Ligamentum flavum: appearance on sagittal and coronal MR images

The appearance of the ligamentum flavum on sagittal and coronal magnetic resonance (MR) images has not been described in detail in the radiologic literature. The authors reviewed correlative MR images and anatomic sections obtained with a cryomicrotome in 20 cadavers in order to analyze anatomic relationships, variations, and progressive degenerative changes of the ligamentum flavum in the lumbar region. MR imaging showed the ligamentum flavum as an intermediate-signal-intensity structure on images obtained with short and long repetition times (TRs). Sagittal short TR images were effective for evaluating relationships between the ligamentum flavum, spinal canal, and nerve roots. Degenerative changes in the ligamentum flavum appeared as changes in shape or thickness of the ligaments on MR images. Calcification and fat infiltration, which were well depicted on anatomic sections, were not visualized on MR images.     

MR imaging of the thorax: a comparison of axial, coronal, and sagittal imaging planes

We performed direct multisection coronal and sagittal magnetic resonance (MR) images in addition to axial images to determine the value and limitations of coronal and sagittal planes compared with axial planes. Ninety-four MR examinations of the thorax were performed with a 0.3 T permanent magnet system (Fonar) by spin echo technique. The MR axial images were found superior to coronal in demonstrating prevascular adenopathy (one case), pretracheal nodes (nine cases), left paraaortic nodes (three cases), subcarinal nodes (three cases), and small pleural effusions (three cases). The coronal or sagittal planes were better to determine relationship of a mass at the lung apex (five cases) or an abnormality at the lung base (five cases). The anteroposterior displacement or compromise of great vessels and bronchi was best displayed on the axial plane whereas craniocaudal displacement of above structures was best seen on the coronal plane. The axial images were found most informative and we suggest that they be performed routinely. Coronal or sagittal planes may be added in selected cases.     

Os acromiale: evaluation of markers for identification on sagittal and coronal oblique MR images

 An os acromiale is a developmental abnormality of ossification involving the anterior acromion which may contribute to impingement and rotator cuff disease. When axial MR sections do not include the acromioclavicular joint, the diagnosis of this often subtle abnormality will rest on its recognition on oblique coronal and sagittal images where it mimics the acromioclavicular joint. The identification of this anomaly is important as it frequently alters the type of surgical procedure utilized in symptomatic patients. We evaluate several imaging features which may be used to diagnose an os acromiale in these cases.     

Diagnostic maxillofacial coronal images reformatted from helically acquired thin-section axial CT data

OBJECTIVE. This study was undertaken to determine the sensitivity and specificity of coronal images reformatted from helical thin-section axial CT data obtained for the evaluation of maxillofacial fractures. MATERIALS AND METHODS. Multiple fractures were created in nine cadaver heads by blunt trauma and were then evaluated using a late-generation helical CT scanner. Two neuroradiologists then independently evaluated the axial and reformatted coronal maxillofacial images. Subsequently, they reviewed the axial and direct coronal CT images, which were considered the criterion standard. RESULTS. A total of 87 fractures were identified. An experienced neuroradiologist failed to identify one displaced fracture and two nondisplaced fractures when evaluating the reformatted coronal and direct axial images for an overall sensitivity of 97%. A less experienced neuroradiologist failed to identify a total of five minimally displaced or nondisplaced fractures for an overall sensitivity of 94%. For each radiologist, no significant difference in the time required to interpret the direct versus the reformatted coronal images was seen. CONCLUSION. Interpretation of axial and reformatted coronal images resulted in accurate identification of displaced maxillofacial fractures in cadavers. This study suggests that the added cost and radiation exposure associated with incremental direct coronal CT may not be necessary for detection of clinically significant maxillofacial fractures and that further evaluation of this protocol in live trauma patients is warranted. However, because nondisplaced fractures were not routinely detected using reformatted coronal images, physical examination and clinical suspicion will still also remain necessary to determine the need for further imaging.     

Cervical spine MR imaging: generating high-signal CSF in sagittal and axial images

Three magnetic resonance (MR) imaging techniques were compared as to their ability to generate images with high-signal cerebrospinal fluid (CSF) to provide a high-contrast CSF-dura interface. The three techniques were CSF gating to the peripheral pulse, selective saturation recovery with gradient refocusing (SSRGR), and gradient recalled acquisition in the steady state (GRASS). In sagittal views of the cervical spine, CSF gating proved to be a reliable technique for producing images with uniform high-signal CSF in a single-section or multi-section mode. In axial views, SSRGR and GRASS techniques were more consistent than CSF gating in producing high-signal CSF images, especially in a multisection mode. Although axial image quality was nearly equivalent for SSRGR and GRASS techniques, the latter was clinically more efficient because of shorter imaging times. These methods of imaging in the cervical spine yield sufficient CSF-dura contrast and spatial resolution to be of use in the diagnosis of cervical disk disease.     

Development of a protocol for coronal reconstruction of the maxillofacial region from axial helical CT data

Using a fresh frozen cadaver head, a series of axial helical CT scans were obtained using varying imaging parameters both before and after traumatizing the head. The appearance of reformatted coronal images was optimized for the lowest radiation dose. A protocol for imaging the maxillofacial region was developed that produced diagnostic coronal reconstructed images from the axial helical CT data.     

Dynamic gadolinium-enhanced MR imaging of pituitary adenomas: usefulness of sequential sagittal and coronal plane images

Dynamic magnetic resonance (MR) imaging for pituitary adenomas is usually performed in a coronal direction; however, small lesions between slices, or lesions located at the anterior or posterior aspect of the pituitary gland might be overlooked on MR images in only the coronal direction. The purpose of our study was to evaluate whether consecutive dynamic MR images in the coronal and sagittal planes improve detection of pituitary adenomas. Eighteen patients with pituitary microadenomas and nine with healthy pituitary glands were included in this study. MR images were performed with 1.5 T superconductive units and commercially-available head coils. After a 5 ml gadolinium contrast injection, eight serial dynamic sagittal images were obtained. Within 3 or 6 min, this was followed by a 10-15 ml gadolinium injection and acquisition of eight serial dynamic coronal images. Dynamic MR images and conventional noncontrast- and contrast-enhanced sagittal and coronal T1-weighted images were evaluated independently in a blind fashion by two neuroradiologists regarding the depiction of pituitary microadenomas. The sensitivities of dynamic enhanced MR imaging in the detection of microadenomas were 61.1% in sagittal direction, 72.2% in coronal direction respectively, and were superior to those of conventional noncontrast- and contrast-enhanced T1-weighted imaging (22.2-50%). The sensitivity of a combination of sagittal and coronal dynamic enhanced MR imaging for the detection of microadenomas was 88.9% and was superior to those of conventional noncontrast- and contrast-enhanced T1-weighted imaging combining sagittal and coronal directions (61.1%, 61.1%) (P<0.05, P<0.05, respectively). The specificity and accuracy of dynamic enhanced MR imaging with combination of sagittal and coronal images was 88.9% respectively. Dynamic gadolinium-enhanced MR imaging, especially using both sagittal and coronal planes, was concluded to be useful for the detection of pituitary microadenomas.     

The MRI findings of meniscal root tear of the medial meniscus: emphasis on coronal, sagittal and axial images

Purpose

The purpose of this study was to evaluate the accuracy of the characteristic magnetic resonance imaging (MRI) findings of medial meniscal root tear in the coronal, sagittal and axial planes.

Methods

Thirty arthroscopically diagnosed patients who had undergone preoperative knee MRI were included in this study. They were compared to 30 age-matched patients with medial meniscus tears without root tears. The findings used for imaging analysis were as follows: the radial tear on the meniscal root of the medial meniscus in the axial plane, the presence of the truncation sign in the coronal plane and the ghost meniscus sign in the sagittal plane. Meniscal extrusion in the coronal plane was also evaluated. All the MRI findings of both groups were statistically analyzed.

Results

All the findings were more frequently found in the root tear group than those in the control group (P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of finding a radial tear in the axial plane were 93.3, 100, 100 and 93.8%, respectively. In the coronal plane, rates for the presence of the truncation sign were 90, 100, 100 and 90.9%, respectively. In the sagittal plane, rates for the presence of the ghost meniscus sign were 96.7, 96.7, 96.7 and 96.7%, respectively. The rates for the meniscus extrusion in the coronal plane were 63.3, 90, 86.4 and 71.1%, respectively.

Conclusions

The findings of medial meniscal root tear were characteristic as compared with the control group. Radial tear in the axial plane also showed similar diagnostic accuracy as that seen in the other planes. The characteristic findings provide high diagnostic accuracy, and axial plane is helpful to detect medial meniscal root tear.

Level of evidence

Diagnostic study, Level III.     

Development of automated segmentation method for the posterior portion of the temporal lobe on coronal MR images

Brain MRI is an important method for examining the diseases caused by various cerebral pathologies, and the measurement of temporal lobe volume is useful for identifying dementia and temporal lobe abnormalities. However, no segmentation algorithm for the temporal lobe on coronal MR images has been established. Such an algorithm is needed because the shape of the temporal lobe on coronal images varies from area to area. The purpose of this research was to develop a segmentation method for the posterior portion of the temporal lobe on coronal MR images. The subjects were 11 normal patients, whose coronal T(1)-weighted images were selected for this study. The preprocessing algorithm for segmentation consists of smoothing, binarization, and thinning. The first step of the segmentation process consists of recognition techniques for the temporal lobe region on thinning images. The next step is distance transformation on identified thinning images. Finally, the temporal lobe was segmented by using the original images and distance transformation images and employing the newly developed algorithm. The rate of accuracy of automated recognition was over 74% for all cases, while the average rate of accuracy was 83.2+/-4.0%. These results suggest that this segmentation method can clearly segment the temporal lobe and has potential for clinical use. Based on this study, although it included only 11 normal patients, we have started applying this segmentation method to many patients, with or without temporal lobe disease.     

Liver volume measurements and three-dimensional display from MR images

A method was investigated for measuring the volumes of human livers in vivo from magnetic resonance images and subsequently displaying these livers in three dimensions. Volumetric image sets of phantoms, healthy volunteers, and patients with cirrhotic livers were processed. Two image-processing approaches were compared for accuracy of liver measurements, intrasubject and interobserver variation, and speed of processing. Results indicated that both processing methods had a high degree of volume-measuring accuracy (within 8%), the interobserver measurements had a high coefficient of correlation (r = .9994), the intrasubject measurements had a low coefficient of variation (1.8%), and one method was four to five times faster than the other. The faster and easier of the two image-processing approaches provided satisfactory results for measuring liver volumes, but the slower approach provided more realistic-looking three-dimensional images of the liver.     

Algorithms of CT value correction for reconstructing a radiotherapy simulation image through axial CT images

New algorithms of CT value correction for reconstructing a radiotherapy simulation image through axial CT images were developed. One, designated plane weighting method, is to correct CT value in proportion to the position of the beam element passing through the voxel. The other, designated solid weighting method, is to correct CT value in proportion to the length of the beam element passing through the voxel and the volume of voxel. Phantom experiments showed fair spatial resolution in the transverse direction. In the longitudinal direction, however, spatial resolution of under slice thickness could not be obtained. Contrast resolution was equivalent for both methods. In patient studies, the reconstructed radiotherapy simulation image was almost similar in visual perception of the density resolution to a simulation film taken by an X-ray simulator.     

Clinical usefulness of artronix brain scanner multiplanar coronal and sagittal brain images

Summary The Artronix 1100 head scanner is a promising unit which allows reconstitution of the images in coronal and sagittal planes from the axial slice. The clinical usefulness of coronal and sagittal images thus obtained is illustrated and discussed.     

Automated method for identification of patients with Alzheimer's disease based on three-dimensional MR images

RATIONALE AND OBJECTIVES: An automated method for identification of patients with cerebral atrophy due to Alzheimer's disease (AD) was developed based on three-dimensional (3D) T1-weighted magnetic resonance (MR) images. MATERIALS AND METHODS: Our proposed method consisted of determination of atrophic image features and identification of AD patients. The atrophic image features included white matter and gray matter volumes, cerebrospinal fluid (CSF) volume, and cerebral cortical thickness determined based on a level set method. The cortical thickness was measured with normal vectors on a voxel-by-voxel basis, which were determined by differentiating a level set function. The CSF spaces within cerebral sulci and lateral ventricles (LVs) were extracted by wrapping the brain tightly in a propagating surface determined with a level set method. Identification of AD cases was performed using a support vector machine (SVM) classifier, which was trained by the atrophic image features of AD and non-AD cases, and then an unknown case was classified into either AD or non-AD group based on an SVM model. We applied our proposed method to MR images of the whole brains obtained from 54 cases, including 29 clinically diagnosed AD cases (age range, 52-82 years; mean age, 70 years) and 25 non-AD cases (age range, 49-78 years; mean age, 62 years). RESULTS: As a result, the area under a receiver operating characteristic (ROC) curve (Az value) obtained by our computerized method was 0.909 based on a leave-one-out test in identification of AD cases among 54 cases. CONCLUSION: This preliminary result showed that our method may be promising for detecting AD patients.     

Development of a three-dimensional data acquisition method for standardization of beta-emitting nuclides

We have developed a three-dimensional data-acquisition system with which pulse heights from an array of detectors can be multi-scaled with dwell times as short as 31 ns. The main part of the system consists of three ADCs of SAR (Successive Approximation Register) type, a 32 MHz oscillation clock and DRAM (Dynamic Random Access Memory) of 192 Mbyte capacity. The clock time is determined by count the clock pulse generated by 28 bits synchronous counter. Both the pulse height and the time information are stored at an array of DRAM, of 40-bits width, 12-bits for pulse height and 28-bits for clock time.The technique is particularly suitable for experiments such as both double and triple coincidence distributions are required. Virtues of the method are demonstrated by measuring the activity of ¹⁴C with a 3-PM liquid scintillation counting system. The computer discrimination together with the MCTS (multi-channel time scaling) technique is applied for efficiency variation method in the analysis.     

Size of noncancerous hilomediastinal lymph nodes measured on coronal and sagittal reconstruction CT images

Purpose  

To determine the sizes of hilomediastinal lymph nodes on coronal and sagittal reconstruction computed tomographic images of subjects without known malignancies.     

Model-free reconstruction of three-dimensional myocardial strain from planar tagged MR images

A technique is presented for reconstructing a three-dimensional myocardial strain map from a set of parallel-tagged MR images. Radial strains were reconstructed from in vivo data from an anesthetized dog with values between .05 and .1 with a precision of ± .003 for a tag detection accuracy of .1 mm and a tag spacing of 2.5 mm. The reconstruction spatial resolution was demonstrated by reconstructing a localized displacement abnormality. In the circumferential direction, the abnormality that resulted in 50% displacement attenuation had a full width at half maximum of 5.4 ± .4 mm (mean ± SD). Graphs are presented showing the relationship between the size of an abnormality and the ability of the method to reconstruct that abnormality. The combination of high resolution parallel-tagged MR images and the model-free, coordinate system-free strain reconstruction technique presented in this paper is capable of producing accurate, high resolution strain maps of the myocardium.