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Li J, Sun L, Hu N, Li L, Song G, Xu H, Xu T, Cheng Y, Xiao L, Wang L, Gong R, Li C. A Novel MR Imaging Sequence of 3D-ZOOMit Real Inversion-Recovery Imaging Improves Endolymphatic Hydrops Detection in Patients with Ménière Disease. AJNR Am J Neuroradiol 2023; 44:595-601. [PMID: 37105675 PMCID: PMC10171393 DOI: 10.3174/ajnr.a7842] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/08/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND AND PURPOSE The detection rate of premortem MR imaging endolymphatic hydrops is lower than that of postmortem endolymphatic hydrops in Ménière disease, indicating that current MR imaging techniques may underestimate endolymphatic hydrops. Therefore, we prospectively investigated whether a novel high-resolution MR imaging technique, the 3D zoomed imaging technique with parallel transmission real inversion-recovery (3D-ZOOMit real IR), would improve the detection of endolymphatic hydrops compared with conventional 3D TSE inversion-recovery with real reconstruction. MATERIALS AND METHODS Fifty patients with definite unilateral Ménière disease were enrolled and underwent 3D-ZOOMit real IR and 3D TSE inversion-recovery with real reconstruction 6 hours after IV gadolinium injection. The endo- and perilymph spaces were scored separately. The contrast-to-noise ratio, SNR, and signal intensity ratio of the 2 sequences were respectively calculated and compared. The presence of endolymphatic hydrops was evaluated. RESULTS The endolymphatic space in the cochlea and vestibule was better visualized with 3D-ZOOMit real IR than with conventional 3D TSE inversion-recovery with real reconstruction (P < .001). There were differences between the 2 sequences in the evaluation of no cochlear hydrops and cochlear hydrops (both, P < .017). All contrast-to-noise ratio, SNR, and signal intensity ratio values of 3D-ZOOMit real IR images were statistically higher than those of conventional 3D TSE inversion-recovery with real reconstruction (all, P < .001). CONCLUSIONS The 3D-ZOOMit real IR sequences are superior to conventional 3D TSE inversion-recovery with real reconstruction sequences in visualizing the endolymphatic space, detecting endolymphatic hydrops, and discovering contrast permeability.
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Affiliation(s)
- J Li
- From the Departments of Radiology (J.L., L.S., N.H., T.X., L.W., R.G.)
| | - L Sun
- From the Departments of Radiology (J.L., L.S., N.H., T.X., L.W., R.G.)
| | - N Hu
- From the Departments of Radiology (J.L., L.S., N.H., T.X., L.W., R.G.)
| | - L Li
- Medical Service (L.L.), Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - G Song
- Department of Radiology (G.S.), Shandong Province Qianfoshan Hospital, Jinan, China
| | - H Xu
- Department of Radiology (H.X., R.G., C.L.)
| | - T Xu
- From the Departments of Radiology (J.L., L.S., N.H., T.X., L.W., R.G.)
| | - Y Cheng
- Siemens Healthineers Digital Technology (Shanghai) Co. Ltd (Y.C.), Shanghai, China
| | - L Xiao
- MR Scientific Marketing (L.X.), Diagnostic Imaging, Siemens Healthineers Ltd, Shanghai, China
| | - L Wang
- From the Departments of Radiology (J.L., L.S., N.H., T.X., L.W., R.G.)
| | - R Gong
- From the Departments of Radiology (J.L., L.S., N.H., T.X., L.W., R.G.)
- Department of Radiology (H.X., R.G., C.L.)
- Gong Ruozhen Innovation Studio (R.G.), Shandong Provincial Hospital, Shandong University, Jinan, China
| | - C Li
- Department of Radiology (H.X., R.G., C.L.)
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Lee EM, Ibrahim ESH, Dudek N, Lu JC, Kalia V, Runge M, Srinivasan A, Stojanovska J, Agarwal PP. Improving MR Image Quality in Patients with Metallic Implants. Radiographics 2021; 41:E126-E137. [PMID: 34143712 DOI: 10.1148/rg.2021200092] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The number of implanted devices such as orthopedic hardware and cardiac implantable devices continues to increase with an increase in the age of the patient population, as well as an increase in the number of indications for specific devices. Many patients with these devices have or will develop clinical conditions that are best depicted at MRI. However, implanted devices containing paramagnetic or ferromagnetic substances can cause significant artifact, which could limit the diagnostic capability of this modality. Performing imaging with MRI when an implant is present may be challenging, and there are numerous techniques the radiologist and technologist can use to help minimize artifacts related to implants. First, knowledge of the presence of an implant before patient arrival is critical to ensure safety of the patient when the device is subjected to a strong magnetic field. Once safety is ensured, the examination should be performed with the MRI system that is expected to provide the best image quality. The selection of the MRI system includes multiple considerations such as the effects of field strength and availability of specific sequences, which can reduce metal artifact. Appropriate patient positioning, attention to MRI parameters (including bandwidth, voxel size, and echo), and appropriate selection of sequences (those with less metal artifact and advanced metal reduction sequences) are critical to improve image quality. Patients with implants can be successfully imaged with MRI with appropriate planning and understanding of how to minimize artifacts. This improves image quality and the diagnostic confidence of the radiologist. ©RSNA, 2021.
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Affiliation(s)
- Elizabeth M Lee
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
| | - El-Sayed H Ibrahim
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
| | - Nancy Dudek
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
| | - Jimmy C Lu
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
| | - Vivek Kalia
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
| | - Mason Runge
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
| | - Ashok Srinivasan
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
| | - Jadranka Stojanovska
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
| | - Prachi P Agarwal
- From the Department of Radiology, Division of Cardiothoracic Imaging (E.M.L., J.S., P.P.A.), Department of Radiology (N.D.), Department of Pediatrics, Division of Cardiology, CS Mott Children's Hospital (J.C.L.), Department of Radiology, Division of Musculoskeletal Radiology (V.K.), University of Michigan Medical School (M.R.), and Department of Radiology, Division of Neuroradiology (A.S.), University of Michigan, University Hospital Floor B1 Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, Wis (E.H.I.)
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Abstract
Clinical MRI systems have continually improved over the years since their introduction in the 1980s. In MRI technical development, the developments in each MRI system component, including data acquisition, image reconstruction, and hardware systems, have impacted the others. Progress in each component has induced new technology development opportunities in other components. New technologies outside of the MRI field, for example, computer science, data processing, and semiconductors, have been immediately incorporated into MRI development, which resulted in innovative applications. With high performance computing and MR technology innovations, MRI can now provide large volumes of functional and anatomical image datasets, which are important tools in various research fields. MRI systems are now combined with other modalities, such as positron emission tomography (PET) or therapeutic devices. These hybrid systems provide additional capabilities. In this review, MRI advances in the last two decades will be considered. We will discuss the progress of MRI systems, the enabling technology, established applications, current trends, and the future outlook.
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Affiliation(s)
- Hiroyuki Kabasawa
- Department of Radiological Sciences, School of Health Sciences at Narita, International University of Health and Welfare
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4
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Interpretation of fluid-attenuated inversion recovery vascular hyperintensity in stroke. J Neuroradiol 2021; 49:258-266. [PMID: 33515596 DOI: 10.1016/j.neurad.2021.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 01/01/2023]
Abstract
Fluid-attenuation inversion recovery (FLAIR) vascular hyperintensity (FVH) is a common presentation on brain magnetic resonance images of patients with acute ischemic stroke. This sign is known as a sluggish collateral flow. Although FVH represents the large ischemic penumbra and collateral circulation, the clinical significance of FVH has not been established. Varying protocols for FLAIR, treatment differences, and heterogeneity of endpoints across studies have complicated the interpretation of FVH in patients with acute stroke. In this review article, we describe the mechanism of FVH, as well as its association with functional outcome, perfusion-weighted images, and large artery stenosis. In addition, we review the technological variables that affect FVH and discuss the future perspectives.
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Mascalchi M, Bianchi A, Basile M, Gulino P, Trifan MR, Difeo D, Bartolini E, Defilippi C, Diciotti S. Effectiveness of 3D T2-Weighted FLAIR FSE Sequences with Fat Suppression for Detection of Brain MR Imaging Signal Changes in Children. AJNR Am J Neuroradiol 2016; 37:2376-2381. [PMID: 27585701 DOI: 10.3174/ajnr.a4915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/04/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE T2-weighted FLAIR can be combined with 3D-FSE sequences with isotropic voxels, yielding higher signal-to-noise ratio than 2D-FLAIR. Our aim was to explore whether a T2-weighted FLAIR-volume isotropic turbo spin-echo acquisition sequence (FLAIR-VISTA) with fat suppression shows areas of abnormal brain T2 hyperintensities with better conspicuity in children than a single 2D-FLAIR sequence. MATERIALS AND METHODS One week after a joint training session with 20 3T MR imaging examinations (8 under sedation), 3 radiologists independently evaluated the presence and conspicuity of abnormal areas of T2 hyperintensities of the brain in FLAIR-VISTA with fat suppression (sagittal source and axial and coronal reformatted images) and in axial 2D-FLAIR without fat suppression in a test set of 100 3T MR imaging examinations (34 under sedation) of patients 2-18 years of age performed for several clinical indications. Their agreement was measured with weighted κ statistics. RESULTS Agreement was "substantial" (mean, 0.61 for 3 observers; range, 0.49-0.69 for observer pairs) for the presence of abnormal T2 hyperintensities and "fair" (mean, 0.29; range, 0.23-0.38) for the comparative evaluation of lesion conspicuity. In 21 of 23 examinations in which the 3 radiologists agreed on the presence of abnormal T2 hyperintensities, FLAIR-VISTA with fat suppression images were judged to show hyperintensities with better conspicuity than 2D-FLAIR. In 2 cases, conspicuity was equal, and in no case was conspicuity better in 2D-FLAIR. CONCLUSIONS FLAIR-VISTA with fat suppression can replace the 2D-FLAIR sequence in brain MR imaging protocols for children.
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Affiliation(s)
- M Mascalchi
- From the "Mario Serio" Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy .,Structural and Functional Neuroradiology Research Unit (M.M.)
| | - A Bianchi
- From the "Mario Serio" Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy
| | - M Basile
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - P Gulino
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - M R Trifan
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - D Difeo
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - E Bartolini
- Neurology Unit and Laboratories (E.B.), Meyer Children's Hospital, Florence, Italy
| | - C Defilippi
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - S Diciotti
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" (S.D.), University of Bologna, Cesena, Italy
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Wardlaw JM, Valdés Hernández MC, Muñoz-Maniega S. What are white matter hyperintensities made of? Relevance to vascular cognitive impairment. J Am Heart Assoc 2015; 4:001140. [PMID: 26104658 PMCID: PMC4599520 DOI: 10.1161/jaha.114.001140] [Citation(s) in RCA: 521] [Impact Index Per Article: 57.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Joanna M Wardlaw
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
| | - Maria C Valdés Hernández
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
| | - Susana Muñoz-Maniega
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
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Naganawa S. The Technical and Clinical Features of 3D-FLAIR in Neuroimaging. Magn Reson Med Sci 2015; 14:93-106. [PMID: 25833275 DOI: 10.2463/mrms.2014-0132] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In clinical MR neuroimaging, 3D fluid-attenuated inversion recovery (3D-FLAIR) with a variable-flip-angle turbo spin echo sequence is becoming popular. There are more than 100 reports regarding 3D-FLAIR in the PubMed database. In this article, the technical and clinical features of 3D-FLAIR for neuroimaging are reviewed and summarized. 3D-FLAIR allows thinner slices with multi-planar reformation capability, a higher flow sensitivity, high sensitivity to subtle T1 changes in fluid, images without cerebrospinal fluid (CSF) inflow artifacts, and a 3D dataset compatible with computer-aided analysis. In addition, 3D-FLAIR can be obtained within a clinically reasonable scan time. It is important for radiologists to be familiar with the features of 3D-FLAIR and to provide useful information for patients.
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Affiliation(s)
- Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine
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Naganawa S, Nakashima T. Visualization of endolymphatic hydrops with MR imaging in patients with Ménière's disease and related pathologies: current status of its methods and clinical significance. Jpn J Radiol 2014; 32:191-204. [PMID: 24500139 DOI: 10.1007/s11604-014-0290-4] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 01/16/2014] [Indexed: 12/01/2022]
Abstract
Ménière's disease is an inner ear disorder characterized by vertigo attacks, fluctuating low-frequency hearing loss, ear fullness, and tinnitus. Endolymphatic hydrops has long been thought to be the pathological basis for Ménière's disease. Some patients have inner ear symptoms that do not match the diagnostic guidelines for Ménière's disease, and these are also thought to be related to endolymphatic hydrops. The diagnosis of endolymphatic hydrops is usually made based on clinical symptoms with some assistance from otological functional tests. Recently, the objective diagnosis of endolymphatic hydrops by MR imaging has become possible and many research results have been reported regarding the imaging methods, evaluation methods, the correlation between imaging results and functional otological tests and the correlation between imaging findings and clinical symptoms. In this article we summarize the development of current imaging methods, evaluation techniques and clinical reports based on a review of the literature. We also attempt to characterize the current significance and future directions of MR imaging of endolymphatic hydrops.
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Affiliation(s)
- Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8550, Japan,
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Detection of brain metastases by 3-dimensional magnetic resonance imaging at 3 T: comparison between T1-weighted volume isotropic turbo spin echo acquisition and 3-dimensional T1-weighted fluid-attenuated inversion recovery imaging. J Comput Assist Tomogr 2013; 37:84-90. [PMID: 23321838 DOI: 10.1097/rct.0b013e318271f216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study aimed to compare the diagnostic performance in the detection of brain metastases between contrast-enhanced T1-weighted volume isotropic turbo spin echo acquisition (T1-VISTA) and 3-dimensional T1-weighted fluid-attenuated inversion recovery (3D-T1-FLAIR) imaging at 3 T. METHODS Two neuroradiologists selected 129 true (metastases) and 70 false (vessels and artifacts) lesions on the contrast-enhanced T1-VISTA and 3D-T1-FLAIR images of 14 cancer patients with hyperintense brain lesions. Four blinded neuroradiologists distinguished between the true and false lesions, using a 5-point confidence rating scale. The receiver operating characteristic analysis was performed to compare the diagnostic performance. Contrast-to-noise ratio of the true lesions was also compared between the 2 sequences by using paired t tests. RESULTS For lesions less than 3 mm, the area under curve and sensitivity achieved by T1-VISTA imaging were significantly greater than 3D-T1-FLAIR imaging. The contrast-to-noise ratio was also significantly greater with T1-VISTA imaging. CONCLUSIONS The contrast-enhanced T1-VISTA imaging is better suited than 3D-T1-FLAIR imaging, for detection of small metastases.
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Diaz-de-Grenu LZ, Acosta-Cabronero J, Pereira JM, Pengas G, Williams GB, Nestor PJ. MRI detection of tissue pathology beyond atrophy in Alzheimer's disease: Introducing T2-VBM. Neuroimage 2011; 56:1946-53. [DOI: 10.1016/j.neuroimage.2011.03.082] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 03/11/2011] [Accepted: 03/30/2011] [Indexed: 11/24/2022] Open
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Yu JS, Chung JJ, Kim JH, Cho ES, Kim DJ, Ahn JH, Kim KW. Detection of small intrahepatic metastases of hepatocellular carcinomas using diffusion-weighted imaging: comparison with conventional dynamic MRI. Magn Reson Imaging 2011; 29:985-92. [PMID: 21616624 DOI: 10.1016/j.mri.2011.04.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 04/07/2011] [Accepted: 04/13/2011] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of our study was to compare diffusion-weighted MR imaging (DWI) with conventional dynamic MRI in terms of the assessment of small intrahepatic metastases from hepatocellular carcinoma (HCC). MATERIALS AND METHODS In 24 patients with multifocal, small (≤2 cm) intrahepatic metastatic foci of advanced HCC, a total of 134 lesions (≤1 cm, n=81; >1 cm, n=53) were subjected to a comparative analysis of hepatic MRI including static and gadopentetate dimeglumine-enhanced dynamic imaging, and DWI using a single-shot spin-echo echo-planar MRI (b values=50, 400 and 800 s/mm(2)), by two independent reviewers. RESULTS A larger number of the lesions were detected and diagnosed as intrahepatic metastases on DWI [Reviewer 1, 121 (90%); Reviewer 2, 117 (87%)] than on dynamic imaging [Reviewer 1, 107 (80%); Reviewer 2, 105 (78%)] (P<.05). For the 81 smaller lesions (≤1 cm), DWI was able to detect more lesions than dynamic imaging [Reviewer 1, 68 (84%) vs. 56 (69%), P=.008; Reviewer 2, 65 (80%) vs. 55 (68%), P=.031], but there was no statistically significant difference between the two image sets for larger (>1 cm) lesions. CONCLUSION Due to its higher detection rate of subcentimeter lesions, DWI could be considered complementary to dynamic MRI in the diagnosis of intrahepatic metastases of HCCs.
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Affiliation(s)
- Jeong-Sik Yu
- Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Seoul 135-720, South Korea.
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NAGANAWA S, YAMAZAKI M, KAWAI H, SONE M, NAKASHIMA T. Contrast Enhancement of the Anterior Eye Segment and Subarachnoid Space: Detection in the Normal State by Heavily T2-weighted 3D FLAIR. Magn Reson Med Sci 2011; 10:193-9. [DOI: 10.2463/mrms.10.193] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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13
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Pyykkö I, Zou J, Poe D, Nakashima T, Naganawa S. Magnetic resonance imaging of the inner ear in Meniere's disease. Otolaryngol Clin North Am 2010; 43:1059-80. [PMID: 20713245 DOI: 10.1016/j.otc.2010.06.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Recent magnetic resonance imaging (MRI) techniques have made it possible to examine the compartments of the cochlea using gadolidium-chelate (GdC) as a contrast agent. As GdC loads into the perilymph space without entering the endolymph in healthy inner ears, the technique provides possibilities to visualize the different cochlear compartments and evaluate the integrity of the inner ear barriers. This critical review presents the recent advancements in the inner ear MRI technology, contrast agent application and the correlated ototoxicity study, and the uptake dynamics of GdC in the inner ear. GdC causes inflammation of the mucosa of the middle ear, but there are no reports or evidence of toxicity-related changes in vivo either in animals or in humans. Intravenously administered GdC reached the guinea pig cochlea about 10 minutes after administration and loaded the scala tympani and scala vestibuli with the peak at 60 minutes. However, the perilymphatic loading peak was 80 to 100 minutes in mice after intravenous administration of GdC. In healthy animals the scala media did not load GdC. In mice in which GdC was administered topically onto the round window, loading of the cochlea peaked at 4 hours, at which time it reached the apex. The initial portions of the organ to be filled were the basal turn of the cochlea and vestibule. In animal models with endolymphatic hydrops (EH), bulging of the Reissner's membrane was observed as deficit of GdC in the scala vestibuli. Histologically the degree of bulging correlated with the MR images. In animals with immune reaction-induced EH, MRI showed that EH could be limited to restricted regions of the inner ear, and in the same inner ear both EH and leakage of GdC into the scala media were visualized. More than 100 inner ear MRI scans have been performed to date in humans. Loading of GdC followed the pattern seen in animals, but the time frame was different. In intravenous delivery of double-dose GdC, the inner ear compartments were visualized after 4 hours. The uptake pattern of GdC in the perilymph of humans between 2 hours and 7 hours after local delivery needs to be clarified. In almost all patients with probable or suspected Ménière's disease, EH was verified. Specific algorithms with a 12-pole coil using fluid attenuation inversion recovery sequences are recommended for initial imaging in humans.
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Affiliation(s)
- Ilmari Pyykkö
- Department of Otolaryngology, University of Tampere, Teiskontie 35, 33520, Tampere, Finland.
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Naganawa S, Kawai H, Sone M, Nakashima T. Increased sensitivity to low concentration gadolinium contrast by optimized heavily T2-weighted 3D-FLAIR to visualize endolymphatic space. Magn Reson Med Sci 2010; 9:73-80. [PMID: 20585197 DOI: 10.2463/mrms.9.73] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To increase the sensitivity of 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) to low concentration gadolinium (Gd)-based contrast medium, we optimized sequence parameters on a phantom and evaluated the optimized sequence in patients suspicious for endolymphatic hydrops. MATERIALS AND METHODS All scans were performed on a 3-tesla magnetic resonance (MR) unit using a 32-channel head coil. We optimized sequence parameters using a phantom filled with diluted Gd and compared the optimized protocol with 3D-FLAIR using conventional turbo spin echo sequence (3D-FLAIR-CONV). Nine patients underwent scanning using the newly optimized sequence and 3D-FLAIR-CONV 4 hours after double-dose administration of intravenous Gd. We subjectively scored separation of endo- and perilymph space and measured contrast-to-noise ratio (CNR) between endo- and perilymph. RESULTS The optimized sequence in the phantom study consisted of: repetition time, 9000 ms; echo time, 540 ms; inversion time, 2400 ms; low constant readout flip angle, 120 degrees in the later part of the echo train. Image contrast became heavily T(2)-weighted (hT(2)W-3D-FLAIR). In patients, we recognized endolymphatic space for both the cochlea and vestibule significantly better by hT(2)W-3D-FLAIR than 3D-FLAIR-CONV (P<0.01). The mean CNR of the new method was also better than that of 3D-FLAIR-CONV (P<0.01). CONCLUSIONS The newly optimized hT(2)W-3D-FLAIR was more sensitive than the previous method to low concentration of Gd. Visualization of the endolymphatic space by double-dose administration of intravenous Gd would be more reliable using hT(2)W-3D-FLAIR.
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Affiliation(s)
- Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Shouwa-ku, Nagoya, Japan.
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Yamazaki M, Naganawa S, Kawai H, Nihashi T, Fukatsu H, Nakashima T. Increased signal intensity of the cochlea on pre- and post-contrast enhanced 3D-FLAIR in patients with vestibular schwannoma. Neuroradiology 2010; 51:855-63. [PMID: 19727694 DOI: 10.1007/s00234-009-0588-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Accepted: 08/17/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION In the vestibular schwannoma patients, the pathophysiologic mechanism of inner ear involvement is still unclear. We investigated the status of the cochleae in patients with vestibular schwannoma by evaluating the signal intensity of cochlear fluid on pre- and post-contrast enhanced thin section three-dimensional fluid-attenuated inversion recovery (3D-FLAIR). METHODS Twenty-eight patients were retrospectively analyzed. Post-contrast images were obtained in 18 patients, and 20 patients had the records of their pure-tone audiometry. Regions of interest of both cochleae (C) and of the medulla oblongata (M) were determined on 3D-FLAIR images by referring to 3D heavily T2-weighted images on a workstation. The signal intensity ratio between C and M on the 3D-FLAIR images (CM ratio) was then evaluated. In addition, correlation between the CM ratio and the hearing level was also evaluated. RESULTS The CM ratio of the affected side was significantly higher than that of the unaffected side (rho < 0.001). In the affected side, post-contrast signal elevation was observed (rho < 0.005). In 13 patients (26 cochleae) who underwent both gadolinium injection and the pure-tone audiometry, the post-contrast CM ratio correlated with hearing level (rho < 0.05). CONCLUSION The results of the present study suggest that alteration of cochlear fluid composition and increased permeability of the blood-labyrinthine barrier exist in the affected side in patients with vestibular schwannoma. Furthermore, although weak, positive correlation between post-contrast cochlear signal intensity on 3D-FLAIR and hearing level warrants further study to clarify the relationship between 3D-FLAIR findings and prognosis of hearing preservation surgery.
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Affiliation(s)
- Masahiro Yamazaki
- Department of Radiology, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
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Lee IH, Kim HJ, Chung WH, Kim E, Moon JW, Kim ST, Kim KH, Jeon P, Byun HS. Signal intensity change of the labyrinth in patients with surgically confirmed or radiologically diagnosed vestibular schwannoma on isotropic 3D fluid-attenuated inversion recovery MR imaging at 3 T. Eur Radiol 2009; 20:949-57. [PMID: 19898851 DOI: 10.1007/s00330-009-1626-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2009] [Revised: 08/04/2009] [Accepted: 08/29/2009] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the signal intensity (SI) change of the labyrinth in patients with vestibular schwannoma on isotropic 3D fluid-attenuated inversion recovery (FLAIR) imaging at 3 T. METHODS Thirty-four patients with surgically confirmed or radiologically diagnosed vestibular schwannoma were included in this study. Retrospectively, we visually and quantitatively compared the SIs of the cochlea and vestibule on the affected side with those on the unaffected side. We also investigated whether there was correlation between the SI ratios (SIRs) of the labyrinth and the audiometric findings. RESULTS On 3D FLAIR images, the SI of the cochlea and vestibule on the affected side was significantly increased in 97% (33/34) and 91% (31/34), respectively. While the SI of the cochlea was diffusely increased, that of the vestibule was only partially increased. Quantitative study also revealed statistically significantly higher SIRs of the cochlea (0.99 +/- 0.29) and vestibule (0.73 +/- 0.31) on the affected side, compared with the cochlea (0.47 +/- 0.20) and vestibule (0.19 +/- 0.10) on the unaffected side. There was no significant correlation of the SIRs of the labyrinth with the degree of hearing loss. CONCLUSION In patients with vestibular schwannoma, isotropic 3D FLAIR imaging is a useful method for the evaluation of the SI changes of the labyrinth.
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Affiliation(s)
- In Ho Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lin CY, Lin MH, Cheung WM, Lin TN, Chen JH, Chang C. In vivo cerebromicrovasculatural visualization using 3D ΔR2-based microscopy of magnetic resonance angiography (3DΔR2-mMRA). Neuroimage 2009; 45:824-31. [DOI: 10.1016/j.neuroimage.2008.12.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Revised: 11/13/2008] [Accepted: 12/08/2008] [Indexed: 11/16/2022] Open
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Busse RF, Brau ACS, Vu A, Michelich CR, Bayram E, Kijowski R, Reeder SB, Rowley HA. Effects of refocusing flip angle modulation and view ordering in 3D fast spin echo. Magn Reson Med 2009; 60:640-9. [PMID: 18727082 DOI: 10.1002/mrm.21680] [Citation(s) in RCA: 211] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Recent advances have reduced scan time in three-dimensional fast spin echo (3D-FSE) imaging, including very long echo trains through refocusing flip angle (FA) modulation and 2D-accelerated parallel imaging. This work describes a method to modulate refocusing FAs that produces sharp point spread functions (PSFs) from very long echo trains while exercising direct control over minimum, center-k-space, and maximum FAs in order to accommodate the presence of flow and motion, SNR requirements, and RF power limits. Additionally, a new method for ordering views to map signal modulation from the echo train into k(y)-k(z) space that enables nonrectangular k-space grids and autocalibrating 2D-accelerated parallel imaging is presented. With long echo trains and fewer echoes required to encode large matrices, large volumes with high in- and through-plane resolution matrices may be acquired with scan times of 3-6 min, as demonstrated for volumetric brain, knee, and kidney imaging.
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Affiliation(s)
- Reed F Busse
- GE Healthcare, MR Applied Science Lab, Madison, Wisconsin 53717, USA.
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Abstract
CONCLUSION Recent advances in clinical MR imagers, such as the 3-Tesla, multi-channel phased-array coil and novel pulse sequences, allow the evaluation of subtle alterations in the inner ear fluid environments and breakdown of the blood-labyrinthine barrier. Intratympanic injection of Gd-DTPA allows the imaging detection of endolymphatic hydrops in patients. OBJECTIVES To describe the current status of inner ear MRI and future directions for imaging. MATERIALS AND METHODS Based on our experiences and literature research, a brief review of the history and recent developments of inner ear MRI is presented. RESULTS The 3D-FLAIR technique can detect abnormalities that could not be visualized previously in many inner ear diseases, such as sudden deafness, otosclerosis, lupus erythematosus, mumps, and Ramsay-Hunt syndrome. Imaging techniques, indications, and findings for the visualization of endolymphatic hydrops after intratympanic injection of Gd-DTPA are also discussed. This procedure enabled the visualization of endolymphatic hydrops in vivo. Newly developed 3D-real IR techniques and utilities of 32 channel coil are also presented.
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Naganawa S, Satake H, Iwano S, Sone M, Nakashima T. Communication between cochlear perilymph and cerebrospinal fluid through the cochlear modiolus visualized after intratympanic administration of Gd-DTPA. ACTA ACUST UNITED AC 2009; 26:597-602. [DOI: 10.1007/s11604-008-0286-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Accepted: 09/22/2008] [Indexed: 10/21/2022]
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Naganawa S, Satake H, Iwano S, Fukatsu H, Sone M, Nakashima T. Imaging endolymphatic hydrops at 3 tesla using 3D-FLAIR with intratympanic Gd-DTPA administration. Magn Reson Med Sci 2008; 7:85-91. [PMID: 18603840 DOI: 10.2463/mrms.7.85] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Visualization of endolymphatic hydrops by 3-dimensional fluid-attenuated inversion recovery-FLAIR using conventional turbo-spin-echo (3D-FLAIR-CONV) after intratympanic injection of Gd-DTPA has been reported in patients with Ménière's disease. Compared to 3D-FLAIR-CONV used in previous studies, the addition of a variable flip-angle technique (3D-FLAIR-VFL) enables very long echo trains and, therefore, shorter scan times. We evaluated whether 3D-FLAIR-VFL could replace 3D-FLAIR-CONV in detecting endolymphatic hydrops after intratympanic Gd-DTPA administration. METHODS Eleven patients were included in this study. Twenty-four hours after Gd-DTPA injection, we performed 3D-FLAIR-CONV and 3D-FLAIR-VFL imaging at 3T. We compared the contrast-to-noise ratio (CNR) between cochlear fluid and the cerebellum between the 2 FLAIR sequences. We subjectively scored the size of the endolymphatic space in the cochlea and vestibule for each patient and correlated the scores with the clinical diagnoses. RESULTS The CNR of 3D-FLAIR-CONV was significantly higher than that of 3D-FLAIR-VFL. Scores for the size of endolymphatic space in the vestibule were identical between the 2 sequences; however, those in the cochlea disagreed in 3 cases. 3D-FLAIR-CONV correlated better with the clinical diagnoses. CONCLUSIONS Currently, we may not be able to replace 3D-FLAIR-CONV with 3D-FLAIR-VFL, at least not with the scanning parameters used in the present study.
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Affiliation(s)
- Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Komada T, Naganawa S, Ogawa H, Matsushima M, Kubota S, Kawai H, Fukatsu H, Ikeda M, Kawamura M, Sakurai Y, Maruyama K. Contrast-enhanced MR imaging of metastatic brain tumor at 3 tesla: utility of T(1)-weighted SPACE compared with 2D spin echo and 3D gradient echo sequence. Magn Reson Med Sci 2008; 7:13-21. [PMID: 18460844 DOI: 10.2463/mrms.7.13] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We evaluated the newly developed whole-brain, isotropic, 3-dimensional turbo spin-echo imaging with variable flip angle echo train (SPACE) for contrast-enhanced T(1)-weighted imaging in detecting brain metastases at 3 tesla (T). Twenty-two patients with suspected brain metastases underwent postcontrast study with SPACE, magnetization-prepared rapid gradient-echo (MP-RAGE), and 2-dimensional T(1)-weighted spin echo (2D-SE) imaging at 3T. We quantitatively compared SPACE, MP-RAGE, and 2D-SE images by using signal-to-noise ratios (SNRs) for gray matter (GM) and white matter (WM) and contrast-to-noise ratios (CNRs) for GM-to-WM, lesion-to-GM, and lesion-to-WM. Two blinded radiologists evaluated the detection of brain metastases by segment-by-segment analysis and continuously-distributed test. The CNR between GM and WM was significantly higher on MP-RAGE images than on SPACE images (P<0.01). The CNRs for lesion-to-GM and lesion-to-WM were significantly higher on SPACE images than on MP-RAGE images (P<0.01). There was no significant difference in each sequence in detection of brain metastases by segment-by-segment analysis and the continuously-distributed test. However, in some cases, the lesions were easier to detect in SPACE images than in other sequences, and also the vascular signals, which sometimes mimic lesions in MP-RAGE and 2D-SE images, were suppressed in SPACE images. In detection of brain metastases at 3T magnetic resonance (MR) imaging, SPACE imaging may provide an effective, alternative approach to MP-RAGE imaging for 3D T(1)-weighted imaging.
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Affiliation(s)
- Tomohiro Komada
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Three-dimensional fluid attenuated inversion recovery imaging with isotropic resolution and nonselective adiabatic inversion provides improved three-dimensional visualization and cerebrospinal fluid suppression compared to two-dimensional flair at 3 tesla. Invest Radiol 2008; 43:547-51. [PMID: 18648253 DOI: 10.1097/rli.0b013e3181814d28] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES In this investigation, we compare two-dimensional (2D) fluid-attenuated inversion recovery (FLAIR) imaging of the brain to an isotropic three-dimensional (3D) FLAIR technique that uses a modulated refocusing flip angle echo train and parallel imaging with 2D acceleration. MATERIALS AND METHODS Two-dimensional and 3D FLAIR sequences were obtained in 16 patients. All examinations were performed on a 3 Tesla (T) magnetic resonance (MR) system. Flow artifacts within the subarachnoid space and ventricles were scored using a 4-point scale. For 2D and 3D FLAIR, the signal-to-noise ratios and contrast-to-noise ratios were calculated. RESULTS Compared to 2D FLAIR, the 3D FLAIR images were less degraded by flow artifacts in the subarachnoid space and ventricle (P < 0.03) based on the qualitative imaging scores. Signal-to-noise ratios and contrast-to-noise ratios were higher for 3D FLAIR (P < 0.02) for all variables when compared with 2D FLAIR sequence. CONCLUSIONS The acquisition time for whole brain isotropic fast spin echo 3D FLAIR can be dramatically reduced by using an extended echo train with flip angle modulation and parallel imaging. The adiabatic, nonselective inversion pulse encompasses the entire volume and provides uniform suppression of the cerebrospinal fluid signal eliminating cerebrospinal fluid pulsation artifacts. Other advantages include reformatting in any desired plane, volume measurements, displays of surface anatomy, and coregistration.
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Ley S, Zaporozhan J, Arnold R, Eichhorn J, Schenk JP, Ulmer H, Kreitner KF, Kauczor HU. Preoperative assessment and follow-up of congenital abnormalities of the pulmonary arteries using CT and MRI. Eur Radiol 2006; 17:151-62. [PMID: 16799783 DOI: 10.1007/s00330-006-0300-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Revised: 04/09/2006] [Accepted: 04/18/2006] [Indexed: 12/01/2022]
Abstract
Congenital heart disease (CHD), including complex anomalies of the pulmonary arteries, are now earlier diagnosed and treated. Due to improvements in interventional and surgical therapy, the number of patients with the need for follow-up examinations is increasing. Pre- and postinterventional imaging should be done as gently as possible, avoiding invasive techniques if possible. With the technical improvement of multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI), both techniques are increasingly used for noninvasive assessment of the pulmonary vasculature in children with CHD. Knowledge of the most common diseases affecting the pulmonary vasculature and the kind of surgical and interventional procedures is essential for optimal imaging planning. This is especially important because interventions can be positively influenced by high-quality imaging. Therefore, the most common diseases and procedures are described and imaging modality of choice and important image findings are discussed.
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Affiliation(s)
- Sebastian Ley
- Department of Pediatric Radiology, University Children's Hospital, Im Neuenheimer Feld 153, 69120 Heidelberg, Germany.
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Naganawa S, Sugiura M, Kawamura M, Fukatsu H, Nakashima T, Maruyama K. Prompt Contrast Enhancement of Cerebrospinal Fluid Space in the Fundus of the Internal Auditory Canal: Observations in Patients with Meningeal Diseases on 3D-FLAIR Images at 3 Tesla. Magn Reson Med Sci 2006; 5:151-5. [PMID: 17139141 DOI: 10.2463/mrms.5.151] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We speculated that meningeal pathologies might facilitate the permeability of cranial nerves at the fundus of the internal auditory canal (IAC), causing prompt enhancement after administration of Gd-DTPA. Using a 3D- fluid-attenuated inversion recovery (FLAIR) sequence, we evaluated the enhancement of the cerebrospinal fluid (CSF) space in the IAC fundus 10 min after Gd-DTPA administration in patients with meningeal diseases. Twenty patients (aged 22 to 79 years) were divided into 2 groups, a group with meningeal disease comprising 9 patients with meningeal abnormalities (6, tumor dissemination; 3, infection) and a control group of 11 patients with unilateral IAC pathology whose healthy sides were included as controls. Six of the 9 patients in the group with meningeal disease showed bilateral enhancement; one showed unilateral enhancement. None of the control group showed enhancement in the healthy side. One patient with Ramsay-Hunt syndrome showed only ipsilateral enhancement. Enhancement in the IAC fundus was frequently observed in patients with meningeal disease, even just 10 min after administration of contrast agent. This enhancement in the IAC fundus was never visible on T1-weighted 3D-FLASH images.
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Affiliation(s)
- Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Japan.
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