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Abstract
There is a great clinical and genetic heterogeneity in congenital myopathies. Myo-MRI with pattern recognition has become a first-line complementary tool in clinical practice for this group of diseases. For diagnostic purposes, whole-body imaging techniques are preferred when involvement is axial or diffuse, as in most congenital myopathies, because of involvement of the tongue, masticator, neck or trunk muscles. Myo-MRI is widely used to identify abnormalities in muscle signal, volume or texture. Recognizable profiles or patterns have been identified in many of these genetic myopathies. The role of the radiologist is crucial in order to adapt the Myo-MRI protocols to the age of the patient and several clinical situations. Myo-MRI in children with congenital myopathies is a very demanding technique with a balance between acceptable time of examination and sufficient spatial resolution in order to detect subtle changes. Technical evolutions combining qualitative and quantitative analysis are useful to follow disease progression overtime. Outcome measures are expected to play a role in natural history description as well as in future therapeutic trials. Genetic diagnosis and interpretation of next generation sequencing results could be greatly influenced by statistical analysis with tools such as algorithms as well as graphical representations using heatmaps.
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Guo RM, Li QL, Luo ZX, Tang W, Jiao J, Wang J, Kang Z, Chen SQ, Zhang Y. In Vivo Assessment of Neurodegeneration in Type C Niemann-Pick Disease by IDEAL-IQ. Korean J Radiol 2018; 19:93-100. [PMID: 29354005 PMCID: PMC5768513 DOI: 10.3348/kjr.2018.19.1.93] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/01/2017] [Indexed: 11/24/2022] Open
Abstract
Objective To noninvasively assess the neurodegenerative changes in the brain of patients with Niemann-Pick type C (NPC) disease by measuring the lesion tissue with the iterative decomposition of water and fat with echo asymmetry and least square estimation-iron quantification (IDEAL-IQ). Materials and Methods Routine brain MRI, IDEAL-IQ and 1H-proton magnetic resonance spectroscopy (1H-MRS, served as control) were performed on 12 patients with type C Niemann-Pick disease (4 males and 8 females; age range, 15–61 years; mean age, 36 years) and 20 healthy subjects (10 males and 10 females; age range, 20–65 years; mean age, 38 years). The regions with lesion and the normal appearing regions (NARs) of patients were measured and analyzed based on the fat/water signal intensity on IDEAL-IQ and the lipid peak on 1H-MRS. Results Niemann-Pick type C patients showed a higher fat/water signal intensity ratio with IDEAL-IQ on T2 hyperintensity lesions and NARs (3.7–4.9%, p < 0.05 and 1.8–3.0%, p < 0.05, respectively), as compared to healthy controls (HCs) (1.2–2.3%). After treatment, the fat/water signal intensity ratio decreased (2.2–3.4%), but remained higher than in the HCs (p < 0.05). The results of the 1H-MRS measurements showed increased lipid peaks in the same lesion regions, and the micro-lipid storage disorder of NARs in NPC patients was detectable by IDEAL-IQ instead of 1H-MRS. Conclusion The findings of this study suggested that IDEAL-IQ may be useful as a noninvasive and objective method in the evaluation of patients with NPC; additionally, IDEAL-IQ can be used to quantitatively measure the brain parenchymal adipose content and monitor patient follow-up after treatment of NPC.
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Affiliation(s)
- Ruo-Mi Guo
- Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.,Department of Nuclear Medicine, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Qing-Ling Li
- Department of VIP Medical Center, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Zhong-Xing Luo
- Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Wen Tang
- Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Ju Jiao
- Department of Nuclear Medicine, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Jin Wang
- Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Zhuang Kang
- Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Shao-Qiong Chen
- Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Yong Zhang
- Department of Radiology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.,Department of Nuclear Medicine, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
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Guo RM, Lin WS, Liu WM, Zhou WY, Cao SE, Wang J, Li QL. Quantification of fat infiltration in the sacroiliac joints with ankylosing spondylitis using IDEAL sequence. Clin Radiol 2017; 73:231-236. [PMID: 29167015 DOI: 10.1016/j.crad.2017.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/06/2017] [Accepted: 10/20/2017] [Indexed: 11/16/2022]
Abstract
AIM To quantitatively assess fat infiltration in the sacroiliac joints (SIJs) of patients with ankylosing spondylitis (AS) by measuring the fat/water signal ratios of periarticular bone marrow with iterative decomposition of water and fat with echo asymmetry and least square estimation (IDEAL). MATERIALS AND METHODS Routine SIJ magnetic resonance imaging (MRI) and IDEAL were performed on 40 patients with AS and 30 healthy subjects. The fat infiltration regions (FIRs) and normal-appearing regions (NARs) of patients were measured based on the fat/water signal intensity on IDEAL. RESULTS AS patients had higher fat/water signal ratios on FIRs and NARs (65.4-85.4%, p<0.05, and 44.1-70.7%, p<0.05, respectively) compared to healthy controls (38.3-43.3%). After treatment, the fat/water signal ratios of FIRs and NARs decreased (42.1-53.7% and 41.5-50.3%, respectively), but they remained higher than in the healthy controls (p<0.05). The fat infiltration was detected more effectively with a fat fraction map of the IDEAL sequence (95%) than other sequences, including the T1-weighted sequence (65%), and the fat/water signal ratios of the sacrum and ilium between the left and right sides of SIJs were approximately the same. CONCLUSION The findings of this study suggest that IDEAL may be useful as a quantitative and objective method for evaluating the fat infiltration in the periarticular bone marrow of SIJs with AS; additionally, the sensitivity of IDEAL is better than that of routine sequences in detecting micro-fat infiltration of SIJs, and IDEAL can be used to quantitatively measure the adipose content and monitor patient follow-up after AS treatment.
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Affiliation(s)
- R-M Guo
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - W-S Lin
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - W-M Liu
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - W-Y Zhou
- Department of Laboratory, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - S-E Cao
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - J Wang
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Q-L Li
- Department of VIP Medical Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
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Pokorney AL, Chia JM, Pfeifer CM, Miller JH, Hu HH. Improved fat-suppression homogeneity with mDIXON turbo spin echo (TSE) in pediatric spine imaging at 3.0 T. Acta Radiol 2017; 58:1386-1394. [PMID: 28165290 DOI: 10.1177/0284185117690424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Robust fat suppression remains essential in clinical MRI to improve tissue signal contrast, minimize fat-related artifacts, and enhance image quality. Purpose To compare fat suppression between mDIXON turbo spin echo (TSE) and conventional frequency-selective and inversion-recovery methods in pediatric spine MRI. Material and Methods Images from T1-weighted (T1W) and T2-weighted (T2W) TSE sequences coupled with conventional methods and the mDIXON technique were compared in 36 patients (5.8 ± 5.4 years) at 3.0 T. Images from 42 pairs of T1W (n = 16) and T2W (n = 26) scans were acquired. Two radiologists reviewed the data and rated images using a three-point scale in two categories, including the uniformity of fat suppression and overall diagnostic image quality. The Wilcoxon rank-sum test was used to compare the scores. Results The Cohen's kappa coefficient for inter-rater agreement was 0.69 (95% confidence interval [CI], 0.56-0.83). Images from mDIXON TSE were considered superior in fat suppression ( P < 0.01) in 22 (rater 1) and 25 (rater 2) cases, respectively. In 13 (rater 1) and 11 (rater 2) cases, mDIXON TSE demonstrated improved diagnostic image quality ( P < 0.01). In three cases, fat suppression was superior using inversion-recovery and likewise in one case mDIXON had poorer image diagnostic quality. Lastly, mDIXON and conventional fat-suppression methods performed similarly in 17 (rater 1) and 14 (rater 2) cases, and yielded equal diagnostic image quality in 28 (rater 1) and 30 (rater 2) cases. Conclusion Robust fat suppression can be achieved with mDixon TSE pediatric spine imaging at 3.0 T and should be considered as a permanent replacement of traditional methods, in particular frequency-selective techniques.
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Affiliation(s)
- Amber L Pokorney
- Department of Medical Imaging and Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA
| | | | - Cory M Pfeifer
- Department of Medical Imaging and Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA
| | - Jeffrey H Miller
- Department of Medical Imaging and Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA
| | - Houchun H Hu
- Department of Medical Imaging and Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA
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Hansen BB, Hansen P, Carrino JA, Fournier G, Rasti Z, Boesen M. Imaging in mechanical back pain: Anything new? Best Pract Res Clin Rheumatol 2016; 30:766-785. [DOI: 10.1016/j.berh.2016.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/21/2016] [Accepted: 08/04/2016] [Indexed: 12/13/2022]
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Tomura N, Saginoya T, Kokubun M, Tsuchiya M, Yamamoto T. T2-weighted IDEAL fast spin echo imaging of the brachial plexus: comparison with STIR. Acta Radiol 2015; 56:1242-7. [PMID: 25318744 DOI: 10.1177/0284185114552292] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 08/30/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Short TI inversion-recovery (STIR) imaging is widely used, but its signal-to-noise-ratio (SNR) is relatively low. Iterative decomposition of water and fat with echo asymmetric and least-squares estimation (IDEAL) imaging has demonstrated promising results in several areas. PURPOSE To compare T2-weighted fast spin-echo IDEAL (T2W IDEAL-FSE) with STIR to determine which sequence is superior to image the brachial plexus. MATERIAL AND METHODS The brachial plexus was imaged in 18 patients and six volunteers. The patients' diseases comprised of: suspected chronic inflammatory demyelinating polyneuropathy (CIDP), brachial plexus palsy of unknown origin, and suspected amyotrophic lateral sclerosis. Frontal partial MIP images were acquired. Image quality was qualitatively and independently scored by two radiologists on a three-point grading scale for noise, visibility of the nerve roots, and overall image quality. Inter-observer agreement of the rating by two readers was assessed. The SNR and contrast-to-noise-ratio (CNR) were quantitatively calculated, and differences between T2W IDEAL-FSE and STIR were compared. RESULTS Qualitatively, each score for T2W IDEAL-FSE was significantly higher (P < 0.01) than that for STIR. Quantitatively, both SNR and CNR for T2W IDEAL-FSE (45.3 ± 12.6 and 27.1 ± 12.1, respectively) were significantly higher (P < 0.001) than those for STIR (17.4 ± 6.1 and 8.2 ± 4.7, respectively). CONCLUSION T2W IDEAL-FSE could be used to replace STIR for visualization of the brachial plexus.
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Affiliation(s)
- Noriaki Tomura
- Department of Radiology and Neurology, Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan
| | - Toshiyuki Saginoya
- Department of Radiology and Neurology, Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan
| | - Mika Kokubun
- Department of Radiology and Neurology, Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan
| | - Mario Tsuchiya
- Department of Radiology and Neurology, Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan
| | - Teiji Yamamoto
- Department of Radiology and Neurology, Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan
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Abstract
Primary or metastatic spine tumors can present with pain and/or neurologic compromise depending on their location within the spinal axis. Metastases and multiple myeloma comprise most of these lesions. Management of spinal tumors includes surgical decompression with stabilization (neo), adjuvant chemotherapy and radiation therapy, curettage, bone grafting, bone marrow replacement, and palliative treatment with vertebral augmentation. Pre- and postoperative imaging plays a critical role in the diagnosis and management of patients with spinal tumors. This article reviews postoperative imaging of the spine, including imaging protocols, immediate and long-term routine imaging findings, and emergent findings in symptomatic patients.
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Affiliation(s)
- Esther E Coronel
- Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA
| | - Ruby J Lien
- Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA
| | - A Orlando Ortiz
- Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA.
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