Simultaneous assessment of left ventricular mechanical dyssynchrony using integrated 13N-ammonia PETMR system: direct comparison of PET phase analysis and MR feature tracking.

BACKGROUND: To compare phase analysis with positron emission tomography (PA) and magnetic resonance feature tracking derived myocardial strain (FT) for left ventricular (LV) mechanical dyssynchrony using PETMR system in patients with ischemic heart disease. METHODS AND RESULTS: Patients who underwent rest-pharmacological stress 13N ammonia PETMR were enrolled. Histogram bandwidth (BW) and phase standard deviation (PSD) were compared to global longitudinal, long axis radial, short axis circumferential, and radial strain (GLS, GRS, SA Circ, and SA Rad) obtained from FT. LV dyssynchrony index (SDI) derived from PA and FT were compared. BW and PSD showed significant correlations with FT (a Pearson's coefficient r = 0.64, P < .0001, and r = 0.51, P < .0001 for SA Circ; r = 0.67, P < .0001, and r = 0.74, P < .0001 for GLS; r = - 0.60, P < .0001, r = - 0.61, P < .0001 for SA Rad; r = - 0.62, P < .0001, and r = - 0.68, P < .0001 for GRS, respectively). Bland-Altman plots for SDI showed a preferable agreement (95% limit of agreement - 0.12 to 0.075, - 0.20 to 0.098, - 0.38 to 0.077, and - 0.37 to 0.032; bias 0.0068 ± 0.056, 0.026 ± 0.068, 0.11 ± 0.088, and 0.13 ± 0.079 for SA Circ, SA Rad, GLS, and GRS, respectively). CONCLUSION: In simultaneous acquisition using PETMR, comparison of PET phase analysis and MR strain showed a good correlation.

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.

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.

Quantification of subarachnoid hemorrhage by three-dimensional computed tomography: correlation between hematoma volume and symptomatic vasospasm.

Subarachnoid hemorrhage (SAH) volume was measured by three-dimensional computed tomography (3D-CT) and the correlation examined between the SAH volume and the occurrence of symptomatic vasospasm (SVS). Experimental (in vitro) hematomas were made with blood obtained from 10 volunteers. The hematoma volume was determined by actual measurements and by 3D-CT using a CT number in the range of 40-80 Hounsfield units (HU) on days 1, 4, 7, 11, and 14. The coefficients on days 1 and 4 were relatively high and the correlation between measured and estimated volumes was significant on days 7, 11, and 14. 3D-CT was also performed in 50 patients with SAH at onset (day 0) and on days 1, 4, 7, and 14. The hematoma volume including the volume of normal structures was automatically calculated (V1). The volume of normal structures (V2) with CT numbers of 40-80 HU was calculated in another 50 patients without intracranial lesions as 12 ml. The total hematoma volume was defined as V1 minus mean V2. The mean SAH volume was 44, 36, 21, 11, and 8 ml on days 0, 1, 4, 7, and 14, respectively. The hematoma volumes were significantly larger in patients with SVS than in patients without SVS at all time points. The minimum hematoma volume in patients with SVS was 92, 76, 42, 24, and 12 ml on days 0, 1, 4, 7, and 14, respectively. This method allows the quantitative determination of SAH volume based on 3D-CT, and may be useful in clinical studies of cerebral vasospasm.