Motion-robust MR imaging of the shoulder using compressed SENSE MultiVane.

Purpose: Motion artifacts caused by breathing or involuntary motion of patients, which may lead to reduced image quality and a loss of diagnostic information, are a major problem in shoulder magnetic resonance imaging (MRI). The MultiVane (MV) technique decreases motion artifacts; however, it tends to prolong the acquisition time. As a parallel imaging technique, SENSitivity Encoding (SENSE) can be combined with the compressed sensing method to produce compressed SENSE (C-SENSE), resulting in a markedly reduced acquisition time. This study aimed to evaluate the use of C-SENSE MV for MRI of the shoulder joint. Methods: Thirty-one patients who were scheduled to undergo MRI of the shoulder were included. This prospective study was approved by our institution's medical ethics committee, and written informed consent was obtained from all 31 patients. Two sets of oblique coronal images derived from the standard protocol were acquired without (standard) or with C-SENSE MV: proton-density weighted imaging (PDWI), PDWI with C-SENSE MV, T2-weighted imaging (T2WI) with fat suppression (fs), and T2WI fs with C-SENSE MV. Two radiologists graded motion artifacts and the detectability of anatomical shoulder structures on a 4-point scale (3, no artifacts/excellent delineation; 0, severe artifacts/difficulty with delineation). The Wilcoxon signed-rank test was used to compare the data for the standard and C-SENSE MV images. Results: Motion artifacts were significantly reduced on the C-SENSE MV images (p < 0.001). Regarding the detectability of anatomical structures, the ratings for the C-SENSE MV sequences were significantly better (p < 0.001).In conclusion, in shoulder MRI the newly developed C-SENSE MV technique reduces motion artifacts and increases the detectability of anatomical structures compared with standard sequences.

Free-breathing non-contrast-enhanced flow-independent MR angiography using magnetization-prepared 3D non-balanced dual-echo Dixon method: A feasibility study at 3 Tesla.

In this work we aimed to investigate the feasibility of using a new pulse sequence called Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) for free-breathing non-contrast-enhanced MR angiography (NCE-MRA) for multiple anatomies on 3T. Two magnetization-preparation pulses were incorporated with a three-dimensional dual-echo Dixon sequence. A T2-prep pulse, followed by a non-selective inversion pulse with a short inversion time, together suppressed tissue with short T1 and T2, while enhancing the signal of native blood with long T1 and T2. A two-point non-balanced gradient-echo Dixon method, based on dual-echo acquisition with semi-flexible echo times for water-fat separation, was used for improved fat suppression over a large field of view. General image quality, vasculature visibility, and clinical indications of the proposed method were investigated in healthy subjects and patients in both torso and extremities based on visual inspection. Preliminary results from REACT obtained in free-breathing with no cardiac triggering showed uniform suppression of background tissue over the field of view and robust blood-to-tissue contrast over multiple anatomies. Future clinical studies are warranted for further investigation of its diagnostic performance and limitations.

Differentiation of hypointense nodules on gadoxetic acid-enhanced hepatobiliary-phase MRI using T2 enhanced spin-echo imaging with the time-reversed gradient echo sequence: An initial experience.

PURPOSE: To optimize the flip angle (FA) of the T2 enhanced spin-echo imaging using the time reversed gradient echo (T2FFE) and evaluate its utility for differentiating hypointensity nodules in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced (Gd-EOB) MRI. MATERIALS AND METHODS: First, FA optimization of the T2FFE in the HBP was investigated by comparing signal-to-noise ratio (SNR) among different FAs using phantoms. The liver-to-muscle contrast ratios (CRLiver-Muscle) and image quality among three FAs (20°, 50° and 80°) were compared using images of 10 patients. Next, the utility of the T2FFE with an optimized FA for differentiating hypointensity nodules in the HBP was assessed by comparing the lesion-to-liver contrast ratio (CRLesion-Liver) among cysts, hemangiomas, hepatocellular carcinomas, and metastatic tumors in 32 patients. RESULTS: SNR increased as FA increased, but leveled off at FAs of 50° and greater. The FA of 50° showed significantly better image quality scores than that of 80° (p<0.05). After employing an FA of 50°, the CRLesion-Liver value indicated that the T2FFE depicted benign lesions as hyperintense and most malignant lesions as hypointense in relation with the liver parenchyma (p<0.05). CONCLUSION: The T2FFE in the HBP of Gd-EOB-MRI is useful for differentiating benign and malignant liver lesions.

Usefulness of dual echo volumetric isotropic turbo spin echo acquisition (VISTA) in MR imaging of the temporomandibular joint.

PURPOSE: We investigated the ability to detect the articular disk and joint effusion of the temporomandibular joint (TMJ) of a method of dual echo volumetric isotropic turbo spin echo acquisition (DE-VISTA) additional fusion images (AFI). METHODS: DE-VISTA was performed in the 26 TMJ of 13 volunteers and 26 TMJ of 13 patients. Two-dimensional (2D) dual echo turbo spin echo was performed in the 26 TMJ of 13 volunteers. On a workstation, we added proton density-weighted images (PDWI) and T2 weighted images (T2WI) of the DE-VISTA per voxel to reconstruct DE-VISTA-AFI. Two radiologists reviewed these images visually and quantitatively. RESULTS: Visual evaluation of the articular disk was equivalent between DE-VISTA-AFI and 2D-PDWI. The sliding thin-slab multiplanar reformation (MPR) method of DE-VISTA-AFI could detect all articular disks. The ratio of contrast (CR) of adipose tissue by the articular disk to that of the articular disk itself was significantly higher in DE-VISTA-AFI than DE-VISTA-PDWI (P<0.05) in patients and volunteers with closed or open mouth. In volunteers, the CR between adipose tissue and the disk on DE-VISTA-AFI was marginally significant to that on 2D-PDWI at opened mouth (P=0.071) and not significantly different (P=0.18) from that at closed mouth. Joint effusion could be identified in DE-VISTA-AFI in all 8 joints that had joint effusion in DE-VISTA-T2WI but in only 3 of those joints in 2D-T2WI. The CR of joint effusion to adipose tissue on DE-VISTA-AFI did not differ significantly from that on DE-VISTA-PDWI. However, using DE-VISTA-T2WI in addition to DE-VISTA-PDWI, we could visually identify joint effusion on DE-VISTA-AFI that could not be identified on DE-VISTA-PDWI alone. CONCLUSION: DE-VISTA-AFI can depict the articular disk and a small amount of joint effusion by the required plane of MPR using the sliding thin-slab MPR method.

[T2 and T1rho values of the knee joint cartilage].

Measurement of T(2) and T(1)ρ relaxation time is a quantitative evaluation technique that uses magnetic resonance imaging. This study aimed to evaluate T(2) and T(1)ρ relaxation time considering the load on the knee. 14 healthy volunteers were studied at 3 T. Four main compartments were defined for cartilage analysis in the knee joint: lateral femoral condyle (LFC), medial femoral condyle (MFC), and lateral and medial tibia (LT and MT). Femur cartilage was partitioned into anterior, middle, and posterior nonweight-bearing (a-NWB, m-NWB, p-NWB) portions and weight-bearing (WB) portions. T(2) and T(1)ρ values between the medial side and lateral side indicated a nonsignificant difference. T(2) and T(1)ρ values of NWB portions were higher than those of WB portions. The measured value rate of extension of NWB to WB was more remarkable in the T(1)ρ value than in the T(2) value. Therefore, evaluating cartilaginous injuries and damages using the T(1)ρ value seems to more effectively describe them.

Efficacy of spectral presaturation of inversion recovery in evaluating delayed myocardial enhancement.

OBJECTIVE: Delayed myocardial enhancement is caused by a variety of cardiovascular diseases. The extent of the enhanced area has been examined by the inversion recovery (IR) method, whereby at the inversion time (TI), normal myocardium shows a low signal intensity. In this sequence, as pericardial fat shows a very high intensity, a delayed enhancement just below the pericardium may be indistinct. To improve the accuracy of delayed myocardial enhancement, we employed the spectral presaturation of inversion recovery (SPIR) method. MATERIALS AND METHODS: Thirty-five patients with symptoms of cardiovascular disease aged between 36 and 80 years old (mean age, 62 years old) were investigated. Thirty were men and five were women. Inversion recovery and SPIR images were obtained 25 min after initial administration of a gadolinium-based contrast material. Each TI, when the signal intensity of the normal myocardium was null, was determined by images obtained at serial different TIs. A radiologist and a cardiologist examined each image by a consensus reading. The extent of myocardial enhancement was described as none, subendocardial, transmural and a random pattern in each case. Images were ranked over three levels and were based on whether myocardial enhancement could be easily detected or whether the contour of the myocardium was visualized precisely. Student's t-test was conducted to compare the quality of two sequences in all patients and in 22 patients who showed delayed myocardial enhancement. RESULTS: The imaging quality in evaluating delayed myocardial enhancement in all patients was superior with IR compared with SPIR, although it was not statistically significant. The imaging quality in the patients with delayed myocardial enhancement was similar between SPIR and IR. SPIR was superior to the IR sequence in two of the four patients who exhibited transmural enhancement. CONCLUSION: SPIR exhibited equivalent image quality to IR in evaluating delayed myocardial enhancement. As it has the potential advantage in patients with rich adipose tissue surrounding the myocardium, it can be an alternative sequence to evaluate myocardial viability.