F, Ramalho M, AlObaidy M, Rajapaksha A, Semelka RC. Focal liver lesions: Practical magnetic resonance imaging approach. World J Hepatol 2015; 7:1987-2008. [PMID: 26261689 PMCID: PMC4528273 DOI: 10.4254/wjh.v7.i16.1987] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 06/24/2015] [Accepted: 07/23/2015] [Indexed: 02/06/2023] Open
Abstract
With the widespread of cross-sectional imaging, a growth of incidentally detected focal liver lesions (FLL) has been observed. A reliable detection and characterization of FLL is critical for optimal patient management. Maximizing accuracy of imaging in the context of FLL is paramount in avoiding unnecessary biopsies, which may result in post-procedural complications. A tremendous development of new imaging techniques has taken place during these last years. Nowadays, Magnetic resonance imaging (MRI) plays a key role in management of liver lesions, using a radiation-free technique and a safe contrast agent profile. MRI plays a key role in the non-invasive correct characterization of FLL. MRI is capable of providing comprehensive and highly accurate diagnostic information, with the additional advantage of lack of harmful ionizing radiation. These properties make MRI the mainstay for the noninvasive evaluation of focal liver lesions. In this paper we review the state-of-the-art MRI liver protocol, briefly discussing different sequence types, the unique characteristics of imaging non-cooperative patients and discuss the role of hepatocyte-specific contrast agents. A review of the imaging features of the most common benign and malignant FLL is presented, supplemented by a schematic representation of a simplistic practical approach on MRI.
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Affiliation(s)
- António P Matos
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Fernanda Velloni
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Miguel Ramalho
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Mamdoh AlObaidy
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Aruna Rajapaksha
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
| | - Richard C Semelka
- António P Matos, Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, Aruna Rajapaksha, Richard C Semelka, Department of Radiology, University of North Carolina, Chapel Hill, NC 27599-7510, United States
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Neri E, Bali MA, Ba-Ssalamah A, Boraschi P, Brancatelli G, Alves FC, Grazioli L, Helmberger T, Lee JM, Manfredi R, Martì-Bonmatì L, Matos C, Merkle EM, Op De Beeck B, Schima W, Skehan S, Vilgrain V, Zech C, Bartolozzi C. ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents. Eur Radiol 2015; 26:921-31. [PMID: 26194455 PMCID: PMC4778143 DOI: 10.1007/s00330-015-3900-3] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 06/07/2015] [Accepted: 06/22/2015] [Indexed: 02/06/2023]
Abstract
Objectives To develop a consensus and provide updated recommendations on liver MR imaging and the clinical use of liver-specific contrast agents. Methods The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) formed a multinational European panel of experts, selected on the basis of a literature review and their leadership in the field of liver MR imaging. A modified Delphi process was adopted to draft a list of statements. Descriptive and Cronbach’s statistics were used to rate levels of agreement and internal reliability of the consensus. Results Three Delphi rounds were conducted and 76 statements composed on MR technique (n = 17), clinical application of liver-specific contrast agents in benign, focal liver lesions (n = 7), malignant liver lesions in non-cirrhotic (n = 9) and in cirrhotic patients (n = 18), diffuse and vascular liver diseases (n = 12), and bile ducts (n = 13). The overall mean score of agreement was 4.84 (SD ±0.17). Full consensus was reached in 22 % of all statements in all working groups, with no full consensus reached on diffuse and vascular diseases. Conclusions The consensus provided updated recommendations on the methodology, and clinical indications, of MRI with liver specific contrast agents in the study of liver diseases. Key points • Liver-specific contrast agents are recommended in MRI of the liver. • The hepatobiliary phase improves the detection and characterization of hepatocellular lesions. • Liver-specific contrast agents can improve the detection of HCC.
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Affiliation(s)
- E Neri
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy.
| | - M A Bali
- Department of Radiology, Hôpital Erasme, MRI Clinics, Bruxelles, Belgium
| | - A Ba-Ssalamah
- Department of Biomedical Imaging and Image-guided Therapy, The General Hospital of the Medical University of Vienna, Vienna, Austria
| | - P Boraschi
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
| | - G Brancatelli
- Department of Radiology, University of Palermo, Palermo, Italy
| | - F Caseiro Alves
- Medical Imaging Department and Faculty of Medicine, University Hospital of Coimbra, Coimbra, Portugal
| | - L Grazioli
- Department of Radiology, Spedali Civili di Brescia, Brescia, Italy
| | - T Helmberger
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University, Munich, Germany
| | - J M Lee
- Division of Abdominal Imaging, Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - R Manfredi
- Department of Radiology, University of Verona, Verona, Italy
| | - L Martì-Bonmatì
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - C Matos
- Department of Radiology, Hôpital Erasme, MRI Clinics, Bruxelles, Belgium
| | - E M Merkle
- Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Basel, Switzerland
| | - B Op De Beeck
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
| | - W Schima
- Department of Diagnostic and Interventional Radiology, KH Goettlicher Heiland, Krankenhaus der Barmherzigen Schwestern and Sankt Josef-Krankenhaus, Vienna, Austria
| | - S Skehan
- Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - V Vilgrain
- Radiology Department, Assistance Publique-Hôpitaux de Paris, APHP, Hôpital Beaujon, Clichy, Paris, France
| | - C Zech
- Abteilungsleiter Interventionelle Radiologie, Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Basel, Switzerland
| | - C Bartolozzi
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
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Quantitative and qualitative comparison of 0.025 mmol/kg gadobenate dimeglumine for abdominal MRI at 1.5T and 3T MRI in patients with low estimated glomerular filtration rate. Eur J Radiol 2014; 84:26-32. [PMID: 25467229 DOI: 10.1016/j.ejrad.2014.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/14/2014] [Accepted: 10/20/2014] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the efficacy and adequacy of enhancement employing 0.025 mmol/kg of gadobenate dimeglumine at 1.5 Tesla (T), and to compare the extent of enhancement of this dosage between 1.5T and 3T systems. MATERIALS AND METHODS Our final population included 116 consecutive patients who underwent 0.025 mmol/kg gadobenate dimeglumine-enhanced abdominal MRI (78 men and 38 women; age, 64.1 ± 13.6 years). Sixty patients underwent imaging at 1.5T and 56 patients underwent imaging at 3T. Abdominal enhancement was evaluated qualitatively and quantitatively. The quality of enhancement was compared using Mann-Whitney U test. The percentage of enhancement of each organ was compared using Student t-test. RESULTS The mean quality rating of enhancement was at least "good" in all phases of enhancement for both 1.5T and 3T. There was a non-significant trend to higher mean ratings at 3T. The liver showed a 1.3-fold higher arterial-phase percentage of enhancement at 3T (p=0.0138). There were no differences between the mean relative enhancement of the pancreas and aorta throughout all phases of enhancement. The percentage of enhancement of the renal cortex was significantly higher at 3T (p<0.0001 to p=0.0293). CONCLUSION A dose of 0.025 mmol/kg of gadobenate dimeglumine demonstrates diagnostic enhancement in the majority of patients at 1.5T, without significant differences on qualitative evaluation compared to 3T.
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Abstract
Preoperative evaluation of donors for living-donor liver transplantation aims to select a suitable donor with optimal graft quality and to ensure donor safety. Hepatic steatosis, a common finding in living liver donors, not only influences the outcome of liver transplantation for the recipient but also affects the recovery of the living donor after partial hepatectomy. Histopathologic analysis is the reference standard to detect and quantify fat in the liver, but it is invasive, and results are vulnerable to sampling error. Imaging can be repeated regularly and allows assessment of the entire liver, thus avoiding sampling error. Selection of appropriate imaging methods demands understanding of their advantages and limitations and the suitable clinical setting. This article describes potential clinical applications for liver fat quantification of imaging methods for fat detection and quantification, with an emphasis on the advantages and limitations of ultrasonography, computed tomography, and magnetic resonance imaging for quantifying liver fat.
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17
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Abstract
Magnetic resonance (MR) imaging is a robust imaging modality for evaluation of vascular diseases. Technological advances have made MR imaging widely available for accurate and time-efficient vascular assessment. In this article the clinical usefulness of MR imaging techniques and their application are reviewed, using examples of vascular abnormalities commonly encountered in clinical practice, including abdominal, pelvic, and thoracic vessels. Common pitfalls and problem solving in interpretation of vascular findings in body MR imaging are also discussed.
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Affiliation(s)
- Wirana Angthong
- Department of Radiology, University of North Carolina Hospitals, UNC at Chapel Hill, CB 7510, 2001 Old Clinic Building, Chapel Hill, NC 27599-7510, USA; Department of Radiology, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, 62 Moo 7, Khlong Sip, Ongkharak, Nakhon Nayok, Thailand
| | - Richard C Semelka
- Department of Radiology, University of North Carolina Hospitals, UNC at Chapel Hill, CB 7510, 2001 Old Clinic Building, Chapel Hill, NC 27599-7510, USA.
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18
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Fischer A, Kraff O, Maderwald S, Beiderwellen K, Ladd ME, Forsting M, Lauenstein TC, Umutlu L. Non-enhanced T1-weighted liver vessel imaging at 7 Tesla. PLoS One 2014; 9:e97465. [PMID: 24887206 PMCID: PMC4041637 DOI: 10.1371/journal.pone.0097465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 04/21/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives Aim of the study was to assess the feasibility and to compare three non-enhanced T1-weighted (w) sequences for liver vessel imaging at 7 Tesla (T). Material and Methods 12 healthy volunteers were examined on a 7 T whole-body MR-system. The following non-enhanced sequences were acquired: T1w 2D FLASH, T1w 3D FLASH and Time of flight (TOF)-MRA. Qualitative image analysis was performed by two radiologists including over all image quality as well as vessel delineation of the liver arteries, liver veins and portal vein and the presence of artifacts using a five-point scale (5 = excellent vessel delineation to 1 = non-diagnostic). Contrast ratios (CR), SNR und CNR of the above named vessels in correlation to adjacent liver tissue were calculated for quantitative assessment. For statistical analysis, a Wilcoxon Rank Test was applied. Results All three sequences provided a homogenous hyperintense delineation of the assessed liver vessels. Qualitative image analysis demonstrated the superiority of TOF-MRA, providing best overall image quality (TOF 4.17, 2D FLASH 3.42, 3D FLASH 3.46; p<0.01) as well as highest image quality values for all analyzed liver vessel segments. TOF-MRA was least impaired by B1 inhomogeneity (4.13) and susceptibility artifacts (4.63) out of all three sequences (p<0.01). Quantitative image analysis confirmed the superiority of TOF MRA showing significant higher CR values for all liver vessels (e.g. right hepatic artery TOF 0.47, 2D FLASH 0.09, 3D FLASH 0.11 with p = 0.02 and 0.01, respectively). Providing the lowest standard deviation in noise, TOF showed highest values for SNR and CNR. Conclusions Non-enhanced T1w imaging in general and TOF MRA in particular, appear to be promising techniques for high quality non-enhanced liver vessel assessment at 7 T.
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Affiliation(s)
- Anja Fischer
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
- * E-mail:
| | - Oliver Kraff
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Stefan Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Karsten Beiderwellen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Mark E. Ladd
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Thomas C. Lauenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
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Latif MA, Hawary GE, Badrawy AE, Alfy HE. The role of MR diffusion in differentiation of malignant and benign hepatic focal lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2013.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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20
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Park YS, Lee CH, Kim BH, Lee J, Choi JW, Kim KA, Ahn JH, Park CM. Using Gd-EOB-DTPA-enhanced 3-T MRI for the differentiation of infiltrative hepatocellular carcinoma and focal confluent fibrosis in liver cirrhosis. Magn Reson Imaging 2013; 31:1137-42. [PMID: 23688409 DOI: 10.1016/j.mri.2013.01.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 01/03/2013] [Accepted: 01/07/2013] [Indexed: 02/08/2023]
Abstract
PURPOSE The purpose of the study was to determine significant imaging features to differentiate between infiltrative hepatocellular carcinoma (HCC) and confluent fibrosis (CF) in liver cirrhosis using Gd-EOB-DTPA-enhanced 3-T magnetic resonance imaging. MATERIAL AND METHODS Nineteen infiltrative HCCs and eight CFs were included. We evaluated the difference in imaging findings and apparent diffusion coefficient (ADC) between the two entities. We compared T2-weighted image (WI) and hepatobiliary phase (HBP) in terms of the clarity of the lesion outer margin. RESULTS Seventeen infiltrative HCCs showed lobulated margin, while focal CFs showed either straight (n=3) or irregular margins (n=5) (P=.001). All infiltrative HCCs had intact or bulging contours, and all focal CFs showed capsular retraction (P=.001). Fourteen infiltrative HCCs and two focal CFs showed arterial enhancement (P=.035). The ADC of infiltrative HCCs was significantly lower than that of CFs (P=.001). Satellite nodules were noted in 10 infiltrative HCCs. In terms of outer margin clarity, infiltrative HCCs showed a more distinct margin on HBP than on T2-WI (P=.005), while these two sequences were not significantly different in focal CFs (P=1.000). CONCLUSION HBP improved the imaging characteristics of infiltrative HCC, allowing it to be distinguished from focal CF. Infiltrative HCC showed lower ADC values than focal CF. Lobular configuration, contour bulging, enhancement pattern, associated satellite nodules and portal vein thrombosis were still found to be highly suggestive MR findings for infiltrative HCC.
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Affiliation(s)
- Yang Shin Park
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, South Korea
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21
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Abstract
Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy, and usually develops in the setting of liver cirrhosis. The early diagnosis of HCC is essential as curative treatment (including surgical resection and liver transplantation) improves survival. While screening and surveillance are traditionally performed with ultrasound, reported accuracies of ultrasound vary greatly, and poor sensitivity for small nodules is a uniformly recognized concern. Advances in computed tomography (CT) and magnetic resonance imaging (MRI), including multidetector technology and fast breath hold sequences now allow dynamic multiphasic enhanced imaging of the liver with excellent spatial and temporal resolution, holding much promise for improved HCC detection.
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Pang Y, Yu B, Zhang X. Hepatic fat assessment using advanced Magnetic Resonance Imaging. Quant Imaging Med Surg 2012; 2:213-8. [PMID: 23256082 DOI: 10.3978/j.issn.2223-4292.2012.08.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 08/31/2012] [Indexed: 01/12/2023]
Affiliation(s)
- Yong Pang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
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24
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Umutlu L, Forsting M, Ladd ME. Ultrahigh-field magnetic resonance imaging: the clinical potential for anatomy, pathogenesis, diagnosis and treatment planning in neck and spine disease. Neuroimaging Clin N Am 2012; 22:363-71, xii. [PMID: 22548937 DOI: 10.1016/j.nic.2012.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An increase of the magnetic field strength to ultrahigh-field yields advantageous as well as disadvantageous changes in physical effects. The beneficial increase in signal/noise ratio can be leveraged into higher spatiotemporal resolution, and an exacerbation of artifacts can impede ultrahigh-field imaging. With the successful introduction of intracranial and musculoskeletal imaging at 7 T, recent advances in coil design have created opportunities for further applications of ultrahigh-field magnetic resonance (MR) imaging in other parts of the body. Initial studies in 7 T neck and spine MR imaging have revealed promising insights and new challenges, demanding further research and methodological optimization.
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Affiliation(s)
- Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany.
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25
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Ramalho M, Herédia V, de Campos ROP, Dale BM, Azevedo RM, Semelka RC. In-phase and out-of-phase gradient-echo imaging in abdominal studies: intra-individual comparison of three different techniques. Acta Radiol 2012; 53:441-9. [PMID: 22535885 DOI: 10.1258/ar.2012.110695] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND T1-weighted gradient-echo in-phase and out-of-phase imaging is an essential component of comprehensive abdominal MR exams. It is useful for the study of fat-containing lesions and to identify various disease states related to the presence of fat in the liver. PURPOSE To compare three T1-weighted in-phase and out-of-phase (IP/OP) gradient-echo imaging sequences in an intra-individual fashion, and to determine whether advantages exist for each of these sequences for various patient types. MATERIAL AND METHODS One hundred and eighteen consecutive subjects (74 men, 44 women; mean age 53.9 ± 13.8 years) who had MRI examinations containing all three different IP/OP sequences (two-dimensional spoiled gradient-echo [2D-GRE], three-dimensional gradient-echo [3D-GRE], and magnetization-prepared gradient-recall echo [MP-GRE]) were included. Two different reviewers independently and blindly qualitatively evaluated IP/OP sequences to determine image quality, extent of artifacts, lesion detectability and conspicuity, and subjective grading of liver steatosis for the various sequences. Quantitative analysis was also performed. Qualitative and quantitative data were subjected to statistical analysis. RESULTS Respiratory ghosting, parallel imaging, and truncation artifacts as well as shading and blurring were more pronounced with 3D-GRE IP/OP imaging. Overall image quality was higher with 2D-GRE (P < 0.05). Detectability of low-fluid content lesions was lower with IP/OP MP-GRE sequences. MP-GRE sequences had the lowest SNRs (P < 0.001). Liver-to-spleen and liver-to-lesion CNRs were significantly lower with 3D-GRE and MP-GR, respectively (P < 0.001). Fat liver indexes showed strongly positive correlation between all sequences. CONCLUSION Currently, 2D-GRE remains the best approach for clinical IP/OP imaging. The good image quality of MP-GRE sequences acquired in a free-breathing manner should recommend its use in patients unable to suspend breathing.
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Affiliation(s)
- Miguel Ramalho
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA
| | - Vasco Herédia
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA
| | - Rafael OP de Campos
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA
| | | | - Rafael M Azevedo
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA
| | - Richard C Semelka
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA
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Hwang J, Kim SH, Lee MW, Lee JY. Small (≤ 2 cm) hepatocellular carcinoma in patients with chronic liver disease: comparison of gadoxetic acid-enhanced 3.0 T MRI and multiphasic 64-multirow detector CT. Br J Radiol 2011; 85:e314-22. [PMID: 22167508 DOI: 10.1259/bjr/27727228] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To compare the diagnostic performance of gadoxetic acid-enhanced MRI using 3.0 T with that of multiphasic 64-multirow detector CT (MDCT) for the detection of small (≤2 cm) hepatocellular carcinoma (HCC) in patients with chronic liver disease. METHODS A total of 54 patients (44 men, 10 women; age range, 33-81 years) with 59 HCCs (≤2 cm in diameter) who underwent both multiphasic (arterial, portal venous, equilibrium) 64-MDCT and gadoxetic acid-enhanced 3.0 T MRI were enrolled in this study. Two observers independently and randomly reviewed the MR and CT images on a lesion-by-lesion basis. The diagnostic performance of these techniques for the detection of HCC was assessed by alternative free-response receiver operating characteristic (ROC) analysis, in addition to evaluating the sensitivity and positive predictive value. RESULTS For each observer, the areas under the ROC curve were 0.874 and 0.863 for MRI, respectively, as opposed to 0.660 and 0.687 for CT, respectively. The differences between the two techniques were statistically significant for each observer (p<0.001). The sensitivities (89.8% and 86.4%) of MRI for both observers were significantly higher than those (57.6% and 61.0% for each observer, respectively) of MDCT. No significant difference was seen between the positive predictive values for the two techniques (p>0.05). CONCLUSION Gadoxetic acid-enhanced 3.0 T MRI shows a better diagnostic performance than that of 64-MDCT for the detection of small (≤2 cm) HCCs in patients with chronic liver disease.
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Affiliation(s)
- J Hwang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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27
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Ferreira A, Ramalho M, de Campos ROP, Heredia V, Azevedo RM, Dale B, Semelka RC. Comparison of T1-weighted in- and out-of-phase single shot magnetization-prepared gradient-recalled-echo with three-dimensional gradient-recalled-echo at 3.0 Tesla: preliminary observations in abdominal studies. J Magn Reson Imaging 2011; 35:1187-95. [PMID: 22128047 DOI: 10.1002/jmri.23518] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Accepted: 10/26/2011] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To describe in-phase (IP)/out-of-phase (OP) imaging with single shot magnetization-prepared gradient-recalled-echo (MP-GRE) and to compare intra-individually IP/OP MP-GRE with IP/OP three-dimensional gradient-recalled-echo (3D-GRE) at 3.0 Tesla (T). MATERIALS AND METHODS Thirty-six subjects (15 males, 21 females; mean age 46.97 ± 14.97) who had abdominal MRI examinations including precontrast T1-weighted IP/OP MP-GRE, IP/OP 3D-GRE were included in the study. Two radiologists independently evaluated the sequences qualitatively for extent of artifacts, lesion detectability, and conspicuity and subjective grading of liver steatosis. Quantitative evaluation was performed by one radiologist and included liver fat index, liver and spleen SNR, and liver-lesion and liver-spleen CNR. RESULTS Respiratory ghosting was more pronounced on 3D-GRE (P < 0.0008). The degrees of parallel imaging residual artifacts, shading and blurring were significantly higher on the 3D-GRE sequences (P < 0.0008). Spatial misregistration and bounce point artifacts were only observed with MP-GRE images. Pixel graininess was more apparent on MP-GRE (P < 0.0008). Lesion detectability, confidence, and conspicuity were considerably higher on MP-GRE. Visual appreciation of steatosis was superior on 3D-GRE. Overall image quality was superior on MP-GRE (P < 0.0008). CONCLUSION Higher image quality and improved lesion detectability were present with IP/OP MP-GRE technique. Inversion-recovery prepared techniques may represent an important evolution for precontrast T1-weighted image at 3.0T. The good image quality of MP-GRE sequences acquired in a free breathing manner should recommend its use in patients unable to suspend breathing.
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Affiliation(s)
- Ana Ferreira
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Pang Y, Wu B, Wang C, Vigneron DB, Zhang X. Numerical Analysis of Human Sample Effect on RF Penetration and Liver MR Imaging at Ultrahigh Field. CONCEPTS IN MAGNETIC RESONANCE. PART B, MAGNETIC RESONANCE ENGINEERING 2011; 39B:206-216. [PMID: 22337345 PMCID: PMC3277816 DOI: 10.1002/cmr.b.20209] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Magnetic resonance imaging (MRI) can provide clinically-valuable images for hepatic diseases and has become one of the most promising noninvasive methods in evaluating liver lesions. To facilitate the ultrahigh field human liver MRI, in this work, the RF penetration behavior in the conductive and high dielectric human body at the ultrahigh field of 7 Tesla (7T) is investigated and evaluated using the finite-difference time-domain numerical analysis. The study shows that in brain imaging at the ultrahigh field of 7T, the "dielectric resonance" effect dominates among other factors, resulting in improved B(1) penetration; while in liver imaging, due to its irregular geometry of the liver, the "dielectric resonance" effect is not readily to be established, leading to a reduced B(1) penetration or limited image coverage comparing to that in the brain. Therefore, it is necessary to build a large size coil to have deeper penetration to image human liver although the coil design may become more challenging due to the required high frequency. Based on this study, a bisected microstrip coil operating at 300 MHz range is designed and constructed. Three-dimensional in vivo liver images in axial, sagittal and coronal orientations are then acquired from healthy volunteers using this dedicated RF coil on a 7T whole body MR scanner.
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Affiliation(s)
- Yong Pang
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Bing Wu
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Chunsheng Wang
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Daniel B. Vigneron
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA
- UCSF/UC Berkeley Joint Graduate Group in Bioengineering, San Francisco & Berkeley, CA
| | - Xiaoliang Zhang
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA
- UCSF/UC Berkeley Joint Graduate Group in Bioengineering, San Francisco & Berkeley, CA
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Umutlu L, Bitz AK, Maderwald S, Orzada S, Kinner S, Kraff O, Brote I, Ladd SC, Schroeder T, Forsting M, Antoch G, Ladd ME, Quick HH, Lauenstein TC. Contrast-enhanced ultra-high-field liver MRI: a feasibility trial. Eur J Radiol 2011; 82:760-7. [PMID: 21862273 DOI: 10.1016/j.ejrad.2011.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 07/22/2011] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the feasibility of dynamic contrast-enhanced 7 T MRI of the liver using an eight-channel radiofrequency (RF) transmit/receive body-coil. 16 healthy subjects were examined on a 7 T MR system utilizing a custom-built eight-channel RF body-coil suitable for RF-shimming. The following data were acquired: (1) steady state free precession imaging, (2) T2w turbo spin echo imaging, (3) T1w in and opposed-phase imaging, (4) T1w 3D FLASH images pre-contrast and in arterial, portal-venous and venous phase and (5) a fat-saturated pre- and post-contrast 2D FLASH sequence. Visual evaluation of (1) the delineation of liver vasculature, (2) the overall image quality, and (3) artifact presence and consequent image impairment was performed. SNR of the liver parenchyma was measured for the contrast-enhanced 2D and 3D FLASH sequences. For statistical analysis, a Wilcoxon-Rank Test was used. Best delineation of non-enhanced liver vasculature and overall image quality was found for 2D FLASH MRI, with only slight improvement in vessel conspicuity after the application of contrast media. T2-weighted TSE imaging remained strongly impaired, falling short of diagnostic relevance and precluding a clinical application. Our results demonstrate the feasibility and diagnostic potential of dedicated contrast-enhanced 7 T liver MRI as well as the potential for non-contrast-enhanced angiographic application.
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Affiliation(s)
- Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.
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Burke LMB, Vachiranubhap B, Tannaphai P, Semelka RC. Realce por contraste de lesões hepáticas em pacientes com cirrose: estudo cruzado comparativo de dois agentes de contraste para RM realizado em uma única instituição. Resultados preliminares. Radiol Bras 2011. [DOI: 10.1590/s0100-39842011000300005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Comparar, prospectivamente, gadopentato de dimeglumina (Gd-DTPA) e gadobenato de dimeglumina (Gd-BOPTA), ambos em dose plena, na detecção de lesões hepáticas focais, por meio de RM em pacientes com doença hepática crônica. MATERIAIS E MÉTODOS: Oito pacientes com cirrose hepática e forte suspeita de um pequeno carcinoma hepatocelular, baseada em RM anterior, foram submetidos a exames de RM contrastada, um com dose plena de Gd-DTPA e outro com dose plena de Gd-BOPTA. Os exames foram realizados com um intervalo de 72 a 108 horas. Dois radiologistas independentes realizaram avaliação às cegas das imagens, considerando número, caracterização e realce das lesões, além de preferências subjetivas. RESULTADOS: Não houve diferença estatisticamente significante entre os dois exames quanto à detecção e caracterização das lesões. Observou-se um incremento de 18% no realce da lesão dominante pelo Gd-BOPTA, em comparação com o Gd-DTPA. Na maioria dos casos, ambos os observadores cegos subjetivamente preferiram as imagens utilizando Gd-BOPTA àquelas com Gd-DTPA, com base no maior realce e melhor definição das margens das lesões. CONCLUSÃO: Em doses plenas equivalentes, Gd-BOPTA e Gd-DTPA são similares na detecção e caracterização de lesões hepáticas focais em pacientes com doença hepática crônica. Entretanto, o Gd-BOPTA foi superior em relação ao realce da lesão, assim como na preferência subjetiva dos observadores.
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Isoda H, Arizono S, Shimada K, Hirokawa Y, Maetani YS, Kataoka M, Nakamoto Y, Shibata T, Togashi K. Contrast behavior of high-spatial-resolution T1-weighted MR imaging at 3.0 T vs. 1.5 T. Clin Imaging 2011; 35:133-8. [DOI: 10.1016/j.clinimag.2010.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 03/05/2010] [Indexed: 10/18/2022]
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Li Y, Chen Z, Wang J. Differential diagnosis between malignant and benign hepatic tumors using apparent diffusion coefficient on 1.5-T MR imaging: a meta analysis. Eur J Radiol 2011; 81:484-90. [PMID: 21333477 DOI: 10.1016/j.ejrad.2010.12.069] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 12/27/2010] [Accepted: 12/28/2010] [Indexed: 12/15/2022]
Abstract
This meta-analysis evaluates the diagnostic accuracy of diffusion-weighted MR imaging with ADC values for differentiation between malignant and benign hepatic focal lesions. From retrieved articles, we selected 7 sets of data in 6 articles, which met all the included criteria, for meta-analysis. The pooled sensitivity and specificity were 86% (95% CI, 0.83-0.90) and 84% (95% CI, 0.78-0.88), respectively. However, notable heterogeneity between studies was noted and no covariate evaluated can explain the cause. Only b factor correlated with the mean ADC values of malignant and benign hepatic tumors. In conclusion, ADC value was useful for differentiation between malignant and benign hepatic focal lesions. But, significant heterogeneity between studies underlines the need for further efforts to optimize standardization and reproducibility of the utilized techniques and methods.
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Affiliation(s)
- Youwei Li
- Department of Radiology, Beijing Chuiyangliu Hospital, Beijing 100022, China
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Umutlu L, Orzada S, Kinner S, Maderwald S, Brote I, Bitz AK, Kraff O, Ladd SC, Antoch G, Ladd ME, Quick HH, Lauenstein TC. Renal imaging at 7 Tesla: preliminary results. Eur Radiol 2010; 21:841-9. [PMID: 20872006 DOI: 10.1007/s00330-010-1962-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 08/02/2010] [Accepted: 08/03/2010] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate the feasibility of 7T MR imaging of the kidneys utilising a custom-built 8-channel transmit/receive radiofrequency body coil. METHODS In vivo unenhanced MR was performed in 8 healthy volunteers on a 7T whole-body MR system. After B(0) shimming the following sequences were obtained: 1) 2D and 3D spoiled gradient-echo sequences (FLASH, VIBE), 2) T1-weighted 2D in and opposed phase 3) True-FISP imaging and 4) a T2-weighted turbo spin echo (TSE) sequence. Visual evaluation of the overall image quality was performed by two radiologists. RESULTS Renal MRI at 7T was feasible in all eight subjects. Best image quality was found using T1-weighted gradient echo MRI, providing high anatomical details and excellent conspicuity of the non-enhanced vasculature. With successful shimming, B(1) signal voids could be effectively reduced and/or shifted out of the region of interest in most sequence types. However, T2-weighted TSE imaging remained challenging and strongly impaired because of signal heterogeneities in three volunteers. CONCLUSION The results demonstrate the feasibility and diagnostic potential of dedicated 7T renal imaging. Further optimisation of imaging sequences and dedicated RF coil concepts are expected to improve the acquisition quality and ultimately provide high clinical diagnostic value.
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Affiliation(s)
- Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, Essen, Germany.
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Lee SA, Lee CH, Jung WY, Lee J, Choi JW, Kim KA, Park CM. Paradoxical high signal intensity of hepatocellular carcinoma in the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI: initial experience. Magn Reson Imaging 2010; 29:83-90. [PMID: 20832227 DOI: 10.1016/j.mri.2010.07.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Revised: 07/16/2010] [Accepted: 07/26/2010] [Indexed: 12/14/2022]
Abstract
PURPOSE To describe the paradoxical high signal intensity of hepatocellular carcinoma (HCC) in the hepatobiliary phase on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS A database search was performed to identify cases of HCC that showed unusual prolonged enhancement in the hepatobiliary phase of Gd-EOB-DTPA MRI. All patients received 3.0-T liver MRI including precontrast T1-weighted images, T2-weighted images and a post Gd-EOB-DTPA-enhanced dynamic study. The signal intensity of HCC was measured at pre-enhanced, arterial, portal, delayed and hepatobiliary phase using regions of interest. Radiologic and pathologic correlation was performed for the paradoxically prolonged enhancing portion of HCC in the hepatobiliary phase. RESULTS Four patients (all male, age range 44-70; mean 57.5 years) were included in this study. All patients showed HCC lesions that were low signal intensity (SI) on T1-WI, high SI on T2-WI, enhanced in arterial phase, and washed-out in delayed phase. All cases showed paradoxically high SI in hepatobiliary phase, which was unusual for HCC. Pathologically, they were all diagnosed as well-differentiated HCC with prominent cytoplasm and a bile secreting appearance. CONCLUSION HCC may demonstrate the prolonged high signal intensity at the hepatobiliary phase on Gd-EOB-DTPA enhanced MRI. These HCCs tended to be highly differentiated and to have prominent bile secretion.
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Affiliation(s)
- Seun Ah Lee
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, Korea
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Goncalves Neto JA, Altun E, Elazzazi M, Vaidean GD, Chaney M, Semelka RC. Enhancement of abdominal organs on hepatic arterial phase: quantitative comparison between 1.5- and 3.0-T magnetic resonance imaging. Magn Reson Imaging 2010; 28:47-55. [DOI: 10.1016/j.mri.2009.05.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2008] [Revised: 03/19/2009] [Accepted: 05/10/2009] [Indexed: 10/20/2022]
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Rha SE. High field strength magnetic resonance imaging of abdominal diseases. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2010. [DOI: 10.5124/jkma.2010.53.12.1065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sung Eun Rha
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Tanimoto A, Min Lee J, Murakami T, Huppertz A, Kudo M, Grazioli L. Consensus report of the 2nd International Forum for Liver MRI. Eur Radiol 2009; 19 Suppl 5:S975-89. [DOI: 10.1007/s00330-009-1624-y] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Ma X, Holalkere NS, Kambadakone R A, Mino-Kenudson M, Hahn PF, Sahani DV. Imaging-based quantification of hepatic fat: methods and clinical applications. Radiographics 2009; 29:1253-77. [PMID: 19755595 DOI: 10.1148/rg.295085186] [Citation(s) in RCA: 226] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Fatty liver disease comprises a spectrum of conditions (simple hepatic steatosis, steatohepatitis with inflammatory changes, and end-stage liver disease with fibrosis and cirrhosis). Hepatic steatosis is often associated with diabetes and obesity and may be secondary to alcohol and drug use, toxins, viral infections, and metabolic diseases. Detection and quantification of liver fat have many clinical applications, and early recognition is crucial to institute appropriate management and prevent progression. Histopathologic analysis is the reference standard to detect and quantify fat in the liver, but results are vulnerable to sampling error. Moreover, it can cause morbidity and complications and cannot be repeated often enough to monitor treatment response. Imaging can be repeated regularly and allows assessment of the entire liver, thus avoiding sampling error. Selection of appropriate imaging methods demands understanding of their advantages and limitations and the suitable clinical setting. Ultrasonography is effective for detecting moderate or severe fatty infiltration but is limited by lack of interobserver reliability and intraobserver reproducibility. Computed tomography allows quantitative and qualitative evaluation and is generally highly accurate and reliable; however, the results may be confounded by hepatic parenchymal changes due to cirrhosis or depositional diseases. Magnetic resonance (MR) imaging with appropriate sequences (eg, chemical shift techniques) has similarly high sensitivity, and MR spectroscopy provides unique advantages for some applications. However, both are expensive and too complex to be used to monitor steatosis.
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Affiliation(s)
- Xiaozhou Ma
- Division of Abdominal Imaging and Intervention Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114, USA
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Erturk SM, Alberich-Bayarri A, Herrmann KA, Marti-Bonmati L, Ros PR. Use of 3.0-T MR Imaging for Evaluation of the Abdomen. Radiographics 2009; 29:1547-63. [DOI: 10.1148/rg.296095516] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ramalho M, Herédia V, Tsurusaki M, Altun E, Semelka RC. Quantitative and qualitative comparison of 1.5 and 3.0 Tesla MRI in patients with chronic liver diseases. J Magn Reson Imaging 2009; 29:869-79. [PMID: 19306415 DOI: 10.1002/jmri.21719] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To compare the quantitative and qualitative image quality intra-individually, at 1.5 and 3.0 Tesla (T) in patients with chronic liver diseases. MATERIALS AND METHODS The study group included 24 consecutive patients (17 males, 7 females; mean age +/- standard deviation 56.5 +/- 11.5) who had chronic liver diseases and underwent abdominal MRI for the liver evaluation at both 1.5 and 3.0 T within a 4-month period. All MRI studies were retrospectively evaluated quantitatively and qualitatively. Quantitative analysis was performed by measuring signal to noise ratio (SNR) on various abdominal organs. Qualitative analysis was performed by two reviewers to assess image quality, artifacts, and imaging findings of chronic liver diseases. Quantitative and qualitative analyses findings were compared between 1.5 and 3.0 T using the paired Student t-test and Wilcoxon signed rank test, respectively. RESULTS The statistically significant increase in SNRs in various abdominal tissues ranged from 1.3- to 3.5-fold at 3.0 T compared to 1.5 T. Three-dimensional gradient echo (3D-GE) sequences demonstrated significantly higher image quality at 3.0 T (P < 0.01), whereas precontrast spoiled gradient echo (SGE) sequences demonstrated significantly higher image quality at 1.5 T (P < 0.01). T2-weighted sequences did not show any significant difference in image quality between 1.5 and 3.0 T (P > 0.05). CONCLUSION The SNRs of various abdominal tissues demonstrated significant increases at 3.0 T. The image quality of 3D-GE sequences was higher at 3.0 T, whereas the image quality of precontrast SGE sequences was higher at 1.5T.
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Affiliation(s)
- Miguel Ramalho
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
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Elias J, Altun E, Zacks S, Armao DM, Woosley JT, Semelka RC. MRI findings in nonalcoholic steatohepatitis: correlation with histopathology and clinical staging. Magn Reson Imaging 2009; 27:976-87. [PMID: 19356874 DOI: 10.1016/j.mri.2009.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 01/15/2009] [Accepted: 02/04/2009] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate magnetic resonance imaging (MRI) findings of nonalcoholic steatohepatitis (NASH) and to determine the correlation of MRI findings with histopathology and Mayo End-Stage Liver Disease (MELD) score. MATERIALS AND METHODS Thirty patients (18 males, 12 females; mean age: 57+/-8.9 years; age range: 35-71 years) with histopathologically proven NASH who underwent MRI examinations between January 2001 and October 2005 were included in the study. Two radiologists retrospectively reviewed all magnetic resonance (MR) examinations in consensus to evaluate the presence and extent of predetermined findings of NASH including liver steatosis, early patchy liver enhancement indicating inflammation and liver fibrosis. The findings detected on MRI were correlated and compared to histopathological findings and MELD score by using nonparametric Spearman correlation coefficient and Kruskal-Wallis analysis of variance. RESULTS Liver steatosis was observed in 10 of 30 patients; early patchy liver enhancement, in 8 of 30 patients and liver fibrosis in 19 of 30 patients on MR images. Liver fibrosis was reticular in all these patients. There were statistically significant moderate correlations between MRI findings of liver steatosis and histopathologic grades of steatosis (r=0.43; P<.05), and between MRI findings of fibrosis and histopathologic stages of fibrosis (r=0.61; P<.001). Early patchy enhancement did not demonstrate statistically significant correlation with inflammation (P=.28). There was no statistically significant overall correlation between MRI findings of NASH and MELD score. CONCLUSION MRI findings of liver steatosis and fibrosis in NASH showed moderate correlations with histopathologic grades of steatosis and stages of fibrosis, but MRI findings of NASH did not demonstrate any significant correlations with MELD score.
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Affiliation(s)
- Jorge Elias
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Kilickesmez O, Bayramoglu S, Inci E, Cimilli T. Value of apparent diffusion coefficient measurement for discrimination of focal benign and malignant hepatic masses. J Med Imaging Radiat Oncol 2009; 53:50-5. [DOI: 10.1111/j.1754-9485.2009.02036.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Goncalves Neto JA, Altun E, Vaidean G, Elazzazi M, Troy J, Ramachandran S, Semelka RC. Early contrast enhancement of the liver: exact description of subphases using MRI. Magn Reson Imaging 2009; 27:792-800. [PMID: 19121908 DOI: 10.1016/j.mri.2008.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2008] [Revised: 10/14/2008] [Accepted: 11/10/2008] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to describe the subphases of early post-contrast enhancement of the liver, using vessel enhancement patterns, and correlate these findings with enhancement patterns of abdominal organs. MATERIALS AND METHODS A total of 114 patients who underwent gadolinium-enhanced abdominal magnetic resonance imaging examinations constituted the final study group, of which 56 were women (age range, 3-94 years; mean, 50 years) and 58 were men (age range, 6-85 years; mean, 54 years). Early post-contrast sequences in all patients were evaluated retrospectively by two reviewers for the determination of the presence of contrast enhancement in predetermined major vessels of the abdomen and qualitative and quantitative extent of enhancement of the renal cortex, spleen, pancreas and liver. Based on the overall findings, subphases of early contrast enhancement of the liver were described and quantitative extent of enhancement of organs was correlated with subphases of early contrast enhancement of the liver. Mann-Whitney U test and one-way unbalanced analysis of variance tests were used for the comparisons. RESULTS Early hepatic arterial phase was observed in 14/114 patients, mid-hepatic arterial phase in 23/114 patients, late hepatic arterial phase in 33/114 patients, splenic vein only hepatic arterial dominant phase in 20/114 patients and hepatic arterial dominant phase in 24/114 patients. There was an overall association between the subphases of enhancement and the quantitative extent of enhancement for all studied organs (P<.0001). CONCLUSION The evaluation of vessel and organ enhancement patterns has allowed the characterization of five different subphases in early post-contrast enhancement of the liver. The quantitative extent of enhancement of abdominal organs also demonstrated significant correlation with these five subphases.
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Affiliation(s)
- Jose A Goncalves Neto
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Zapparoli M, Semelka RC, Altun E, Tsurusaki M, Pamuklar E, Dale BM, Gasparetto EL, Elias J. 3.0-T MRI evaluation of patients with chronic liver diseases: initial observations. Magn Reson Imaging 2008; 26:650-60. [PMID: 18440749 DOI: 10.1016/j.mri.2008.01.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Revised: 01/11/2008] [Accepted: 01/28/2008] [Indexed: 12/28/2022]
Abstract
PURPOSE To describe the use of 3.0-T magnetic resonance imaging (MRI) for the evaluation of chronic liver diseases. MATERIALS AND METHODS Two groups of patients who had chronic liver diseases and underwent 3.0-T MRI for evaluation of the liver were included in the study. The first group of patients included 66 consecutive patients (33 male, 33 female; mean age+/-standard deviation, 56+/-11). The second group of patients included 30 consecutive patients (18 males, 12 females; mean age+/-standard deviation, 53+/-10) in whom Variable-Rate Selective Excitation (VERSE) pulses and improved adjustments procedure were used during the acquisitions. Imaging findings of chronic liver diseases, predetermined artifacts and image quality of all individual sequences in the first group and predetermined artifacts and image quality of T2-weighted sequences in the second group were reviewed retrospectively and independently by two reviewers. chi-Square tests were used to compare the findings between two groups of patients and individual sequences. Kappa statistics were used to determine the extent of agreement between the reviewers. RESULTS Fifteen dysplastic nodules in 6 of 66 (9%) patients and 12 hepatocellular carcinomas in 11 of 66 (17%) patients were detected. Excluding motion artifacts, three-dimensional (3D) T1-weighted gradient-echo (GE) sequence was the least affected sequence by the artifacts. Image quality of T1-weighted 3D-GE sequences was excellent in 43 of 66 (65%) patients. In-phase and out-of-phase T1-weighted spoiled GE (SGE) images were fair in 62 of 66 (94%) and 61 of 66 (92%) patients, respectively. The image quality of short tau inversion recovery (STIR) and half-Fourier rapid acquisition with relaxation enhancement (RARE) sequences were fair in 31 of 66 (47%) and 53 of 66 (80%) patients. STIR and half-Fourier RARE sequences in the second group demonstrated significantly better image quality (P=.03 and P<.0001). CONCLUSION 3.0-T MRI allows the acquisition of very high quality postgadolinium 3D-GE sequence, which permitted the detection and characterization of lesions in the setting of chronic liver diseases. The use of VERSE pulses and improved adjustments procedure improved the image quality of T2-weighted sequences. In-phase/out-of-phase SGE sequences are at present of fair quality.
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Affiliation(s)
- Mauricio Zapparoli
- Department of Radiology, University of North Carolina at Chapel Hill, Campus Box 7510, Chapel Hill, NC 27599-7510, USA
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