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PURPOSE: To develop a new sequence to simultaneously acquire Cartesian sodium (23Na) MRI and accelerated Cartesian single (SQ) and triple quantum (TQ) sodium MRI of in vivo human brain at 7 T by leveraging two dedicated low-rank reconstruction frameworks. THEORY AND METHODS: The Double Half-Echo technique enables short echo time Cartesian 23Na MRI and acquires two k-space halves, reconstructed by a low-rank coupling constraint. Additionally, three-dimensional (3D) 23Na Multi-Quantum Coherences (MQC) MRI requires multi-echo sampling paired with phase-cycling, exhibiting a redundant multidimensional space. Simultaneous Autocalibrating and k-Space Estimation (SAKE) were used to reconstruct highly undersampled 23Na MQC MRI. Reconstruction performance was assessed against five-dimensional (5D) CS, evaluating structural similarity index (SSIM), root mean squared error (RMSE), signal-to-noise ratio (SNR), and quantification of tissue sodium concentration and TQ/SQ ratio in silico, in vitro, and in vivo. RESULTS: The proposed sequence enabled the simultaneous acquisition of fully sampled 23Na MRI while leveraging prospective undersampling for 23Na MQC MRI. SAKE improved TQ image reconstruction regarding SSIM by 6% and reduced RMSE by 35% compared to 5D CS in vivo. Thanks to prospective undersampling, the spatial resolution of 23Na MQC MRI was enhanced from 8 × 8 × 15 $$ 8\times 8\times 15 $$ mm3 to 8 × 8 × 8 $$ 8\times 8\times 8 $$ mm3 while reducing acquisition time from 2 × 31 $$ 2\times 31 $$ min to 2 × 23 $$ 2\times 23 $$ min. CONCLUSION: The proposed sequence, coupled with low-rank reconstructions, provides an efficient framework for comprehensive whole-brain sodium MRI, combining TSC, T2*, and TQ/SQ ratio estimations. Additionally, low-rank matrix completion enables the reconstruction of highly undersampled 23Na MQC MRI, allowing for accelerated acquisition or enhanced spatial resolution.
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Algoritmos , Encéfalo , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Fantasmas de Imagen , Relación Señal-Ruido , Sodio , Humanos , Imagen por Resonancia Magnética/métodos , Encéfalo/diagnóstico por imagen , Sodio/química , Procesamiento de Imagen Asistido por Computador/métodos , Isótopos de Sodio , Imagenología Tridimensional/métodos , Simulación por ComputadorRESUMEN
PURPOSE: Balanced steady-state free precession (bSSFP) imaging is susceptible to outflow effects where excited spins leaving the slice as part of the blood stream are misprojected back onto the imaging plane. Previous work proposed using slice-encoding steps to localize these outflow effects from corrupting the target slice, at the expense of prolonged scan time. This present study extends this idea by proposing a means of significantly reducing most of the outflowing signal from the imaged slice using a coil localization method that acquires a slice-encoded calibration scan in addition to the 2D data, without being nearly as time-demanding as our previous method. This coil localization method is titled UNfolding Coil Localized Errors from an imperfect slice profile using a Structured Autocalibration Matrix (UNCLE SAM). METHODS: Retrospective and prospective evaluations were carried out. Both featured a 2D acquisition and a separate slice-encoded calibration of the center in-plane k $$ k $$ -space lines across all desired slice-encoding steps. RESULTS: Retrospective results featured a slice-by-slice comparison of the slice-encoded images with UNCLE SAM. UNCLE SAM's subtraction from the slice-encoded image was compared with a subtraction from the flow-corrupted 2D image, to demonstrate UNCLE SAM's capability to unfold outflowing spins. UNCLE SAM's comparison with slice encoding showed that UNCLE SAM was able to unfold up to 74% of what slice encoding achieved. Prospective results showed significant reduction in outflow effects with only a marginal increase in scan time from the 2D acquisition. CONCLUSIONS: We developed a method that effectively unfolds most outflowing spins from corrupting the target slice and does not require the explicit use of slice-encoding gradients. This development offers a method to reduce most outflow effects from the target slice within a clinically feasible scan duration compared with the fully sampled slice-encoding technique.
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PURPOSE: Standard balanced SSFP (bSSFP) cine MRI often suffers from blood outflow artifacts. We propose a method that spatially encodes these outflowing spins to reduce their effects in the intended slice. METHODS: Bloch simulations were performed to characterize through-plane flow and to investigate how the use of phase encoding along the slice select's direction ("slice encoding") could alleviate its issues. Phantom scans and in vivo cines were acquired on a 3T system, comparing the standard 2D acquisition to the proposed slice-encoding method. Nineteen healthy volunteers were recruited for short-axis and horizontal long-axis oriented scans. An expert radiologist evaluated each slice-encoded/standard cine pairs in a rank comparison test and graded their quality on a 1-5 scale. The grades were used for a nonparametric paired evaluation for independent samples with a null hypothesis that there was no statistical difference between the two quality-grade distributions for α = 0.05 significance. RESULTS: Bloch simulation results demonstrated this technique's feasibility, showing a fully resolved slice profile given a sufficient number of slice encodes. These results were confirmed with the phantom experiments. Each in vivo slice-encoded cine had a higher quality than its corresponding standard acquisition. The nonparametric paired evaluation came to 0.01 significance, encouraging us to reject the null hypothesis and conclude that slice-encoding effectively works in reducing outflow effects. CONCLUSION: The slice-encoding balanced SSFP technique is helpful in mitigating outflow effects and is achievable within a single breath hold, being a useful alternative for cases in which the flow artifacts are significant.
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Artefactos , Interpretación de Imagen Asistida por Computador , Contencion de la Respiración , Humanos , Imagen por Resonancia Cinemagnética , Fantasmas de ImagenRESUMEN
PURPOSE: Develop a novel three-dimensional (3D) generative adversarial network (GAN)-based technique for simultaneous image reconstruction and respiratory motion compensation of 4D MRI. Our goal was to enable high-acceleration factors 10.7X-15.8X, while maintaining robust and diagnostic image quality superior to state-of-the-art self-gating (SG) compressed sensing wavelet (CS-WV) reconstruction at lower acceleration factors 3.5X-7.9X. METHODS: Our GAN was trained based on pixel-wise content loss functions, adversarial loss function, and a novel data-driven temporal aware loss function to maintain anatomical accuracy and temporal coherence. Besides image reconstruction, our network also performs respiratory motion compensation for free-breathing scans. A novel progressive growing-based strategy was adapted to make the training process possible for the proposed GAN-based structure. The proposed method was developed and thoroughly evaluated qualitatively and quantitatively based on 3D cardiac cine data from 42 patients. RESULTS: Our proposed method achieved significantly better scores in general image quality and image artifacts at 10.7X-15.8X acceleration than the SG CS-WV approach at 3.5X-7.9X acceleration (4.53 ± 0.540 vs. 3.13 ± 0.681 for general image quality, 4.12 ± 0.429 vs. 2.97 ± 0.434 for image artifacts, P < .05 for both). No spurious anatomical structures were observed in our images. The proposed method enabled similar cardiac-function quantification as conventional SG CS-WV. The proposed method achieved faster central processing unit-based image reconstruction (6 s/cardiac phase) than the SG CS-WV (312 s/cardiac phase). CONCLUSION: The proposed method showed promising potential for high-resolution (1 mm3 ) free-breathing 4D MR data acquisition with simultaneous respiratory motion compensation and fast reconstruction time.
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Corazón , Imagen por Resonancia Magnética , Artefactos , Estudios de Factibilidad , Corazón/diagnóstico por imagen , Humanos , Procesamiento de Imagen Asistido por Computador , Movimiento (Física)RESUMEN
PURPOSE: Chemical shift-encoded MRI (CSE-MRI) is well-established to quantify proton density fat fraction (PDFF) as a quantitative biomarker of hepatic steatosis. However, temperature is known to bias PDFF estimation in phantom studies. In this study, strategies were developed and evaluated to correct for the effects of temperature on PDFF estimation through simulations, temperature-controlled experiments, and a multi-center, multi-vendor phantom study. THEORY AND METHODS: A technical solution that assumes and automatically estimates a uniform, global temperature throughout the phantom is proposed. Computer simulations modeled the effect of temperature on PDFF estimation using magnitude-, complex-, and hybrid-based CSE-MRI methods. Phantom experiments were performed to assess the temperature correction on PDFF estimation at controlled phantom temperatures. To assess the temperature correction method on a larger scale, the proposed method was applied to data acquired as part of a nine-site multi-vendor phantom study and compared to temperature-corrected PDFF estimation using an a priori guess for ambient room temperature. RESULTS: Simulations and temperature-controlled experiments show that as temperature deviates further from the assumed temperature, PDFF bias increases. Using the proposed correction method and a reasonable a priori guess for ambient temperature, PDFF bias and variability were reduced using magnitude-based CSE-MRI, across MRI systems, field strengths, protocols, and varying phantom temperature. Complex and hybrid methods showed little PDFF bias and variability both before and after correction. CONCLUSION: Correction for temperature reduces temperature-related PDFF bias and variability in phantoms across MRI vendors, sites, field strengths, and protocols for magnitude-based CSE-MRI, even without a priori information about the temperature.
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Hígado , Protones , Imagen por Resonancia Magnética , Reproducibilidad de los Resultados , TemperaturaRESUMEN
Sampling k-space asymmetrically (ie, partial Fourier sampling) in the readout direction is a common way to reduce the echo time (TE) during magnetic resonance image acquisitions. This technique requires overlap around the center of k-space to provide a calibration region for reconstruction, which limits the minimum fractional echo to ~60% before artifacts are observed. The present study describes a method for reconstructing images from exact half echoes using two separate acquisitions with reversed readout polarity, effectively providing a full line of k-space without additional data around central k-space. This approach can benefit sequences or applications that prioritize short TE, short inter-echo spacing or short repetition time. An example of the latter is demonstrated to reduce banding artifacts in balanced steady-state free precession.
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Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , HumanosRESUMEN
The aim of this study was to develop a deep neural network for respiratory motion compensation in free-breathing cine MRI and evaluate its performance. An adversarial autoencoder network was trained using unpaired training data from healthy volunteers and patients who underwent clinically indicated cardiac MRI examinations. A U-net structure was used for the encoder and decoder parts of the network and the code space was regularized by an adversarial objective. The autoencoder learns the identity map for the free-breathing motion-corrupted images and preserves the structural content of the images, while the discriminator, which interacts with the output of the encoder, forces the encoder to remove motion artifacts. The network was first evaluated based on data that were artificially corrupted with simulated rigid motion with regard to motion-correction accuracy and the presence of any artificially created structures. Subsequently, to demonstrate the feasibility of the proposed approach in vivo, our network was trained on respiratory motion-corrupted images in an unpaired manner and was tested on volunteer and patient data. In the simulation study, mean structural similarity index scores for the synthesized motion-corrupted images and motion-corrected images were 0.76 and 0.93 (out of 1), respectively. The proposed method increased the Tenengrad focus measure of the motion-corrupted images by 12% in the simulation study and by 7% in the in vivo study. The average overall subjective image quality scores for the motion-corrupted images, motion-corrected images and breath-held images were 2.5, 3.5 and 4.1 (out of 5.0), respectively. Nonparametric-paired comparisons showed that there was significant difference between the image quality scores of the motion-corrupted and breath-held images (P < .05); however, after correction there was no significant difference between the image quality scores of the motion-corrected and breath-held images. This feasibility study demonstrates the potential of an adversarial autoencoder network for correcting respiratory motion-related image artifacts without requiring paired data.
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Artefactos , Corazón/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Cinemagnética/métodos , Redes Neurales de la Computación , Respiración , Aprendizaje Automático no Supervisado , Contencion de la Respiración , Simulación por Computador , Humanos , Movimiento (Física) , Estadísticas no ParamétricasRESUMEN
A novel magnetic resonance imaging (MRI) acquisition and reconstruction method for obtaining a series of dynamic sodium 23Na-MRI acquisitions was designed to non-invasively assess the signal variations of brain sodium during a hand motor task in 14 healthy human volunteers on an ultra high field (7T) MR scanner. Regions undergoing activation and deactivation were identified with reference to conventional task-related BOLD functional MRI (fMRI). Activation observed in the left central regions, the supplementary motor areas and the left cerebellum induced an increase in the sodium signal observed at ultra short echo time and a decrease in the 23Na signal observed at long echo time. Based on a simple model of two distinct sodium pools (namely, restricted and mobile sodium), the ultra short echo time measures the totality of sodium whereas the long echo time is mainly sensitive to mobile sodium. This activation pattern is consistent with previously described processes related to an influx of Na+ into the intracellular compartments and a moderate increase in the cerebral blood volume (CBV). In contrast, deactivation observed in the right central regions ipsilateral to the movement, the precuneus and the left cerebellum induced a slight decrease in sodium signal at ultra short echo time and an increase of sodium signal at longer echo times. This inhibitory pattern is compatible with a slight decrease in CBV and an efflux of intracellular Na+ to the extracellular compartments that may reflect neural dendritic spine and astrocytic shrinkage, and an increase of sodium in the extracellular fraction. In conclusion, cerebral dynamic 23Na MRI experiments can provide access to the ionic transients following a functional task occurring within the neuro-glial-vascular ensemble. This has the potential to open up a novel non-invasive window on the mechanisms underlying brain function.
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Mapeo Encefálico/métodos , Encéfalo/irrigación sanguínea , Encéfalo/metabolismo , Imagen por Resonancia Magnética/métodos , Neuroglía/metabolismo , Sodio/metabolismo , Adulto , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Desempeño Psicomotor , Isótopos de Sodio , Adulto JovenRESUMEN
BACKGROUND: Improving the signal-to-noise ratio (SNR) of chemical-shift-encoded MRI acquisition with complex reconstruction (MRI-C) may improve the accuracy and precision of noninvasive proton density fat fraction (PDFF) quantification in patients with hepatic steatosis. PURPOSE: To assess the accuracy of high SNR (Hi-SNR) MRI-C versus standard MRI-C acquisition to estimate hepatic PDFF in adult and pediatric nonalcoholic fatty liver disease (NAFLD) using an MR spectroscopy (MRS) sequence as the reference standard. STUDY TYPE: Prospective. POPULATION/SUBJECTS: In all, 231 adult and pediatric patients with known or suspected NAFLD. FIELD STRENGTH/SEQUENCE: PDFF estimated at 3T by three MR techniques: standard MRI-C; a Hi-SNR MRI-C variant with increased slice thickness, decreased matrix size, and no parallel imaging; and MRS (reference standard). ASSESSMENT: MRI-PDFF was measured by image analysts using a region of interest coregistered with the MRS-PDFF voxel. STATISTICAL TESTS: Linear regression analyses were used to assess accuracy and precision of MRI-estimated PDFF for MRS-PDFF as a function of MRI-PDFF using the standard and Hi-SNR MRI-C for all patients and for patients with MRS-PDFF <10%. RESULTS: In all, 271 exams from 231 patients were included (mean MRS-PDFF: 12.6% [SD: 10.4]; range: 0.9-41.9). High agreement between MRI-PDFF and MRS-PDFF was demonstrated across the overall range of PDFF, with a regression slope of 1.035 for the standard MRI-C and 1.008 for Hi-SNR MRI-C. Hi-SNR MRI-C, compared to standard MRI-C, provided small but statistically significant improvements in the slope (respectively, 1.008 vs. 1.035, P = 0.004) and mean bias (0.412 vs. 0.673, P < 0.0001) overall. In the low-fat patients only, Hi-SNR MRI-C provided improvements in the slope (1.058 vs. 1.190, P = 0.002), mean bias (0.168 vs. 0.368, P = 0.007), intercept (-0.153 vs. -0.796, P < 0.0001), and borderline improvement in the R2 (0.888 vs. 0.813, P = 0.01). DATA CONCLUSION: Compared to standard MRI-C, Hi-SNR MRI-C provides slightly higher MRI-PDFF estimation accuracy across the overall range of PDFF and improves both accuracy and precision in the low PDFF range. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:229-238.
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Tejido Adiposo/diagnóstico por imagen , Constricción Patológica/diagnóstico por imagen , Hígado/diagnóstico por imagen , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Enfermedad del Hígado Graso no Alcohólico/diagnóstico por imagen , Relación Señal-Ruido , Adolescente , Adulto , Anciano , Niño , Estudios Transversales , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Protones , Estándares de Referencia , Análisis de Regresión , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
The purpose of this work was to investigate sources of bias in magnetic resonance imaging (MRI) liver fat quantification that lead to a dependence of the proton density fat fraction (PDFF) on the number of echoes. This was a retrospective analysis of liver MRI data from 463 subjects. The magnitude signal variation with TE from spoiled gradient echo images was curve fitted to estimate the PDFF using a model that included monoexponential R2 * decay and a multi-peak fat spectrum. Additional corrections for non-exponential decay (Gaussian), bi-exponential decay, degree of fat saturation, water frequency shift and noise bias were introduced. The fitting error was minimized with respect to 463 × 3 = 1389 subject-specific parameters and seven additional parameters associated with these corrections. The effect on PDFF was analyzed, notably the dependence on the number of echoes. The effects on R2 * were also analyzed. The results showed that the inclusion of bias corrections resulted in an increase in the quality of fit (r2 ) in 427 of 463 subjects (i.e. 92.2%) and a reduction in the total fitting error (residual norm) of 43.6%. This was largely a result of the Gaussian decay (57.8% of the reduction), fat spectrum (31.0%) and biexponential decay (8.8%) terms. The inclusion of corrections was also accompanied by a decrease in the dependence of PDFF on the number of echoes. Similar analysis of R2 * showed a decrease in the dependence on the number of echoes. Comparison of PDFF with spectroscopy indicated excellent agreement before and after correction, but the latter exhibited lower bias on a Bland-Altman plot (1.35% versus 0.41%). In conclusion, correction for known and expected biases in PDFF quantification in liver reduces the fitting error, decreases the dependence on the number of echoes and increases the accuracy.
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Adiposidad , Hígado/metabolismo , Imagen por Resonancia Magnética , Protones , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Adulto JovenRESUMEN
PURPOSE: To investigate in adults the associations between histologic features of nonalcoholic fatty liver disease (NAFLD) and quantitative measures derived from diffusion-weighted imaging (DWI). MATERIALS AND METHODS: Eighty-nine adults undergoing standard-of-care liver biopsy for NAFLD were recruited for DWI. Biopsies were scored for histologic features of NAFLD. DWI was performed using b-values of 0, 100, and 500 s/mm(2) . Images were reconstructed using either conventional magnitude averaging (CMA) or a method to address bulk motion artifacts (Beta*LogNormal, BLN). The apparent diffusion coefficient (ADC) and the diffusivity (D) and perfusion fraction (F) of the intravoxel incoherent motion (IVIM) model were measured in the right hepatic lobe using both reconstructions. Associations between histologic features and DWI-derived measures were tested statistically with several methods including multiple linear regression. RESULTS: Using CMA and BLN reconstructions, respectively, the means (and ranges) were 1.7 (1.1-3.5) and 1.4 (1.0-3.2) × 10(-3) mm(2) /s for ADC, 1.1 (0.84-1.4) and 0.84 (0.53-1.1) × 10(-3) mm(2) /s for D, and 17 and 18 (2.3-35)% for F. For both reconstruction methods, D decreased with steatosis and F decreased with fibrosis (P < 0.05). ADC was not independently associated with any histologic feature. CONCLUSION: Steatosis and fibrosis have significant independent effects on D and F in adults undergoing biopsy for NAFLD.
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Imagen de Difusión por Resonancia Magnética/métodos , Enfermedad del Hígado Graso no Alcohólico/patología , Adulto , Anciano , Biopsia , Estudios Transversales , Femenino , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Masculino , Persona de Mediana Edad , Estudios ProspectivosAsunto(s)
Imagen por Resonancia Magnética , Músculo Esquelético/diagnóstico por imagen , Adulto , Calibración , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Músculo Esquelético/lesiones , Enfermedades Neuromusculares/diagnóstico por imagen , Valores de Referencia , Regeneración , Relación Señal-RuidoRESUMEN
Divided and subtracted MRI is a novel imaging processing technique, where the difference of two images is divided by their sum. When the sequence parameters are chosen properly, this results in images with a high T1 or T2 weighting over a small range of tissues with specific T1 and T2 values. In the T1 domain, we describe the implementation of the divided Subtracted Inversion Recovery Sequence (dSIR), which is used to image very small changes in T1 from normal in white matter. dSIR has shown widespread changes in otherwise normal-appearing white matter in patients suffering from mild traumatic brain injury (mTBI), substance abuse, and ischemic leukoencephalopathy. It can also be targeted to measure small changes in T1 from normal in other tissues. In the T2 domain, we describe the divided echo subtraction (dES) sequence that is used to image musculoskeletal tissues with a very short T2*. These tissues include fascia, tendons, and aponeuroses. In this manuscript, we explain how this contrast is generated, review how these techniques are used in our research, and discuss the current challenges and limitations of this technique.
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Ultra-high contrast (UHC) MRI describes forms of MRI in which little or no contrast is seen on conventional MRI images but very high contrast is seen with UHC techniques. One of these techniques uses the divided subtracted inversion recovery (dSIR) sequence, which, in modelling studies, can produce ten times the contrast of conventional inversion recovery (IR) sequences. When used in cases of mild traumatic brain injury (mTBI), the dSIR sequence frequently shows extensive abnormalities in white matter that appears normal when imaged with conventional T2-fluid-attenuated IR (T2-FLAIR) sequences. The changes are bilateral and symmetrical in white matter of the cerebral and cerebellar hemispheres. They partially spare the anterior and posterior central corpus callosum and peripheral white matter of the cerebral hemispheres and are described as the whiteout sign. In addition to mTBI, the whiteout sign has also been seen in methamphetamine use disorder and Grinker's myelinopathy (delayed post-hypoxic leukoencephalopathy) in the absence of abnormalities on T2-FLAIR images, and is a central component of post-insult leukoencephalopathy syndromes. This paper describes the concept of ultra-high contrast MRI, the whiteout sign, the theory underlying the use of dSIR sequences and post-insult leukoencephalopathy syndromes.
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Leucoencefalopatías , Imagen por Resonancia Magnética , Humanos , Imagen por Resonancia Magnética/métodos , Leucoencefalopatías/diagnóstico por imagen , Lesiones Encefálicas/diagnóstico por imagen , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patologíaRESUMEN
Background: Delayed Post-Hypoxic Leukoencephalopathy (DPHL), or Grinker's myelinopathy, is a syndrome in which extensive changes are seen in the white matter of the cerebral hemispheres with MRI weeks or months after a hypoxic episode. T2-weighted spin echo (T2-wSE) and/or T2-Fluid Attenuated Inversion Recovery (T2-FLAIR) images classically show diffuse hyperintensities in white matter which are thought to be near pathognomonic of the condition. The clinical features include Parkinsonism and akinetic mutism. DPHL is generally regarded as a rare condition. Methods and Results: Two cases of DPHL imaged with MRI nine months and two years after probable hypoxic episodes are described. No abnormalities were seen on the T2-FLAIR images with MRI, but very extensive changes were seen in the white matter of the cerebral and cerebellar hemisphere on divided Subtraction Inversion Recovery (dSIR) images. dSIR sequences may produce ten times the contrast of conventional inversion recovery (IR) sequences from small changes in T1. The clinical findings in both cases were of cognitive impairment without Parkinsonism or akinetic mutism. Conclusion: The classic features of DPHL may only represent the severe end of a spectrum of diseases in white matter following global hypoxic injury to the brain. The condition may be much more common than is generally thought but may not be recognized using conventional clinical and MRI criteria for diagnosis. Reappraisal of the syndrome of DPHL to include clinically less severe cases and to encompass recent advances in MRI is advocated.
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PURPOSE: To evaluate the diagnostic performance of magnetic resonance (MR) imaging-estimated proton density fat fraction (PDFF) for assessing hepatic steatosis in nonalcoholic fatty liver disease (NAFLD) by using centrally scored histopathologic validation as the reference standard. MATERIALS AND METHODS: This prospectively designed, cross-sectional, internal review board-approved, HIPAA-compliant study was conducted in 77 patients who had NAFLD and liver biopsy. MR imaging-PDFF was estimated from magnitude-based low flip angle multiecho gradient-recalled echo images after T2* correction and multifrequency fat modeling. Histopathologic scoring was obtained by consensus of the Nonalcoholic Steatohepatitis (NASH) Clinical Research Network Pathology Committee. Spearman correlation, additivity and variance stabilization for regression for exploring the effect of a number of potential confounders, and receiver operating characteristic analyses were performed. RESULTS: Liver MR imaging-PDFF was systematically higher, with higher histologic steatosis grade (P < .001), and was significantly correlated with histologic steatosis grade (ρ = 0.69, P < .001). The correlation was not confounded by age, sex, lobular inflammation, hepatocellular ballooning, NASH diagnosis, fibrosis, or magnetic field strength (P = .65). Area under the receiver operating characteristic curves was 0.989 (95% confidence interval: 0.968, 1.000) for distinguishing patients with steatosis grade 0 (n = 5) from those with grade 1 or higher (n = 72), 0.825 (95% confidence interval: 0.734, 0.915) to distinguish those with grade 1 or lower (n = 31) from those with grade 2 or higher (n = 46), and 0.893 (95% confidence interval: 0.809, 0.977) to distinguish those with grade 2 or lower (n = 58) from those with grade 3 (n = 19). CONCLUSION: MR imaging-PDFF showed promise for assessment of hepatic steatosis grade in patients with NAFLD. For validation, further studies with larger sample sizes are needed.
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Hígado Graso/diagnóstico , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Biopsia , Niño , Estudios Transversales , Hígado Graso/patología , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Enfermedad del Hígado Graso no Alcohólico , Valor Predictivo de las Pruebas , Estudios Prospectivos , Protones , Curva ROC , Sensibilidad y EspecificidadRESUMEN
Diffusion-weighted images of the liver exhibit signal dropout from cardiac and respiratory motion, particularly in the left lobe. These artifacts cause bias and variance in derived parameters that quantify intravoxel incoherent motion. Many models of diffusion have been proposed, but few separate attenuation from diffusion or perfusion from that of bulk motion. The error model proposed here (Beta*LogNormal) is intended to accomplish that separation by modeling stochastic attenuation from bulk motion as multiplication by a Beta-distributed random variate. Maximum likelihood estimation with this error model can be used to derive intravoxel incoherent motion parameters separate from signal dropout, and does not require a priori specification of parameters to do so. Liver intravoxel incoherent motion parameters were derived for six healthy subjects under this error model and compared with least-squares estimates. Least-squares estimates exhibited bias due to cardiac and respiratory gating and due to location within the liver. Bias from these factors was significantly reduced under the Beta*LogNormal model, as was within-organ parameter variance. Similar effects were appreciable in diffusivity maps in two patients with focal liver lesions. These results suggest that, relative to least-squares estimation, the Beta*LogNormal model accomplishes the intended reduction of bias and variance from bulk motion in liver diffusion imaging.
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Artefactos , Técnicas de Imagen Sincronizada Cardíacas/métodos , Imagen de Difusión por Resonancia Magnética/métodos , Aumento de la Imagen/métodos , Neoplasias Hepáticas/patología , Modelos Estadísticos , Técnicas de Imagen Sincronizada Respiratorias/métodos , Adulto , Anciano , Algoritmos , Simulación por Computador , Interpretación Estadística de Datos , Femenino , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Masculino , Persona de Mediana Edad , Movimiento (Física) , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Adulto JovenRESUMEN
PURPOSE: To characterize cardiac motion artifacts in the liver and assess the use of a postprocessing method to mitigate these artifacts in repeat measurements. MATERIALS AND METHODS: Three subjects underwent breathhold diffusion-weighted (DW) scans consisting of 25 repetitions for three b-values (0, 500, 1000 sec/mm(2)). Statistical maps computed from these repetitions were used to assess the distribution and behavior of cardiac motion artifacts in the liver. An objective postprocessing method to reduce the artifacts was compared with radiologist-defined gold standards. RESULTS: Signal dropout is pronounced in areas proximal to the heart, such as the left lobe, but also present in the right lobe and in distal liver segments. The dropout worsens with b-value and leads to overestimation of the diffusivity. By reference to a radiologist-defined gold standard, a postprocessing correction method is shown to reduce cardiac motion artifact. CONCLUSION: Cardiac motion leads to significant artifacts in liver DW imaging; we propose a postprocessing method that may be used to mitigate the artifact and is advantageous to standard signal averaging in acquisitions with multiple repetitions.
Asunto(s)
Imagen de Difusión por Resonancia Magnética/métodos , Contracción Miocárdica/fisiología , Adulto , Anciano , Artefactos , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Hígado , Masculino , Movimiento (Física) , Relación Señal-RuidoRESUMEN
This paper updates and extends three previous papers on tissue property filters (TP-filters), Multiplied, Added, Divided and/or Subtracted Inversion Recovery (MASTIR) pulse sequences and synergistic contrast MRI (scMRI). It does this by firstly adding the central contrast theorem (CCT) to TP-filters, secondly including division with MASTIR sequences to make them Multiplied, Added, Subtracted and/or Divided IR (MASDIR) sequences, and thirdly incorporating division into the image processing needed for scMR to increase synergistic T1 contrast. These updated concepts are then used to explain and improve contrast at tissue boundaries, as well as to develop imaging regimes to detect and monitor small changes to the brain over time and quantify T1. The CCT is in two parts: the first part states that contrast produced by each TP is the product of the change in TP multiplied by the TP sequence weighting which is the first partial derivative of the TP-filter. The second part states that the overall fractional contrast is the algebraic sum of the fractional contrasts produced by each of the TPs. Subtraction of two IR sequences alone about doubles contrast relative to a conventional single IR sequence. Division of this subtraction can amplify contrast 5-15 times compared with conventional IR sequences. Dividing sequences can be problematic in areas where the signal is zero but this is avoided by dividing the difference in signal of two magnitude reconstructed IR sequences by the sum of their signals. The basis for the production of high contrast, high spatial resolution boundaries at white-gray matter junctions, between cerebral cortex and cerebrospinal fluid (CSF) and at other sites with subtracted IR (SIR) and divided subtracted IR (dSIR) sequences is explained and examples are shown. A key concept is the tissue fraction f, which is the proportion of a tissue in a mixture of two tissues within a voxel. Contrast at boundaries is a function of the partial derivative of the TP-filter, the partial derivative of the relevant TP with respect to f, and the partial derivative of f with respect to distance, x. Location of tissue boundaries is important for segmentation and is helpful in determining if inversion times have been chosen correctly. In small change regimes, the high sensitivity to small changes in T1 provided by dSIR images, together with the high definition boundaries, afford mechanisms for detecting small changes due to contrast agents, disease, perfusion and other causes. 3D isotropic rigid body registration provides a technique for following these changes over time in serial studies. Images showing high lesion contrast, high definition tissue and fluid boundaries, and the detection of small changes are included. T1 maps can be created by linearly scaling dSIR images.
RESUMEN
The present study describes a model-based approach for correcting off-resonance in the context of double half-echo k-space acquisitions. This technique employs center-out readouts in forward and reverse directions to reduce echo-times but is sensitive to off-resonance, which manifests as pixel shifts in both directions. Demodulating the k-space signal with a constant off-resonance term per slice removes pixel shifts and results in a marked reduction in blurring. Phantom and in vivo datasets are demonstrated from low bandwidth sodium imaging.