half-Fourier Acquired Single-shot Turbo Spin-echo Research Articles

Risk Stratification for Pregnancies Diagnosed With Fetal Growth Restriction Based on Placental MRI.

Diagnosis of fetal growth restriction (FGR) entails difficulties with differentiating fetuses not fulfilling their growth potential because of pathologic conditions, such as placental insufficiency, from constitutionally small fetuses. The feasibility of placental MRI for risk stratification among pregnancies diagnosed with FGR remains unexplored. To explore quantitative MRI features useful to identify pregnancies with unfavorable outcomes and to assess the diagnostic performance of visual analysis of MRI to detect pregnancies with unfavorable outcomes, among pregnancies diagnosed with FGR. Retrospective. Thirteen pregnancies with unfavorable outcomes (preterm emergency cesarean section or intrauterine fetal death) and 11 pregnancies with favorable outcomes performed MRI at gestational weeks 21-36. A 5-T, half-Fourier-acquired single-shot turbo spin echo (HASTE), spin-echo echo-planar imaging (SE-EPI) and T2 map derived from SE-EPI. Placental size on HASTE sequences and T2 mapping-based histogram features were extracted. Three radiologists qualitatively evaluated the visibility of maternal cotyledon on HASTE and SE-EPI sequences with echo times (TEs)=60, 90, and 120 msec using 3-point Likert scales: 0, absent; 1, equivocal; and 2, present. Welch's t-test or Mann-Whitney U test for quantitative features between the favorable and unfavorable outcome groups. Areas under the receiver operating curves (AUCs) of the three readers' visual analyses to detect pregnancies with unfavorable outcomes. A P value of <0.05 was inferred as statistically significant. Placental size (major and minor axis, estimated area of placental bed, and volume of placenta) and T2 mapping-based histogram features (mean, skewness, and kurtosis) were statistically significantly different between the two groups. Visual analysis of HASTE and SE-EPI with TE=60 msec showed AUCs of 0.80-0.86 to detect pregnancies with unfavorable outcomes. Placental size, histogram features, and visual analysis of placental MRI may allow for risk stratification regarding outcomes among pregnancies diagnosed with FGR. 3 TECHNICAL EFFICACY: Stage 5.

Development of a Comprehensive Cardiac MRI Atlas of Half Fourier-Acquired Single-Shot Turbo Spin-Echo (HASTE) and 3D Balanced Steady-State Free Precession (bSSFP) Sequences Prospectively Acquired From a 1.5T MR-Linac

The 1.5 Tesla (T) Magnetic Resonance Linac (MRL) provides an innovative modality for improved cardiac imaging given its exceptional soft tissue contrast and potential application of real time, adaptive, image guided treatment. A thorough understanding of normal anatomy as seen on the MRL is required for radiotherapy to the heart, such as in treating arrhythmias, thoracic tumors, and breast tumors. To assist radiation oncologists and physicists in further developing and perfecting MRL based radiotherapy techniques, a cardiac MRL based atlas designed for radiation oncologists is necessary. This atlas could also be used for image registration to enhance future adaptive radiotherapy techniques and as a basis for developing novel protocols for treating these diseases. We sought to comprehensively characterize cardiac structures on 1.5 T MR cardiac images.5 subjects were enrolled in a prospective protocol (NCT03500081) and were imaged on the 1.5 T MRL. Images acquired included breath held Half Fourier-Acquired Single-Shot Turbo Spin-Echo (HASTE) in axial, sagittal, coronal, short axis, and vertical long axis and free-breathing 3D radial stack of stars balanced steady-state free precession (3D bSSFP). These images were then uploaded in commercially available software where cardiac anatomy was contoured, labeled, and confirmed by a licensed cardiologist (JR). Contours of basic cardiac anatomy, the electrical conduction system, cardiac imaging principles, and explanations of the cardiac planes were also created to better prepare clinicians for treating arrhythmias with radiation.A total of 5 subjects had images acquired with the HASTE sequence, and 1 patient with 4D vane in the cardiac planes. A total of 20 contours were created on each image set for each patient. Contours generated (with respective median volume in cubic centimeters in parentheses) included Left ventricle (LV wall + LV interior) (271.95), Left atrium (84.52), Right ventricle (117.06), Right atrium (80.38), Interventricular septum (39.09), Atrial septum (5.77), Atrioventricular septum (11.13), Tricuspid valve (0.16), Inferior vena cava (13.72), Superior vena cava (14.76), Aorta (126.93), Pulmonary trunk (36.4), Left pulmonary artery (15.76), Right pulmonary artery (24.13), Trachea (4.11), Esophagus (25.78), Right main bronchus (2.38), Left main bronchus (2.22), Tricuspid valve (0.16), and Mitral valve (0.21).We present a comprehensive cardiac atlas using novel images acquired prospectively on a 1.5 T MRL. This cardiac atlas will provide an excellent resource for radiation oncologists in delineating cardiac structures for radiotherapy planning and delivery, with a special focus on providing background information and relevant anatomy essential for treating nearby tumors and refractory arrhythmias using 1.5 T MR guidance.

MRI of middle ear cholesteatoma: The importance of observer reliance from diffusion sequences.

Diffusion-weighted imaging(DWI) in MRI has been developed as an important tool for the detection of cholesteatoma. Various DWI sequences are available. This study aims to evaluate the importance of the observer's reliance level for the detection of cholesteatoma. Forty patients meeting the following criteria were included in the study: (1) chronic otitis media, (2) preoperative MRI including various DWI sequences, and (3) middle-ear surgery. The MRI protocol contained the following sequences: (1) axial and (2) coronal echoplanar imaging (EPI) readout-segmented (RESOLVE) DWI with Trace acquisition and (3) coronal non-EPI half-Fourier acquired single-shot turbo spin-echo (HASTE) DWI. Cholesteatoma diagnosis was based on standard diagnostic criteria for cholesteatoma with DWI. Additionally, the radiologists were asked to grade personal reliance on their diagnosis using a Likert-type scale from 1 = very insecure to 5 = very secure. Axial and coronal RESOLVE DWI showed a sensitivity of 77.3% and a specificity of 72.2%, respectively. The mean reliance was 3.9 for axial and 3.8 for coronal images. HASTE DWI had a sensitivity/specificity of 81.8%/66.7% with the highest reliance of all evaluated sequences (4.4). Cases with a reliance level of 5 showed a sensitivity/specificity of 100% in all sequences. A reliance level of 5 was given in the axial and coronal RESOLVE DWI in 32.5% of cases and in the HASTE DWI in 57.5%. The evaluated DWI sequences showed comparable results. The reliance level significantly improved the predictor of cholesteatoma disease with MRI techniques.

Retrobulbar Optic Nerve Diameter Measured by High-Speed Magnetic Resonance Imaging as a Biomarker for Axonal Loss in Glaucomatous Optic Atrophy

To assess a novel magnetic resonance imaging (MRI) protocol for quantifying the optic nerve diameter (OND) as a measure of axonal loss in the optic nerve. Included in the study was one eye each from 47 subjects, of whom 9 had no eye disease, 16 had preperimetric glaucoma, 11 had a glaucomatous mean visual field defect of <10 dB and 11 of >10 dB. Each subject underwent automated perimetry, scanning laser polarimetry, optic coherence tomography, scanning laser tomography, and ultrafast high-resolution MRI at 3 T. OND was determined 5, 10, and 15 mm behind the eye with a half Fourier-acquired single-shot turbo spin-echo (HASTE)-sequence requiring 1.5 seconds of data acquisition time per slice and providing a spatial resolution of 0.11 mm. A multiple linear regression model was applied to determine correlations (r) among the different techniques. The correlation (r) was <0.37 for OND measurements taken 5 mm behind the eye. At 10 mm behind the eye, r increased to 0.57 and was statistically significant in four out six instances. In the orbital apex 15 mm behind the eye, r reached a maximum of 0.80 and was statistically significant in all instances. OND correlated best with the retinal nerve fiber layer thickness measured by optic coherence tomography. Retina- or optic nerve head-related surrogate markers for axonal content correlated closely with the OND, although only when it was measured in the orbital apex. High-resolution MRI using an ultrafast HASTE-sequence at 3 T proved useful for OND quantification and may be a valuable asset in future neuroprotection trials.

Diffusion-weighted imaging (DWI) in MR mammography (MRM): clinical comparison of echo planar imaging (EPI) and half-Fourier single-shot turbo spin echo (HASTE) diffusion techniques

Diffusion-weighted imaging (DWI) techniques have shown potential to differentiate between benign and malignant neoplasms. However, the diagnostic significance of using DWI under routine conditions remains unclear. This study investigated the use of echo planar imaging (EPI) and half-Fourier acquired single-shot turbo spin echo (HASTE)-DWI with respect to the three parameters: lesion visibility, apparent diffusion coefficient (ADC) measurements, and size estimation. Following MRM (1.5 T), EPI- and HASTE-DWI were applied in 65 patients. Lesion visibility on DWI was compared with lesion visibility on subtracted contrast-enhanced T1w images (CE-T1w). Statistical tests were applied to diameter, visibility, and ADC value measurements. Seventy-four lesions were identified. ADC value measurements did not differ significantly between the two DWI sequences. The sensitivity and specificity of routine diagnostics (97.4% and 85.7%) were superior to EPI-DWI (87.2% and 82.9%) and HASTE-DWI (76.9% and 88.6%). Selecting only nonmass lesions, DWI did not prove to be of diagnostic value. Lesion demarcation by DWI was significantly lower compared with that by CE-T1w, with EPI-DWI showing the better performance (p < 0.001). No significant differences were found for size measurements between CE-T1w and DWI. Although clearly inferior compared with CE-T1w imaging, both DWI techniques are applicable for lesion assessment and size measurements.

Contrast behavior and image quality of magnetic resonance cholangiopancreatography imaging using variable echo times at 3.0 T

Twenty-five volunteers were examined at three different echo times (TE) using magnetic resonance cholangiopancreatography (MRCP) images obtained with half-Fourier-acquired single-shot turbo spin echo (HASTE) thick-slab and multislice HASTE to identify the optimal TE at 3.0 T. No significant difference in the overall image quality was found comparing three different TEs within commonly used ranges. We observed an almost identical duct visibility with different TEs, while we found a trend toward superior visibility of the cystic duct at shorter TE.

Prospective navigator-echo-based real-time triggering of fetal head movement for the reduction of artifacts

The purpose of this study was to evaluate the neuroimaging quality and accuracy of prospective real-time navigator-echo acquisition correction versus untriggered intrauterine magnetic resonance imaging (MRI) techniques. Twenty women in whom fetal motion artifacts compromised the neuroimaging quality of fetal MRI taken during the 28.7 +/- 4 week of pregnancy below diagnostic levels were additionally investigated using a navigator-triggered half-Fourier acquired single-shot turbo-spin echo (HASTE) sequence. Imaging quality was evaluated by two blinded readers applying a rating scale from 1 (not diagnostic) to 5 (excellent). Diagnostic criteria included depiction of the germinal matrix, grey and white matter, CSF, brain stem and cerebellum. Signal-difference-to-noise ratios (SDNRs) in the white matter and germinal zone were quantitatively evaluated. Imaging quality improved in 18/20 patients using the navigator echo technique (2.4 +/- 0.58 vs. 3.65 +/- 0.73 SD, p < 0.01 for all evaluation criteria). In 2/20 patients fetal movement severely impaired image quality in conventional and navigated HASTE. Navigator-echo imaging revealed additional structural brain abnormalities and confirmed diagnosis in 8/20 patients. The accuracy improved from 50% to 90%. Average SDNR increased from 0.7 +/- 7.27 to 19.83 +/- 15.71 (p < 0.01). Navigator-echo-based real-time triggering of fetal head movement is a reliable technique that can deliver diagnostic fetal MR image quality despite vigorous fetal movement.

Dynamic Sagittal Half-Fourier Acquired Single-Shot Turbo Spin-Echo MR Imaging of the Temporomandibular Joint: Initial Experience and Comparison with Sagittal Oblique Proton-Attenuation Images

Our aim was to assess dynamic half-Fourier acquired single-shot turbo spin-echo (HASTE) MR imaging of the temporomandibular joint (TMJ) using parallel imaging, in comparison with static proton density (Pd) imaging. Thirty-four TMJs from 17 subjects (7 volunteers, 10 patients) were imaged in a multichannel head coil on a 1.5 T magnet by using a 35-second dynamic sagittal HASTE acquisition (TR/TE, 1180/65 msec; matrix, 128 x 128; section thickness, 7 mm; 30 images) and sagittal oblique Pd in closed- and open-mouthed positions (TR/TE, 1800/12 msec; matrix, 256 x 256; section thickness, 2 mm; 15 sections). Images were reviewed by 3 readers and rated for confidence of disk position, presence of motion artifact, range of motion, and presence of disk displacement on a 5-point scale. Consensus review of cases was also performed to assess disk dislocation and limited range of motion. More static examinations were rated as having motion artifact (19.6% versus 6.9%, P=.016), limited range of motion (30.4% versus 17.7%, P=.016), and disk dislocations (31.4% versus 22.6%, P=.071). Confidence ratings were higher on dynamic examinations (4.11 versus 3.74, P=.018). Chi-squared tests demonstrated no significant difference in consensus reviews of the 2 examination types. Dynamic HASTE TMJ MR imaging is a time-efficient adjunct to standard MR imaging protocols, producing fewer motion artifacts, additional range of motion information, and a dynamic assessment of disk position, when compared with static imaging. Further study is needed to evaluate the role of this sequence in diagnosing disk displacement.

Morphometry of the Retrobulbar Human Optic Nerve: Comparison between Conventional Sonography and Ultrafast Magnetic Resonance Sequences

To compare different methods for quantification of optic nerve and nerve sheath diameter. To apply a novel magnetic resonance protocol using half-Fourier acquired single-shot turbo spin-echo (HASTE) sequences to analyze optic nerve dimensions. Measurements were taken in right eyes of 33 subjects whose median age was 25 years. A-scan ultrasonography was repeated three times in straight gaze. B-scan ultrasonography was repeated three times in straight gaze and abduction. HASTE sequences were applied in straight gaze, analyzed twice by two different radiologists, and completely repeated in a subset of 10 subjects; 95% confidence intervals and coefficients of variation were calculated. HASTE sequences yielded high contrast between cerebrospinal fluid and optic nerve parenchyma. Acquisition time for each sequence was 1.5 seconds per slice. Optic nerve diameters decreased from 3.23 mm at 5 mm to 2.67 mm at 15 mm behind the eye. Sheath diameters decreased from 5.72 mm to 3.98 mm. A- and B-scan ultrasonography yielded significantly smaller diameters. For HASTE sequences, the coefficients of variation ranged from 2% to 7% and were significantly smaller than those obtained with ultrasonographic measurements (9%-13%). The precision of magnetic resonance imaging exceeds that of ultrasonographic methods for determining optic nerve and nerve sheath diameters. HASTE sequences appear particularly appropriate for investigating the retrobulbar optic nerve complex and may be useful in future studies quantifying axonal loss within the optic nerve.

MRCP imaging at 3.0 T vs. 1.5 T: Preliminary experience in healthy volunteers

To evaluate the impact of magnetic resonance cholangiopancreatography (MRCP) imaging at 1.5T and 3.0T on image quality. Fourteen volunteers were examined at both 1.5T and 3.0T using MRCP imaging performed with a breath-held two-dimensional (2D) half-Fourier acquired single-shot turbo spin-echo (HASTE) thick-slab sequence, a free-breathing navigator-triggered three-dimensional (3D) turbo spin-echo (TSE) sequence with prospective acquisition correction, and a heavily T2-weighted (T2W) sequence with breath-held multislice HASTE. All images were scored for visualization of the biliary and pancreatic ducts, severity of artifacts, image noise, and overall image quality. MRCP imaging at 3.0T yielded a significant improvement in overall image quality compared to 1.5T. We found a trend for superior visualization of the biliary and pancreatic ducts at 3.0T. Heavily T2W imaging with thin sections (1.4 mm) at 3.0T provided diagnostic images and better visualization of the biliary and pancreatic ducts than heavily T2W imaging with standard sections (2.8 mm) at 3.0T. Our experience suggests that MRCP imaging at 3.0T has the potential to provide excellent images. High-resolution heavily T2W imaging with a small voxel size (1.3 x 1.3 x 1.4 mm) at 3.0T can provide diagnostic images and allow evaluation of small pathologies of the bile and pancreatic ducts, which 1.5T MRI cannot sufficiently visualize.

Foetal magnetic resonance imaging and echogenic bowel

To evaluate how foetal magnetic resonance imaging (MRI) may change the diagnosis in cases of ultrasound (U/S) findings of echogenic bowel (EB). Seventeen foetuses with EB underwent serial U/S examinations, foetal MRI, cystic fibrosis screening and maternal viral serologic tests. MRI protocol included T2-weighted half-Fourier acquired single-shot turbo spin-echo (HASTE) sequence and gradient echo (GE) T1-weighted images. Foetal abdominal MRI analyzed patterns were size and signal of small bowel, colon and rectum, ascites and abdominal mass. All neonates had complete clinical examination, abdominal sonography, and a 6 months clinical follow-up. Eleven foetuses with isolated EB had normal MRI and normal outcome. In comparison, all the 6 foetuses whose U/S patterns showed associated signs had abnormal MRI (p < 0.001). Five had proven pathology (83.3%: 5/6) and only 1 (16.7%: 1/6) had no proven pathology and normal postnatal outcome (p = 0.001). For those five, foetal MRI showed bowel abnormalities with one case of bowel duplication and four cases of bowel obstruction. Two out of the four cases of bowel obstruction were genetically diagnosed as cystic fibrosis. The two remaining cases were diagnosed as ileal atresia. MRI could provide additive information in cases of EB associated with bowel dilatation.

Imaging and intervention of retroperitoneal fibrosis

Retroperitoneal fibrosis is a rare condition characterized by the development of fibrous plaques in the retroperitoneal space. The fibrous plaques characteristically arise distal to the bifurcation of the abdominal aorta and progress to encase the iliac vessels distally and are defined by the associated encasement of one or both ureters. Imaging plays an important role in not only establishing the diagnosis, but also in monitoring disease progression. Historically, the radiological diagnosis was made predominantly by intravenous urography and retrograde pyelography. More recently, advances in cross-sectional imaging with ultrasound and contrast-enhanced CT have allowed for a more precise diagnosis as well as helping to accurately define the extent of the disease. At our institution, we have found ultra-fast MRI to also play a useful role in establishing the diagnosis. In particular, magnetic resonance urography using HASTE (half Fourier-acquired single shot turbo spin-echo) sequences allow a safe alternative to intravenous urography, particularly in patients with poor renal function. The purpose of this article is to describe the role of the various imaging methods available to the radiologist and to emphasize the important role that the interventional radiologist now plays, not only in obtaining tissue for diagnosis, but also in providing treatment of the disease by percutaneous nephrostomy drainage and subsequent stent placement in select cases.

Fetal magnetic resonance hydrography: evaluation of a single-shot thick-slab RARE (rapid acquisition with relaxation enhancement) sequence in fetal thoracoabdominal pathology

To evaluate the potential of a single-shot thick-slab RARE (rapid acquisition with relaxation enhancement) sequence in fetal thoracoabdominal magnetic resonance (MR) examinations compared with multislice T2-weighted sequence and postnatal imaging. RARE sequence is rapid and provides very heavily T2-weighted images. Twenty-seven fetal thoracoabdominal MR imaging examinations were performed at 23-38 weeks using our conventional protocol. This included thin multislice T2-weighted half-Fourier acquired single-shot turbo spin-echo (HASTE) sequence and thin-slice GE (gradient echo) T1-weighted images with a 1.5-T MR unit. A single-shot thick-slab (60 mm) RARE sequence was added to all MR examinations. The acquisitions were obtained with the mother breath-holding. The thick-slab heavily T2-weighted images were compared with HASTE sequence images and with postnatal imaging in all cases. The thick-slab RARE sequence did not show additional abnormalities compared with the conventional protocol but displayed an overall view of the urinary tract, tracheobronchial tract and small bowel. It gave information that was highly correlated with postnatal imaging, such as abdominal plain films, chest film or cystography. The quality of the thick-slab RARE images was considered as good in 13 cases (48%), moderate in 12 cases (45%) and poor in two cases (7%). Although thick-slab RARE sequence does not show additional abnormalities compared with the conventional protocol, it illustrates very nicely static fluids such as those in urinary dilatation, the esophagus and small bowel (normal or dilated) and thoracic cystic masses. It is very rapid (5 s) to perform, allows fetal hydrography, and correlates well with postnatal imaging.

Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities.

Fetal MR imaging often poses a diagnostic challenge for the radiologist. Both fetal anatomy and pathology differ decidedly from pediatric and adult MR imaging. While ultrasound remains the method of choice for screening examinations of the fetus, MR imaging is playing an increasingly important role in the detection and classification of malformations not diagnosable by ultrasonography alone. Recently, advances in fast single-shot MR sequences have allowed high-resolution, high-quality imaging of the moving fetus. Preferable sequences to be applied are a true fast imaging steady precession (true-FISP) or a half-Fourier acquired single-shot turbo spin-echo (HASTE) sequence. Premedication is generally no longer required. In all fetal MR imaging, every aspect of fetal anatomy has to be scrutinized. Subsequently, any abnormalities need to be described and classified. A close collaboration with the referring obstetrician is of paramount importance.