1
|
Metz C, Weng AM, Heidenreich JF, Slawig A, Benkert T, Köstler H, Veldhoen S. Reproducibility of non-contrast enhanced multi breath-hold ultrashort echo time functional lung MRI. Magn Reson Imaging 2023; 98:149-154. [PMID: 36681313 DOI: 10.1016/j.mri.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/14/2022] [Accepted: 01/14/2023] [Indexed: 01/20/2023]
Abstract
PURPOSE To evaluate the intraindividual reproducibility of functional lung imaging using non-contrast enhanced multi breath-hold 3D-UTE MRI. METHODS Ten healthy volunteers underwent non-contrast enhanced 3D-UTE MRI at three time points for same-day and different-day measurements employing a stack-of-spirals trajectory at 3 T. At each time point, inspiratory and expiratory breathing states were acquired for tidal and deep breathing, each within a single breath-hold. For functional image analysis, fractional ventilation (FV) was calculated pixelwise after image registration from the MR signal change. To decouple FV from breathing depth, the individual lung volume was used for volume adjustment (rFV). Reproducibility evaluation was performed in eight lung segments. Statistical analyses included two way mixed intraclass correlation (ICC), sign-test, Friedman-test and modified Bland-Altman analyses. RESULTS FV from tidal breathing showed an ICC of 0.81, a bias of 1.3% and an interval of confidence (CI) ranging from -67.1 to 69.6%. FV from deep breathing was higher reproducible with an ICC of 0.92 (bias, -0.2%; CI, -34.2 to 33.7%). Following volume adjustment, reproducibility of rFV for tidal breathing improved (ICC, 0,86; bias, 2.0%; CI, -34.3 to 38.3%), whereas it did not bear significant benefits for deep breathing (ICC, 0.89; bias, 2.8%; CI, -24.9 to 30.5%). Reproducibility was independent from the examination day. CONCLUSION Non-contrast-enhanced multi breath-hold 3D-UTE MRI allows for highly reproducible ventilation imaging.
Collapse
Affiliation(s)
- C Metz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany.
| | - A M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - J F Heidenreich
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - A Slawig
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - T Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - H Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - S Veldhoen
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| |
Collapse
|
2
|
Mendes Pereira L, Wech T, Weng AM, Kestler C, Veldhoen S, Bley TA, Köstler H. UTE-SENCEFUL: first results for 3D high-resolution lung ventilation imaging. Magn Reson Med 2018; 81:2464-2473. [PMID: 30393947 DOI: 10.1002/mrm.27576] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/27/2018] [Accepted: 10/01/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aimed to develop a 3D MRI technique to assess lung ventilation in free-breathing and without the administration of contrast agent. METHODS A 3D-UTE sequence with a koosh ball trajectory was developed for a 3 Tesla scanner. An oversampled k-space was acquired, and the direct current signal from the k-space center was used as a navigator to sort the acquired data into 8 individual breathing phases. Gradient delays were corrected, and iterative SENSE was used to reconstruct the individual timeframes. Subsequently, the signal changes caused by motion were eliminated using a 3D image registration technique, and ventilation-weighted maps were created by analyzing the signal changes in the lung tissue. Six healthy volunteers and 1 patient with lung cancer were scanned with the new 3D-UTE and the standard 2D technique. Image quality and quantitative ventilation values were compared between both methods. RESULTS UTE-based self-gated noncontrast-enhanced functional lung (SENCEFUL) MRI provided a time-resolved reconstruction of the breathing motion, with a 49% increase of the SNR. Ventilation quantification for healthy subjects was in statistical agreement with 2D-SENCEFUL and the literature, with a mean value of 0.11 ± 0.08 mL/mL for the whole lung. UTE-SENCEFUL was able to visualize and quantify ventilation deficits in a patient with lung tumor that were not properly depicted by 2D-SENCEFUL. CONCLUSION UTE-SENCEFUL represents a robust MRI method to assess both morphological and functional information of the lungs in 3D. When compared to the 2D approach, 3D-UTE offered ventilation maps with higher resolution, improved SNR, and reduced ventilation artifacts.
Collapse
Affiliation(s)
- L Mendes Pereira
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - T Wech
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - A M Weng
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - C Kestler
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - S Veldhoen
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - T A Bley
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - H Köstler
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| |
Collapse
|
3
|
Gilbert F, Meffert RH, Schmalzl J, Weng AM, Köstler H, Eden L. Grade of retraction and tendon thickness correlates with MR-spectroscopically measured amount of fatty degeneration in full thickness supraspinatus tears. BMC Musculoskelet Disord 2018; 19:197. [PMID: 30037322 PMCID: PMC6055352 DOI: 10.1186/s12891-018-2096-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/16/2018] [Indexed: 12/11/2022] Open
Abstract
Background The amount of fatty degeneration (FD) has major impact on the clinical result and cuff integrity after rotator cuff repair. A quantitative analysis with magnet resonance imaging (MRI) spectroscopy was employed to analyze possible correlation of FD with tendon retraction, tendon thickness and patients’ characteristics in full thickness supraspinatus tears. Methods Forty-two patients with full-thickness supraspinatus tears underwent shoulder MRI including an experimental spectroscopic sequence allowing quantification of the fat fraction in the supraspinatus muscle belly. The amount of fatty degeneration was correlated with tendon retraction, tendon thickness, patients’ age, gender, smoker status, symptom duration and body mass index (BMI). Patients were divided in to three groups of retraction (A) 0-10 mm (n=), (B) 11-20 mm (n=) and (C) < 21 mm (n=) and the means of FD for each group were calculated. Results Tendon retraction (R = 0.6) and symptom duration (R = 0.6) correlated positively, whereas tendon thickness correlated negatively (R = − 0.6) with the amount of FD. The fat fraction increased significantly with tendon retraction: Group (A) showed a mean fat mount of 3.7% (±4%), group (B) of 16.7% (±8.2%) and group (C) of 37.5% (±19%). BMI, age and smoker-status only showed weak to moderate correlation with the amount of FD in this cohort. Conclusion MRI spectroscopy revealed significantly higher amount of fat with increasing grade of retraction, symptom duration and decreased tendon thickness. Thus, these parameters may indirectly be associated with the severity of tendon disease.
Collapse
Affiliation(s)
- F Gilbert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany.
| | - R H Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - J Schmalzl
- Department of Traumatology and Hand Surgery, St. Vincentius Klinik, ViDia Kliniken, Suedendstraße 32, D-76137, Karlsruhe, Germany
| | - A M Weng
- Department of Radiology, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - H Köstler
- Department of Radiology, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - L Eden
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| |
Collapse
|
4
|
Gilbert F, Heintel TM, Jakubietz MG, Köstler H, Sebald C, Meffert RH, Weng AM. Quantitative MRI comparison of multifidus muscle degeneration in thoracolumbar fractures treated with open and minimally invasive approach. BMC Musculoskelet Disord 2018. [PMID: 29514622 PMCID: PMC5842610 DOI: 10.1186/s12891-018-2001-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Minimally invasive pedicle screw fixation has less approach-related morbidity than open screw placement and is allegedly less traumatizing on paravertebral muscles, as there is no requirement to mobilize and retract the adjacent muscle portion. The approach-related long-term effects to the morphology of the paravertebral muscles are unknown. The purpose of this study was to compare the long-term amount of fatty degeneration of the multifidus muscle in patients treated with a classical open or a minimally invasive approach. Methods Fourteen Patients meeting inclusion criteria were selected. In all patients a singular fracture of the thoracolumbar spine with a two-level posterior instrumentation was treated, either using an open approach or a minimally invasive approach. All patients underwent quantitative MRI spectroscopy for quantification of the fatty degeneration in the multifidus muscle as a long-term proof for muscle loss after minimum 4-year follow-up. Clinical outcome was assessed using Oswestry Low Back Pain Disability Questionnaire, SF-36 and VA-scale for pain. Results The minimally invasive approach group failed to show less muscle degeneration in comparison to the open group. Total amount of fatty degeneration was 14.22% in the MIS group and 12.60% in the open group (p = 0.64). In accordance to MRI quantitative results there was no difference in the clinical outcome after a mean follow up of 5.9 years (±1.8). Conclusion As short-term advantages of minimal invasive screw placement have been widely demonstrated, no advantage of the MIS, displaying a significant difference in the amount of fatty degeneration and resulting in a better clinical outcome could be found. Besides the well-known short-term advantage of minimally invasive pedicle screw placement, a long-term advantage, such as less muscle degeneration and thus superior clinical results, compared to the open approach could not be shown.
Collapse
Affiliation(s)
- F Gilbert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany.
| | - T M Heintel
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - M G Jakubietz
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - H Köstler
- Department of Radiology Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - C Sebald
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - R H Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - A M Weng
- Department of Radiology Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| |
Collapse
|
5
|
Petritsch B, Köstler H, Weng AM, Horn M, Gassenmaier T, Kunz AS, Weidemann F, Wanner C, Bley TA, Beer M. Myocardial lipid content in Fabry disease: a combined 1H-MR spectroscopy and MR imaging study at 3 Tesla. BMC Cardiovasc Disord 2016; 16:205. [PMID: 27793097 PMCID: PMC5084400 DOI: 10.1186/s12872-016-0382-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 10/22/2016] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Fabry disease is characterized by a progressive deposition of sphingolipids in different organ systems, whereby cardiac involvement leads to death. We hypothesize that lysosomal storage of sphingolipids in the heart as occurring in Fabry disease does not reflect in higher cardiac lipid concentrations detectable by 1H magnetic resonance spectroscopy (MRS) at 3 Tesla. METHODS Myocardial lipid content was quantified in vivo by 1H-MRS in 30 patients (12 male, 18 female; 18 patients treated with enzyme replacement therapy) with genetically proven Fabry disease and in 30 healthy controls. The study protocol combined 1H-MRS with cardiac cine imaging and LGE MRI in a single examination. RESULTS Myocardial lipid content was not significantly elevated in Fabry disease (p = 0.225). Left ventricular (LV) mass was significantly higher in patients suffering from Fabry disease compared to controls (p = 0.019). Comparison of patients without signs of myocardial fibrosis in MRI (LGE negative; n = 12) to patients with signs of fibrosis (LGE positive; n = 18) revealed similar myocardial lipid content in both groups (p > 0.05), while the latter showed a trend towards elevated LV mass (p = 0.076). CONCLUSIONS This study demonstrates the potential of lipid metabolic investigation embedded in a comprehensive examination of cardiac morphology and function in Fabry disease. There was no evidence that lysosomal storage of sphingolipids influences cardiac lipid content as measured by 1H-MRS. Finally, the authors share the opinion that a comprehensive cardiac examination including three subsections (LGE; 1H-MRS; T1 mapping), could hold the highest potential for the final assessment of early and late myocardial changes in Fabry disease.
Collapse
Affiliation(s)
- B Petritsch
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.
| | - H Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.,University of Würzburg, Comprehensive Heart Failure Center, 97080, Würzburg, Germany
| | - A M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - M Horn
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - T Gassenmaier
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - A S Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - F Weidemann
- University of Würzburg, Comprehensive Heart Failure Center, 97080, Würzburg, Germany.,Department of Internal Medicine II/Cardiology, Katharinen-Hospital Unna, Obere Husemannstr.2, 59423, Unna, Germany
| | - C Wanner
- Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - T A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany
| | - M Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| |
Collapse
|
6
|
Abstract
OBJECTIVE To calculate and evaluate absolute quantitative myocardial perfusion maps from rest first-pass perfusion MRI. METHODS 10 patients after revascularization of myocardial infarction underwent cardiac rest first-pass perfusion MRI. Additionally, perfusion examinations were performed in 12 healthy volunteers. Quantitative myocardial perfusion maps were calculated by using a deconvolution technique, and results were compared were the findings of a sector-based quantification. RESULTS Maps were typically calculated within 3 min per slice. For the volunteers, myocardial blood flow values of the maps were 0.51 ± 0.16 ml g(-1) per minute, whereas sector-based evaluation delivered 0.52 ± 0.15 ml g(-1) per minute. A t-test revealed no statistical difference between the two sets of values. For the patients, all perfusion defects visually detected in the dynamic perfusion series could be correctly reproduced in the maps. CONCLUSION Calculation of quantitative perfusion maps from myocardial perfusion MRI examinations is feasible. The absolute quantitative maps provide additional information on the transmurality of perfusion defects compared with the visual evaluation of the perfusion series and offer a convenient way to present perfusion MRI findings. ADVANCES IN KNOWLEDGE Voxelwise analysis of myocardial perfusion helps clinicians to assess the degree of tissue damage, and the resulting maps are a good tool to present findings to patients.
Collapse
Affiliation(s)
- A M Weng
- 1 Institute of Radiology, University of Würzburg, Würzburg, Germany
| | | | | | | | | |
Collapse
|
7
|
Wilimsky S, Weng AM, Bender G, Hahn D, Köstler H, Ritter CO. MR-Cold Pressor Test zur Absolutquantifizierung der myokardialen Perfusion bei Typ I Diabetikern. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
8
|
Neubauer H, Hebestreit H, Platek K, Weng AM, Hahn D, Köstler H, Beer M. Muskelarbeit live in der dynamischen 31P-MR-Spektroskopie. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1286243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
9
|
Ritter CO, Kowalski M, Weng AM, Beer M, Hahn D, Köstler H. Quantitative myocardial perfusion imaging with a MR cold pressor test. Magn Reson Med 2011; 67:246-50. [PMID: 21630345 DOI: 10.1002/mrm.22941] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 03/04/2011] [Accepted: 03/07/2011] [Indexed: 01/30/2023]
Abstract
The response of myocardial blood flow to sympathetic stimulation with cold is modulated by endothelium-related factors. As endothelial dysfunction is an early step in patients with coronary artery disease, the aim of this study was to establish a cold pressor test (CPT) setting for quantitative analysis of myocardial perfusion in a MR scanner. First pass perfusion studies were performed in 10 healthy volunteers using a 1.5 T MR scanner with a multislice steady state free precession perfusion trueFISP sequence in prebolus technique (1 cc/4 cc gadobenate dimeglumine). MR-CPT was established using an over head ice-water bath of the left hand. First pass perfusion imaging was started after 1 min to assure an adequate stimulus followed by a second series after 15 min to evaluate the rest perfusion. After motion correction images were segmented with an adapted, automated tool, myocardial contours were determined. Perfusion was quantitatively evaluated after contamination and baseline correction by deconvolution with the arterial input function using an exponential function model as residuum. All data could be evaluated. Mean myocardial perfusion rose from 0.61 ± 0.22 cc/g/min at rest to 1.15 ± 0.34 cc/g/min under CPT. MR myocardial perfusion values show a comparable increase under CPT as published positron emission tomography data. Consequently, CPT for the presence of endothelial dysfunction is feasible in the MR environment.
Collapse
Affiliation(s)
- C O Ritter
- Institute of Radiology, University of Würzburg, Würzburg, Germany.
| | | | | | | | | | | |
Collapse
|
10
|
Weng AM, Ritter CO, Lotz J, Beer M, Hahn D, Köstler H. Pixelbasierte Absolutquantifizierung der myokardialen Perfusion in der MRT – Berechnung von Perfusionskarten aus MR First-Pass Perfusionsuntersuchungen. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0029-1247986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|