Mitral Valve Flow and Myocardial Motion Assessed with Dual-Echo Dual-Velocity Cardiac MRI.

PURPOSE: To develop a dual-echo phase-contrast (DEPC) MRI approach with which each echo is acquired by using a different velocity sensitivity within one repetition time (TR) and demonstrate the feasibility of this approach to measure transmitral blood flow (E) and myocardial tissue (E m) velocities. MATERIALS AND METHODS: The flow across tubes of known diameter was measured by using the proposed DEPC method and compared with flowmeter measurements and theoretic predictions. Then, with both the DEPC MRI sequence and the conventional single-echo phase-contrast (SEPC) MRI sequence, E, E m, and E/E m were measured in six healthy volunteers (mean age, 49 years ± 13 [standard deviation]) and eight patients (mean age, 54 years ± 15) being evaluated for cardiac disease. Differences between the DEPC and conventional SEPC MRI methods were assessed by percent error, Pearson correlation, and Bland-Altman analyses. RESULTS: Velocities measured in vitro and in vivo by using the SEPC and DEPC MRI approaches were well correlated (r 2 > 0.97), with negligible bias (<0.5 cm/sec) and comparable velocity-to-noise ratios. Imaging times were approximately 19% shorter with the DEPC method (TR, 5.7 msec) than with the SEPC method (TR, 2.8 msec ± 4.2) (P < .05). CONCLUSION: The proposed DEPC method was sensitive to two velocity regimes within a single TR, resulting in a shorter imaging time compared with the imaging time in conventional SEPC MRI. Preliminary human study results suggest the feasibility of using this approach to estimate E/E m.Supplemental material is available for this article.© RSNA, 2020.

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T2 correction.

BACKGROUND: Diminished signal intensity of uterine fibroids in T2 -weighted images is routinely used as a qualitative marker of fibroid hypoperfusion. However, quantitative classification of fibroid perfusion with intravoxel incoherent motion (IVIM) model-based metrics is not yet clinically accepted. PURPOSE: To investigate the influence of T2 correction on the estimation of IVIM model parameters for characterizing uterine fibroid tissue. STUDY TYPE: Prospective. POPULATION: Fourteen women with 41 fibroids (12 Type I and 29 Type II, per Funaki classification) underwent diffusion-weighted imaging and T2 mapping. FIELD STRENGTH: Diffusion-weighted images (b values: 0, 20, 40, 60, 100, 200, 400, 600, 800, 1000 s/mm2 ) and T2 maps were obtained at 1.5T. ASSESSMENT: The effect of uterine fibroid T2 variation on IVIM model parameters (diffusion coefficient, perfusion coefficient, and perfusion volume fraction) were numerically modeled and experimentally evaluated without (D, D*, f) and with (Dc , D c * , fc ) T2 correction. The relationship of T2 with D and the T2 -corrected perfusion volume fraction (fc ) was also examined. STATISTICAL TEST: D-values and f-values estimated with and without T2 correction were compared by using a two-tailed Student's t-test. RESULTS: Type II fibroids had higher D and f than Type I fibroids, but the differences were not significant (Type I vs. Type II, D: 0.83 ± 0.20 vs. 0.80 ± 0.25 mm2 /s, P = 0.78; f: 23.64 ± 4.87% vs. 25.27 ± 7.46%, P = 0.49). For Type I and Type II fibroids, fc was lower than f, and fc of Type II fibroids was significantly higher than that of Type I fibroids (Type I vs. Type II, fc : 7.80 ± 1.88% vs. 11.82 ± 4.13%, P = 0.003). Both D and fc exponentially increased with the increase of fibroid T2 as functions: D c ( T 2 ) = - 1.52 × 10 - 3 ⋅ e - 3.42 T 2 290 + 1.84 × 10 - 3 and f c ( T 2 ) = - 0.2336 ⋅ e - 3.217 T 2 290 + 0.2269 , respectively. D asymptotically approached 1.79 × 10-3 mm2 /s, and fc approached 21.74%. DATA CONCLUSION: T2 correction is important when using IVIM-based models to characterize uterine fibroid tissue. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;48:994-1001.

Noninvasive, in vivo determination of uterine fibroid thermal conductivity in MRI-guided high intensity focused ultrasound therapy.

PURPOSE: To estimate the local thermal conductivity of uterine fibroid in vivo at a high temperature range (60-80°C) typically encountered in magnetic resonance imaging-guided high-intensity focused ultrasound (MRgHIFU) surgery. The thermal conductivity of uterine fibroids in vivo is unknown and knowledge about tissue thermal conductivity may aid in effective delivery of thermal energy for ablation. MATERIALS AND METHODS: All subjects (nine women) provided written informed consent to participate in this Institutional Review Board-approved study. A total of 10 fibroids were treated using MRgHIFU surgery with real-time temperature monitoring during both heating and cooling periods. The local thermal conductivity was determined by analyzing the spatiotemporal spread of temperature during the cooling period. RESULTS: The thermal conductivity of MRgHIFU-treated uterine fibroids was 0.47 ± 0.07 W·m(-1) ·K(-1) (range: 0.25∼0.67 W·m(-1) ·K(-1) ) which is slightly lower than the reported value for skeletal muscle at temperatures of <40°C (0.52 to 0.62 W·m(-1) ·K(-1) ). CONCLUSION: It is possible to estimate the thermal conductivity of uterine fibroids in vivo from the spatiotemporal spread of temperature around the HIFU focus during the cooling period.

Volumetric MRI-guided high-intensity focused ultrasound for noninvasive, in vivo determination of tissue thermal conductivity: initial experience in a pig model.

PURPOSE: To estimate the local thermal conductivity of porcine thigh muscle at temperatures required for magnetic resonance imaging (MRI)-guided high-intensity focused ultrasound (MRgHIFU) surgery (60-90°C). MATERIALS AND METHODS: Using MRgHIFU, we performed 40 volumetric ablations in the thigh muscles of four pigs. Thirty-five of the sonications were successful. We used MRI to monitor the resulting temperature increase. We then determined local thermal conductivity by analyzing the spatiotemporal spread of temperature during the cooling period. RESULTS: The thermal conductivity of MRgHIFU-treated porcine thigh muscle fell within a narrow range (0.52 ± 0.05 W/[m*K]), which is within the range reported for porcine thigh muscle at temperatures of <40°C (0.52 to 0.62 W/[m*K]). Thus, there was little change in the thermal conductivity of porcine thigh muscle at temperatures required for MRgHIFU surgery compared to lower temperatures. CONCLUSION: Our MRgHIFU-based approach allowed us to estimate, with good reproducibility, the local thermal conductivity of in vivo deep tissue in real time at temperatures of 60°C to 90°C. Therefore, our method provides a valuable tool for quantifying the influence of thermal conductivity on temperature distribution in tissues and for optimizing thermal dose delivery during thermal ablation with clinical MRgHIFU.

A basic step toward understanding skin surface temperature distributions caused by internal heat sources.

This study uses numerical solutions of a bio-heat transfer equation to investigate the relationship between skin surface temperature distributions and internal heat sources under various physiological and environmental conditions. It is found that although a surface temperature distribution depends on all heat source parameters, the properly normalized distribution is primarily affected only by the depth of the heat source. This study provides a physical basis for determining the depth and type of an internal heat source from a thermogram acquired in various environmental conditions and an understanding of the basic relationship between skin surface temperature distributions and internal heat sources.