Methemoglobin suppression in T2-weighted pulse sequences: an adjunctive technique in MR imaging of hemorrhagic tumors.
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OBJECTIVE: The purpose of this study is to compare ultrashort TR, segmented trueFISP (fast imaging with steady-state precession) cine MR imaging with segmented FLASH (fast low-angle shot) cine MR imaging for the detection and characterization of congenital and acquired adult cardiac abnormalities. SUBJECTS AND METHODS: Twenty-five patients with known or clinically suspected cardiac abnormalities were imaged on a 1.5-T scanner. Valve plane movies were obtained in patients with suspected valve morphology or function abnormalities or whose horizontal long-axis images showed jets. For each patient, three radiologists independently compared corresponding matched cine FLASH and trueFISP movies for image quality in evaluating anatomy and function of the great vessels and heart. Image quality was rated on a five-point scale, and data were analyzed using both a Wilcoxon's signed rank test and a repeated-measures analysis of variance. RESULTS: Image quality ratings of trueFISP and FLASH showed a statistically significant difference (F = 58.67; df = 1, 72; p < 0.0001), with the average rating for the trueFISP images being significantly higher (mean rating, 4.1 +/- 0.92) than that for the FLASH images (mean, 3.0 +/- 1.0). However, valve architecture in the aortic valves appeared to be better visualized and was more easily measured in valve plane images with FLASH. No statistically significant differences among the ratings of the interpreters (F = 0.018; df = 2, 72; p = 0.9821) were evident, and, therefore, no suggestion of bias was indicated (F = 0.775; df = 1, 2; p = 0.4645). TrueFISP yielded the correct diagnosis prospectively in 13 (100%) of 13 patients, whereas FLASH yielded the correct diagnosis in 12 (92%) of 13 patients. CONCLUSION: TrueFISP images depict morphologic and functional abnormalities with greater clarity and provide greater diagnostic confidence than FLASH images-and in a fraction of the time. A specific exception is in the assessment of valve leaflet architecture and cross-sectional area calculation (i.e., bicuspid aortic valves); in these evaluations, FLASH maintains a complementary diagnostic imaging role.
PURPOSE: To develop a method for making three-dimensional (3D) reconstructions of liver vessels and hepatic lesions from different MR data sets. MATERIAL AND METHODS: To reduce the time required for segmentation and reconstructions, we used T1, T2 and phase contrast angiography, optimised for liver, lesion and vessels respectively. Following segmentation and reconstruction, the different volumes were combined on the same workstation and presented to the surgeon. RESULTS AND CONCLUSION: Segmentation and reconstruction took 1-2 h. To be able to combine the volumes from the different data sets, certain criteria had to be fulfilled: a) the field of view had to be constant; b) the same volume had to be scanned every time which meant that the slice thickness and the number of slices could be adjusted as long as the volume covered was the same; and c) the positioning of each volume had to be identical between every scan. The resulting 3D reconstruction gave the surgeon a clear appreciation of the different lesions and their relation to the different liver segments in the pre-operative planning of hepatic resections.
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The purpose of this retrospective MRI work was to evaluate the use of turbo gradient spin echo (TGSE) high resolution imaging for the detection of eighth nerve schwannomas, without injection of gadolinium. The TGSE sequence (slice thickness: 3 mm with 1.5 mm interleaving; matrix: 512) was compared with a reference sequence: T1-weighted spin echo (SE) after gadolinium injection (slice thickness: 3 mm, matrix: 256). Among 380 internal auditory meatus (IAM) explored, 34 abnormalities were detected on T2-weighted TGSE images compared with 19 on contrast-enhanced T1-weighted SE images. This new sequence has a 100% sensitivity, a 96% specificity and a 100% negative predictive value. Using a rigorous protocol for IAM analysis with the TGSE sequence, gadolinium injection may no longer be needed systematically for vestibular schwannoma screening, but might only be necessary when an abnormality or a doubt persists after TGSE. This approach allows about 20% cost reduction for each patient, a savings of 11,433 euros considering only the true negatives observed in this study.
MR imaging at 0.6 T was performed in 22 patients with acute (less than 7 days) intracranial hemorrhage to determine the efficacy of prolongation of the interecho interval, which has been demonstrated to enhance T2 shortening in vitro, as a method to improve the detection of hemorrhage in clinical imaging. The protocol included 750/33 (TR/TE), 2150/60,120 (short interecho interval of 60 msec), and 2150/120 (long interecho interval of 120 msec) sequences. Visual comparisons of the 2150/120 images obtained with the short and long interecho intervals demonstrated no difference in the degree of hypointensity in 21 of 22 cases. Quantitative comparisons demonstrated no statistically significant difference in the degree of maximal hypointensity, in the ease of detectability of hypointensity, or in the overall image contrast in 16 of 22 cases. We conclude that prolongation of the interecho interval is not a clinically useful technique to improve the detection of acute hemorrhage.
To obtain a fast MRI sequence for detection of liver metastases under suspended respiration, two healthy volunteers were examined with the field echo sequence FLASH, using a large number of repetition times, echo times, flip angels and matrix sizes. The spleen was used to simulate liver metastases and contrast-to-noise ratios between liver and spleen were calculated and the sequence with the highest ratio was considered optimal. The different FLASH sequences were also compared with spin echo sequences using short repetition and echo times. A FLASH sequence with a repetition time of 140 ms, an echo time of 14 ms, a flip angle of 80 to 100 degrees and a matrix size of 128 x 256 was considered the most suitable for detecting liver metastases. This sequence, together with other FLASH and spin echo sequences, were used for examination of five patients with liver metastases from endocrine gastrointestinal tumours.
The magnetic resonance (MR) appearance of carotid body tumors has been previously described. Classically, these lesions are well circumscribed and highly vascular and cause a characteristic separation of the external and internal carotid arteries. Hypointense foci within these tumors are seen on T1-weighted images. The T2-weighted images snow a "salt and pepper" pattern. We report a carotid bifurcation glomus tumor that exhibited the above features on conventional MR. Multiplanar gadolinium enhanced MR as well as flow-sensitive MR techniques including small flip angle gradient refocused images and MR angiography were performed. Magnetic resonance angiography demonstrated the abnormal morphology of the carotid bifurcation. Axial gradient refocused images revealed evidence of flow within the lesion. The findings were then correlated with postcontrast CT, arterial digital subtraction angiography, and histopathology.
Seventy-one patients having clinical laboratory findings consistent with multiple sclerosis (MS) were imaged with a 1.5 tesla MR instrument using multiple spin echo sequences (TR = 2,000 ms and TE = 30, 60, 90, 120 ms). Multiple spin echo is a sensitive method for detecting MS lesions. Sixty-seven patients (94%) demonstrated lesions consistent with MS. With the exception of those located in the cortex, optic nerve and chiasm the lesions detected correlated with pathologic data. Lesions of the cerebral hemispheres, corpus callosum and cerebellum were generally multiple while lesions of the brain stem and optic tracts were generally singular. The majority of the lesions were associated with the white matter tracts of the cerebral hemispheres and brain stem.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report preliminary results applying fluid-attenuated inversion-recovery (FLAIR) sequences to three patients with acute subarachnoid hemorrhage. Acute subarachnoid hemorrhage could be clearly demonstrated as areas of high signal intensity on FLAIR sequences in all patients. These preliminary results suggest that with FLAIR sequences one could reliably diagnose acute subarachnoid hemorrhage.