ABSTRACT
Abstract Crohn's disease is an inflammatory bowel disease that can affect any segment of the gastrointestinal tract. It has a variable clinical course, with alternating periods of disease activity and remission. Because the incidence and prevalence of Crohn's disease have been increasing, evaluation by imaging methods has become more important. The most widely used methods are computed tomography enterography, magnetic resonance enterography (as an elective examination), and contrast-enhanced computed tomography (in the context of emergency). Computed tomography enterography and magnetic resonance enterography are useful for diagnosis, follow-up, evaluation of complications, and prognosis. Both can be used in order to evaluate the small bowel loops and the associated mesenteric findings, as well as to evaluate other abdominal organs. They both also can detect signs of disease activity, fibrosis, penetrating disease, and complications. The interpretation of such changes is essential to the multidisciplinary approach, as is the standardization of the nomenclature employed in the reports. In this paper, we review and illustrate the imaging findings of Crohn's disease, using the standardized nomenclature proposed in the multidisciplinary consensus statement issued by the Society of Abdominal Radiology, the Society of Pediatric Radiology, and the American Gastroenterology Association, with recommendations for descriptions, interpretations, and impressions related to those findings.
Resumo Doença de Crohn é uma doença inflamatória intestinal que pode acometer qualquer segmento do trato gastrointestinal, com curso clínico variado, alternando períodos de atividade de doença e remissão. Sua incidência e prevalência vêm aumentando, tornando a avaliação por métodos de imagem mais importante. Os métodos mais utilizados são enterotomografia computadorizada, enterorressonância magnética eletivamente e tomografia computadorizada com contraste no contexto da emergência. A enterotomografia computadorizada e a enterorressonância magnética são úteis para diagnóstico, seguimento, avaliação de complicações e para prognóstico. Avaliam as alças intestinais delgadas e os achados mesentéricos associados, além dos demais órgãos abdominais. Detectam sinais de atividade de doença, sinais de cronicidade e doença penetrante e complicações, importantes para a escolha do melhor tratamento. A interpretação dessas alterações é fundamental para que a equipe multidisciplinar trabalhe conjuntamente com compreensão da linguagem utilizada nos relatórios. Neste artigo, apresentamos uma revisão dos achados de imagem da doença de Crohn e ilustramos os possíveis achados dessa doença utilizando a nomenclatura padronizada proposta no consenso multidisciplinar composto pelas Sociedade de Radiologia Abdominal, Sociedade de Radiologia Pediátrica e a Associação Americana de Gastroenterologia, com recomendações de descrição, interpretação dos achados e recomendações de impressão.
ABSTRACT
Abstract Objective: To evaluate cerebrospinal fluid dynamics, using cine phase-contrast magnetic resonance imaging (cine-PC MRI), in healthy pediatric subjects, determining the normal flow values in this population, as well as identifying differences related to age, sex, and body surface area. Materials and Methods: This was a descriptive cross-sectional study involving 32 healthy children and adolescents, in whom the flow of cerebrospinal fluid through the cerebral aqueduct was evaluated quantitatively with cine-PC MRI. We used specialized software to analyze the images obtained with cine-PC MRI, drawing a region of interest on the aqueduct. A flow-time curve was obtained, as were automated measurements of the various parameters. Results: The following normal (mean) values were obtained: net flow, 1.10 ± 0.99 mL/m; stroke volume, 12.2 ± 10.1 μL/cycle; mean velocity, 0.72 ± 1.00 cm/s; peak systolic velocity, 5.28 ± 2.30 cm/s; peak diastolic velocity, 4.51 ± 1.77 cm/s. These values were not affected by age or sex. In addition, body surface area was not found to correlate significantly with mean velocity or stroke volume. Conclusion: In children and adolescents, the basic cerebrospinal fluid flow parameters, as determined by cine-PC MRI, appear to be independent of age and sex.
Resumo Objetivo: Avaliar a dinâmica do fluxo do líquido cerebrospinal por cine-ressonância magnética com contraste de fase em crianças saudáveis, para determinar os valores normais de fluxo nesta população, bem como a diferença entre medições distintas de acordo com idade, sexo ou área da superfície corporal. Materiais e Métodos: Convocamos 32 crianças saudáveis em uma análise descritiva de prevalência para a avaliação quantitativa do fluxo do líquido cerebrospinal pelo aqueduto de Sylvius. A análise foi realizada por meio de software especializado, desenhando uma região de interesse no aqueduto. Uma curva de fluxo-tempo e medições automáticas de diversos parâmetros foram obtidas. Resultados: Os seguintes valores normais foram obtidos: fluxo efetivo de 1,10 ± 0,99 mL/m; volume médio de 12,2 ± 10,1 μL/ciclo; velocidade média de 0,72 ± 1,00 cm/s; pico de velocidade sistólica de 5,28 ± 2,30 cm/s; pico de velocidade diastólica de 4,51 ± 1,77 cm/s. Esses valores não foram afetados pela idade ou sexo das crianças. Além disso, não foi encontrada correlação significativa entre a área corporal, a velocidade média e o volume sistólico. Conclusão: De modo geral, os parâmetros básicos do fluxo do líquido cerebrospinal independem de idade e sexo em crianças.
ABSTRACT
Purpose To measure the longitudinal and transverse strain and displacement parameters of each segment of long axis myocardium on cardiac MRI film images of normal young volunteers using feature tracking technique (FT), and to analyze the regularity of left ventricular long axis strain and establish peak and time to peak (TTP) reference range concerning the longitudinal and transverse strain and displacement. Materials and Methods Cardiac film images of 29 healthy volunteers aged 24 to 34 were collected using Philips Multiva 1.5T MRI scanner, including three typical long axis planes of the left ventricular long axis, left ventricular outflow tract, and four-chamber view. The MRI film images were analyzed drawing on myocardial feature tracking software TOMTEC, and the peak value and TTP of longitudinal and transverse strain and displacement of the 16 AHA segments excluding apex cordis were obtained thereby. The regularity of each parameter concerning the plane, layer, and segment was summarized and analyzed. Results The TTP of longitudinal strain, longitudinal displacement and transverse strain were consistent among each myocardial segment, which was a constant indicator in (41.24±12.51) ％ RR interphase. The peak value of longitudinal displacement was represented by apex cordis (2.56±0.89) mm < middle (6.09±2.03) mm < cardiac base (8.07±2.05) mm, and the peak value of transverse displacement was manifested as apex cordis (4.57±1.18) mm < middle (5.65±0.84) mm < cardiac base (8.48 ±1.18) mm, which was consistent with cardiac geometric deformation visually observed. The longitudinal strain showed consistency on 2CH-3CH-4CH plane, whose peak reference value was (-22.46±13.19)％; while the peak value of transverse strain displayed no consistency on different planes. Conclusion The longitudinal strain of the left ventricular on different planes has consistent peak value and TTP, suggesting good reference value.
ABSTRACT
La técnica 4D Flow hace referencia a las imágenes de resonancia magnética (RM) adquiridas mediante una secuencia retrospectiva de angiografía contraste de fase, en la cual se obtienen datos de la velocidad de la sangre en las tres direcciones, en un espacio de 3 dimensiones (3D) y a través de todo el ciclo cardiaco. Con las imágenes obtenidas mediante 4D Flow se puede evaluar de forma cuantitativa la dinámica regional y global del flujo sanguíneo con medidas hemodinámicas, tales como: velocidad promedio, máxima y mínima, flujo latido promedio, flujo de avance y regurgitante, volumen de eyección, y aproximaciones matemáticas a los gradientes de presión y fuerzas de cizallamiento en las paredes de los vasos; además, permite analizar cualitativamente la evolución temporal de los complejos patrones de flujo sanguíneo por medio de líneas de flujo, trazadores de partículas, gráficas de velocidad 3D y vectores; representaciones que describen la trayectoria de la sangre, a través del tiempo, en el sistema cardiovascular. Estas características permiten que la técnica tenga muchas aplicaciones potenciales en la práctica clínica, ya que brindan al especialista información valiosa sobre la función y el estado del sistema cardiovascular del paciente. A continuación se evalúa mediante 4D Flow, en algunas patologías congénitas: estenosis valvular pulmonar, conducto arterioso persistente y estenosis aórtica.
4D Flow technique refers to MR images acquired through a phase contrast angiography retrospective sequence, in which blood velocity data are obtained in three directions, in a 3-dimensional space, and through all of the cardiac cycle. With the 4D flow images, the regional and global dynamics of blood flow can be quantitatively analyzed through hemodynamic measurements, such as: average, maximum and minimum velocity, average flow, forward and regurgitation flow, ejection volume, and mathematical approximations to pressure gradients and shear forces in vessel walls; It also allows analyze qualitatively the temporal evolution of complex blood flow patterns through flow lines, particle tracers, 3D velocity graphs and vectors; representations that describe the trajectory of the blood, over time, in the cardiovascular system. These characteristics make the technique have many potential applications in clinical practice, as it provides information on the function and status of the patient's cardiovascular system. In this study we evaluated with the 4D flow technique some congenital pathologies: pulmonary stenosis, patent ductus arteriosus, and aortic stenosis.
Subject(s)
Magnetic Resonance Imaging , Magnetic Resonance Imaging, Cine , Heart Defects, Congenital , HemodynamicsABSTRACT
[ABSTRACT]OBJECTIVETo assess the upper airway and related structures in different patterns of the upper airway obstruction on cine magnetic resonance (CMR) imaging in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).METHODSCMR images of upper airway were obtained in 30 male patients with severe OSAHS during waking state and natural sleep. The midsagittal plane images were obtained. Patients were classified into 3 groups based on the upper airway obstruction patterns at apnea events and the reference data of the upper airway were measured.RESULTSDuring natural sleep, the diameter of retropalatal region, retroglossal region, retroepiglottic region and the length of suprahyoid muscles were significantly shorter than those during waking state (P<0.01). The maximum angle between the suprahyoid muscles and the apex of the tongue during natural sleep was significantly larger than that during waking state (P<0.01). During wakefulness, there was a significantly difference in the diameter of retropalatal region among 3 obstruction patterns (P<0.01). During natural sleep, there were statistical difference in the diameter of retropalatal region and the upper tongue, the angle between the hard palate and soft palate, the maximum angle between the suprahyoid muscles and the apex of the tongue, and their change values among 3 obstruction patterns (P<0.05). CONCLUSIONThe measurements of the upper airway and related structures on CMR imaging in OSAHS patients could provide useful information in assessing upper airway.
ABSTRACT
OBJECTIVE: To evaluate the influence of papillary muscles and trabeculae on left ventricular (LV) cardiovascular magnetic resonance (CMR) analysis using three methods of cavity delineation (classic or modified inclusion methods, and the exclusion method) in patients with hypertrophic cardiomyopathy (HCM). MATERIALS AND METHODS: This retrospective study included 20 consecutive HCM patients who underwent 1.5-T CMR imaging with short-axis cine stacks of the entire LV. LV measurements were performed using three different methods of manual cavity delineation of the endocardial and epicardial contours: method A, presumed endocardial boundary as seen on short-axis cine images; method B, including solely the cavity and closely adjacent trabeculae; or method C, excluding papillary muscles and trabeculae. Ascending aorta forward flow was measured as reference for LV-stroke volume (SV). Interobserver reproducibility was assessed using intraclass correlation coefficients. RESULTS: Method A showed larger end-diastole and end-systole volumes (largest percentage differences of 25% and 68%, respectively, p 0.05). CONCLUSION: In HCM patients, LV measurements are strikingly different dependent on whether papillary muscles and trabeculae are included or excluded. Therefore, a consistent method of LV cavity delineation may be crucial during longitudinal follow-up to avoid misinterpretation and erroneous clinical decision-making.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cardiomyopathy, Hypertrophic/pathology , Heart Ventricles/physiopathology , Magnetic Resonance Imaging, Cine , Papillary Muscles/physiopathology , Retrospective Studies , Stroke Volume/physiology , Systole/physiologyABSTRACT
Objective To investigate the imaging techniques of enhanced T1 high resolution isotropic volume examination (e-THRIVE) multi-phase dynamic contrast-enhanced scanning technology.Methods 83 patients with liver diseases underwent routine and contrast-enhanced MR scanning.e-THRIVE axial volume scan was used in contrast enhanced MRI.The raw data acquired were post-processed with maximum intensity projection(MIP) technique,and to observe the esophageal and gastric varicose vein's display in different injection rates of contrast agent with delayed scan time.Results The varciation of esophageal and gastric blood vessels in 79 cases were detected,the MIP images showed the overall effect of varicose blood vessels,and the axial images displayed that varicose blood vessels' location,in the submucosal or the inside or outside of the lumens.The ratio of high-quality image reached 72％.Conclusion The high-quality vascular imaging technology of e-THRIVE depends on appropriate injection rate and the right amount of contrast agent,the best delayed scanning time and patients with good breath-hold.
ABSTRACT
Objective To analyse the flow characteristics in the true lumen and false lumen,and the relationship between the flow characteristics and the collapse degree of the true lumen using MRI.Methods Eleven patients with acute Stanford type B aortic dissection were examined by true FISP、3D CE MRA、PC cine MRI on a Siemens Sonata 1.5 T.Not only the quantitative data on the hemodynamics such as peak velocity,average velocity,average flow volume,forward volume,retrograde volume and net volume,and the area of the true lumen and false lumen can be acquired,but also the blood flow model,ie the velocity-mapping.Then we analysed the relationship between the flow characteristics and the collapse degree of the true lumen.Results The average area of the false lumen in the proximal descending aorta(about 2 cm distal to the entry)was(8.10±2.93)cm2,and(2.59±0.93)cm2 of the true lumen in the same slice (P＜0.05).The average velocity in the false lumen,(2.81±0.73)cm/s,was significantly lower than in the true lumen[(15.52±2.84)cm/s,P＜0.01],wheras the average flow(36.32±5.37)ml/s,was not significantly difierent(P＞0.05)from the average flow in the false lumen(37.62±24.58)ml/s.The velocity-mapping curve looked like same in the true and false lumen in this level.And in the abdominal aorta(about the level of the hepatic hilar),the average flow(10.46±5.57)cm/s was significantly lower(P＜0.05)than in true lumen[(4.04±2.96)cm/s].At this level,the direction of blood flow in the true lumen was retrograde(upward)in the mid and late systolic phase in six patients,and normal in the diastolic phase and early systolic phase,that was to say,bidirectional blood flow can be caught in the true lumen of the abdominal aorta.The collapse degree of the true lumen was closely correlated with the the average velocity and the flow volume in the false Iumen,and the coefficient correlation and P value were 0.931 and 0.000,0.926 and 0.000 respectively.Conclusions PC cine MRI can quantitatively measure the peak velocity,average velocity,average flow volume,forward volume,retrograde volume and net volume,and combined with 3D CE MRA can evaluate the collapse degree of the true lumen.It is important for clinical application in the diagnosis,therapeutic management and the therapeutic opportunity choice of the acute Stanford type B aortic dissection.
ABSTRACT
PURPOSE: The purpose of this study was to evaluate comparison of static MRI and pseudo-dynamic (cine) MRI in temporomandibular joint (TMJ) disorder patients. MATERIALS AND METHODS: In this investigation, 33 patients with TMJ disorders were examined using both conventional static MRI and pseudo-dynamic MRI. Multiple spoiled gradient recalled acquisition in the steady state (SPGR) images were obtained when mouth opened and closed. Proton density weighted images were obtained at the closed and open mouth position in static MRI. Two oral and maxillofacial radiologists evaluated location of the articular disk, movement of condyle and bony change respectively and the posterior boundary of articular disk was obtained. RESULTS: No statistically significant difference was found in the observation of articular disk position, mandibular condylar movement and posterior boundary of articular disk using static MRI and pseudo-dynamic MRI (P>0.05). Statistically significant difference was noted in bony changes of condyle using static MRI and pseudo-dynamic MRI (P<0.05). CONCLUSION: This study showed that pseudo-dynamic MRI didn't make a difference in diagnosing internal derangement of TMJ in comparison with static MRI. But it was considered as an additional method to be supplemented in observing bony change.
Subject(s)
Humans , Joints , Magnetic Resonance Imaging , Magnetic Resonance Imaging, Cine , Mouth , Protons , Temporomandibular Joint , Temporomandibular Joint DisordersABSTRACT
Objective To assess the accuracy of two-dimensional phase contrast (2D-PC) MR method for blood flow measurement within transverse sinusesby comparing this method with cine phase contrast (cine-PC) MR and Doppler in volunteers and patients. Methods (1) A total of 12 transverse sinuses were examined in 8 healthy volunteers. 2D-PC MR and cine-PC MR were used respectively to measure the transverse area of flow, the flow velocities, and the volumetric flow rates in the same position in every transverse sinus. Paired t-test was used for comparison between the results determined by 2D-PC MR and that determined by cine-PC MR. (2) A total of 6 transverse sinuses were examined in 5 patients who needed operation. 2D-PC MR was used to determine the blood flow velocity of transverse sinus before operation, and Doppler was used to determine the blood flow velocity of the same transverse sinus during operation. The linear regression analysis was used for statistical analysis. Results (1) Statistical analysis indicated that there were no significant difference among the transverse area of flow (t=-1.106, P=0.293), the flow velocities (t=0.262, P=0.798), and the volumetric flow rates (t=0.439, P=0.669) measured by using 2D-PC MR and cine PC MR, respectively. (2) The correlation between flow velocities determined by 2D-PC MR imaging before operation and that determined by Doppler during operation was in excellent agreement (=1.303x+0.62,r 2=0.88). Conclusion 2D-PC MR may be a practical convenient method for blood flow measurement within transverse sinuses system.
ABSTRACT
Recently, endoscopic procedures have been recommended as the first surgical option for cerebral arachnoid cyst (AC). The author reports seven ACs treated endoscopically and discuss the role of endoscopic fenestration. The age of the patients ranged from two to 62 years. Three ACs were located in the posterior cranial fossa, two in the suprasellar area, one in the middle cranial fossa, and one in the convexity. All cases were examined by cine magnetic resonance (MR) flow study. The patient's symptoms included headache, vomiting, dizziness, problems in balance, visual disturbance, and seizure. The author performed a cysto-cisternostomy or cysto-ventriculostomy via a single burr hole. The follow-up periods ranged from six to 18 months. There was no mortality or morbidity except one case of intracisternal bleeding during endoscopic procedure. Symptoms were relieved in all seven patients. Follow-up imaging studies revealed a decrease in the size or disappearance of the cysts. The results support that the minimal fenestration procedure as possibly as preserving the internal environment is valuable for the management of ACs.
Subject(s)
Adult , Child, Preschool , Female , Humans , Male , Adolescent , Anesthesia, General , Arachnoid Cysts/surgery , Arachnoid Cysts/diagnosis , Endoscopy/methods , Follow-Up Studies , Magnetic Resonance Imaging , Middle Aged , Prospective Studies , Treatment OutcomeABSTRACT
0.05) The correlation coefficients were 0 52-0 96 (2) The correlation coefficients of left ventricular mass(EDM and ESM) among three methods were lower than those of left ventricular volume ,and there was statistically significant difference in ESM between MRI and echocardiography( P
ABSTRACT
Objective To assess hemodynamics of pulmonary arterial flow and to count the pulmonary artery diastolic pressure (PADP) by analysis using velocity study of main pulmonary with phase-contrast MR imaging. Methods The diameter、velocity and the maximal retrograde velocity of main pulmonary artery in 45 patients were measured with phase-contrast MR imaging and compared with cardiac catheterization. The accuracy and specificity of PADP measured with phase-contrast MR imaging were evaluated by relativity and regression analysis. Results The PADP measured with phase-contrast MR imaging was (4.82?1.24) mm Hg and that measured with right cardiac catheterization was (4.52?2.00) mm Hg in 40 patients with pulmonary regurgitation. With good correlation the correlation coefficient was 0.94(P