Magnetic Resonance in Medical Sciences
Online ISSN : 1880-2206
Print ISSN : 1347-3182
ISSN-L : 1347-3182
Advance online publication
Displaying 1-38 of 38 articles from this issue
  • Chiaki Tokunaga, Tatsuhiro Wada, Osamu Togao, Yasuo Yamashita, Kouji K ...
    Article ID: mp.2021-0109
    Published: 2022
    Advance online publication: September 01, 2022
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    Purpose: Amide proton transfer (APT) imaging may detect changes in tissues’ pH based on the chemical exchange saturation transfer (CEST) phenomenon, and thus it may be useful for identifying the penumbra in ischemic stroke patients. We investigated the effect of saturation pulse duration and power on the APT effect in phantoms with different pH values.

    Methods: Five samples were prepared from a 1:10 solution of egg-white albumin in phosphate-buffered saline at pH 6.53–7.65. The APT signal intensity (SI) was defined as asymmetry of the magnetization transfer ratio at 3.5 ppm. We measured the APT SIs in the egg-white albumin samples of different pH values with saturation pulse durations of 0.5, 1.0, 2.0, and 3.0 sec and saturation pulse powers of 0.5, 1.5, and 2.5 μT. The relative change in the APT SI in relation to the saturation duration and power at different pH values was defined as follows: (APT SI each saturation pulse − APT SI shortest or weakest pulse)/APT SIshortest or weakest pulse. The dependence of the APT SI on pH and the relative change in the APT SI were calculated as the slope of the linear regression.

    Results: The lower the pH, the larger the relative change in the APT SI, due to the change in saturation pulse duration and power. The APT SI was highly correlated with the pH at all saturation pulse durations and powers.

    Conclusion: The influence of saturation duration and power on the APT effect was greater at lower pH than higher pH. The combination of saturation pulse ≥ 1.0 s and power ≥ 1.5 μT was useful for the sensitive detection of changes in APT effects in the egg-white albumin samples with different pH values.

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  • Kazuki Oyama, Fumihito Ichinohe, Akira Yamada, Yoshihiro Kitoh, Yasuo ...
    Article ID: mp.2022-0035
    Published: 2022
    Advance online publication: August 23, 2022
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    Purpose: The optimal temporal resolution for free-breathing dynamic contrast-enhanced MRI (FBDCE-MRI) of the pancreas has not been determined. This study aimed to evaluate the appropriate temporal resolution to achieve good image quality and to perform pharmacokinetic analysis in FBDCE-MRI of the pancreas using golden-angle radial sparse parallel (GRASP).

    Methods: Sixteen participants (53 ± 15 years, eight females) undergoing FBDCE-MRI were included in this prospective study. Images were retrospectively reconstructed at four temporal resolutions (1.8, 3.0, 4.8, and 7.8s). Two radiologists (5 years of experience) evaluated the image quality of each reconstructed image by assessing the visualization of the celiac artery (CEA), the common hepatic artery, the splenic artery, each area of the pancreas, and artifacts using a 5-point scale. Using Tissue-4D, pharmacokinetic parameters were calculated for each area in the reconstructed images at each temporal resolution for 16 examinations, excluding two with errors in the pharmacokinetic modeling analysis. Friedman and Bonferroni tests were used for analysis. A P value < 0.05 was considered statistically significant.

    Results: During vascular assessment, only scores for the CEA at 7.8s were significantly lower than the other temporal resolutions. Scores of all pancreatic regions and artifacts were significantly lower at 1.8s than at 4.8s and 7.8s. In the pharmacokinetic analysis, all volume transfer coefficients (Ktrans), rate constants (Kep), and the initial area under the concentration curve (iAUC) in the pancreatic head and tail were significantly lower at 4.8s and 7.8s than at 1.8s. iAUC in the pancreatic body and extracellular extravascular volume fraction (Ve) in the pancreatic head were significantly lower at 7.8s than at 1.8s.

    Conclusion: A temporal resolution of 3.0s is appropriate to achieve image quality and perform pharmacokinetic analysis in FBDCE-MRI of the pancreas using GRASP.

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  • Maya Honda, Mami Iima, Masako Kataoka, Yasuhiro Fukushima, Rie Ota, Ak ...
    Article ID: mp.2022-0060
    Published: 2022
    Advance online publication: August 03, 2022
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    Purpose: To investigate whether intravoxel incoherent motion (IVIM) and/or non-Gaussian diffusion parameters are associated with distant disease-free survival (DDFS) in patients with invasive breast cancer.

    Methods: From May 2013 to March 2015, 101 patients (mean age 60.0, range 28–88) with invasive breast cancer were evaluated prospectively. IVIM parameters (flowing blood volume fraction [fIVIM] and pseudodiffusion coefficient [D*]) and non-Gaussian diffusion parameters (theoretical apparent diffusion coefficient [ADC] at a b value of 0 s/mm2 [ADC0] and kurtosis [K]) were estimated using a diffusion-weighted imaging series of 16 b values up to 2500 s/mm2. Shifted ADC values (sADC200–1500) and standard ADC values (ADC0–800) were also calculated. The Kaplan–Meier method was used to generate survival analyses for DDFS, which were compared using the log-rank test. Univariable Cox proportional hazards models were used to assess any associations between each parameter and distant metastasis-free survival.

    Results: The median observation period was 80 months (range, 35–92 months). Among the 101 patients, 12 (11.9%) developed distant metastasis, with a median time to metastasis of 79 months (range, 10–92 months). Kaplan–Meier analysis showed that DDFS was significantly shorter in patients with K > 0.98 than in those with K ≤ 0.98 (P = 0.04). Cox regression analysis showed a marginal statistical association between K and distant metastasis-free survival (P = 0.05).

    Conclusion: Non-Gaussian diffusion may be associated with prognosis in invasive breast cancer. A higher K may be a marker to help identify patients at an elevated risk of distant metastasis, which could guide subsequent treatment.

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  • Yo Taniguchi, Suguru Yokosawa, Toru Shirai, Ryota Sato, Tomoki Amemiya ...
    Article ID: mp.2021-0045
    Published: 2022
    Advance online publication: July 30, 2022
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    Purpose: MR parameter mapping is a technique that obtains distributions of parameters such as relaxation time and proton density (PD) and is starting to be used for disease quantification in clinical diagnoses. Quantitative susceptibility mapping is also promising for the early diagnosis of brain disorders such as degenerative neurological disorders. Therefore, we developed an MR quantitative parameter mapping (QPM) method to map four tissue-related parameters (T1, T2*, PD, and susceptibility) and B1 simultaneously by using a 3D partially RF-spoiled gradient echo (pRSGE). We verified the accuracy and repeatability of QPM in phantom and volunteer experiments.

    Methods: Tissue-related parameters are estimated by varying four scan parameters of the 3D pRSGE: flip angle, RF-pulse phase increment, TR and TE, performing multiple image scans, and finding a least-squares fit for an intensity function (which expresses the relationship between the scan parameters and intensity values). The intensity function is analytically complex, but by using a Bloch simulation to create it numerically, the least-squares fitting can be used to estimate the quantitative values. This has the advantage of shortening the image-reconstruction processing time needed to estimate the quantitative values than with methods using pattern matching.

    Results: A 1.1-mm isotropic resolution scan covering the whole brain was completed with a scan time of approximately 12 minutes, and the reconstruction time using a GPU was approximately 1 minute. The phantom experiments confirmed that both the accuracy and repeatability of the quantitative values were high. The volunteer scans also confirmed that the accuracy of the quantitative values was comparable to that of conventional methods.

    Conclusion: The proposed QPM method can map T1, T2*, PD, susceptibility, and B1 simultaneously within a scan time that can be applied to human subjects.

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  • Hiroyuki Akai, Koichiro Yasaka, Haruto Sugawara, Taku Tajima, Masaaki ...
    Article ID: mp.2022-0020
    Published: 2022
    Advance online publication: July 09, 2022
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    Supplementary material

    Purpose: This study aimed to evaluate whether the image quality of 1.5T magnetic resonance imaging (MRI) of the knee is equal to or higher than that of 3T MRI by applying deep learning reconstruction (DLR).

    Methods: Proton density-weighted images of the right knee of 27 healthy volunteers were obtained by 3T and 1.5T MRI scanners using similar imaging parameters (21 for high resolution image and 6 for normal resolution image). Commercially available DLR was applied to the 1.5T images to obtain 1.5T/DLR images. The 3T and 1.5T/DLR images were compared subjectively for visibility of structures, image noise, artifacts, and overall diagnostic acceptability and objectively. One-way ANOVA and Friedman tests were used for the statistical analyses.

    Results: For the high resolution images, all of the anatomical structures, except for bone, were depicted significantly better on the 1.5T/DLR compared with 3T images. Image noise scored statistically lower and overall diagnostic acceptability scored higher on the 1.5T/DLR images. The contrast between lateral meniscus and articular cartilage of the 1.5T/DLR images was significantly higher (5.89 ± 1.30 vs. 4.34 ± 0.87, P < 0.001), and also the contrast between medial meniscus and articular cartilage of the 1.5T/DLR images was significantly higher (5.12 ± 0.93 vs. 3.87 ± 0.56, P < 0.001). Similar image quality improvement by DLR was observed for the normal resolution images.

    Conclusion: The 1.5T/DLR images can achieve less noise, more precise visualization of the meniscus and ligaments, and higher overall image quality compared with the 3T images acquired using a similar protocol.

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  • Yuta Endo, Kuninori Kobayashi, Haruna Shibo, Makoto Amanuma, Shigehide ...
    Article ID: tn.2022-0013
    Published: 2022
    Advance online publication: June 23, 2022
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    We analyzed modified Look-Locker inversion recovery (MOLLI) T1 measurements by applying a dictionary matching strategy and aimed to acquire T1 measurements more accurately than those acquired by the conventional three-parameter matching analysis. We particularly clarified the robustness of this method for measuring heart rate (HR) variability. A phantom experiment using a 3T MRI system was performed for various HRs. The ideal MOLLI signal corresponding to the scan parameter in the MRI experiment was simulated over a wide range of T1 values according to the dictionary. The unknown T1 values were determined by finding the simulated signals in the dictionary corresponding to the measured signals using pattern matching. The measured T1 values showed that the proposed analysis improved the accuracy of T1 measurements compared to those acquired by traditional analysis by up to 10%. In addition, the variability of measurements at several HRs was reduced by up to 100 ms.

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  • Ying Yang, Kuanghui Xu, Xiaofei Chen, Jianping Ding, Junping Shi, Jie ...
    Article ID: mp.2021-0168
    Published: 2022
    Advance online publication: June 07, 2022
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    Purpose: The Multi-echo Dixon (ME-Dixon) is a non-invasive quantitative MRI technique to diagnose non-alcoholic fatty liver disease (NAFLD). In this study, the hydrogen proton MR spectroscopy (1H-MRS) was used as a reference to explore the accuracy of the ME-Dixon technique in evaluating hepatic steatosis in NAFLD patients after ingesting formulated food and its correlation with changes in clinical indicators.

    Methods: Twenty-seven patients with NAFLD were enrolled. Fifteen patients completed 12 weeks of treatment with prebiotics and dietary fiber. In addition, abdominal MRI scans and blood tests were performed before and after treatment. The MRI-proton density fat fraction (MRI-PDFF) and MRS-PDFF were measured using the ME-Dixon and 1H-MRS techniques. The Bland–Altman method and Pearson correlation analysis were used to test the consistency of the two techniques for measuring the liver fat content and the changed values. Besides, correlation analysis was conducted between the MRI-PDFF value and metabolic indicators.

    Results: In the PDFF quantification of 42 person-times and the monitoring of the PDFF change in 15 patients under treatment, there was a good consistency and a correlation between MRI and MRS. At baseline, MRI-PDFF was positively correlated with insulin resistance index (HOMA-IR), fatty liver index (FLI), and liver enzymes. After treatment, the changes in MRI-PDFF were positively correlated with the recovery degree of FLI and liver enzymes.

    Conclusion: ME-Dixon has a good consistency and a correlation with MRS in quantifying the liver fat content and monitoring the treatment effect, which may be used as an accurate indicator for clinical monitoring of changes in the liver fat content.

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  • Shota Kondo, Yuko Nakamura, Toru Higaki, Takashi Nishihara, Masahiro T ...
    Article ID: mp.2022-0041
    Published: 2022
    Advance online publication: June 01, 2022
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    Supplementary material

    Purpose: The wavelet denoising with geometry factor weighting (g-denoising) method can reduce the image noise by adapting to spatially varying noise levels induced by parallel imaging. The aim of this study was to investigate the clinical applicability of g-denoising on hepatobiliary-phase (HBP) images with gadoxetic acid.

    Methods: We subjected 53 patients suspected of harboring hepatic neoplastic lesions to gadoxetic acid-enhanced HBP imaging with and without g-denoising (g+HBP and gHBP). The matrix size was reduced for g+HBP images to avoid prolonging the scanning time. Two radiologists calculated the SNR, the portal vein-, and paraspinal muscle contrast-to-noise ratio (CNR) relative to the hepatic parenchyma (liver-to-portal vein- and liver-to-muscle CNR). Two other radiologists independently graded the sharpness of the liver edge, the visibility of intrahepatic vessels, the image noise, the homogeneity of liver parenchyma, and the overall image quality using a 5-point scale. Differences between gHBP and g+HBP images were determined with the two-sided Wilcoxon signed-rank test.

    Results: The liver-to-portal- and liver-to-muscle CNR and the SNR were significantly higher on g+HBP- than gHBP images (P < 0.01), as was the qualitative score for the image noise, homogeneity of liver parenchyma, and overall image quality (P < 0.01). Although there were no significant differences in the scores for the sharpness of the liver edge or the score assigned for the visibility of intrahepatic vessels (P = 0.05, 0.43), with g+HBP the score was lower in three patients for the sharpness of the liver edge and in six patients for the visibility of intrahepatic vessels.

    Conclusion: At gadoxetic acid-enhanced HBP imaging, g-denoising yielded a better image quality than conventional HBP imaging although the anatomic details may be degraded.

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  • Yushi Tsujita, Keitaro Sofue, Eisuke Ueshima, Yoshiko Ueno, Masatoshi ...
    Article ID: rev.2021-0152
    Published: 2022
    Advance online publication: May 18, 2022
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    Viral hepatitis was previously the most common cause of chronic liver disease. However, in recent years, nonalcoholic fatty liver disease (NAFLD) cases have been increasing, especially in developed countries. NAFLD is histologically characterized by fat, fibrosis, and inflammation in the liver, eventually leading to cirrhosis and hepatocellular carcinoma. Although biopsy is the gold standard for the assessment of the liver parenchyma, quantitative evaluation methods, such as ultrasound, CT, and MRI, have been reported to have good diagnostic performances. The quantification of liver fat, fibrosis, and inflammation is expected to be clinically useful in terms of the prognosis, early intervention, and treatment response for the management of NAFLD. The aim of this review was to discuss the basics and prospects of MRI-based tissue quantifications of the liver, mainly focusing on proton density fat fraction for the quantification of fat deposition, MR elastography for the quantification of fibrosis, and multifrequency MR elastography for the evaluation of inflammation.

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  • Keita Fukushima, Katsuhiro Sano, Haruhiko Machida, Toshiya Kariyasu, T ...
    Article ID: mp.2021-0077
    Published: 2022
    Advance online publication: May 11, 2022
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    Purpose: To assess the effect of an ultrahigh b value of 3000 s/mm2 and the minimal TE of 53 ms on image quality and T2 shine-through effect in liver diffusion-weighted imaging (DWI) using a 3-Tesla MRI scanner with a peak gradient of 100 mT/m.

    Methods: At b values of 1000 and 3000 s/mm2 and at the minimal (44–53 ms) and routine TEs (70 ms), DWI of our original phantom and liver DWI in 10 healthy volunteers and 26 patients with 35 hepatic hemangiomas were acquired with this scanner, and the quantified SNR of the phantom and the hepatic parenchyma in the volunteers and the contrast-to-noise ratio (CNR) of the hepatic hemangiomas were calculated; two independent readers qualitatively graded the overall image quality in the volunteers and determined the presence or absence of the T2 shine-through effect related to the hemangiomas in the patients. We compared the SNR and subjective overall image quality between the minimal and routine TEs and the CNR and incidence of the T2 shine-through effect between b values of 1000 and 3000 s/mm2. Inter-reader agreement was also evaluated.

    Results: The SNR at both b values was significantly higher, and the subjective overall image quality at a b value of 3000 s/mm2 was significantly better at the minimal TE than at the routine TE (P < 0.05 for all). The CNR at both TEs and the incidence of the T2 shine-through effect at the minimal TE were significantly lower at a b value of 3000 s/mm2 than at a b value of 1000 s/mm2 (P < 0.05 for all). Inter-reader agreement was excellent.

    Conclusion: Liver DWI at the ultrahigh b value can reduce the T2 shine-through effect with improvement of image quality using the minimal TE.

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  • Kayo Takeuchi, Makoto Isozaki, Yoshifumi Higashino, Nobuyuki Kosaka, K ...
    Article ID: mp.2020-0123
    Published: 2022
    Advance online publication: May 10, 2022
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    Purpose: To verify whether arterial transit time (ATT) mapping can correct arterial spin labeling-cerebral blood flow (ASL-CBF) values and to verify whether ATT is a parameter that correlates with positron emission tomography (PET)-oxygen extraction fraction (OEF) and PET-mean transit time (MTT).

    Methods: Eleven patients with unilateral major cerebral artery stenosis or occlusion underwent MRI and PET in the chronic or asymptomatic phase. ASL-MRI acquisitions were conducted with each of two post-label delay (PLD) settings (0.7s and 2.0s) using a pseudo-continuous ASL pulse sequence and 3D-spin echo spiral readout with vascular crusher gradient. ATT maps were obtained using a low-resolution pre-scan approach with five PLD settings. Using the ASL perfusion images and ATT mapping, ATT-corrected ASL-CBF images were obtained. Four kinds of ASL-CBF methods (PLD 0.7s with or without ATT correction and PLD 2.0s with or without ATT correction) were compared to PET-CBF, using vascular territory ROIs. ATT and OEF were compared for all ROIs, unaffected side ROIs, and affected side ROIs, respectively. ATT and MTT were compared by the ratio of the affected side to the unaffected side. Transit time-based ROIs were used for the comparison with ATT.

    Results: Comparing ASL-CBF and PET-CBF, the correlation was higher with ATT correction than without correction, and for a PLD of 2.0s compared with 0.7s. The best correlation was for PLD of 2.0s with ATT correction (R2 = 0.547). ROIs on the affected side showed a low but significant correlation between ATT and PET-OEF (R2 = 0.141). There was a low correlation between the ATT ratio and the MTT ratio (R2 = 0.133).

    Conclusion: Low-resolution ATT correction may increase the accuracy of ASL-CBF measurements in patients with unilateral major cerebral artery stenosis or occlusion. In addition, ATT itself might have a potential role in detecting compromised hemodynamic state.

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  • Yoshio Kitazume, Kento Takenaka, Kazuo Ohtsuka, Yasuo Ozawa, Koichiro ...
    Article ID: mp.2021-0037
    Published: 2022
    Advance online publication: May 10, 2022
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    Supplementary material

    Purpose: To quantify bowel motility shown on cine MRI using the classical optical flow algorithm and compare it with balloon-assisted enteroscopy (BAE) findings in patients with Crohn’s disease (CD).

    Methods: This retrospective study included 29 consecutive patients with CD who had undergone MR enterocolonography (MREC) and BAE between March and May 2017. We developed computer software to present motion vector magnitudes between consecutive cine MR images as bowel motility maps via a classical optical flow algorithm using the Horn-Schunck method. Cine MR images were acquired with a balanced steady-state free precession sequence in the coronal direction to capture small bowel motility. The small bowels were divided into three segments. In total, 63 bowel segments were assessed via BAE and MREC. Motility scores on the maps, simplified MR index of activity (sMaRIA), and MREC score derived from a 5-point MR classification were assessed independently by two radiologists and compared with the CD endoscopic index of severity (CDEIS). Correlations were assessed using Spearman’s rank coefficient. The areas under the receiver-operating characteristic curve (AUCs) of motility score for differentiating CDEIS was calculated; a P value < 0.05 was considered statistically significant.

    Results: Motility score was negatively correlated with CDEIS (r = −0.59 [P < 0.001] and −0.54 [P < 0.001]), and the AUCs of motility scores for detecting CDEIS ≥ 3 were 88.2% and 78.6% for observers 1 and 2, respectively. There were no significant differences in the AUC for detecting CDEIS ≥ 3 and CDEIS ≥ 12 between motility and sMaRIA or MREC score.

    Conclusion: The motility map was feasible for locally quantifying the bowel motility. In addition, the motility score on the map reflected the endoscopic inflammatory activity of each small bowel segment in patients with CD; hence, it could be used as a tool in objectively interpreting cine MREC to predict inflammatory activity in CD.

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  • Sohei Kuribayashi, Shigeyoshi Saito, Reika Sawaya, Yusuke Takahashi, H ...
    Article ID: mp.2021-0125
    Published: 2022
    Advance online publication: May 10, 2022
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    Purpose: This study aimed to investigate the ability of creatine-chemical exchange saturation transfer (Cr-CEST) technique assessed through 7-T MRI to evaluate cisplatin-induced testicular damage.

    Methods: We used 8–10 weeks C57BL/6 mice (n = 10) that were divided into a control group (n = 5) and a cisplatin-treated group (n = 5). The cisplatin group received cisplatin at a dose of 15 mg/kg, via intraperitoneal injection, while the control group received saline. MR images of mouse testes were acquired under anesthesia 18 days after the injection using a horizontal 7-T scanner. The pulse sequence consisted of rapid acquisition with a relaxation enhancement (RARE) with magnetization transfer. The Z-spectra were collected using a 2000-ms saturation pulse at a B1 amplitude of 1.2 μT, with frequencies varying from −4.8 to +4.8 parts per million (ppm). Maps of magnetization transfer ratio with asymmetric analysis (MTRasym) were reconstructed at a Cr metabolite concentration of 1.8 ppm.

    Results: The Cr-CEST effect was significantly reduced in the cisplatin-treated group compared to the control group (MTRasym of control mice vs. cisplatin-treated mice: 6.9 [6–7.5] vs. 5.2 [4–5.5], P = 0.008). Correlation analysis revealed a strong correlation between the Cr-CEST effect and the pathological score (ρ = 0.93, P < 0.001).

    Conclusion: Cr-CEST MRI can be useful for the evaluation of cisplatin-induced testicular damage in mice.

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  • Yutaka Kato, Shinji Naganawa, Toshiaki Taoka, Tadao Yoshida, Michihiko ...
    Article ID: mp.2022-0017
    Published: 2022
    Advance online publication: May 10, 2022
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    Purpose: To determine whether T2-contrast enhancement techniques can be used to diagnose endolymphatic hydrops, we compared fluid signal artifacts with and without T2-contrast enhancement techniques in 3D fluid-attenuated inversion recovery (3D-FLAIR).

    Methods: We prepared a custom-made phantom consisting of eight tubes half-filled with saline. Images were obtained using four 3D-FLAIR: without T2-contrast enhancement (Normal), with non-selective T2-inversion recovery (T2-IR), and two with non-selective T2 preparation IR (T2-prep). Scans were performed with and without rice covering the phantom to simulate minimal and severe B0-inhomogeneity conditions. The average signal intensity (SI) values of eight saline tubes were compared between the four sequences and between each other. Comparisons were performed for all measurement slices and the central 10 slices. The images using T2-contrast enhancement technique were obtained from a volunteer and a patient suspected of Meniere’s disease.

    Results: The Normal sequence SI for all slices was significantly lower than that for the other sequences, with smaller standard deviation (SD) and no outliers. Several outliers were detected in the other sequences. The SDs and outliers were larger without rice than with rice. When the central 10 slices with rice, the T2-IR had a significantly higher SI with more outliers compared with the Normal sequence. The T2-prep had no outliers and SIs that were comparable to those of the Normal sequence. However, without rice, the T2-IR and T2-prep sequences had significantly higher SIs with outliers and larger SDs compared to the Normal sequence. In the corresponding images, the Normal sequence achieved excellent fluid suppression, whereas the T2-IR and T2-prep sequences showed high-signal artifacts. Imperfect fluid suppressions were observed in the volunteer image and the endolymphatic hydrops on the post-gadolinium image differed in size and shape in the non-injected T2-IR in the patient image.

    Conclusion: T2-contrast enhancement techniques should be used with caution in 3D-FLAIR for diagnosing endolymphatic hydrops.

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  • Tomoki Miyasaka, Michiru Kajiwara, Akito Kawasaki, Yoshikazu Okamoto, ...
    Article ID: tn.2021-0158
    Published: 2022
    Advance online publication: April 26, 2022
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    Supplementary material

    Portable MRI scanners, in which a permanent magnet with a low magnetic field is mounted on a small car, have enabled the performance of MRI examinations in various remote environments. Here, we have modified the portable MRI system to enable the early diagnosis of wrist sports injuries among tennis players. A RF probe specifically designed for the human wrist was developed, and a power supply scheme using a small generator was introduced. The portable MRI system was located at a tennis school and imaging of the wrists of junior tennis players was performed. To demonstrate clinical feasibility, image quality was assessed by a radiologist and clinical evaluations were performed. In most cases, the image quality was sufficient for diagnosis, and triangular fibrocartilage complex damage could be detected. The results indicated that the modified portable MRI system could be applied for an early diagnosis of wrist injuries.

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  • Ryusuke Irie, Shiori Amemiya, Tsuyoshi Ueyama, Yuichi Suzuki, Hidemasa ...
    Article ID: tn.2022-0002
    Published: 2022
    Advance online publication: April 05, 2022
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    Liver acquisition with volume acceleration-flex (LAVA-Flex) acquires out-of-phase and in-phase echo images and automatically generates water-only and fat-only images from one single acquisition. The scan time of carotid MR angiography (MRA) using LAVA-Flex (LAVA MRA) is about one-fifth that of conventional time-of-flight MRA (cTOF MRA). We aimed to investigate whether LAVA MRA could provide useful information for the diagnosis of carotid plaque by utilizing the ability to acquire multiple sequences simultaneously. Comparing LAVA MRA and cTOF MRA images for carotid plaque, low-intensity plaques were more clearly identified in the in-phase images, and high-intensity plaques were more clearly identified in the water-only or out-of-phase images. None of the plaques exhibited superior visualization with the cTOF sequence. We concluded that LAVA MRA can provide more useful information on plaque evaluation using multiple sequences than cTOF MRA.

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  • Toshihiko Ebisu, Masaki Fukunaga, Tomokazu Murase, Toyoshi Matsuura, N ...
    Article ID: mp.2022-0010
    Published: 2022
    Advance online publication: April 02, 2022
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    Supplementary material

    Purpose: To determine if functional connectivity measured with resting-state functional MRI could be used as a tool to assess unilateral spatial neglect during stroke recovery.

    Methods: Resting-state functional MRI was performed on 13 stroke patients with lesions in the right cerebral hemisphere and 31 healthy subjects. The functional connectivity score was defined as a correlation of a target region with the right inferior parietal lobule. Spatial neglect was measured with a behavioral inattention test.

    Results: First, the functional connectivity scores between the right inferior parietal lobule and right inferior frontal gyrus, including the opercular and triangular parts, were significantly decreased in stroke patients with unilateral spatial neglect compared with patients without unilateral spatial neglect and were significantly correlated with the behavioral inattention test score. Second, the functional connectivity scores between the bilateral inferior parietal lobules were also significantly decreased in patients with unilateral spatial neglect compared with patients without unilateral spatial neglect and were significantly correlated with the behavioral inattention test score. Third, negative functional connectivity scores between the right inferior parietal lobule and bilateral medial orbitofrontal cortexes, which are related to the default mode network, were detected in patients without unilateral spatial neglect in contrast to a reduction of this negative tendency in patients with unilateral spatial neglect. The functional connectivity scores between these regions were significantly different between patients with and without unilateral spatial neglect and were negatively correlated with the behavioral inattention test score.

    Conclusion: Though still in the pilot research stage and using a small number of cases, our findings are consistent with the hypothesis that functional connectivity maps generated with resting-state functional MRI may be used as a tool to evaluate unilateral spatial neglect during stroke recovery.

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  • Hideki Hoshi, Reiji Sugita, Yoshio Machida
    Article ID: tn.2022-0018
    Published: 2022
    Advance online publication: March 29, 2022
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    This study evaluated the dependence of the signal characteristics of time-spatial labeling inversion pulse (time-SLIP) on flow velocity and tag thickness to depict the pancreatic juice flow by analyzing signal profile using a tube phantom study. The tag edge property was evaluated by edge rise distance (ERD). For various slow flow velocities and tag thicknesses, the signal profile characteristics were evaluated using two indices: the tag center value (RTCV) reduction rate and the total signal value along the tube (TSVT). ERD, which was about 10% of the tag thickness, was higher for thicker tags, making slow flow detection difficult. TSVT was proportional to the thickness of the tag and was preserved irrespective of the flow velocity. RTCV became lower with higher flow velocity and decreased significantly with thinner tags. These results suggest that the visualization of pancreatic juice flow might improve stability by considering the appropriate tag thickness.

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  • Mika Kitajima, Hiroyuki Uetani
    Article ID: rev.2021-0118
    Published: 2022
    Advance online publication: March 23, 2022
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    Supplementary material

    Dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL) are techniques used to evaluate brain perfusion using MRI. DSC requires dynamic image acquisition with a rapid administration of gadolinium-based contrast agent. In contrast, ASL obtains brain perfusion information using magnetically labeled blood water as an endogenous tracer. For the evaluation of brain perfusion in pediatric neurological diseases, ASL has a significant advantage compared to DSC, CT, and single-photon emission CT/positron emission tomography because of the lack of radiation exposure and contrast agent administration. However, in ASL, optimization of several parameters, including the type of labeling, image acquisition, background suppression, and postlabeling delay, is required, because they have a significant effect on the quantification of cerebral blood flow (CBF).

    In this article, we first review recent technical developments of ASL and age-dependent physiological characteristics in pediatric brain perfusion. We then review the clinical implementation of ASL in pediatric neurological diseases, including vascular diseases, brain tumors, acute encephalopathy with biphasic seizure and late reduced diffusion (AESD), and migraine. In moyamoya disease, ASL can be used for brain perfusion and vessel assessment in pre- and post-treatment. In arteriovenous malformations, ASL is sensitive to detect small degrees of shunt. Furthermore, in vascular diseases, the implementation of ASL-based time-resolved MR angiography is described. In neoplasms, ASL-derived CBF has a high diagnostic accuracy for differentiation between low- and high-grade pediatric brain tumors. In AESD and migraine, ASL may allow for accurate early diagnosis and provide pathophysiological information.

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  • Masayuki Yamaguchi, Kosuke Kojo, Mizuki Akatsuka, Tomoyuki Haishi, Tat ...
    Article ID: tn.2021-0130
    Published: 2022
    Advance online publication: March 23, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    We have developed a new device, consisting of a 3-cm RF coil and an immobilizer, to acquire high-resolution MR images of the testis. With the approval of our institutional review board, we conducted an MRI study on a cohort of healthy volunteers to test this device. With the participants in the supine position, we placed the dedicated immobilizer and RF coil on the scrotum for typically no more than 3 min. Subsequently, T2-weighted images were acquired with an in-plane resolution of 117 µm using a 3-T MR scanner and the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) sequence. The total scan time ranged from 12 to 30 min (average 20 min). High-resolution MR images of the testis were acquired without deterioration by motion artifacts. Our results showed that the combined use of a small RF coil and an immobilizer is a feasible option for acquiring high-resolution MR images of the testis.

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  • Shintaro Ichikawa, Utaroh Motosugi, Tetsuya Wakayama, Hiroyuki Morisak ...
    Article ID: mp.2021-0143
    Published: 2022
    Advance online publication: March 17, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: To compare the quality of dynamic imaging between stack-of-stars acquisition without breath-holding (DISCO-Star) and the breath-holding method (Cartesian LAVA and DISCO).

    Methods: This retrospective study was conducted between October 2019 and February 2020. Two radiologists performed visual assessments of respiratory motion or pulsation artifacts, streak artifacts, liver edge sharpness, and overall image quality using a 5-point scale for two datasets: Dataset 1 (n = 107), patients with Cartesian LAVA and DISCO-Star; Dataset 2 (n = 41), patients with DISCO and DISCO-Star at different time points. Diagnosable image quality was defined as ≥ 3 points in overall image quality. Whether the scan timing of the arterial phase (AP) was appropriate was evaluated, and results between the pulse sequences were compared. In cases of inappropriate scan timing in the DISCO-Star group, retrospective reconstruction with a high frame rate (80 phases, 3 s/phase) was added.

    Results: The overall image quality of Cartesian LAVA was better than that of DISCO-Star in AP. However, noninferiority was shown in the ratio of diagnosable images between Cartesian LAVA and DISCO-Star in AP. There was no significant difference in the ratio of appropriate scan timing between DISCO-Star and Cartesian LAVA; however, the ratio of appropriate scan timing in DISCO-Star with high frame rate reconstruction was significantly higher than that in Cartesian LAVA in both readers. Overall image quality scores between DISCO and DISCO-Star were not significantly different in AP. There was no significant difference in the ratio of appropriate scan timing between DISCO-Star with high frame rate reconstruction and DISCO in both readers.

    Conclusion: The use of DISCO-Star with high frame rate reconstruction is a good solution to obtain appropriate AP scan timing compared with Cartesian LAVA. DISCO-Star showed equivalent image quality in all phases and in the ratio of appropriate AP scan timing compared with DISCO.

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  • Sho Maruyama, Sayuri Tatsuo, Soichiro Tatsuo, Saya Iida, Fumiyasu Tsus ...
    Article ID: mp.2021-0144
    Published: 2022
    Advance online publication: March 17, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: The human primary auditory cortex is located in the Heschl’s gyrus (HG). To assess the intrinsic MR property in the gray matter of the HG (GM-HG) with T1 and T2 values using a commercially available MR fingerprinting (MRF) technique.

    Methods: The subjects were 10 healthy volunteers (with 20 HGs; mean age, 31.5 years old; range, 25–53 years old). Coronal T1 and T2 maps were obtained with commercially available MRF using a 3-Tesla MR system. Two radiologists measured the T1 and T2 values of the GM-HG, the GM in the superior temporal gyrus (GM-STG), and the GM in the middle temporal gyrus (GM-MTG) by drawing a ROI on coronal maps.

    Results: For both radiologists, the mean T1 and T2 values of the GM-HG were significantly lower than those in the GM-STG or GM-MTG (P < 0.01). The interobserver reliability using the intraclass correlation coefficients (ICC) (2,1) showed strong agreement for the measurement of the T1 and T2 values (ICCs =⃥ 0.80 and 0.78 for T1 and T2 values, respectively).

    Conclusion: The T1 and T2 values on MRF for the GM-HG were lower than those for the GM-STG and GM-MTG, likely reflecting a higher myelin content and iron deposition in the GM-HG. Quantitative measurements using the MRF can clarify cortical properties with high reliability, which may indicate that MRF mapping provides new insights into the structure of the human cortical GM.

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  • Takahiko Nakazono, Ken Yamaguchi, Ryoko Egashira, Mizuki Iyadomi, Kazu ...
    Article ID: rev.2021-0098
    Published: 2022
    Advance online publication: March 17, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    The anterior mediastinum is the most common location of mediastinal tumors, and thymic epithelial tumors are the most common mediastinal tumors. It is important to differentiate thymic epithelial tumors from malignant lymphomas and malignant germ cell tumors because of the different treatment strategies. Dynamic contrast-enhanced MRI and diffusion-weighted imaging can provide additional information on the differential diagnosis. Chemical shift imaging can detect tiny fat tissues in the lesion and is useful in differentiating thymic hyperplasia from other solid tumors such as thymomas. MRI findings reflect histopathological features of mediastinal tumors, and a comprehensive evaluation of MRI sequences is important for estimation of the histopathological features of the tumor. In this manuscript, we describe the MRI findings of anterior mediastinal solid tumors and the role of MRI in the differential diagnosis.

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  • Tomohiro Takamura, Shoko Hara, Tadashi Nariai, Yutaka Ikenouchi, Michi ...
    Article ID: mp.2021-0162
    Published: 2022
    Advance online publication: March 15, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    Purpose: The effect of temporal sampling rate (TSR) on perfusion parameters has not been fully investigated in Moyamoya disease (MMD); therefore, this study evaluated the influence of different TSRs on perfusion parameters quantitatively and qualitatively by applying simultaneous multi-slice (SMS) dynamic susceptibility contrast-enhanced MR imaging (DSC-MRI).

    Methods: DSC-MRI datasets were acquired from 28 patients with MMD with a TSR of 0.5 s. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and time to maximum tissue residue function (Tmax) were calculated for eight TSRs ranging from 0.5 to 4.0 s in 0.5-s increments that were subsampled from a TSR of 0.5 s datasets. Perfusion measurements and volume for chronic ischemic (Tmax ≥ 2 s) and non-ischemic (Tmax < 2 s) areas for each TSR were compared to measurements with a TSR of 0.5 s, as was visual perfusion map analysis.

    Results: CBF, CBV, and Tmax values tended to be underestimated, whereas MTT and TTP values were less influenced, with a longer TSR. Although Tmax values were overestimated in the TSR of 1.0 s in non-ischemic areas, differences in perfusion measurements between the TSRs of 0.5 and 1.0 s were generally minimal. The volumes of the chronic ischemic areas with a TSR ≥ 3.0 s were significantly underestimated. In CBF and CBV maps, no significant deterioration was noted in image quality up to 3.0 and 2.5 s, respectively. The image quality of MTT, TTP, and Tmax maps for the TSR of 1.0 s was similar to that for the TSR of 0.5 s but was significantly deteriorated for the TSRs of ≥ 1.5 s.

    Conclusion: In the assessment of MMD by SMS DSC-MRI, application of TSRs of ≥ 1.5 s may lead to deterioration of the perfusion measurements; however, that was less influenced in TSRs of ≤ 1.0 s.

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  • Hirotaka Muraoka, Takashi Kaneda, Naohisa Hirahara, Kotaro Ito, Shunya ...
    Article ID: mp.2021-0153
    Published: 2022
    Advance online publication: March 11, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Chronic diffuse sclerosing osteomyelitis (CDSO) is a non-suppurative inflammatory bone disease diagnosed based on combined clinical, histopathological, and radiological findings. Accurate diagnosis is important since CDSO is more refractory to treatment than suppurative osteomyelitis. The purpose of this study was to determine the diagnostic efficacy of diffusion-weighted imaging (DWI) in the quantitative assessment of CDSO to distinguish it from acute suppurative osteomyelitis (ASO) and chronic suppurative osteomyelitis (CSO) of the mandible.

    Methods: Using a retrospective cohort study design, we analyzed MRI data of 6 patients with CDSO and 34 patients with ASO and CSO. The mean apparent diffusion coefficient (ADC) values of the three groups (CDSO, ASO, and CSO groups) were calculated, and differences were analyzed using Kruskal–Wallis and post-hoc Mann–Whitney tests with Bonferroni adjustments. We performed a receiver operating characteristic (ROC) curve analysis to evaluate the ability of the ADC to predict CDSO. P < 0.05 was considered statistically significant.

    Results: The mean ADCs in the CDSO, ASO, and CSO groups were 1.22 ± 0.04 × 10–3 mm2/s, 1.28 ± 0.08 × 10–3 mm2/s, and 1.06 ± 0.09 × 10–3 mm2/s, respectively. Significant differences were observed between the ASO and CSO groups (P < 0.001) and CSO and CDSO groups (P < 0.01). However, there was no significant difference between the ASO and CDSO groups (P = 0.21). The ROC analysis revealed a cut-off ADC value of 1.19 for distinguishing the CSO group from the CDSO group. Sensitivity, specificity, accuracy, and area under the ROC curve were 1.0, 0.92, 0, 95, and 0.94, respectively.

    Conclusion: The results suggest that ADC may be useful in distinguishing CDSO from mandibular suppurative osteomyelitis.

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  • Akinori Yamaguchi, Kohsuke Kudo, Ryota Sato, Yasuo Kawata, Niki Udo, M ...
    Article ID: mp.2021-0015
    Published: 2022
    Advance online publication: March 10, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Studies on quantitative susceptibility mapping (QSM) have reported an increase in magnetic susceptibilities in patients with Alzheimer’s disease (AD). Despite the pathological importance of the brain surface areas, they are sometimes excluded in QSM analysis. This study aimed to reveal the efficacy of QSM analysis with brain surface correction (BSC) and/or vein removal (VR) procedures.

    Methods: Thirty-seven AD patients and 37 age- and sex-matched, cognitively normal (CN) subjects were included. A 3D-gradient echo sequence at 3T MRI was used to obtain QSM. QSM images were created with regularization enabled sophisticated harmonic artifact reduction for phase data (RESHARP) and constrained RESHARP with BSC and/or VR. We conducted ROI analysis between AD patients and CN subjects who did or did not undergo BSC and/or VR using a t-test, to compare the susceptibility values after gray matter weighting.

    Results: The susceptibility values in RESHARP without BSC were significantly larger in AD patients than in CN subjects in one region (precentral gyrus, 8.1 ± 2.9 vs. 6.5 ± 2.1 ppb) without VR and one region with VR (precentral gyrus, 7.5 ± 2.8 vs. 5.9 ± 2.0 ppb). Three regions in RESHARP with BSC had significantly larger susceptibilities without VR (precentral gyrus, 7.1 ± 2.0 vs. 5.9 ± 2.0 ppb; superior medial frontal gyrus, 5.7 ± 2.6 vs. 4.2 ± 3.1 ppb; putamen, 47,8 ± 16.5 vs. 40.0 ± 15.9 ppb). In contrast, six regions showed significantly larger susceptibilities with VR in AD patients than in CN subjects (precentral gyrus, 6.4 ± 1.9 vs. 4.9 ± 2.7 ppb; superior medial frontal gyrus, 5.3 ± 2.7 vs. 3.7 ± 3.3 ppb; orbitofrontal cortex, –2.1 ± 2.7 vs. –3.6 ± 3.2 ppb; parahippocampal gyrus, 0.1 ± 3.6 vs. –1.7 ± 3.7 ppb; putamen, 45.0 ± 14.9 vs. 37.6 ± 14.6 ppb; inferior temporal gyrus, –3.4 ± 1.5 vs. –4.4 ± 1.5 ppb).

    Conclusion: RESHARP with BSC and VR showed more regions of increased susceptibility in AD patients than in CN subjects. This study highlights the efficacy of this method in facilitating the diagnosis of AD.

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  • Hirotaka Yamamoto, Mami Iima, Yo Kishimoto, Ayami Ohno Kishimoto, Sho ...
    Article ID: mp.2021-0149
    Published: 2022
    Advance online publication: March 04, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: To evaluate whether readout-segmented echo-planar imaging (RS-EPI) diffusion-weighted imaging (DWI) can reduce image distortion and improve the lesion identification in parathyroid adenomas (PTAs) compared to single-shot EPI (SS-EPI) DWI, and to determine whether PTAs can be differentiated from other soft tissue structures of the head and neck region by using the apparent diffusion coefficient (ADC) value.

    Methods: We retrospectively analyzed the preoperative MR images including DWI of 24 patients with surgically confirmed PTA. RS-EPI and SS-EPI DWI were evaluated by two independent readers for the identification of the lesions and distortion. The ADC values of the PTAs were compared with those of thyroid glands and cervical lymph nodes.

    Results: RS-EPI provided significantly less distortion compared to SS-EPI. RS-EPI tended to have better lesion identification compared with SS-EPI without a statistically significant difference. On SS-EPI, the PTAs had significantly higher ADC values compared with the cervical lymph nodes. On RS-EPI, the PTAs had significantly higher ADC values compared with the thyroid glands and cervical lymph nodes.

    Conclusion: RS-EPI reduces the DWI distortion in PTAs. The ADC value obtained using RS-EPI enables the differentiation of PTAs from nearby structures, such as thyroid glands and cervical lymph nodes.

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  • Minghui Tang, Toru Yamamoto
    Article ID: rev.2021-0047
    Published: 2022
    Advance online publication: February 26, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    RF electromagnetic wave exposure during MRI scans induces heat and occasionally causes burn injuries to patients. Among all the types of physical injuries that have occurred during MRI examinations, RF burn injuries are the most common ones. The number of RF burn injuries increases as the static magnetic field of MRI systems increases because higher RFs lead to higher heating. The commonly believed mechanisms of RF burn injuries are the formation of a conductive loop by the patient’s posture or cables, such as an electrocardiogram lead; however, the mechanisms of RF burn injuries that occur at the contact points, such as the bore wall and the elbow, remain unclear. A comprehensive understanding of RF heating is needed to address effective countermeasures against all RF burn injuries for safe MRI examinations. In this review, we summarize the occurrence of RF burn injury cases by categorizing RF burn injuries reported worldwide in recent decades. Safety standards and regulations governing RF heating that occurs during MRI examinations are presented, along with their theoretical and physiological backgrounds. The experimental assessment techniques for RF heating are then reviewed, and the development of numerical simulation techniques is explained. In addition, a comprehensive theoretical interpretation of RF burn injuries is presented. By including the results of recent experimental and numerical simulation studies on RF heating, this review describes the progress achieved in understanding RF heating from the standpoint of MRI burn injury prevention.

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  • Hirotaka Takita, Satoshi Doishita, Tetsuya Yoneda, Hiroyuki Tatekawa, ...
    Article ID: mp.2021-0123
    Published: 2022
    Advance online publication: January 26, 2022
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    Purpose: While amyloid-β deposition in the cerebral cortex for Alzheimer’s disease (AD) is often evaluated by amyloid positron emission tomography (PET), amyloid-β-related iron can be detected using phase difference enhanced (PADRE) imaging; however, no study has validated the association between PADRE imaging and amyloid PET. This study investigated whether the degree of hypointense areas on PADRE imaging correlated with the uptake of amyloid PET.

    Methods: PADRE imaging and amyloid PET were performed in 8 patients with AD and 10 age-matched normal controls. ROIs in the cuneus, precuneus, superior frontal gyrus (SFG), and superior temporal gyrus (STG) were automatically segmented. The degree of hypointense areas on PADRE imaging in each ROI was evaluated using 4-point scaling of visual assessment or volumetric semiquantitative assessment (the percentage of hypointense volume within each ROI). The mean standardized uptake value ratio (SUVR) of amyloid PET in each ROI was also calculated. The Spearman’s correlation coefficient between the 4-point scale of PADRE imaging and SUVR of amyloid PET or between the semiquantitative hypointense volume percentage and SUVR in each ROI was evaluated.

    Results: In the precuneus, a significant positive correlation was identified between the 4-point scale of PADRE imaging and SUVR of amyloid PET (Rs = 0.5; P = 0.034) in all subjects. In the cuneus, a significant positive correlation was identified between the semiquantitative volume percentage of PADRE imaging and SUVR of amyloid PET (Rs = 0.55; P = 0.02) in all subjects.

    Conclusion: Amyloid-β-enhancing PADRE imaging can be used to predict the SUVR of amyloid PET, especially in the cuneus and precuneus, and may have the potential to be used for diagnosing AD by detecting amyloid deposition.

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  • Shinji Naganawa, Rintaro Ito, Toshiaki Taoka, Tadao Yoshida, Michihiko ...
    Article ID: bc.2021-0141
    Published: 2021
    Advance online publication: December 25, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    It has been reported that perivenous cystic structures near the parasagittal dura are associated with the leakage of gadolinium-based contrast agents at 4 hours after intravenous administration. The origin of such cystic structures remains unknown. While reading many cases of MR cisternography, we noticed that some of the cystic structures appeared to connect to the perivenous subpial space. This new imaging finding might facilitate future research of the waste clearance system for the central nervous system.

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  • Yusuke Ayabe, Kohei Hamamoto, Yoshikazu Yoshino, Yoshimasa Ikeda, Emik ...
    Article ID: tn.2021-0106
    Published: 2021
    Advance online publication: December 11, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    A flow-diverter (FD) device is a well-established tool for the treatment of unruptured intracranial aneurysms. Time-of-flight (TOF) MR angiography (MRA) is widely used for postoperative assessment after the treatment with FD; however, it cannot fully visualize intra-aneurysmal and intrastent flow signals due to the magnetic susceptibility from the FD. Recently, the utility of MRA with ultra-short TE (UTE) sequence and arterial spin labeling technique in assessing the therapeutic efficacy of intracranial aneurysms treated with metallic devices has been reported, but long image acquisition time is one of the drawbacks of this method. Herein, we introduce a novel UTE MRA using the subtraction method that enables the reduction in susceptibility artifacts with a short image acquisition time.

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  • Akihiko Wada, Yuya Saito, Shohei Fujita, Ryusuke Irie, Toshiaki Akashi ...
    Article ID: mp.2021-0068
    Published: 2021
    Advance online publication: December 10, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Myelination-related MR signal changes in white matter are helpful for assessing normal development in infants and children. A rule-based myelination evaluation workflow regarding signal changes on T1-weighted images (T1WIs) and T2-weighted images (T2WIs) has been widely used in radiology. This study aimed to simulate a rule-based workflow using a stacked deep learning model and evaluate age estimation accuracy.

    Methods: The age estimation system involved two stacked neural networks: a target network-to extract five myelination-related images from the whole brain, and an age estimation network from extracted T1- and T2WIs separately. A dataset was constructed from 119 children aged below 2 years with two MRI systems. A four-fold cross-validation method was adopted. The correlation coefficient (CC), mean absolute error (MAE), and root mean squared error (RMSE) of the corrected chronological age of full-term birth, as well as the mean difference and the upper and lower limits of 95% agreement, were measured. Generalization performance was assessed using datasets acquired from different MR images. Age estimation was performed in Sturge–Weber syndrome (SWS) cases.

    Results: There was a strong correlation between estimated age and corrected chronological age (MAE: 0.98 months; RMSE: 1.27 months; and CC: 0.99). The mean difference and standard deviation (SD) were −0.15 and 1.26, respectively, and the upper and lower limits of 95% agreement were 2.33 and −2.63 months. Regarding generalization performance, the performance values on the external dataset were MAE of 1.85 months, RMSE of 2.59 months, and CC of 0.93. Among 13 SWS cases, 7 exceeded the limits of 95% agreement, and a proportional bias of age estimation based on myelination acceleration was exhibited below 12 months of age (P = 0.03).

    Conclusion: Stacked deep learning models automated the rule-based workflow in radiology and achieved highly accurate age estimation in infants and children up to 2 years of age.

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  • Michiru Kajiwara, Tomoyuki Haishi, Dwi Prananto, Susumu Sasaki, Ryohei ...
    Article ID: tn.2021-0094
    Published: 2021
    Advance online publication: December 10, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    23Na-MRI provides information on Na+ content, and its application in the medical field has been highly anticipated. However, for existing clinical 1H-MRI systems, its implementation requires an additional broadband RF transmitter, dedicated transceivers, and RF coils for Na+ imaging. However, a standard medical MRI system cannot often be modified to perform 23Na imaging. We have developed an add-on crossband RF repeater system that enables 23Na-MRI simply by inserting it into the magnet bore of an existing 1H MRI. The three axis gradient fields controlled by the 1H-MRI system were directly used for 23Na imaging without any deformation. A crossband repeater is a common technique used for amateur radio. This concept was proven by a saline solution phantom and in vivo mouse experiments. This add-on RF platform is applicable to medical 1H MRI systems and can enhance the application of 23Na-MRI in clinical usage.

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  • Ryota Hyodo, Yasuo Takehara, Takashi Mizuno, Kazushige Ichikawa, Shiny ...
    Article ID: ici.2021-0110
    Published: 2021
    Advance online publication: December 09, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    A man in his 50s with Budd-Chiari syndrome diagnosed with the suprahepatic inferior vena cava (IVC) obstruction on CT was assessed using 4D Flow MRI before and after balloon angioplasty. 4D Flow MRI acquired in two respiratory phases, depicted complex hemodynamic and respiratory variability, and a jet stream at the narrowed channel of the membranous IVC. Post-interventional 4D Flow MRI showed that the IVC blood flow increased with corrected flow directions in the infrarenal IVC.

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  • Naoki Ohno, Kotaro Yoshida, Yu Ueda, Yuki Makino, Tosiaki Miyati, Tosh ...
    Article ID: mp.2021-0087
    Published: 2021
    Advance online publication: November 02, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: This multi-scanner study aimed to investigate the validity of single breath-hold (BH) diffusion-weighted imaging (DWI) using simultaneous-multislice (SMS) echo-planar imaging in multiple abdominal organs to enable faster acquisition and reliable quantification of apparent diffusion coefficient (ADC).

    Methods: SNR, geometric distortion (GD), and ADC in a phantom; the ADC in the liver, renal cortex, paraspinal muscle, spleen, and pancreas; and the signal intensity ratio of the portal vein-to-muscle (SIRPV-M) in healthy volunteers were compared between BH- and respiratory-triggered (RT) DWI with b-values of 0 and 800 s/mm2 in two different MRI scanners.

    Results: The phantom study showed that the SNR of BH-DWI was significantly lower than that of the RT-DWI (P < 0.05 for both scanners), whereas the GD and ADC of BH-DWI did not differ significantly from those of the RT-DWI (P = 0.09–0.60). In the volunteer study, the scan times were 23 seconds for BH-DWI and 184±33 seconds for RT-DWI, respectively. The ADC of the liver in BH-DWI was significantly lower than that in RT-DWI (P < 0.05 for both scanners), whereas there were no significant differences in the ADCs of the renal cortex, paraspinal muscle, spleen, or pancreas between BH-DWI and RT-DWI (P = 0.07–0.86). The SIRPV-M in BH-DWI was significantly smaller than in RT-DWI (P < 0.05 for both scanners).

    Conclusion: The proposed method enables the acquisition of abdominal diffusion-weighted images in a single BH.

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  • Shinji Naganawa, Rintaro Ito, Mariko Kawamura, Toshiaki Taoka, Tadao Y ...
    Article ID: mp.2021-0100
    Published: 2021
    Advance online publication: October 16, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Peripheral retinal leakage (PRL) of contrast medium from the ora serrata (i.e., the peripheral part of the retina) was recently reported in normal eyes using ultra-widefield fluorescein angiography. We occasionally see PRL of gadolinium-based contrast agents (GBCAs) in the vitreous from the temporal and inferior sides of the ora serrata on MR images of subjects without ophthalmic disease. In this study, we retrospectively evaluated these MR images to determine if PRL was associated with aging. We also evaluated whether the initial leakage appeared in the temporal and inferior sides, and whether there was uniform distribution within the vitreous after 24 hours.

    Methods: In 127 subjects (9 volunteers, 85 patients with sudden deafness, and 33 patients with a suspicion of endolymphatic hydrops), pre- and post-contrast-enhanced heavily T2-weighted 3D-fluid attenuated inversion recovery (FLAIR) images were obtained. The presence or absence of PRL was subjectively evaluated. For patients with a suspicion of endolymphatic hydrops, 3D-real inversion recovery (IR) images were also obtained at pre-, 10 mins, 4 hours, and 24 hours after intravenous administration (IV) of GBCA. Four circular ROIs were placed in the vitreous humor and the signal intensity was measured.

    Results: In the cases with PRL (n = 88) and without PRL (n = 47), the median age was 59 and 47 years, respectively (P = 0.001). At 4 hours after IV-GBCA, the mean signal increase in the inferior temporal ROI was greater than all the other ROIs. At 24 hours after IV-GBCA, no significant difference in signal intensity was observed for the four ROIs.

    Conclusion: PRL of GBCA is age-dependent and occurs mainly from the inferior temporal side of the ora serrata. The contrast effect was uniformly distributed at 24 hours after IV-GBCA. Future observations in a variety of diseases will determine the clinical significance of these findings.

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  • Koichi Oshio
    Article ID: bc.2021-0059
    Published: 2021
    Advance online publication: October 13, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Although the glymphatic system hypothesis is highly popular, it also lacks certain details. In this paper, an attempt was made to present a more clearly defined hypothesis, which is consistent with the past experiment results. The new hypothesis consists of (1) water flux in the brain parenchyma, (2) water and solutes pathway of the perivascular space, and (3) maintenance of this pathway by the network of astrocytes.

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  • Ryota Hyodo, Yasuo Takehara, Ayumi Nishida, Masaya Matsushima, Shinji ...
    Article ID: mp.2021-0069
    Published: 2021
    Advance online publication: October 07, 2021
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: To elucidate MRI features of primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma, particularly, the “speckled enhancement” on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI.

    Methods: The institutional review board approved this retrospective observational study and waived informed consent. Using our picture archiving and communication systems and electronic medical records, five patients histopathologically diagnosed as hepatic MALT lymphoma and clinically confirmed as primary lesions who had undergone dynamic contrast-enhanced (DCE)-CT and DCE-MRI with Gd-EOB-DTPA were identified from September 2009 to December 2020. Two radiologists assessed their CT and MRI data in consensus with a pathologist’s advice.

    Results: Overall, five lesions in five patients were included in this study. Precontrast CT showed hypoattenuation in all lesions. In the arterial phase of DCE-CT, four lesions (80%) showed hyperattenuation, whereas all lesions showed iso- to hypoattenuation in the delayed phase. A vessel penetration sign was also observed in all lesions. On MRI, all lesions showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and restricted diffusion on diffusion-weighted images. Both DCE-CT and DCE-MRI with Gd-EOB-DTPA showed similar enhancement patterns, except for the hepatocyte phase. Notably, however, four out of five lesions showed characteristic “speckled enhancement” that refers to punctate positive enhancements within the low signal lesions on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI pathologically confirmed to be hepatocyte clusters that remained in the tumor.

    Conclusion: Primary hepatic MALT lymphomas were characterized by arterial phase enhancement, restricted diffusion, vessel penetration sign, and more specifically “speckled enhancement” in the hepatobiliary phase of DCE-MRI with Gd-EOB-DTPA.

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