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Liu Z, Gu A, Kuang Y, Yu D, Sun Y, Liu H, Xie G. Water excitation with LIBRE pulses in three-dimensional variable flip angle fast spin echo for fat-free and large field of view imaging at 3 tesla. Magn Reson Imaging 2023; 96:17-26. [PMID: 36375762 DOI: 10.1016/j.mri.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/12/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To develop and evaluate a sequence in which water excitation with lipid insensitive binomial off-resonant radio frequency excitation (LIBRE) pulses is incorporated into three-dimensional (3D) variable flip angle fast spin echo (LIBRE-vf-FSE) for fat-free and large field of view imaging at 3 Tesla (T). MATERIALS AND METHODS Numerical simulation was conducted to optimize the parameters of LIBRE pulses, including the flip angle, pulse duration, and frequency offset, for maximizing the fat suppression effect of the proposed LIBRE-vf-FSE sequence. The sequence was then implemented at 3 T and assessed in phantoms, lower extremity imaging of 8 healthy volunteers, and head/neck imaging of 5 healthy volunteers. Conventional water excitation (WE) and fat saturation (FatSat) were also performed for comparison. Signal-to-noise ratio (SNR) of fat and contrast-to-noise ratio (CNR) between fat and water were used to evaluate the level of fat suppression. Standard deviation (SD) of SNR was used to evaluate the uniformity of fat suppression. RESULTS The numerical simulation demonstrated that LIBRE-vf-FSE enables large volume imaging with uniform fat suppression, which was further confirmed by phantom and healthy volunteer experiments. LIBRE provided the lowest fat SNR and offered more uniform fat suppression compared with the WE and FatSat. Specifically, average oil SNRs obtained by LIBRE (1.10 ms, 360 Hz, and 60°), WE, and FatSat were (180.1 vs. 280.2 vs. 811.2) in phantom experiments, and average fat SNRs and SDs in legs obtained by LIBRE (1.10 ms, 360 Hz, and 60°), WE, and FatSat were (85.1 vs. 105.0 vs. 105.1) and (22.4 vs. 27.4 vs. 56.4) in vivo experiments, respectively. CONCLUSION The proposed LIBRE-vf-FSE sequence allows for fat suppression and large field of view imaging at 3 T. It could be an alternative approach for fat-free vf-FSE scan.
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Affiliation(s)
- Zeping Liu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Anyan Gu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yinan Kuang
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Donglin Yu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yi Sun
- Siemens Healthineers, Shanghai 201318, China
| | - Hongyan Liu
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
| | - Guoxi Xie
- School of Biomedical Engineering, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
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Jain N, Avanthika C, Singh A, Jhaveri S, De la Hoz I, Hassen G, Camacho L GP, Carrera KG. Deep Vein Thrombosis in Intravenous Drug Users: An Invisible Global Health Burden. Cureus 2021; 13:e18457. [PMID: 34745781 PMCID: PMC8563142 DOI: 10.7759/cureus.18457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/03/2021] [Indexed: 12/16/2022] Open
Abstract
The prevalence of intravenous drug use has increased in the past decade and it represents an important risk factor for deep vein thrombosis. Intravenous drug use is a global problem, with the main culprit being heroin. Peer pressure and poverty in high-risk groups such as sex workers, females, and young adults raise the risk of intravenous drug use, which expresses itself in the form of venous thromboembolism eventually. Deep vein thrombosis typically manifests itself eight years after the initial intravenous drug administration, rendering it a silent killer. Aiming to review and summarize existing articles in this context, we performed an exhaustive literature search online on PubMed and Google Scholar indexes using the keywords "Deep Venous Thrombosis (DVT)" and "Intravenous Drug Users (IVDU)." English articles that addressed epidemiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, management, and outcomes of DVT, including those in IVDU, were selected and analyzed. The pathogenesis of DVT development in IVDU is mainly attributed to the interplay of trauma to the vessel by repeated injection and the injected drug itself. The right-sided femoral vein is the most common vein affected. Prevalent clinical presentations include local pain, swelling, and redness with typical systemic symptoms including fever, cough, dyspnea, and chest pain on top of addiction features. There appeared to be a delay in reporting symptoms, which was most likely due to the social stigma attached to IVDU. There are over 50 conditions that present with swollen and painful limbs comparable to DVT in IVDU, making precise diagnosis critical for timely treatment. Venous ultrasound is the method of choice for diagnosing DVT. Extended anticoagulant therapy with low-molecular-weight heparin combined with warfarin is the recommended treatment. Intravenous drug abusers having DVT are affected by multiple complications and poorer outcomes such as slower recovery, recurrent venous thromboembolism (VTE), and a longer hospital stay, which put them at higher risk of morbidity, mortality, reduced productivity, and economic burden.
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Affiliation(s)
- Nidhi Jain
- Medicine and Surgery, Himalayan Institute of Medical Sciences, Dehradun, IND
- Internal Medicine, Sir Ganga Ram Hospital, Delhi, IND
- Hematology and Oncology, Brooklyn Cancer Care, Brooklyn, USA
| | | | - Abhishek Singh
- Internal Medicine, Mount Sinai Morningside, New York, USA
| | - Sharan Jhaveri
- Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | | | - Gashaw Hassen
- Medicine and Surgery, University of Parma, Parma, ITA
- Medicine, Addis Ababa University, Addis Ababa, ETH
- Progressive Care Unit, Mercy Medical Center, Baltimore, USA
| | - Genesis P Camacho L
- Division de Estudios para Graduados, Facultad de Medicina, Universidad del Zulia, Maracaibo, VEN
| | - Keila G Carrera
- Gastroenterology, Universidad de Oriente (VEN), Maturin, VEN
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Wu X, Sun J, Chen Z, Ding Y, Meng R. Magnetic resonance black-blood thrombus imaging can confirm chronic cerebral venous thrombosis: a case report and literature review. J Int Med Res 2021; 49:3000605211017001. [PMID: 34013759 PMCID: PMC8142535 DOI: 10.1177/03000605211017001] [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] [Indexed: 12/03/2022] Open
Abstract
Background Cerebral venous thrombosis (CVT) is easily missed or misdiagnosed in clinical settings because of its high variability in terms of symptoms and radiological findings. Herein, we aimed to explore a promising modality for confirming presumed CVT in the hope to uncover its superior diagnostic performance to conventional imaging modalities. Case presentation: The patient complained of intolerable pain in her forehead and left eye. Her lumbar puncture opening pressure was 140 mmH2O, and her cerebrospinal fluid composition was normal. No marked abnormalities were observed in routine brain images, including non-contrast computed tomography, magnetic resonance imaging, and contrast-enhanced magnetic resonance venography. However, chronic mural thrombi in the lumen of the left cortical veins, transverse/sigmoid sinus, and superior sagittal sinus were identified in magnetic resonance black-blood thrombus imaging (MRBTI) maps. Conclusions MRBTI can be used to directly and non-invasively visualize thrombi, and may thus be a promising tool over alternative routine techniques for confirming the diagnosis of CVT.
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Affiliation(s)
- Xiaoqin Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jingkun Sun
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhiying Chen
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuchuan Ding
- Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ran Meng
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
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