WorldWideScience

Sample records for diffusion-weighted brain mri

  1. Diffusion-weighted MRI of myelination in the rat brain following treatment with gonadal hormones

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, D. [Department of Radiology, Section of Neuroradiology, University of Vienna (Austria); Roberts, T. [Department of Radiology, Section of Neuroradiology, University of California at San Francisco (UCSF), CA (United States); Barkovich, A.J. [Department of Radiology, Section of Neuroradiology, University of California at San Francisco (UCSF), CA (United States); Prayer, L. [Department of Radiology, Section of Neuroradiology, University of Vienna (Austria); Kucharczyk, J. [Department of Radiology, Section of Neuroradiology, University of California at San Francisco (UCSF), CA (United States); Moseley, M. [Department of Radiology, Section of Neuroradiology, University of California at San Francisco (UCSF), CA (United States); Arieff, A. [Department of Medicine, Geriatrics Section, Veteran`s Affairs Medical Center and University of California at San Francisco (UCSF), CA (United States)

    1997-05-01

    Previous studies have demonstrated the ability of high-resolution diffusion-weighted MRI to show maturation of white-matter structures in the developing rat brain. The purpose of this study was to investigate the influence of gonadal steroid hormones on the rate of this development. Starting from their second postnatal day, 16 rat-pups of either sex were repeatedly treated with subcutaneous implants containing 17-beta estradiol or delta-androstene 3,17 dione, respectively. Serial T1-, T2- and diffusion-weighted MRI was performed weekly for 8 weeks using a 4.7 T unit. Maturation of anterior optic pathways and hemisphere commissures was assessed. Diffusion-weighted images were processed to produce ``anisotropy index maps``, previously shown to be sensitive to white-matter maturation. Compared with untreated rat-pups, estrogen-treated animals showed accelerated, and testosterone-treated animals delayed maturation on anisotropy index maps and histological sections. In all animals, maturational changes appeared earlie on anisotropy index maps than on other MRI sequences or on myelin-sensitive stained sections. Diffusion-weighted imaging, and the construction of spatial maps sensitive to diffusion anisotropy, seem to be the most sensitive approach for the detection of maturational white-matter changes, and thus may hold potential for early diagnosis of temporary delay or permanent disturbances of white-matter development. (orig.). With 6 figs., 1 tab.

  2. Diffusion-weighted MRI of myelination in the rat brain following treatment with gonadal hormones

    International Nuclear Information System (INIS)

    Prayer, D.; Roberts, T.; Barkovich, A.J.; Prayer, L.; Kucharczyk, J.; Moseley, M.; Arieff, A.

    1997-01-01

    Previous studies have demonstrated the ability of high-resolution diffusion-weighted MRI to show maturation of white-matter structures in the developing rat brain. The purpose of this study was to investigate the influence of gonadal steroid hormones on the rate of this development. Starting from their second postnatal day, 16 rat-pups of either sex were repeatedly treated with subcutaneous implants containing 17-beta estradiol or delta-androstene 3,17 dione, respectively. Serial T1-, T2- and diffusion-weighted MRI was performed weekly for 8 weeks using a 4.7 T unit. Maturation of anterior optic pathways and hemisphere commissures was assessed. Diffusion-weighted images were processed to produce ''anisotropy index maps'', previously shown to be sensitive to white-matter maturation. Compared with untreated rat-pups, estrogen-treated animals showed accelerated, and testosterone-treated animals delayed maturation on anisotropy index maps and histological sections. In all animals, maturational changes appeared earlie on anisotropy index maps than on other MRI sequences or on myelin-sensitive stained sections. Diffusion-weighted imaging, and the construction of spatial maps sensitive to diffusion anisotropy, seem to be the most sensitive approach for the detection of maturational white-matter changes, and thus may hold potential for early diagnosis of temporary delay or permanent disturbances of white-matter development. (orig.). With 6 figs., 1 tab

  3. Persistent lesion hyperintensity on brain diffusion-weighted MRI is an early sign of intravascular lymphoma.

    Science.gov (United States)

    Kageyama, Takashi; Yamanaka, Haruo; Nakamura, Fumihiko; Suenaga, Toshihiko

    2017-06-08

    A 63-year-old man presented with right-sided hemianopia and unsteady gait. Brain MRI revealed multiple hyperintense infarct-like lesions on diffusion-weighted images (DWI). Hyperintensity persisted in some of these lesions even after 6 weeks, although his symptoms were ameliorated then. The patient developed episodic dizziness and a transient event of apraxia at 18 weeks after the first episode. Brain MRI revealed additional hyperintense lesions on DWI, which persisted even after 7 weeks. Eventually, the patient manifested cauda equina syndrome 39 weeks after the first episode. Brain MRI showed the presence of new lesions in addition to the persistent hyperintense lesions on DWI over 21 weeks in the right frontal lobe. Based on laboratory findings and the pathological assessment of bone marrow and random skin biopsies, the patient was diagnosed with intravascular lymphoma (IVL). Persistent hyperintense lesions on DWI of brain MRI may precede the clinical exacerbation of IVL. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Quantifying Pathology in Diffusion Weighted MRI

    NARCIS (Netherlands)

    Caan, M.W.A.

    2010-01-01

    In this thesis algorithms are proposed for quantification of pathology in Diffusion Weighted Magnetic Resonance Imaging (DW-MRI) data. Functional evidence for brain diseases can be explained by specific structural loss in the white matter of the brain. That is, certain biomarkers may exist where the

  5. CADrx for GBM Brain Tumors: Predicting Treatment Response from Changes in Diffusion-Weighted MRI

    Directory of Open Access Journals (Sweden)

    Matthew S. Brown

    2009-11-01

    Full Text Available The goal of this study was to develop a computer-aided therapeutic response (CADrx system for early prediction of drug treatment response for glioblastoma multiforme (GBM brain tumors with diffusion weighted (DW MR images. In conventional Macdonald assessment, tumor response is assessed nine weeks or more post-treatment. However, we will investigate the ability of DW-MRI to assess response earlier, at five weeks post treatment. The apparent diffusion coefficient (ADC map, calculated from DW images, has been shown to reveal changes in the tumor’s microenvironment preceding morphologic tumor changes. ADC values in treated brain tumors could theoretically both increase due to the cell kill (and thus reduced cell density and decrease due to inhibition of edema. In this study, we investigated the effectiveness of features that quantify changes from pre- and post-treatment tumor ADC histograms to detect treatment response. There are three parts to this study: first, tumor regions were segmented on T1w contrast enhanced images by Otsu’s thresholding method, and mapped from T1w images onto ADC images by a 3D region of interest (ROI mapping tool using DICOM header information; second, ADC histograms of the tumor region were extracted from both pre- and five weeks post-treatment scans, and fitted by a two-component Gaussian mixture model (GMM. The GMM features as well as standard histogram-based features were extracted. Finally, supervised machine learning techniques were applied for classification of responders or non-responders. The approach was evaluated with a dataset of 85 patients with GBM under chemotherapy, in which 39 responded and 46 did not, based on tumor volume reduction. We compared adaBoost, random forest and support vector machine classification algorithms, using ten-fold cross validation, resulting in the best accuracy of 69.41% and the corresponding area under the curve (Az of 0.70.

  6. Brain MRI diffusion-weighted imaging in patients with classical phenylketonuria

    International Nuclear Information System (INIS)

    Manara, Renzo; Citton, Valentina; Carollo, Carla; Burlina, Alessandro P.; Ermani, Mario; Vespignani, Francesco; Burlina, Alberto B.

    2009-01-01

    The aim of this study was to grade magnetic resonance white matter abnormalities (WMAs) of classical phenylketonuria (cPKU) patients treated from birth and to compare sensitivity and specificity of T2-weighted and diffusion-weighted images (DWI). Twenty early-treated cPKU patients still on a low-phenylalanine diet (12 males; mean age 21.2 years) and 26 normal subjects (ten males; mean age 25.1 years) were enrolled. Typical T2- and diffusion-weighted WMAs were semiquantitatively graded according to Thompson score (TS). Besides, a regional magnetic resonance imaging (MRI) score (mTS) was developed according to extension and intensity of WMAs. Phenylalanine and tyrosine plasma concentrations before performing MRI and the amino acid mean levels collected the year before MRI (Tyr year and Phe year ) were measured. No patient with Phe year concentration below 460 μmol/L showed WMAs. In cPKU patients, TS and mTS were significantly higher on DWI than on T2 images (3.50 vs 2.65 and 23.65 vs 15.85, respectively, p year levels. Among the different MR sequences, DWI seems to be the most sensitive and reliable in detecting and grading the typical WMAs of cPKU patients. (orig.)

  7. Brain MRI diffusion-weighted imaging in patients with classical phenylketonuria

    Energy Technology Data Exchange (ETDEWEB)

    Manara, Renzo; Citton, Valentina; Carollo, Carla [University Hospital of Padua, Neuroradiologic Unit, Padua (Italy); Burlina, Alessandro P.; Ermani, Mario [University Hospital of Padua, Neurological Clinic, Department of Neuroscience, Padua (Italy); Vespignani, Francesco; Burlina, Alberto B. [University Hospital of Padua, Metabolic Diseases Unit, Department of Paediatrics, Padua (Italy)

    2009-12-15

    The aim of this study was to grade magnetic resonance white matter abnormalities (WMAs) of classical phenylketonuria (cPKU) patients treated from birth and to compare sensitivity and specificity of T2-weighted and diffusion-weighted images (DWI). Twenty early-treated cPKU patients still on a low-phenylalanine diet (12 males; mean age 21.2 years) and 26 normal subjects (ten males; mean age 25.1 years) were enrolled. Typical T2- and diffusion-weighted WMAs were semiquantitatively graded according to Thompson score (TS). Besides, a regional magnetic resonance imaging (MRI) score (mTS) was developed according to extension and intensity of WMAs. Phenylalanine and tyrosine plasma concentrations before performing MRI and the amino acid mean levels collected the year before MRI (Tyr{sub year} and Phe{sub year}) were measured. No patient with Phe{sub year} concentration below 460 {mu}mol/L showed WMAs. In cPKU patients, TS and mTS were significantly higher on DWI than on T2 images (3.50 vs 2.65 and 23.65 vs 15.85, respectively, p<0.002, Wilcoxon test). All controls were scored 0 on DWI, while in T2 images, TS and mTS were 0.19 and 1.70. DWI evaluated by mTS disclosed a frontotemporal, occipital, and parietal WM progressive involvement. TS and mTS, both on T2 images and on DWI, showed no correlation with tyrosine while they proved to have a strong correlation with phenylalaninemia and an excellent one with Phe{sub year} levels. Among the different MR sequences, DWI seems to be the most sensitive and reliable in detecting and grading the typical WMAs of cPKU patients. (orig.)

  8. Cortical hypoxic-ischemic brain damage in shaken-baby (shaken impact) syndrome: value of diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Parizel, Paul M.; Oezsarlak, Oezkan; Goethem, Johan W. van; Ceulemans, Berten; Laridon, Annick; Jorens, Philippe G.

    2003-01-01

    Shaken-baby syndrome (SBS) is a type of child abuse caused by violent shaking of an infant, with or without impact, and characterized by subdural hematomas, retinal hemorrhages, and occult bone fractures. Parenchymal brain lesions in SBS may be missed or underestimated on CT scans, but can be detected at an earlier stage with diffusion-weighted MRI (DW-MRI) as areas of restricted diffusion. We demonstrate the value of DW-MRI in a 2-month-old baby boy with suspected SBS. The pattern of diffusion abnormalities indicates that the neuropathology of parenchymal lesions in SBS is due to hypoxic-ischemic brain injuries, and not to diffuse axonal injury. (orig.)

  9. Cortical hypoxic-ischemic brain damage in shaken-baby (shaken impact) syndrome: value of diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Parizel, Paul M.; Oezsarlak, Oezkan; Goethem, Johan W. van [Department of Radiology, University of Antwerp, Wilrijkstraat 10, 2650, Edegem (Belgium); Ceulemans, Berten; Laridon, Annick [Department of Pediatric Neurology, University of Antwerp, Wilrijkstraat 10, 2650, Edegem (Belgium); Jorens, Philippe G. [Department of Pediatric Intensive Care Medicine, University of Antwerp, Wilrijkstraat 10, 2650, Edegem (Belgium)

    2003-12-01

    Shaken-baby syndrome (SBS) is a type of child abuse caused by violent shaking of an infant, with or without impact, and characterized by subdural hematomas, retinal hemorrhages, and occult bone fractures. Parenchymal brain lesions in SBS may be missed or underestimated on CT scans, but can be detected at an earlier stage with diffusion-weighted MRI (DW-MRI) as areas of restricted diffusion. We demonstrate the value of DW-MRI in a 2-month-old baby boy with suspected SBS. The pattern of diffusion abnormalities indicates that the neuropathology of parenchymal lesions in SBS is due to hypoxic-ischemic brain injuries, and not to diffuse axonal injury. (orig.)

  10. Transient ischemic attacks and presence of an acute brain lesion in diffusion-weighted MRI: study of 50 patients

    Directory of Open Access Journals (Sweden)

    Sabeti M

    2012-10-01

    Full Text Available Background: Finding an acute brain lesion by diffusion-weighted (DW MRI upon an episode of transient ischemic attack (TIA is a predictor of imminent stroke in the near future. Therefore, exploring risk factors associated with lesions in DW-MRI of the brain is important in adopting an approach to TIA management. In the current study, we tried to determine the risk factors associated with lesions in DW-MRI of the brain in patients experiencing TIA episodes.Methods: Fifty patients with TIA were recruited consecutively in Sina Hospital, Tehran, Iran, over a 6-month period between July 2008 and January 2009. All of the patients underwent a complete neurological examination and laboratory tests. Brain DW-MRIs were performed for all the patients within 72 hours of a TIA episode.Results: DW-MRI revealed an acute lesion in 16% of the participants. There was a significant correlation between presence of an acute lesion in DW-MRI and TIA duration, history of diabetes mellitus and presence of unilateral facial palsy (P=0.0003, P=0.02 and P=0.008, respectively. Other variables such as age, hypertension, hyperlipidemia, past history of TIA, headache, vertigo, and sensory or visual disturbances had no significant relation with the presence of an acute lesion in DW-MRI.Conclusion: Duration of TIA, presence of diabetes mellitus and unilateral facial palsy are risk factors for an acute lesion in DW-MRI, meaning that patients with such risk factors are at risk for stroke in the near future.

  11. Co-analysis of brain structure and function using fMRI and diffusion-weighted imaging.

    Science.gov (United States)

    Phillips, Jeffrey S; Greenberg, Adam S; Pyles, John A; Pathak, Sudhir K; Behrmann, Marlene; Schneider, Walter; Tarr, Michael J

    2012-11-08

    The study of complex computational systems is facilitated by network maps, such as circuit diagrams. Such mapping is particularly informative when studying the brain, as the functional role that a brain area fulfills may be largely defined by its connections to other brain areas. In this report, we describe a novel, non-invasive approach for relating brain structure and function using magnetic resonance imaging (MRI). This approach, a combination of structural imaging of long-range fiber connections and functional imaging data, is illustrated in two distinct cognitive domains, visual attention and face perception. Structural imaging is performed with diffusion-weighted imaging (DWI) and fiber tractography, which track the diffusion of water molecules along white-matter fiber tracts in the brain (Figure 1). By visualizing these fiber tracts, we are able to investigate the long-range connective architecture of the brain. The results compare favorably with one of the most widely-used techniques in DWI, diffusion tensor imaging (DTI). DTI is unable to resolve complex configurations of fiber tracts, limiting its utility for constructing detailed, anatomically-informed models of brain function. In contrast, our analyses reproduce known neuroanatomy with precision and accuracy. This advantage is partly due to data acquisition procedures: while many DTI protocols measure diffusion in a small number of directions (e.g., 6 or 12), we employ a diffusion spectrum imaging (DSI)(1, 2) protocol which assesses diffusion in 257 directions and at a range of magnetic gradient strengths. Moreover, DSI data allow us to use more sophisticated methods for reconstructing acquired data. In two experiments (visual attention and face perception), tractography reveals that co-active areas of the human brain are anatomically connected, supporting extant hypotheses that they form functional networks. DWI allows us to create a "circuit diagram" and reproduce it on an individual-subject basis

  12. Detection of electroporation-induced membrane permeabilization states in the brain using diffusion-weighted MRI

    DEFF Research Database (Denmark)

    Mahmood, Faisal; Hansen, Rasmus H; Agerholm-Larsen, Birgit

    2015-01-01

    (NP), transient membrane permeabilization (TMP), and permanent membrane permeabilization (PMP), respectively. DW-MRI was acquired 5 minutes, 2 hours, 24 hours and 48 hours after EP. Histology was performed for validation of the permeabilization states. Tissue content of water, Na+, K+, Ca2...... minutes after EP, compared to NP. Kurtosis was also significantly higher at 24 hours (pPhysiological parameters indicated correlation with the permeabilization states, supporting the DW-MRI findings. We conclude that DW-MRI is capable of detecting EP...

  13. Diffusion-weighted MRI of the prostate

    International Nuclear Information System (INIS)

    Mueller-Lisse, U.G.; Scherr, M.K.; Mueller-Lisse, U.L.; Zamecnik, P.; Schlemmer, H.P.W.

    2011-01-01

    Diffusion-weighted magnetic resonance imaging (DWI) can complement MRI of the prostate in the detection and localization of prostate cancer, particularly after previous negative biopsy. A total of 13 original reports and 2 reviews published in 2010 demonstrate that prostate cancer can be detected by DWI due to its increased cell density and decreased diffusiveness, either qualitatively in DWI images or quantitatively by means of the apparent diffusion coefficient (ADC). In the prostate, the ADC is influenced by the strength of diffusion weighting, localization (peripheral or transitional zone), presence of prostatitis or hemorrhage and density and differentiation of prostate cancer cells. Mean differences between healthy tissue of the peripheral zone and prostate cancer appear to be smaller for ADC than for the (choline + creatine)/citrate ratio in MR spectroscopy. Test quality parameters vary greatly between different studies but appear to be slightly better for combined MRI and DWI than for MRI of the prostate alone. Clinical validation of DWI of the prostate requires both increased technical conformity and increased numbers of patients in clinical studies. (orig.) [de

  14. Detection of hyperacute parenchymal hemorrhage of the brain using echo-planar T2{sup *}-weighted and diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmann, M. [Dept. of Radiology, Medizinische Universitaet zu Luebeck (Germany); Mayer, T.E.; Yousry, I.; Brueckmann, H. [Dept. of Neuroradiology, Klinikum Grosshadern, Ludwig-Maximilians-Universitaet, Muenchen (Germany); Hamann, G.F. [Dept. of Neurology, Klinikum Grosshadern, Ludwig-Maximilians-Universitaet, Muenchen (Germany)

    2001-05-01

    We investigated the usefulness of echo-planar imaging (EPI) as well as T2{sup *}-weighted and diffusion-weighted MRI (DWI) to identify hyperacute hemorrhage (within 24 h after ictus) in the brain. Seven patients were examined 3.5 to 24 h after onset of symptoms using a whole-body 1.5-T MR system. Two diffusion-weighted sequences were run to obtain isotropic and anisotropic diffusion images. Apparent diffusion coefficients (ADC) were calculated from the isotropic diffusion images. All DWI images as well as the T2*-weighted EPI images showed the hematomas as either discrete, deeply hypointense homogeneous lesions, or as lesions of mixed signal intensity containing hypointense areas. We conclude that even in the early phase after hemorrhage, sufficient amounts of paramagnetic deoxyhemoglobin are present in intracerebral hemorrhages to cause hypointensity on EPI T2{sup *}-weighted and DWI images; thus, use of ultrafast EPI allows identification of intracerebral hemorrhage. (orig.)

  15. Diffusion-weighted MRI in cervical cancer

    International Nuclear Information System (INIS)

    McVeigh, Patrick Z.; Haider, Masoom A.; Syed, Aejaz M.; Milosevic, Michael; Fyles, Anthony

    2008-01-01

    The purpose was to investigate the potential value of apparent diffusion coefficient (ADC) measurement with MRI in the assessment of cervix cancer. Diffusion-weighted MRI was performed in 47 patients with cervical carcinoma undergoing chemoradiation therapy and 26 normal controls on a 1.5-T system with a b-value of 600 s/mm 2 . FIGO stage, tumor volume, nodal status, interstitial fluid pressure (IFP) and oxygen measurements were recorded. Response was defined as no visible tumor 3-6 months following completion of therapy. The average median ADC (mADC) of cervical carcinomas (1.09±0.20 x 10 -3 mm 2 /s) was significantly lower than normal cervix (2.09±0.46 x 10 -3 mm 2 /s) (P -3 mm 2 /s) compared to T2b (1.21 x 10 -3 mm 2 /s) and T3/T4 (1.10 x 10 -3 mm 2 /s) (P<0.001). In patients with squamous carcinomas the 90th percentile of ADC values was lower in responders than non-responders (P<0.05). Median ADC in cervix carcinoma is significantly lower compared to normal cervix. ADC may have predictive value in squamous tumors, but further long-term study will determine the ultimate clinical utility. (orig.)

  16. Diffusion-Weighted MRI and apparent

    Directory of Open Access Journals (Sweden)

    Doaa Ibrahim Hasan

    2016-12-01

    Full Text Available The purpose of this study was to evaluate use of Diffusion-Weighted MRI (DWI and apparent diffusion coefficient value (ADC in differentiation of intra-medullary spinal cord masses (IMSCM. Patients and methods: This study was carried out during the period from June 2013 to January 2016. It included 66 adult consecutive patients with intra-medullary SC masses. Results: The patients mean age was 45.48 ± 15.9 (18–72 y. Histopathological classification to benign/low grade malignancy group was in 53 patients and high grade malignancy group in 13 patients. No statistically significant difference between both groups regarding the patient age or their clinical presentation. There was a statistically significant difference between the two groups regarding the tumor location and enhancement pattern. There was statistically significant difference between the benign/low grade IMSC masses and high grade IMSC tumors (p < 0.001. Calculated mean ADC values in the benign/low grade tumors were high (1.26 × 10–3 mm2/sec compared to high grade tumors which were 0.89 ± 0.40 × 10–3 mm2/sec. Conclusion: DWI and ADC values may be useful in providing information about tumors grading not available with conventional MR imaging in the evaluation of IMSC masses.

  17. Q-ball imaging models: comparison between high and low angular resolution diffusion-weighted MRI protocols for investigation of brain white matter integrity

    Energy Technology Data Exchange (ETDEWEB)

    Caiazzo, Giuseppina; Trojsi, Francesca; Cirillo, Mario; Tedeschi, Gioacchino [MRI Research Center SUN-FISM-Neurological Institute for Diagnosis and Care ' ' Hermitage Capodimonte' ' , Naples (Italy); Second University of Naples, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Naples (Italy); Esposito, Fabrizio [University of Salerno, Department of Medicine and Surgery, Baronissi (Salerno) (Italy); Maastricht University, Department of Cognitive Neuroscience, Maastricht (Netherlands)

    2016-02-15

    Q-ball imaging (QBI) is one of the typical data models for quantifying white matter (WM) anisotropy in diffusion-weighted MRI (DwMRI) studies. Brain and spinal investigation by high angular resolution DwMRI (high angular resolution imaging (HARDI)) protocols exhibits higher angular resolution in diffusion imaging compared to low angular resolution models, although with longer acquisition times. We aimed to assess the difference between QBI-derived anisotropy values from high and low angular resolution DwMRI protocols and their potential advantages or shortcomings in neuroradiology. Brain DwMRI data sets were acquired in seven healthy volunteers using both HARDI (b = 3000 s/mm{sup 2}, 54 gradient directions) and low angular resolution (b = 1000 s/mm{sup 2}, 32 gradient directions) acquisition schemes. For both sequences, tract of interest tractography and generalized fractional anisotropy (GFA) measures were extracted by using QBI model and were compared between the two data sets. QBI tractography and voxel-wise analyses showed that some WM tracts, such as corpus callosum, inferior longitudinal, and uncinate fasciculi, were reconstructed as one-dominant-direction fiber bundles with both acquisition schemes. In these WM tracts, mean percent different difference in GFA between the two data sets was less than 5 %. Contrariwise, multidirectional fiber bundles, such as corticospinal tract and superior longitudinal fasciculus, were more accurately depicted by HARDI acquisition scheme. Our results suggest that the design of optimal DwMRI acquisition protocols for clinical investigation of WM anisotropy by QBI models should consider the specific brain target regions to be explored, inducing researchers to a trade-off choice between angular resolution and acquisition time. (orig.)

  18. Purulent meningitis with unusual diffusion-weighted MRI findings

    International Nuclear Information System (INIS)

    Abe, M.; Takayama, Y.; Yamashita, H.; Noguchi, M.; Sagoh, T.

    2002-01-01

    We describe unusual findings obtained by diffusion-weighted magnetic resonance imaging (MRI) in a patient with acute purulent meningitis caused by penicillin-resistant Streptococcus pneumoniae. Along cerebral convexities and the Sylvian fissure, multiple small intense lesions showed high signal intensity in these sequences. This may be the first report of diffusion-weighted in purulent meningitis

  19. Diffusion-weighted MRI in acute cerebral stroke

    Energy Technology Data Exchange (ETDEWEB)

    Takayama, Hideichi; Kobayashi, Masahito; Suga, Sadao; Kawase, Takeshi; Nagasawa, Masakazu; Sadanaga, Humiko; Okamura, Miyuki; Kanai, Yoshihiro; Mihara, Ban [Mihara Memorial Hospital, Isezaki, Gunma (Japan)

    1999-03-01

    Diffusion-weighted MRI has been demonstrated to be valuable in the assessment of cerebral stroke. Recent advance in MR systems of hardware with larger maximum gradient amplitude and faster imaging strategies, such as EPI, has made it possible to acquire whole brain diffusion-weighted imaging (DWI) in less that one minute. The purposes of this study are to evaluate clinical usefulness of DWI and to clarify pitfalls in the diagnosis of acute cerebral stroke. Seventeen patients with 18 ischemic lesions were studied. DWI were taken with 1.5 Tesla MRI (Magnetom Vision, Siemens, Germany) using EPI sequence. Fifteen lesions out of them (3 in cerebral cortex, 9 in basal ganglia/deep white matter and 3 in cerebellum) were studied serially at various times up to 147 days. Acute cerebral infarction was seen clearly as an area of hyperintensity with DWI and as hypointensity in apparent diffusion coefficient (ADC) maps which are indicative of decreased diffusion. DWI detected areas of hyperintense acute infarcts, as early as 2.5 hours after onset, which were not visualized on T{sub 2}-weighted image (T2WI). The lesion of cerebral infarction became isointense in ADC maps at 14-28 days after onset, whereas with DWI it became isointense at about 2 months. Because ADC changed earlier than DWI, ADC maps were useful for differentiate acute from nonacute lesion in cases of recurrent stroke within a short period. In a patient with transient global amnesia for 7 hours, DWI did not show any lesion at 8 hours. In terms of cerebral hemorrhage, lesions were seen as area of hyperintensity in DWI at 3 days and were not distinguishable from that of infarct. Despite limitations in the diagnosis of transient ischemia and cerebral hemorrhage, DWI is a useful technique for early detection of cerebral infarction, especially within the first 6 hours after stroke onset. (author)

  20. Diffusion-weighted MRI in acute cerebral stroke

    International Nuclear Information System (INIS)

    Takayama, Hideichi; Kobayashi, Masahito; Suga, Sadao; Kawase, Takeshi; Nagasawa, Masakazu; Sadanaga, Humiko; Okamura, Miyuki; Kanai, Yoshihiro; Mihara, Ban

    1999-01-01

    Diffusion-weighted MRI has been demonstrated to be valuable in the assessment of cerebral stroke. Recent advance in MR systems of hardware with larger maximum gradient amplitude and faster imaging strategies, such as EPI, has made it possible to acquire whole brain diffusion-weighted imaging (DWI) in less that one minute. The purposes of this study are to evaluate clinical usefulness of DWI and to clarify pitfalls in the diagnosis of acute cerebral stroke. Seventeen patients with 18 ischemic lesions were studied. DWI were taken with 1.5 Tesla MRI (Magnetom Vision, Siemens, Germany) using EPI sequence. Fifteen lesions out of them (3 in cerebral cortex, 9 in basal ganglia/deep white matter and 3 in cerebellum) were studied serially at various times up to 147 days. Acute cerebral infarction was seen clearly as an area of hyperintensity with DWI and as hypointensity in apparent diffusion coefficient (ADC) maps which are indicative of decreased diffusion. DWI detected areas of hyperintense acute infarcts, as early as 2.5 hours after onset, which were not visualized on T 2 -weighted image (T2WI). The lesion of cerebral infarction became isointense in ADC maps at 14-28 days after onset, whereas with DWI it became isointense at about 2 months. Because ADC changed earlier than DWI, ADC maps were useful for differentiate acute from nonacute lesion in cases of recurrent stroke within a short period. In a patient with transient global amnesia for 7 hours, DWI did not show any lesion at 8 hours. In terms of cerebral hemorrhage, lesions were seen as area of hyperintensity in DWI at 3 days and were not distinguishable from that of infarct. Despite limitations in the diagnosis of transient ischemia and cerebral hemorrhage, DWI is a useful technique for early detection of cerebral infarction, especially within the first 6 hours after stroke onset. (author)

  1. Clinical single-shot diffusion-weighted MRI of the human brain on a short-bore medium-field imager

    International Nuclear Information System (INIS)

    Loevblad, K.O.; Remonda, L.; Schneider, J.; Goenner, F.; Schroth, G.; Heid, O.

    1999-01-01

    Diffusion-weighted MRI (DWI) is becoming important for assessment of acute stroke. Until recently single-shot DWI required expensive technology such as echo-planar imaging (EPI) available only at some research sites. A new medium-field (1.0 T) short-bore MR imager has been developed with which DWI data sets can be acquired. We prospectively studied 169 patients on this 1.0 T commercial system. After conventional imaging, DWI was performed with a single-shot multi-slice sequence with b values 0 an 900 s/mm 2 , and with the gradients switched in three directions. The apparent diffusion coefficients were calculated with online calculation software. There were 50 patients with totally normal MRI, and 17 had strokes, these strokes were detected as areas of high signal on the images at a maximal b value. There was a drop in the ADC in ischaemic regions: in subacute infarcts, the values were between 0.41 and 0.531 x 10 - 3 mm 2 /s. In old infarcts the ADC was 1.15 x 10 - 3 mm 2 /s. Cerebrospinal fluid (CSF) gave low signal whereas areas in the brain had more intermediate intensities (CSF: 3.00; deep white matter: 0.75, cortical grey matter: 0.80, basal ganglia (thalamus): 0.70 and cerebellar white matter: 0.65 x 10 - 3 mm 2 /s). Anisotropy was detected as areas of restricted diffusion along the tracts. These preliminary data show that DWI can be aquired successfully on a medium-field short-bore system. This should allow the technique to be implemented at more sites, therefore facilitating the diagnosis of acute stroke and rendering early intervention feasible. (orig.)

  2. Differentiation of thyroid nodules using diffusion-weighted MRI ...

    African Journals Online (AJOL)

    Routine MRI of neck and diffusion-weighted MR imaging was performed using multiple b-values. Apparent diffusion coefficient (ADC) values were done for the different b-values. Histopathological results of the thyroidectomy samples were obtained. Comparison of apparent diffusion coefficient values of thyroid nodules with ...

  3. Diffusion-weighted MRI in shaken baby syndrome

    International Nuclear Information System (INIS)

    Chan, Yu-Leung; Chu, Winnie C.W.; Wong, Gary W.K.; Yeung, David K.W.

    2003-01-01

    We present the characteristic CT and MRI findings of a 2-month-old girl with shaken baby syndrome. Diffusion-weighted MR imaging performed 8 days after the insult established the presence of injury to the white matter in the corpus callosum and subcortical white matter in the temporo-occipito-parietal region. Diffusion-weighted MR imaging is valuable in the diagnostic work-up of suspected shaken baby syndrome, as injury to the white matter can be demonstrated days after the injury. (orig.)

  4. Diffusion-weighted MRI of maple syrup urine disease encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Cavalleri, F.; Mavilla, L. [Servizio di Neuroradiologia, Azienda Ospedaliera Policlinico, Modena (Italy); Berardi, A.; Ferrari, F. [Servizio di Neonatologia, Azienda Ospedaliera Policlinico, Modena (Italy); Burlina, A.B. [Dipartimento di Pediatria, Azienda Ospedaliera, Universita di Padova, Padua (Italy)

    2002-06-01

    We report the case of a newborn child with maple syrup urine disease (MSUD), diagnosed at 10 days of life. Diffusion-weighted echoplanar MRI showed marked hyperintensity of the cerebellar white matter, the brainstem, the cerebral peduncles, the thalami, the dorsal limb of the internal capsule and the centrum semiovale, while conventional dual-echo sequence evidenced only a weak diffuse T2 hyperintensity in the cerebellar white matter and in the dorsal brainstem. The apparent diffusion coefficient (ADC) of these regions was markedly (>80%) decreased. Therefore, in agreement with current hypotheses on MSUD pathogenesis, MSUD oedema proves to be a cytotoxic oedema. Diffusion-weighted MRI may be a valuable tool, more sensitive than conventional spin-echo techniques, to assess the extent and progression of cytotoxicity in MSUD, as well as the effectiveness of the therapeutic interventions. (orig.)

  5. Diffusion-weighted MRI of maple syrup urine disease encephalopathy

    International Nuclear Information System (INIS)

    Cavalleri, F.; Mavilla, L.; Berardi, A.; Ferrari, F.; Burlina, A.B.

    2002-01-01

    We report the case of a newborn child with maple syrup urine disease (MSUD), diagnosed at 10 days of life. Diffusion-weighted echoplanar MRI showed marked hyperintensity of the cerebellar white matter, the brainstem, the cerebral peduncles, the thalami, the dorsal limb of the internal capsule and the centrum semiovale, while conventional dual-echo sequence evidenced only a weak diffuse T2 hyperintensity in the cerebellar white matter and in the dorsal brainstem. The apparent diffusion coefficient (ADC) of these regions was markedly (>80%) decreased. Therefore, in agreement with current hypotheses on MSUD pathogenesis, MSUD oedema proves to be a cytotoxic oedema. Diffusion-weighted MRI may be a valuable tool, more sensitive than conventional spin-echo techniques, to assess the extent and progression of cytotoxicity in MSUD, as well as the effectiveness of the therapeutic interventions. (orig.)

  6. Quick Brain Magnetic Resonance Imaging With Diffusion-Weighted Imaging as a First Imaging Modality in Pediatric Stroke.

    Science.gov (United States)

    Christy, Alison; Murchison, Charles; Wilson, Jenny L

    2018-01-01

    Diagnostic delay hinders management of pediatric arterial ischemic stroke. Quick brain MRI with diffusion-weighted imaging sequences may provide a rapid diagnosis without the ionizing radiation of a computed tomography (CT) scan. This was a single center retrospective chart review of children one month to 18 years old with acute arterial ischemic stroke hospitalized between January 2010 and January 2017. We evaluated sensitivity and the time to diagnostic study based on the first imaging study (CT or quick brain MRI with diffusion-weighted imaging). Twenty-five patients were included. Eleven patients (44%) were initially assessed with CT, 10 (40%) with quick brain MRI with diffusion-weighted imaging, and four (16%) with a full MRI. Compared with children undergoing CT, children with quick brain MRI with diffusion-weighted imaging as first study were younger (5.8 versus 14.1 years, P hospitalized at stroke onset (70% versus 18.2%, P = 0.03). Quick brain MRI with diffusion-weighted imaging was more sensitive for ischemia than CT (100% versus 27.3%). The median time from presentation to diagnostic imaging was 4.3 hours, with no differences between CT and quick brain MRI with diffusion-weighted imaging groups, although the quick brain MRI with diffusion-weighted imaging group had a shorter median time from first imaging to diagnostic imaging (P = 0.002). There were no significant missed findings on quick brain MRI with diffusion-weighted imaging. Quick brain MRI with diffusion-weighted imaging was more sensitive than CT for detecting ischemia and may be considered as the first study for some children presenting with suspected arterial ischemic stroke. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Differential diagnostic value of diffusion weighted imaging on brain abscess and necrotic or cystic brain tumors

    International Nuclear Information System (INIS)

    Zhang Xiaoya; Yin Jie; Wang Kunpeng; Zhang Jiandang; Liang Biling

    2009-01-01

    Objective: To investigate the value of diffusion weighted imaging (DWI)on brain abscess and necrotic or cystic brain tumors. Methods: 27 cases with brain abscesses and 33 cases with necrotic or cystic brain tumors (gliomas or metastases) were performed conventional MRI and DWI. Apparent diffusion coefficient (ADC) of region of interest (ROI) was measured and statistically tested. Sensitivity and specificity were calculated and compared with conventional MR and DWI. Results: Hyperintensity signal was seen on most brain abscesses. All necrotic or cystic brain tumors showed hypointensity signal on DWI. There was statistical significance on ADC of them. The sensitivity and specificity of conventional MRI was lower than that of DWI. Conclusion: DWI and ADC were useful in distinguishing brain abscessed from necrotic or cystic brain tumors, which was important in addition to conventional MRI. (authors)

  8. Thoracic splenosis after a gunshot: diffusion-weighted MRI findings.

    Science.gov (United States)

    Tutar, Onur; Bakan, Selim; Samanci, Cesur; Nurili, Fuat; Sayman, Haluk Burcak; Akman, Canan

    2015-01-01

    Intrathoracic splenosis is a rare condition resulting from concomitant rupture of the spleen and left hemidiaphragm after a traumatic event involving the spleen and the diaphragma and is defined as autotransplantation of splenic tissue in thorax. The aim of this study was to present a case report of a combined intrathoracic and subcutaneous splenosis in a patient 19 years after penetrating trauma. She has left dorsal side pain and routine chest roentgenogram shows pleural nodular masses. The patient was referred to us for radiologic work up. The MRI scans revealed the intrathoracic and subcutan masses as mainly hypointense on T1-weighted images and hyperintense on T2-weighted images and significant restriction in diffusion-weighted images. Scintigraphy revealed abnormal hot spots in subcutaneous tissue and diaphragmatic pleura of the left hemithorax.

  9. Comparison of diffusion-weighted fMRI and BOLD fMRI responses in a verbal working memory task

    International Nuclear Information System (INIS)

    Aso, Toshihiko; Urayama, Shin-ichi; Fukuyama, Hidenao; Le Bihan, Denis

    2013-01-01

    Diffusion-weighted functional MRI (DfMRI) has been reported to have a different response pattern in the visual cortex than that of BOLD-fMRI. Especially, the DfMRI signal shows a constantly faster response at both onset and offset of the stimulus, suggesting that the DfMRI signal might be more directly linked to neuronal events than the hemodynamic response. However, because the DfMRI response also contains a residual sensitivity to BOLD this hypothesis has been challenged. Using a verbal working memory task we show that the DfMRI time-course features are preserved outside visual cortices, but also less liable to between-subject/between-regional variation than the BOLD response. The overall findings not only support the feasibility of DfMRI as an approach for functional brain imaging, but also strengthen the uniqueness of the DfMRI signal origin. (authors)

  10. Diffusion-weighted MRI for verification of electroporation-based treatments

    DEFF Research Database (Denmark)

    Mahmood, Faisal; Hansen, Rasmus H; Agerholm-Larsen, Birgit

    2011-01-01

    such a tissue reaction represents a great clinical benefit since, in case of target miss, retreatment can be performed immediately. We propose diffusion-weighted magnetic resonance imaging (DW-MRI) as a method to monitor EP tissue, using the concept of the apparent diffusion coefficient (ADC). We hypothesize...... that the plasma membrane permeabilization induced by EP changes the ADC, suggesting that DW-MRI constitutes a noninvasive and quick means of EP verification. In this study we performed in vivo EP in rat brains, followed by DW-MRI using a clinical MRI scanner. We found a pulse amplitude-dependent increase...... in the ADC following EP, indicating that (1) DW-MRI is sensitive to the EP-induced changes and (2) the observed changes in ADC are indeed due to the applied electric field....

  11. Multishot diffusion-weighted SPLICE PROPELLER MRI of the abdomen.

    Science.gov (United States)

    Deng, Jie; Omary, Reed A; Larson, Andrew C

    2008-05-01

    Multishot FSE (fast spin echo)-based diffusion-weighted (DW)-PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) MRI offers the potential to reduce susceptibility artifacts associated with single-shot DW-EPI (echo-planar imaging) approaches. However, DW-PROPELLER in the abdomen is challenging due to the large field-of-view and respiratory motion during DW preparation. Incoherent signal phase due to motion will violate the Carr-Purcell-Meiboom-Gill (CPMG) conditions, leading to destructive interference between spin echo and stimulated echo signals and consequent signal cancellation. The SPLICE (split-echo acquisition of FSE signals) technique can mitigate non-CPMG artifacts in FSE-based sequences. For SPLICE, spin echo and stimulated echo are separated by using imbalanced readout gradients and extended acquisition window. Two signal families each with coherent phase properties are acquired at different intervals within the readout window. Separate reconstruction of these two signal families can avoid destructive phase interference. Phantom studies were performed to validate signal phase properties with different initial magnetization phases. This study evaluated the feasibility of combining SPLICE and PROPELLER for DW imaging of the abdomen. It is demonstrated that DW-SPLICE-PROPELLER can effectively mitigate non-CPMG artifacts and improve DW image quality and apparent diffusion coefficient (ADC) map homogeneity. (c) 2008 Wiley-Liss, Inc.

  12. Contribution of the diffusion-weighted MRI in the diagnosis and follow-up of encephalopathy caused by maple syrup urine disease in a full-term newborn

    International Nuclear Information System (INIS)

    Ferraz-Filho, Jose Roberto Lopes; Floriano, Valdeci Helio; Quirici, Marcelo Bianco; Souza, Antonio Soares; Albuquerque, Regina Pires de

    2009-01-01

    The purpose of this case report is to show conventional MRI and diffusion-weighted imaging (DWI) findings of the different evolutionary phases in MSUD (Maple syrup urine disease) of a newborn that evolved with brain white matter lesions (author)

  13. Contribution of the diffusion-weighted MRI in the diagnosis and follow-up of encephalopathy caused by maple syrup urine disease in a full-term newborn

    Energy Technology Data Exchange (ETDEWEB)

    Ferraz-Filho, Jose Roberto Lopes; Floriano, Valdeci Helio; Quirici, Marcelo Bianco; Souza, Antonio Soares [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Dept. de Radiologia; Albuquerque, Regina Pires de [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Dept. de Pediatria

    2009-07-01

    The purpose of this case report is to show conventional MRI and diffusion-weighted imaging (DWI) findings of the different evolutionary phases in MSUD (Maple syrup urine disease) of a newborn that evolved with brain white matter lesions (author)

  14. Atypical abdominal paediatric lymphangiomatosis: diagnosis aided by diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Humphries, Paul D.; Olsen, Oeystein E.; Wynne, Catherine S.; Sebire, Neil J.

    2006-01-01

    We report a 4-year-old child with a mesenteric mass, which on ultrasound, CT and conventional MRI appeared solid, raising lymphoma as a possible diagnosis. Diffusion weighted MRI (DW-MRI), however, suggested a low-cellularity lesion, making lymphoma less likely. Biopsy confirmed lymphangioma. DW-MRI may be a useful adjunct to conventional imaging, even in the abdomen. (orig.)

  15. Diffusion-weighted MRI and selection of patients for fibrinolytic therapy of acute cerebral ischaemia

    International Nuclear Information System (INIS)

    Ezura, M.; Takahashi, A.; Shimizu, H.; Yoshimoto, T.

    2000-01-01

    Treatment of patients with acute cerebral ischaemic events remains controversial. We investigated the reversibility of high signal intensity on diffusion-weighted (DW) MRI after acute local intra-arterial fibrinolysis (LIF) and the feasibility of DW MRI for selecting patients for acute LIF. Nine patients with acute middle cerebral artery embolic occlusion underwent single-photon emission computed tomography (SPECT) and DW MRI followed by acute LIF using tissue plasminogen activator. Recanalisation was observed in all patients, and eight improved clinically. The area of high signal intensity on pretreatment DW MRI was smaller than the low-uptake area on SPECT in all patients, and went on to infarction, as detected by MRI or CT 3 days after onset in all patients. It appears to correlate, at least clinically, with irreversible brain damage. Therefore, acute LIF should not be performed in patients with areas of high signal intensity in the cortex responsible for the symptoms. SPECT remains important, because areas normal on DW MRI with low uptake on SPECT often contribute to functional prognosis. (orig.)

  16. Heroin-induced leukoencephalopathy: characterization using MRI, diffusion-weighted imaging, and MR spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Offiah, C. [Department of Neuroradiology, St Bartholomew' s and the London Hospitals NHS Trust, London (United Kingdom); Hall, E. [Department of Neuroradiology, St Bartholomew' s and the London Hospitals NHS Trust, London (United Kingdom)], E-mail: curtis.offiah@bartsandthelondon.nhs.uk

    2008-02-15

    Aim: To describe the magnetic resonance imaging (MRI) characteristics of heroin-induced leukoencephalopathy or 'chasing the dragon syndrome' and, in particular, the diffusion-weighted imaging (DWI) and MR spectroscopy (MRS) features. Material and methods: Six patients with a clinical or histopathological diagnosis of heroin-induced leukoencephalopathy were identified and MRI examinations, including DWI and single-voxel MRS, reviewed. Results: Cerebellar white matter was involved in all six cases demonstrating similar symmetrical distribution with sparing of the dentate nuclei. Brain stem signal change was evident in five of the six patients imaged. Supratentorial brain parenchymal involvement, as well as brain stem involvement, correlated anatomically with corticospinal tract distribution. None of the areas of signal abnormality were restricted on DWI. Of those patients subjected to MRS, the areas of parenchymal damage demonstrated reduced N-acetylaspartate, reduced choline, and elevated lactate. Conclusion: Heroin-induced leukoencephalopathy results in characteristic and highly specific signal abnormalities on MRI, which can greatly aid diagnosis. DWI and MRS findings can be explained by known reported neuropathological descriptions in this condition and can be used to support a proposed mechanism for the benefit of current recommended drug treatment regimes.

  17. Value of MRI and diffusion-weighted MRI for the diagnosis of locally recurrent rectal cancer

    International Nuclear Information System (INIS)

    Lambregts, Doenja M.J.; Maas, Monique; Cappendijk, Vincent C.; Beets-Tan, Regina G.H.; Beets, Geerard L.

    2011-01-01

    To evaluate the accuracy of standard MRI, diffusion-weighted MRI (DWI) and fusion images for the diagnosis of locally recurrent rectal cancer in patients with a clinical suspicion of recurrence. Forty-two patients with a clinical suspicion of recurrence underwent 1.5-T MRI consisting of standard T2-weighted FSE (3 planes) and an axial DWI (b0,500,1000). Two readers (R1,R2) independently scored the likelihood of recurrence; [1] on standard MRI, [2] on standard MRI+DWI, and [3] on T2-weighted+DWI fusion images. 19/42 patients had a local recurrence. R1 achieved an area under the ROC-curve (AUC) of 0.99, sensitivity 100% and specificity 83% on standard MRI versus 0.98, 100% and 91% after addition of DWI (p = 0.78). For R2 these figures were 0.87, 84% and 74% on standard MRI and 0.91, 89% and 83% with DWI (p = 0.09). Fusion images did not significantly improve the performance. Interobserver agreement was κ0.69 for standard MRI, κ0.82 for standard MRI+DWI and κ0.84 for the fusion images. MRI is accurate for the diagnosis of locally recurrent rectal cancer in patients with a clinical suspicion of recurrence. Addition of DWI does not significantly improve its performance. However, with DWI specificity and interobserver agreement increase. Fusion images do not improve accuracy. (orig.)

  18. Ultrasound elastography and diffusion weighted MRI in patients with rectal cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Vagn-Hansen, Chris Aksel; Sørensen, Torben

    coefficient (ADC). The purpose of the present study was to compare quantitative elastography based on ultrasound shear wave measurements with MRI ADC. METHODS AND MATERIALS: We prospectively examined consecutive 52 patients with histopathological proven rectal cancer. The tumour elasticity was measured using......OBJECTIVE: The current literature has described the usefulness of elastography and diffusion weighted MRI in cancer patients, but to the best of our knowledge so far none of them have compared the two new methods. The tumour cell density is related to the MRI measured apparent diffusion weighted.......59), P rectal tumours. The relationship between ARFI and ADC measurement was linear in our study population....

  19. Differentiation of thyroid nodules using diffusion-weighted MRI

    African Journals Online (AJOL)

    Lamiss Mohamed Abd el Aziz

    2014-10-19

    Oct 19, 2014 ... technique for brain tumors. DWI is sensitive to changes in the microstructural organization of tissue that may affect water diffusion. It has been used to evaluate head and neck tumors.9–11 The Apparent Diffusion Coefficient (ADC) value is a quantitative parameter for distinguishing malignant tumors from ...

  20. Clinical usefulness of diffusion-weighted MRI in various stages of ischemic stroke

    International Nuclear Information System (INIS)

    Song, So Youne; Cho, Woo Ho; Kim, Soung Hee; Kim, Jung Sook; Kim, Young Hoon; Kim, Myung Gyu; Hur, Gham

    2002-01-01

    Diffusion-weighted MRI (DWI) is well known to be sensitive in the detection of hyperacute infarct, but has not been systematically investigated in patients with acute or subacute infarct. We evaluated the usefulness of diffusion-weighted MRI in assessing the various stages of brain infarct. Fifty-five consecutive patients with symptoms of brain infarct underwent fast spinecho T2-weighted MRI (T2WI) and DWI. Using only a brief clinical history, two radiologists first attempted to detect the lesion using T2W1, which was then compared with DWI. The usefulness of the latter was then evaluated in terms of the following criteria: 1) Its abilility to detect a lesion not seen at T2WI(detection); 2) localization of the responsible ischemic focus among multiple high-signal intensities seen at T2WI (localization); 3) conspicuity of a lesion which was subtle at T2WI (conspicuity); 4) detection of multiple lesions (multiplicity). DWI was useful in 44 of 55 patients (80%), including 9 of 9 (100%) with hyperacute infarct (<6 hours), 20 of 27 (74%) with acute infarct (<48 hours), and 15 of 19 (79%) with subacute infarct (<2 weeks). Among the nine patients at the hyperacute stage, DWI was useful for detection of the lesion in six (67%), for localization, 4 (44%) in one (11%), for conspicuity in four (44%), and for multiplicity in five (56%); at the acute stage (20 patients), for detection in three (15%), for localization in ten (50%), for conspicuity in eight (40%), and for moltiplicity in five (25%); and at the subacute stage (15 patients), for detection in three (20%), for localization in nine (60%), for conspicuity in two (13%), and for multiplicity in three (20%). DWI is very sensitive for the diagnosis of hyperacute infarct. In the assessment of this, it is useful during the acute or subacute period for the detection of small lesions, the localization of ongoing lesions among multiple high signal intensities seen at T2WI, and the determination of lesion conspicuity

  1. Ultrasound elastography and diffusion weighted MRI in patients with rectal cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Vagn-Hansen, Chris Aksel; Sørensen, Torben

    coefficient (ADC). The purpose of the present study was to compare quantitative elastography based on ultrasound shear wave measurements with MRI ADC. METHODS AND MATERIALS: We prospectively examined consecutive 52 patients with histopathological proven rectal cancer. The tumour elasticity was measured using...... the Acoustic Radiation Force Impulse (ARFI) to generate information on the mechanical properties of the tissue. The objective quantitative elastography shear wave velocity was blindly compared to the ADC measurements using a 1.5 Tesla MRI system. The study was approved by the local Clinical Ethics Committee......OBJECTIVE: The current literature has described the usefulness of elastography and diffusion weighted MRI in cancer patients, but to the best of our knowledge so far none of them have compared the two new methods. The tumour cell density is related to the MRI measured apparent diffusion weighted...

  2. Diffusion-weighted imaging of brain metastases: their potential to be misinterpreted as focal ischaemic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, B. [Department of Radiology, University Hospital, Lund (Sweden); Holtaas, S. [Department of Diagnostic Imaging, King Fahd Hospital, Riyadh (Saudi Arabia)

    2002-07-01

    Small focal ischaemic brain lesions are said to be easy to identify in the acute stage and to differentiate from older lesions using diffusion-weighted imaging (DWI). Brain metastases are common and the aim of this study was to evaluate the risk of misinterpretation as ischaemic lesions in a standard MRI protocol for clinical stroke. Of 26 patients investigated with MRI for possible metastases, 12 did have metastatic brain lesions, including most of the common tumours. On a 1.5 tesla imager, we obtained DWI, plus T2- and T1-weighted images, the latter before and after triple-dose contrast medium. Well-circumscribed brain lesions with a decreased apparent diffusion coefficient and a slightly or moderately increased signal on T2-weighted images were found in patients with metastases from a small-cell bronchial carcinoma and a pulmonary adenocarcinoma. The same features were also found in metastases from a breast carcinoma but the lesions were surrounded by oedema. With a standard DWI protocol, the features of common brain metastases may overlap with those of small acute and subacute ischaemic lesions. (orig.)

  3. Elastography and diffusion-weighted MRI in patients with rectal cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Vagn-Hansen, Chris Aksel; Sørensen, Torben

    2015-01-01

    -weighted coefficient (ADC). The purpose of the present study was to compare quantitative elastography based on ultrasound shear wave measurements with MRI ADC. METHODS: We prospectively examined 52 patients with histopathologically proven rectal cancer. The mean age was 67 years (range 42-90 years). Males: 39, females...... a correlation between tissue elasticity and diffusion in rectal cancer.......OBJECTIVE: The current literature has described the usefulness of elastography and diffusion-weighted MRI in patients with cancer, but to the best of our knowledge so far none of them has compared the two new methods. The tumour cell density is related to the MRI-measured apparent diffusion...

  4. Conventional and Diffusion-Weighted MRI in the Evaluation of Methanol Poisoning. A case report

    International Nuclear Information System (INIS)

    Server, A.; Nakstad, P.Hj.; Dullerud, R.; Haakonsen, M.; Hovda, K.E.; Jacobsen, D.

    2003-01-01

    Cerebral lesions were studied in 2 methanol-poisoned patients using conventional magnetic resonance imaging (MRI). In 1 patient, diffusion-weighted MRI (DWI) was also performed. In this patient, conventional MRI showed symmetrical, bilateral increased signal in the lentiform nuclei, involving predominantly putamina, but also extending into the corona radiata, centrum semiovale and subcortical white matter. DWI showed decreased diffusion, which most probably reflects cytotoxic edema. In the other patient, fluid attenuated-inversion recovery (FLAIR) and T2-weighted images showed hyperintensity in the putamina, characteristic of post-necrotic changes

  5. Quantitative Analysis of Diffusion Weighted MR Images of Brain Tumor Using Signal Intensity Gradient Technique

    Directory of Open Access Journals (Sweden)

    S. S. Shanbhag

    2014-01-01

    Full Text Available The purpose of this study was to evaluate the role of diffusion weighted-magnetic resonance imaging (DW-MRI in the examination and classification of brain tumors, namely, glioma and meningioma. Our hypothesis was that as signal intensity variations on diffusion weighted (DW images depend on histology and cellularity of the tumor, analysing the signal intensity characteristics on DW images may allow differentiating between the tumor types. Towards this end the signal intensity variations on DW images of the entire tumor volume data of 20 subjects with glioma and 12 subjects with meningioma were investigated and quantified using signal intensity gradient (SIG parameter. The relative increase in the SIG values (RSIG for the subjects with glioma and meningioma was in the range of 10.08–28.36 times and 5.60–9.86 times, respectively, compared to their corresponding SIG values on the contralateral hemisphere. The RSIG values were significantly different between the subjects with glioma and meningioma (P<0.01, with no overlap between RSIG values across the two tumors. The results indicate that the quantitative changes in the RSIG values could be applied in the differential diagnosis of glioma and meningioma, and their adoption in clinical diagnosis and treatment could be helpful and informative.

  6. Comparison of CT with diffusion-weighted MRI in patients with hyperacute stroke

    International Nuclear Information System (INIS)

    Fiebach, J.; Jansen, O.; Knauth, M.; Hartmann, M.; Heiland, S.; Ryssel, H.; Pohlers, O.; Sartor, K.; Schellinger, P.; Hacke, W.

    2001-01-01

    Tissue changes in ischaemic stroke are detectable by diffusion-weighted MRI (DWI) within minutes of the onset of symptoms. However, in daily routine CT is still the preferred imaging modality for patients with acute stroke. Our purpose of this study was to determine how early and reliably ischaemic brain infarcts can be identified by CT and DWI. Three neuroradiologists, blinded to clinical signs but aware that they were dealing with stroke, analysed the CT and DWI of 31 patients with an acute ischaemic stroke. We calculated k-values to analyse inter-rater variability. The ratings were compared with follow-up studies showing the extent of the infarct. The combined assessment of all observers gave positive findings in 77.4 % of all CT examinations, with k = 0.58. Areas of high signal were seen on all DWI studies by all observers (k = 1). Estimation of the extent of the infarct based on DWI yielded k = 0.70 and that based on CT k = 0.39. DWI was much more reliable than CT in the detection of early ischaemic lesions and we believe that it should be used in acute ischaemic stroke before aggressive therapeutic intervention. (orig.)

  7. Comparison of CT with diffusion-weighted MRI in patients with hyperacute stroke

    Energy Technology Data Exchange (ETDEWEB)

    Fiebach, J.; Jansen, O.; Knauth, M.; Hartmann, M.; Heiland, S.; Ryssel, H.; Pohlers, O.; Sartor, K. [Dept. of Neuroradiology, Univ. of Heidelberg (Germany); Schellinger, P.; Hacke, W. [Dept. of Neurology, Univ. of Heidelberg (Germany)

    2001-08-01

    Tissue changes in ischaemic stroke are detectable by diffusion-weighted MRI (DWI) within minutes of the onset of symptoms. However, in daily routine CT is still the preferred imaging modality for patients with acute stroke. Our purpose of this study was to determine how early and reliably ischaemic brain infarcts can be identified by CT and DWI. Three neuroradiologists, blinded to clinical signs but aware that they were dealing with stroke, analysed the CT and DWI of 31 patients with an acute ischaemic stroke. We calculated k-values to analyse inter-rater variability. The ratings were compared with follow-up studies showing the extent of the infarct. The combined assessment of all observers gave positive findings in 77.4 % of all CT examinations, with k = 0.58. Areas of high signal were seen on all DWI studies by all observers (k = 1). Estimation of the extent of the infarct based on DWI yielded k = 0.70 and that based on CT k = 0.39. DWI was much more reliable than CT in the detection of early ischaemic lesions and we believe that it should be used in acute ischaemic stroke before aggressive therapeutic intervention. (orig.)

  8. Usefulness of MRI diffusion weighted images in cases of brainstem infarction

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, Yoshikiyo; Mokuno, Kenji; Ito, Sayaka [Toyohashi Municipal Hospital, Aichi (Japan)

    1999-06-01

    We examined the chronological changes in usefulness of MRI diffusion weighted images (DWIs) in 30 patients with brain-stem infarction. All patients were admitted during acute phase and treatment was begun. Of the 30 patients, nine had lesions in the medulla oblongata, 18 in the pons, and three in the midbrain. Serial DWIs were done on 15 patients, and total 47 MRIs were evaluated. The first MRIs, taken within seven days after onset, showed high signal intensities on the DWIs of all 30 patients. The high signal intensities were more apparent on DWIs than on T{sub 2} weighted images (T{sub 2}WIs) in 21 patients, especially in those with small lesion. Moreover, the lesions of five patients with medullary infarction were seen only on DWIs. However, in nine patients with large pontine infarctions the lesions were recognizable on both DWIs and T{sub 2}WIs. As the days went on, the superiority of DWIs over T{sub 2}WIs in the early detection of the infarct lesions decreased, as the lesions gradually became apparent on T{sub 2}WIs as well. These results indicate that DWIs are useful in the early diagnosis of brainstem infarction, especially when the lesion is small. (author)

  9. Diffusion-weighted MRI and quantitative biophysical modeling of hippocampal neurite loss in chronic stress.

    Directory of Open Access Journals (Sweden)

    Peter Vestergaard-Poulsen

    Full Text Available Chronic stress has detrimental effects on physiology, learning and memory and is involved in the development of anxiety and depressive disorders. Besides changes in synaptic formation and neurogenesis, chronic stress also induces dendritic remodeling in the hippocampus, amygdala and the prefrontal cortex. Investigations of dendritic remodeling during development and treatment of stress are currently limited by the invasive nature of histological and stereological methods. Here we show that high field diffusion-weighted MRI combined with quantitative biophysical modeling of the hippocampal dendritic loss in 21 day restraint stressed rats highly correlates with former histological findings. Our study strongly indicates that diffusion-weighted MRI is sensitive to regional dendritic loss and thus a promising candidate for non-invasive studies of dendritic plasticity in chronic stress and stress-related disorders.

  10. Diffusion Weighted MRI as a predictive tool for effect of radiotherapy in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Haack, Søren; Tanderup, Kari; Fokdal, Lars

    Diffusion weighted MRI has shown great potential in diagnostic cancer imaging and may also have value for monitoring tumor response during radiotherapy. Patients with advanced cervical cancer are treated with external beam radiotherapy followed by brachytherapy. This study evaluates the value of DW......-MRI for predicting outcome of patients with advanced cervical cancer at time of brachytherapy. Volume of hyper-intensity on highly diffusion sensitive images and resulting ADC value for treatment responders and non-responders is compared. The change of ADC and volume of hyper-intensity over time of BT is also...

  11. Associations among q-space MRI, diffusion-weighted MRI and histopathological parameters in meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Fatima, Zareen; Motosugi, Utaroh; Ishigame, Keiichi; Araki, Tsutomu [University of Yamanashi, Department of Radiology, Chuo-shi, Yamanashi (Japan); Waqar, Ahmed Bilal [University of Yamanashi, Department of Molecular Pathology, Interdisciplinary Graduate School of Medicine and Engineering, Chuo-shi, Yamanashi (Japan); Hori, Masaaki [Juntendo University, Department of Radiology, School of Medicine, Tokyo (Japan); Oishi, Naoki; Katoh, Ryohei [University of Yamanashi, Department of Pathology, Chuo-shi, Yamanashi (Japan); Onodera, Toshiyuki; Yagi, Kazuo [Tokyo Metropolitan University, Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo (Japan)

    2013-08-15

    The purposes of this MR-based study were to calculate q-space imaging (QSI)-derived mean displacement (MDP) in meningiomas, to evaluate the correlation of MDP values with apparent diffusion coefficient (ADC) and to investigate the relationships among these diffusion parameters, tumour cell count (TCC) and MIB-1 labelling index (LI). MRI, including QSI and conventional diffusion-weighted imaging (DWI), was performed in 44 meningioma patients (52 lesions). ADC and MDP maps were acquired from post-processing of the data. Quantitative analyses of these maps were performed by applying regions of interest. Pearson correlation coefficients were calculated for ADC and MDP in all lesions and for ADC and TCC, MDP and TCC, ADC and MIB-1 LI, and MDP and MIB-1 LI in 17 patients who underwent subsequent surgery. ADC and MDP values were found to have a strong correlation: r = 0.78 (P = <0.0001). Both ADC and MDP values had a significant negative association with TCC: r = -0.53 (p = 0.02) and -0.48 (P = 0.04), respectively. MIB-1 LI was not, however, found to have a significant association with these diffusion parameters. In meningiomas, both ADC and MDP may be representative of cell density. (orig.)

  12. Report of diffusion-weighted MRI in two cases with different cerebral hydatid disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitis, O.; Calli, C.; Yunten, N. [Ege Univ., Izmir (Turkey). Dept. of Radiology

    2004-02-01

    To present MRI findings in two cases of cerebral hydatid disease with an emphasis on diffusion-weighted imaging (DWI) findings of Echinococcus granulosus (EG) versus Echinococcus alveolaris (EA). EG lesions were isointense with cerebrospinal fluid in all sequences including DWI. On DWI, EA lesions remained hypointense on b = 1000 s/mm2 diffusion-weighted images. Apparent diffusion coefficient (ADC) values of EG and EA lesions were completely different from each other, 2.88 {+-} 0.24 x 10{sup -3} s/mm{sup 2} and 1.33 {+-} 0.15 x 10{sup -3} s/mm{sup 2}, respectively. The ADC values could not be used to discriminate from other differential diagnoses.

  13. Diffusion weighted MRI by spatiotemporal encoding: Analytical description and in vivo validations

    Science.gov (United States)

    Solomon, Eddy; Shemesh, Noam; Frydman, Lucio

    2013-07-01

    Diffusion-weighted (DW) MRI is a powerful modality for studying microstructure in normal and pathological tissues. The accuracy derived from DW MRI depends on the acquisition of quality images, and on a precise assessment of the b-values involved. Conventional DW MRI tends to be of limited use in regions suffering from large magnetic field or chemical shift heterogeneities, which severely distort the MR images. In this study we propose novel sequences based on SPatio-temporal ENcoding (SPEN), which overcome such shortcomings owing to SPEN's inherent robustness to offsets. SPEN, however, relies on the simultaneous application of gradients and radiofrequency-swept pulses, which may impart different diffusion weightings along the spatial axes. These will be further complicated in DW measurements by the diffusion-sensitizing gradients, and will in general lead to complex, spatially-dependent b-values. This study presents a formalism for analyzing these diffusion-weighted SPEN (dSPEN) data, which takes into account the concomitant effects of adiabatic pulses, of the imaging as well as diffusion gradients, and of the cross-terms between them. These analytical b-values derivations are subject to experimental validations in phantom systems and ex vivo spinal cords. Excellent agreement is found between the theoretical predictions and these dSPEN experiments. The ensuing methodology is then demonstrated by in vivo mapping of diffusion in human breast - organs where conventional k-space DW acquisition methods are challenged by both field and chemical shift heterogeneities. These studies demonstrate the increased robustness of dSPEN vis-à-vis comparable DW echo planar imaging, and demonstrate the value of this new methodology for medium- or high-field diffusion measurements in heterogeneous systems.

  14. Pseudotumours in chronic kidney disease: Can diffusion-weighted MRI rule out malignancy

    International Nuclear Information System (INIS)

    Goyal, Ankur; Sharma, Raju; Bhalla, Ashu S.; Gamanagatti, Shivanand; Seth, Amlesh

    2013-01-01

    Highlights: •Conventional non-contrast MRI is unable to distinguish CKD pseudotumors from RCCs. •Pseudotumours in a background of CKD do not show restricted diffusion. •CKD pseudotumours demonstrate high ADC values whereas RCCs show restricted diffusion. •DW-MRI is reliable in ruling out malignancy incase of pseudotumours found in chronic kidney disease. •DW-MRI may obviate contrast administration and/or tissue sampling in renal pseudotumours and prevent inadvertent surgeries. -- Abstract: Objectives: To evaluate whether diffusion-weighted MRI (DW-MRI) can distinguish pseudotumours in chronic kidney disease (CKD pseudotumours) from renal-cell-carcinomas (RCCs) (with or without CKD) and whether it offers additional benefit over conventional MRI. Methods: One-hundred patients underwent MDCT, MRI and DW-MRI (at b-values of 0 and 500 s/mm 2 ) for evaluation of focal renal lesions. Of these, 20 patients with 40 CKD pseudotumours and 36 patients with 40 RCCs were retrospectively analyzed. T1-weighted, T2-weighted, diffusion-weighted images were evaluated, apparent-diffusion-coefficient (ADC) values were compared and receiver-operating-characteristic (ROC) curves were drawn to establish cut-off ADC-values. Results: 92.5% of CKD pseudotumours remained indeterminate after conventional MRI. On DW-MRI, none of them showed restricted diffusion and thus malignancy could be ruled out in 100% of the lesions. In contrast, all the solid RCCs showed diffusion restriction. Mean ADC-value for CKD pseudotumours was significantly higher than RCCs and surrounding diseased parenchyma [2.50 vs 1.56 (×10 −3 mm 2 /s) (P < 0.0001) and 2.05 (×10 −3 mm 2 /s) (P = 0.0001) respectively]. ROC analysis for differentiating CKD pseudotumours and RCC yielded high sensitivity (91.7%) and specificity (100%) for cut-off ADC-value of 2.04 (×10 −3 mm 2 /s). Conclusions: CKD pseudotumors usually remain indeterminate on conventional non-contrast MRI. DW-MRI can distinguish CKD pseudotumors

  15. Pseudotumours in chronic kidney disease: Can diffusion-weighted MRI rule out malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, Ankur, E-mail: ankurgoyalaiims@gmail.com [Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi (India); Sharma, Raju, E-mail: raju152@yahoo.com [Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi (India); Bhalla, Ashu S., E-mail: ashubhalla1@yahoo.com [Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi (India); Gamanagatti, Shivanand, E-mail: shiv223@rediffmail.com [Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi (India); Seth, Amlesh, E-mail: amlesh.seth@gmail.com [Department of Urology, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi (India)

    2013-11-01

    Highlights: •Conventional non-contrast MRI is unable to distinguish CKD pseudotumors from RCCs. •Pseudotumours in a background of CKD do not show restricted diffusion. •CKD pseudotumours demonstrate high ADC values whereas RCCs show restricted diffusion. •DW-MRI is reliable in ruling out malignancy incase of pseudotumours found in chronic kidney disease. •DW-MRI may obviate contrast administration and/or tissue sampling in renal pseudotumours and prevent inadvertent surgeries. -- Abstract: Objectives: To evaluate whether diffusion-weighted MRI (DW-MRI) can distinguish pseudotumours in chronic kidney disease (CKD pseudotumours) from renal-cell-carcinomas (RCCs) (with or without CKD) and whether it offers additional benefit over conventional MRI. Methods: One-hundred patients underwent MDCT, MRI and DW-MRI (at b-values of 0 and 500 s/mm{sup 2}) for evaluation of focal renal lesions. Of these, 20 patients with 40 CKD pseudotumours and 36 patients with 40 RCCs were retrospectively analyzed. T1-weighted, T2-weighted, diffusion-weighted images were evaluated, apparent-diffusion-coefficient (ADC) values were compared and receiver-operating-characteristic (ROC) curves were drawn to establish cut-off ADC-values. Results: 92.5% of CKD pseudotumours remained indeterminate after conventional MRI. On DW-MRI, none of them showed restricted diffusion and thus malignancy could be ruled out in 100% of the lesions. In contrast, all the solid RCCs showed diffusion restriction. Mean ADC-value for CKD pseudotumours was significantly higher than RCCs and surrounding diseased parenchyma [2.50 vs 1.56 (×10{sup −3} mm{sup 2}/s) (P < 0.0001) and 2.05 (×10{sup −3} mm{sup 2}/s) (P = 0.0001) respectively]. ROC analysis for differentiating CKD pseudotumours and RCC yielded high sensitivity (91.7%) and specificity (100%) for cut-off ADC-value of 2.04 (×10{sup −3} mm{sup 2}/s). Conclusions: CKD pseudotumors usually remain indeterminate on conventional non-contrast MRI. DW-MRI

  16. [Utility of diffusion-weighted magnetic resonance imaging in severe focal traumatic brain injuries].

    Science.gov (United States)

    Prieto-Valderrey, F; Muñiz-Montes, J R; López-García, J A; Villegas-Del Ojo, J; Málaga-Gil, J; Galván-García, R

    2013-01-01

    To describe the apparent diffusion coefficient (ADC) in a series of severe traumatic brain injuries, their clinical and outcome features, and possible implications. A descriptive, observational case-series study was carried out. Patients with severe traumatic brain injuries (TBIs) admitted to the ICU were subjected to MRI study using a 1.5 T scanner. Diffusion-weighted images (DWMR) were obtained using the following echo-planar pulse sequence: TR 10000 ms, TE 126.9 ms, with b values 1000 s/mm2 in the three spatial dimensions. Combining the three sets of images, an isotropic image conforming a map of the mean ADCs was obtained. DWMR was performed in 23 patients with severe TBI admitted to the ICU between 2001 and 2004. In the MR images we selected 26 regions of interest (ROIs) where ADC was recorded. We observed a clear increase in diffusion in non-treated space-occupying lesions versus other types of injuries and the normal values. A poorer outcome was recorded in patients with lower ADC values. Mean ADC in the lesions was greater than the normal values and greater in contusions than in other types of injuries, as an expression of extracellular edema. ADCs were decreased in patients with a poor outcome, suggesting an association between ischemia and the patient prognosis. Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  17. Selection for biopsy of kidney transplant patients by diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Steiger, Philipp; Barbieri, Sebastiano; Ith, Michael; Thoeny, Harriet C. [Inselspital, Bern University Hospital, University of Bern, Inselspital, Department of Radiology, Neuroradiology, and Nuclear Medicine, Institute of Diagnostic, Pediatric, and Interventional Radiology, Bern (Switzerland); Kruse, Anja [Inselspital, Bern University Hospital, University of Bern, Inselspital, Department of Nephrology and Hypertension, Bern (Switzerland)

    2017-10-15

    To assess retrospectively whether diffusion-weighted magnetic resonance imaging (DW-MRI) allows physicians to determine the severity of histopathologic findings in biopsies of renal allograft patients with deteriorating renal function. Forty consecutive kidney transplant patients underwent DW-MRI and biopsy. Patients were assigned to one group with severe and to another group with normal or mild histopathologic findings. These two groups were compared based on a qualitative DW-MRI assessment (homo-/heterogeneity) and the combination of qualitative and quantitative DW-MRI parameters (ADC, and intravoxel incoherent motion, IVIM, parameters: D, f, D*). Sensitivity, specificity, and accuracy were determined for each parameter. Biopsy findings were severe in 25 patients and normal or mild in 15 patients. Qualitative DW-MRI led to a sensitivity of 44.0% and a specificity of 93.3%. Combined qualitative and quantitative DW-MRI led to an accuracy of 80% for both the minimal ADC (ADCmin) and the minimal perfusion fraction (fmin) with a sensitivity of 84.0% and 92.0% and a specificity of 73.3% and 60.0%, respectively. Combined qualitative and quantitative DW-MRI might allow physicians to determine the severity of histopathologic findings in biopsies of a high number of kidney transplant patients. (orig.)

  18. Whole-body MRI, dynamic contrast-enhanced MRI, and diffusion-weighted imaging for the staging of multiple myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Dutoit, Julie C.; Verstraete, Koenraad L. [Ghent University Hospital, Department of Radiology, Ghent (Belgium)

    2017-06-15

    Magnetic resonance imaging (MRI) is the most sensitive imaging technique for the detection of bone marrow infiltration, and has therefore recently been included in the new diagnostic myeloma criteria, as proposed by the International Myeloma Working Group. Nevertheless, conventional MRI only provides anatomical information and is therefore only of limited use in the response assessment of patients with multiple myeloma. The additional information from functional MRI techniques, such as diffusion-weighted imaging and dynamic contrast-enhanced MRI, can improve the detection rate of bone marrow infiltration and the assessment of response. This can further enhance the sensitivity and specificity of MRI in the staging of multiple myeloma patients. This article provides an overview of the technical aspects of conventional and functional MRI techniques with practical recommendations. It reviews the diagnostic performance, prognostic value, and role in therapy assessment in multiple myeloma and its precursor stages. (orig.)

  19. Transient detection of early wallerian degeneration on diffusion-weighted MRI after an acute cerebrovascular accident

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Sawada, A.; Takase, Y.; Egashira, R.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1 Nabeshima, Saga, 849-8501 (Japan)

    2004-03-01

    We report three patients with a cerebrovascular accident studied serially by MRI, including diffusion-weighted imaging (DWI). In case 1, DWI 1 day after the onset of left frontoparietal cortical infarcts showed no abnormal signal in the left corticospinal tract. DWI 12 days after onset showed high signal in the corticospinal tract, interpreted as early wallerian degeneration. This had disappeared by 22 days after onset. In case 2, DWI obtained 7 days after the onset of a right internal capsule lacunar infarct showed high signal from the right corticospinal tract in the brainstem, which was less marked 15 days after onset. In case 3, MRI on postnatal day 7 showed a cerebral haemorrhage in the right corona radiata and high signal from the right corticospinal tract on DWI. The latter disappeared by day 23. DWI shows early wallerian degeneration; transient signal abnormalities within 2 weeks of stroke should not be mistaken for new ischaemic lesions. (orig.)

  20. Improving non-invasive detection of prostate cancer using diffusion-weighted MRI

    Directory of Open Access Journals (Sweden)

    Michelle Leech

    2016-12-01

    Full Text Available Prostate cancer represents 11% of all cancers in the European Union and 9% of all cancer deaths. Standard MRI for prostate cancer includes high-resolution T2-weighted images, which allow for the assessment of the prostate and the tumour, as tumours arising from the peripheral zone appear dark compared to the expected normally bright peripheral gland tissue. Over the past number of years, the application of diffusion-weighted MRI (DW-MRI has progressed to include both diagnostic and prognostic roles in oncology. DW-MRI images should be analysed together with the T2-weighted images and the corresponding apparent diffusion coefficient (ADC maps. We searched PubMed, Cochrane, and Science Direct for relevant journal articles and reviews published up until April 2015 using the search terms “functional MRI” OR “multiparametric MRI” OR “MRSI” AND “diagnosis” AND “prostate cancer” OR “prostate”. The literature indicates that DW-MRI is an important parameter in the identification of prostate cancer. It has the ability to improve sensitivity and specificity, relative to T2-weighted images alone, and has been demonstrated to correlate with tumour grade.

  1. Correlation of perfusion- and diffusion-weighted MRI with Japan stroke scale in acute stroke

    International Nuclear Information System (INIS)

    Kawaguchi, Naoki; Murakami, Masato; Mikami, Taishi; Kamoshita, Hiroshi

    2000-01-01

    Diffusion-weighted imaging (DWI) and perfusion-imaging (PI) MRI are powerful new techniques for the assessment of early ischemic changes in acute stroke patients. We aimed to determine whether the results of these acute phase DWI and PI MRI are useful to predict their neurological outcomes. DWI, PI and fluid-attenuated inversion recovery imaging (FLAIR) MRI lesion volumes were compared with neurological deficit as determined by Japan Stroke Scale (JSS) and Barthel index in 12 patients with acute stroke at two time points. Patients were scanned and their clinical severity was measured first at their admission and two weeks after the initial scan. We could perform MRI within 5 days (mean: 2.6 days), and detect the latest ischemic lesions with initial DWI in all cases. Most patients showed decreased DWI lesion volumes, increased FLAIR volumes and decreased JSS scores reflecting their neurological improvements. Initial DWI volumes correlated with follow-up FLAIR volumes (p=0.0047, r 2 =0.976). The results seem to indicate that lesion volumes determined by DWI in the acute phase may be predictive of irreversible ischemic lesion, although the initial MRI study did not correlate with JSS, BI and patients' age. (author)

  2. Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn's disease assessment with histopathology of surgical specimens

    NARCIS (Netherlands)

    Tielbeek, Jeroen A. W.; Ziech, Manon L. W.; Li, Zhang; Lavini, Cristina; Bipat, Shandra; Bemelman, Willem A.; Roelofs, Joris J. T. H.; Ponsioen, Cyriel Y.; Vos, Frans M.; Stoker, Jaap

    2014-01-01

    To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn's disease. 3-T MR enterography was performed in consecutive Crohn's disease patients scheduled for surgery within 4 weeks.

  3. Assessment of the link between quantitative biexponential diffusion-weighted imaging and contrast-enhanced MRI in the liver

    NARCIS (Netherlands)

    Dijkstra, Hildebrand; Oudkerk, Matthijs; Kappert, Peter; Sijens, Paul E.

    Purpose: To investigate if intravoxel incoherent motion (IVIM) modeled diffusion-weighted imaging (DWI) can be linked to contrast-enhanced (CE-)MRI in liver parenchyma and liver lesions. Methods: Twenty-five patients underwent IVIM-DWI followed by multiphase CE-MRI using Gd-EOB-DTPA (n = 20) or

  4. MRI of cerebral micro-vascular flow patterns: A multi-direction diffusion-weighted ASL approach.

    Science.gov (United States)

    Wells, J A; Thomas, D L; Saga, T; Kershaw, J; Aoki, I

    2017-06-01

    The study and clinical assessment of brain disease is currently hindered by a lack of non-invasive methods for the detailed and accurate evaluation of cerebral vascular pathology. Angiography can detect aberrant flow in larger feeding arteries/arterioles but cannot resolve the micro-vascular network. Small vessels are a key site of vascular pathology that can lead to haemorrhage and infarction, which may in turn trigger or exacerbate neurodegenerative processes. In this study, we describe a method to investigate microvascular flow anisotropy using a hybrid arterial spin labelling and multi-direction diffusion-weighted MRI sequence. We present evidence that the technique is sensitive to the mean/predominant direction of microvascular flow in localised regions of the rat cortex. The data provide proof of principle for a novel and non-invasive imaging tool to investigate cerebral micro-vascular flow patterns in healthy and disease states.

  5. Diffusion-weighted MRI of the prostate; Diffusionsgewichtete MRT der Prostata

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Lisse, U.G.; Scherr, M.K. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Mueller-Lisse, U.L. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Klinik und Poliklinik fuer Urologie, Muenchen (Germany); Zamecnik, P.; Schlemmer, H.P.W. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung fuer Radiologische Diagnostik, Heidelberg (Germany)

    2011-03-15

    Diffusion-weighted magnetic resonance imaging (DWI) can complement MRI of the prostate in the detection and localization of prostate cancer, particularly after previous negative biopsy. A total of 13 original reports and 2 reviews published in 2010 demonstrate that prostate cancer can be detected by DWI due to its increased cell density and decreased diffusiveness, either qualitatively in DWI images or quantitatively by means of the apparent diffusion coefficient (ADC). In the prostate, the ADC is influenced by the strength of diffusion weighting, localization (peripheral or transitional zone), presence of prostatitis or hemorrhage and density and differentiation of prostate cancer cells. Mean differences between healthy tissue of the peripheral zone and prostate cancer appear to be smaller for ADC than for the (choline + creatine)/citrate ratio in MR spectroscopy. Test quality parameters vary greatly between different studies but appear to be slightly better for combined MRI and DWI than for MRI of the prostate alone. Clinical validation of DWI of the prostate requires both increased technical conformity and increased numbers of patients in clinical studies. (orig.) [German] Die diffusionsgewichtete MRT (''diffusion-weighted imaging'', DWI) kann die MRT der Prostata bei der Erkennung und Lokalisation von Prostatakarzinomen besonders nach vorangehender, negativer Stanzbiopsie ergaenzen. In 13 klinischen Original- und 2 Uebersichtsarbeiten des Jahres 2010 zeigt sich, dass die DWI Prostatakarzinome an Einschraenkungen der freien Teilchenbeweglichkeit bei erhoehter Zelldichte qualitativ im Bild oder quantitativ an Hand des ''apparent diffusion coefficient'' (ADC) nachweist. Den ADC in der Prostata beeinflussen Staerke der Diffusionsgewichtung, Lokalisation (periphere Zone, Transitionalzone), Vorliegen von Prostatitis oder Einblutung sowie Streudichte und Differenzierung von Prostatakarzinomzellen. Unterschiede zwischen gesundem

  6. [Asymmetric cortical high signal on diffusion weighted-MRI in a case of Creutzfeldt-Jakob disease].

    Science.gov (United States)

    Nitrini, Ricardo; Areza-Fegyveres, Renata; Martins, Vilma R; Castro, Rosa Maria R P S; Landemberger, Michele C; Huang, Nancy; Bacheschi, Luiz A; Bacheschi, Luiz E; Leite, Cláudia C; Buchpiguel, Carlos A; Rosemberg, Sérgio

    2005-06-01

    High signal in the cerebral cortex and/or basal ganglia on diffusion-weighted magnetic resonance imaging (DW-MRI) has been described as a good diagnostic marker for sporadic Creutzfeldt-Jakob disease (sCJD). We report a case of sCJD with atypical clinical evolution and unusual DW-MRI findings. A 53-year-old man was seen with a 2-year history of a rapidly progressive dementia and cerebellar ataxia. Cerebrospinal fluid analysis, including the test for 14-3-3 protein, was normal. EEG did not show periodic activity. However, DW-MRI showed gyriform hyperintensity involving practically the entire cortical ribbon of the left hemisphere, whilst being limited to the posterior cingulate gyrus in the right hemisphere. DNA analysis showed no mutations or insertions in the prion protein gene, and homozigozity for methionine in codon 129. A subsequent brain biopsy confirmed the diagnosis of CJD. Thus, high signal on DW-MRI may be limited to the cerebral cortex and may present a very asymmetric distribution in sCJD.

  7. Diffusion weighted MRI in head-and-neck cancer: geometrical accuracy.

    Science.gov (United States)

    Schakel, Tim; Hoogduin, Johannes M; Terhaard, Chris H J; Philippens, Marielle E P

    2013-12-01

    The aim of this study is to assess the geometric accuracy of diffusion weighted (DW)-MRI by quantification of geometric distortions in the gross tumor volume (GTV) in head and neck (HN) cancer. A retrospective analysis was performed on the data of 23 patients (with 24 lesions). For these patients, magnetic field maps and DW-MRI were acquired. The magnetic field maps were converted to voxel displacement maps. GTV delineations were transferred onto these voxel displacement maps and the voxel shifts in the GTV were analyzed. The median shift was 3.2mm and the maximal posterior and anterior shifts were up to 15.0 and 26.0mm respectively. The range of shifts varied from 11.8 to 25.6mm. The percentage of GTV voxels that showed a shift of at least 6mm was found to be 23.2%. Current DW-MRI images of HN tumors show severe distortions up to centimeters, which restrict the use of DW-MRI scans for GTV definition in RT treatment planning. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Diffusion-weighted MRI for the assessment of liver fibrosis: principles and applications.

    Science.gov (United States)

    Palmucci, Stefano; Cappello, Giuseppina; Attinà, Giancarlo; Fuccio Sanzà, Giovanni; Foti, Pietro Valerio; Ettorre, Giovanni Carlo; Milone, Pietro

    2015-01-01

    The importance of an early identification of hepatic fibrosis has been emphasized, in order to start therapy and obtain fibrosis regression. Biopsy is the gold-standard method for the assessment of liver fibrosis in chronic liver diseases, but it is limited by complications, interobserver variability, and sampling errors. Several noninvasive methods have been recently introduced into clinical routine, in order to detect liver fibrosis early. One of the most diffuse approaches is represented by diffusion-weighted liver MRI. In this review, the main technical principles are briefly reported in order to explain the rationale for clinical applications. In addition, roles of apparent diffusion coefficient, intravoxel incoherent motion, and relative apparent diffusion coefficient are also reported, showing their advantages and limits.

  9. Assessment of renal fibrosis in chronic kidney disease using diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Zhao, J.; Wang, Z.J.; Liu, M.; Zhu, J.; Zhang, X.; Zhang, T.; Li, S.; Li, Y.

    2014-01-01

    Aim: To assess the performance of diffusion-weighted magnetic resonance imaging (MRI) for the assessment of renal fibrosis in chronic kidney disease (CKD), with histopathology as a reference standard. Materials and methods: Forty patients with CKD and 30 healthy volunteers were recruited for the study. All participants underwent diffusion-weighted MRI. Renal biopsy was performed in 25 patients with CKD. Mean renal medullary and cortical apparent diffusion coefficient (ADC) values were compared between CKD patients and the healthy volunteers. Pearson's correlation coefficient was calculated to investigate the relationship between ADC values, serum creatinine (SCr), estimated glomerular filtration rate (eGFR), 24 h urinary protein (24h-UPRO), and renal histopathological scores. Results: Cortical and medullary ADC values in the CKD group were significantly lower compared to those in the healthy controls. In the CKD group, a significant negative correlation was found between cortical ADC values and SCr/24h-UPRO, and significant positive correlation was found between cortical ADC and eGFR. There was also a significant negative correlation between medullary ADC values and SCr. Both cortical and medullary ADC values were significantly correlated with histopathological fibrosis score. Conclusion: Renal ADC values strongly correlate with histological measures of fibrosis, and have the potential to enhance the non-invasive monitoring of chronic kidney disease. - Highlights: • Renal ADC values in the CKD patients were lower than those in controls. • Renal ADC values were strongly correlated with histological fibrosis score. • Renal ADC values have the potential to enhance the noninvasive monitoring of CKD

  10. Carcinosarcoma of the uterus: MRI findings including diffusion-weighted imaging and MR spectroscopy.

    Science.gov (United States)

    Takeuchi, Mayumi; Matsuzaki, Kenji; Harada, Masafumi

    2016-10-01

    Recently carcinosarcoma has become regarded as a subset of endometrial carcinoma. Because the clinical course of carcinosarcoma is aggressive with poor prognosis, it should be differentiated from endometrial carcinomas for the appropriate surgical management and adjuvant therapy. To clarify the magnetic resonance imaging (MRI) characteristics of uterine carcinosarcoma including diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurement and MR spectroscopy (MRS) with quantitative metabolite evaluation. MRI findings of 12 pathologically diagnosed uterine carcinosarcomas obtained on 3T MRI were retrospectively evaluated. The mean and minimum ADCs, and the lipid and choline concentration levels were compared with those of pathologically diagnosed 38 endometrial carcinomas. The mean and minimum ADCs in carcinosarcomas and endometrial carcinomas were not significantly different. The mean ADC of carcinosarcomas was significantly higher than that of higher grade (G2 and G3) endometrial carcinomas. The choline concentration in carcinosarcomas was significantly lower than that in endometrial carcinomas. High lipid peak was observed in 91% of carcinosarcomas and in 24% of endometrial carcinomas. Large, exophytic heterogeneous endometrial mass containing strongly enhanced areas, which may exhibit "tumor delivery", is a suggestive of carcinosarcoma. Relatively high mean ADC and low choline concentration considering its highly malignant nature due to intra-tumoral heterogeneity with necrosis and epithelial cystic components, and the presence of necrosis-associated high lipid peak may be compatible with carcinosarcoma. © The Foundation Acta Radiologica 2016.

  11. Diffusion-weighted MRI for detecting prostate tumour in men at increased genetic risk

    International Nuclear Information System (INIS)

    Souza, Nandita M. de; Morgan, Veronica A.; Bancroft, Elizabeth; Sohaib, S. Aslam; Giles, Sharon L.; Kote-Jarai, Zsofia; Castro, Elena; Hazell, Steven; Jafar, Maysam; Eeles, Rosalind

    2014-01-01

    •Endorectal T2W + DW-MRI is potentially useful for prostate cancer screening.•MRI is specific for detecting prostate cancer in men with increased genetic risk.•Detection of prostate cancer in men at genetically low risk with MRI is limited. Endorectal T2W + DW-MRI is potentially useful for prostate cancer screening. MRI is specific for detecting prostate cancer in men with increased genetic risk. Detection of prostate cancer in men at genetically low risk with MRI is limited. Diffusion-weighted (DW)-MRI is invaluable in detecting prostate cancer. We determined its sensitivity and specificity and established interobserver agreement for detecting tumour in men with a family history of prostate cancer stratified by genetic risk. 51 men with a family history of prostate cancer underwent T2-W + DW-endorectal MRI at 3.0 T. Presence of tumour was noted at right and left apex, mid and basal prostate sextants by 2 independent observers, 1 experienced and the other inexperienced in endorectal MRI. Sensitivity and specificity against a 10-core sampling technique (lateral and medial cores at each level considered together) in men with >2× population risk based on 71 SNP analysis versus those with lower genetic risk scores was established. Interobserver agreement was determined at a subject level. Biopsies indicated cancer in 28 sextants in 13/51 men; 32 of 51 men had twice the population risk (>0.25) based on 71 SNP profiling. Sensitivity/specificity per-subject for patients was 90.0%/86.4% (high-risk) vs. 66.7%/100% (low-risk, observer 1) and 60.0%/86.3% (high-risk) vs. 33.3%/93.8% (low-risk, observer 2) with moderate overall inter-observer agreement (kappa = 0.42). Regional sensitivities/specificities for high-risk vs. low-risk for observer 1 apex 72.2%/100% [33.3%/100%], mid 100%/93.1% [100%/97.3%], base 16.7%/98.3% [0%/100%] and for observer 2 apex 36.4%/98.1% [0%/100%], mid 28.6%/96.5% [100%/100%], base 20%/100% [0%/97.3%] were poorer as they failed to detect

  12. A characteristic feature of acute haematomas in the brain on echo-planar diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Morita, N.; Yoneda, K.; Nishitani, H. [Department of Radiology, School of Medicine, University of Tokushima, 3-18-15, Kuramoto-Cho, Tokushima 770-8503 (Japan); Harada, M. [Department of Radiologic Technology, School of Health Sciences, University of Tokushima, 3-18-15, Kuramoto-Cho, Tokushima 770-8509 (Japan); Uno, M. [Department of Neurosurgery, School of Medicine, University of Tokushima, 3-18-15, Kuramoto-Cho, Tokushima 770-8503 (Japan)

    2002-11-01

    Diffusion-weighted MRI (DWI) is used in the diagnosis of acute ischaemic disease of the brain, but it is not clear whether or not it can be used to differentiate an acute haematoma from an infarct. Our purpose was to identify any characteristic feature of acute haematomas which can be recognised on DWI and to evaluate the usefulness of DWI in acute cerebral stroke. We examined nine patients with acute haemorrhage using CT and MRI including DWI. We measured the volume and apparent diffusion coefficient (ADC) of the haematomas. All showed heterogeneous signal on DWI, and the centre of the large (>20 ml) haematomas especially a mixed pattern with high and low signal. The characteristic feature of acute haematomas was a peripheral low-signal region, found in all subjects regardless of the size of the haematoma; acute infarcts did not show this. This low-signal rim on DWI may be useful for differentiating an acute haematoma from an infarct. (orig.)

  13. Intraparenchymal epidermoid cysts in the brain: diagnostic value of MR diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hu, X.-Y. [Medical Imaging Center, The First Affiliated Hospital of Suzhou, Jiangsu Province (China); Hu, C.-H. [Imaging Center, Soochow University (China)], E-mail: wpdrhxy@hotmail.com; Fang, X.-M.; Cui, L.; Zhang, Q.-H. [Medical Imaging Center, The First Affiliated Hospital of Suzhou, Jiangsu Province (China)

    2008-07-15

    Aim: To evaluate the value of magnetic resonance (MR) diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADC) maps in the diagnosis of intraparenchymal epidermoid cysts (ECs). Materials and methods: Six cases of histopathologically proven intraparenchymal ECs were studied. All patients were examined with conventional MR (T1WI, T2WI, contrast-enhanced T1WI) and DWI sequences. Along with the mean ADC values (mADC) of the ECs, the cerebrospinal fluid (CSF) and grey matter (GM) were measured. Qualitative and quantitative assessments, as well as MRI findings, were retrospectively analysed using a double blind method by three radiologists in consensus. Results: Four lesions were located in the cerebellum, among them, one was accompanied by an arachnoid cyst; one huge lesion crossed the parenchyma of the frontal and temporal lobes; the other was located in the left temporal lobe. Two lesions had a homogeneous CSF-like intensity on both T1WI and T2WI. The other four were of mixed-intensity on both T1WI and T2WI. All lesions were strikingly hyperintense on DWI, and iso- or slightly hypointense on ADC (relative to the brain). The mADCs of the ECs were significantly higher than that of GM, but significantly lower than that of CSF. Three cases (3/6) were accurately diagnosed using conventional MR sequences without DWI, but in the remaining three cases, correct diagnosis could only be made with help of DWI. Conclusion: DWI sequences can facilitate the diagnosis of intraparenchymal ECs, thus alerting surgeons of the risk of chemical meningitis at surgery. The MR findings of intraparenchymal ECs are basically as the same as those of extracerebral ECs, but the former is likely to have a mixed signal. The hyperintense signal of ECs on DWI is probably caused by the T2 shine-through effect in tumour tissue.

  14. Diffusion-weighted (DW) MRI in lung cancers. ADC test-retest repeatability

    Energy Technology Data Exchange (ETDEWEB)

    Weller, Alex; Papoutsaki, Marianthi Vasiliki; Blackledge, Matthew; DeSouza, Nandita M. [Institute of Cancer Research and Royal Marsden NHS Foundation Trust, CRUK Cancer Imaging Centre, Surrey (United Kingdom); Waterton, John C. [University of Manchester, Manchester (United Kingdom); Chiti, Arturo [Humanitas University, Milan (Italy); Stroobants, Sigrid [Universiteit Antwerpen, Antwerpen (Belgium); Kuijer, Joost [Vrije Universiteit Medisch Centrum, Amsterdam (Netherlands); Morgan, Veronica [Royal Marsden NHS Foundation Trust, Department of Medicine, London (United Kingdom)

    2017-11-15

    To determine the test-retest repeatability of Apparent Diffusion Coefficient (ADC) measurements across institutions and MRI vendors, plus investigate the effect of post-processing methodology on measurement precision. Thirty malignant lung lesions >2 cm in size (23 patients) were scanned on two occasions, using echo-planar-Diffusion-Weighted (DW)-MRI to derive whole-tumour ADC (b = 100, 500 and 800 s/mm{sup -2}). Scanning was performed at 4 institutions (3 MRI vendors). Whole-tumour volumes-of-interest were copied from first visit onto second visit images and from one post-processing platform to an open-source platform, to assess ADC repeatability and cross-platform reproducibility. Whole-tumour ADC values ranged from 0.66-1.94x10{sup -3} mm{sup 2}s{sup -1} (mean = 1.14). Within-patient coefficient-of-variation (wCV) was 7.1% (95% CI 5.7-9.6%), limits-of-agreement (LoA) -18.0 to 21.9%. Lesions >3 cm had improved repeatability: wCV 3.9% (95% CI 2.9-5.9%); and LoA -10.2 to 11.4%. Variability for lesions <3 cm was 2.46 times higher. ADC reproducibility across different post-processing platforms was excellent: Pearson's R{sup 2} = 0.99; CoV 2.8% (95% CI 2.3-3.4%); and LoA -7.4 to 8.0%. A free-breathing DW-MRI protocol for imaging malignant lung tumours achieved satisfactory within-patient repeatability and was robust to changes in post-processing software, justifying its use in multi-centre trials. For response evaluation in individual patients, a change in ADC >21.9% will reflect treatment-related change. (orig.)

  15. Relationship between pretreatment FDG-PET and diffusion-weighted MRI biomarkers in diffuse large B-cell lymphoma

    NARCIS (Netherlands)

    de Jong, Antoinette; Kwee, Thomas C.; de Klerk, John M. H.; Adam, Judit A.; de Keizer, Bart; Fijnheer, Rob; Kersten, Marie José; Ludwig, Inge; Jauw, Yvonne W. S.; Zijlstra, Josée M.; Pieters-van den Bos, Indra C.; Stoker, Jaap; Hoekstra, Otto S.; Nievelstein, Rutger A. J.

    2014-01-01

    The purpose of this study was to determine the correlation between the (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) standardized uptake value (SUV) and the diffusion-weighted magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) in newly diagnosed diffuse

  16. Diffusion-Weighted MRI of Malignant versus Benign Portal Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jhii-Hyun; Yu, Jeong-Sik; Cho, Eun-Suk; Chung, Jae-Joon; Kim, Joo Hee; Kim, Ki Whang [Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273 (Korea, Republic of)

    2016-11-01

    To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40–85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients. DWI was performed using b values of 50 and 800 sec/mm{sup 2} at 1.5-T unit. A thrombus was considered malignant if it enhanced on dynamic CT or MRI; otherwise, it was considered bland. There were 18 bland thrombi and 49 malignant thrombi in 59 patients, including 8 patients with simultaneous benign and malignant PVT. Mean apparent diffusion coefficients (ADCs) of benign and malignant PVTs were compared by using Mann-Whitney U test. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. The mean ADC ± standard deviation of bland and malignant PVT were 1.00 ± 0.39 × 10{sup -3} mm{sup 2}/sec and 0.92 ± 0.25 × 10{sup -3} mm{sup 2}/sec, respectively; without significant difference (p = 0.799). The area under ROC curve for ADC was 0.520. An ADC value of > 1.35 × 10{sup -3} mm{sup 2}/sec predicted bland PVT with a specificity of 94.6% (95% confidence interval [CI]: 84.9–98.9%) and a sensitivity of 22.2% (95% CI: 6.4–47.6%), respectively. Due to the wide range and considerable overlap of the ADCs, DWI cannot differentiate the benign from malignant thrombi efficiently.

  17. Diffusion-weighted MRI of malignant versus benign portal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jhii Hyun; Yu, Jeong Sik; Cho, Eun Suk; Chung, Jae Joon; Kim, Joo Hee; Kim, Ki Whang [Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul(Korea, Republic of)

    2016-07-15

    To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40-85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients. DWI was performed using b values of 50 and 800 sec/mm2 at 1.5-T unit. A thrombus was considered malignant if it enhanced on dynamic CT or MRI; otherwise, it was considered bland. There were 18 bland thrombi and 49 malignant thrombi in 59 patients, including 8 patients with simultaneous benign and malignant PVT. Mean apparent diffusion coefficients (ADCs) of benign and malignant PVTs were compared by using Mann-Whitney U test. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. The mean ADC ± standard deviation of bland and malignant PVT were 1.00 ± 0.39 × 10(-3) mm{sup 2}/sec and 0.92 ± 0.25 × 10(-3) mm{sup 2}/sec, respectively; without significant difference (p = 0.799). The area under ROC curve for ADC was 0.520. An ADC value of > 1.35 × 10(-3) mm{sup 2}/sec predicted bland PVT with a specificity of 94.6% (95% confidence interval [CI]: 84.9-98.9%) and a sensitivity of 22.2% (95% CI: 6.4-47.6%), respectively. Due to the wide range and considerable overlap of the ADCs, DWI cannot differentiate the benign from malignant thrombi efficiently.

  18. Persistent high signal on diffusion-weighted MRI in the late stages of small cortical and lacunar ischaemic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, B.; Holtaas, S. [Univ. Hospital, Lund (Sweden). Dept. of Radiology; Lindgren, A. [Dept. of Neurology, Univ. Hospital, Lund (Sweden); Brockstedt, S.; Staahlberg, F. [Univ. Hospital, Lund (Sweden). Dept. of Radiology; Dept. of Radiation Physics, Univ. Hospital, Lund (Sweden)

    2001-02-01

    Diffusion-weighted imaging (DWI) is very sensitive to early brain infarcts. However, the late stages have been insufficiently studied. Infarcts in small vessel disease are often multiple and of different ages, and differentiation between new and old lesions might be difficult. We have therefore studied the change with time in DWI of small (< 3 ml) ischaemic lesions. We imaged 21 patients with an acute lacunar syndrome and a lesion visible on early DWI. They all had three MRI examinations 12-58 h (early), 7-16 and 54-144 days after the onset of stroke; 10 patients with high DWI signal on the third examination had a fourth examination 12-28 months after the stroke. MRI was performed at 1.5 T, using echo-planar DWI with 7 b-values from 0 to 1200 x 10{sup 6} s/m{sup 2} and conventional T2-weighted imaging. After 7-16 days 18 of 21 lesions gave high signal on DWI, and 12/16 measurable lesions had a decreased apparent diffusion coefficient (ADC). After 54-144 days ten lesions still gave high DWI signal and two still had an ADC below normal. On the fourth examination there was no remaining high DWI signal and all ADC were higher than normal. (orig.)

  19. Correlation of brain stem diffusion-weighted imaging score with vertebrobasilar artery stenosis in patients with acute brain stem infarction

    OpenAIRE

    Jing-sheng YU; Hui-sheng CHEN

    2015-01-01

    Objective To investigate the correlation of brain stem diffusion-weighted imaging (DWI) lesion score with vertebrobasilar artery stenosis as revealed by magnetic resonance angiography (MRA) in patients with acute brain stem infarction. Methods A total of 253 patients diagnosed as acute brain stem infarction by means of brain magnetic resonance imaging were analyzed retrospectively. Of them 211 patients were enrolled in the present study, and they were qualified with the enrolling standard, an...

  20. Diffusion Weighted/Tensor Imaging, Functional MRI and Perfusion Weighted Imaging in Glioblastoma—Foundations and Future

    Directory of Open Access Journals (Sweden)

    Gayle R. Salama

    2018-01-01

    Full Text Available In this article, we review the basics of diffusion tensor imaging and functional MRI, their current utility in preoperative neurosurgical mapping, and their limitations. We also discuss potential future applications, including implementation of resting state functional MRI. We then discuss perfusion and diffusion-weighted imaging and their application in advanced neuro-oncologic practice. We explain how these modalities can be helpful in guiding surgical biopsies and differentiating recurrent tumor from treatment related changes.

  1. Optimising diffusion weighted MRI for imaging metastatic and myeloma bone disease and assessing reproducibility

    International Nuclear Information System (INIS)

    Messiou, C.; Collins, D.J.; Morgan, V.A.; DeSouza, N.M.

    2011-01-01

    To establish normal bone marrow values of apparent diffusion coefficient (ADC) over an age range, compare them with metastatic and myelomatous involvement, to establish reproducibility and to optimise b values. The ADCs of bone marrow in 7 volunteers (mean age 29.7 years), 34 volunteers (mean age 63.3 years) and 43 patients with metastatic and myelomatous involvement (mean age 65.5 years) were measured. In 9 volunteers diffusion weighted MRI was repeated within 7 days. b values were derived to optimise contrast between normal and pathological marrow. The mean ADC of bone marrow in younger volunteers was significantly higher than that of older volunteers. The coefficient of reproducibility was 14.8%. The ADC mean of metastatic and myeloma bone disease was 1054+/-456 x 10 -6 mm 2 s -1 . An ADC threshold of 655 x 10 -6 mm 2 s -1 separated normal and abnormal marrow with a sensitivity and specificity of 90% and 93% respectively. Contrast between normal and abnormal marrow was optimal at b = 1389 smm -2 . The reproducibility of ADC measurements in bone is equivalent to published data for soft tissue with a high sensitivity and specificity for separating abnormal from age matched normal bone marrow. A b value of around 1,400 smm -2 is optimal for imaging bone marrow. (orig.)

  2. Comparison of CT and diffusion-weighted MRI in acute ischemic stroke

    International Nuclear Information System (INIS)

    Moriwaki, Hiroshi; Okazaki, Shuhei; Yamada, Naoaki; Naritomi, Hiroaki

    2006-01-01

    Non-contrast CT and diffusion-weighted MRI (DWI) are widely used for assessing patients with acute ischemic stroke including candidates for thrombolytic therapy. Early CT signs, still a gold standard as the diagnostic measure for thrombolysis, are quite subtle and strongly depend on image quality. We evaluated 76 patients (47 male, mean age 71.0 yrs) with ischemic stroke of the anterior cerebral circulation who underwent CT and DWI within 6 hours of onset. The scans were examined separately by two neurologists in a blinded fashion with knowledge of the affected hemisphere. Detection of acute ischemic changes were significantly higher on DWI (72/76, 95%) compared with that on CT (50/76, 66%) (P<0.0001), especially in cases with subcortical lesions (P<0.001). Detection of the lesion with more than 33% of MCA involvement, which should exclude from the thrombolitic therapy, was somewhat higher for DWI (26/26, 100%) compared with CT (22/26, 85%). DWI is more sensitive than CT in the identification of acute ischemic stroke and can visualize major ischemia more easily than CT. Additional studies are required to determine whether these advantages of DWI are clinically relevant in the management of patients with acute stroke. (author)

  3. Accuracies and Contrasts of Models of the Diffusion-weighted-dependent Attenuation of the Mri Signal at Intermediate -values

    Directory of Open Access Journals (Sweden)

    Renaud Nicolas

    2015-01-01

    Full Text Available The diffusion-weighted-dependent attenuation of the MRI signal E ( b is extremely sensitive to microstructural features. The aim of this study was to determine which mathematical model of the E ( b signal most accurately describes it in the brain. The models compared were the monoexponential model, the stretched exponential model, the truncated cumulant expansion (TCE model, the biexponential model, and the triexponential model. Acquisition was performed with nine b -values up to 2500 s/mm 2 in 12 healthy volunteers. The goodness-of-fit was studied with F -tests and with the Akaike information criterion. Tissue contrasts were differentiated with a multiple comparison corrected nonparametric analysis of variance. F -test showed that the TCE model was better than the biexponential model in gray and white matter. Corrected Akaike information criterion showed that the TCE model has the best accuracy and produced the most reliable contrasts in white matter among all models studied. In conclusion, the TCE model was found to be the best model to infer the microstructural properties of brain tissue.

  4. Acute bilateral basal ganglia lesions in diabetic uraemia: diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ja; Park, Chan Sup [Kwandong University, College of Medicine, Department of Radiology, Myongji Hospital, Koyang-City, Gyunggi-Do (Korea); Park, Jong-Ho [Myongji Hospital, Kwandong University, College of Medicine, Department of Neurology, Koyang (Korea); Ihn, Yon kwon; Kim, Young Joo [The Catholic University of Korea, Department of Radiology, Seoul (Korea); Lee, Seon Kyu [University of Toronto, Department of Medical Imaging, Toronto Western Hospital, Toronto (Canada)

    2007-12-15

    We studied four patients with diabetes mellitus and chronic renal failure who developed sudden choreic movement disorders. The clinical manifestations, laboratory findings, MR imaging findings, and clinical outcome in each patient were evaluated. All four patients had long-term diabetes mellitus and severe azotaemia. Brain MR findings consisted of bilateral symmetric basal ganglia lesions, with decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images. All three patients who underwent diffusion-weighted MR imaging (DWI) showed signal intensities similar to those of the surroundings in regions corresponding to increased signal intensity on T2-weighted images, with slightly increased apparent diffusion coefficient (ADC) values. Two of the patients showed small focal areas of restricted diffusion within the basal ganglia lesions. After haemodialysis, follow-up MR imaging in all patients demonstrated that the basal ganglia lesions had regressed markedly, with some residual changes. The movement disorders also improved in all patients. A syndrome associated with acute bilateral basal ganglia lesions in diabetic uraemic patients is rare, with reversible changes demonstrated by clinical and imaging findings. DWI showed that the bilateral basal ganglia lesions in this syndrome were primarily vasogenic in origin, although there were small foci of cytotoxic oedema within the lesions. (orig.)

  5. Support vector machine for breast cancer classification using diffusion-weighted MRI histogram features: Preliminary study.

    Science.gov (United States)

    Vidić, Igor; Egnell, Liv; Jerome, Neil P; Teruel, Jose R; Sjøbakk, Torill E; Østlie, Agnes; Fjøsne, Hans E; Bathen, Tone F; Goa, Pål Erik

    2018-05-01

    Diffusion-weighted MRI (DWI) is currently one of the fastest developing MRI-based techniques in oncology. Histogram properties from model fitting of DWI are useful features for differentiation of lesions, and classification can potentially be improved by machine learning. To evaluate classification of malignant and benign tumors and breast cancer subtypes using support vector machine (SVM). Prospective. Fifty-one patients with benign (n = 23) and malignant (n = 28) breast tumors (26 ER+, whereof six were HER2+). Patients were imaged with DW-MRI (3T) using twice refocused spin-echo echo-planar imaging with echo time / repetition time (TR/TE) = 9000/86 msec, 90 × 90 matrix size, 2 × 2 mm in-plane resolution, 2.5 mm slice thickness, and 13 b-values. Apparent diffusion coefficient (ADC), relative enhanced diffusivity (RED), and the intravoxel incoherent motion (IVIM) parameters diffusivity (D), pseudo-diffusivity (D*), and perfusion fraction (f) were calculated. The histogram properties (median, mean, standard deviation, skewness, kurtosis) were used as features in SVM (10-fold cross-validation) for differentiation of lesions and subtyping. Accuracies of the SVM classifications were calculated to find the combination of features with highest prediction accuracy. Mann-Whitney tests were performed for univariate comparisons. For benign versus malignant tumors, univariate analysis found 11 histogram properties to be significant differentiators. Using SVM, the highest accuracy (0.96) was achieved from a single feature (mean of RED), or from three feature combinations of IVIM or ADC. Combining features from all models gave perfect classification. No single feature predicted HER2 status of ER + tumors (univariate or SVM), although high accuracy (0.90) was achieved with SVM combining several features. Importantly, these features had to include higher-order statistics (kurtosis and skewness), indicating the importance to account for heterogeneity. Our

  6. Is diffusion-weighted MRI sufficient for follow-up of neuroendocrine tumour liver metastases?

    International Nuclear Information System (INIS)

    Lavelle, L.P.; O'Neill, A.C.; McMahon, C.J.; Cantwell, C.P.; Heffernan, E.J.; Malone, D.E.; Daly, L.; Skehan, S.J.

    2016-01-01

    Aim: To assess if diffusion-weighted imaging (DWI) alone could be used for follow-up of neuroendocrine hepatic metastases. Material and methods: This was a retrospective study, approved by the institutional review board. Twenty-two patients with neuroendocrine liver metastases who had undergone more than one liver magnetic resonance imaging (MRI) examination, (including DWI and using hepatocyte-specific contrast medium) were evaluated. Up to five metastases were measured at baseline and at each subsequent examination. The reference standard measurement was performed on the hepatocyte phase by one reader. Three independent readers separately measured the same lesions on DWI sequences alone, blinded to other sequences, and recorded the presence of any new lesions. Results: The longest diameters of 317 liver metastases (91 on 22 baseline examinations and a further 226 measurements on follow-up) were measured on the reference standard by one reader and on three b-values by three other readers. The mean difference between DWI measurements and the reference standard measurement was between 0.01–0.08 cm over the nine reader/b-value combinations. Based on the width of the Bland and Altman interval containing approximately 95% of the differences between the reader observation and the mean of reference standard and DWI measurement, the narrowest interval over the nine reader/b-value combinations was −0.6 to +0.7 cm and the widest was −0.9 to 1 cm. In the evaluation of overall response using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria, the weighted kappa statistic was between 0.49 and 0.86, indicating moderate-to-good agreement between the reference standard and DWI. Conclusion: The visualisation and measurement of hepatic metastases using DWI alone are within acceptable limits for clinical use, allowing the use of this rapid technique to restage hepatic disease in patients with neuroendocrine metastases. - Highlights: • DWI showed excellent

  7. A biomimetic tumor tissue phantom for validating diffusion-weighted MRI measurements.

    Science.gov (United States)

    McHugh, Damien J; Zhou, Feng-Lei; Wimpenny, Ian; Poologasundarampillai, Gowsihan; Naish, Josephine H; Hubbard Cristinacce, Penny L; Parker, Geoffrey J M

    2018-07-01

    To develop a biomimetic tumor tissue phantom which more closely reflects water diffusion in biological tissue than previously used phantoms, and to evaluate the stability of the phantom and its potential as a tool for validating diffusion-weighted (DW) MRI measurements. Coaxial-electrospraying was used to generate micron-sized hollow polymer spheres, which mimic cells. The bulk structure was immersed in water, providing a DW-MRI phantom whose apparent diffusion coefficient (ADC) and microstructural properties were evaluated over a period of 10 months. Independent characterization of the phantom's microstructure was performed using scanning electron microscopy (SEM). The repeatability of the construction process was investigated by generating a second phantom, which underwent high resolution synchrotron-CT as well as SEM and MR scans. ADC values were stable (coefficients of variation (CoVs) < 5%), and varied with diffusion time, with average values of 1.44 ± 0.03 µm 2 /ms (Δ = 12 ms) and 1.20 ± 0.05 µm 2 /ms (Δ = 45 ms). Microstructural parameters showed greater variability (CoVs up to 13%), with evidence of bias in sphere size estimates. Similar trends were observed in the second phantom. A novel biomimetic phantom has been developed and shown to be stable over 10 months. It is envisaged that such phantoms will be used for further investigation of microstructural models relevant to characterizing tumor tissue, and may also find application in evaluating acquisition protocols and comparing DW-MRI-derived biomarkers obtained from different scanners at different sites. Magn Reson Med 80:147-158, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is

  8. Detectability and detection rate of acute cerebral hemisphere infarcts on CT and diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Urbach, H.; Flacke, S.; Keller, E.; Textor, J.; Berlis, A.; Reul, J.; Schild, H.H.; Hartmann, A.; Solymosi, L.

    2000-01-01

    Our purpose was to compare the detectability and detection rate of acute ischaemic cerebral hemisphere infarcts on CT and diffusion-weighted MRI (DWI). We investigated 32 consecutive patients with acute hemisphere stroke with unenhanced CT and DWI within 6 h of stroke onset. The interval between CT and DWI ranged from 15 to 180 min (mean 60 min). Infarct detectability on CT and DWI was determined by comparing the initial CT, DWI and later reference images in a consensus reading of five independent examiners. The ''true'' detection rate was assessed by analysing all single readings. Two patients had intracerebral haematomas on DWI and CT and were excluded. There were 27 patients with ischaemic infarcts; all were visible on DWI and proven by follow-up. DWI was negative in three patients without a final diagnosis of infarct (100 % sensitivity, 100 % specificity, χ 2 = 30, P 2 = 1.48, P = 0.224). With regard to the single readings (30 examinations x 5 examiners = 150 readings), 63 CT readings were true positive and 72 false negative (sensitivity 47 %, specificity 86 %, χ 2 = 2.88, P = 0.089). Of the DWI readings 128 were true positive and 7 false negative (sensitivity 95 %, specificity 87 %, χ 2 = 70.67, P < 0.0001). Interobserver agreement was substantial for CT (χ= 0.72, 95 % confidence interval, 0.6-0.84) and DWI (χ= 0.82, 95 % confidence interval, 0.46-1). Taken together, detectability and detection rate of acute (< 6 h) hemisphere infarcts are significantly higher with DWI than with CT. (orig.)

  9. Meningoencephalitis caused by Streptococcus pneumoniae: a diagnostic and therapeutic challenge. Diagnosis with diffusion-weighted MRI leading to treatment with corticosteroids

    Energy Technology Data Exchange (ETDEWEB)

    Jorens, Philippe G.; Demey, Hendrik E. [University Hospital of Antwerp, UZA, Department of Intensive Care Medicine, Edegem (Belgium); Parizel, Paul M. [University of Antwerp, Department of Radiology, Edegem (Belgium); Smets, Katrien [University of Antwerp, Department of Neurology, Edegem (Belgium); General Hospital AZ Middelares, Department of Neurology, Sint-Niklaas (Belgium); Jadoul, Kris [General Hospital AZ Middelares, Department of Neurology, Sint-Niklaas (Belgium); Verbeek, M.M.; Wevers, R.A. [University Hospital of Nijmegen, Laboratory of Paediatrics and Neurology, Nijmegen (Netherlands); Cras, Patrick [University of Antwerp, Department of Neurology, Edegem (Belgium)

    2005-10-01

    Streptococcus pneumoniae is a common cause of bacterial meningitis but only rarely causes other infections such as brain abscess, encephalitis, encephalomyelitis or meningoencephalitis. We report on three adult patients with meningoencephalitis caused by S. pneumoniae. In all three, CT and MRI revealed widespread brain lesions, suggesting extensive parenchymal injury. Diffusion-weighted MRI showed lesions with restricted diffusion, reflecting local areas of ischaemia with cytotoxic oedema secondary to an immunologically mediated necrotising vasculitis and thrombosis. High levels of markers of neuronal, glial and myelin damage were found in the cerebrospinal fluid. According to the literature, brain parenchyma lesions in adults with pneumococcal meningoencephalitis are often associated with death or severe neurological deficit. Our patients were treated with pulse doses of glucocorticoids: this resulted in dramatic clinical improvement and an excellent final neurological recovery. (orig.)

  10. Diffusion-weighted MR and apparent diffusion coefficient in the evaluation of severe brain injury

    International Nuclear Information System (INIS)

    Nakahara, M.; Ericson, K.; Bellander, B.M.

    2001-01-01

    Purpose: To study apparent diffusion coefficient (ADC) maps in severely brain-injured patients. Material and Methods: Four deeply comatose patients with severe brain injury were investigated with single-shot, diffusion-weighted, spin-echo echo planar imaging. The tetrahedral diffusion gradient configuration and four iterations of a set of b-values (one time of 0 mm2/s, and four times of 1000 mm2/s) were used to create isotropic ADC maps with high signal-to-noise ratio. ADC values of gray and white matter were compared among patients and 4 reference subjects. Results: one patient was diagnosed as clinically brain dead after the MR examination. The patient's ADC values of gray and white matter were significantly lower than those of 3 other brain-injured patients. In addition the ADC value of white matter was significantly lower than that of gray matter. Conclusion: The patient with fatal outcome shortly after MR examination differed significantly from other patients with severe brain injury but non-fatal outcome, with regard to ADC values in gray and white matter. This might indicate a prognostic value of ADC maps in the evaluation of traumatic brain injury

  11. Feasibility of whole-body diffusion-weighted MRI for detection of primary tumour, nodal and distant metastases in women with cancer during pregnancy: a pilot study

    NARCIS (Netherlands)

    Han, Sileny N.; Amant, Frédéric; Michielsen, Katrijn; de Keyzer, Frederik; Fieuws, Steffen; van Calsteren, Kristel; Dresen, Raphaëla C.; Gziri, Mina Mhallem; Vandecaveye, Vincent

    2017-01-01

    To evaluate the feasibility of whole-body diffusion-weighted MRI (WB-DWI/MRI) for detecting primary tumour, nodal and distant metastases in pregnant women with cancer. Twenty pregnant patients underwent WB-DWI/MRI in additional to conventional imaging. Reproducibility of WB-DWI/MRI between two

  12. Feasibility of a RARE-based sequence for quantitative diffusion-weighted MRI of the spine

    International Nuclear Information System (INIS)

    Raya, J.G.; Dietrich, O.; Sommer, J.; Reiser, M.F.; Baur-Melnyk, A.; Birkenmaier, C.

    2007-01-01

    The feasibility of a diffusion-weighted single-shot fast-spin-echo sequence for the diagnostic work-up of bone marrow diseases was assessed. Twenty healthy controls and 16 patients with various bone marrow pathologies of the spine (bone marrow edema, tumor and inflammation) were examined with a diffusion-weighted single-shot sequence based on a modified rapid acquisition with relaxation enhancement (mRARE) technique; four diffusion weightings (b-values: 50, 250, 500 and 750 s/mm 2 ) in three orthogonal orientations were applied. Apparent diffusion coefficients (ADCs) were determined in the bone marrow and in the intervertebral discs of healthy volunteers and in diseased bone marrow. Ten of the 20 volunteers were repeatedly scanned within 30 min to examine short-time reproducibility. Spatial reproducibility was assessed by measuring ADCs in two different slices including the same lesion in 12 patients. The ADCs of the lesions exhibited significantly higher values, (1.27 ± 0.32) x 10 -3 mm 2 /s, compared with healthy bone marrow, (0.21 ± 0.10) x 10 -3 mm 2 /s. Short-time and spatial reproducibility had a mean coefficient of variation of 2.1% and 6.4%, respectively. The diffusion-weighted mRARE sequence provides a reliable tool for determining quantitative ADCs in vertebral bone marrow with adequate image quality. (orig.)

  13. Utility of computed diffusion-weighted MRI for predicting aggressiveness of prostate cancer

    NARCIS (Netherlands)

    Waseda, Yuma; Yoshida, Soichiro; Takahara, Taro; Kwee, Thomas Christian; Matsuoka, Yoh; Saito, Kazutaka; Kihara, Kazunori; Fujii, Yasuhisa

    PurposeTo investigate the value of computed (c) diffusion-weighted imaging (DWI) in assessing prostate cancer aggressiveness. Materials and MethodsFifty-five patients with peripheral zone prostate cancer who underwent prebiopsy 1.5T magnetic resonance imaging (including native DWI at b-values of 0

  14. Multiband diffusion-weighted MRI of the eye and orbit free of geometric distortions using a RARE-EPI hybrid.

    Science.gov (United States)

    Paul, Katharina; Huelnhagen, Till; Oberacker, Eva; Wenz, Daniel; Kuehne, André; Waiczies, Helmar; Schmitter, Sebastian; Stachs, Oliver; Niendorf, Thoralf

    2018-03-01

    Diffusion-weighted imaging (DWI) provides information on tissue microstructure. Single-shot echo planar imaging (EPI) is the most common technique for DWI applications in the brain, but is prone to geometric distortions and signal voids. Rapid acquisition with relaxation enhancement [RARE, also known as fast spin echo (FSE)] imaging presents a valuable alternative to DWI with high anatomical accuracy. This work proposes a multi-shot diffusion-weighted RARE-EPI hybrid pulse sequence, combining the anatomical integrity of RARE with the imaging speed and radiofrequency (RF) power deposition advantage of EPI. The anatomical integrity of RARE-EPI was demonstrated and quantified by center of gravity analysis for both morphological images and diffusion-weighted acquisitions in phantom and in vivo experiments at 3.0 T and 7.0 T. The results indicate that half of the RARE echoes in the echo train can be replaced by EPI echoes whilst maintaining anatomical accuracy. The reduced RF power deposition of RARE-EPI enabled multiband RF pulses facilitating simultaneous multi-slice imaging. This study shows that diffusion-weighted RARE-EPI has the capability to acquire high fidelity, distortion-free images of the eye and the orbit. It is shown that RARE-EPI maintains the immunity to B 0 inhomogeneities reported for RARE imaging. This benefit can be exploited for the assessment of ocular masses and pathological changes of the eye and the orbit. Copyright © 2018 John Wiley & Sons, Ltd.

  15. Diffusion weighted MR imaging in non-infarct lesions of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Karaarslan, E. [Department of Radiology, American Hospital, Sisli, Istanbul (Turkey)], E-mail: ercankaraarslan@yahoo.com; Arslan, A. [Department of Radiology, Kocaeli University Medical School, Kocaeli (Turkey)], E-mail: arzuarslan@netscape.net

    2008-03-15

    Diffusion weighted imaging (DWI) is a relatively new method in which the images are formed by the contrast produced by the random microscopic motion of water molecules in different tissues. Although DWI has been tried for different organ systems, it has been found its primary use in the central nervous system. The most widely used clinical application is in the detection of hyperacute infarcts and the differentiation of acute or subacute infarction from chronic infarction. Recently DWI has been applied to various other cerebral diseases. In this pictorial paper the authors demonstrated different DWI patterns of non-infarct lesions of the brain which are hyperintense in the diffusion trace image, such as infectious, neoplastic and demyelinating diseases, encephalopathies - including hypoxic-ischemic, hypertensive, eclamptic, toxic, metabolic and mitochondrial encephalopathies - leukodystrophies, vasculitis and vasculopathies, hemorrhage and trauma.

  16. Diffusional anisotropy of the human brain assessed with diffusion-weighted MR: Relation with normal brain development and aging

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Toshiyuki; Sakuma, Hajime; Takeda, Kan; Tagami, Tomoyasu; Okuda, Yasuyuki; Nakagawa, Tsuyoshi (Mie Univ. School of Medicine (Japan))

    1994-02-01

    To analyze diffusional anisotropy in frontal and occipital white matter of human brain quantitatively as a function of age by using diffusion-weighted MR imaging. Ten neonates (<1 month), 13 infants (1-10 months), 9 children (1-11 years), and 16 adults (20-79 years) were examined. After taking axial spin-echo images of the brain, diffusion-sensitive gradients were added parallel or perpendicular to the orientation of nerve fibers. The apparent diffusion coefficient parallel to the nerve fibers (0) and that perpendicular to the fibers (90) were computed. The anisotropic ratio (90/0) was calculated as a function of age. Anisotropic ratios of frontal white matter were significantly larger in neonates as compared with infants, children, or adults. The ratios showed rapid decrease until 6 months and thereafter were identical in all subjects. In the occipital lobe, the ratios were also greater in neonates, but the differences from other age groups were not so prominent as in the frontal lobe. Comparing anisotropic ratios between frontal and occipital lobes, a significant difference was observed only in neonates. Diffusion-weighted images demonstrated that the myelination process starts earlier in the occipital lobe than in the frontal lobe. The changes of diffusional anisotropy in white matter are completed within 6 months after birth. Diffusion-weighted imaging provides earlier detection of brain myelination compared with the conventional T1- and T2-weighted images. 18 refs., 6 figs., 1 tab.

  17. Diffusion-weighted echo planar imaging of acute brain infarction. A preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Haruyuki; Ezuka, Isamu; Ikegami, Yoh; Suda, Tsuyoshi; Kakinuma, Kenichi; Kanazawa, Tsutomu; Higuchi, Shoichi [Niigata Rosai Hospital, Joetsu (Japan)

    1999-12-01

    The clinical usefulness of diffusion-weighted echo planar imaging (DW-EPI) was studied in 55 patients with acute brain ischemia. Ischemic lesions were identified on DW-EPI as hyperintense regions in all patients before changes were detected by conventional magnetic resonance imaging techniques in 12 cases studied earlier than 6 hours after onset. The earliest case was verified on DW-EPI at 50 minutes after onset. The ultra-fast imaging technique took less than 2 minutes to perform even for restless patients. Three patients had cardioembolic middle cerebral artery occlusion, and emergent percutaneous transluminal recanalization was carried out. Chronological changes in the signal of brain ischemia on DW-EPI depended on the site and size of the lesion, lacunar infarct of basal ganglia, and/or massive infarct due to major vessel occlusion, and were affected by associated hemorrhagic events. Coronal DW-EPI could more easily demarcate ischemia in the brainstem and/or cerebellum than axial scans when susceptibility artifacts were present. Coronal scans also demonstrated the site and direction of the pyramidal tract and its anatomical correlation with the lesions. DW-EPI has potential for the diagnostic and therapeutic planning of patients with acute brain ischemia. (author)

  18. Abnormal diffusion-weighted MRI in medulloblastoma: does it reflect small cell histology?

    International Nuclear Information System (INIS)

    Kotsenas, A.L.; Roth, T.C.; Manness, W.K.; Faerber, E.N.

    1999-01-01

    A 12-year-old boy presented with the classic CT and MRI findings of medulloblastoma and the unusual finding of increased signal on diffusion MRI. The small-cell histology of medulloblastoma may account for the increased signal seen on diffusion MRI. Diffusion MRI with echoplanar technique may be useful in evaluation of these tumors and metastatic disease. (orig.)

  19. Diffusion-weighted MRI in locally advanced rectal cancer : pathological response prediction after neo-adjuvant radiochemotherapy.

    Science.gov (United States)

    Intven, M; Reerink, O; Philippens, M E P

    2013-02-01

    The aim of this study was to assess the predictive potential of diffusion-weighted magnetic resonance imaging (MRI) for the selection of favorable pathological responders after radiochemotherapy for locally advanced rectal cancer. In 59 patients with locally advanced rectal cancer, the apparent diffusion coefficient (ADC) in the tumor was obtained at 3 Tesla before radiochemotherapy and surgery. The predictive potential for pathological complete response (pCR) and good response (GR) was assessed. GR was defined as pCR and near-pCR based on the tumor regression grade. The GR group consisted of 13 patients (22%) with 9 complete responders. Both the preradiochemotherapy ADC values and relative change in ADC (ΔADC) were predictive for pathological response. Preradiochemotherapy ADC values showed a positive predictive value of 42% for pCR and 67% for GR using a similar cut-off value of 0.97(*)10(-3) mm(2)/s. For ΔADC, the optimal threshold for predicting GR or pCR was a 41% increase of the ADC. With this threshold, positive predictive values of 64% and 91% were found for pCR and GR, respectively. Low preradiochemotherapy ADC values and high ΔADC correspond to pathological good response. Diffusion-weighted MRI may be used as an additional tool for selecting good treatment responders after radiochemotherapy.

  20. Diffusion-weighted MRI in locally advanced rectal cancer. Pathological response prediction after neo-adjuvant radiochemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Intven, M.; Reerink, O.; Philippens, M.E.P. [University Medical Center Utrecht (Netherlands). Dept. of Radiotherapy

    2013-02-15

    Background and purpose: The aim of this study was to assess the predictive potential of diffusion-weighted magnetic resonance imaging (MRI) for the selection of favorable pathological responders after radiochemotherapy for locally advanced rectal cancer. Patients and methods: In 59 patients with locally advanced rectal cancer, the apparent diffusion coefficient (ADC) in the tumor was obtained at 3 Tesla before radiochemotherapy and surgery. The predictive potential for pathological complete response (pCR) and good response (GR) was assessed. GR was defined as pCR and near-pCR based on the tumor regression grade. Results: The GR group consisted of 13 patients (22%) with 9 complete responders. Both the preradiochemotherapy ADC values and relative change in ADC ({Delta}ADC) were predictive for pathological response. Preradiochemotherapy ADC values showed a positive predictive value of 42% for pCR and 67% for GR using a similar cut-off value of 0.97{sup 1}0{sup -3} mm{sup 2}/s. For {Delta}ADC, the optimal threshold for predicting GR or pCR was a 41% increase of the ADC. With this threshold, positive predictive values of 64% and 91% were found for pCR and GR, respectively. Conclusion: Low preradiochemotherapy ADC values and high {Delta}ADC correspond to pathological good response. Diffusion-weighted MRI may be used as an additional tool for selecting good treatment responders after radiochemotherapy. (orig.)

  1. Diffusion-weighted MRI in locally advanced rectal cancer. Pathological response prediction after neo-adjuvant radiochemotherapy

    International Nuclear Information System (INIS)

    Intven, M.; Reerink, O.; Philippens, M.E.P.

    2013-01-01

    Background and purpose: The aim of this study was to assess the predictive potential of diffusion-weighted magnetic resonance imaging (MRI) for the selection of favorable pathological responders after radiochemotherapy for locally advanced rectal cancer. Patients and methods: In 59 patients with locally advanced rectal cancer, the apparent diffusion coefficient (ADC) in the tumor was obtained at 3 Tesla before radiochemotherapy and surgery. The predictive potential for pathological complete response (pCR) and good response (GR) was assessed. GR was defined as pCR and near-pCR based on the tumor regression grade. Results: The GR group consisted of 13 patients (22%) with 9 complete responders. Both the preradiochemotherapy ADC values and relative change in ADC (ΔADC) were predictive for pathological response. Preradiochemotherapy ADC values showed a positive predictive value of 42% for pCR and 67% for GR using a similar cut-off value of 0.97 1 0 -3 mm 2 /s. For ΔADC, the optimal threshold for predicting GR or pCR was a 41% increase of the ADC. With this threshold, positive predictive values of 64% and 91% were found for pCR and GR, respectively. Conclusion: Low preradiochemotherapy ADC values and high ΔADC correspond to pathological good response. Diffusion-weighted MRI may be used as an additional tool for selecting good treatment responders after radiochemotherapy. (orig.)

  2. Diffusion-weighted MR of the brain: methodology and clinical applications

    International Nuclear Information System (INIS)

    Mascalchi, Mario; Filippi, Massimo; Floris, Roberto; Fonda, Claudio; Gasparotti, Roberto; Villari, Natale

    2005-01-01

    Clinical diffusion magnetic resonance (MR) imaging in humans started in the last decade with the demonstration of the capabilities of this technique of depicting the anatomy of the white matter fibre tracts in the brain. Two main approaches in terms of reconstruction and evaluation of the images obtained with application of diffusion sensitising gradients to an echo planar imaging sequence are possible. The first approach consists of reconstruction of images in which the effect of white matter anisotropy is averaged -know as the isotropic or diffusion weighted images, which are usually evaluated subjectively for possible areas of increased or decreased signal, reflecting restricted and facilitated diffusion, respectively. The second approach implies reconstruction of image maps of the apparent diffusion coefficient (ADC), in which the T2 weighting of the echo planar diffusion sequence is cancelled out, and their objective, i.e. numerical, evaluation with regions of interest or histogram analysis. This second approach enables a quantitative and reproducible assessment of the diffusion changes mot only in areas exhibiting signal abnormality in conventional MR images, but also in areas of normal signal. A further level of image post-processing requires the acquisition of images after application of sensitive gradients along at least 6 different spatial orientations and consists of computation of the diffusion tensor and reconstruction of maps of the mean diffusivity (D) and of the white matter anisotropic properties, usually in terms of fractional anisotropy (FA). Diffusion-weighted imaging is complementary to conventional MR imaging in the evaluation of the acute ischaemic stroke. The combination of diffusion and perfusion MR imaging has the potential of providing all the information necessary for the diagnosis and management of the individual patient with acute ischaemic stroke. Diffusion-weighted MR, in particular quantitative evaluation based on the diffusion

  3. Unsupervised 3D Prostate Segmentation Based on Diffusion-Weighted Imaging MRI Using Active Contour Models with a Shape Prior

    Directory of Open Access Journals (Sweden)

    Xin Liu

    2011-01-01

    plays a crucial role in various clinical applications. Recently, magnetic resonance imaging (MRI is proposed as a promising modality to detect and monitor prostate-related diseases. In this paper, we propose an unsupervised algorithm to segment prostate with 3D apparent diffusion coefficient (ADC images derived from diffusion-weighted imaging (DWI MRI without the need of a training dataset, whereas previous methods for this purpose require training datasets. We first apply a coarse segmentation to extract the shape information. Then, the shape prior is incorporated into the active contour model. Finally, morphological operations are applied to refine the segmentation results. We apply our method to an MR dataset obtained from three patients and provide segmentation results obtained by our method and an expert. Our experimental results show that the performance of the proposed method is quite successful.

  4. Functional imaging of parotid glands: Diffusion-weighted echo-planar MRI before and after stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Habermann, C.R.; Cramer, M.C.; Gossrau, P.; Adam, G. [University Hospital Hamburg-Eppendorf (Germany). Department of Diagnostic and Interventional Radiology; Graessner, J. [Siemens AG, Hamburg (Germany). Medical Solutions; Reitmeier, F.; Jaehne, M. [University Hospital Hamburg-Eppendorf (Germany). Department of Oto-, Rhino-, Laryngology; Fiehler, J. [University Hospital Hamburg-Eppendorf (Germany). Department of Neuroradiology; Schoder, V. [University Hospital Hamburg-Eppendorf (Germany). Institute for Medical Biometry and Epidemiology

    2004-10-01

    Purpose: To investigate the feasibility of diffusion-weighted (DW) echo-planar imaging (EPI) for measuring different functional conditions of the parotid gland and to compare different measurement approaches. Materials and Methods: Parotid glands of 27 healthy volunteers were examined with a DW EPI sequence (TR 1,500 msec, TE 77 msec, field-of-view 250 x 250 mm, pixel size 2.10 x 1.95 mm, section thickness 5 mm) before and after oral stimulation with commercially available lemon juice. The b factors used were 0, 500, and 1,000 sec/mm{sup 2}. Apparent diffusion coefficient (ADC) maps were digitally transferred to MRIcro (Chris Rorden, University of Nottingham, Great Britain) and evaluated with a manually placed circular region of interest (ROI) containing 100-200 pixel. Additional ROIs including the entire parotid gland were placed on either side. The results of both measurements were compared, using the Student's t test based on the median ADC values for each person. A two-tailed p-value of less than.05 was determined to indicate statistical significance. To compare both measurement approaches, the Pearson's correlation coefficient (r) was calculated. Results: Diffusion-weighted echo-planar MR imaging successfully visualized the parotid gland of all volunteers. In a first step, the median ADC value per person was computed. Using ROIs of 100-200 pixels, the mean was calculated to be 1.08 x 10{sup -3} mm{sup 2}/sec{+-}0.12 x 10{sup -3} mm{sup 2}/sec for both parotid glands prior to simulation. After stimulation, the mean ADC was measured at 1.15 x 10{sup -3} mm{sup 2}/sec{+-}0.11 x 10{sup -3} mm{sup 2}/sec for both parotid glands. Evaluating the entire parotid gland, the ADC was 1.12 x 10{sup -3} mm{sup 2}/sec{+-}0.08 x 10{sup -3} mm{sup 2}/sec prior to simulation, whereas the ADC increased to 1.18 x 10{sup -3} mm{sup 2}/sec{+-}0.09 x 10{sup -3} mm{sup 2}/sec after simulation with lemon juice. For both types of measurements, the increase in ADC after

  5. Clinical presentation and diffusion weighted MRI of acute cerebral infarction. The Bergen Stroke Study

    Directory of Open Access Journals (Sweden)

    Waje-Andreassen Ulrike

    2009-08-01

    Full Text Available Abstract Background No large study has compared the yield of diffusion-weighted imaging (DWI with clinical examination in order to differentiate lacunar stroke from other stroke subtypes. This differentiation is important for guiding further investigations and treatment. Methods Consecutive patients admitted with cerebral infarction were classified according to the Oxfordshire Community Stroke Project scale. Based on DWI and CT stroke was classified as lacunar (LI and non-lacunar (NLI. Acute ischemic lesion Results DWI was performed in 419 (69% patients. Among patients with lacunar syndrome (LACS 45 (40.5% had NLI on DWI. All patients with total anterior syndrome (TACS and 144 (88.3% with partial anterior syndrome (PACS had NLI on DWI. Conclusion DWI is important among patients presenting with clinical symptoms suggestive of lacunar syndrome to differentiate between LI and NLI. On the other hand, there is good correspondence between TACS or PACS and NLI on DWI.

  6. Automatic quantification of ischemic injury on diffusion-weighted MRI of neonatal hypoxic ischemic encephalopathy

    Directory of Open Access Journals (Sweden)

    Keelin Murphy

    2017-01-01

    Full Text Available A fully automatic method for detection and quantification of ischemic lesions in diffusion-weighted MR images of neonatal hypoxic ischemic encephalopathy (HIE is presented. Ischemic lesions are manually segmented by two independent observers in 1.5 T data from 20 subjects and an automatic algorithm using a random forest classifier is developed and trained on the annotations of observer 1. The algorithm obtains a median sensitivity and specificity of 0.72 and 0.99 respectively. F1-scores are calculated per subject for algorithm performance (median = 0.52 and observer 2 performance (median = 0.56. A paired t-test on the F1-scores shows no statistical difference between the algorithm and observer 2 performances. The method is applied to a larger dataset including 54 additional subjects scanned at both 1.5 T and 3.0 T. The algorithm findings are shown to correspond well with the injury pattern noted by clinicians in both 1.5 T and 3.0 T data and to have a strong relationship with outcome. The results of the automatic method are condensed to a single score for each subject which has significant correlation with an MR score assigned by experienced clinicians (p < 0.0001. This work represents a quantitative method of evaluating diffusion-weighted MR images in neonatal HIE and a first step in the development of an automatic system for more in-depth analysis and prognostication.

  7. Diffusion-weighted MRI. How many B-values are necessary?

    International Nuclear Information System (INIS)

    Kuhnke, M.; Hosten, N.; Kirsch, M.; Langner, S.; Khaw, A.V.; Angermaier, A.

    2012-01-01

    Diffusion-weighted imaging (DWI) has become an important component in modern stroke imaging. This MR technique detects diffusion abnormalities, which can be quantified by computing apparent diffusion coefficient (ADC) maps. ADC values are typically calculated from a set of MR images obtained with varying degrees of diffusion weighting (b-values) using nonlinear regression. However, there is no agreement concerning the number of images needed for ADC calculation. The aim of our study was to determine how many b-values are necessary to reliably calculate ADC maps. In 100 consecutive patients with clinical signs of acute ischemic stroke, 6 identically oriented and centered diffusion data sets with different b-values were acquired. ROI analysis was performed for DWI-positive lesions, normal-appearing gray and white matter, CSF, and background noise. ADC values for each ROI were calculated using a nonlinear regression model. Additionally, the CNR and SNR were calculated for each ROI. Acquisition time was 0:39 min for 2 b-values and up to 2:49 min for a sequence with 7 b-values. The mean ADC (x 10 -3 mm 2 /s) for ischemic lesions was 58.29, 58.47, 57.83, 57.81, 57.58 and 54.51 using 2, 3, 4, 5, 6, and 7 b-values. Ischemic lesions had significantly different mean ADC values only for high b-values (b = 2000 s/mm 2 ). ADC values can be reliably calculated using 2 b-values. Radiologists may use the more time-efficient 2-point method for reliably estimating ADC values and detecting ischemic lesions in the daily clinical routine. (orig.)

  8. Liver Imaging Reporting and Data System on CT and gadoxetic acid-enhanced MRI with diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Dong Ik; Jang, Kyung Mi; Kim, Seong Hyun; Kang, Tae Wook; Song, Kyoung Doo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of)

    2017-10-15

    To assess major imaging features of Liver Imaging Reporting and Data System (LI-RADS) on contrast-enhanced CT and gadoxetic acid-enhanced MRI and to estimate whether the combination of signal intensity favouring HCC on hepatobiliary phase (HBP) and diffusion-weighted images (DWI) can act as a major feature in LI-RADS. Four hundred twenty one patients with 445 observations were included. Major features of LI-RADS on CT and MRI as well as HBP and DWI features were assessed. Diagnostic performances of LR-5 according to LI-RADS v2014 and modified LI-RADS which incorporate combination of HBP and DWI were assessed. Pairwise comparisons of the receiver operating characteristic (ROC) curves were performed. For HCCs, capsule appearance had the highest rate of discordance between CT and MRI (32.7%), followed by washout appearance (22.2%). Specificity (75%) of LR-5 of LI-RADS v2014 was lower than that (77.1-79.2%) of modified LI-RADS. Area under the ROC curve of modified LI-RADS (0.755-0.775) was not significantly different from that of LI-RADS v 2014 (0.709) (p > 0.05). There were substantial discordances between CT and MRI for capsule and washout appearances in hepatic observations, and combination of gadoxetic acid-enhanced MRI and DWI might be able to be incorporated as a major feature of LI-RADS. (orig.)

  9. Lymphoma and inflammation in the orbit: Diagnostic performance with diffusion-weighted imaging and dynamic contrast-enhanced MRI.

    Science.gov (United States)

    Sun, Bo; Song, Liyuan; Wang, Xinyan; Li, Jing; Xian, Junfang; Wang, Feifei; Tan, Pan

    2017-05-01

    To investigate the diagnostic performance of diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), and the combination of both in the differential diagnosis of lymphoma and inflammation in the orbit. This retrospective study was approved by the Institutional Review Board and the informed consent requirement was waived. A total of 53 patients underwent preoperative 3T MRI. Parameters of DWI and DCE MRI were evaluated in these 30 patients with orbital lymphoma and 23 patients with orbital inflammation. The diagnostic performance was evaluated using receiver operating characteristic curve analysis. Apparent diffusion coefficient (ADC) values and parameters derived from DCE MRI of orbital lymphoma and orbital inflammation differed significantly (ADC, T max , contrast index [CI], enhancement ratio [ER], and washout ratio [WR]: P inflammation (P = 0.016 for reviewer 1; P = 0.001 for reviewer 2). The combination of DWI and DCE MRI can improve diagnostic performance in differentiating lymphoma from inflammation in the orbit compared with DWI alone. 3 J. MAGN. RESON. IMAGING 2017;45:1438-1445. © 2016 International Society for Magnetic Resonance in Medicine.

  10. Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn's disease assessment with histopathology of surgical specimens

    International Nuclear Information System (INIS)

    Tielbeek, Jeroen A.W.; Ziech, Manon L.W.; Lavini, Cristina; Bipat, Shandra; Stoker, Jaap; Li, Zhang; Bemelman, Willem A.; Roelofs, Joris J.T.H.; Ponsioen, Cyriel Y.; Vos, Frans M.

    2014-01-01

    To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn's disease. 3-T MR enterography was performed in consecutive Crohn's disease patients scheduled for surgery within 4 weeks. One to four sections of interest per patient were chosen for analysis. Evaluated parameters included mural thickness, T1 ratio, T2 ratio; on DCE-MRI maximum enhancement (ME), initial slope of increase (ISI), time-to-peak (TTP); and on DWI apparent diffusion coefficient (ADC). These were compared with location-matched histopathological grading of inflammation (AIS) and fibrosis (FS) using Spearman correlation, Kruskal-Wallis and Chi-squared tests. Twenty patients (mean age 38 years, 12 female) were included and 50 sections (35 terminal ileum, 11 ascending colon, 2 transverse colon, 2 descending colon) were matched to AIS and FS. Mural thickness, T1 ratio, T2 ratio, ME and ISI correlated significantly with AIS, with moderate correlation (r = 0.634, 0.392, 0.485, 0.509, 0.525, respectively; all P < 0.05). Mural thickness, T1 ratio, T2 ratio, ME, ISI and ADC correlated significantly with FS (all P < 0.05). Quantitative parameters from conventional, DCE-MRI and DWI sequences correlate with histopathological scores of surgical specimens. DCE-MRI and DWI parameters provide additional information. (orig.)

  11. Differentiation of prostate cancer lesions with high and with low Gleason score by diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Barbieri, Sebastiano; Broennimann, Michael; Vermathen, Peter; Thoeny, Harriet C. [Inselspital University Hospital, Institute of Diagnostic, Pediatric, and Interventional Radiology, Bern (Switzerland); Boxler, Silvan [Inselspital, Inselspital University Hospital, Department of Urology, Bern (Switzerland)

    2017-04-15

    To differentiate prostate cancer lesions with high and with low Gleason score by diffusion-weighted-MRI (DW-MRI). This prospective study was approved by the responsible ethics committee. DW-MRI of 84 consenting prostate and/or bladder cancer patients scheduled for radical prostatectomy were acquired and used to compute apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM: the pure diffusion coefficient D{sub t}, the pseudo-diffusion fraction F{sub p} and the pseudo-diffusion coefficient D{sub p}), and high b value (as acquired and Hessian filtered) parameters within the index lesion. These parameters (separately and combined in a logistic regression model) were used to differentiate lesions depending on whether whole-prostate histopathological analysis after prostatectomy determined a high (≥7) or low (6) Gleason score. Mean ADC and D{sub t} differed significantly (p of independent two-sample t test < 0.01) between high- and low-grade lesions. The highest classification accuracy was achieved by the mean ADC (AUC 0.74) and D{sub t} (AUC 0.70). A logistic regression model based on mean ADC, mean F{sub p} and mean high b value image led to an AUC of 0.74 following leave-one-out cross-validation. Classification by IVIM parameters was not superior to classification by ADC. DW-MRI parameters correlated with Gleason score but did not provide sufficient information to classify individual patients. (orig.)

  12. Single breath-hold diffusion-weighted MRI of the liver with parallel imaging: initial experience

    International Nuclear Information System (INIS)

    Oner, A.Y.; Celik, H.; Oktar, S.O.; Tali, T.

    2006-01-01

    Aim: To evaluate prospectively the improvement in the signal:noise ratio (SNR), with the use of parallel technique in single breath-hold diffusion-weighted imaging (DWI) of the liver and its affect on apparent diffusion coefficient (ADC) measurements. Materials and methods: This study was approved by our institutional review board. Written informed consent was obtained from all participants. Fifteen patients underwent single breath-hold DWI of the liver with and without parallel imaging technique. SNR and ADC values were measured over a lesion-free right hepatic lobe by two radiologists in both series. When a focal hepatic lesion was present the contrast:noise ratio (CNR) and ADC were also measured. Paired Student's t-tests were used for statistical analysis. Results: Mean SNR values of the liver were 20.82 ± 7.54 and 15.83 ± 5.95 for DWI with and without parallel imaging, respectively. SNR values measured in DWI using parallel imaging were found to be significantly higher (p -3 mm 2 /s and 1.56 ± 0.28 x 10 -3 mm 2 /s for DWI with and without parallel imaging, respectively. No significant difference was found between the two sequences for hepatic ADC measurement (p > 0.05). Overall lesion CNR was found to be higher in DWI with parallel imaging. Conclusion: Parallel imaging is useful in improving SNR of single breath-hold DWI of the liver without compromising ADC measurements

  13. Diffusion-weighted MRI of denervated muscle: a clinical and experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Holl, Nathalie; Bierry, Guillaume; Moser, Thomas; Dietemann, Jean-Louis; Kremer, Stephane [Hopitaux Universitaires de Strasbourg, Service de Radiologie 2, Strasbourg (France); Echaniz-Laguna, Andoni [Hopitaux Universitaires de Strasbourg, Departement de Neurologie, BP 426, Strasbourg (France); Mohr, Michel [Hopitaux Universitaires de Strasbourg, Departement d' Anatomie Pathologique, Strasbourg (France); Loeffler, Jean-Philippe [INSERM U692, Laboratoire de Signalisations Moleculaires et Neurodegenerescence, Faculte de Medecine, Strasbourg (France)

    2008-12-15

    The aim of this study was to investigate skeletal muscle denervation using diffusion-weighted magnetic resonance imaging (DWMRI). Sciatic nerve axotomy was performed in a group of nine New Zealand White rabbits, and electromyographic (EMG), pathological, and DWMRI studies were conducted on ipsilateral hamstring muscles 1 and 8 days after axotomy. In addition, DWMRI studies were carried out on leg muscles of ten patients with acute and subacute lumbosacral radiculopathy. High intensity signals on short tau inversion recovery (STIR) magnetic resonance imaging and an increased apparent diffusion coefficient (ADC) were observed in denervated muscles of the animals 1 and 8 days after axotomy as well as in denervated muscles of the patients with radiculopathy. In the clinical study, ADC was 1.26{+-}0.18 x 10{sup -9} m{sup 2}/s in normal muscle and increased to 1.56{+-}0.23 x 10{sup -9} m{sup 2}/s in denervated muscles (p =0.0016). In animals, EMG and muscle pathological studies were normal 1 day after axotomy, and the muscles demonstrated spontaneous activity on EMG and neurogenic atrophy on histological studies 7 days later. This DWMRI study demonstrates that enlargement of extracellular fluid space in muscle denervation is an early phenomenon occurring several days before the appearance of EMG and histological abnormalities. (orig.)

  14. Silent ischemia after neuroprotected percutaneous carotid stenting: a diffusion-weighted MRI study.

    Science.gov (United States)

    Piñero, P; González, A; Mayol, A; Martínez, E; González-Marcos, J R; Boza, F; Cayuela, A; Gil-Peralta, A

    2006-01-01

    To assess by diffusion-weighted MR imaging (DWI) the efficacy of cerebral protection devices in avoiding embolization and new ischemic lesions in patients with severe internal carotid artery (ICA) stenosis undergoing carotid artery stent placement (CAS). One hundred sixty-two CASs in the extracranial ICA were performed with the use of distal filters. Mean age of the patients was 68.5 years (range, 33-86) and 122 patients (75.3%) were symptomatic. MR imaging was performed in all patients during the 3-day period before CAS, and DWI was obtained within 24 hours after the procedure. Ninety-five patients (58.6%) were monitored by transcranial Doppler ultrasonography for microemboli detection in the territory of the middle cerebral artery (MCA), ipsilateral to the vessel being treated. Twenty-eight patients (17.3%) showed 58 new ischemic foci in DWI, and 13 patients (46.4%) had multiple foci. Location of new lesions was mainly in the vascular territory supplied by the treated vessel (19 patients; 67.9%), but also in the contralateral MCA (1 patient; 3.6%), and the posterior fossa (4 patients; 14.3%). A significant relationship (P neuroprotected CAS. Appearance of new ischemic lesions were only significantly related to the occurrence of TIA but not to the number of MES registered or other variables. Despite the encouraging results, the incidence of new ischemic lesions should promote research for safer techniques and devices.

  15. Primary and metastatic ovarian cancer: Characterization by 3.0T diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Lindgren, Auni; Anttila, Maarit; Rautiainen, Suvi; Arponen, Otso; Haermae, Kirsi; Kivelae, Annukka; Maekinen, Petri; Ylae-Herttuala, Seppo; Haemaelaeinen, Kirsi; Kosma, Veli-Matti; Vanninen, Ritva; Sallinen, Hanna

    2017-01-01

    We aimed to investigate whether apparent diffusion coefficients (ADCs) measured by 3.0T diffusion-weighted magnetic resonance imaging (DWI) associate with histological aggressiveness of ovarian cancer (OC) or predict the clinical outcome. This prospective study enrolled 40 patients with primary OC, treated 2011-2014. DWI was performed prior to surgery. Two observers used whole lesion single plane region of interest (WLsp-ROI) and five small ROIs (S-ROI) to analyze ADCs. Samples from tumours and metastases were collected during surgery. Immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR) were used to measure the expression of vascular endothelial growth factor (VEGF) and its receptors. The interobserver reliability of ADC measurements was excellent for primary tumours ICC 0.912 (WLsp-ROI). Low ADCs significantly associated with poorly differentiated OC (WLsp-ROI P = 0.035). In primary tumours, lower ADCs significantly associated with high Ki-67 (P = 0.001) and low VEGF (P = 0.001) expression. In metastases, lower ADCs (WLsp-ROI) significantly correlated with low VEGF receptors mRNA levels. ADCs had predictive value; 3-year overall survival was poorer in patients with lower ADCs (WLsp-ROI P = 0.023, S-ROI P = 0.038). Reduced ADCs are associated with histological severity and worse outcome in OC. ADCs measured with WLsp-ROI may serve as a prognostic biomarker of OC. (orig.)

  16. Primary and metastatic ovarian cancer: Characterization by 3.0T diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lindgren, Auni [Kuopio University Hospital, Department of Gynaecology and Obstetrics, Kuopio (Finland); Anttila, Maarit [Kuopio University Hospital, Department of Gynaecology and Obstetrics, Kuopio (Finland); University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Gynaecology, Kuopio (Finland); Rautiainen, Suvi; Arponen, Otso; Haermae, Kirsi [Kuopio University Hospital, Department of Clinical Radiology, Kuopio (Finland); Kivelae, Annukka; Maekinen, Petri; Ylae-Herttuala, Seppo [University of Eastern Finland, Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, Kuopio (Finland); Haemaelaeinen, Kirsi [Kuopio University Hospital, Department of Pathology and Forensic Medicine, Kuopio (Finland); University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Pathology and Forensic Medicine, Kuopio (Finland); Kosma, Veli-Matti [Kuopio University Hospital, Department of Pathology and Forensic Medicine, Kuopio (Finland); University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Pathology and Forensic Medicine, Kuopio (Finland); University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio (Finland); Vanninen, Ritva [Kuopio University Hospital, Department of Clinical Radiology, Kuopio (Finland); University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio (Finland); University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Clinical Radiology, Kuopio (Finland); Sallinen, Hanna [Kuopio University Hospital, Department of Gynaecology and Obstetrics, Kuopio (Finland); University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Gynaecology, Kuopio (Finland); University of Eastern Finland, Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, Kuopio (Finland)

    2017-09-15

    We aimed to investigate whether apparent diffusion coefficients (ADCs) measured by 3.0T diffusion-weighted magnetic resonance imaging (DWI) associate with histological aggressiveness of ovarian cancer (OC) or predict the clinical outcome. This prospective study enrolled 40 patients with primary OC, treated 2011-2014. DWI was performed prior to surgery. Two observers used whole lesion single plane region of interest (WLsp-ROI) and five small ROIs (S-ROI) to analyze ADCs. Samples from tumours and metastases were collected during surgery. Immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR) were used to measure the expression of vascular endothelial growth factor (VEGF) and its receptors. The interobserver reliability of ADC measurements was excellent for primary tumours ICC 0.912 (WLsp-ROI). Low ADCs significantly associated with poorly differentiated OC (WLsp-ROI P = 0.035). In primary tumours, lower ADCs significantly associated with high Ki-67 (P = 0.001) and low VEGF (P = 0.001) expression. In metastases, lower ADCs (WLsp-ROI) significantly correlated with low VEGF receptors mRNA levels. ADCs had predictive value; 3-year overall survival was poorer in patients with lower ADCs (WLsp-ROI P = 0.023, S-ROI P = 0.038). Reduced ADCs are associated with histological severity and worse outcome in OC. ADCs measured with WLsp-ROI may serve as a prognostic biomarker of OC. (orig.)

  17. Diffusion-weighted MRI of the testis in hydrocele: a pilot study.

    Science.gov (United States)

    Gulum, Mehmet; Cece, Hasan; Yeni, Ercan; Savas, Murat; Ciftci, Halil; Karakas, Ekrem; Celik, Hakim; Yagmur, Ismail

    2012-01-01

    To investigate the effects of increased pressure due to the accumulated fluid around testis in hydrocele on testis diffusion and whether this effect (if any) is correlated with the amount of fluid and duration of hydrocele. 49 patients with unilateral hydrocele were evaluated by magnetic resonance diffusion-weighted imaging. In the study group, while the apparent diffusion coefficient (ADC) values of the testicles with hydrocele differed significantly before and 3 months after the hydrocelectomy (p = 0.001), the ADC values of the testicles without hydrocele were not statistically different (p = 0.101). There was a significant negative correlation between the ADC values of the testicles with hydrocele and the amount of the liquid aspirated during the hydrocelectomy (r = -0.615, p = 0.001). There was no correlation between the ADC values of testis and the duration of hydrocele (r = -287, p = 0.156). This is supported by the findings of the present study of reduced ADC values of testis, meaning reduced diffusion of the testis, with an increasing amount of fluid. The pressure of the fluid was suggested to show a mechanical effect that plays an important role in the dysfunction of the testis. The possible dysfunctions of the testicular tissue suggest that they may have a negative effect on fertility. Copyright © 2012 S. Karger AG, Basel.

  18. Diffusion-weighted MRI of denervated muscle: a clinical and experimental study

    International Nuclear Information System (INIS)

    Holl, Nathalie; Bierry, Guillaume; Moser, Thomas; Dietemann, Jean-Louis; Kremer, Stephane; Echaniz-Laguna, Andoni; Mohr, Michel; Loeffler, Jean-Philippe

    2008-01-01

    The aim of this study was to investigate skeletal muscle denervation using diffusion-weighted magnetic resonance imaging (DWMRI). Sciatic nerve axotomy was performed in a group of nine New Zealand White rabbits, and electromyographic (EMG), pathological, and DWMRI studies were conducted on ipsilateral hamstring muscles 1 and 8 days after axotomy. In addition, DWMRI studies were carried out on leg muscles of ten patients with acute and subacute lumbosacral radiculopathy. High intensity signals on short tau inversion recovery (STIR) magnetic resonance imaging and an increased apparent diffusion coefficient (ADC) were observed in denervated muscles of the animals 1 and 8 days after axotomy as well as in denervated muscles of the patients with radiculopathy. In the clinical study, ADC was 1.26±0.18 x 10 -9 m 2 /s in normal muscle and increased to 1.56±0.23 x 10 -9 m 2 /s in denervated muscles (p =0.0016). In animals, EMG and muscle pathological studies were normal 1 day after axotomy, and the muscles demonstrated spontaneous activity on EMG and neurogenic atrophy on histological studies 7 days later. This DWMRI study demonstrates that enlargement of extracellular fluid space in muscle denervation is an early phenomenon occurring several days before the appearance of EMG and histological abnormalities. (orig.)

  19. Correlation of brain stem diffusion-weighted imaging score with vertebrobasilar artery stenosis in patients with acute brain stem infarction

    Directory of Open Access Journals (Sweden)

    Jing-sheng YU

    2015-07-01

    Full Text Available Objective To investigate the correlation of brain stem diffusion-weighted imaging (DWI lesion score with vertebrobasilar artery stenosis as revealed by magnetic resonance angiography (MRA in patients with acute brain stem infarction. Methods A total of 253 patients diagnosed as acute brain stem infarction by means of brain magnetic resonance imaging were analyzed retrospectively. Of them 211 patients were enrolled in the present study, and they were qualified with the enrolling standard, and they underwent examination of brain DWI and MRA simultaneously. The DWI lesion scores and imaging data were analyzed comparatively and statistically. Results Significant correlation was found between DWI lesion score and the main trunk stenosis degree of vertebrobasilar artery in patients with acute brain stem infarction (P=0.009. An increase in overall stenosis degree was found along with an increase in DWI lesion score (P=0.005. When the DWI lesion score was ≥4, occlusion of the main trunk of vertebrobasilar artery could be predicted with sensitivity of 74.5% and specificity of 93.2%, respectively (P=0.000. Conclusions  The DWI lesion score increases as the degree of main trunk stenosis of vertebrobasilar artery increased in patients with acute brain stem infarction. The DWI lesion score, in certain extent, may predict the existence and degree of stenosis of the main trunk of vertebrobasilar artery. DOI: 10.11855/j.issn.0577-7402.2015.06.04

  20. Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma—Relationship with local invasiveness

    International Nuclear Information System (INIS)

    Cao, Kun; Gao, Min; Sun, Ying-Shi; Li, Yan-Ling; Sun, Yu; Gao, Yu-Nong; Zhang, Xiao-Peng

    2012-01-01

    Objective: To evaluate the relationship between apparent diffusion coefficient (ADC) value and the local invasiveness of endometrial carcinoma. Methods and materials: The MR imaging of seventy-three patients with endometrial carcinoma proved by post-operative pathology and sixty-four patients with healthy uteri were retrospectively reviewed. All MR examinations included axial T2WI and T1WI, sagittal T2WI and diffusion-weighted sequences (b = 0 and b = 1000 s/mm 2 ). Tumor size, mean ADC value (ADCm) and quartile ADC (ADCq) were acquired on post-processing workstation using voxel-analysis software. Differences between the ADC values among three layers of normal uterine body and endometrial carcinomas were compared by ANOVA test. Groups were divided according to pathologic type, histologic grade, depth of myometrial infiltration, presence of cervical invasion and lymphovascular space invasion, and lymph node metastasis. Tumor size and ADC values were compared and analyzed. Results: ADC values were different in three zones of uterine body (P −3 mm 2 /s] and highest in outer myometrium [(1.496 ± 0.196) × 10 −3 mm 2 /s]. Mean ADC value of endometrial carcinomas [(1.011 ± 0.121) × 10 −3 mm 2 /s] was lower than the normal uterine body. Quartile ADC and tumor size were greater in groups with more invasive pathologic factors (P < 0.05). Deep myometrial infiltration, cervical invasion, lymphovascular space invasion and lymph node metastasis were more common as quartile ADC values and tumor sizes increased. Conclusion: Mean ADC value was lower in endometrial carcinoma was lower than the normal uterus. Quartile ADC, representing the intra-tumor heterogeneity of water movement, had a profound relationship with invasiveness of endometrial carcinomas, while mean ADC value did not. ADC values may serve as a quantitative indicator to complement routine sequences.

  1. Analysis of acute ischemic stroke presenting classic lacunar syndrome. A study by diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Terai, Satoshi; Ota, Kazuki; Tamaki, Kinya [Hakujyuji Hospital, Fukuoka (Japan)

    2002-03-01

    We retrospectively assessed the pathophysiological features of acute ischemic stroke presenting ''classic'' lacunar syndrome by using diffusion-weighted imaging (DWI). Subjects were 16 patients who were admitted to our hospital within 24 hours of stroke onset and underwent DWI examination on admission. These were divided into three categorical groups; pure motor hemiplegia (PMH) in 8, sensorimotor stroke (SMS) in 7, and dysarthria-clumsy hand syndrome (DCHS) in 1. The fresh responsible lesions were identified by DWI in the perforating territory in 7 patients with PMH and 7 with SMS. Four (one had two possible response lesions; pons and corona radiata) and five patients in the respective groups were diagnosed as lacunar infarction on admission (the largest dimension of the lesion measuring smaller than 15 mm). On the contralateral side to the neurological symptoms, DWI revealed high intensities in cortex, subcortical white matter, and anterior and posterior border zones in the remaining one patient with PMH and in the precentral arterial region in one with DCHS. They were diagnosed as atherothrombotic infarction resulting from the occlusion of the internal carotid artery and cerebral embolism due to atrial fibrillation, respectively. Three patients with PMH showed progressive deterioration after admission and follow-up DWI study in an acute stage revealed enlargement of heir ischemic lesions. The present study suggests that DWI is a useful imaging technique for diagnosis of clinical categories and observation for pathophsiological alteration in the acute ischemic stroke patients with ''classic'' lacunar syndrome. Our results also indicate a necessity to be aware that various types of fresh ischemic lesions other than a single lacune might possibly be developing in cases with this syndrome. (author)

  2. MRI-only lesions: application of diffusion-weighted imaging obviates unnecessary MR-guided breast biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Spick, Claudio; Pinker-Domenig, Katja; Helbich, Thomas H.; Baltzer, Pascal A. [Medical University of Vienna (AKH), General Hospital Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Wien (Austria); Rudas, Margaretha [Medical University of Vienna (AKH), Clinical Institute of Pathology, Wien (Austria)

    2014-06-15

    To assess if the application of diffusion-weighted imaging (DWI) obviates unnecessary MR-guided biopsies in suspicious breast lesions visible only on contrast-enhanced MRI (CE-MRI). This institutional review board (IRB)-approved, retrospective, single-centre study included 101 patients (mean age, 49.5; SD 13.9 years) who underwent additional DWI at 1.5 T prior to MRI-guided biopsy of 104 lesions classified as suspicious for malignancy and visible on CE-MRI only. An experienced radiologist, blinded to histopathologic and follow-up results, measured apparent diffusion coefficient (ADC) values obtained from DWI. Diagnostic accuracy was investigated using receiver operating characteristics (ROC) analysis. Histopathology revealed 20 malignant and 84 benign lesions. Lesions were masses in 61 (15 malignant, 24.6 %) and non-masses in 43 cases (five malignant, 11.6 %). Mean ADC values were 1.53 ± 0.38 x 10{sup -3} mm{sup 2}/s in benign lesions and 1.06 ± 0.27 x 10{sup -3} mm{sup 2}/s in malignant lesions. ROC analysis revealed exclusively benign lesions if ADC values were greater than 1.58 x 10{sup -3} mm{sup 2}/s. As a consequence, 29 false-positive biopsies (34.5 %) could have been avoided without any false-negative findings. Both in mass and in non-mass lesions, rule-in and rule-out criteria were identified using flexible ADC thresholds based on ROC analysis. Additional application of DWI in breast lesions visible only on MRI can avoid false-positive, MR-guided biopsies. Thus, DWI should be an integral part of breast MRI protocols. (orig.)

  3. Separation of type and grade in cervical tumours using non-mono-exponential models of diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Winfield, Jessica M.; Collins, David J.; Morgan, Veronica A.; DeSouza, Nandita M.; Orton, Matthew R.; Ind, Thomas E.J.; Attygalle, Ayoma; Hazell, Steve

    2017-01-01

    Assessment of empirical diffusion-weighted MRI (DW-MRI) models in cervical tumours to investigate whether fitted parameters distinguish between types and grades of tumours. Forty-two patients (24 squamous cell carcinomas, 14 well/moderately differentiated, 10 poorly differentiated; 15 adenocarcinomas, 13 well/moderately differentiated, two poorly differentiated; three rare types) were imaged at 3 T using nine b-values (0 to 800 s mm -2 ). Mono-exponential, stretched exponential, kurtosis, statistical, and bi-exponential models were fitted. Model preference was assessed using Bayesian Information Criterion analysis. Differences in fitted parameters between tumour types/grades and correlation between fitted parameters were assessed using two-way analysis of variance and Pearson's linear correlation coefficient, respectively. Non-mono-exponential models were preferred by 83 % of tumours with bi-exponential and stretched exponential models preferred by the largest numbers of tumours. Apparent diffusion coefficient (ADC) and diffusion coefficients from non-mono-exponential models were significantly lower in poorly differentiated tumours than well/moderately differentiated tumours. α (stretched exponential), K (kurtosis), f and D* (bi-exponential) were significantly different between tumour types. Strong correlation was observed between ADC and diffusion coefficients from other models. Non-mono-exponential models were preferred to the mono-exponential model in DW-MRI data from cervical tumours. Parameters of non-mono-exponential models showed significant differences between types and grades of tumours. (orig.)

  4. Separation of type and grade in cervical tumours using non-mono-exponential models of diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Winfield, Jessica M.; Collins, David J.; Morgan, Veronica A.; DeSouza, Nandita M. [The Royal Marsden NHS Foundation Trust, MRI Unit, Sutton, Surrey (United Kingdom); The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, London (United Kingdom); Orton, Matthew R. [The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, London (United Kingdom); Ind, Thomas E.J. [The Royal Marsden NHS Foundation Trust, Gynaecology Unit, London (United Kingdom); Attygalle, Ayoma; Hazell, Steve [The Royal Marsden NHS Foundation Trust, Department of Histopathology, London (United Kingdom)

    2017-02-15

    Assessment of empirical diffusion-weighted MRI (DW-MRI) models in cervical tumours to investigate whether fitted parameters distinguish between types and grades of tumours. Forty-two patients (24 squamous cell carcinomas, 14 well/moderately differentiated, 10 poorly differentiated; 15 adenocarcinomas, 13 well/moderately differentiated, two poorly differentiated; three rare types) were imaged at 3 T using nine b-values (0 to 800 s mm{sup -2}). Mono-exponential, stretched exponential, kurtosis, statistical, and bi-exponential models were fitted. Model preference was assessed using Bayesian Information Criterion analysis. Differences in fitted parameters between tumour types/grades and correlation between fitted parameters were assessed using two-way analysis of variance and Pearson's linear correlation coefficient, respectively. Non-mono-exponential models were preferred by 83 % of tumours with bi-exponential and stretched exponential models preferred by the largest numbers of tumours. Apparent diffusion coefficient (ADC) and diffusion coefficients from non-mono-exponential models were significantly lower in poorly differentiated tumours than well/moderately differentiated tumours. α (stretched exponential), K (kurtosis), f and D* (bi-exponential) were significantly different between tumour types. Strong correlation was observed between ADC and diffusion coefficients from other models. Non-mono-exponential models were preferred to the mono-exponential model in DW-MRI data from cervical tumours. Parameters of non-mono-exponential models showed significant differences between types and grades of tumours. (orig.)

  5. Novel Diffusion-Weighted MRI for High-Grade Prostate Cancer Detection

    Science.gov (United States)

    2016-10-01

    RP sections is a challenging technical process given the vast difference in image resolution and scale . • This process is critical for evaluating...aggressive prostate cancer. INTRODUCTION METHODS A cohort of patients was identified that underwent in-vivo 3 T multi- parametric MRI (GE Healthcare

  6. Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma-Relationship with local invasiveness

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Kun, E-mail: kun-cao@hotmail.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Gao, Min, E-mail: gaominmin202@163.com [Department of Gynecology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Sun, Ying-Shi, E-mail: sunysabc@163.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Li, Yan-Ling, E-mail: yanlingli1982@gmail.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Sun, Yu, E-mail: sunyu_bch@163.com [Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Gao, Yu-Nong, E-mail: gaoyunong@vip.sina.com [Department of Gynecology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Zhang, Xiao-Peng, E-mail: zxp@bjcancer.org [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China)

    2012-08-15

    Objective: To evaluate the relationship between apparent diffusion coefficient (ADC) value and the local invasiveness of endometrial carcinoma. Methods and materials: The MR imaging of seventy-three patients with endometrial carcinoma proved by post-operative pathology and sixty-four patients with healthy uteri were retrospectively reviewed. All MR examinations included axial T2WI and T1WI, sagittal T2WI and diffusion-weighted sequences (b = 0 and b = 1000 s/mm{sup 2}). Tumor size, mean ADC value (ADCm) and quartile ADC (ADCq) were acquired on post-processing workstation using voxel-analysis software. Differences between the ADC values among three layers of normal uterine body and endometrial carcinomas were compared by ANOVA test. Groups were divided according to pathologic type, histologic grade, depth of myometrial infiltration, presence of cervical invasion and lymphovascular space invasion, and lymph node metastasis. Tumor size and ADC values were compared and analyzed. Results: ADC values were different in three zones of uterine body (P < 0.001), with the lowest in junctional zone [(1.126 {+-} 0.190) Multiplication-Sign 10{sup -3} mm{sup 2}/s] and highest in outer myometrium [(1.496 {+-} 0.196) Multiplication-Sign 10{sup -3} mm{sup 2}/s]. Mean ADC value of endometrial carcinomas [(1.011 {+-} 0.121) Multiplication-Sign 10{sup -3} mm{sup 2}/s] was lower than the normal uterine body. Quartile ADC and tumor size were greater in groups with more invasive pathologic factors (P < 0.05). Deep myometrial infiltration, cervical invasion, lymphovascular space invasion and lymph node metastasis were more common as quartile ADC values and tumor sizes increased. Conclusion: Mean ADC value was lower in endometrial carcinoma was lower than the normal uterus. Quartile ADC, representing the intra-tumor heterogeneity of water movement, had a profound relationship with invasiveness of endometrial carcinomas, while mean ADC value did not. ADC values may serve as a quantitative

  7. Whole body MRI, including diffusion-weighted imaging in follow-up of patients with testicular cancer.

    Science.gov (United States)

    Mosavi, Firas; Laurell, Anna; Ahlström, Håkan

    2015-11-01

    Whole body (WB) magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) has become increasingly utilized in cancer imaging, yet the clinical utility of these techniques in follow-up of testicular cancer patients has not been evaluated. The purpose of this study was to evaluate the feasibility of WB MRI with continuous table movement (CTM) technique, including multistep DWI in follow-up of patients with testicular cancer. WB MRI including DWI was performed in follow-up of 71 consecutive patients (median age, 37 years; range 19-84) with histologically confirmed testicular cancer. WB MRI protocol included axial T1-Dixon and T2-BLADE sequences using CTM technique. Furthermore, multi-step DWI was performed using b-value 50 and 1000 s/mm(2). One criterion for feasibility was patient tolerance and satisfactory image quality. Another criterion was the accuracy in detection of any pathological mass, compared to standard of reference. Signal intensity in DWI was used for evaluation of residual mass activity. Clinical, laboratory and imaging follow-up were applied as standard of reference for the evaluation of WB MRI. WB MRI was tolerated in nearly all patients (69/71 patients, 97%) and the image quality was satisfactory. Metal artifacts deteriorated the image quality in six patients, but it did not influence the overall results. No case of clinical relapse was observed during the follow-up time. There was a good agreement between conventional WB MRI and standard of reference in all patients. Three patients showed residual masses and DWI signal was not restricted in these patients. Furthermore, DWI showed abnormally high signal intensity in a normal-sized retroperitoneal lymph node indicating metastasis. The subsequent (18)F-FDG PET/CT could verify the finding. WB MRI with CTM technique including multi-step DWI is feasible in follow-up of patients with testicular cancer. DWI may contribute to important added-value data to conventional MRI sequences

  8. Persistent high signal on diffusion-weighted MRI in the late stages of small cortical and lacunar ischaemic lesions

    International Nuclear Information System (INIS)

    Geijer, B.; Holtaas, S.; Brockstedt, S.; Staahlberg, F.

    2001-01-01

    Diffusion-weighted imaging (DWI) is very sensitive to early brain infarcts. However, the late stages have been insufficiently studied. Infarcts in small vessel disease are often multiple and of different ages, and differentiation between new and old lesions might be difficult. We have therefore studied the change with time in DWI of small ( 6 s/m 2 and conventional T2-weighted imaging. After 7-16 days 18 of 21 lesions gave high signal on DWI, and 12/16 measurable lesions had a decreased apparent diffusion coefficient (ADC). After 54-144 days ten lesions still gave high DWI signal and two still had an ADC below normal. On the fourth examination there was no remaining high DWI signal and all ADC were higher than normal. (orig.)

  9. Small-bowel MRI in children and young adults with Crohn disease: retrospective head-to-head comparison of contrast-enhanced and diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Neubauer, Henning; Evangelista, Laura; Wirth, Clemens; Beer, Meinrad; Pabst, Thomas; Machann, Wolfram; Koestler, Herbert; Hahn, Dietbert; Dick, Anke

    2013-01-01

    Small-bowel MRI based on contrast-enhanced T1-weighted sequences has been challenged by diffusion-weighted imaging (DWI) for detection of inflammatory bowel lesions and complications in patients with Crohn disease. To evaluate free-breathing DWI, as compared to contrast-enhanced MRI, in children, adolescents and young adults with Crohn disease. This retrospective study included 33 children and young adults with Crohn disease ages 17 ± 3 years (mean ± standard deviation) and 27 matched controls who underwent small-bowel MRI with contrast-enhanced T1-weighted sequences and DWI at 1.5 T. The detectability of Crohn manifestations was determined. Concurrent colonoscopy as reference was available in two-thirds of the children with Crohn disease. DWI and contrast-enhanced MRI correctly identified 32 and 31 patients, respectively. All 22 small-bowel lesions and all Crohn complications were detected. False-positive findings (two on DWI, one on contrast-enhanced MRI), compared to colonoscopy, were a result of large-bowel lumen collapse. Inflammatory wall thickening was comparable on DWI and contrast-enhanced MRI. DWI was superior to contrast-enhanced MRI for detection of lesions in 27% of the assessed bowel segments and equal to contrast-enhanced MRI in 71% of segments. DWI facilitates fast, accurate and comprehensive workup in Crohn disease without the need for intravenous administration of contrast medium. Contrast-enhanced MRI is superior in terms of spatial resolution and multiplanar acquisition. (orig.)

  10. IgG4-related kidney disease: MRI findings with emphasis on the usefulness of diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bohyun; Kim, Jin Hee, E-mail: kimjhrad@amc.seoul.kr; Byun, Jae Ho; Kim, Hyoung Jung; Lee, Seung Soo; Kim, So Yeon; Lee, Moon-Gyu

    2014-07-15

    Objectives: To investigate the imaging findings of immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) on magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) and to evaluate the usefulness of DWI in lesion detection. Methods: This retrospective cohort study included 31 patients with IgG4-KD who underwent MRI covering both kidneys. Two radiologists reviewed in consensus the MR images to determine the distribution pattern (location, laterality, and multiplicity) and the visually assessed signal intensity (hypointense, isointense or hyperintense) of the renal lesions compared to the normal renal parenchyma on each sequence. Per-patient sensitivity for detecting IgG4-KD and the number of detectable lesions were compared in T2-weighted images, DWI, and dynamic contrast-enhanced images. Results: IgG4-KD typically manifested as bilateral (83.9%), multiple (93.5%), and renal parenchymal (87.1%) nodules appearing isointense (93.5%) on T1-weighted images, hypointense (77.4%) on T2-weighted images, hyperintense (100%) on DWI (b = 1000), and hypointense (83.3%) in the arterial phase and with a progressive enhancement pattern on dynamic contrast-enhanced images. The sensitivity of DWI for detecting IgG4-KD was significantly higher than that of T2-weighted images (100% vs. 77.4%, P = 0.034). The median number of detectable lesions was significantly greater in DWI (n = 9) than in T2-weighted images (n = 2) and dynamic contrast-enhanced images (n = 5) (P ≤ 0.008). Conclusions: The characteristic MRI findings of IgG4-KD were bilateral, multiple, renal parenchymal nodules with T2 hypointensity, diffusion restriction, and a progressive enhancement pattern. As DWI was useful in the detection of IgG4-KD, adding DWI to conventional MRI for patients suspected of having IgG4-KD may enhance the diagnosis.

  11. Diffusion-weighted MRI to assess response to chemoradiotherapy in rectal cancer: main interpretation pitfalls and their use for teaching

    International Nuclear Information System (INIS)

    Lambregts, Doenja M.J.; Lahaye, Max J.; Maas, Monique; Heeswijk, Miriam M. van; Delli Pizzi, Andrea; Elderen, Saskia G.C. van; Andrade, Luisa; Peters, Nicky H.G.M.; Osinga-de Jong, Margreet; Kint, Peter A.M.; Bipat, Shandra; Ooms, Rik; Beets, Geerard L.; Bakers, Frans C.H.; Beets-Tan, Regina G.H.

    2017-01-01

    To establish the most common image interpretation pitfalls for non-expert readers using diffusion-weighted imaging (DWI) to assess response to chemoradiotherapy in patients with rectal cancer and to explore the use of these pitfalls in an expert teaching setting. Two independent non-expert readers (R1 and R2) scored the restaging DW MRI scans (b1,000 DWI, in conjunction with ADC maps and T2-W MRI scans for anatomical reference) in 100 patients for the likelihood of a complete response versus residual tumour using a five-point confidence score. The readers received expert feedback and the final response outcome for each case. The supervising expert documented any potential interpretation errors/pitfalls discussed for each case to identify the most common pitfalls. The most common pitfalls were the interpretation of low signal on the ADC map, small susceptibility artefacts, T2 shine-through effects, suboptimal sequence angulation and collapsed rectal wall. Diagnostic performance (area under the ROC curve) was 0.78 (R1) and 0.77 (R2) in the first 50 patients and 0.85 (R1) and 0.85 (R2) in the final 50 patients. Five main image interpretation pitfalls were identified and used for teaching and feedback. Both readers achieved a good diagnostic performance with an AUC of 0.85. (orig.)

  12. Case report of a young stroke patient showing interim normalization of the MRI diffusion-weighted imaging lesion

    International Nuclear Information System (INIS)

    Ostwaldt, Ann-Christin; Usnich, Tatiana; Nolte, Christian H.; Villringer, Kersten; Fiebach, Jochen B.

    2015-01-01

    In acute ischemic stroke, diffusion weighted imaging (DWI) shows hyperintensities and is considered to indicate irreversibly damaged tissue. We present the case of a young stroke patient with unusual variability in the development of signal intensities within the same vessel territory. A 35-year-old patient presented with symptoms of global aphasia and hypesthesia of the left hand. MRI demonstrated a scattered lesion in the MCA territory. After rtPA therapy the patient received further MRI examination, three times on day 1, and once on day 2, 3, 5 and 43. The posterior part of the lesion showed the usual pattern with increasing DWI hyperintensity and decreased ADC, as well as delayed FLAIR positivity. However, the anterior part of the lesion, which was clearly visible in the first examination completely normalized on the first day and only reappeared on day 2. This was accompanied by a normalization of the ADC as well as an even further delayed FLAIR positivity. We showed that interim normalization of DWI and ADC in the acute phase can not only be found in rodent models of stroke, but also in humans. We propose that DWI lesion development might be more variable during the first 24 h after stroke than previously assumed

  13. Diffusion-weighted MRI to assess response to chemoradiotherapy in rectal cancer: main interpretation pitfalls and their use for teaching

    Energy Technology Data Exchange (ETDEWEB)

    Lambregts, Doenja M.J.; Lahaye, Max J.; Maas, Monique [The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands); Heeswijk, Miriam M. van [The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands); Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Maastricht University Medical Centre, Department of Surgery, Maastricht (Netherlands); Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Delli Pizzi, Andrea [Gabriele d' Annunzio University, SS. Annunziate Hospital, Department of Neuroscience and Imaging, Chieti (Italy); Elderen, Saskia G.C. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Andrade, Luisa [Hospitais da Universidade de Coimbra, Department of Radiology, Coimbra (Portugal); Peters, Nicky H.G.M.; Osinga-de Jong, Margreet [Zuyderland Medical Center, location Heerlen, Heerlen (Netherlands); Kint, Peter A.M. [Amphia Hospital, Department of Radiology, Breda (Netherlands); Bipat, Shandra [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Ooms, Rik [Maxima Medical Centre, Department of Radiology, Eindhoven-Veldhoven (Netherlands); Beets, Geerard L. [The Netherlands Cancer Institute, Department of Surgery, Amsterdam (Netherlands); Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Bakers, Frans C.H. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Beets-Tan, Regina G.H. [The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands); Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2017-10-15

    To establish the most common image interpretation pitfalls for non-expert readers using diffusion-weighted imaging (DWI) to assess response to chemoradiotherapy in patients with rectal cancer and to explore the use of these pitfalls in an expert teaching setting. Two independent non-expert readers (R1 and R2) scored the restaging DW MRI scans (b1,000 DWI, in conjunction with ADC maps and T2-W MRI scans for anatomical reference) in 100 patients for the likelihood of a complete response versus residual tumour using a five-point confidence score. The readers received expert feedback and the final response outcome for each case. The supervising expert documented any potential interpretation errors/pitfalls discussed for each case to identify the most common pitfalls. The most common pitfalls were the interpretation of low signal on the ADC map, small susceptibility artefacts, T2 shine-through effects, suboptimal sequence angulation and collapsed rectal wall. Diagnostic performance (area under the ROC curve) was 0.78 (R1) and 0.77 (R2) in the first 50 patients and 0.85 (R1) and 0.85 (R2) in the final 50 patients. Five main image interpretation pitfalls were identified and used for teaching and feedback. Both readers achieved a good diagnostic performance with an AUC of 0.85. (orig.)

  14. Assessment of early renal allograft dysfunction with blood oxygenation level-dependent MRI and diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Yoon [Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Chan Kyo, E-mail: chankyokim@skku.edu [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Park, Byung Kwan [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Sung Ju; Lee, Sanghoon [Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Huh, Wooseong [Department of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    Highlights: • R2* and ADC in renal allografts are moderately correlated with eGFR. • R2* and ADC are lower in early allograft dysfunction than normal allograft function. • No significant difference between AR and ATN was found in both R2* and ADC. - Abstract: Purpose: To investigate blood oxygenation level-dependent (BOLD) MRI and diffusion-weighted imaging (DWI) at 3 T for assessment of early renal allograft dysfunction. Materials and methods: 34 patients with a renal allograft (early dysfunction, 24; normal, 10) were prospectively enrolled. BOLD MRI and DWI were performed at 3 T. R2* and apparent diffusion coefficient (ADC) values were measured in cortex and medulla of the allografts. Correlation between R2* or ADC values and estimated glomerular filtration rate (eGFR) was investigated. R2* or ADC values were compared among acute rejection (AR), acute tubular necrosis (ATN) and normal function. Results: In all renal allografts, cortical or medullary R2* and ADC values were moderately correlated with eGFR (P < 0.05). Early dysfunction group showed lower R2* and ADC values than normal function group (P < 0.05). AR or ATN had lower R2* values than normal allografts (P < 0.05), and ARs had lower cortical ADC values than normal allografts (P < 0.05). No significant difference of R2* or ADC values was found between AR and ATN (P > 0.05). Conclusion: BOLD MRI and DWI at 3 T may demonstrate early functional state of renal allografts, but may be limited in characterizing a cause of early renal allograft dysfunction. Further studies are needed.

  15. Lesion patterns and etiology of ischemia in the anterior inferior cerebellar artery territory involvement: a clinical - diffusion weighted - MRI study.

    Science.gov (United States)

    Kumral, E; Kisabay, A; Ataç, C

    2006-04-01

    The topography and mechanism of stroke in the anterior inferior cerebellar artery (AICA) territory are delineated before, but the detailed clinical spectrum of lesions involving AICA territory was not studied by diffusion weighted imaging (DWI). We reviewed 1350 patients with posterior circulation ischemic stroke in our registry. We included patients if the diagnosis of AICA territory involvement was confirmed, and DWI, and magnetic resonance angiography were obtained in the 3 days of symptoms onset. The potential feeding arteries of the AICA territory were evaluated on magnetic resonance imaging (MRI) using a three-dimensional rotating cineoangiographic method. There were 23 consecutive patients with lesion involving AICA territory, six with isolated lesion in the AICA territory, six with posterior inferior cerebellar artery, 11 with multiple posterior circulation infarcts (MPCIs). The clinical feature of isolated AICA infarct was vertigo, tinnitus, dysmetria, ataxia, facial weakness, facial sensory deficits, lateral gaze palsy, and sensory-motor deficits in patients with pontine involvement. Patients with largest lesion extending to the anterior and inferolateral cerebellum showed mixed symptomatology of the lateral medullary (Wallenberg's syndrome) and AICA territory involvement. Patients with MPCIs presented various clinical pictures with consciousness disturbances and diverse clinical signs because of involvement of different anatomical structures. Large-artery atherosclerotic disease in the vertebrobasilar system was the main cause of stroke in 12 (52%) patients, cardioembolism (CE) in one (4%), and coexisting large-artery disease and a source of CE in four (17%). The main cause of stroke was atheromatous vertebrobasilar artery disease either in the distal vertebral or proximal basilar artery. The outcome was usually good except those with multiple lesions. The new MRI techniques and clinical correlations allow better definition of the diverse topographical

  16. Whole-body MRI including diffusion-weighted MRI compared with 5-HTP PET/CT in the detection of neuroendocrine tumors.

    Science.gov (United States)

    Carlbom, Lina; Caballero-Corbalán, José; Granberg, Dan; Sörensen, Jens; Eriksson, Barbro; Ahlström, Håkan

    2017-03-01

    We wanted to explore if whole-body magnetic resonance imaging (MRI) including diffusion-weighted (DW) and liver-specific contrast agent-enhanced imaging could be valuable in lesion detection of neuroendocrine tumors (NET). [11C]-5-Hydroxytryptophan positron emission tomography/computed tomography (5-HTP PET/CT) was used for comparison. Twenty-one patients with NET were investigated with whole-body MRI, including DW imaging (DWI) and contrast-enhanced imaging of the liver, and whole-body 5-HTP PET/CT. Seven additional patients underwent upper abdomen MRI including DWI, liver-specific contrast agent-enhanced imaging, and 5-HTP PET/CT. There was a patient-based concordance of 61% and a lesion-based concordance of 53% between the modalities. MRI showed good concordance with PET in detecting bone metastases but was less sensitive in detecting metastases in mediastinal lymph nodes. MRI detected more liver metastases than 5-HTP PET/CT. Whole-body MRI with DWI did not detect all NET lesions found with whole-body 5-HTP PET/CT. Our findings indicate that MRI of the liver including liver-specific contrast agent-enhanced imaging and DWI could be a useful complement to whole-body 5-HTP PET/CT.

  17. Microstructural changes in ischemic cortical gray matter predicted by a model of diffusion-weighted MRI

    DEFF Research Database (Denmark)

    Vestergaard-Poulsen, Peter; Hansen, Brian; Østergaard, Leif

    2007-01-01

    PURPOSE: To understand the diffusion attenuated MR signal from normal and ischemic brain tissue in order to extract structural and physiological information using mathematical modeling, taking into account the transverse relaxation rates in gray matter. MATERIALS AND METHODS: We fit our diffusion...... compartment. A global optimum was found from a wide range of parameter permutations using cluster computing. We also present simulations of cell swelling and changes of exchange rate and intracellular diffusion as possible cellular mechanisms in ischemia. RESULTS: Our model estimates an extracellular volume...... fraction of 0.19 in accordance with the accepted value from histology. The absolute apparent diffusion coefficient obtained from the model was similar to that of experiments. The model and the experimental results indicate significant differences in diffusion and transverse relaxation between the tissue...

  18. Diffusion-Weighted MRI Assessment of Adjacent Disc Degeneration After Thoracolumbar Vertebral Fractures

    Energy Technology Data Exchange (ETDEWEB)

    Noriega, David C., E-mail: dcnoriega1970@gmail.com [Valladolid University Hospital, Spine Department (Spain); Marcia, Stefano, E-mail: stemarcia@gmail.com [SS. Trinità Hospital ASL 8 Cagliari, Department of Radiology (Italy); Ardura, Francisco, E-mail: fardura@ono.com [Valladolid University Hospital, Spine Department (Spain); Lite, Israel Sanchez, E-mail: israelslite@hotmail.com [Valladolid University Hospital, Radiology Department (Spain); Marras, Mariangela, E-mail: mariangela.marrasmd@gmail.com [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology (Italy); Saba, Luca, E-mail: lucasaba@tiscali.it [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology (Italy)

    2016-09-15

    ObjectiveThe purpose of this study was to assess, by the mean apparent diffusion coefficient (ADC), if a relationship exists between disc ADC and MR findings of adjacent disc degeneration after thoracolumbar fractures treated by anatomic reduction using vertebral augmentation (VAP).Materials and MethodsTwenty non-consecutive patients (mean age 50.7 years; range 45–56) treated because of vertebral fractures, were included in this study. There were 10 A3.1 and 10 A1.2 fractures (AO classification). Surgical treatment using VAP was applied in 14 cases, and conservative in 6 patients. MRI T2-weighted images and mapping of apparent diffusion coefficient (ADC) of the intervertebral disc adjacent to the fractured segment were performed after a mean follow-up of 32 months. A total of 60 discs, 3 per patient, were analysed: infra-adjacent, supra-adjacent and a control disc one level above the supra-adjacent.ResultsNo differences between patients surgically treated and those following a conservative protocol regarding the average ADC values obtained in the 20 control discs analysed were found. Considering all discs, average ADC in the supra-adjacent level was lower than in the infra-adjacent (1.35 ± 0.12 vs. 1.53 ± 0.06; p < 0.001). Average ADC values of the discs used as a control were similar to those of the infra-adjacent level (1.54 ± 0.06). Compared to surgically treated patients, discs at the supra-adjacent fracture level showed statistically significant lower values in cases treated conservatively (p < 0.001). The variation in the delay of surgery had no influence on the average values of ADC at any of the measured levels.ConclusionsADC measurements of the supra-adjacent discs after a mean follow-up of 32 months following thoracolumbar fractures, showed that restoration of the vertebral collapse by minimally invasive VAP prevents posttraumatic disc degeneration.

  19. Imaging of the brain, including diffusion-weighted imaging in methylmalonic acidemia

    Energy Technology Data Exchange (ETDEWEB)

    Michel, Steven J.; Given, Curtis A. [Department of Diagnostic Radiology, University of Kentucky Chandler Medical Center, Room HX-311C, 800 Rose Street, Lexington, KY 40536 (United States); Robertson, William C. [Department of Pediatric Neurology, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536 (United States)

    2004-07-01

    Methylmalonic acidemia (MMA) is a multifactorial autosomal recessive inborn error of organic acid metabolism, often presenting with neurologic findings. We report the imaging findings in a case of a child with classic neurological and laboratory findings for MMA. Imaging studies demonstrated abnormalities within the basal ganglia, particularly the globi pallidi (GP). Diffusion-weighted abnormalities seen in patients with MMA during an acute episode of metabolic acidosis and at follow-up are discussed. The authors are aware of only one prior report of serial examinations demonstrating resolution of restricted diffusion in the GP. The biochemical and pathophysiologic basis of the imaging findings of MMA are explained. (orig.)

  20. Differentiating xanthogranulomatous cholecystitis from wall-thickening type of gallbladder cancer: added value of diffusion-weighted MRI.

    Science.gov (United States)

    Kang, T W; Kim, S H; Park, H J; Lim, S; Jang, K M; Choi, D; Lee, S J

    2013-10-01

    To evaluate the benefit of diffusion-weighted imaging (DWI) in differentiating xanthogranulomatous cholecystitis from the wall-thickening type of gallbladder cancer. This retrospective study was approved by the institutional review board. Fourteen patients with xanthogranulomatous cholecystitis and 19 patients with the wall-thickening type of gallbladder cancer were included. Qualitative (visual diffusion restriction compared to liver parenchyma) and quantitative [apparent diffusion coefficient (ADC)] analyses were performed. Conventional MRI findings including dynamic enhancement pattern between the two groups were also analysed. Two observers independently reviewed conventional magnetic resonance imaging (MRI) images and subsequently reviewed combined conventional MRI and DWI images. Pairwise comparison of the receiver operating characteristic (ROC) curves was used to compare diagnostic performances. In conventional MRI findings, xanthogranulomatous cholecystitis showed significant continuity of enhancing mucosal line [79% (11/14) versus 26% (5/19), p = 0.003] and intramural T2-high signal intensity [64% (9/14) versus 21% (4/19), p = 0.012] compared to the wall-thickening type of gallbladder cancer. The enhancement pattern of gallbladder cancer compared to liver parenchyma showed earlier onset than that of xanthogranulomatous cholecystitis (p = 0.001). Diffusion restriction was more frequently seen in the wall-thickening type of gallbladder cancer (68%, 13/19) than in xanthogranulomatous cholecystitis (7%, 1/14; p cholecystitis was higher than that of the wall-thickening type of gallbladder cancer with statistical significance (1.637 × 10(-3) mm(2)/s versus 1.076 × 10(-3) mm(2)/s, p = 0.005). Diagnostic performance [area under ROC curve (Az)] of both observers improved significantly after additional review of DWI; Az improved from 0.737 to 0.930 (p = 0.027) for observer 1 and from 0.675 to 0.938 (p = 0.008) for observer 2. Addition of DWI to conventional MRI

  1. Diffusion-weighted MR imaging in animal modil with acute ischemic brain infarction : evaluation of reversible brain injury

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Woo Mok; Chang, Han Won; Cho, Inn Ho; Hah, Jung Sang; Sung, Eon Gi [Yeungnam Univ. College of Medicine, Taegu (Korea, Republic of)

    2001-04-01

    To determine whether the analysis of abnormally high signal intensities in ischemic tissue, as revealed by diffusion-weighted MR imaging (DWI) can be used to evaluate reversible brain lesions in a cat model of acute ischemia. Ten cats were divided into two groups of five (Group I and Group II), and in all animals the middle cerebral artery was temporarily occluded. Group I underwent T2-DWI 30 minutes after occlusion, and Group II 120 minutes after occlusion. In both groups, DWI was performed one hour and 24 hours after reperfusion (at one hour, non-T2-weighted; at 24 hours, T2-weighted). Both occlusion and reperfusion were monitored by {sup 99m}TC-ECD brain perfusion SPECT. All animals were sacrificed 24 hours later and their brain tissue was stained with TTC. Signal intensity ratios (SIR, signifying average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region) of the two groups, as seen on DWI were compared. The percentage of hemispheric lesions occurring in the two groups was also compared. SIR after occlusion of the middle cerebral artery was 1.29 in Group I and 1.59 in Group II. Twenty-four hours after reperfusion, SIR in Group I was higher than in Group II (p<0.01). After occlusion and reperfusion, the percentage of hemispheric lesions in Group I was less than in Group II. For the latter, the percentage of these lesions revealed by TTC staining and T2-weighted imaging was 48% and 59%, respectively, findings distinctly different from those for Group I. In addition, in group I, infarction was revealed by neither TTC staining nor T2-weighted imaging (p<0.01). The use of DWI to evaluate signal intensity ratios can help determine whether or not brain injury after temporary cerebral ischemia is reversible.

  2. Modern MRI tools for the characterization of acute demyelinating lesions: value of chemical shift and diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kueker, W.; Mehnert, F.; Mader, I.; Naegele, T. [Department of Neuroradiology, University of Tuebingen Medical School, Hoppe-Seyler-Str. 3, 72076, Tuebingen (Germany); Ruff, J. [Siemens Medical Solutions, Erlangen (Germany); Gaertner, S. [Department of Neurology, University of Tuebingen Medical School, Tuebingen (Germany)

    2004-06-01

    Acute demyelinating lesions occur in various inflammatory disorders of the CNS. Apart from multiple sclerosis, most cases can be attributed to an overshooting immunological response to infectious agents called acute disseminated encephalomyelitis (ADEM). ADEM, which is mostly characterized by a monophasic course, has a multiphasic variant (MDEM). The early application of corticosteroids has been shown to be beneficial for the outcome; thus, an early diagnosis is highly desirable. Furthermore, the differential diagnosis ruling out neoplastic disorders may be difficult using conventional MRI alone. The potential diagnostic value of advanced MR techniques such as chemical shift imaging (CSI) and diffusion-weighted imaging (DWI) was investigated in a patient with MDEM, who had a new lesion in continuity with the initial disease manifestation. CSI was performed at 1.5 T with a long echo time of 135 ms for the evaluation of N-acetyl-aspartate (NAA) and choline (Cho) and with short TE of 30 ms for macromolecules (mm) and myo-Inositol (mI). DWI was performed using a single-shot isotropic EPI sequence. Whereas acute and chronic areas of demyelination were neither distinguishable on T2- nor on contrast-enhanced T1-weigted images, CSI and DWI revealed different metabolite concentrations and diffusion characteristics within the composite lesion, clearly separating acute from chronic areas of demyelination. In conclusion, the addition of CSI and DWI may add to the diagnostic power of MRI in the setting of demyelinating disorders by identifying areas of acute and chronic demyelination, even in the absence of contrast enhancement. (orig.)

  3. Modern MRI tools for the characterization of acute demyelinating lesions: value of chemical shift and diffusion-weighted imaging

    International Nuclear Information System (INIS)

    Kueker, W.; Mehnert, F.; Mader, I.; Naegele, T.; Ruff, J.; Gaertner, S.

    2004-01-01

    Acute demyelinating lesions occur in various inflammatory disorders of the CNS. Apart from multiple sclerosis, most cases can be attributed to an overshooting immunological response to infectious agents called acute disseminated encephalomyelitis (ADEM). ADEM, which is mostly characterized by a monophasic course, has a multiphasic variant (MDEM). The early application of corticosteroids has been shown to be beneficial for the outcome; thus, an early diagnosis is highly desirable. Furthermore, the differential diagnosis ruling out neoplastic disorders may be difficult using conventional MRI alone. The potential diagnostic value of advanced MR techniques such as chemical shift imaging (CSI) and diffusion-weighted imaging (DWI) was investigated in a patient with MDEM, who had a new lesion in continuity with the initial disease manifestation. CSI was performed at 1.5 T with a long echo time of 135 ms for the evaluation of N-acetyl-aspartate (NAA) and choline (Cho) and with short TE of 30 ms for macromolecules (mm) and myo-Inositol (mI). DWI was performed using a single-shot isotropic EPI sequence. Whereas acute and chronic areas of demyelination were neither distinguishable on T2- nor on contrast-enhanced T1-weigted images, CSI and DWI revealed different metabolite concentrations and diffusion characteristics within the composite lesion, clearly separating acute from chronic areas of demyelination. In conclusion, the addition of CSI and DWI may add to the diagnostic power of MRI in the setting of demyelinating disorders by identifying areas of acute and chronic demyelination, even in the absence of contrast enhancement. (orig.)

  4. The stratification of severity of acute radiation proctopathy after radiotherapy for cervical carcinoma using diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Li, Xiang Sheng; Fang, Hong; Song, Yunlong; Li, Dechang; Wang, Yingjie; Zhu, Hongxian; Meng, Limin; Wang, Ping; Wang, Dong; Fan, Hongxia

    2017-01-01

    Objective: To determine whether diffusion-weighted imaging (DWI) can be used for quantitatively evaluating severity of acute radiation proctopathy after radiotherapy for cervical carcinoma. Materials and methods: One hundred and twenty-four patients with cervical carcinoma underwent MR examination including DWI before and after radiotherapy. Acute radiation proctopathy was classified into three groups (grade 0, grade I–II and grade III–IV) according to Toxicity Criteria of the Radiation Therapy Oncology Group (RTOG). The pretreatment ADC (ADC_p_r_e), ADC after treatment (ADC_p_o_s_t) and ADC change (ΔADC) were compared among three groups. In addition, acute radiation proctopathy was classified into good-prognosis group and poor-prognosis group. ADC_p_r_e, ADC_p_o_s_t and ΔADC were compared between two groups. For DWI parameter that had significant difference, discriminatory capability of the parameter was determined using receiver operating characteristics (ROC) analysis. Results: ADC_p_o_s_t and ΔADC were higher in grade I–II group than in grade 0 group (p < 0.05), yielding a sensitivity of 79.3% and specificity of 69.4% for ADC_p_o_s_t, and 85.1%, 72.3% for ΔADC for discrimination between two groups. ADC_p_o_s_t and ΔADC were higher in grade III–IV group than in grade I–II group (p < 0.05), yielding a sensitivity of 80.3% and specificity of 72.5% for ADC_p_o_s_t, and 84.1%, 74.5% for ΔADC for discrimination between two groups. ADC_p_o_s_t and ΔADC were higher in poor-prognosis group than in good-prognosis group (p < 0.05), yielding a sensitivity of 79.5% and specificity of 73.4% for ADC_p_o_s_t, and 87.2%, 78.3% for ΔADC for discrimination between two groups. Conclusion: Diffusion-weighted MRI can be used for quantitative stratification of severity of acute radiation proctopathy, which serves as an important basis for appropriate timely adjustment of radiotherapy for cervical carcinoma in order to maximally reduce the radiation injury of rectum.

  5. The stratification of severity of acute radiation proctopathy after radiotherapy for cervical carcinoma using diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Li, Xiang Sheng, E-mail: lxsheng500@163.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Fang, Hong, E-mail: hongfang196808@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Song, Yunlong, E-mail: yunlongsong010@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Li, Dechang, E-mail: dechangli1972@sina.com [Department of Pathology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Wang, Yingjie, E-mail: wangyj19710813@sina.com [Department of Radiotherapy, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Zhu, Hongxian, E-mail: hongxian0102@sina.cn [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Meng, Limin, E-mail: liminmeng1977@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Wang, Ping, E-mail: pingwang1978@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Wang, Dong, E-mail: dongwang1964@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Fan, Hongxia, E-mail: fanhongxia1975@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China)

    2017-02-15

    Objective: To determine whether diffusion-weighted imaging (DWI) can be used for quantitatively evaluating severity of acute radiation proctopathy after radiotherapy for cervical carcinoma. Materials and methods: One hundred and twenty-four patients with cervical carcinoma underwent MR examination including DWI before and after radiotherapy. Acute radiation proctopathy was classified into three groups (grade 0, grade I–II and grade III–IV) according to Toxicity Criteria of the Radiation Therapy Oncology Group (RTOG). The pretreatment ADC (ADC{sub pre}), ADC after treatment (ADC{sub post}) and ADC change (ΔADC) were compared among three groups. In addition, acute radiation proctopathy was classified into good-prognosis group and poor-prognosis group. ADC{sub pre}, ADC{sub post} and ΔADC were compared between two groups. For DWI parameter that had significant difference, discriminatory capability of the parameter was determined using receiver operating characteristics (ROC) analysis. Results: ADC{sub post} and ΔADC were higher in grade I–II group than in grade 0 group (p < 0.05), yielding a sensitivity of 79.3% and specificity of 69.4% for ADC{sub post}, and 85.1%, 72.3% for ΔADC for discrimination between two groups. ADC{sub post} and ΔADC were higher in grade III–IV group than in grade I–II group (p < 0.05), yielding a sensitivity of 80.3% and specificity of 72.5% for ADC{sub post}, and 84.1%, 74.5% for ΔADC for discrimination between two groups. ADC{sub post} and ΔADC were higher in poor-prognosis group than in good-prognosis group (p < 0.05), yielding a sensitivity of 79.5% and specificity of 73.4% for ADC{sub post}, and 87.2%, 78.3% for ΔADC for discrimination between two groups. Conclusion: Diffusion-weighted MRI can be used for quantitative stratification of severity of acute radiation proctopathy, which serves as an important basis for appropriate timely adjustment of radiotherapy for cervical carcinoma in order to maximally reduce the

  6. The role of diffusion weighted magnetic resonance imaging in ...

    African Journals Online (AJOL)

    Aim of the work: To demonstrate the role of Diffusion Weighted Imaging and ADC maps in assessing normal progression of the infantile brain myelination. Patients and methods: The present work included 30 infants with normal MRI study of the brain, normal psychomotor development and normal neurological examination.

  7. Diffusion-weighted imaging and dynamic contrast-enhanced MRI of experimental breast cancer bone metastases – A correlation study with histology

    Energy Technology Data Exchange (ETDEWEB)

    Merz, Maximilian [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Seyler, Lisa; Bretschi, Maren; Semmler, Wolfhard [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Bäuerle, Tobias, E-mail: tobias.baeuerle@uk-erlangen.de [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Institute of Radiology, University Medical Center Erlangen, Palmsanlage 5, 90154 Erlangen (Germany)

    2015-04-15

    Purpose: To validate imaging parameters from diffusion-weighted imaging and dynamic contrast-enhanced MRI with immunohistology and to non-invasively assess microstructure of experimental breast cancer bone metastases. Materials and methods: Animals bearing breast cancer bone metastases were imaged in a clinical 1.5 T MRI scanner. HASTE sequences were performed to calculate apparent diffusion coefficients. Saturation recovery turbo FLASH sequences were conducted while infusing 0.1 mmol/l Gd–DTPA for dynamic contrast-enhanced MRI to quantify parameters amplitude A and exchange rate constant k{sub ep}. After imaging, bone metastases were analyzed immunohistologically. Results: We found correlations of the apparent diffusion coefficients from diffusion-weighted imaging with tumor cellularity as assessed with cell nuclei staining. Histological vessel maturity was correlated negatively with parameters A and k{sub ep} from dynamic contrast-enhanced MRI. Tumor size correlated inversely with cell density and vessel permeability as well as positively with mean vessel calibers. Parameters from the rim of bone metastases differed significantly from values of the center. Conclusion: In vivo diffusion-weighted imaging and dynamic contrast-enhanced MRI in experimental bone metastases provide information about tumor cellularity and vascularity and correlate well with immunohistology.

  8. Optimal high b-value for diffusion weighted MRI in diagnosing high risk prostate cancers in the peripheral zone.

    Science.gov (United States)

    Agarwal, Harsh K; Mertan, Francesca V; Sankineni, Sandeep; Bernardo, Marcelino; Senegas, Julien; Keupp, Jochen; Daar, Dagane; Merino, Maria; Wood, Bradford J; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris

    2017-01-01

    To retrospectively determine the optimal b-value(s) of diffusion-weighted imaging (DWI) associated with intermediate-high risk cancer in the peripheral zone (PZ) of the prostate. Forty-two consecutive patients underwent multi b-value (16 evenly spaced b-values between 0 and 2000 s/mm 2 ) DWI along with multi-parametric MRI (MP-MRI) of the prostate at 3 Tesla followed by trans-rectal ultrasound/MRI fusion guided targeted biopsy of suspicious lesions detected at MP-MRI. Computed DWI images up to a simulated b-value of 4000 s/mm 2 were also obtained using a pair of b-values (b = 133 and 400 or 667 or 933 s/mm 2 ) from the multi b-value DWI. The contrast ratio of average intensity of the targeted lesions and the background PZ was determined. Receiver operator characteristic curves and the area under the curve (AUCs) were obtained for separating patients eligible for active surveillance with low risk prostate cancers from intermediate-high risk prostate cancers as per the cancer of the prostate risk assessment (CAPRA) scoring system. The AUC first increased then decreased with the increase in b-values reaching maximum at b = 1600 s/mm 2 (0.74) with no statistically significant different AUC of DWI with b-values 1067-2000 s/mm 2 . The AUC of computed DWI increased then decreased with the increase in b-values reaching a maximum of 0.75 around b = 2000 s/mm 2 . There was no statistically significant difference between the AUC of optimal acquired DWI and either of optimal computed DWI. The optimal b-value for acquired DWI in differentiating intermediate-high from low risk prostate cancers in the PZ is b = 1600 s/mm 2 . The computed DWI has similar performance as that of acquired DWI with the optimal performance around b = 2000 s/mm 2 . 4 J. Magn. Reson. Imaging 2017;45:125-131. © 2016 International Society for Magnetic Resonance in Medicine.

  9. Dependence on b-value of the direction-averaged diffusion-weighted imaging signal in brain.

    Science.gov (United States)

    McKinnon, Emilie T; Jensen, Jens H; Glenn, G Russell; Helpern, Joseph A

    2017-02-01

    The dependence of the direction-averaged diffusion-weighted imaging (DWI) signal in brain was studied as a function of b-value in order to help elucidate the relationship between diffusion weighting and brain microstructure. High angular resolution diffusion imaging (HARDI) data were acquired from two human volunteers with 128 diffusion-encoding directions and six b-value shells ranging from 1000 to 6000s/mm 2 in increments of 1000s/mm 2 . The direction-averaged signal was calculated for each shell by averaging over all diffusion-encoding directions, and the signal was plotted as a function of b-value for selected regions of interest. As a supplementary analysis, similar methods were also applied to retrospective DWI data obtained from the human connectome project (HCP), which includes b-values up to 10,000s/mm 2 . For all regions of interest, a simple power law relationship accurately described the observed dependence of the direction-averaged signal as a function of the diffusion weighting. In white matter, the characteristic exponent was 0.56±0.05, while in gray matter it was 0.88±0.11. Comparable results were found with the HCP data. The direction-averaged DWI signal varies, to a good approximation, as a power of the b-value, for b-values between 1000 and 6000s/mm 2 . The exponents characterizing this power law behavior were markedly different for white and gray matter, indicative of sharply contrasting microstructural environments. These results may inform the construction of microstructural models used to interpret the DWI signal. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Application of EPI diffusion-weighted and Gd-DTPA T2* perfusion imaging in the diagnosis of brain ischemia

    International Nuclear Information System (INIS)

    Han Hongbin; Xie Jingxia

    1998-01-01

    Purpose: To study the MR and CT appearances of brain ischemia on diffusion-weighted imaging (DWI) and evaluate the role of EPI ADC-map, DWI and T 2 * perfusion imaging in acute stroke. Methods: DWI or ADC-map and routine T 1 WI and T 2 WI were performed in 36 patients with stroke (the time after onset of stroke: 2 hours - 2 months). Among them, 12 cases had perfusion imaging simultaneously. Results: Gd-DTPA T 2 * perfusion imaging demonstrated decrease of rrCBV and rrCBF in 10 cases; identical in 1 case and increase in 1 case. The mean transit time in the diseased area was longer than that of the contralateral corresponding region (paired t test: P 2 * perfusion imaging can demonstrate the decrease and restoration of CBF in the brain ischemic regions. DWI and ADC-map are highly valuable in the early diagnosis and monitoring the development of brain ischemic disease

  11. Quantification of fibrosis in infarcted swine hearts by ex vivo late gadolinium-enhancement and diffusion-weighted MRI methods

    Science.gov (United States)

    Pop, Mihaela; Ghugre, Nilesh R.; Ramanan, Venkat; Morikawa, Lily; Stanisz, Greg; Dick, Alexander J.; Wright, Graham A.

    2013-08-01

    Many have speculated that MRI signal characteristics can be used to identify regions of heterogeneous infarct associated with an arrhythmogenic substrate; however, direct evidence of this relationship is limited. The aim of this study was to demonstrate the remodelling characteristics of fibrosis by means of histology and high-resolution MR imaging. For this purpose, we performed whole-mount histology in heart samples (n = 9) collected from five swine at six weeks post-infarction and compared the extent of fibrosis in the infarcted areas delineated in these histological images with that obtained ex vivo by MRI using late gadolinium-enhancement (LGE) and diffusion-weighted imaging (DWI) methods. All MR images were obtained at a submillimetre resolution (i.e., voxel size of 0.6×0.6×1.2 mm3). Specifically, in the histology images, we differentiated moderate fibrosis (consisting of a mixture of viable and non-viable myocytes, known as border zone, BZ) from severe fibrosis (i.e., the dense scar). Correspondingly, tissue heterogeneities in the MR images were categorized by a Gaussian mixture model into healthy, BZ and scar. Our results showed that (a) both MRI methods were capable of qualitatively distinguishing sharp edges between dense scar and healthy tissue from regions of heterogeneous BZ; (b) the BZ and dense scar areas had intermediate-to-high increased values of signal intensity in the LGE images and of apparent diffusion coefficient in the DWI, respectively. In addition, as demonstrated by the Picrosirius Red and immunohistochemistry stains, the viable bundles in the BZ were clearly separated by thin collagen strands and had reduced expression of Cx43, whereas the core scar was composed of dense fibrosis. A quantitative analysis demonstrated that the comparison between BZ/scar extent in LGE and DWI to the corresponding areas identified in histology yielded very good correlations (i.e., for the scar identified by LGE, R2 was 0.96 compared to R2 = 0.93 for the

  12. Assessment of brain temperatures during different phases of the menstrual cycle using diffusion-weighted imaging thermometry.

    Science.gov (United States)

    Tsukamoto, Taro; Shimono, Taro; Sai, Asari; Sakai, Koji; Yamamoto, Akira; Sakamoto, Shinichi; Miki, Yukio

    2016-04-01

    To investigate changes in brain temperature according to the menstrual cycle in women using diffusion-weighted imaging (DWI) thermometry and to clarify relationships between brain and body temperatures. In 20 healthy female volunteers (21.3-38.8 years), DWI of the brain was performed during the follicular and luteal phases to calculate the brain temperature. During DWI, body temperatures were also measured. Group comparisons of each temperature between the two phases were performed using the paired t test. Correlations between brain and body temperatures were analyzed using Pearson's correlation coefficient test. Mean diffusion-based brain temperature was 36.24 °C (follicular) and 36.96 °C (luteal), showing a significant difference (P < 0.0001). Significant differences were also seen for each body temperature between the two phases. Correlation coefficients between diffusion-based brain and each body temperature were r = 0.2441 (P = 0.1291), -0.0332 (0.8387), and -0.0462 (0.7769), respectively. In women of childbearing age, brain and body temperatures appear significantly higher in the luteal than in the follicular phase. However, brain and body temperatures show no significant correlations.

  13. Diagnostic value of diffusion-weighted MRI for tumor characterization, differentiation and monitoring in pediatric patients with neuroblastic tumors

    Energy Technology Data Exchange (ETDEWEB)

    Neubauer, Henning [Univ. Hospital Ulm (Germany). Dept. of Diagnostic and Interventional Radiology; Univ. Hospital Wuerzburg (Germany). Dept. of Diagnostic and Interventional Radiology; Li, Mengxia [Univ. Hospital Wuerzburg (Germany). Dept. of Radiation Oncology; Mueller, Verena Rabea [Univ. Hospital Wuerzburg (Germany). Dept. of Paediatrics; Pabst, Thomas [Univ. Hospital Wuerzburg (Germany). Dept. of Diagnostic and Interventional Radiology; Beer, Meinrad [Univ. Hospital Ulm (Germany). Dept. of Diagnostic and Interventional Radiology

    2017-07-15

    We explored the diagnostic value of diffusion-weighted MRI (DWI) for tumor characterization, differentiation and therapy monitoring in pediatric patients with extracranial neuroblastic tumors. All 29 patients (14 girls, median age: 3 years) with neuroblastoma (NB, n = 19), ganglioneuroblastoma (GNB, n = 4) and ganglioneuroma (GN, n = 6) who had had at least one in-house DWI examination since 2005 were identified and retrospectively analyzed. Two independent blinded readers measured ADC values (unit: 10-3 mm{sup 2}/s) and signal intensity ratios (SIRs) of the primary tumor and, if applicable, of the tumor after chemotherapy, metastases and tumor relapse. The pre-treatment ADC was 0.90 ± 0.23 in NB/GNB and 1.70 ± 0.36 in GN without overlap between the two entities for both readers, 0.67 ± 0.14 in metastases and 0.72 ± 0.18 in tumor relapse. With chemotherapy, mean ADC increased to 1.54 ± 0.33 in NB/GNB and to 1.23 ± 0.27 in metastases (p < 0.05). The median SIRs of various tumor lesions vs. liver, vs. muscle tissue and vs. adjacent tissue were significantly higher on DWI (range: 2.4 -9.9) than on ce-T1w (range: 1.0 - 1.8, all p < 0.05). The coefficient of variation (CV) was ≤ 8.0% for ADC and ≤ 16.4% for signal intensity data. Based on mean ADC, DWI distinguishes between NB/GNB and GN with high certainty and provides plausible quantitative data on tumor response to therapy. Lesion conspicuity, as measured by SIR, is superior on DWI, compared to ce-T1w. DWI as a noninvasive, radiation-free and widely available imaging technique should be an integral part of MR imaging for neuroblastic tumors and should undergo prospective evaluation in multicenter studies.

  14. [Portal-systemic encephalopathy with bilateral thalamic and internal capsule lesions using diffusion-weighted MRI in a super-aged patient].

    Science.gov (United States)

    Matsuda, Michiaki; Takesako, Shinpei; Nakazaki, Mitsuhiro; Nandate, Toru; Umehara, Fujio

    2017-12-27

    We describe the case of a 90-year-old woman who was hospitalized in July 2016 and subsequently experienced a sudden decline in consciousness level resulting in a state of deep coma. Involuntary movements were not observed, and bilateral Babinski signs were inconclusive. Diffusion-weighted MRI (DWI) of the brain showed bilateral hyperintensity in the thalamus and internal capsule, laboratory testing detected high levels of plasma ammonia, and an electroencephalogram showed delta waves and triphasic waves predominantly in the frontal lobe. Based on these results, treatment for hepatic encephalopathy was administered, which led to an improvement in consciousness level, a decrease in plasma ammonia levels, and a normalization in the DWI scan. Abdominal computed tomography scan showed no abnormality in the liver, but revealed an abnormal blood vessel leading from the ileocolic vein to the inferior vena cava; the patient was diagnosed with portal-systemic encephalopathy. In deep coma patients, acute encephalopathy with hyperammonemia is important for differential diagnosis when DWI shows high-density legions in the thalamus and internal capsule.

  15. Demonstration of the reproducibility of free-breathing diffusion-weighted MRI and dynamic contrast enhanced MRI in children with solid tumours: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Miyazaki, Keiko; Jerome, Neil P.; Collins, David J.; Orton, Matthew R.; D' Arcy, James A.; Leach, Martin O. [Cancer Research UK Cancer Imaging Centre at The Institute of Cancer Research, London (United Kingdom); Wallace, Toni; Koh, Dow-Mu [Royal Marsden Hospital, Department of Radiology, London, England (United Kingdom); Moreno, Lucas [The Institute of Cancer Research, Paediatric Drug Development Team, Divisions of Cancer Therapeutics and Clinical Studies, London (United Kingdom); Spanish National Cancer Research Centre (CNIO), Clinical Research Programme, Madrid (Spain); The Royal Marsden NHS Foundation Trust, Paediatric Drug Development Unit, Children and Young People' s Unit, Sutton (United Kingdom); Pearson, Andrew D.J.; Marshall, Lynley V.; Carceller, Fernando; Zacharoulis, Stergios [The Institute of Cancer Research, Paediatric Drug Development Team, Divisions of Cancer Therapeutics and Clinical Studies, London (United Kingdom); The Royal Marsden NHS Foundation Trust, Paediatric Drug Development Unit, Children and Young People' s Unit, Sutton (United Kingdom)

    2015-09-15

    The objectives are to examine the reproducibility of functional MR imaging in children with solid tumours using quantitative parameters derived from diffusion-weighted (DW-) and dynamic contrast enhanced (DCE-) MRI. Patients under 16-years-of age with confirmed diagnosis of solid tumours (n = 17) underwent free-breathing DW-MRI and DCE-MRI on a 1.5 T system, repeated 24 hours later. DW-MRI (6 b-values, 0-1000 sec/mm{sup 2}) enabled monoexponential apparent diffusion coefficient estimation using all (ADC{sub 0-1000}) and only ≥100 sec/mm{sup 2} (ADC{sub 100-1000}) b-values. DCE-MRI was used to derive the transfer constant (K{sup trans}), the efflux constant (k{sub ep}), the extracellular extravascular volume (v{sub e}), and the plasma fraction (v{sub p}), using a study cohort arterial input function (AIF) and the extended Tofts model. Initial area under the gadolinium enhancement curve and pre-contrast T{sub 1} were also calculated. Percentage coefficients of variation (CV) of all parameters were calculated. The most reproducible cohort parameters were ADC{sub 100-1000} (CV = 3.26 %), pre-contrast T{sub 1} (CV = 6.21 %), and K{sup trans} (CV = 15.23 %). The ADC{sub 100-1000} was more reproducible than ADC{sub 0-1000}, especially extracranially (CV = 2.40 % vs. 2.78 %). The AIF (n = 9) derived from this paediatric population exhibited sharper and earlier first-pass and recirculation peaks compared with the literature's adult population average. Free-breathing functional imaging protocols including DW-MRI and DCE-MRI are well-tolerated in children aged 6 - 15 with good to moderate measurement reproducibility. (orig.)

  16. Gadoxetate-enhanced versus diffusion-weighted MRI for fused Ga-68-DOTANOC PET/MRI in patients with neuroendocrine tumours of the upper abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Mayerhoefer, Marius E. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Medical University of Vienna/Vienna General Hospital, PET/CT Center, Departments of Radiology and Nuclear Medicine, Vienna (Austria); Ba-Ssalamah, Ahmed; Weber, Michael; Trattnig, Siegfried; Herneth, Andreas [Medical University of Vienna, Department of Radiology, Vienna (Austria); Mitterhauser, Markus; Eidherr, Harald; Wadsak, Wolfgang [Medical University of Vienna, Department of Nuclear Medicine, Radiochemistry and Biomarker Development Unit, Vienna (Austria); Raderer, Markus [Medical University of Vienna, Department of Internal Medicine I, Division of Oncology, Vienna (Austria); Karanikas, Georgios [Medical University of Vienna, Department of Nuclear Medicine, Vienna (Austria)

    2013-07-15

    To compare fused gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI (diffusion-weighted imaging) for the assessment of abdominal neuroendocrine tumours (NETs). Eighteen patients with suspected or histologically proven NETs of the abdomen were enrolled in this retrospective study. All patients underwent Ga-68-DOTANOC PET/CT for a primary search, staging, or restaging, and received an additional MRI, including dynamic gadoxetate-enhanced T1-weighted sequences and DWI (b-values 50, 300 and 600). Co-registered gadoxetate-enhanced PET/MRI and PET/DWI were separately analysed for NET lesions by a nuclear medicine physician and a radiologist in consensus. Sensitivity and specificity were calculated on a per-region, per-organ and per-patient basis. Eighty-seven out of 684 anatomical regions, and 23 out of 270 organs, were NET-positive in 14 out of 18 patients. Region-based sensitivities and specificities were 97.7 % and 99.7 % for gadoxetate-enhanced PET/MRI and 98.9 % and 99.7 % for PET/DWI. Organ-based sensitivities and specificities were 91.3 % and 99.6 % for gadoxetate-enhanced PET/MRI and 95.7 % and 99.6 % for PET/DWI. Finally, patient-based sensitivities and specificities were 100 % and 100 % for gadoxetate-enhanced PET/MRI and 100 % and 75 % for PET/DWI. Sensitivities and specificities of the two methods did not differ significantly. Gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI are equally useful for the assessment of abdominal NETs. (orig.)

  17. Demonstration of the reproducibility of free-breathing diffusion-weighted MRI and dynamic contrast enhanced MRI in children with solid tumours: a pilot study

    International Nuclear Information System (INIS)

    Miyazaki, Keiko; Jerome, Neil P.; Collins, David J.; Orton, Matthew R.; D'Arcy, James A.; Leach, Martin O.; Wallace, Toni; Koh, Dow-Mu; Moreno, Lucas; Pearson, Andrew D.J.; Marshall, Lynley V.; Carceller, Fernando; Zacharoulis, Stergios

    2015-01-01

    The objectives are to examine the reproducibility of functional MR imaging in children with solid tumours using quantitative parameters derived from diffusion-weighted (DW-) and dynamic contrast enhanced (DCE-) MRI. Patients under 16-years-of age with confirmed diagnosis of solid tumours (n = 17) underwent free-breathing DW-MRI and DCE-MRI on a 1.5 T system, repeated 24 hours later. DW-MRI (6 b-values, 0-1000 sec/mm 2 ) enabled monoexponential apparent diffusion coefficient estimation using all (ADC 0-1000 ) and only ≥100 sec/mm 2 (ADC 100-1000 ) b-values. DCE-MRI was used to derive the transfer constant (K trans ), the efflux constant (k ep ), the extracellular extravascular volume (v e ), and the plasma fraction (v p ), using a study cohort arterial input function (AIF) and the extended Tofts model. Initial area under the gadolinium enhancement curve and pre-contrast T 1 were also calculated. Percentage coefficients of variation (CV) of all parameters were calculated. The most reproducible cohort parameters were ADC 100-1000 (CV = 3.26 %), pre-contrast T 1 (CV = 6.21 %), and K trans (CV = 15.23 %). The ADC 100-1000 was more reproducible than ADC 0-1000 , especially extracranially (CV = 2.40 % vs. 2.78 %). The AIF (n = 9) derived from this paediatric population exhibited sharper and earlier first-pass and recirculation peaks compared with the literature's adult population average. Free-breathing functional imaging protocols including DW-MRI and DCE-MRI are well-tolerated in children aged 6 - 15 with good to moderate measurement reproducibility. (orig.)

  18. Diagnostic use of isotropic diffusion-weighted MRI in patients with ischaemic stroke: detection of the lesion responsible for the clinical deficit

    International Nuclear Information System (INIS)

    Kumon, Y.; Ohue, S.; Ohta, S.; Sakaki, S.; Zenke, K.; Kusunoki, K.; Oka, Y.; Sadamoto, K.

    1999-01-01

    We examined the diagnostic use of isotropic diffusion-weighted (DW) MRI in 140 consecutive patients suspected of or diagnosed as having an ischaemic stroke. Isotropic DW imaging could demonstrate the lesion responsible for the clinical deficit in patients with multiple cerebral infarts at an early stage, even small lesions without a perifocal oedema or mass effect. Accurate diagnosis by DW images may, however, be difficult about 2 weeks after the onset of stroke. (orig.)

  19. Role of diffusion-weighted MRI in the differential diagnosis of endometrioid and non-endometrioid cancer of the uterus.

    Science.gov (United States)

    Bakir, Vuslat Lale; Bakir, Baris; Sanli, Sükrü; Yildiz, Sevda Ozel; Iyibozkurt, Ahmet Cem; Kartal, Merve Gülbiz; Yavuz, Ekrem

    2017-06-01

    Background Many publications have examined the relationship between apparent diffusion coefficient (ADC) values and tumor grade in endometrial cancer. Nevertheless, none were designed to evaluate according to the histopathological type of endometrioid and non-endometrioid tumors. Purpose To evaluate the role of diffusion-weighted imaging (DWI) in the differential diagnosis of endometrioid and non-endometrioid cancer of the uterus, by comparing them with contrast-enhanced magnetic resonance imaging (MRI) findings. Material and Methods Institutional review board approval and informed consent were obtained. The MRI findings of 63 patients with endometrial cancer were retrospectively evaluated and divided into four groups: Grades I, II, and III endometrioid tumors, and non-endometrioid tumors. ADC values, DWI quotients ( b = 1000 s/mm 2 ), and post-contrast signal intensities between lesions and the myometrium (b1000q-Cq values) were evaluated. The one-way-ANOVA, student's t-test, Kruskal-Wallis test, and receiver operating characteristic (ROC) analysis were used for statistical evaluation. Results Mean ADC values were 0.86 ± 0.14 in Grade I, 0.80 ± 0.7 in Grade II, 0.71 ± 0.14 in Grade III for endometrioid tumors, and 0.70 ± 0.12 in non-endometrioid tumors. There was a significant difference in ADC values between Grade I and Grade III ( P = 0.006), and non-endometrioid tumors ( P = 0.003). The difference was also significant between Grades I + II and Grade III ( P = 0.009), and non-endometrioid tumors ( P = 0.004). Besides, there was a significant difference between endometrioid and non-endometrioid tumors ( P = 0.022). However, when considering b1000q (F = 0.640, P = 0.593) and Cq (χ 2  = 6.233; P = 0.101), no significant difference was detected among the groups. Conclusion The difference in ADC values between the endometrioid and non-endometrioid tumors was statistically significant. However, the

  20. Quantitative evaluation of brain involvement in ataxia telangiectasia by diffusion weighted MR imaging

    International Nuclear Information System (INIS)

    Firat, Ahmet Kemal; Karakas, Hakki Muammer; Firat, Yezdan; Yakinci, Cengiz

    2005-01-01

    Objective: To evaluate the value of diffusion weighted imaging (DWI) in diagnosing ataxia telangiectasia (AT) and to investigate the spatial distribution of cerebral microstructural changes caused by the disease. Methods: Six AT patients (9-13 years) and nine healthy control subjects were examined on 1.5 T scanner. In addition to conventional MR images, DWI were performed with a fat suppressed, multishot spin echo EPI sequence using B values of 0, 500 and 1000 s/mm 2 . Mean ADC values were measured from 16 different supra and infratentorial location. The difference between controls and AT patients regarding ADC values, and the accuracy, sensitivity and specificity of them in discrimination were analyzed with t-tests, logistic regression analysis, ANOVA and ROC curves. Results: Conventional images of the controls were normal. In AT patients, the only conventional MR abnormality was cerebellar atrophy. The difference between both groups regarding mean ADC values was not significant for any of the cerebral structures. In contrary to cerebrum, cerebellar mean ADC values of patients and controls were statistically different (p 2 /s) for middle cerebellar cortex had produced highest (100%) sensitivity and specificity. There was a difference between superior, middle and inferior cerebellar cortex regarding ADC values (p 2 /s) had higher ADC values than the middle and inferior cerebellar cortex. Conclusion: DWI provides a supplementary and objective imaging finding in AT. This finding is highly accurate in the radiological discrimination of healthy subjects and AT. Our findings also implicate that AT causes a diffuse atrophy and mostly affects superior part of the cortex

  1. Neural - levelset shape detection segmentation of brain tumors in dynamic susceptibility contrast enhanced and diffusion weighted magnetic resonance images

    International Nuclear Information System (INIS)

    Vijayakumar, C.; Bhargava, Sunil; Gharpure, Damayanti Chandrashekhar

    2008-01-01

    A novel Neuro - level set shape detection algorithm is proposed and evaluated for segmentation and grading of brain tumours. The algorithm evaluates vascular and cellular information provided by dynamic contrast susceptibility magnetic resonance images and apparent diffusion coefficient maps. The proposed neural shape detection algorithm is based on the levels at algorithm (shape detection algorithm) and utilizes a neural block to provide the speed image for the level set methods. In this study, two different architectures of level set method have been implemented and their results are compared. The results show that the proposed Neuro-shape detection performs better in differentiating the tumor, edema, necrosis in reconstructed images of perfusion and diffusion weighted magnetic resonance images. (author)

  2. Diffusion-weighted MRI of epithelial ovarian cancers: Correlation of apparent diffusion coefficient values with histologic grade and surgical stage

    International Nuclear Information System (INIS)

    Oh, Ji-Won; Rha, Sung Eun; Oh, Soon Nam; Park, Michael Yong; Byun, Jae Young; Lee, Ahwon

    2015-01-01

    Highlights: •The solid component of all invasive epithelial cancers showed high b 1000 signal intensity. •ADCs can predict the histologic grade of epithelial ovarian cancer. •ADCs correlate negatively to the surgical stage of epithelial ovarian cancer. •ADCs may be useful imaging biomarkers to assess epithelial ovarian cancer. -- Abstract: Objective: The purpose of this article is to correlate the apparent diffusion coefficient (ADC) values of epithelial ovarian cancers with histologic grade and surgical stage. Materials and methods: We enrolled 43 patients with pathologically proven epithelial ovarian cancers for this retrospective study. All patients underwent preoperative pelvic magnetic resonance imaging (MRI) including diffusion-weighted images with b value of 0 and 1000 s/mm 2 at 3.0-T unit. The mean ADC values of the solid portion of the tumor were measured and compared among different histologic grades and surgical stages. Results: The mean ADC values of epithelial ovarian cancers differed significantly between grade 1 (well-differentiated) and grade 2 (moderately-differentiated) (P = 0.013) as well as between grade 1 and grade 3 (poorly-differentiated) (P = 0.01); however, no statistically significant difference existed between grade 2 and grade 3 (P = 0.737). The receiver-operating characteristic analysis indicated that a cutoff ADC value of less than or equal to 1.09 × 10 −3 mm 2 /s was associated with 94.4% sensitivity and 85.7% specificity in distinguishing grade 1 and grade 2/3 cancer. The difference in mean ADC values was statistically significant for early stage (FIGO stage I) and advanced stage (FIGO stage II-IV) cancer (P = 0.011). The interobserver agreement for the mean ADC values of epithelial ovarian cancers was excellent. Conclusion: The mean ADC values of the solid portion of epithelial ovarian cancers negatively correlated to histologic grade and surgical stage. The mean ADC values may be useful imaging biomarkers for assessment

  3. Automated and Semiautomated Segmentation of Rectal Tumor Volumes on Diffusion-Weighted MRI: Can It Replace Manual Volumetry?

    Energy Technology Data Exchange (ETDEWEB)

    Heeswijk, Miriam M. van [Department of Radiology, Maastricht University Medical Centre, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Centre, Maastricht (Netherlands); Lambregts, Doenja M.J., E-mail: d.lambregts@nki.nl [Department of Radiology, Maastricht University Medical Centre, Maastricht (Netherlands); Department of Radiology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Griethuysen, Joost J.M. van [GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Department of Radiology, The Netherlands Cancer Institute, Amsterdam (Netherlands); Oei, Stanley [Department of Radiology, Maastricht University Medical Centre, Maastricht (Netherlands); Rao, Sheng-Xiang [Department of Radiology, Maastricht University Medical Centre, Maastricht (Netherlands); Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai (China); Graaff, Carla A.M. de [Department of Radiology, Maastricht University Medical Centre, Maastricht (Netherlands); Vliegen, Roy F.A. [Atrium Medical Centre Parkstad/Zuyderland Medical Centre, Heerlen (Netherlands); Beets, Geerard L. [GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Department of Surgery, The Netherlands Cancer Institute, Amsterdam (Netherlands); Papanikolaou, Nikos [Laboratory of Computational Medicine, Institute of Computer Science, FORTH, Heraklion, Crete (Greece); Beets-Tan, Regina G.H. [GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Department of Radiology, The Netherlands Cancer Institute, Amsterdam (Netherlands)

    2016-03-15

    Purpose: Diffusion-weighted imaging (DWI) tumor volumetry is promising for rectal cancer response assessment, but an important drawback is that manual per-slice tumor delineation can be highly time consuming. This study investigated whether manual DWI-volumetry can be reproduced using a (semi)automated segmentation approach. Methods and Materials: Seventy-nine patients underwent magnetic resonance imaging (MRI) that included DWI (highest b value [b1000 or b1100]) before and after chemoradiation therapy (CRT). Tumor volumes were assessed on b1000 (or b1100) DWI before and after CRT by means of (1) automated segmentation (by 2 inexperienced readers), (2) semiautomated segmentation (manual adjustment of the volumes obtained by method 1 by 2 radiologists), and (3) manual segmentation (by 2 radiologists); this last assessment served as the reference standard. Intraclass correlation coefficients (ICC) and Dice similarity indices (DSI) were calculated to evaluate agreement between different methods and observers. Measurement times (from a radiologist's perspective) were recorded for each method. Results: Tumor volumes were not significantly different among the 3 methods, either before or after CRT (P=.08 to .92). ICCs compared to manual segmentation were 0.80 to 0.91 and 0.53 to 0.66 before and after CRT, respectively, for the automated segmentation and 0.91 to 0.97 and 0.61 to 0.75, respectively, for the semiautomated method. Interobserver agreement (ICC) pre and post CRT was 0.82 and 0.59 for automated segmentation, 0.91 and 0.73 for semiautomated segmentation, and 0.91 and 0.75 for manual segmentation, respectively. Mean DSI between the automated and semiautomated method were 0.83 and 0.58 pre-CRT and post-CRT, respectively; DSI between the automated and manual segmentation were 0.68 and 0.42 and 0.70 and 0.41 between the semiautomated and manual segmentation, respectively. Median measurement time for the radiologists was 0 seconds (pre- and post-CRT) for the

  4. Automated and Semiautomated Segmentation of Rectal Tumor Volumes on Diffusion-Weighted MRI: Can It Replace Manual Volumetry?

    International Nuclear Information System (INIS)

    Heeswijk, Miriam M. van; Lambregts, Doenja M.J.; Griethuysen, Joost J.M. van; Oei, Stanley; Rao, Sheng-Xiang; Graaff, Carla A.M. de; Vliegen, Roy F.A.; Beets, Geerard L.; Papanikolaou, Nikos; Beets-Tan, Regina G.H.

    2016-01-01

    Purpose: Diffusion-weighted imaging (DWI) tumor volumetry is promising for rectal cancer response assessment, but an important drawback is that manual per-slice tumor delineation can be highly time consuming. This study investigated whether manual DWI-volumetry can be reproduced using a (semi)automated segmentation approach. Methods and Materials: Seventy-nine patients underwent magnetic resonance imaging (MRI) that included DWI (highest b value [b1000 or b1100]) before and after chemoradiation therapy (CRT). Tumor volumes were assessed on b1000 (or b1100) DWI before and after CRT by means of (1) automated segmentation (by 2 inexperienced readers), (2) semiautomated segmentation (manual adjustment of the volumes obtained by method 1 by 2 radiologists), and (3) manual segmentation (by 2 radiologists); this last assessment served as the reference standard. Intraclass correlation coefficients (ICC) and Dice similarity indices (DSI) were calculated to evaluate agreement between different methods and observers. Measurement times (from a radiologist's perspective) were recorded for each method. Results: Tumor volumes were not significantly different among the 3 methods, either before or after CRT (P=.08 to .92). ICCs compared to manual segmentation were 0.80 to 0.91 and 0.53 to 0.66 before and after CRT, respectively, for the automated segmentation and 0.91 to 0.97 and 0.61 to 0.75, respectively, for the semiautomated method. Interobserver agreement (ICC) pre and post CRT was 0.82 and 0.59 for automated segmentation, 0.91 and 0.73 for semiautomated segmentation, and 0.91 and 0.75 for manual segmentation, respectively. Mean DSI between the automated and semiautomated method were 0.83 and 0.58 pre-CRT and post-CRT, respectively; DSI between the automated and manual segmentation were 0.68 and 0.42 and 0.70 and 0.41 between the semiautomated and manual segmentation, respectively. Median measurement time for the radiologists was 0 seconds (pre- and post-CRT) for the

  5. Anterior mediastinal solid tumours in adults: characterisation using dynamic contrast-enhanced MRI, diffusion-weighted MRI, and FDG-PET/CT

    International Nuclear Information System (INIS)

    Yabuuchi, H.; Matsuo, Y.; Abe, K.; Baba, S.; Sunami, S.; Kamitani, T.; Yonezawa, M.; Yamasaki, Y.; Kawanami, S.; Nagao, M.; Okamoto, T.; Nakamura, K.; Yamamoto, H.; Sasaki, M.; Honda, H.

    2015-01-01

    Aim: To find significant parameters to characterise anterior mediastinal solid tumours in adults using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted MRI (DWI), and combined 2-[ 18 F]-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography (FDG-PET/CT). Materials and methods: Forty-eight histologically confirmed anterior mediastinal solid tumours in 48 patients (24 men, 24 women; age range 21–83 years, mean 50.7 years) were examined. The parameters analysed were maximal diameter, presence of capsule/septa on T2-weighted images, time–signal intensity curves (TICs), apparent diffusion coefficient (ADC), and maximum standardised uptake value (SUV max ). Also examined was whether any differences between histological types could be seen in these parameters. In a validation study, 42 anterior mediastinal solid tumours in 42 patients were examined consecutively. Results: The washout pattern on TIC was seen only in thymic epithelial tumours (20/32). SUV max of lymphoma (mean, 17.9), malignant germ cell tumours (14.2), and thymic carcinomas (15.6) were significantly higher than that of thymomas (6.1). The mean maximal diameter of thymic epithelial tumours was significantly smaller than that of lymphomas (p<0.01) and malignant germ cell tumours (p<0.05). The validation study also yielded high accuracy (38/42, 91%) in differentiation among the anterior mediastinal solid tumours. Conclusion: The SUV max , TIC pattern on DCE-MRI, and maximal diameter might be useful to differentiate anterior mediastinal solid tumours in adults. - Highlights: • The washout pattern on DCE-MRI was seen only in thymic epithelial tumors. • ADC was not a significant parameter to characterize anterior mediastinal solid tumors. • Combination of maximal diameter, SUVmax, and time-intensity curve pattern might be useful. • Preoperative accurate discrimination of anterior mediastinal solid tumors may avoid unnecessary thoracotomy.

  6. Three-dimensional reconstruction of brain surface anatomy: technique comparison between flash and diffusion-weighted imaging

    International Nuclear Information System (INIS)

    Sun Jianzhong; Wang Zhikang; Gong Xiangyang

    2006-01-01

    Objective: To compare two methods 3D flash and diffusion-weighted images (DWI) in reconstructing the brain surface anatomy, and to evaluate their displaying ability, advantages, limitations and clinical application. Methods: Thrity normal cases were prospectively examined with 3D flash sequence and echo-planar DWI. Three-dimensional images were acquired with volume-rendering on workstation. Brain surface structures were evaluated and scored by a group of doctors. Results: Main structures of brain surface were clearly displayed on three-dimensional images based on 3D flash sequence. Average scores were all above 2.50. For images based on DWI, precentral gyrus, postcentral gyrus, superior parietal lobule, superior frontal gyrus, precentral sulcus, central sulcus, postcentral sulcus, intraparietal sulcus and superior frontal sulcus were best shown with average scores between 2.60-2.75, However, supramarginal gyrus, angular gyrus, middle frontal gyrus, inferior frontal gyrus, superior temporal gyrus, lateral sulcus, inferior frontal sulcus could not be well shown, with average scores between 1.67-2.48. Middle temporal gyrus, inferior temporal gyrus, superior temporal sulcus and inferior temporal sulcus can only get scores from 0.88 to 1.27. Scores of images based on 3D flash were much higher than that based on DWI with distinct differentiations, P values were all below 0.01. Conclusion: Three-dimensional images based on 3D flash can really display brain surface structures. It is very useful for anatomic researches. Three-dimensional reconstruction of brain surface based on DWI is a worthy technique to display brain surface anatomy, especially for frontal and parietal structures. (authors)

  7. Central pontine myelinolysis with a hyperintense lesion in diffusion weighted MRI: overview by means of a case report

    International Nuclear Information System (INIS)

    Kuhn, J.; Bewermeyer, H.; Harzheim, A.

    2005-01-01

    Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with demyelination of other areas of the central nervous system (CNS). The etiology and pathogenesis of this disorder are still not fully understood. However, almost all cases of CPM are related to severe diseases or chronic alcoholism and occur in the setting of rapidly corrected serum hyponatremia and hypotonicity respectively. Depending on the involvement of other CNS structures, the clinical picture can vary considerably. Magnetic resonance imaging is the most sensitive investigation for the antemortem diagnosis of CPM, although the radiological findings lag behind and do not necessarily correlate with the clinical picture. Quite obviously diffusion-weighted imaging can be useful in the rapid diagnosis of CPM. This short review summarizes the current knowledge on the pathogenesis, clinical presentation, radiological findings, prognosis and therapeutic approaches of CPM. Characteristical clinical features and MR-findings including hyperintensity on diffusion-weighted images are illustrated by a typical case. (orig.)

  8. Incremental value of diffusion weighted and dynamic contrast enhanced MRI in the detection of locally recurrent prostate cancer after radiation treatment: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Akin, Oguz; Vargas, Hebert Alberto; Hricak, Hedvig [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Gultekin, David H. [Memorial Sloan-Kettering Cancer Center, Medical Physics, New York, NY (United States); Zheng, Junting; Moskowitz, Chaya [Memorial Sloan-Kettering Cancer Center, Epidemiology and Biostatistics, New York, NY (United States); Pei, Xin; Sperling, Dahlia; Zelefsky, Michael J. [Memorial Sloan-Kettering Cancer Center, Radiation Oncology, New York, NY (United States); Schwartz, Lawrence H. [Columbia University College of Physicians and Surgeons, Radiology, New York, NY (United States)

    2011-09-15

    To assess the incremental value of diffusion-weighted (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) to T2-weighted MRI (T2WI) in detecting locally recurrent prostate cancer after radiotherapy. Twenty-four patients (median age, 70 years) with a history of radiotherapy-treated prostate cancer underwent multi-parametric MRI (MP-MRI) and transrectal prostate biopsy. Two readers independently scored the likelihood of cancer on a 1-5 scale, using T2WI alone and then adding DW-MRI and DCE-MRI. Areas under receiver operating characteristic curves (AUCs) were estimated at the patient and prostate-side levels. The apparent diffusion coefficient (ADC) from DW-MRI and the K{sup trans}, k{sub ep}, v{sub e}, AUGC90 and AUGC180 from DCE-MRI were recorded. Biopsy was positive in 16/24 (67%) and negative in 8/24 (33%) patients. AUCs for readers 1 and 2 increased from 0.64 and 0.53 to 0.95 and 0.86 with MP-MRI, at the patient level, and from 0.73 and 0.66 to 0.90 and 0.79 with MP-MRI, at the prostate-side level (p values < 0.05). Biopsy-positive and biopsy-negative prostate sides differed significantly in median ADC [1.44 vs. 1.68 (x 10{sup -3} mm{sup 2}/s)], median K{sup trans} [1.07 vs. 0.34 (1/min)], and k{sub ep} [2.06 vs 1.0 (1/min)] (p values < 0.05). MP-MRI was significantly more accurate than T2WI alone in detecting locally recurrent prostate cancer after radiotherapy. (orig.)

  9. Incremental value of diffusion weighted and dynamic contrast enhanced MRI in the detection of locally recurrent prostate cancer after radiation treatment: preliminary results

    International Nuclear Information System (INIS)

    Akin, Oguz; Vargas, Hebert Alberto; Hricak, Hedvig; Gultekin, David H.; Zheng, Junting; Moskowitz, Chaya; Pei, Xin; Sperling, Dahlia; Zelefsky, Michael J.; Schwartz, Lawrence H.

    2011-01-01

    To assess the incremental value of diffusion-weighted (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) to T2-weighted MRI (T2WI) in detecting locally recurrent prostate cancer after radiotherapy. Twenty-four patients (median age, 70 years) with a history of radiotherapy-treated prostate cancer underwent multi-parametric MRI (MP-MRI) and transrectal prostate biopsy. Two readers independently scored the likelihood of cancer on a 1-5 scale, using T2WI alone and then adding DW-MRI and DCE-MRI. Areas under receiver operating characteristic curves (AUCs) were estimated at the patient and prostate-side levels. The apparent diffusion coefficient (ADC) from DW-MRI and the K trans , k ep , v e , AUGC90 and AUGC180 from DCE-MRI were recorded. Biopsy was positive in 16/24 (67%) and negative in 8/24 (33%) patients. AUCs for readers 1 and 2 increased from 0.64 and 0.53 to 0.95 and 0.86 with MP-MRI, at the patient level, and from 0.73 and 0.66 to 0.90 and 0.79 with MP-MRI, at the prostate-side level (p values -3 mm 2 /s)], median K trans [1.07 vs. 0.34 (1/min)], and k ep [2.06 vs 1.0 (1/min)] (p values < 0.05). MP-MRI was significantly more accurate than T2WI alone in detecting locally recurrent prostate cancer after radiotherapy. (orig.)

  10. Whole-Body MRI Virtual Autopsy Using Diffusion-weighted Imaging With Background Suppression (DWIBS) at 3 T in a Child Succumbing to Chordoma.

    Science.gov (United States)

    Andronikou, Savvas; Kemp, Marnie L; Meiring, Michelle

    2017-03-01

    We report the use of diffusion-weighted imaging with background suppression (DWIBS) in pediatric virtual magnetic resonance imaging (MRI) autopsy of a child who succumbed to chordoma. A 10-year-old girl who succumbed to relapse of a chordoma underwent whole-body virtual MRI autopsy 12 hours postmortem with short Tau inversion recovery (STIR) and DWIBS on 3 T, which demonstrated the primary mass, local and cardiac invasion, and metastatic disease to the thorax, abdomen, head/neck, and musculoskeletal system. Postmortem virtual MRI autopsy including DWIBS successfully demonstrated the transthoracic spread of chordoma and invasion of the heart, resulting in blood-borne metastases. Motion and respiratory artifact were not factors during virtual autopsy using DWIBS on 3 T, making ideal use of this technology.

  11. Detection of hepatocellular carcinoma in gadoxetic acid-enhanced MRI and diffusion-weighted MRI with respect to the severity of liver cirrhosis

    International Nuclear Information System (INIS)

    Kim, Ah Yeong; Kim, Young Kon; Lee, Min Woo; Park, Min Jung; Hwang, Jiyoung; Lee, Mi Hee; Lee, Jae Won

    2012-01-01

    Background As gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) have been widely used for the evaluation of hepatocellular carcinoma (HCC), it is clinically relevant to determine the diagnostic efficacy of gadoxetic acid-enhanced MRI and DWI for detection of HCCs with respect to the severity of liver cirrhosis. Purpose To compare the diagnostic accuracy and sensitivity of gadoxetic acid-enhanced MRI and DWI for detection of HCCs with respect to the severity of liver cirrhosis. Material and Methods A total of 189 patients with 240 HCCs (≤3.0 cm) (Child-Pugh A, 81 patients with 90 HCCs; Child-Pugh B, 65 patients with 85 HCCs; Child-Pugh C, 43 patients with 65 HCCs) underwent DWI and gadoxetic acid-enhanced MRI at 3.0 T. A gadoxetic acid set (dynamic and hepatobiliary phase plus T2-weighted image) and DWI set (DWI plus unenhanced MRIs) for each Child-Pugh class were analyzed independently by two observers for detecting HCCs using receiver-operating characteristic analysis. The diagnostic accuracy and sensitivity were calculated. Results There was a trend toward decreased diagnostic accuracy for gadoxetic acid and DWI set with respect to the severity of cirrhosis (Child-Pugh A [mean 0.974, 0.961], B [mean 0.904, 0.863], C [mean 0.779, 0.760]). For both observers, the sensitivities of both image sets were highest in Child-Pugh class A (mean 95.6%, 93.9%), followed by class B (mean 83.0%, 77.1%), and class C (mean 60.6%, 60.0%) (P < 0.05). Conclusion In HCC detection, the diagnostic accuracy and sensitivity for gadoxetic acid-enhanced MRI and DWI were highest in Child-Pugh class A, followed by Child-Pugh class B, and Child-Pugh class C, indicating a tendency toward decreased diagnostic capability with the severity of cirrhosis

  12. Diffusion-weighted imaging in the evaluation of watershed hypoxic-ischemic brain injury in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Liu, A.Y.; Zimmerman, R.A.; Haselgrove, J.C.; Bilaniuk, L.T.; Hunter, J.V. [Hospital of the Univ. of Pennsylvania (HUP), Philadelphia (United States). Dept. of Radiology

    2001-11-01

    The purpose of our study was to determine the usefulness of echo-planar diffusion-weighted imaging (EPDI) in the evaluation of watershed hypoxic-ischemic brain injury in pediatric patients. Eighteen patients ranging in age from 3 weeks to 12 years were evaluated for evidence of ischemic/infarction changes on conventional MR and EPDI. Included in the study group were five patients with sickle cell disease, four with congenital heart disease, four with hypotensive episodes with various etiologies, three with sepsis, and two with encephalitis or meningitis. Patients were examined 2 h to 6 days after the initial insult, with follow-up studies in four patients at 1 to 62 days after the initial examination. After conventional MR imaging (T1, FSE T2, and FLAIR), diffusion-weighted MR imaging was performed using high-speed, single-shot EP techniques with TR 6000, TE 144, matrix 96 x 128, FOV 23.3 x 31 and five b values of 0, 160, 360, 640, and 1,000 s/mm{sup 2}. EPDI demonstrated abnormally increased signal in watershed ischemic/infarction zones in all initial cases. Apparent diffusion coefficients (ADC) were obtained in 59 lesions. When compared with radiographically normal (on EPDI) contralateral brain parenchyma, 45 demonstrated a relatively decreased ADC, while eight had normal ({+-} 10 %) and six had increased ADC. In four cases, signal abnormalities on EPDI were not seen or exceeded that seen with conventional MR imaging. In the remaining cases, signal abnormalities were obvious on EPDI and more subtle on conventional MR imaging. Follow-up studies demonstrated resolution of abnormal EPDI signal with persistent abnormalities on conventional imaging in some cases, while others revealed an increase in size or number of EPDI signal abnormalities, suggesting ongoing acute ischemic/infarctive changes. EPDI is a rapid, sensitive technique for detecting watershed ischemic/infarction changes in pediatric patients with hypoperfusion episodes, at times before such changes are

  13. Correlation of human papillomavirus status with apparent diffusion coefficient of diffusion-weighted MRI in head and neck squamous cell carcinomas.

    Science.gov (United States)

    Driessen, Juliette P; van Bemmel, Alexander J M; van Kempen, Pauline M W; Janssen, Luuk M; Terhaard, Chris H J; Pameijer, Frank A; Willems, Stefan M; Stegeman, Inge; Grolman, Wilko; Philippens, Marielle E P

    2016-04-01

    Identification of prognostic patient characteristics in head and neck squamous cell carcinoma (HNSCC) is of great importance. Human papillomavirus (HPV)-positive HNSCCs have favorable response to (chemo)radiotherapy. Apparent diffusion coefficient, derived from diffusion-weighted MRI, has also shown to predict treatment response. The purpose of this study was to evaluate the correlation between HPV status and apparent diffusion coefficient. Seventy-three patients with histologically proven HNSCC were retrospectively analyzed. Mean pretreatment apparent diffusion coefficient was calculated by delineation of total tumor volume on diffusion-weighted MRI. HPV status was analyzed and correlated to apparent diffusion coefficient. Six HNSCCs were HPV-positive. HPV-positive HNSCC showed significantly lower apparent diffusion coefficient compared to HPV-negative. This correlation was independent of other patient characteristics. In HNSCC, positive HPV status correlates with low mean apparent diffusion coefficient. The favorable prognostic value of low pretreatment apparent diffusion coefficient might be partially attributed to patients with a positive HPV status. © 2015 Wiley Periodicals, Inc. Head Neck 38: E613-E618, 2016. © 2015 Wiley Periodicals, Inc.

  14. Technical Note: Diffusion-weighted MRI with minimal distortion in head-and-neck radiotherapy using a turbo spin echo acquisition method.

    Science.gov (United States)

    Schakel, Tim; Hoogduin, Johannes M; Terhaard, Chris H J; Philippens, Marielle E P

    2017-08-01

    Diffusion-weighted (DW) MRI, showing high contrast between tumor and background tissue, is a promising technique in radiotherapy for tumor delineation. However, its use for head-and-neck patients is hampered by poor geometric accuracy in conventional echo planar imaging (EPI) DW-MRI. An alternative turbo spin echo sequence, DW-SPLICE, is implemented and demonstrated in patients. The DW-SPLICE sequence was implemented on a 3.0 T system and evaluated in 10 patients. The patients were scanned in treatment position, using a customized head support and immobilization mask. Image distortions were quantified at the gross tumor volume (GTV) using field map analysis. The apparent diffusion coefficient (ADC) was evaluated using an ice water phantom. The DW images acquired by DW-SPLICE showed no image distortions. Field map analysis at the gross tumor volumes resulted in a median distortion of 0.2 mm for DW-SPLICE, whereas for the conventional method this was 7.2 mm. ADC values, measured using an ice water phantom were in accordance with literature values. The implementation of DW-SPLICE allows for diffusion-weighted imaging of patients in treatment position with excellent geometrical accuracy. The images can be used to facilitate target volume delineation in RT treatment planning. © 2017 The Authors. Medical Physics published by Wiley periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  15. Non-echoplanar diffusion-weighted MRI in children and adolescents with cholesteatoma: reliability and pitfalls in comparison to middle ear surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kalle, Thekla von [Olgahospital Klinikum Stuttgart, Pediatric Radiology, Radiologisches Institut, Stuttgart (Germany); Amrhein, Peter; Koitschev, Assen [Olgahospital Klinikum Stuttgart, Division of Pediatric Otorhinolaryngology and Otology, Department of Otorhinolaryngology, Stuttgart (Germany)

    2015-07-15

    Currently, there is only limited and contradictory evidence of the role of diffusion-weighted MRI (DW-MRI) in the management of children with cholesteatoma. To provide surgically controlled data that may allow to replace second-look surgery by non-echoplanar DW-MRI in children. Fifty-five children and adolescents with a median age of 8.6 years (2.2-17.7 years) underwent 61 preoperative half-Fourier acquisition single-shot turbo spin-echo (HASTE) DW-MRI of their petrous bone. Surgical interventions followed within 24 h (79%), within 5 months (20%) or at 18 months (1 case). Surgery detected a cholesteatoma or retraction pocket in 41 of 61 cases (67%). In 49 cases (80%), the MR result was confirmed by surgical findings. Two MR findings were false-positive and 10 false-negative (including cholesteatomas <4 mm). HASTE DW-MRI alone had a sensitivity of 76% and a specificity of 90%. The positive predictive value was 94%, the negative predictive value 64%. In combination with preoperative otoscopy, sensitivity was 90% and negative predictive value 82%. DW-MRI correctly detected the majority of lesions but could not reliably exclude small cholesteatomas and empty retraction pockets. We would therefore not generally recommend MR as a substitute for second-look surgery. (orig.)

  16. Detection of the index tumour and tumour volume in prostate cancer using T2-weighted and diffusion-weighted magnetic resonance imaging (MRI) alone.

    Science.gov (United States)

    Rud, Erik; Klotz, Dagmar; Rennesund, Kristin; Baco, Eduard; Berge, Viktor; Lien, Diep; Svindland, Aud; Lundeby, Eskild; Berg, Rolf E; Eri, Lars M; Eggesbø, Heidi B

    2014-12-01

    To examine the performance of T2-weighted (T2W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) for detecting the index tumour in patients with prostate cancer and to examine the agreement between MRI and histology when assessing tumour volume (TV) and overall tumour burden. The study included 199 consecutive patients with biopsy confirmed prostate cancer randomised to MRI before radical prostatectomy from December 2009 to July 2012. MRI-detected tumours (MRTs) were ranked from 1 to 3 according to decreasing volume and were compared with histologically detected tumours (HTs) ranked from 1 to 3, with HT 1 = index tumour. Whole-mount section histology was used as a reference standard. The TVs of true-positive MRTs (MRTVs 1-3) were compared with the TVs found by histology (HTVs 1-3). All tumours were registered on a 30-sector map and by classifying each sector as positive/negative, the rate of true-positive and -negative sectors was calculated. The detection rate for the HT 1 (index tumour) was 92%; HT 2, 45%; and HT 3, 37%. The MRTV 1-3 vs the HTV 1-3 were 2.8 mL vs 4.0 mL (index tumour, P MRI detects the index tumour in 92% of cases, although MRI underestimates both TV and tumour burden compared with histology. © 2014 The Authors. BJU International © 2014 BJU International.

  17. Influence of menopausal status on diagnostic accuracy of myometrial invasion in endometrial cancer: diffusion-weighted and dynamic contrast-enhanced MRI at 3 T

    International Nuclear Information System (INIS)

    Lin, G.; Huang, Y.-T.; Chao, A.; Ng, K.-K.; Yang, L.-Y.; Ng, S.-H.; Lai, C.-H.

    2015-01-01

    Aim: To assess the influence of menopausal status on the diagnostic accuracy of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for evaluating myometrial invasion in patients diagnosed with endometrial cancer. Materials and methods: In this prospective study, 91 consecutive female patients diagnosed with endometrial cancer were enrolled for preoperative evaluation using 3 T MRI. Two radiologists interpreted myometrial invasion depth on DW (b=1000 s/mm 2 ) and DCE MRI images, with surgical histopathology as the reference standard. Statistical methods included kappa statistics for evaluating reader agreement and diagnostic performance analysis between pre- and postmenopausal groups. Results: Reader agreement of DW MRI was poor (κ=0.20) for premenopausal patients. The diagnostic accuracy of DW MRI in detecting myometrial involvement was significantly lower in premenopausal compared with postmenopausal patients (0.42 versus 0.73, p=0.006). There was no difference in the diagnostic accuracy of DW MRI in detecting deep myometrial invasion between premenopausal and postmenopausal groups (0.94 versus 0.95, p>0.99). Conclusion: For premenopausal patients who plan to receive fertility-preserving treatment for endometrial cancer, DCE MRI is superior to DW MRI in excluding any possible myometrial invasion. For preoperative assessment of deep myometrial invasion, DW MRI can be a legitimate alternative to DCE MRI regardless of menopausal status and is particularly beneficial for patients at risk of nephrogenic systemic fibrosis. - Highlights: • Tumour ADC value is higher in premenopausal patients or with Type 1 cancer. • DWI can be an alternative to DCE for assessing deep myometrial invasion. • Caution should be made in assessing premenopausal patients by using DWI.

  18. MRI of perinatal brain injury

    Energy Technology Data Exchange (ETDEWEB)

    Rutherford, Mary; Allsop, Joanna [Imperial College, Robert Steiner MR Unit, Perinatal Imaging, MRC Clinical Sciences Centre, Hammersmith Hospital, London (United Kingdom); Martinez Biarge, Miriam [La Paz University Hospital, Dept of Neonatology, Madrid (Spain); Counsell, Serena [Imperial College, Robert Steiner MR Unit, Neonatal Medicine, MRC Clinical Sciences Centre, Hammersmith Hospital, London (United Kingdom); Cowan, Frances [Imperial College, Dept of Paediatrics, Hammersmith Hospital, London (United Kingdom)

    2010-06-15

    MRI is invaluable in assessing the neonatal brain following suspected perinatal injury. Good quality imaging requires adaptations to both the hardware and the sequences used for adults or older children. The perinatal and postnatal details often predict the pattern of lesions sustained and should be available to aid interpretation of the imaging findings. Perinatal lesions, the pattern of which can predict neurodevelopmental outcome, are at their most obvious on conventional imaging between 1 and 2 weeks from birth. Very early imaging during the first week may be useful to make management decisions in ventilated neonates but brain abnormalities may still be subtle using conventional sequences. Diffusion-weighted imaging (DWI) is very useful for the early identification of ischaemic tissue in the neonatal brain but may underestimate the final extent of injury, particularly basal ganglia and thalamic lesions. MR imaging is an excellent predictor of outcome following perinatal brain injury and can therefore be used as a biomarker in interventional trials designed to reduce injury and improve neurodevelopmental outcome. (orig.)

  19. MRI of perinatal brain injury

    International Nuclear Information System (INIS)

    Rutherford, Mary; Allsop, Joanna; Martinez Biarge, Miriam; Counsell, Serena; Cowan, Frances

    2010-01-01

    MRI is invaluable in assessing the neonatal brain following suspected perinatal injury. Good quality imaging requires adaptations to both the hardware and the sequences used for adults or older children. The perinatal and postnatal details often predict the pattern of lesions sustained and should be available to aid interpretation of the imaging findings. Perinatal lesions, the pattern of which can predict neurodevelopmental outcome, are at their most obvious on conventional imaging between 1 and 2 weeks from birth. Very early imaging during the first week may be useful to make management decisions in ventilated neonates but brain abnormalities may still be subtle using conventional sequences. Diffusion-weighted imaging (DWI) is very useful for the early identification of ischaemic tissue in the neonatal brain but may underestimate the final extent of injury, particularly basal ganglia and thalamic lesions. MR imaging is an excellent predictor of outcome following perinatal brain injury and can therefore be used as a biomarker in interventional trials designed to reduce injury and improve neurodevelopmental outcome. (orig.)

  20. 1H diffusion-weighted, 13C and 17O NMR spectroscopy: methodological developments to study brain structure and function in vivo

    International Nuclear Information System (INIS)

    Najac, Chloe

    2014-01-01

    Magnetic Resonance Spectroscopy is a unique tool that allows acquiring brain biochemical profiles and quantifying many cellular parameters in vivo. During this thesis, three different techniques have been developed: (i) 1 H diffusion-weighted, (ii) carbon-13 ( 13 C) and (iii) oxygen-17 ( 17 O) NMR spectroscopy to study brain structure and function in vivo. Brain metabolites are cell-specific endogenous tracers of the intracellular space whose translational diffusion depends on many cellular properties (e.g.: cytosol viscosity and intracellular restriction). Studying the variation of the diffusion coefficient (ADC) as a function of diffusion time (td) allows untangling and quantifying those parameters. In particular, measuring metabolites ADC at long diffusion times gives information about the metabolites compartmentation in cells. In a first study, we measured neuronal and astrocytic metabolites ADC over a large time window (from 80 ms to 1 s) in a large voxel in the macaque brain. No dependence of all metabolites ADC on td was observed suggesting that metabolites primarily diffuse in neuronal (dendrites and axons) and astrocytic processes and are not confined inside the cell body and organelles (nucleus, mitochondria). The large size of the voxel, due to low detection sensitivity, did not allow us to study metabolites compartmentation in pure white (WM) and grey matters (GM). Therefore, we performed a new study in the human brain. Results showed that in both WM and GM metabolites diffuse in fiber-like cell structure. Finally, using an even larger time window (up to 2 s) in the macaque brain and analytical models mimicking the cell structure, we estimated the length of neuronal (∼110 μm) and astrocytic (∼70 μm) processes. ATP (adenosine triphosphate), the main source of energy in the organism, is produced thanks to glucose oxidation inside the mitochondria. 13 C NMR spectroscopy is a well-known technique to study brain energy metabolism and can be used to

  1. Dynamic Contrast Magnetic Resonance Imaging (DCE-MRI and Diffusion Weighted MR Imaging (DWI for Differentiation between Benign and Malignant Salivary Gland Tumors

    Directory of Open Access Journals (Sweden)

    Assili S

    2012-12-01

    Full Text Available Background: Salivary gland tumors form nearly 3% of head and neck tumors. Due to their large histological variety and vicinity to facial nerves, pre-operative diagnosis and differentiation of benign and malignant parotid tumors are a major challenge for radiologists. Objective: The majority of these tumors are benign; however, sometimes they tend to transform into a malignant form. Functional MRI techniques, namely dynamic contrast enhanced (DCE- MRI and diffusion-weighted MRI (DWI can indicate the characteristics of tumor tissue. Methods: DCE-MRI analysis is based on the parameters of time intensity curve (TIC before and after contrast agent injection. This method has the potential to identify the angiogenesis of tumors. DWI analysis is performed according to diffusion of water molecules in a tissue for determination of the cellularity of tumors. Conclusion: According to the literature, these methods cannot be used individually to differentiate benign from malignant salivary gland tumors. An effective approach could be to combine the aforementioned methods to increase the accuracy of discrimination between different tumor types. The main objective of this study is to explore the application of DCE-MRI and DWI for assessment of salivary gland tumor types.

  2. Dynamic Contrast Magnetic Resonance Imaging (DCE-MRI) and Diffusion Weighted MR Imaging (DWI) for Differentiation between Benign and Malignant Salivary Gland Tumors.

    Science.gov (United States)

    Assili, S; Fathi Kazerooni, A; Aghaghazvini, L; Saligheh Rad, H R; Pirayesh Islamian, J

    2015-12-01

    Salivary gland tumors form nearly 3% of head and neck tumors. Due to their large histological variety and vicinity to facial nerves, pre-operative diagnosis and differentiation of benign and malignant parotid tumors are a major challenge for radiologists. The majority of these tumors are benign; however, sometimes they tend to transform into a malignant form. Functional MRI techniques, namely dynamic contrast enhanced (DCE-) MRI and diffusion-weighted MRI (DWI) can indicate the characteristics of tumor tissue. DCE-MRI analysis is based on the parameters of time intensity curve (TIC) before and after contrast agent injection. This method has the potential to identify the angiogenesis of tumors. DWI analysis is performed according to diffusion of water molecules in a tissue for determination of the cellularity of tumors. According to the literature, these methods cannot be used individually to differentiate benign from malignant salivary gland tumors. An effective approach could be to combine the aforementioned methods to increase the accuracy of discrimination between different tumor types. The main objective of this study is to explore the application of DCE-MRI and DWI for assessment of salivary gland tumor types.

  3. CT and MRI findings of Creutzfeldt-Jakob disease in the early stage. The usefulness of diffusion-weighted images

    International Nuclear Information System (INIS)

    Ukisu, Ryutaro; Kushihashi, Tamio; Gokan, Takehiko

    2001-01-01

    To detect subtle CT and MRI features of Creutzfeldt-Jacob disease (CJD) in the early stage is important to prevent a human-to-human transmission. This study included 10 patients of CJD who underwent CT and/or MRI in its early stage. CT, T1- and T2-weighted MRI, DWI, and FLAIR images were obtained in 10, 6, 4, and 2 patients respectively. On DWI, abnormal hyperintensities were observed in both cerebral cortex, and in basal ganglia in all patients. On FLAIR images, abnormal hyperintensies were observed in one patient. Detection of abnormal intensities may be possible in the early stage of CJD using MRI, particularly with DWI. (author)

  4. CT and MRI findings of Creutzfeldt-Jakob disease in the early stage. The usefulness of diffusion-weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Ukisu, Ryutaro; Kushihashi, Tamio; Gokan, Takehiko [Showa Univ., Tokyo (Japan). School of Medicine] [and others

    2001-02-01

    To detect subtle CT and MRI features of Creutzfeldt-Jacob disease (CJD) in the early stage is important to prevent a human-to-human transmission. This study included 10 patients of CJD who underwent CT and/or MRI in its early stage. CT, T1- and T2-weighted MRI, DWI, and FLAIR images were obtained in 10, 6, 4, and 2 patients respectively. On DWI, abnormal hyperintensities were observed in both cerebral cortex, and in basal ganglia in all patients. On FLAIR images, abnormal hyperintensies were observed in one patient. Detection of abnormal intensities may be possible in the early stage of CJD using MRI, particularly with DWI. (author)

  5. Multiparametric MRI With Dynamic Contrast Enhancement, Diffusion-Weighted Imaging, and 31-Phosphorus Spectroscopy at 7 T for Characterization of Breast Cancer.

    Science.gov (United States)

    Schmitz, Alexander M Th; Veldhuis, Wouter B; Menke-Pluijmers, Marian B E; van der Kemp, Wybe J M; van der Velden, Tijl A; Kock, Marc C J M; Westenend, Pieter J; Klomp, Dennis W J; Gilhuijs, Kenneth G A

    2015-11-01

    To describe and to correlate tumor characteristics on multiparametric 7 tesla (T) breast magnetic resonance imaging (MRI) with prognostic characteristics from postoperative histopathology in patients with breast cancer. Institutional review board approval and written informed consent of 15 women (46-70 years) with 17 malignant lesions were obtained. In this prospective study (March 2013 to March 2014), women were preoperatively scanned using dynamic contrast-enhanced MRI, diffusion-weighted imaging, and 31-phosphorus spectroscopy (¹³P-MRS). The value of the protocol was assessed to quantify tumor differentiation and proliferation. Dynamic contrast-enhanced MRI was assessed according to the American College of Radiology Breast Imaging Reporting and Data System-MRI lexicon. Apparent diffusion coefficients (ADCs) were calculated from diffusion-weighted imaging. On ¹³P-MRS, at the location of the tumor, the amount of phosphorus components was obtained in a localized spectrum. In this spectrum, the height of phosphodiester (PDE) and phosphomonoester (PME) peaks was assessed to serve as a measure for metabolic activity, stratifying tumors into a PDE > PME, PDE = PME, or PDE PME group. Tumor grade and mitotic count from resection specimen were compared with the MRI characteristics using explorative analyses. On dynamic contrast-enhanced MRI, the mean tumor size was 24 mm (range, 6-55 mm). An inverse trend was seen between ADC and tumor grade (P = 0.083), with mean ADC of 867 × 10⁻⁶ mm²/s for grade 1 (N = 4), 751 × 10⁻⁶ mm²/s for grade 2 (N = 6), and 659 × 10⁻⁶ mm²/s for grade 3 (N = 2) tumors. Between P-MR spectra and mitotic count, a relative increase of PME over PDE showed significant association with increasing mitotic counts (P = 0.02); a mean mitotic count of 6 was found in the PDE greater than PME group (N = 7), 8 in the PDE = PME group (N = 1), and 17 in the PDE PME group (N = 3). Multiparametric 7 T breast MRI is feasible in clinical setting

  6. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging of bone marrow in healthy individuals

    Energy Technology Data Exchange (ETDEWEB)

    Hillengass, Jens (Dept. of Radiology, German Cancer Research Center, Heidelberg (Germany); Dept. of Hematology, Oncology and Rheumatology, Univ. of Heidelberg (Germany)), e-mail: j.hillengass@dkfz.de; Stieltjes, Bram (Dept. of Radiology, German Cancer Research Center, Heidelberg (Germany)); Baeuerle, Tobias (Dept. of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany)) (and others)

    2011-04-15

    Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) displays microcirculation and permeability by application of contrast-media and diffusion-weighted imaging (DWI) is a tool for quantification of cellularity in the investigated area. Recently published examples cover breast cancer, CNS tumors, head and neck cancer, gastrointestinal cancer, prostate cancer as well as hematologic malignancies. Purpose: To investigated the influence of age, sex, and localization of the investigated region on findings of DCE-MRI and DWI. Material and Methods: DCE-MRI-parameters amplitude A and exchange rate constant kep as well as the DWI-parameter ADC of the bone marrow of the lumbar vertebral column of 30 healthy individuals covering the typical range of age of tumor patients were evaluated. ADC was calculated using b=0 and a maximal b value of either 400 or 750 s/mm2. Results: Amplitude A of DCE-MRI decreased with age (P = 0.01) and amplitude A, exchange rate constant kep as well as ADC based on b = 400 s/mm2 and b = 750 s/mm2, respectively, decreased significantly from the first to the fifth lumbar vertebra with P = 0.02, P = 0.05, P = 0.003, and P = 0.002, respectively. Conclusion: Quantitative parameters of functional imaging techniques in bone marrow are influenced by the age of the examined individual and the anatomical location of the investigated region

  7. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging of bone marrow in healthy individuals

    International Nuclear Information System (INIS)

    Hillengass, Jens; Stieltjes, Bram; Baeuerle, Tobias

    2011-01-01

    Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) displays microcirculation and permeability by application of contrast-media and diffusion-weighted imaging (DWI) is a tool for quantification of cellularity in the investigated area. Recently published examples cover breast cancer, CNS tumors, head and neck cancer, gastrointestinal cancer, prostate cancer as well as hematologic malignancies. Purpose: To investigated the influence of age, sex, and localization of the investigated region on findings of DCE-MRI and DWI. Material and Methods: DCE-MRI-parameters amplitude A and exchange rate constant kep as well as the DWI-parameter ADC of the bone marrow of the lumbar vertebral column of 30 healthy individuals covering the typical range of age of tumor patients were evaluated. ADC was calculated using b=0 and a maximal b value of either 400 or 750 s/mm2. Results: Amplitude A of DCE-MRI decreased with age (P = 0.01) and amplitude A, exchange rate constant kep as well as ADC based on b = 400 s/mm 2 and b = 750 s/mm 2 , respectively, decreased significantly from the first to the fifth lumbar vertebra with P = 0.02, P = 0.05, P = 0.003, and P = 0.002, respectively. Conclusion: Quantitative parameters of functional imaging techniques in bone marrow are influenced by the age of the examined individual and the anatomical location of the investigated region

  8. Diffusion-Weighted MRI in Creutzfeldt-Jakob Disease: Focus on the Cerebral Cortex and Chronologic Change

    International Nuclear Information System (INIS)

    Lee, Jeong Eun; Song, Chang Joon; Lee, In Ho; Yu, In Kyu; Choi, See Sung

    2010-01-01

    To evaluate high cortical signal intensity and chronologic changes for diffusion-weighted MR imaging (DWI) in sporadic Creutzfeldt-Jakob disease. We retrospectively analyzed the DWI results of 16 patients with probable CJD (according to WHO criteria) and evaluated the distribution, extent and bilaterality of the lesions in the cortex, basal ganglia and thalamus. We also reviewed the chronologic changes of the lesions by evaluating the followup MR examination results in 8 of 16 patients. Cortical abnormalities were present in 15 (94%) of 16 patients. Isolated cortical involvement was present in 6 patients (40%), while the combined involvement of the cortex and basal ganglia was present in 9 patients (60%). The distribution of the lesions was bilateral in 12 patients and predominantly on the right side in 8 patients. Upon follow-up MR imaging, the cortical lesions showed progress in terms of extent and signal intensity. Basal ganglia abnormalities were present in 9 of 15 patients. Moreover, 4 of 6 patients who had no abnormal signal intensity in the basal ganglia on the initial MR imaging results, showed abnormally high signal intensity upon follow-up MR imaging. The characteristically high cortical signal intensities on DWI in an elderly patient with rapidly progressive dementia should point to the diagnosis of early phase CJD and might be useful for the differential diagnosis

  9. Diffusion-Weighted MRI in Creutzfeldt-Jakob Disease: Focus on the Cerebral Cortex and Chronologic Change

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Eun; Song, Chang Joon; Lee, In Ho [Chungnam National University, Daejeon (Korea, Republic of); Yu, In Kyu [Eulji University Hospital, Seoul (Korea, Republic of); Choi, See Sung [Wonkwang University Hospital, Iksan (Korea, Republic of)

    2010-08-15

    To evaluate high cortical signal intensity and chronologic changes for diffusion-weighted MR imaging (DWI) in sporadic Creutzfeldt-Jakob disease. We retrospectively analyzed the DWI results of 16 patients with probable CJD (according to WHO criteria) and evaluated the distribution, extent and bilaterality of the lesions in the cortex, basal ganglia and thalamus. We also reviewed the chronologic changes of the lesions by evaluating the followup MR examination results in 8 of 16 patients. Cortical abnormalities were present in 15 (94%) of 16 patients. Isolated cortical involvement was present in 6 patients (40%), while the combined involvement of the cortex and basal ganglia was present in 9 patients (60%). The distribution of the lesions was bilateral in 12 patients and predominantly on the right side in 8 patients. Upon follow-up MR imaging, the cortical lesions showed progress in terms of extent and signal intensity. Basal ganglia abnormalities were present in 9 of 15 patients. Moreover, 4 of 6 patients who had no abnormal signal intensity in the basal ganglia on the initial MR imaging results, showed abnormally high signal intensity upon follow-up MR imaging. The characteristically high cortical signal intensities on DWI in an elderly patient with rapidly progressive dementia should point to the diagnosis of early phase CJD and might be useful for the differential diagnosis.

  10. [Examination of upper abdominal region in high spatial resolution diffusion-weighted imaging using 3-Tesla MRI].

    Science.gov (United States)

    Terada, Masaki; Matsushita, Hiroki; Oosugi, Masanori; Inoue, Kazuyasu; Yaegashi, Taku; Anma, Takeshi

    2009-03-20

    The advantage of the higher signal-to-noise ratio (SNR) of 3-Tesla magnetic resonance imaging (3-Tesla) has the possibility of contributing to the improvement of high spatial resolution without causing image deterioration. In this study, we compared SNR and the apparent diffusion coefficient (ADC) value with 3-Tesla as the condition in the diffusion-weighted image (DWI) parameter of the 1.5-Tesla magnetic resonance imaging (1.5-Tesla) and we examined the high spatial resolution images in the imaging method [respiratory-triggering (RT) method and breath free (BF) method] and artifact (motion and zebra) in the upper abdominal region of DWI at 3-Tesla. We have optimized scan parameters based on phantom and in vivo study. As a result, 3-Tesla was able to obtain about 1.5 times SNR in comparison with the 1.5-Tesla, ADC value had few differences. Moreover, the RT method was effective in correcting the influence of respiratory movement in comparison with the BF method, and image improvement by the effective acquisition of SNR and reduction of the artifact were provided. Thus, DWI of upper abdominal region was a useful sequence for the high spatial resolution in 3-Tesla.

  11. Task-based evaluation of segmentation algorithms for diffusion-weighted MRI without using a gold standard.

    Science.gov (United States)

    Jha, Abhinav K; Kupinski, Matthew A; Rodríguez, Jeffrey J; Stephen, Renu M; Stopeck, Alison T

    2012-07-07

    In many studies, the estimation of the apparent diffusion coefficient (ADC) of lesions in visceral organs in diffusion-weighted (DW) magnetic resonance images requires an accurate lesion-segmentation algorithm. To evaluate these lesion-segmentation algorithms, region-overlap measures are used currently. However, the end task from the DW images is accurate ADC estimation, and the region-overlap measures do not evaluate the segmentation algorithms on this task. Moreover, these measures rely on the existence of gold-standard segmentation of the lesion, which is typically unavailable. In this paper, we study the problem of task-based evaluation of segmentation algorithms in DW imaging in the absence of a gold standard. We first show that using manual segmentations instead of gold-standard segmentations for this task-based evaluation is unreliable. We then propose a method to compare the segmentation algorithms that does not require gold-standard or manual segmentation results. The no-gold-standard method estimates the bias and the variance of the error between the true ADC values and the ADC values estimated using the automated segmentation algorithm. The method can be used to rank the segmentation algorithms on the basis of both the ensemble mean square error and precision. We also propose consistency checks for this evaluation technique.

  12. High spatial resolution diffusion weighted imaging on clinical 3 T MRI scanners using multislab spiral acquisitions.

    Science.gov (United States)

    Holtrop, Joseph L; Sutton, Bradley P

    2016-04-01

    A diffusion weighted imaging (DWI) approach that is signal-to-noise ratio (SNR) efficient and can be applied to achieve sub-mm resolutions on clinical 3 T systems was developed. The sequence combined a multislab, multishot pulsed gradient spin echo diffusion scheme with spiral readouts for imaging data and navigators. Long data readouts were used to keep the number of shots, and hence total imaging time, for the three-dimensional acquisition short. Image quality was maintained by incorporating a field-inhomogeneity-corrected image reconstruction to remove distortions associated with long data readouts. Additionally, multiple shots were required for the high-resolution images, necessitating motion induced phase correction through the use of efficiently integrated navigator data. The proposed approach is compared with two-dimensional (2-D) acquisitions that use either a spiral or a typical echo-planar imaging (EPI) acquisition to demonstrate the improved SNR efficiency. The proposed technique provided 71% higher SNR efficiency than the standard 2-D EPI approach. The adaptability of the technique to achieve high spatial resolutions is demonstrated by acquiring diffusion tensor imaging data sets with isotropic resolutions of 1.25 and 0.8 mm. The proposed approach allows for SNR-efficient sub-mm acquisitions of DWI data on clinical 3 T systems.

  13. Tumor spatial heterogeneity in myxoid-containing soft tissue using texture analysis of diffusion-weighted MRI.

    Directory of Open Access Journals (Sweden)

    Hyun Su Kim

    Full Text Available The objective of this study was to examine the tumor spatial heterogeneity in myxoid-containing soft-tissue tumors (STTs using texture analysis of diffusion-weighted imaging (DWI. A total of 40 patients with myxoid-containing STTs (23 benign and 17 malignant were included in this study. The region of interest (ROI was manually drawn on the apparent diffusion coefficient (ADC map. For texture analysis, the global (mean, standard deviation, skewness, and kurtosis, regional (intensity variability and size-zone variability, and local features (energy, entropy, correlation, contrast, homogeneity, variance, and maximum probability were extracted from the ADC map. Student's t-test was used to test the difference between group means. Analysis of covariance (ANCOVA was performed with adjustments for age, sex, and tumor volume. The receiver operating characteristic (ROC analysis was performed to compare diagnostic performances. Malignant myxoid-containing STTs had significantly higher kurtosis (P = 0.040, energy (P = 0.034, correlation (P<0.001, and homogeneity (P = 0.003, but significantly lower contrast (P<0.001 and variance (P = 0.001 compared with benign myxoid-containing STTs. Contrast showed the highest area under the curve (AUC = 0.923, P<0.001, sensitivity (94.12%, and specificity (86.96%. Our results reveal the potential utility of texture analysis of ADC maps for differentiating benign and malignant myxoid-containing STTs.

  14. Serial diffusion-weighted MRI correlates with clinical course and treatment response in children with intracranial pus collections

    International Nuclear Information System (INIS)

    Fanning, Noel F.; Laffan, Eoghan E.; Shroff, Manohar M.

    2006-01-01

    Accurate assessment of treatment response in children with intracranial pus collections is vital to guide appropriate therapy and reduce morbidity and mortality. To correlate serial MR-measurable changes in diffusion-weighted imaging (DWI) with clinical response to treatment. We retrospectively reviewed clinical notes, conventional MR sequences and DWI in eight children with intracranial pus collections. Trace DWI signal intensity and apparent diffusion coefficient (ADC) values were compared at three time points: at initial diagnosis (eight children, 13 collections), at follow-up during continued clinical infection (three children, sp collections), and at follow-up when clinical infection had resolved (seven children, 12 collections). At initial diagnosis all patients were septic and collections showed restricted diffusion (mean ADC 0.61±0.15 x 10 -3 mm 2 /s). Patients with persistent clinical sepsis at follow-up DWI had collections with persistent low ADC values (0.66±0.21 x 10 -3 mm 2 /s), significantly (P -3 mm 2 /s, P<0.01) compared both to patients with signs of continued sepsis and to normal gray matter values. Persistent restricted diffusion in pus collections correlates with continued sepsis. Treatment response is associated with clinical resolution of sepsis and ADC value elevation significantly above normal gray matter values. (orig.)

  15. MRI of 'brain death'

    International Nuclear Information System (INIS)

    Nishino, Shigeki; Itoh, Takahiko; Tuchida, Shohei; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira; Sanou, Kazuo.

    1990-01-01

    Magnetic resonance imaging (MRI) was undertaken for two patients who suffered from severe cerebrovascular diseases and were clinically brain dead. The MRI system we used was Resona (Yokogawa Medical Systems, superconductive system 0.5 T) and the CT apparatus was Toshiba TCT-300. Initial CT and MRI were undertaken as soon as possible after admission, and repeated sequentially. After diagnosis of brain death, we performed angiography to determine cerebral circulatory arrest, and MRI obtained at the same time was compared with the angiogram and CT. Case 1 was a 77-year-old man who was admitted in an unconscious state. CT and MRI on the second day after hospitalization revealed cerebellar infarction. He was diagnosed as brain dead on day 4. Case 2 was a 35-year-old man. When he was transferred to our hospital, he was in cardiorespiratory arrested. Cardiac resuscitation was successful but no spontaneous respiration appeared. CT and MRI on admission revealed right intracerebral hemorrhage. Angiography revealed cessation of contrast medium in intracranial vessels in both of the patients. We found no 'flow signal void sign' in the bilateral internal carotid and basilar arteries on MRI images in both cases after brain death. MRI, showing us the anatomical changes of the brain, clearly revealed brain herniations, even though only nuclear findings of 'brain tamponade' were seen on CT. But in Case 1, we could not see the infarct lesions in the cerebellum on MR images obtained after brain death. This phenomenon was caused by the whole brain ischemia masking the initial ischemic lesions. We concluded that MRI was useful not only the anatomical display of lesions and brain herniation with high contrast resolution but for obtaining information on cerebral circulation of brain death. (author)

  16. Role of dynamic contrast-enhanced and diffusion weighted MRI in evaluation of hepatocellular carcinoma after chemoembolization

    Directory of Open Access Journals (Sweden)

    Ahmed Ebraheem Ebeed

    2017-12-01

    Conclusion: Dynamic and diffusion MRI complete each other in assessment of HCC response to therapy, especially in those who cannot properly hold their breath that cause degradation of the dynamic MR quality.

  17. Selected clinically established and scientific techniques of diffusion-weighted MRI. In the context of imaging in oncology; Ausgewaehlte klinisch etablierte und wissenschaftliche Techniken der diffusionsgewichteten MRT. Im Kontext der onkologischen Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Freitag, M.T.; Bickelhaupt, S.; Ziener, C.; Mosebach, J.; Schlemmer, H.P. [Deutsches Krebsforschungszentrum, Abteilung fuer Radiologie, Heidelberg (Germany); Meier-Hein, K. [Deutsches Krebsforschungszentrum, Abteilung fuer medizinische Informatik, Heidelberg (Germany); Radtke, J.P. [Deutsches Krebsforschungszentrum, Abteilung fuer Radiologie, Heidelberg (Germany); Universitaetsklinik Heidelberg, Abteilung fuer Urologie, Heidelberg (Germany); Kuder, T.A.; Laun, F.B. [Deutsches Krebsforschungszentrum, Abteilung fuer Medizinische Physik in der Radiologie, Heidelberg (Germany)

    2016-02-15

    Diffusion-weighted imaging (DWI) is a magnetic resonance imaging (MRI) technique that was established in the clinical routine primarily for the detection of brain ischemia. In the past 15 years its clinical use has been extended to oncological radiology, as tumor and metastases can be depicted in DWI due to their hypercellular nature. The basis of DWI is the Stejskal-Tanner experiment. The diffusion properties of tissue can be visualized after acquisition of at least two diffusion-weighted series using echo planar imaging and a specific sequence of gradient pulses. The use of DWI in prostate MRI was reported to be one of the first established applications that found its way into internationally recognized clinical guidelines of the European Society of Urological Radiology (ESUR) and the prostate imaging reporting and data system (PI-RADS) scale. Due to recently reported high specificity and negative predictive values of 94 % and 92 %, respectively, its regular use for breast MRI is expected in the near future. Furthermore, DWI can also reliably be used for whole-body imaging in patients with multiple myeloma or for measuring the extent of bone metastases. New techniques in DWI, such as intravoxel incoherent motion imaging, diffusion kurtosis imaging and histogram-based analyses represent promising approaches to achieve a more quantitative evaluation for tumor detection and therapy response. (orig.) [German] Die diffusionsgewichtete Bildgebung (''diffusion-weighted imaging'', DWI), ein Verfahren aus der Magnetresonanztomographie (MRT), wurde in der klinischen Routine primaer fuer die Detektion von Schlaganfaellen etabliert. Der Einsatz dieser Methode hat in den letzten 15 Jahren auch fuer die onkologische Diagnostik stark zugenommen, da Tumoren und Metastasen aufgrund ihrer hochzellulaeren Zusammensetzung in der DWI sehr gut sichtbar gemacht werden koennen. Basis der diffusionsgewichteten Bildgebung ist das Experiment nach Stejskal-Tanner. Hier

  18. Diffusion-weighted MRI of the Prostate: Advantages of Zoomed EPI with Parallel-transmit-accelerated 2D-selective Excitation Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Thierfelder, Kolja M.; Scherr, Michael K.; Weiss, Jakob; Mueller-Lisse, Ullrich G.; Theisen, Daniel [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Notohamiprodjo, Mike; Nikolaou, Konstantin [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); University Hospital Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Dietrich, Olaf [Ludwig-Maximilians-University Hospital Munich, Josef Lissner Laboratory for Biomedical Imaging, Institute for Clinical Radiology, Munich (Germany); Pfeuffer, Josef [Siemens Healthcare, Application Development, Erlangen (Germany)

    2014-12-15

    The purpose of our study was to evaluate the use of 2D-selective, parallel-transmit excitation magnetic resonance imaging (MRI) for diffusion-weighted echo-planar imaging (pTX-EPI) of the prostate, and to compare it to conventional, single-shot EPI (c-EPI). The MRI examinations of 35 patients were evaluated in this prospective study. PTX-EPI was performed with a TX-acceleration factor of 1.7 and a field of view (FOV) of 150 x 90 mm{sup 2}, whereas c-EPI used a full FOV of 380 x 297 mm{sup 2}. Two readers evaluated three different aspects of image quality on 5-point Likert scales. To quantify distortion artefacts, maximum diameters and prostate volume were determined for both techniques and compared to T2-weighted imaging. The zoomed pTX-EPI was superior to c-EPI with respect to overall image quality (3.39 ± 0.62 vs 2.45 ± 0.67) and anatomic differentiability (3.29 ± 0.65 vs 2.41 ± 0.65), each with p < 0.0001. Artefacts were significantly less severe in pTX-EPI (0.93 ± 0.73 vs 1.49 ± 1.08), p < 0.001. The quantitative analysis yielded a higher agreement of pTX-EPI with T2-weighted imaging than c-EPI with respect to coronal (ICCs: 0.95 vs 0.93) and sagittal (0.86 vs 0.73) diameters as well as prostate volume (0.94 vs 0.92). Apparent diffusion coefficient (ADC) values did not differ significantly between the two techniques (p > 0.05). Zoomed pTX-EPI leads to substantial improvements in diffusion-weighted imaging (DWI) of the prostate with respect to different aspects of image quality and severity of artefacts. (orig.)

  19. Evaluation of MR spectroscopy and diffusion-weighted MRI in detecting bone marrow changes in postmenopausal women with osteoporosis

    Energy Technology Data Exchange (ETDEWEB)

    Tang, G.Y., E-mail: tgy17@126.co [Department of Radiology, Affiliated Tenth People' s Hospital of Tongji University, Shanghai 200072 (China); Lv, Z.W.; Tang, R.B.; Liu, Y.; Peng, Y.F.; Li, W.; Cheng, Y.S. [Department of Radiology, Affiliated Tenth People' s Hospital of Tongji University, Shanghai 200072 (China)

    2010-05-15

    Aim: To prospectively investigate the role of MR spectroscopy (MRS) and diffusion-weighted magnetic resonance imaging (DWI) in assessing vertebral marrow changes in postmenopausal women with osteoporosis. Materials and methods: Seventy-eight postmenopausal women (mean age 63.7 +- 3.5 years; range 55-81 years), who underwent dual-energy x-ray absorptiometry of the spine, were divided into three bone density groups (24 with normal, 25 with osteopaenic, and 29 with osteoporotic) based on T score. Both MRS and DWI of the L3 vertebral body were performed to calculate the marrow fat content and apparent diffusion coefficient (ADC). The results were compared between three groups and correlated with BMD. Results: Vertebral marrow fat content was significantly increased in the osteoporotic group (59.97 +- 5.78%), when compared with that of the osteopaenic group (53.04 +- 7.66%, p = 0.001) and the normal bone density group (48.79 +- 7.1%, p < 0.001). ADC values in the osteoporotic, osteopaenic, and normal bone density groups were 0.39 +- 0.02 x 10{sup -3} mm{sup 2}/s, 0.41 +- 0.02 x 10{sup -3} mm{sup 2}/s, and 0.47 +- 0.03 x 10{sup -3} mm{sup 2}/s, respectively, with statistically significant difference (P < 0.001). A statistically significant positive correlation between T scores and ADC existed (r = 0.835, p < 0.001). The vertebral marrow fat content was negatively correlated to the bone density (r = -0.639, p < 0.001) and to marrow ADC (r = -0.554, p < 0.001). Conclusion: The postmenopausal women with osteoporosis exhibited a corresponding increase in vertebral marrow fat content as the bone density decreased. Marrow fat content and ADC were related to the bone density. MRS and DWI are helpful in evaluating the bone marrow changes in postmenopausal women.

  20. Diffusion measurement of intraplaque hemorrhage and intramural hematoma using diffusion weighted MRI at 3T in cervical artery

    International Nuclear Information System (INIS)

    Yao, Bin; Yang, Li; Wang, Guangbin; Shi, Honglu; Wang, Shanshan; Li, Huihua; Chen, Weibo; Chan, Queenie

    2016-01-01

    To assess the difference between carotid haemorrhagic plaque and non-haemorrhagic plaque by using diffusion-weighted imaging (DWI) and to evaluate carotid intraplaque haemorrhage (IPH) and intramural hematoma (IMH) of cervical artery dissection with apparent diffusion coefficient (ADC) measurement. Fifty-one symptomatic patients underwent 3.0-T carotid MR imaging, including conventional sequences, three-dimensional (3D) magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequence, and DWI. Thirty-nine patients with carotid plaque and eight patients with IMH of cervical artery dissection were finally included. The groups of hemorrhagic plaque, non-hemorrhagic plaque and IMH were divided according to 3D MPRAGE sequence. ADC values of different groups were measured, and t tests were performed. The mean ADC values of hemorrhagic plaques, non-hemorrhagic plaque and IMH were (1.284 ± 0.327) x 10 -3 mm 2 /s, (1.766 ± 0.477) x 10 -3 mm 2 /s, and (0.563 ± 0.119) x 10 -3 mm 2 /s, respectively. The mean ADC values of hemorrhagic and non-hemorrhagic regions in the hemorrhagic plaque group were (0.985 ± 0.376) x 10 -3 mm 2 /s and (1.480 ± 0.465) x 10 -3 mm 2 /s, respectively. The differences between the hemorrhagic plaque and non-hemorrhagic plaque, hemorrhagic region and non-hemorrhagic region in hemorrhagic plaque, and the hemorrhagic region in the hemorrhagic plaque and IMH of artery dissection were significant (P < 0.05). DWI may be a useful complement to conventional MR imaging for identifying haemorrhage of carotid plaques and differentiate IMHs from IPH. (orig.)

  1. Diffusion measurement of intraplaque hemorrhage and intramural hematoma using diffusion weighted MRI at 3T in cervical artery

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Bin [The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi (China); Yang, Li [Fudan University, Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Shanghai (China); Wang, Guangbin; Shi, Honglu; Wang, Shanshan; Li, Huihua [Shandong University, Shandong Medical Imaging Research Institute, Jinan, Shandong (China); Chen, Weibo; Chan, Queenie [Philips Healthcare, Shanghai (China)

    2016-10-15

    To assess the difference between carotid haemorrhagic plaque and non-haemorrhagic plaque by using diffusion-weighted imaging (DWI) and to evaluate carotid intraplaque haemorrhage (IPH) and intramural hematoma (IMH) of cervical artery dissection with apparent diffusion coefficient (ADC) measurement. Fifty-one symptomatic patients underwent 3.0-T carotid MR imaging, including conventional sequences, three-dimensional (3D) magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequence, and DWI. Thirty-nine patients with carotid plaque and eight patients with IMH of cervical artery dissection were finally included. The groups of hemorrhagic plaque, non-hemorrhagic plaque and IMH were divided according to 3D MPRAGE sequence. ADC values of different groups were measured, and t tests were performed. The mean ADC values of hemorrhagic plaques, non-hemorrhagic plaque and IMH were (1.284 ± 0.327) x 10{sup -3}mm{sup 2}/s, (1.766 ± 0.477) x 10{sup -3}mm{sup 2}/s, and (0.563 ± 0.119) x 10{sup -3}mm{sup 2}/s, respectively. The mean ADC values of hemorrhagic and non-hemorrhagic regions in the hemorrhagic plaque group were (0.985 ± 0.376) x 10{sup -3}mm{sup 2}/s and (1.480 ± 0.465) x 10{sup -3}mm{sup 2}/s, respectively. The differences between the hemorrhagic plaque and non-hemorrhagic plaque, hemorrhagic region and non-hemorrhagic region in hemorrhagic plaque, and the hemorrhagic region in the hemorrhagic plaque and IMH of artery dissection were significant (P < 0.05). DWI may be a useful complement to conventional MR imaging for identifying haemorrhage of carotid plaques and differentiate IMHs from IPH. (orig.)

  2. Minimal hepatic encephalopathy in children with liver cirrhosis: diffusion-weighted MR imaging and proton MR spectroscopy of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Abdel Razek, Ahmed Abdel Khalek; Ezzat, Amany [Mansoura University Hospital, Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura (Egypt); Abdalla, Ahmed; Megahed, Ahmed; Barakat, Tarek [Mansoura Children Hospital, Gastroenterology and Hepatology Unit, Mansoura Faculty of Medicine, Mansoura (Egypt)

    2014-10-15

    The aim of this work was to detect minimal hepatic encephalopathy (minHE) in children with diffusion-weighted MR imaging (DWI) and proton magnetic resonance spectroscopy ({sup 1}H-MRS) of the brain. Prospective study conducted upon 30 consecutive children (age range 6-16 years, 21 boys and 9 girls) with liver cirrhosis and 15 age- and sex-matched healthy control children. Patients with minHE (n = 17) and with no minHE (n = 13) groups and control group underwent DWI, {sup 1}H-MRS, and neuropsychological tests (NPTs). The glutamate or glutamine (Glx), myoinositol (mI), choline (Cho), and creatine (Cr) at the right ganglionic region were determined at {sup 1}H-MRS. The apparent diffusion coefficient (ADC) value and metabolic ratios of Glx/Cr, mI/Cr, and Cho/Cr were calculated. There was elevated ADC value and Glx/Cr and decreased mI/CI and Ch/Cr in patients with minHE compared to no minHE and control group. There was significant difference between minHE, no minHE, and control group in the ADC value (P = 0.001 for all groups), GLx/Cr (P = 0.001 for all groups), mI/Cr (P = 0.004, 0.001, and 0.001, respectively), Ch/Cr (P = 0.001 for all groups), and full-scale IQ of NPT (P = 0.001, 0.001, and 0.143, respectively). The NPT of minHE had negative correlation with ADC value (r = -0.872, P = 0.001) and GLx/Cr (r = -0.812, P = 0.001) and positive correlation with mI/Cr (r = 0.732, P = 0.001). DWI and {sup 1}H-MRS are imaging modalities that can detect minHE in children with liver cirrhosis and correlate well with parameters of NPT. (orig.)

  3. Disappearing or residual tiny (≤5 mm) colorectal liver metastases after chemotherapy on gadoxetic acid-enhanced liver MRI and diffusion-weighted imaging: Is local treatment required?

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Soo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Cheonan Hospital, Department of Radiology, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do (Korea, Republic of); Song, Kyoung Doo; Kim, Young Kon [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Hee Cheol; Huh, Jung Wook [Sungkyunkwan University School of Medicine, Department of Surgery, Samsung Medical Center, Seoul (Korea, Republic of); Park, Young Suk; Park, Joon Oh; Kim, Seung Tae [Sungkyunkwan University School of Medicine, Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul (Korea, Republic of)

    2017-07-15

    To evaluate the clinical course of disappearing colorectal liver metastases (DLM) or residual tiny (≤5 mm) colorectal liver metastases (RTCLM) on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in patients who had colorectal liver metastases (CLM) and received chemotherapy. Among 137 patients who received chemotherapy for CLM and underwent gadoxetic acid-enhanced MRI and DWI between 2010 and 2012, 43 patients with 168 DLMs and 48 RTCLMs were included. The cumulative in situ recurrence rate of DLM and progression rate of RTCLM and their predictive factors were evaluated. A total of 150 DLMs and 26 RTCLMs were followed up without additional treatment. At 1 and 2 years, respectively, the cumulative in situ recurrence rates for DLM were 10.9 % and 15.7 % and the cumulative progression rates for RTCLM were 27.2 % and 33.2 %. The in situ recurrence rate at 2 years was 4.9 % for the DLM group that did not show reticular hypointensity of liver parenchyma on hepatobiliary phase. DLM on gadoxetic acid-enhanced liver MRI and DWI indicates a high possibility of clinical complete response, especially in patients without chemotherapy-induced sinusoidal obstruction syndrome. Thirty-three percent of RTCLMs showed progression at 2 years. (orig.)

  4. Comparison of abdominal MRI with diffusion-weighted imaging to {sup 68}Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Schmid-Tannwald, Christine; Schmid-Tannwald, Christoph M.; Neumann, Ralph; Nikolaou, Konstantin; Schramm, Nicolai; Reiser, Maximilian F.; Rist, Carsten [Ludwig Maximilians University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Morelli, John N. [Scott and White Hospital Temple, Department of Radiology, Temple, TX (United States); Haug, Alexander R.; Jansen, Nathalie [Ludwig Maximilians University Hospital Munich, Department of Nuclear Medicine, Munich (Germany)

    2013-06-15

    The aim of the study was to evaluate contrast-enhanced MRI, diffusion-weighted MRI (DW MRI), and {sup 68}Ga-DOTATATE positron emission tomography (PET)/CT in the detection of intermediate to well-differentiated neuroendocrine tumors (NET) of the pancreas. Eighteen patients with pathologically proven pancreatic NET who underwent MRI including DW MRI and PET/CT within 6 weeks of each other were included in this retrospective study. Two radiologists evaluated T2-weighted (T2w), T2w + DW MRI, T2w + contrast-enhanced T1-weighted (CE T1w) MR images, and PET/CT for NET detection. The sensitivity and level of diagnostic confidence were compared among modalities using McNemar's test and a Wilcoxon signed rank test. Apparent diffusion coefficients (ADC) of pancreatic NETs and normal pancreatic tissue were compared with Student's t test. Of the NETs, 8/23 (34.8 %) and 9/23 (39.1 %) were detected on T2w images by observers 1 and 2, respectively. Detection rates improved significantly by combining T2w images with DW MRI (observer 1: 14/23 = 61 %; observer 2: 15/23 = 65.2 %; p < 0.05) or CE T1w images (observer 1: 14/23 = 61 %; observer 2: 15/23 = 65.2 %; p < 0.05). Detection rates of pancreatic NET with PET/CT (both observers: 23/23 = 100 %) were statistically significantly higher than with MRI (p < 0.05). The mean ADC value of NET (1.02 {+-} 0.26 x 10{sup -3} mm{sup 2}/s) was statistically significantly lower than that of normal pancreatic tissue (1.48 {+-} 0.39 x 10{sup -3} mm{sup 2}/s). DW MRI is a valuable adjunct to T2w imaging and comparable to CE T1w imaging in pancreatic NET detection, quantitatively differentiating between NET and normal pancreatic tissue with ADC measurements. {sup 68}Ga-DOTATATE PET/CT is more sensitive than MRI in the detection of pancreatic NET. (orig.)

  5. Upper abdominal gadoxetic acid-enhanced and diffusion-weighted MRI for the detection of gastric cancer: Comparison with two-dimensional multidetector row CT

    International Nuclear Information System (INIS)

    Jang, K.M.; Kim, S.H.; Lee, S.J.; Lee, M.W.; Choi, D.; Kim, K.M.

    2014-01-01

    Aim: To evaluate the diagnostic performance of abdominal magnetic resonance imaging (MRI) for the detection of gastric cancer in comparison with that of two-dimensional (2D) multidetector row computed tomography (CT). Materials and methods: The study included 189 patients with 170 surgically confirmed gastric cancers and 19 patients without gastric cancer, all of whom underwent gadoxetic acid-enhanced MRI with diffusion-weighted (DW) imaging, and multidetector contrast-enhanced abdominal CT imaging. Two observers independently analysed three sets of images (CT set, conventional MRI set, and combined conventional and DW MRI set). A five-point scale for likelihood of gastric cancer was used. Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were evaluated. Quantitative [apparent diffusion coefficient (ADC) analyses with Mann–Whitney U-test were conducted for gastric cancers and the nearby normal gastric wall. Results: The diagnostic accuracy and sensitivity for detection of gastric cancer were significantly higher on combined conventional and DW MRI set (77.8–78.3%; 75.3–75.9%) than the CT imaging set (67.7–71.4%; 64.1–68.2%) or the conventional MRI set (72–73%; 68.8–70%; p < 0.01). In particular, for gastric cancers with pT2 and pT3, the combined conventional and DW MRI set (91.6–92.6%) yielded significantly higher sensitivity for detection of gastric cancer than did the CT imaging set (76.8–81.1%) by both observers (p < 0.01). The mean ADC of gastric cancer lesions (1 ± 0.23 × 10 −3 mm 2 /s) differed significantly from that of normal gastric wall (1.77 ± 0.25 × 10 −3  mm 2 /s; p < 0.01). Conclusion: Abdominal MRI with DW imaging was more sensitive for the detection of gastric cancer than 2D-multidetector row CT or conventional MRI alone. - Highlights: • The sensitivity for detection of gastric cancer is high on abdominal MR imaging. • DW imaging is helpful for

  6. Diffusion-weighted MRI of the prostate at 3.0 T: comparison of endorectal coil (ERC) MRI and phased-array coil (PAC) MRI-The impact of SNR on ADC measurement.

    Science.gov (United States)

    Mazaheri, Yousef; Vargas, H Alberto; Nyman, Gregory; Shukla-Dave, Amita; Akin, Oguz; Hricak, Hedvig

    2013-10-01

    To compare ADC values measured from diffusion-weighted MR (DW-MR) images of the prostate obtained with both endorectal and phased-array coils (ERC+PAC) to those from DW-MRI images obtained with an eight-channel torso phased-array coil (PAC) at 3.0 T. The institutional review board issued a waiver of informed consent for this HIPAA-compliant study. Twenty-five patients with biopsy-proven prostate cancer underwent standard 3-T MRI using 2 different coil arrangements (ERC+PAC and PAC only) in the same session. DW-MRI at five b-values (0, 600, 1000, 1200, and 1500 s/mm(2)) were acquired using both coil arrangements. On b=0 images, signal-to-noise ratios (SNRs) were measured as the ratio of the mean signal from PZ and TZ ROIs to the standard deviation from the mean signal in an artifact-free ROI in the rectum. Matching regions-of-interest (ROIs) were identified in the peripheral zone and transition zone on ERC-MRI and PAC-MRI. For each ROI, mean ADC values for all zero and non-zero b-value combinations were computed. Mean SNR with ERC-MRI at PZ (66.33 ± 27.07) and TZ (32.69 ± 12.52) was 9.27 and 5.52 times higher than with PAC-MRI ((7.32 ± 2.30) and (6.13 ± 1.56), respectively) (PERC-MRI (PERC. To address these requirements, clinical MR systems should have image processing capabilities which incorporate the noise distribution. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Evidence of Brain Inflammation in Patients with Human T-Lymphotropic Virus Type 1-Associated Myelopathy (HAM): A Pilot, Multimodal Imaging Study Using 11C-PBR28 PET, MR T1-Weighted, and Diffusion-Weighted Imaging.

    Science.gov (United States)

    Dimber, Rahul; Guo, Qi; Bishop, Courtney; Adonis, Adine; Buckley, Aisling; Kocsis, Agnes; Owen, David; Kalk, Nicola; Newbould, Rexford; Gunn, Roger N; Rabiner, Eugenii A; Taylor, Graham P

    2016-12-01

    HTLV-1-associated myelopathy (HAM; HTLV-1 is human T-lymphotropic virus type 1) is a chronic debilitating neuroinflammatory disease with a predilection for the thoracic cord. Tissue damage is attributed to the cellular immune response to HTLV-1-infected lymphocytes. The brains of HTLV-1-infected patients, with and without HAM but no clinical evidence of brain involvement, were examined using a specific 18-kDa translocator protein ligand, 11 C-PBR28, and T1-weighted and diffusion-weighted MRI. Five subjects with HAM and 2 HTLV-1 asymptomatic carriers were studied. All underwent clinical neurologic assessment including cognitive function and objective measures of gait, quantification of HTLV-1 proviral load in peripheral blood mononuclear cells, and human leukocyte antigen-antigen D related expression on circulating CD8+ lymphocytes. 11 C-PBR28 PET and MRI were performed on the same day. 11 C-PBR28 PET total volume of distribution and distribution volume ratio (DVR) were estimated using 2-tissue-compartment modeling. MRI data were processed using tools from the FMRIB Software Library to estimate mean diffusivity (MD) and gray matter (GM) fraction changes. The results were compared with data from age-matched healthy volunteers. Across the whole brain, the total volume of distribution for the subjects with HAM (5.44 ± 0.84) was significantly greater than that of asymptomatic carriers (3.44 ± 0.80). The DVR of the thalamus in patients with severe and moderate HAM was higher than that in the healthy volunteers, suggesting increased translocator protein binding (z > 4.72). Subjects with more severe myelopathy and with high DR expression on CD8+ lymphocytes had increased DVR and MD (near-significant correlation found for the right thalamus MD: P = 0.06). On the T1-weighted MRI scans, the GM fraction of the brain stem was reduced in all HTLV-1-infected patients compared with controls (P HAM and correlated with the disease severity. There was no correlation between

  8. Diffusion-weighted MRI for Early Prediction of Treatment Response on Preoperative Chemoradiotherapy for Patients With Locally Advanced Rectal Cancer: A Feasibility Study.

    Science.gov (United States)

    Jacobs, Lotte; Intven, Martijn; van Lelyveld, Niels; Philippens, Marielle; Burbach, Maarten; Seldenrijk, Kees; Los, Maartje; Reerink, Onne

    2016-03-01

    This study investigates the predictive value of diffusion-weighted magnetic resonance imaging (DW-MRI) for good pathological response at different time points during and after preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer. Preoperative CRT followed by total mesorectal excision (TME) is the standard of care for locally advanced rectal cancer. The use of standard radical surgery in good treatment responders after CRT is being questioned. Patients with locally advanced rectal adenocarcinoma were treated with preoperative CRT followed by surgery. DW-MRI scans were performed before CRT, during the third week of CRT, 4 weeks post-CRT and presurgery. Tumor apparent diffusion coefficient (ADC) values were acquired from the DW-MRI scans. After surgery the pathological tumor regression grade was assessed according to the classification by Mandard et al [Cancer. 1994;73:2680-2686]. Patients with pathological complete or near-complete response (tumor regression grade 1-2) were classified as good responders (GRs). Twenty-two patients participated of which 9 were GRs (41%). Pre-CRT ADC values were lower in good versus moderate/poor responders (P = 0.04). ADC values during CRT and four weeks post-CRT were higher in GR. ADC values presurgery did not differ between response groups. For all time points the relative ADC increase (ΔADC) compared to the ADC pre-CRT was higher in GR (P < 0.001). The ΔADC during CRT and four weeks post-CRT were the best predictive parameters for pathological good response. This study shows that DW-MRI is feasible to select good treatment responders during preoperative CRT for locally advanced rectal cancer.

  9. Diffusion Weighted Imaging in Magnetic Resonance Imaging for Prostate Cancer Diagnosis: Current Efficiency as a Standalone Sequence for an Unenhanced MRI Experience - a Pilot Study

    Directory of Open Access Journals (Sweden)

    Nechifor-Boilă I.A.

    2016-03-01

    Full Text Available Objective: Diffusion Weighted Imaging (DWI is the main sequence in the multiparametric prostate MRI protocol together with T2 and dynamic contrast-enhanced T1, leading to detection rates up to 60% in prostate cancer diagnosis. However, the use of intravenous contrast can have severe side-effects, making the use of unenhanced MRI sequences essential. The aim of our study was to assess the feasibility and efficiency of DWI as a standalone MRI technique for prostate cancer diagnosis. Methods: We performed a prospective cohort study at our department (09.2014-05.2015 and formed a study lot consisting in five prostate cancer patients that were scheduled for radical prostatectomy. Multiparametric MRI was performed (with DWI and T2 sequences and the images were interpreted according to the PI-RADS system. The final histopathological result after prostatectomy served as gold standard. Results: A series of 9 lesions were detected and analyzed on DWI. At qualitative interpretation, DWI had a sensitivity of 85.7% and a specificity of 50%. The corresponding positive and negative likelihood ratios were 1.71 and 0.286, respectively (p=0.417. ADC analysis revealed a mean value of 1.2*10-3mm2/s for the benign lesions while the corresponding value was 0.8*10-3 for the malignant ones, regardless of tumor size and Gleason scoring. Conclusion: DWI is a feasible technique in the current clinical environment, with a good sensitivity and a medium specificity. Furthermore, an association to the anatomical T2 sequence could enhance the diagnostic efficiency of DWI and should be assessed in larger studies.

  10. Additional value of diffusion-weighted imaging to evaluate multifocal and multicentric breast cancer detected using pre-operative breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sung Eun; Park, Eun Kyung; Cho, Kyu Ran; Cho, Sung Bum [Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seo, Bo Kyoung [Korea University Ansan Hospital, Korea University College of Medicine, Department of Radiology, Ansan (Korea, Republic of); Woo, Ok Hee [Korea University Guro Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Jung, Seung Pil [Korea University Anam Hospital, Korea University College of Medicine, Department of Surgery, Seoul (Korea, Republic of)

    2017-11-15

    To investigate whether diffusion-weighted imaging (DWI) aids pre-operative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to evaluate additional lesions in breast cancer patients. DCE-MRI and DWI were performed on 131 lesions, with available histopathological results. The apparent diffusion coefficient (ADC) of each lesion was measured, and the cut-off value for differentiation between malignant and benign lesions was calculated. A protocol combining the ADC cut-off value with DCE-MRI was validated in a cohort of 107 lesions in 77 patients. When an ADC cut-off value of 1.11 x 10{sup -3} mm{sup 2}/s from the development cohort was applied to the additional lesions in the validation cohort, the specificity increased from 18.9% to 67.6% (P < 0.001), and the diagnostic accuracy increased from 61.7% to 82.2% (P = 0.05), without significant loss of sensitivity (98.6% vs. 90.0%, P = 0.07). The negative predictive values of lesions in the same quadrant had decreased, as had those of lesions ≥1 cm in diameter. The ADC cut-off value in the validation cohort was 1.05 x 10{sup -3} mm{sup 2}/s. Additional implementation of DWI for breast lesions in pre-operative MRI can help to obviate unnecessary biopsies by increasing specificity. However, to avoid missing cancers, clinicians should closely monitor lesions located in the same quadrant or lesions ≥1 cm. (orig.)

  11. Diffusion-weighted MRI of the cervical spinal cord using a single-shot fast spin-echo technique: findings in normal subjects and in myelomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, K.; Katase, S.; Fujikawa, A.; Hachiya, J. [Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, 181-8611, Tokyo (Japan); Kanazawa, H. [Toshiba Corporation, 1-1-1 Shibaura, Minato-ku, 105-8001, Tokyo (Japan); Yodo, K. [Toshiba Medical Systems, 3-26-5 Hongo, Bunkyo-ku, 113-8456, Tokyo (Japan)

    2003-02-01

    We have implemented a new diffusion-weighted MRI (DWI) sequence based on the single-shot fast spin-echo technique. We hypothesised that this would add information to conventional MRI for diagnosis of lesions of the cervical spinal cord. DWI was performed using a technique in which echo collection after the application of motion-probing gradients was done in the same manner as in the single-shot fast spin-echo technique. We first imaged six healthy volunteers to demonstrate the cervical spinal cord using the sequence. Then we applied the sequence to 12 patients with cervical myelomalacia due to chronic cord compression. The spinal cord was well seen in all subjects without the distortion associated with echo-planar DWI. In the patients, lesions appeared as areas of low- or isointense signal on DWI. Calculated apparent diffusion coefficients of the lesions (3.30{+-}0.38 x 10{sup -3} mm{sup 2}/s) were significantly higher than those of normal volunteers (2.26{+-}0.08 x 10{sup -3} mm{sup 2}/s). Increased diffusion in areas of cervical myelomalacia, suggesting irreversible damage, can be detected using this technique. (orig.)

  12. Extended diffusion weighted magnetic resonance imaging with two-compartment and anomalous diffusion models for differentiation of low-grade and high-grade brain tumors in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Burrowes, Delilah; Deng, Jie [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States); Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Fangusaro, Jason R. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Hematology/Oncology, Chicago, IL (United States); Northwestern University, Feinberg School of Medicine, Department of Pediatrics-Hematology, Oncology, and Stem Cell Transplantation, Chicago, IL (United States); Nelson, Paige C.; Rozenfeld, Michael J. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States); Zhang, Bin [Cincinnati Children' s Hospital Medical Center, Department of Biostatistics and Epidemiology, Cincinnati, OH (United States); Wadhwani, Nitin R. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Pathology and Laboratory Medicine, Chicago, IL (United States); Northwestern University, Feinberg School of Medicine, Department of Pathology, Chicago, IL (United States)

    2017-08-15

    The purpose of this study was to examine advanced diffusion-weighted magnetic resonance imaging (DW-MRI) models for differentiation of low- and high-grade tumors in the diagnosis of pediatric brain neoplasms. Sixty-two pediatric patients with various types and grades of brain tumors were evaluated in a retrospective study. Tumor type and grade were classified using the World Health Organization classification (WHO I-IV) and confirmed by pathological analysis. Patients underwent DW-MRI before treatment. Diffusion-weighted images with 16 b-values (0-3500 s/mm{sup 2}) were acquired. Averaged signal intensity decay within solid tumor regions was fitted using two-compartment and anomalous diffusion models. Intracellular and extracellular diffusion coefficients (D{sub slow} and D{sub fast}), fractional volumes (V{sub slow} and V{sub fast}), generalized diffusion coefficient (D), spatial constant (μ), heterogeneity index (β), and a diffusion index (index{sub d}iff = μ x V{sub slow}/β) were calculated. Multivariate logistic regression models with stepwise model selection algorithm and receiver operating characteristic (ROC) analyses were performed to evaluate the ability of each diffusion parameter to distinguish tumor grade. Among all parameter combinations, D and index{sub d}iff jointly provided the best predictor for tumor grades, where lower D (p = 0.03) and higher index{sub d}iff (p = 0.009) were significantly associated with higher tumor grades. In ROC analyses of differentiating low-grade (I-II) and high-grade (III-IV) tumors, index{sub d}iff provided the highest specificity of 0.97 and D provided the highest sensitivity of 0.96. Multi-parametric diffusion measurements using two-compartment and anomalous diffusion models were found to be significant discriminants of tumor grading in pediatric brain neoplasms. (orig.)

  13. Maple syrup urine disease encephalopathy: a follow-up study in the acute stage using diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Ha, Jong Su; Kim, Taik-Kun; Lee, Ki Yeol; Seol, Hae Young; Cha, Sang Hoon; Eun, Baik-Lin; Lee, Hee Sun

    2004-01-01

    Neonatal maple syrup urine disease (MSUD) is associated with diffuse oedema and characteristic MSUD oedema. We present a newborn infant with two coexisting different types of oedema. The myelinated white matter showed a marked decrease in the water apparent diffusion coefficient (ADC) compatible with cytotoxic oedema. The unmyelinated white matter showed an increase in ADC, consistent with vasogenic-interstitial oedema. On follow-up studies, the cytotoxic oedema showed improvement, but the vasogenic-interstitial oedema progressed into brain atrophy. (orig.)

  14. Brain MRI in Parkinson's disease

    NARCIS (Netherlands)

    Meijer, F.J.A.; Goraj, B.M.

    2014-01-01

    In this review article, conventional brain MRI and advanced MRI techniques in Parkinson`s disease (PD) are discussed, with emphasis on clinical relevance. Conventional brain MRI sequences generally demonstrate limited abnormalities specific for PD and in clinical practice brain MRI is mainly used to

  15. Breast cancer detection using double reading of unenhanced MRI including T1-weighted, T2-weighted STIR, and diffusion-weighted imaging: a proof of concept study.

    Science.gov (United States)

    Trimboli, Rubina M; Verardi, Nicola; Cartia, Francesco; Carbonaro, Luca A; Sardanelli, Francesco

    2014-09-01

    The purpose of this study was to investigate the diagnostic performance of unenhanced MRI in detecting breast cancer and to assess the impact of double reading. A total of 116 breasts of 67 women who were 36-89 years old were studied at 1.5 T using an unenhanced protocol including axial T1-weighted gradient-echo, T2-weighted STIR, and echo-planar diffusion-weighted imaging (DWI). Two blinded readers (R1 and R2) independently evaluated unenhanced images using the BIRADS scale. A combination of pathology and negative follow-up served as the reference standard. McNemar and kappa statistics were used. Per-breast cancer prevalence was 37 of 116 (32%): 30 of 37 (81%) invasive ductal carcinoma, five of 37 (13%) ductal carcinoma in situ, and two of 37 (6%) invasive lobular carcinoma. Per-breast sensitivity of unenhanced MRI was 29 of 37 (78%) for R1, 28 of 37 (76%) for R2, and 29 of 37 (78%) for double reading. Specificity was 71 of 79 (90%) for both R1 and R2 and 69 of 79 (87%) for double reading. Double reading did not provide a significant increase in sensitivity. Interobserver agreement was almost perfect (Cohen κ = 0.873). An unenhanced breast MRI protocol composed of T1-weighted gradient echo, T2-weighted STIR, and echo-planar DWI enabled breast cancer detection with sensitivity of 76-78% and specificity of 90% without a gain in sensitivity from double reading.

  16. Reversible diffusion weighted imaging changes in propionic acidemia.

    Science.gov (United States)

    Kandel, Amit; Amatya, Sirisa Kandel; Yeh, E Ann

    2013-01-01

    Propionic acidemia is an inborn error of metabolism with neurologic manifestations. We describe a 3-year-old boy with propionic acidemia presenting with a metabolic crisis including headache, vomiting, and altered mental status with metabolic acidosis. Electroencephalography showed focal slowing in right temporal region. Magnetic resonance imaging (MRI) of the brain showed restricted diffusion with apparent diffusion coefficient correlate in the right parietooccipital region. Correction of metabolic acidosis led to clinical improvement and normalization of MRI diffusion weighted imaging/apparent diffusion coefficient changes. This article suggests that restricted diffusion resulting from metabolic crises in propionic acidemia may be reversible in some cases.

  17. Is quantitative diffusion-weighted MRI a valuable technique for the detection of changes in kidneys after extracorporeal shock wave lithotripsy?

    Directory of Open Access Journals (Sweden)

    Elif Hocaoglu

    2015-02-01

    Full Text Available Objective The aim of this study was to evaluate the capability and the reliability of diffusion-weighted imaging (DWI in the changes of kidneys occurring after extracorporeal shock wave lithotripsy (ESWL treatment for renal stones. Materials and Methods A total of 32 patients who underwent ESWL treatment for renal stone disease between June and December 2011 were enrolled in this prospective study. Color Doppler ultrasonography (CDUS and DWI were performed before and within 24 hours after ESWL. DWI was obtained with b factors of 0, 500 and 1000 s/mm2 at 1.5 T MRI. Each of Resistive index (RI and ADC values were calculated from the three regions of renal upper, middle and lower zones for both of the affected and contralateral kidneys. Paired sample t test was used for statistical analyses. Results After ESWL, the treated kidneys had statistically significant lower ADC values in all different regions compared with previous renal images. The best discriminative parameter was signal intensity with a b value of 1000 s/mm2. The changes of DWI after ESWL were noteworthy in the middle of the treated kidney (p0.05. Conclusion DWI is a valuable technique enables the detection of changes in DWI after ESWL treatment that may provide useful information in prediction of renal damage by shock waves, even CDUS is normal.

  18. Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, Paul C.; Donovan Post, M. Judith; Bruce-Gregorios, Jocelyn [University of Miami, Jackson Memorial Hospital, Miami, FL (United States); Oschatz, Elizabeth; Stadler, Alfred; Thurnher, Majda M. [Medical University of Vienna, Department of Radiology Neuroradiology Section, Vienna (Austria)

    2006-10-15

    Toxoplasmosis and lymphoma are common lesions of the central nervous system in patients with AIDS. It is often difficult to distinguish between these lesions both clinically and radiographically. Previous research has demonstrated restricted diffusion within cerebral lymphomas and bacterial abscesses. However, little work has been done to evaluate the diffusion characteristics of toxoplasmosis lesions. This study was designed to explore further the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps and values in making the distinction between toxoplasmosis and lymphoma. The magnetic resonance imaging (MRI) studies of 36 patients, including 22 with toxoplasmosis (all of whom had AIDS) and 14 with lymphoma (8 of whom had AIDS), at two institutions were reviewed retrospectively. The characteristics of the lesions on DWI were evaluated, and the ADC ratios of the lesions were calculated and compared. There was significant overlap of the ADC ratios of toxoplasma and lymphoma, most notably in the intermediate (1.0-1.6) range. There was variability in ADC ratios even among different lesions in the same patient. In only a minority of the lymphoma patients were the ADC ratios low enough to suggest the correct diagnosis. Our study showed that toxoplasmosis exhibits a wide spectrum of diffusion characteristics with ADC ratios which have significant overlap with those of lymphoma. Therefore, in the majority of patients, ADC ratios are not definitive in making the distinction between toxoplasmosis and lymphoma. (orig.)

  19. Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma

    International Nuclear Information System (INIS)

    Schroeder, Paul C.; Donovan Post, M. Judith; Bruce-Gregorios, Jocelyn; Oschatz, Elizabeth; Stadler, Alfred; Thurnher, Majda M.

    2006-01-01

    Toxoplasmosis and lymphoma are common lesions of the central nervous system in patients with AIDS. It is often difficult to distinguish between these lesions both clinically and radiographically. Previous research has demonstrated restricted diffusion within cerebral lymphomas and bacterial abscesses. However, little work has been done to evaluate the diffusion characteristics of toxoplasmosis lesions. This study was designed to explore further the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps and values in making the distinction between toxoplasmosis and lymphoma. The magnetic resonance imaging (MRI) studies of 36 patients, including 22 with toxoplasmosis (all of whom had AIDS) and 14 with lymphoma (8 of whom had AIDS), at two institutions were reviewed retrospectively. The characteristics of the lesions on DWI were evaluated, and the ADC ratios of the lesions were calculated and compared. There was significant overlap of the ADC ratios of toxoplasma and lymphoma, most notably in the intermediate (1.0-1.6) range. There was variability in ADC ratios even among different lesions in the same patient. In only a minority of the lymphoma patients were the ADC ratios low enough to suggest the correct diagnosis. Our study showed that toxoplasmosis exhibits a wide spectrum of diffusion characteristics with ADC ratios which have significant overlap with those of lymphoma. Therefore, in the majority of patients, ADC ratios are not definitive in making the distinction between toxoplasmosis and lymphoma. (orig.)

  20. Functional evaluation of therapeutic response of HCC827 lung cancer to bevacizumab and erlotinib targeted therapy using dynamic contrast-enhanced and diffusion-weighted MRI.

    Science.gov (United States)

    Chen, Yi-Fang; Yuan, Ang; Cho, Kuan-Hung; Lu, Yi-Chien; Kuo, Mark Yen-Ping; Chen, Jyh-Horng; Chang, Yeun-Chung

    2017-01-01

    This study aimed to investigate the therapeutic responses of lung cancer mice models with adenocarcinoma HCC827 (gefitinib sensitive) and HCC827R (gefitinib resistant) to the epidermal growth factor receptor-tyrosine kinase inhibitor erlotinib alone and in combination with the anti-angiogenesis agent bevacizumab using dynamic contrast enhanced (DCE) and diffusion-weighted MRI. In the HCC827 model, temporal changes in DCE-MRI derived parameters (Ktrans, kep, and iAUC90) and apparent diffusion coefficient (ADC) were significantly correlated with tumor size. Ktrans and iAUC90 significantly decreased at week 2 in the groups receiving erlotinib alone and in combination with bevacizumab, whereas kep decreased at week 1 and 2 in both treatment groups. In addition, there was a significant difference in iAUC90 between the treatment groups at week 1. Compared to the control group of HCC827, there was a significant reduction in microvessel density and increased tumor apoptosis in the two treatment group. ADC value increased in the erlotinib alone group at week 1 and week 2, and in the erlotinib combined with bevacizumab group at week 2. Enlarged areas of central tumor necrosis were associated with a higher ADC value. However, progressive enlargement of the tumors but no significant differences in DCE parameters or ADC were noted in the HCC827R model. These results showed that both erlotinib alone and in combination with bevacizumab could effectively inhibit tumor growth in the gefitinib-sensitive lung cancer mice model, and that this was associated with decreased vascular perfusion, increased ADC percentage, decreased microvessel density, and increased tumor apoptosis with a two-week treatment cycle.

  1. Functional evaluation of therapeutic response of HCC827 lung cancer to bevacizumab and erlotinib targeted therapy using dynamic contrast-enhanced and diffusion-weighted MRI.

    Directory of Open Access Journals (Sweden)

    Yi-Fang Chen

    Full Text Available This study aimed to investigate the therapeutic responses of lung cancer mice models with adenocarcinoma HCC827 (gefitinib sensitive and HCC827R (gefitinib resistant to the epidermal growth factor receptor-tyrosine kinase inhibitor erlotinib alone and in combination with the anti-angiogenesis agent bevacizumab using dynamic contrast enhanced (DCE and diffusion-weighted MRI. In the HCC827 model, temporal changes in DCE-MRI derived parameters (Ktrans, kep, and iAUC90 and apparent diffusion coefficient (ADC were significantly correlated with tumor size. Ktrans and iAUC90 significantly decreased at week 2 in the groups receiving erlotinib alone and in combination with bevacizumab, whereas kep decreased at week 1 and 2 in both treatment groups. In addition, there was a significant difference in iAUC90 between the treatment groups at week 1. Compared to the control group of HCC827, there was a significant reduction in microvessel density and increased tumor apoptosis in the two treatment group. ADC value increased in the erlotinib alone group at week 1 and week 2, and in the erlotinib combined with bevacizumab group at week 2. Enlarged areas of central tumor necrosis were associated with a higher ADC value. However, progressive enlargement of the tumors but no significant differences in DCE parameters or ADC were noted in the HCC827R model. These results showed that both erlotinib alone and in combination with bevacizumab could effectively inhibit tumor growth in the gefitinib-sensitive lung cancer mice model, and that this was associated with decreased vascular perfusion, increased ADC percentage, decreased microvessel density, and increased tumor apoptosis with a two-week treatment cycle.

  2. Diagnostic performance and reproducibility of T2w based and diffusion weighted imaging (DWI) based PI-RADSv2 lexicon descriptors for prostate MRI.

    Science.gov (United States)

    Benndorf, Matthias; Hahn, Felix; Krönig, Malte; Jilg, Cordula Annette; Krauss, Tobias; Langer, Mathias; Dovi-Akué, Philippe

    2017-08-01

    To examine the diagnostic performance of PI-RADSv2 T2w and diffusion weighted imaging (DWI) based lexicon descriptors, inter-observer agreement for descriptor assignment and diagnostic accuracy of the PI-RADSv2 assessment categories for multiparametric prostate MRI. 176 lesions in 79 consecutive patients are analyzed, lesions are histopathologically verified by MRI-ultrasound fusion biopsy. All lesions are rated according to the PI-RADSv2 lexicon, descriptors for T2w and DWI sequences and resulting assessment categories are assigned by two independent blinded radiologists. We perform receiver-operating-characteristic analysis using the assessment categories. To analyze inter-observer agreement, we calculate weighted kappa values for assessment category assignment and unweighted kappa values for descriptor assignment. PI-RADSv2 assessment categories yield an area under the curve of 0.76/0.74 (radiologist 1/radiologist 2), P >0.05. Weighted kappa for agreement is 0.601 in the peripheral zone and 0.580 in the transition zone. We detect a difference in the cancer rate for PI-RADSv2 category 3 between peripheral zone (32%) and transition zone (12%), P PI-RADSv2 lexicon is at most moderate in our study. Typical descriptors for benign and malignant lesions are validated, whereas the discriminatory power of some descriptors is challenged. The difference in the cancer rate for PI-RADSv2 category 3 between peripheral zone and transition zone should be considered when management recommendations are linked to assessment categories in the future. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Correlations between functional imaging markers derived from PET/CT and diffusion-weighted MRI in diffuse large B-cell lymphoma and follicular lymphoma.

    Directory of Open Access Journals (Sweden)

    Xingchen Wu

    Full Text Available OBJECTIVES: To investigate the correlations between functional imaging markers derived from positron emission tomography/computed tomography (PET/CT and diffusion-weighted magnetic resonance imaging (DWI in diffuse large B-cell lymphoma (DLBCL and follicular lymphoma (FL. Further to compare the usefulness of these tumor markers in differentiating diagnosis of the two common types of Non-Hodgkin's lymphoma (NHL. MATERIALS AND METHODS: Thirty-four consecutive pre-therapy adult patients with proven NHL (23 DLBCL and 11 FL underwent PET/CT and MRI examinations and laboratory tests. The maximum standardized uptake value (SUV(max, metabolic tumor volume (MTV, and metabolic tumor burden (MTB were determined from the PET/CT images. DWI was performed in addition to conventional MRI sequences using two b values (0 and 800 s/mm(2. The minimum and mean apparent diffusion coefficient (ADC(min and ADC(mean were measured on the parametric ADC maps. RESULTS: The SUV(max correlated inversely with the ADC(min (r =  -0.35, p<0.05. The ADC(min, ADC(mean, serum thymidine kinase (TK, Beta 2-microglobulin (B2m, lactate dehydrogenase (LD, and C-reactive protein (CRP correlated with both whole-body MTV and whole-body MTB (p<0.05 or 0.01. The SUV(max, TK, LD, and CRP were significantly higher in the DLBCL group than in the FL group. Receiver operating characteristic curve analysis showed that they were reasonable predictors in differentiating DLBCL from FL. CONCLUSIONS: The functional imaging markers determined from PET/CT and DWI are associated, and the SUV(max is superior to the ADC(min in differentiating DLBCL from FL. All the measured serum markers are associated with functional imaging markers. Serum LD, TK, and CRP are useful in differentiating DLBCL from FL.

  4. Patterns of accentuated grey-white differentiation on diffusion-weighted imaging or the apparent diffusion coefficient maps in comatose survivors after global brain injury

    International Nuclear Information System (INIS)

    Kim, E.; Sohn, C.-H.; Chang, K.-H.; Chang, H.-W.; Lee, D.H.

    2011-01-01

    Aim: To determine what disease entities show accentuated grey-white differentiation of the cerebral hemisphere on diffusion-weighted images (DWI) or apparent diffusion coefficient (ADC) maps, and whether there is a correlation between the different patterns and the cause of the brain injury. Methods and materials: The DWI and ADC maps of 19 patients with global brain injury were reviewed and evaluated to investigate whether there was a correlation between the different patterns seen on the DWI and ADC maps and the cause of global brain injury. The ADC values were measured for quantitative analysis. Results: There were three different patterns of ADC decrease: a predominant ADC decrease in only the cerebral cortex (n = 8; pattern I); an ADC decrease in both the cerebral cortex and white matter (WM) and a predominant decrease in the WM (n = 9; pattern II); and a predominant ADC decrease in only the WM (n = 3; pattern III). Conclusion: Pattern I is cerebral cortical injury, suggesting cortical laminar necrosis in hypoxic brain injury. Pattern II is cerebral cortical and WM injury, frequently seen in brain death, while pattern 3 is mainly WM injury, especially found in hypoglycaemic brain injury. It is likely that pattern I is decorticate injury and pattern II is decerebrate injury in hypoxic ischaemic encephalopathy.Patterns I and II are found in severe hypoxic brain injury, and pattern II is frequently shown in brain death, whereas pattern III was found in severe hypoglycaemic injury.

  5. Advance MRI for pediatric brain tumors with emphasis on clinical benefits

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Ra, Young Shin [Asan Medical Center, University of Ulsan College of Medicine, Seoul(Korea, Republic of)

    2017-01-15

    Conventional anatomic brain MRI is often limited in evaluating pediatric brain tumors, the most common solid tumors and a leading cause of death in children. Advanced brain MRI techniques have great potential to improve diagnostic performance in children with brain tumors and overcome diagnostic pitfalls resulting from diverse tumor pathologies as well as nonspecific or overlapped imaging findings. Advanced MRI techniques used for evaluating pediatric brain tumors include diffusion-weighted imaging, diffusion tensor imaging, functional MRI, perfusion imaging, spectroscopy, susceptibility-weighted imaging, and chemical exchange saturation transfer imaging. Because pediatric brain tumors differ from adult counterparts in various aspects, MRI protocols should be designed to achieve maximal clinical benefits in pediatric brain tumors. In this study, we review advanced MRI techniques and interpretation algorithms for pediatric brain tumors.

  6. Assessment of treatment response by total tumor volume and global apparent diffusion coefficient using diffusion-weighted MRI in patients with metastatic bone disease: a feasibility study.

    Directory of Open Access Journals (Sweden)

    Matthew D Blackledge

    Full Text Available We describe our semi-automatic segmentation of whole-body diffusion-weighted MRI (WBDWI using a Markov random field (MRF model to derive tumor total diffusion volume (tDV and associated global apparent diffusion coefficient (gADC; and demonstrate the feasibility of using these indices for assessing tumor burden and response to treatment in patients with bone metastases. WBDWI was performed on eleven patients diagnosed with bone metastases from breast and prostate cancers before and after anti-cancer therapies. Semi-automatic segmentation incorporating a MRF model was performed in all patients below the C4 vertebra by an experienced radiologist with over eight years of clinical experience in body DWI. Changes in tDV and gADC distributions were compared with overall response determined by all imaging, tumor markers and clinical findings at serial follow up. The segmentation technique was possible in all patients although erroneous volumes of interest were generated in one patient because of poor fat suppression in the pelvis, requiring manual correction. Responding patients showed a larger increase in gADC (median change = +0.18, range = -0.07 to +0.78 × 10(-3 mm2/s after treatment compared to non-responding patients (median change = -0.02, range = -0.10 to +0.05 × 10(-3 mm2/s, p = 0.05, Mann-Whitney test, whereas non-responding patients showed a significantly larger increase in tDV (median change = +26%, range = +3 to +284% compared to responding patients (median change = -50%, range = -85 to +27%, p = 0.02, Mann-Whitney test. Semi-automatic segmentation of WBDWI is feasible for metastatic bone disease in this pilot cohort of 11 patients, and could be used to quantify tumor total diffusion volume and median global ADC for assessing response to treatment.

  7. Feasibility of diffusion-weighted magnetic resonance imaging in patients with juvenile idiopathic arthritis on 1.0-T open-bore MRI

    Energy Technology Data Exchange (ETDEWEB)

    Barendregt, Anouk M.; Nusman, Charlotte M. [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Hemke, Robert; Lavini, Cristina; Maas, Mario [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Amiras, Dimitri [Imperial College Healthcare NHS Trust, Radiology Department, St. Mary' s Hospital, Paddington, London (United Kingdom); Kuijpers, Taco W. [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands)

    2015-12-15

    To evaluate the feasibility of non-invasive diffusion-weighted imaging (DWI) of the knee of children with juvenile idiopathic arthritis (JIA) and, further, to analyze the apparent diffusion coefficient (ADC) levels to distinguish synovium from effusion. Standard magnetic resonance imaging of the knee including post-contrast imaging was obtained in eight patients (mean age, 12 years 8 months, five females) using an open-bore magnetic resonance imaging system (1.0 T). In addition, axially acquired echo-planar DWI datasets (b-values 0, 50, and 600) were prospectively obtained and the diffusion images were post-processed into ADC{sub 50-600} maps. Two independent observers selected a region of interest (ROI) for both synovium and effusion using aligned post-contrast images as landmarks. Mann-Whitney U test was performed to compare ADC synovium and ADC effusion. DWI was successfully obtained in all patients. When data of both observers was combined, ADC synovium was lower than ADC effusion in the ROI in seven out of eight patients (median, 1.92 x 10{sup -3} mm{sup 2}/s vs. 2.40 x 10{sup -3} mm{sup 2}/s, p = 0.006, respectively). Similar results were obtained when the two observers were analyzed separately (observer 1: p = 0.006, observer 2: p = 0.04). In this pilot study, on a patient-friendly 1.0-T open-bore MRI, we demonstrated that DWI may potentially be a feasible non-invasive imaging technique in children with JIA. We could differentiate synovium from effusion in seven out of eight patients based on the ADC of synovium and effusion. However, to select synovium and effusion on DWI, post-contrast images were still a necessity. (orig.)

  8. Diffusion-weighted imaging for evaluating inflammatory activity in Crohn's disease: comparison with histopathology, conventional MRI activity scores, and faecal calprotectin.

    Science.gov (United States)

    Pendsé, D A; Makanyanga, J C; Plumb, A A; Bhatnagar, G; Atkinson, D; Rodriguez-Justo, Manuel; Halligan, S; Taylor, S A

    2017-01-01

    To evaluate whether the extent of enteric diffusion-weighted imaging (DWI) signal abnormality reflects inflammatory burden in Crohn's disease (CD), and to compare qualitative and quantitative grading. 69 CD patients (35 male, age 16-78) undergoing MR enterography with DWI (MRE-D) and the same-day faecal calprotectin (cohort 1) were supplemented by 29 patients (19 male, age 16-70) undergoing MRE-D and terminal ileal biopsy (cohort 2). Global (cohort 1) and terminal ileal (cohort 2) DWI signal was graded (0 to 3) by 2 radiologists and segmental apparent diffusion coefficient (ADC) calculated. Data were compared to calprotectin and a validated MRI activity score [MEGS] (cohort 1), and a histopathological activity score (eAIS) (cohort 2) using nonparametric testing and rank correlation. Patients with normal (grades 0 and 1) DWI signal had lower calprotectin and MEGS than those with abnormal signal (grades 2 and 3) (160 vs. 492 μg/l, p = 0.0004, and 3.3 vs. 21, p disease (calprotectin > 120 μg/l) were 83% and 52%, respectively. There was a negative correlation between ileal MEGS and ADC (r = -0.41, p = 0.017). There was no significant difference in eAIS between qualitative DWI scores (p = 0.42). Mean ADC was not different in those with and without histological inflammation (2077 vs. 1622 × 10 -6 mm 2 /s, p = 0.10) CONCLUSIONS: Qualitative grading of DWI signal has utility in defining the burden of CD activity. Quantitative ADC measurements have poor discriminatory ability for segmental disease activity.

  9. Collateral flow and brain changes on computed tomography angiography predict infarct volume on early diffusion-weighted imaging.

    Science.gov (United States)

    Aoki, Junya; Tateishi, Yohei; Cummings, Christopher L; Cheng-Ching, Esteban; Ruggieri, Paul; Hussain, Muhammad Shazam; Uchino, Ken

    2014-01-01

    We investigated whether a computed tomography (CT)-based score could predict a large infarct (≥ 80 mL) on early diffusion-weighted magnetic resonance imaging (DWI). Acute stroke patients considered for endovascular therapy within 8 hours of the onset of symptoms were included. The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) was determined on noncontrast CT and computed tomography angiography source images (CTA-SI). Limited collateral flow was defined as less than 50% collateral filling on CTA-SI. Fifty-six patients were analyzed. National Institutes of Health Stroke Scale score was 20 (15-24) in the large infarct group and 16 (11-20) in the small infarct group (P = .049). ASPECTS on noncontrast CT and CTA-SI was 5 (3-8) and 3 (2-6) in the large infarct group and 9 (8-10) and 8 (7-9) in the small infarct group (both P < .001), respectively. Limited collateral flow was frequent in the large infarct group than in the small infarct group (92% vs. 11%, P < .001). Multivariate analysis found that CTA-SI ASPECTS less than or equal to 5 (odds ratio [OR], 40.55; 95% confidence interval [CI], 1.10-1493.44; P = .044) and limited collateral flow (OR, 114.64; 95% CI, 1.93-6812.79; P = .023) were associated with a large infarct. Absence of ASPECTS less than or equal to 5 and limited collateral flow on CTA-SI predicted absence of a large infarct with a sensitivity of .89, specificity of 1.00, positive predictive value of 1.00, and negative predictive value of .71. Assessment of ASPECTS and collateral flow on CTA-SI may be able to exclude a patient with large infarct on early DWI. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. TU-F-CAMPUS-J-02: Evaluation of Textural Feature Extraction for Radiotherapy Response Assessment of Early Stage Breast Cancer Patients Using Diffusion Weighted MRI and Dynamic Contrast Enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Y; Wang, C; Horton, J; Chang, Z [Duke University Medical Center, Durham, NC (United States)

    2015-06-15

    Purpose: To investigate the feasibility of using classic textural feature extraction in radiotherapy response assessment, we studied a unique cohort of early stage breast cancer patients with paired pre - and post-radiation Diffusion Weighted MRI (DWI-MRI) and Dynamic Contrast Enhanced MRI (DCE-MRI). Methods: 15 female patients from our prospective phase I trial evaluating preoperative radiotherapy were included in this retrospective study. Each patient received a single-fraction radiation treatment, and DWI and DCE scans were conducted before and after the radiotherapy. DWI scans were acquired using a spin-echo EPI sequence with diffusion weighting factors of b = 0 and b = 500 mm{sup 2} /s, and the apparent diffusion coefficient (ADC) maps were calculated. DCE-MRI scans were acquired using a T{sub 1}-weighted 3D SPGR sequence with a temporal resolution of about 1 minute. The contrast agent (CA) was intravenously injected with a 0.1 mmol/kg bodyweight dose at 2 ml/s. Two parameters, volume transfer constant (K{sup trans} ) and k{sub ep} were analyzed using the two-compartment Tofts kinetic model. For DCE parametric maps and ADC maps, 33 textural features were generated from the clinical target volume (CTV) in a 3D fashion using the classic gray level co-occurrence matrix (GLCOM) and gray level run length matrix (GLRLM). Wilcoxon signed-rank test was used to determine the significance of each texture feature’s change after the radiotherapy. The significance was set to 0.05 with Bonferroni correction. Results: For ADC maps calculated from DWI-MRI, 24 out of 33 CTV features changed significantly after the radiotherapy. For DCE-MRI pharmacokinetic parameters, all 33 CTV features of K{sup trans} and 33 features of k{sub ep} changed significantly. Conclusion: Initial results indicate that those significantly changed classic texture features are sensitive to radiation-induced changes and can be used for assessment of radiotherapy response in breast cancer.

  11. Multimodality Functional Imaging in Radiation Therapy Planning: Relationships between Dynamic Contrast-Enhanced MRI, Diffusion-Weighted MRI, and 18F-FDG PET

    Directory of Open Access Journals (Sweden)

    Moisés Mera Iglesias

    2015-01-01

    Full Text Available Objectives. Biologically guided radiotherapy needs an understanding of how different functional imaging techniques interact and link together. We analyse three functional imaging techniques that can be useful tools for achieving this objective. Materials and Methods. The three different imaging modalities from one selected patient are ADC maps, DCE-MRI, and 18F-FDG PET/CT, because they are widely used and give a great amount of complementary information. We show the relationship between these three datasets and evaluate them as markers for tumour response or hypoxia marker. Thus, vascularization measured using DCE-MRI parameters can determine tumour hypoxia, and ADC maps can be used for evaluating tumour response. Results. ADC and DCE-MRI include information from 18F-FDG, as glucose metabolism is associated with hypoxia and tumour cell density, although 18F-FDG includes more information about the malignancy of the tumour. The main disadvantage of ADC maps is the distortion, and we used only low distorted regions, and extracellular volume calculated from DCE-MRI can be considered equivalent to ADC in well-vascularized areas. Conclusion. A dataset for achieving the biologically guided radiotherapy must include a tumour density study and a hypoxia marker. This information can be achieved using only MRI data or only PET/CT studies or mixing both datasets.

  12. Prenatal MR diffusion-weighted imaging in a fetus with hemimegalencephaly

    Energy Technology Data Exchange (ETDEWEB)

    Agid, Ronit; Lieberman, Sivan; Gomori, John M. [Hadassah University Hospital, Division of Neuroradiology, Department of Radiology, Kiryat Hadassah, Ein-Karem, P.O. Box 12000, Jerusalem (Israel); Nadjari, Michael [Hadassah University Hospital, Department of Obstetrics and Gynecology, Jerusalem (Israel)

    2006-02-01

    We report a case of hemimegalencephaly diagnosed by prenatal MRI with an emphasis on its appearance on diffusion-weighted images. This case shows that in this condition the enlarged hemisphere may show restricted diffusion on prenatal MRI. In our opinion, this finding may result from a combination of increased cellularity and advanced myelination in the affected hemisphere. Restricted diffusion is an additional valuable indicator in the analysis of the fetal brain. (orig.)

  13. A time-efficient acquisition protocol for multipurpose diffusion-weighted microstructural imaging at 7 Tesla.

    Science.gov (United States)

    Sepehrband, Farshid; O'Brien, Kieran; Barth, Markus

    2017-12-01

    Several diffusion-weighted MRI techniques have been developed and validated during the past 2 decades. While offering various neuroanatomical inferences, these techniques differ in their proposed optimal acquisition design, preventing clinicians and researchers benefiting from all potential inference methods, particularly when limited time is available. This study reports an optimal design that enables for a time-efficient diffusion-weighted MRI acquisition scheme at 7 Tesla. The primary audience of this article is the typical end user, interested in diffusion-weighted microstructural imaging at 7 Tesla. We tested b-values in the range of 700 to 3000 s/mm 2 with different number of angular diffusion-encoding samples, against a data-driven "gold standard." The suggested design is a protocol with b-values of 1000 and 2500 s/mm 2 , with 25 and 50 samples, uniformly distributed over two shells. We also report a range of protocols in which the results of fitting microstructural models to the diffusion-weighted data had high correlation with the gold standard. We estimated minimum acquisition requirements that enable diffusion tensor imaging, higher angular resolution diffusion-weighted imaging, neurite orientation dispersion, and density imaging and white matter tract integrity across whole brain with isotropic resolution of 1.8 mm in less than 11 min. Magn Reson Med 78:2170-2184, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  14. Magnetic resonance imaging of blood-brain barrier permeability in ischemic stroke using diffusion-weighted arterial spin labeling in rats.

    Science.gov (United States)

    Tiwari, Yash V; Lu, Jianfei; Shen, Qiang; Cerqueira, Bianca; Duong, Timothy Q

    2017-08-01

    Diffusion-weighted arterial spin labeling magnetic resonance imaging has recently been proposed to quantify the rate of water exchange (K w ) across the blood-brain barrier in humans. This study aimed to evaluate the blood-brain barrier disruption in transient (60 min) ischemic stroke using K w magnetic resonance imaging with cross-validation by dynamic contrast-enhanced magnetic resonance imaging and Evans blue histology in the same rats. The major findings were: (i) at 90 min after stroke (30 min after reperfusion), group K w magnetic resonance imaging data showed no significant blood-brain barrier permeability changes, although a few animals showed slightly abnormal K w . Dynamic contrast-enhanced magnetic resonance imaging confirmed this finding in the same animals. (ii) At two days after stroke, K w magnetic resonance imaging revealed significant blood-brain barrier disruption. Regions with abnormal K w showed substantial overlap with regions of hyperintense T 2 (vasogenic edema) and hyperperfusion. Dynamic contrast-enhanced magnetic resonance imaging and Evans blue histology confirmed these findings in the same animals. The K w values in the normal contralesional hemisphere and the ipsilesional ischemic core two days after stroke were: 363 ± 17 and 261 ± 18 min -1 , respectively (P < 0.05, n = 9). K w magnetic resonance imaging is sensitive to blood-brain barrier permeability changes in stroke, consistent with dynamic contrast-enhanced magnetic resonance imaging and Evans blue extravasation. K w magnetic resonance imaging offers advantages over existing techniques because contrast agent is not needed and repeated measurements can be made for longitudinal monitoring or averaging.

  15. Brain venous pathologies: MRI findings

    International Nuclear Information System (INIS)

    Salvatico, Rosana; Gonzalez, Alejandro; Yanez, Paulina; Romero, Carlos; Trejo, Mariano; Lambre, Hector

    2006-01-01

    Purpose: To describe MRI findings of the different brain venous pathologies. Material and Methods: Between January 2002 and March 2004, 18 patients were studied 10 males and 8 females between 6 and 63 years old; with different brain venous pathologies. In all cases brain MRI were performed including morphological sequences with and without gadolinium injection and angiographic venous sequences. Results: 10 venous occlusions were found, 6 venous angiomas, and 2 presented varices secondary to arteriovenous dural fistula. Conclusion: Brain venous pathologies can appear in many different clinical contexts, with different prognosis and treatment. In all the cases brain MRI was the best imaging study to disclose typical morphologic abnormalities. (author) [es

  16. Diffusion-weighted MR of the brain: methodology and clinical applications; Diffusione in RM dell'encefalo: metodologia e applicazioni cliniche

    Energy Technology Data Exchange (ETDEWEB)

    Mascalchi, Mario [Firenze Univ., Firenze (Italy). Dipartimento di Fisiopatologia clinica, Sezione di Radiodiagnostica; Filippi, Massimo [Istituto Scientifico Ospedale S. Raffaele, Milano (Italy)Unita di Neuroimaging Quantitativo; Floris, Roberto [Tor Vergata Univ., Roma (Italy). Dipartimento di Diagnostica per immagini e radiologia interventistica; Fonda, Claudio [Ospedale Meyer, Firenze (Italy). Servizio di radiologia; Gasparotti, Roberto [Brescia Univ., Brescia (Italy). Neuroradiologia; Villari, Natale

    2005-03-01

    Clinical diffusion magnetic resonance (MR) imaging in humans started in the last decade with the demonstration of the capabilities of this technique of depicting the anatomy of the white matter fibre tracts in the brain. Two main approaches in terms of reconstruction and evaluation of the images obtained with application of diffusion sensitising gradients to an echo planar imaging sequence are possible. The first approach consists of reconstruction of images in which the effect of white matter anisotropy is averaged -know as the isotropic or diffusion weighted images, which are usually evaluated subjectively for possible areas of increased or decreased signal, reflecting restricted and facilitated diffusion, respectively. The second approach implies reconstruction of image maps of the apparent diffusion coefficient (ADC), in which the T2 weighting of the echo planar diffusion sequence is cancelled out, and their objective, i.e. numerical, evaluation with regions of interest or histogram analysis. This second approach enables a quantitative and reproducible assessment of the diffusion changes mot only in areas exhibiting signal abnormality in conventional MR images, but also in areas of normal signal. A further level of image post-processing requires the acquisition of images after application of sensitive gradients along at least 6 different spatial orientations and consists of computation of the diffusion tensor and reconstruction of maps of the mean diffusivity (D) and of the white matter anisotropic properties, usually in terms of fractional anisotropy (FA). Diffusion-weighted imaging is complementary to conventional MR imaging in the evaluation of the acute ischaemic stroke. The combination of diffusion and perfusion MR imaging has the potential of providing all the information necessary for the diagnosis and management of the individual patient with acute ischaemic stroke. Diffusion-weighted MR, in particular quantitative evaluation based on the diffusion

  17. Functional imaging of submandibular glands: diffusion-weighted echo-planar MRI before and after stimulation; Diffusionsgewichtete MRT zur Funktionsdiagnostik der Glandula submandibularis

    Energy Technology Data Exchange (ETDEWEB)

    Arndt, C.; Cramer, M.C.; Weiss, F.; Kaul, M.G.; Adam, G.; Habermann, C.R. [Zentrum fuer Bildgebende Diagnostik und Intervention, Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Graessner, J. [Siemens Medical Solutions (Germany); Petersen, K. [Zentrum fuer Psychosoziale Medizin, Klinik und Poliklinik fuer Psychiatrie und Psychotherapie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Reitmeier, F.; Jaehne, M. [Kopf und Hautzentrum, Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde, Universitaetsklinikum Hamburg Eppendorf (Germany)

    2006-09-15

    Purpose: To investigate the feasibility of diffusion-weighted (DWI) echo-planar imaging (EPI) to depict the submandibular glands and to measure different functional conditions. Materials and Methods: Twenty-seven healthy volunteers were examined. Diffusion weighted sequence was performed prior to stimulation. Exactly 30 seconds after a commercially available lemon juice was given orally, the diffusion weighted sequence was repeated. All examinations were performed by using a 1.5-T superconducting system with a 30 mT/m maximum gradient capability and maximum slew rate of 125 mT/m/sec (Magnetom Symphony, Siemens, Erlangen, Germany). The lower part of the circularly polarized (CP) head coil and a standard two-element CP neck array coil were used. The flexibility of the neck array coil allowed positioning the N1 element (upper part of the coil) right next to the submandibular gland. The axial diffusion-weighted EPI (echo planar imaging) sequence was performed using a matrix of 119 x 128, a field of view of 250 x 250 mm (pixel size 2.1 x 1.95 mm), a section thickness of 5 mm with an interslice gap of 1 mm. The b factors used were 0 sec/mm{sup 2}, 500 sec/mm{sup 2} and 1000 sec/mm{sup 2}. Apparent diffusion coefficient (ADC) maps were digitally transferred to MRIcro (Chris Rorden, University of Nottingham, Great Britain). After detecting the submandibular glands a region of interest (ROI) was placed manually exactly within the boarder of both submandibular glands, excluding the external carotid artery on ADC maps. These procedures were performed on all ADC slices the submandibular glands could be differentiated in before and after oral stimulation. For statistical comparison of results, a student's t-test was performed with an overall two-tailed significance level of p=0.05. Results: The visualization of the submandibular glands using the diffusion-weighted EPI sequence was possible in all of the 27 volunteers. Prior to oral stimulation an ADC of 1.31 x 10{sup -3

  18. Whole-body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Michielsen, Katrijn; Op de beeck, Katya; Dymarkowski, Steven; Keyzer, Frederik de; Vandecaveye, Vincent [University Hospitals Leuven, Department of Radiology, Medical Imaging Research Centre, Leuven (Belgium); Vergote, Ignace; Amant, Frederic; Leunen, Karin [University Hospitals Leuven, Department of Obstetrics and Gynaecology, Leuven Cancer Institute, Leuven (Belgium); Moerman, Philippe [University Hospitals Leuven, Department of Morphology and Molecular Pathology, Leuven (Belgium); Deroose, Christophe [University Hospitals Leuven, Department of Nuclear Medicine, Medical Imaging Research Centre, Leuven (Belgium); Souverijns, Geert [Jessa Ziekenhuis - Campus Virga Jessa, Department of Radiology, Hasselt (Belgium)

    2014-04-15

    To evaluate whole-body MRI with diffusion-weighted sequence (WB-DWI/MRI) for staging and assessing operability compared with CT and FDG-PET/CT in patients with suspected ovarian cancer. Thirty-two patients underwent 3-T WB-DWI/MRI, {sup 18} F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and CT before diagnostic open laparoscopy (DOL). Imaging findings for tumour characterisation, peritoneal and retroperitoneal staging were correlated with histopathology after DOL and/or open surgery. For distant metastases, FDG-PET/CT or image-guided biopsies were the reference standards. For tumour characterisation and peritoneal staging, WB-DWI/MRI was compared with CT and FDG-PET/CT. Interobserver agreement for WB-DWI/MRI was determined. WB-DWI/MRI showed 94 % accuracy for primary tumour characterisation compared with 88 % for CT and 94 % for FDG-PET/CT. WB-DWI/MRI showed higher accuracy of 91 % for peritoneal staging compared with CT (75 %) and FDG-PET/CT (71 %). WB-DWI/MRI and FDG-PET/CT showed higher accuracy of 87 % for detecting retroperitoneal lymphadenopathies compared with CT (71 %). WB-DWI/MRI showed excellent correlation with FDG-PET/CT (κ = 1.00) for detecting distant metastases compared with CT (κ = 0.34). Interobserver agreement was moderate to almost perfect (κ = 0.58-0.91). WB-DWI/MRI shows high accuracy for characterising primary tumours, peritoneal and distant staging compared with CT and FDG-PET/CT and may be valuable for assessing operability in ovarian cancer patients. (orig.)

  19. Dynamic contrast-enhanced MRI, diffusion-weighted MRI and {sup 18}F-FDG PET/CT for the prediction of survival in oropharyngeal or hypopharyngeal squamous cell carcinoma treated with chemoradiation

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Shu-Hang [Chang Gung University, Molecular Imaging Center, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Chang Gung University, Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Chang Gung University, Department of Medical Imaging and Radiological Sciences, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Liao, Chun-Ta [Chang Gung University, Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Lin, Chien-Yu; Chang, Joseph Tung-Chieh; Fan, Kang-Hsing [Chang Gung University, Department of Radiation Oncology, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Chan, Sheng-Chieh; Yen, Tzu-Chen [Chang Gung University, Molecular Imaging Center, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Chang Gung University, Department of Nuclear Medicine, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Lin, Yu-Chun [Chang Gung University, Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Chang Gung University, Department of Medical Imaging and Radiological Sciences, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Ko, Sheung-Fat [Chang Gung University, Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Wang, Hung-Ming [Chang Gung University, Department of Medical Oncology, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Yang, Lan-Yan [Chang Gung University, Biostatistics and Informatics Unit, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Wang, Jiun-Jie [Chang Gung University, Department of Medical Imaging and Radiological Sciences, Chang Gung Memorial Hospital, Kueishan, Taoyuan (China); Chang Gung Memorial Hospital, Neuroscience Research Center, Taoyuan (China); Chang Gung Memorial Hospital, Department of Diagnostic Radiology, Keelung (China); Chang Gung University / Chang Gung Memorial Hospital, Linkou, Medical Imaging Research Center, Institute for Radiological Research, Taoyuan (China)

    2016-11-15

    We prospectively investigated the roles of pretreatment dynamic contrast-enhanced MR imaging (DCE-MRI), diffusion-weighted MR imaging (DWI) and {sup 18}F-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG PET)/CT for predicting survival of oropharyngeal or hypopharyngeal squamous cell carcinoma (OHSCC) patients treated with chemoradiation. Patients with histologically proven OHSCC and neck nodal metastases scheduled for chemoradiation were eligible. Clinical variables as well as DCE-MRI-, DWI- and {sup 18}F-FDG PET/CT-derived parameters of the primary tumours and metastatic neck nodes were analysed in relation to 3-year progression-free survival (PFS) and overall survival (OS) rates. Eighty-six patients were available for analysis. Multivariate analysis identified the efflux rate constant (K{sub ep})-tumour < 3.79 min{sup -1} (P = 0.001), relative volume of extracellular extravascular space (V{sub e})-node < 0.23 (P = 0.004) and SUV{sub max}-tumour > 19.44 (P = 0.025) as independent risk factors for both PFS and OS. A scoring system based upon the sum of each of the three imaging parameters allowed stratification of our patients into three groups (patients with 0/1 factor, patients with 2 factors and patients with 3 factors, respectively) with distinct PFS (3-year rates = 72 %, 38 % and 0 %, P < 0.0001) and OS (3-year rates = 81 %, 46 % and 20 %, P < 0.0001). K{sub ep}-tumour, V{sub e}-node and SUV{sub max}-tumour were independent prognosticators for OHSCC treated with chemoradiation. Their combination helped survival stratification. (orig.)

  20. Dynamic contrast-enhanced MRI, diffusion-weighted MRI and 18F-FDG PET/CT for the prediction of survival in oropharyngeal or hypopharyngeal squamous cell carcinoma treated with chemoradiation

    International Nuclear Information System (INIS)

    Ng, Shu-Hang; Liao, Chun-Ta; Lin, Chien-Yu; Chang, Joseph Tung-Chieh; Fan, Kang-Hsing; Chan, Sheng-Chieh; Yen, Tzu-Chen; Lin, Yu-Chun; Ko, Sheung-Fat; Wang, Hung-Ming; Yang, Lan-Yan; Wang, Jiun-Jie

    2016-01-01

    We prospectively investigated the roles of pretreatment dynamic contrast-enhanced MR imaging (DCE-MRI), diffusion-weighted MR imaging (DWI) and 18 F-fluorodeoxyglucose-positron emission tomography ( 18 F-FDG PET)/CT for predicting survival of oropharyngeal or hypopharyngeal squamous cell carcinoma (OHSCC) patients treated with chemoradiation. Patients with histologically proven OHSCC and neck nodal metastases scheduled for chemoradiation were eligible. Clinical variables as well as DCE-MRI-, DWI- and 18 F-FDG PET/CT-derived parameters of the primary tumours and metastatic neck nodes were analysed in relation to 3-year progression-free survival (PFS) and overall survival (OS) rates. Eighty-six patients were available for analysis. Multivariate analysis identified the efflux rate constant (K ep )-tumour < 3.79 min -1 (P = 0.001), relative volume of extracellular extravascular space (V e )-node < 0.23 (P = 0.004) and SUV max -tumour > 19.44 (P = 0.025) as independent risk factors for both PFS and OS. A scoring system based upon the sum of each of the three imaging parameters allowed stratification of our patients into three groups (patients with 0/1 factor, patients with 2 factors and patients with 3 factors, respectively) with distinct PFS (3-year rates = 72 %, 38 % and 0 %, P < 0.0001) and OS (3-year rates = 81 %, 46 % and 20 %, P < 0.0001). K ep -tumour, V e -node and SUV max -tumour were independent prognosticators for OHSCC treated with chemoradiation. Their combination helped survival stratification. (orig.)

  1. Spontaneous mechanical and electrical activities of human calf musculature at rest assessed by repetitive single-shot diffusion-weighted MRI and simultaneous surface electromyography.

    Science.gov (United States)

    Schwartz, Martin; Steidle, Günter; Martirosian, Petros; Ramos-Murguialday, Ander; Preißl, Hubert; Stemmer, Alto; Yang, Bin; Schick, Fritz

    2018-05-01

    Assessment of temporal and spatial relations between spontaneous mechanical activities in musculature (SMAM) at rest as revealed by diffusion-weighted imaging (DWI) and electrical muscular activities in surface EMG (sEMG). Potential influences of static and radiofrequency magnetic fields on muscular activity on sEMG measurements at rest were examined systematically. Series of diffusion-weighted stimulated echo planar imaging were recorded with concurrent sEMG measurements. Electrical activities in sEMG were analyzed by non-parametric Friedman and two-sample Kolmogorov-Smirnov test. Direct correlation of both modalities was investigated by temporal mapping of electrical activity in sEMG to DWI repetition interval. Electrical activities in sEMG and number of visible SMAMs in DWI showed a strong correlation (ρ = 0.9718). High accordance between sEMG activities and visible SMAMs in DWI in a near-surface region around sEMG electrodes was achieved. Characteristics of sEMG activities were almost similar under varying magnetic field conditions. Visible SMAMs in DWI have shown a close and direct relation to concurrent signals recorded by sEMG. MR-related magnetic fields had no significant effects on findings in sEMG. Hence, appearance of SMAMs in DWI should not be considered as imaging artifact or as effects originating from the special conditions of MR examinations. Spatial and temporal distributions of SMAMs indicate characteristics of spontaneous (microscopic) mechanical muscular action at rest. Therefore, DWI techniques should be considered as non-invasive tools for studying physiology and pathophysiology of spontaneous activities in resting muscle. Magn Reson Med 79:2784-2794, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  2. Super-resolution reconstruction of diffusion parameters from diffusion-weighted images with different slice orientations.

    Science.gov (United States)

    Van Steenkiste, Gwendolyn; Jeurissen, Ben; Veraart, Jelle; den Dekker, Arnold J; Parizel, Paul M; Poot, Dirk H J; Sijbers, Jan

    2016-01-01

    Diffusion MRI is hampered by long acquisition times, low spatial resolution, and a low signal-to-noise ratio. Recently, methods have been proposed to improve the trade-off between spatial resolution, signal-to-noise ratio, and acquisition time of diffusion-weighted images via super-resolution reconstruction (SRR) techniques. However, during the reconstruction, these SRR methods neglect the q-space relation between the different diffusion-weighted images. An SRR method that includes a diffusion model and directly reconstructs high resolution diffusion parameters from a set of low resolution diffusion-weighted images was proposed. Our method allows an arbitrary combination of diffusion gradient directions and slice orientations for the low resolution diffusion-weighted images, optimally samples the q- and k-space, and performs motion correction with b-matrix rotation. Experiments with synthetic data and in vivo human brain data show an increase of spatial resolution of the diffusion parameters, while preserving a high signal-to-noise ratio and low scan time. Moreover, the proposed SRR method outperforms the previous methods in terms of the root-mean-square error. The proposed SRR method substantially increases the spatial resolution of MRI that can be obtained in a clinically feasible scan time. © 2015 Wiley Periodicals, Inc.

  3. Accuracy of diffusion-weighted (DW) MRI with background signal suppression (MR-DWIBS) in diagnosis of mediastinal lymph node metastasis of nonsmall-cell lung cancer (NSCLC).

    Science.gov (United States)

    Xu, Liang; Tian, Jiakai; Liu, Yuhui; Li, Chuanfu

    2014-07-01

    To prospectively evaluate the accuracy of diffusion-weighted (DW) magnetic resonance (MR) imaging with background signal suppression (MR-DWIBS) for detecting mediastinal lymph node metastasis of nonsmall-cell lung cancer (NSCLC). MR-DWIBS was performed in 42 consecutive patients (27 men, 15 women; age range, 42-78 years; median age, 55 years) with histologically proven NSCLC. The visualization rate of metastatic lymph node (MLN) and benign lymph node (BLN) of enlarged lymph nodes (ELN) and normal-sized lymph nodes (NLN) was compared by using a chi-square test or Fisher's exact test on a per-nodal basis. Apparent diffusion coefficient (ADC) of MLN and BLN was measured and compared by using two-tailed unpaired Student's t-test. Receiver operating characteristic (ROC) analysis was used to assess the overall diagnostic accuracy of ADC for ELN and NLN. The optimal cutoff value was determined and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy was calculated. Thirty-five out of 119 lymph resected nodes were confirmed to be metastatic by histologic examination. The visualization rate of MLN was significantly higher than that of BLN for ELN (P accuracy were 75.0%, 90.9%, 66.7%, 93.8%, and 87.8%, respectively. MR-DWIBS may be clinically useful to visually detect mediastinal lymph nodes and ADC measurement can aid in malignant node discrimination. © 2013 Wiley Periodicals, Inc.

  4. [A case of cerebral venous thrombosis with reversible brain parenchymal lesions: usefulness of diffusion weighted imaging and measurement of apparent diffusion coefficient].

    Science.gov (United States)

    Kuwahara, S; Abe, T; Kawada, M; Uga, S; Shimizu, K

    2001-01-01

    A 47-year-old man with a history of thrombophlebitis of his left leg for several years presented with a mild left hemiparesis and ipsilateral hypesthesia. Magnetic resonance imaging showed subacute thrombosis of the superior sagittal sinus and a cortical vein of the right cerebral hemisphere. A linear hyperintense area was found in the white matter of the right postcentral gyrus on T 2- and diffusion weighted axial imagings on the 7 days after the onset. The patient was treated conservatively, and his clinical course was uneventful. His neurological dysfunctions recovered within approximately three weeks after the onset. The white matter lesion in the right postcentral gyrus also disappeared one month later. The apparent diffusion coefficients (ADCs) in the white matter of the pre- and postcentral gyrus were measured bilaterally on the ADC mapping imaging. In the subacute stage, the ADC values in the white matter of the right pre- and postcentral gyrus were 0.50 x 10(-3) mm2/sec and 0.91 x 10(-3) mm2/sec, respectively. The %ADC indicating the ratio of ADC value of the lesion to that of the contralateral brain tissue was calculated. The %ADCs in the white matter of the pre- and postcentral gyrus were 64.9% and 124.5% respectively. In the chronic stage, the ADC values in the white matter of the right pre- and postcentral gyrus were 0.96 x 10(-3) mm2/sec and 0.99 x 10(-3) mm2/sec, and the %ADCs improved to 106.7% and 106.5% respectively. The lesions in the white matter of the right pre- and postcentral gyrus were reversible. The former was thought to be mainly ascribed to cellular edema and the latter was vasogenic edema. The present case showed when %ADC of the ischemic lesion in cerebral venous thrombosis was higher than 60%-70%, conservative therapy alone is sufficient effective for the improvement of neurological deficits.

  5. Prostate cancer: assessing the effects of androgen-deprivation therapy using quantitative diffusion-weighted and dynamic contrast-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hoetker, Andreas M. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Universitaetsmedizin Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mazaheri, Yousef [Memorial Sloan-Kettering Cancer Center, Department of Medical Physics, New York, NY (United States); Zheng, Junting; Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Berkowitz, Joshua; Pei, Xin; Zelefsky, Michael J. [Memorial Sloan-Kettering Cancer Center, Department of Radiation Oncology, New York, NY (United States); Lantos, Joshua E.; Hricak, Hedvig; Akin, Oguz [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States)

    2015-09-15

    To investigate the effects of androgen-deprivation therapy (ADT) on MRI parameters and evaluate their associations with treatment response measures. The study included 30 men with histopathologically confirmed prostate cancer who underwent MRI before and after initiation of ADT. Thirty-four tumours were volumetrically assessed on DW-MRI (n = 32) and DCE-MRI (n = 18), along with regions of interest in benign prostatic tissue, to calculate apparent diffusion coefficient (ADC) and transfer constant (K{sup trans}) values. Changes in MRI parameters and correlations with clinical parameters (change in prostate-specific antigen [PSA], treatment duration, PSA nadir) were assessed. Prostate volume and PSA values decreased significantly with therapy (p < 0.001). ADC values increased significantly in tumours and decreased in benign prostatic tissue (p < 0.05). Relative changes in ADC and absolute post-therapeutic ADC values differed significantly between tumour and benign tissue (p < 0.001). K{sup trans} decreased significantly only in tumours (p < 0.001); relative K{sup trans} changes and post-therapeutic values were not significantly different between tumour and benign tissue. The relative change in tumour ADC correlated significantly with PSA decrease. No changes were associated with treatment duration or PSA nadir. Multi-parametric MRI shows significant measurable changes in tumour and benign prostate caused by ADT and may help in monitoring treatment response. (orig.)

  6. Independent value of image fusion in unenhanced breast MRI using diffusion-weighted and morphological T2-weighted images for lesion characterization in patients with recently detected BI-RADS 4/5 X-ray mammography findings

    Energy Technology Data Exchange (ETDEWEB)

    Bickelhaupt, Sebastian; Tesdorff, Jana; Delorme, Stefan; Schlemmer, Heinz-Peter [German Cancer Research Center (dkfz), Department of Radiology, Heidelberg (Germany); Laun, Frederik Bernd; Kuder, Tristan Anselm [German Cancer Research Center (dkfz), Medical Physics in Radiology, Heidelberg (Germany); Lederer, Wolfgang; Teiner, Susanne [Radiological Practice at the ATOS Clinic Heidelberg, Heidelberg (Germany); Maier-Hein, Klaus [German Cancer Research Center (dkfz), Junior Group Medical Image Computing, Heidelberg (Germany); Daniel, Heidi [Radiology Center Mannheim (RZM), Mannheim (Germany); Stieber, Anne [University Hospital Heidelberg, Department of Clinical and Interventional Radiology, Heidelberg (Germany)

    2017-02-15

    The aim of this study was to evaluate the accuracy and applicability of solitarily reading fused image series of T2-weighted and high-b-value diffusion-weighted sequences for lesion characterization as compared to sequential or combined image analysis of these unenhanced sequences and to contrast- enhanced breast MRI. This IRB-approved study included 50 female participants with suspicious breast lesions detected in screening X-ray mammograms, all of which provided written informed consent. Prior to biopsy, all women underwent MRI including diffusion-weighted imaging (DWIBS, b = 1500s/mm{sup 2}). Images were analyzed as follows: prospective image fusion of DWIBS and T2-weighted images (FU), side-by-side analysis of DWIBS and T2-weighted series (CO), combination of the first two methods (CO+FU), and full contrast-enhanced diagnostic protocol (FDP). Diagnostic indices, confidence, and image quality of the protocols were compared by two blinded readers. Reading the CO+FU (accuracy 0.92; NPV 96.1 %; PPV 87.6 %) and the CO series (0.90; 96.1 %; 83.7 %) provided a diagnostic performance similar to the FDP (0.95; 96.1 %; 91.3 %; p > 0.05). FU reading alone significantly reduced the diagnostic accuracy (0.82; 93.3 %; 73.4 %; p = 0.023). MR evaluation of suspicious BI-RADS 4 and 5 lesions detected on mammography by using a non-contrast-enhanced T2-weighted and DWIBS sequence protocol is most accurate if MR images were read using the CO+FU protocol. (orig.)

  7. Characterization of the collagen component of cartilage repair tissue of the talus with quantitative MRI: comparison of T2 relaxation time measurements with a diffusion-weighted double-echo steady-state sequence (dwDESS)

    Energy Technology Data Exchange (ETDEWEB)

    Kretzschmar, M.; Hainc, N.; Studler, U. [University Hospital Basel, Department of Radiology, Basel (Switzerland); Bieri, O. [University Hospital Basel, Division of Radiological Physics, Basel (Switzerland); Miska, M. [University Hospital, Department of Orthopedics, Heidelberg (Germany); Wiewiorski, M.; Valderrabano, V. [University Hospital Basel, Department of Orthopedic Surgery, Basel (Switzerland)

    2015-04-01

    The purpose of this study was to characterize the collagen component of repair tissue (RT) of the talus after autologous matrix-induced chondrogenesis (AMIC) using quantitative T2 and diffusion-weighted imaging. Mean T2 values and diffusion coefficients of AMIC-RT and normal cartilage of the talus of 25 patients with posttraumatic osteochondral lesions and AMIC repair were compared in a cross-sectional design using partially spoiled steady-state free precession (pSSFP) for T2 quantification, and diffusion-weighted double-echo steady-state (dwDESS) for diffusion measurement. RT and cartilage were graded with modified Noyes and MOCART scores on morphological sequences. An association between follow-up interval and quantitative MRI measures was assessed using multivariate regression, after stratifying the cohort according to time interval between surgery and MRI. Mean T2 of the AMIC-RT and cartilage were 43.1 ms and 39.1 ms, respectively (p = 0.26). Mean diffusivity of the RT (1.76 μm{sup 2}/ms) was significantly higher compared to normal cartilage (1.46 μm{sup 2}/ms) (p = 0.0092). No correlation was found between morphological and quantitative parameters. RT diffusivity was lowest in the subgroup with follow-up >28 months (p = 0.027). Compared to T2-mapping, dwDESS demonstrated greater sensitivity in detecting differences in the collagen matrix between AMIC-RT and cartilage. Decreased diffusivity in patients with longer follow-up times may indicate an increased matrix organization of RT. (orig.)

  8. Diffusion-weighted MR imaging (DWI) in spinal cord ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Thurnher, Majda M. [Medical University of Vienna, Department of Radiology, Neuroradiology Section, Vienna (Austria); Bammer, Roland [Stanford University, Lucas MRS/I Center, Department of Radiology, Stanford, CA (United States)

    2006-11-15

    Spinal cord infarction is a rare clinical diagnosis characterized by a sudden onset of paralysis, bowel and bladder dysfunction, and loss of pain and temperature perception, with preservation of proprioception and vibration sense. Magnetic resonance imaging (MRI) usually demonstrates intramedullary hyperintensity on T2-weighted MR images with cord enlargement. However, in approximately 45% of patients, MR shows no abnormality. Diffusion-weighted MR imaging (DWI) has been widely used for the evaluation of a variety of brain disorders, especially for acute stroke. Preliminary data suggest that DWI has the potential to be useful in the early detection of spinal infarction. We performed DWI, using navigated, interleaved, multishot echo planar imaging (IEPI), in a series of six patients with a clinical suspicion of acute spinal cord ischemia. In all patients, high signal was observed on isotropic DWI images with low ADC values (0.23 and 0.86 x 10{sup -3} cm{sup 2}/s), indicative of restricted diffusion. We analyzed the imaging findings from conventional MR sequences and diffusion-weighted MR sequences in six patients with spinal cord infarction, compared the findings with those in published series, and discuss the value of DWI in spinal cord ischemia based on current experience. Although the number of patients with described DWI findings totals only 23, the results of previously published studies and those of our study suggest that DWI has the potential to be a useful and feasible technique for the detection of spinal infarction. (orig.)

  9. Diffusion-weighted MR imaging (DWI) in spinal cord ischemia

    International Nuclear Information System (INIS)

    Thurnher, Majda M.; Bammer, Roland

    2006-01-01

    Spinal cord infarction is a rare clinical diagnosis characterized by a sudden onset of paralysis, bowel and bladder dysfunction, and loss of pain and temperature perception, with preservation of proprioception and vibration sense. Magnetic resonance imaging (MRI) usually demonstrates intramedullary hyperintensity on T2-weighted MR images with cord enlargement. However, in approximately 45% of patients, MR shows no abnormality. Diffusion-weighted MR imaging (DWI) has been widely used for the evaluation of a variety of brain disorders, especially for acute stroke. Preliminary data suggest that DWI has the potential to be useful in the early detection of spinal infarction. We performed DWI, using navigated, interleaved, multishot echo planar imaging (IEPI), in a series of six patients with a clinical suspicion of acute spinal cord ischemia. In all patients, high signal was observed on isotropic DWI images with low ADC values (0.23 and 0.86 x 10 -3 cm 2 /s), indicative of restricted diffusion. We analyzed the imaging findings from conventional MR sequences and diffusion-weighted MR sequences in six patients with spinal cord infarction, compared the findings with those in published series, and discuss the value of DWI in spinal cord ischemia based on current experience. Although the number of patients with described DWI findings totals only 23, the results of previously published studies and those of our study suggest that DWI has the potential to be a useful and feasible technique for the detection of spinal infarction. (orig.)

  10. Anatomical and functional volume concordance between FDG PET, and T2 and diffusion-weighted MRI for cervical cancer: a hybrid PET/MR study.

    Science.gov (United States)

    Sun, Hongzan; Xin, Jun; Zhang, Shaomin; Guo, Qiyong; Lu, Yueyue; Zhai, Wei; Zhao, Long; Peng, Weiai; Wang, Baijun

    2014-05-01

    To evaluate the concordance among (18)F-FDG PET imaging, MR T2-weighted (T2-W) imaging and apparent diffusion coefficient (ADC) maps with diffusion-weighted (DW) imaging in cervical cancer using hybrid whole-body PET/MR. This study prospectively included 35 patients with cervical cancer who underwent pretreatment (18)F-FDG PET/MR imaging. (18)F-FDG PET and MR images were fused using standard software. The percent of the maximum standardized uptake values (SUV max) was used to contour tumours on PET images, and volumes were calculated automatically. Tumour volumes measured on T2-W and DW images were calculated with standard techniques of tumour area multiplied by the slice profile. Parametric statistics were used for data analysis. FDG PET tumour volumes calculated using SUV max (14.30 ± 4.70) and T2-W imaging volume (33.81 ± 27.32 cm(3)) were similar (P > 0.05) at 35 % and 40 % of SUV max (32.91 ± 18.90 cm(3) and 27.56 ± 17.19 cm(3) respectively) and significantly correlated (P W imaging volumes (P > 0.05). PET subvolumes with increasing SUV max cut-off percentage showed an inverse change in mean ADC values on DW imaging (P W and DW imaging in cervical cancer. Cut-off at 35 % or 40 % of SUV max is recommended for (18)F-FDG PET/MR SUV-based tumour volume estimation. The linear tumour subvolume concordance between FDG PET and DW imaging demonstrates individual regional concordance of metabolic activity and cell density.

  11. Can diffusion-weighted whole-body MRI replace contrast-enhanced CT for initial staging of Hodgkin lymphoma in children and adolescents?

    Science.gov (United States)

    Regacini, Rodrigo; Puchnick, Andrea; Luisi, Flavio Augusto Vercillo; Lederman, Henrique Manoel

    2018-01-23

    Although positron emission tomography with 18F-fluoro-2-deoxyglucose (FDG-PET/CT) has been recommended as the method of choice for lymphoma staging, it has limited availability in several countries, therefore, studies comparing whole-body magnetic resonance imaging (MRI) to conventional staging methods or to FDG-PET/CT are an important tool to establish whole-body MRI as an alternative to these methods. To compare whole-body MRI versus conventional imaging methods for staging of Hodgkin lymphoma in children and adolescents. The study included 22 patients ages 5 to 21 years. Staging was performed using conventional imaging methods and whole-body MRI. Conventional imaging methods were defined as computed tomography (CT) of the neck, chest, abdomen and pelvis and ultrasonography of the neck and/or abdomen. We calculated the sensitivity of these methods for Hodgkin lymphoma staging and their sensitivity and specificity for detecting sites of nodal and extranodal involvement. The sensitivity of whole-body MRI for Hodgkin lymphoma staging was superior to that of conventional imaging methods (95.5% vs. 86.4%, respectively), but both methods had similar sensitivity and specificity for detecting involvement of nodal sites (99.1% and 100% vs. 97.3% and 100%, respectively) and extranodal sites (90.5% and 98.7% vs. 90.5% and 99.4%, respectively). Whole-body MRI has excellent sensitivity for staging of Hodgkin lymphoma in children and adolescents. It can thus be considered an alternative for this purpose, particularly because it does not expose patients to ionizing radiation.

  12. Anatomical and functional volume concordance between FDG PET, and T2 and diffusion-weighted MRI for cervical cancer: a hybrid PET/MR study

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Hongzan; Xin, Jun; Zhang, Shaomin; Guo, Qiyong; Lu, Yueyue; Zhai, Wei; Zhao, Long [Shengjing Hospital of China Medical University, Department of Radiology, Shenyang, Liaoning (China); Peng, Weiai [NM Marketing, Great China, Philips Healthcare, Guangzhou (China); Wang, Baijun [Philips China Investment Co. Ltd. Shenyang Office, Shenyang, Liaoning (China)

    2014-05-15

    To evaluate the concordance among {sup 18}F-FDG PET imaging, MR T2-weighted (T2-W) imaging and apparent diffusion coefficient (ADC) maps with diffusion-weighted (DW) imaging in cervical cancer using hybrid whole-body PET/MR. This study prospectively included 35 patients with cervical cancer who underwent pretreatment {sup 18}F-FDG PET/MR imaging. {sup 18}F-FDG PET and MR images were fused using standard software. The percent of the maximum standardized uptake values (SUV{sub max}) was used to contour tumours on PET images, and volumes were calculated automatically. Tumour volumes measured on T2-W and DW images were calculated with standard techniques of tumour area multiplied by the slice profile. Parametric statistics were used for data analysis. FDG PET tumour volumes calculated using SUV{sub max} (14.30 ± 4.70) and T2-W imaging volume (33.81 ± 27.32 cm{sup 3}) were similar (P > 0.05) at 35 % and 40 % of SUV{sub max} (32.91 ± 18.90 cm{sup 3} and 27.56 ± 17.19 cm{sup 3} respectively) and significantly correlated (P < 0.001; r = 0.735 and 0.766). The mean DW volume was 30.48 ± 22.41 cm{sup 3}. DW volumes were not significantly different from FDG PET volumes at either 35 % SUV{sub max} or 40 % SUV{sub max} or from T2-W imaging volumes (P > 0.05). PET subvolumes with increasing SUV{sub max} cut-off percentage showed an inverse change in mean ADC values on DW imaging (P < 0.001, ANOVA). Hybrid PET/MR showed strong volume concordance between FDG PET, and T2-W and DW imaging in cervical cancer. Cut-off at 35 % or 40 % of SUV{sub max} is recommended for {sup 18}F-FDG PET/MR SUV-based tumour volume estimation. The linear tumour subvolume concordance between FDG PET and DW imaging demonstrates individual regional concordance of metabolic activity and cell density. (orig.)

  13. Diffusion-weighted imaging: basic concepts and application in cerebral stroke and head trauma

    International Nuclear Information System (INIS)

    Huisman, Thierry A.G.M.

    2003-01-01

    Diffusion-weighted imaging (DWI) of the brain represents a new imaging technique that extends imaging from depiction of neuroanatomy to the level of function and physiology. DWI measures a fundamentally different physiological parameter compared with conventional MRI. Image contrast is related to differences in the diffusion rate of water molecules rather than to changes in total tissue water. DWI can reveal pathology in cases where conventional MRI remains unremarkable. DWI has proven to be highly sensitive in the early detection of acute cerebral ischemia and seems promising in the evaluation of traumatic brain injury. DWI can differentiate between lesions with decreased and increased diffusion. In addition, full-tensor DWI can evaluate the microscopic architecture of the brain, in particular white matter tracts, by measuring the degree and spatial distribution of anisotropic diffusion within the brain. This article reviews the basic concepts of DWI and its application in cerebral ischemia and traumatic brain injury. (orig.)

  14. Whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) vs choline-positron emission tomography-computed tomography (choline-PET/CT) for selecting treatments in recurrent prostate cancer.

    Science.gov (United States)

    Conde-Moreno, A J; Herrando-Parreño, G; Muelas-Soria, R; Ferrer-Rebolleda, J; Broseta-Torres, R; Cozar-Santiago, M P; García-Piñón, F; Ferrer-Albiach, C

    2017-05-01

    To determine the effectiveness of whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) in detecting metastases by comparing the results with those from choline-positron emission tomography-computed tomography (choline-PET/CT) in patients with biochemical relapse after primary treatment, and no metastases in bone scintigraphy, CT and/or pelvic MRI, or metastatic/oligometastatic prostate cancer (PCa). Patients with this disease profile who could benefit from treatment with stereotactic body radiation therapy (SBRT) were selected and their responses to these techniques were rated. This was a prospective, controlled, unicentric study, involving 46 consecutive patients from our centre who presented biochemical relapse after adjuvant, salvage or radical treatment with external beam radiotherapy, or brachytherapy. After initial tests (bone scintigraphy, CT, pelvic MRI), 35 patients with oligometastases or without them were selected. 11 patients with multiple metastases were excluded from the study. WB-DW-MRI and choline-PET/CT was then performed on each patient within 1 week. The results were interpreted by specialists in nuclear medicine and MRI. If they were candidates for treatment with ablative SBRT (SABR), they were then evaluated every three months with both tests. Choline-PET/CT detected lesions in 16 patients that were not observable using WB-DW-MRI. The results were consistent in seven patients and in three cases, a lesion was observed using WB-DW-MRI that was not detected with choline-PET/CT. The Kappa value obtained was 0.133 (p = 0.089); the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of WB-DW-MRI were estimated at 44.93, 64.29, 86.11, and 19.15%, respectively. For choline-PET/CT patients, the sensitivity, specificity, PPV, and NPV were 97.10, 58.33, 93.06, and 77.78%, respectively. Choline-PET/CT has a high global sensitivity while WB-DW-MRI has a high specificity, and so they are

  15. Comparison of qualitative and quantitative evaluation of diffusion-weighted MRI and chemical-shift imaging in the differentiation of benign and malignant vertebral body fractures.

    Science.gov (United States)

    Geith, Tobias; Schmidt, Gerwin; Biffar, Andreas; Dietrich, Olaf; Dürr, Hans Roland; Reiser, Maximilian; Baur-Melnyk, Andrea

    2012-11-01

    The objective of our study was to compare the diagnostic value of qualitative diffusion-weighted imaging (DWI), quantitative DWI, and chemical-shift imaging in a single prospective cohort of patients with acute osteoporotic and malignant vertebral fractures. The study group was composed of patients with 26 osteoporotic vertebral fractures (18 women, eight men; mean age, 69 years; age range, 31 years 6 months to 86 years 2 months) and 20 malignant vertebral fractures (nine women, 11 men; mean age, 63.4 years; age range, 24 years 8 months to 86 years 4 months). T1-weighted, STIR, and T2-weighted sequences were acquired at 1.5 T. A DW reverse fast imaging with steady-state free precession (PSIF) sequence at different delta values was evaluated qualitatively. A DW echo-planar imaging (EPI) sequence and a DW single-shot turbo spin-echo (TSE) sequence at different b values were evaluated qualitatively and quantitatively using the apparent diffusion coefficient. Opposed-phase sequences were used to assess signal intensity qualitatively. The signal loss between in- and opposed-phase images was determined quantitatively. Two-tailed Fisher exact test, Mann-Whitney test, and receiver operating characteristic analysis were performed. Sensitivities, specificities, and accuracies were determined. Qualitative DW-PSIF imaging (delta = 3 ms) showed the best performance for distinguishing between benign and malignant fractures (sensitivity, 100%; specificity, 88.5%; accuracy, 93.5%). Qualitative DW-EPI (b = 50 s/mm(2) [p = 1.00]; b = 250 s/mm(2) [p = 0.50]) and DW single-shot TSE imaging (b = 100 s/mm(2) [p = 1.00]; b = 250 s/mm(2) [p = 0.18]; b = 400 s/mm(2) [p = 0.18]; b = 600 s/mm(2) [p = 0.39]) did not indicate significant differences between benign and malignant fractures. DW-EPI using a b value of 500 s/mm(2) (p = 0.01) indicated significant differences between benign and malignant vertebral fractures. Quantitative DW-EPI (p = 0.09) and qualitative opposed-phase imaging (p = 0

  16. [68Ga]DOTATATE PET/MRI and [18F]FDG PET/CT are complementary and superior to diffusion-weighted MR imaging for radioactive-iodine-refractory differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Vrachimis, Alexis; Stegger, Lars; Wenning, Christian; Noto, Benjamin; Konnert, Julia Renate; Riemann, Burkhard; Weckesser, Matthias; Burg, Matthias Christian; Allkemper, Thomas; Heindel, Walter; Schaefers, Michael

    2016-01-01

    The purpose of this study was to determine whether [ 68 Ga]DOTATATE PET/MRI with diffusion-weighted imaging (DWI) can replace or complement [ 18 F]FDG PET/CT in patients with radioactive-iodine (RAI)-refractory differentiated thyroid cancer (DTC). The study population comprised 12 patients with elevated thyroglobulin and a negative RAI scan after thyroidectomy and RAI remnant ablation who underwent both [ 18 F]FDG PET/CT and [ 68 Ga]DOTATATE PET/MRI within 8 weeks of each other. The presence of recurrent cancer was evaluated on a per-patient, per-organ and per-lesion basis. Histology, and prior and follow-up examinations served as the standard of reference. Recurrent or metastatic tumour was confirmed in 11 of the 12 patients. [ 68 Ga]DOTATATE PET(/MRI) correctly identified the tumour burden in all 11 patients, whereas in one patient local relapse was missed by [ 18 F]FDG PET/CT. In the lesion-based analysis, overall lesion detection rates were 79/85 (93 %), 69/85 (81 %) and 27/82 (33 %) for [ 18 F]FDG PET/CT, [ 68 Ga]DOTATATE PET/MRI and DWI, respectively. [ 18 F]FDG PET(/CT) was superior to [ 68 Ga]DOTATATE PET(/MRI) in the overall evaluation and in the detection of pulmonary metastases. In the detection of extrapulmonary metastases, [ 68 Ga]DOTATATE PET(/MRI) showed a higher sensitivity than [ 18 F]FDG PET(/CT), at the cost of lower specificity. DWI achieved only poor sensitivity and was significantly inferior to [ 18 F]FDG PET in the lesion-based evaluation in the detection of both extrapulmonary and pulmonary metastases. [ 18 F]FDG PET/CT was more sensitive than [ 68 Ga]DOTATATE PET/MRI in the evaluation of RAI-refractory DTC, mostly because of its excellent ability to detect lung metastases. In the evaluation of extrapulmonary lesions, [ 68 Ga]DOTATATE PET(/MRI) was more sensitive and [ 18 F]FDG PET(/CT) more specific. Furthermore, DWI did not provide additional information and cannot replace [ 18 F]FDG PET for postoperative monitoring of patients with

  17. Quantitation of brain tissue changes associated with white matter hyperintensities by diffusion-weighted and magnetization transfer imaging: the LADIS (Leukoaraiosis and Disability in the Elderly) study

    DEFF Research Database (Denmark)

    Ropele, Stefan; Seewann, Alexandra; Gouw, Alida A

    2009-01-01

    PURPOSE: To explore the value of diffusion-weighted imaging (DWI) and magnetization transfer imaging (MTI) for the improved detection and quantification of cerebral tissue changes associated with ageing and white matter hyperintensities (WMH). MATERIALS AND METHODS: DWI (n = 340) and MTI (n = 177......) were performed in nine centers of the multinational Leukoaraiosis And DISability (LADIS) study investigating the impact of WMH on 65- to 85-year-old individuals without prior disability. We assessed the apparent diffusion coefficient (ADC) and magnetization transfer ratio (MTR) of normal appearing...

  18. Subcategorization of Suspicious Breast Lesions (BI-RADS Category 4) According to MRI Criteria: Role of Dynamic Contrast-Enhanced and Diffusion-Weighted Imaging.

    Science.gov (United States)

    Maltez de Almeida, João Ricardo; Gomes, André Boechat; Barros, Thomas Pitangueira; Fahel, Paulo Eduardo; de Seixas Rocha, Mário

    2015-07-01

    The purposes of this study were to investigate whether dynamic contrast-enhanced MRI is adequate for subcategorization of suspicious lesions (BI-RADS category 4) and to evaluate whether use of DWI improves diagnostic performance. The study group was composed of 103 suspicious lesions found in 83 subjects. Patient ages and lesion sizes were compiled, and two radiologists reanalyzed the images; subcategorized the findings as BI-RADS 4A, 4B, or 4C; and calculated apparent diffusion coefficient (ADC) values. The stratified variables were tested by univariate analysis and inserted in two multivariate predictive models, which were used to generate ROC curves and compare AUCs. Positive predictive values (PPVs) for each subcategory and ADC level were calculated, and interobserver agreement was tested. Forty-four (42.7%) suspicious findings proved malignant. Except for age (p = 0.08), all stratified predictor variables were significant in univariate analyses (p BI-RADS 4 subcategory (4A, 0.15; 4B, 0.37; 4C, 0.84). ADC values of 1.10 × 10(-3) mm(2)/s or less had the second highest PPV (0.77). Interobserver agreement was substantial at a kappa value of 0.80 (95% CI, 0.70-0.90; p BI-RADS category 4) can be satisfactorily performed with DCE-MRI and slightly improved when DWI is introduced.

  19. Diffusion weighted imaging of female pelvic cancers: Concepts and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Punwani, Shonit, E-mail: shonit.punwani@gmail.com [Department of Academic Radiology, 2nd Floor Podium, University College London Hospital, 235 Euston Road, London NW1 2BU (United Kingdom)

    2011-04-15

    Early applications of diffusion weighted magnetic resonance imaging (DWI) were limited to neuroimaging, concentrating either on stroke or brain tumours. With recent advances in MRI hardware and software DWI is now increasingly being investigated for cancer assessment throughout the body. Clinical applications of DWI relating to female pelvic cancers have largely concentrated on detection, localisation and staging of disease. More recently investigators have started to evaluate the ability of DWI for determining tumour histology and even predicting the outcome of chemoradiation treatment. This article reviews the physical concepts of MR diffusion weighting, illustrates the biophysical basis of diffusion contrast and reports the clinical applications of DWI for cervical, endometrial, ovarian, rectal and bladder tumours.

  20. Diffusion-weighted MRI measures suggest increased white-matter integrity in Internet gaming disorder: Evidence from the comparison with recreational Internet game users.

    Science.gov (United States)

    Dong, Guangheng; Wu, Lingdan; Wang, Ziliang; Wang, Yifan; Du, Xiaoxia; Potenza, Marc N

    2018-06-01

    Several studies have suggested that Internet gaming disorder (IGD) is related to altered brain white matter integrity. However, seeming inconsistencies exist and may reflect comparison groups not matched well for certain gaming characteristics. In order to address this possible concern, we recruited in the present study individuals with recreational Internet game use (RGU) comprised of individuals who spend similar amounts of time as IGD subjects playing online games without developing IGD. Diffusion tensor imaging data were collected from 42 IGD and 44 RGU subjects. Whole-brain comparisons showed that IGD subjects demonstrated increased fractional anisotropy (FA) in the bilateral anterior thalamic radiation, anterior limb of the internal capsule, bilateral corticospinal tract, bilateral inferior fronto-occipital fasciculus, corpus callosum, and bilateral inferior longitudinal fasciculus. In addition, Internet-addiction severity was positively correlated with FA values. Taken together, we conclude that IGD is associated with measures of increased white-matter integrity in tracts linking reward circuitry and sensory and motor control systems. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Quantitative and qualitative evaluation of brain diffusion weighted magnetic resonance imaging comparison with 1.5 T and 3.0 T units

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Eun Hoe [Dept. of Radiological Science, Cheongju University, Cheongju (Korea, Republic of); Dong, Kyung Rae [Dept. of Radiological Technology, Gwangju Health University, Gwangju (Korea, Republic of)

    2017-02-15

    DWI of biological effects are independent of magnetic field strength in various regions. High field strength, however, does affect the signal to noise ratio (SNR) and artifacts of diffusion weighted imaging (DWI) images, which ultimately will influence the quantitative of diffusion imaging . In this study, the effects of field strength on DWI are reviewed. The effects of the diseases also are discussed. Comparing DWI in cerebellum, WM, GM, Hyperacute region measurements both as a function of field strength (1.5 T and 3.0 T). Overall, the SNR of the DWI roughly doubled going from 1.5 T to 3.0 T. In summary, DWI studies at 3.0 T is provided significantly improved DWI measurements relative to studies at 1.5 T.

  2. Clinical relevance of the apparent diffusion coefficient value of metastatic bone tumours on diffusion-weighted MRI images: differences according to the types of primary tumour, the affected bones, and clinical factors.

    Science.gov (United States)

    Cha, M J; Yoon, Y C

    2015-10-01

    To evaluate whether the apparent diffusion coefficient (ADC) of metastatic bone tumours on diffusion-weighted magnetic resonance imaging (MRI) images differs according to the type of primary cancer, the affected bone, and clinical factors. For this retrospective study, two radiologists reviewed MRI images, including ADC maps, of 67 patients (M:F=38:29; median age, 48 years) who were diagnosed with bone metastasis by means of histological or clinical confirmation. The primary tumours included 29 lung adenocarcinomas, 15 invasive ductal adenocarcinomas of the breast, 13 hepatocellular carcinomas, six prostatic carcinomas, and four renal cell carcinomas. ADC values of the metastatic tumour were compared according to the type of primary malignancy, the affected bone, and the age and sex of the patient using Kruskal-Wallis and Mann-Whitney U-tests with Bonferroni correction. In addition, pre-contrast CT images were available in 38 of 67 patients; a subanalysis of the CT radiodensity and ADC values were performed with Spearman correlation. The mean, standard deviation, and minimum and maximum values of the ADC of metastatic bone tumours did not differ significantly according to type of primary malignancy, the affected bone, or clinical variables (p>0.1). The ADC value was not significantly correlated with CT radiodensity (p=0.24). Intra- and interobserver agreements for the mean ADC values were excellent (intra-observer: p=0.98; interobserver: p=0.98). Assessment of the ADC value of metastatic bone tumours is not reliable for differentiation of the type of primary cancer. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  3. Local structure and global connectivity in the cerebral cortex: neuroinformatics, histology and ultra high resolution diffusion MRI in the rhesus and marmoset monkey brain

    OpenAIRE

    Reveley, Colin

    2017-01-01

    This thesis concerns the cortical connectivity in Primates. The efficacy of Diffusion weighted MRI (dMRI) is examined. White matter (“WM”) systems subjacent to cortex (“superficial WM” ) are found to be a limiting factor to dMRI tractography. Superficial WM systems are examined with dMRI itself, and with analysis of histological data from the scanned brains. dMRI data was acquired ex-vivo at exceptional spatial and angular resolution (250μm in Rhesus, 150μm in Marmoset). The superficial WM wa...

  4. Gas-induced susceptibility artefacts on diffusion-weighted MRI of the rectum at 1.5 T - Effect of applying a micro-enema to improve image quality.

    Science.gov (United States)

    van Griethuysen, Joost J M; Bus, Elyse M; Hauptmann, Michael; Lahaye, Max J; Maas, Monique; Ter Beek, Leon C; Beets, Geerard L; Bakers, Frans C H; Beets-Tan, Regina G H; Lambregts, Doenja M J

    2018-02-01

    Assess whether application of a micro-enema can reduce gas-induced susceptibility artefacts in Single-shot Echo Planar Imaging (EPI) Diffusion-weighted imaging of the rectum at 1.5 T. Retrospective analysis of n = 50 rectal cancer patients who each underwent multiple DWI-MRIs (1.5 T) from 2012 to 2016 as part of routine follow-up during a watch-and-wait approach after chemoradiotherapy. From March 2014 DWI-MRIs were routinely acquired after application of a preparatory micro-enema (Microlax ® ; 5 ml; self-administered shortly before acquisition); before March 2014 no bowel preparation was given. In total, 335 scans were scored by an experienced reader for the presence/severity of gas-artefacts (on b1000 DWI), ranging from 0 (no artefact) to 5 (severe artefact). A score ≥3 (moderate-severe) was considered a clinically relevant artefact. A random sample of 100 scans was re-assessed by a second independent reader to study inter-observer effects. Scores were compared between the scans performed without and with a preparatory micro-enema using univariable and multivariable logistic regression taking into account potential confounding factors (age/gender, acquisition parameters, MRI-hardware, rectoscopy prior to MRI). Clinically relevant gas-artefacts were seen in 24.3% (no micro-enema) vs. 3.7% (micro-enema), odds ratios were 0.118 in univariable and 0.230 in multivariable regression (P = 0.0005 and 0.0291). Mean severity score (±SD) was 1.19 ± 1.71 (no-enema) vs 0.32 ± 0.77 (micro-enema), odds ratios were 0.321 (P < 0.0001) and 0.489 (P = 0.0461) in uni- and multivariable regression, respectively. Inter-observer agreement was excellent (κ0.85). Use of a preparatory micro-enema shortly before rectal EPI-DWI examinations performed at 1.5 T MRI significantly reduces both the incidence and severity of gas-induced artefacts, compared to examinations performed without bowel preparation. Copyright © 2017 Elsevier B.V. All rights

  5. Assessment of pathological complete response to preoperative chemoradiotherapy by means of multiple mathematical models of diffusion-weighted MRI in locally advanced rectal cancer: A prospective single-center study.

    Science.gov (United States)

    Zhu, Hai-Bin; Zhang, Xiao-Yan; Zhou, Xiao-Hong; Li, Xiao-Ting; Liu, Yu-Liang; Wang, Shuai; Sun, Ying-Shi

    2017-07-01

    To assess stretched-exponential, mono-exponential and intravoxel incoherent motion (IVIM) models of diffusion-weighted MRI(DWI) in predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) in rectal cancer patients. This prospective study recruited 98 consecutive patients with locally advanced rectal cancer who underwent 3 Tesla MR examination before, during and after CRT. The apparent diffusion coefficient (ADC), IVIM-derived parameters (D, f, and D*), and stretched-exponential model-derived parameters (DDC and α) were measured. The parameters and their corresponding changes during and after CRT were compared between pCR and non-pCR. Receiver-operating characteristic curve analysis was performed to evaluate the diagnostic performance. Coefficient of variations and intraclass correlation coefficient were calculated to assess reliability and agreement. Nineteen patients achieved pCR while 79 did not. The pCR group had higher ADC and α (ADC 2 and α 2 ), and their changes (ΔADC 2 , and Δα 2 ) at the endpoint than non-pCR group. α 2 and ADC 2 yielded similar AUCs (P = 0.339), Δα 2 and ΔADC 2 yielded similar AUCs (P = 0.263) ADC and α presented substantial agreement, and α presented the minimum CV (5.0-7.0%). ADC and α were useful for assessing pCR after CRT. α might be more useful because it demonstrated better diagnostic performance than IVIM-derived parameters and better reliability than ADC. 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:175-183. © 2016 International Society for Magnetic Resonance in Medicine.

  6. The role of diffusion weighted magnetic resonance imaging in ...

    African Journals Online (AJOL)

    Shaimaa R.A. Fadeel

    2015-06-16

    Jun 16, 2015 ... diffusion-weighted images and the measurement of the apparent diffusion coefficient (ADC) have been applied to the study of normal .... time msec/echo time msec); section thickness, 5 mm; intersec- tion gap, 2.5 mm; field of view, 20 cm; ..... 11. Forbes KP, Pipe JG, Bird CR. Changes in brain water diffusion.

  7. Diffusion-Weighted Magnetic Resonance Imaging in Cervical Lymphadenopathy: Report of Three Cases of Patients with Bartonella henselae Infection Mimicking Malignant Disease

    Energy Technology Data Exchange (ETDEWEB)

    Muenzel, D.; Gaa, J.; Rummeny, E. J.; Holzapfel, K. (Dept. of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich (Germany)); Duetsch, S.; Fauser, C. (Dept. of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich (Germany)); Slotta-Huspenina, J. (Dept. of Pathology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich (Germany))

    2009-10-15

    Diffusion-weighted MR imaging is a potential technique for differentiation between benign and malignant lymph nodes. However, lymphadenopathy caused by Bartonella henselae infection shows low ADC values in diffusion weighted MRI as typically seen in malignant disease.

  8. Comparative Analysis of Signal Intensity and Apparent Diffusion Coefficient at Varying b-values in the Brain : Diffusion Weighted-Echo Planar Image (T{sub 2} and FLAIR) Sequence

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jong Kap [Dept. of Radiology, Cheomdan Medical Center, Gwangju (Korea, Republic of); Im, Jung Yeol [Dept. of Digital Management Information Graduate School of Nambu Univesity, Gwangju (Korea, Republic of)

    2009-09-15

    Diffusion-weighted imaging (DWI) has been demonstrated to be a practical method for the diagnosis of various brain diseases such as acute infarction, brain tumor, and white matter disease. In this study, we used two techniques to examine the average signal intensity (SI) and apparent diffusion coefficient (ADC) of the brains of patients who ranged in age from 10 to 60 years. Our results indicated that the average SI was the highest in amygdala (as derived from DWI), whereas that in the cerebrospinal fluid was the lowest. The average ADC was the highest in the cerebrospinal fluid, whereas the lowest measurement was derived from the pons. The average SI and ADC were higher in T{sub 2}-DW-EPI than in FLAIR-DW-EPI. The higher the b-value, the smaller the average difference in both imaging techniques; the lower the b-value, the greater the average difference. Also, comparative analysis of the brains of patients who had experienced cerebral infarction showed no distinct lesion in the general MR image over time. However, there was a high SI in apparent weighted images. Analysis of other brain diseases (e.g., bleeding, acute, subacute, chronic infarction) indicated SI variance in accordance with characteristics of the two techniques. The higher the SI, the lower the ADC. Taken together, the value of SI and ADC in accordance with frequently occurring areas and various brain disease varies based on the b-value and imaging technique. Because they provide additional useful information in the diagnosis and treatment of patients with various brain diseases through signal recognition, the proper imaging technique and b-value are important for the detection and interpretation of subacute stroke and other brain diseases.

  9. The Gini coefficient: a methodological pilot study to assess fetal brain development employing postmortem diffusion MRI

    Energy Technology Data Exchange (ETDEWEB)

    Viehweger, Adrian; Sorge, Ina; Hirsch, Wolfgang [University Hospital Leipzig, Department of Pediatric Radiology, Leipzig (Germany); Riffert, Till; Dhital, Bibek; Knoesche, Thomas R.; Anwander, Alfred [Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig (Germany); Stepan, Holger [University Leipzig, Department of Obstetrics, Leipzig (Germany)

    2014-10-15

    Diffusion-weighted imaging (DWI) is important in the assessment of fetal brain development. However, it is clinically challenging and time-consuming to prepare neuromorphological examinations to assess real brain age and to detect abnormalities. To demonstrate that the Gini coefficient can be a simple, intuitive parameter for modelling fetal brain development. Postmortem fetal specimens(n = 28) were evaluated by diffusion-weighted imaging (DWI) on a 3-T MRI scanner using 60 directions, 0.7-mm isotropic voxels and b-values of 0, 150, 1,600 s/mm{sup 2}. Constrained spherical deconvolution (CSD) was used as the local diffusion model. Fractional anisotropy (FA), apparent diffusion coefficient (ADC) and complexity (CX) maps were generated. CX was defined as a novel diffusion metric. On the basis of those three parameters, the Gini coefficient was calculated. Study of fetal brain development in postmortem specimens was feasible using DWI. The Gini coefficient could be calculated for the combination of the three diffusion parameters. This multidimensional Gini coefficient correlated well with age (Adjusted R{sup 2} = 0.59) between the ages of 17 and 26 gestational weeks. We propose a new method that uses an economics concept, the Gini coefficient, to describe the whole brain with one simple and intuitive measure, which can be used to assess the brain's developmental state. (orig.)

  10. The Gini coefficient: a methodological pilot study to assess fetal brain development employing postmortem diffusion MRI

    International Nuclear Information System (INIS)

    Viehweger, Adrian; Sorge, Ina; Hirsch, Wolfgang; Riffert, Till; Dhital, Bibek; Knoesche, Thomas R.; Anwander, Alfred; Stepan, Holger

    2014-01-01

    Diffusion-weighted imaging (DWI) is important in the assessment of fetal brain development. However, it is clinically challenging and time-consuming to prepare neuromorphological examinations to assess real brain age and to detect abnormalities. To demonstrate that the Gini coefficient can be a simple, intuitive parameter for modelling fetal brain development. Postmortem fetal specimens(n = 28) were evaluated by diffusion-weighted imaging (DWI) on a 3-T MRI scanner using 60 directions, 0.7-mm isotropic voxels and b-values of 0, 150, 1,600 s/mm 2 . Constrained spherical deconvolution (CSD) was used as the local diffusion model. Fractional anisotropy (FA), apparent diffusion coefficient (ADC) and complexity (CX) maps were generated. CX was defined as a novel diffusion metric. On the basis of those three parameters, the Gini coefficient was calculated. Study of fetal brain development in postmortem specimens was feasible using DWI. The Gini coefficient could be calculated for the combination of the three diffusion parameters. This multidimensional Gini coefficient correlated well with age (Adjusted R 2 = 0.59) between the ages of 17 and 26 gestational weeks. We propose a new method that uses an economics concept, the Gini coefficient, to describe the whole brain with one simple and intuitive measure, which can be used to assess the brain's developmental state. (orig.)

  11. MRI of fetal acquired brain lesions

    International Nuclear Information System (INIS)

    Prayer, Daniela; Brugger, Peter C.; Kasprian, Gregor; Witzani, Linde; Helmer, Hanns; Dietrich, Wolfgang; Eppel, Wolfgang; Langer, Martin

    2006-01-01

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images

  12. Diffusion-Weighted Magnetic Resonance Imaging in Renal Lesion Characterization

    Directory of Open Access Journals (Sweden)

    Elif Karadeli

    2012-03-01

    Conclusion: The technique has the advantage that it is non-invasive without need for gadolinium administration, takes about 2 minute. This method provides qualitative and quantitative infomation on tissue characterization. DA-MRI and ADC values are important for characterization of renal lesions. Especially, utility of diffusion-weighted magnetic resonance imaging in the patients with risk for nephrogenic systemic fibrosis (NSF could be beneficial. [Cukurova Med J 2012; 37(1: 27-36

  13. Asymmetric cortical high signal on diffusion weighted-MRI in a case of Creutzfeldt-Jakob disease Hipersinal cortical assimétrico na ressonância magnética na imagem em difusão em caso de doença de Creutzfeldt-Jakob

    Directory of Open Access Journals (Sweden)

    Ricardo Nitrini

    2005-06-01

    Full Text Available High signal in the cerebral cortex and/or basal ganglia on diffusion-weighted magnetic resonance imaging (DW-MRI has been described as a good diagnostic marker for sporadic Creutzfeldt-Jakob disease (sCJD. We report a case of sCJD with atypical clinical evolution and unusual DW-MRI findings. A 53-year-old man was seen with a 2-year history of a rapidly progressive dementia and cerebellar ataxia. Cerebrospinal fluid analysis, including the test for 14-3-3 protein, was normal. EEG did not show periodic activity. However, DW-MRI showed gyriform hyperintensity involving practically the entire cortical ribbon of the left hemisphere, whilst being limited to the posterior cingulate gyrus in the right hemisphere. DNA analysis showed no mutations or insertions in the prion protein gene, and homozigozity for methionine in codon 129. A subsequent brain biopsy confirmed the diagnosis of CJD. Thus, high signal on DW-MRI may be limited to the cerebral cortex and may present a very asymmetric distribution in sCJD.Hipersinal no cortex cerebral e/ou nos gânglios da base observado com a técnica de difusão da ressonância magnética (RM-DIF tem sido descrito como bom marcador diagnóstico da doença de Creutzfeldt-Jakob esporádica (DCJe. Relatamos caso de DCJe com evolução clínica atípica e achados incomuns na RM-DIF. Homem de 53 anos foi examinado com história de dois anos de demência rapidamente progressiva e ataxia cerebelar. Exame do líquido cefalorraqueano, incluindo pesquisa da proteína 14-3-3, foi normal; EEG não revelou atividade periódica; RM-DIF mostrou hiperintensidade nos giros que afetava quase inteiramente o manto cortical do hemisfério cerebral esquerdo e que no hemisfério direito se limitava à parte posterior do giro cíngulo. Análise do DNA revelou ausência de mutação ou de inserção no gene da proteína priônica e a presença de homozigose para metionina no códon 129. Biópsia cerebral confirmou o diagnóstico de DCJ

  14. Brain microstructure mapping using quantitative and diffusion MRI

    International Nuclear Information System (INIS)

    Lebois, Alice

    2014-01-01

    This thesis is focused on the human brain microstructure mapping using quantitative and diffusion MRI. The T1/T2 quantitative imaging relies on sequences dedicated to the mapping of T1 and T2 relaxation times. Their variations within the tissue are linked to the presence of different water compartments defined by a specific organization of the tissue at the cell scale. Measuring these parameters can help, therefore, to better characterize the brain microstructure. The dMRI, on the other hand, explores the brownian motion of water molecules in the brain tissue, where the water molecules' movement is constrained by natural barriers, such as cell membranes. Thus, the information on their displacement carried by the dMRI signal gives access to the underlying cyto-architecture. Combination of these two modalities is, therefore, a promising way to probe the brain tissue microstructure. The main goal of the present thesis is to set up the methodology to study the microstructure of the white matter of the human brain in vivo. The first part includes the acquisition of a unique MRI database of 79 healthy subjects (the Archi/CONNECT), which includes anatomical high resolution data, relaxometry data, diffusion-weighted data at high spatio-angular resolution and functional data. This database has allowed us to build the first atlas of the anatomical connectivity of the healthy brain through the automatic segmentation of the major white matter bundles, providing an appropriate anatomical reference for the white matter to study individually the quantitative parameters along each fascicle, characterizing its microstructure organization. Emphasis was placed on the construction of the first atlas of the T1/T2 profiles along the major white matter pathways. The profiles of the T1 and T2 relaxation times were then correlated to the quantitative profiles computed from the diffusion MRI data (fractional anisotropy, radial and longitudinal diffusivities, apparent diffusion coefficient

  15. Progressive multifocal leukoencephalopathy: diffusion-weighted imaging and pathological correlations.

    Science.gov (United States)

    Bergui, M; Bradac, G B; Oguz, K K; Boghi, A; Geda, C; Gatti, G; Schiffer, D

    2004-01-01

    We examined MRI of two patients with progressive multifocal leukoencephalopathy (PML), including diffusion-weighted imaging (DWI), with calculation of apparent diffusion coefficients (ADC). The pathology findings of one patient were compared with those of MRI. The lesions had different ADC and DWI appearances, depending on the stage of the disease. Newer lesions and the advancing edge of large lesions had normal-to-low ADC and gave high signal on DWI. Older lesions and the centre of large lesions had increased ADC and gave low signal. High signal on DWI and low ADC mark the regions of active infection and cell swelling, distinguishing them from areas of reparative gliosis.

  16. Progressive multifocal leukoencephalopathy: diffusion-weighted imaging and pathological correlations

    Energy Technology Data Exchange (ETDEWEB)

    Bergui, M.; Bradac, G.B.; Boghi, A. [Department of Neuroradiology, University of Turin, Via Cherasco 15, 10126, Torino (Italy); Oguz, K.K. [Department of Radiology, Hacettepe University, Sihhiye, Ankara (Turkey); Geda, C.; Gatti, G. [Chivasso General Hospital, Torino (Italy); Schiffer, D. [Department of Neuropathology, University of Turin, Via Cherasco 15, 10126, Torino (Italy)

    2004-01-01

    We examined MRI of two patients with progressive multifocal leukoencephalopathy (PML), including diffusion-weighted imaging (DWI), with calculation of apparent diffusion coefficients (ADC). The pathology findings of one patient were compared with those of MRI. The lesions had different ADC and DWI appearances, depending on the stage of the disease. Newer lesions and the advancing edge of large lesions had normal-to-low ADC and gave high signal on DWI. Older lesions and the centre of large lesions had increased ADC and gave low signal. High signal on DWI and low ADC mark the regions of active infection and cell swelling, distinguishing them from areas of reparative gliosis. (orig.)

  17. Sensitivity of different MRI sequences in the early detection of melanoma brain metastases

    Science.gov (United States)

    Breckwoldt, Michael O.; Schwarz, Daniel; Radbruch, Alexander; Enk, Alexander; Bendszus, Martin; Hassel, Jessica; Schlemmer, Heinz-Peter

    2018-01-01

    Background After the emergence of new MRI techniques such as susceptibility- and diffusion-weighted imaging (SWI and DWI) and because of specific imaging characteristics of melanoma brain metastases (MBM), it is unclear which MRI sequences are most beneficial for detection of MBM. This study was performed to investigate the sensitivity of six clinical MRI sequences in the early detection of MBM. Methods Medical records of all melanoma patients referred to our center between November 2005 and December 2016 were reviewed for presence of MBM. Analysis encompassed six MRI sequences at the time of initial diagnosis of first or new MBM, including non-enhanced T1-weighted (T1w), contrast-enhanced T1w (ceT1w), T2-weighted (T2w), T2w-FLAIR, susceptibility-weighted (SWI) and diffusion-weighted (DWI) MRI. Each lesion was rated with respect to its conspicuity (score from 0—not detectable to 3—clearly visible). Results Of 1210 patients, 217 with MBM were included in the analysis and up to 5 lesions per patient were evaluated. A total of 720 metastases were assessed and all six sequences were available for 425 MBM. Sensitivity (conspicuity ≥2) was 99.7% for ceT1w, 77.0% for FLAIR, 64.7% for SWI, 61.0% for T2w, 56.7% for T1w, and 48.4% for DWI. Thirty-one (7.3%) of 425 lesions were only detectable by ceT1w but no other sequence. Conclusions Contrast-enhanced T1-weighting is more sensitive than all other sequences for detection of MBM. Disruption of the blood-brain-barrier is consistently an earlier sign in MBM than perifocal edema, signal loss on SWI or diffusion restriction. PMID:29596475

  18. MR diffusion-weighted imaging in differential diagnosis of intracranial cystic lesions

    International Nuclear Information System (INIS)

    Ji Xueman; Lu Guangming; Wang Zhongqiu; Zhang Zongjun; Zhang Zhiqiang; Wang Junpeng

    2007-01-01

    Objective: To evaluate the value of diffusion-weighted imaging (DWI) on differential diagnosis of intracranial cystic lesions. Methods: Seventy-six patients with surgically and pathologically confirmed intracranial cystic lesions undergone conventional MRI, DWI and contrast enhanced MRI examination. The signal characteristics of intracranial cystic lesions on DWI were analysed retrospectively, the apparent diffusion coefficient (ADC) values of cystic areas were measured quantitatively. Results: Nineteen brain abscesses showed hyperintense signal on DWI. Among 34 brain tumors, 3 brain gliomas were hyperintense signal, 1 brain glioma was isointense signal and 1 metastasis was hyperintense signal; the other 29 brain tumors showed hypointense signal on DWI. The ADC values of all lesions were: (0.62 ± 0.15) x 10 -3 mm 2 /s in brain abscesses, (2.39 ± 0.78) x 10 -3 mm 2 /s in brain gliomas, (2.68 ± 0.40) x 10 -3 mm 2 /s in brain hemangioblastomas, (2.79 ± 0.79) x 10 -3 mm 2 /s in brain metastases, respectively. There were significant differences between the ADC values of brain abscess and the cystic or necrotic portions of brain glioma, hemangioblastoma, metastasis (P 0.05). Seven intracranial arachnoid cysts showed hypointense signal and 16 epidermoid cysts strikingly hyperintense signal on DWI. The ADC values of arachnoid cysts and epidermoid cysts were (2.96 ± 0.36) x 10 -3 mm 2 /s and (0.94 ± 0.13) x 10 -3 mm 2 /s respectively. There was significant difference between the ADC values of arachnoid cysts and epidermoid cysts (P<0.01). Conclusion: DWI and ADC values have important contribution to the differentiation of brain abscesses from cystic or necrotic tumors, intracranial cystic lesions showing hypointense signal on DWI can exclude brain abscess. (authors)

  19. Central pontine myelinolysis with a hyperintense lesion in diffusion weighted MRI: overview by means of a case report; Zentrale pontine Myelinolyse mit hyperintenser Laesion im diffusionsgewichteten MRT: Uebersicht anhand eines Fallberichtes

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, J.; Bewermeyer, H. [Neurologische Klinik, Kliniken der Stadt Koeln gGmbH, Krankenhaus Merheim, Koeln (Germany); Harzheim, A. [Radiologische Klinik, Kliniken der Stadt Koeln gGmbH, Krankenhaus Merheim, Koeln (Germany)

    2005-07-01

    Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with demyelination of other areas of the central nervous system (CNS). The etiology and pathogenesis of this disorder are still not fully understood. However, almost all cases of CPM are related to severe diseases or chronic alcoholism and occur in the setting of rapidly corrected serum hyponatremia and hypotonicity respectively. Depending on the involvement of other CNS structures, the clinical picture can vary considerably. Magnetic resonance imaging is the most sensitive investigation for the antemortem diagnosis of CPM, although the radiological findings lag behind and do not necessarily correlate with the clinical picture. Quite obviously diffusion-weighted imaging can be useful in the rapid diagnosis of CPM. This short review summarizes the current knowledge on the pathogenesis, clinical presentation, radiological findings, prognosis and therapeutic approaches of CPM. Characteristical clinical features and MR-findings including hyperintensity on diffusion-weighted images are illustrated by a typical case. (orig.)

  20. Added value of diffusion weighted imaging in pediatric central nervous system embryonal tumors surveillance

    Science.gov (United States)

    Tortora, Domenico; Severino, Mariasavina; Nozza, Paolo; Cama, Armando; Ravegnani, Marcello; D'Apolito, Gabriella; Raso, Alessandro; Milanaccio, Claudia; da Costa Leite, Claudia; Garrè, Maria Luisa; Rossi, Andrea

    2017-01-01

    Diffusion weighted imaging (DWI) has an established role in primary CNS embryonal tumor (ET) characterization; however, its diagnostic utility in detecting relapse has never been determined. We aimed to compare DWI and conventional MRI sensitivity in CNS ET recurrence detection, and to evaluate the DWI properties of contrast-enhancing radiation induced lesions (RIL). Fifty-six patients with CNS ET (25 with disease relapse, 6 with RIL and 25 with neither disease relapse nor RIL) were retrospectively evaluated with DWI, conventional MRI (including both T2/FLAIR and post-contrast images), or contrast-enhanced MR imaging (CE-MRI) alone. MRI studies were independently reviewed by two neuroradiologists for detection and localization of potential brain relapses. Sensitivity for focal relapse detection was calculated for each image set on a lesion-by-lesion basis. A descriptive per subject analysis was also performed. Evaluation of follow-up MRI studies served as standard of reference. Focal recurrence detection sensitivity of DWI (96%) was significantly higher than conventional MRI (77%) and CE-MRI alone (51%) (p=0.0003 and p<0.0001). On per subject analysis there were not missed diagnoses for DWI. At the time of DWI relapse detection, conventional MRI missed 2 diagnoses, and CE-MRI 8. Analysis of medulloblastoma relapses revealed that DWI identified a higher number of focal lesions than CE-MRI in subjects with classic variant. All but one RIL did not show restricted diffusion. In conclusion, DWI is a valuable complementary technique allowing for improved detection of focal relapse in CNS ET patients, particularly in children with classic medulloblastoma, and may assist in differentiating recurrence from RIL. PMID:28947980

  1. Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion-diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study.

    Science.gov (United States)

    Hacke, Werner; Furlan, Anthony J; Al-Rawi, Yasir; Davalos, Antoni; Fiebach, Jochen B; Gruber, Franz; Kaste, Markku; Lipka, Leslie J; Pedraza, Salvador; Ringleb, Peter A; Rowley, Howard A; Schneider, Dietmar; Schwamm, Lee H; Leal, Joaquin Serena; Söhngen, Mariola; Teal, Phil A; Wilhelm-Ogunbiyi, Karin; Wintermark, Max; Warach, Steven

    2009-02-01

    Previous studies have suggested that desmoteplase, a novel plasminogen activator, has clinical benefit when given 3-9 h after the onset of the symptoms of stroke in patients with presumptive tissue at risk that is identified by magnetic resonance perfusion imaging (PI) and diffusion-weighted imaging (DWI). In this randomised, placebo-controlled, double-blind, dose-ranging study, patients with acute ischaemic stroke and tissue at risk seen on either MRI or CT imaging were randomly assigned (1:1:1) to 90 microg/kg desmoteplase, 125 microg/kg desmoteplase, or placebo within 3-9 h after the onset of symptoms of stroke. The primary endpoint was clinical response rates at day 90, defined as a composite of improvement in National Institutes of Health stroke scale (NIHSS) score of 8 points or more or an NIHSS score of 1 point or less, a modified Rankin scale score of 0-2 points, and a Barthel index of 75-100. Secondary endpoints included change in lesion volume between baseline and day 30, rates of symptomatic intracranial haemorrhage, and mortality rates. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, NCT00111852. Between June, 2005, and March, 2007, 193 patients were randomised, and 186 patients received treatment: 57 received 90 microg/kg desmoteplase; 66 received 125 microg/kg desmoteplase; and 63 received placebo. 158 patients completed the study. The median baseline NIHSS score was 9 (IQR 6-14) points, and 30% (53 of 179) of the patients had a visible occlusion of a vessel at presentation. The core lesion and the mismatch volumes were small (median volumes were 10.6 cm(3) and 52.5 cm(3), respectively). The clinical response rates at day 90 were 47% (27 of 57) for 90 microg/kg desmoteplase, 36% (24 of 66) for 125 microg/kg desmoteplase, and 46% (29 of 63) for placebo. The median changes in lesion volume were: 90 microg/kg desmoteplase 14.0% (0.5 cm(3)); 125 microg/kg desmoteplase 10.8% (0.3 cm(3)); placebo -10.0% (-0.9 cm(3

  2. Function–structure connectivity in patients with severe brain injury as measured by MRI-DWI and FDG-PET

    DEFF Research Database (Denmark)

    Annen, J.; Heine, Lizette; Ziegler, E.

    2016-01-01

    brain injured patients remains ill-defined. FDG-PET and MRI-DWI in 25 severely brain injured patients (19 Disorders of Consciousness of which 7 unresponsive wakefulness syndrome, 12 minimally conscious; 6 emergence from minimally conscious state) and 25 healthy control subjects were acquired here......, a function–structure relationship was present in brain-damaged patients between functional metabolism of inferior-parietal, precuneus, and frontal regions and structural integrity of the frontal-inferiorparietal, precuneus-inferiorparietal, thalamo-inferioparietal, and thalamofrontal tracts. When focusing......A vast body of literature exists showing functional and structural dysfunction within the brains of patients with disorders of consciousness. However, the function (fluorodeoxyglucose FDG-PET metabolism)–structure (MRI-diffusion-weighted images; DWI) relationship and how it is affected in severely...

  3. Tumor hypoxia and microscopic diffusion capacity in brain tumors: A comparison of {sup 62}Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) PET/CT and diffusion-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hino-Shishikura, Ayako; Tateishi, Ukihide; Shibata, Hirofumi; Yoneyama, Tomohiro; Nishii, Toshiaki; Torii, Ikuo; Inoue, Tomio [Graduate School of Medicine, Yokohama City University, Department of Radiology, Yokohama (Japan); Tateishi, Kensuke; Ohtake, Makoto; Kawahara, Nobutaka [Graduate School of Medicine, Yokohama City University, Department of Neurosurgery, Yokohama (Japan)

    2014-07-15

    The aim of this study was to clarify the relationship between tumor hypoxia and microscopic diffusion capacity in primary brain tumors using {sup 62}Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) ({sup 62}Cu-ATSM) PET/CT and diffusion-weighted MR imaging (DWI). This study was approved by the institutional human research committee and was HIPAA compliant, and informed consent was obtained from all patients. {sup 62}Cu-ATSM PET/CT and DWI were performed in a total of 40 primary brain tumors of 34 patients with low grade glioma (LGG, n = 13), glioblastoma (GBM, n = 20), and primary central nervous system lymphoma (PCNSL, n = 7). {sup 62}Cu-ATSM PET/CT parameters and apparent diffusion coefficient (ADC) obtained by DWI were compared. High intensity signals by {sup 62}Cu-ATSM PET/CT and DWI in patients with GBM and PCNSL, and low intensity signals in LGG patients were observed. An inverse correlation was found between maximum SUV (SUV{sub max}) and minimum ADC (ADC{sub min}) (r = -0.583, p < 0.0001), and between tumor/brain ratio (T/B{sub ratio}) and ADC{sub min} for all tumors (r = -0.532, p < 0.0001). Both SUV{sub max} and T/B{sub ratio} in GBM were higher than LGG (p < 0.0001 and p < 0.0001), and those in PCNSL were also higher than GBM (p = 0.033 and p = 0.044). The ADC{sub min} was lower in GBM (p = 0.011) and PCNSL (p = 0.01) than in LGG, while no significant difference was found between GBM and PCNSL (p = 0.90). Tumor hypoxia assessed by {sup 62}Cu-ATSM PET/CT correlated with microscopic diffusion capacity obtained by DWI in brain tumors. Both {sup 62}Cu-ATSM PET/CT and DWI were considered feasible imaging methods for grading glioma. However, {sup 62}Cu-ATSM PET/CT provided additional diagnostic information to differentiate between GBM and PCNSL. (orig.)

  4. In vivo MRI of the fetal brain.

    Science.gov (United States)

    Girard, N; Raybaud, C; Dercole, C; Boubli, L; Chau, C; Cahen, S; Potier, A; Gamerre, M

    1993-01-01

    We report MRI of the brain in 45 fetuses; the findings were confirmed by pathological examination or postnatal neuroradiological studies. MRI necessitates medication to eliminate fetal motion; curare was injected into the umbilical cord, and MRI is therefore limited to cases in which umbilical cord puncture is indicated. T1-weighted images were obtained in axial, sagittal and coronal planes; the last of these were generally as the most useful as regards morphology. We demonstrated cerebral malformations (n = 13), brain haemorrhage (n = 1), a facial angioma (n = 1), a facial mass (n = 1), hydrocephalus (n = 5), unilateral ventricular enlargement (n = 1), atrophy (n = 4), a porencephalic cyst (n = 1) and normal appearances of the brain in 18 cases. Twenty-two of the fetuses were born alive, and the clinical and/or neuroradiological examination confirmed the antenatal findings. The diagnosis was also confirmed in 8 cases in which a neuropathological examination was possible.

  5. Diffusion-weighted imaging in acute demyelinating myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Zecca, Chiara; Cereda, Carlo; Tschuor, Silvia; Staedler, Claudio; Nadarajah, Navarajah; Bassetti, Claudio L.; Gobbi, Claudio [Ospedale Regionale di Lugano, Servizio di Neurologia e Neuroradiologia, Neurocenter of Southern Switzerland, Lugano (Switzerland); Wetzel, Stephan [Swiss Neuro Institute (SNI), Abteilung fuer Neuroradiologie, Hirslanden Klinik Zuerich, Zuerich (Switzerland); Santini, Francesco [University of Basel Hospital, Division of Radiological Physics, Basel (Switzerland)

    2012-06-15

    Diffusion-weighted imaging (DWI) has become a reference MRI technique for the evaluation of neurological disorders. Few publications have investigated the application of DWI for inflammatory demyelinating lesions. The purpose of the study was to describe diffusion-weighted imaging characteristics of acute, spinal demyelinating lesions. Six consecutive patients (two males, four females; aged 28-64 years) with acute spinal cord demyelinating lesions were studied in a prospective case series design from June 2009 to October 2010. We performed magnetic resonance imaging studies from 2 to 14 days from symptom onset on the patients with relapsing remitting multiple sclerosis (n = 3) or clinically isolated syndrome (n = 3). Main outcome measures were diffusion-weighted imaging and apparent diffusion coefficient pattern (ADC) of acute spinal cord demyelinating lesions. All spinal lesions showed a restricted diffusion pattern (DWI+/ADC-) with a 24% median ADC signal decrease. A good correlation between clinical presentation and lesion site was observed. Acute demyelinating spinal cord lesions show a uniform restricted diffusion pattern. Clinicians and neuro-radiologists should be aware that this pattern is not necessarily confirmatory for an ischaemic aetiology. (orig.)

  6. Diffusion-weighted imaging in acute demyelinating myelopathy

    International Nuclear Information System (INIS)

    Zecca, Chiara; Cereda, Carlo; Tschuor, Silvia; Staedler, Claudio; Nadarajah, Navarajah; Bassetti, Claudio L.; Gobbi, Claudio; Wetzel, Stephan; Santini, Francesco

    2012-01-01

    Diffusion-weighted imaging (DWI) has become a reference MRI technique for the evaluation of neurological disorders. Few publications have investigated the application of DWI for inflammatory demyelinating lesions. The purpose of the study was to describe diffusion-weighted imaging characteristics of acute, spinal demyelinating lesions. Six consecutive patients (two males, four females; aged 28-64 years) with acute spinal cord demyelinating lesions were studied in a prospective case series design from June 2009 to October 2010. We performed magnetic resonance imaging studies from 2 to 14 days from symptom onset on the patients with relapsing remitting multiple sclerosis (n = 3) or clinically isolated syndrome (n = 3). Main outcome measures were diffusion-weighted imaging and apparent diffusion coefficient pattern (ADC) of acute spinal cord demyelinating lesions. All spinal lesions showed a restricted diffusion pattern (DWI+/ADC-) with a 24% median ADC signal decrease. A good correlation between clinical presentation and lesion site was observed. Acute demyelinating spinal cord lesions show a uniform restricted diffusion pattern. Clinicians and neuro-radiologists should be aware that this pattern is not necessarily confirmatory for an ischaemic aetiology. (orig.)

  7. Respiratory syncytial virus-related encephalitis: magnetic resonance imaging findings with diffusion-weighted study

    Energy Technology Data Exchange (ETDEWEB)

    Park, Arim; Suh, Sang-il; Seol, Hae-Young [Korea University College of Medicine, Department of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Son, Gyu-Ri; Lee, Nam-Joon [Korea University College of Medicine, Department of Radiology, Korea University Anam Hospital, Seoul (Korea, Republic of); Lee, Young Hen; Seo, Hyung Suk [Korea University College of Medicine, Department of Radiology, Korea University Ansan Hospital, Gyeonggi-do (Korea, Republic of); Eun, Baik-Lin [Korea University College of Medicine, Department of Pediatrics, Korea University Guro Hospital, Seoul (Korea, Republic of)

    2014-02-15

    Respiratory syncytial virus (RSV) is a common pathogen causing acute respiratory infection in children. Herein, we describe the incidence and clinical and magnetic resonance imaging (MRI) findings of RSV-related encephalitis, a major neurological complication of RSV infection. We retrospectively reviewed the medical records and imaging findings of the patients over the past 7 years who are admitted to our medical center and are tested positive for RSV-RNA by reverse transcriptase PCR. In total, 3,856 patients were diagnosed with RSV bronchiolitis, and 28 of them underwent brain MRI for the evaluation of neurologic symptoms; 8 of these 28 patients had positive imaging findings. Five of these 8 patients were excluded because of non-RSV-related pathologies, such as subdural hemorrhage, brain volume loss due to status epilepticus, periventricular leukomalacia, preexisting ventriculomegaly, and hypoxic brain injury. The incidence of RSV-related encephalitis was as follows: 3/3,856 (0.08 %) of the patients are positive for RSV RNA, 3/28 (10.7 %) of the patient underwent brain MRI for neurological symptom, and 3/8 (37.5 %) of patients revealed abnormal MR findings. The imaging findings were suggestive of patterns of rhombenmesencephalitis, encephalitis with acute disseminated encephalomyelitis, and limbic encephalitis. They demonstrated no diffusion abnormality on diffusion-weighted image and symptom improvement on the follow-up study. Encephalitis with RSV bronchiolitis occurs rarely. However, on brain MRI performed upon suspicion of neurologic involvement, RSV encephalitis is not infrequently observed among the abnormal MR findings and may mimic other viral and limbic encephalitis. Physicians should be aware of this entity to ensure proper diagnosis and neurologic care of RSV-positive patients. (orig.)

  8. Brain MRI abnormalities in neuromyelitis optica

    Energy Technology Data Exchange (ETDEWEB)

    Wang Fei, E-mail: feiwang1973@gmail.com [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China); Liu Yaou, E-mail: asiaeurope80@gmail.com [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China); Duan Yunyun, E-mail: duanyun2003@sohu.com [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China); Li Kuncheng, E-mail: kunchengli@yahoo.com.cn [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China); Education Ministry Key Laboratory for Neurodegenerative Disease, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China)

    2011-11-15

    Objective: The purpose of this study was to explore brain MRI findings in neuromyelitis optica (NMO) and to investigate specific brain lesions with respect to the localization of aquaporin-4 (AQP-4). Materials and methods: Forty admitted patients (36 women) who satisfied the 2006 criteria of Wingerchuk et al. for NMO were included in this study. All patients received a neurological examination and MRI scanning including brain and spinal cord. MRIs were classified as normal, nonspecific, multiple sclerosis-like, typical abnormalities. MS-like lesions were too few to satisfy the Barkhof et al. criteria for MS. Confluent lesions involving high AQP-4 regions were considered typical. Non-enhancing deep white matter lesions other than MS-like lesions or typical lesions were classified as nonspecific. Results: Brain MRI lesions were delineated in 12 patients (25%). Four patients (10%) had hypothalamus, brainstem or periventricle lesions. Six (15%) patients were nonspecific, and 2 (5%) patients had multiple sclerosis-like lesions. Conclusion: Brain MRIs are negative in most NMO, and brain lesions do not exclude the diagnosis of NMO. Hypothalamus, brainstem or periventricle lesions, corresponding to high sites of AQP-4 in the brain, are indicative of lesions of NMO.

  9. MRI of the brain: malformations

    International Nuclear Information System (INIS)

    Treguier, C.; Heautot, J.F.; Gandon, Y.; Carsin, M.; Buhe, T.; Weppe, V.

    1990-01-01

    Brain malformations include occlusion, diverticula, neuronal migration abnormalities, cystic malformations, and histogenetic disorders in neurocutaneous syndromes. The multiple planes of section, excellent white/gray matter differentiation and accurate delineation of the brain cortex available with magnetic resonance imaging make it a tool of choice for the diagnosis of malformations, as well as for prognosis and genetic counseling [fr

  10. Diffusion-weighted magnetic resonance imaging of borderzone necrosis in paediatric tuberculous meningitis

    International Nuclear Information System (INIS)

    Omar, Nadir; Pienaar, Manana; Andronikou, Savvas; Van Toorn, Ronald

    2011-01-01

    Tuberculous meningitis (TBM) is associated with borderzone necrosis (BZN) of the brain parenchyma in areas adjacent to meningeal inflammation. Diffusion-weighted MRI (DWI) allows for accurate detection of cytotoxic oedema associated with necrosis. Detection and characterisation of BZN using DWI to explain its pathogenesis in TBM have not been performed previously in children. Our objective was to identify the prevalence and characteristics of BZN using DWI in children with TBM and to correlate it with the presence, degree and distribution of basal meningeal enhancement (BE) in the absence of large-vessel thrombosis. A retrospective descriptive MRI DWI study of 34 children with TBM was conducted. The topography of BZN was compared with the presence and severity of BE on specific MRI sequences. BZN was identified on MRI DWI in 50% of patients of which 82% had involvement of the temporal lobes. The severity and extent of BE in either middle cerebral artery cistern correlated with the presence of BZN (P = 0.02). BZN did not correlate with radiologically detectable vascular occlusion BZN is common in TBM occurring in 50% of children. Detection and confirmation of cytotoxic oedema associated with BZN using DWI, and its clear relation to BE supports existing pathogenetic descriptions. The pathogenesis of BZN differs to that of topographical infarction on the basis of distribution as well as an absent statistical relationship between vascular occlusion and BZN.

  11. MRI findings of brain damage due to neonatal hypoglycemia

    International Nuclear Information System (INIS)

    Wang Lu; Fan Guoguang; Ji Xu; Sun Baohai; Guo Qiyong

    2009-01-01

    Objective: To report the MRI findings of brain damage observed in neonatal patients who suffered from isolated hypoglycemia and to explore the value of diffusion-weighted imaging(DWI) in early detection of neonatal hypoglycemic brain injury. Methods: Twelve neonates with isolated hypoglycemia (10 of the 12 were diagnosed to suffer from hypoglycemic encephalopathy) were enrolled in this study. They were first scanned at age from 3 days to 10 days with T 1 WI, T 2 WI and DWI(b is 0 s/mm 2 , 1000 s/mm 2 ), and 4 of them were then scanned from 7 days to 10 days following the initial scan. All acquired MR images were retrospectively analysed. Results: First series of DWI images showed distinct hyperintense signal in 11 cases in several areas including bilateral occipital cortex (2 cases), right occipital cortex (1 case), left occipital cortex and subcortical white matter(1 case), bilateral occipital cortex and subcortical white matter (2 cases), bilateral parieto-occipital cortex (2 cases), bilateral parieto-occipital cortex and subcortical white matter(2 cases), the splenium of corpus callosum (4 cases), bilateral corona radiata( 2 cases), left caudate nucleus and globus pallidus (1 case), bilateral thalamus (1 case), bilaterally posterior limb of internal capsule (1 case). In the initial T 1 WI and T 2 WI images, there were subtle hypointensity in the damaged cortical areas (3 cases), hyperintensity in the bilaterally affected occipital cortex( 1 case) on T 1 weighted images, and hyperintensity in the affected cortex and subcortical white matter with poor differentiation on T 2 weighted images. The followed-up MRI of 4 cases showed regional encephalomalacia in the affected occipital lobes(4 cases), slightly hyperintensity on T 2 weighted images in the damaged occipital cortex (2 cases), extensive demyelination (1 case), disappearance of hyperintensity of the splenium of corpus callosum (1 case), and persistent hyperintensity in the splenium of corpus callosum (1 case

  12. Microvascular brain pathology on high resolution MRI

    NARCIS (Netherlands)

    Veluw, S.J. van

    2015-01-01

    Cerebral small vessel disease (SVD) is a common finding in the aging human brain and is associated with stroke, cognitive decline, and dementia. On autopsy, SVD encompasses pathological processes affecting small arteries and arterioles. Magnetic resonance imaging (MRI) detects the consequences of

  13. An algorithm to estimate anatomical connectivity between brain regions using diffusion MRI.

    Science.gov (United States)

    Campanella, Martina; Molinari, Elisa; Baraldi, Patrizia; Nocetti, Luca; Porro, Carlo A; Alexander, Daniel C

    2013-04-01

    The study of anatomical connectivity is essential for interpreting functional MRI data and for establishing how brain areas are linked together into networks to support higher-order functions. Diffusion-weighted MR images (DWI) and tractography provide a unique noninvasive tool to explore the connectional architecture of the brain. The identification of anatomical circuits associated with a specific function can be better accomplished by the joint application of diffusion and functional MRI. In this article, we propose a simple algorithm to identify the set of pathways between two regions of interest. The method is based upon running deterministic tractography from all possible starting positions in the brain and selecting trajectories that intersect both regions. We compare results from single-fiber tractography using diffusion tensor imaging and from multi-fiber tractography using reduced-encoding persistent angular structure (PAS) MRI on standard DWI datasets from healthy human volunteers. Our results show that, in comparison with single-fiber tractography, the multi-fiber technique reveals additional putative routes of connection. We demonstrate highly consistent results of the proposed technique over a cohort of 16 healthy subjects. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner-the Diabetes Research in Children Network (DirecNet) experience

    Energy Technology Data Exchange (ETDEWEB)

    Barnea-Goraly, Naama; Marzelli, Matt J.; Mazaika, Paul K. [Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Weinzimer, Stuart A. [Yale University, Pediatric Endocrinology, New Haven, CT (United States); Ruedy, Katrina J.; Beck, Roy W.; Kollman, Craig; Cheng, Peiyao [Jaeb Center for Health Research, Tampa, FL (United States); Mauras, Nelly; Fox, Larry [Nemours Children' s Clinic, Pediatric Endocrinology, Jacksonville, FL (United States); Aye, Tandy [Stanford University, Department of Pediatrics, Stanford, CA (United States); White, Neil H. [Washington University in St. Louis, Department of Pediatrics, St. Louis, MO (United States); Tsalikian, Eva [University of Iowa, Pediatric Endocrinology, Iowa City, IA (United States); Reiss, Allan L. [Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Stanford University, Department of Pediatrics, Stanford, CA (United States); Stanford University, Department of Radiology, Diabetes Research in Children Network (DirecNet), Stanford, CA (United States); Collaboration: on behalf of the Diabetes Research in Children Network (DirecNet)

    2014-02-15

    The ability to lie still in an MRI scanner is essential for obtaining usable image data. To reduce motion, young children are often sedated, adding significant cost and risk. We assessed the feasibility of using a simple and affordable behavioral desensitization program to yield high-quality brain MRI scans in sedation-free children. 222 children (4-9.9 years), 147 with type 1 diabetes and 75 age-matched non-diabetic controls, participated in a multi-site study focused on effects of type 1 diabetes on the developing brain. T1-weighted and diffusion-weighted imaging (DWI) MRI scans were performed. All children underwent behavioral training and practice MRI sessions using either a commercial MRI simulator or an inexpensive mock scanner consisting of a toy tunnel, vibrating mat, and video player to simulate the sounds and feel of the MRI scanner. 205 children (92.3%), mean age 7 ± 1.7 years had high-quality T1-W scans and 174 (78.4%) had high-quality diffusion-weighted scans after the first scan session. With a second scan session, success rates were 100% and 92.5% for T1-and diffusion-weighted scans, respectively. Success rates did not differ between children with type 1 diabetes and children without diabetes, or between centers using a commercial MRI scan simulator and those using the inexpensive mock scanner. Behavioral training can lead to a high success rate for obtaining high-quality T1-and diffusion-weighted brain images from a young population without sedation. (orig.)

  15. Brain development in preterm infants assessed using advanced MRI techniques.

    Science.gov (United States)

    Tusor, Nora; Arichi, Tomoki; Counsell, Serena J; Edwards, A David

    2014-03-01

    Infants who are born preterm have a high incidence of neurocognitive and neurobehavioral abnormalities, which may be associated with impaired brain development. Advanced magnetic resonance imaging (MRI) approaches, such as diffusion MRI (d-MRI) and functional MRI (fMRI), provide objective and reproducible measures of brain development. Indices derived from d-MRI can be used to provide quantitative measures of preterm brain injury. Although fMRI of the neonatal brain is currently a research tool, future studies combining d-MRI and fMRI have the potential to assess the structural and functional properties of the developing brain and its response to injury. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Diffusion-Weighted Magnetic Resonance Imaging in Rhombencephalitis due to Listeria monocytogenes

    Energy Technology Data Exchange (ETDEWEB)

    Hatipoglu, H.G.; Onbasioglu Gurbuz, M.; Sakman, B.; Yuksel, E. [Dept. of Radiology, Ankara Numune Education and Research Hospital, Ankara (Turkey)

    2007-04-15

    We present diffusion-weighted imaging findings of a case of rhombencephalitis due to Listeria monocytogenes. It is a rare, life-threatening disorder. The diagnosis is difficult by clinical findings only. In this report, we aim to draw attention to the role of conventional and diffusion-weighted magnetic resonance imaging findings. To our knowledge, this is the first case report in the literature with apparent diffusion coefficient values of diseased brain parenchyma.

  17. Role of diffusion weighted imaging in musculoskeletal infections: Current perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Yogesh [Yale New Haven Health System at Bridgeport Hospital, Department of Radiology, Bridgeport, CT (United States); Khaleel, Mohammad [UT Southwestern Medical Center, Department of Orthopaedic Surgery, Dallas, TX (United States); Boothe, Ethan; Awdeh, Haitham [UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Wadhwa, Vibhor [University of Arkansas for Medical Sciences, Department of Radiology, Little Rock, AR (United States); Chhabra, Avneesh [UT Southwestern Medical Center, Department of Orthopaedic Surgery, Dallas, TX (United States); UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States)

    2017-01-15

    Accurate diagnosis and prompt therapy of musculoskeletal infections are important prognostic factors. In most cases, clinical history, examination and laboratory findings help one make the diagnosis, and routine magnetic resonance imaging (MRI) is useful to identify the extent of the disease process. However, in many situations, a routine MRI may not be specific enough especially if the patient cannot receive contrast intravenously, thereby delaying the appropriate treatment. Diffusion-weighted imaging (DWI) can help in many such situations by providing additional information, accurate characterization and defining the extent of the disease, so that prompt treatment can be initiated. In this article, we illustrate the imaging findings of the spectrum of musculoskeletal infections, emphasizing the role of DWI in this domain. (orig.)

  18. Value of diffusion-weighted MR imaging in the diagnosis of Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Xu Quangang; Wu Weiping; Huang Dehui; Zhang Jiatang; Lang Senyang; Pu Chuanqiang

    2005-01-01

    Objective: To assess the diagnosis value of diffusion- weighted imaging (DWI) in Creutzfeldt-Jakob disease (CJD). Methods: 8 cases of sporadic CJD who underwent MRI were reported. 4 cases were definite, 3 cases were probable and 1 case was possible. The sensitivity of DWI and conventional MRI were compared. Results: T 1 WI and T 2 WI revealed no abnormal signals except nonspecific diffuse brain atrophy in 4 cases, whereas DWI detected hyperintense abnormalities in all cases. 2 cases showed linear lesions only in the cerebral cortex, and 6 cases showed lesions in both the cerebral cortex and the striatum. The lesions were symmetric in 5 cases, but were asymmetric in the other 3 cases. Although fluid- attenuated inversion recovery (FLAIR) imaging also showed cortical hyperintensity in 1 case, the high signal changes were more evident and extensive on DWI. Conclusions: The hyperintense changes in the cerebral cortices and/or striata on DWI are considered characteristic of CJD. DWI is more sensitive than conventional MRI in depicting lesions of CJD and may be an essential tool for the early diagnosis of this disease. (authors)

  19. Sjoegren's syndrome of the parotid gland: value of diffusion-weighted echo-planar MRI for diagnosis at an early stage based on MR sialography grading in comparison with healthy volunteers

    International Nuclear Information System (INIS)

    Regier, Marc; Ries, T.; Arndt, C.; Cramer, M.C.; Adam, G.; Habermann, C.R.; Graessner, J.; Reitmeier, F.; Jaehne, M.

    2009-01-01

    To investigate the value of diffusion-weighted echo-planar imaging (DW-EPI) for quantifying functional changes of the parotid gland in Sjoegren's disease and to evaluate whether ADC mapping allows for early diagnosis based on MR sialography grading. Using a DW-EPI sequence at 1.5T (b-factors: 0, 500 and 1000 sec/mm 2 ), the parotid glands of 52 healthy volunteers and 13 patients with histologically verified affection of Sjoegren's disease were examined. All scans were performed prior to and following gustatory stimulation with 5 ml of lemon juice. ADC maps were evaluated by placing an inordinate region-of-interest (ROI) enclosing the entire parotid gland. Sjoegren's disease was graded based on MR sialography findings using a 4-point grading-scale. Statistics included student t-test and kappa-analysis. In healthy volunteers mean ADCs of 1.14 x 10 -3 mm 2 /sec before and 1.2 x 10 -3 mm 2 /sec after stimulation were observed. Higher ADCs were determined for early-stage Sjoegren's disease, averaging 1.22 x 10 -3 mm 2 /sec before and 1.29 x 10 -3 mm 2 /sec after stimulation. Advanced disease revealed significantly lower ADCs (0.97 x 10 -3 mm 2 /sec (p = 0.002) before and 1.01 x 10 -3 mm 2 /sec (p < 0.001) after stimulation). (orig.)

  20. Brain MRI findings in Wernicke encephalopathy.

    Science.gov (United States)

    Wicklund, Meredith R; Knopman, David S

    2013-08-01

    A 71-year-old woman with myelofibrosis on chemotherapy experienced an acute illness with nausea, vomiting, and diarrhea. Two weeks later, she developed an acute confusional state characterized by disorientation and fluctuating alertness with normal speech and language. Her neurologic examination demonstrated an upper motor neuron pattern of right hemiparesis. She reported double vision though ophthalmoparesis was not appreciated. Her gait was normal. While hospitalized, she developed generalized tonic-clonic seizures. Brain MRI revealed a small area of restricted diffusion of the left precentral gyrus (figure). She was diagnosed with a stroke with secondary seizures; however, as the confusional state resolved, she developed profound retrograde and anterograde amnesia. Review of the brain MRI showed high T2 signal in the medial thalamus and contrast enhancement of the mamillary bodies; a diagnosis of Wernicke-Korsakoff syndrome was entertained and she was started on thiamine replacement. The encephalopathy and hemiparesis resolved though she remains severely amnestic.

  1. MRI of radiation injury to the brain

    International Nuclear Information System (INIS)

    Curnes, J.T.; Laster, D.W.; Ball, M.R.; Moody, D.M.; Witcofski, R.L.

    1986-01-01

    Nine patients with a history of radiation of 2400-6000 rad (24-60 Gy) to the brain were examined by magnetic resonance imaging (MRI) and computed tomography (CT). MRI demonstrated abnormalities in the periventricular white matter in all patients. The abnormal periventricular signal was characterized by a long T2 and was demonstrated best on coronal spin-echo (SE) 1000/80 images. A characteristic scalloped appearance at the junction of the gray-white matter was seen on MR images of seven patients, and represented extensive white-matter damage involving the more peripheral arcuate fiber systems. This differs from transependymal absorption, which is seen best on SE 3000/80 images and has a smooth peripheral margin. Cranial CT demonstrated white-matter lucencies in six cases but generally failed to display the extent of white-matter injury demonstrated by MRI. MRI is uniquely suited to detect radiation injury to the brain because of its extreme sensitivity to white-matter edema

  2. Current and future diagnostic tools for traumatic brain injury: CT, conventional MRI, and diffusion tensor imaging.

    Science.gov (United States)

    Brody, David L; Mac Donald, Christine L; Shimony, Joshua S

    2015-01-01

    Brain imaging plays a key role in the assessment of traumatic brain injury. In this review, we present our perspectives on the use of computed tomography (CT), conventional magnetic resonance imaging (MRI), and newer advanced modalities such as diffusion tensor imaging. Specifically, we address assessment for immediately life-threatening intracranial lesions (noncontrast head CT), assessment of progression of intracranial lesions (noncontrast head CT), documenting intracranial abnormalities for medicolegal reasons (conventional MRI with blood-sensitive sequences), presurgical planning for post-traumatic epilepsy (high spatial resolution conventional MRI), early prognostic decision making (conventional MRI with diffusion-weighted imaging), prognostic assessment for rehabilitative planning (conventional MRI and possibly diffusion tensor imaging in the future), stratification of subjects and pharmacodynamic tracking of targeted therapies in clinical trials (specific MRI sequences or positron emission tomography (PET) ligands, e.g., diffusion tensor imaging for traumatic axonal injury). We would like to emphasize that all of these methods, especially the newer research approaches, require careful radiologic-pathologic validation for optimal interpretation. We have taken this approach in a mouse model of pericontusional traumatic axonal injury. We found that the extent of reduction in the diffusion tensor imaging parameter relative anisotropy directly correlated with the number of amyloid precursor protein (APP)-stained axonal varicosities (r(2)=0.81, p<0.0001, n=20 injured mice). Interestingly, however, the least severe contusional injuries did not result in APP-stained axonal varicosities, but did cause reduction in relative anisotropy. Clearly, both the imaging assessments and the pathologic assessments will require iterative refinement. © 2015 Elsevier B.V. All rights reserved.

  3. Brain MRI findings of neuropsychiatric lupus

    International Nuclear Information System (INIS)

    Kim, Jang-Wook; Kwon, Bae Ju; Lee, Seung-Ro; Hahm, Chang-Kok; Moon, Won Jin; Jeon, Eui Yong; Bae, Sang-Chul

    2000-01-01

    To evaluate the brain MRI findings in patients with neuropsychiatric lupus. In 26 patients (M:F = 2:24 ; aged 9-48 years) in whom the presence of systemic lupus erythematosus was clinically or pathologically proven and in whom neuropsychiatric lupus was also clinically diagnosed, the findings of brain MRI were retrospectively evaluated. MR images were analyzed with regard to the distribution, location, size and number of lesions due to cerebral ischemia or infarction, the presence of cerebral atrophy, and the extent and degree of brain parenchymal and intravascular enhancement. The most common MRI findings were lesions due to cerebral ischemia or infarction occurring in 18 patients (69%), and located within deep periventricular white matter (n=10), subcortical white matter (n=8), the cerebral cortex (n=7), basal ganglia (n=7), or brain stem or cerebellum (n=2). The lesions were single (n=3) or multiple (n=15), and in 17 patients were less than 1cm in diameter in regions other than the cerebral cortex. In six of these patients, lesions of 1-4cm in diameter in this region were combined, and one occurred in the cerebral cortex only. Cerebral atrophy was seen in 16 patients (62%), in ten of whom there was no past history of treatment with steroids for more than six months. In 15 patients (58%), contrast-enhanced MR image revealed diffuse enhancement of the basal ganglia or intravascular enhancement. In no case were MRI findings normal. The primary mainfestations of neuropsychiatric lupus are multifocal ischemia or infarctions in the cerebral cortex, and subcortical and deep white matter, and the cerebral atrophy. Contrast-enhanced MR images also demonstrated diffuse enhancement of the basal ganglia and intravascular enhancement, both thought to be related to the congestion due to the stagnation of cerebral blood flow

  4. PET/MRI for Oncologic Brain Imaging

    DEFF Research Database (Denmark)

    Rausch, Ivo; Rischka, Lucas; Ladefoged, Claes N

    2017-01-01

    The aim of this study was to compare attenuation-correction (AC) approaches for PET/MRI in clinical neurooncology.Methods:Forty-nine PET/MRI brain scans were included: brain tumor studies using18F-fluoro-ethyl-tyrosine (18F-FET) (n= 31) and68Ga-DOTANOC (n= 7) and studies of healthy subjects using18...... by Siemens Healthcare). As a reference, AC maps were derived from patient-specific CT images (CTref). PET data were reconstructed using standard settings after AC with all 4 AC methods. We report changes in diagnosis for all brain tumor patients and the following relative differences values (RDs...... of the whole brain and 10 anatomic regions segmented on MR images.Results:For brain tumor imaging (A and B), the standard PET-based diagnosis was not affected by any of the 3 MR-AC methods. For A, the average RDs of SUVmeanwere -10%, -4%, and -3% and of the VOIs 1%, 2%, and 7% for DIXON, UTE, and BD...

  5. Repeatability of diffusion-weighted imaging in rectal cancer.

    Science.gov (United States)

    Intven, Martijn; Reerink, Onne; Philippens, Marielle E P

    2014-07-01

    Serial diffusion-weighted MRI (DW-MRI) measurements of the apparent diffusion coefficient (ADC) of rectal tumors are used for rectal cancer response evaluation after neo-adjuvant treatment. In this study, we determined the repeatability of DW-MRI to distinguish therapy-related response from measurement variations. In 18 patients with rectal cancer on five consecutive days, 1.5 Tesla (T) MR imaging was performed including two identical DW-MRI sequences. The repeatability of the tumor ADC measurements and the intraobserver ADC variation were depicted in a Bland-Altman plot. The repeatability coefficient was calculated as the range of ADC values of two identical DWI measurements for 95% of subjects. It was expressed as percentage of the mean ADC value. Three females and 15 males were included. The mean tumor ADC value was 1.15 × 10(-3) mm(2)/s (SD 0.07 × 10(-3) mm(2)). The repeatability coefficient of the ADC value was 9.8% and for the intraobserver repeatability 4.7%. In serial DW-MRI for rectal cancer treatment response evaluation, a repeatability coefficient of 9.8% has to be considered to account for measurement variations in rectal tumor ADC. These variations represent observer judgement and patient and MR spectrometer induced variations. © 2013 Wiley Periodicals, Inc.

  6. Diffusion-weighted MR imaging in leukodystrophies

    International Nuclear Information System (INIS)

    Patay, Zoltan

    2005-01-01

    Leukodystrophies are genetically determined metabolic diseases, in which the underlying biochemical abnormality interferes with the normal build-up and/or maintenance of myelin, which leads to hypo- (or arrested) myelination, or dysmyelination with resultant demyelination. Although conventional magnetic resonance imaging has significantly contributed to recent progress in the diagnostic work-up of these diseases, diffusion-weighted imaging has the potential to further improve our understanding of underlying pathological processes and their dynamics through the assessment of normal and abnormal diffusion properties of cerebral white matter. Evaluation of conventional diffusion-weighted and ADC map images allows the detection of major diffusion abnormalities and the identification of various edema types, of which the so-called myelin edema is particularly relevant to leukodystrophies. Depending on the nature of histopathological changes, stage and progression gradient of diseases, various diffusion-weighted imaging patterns may be seen in leukodystrophies. Absent or low-grade myelin edema is found in mucopolysaccharidoses, GM gangliosidoses, Zellweger disease, adrenomyeloneuropathy, L-2-hydroxyglutaric aciduria, non-ketotic hyperglycinemia, classical phenylketonuria, Van der Knaap disease and the vanishing white matter, medium grade myelin edema in metachromatic leukodystrophy, X-linked adrenoleukodystrophy and HMG coenzyme lyase deficiency and high grade edema in Krabbe disease, Canavan disease, hyperhomocystinemias, maple syrup urine disease and leukodystrophy with brainstem and spinal cord involvement and high lactate. (orig.)

  7. Diffusion-weighted MR imaging in leukodystrophies

    Energy Technology Data Exchange (ETDEWEB)

    Patay, Zoltan [King Faisal Specialist Hospital and Research Centre, Department of Radiology, Riyadh (Saudi Arabia)

    2005-11-01

    Leukodystrophies are genetically determined metabolic diseases, in which the underlying biochemical abnormality interferes with the normal build-up and/or maintenance of myelin, which leads to hypo- (or arrested) myelination, or dysmyelination with resultant demyelination. Although conventional magnetic resonance imaging has significantly contributed to recent progress in the diagnostic work-up of these diseases, diffusion-weighted imaging has the potential to further improve our understanding of underlying pathological processes and their dynamics through the assessment of normal and abnormal diffusion properties of cerebral white matter. Evaluation of conventional diffusion-weighted and ADC map images allows the detection of major diffusion abnormalities and the identification of various edema types, of which the so-called myelin edema is particularly relevant to leukodystrophies. Depending on the nature of histopathological changes, stage and progression gradient of diseases, various diffusion-weighted imaging patterns may be seen in leukodystrophies. Absent or low-grade myelin edema is found in mucopolysaccharidoses, GM gangliosidoses, Zellweger disease, adrenomyeloneuropathy, L-2-hydroxyglutaric aciduria, non-ketotic hyperglycinemia, classical phenylketonuria, Van der Knaap disease and the vanishing white matter, medium grade myelin edema in metachromatic leukodystrophy, X-linked adrenoleukodystrophy and HMG coenzyme lyase deficiency and high grade edema in Krabbe disease, Canavan disease, hyperhomocystinemias, maple syrup urine disease and leukodystrophy with brainstem and spinal cord involvement and high lactate. (orig.)

  8. Sjoegren's syndrome of the parotid gland: value of diffusion-weighted echo-planar MRI for diagnosis at an early stage based on MR sialography grading in comparison with healthy volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Regier, Marc; Ries, T.; Arndt, C.; Cramer, M.C.; Adam, G.; Habermann, C.R. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie; Graessner, J. [Siemens AG, Hamburg (Germany). Medical Solutions; Reitmeier, F.; Jaehne, M. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde

    2009-03-15

    To investigate the value of diffusion-weighted echo-planar imaging (DW-EPI) for quantifying functional changes of the parotid gland in Sjoegren's disease and to evaluate whether ADC mapping allows for early diagnosis based on MR sialography grading. Using a DW-EPI sequence at 1.5T (b-factors: 0, 500 and 1000 sec/mm{sup 2}), the parotid glands of 52 healthy volunteers and 13 patients with histologically verified affection of Sjoegren's disease were examined. All scans were performed prior to and following gustatory stimulation with 5 ml of lemon juice. ADC maps were evaluated by placing an inordinate region-of-interest (ROI) enclosing the entire parotid gland. Sjoegren's disease was graded based on MR sialography findings using a 4-point grading-scale. Statistics included student t-test and kappa-analysis. In healthy volunteers mean ADCs of 1.14 x 10{sup -3} mm{sup 2} /sec before and 1.2 x 10{sup -3} mm{sup 2} /sec after stimulation were observed. Higher ADCs were determined for early-stage Sjoegren's disease, averaging 1.22 x 10{sup -3} mm{sup 2} /sec before and 1.29 x 10{sup -3} mm{sup 2} /sec after stimulation. Advanced disease revealed significantly lower ADCs (0.97 x 10{sup -3} mm{sup 2} /sec (p = 0.002) before and 1.01 x 10{sup -3} mm{sup 2} /sec (p < 0.001) after stimulation). (orig.)

  9. Unexplained mental retardation: is brain MRI useful?

    Energy Technology Data Exchange (ETDEWEB)

    Decobert, Fabrice; Merzoug, Valerie; Kalifa, Gabriel; Adamsbaum, Catherine [Saint Vincent de Paul Hospital, Department of Radiology, 75674 Paris Cedex 14 (France); Grabar, Sophie [Cochin Hospital, Department of Biostatistics and Medical Information, Paris (France); Ponsot, Gerard [Saint Vincent de Paul Hospital, Department of Neuropaediatrics, Paris (France); Des Portes, Vincent [Saint Vincent de Paul Hospital, Department of Neuropaediatrics, Paris (France); Debrousse Hospital, Department of Neuropaediatrics, Lyon (France)

    2005-06-01

    Mental retardation (MR), defined as an IQ below 70, is a frequent cause of consultation in paediatrics. To evaluate the yield of brain MRI in the diagnostic work-up of unexplained MR in children. Patients and methods: The MRI features and clinical data of 100 patients (age 1-18 years) affected with non-progressive MR of unknown origin were compared to an age-matched control group (n=100). Two radiologists conducted an independent review of the MRI scans. Univariate and multivariate analyses showed a higher incidence of brain anomalies in the MR group than in the control group (53 vs 17, OR=5.7 [2.9-11.1]), for signal abnormalities within the periventricular white matter (OR=20.3 [2.6-155.3]), lateral ventricular dilatation (OR=15.6 [2.0-124]), mild corpus callosum abnormalities (shortness, atrophy) (OR=6.8 [1.8-25.6]) and subtle cerebellar abnormalities, including fissure enlargement (OR=5.2 [1.1-26.2]). The diagnostic value of MRI abnormalities was considered good in 5% of patients (Alexander disease n=1, diffuse cortical malformation n=1, leukomalacia n=1, vermian agenesis n=1, commissural agenesis n=1), and weak in 48% of patients, in whom non-specific abnormalities did not lead to a diagnosis. Some clinical features resulted in a significantly higher percentage of abnormal MRI scans: abnormal neurological examination (82% vs 47%, P=0.008), abnormal skull circumference (66% vs 49%, P=0.04). Motor delay was associated with cerebellar abnormalities (P=0.01). (orig.)

  10. Unexplained mental retardation: is brain MRI useful?

    International Nuclear Information System (INIS)

    Decobert, Fabrice; Merzoug, Valerie; Kalifa, Gabriel; Adamsbaum, Catherine; Grabar, Sophie; Ponsot, Gerard; Des Portes, Vincent

    2005-01-01

    Mental retardation (MR), defined as an IQ below 70, is a frequent cause of consultation in paediatrics. To evaluate the yield of brain MRI in the diagnostic work-up of unexplained MR in children. Patients and methods: The MRI features and clinical data of 100 patients (age 1-18 years) affected with non-progressive MR of unknown origin were compared to an age-matched control group (n=100). Two radiologists conducted an independent review of the MRI scans. Univariate and multivariate analyses showed a higher incidence of brain anomalies in the MR group than in the control group (53 vs 17, OR=5.7 [2.9-11.1]), for signal abnormalities within the periventricular white matter (OR=20.3 [2.6-155.3]), lateral ventricular dilatation (OR=15.6 [2.0-124]), mild corpus callosum abnormalities (shortness, atrophy) (OR=6.8 [1.8-25.6]) and subtle cerebellar abnormalities, including fissure enlargement (OR=5.2 [1.1-26.2]). The diagnostic value of MRI abnormalities was considered good in 5% of patients (Alexander disease n=1, diffuse cortical malformation n=1, leukomalacia n=1, vermian agenesis n=1, commissural agenesis n=1), and weak in 48% of patients, in whom non-specific abnormalities did not lead to a diagnosis. Some clinical features resulted in a significantly higher percentage of abnormal MRI scans: abnormal neurological examination (82% vs 47%, P=0.008), abnormal skull circumference (66% vs 49%, P=0.04). Motor delay was associated with cerebellar abnormalities (P=0.01). (orig.)

  11. Digital atlas of fetal brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Teresa; Weinberger, E. [Department of Radiology, Seattle Children' s Hospital, Seattle, WA (United States); Matesan, Manuela [University of Washington, Department of Radiology, Seattle, WA (United States); Bulas, Dorothy I. [Division of Diagnostic Imaging and Radiology, Children' s National Medical Center, Washington, DC (United States)

    2010-02-15

    Fetal MRI can be performed in the second and third trimesters. During this time, the fetal brain undergoes profound structural changes. Interpretation of appropriate development might require comparison with normal age-based models. Consultation of a hard-copy atlas is limited by the inability to compare multiple ages simultaneously. To provide images of normal fetal brains from weeks 18 through 37 in a digital format that can be reviewed interactively. This will facilitate recognition of abnormal brain development. T2-W images for the atlas were obtained from fetal MR studies of normal brains scanned for other indications from 2005 to 2007. Images were oriented in standard axial, coronal and sagittal projections, with laterality established by situs. Gestational age was determined by last menstrual period, earliest US measurements and sonogram performed on the same day as the MR. The software program used for viewing the atlas, written in C, permits linked scrolling and resizing the images. Simultaneous comparison of varying gestational ages is permissible. Fetal brain images across gestational ages 18 to 37 weeks are provided as an interactive digital atlas and are available for free download. Improved interpretation of fetal brain abnormalities can be facilitated by the use of digital atlas cataloging of the normal changes throughout fetal development. Here we provide a description of the atlas and a discussion of normal fetal brain development. (orig.)

  12. Digital atlas of fetal brain MRI

    International Nuclear Information System (INIS)

    Chapman, Teresa; Weinberger, E.; Matesan, Manuela; Bulas, Dorothy I.

    2010-01-01

    Fetal MRI can be performed in the second and third trimesters. During this time, the fetal brain undergoes profound structural changes. Interpretation of appropriate development might require comparison with normal age-based models. Consultation of a hard-copy atlas is limited by the inability to compare multiple ages simultaneously. To provide images of normal fetal brains from weeks 18 through 37 in a digital format that can be reviewed interactively. This will facilitate recognition of abnormal brain development. T2-W images for the atlas were obtained from fetal MR studies of normal brains scanned for other indications from 2005 to 2007. Images were oriented in standard axial, coronal and sagittal projections, with laterality established by situs. Gestational age was determined by last menstrual period, earliest US measurements and sonogram performed on the same day as the MR. The software program used for viewing the atlas, written in C, permits linked scrolling and resizing the images. Simultaneous comparison of varying gestational ages is permissible. Fetal brain images across gestational ages 18 to 37 weeks are provided as an interactive digital atlas and are available for free download. Improved interpretation of fetal brain abnormalities can be facilitated by the use of digital atlas cataloging of the normal changes throughout fetal development. Here we provide a description of the atlas and a discussion of normal fetal brain development. (orig.)

  13. Tensor Based Representation and Analysis of Diffusion-Weighted Magnetic Resonance Images

    Science.gov (United States)

    Barmpoutis, Angelos

    2009-01-01

    Cartesian tensor bases have been widely used to model spherical functions. In medical imaging, tensors of various orders can approximate the diffusivity function at each voxel of a diffusion-weighted MRI data set. This approximation produces tensor-valued datasets that contain information about the underlying local structure of the scanned tissue.…

  14. Cerebral Effects of Targeted Temperature Management Methods Assessed by Diffusion-Weighted Magnetic Resonance Imaging

    DEFF Research Database (Denmark)

    Grejs, Anders Morten; Gjedsted, Jakob; Pedersen, Michael

    2016-01-01

    The aim of this randomized porcine study was to compare surface targeted temperature management (TTM) to endovascular TTM evaluated by cerebral diffusion-weighted magnetic resonance imaging (MRI): apparent diffusion coefficient (ADC), and by intracerebral/intramuscular microdialysis. It is well...

  15. Superselective intra-arterial fibrinolysis for acute cerebral ischemic infarct : usefulness of diffusion weighted MR imaging

    International Nuclear Information System (INIS)

    Byun, Woo Mok; Lee, Se Jin; Kim, Yong Sun; Han, Gun Soo; Bae, Won Kyong

    1999-01-01

    To evaluate the efficacy of superselective intra-arterial fibrinolysis for acute cerebral stroke and the usefulness of pre-and postfibrinolysis diffusion-weighted MRI (DWI). In 41 patients with acute ischemic stroke whose treatment involved intra-arterial fibrinolysis, the occlusion site, degree of recanalization, and clinical results were compared. In 12 patients, diffusion weighted MRI was performed before fibrinolysis, and eight of these also underwent diffusion-weighted MRI after fibrinolysis. Using diffusion-weighted MRI, neurological outcomes were compared with signal intensity ratio (SIR, or the average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region). Twenty patients showed complete recanalization, nine partial recanalization, and in twelve there was no recanalization. Fourteen patients (34%) improved neurologically. No relationship existed between occlusion sites, degree of recanalization, and clinical outcome. Among 12 patients who underwent DWI before fibrinolysis, complete recanalization was noted in eight. Neurological improvement was seen in four patients with low SIR( 1.7), neurological outcome was poor despite complete recanalization. Although superselective intra-arterial fibrinolysis for acute cerebral stroke is a good therapeutic method for recanalization, the clinical outcome can be disappointing. We therefore suggest that in cases of acute cerebral ischemic infaret, SIR-as seen on DWI-might be useful for predicting the benefits of recanalization. In such cases, further investigation of the use of DWI prior to fibrinolysis is therefore needed

  16. Brain MRI findings of carbon disulfide poisoning

    International Nuclear Information System (INIS)

    Cha, Joo Hee; Kim, Mi Jung; Yim, Sang Hyuk; Kim, Sam Soo; Han, Heon; Kim, Rok Ho

    2002-01-01

    To evaluate the findings of brain MRI in patients with carbon disulfide poisoning. Ninety-one patients who had suffered carbon disulfide poisoning [male:female=87:4; age, 32-74 (mean 53.3) years] were included in this study. To determine the extent of white matter hyperintensity (Grade 0-V) and lacunar infarction, T2-weighted MR imaging of the brain was performed. T2-weighted images depicted white matter hyperintensity in 70 patients (76.9%) and lacunar infarcts in 27 (29.7%). In these patients, the prevalent findings at T2-weighted MR imaging of the brain were white matter hyperintensity and lacunar infarcts. Disturbance of the cardiovascular system by carbon disulfide might account for these results

  17. Intraoperative MRI in pediatric brain tumors

    International Nuclear Information System (INIS)

    Choudhri, Asim F.; Siddiqui, Adeel; Klimo, Paul; Boop, Frederick A.

    2015-01-01

    Intraoperative magnetic resonance imaging (iMRI) has emerged as an important tool in guiding the surgical management of children with brain tumors. Recent advances have allowed utilization of high field strength systems, including 3-tesla MRI, resulting in diagnostic-quality scans that can be performed while the child is on the operating table. By providing information about the possible presence of residual tumor, it allows the neurosurgeon to both identify and resect any remaining tumor that is thought to be safely accessible. By fusing the newly obtained images with the surgical guidance software, the images have the added value of aiding in navigation to any residual tumor. This is important because parenchyma often shifts during surgery. It also gives the neurosurgeon insight into whether any immediate postoperative complications have occurred. If any complications have occurred, the child is already in the operating room and precious minutes lost in transport and communications are saved. In this article we review the three main approaches to an iMRI system design. We discuss the possible roles for iMRI during intraoperative planning and provide guidance to help radiologists and neurosurgeons alike in the collaborative management of these children. (orig.)

  18. Brain MRI findings of spontaneous intracranial hypotension

    Energy Technology Data Exchange (ETDEWEB)

    Park, Won Kyu; Byun, Woo Mok; Cho, Jae Ho; Cho Kil Ho; Hwang, Mi Soo; Park, Bok Hwan [Yeungnam Univ. College of Medicine, Taegu (Korea, Republic of); Joo, Yang Gu [Keimyoung Univ. College of Medicine, Taegu (Korea, Republic of); Lee, Sang Jin [Soonchunhyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    To evaluate brain MRI findings of spontaneous intracranial hypotension. A retrospective review of MRI findings was conducted on six patients with clinically proven spontaneous intracranial hypotension; no patient had a history of previous spinal puncture. Follow-up MRI was available in two patients, and to detect CSF leakage, radio-nuclide cisternography(n=3D5), myelography(n=3D1), and MR myelography(n=3D1) were performed. On contrast-enhanced T1WI, diffuse dural enhancement was seen in all cases, subdural hematoma or hygroma was seen in four cases, pituitary gland prominence in four, dural sinus dilatation in four, downward displacement of the cerebellar tonsil in two, downward displacement of the iter in one, and suprasellar and prepontine cistern effacement in two. In no patient was abnormal CSF leakage found. Although dural enhancement, as seen on MRI, is not specific, diffuse enhancement of the dura mater accompanied by subdural hematoma, hygroma, pituitary gland prominence, dural sinus dilatation, downward displacement of the cerebellar tonsil, or suprasellar and prepontine cistern effacement can strongly suggest intracranial hypotension.=20.

  19. The diagnostic value of high-frequency power-based diffusion-weighted imaging in prediction of neuroepithelial tumour grading.

    Science.gov (United States)

    Chen, Zhiye; Zhou, Peng; Lv, Bin; Liu, Mengqi; Wang, Yan; Wang, Yulin; Lou, Xin; Gui, Qiuping; He, Huiguang; Ma, Lin

    2017-12-01

    To retrospectively evaluate the diagnostic value of high-frequency power (HFP) compared with the minimum apparent diffusion coefficient (MinADC) in the prediction of neuroepithelial tumour grading. Diffusion-weighted imaging (DWI) data were acquired on 115 patients by a 3.0-T MRI system, which included b0 images and b1000 images over the whole brain in each patient. The HFP values and MinADC values were calculated by an in-house script written on the MATLAB platform. There was a significant difference among each group excluding grade I (G1) vs. grade II (G2) (P = 0.309) for HFP and among each group for MinADC. ROC analysis showed a higher discriminative accuracy between low-grade glioma (LGG) and high-grade glioma (HGG) for HFP with area under the curve (AUC) value 1 compared with that for MinADC with AUC 0.83 ± 0.04 and also demonstrated a higher discriminative ability among the G1-grade IV (G4) group for HFP compared with that for MinADC except G1 vs. G2. HFP could provide a simple and effective optimal tool for the prediction of neuroepithelial tumour grading based on diffusion-weighted images in routine clinical practice. • HFP shows positive correlation with neuroepithelial tumour grading. • HFP presents a good diagnostic efficacy for LGG and HGG. • HFP is helpful in the selection of brain tumour boundary.

  20. An autopsied case of MM1 + MM2-cortical with thalamic-type sporadic Creutzfeldt-Jakob disease presenting with hyperintensities on diffusion-weighted MRI before clinical onset.

    Science.gov (United States)

    Iwasaki, Yasushi; Mori, Keiko; Ito, Masumi; Mimuro, Maya; Kitamoto, Tetsuyuki; Yoshida, Mari

    2017-02-01

    A 78-year-old Japanese man presented with rapidly progressive dementia and gait disturbances. Eight months before the onset of clinical symptoms, diffusion-weighted magnetic resonance imaging (DWI) demonstrated hyperintensities in the right temporal, right parietal and left medial occipital cortices. Two weeks after symptom onset, DWI showed extensive hyperintensity in the bilateral cerebral cortex, with regions of higher brightness that existed prior to symptom onset still present. Four weeks after clinical onset, periodic sharp wave complexes were identified on an electroencephalogram. Myoclonus was observed 8 weeks after clinical onset. The patient reached an akinetic mutism state and died 5 months after onset. Neuropathological examination showed widespread cerebral neocortical involvement of fine vacuole-type spongiform changes with large confluent vacuole-type spongiform changes. Spongiform degeneration with neuron loss and hypertrophic astrocytosis was also observed in the striatum and medial thalamus. The inferior olivary nucleus showed severe neuron loss with hypertrophic astrocytosis. Prion protein (PrP) immunostaining showed widespread synaptic-type PrP deposition with perivacuolar-type PrP deposition in the cerebral neocortex. Mild to moderate PrP deposition was also observed extensively in the basal ganglia, thalamus, cerebellum and brainstem, but it was not apparent in the inferior olivary nucleus. PrP gene analysis showed no mutations, and polymorphic codon 129 showed methionine homozygosity. Western blot analysis of protease-resistant PrP showed both type 1 scrapie type PrP (PrP Sc ) and type 2 PrP Sc . Based on the relationship between the neuroimaging and pathological findings, we speculated that cerebral cortical lesions with large confluent vacuoles and type 2 PrP Sc would show higher brightness and continuous hyperintensity on DWI than those with fine vacuoles and type 1 PrP Sc . We believe the present patient had a combined form of MM1

  1. Whole Body MRI at 3T with Quantitative Diffusion Weighted Imaging and Contrast-Enhanced Sequences for the Characterization of Peripheral Lesions in Patients with Neurofibromatosis Type 2 and Schwannomatosis

    International Nuclear Information System (INIS)

    Fayad, Laura M.; Blakeley, Jaishri; Plotkin, Scott; Widemann, Brigitte; Jacobs, Michael A.

    2013-01-01

    Purpose. WB-MRI is mainly used for tumor detection and surveillance. The purpose of this study is to establish the feasibility of WB-MRI at 3T for lesion characterization, with DWI/ADC-mapping and contrast-enhanced sequences, in patients with neurofibromatosis type 2 (NF-2) and schwannomatosis. Materials and Methods. At 3T, WB-MRI was performed in 11 subjects (10 NF-2 and 1 schwannomatosis) with STIR, T1, contrast-enhanced T1, and DWI/ADC mapping (b = 50, 400, 800 s/mm 2 ). Two readers reviewed imaging for the presence and character of peripheral lesions. Lesion size and features (signal intensity, heterogeneity, enhancement characteristics, and ADC values) were recorded. Descriptive statistics were reported. Results. Twenty-three lesions were identified, with average size of 4.6 ± 2.8 cm. Lesions were characterized as tumors (21/23) or cysts (2/23) by contrast-enhancement properties (enhancement in tumors, no enhancement in cysts). On T1, tumors were homogeneously isointense (5/21) or hypointense (16/21); on STIR, tumors were hyperintense and homogeneous (10/21) or heterogeneous (11/21); on postcontrast T1, tumors enhanced homogeneously (14/21) or heterogeneously (7/21); on DWI, tumor ADC values were variable (range 0.8–2.7), suggesting variability in intrinsic tumor properties. Conclusion. WB-MRI with quantitative DWI and contrast-enhanced sequences at 3T is feasible and advances the utility of WB-MRI not only to include detection, but also to provide additional metrics for lesion characterization

  2. In vitro MRI of brain development

    Energy Technology Data Exchange (ETDEWEB)

    Rados, Marko [Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Salata 12, 10000 Zagreb (Croatia); Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, Kispaticeva 12, 10000 Zagreb (Croatia); Judas, Milos [Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Salata 12, 10000 Zagreb (Croatia); Kostovic, Ivica [Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Salata 12, 10000 Zagreb (Croatia)]. E-mail: ikostov@hiim.h

    2006-02-15

    In this review, we demonstrate the developmental appearance, structural features, and reorganization of transient cerebral zones and structures in the human fetal brain using a correlative histological and MRI analysis. The analysis of postmortem aldehyde-fixed specimens (age range: 10 postovulatory weeks to term) revealed that, at 10 postovulatory weeks, the cerebral wall already has a trilaminar appearance and consists of: (1) a ventricular zone of high cell-packing density; (2) an intermediate zone; (3) the cortical plate (in a stage of primary consolidation) with high MRI signal intensity. The anlage of the hippocampus is present as a prominent bulging in the thin limbic telencephalon. The early fetal telencephalon impar also contains the first commissural fibers and fornix bundles in the septal area. The ganglionic eminence is clearly visible as an expanded continuation of the proliferative ventricular zone. The basal ganglia showed an initial aggregation of cells. The most massive fiber system is in the hemispheric stalk, which is in continuity with thalamocortical fibers. During the mid-fetal period (15-22 postovulatory weeks), the typical fetal lamination pattern develops and the cerebral wall consists of the following zones: (a) a marginal zone (visible on MRI exclusively in the hippocampus); (b) the cortical plate with high cell-packing density and high MRI signal intensity; (c) the subplate zone, which is the most prominent zone rich in extracellular matrix and with a very low MRI signal intensity; (d) the intermediate zone (fetal 'white matter'); (e) the subventricular zone; (f) the periventricular fiber-rich zone; (g) the ventricular zone. The ganglionic eminence is still a very prominent structure with an intense proliferative activity. During the next period (22-26 postovulatory weeks), there is the developmental peak of transient MRI features, caused by the high content of hydrophyllic extracellular matrix in the subplate zone and the

  3. In vitro MRI of brain development

    International Nuclear Information System (INIS)

    Rados, Marko; Judas, Milos; Kostovic, Ivica

    2006-01-01

    In this review, we demonstrate the developmental appearance, structural features, and reorganization of transient cerebral zones and structures in the human fetal brain using a correlative histological and MRI analysis. The analysis of postmortem aldehyde-fixed specimens (age range: 10 postovulatory weeks to term) revealed that, at 10 postovulatory weeks, the cerebral wall already has a trilaminar appearance and consists of: (1) a ventricular zone of high cell-packing density; (2) an intermediate zone; (3) the cortical plate (in a stage of primary consolidation) with high MRI signal intensity. The anlage of the hippocampus is present as a prominent bulging in the thin limbic telencephalon. The early fetal telencephalon impar also contains the first commissural fibers and fornix bundles in the septal area. The ganglionic eminence is clearly visible as an expanded continuation of the proliferative ventricular zone. The basal ganglia showed an initial aggregation of cells. The most massive fiber system is in the hemispheric stalk, which is in continuity with thalamocortical fibers. During the mid-fetal period (15-22 postovulatory weeks), the typical fetal lamination pattern develops and the cerebral wall consists of the following zones: (a) a marginal zone (visible on MRI exclusively in the hippocampus); (b) the cortical plate with high cell-packing density and high MRI signal intensity; (c) the subplate zone, which is the most prominent zone rich in extracellular matrix and with a very low MRI signal intensity; (d) the intermediate zone (fetal 'white matter'); (e) the subventricular zone; (f) the periventricular fiber-rich zone; (g) the ventricular zone. The ganglionic eminence is still a very prominent structure with an intense proliferative activity. During the next period (22-26 postovulatory weeks), there is the developmental peak of transient MRI features, caused by the high content of hydrophyllic extracellular matrix in the subplate zone and the accumulation

  4. Diffusion-weighted MR imaging in biopsy-proven Creutzfeldt-Jakob disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyo Cheol; Chang, Kee Hyun; Song In Chan; Lee, Sang Hyun; Kwon, Bae Ju; Han, Moon Hee; Kim, Sang Yun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2001-12-01

    To compare conventional and diffusion-weighted MR imaging in terms of their depiction of the abnormalities occurring in Creutzfeldt-Jakob disease. We retrospectively analyzed the findings of conventional (T2-weighted and fluid-attenuated inversion recovery) and diffusion-weighted MR imaging in four patients with biopsy-proven Creutzfeldt-Jakob disease. The signal intensity of the lesion was classified by visual assessment as markedly high, slightly high, or isointense, relative to normal brain parenchyma. Both conventional and diffusion-weighted MR images demonstrated bilateral high signal intensity in the basal ganglia in all four patients. Cortical lesions were observed on diffusion-weighted MR images in all four, and on fluidattenuated inversion recovery MR images in one, but in no patient on T2-weighted images. Conventional MR images showed slightly high signal intensity in all lesions, while diffusion-weighted images showed markedly high signal intensity in most. Diffusion-weighted MR imaging is more sensitive than its conventional counterpart in the depiction of Creutzfeldt-Jakob disease, and permits better detection of the lesion in both the cerebral cortices and basal ganglia.

  5. Diffusion-weighted MR imaging in biopsy-proven Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Kim, Hyo Cheol; Chang, Kee Hyun; Song In Chan; Lee, Sang Hyun; Kwon, Bae Ju; Han, Moon Hee; Kim, Sang Yun

    2001-01-01

    To compare conventional and diffusion-weighted MR imaging in terms of their depiction of the abnormalities occurring in Creutzfeldt-Jakob disease. We retrospectively analyzed the findings of conventional (T2-weighted and fluid-attenuated inversion recovery) and diffusion-weighted MR imaging in four patients with biopsy-proven Creutzfeldt-Jakob disease. The signal intensity of the lesion was classified by visual assessment as markedly high, slightly high, or isointense, relative to normal brain parenchyma. Both conventional and diffusion-weighted MR images demonstrated bilateral high signal intensity in the basal ganglia in all four patients. Cortical lesions were observed on diffusion-weighted MR images in all four, and on fluidattenuated inversion recovery MR images in one, but in no patient on T2-weighted images. Conventional MR images showed slightly high signal intensity in all lesions, while diffusion-weighted images showed markedly high signal intensity in most. Diffusion-weighted MR imaging is more sensitive than its conventional counterpart in the depiction of Creutzfeldt-Jakob disease, and permits better detection of the lesion in both the cerebral cortices and basal ganglia

  6. Antemortem cranial MRI compared with postmortem histopathologic examination of the brain in term infants with neonatal encephalopathy following perinatal asphyxia.

    Science.gov (United States)

    Alderliesten, Thomas; Nikkels, Peter G J; Benders, Manon J N L; de Vries, Linda S; Groenendaal, Floris

    2013-07-01

    To compare antemortem cranial MRI with postmortem histopathological examination of the brain in full-term infants with neonatal encephalopathy following perinatal asphyxia. In this retrospective observational cohort study, 23 infants with neonatal encephalopathy who subsequently died, were analysed. Infants underwent antemortem cranial MRI and postmortem histopathological examination of the brain. MRI included T1, T2 and diffusion-weighted sequences. Histopathology included staining with H&E, and monoclonal antibodies to CD68 and HLA-DR. Histological abnormalities were compared with MRI in 10 different brain regions. All neonates underwent cranial MRI within 7 days after birth (median day 3, IQR 2-4 days). Infants died on median day 4 (IQR 2-5 days). Histopathology demonstrated significantly (p=0.0016) more abnormal regions (median 10, IQR 7-10) per patient than did MRI (median 8, IQR 5-9). The number of cases with abnormalities in the thalamus, basal ganglia, posterior limb of the internal capsule (PLIC), cerebral cortex and cerebellum were not significantly different between MRI and histopathology. By contrast, the hippocampus (70% vs 96%, p=0.047), cerebral white matter (anterior 65% vs 96%, p=0.022, posterior 61% vs 91%, p=0.035) and brainstem (57% vs 96%, p=0.004) were confirmed to be affected more often on histopathological examination than with MRI. Whereas early postnatal MR imaging is excellent in detecting injury to the basal ganglia and thalamus, PLIC, cortex and cerebellum, it may underestimate injury to the hippocampus, cerebral white matter, and the brainstem in term infants with neonatal encephalopathy following perinatal asphyxia.

  7. Diffusion-weighted imaging in the diagnosis of enterovirus 71 encephalitis

    International Nuclear Information System (INIS)

    Lian, Zhou-yang; Huang, Biao; Liang, Chang-hong; He, Shaoru; Guo, Yuxiong

    2012-01-01

    Background. In the early phase of viral encephalitis, conventional MRI may appear normal. Diffusion-weighted imaging (DWI) is a sensitive tool for detecting early changes in cellular function in the central nervous system. Purpose. To investigate the usefulness of DWI in the diagnosis of enterovirus 71 (EV71) encephalitis, and to determine whether DWI is superior to conventional MR sequences. Material and Methods. MRI scans in 26 patients were retrospectively evaluated for distribution of lesions on T1-weighted images (T1WI), T2-weighted images (T2WI), fluid-attenuated inversion recovery (FLAIR), and DWI. Contrast-to-noise ratios (CNRs) were calculated for all regions on each sequence and differences in the four MRI sequences were assessed using CNRs. Apparent diffusion coefficient (ADC) values were measured for all regions to look for true restriction of diffusion. Results. Fifteen out of 26 cases showed positive findings on MR imaging. The brain stem was involved in 11 patients, cortex and subcortical white matter in four patients. DWI was more sensitive in detecting the abnormalities (89.7%) compared to T2WI (48.7%), FLAIR (41.0%), and T1WI (35.9%), and the positive ratio of DWI was significantly higher compared to other sequences. Furthermore, no significant difference was found between T2WI and FLAIR (P 0.649). The corresponding mean CNRs were 8.73 ± 2.57, 83.59 ± 29.28, 24.22 ± 6.22, and 132.27 ± 78.32 on T1WI, T2WI, FLAIR, and DWI, respectively. The absolute values of CNRs of lesions on DWI were significantly greater than those on other sequences. Conclusion. DWI appears to be more sensitive in detecting EV71 encephalitis than conventional MRI sequences. This capability may improve the accuracy in diagnosing EV71 encephalitis, especially at the early stage

  8. Diffusion-weighted imaging in the diagnosis of enterovirus 71 encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Lian, Zhou-yang; Huang, Biao; Liang, Chang-hong (Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China)), Email: cjr.huangbiao@vip.163.com; He, Shaoru; Guo, Yuxiong (Department of Pediatrics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China))

    2012-03-15

    Background. In the early phase of viral encephalitis, conventional MRI may appear normal. Diffusion-weighted imaging (DWI) is a sensitive tool for detecting early changes in cellular function in the central nervous system. Purpose. To investigate the usefulness of DWI in the diagnosis of enterovirus 71 (EV71) encephalitis, and to determine whether DWI is superior to conventional MR sequences. Material and Methods. MRI scans in 26 patients were retrospectively evaluated for distribution of lesions on T1-weighted images (T1WI), T2-weighted images (T2WI), fluid-attenuated inversion recovery (FLAIR), and DWI. Contrast-to-noise ratios (CNRs) were calculated for all regions on each sequence and differences in the four MRI sequences were assessed using CNRs. Apparent diffusion coefficient (ADC) values were measured for all regions to look for true restriction of diffusion. Results. Fifteen out of 26 cases showed positive findings on MR imaging. The brain stem was involved in 11 patients, cortex and subcortical white matter in four patients. DWI was more sensitive in detecting the abnormalities (89.7%) compared to T2WI (48.7%), FLAIR (41.0%), and T1WI (35.9%), and the positive ratio of DWI was significantly higher compared to other sequences. Furthermore, no significant difference was found between T2WI and FLAIR (P 0.649). The corresponding mean CNRs were 8.73 +- 2.57, 83.59 +- 29.28, 24.22 +- 6.22, and 132.27 +- 78.32 on T1WI, T2WI, FLAIR, and DWI, respectively. The absolute values of CNRs of lesions on DWI were significantly greater than those on other sequences. Conclusion. DWI appears to be more sensitive in detecting EV71 encephalitis than conventional MRI sequences. This capability may improve the accuracy in diagnosing EV71 encephalitis, especially at the early stage

  9. Volumetric quantification of brain development using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Iwasaki, N.; Hamano, K.; Okada, Y.; Horigome, Y.; Nakayama, J.; Takeya, T.; Takita, H. [Department of Paediatrics, University of Tsukuba, Ibaraki-ken (Japan); Nose, T. [Department of Neurosurgery, University of Tsukuba, Ibaraki-ken (Japan)

    1997-12-01

    We devised a three-dimensional method for estimation of cerebral development and myelination which measures cerebral volume using MRI. Accuracy of the system was estimated using cadaver brains. The mean percentage error in the calculated volumes compared with the real volumes was 2.33 %, range 0.00-5.33 %. We applied the method to the volume of both cerebral hemispheres (CH), basal ganglia, thalamus and internal capsule (BT), and myelinated white matter (WM) in 44 neurologically normal individuals (4 months to 28 years of age), 13 patients with spastic motor disturbances (2-25 years of age), and 9 patients with athetotic motor disturbances (2-23 years of age). In the neurologically normal cases, the volumes of CH, BT and WM increased with age; the volume of MW more slowly than that of CH. In cases with spastic motor disturbances, the volumes of CH, BT and WM were between -1.4 and 3.5 SD, -1.0 and -3.5 SD, and 0.0 and -5.2 SD respectively, of those of neurologically-normal cases. On the other hand, 7 of the 9 cases with athetotic motor disturbances were within 2 SD of the volume of CH in neurologically normal cases. Our method for direct measurement of cerebral volume based on serial MRI should be useful for the accurate assessment of brain development and quantitative analysis of delayed myelination. (orig.) With 7 figs., 1 tab., 22 refs.

  10. Chediak-Higashi syndrome: brain MRI and MR spectroscopy manifestations

    International Nuclear Information System (INIS)

    Lolli, Valentina; Soto Ares, Gustavo; Pruvo, Jean-Pierre; Abou Chahla, Wadih; Jissendi-Tchofo, Patrice

    2015-01-01

    Chediak-Higashi syndrome is a rare inherited metabolic disorder characterized by partial oculocutaneous albinism, immunodeficiency, and neurological dysfunction. We present the brain magnetic resonance imaging (MRI) and MR spectroscopy (MRS) findings obtained during the accelerated phase of the disorder in an 8-year-old. The brain MRI manifestations at recurrences 15 months and 24 months later are reported as well. (orig.)

  11. Chediak-Higashi syndrome: brain MRI and MR spectroscopy manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Lolli, Valentina; Soto Ares, Gustavo; Pruvo, Jean-Pierre [Roger Salengro Hospital, CHRU, Neuroradiology Department, Lille (France); Abou Chahla, Wadih [Jeanne de Flandre Hospital, Pediatric Hematology and Oncology Department, Lille (France); Jissendi-Tchofo, Patrice [University Hospital Saint-Pierre, Radiology Department - Pediatric Neuroradiology Section, Brussels (Belgium)

    2015-08-15

    Chediak-Higashi syndrome is a rare inherited metabolic disorder characterized by partial oculocutaneous albinism, immunodeficiency, and neurological dysfunction. We present the brain magnetic resonance imaging (MRI) and MR spectroscopy (MRS) findings obtained during the accelerated phase of the disorder in an 8-year-old. The brain MRI manifestations at recurrences 15 months and 24 months later are reported as well. (orig.)

  12. The diagnostic value of high-frequency power-based diffusion-weighted imaging in prediction of neuroepithelial tumour grading

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Zhiye; Liu, Mengqi [Chinese PLA General Hospital, Department of Radiology, Beijing (China); Hainan Branch of Chinese PLA General Hospital, Department of Radiology, Sanya (China); Zhou, Peng [Chinese Academy of Sciences, Research Center for Brain-inspired Intelligence, Institute of Automation, Beijing (China); University of Chinese Academy of Sciences, Beijing (China); Lv, Bin [Academy of Telecommunication Research of MIIT, Beijing (China); Wang, Yan; Wang, Yulin; Lou, Xin; Ma, Lin [Chinese PLA General Hospital, Department of Radiology, Beijing (China); Gui, Qiuping [Chinese PLA General Hospital, Department of Pathology, Beijing (China); He, Huiguang [Chinese Academy of Sciences, Research Center for Brain-inspired Intelligence, Institute of Automation, Beijing (China); University of Chinese Academy of Sciences, Beijing (China); Chinese Academy of Sciences, Center for Excellence in Brain Science and Intelligence Technology, Beijing (China)

    2017-12-15

    To retrospectively evaluate the diagnostic value of high-frequency power (HFP) compared with the minimum apparent diffusion coefficient (MinADC) in the prediction of neuroepithelial tumour grading. Diffusion-weighted imaging (DWI) data were acquired on 115 patients by a 3.0-T MRI system, which included b0 images and b1000 images over the whole brain in each patient. The HFP values and MinADC values were calculated by an in-house script written on the MATLAB platform. There was a significant difference among each group excluding grade I (G1) vs. grade II (G2) (P = 0.309) for HFP and among each group for MinADC. ROC analysis showed a higher discriminative accuracy between low-grade glioma (LGG) and high-grade glioma (HGG) for HFP with area under the curve (AUC) value 1 compared with that for MinADC with AUC 0.83 ± 0.04 and also demonstrated a higher discriminative ability among the G1-grade IV (G4) group for HFP compared with that for MinADC except G1 vs. G2. HFP could provide a simple and effective optimal tool for the prediction of neuroepithelial tumour grading based on diffusion-weighted images in routine clinical practice. (orig.)

  13. Preliminary evaluation of a brain PET insertable to MRI

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Gyuseng [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 305-701 South (Korea, Republic of); Choi, Yong [Department of Electronic Engineering, Sogang University, Seoul, 121-742 South (Korea, Republic of); Lee, Jae Sung; An, Hyun Joon [Department of Nuclear Medicine, Seoul National University, Seoul, 110-744 South (Korea, Republic of); Jung, Jin Ho [Department of Electronic Engineering, Sogang University, Seoul, 121-742 South (Korea, Republic of); Park, Hyun Wook; Oh, Chang Hyun; Park, Kyeongjin; Lim, Kyung Taek; Cho, Minsik [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 305-701 South (Korea, Republic of); Sul, Woo Suk [National NanoFab Center, Deajeon, 305-806 South (Korea, Republic of); Kim, Hyoungtaek; Kim, Hyunduk [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 305-701 South (Korea, Republic of)

    2014-07-29

    There is a new trend of the medical image that diagnoses a brain disease as like Alzheimer dementia. The first qualified candidate is a PET-MRI fusion modality because MRI is a more powerful anatomic diagnosis tool than other modalities. In our study, in order to solve the high magnetic field from MRI, the development was consisted with four main items such as photo-sensor, PET scanner, MRI head-coil and attenuation correction algorithm development.

  14. Evolution of Diffusion-Weighted Magnetic Resonance Imaging Signal Abnormality in Sporadic Creutzfeldt-Jakob Disease, With Histopathological Correlation.

    Science.gov (United States)

    Eisenmenger, Laura; Porter, Marie-Claire; Carswell, Christopher J; Thompson, Andrew; Mead, Simon; Rudge, Peter; Collinge, John; Brandner, Sebastian; Jäger, Hans R; Hyare, Harpreet

    2016-01-01

    Prion diseases represent the archetype of brain diseases caused by protein misfolding, with the most common subtype being sporadic Creutzfeldt-Jakob disease (sCJD), a rapidly progressive dementia. Diffusion-weighted imaging (DWI) has emerged as the most sensitive magnetic resonance imaging (MRI) sequence for the diagnosis of sCJD, but few studies have assessed the evolution of MRI signal as the disease progresses. To assess the natural history of the MRI signal abnormalities on DWI in sCJD to improve our understanding of the pathogenesis and to investigate the potential of DWI as a biomarker of disease progression, with histopathological correlation. Gray matter involvement on DWI was assessed among 37 patients with sCJD in 26 cortical and 5 subcortical subdivisions per hemisphere using a semiquantitative scoring system of 0 to 2 at baseline and follow-up. A total brain score was calculated as the summed scores in the individual regions. In 7 patients, serial mean diffusivity measurements were obtained. Age at baseline MRI, disease duration, atrophy, codon 129 methionine valine polymorphism, Medical Research Council Rating Scale score, and histopathological findings were documented. The study setting was the National Prion Clinic, London, England. All participants had a probable or definite diagnosis of sCJD and had at least 2 MRI studies performed during the course of their illness. The study dates were October 1, 2008 to April 1, 2012. The dates of our analysis were January 19 to April 20, 2012. Correlation of regional and total brain scores with disease duration. Among the 37 patients with sCJD in this study there was a significant increase in the number of regions demonstrating signal abnormality during the study period, with 59 of 62 regions showing increased signal intensity (SI) at follow-up, most substantially in the caudate and putamen (P disease duration (r = 0.47, P = .003 at baseline and r = 0.35, P = .03 at follow-up), and the left

  15. Pediatric brain MRI in neurofibromatosis type I

    Energy Technology Data Exchange (ETDEWEB)

    Mentzel, Hans-J.; Fitzek, Clemens; Vogt, Susanna; Reichenbach, Juergen R.; Kaiser, Werner A. [Friedrich-Schiller-University Jena, Department of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, Jena (Germany); Seidel, Joerg; Eichhorn, Annegret; Zintl, Felix [Friedrich-Schiller-University Jena, Department of Pediatrics, Jena (Germany)

    2005-04-01

    Neurofibromatosis (NF) is the most common of the phakomatoses, with a prevalence of 1 in 3-4,000. Many organ systems can be affected. In addition to multiple peripheral neurofibromas, NF I predisposed to CNS tumors including optic glioma, astrocytoma and plexiform neurofibroma. The purpose of this pictorial review is to illustrate characteristic brain MR imaging lesions in children with NF I and to give some recommendations about diagnostic imaging procedures in children suffering from NF I. Typical findings in brain MRI are hyperintense lesion on T2-weighted images, so-called unknown bright objects, which may be useful as an additional imaging criterion for NF I. Contrast administration is necessary in MR studies to maximize tumor detection and characterization, to add confidence to the diagnosis of benign probable myelin vacuolization, and to document stability of neoplasm on follow-up examinations. We recommend to perform serial MR imaging in children every 12 months. The frequency of follow-up in children with known brain tumors will vary with the tumor grade, biological activity and treatment. (orig.)

  16. MRI of 'brain death'

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Shigeki; Itoh, Takahiko; Tuchida, Shohei; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira (Okayama Univ. (Japan). School of Medicine); Sanou, Kazuo

    1990-12-01

    Magnetic resonance imaging (MRI) was undertaken for two patients who suffered from severe cerebrovascular diseases and were clinically brain dead. The MRI system we used was Resona (Yokogawa Medical Systems, superconductive system 0.5 T) and the CT apparatus was Toshiba TCT-300. Initial CT and MRI were undertaken as soon as possible after admission, and repeated sequentially. After diagnosis of brain death, we performed angiography to determine cerebral circulatory arrest, and MRI obtained at the same time was compared with the angiogram and CT. Case 1 was a 77-year-old man who was admitted in an unconscious state. CT and MRI on the second day after hospitalization revealed cerebellar infarction. He was diagnosed as brain dead on day 4. Case 2 was a 35-year-old man. When he was transferred to our hospital, he was in cardiorespiratory arrested. Cardiac resuscitation was successful but no spontaneous respiration appeared. CT and MRI on admission revealed right intracerebral hemorrhage. Angiography revealed cessation of contrast medium in intracranial vessels in both of the patients. We found no 'flow signal void sign' in the bilateral internal carotid and basilar arteries on MRI images in both cases after brain death. MRI, showing us the anatomical changes of the brain, clearly revealed brain herniations, even though only nuclear findings of 'brain tamponade' were seen on CT. But in Case 1, we could not see the infarct lesions in the cerebellum on MR images obtained after brain death. This phenomenon was caused by the whole brain ischemia masking the initial ischemic lesions. We concluded that MRI was useful not only the anatomical display of lesions and brain herniation with high contrast resolution but for obtaining information on cerebral circulation of brain death. (author).

  17. Diffusion-weighted imaging in characterization of cystic pancreatic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sandrasegaran, K., E-mail: ksandras@iupui.edu [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Akisik, F.M.; Patel, A.A.; Rydberg, M. [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Cramer, H.M.; Agaram, N.P. [Department of Pathology, Indiana University School of Medicine, Indianapolis, IN (United States); Schmidt, C.M. [Department of Surgery, Indiana University School of Medicine, Indianapolis, IN (United States)

    2011-09-15

    Aim: To evaluate whether apparent diffusion coefficient (ADC) measurements from diffusion-weighted imaging (DWI) can characterize or predict the malignant potential of cystic pancreatic lesions. Materials and methods: Retrospective review of the magnetic resonance imaging (MRI) database over a 2-year period revealed 136 patients with cystic pancreatic lesions. Patients with DWI studies and histological confirmation of cystic mass were included. In patients with known pancreatitis, lesions with amylase content of >1000 IU/l that resolved on subsequent scans were included as pseudocysts. ADC of cystic lesions was measured by two independent reviewers. These values were then compared to categorize these lesions as benign or malignant using conventional MRI sequences. Results: Seventy lesions were analysed: adenocarcinoma (n = 4), intraductal papillary mucinous neoplasm (IPMN; n = 28), mucinous cystic neoplasm (MCN; n = 9), serous cystadenoma (n = 16), and pseudocysts (n = 13). There was no difference between ADC values of malignant and non-malignant lesions (p = 0.06), between mucinous and serous tumours (p = 0.12), or between IPMN and MCN (p = 0.42). ADC values for low-grade IPMN were significantly higher than those for high-grade or invasive IPMN (p = 0.03). Conclusion: ADC values may be helpful in deciding the malignant potential of IPMN. However, they are not useful in differentiating malignant from benign lesions or for characterizing cystic pancreatic lesions.

  18. Diffusion-weighted imaging in acute bacterial meningitis in infancy

    Energy Technology Data Exchange (ETDEWEB)

    Jan, W.; Zimmerman, R.A.; Bilaniuk, L.T.; Hunter, J.V.; Simon, E.M.; Haselgrove, J. [Department of Radiology, Children' s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, PA 19104, Philadelphia (United States)

    2003-09-01

    Bacterial meningitis is frequently fatal or leads to severe neurological impairment. Complications such as vasculitis, resulting in infarcts, should be anticipated and dealt with promptly. Our aim was to demonstrate the complications of meningitis by diffusion weighted imaging (DWI) in patients who deteriorated despite therapy. We studied 13 infants between the ages of 1 day and 32 months who presented with symptoms ranging from fever and vomiting to seizures, encephalopathy and coma due to bacterial meningitis, performing MRI, including DWI, 2-5 days after presentation. Multiple infarcts were found on DWI in 12 of the 13, most commonly in the frontal lobes (in 10). Global involvement was seen in four children, three of whom died; the fourth had a very poor outcome. In one case abnormalities on DWI were due to subdural empyemas. We diagnosed vasculitis in three of five patients studied with MRA. We think DWI an important part of an MRI study in infants with meningitis. Small cortical or deep white-matter infarcts due to septic vasculitis can lead to tissue damage not easily recognized on routine imaging and DWI can be used to confirm that extra-axial collections represent empyemas. (orig.)

  19. Diffusion-weighted imaging in acute bacterial meningitis in infancy

    International Nuclear Information System (INIS)

    Jan, W.; Zimmerman, R.A.; Bilaniuk, L.T.; Hunter, J.V.; Simon, E.M.; Haselgrove, J.

    2003-01-01

    Bacterial meningitis is frequently fatal or leads to severe neurological impairment. Complications such as vasculitis, resulting in infarcts, should be anticipated and dealt with promptly. Our aim was to demonstrate the complications of meningitis by diffusion weighted imaging (DWI) in patients who deteriorated despite therapy. We studied 13 infants between the ages of 1 day and 32 months who presented with symptoms ranging from fever and vomiting to seizures, encephalopathy and coma due to bacterial meningitis, performing MRI, including DWI, 2-5 days after presentation. Multiple infarcts were found on DWI in 12 of the 13, most commonly in the frontal lobes (in 10). Global involvement was seen in four children, three of whom died; the fourth had a very poor outcome. In one case abnormalities on DWI were due to subdural empyemas. We diagnosed vasculitis in three of five patients studied with MRA. We think DWI an important part of an MRI study in infants with meningitis. Small cortical or deep white-matter infarcts due to septic vasculitis can lead to tissue damage not easily recognized on routine imaging and DWI can be used to confirm that extra-axial collections represent empyemas. (orig.)

  20. Diffusion-weighted imaging and cognition in the leukoariosis and disability in the elderly study

    DEFF Research Database (Denmark)

    Schmidt, Reinhold; Ropele, Stefan; Ferro, José

    2010-01-01

    BACKGROUND AND PURPOSE: The mechanisms by which leukoariosis impacts on clinical and cognitive functions are not yet fully understood. We hypothesized that ultrastructural abnormalities of the normal-appearing brain tissue (NABT) assessed by diffusion-weighted imaging played a major and independe...

  1. Optimizing full-brain coverage in human brain MRI through population distributions of brain size

    NARCIS (Netherlands)

    Mennes, M.; Jenkinson, M.; Valabregue, R.; Buitelaar, J.K.; Beckmann, C.F.; Smith, S.

    2014-01-01

    When defining an MRI protocol, brain researchers need to set multiple interdependent parameters that define repetition time (TR), voxel size, field-of-view (FOV), etc. Typically, researchers aim to image the full brain, making the expected FOV an important parameter to consider. Especially in 2D-EPI

  2. Multidimensional Brain MRI segmentation using graph cuts

    International Nuclear Information System (INIS)

    Lecoeur, Jeremy

    2010-01-01

    This thesis deals with the segmentation of multimodal brain MRIs by graph cuts method. First, we propose a method that utilizes three MRI modalities by merging them. The border information given by the spectral gradient is then challenged by a region information, given by the seeds selected by the user, using a graph cut algorithm. Then, we propose three enhancements of this method. The first consists in finding an optimal spectral space because the spectral gradient is based on natural images and then inadequate for multimodal medical images. This results in a learning based segmentation method. We then explore the automation of the graph cut method. Here, the various pieces of information usually given by the user are inferred from a robust expectation-maximization algorithm. We show the performance of these two enhanced versions on multiple sclerosis lesions. Finally, we integrate atlases for the automatic segmentation of deep brain structures. These three new techniques show the adaptability of our method to various problems. Our different segmentation methods are better than most of nowadays techniques, speaking of computation time or segmentation accuracy. (authors)

  3. Diffusion-weighted imaging features in spinal cord infarction

    International Nuclear Information System (INIS)

    Zhang Jingsong; Huan Yi; Sun Lijun; Chang Yingjuan; Zhao Haitao; Yang Chunmin; Zhang Guangyun

    2005-01-01

    Objective: To analyze the diffusion-weighted MR imaging findings in ischemic spinal cord lesions and discuss the value of diffusion-weighted MR imaging in differentiating diagnosis with inflammatory diseases and tumors. Methods: Six patients (2 male, 4 female) with typical sudden onset of neurological deficits caused by spinal cord ischemia were evaluated. There were no definite etiologies in all patients. DW imaging was performed within 1 to 30 days after the initial neurological symptoms using a Philips Gyroscan 1.5 TMR system. Four patients had other scans including contrast-enhanced MR imaging (CE-MRI) and/or FLAIR scans. Two of them followed up with MR images in three months. All six patients were imaged using a multi-shot, navigator-corrected, echo-planar pulse sequence, and ADC values were calculated in sagittal-oriented plane. Results: MR abnormalities were demonstrated on sagittal T 2 -weighted images with 'patch-like' or 'strip-like' hyperintensities (6/6) and cord enlargement (5/6). Axial T 2 -weighted images showed bilateral (6/6) hyperintensities. In one patient only the posterior spinal artery (PSA) territory was involved. Spinal cord was mainly affected at the cervical (2/6) and thoracolumbar (4/6) region, two of them included the conus medullaris (T10-L1). DW images showed high signals in all infarct lesions, degree of intensity depended on scanning time from ill-onset and progress of illness and whether companied with hemorrhage. In this group, except one case with closely normal ADC value due to one month course of illness, the five others ADC values of lesions calculated from ADC maps arranged from 0.23 x 10 -3 mm 2 /s to 0.47 x 10 -3 mm 2 /s [average value (0.37 ± 0.10) x 10 -3 mm 2 /s], markedly lower than normal parts [ average value (0.89 ± 0.08) x 10 -3 mm 2 /s]. There were marked difference between lesions and normal regions (t=4.71, P 2 W images. Meanwhile, lesions could be displayed much better in DW images than in T 2 W images because

  4. Transient Splenial Lesion of Corpus Callosum Associated with Antiepileptic Drug: Conventional and Diffusion-weighted Magnetic Resonance Images

    International Nuclear Information System (INIS)

    Hakyemez, B.; Erdogan, C.; Yildirim, N.; Gokalp, G.; Parlak, M.

    2005-01-01

    Transient focal lesions of splenium of corpus callosum can be seen as a component of many central nervous system diseases, including antiepileptic drug toxicity. The conventional magnetic resonance (MR) findings of the disease are characteristic and include ovoid lesions with high signal intensity at T2-weighted MRI. Limited information exists about the diffusion-weighted MRI characteristics of these lesions vanishing completely after a period of time. We examined the conventional, FLAIR, and diffusion-weighted MR images of a patient complaining of depressive mood and anxiety disorder after 1 year receiving antiepileptic medication

  5. Transient Splenial Lesion of Corpus Callosum Associated with Antiepileptic Drug: Conventional and Diffusion-weighted Magnetic Resonance Images

    Energy Technology Data Exchange (ETDEWEB)

    Hakyemez, B.; Erdogan, C.; Yildirim, N.; Gokalp, G.; Parlak, M. [Uludag Univ. Medical School, Bursa (Turkey). Dept. of Radiology

    2005-11-01

    Transient focal lesions of splenium of corpus callosum can be seen as a component of many central nervous system diseases, including antiepileptic drug toxicity. The conventional magnetic resonance (MR) findings of the disease are characteristic and include ovoid lesions with high signal intensity at T2-weighted MRI. Limited information exists about the diffusion-weighted MRI characteristics of these lesions vanishing completely after a period of time. We examined the conventional, FLAIR, and diffusion-weighted MR images of a patient complaining of depressive mood and anxiety disorder after 1 year receiving antiepileptic medication.

  6. MRI Segmentation of the Human Brain: Challenges, Methods, and Applications

    Science.gov (United States)

    Despotović, Ivana

    2015-01-01

    Image segmentation is one of the most important tasks in medical image analysis and is often the first and the most critical step in many clinical applications. In brain MRI analysis, image segmentation is commonly used for measuring and visualizing the brain's anatomical structures, for analyzing brain changes, for delineating pathological regions, and for surgical planning and image-guided interventions. In the last few decades, various segmentation techniques of different accuracy and degree of complexity have been developed and reported in the literature. In this paper we review the most popular methods commonly used for brain MRI segmentation. We highlight differences between them and discuss their capabilities, advantages, and limitations. To address the complexity and challenges of the brain MRI segmentation problem, we first introduce the basic concepts of image segmentation. Then, we explain different MRI preprocessing steps including image registration, bias field correction, and removal of nonbrain tissue. Finally, after reviewing different brain MRI segmentation methods, we discuss the validation problem in brain MRI segmentation. PMID:25945121

  7. Diffusion-weighted and dynamic contrast-enhanced imaging as markers of clinical behavior in children with optic pathway glioma

    Energy Technology Data Exchange (ETDEWEB)

    Jost, Sarah C. [Swedish Neuroscience Institute, Department of Neurosurgery, Seattle, WA (United States); Ackerman, Joseph W. [Washington University School of Medicine, Department of Radiology, 660 South Euclid Ave., Box 8131, St. Louis, MO (United States); Garbow, Joel R. [Washington University School of Medicine, Department of Radiology, 660 South Euclid Ave., Box 8131, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, St. Louis, MO (United States); Manwaring, Linda P. [Washington University School of Medicine, Department of Pediatrics, St. Louis, MO (United States); Washington University School of Medicine, Department of Genetics and Genomic Medicine, St. Louis, MO (United States); Gutmann, David H. [Washington University School of Medicine, Department of Neurology, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, St. Louis, MO (United States); McKinstry, Robert C. [Washington University School of Medicine, Department of Radiology, 660 South Euclid Ave., Box 8131, St. Louis, MO (United States); Washington University School of Medicine, Department of Pediatrics, St. Louis, MO (United States)

    2008-12-15

    Optic pathway gliomas (OPGs) are common pediatric brain tumors that pose significant clinical challenges with regard to predicting which tumors are likely to become symptomatic and require treatment. These tumors can arise sporadically or in the context of the inherited cancer predisposition syndrome neurofibromatosis type 1 (NF1). Few studies have suggested biological or imaging markers that predict the clinical course of this disease. In this cross-sectional study, we hypothesized that the clinical behavior of OPGs in children can be differentiated by diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI. A total of 27 children with OPG were studied using DW and DCE MRI protocols. Diffusivity and permeability were calculated and correlated with the clinical behavior the OPG. Mean diffusivity values of 1.39 {mu}m{sup 2}/ms and mean permeability values of 2.10 ml/min per 100 cm{sup 3} of tissue were measured. Clinically aggressive OPGs had significantly higher mean permeability values (P = 0.05) than clinically stable tumors. In addition, there was a strong correlation between clinical aggressiveness and the absence of NF1 (P < 0.01). These results suggest that DCE MRI might be a useful biomarker for clinically aggressive OPG, which should be confirmed in larger prospective longitudinal studies. (orig.)

  8. Prematurity and brain perfusion: Arterial spin labeling MRI

    Directory of Open Access Journals (Sweden)

    Domenico Tortora

    2017-01-01

    Conclusions: ASL MRI demonstrated differences in brain perfusion of the basal ganglia between PN and TN. In PN, a positive correlation between CBF and neuromotor outcome was demonstrated in this area.

  9. Ultra High Field MRI-Guided Deep Brain Stimulation.

    Science.gov (United States)

    Forstmann, Birte U; Isaacs, Bethany R; Temel, Yasin

    2017-10-01

    Deep brain stimulation (DBS) is a neurosurgical treatment for neurological disorders often planned with 1.5-T or 3-T MRI. The clinical efficacy of DBS can be improved using ultrahigh-field (UHF) MRI for planning by increasing the level of precision required for an individualized approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. DTIPrep: Quality Control of Diffusion-Weighted Images

    Directory of Open Access Journals (Sweden)

    Ipek eOguz

    2014-01-01

    Full Text Available In the last decade, diffusion MRI (dMRI studies of the human and animal brain have been used to investigate a multitude of pathologies and drug-related effects in neuroscience research. Study after study identifies white matter (WM degeneration as a crucial biomarker for all these diseases. The tool of choice for studying WM is dMRI. However, dMRI has inherently low signal-to-noise ratio and its acquisition requires a relatively long scan time; in fact, the high loads required occasionally stress scanner hardware past the point of physical failure. As a result, many types of artifacts implicate the quality of diffusion imagery. Using these complex scans containing artifacts without quality control (QC can result in considerable error and bias in the subsequent analysis, negatively affecting the results of research studies using them. However, dMRI QC remains an under-recognized issue in the dMRI community as there are no user-friendly tools commonly available to comprehensively address the issue of dMRI QC. As a result, current dMRI studies often perform a poor job at dMRI QC.Thorough QC of diffusion MRI will reduce measurement noise and improve reproducibility, and sensitivity in neuroimaging studies; this will allow researchers to more fully exploit the power of the dMRI technique and will ultimately advance neuroscience. Therefore, in this manuscript, we present our open-source software, DTIPrep, as a unified, user friendly platform for thorough quality control of dMRI data. These include artifacts caused by eddy-currents, head motion, bed vibration and pulsation, venetian blind artifacts, as well as slice-wise and gradient-wise intensity inconsistencies. This paper summarizes a basic set of features of DTIPrep described earlier and focuses on newly added capabilities related to directional artifacts and bias analysis.

  11. DTIPrep: quality control of diffusion-weighted images.

    Science.gov (United States)

    Oguz, Ipek; Farzinfar, Mahshid; Matsui, Joy; Budin, Francois; Liu, Zhexing; Gerig, Guido; Johnson, Hans J; Styner, Martin

    2014-01-01

    In the last decade, diffusion MRI (dMRI) studies of the human and animal brain have been used to investigate a multitude of pathologies and drug-related effects in neuroscience research. Study after study identifies white matter (WM) degeneration as a crucial biomarker for all these diseases. The tool of choice for studying WM is dMRI. However, dMRI has inherently low signal-to-noise ratio and its acquisition requires a relatively long scan time; in fact, the high loads required occasionally stress scanner hardware past the point of physical failure. As a result, many types of artifacts implicate the quality of diffusion imagery. Using these complex scans containing artifacts without quality control (QC) can result in considerable error and bias in the subsequent analysis, negatively affecting the results of research studies using them. However, dMRI QC remains an under-recognized issue in the dMRI community as there are no user-friendly tools commonly available to comprehensively address the issue of dMRI QC. As a result, current dMRI studies often perform a poor job at dMRI QC. Thorough QC of dMRI will reduce measurement noise and improve reproducibility, and sensitivity in neuroimaging studies; this will allow researchers to more fully exploit the power of the dMRI technique and will ultimately advance neuroscience. Therefore, in this manuscript, we present our open-source software, DTIPrep, as a unified, user friendly platform for thorough QC of dMRI data. These include artifacts caused by eddy-currents, head motion, bed vibration and pulsation, venetian blind artifacts, as well as slice-wise and gradient-wise intensity inconsistencies. This paper summarizes a basic set of features of DTIPrep described earlier and focuses on newly added capabilities related to directional artifacts and bias analysis.

  12. Diffusion-weighted MR imaging in transient ischaemic attacks

    Energy Technology Data Exchange (ETDEWEB)

    Lamy, C.; Calvet, D.; Domigo, V.; Mas, J. [de l' Hopital Sainte-Anne, Service de Neurologie, Paris Cedex 14 (France); Oppenheim, C.; Naggara, O.; Meder, J.F. [Hoepital Sainte-Anne, Departement d' Imagere Morphologique et Fonchonnille, Paris (France)

    2006-05-15

    The purpose of this study was to determine frequency and the characteristics of diffusion-weighted imaging (DWI) abnormalities in patients with transient ischaemic attack (TIA). We analysed data of 98 consecutive patients (mean age: 60.6{+-}15.4 years, 56 men) admitted between January 2003 and April 2004 for TIA. Age, gender, symptom type and duration, delay from onset to magnetic resonance imaging (MRI), probable or possible TIA and cause of TIA were compared in patients with (DWI+) and without (DWI-) lesions on DWI. Volume and apparent diffusion coefficient (ADC) values of DWI lesions were computed. DWI revealed ischaemic lesions in 34 patients (34.7%). Lesions were small (mean volume: 1.9 cm{sup 3}{+-}3.3), and ADC was moderately decreased (mean ADC ratio: 79.5%). The diagnosis of TIA was considered as probable in all DWI+ patients. A multiple logistic regression model demonstrated that TIA duration greater than or equal to 60 min (OR, 7.6; 95% CI, 2.3-25.7), aphasia (OR, 9.2; 95% CI, 2.7-31.4) and motor deficit (OR, 5.1; 95% CI, 1.5-17.8) were independent predictors of DWI lesions. Prolonged TIA duration, aphasia and motor deficits are associated with DWI lesions. More than half of TIA patients with symptoms lasting more than 60 min have DWI lesions. (orig.)

  13. Diffusion-weighted MR imaging in transient ischaemic attacks

    International Nuclear Information System (INIS)

    Lamy, C.; Calvet, D.; Domigo, V.; Mas, J.; Oppenheim, C.; Naggara, O.; Meder, J.F.

    2006-01-01

    The purpose of this study was to determine frequency and the characteristics of diffusion-weighted imaging (DWI) abnormalities in patients with transient ischaemic attack (TIA). We analysed data of 98 consecutive patients (mean age: 60.6±15.4 years, 56 men) admitted between January 2003 and April 2004 for TIA. Age, gender, symptom type and duration, delay from onset to magnetic resonance imaging (MRI), probable or possible TIA and cause of TIA were compared in patients with (DWI+) and without (DWI-) lesions on DWI. Volume and apparent diffusion coefficient (ADC) values of DWI lesions were computed. DWI revealed ischaemic lesions in 34 patients (34.7%). Lesions were small (mean volume: 1.9 cm 3 ±3.3), and ADC was moderately decreased (mean ADC ratio: 79.5%). The diagnosis of TIA was considered as probable in all DWI+ patients. A multiple logistic regression model demonstrated that TIA duration greater than or equal to 60 min (OR, 7.6; 95% CI, 2.3-25.7), aphasia (OR, 9.2; 95% CI, 2.7-31.4) and motor deficit (OR, 5.1; 95% CI, 1.5-17.8) were independent predictors of DWI lesions. Prolonged TIA duration, aphasia and motor deficits are associated with DWI lesions. More than half of TIA patients with symptoms lasting more than 60 min have DWI lesions. (orig.)

  14. Multispectral diffusion-weighted imaging near metal implants.

    Science.gov (United States)

    Koch, Kevin M; Bhave, Sampada; Gaddipati, Ajeet; Hargreaves, Brian A; Gui, Dawei; Peters, Robert; Bedi, Meena; Mannem, Rajeev; Kaushik, S Sivaram

    2018-02-01

    The need for diffusion-weighted-imaging (DWI) near metallic implants is becoming increasingly relevant for a variety of clinical diagnostic applications. Conventional DWI methods are significantly hindered by metal-induced image artifacts. A novel approach relying on multispectral susceptibility artifact reduction techniques is presented to address this unmet need. DWI near metal implants is achieved through a combination of several advanced MRI acquisition technologies. Previously described approaches to Carr-Purcell-Meiboom-Gill spin-echo train DWI sequences using the periodically rotated overlapping parallel lines with enhanced reconstruction are combined with multispectral-imaging metal artifact reduction principles to provide DWI with substantially reduced artifact levels. The presented methods are applied to limited sets of slices over areas of sarcoma risk near six implanted devices. Using the presented methods, DWI assessment without bulk image distortions is demonstrated in the immediate vicinity of metallic interfaces. In one subject, the apparent diffusion coefficient was reduced in a region of suspected sarcoma directly adjacent to fixation hardware. An initial demonstration of minimal-artifact multispectral DWI in the near vicinity of metallic hardware is described and successfully demonstrated on clinical subjects. Magn Reson Med 79:987-993, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  15. Enhanced diffusion weighting generated by selective adiabatic pulse trains

    Science.gov (United States)

    Sun, Ziqi; Bartha, Robert

    2007-09-01

    A theoretical description and experimental validation of the enhanced diffusion weighting generated by selective adiabatic full passage (AFP) pulse trains is provided. Six phantoms (Ph-1-Ph-6) were studied on a 4 T Varian/Siemens whole body MRI system. Phantoms consisted of 2.8 cm diameter plastic tubes containing a mixture of 10 μm ORGASOL polymer beads and 2 mM Gd-DTPA dissolved in 5% agar (Ph-1) or nickel(II) ammonium sulphate hexahydrate doped (56.3-0.8 mM) water solutions (Ph-2-Ph-6). A customized localization by adiabatic selective refocusing (LASER) sequence containing slice selective AFP pulse trains and pulsed diffusion gradients applied in the phase encoding direction was used to measure 1H 2O diffusion. The b-value associated with the LASER sequence was derived using the Bloch-Torrey equation. The apparent diffusion coefficients measured by LASER were comparable to those measured by a conventional pulsed gradient spin-echo (PGSE) sequence for all phantoms. Image signal intensity increased in Ph-1 and decreased in Ph-2-Ph-6 as AFP pulse train length increased while maintaining a constant echo-time. These experimental results suggest that such AFP pulse trains can enhance contrast between regions containing microscopic magnetic susceptibility variations and homogeneous regions in which dynamic dephasing relaxation mechanisms are dominant.

  16. A comparative quantitative analysis of magnetic susceptibility artifacts in echo planar and PROPELLER diffusion-weighted images

    Science.gov (United States)

    Cho, Jae-Hwan; Lee, Hae-Kag; Yang, Han-Joon; Lee, Gui-Won; Park, Yong-Soon; Chung, Woon-Kwan

    2013-01-01

    In this study, the authors investigated whether periodically-rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted imaging (DWI) can remove magnetic susceptibility artifacts and compared apparent diffusion coefficient (ADC) values for PROPELLER DWI and the common echo planar (EP) DWI. Twenty patients that underwent brain MRI with a metal dental implant were selected. A 3.0T MR scanner was then used to obtain EP DWI, PROPELLER DWI, and corresponding apparent diffusion coefficient (ADC) maps for a b-value of 0 and 1,000 s/mm2. The frequencies of magnetic susceptibility artifacts in four parts of the brain (bilateral temporal lobes, pons, and orbit) were selected. In the ADC maps, we measured the ADC values of both sides of the temporal lobe and the pons. According to the study results, the frequency of magnetic susceptibility artifacts in PROPELLER DW images was lower than it was in EP DW images. In ADC maps, the ADC values of the bilateral temporal lobes and the pons were all higher in PROPELLER ADC maps than in EP ADC maps. Our findings show that when a high-field MRI machine is used, magnetic susceptibility artifacts can distort anatomical structures and produce high-intensity signals. Furthermore, our findings suggest that in many cases, PROPELLER DWI would be helpful in terms of achieving a correct diagnosis.

  17. Diagnostic value of diffusion weighted MRI and ADC in differential ...

    African Journals Online (AJOL)

    –49. 13. Namimoto T, Yamashita Y, Mitsuzaki K, Nakayama. Y, Tang Y, Takahashi M. Measurement of the apparent diffusion coefficient in diffuse renal disease by diffu- sionweighted echo-planar MR imaging. J Magn Reson Im- aging 1999 ...

  18. Diagnostic value of diffusion weighted MRI and ADC in differential ...

    African Journals Online (AJOL)

    After DWI examination, an ADC map was created and ADC values were measured for 72 liver masses and normal liver tissue (control group). The average ADC values of normal liver tissue and focal liver lesions, the “cut-off ” ADC values, and the diagnostic sensitivity and specificity of the ADC map in diagnosing ...

  19. Anisotropic Diffusion based Brain MRI Segmentation and 3D Reconstruction

    OpenAIRE

    M. Arfan Jaffar; Sultan Zia; Ghaznafar Latif; AnwarM. Mirza; Irfan Mehmood; Naveed Ejaz; Sung Wook Baik

    2012-01-01

    In medical field visualization of the organs is very imperative for accurate diagnosis and treatment of any disease. Brain tumor diagnosis and surgery also required impressive 3D visualization of the brain to the radiologist. Detection and 3D reconstruction of brain tumors from MRI is a computationally time consuming and error-prone task. Proposed system detects and presents a 3D visualization model of the brain and tumor inside which greatly helps the radiologist to effectively diagnose and ...

  20. MRI Segmentation of the Human Brain: Challenges, Methods, and Applications

    Directory of Open Access Journals (Sweden)

    Ivana Despotović

    2015-01-01

    Full Text Available Image segmentation is one of the most important tasks in medical image analysis and is often the first and the most critical step in many clinical applications. In brain MRI analysis, image segmentation is commonly used for measuring and visualizing the brain’s anatomical structures, for analyzing brain changes, for delineating pathological regions, and for surgical planning and image-guided interventions. In the last few decades, various segmentation techniques of different accuracy and degree of complexity have been developed and reported in the literature. In this paper we review the most popular methods commonly used for brain MRI segmentation. We highlight differences between them and discuss their capabilities, advantages, and limitations. To address the complexity and challenges of the brain MRI segmentation problem, we first introduce the basic concepts of image segmentation. Then, we explain different MRI preprocessing steps including image registration, bias field correction, and removal of nonbrain tissue. Finally, after reviewing different brain MRI segmentation methods, we discuss the validation problem in brain MRI segmentation.

  1. Sequential MRI in a case of Creutzfeldt-Jakob disease

    Energy Technology Data Exchange (ETDEWEB)

    Tribl, G.G.; Zeitlhofer, J.; Asenbaum, S.; Wessely, P. [Universitaetsklinik fuer Neurologie, Allgemeines Krankenhaus Wien (Austria); Strasser, G.; Prayer, D. [Universitaetsklinik fuer Radiodiagnostik, Allgemeines Krankenhaus Wien (Austria); Jarius, C. [Klinisches Institut fuer Neurologie, Universitaet Wien (Austria)

    2002-03-01

    A 48-year-old man suddenly developed clinically and electroencephalographically nonspecific dementia. On MRI sequences, only diffusion-weighted images (DWI) of the cortex were unequivocally pathological. Obvious atrophy and basal ganglia signal changes appeared only 9 months after the onset. Brain biopsy confirmed Creutzfeldt-Jakob disease (CJD). In rapidly progressive dementia, we recommend DWI for early diagnosis of CJD. (orig.)

  2. Sequential MRI in a case of Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Tribl, G.G.; Zeitlhofer, J.; Asenbaum, S.; Wessely, P.; Strasser, G.; Prayer, D.; Jarius, C.

    2002-01-01

    A 48-year-old man suddenly developed clinically and electroencephalographically nonspecific dementia. On MRI sequences, only diffusion-weighted images (DWI) of the cortex were unequivocally pathological. Obvious atrophy and basal ganglia signal changes appeared only 9 months after the onset. Brain biopsy confirmed Creutzfeldt-Jakob disease (CJD). In rapidly progressive dementia, we recommend DWI for early diagnosis of CJD. (orig.)

  3. Cognition and brain abnormalities on MRI in pituitary patients

    International Nuclear Information System (INIS)

    Brummelman, Pauline; Sattler, Margriet G.A.; Meiners, Linda C.; Berg, Gerrit van den; Klauw, Melanie M. van der; Elderson, Martin F.; Dullaart, Robin P.F.; Koerts, Janneke; Werumeus Buning, Jorien; Tucha, Oliver; Wolffenbuttel, Bruce H.R.; Bergh, Alfons C.M. van den; Beek, André P. van

    2015-01-01

    Highlights: • Cognitive impairments are frequently observed in treated NFA patients. • NFA patients with cognitive impairments do not show brain abnormalities on MRI more frequently than patients without cognitive impairments. • The absence of brain abnormalities on brain MRI does not exclude impairments of cognition. - Abstract: Purpose: The extent to which cognitive dysfunction is related to specific brain abnormalities in patients treated for pituitary macroadenoma is unclear. Therefore, we compared brain abnormalities seen on Magnetic Resonance Imaging (MRI) in patients treated for nonfunctioning pituitary macroadenoma (NFA) with or without impairments in cognitive functioning. Methods: In this cross-sectional design, a cohort of 43 NFA patients was studied at the University Medical Center Groningen. White matter lesions (WMLs), cerebral atrophy, (silent) brain infarcts and abnormalities of the temporal lobes and hippocampi were assessed on pre-treatment and post-treatment MRI scans. Post-treatment cognitive examinations were performed using a verbal memory and executive functioning test. We compared our patient cohort with large reference populations representative of the Dutch population. Results: One or more impairments on both cognitive tests were frequently observed in treated NFA patients. No treatment effects were found with regard to the comparison between patients with and without impairments in executive functioning. Interestingly, in patients with one or more impairments on verbal memory function, treatment with radiotherapy had been given more frequently (74% in the impaired group versus 40% in the unimpaired group, P = 0.025). Patients with or without any brain abnormality on MRI did not differ in verbal memory or executive functioning. Conclusions: Brain abnormalities on MRI are not observed more frequently in treated NFA patients with impairments compared to NFA patients without impairments in verbal memory or executive functioning

  4. Cognition and brain abnormalities on MRI in pituitary patients

    Energy Technology Data Exchange (ETDEWEB)

    Brummelman, Pauline [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Sattler, Margriet G.A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen (Netherlands); Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Meiners, Linda C. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Berg, Gerrit van den; Klauw, Melanie M. van der [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Elderson, Martin F. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); LifeLines Cohort Study and Biobank, University of Groningen, University Medical Center Groningen (Netherlands); Dullaart, Robin P.F. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Koerts, Janneke [Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen (Netherlands); Werumeus Buning, Jorien, E-mail: j.werumeus.buning@umcg.nl [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Tucha, Oliver [Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen (Netherlands); Wolffenbuttel, Bruce H.R. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); LifeLines Cohort Study and Biobank, University of Groningen, University Medical Center Groningen (Netherlands); Bergh, Alfons C.M. van den [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen (Netherlands); Beek, André P. van, E-mail: a.p.van.beek@umcg.nl [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands)

    2015-02-15

    Highlights: • Cognitive impairments are frequently observed in treated NFA patients. • NFA patients with cognitive impairments do not show brain abnormalities on MRI more frequently than patients without cognitive impairments. • The absence of brain abnormalities on brain MRI does not exclude impairments of cognition. - Abstract: Purpose: The extent to which cognitive dysfunction is related to specific brain abnormalities in patients treated for pituitary macroadenoma is unclear. Therefore, we compared brain abnormalities seen on Magnetic Resonance Imaging (MRI) in patients treated for nonfunctioning pituitary macroadenoma (NFA) with or without impairments in cognitive functioning. Methods: In this cross-sectional design, a cohort of 43 NFA patients was studied at the University Medical Center Groningen. White matter lesions (WMLs), cerebral atrophy, (silent) brain infarcts and abnormalities of the temporal lobes and hippocampi were assessed on pre-treatment and post-treatment MRI scans. Post-treatment cognitive examinations were performed using a verbal memory and executive functioning test. We compared our patient cohort with large reference populations representative of the Dutch population. Results: One or more impairments on both cognitive tests were frequently observed in treated NFA patients. No treatment effects were found with regard to the comparison between patients with and without impairments in executive functioning. Interestingly, in patients with one or more impairments on verbal memory function, treatment with radiotherapy had been given more frequently (74% in the impaired group versus 40% in the unimpaired group, P = 0.025). Patients with or without any brain abnormality on MRI did not differ in verbal memory or executive functioning. Conclusions: Brain abnormalities on MRI are not observed more frequently in treated NFA patients with impairments compared to NFA patients without impairments in verbal memory or executive functioning

  5. Diffusion weighted imaging in cystic fibrosis disease: beyond morphological imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ciet, Pierluigi [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus Medical Center - Sophia Children' s Hospital, Department of Paediatrics, Respiratory Medicine and Allergology, P.O. Box 2060, Rotterdam, Zuid-Holland (Netherlands); Ca' Foncello - General Hospital, Department of Radiology, Treviso (Italy); Serra, Goffredo; Catalano, Carlo [University of Rome ' ' Sapienza' ' , Department of Radiology, Rome (Italy); Andrinopoulou, Eleni Rosalina [Erasmus Medical Center, Department of Biostatistics, Rotterdam (Netherlands); Bertolo, Silvia; Morana, Giovanni [Ca' Foncello - General Hospital, Department of Radiology, Treviso (Italy); Ros, Mirco [Ca' Foncello Hospital, Department of Pediatrics, Treviso (Italy); Colagrande, Stefano [University of Florence - Azienda Ospedaliero-Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, Florence (Italy); Tiddens, Harm A.W.M. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus Medical Center - Sophia Children' s Hospital, Department of Paediatrics, Respiratory Medicine and Allergology, P.O. Box 2060, Rotterdam, Zuid-Holland (Netherlands)

    2016-11-15

    To explore the feasibility of diffusion-weighted imaging (DWI) to assess inflammatory lung changes in patients with Cystic Fibrosis (CF) CF patients referred for their annual check-up had spirometry, chest-CT and MRI on the same day. MRI was performed in a 1.5 T scanner with BLADE and EPI-DWI sequences (b = 0-600 s/mm{sup 2}). End-inspiratory and end-expiratory scans were acquired in multi-row scanners. DWI was scored with an established semi-quantitative scoring system. DWI score was correlated to CT sub-scores for bronchiectasis (CF-CT{sub BE}), mucus (CF-CT{sub mucus}), total score (CF-CT{sub total-score}), FEV{sub 1}, and BMI. T-test was used to assess differences between patients with and without DWI-hotspots. Thirty-three CF patients were enrolled (mean 21 years, range 6-51, 19 female). 4 % (SD 2.6, range 1.5-12.9) of total CF-CT alterations presented DWI-hotspots. DWI-hotspots coincided with mucus plugging (60 %), consolidation (30 %) and bronchiectasis (10 %). DWI{sub total-score} correlated (all p < 0.0001) positively to CF-CT{sub BE} (r = 0.757), CF-CT{sub mucus} (r = 0.759) and CF-CT{sub total-score} (r = 0.79); and negatively to FEV{sub 1} (r = 0.688). FEV{sub 1} was significantly higher (p < 0.0001) in patients without DWI-hotspots. DWI-hotspots strongly correlated with radiological and clinical parameters of lung disease severity. Future validation studies are needed to establish the exact nature of DWI-hotspots in CF patients. (orig.)

  6. MRI study on reversible and irreversible electroporation induced blood brain barrier disruption.

    Directory of Open Access Journals (Sweden)

    Mohammad Hjouj

    Full Text Available Electroporation, is known to induce cell membrane permeabilization in the reversible (RE mode and cell death in the irreversible (IRE mode. Using an experimental system designed to produce a continuum of IRE followed by RE around a single electrode we used MRI to study the effects of electroporation on the brain. Fifty-four rats were injected with Gd-DOTA and treated with a G25 electrode implanted 5.5 mm deep into the striata. MRI was acquired immediately after treatment, 10 min, 20 min, 30 min, and up to three weeks following the treatment using: T1W, T2W, Gradient echo (GE, serial SPGR (DCE-MRI with flip angles ranging over 5-25°, and diffusion-weighted MRI (DWMRI. Blood brain barrier (BBB disruption was depicted as clear enhancement on T1W images. The average signal intensity in the regions of T1-enhancement, representing BBB disruption, increased from 1887±83 (arbitrary units immediately post treatment to 2246±94 20 min post treatment, then reached a plateau towards the 30 min scan where it reached 2289±87. DWMRI at 30 min showed no significant effects. Early treatment effects and late irreversible damage were clearly depicted on T2W. The enhancing volume on T2W has increased by an average of 2.27±0.27 in the first 24-48 hours post treatment, suggesting an inflammatory tissue response. The permanent tissue damage, depicted as an enhancing region on T2W, 3 weeks post treatment, decreased to an average of 50±10% of the T2W enhancing volumes on the day of the treatment which was 33±5% of the BBB disruption volume. Permanent tissue damage was significantly smaller than the volume of BBB disruption, suggesting, that BBB disruption is associated with RE while tissue damage with IRE. These results demonstrate the feasibility of applying reversible and irreversible electroporation for transient BBB disruption or permanent damage, respectively, and applying MRI for planning/monitoring disruption volume/shape by optimizing electrode positions

  7. Diffusion MRI processing for multi-compartment characterization of brain pathology

    International Nuclear Information System (INIS)

    Hedouin, Renaud

    2017-01-01

    Diffusion weighted imaging (DWI) is a specific type of MRI acquisition based on the direction of diffusion of the brain water molecules. It allows, through several acquisitions, to model the brain microstructure, as white matter, which is significantly smaller than the voxel-resolution. To acquire a large number of images in a clinical setting, very-fast acquisition techniques are required as single-shot imaging. However these acquisitions suffer locally large distortions. We propose a block-matching registration method based on the acquisition of images with opposite phase-encoding directions (PED). This technique specially designed for Echo-Planar Images (EPI) robustly correct images and provides a deformation field. This field is applicable to an entire DWI series from only one reversed EPI allowing distortion correction with a minimal acquisition time cost. This registration algorithm has been validated both on phantom and on in vivo data and is available in our source medical image processing toolbox Anima. From these diffusion images, we are able to construct multi-compartments models (MCM) which can represent complex brain microstructure. Doing registration, averaging and atlas creation on these MCM images is required to perform studies and statistic analyses. We propose a general method to interpolate MCM as a simplification problem based on spectral clustering. This technique, which is adaptable for any MCM, has been validated on both synthetic and real data. Then, from a registered dataset, we performed a patient to population analysis at a voxel-level computing statistics on MCM parameters. Specifically designed tractography can also be used to make analysis, following tracks, based on individual anisotropic compartments. All these tools are designed and used on real data and contribute to the search of bio-markers for brain diseases such as multiple sclerosis. (author)

  8. Whole-body diffusion-weighted imaging for staging malignant lymphoma in children

    Energy Technology Data Exchange (ETDEWEB)

    Kwee, Thomas C.; Takahara, Taro; Vermoolen, Malou A.; Mali, Willem P.; Nievelstein, Rutger A.J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Bierings, Marc B. [University Medical Center Utrecht, Department of Pediatric Hematology, Utrecht (Netherlands)

    2010-10-15

    CT is currently the mainstay in staging malignant lymphoma in children, but the risk of second neoplasms due to ionizing radiation associated with CT is not negligible. Whole-body MRI techniques and whole-body diffusion-weighted imaging (DWI) in particular, may be a good radiation-free alternative to CT. DWI is characterized by high sensitivity for the detection of lesions and allows quantitative assessment of diffusion that may aid in the evaluation of malignant lymphomas. This article will review whole-body MRI techniques for staging malignant lymphoma with emphasis on whole-body DWI. Furthermore, future considerations and challenges in whole-body DWI will be discussed. (orig.)

  9. Diffusion weighted imaging reflects variable cellularity and stromal density present in breast fibroadenomas

    Science.gov (United States)

    Parsian, Sana; Giannakopoulos, Nadia V.; Rahbar, Habib; Rendi, Mara H.; Chai, Xiaoyu

    2016-01-01

    OBJECTIVE To determine the underlying histopathologic features influencing apparent diffusion coefficient (ADC) values of breast fibroadenomas. MATERIALS AND METHODS Biopsy proven fibroadenomas (n=26) initially identified as suspicious on breast MRI were retrospectively evaluated. Histopathological assessments of lesion cellularity and stromal type were compared with ADC measures on diffusion-weighted MRI. RESULTS Presence of epithelial hyperplasia (increased cellularity) and dense collagenous stroma were both significantly associated with lower lesion ADC values (p=0.02 and 0.004, respectively. CONCLUSION Variations in epithelial cellularity and stromal type influence breast lesion ADC values and may explain the wide range of ADC measures observed in benign fibroadenomas. PMID:27379441

  10. Human cerebral cortices: signal variation on diffusion-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Asao, Chiaki [Kumamoto Regional Medical Center, Department of Radiology, Kumamoto (Japan); National Hospital Organization Kumamoto Medical Center, Department of Radiology, Kumamoto (Japan); Hirai, Toshinori; Yamashita, Yasuyuki [Kumamoto University Graduate School of Medical Sciences, Department of Diagnostic Radiology, Kumamoto (Japan); Yoshimatsu, Shunji [National Hospital Organization Kumamoto Medical Center, Department of Radiology, Kumamoto (Japan); Matsukawa, Tetsuya; Imuta, Masanori [Kumamoto Regional Medical Center, Department of Radiology, Kumamoto (Japan); Sagara, Katsuro [Kumamoto Regional Medical Center, Department of Internal Medicine, Kumamoto (Japan)

    2008-03-15

    We have often encountered high signal intensity (SI) of the cingulate gyrus and insula during diffusion-weighted magnetic resonance imaging (DW-MRI) on neurologically healthy adults. To date, cortical signal heterogeneity on DW images has not been investigated systematically. The purpose of our study was to determine whether there is regional signal variation in the brain cortices of neurologically healthy adults on DW-MR images. The SI of the cerebral cortices on DW-MR images at 1.5 T was evaluated in 50 neurologically healthy subjects (34 men, 16 women; age range 33-84 years; mean age 57.6 years). The cortical SI in the cingulate gyrus, insula, and temporal, occipital, and parietal lobes was graded relative to the SI of the frontal lobe. Contrast-to-noise ratios (CNRs) on DW-MR images were compared for each cortical area. Diffusion changes were analyzed by visually assessment of the differences in appearance among the cortices on apparent diffusion coefficient (ADC) maps. Increased SI was frequently seen in the cingulate gyrus and insula regardless of patient age. There were no significant gender- or laterality-related differences. The CNR was significantly higher in the cingulate gyrus and insula than in the other cortices (p <.01), and significant differences existed among the cortical regions (p <.001). There were no apparent ADC differences among the cortices on ADC maps. Regional signal variation of the brain cortices was observed on DW-MR images of healthy subjects, and the cingulate gyrus and insula frequently manifested high SI. These findings may help in the recognition of cortical signal abnormalities as visualized on DW-MR images. (orig.)

  11. Human cerebral cortices: signal variation on diffusion-weighted MR imaging

    International Nuclear Information System (INIS)

    Asao, Chiaki; Hirai, Toshinori; Yamashita, Yasuyuki; Yoshimatsu, Shunji; Matsukawa, Tetsuya; Imuta, Masanori; Sagara, Katsuro

    2008-01-01

    We have often encountered high signal intensity (SI) of the cingulate gyrus and insula during diffusion-weighted magnetic resonance imaging (DW-MRI) on neurologically healthy adults. To date, cortical signal heterogeneity on DW images has not been investigated systematically. The purpose of our study was to determine whether there is regional signal variation in the brain cortices of neurologically healthy adults on DW-MR images. The SI of the cerebral cortices on DW-MR images at 1.5 T was evaluated in 50 neurologically healthy subjects (34 men, 16 women; age range 33-84 years; mean age 57.6 years). The cortical SI in the cingulate gyrus, insula, and temporal, occipital, and parietal lobes was graded relative to the SI of the frontal lobe. Contrast-to-noise ratios (CNRs) on DW-MR images were compared for each cortical area. Diffusion changes were analyzed by visually assessment of the differences in appearance among the cortices on apparent diffusion coefficient (ADC) maps. Increased SI was frequently seen in the cingulate gyrus and insula regardless of patient age. There were no significant gender- or laterality-related differences. The CNR was significantly higher in the cingulate gyrus and insula than in the other cortices (p <.01), and significant differences existed among the cortical regions (p <.001). There were no apparent ADC differences among the cortices on ADC maps. Regional signal variation of the brain cortices was observed on DW-MR images of healthy subjects, and the cingulate gyrus and insula frequently manifested high SI. These findings may help in the recognition of cortical signal abnormalities as visualized on DW-MR images. (orig.)

  12. Image processing techniques for quantification and assessment of brain MRI

    NARCIS (Netherlands)

    Kuijf, H.J.

    2013-01-01

    Magnetic resonance imaging (MRI) is a widely used technique to acquire digital images of the human brain. A variety of acquisition protocols is available to generate images in vivo and noninvasively, giving great opportunities to study the anatomy and physiology of the human brain. In my thesis,

  13. Transient global amnesia: increased signal intensity in the right hippocampus on diffusion-weighted magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, M.; Sakamoto, S.; Ishii, K. [Division of Neuroimaging Research, Hyogo Institute for Aging Brain and Cognitive Disorders (Japan); Imamura, T.; Kazui, H.; Mori, E. [Division of Clinical Neurosciences, Hyogo Institute for Aging Brain and Cognitive Disorders, Hyogo (Japan)

    2002-03-01

    We report on a patient with pure transient global amnesia (TGA) whose magnetic resonance imaging (MRI) demonstrated a small region of increased signal intensity in the right hippocampus on diffusion-weighted imaging (DWI). DWI was sensitive and useful for evaluating the early stage of TGA and might help to explain the pathophysiology of TGA. (orig.)

  14. Transient global amnesia: increased signal intensity in the right hippocampus on diffusion-weighted magnetic resonance imaging

    International Nuclear Information System (INIS)

    Matsui, M.; Sakamoto, S.; Ishii, K.; Imamura, T.; Kazui, H.; Mori, E.

    2002-01-01

    We report on a patient with pure transient global amnesia (TGA) whose magnetic resonance imaging (MRI) demonstrated a small region of increased signal intensity in the right hippocampus on diffusion-weighted imaging (DWI). DWI was sensitive and useful for evaluating the early stage of TGA and might help to explain the pathophysiology of TGA. (orig.)

  15. DIAGNOSTIC ABILITY OF MRI IN CHARACTERISATION OF SUPRATENTORIAL BRAIN TUMOURS

    Directory of Open Access Journals (Sweden)

    Indira Sri Sailaja Rednam

    2017-04-01

    Full Text Available BACKGROUND Brain tumours arise from the normal constituents of brain and its coverings; 80% of all the intracranial tumours are supratentorial. Imaging plays a crucial function in the management of patients with brain tumours. Magnetic Resonance Imaging (MRI has earned recognition as the optimal screening technique for the detection of most intracranial tumours. MRI using conventional Spin-Echo sequences like axial T1, T2 and Fluid-Attenuated Inversion Recovery (FLAIR, coronal T2, sagittal T1, post contrast SE T1 axial, sagittal and coronal sequences were taken which provides inherently illustrious contrast resolution between structural abnormalities and adjacent brain parenchyma and has proved to be more sensitive in identification of focal lesions of the brain. MATERIALS AND METHODS The present study was conducted in 50 patients who all were clinically suspected of supratentorial brain tumour cases and underwent MRI in the Department of Radiodiagnosis, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, during the period of 18 months from July 2015 to December 2016. RESULTS The MRI features of 50 supratentorial tumours were reviewed, out of which 72% were found to be extra-axial tumours and 28% intra-axial tumours. About 48% were found to be glial tumours and 52% were found to be non-glial tumours. CONCLUSION MRI proves to be a valuable modality of imaging in evaluating the characteristics, distribution, location and assessing the extent of various intra- and extra-axial tumours in the supratentorial region.

  16. Brain activation studies with PET and functional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yonekura, Yoshiharu [Fukui Medical Univ., Matsuoka (Japan). Biomedical Imaging Research Center; Sadato, Norihiro [Okazaki National Research Inst., Aichi (Japan). National Inst. for Physiological Sciences

    2002-01-01

    Application of PET and functional MRI in brain activation studies is reviewed. 3D-PET images obtained repeatedly after intravenous injection of about 370 MBq of H{sub 2}{sup 15}O can detect a faint blood flow change in the brain. Functional MRI can also detect the blood flow change in the brain due to blood oxygen level-dependent effect. Echo-planar imaging is popular in MRI with 1.5 or 3 T. Images are analyzed by statistical parametric mapping with correction of cerebral regions, anatomical normalization and statistics. PET data give the blood flow change by the H{sub 2}{sup 15}O incorporation into the brain and MRI data, by the scarce tissue oxygen consumption despite the change. Actual images during the cognition task-performance and of frequent artifacts are given. PET is suitable for studies of brain functions like sensibility and emotion and functional MRI, like cortex functions and clinical practices in identification of functional regions prior to surgery and evaluation of functional recovery of damaged brain. (K.H.)

  17. Human brain functional MRI and DTI visualization with virtual reality.

    Science.gov (United States)

    Chen, Bin; Moreland, John; Zhang, Jingyu

    2011-12-01

    Magnetic resonance diffusion tensor imaging (DTI) and functional MRI (fMRI) are two active research areas in neuroimaging. DTI is sensitive to the anisotropic diffusion of water exerted by its macromolecular environment and has been shown useful in characterizing structures of ordered tissues such as the brain white matter, myocardium, and cartilage. The diffusion tensor provides two new types of information of water diffusion: the magnitude and the spatial orientation of water diffusivity inside the tissue. This information has been used for white matter fiber tracking to review physical neuronal pathways inside the brain. Functional MRI measures brain activations using the hemodynamic response. The statistically derived activation map corresponds to human brain functional activities caused by neuronal activities. The combination of these two methods provides a new way to understand human brain from the anatomical neuronal fiber connectivity to functional activities between different brain regions. In this study, virtual reality (VR) based MR DTI and fMRI visualization with high resolution anatomical image segmentation and registration, ROI definition and neuronal white matter fiber tractography visualization and fMRI activation map integration is proposed. Rationale and methods for producing and distributing stereoscopic videos are also discussed.

  18. Diffusion-weighted MR imaging in the early diagnosis of periventricular leukomalacia

    International Nuclear Information System (INIS)

    Bozzao, Alessandro; Di Paolo, Ambrogio; Simonetti, Alessandra; Mazzoleni, Clarissa; Fasoli, Fabrizio; Floris, Roberto; Fantozzi, Luigi Maria

    2003-01-01

    Diffusion-weighted imaging (DWI) has been shown to be highly sensitive in detecting acute cerebral infarction, but its use in detecting hypoxic-ischemic encephalopathy (HIE) in neonates is still controversial. Moreover, few reports concern pre-term infants with possible periventricular leukomalacia (PVL). We examined the ability of this technique to detect cerebral changes in the acute phase of PVL. Fifteen MR examinations were performed in 11 pre-term infants (mean age 3.4 days, range 2-6 days). Conventional DWI sequences, apparent diffusion coefficient (ADC) maps, and US obtained in the acute phase were compared. All the neonates underwent US follow-up up to 4 months after delivery; those with suspected PVL also underwent MRI follow-up for up to 2 months. Qualitative and quantitative evaluations were performed to assess the presence of DW changes compatible with PVL. Diffusion-weighted MRI showed signal hyperintensity associated with decreased ADC values in 3 subjects (27%). In these patients conventional MRI sequences were interpreted as normal and US (performed at the same time) as doubtful in 2 and compatible with PVL in 1 subject. The MRI and US follow-up confirmed severe damage in all these patients. In 1 neonate hemorrhages involving the germinative matrix were identified. In 8 neonates MRI was considered normal. In these subjects US follow-up (up to 4 months) confirmed no signs of PVL. Diffusion-weighted imaging may have a higher correlation with later evidence of PVL than does conventional MR imaging and US when performed in the acute phase of the disease. (orig.)

  19. MRI assessment of whole-brain structural changes in aging.

    Science.gov (United States)

    Guo, Hui; Siu, William; D'Arcy, Ryan Cn; Black, Sandra E; Grajauskas, Lukas A; Singh, Sonia; Zhang, Yunting; Rockwood, Kenneth; Song, Xiaowei

    2017-01-01

    One of the central features of brain aging is the accumulation of multiple age-related structural changes, which occur heterogeneously in individuals and can have immediate or potential clinical consequences. Each of these deficits can coexist and interact, producing both independent and additive impacts on brain health. Many of the changes can be visualized using MRI. To collectively assess whole-brain structural changes, the MRI-based Brain Atrophy and Lesion Index (BALI) has been developed. In this study, we validate this whole-brain health assessment approach using several clinical MRI examinations. Data came from three independent studies: the Alzheimer's Disease Neuroimaging Initiative Phase II (n=950; women =47.9%; age =72.7±7.4 years); the National Alzheimer's Coordinating Center (n=722; women =55.1%; age =72.7±9.9 years); and the Tianjin Medical University General Hospital Research database on older adults (n=170; women =60.0%; age =62.9±9.3 years). The 3.0-Tesla MRI scans were evaluated using the BALI rating scheme on the basis of T1-weighted (T1WI), T2-weighted (T2WI), T2-weighted fluid-attenuated inversion recovery (T2-FLAIR), and T2*-weighted gradient-recalled echo (T2*GRE) images. Atrophy and lesion changes were commonly seen in each MRI test. The BALI scores based on different sequences were highly correlated (Spearman r 2 >0.69; P age ( r 2 >0.29; P 26.48, P aging and dementia-related decline of structural brain health. Inclusion of additional MRI tests increased lesion differentiation. Further research is to integrate MRI tests for a clinical tool to aid the diagnosis and intervention of brain aging.

  20. Diffusion-weighted images of intracranial cyst-like lesions

    Energy Technology Data Exchange (ETDEWEB)

    Bergui, M.; Zhong, J.; Sales, S. [Dept. of Neuroradiology, University of Turin (Italy); Bradac, G.B. [Dept. of Neuroradiology, University of Turin (Italy); Neuroradiologia Universitaria, Ospedale S. G. Battista, Turin (Italy)

    2001-10-01

    Magnetic resonance sequences may be designed to evaluate the diffusion movements of the protons (diffusion-weighted images, DWI). In these images, a bright signal identifies a region where the diffusion along a spatial axis is restricted. The contents of a cystic lesion frequently have the signal intensities of a generic homogeneous hyperproteinic fluid (hypointensity in T1-, hyperintensity in T2-weighted images). DWI may give further information about the microscopic organisation of these fluids: a hyperintense signal indicates the presence of a restricted diffusion, due to some kind of microscopic organisation, at the cellular or macromolecular level. This may provide additional information useful for clinical purposes. We obtained DWI in 24 consecutive patients with intracranial cystic lesions, (19 intra-axial: five abscesses, five gliomas, six metastases, two demyelinating lesions, one neurocysticercosis; five extra-axial: two arachnoid cysts, two epidermoid cysts, one cholesteatoma). We found a strongly hyperintense signal, indicating restricted diffusion, in brain abscesses, epidermoid cysts and cholesteatoma; all the remaining lesions were hypointense or mildly hyperintense. We found these data useful in critical diagnoses, such as in differentiating abscesses from tumours, and in identifying elusive tumours such as epidermoid cysts. (orig.)

  1. Diffusion-weighted imaging of the musculoskeletal system in humans

    International Nuclear Information System (INIS)

    Baur, A.; Reiser, M.F.

    2000-01-01

    This article reviews the principles of diffusion-weighted imaging (DWI) and recent results in DWI of the musculoskeletal system. The potential of DWI in the diagnosis of pathology of the musculoskeletal system is discussed. DWI is a relatively new MR imaging technique that has already been established in neuroradiology, especially in the early detection of brain ischemia. The random motion of water protons on a molecular basis can be measured with DWI. To date DWI of the abdomen and of the musculoskeletal system has only been employed in scientific studies, but first results indicate that it may also be beneficial in these fields. Different diffusion characteristics have been found in normal tissues such as muscle, fat and bone marrow. Also, pathologic entities such as neoplasms, post-therapeutic soft tissue changes and inflammatory processes can be differentiated. Normal muscle shows significantly higher diffusion values than subcutaneous fat and bone marrow, due to a higher mobility of water protons within muscle. Soft tissue tumors exhibit a significantly lower diffusion value compared with post-therapeutic soft tissue changes and inflammatory processes. Necrotic tumor tissue can be distinguished from viable tumor due to significantly higher diffusion of water protons within necrotic tissue. (orig.)

  2. Preoperative CT versus diffusion weighted magnetic resonance imaging of the liver in patients with rectal cancer

    DEFF Research Database (Denmark)

    Achiam, Michael P; Løgager, Vibeke B; Skjoldbye, Bjørn

    2016-01-01

    . The aim of this study was to evaluate the feasibility of diffusion weighted MRI of the liver as part of a combined MR evaluation of patients with rectal cancers and compare it with the standard preoperative evaluation of the liver with CT. Methods. Consecutive patients diagnosed with rectal cancers were...... asked to participate in the study. Preoperative CT and diffusion weighted MR (DWMR) were compared to contrast enhanced laparoscopic ultrasound (CELUS). Results. A total of 35 patients were included, 15 patients in Group-1 having the standard CT evaluation of the liver and 20 patients in Group-2 having....... Furthermore, one patient had non-resectable metastases after DWMR despite being diagnosed with resectable metastases after CT. Another patient was diagnosed with multiple liver metastases during CELUS, despite a negative CT-scan. Discussion. DWMR is feasible for preoperative evaluation of liver metastases...

  3. Imaging Appearance of Human Immunodeficiency Virus Encephalitis on the Diffusion Weighted Images: A Case Report

    International Nuclear Information System (INIS)

    Lim, Hun Cheol; Yu, In Kyu; Oh, Keon Se

    2011-01-01

    Imaging finding of human immunodeficiency virus (HIV) encephalitis contain bilateral, symmetric, patchy, or diffuse increased T2WI signal intensities in the basal ganglia, cerebellum, brainstem, and centrum semiovale. In particular, the centrum semiovale is most commonly involved. Most of the HIV encephalitis cases are accompanied by brain atrophy. No previous study has reported symmetric increased signal intensity at the bilateral centrum semiovale without brain atrophy on diffusion weighted images in HIV encephalitis patients. Here, we report a case of this. We suggest that radiologists should consider the possibility of HIV encephalitis if there are symmetric increases in signal intensity at the bilateral centrum semiovale on diffusion weighted images of patients with a history of HIV infection.

  4. Diffusion-weighted imaging and cognition in the leukoariosis and disability in the elderly study

    DEFF Research Database (Denmark)

    Schmidt, Reinhold; Ropele, Stefan; Ferro, José

    2010-01-01

    BACKGROUND AND PURPOSE: The mechanisms by which leukoariosis impacts on clinical and cognitive functions are not yet fully understood. We hypothesized that ultrastructural abnormalities of the normal-appearing brain tissue (NABT) assessed by diffusion-weighted imaging played a major and independent...... role. METHODS: In addition to a comprehensive clinical, neuropsychologic, and imaging work-up, diffusion-weighted imaging was performed in 340 participants of the multicenter leukoariosis and disability study examining the impact of white matter hyperintensities (WMH) on 65- to 85-year old individuals...... without previous disability. WMH severity was rated according to the Fazekas score. Multivariate regression analysis served to assess correlations of histogram metrics of the apparent diffusion coefficient (ADC) of whole-brain tissue, NABT, and of the mean ADC of WMH with cognitive functions. RESULTS...

  5. Magnetic Resonance Imaging (MRI): Brain (For Parents)

    Science.gov (United States)

    ... cause a problem near a strong magnetic field. Electronic devices aren't permitted in the MRI room. ... child may be given headphones to listen to music or earplugs to block the noise, and will ...

  6. Diffusion-weighted MR imaging of intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Bo Kiung; Na, Dong Gyu; Ryoo, Jae Wook; Byun, Hong Sik; Roh, Hong Gee; Pyeun, Yong Seon [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2001-12-01

    To document the signal characteristics of intracerebral hemorrhage (ICH) at evolving stages on diffusion-weighted images (DWI) by comparison with conventional MR images. In our retrospective study, 38 patients with ICH underwent a set of imaging sequences that included DWI, T1-and T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR). In 33 and 10 patients, respectively, conventional and echo-planar T2 gradient-echo images were also obtained. According to the time interval between symptom onset and initial MRI, five stages were categorized: hyperacute (n=6); acute (n=7); early subacute (n=7); late subacute (n=10); and chronic (n=8). We investigated the signal intensity and apparent diffusion coefficient (ADC) of ICH and compared the signal intensities of hematomas at DWI and on conventional MR images. DWI showed that hematomas were hyperintense at the hyperacute and late subacute stages, and hypointense at the acute, early subacute and chronic stages. Invariably, focal hypointensity was observed within a hyperacute hematoma. At the hyperacute, acute and early subacute stages, hyperintense rims that corresponded with edema surrounding the hematoma were present. The mean ADC ratio was 0.73 at the hyperacute stage, 0.72 at the acute stage, 0.70 at the early subacute stage, 0.72 at the late subacute stage, and 2.56 at the chronic stage. DWI showed that the signal intensity of an ICH may be related to both its ADC value and the magnetic susceptibility effect. In patients with acute stroke, an understanding of the characteristic features of ICH seen at DWI can be helpful in both the characterization of intracranial hemorrhagic lesions and the differentiation of hemorrhage from ischemia.

  7. Quantitative diffusion characteristics of the human brain depend on MRI sequence parameters

    International Nuclear Information System (INIS)

    Wilson, M.; Blumhardt, L.D.; Morgan, P.S.

    2002-01-01

    Quantitative diffusion-weighted MRI has been applied to the study of neurological diseases, including multiple sclerosis, where the molecular self-diffusion coefficient D has been measured in both lesions and normal-appearing white matter. Histograms of D have been used as a novel measure of the ''lesion load'', with potential applications that include the monitoring of efficacy in new treatment trials. However different ways of measuring D may affect its value, making comparison between different centres and research groups impossible. We aimed to assess the effect, if any, of using two different MRI sequences on the value of D. We studied 13 healthy volunteers, using two different quantitative diffusion sequences (including different b max values and gradient applications). Maps of D were analysed using both regions of interest (ROI) in white matter and ''whole brain'' histograms, and compared between the two sequences. In addition, we studied three standardised test liquids (with known values of D) using both sequences. Histograms from the two sequences had different distributions, with a greater spread and higher peak position from the sequence with lower b max . This greater spread of D was also evident in the white matter and test liquid ROI. ''Limits of agreement'' analysis demonstrated that the differences could be clinically relevant, despite significant correlations between the sequences obtained using simple rank methods. We conclude that different quantitative diffusion sequences are unlikely to produce directly comparable values of D, particularly if different b max values are used. In addition, the use of inappropriate statistical tests may give false impressions of close agreement. Standardisation of methods for the measurement of D are required if these techniques are to become useful tools, for example in monitoring changes in the disease burden of multiple sclerosis. (orig.)

  8. Prion diseases of the brain

    International Nuclear Information System (INIS)

    Lutz, Kira; Urbach, Horst

    2015-01-01

    The prion diseases of the brain, especially Creutzfeldt-Jakob disease, are rare fatal neurodegenerative disorders. A definitive CJD diagnosis is currently only possible by a brain biopsy or post mortem autopsy. The diagnosis of Creutzfeldt-Jakob disease is based on clinical signs, pathognomonic EEG, on typical MRI findings and the examination of the cerebrospinal fluid. Using the MRI the diagnosis Creutzfeldt-Jakob disease can be confirmed or excluded with high certainty. The MRI examination should contain diffusion-weighted and FLAIR imaging sequences. This review article provides an overview of the prion diseases of the brain with the corresponding imaging findings.

  9. Probing the brain with molecular fMRI.

    Science.gov (United States)

    Ghosh, Souparno; Harvey, Peter; Simon, Jacob C; Jasanoff, Alan

    2018-04-09

    One of the greatest challenges of modern neuroscience is to incorporate our growing knowledge of molecular and cellular-scale physiology into integrated, organismic-scale models of brain function in behavior and cognition. Molecular-level functional magnetic resonance imaging (molecular fMRI) is a new technology that can help bridge these scales by mapping defined microscopic phenomena over large, optically inaccessible regions of the living brain. In this review, we explain how MRI-detectable imaging probes can be used to sensitize noninvasive imaging to mechanistically significant components of neural processing. We discuss how a combination of innovative probe design, advanced imaging methods, and strategies for brain delivery can make molecular fMRI an increasingly successful approach for spatiotemporally resolved studies of diverse neural phenomena, perhaps eventually in people. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Neonatal brain MRI: how reliable is the radiologist's eye?

    Science.gov (United States)

    Morel, B; Antoni, G; Teglas, J P; Bloch, I; Adamsbaum, C

    2016-02-01

    White matter (WM) analysis in neonatal brain magnetic resonance imaging (MRI) is challenging, as demonstrated by the issue of diffuse excessive high signal intensity (DEHSI). We evaluated the reliability of the radiologist's eye in this context. Three experienced observers graded the WM signal intensity on axial T2-weighted 1.5T images from 60 different premature newborns on 2 occasions 4 weeks apart with a semi-quantitative classification under identical viewing conditions. The intra- and inter-observer correlation coefficients were fair to moderate (Fleiss' kappa between 0.21 and 0.60). This is a serious limitation of which we need to be aware, as it can lead to contradictory conclusions in the challenging context of term-equivalent age brain MRI in premature infants. These results highlight the need for a semiautomatic tool to help in objectively analyzing MRI signal intensity in the neonatal brain.

  11. MRI evaluation and safety in the developing brain.

    Science.gov (United States)

    Tocchio, Shannon; Kline-Fath, Beth; Kanal, Emanuel; Schmithorst, Vincent J; Panigrahy, Ashok

    2015-03-01

    Magnetic resonance imaging (MRI) evaluation of the developing brain has dramatically increased over the last decade. Faster acquisitions and the development of advanced MRI sequences, such as magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), perfusion imaging, functional MR imaging (fMRI), and susceptibility-weighted imaging (SWI), as well as the use of higher magnetic field strengths has made MRI an invaluable tool for detailed evaluation of the developing brain. This article will provide an overview of the use and challenges associated with 1.5-T and 3-T static magnetic fields for evaluation of the developing brain. This review will also summarize the advantages, clinical challenges, and safety concerns specifically related to MRI in the fetus and newborn, including the implications of increased magnetic field strength, logistics related to transporting and monitoring of neonates during scanning, and sedation considerations, and a discussion of current technologies such as MRI conditional neonatal incubators and dedicated small-foot print neonatal intensive care unit (NICU) scanners. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. MRI Evaluation and Safety in the Developing Brain

    Science.gov (United States)

    Tocchio, Shannon; Kline-Fath, Beth; Kanal, Emanuel; Schmithorst, Vincent J.; Panigrahy, Ashok

    2015-01-01

    Magnetic resonance imaging (MRI) evaluation of the developing brain has dramatically increased over the last decade. Faster acquisitions and the development of advanced MRI sequences such as magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), perfusion imaging, functional MR imaging (fMRI), and susceptibility weighted imaging (SWI), as well as the use of higher magnetic field strengths has made MRI an invaluable tool for detailed evaluation of the developing brain. This article will provide an overview of the use and challenges associated with 1.5T and 3T static magnetic fields for evaluation of the developing brain. This review will also summarize the advantages, clinical challenges and safety concerns specifically related to MRI in the fetus and newborn, including the implications of increased magnetic field strength, logistics related to transporting and monitoring of neonates during scanning, sedation considerations and a discussion of current technologies such as MRI-conditional neonatal incubators and dedicated small-foot print neonatal intensive care unit (NICU) scanners. PMID:25743582

  13. Cerebral edema induced in mice by a convulsive dose of soman. Evaluation through diffusion-weighted magnetic resonance imaging and histology

    International Nuclear Information System (INIS)

    Testylier, Guy; Lahrech, Hana; Montigon, Olivier; Foquin, Annie; Delacour, Claire; Bernabe, Denis; Segebarth, Christoph; Dorandeu, Frederic; Carpentier, Pierre

    2007-01-01

    Purpose: In the present study, diffusion-weighted magnetic resonance imaging (DW-MRI) and histology were used to assess cerebral edema and lesions in mice intoxicated by a convulsive dose of soman, an organophosphate compound acting as an irreversible cholinesterase inhibitor. Methods: Three hours and 24 h after the intoxication with soman (172 μg/kg), the mice were anesthetized with an isoflurane/N 2 O mixture and their brain examined with DW-MRI. After the imaging sessions, the mice were sacrificed for histological analysis of their brain. Results: A decrease in the apparent diffusion coefficient (ADC) was detected as soon as 3 h after the intoxication and was found strongly enhanced at 24 h. A correlation was obtained between the ADC change and the severity of the overall brain damage (edema and cellular degeneration): the more severe the damage, the stronger the ADC drop. Anesthesia was shown to interrupt soman-induced seizures and to attenuate edema and cell change in certain sensitive brain areas. Finally, brain water content was assessed using the traditional dry/wet weight method. A significant increase of brain water was observed following the intoxication. Conclusions: The ADC decrease observed in the present study suggests that brain edema in soman poisoning is mainly intracellular and cytotoxic. Since entry of water into Brain was also evidenced, this type of edema is certainly mixed with others (vasogenic, hydrostatic, osmotic). The present study confirms the potential of DW-MRI as a non-invasive tool for monitoring the acute neuropathological consequences (edema and neurodegeneration) of soman-induced seizures

  14. Clinical applications of 7 T MRI in the brain

    Energy Technology Data Exchange (ETDEWEB)

    Kolk, Anja G. van der, E-mail: A.G.vanderKolk@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Hendrikse, Jeroen, E-mail: J.Hendrikse@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Zwanenburg, Jaco J.M., E-mail: J.J.M.Zwanenburg@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Image Sciences Institute, University Medical Center Utrecht (Netherlands); Visser, Fredy, E-mail: F.Visser-2@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Philips Healthcare, Best (Netherlands); Luijten, Peter R., E-mail: P.Luijten@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands)

    2013-05-15

    This review illustrates current applications and possible future directions of 7 Tesla (7 T) Magnetic Resonance Imaging (MRI) in the field of brain MRI, in clinical studies as well as clinical practice. With its higher signal-to-noise (SNR) and contrast-to-noise ratio (CNR) compared to lower field strengths, high resolution, contrast-rich images can be obtained of diverse pathologies, like multiple sclerosis (MS), brain tumours, aging-related changes and cerebrovascular diseases. In some of these diseases, additional pathophysiological information can be gained compared to lower field strengths. Because of clear depiction of small anatomical details, and higher lesion conspicuousness, earlier diagnosis and start of treatment of brain diseases may become possible. Furthermore, additional insight into the pathogenesis of brain diseases obtained with 7 T MRI could be the basis for new treatment developments. However, imaging at high field comes with several limitations, like inhomogeneous transmit fields, a higher specific absorption rate (SAR) and, currently, extensive contraindications for patient scanning. Future studies will be aimed at assessing the advantages and disadvantages of 7 T MRI over lower field strengths in light of clinical applications, specifically the additional diagnostic and prognostic value of 7 T MRI.

  15. Function-structure connectivity in patients with severe brain injury as measured by MRI-DWI and FDG-PET.

    Science.gov (United States)

    Annen, J; Heine, L; Ziegler, E; Frasso, G; Bahri, M; Di Perri, C; Stender, J; Martial, C; Wannez, S; D'ostilio, K; Amico, E; Antonopoulos, G; Bernard, C; Tshibanda, F; Hustinx, R; Laureys, S

    2016-11-01

    A vast body of literature exists showing functional and structural dysfunction within the brains of patients with disorders of consciousness. However, the function (fluorodeoxyglucose FDG-PET metabolism)-structure (MRI-diffusion-weighted images; DWI) relationship and how it is affected in severely brain injured patients remains ill-defined. FDG-PET and MRI-DWI in 25 severely brain injured patients (19 Disorders of Consciousness of which 7 unresponsive wakefulness syndrome, 12 minimally conscious; 6 emergence from minimally conscious state) and 25 healthy control subjects were acquired here. Default mode network (DMN) function-structure connectivity was assessed by fractional anisotropy (FA) and metabolic standardized uptake value (SUV). As expected, a profound decline in regional metabolism and white matter integrity was found in patients as compared with healthy subjects. Furthermore, a function-structure relationship was present in brain-damaged patients between functional metabolism of inferior-parietal, precuneus, and frontal regions and structural integrity of the frontal-inferiorparietal, precuneus-inferiorparietal, thalamo-inferioparietal, and thalamofrontal tracts. When focusing on patients, a stronger relationship between structural integrity of thalamo-inferiorparietal tracts and thalamic metabolism in patients who have emerged from the minimally conscious state as compared with patients with disorders of consciousness was found. The latter finding was in line with the mesocircuit hypothesis for the emergence of consciousness. The findings showed a positive function-structure relationship within most regions of the DMN. Hum Brain Mapp 37:3707-3720, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. MRI of the brain and craniocervical junction in Morquio's disease

    International Nuclear Information System (INIS)

    Hughes, D.G.; Chadderton, R.D.; Cowie, R.A.; Wraith, J.E.; Jenkins, J.P.R.

    1997-01-01

    We reviewed MRI of the brain and cervical spine in 11 patients with Morquio's disease. No abnormality was seen in the brain. The odontoid peg was abnormal in all patients, with varying degrees of cord compression due to an anterior soft tissue mass and indentation by the posterior arch of the atlas. The degree of cord compression was more marked than suggested by the symptoms and signs. We recommend MRI of the cervical spine in children with Morquio's disease before the development of neurological symptoms, to optimise the timing and type of surgical intervention. (orig.). With 5 figs., 2 tabs

  17. Imaging the premature brain: ultrasound or MRI?

    Energy Technology Data Exchange (ETDEWEB)

    Vries, Linda S. de; Benders, Manon J.N.L.; Groenendaal, Floris [UMC Utrecht, Department of Neonatology, Wilhelmina Children' s Hospital, PO Box 85090, Utrecht (Netherlands)

    2013-09-15

    Neuroimaging of preterm infants has become part of routine clinical care, but the question is often raised on how often cranial ultrasound should be done and whether every high risk preterm infant should at least have one MRI during the neonatal period. An increasing number of centres perform an MRI either at discharge or around term equivalent age, and a few centres have access to a magnet in or adjacent to the neonatal intensive care unit and are doing sequential MRIs. In this review, we try to discuss when best to perform these two neuroimaging techniques and the additional information each technique may provide. (orig.)

  18. Mapping human whole-brain structural networks with diffusion MRI.

    Directory of Open Access Journals (Sweden)

    Patric Hagmann

    Full Text Available Understanding the large-scale structural network formed by neurons is a major challenge in system neuroscience. A detailed connectivity map covering the entire brain would therefore be of great value. Based on diffusion MRI, we propose an efficient methodology to generate large, comprehensive and individual white matter connectional datasets of the living or dead, human or animal brain. This non-invasive tool enables us to study the basic and potentially complex network properties of the entire brain. For two human subjects we find that their individual brain networks have an exponential node degree distribution and that their global organization is in the form of a small world.

  19. Diffusion-weighted imaging of the pancreas; Diffusionsbildgebung des Pankreas

    Energy Technology Data Exchange (ETDEWEB)

    Gruenberg, K. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie, E010, Heidelberg (Germany); Grenacher, L.; Klauss, M. [Universitaetsklinikum Heidelberg, Abt. Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

    2011-03-15

    Diffusion-weighted imaging (DWI) has increasingly gained in importance over the last 10 years especially in cancer imaging for differentiation of malignant and benign lesions. Through development of fast magnetic resonance imaging (MRI) sequences DWI is not only applicable in neuroradiology but also in abdominal imaging. As a diagnostic tool of the pancreas DWI enables a differentiation between normal tissue, cancer and chronic pancreatitis. The ADC values (apparent diffusion coefficient, the so-called effective diffusion coefficient) reported in the literature for healthy pancreatic tissue are in the range from 1.49 to 1.9 x 10{sup -3} mm{sup 2}/s, for pancreatic cancer in the range from 1.24 to 1.46 x 10{sup -3} mm{sup 2}/s and for autoimmune pancreatitis an average ADC value of 1.012 x 10{sup -3} mm{sup 2}/s. There are controversial data in the literature concerning the differentiation between chronic pancreatitis and pancreatic cancer. Using DWI-derived IVIM (intravoxel incoherent motion) the parameter f (perfusion fraction) seems to be advantageous but it is important to use several b values. In the literature the mean f value in chronic pancreatitis is around 16%, in pancreatic cancer 8% and in healthy pancreatic tissue around 25%. So far, DWI has not been helpful for differentiating cystic lesions of the pancreas. There are many references with other tumor entities and in animal models which indicate that there is a possible benefit of DWI in monitoring therapy of pancreatic cancer but so far no original work has been published. (orig.) [German] Die Diffusionsbildgebung (''diffusion-weighted imaging'', DWI) gewann in den letzten 10 Jahren insbesondere in der Tumorbildgebung zur Unterscheidung zwischen malignen und benignen Laesionen zunehmend an Bedeutung. Durch Entwicklung schnellerer MR-Sequenzen ist sie nicht nur in der Neuroradiologie, sondern auch in der Abdomenbildgebung einsetzbar. In der Pankreasdiagnostik ermoeglicht sie

  20. Joint brain connectivity estimation from diffusion and functional MRI data

    Science.gov (United States)

    Chu, Shu-Hsien; Lenglet, Christophe; Parhi, Keshab K.

    2015-03-01

    Estimating brain wiring patterns is critical to better understand the brain organization and function. Anatomical brain connectivity models axonal pathways, while the functional brain connectivity characterizes the statistical dependencies and correlation between the activities of various brain regions. The synchronization of brain activity can be inferred through the variation of blood-oxygen-level dependent (BOLD) signal from functional MRI (fMRI) and the neural connections can be estimated using tractography from diffusion MRI (dMRI). Functional connections between brain regions are supported by anatomical connections, and the synchronization of brain activities arises through sharing of information in the form of electro-chemical signals on axon pathways. Jointly modeling fMRI and dMRI data may improve the accuracy in constructing anatomical connectivity as well as functional connectivity. Such an approach may lead to novel multimodal biomarkers potentially able to better capture functional and anatomical connectivity variations. We present a novel brain network model which jointly models the dMRI and fMRI data to improve the anatomical connectivity estimation and extract the anatomical subnetworks associated with specific functional modes by constraining the anatomical connections as structural supports to the functional connections. The key idea is similar to a multi-commodity flow optimization problem that minimizes the cost or maximizes the efficiency for flow configuration and simultaneously fulfills the supply-demand constraint for each commodity. In the proposed network, the nodes represent the grey matter (GM) regions providing brain functionality, and the links represent white matter (WM) fiber bundles connecting those regions and delivering information. The commodities can be thought of as the information corresponding to brain activity patterns as obtained for instance by independent component analysis (ICA) of fMRI data. The concept of information

  1. Brain CT and MRI findings in fat embolism syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Shin; Hayashi, Takaki; Ri, Kyoshichi [Showa Univ., Tokyo (Japan). School of Medicine] [and others

    1996-05-01

    To elucidate brain CT and MRI findings in fat embolism syndrome (FES), we retrospectively analyzed images from 5 patients with FES during the acute and subacute stages. Brain CT examinations demonstrated brain edema in 2 patients and transient spotty low density lesions in 2 patients. Three patients showed no abnormalities. Brain MRI, however, showed brain abnormalities in all patients during the acute stages. These were revealed as spotty high signal intensity lesions on T2WI, and some showed low intensity on T1WI. These spotty lesions were considered to reflect edematous fluid occurring as a result of the unique pathophysiological condition of FES. While the spotty high signal intensity lesions on T2WI were distributed in the cerebrum, cerebellum, brain stem, thalamus, basal ganglia, internal capsule and corpus callosum, cerebral and cerebellar spotty lesions were characteristically located along the boundary zones of the major vascular territories. This characteristic location might be induced by a hypoxic brain condition in FES because the numerous fat globules present in this condition can block entire brain capillaries. This characteristic signal location on T2WI is a useful indicator for differentiating FES from the primary intra-axial brain injury in patients with multifocal trauma. (author)

  2. Brain CT and MRI findings in fat embolism syndrome

    International Nuclear Information System (INIS)

    Suzuki, Shin; Hayashi, Takaki; Ri, Kyoshichi

    1996-01-01

    To elucidate brain CT and MRI findings in fat embolism syndrome (FES), we retrospectively analyzed images from 5 patients with FES during the acute and subacute stages. Brain CT examinations demonstrated brain edema in 2 patients and transient spotty low density lesions in 2 patients. Three patients showed no abnormalities. Brain MRI, however, showed brain abnormalities in all patients during the acute stages. These were revealed as spotty high signal intensity lesions on T2WI, and some showed low intensity on T1WI. These spotty lesions were considered to reflect edematous fluid occurring as a result of the unique pathophysiological condition of FES. While the spotty high signal intensity lesions on T2WI were distributed in the cerebrum, cerebellum, brain stem, thalamus, basal ganglia, internal capsule and corpus callosum, cerebral and cerebellar spotty lesions were characteristically located along the boundary zones of the major vascular territories. This characteristic location might be induced by a hypoxic brain condition in FES because the numerous fat globules present in this condition can block entire brain capillaries. This characteristic signal location on T2WI is a useful indicator for differentiating FES from the primary intra-axial brain injury in patients with multifocal trauma. (author)

  3. The diagnostic value of diffusion-weighted magnetic resonance imaging in soft tissue abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Unal, Ozkan; Koparan, Halil Ibrahim [Yuezuencue Yil University, Department of Radiology, Van (Turkey); Avcu, Serhat, E-mail: serhatavcu@hotmail.com [Yuezuencue Yil University, Department of Radiology, Van (Turkey); Kalender, Ali Murat [Yuezuencue Yil University, Department of Orthopaedics, General Surgery, Van (Turkey); Kisli, Erol [Yuezuencue Yil University, Department of General Surgery, Van (Turkey)

    2011-03-15

    Purpose: To study the diagnostic value of diffusion-weighted imaging (DWI) in soft tissue abscesses. Materials and methods: Fifty patients were included in this study who were thought to have soft tissue abscess or cystic lesion as a result of clinical and radiological examinations. Localisations of the lesions were: 1 periorbital, 3 breast, 14 intraabdominal, and 32 intramuscular lesions. After other radiological examinations, DWI was performed. The signal intensity values of the lesions were evaluated qualitatively according to the hyperintensity on b-1000 DWI, using 1.5 T MR system. All of the lesions were aspirated after DWI, and detection of pus in the aspiration material was accepted as gold standard for the diagnosis of abscess. Results: In 38 of the 50 patients, hyperintensity was obtained on diffusion-weighted images. False-positive results were maintained in 2 of these patients, and true-positive results were maintained in 36 of them. In 11 of the 50 patients, hypointensity was visualised on diffusion-weighted images. False-negative results were maintained in 3 of these patients, and true-negative results were maintained in 8 of them. An abscess which was seen on post-contrast conventional MRI could not be seen on DWI, and this was regarded as false-negative. Conclusion: The sensitivity and specificity of diffusion-weighted images for detecting soft tissue abscesses were found to be 92% and 80%, respectively. DWI has a high diagnostic value in soft tissue abscesses, and is an important imaging modality that may be used for the differentiation of cysts and abscesses.

  4. Anisotropic Diffusion based Brain MRI Segmentation and 3D Reconstruction

    Directory of Open Access Journals (Sweden)

    M. Arfan Jaffar

    2012-06-01

    Full Text Available In medical field visualization of the organs is very imperative for accurate diagnosis and treatment of any disease. Brain tumor diagnosis and surgery also required impressive 3D visualization of the brain to the radiologist. Detection and 3D reconstruction of brain tumors from MRI is a computationally time consuming and error-prone task. Proposed system detects and presents a 3D visualization model of the brain and tumor inside which greatly helps the radiologist to effectively diagnose and analyze the brain tumor. We proposed a multi-phase segmentation and visualization technique which overcomes the many problems of 3D volume segmentation methods like lake of fine details. In this system segmentation is done in three different phases which reduces the error chances. The system finds contours for skull, brain and tumor. These contours are stacked over and two novel methods are used to find the 3D visualization models. The results of these techniques, particularly of interpolation based, are impressive. Proposed system is tested against publically available data set [41] and MRI datasets available from MRI aamp; CT center Rawalpindi, Pakistan [42].

  5. Normal diffusion-weighted imaging in cerebral air embolism complicating angiography

    Energy Technology Data Exchange (ETDEWEB)

    Sayama, T.; Inamura, T.; Fukui, M. [Dept. of Neurosurgery, Kyushu University Hospital, Fukuoka (Japan); Mitani, M.; Yagi, H. [Dept. of Neurosurgery, Yagi Hospital, Fukuoka (Japan)

    2000-03-01

    We report a case of cerebral air embolism resulting from accidental air infection during cerebral angiography. A 60-year-old man was accidentally injected with air via the left subclavian artery. Angiography demonstrated air within the basilar artery. The patient showed signs of posterior circulation ischaemia (confusion, blindness, gaze palsy and hemiparesis). However, MRI, including diffusion-weighted imaging, showed no abnormality 4 h later. The patient was treated with hyperbaric oxygen within 5 h of the embolism. All symptoms and signs resolved completely within a week. (orig.)

  6. Multiresolution texture models for brain tumor segmentation in MRI.

    Science.gov (United States)

    Iftekharuddin, Khan M; Ahmed, Shaheen; Hossen, Jakir

    2011-01-01

    In this study we discuss different types of texture features such as Fractal Dimension (FD) and Multifractional Brownian Motion (mBm) for estimating random structures and varying appearance of brain tissues and tumors in magnetic resonance images (MRI). We use different selection techniques including KullBack - Leibler Divergence (KLD) for ranking different texture and intensity features. We then exploit graph cut, self organizing maps (SOM) and expectation maximization (EM) techniques to fuse selected features for brain tumors segmentation in multimodality T1, T2, and FLAIR MRI. We use different similarity metrics to evaluate quality and robustness of these selected features for tumor segmentation in MRI for real pediatric patients. We also demonstrate a non-patient-specific automated tumor prediction scheme by using improved AdaBoost classification based on these image features.

  7. Cribriform pattern in brain MRI: A diagnostic clue for ...

    African Journals Online (AJOL)

    To date, 11 distinct types of MPS have been described, each as a result of deficient enzymatic activity of specific lysosomal hydrolase. The most common types are Hurler and Hunter syndromes. We report a case of a child presenting with macrocephaly, clinically suspected to be due to hydrocephalus. An MRI (3 Tesla) brain ...

  8. Brain MRI tumor image fusion combined with Shearlet and wavelet

    Science.gov (United States)

    Zhang, Changjiang; Fang, Mingchao

    2017-11-01

    In order to extract the effective information in different modalities of the tumor region in brain Magnetic resonance imaging (MRI) images, we propose a brain MRI tumor image fusion method combined with Shearlet and wavelet transform. First, the source images are transformed into Shearlet domain and wavelet domain. Second, the low frequency component of Shearlet domain is fused by Laplace pyramid decomposition. Then the low-frequency fusion image is obtained through inverse Shearlet transform. Third, the high frequency subimages in wavelet domain are fused. Then the high-frequency fusion image is obtained through inverse wavelet transform. Finally, the low-frequency fusion image and high-frequency fusion image are summated to get the final fusion image. Through experiments conducted on 10 brain MRI tumor images, the result shown that the proposed fusion algorithm has the best fusion effect in the evaluation indexes of spatial frequency, edge strength and average gradient. The main spatial frequency of 10 images is 29.22, and the mean edge strength and average gradient is 103.77 and 10.42. Compared with different fusion methods, we find that the proposed method effectively fuses the information of multimodal brain MRI tumor images and improves the clarity of the tumor area well.

  9. Novel whole brain segmentation and volume estimation using quantitative MRI

    Energy Technology Data Exchange (ETDEWEB)

    West, J. [Linkoeping University, Radiation Physics, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); SyntheticMR AB, Linkoeping (Sweden); Warntjes, J.B.M. [Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); SyntheticMR AB, Linkoeping (Sweden); Linkoeping University and Department of Clinical Physiology UHL, County Council of Oestergoetland, Clinical Physiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Lundberg, P. [Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); Linkoeping University and Department of Radiation Physics UHL, County Council of Oestergoetland, Radiation Physics, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Linkoeping University and Department of Radiology UHL, County Council of Oestergoetland, Radiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden)

    2012-05-15

    Brain segmentation and volume estimation of grey matter (GM), white matter (WM) and cerebro-spinal fluid (CSF) are important for many neurological applications. Volumetric changes are observed in multiple sclerosis (MS), Alzheimer's disease and dementia, and in normal aging. A novel method is presented to segment brain tissue based on quantitative magnetic resonance imaging (qMRI) of the longitudinal relaxation rate R{sub 1}, the transverse relaxation rate R{sub 2} and the proton density, PD. Previously reported qMRI values for WM, GM and CSF were used to define tissues and a Bloch simulation performed to investigate R{sub 1}, R{sub 2} and PD for tissue mixtures in the presence of noise. Based on the simulations a lookup grid was constructed to relate tissue partial volume to the R{sub 1}-R{sub 2}-PD space. The method was validated in 10 healthy subjects. MRI data were acquired using six resolutions and three geometries. Repeatability for different resolutions was 3.2% for WM, 3.2% for GM, 1.0% for CSF and 2.2% for total brain volume. Repeatability for different geometries was 8.5% for WM, 9.4% for GM, 2.4% for CSF and 2.4% for total brain volume. We propose a new robust qMRI-based approach which we demonstrate in a patient with MS. (orig.)

  10. Simultaneous MRI and PET imaging of a rat brain

    International Nuclear Information System (INIS)

    Multi-modality imaging is rapidly becoming a valuable tool in the diagnosis of disease and in the development of new drugs. Functional images produced with PET fused with anatomical structure images created by MRI will allow the correlation of form with function. Our group is developing a system to acquire MRI and PET images contemporaneously. The prototype device consists of two opposed detector heads, operating in coincidence mode. Each MRI-PET detector module consists of an array of LSO detector elements coupled through a long fibre optic light guide to a single Hamamatsu flat panel position-sensitive photomultiplier tube (PSPMT). The use of light guides allows the PSPMTs to be positioned outside the bore of a 3T MRI scanner where the magnetic field is relatively small. To test the device, simultaneous MRI and PET images of the brain of a male Sprague Dawley rat injected with FDG were successfully obtained. The images revealed no noticeable artefacts in either image set. Future work includes the construction of a full ring PET scanner, improved light guides and construction of a specialized MRI coil to permit higher quality MRI imaging

  11. Longitudinal MRI studies of brain morphometry

    DEFF Research Database (Denmark)

    Skimminge, Arnold Jesper Møller

    High resolution MR images acquired at multiple time points of the brain allow quantification of localized changes induced by external factors such as maturation, ageing or disease progression/recovery. High-dimensional warping of such MR images incorporates changes induced by external factors...... into the accompanying deformation field. Deformation fields from high dimensional warping founds tensor based morphometry (TBM), and provides unique opportunities to study human brain morphology and plasticity. In this thesis, specially adapted image processing streams utilizing several image registration techniques...... to characterize differences between brains, demonstrate the versatility and specificity of the employed voxel-wise morphometric methods. More specifically TBM is used to study neurodegenerative changes following severe traumatic brain injuries. Such injuries progress for months, perhaps even years postinjury...

  12. Value of repeat brain MRI in children with focal epilepsy and negative findings on initial MRI

    International Nuclear Information System (INIS)

    Jeon, Tae Yeon; Kim, Ji Hye; Lee, Jee Hun; Yoo, So Young; Hwang, Sook Min; Lee, Mun Hyang

    2017-01-01

    To evaluate the value of repeat brain magnetic resonance imaging (MRI) in identifying potential epileptogenic lesions in children with initial MRI-negative focal epilepsy. Our Institutional Review Board approved this retrospective study and waived the requirement for informed consent. During a 15-year period, 257 children (148 boys and 109 girls) with initial MRI-negative focal epilepsy were included. After re-evaluating both initial and repeat MRIs, positive results at repeat MRI were classified into potential epileptogenic lesions (malformation of cortical development and hippocampal sclerosis) and other abnormalities. Contributing factors for improved lesion conspicuity of the initially overlooked potential epileptogenic lesions were analyzed and classified into lesion factors and imaging factors. Repeat MRI was positive in 21% (55/257) and negative in 79% cases (202/257). Of the positive results, potential epileptogenic lesions comprised 49% (27/55) and other abnormalities comprised 11% of the cases (28/257). Potential epileptogenic lesions included focal cortical dysplasia (n = 11), hippocampal sclerosis (n = 10), polymicrogyria (n = 2), heterotopic gray matter (n = 2), microlissencephaly (n = 1), and cortical tumor (n = 1). Of these, seven patients underwent surgical resection. Contributing factors for new diagnoses were classified as imaging factors alone (n = 6), lesion factors alone (n = 2), both (n = 18), and neither (n = 1). Repeat MRI revealed positive results in 21% of the children with initial MRI-negative focal epilepsy, with 50% of the positive results considered as potential epileptogenic lesions. Enhanced MRI techniques or considering the chronological changes of lesions on MRI may improve the diagnostic yield for identification of potential epileptogenic lesions on repeat MRI

  13. Value of repeat brain MRI in children with focal epilepsy and negative findings on initial MRI

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Tae Yeon; Kim, Ji Hye; Lee, Jee Hun; Yoo, So Young; Hwang, Sook Min; Lee, Mun Hyang [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-08-01

    To evaluate the value of repeat brain magnetic resonance imaging (MRI) in identifying potential epileptogenic lesions in children with initial MRI-negative focal epilepsy. Our Institutional Review Board approved this retrospective study and waived the requirement for informed consent. During a 15-year period, 257 children (148 boys and 109 girls) with initial MRI-negative focal epilepsy were included. After re-evaluating both initial and repeat MRIs, positive results at repeat MRI were classified into potential epileptogenic lesions (malformation of cortical development and hippocampal sclerosis) and other abnormalities. Contributing factors for improved lesion conspicuity of the initially overlooked potential epileptogenic lesions were analyzed and classified into lesion factors and imaging factors. Repeat MRI was positive in 21% (55/257) and negative in 79% cases (202/257). Of the positive results, potential epileptogenic lesions comprised 49% (27/55) and other abnormalities comprised 11% of the cases (28/257). Potential epileptogenic lesions included focal cortical dysplasia (n = 11), hippocampal sclerosis (n = 10), polymicrogyria (n = 2), heterotopic gray matter (n = 2), microlissencephaly (n = 1), and cortical tumor (n = 1). Of these, seven patients underwent surgical resection. Contributing factors for new diagnoses were classified as imaging factors alone (n = 6), lesion factors alone (n = 2), both (n = 18), and neither (n = 1). Repeat MRI revealed positive results in 21% of the children with initial MRI-negative focal epilepsy, with 50% of the positive results considered as potential epileptogenic lesions. Enhanced MRI techniques or considering the chronological changes of lesions on MRI may improve the diagnostic yield for identification of potential epileptogenic lesions on repeat MRI.

  14. Pediatric brain MRI. Pt. 2. Advanced techniques

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Mai-Lan; Campeau, Norbert G.; Welker, Kirk M. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Ngo, Thang D. [Nemours Children' s Hospital, Department of Radiology, Orlando, FL (United States); Udayasankar, Unni K. [University of Arizona, Department of Radiology, Tucson, AZ (United States)

    2017-05-15

    Pediatric neuroimaging is a complex and specialized field that uses magnetic resonance (MR) imaging as the workhorse for diagnosis. MR protocols should be tailored to the specific indication and reviewed by the supervising radiologist in real time. Targeted advanced imaging sequences can be added to provide information regarding tissue microstructure, perfusion, metabolism and function. In part 2 of this review, we highlight the utility of advanced imaging techniques for superior evaluation of pediatric neurologic disease. We focus on the following techniques, with clinical examples: phase-contrast imaging, perfusion-weighted imaging, vessel wall imaging, diffusion tensor imaging, task-based functional MRI and MR spectroscopy. (orig.)

  15. Clinical evaluation of single-shot and readout-segmented diffusion-weighted imaging in stroke patients at 3 T

    International Nuclear Information System (INIS)

    Morelli, John; Porter, David; Ai, Fei

    2013-01-01

    Background: Diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) is most commonly performed utilizing a single-shot echo-planar imaging technique (ss-EPI). Susceptibility artifact and image blur are severe when this sequence is utilized at 3 T. Purpose: To evaluate a readout-segmented approach to DWI MR in comparison with single-shot echo planar imaging for brain MRI. Material and Methods: Eleven healthy volunteers and 14 patients with acute and early subacute infarctions underwent DWI MR examinations at 1.5 and 3T with ss-EPI and readout-segmented echo-planar (rs-EPI) DWI at equal nominal spatial resolutions. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) calculations were made, and two blinded readers ranked the scans in terms of high signal intensity bulk susceptibility artifact, spatial distortions, image blur, overall preference, and motion artifact. Results: SNR and CNR were greatest with rs-EPI (8.1 ± 0.2 SNR vs. 6.0 ± 0.2; P -4 at 3T). Spatial distortions were greater with single-shot (0.23 ± 0.03 at 3T; P <0.001) than with rs-EPI (0.12 ± 0.02 at 3T). Combined with blur and artifact reduction, this resulted in a qualitative preference for the readout-segmented scans overall. Conclusion: Substantial image quality improvements are possible with readout-segmented vs. single-shot EPI - the current clinical standard for DWI - regardless of field strength (1.5 or 3 T). This results in improved image quality secondary to greater real spatial resolution and reduced artifacts from susceptibility in MR imaging of the brain

  16. Quantitative Machine Learning Analysis of Brain MRI Morphology throughout Aging.

    Science.gov (United States)

    Shamir, Lior; Long, Joe

    2016-01-01

    While cognition is clearly affected by aging, it is unclear whether the process of brain aging is driven solely by accumulation of environmental damage, or involves biological pathways. We applied quantitative image analysis to profile the alteration of brain tissues during aging. A dataset of 463 brain MRI images taken from a cohort of 416 subjects was analyzed using a large set of low-level numerical image content descriptors computed from the entire brain MRI images. The correlation between the numerical image content descriptors and the age was computed, and the alterations of the brain tissues during aging were quantified and profiled using machine learning. The comprehensive set of global image content descriptors provides high Pearson correlation of ~0.9822 with the chronological age, indicating that the machine learning analysis of global features is sensitive to the age of the subjects. Profiling of the predicted age shows several periods of mild changes, separated by shorter periods of more rapid alterations. The periods with the most rapid changes were around the age of 55, and around the age of 65. The results show that the process of brain aging of is not linear, and exhibit short periods of rapid aging separated by periods of milder change. These results are in agreement with patterns observed in cognitive decline, mental health status, and general human aging, suggesting that brain aging might not be driven solely by accumulation of environmental damage. Code and data used in the experiments are publicly available.

  17. Structural MRI markers of brain aging early after ischemic stroke.

    Science.gov (United States)

    Werden, Emilio; Cumming, Toby; Li, Qi; Bird, Laura; Veldsman, Michele; Pardoe, Heath R; Jackson, Graeme; Donnan, Geoffrey A; Brodtmann, Amy

    2017-07-11

    To examine associations between ischemic stroke, vascular risk factors, and MRI markers of brain aging. Eighty-one patients (mean age 67.5 ± 13.1 years, 31 left-sided, 61 men) with confirmed first-ever (n = 66) or recurrent (n = 15) ischemic stroke underwent 3T MRI scanning within 6 weeks of symptom onset (mean 26 ± 9 days). Age-matched controls (n = 40) completed identical testing. Multivariate regression analyses examined associations between group membership and MRI markers of brain aging (cortical thickness, total brain volume, white matter hyperintensity [WMH] volume, hippocampal volume), normalized against intracranial volume, and the effects of vascular risk factors on these relationships. First-ever stroke was associated with smaller hippocampal volume ( p = 0.025) and greater WMH volume ( p = 0.004) relative to controls. Recurrent stroke was in turn associated with smaller hippocampal volume relative to both first-ever stroke ( p = 0.017) and controls ( p = 0.001). These associations remained significant after adjustment for age, sex, education, and, in stroke patients, infarct volume. Total brain volume was not significantly smaller in first-ever stroke patients than in controls ( p = 0.056), but the association became significant after further adjustment for atrial fibrillation ( p = 0.036). Cortical thickness and brain volumes did not differ as a function of stroke type, infarct volume, or etiology. Brain structure is likely to be compromised before ischemic stroke by vascular risk factors. Smaller hippocampal and total brain volumes and increased WMH load represent proxies for underlying vascular brain injury. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  18. The Implications of Brain MRI in Autism Spectrum Disorder.

    Science.gov (United States)

    Cooper, Alison S; Friedlaender, Eron; Levy, Susan E; Shekdar, Karuna V; Bradford, Andrea Bennett; Wells, Kimberly E; Mollen, Cynthia

    2016-12-01

    Our objective was to describe the types of providers who refer children with autism spectrum disorder (ASD) for brain magnetic resonance imaging (MRI), the referral reason, and MRI results. The most common referral reasons were autism spectrum disorder with seizures (33.7%), autism spectrum disorder alone (26.3%), and autism spectrum disorder with abnormal neurologic examination or preexisting finding (24%). Neurology (62.5%), general pediatric (22.3%), and developmental/behavioral practitioners (8.9%) referred the most patients. The prevalence of definite pathology was highest in children referred for autism spectrum disorder with abnormal neurologic examination/preexisting finding (26.2%, 95% CI: 16.8%-36%), headaches (25.7%, 95% CI: 11.2%-40.2%), or seizures (22%, 95% CI: 14.6%-29.5%), and was lowest in children referred for autism spectrum disorder alone (6.5%, 95% CI: 1.5%-11.6%). We concluded that there is a low prevalence of definite pathology in children with autism spectrum disorder undergoing brain MRI. In children with abnormal neurologic examination or preexisting finding, seizures, or headaches, one may consider performing brain MRI given the higher prevalence of pathology. © The Author(s) 2016.

  19. Value of diffusion weighted magnetic resonance imaging in the ...

    African Journals Online (AJOL)

    Value of diffusion weighted magnetic resonance imaging in the prediction of cancer prostate. AHAA Afifi, AN Etaby, MAY Ahmad, YT Farghaly. Abstract. Introduction: Benign prostatic hyperplasia (BPH) and prostatic carcinoma (Pca) are the commonest diseases of the prostate with increased morbidities all over the world ...

  20. Diffusion-weighted MR imaging for detection of extrahepatic cholangiocarcinoma

    International Nuclear Information System (INIS)

    Cui, Xing-Yu; Chen, Hong-Wei; Cai, Song; Bao, Jian; Tang, Qun-Feng; Wu, Li-Yuan; Fang, Xiang-Ming

    2012-01-01

    Objectives: To measure the sensitivity of diffusion-weighted imaging (DWI) and determine the most appropriate b value for DWI; to explore the correlation between the apparent diffusion coefficient (ADC) value and the degree of extrahepatic cholangiocarcinoma differentiation. Methods: Preoperative diffusion-weighted imaging and magnetic resonance examinations were performed for 31 patients with extrahepatic cholangiocarcinoma. Tumor ADC values were measured, and the signal-to-noise ratio, contrast-to-noise ratio, and signal-intensity ratio between the diffusion-weighted images with various b values as well as the T2-weighted images were calculated. Pathologically confirmed patients were pathologically graded to compare the ADC value with different b values of tumor at different degrees of differentiation, and the results were statistically analyzed by using the Friedman test. Results: A total of 29 cases of extrahepatic cholangiocarcinoma were detected by DWI. As the b value increased, tumor signal-to-noise ratio and contrast-to-noise ratio between the tumor and normal liver gradually decreased, but the tumor signal-intensity ratio gradually increased. When b = 800 s/mm 2 , contrast-to-noise ratio between tumor and normal liver, tumor signal-intensity ratio, and tumor signal-to-noise ratio of diffusion-weighted images were all higher than those of T2-weighted images; the differences were statistically significant (P 2 was the best in DWI of extrahepatic cholangiocarcinoma; the lesion ADC value declined as the degree of cancerous tissue differentiation decreased.

  1. Effects of microperfusion in hepatic diffusion weighted imaging

    NARCIS (Netherlands)

    Dijkstra, Hildebrand; Baron, Paul; Kappert, Peter; Oudkerk, Matthijs; Sijens, Paul E.

    Clinical hepatic diffusion weighted imaging (DWI) generally relies on mono-exponential diffusion. The aim was to demonstrate that mono-exponential diffusion in the liver is contaminated by microperfusion and that the bi-exponential model is required. Nineteen fasting healthy volunteers were examined

  2. New asymptomatic ischemic lesions on diffusion-weighted imaging after cerebral angiography

    International Nuclear Information System (INIS)

    Shibazaki, Kensaku

    2006-01-01

    Conventional cerebral angiography (CAG) is relatively low risk for neurological complications. However, diffusion-weighted imaging (DWI) after CAG occasionally reveal an asymptomatic ischemic lesion on the brain. The aim of this study was to investigate the frequency of new asymptomatic or symptomatic DWI lesions after CAG and to clarify the factors associated with them. Fifty-six patients with acute ischemic stroke and transient ischemic attack were prospectively enrolled. Magnetic resonance imaging (MRI) studies including DWI were studied twice, within 48 hours before and after CAG. The following factors were assessed; age, gender, history of stroke, history of ischemic heart disease, vascular risk factors, National Institutes of Health Stroke Scale (NIHSS) score on admission, stroke subtype, treatment before stroke or transient ischemic attack (TIA) (antiplatelets or warfarin), approach for catheters (transbrachial or femoral artery), amount of contrast medium used, length of the angiographic procedure, and fluoroscophy time. We divided the patients into two groups according to the presence of new DWI lesions after CAG; Positive group had new DWI lesions, whereas the Negative group had none. After CAG, no patients had new neurological deficits. New asymptomatic DWI lesions were observed in 24 patients (42.9%). The significant differences observed between two groups were as follows; age (69.8±11.3 for the Positive group versus 61.9±11.3 for the Negative group, p=0.043), female (54% versus 28%, p=0.048), non-small vessel occlusion (100% versus 66%, p=0.009), catheter approach for transfemoral artery (63% versus 13%, p<0.001), mean length of the angiographic procedure (63.1±21.6 min versus 43.7±14.2 min, p<0.001), mean fluoroscopy time (26.5±13.0 min versus 14.9±5.9 mm, p<0.001). Sensitivity and specificity analysis to discriminate the positive and negative groups revealed 17 minutes to be the critical threshold point (sensitivity 66.6% and specificity 68

  3. Prematurity and brain perfusion: Arterial spin labeling MRI.

    Science.gov (United States)

    Tortora, Domenico; Mattei, Peter Angelo; Navarra, Riccardo; Panara, Valentina; Salomone, Rita; Rossi, Andrea; Detre, John A; Caulo, Massimo

    2017-01-01

    Abnormal brain perfusion is a critical mechanism in neonatal brain injury. The aim of the present study was to compare Cerebral Blood Flow (CBF) evaluated with ASL MRI in three groups of neonates: preterms without brain lesions on MRI (PN), preterms with periventricular white matter lesions (PNp) and term neonates with normal MRI (TN). The correlation between CBF and clinical outcome was explored. The institutional review board approved this prospective study and waived informed consent. The perfusion ASL data from 49 consecutive preterm neonates (PN) studied at term-equivalent age and 15 TN were evaluated. Statistically significant differences in gray matter CBF were evaluated by using a linear mixed-model analysis and Mann-Whitney U test. Logistic regression analysis was used to assess the relation between CBF and neuromotor outcome at 12 months. Comparison of means indicated that the CBF of the whole brain were significantly higher in PN compared to TN ( P  = 0.011). This difference remained significant when considering the frontal ( P  = 0.038), parietal ( P  = 0.002), temporal ( P  = 0.030), occipital ( P  = 0.041) and cerebellar ( P  = 0.010) gray matter. In the PN group, lower CBF in basal ganglia was associated with a worse neuromotor outcome ( P  = 0.012). ASL MRI demonstrated differences in brain perfusion of the basal ganglia between PN and TN. In PN, a positive correlation between CBF and neuromotor outcome was demonstrated in this area.

  4. Pediatric brain MRI. Pt. 1. Basic techniques

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Mai-Lan; Campeau, Norbert G.; Welker, Kirk M. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Ngo, Thang D. [Nemours Children' s Hospital, Department of Radiology, Orlando, FL (United States); Udayasankar, Unni K. [University of Arizona, Department of Radiology, Tucson, AZ (United States)

    2017-05-15

    Pediatric neuroimaging is a complex and specialized field that uses magnetic resonance (MR) imaging as the workhorse for diagnosis. Standard MR techniques used in adult neuroimaging are suboptimal for imaging in pediatrics because there are significant differences in the child's developing brain. These differences include size, myelination and sulcation. MR protocols need to be tailored to the specific indication and reviewed by the supervising radiologist in real time, and the specialized needs of this population require careful consideration of issues such as scan timing, sequence order, sedation, anesthesia and gadolinium administration. In part 1 of this review, we focus on basic protocol development and anatomical characterization. We provide multiple imaging examples optimized for evaluation of supratentorial and infratentorial brain, midline structures, head and neck, and intracranial vasculature. (orig.)

  5. Combined MRI and MRS improves pre-therapeutic diagnoses of pediatric brain tumors over MRI alone

    International Nuclear Information System (INIS)

    Shiroishi, Mark S.; Nelson, Marvin D.; Panigrahy, Ashok; Moore, Kevin R.; Gilles, Floyd H.; Gonzalez-Gomez, Ignacio; Blueml, Stefan

    2015-01-01

    The specific goal of this study was to determine whether the inclusion of MRS had a measureable and positive impact on the accuracy of pre-surgical MR examinations of untreated pediatric brain tumors over that of MRI alone in clinical practice. Final imaging reports of 120 pediatric patients with newly detected brain tumors who underwent combined MRI/MRS examinations were retrospectively reviewed. Final pathology was available in all cases. Group A comprised 60 subjects studied between June 2001 and January 2005, when MRS was considered exploratory and radiologists utilized only conventional MRI to arrive at a diagnosis. For group B, comprising 60 subjects studied between January 2005 and March 2008, the radiologists utilized information from both MRI and MRS. Furthermore, radiologists revisited group A (blind review, time lapse >4 years) to determine whether the additional information from MRS would have altered their interpretation. Sixty-three percent of patients in group A were diagnosed correctly, whereas in 10 % the report was partially correct with the final tumor type mentioned (but not mentioned as most likely tumor), while in 27 % of cases the reports were wrong. For group B, the diagnoses were correct in 87 %, partially correct in 5 %, and incorrect in 8 % of the cases, which is a significant improvement (p < 0.005). Re-review of combined MRI and MRS of group A resulted 87 % correct, 7 % partially correct, and 7 % incorrect diagnoses, which is a significant improvement over the original diagnoses (p < 0.05). Adding MRS to conventional MRI significantly improved diagnostic accuracy in preoperative pediatric patients with untreated brain tumors. (orig.)

  6. Hemorrhage detection in MRI brain images using images features

    Science.gov (United States)

    Moraru, Luminita; Moldovanu, Simona; Bibicu, Dorin; Stratulat (Visan), Mirela

    2013-11-01

    The abnormalities appear frequently on Magnetic Resonance Images (MRI) of brain in elderly patients presenting either stroke or cognitive impairment. Detection of brain hemorrhage lesions in MRI is an important but very time-consuming task. This research aims to develop a method to extract brain tissue features from T2-weighted MR images of the brain using a selection of the most valuable texture features in order to discriminate between normal and affected areas of the brain. Due to textural similarity between normal and affected areas in brain MR images these operation are very challenging. A trauma may cause microstructural changes, which are not necessarily perceptible by visual inspection, but they could be detected by using a texture analysis. The proposed analysis is developed in five steps: i) in the pre-processing step: the de-noising operation is performed using the Daubechies wavelets; ii) the original images were transformed in image features using the first order descriptors; iii) the regions of interest (ROIs) were cropped from images feature following up the axial symmetry properties with respect to the mid - sagittal plan; iv) the variation in the measurement of features was quantified using the two descriptors of the co-occurrence matrix, namely energy and homogeneity; v) finally, the meaningful of the image features is analyzed by using the t-test method. P-value has been applied to the pair of features in order to measure they efficacy.

  7. Quantifying brain microstructure with diffusion MRI

    DEFF Research Database (Denmark)

    Novikov, Dmitry S.; Jespersen, Sune N.; Kiselev, Valerij G.

    2016-01-01

    We review, systematize and discuss models of diffusion in neuronal tissue, by putting them into an overarching physical context of coarse-graining over an increasing diffusion length scale. From this perspective, we view research on quantifying brain microstructure as occurring along the three ma...... on the future research directions which can open exciting possibilities for developing markers of pathology and development based on methods of studying mesoscopic transport in disordered systems....

  8. Head and neck paragangliomas: diffusion weighted and dynamic contrast enhanced magnetic resonance imaging characteristics

    International Nuclear Information System (INIS)

    Yuan, Ying; Shi, Huimin; Tao, Xiaofeng

    2016-01-01

    To determine the feature values of head and neck paragangliomas on diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI). Patients with primary head and neck paraganglioma who underwent both DWI and DCE-MRI before treatment between January 2010 and June 2013 were identified. Two radiologists assessed apparent diffusion coefficient (ADC) values on DWI and kinetic characteristics on DCE-MRI. The time intensity curves (TICs) and dynamic parameters, including peak height (PH), maximum enhancement ratio (ER max ), time to peak enhancement (T peak ) and maximum rise slope (Slope max ), were generated and evaluated. Ten patients with head and neck paraganglioma were retrospectively analyzed. On conventional MRI, the tumors demonstrated as well-circumscribed, strongly enhanced lesions. Mean ADC value of the lesions was 1.12 ± 0.15 × 10 −3 mm 2 /s. The TICs demonstrated washout pattern (type-III) in all lesions. The mean PH, ER max , T peak and Slope max value was 121.24 ± 63.99, 193.79 ± 67.18, 8.16 ± 3.29 and 25.42 ± 7.91, respectively. Head and neck paragangliomas demonstrate distinctive DWI and DCE-MRI results than for other benign tumors which should be taken into account in further evaluation of MRI on head and neck lesions

  9. The application of in vivo diffusion weighted magnetic resonance imaging on intracranial disorders

    International Nuclear Information System (INIS)

    Ebisu, Toshihiko; Naruse, Shoji; Horikawa, Yoshiharu

    1991-01-01

    Diffusion weighted magnetic resonance (MR) images were obtained by using motion-probing gradient (MPG) pulses in one or three orthogonal directions in the following subjects: (1) phantom models; (2) Wistar rats with experimentally induced brain edema; (3) normal volunteers, and patients with brain tumor, brain edema or cerebral infarction. A one direction method was capable of defining diffusion anisotropy of myelinated axonal fibers in white matter. A three orthogonal gradients method was useful for demonstrating the difference in the diffusion coefficients in various diseases due to its larger total gradient strength. Faster diffusion was detected in white matter parallel to the direction of MPG; and slower diffusion was detected perpendicular to the direction of MPG because the myelin sheath restricted water diffusion. Brain tumor and vasogenic edema were shown as faster diffusion, while cytotoxic edema, cerebral ischemia, and infarction (at the subacute or early chronic stage) were shown as slower diffusion. Thus, diffusion weighted MR imaging seemed to be a useful approach to qualitative and dynamic analyses of intracranial diseases. (N.K.)

  10. Relationship between the diffusion time and the diffusion MRI signal observed at 17.2 Tesla in the healthy rat brain cortex.

    Science.gov (United States)

    Pyatigorskaya, Nadya; Le Bihan, Denis; Reynaud, Olivier; Ciobanu, Luisa

    2014-08-01

    To investigate the diffusion time dependency of water diffusion in cortical brain tissue. We have combined an oscillating gradient spin-echo (OGSE) and a pulse gradient spin echo (PGSE) spin-echo sequence to acquire diffusion-weighted MRI images in vivo in healthy rat brains over a wide range of diffusion times (1.9-29.2 ms) and estimated the parameters of the biexponential and cumulant expansion diffusion MRI signal models. Diffusion images were obtained at 17.2 Tesla with maximum gradient strength of 1000 mT/m allowing 40 b values up to approximately 4000 s/mm(2). At all diffusion times the log plot of diffusion signal attenuation versus b value was curved, confirming that diffusion is not free, even at very short diffusion times. This suggests that the length scale of obstacles to diffusion must be smaller than the corresponding shortest observed diffusion distance (approximately 1.7 μm). The diffusion MRI signal was also not found in a steady-state, even at our longest diffusion time (29.2 ms), suggesting some degree of segregation of water in pools. Overall, the results showed that the parameters derived from the two diffusion models could not well be related to specific tissue features. More specific models must be developed taking into account diffusion signal behavior at high b values and short diffusion times. Copyright © 2013 Wiley Periodicals, Inc.

  11. Tuberous sclerosis: diffusion MRI findings in the brain

    International Nuclear Information System (INIS)

    Sener, R.N.

    2002-01-01

    Diffusion MRI has mainly been used for detection of acute ischemia, and for distinction of cytotoxic and vasogenic edema. We applied diffusion MRI in patients with tuberous sclerosis in order to evaluate diffusion imaging characteristics of parenchymal changes. Five children with known tuberous sclerosis were included in this study. The MRI examinations were performed on a 1.5-T MR unit. Diffusion MRI was obtained using the echo-planar imaging sequence. Apparent diffusion coefficient (ADC) values from the abnormal brain parenchyma were calculated directly from automatically generated ADC maps. Seven normal children were available for comparison. In this control group the mean ADC value of the normal white matter was 0.84±0.12 x 10 -3 mm 2 /s. In tuberous sclerosis patients the mean ADC value of the white matter hamartomas (n=20) was apparently high (1.52±0.24 x 10 -3 mm 2 /s) compared with that of normal white matter. The ADC value of calcified hamartomas was ''zero''. The ADC value within a giant cell tumor was 0.89 x 10 -3 mm 2 /s, similar to that of normal cerebral white matter. The ADC maps were superior to b=1000 s/mm 2 (true diffusion) images with respect to lesion evaluation, and they provided mathematical information on tissue integrity. With respect to detection of the exact numbers and sizes of the parenchymal hamartomas fluid-attenuated inversion recovery images were superior to ADC maps. It is believed that diffusion MRI can be useful in evaluation of various parenchymal changes associated with tuberous sclerosis. Further studies on tuberous sclerosis, and on various brain lesions, would provide increasing data on this relatively new MRI sequence. (orig.)

  12. CT and MRI imaging of the brain in MELAS syndrome

    International Nuclear Information System (INIS)

    Pauli, Wojciech; Zarzycki, Artur; Krzyształowski, Adam; Walecka, Anna

    2013-01-01

    MELAS syndrome (mitochondrial myopathy, encephalopathy, lactic acidosis, stroke-like episodes) is a rare, multisystem disorder which belongs to a group of mitochondrial metabolic diseases. As other diseases in this group, it is inherited in the maternal line. In this report, we discussed a case of a 10-year-old girl with clinical and radiological picture of MELAS syndrome. We would like to describe characteristic radiological features of MELAS syndrome in CT, MRI and MR spectroscopy of the brain and differential diagnosis. The rarity of this disorder and the complexity of its clinical presentation make MELAS patients among the most difficult to diagnose. Brain imaging studies require a wide differential diagnosis, primarily to distinguish between MELAS and ischemic stroke. Particularly helpful are the MRI and MR spectroscopy techniques