Evaluation of image quality of DWIBS versus DWI sequences in thoracic MRI at 3 T

Purpose

To compare diffusion weighted imaging with background suppression (DWIBS) sequence with classic spectral diffusion sequence (DWI) with and without respiratory gating in mediastinal lymph node analysis at 3 T.

Materials and methods

26 patients scheduled for mediastinoscopic lymph node analysis, prospectively undergone a thoracic 3 T MRI with DWIBS (FatSat = STIR; TR/TE = 6674.1/44.7 ms; IR = 260 ms) and DWI sequences (FatSat = SPIR; TR/TE = 1291/59.6 ms) (b = 0-400-800 s/mm2) with and without (free breathing) respiratory gating.Images at b = 800 were analyzed by two radiologists. They performed qualitative analysis of fat-sat homogeneity and motion artifacts, rated from 0 to 4, and quantitative evaluation by studying signal to background (STB) of lymph nodes.

Results

Quality of fat suppression was significantly higher for DWIBS than for DWI both for free-breathing (score 3.48 ± 0.65 vs. 1.76 ± 0.96, p < 0.0001) and respiratory-gated scans (3.17 ± 0.77 vs. 1.72 ± 0.73, p = 0.0001). Similarly, artifacts were reduced with DWIBS (3.16 ± 0.47 vs. 1.76 ± 0.59, p < 0.0001; 3.0 ± 0.73 vs. 2.04 ± 0.53, p = 0.0001). Quantitative analysis showed higher STB with DWIBS (3.26 ± 1.83 vs. 0.98 ± 0.44, p < 0.0001; 3.56 ±, 2.09 vs. 0.92 ± 0.59, p < 0.0001). Gating did not improve image quality and STB on DWIBS (p > 0.05).

Conclusion

In thoracic MRI, ungated DWIBS sequence improves fat-sat homogeneity, reduces motion artifacts and increases STB of lymph nodes. Respiratory gating does not improve DWIBS image quality.     

Assessment of pulmonary artery pulse wave velocity in children: An MRI pilot study

Purpose

To assess the feasibility of measuring pulmonary artery (PA) pulse wave velocity (PWV) in children breathing ambient air and 12% oxygen.

Methods

Velocity-encoded phase-contrast MR images of the PA were acquired in 15 children, aged 9–12 years, without evidence of cardiac or pulmonary diseases. PWV was derived as the ratio of flow to area changes during early systole. Each child was scanned twice, in air and after at least 20 minutes into inspiratory hypoxic challenge. Intra-observer and inter-observer variability and repeatability were also compared.

Results

PA PWV, which was successfully measured in all subjects, increased from 1.31 ± 0.32 m/s in air to 1.61 ± 0.58 m/s under hypoxic challenge (p = 0.03). Intra- and inter-observer coefficients of variations were 9.0% and 15.6% respectively. Good correlation within and between observers of r = 0.92 and r = 0.72 respectively was noted for PA PWV measurements. Mean (95% limit of agreement) intra- and inter-observer agreement on Bland–Altman analysis were − 0.02 m/s (− 0.41–0.38 m/s) and -0.28 m/s (− 1.06–0.49 m/s).

Conclusion

PA PWV measurement in children using velocity-encoded MRI is feasible, reproducible and sufficiently sensitive to detect differences in PA compliance between normoxia and hypoxia. This technique can be used to detect early changes of PA compliance and monitor PAH in children.     

Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI

Purposes

To evaluate the diagnostic value of diffusion-weighted MRI (DWI) and combination of conventional MRI and DWI to predict metastatic axillary lymph nodes in breast cancer.

Materials and methods

Two hundred fifty-two breast cancer patients with 253 axillae were included. The morphological parameters on axial T2-weighted images without fat saturation and apparent diffusion coefficient (ADC) values were retrospectively analyzed. An independent t-test/chi-square test and receiver operating characteristics (ROC) curve analysis were used.

Results

On conventional MRI, short and long axis length, maximal cortical thickness, relative T2 value, loss of fatty hilum (p < 0.001 for each), and eccentric cortical thickening (p < 0.003) were statistically significantly different between the metastatic and nonmetastatic groups. The short axis to long axis ratio was not a statistically significant parameter. The ADC value was significantly different between the 2 groups, with an AUC that was higher than that of conventional MR parameters (AUC, 0.815; threshold, ≤ 0.986 × 10–3 mm²/sec; sensitivity, 75.8%; specificity, 83.9%). Using the adopted thresholds for each parameter, a total number of findings suggesting malignancy of 4 or higher was determined as the threshold, with high specificity (90.1%).

Conclusion

Using conventional MRI and DWI, we can evaluate the axilla in breast cancer with high specificity.     

Diffusion kurtosis imaging of the human kidney: A feasibility study

Purpose

To assess the feasibility and to optimize imaging parameters of diffusion kurtosis imaging (DKI) in human kidneys.

Methods

The kidneys of ten healthy volunteers were examined on a clinical 3 T MR scanner. For DKI, respiratory triggered EPI sequences were acquired in the coronal plane (3 b-values: 0, 300, 600 s/mm², 30 diffusion directions). A goodness of fit analysis was performed and the influence of the signal-to-noise ratio (SNR) on the DKI results was evaluated. Region-of-interest (ROI) measurements were performed to determine apparent diffusion coefficient (ADC), fractional anisotropy (FA) and mean kurtosis (MK) of the cortex and the medulla of the kidneys. Intra-observer and inter-observer reproducibility using Bland-Altman plots as well as subjective image quality of DKI were examined and ADC, FA, and MK parameters were compared.

Results

The DKI model fitted better to the experimental data (r = 0.99) with p < 0.05 than the common mono-exponential ADC model (r = 0.96).Calculation of reliable kurtosis parameters in human kidneys requires a minimum SNR of 8.31 on b = 0 s/mm² images.Corticomedullary differentiation was possible on FA and MK maps. ADC, FA and MK revealed significant differences in medulla (ADC = 2.82 × 10^− 3 mm²/s ± 0.25, FA = 0.42 ± 0. 05, MK = 0.78 ± 0.07) and cortex (ADC = 3.60 × 10^− 3 mm²/s ± 0.28, FA = 0.18 ± 0.04, MK = 0.94 ± 0.07) with p < 0.001.

Conclusion

Our initial results indicate the feasibility of DKI in the human kidney presuming an adequate SNR. Future studies in patients with kidney diseases are required to determine the value of DKI for functional kidney imaging.     

Quantitative assessment of regional systolic and diastolic functions and temporal heterogeneity of myocardial contraction in patients with myocardial infarction using cine magnetic resonance imaging and Fourier fitting

Purpose

The objective of this study is to determine regional left ventricle (LV) function and temporal heterogeneity of LV wall contraction by analyzing regional time–volume curve (TVC) after Fourier fitting and to assess altered systolic and diastolic functions and temporal indices of myocardial contraction in infarcted segments in comparison with noninfarcted myocardium in patients with myocardial infarction (MI).

Methods

Steady-state cine magnetic resonance (MR) and late gadolinium-enhanced (LGE) MR images were acquired using a 1.5-T MR system in 60 patients with MI. Regional LV function was determined by analyzing regional TVC in 16 segments. The fitted regional TVC was generated by Fourier curve fitting with five harmonics. Regional LV ejection fraction (EF), peak ejection rate (PER), peak filling rate (PFR), time to end-systole and time to peak filling (TPF) were determined from TVC and the first derivative curve.

Results

On LGE MR imaging (MRI), MI was observed in 307 of 960 segments (32.0%). Regional EF and PER averaged in LGE segments were 49.3±14.5% and 2.83±0.65 end-diastolic volume (EDV)/s, significantly lower than those in normal segments (66.7±11.9% and 3.63±0.60 EDV/s, P<.001 and P<.01, respectively). In addition, regional PFR, an index of diastolic function, was significantly reduced in LGE segments (1.94±0.54 vs. 2.86±0.68 EDV/s, P<.01). Time to end-systole and TPF were significantly greater in LGE segments (380.2±57.6 and 169.3±45.4 ms) than in normal segments (300.9±55.1 and 132.3±43.0 ms, P<.01 and P<.01, respectively).

Conclusions

Analysis of regional TVC on cine MRI after Fourier fitting allows quantitative assessment of regional systolic and diastolic LV functions and temporal heterogeneity of LV wall contraction in patients with MI.     

Comparison of different mathematical models of diffusion-weighted prostate MR imaging

Purpose

To evaluate which mathematical model (monoexponential, biexponential, statistical, kurtosis) fits best to the diffusion-weighted signal in prostate magnetic resonance imaging (MRI).

Materials and Methods

24 prostate 3-T MRI examinations of young volunteers (YV, n= 8), patients with biopsy proven prostate cancer (PC, n= 8) and an aged matched control group (AC, n= 8) were included. Diffusion-weighted imaging was performed using 11 b-values ranging from 0 to 800 s/mm².

Results

Monoexponential apparent diffusion coefficient (ADC) values were significantly (P<.001) lower in the peripheral (PZ) zone (1.18±0.16 mm²/s) and the central (CZ) zone (0.73±0.13 mm²/s) of YV compared to AC (PZ 1.92±0.17 mm²/s; CZ 1.35±0.21 mm²/s). In PC ADC_mono values (0.61±0.06 mm²/s) were significantly (P<.001) lower than in the peripheral of central zone of AC. Using the statistical analysis (Akaike information criteria) in YV most pixels were best described by the biexponential model (82%), the statistical model, respectively kurtosis (93%) each compared to the monoexponential model. In PC the majority of pixels was best described by the monoexponential model (57%) compared to the biexponential model.

Conclusion

Although a more complex model might provide a better fitting when multiple b-values are used, the monoexponential analyses for ADC calculation in prostate MRI is sufficient to discriminate prostate cancer from normal tissue using b-values ranging from 0 to 800 s/mm².     

RF-related heating assessment of extracranial neurosurgical implants at 7 T

Purpose

The purpose was to evaluate radiofrequency (RF)-related heating of commonly used extracranial neurosurgical implants in 7-T magnetic resonance imaging (MRI).

Materials and methods

Experiments were performed using a 7-T MR system equipped with a transmit/receive RF head coil. Four commonly used titanium neurosurgical implants were studied using a test procedure adapted from the American Society for Testing and Materials Standard F2182-11a. Implants (n = 4) were tested with an MRI turbo spin echo pulse sequence designed to achieve maximum RF exposure [specific absorption rate (SAR) level = 9.9 W/kg], which was further validated by performing calorimetry. Maximum temperature increases near each implant's surface were measured using fiberoptic temperature probes in a gelled-saline-filled phantom that mimicked the conductive properties of soft tissue. Measurement results were compared to literature data for patient safety.

Results

The highest achievable phantom averaged SAR was determined by calorimetry to be 2.0 ± 0.1 W/kg due to the highly conservative SAR estimation model used by this 7-T MR system. The maximum temperature increase at this SAR level was below 1.0 °C for all extracranial neurosurgical implants that underwent testing.

Conclusion

The findings indicated that RF-related heating under the conditions used in this investigation is not a significant safety concern for patients with the particular extracranial neurosurgical implants evaluated in this study.     

Diagnosis of relevant prostate cancer using supplementary cores from magnetic resonance imaging-prompted areas following multiple failed biopsies

Objectives

To establish the value of MRI in targeting re-biopsy for undiagnosed prostate cancer despite multiple negative biopsies and determine clinical relevance of detected tumors.

Materials and Methods

Thirty-eight patients who underwent MRI after 2 or more negative biopsies due to continued clinical suspicion and later underwent TRUS-guided biopsy supplemented by biopsy of suspicious areas depicted by MRI were identified. Diagnostic performance of endorectal 3T MRI in diagnosing missed cancer foci was assessed using biopsy results as the standard of reference. Ratio of positive biopsies using systematic versus MRI-prompted approaches was compared. Gleason scores of detected cancers were used as surrogate for clinical relevance.

Results

Thirty-four percent of patients who underwent MRI before re-biopsy had prostate cancer on subsequent biopsy. The positive biopsy yield with systematic sampling was 23% versus 92% with MRI-prompted biopsies(p < 0.0001). Seventy-seven percent of tumors were detected exclusively in the MRI-prompted zones. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI to provide a positive biopsy were 92%, 60%, 55%, 94% and 71%, respectively. The anterior gland and apical regions contained most tumors; 75% of cancers detected by MRI-prompted biopsy had Gleason score ≥ 7.

Conclusions

Clinically relevant tumors missed by multiple TRUS-guided biopsies can be detected by a MRI-prompted approach.     

Assessing reproducibility of diffusion-weighted magnetic resonance imaging studies in a murine model of HER2 + breast cancer

Background and purpose

The use of diffusion-weighted magnetic resonance imaging (DW-MRI) as a surrogate biomarker of response in preclinical studies is increasing. However, before a biomarker can be reliably employed to assess treatment response, the reproducibility of the technique must be established. There is a paucity of literature that quantifies the reproducibility of DW-MRI in preclinical studies; thus, the purpose of this study was to investigate DW-MRI reproducibility in a murine model of HER2 + breast cancer.

Materials and methods

Test–Retest DW-MRI scans separated by approximately six hours were acquired from eleven athymic female mice with HER2 + xenografts using a pulsed gradient spin echo diffusion-weighted sequence with three b values [150, 500, and 800 s/mm²]. Reproducibility was assessed for the mean apparent diffusion coefficient (ADC) from tumor and muscle tissue regions.

Results

The threshold to reflect a change in tumor physiology in a cohort of mice is defined by the 95% confidence interval (CI), which was ± 0.0972 × 10^- 3 mm²/s (± 11.8%) for mean tumor ADC. The repeatability coefficient defines this threshold for an individual mouse, which was ± 0.273 × 10^- 3 mm²/s. The 95% CI and repeatability coefficient for mean ADC of muscle tissue were ± 0.0949 × 10^- 3 mm²/s (± 8.30%) and ± 0.266 × 10^- 3 mm²/s, respectively.

Conclusions

Mean ADC of tumors is reproducible and appropriate for detecting treatment-induced changes on both an individual and mouse cohort basis.     

In vitro assessment of 3-T MRI issues for a bioabsorbable,coronary artery scaffold with metallic markers

Objective

Coronary artery stents are made from metallic mesh and, therefore, to ensure patient safety, these implants must be evaluated to determine risks associated with MRI. Recently, bioabsorbable scaffolds, which have metallic markers, have been developed for use in the coronary arteries. Because of the metallic materials, these implants may present issues for patients undergoing MRI. Therefore, the objective of this investigation was to assess MRI issues (i.e., magnetic field interactions, MRI-related heating, and artifacts at 3 T) for a new bioabsorbable, coronary artery scaffold with metallic markers.

Methods

A bioabsorbable, coronary artery scaffold (Mirage Microfiber Scaffold) underwent assessments for magnetic field interactions, MRI-related heating, and artifacts at 3-Tesla using standard techniques. MRI-related heating was evaluated with the scaffold placed in a gelled-saline-filled phantom and MRI was performed at an MR system reported, whole body averaged SAR of 2.9 W/kg for 15 minutes. Artifacts were characterized using T1-weighted spin echo and gradient echo, pulse sequences.

Results

There were no magnetic field interactions. The highest temperature rise was 1.6 °C (highest background temperature rise, 1.6 °C). Artifacts were relatively small in relation to the size and shape of this coronary artery scaffold. Notably, the lumen of the scaffold could be visualized on the GRE pulse sequence.

Conclusion

The results demonstrated that the coronary artery scaffold is acceptable (or “MR conditional,” using current MRI labeling terminology) for a patient undergoing an MRI procedure at 3 T or less. To our knowledge, this is the first bioabsorbable, coronary artery scaffold that has been evaluated for MRI issues.     

MRI allows for longitudinal quantitative analysis of body fat composition in rats: An analysis of sibutramine-associated changes at the group level

Purpose

Body fat distribution changes are associated with multiple alterations in metabolism. Therefore, the assessment of body fat compartments by MRI in animal models is a promising approach to obesity research. Standard T1-weighted (T1w) whole body MRI was used here to quantify different effects in the subcutaneous and visceral fat compartments in rats under treatment with an anorexiant.

Materials and methods

Twenty rats on a high caloric diet were investigated by the identical MRI protocol at baseline and after seven weeks. Ten rats received a treatment with sibutramine, 10 rats served as vehicle control group. To longitudinally assess body fat components, MRI analysis was used with two approaches: 2D slicewise graphic analysis (SGA) was compared with an automated 3D analysis algorithm (3DA).

Results

At the group level, fat volume differences showed a longitudinal increase of subcutaneous and visceral fat volumes for the control group, whereas the sibutramine group showed stable subcutaneous fat volumes and decrease in visceral fat volumes. SGA and 3DA volume determination showed significant correlations for subcutaneous fat volume (C = 0.85, p < 0.001), visceral fat volume (C = 0.87, p < 0.001), and total fat volume (C = 0.90, p < 0.001).

Conclusion

It could be demonstrated that computer-based analysis of T1w MRI could be used to longitudinally assess changes in body fat compartments in rats at the group level. In detail, it was possible to investigate the effect of sibutramine separate on the fat compartments in rats.     

Effect of gadolinium injection on diffusion-weighted imaging with background body signal suppression (DWIBS) imaging of breast lesions

Objectives

Diffusion-weighted imaging with background body signal suppression (DWIBS) provides both qualitative and quantitative imaging of breast lesions and are usually performed before contrast material injection (CMI). This study aims to assess whether the administration of gadolinium significantly affects DWIBS imaging.

Methods

200 patients were prospectively evaluated by MRI with STIR, TSE-T2, pre-CMI DWIBS, contrast enhanced THRIVE-T1 and post-CMI DWIBS sequences. Pre and post-CMI DWIBS were analyzed searching for the presence of breast lesions and calculating the ADC value. ADC values of ≤ 1.44 × 10^- 3 mm²/s were considered suspicious for malignancy. This analysis was then compared with the histological findings. Sensitivity, specificity, diagnostic accuracy (DA), positive predictive value (PPV) and negative (NPV) were calculated for both sequences and represented by ROC analysis. Pre and post-CMI ADC values were compared by using the paired t test.

Results

In 150/200 (59%) patients, pre and post-CMI DWIBS indicated the presence of breast lesions, 53 (35%) with ADC values of > 1.44 × 10^- 3 mm²/s and 97 (65%) with ADC ≤ 1.44 × 10^- 3 mm²/s. Pre-CMI and post-DWIBS sequences obtained the same sensitivity, specificity, DA, PPV and NPV values of 97%, 83%, 89%, 79% and 98%. The mean ADC value of benign lesions was 1.831 ± 0.18 × 10^- 3 mm²/s before and 1.828 ± 0.18 × 10^- 3 mm²/s after CMI. The mean ADC value of the malignant lesions was 1.146 ± 0.16 × 10^- 3 mm²/s before and 1.144 ± 0.16 × 10^- 3 mm²/s after CMI. No significant difference was found between pre and post CMI ADC values (p > 0.05).

Conclusion

DWIBS imaging is not influenced by CMI. Breast MR protocol could be modified by placing DWIBS after dynamic contrast enhanced sequences in order to maximize patient cooperation.     

Highly accelerated aortic 4D flow MR imaging with variable-density random undersampling

Purpose

To investigate an effective time-resolved variable-density random undersampling scheme combined with an efficient parallel image reconstruction method for highly accelerated aortic 4D flow MR imaging with high reconstruction accuracy.

Materials and Methods

Variable-density Poisson-disk sampling (vPDS) was applied in both the phase-slice encoding plane and the temporal domain to accelerate the time-resolved 3D Cartesian acquisition of flow imaging. In order to generate an improved initial solution for the iterative self-consistent parallel imaging method (SPIRiT), a sample-selective view sharing reconstruction for time-resolved random undersampling (STIRRUP) was introduced. The performance of different undersampling and image reconstruction schemes were evaluated by retrospectively applying those to fully sampled data sets obtained from three healthy subjects and a flow phantom.

Results

Undersampling pattern based on the combination of time-resolved vPDS, the temporal sharing scheme STIRRUP, and parallel imaging SPIRiT, were able to achieve 6-fold accelerated 4D flow MRI with high accuracy using a small number of coils (N = 5). The normalized root mean square error between aorta flow waveforms obtained with the acceleration method and the fully sampled data in three healthy subjects was 0.04 ± 0.02, and the difference in peak-systolic mean velocity was − 0.29 ± 2.56 cm/s.

Conclusion

Qualitative and quantitative evaluation of our preliminary results demonstrate that time-resolved variable-density random sampling is efficient for highly accelerating 4D flow imaging while maintaining image reconstruction accuracy.     

Feasibility of diffusional kurtosis tensor imaging in prostate MRI for the assessment of prostate cancer: Preliminary results

Purpose

To assess the feasibility of full diffusional kurtosis tensor imaging (DKI) in prostate MRI in clinical routine. Histopathological correlation was achieved by targeted biopsy.

Materials and Methods

Thirty-one men were prospectively included in the study. Twenty-one were referred to our hospital with increased prostate specific antigen (PSA) values (> 4 ng/ml) and suspicion of prostate cancer. The other 10 men were volunteers without any history of prostate disease. DKI applying diffusion gradients in 20 different spatial directions with four b-values (0, 300, 600, 1000 s/mm²) was performed additionally to standard functional prostate MRI. Region of interest (ROI)-based measurements were performed in all histopathologically verified lesions of every patient, as well as in the peripheral zone, and the central gland of each volunteer.

Results

DKI showed a substantially better fit to the diffusion-weighted signal than the monoexponential apparent diffusion coefficient (ADC). Altogether, 29 lesions were biopsied in 14 different patients with the following results: Gleason score 3 + 3 = 6 (n = 1), 3 + 4 = 7 (n = 7), 4 + 3 = 7 (n = 6), 4 + 4 = 8 (n = 1), and 4 + 5 = 9 (n = 2), and prostatitis (n = 12). Values of axial (K_ax) and mean kurtosis (K_mean) were significantly different in the tumor (K_ax 1.78 ± 0.39, K_mean 1.84 ± 0.43) compared with the normal peripheral zone (K_ax 1.09 ± 0.12, K_mean 1.16 ± 0.13; p < 0.001) or the central gland (K_ax 1.40 ± 0.12, K_mean 1.44 ± 0.17; p = 0.01 respectively). There was a minor correlation between axial kurtosis (r = 0.19) and the Gleason score.

Conclusion

Full DKI is feasible to utilize in a routine clinical setting. Although there is some overlap some DKI parameters can significantly distinguish prostate cancer from the central gland or the normal peripheral zone. Nevertheless, the additional value of DKI compared with conventional monoexponential ADC calculation remains questionable and requires further research.     

Evaluation of aortic stenosis severity using 4D flow jet shear layer detection for the measurement of valve effective orifice area

Aims

The objective of this study was to evaluate the potential of 4D flow MRI to assess valve effective orifice area (EOA) in patients with aortic stenosis as determined by the jet shear layer detection (JSLD) method.

Methods and Results

An in-vitro stenosis phantom was used for validation and in-vivo imaging was performed in 10 healthy controls and 40 patients with aortic stenosis. EOA was calculated by the JSLD method using standard 2D phase contrast MRI (PC-MRI) and 4D flow MRI measurements (EOA_JSLD-2D and EOA_JSLD-4D, respectively). As a reference standard, the continuity equation was used to calculate EOA (EOA_CE) with the 2D PC-MRI velocity field and compared to the EOA_JSLD measurements. The in-vitro results exhibited excellent agreement between flow theory (EOA = 0.78 cm²) and experimental measurement (EOA_JSLD-4D = 0.78 ± 0.01 cm²) for peak velocities ranging from 0.9 to 3.7 m/s. In-vivo results showed good correlation and agreement between EOA_JSLD-2D and EOA_CE (r = 0.91, p < 0.001; bias: − 0.01 ± 0.38 cm²; agreement limits: 0.75 to − 0.77 cm²), and between EOA_JSLD-4D and EOA_CE (r = 0.95, p < 0.001; bias: − 0.09 ± 0.26 cm²; limits: 0.43 to − 0.62 cm²).

Conclusion

This study demonstrates the feasibility of measuring EOA_JSLD using 4D flow MRI. The technique allows for optimization of the EOA measurement position by visualizing the 3D vena contracta, and avoids potential sources of EOA_CE measurement variability.     

A new vascular coupling device: Assessment of MRI issues at 3-tesla

Objective

Vascular grafting frequently involves a time-consuming operation. A new vascular coupling device (VCD) made from metallic material was recently developed that may be advantageous because of the reduced operative time and decreased patient risks. Because of the metal, there are safety concerns related to MRI. Therefore, the purpose of this investigation was to use standardized testing techniques to evaluate MRI issues for this VCD in association with a 3-Tesla MR system.

Methods

The VCD (corlife oHG, Hannover, Germany) was evaluated for magnetic field interactions (translational attraction and torque), MRI-related heating, and artifacts at 3-Tesla. MRI-related heating was assessed with the VCD in a gelled-saline-filled phantom with MRI performed at a whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were assessed using T1-weighted, spin echo, and gradient echo pulse sequences.

Results

The VCD exhibited minor magnetic field interactions and minimal heating (maximum temperature elevation, 1.8 °C). Artifacts were relatively small in relation to the size and shape of this implant. The lumen of the VCD could not be visualized using the gradient echo pulse sequence.

Conclusions

The metallic VCD that underwent evaluation is MR conditional for a patient undergoing an MRI procedure at 3-Tesla or less.     

Focal nodular hyperplasia of the liver: diffusion and perfusion MRI characteristics

Purpose

To present diffusion and perfusion magnetic resonance imaging (MRI) characteristics of focal nodular hyperplasia (FNH) of the liver.

Materials and Methods

Thirty-five patients with 52 FNHs (21 were pathologically-confirmed) underwent MRI at 1.5-T device. MR diffusion [diffusion-weighted imaging (DWI)] was performed using a free-breathing single-shot, spin-echo, echo-planar sequence with b gradient factor value of 500 s/mm². MR perfusion [perfusion-weighted imaging (PWI)] consisted of a 3D free-breathing LAVA sequence repeated up to 5 minutes after injection of 7 mL Gd-BOPTA (MultiHance, Bracco, Italy) and 20 mL saline flush at a flow rate of 4 mL/s. Apparent diffusion coefficient (ADC) and time-signal intensity curve (TSIC) were obtained for both normal liver and each FNH by two reviewers in conference; maximum enhancement (ME) percentage, time to peak enhancement (TTP), and maximal slope (MS) were also calculated.

Results

On DWI mean ADC value was 1.624×10^− 3 mm²/s for normal liver and 1.629×10^− 3 mm²/s for FNH. ADC value for each FNH and the normal liver was not statistically different (P= .936). On PWI, TSIC-Type 1 (quick and marked enhancement and quick decay followed by slowly decaying) was observed in all 52 FNHs, and TSIC-Type 2 (fast enhancement followed by slowly decaying plateau) in all normal livers. The mean ME, TTP and MS values were significantly different for FNH and normal liver (P= .005).

Conclusion

FNHs of the liver showed typical diffusion and perfusion MRI characteristics in all cases. On the ADC map, we could get similar value between the FNHs and the background parenchyma. On the perfusion imaging, FNHs showed a different pattern distinguished from the background liver.     

Cervical spondylosis: Evaluation of microstructural changes in spinal cord white matter and gray matter by diffusional kurtosis imaging

Introduction

We investigated microstructural changes in the spinal cord, separately for white matter and gray matter, in patients with cervical spondylosis by using diffusional kurtosis imaging (DKI).

Methods

We studied 13 consecutive patients with cervical myelopathy (15 affected sides and 11 unaffected sides). After conventional magnetic resonance (MR) imaging, DKI data were acquired by using a 3 T MR imaging scanner. Values for fractional anisotropy (FA), apparent diffusion coefficient (ADC), and mean diffusional kurtosis (MK) were calculated and compared between unaffected and affected spinal cords, separately for white matter and gray matter.

Results

Tract-specific analysis of white matter in the lateral funiculus showed no statistical differences between the affected and unaffected sides. In gray matter, only MK was significantly lower in the affected spinal cords than in unaffected spinal cords (0.60 ± 0.18 vs. 0.73 ± 0.13, P = 0.0005, Wilcoxon’s signed rank test).

Conclusions

MK values in the spinal cord may reflect microstructural changes and gray matter damage and can potentially provide more information beyond that obtained with conventional diffusion metrics.     

Using intravoxel incoherent motion (IVIM) MR imaging to predict lipiodol uptake in patients with hepatocellular carcinoma following transcatheter arterial chemoembolization: A preliminary result

Purpose

To assess the usefulness of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) for predicting lipiodol uptake in patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).

Materials and methods

The institutional review board approved this study. 44 HCC patients underwent IVIM-DWI and Gd-EOB-DTPA-enhanced MRI prior to TACE. Using post-TACE CT as a reference standard, each HCC was classified into either lipiodol good uptake (LGU) or poor uptake (LPU) group. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion coefficient (D*), and perfusion fraction (f) in HCC were calculated. Arterial enhancement ratio (AER) and IVIM parameters were compared between those two groups using the Mann-Whitney U test.

Results

Of the 51 HCCs, 37 (72.5%) were LGU group and 14 (27.5%) were LPU group. AER of HCC was significantly higher in LGU than LPU (0.99 ± 0.54 and 0.67 ± 0.45; P = .034). ADC, D, and f values were not significantly different (P = .073, .059, and .196, respectively) between these two groups. D* was significantly elevated in LGU than LPU (48.10 ± 15.33 and 26.75 ± 9.55; P = .001).

Conclusion

Both AER derived from contrast enhanced MRI and D* values derived from IVIM-DWI for HCC were significantly higher in LGU than in LPU. These parameters would be helpful for predicting the lipiodol uptake.     

Effect of Gd-EOB-DTPA on hepatic fat quantification using high-speed T2-corrected multi-echo acquisition in H MR spectroscopy

Purpose

To determine whether gadolinium ethoxybenzyldiethylenetriaminepentaacetic acid (Gd-EOB-DTPA) administration affects hepatic fat quantification by magnetic resonance spectroscopy (MRS) using the fast breath-hold high-speed T2-corrected multiecho (HISTO) technique.

Materials and Methods

Seventy-six patients underwent Gd-EOB-DTPA-enhanced liver MR and 15 sec breath-hold HISTO MRS (4 times), twice before and twice after Gd-EOB-DTPA administration. Two consecutive MRSs were performed immediately before the dynamic study. Post-contrast MRS was performed twice continuously, approximately 15 min after contrast injection, prior to obtaining 20-min hepatobiliary phase images. We used paired t-test and intraclass correlation coefficient (ICC) to evaluate the variability of the mean fat fraction (FF) on pre-contrast MRS and post-contrast MRS and the effect of the contrast agent on the mean FF.

Results

The mean FFs were not significantly different between pre-contrast MRS and post-contrast MRS (6.50% ± 6.54 versus 6.70% ± 6.61, P = 0.15). The ICC of FF calculation between pre- and post-contrast MRS was 0.984. The ICCs for the FF magnitude between pre- and post-contrast MRS were 0.452, 0.771, and 0.995 for FF < 5%, FF 5–10%, and FF ≥ 10%, respectively.

Conclusion

Gd-EOB-DTPA does not appear to influence hepatic fat quantification, especially for patients with hepatic steatosis.