High-resolution MR Research Articles

Association of pre-diabetes and type 2 diabetes mellitus with intracranial plaque characteristics in patients with acute ischemic stroke.

To investigate the association of pre-diabetes(i.e., the early stages of glucometabolic disturbance) and Type 2 diabetes mellitus (T2DM) with intracranial plaque characteristics in patients with acute ischemic stroke using three-dimensional high-resolution MR imaging. One hundred and forty-three symptomatic patients with acute ischemic stroke attribute to intracranial atherosclerotic plaque were prospectively enrolled. All participants were further divided into three groups: normal glucose metabolism(non-diabetes) group(n = 41), pre-diabetes group(n = 45), and T2DM group(n = 57) according to glucometabolic status. Culprit plaque characteristics (such as plaque burden, normalized wall index and enhancement ratio), total plaque number, and global plaque enhancement score were analyzed and compared among the three glucometabolic groups. The association between pre-diabetes and T2DM with intracranial plaque characteristics was assessed by logistic regression and multivariate linear regression. Plaque number was higher in patients with pre-diabetes and T2DM compared with those with non-diabetes(3.71 ± 1.83 and 3.75 ± 1.71 vs 2.24 ± 1.46, p = 0.006). Multivariate logistic regression showed a significant association of multiple intracranial plaques with pre-diabetes(OR 3.524, 95% CI 1.082 ~ 11.479, p = 0.037), T2DM(OR 3.760, 95% CI 1.098 ~ 12.872, p = 0.035) and luminal stenotic rate. Both pre-diabetes and T2DM were significantly associated with culprit plaque enhancement ratio(β = 0.527 and β = 0.536; respectively; p < 0.001) and global plaque enhancement score(β = 0.264 and β = 0.373; respectively; p < 0.05). Patients with pre-diabetes and T2DM had similar intracranial atherosclerotic plaque vulnerability, as demonstrated by multiple plaques, increased culprit plaque enhancement ratio and global plaque enhancement score. Pre-diabetes might be a risk factor for intracranial plaque vulnerability. It is necessary to monitor a slight increase in blood glucose in non-diabetes patients with acute ischemic stroke.

Single-spoke binning: Reducing motion artifacts in abdominal radial stack-of-stars imaging.

To increase the effectiveness of respiratory gating in radial stack-of-stars MRI, particularly when imaging at high spatial resolutions or with multiple echoes. Free induction decay (FID) navigators were integrated into a three-dimensional gradient echo radial stack-of-stars pulse sequence. These navigators provided a motion signal with a high temporal resolution, which allowed single-spoke binning (SSB): each spoke at each phase encode step was sorted individually to the corresponding motion state of the respiratory signal. SSB was compared with spoke-angle binning (SAB), in which all phase encode steps of one projection angle were sorted without the use of additional navigator data. To illustrate the benefit of SSB over SAB, images of a motion phantom and of six free-breathing volunteers were reconstructed after motion-gating using either method. Image sharpness was quantitatively compared using image gradient entropies. The proposed method resulted in sharper images of the motion phantom and free-breathing volunteers. Differences in gradient entropy were statistically significant (p = 0.03) in favor of SSB. The increased accuracy of motion-gating led to a decrease of streaking artifacts in motion-gated four-dimensional reconstructions. To consistently estimate respiratory signals from the FID-navigator data, specific types of gradient spoiler waveforms were required. SSB allowed high-resolution motion-corrected MR imaging, even when acquiring multiple gradient echo signals or large acquisition matrices, without sacrificing accuracy of motion-gating. SSB thus relieves restrictions on the choice of pulse sequence parameters, enabling the use of motion-gated radial stack-of-stars MRI in a broader domain of clinical applications.

Persistent luminescent metal-organic framework nanocomposite enables autofluorescence-free dual modal imaging-guided drug delivery.

Molecular imaging-guided therapy was essential for realizing precise cancer intervention, while designing an imaging platform to achieve autofluorescence-free imaging for dual modal imaging-guided drug delivery remains a challenge. Near-infrared persistent luminescence nanoparticles (NIR PLNPs) were promising for tumor imaging due to no background interference from the tissue. Herein, a persistent luminescent metal-organic framework (PLNPs@MIL-100(Fe)) is prepared via a layer-by-layer method for dual-modal imaging-guided drug delivery. The PLNPs@MIL-100(Fe) exhibit NIR persistent luminescence emitting and T2-weighted signal, achieving precise in vivo dual-modal imaging of tumor-bearing mice by providing high spatial resolution MR imaging and autofluorescence-free NIR imaging. The porous MIL-100(Fe) shell provides PLNPs@MIL-100(Fe) with up to 87.1% drug loading capacity and acid-triggered drug release for drug delivery. We envision that the proposed PLNPs@MIL-100(Fe) platform would provide an effective approach for precise tumor imaging and versatile drug delivery.

Post-mortem Magnetic Resonance Imaging of Degenerating and Reorganizing White Matter in Post-stroke Rodent Brain.

Magnetic resonance imaging (MRI) allows noninvasive and non-destructive imaging of brain tissue. More specifically, the status of white matter fibers can be measured with diffusion-weighted MRI, enabling assessment of structural degeneration or remodeling of white matter tracts in diseased brain. Here, we describe the preparation of post-stroke rodent brain samples for post-mortem high-resolution 3D diffusion-weighted MR imaging, accompanied with guidelines for acquiring and processing the images.

High Resolution MR Imaging of the Testis Using a Small Radiofrequency Coil.

We have developed a new device, consisting of a 3-cm RF coil and an immobilizer, to acquire high-resolution MR images of the testis. With the approval of our institutional review board, we conducted an MRI study on a cohort of healthy volunteers to test this device. With the participants in the supine position, we placed the dedicated immobilizer and RF coil on the scrotum for typically no more than 3 min. Subsequently, T2-weighted images were acquired with an in-plane resolution of 117 µm using a 3-T MR scanner and the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) sequence. The total scan time ranged from 12 to 30 min (average 20 min). High-resolution MR images of the testis were acquired without deterioration by motion artifacts. Our results showed that the combined use of a small RF coil and an immobilizer is a feasible option for acquiring high-resolution MR images of the testis.

Application of high-resolution MR imaging in intracranial diseases

Application of high-resolution MR imaging in intracranial diseases

Congenital isolated unilateral third nerve palsy in children: the diagnostic contribution of high-resolution MR imaging.

To describe the neuroanatomical correlates of unilateral congenital isolated oculomotor palsy by means of high-resolution MRI. Children with a clinical diagnosis of congenital isolated oculomotr palsy and with a high-resolution MRI acquisition targeted on the orbits and cranial nerves were selected and included in the study. An experienced pediatric neuroradiologist evaluated all the exams, assessing the integrity and morphology of extraocular muscles, oculomotor, trochlear and abducens nerves as well as optic nerves and globes. Clinical data and ophthalmologic evaluations were also collected. Six children (age range: 1-16 years; males: 3) were selected. All patients showed, on the affected side (left:right = 5:1), anomalies of the III nerve and extraocular muscles innervated by the pathological nerve. One patient had complete nerve agenesis, two patients showed a diffuse thinning of the nerve, from the brainstem to the orbit and 3 patients showed a distal thinning of the oculomotor nerve, starting at the level of the cavernous sinus. In all cases atrophy of corresponding muscles was noticed, but the involvement of the affected muscles varied with the nervous pattern of injury. High-resolution MRI represents a valuable tool for the diagnosis of III nerve anomalies in unilateral congenital IOP, showing different patterns of nerve involvement and muscular atrophy.

Prediction of new cerebral ischemic lesion after carotid artery stenting: a high-resolution vessel wall MRI-based radiomics analysis.

Carotid artery stenting (CAS) is an established treatment for local stenosis. The most common complication is new ipsilateral ischemic lesions (NIILs). This study aimed to develop models considering lesion morphological and compositional features, and radiomics to predict NIILs. One hundred and forty-six patients who underwent brain MRI and high-resolution vessel wall MR imaging (hrVWI) before and after CAS were retrospectively recruited. Lumen and outer wall boundaries were segmented on hrVWI as well as atherosclerotic components. A traditional model was constructed with patient clinical information, and lesion morphological and compositional features. Least absolute shrinkage and selection operator algorithm was performed to determine key radiomics features for reconstructing a radiomics model. The model in predicting NIILs was trained and its performance was tested. Sixty-one patients were NIIL-positive and eighty-five negative. Volume percentage of intraplaque hemorrhage (IPH) and patients' clinical presentation (symptomatic/asymptomatic) were risk factors of NIILs. The traditional model considering these two features achieved an area under the curve (AUC) of 0.778 and 0.777 in the training and test cohorts, respectively. Twenty-two key radiomics features were identified and the model based on these features achieved an AUC of 0.885 and 0.801 in the two cohorts. The AUCs of the combined model considering IPH volume percentage, clinical presentation, and radiomics features were 0.893 and 0.842 in the training and test cohort respectively. Compared with traditional features (clinical and compositional features), the combination of traditional and radiomics features improved the power in predicting NIILs after CAS. • Volume percentage of IPH and symptomatic events were independent risk factors of new ipsilateral ischemic lesions (NIILs). • Radiomics features derived from carotid artery high-resolution vessel wall imaging had great potential in predicting NIILs after CAS. • The combination model with radiomics and traditional features further improved the diagnostic performance than traditional features alone.

Efficacy of medical treatment and balloon angioplasty for severe intracranial atherosclerosis: a high-resolution MR vessel wall imaging.

To investigate the efficacy of medical treatment and balloon angioplasty for intracranial atherosclerosis using high-resolution MR vessel wall imaging (HR-MRI). In this prospective study, patients with symptomatic severe stenosis from January 2018 to August 2021 were treated with medical treatment or balloon angioplasty. The patients underwent HR-MRI at baseline and at 3, 6, and 12 months. Plaque characteristics at follow-up were compared with those at baseline using paired sample T-test or Wilcoxon rank sum test. The difference in the recurrence of ischemic events between two groups was compared. A total of 37 patients (26 males; mean age = 60.5 ± 11.6 years) were evaluated. Of 68 plaques, 42 (61.8%) were treated with medication only. At 12 months of medical treatment, maximum plaque length (p = 0.004), maximum wall thickness (p = 0.036), and plaque enhancement (p = 0.001) were significantly reduced than baseline. At 3 months after balloon angioplasty, luminal stenosis (p = 0.048) was significantly reduced compared to baseline. At 6 months after balloon angioplasty, maximum plaque length (p = 0.011), maximum wall thickness (p = 0.003), and luminal stenosis (p = 0.001) were significantly reduced than baseline. No difference was found in the recurrence of ischemic events between two groups (p = 0.458). Intracranial atherosclerotic plaque shrank and tended to be stable at 12 months of medical treatment. Plaque burden was significantly reduced 6 months after balloon angioplasty. This may provide evidence for the application and selection of treatment strategies for intracranial atherosclerotic disease. • Plaque burden and plaque enhancement were significantly reduced at 12 months of medical treatment compared to baseline. • Plaque burden was significantly reduced at 6 months after balloon angioplasty compared with baseline. • No significant difference in the recurrence rate of ischemic stroke between patients treated with medication and balloon angioplasty.

Self-labelled encoder-decoder (SLED) for multi-echo gradient echo-based myelin water imaging

PurposeReconstruction of high quality myelin water imaging (MWI) maps is challenging, particularly for data acquired using multi-echo gradient echo (mGRE) sequences. A non-linear least squares fitting (NLLS) approach has often been applied for MWI. However, this approach may produce maps with limited detail and, in some cases, sub-optimal signal to noise ratio (SNR), due to the nature of the voxel-wise fitting. In this study, we developed a novel, unsupervised learning method called self-labelled encoder-decoder (SLED) to improve gradient echo-based MWI data fitting. MethodsUltra-high resolution, MWI data was collected from five mouse brains with variable levels of myelination, using a mGRE sequence. Imaging data was acquired using a 7T preclinical MRI system. A self-labelled, encoder-decoder network was implemented in TensorFlow for calculation of myelin water fraction (MWF) based on the mGRE signal decay. A simulated MWI phantom was also created to evaluate the performance of MWF estimation. ResultsCompared to NLLS, SLED demonstrated improved MWF estimation, in terms of both stability and accuracy in phantom tests. In addition, SLED produced less noisy MWF maps from high resolution MR microscopy images of mouse brain tissue. It specifically resulted in lower noise amplification for all mouse genotypes that were imaged and yielded mean MWF values in white matter ROIs that were highly correlated with those derived from standard NLLS fitting. Lastly, SLED also exhibited higher tolerance to low SNR data. ConclusionDue to its unsupervised and self-labeling nature, SLED offers a unique alternative to analyze gradient echo-based MWI data, providing accurate and stable MWF estimations.

Patient-Specific Self-Supervised Resolution-Enhancing Network for High-Resolution MR Imaging in MRI-Guided Radiotherapy

<h3>Purpose/Objective(s)</h3> The application of MRI significantly improves the accuracy and reliability of target delineation for many disease sites in radiotherapy (RT) due to its superior soft tissue contrast as compared with CT. One common practice in acquiring the MR images is to use thick slices while keeping the in-plane resolution, especially for the large imaging field, to ensure enough coverage and avoid aliasing. However, this approach may lose high-definition information in the through-plane direction, which cannot be resolved through simple interpolation. Therefore, it is essential to develop an efficient and clinically applicable method to generate the high-resolution (HR) information of the MR image in the low-resolution (LR) direction to generate respective HR images. <h3>Materials/Methods</h3> We report a self-supervised deep learning algorithm to enhance image resolution, which does not use any training images with high through-plane resolution, yet can still generate high through-plane resolution images only relying on the acquired images with low through-plane resolution. The workflow consists of training two deep neural networks in parallel that independently predict the HR images in sagittal and coronal planes from images acquired in the axial direction, respectively. Then the final synthesized HR MR images are generated by fusing the two predicted images. We used 250 brain patient MR images obtained from the BraTS2020 dataset to evaluate the proposed workflow. In each direction of MR images, ground truth images were down-sampled by a factor of 3 to simulate low through-plane MR images to test our model. Normalized mean absolute error (NMAE) and peak SNR (PSNR) were used to quantify the performance. Institutional MRIs were also used for a proof-of-concept study of the proposed method since no HR images are available as the ground truth. <h3>Results</h3> The mean NMAE and PSNR were 0.053±0.017 and 34.1±1.7 dB for T1, 0.069±0.025 and 31.3±2.0 dB for contrast-enhanced T1, and 0.068±0.026 and 31.2±1.8 dB for T2, as well as 0.051±0.018 and 34.5±2.1 dB for FLAIR images, demonstrating the accuracy of the proposed method. Qualitative evaluation of the synthetic HR MR images of the clinical collected dataset could also confirm the feasibility of the proposed method. <h3>Conclusion</h3> We have shown a patient-specific deep learning-based method with self-supervised parallel networks to synthesize HR MR images without the need for traditional large training datasets or ground truth images. The results support the potential of using artificial intelligence to improve image resolution beyond the limits of current MRI data acquisition. The self-supervision capability could have broad clinical applications, especially with regards to shortening MR acquisition time in clinical MRI practices (e.g., MRI-guided RT) to enable accelerated MRI without sacrificing the spatial resolution.

Improved Blood Suppression of Motion-Sensitized Driven Equilibrium in High-Resolution Whole-Brain Vessel Wall Imaging: Comparison of Contrast-Enhanced 3D T1-Weighted FSE with Motion-Sensitized Driven Equilibrium and Delay Alternating with Nutation for Tailored Excitation.

High-resolution vessel wall MR imaging is prone to slow-flow artifacts, particularly when gadolinium shortens the T1 relaxation time of blood. This study aimed to determine the optimal preparation pulses for contrast-enhanced high-resolution vessel wall MR imaging. Fifty patients who underwent both motion-sensitized driven equilibrium and delay alternating with nutation for tailored excitation (DANTE) preparation pulses with contrast-enhanced 3D-T1-FSE were retrospectively included. Qualitative analysis was performed using a 4-grade visual scoring system for black-blood performance in the small-sized intracranial vessels, overall image quality, severity of artifacts, and the degree of blood suppression in all cortical veins as well as transverse sinuses. Quantitative analysis of the M1 segment of the MCA was also performed. The qualitative analysis revealed that motion-sensitized driven equilibrium demonstrated a significantly higher black-blood score than DANTE in contrast-enhanced 3D-T1-FSE of the A3 segment (3.90 versus 3.58, P < .001); M3 (3.72 versus 3.26, P = .004); P2 to P3 (3.86 versus 3.64, P = .017); the internal cerebral vein (3.72 versus 2.32, P < .001); and overall cortical veins (3.30 versus 2.74, P < .001); and transverse sinuses (2.82 versus 2.38, P < .001). SNRlumen, contrast-to noise ratiowall-lumen, and SNRwall in the M1 vessel were not significantly different between the 2 preparation pulses (all, P > .05). Motion-sensitized driven equilibrium demonstrated improved blood suppression on contrast-enhanced 3D-T1-FSE in the small intracranial arteries and veins compared with DANTE. Motion-sensitized driven equilibrium is a useful preparation pulse for high-resolution vessel wall MR imaging to decrease venous contamination and suppress slow-flow artifacts when using contrast enhancement.

Extra-articular findings in patients with suspected labral tear and value of screening pelvis sequence

Objectives: There are multiple etiologies of hip pain, of which labral tear is one of the most common in young adults which may be difficult to distinguish on history and clinical examination. Labral tears can be diagnosed using high-resolution non-contrast magnetic resonance imaging (MRI) or MR arthrogram that involves imaging the concerned hip. At our institute, we perform an additional proton density fat saturated axial sequence of the pelvis to screen for alternative pathology and we investigate the value of this in this study. Material and Methods: A retrospective review of high-resolution non-arthrographic 3T MR of hips that were referred from young adult hip services with a history of hip or groin pain and the clinical suspicion of a labral tear over 2 years was performed. Those &lt;50 years were included in the study. Results: Of 648 patients with suspected labral tears, 18% showed evidence of extra-articular hip pathologies (sacroiliac joint pathology, iliopsoas pathology, and ischiofemoral impingement) on MRI. This study has shown that approximately one in five patients with a clinically suspected labral tear showed radiological evidence of extra-articular hip pathology (sacroiliac joint pathology, iliopsoas pathology, ischiofemoral impingement, and hamstring pathology). There is therefore the potential for misdiagnosis and increased morbidity if these alternative diagnoses were not appreciated. Conclusion: A high-resolution hip MRI protocol for suspected labral tears of the hip joint should include at least one sequence of the entire pelvis to evaluate for extra-articular findings.

High-Resolution Three-Dimensional Hybrid MRI + Low Dose CT Vocal Tract Modeling: A Cadaveric Pilot Study

<h2>Summary</h2><h3>Objectives</h3> MRI based vocal tract models have many applications in voice research and education. These models do not adequately capture bony structures (e.g. teeth, mandible), and spatial resolution is often relatively low in order to minimize scanning time. Most MRI sequences achieve 3D vocal tract coverage at gross resolutions of 2 mm³ within a scan time of <20 seconds. Computed tomography (CT) is well suited for vocal tract imaging, but is infrequently used due to the risk of ionizing radiation. In this cadaveric study, a single, extremely low-dose CT scan of the bony structures is blended with accelerated high-resolution (1 mm³) MRI scans of the soft tissues, creating a high-resolution hybrid CT-MRI vocal tract model. <h3>Methods</h3> Minimum CT dosages were determined and a custom 16-channel airway receiver coil for accelerated high (1 mm³) resolution MRI was evaluated. A rigid body landmark based partial volume registration scheme was then applied to the images, creating a hybrid CT-MRI model that was segmented in Slicer. <h3>Results</h3> Ultra-low dose CT produced images with sufficient quality to clearly visualize the bone, and exposed the cadaver to 0.06 mSv. This is comparable to atmospheric exposures during a round trip transatlantic flight. The custom 16-channel vocal tract coil produced acceptable image quality at 1 mm³ resolution when reconstructed from ∼6 fold undersampled data. High (1 mm³) resolution MR imaging of short (<10 seconds) sustained sounds was achieved. The feasibility of hybrid CT-MRI vocal tract modeling was successfully demonstrated using the rigid body landmark based partial volume registration scheme. Segmentations of CT and hybrid CT-MRI images provided more detailed 3D representations of the vocal tract than 2 mm³ MRI based segmentations. <h3>Conclusions</h3> The method described in this study indicates that high-resolution CT and MR image sets can be combined so that structures such as teeth and bone are accurately represented in vocal tract reconstructions. Such scans will aid learning and deepen understanding of anatomical features that relate to voice production, as well as furthering knowledge of the static and dynamic functioning of individual structures relating to voice production.

Development of a new toolbox for mouse PET–CT brain image analysis fully based on CT images and validation in a PD mouse model

Automatic analysis toolboxes are popular in brain image analysis, both in clinical and in preclinical practices. In this regard, we proposed a new toolbox for mouse PET–CT brain image analysis including a new Statistical Parametric Mapping-based template and a pipeline for image registration of PET–CT images based on CT images. The new templates is compatible with the common coordinate framework (CCFv3) of the Allen Reference Atlas (ARA) while the CT based registration step allows to facilitate the analysis of mouse PET–CT brain images. From the ARA template, we identified 27 volumes of interest that are relevant for in vivo imaging studies and provided binary atlas to describe them. We acquired 20 C57BL/6 mice with [18F]FDG PET–CT, and 12 of them underwent 3D T2-weighted high-resolution MR scans. All images were elastically registered to the ARA atlas and then averaged. High-resolution MR images were used to validate a CT-based registration pipeline. The resulting method was applied to a mouse model of Parkinson’s disease subjected to a test–retest study (n = 6) with the TSPO-specific radioligand [18F]VC701. The identification of regions of microglia/macrophage activation was performed in comparison to the Ma and Mirrione template. The new toolbox identified 11 (6 after false discovery rate adjustment, FDR) brain sub-areas of significant [18F]VC701 uptake increase versus the 4 (3 after FDR) macro-regions identified by the Ma and Mirrione template. Moreover, these 11 areas are functionally connected as found by applying the Mouse Connectivity tool of ARA. In conclusion, we developed a mouse brain atlas tool optimized for PET–CT imaging analysis that does not require MR. This tool conforms to the CCFv3 of ARA and could be applied to the analysis of mouse brain disease models.

Multi-scale deformable transformer for multi-contrast knee MRI super-resolution

Background and objective:Magnetic resonance imaging can present the precise anatomic structure in clinical applications. Nevertheless, due to the limited scanning equipment cost, scanning time and so on, high-resolution knee MR images are difficult to obtain. So the super-resolution technique is developed to improve the image quality. Unfortunately, conventional CNN-based methods cannot explicitly learn the long-range dependencies in images and simply integrate the auxiliary contrast without considering the characteristics of medical images. To tackle this issue, our approach aims to adaptively capture and fuse the significant auxiliary information of the multi-contrast images to improve the knee magnetic resonance image quality. Methods:We propose a multi-scale deformable transformer network (MSDT) for multi-contrast knee magnetic resonance imaging super-resolution. First, we aggregate multi-scale patch embedding from the multi-contrast knee MR images to effectively preserve the local contextual details and global structure information. Then, the deformable transformer architecture is designed to learn the data-dependent sparse attention of the knee MR image, which can adaptively obtain the high-frequency foreground details according to the image content. Results:The proposed method is evaluated on the fastMRI dataset under 2× and 4× enlargements. Our MSDT achieves higher PSNR of 31.98 and SSIM of 0.713 at 2× upsampling factor and PSNR of 30.38 and SSIM of 0.615 at 4× upsampling factor. Moreover, our method can generate clear tissue structures and fine details. Conclusions:The experimental results show superior performance in comparison to the state-of-the-art super-resolution methods. This indicates that the MSDT can effectively reconstruct the high-quality knee MR images.

Enhancement of Medical Images through an Iterative McCann Retinex Algorithm: A Case of Detecting Brain Tumor and Retinal Vessel Segmentation

Analyzing medical images has always been a challenging task because these images are used to observe complex internal structures of the human body. This research work is based on the study of the retinal fundus and magnetic resonance images (MRI) for the analysis of ocular and cerebral abnormalities. Typically, clinical quality images of the eyes and brain have low-varying contrast, making it challenge to diagnose a specific disease. These issues can be overcome, and preprocessing or an image enhancement technique is required to properly enhance images to facilitate postprocessing. In this paper, we propose an iterative algorithm based on the McCann Retinex algorithm for retinal and brain MRI. The foveal avascular zone (FAZ) region of retinal images and the coronal, axial, and sagittal brain images are enhanced during the preprocessing step. The High-Resolution Fundus (HRF) and MR brain Oasis images databases are used, and image contrast and peak signal-to-noise ratio (PSNR) are used to assess the enhancement step parameters. The average PSNR enhancement on images from the Oasis brain MRI database was about 3 dB with an average contrast of 57.4. The average PSNR enhancement of the HRF database images was approximately 2.5 dB with a contrast average of 40 over the database. The proposed method was also validated in the postprocessing steps to observe its impact. A well-segmented image was obtained with an accuracy of 0.953 and 0.0949 on the DRIVE and STARE databases. Brain tumors were detected from the Oasis brain MRI database with an accuracy of 0.97. This method can play an important role in helping medical experts diagnose eye diseases and brain tumors from retinal images and Oasis brain images.

3D Enhancement Color Maps in the Characterization of Intracranial Atherosclerotic Plaques.

High-resolution MR imaging allows the identification of culprit symptomatic plaques after the administration of gadolinium. Current high-resolution MR imaging methods are limited by 2D multiplanar views and manual sampling of ROIs. We analyzed a new 3D method to objectively quantify gadolinium plaque enhancement. Patients with stroke due to intracranial atherosclerotic disease underwent 7T high-resolution MR imaging. 3D segmentations of the plaque and its parent vessel were generated. Signal intensity probes were automatically extended from the lumen into the plaque and the vessel wall to generate 3D enhancement color maps. Plaque gadolinium (Gd) uptake was quantified from 3D color maps as gadolinium uptake = (µPlaque T1 + Gd -µPlaque T1/SDPlaque T1). Additional metrics of enhancement such as enhancement ratio, variance, and plaque-versus-parent vessel enhancement were also calculated. Conventional 2D measures of enhancement were collected for comparison. Thirty-six culprit and 44 nonculprit plaques from 36 patients were analyzed. Culprit plaques had higher gadolinium uptake than nonculprit plaques (P < .001). Gadolinium uptake was the most accurate metric for identifying culprit plaques (OR, 3.9; 95% CI 2.1-8.3). Gadolinium uptake was more sensitive (86% versus 70%) and specific (71% versus 68%) in identifying culprit plaques than conventional 2D measurements. A multivariate model, including gadolinium uptake and plaque burden, identified culprit plaques with an 83% sensitivity and 86% specificity. The new 3D color map method of plaque-enhancement analysis is more accurate for identifying culprit plaques than conventional 2D methods. This new method generates a new set of metrics that could potentially be used to assess disease progression.

Assessment of epidermoid cyst with trigeminal neuralgia before neuroendoscopy: A high-resolution MR study based on 3D-FIESTA and MR angiography

PurposeTo assess the value of preoperative 3D-FIESTA and MR angiography (MRA) in endoscopic resection of epidermoid cysts presenting with trigeminal neuralgia (TN). Methods3D-FIESTA and MRA were performed before neuroendoscopy in 32 cases of epidermoid cysts with TN, and the tumors were grouped into types A, B, C, and D according to the relationship between the tumor and adjacent nerves and arteries (Hitoshi Kobata's classification). Evaluation of the neuroendoscopic resectability of different types of tumors, included gross total tumor removal (GTR), subtotal tumor removal (STR), and partial tumor removal (PTR). During the 5-year follow-up, symptoms were assessed based on facial pain relief using the Barrow Neurological Institute (BNI) score. ResultsThe coincidence rate between MRI classification of the tumor and the operation was 100%. Type B tumors were the most common (18/32, 56.3%). Type A tumors showed the highest resectability (9/9, 100%), followed by type B tumors (14/18, 77.8%). Moreover, microvascular decompression was performed in all 4 cases of type C and 1 case of type D tumors. During follow-up, 23 patients showed marked improvement in symptoms (15, 8 of BNI I or II), 8 cases showed partial improvement (BNI III), and only 1 case of type C tumor was associated with poor facial pain relief, which recurred 5 years later (BNI IV). ConclusionsPreoperative high-resolution MR can accurately analyze the relationship between epidermoid cysts and adjacent nerves and arteries. It could act as a powerful tool in the evaluation of tumor resectability and the prognosis of surgery.

High-Resolution MRI for Evaluation of the Possibility of Successful Recanalization in Symptomatic Chronic ICA Occlusion: A Retrospective Study.

Accurate radiologic evaluation of the possibility of successful recanalization in symptomatic chronic ICA occlusion remains challenging. This study aimed to investigate the high-resolution MR imaging characteristics of symptomatic chronic ICA occlusion and their association with successful recanalization. Consecutive patients with symptomatic chronic ICA occlusion who underwent balloon dilation plus stent implantation were identified retrospectively and divided into 2 groups: a successful recanalization group and an unsuccessful recanalization group. Clinical and high-resolution MR imaging characteristics were compared between the groups. Univariate and multivariate analyses were used to identify the characteristics associated with successful recanalization. A total of 114 patients were included in the study. High-resolution MR imaging characteristics independently associated with unsuccessful recanalization were longer lesion length (OR, 0.41; 95% CI, 0.36-0.55; P = .009) and larger calcification volume (OR, 0.56; 95% CI, 0.37-0.68; P = .002) for proximal occlusion and reversed distal ICA flow at the level of ophthalmic segment or above (OR, 0.14; 95% CI, 0.08-0.48; P = .001). Reversed distal ICA flow at the level of the petrous segment or below (OR, 4.07; 95% CI, 1.65-8.38; P = .001) and lumen area (OR, 1.13; 95% CI, 1.04-1.61; P = .002) for distal occlusion were risk factors of successful recanalization. In symptomatic chronic ICA occlusion, lesion length and calcification volume (for proximal occlusion), the level of reversed distal ICA flow, and the lumen area (for distal occlusion) appear to be predictors of successful recanalization. High-resolution MR imaging can evaluate chronic ICA occlusion and help in clinical decision-making.