Shortening the acquisition time of whole-body MRI: 3D T1 gradient echo Dixon vs fast spin echo for metastatic screening in prostate cancer

European Radiology - To compare 3D T1-weighted fast spin echo (FSE) and 3D T1-weighted gradient echo (GE) mDixon as morphologic sequences to complement diffusion-weighted imaging (DWI) for the...     

Assessment of bone marrow oedema-like lesions using MRI in patellofemoral knee osteoarthritis: comparison of different MRI pulse sequences

Objective:To compare bone marrow oedema-like lesion (BML) volume in subjects with symptomatic patellofemoral (PF) knee osteoarthritis (OA) using four different MRI sequences and to determine reliability of BML volume assessment using these sequences and their correlation with pain.Methods:76 males and females (mean age 55.8 years) with symptomatic patellofemoral knee OA had 1.5 T MRI scans. PD fat suppressed (FS), STIR, contrast-enhanced (CE) T₁W FS, and 3D T₁W fast field echo (FFE) sequences were obtained. All sequences were assessed by one reader, including repeat assessment of 15 knees using manual segmentation and the measurements were compared. We used random-effects panel linear regression to look for differences in the log-transformed BML volume (due to positive skew in the BML volume distribution) between sequences and to determine associations between BML volumes and knee pain.Results:58 subjects had PF BMLs present on at least one sequence. Median BML volume measured using T₁W FFE sequence was significantly smaller (224.7 mm³, interquartile range [IQR] 82.50–607.95) than the other three sequences. BML volume was greatest on the CE sequence (1129.8 mm³, IQR 467.28–3166.02). Compared to CE sequence, BML volumes were slightly lower when assessed using PDFS (proportional difference = 0.79; 95% confidence interval [CI] 0.62, 1.01) and STIR sequences (proportional difference = 0.85; 95% CI 0.67, 1.08). There were strong correlations between BML volume on PDFS, STIR, and CE T₁W FS sequences (ρs = 0.98). Correlations were lower between these three sequences and T₁W FFE (ρs = 0.80–0.81). Intraclass correlation coefficients were excellent for proton density fat-suppressed, short-tau inversion recovery, and CE T₁W FS sequences (0.991–0.995), while the ICC for T₁W FFE was good at 0.88. We found no significant association between BML volumes assessed using any of the sequences and knee pain.Conclusion:T₁W FFE sequences were less reliable and measured considerably smaller BML volume compared to other sequences. BML volume was larger when assessed using the contrast enhanced T₁W FS though not statistically significantly different from BMLs when assessed using PDFS and STIR sequences.Advances in knowledge:This is the first study to assess BMLs by four different MRI pulse sequences on the same data set, including different fluid sensitive sequences and gradient echo type sequence.     

Comparison of three-dimensional fast spin echo and gradient echo sequences for high-resolution temporal bone imaging

T2-weighted high-resolution gradient and fast spin echo sequences are widely used as an alternative or adjunct to contrast-enhanced T1-weighted temporal bone imaging. However, to date no systematic comparison has been presented. The purpose of this work is to identify optimal acquisition parameters and to compare volume gradient and fast spin echo techniques. Signal intensities and scan efficiency were computed for gradient echo segment-interleaved motion-compensated acquisition into steady state (SIMCAST), standard fast spin echo (FSE), and fast recovery fast spin echo (FR-FSE). Computations were compared with inner ear images acquired with cubic voxel sizes of 0.35-0.40 mm(3)in 5-8 minutes. Given otherwise identical conditions, the FR-FSE sequence produces images with improved SNR in shorter scan times than standard FSE. For FR-FSE, the scan efficiency is optimal for specific pairs of TR and echo train length, eg, 400 ms/8, 735 ms/16, and 2,050 ms/48. FR-FSE images with large TR and echo trains, while achieving better SNR, are severely compromised by blurring. Imaging with echo train lengths of 16-24 and TR of 800-1,200 ms is a good compromise, and FR-FSE signal-to-noise ratio (SNR) and scan efficiency become comparable to SIMCAST. In vivo image quality is excellent with both FR-FSE and SIMCAST, but SIMCAST images have slightly higher SNR and are significantly more crisp. J. Magn. Reson. Imaging 2000;12:814-825.     

Detection of malignant hepatic tumors with ferumoxides-enhanced MRI: comparison of five gradient-recalled echo sequences with different TEs

OBJECTIVE: The purpose of our study was to compare the detectability of malignant hepatic tumors on ferumoxides-enhanced MRI using five gradient-recalled echo sequences at different TEs. MATERIALS AND METHODS: Ferumoxides-enhanced MRIs obtained in 31 patients with 50 malignant hepatic tumors (33 hepatocellular carcinomas, 17 metastases) were reviewed retrospectively by three independent offsite radiologists. T1-weighted gradient-recalled echo images with TEs of 1.4 and 4.2 msec; T2*-weighted gradient-recalled echo images with TEs of 6, 8, and 10 msec; and T2-weighted fast spin-echo images of livers were randomly reviewed on a segment-by-segment basis. Observer performance was tested using the McNemar test and receiver operating characteristic analysis for the clustered data. Lesion-to-liver contrast-to-noise ratio was also assessed. RESULTS: Mean lesion-to-liver contrast-to-noise ratios were negative and lower with gradient-recalled echo at 1.4 msec than with the other sequences. Sensitivity was higher (p < 0.05) with gradient-recalled echo at 6, 8, and 10 msec and fast spin-echo sequences (75-83%) than with gradient-recalled echo sequences at 1.4 and 4.2 msec (46-48%), and was higher (p < 0.05) with gradient-recalled echo sequence at 8 msec (83%) than with gradient-recalled echo at 6 msec and fast spin-echo sequences (75-78%). Specificity was comparably high with all sequences (95-98%). The area under the receiver operating characteristic curve (A(z)) was greater (p < 0.05) with gradient-recalled echo at 6, 8, and 10 msec and fast spin-echo sequences (A(z) = 0.91-0.93) than with gradient-recalled echo sequences at 1.4 and 4.2 msec (A(z) = 0.82-0.85). CONCLUSION: In the detection of malignant hepatic tumors, gradient-recalled echo sequences at 8 msec showed the highest sensitivity and had an A(z) value and lesion-to-liver contrast-to-noise ratio comparable with values from gradient-recalled echo sequences at 6 and 10 msec and fast spin-echo sequences.     

Cine gradient refocused echo (GRE) imaging of intravascular masses: differentiation between tumor and nontumor thrombus.

Spin echo MR imaging has not permitted reliable differentiation between intraluminal blood clot and tumor thrombus. This study assessed the role of ECG referenced repetitive gradient refocused echo (cine GRE) imaging for the differentiation of intravascular tumor from blood clot. Cine GRE images were reviewed in 23 patients, 11 of whom had intravascular tumor and 12 of whom had intravascular blood clots. Percentage contrast between the lesion and skeletal muscle as the reference tissue was determined from a subjective review of the images and objective signal intensity measurements. Intravascular clots were found to be lower in signal intensity than muscle (mean -55 +/- 29%). Intravascular tumors showed higher signal intensity relative to muscle (mean +17 +/- 9%) with the exception of myxomas (n = 2), which had signal intensity values relative to muscle as low as clots (mean -41 +/- 17%). Three masses in the inferior vena cava were composed of central tumor and peripheral clot; the two components could be differentiated with cine GRE imaging. Cine GRE imaging provides adequate signal intensity differences to visualize intravascular masses and helps to differentiate intravascular clot from tumor thrombus. However, if the tumor contains substantial amounts of iron, then the signal is also low and consequently clot and thrombus may not be distinguishable. This can occur in some atrial myxomas.     

Free-breathing dynamic contrast-enhanced MRI of the abdomen and chest using a radial gradient echo sequence with K-space weighted image contrast (KWIC)

Objectives

To evaluate the feasibility of free-breathing, dynamic contrast-enhanced (DCE) MRI of the abdomen and thorax using the radial-gradient-echo sequence with k-space weighted image contrast (KWIC) reconstruction.

Methods

Institutional review board approval was obtained. Fourteen patients underwent free-breathing radial DCE-MRI. Radial MRI yielded full-frame images by gridding all k-space data and time-resolved subframe images by using KWIC reconstruction technique. Using subframe KWIC images, voxel-wise perfusion maps were created. For comparison, the breath-hold conventional Cartesian 3D-gradient-echo sequence (VIBE) was also performed during the equilibrium phase. The image qualities of radial and conventional VIBE images were compared quantitatively and qualitatively.

Results

Radial DCE-MRI provided high spatial resolution (1.4?×?1.4 mm) and temporal resolution (4.1 s for subframe images) allowing voxel-wise perfusion mapping with negligible motion or streaking artefacts. There were no significant differences in SNR between full-frame radial images and conventional VIBE images (79.08 vs 74.80, P?>?0.05). Overall image quality score of full-frame radial images was slightly lower than that of conventional VIBE images (3.88?±?0.59 vs. 4.31?±?0.97, P?<?0.05), but provided clinically useful images.

Conclusions

The free-breathing radial DCE-MRI can provide high spatial and temporal resolution while maintaining reasonably high image quality and thus is a feasible technique for DCE-MRI in the abdomen and thorax.

Key Points

? Dynamic contrast-enhanced magnetic resonance imaging (DCE) MRI is important in oncological imaging ? Radial MRI with k-space weighted image contrast (KWIC) reconstruction offers potential improvements ? Radial DCE-MRI provides good image quality, reduced artefacts and high spatial/temporal resolution     

Contrast-enhanced hepatic MRI: comparison of half-dose and standard-dose gadolinium DTPA administration in lesion characterization with T1-weighted gradient echo sequences

The objective of this article was to compare half-dose (0.05 mm/kg) gadolinium-enhanced dynamic hepatic MR imaging to standard doses (0.10 mm/kg). Eighteen patients for follow-up hepatic MR received 0.05 mm/kg of gadolinium DTPA dynamically with gradient-echo imaging. Imaging parameters were identical to a 0.10-mm/kg study; patients were imaged during multiple phases of contrast enhancement. Two readers assessed for enhancement patterns and characterization. Quantitative signal-to-noise ratios (S/N) were obtained for abdominal viscera and contrast-to-noise ratios (C/N) were obtained on up to three lesions. No significant difference for the arterial dominant phase (P > 0.05) was found. Significant differences were found in all categories during the portal venous phase (except pancreas) and equilibrium phase (except liver). Lesion C/N ratios were not significant at any point (P > 0.05). Sixty-two out of 64 lesions (97%) were identically characterized. Therefore, half-dose dynamic gadolinium-enhanced MR may have diagnostic value.     

脑膜瘤相对血流量MR定量检测:梯度回波与平面回波序列法的比较

目的通过对梯度回波序列法与平面回波(echoplanerimaging,EPI)序列法重建脑膜瘤相对血流量图的比较,对脑膜瘤相对血流量的定量检测进行评价。方法应用西门子1.5TMR仪对18例脑膜瘤病人进行检查,获取常规的T1WI、T2WI和增强T1WI,以及动态的磁顺应敏感图像(T2WI梯度回波序列或SEEPI序列)。在采集动态的磁顺应敏感图像期间(梯度回波法12例,EPI法6例),应用程控注射器以每秒5ml的流率注入钆喷替酸葡甲胺(GdDTPA)(0.2mmol/kg)。应用优视系统(advancedvisualsystem,AVS)软件逐点处理动态的磁顺应敏感资料,对重建的全部相对血流量图作感兴趣区分析,通过借鉴文献中脑灰质血流量数值,定量计算脑膜瘤的相对血流量。结果肿瘤相对血流量与脑灰质相对血流量的比率是3.01±1.18(梯度回波序列法为3.07±1.39;EPI序列法为2.84±0.94)。脑膜瘤的平均相对血流量为(14.47±5.96)ml/100g:梯度回波序列法为(14.85±6.72)ml/100g,EPI序列法为(13.72±4.54)ml/100g;梯度回波序列法与EPI序列法的结果比较差异无统计学意义(t=0.42,P=0.68)。结论应用脑灰质血流量数值法可便捷地定量检测脑膜瘤的相对血流量,脑膜瘤的相对血流量明显增高而且非均匀性;血脑屏障破坏情况下,仍可估算相对血流量值;尽管EPI序列法更具有效应,梯度回波序列法和EPI序列法均能有效地应用于相对血流量的测定。     

Cardiac MRI: comparison between single-shot fast spin echo and conventional spin echo sequences in the morphological evaluation of the ventricles

PURPOSE: Black blood single shot FSE sequences (Nffse) employ 180 degrees RF refocalisation pulses preceded by an inversion RF double pulse associated to presaturation pulses. The latter produce signal void of the external volume, and possible reduction of the field of view without wrap-around artifacts along the phase coding direction. The aim of our study was to compare the diagnostic possibilities of the Nffse sequences with those of conventional SE study of cardiac morphology. MATERIAL AND METHODS: Twenty-five patients (19 males and 9 females with age ranging from 20 to 54 years) presented findings suggesting right ventricular arrhythmogenic dysplasia. MR examinations were performed with a 1,5 T unit (GE Signa Horizon Echospeed 8.3, Milwaukee, USA) and Torso Phased Array coil positioned at thoracic level. The morphologic study was performed with SE multiphase-multislice ECG-gated sequences (TR: R-R, TE: 30 ms, FOV 320X250, matrix 160X256, slice thickness 10 mm, acquisition time about 5 minutes) and Single-Shot FSE Half Fourier sequences (TR: R-R, TE: 30 ms, flip angle 120 degrees, ETL 30-40, FOV 360X180, Phase FOV 0,5, VBW 64 MHz, slice tickness 10 mm, acquisition time about 10-12 seconds), by imaging along the long and short axis. The study was completed with Fast Gradient Echo sequences (TR: 9ms, TE: 8,2ms, flip angle 25 degrees, VBW 15,63 MHz, FOV 320X250, 10 mm slice thickness, matrix 128X256), subsequently assessed by cine-MR. In order to compare both sequences, two experienced radiologists performed an analysis of quantitative parameters (signal intensity ratio between fat and muscular interventricular septum) and qualitative parameters (double blind evaluation for the presence of cardiac and respiratory artifacts). RESULTS: The signal intensity ratio for the Nffse sequence images was 4.63 +/- 1.56 on the long axis and 7.69 +/- 2.46 on the short axis, whereas it was 3.17 +/- 0.64 on the long axis and 3,50 +/- 0,75 on the axis one for SE images, with a statistically significant difference (p<0,001 and p<0.002 for the long and short axis, respectively). The two radiologists evaluation of the magnitude of artifacts on the SE and Nffse images was similar only as regards the images with significant artefacts alone. Nffse images consistently afforded a detailed evaluation of the right ventricular wall, although blurring artifacts were more common than with good quality SE images. Presence of fatty infiltration of the right ventricle wall was observed in 5 out of 25 patients. In the remaining 20 patients no fatty substitution of the muscular wall of the right ventricle was observed. DISCUSSION AND CONCLUSIONS: The Nffse sequences provide a number of gated multiphase-multislice images, similar to that obtained by conventional SE sequences, in one breath-hold time interval. Due to high intrinsic contrast and reduction of motion artifacts, the Nffse sequences allow a good evaluation of the ventricular morphology and subepicardial and paracardiac adipose tissue. Image quality can be suboptimal due to blurring artifacts. Therefore Nffse sequences can be advantageously employed to image patients with suspected right ventricular arrhythmogenic dysplasia, whenever conventional SE images exhibit substandard quality.     

Magnetic resonance tomography of adrenal gland tumors. Detection and differentiation using fast gradient echo sequences and dynamic contrast media studies

The use of fast gradient echo sequences enable reduction of the acquisition times in MR imaging, allowing examinations during suspended respiration. Furthermore, repeated single slices in the same position after administration of a paramagnetic contrast agent provide dynamic evaluation of tissue perfusion. These new diagnostic modalities were applied for imaging normal adrenal glands in 128 cases and for differentiation of 83 adrenal tumors in 74 patients. CT remains the imaging method of choice for the detection of adrenal masses, due to the higher spatial resolution. Fast gradient echo MRI offers the possibility of differentiation between benign and malignant adrenal lesions. The 70% accuracy reached with precontrast scans can be augmented to 90% using dynamic contrast-enhanced studies.     

Hepatic T2-weighted MRI: A prospective comparison of sequences,including breath-hold,half-Fourier turbo spin echo (HASTE)

The purpose of this study was to quantitatively compare the hepatic contrast characteristics of conventional spin-echo (CSE) and fast spin-echo (FSE) sequences with breath-hold T2-weighted images acquired with half-Fourier turbo spin echo (HASTE). Forty-five patients were examined with a phased-array surface coil. Nineteen patients had focal hepatic lesions, including eight malignant tumors, 10 cavernous hemangiomas, and one hepatic adenoma. Twenty-six patients had no focal hepatic lesions. T2-weighted images with comparable TE were acquired with CSE, FSE, and HASTE pulse sequences. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for liver, spleen, and lesions were measured. FSE demonstrated significantly better quantitative performance than CSE for liver-spleen CNR (P = .0084). No statistically significant difference was demonstrated between FSE and CSE for liver or spleen SNR. FSE demonstrated clear scan time and resolution advantages over CSE. HASTE performed significantly poorer than CSE and FSE for liver-spleen CNR (P < .0001), liver SNR (P = .0002 for CSE and P < .0001 for FSE), and spleen SNR (P < .0001). Optimized FSE images with a short echo train length performed comparably to CSE images of equivalent TE. Liver-lesion CNR was suppressed on HASTE images, suggesting that long echo train length FSE sequences could diminish solid lesion detection compared to CSE and short echo train length FSE.     

Cost comparison analysis of low-field (0.23 T) MRI- and CT-guided bone biopsies

The aim of this study was to analyze and compare the costs of low-field (0.23 T) MRI- and CT-guided bone biopsies. The cost comparison consisted of 18 MRI-guided and 12 CT-guided bone biopsies performed during a 1-year period. The costs and activities of these two methods were analyzed by using activity-based cost accounting (ABC). The costs of MRI-guided bone biopsy (1205 Euro) were 2.55-fold compared with those of the CT-guided bone biopsy (472 Euro). The higher costs of the biopsy procedure in MRI were due to the higher material (5.57-fold) and personnel (2.73-fold) costs. The MRI-guided bone biopsies proved to be considerably more expensive than CT-guided bone biopsies. This was due to the higher material costs, especially the highly priced MRI compatible instrumentation and the longer procedure time. The MRI guidance in performing bone biopsies should be justified on the basis of the better accuracy and the lack of radiation. Evaluations of cost-effectiveness concerning MRI-guided bone biopsy are needed.     

Superparamagnetic iron oxide (SPIO) MRI contrast agent for bone marrow imaging: differentiating bone metastasis and osteomyelitis.

PURPOSE: We explored appropriate scan timing for bone marrow imaging enhanced using superparamagnetic iron oxide (SPIO) and evaluated the usefulness of SPIO in differentiating metastasis and osteomyelitis in patients. METHODS: To determine the adequate scan timing after administration of SPIO, 5 healthy subjects were examined using a 1.5T magnetic resonance (MR) imaging scanner. Sagittal images of their lumbar spines were obtained using short-TI inversion recovery (STIR) sequence before and 3, 6, 9, 24, and 48 hours after intravenous injection of 8 micromol Fe/kg SPIO (ferucarbotran). MR signal intensities (SIs) were evaluated. Based on the results, 12 patients, five with bone metastasis and seven with vertebral osteomyelitis, were examined using the same procedure before and 3 hours after intravenous injection of ferucarbotran at the same dose. SIs of the bone metastases, osteomyelitis, and surrounding normal bone marrow were measured, and relative enhancement (RE) was calculated for each lesion. RESULTS: In the healthy volunteers, maximum reduction in signal was observed 3 to 24 hours (P<0.05) after administration of SPIO; thereafter and up to 48 hours, the SI gradually recovered. In the patients, the RE of the bone metastases was -12.2%, which was significantly higher than that in the osteomyelitis (-35.0%, P<0.001) and normal bone marrow (-46.6%, P<0.0005). CONCLUSION: Maximum suppression of signal intensity in bone marrow was seen 3 hours after injection of ferucarbotran, the point at which ferucarbotran allows differentiation of bone metastasis from ostoemyelitis.     

Contrast-enhanced MRI of the menisci of the knee using ultrashort echo time (UTE) pulse sequences: imaging of the red and white zones

The objective of this study was to demonstrate the red and white zones of the meniscus of the knee using MRI. Ultrashort echo time (UTE) pulse sequences with an initial TE of 0.08 ms and later echoes at 5.95 ms, 11.08 ms and 17.70 ms were used to image the meniscus of the knee in two normal subjects before and after intravenous administration of gadodiamide. Difference images were formed by subtraction of later echo images from the first. The difference images showed obvious enhancement in an area consistent in location and dimensions with the red zone of the meniscus. Regions of interest placed within this area, central to it (corresponding to the white zone), and peripheral to it (corresponding to perimeniscal tissue) all showed increases in signal intensity after intravenous contrast administration. The greatest change in signal intensity in these regions of interest was seen with the shortest TE and in perimeniscal tissue on the original images. The increase in signal intensity was greatest in the red zone on the difference images. Using UTE pulse sequences and difference images derived from them, it is possible to visualize enhancement selectively in the red zone of the meniscus. Less obvious but significant changes in signal intensity were also present in the white zone.