Magnetic Resonance in Medical Sciences
Online ISSN : 1880-2206
Print ISSN : 1347-3182
ISSN-L : 1347-3182
Volume 18 , Issue 2
Showing 1-13 articles out of 13 articles from the selected issue
Clinical Images
Major Papers
  • Takayuki Tamura, Miyuki Takasu, Toru Higaki, Kazushi Yokomachi, Yuji A ...
    2019 Volume 18 Issue 2 Pages 119-125
    Published: 2019
    Released: April 10, 2019
    [Advance publication] Released: July 13, 2018
    JOURNALS OPEN ACCESS

    Purpose: The aim of this study was to compare the tumor conspicuity on actual measured diffusion-weighted images (aDWIs) and computed DWI (cDWI) of human breast tumors and to examine, by use of a phantom, whether cDWI improves their conspicuity.

    Materials and Methods: We acquired DWIs (b-value 0, 700, 1400, 2100, 2800, and 3500 s/mm2) of 148 women with breast tumors. cDWIs with b-values of 1400, 2100, 2800, and 3500 s/mm2 were calculated from aDWI scans where b = 0 and 700 s/mm2; the tumor signal-to-noise ratio (SNR) was compared at each b-value. We also subjected a phantom harboring a breast tumor and mammary glands to DWI. For reference we used two models. The model with b = 0, 1000, 1500, 2000, 2500, and 3000 s/mm2 was our multiple b-value model. In the single b-value model, we applied b = 0 and 1000 s/mm2 and changed the number of excitations (NEX). cDWIs were generated at b = 0 and 1000 and used to compare the SNR, the contrast ratio (CR), and the contrast-to-noise ratio (CNR).

    Results: In the phantom study, the CNR of cDWI generated from high SNR images obtained at lower b-values and a high NEX was outperformed aDWI. However, the CR and CNR on cDWI obtained using the same scanning parameters were inferior to aDWI scans. Similarly, in the clinical study, breast tumor conspicuity was worse on high b-value cDWIs than aDWIs.

    Conclusion: To improve tumor conspicuity on cDWI, the quality of the source images must be improved. It may easily cause inferior conspicuity to aDWIs if high b-value cDWIs were generated from insufficient SNR images.

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  • Koung Mi Kang, Seung Hong Choi, Hyeonjin Kim, Moonjung Hwang, Roh-Eul ...
    2019 Volume 18 Issue 2 Pages 126-133
    Published: 2019
    Released: April 10, 2019
    [Advance publication] Released: July 06, 2018
    JOURNALS OPEN ACCESS

    Purpose: The purpose of our study was to investigate the effect of different slice thicknesses and/or interslice gaps on longitudinal and transverse relaxation times (T1 and T2) measured by a multi-dynamic, multi-echo (MDME) sequence.

    Materials and Methods: This retrospective study included nine healthy subjects who underwent MDME sequence (at 3T) with four different combinations of slice thicknesses and/or interslice gaps: slice thickness of 4 mm and interslice gap of 0 mm (TH4/G0), TH4/G1, TH5/G0, and TH5/G1. T1 and T2 were measured in various brain regions by a qualified neuroradiologist with 8 years of clinical experience: the frontal white matter (WM), occipital WM, genu, splenium, frontal cortex, thalamus, putamen, caudate head, and cerebrospinal fluid (CSF). The paired samples t-test was used to investigate the effect of different slice thicknesses and interslice gaps (TH4/G0 versus TH4/G1 and TH5/G0 versus TH5/G1). P < 0.013 was considered statistically significant.

    Results: T2 in all brain regions and T1 in the frontal WM, putamen, and CSF did not significantly change for different slice thicknesses and/or gaps (Ps > 0.013). In addition, T1 in all brain regions of interest did not significantly change between TH4/G0, TH4/G1, TH5/G0 and TH5/G1. However, T1 in some of the brain regions was higher with TH4/G0 than with TH5/G0 (occipital WM, frontal cortex, and caudate head) and with TH4/G1 than with TH5/G1 (occipital WM, genu, splenium and thalamus, all Ps < 0.013).

    Conclusion: T2 estimated using the MDME sequence was stable regardless of slice thickness or gap. Although the sequence seems to provide stable relaxation values, identical slice thicknesses need to be used for follow-up to prevent potential T1 changes.

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  • Yasuka Kikuchi, Masanao Naya, Noriko Oyama-Manabe, Osamu Manabe, Hiroy ...
    2019 Volume 18 Issue 2 Pages 134-141
    Published: 2019
    Released: April 10, 2019
    [Advance publication] Released: July 26, 2018
    JOURNALS OPEN ACCESS

    Purpose: The aim of this study was to verify coronary flow velocity reserve (CFVR) on the left main trunk (LMT) in comparison with myocardial flow reserve (MFR) by 15O-labeled water positron emission tomography (PET) (MFR-PET) in both the healthy adults and the patients with coronary artery disease (CAD), and to evaluate the feasibility of CFVR to detect CAD.

    Methods: Eighteen healthy adults and 13 patients with CAD were evaluated. CFVR in LMT was estimated by 3T magnetic resonance imaging (MRI) with phase contrast technique. MFR-PET in the LMT territory including anterior descending artery and circumflex artery was calculated as the ratio of myocardial blood flow (MBF)-PET at stress to MBF-PET at rest.

    Results: There was a significant positive relationship between CFVR and MFR-PET (R = 0.45, P < 0.0001). Inter-observer calculations of CFVR showed good correlation (R2 = 0.93, P < 0.0001). The CFVR in patients with CAD was significantly lower than that in healthy adults (1.90 ± 0.61 vs. 2.77 ± 1.03, respectively, P = 0.01), which were similar to the results of MFR-PET (2.23 ± 0.84 vs. 3.96 ± 1.04, respectively, P < 0.0001). For the detection of patients with CAD, the area under the curve was 0.78 (P = 0.01). The sensitivity was 0.77 and specificity was 0.72 when a cut-off of 2.15 was used.

    Conclusion: CFVR by 3T was validated with MFR-PET. CFVR could detect the patients with CAD. This method is a simple and reliable index without radiation or contrast material.

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  • Akihiro Nishie, Osamu Togao, Chihiro Tamura, Mayumi Yamato, Kazuhiro I ...
    2019 Volume 18 Issue 2 Pages 142-149
    Published: 2019
    Released: April 10, 2019
    [Advance publication] Released: October 02, 2018
    JOURNALS OPEN ACCESS

    Purpose: To investigate the binding potential of newly developed Annexin V-conjugated ultrasmall superparamagnetic iron oxide (V-USPIO) for detection of drug-induced apoptosis in vitro and in vivo.

    Methods: Apoptotic cells induced by camptothecin were incubated with or without Annexin V-USPIO at a concentration of 0.089 mmol Fe/L in vitro. T2 values of the two cell suspensions were measured by 0.47T nuclear magnetic resonance (NMR) spectrometer. Tumor-bearing mice were subjected to 1.5T MR scanner at 2 h after intraperitoneal injection of etoposide and cyclophosphamide. Following the pre-contrast T1- and T2-weighted imaging (0 h), the post-contrast scan was performed at 2, 4, 6 and 24 h after intravenous injection of Annexin V-USPIO (100 μmol Fe/kg). As a control, MRI was also obtained at 4 h after injection of USPIO without Annexin V. The ratio of tumor signal intensity (SI) on post-MRI for that on pre-MRI (Post/Pre-SI ratio) was calculated. After scanning, tumors were resected for pathological analysis to evaluate the distribution of iron and apoptotic cells.

    Results: The suspension of apoptotic cells incubated with Annexin V-USPIO showed shorter T2 value than that without it. On T1-weighted imaging post/pre-SI ratio at 4 h after injection of Annexin V-USPIO showed 1.46, while after injection of USPIO without Annexin V was 1.17. The similar distribution of iron and apoptotic cells was observed in concordance with high signal intensity area on post-T1-weighted imaging.

    Conclusion: A newly developed Annexin V-USPIO could have the potential for detection of drug-induced apoptosis.

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  • Michael J. Ho, Alexander Ciritsis, Andrei Manoliu, Bram Stieltjes, Mag ...
    2019 Volume 18 Issue 2 Pages 150-157
    Published: 2019
    Released: April 10, 2019
    [Advance publication] Released: November 09, 2018
    JOURNALS OPEN ACCESS

    Purpose: Diffusion tensor imaging (DTI) adds functional information to morphological magnetic resonance neurography (MRN) in the assessment of the brachial nerve plexus. To determine the most appropriate pulse sequence in scan times suited for diagnostic imaging in clinical routine, we compared image quality between simultaneous multi-slice readout-segmented (rs-DTI) and conventional single-shot (ss-DTI) echo-planar imaging techniques.

    Methods: Institutional Review Board (IRB) approved study including 10 healthy volunteers. The supraclavicular brachial plexus, covering the nerve roots and trunks from C5 to C7, was imaged on both sides with rs-DTI and ss-DTI. Both sequences were acquired in scan times <7 min with b-values of 900 s/mm2 and with isotropic spatial resolution.

    Results: In rs-DTI image, the overall quality was significantly better and distortion artifacts were significantly lower (P = 0.001–0.002 and P = 0.001–0.002, respectively) for both readers. In ss-DTI, a trend toward lower degree of ghosting and motion artifacts was elicited (reader 1, P = 0.121; reader 2, P = 0.264). No significant differences between the two DTI techniques were found for signal-to-noise ratios (SNR), contrast-to-noise ratios (CNR) and fractional anisotropy (FA) (P ≥ 0.475, P ≥ 0.624, and P ≥ 0.169, respectively). Interreader agreement for all examined parameters and all sequences ranged from intraclass correlation coefficient (ICC) 0.064 to 0.905 and Kappa 0.40 to 0.851.

    Conclusion: Incomparable acquisition times rs-DTI showed higher image quality and less distortion artifacts than ss-DTI. The trend toward a higher degree of ghosting and motion artifacts in rs-DTI did not deteriorate image quality to a significant degree. Thus, rs-DTI should be considered for functional MRN of the brachial plexus.

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  • Mayumi Takeuchi, Kenji Matsuzaki, Yoshimi Bando, Masafumi Harada
    2019 Volume 18 Issue 2 Pages 158-162
    Published: 2019
    Released: April 10, 2019
    [Advance publication] Released: October 01, 2018
    JOURNALS OPEN ACCESS

    Purpose: Red degeneration of uterine leiomyoma (RDL) is a hemorrhagic infarction caused by peripheral venous thrombosis. The peripheral high-intensity rim on T1-weighted MRI is characteristic for RDL; however, it may not be observed at all the phases of RDL. Susceptibility-weighted MR sequences (SWS) have exquisite sensitivity to blood products, and we hypothesized that the low-intensity rim due to the T2* shortening effects of blood products may be more clearly demonstrated on SWS. The purpose of this study is to evaluate the capability of SWS for the diagnosis of RDL.

    Methods: Surgically proven 15 RDL, which showed suggestive MRI findings (high-intensity rim or entirely high signal intensity on T1-weighted imaging) were retrospectively evaluated. MRI was qualitatively evaluated for the presence of high-intensity rim around a mass on fat-saturated T1-weighted images, and low-intensity rim on T2-weighted images and on SWS (susceptibility-weighted imaging [SWI] or T2-star-weighted angiography [SWAN]).

    Results: The high-intensity rim on T1-weighted images, low-intensity rim on T2-weighted images and on SWS were observed in 47%, 47%, and 100% of RDL, respectively. The other 53% of lesions showed entirely high signal intensity on T1-weighted images. Pathological examination revealed coagulative necrosis in all 15 lesions.

    Conclusion: SWS may be helpful for the diagnosis of RDL by revealing characteristic peripheral low-intensity rim.

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  • Shinji Naganawa, Toshiki Nakane, Hisashi Kawai, Toshiaki Taoka
    2019 Volume 18 Issue 2 Pages 163-169
    Published: 2019
    Released: April 10, 2019
    [Advance publication] Released: November 05, 2018
    JOURNALS OPEN ACCESS

    Purpose: It has been reported that intravenously administered gadolinium-based contrast agents (IV-GBCAs) leak into the cerebrospinal fluid (CSF) even in healthy subjects. The purpose of this study was to evaluate GBCA leakage from the cortical veins in patients with delayed imaging after IV-GBCA.

    Materials and Methods: There are two parts of retrospective study. In the first part, we reviewed six patients with suspected endolymphatic hydrops (EH) who received a single dose of IV-GBCA (37–58 years old). The 3D-real inversion recovery images were obtained prior to the contrast administration as well as 5 min and 4 h after IV-GBCA. Leakage from the cortical veins to the CSF was graded as positive if enhancement around the cortical veins at 5 min was observed and had further spread into the CSF at 4 h after IV-GBCA.

    In the second part of this study, we reviewed 21 patients with suspected EH (17–69 years old). Images were obtained only at 4 h after IV-GBCA. The number of slices (NOS) with a positive GBCA leakage from the cortical veins was counted. The correlation of the NOS with age, gender, and degree of EH was evaluated by Spearman’s rank correlation coefficient.

    Results: In the first part of the study, the GBCA leakage from the cortical veins was positive in all patients. In the second part of the study, the GBCA leakage from the cortical veins was seen in all older patients (above 37 years old), but not in the five younger patients (younger than 37 years old). The NOS correlated significantly only with age (r = 0.755, P < 0.01), but not with gender or degree of EH.

    Conclusion: IV-GBCA leaks from the cortical veins into the surrounding CSF. The leakiness of the cortical veins significantly correlated with age, but not with gender or degree of EH.

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