Sodium T2*-weighted MR imaging of acute focal cerebral ischemia in rabbits

Changes in T2*-weighted tissue sodium (23Na) signal following acute ischemia may help to identify necrotic tissue and estimate the duration of ischemia. Sodium signal was monitored in a rabbit model of acute (0-4 h) focal cerebral ischemia, using gradient echo 23Na MR images (echo time = 3.2 ms) acquired continuously in 20-min intervals on a 4-Tesla MRI. 2,3,5-Triphenyl-tetrazolium chloride staining was used to identify regions of necrosis. In necrotic tissue, average 23Na image signal intensity decreased by 11% +/- 8% during the first 40 min of ischemia followed by a linear increase (0.19%/min) to 25% +/- 14% greater than baseline after 4 h of ischemia. The time course of 23Na signal change observed in necrotic tissue following focal ischemia in this rabbit model is consistent with an initial decrease in 23Na T2* relaxation time followed by an increase in tissue sodium concentration and provides further evidence that tissue 23Na signal may offer unique information regarding tissue viability that is complementary to other MR imaging techniques.     

Synthetic T2-weighted images of the lumbar spine derived from an accelerated T2 mapping sequence: Comparison to conventional T2w turbo spin echo

ObjectivesTo evaluate the diagnostic usefulness of synthetic T₂-weighted images of the lumbar spine derived from ten-fold undersampled k-space data using GRAPPATINI, a combination of a model-based approach for rapid T₂ and M₀ quantification (MARTINI) extended by generalized autocalibrating partial parallel acquistion (GRAPPA).Materials and methodsOverall, 58 individuals (26 female, mean age 23.3 ± 8.1 years) were examined at 3 Tesla with sagittal and axial T₂w turbo spin echo (TSE) sequences compared to synthetic T₂₋weighted contrasts derived at identical effective echo times and spatial resolutions. Two blinded readers graded disk degeneration and evaluated the lumbar intervertebral disks for present herniation or annular tear. One reader reassessed all studies after four weeks. Weighted kappa statistics were calculated to assess inter-rater and intra-rater agreement. Also, all studies were segmented manually by one reader to compute contrast ratios (CR) and contrast-to-noise ratios (CNR) of the nucleus pulposus and the annulus fibrosus.ResultsOverall, the CR_T2w was 4.45 ± 1.80 and CR_T2synth was 4.71 ± 2.14. Both correlated (rsp = 0.768;p < 0.001) and differed (0.26 ± 1.38;p = 0.002) significantly. The CNR_T2w was 1.73 ± 0.52 and CNR_T2synth was 1.63 ± 0.50. Both correlated (rsp = 0.875;p < 0.001) and differed (−0.10 ± 0.25;p < 0.001) significantly. The inter-rater agreement was substantial to almost perfect (κ = 0.808–0.925) with the intra-rater agreement also substantial to almost perfect (κ = 0.862–0.963). The area under the curve of the receiver operating characteristics assessing disk herniation or annular tear ranged from 0.787 to 0.892.ConclusionsThis study concludes that synthetic images derived by GRAPPATINI can be used for clinical routine assessment with inter-rater and intra-rater agreements comparable to conventional T₂w TSE.     

Dual-echo breathhold T(2)-weighted fast spin echo MR imaging of liver lesions

The purpose of this study was to develop a multi-shot dual-echo breathhold fast spin echo technique (DFSE) and compare it with conventional spin echo (T2SE) for T(2)-weighted MR imaging of liver lesions. The DFSE acquisition (EffTE1/EffTE2/TR = 66/143/2100 ms) imaged 5 sections per 17 s breathhold. T2SE imaging (TE1/TE2/TR = 60/120/2500 ms) required 16:55 (min:s) for 14 sections. Both techniques used a receive-only phased-array abdominal multicoil and provided 192 x 256 effective resolution. The results showed first and second echo relative DFSE/T2SE contrast values for 27 representative lesions (15 consecutive patients) were 1.08 +/- 0.05 and 1.16 +/- 0.09 (mean +/- STD mean), respectively. Corresponding CNR values were 1.12 +/- 0.09 and 0.97 +/- 0.12. Overall DFSE was comparable-to-superior to T2SE for lesion sizing and image artifact. DFSE lesion detection was inferior to T2SE's in several patient studies because of decreased conspicuity of lesions located near multicoil edges and because of poor breathhold-to-breathhold reproducibility and lack of breathholding. However both DFSE (and T2SE) provided lesion detection rated to be of diagnostic quality for all patient studies. In conclusion, we found that DFSE provides diagnostically useful dual-echo T(2)-weighted MR liver images in a greatly decreased acquisition time.     

Quantitative T2 mapping using accelerated 3D stack-of-spiral gradient echo readout

PurposeTo develop a rapid T₂ mapping protocol using optimized spiral acquisition, accelerated reconstruction, and model fitting.Materials and methodsA T₂-prepared stack-of-spiral gradient echo (GRE) pulse sequence was applied. A model-based approach joined with compressed sensing was compared with the two methods applied separately for accelerated reconstruction and T₂ mapping. A 2-parameter-weighted fitting method was compared with 2- or 3-parameter models for accurate T₂ estimation under the influences of noise and B₁ inhomogeneity. The performance was evaluated using both digital phantoms and healthy volunteers. Mitigating partial voluming with cerebrospinal fluid (CSF) was also tested.ResultsSimulations demonstrates that the 2-parameter-weighted fitting approach was robust to a large range of B₁ scales and SNR levels. With an in-plane acceleration factor of 5, the model-based compressed sensing-incorporated method yielded around 8% normalized errors compared to references. The T₂ estimation with and without CSF nulling was consistent with literature values.ConclusionThis work demonstrated the feasibility of a T₂ quantification technique with 3D high-resolution and whole-brain coverage in 2–3 min. The proposed iterative reconstruction method, which utilized the model consistency, data consistency and spatial sparsity jointly, provided reasonable T₂ estimation. The technique also allowed mitigation of CSF partial volume effect.     

Field strength influences on gradient recalled echo MRI signal compartment frequency shifts

Different trends of echo time dependent gradient recalled echo MRI signals in different brain regions have been attributed to signal compartments in image voxels. It remains unclear how variations in gradient recalled echo MRI signals change as a function of MRI field strength, and how data processing may impact signal compartment parameters. We used two popular quantitative susceptibility mapping methods of processing raw phase images (Laplacian and path-based unwrapping with V-SHARP) and expressed values in the form of induced frequency shifts (in Hz) in six specific brain regions at 3T and 7T. We found the frequency shift curves to vary with echo time, and a good overlap between 3T and 7T mean frequency shift curves was present. However, the amount of variation across participants was greater at 3T, and we were able to obtain better compartment model fits of the signal at 7T. We also found the temporal trends in the signal and compartment frequency shifts to change with the method used to process images. The inter-participant averaged trends were consistent between 3T and 7T for each quantitative susceptibility pipeline. However, signal compartment frequency shifts generated using different pipelines may not be comparable.     

MRI of aggressive fibromatosis: frequent appearance of high signal intensity on T2-weighted images

Magnetic resonance imaging of seven patients with eight pathologically proven desmoid tumor tumors was performed and retrospectively reviewed. On T2-weighted images, all but one lesion demonstrated increased signal intensity relative to muscle, and had signal intensity similar to that of fat. The signal was heterogenous in six of these seven lesions. In a patient with synchronous multicentric lesions, light microscopy correlation revealed increased cellularity in one lesion with increased signal intensity and dense collagenous elements in a second lesion, with decreased signal intensity. High signal intensity appears to be typical but nonspecific, and in following these patients could indicate recurrent tumor, superimposed inflammatory process or granulation tissue.     

A fast spin echo two-point Dixon technique and its combination with sensitivity encoding for efficient T2-weighted imaging

A fast spin echo two-point Dixon (fast 2PD) technique was developed for efficient T2-weighted imaging with uniform water and fat separation. The technique acquires two interleaved fast spin echo images with water and fat in-phase and 180° out-of-phase, respectively, and generates automatically separate water and fat images for each slice. The image reconstruction algorithm uses an improved and robust region-growing scheme for phase correction and achieves consistency in water and fat identification between different slices by exploiting the intrinsic correlation between the complex images from two neighboring slices. To further lower the acquisition time to that of a regular fast spin echo acquisition with a single signal average, we combined the fast 2PD technique with sensitivity encoding (SENSE). Phantom experiments show that the fast 2PD and SENSE are complementary in scan efficiency and signal-to-noise ratio (SNR). In vivo data from scanning of clinical patients demonstrate that T2-weighted imaging with uniform and consistent fat separation, including breath-hold abdominal examinations, can be readily performed with the fast 2PD technique or its combination with SENSE.     

Quantification of water compartmentation in cell suspensions by diffusion-weighted and T(2)-weighted MRI

When studying water diffusion in biological systems, any specific signal attenuation curve may be reproduced by a broad range of mathematical functions. Our goals were to quantify the diffusion and T₂ relaxation properties of water in a simple biological system and to study the changes that occur in osmotically stressed cells.     

Comparison of dual spin echo echo planar imaging (SE_EPI), turbo spin echo with fat suppression and conventional dual spin echo sequences for T(2)-weighted MR imaging of focal liver lesions

The performance of T(2)-weighted spin-echo version of echo planar imaging (SE_EPI), conventional spin echo (SE) and fat-suppressed turbo spin-echo (TSE_SPIR) sequences for the detection of focal liver lesions was evaluated. Twenty patients that were included in our study, had CT examinations prior to the MR study and were scheduled for surgery for removal of liver lesions. All patients had intraoperative sonographic examinations. Qualitative and quantitative analysis of the images was performed. Overall image quality of SE_EPI sequences was better than SE (p<0.001) and similar to TSE_SPIR sequences. There were fewer motion and ghost artifacts on SE_EPI and TSE_SPIR images compared to SE images (p<0.001). Susceptibility artifacts were statistically equivalent on SE_EPI and SE images (p<0.001) while chemical shift artifacts were equally observed on SE and SE_EPI sequences. Overall image quality of EPI-SE and TSE_SPIR sequences was better compared to SE sequences. There was no significant difference in the number of lesions detected by each of the three sequences. Quantitative analysis showed that liver/lesion contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) of liver, lesion, spleen was higher on TSE_SPIR sequences (p<0.001) while SE_EPI and SE sequences showed non-significant differences (p>0.05). SE_EPI sequences of the liver resulted in fewer artifacts and shorter acquisition times than SE sequences. They provide a diagnostic performance similar to TSE_SPIR and better than that of SE sequences.     

Fast 3D T(2)-weighted MRI with Hadamard encoding in the slice select direction

A fast method to obtain 3-dimensional (3D) magnetic resonance imaging with long repetition times is presented. It can be used to obtain fast 3D MRI with for example T(2) or diffusion weighted imaging. The method uses a 3D multiple thin slab sequence with radio frequency encoding, preferably Hadamard encoding, in the slice select direction. The point-spread function of the Hadamard-encoded slices is close to ideal even at low encoding numbers. This allows the acquisition of 3D data volumes with tolerable image quality up to four times faster than is possible using Fourier phase encoding. The scope of the method includes both longitudinal and transverse encoding. Longitudinal encoding provides a better point spread function than transverse encoding, at the expense of having to discard one slice per slab. The method is demonstrated experimentally for 4th order longitudinal Hadamard encoding to obtain 3D T(2)-weighted images.     

Quantitative NumART2* mapping in functional MRI studies at 1.5 T

Quantitative mapping of the effective transverse relaxation time, T₂* and proton density was performed in a motor activation functional MRI (fMRI) study using multi-echo, echo planar imaging (EPI) and NumART₂* (Numerical Algorithm for Real time T₂*). Comparisons between NumART₂* and conventional single echo EPI with an echo time of 64 ms were performed for five healthy participants examined twice. Simulations were also performed to address specific issues associated with the two techniques, such as echo time-dependent signal variation. While the single echo contrast varied with the baseline T₂* value, relative changes in T₂* remained unaffected. Statistical analysis of the T₂* maps yielded fMRI activation patterns with an improved statistical detection relative to conventional EPI but with less activated voxels, suggesting that NumART₂* has superior spatial specificity. Two effects, inflow and dephasing, that may explain this finding were investigated. Particularly, a statistically significant increase in proton density was found in a brain area that was detected as activated by conventional EPI but not by NumART₂* while no such changes were observed in brain areas that showed stimulus correlated signal changes on T₂* maps.     

The use of T2*-weighted multi-echo GRE imaging as a novel method to diagnose hepatocellular carcinoma compared with gadolinium-enhanced MRI: a feasibility study

Background

The goal of the study was to assess a T2*-weighted MRI sequence for the ability to identify hepatocellular carcinoma (HCC).

Methods

Hepatic iron deposition, which is common in chronic liver disease (CLD), may increase the conspicuity of HCC on GRE imaging due to increased T2* signal decay in liver parenchyma. In this study, a breath-hold T2*-weighted MRI sequence was evaluated by a blinded observer for HCC and the results compared to a reference standard of gadolinium-enhanced MRI in these same patients. Forty-one patients (mean age 56.2 years; 17 females) were included in this approved, retrospective study.

Results

By the reference standard, 14 of 41 patients had a total of 25 HCCs. The sensitivity of the T2*-weighted MR sequence for identifying HCC, per lesion, was 60%, while the specificity was 100%. There was a significantly lower T2* value of liver parenchyma in patients with HCC identified by the T2*-weighted sequence than in those with HCCs which were not identified by the T2*-weighted sequence (27.8±2.2 vs. 21.9±2.1 ms; P=.02).

Conclusions

A T2*-weighted MRI sequence can identify HCC in patients with CLD. This technique may be beneficial for imaging of patients contraindicated for gadolinium.     

Lesion load quantification on fast-FLAIR, rapid acquisition relaxation-enhanced, and gradient spin echo brain MRI scans from multiple sclerosis patients.

Previous studies have addressed the issue of the usefullness of fast fluid-attenuated (fast-FLAIR), rapid acquisition relaxation-enhanced (RARE), and gradient spin echo (GRASE) sequences in small groups of patients with multiple sclerosis (MS). The aim of this study was to assess and compare the lesion volumes and the intra-rater reproducibility of such measurements using fast-FLAIR, dual echo RARE, and dual echo GRASE brain scans from a large sample of MS patients. Using a 1.5 Tesla scanner, fast-FLAIR, dual echo RARE, and dual echo GRASE scans (24 axial, 5-mm thick contiguous interleaved slices) of the brain were obtained from 50 MS patients. Total lesion loads (TLL) were assessed twice using a semi-automated local thresholding segmentation technique by the same rater from the scans obtained with the three techniques. Mean TLL were 20.3 mL for fast-FLAIR, 16.6 mL for RARE, and 17.6 mL for GRASE sequences. Mean TLL detected by the three techniques were significantly heterogeneous (p < 0.001); at post-hoc analysis, the mean lesion volume detected on fast-FLAIR images was significantly higher than that on both RARE and GRASE images (p < 0.001) and the mean TLL on GRASE scans was significantly higher than that on RARE scans (p = 0.001). The mean values of intra-observer coefficient of variation for TLL measurements were similar for the three techniques (2.69% for fast-FLAIR, 2.33% for RARE, and 2.65% for GRASE). Our results confirm that fast-FLAIR sequences detect higher lesion volumes than those detected by other magnetic resonance imaging (MRI) sequences with shorter acquisition times. However, the reproducibility of TLL measurements is comparable among fast-FLAIR, RARE, and GRASE. This suggests that when assessing MS disease burden with MRI, the choice of the pulse sequence to be used should be dictated by the clinical setting.     

Optimizing brain MRI protocols in the follow-up of patients with multiple sclerosis T2-weighted MRI of the brain after the administration of gadopentetate dimeglumine

The aim of our study was to determine whether T2-weighted (T2w) MRI of the brain could be performed immediately after the administration of gadopentetate dimeglumine (gadolinium DTPA) in patients with multiple sclerosis (MS) without a loss in image quality or diagnostic reliability. Sixteen patients with clinically diagnosed MS were included in the study. Twenty-four patients with various cerebral pathologies (14 patients with multiple lacunar lesions) were examined in order to exclude masking of T2 hyperintense lesions other than MS lesions. Images of 10 patients without pathological changes served as a control condition for the qualitative analysis. In these 50 patients, T1w and T2w MRI was performed before and after the administration of gadolinium DTPA. Signal intensities were measured within T2 hyperintense cerebral lesions, in T1-enhancing lesions and in normal appearing brain tissue on T2w turbo spin-echo (TSE) sequences. Both quantitative and qualitative analysis did not show significant differences between T2w pre- and postcontrast series. T2w MRI performed prior to and after the administration of gadolinium DTPA provides similar information in patients with MS. With a TR of 3.2 s, not a single lesion was obscured on T2w postcontrast series. Acquisition of T2w MR images immediately after the administration of gadolinium DTPA allows for shorter examination time and assures sufficient time for contrast enhancement in cerebral lesions with a disrupted blood-brain barrier.     

Diffusion- and T2-weighted MRI of closed-head injury in rats: A time course study and correlation with histology

Diffusion- and T₂-weighted MRI were used to evaluate changes in brain water characteristics following closed-head injury in rats. Images were collected within the first 2 h and at 24 h and 7 days following the traumatic event and then compared with histology. The ratios between the apparent diffusion coefficients (ADCs) of the traumatized tissues and normal brain tissues were significantly different from unity and were found to be 0.79 ± 0.25 (p < 0.01), 0.49 ± 0.33 (p < 0.0002), and 3.47 ± 1.36 (p < 10⁻⁶) at 1–2 h, 24 h, and 1 week after the trauma, respectively. In severe trauma, areas of hyperintensity which were not apparent on the T₂-weighted images could be detected on the diffusion-weighted images within 1–2 h after the trauma. At 24 h following the traumatic event, large areas of hyperintensity are observed in both types of images. One week following the trauma, the ADCs of the traumatized tissues (1.84 ± 0.69 × 10⁻⁵ cm²/s) are much larger than those of normal brain (0.57 ± 0.19 × 10⁻⁵ cm²/s) and approach the value of free water. At 7 days, the areas of hyperintensity in the T₂-weighted images seem to underestimate the injured areas found by histology. At this time point a good correlation is obtained between the areas of hypointensity observed on the diffusion-weighted images and the infarct areas obtained by histology (r = 0.88).     

Recovery of accurate T2 from historical 1.5 tesla proton density and T2-weighted images: Application to 7-year T2 changes in multiple sclerosis brain

ObjectiveTo determine accurate quantitative transverse relaxation times (T₂) using retrospective clinical images and apply it to examine 7-year changes in multiple sclerosis (MS) brain.MethodsA method for T₂ mapping from retrospective proton density (PD) and T₂-weighted fast spin echo images was recently introduced, but requires measurement of flip angles. We examined whether 1.5 T flip angle variation in brain can be predicted, thus enabling T₂ analysis of historical PD and T₂-weighted images without a concurrent flip angle map. After method validation in healthy volunteers, retrospective longitudinal T₂ analysis was performed in 14 MS subjects over seven years. Changes in patient T₂ values were compared with brain atrophy, T₂ lesion load and disability score in MS.ResultsSimilar flip angle maps across volunteers enabled retrospective T₂ from PD and T₂-weighted images even when different refocusing angles were used. Over seven years, significant T₂ changes of 2–4% were observed when using T₂ modelling and the 7-year effect size for globus pallidus T₂ was 0.56, which was more significant than brain atrophy. No significant T₂ results were found when using exponential fit, which cannot account for refocusing angle variation. Moreover, change is T₂ in globus pallidus and internal capsule correlated with MS disability score over time when using T₂ modelling.ConclusionsAccurate quantitative T₂ can be extracted from standard clinical 1.5 T MRI exams that include PD and T₂-weighted imaging even when no flip angle map is available. This method was applied retrospectively to examine seven year changes in MS.     

Quantitative susceptibility mapping using principles of echo shifting with a train of observations sequence on 1.5 T MRI

PurposeTo evaluate the accuracy of susceptibility estimated from the principles of echo shifting with a train of observations (PRESTO) sequence using a 1.5 T MRI system, we conducted experiments on the human brain using the PRESTO sequence and compared our results with the susceptibility obtained from spoiled gradient-recalled echo (GRE) sequence with flow compensation using quantitative susceptibility mapping (QSM) reconstruction.Materials and methodsExperiments on the human brain were conducted on 12 healthy volunteers (27 ± 4 years) using PRESTO and spoiled GRE sequences on a 1.5 T scanner. The PRESTO sequence is an echo-shifted gradient echo sequence that allows high susceptibility sensitivity and rapid acquisition because of TE > TR compared with the spoiled GRE sequence. QSM analysis was performed on the obtained phase images using the iLSQR method. Estimated susceptibility maps were used for region of interest analyses and estimation of line profiles through iron-rich tissue and major vessels.ResultsOur results demonstrated that susceptibility maps were accurately estimated, without error, by QSM analysis of PRESTO and spoiled GRE sequences. Acquisition time in the PRESTO sequence was reduced by 43% compared with that in the spoiled GRE sequence. Differences did exist between susceptibility maps in PRESTO and spoiled GRE sequences for visualization and quantitative values of major blood vessels and the areas around themConclusionThe PRESTO sequence enables correct estimation of tissue susceptibility with rapid acquisition and may be useful for QSM analysis of clinical use of 1.5 T scanners.     

Differentiation of bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone with multiparametric MRI

PurposeTo investigate the diagnostic utilities of imaging parameters derived from T1-weighted imaging (T1WI), diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to differentiate bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone.Materials and methodsThirty-six lesions from 36 patients with prostate cancer were analyzed with T1WI, DWI, and DCE-MRI. The lesions were classified in the bone metastases (n = 22) and benign red marrow depositions (n = 14). Lesion-muscle ratio (LMR), apparent diffusion coefficient (ADC), volume transfer constant (K^trans), reflux rate (Kep), and volume fraction of the extravascular extracellular matrix (Ve) values were obtained from the lesions. The imaging parameters of the both groups were compared using the Mann-Whitney U test, receiver operating characteristics (ROC) curves were analyzed. For the ROC curves, area under the curves (AUCs) were compared.ResultsThe ADC, K^trans, K_ep, and V_e values of bone metastases were significantly higher than those of benign red marrow depositions (Mann-Whitney U test, p < 0.05). However, there was no significant difference in LMR between the two groups (Mann-Whitney U test, p = 0.360). The AUCs of K^trans_, K_ep, ADC, V_e, and LMR were 0.896, 0.844, 0.812, 0.724, and 0.448, respectively. In the pairwise comparison of ROC curves, the AUCs of K^trans and K_ep was significantly higher than LMR.ConclusionsK^trans, K_ep, V_e, and ADC values can be used as imaging tools to differentiate bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone.     

Automated analysis of immediate reliability of T2 and T2* relaxation times of hip joint cartilage from 3 T MR examinations

BackgroundMagnetic resonance (MR) T2 and T2* mapping sequences allow in vivo quantification of biochemical characteristics within joint cartilage of relevance to clinical assessment of conditions such as hip osteoarthritis (OA).PurposeTo evaluate an automated immediate reliability analysis of T2 and T2* mapping from MR examinations of hip joint cartilage using a bone and cartilage segmentation pipeline based around focused shape modelling.Study typeTechnical validation.Subjects17 asymptomatic volunteers (M: F 7:10, aged 22–47 years, mass 50–90 kg, height 163-189 cm) underwent unilateral hip joint MR examinations. Automated analysis of cartilage T2 and T2* data immediate reliability was evaluated in 9 subjects (M: F 4: 5) for each sequence.Field strength/sequenceA 3 T MR system with a body matrix flex-coil was used to acquire images with the following sequences: T2 weighted 3D-trueFast Imaging with Steady-State Precession (water excitation; 10.18 ms repetition time (TR); 4.3 ms echo time (TE); Voxel Size (VS): 0.625 × 0.625 × 0.65 mm; 160 mm field of view (FOV); Flip Angle (FA): 30 degrees; Pixel Bandwidth (PB): 140 Hz/pixel); a multi-echo spin echo (MESE) T2 mapping sequence (TR/TE: 2080/18–90 ms (5 echoes); VS: 4 × 0.78 × 0.78 mm; FOV: 200 mm; FA: 180 degrees; PB: 230 Hz/pixel) and a MESE T2* mapping sequence (TR/TE: 873/3.82–19.1 ms (5 echoes); VS: 3 × 0.625 × 0.625 mm; FOV: 160 mm; FA: 25 degrees; PB: 250 Hz/pixel).AssessmentAutomated cartilage segmentation and quantitative analysis provided T2 and T2* data from test-retest MR examinations to assess immediate reliability.Statistical testsCoefficient of variation (CV) and intraclass correlations (ICC_{2, 1}) to analyse automated T2 and T2* mapping reliability focusing on the clinically important superior cartilage regions of the hip joint.ResultsComparisons between test-retest T2 and (T2*) data revealed mean CV's of 3.385% (1.25%), mean ICC_{2, 1}′s of 0.871 (0.984) and median mean differences of −1.139ms (+0.195ms).ConclusionThe T2 and T2* times from automated analyses of hip cartilage from test-retest MR examinations had high (T2) and excellent (T2*) immediate reliability.     

Small hyperintense hepatic lesions on T1-weighted images in patients with cirrhosis: evaluation with serial MRI and imaging features for clinical benignity

PURPOSE: The aim of this study was to evaluate the frequency and magnetic resonance imaging (MRI) features of clinically benign, small (<2 cm) hyperintense hepatic lesions in the cirrhotic liver on T1-weighted MR images seen at serial MRI. MATERIALS AND METHODS: This study included 189 patients with cirrhosis, who underwent hepatic MRI more than twice with an interval of at least 12 months. The initial MR images were reviewed for the presence of small hyperintense lesions on T1-weighted images. The size, location and signal intensity on T2-weighted images as well as enhancement patterns of the corresponding lesions were recorded. RESULTS: On the initial T1-weighted MR images, 43 small hyperintense hepatic lesions were detected in 23 (12%) of 189 patients. Twelve (28%) of 43 lesions showed early enhancement and were pathologically diagnosed as hepatocellular carcinoma (HCC) during the follow-up period. Thirty-one (72%) of 43 lesions showed no early enhancement with various signal intensity on T2-weighted images (hyperintensity=4, isointensity=20, hypointensity=7). Among these 31 lesions, 12 showed no interval change, while 11 disappeared (n=10) or decreased in size (n=1). In the remaining eight lesions, seven were diagnosed as HCC on the basis of pathologic confirmation or the interval growth. CONCLUSION: Small hyperintense hepatic lesions on T1-weighted magnetic resonance (MR) images without early enhancement on the arterial-phase contrast-enhanced dynamic studies in patients with cirrhosis usually showed no interval growth or disappeared during the serial MRI. These lesions with additional findings of iso- or hypointensity on the T2-weighted MR images without "washout effect" on the contrast-enhanced equilibrium-phase images may more frequently be clinically benign or hyperplastic nodules than HCCs.