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Weigel M, Celicanin Z, Haas T, Bieri O. Feasibility of interleaved multislice averaged magnetization inversion-recovery acquisitions of the spinal cord. Magn Reson Med 2024. [PMID: 39051628 DOI: 10.1002/mrm.30223] [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: 09/01/2023] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE To establish an interleaved multislice variant of the averaged magnetization inversion-recovery acquisitions (AMIRA) approach for 2D spinal cord imaging with increased acquisition efficiency compared with the conventional 2D single-slice approach(es), and to determine essential prerequisites for a working interleaved multislice AMIRA approach in practice. METHODS The general AMIRA concept is based on an inversion recovery-prepared, segmented, and time-limited cine balanced SSFP sequence, generating images of different contrast. For AMIRA imaging of multiple, independent slices in a 2D interleaved fashion, a slice loop within the acquisition loops was programmed. The former non-selective inversions were replaced with slice-selective inversions with user-definable slice thickness. RESULTS The thickness of the slice-selective inversion in 2D interleaved multislice AMIRA should be doubled compared with the manufacturer's standard setting to avoid an increased sensitivity to flow and pulsation effects particularly in the CSF. However, this solution also limits its practical applicability, as slices located at directly adjacent vertebrae cannot be imaged together. Successful interleaved two-slice AMIRA imaging for a "reference" in vivo protocol with 0.50 × 0.50 mm2 in-plane resolution and 8-mm slice thickness is demonstrated, therefore halving its acquisition time per slice from 3 min down to 1.5 min. CONCLUSION The investigated 2D interleaved two-slice AMIRA variant facilitates spinal cord imaging that maintains similar contrast and the same resolution as the conventional 2D single-slice AMIRA approach, but does so with a halved acquisition time.
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Affiliation(s)
- Matthias Weigel
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Zarko Celicanin
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland
- Center for Proton Therapy, Paul Scherrer Institute, Villigen PSI, Switzerland
| | - Tanja Haas
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Oliver Bieri
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
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2
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Chen YL, Chen W. Radial Planes in Hip Magnetic Resonance Imaging: Techniques, Applications, and Perspectives. J Magn Reson Imaging 2024; 60:8-20. [PMID: 37746892 DOI: 10.1002/jmri.29029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023] Open
Abstract
The hip cartilage and labrum, as the main targets of femoroacetabular impingement, sports-related or traumatic damage, as well as congenital and developmental abnormalities, have attracted increasing attention with the development of magnetic resonance imaging (MRI) and hip arthroscopy. MRI is a commonly used imaging modality to noninvasively visualize the hip cartilage and labral lesions. However, conventional orthogonal MRI planes encounter unique challenges given the ball-and-socket configuration of the hip joint, its anatomically abducted and anteverted orientation, and the thin, closely apposed cartilage enveloping the femoral head and acetabulum. Advancements in hip MRI's radial plane, which is acquired through the center of the hip joint, offer a solution. This technology provides true cross-sectional images of the cartilage and labrum perpendicular to the curvature of the joint, thereby mitigating the partial-volume-averaging effects. The integration of 3.0-Tesla high field strength and three-dimensional (3D) acquisition techniques further enhances the capabilities of the radial plane. This combination yields a high signal-to-noise ratio, high spatial resolution, high contrast between intraarticular structures, while minimizing partial-volume-averaging effects. Such improvements potentially facilitate the comprehensive detection of even minor chondral and labral lesions. The capability for multiplanar reconstruction from a single 3D volumetric acquisition further strengthens the usefulness of the radial plane by aiding in precise localization of hip cartilage and labral lesions, in line with hip arthroscopy findings. These advancements have the potential to standardize MRI evaluations and radiographic reporting systems for hip cartilage and labrum, offering precise guidance for hip arthroscopy. This article presents a comprehensive review of radial plane technology applied to the hip MRI, and discusses the morphological assessment and localization of hip cartilage and labral lesions utilizing this advanced imaging technique. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yan-Li Chen
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- 7T Magnetic Resonance Imaging Translational Medical Center, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wei Chen
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- 7T Magnetic Resonance Imaging Translational Medical Center, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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3
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Padilha IG, Fonseca APA, Amancio CT, Vieira APF, Pacheco FT, da Rocha AJ. Vascular Myelopathies. Semin Ultrasound CT MR 2023; 44:408-423. [PMID: 37690793 DOI: 10.1053/j.sult.2023.03.014] [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: 04/08/2023]
Abstract
There are many vascular disorders that can affect the spinal cord, and their prevalence and etiology are highly influenced by age, sex, and risk factors. This article reviews the embryology and anatomy of the spinal cord, as well as several vascular conditions, describing their clinical and imaging presentation, emphasizing the different imaging modalities' contributions to increasing specificity and better defining the most appropriate therapy strategy for improving the patient's prognosis.
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Affiliation(s)
- Igor Gomes Padilha
- Division of Neuroradiology, Diagnósticos da América SA-DASA, São Paulo, SP, Brazil; Division of Neuroradiology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil; Division of Neuroradiology, Unitedhealth Group, São Paulo, SP, Brazil.
| | - Ana Paula Alves Fonseca
- Division of Neuroradiology, Diagnósticos da América SA-DASA, São Paulo, SP, Brazil; Division of Neuroradiology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil; Division of Neuroradiology, Unitedhealth Group, São Paulo, SP, Brazil
| | - Camila Trolez Amancio
- Division of Neuroradiology, Diagnósticos da América SA-DASA, São Paulo, SP, Brazil; Division of Neuroradiology, Hospital Sirio-Libanês, São Paulo, SP, Brazil
| | | | - Felipe Torres Pacheco
- Division of Neuroradiology, Diagnósticos da América SA-DASA, São Paulo, SP, Brazil; Division of Neuroradiology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Antônio José da Rocha
- Division of Neuroradiology, Diagnósticos da América SA-DASA, São Paulo, SP, Brazil; Division of Neuroradiology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
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4
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Optimized multi-echo gradient-echo magnetic resonance imaging for gray and white matter segmentation in the lumbosacral cord at 3 T. Sci Rep 2022; 12:16498. [PMID: 36192560 PMCID: PMC9530158 DOI: 10.1038/s41598-022-20395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022] Open
Abstract
Atrophy in the spinal cord (SC), gray (GM) and white matter (WM) is typically measured in-vivo by image segmentation on multi-echo gradient-echo magnetic resonance images. The aim of this study was to establish an acquisition and analysis protocol for optimal SC and GM segmentation in the lumbosacral cord at 3 T. Ten healthy volunteers underwent imaging of the lumbosacral cord using a 3D spoiled multi-echo gradient-echo sequence (Siemens FLASH, with 5 echoes and 8 repetitions) on a Siemens Prisma 3 T scanner. Optimal numbers of successive echoes and signal averages were investigated comparing signal-to-noise (SNR) and contrast-to-noise ratio (CNR) values as well as qualitative ratings for segmentability by experts. The combination of 5 successive echoes yielded the highest CNR between WM and cerebrospinal fluid and the highest rating for SC segmentability. The combination of 3 and 4 successive echoes yielded the highest CNR between GM and WM and the highest rating for GM segmentability in the lumbosacral enlargement and conus medullaris, respectively. For segmenting the SC and GM in the same image, we suggest combining 3 successive echoes. For SC or GM segmentation only, we recommend combining 5 or 3 successive echoes, respectively. Six signal averages yielded good contrast for reliable SC and GM segmentation in all subjects. Clinical applications could benefit from these recommendations as they allow for accurate SC and GM segmentation in the lumbosacral cord.
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Evaluation of axial gradient Echo spiral MRI of the spine at 1.5 T. Magn Reson Imaging 2022; 89:24-32. [DOI: 10.1016/j.mri.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 11/18/2022]
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Uchiyama Y, Sasai T, Murakami S. Multiple-echo recombined gradient echo MR imaging of the temporomandibular joint. Oral Radiol 2022; 38:490-496. [PMID: 35022930 DOI: 10.1007/s11282-021-00579-7] [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: 07/26/2021] [Accepted: 11/19/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study was to compare images generated by a multiple-echo recombined gradient echo (MERGE) with the proton density-weighted fast spin-echo (PD-weighted FSE) sequence, T1-weighted fast spin-echo sequence (T1-weighted FSE), and T2-weighted fast spin-echo sequence (T2-weighted FSE) for the diagnostic imaging of the temporomandibular joint (TMJ). MATERIALS AND METHODS Twenty-three patients with signs and symptoms of TMJ dysfunction were enrolled in this study. The four imaging modalities were used to examine the TMJ. Three images (lateral, middle, and medial parts of the condylar head) were reviewed by two radiologists, who rated the visibility of the disk and cortex of the condylar head. RESULTS For the medial part of the TMJ, in cases with a normally positioned disk, the results of the MERGE and PD-weighted FSE techniques were significantly better than those of the T1-weighted FSE and T2-weighted FSE. For visibility of the cortex in the normally positioned disk, MERGE was significantly better than PD-weighted FSE [P < 0.0125 (0.05/4)] at the middle and medial parts of the TMJ. MERGE was also significantly better than T1-weighted FSE [P < 0.0125 (0.05/4)] and T2-weighted FSE [P < 0.0125 (0.05/4)]. CONCLUSION MERGE is better for visualizing the condylar only at the middle and the medial aspects of the TMJ in a normally positioned disk.
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Affiliation(s)
- Yuka Uchiyama
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Tadashi Sasai
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Barnaure I, Galley J, Fritz B, Sutter R. Magnetic resonance imaging in the evaluation of cervical foraminal stenosis: comparison of 3D T2 SPACE with sagittal oblique 2D T2 TSE. Skeletal Radiol 2022; 51:1453-1462. [PMID: 35006279 PMCID: PMC9098590 DOI: 10.1007/s00256-022-03988-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/30/2021] [Accepted: 01/02/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The oblique orientation of the cervical neural foramina challenges the implementation of a short MRI protocol with concurrent excellent visualization of the spine. While sagittal oblique T2-weighted sequences permit good evaluation of the cervical neuroforamina, all segments may not be equally well depicted on a single sequence and conspicuity of foraminal stenosis may be limited. 3D T2-weighted sequences can be reformatted in arbitrary planes, including the sagittal oblique. We set out to compare 3D T2w SPACE sequences with sagittal oblique reformations and sagittal oblique 2D T2w TSE sequences for the evaluation of cervical foraminal visibility and stenosis. MATERIALS AND METHODS Sixty consecutive patients who underwent MRI of the cervical spine with sagittal oblique 2D T2w TSE and 3D T2w SPACE sequences were included. Image homogeneity of the sequences was evaluated. Imaging sets were assessed for structure visibility and foraminal stenosis by two independent readers. Results of the sequences were compared by Wilcoxon matched-pairs tests. Interreader agreement was evaluated by weighted κ. RESULTS Visibility of most structures was rated good to excellent on both sequences (mean visibility scores ≥ 4.5 of 5), though neuroforaminal contents were better seen on sagittal oblique T2w TSE (mean scores 4.1-4.6 vs. 3.1-4.1 on 3D T2w SPACE, p < 0.01). Stenosis grades were comparable between sequences (mean 1.1-2.6 of 4), with slightly higher values for 3D T2w SPACE at some levels (difference ≤ 0.3 points). CONCLUSION 3D T2w SPACE is comparable with sagittal oblique 2D T2w TSE in the evaluation of cervical neural foramina.
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Affiliation(s)
- I Barnaure
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - J Galley
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - B Fritz
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - R Sutter
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
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New and Advanced Magnetic Resonance Imaging Diagnostic Imaging Techniques in the Evaluation of Cranial Nerves and the Skull Base. Neuroimaging Clin N Am 2021; 31:665-684. [PMID: 34689938 DOI: 10.1016/j.nic.2021.06.006] [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: 11/20/2022]
Abstract
The skull base and cranial nerves are technically challenging to evaluate using magnetic resonance (MR) imaging, owing to a combination of anatomic complexity and artifacts. However, improvements in hardware, software and sequence development seek to address these challenges. This section will discuss cranial nerve imaging, with particular attention to the techniques, applications and limitations of MR neurography, diffusion tensor imaging and tractography. Advanced MR imaging techniques for skull base pathology will also be discussed, including diffusion-weighted imaging, perfusion and permeability imaging, with a particular focus on practical applications.
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9
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Truong M, Håkansson C, HaileMichael M, Svensson J, Lätt J, Markenroth Bloch K, Siemund R, Gonçalves I, Wassélius J. The potential role of T2*-weighted multi-echo data image combination as an imaging marker for intraplaque hemorrhage in carotid plaque imaging. BMC Med Imaging 2021; 21:121. [PMID: 34380454 PMCID: PMC8356411 DOI: 10.1186/s12880-021-00652-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/14/2021] [Indexed: 01/14/2023] Open
Abstract
Background Carotid atherosclerotic plaques with intraplaque hemorrhage (IPH) are associated with elevated stroke risk. IPH is predominantly imaged based on paramagnetic properties of the upstream hemoglobin degradation product methemoglobin. This is an explorative observational study to test the feasibility of a spoiled gradient echo based T2* weighted MRI sequence (3D MEDIC) for carotid plaque imaging, and to compare signs suggestive of the downstream degradation product hemosiderin on 3D MEDIC with signs of methemoglobin on a T1wBB sequence.
Methods Patients with recent TIA or stroke were selected based on the presence on non-calcified plaque components on CTA to promote an enriched prevalence of IPH in the material. Patients (n = 42) underwent 3T MRI with 3D MEDIC and 2D turbo spin echo T1w black blood (T1wBB). Images were independently evaluated by two neuroradiologists and Cohens Kappa was used for inter-reader agreement for each sequence. Results The technical feasibility for 3D MEDIC, was 34/42 patients (81%). Non-calcified plaque components with susceptibility effect without simultaneous T1-shortening—a combination suggestive of hemosiderin, was seen in 13/34 of the plaques. An equally large group display elevated T1w signal in combination with signal loss on 3D MEDIC, a combination suggestive of both hemosiderin and methemoglobin. Cohen’s kappa for inter-reader agreement was 0.64 (CI 0.345–0.925) for 3D MEDIC and 0.94 (CI 0.81–1.00) for T1wBB. Conclusions 3D MEDIC shows signal loss, without elevated T1w signal on T1wBB, in non-calcified tissue in many plaques in this group of patients. If further studies, including histological verification, confirm that the 3D MEDIC susceptibility effect is indeed caused by hemosiderin, 3D MEDIC could aid in the detection of IPH, beyond elevation of T1w signal.
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Affiliation(s)
- My Truong
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Claes Håkansson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Makda HaileMichael
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Jonas Svensson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Medical Radiation Physics, Department of Translational Medicine, Lund University , Lund, Sweden
| | - Jimmy Lätt
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | | | - Roger Siemund
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Isabel Gonçalves
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö , Sweden
| | - Johan Wassélius
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden. .,Department of Clinical Sciences, Lund University, Lund, Sweden. .,Department of Radiology, Skåne University Hospital, 221 85, Lund, Sweden.
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Spinal vascular lesions: anatomy, imaging techniques and treatment. Eur J Radiol Open 2021; 8:100369. [PMID: 34307789 PMCID: PMC8283341 DOI: 10.1016/j.ejro.2021.100369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/23/2021] [Accepted: 07/04/2021] [Indexed: 11/23/2022] Open
Abstract
Vascular myelopathies include different aetiology and mechanism of damage. The level of the lesion and the localization within the SC correlates with the clinical symptoms. CT, MRI and angiography are essential for diagnosis and treatment playing a complementary role. MRI is the gold standard for the evaluation of spinal cord lesions. Spinal angiography is the gold standard for evaluation of spinal cord vasculature and vascular malformations.
Background Vascular lesions of the spinal cord are rare but potentially devastating conditions whose accurate recognition critically determines the clinical outcome. Several conditions lead to myelopathy due to either arterial ischemia, venous congestion or bleeding within the cord. The clinical presentation varies, according with the different aetiology and mechanism of damage. Purpose The aim is to provide a comprehensive review on the radiological features of the most common vascular myelopathies, passing through the knowledge of the vascular spinal anatomy and the clinical aspects of the different aetiologies, which is crucial to promptly address the diagnosis and the radiological assessment.
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Condette-Auliac S, Gratieux J, Boulin A, Di Maria F, Consoli A, Coskun O, Smajda S, Rodesch G. Imaging of vascular diseases of the spinal cord. Rev Neurol (Paris) 2021; 177:477-489. [PMID: 33902944 DOI: 10.1016/j.neurol.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/13/2021] [Indexed: 11/15/2022]
Affiliation(s)
- S Condette-Auliac
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch, Suresnes, France.
| | - J Gratieux
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch, Suresnes, France
| | - A Boulin
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch, Suresnes, France
| | - F Di Maria
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch, Suresnes, France
| | - A Consoli
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch, Suresnes, France
| | - O Coskun
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch, Suresnes, France
| | - S Smajda
- Department of interventional Neuroradiology, Fondation Rotschild, Paris, France
| | - G Rodesch
- Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch, Suresnes, France
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Asiri A, Dimpudus F, Atcheson N, Al‐Najjar A, McMahon K, Kurniawan ND. Comparison between 2D and 3D MEDIC for human cervical spinal cord MRI at 3T. J Med Radiat Sci 2021; 68:4-12. [PMID: 32931647 PMCID: PMC7890925 DOI: 10.1002/jmrs.433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 08/06/2020] [Accepted: 08/27/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION High-resolution magnetic resonance imaging (MRI) of the cervical spinal cord is important to provide accurate diagnosis and pathological assessment of injuries. MEDIC (Multiple Echo Data Image Combination) sequences have been used in clinical MRI; however, a comparison of the performance of 2D and 3D MEDIC for cervical spinal cord imaging has not been reported. The aim of this study is to compare axial 2D and 3D MEDIC for the visualisation of the grey matter (GM) and white matter (WM) of the human cervical spinal cord. METHODS Eight healthy participants were scanned using Siemens Prismafit 3T MRI. T2*-weighted gradient spoiled 2D and 3D MEDIC sequences were acquired at 0.4 × 0.4 × 3.0 and 0.3 × 0.3 × 3.0 mm resolutions, with the acquisition times of 6 and 7 min, respectively. Quantitative analyses of the images were made based on the image signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and non-uniformity (NU). Two independent radiologists (CS and FN), each provided Likert scoring assessments of anatomical visibility of the GM and WM structures and image clarity for all samples. RESULTS Quantitative evaluation showed that 3D MEDIC provided higher SNR, higher CNR and lower NU than 2D MEDIC. However, 2D MEDIC provided better anatomical visibility for the GM, WM and CSF, and higher image clarity (lower artefacts) compared to 3D MEDIC. CONCLUSIONS 2D MEDIC provides better information for depicting the internal structures of the cervical spinal cord compared to 3D MEDIC.
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Affiliation(s)
- Abdullah Asiri
- Centre for Advanced ImagingUniversity of QueenslandBrisbaneAustralia
- Radiological Sciences DepartmentCollege of Applied Medical SciencesNajran UniversityNajranSaudi Arabia
| | - Franky Dimpudus
- Centre for Advanced ImagingUniversity of QueenslandBrisbaneAustralia
- Rumah Sakit Premier Surabaya ‐ Ramsay Sime Darby HealthcareSurabayaIndonesia
| | - Nicole Atcheson
- Centre for Advanced ImagingUniversity of QueenslandBrisbaneAustralia
| | - Aiman Al‐Najjar
- Centre for Advanced ImagingUniversity of QueenslandBrisbaneAustralia
| | - Katie McMahon
- Centre for Advanced ImagingUniversity of QueenslandBrisbaneAustralia
- Herston Imaging Research FacilitySchool of Clinical SciencesInstitute of Health and Biomedical InnovationQueensland University of TechnologyBrisbaneAustralia
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Koktzoglou I, Huang R, Ong AL, Aouad PJ, Walker MT, Edelman RR. High spatial resolution whole-neck MR angiography using thin-slab stack-of-stars quiescent interval slice-selective acquisition. Magn Reson Med 2020; 84:3316-3324. [PMID: 32521094 DOI: 10.1002/mrm.28339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To report a 3D multi-echo thin-slab stack-of-stars (tsSOS) quiescent-interval slice-selective (QISS) strategy for high-resolution magnetic resonance angiography (MRA) of the entire neck in under seven minutes. METHODS The neck arteries of eight subjects were imaged at 3 Tesla. Multi-echo 3D tsSOS QISS using a FLASH readout was compared with 3D tsSOS FLASH, 2D QISS, 2D TOF, and 3D TOF. A root-mean-square (RMS) combination of echo time images was tested. Evaluation metrics included arterial signal-to-noise ratio (SNR), arterial-to-muscle contrast-to-noise ratio (CNR), and image quality. RESULTS 3D multi-echo tsSOS QISS using a RMS combination of echo time images increased SNR and CNR by 60% and 63% with respect to the reconstruction obtained with the shortest echo time. 3D tsSOS QISS showed superior CNR with respect to 3D tsSOS FLASH imaging, and more than 3-fold higher SNR and CNR with respect to 2D radial QISS when normalized for voxel size. 3D tsSOS QISS provided good to excellent image quality that exceeded the image quality of 2D QISS, 2D TOF, and 3D TOF (P < .05). CONCLUSION Whole-neck high-resolution nonenhanced MRA is feasible using 3D tsSOS QISS, and produced image quality that exceeded those of competing nonenhanced MRA protocols at 3 Tesla.
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Affiliation(s)
- Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Rong Huang
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Archie L Ong
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.,Department of Neurology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Pascale J Aouad
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew T Walker
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Robert R Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Marrodan M, Gaitán MI, Correale J. Spinal Cord Involvement in MS and Other Demyelinating Diseases. Biomedicines 2020; 8:E130. [PMID: 32455910 PMCID: PMC7277673 DOI: 10.3390/biomedicines8050130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
Diagnostic accuracy is poor in demyelinating myelopathies, and therefore a challenge for neurologists in daily practice, mainly because of the multiple underlying pathophysiologic mechanisms involved in each subtype. A systematic diagnostic approach combining data from the clinical setting and presentation with magnetic resonance imaging (MRI) lesion patterns, cerebrospinal fluid (CSF) findings, and autoantibody markers can help to better distinguish between subtypes. In this review, we describe spinal cord involvement, and summarize clinical findings, MRI and diagnostic characteristics, as well as treatment options and prognostic implications in different demyelinating disorders including: multiple sclerosis (MS), neuromyelitis optica spectrum disorder, acute disseminated encephalomyelitis, anti-myelin oligodendrocyte glycoprotein antibody-associated disease, and glial fibrillary acidic protein IgG-associated disease. Thorough understanding of individual case etiology is crucial, not only to provide valuable prognostic information on whether the disorder is likely to relapse, but also to make therapeutic decision-making easier and reduce treatment failures which may lead to new relapses and long-term disability. Identifying patients with monophasic disease who may only require acute management, symptomatic treatment, and subsequent rehabilitation, rather than immunosuppression, is also important.
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Affiliation(s)
| | | | - Jorge Correale
- Neurology Department, Fleni, C1428AQK Buenos Aires, Argentina; (M.M.); (M.I.G.)
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15
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3D PSIR MRI at 3 Tesla improves detection of spinal cord lesions in multiple sclerosis. J Neurol 2019; 267:406-414. [DOI: 10.1007/s00415-019-09591-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
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16
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Comparison Between 3-Dimensional Multiple-Echo Recombined Gradient Echo Magnetic Resonance Imaging and Arthroscopic Findings for the Evaluation of Acetabular Labrum Tear. Arthroscopy 2019; 35:2857-2865. [PMID: 31604505 DOI: 10.1016/j.arthro.2019.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate radially reconstructed 3.0-Tesla 3-dimensional multiple-echo recombined gradient echo (MERGE) magnetic resonance imaging (MRI) without arthrography for the assessment of acetabular labrum tears, using arthroscopic evaluation as the reference standard. METHODS A total of 71 consecutive hips, including 29 with femoroacetabular impingement, 26 with borderline developmental dysplasia of the hip, and 16 with early-stage osteoarthritis, were evaluated in this retrospective study. MERGE MRI findings were evaluated according to the modified Czerny classification for 3 regions of interest: anterior region, anterolateral region, and lateral region. Cases with severe degeneration that was not concordant with any stage in the original Czerny classification were defined as stage Ⅳ. MERGE MRI findings were compared with arthroscopic findings, and the sensitivity, specificity, positive predictive value, and negative predictive value in terms of the existence of labrum tears were calculated. RESULTS MERGE MRI findings revealed labrum tears more frequently in the anterolateral region than in the anterior and lateral regions (P < .01). In cases of femoroacetabular impingement and borderline developmental dysplasia of the hip in particular, labrum tears were more frequently observed on MRI in the anterolateral region than in the lateral region (P < .05). In comparison with MRI findings and arthroscopic findings, our newly defined stage IV in the modified Czerny classification was more frequently observed in cases with a Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN) classification of degenerative or complex (P < .01). The average sensitivity and specificity of all regions for the existence of labrum tears were 85% and 56%, respectively. Sensitivity and specificity were 79% and 50%, respectively, in the anterior region; 96% and 50%, respectively, in the anterolateral region; and 70% and 57%, respectively, in the lateral region. CONCLUSIONS We validated the diagnostic performance of 3.0-Tesla 3-dimensional MERGE MRI for evaluating acetabular labrum tears and made comparisons with arthroscopic findings. Radially reconstructed MERGE magnetic resonance images showed excellent sensitivity for the diagnosis of labrum tears, particularly in the anterolateral region. The newly defined stage IV was distinctive of early-stage osteoarthritis cases with degeneration and/or complex arthroscopic findings. The noninvasive imaging modality of radially reconstructed MERGE MRI may be an alternative to magnetic resonance arthrography for evaluating labrum tears. LEVELS OF EVIDENCE Level Ⅱ, development of diagnostic criteria.
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17
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Juliano AF, Policeni B, Agarwal V, Burns J, Bykowski J, Harvey HB, Hoang JK, Hunt CH, Kennedy TA, Moonis G, Pannell JS, Parsons MS, Powers WJ, Rosenow JM, Schroeder JW, Slavin K, Whitehead MT, Corey AS. ACR Appropriateness Criteria® Ataxia. J Am Coll Radiol 2019; 16:S44-S56. [PMID: 31054758 DOI: 10.1016/j.jacr.2019.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/08/2019] [Indexed: 01/14/2023]
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18
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Pathmanathan AU, Schmidt MA, Brand DH, Kousi E, van As NJ, Tree AC. Improving fiducial and prostate capsule visualization for radiotherapy planning using MRI. J Appl Clin Med Phys 2019; 20:27-36. [PMID: 30756456 PMCID: PMC6414142 DOI: 10.1002/acm2.12529] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/06/2018] [Accepted: 12/10/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Intraprostatic fiducial markers (FM) improve the accuracy of radiotherapy (RT) delivery. Here we assess geometric integrity and contouring consistency using a T2*-weighted (T2*W) sequence alone, which allows visualization of the FM. MATERIAL AND METHODS Ten patients scanned within the Prostate Advances in Comparative Evidence (PACE) trial (NCT01584258) had prostate images acquired with computed tomography (CT) and Magnetic Resonance (MR) Imaging: T2-weighted (T2W) and T2*W sequences. The prostate was contoured independently on each imaging dataset by three clinicians. Interobserver variability was assessed using comparison indices with Monaco ADMIRE (research version 2.0, Elekta AB) and examined for statistical differences between imaging sets. CT and MR images of two test objects were acquired to assess geometric distortion and accuracy of marker positioning. The first was a linear test object comprising straight tubes in three orthogonal directions, the second was a smaller test object with markers suspended in gel. RESULTS Interobserver variability for prostate contouring was lower for both T2W and T2*W compared to CT, this was statistically significant when comparing CT and T2*W images. All markers are visible in T2*W images with 29/30 correctly identified, only 3/30 are visible in T2W images. Assessment of geometric distortion revealed in-plane displacements were under 0.375 mm in MRI, and through plane displacements could not be detected. The signal loss in the MR images is symmetric in relation to the true marker position shown in CT images. CONCLUSION Prostate T2*W images are geometrically accurate, and yield consistent prostate contours. This single sequence can be used to identify FM and for prostate delineation in a mixed MR-CT workflow.
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Affiliation(s)
- Angela U Pathmanathan
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Maria A Schmidt
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Douglas H Brand
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Evanthia Kousi
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Nicholas J van As
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Alison C Tree
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
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19
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Abstract
There are many ways to image the spine. Although there is not one correct and many incorrect ways, the choice of sequences and parameters allows optimization of the protocol to the particular question that is to be answered and also to the particular preferences of the Radiologist.
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20
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Sueoka T, Tanitame K, Honda Y, Shoji T, Yamasaki T, Adachi N, Kazuo A. Utility of radial reformation of three-dimensional fat-suppressed multi-echo gradient-recalled-echo images for the evaluation of acetabular labral injuries and femoroacetabular impingement. Skeletal Radiol 2019; 48:267-273. [PMID: 30006827 DOI: 10.1007/s00256-018-3026-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/24/2018] [Accepted: 07/05/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To assess the utility of the radial reformation of three-dimensional fat-suppressed multi-echo gradient-recalled-echo (3D FS me-GRE) for evaluating acetabular labral injuries and femoroacetabular impingement (FAI). MATERIALS AND METHODS A total of 25 patients with suspected acetabular labral injuries were examined using 3D FS me-GRE and radial 2D T2*-weighted imaging (T2*WI) on a 3-T magnetic resonance imaging (MRI) scanner. The range of acetabular labral injuries was evaluated by radial reformation through the center of the acetabulum perpendicular to the plane across the entire acetabular rim (type 1 radial reformation) of 3D FS me-GRE and radial 2D T2*WI. To evaluate the FAI morphology, we performed radial reformation perpendicular to the central axis of the femoral head and neck (type 2 radial reformation) of 3D FS me-GRE. RESULTS Acetabular labral injuries were identified in 23 patients, and no acetabular labral injury was seen in two patients on type 1 radial reformation of 3D FS me-GRE and radial 2D T2*WI. The diagnostic concordance rate for the range of acetabular labral injuries between the two imaging methods was 76.0%, and there was excellent agreement for the injured angles (r = 0.977, p < 0.001). FAI morphology could be evaluated in all patients (no FAI, n = 8; cam, n = 10; pincer, n = 4; combined cam and pincer, n = 3) using type 2 radial reformation of 3D FS me-GRE. CONCLUSIONS Type 1 and type 2 radial reformations of 3D FS me-GRE imaging were useful for evaluating acetabular labral injuries and determining whether patients with acetabular labral injuries have FAI, respectively.
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Affiliation(s)
- Takahiro Sueoka
- Department of Diagnostic Radiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Keizo Tanitame
- Department of Radiology, Chugoku Rosai Hospital, Hiro-Tagaya 1-5-1, Kure, 737-0193, Japan.
| | - Yukiko Honda
- Department of Diagnostic Radiology, Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Shoji
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Takuma Yamasaki
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Awai Kazuo
- Department of Diagnostic Radiology, Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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21
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Fechner A, Savatovsky J, El Methni J, Sadik JC, Gout O, Deschamps R, Gueguen A, Lecler A. A 3T Phase-Sensitive Inversion Recovery MRI Sequence Improves Detection of Cervical Spinal Cord Lesions and Shows Active Lesions in Patients with Multiple Sclerosis. AJNR Am J Neuroradiol 2019; 40:370-375. [PMID: 30679225 DOI: 10.3174/ajnr.a5941] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/29/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Magnetic Resonance Imaging is the modality of choice to detect spinal cord lesions in patients with Multiple Sclerosis (MS). However, this imaging is challenging. New sequences such as phase-sensitive inversion recovery have been developed to improve detection. Our aim was to compare a 3D phase-sensitive inversion recovery and a conventional imaging dataset including postcontrast T2WI and T1WI to detect MS spinal cord lesions. MATERIALS AND METHODS This retrospective single-center study included 100 consecutive patients with MS (mean age, 41 years) from January 2015 to June 2016. One senior neuroradiologist and 1 junior radiologist blinded to clinical data checked for new spinal cord lesions, individually analyzing conventional and 3D phase-sensitive inversion recovery datasets separately, placing a 3-week delay between the 2 readings. A consensus reading was done with a third senior neuroradiologist. A Wilcoxon test was used to compare the 2 imaging datasets. Intra- and interobserver agreement was assessed by the κ coefficient. RESULTS 3D phase-sensitive inversion recovery detected significantly more lesions than conventional imaging (480 versus 168, P < .001). Eleven patients had no detected lesions on T2WI, whereas 3D phase-sensitive inversion recovery detected at least 1 lesion. All postcontrast T1WI enhancing lesions were also visible on 3D phase-sensitive inversion recovery. The signal-to-noise ratio was significantly higher using 3D phase-sensitive inversion recovery (0.63 versus 0.46, P = .03). Mean reading confidence was significantly higher using 3D phase-sensitive inversion recovery. Inter- and intraobserver agreement was good for both datasets. CONCLUSIONS Our study showed that 3D phase-sensitive inversion recovery significantly improved detection of cervical spinal cord lesions, including both enhancing and nonenhancing lesions in patients with MS.
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Affiliation(s)
- A Fechner
- From the Departments of Neuroradiology (A.F., J.S., J.C.S., A.L.)
| | - J Savatovsky
- From the Departments of Neuroradiology (A.F., J.S., J.C.S., A.L.)
| | - J El Methni
- Laboratoire MAP5, UMR CNRS 8145 (J.E.M.), Université Paris Descartes, Paris, France
| | - J C Sadik
- From the Departments of Neuroradiology (A.F., J.S., J.C.S., A.L.)
| | - O Gout
- Neurology (O.G., R.D., A.G.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - R Deschamps
- Neurology (O.G., R.D., A.G.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - A Gueguen
- Neurology (O.G., R.D., A.G.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - A Lecler
- From the Departments of Neuroradiology (A.F., J.S., J.C.S., A.L.)
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22
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Abstract
Spinal cord (SC) MRI in multiple sclerosis (MS) has significant usefulness in clinical and investigational settings. Conventional MRI of the SC is used in clinical practice, because it has both diagnostic and prognostic value. A number of advanced, quantitative SC MRI measures that assess the structural and functional integrity of the SC have been evaluated in investigational settings. These techniques have collectively demonstrated usefulness in providing insight into microstructural and functional changes relevant to disability in MS. With further development, these techniques may be useful in clinical trial settings as biomarkers of neurodegeneration and protection, and in day-to-day clinical practice.
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Affiliation(s)
- Alexandra Muccilli
- Division of Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada; Division of Neurology, Centre Hospitalier de L'Université de Montréal, Université de Montréal, 1058 Saint-Denis Street, Montreal, Quebec H2X 3J4, Canada
| | - Estelle Seyman
- Division of Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada
| | - Jiwon Oh
- Division of Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada; Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
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23
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Zarghami N, Khrapitchev AA, Perez-Balderas F, Soto MS, Larkin JR, Bau L, Sibson NR. Optimization of molecularly targeted MRI in the brain: empirical comparison of sequences and particles. Int J Nanomedicine 2018; 13:4345-4359. [PMID: 30100719 PMCID: PMC6064157 DOI: 10.2147/ijn.s158071] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Molecular MRI is an evolving field of research with strong translational potential. Selection of the appropriate MRI sequence, field strength and contrast agent depend largely on the application. The primary aims of the current study were to: 1) assess the sensitivity of different MRI sequences for detection of iron oxide particles in mouse brain; 2) determine the effect of magnetic field strength on detection of iron oxide particles in vivo; and 3) compare the sensitivity of targeted microparticles of iron oxide (MPIO) or ultra-small superparamagnetic iron oxide (USPIO) for detection of vascular cell adhesion molecule-1 (VCAM-1) in vivo. METHODS Mice were injected intrastriatally with interleukin 1β to induce VCAM-1 expression on the cerebral vasculature. Subsequently, animals were injected intravenously with either VCAM-MPIO or VCAM-USPIO and imaged 1 or 13 hours post-injection, respectively. MRI was performed at 4.7, 7.0, or 9.4 T, using three different T2*-weighted sequences: single gradient echo 3D (GE3D), multi-gradient echo 3D (MGE3D) and balanced steady-state free precession 3D (bSSFP3D). RESULTS MGE3D yielded the highest signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for the detection of iron oxide particles. All sequences showed a significant increase in SNR and CNR from 4.7 to 7.0 T, but no further improvement at 9.4 T. However, whilst targeted MPIO enabled sensitive detection of VCAM-1 expression on the cerebral vasculature, the long half-life (16.5 h vs 1.2 min) and lower relaxivity per particle (1.29×10-14 vs 1.18×10-9 Hz L/particle) of USPIO vs. MPIO rendered them impractical for molecular MRI. CONCLUSION These findings demonstrate clear advantages of MPIO compared to USPIO for molecularly-targeted MRI, and indicate that the MGE3D sequence is optimal for MPIO detection. Moreover, higher field strengths (7.0/9.4 T) showed enhanced sensitivity over lower field strengths (4.7 T). With the development of biodegradable MPIO, these agents hold promise for clinical translation.
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Affiliation(s)
- Niloufar Zarghami
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Alexandre A Khrapitchev
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Francisco Perez-Balderas
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Manuel Sarmiento Soto
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - James R Larkin
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Luca Bau
- Institute of Biomedical Engineering, Department of Engineering Sciences, University of Oxford, Oxford, UK
| | - Nicola R Sibson
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
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24
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25
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Weigel M, Bieri O. Spinal cord imaging using averaged magnetization inversion recovery acquisitions. Magn Reson Med 2017; 79:1870-1881. [PMID: 28714105 DOI: 10.1002/mrm.26833] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 06/19/2017] [Accepted: 06/19/2017] [Indexed: 11/06/2022]
Abstract
PURPOSE To establish a novel approach for fast high-resolution spinal cord (SC) imaging using averaged magnetization inversion recovery acquisitions (AMIRA). METHODS The AMIRA concept is based on an inversion recovery (IR) prepared, segmented, and time-limited cine balanced steady state free precession sequence. Typically, for the fastest SC imaging without any signal averaging, eight consecutive images in time with an in-plane resolution of 0.67 × 0.67 mm2 and 6 mm to 8 mm slice thickness are acquired in 51 s. AMIRA does not require parallel acquisition techniques. RESULTS AMIRA measures eight images of remarkable tissue contrast variation between spinal cord gray (GM) and white matter (WM) and cerebrospinal fluid (CSF). Following the AMIRA concept, averaging the first IR contrast images not only improves the signal-to-noise ratio but also offers a surprising enhancement of the contrast-to-noise ratio between GM and WM, whereas averaging the last images considerably improves the contrast-to-noise ratio between WM and CSF. These observations are supported by quantitative data. CONCLUSION The AMIRA concept provides 2D spinal cord imaging with multiple tissue contrasts and enhanced contrast-to-noise ratios with a typical 0.67 × 0.67 mm2 in-plane resolution and a slice thickness between 4 mm and 8 mm acquired in only 1 to 2 min per slice. Magn Reson Med 79:1870-1881, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Matthias Weigel
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Oliver Bieri
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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26
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Clinical utility of optimized three-dimensional T1-, T2-, and T2*-weighted sequences in spinal magnetic resonance imaging. Jpn J Radiol 2017; 35:135-144. [PMID: 28233194 DOI: 10.1007/s11604-017-0621-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Abstract
This article reviews the clinical utility of 3D magnetic resonance imaging (MRI) sequences optimized for the evaluation of various intraspinal lesions. First, intraspinal tumors with hypervascular components and arteriovenous malformations (AVM) are clearly shown on contrast-enhanced (CE)-3D T1-weighted gradient-echo (GE) sequences with high spatial resolution. Second, dynamic CE-3D time-resolved magnetic resonance angiography (MRA) shows delineated feeding arteries of intraspinal AVM or arteriovenous fistula (AVF), greatly aiding subsequent digital subtraction angiography (DSA). Third, 3D multiecho T2*-weighted GE sequences are used to visualize intraspinal structures and spinal cord lesions and are sensitive to the magnetic susceptibility of intraspinal hemorrhages. Three-dimensional balanced steady-state free precession (SSFP) and multishot 3D balanced non-SSFP sequences produce contiguous thin images with high signal-to-noise ratio (SNR) in short scanning times. Intraspinal cystic lesions and small nerve-root tumors in subarachnoid space can be viewed using 3D balanced SSFP. Spinal cord myelomalacia and cord compression can be evaluated on fat-suppressed multishot 3D balanced non-SSFP. Finally, a 3D T2-weighted fast spin-echo (FSE) sequence with variable flip angle (FA) refocusing pulse improves through-plane spatial resolution over conventional 2D T2-weighted FSE sequences while matching image contrast.
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27
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Soman S, Bregni JA, Bilgic B, Nemec U, Fan A, Liu Z, Barry RL, Du J, Main K, Yesavage J, Adamson MM, Moseley M, Wang Y. Susceptibility-Based Neuroimaging: Standard Methods, Clinical Applications, and Future Directions. CURRENT RADIOLOGY REPORTS 2017; 5. [PMID: 28695062 DOI: 10.1007/s40134-017-0204-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The evaluation of neuropathologies using MRI methods that leverage tissue susceptibility have become standard practice, especially to detect blood products or mineralization. Additionally, emerging MRI techniques have the ability to provide new information based on tissue susceptibility properties in a robust and quantitative manner. This paper discusses these advanced susceptibility imaging techniques and their clinical applications.
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Affiliation(s)
- Salil Soman
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Rosenberg 90A, 1 Deaconess Road, Boston, MA 02215, Tel: 617-754-2009
| | | | - Berkin Bilgic
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, A.A. Martinos Center for Biomedical Imaging 149 13th Street, Room 2.102, Charlestown, MA 02129, Tel: 617-866-8740
| | - Ursula Nemec
- Department of Radiology, Medical University of Vienna, Austria
| | - Audrey Fan
- Department of Radiology, Stanford School of Medicine 300 Pasteur Dr, MC 5105, Stanford, CA94305
| | - Zhe Liu
- Cornell MRI Research Lab, Cornell University, 515 East 71st St, Suite 104, New York, NY 10021, ,
| | - Robert L Barry
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, A.A. Martinos Center for Biomedical Imaging 149 13th Street, Suite 2.301, Charlestown, MA 02129 USA, Tel: 615-801-0795
| | - Jiang Du
- Department of Radiology, UCSD, 200 West Arbor Drive, San Diego, CA 92103-8226, Tel: 619-471-0519
| | - Keith Main
- Principal Scientist (SME), Research Division, Defense and Veterans Brain Injury Center, General Dynamics Health Solutions, 1335 East-West Hwy, Suite 4-100, Silver Spring, MD 20910
| | - Jerome Yesavage
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Mail Code 151-Y, 3801 Miranda Avenue, Palo Alto, California 94304, Phone (650) 852-3287
| | - Maheen M Adamson
- Department of Neurosurgery, Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System (PSC/117), 3801 Miranda Avenue (151Y), Palo Alto, CA 94304
| | - Michael Moseley
- Department of Radiology, Stanford School of Medicine, Mail Code 5488, Route 8, Rm PS059, Stanford, CA, 94305-5488, Tel: 650-725-6077
| | - Yi Wang
- Department of Radiology, Cornell Medical School, Department of Biomedical Engineering, Cornell University, 301 Weill Hall, 237 Tower Road, Ithaca, NY 14853, Tel: 646 962-2631
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28
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Philips BWJ, Fortuin AS, Orzada S, Scheenen TWJ, Maas MC. High resolution MR imaging of pelvic lymph nodes at 7 Tesla. Magn Reson Med 2016; 78:1020-1028. [PMID: 27714842 DOI: 10.1002/mrm.26498] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/30/2016] [Accepted: 09/16/2016] [Indexed: 11/06/2022]
Abstract
PURPOSE Pelvic lymph node (PLN) metastases are often smaller than 5 mm and difficult to detect. This work presents a method to perform PLN imaging with ultrahigh-field MRI, using spectrally selective excitation to acquire water and lipid-selective imaging at high spatial resolution. METHODS A 3D water-selective multigradient echo (mGRE) sequence and lipid-selective gradient echo (GRE) sequence were tested in six healthy volunteers on a 7 Tesla (T) MRI system, using time interleaved acquisition of modes (TIAMO) to improve image homogeneity. The size distribution of the first 10 iliac PLNs detected in each volunteer was determined, and the contrast-to-noise ratio (CNR) of these lymph nodes (LNs) was compared with the individual mGRE images, sum-of-squares echo addition, and computed T2*-weighted images derived from the T2* fits. RESULTS LN imaging was acquired robustly at ultrahigh field with high resolution and homogeneous lipid or water-selective contrast. PLNs down to 1.5-mm short axis were detected with mean ± standard error of the mean (SEM) short and long axes of 2.2 ± 0.1 and 3.7 ± 0.2 mm, respectively. Computed T2*-weighted imaging allowed flexibility in T2* contrast while featuring a CNR up to 90% of the sum-of-squares echo addition. CONCLUSION Ultrahigh-field MRI in combination with TIAMO and frequency-selective excitation enables high-resolution, large field-of-view MRI of the lower abdomen, and may ultimately be suitable for detecting small PLN metastases. Magn Reson Med 78:1020-1028, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Bart W J Philips
- Department of Radiology and Nuclear Medicine (766), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ansje S Fortuin
- Department of Radiology and Nuclear Medicine (766), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Stephan Orzada
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, UNESCO World Cultural Heritage Zollverein, Essen, Germany
| | - Tom W J Scheenen
- Department of Radiology and Nuclear Medicine (766), Radboud University Medical Center, Nijmegen, the Netherlands.,Erwin L. Hahn Institute for Magnetic Resonance Imaging, UNESCO World Cultural Heritage Zollverein, Essen, Germany
| | - Marnix C Maas
- Department of Radiology and Nuclear Medicine (766), Radboud University Medical Center, Nijmegen, the Netherlands
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Harder LK. [Diagnostic imaging of changes of the canine intervertebral disc]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:359-371. [PMID: 27658268 DOI: 10.15654/tpk-160468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/16/2016] [Indexed: 12/27/2022]
Abstract
Intervertebral disc degeneration can cause intervertebral disc herniation. Diagnostic imaging, including radiography, computed tomography and magnetic resonance imaging, is the most important tool in diagnosis. Firstly, an overview of macroscopic and biochemical physiology and pathology of the intervertebral disc will be given. Subsequently, the physics of diagnostic imaging and the appearance of intervertebral disc degeneration and displacement in several imaging methods are described.
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Affiliation(s)
- Lisa K Harder
- Lisa K. Harder, Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Bünteweg 9, 30559 Hannover, E-Mail:
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Galler S, Stellmann JP, Young KL, Kutzner D, Heesen C, Fiehler J, Siemonsen S. Improved Lesion Detection by Using Axial T2-Weighted MRI with Full Spinal Cord Coverage in Multiple Sclerosis. AJNR Am J Neuroradiol 2016; 37:963-9. [PMID: 26744444 DOI: 10.3174/ajnr.a4638] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/03/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Identification of lesions in specific locations gains importance in multiple sclerosis imaging diagnostic criteria. In clinical routine, axial scans are usually exclusively obtained to depict the cervical spinal cord or used to confirm suspected lesions on sagittal scans. We sought to evaluate the detection rate for MS lesions on axial T2WI scans with full spinal cord coverage in comparison with sagittal scans. MATERIALS AND METHODS One hundred fifteen patients with definite or suspected MS underwent an MR imaging examination including 3-mm sagittal and 3.5-mm axial T2-weighted images with full spinal cord coverage. T2WI lesions were identified on axial and sagittal scans independently by 2 raters. Axial diameter, craniocaudal extension, lesion intensity, and location were analyzed. RESULTS Four hundred forty-nine of 509 (88.2%) lesions were detected on axial and 337/509 (66.2%) on sagittal scans. Only 277/449 (61.7%) axial lesions were also detected on sagittal images. The number of lesions visible on sagittal and axial images was dependent on the axial lesion diameter (P < .001). CONCLUSIONS Axial T2WI scans with full spinal cord coverage showed 22% more lesions in patients with MS in comparison with sagittal scans, especially for lesions with small axial diameters. We suggest including biplanar spinal MR imaging with full spinal cord coverage for lesion detection in MS in clinical routine and for clinical studies.
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Affiliation(s)
- S Galler
- From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.)
| | - J-P Stellmann
- Neurology (J.-P.S., K.L.Y., C.H.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K L Young
- Neurology (J.-P.S., K.L.Y., C.H.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Kutzner
- From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.)
| | - C Heesen
- Neurology (J.-P.S., K.L.Y., C.H.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Fiehler
- From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.)
| | - S Siemonsen
- From the Departments of Diagnostic and Interventional Neuroradiology (S.G., D.K., J.F., S.S.) the Institute of Neuroimmunology and Multiple Sclerosis (J.-P.S., K.L.Y., C.H., S.S.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kearney H, Miszkiel KA, Yiannakas MC, Altmann DR, Ciccarelli O, Miller DH. Grey matter involvement by focal cervical spinal cord lesions is associated with progressive multiple sclerosis. Mult Scler 2015; 22:910-20. [DOI: 10.1177/1352458515604905] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 08/17/2015] [Indexed: 11/17/2022]
Abstract
Background: The in vivo relationship of spinal cord lesion features with clinical course and function in multiple sclerosis (MS) is poorly defined. Objective: The objective of this paper is to investigate the associations of spinal cord lesion features on MRI with MS subgroup and disability. Methods: We recruited 120 people: 25 clinically isolated syndrome, 35 relapsing–remitting (RR), 30 secondary progressive (SP), and 30 primary progressive (PP) MS. Disability was measured using the Expanded Disability Status Scale. We performed 3T axial cervical cord MRI, using 3D-fast-field-echo and phase-sensitive-inversion-recovery sequences. Both focal lesions and diffuse abnormalities were recorded. Focal lesions were classified according to the number of white matter (WM) columns involved and whether they extended to grey matter (GM). Results: The proportion of patients with focal lesions involving at least two WM columns and extending to GM was higher in SPMS than in RRMS ( p = 0.03) and PPMS ( p = 0.015). Diffuse abnormalities were more common in both PPMS and SPMS, compared with RRMS (OR 6.1 ( p = 0.002) and 5.7 ( p = 0.003), respectively). The number of lesions per patient involving both the lateral column and extending to GM was independently associated with disability ( p < 0.001). Conclusions: More extensive focal cord lesions, extension of lesions to GM, and diffuse abnormalities are associated with progressive MS and disability.
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Affiliation(s)
- Hugh Kearney
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, UK
| | - Katherine A Miszkiel
- Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UK
| | - Marios C Yiannakas
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, UK
| | - Daniel R Altmann
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, UK/Medical Statistics Department, London School of Hygiene & Tropical Medicine, UK
| | - Olga Ciccarelli
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, UK/NIHR University College London Hospitals Biomedical Research Centre, UK
| | - David H Miller
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, UK/NIHR University College London Hospitals Biomedical Research Centre, UK
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Xiao L, Siu C, Yeung K, Leung A, Yuen M, Wong Y. MRI of the cervical spine with 3D gradient echo sequence at 3 T: initial experience. Clin Radiol 2015; 70:926-31. [DOI: 10.1016/j.crad.2015.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 05/05/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
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Magnetic resonance imaging findings compared with histological findings of the labrum in hip osteoarthritis. Skeletal Radiol 2015; 44:767-75. [PMID: 25616616 DOI: 10.1007/s00256-015-2096-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/24/2014] [Accepted: 01/05/2015] [Indexed: 02/02/2023]
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Miller TR, Mohan S, Choudhri AF, Gandhi D, Jindal G. Advances in multiple sclerosis and its variants: conventional and newer imaging techniques. Radiol Clin North Am 2014; 52:321-36. [PMID: 24582342 DOI: 10.1016/j.rcl.2013.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Multiple sclerosis (MS) and its variants are inflammatory as well as neurodegenerative diseases that diffusely affect the central nervous system (CNS). There is a poor correlation between traditional imaging findings and symptoms in patients with MS. Current research in conventional magnetic resonance (MR) imaging of MS and related diseases includes optimization of hardware and pulse sequences and the development of automated and semiautomated techniques to measure and quantify disease burden. Advanced nonconventional MR techniques such as diffusion tensor and functional MR imaging probe the changes found in the CNS, and correlate these findings with clinical measures of disease.
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Affiliation(s)
- Timothy R Miller
- Neuroradiology Division, Department of Radiology, University of Maryland Medical Center, Baltimore, MD 21201, USA.
| | - Suyash Mohan
- Neuroradiology Division, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Asim F Choudhri
- Neuroradiology Division, Department of Radiology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Dheeraj Gandhi
- Neuroradiology Division, Department of Radiology, University of Maryland Medical Center, Baltimore, MD 21201, USA
| | - Gaurav Jindal
- Neuroradiology Division, Department of Radiology, University of Maryland Medical Center, Baltimore, MD 21201, USA
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El Mendili MM, Chen R, Tiret B, Pélégrini-Issac M, Cohen-Adad J, Lehéricy S, Pradat PF, Benali H. Validation of a semiautomated spinal cord segmentation method. J Magn Reson Imaging 2014; 41:454-9. [PMID: 24436309 DOI: 10.1002/jmri.24571] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 01/03/2014] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To validate semiautomated spinal cord segmentation in healthy subjects and patients with neurodegenerative diseases and trauma. MATERIALS AND METHODS Forty-nine healthy subjects, as well as 29 patients with amyotrophic lateral sclerosis, 19 with spinal muscular atrophy, and 14 with spinal cord injuries were studied. Cord area was measured from T2 -weighted 3D turbo spin echo images (cord levels from C2 to T9) using the semiautomated segmentation method of Losseff et al (Brain [1996] 119(Pt 3):701-708), compared with manual segmentation. Reproducibility was evaluated using the inter- and intraobserver coefficient of variation (CoV). Accuracy was assessed using the Dice similarity coefficient (DSC). Robustness to initialization was assessed by simulating modifications to the contours drawn manually prior to segmentation. RESULTS Mean interobserver CoV was 4.00% for manual segmentation (1.90% for Losseff's method) in the cervical region and 5.62% (respectively 2.19%) in the thoracic region. Mean intraobserver CoV was 2.34% for manual segmentation (1.08% for Losseff's method) in the cervical region and 2.35% (respectively 1.34%) in the thoracic region. DSC was high (0.96) in both cervical and thoracic regions. DSC remained higher than 0.8 even when modifying initial contours by 50%. CONCLUSION The semiautomated segmentation method showed high reproducibility and accuracy in measuring spinal cord area.
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Affiliation(s)
- Mohamed-Mounir El Mendili
- Inserm U678, UPMC Univ Paris 6 UMR-S 678, Laboratoire d'imagerie fonctionnelle, Paris, France; Univ Paris 11, IFR 49, Institut fédératif de recherche en imagerie neurofonctionnelle, DSV/I2BM Neurospin, Gif-sur-Yvette, France
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Nair G, Absinta M, Reich DS. Optimized T1-MPRAGE sequence for better visualization of spinal cord multiple sclerosis lesions at 3T. AJNR Am J Neuroradiol 2013; 34:2215-22. [PMID: 23764721 DOI: 10.3174/ajnr.a3637] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Spinal cord lesions are highly prevalent in MS, and their visualization can help both in diagnosis and patient follow-up. However, the sensitivity of MR imaging to spinal cord lesions remains poor, primarily because of suboptimal contrast between lesions and a normal-appearing cord. Here, we propose an optimized 3D MPRAGE sequence for improved detection of MS lesions in the spinal cord at 3T. MATERIALS AND METHODS Images were acquired by use of T2 FSE, STIR, T1-gradient recalled-echo (for T1 mapping), and T1-MPRAGE in the sagittal plane, and T2*-weighted scans in the axial plane, on 40 patients with MS and 7 healthy volunteers. Two observers qualitatively evaluated the images for lesion conspicuity. Lesions seen between the C1 and C4 segments in 10 randomly selected patients with MS were further evaluated quantitatively for contrast-to-noise ratio between the lesion and normal-appearing cord, and for lesion burden. RESULTS Spinal cord lesions were more conspicuous on the optimized T1-MPRAGE sequence than on any other sequence tested. Detailed analysis revealed that lesions were almost 3 times more conspicuous (P < .01), and the total lesion volume was 2 times greater (P < .05, n=10), in the T1-MPRAGE sequence compared with the standard STIR sequence. Correlation of clinical disability (Expanded Disability Status Score) with lesion load from each sequence also demonstrated the importance of the improved lesion conspicuity with T1-MPRAGE. CONCLUSIONS The optimized T1-MPRAGE sequence described here improves the reliability of lesion visualization and estimation of lesion burden, especially when used in conjunction with other well-established clinical sequences.
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Affiliation(s)
- G Nair
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
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Kearney H, Miszkiel K, Yiannakas M, Ciccarelli O, Miller D. A pilot MRI study of white and grey matter involvement by multiple sclerosis spinal cord lesions. Mult Scler Relat Disord 2013; 2:103-8. [DOI: 10.1016/j.msard.2012.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 08/30/2012] [Accepted: 09/12/2012] [Indexed: 01/04/2023]
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Ozturk A, Aygun N, Smith SA, Caffo B, Calabresi PA, Reich DS. Axial 3D gradient-echo imaging for improved multiple sclerosis lesion detection in the cervical spinal cord at 3T. Neuroradiology 2013; 55:431-9. [PMID: 23208410 PMCID: PMC3602327 DOI: 10.1007/s00234-012-1118-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 11/02/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In multiple sclerosis (MS), spinal cord imaging can help in diagnosis and follow-up evaluation. However, spinal cord magnetic resonance imaging (MRI) is technically challenging, and image quality, particularly in the axial plane, is typically poor compared to brain MRI. Because gradient-recalled echo (GRE) images might offer improved contrast resolution within the spinal cord at high magnetic field strength, both without and with a magnetization transfer prepulse, we compared them to T2-weighted fast-spin-echo (T2-FSE) images for the detection of MS lesions in the cervical cord at 3T. METHODS On a clinical 3T MRI scanner, we studied 62 MS cases and 19 healthy volunteers. Axial 3D GRE sequences were performed without and with off-resonance radiofrequency irradiation. To mimic clinical practice, all images were evaluated in conjunction with linked images from a sagittal short tau inversion recovery scan, which is considered the gold standard for lesion detection in MS. Two experienced observers recorded image quality, location and size of focal lesions, atrophy, swelling, and diffuse signal abnormality independently at first and then in consensus. RESULTS The number and volume of lesions detected with high confidence was more than three times as high on both GRE sequences compared to T2-FSE (p < 0.0001). Approximately 5 % of GRE scans were affected by artifacts that interfered with image interpretation, not significantly different from T2W-FSE. CONCLUSIONS Axial 3D GRE sequences are useful for MS lesion detection when compared to 2D T2-FSE sequences in the cervical spinal cord at 3T and should be considered when examining intramedullary spinal cord lesions.
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Affiliation(s)
- Arzu Ozturk
- Department of Radiology, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA
| | - Nafi Aygun
- Department of Radiology, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA
| | - Seth A. Smith
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA
| | - Brian Caffo
- Department of Biostatistics, Johns Hopkins Bloomberg, School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Peter A. Calabresi
- Department of Neurology, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA
| | - Daniel S. Reich
- Department of Radiology, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA. Department of Biostatistics, Johns Hopkins Bloomberg, School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA. Department of Neurology, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA. Translational Neuroradiology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bldg 10, Rm 5C103; 10 Center Drive, MSC 1400, Bethesda, MD 20892, USA
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