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Magnetic resonance artifact in the postoperative cervical spine. A potential pitfall.

An magnetic resonance imaging artifact that stimulates hypertrophic bone formation is described in patients who have had an anterior cervical discectomy. The magnetic resonance images of 26 patients with anterior cervical discectomy were retrospectively reviewed. Comparison was made to the available concurrent computed tomographic scans, computed tomographic myelograms, and operative reports. A bovine spine was drilled with a drill only at one level and with a metal suction tip in close proximity to the drill at another level, and magnetic resonance images were obtained. Artifact was present in 12 patients and absent in 14; this was confirmed in the 8 patients with comparison studies. Close correlation was seen with the prospective reading of the presence of artifact and operative drill use in the seven patients with available operative reports. The bovine spine model showed no artifact at the drill-only level and significant artifact at the level where the metal suction tip was positioned next to the drill. Small metal flecks were seen grossly at the second level, but not on plain roentgenograms. The metallic magnetic resonance artifact seen in postoperative cervical spines is probably from small bits of metal from the metal suction tip as it occasionally hits the drill. Bone abnormalities seen on magnetic resonance imaging at the level of a previous anterior cervical discectomy may need a cervical computed tomogram to confirm the findings.

Adult↗

The effect of artifact rejection by signal-space projection on source localization accuracy in MEG measurements.

The consequences of artifact suppression by means of signal-space projection on dipole localization accuracy for magnetoencephalography measurements are studied. Approximate analytical formulas, equivalent to the Cramer-Rao bound, are presented and verified by Monte Carlo simulations which relate the increase of localization error for individual coordinates to the similarity of the artifact field and respective (contravariant) quadrupole fields obtained by differentiating the dipole field with respect to its origin. The expressions simplify significantly for dipoles placed below the center of the measuring system giving rise to highly symmetric field patterns. Formulas are presented both for single- and for multiple-artifact rejection. As illustrative examples artifact fields are constructed which a) lead to highly decreasing signal-to-noise ratio and goodness-of-fit (GOF), while the localization error is unaffected for all coordinates and b) lead to an increase of localization error while the SNR and the GOF stays constant. Finally, the rich structure of localization error increase is demonstrated for a class of artifact fields originating from artifact current dipoles.

Artifacts↗

Cardiac artifact subspace identification and elimination in cognitive MEG data using time-delayed decorrelation.

To reduce physiological artifacts in magnetoencephalographic (MEG) and electroencephalographic recordings, a number of methods have been applied in the past such as principal component analysis, signal-space projection, regression using secondary information, and independent component analysis. This method has become popular as it does not have constraints such as orthogonality between artifact and signal or the need for a priori information. Applying the time-delayed decorrelation algorithm to raw data from a visual stimulation MEG experiment, we show that several of the independent components can be attributed to the cardiac artifact. Calculating an average cardiac activity shows that physiologically different excitation states of the heart produce similar field distributions in the MEG sensor system. This is equivalent to differing spectral properties of cardiac field distributions in the raw data. As a consequence, the algorithm combines, e.g., the R peak and the T wave of the cardiac cycle into a single component and the one-to-one assignment of each independent component with a physiological source is not justified in this case. To improve the signal quality of visually evoked fields, the multidimensional cardiac artifact subspace is suppressed from the data. To assess the preservation of the evoked signal after artifact suppression, a geometrical and a temporal measure are introduced. The suppression of cardiac and alpha wave artifacts allows, in our experimental setting, the reduction of the number of epochs to one half while preserving the visually evoked signal.

Algorithms↗

Stimulus artifact cancellation in the serosal recordings of gastric myoelectric activity using wavelet transform.

Previous studies have shown that electrical stimulation of the stomach (i.e., gastric pacing) with appropriate parameters is a promising method for treatment of gastroparetic patients. The recording of gastric myoelectric activity (GMA) by serosal electrodes is often used to evaluate the effect of stimulation. However, the major problem with the measurement of GMA during gastric pacing is the stimulus artifacts which are often superimposed on the serosal recording and make analysis difficult. The frequency-domain adaptive filter has been used to reduce the stimulus artifacts but only with limited success. This paper describes a wavelet transform-based method for the reduction of stimulus artifacts in the serosal recordings of GMA. The key of this method lies in the use of the fuzzy set theory to select the stimulus artifact-related modulus maxima in the wavelet domain. Both quantitative and qualitative measures show that significant stimulus artifact cancellation was achieved through a series of computer simulations. Results from both single- and multichannel serosally recorded myoelectric signals during gastric pacing are presented to demonstrate the efficiency of the proposed method for the cancellation of stimulus artifacts.

Algorithms↗

Interpolation artifacts in multimodality image registration based on maximization of mutual information.

Mutual information (MI) is an increasingly popular match metric for multimodality image registration. However, its value is affected by interpolation, which may limit registration accuracy. The purpose of this study was to characterize the artifacts from eight interpolators and to investigate efficient strategies to overcome these artifacts. The interpolators were: 1) nearest neighbor; 2) linear; 3) cubic Catmull-Rom; 4) Hamming-windowed sinc; 5) partial volume; 6) NN with jittered sampling (JIT); 7) NN with histogram blurring (BLUR); and 8) NN with JIT and BLUR. The impact of interpolation on MI was evaluated in two dimensions over different translational and rotational misregistration. Interpolation caused spurious fluctuations in MI whenever the voxel grids had coinciding periodicities and were nearly aligned. The artifacts did not lessen by using intensity interpolators with wider support (e.g., cubic Catmull-Rom, Hamming-windowed sinc). PV could lead to either arch artifacts or inverted-arch artifacts, depending on the relative voxel sizes. Several strategies reduced artifacts and improved registration robustness: JIT, BLUR, avoiding an extreme number of intensity bins, and resampling the images in a rotated orientation with different relative voxel sizes (e.g., pi/3). These findings also apply to related methods, including normalized MI, joint entropy, and Hill's third moment.

Algorithms↗

Metal artifact reduction in CT using tissue-class modeling and adaptive prefiltering.

High-density objects such as metal prostheses, surgical clips, or dental fillings generate streak-like artifacts in computed tomography images. We present a novel method for metal artifact reduction by in-painting missing information into the corrupted sinogram. The information is provided by a tissue-class model extracted from the distorted image. To this end the image is first adaptively filtered to reduce the noise content and to smooth out streak artifacts. Consecutively, the image is segmented into different material classes using a clustering algorithm. The corrupted and missing information in the original sinogram is completed using the forward projected information from the tissue-class model. The performance of the correction method is assessed on phantom images. Clinical images featuring a broad spectrum of metal artifacts are studied. Phantom and clinical studies show that metal artifacts, such as streaks, are significantly reduced and shadows in the image are eliminated. Furthermore, the novel approach improves detectability of organ contours. This can be of great relevance, for instance, in radiation therapy planning, where images affected by metal artifacts may lead to suboptimal treatment plans.

Algorithms↗

Reduced partial volume artifacts using spiral computed tomography and an integrating interpolator.

A technique is described for obtaining computed tomography (CT) head images with significantly reduced partial volume artifacts while retaining excellent low contrast resolution. Partial volume artifacts could be reduced by narrowing the collimation and summing thin slices. However, in axial scans, the acquisition and reconstruction time required for generating all the thin slices would prove clinically impractical. In addition, image artifacts could occur due to patient motion during the scans, particularly in trauma cases. In the case of spiral CT, a narrow collimation along with a small pitch can be used to reduce partial volume artifacts. However, the time required to reconstruct and sum the thin slices is still prohibitive. In this paper, we present a spiral technique using an integrating spiral interpolator (ISI) that allows a head study to be performed in less time without the partial volume artifacts normally seen. Using this interpolator, thick slices can be prospectively reconstructed from a spiral scan with a narrow collimation. The slice sensitivity profile for this interpolator was obtained and the full width at half-maximum and full width at tenth-maximum values were compared with both axial and predicted values. Noise values were also measured and compared to axial and theoretical predictions. Using this ISI interpolator, high quality head images were obtained with significantly reduced partial volume artifacts compared to standard axial and spiral scans. Total acquisition time is less than that of standard contiguous axial head scans.

Artifacts↗

Pitfalls and artifacts encountered in clinical MR imaging of the spine.

Magnetic resonance (MR) imaging of the spine has become widely accepted as a valuable diagnostic tool. However, there are a number of artifacts and pitfalls associated with spinal MR imaging. Chemical shift artifacts may be induced by bone marrow, epidural fat, or intradural fat. Motion artifacts arise from several sources, which include respiration, flow of fluids, and swallowing. Artifacts due to a nonuniform magnetic field are particularly noticeable within trabecular bone or at bone-soft tissue interfaces but may also be caused by incomplete fat saturation or the presence of metal near the spine. Protocol errors may cause artifacts such as saturation, phase wraparound, truncation, radio-frequency interference, shading, and partial volume averaging. Use of fat saturation, use of motion and flow compensation, and careful screening of patients for metal in clothing can help reduce the occurrence of artifacts. In addition, use of an optimal imaging technique is essential and should include use of the proper surface coil, field of view, and pulse sequence.

Artifacts↗

Quality assurance in mammography: artifact analysis.

Evaluation of mammograms for artifacts is essential for mammographic quality assurance. A variety of mammographic artifacts (i.e., variations in mammographic density not caused by true attenuation differences) can occur and can create pseudolesions or mask true abnormalities. Many artifacts are readily identified, whereas others present a true diagnostic challenge. Factors that create artifacts may be related to the processor (eg, static, dirt or excessive developer buildup on the rollers, excessive roller pressure, damp film, scrapes and scratches, incomplete fixing, power failure, contaminated developer), the technologist (eg, improper film handling and loading, improper use of the mammography unit and related equipment, positioning and darkroom errors), the mammography unit (eg, failure of the collimation mirror to rotate, grid inhomogeneity, failure of the reciprocating grid to move, material in the tube housing, compression failure, improper alignment of the compression paddle with the Bucky tray, defective compression paddle), or the patient (e.g., motion, superimposed objects or substances [jewelry, body parts, clothing, hair, implanted medical devices, foreign bodies, substances on the skin]). Familiarity with the broad range of artifacts and the measures required to eliminate them is vital. Careful attention to darkroom cleanliness, care in film handling, regularly scheduled processor maintenance and chemical replenishment, daily quality assurance activities, and careful attention to detail during patient positioning and mammography can reduce or eliminate most mammographic artifacts.

Artifacts↗

Metallic artifacts on MR images of the postoperative spine: reduction with fast spin-echo techniques.

PURPOSE: To determine whether the relative insensitivity of T2-weighted fast spin-echo (FSE) techniques to magnetic susceptibility can be exploited to reduce metallic artifacts on images of the postoperative spine and, thus, improve the interpretation of the postoperative study. MATERIALS AND METHODS: Three neuroradiologists retrospectively evaluated sagittal T2-weighted conventional spin-echo and FSE images obtained in 15 patients with metallic artifacts from various sources including drill particles from anterior cervical diskectomy, posterior fixation wires, fixation rods or plates, and an inferior vena cava filter. The amount of artifact present and whether these artifacts affected image interpretation were evaluated. RESULTS: Among the 45 paired evaluations, the artifact was judged to be less apparent with FSE sequences in 39. In eight of 45 evaluations (18%), the interpretation of the area of interest was possible only on the FSE images. CONCLUSION: FSE imaging, especially when performed with shorter echo spacing, increases the amount of T2-weighted information in the presence of metallic artifact because it decreases magnetic susceptibility effects.

Artifacts↗

Stair-step artifacts in three-dimensional helical CT: an experimental study.

PURPOSE: Stair-step artifacts in helical computed tomography (CT) are associated with inclined surfaces in longitudinal sections. The authors investigated the origin and the characteristics of the artifacts. MATERIALS AND METHODS: A cone phantom and a skull were dry-scanned with a helical CT scanner, and images were reconstructed by using the half-scan interpolation algorithm with combinations of detector collimation (1 and 5 mm), table feed (1, 2, 5, and 10 mm), and reconstruction interval (1, 2, 5, and 10 mm). RESULTS: Stair-step artifacts were perceived in most instances. Stair-step artifacts arose from two sources: large reconstruction intervals and asymmetric helix interpolation, forming isoclosed curves and spirallike patterns in three-dimensional axial views, respectively. CONCLUSION: To eliminate the stair-step artifacts, both the collimation and the table feed should be less than the longitudinal dimension of the important feature on inclined surfaces, and the reconstruction interval should be less than the table feed. Adaptive interpolation may correct the artifacts.

Artifacts↗

Color Doppler twinkling artifact in hyperechoic regions.

PURPOSE: To investigate a new color Doppler ultrasound (US) artifact that manifested as a rapidly changing mixture of red and blue behind a strongly reflecting structure. MATERIALS AND METHODS: In 140 consecutive patients with parenchymal calcifications seen at US, the presence of color signal was assessed in calcified areas relative to adjacent noncalcified tissue. The artifact, called the twinkling color artifact, was stimulated with various strongly reflecting structures immersed in still water. RESULTS: The artifact was found in 42 parenchymal calcifications. In vitro experiments showed that the twinkling artifact was present in granular structures, whereas no color signal was noted in smooth surfaces. The "twinkling sign" appeared to be generated by a strongly reflecting medium composed of individual reflectors. CONCLUSION: The presence of a color signal close to calcifications should be interpreted with caution, and a flow spectrum should always be recorded to eliminate the twinkling artifact.

Artifacts↗

Gliomas: correlation of magnetic susceptibility artifact with histologic grade.

PURPOSE: To determine whether magnetic susceptibility artifact on magnetic resonance (MR) images can be used to grade gliomas. MATERIALS AND METHODS: Twenty-nine patients with gliomas were prospectively examined with spin-echo T1-weighted MR imaging without and with contrast material enhancement, spin-echo or fast spin-echo T2- and proton-density-weighted MR imaging, and gradient-echo T2*-weighted MR imaging. Images were reviewed by two neuroradiologists, and susceptibility artifacts in the tumor region were graded. Heterogeneity, mass effect, contrast enhancement, and necrosis were also graded. Tumors were graded according to the World Health Organization classification. RESULTS: Increased susceptibility artifact was detected by at least one observer on gradient-echo MR images of 19 tumors. This feature was seen on only 10 of the spin-echo or fast spin-echo T2-weighted MR images of lesions. Fifteen neoplasms with increased susceptibility artifact detected on MR images by at least one observer were high-grade lesions (anaplastic astrocytoma or glioblastoma multiforme). Lesion susceptibility artifact detected on T2*-weighted MR images was associated with tumor grade (P < .05). CONCLUSION: Susceptibility artifacts on T2*-weighted gradient-echo MR images appear to be valuable in the preoperative evaluation of gliomas.

Adult↗

Pitfalls, artifacts, and remedies in multi- detector row CT coronary angiography.

Coronary angiography is increasingly performed with multi-detector row computed tomography (CT) in the clinical setting. Successful use of this method, however, depends on the radiologist's knowledge of its potential pitfalls and familiarity with methods for minimizing or avoiding them. To identify artifacts and other pitfalls that commonly degrade image quality and that could result in misinterpretation, contrast-enhanced coronary angiograms acquired with a multi-detector row CT scanner with four detector rows in 110 consecutive patients were analyzed. The problems identified were classified into four broad categories: (a) motion-related artifacts caused by cardiac, pulmonary, or other body motion; (b) beam-hardening effects caused by metallic implants, severe calcifications, or air bubbles in the pulmonary artery that obscured the underlying coronary vessel lumen; (c) structural artifacts produced by adjacent contrast material-filled structures and overlying vessels; and (d) artifacts that resulted from technical errors or limitations. The most frequently observed artifacts were those related to cardiac motion. The most effective methods for minimizing cardiac motion artifacts are (a) premedication with beta-blockers to maintain optimal heart rate during scanning and (b) optimal selection of the reconstruction window.

Adrenergic beta-Antagonists↗

Calculus artifact. A challenge in urinary cytology.

OBJECTIVE: To retrospectively review calculus artifact and compare it with instrument artifact and papillary transitional cell carcinoma (TCC). STUDY DESIGN: Voided urine specimens from patients with calculi (65), TCC (low grade, 10, high grade, 34) and history of prior instrumentation (12) were studied. RESULTS: Nineteen specimens of calculus artifact had unremarkable cytology. Forty-six specimens had abnormal single cells or papillary clusters and cell balls or a mixture of both. The papillary groups had smooth as well as irregular borders, a cytoplasmic collar and cells with occasional cytoplasmic vacuoles, slightly increased nuclear/cytoplasmic (N/C) ratio and inconspicuous nucleoli. Squamous preponderance and birefringent crystals were seen. In instrumentation artifact, papillary clusters or three-dimensional cell balls had smooth borders, cytoplasmic collars, an occasional cytoplasmic vacuole, normal N/C ratio, regular nuclear membrane and finely granular nuclear chromatin. In TCC, papillary clusters with loss of polarity and irregular borders were present in both grades but were predominant in low grade TCC. No cytoplasmic collar was noted. In high grade TCC, single cells and nuclear alterations were more pronounced, with increased N/C ratio, hyperchromasia, coarse chromatin, irregular nuclear envelopes, prominent nucleoli and rare mitosis. CONCLUSION: Calculus artifact can produce papillary clusters masquerading as papillary TCC. Unlike instrument artifact, there may be significant nuclear atypia, which could be reversible. To avoid diagnostic pitfalls, further investigation is suggested after removal of calculus.

Artifacts↗

Artifacts from dental casting alloys in magnetic resonance imaging.

The potential advantage of magnetic resonance imaging (MRI) has been limited by artifacts due to the presence of metallic materials. For quantitative evaluation of the magnitude of artifacts from dental casting alloys and implant materials in MR imaging, 11 dental casting or implant materials were imaged by means of 1.5 T MRI apparatus with three different sequences. Mean and standard deviation of water signal intensity (SI) around the sample in the region of interest (1200 mm(2)) were determined, and the coefficient of variation was compared for evaluation of the homogeneity of the SI. A variety of artifacts with different magnitudes was observed. Only one of the samples, composed mainly of Pd, In, and Sb, showed no artifacts in all imaging sequences. We concluded that selection of specific dental casting alloys according to their elemental compositions could minimize the metal artifacts in MRI; however, titanium alloys currently pose a problem with respect to causing MRI artifacts.

Alloys↗

The problem of artifacts in patient monitor data during surgery: a clinical and methodological review.

Artifacts are a significant problem affecting the accurate display of information during surgery. They are also a source of false alarms. A secondary problem is the inadvertent recording of artifactual and inaccurate information in automated record keeping systems. Though most of the currently available patient monitors use techniques to minimize the effect of artifacts, their success is limited. We reviewed the problem of artifacts affecting patient monitor data during surgical cases. Methods adopted by currently marketed patient monitors to eliminate and minimize artifacts due to technical and environmental factors are reviewed and discussed. Also discussed are promising artifact detection and correction methods that are being investigated. These might be used to detect and eliminate artifacts with improved accuracy and specificity.

Artifacts↗

Differential transesophageal echocardiographic diagnosis between linear artifacts and intraluminal flap of aortic dissection or disruption.

BACKGROUND: The relatively low specificity of transesophageal echocardiography (TEE) for the diagnosis of aortic dissection (AD) or traumatic disruption of the aorta (TDA) has been attributed to linear artifacts. We sought to determine the incidence of intra-aortic linear artifacts in a cohort of patients with suspected AD or TDA, to establish the differential TEE diagnostic criteria between these artifacts and true aortic flaps, and to evaluate their impact on TEE diagnostic accuracy. METHODS AND RESULTS: During an 8-year period, patients at high risk of AD (n = 261) or TDA (n = 90) who underwent a TEE study and had confirmed final diagnoses were studied. In an initial retrospective series, linear artifacts were observed within the ascending and descending aorta in 59 of 230 patients (26%) and 17 of 230 patients (7%), respectively. TEE findings associated with linear artifacts in the ascending aorta were as follows: displacement parallel to aortic walls; similar blood flow velocities on both sides; angle with the aortic wall > 85 degrees; and thickness > 2.5 mm. Diagnostic criteria of reverberant images in the descending aorta were as follows: displacement parallel to aortic walls, overimposition of blood flow, and similar blood flow velocities on both sides of the image. In a subsequent prospective series (n = 121), systematic use of these diagnostic criteria resulted in improved TEE specificity for the identification of true intra-aortic flaps. CONCLUSIONS: Misleading intra-aortic linear artifacts are frequently observed in patients undergoing a TEE study for suspected AD or TDA. Routine use of the herein-proposed diagnostic criteria promises to further improve TEE diagnostic accuracy in the setting of severely ill patients with potential need for prompt surgery.

Adolescent↗