T2 FSE Research Articles

Osseous cyst‐like lesions in an unusual location in the equine distal phalanx

SummaryOsseous cyst‐like lesions (OCLLs) of the distal phalanx commonly occur around midline. The dorsopalmar location can be challenging to identify radiographically; however, advanced imaging has shown they are typically located in the central and palmar thirds of the bone. This study reports unusually located OCLLs in the dorsal, axial aspect of the palmar processes of the distal phalanx in three horses, with communication with the distal interphalangeal (DIP) joint confirmed by contrast arthrography in two horses. All horses were lame and had lameness localised to the distal limb with diagnostic anaesthesia. A rounded radiolucency with a surrounding rim of increased opacity was identified in the dorsal aspect of a palmar process on radiographs, with the palmaroproximal–palmarodistal oblique (PaPrPaDiO) view being most useful. On magnetic resonance imaging (MRI), the lesions were seen as hyperintense structure on T2*, T2 FSE and STIR sequences; a thin rim of intermediate signal surrounding a low signal centre was seen on T1 images. A rim of low T1/T2 FSE signal was seen in the surrounding bone in all cases, consistent with sclerosis, and mildly increased STIR signal was present in the surrounding trabecular bone in two cases. Two horses underwent standing cone‐beam computed tomography (CT) examination of the affected foot, revealing a well‐defined hypoattenuating region within the dorsal, axial aspect of the palmar process of the distal phalanx, with surrounding rim of increased attenuation. Contrast arthrography was performed in two cases, one using radiographs and the other CT, and confirmed communication of the cystic lesion with the DIP joint in both cases. Although advanced imaging provided further information and allowed other possible causes of lameness to be identified, careful assessment of radiographs allowed these unusually located OCLLs to be identified in all cases.

Influence of diffusion weighted imaging and contrast enhanced T1 sequences on the diagnostic accuracy of magnetic resonance enterography for Crohn’s disease

ObjectivesTo evaluate the additional diagnostic benefit of diffusion weighted imaging (DWI) and contrast enhanced (CE) images during MR enterography (MRE) of Crohn’s disease. MethodsDatasets from 73 patients (mean age 32; 40 male) (28 new-diagnosis, 45 relapsed) were read independently by two radiologists selected from a pool of 13. Radiologists interpreted datasets using three sequential sequence blocks: (1) T2 weighted and steady state free precession gradient echo (SSFP) images alone (T2^); (2) T2 weighted and SSFP images with DWI (T2 + DWI^) and; (3) T2 weighted images, SSFP, DWI and post-contrast enhanced (CE) T1 images (T2 + DWI + CE^), documenting presence, location, and activity of small bowel disease. For each sequence block, sensitivity and specificity (readers combined) was calculated against an outcome-based construct reference standard. Results59/73 patients had small bowel disease. Per-patient sensitivity for disease detection was essentially identical (80 % [95 % CI 72, 86], 81 % [73,87], and 79 % [71,86] for T2^, T2 + DWI^and T2 + DWI + CE^respectively). Specificity was identical (82 % [64 to 92]). Per patient sensitivity for disease extent was 56 % (47,65), 56 % (47,65) and 52 % (43 to 61) respectively, and specificity was 82 % (64 to 92) for all blocks. Sensitivity for active disease was 97 % (90,99), 97 % (90,99) and 98 % (92,99), and specificity was also comparable between all sequence combination reads. Results were consistent across segments and newly diagnosed/relapse patients. ConclusionThere is no additional diagnostic benefit of adding either DWI or CE to T2 FSE and SSFP sequences for evaluating small bowel Crohn’s disease, suggesting MRE protocols can be simplified safely.

Development and Preliminary Validation of a Novel Convolutional Neural Network Model for Predicting Treatment Response in Patients with Unresectable Hepatocellular Carcinoma Receiving Hepatic Arterial Infusion Chemotherapy.

The goal of this study was to evaluate the performance of a convolutional neural network (CNN) with preoperative MRI and clinical factors in predicting the treatment response of unresectable hepatocellular carcinoma (HCC) patients receiving hepatic arterial infusion chemotherapy (HAIC). A total of 191 patients with unresectable HCC who underwent HAIC in our hospital between May 2019 and March 2022 were retrospectively recruited. We selected InceptionV4 from three representative CNN models, AlexNet, ResNet, and InceptionV4, according to the cross-entropy loss (CEL). We subsequently developed InceptionV4 to fuse the information from qualified pretreatment MRI data and patient clinical factors. Radiomic information was evaluated based on several constant sequences, including enhanced T1-weighted sequences (with arterial, portal, and delayed phases), T2 FSE sequences, and dual-echo sequences. The performance of InceptionV4 was cross-validated in the training cohort (n = 127) and internally validated in an independent cohort (n = 64), with comparisons against single important clinical factors and radiologists in terms of receiver operating characteristic (ROC) curves. Class activation mapping was used to visualize the InceptionV4 model. The InceptionV4 model achieved an AUC of 0.871 (95% confidence interval [CI] 0.761-0.981) in the cross-validation cohort and an AUC of 0.826 (95% CI 0.682-0.970) in the internal validation cohort; these two models performed better than did the other methods (AUC ranges 0.783-0.873 and 0.708-0.806 for cross- and internal validations, respectively; P < 0.01). The present InceptionV4 model, which integrates radiomic information and clinical factors, helps predict the treatment response of unresectable HCC patients receiving HAIC treatment.

Radiomics of fetal magnetic resonance imaging in congenital diaphragmatic hernia

Objectives. Analysis of possibilities of radiomics as a source of additional diagnostic information about the structural maturity of the lungsMaterials and methods. A retrospective study included 72 pregnant women: 35 with congenital fetal diaphragmatic hernia (group 1) and 37 without fetal lung pathology (group 2). Frontal or co-frontal T2 images (T2 FSE) were obtained. Segmentation of regions of interest at the fetal lung level was performed manually with ITK-Snap. A total of 107 radiomic features were extracted using pyradiomics. The statistical analysis was performed using the STATISTICA 10 statistical analysis package (USA) to detect correlation between trait values and the target variable (presence of lung pathology in CDH), and to show differences in the comparison groups according to the detected parameters.Results. Statistically significant features were identified for 2D and 3D segmentations (p &lt; 0.05). For 2D and 3D segmentations, the number of significant features was 14 and 73, respectively. After exclusion of features with cross-correlations, their number decreased to 6 and 8 for single slices and 3D images, respectively. Correlation coefficients between the features and the presence of lung pathology were also calculated. In the case of 3D images, the number of features with significant correlation coefficients (r &gt; 0.4, p &lt; 0.05) equaled 20, while for single-slice images this number was 3.Conclusion. The data obtained allow to conclude that it is reasonable to use texture analysis of the 3D MRI images as a source of additional diagnostic information concerning the structural maturity of the lungs.

Assessment of global and segmental strain in heterozygous APE1/Ref-1 transgenic mice using cardiac magnetic resonance imaging

Abstract Background Apurinic/apyrimidinic-endonuclease1(APE1/Ref-1) is a redox factor necessary for DNA binding and transcription regulator in ROS generation. The association between APE1/Ref-1 and heart failure(HF) has been observed in previous studies. Heterozygous APE1/Ref-1 transgenic mice displayed endothelial cell dysfunction with systemic hypertension. Global strain(GS) measures the myocardium's deformation along its axis and is known to be a sensitive marker of subclinical HF in hypertensive patients with preserved ejection fraction. Purpose This study aims to investigate the functional dynamics and GS of the heart in heterozygous APE1/Ref-1 mice to help identify the association between APE1/Ref-1 and early signs of HF and translate to clinical applications. Methods A study was conducted to assess the functional parameters of both the left ventricle(LV) and right ventricle (RV) and perform LV global and segmental strain analysis using cardiac magnetic resonance imaging(CMR) in heterozygous APE1/Ref-1 transgenic mice(n=4) and wild type mice (n=4) of age 10-12 weeks. A 7T CMR scanner and FSE T1 sequence were used to acquire short-axis views of mouse cardiac images. LV and RV functional parameters including ejection fraction(EF), stroke volume(SV), cardiac output, peak filling rate, peak emptying rate and strain indices including global circumferential strain, global radial strain, segmental circumferential strain, and segmental radial strain were calculated with a software dedicated to analyzing CMR images. Global LV and RV function was quantified both manually and using an AI-based algorithm of LV and RV segmentation. The strain analysis was performed using the strain medical image tracking toolbox module. Additionally, reproducibility testing was done to validate the accuracy of AI-driven calculations. Results We found that heterozygous APE1/Ref-1 mice displayed a decrease in SV(8.00±0.01ul vs 9.75±0.96ul, p=0.01) and LVEF(58.75±2.63% vs 66.50±2.89%, p=0.007) compared to controls while the functional parameters of RV were similar. Interestingly, the circumferential strain rate of LV was significantly reduced in APE1/Ref-1 mice compared to controls(p&amp;lt;0.001), particularly in the systolic phase. In addition, the study showed that manually-calculated and AI-derived indices were within an acceptable margin of error, rendering the AI system reproducible and reliable in calculating volumetric parameters and strain of the mice's hearts. Conclusions This study demonstrated that LV global circumferential strain rate, along with SV and LVEF decreased in heterozygous APE1/Ref-1 transgenic mice. These parameters could serve as markers for assessing early functional changes of mice hearts in a non-invasive manner. Volumetric and strain indices measured by AI-based analysis of mouse CMR images are reproducible parameters for cardiovascular research in small animals.LV strain analysis of mice CMRTable of volumetric parameters

“Bone marrow edema” in the differential diagnosis of traumatic injuries of the knee

Bone marrow edema is MR images is defined by the presence of hypointense infiltration on T1-weighted images and clear high signal intensity on fat-saturated T2-weighted sequences (T2 FSE FAT SATURATED, T2-weighted short-tau inversion recovery (T2w-STIR)).Aim: To demonstrate the features of manifestation of “bone marrow edema” at different severity and character of traumatic injury of the knee.Materials and Methods. A series of clinical cases with subchondral bone involvement in the form of “bone marrow edema” resulting from trauma is presented using the example of the knee joint as the most common area of MRI for differential diagnosis.Results. The features of “marrow edema” of the femoral and tibial condyles were analyzed using clinical examples. It was shown that the severity and nature of injury can be judged by the nature of the edema, presence of linear hypointensities, articular surface deforms and the bone defects.Conclusion. Evaluation of “bone marrow edema” revealed on MRI examination in case of pain syndrome after a knee joint injury allows timely clarification of the diagnosis and adequate treatment.

Peran Sequence Paracoronal T2FSE Pada Informasi Citra Magnetic Resonance Imaging (MRI) Pelvis Pada Kasus Fistula

The Role Of The T2FSE Paracoronal Sequence On Pelvic Magnetic Resonance Imaging (MRI) Image Information In Fistula Pelvic MRI is the most ideal part to be examined using Magnetic Resonance Imaging because it is very suitable for detecting abnormalities in the pelvis which most of the organs consist of soft tissue can be seen using MRI techniques . A fistula is an abnormal connection between two epithelial sites. A fistula is one that connects the anus with the skin around the anus or with other organs such as the vagina. One or more fistula bones are visible on the surface of the skin, which can become pus or feces during bowel movements. This study aims to determine the role of pelvic MRI examination with clinical fistula and to find out paracoronal sequence information can establish the clinical diagnosis of fistula. This study uses qualitative descriptive with a case study approach, the subject consists of one patient who will indeed perform a pelvic MRI examination with clinical fistula, the subject is carried out a 1.5 Tesla MRI examination to find out the sequence and procedure and sequence information used. The results of the study were obtained according to theory using sagittal sequences SE / FSE T2, axial SE / FSE T2, axial SE / FSE T1, coronal SE / FSE T2, and coronal GRE / SE / FSE T1, while in the field using sequences axial T2, axial Fat Sat, coronal T1, coronal T2, coronal T2 Fat Sat, sagittal T1 and sagittal T2 Fat Sat.

Penatalaksanaan Pemeriksaan MRI Cervical Pada Kasus Syringomyelia Pada Medulla Spinalis Di Rumah Sakit Primaya Tangerang

Management of Cervical MRI Examination in Cases of Syringomyelia in the Spinal Medulla at Primaya Hospital Tangerang. Magnetic Resonance Imaging (MRI) is a state-of-the-art diagnostic tool for examining and detecting the body using a large magnetic field and radio frequency waves, without the use of X-rays or radioactive materials, which produces cross-sectional images of the human body/organs using a magnetic field. strength between 0.064 – 1.5 tesla (1 tesla = 1000 Gauss) and vibrational resonance of the hydrogen atom nucleus. MRI can produce images of the vertebral column, spinal cord, and also the CSF. The MRI screening procedure is ideal for the differential diagnosis of structural disorders that can affect the spinal roots and spinal cord. This examination is used in carrying out a vertebral examination at once, namely scanning starting directly from the cervical vertebrae and also up to the sacrum. So this examination can directly diagnose the cervical, thoracic, lumbar, sacral vertebrae and also includes the coccyx. The purpose of this study was to determine the management of cervical MRI examination with clinical syringomyelia. This research is descriptive qualitative with a case study approach. The subject is a patient with clinical syringomyelia. All subjects underwent Cervical MRI examination at 1.5 tesla to find out the sequence and procedure and sequence information used. From the research results obtained according to the theory using T1-weighted imaging with administration of contrast agent. While in the field using the cervical MRI protocol without contrast, it is sufficient to establish a diagnosis using an examination procedure with a localizer sequence design, sagittal T1, Axial T1 FSE, Axial T2, Axial 2D marge, sagittal T2 fat sat, Axial T2 thoracic 2-3, myelo 2D. The T2 fat sat sagittal sequence section makes it possible to see the anatomy, namely syringomyelia.

Field strength difference in extent of artifacts induced by CERTAS Plus valves in patients with idiopathic normal pressure hydrocephalus.

: Post-shunt MRI is usually performed at 1.5T under the general assumption that shunt-related susceptibility artifacts would be greater at higher field strengths. The purpose is to show that imaging post-shunt idiopathic normal pressure hydrocephalus (iNPH) patients at 3T is feasible and with reduced artifacts as compared to 1.5T. We manually measured transverse dimensions of artifact at the levels of lateral ventricles, cerebral aqueduct, and cerebellar hemisphere. Areas/volumes of artifacts were calculated assuming an elliptic/ellipsoid shape. Relative extent of shunt-related artifact between field strengths was rated by 3 readers on a 5-point Likert scale. A Wilcoxon Signed Rank Test was used to compare artifact at 1.5T vs 3T for each sequence, with a significance level set at p < 0.05. Artifact areas were calculated in 22 iNPH patients; artifacts were on average smaller at 3T vs 1.5T on MPRAGE, DWI, and GRE sequences. On T2 FLAIR and T2 FSE, artifacts at 3T were larger than 1.5T. On the qualitative analysis, artifact effects were less at 3T vs 1.5T on DWI, greater at 3T on T2 FSE, and had mixed results on GRE. Our results indicate feasibility of post-shunt imaging with the CERTAS Plus valve at 3T based on shunt-related artifact that is less than or equal in extent to that on 1.5T on most standard clinical imaging sequences. Our findings, corroborated by the qualitative image review, suggest that dedicated clinical imaging sequences for devices may allow for reduction in artifact extent at both 1.5T and 3T.

Diagnostic Utility of 3D Gradient-Echo MR Imaging Sequences through the Filum Compared with Spin-Echo T1 in Children with Concern for Tethered Cord.

Fatty intrathecal lesions are a cause of tethered cord, and detection of these on spinal MR imaging is paramount. Conventional T1 FSE sequences are the mainstay of detecting fatty elements; however, 3D gradient-echo MR images, volumetric interpolated breath-hold examination/liver acquisition with volume acceleration (VIBE/LAVA), are popular, given the increased motion resistance. We sought to evaluate the diagnostic accuracy of VIBE/LAVA compared with T1 FSE for detection of fatty intrathecal lesions. In this retrospective, institutional review board-approved study, 479 consecutive pediatric spine MRIs obtained to evaluate cord tethering between January 2016 and April 2022 were reviewed. Inclusion criteria were patients who were 20 years of age or younger who underwent spine MRIs containing both axial T1 FSE and VIBE/LAVA sequences of the lumbar spine. The presence or absence of fatty intrathecal lesions was recorded for each sequence. If fatty intrathecal lesions were present, anterior-posterior and transverse dimensions were recorded. VIBE/LAVA and T1 FSE sequences were evaluated on 2 separate occasions (VIBE/LAVAs first followed by T1 FSE several weeks later) to minimize bias. Basic descriptive statistics compared fatty intrathecal lesion sizes on T1 FSEs and VIBE/LAVAs. Receiver operating characteristic curves were used to determine minimal fatty intrathecal lesion size detectable by VIBE/LAVA. Sixty-six patients were included, with 22 having fatty intrathecal lesions (mean age, 7.2 years). T1 FSE sequences revealed fatty intrathecal lesions in 21/22 cases (95%); however, fatty intrathecal lesions on VIBE/LAVA were detected in 12/22 patients (55%). Mean anterior-posterior and transverse dimensions of fatty intrathecal lesions measured larger on T1 FSE compared with VIBE/LAVA sequences (5.4 × 5.0 mm versus 1.5 × 1.6 mm, respectively; P values = .039 anterior-posterior; .027 transverse). While T1 3D gradient-echo MR images may have decreased the acquisition time and are more motion-resistant than conventional T1 FSE sequences, they are less sensitive and may miss small fatty intrathecal lesions.

Enhancement in the Round Window Niche: A Potential Pitfall in High-Resolution MR Imaging of the Internal Auditory Canal.

There is limited discussion in current literature about the normal imaging appearance of the round window. The purpose of this study was to assess the prevalence and imaging characteristics of gadolinium enhancement in the round window niche on MR imaging to the internal auditory canal. The presence or absence and laterality of enhancement in the round window niche on MR imaging was retrospectively reviewed in 95 patients from 1 institution. All studies included high-resolution (≤0.5-mm section thickness) pre- and postgadolinium 3D FSE T1 with fat-saturation and postgadolinium 3D FLAIR image sequences. T1 and T2 acquisitions were viewed as coregistered overlays to confirm that enhancement was lateral to the round window membrane within the round window niche. CT was reviewed when available to assess the presence and laterality of soft tissue in the round window niche. Ninety-five patients with internal auditory canal MRIs were included. Enhancement was present in the round window of 15 of 95 patients (15.8%). Of the 27 patients who underwent CT, 4 (14.8%) had concordant soft tissue on CT and MR imaging enhancement in the round window niche. One patient had MR imaging enhancement within the round window niche without a corresponding abnormality on CT. The absence of soft tissue on CT and the corresponding lack of MR imaging enhancement were present in 22 (81.5%) patients. Enhancement can be visualized within the round window niche on MR imaging as an incidental finding. This enhancement probably represents postinflammatory granulation tissue and does not require further intervention. However, the potential for this enhancement to be misdiagnosed as a pathologic process can be a pitfall in MR imaging.

Combination T2 multiple echo data imaging and fast spin echo fat saturation technique to improve image quality on ankle magnetic resonance imaging

Objective: To determine the effect of the T2 Fast Spin Echo Fat Saturation (T2 FSE FAT SAT) sequence and T2 Multiple Echo Data Imaging Combination (T2 MEDIC) sequence on ankle images MRI. Methodology: The sequence variations were T2 FSE FAT SAT and T2 MEDIC. The effect of the sequence on the quality of the MRI ankle image was analyzed on the image of one patient and the sound intensity value through a sound level meter. Result: Data analysis was carried out quantitatively with the Region of Interest (ROI) method directly on the computer image of the MRI, then SNR (Signal to Noise Ratio) and CNR (Contras to Noise Ratio) analysis were carried out, and PSNR and MSE analysis was carried out through digital image processing to determine the value magnitudes. The highest SNR and CNR were found in the T2 MEDIC sequence. The lowest acoustic noise value is in the T2 MEDIC sequence. The differences in the physical mechanism of image formation are T2 FSE FAT SAT refocusing 180º RF and T2 MEDIC refocusing gradient fields. Conclusion: Because the SNR and CNR on T2 MEDIC are higher and the value of the sound intensity level is low, it can be said that the sequence provides optimal results and low acoustic noise.

MENISCAL EXTRUSION IN ASYMPTOMATIC KNEES: THE 3MM CUTOFF MUST BE REVISITED

Meniscal extrusion is frequently encountered in OA, and an arbitrary cutoff value of 3 mm is commonly accepted for a significant extrusion of the body of the medial meniscus (MM). Different methods of measurement have also been described. We aim to provide the normal range of MM extrusion in different zones in asymptomatic volunteers without radiographic and/or MRI OA and to compare different measurement methods on coronal and sagittal 2D images to those performed on 3D images in radial planes. This is a post-hoc analysis of knee MRIs of 93 participants (39.6±16.0 years; mean ± SD) with asymptomatic, healthy knees (KOOS score 97.42±3.22 and WOMAC score 97.41±7.54) from the Lausanne Knee Study. Inclusion criteria: age between 18-35 or 45-70 years, no knee symptoms in the past 12 months, no history of severe lower limb injury, no impairment that might affect gait, BMI≤30. Imaging protocol included weight-bearing Schuss and lateral radiographs of both knees and 3T MRI of a randomly selected knee. MRI protocol included 2D fat-suppressed FSE IW images (sagittal, coronal, and transverse planes), isotropic 3D DESS, and high-resolution 3D T1. One radiologist measured the maximal extrusion of the MM in the radial plane using 3D FSE T1 images in 4 anatomical subregions: zones II-a (anterior), II-b (anteromedial), III (medial), and IV (posterior). Measurements were also performed on coronal and sagittal 2D images using two different methods: on the image where the maximal extrusion was seen (methodMax) and on an image selected based on anatomical landmarks (methodLandmark). Another musculoskeletal radiologist graded knee MRIs for all structural lesions included in the MOAKS criteria. In addition, meniscal extrusion was measured in the sagittal and radial planes to assess interobserver agreement. Measurements on 2D images were compared to those on the radial plane, considered as the reference, using the Bland and Altman method. Sixty-one (65.5%) participants (41.4±16.6 years) who did not have either radiographic OA (KL<2) or MRI-OA (Hunter 2011 criteria) were used to provide the normal range of meniscal extrusion. Among the 61 participants without radiographic or MRI OA, the mean extrusion of MM was 2.39mm±1.41 (zone II-a), 3mm±0.85 (zone II-b), 2.4mm±0.81 (zone III), and 0.3mm±0.9 (zone IV). The 95th percentile of the reference interval for meniscal extrusion in the radial plane was 4.7mm for zone II-a, 4.4mm (zone II-b), 3.7mm (zone III), and 2mm (zone IV). By applying a cutoff value of >3mm for significant meniscal extrusion on measurements in the radial plane, 28/61 (46%) would have been categorized as having extrusion in zone II-b and 12/61 (20%) in zone III. In the coronal plane, 13/61 (21%) or 18/61 (30%) would have been categorized as having meniscal extrusion depending on whether measurements were performed using methodLandmark, or methodMax respectively. In both sagittal and coronal planes, methodMax overestimated meniscal extrusion (95%CI for systematic bias=0.5, 1 in the sagittal plan, 0.1, 0.3 in the coronal plane), while there was no systematic bias for methodLandmark. The width of limits of agreement was similar in both planes and for both methods. Interobserver agreement was moderate for measurements in the radial (ICC=0.67) and sagittal (0.68) plane. This study provided the normal range of meniscal extrusion in asymptomatic knees without radiographic/MRI OA. Applying a 3mm cutoff value for the diagnosis of significant meniscal extrusion would carry a risk to categorize normal menisci as being extruded. Methods of measurement based on anatomical landmarks correlated better with measurements in the radial plane. This work was supported by the Swiss National Science Foundation, Switzerland (SNSF Grant #CRSII5_177155). None to declare. CORRESPONDENCE ADDRESS: [email protected]

Detection of erosions and fat metaplasia of the sacroiliac joints in patients with suspected sacroiliitis using a chemical shift-encoded sequence (IDEAL-IQ)

PurposeTo evaluate the performance of a chemical shift-encoded sequence called IDEAL-IQ for detecting sacroiliac joint (SIJ) erosions and fat metaplasia compared to T1-weighted fast spin echo (T1 FSE) using qualitative and quantitative analysis. MethodThirty-four patients with suspicion of sacroiliitis who underwent both MRI and CT were included. Each SIJ was divided into four quadrants for analysis. For qualitative analysis, the diagnostic performance of IDEAL-IQ and T1 FSE for erosions were compared by the McNemar test, using CT as the gold standard. Cochran’s Q and McNemar tests were used to determine differences in structural changes detected by different imaging methods. For quantitative analysis, two-sample t test and receiver operating characteristic (ROC) analysis were used for the analysis of histogram parameters of proton density fat fraction (PDFF). ResultsDiagnostic sensitivity and accuracy of IDEAL-IQ were greater than T1 FSE for erosions (all P < 0.05). IDEAL-IQ and CT detected more erosions than T1 FSE (all P < 0.05). IDEAL-IQ did not statistically significantly differ from T1 FSE for the detection of fat metaplasia (P = 0.678). All histogram parameters were different between groups with and without fat metaplasia (all P < 0.05) and could distinguish the two groups (all P < 0.05). PDFF75th was the most effective histogram parameter. ConclusionIDEAL-IQ detects SIJ erosions with better accuracy than T1 FSE and is similar to T1 FSE for detection of fat metaplasia, enabling further quantitative analysis of the latter via histogram analysis.

Normal Enhancement within the Vestibular Aqueduct: An Anatomic Review with High-Resolution MRI.

The normal appearance of the vestibular aqueduct on postcontrast MR images has not been adequately described in the literature. This study set out to characterize the expected appearance of the vestibular aqueduct, with particular emphasis on the enhancement of the structure on both 3D FSE T1 and 3D-FLAIR sequences. All MR imaging examinations of the internal auditory canals performed between March 1, 2021, and May 20, 2021, were retrospectively reviewed. All studies included high-resolution (≤0.5-mm section thickness) pre- and postgadolinium 3D FSE T1 with fat-saturated and postgadolinium 3D-FLAIR sequences. Two neuroradiologists independently reviewed the MR images of the vestibular aqueduct for the presence or absence of enhancement on both T1 and FLAIR images and compared the relative intensity of enhancement between sequences. The presence or absence of an enlarged vestibular aqueduct was also noted. Ninety-five patients made up the patient cohort, of whom 5 did not have postcontrast FLAIR images available (50 women [55.6%]). On both sides, enhancement was significantly more commonly seen on postgadolinium FLAIR (76/180, 42.2%) than on T1 fat-saturated images (41/190, 21.6%) (P < .001). The intensity of enhancement was significantly greater on postgadolinium FLAIR images than on T1 fat-saturated images (38.9% versus 3.7%, respectively; P < .001). Enhancement within the vestibular aqueduct is an expected finding on MR imaging and is both more common and more intense on postgadolinium 3D-FLAIR than on T1 fat-saturated sequences. Such enhancement should not be confused with pathology on MR imaging unless other suspicious findings are present.

Abstracts from The 39th Annual Symposium of the National Neurotrauma Society, including the AANS/CNS Joint Section on Neurotrauma and Critical Care

Abstracts from The 39^th Annual Symposium of the National Neurotrauma Society, including the AANS/CNS Joint Section on Neurotrauma and Critical Care

Texture Analysis of Enhanced MRI and Pathological Slides Predicts EGFR Mutation Status in Breast Cancer.

Objective Image texture information was extracted from enhanced magnetic resonance imaging (MRI) and pathological hematoxylin and eosin- (HE-) stained images of female breast cancer patients. We established models individually, and then, we combine the two kinds of data to establish model. Through this method, we verified whether sufficient information could be obtained from enhanced MRI and pathological slides to assist in the determination of epidermal growth factor receptor (EGFR) mutation status in patients. Methods We obtained enhanced MRI data from patients with breast cancer before treatment and selected diffusion-weighted imaging (DWI), T1 fast-spin echo (T1 FSE), and T2 fast-spin echo (T2 FSE) as the data sources for extracting texture information. Imaging physicians manually outlined the 3D regions of interest (ROIs) and extracted texture features according to the gray level cooccurrence matrix (GLCM) of the images. For the HE staining images of the patients, we adopted a specific normalization algorithm to simulate the images dyed with only hematoxylin or eosin and extracted textures. We extracted texture features to predict the expression of EGFR. After evaluating the predictive power of each model, the models from the two data sources were combined for remodeling. Results For enhanced MRI data, the modeling of texture information of T1 FSE had a good predictive effect for EGFR mutation status. For pathological images, eosin-stained images can achieve a better prediction effect. We selected these two classifiers as the weak classifiers of the final model and obtained good results (training group: AUC, 0.983; 95% CI, 0.95-1.00; accuracy, 0.962; specificity, 0.936; and sensitivity, 0.979; test group: AUC, 0.983; 95% CI, 0.94-1.00; accuracy, 0.943; specificity, 1.00; and sensitivity, 0.905). Conclusion The EGFR mutation status of patients with breast cancer can be well predicted based on enhanced MRI data and pathological data. This helps hospitals that do not test the EGFR mutation status of patients with breast cancer. The technology gives clinicians more information about breast cancer, which helps them make accurate diagnoses and select suitable treatments.

Bilateral pectoralis major MRI in weightlifters: findings of the non-injured side versus age-matched asymptomatic athletes.

To evaluate magnetic resonance imaging (MRI) features of the contralateral side in weightlifting athletes with pectoralis major (PM) tears. We hypothesized that MRI of the non-injured side may present increased pectoralis major tendon (PMT) length and thickness and greater pectoralis major muscle (PMM) volume and cross-sectional area when compared with the control group. We retrospectively identified MRI cases with unilateral PM injury and reviewed imaging findings of the contralateral side. Also, we evaluated MRI from ten asymptomatic control weightlifting athletes, with PM imaging from both sides. Two musculoskeletal radiologists independently reviewed MRI and measured PMT length, PMT thickness, PMM volume (PMM-vol) and PMM cross-sectional area (PMM-CSA), as well as humeral shaft cross-sectional area (Hum-CSA) and the ratio between PMM-CSA and Hum-CSA (PMM-CSA/Hum-CSA). Data were compared between the non-injured side and controls. The MRI protocol from both groups was the same and included T1 FSE and T2 FATSAT axial, coronal, and sagittal images, one side at a time. We identified 36 male subjects with unilateral PM injury with mean age 35.7 ± 8years and 10 age- and gender-matched controls (p = 0.45). A total of 36 PM MRI with non-injured PM and 20 PM MRI studies were included in this study. PMT length and PMT thickness were significantly higher in contralateral PM injury versus control subjects (both P < 0.001). Also, PM-CSA and Hum-CSA were greater in the contralateral PM injury group (P = 0.032 and P < 0.001, respectively). PMT thickness > 2.95mm had 80.6% sensitivity and 90.0% specificity to differentiate the non-injured PM group from controls. Non-injured side MR imaging of patients with previous contralateral PM lesion demonstrates greater PMT thickness and length as well as PM-CSA and Hum-CSA than controls.

Comparison of zero echo time MRI with T1-weighted fast spin echo for the recognition of sacroiliac joint structural lesions using CT as the reference standard.

To evaluate the diagnostic performance of zero echo time (ZTE) MRI in the depiction of structural lesions of sacroiliac joints (SIJs) in patients with the suspicion of sacroiliitis compared with T1-weighted fast spin echo (T1 FSE), using CT as the reference standard. Forty patients with suspicion of sacroiliitis underwent both CT and MR scans of SIJs with 80 SIJs (160 bone articular surfaces) included for analysis. Two readers independently scored SIJs for structural lesions on CT and MR images. The diagnostic capability of ZTE MRI and T1 FSE were compared by the McNemar test, using CT as the reference standard. Agreements of diagnosis and sum scores of lesions between MR sequences and CT as well as between readers were also investigated using Cohen's κappa tests and intraclass correlation coefficients. Diagnostic accuracy of ZTE MRI was higher than that of T1 FSE for erosions, sclerosis, and joint space changes (e.g., joint space changes: 91.3% vs 75.0%). ZTE MRI also improved sensitivity for detection of erosions and sclerosis (e.g., erosions at the joint level: 98.2% vs 80.0%) as well as specificity for detection of joint space changes (93.0% vs 67.4%). ZTE MRI had more consistency with CT than T1 FSE for both diagnosis and sum scores. Inter-reader agreements were higher for CT and ZTE MRI than those for T1 FSE. ZTE MRI showed superior diagnostic performance in the depiction of SIJ structural lesions compared with routine T1-weighted MRI and had reliability comparable to CT. • ZTE MRI can provide CT-like bone contrast for the depiction of osseous structural lesions of the sacroiliac joints. • ZTE MRI showed superior diagnostic performance than conventional T1 FSE in the detection of osseous structural lesions of sacroiliitis, using CT as the reference standard. • In terms of inter-reader reliability, ZTE MRI performed comparably to CT and better than conventional T1 FSE.

Deep Learning Reconstruction Helps to Achieve Diagnostic-like Image Quality in MR Radiation Therapy of Brain

Deep Learning Reconstruction Helps to Achieve Diagnostic-like Image Quality in MR Radiation Therapy of Brain