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Yagis E, Aslani S, Jain Y, Zhou Y, Rahmani S, Brunet J, Bellier A, Werlein C, Ackermann M, Jonigk D, Tafforeau P, Lee PD, Walsh C. Deep Learning for 3D Vascular Segmentation in Phase Contrast Tomography. RESEARCH SQUARE 2024:rs.3.rs-4613439. [PMID: 39070623 PMCID: PMC11276017 DOI: 10.21203/rs.3.rs-4613439/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Automated blood vessel segmentation is critical for biomedical image analysis, as vessel morphology changes are associated with numerous pathologies. Still, precise segmentation is difficult due to the complexity of vascular structures, anatomical variations across patients, the scarcity of annotated public datasets, and the quality of images. Our goal is to provide a foundation on the topic and identify a robust baseline model for application to vascular segmentation using a new imaging modality, Hierarchical Phase-Contrast Tomography (HiP-CT). We begin with an extensive review of current machine learning approaches for vascular segmentation across various organs. Our work introduces a meticulously curated training dataset, verified by double annotators, consisting of vascular data from three kidneys imaged using Hierarchical Phase-Contrast Tomography (HiP-CT) as part of the Human Organ Atlas Project. HiP-CT, pioneered at the European Synchrotron Radiation Facility in 2020, revolutionizes 3D organ imaging by offering resolution around 20μm/voxel, and enabling highly detailed localized zooms up to 1μm/voxel without physical sectioning. We leverage the nnU-Net framework to evaluate model performance on this high-resolution dataset, using both known and novel samples, and implementing metrics tailored for vascular structures. Our comprehensive review and empirical analysis on HiP-CT data sets a new standard for evaluating machine learning models in high-resolution organ imaging. Our three experiments yielded Dice scores of 0.9523 and 0.9410, and 0.8585, respectively. Nevertheless, DSC primarily assesses voxel-to-voxel concordance, overlooking several crucial characteristics of the vessels and should not be the sole metric for deciding the performance of vascular segmentation. Our results show that while segmentations yielded reasonably high scores-such as centerline Dice values ranging from 0.82 to 0.88, certain errors persisted. Specifically, large vessels that collapsed due to the lack of hydro-static pressure (HiP-CT is an ex vivo technique) were segmented poorly. Moreover, decreased connectivity in finer vessels and higher segmentation errors at vessel boundaries were observed. Such errors, particularly in significant vessels, obstruct the understanding of the structures by interrupting vascular tree connectivity. Through our review and outputs, we aim to set a benchmark for subsequent model evaluations using various modalities, especially with the HiP-CT imaging database.
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Affiliation(s)
- Ekin Yagis
- Department of Mechanical Engineering, University College London, London, UK
| | - Shahab Aslani
- Department of Mechanical Engineering, University College London, London, UK
- Centre for Medical Image Computing, University College London, London UK
| | - Yashvardhan Jain
- Department of Intelligent Systems Engineering, Luddy School of Informatics, Computing, and Engineering, Indiana University, Bloomington, USA
| | - Yang Zhou
- Department of Mechanical Engineering, University College London, London, UK
| | - Shahrokh Rahmani
- Department of Mechanical Engineering, University College London, London, UK
| | - Joseph Brunet
- Department of Mechanical Engineering, University College London, London, UK
- European Synchrotron Radiation Facility, Grenoble, France
| | | | - Christopher Werlein
- Institute of Pathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | | | - Danny Jonigk
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Paul Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France
| | - Peter D. Lee
- Department of Mechanical Engineering, University College London, London, UK
| | - Claire Walsh
- Department of Mechanical Engineering, University College London, London, UK
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2
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Si G, Du Y, Tang P, Ma G, Jia Z, Zhou X, Mu D, Shen Y, Lu Y, Mao Y, Chen C, Li Y, Gu N. Unveiling the next generation of MRI contrast agents: current insights and perspectives on ferumoxytol-enhanced MRI. Natl Sci Rev 2024; 11:nwae057. [PMID: 38577664 PMCID: PMC10989670 DOI: 10.1093/nsr/nwae057] [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: 11/10/2023] [Revised: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 04/06/2024] Open
Abstract
Contrast-enhanced magnetic resonance imaging (CE-MRI) is a pivotal tool for global disease diagnosis and management. Since its clinical availability in 2009, the off-label use of ferumoxytol for ferumoxytol-enhanced MRI (FE-MRI) has significantly reshaped CE-MRI practices. Unlike MRI that is enhanced by gadolinium-based contrast agents, FE-MRI offers advantages such as reduced contrast agent dosage, extended imaging windows, no nephrotoxicity, higher MRI time efficiency and the capability for molecular imaging. As a leading superparamagnetic iron oxide contrast agent, ferumoxytol is heralded as the next generation of contrast agents. This review delineates the pivotal clinical applications and inherent technical superiority of FE-MRI, providing an avant-garde medical-engineering interdisciplinary lens, thus bridging the gap between clinical demands and engineering innovations. Concurrently, we spotlight the emerging imaging themes and new technical breakthroughs. Lastly, we share our own insights on the potential trajectory of FE-MRI, shedding light on its future within the medical imaging realm.
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Affiliation(s)
- Guangxiang Si
- Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210009, China
| | - Yue Du
- Key Laboratory for Bio-Electromagnetic Environment and Advanced Medical Theranostics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 210029, China
| | - Peng Tang
- Key Laboratory for Bio-Electromagnetic Environment and Advanced Medical Theranostics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 210029, China
| | - Gao Ma
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhaochen Jia
- Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210009, China
| | - Xiaoyue Zhou
- MR Collaboration, Siemens Healthineers Ltd., Shanghai 200126, China
| | - Dan Mu
- Department of Radiology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Yan Shen
- Key Laboratory for Bio-Electromagnetic Environment and Advanced Medical Theranostics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 210029, China
| | - Yi Lu
- School of Mathematical Sciences, Capital Normal University, Beijing 100048, China
| | - Yu Mao
- Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Institute of Clinical Medicine, Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing 210093, China
| | - Chuan Chen
- Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210009, China
| | - Yan Li
- Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210009, China
| | - Ning Gu
- Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Institute of Clinical Medicine, Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing 210093, China
- Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210009, China
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Garg I, Siembida JM, Hedgire S, Priya S, Nagpal P. Computed Tomography Angiography for Aortic Diseases. Radiol Clin North Am 2024; 62:509-525. [PMID: 38553183 DOI: 10.1016/j.rcl.2024.01.001] [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: 04/02/2024]
Abstract
Aortic pathologies encompass a heterogeneous group of disorders, including acute aortic syndrome, traumatic aortic injury , aneurysm, aortitis, and atherosclerosis. The clinical manifestations of these disorders can be varied and non-specific, ranging from acute presentations in the emergency department to chronic incidental findings in an outpatient setting. Given the non-specific nature of their clinical presentations, the reliance on non-invasive imaging for screening, definitive diagnosis, therapeutic strategy planning, and post-intervention surveillance has become paramount. Commonly used imaging modalities include ultrasound, computed tomography (CT), and MR imaging. Among these modalities, computed tomography angiography (CTA) has emerged as a first-line imaging modality owing to its excellent anatomic detail, widespread availability, established imaging protocols, evidence-proven indications, and rapid acquisition time.
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Affiliation(s)
- Ishan Garg
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Jakub M Siembida
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Sandeep Hedgire
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Sarv Priya
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Prashant Nagpal
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
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Balodis A, Kalējs VR, Migunova K. Bilateral Low-Flow Type-D Dural Carotid-Cavernous Fistula: Diagnosis and Treatment with 3D Time-of-Flight Magnetic Resonance Angiography. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e942833. [PMID: 38504435 DOI: 10.12659/ajcr.942833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND Carotid-cavernous fistula (CCF) is a rare, atypical vascular shunt between the carotid arterial system and the venous channels of the cavernous sinus, classified according to the shunt's anatomy, by etiology (resulting from trauma or occurring spontaneously), or by hemodynamic characteristics (such as low- or high-flow fistulas). CASE REPORT A 62-year-old female patient with poorly controlled arterial hypertension presented with bilateral periorbital edema, conjunctival chemosis, ophthalmoplegia, diplopia, and diminished visual acuity. On magnetic resonance angiography (MRA), abnormal arterial flow along the cavernous sinuses was noted, suggestive of bilateral CCF. The diagnosis of indirect dural low-flow CCF (Barrow Type D) was later confirmed by digital subtraction angiography, with feeding arteries from intracavernous internal carotid artery branches, and meningeal branches of the external carotid artery, draining bilaterally to ophthalmic veins, the intracavernous sinus, and the inferior petrosal sinus. The patient was successfully treated with endovascular embolization. At 7-month follow-up, no residual arteriovenous shunting was detected. This case highlights the importance of non-invasive radiological methods for CCF, and presents rarely published radiological findings of bilateral Type-D dural CCFs on 3-dimensional time-of-flight MRA with post-treatment MRA follow-up. CONCLUSIONS Regardless of the patient's history of possible trauma, a patient presenting with bilateral periorbital edema, conjunctival chemosis, ophthalmoplegia, diplopia, and diminished visual acuity should have a spontaneous bilateral CCF investigated to prevent delayed treatment. Experienced neuroradiologists are needed to accurately detect indirect CCF, since this condition often does not demonstrate classic symptoms.
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Affiliation(s)
- Arturs Balodis
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
- Department of Radiology, Riga Stradins University, Riga, Latvia
| | - Verners Roberts Kalējs
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
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Materka A, Jurek J. Using Deep Learning and B-Splines to Model Blood Vessel Lumen from 3D Images. SENSORS (BASEL, SWITZERLAND) 2024; 24:846. [PMID: 38339562 PMCID: PMC10857344 DOI: 10.3390/s24030846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/20/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Accurate geometric modeling of blood vessel lumen from 3D images is crucial for vessel quantification as part of the diagnosis, treatment, and monitoring of vascular diseases. Our method, unlike other approaches which assume a circular or elliptical vessel cross-section, employs parametric B-splines combined with image formation system equations to accurately localize the highly curved lumen boundaries. This approach avoids the need for image segmentation, which may reduce the localization accuracy due to spatial discretization. We demonstrate that the model parameters can be reliably identified by a feedforward neural network which, driven by the cross-section images, predicts the parameter values many times faster than a reference least-squares (LS) model fitting algorithm. We present and discuss two example applications, modeling the lower extremities of artery-vein complexes visualized in steady-state contrast-enhanced magnetic resonance images (MRI) and the coronary arteries pictured in computed tomography angiograms (CTA). Beyond applications in medical diagnosis, blood-flow simulation and vessel-phantom design, the method can serve as a tool for automated annotation of image datasets to train machine-learning algorithms.
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Affiliation(s)
- Andrzej Materka
- Institute of Electronics, Lodz University of Technology, 90-924 Lodz, Poland;
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Bendszus M, Laghi A, Munuera J, Tanenbaum LN, Taouli B, Thoeny HC. MRI Gadolinium-Based Contrast Media: Meeting Radiological, Clinical, and Environmental Needs. J Magn Reson Imaging 2024. [PMID: 38226697 DOI: 10.1002/jmri.29181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 01/17/2024] Open
Abstract
Gadolinium-based contrast agents (GBCAs) are routinely used in magnetic resonance imaging (MRI). They are essential for choosing the most appropriate medical or surgical strategy for patients with serious pathologies, particularly in oncologic, inflammatory, and cardiovascular diseases. However, GBCAs have been associated with an increased risk of nephrogenic systemic fibrosis in patients with renal failure, as well as the possibility of deposition in the brain, bones, and other organs, even in patients with normal renal function. Research is underway to reduce the quantity of gadolinium injected, without compromising image quality and diagnosis. The next generation of GBCAs will enable a reduction in the gadolinium dose administered. Gadopiclenol is the first of this new generation of GBCAs, with high relaxivity, thus having the potential to reduce the gadolinium dose while maintaining good in vivo stability due to its macrocyclic structure. High-stability and high-relaxivity GBCAs will be one of the solutions for reducing the dose of gadolinium to be administered in clinical practice, while the development of new technologies, including optimization of MRI acquisitions, new contrast mechanisms, and artificial intelligence may help reduce the need for GBCAs. Future solutions may involve a combination of next-generation GBCAs and image-processing techniques to optimize diagnosis and treatment planning while minimizing exposure to gadolinium. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Martin Bendszus
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Andrea Laghi
- Department of Medical Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Josep Munuera
- Advanced Medical Imaging, Artificial Intelligence, and Imaging-Guided Therapy Research Group, Institut de Recerca Sant Pau - Centre CERCA, Barcelona, Spain
- Diagnostic Imaging Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Bachir Taouli
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Harriet C Thoeny
- Department of Diagnostic and Interventional Radiology, Fribourg Cantonal Hospital, Fribourg, Switzerland
- Faculty of Medicine, University of Fribourg, Fribourg, Switzerland
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7
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Li Y, Zhu Y, Liu Y, Li G, Qu X. Comparative Study of the Diagnostic Value of Zero-Echo-Time Magnetic Resonance Angiography With Time-of-Flight Magnetic Resonance Angiography for Intracranial Aneurysm. J Comput Assist Tomogr 2024; 48:169-174. [PMID: 37531630 DOI: 10.1097/rct.0000000000001518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
OBJECTIVE Intracranial aneurysm (IAN) is a class of cerebrovascular diseases with a serious threat to patients, and an accurate diagnosis of IAN is very important for both selection of the appropriate therapy and prediction of the prognosis. This study aimed to evaluate the diagnostic values of zero-echo-time magnetic resonance angiography (ZTE-MRA) and time-of-flight magnetic resonance angiography (TOF-MRA) in patients with IAN. METHODS Digital subtraction angiography, ZTE-MRA, and TOF-MRA were performed in 18 patients diagnosed with IAN. The images of ZTE-MRA and TOF-MRA were compared for image quality, qualitative diagnosis, detailed diagnosis, number of thrombi, and residual aneurysm lumen, with digital subtraction angiography as the reference. RESULTS Zero-echo-time MRA and TOF-MRA did not show a significant difference in image quality or detailed information (including aneurysm size, growth direction, and angle with the aneurysm-carrying vessel) ( P > 0.05). However, ZTE-MRA showed advantages over TOF-MRA in terms of qualitative diagnosis (sensitivity and specificity), intra-aneurismal thrombus detection, and residual aneurysm lumen detection after embolization ( P < 0.05). CONCLUSIONS Compared with TOF-MRA, ZTE-MRA showed greater diagnostic value for IAN patients in terms of qualitative diagnosis, as well as the detection of intra-aneurysm thrombi and residual aneurysm lumen after embolization.
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Affiliation(s)
- Yushi Li
- From the Department of Radiology, The Second Hospital, Dalian Medical University, Dalian
| | - Yifeng Zhu
- From the Department of Radiology, The Second Hospital, Dalian Medical University, Dalian
| | - Yajie Liu
- From the Department of Radiology, The Second Hospital, Dalian Medical University, Dalian
| | - Ge Li
- Department of Oncology, Yankuang New Journey General Hospital, Jining, China
| | - Xiaofeng Qu
- From the Department of Radiology, The Second Hospital, Dalian Medical University, Dalian
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8
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Black SM, Maclean C, Barrientos PH, Ritos K, Kazakidi A. Reconstruction and Validation of Arterial Geometries for Computational Fluid Dynamics Using Multiple Temporal Frames of 4D Flow-MRI Magnitude Images. Cardiovasc Eng Technol 2023; 14:655-676. [PMID: 37653353 PMCID: PMC10602980 DOI: 10.1007/s13239-023-00679-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/08/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE Segmentation and reconstruction of arterial blood vessels is a fundamental step in the translation of computational fluid dynamics (CFD) to the clinical practice. Four-dimensional flow magnetic resonance imaging (4D Flow-MRI) can provide detailed information of blood flow but processing this information to elucidate the underlying anatomical structures is challenging. In this study, we present a novel approach to create high-contrast anatomical images from retrospective 4D Flow-MRI data. METHODS For healthy and clinical cases, the 3D instantaneous velocities at multiple cardiac time steps were superimposed directly onto the 4D Flow-MRI magnitude images and combined into a single composite frame. This new Composite Phase-Contrast Magnetic Resonance Angiogram (CPC-MRA) resulted in enhanced and uniform contrast within the lumen. These images were subsequently segmented and reconstructed to generate 3D arterial models for CFD. Using the time-dependent, 3D incompressible Reynolds-averaged Navier-Stokes equations, the transient aortic haemodynamics was computed within a rigid wall model of patient geometries. RESULTS Validation of these models against the gold standard CT-based approach showed no statistically significant inter-modality difference regarding vessel radius or curvature (p > 0.05), and a similar Dice Similarity Coefficient and Hausdorff Distance. CFD-derived near-wall hemodynamics indicated a significant inter-modality difference (p > 0.05), though these absolute errors were small. When compared to the in vivo data, CFD-derived velocities were qualitatively similar. CONCLUSION This proof-of-concept study demonstrated that functional 4D Flow-MRI information can be utilized to retrospectively generate anatomical information for CFD models in the absence of standard imaging datasets and intravenous contrast.
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Affiliation(s)
| | - Craig Maclean
- Research and Development, Terumo Aortic, Glasgow, UK
| | - Pauline Hall Barrientos
- Clinical Physics, Queen Elizabeth University Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Konstantinos Ritos
- Department of Mechanical and Aerospace Engineering, Glasgow, UK
- Department of Mechanical Engineering, University of Thessaly, Volos, Greece
| | - Asimina Kazakidi
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
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Nagpal P, Grist TM. MR Angiography: Contrast-Enhanced Acquisition Techniques. Magn Reson Imaging Clin N Am 2023; 31:493-501. [PMID: 37414474 DOI: 10.1016/j.mric.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Contrast-enhanced MR angiography (CE-MRA) is a frequently used MR imaging technique for evaluating cardiovascular structures. In many ways, it is similar to contrast-enhanced computed tomography (CT) angiography, except a gadolinium-based contrast agent (instead of iodinated contrast) is injected. Although the physiological principles of contrast injection overlap, the technical factors behind enhancement and image acquisition are different. CE-MRA provides an excellent alternative to CT for vascular evaluation and follow-up without requiring nephrotoxic contrast and ionizing radiation. This review describes the physical principles, limitations, and technical applications of CE-MRA techniques.
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Affiliation(s)
- Prashant Nagpal
- Cardiovascular Imaging, Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53705, USA.
| | - Thomas M Grist
- Radiology, University of Wisconsin Madison, E3/366 600 Highland Avenue, Madison, WI 53792, USA
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10
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Garg I, Grist TM, Nagpal P. MR Angiography for Aortic Diseases. Magn Reson Imaging Clin N Am 2023; 31:373-394. [PMID: 37414467 DOI: 10.1016/j.mric.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Aortic pathologic conditions represent diverse disorders, including aortic aneurysm, acute aortic syndrome, traumatic aortic injury, and atherosclerosis. Given the nonspecific clinical features, noninvasive imaging is critical in screening, diagnosis, management, and posttherapeutic surveillance. Of the commonly used imaging modalities, including ultrasound, computed tomography, and MR imaging, the final choice often depends on a combination of factors: acuity of clinical presentation, suspected underlying diagnosis, and institutional practice. Further research is needed to identify the potential clinical role and define appropriate use criteria for advanced MR applications such as four-dimenional flow to manage patients with aortic pathologic conditions.
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Affiliation(s)
- Ishan Garg
- Department of Internal Medicine, University of New Mexico Health Sciences Center, 1 University Of New Mexico, Albuquerque, NM 87131, USA
| | - Thomas M Grist
- Department of Radiology, University of Wisconsin-Madison, E3/366 Clinical Science Center 600 Highland Avenue Madison, WI 53792, USA
| | - Prashant Nagpal
- Cardiovascular and Thoracic Radiology, University of Wisconsin School of Medicine and Public Health, E3/366 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
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11
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Counseller Q, Aboelkassem Y. Recent technologies in cardiac imaging. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 4:984492. [PMID: 36704232 PMCID: PMC9872125 DOI: 10.3389/fmedt.2022.984492] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/30/2022] [Indexed: 01/11/2023] Open
Abstract
Cardiac imaging allows physicians to view the structure and function of the heart to detect various heart abnormalities, ranging from inefficiencies in contraction, regulation of volumetric input and output of blood, deficits in valve function and structure, accumulation of plaque in arteries, and more. Commonly used cardiovascular imaging techniques include x-ray, computed tomography (CT), magnetic resonance imaging (MRI), echocardiogram, and positron emission tomography (PET)/single-photon emission computed tomography (SPECT). More recently, even more tools are at our disposal for investigating the heart's physiology, performance, structure, and function due to technological advancements. This review study summarizes cardiac imaging techniques with a particular interest in MRI and CT, noting each tool's origin, benefits, downfalls, clinical application, and advancement of cardiac imaging in the near future.
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Affiliation(s)
- Quinn Counseller
- College of Health Sciences, University of Michigan, Flint, MI, United States
| | - Yasser Aboelkassem
- College of Innovation and Technology, University of Michigan, Flint, MI, United States,Michigan Institute for Data Science, University of Michigan, Ann Arbor, MI, United States,Correspondence: Yasser Aboelkassem
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12
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Manole S, Pintican R, Manole V, Rusneac C, Schiau C, Bene I, Solomon C, Dudea S. Rare Case of Intravascular Myopericytoma-Imaging Characteristics and Review of the Literature. Diagnostics (Basel) 2022; 12:diagnostics12102473. [PMID: 36292162 PMCID: PMC9600947 DOI: 10.3390/diagnostics12102473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/26/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
Myopericytoma is a rare vessel wall tumor, a subtype of hemangiopericytoma that usually develops subcutaneously. Intravascular myopericytoma is a rarer subtype, with only few cases reported in the literature and even fewer with imaging modalities included. We report the case of a 36-year-old man who was referred to our institution with a painless, palpable mass in the right arm and was evaluated with MRI, grey-scale and Doppler-mode ultrasound. Tumor histopathology and imaging characteristics are presented together with the role that each imaging modality played in the management of the patient.
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Affiliation(s)
- Simona Manole
- Department of Radiology, “Niculae Stancioiu” Heart Institute, Motilor Street, n. 19-21, 400001 Cluj-Napoca, Romania
- Department of Radiology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Babes Street, nr. 8, 400000 Cluj-Napoca, Romania
| | - Roxana Pintican
- Department of Radiology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Babes Street, nr. 8, 400000 Cluj-Napoca, Romania
- Correspondence:
| | - Viorel Manole
- Department of Cardiovascular Surgery, “Niculae Stancioiu” Heart Institute, Motilor Street, n. 19-21, 400001 Cluj-Napoca, Romania
| | - Cosmin Rusneac
- Department of Radiology, Emergency Clinical County Hospital Cluj-Napoca, Clinicilor Street, n. 3-5, 400006 Cluj-Napoca, Romania
| | - Calin Schiau
- Department of Radiology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Babes Street, nr. 8, 400000 Cluj-Napoca, Romania
| | - Ioana Bene
- Department of Radiology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Babes Street, nr. 8, 400000 Cluj-Napoca, Romania
| | - Carolina Solomon
- Department of Radiology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Babes Street, nr. 8, 400000 Cluj-Napoca, Romania
| | - Sorin Dudea
- Department of Radiology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Babes Street, nr. 8, 400000 Cluj-Napoca, Romania
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Zahergivar A, Kocher M, Waltz J, Kabakus I, Chamberlin J, Akkaya S, Agha AM, Schoepf UJ, Burt JR. The diagnostic value of non-contrast magnetic resonance coronary angiography in the assessment of coronary artery disease: A systematic review and meta-analysis. Heliyon 2021; 7:e06386. [PMID: 33817362 PMCID: PMC8010401 DOI: 10.1016/j.heliyon.2021.e06386] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/28/2020] [Accepted: 02/24/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose The current literature reports a wide range of diagnostic accuracy of non-contrast magnetic resonance coronary angiography (NC-MRCA) for the assessment of coronary artery disease (CAD). We aimed to compare the clinical effectiveness of NC-MRCA with that of invasive coronary angiography (ICA) in patients with suspected CAD using a systematic review and meta-analysis. Methods Two investigators independently extracted 36 published manuscripts between 2010 and 2019. Databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were searched using pre-established keywords. Analysis of the data followed the PRISMA statement for reporting systematic reviews and meta-analyses and primary analysis followed the Mantel-Hansel methodology. Correctness of classification for detecting coronary artery stenosis ≥50% (CAS) was measured using ICA as the gold standard. Results A total of five studies met inclusion criteria, with a total of 417 patients and 2883 coronary segments. The pooled per patient sensitivity and specificity of NC-MRCA for CAS in suspected patients was 90.3% (95% CI 85.6–95.1%) and 77.9% (95% CI 69.5–86.3%). Pooled per vessel assessment of NC- MRCA revealed a sensitivity of 83.7% (95%CI 79.7–87.8%) and specificity of 90.0% (95%CI 86.7–93.4%). Per-segment assessment of NC-MRCA showed a pooled sensitivity of 81.6% (95% CI 76.8–86.4) and specificity of 97.0% (95% CI 95.5–98.5). Mild to moderate heterogeneity was noted in most diagnostic parameters with larger heterogeneity noted in the per-segment analyses. There was less heterogeneity in sensitivity and NPV than specificity and PPV. Conclusion According to this meta-analysis, non-contrast coronary MRA resulted in adequate screening in patients with suspected CAD with high sensitivity and specificity. This result was true for per-patient, per-vessel, and per-segment assessment.
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Affiliation(s)
- Aryan Zahergivar
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Madison Kocher
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Jeffrey Waltz
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Ismail Kabakus
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Jordan Chamberlin
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Selcuk Akkaya
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Ali M Agha
- Department of Internal Medicine, Division of Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - U Joseph Schoepf
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Jeremy R Burt
- Department of Radiology, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
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