Comparison of qualitative and fully automated quantitative tools for classifying severity of white matter hyperintensity.

OBJECTIVE: In this study, we aimed to compare the Fazekas scoring system and quantitative white matter hyperintensity volume in the classification of white matter hyperintensity severity using a fully automated analysis software to investigate the reliability of quantitative evaluation. MATERIALS AND METHODS: Patients with suspected cognitive impairment who underwent medical examinations at our institution between January 2010 and May 2021 were retrospectively examined. White matter hyperintensity volumes were analyzed using fully automated analysis software and Fazekas scoring (scores 0-3). Using one-way analysis of variance, white matter hyperintensity volume differences across Fazekas scores were assessed. We employed post-hoc pairwise comparisons to compare the differences in the mean white matter hyperintensity volume between each Fazekas score. Spearman's rank correlation test was used to investigate the association between Fazekas score and white matter hyperintensity volume. RESULTS: Among the 839 patients included in this study, Fazekas scores 0, 1, 2, and 3 were assigned to 68, 198, 217, and 356 patients, respectively. White matter hyperintensity volumes significantly differed according to Fazekas score (F=623.5, p<0.001). Post-hoc pairwise comparisons revealed significant differences in mean white matter hyperintensity volume between all Fazekas scores (p<0.05). We observed a significantly positive correlation between the Fazekas scores and white matter hyperintensity volume (R=0.823, p<0.01). CONCLUSIONS: Quantitative white matter hyperintensity volume and the Fazekas scores are highly correlated and may be used as indicators of white matter hyperintensity severity. In addition, quantitative analysis may be more effective in classifying advanced white matter hyperintensity lesions than the Fazekas classification.

[Evaluation of Detectability in Clinical Practice of Metal Detectors, etc. for Magnetic Resonance Imaging].

PURPOSE: In order to prevent magnetic materials from being brought into the magnetic resonance imaging (MRI) examination room, many facilities have metal detectors, etc., but there are various types of equipment with different performance and characteristics. The purpose of this study was to evaluate each detector in actual clinical practice. METHODS: At multiple facilities, gate-type magnetic detectors, pole-type magnetic detectors, handy-type magnetic detectors, and handy-type metal detectors were used to identify 9 types of objects that may be brought into the MRI examination room. We performed evaluation of detection distance measurement assuming actual operation. RESULTS: The gate type was only able to detect objects with strong magnetism. With the pole type, the closer the measurement distance was to the pole, the more objects could be detected, and the lower the pole, the shorter the detection distance. With the handy type, there were many objects that could be detected when the device and the object were brought into close contact. CONCLUSION: The detectability of the instruments varied depending on the size and type of the object. It is important to understand the characteristics of each device and use it according to the purpose in carrying-in confirmation before the examination.

[Echo Train Length (ETL) of Fluid-attenuated Inversion Recovery (FLAIR) and Extraction Volume of White Matter Hyperintensity Volume in Automated White Matter Signal Analysis].

PURPOSE: To investigate whether the volume of white matter hyperintensity (WMH) extracted from FLAIR images changes when the imaging parameters of the original images are changed. METHODS: Seven healthy volunteers were imaged by changing the imaging parameter ETL of FLAIR images, and WMHs were extracted and their volumes were calculated by the automatic extraction software. The results were statistically analyzed to examine the relationship (Experiment 1). Simulated images with different SNRs were created by adding white noise to four examples of healthy volunteer images. The SNR of the simulated images simulated the SNR of the measured images of different ETLs. The WMH was extracted from the simulated images and its volume was calculated using the automatic extraction software (Experiment 2). RESULTS: Experiment 1 showed that there was no significant difference between FLAIR imaging parameters and WMH volume in automatic white matter signal analysis, except for some conditions. Experiment 2 showed that as the SNR of the original image decreased, the volume of high white matter signal extracted decreased. CONCLUSION: In automatic white matter signal analysis, WMH was shown to be small when the ETL of the FLAIR sequence was larger than normal and/or the SNR of the image was low.

MRI safety for leave-on powdered hair thickeners under 1.5-T and 3.0-T MRI: measurement of deflection force, MRI artifact, and evaluation of preexamination screening.

This study aimed to clarify the magnetic resonance imaging (MRI) compatibility of leave-on powdered hair thickeners by evaluating the displacement force and image artifacts of commercially available leave-on powdered hair thickeners on MRI devices and their response to metal and ferromagnetic detectors. Thirteen types of leave-on powdered hair thickeners were studied: nine hair thickener and four foundation types. MRI systems of 1.5 T and 3.0 T were used. Deflection angles and MR image artifacts according to ASTM F2052 and F2119 were evaluated. Handheld metal and ferromagnetic detectors were used to investigate whether hair thickeners could be detected in screening before MRI examinations. The hair thickener type had a deflection angle of 0°, whereas the foundation type had a deflection angle of 90°, indicating a strong physical effect. Significant image artifacts appeared only on the foundation type. The foundation type reacted at distances of less than 10 cm only with a ferromagnetic detector. Foundation-type leave-on powdered hair thickeners containing magnetic substances exhibited strong physical effects and produced significant image artifacts, and those can only be detected by screening with a ferromagnetic detector.

Optimization of the fluid-attenuated inversion recovery (FLAIR) imaging for use in autopsy imaging of the brain region using synthetic MRI.

BACKGROUND: The failure of cerebrospinal fluid (CSF) signal suppression in postmortem fluid-attenuated inversion recovery (FLAIR) of the brain is a problem. OBJECTIVE: The present study was to clarify the relationship between the temperature of deceased persons and CSF T1, and to optimize the postmortem brain FLAIR imaging method using synthetic MRI. METHODS: Forehead temperature was measured in 15 deceased persons. Next, synthetic MRI of the brain was performed, the CSF T1 was measured, and the optimal TI was calculated. Two types of FLAIR images were obtained with the clinical and optimal TI. The relationship between forehead temperature and the CSF T1 and optimal TI was evaluated. The optimized FLAIR images were physically and visually evaluated. RESULTS: The CSF T1 and optimal TI were strongly correlated with forehead temperature. Comparing the average SNR and CNR ratios and visual evaluation scores of the two FLAIR images, those captured with the optimal TI showed statistically lower SNR, higher CNR, and higher visual evaluation scores (p< 0.01). CONCLUSIONS: Synthetic MRI enables the quantification of the CSF T1 resulting from postmortem temperature decreases and calculation of the optimal TI, which could aid in improving the failure of CSF signal suppression and in optimizing postmortem brain FLAIR imaging.