1
|
Roberts R, Hadi M, Ram C, Affan M. What the Diagnostic Neuroradiologist Needs to Know About Diseases of the Cerebral Veins. Semin Roentgenol 2024; 59:172-190. [PMID: 38880516 DOI: 10.1053/j.ro.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/10/2024] [Accepted: 02/20/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Rebecca Roberts
- Department of Neurology, University of Minnesota, Minneapolis, MN
| | - Mohiuddin Hadi
- Department of Radiology, University of Louisville, Louisville, KY
| | - Chithra Ram
- Department of Radiology, University of Louisville, Louisville, KY
| | - Muhammad Affan
- Department of Neurology, University of Minnesota, Minneapolis, MN.
| |
Collapse
|
2
|
Wheeler KV, Irimia A, Braskie MN. Using Neuroimaging to Study Cerebral Amyloid Angiopathy and Its Relationship to Alzheimer's Disease. J Alzheimers Dis 2024; 97:1479-1502. [PMID: 38306032 DOI: 10.3233/jad-230553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Cerebral amyloid angiopathy (CAA) is characterized by amyloid-β aggregation in the media and adventitia of the leptomeningeal and cortical blood vessels. CAA is one of the strongest vascular contributors to Alzheimer's disease (AD). It frequently co-occurs in AD patients, but the relationship between CAA and AD is incompletely understood. CAA may drive AD risk through damage to the neurovascular unit and accelerate parenchymal amyloid and tau deposition. Conversely, early AD may also drive CAA through cerebrovascular remodeling that impairs blood vessels from clearing amyloid-β. Sole reliance on autopsy examination to study CAA limits researchers' ability to investigate CAA's natural disease course and the effect of CAA on cognitive decline. Neuroimaging allows for in vivo assessment of brain function and structure and can be leveraged to investigate CAA staging and explore its associations with AD. In this review, we will discuss neuroimaging modalities that can be used to investigate markers associated with CAA that may impact AD vulnerability including hemorrhages and microbleeds, blood-brain barrier permeability disruption, reduced cerebral blood flow, amyloid and tau accumulation, white matter tract disruption, reduced cerebrovascular reactivity, and lowered brain glucose metabolism. We present possible areas for research inquiry to advance biomarker discovery and improve diagnostics.
Collapse
Affiliation(s)
- Koral V Wheeler
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina Del Rey, CA, USA
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, USC Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, Corwin D. Denney Research Center, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Meredith N Braskie
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina Del Rey, CA, USA
| |
Collapse
|
3
|
Lee K, Ellison B, Selim M, Long NH, Filippidis A, Thomas AJ, Spincemaille P, Wang Y, Soman S. Quantitative susceptibility mapping improves cerebral microbleed detection relative to susceptibility-weighted images. J Neuroimaging 2023; 33:138-146. [PMID: 36168880 DOI: 10.1111/jon.13054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Cerebral microbleed (CMB) detection impacts disease diagnosis and management. Susceptibility-weighted imaging (SWI) MRI depictions of CMBs are used with phase images (SWIP) to distinguish blood from calcification, via qualitative intensity evaluation (bright/dark). However, the intensities depicted for a single lesion can vary within and across consecutive SWIP image planes, impairing the classification of findings as a CMB. We hypothesize that quantitative susceptibility mapping (QSM) MRI, which maps tissue susceptibility, demonstrates less in- and through-plane intensity variation, improving the clinician's ability to categorize a finding as a CMB. METHODS Forty-eight patients with acute intracranial hemorrhage who received multi-echo gradient echo MRI used to generate both SWI/SWIP and morphology-enabled dipole inversion QSM images were enrolled. Five hundred and sixty lesions were visually classified as having homogeneous or heterogeneous in-plane and through-plane intensity by a neuroradiologist and two diagnostic radiology residents using published rating criteria. When available, brain CT scans were analyzed for calcification or acute hemorrhage. Relative risk (RR) ratios and confidence intervals (CIs) were calculated using a generalized linear model with log link and binary error. RESULTS QSM showed unambiguous lesion signal intensity three times more frequently than SWIP (RR = 0.3235, 95% CI 0.2386-0.4386, p<.0001). The probability of QSM depicting homogeneous lesion intensity was three times greater than SWIP for small (RR = 0.3172, 95% CI 0.2382-0.4225, p<.0001), large (RR = 0.3431, 95% CI 0.2045-0.5758, p<.0001), lobar (RR = 0.3215, 95% CI 0.2151-0.4805, p<.0001), cerebellar (RR = 0.3215, 95% CI 0.2151-0.4805, p<.0001), brainstem (RR = 0.3100, 95% CI 0.1192-0.8061, p = .0163), and basal ganglia (RR = 0.3380, 95% CI 0.1980-0.5769, p<.0001) lesions. CONCLUSIONS QSM more consistently demonstrates interpretable lesion intensity compared to SWIP as used for distinguishing CMBs from calcification.
Collapse
Affiliation(s)
- Kyuwon Lee
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Brian Ellison
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Magdy Selim
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Ngo H Long
- Department of General Medicine/Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Aristotelis Filippidis
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Ajith J Thomas
- Department of Neurological Surgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | | | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Salil Soman
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Jang H, Sedaghat S, Athertya JS, Moazamian D, Carl M, Ma Y, Lu X, Ji A, Chang EY, Du J. Feasibility of ultrashort echo time quantitative susceptibility mapping with a 3D cones trajectory in the human brain. Front Neurosci 2022; 16:1033801. [PMID: 36419458 PMCID: PMC9676465 DOI: 10.3389/fnins.2022.1033801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose Quantitative susceptibility mapping (QSM) has surfaced as a promising non-invasive quantitative biomarker that provides information about tissue composition and microenvironment. Recently, ultrashort echo time quantitative susceptibility mapping (UTE-QSM) has been investigated to achieve QSM of short T2 tissues. As the feasibility of UTE-QSM has not been demonstrated in the brain, the goal of this study was to develop a UTE-QSM with an efficient 3D cones trajectory and validate it in the human brain. Materials and methods An ultrashort echo time (UTE) cones sequence was implemented in a 3T clinical MRI scanner. Six images were acquired within a single acquisition, including UTE and gradient recalled echo (GRE) images. To achieve QSM, a morphology-enabled dipole inversion (MEDI) algorithm was incorporated, which utilizes both magnitude and phase images. Three fresh cadaveric human brains were scanned using the 3D cones trajectory with eight stretching factors (SFs) ranging from 1.0 to 1.7. In addition, five healthy volunteers were recruited and underwent UTE-QSM to demonstrate the feasibility in vivo. The acquired data were processed with the MEDI-QSM pipeline. Results The susceptibility maps estimated by UTE-QSM showed reliable tissue contrast. In the ex vivo experiment, high correlations were found between the baseline (SF of 1.0) and SFs from 1.1 to 1.7 with Pearson's correlations of 0.9983, 0.9968, 0.9959, 0.9960, 0.9954, 0.9943, and 0.9879, respectively (all p-values < 0.05). In the in vivo experiment, the measured QSM values in cortical gray matter, juxtacortical white matter, corpus callosum, caudate, and putamen were 25.4 ± 4.0, -21.8 ± 3.2, -22.6 ± 10.0, 77.5 ± 18.8, and 53.8 ± 7.1 ppb, consistent with the values reported in the literature. Conclusion Ultrashort echo time quantitative susceptibility mapping enables direct estimation of the magnetic susceptibility in the brain with a dramatically reduced total scan time by use of a stretched 3D cones trajectory. This technique provides a new biomarker for susceptibility mapping in the in vivo brain.
Collapse
Affiliation(s)
- Hyungseok Jang
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Sam Sedaghat
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Jiyo S. Athertya
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Dina Moazamian
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | | | - Yajun Ma
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Xing Lu
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Alicia Ji
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Eric Y. Chang
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
- Radiology Service, Veterans Affairs (VA) San Diego Healthcare System, San Diego, CA, United States
| | - Jiang Du
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
- Radiology Service, Veterans Affairs (VA) San Diego Healthcare System, San Diego, CA, United States
- Department of Bioengineering, University of California, San Diego, San Diego, CA, United States
| |
Collapse
|
5
|
Weerink LBM, Appelman APA, Kloet RW, Van der Hoorn A. Susceptibility-weighted imaging in intracranial hemorrhage: not all bleeds are black. Br J Radiol 2022:20220304. [PMID: 35766940 PMCID: PMC10392652 DOI: 10.1259/bjr.20220304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
To correctly recognize intracranial hemorrhage (ICH) and differentiate it from other lesions, knowledge of the imaging characteristics of an ICH on susceptibility weighted imaging (SWI) is essential. It is a common misconception that blood is always black on SWI, and it is important to realize that hemorrhage has a variable appearance in different stages on SWI. Furthermore, the presence of a low signal on SWI does not equal the presence of blood products. In this review, the appearance of ICH on SWI during all its stages and common other causes of a low signal on SWI are further discussed and illustrated.
Collapse
Affiliation(s)
- Linda BM Weerink
- Department of Radiology, University Medical Center Groningen, Groningen, Netherlands
- Department of Radiology, Medisch Spectrum Twente, Enschede, Netherlands
| | - Auke PA Appelman
- Department of Radiology, University Medical Center Groningen, Groningen, Netherlands
| | - Reina W Kloet
- Department of Radiology, University Medical Center Groningen, Groningen, Netherlands
| | - Anouk Van der Hoorn
- Department of Radiology, University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|
6
|
Gao Y, Xiong Z, Fazlollahi A, Nestor PJ, Vegh V, Nasrallah F, Winter C, Pike GB, Crozier S, Liu F, Sun H. Instant tissue field and magnetic susceptibility mapping from MRI raw phase using Laplacian enhanced deep neural networks. Neuroimage 2022; 259:119410. [PMID: 35753595 DOI: 10.1016/j.neuroimage.2022.119410] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/12/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
Quantitative susceptibility mapping (QSM) is an MRI post-processing technique that produces spatially resolved magnetic susceptibility maps from phase data. However, the traditional QSM reconstruction pipeline involves multiple non-trivial steps, including phase unwrapping, background field removal, and dipole inversion. These intermediate steps not only increase the reconstruction time but accumulates errors. This study aims to overcome existing limitations by developing a Laplacian-of-Trigonometric-functions (LoT) enhanced deep neural network for near-instant quantitative field and susceptibility mapping (i.e., iQFM and iQSM) from raw MRI phase data. The proposed iQFM and iQSM methods were compared with established reconstruction pipelines on simulated and in vivo datasets. In addition, experiments on patients with intracranial hemorrhage and multiple sclerosis were also performed to test the generalization of the proposed neural networks. The proposed iQFM and iQSM methods in healthy subjects yielded comparable results to those involving the intermediate steps while dramatically improving reconstruction accuracies on intracranial hemorrhages with large susceptibilities. High susceptibility contrast between multiple sclerosis lesions and healthy tissue was also achieved using the proposed methods. Comparative studies indicated that the most significant contributor to iQFM and iQSM over conventional multi-step methods was the elimination of traditional Laplacian unwrapping. The reconstruction time on the order of minutes for traditional approaches was shortened to around 0.1 seconds using the trained iQFM and iQSM neural networks.
Collapse
Affiliation(s)
- Yang Gao
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Zhuang Xiong
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Amir Fazlollahi
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Peter J Nestor
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Viktor Vegh
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia; ARC Training Centre for Innovation in Biomedical Imaging Technology, Brisbane, Australia
| | - Fatima Nasrallah
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Craig Winter
- Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Australia; Centre for Clinical Research, University of Queensland, Brisbane, Australia; School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
| | - G Bruce Pike
- Departments of Radiology and Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Stuart Crozier
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Feng Liu
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Hongfu Sun
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia.
| |
Collapse
|
7
|
Matrosova MS, Bryukhov VV, Belskaya GN, Krotenkova MV. [Quantitative susceptibility mapping in assessment of inflammation and neurodegeneration in multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:16-22. [PMID: 36537626 DOI: 10.17116/jnevro202212212116] [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] [Indexed: 06/17/2023]
Abstract
Quantitative susceptibility mapping (QSM) is a relatively new MRI technique that may potentially help estimate iron concentrations in the brain. It plays a big role in diagnosis of many pathological processes, including multiple sclerosis (MS). Iron metabolism in the brain is a complex and not fully understood process. It is known that the content of iron in the brain increases with age; in addition, its accumulation is often observed in many neurodegenerative diseases, including MS foci, and its amount changes over time. In this regard, the values of magnetic susceptibility obtained using QSM can potentially become a convenient biomarker that reflects the latent activity and progression of MS, which, in turn, can influence the choice of therapy and the tactics of treating patients.
Collapse
|
8
|
Xie H, Zhuang H, Guo Y, Sharma RD, Zhang Q, Li J, Lu S, Xu L, Chan Q, Yoneda T, Spincemaille P, Zhang H, Guo H, Prince MR, Yu C, Wang Y. The appearance of magnetic susceptibility objects in SWI phase depends on object size: Comparison with QSM and CT. Clin Imaging 2021; 82:67-72. [PMID: 34798560 DOI: 10.1016/j.clinimag.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/14/2021] [Accepted: 11/07/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Tissue magnetic susceptibility sign can potentially be detected on susceptibility weighted imaging (SWI) phase (SW-P). This study aims to investigate its performance for depicting brain susceptibility structures. METHODS A simulation was performed to depict magnetic susceptibility structures of various geometries on SW-P and quantitative susceptibility mapping (QSM). Brain MRI was performed on 25 subjects using SWI on a 3 T MRI system. QSM was generated from the same data. SW-P and QSM were analyzed according to radiological assessment for depicting globus pallidus nuclei, optic radiation white matter tracts, and lateral ventricular choroid plexus calcifications. In 11 of these subjects, CT was available and correlated with SW-P and QSM to assess their performance in quantifying calcifications in the choroid plexus. RESULTS In simulation, the appearance of a sphere on SW-P ranged from centric nodule to mixed positive and negative values as the diameter increased. Large cylinders also appeared as mixed positive and negative values. In comparison, QSM correctly depicted the susceptibility distribution of all magnetic structures. On human brain images, SW-P depicted the globus pallidus and optic radiation with mixed positive and negative values, consistent with simulation, and small choroid plexus calcifications as either mixed positive and negative values or as centric nodules; QSM depicted all structures as solid structures with the expected signs. For measuring calcification in the choroid plexus, QSM vs CT linear regression had a higher coefficient of determination compared to SW-P vs CT and SW-P vs QSM. CONCLUSION Appearance of susceptibility sources on SW-P changes with object size. This problem can be overcome using QSM.
Collapse
Affiliation(s)
- Hong Xie
- Department of Radiology, The First College of Clinical Medical Science, Three Gorges University, Yichang, Hubei Province, China
| | - Hangwei Zhuang
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Yihao Guo
- Department of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Ria D Sharma
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Qihao Zhang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Jiahao Li
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Shimin Lu
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Liang Xu
- Department of Radiology, The First College of Clinical Medical Science, Three Gorges University, Yichang, Hubei Province, China
| | | | - Tetsuya Yoneda
- Department of Medical Imaging Sciences, Kumamoto University, Kumamoto, Japan
| | - Pascal Spincemaille
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Honglei Zhang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hua Guo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Martin R Prince
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Chengxin Yu
- Department of Radiology, The First College of Clinical Medical Science, Three Gorges University, Yichang, Hubei Province, China
| | - Yi Wang
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA.
| |
Collapse
|
9
|
A Comprehensive Analysis of Deep Neural-Based Cerebral Microbleeds Detection System. ELECTRONICS 2021. [DOI: 10.3390/electronics10182208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Machine learning-based systems are gaining interest in the field of medicine, mostly in medical imaging and diagnosis. In this paper, we address the problem of automatic cerebral microbleeds (CMB) detection in magnetic resonance images. It is challenging due to difficulty in distinguishing a true CMB from its mimics, however, if successfully solved, it would streamline the radiologists work. To deal with this complex three-dimensional problem, we propose a machine learning approach based on a 2D Faster RCNN network. We aimed to achieve a reliable system, i.e., with balanced sensitivity and precision. Therefore, we have researched and analysed, among others, impact of the way the training data are provided to the system, their pre-processing, the choice of model and its structure, and also the ways of regularisation. Furthermore, we also carefully analysed the network predictions and proposed an algorithm for its post-processing. The proposed approach enabled for obtaining high precision (89.74%), sensitivity (92.62%), and F1 score (90.84%). The paper presents the main challenges connected with automatic cerebral microbleeds detection, its deep analysis and developed system. The conducted research may significantly contribute to automatic medical diagnosis.
Collapse
|
10
|
Martín-Noguerol T, Concepción-Aramendia L, Lim CT, Santos-Armentia E, Cabrera-Zubizarreta A, Luna A. Conventional and advanced MRI evaluation of brain vascular malformations. J Neuroimaging 2021; 31:428-445. [PMID: 33856735 DOI: 10.1111/jon.12853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/14/2021] [Accepted: 03/02/2021] [Indexed: 11/26/2022] Open
Abstract
Vascular malformations (VMs) of the central nervous system (CNS) include a wide range of pathological conditions related to intra and extracranial vessel abnormalities. Although some VMs show typical neuroimaging features, other VMs share and overlap pathological and neuroimaging features that hinder an accurate differentiation between them. Hence, it is not uncommon to misclassify different types of VMs under the general heading of arteriovenous malformations. Thorough knowledge of the imaging findings of each type of VM is mandatory to avoid these inaccuracies. Conventional MRI sequences, including MR angiography, have allowed the evaluation of CNS VMs without using ionizing radiation. Newer MRI techniques, such as susceptibility-weighted imaging, black blood sequences, arterial spin labeling, and 4D flow imaging, have an added value of providing physiopathological data in real time regarding the hemodynamics of VMs. Beyond MR images, new insights using 3D printed models are being incorporated as part of the armamentarium for a noninvasive evaluation of VMs. In this paper, we briefly review the pathophysiology of CNS VMs, focusing on the MRI findings that may be helpful to differentiate them. We discuss the role of each conventional and advanced MRI sequence for VMs assessment and provide some insights about the value of structured reports of 3D printing to evaluate VMs.
Collapse
Affiliation(s)
| | | | - Cc Tchoyoson Lim
- Neuroradiology Department, National Neuroscience Institute and Duke-NUS Medical School, Singapore
| | | | | | - Antonio Luna
- MRI Unit, Radiology Department, HT Medica, Jaén, Spain
| |
Collapse
|
11
|
Multi-centre, multi-vendor reproducibility of 7T QSM and R 2* in the human brain: Results from the UK7T study. Neuroimage 2020; 223:117358. [PMID: 32916289 PMCID: PMC7480266 DOI: 10.1016/j.neuroimage.2020.117358] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction We present the reliability of ultra-high field T2* MRI at 7T, as part of the UK7T Network's “Travelling Heads” study. T2*-weighted MRI images can be processed to produce quantitative susceptibility maps (QSM) and R2* maps. These reflect iron and myelin concentrations, which are altered in many pathophysiological processes. The relaxation parameters of human brain tissue are such that R2* mapping and QSM show particularly strong gains in contrast-to-noise ratio at ultra-high field (7T) vs clinical field strengths (1.5–3T). We aimed to determine the inter-subject and inter-site reproducibility of QSM and R2* mapping at 7T, in readiness for future multi-site clinical studies. Methods Ten healthy volunteers were scanned with harmonised single- and multi-echo T2*-weighted gradient echo pulse sequences. Participants were scanned five times at each “home” site and once at each of four other sites. The five sites had 1× Philips, 2× Siemens Magnetom, and 2× Siemens Terra scanners. QSM and R2* maps were computed with the Multi-Scale Dipole Inversion (MSDI) algorithm (https://github.com/fil-physics/Publication-Code). Results were assessed in relevant subcortical and cortical regions of interest (ROIs) defined manually or by the MNI152 standard space. Results and Discussion Mean susceptibility (χ) and R2* values agreed broadly with literature values in all ROIs. The inter-site within-subject standard deviation was 0.001–0.005 ppm (χ) and 0.0005–0.001 ms−1 (R2*). For χ this is 2.1–4.8 fold better than 3T reports, and 1.1–3.4 fold better for R2*. The median ICC from within- and cross-site R2* data was 0.98 and 0.91, respectively. Multi-echo QSM had greater variability vs single-echo QSM especially in areas with large B0 inhomogeneity such as the inferior frontal cortex. Across sites, R2* values were more consistent than QSM in subcortical structures due to differences in B0-shimming. On a between-subject level, our measured χ and R2* cross-site variance is comparable to within-site variance in the literature, suggesting that it is reasonable to pool data across sites using our harmonised protocol. Conclusion The harmonized UK7T protocol and pipeline delivers on average a 3-fold improvement in the coefficient of reproducibility for QSM and R2* at 7T compared to previous reports of multi-site reproducibility at 3T. These protocols are ready for use in multi-site clinical studies at 7T.
Collapse
|
12
|
Utrera Pérez E, Santos Armentia E, Silva Priegue N, Villanueva Campos A, Jurado Basildo C. Should susceptibility-weighted imaging be included in the basic protocol for magnetic resonance imaging of the brain? RADIOLOGIA 2020. [DOI: 10.1016/j.rxeng.2020.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Utrera Pérez E, Santos Armentia E, Silva Priegue N, Villanueva Campos A, Jurado Basildo C. ¿Se debe incluir la secuencia de susceptibilidad magnética en el protocolo de resonancia magnética cerebral básico? RADIOLOGIA 2020; 62:320-326. [DOI: 10.1016/j.rx.2019.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 09/21/2019] [Accepted: 12/30/2019] [Indexed: 11/16/2022]
|
14
|
Scarlini S, Cavallieri F, Fiorini M, Menozzi E, Ferrara F, Cavalleri F, Reale C, Garavaglia B, Pietrangelo A, Valzania F, Corradini E. Idiopathic brain calcification in a patient with hereditary hemochromatosis. BMC Neurol 2020; 20:113. [PMID: 32228506 PMCID: PMC7106592 DOI: 10.1186/s12883-020-01689-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 03/17/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Detection of brain-MRI T2/T2* gradient echo images (T2*GRE)-hypointensity can be compatible with iron accumulation and leads to a differential diagnosis work-up including neurodegeneration with brain iron accumulation (NBIA) and Wilson Disease. Idiopathic or secondary brain calcification can be also associated with neurological involvement and brain-MRI T2/T2*GRE-hypointensity. Hereditary hemochromatosis (HH), characterized by systemic iron loading, usually does not involve the CNS, and only sporadic cases of neurological abnormalities or brain-MRI T2/T2*GRE-hypointensity have been reported. CASE PRESENTATION A 59-year-old man came to our observation after a diagnosis of HH carried out in another hospital 2 years before. First-level genetic test had revealed a homozygous HFE p.Cys282Tyr (C282Y) mutation compatible with the diagnosis of HFE-related HH, thus phlebotomy treatment was started. The patient had a history of metabolic syndrome, type-2 diabetes, autoimmune thyroiditis and severe chondrocalcinosis. Brain-MRI showed the presence of bilateral T2*GRE hypointensities within globus pallidus, substantia nigra, dentate nucleus and left pulvinar that were considered expression of cerebral siderosis. No neurological symptoms or family history of neurological disease were reported. Neurological examination revealed only mild right-sided hypokinetic-rigid syndrome. Vitamin D-PTH axis, measurements of serum ceruloplasmin and copper, and urinary copper were within the normal range. A brain computed tomography (CT) was performed to better characterize the suspected and unexplained brain iron accumulation. On the CT images, the hypointense regions in the brain MRI were hyperdense. DNA sequence analysis of genes associated with primary familial brain calcification and NBIA was negative. CONCLUSIONS This report highlights the importance of brain CT-scan in ambiguous cases of suspected cerebral siderosis, and suggests that HH patients with a severe phenotype, and likely associated with chondrocalcinosis, may display also brain calcifications. Further studies are needed to confirm this hypothesis. So far, we can speculate that iron and calcium homeostasis could be reciprocally connected within the basal ganglia.
Collapse
Affiliation(s)
- Stefania Scarlini
- Internal Medicine Unit and Centre for Hemochromatosis and Heredometabolic Liver Diseases, EuroBloodNet Referral Center for Iron Disorders, Policlinico, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Francesco Cavallieri
- Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Fiorini
- Internal Medicine Unit and Centre for Hemochromatosis and Heredometabolic Liver Diseases, EuroBloodNet Referral Center for Iron Disorders, Policlinico, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Elisa Menozzi
- Department of Neuroscience, S. Agostino-Estense Hospital, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Francesca Ferrara
- Internal Medicine Unit and Centre for Hemochromatosis and Heredometabolic Liver Diseases, EuroBloodNet Referral Center for Iron Disorders, Policlinico, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Francesca Cavalleri
- Department of Neuroradiology, Policlinico|, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Chiara Reale
- Medical Genetics and Neurogenetics Unit, Movement Disorders Diagnostic Section, Fondazione IRCCS Istituto Neurologico “C. Besta”, Milan, Italy
| | - Barbara Garavaglia
- Medical Genetics and Neurogenetics Unit, Movement Disorders Diagnostic Section, Fondazione IRCCS Istituto Neurologico “C. Besta”, Milan, Italy
| | - Antonello Pietrangelo
- Internal Medicine Unit and Centre for Hemochromatosis and Heredometabolic Liver Diseases, EuroBloodNet Referral Center for Iron Disorders, Policlinico, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Franco Valzania
- Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Elena Corradini
- Internal Medicine Unit and Centre for Hemochromatosis and Heredometabolic Liver Diseases, EuroBloodNet Referral Center for Iron Disorders, Policlinico, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
15
|
Liang JJ, Lei L, Zeng YP, Xiao ZM. High signal-intensity abnormalities in susceptibility-weighted imaging for primary intracerebral hemorrhage. Int J Neurosci 2019; 129:842-847. [PMID: 30724645 DOI: 10.1080/00207454.2019.1576659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To identify the regularity of signal evolution of intracerebral hemorrhage on susceptibility-weighted imaging (SWI) at different stages compared with T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI). Methods: We retrospectively evaluated a series of 365 patients who underwent T1WI, T2WI, and SWI examination simultaneously or sequentially in our hospital from January 2015 to May 2017. Two neuroradiologists assessed the images and discrepancies between their interpretations were resolved by consensus. Statistical analysis was performed using Chi-squared and Kappa tests. Results: Of the 365 patients on SWI sequence, 94 were enrolled. SWI detected the cases at different stages; T1WI detected 89 cases and T2WI detected 91 cases. The signal intensity of intracerebral hemorrhage on SWI was significantly associated with T1WI imaging and T2WI (χ2 = 4.651; p < 0.05; χ2 = 26.396; p < 0.01, respectively), especially at the late subacute stage. There was moderate consistency between the signal intensity of intracerebral hemorrhage on T2WI and SWI (Kappa coefficient = 0.530). Conclusion: Intracerebral hemorrhage has a varied appearance on SWI, and the evolution of signal of intracerebral hemorrhage on SWI sequence is influenced by T1WI and T2WI. Hematoma detection should be closely combined with clinical manifestation.
Collapse
Affiliation(s)
- Jing-Jing Liang
- a Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei Province , P. R. China
| | - Lu Lei
- a Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei Province , P. R. China
| | - Yan-Ping Zeng
- a Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei Province , P. R. China
| | - Zhe-Man Xiao
- a Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei Province , P. R. China
| |
Collapse
|
16
|
Multiparametric MRI Features and Pathologic Outcome of Wedge-Shaped Lesions in the Peripheral Zone on T2-Weighted Images of the Prostate. AJR Am J Roentgenol 2019; 212:124-129. [PMID: 30403532 PMCID: PMC6437777 DOI: 10.2214/ajr.18.19742] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study investigates the multiparametric MRI (mpMRI) characteristics and pathologic outcome of wedge-shaped lesions observed on T2-weighted images. MATERIALS AND METHODS Seventy-six patients with histologically confirmed prostate cancer underwent preoperative 3-T MRI before undergoing radical prostatectomy. Two radiologists worked in consensus to mark wedge-shaped regions of hypointensity on T2-weighted images and assess their appearance on apparent diffusion coefficient (ADC) maps (to determine the degree of hypointensity) and dynamic contrast-enhanced (DCE) MRI (DCE-MRI) (to assess whether they showed early enhancement). The pathologic outcome of wedge-shaped lesions was assessed by matching MR images with whole-mount histologic specimens retrospectively. The difference in quantitative ADC values between malignant and benign wedge-shaped lesions was assessed using a t test. RESULTS Thirty-five wedge-shaped regions were identified, 12 (34%) of which were found be malignant. Most malignant wedge-shaped regions were highly hypointense (10/12; 83%) on ADC maps and showed early enhancement on DCE-MRI (7/12; 58%). However, benign wedge-shaped lesions were predominantly mildly hypointense (13/23; 57%) on ADC maps and showed no early enhancement (15/23; 65%). Histologic correlates of the benign wedge-shaped regions showed prostatitis (acute inflammation [7/23; 30%] or chronic inflammation [9/23; 39%]), hemosiderin-laden macrophages (6/23; 26%), prominent blood vessels (7/23; 30%), intraluminal blood (6/23; 26%), and nonspecific atrophy (6/23; 26%). The mean (± SD) quantitative ADC value of malignant wedge-shaped regions (1.13 ± 0.11 μm2/ms) was significantly lower (p = 0.0001) than that of benign wedge-shaped regions (1.52 ± 0.27 μm2/ms). CONCLUSION This study shows that a greater percentage of wedge-shaped features are malignant than was previously thought. Of importance, mpMRI (specifically, ADC maps) can distinguish between malignant and benign wedge-shaped features.
Collapse
|
17
|
Chellathurai A, Subbiah K, Abdul Ajis BN, Balasubramaniam S, Gnanasigamani S. Role of 3D SPACE sequence and susceptibility weighted imaging in the evaluation of hydrocephalus and treatment-oriented refined classification of hydrocephalus. Indian J Radiol Imaging 2018; 28:385-394. [PMID: 30662197 PMCID: PMC6319109 DOI: 10.4103/ijri.ijri_161_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The aim of our study was to evaluate the diagnostic utility of three-dimensional sampling perfection with application optimized contrast using different flip angle evolution (3D SPACE) sequence and Susceptibility Weighted Imaging (SWI) in hydrocephalus and to propose a refined definition and classification of hydrocephalus with relevance to the selection of treatment option. MATERIALS AND METHODS A prospective study of 109 patients with hydrocephalus was performed with magnetic resonance imaging (MRI) brain using standardized institutional sequences along with additional sequences 3D SPACE and SWI. The images were independently read by two senior neuroradiologists and the etiopathogenesis of hydrocephalus was arrived by consensus. RESULTS With conventional sequences, 46 out of 109 patients of hydrocephalus were diagnosed as obstructive of which 21 patients showed direct signs of obstruction and 25 showed indirect signs. In the remaining 63 patients of communicating hydrocephalus, cause could not be found out in 41 patients. Whereas with 3D SPACE sequence, 88 patients were diagnosed as obstructive hydrocephalus in which all of them showed direct signs of obstruction and 21 patients were diagnosed as communicating hydrocephalus. By including SWI, we found out hemorrhage causing intraventricular obstruction in three patients and hemorrhage at various sites in 24 other patients. With these findings, we have classified the hydrocephalus into communicating and noncommunicating, with latter divided into intraventricular and extraventricular obstruction, which is very well pertaining to the selection of surgical option. CONCLUSION We strongly suggest to include 3D SPACE and SWI sequences in the set of routine MRI sequences, as they are powerful diagnostic tools and offer complementary information regarding the precise evaluation of the etiopathogenesis of hydrocephalus and have an effective impact in selecting the mode of management.
Collapse
Affiliation(s)
- Amarnath Chellathurai
- Department of Radiodiagnosis, Govt Stanley Medical College, Affiliated to The Tamil Nadu Dr. MGR Medical University, Anna Salai, Guindy, Chennai, Tamil Nadu, India
| | - Komalavalli Subbiah
- Department of Radiodiagnosis, Govt Stanley Medical College, Affiliated to The Tamil Nadu Dr. MGR Medical University, Anna Salai, Guindy, Chennai, Tamil Nadu, India
| | - Barakath Nisha Abdul Ajis
- Department of Radiodiagnosis, Govt Stanley Medical College, Affiliated to The Tamil Nadu Dr. MGR Medical University, Anna Salai, Guindy, Chennai, Tamil Nadu, India
| | - Suhasini Balasubramaniam
- Department of Radiodiagnosis, Govt Stanley Medical College, Affiliated to The Tamil Nadu Dr. MGR Medical University, Anna Salai, Guindy, Chennai, Tamil Nadu, India
| | - Sathyan Gnanasigamani
- Department of Radiodiagnosis, Govt Stanley Medical College, Affiliated to The Tamil Nadu Dr. MGR Medical University, Anna Salai, Guindy, Chennai, Tamil Nadu, India
| |
Collapse
|
18
|
Saad AF, Chaudhari R, Fischbein NJ, Wintermark M. Intracranial Hemorrhage Imaging. Semin Ultrasound CT MR 2018; 39:441-456. [DOI: 10.1053/j.sult.2018.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
19
|
Performance of Magnetic Resonance Susceptibility-Weighted Imaging for Detection of Calcifications in Patients With Hepatic Echinococcosis. J Comput Assist Tomogr 2018; 42:211-215. [PMID: 29189399 DOI: 10.1097/rct.0000000000000687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We evaluated the performance of susceptibility-weighted imaging (SWI) for identification of hepatic calcifications in alveolar echinococcosis and cystic echinococcosis. METHODS The SWI images of 58 lesions in 40 patients (age, 49 ± 14 y) with alveolar echinococcosis (n = 22) or cystic echinococcosis (n = 18) were reviewed for calcifications. First, calcifications were suggested by visual assessment. Second, ratios of minimum intralesional intensity and mean lumbar muscle intensity were recorded. Computed tomography (CT) served as the criterion standard. RESULTS Thirty-seven lesions showed calcifications on CT. Susceptibility-weighted imaging provided a sensitivity of 89.2% (95% confidence interval [CI], 50.1-75.7) and a specificity of 57.1% (95% CI, 34.4-77.4) for calcifications detected by visual assessment. Receiver operating characteristic curves demonstrated a sensitivity of 67.6% and a specificity of 85.0% for an intensity ratio of 0.61. A specificity of 100% (95% CI, 80.8-100) and a sensitivity of 84.5% (95% CI, 67.3-93.2) were achieved by SWI for calcifications with a density greater than 184 HU in CT. CONCLUSIONS Identification of hepatic calcifications is possible with SWI. Susceptibility-weighted imaging offers the potential to reduce the need for of CT imaging for evaluation of echinococcosis.
Collapse
|
20
|
Abstract
Susceptibility Weighted Imaging (SWI) is an established part of the clinical neuroimaging toolbox and, since its inception, has also successfully been used in various preclinical studies. Exploiting the effect of variations of magnetic susceptibility between different tissues on the externally applied, static, homogeneous magnetic field, the method visualizes venous vasculature, hemorrhages and blood degradation products, calcifications, and tissue iron deposits. The chapter describes in vivo and ex vivo protocols for preclinical SWI in rodents.
Collapse
Affiliation(s)
- Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA.
- Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY, USA.
| | - Marilena Preda
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
- Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
- Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY, USA
| |
Collapse
|
21
|
Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the detection of calcifications: A systematic review and meta-analysis. Sci Rep 2017; 7:15506. [PMID: 29138506 PMCID: PMC5686169 DOI: 10.1038/s41598-017-15860-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 11/03/2017] [Indexed: 12/21/2022] Open
Abstract
Since its introduction, susceptibility-weighted-magnetic resonance imaging (SW-MRI) has shown the potential to overcome the insensitivity of MRI to calcification. Previous studies reporting the diagnostic performance of SW-MRI and magnetic resonance imaging (MRI) for the detection of calcifications are inconsistent and based on single-institution designs. To our knowledge, this is the first meta-analysis on SW-MRI, determining the potential of SW-MRI to detect calcifications. Two independent investigators searched MEDLINE, EMBASE and Web of Science for eligible diagnostic accuracy studies, which were published until March 24, 2017 and investigated the accuracy of SW-MRI to detect calcifications, using computed tomography (CT) as a reference. The QUADAS-2 tool was used to assess study quality and methods for analysis were based on PRISMA. A bivariate diagnostic random-effects model was applied to obtain pooled sensitivities and specificities. Out of the 4629 studies retrieved by systematic literature search, 12 clinical studies with 962 patients and a total of 1,032 calcifications were included. Pooled sensitivity was 86.5% (95%-confidence interval (CI): 73.6–93.7%) for SW-MRI and 36.7% (95%–CI:29.2–44.8%) for standard MRI. Pooled specificities of SW-MRI (90.8%; 95%–CI:81.0–95.8%) and standard MRI (94.2; 95%–CI:88.9–96.7%) were comparable. Results of the present meta-analysis suggest, that SW-MRI is a reliable method for detecting calcifications in soft tissues.
Collapse
|
22
|
Azad R, Mittal P, Malhotra A, Gangrade S. Detection and Differentiation of Focal Intracranial Calcifications and Chronic Microbleeds Using MRI. J Clin Diagn Res 2017; 11:TC19-TC23. [PMID: 28658873 DOI: 10.7860/jcdr/2017/24076.9846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 01/26/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Differentiating calcification from chronic micro-bleeds on imaging may have important clinical implications. AIM The present study aimed to evaluate the role and relative advantages of Magnetic Resonance Imaging (MRI) in the detection and differentiation of intracranial calcifications and chronic microbleeds. MATERIALS AND METHODS The retrospective study comprised of 100 patients having either intracranial calcifications or microhaemorrhages selected on the basis of Computerized Tomography (CT) and MRI using predefined criteria. Two independent blinded observers evaluated the images qualitatively and quantitatively. Single pixel values were taken in the circular Region of Interest (ROI) on magnitude SWI, phase Susceptibility Weighted Imaging (SWI) and Diffusion Weighted Imaging (DWI) for quantitative analysis. RESULTS Fifty patients with 76 focal calcifications and another 50 patients with 245 chronic microbleeds formed part of the study. Overall sensitivity of SWI in detection of calcification was 93.9% with good inter observer agreeability (k= 0.7) on phase SWI. All the chronic microbleeds were seen on SWI but there was only moderate inter observer agreeability in evaluation of signal on phase component (k= 0.5). Average pixel values of calcifications and chronic microbleeds were -312.5±187 SD and 541.9±301.7 SD respectively on phase SWI, (p=0.0001, <0.05). CONCLUSION SWI can play a pivotal role in the detection of intracranial calcifications and chronic microbleeds and resolving the ambiguity in their diagnosis.
Collapse
Affiliation(s)
- Rajiv Azad
- Professor and Head, Department of Radiodiagnosis, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Priyanka Mittal
- Junior Resident, Department of Radiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Ankur Malhotra
- Assistant Professor, Department of Radiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Sharad Gangrade
- Senior Resident, Department of Radiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| |
Collapse
|
23
|
Adams LC, Böker SM, Bender YY, Diederichs G, Fallenberg EM, Wagner M, Hamm B, Makowski MR. Diagnostic accuracy of susceptibility-weighted magnetic resonance imaging for the evaluation of pineal gland calcification. PLoS One 2017; 12:e0172764. [PMID: 28278291 PMCID: PMC5344338 DOI: 10.1371/journal.pone.0172764] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/09/2017] [Indexed: 12/13/2022] Open
Abstract
Objectives To determine the diagnostic performance of susceptibility-weighted magnetic resonance imaging (SWMR) for the detection of pineal gland calcifications (PGC) compared to conventional magnetic resonance imaging (MRI) sequences, using computed tomography (CT) as a reference standard. Methods 384 patients who received a 1.5 Tesla MRI scan including SWMR sequences and a CT scan of the brain between January 2014 and October 2016 were retrospectively evaluated. 346 patients were included in the analysis, of which 214 showed PGC on CT scans. To assess correlation between imaging modalities, the maximum calcification diameter was used. Sensitivity and specificity and intra- and interobserver reliability were calculated for SWMR and conventional MRI sequences. Results SWMR reached a sensitivity of 95% (95% CI: 91%-97%) and a specificity of 96% (95% CI: 91%-99%) for the detection of PGC, whereas conventional MRI achieved a sensitivity of 43% (95% CI: 36%-50%) and a specificity of 96% (95% CI: 91%-99%). Detection rates for calcifications in SWMR and conventional MRI differed significantly (95% versus 43%, p<0.001). Diameter measurements between SWMR and CT showed a close correlation (R2 = 0.85, p<0.001) with a slight but not significant overestimation of size (SWMR: 6.5 mm ± 2.5; CT: 5.9 mm ± 2.4, p = 0.02). Interobserver-agreement for diameter measurements was excellent on SWMR (ICC = 0.984, p < 0.0001). Conclusions Combining SWMR magnitude and phase information enables the accurate detection of PGC and offers a better diagnostic performance than conventional MRI with CT as a reference standard.
Collapse
Affiliation(s)
- Lisa C. Adams
- Department of Radiology, Charité, Berlin, Germany
- * E-mail:
| | | | | | | | | | | | - Bernd Hamm
- Department of Radiology, Charité, Berlin, Germany
| | | |
Collapse
|
24
|
Ribeiro BNDF, Lima GDA, Ventura N, Gasparetto EL, Marchiori E. Chronic kernicterus: magnetic resonance imaging findings. Radiol Bras 2016; 49:407-408. [PMID: 28057969 PMCID: PMC5210039 DOI: 10.1590/0100-3984.2015.0190] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Nina Ventura
- Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, RJ, Brazil
| | | | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| |
Collapse
|
25
|
Hochhegger B, Irion KL, Zanetti G, Marchiori E. Use of multislice computed tomography in the diagnosis of annular constrictive pericarditis. Radiol Bras 2016; 49:200-1. [PMID: 27403024 PMCID: PMC4938454 DOI: 10.1590/0100-3984.2015.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Bruno Hochhegger
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
| | | | | | | |
Collapse
|
26
|
Ribeiro BNDF, Salata TM, Borges RS, Marchiori E. Posterior reversible encephalopathy syndrome following immunoglobulin therapy in a patient with Miller-Fisher syndrome. Radiol Bras 2016; 49:58-9. [PMID: 26929465 PMCID: PMC4770401 DOI: 10.1590/0100-3984.2015.0129] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Tiago Medina Salata
- Hospital Casa de Portugal / 3D Diagnóstico por Imagem, Rio de Janeiro, RJ, Brazil
| | | | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| |
Collapse
|