Cardiac MRI: accuracy of simultaneous measurement of left and right ventricular parameters using three different sequences

BACKGROUND AND AIM: We evaluated a value of Qp/Qs (left-to-right shunt measurement) using volumetric cardiac magnetic resonance (CMR) cardiac output (CO) measurements. We defined intraobserver, interobserver variability and reproducibility of left and right ventricular parameters by CMR. Furthermore, we studied whether shortened acquisition time has an effect on the accuracy of left and right ventricular parameters both in healthy volunteers and in patients with cardiovascular disease. METHODS: Sixteen subjects were enrolled in this study. Group A (n = 8, five males) consisted of healthy volunteers with a mean age of 25.9 years (range 24-30). Group B (n = 8, four males) was heterogenic consisting of patients with left ventricular (LV) hypertrophy, hypertension or coronary artery disease with their mean age of 56.3 years (range 38-70). RESULTS: The measured Qp/Qs as calculated from the right and LV CO was 0.87 +/- 0.13. Overall variability [as presented with the lowest coefficient of variation (CV)%- the highest CV % of intraobserver, interobserver variability or reproducibility] of LV parameters were for ejection fraction (EF) 1.5-2.8%, stroke volume (SV) 1.3-3.2%, CO 1.4-3.2%, end-diastolic volume 0.5-3.0%, end-systolic volume 1.8-6.2% and LV mass 1.1-2.6%. Corresponding values for right ventricular parameters were for EF 1.1-4.2%, SV 1.9-8.2%, CO 1.9-7.6%, end-diastolic volume 2.1-7.6%, end-systolic volume 2.8-10.2% and right ventricle mass 2.9-8.3%. There was no statistically significant difference between the results of different sequences. CONCLUSIONS: The CMR allows accurate Qp/Qs observation but the absolute value is at slightly different level compared with reference methods. Both left and right ventricular parameters are highly reproducible and even small clinically relevant changes can be measured with CMR. The shortened acquisition does not affect significantly to the accuracy of CMR-derived parameters.     

MRI findings in Marinesco-Sjögren syndrome: Report of three cases with unusual features

Marinesco-Sjögren syndrome is an inherited neuro-ocular disease with spinocerebellar symptoms and cataracts. The authors report three cases, two of them belonging to the same family, with unusual magnetic resonance imaging findings, consisting of atrophy of optic nerve, optic chiasm and occipital cortex. Like in other progressive ataxias, the authors are probably dealing with different neuropathological and clinical forms, some of which combining atrophy of the optic nerve and optic pathway with the basic features of cerebellar and brain stem atrophy.     

Robust fat suppression at 3T in high‐resolution diffusion‐weighted single‐shot echo‐planar imaging of human brain

Single‐shot echo‐planar imaging is the most common acquisition technique for whole‐brain diffusion tensor imaging (DTI) studies in vivo. Higher field MRI systems are readily available and advantageous for acquiring DTI due to increased signal. One of the practical issues for DTI with single‐shot echo‐planar imaging at high‐field is incomplete fat suppression resulting in a chemically shifted fat artifact within the brain image. Unsuppressed fat is especially detrimental in DTI because the diffusion coefficient of fat is two orders of magnitude lower than that of parenchyma, producing brighter appearing fat artifacts with greater diffusion weighting. In this work, several fat suppression techniques were tested alone and in combination with the goal of finding a method that provides robust fat suppression and can be used in high‐resolution single‐shot echo‐planar imaging DTI studies. Combination of chemical shift saturation with slice‐select gradient reversal within a dual‐spin‐echo diffusion preparation period was found to provide robust fat suppression at 3 T. Magn Reson Med, 2011. © 2011 Wiley Periodicals, Inc.     

No Difference in Hip Muscle Volumes and Fatty Infiltration in Those With Hip-Related Pain Compared to Controls

BackgroundLittle is known about muscle morphology in people with hip-related pain, without signs of femoro-acetabular impingement syndrome (FAIS). Identifying changes in hip muscle volume, fatty infiltrate and establishing relationships between muscle volume and strength, may provide insight into potential early treatment strategies.PurposesTo: (i) compare the volumes and fatty infiltrate of gluteus maximus, gluteus medius, gluteus minimis, tensor fascia latae and quadratus femoris between symptomatic and less-symptomatic sides of participants with hip-related pain; (ii) compare the volumes and fatty infiltrate of hip muscles between healthy controls and symptomatic participants; and (iii) explore relationships of hip muscle volumes to muscle strength and patient-reported outcome measures in people with hip-related pain.Study DesignCross-sectional studyMethodsMuscle volume and fatty infiltrate (from magnetic resonance imaging), hip muscle strength, patient-reported symptoms, function and quality of life (QOL) were determined for 16 participants with hip-related pain (no clinical signs of FAIS; 37±9 years) and 15 controls (31±9 years). Using One Way Analysis of Co-Variance tests, muscle volume and fatty infiltrate was compared between the symptomatic and less-symptomatic sides in participants with hip-related pain as well as between healthy controls and symptomatic participants. In addition, hip muscle volume was correlated with hip muscle strength, hip-reported symptoms, function and QOL.ResultsNo differences in all the studied muscle volumes or fatty infiltrate were identified between the symptomatic and less-symptomatic hips of people with hip-related pain; or between people with and without hip-related pain. Greater GMED volume on the symptomatic side was associated with less symptoms and better function and QOL (ρ=0.522-0.617) for those with hip-related pain. Larger GMAX volume was associated with greater hip abduction and internal rotation strength, larger GMED volume was associated with greater hip extension strength, and larger QF volume was associated with greater hip abduction strength (rho=0.507-0.638).ConclusionPeople with hip-related pain and no clinical signs of FAIS have hip muscle volumes that are not significantly different than those of matched pain-free controls or their less-symptomatic hip. Larger GMED muscle volume was associated with fewer symptoms and greater strength.Level of evidenceLevel 3a     

Myocardial tagging with steady state free precession techniques and semi-automatic postprocessing—impact on diagnostic value

Our aim was to determine the diagnostic value of myocardial tagging sequences with regard to the evaluable share of the cardiac cycle. Thirty-three patients were examined at 1.5 T using tagging sequences with gradient-echo (GRE) readout, 18 patients at 1.5 T with steady-state free precession (SSFP), and 11 patients at 3 T using GRE. Two observers graded image quality and determined the share of the cardiac cycle for which postprocessing could be performed (1, optimal; 2, little interaction; 3, whole cycle assessable; 4, diastole non-assessable; 5, systole incomplete; 6, non-diagnostic). With GRE at 1.5 T, median image quality was 4.0 (95% CI 4.0–5.0), while it was significantly better with 2.0 (2.0–3.0) using the SSFP technique and similar at 3 T with 2.9 (1.7–3.5). With GRE at 1.5 T, systole could be assessed in 69% of patients, and an evaluation of the whole cardiac cycle was not possible. With the SSFP sequence at 1.5 T and GRE at 3 T, an evaluation of the whole cardiac cycle was possible in 71% and 70% of the patients, respectively, and systole was assessable in all patients. Tagging sequences with SSFP readout at 1.5 T make a semi-automatic evaluation of the whole cardiac cycle feasible in a large share of patients.     

Does neurologic deterioration help to differentiate between pseudoprogression and true disease progression in newly diagnosed glioblastoma multiforme?

Enlarging or new lesions frequently appear on magnetic resonance imaging (mri) after concurrent administration of radiation therapy and temozolomide in glioblastoma multiforme (gbm) patients. However, in nearly half such cases, the observed radiologic changes are not due to true disease progression, but instead are a result of a post-radiation inflammatory state called "pseudoprogression." Retrospective studies have reported that neurologic deterioration at the time of the post-chemoradiotherapy mri is found more commonly in patients with true disease progression. We report a gbm patient with both radiologic progression on the post-chemoradiotherapy mri and concomitant neurologic deterioration, and we caution against incorporating clinical deterioration into the management schema of patients with possible pseudoprogression.     

Conventions and nomenclature for double diffusion encoding NMR and MRI

Stejskal and Tanner's ingenious pulsed field gradient design from 1965 has made diffusion NMR and MRI the mainstay of most studies seeking to resolve microstructural information in porous systems in general and biological systems in particular. Methods extending beyond Stejskal and Tanner's design, such as double diffusion encoding (DDE) NMR and MRI, may provide novel quantifiable metrics that are less easily inferred from conventional diffusion acquisitions. Despite the growing interest on the topic, the terminology for the pulse sequences, their parameters, and the metrics that can be derived from them remains inconsistent and disparate among groups active in DDE. Here, we present a consensus of those groups on terminology for DDE sequences and associated concepts. Furthermore, the regimes in which DDE metrics appear to provide microstructural information that cannot be achieved using more conventional counterparts (in a model‐free fashion) are elucidated. We highlight in particular DDE's potential for determining microscopic diffusion anisotropy and microscopic fractional anisotropy, which offer metrics of microscopic features independent of orientation dispersion and thus provide information complementary to the standard, macroscopic, fractional anisotropy conventionally obtained by diffusion MR. Finally, we discuss future vistas and perspectives for DDE. Magn Reson Med 75:82–87, 2016. © 2015 Wiley Periodicals, Inc.     

In vivo chlorine‐35, sodium‐23 and proton magnetic resonance imaging of the rat brain

In this study we demonstrate the feasibility of combined chlorine‐35, sodium‐23 and proton magnetic resonance imaging (MRI) at 9.4 Tesla, and present the first in vivo chlorine‐35 images obtained by means of MRI. With the experimental setup used in this study all measurements could be done in one session without changing the setup or moving the subject. The multinuclear measurement requires a total measurement time of 2 h and provides morphological (protons) and physiological (sodium‐23, chlorine‐35) information in one scanning session. Chlorine‐35, sodium‐23 and high resolution proton images were acquired from a phantom, a healthy rat and from a rat displaying a focal cerebral infarction. Compared to the healthy tissue a signal enhancement of a factor of 2.2 ± 0.2 in the chlorine‐35 and a factor of 2.9 ± 0.6 in the sodium‐23 images is observed in the areas of infarction. Exemplary unlocalized measurement of the in vivo longitudinal and transversal relaxation time of chlorine‐35 in a healthy rat showed multi‐exponential behaviour. A biexponential fit revealed a fast and a slow relaxing component with T_1,a = (1.7 ± 0.4) ms, T_1,b = (25.1 ± 1.4) ms, amplitudes of A = 0.26 ± 0.02, (1–A) = 0.74 ± 0.02 and T_2,a = (1.3 ± 0.1) ms, T_2,b = (11.8 ± 1.1) ms, A = 0.64 ± 0.02, (1–A) = 0.36 ± 0.02. Combined proton, sodium‐23 and chlorine‐35 MRI may provide a new approach for non‐invasive studies of ionic regulatory processes under physiological and pathological conditions in vivo. Copyright © 2010 John Wiley & Sons, Ltd.