A multispectral three‐dimensional acquisition technique for imaging near metal implants

Metallic implants used in bone and joint arthroplasty induce severe spatial perturbations to the B₀ magnetic field used for high‐field clinical magnetic resonance. These perturbations distort slice‐selection and frequency encoding processes applied in conventional two‐dimensional MRI techniques and hinder the diagnosis of complications from arthroplasty. Here, a method is presented whereby multiple three‐dimensional fast‐spin‐echo images are collected using discrete offsets in RF transmission and reception frequency. It is demonstrated that this multi acquisition variable‐resonance image combination technique can be used to generate a composite image that is devoid of slice‐plane distortion and possesses greatly reduced distortions in the readout direction, even in the immediate vicinity of metallic implants. Magn Reson Med 61:381–390, 2009. © 2009 Wiley‐Liss, Inc.     

Magnetic resonance imaging of Trilucent TM breast implants

AIM: To demonstrate the magnetic resonance imaging (MRI) appearances of intact and ruptured Trilucent TM implants with imaging and surgical correlation. The appearances of the implant transponder artefact are also described MATERIALS AND METHODS: A retrospective review of the MRI findings in 34 patients with bilateral subpectoral Trilucent TM breast implants (Lipomatrix, Inc./Collagen Aesthetics International Inc., Neuchatel, Switzerland) was performed. Patients under implant surveillance and those with suspected implant rupture formed the study group. Imaging findings were correlated with surgical appearances. RESULTS: Surgical correlation was available in 53% of patients. Fifty per cent (18/36) of implants were intact at surgery, 50% (18/36) of implants were ruptured. Of the 18 ruptured implants, 17 were intracapsular ruptures and one an extracapsular rupture. The sensitivity of MRI for detection of intracapsular rupture in Trilucent TM breast implants was 82% specificity 76%, positive predictive value 78%, negative predictive value 81% and accuracy 79% in this study group. No case of implant rupture was obscured by the transponder artefact. Four implants were found to have 'pseudocapsules' at surgery (5.9%), the implants were intact with fluid present between the implant and capsule. Only one pseudocapsule was demonstrated on MRI. CONCLUSION: Magnetic resonance imaging is currently the most accurate technique for diagnosis of implant rupture in Trilucent TM breast implants. Transponder artefact does not appear to interfere with the assessment of implant rupture.     

Imaging near metal with a MAVRIC‐SEMAC hybrid

The recently developed multi‐acquisition with variable resonance image combination (MAVRIC) and slice‐encoding metal artifact correction (SEMAC) techniques can significantly reduce image artifacts commonly encountered near embedded metal hardware. These artifact reductions are enabled by applying alternative spectral and spatial‐encoding schemes to conventional spin‐echo imaging techniques. Here, the MAVRIC and SEMAC concepts are connected and discussed. The development of a hybrid technique that utilizes strengths of both methods is then introduced. The presented technique is shown capable of producing minimal artifact, high‐resolution images near total joint replacements in a clinical setting. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Magnetic resonance imaging of the postoperative hip

Magnetic resonance imaging (MRI) is ideally suited to imaging the patient with painful hip arthroplasty due to its superior soft tissue contrast, multiplanar capabilities, and lack of ionizing radiation. MRI is the most accurate imaging modality in the assessment of periprosthetic osteolysis and wear-induced synovitis, and can also assess regional tendons and neurovascular structures. This article discusses the technical aspects of MRI around metallic implants as well as the appearance of potential complications following hip arthroplasty, including osteolysis, wear-induced synovitis, infection, hemarthrosis, fracture, loosening, component displacement, heterotopic ossification, tendinopathy, and neurovascular impingement. The specific complication of metal hypersensitivity following metal-on-metal prostheses is reviewed.     

Magnetic resonance safety update 2002: implants and devices

The preservation of a safe magnetic resonance (MR) environment requires constant vigilance by MR healthcare professionals, particularly with regard to the management of patients with metallic biomedical implants or devices. The variety and complexity of implants and devices constantly changes, requiring continuous attention and diligence with regard to obtaining the most current and accurate information about these objects relative to the MR environment. This review article discusses MR safety and MR compatibility issues and presents important information for a variety of implants and devices, with an emphasis on those objects that have recently undergone evaluation or that require additional consideration because of existing controversy or confusion.     

Magnetic resonance imaging artifacts produced by dental implants with different geometries

Objectives:The purpose of this study was to evaluate the MRI-artifact pattern produced by titanium and zirconia dental implants with different geometries (diameter and height).Methods:Three titanium (Titan SLA, Straumann) and three zirconia (Pure Ceramic Implant, Straumann) dental implants differing on their design (diameter x height) were installed in porcine bone samples. Samples were scanned with a MRI (3T, T1W turbo spin echo sequence, TR/TE 25/3.5ms, voxel size 0.22×0.22×0.50 mm, scan time 11:18). Micro-CT was used as control group (80kV, 125mA, voxel size 16µm). Artifacts’ distribution was measured at vestibular and lingual sites, mesial and distal sites, and at the apex. Statistical analysis was performed with Within-ANOVA (p=0.05).Results:Artifacts distribution measured 2.57 ± 1.09 mm for titanium artifacts and 0.37 ± 0.20 mm for zirconia artifacts (p<0.05). Neither the measured sites (p=0.73) nor the implant geometries (p=0.43) influenced the appearance of artifacts.Conclusion:Artifacts were higher for titanium than zirconia implants. The artifacts pattern was similar for different dental implant geometries.     

MR imaging near metal with undersampled 3D radial UTE‐MAVRIC sequences

Recently developed techniques such as the multiple acquisition with variable resonance image combination and slice encoding for metal artifact correction techniques have improved the ability of clinical magnetic resonance scanners to image near metal implants. These sequences are based on fast spin echo sequences which preclude detection of short T₂ tissues such as tendons, ligaments, and cortical bone. Ultrashort echo time sequences have the potential to detect signals from these tissues. In this study, we investigate the potential of combining ultrashort echo time with multiple acquisition with variable resonance image combination to image short T₂ musculoskeletal tissues adjacent to metallic implants. Different radio frequency excitation pulse types and spectral binning strategies were studied. We found that ultrashort echo time‐multiple acquisition with variable resonance image combination sequences were able to significantly reduce typical artifacts near metal, as well as detect very short T₂ signals that are usually not visualized using clinical pulse sequences. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

Safety of metallic implants in magnetic resonance imaging

Magnetic resonance (MR) imaging has become a commonly accepted medical procedure. Manufacturers of medical implant devices are submitting claims that their devices are safe and effective in a MR environment. This paper concentrates on the issue of heating of patients due to the interaction of metallic implants with the strong radiofrequency (RF) magnetic field produced by the MR scanner. The commercially available program XFDTD was used to calculate the specific absorption rate (SAR) distribution in a realistic model of the human body. The body contained a metallic implant and was exposed to RF magnetic fields at 64 MHz from a model of a MR birdcage body coil. The results of the calculation showed that the magnitude of the increased heating of tissues due to the presence of the metallic implant depended on the dimensions, orientation, shape, and location of the metallic implant in the patient. This increased heating of surrounding tissues primarily concentrates in a small volume near the tip of the metallic wire. When the whole-body SAR was normalized to 1 W/kg, a calculated value of 41 W/kg was obtained at this location if the absorption was averaged over 1 g of tissue. However, a maximum value of 310 W/kg was calculated when the absorption was averaged over 1/8 g of tissue.     

Development of a functional magnetic resonance imaging simulator for modeling realistic rigid-body motion artifacts.

Functional magnetic resonance imaging (FMRI) is a noninvasive method of imaging brain function in vivo. However, images produced in FMRI experiments are imperfect and contain several artifacts that contaminate the data. These artifacts include rigid-body motion effects, B0-field inhomogeneities, chemical shift, and eddy currents. To investigate these artifacts, with the eventual aim of minimizing or removing them completely, a computational model of the FMR image acquisition process was built that can simulate all of the above-mentioned artifacts. This paper gives an overview of the development of the FMRI simulator. The simulator uses the Bloch equations together with a geometric definition of the object (brain) and a varying T2* model for the BOLD activations. Furthermore, it simulates rigid-body motion of the object by solving Bloch equations for given motion parameters that are defined for an object moving continuously in time, including during the read-out period, which is a novel approach in the area of MRI computer simulations. With this approach it is possible, in a controlled and precise way, to simulate the full effects of various rigid-body motion artifacts in FMRI data (e.g. spin-history effects, B0-motion interaction, and within-scan motion blurring) and therefore formulate and test algorithms for their reduction.