The Relationship Between Conventionally Obtained Serum-Based Liver Function Indices and Intravoxel Incoherent Motion Diffusion-Weighted Imaging and Magnetic Resonance Elastography in Patients With Hepatocellular Carcinoma.

OBJECTIVES: To investigate the relationship between conventionally obtained serum-based biochemical indices and intravoxel incoherent motion imaging (IVIM) parameters compared with magnetic resonance elastography (MRE). METHODS: Patients with hepatocellular carcinoma who underwent ≥2 liver magnetic resonance imaging (MRI) scan, including IVIM and MRE, between 2017 and 2020 and biochemical testing within 1 week before or after MRI were included in this study. Biochemical tests were performed to determine the albumin-bilirubin (ALBI) score and modified ALBI (mALBI) grade, aspartate aminotransferase to platelet ratio index (APRI), and fibrosis-4 index (FIB-4). The diffusion coefficient ( D ), pseudo-diffusion coefficient ( D *), fractional volume occupied by flowing spins ( f ), and apparent diffusion coefficient were calculated for IVIM. The correlations between (1) the imaging parameters and biochemical indices and (2) the changes in mALBI grades and imaging parameters were evaluated. RESULTS: This study included 98 scans of 40 patients (31 men; mean age, 67.7 years). The correlation analysis between the biochemical and IVIM parameters showed that ALBI score and D* had the best correlation ( r = -0.3731, P < 0.001), and the correlation was higher than that with MRE ( r = 0.3289, P < 0.001). However, among FIB-4, APRI, and MRI parameters, MRE outperformed IVIM parameters (MRE and FIB-4, r = 0.3775, P < 0.001; MRE and APRI, r = 0.4687, P < 0.001). There were significant differences in the changes in MRE among the 3 groups (improved, deteriorated, and unchanged mALBI groups) in the analysis of covariance ( P = 0.0434). There were no significant changes in IVIM. CONCLUSIONS: Intravoxel incoherent motion imaging has the potential to develop into a more readily obtainable method of liver function assessment.

Relationship between lumbar spinal stenosis and cauda equina movement during the Valsalva maneuver.

OBJECTIVE: To confirm the relationship between lumbar spinal stenosis (LSS) and cauda equina movement during the Valsalva maneuver. MATERIALS AND METHODS: Two radiologists at our institution independently evaluated cauda equina movement on pelvic cine MRI, which was performed for urethrorrhea after prostatectomy or pelvic prolapse in 105 patients (99 males; mean age: 69.0 [range: 50-78] years), who also underwent abdominopelvic CT within 2 years before or after the MRI. The qualitative assessment of the cine MRI involved subjective determination of the cauda equina movement type (non-movement, flutter, and inchworm-manner). The severity of LSS on abdominopelvic CT was quantified using our LSS scoring system and performed between L1/2 and L5/S1. We calculated the average LSS scores of two analysts and extracted the worst scores among all levels. RESULTS: Cauda equina movement was observed in 15 patients (14%), inchworm-manner in 10 patients, and flutter in five patients. Participants with cauda equina movement demonstrated significantly higher LSS scores than those without movement (P < 0.001, Wilcoxon's rank-sum test). A significant difference was observed in the worst LSS scores between participants without movement and those with inchworm-manner movement (P < 0.001, Bonferroni's corrected). There were no significant differences between participants without movement and those with flutter movement (P = 0.3156) and between participants with flutter movement and those with inchworm-manner movement (P = 0.4843). CONCLUSION: Cauda equina movement in cine MRI during the Valsalva maneuver is occasionally observed in patients with severe LSS, and may be associated with pathogenesis of redundant nerve roots.

Lumbar intradural space reduction during the Valsalva maneuver observed using cine MRI and MR myelography: a single-case experimental study.

BACKGROUND: Previous studies have shown that the Valsalva maneuver (VM) causes spinal canal object movements. We hypothesized that this occurs because of cerebrospinal fluid (CSF) flow generated from intradural space reduction. Previous studies using myelograms reported lumbar CSF space changes during inspiration. However, no similar studies have been conducted using modern MRI. Therefore, this study analyzed intradural space reduction during the VM using cine magnetic resonance imaging (MRI). METHODS: The participant was a 39-year-old, healthy, male volunteer. Cine MRI involved fast imaging employing steady-state acquisition cine sequence during three resting and VM sets for 60 s each. The axial plane was at the intervertebral disc and vertebral body levels between Th12 and S1 during cine MRI. This examination was performed on 3 separate days; hence, data from nine resting and VM sets were available. Additionally, two-dimensional myelography was performed during rest and the VM. RESULTS: Intradural space reduction was observed during the VM using cine MRI and myelography. The intradural space cross-sectional area during the VM (mean: 129.3 mm2; standard deviation [SD]: 27.4 mm2) was significantly lower than that during the resting period (mean: 169.8; SD: 24.8; Wilcoxon signed-rank test, P < 0.001). The reduction rate of the vertebral body level (mean: 26.7%; SD: 9.4%) was larger than that of the disc level (mean: 21.4%; SD: 9.5%; Wilcoxon rank sum test, P = 0.0014). Furthermore, the reduction was mainly observed on the ventral and bilateral intervertebral foramina sides at the vertebral body and intervertebral disc levels, respectively. CONCLUSION: The intradural space was reduced during the VM, possibly because of venous dilatation. This phenomenon may be associated with CSF flow, intradural object movement, and nerve compression, potentially leading to back pain.

[The Measurement Precision and Accuracy of T1 Mapping Using Polarity Corrected (PC) TI Prep Tool].

The aim of this study was to evaluate the measurement precision and accuracy of T1 mapping using a polarity corrected (PC) TI prep tool, which was based on fast field echo (FFE) and obtained one data point with one inversion recovery (IR) pulse. A phantom was used consisting of eight materials with different Gd concentrations. T1 mappings were measured by changing the trigger interval and the inversion time (TI) interval. The T1 mapping measurement precision using the PC TI prep tool increased as the trigger interval was made longer. The measurement precision didn't depend on the interval of TI. On the other hand, when the trigger intervals are more than 1000 ms, the measurement accuracy was less than approximately 8%. By setting the optimal end of TI, the T1 mapping using a PC TI prep tool could measure the T1 value precisely and accurately.

The Safety of MR Conditional Cochlear Implant at 1.5 Tesla Magnetic Resonance Imaging System.

In magnetic resonance imaging (MRI) examination of the patients with the cochlear implant, only limited data have a mention for safety information in the instruction manual supplied by the manufacturers. Therefore, imaging operators require more detailed safety information for implant device. We conducted detailed examination about displacement force, torque, and demagnetizing of the cochlear implant magnet based on American Society for Testing and Materials (ASTM) standard using the PULSAR and CONCERTO (MED-EL) with 1.5 tesla MRI system. As a result, the displacement force and the torque of the implant magnet were less than the numerical values descried in the manual. Therefore, these have almost no effect on the body under the condition described in a manual. In addition, the demagnetizing factor of the cochlear implant magnet occurred by a change magnetic field. The demagnetization depended on the direction of a line of magnetic force of the static magnetic field and the implant magnet. In conclusion, the operator must warn the position of the patients on inducing in the magnet room.

[Survey report on magnetic resonance equipment damage in areas in Miyagi Prefecture affected by the Great East Japan Earthquake].

A questionnaire comprising 14 items, inquiring about the state of damage, whether safety could be ensured, and progress of repair and restoration was distributed to 984 facilities in seven prefectures on the Pacific coast as part of a fact-finding survey of damage caused to magnetic resonance (MR) devices by the Great East Japan Earthquake. In all, 458 responses (46.6%) were collected. In Miyagi Prefecture alone, 65 responses from 105 questionnaires were collected (response rate: 61.9%). The overall incidence of damage was 19.2%, with 57 facilities (12.4%) reporting that displacement of the magnets was the most common problem. The damage event rate in Miyagi Prefecture was 51.3%, with displacement of the magnet being highest at 17 cases (26.2%). There was a high rate of 13 cases (26.5%) of chiller and air conditioning failures and a rapid loss of He in ten MR scanners (20.4%). Notably, 87.8% of facilities in Miyagi Prefecture (24.5% of the total) were affected by earthquakes exceeding 6 on the Japanese Seismic Intensity Scale. Flood damage caused by the tsunami was also seen along the Sanriku coast to Sendai City (six MR scanners, 50% of the total), and was typical of the damage seen in Miyagi Prefecture.

Evaluation of the homogeneity of native T1 myocardial mapping using the polarity corrected inversion time preparation method in a myocardial phantom and healthy volunteers.

Myocardial T1 mapping is a useful technique for the diagnosis of diffuse fibrosis. Although modified look-locker inversion recovery is a widely used T1 mapping method, variation in T1 values has been reported. Non-uniform T1 maps may hinder differentiation between healthy and diseased myocardial tissue. The purpose of this study was to investigate the uniformity of T1 mapping using polarity corrected inversion time preparation (PC TI prep) in a myocardial phantom and healthy volunteers. The myocardial phantom was scanned between polyvinyl alcohol (PVA) and air. T1 values were measured using inversion recovery fast spin-echo (IR-FSE) and PC TI prep in areas adjacent to PVA and air. For the volunteer study, the short-axis plane was imaged using the PC TI prep to compare T1 values in the myocardium of the septal and lateral walls. The T1 value of the phantom using the IR-FSE was not significantly different in the area between PVA and air, whereas the T1 value using the PC TI prep in the air area was significantly lower than that in the PVA area. T1 mapping of the healthy myocardium exhibited no significant difference between the septal and lateral walls. The T1 value using the PC TI prep in the air area was 6.3% lower than that using IR-FSE. In this study, T1 mapping using the PC TI prep exhibited high uniformity of T1 values.

Magnetization and demagnetization of magnetic dental attachments in a 3-T MRI system.

The purpose of this study was to evaluate the magnetization and demagnetization of magnetic dental attachments in a 3.0-T magnetic resonance imaging (MRI) scanner. A high-field-strength (3.0 T) MRI scanner (Achieva 3.0 T, Philips, Amsterdam, Netherlands) was used. Magnetic flux leakage was measured using a gaussmeter. To evaluate the magnetization and demagnetization of the magnetic assemblies and keepers caused by the moving in and out of the MRI scanner, the magnetic force of the attachments was measured before and after the table was moved in and out. Two settings were used wherein the magnetic assemblies and keepers were positioned on the table at angles of 0° or 90° with respect to the magnetic flux of the static magnetic field. The movement of the table was repeated 15 times. In addition, the retentive force of the magnetic dental attachments was measured after magnetic field exposure. The magnetic force of the magnetic attachments positioned at 0° decreased significantly after moving in and out of the MRI scanner (p < 0.05). In contrast, the magnetic force of the magnetic attachments positioned at 90° was stable after the movement of the table. The magnetic force of the keepers placed at both 0° and 90° was slightly increased after the movement of the table. At 0°, the retentive force of the magnet-keeper combinations decreased when the magnetic assembly was exposed to the strong magnetic flux of the MRI scanner. Therefore, the removal of all removable magnetic dentures is recommended before an MRI examination.