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Ahlawat S, Kumar NM, Ghasemi A, Fayad LM. Three-Dimensional Magnetic Resonance Imaging in the Musculoskeletal System: Clinical Applications and Opportunities to Improve Imaging Speed and Resolution. Invest Radiol 2025; 60:184-197. [PMID: 39437020 DOI: 10.1097/rli.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2024]
Abstract
ABSTRACT Although conventional 2-dimensional magnetic resonance (MR) sequences have traditionally comprised the foundational imaging strategy for visualization of musculoskeletal anatomy and pathology, the emergence of isotropic volumetric 3-dimensional sequences offers to advance musculoskeletal evaluation with comparatively similar image quality and diagnostic performance, shorter acquisition times, and the added advantages of improved spatial resolution and multiplanar reformation capability. The purpose of this review article is to summarize the available 3-dimensional MR sequences and their role in the management of patients with musculoskeletal disorders, including sports imaging, rheumatologic conditions, peripheral nerve imaging, bone and soft tissue tumor imaging, and whole-body MR imaging.
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Affiliation(s)
- Shivani Ahlawat
- From The Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD (S.A., N.K., A.G., L.M.F.); Department of Orthopedic Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (L.M.F.); and Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD (L.M.F.)
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Felisaz PF, Napolitano A, Terrani S, Parisi C, Toto-Brocchi M, Cè M, Alessandrino F, Oliva G, Cellina M, Gerevini S. An optimized 1.5 Tesla MRI protocol of the brachial plexus. Neuroradiol J 2024; 37:43-53. [PMID: 37621183 PMCID: PMC10863567 DOI: 10.1177/19714009231196475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
PURPOSE Creating an effective MRI protocol for examining the brachial plexus poses significant challenges, and despite the abundance of protocols in the literature, there is a lack of reference standards for basic sequences and essential parameters needed for replication. The aim of this study is to establish a reproducible 1.5 T brachial plexus imaging protocol, including patient positioning, coil selection, imaging planes, and essential sequence parameters. METHODS We systematically investigated MRI sequences, testing each parameter through in vivo experiments, examining their effects on signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), visual quality scores, and acquisition time. Sequences were refined based on optimal quality and timing scores. The final protocol was tested on scanners from two other vendors for reliability. RESULTS The final protocol included a combination of 2D turbo-spin-echo and 3D SPACE T1, SPACE STIR, and VIBE DIXON sequences. Recommendations for imaging planes, phase encoding, field of view, TR, TE, resolution, number of slices, slice thickness, fat and blood suppression, and acceleration strategies are provided. The protocol was successfully translated to other vendor's scanners with comparable quality. CONCLUSION We present an optimized protocol detailing the essential parameters for reproducibility. Our comprehensive list of experiments describes the impact of each parameter on image quality and scan time, addressing common artifacts and potential solutions. This protocol can benefit both young radiologists new to the field and experienced professionals seeking to refine their existing protocols.
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Affiliation(s)
| | | | | | | | - Marco Toto-Brocchi
- Postgraduate School in Radiodiagnostics, University of Milan, Milan, Italy
| | - Maurizio Cè
- Postgraduate School in Radiodiagnostics, University of Milan, Milan, Italy
| | - Francesco Alessandrino
- Division of Abdominal Imaging, Department of Radiology, University of Miami Health System, Miami, FL, USA
| | - Giancarlo Oliva
- Radiology Department, Ospedale Fatebenefratelli e Oftalmico, Milano, Italy
| | - Michaela Cellina
- Radiology Department, Ospedale Fatebenefratelli e Oftalmico, Milano, Italy
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Chen R, Ran Y, Xu H, Niu J, Wang M, Wu Y, Zhang Y, Cheng J. The guiding value of the cinematic volume rendering technique in the preoperative diagnosis of brachial plexus schwannoma. Front Oncol 2023; 13:1278386. [PMID: 38152370 PMCID: PMC10751301 DOI: 10.3389/fonc.2023.1278386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023] Open
Abstract
This study aimed to explore and compare the guiding value of Maximum Intensity Projection (MIP) and Cinematic Volume Rendering Technique (cVRT) in the preoperative diagnosis of brachial plexus schwannomas. We retrospectively analyzed the clinical and imaging data of 45 patients diagnosed with brachial plexus schwannomas at the First Affiliated Hospital of Zhengzhou University between January 2020 and December 2022. The enhanced three-dimensional short recovery time inversion-recovery fast spin-echo imaging (3D-STIR-SPACE) sequence served as source data for the reconstruction of MIP and cVRT. Two independent observers scored the image quality and evaluated the location of the tumor and the relationship between the tumor and the brachial plexus. The image quality scores of the two reconstruction methods were compared using the nonparametric Wilcoxon signed-rank test, and the consistency between the image and surgical results was assessed using the weighted kappa. Compared to MIP images, cVRT images had a better performance of overall image quality (p < 0.001), nerve and lump visualization (p < 0.001), spatial positional relationship conspicuity (p < 0.001), and diagnostic confidence (p < 0.001). Additionally, the consistency between the cVRT image results and surgical results (kappa =0.913, P<0.001) was higher than that of the MIP images (kappa =0.829, P<0.001). cVRT provides a high guiding value in the preoperative diagnosis of brachial plexus schwannomas and is an important basis for formulating surgical plans.
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Affiliation(s)
- Rui Chen
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuncai Ran
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Haowen Xu
- Department of Interventional Neuroradiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxia Niu
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengzhu Wang
- MR Collaborations, Siemens Healthineers Ltd., Beijing, China
| | - Yanglei Wu
- MR Collaborations, Siemens Healthineers Ltd., Beijing, China
| | - Yong Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Chen R, Ran Y, Wu Y, Xu H, Niu J, Zhang Y, Cheng J. The value of the cinematic volume rendering technique: magnetic resonance imaging in diagnosing tumors associated with the brachial plexus. Eur J Med Res 2023; 28:569. [PMID: 38053185 DOI: 10.1186/s40001-023-01416-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/30/2023] [Indexed: 12/07/2023] Open
Abstract
PURPOSE To examine the diagnostic advantages and clinical application value of the cinematic volume rendering technique (cVRT) when evaluating the relationship between the brachial plexus, peripheral tumor lesions, and blood vessels. MATERIALS AND METHODS Seventy-nine patients with brachial plexus tumors between November 2012 and July 2022 were enrolled in our study. All patients underwent T1WI, T2WI, three-dimensional short recovery time reversal recovery fast spin-echo imaging (3D-STIR-SPACE), and the T1WI enhancement sequence. In addition, cVRT was used to render and obtain a three-dimensional model that clearly showed the location and tissue structure of the brachial plexus nerves and the tumor in all directions. RESULTS Seventy-one patients (mean age, 47.1 years; 33 males, 38 females) with tumors around the brachial plexus were included in the study. The brachial plexus nerve, surrounding tumor lesions, and vascular anatomy of all patients were well displayed with cVRT. The tumors of 37 patients manifested as unilateral or bilateral growths along the brachial plexus nerve and were fusiform, spherical, or multiple beaded; seven patients' tumors pushed against the brachial plexus nerve and were circular, lobular, or irregular; sixteen patients' tumors encircled the brachial plexus nerve and were spherical; and eleven patients' tumors infiltrated the brachial plexus nerve and had irregular morphology. The mass has a moderately uniform or uneven signal on T1WI and a high or mixed signal on T2WI. After enhancement, the signal was evenly or unevenly strengthened. CONCLUSIONS cVRT clearly showed the origin of tumors associated with the brachial plexus and their relationship with the nerves and peripheral blood vessels, providing reliable information for clinical diagnosis and treatment.
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Affiliation(s)
- Rui Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuncai Ran
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanglei Wu
- MR Collaborations, Siemens Healthineers Ltd, Beijing, China
| | - Haowen Xu
- Department of Interventional Neuroradiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxia Niu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Pribowo MA, Harahap MIR, Fazharyasti V, Dwihapsari Y, Kartikasari Y, Sugiyanto. Non-contrast enhancement of brachial plexus magnetic resonance imaging with compressed sensing. Eur J Radiol 2023; 165:110890. [PMID: 37269572 DOI: 10.1016/j.ejrad.2023.110890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/03/2023] [Accepted: 05/20/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE To observe the quality of brachial plexus (BP) images obtained from magnetic resonance imaging (MRI) with 3D T2 STIR SPACE sequence and compressed sensing (CS) and to compare the results with BP images from the same sequence without CS. METHODS In this study, compressed sensing was applied to acquire non-contrast BP images from ten healthy volunteers with 3D T2 STIR SPACE sequence to shorten acquisition time without sacrificing image quality. The acquisition time of scanning with CS was compared to that without CS. The quantitative signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated and compared using paired t-test to determine the quality of images with and without CS. The qualitative assessment by three experienced radiologists was performed using a scoring scale from 1 (poor) to 5 (excellent) and analyzed for interobserver agreement on image quality. RESULTS The increasing SNR and CNR of images with CS were found in nine regions of BP images (p < 0.001) with faster acquisition time. The result of paired t-test (p < 0.001) illustrates the significant difference between images with CS compared to images without CS. The assessment of observers also shows higher scores for images with CS compared to images without CS. CONCLUSIONS This study demonstrates that CS can effectively increase the visibility of images and image boundaries, SNR, and CNR of BP images obtained with 3D T2 STIR SPACE sequence with the good interobserver agreement and within clinically optimal acquisition time compared to images from similar sequence without CS.
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Affiliation(s)
- Muhammad Agus Pribowo
- Department of Radiology, Gatot Soebroto Army Hospital (RSPAD Gatot Soebroto), Jakarta 10410, Indonesia
| | | | - Vininta Fazharyasti
- Department of Radiology, Gatot Soebroto Army Hospital (RSPAD Gatot Soebroto), Jakarta 10410, Indonesia
| | - Yanurita Dwihapsari
- Department of Physics, Institut Teknologi Sepuluh Nopember (ITS), Surabaya 60111, Indonesia.
| | - Yeti Kartikasari
- Health Polytechnic of Semarang, Ministry of Health, Semarang 50239, Indonesia
| | - Sugiyanto
- Health Polytechnic of Semarang, Ministry of Health, Semarang 50239, Indonesia
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Singh DK, Kumar N, Bhayana A, Altamash M, Sharma A, Agarwal A. A pentavalent approach for the evaluation of traumatic brachial plexopathy on MRI: correlation of macropattern and micropattern. Br J Radiol 2023; 96:20220913. [PMID: 36752595 PMCID: PMC10230398 DOI: 10.1259/bjr.20220913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 02/09/2023] Open
Abstract
Macropattern analysis of traumatic brachial plexopathy (TBP) by Magnetic Resonance Imaging (MRI) encompasses localization of injured segments and determination of the severity of injury. The micropattern analysis implies the correlation of the MRI features of TBP with Sunderland's grading of the nerve injury, thereby guiding the management protocol. This review article presents a simplified novel pentavalent approach for the radiological anatomy of brachial plexus, MRI acquisition protocol for the evaluation of brachial plexus, cardinal imaging signs of TBP, and their correlation with Sunderland's microanatomical grading.
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Affiliation(s)
- Dharmendra Kumar Singh
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Nishith Kumar
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Aanchal Bhayana
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Mohd. Altamash
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Anuradha Sharma
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Anuj Agarwal
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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The Application of Contrast-Enhanced 3D-STIR-VISTA MR Imaging of the Brachial Plexus. J Belg Soc Radiol 2022; 106:75. [PMID: 36134175 PMCID: PMC9461682 DOI: 10.5334/jbsr.2803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/09/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: Methods: Results: Conclusion:
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Boulter DJ, Job J, Shah LM, Wessell DE, Lenchik L, Parsons MS, Agarwal V, Appel M, Burns J, Hutchins TA, Kendi AT, Khan MA, Liebeskind DS, Moritani T, Ortiz AO, Shah VN, Singh S, Than KD, Timpone VM, Beaman FD, Corey AS. ACR Appropriateness Criteria® Plexopathy: 2021 Update. J Am Coll Radiol 2021; 18:S423-S441. [PMID: 34794598 DOI: 10.1016/j.jacr.2021.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 10/19/2022]
Abstract
Plexopathy may be caused by diverse pathologies, including trauma, nerve entrapment, neoplasm, inflammation, infection, autoimmune disease, hereditary disease, and idiopathic etiologies. For patients presenting with brachial or lumbosacral plexopathy, dedicated plexus MRI is the most appropriate initial imaging modality for all clinical scenarios and can identify processes both intrinsic and extrinsic to the nerves. Other imaging tests may be appropriate for initial imaging depending on the clinical scenario. This document addresses initial imaging strategies for brachial and lumbosacral plexopathy in the following clinical situations: nontraumatic plexopathy with no known malignancy, traumatic plexopathy (not perinatal), and plexopathy occurring in the context of a known malignancy or posttreatment syndrome. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Daniel J Boulter
- Clinical Director of MRI, The Ohio State University Wexner Medical Center, Columbus, Ohio.
| | - Joici Job
- Research Author, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Lubdha M Shah
- Panel Chair, University of Utah, Salt Lake City, Utah
| | | | - Leon Lenchik
- Panel Vice-Chair, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Matthew S Parsons
- Panel Vice-Chair, Mallinckrodt Institute of Radiology, Saint Louis, Missouri
| | - Vikas Agarwal
- Vice Chair of Education, Chief, Neuroradiology, and Director, Spine Intervention, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Marc Appel
- James J. Peters VA Medical Center, Bronx, New York; American Academy of Orthopaedic Surgeons
| | - Judah Burns
- Program Director, Diagnostic Radiology Residency Program, Montefiore Medical Center, Bronx, New York
| | - Troy A Hutchins
- Chief Value Officer for Radiology, University of Utah Health, Salt Lake City, Utah
| | | | - Majid A Khan
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - David S Liebeskind
- University of California Los Angeles, Los Angeles, California; President, SVIN; and American Academy of Neurology
| | | | - A Orlando Ortiz
- Chairman, Department of Radiology, Jacobi Medical Center, Bronx, New York
| | - Vinil N Shah
- University of California San Francisco, San Francisco, California; and Executive Committee, American Society of Spine Radiology
| | - Simranjit Singh
- Indiana University School of Medicine, Indianapolis, Indiana; Secretary, SHM, Indiana Chapter; Secretary, SGIM, Midwest Region; and American College of Physicians
| | - Khoi D Than
- Duke University, Durham, North Carolina; Neurosurgery expert
| | - Vincent M Timpone
- Co-Director, Neuroradiology Spine Intervention Service, Department of Radiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | | | - Amanda S Corey
- Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia
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Single-direction diffusion-weighted imaging may be a simple complementary sequence for evaluating fetal corpus callosum. Eur Radiol 2021; 32:1135-1143. [PMID: 34331117 DOI: 10.1007/s00330-021-08176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/20/2021] [Accepted: 06/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To explore the feasibility of single-direction diffusion-weighted imaging (DWI) for assessing the fetal corpus callosum (CC). METHODS This prospective study included 67 fetuses with normal CC and 35 fetuses suspected with agenesis of the corpus callosum (ACC). The MR protocols included HASTE, TrueFISP, and single-direction DWI. Two radiologists independently evaluated the optimal visibility and the contrast ratio (CR) of the normal fetal CC. The Chi-squared test or Fisher's exact test was used to compare the proportions of "good" visibility (score ≥ 3, and the CC was almost/entirely visible) between single-direction DWI and HASTE/TrueFISP. The CR difference between single-direction DWI and HASTE/TrueFISP was detected using the paired t-test. The diagnostic accuracies were determined by comparison with postnatal imaging. In fetuses suspected of ACC, we measured and compared the length and area of the mid-sagittal CC in the single-direction DWI images. RESULTS The proportion of "good" visibility in single-direction DWI was higher than that in HASTE/TrueFISP, with p < 0.0001. The mean CR from single-direction DWI was also higher than that of TrueFISP and HASTE (both with p < 0.0001). The diagnostic accuracy of the single-direction DWI combined with HASTE/TrueFisp (97.1%, 34/35) was higher than that of the Haste/TrueFISP (74.3%, 26/35) (p = 0.013). The length and area of the PACC (p < 0.001, p = 0.001, respectively) and HCC (p < 0.001, p = 0.018, respectively) groups were significantly lower than those of the normal group. CONCLUSIONS The single-direction DWI is feasible in displaying fetal CC and can be a complementary sequence in diagnosing ACC. KEY POINTS • We suggest a simple method for the display of the fetal CC. • The optimal visibility and contrast ratio from single-direction DWI were higher than those from HASTE and TrueFISP. • The diagnostic accuracy of the single-direction DWI combined with HASTE/TrueFISP sequences (97.1%, 34/35) was higher than that of the Haste/TrueFISP (74.3%, 26/35).
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Abstract
Head and neck MR imaging is technically challenging because of magnetic field inhomogeneity, respiratory and swallowing motion, and necessity of high-resolution imaging to trace key anatomic structures. These challenges have been answered by advances in MR imaging technology, including isovolumetric three-dimensional imaging, robust fat-water separation techniques, and novel deep learning-based reconstruction algorithms. New applications of MR imaging have been advanced and functional imaging has been improved. Improvements in acquisition and reconstruction technique facilitate novel applications of morphologic and functional imaging. This results in opportunities to improve diagnosis, staging, and treatment selection through application of advanced MR imaging techniques.
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Magnetic resonance neurography appearance and diagnostic evaluation of peripheral nerve sheath tumors. Sci Rep 2019; 9:6939. [PMID: 31061436 PMCID: PMC6502820 DOI: 10.1038/s41598-019-43450-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/24/2019] [Indexed: 02/07/2023] Open
Abstract
Imaging appearances of peripheral nerve sheath tumors by MRI are difficult distinguish from soft-tissue tumors. The objective of this study was to evaluate the feasibility and imaging appearance of high-resolution 3-T magnetic resonance neurography (MRN) of the diagnosis of peripheral nerve sheath tumors (PNSTs) using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences. We retrospectively evaluated the MRI and 3D Short tau inversion recovery sampling perfection with application-optimized contrasts using varying flip-angle evolutions (3D-STIR SPACE) sequences of 30 patients with PNSTs diagnosed by surgery and pathology. The contrast-enhanced 3D-STIR SPACE images were retrospectively analyzed and evaluated for the visualization of PNSTs. The tumors were evaluated by their number, location, morphology, size, signal intensity and enhancement characteristics. The imaging findings and characteristic signs of conventional MRI scanning and contrast-enhanced 3D-STIR SPACE sequences were compared. In these cases, conventional MRI images display the location, number, shape, size and signal characteristics of the lesions. These tumors were mostly solitary and had a well-defined boundary. Compared to conventional MRI images, imaging appearances including neurogenic origin, length of the peripheral nerves and relation to the nerve of PNSTs on 3D-STIR SPACE images were more accuracy (P < 0.05). Compared to 3D-STIR SPACE images, contrast-enhanced images can more clearly display background suppression of the peripheral nerves. The “split fat” sign and “target” sign were seen in some patients. 3D STIR SPACE sequences demonstrate its significant capacity to diagnostic evaluate and location of PNSTs. This article comprehensively reviews radiologic findings and illustrates the MRN features of PNSTs. 3D-STIR SPACE sequences be used for preoperative evaluation of PNSTs.
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Sneag DB, Mendapara P, Zhu JC, Lee SC, Lin B, Curlin J, Bogner EA, Fung M. Prospective respiratory triggering improves high‐resolution brachial plexus MRI quality. J Magn Reson Imaging 2018; 49:1723-1729. [DOI: 10.1002/jmri.26559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Darryl B. Sneag
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Parrykumar Mendapara
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Jacqui C. Zhu
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Susan C. Lee
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Bin Lin
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Jahnavi Curlin
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Eric A. Bogner
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
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Wang X, Greer JS, Dimitrov IE, Pezeshk P, Chhabra A, Madhuranthakam AJ. Frequency Offset Corrected Inversion Pulse for B 0 and B 1 Insensitive Fat Suppression at 3T: Application to MR Neurography of Brachial Plexus. J Magn Reson Imaging 2018; 48:1104-1111. [PMID: 30218576 DOI: 10.1002/jmri.26021] [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] [Received: 12/22/2017] [Accepted: 03/07/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The 3D short tau inversion recovery (STIR) sequence is routinely used in clinical MRI to achieve robust fat suppression. However, the performance of the commonly used adiabatic inversion pulse, hyperbolic secant (HS), is compromised in challenging areas with increased B0 and B1 inhomogeneities, such as brachial plexus at 3T. PURPOSE To demonstrate the frequency offset corrected inversion (FOCI) pulse as an efficient fat suppression STIR pulse with increased robustness to B0 and B1 inhomogeneities at 3T, compared to the HS pulse. STUDY TYPE Prospective. SUBJECTS/PHANTOM Initial evaluation was performed in phantoms and one healthy volunteer by varying the B1 field, while subsequent comparison was performed in three healthy volunteers and five patients without varying the B1 . FIELD STRENGTH/SEQUENCE 3T; 3D TSE-STIR with HS and FOCI pulses. ASSESSMENT Brachial plexus images were qualitatively evaluated by two musculoskeletal radiologists independently using a four-point grading scale for fat suppression, shading artifacts, and nerve visualization. STATISTICAL TEST The Wilcoxon signed-rank test with P < 0.05 was considered statistically significant. RESULTS Simulations and phantom experiments demonstrated broader bandwidth (2.5 kHz vs. 0.83 kHz, increased B0 robustness) at the same adiabatic threshold and lower adiabatic threshold (5 μT vs. 7 μT at 3.5 ppm, increased B1 robustness) at the same bandwidth with the FOCI pulse compared to the HS pulse With increased bandwidth, the FOCI pulse achieved robust fat suppression even at 50% of maximum B1 strength, while the HS pulse required >75% of maximum B1 strength. Compared to the standard 3D TSE-STIR with HS pulse, the FOCI pulse achieved uniform fat suppression (P < 0.05), better nerve visualization (P < 0.05), and minimal shading artifacts (P < 0.01) in brachial plexus at 3T. DATA CONCLUSION The FOCI pulse has increased robustness to B0 and B1 inhomogeneities, compared to the HS pulse, and enables uniform fat suppression in brachial plexus at 3T. LEVEL OF EVIDENCE 1 Techinical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;48:1104-1111.
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Affiliation(s)
- Xinzeng Wang
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Joshua S Greer
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Ivan E Dimitrov
- Philips Medical Systems, Gainesville, Florida, USA.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Parham Pezeshk
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Avneesh Chhabra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ananth J Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Bykowski J, Aulino JM, Berger KL, Cassidy RC, Choudhri AF, Kendi AT, Kirsch CFE, Luttrull MD, Sharma A, Shetty VS, Than K, Winfree CJ, Cornelius RS. ACR Appropriateness Criteria ® Plexopathy. J Am Coll Radiol 2018; 14:S225-S233. [PMID: 28473078 DOI: 10.1016/j.jacr.2017.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 02/01/2017] [Accepted: 02/02/2017] [Indexed: 12/17/2022]
Abstract
MRI without and with contrast is the most accurate imaging method to determine whether a process is intrinsic or extrinsic to a nerve of the brachial or lumbosacral plexus. However, there are no Current Procedural Terminology codes to correspond to imaging studies of the brachial or lumbar plexus discretely. This assessment uses "MRI of the brachial plexus" or "MRI of the lumbosacral plexus" as independent entities given that imaging acquisition for the respective plexus differs in sequences and planes compared with those of a routine neck, chest, spine, or pelvic MRI, yet acknowledges the potential variability of ordering practices across institutions. In patients unable to undergo MRI, CT offers the next highest level of anatomic evaluation. In oncologic patients, PET/CT imaging can identify the extent of tumor involvement and be beneficial to differentiate radiation plexitis from tumor recurrence but provides limited resolution of the plexus itself. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Julie Bykowski
- Principal Author and Panel Chair, UC San Diego Health, San Diego, California.
| | | | | | - R Carter Cassidy
- UK Healthcare Spine and Total Joint Service, Lexington, Kentucky, American Academy of Orthopaedic Surgeons
| | - Asim F Choudhri
- Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee
| | | | - Claudia F E Kirsch
- North Shore-Long Island Jewish Hospital, Hofstra Medical School, Hempstead, New York
| | | | - Aseem Sharma
- Mallinckrodt Institute of Radiology, Saint Louis, Missouri
| | | | - Khoi Than
- Oregon Health & Science University, Portland, Oregon, neurosurgical consultant
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Hirata K, Nakaura T, Okuaki T, Tsuda N, Taguchi N, Oda S, Utsunomiya D, Yamashita Y. 3D hybrid profile order technique in a single breath-hold 3D T2-weighted fast spin-echo sequence: Usefulness in diagnosis of small liver lesions. Eur J Radiol 2018; 98:113-117. [DOI: 10.1016/j.ejrad.2017.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/10/2017] [Accepted: 11/13/2017] [Indexed: 11/26/2022]
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Ahn SJ, Jeong YM, Lee BG, Sim JA, Choi HY, Kim JH, Lee SW. Using three-dimensional isotropic SPACE MRI to detect posterolateral corner injury of the knee. Acta Radiol 2016; 57:1251-60. [PMID: 26823457 DOI: 10.1177/0284185115626470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 11/26/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Reliable magnetic resonance imaging (MRI) diagnosis is important in cases of posterolateral corner (PLC) injury due to the limitations of physical examination in patients with multi-ligament injury. PURPOSE To document the appearance of PLC of the knee on three-dimensional (3D) isotropic MR images, and to determine the significance of MRI findings in patients with confirmed posterolateral rotatory instability. MATERIAL AND METHODS Twenty-five patients that underwent surgery for posterolateral instability, and 25 individuals with normal MRI constituted the study cohort. The PLC appearances (popliteofibular, fabellofibular, arcuate ligaments, popliteomeniscal fascicle) were analyzed using 3D isotropic proton density sequence and routine two-dimensional (2D) MRI. In addition, the "fibular cap" sign was evaluated. Statistical analysis was performed using the Chi-square and McNemar's tests. RESULTS Thickening of popliteofibular, fabellofibular, arcuate ligaments, and popliteomeniscal fascicle was significantly more frequent in the PLC injury group than in the control group (P < 0.05). The sensitivity and specificity of 3D MRI for popliteofibular, fabellofibular, arcuate ligaments, and popliteomeniscal fascicle injury were 63/92%, 54/100%, 46/100%, and 58/92%, respectively. On comparing 3D and 2D images with respect to injury detectability (grade 3 or 4), both modalities visualized injuries, but 3D detected grade 3 or grade 1 rather than grade 4 or 0, respectively. The fibular cap sign was observed significantly more frequently in PLC group, with 58% sensitivity and 100% specificity, and was better observed by 3D than 2D (P < 0.05). CONCLUSION 3D MRI is a valid modality for detecting PLC abnormalities as it visualizes pathologies in each component and exhibits the positive fibular cap sign.
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Affiliation(s)
- Su Joa Ahn
- Department of Radiology, Gachon University, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University, Incheon, Republic of Korea
| | - Beom Goo Lee
- Department of Orthopedics, Gachon University, Incheon, Republic of Korea
| | - Jae Ang Sim
- Department of Orthopedics, Gachon University, Incheon, Republic of Korea
| | - Hye-Young Choi
- Department of Radiology, Gachon University, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University, Incheon, Republic of Korea
| | - Sheen-Woo Lee
- Department of Radiology, Gachon University, Incheon, Republic of Korea
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Zhang X, Li M, Guan J, Wang H, Li S, Guo Y, Liu M. Evaluation of the sacral nerve plexus in pelvic endometriosis by three-dimensional MR neurography. J Magn Reson Imaging 2016; 45:1225-1231. [PMID: 27666420 DOI: 10.1002/jmri.25435] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 08/08/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To investigate the feasibility of three-dimensional MR neurography (3D MRN) for the sacral plexus using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences, and to demonstrate structural abnormalities in the pelvic nerve of women with pelvic endometriosis. MATERIALS AND METHODS Twenty patients with pelvic endometriosis and 20 healthy controls were examined by contrast-enhanced 3D short time inversion recovery T2-weighted imaging (CE 3D STIR T2WI) SPACE sequences on 3 Tesla MRI. Image quality and diagnostic confidence of the sequences in identifying abnormalities of the sacral plexus were analyzed and compared with conventional three-plane images of 2D turbo-spin echo T2-weighted images (2D TSE T2WI). The changes in the sacral plexus caused by endometrial lesions were evaluated. RESULTS The sacral plexus was clearly revealed in both healthy controls and patients with endometriosis on 3D STIR SPACE images. A good agreement was reached in the evaluation of both imaging quality (Kappa value [κ] = 0.73-1.00) and diagnostic confidence (κ = 0.66-0.81) when compared between the two independent readers. Abnormalities caused by endometriosis were identified in 17 patients, unilaterally in 10 patients, and bilaterally in 7 patients. Nerve fiber abnormalities of lumbar 5 (L5) were detected in 11 patients, of sacral 1 (S1) in 14 patients and of sacral 2 (S2) in 9 patients. CONCLUSION CE 3D STIR SPACE sequences demonstrate its significant capacity to investigate and map the sacral plexus, and reveal the compression and adhesion of the sacral plexus nerve as a result of ectopic lesions. LEVEL OF EVIDENCE 3 J. Magn. Reson. Imaging 2017;45:1225-1231.
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Affiliation(s)
- Xiaoling Zhang
- Department of Radiology, First affiliated hospital of Sun Yat-sen University, Guangzhou, China
| | - Meizhi Li
- Department of Radiology, First affiliated hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Guan
- Department of Radiology, First affiliated hospital of Sun Yat-sen University, Guangzhou, China
| | - Huanjun Wang
- Department of Radiology, First affiliated hospital of Sun Yat-sen University, Guangzhou, China
| | - Shurong Li
- Department of Radiology, First affiliated hospital of Sun Yat-sen University, Guangzhou, China
| | - Yan Guo
- Department of Radiology, First affiliated hospital of Sun Yat-sen University, Guangzhou, China
| | - Mingjuan Liu
- Department of Radiology, First affiliated hospital of Sun Yat-sen University, Guangzhou, China
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Tagliafico AS. Peripheral nerve imaging: Not only cross-sectional area. World J Radiol 2016; 8:726-728. [PMID: 27648165 PMCID: PMC5002502 DOI: 10.4329/wjr.v8.i8.726] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 04/19/2016] [Accepted: 06/14/2016] [Indexed: 02/06/2023] Open
Abstract
Peripheral nerve imaging is recognized as a complement to clinical and neurophysiological assessment in the evaluation of peripheral nerves with the ability to impact patient management, even for small and difficult nerves. The European Society of Musculoskeletal Radiology, suggest to use ultrasound (US) for nerve evaluation due to the fact that, in sever anatomical area, magnetic resonance imaging is not able to give additional informations. US could be considered the first-choice approach for the assessment of peripheral nerves. The relative drawback of peripheral nerve US is the long learning curve and the deep anatomic competence to evaluate even small nerves. In the recent years, the role of US in peripheral nerve evaluation has been widened. In the past, nerve US was mainly used to assess nerve-cross sectional area, but now more advanced measurements and considerations are desirable and can boost the role of peripheral nerve US. Nerve echotexture evaluation was defined in 2010: The ratio between the hypoechoic and hyperechoic areas of peripheral nerves on US was called "nerve density". For evaluation of patients who have peripheral neuropathies, the role of peripheral nerve is US wider than simple cross-sectional area evaluation. Quantitative measurements describing the internal fascicular echotexture of peripheral nerves introduce the concept of considering US as a possible quantitative imaging biomarker technique. The potential of nerve US has started to be uncovered. It seems clear that only cross-sectional area measurement is no more sufficient for a comprehensive US evaluation of peripheral nerves.
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Yokoyama K, Nakaura T, Iyama Y, Sakamoto S, Takemura A, Okuaki T, Harada K, Yamashita Y. Usefulness of 3D hybrid profile order technique with 3T magnetic resonance cholangiography: Comparison of image quality and acquisition time. J Magn Reson Imaging 2016; 44:1346-1353. [PMID: 27131338 DOI: 10.1002/jmri.25289] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 04/04/2016] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate the image quality and acquisition time of magnetic resonance cholangiopancreatography (MRCP) with and without the 3D hybrid profile order technique. MATERIALS AND METHODS We studied 32 consecutive patients at 3T. They underwent MRCP with and without the 3D hybrid profile order imaging technique during free breathing and MRCP with the 3D hybrid profile order technique during a single breath-hold. The image acquisition time was 82% shorter with the 3D hybrid profile order technique than without it. The contrast, signal-to-noise-ratio (SNR), and contrast-noise-ratio (CNR) between the common bile duct (CBD) and periductal tissues on 3D-MRCP were evaluated quantitatively. RESULTS The contrast, SNR, and CNR of the CBD under free breathing was significantly higher with the 3D hybrid profile order technique than without it (P < 0.01). The contrast, SNR, and CNR of the CBD under a single breath-hold was significantly higher with the 3D hybrid profile order technique than without it (P < 0.01). There were no significant differences in the contrast, SNR, and CNR of the CBD between the 3D hybrid profile order with a single breath-hold and with free breathing (P = 0.12, 0.28, 0.28, respectively). CONCLUSION Using 3T MRI for MRCP with the 3D hybrid profile order sequence yielded significantly improved contrast and CNR with a shorter image acquisition time without sacrificing image quality when compared to imaging without the 3D hybrid profile order sequence. J. Magn. Reson. Imaging 2016;44:1346-1353.
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Affiliation(s)
- Koichi Yokoyama
- Diagnostic Radiology, Amakusa Medical Center, Kumamoto, Japan. .,Department of Diagnostic Radiology, Graduate School of Medical, Kumamoto University, Japan.
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical, Kumamoto University, Japan
| | - Yuji Iyama
- Department of Diagnostic Radiology, Graduate School of Medical, Kumamoto University, Japan.,Diagnostic Radiology, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Seiji Sakamoto
- Diagnostic Radiology, Kumamoto Orthopedic Hospital, Kumamoto, Japan
| | | | | | - Kazunori Harada
- Department of Surgery, Amakusa Medical Center, Kumamoto, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Graduate School of Medical, Kumamoto University, Japan
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Usefulness of the Short–Echo Time Cube Sequence at 3-T Magnetic Resonance Cholangiopancreatography. J Comput Assist Tomogr 2016; 40:551-6. [DOI: 10.1097/rct.0000000000000401] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tagliafico A, Bignotti B, Tagliafico G, Martinoli C. Usefulness of IDEAL T2 imaging for homogeneous fat suppression and reducing susceptibility artefacts in brachial plexus MRI at 3.0 T. LA RADIOLOGIA MEDICA 2016; 121:45-53. [PMID: 26253383 DOI: 10.1007/s11547-015-0576-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To quantitatively and qualitatively compare fat-suppressed MR imaging quality using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) with that using frequency-selective fat-suppressed (FSFS) T2 images of the brachial plexus at 3.0 T. MATERIALS AND METHODS Prospective MR image analysis was performed in 40 volunteers and 40 patients at a single centre. Oblique-sagittal and coronal IDEAL fat-suppressed T2 images and FSFS T2 images were compared. Visual assessment was performed by two independent musculoskeletal radiologists with respect to: (1) susceptibility artefacts around the neck, (2) homogeneity of fat suppression, (3) image sharpness and (4) tissue resolution contrast of pathologies. The signal-to-noise ratios (SNR) for each image sequence were assessed. RESULTS Compared to FSFS sequences, IDEAL fat-suppressed T2 images significantly reduced artefacts around the brachial plexus and significantly improved homogeneous fat suppression (p < 0.05). IDEAL significantly improved sharpness and lesion-to-tissue contrast (p < 0.05). The mean SNRs were significantly improved on T2-weighted IDEAL images (p < 0.05). CONCLUSION IDEAL technique improved image quality by reducing artefacts around the brachial plexus while maintaining a high SNR and provided superior homogeneous fat suppression than FSFS sequences.
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Affiliation(s)
- Alberto Tagliafico
- Department of Experimental Medicine (DIMES), Institute of Anatomy, University of Genoa, Via de Toni 14, 16132, Genoa, Italy.
| | - Bianca Bignotti
- Department of Health Sciences (DISSAL), University of Genoa, Via Pastore 2, 16132, Genoa, Italy.
| | - Giulio Tagliafico
- Consiglio Nazionale delle Ricerche, Istituto di Matematica Applicata e Tecnologie, Via De Marini 6, 16149, Genoa, Italy.
| | - Carlo Martinoli
- Department of Health Sciences (DISSAL), University of Genoa, Via Pastore 2, 16132, Genoa, Italy.
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22
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High-Resolution 3-T Endorectal Prostate MRI: A Multireader Study of Radiologist Preference and Perceived Interpretive Quality of 2D and 3D T2-Weighted Fast Spin-Echo MR Images. AJR Am J Roentgenol 2015; 206:86-91. [PMID: 26491891 DOI: 10.2214/ajr.14.14065] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The goal of this study was to compare the perceived quality of 3-T axial T2-weighted high-resolution 2D and high-resolution 3D fast spin-echo (FSE) endorectal MR images of the prostate. MATERIALS AND METHODS Six radiologists independently reviewed paired 3-T axial T2-weighted high-resolution 2D and 3D FSE endorectal MR images of the prostates of 85 men in two sessions. In the first session (n = 85), each reader selected his or her preferred images; in the second session (n = 28), they determined their confidence in tumor identification and compared the depiction of the prostatic anatomy, tumor conspicuity, and subjective intrinsic image quality of images. A meta-analysis using a random-effects model, logistic regression, and the paired Wilcoxon rank-sum test were used for statistical analyses. RESULTS Three readers preferred the 2D acquisition (67-89%), and the other three preferred the 3D images (70-80%). The option for one of the techniques was not associated with any of the predictor variables. The 2D FSE images were significantly sharper than 3D FSE (p < 0.001) and significantly more likely to exhibit other (nonmotion) artifacts (p = 0.002). No other statistically significant differences were found. CONCLUSION Our results suggest that there are strong individual preferences for the 2D or 3D FSE MR images, but there was a wide variability among radiologists. There were differences in image quality (image sharpness and presence of artifacts not related to motion) but not in the sequences' ability to delineate the glandular anatomy and depict a cancerous tumor.
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Zhang J, Chen L, Wang QX, Liu R, Zhu WZ, Luo X, Peng L, Xiong W. Diagnostic performance of the three-dimensional fast spin echo-Cube sequence in comparison with a conventional imaging protocol in evaluation of the lachrymal drainage system. Eur Radiol 2014; 25:635-43. [DOI: 10.1007/s00330-014-3462-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/29/2014] [Indexed: 10/24/2022]
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Rehman I, Chokshi FH, Khosa F. MR Imaging of the Brachial Plexus. Clin Neuroradiol 2014; 24:207-16. [DOI: 10.1007/s00062-014-0297-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 02/06/2014] [Indexed: 12/26/2022]
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25
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Mugler JP. Optimized three‐dimensional fast‐spin‐echo MRI. J Magn Reson Imaging 2014; 39:745-67. [PMID: 24399498 DOI: 10.1002/jmri.24542] [Citation(s) in RCA: 264] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- John P. Mugler
- Department of Radiology and Medical ImagingUniversity of Virginia School of MedicineCharlottesville Virginia USA
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Van de Velde J, Audenaert E, Speleers B, Vercauteren T, Mulliez T, Vandemaele P, Achten E, Kerckaert I, D'Herde K, De Neve W, Van Hoof T. An anatomically validated brachial plexus contouring method for intensity modulated radiation therapy planning. Int J Radiat Oncol Biol Phys 2013; 87:802-8. [PMID: 24138919 DOI: 10.1016/j.ijrobp.2013.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 07/17/2013] [Accepted: 08/02/2013] [Indexed: 12/25/2022]
Abstract
PURPOSE To develop contouring guidelines for the brachial plexus (BP) using anatomically validated cadaver datasets. Magnetic resonance imaging (MRI) and computed tomography (CT) were used to obtain detailed visualizations of the BP region, with the goal of achieving maximal inclusion of the actual BP in a small contoured volume while also accommodating for anatomic variations. METHODS AND MATERIALS CT and MRI were obtained for 8 cadavers positioned for intensity modulated radiation therapy. 3-dimensional reconstructions of soft tissue (from MRI) and bone (from CT) were combined to create 8 separate enhanced CT project files. Dissection of the corresponding cadavers anatomically validated the reconstructions created. Seven enhanced CT project files were then automatically fitted, separately in different regions, to obtain a single dataset of superimposed BP regions that incorporated anatomic variations. From this dataset, improved BP contouring guidelines were developed. These guidelines were then applied to the 7 original CT project files and also to 1 additional file, left out from the superimposing procedure. The percentage of BP inclusion was compared with the published guidelines. RESULTS The anatomic validation procedure showed a high level of conformity for the BP regions examined between the 3-dimensional reconstructions generated and the dissected counterparts. Accurate and detailed BP contouring guidelines were developed, which provided corresponding guidance for each level in a clinical dataset. An average margin of 4.7 mm around the anatomically validated BP contour is sufficient to accommodate for anatomic variations. Using the new guidelines, 100% inclusion of the BP was achieved, compared with a mean inclusion of 37.75% when published guidelines were applied. CONCLUSION Improved guidelines for BP delineation were developed using combined MRI and CT imaging with validation by anatomic dissection.
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Affiliation(s)
- Joris Van de Velde
- Department of Anatomy, Ghent University, Ghent, Belgium; Department of Radiotherapy, Ghent University, Ghent, Belgium.
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Chhabra A, Thawait GK, Soldatos T, Thakkar RS, Del Grande F, Chalian M, Carrino JA. High-resolution 3T MR neurography of the brachial plexus and its branches, with emphasis on 3D imaging. AJNR Am J Neuroradiol 2012; 34:486-97. [PMID: 22976233 DOI: 10.3174/ajnr.a3287] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
With advancement in 3D imaging, better fat-suppression techniques, and superior coil designs for MR imaging and the increasing availability and use of 3T magnets, the visualization of the complexity of the brachial plexus has become facile. The relevant imaging findings are described for normal and pathologic conditions of the brachial plexus. These radiologic findings are supported by clinical and/or EMG/surgical data, and corresponding high-resolution MR neurography images are illustrated. Because the brachial plexus can be affected by a plethora of pathologies, resulting in often serious and disabling complications, a better radiologic insight has great potential in aiding physicians in rendering superior services to patients.
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Affiliation(s)
- A Chhabra
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
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3 Tesla MR neurography--technique, interpretation, and pitfalls. Skeletal Radiol 2011; 40:1249-60. [PMID: 21547613 DOI: 10.1007/s00256-011-1183-6] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 04/18/2011] [Accepted: 04/19/2011] [Indexed: 02/02/2023]
Abstract
MRI has been used for almost two decades for the evaluation of peripheral nerve disorders. This article highlights the relative advantages and disadvantages of 3T MR neurography in the evaluation of peripheral neuropathies. The authors also describe the high-resolution MR neurography technique on 3T MRI, along with the approach to its interpretation that has evolved at one institution.
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