3D Volumetric Interpolated Breath-hold Examination Research Articles

The 2D and 3D MR arthrographic description of aponeurotic expansion of supraspinatus tendon and biceps tendon anomaly in a large patient cohort.

To describe the aponeurotic expansion of supraspinatus tendon (AEST) and biceps tendon abnormalities with magnetic resonance (MR) arthrographic examinations and determine their prevalence in patients, we performed a high-resolution 3D direct MR arthrography. This was a retrospective study of 700 shoulder MR arthrograms performed between May 2010 and January 2022. Extension in the coronal plane of an AEST on 3D fat-suppressed T1-weighted volumetric interpolated breath-hold examination (VIBE) MR arthrography was identified. Based on its morphology, the AEST on MR arthrography was divided into four subtypes: absence of tendinous thickness in the bicipital synovial surface or intra-synovial tendon-like structure in the bicipital groove, thin and flat tendinous thickness ≥1 mm of bicipital synovium, oval tendinous structure less than half the size of the adjacent biceps tendon, oval tendinous structure more than half the size of the adjacent biceps tendon, and oval tendinous structure larger than the adjacent biceps tendon. Based on its origin and termination, aponeurotic expansions can be divided into three subtypes: proximal pulley zone, middle humeral neck zone, and distal myotendinous junction zone. Association with the biceps synovium of the AEST was categorized into three types: intra-synovial, extra-synovial, and trans-synovial. An AEST in the anterior shoulder joint in 3D VIBE MR arthrography images was identified in 63 (9%) of 700 arthrograms. The most common arthrographic type of AEST was type 1-this was detected in 39 of 63 patients. The most common course type of the AEST was anteriorly midline. The most common distal insertion type was at the tenosynovial sheath of the long head of the biceps tendon (LHBT) in the middle humeral neck zone-this was detected in 31 of 63 patients. There were only 10 MR arthrograms biceps tendon abnormality, including 4 biceps agenesis and 6 split ruptures. A 2D and high-resolution 3D MR arthrography can demonstrate the anatomical detail around the bicipital groove and facilitate the differentiation between a biceps tendon anomaly and an AEST. On high-resolution 3D MR arthrographic images, the AEST tends to be in the anterior midline and anteromedial portions of the biceps synovium with intra-synovial, extra-synovial, and trans-synovial courses and its three different insertion types.

Detection of the glenoid bare spot by non-arthrographic MR imaging, conventional MR arthrography, and 3D high-resolution T1-weighted VIBE MR arthrography: comparison with CT arthrography.

To determine the diagnostic accuracy of non-arthrographic MR imaging, conventional MR arthrography, and 3D T1-weighted volumetric interpolated breath-hold examination (VIBE) MR arthrography sequences as compared with a CT arthrography in the diagnosis of glenoid bare spot. A retrospective study of 216 patients who underwent non-arthrographic MR imaging, conventional MR arthrography, VIBE MRI arthrography, and CT arthrogram between January 2011 and March 2022 was conducted. The diagnostic accuracy of non-arthrographic MR imaging, direct MR arthrography, and VIBE MRI arthrography in the detection of glenoid bare spot was compared with that of CT arthrography. All studies were reviewed by 2 MSK radiologists. Interobserver agreement for MR imaging and MR arthrographic findings was calculated. Sixteen of 216 patients were excluded. Twenty-three of 200 shoulders had glenoid bare spot on CT arthrographic images. The glenoid bare spot was detected in 11 (47.8%) and 7 (30.4%) patients on conventional non-arthrographic MR images and in 18 (78.3%) and 16 (69.6%) patients on conventional MR arthrograms by observers 1 and 2, respectively. Both observers separately described the bare spot in 22 of 23 patients (95.7%) on 3D volumetric MR arthrograms. Interobserver variabilities were fair agreement for conventional non-arthrographic MR imaging (κ = 0.35, p < 0.05), moderate agreement for conventional MR arthrogram (κ = 0.50, p < 0.05), and near-perfect agreement for 3D volumetric MR arthrogram reading (κ = 0.87, p < 0.05). A 3D high-resolution T1-weighted VIBE MR arthrography sequence may yield diagnostic performance that is comparable with that of CT arthrography in the diagnosis of glenoid bare spot. •Glenoid bare spot should not be misdiagnosed as a transchondral defect of the glenoid surface by radiologists. •A 3D high-resolution T1-weighted VIBE MR arthrography sequence may be used as a high-sensitivity imaging technique in the diagnosis of glenoid bare spot.

Quantification and 3D Localization of Magnetically Navigated Superparamagnetic Particles Using MRI in Phantom and Swine Chemoembolization Models.

Superparamagnetic nanoparticles (SPIONs) can be combined with tumor chemoembolization agents to form magnetic drug-eluting beads (MDEBs), which are navigated magnetically in the MRI scanner through the vascular system. We aim to develop a method to accurately quantify and localize these particles and to validate the method in phantoms and swine models. MDEBs were made of Fe3O4 SPIONs. After injected known numbers of MDEBs, susceptibility artifacts in three-dimensional (3D) volumetric interpolated breath-hold examination (VIBE) sequences were acquired in glass and Polyvinyl alcohol (PVA) phantoms, and two living swine. Image processing of VIBE images provided the volume relationship between MDEBs and their artifact at different VIBE acquisitions and post-processing parameters. Simulated hepatic-artery embolization was performed in vivo with an MRI-conditional magnetic-injection system, using the volume relationship to locate and quantify MDEB distribution. Individual MDEBs were spatially identified, and their artifacts quantified, showing no correlation with magnetic-field orientation or sequence bandwidth, but exhibiting a relationship with echo time and providing a linear volume relationship. Two MDEB aggregates were magnetically steered into desired liver regions while the other 19 had no steering, and 25 aggregates were injected into another swine without steering. The MDEBs were spatially identified and the volume relationship showed accuracy in assessing the number of the MDEBs, with small errors (≤ 8.8%). MDEBs were able to be steered into desired body regions and then localized using 3D VIBE sequences. The resulting volume relationship was linear, robust, and allowed for quantitative analysis of the MDEB distribution.

Optimization of the image contrast for the developing fetal brain using 3D radial VIBE sequence in 3\xa0T magnetic resonance imaging

BackgroundFaster and motion robust magnetic resonance imaging (MRI) sequences are desirable in fetal brain MRI. T1-weighted images are essential for evaluating fetal brain development. We optimized the radial volumetric interpolated breath-hold examination (VIBE) sequence for qualitative T1-weighted images of the fetal brain with improved image contrast and reduced motion sensitivity.Materials and methodsThis was an institutional review board-approved prospective study. Thirty-five pregnant subjects underwent fetal brain scan at 3 Tesla MRI. T1-weighted images were acquired using a 3D radial VIBE sequence with flip angles of 6º, 9º, 12º, and 15º. T1-weighted images of Cartesian VIBE sequence were acquired in three of the subjects. Qualitative assessments including image quality and motion artifact severity were evaluated. The image contrast ratio between gray and white matter were measured. Interobserver reliability and intraobserver repeatability were assessed using intraclass correlation coefficient (ICC).ResultsInterobserver reliability and intraobserver repeatability universally revealed almost perfect agreement (ICC > 0.800). Significant differences in image quality were detected in basal ganglia (P = 0.023), central sulcus (P = 0.028), myelination (P = 0.007) and gray matter (P = 0.023) among radial VIBE with flip angles 6º, 9º, 12º, 15º. Image quality at the 9º flip angle in radial VIBE was generally better than flip angle of 15º. Radial VIBE sequence with 9º flip angle of gray matter was significantly different by gestational age (GA) before and after 28 weeks (P = 0.036). Quantified image contrast was significantly different among different flip angles, consistent with qualitative analysis of image quality.ConclusionsThree-dimensional radial VIBE with 9º flip angle provides optimal, stable T1-weighted images of the fetal brain. Fetal brain structure and development can be evaluated using high-quality images obtained using this angle. However, different scanners will achieve different TRs and so the FA should be re-optimized each time a new protocol is employed.

Quantitative Evaluation of Liver Fibrosis on T1 Relaxometry in Comparison with Fibroscan.

PurposeThis study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease.Materials and MethodsOne hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis.ResultsPreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0–F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis.ConclusionPreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.

Three-dimensional fat-saturated T1-weighted Cartesian volumetric interpolated breath-hold examination (VIBE) for the diagnosis of aortitis in patients with suspected large vessel vasculitis: a comparative study with 18F-FDG PET applying fully integrated PET/MRI

To evaluate the feasibility of T1-weighted (T1W) three-dimensional (3D) fat saturated Cartesian volumetric interpolated breath-hold examination (VIBE) magnetic resonance imaging (MRI) sequence for the diagnosis of aortitis in patients with suspected large vessel vasculitis (LVV) applying fully integrated 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron-emission tomography (PET)/MRI. Fourteen patients with aortitis and 14 patients with a negative study for aortitis using 18F-FDG PET as the standard of reference for the evaluation of inflammatory aortic involvement were included retrospectively. All patients were imaged at 3 T using T1W VIBE pre- and post-contrast. Four aortic segments were evaluated for image quality (IQ), diagnostic confidence (DC), and the degree of inflammatory activity (IA) using a Likert scale. Binomial and generalised estimating equation model tests were used to assess the diagnostic performance of T1W VIBE. Cohen's k was applied to test for interobserver reproducibility with respect to IA. Spearman's rank correlation coefficient was calculated to examine correlations between IQ, DC, IA, and PET results. On a patient- and segment-based analysis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 85.7% and 59.8%, 100% and 100%, 100% and 100%, 87.5% and 68%, and 92.9% and 82.1%, respectively. IQ and DC were acceptable to good in all examinations and substantial interobserver agreement was observed for IA (Cohen's k = 0.69). IQ and DC as well as IA and 18F-FDG vessel wall uptake were significantly correlated (r=0.763 and 0.679, respectively; p<0.0001). T1W 3D fat saturated VIBE MRI allows diagnosis of aortitis and may aid in the management of patients with suspected LVV.

Diagnostic abilities of 3T MRI for assessing mandibular invasion of squamous cell carcinoma in the oral cavity: comparison with 64-row multidetector CT.

To evaluate the diagnostic accuracies of 3T MRI in evaluating mandibular invasion of squamous cell carcinoma (SCC) in the oral cavity and to compare those with that of multidetector CT (MDCT). 41 cases with oral SCC examined by both 3T MRI and MDCT prior to surgery were included in this study. Intravenous contrast medium was administered in all examinations. Images were evaluated for the presence or absence of mandibular invasion and mandibular canal involvement by the tumour. For MRI, both two-dimensional (2D) fast spin echo (FSE) and three-dimensional (3D) volumetric interpolated breath-hold examination (VIBE) images were used for the evaluation. For MDCT, dental CT cross-sectional images were rused. The results were correlated with histopathological findings, and sensitivity and specificity of each imaging technique were calculated.DMFR prrof. Histopathologically, 32 of 41 cases had mandibular invasion and 10 cases had mandibular canal involvement. For mandibular invasion, all three imaging techniques showed sensitivities of 100%. However, the specificities of 2D FSE (56%) and 3D VIBE (78%) were lower than that of MDCT (89%), although the differences were not significant. For mandibular canal involvement, whereas the sensitivities of all three imaging techniques were 100%, the specificities of 2D FSE, 3D VIBE and MDCT were 54, 62 and 85%, respectively. The specificity of 2D FSE was significantlylower than that of MDCT (P < 0.017). In the evaluation of mandibular invasion, 3T MRI was not as accurate as MDCT. In particular, 2D FSE sequences showed significantly lower specificity than MDCT in evaluating the extent of mandibular invasion. The use of 3D VIBE sequence slightly improved the low specificity of 2D FSE sequences.

Efficacy of 3D VIBE Dixon fat quantification for differentiating clear-cell from non-clear-cell renal cell carcinoma

To assess the efficacy of three-dimensional (3D) volumetric interpolated breath-hold examination (VIBE) magnetic resonance imaging (MRI) with Dixon quantification for differentiating clear-cell from non-clear-cell types of renal cell carcinoma (RCC). The 3D VIBE Dixon renal MRI examinations of 44 patients with 45 histologically confirmed RCCs was analysed. The fat fractions and signal intensity indexes (SIindex) of the solid portions of clear-cell and non-clear-cell RCCs were measured and compared using Student's t-test and receiver operating characteristic (ROC) curves. The agreement of measurements among observers was evaluated by the intraclass correlation coefficient (ICC), and Bland-Altman plots. The mean values of fat fraction (13.16±7.16%) and SIindex (22.64±15.7%) in clear-cell RCCs were significantly higher than that in non-clear-cell RCCs (7.7±2% and 7.9±4.8%; p<0.001, respectively). With the area under the ROC curve (AUC) of the fat fraction at 0.811, 75% (95% CI: 55.1-89.43%) sensitivity and 76.5% (95% CI: 50.1-93.2%) specificity for diagnosing clear-cell RCC were obtained at a cut-off fat fraction value of 8.9%. With a cut-off value of 8.89%, the diagnostic sensitivity and specificity were 85.7% (95% CI: 67.3-96%) and 70.6% (95% CI: 44-89.7%), respectively. The AUC of the SIindex was 0.870 (0.766-0.973). ICC and Bland-Altman plots show excellent agreement of the tumour fat fraction and SIindex measurement between the two observers. Intracellular lipid content analysis using the 3D Dixon technique can help to differentiate clear-cell from non-clear-cell RCCs.

Anatomy, variants, and pathologies of the superior glenohumeral ligament: magnetic resonance imaging with three-dimensional volumetric interpolated breath-hold examination sequence and conventional magnetic resonance arthrography.

The purpose of this review was to demonstrate magnetic resonance (MR) arthrography findings of anatomy, variants, and pathologic conditions of the superior glenohumeral ligament (SGHL). This review also demonstrates the applicability of a new MR arthrography sequence in the anterosuperior portion of the glenohumeral joint. The SGHL is a very important anatomical structure in the rotator interval that is responsible for stabilizing the long head of the biceps tendon. Therefore, a torn SGHL can result in pain and instability. Observation of the SGHL is difficult when using conventional MR imaging, because the ligament may be poorly visualized. Shoulder MR arthrography is the most accurately established imaging technique for identifying pathologies of the SGHL and associated structures. The use of three dimensional (3D) volumetric interpolated breath-hold examination (VIBE) sequences produces thinner image slices and enables a higher in-plane resolution than conventional MR arthrography sequences. Therefore, shoulder MR arthrography using 3D VIBE sequences may contribute to evaluating of the smaller intraarticular structures such as the SGHL.

Validity of gradient-echo three-dimensional delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage: A histologically controlled study

ObjectiveTo validate gradient-echo three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) by means of histological analyses in the assessment of hip joint cartilage. Materials and methodsTwenty-one femoral head specimens collected from 21 patients (7 males, 14 females, mean age: 60.9±9.6 years; range: 37.6–77.3 years), who underwent total hip replacement for symptomatic hip joint osteoarthritis, underwent MRI and histological assessment. A region of 2cm2 at the weight-bearing area was marked with four pins to enable multi-planar MRI reformatting to be matched with histological sections. MRI was performed at 3T with a 3D double-echo steady-state (DESS) sequence for morphological cartilage assessment and 3D Volumetric Interpolated Breathhold Examination (VIBE) for T1Gd mapping. Histological sections were evaluated according to the Mankin score system. Total Mankin score, grade of toluidine staining (sensitive for glycosaminoglycan content) and a modified Mankin score classification system with four sub-groups of cartilage damage were correlated with MRI data. ResultsSpearman's rho correlation analyses revealed a statistically significant correlation between T1Gd mapping and histological analyses in all categories including total Mankin score (r=−0.658, p-value≤0.001), toluidine staining (r=−0.802, p-value<0.001) and modified Mankin score (r=−0.716, p-value<0.001). The correlation between morphological MRI and histological cartilage assessment was statistically significant but inferior to the biochemical cartilage MRI (r-values ranging from −0.411 to 0.525, p-values<0.001). ConclusionsGradient-echo dGEMRIC is reliable while offering the unique features of high image resolution and 3D biochemically sensitive MRI for the assessment of early cartilage degeneration.

Glenoid bone lesions: Comparison between 3D VIBE images in MR arthrography and nonarthrographic MSCT

To evaluate the feasibility of using a fat-suppressed 3D volumetric interpolated breath-hold examination (VIBE) sequence in magnetic resonance (MR) arthrography as a substitute for nonarthrographic multislice computed tomography (MSCT) in detecting glenoid bone lesions. Fat-suppressed 3D VIBE MR arthrography and MSCT were performed in 56 patients (46 male, 10 female; age range, 14-51 years; mean age, 26 years). Based on the results of MSCT, the sensitivity and specificity of fat-suppressed 3D VIBE images for detection of bony Bankart lesion and glenoid bone loss were determined. Statistical significance of the percentages of glenoid bone loss between these two methods was calculated. Bony Bankart lesions were noted in 23 (41.1%) of 56 glenohumeral joints, and glenoid bone loss was found in 40 (71.4%) of 56 patients at nonarthrographic MSCT. Compared with MSCT, the sensitivity and specificity of fat-suppressed 3D VIBE images in detecting bony Bankart lesions were 95.7%-100% and 93.9%-97.0%, respectively (kappa value = 0.926), and those in predicting glenoid bone loss were 95.0% and 93.8%, respectively. For quantification of glenoid bone loss, there was a high correlation between fat-suppressed 3D VIBE and MSCT (r = 0.921, P < 0.001). Fat-suppressed 3D VIBE MR arthrography is a promising substitute for MSCT as a reliable method for evaluating bony Bankart lesion and glenoid bone loss.

Fat-Suppressed 3D T1-Weighted Gradient-Echo Imaging of the Cartilage With a Volumetric Interpolated Breath-Hold Examination

The purpose of our study was to evaluate the feasibility of using fat-suppressed 3D volumetric interpolated breath-hold examination (VIBE) as a substitute for fat-suppressed 3D FLASH in cartilage MRI. Fat-suppressed 3D VIBE and fat-suppressed 3D FLASH were prospectively performed in 82 patients. The acquisition time of these two sequences were 2 minutes 42 seconds and 3 minutes 53 seconds, respectively. Quantitative comparisons were made by calculating signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and qualitative comparisons were made on the basis of two subjective scoring systems evaluating image artifacts and cartilage conspicuousness. In addition, in a subgroup of the 43 patients who underwent arthroscopy with cartilage grading, sensitivity and specificity of these two sequences for cartilage lesions were determined in comparison. Fat-suppressed 3D VIBE provided significantly higher cartilage SNR, cartilage-to-synovial fluid CNR, cartilage-to-meniscus CNR, and cartilage-to-bone marrow CNR than fat-suppressed 3D FLASH. Significantly less pulsation artifact and more severe truncation artifact were seen with fat-suppressed 3D VIBE. Deep cartilage surface conspicuousness in fat-suppressed 3D VIBE was better than that in fat-suppressed 3D FLASH, but superficial conspicuousness was relatively worse. In the patients who underwent arthroscopy, sensitivity and specificity for detecting cartilage lesions of grade 2 or higher were comparable for both sequences, with fat-suppressed 3D VIBE at 78.3% and 97.8% and fat-suppressed 3D FLASH at 79.7% and 97.5%, respectively. Fat-suppressed 3D VIBE is a promising substitute for fat-suppressed 3D FLASH as a more effective T1-weighted sequence in cartilage imaging.

Whole-Body MRI for Metastases Screening: A Preliminary Study Using 3D VIBE Sequences With Automatic Subtraction Between Noncontrast and Contrast Enhanced Images

To evaluate 3D Volumetric Interpolated Breath-hold Examination (VIBE) whole-body MRI (WB-MRI) acquisition for the metastases staging. Thirty-two consecutive patients with solid tumor were examined from head to feet before and after contrast injection. An automatic subtraction occurred between the 2 series of images. WB-MRI was compared with conventional staging techniques (CT, scintigraphy, brain MRI, and whole-body PET in 4 cases). WB-MRI and the reference techniques depicted metastases in 25 patients. WB-MRI depicted more bone lesions in the spine, pelvis, skull, femur, and tibia, whereas scintigraphy detected more rib lesions. WB-MRI depicted 27 cerebral metastases, whereas brain MRI depicted 40 cerebral metastases. WB-MRI depicted a total of 8 hepatic metastases, 8 adrenal lesions, and conventional staging 7 hepatic metastases and 10 adrenal lesions. WB-MRI examination depicted lung metastases in 10 patients, and CT examination in 13 patients. The results of this study indicate that WB-MRI is a feasible and promising technique for tumor staging.

Contrast-Enhanced Three-Dimensional MR Imaging Using a Volumetric Interpolated Breath-hold Examination (VIBE): Clinical Utility in the Evaluation of Renal Tumors

Purpose: To compare, in terms of technical feasibility, image quality and clinical efficacy, contrast-enhanced three-dimensional (3D) MR imaging using volumetric interpolated breath-hold examination (VIBE) with twodimensional gradient-echo MR imaging for the evaluation of renal masses. Materials and Methods: Twenty-three patients with 25 renal masses underwent dynamic MR imaging using a 1.5-T MR system and the 3D VIBE, 2D fast low angle shot (FLASH), and combined fat saturation techniques after the injection of 20 ml of Gd-DTPA. We compared postcontrast 2D FLASH and 3D VIBE images with precontrast 2D FLASH images. For quantitative analysis, the signal-to-noise and lesion to kidney contrast-to-noise ratio of the images were calculated using the three different techniques. For qualitative analysis, two experienced radiologists analyzed the images in terms of artifacts, lesion conspicuity and delineation, and general image quality. Delineation of the anatomy of renal vasculature and pelvocalyceal systems on reconstructed 3D VIBE MIP images was also assessed. Results: Quantitative analysis showed that the SNR of a renal mass was slightly higher at postcontrast 2D FLASH than at 3D VIBE imaging, and the SNR of renal cortex was higher at 3D VIBE than at postcontrast 2D FLASH imaging. The differences were, though, statistically insignificant (p>0.05). The CNR of a renal mass was, however, significantly higher at 3D VIBE than at 2D FLASH imaging (p