Whole-body magnetic resonance angiography at 3.0 Tesla

The quality of magnetic resonance (MR) angiography could be substantially improved over the past several years based on the introduction and application of parallel imaging, new sequence techniques, such as, e.g., centric k-space trajectories, dedicated contrast agents, and clinical high-field scanners. All of these techniques have played an important role to improve image resolution or decrease acquisition time for the dedicated examination of a single vascular territory. However, whole-body MR angiography may be the application with the potential to profit most from these technical advances. The present review article describes the technical innovations with a focus on parallel imaging at high field strength and the impact on whole-body MR angiography. The clinical value of advanced whole-body MR angiography techniques is illustrated by characteristic cases.     

磁共振成像设备的状态检测和临床照片评估

目的探讨我国ＭＲＩ设备的状态检测方法。方法ＭＲＩ设备７台,其中有超低磁场强度电磁型３台,低磁场强度永磁型２台,中、高磁场强度超导型各１台,７台中有二手机１台。状态检测的参数为信噪比、均匀度、线性度、层厚、空间分辨率和低对比度分辨率等６项。用美国体模实验室（ＴｈｅＰｈａｎｔｏｍＬａｂｏｒａｔｏｒｙ）和医学物理学家Ｇｏｏｄｅｎｏｕｇｈ博士研制的Ｍａｇｐｈａｎ体模进行性能参数检测。用随机抽取近２周的头部、胸部、腹部、腰椎的Ｔ１、Ｔ２横断面照片进行临床照片质量评估。照片质量从优到劣分为１、２、３等。结果３台超低磁场电磁型磁共振成像设备的６项参数分别有５项以上不合格,照片质量评估为３等;１台低磁场强度永磁型设备除信噪比不合格外,其余５项参数均合格,照片质量为２等;１台低磁场强度永磁型设备和１台二手中磁场强度超导型设备均有２项参数不合格,其中空间分辨率不合格,照片质量为２等。１台高磁场强度超导型设备６项参数均合格,照片质量为１－等。结论该状态检测方法借鉴了国外的经验,同时又根据实际需要进行补充完善,能满足从整体上评价设备的性能质量的要求     

Clinical decision support systems for brain tumor characterization using advanced magnetic resonance imaging techniques

In recent years, advanced magnetic resonance imaging (MRI) techniques, such as magnetic resonance spectroscopy, diffusion weighted imaging, diffusion tensor imaging and perfusion weighted imaging have been used in order to resolve demanding diagnostic problems such as brain tumor characterization and grading, as these techniques offer a more detailed and non-invasive evaluation of the area under study. In the last decade a great effort has been made to import and utilize intelligent systems in the so-called clinical decision support systems (CDSS) for automatic processing, classification, evaluation and representation of MRI data in order for advanced MRI techniques to become a part of the clinical routine, since the amount of data from the aforementioned techniques has gradually increased. Hence, the purpose of the current review article is two-fold. The first is to review and evaluate the progress that has been made towards the utilization of CDSS based on data from advanced MRI techniques. The second is to analyze and propose the future work that has to be done, based on the existing problems and challenges, especially taking into account the new imaging techniques and parameters that can be introduced into intelligent systems to significantly improve their diagnostic specificity and clinical application.     

胎儿三维磁共振成像技术的初步应用

目的：探讨三维磁共振成像（3D-MRI）技术在显示胎儿体表正常解剖和先天畸形方面的应用价值。方法：对40例18~37周的胎儿在超声检查后1~2d内行MRI检查,应用单次激发快速自旋回波序列（SSFSE）行胎儿轴面、矢状面和冠状面二维MRI（2D-MRI）,三维稳态进动快速成像（3D-FIESTA）序列MRI,均使用并行采集技术（ASSET）,在工作站对原始数据进行多平面重组（MPR）、容积重组（VR）和磁共振仿真内窥镜技术（MRVE）等三维图像后处理。将MRI和随访、尸检结果进行比较。结果：36例孕妇3D-MRI检查成功率为94.4%（34/36）,34例胎儿经随访和尸检证实46处畸形。胎儿体表先天畸形2D-MRI正确诊断37处,诊断符合率80.4%（37/46）;误诊1处,假阳性率为2.1%（1/46）;漏诊8处,漏诊率17.4%（8/46）。3D-MRI正确诊断43处,诊断符合率93.5%（43/46）;误诊1处,假阳性率2.1%（1/46）;漏诊2处,漏诊率为4.3%（2/46）。两种方法诊断胎儿体表先天畸形差异无统计学意义（χ2=2.40,P〉0.05）,但3D-MRI对于面部畸形如唇裂和其他复杂畸形如体蒂异常、骶尾部畸胎瘤、联体双胎等显示更直观清楚。结论：3D-MRI一次扫描可直观反映胎儿体表结构的表面特征、立体形态及相互间的位置关系,VR、MRVE对胎儿正常面部、外生殖器、脐带、肢体等的评价有较高价值,MPR可对兴趣区进行多角度观察。磁共振三维成像对显示胎儿正常体表结构和病变及产前咨询和围产期手术具有重要的临床价值。     

小肠磁共振成像的研究进展

影像学检查是诊断小肠疾病的主要检查方法,近年来随着磁共振技术的迅猛发展,磁共振小肠成像临床应用越来越广泛,本文拟从比较影像学、标本及动物实验研究、临床研究等几个方面对小肠的磁共振成像研究状况进行综述,以期对小肠的磁共振检查技术有一个整体的认识。     

Effect of field strength on susceptibility artifacts in magnetic resonance imaging

In magnetic resonance imaging susceptibility artifacts occur at the interface of substances with large magnetic susceptibility differences, resulting in geometric distortions of the image at those boundaries. The susceptibility artifacts are often subtle on clinical images and if not carefully examined they may lead to misdiagnosis. Magnetic susceptibility artifacts are prevalent on the boundary of air-containing paranasal sinuses, as well as bone-soft tissue interfaces in the spinal canal. The appearance of these artifacts on images from three different magnetic field strength instruments, 0.3, 0.5, and 1.5 Tesla were studied. T1- and T2-weighted spin echo and gradient recalled echo pulse sequences were selected to image a water phantom containing substances of varying susceptibilities. The effects were also studied in MR images of the head in a normal human volunteer. At any given field strength the artifacts were more prominent in the gradient echo imaging than in the corresponding spin echo pulse sequence. As expected, the distortions were also greater at higher field strengths. The results in human subject paralleled the findings in the phantom study.     

Functional MR imaging using gradient-echo echo-planar imaging in the presence of large static field inhomogeneities

At 1.5 T, the field strength of most clinical MR imagers, gradient-echo Imaging Is the primary imaging method for measuring brain activation, as such sequences are highly sensitive to changes in blood oxygenation or T2* effects. Unfortunately, gradient-echo sequences are also extremely sensitive to magnetic field inhomogeneities, and this sensitivity has precluded examination of regions of cortex near field inhomogeneities with functional MR imaging. This article presents a gradient-echo echo-planar imaging method that uses variable amplitude scaling on the slice-select refocusing lobe to generate images compensated for static field inhomogeneities. A technique for constructing composite Images to be used in statistical tests for activation is also presented. The method is shown to produce clean activation maps in the presence of large static field inhomogeneities. The technique retains the sensitivity of gradient- echo imaging to changes in blood oxygenation while removing the sensitivity to large static field inhomogeneities.     

High-resolution functional MRI of the human amygdala at 7 T

Functional magnetic resonance imaging (fMRI) has become the primary non-invasive method for investigating the human brain function. With an increasing number of ultra-high field MR systems worldwide possibilities of higher spatial and temporal resolution in combination with increased sensitivity and specificity are expected to advance detailed imaging of distinct cortical brain areas and subcortical structures. One target region of particular importance to applications in psychiatry and psychology is the amygdala. However, ultra-high field magnetic resonance imaging of these ventral brain regions is a challenging endeavor that requires particular methodological considerations. Ventral brain areas are particularly prone to signal losses arising from strong magnetic field inhomogeneities along susceptibility borders. In addition, physiological artifacts from respiration and cardiac action cause considerable fluctuations in the MR signal. Here we show that, despite these challenges, fMRI data from the amygdala may be obtained with high temporal and spatial resolution combined with increased signal-to-noise ratio. Maps of neural activation during a facial emotion discrimination paradigm at 7 T are presented and clearly show the gain in percental signal change compared to 3 T results, demonstrating the potential benefits of ultra-high field functional MR imaging also in ventral brain areas.     

Emergency MRI utilization trends at a tertiary care academic medical center: baseline data

RATIONALE AND OBJECTIVES: This study evaluates utilization trends of emergency department (ED)-ordered magnetic resonance imaging (MRI) examinations in an adult academic medical center over a 5-year period (2001-2005). MATERIALS AND METHODS: MRI examinations from the ED-ordering location were identified by searching the radiology information system (RIS). Overall MRI volume and ED patient encounters were also assessed during the same period. Each examination was assessed by type of examination, examination completion time, and primary and secondary clinical indications by reviewing the RIS and medical record. RESULTS: During the study period, 1,900 ED-ordered MRI examinations were performed on 1,020 patients. During the same period, 62,823 total MRI examinations were performed, and the total ED patient volume was 420,840. ED-ordered MRI volume increased 391% over the study period (125 to 614 examinations/year), whereas total MRI volume increased only 38.9% and ED patient volume in our institution actually decreased by -9%. MRI examinations of the brain, magnetic resonance angiography of the head and neck, and spinal MRI were the most commonly ordered tests. Clinical indications were analyzed. Peak times of ED-ordered examination completion were between 4:00 PM and 11:00 PM. A total of 15.5% of examinations required overtime or callback of MRI technologists for completion. CONCLUSIONS: Multiple reasons are suggested that may increase utilization (perceived need for diagnostic certainty, as well as medico-legal and patient-driven factors). Whether this increase in MRI utilization resulted in improved patient outcomes is unclear and should be studied further. Implications for radiologist coverage and resident training are discussed.     

肌萎缩侧索硬化症MRI研究进展

肌萎缩侧索硬化(ALS)是一种以上、下运动神经元受累为主要特征的慢性进行性神经系统变性性疾病。下运动神经元功能障碍可经肌电图和肌肉活检证实,而上运动神经元受累尤其在早期难以检测。常规MRI和功能MRI技术如扩散张量成像（DTI）、磁共振波谱（MRS）和静息态功能MRI（rs-fMRI）等,可以检测ALS 运动区及非运动区变化,对疾病的早期诊断和监测有一定作用。就MRI技术及其在ALS中的应用进行综述。