Thick-section half-Fourier rapid acquisition with relaxation enhancement MR cholangiopancreatography: effects of i.v. administration of gadolinium chelate

Optimisation of T2 and T2* sequences in MRI for better quantification of iron on transfused dependent sickle cell patients

This work aimed to investigate the effect of different shim techniques, voxel sizes, and repetition time (TR) on using theT2 and T2* sequences to determine their optimum settings to investigate the quantification of iron in transfused dependent sickle cell patients. The effect of each of these parameters was investigated on phantoms of different Gadolinium (Gd) concentrations, on 10 volunteers and 25 patients using a1 5T MRI Philips scanner. No significant difference between the three shim techniques was noticed in either T2 or T2* sequence measurements. Pixel sizes of 1 × 1 and 2 × 2 mm provided optimum results for T2 measurements. At 1 × 1 mm pixel size the T2* measurements experienced less error in measurements than the size of 2.5 × 2.5 mm used in the literature. Even though the slice thickness variation did not provide any changes in T2 measurements, the 12 mm provided optimum T2* measurements. TR variation did not yield significant changes on either T2 or T2* measurements. These results indicate that both T2 and T2* sequences can be further improved by providing more reliable measurements and reducing acquisition time.

Bisphosphonate Functionalized Gadolinium Oxide Nanoparticles Allow Long-Term MRI/CT Multimodal Imaging of Calcium Phosphate Bone Cement

Direct in vivo monitoring of bioconstructs using noninvasive imaging modalities such as magnetic resonance imaging (MRI) or computed tomography (CT) is not possible for many materials. Calcium phosphate-based composites (CPCs) that are applicable to bone regeneration are an example where the materials have poor MRI and CT contrast; hence, they are challenging to detect in vivo. In this study, a CPC construct is designed with gadolinium-oxide nanoparticles incorporated to act as an MRI/CT multimodal contrast agent. The gadolinium(III) oxide nanoparticles are synthesized via the polyol method and surface functionalized with a bisphosphonate (BP) derivative to give a construct (gadolinium-based contrast agents (GBCAs)-BP) with strong affinity toward calcium phosphate. The CPC-GBCAs-BP functional material is longitudinally monitored after in vivo implantation in a condyle defect rat model. The synthetic method developed produces nanoparticles that are stable in aqueous solution (hydrodynamic diameter 70 nm) with significant T₁ and T₂ relaxivity demonstrated in both clinical 3 T and preclinical 11.7 T MRI systems. The combination of GBCAs-BP nanoparticles with CPC gives an injectable material with handling properties that are suitable for clinical applications. The BP functionalization prolongs the residence of the contrast agent within the CPC to allow long-term follow-up imaging studies. The useful contrast agent properties combined with biological compatibility indicate further investigation of the novel bone substitute hybrid material toward clinical application.

Evaluation of hepatic contrast enhancement with a hepatocyte-specific magnetic resonance imaging contrast agent (gadoxetic acid) in healthy dogs

OBJECTIVE

To determine, by means of MRI, the time to maximal contrast enhancement in T1-weighted images following IV administration of gadoxetic acid in healthy dogs and assess the impact of gadoxetic acid on the signal intensity of T2-weighted images.

ANIMALS

7 healthy dogs.

PROCEDURES

No hepatic abnormalities were detected during ultrasonographic examination. Each dog was anesthetized and positioned in dorsal recumbency for MRI. Transverse T1- and T2-weighted images of the liver were acquired prior to and following (at 5-minute intervals) IV injection of 0.1 mL of gadoxetic acid/kg. Signal intensity of the liver parenchyma was measured in 3 regions of interest in the T1- and T2-weighted images before and at various times point after contrast agent administration. Time versus signal-to-noise ratio curves were plotted to determine time to maximal contrast enhancement and contrast agent-related changes in signal intensity in T2-weighted images.

RESULTS

Analysis of T1-weighted images revealed that mean ± SD time to maximal enhancement after gadoxetic acid injection was 10.5 ± 3.99 minutes. Signal intensity of T2-weighted images was not significantly affected by gadoxetic acid administration. No injection-related adverse effects were observed in any dog.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that gadoxetic acid can be used for hepatic MRI in healthy dogs and the resultant hepatic enhancement patterns are similar to those described for humans. Maximal contrast enhancement occurred between 10 and 15 minutes after contrast agent injection; thus, T2-weighted images may be obtained in the interval between injection and maximal enhancement for a more time-efficient clinical protocol.

MR signal changes on hepatobiliary imaging after oral ingestion of manganese chloride tetrahydrate: preliminary examination

PURPOSE

To clarify magnetic resonance (MR) signal changes during hepatobiliary imaging after oral ingestion of manganese chloride tetrahydrate (Bothdel Oral Solution 10) (MCT).

MATERIALS AND METHODS

Subjects were an MCT phantom, 10 healthy volunteers and 155 consecutive patients. The phantom study evaluated the relationship between MCT concentration and MR signal intensity. The volunteer study qualitatively and quantitatively analyzed the time course of hepatobiliary imaging immediately and 30, 60, 120 and 180 min after oral ingestion of MCT. The clinical study analyzed the incidence and factors affecting signal changes on additional MRCP with MCT as a final scan during routine clinical MRCP.

RESULTS

In the phantom study, a significant and excellent positive linear correlation was found between MCT concentration and R2* measurement (r(2) = 0.996, p < 0.01). In the volunteer study, biliary imaging and hepatic R2* values changed significantly after oral ingestion of MCT (p < 0.05). In the clinical study, a signal drop on MRCP with MCT was visually confirmed in 14.8 % of cases. Multivariate logistic regression found no factors significantly affecting signal drop.

CONCLUSION

We recommend performing MRCP early after oral ingestion of MCT, because signal changes occur even during routine MRCP.

The T2-shortening effect of gadolinium and the optimal conditions for maximizing the CNR for evaluating the biliary system: a phantom study

Objective

Clear depiction of the common bile duct is important when evaluating neonatal cholestasis in order to differentiate biliary atresia from other diseases. During MR cholangiopancreatography, the T2-shortening effect of gadolinium can increase the contrast-to-noise ratio (CNR) of the bile duct and enhance its depiction. The purpose of this study was to confirm, by performing a phantom study, the T2-shortening effect of gadolinium, to evaluate the effect of different gadolinium chelates with different gadolinium concentrations and different magnetic field strengths for investigating the optimal combination of these conditions, and for identifying the maximum CNR for the evaluation of the biliary system.

Materials and Methods

MR imaging using a T2-weighted single-shot fast spin echo sequence and T2 relaxometry was performed with a sponge phantom in a syringe tube. Two kinds of contrast agents (Gd-DTPA and Gd-EOB-DTPA) with different gadolinium concentrations were evaluated with 1.5T and 3T scanners. The signal intensities, the CNRs and the T2 relaxation time were analyzed.

Results

The signal intensities significantly decreased as the gadolinium concentrations increased (p < 0.001) with both contrast agents. These signal intensities were higher on a 3T (p < 0.001) scanner. The CNRs were higher on a 1.5T (p < 0.001) scanner and they showed no significant change with different gadolinium concentrations. The T2 relaxation time also showed a negative correlation with the gadolinium concentrations (p < 0.001) and the CNRs showed decrease more with Gd-EOB-DTPA (versus Gd-DTPA; p < 0.001) on a 3T scanner (versus 1.5T; p < 0.001).

Conclusion

A T2-shortening effect of gadolinium exhibits a negative correlation with the gadolinium concentration for both the signal intensities and the T2 relaxation time. A higher CNR can be obtained with Gd-DTPA on a 1.5T MRI scanner.

Gadopentetate dimeglumine-enhanced MR cholangiopancreatography in infants with cholestasis

BACKGROUND

Biliary atresia (BA) is a progressive, obliterative cholangiopathy that occurs in neonates with hepatic portoenterostomy the treatment of choice, but early surgery is important for optimum outcomes. MRI, including MR cholangiopancreatography (MRCP) may be a diagnostically useful alternative to US, but the heavily T2-weighted sequences used include not only bile duct signals, but also other heterogeneously high signal intensities from surrounding structures.

OBJECTIVE

To evaluate the effects of gadolinium when used to decrease background signal intensity on T2-weighted MR cholangiopancreatography (MRCP) in infants and to evaluate the qualitative improvement of the depiction of the common bile duct (CBD) for evaluating neonatal cholestasis.

MATERIALS AND METHODS

Our Institutional Review Board approved this prospective study. MRCP was performed with gadopentetate dimeglumine injection using a 1.5-T scanner. Pre- and postcontrast MRCP images were compared. Forty-nine infants (male:female = 21:28; age 0-12 months, mean 2.3) were included. The final diagnoses were biliary atresia (BA) in 28 cases and non-BA in 21. Quantitative analysis was conducted using region-of-interest measurements of mean signal intensities of the liver, pancreatic head and gallbladder (if defined). Qualitative analysis was performed by four radiologists who subjectively scored image confidence in the presence of CBD on a 4-point scale (0 for definitely absent, 1 for probably absent, 2 for probably present, and 3 for definitely present).

RESULTS

The signal-to-noise ratios were significantly decreased in the liver and pancreatic head after contrast medium enhancement (mean 5.7→4.0 in liver and mean 44.9→12.7 in the pancreatic head; P < 0.0001), and this finding was constant in both the BA and the non-BA group. The mean confidence score in the presence of CBD decreased in the BA group (0.9→0.5; P < 0.0001), but did not change significantly in the non-BA group (2.0→2.1; P = 0.459) after contrast medium enhancement. Both intra- and interobserver agreement was higher after contrast medium enhancement (P = 0.046).

CONCLUSION

Gadopentetate dimeglumine-enhanced MRCP increased the diagnostic confidence of absence of the CBD in cholestatic infants with increased intra- and interobserver agreement.

Cross-Sectional Imaging in Acute Pancreatitis

Acute pancreatitis is a common disease with potentially serious outcomes. Multiple imaging modalities can be used to evaluate the disease process and its associated complications. Familiarity with the pathogenesis of this disease, indications for imaging, imaging protocols, staging systems, and the strengths and weaknesses of various modalities will help the radiologist optimize patient care.

MR Imaging of the Gallbladder and Biliary System

MR imaging is an established technique for the diagnosis of a spectrum of biliary and gallbladder pathologies and continues to improve with the advent of technologic advances, including new contrast agents and new sequences that are capable of improving upon the contrast resolution and signal-to-noise that are afforded by conventional MR imaging. These improvements already have shown promise for the increasing role of MRC as the initial modality in assessing living liver donors and evaluating post-operative hepato-biliary complications. Improved spatial resolution and the added functional or physiologic information afforded by MR imaging promise ever expanding clinical applicability and usefulness.