Spectral Presaturation Inversion Recovery Research Articles

Comparison of the SPIR and STIR MR Pulse Sequences in an Oil and Water Phantom

The coexistence of fat and water in the human body causes difficulties in obtaining accurate images using magnetic resonance imaging (MRI). This study evaluated the usefulness of the spectral pre-saturation inversion recovery (SPIR) and short TI inversion recovery (STIR) pulse sequences in suppressing fat. MRI of a water-oil phantom was performed using an Ingenia 3.0-T scanner (Philips Medical Systems, Best, The Netherlands). For quantitative evaluation of the images, the plot profile, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured and compared using ImageJ program (NIH, Bethesda, MD, USA). The SNR for water was higher by 56.04 % on STIR (403.59) than on SPIR (258.64). The SNR for fat was higher by 52.10 % on STIR (17.34) than on SPIR (11.40). The CNR was higher by 24.87 % on STIR (308.75) than on SPIR (247.24). Compared to SPIR, the STIR pulse sequence showed a better fat clearing effect. Therefore, it is necessary to select the appropriate fat suppression method according to the clinical necessity.

Quantifying the contrast of the human locus coeruleus in vivo at 7 Tesla MRI

The locus coeruleus is a small brainstem nucleus which contains neuromelanin cells and is involved in a number of cognitive functions such as attention, arousal and stress, as well as several neurological and psychiatric disorders. Locus coeruleus imaging in vivo is generally performed using a T1-weighted turbo spin echo MRI sequence at 3 Tesla (T). However, imaging at high magnetic field strength can increase the signal-to-noise ratio and offers the possibility of imaging at higher spatial resolution. Therefore, in the present study we explored the possibility of visualizing the locus coeruleus at 7T. To this end, twelve healthy volunteers participated in three scanning sessions: two with 3T MRI and one with 7T MRI. The volumes of the first 3T session were used to segment the locus coeruleus, whereas the volumes of the second 3T and the 7T session were used to quantify the contrast of the locus coeruleus with several reference regions across eight different structural sequences. The results indicate that several of the 7T sequences provide detectable contrast between the locus coeruleus and surrounding tissue. Of the tested sequences, a T1-weighted sequence with spectral presaturation inversion recovery (SPIR) seems the most promising method for visualizing the locus coeruleus at ultra-high field MRI. While there is insufficient evidence to prefer the 7T SPIR sequence over the 3T TSE sequence, the isotropic voxels at 7T are an important advantage when visualizing small structures such as the locus coeruleus.

The application of T2W SPIR-FLAIR in the diagnosis of hip synovitis in patients with spondyloarthritis.

To investigate the feasibility and accuracy of T2 weighted spectral pre-saturation inversion recovery combined with fluid-attenuated inversion recovery (T2W SPIR-FLAIR) in the diagnosis of hip synovitis in patients with spondyloarthritis (SpA). 10 volunteers underwent a T2W SPIR and 4 T2W SPIR-FLAIR sequence scans with different inversion times (TIs) to determine the optimum TI that could effectively suppress the intra-articular fluid signals. Hip MRI including T2W SPIR-FLAIR and enhanced T1 weighted (T1W) SPIR sequences was performed in 45 patients with SpA and totally 90 hips were evaluated. McNemar's test and Kappa test were used to compare the diagnostic results of synovitis between T2W SPIR-FLAIR and enhanced T1W SPIR. A TI of 2100 ms was selected as the optimum TI. 32 hips from 17 patients exhibited high signal intensity within the articular cavity on both T2W SPIR-FLAIR and enhanced T1W SPIR sequences, while only 3 hips showed high signals within the articular cavity on T2W SPIR-FLAIR. The remaining 55 hips did not show high signals within the articular cavity on both sequences. The T2W SPIR-FLAIR and enhanced T1W SPIR sequences had similar values in the diagnosis of hip synovitis (p = 0.25) and a high degree of diagnostic consistency (Kappa = 0.929). T2W SPIR-FLAIR can effectively suppress the intra-articular fluid signals, while retaining the signals of thickened synovial membranes and can be used for the diagnosis of hip synovitis in patients with SpA. Advances in knowledge: The enhanced T1W SPIR is a classic sequence for synovitis diagnosis, but it requires the injection of contrast agents. The T2W SPIR-FLAIR and enhanced T1W SPIR sequences had similar values in the diagnosis of hip synovitis (p = 0.25) and a high degree of diagnostic consistency (Kappa = 0.929).

Effect of inversion recovery fat suppression on hepatic R2* quantitation in transfusional siderosis.

OBJECTIVE. The purpose of this study is to evaluate whether the application of spectral pre-saturation inversion recovery (SPIR) fat suppression in standard multiecho gradient-echo sequences has a significant effect on hepatic R2* quantitation in patients with iron overload syndromes. MATERIALS AND METHODS. Eighty patients were scanned with a multiecho gradient-echo sequence without and with the application of SPIR. Six different postprocessing approaches were used to extract R2* values for maximum generality. RESULTS. SPIR fat suppression lowered R2* values by 3.9-7.0% (p < 0.0001 in all pairwise comparisons), independently of the postprocessing algorithm. Coefficients of variation for R2* ranged from 4.5% to 10.0%. Regardless of the size of the ROI (area of homogeneous tissue or entire liver profile in the slice), pixelwise approaches combined with an exponential-plus-constant fitting model yielded the lowest coefficients of variation (4.5% and 5.1%), whereas truncated exponential fits of the averaged signals produced the highest coefficients of variation (7.8% and 10%). For R2* values exceeding 200 Hz, a Bland-Altman analysis showed a bias that grew linearly for all postprocessing methods. CONCLUSION. SPIR fat suppression resulted in systematically lower hepatic R2* estimates. Because calibration curves were derived using images without fat suppression, these biases should be corrected when reporting liver iron concentrations estimated from fat-suppressed multiecho T2*-weighted images.

A comparative performance evaluation of various approaches for liver segmentation from SPIR images

Developing a robust method for liver segmentation from magnetic resonance images is a challenging task because of the similar intensity values between adjacent organs, the geometrically complex liver structure, and injection of contrast media. Most importantly, a high anatomical variability of a healthy or diseased liver is a major challenge in defining the exact boundaries of the liver. Several artifacts of pulsation, motion, and partial volume effects are also among the variety of factors that make automatic liver segmentation difficult. In this paper, we present an overview of liver segmentation methods in magnetic resonance images and show comparative results of seven different pseudo-3D liver segmentation approaches chosen from deterministic (K-means-based), probabilistic (Gaussian model-based), supervised neural network (multilayer perceptron-based), and deformable model-based (level set) segmentation methods. The results of quantitative and qualitative analyses using sensitivity, specificity, and accuracy metrics show that the multilayer perceptron-based approach and a level set-based approach, both of which use distance regularization terms and signed pressure force function, are the most successful methods for liver segmentation from spectral presaturation inversion recovery (SPIR) images. However, the multilayer perceptron-based segmentation method has a higher computational cost. The automatic method using the distance regularized level set evolution with signed pressure force function avoids the sensitivity of a user-defined initial contour for each slice, gives the most efficient results for liver segmentation after the preprocessing steps, and also requires less computational time.

Fully automated liver segmentation from SPIR image series

Accurate liver segmentation is an important component of surgery planning for liver transplantation, which enables patients with liver disease a chance to survive. Spectral pre-saturation inversion recovery (SPIR) image sequences are useful for liver vessel segmentation because vascular structures in the liver are clearly visible in these sequences. Although level-set based segmentation techniques are frequently used in liver segmentation due to their flexibility to adapt to different problems by incorporating prior knowledge, the need to initialize the contours on each slice is a common drawback of such techniques. In this paper, we present a fully automated variational level set approach for liver segmentation from SPIR image sequences. Our approach is designed to be efficient while achieving high accuracy. The efficiency is achieved by (1) automatically defining an initial contour for each slice, and (2) automatically computing weight values of each term in the applied energy functional at each iteration during evolution. Automated detection and exclusion of spurious structures (e.g. cysts and other bright white regions on the skin) in the pre-processing stage increases the accuracy and robustness. We also present a novel approach to reduce computational cost by employing binary regularization of level set function. A signed pressure force function controls the evolution of the active contour. The method was applied to ten data sets. In each image, the performance of the algorithm was measured using the receiver operating characteristics method in terms of accuracy, sensitivity and specificity. The accuracy of the proposed method was 96%. Quantitative analyses of results indicate that the proposed method can accurately, efficiently and consistently segment liver images.

O-014 Modelling Unstable Brain Aneurysms: MR Molecular Imaging of Myeloperoxidase in the Aneurysm Wall and Correlation with Human Pathology

IntroductionAn imaging approach identifying patients who benefit from treatment of unruptured intracranial aneurysms (UIA) is desired. We investigate a potential biomarker of UIA instability, myeloperoxidase (MPO), in human aneurysm tissue...

Contrast-enhanced three-dimensional MR imaging using T 1-weighted high-resolution isotropic volume examination (THRIVE): Focus on endometrial cancer

The present study sought to provide optimized radiographic information regarding endometrial cancer by comparing dynamic contrast-enhanced images obtained using the 3-dimensional T1-weighted high-resolution isotropic volume examination (3D-THRIVE) technique to existing 2-dimensional magnetic resonance (MR) images to provide data regarding the radiological advantages and the technical aspects of 3D-THRIVE. This study included 30 patients with suspected endometrial cancer who were referred for an MR exam for disease characterization and staging. A 3.0T MR scanner was used to obtain 2D turbo spin echo (2D-TSE) images prior to injection of the contrast medium. After the injection, 3D-THRIVE images and 2D spectral pre-saturation inversion recovery (2D-SPIR) images were obtained. The imaging methods were quantitatively compared using the signal-to-noise ratios (SNRs) of the uterus and the endometrial cancer, the contrast-to-noise ratio (CNR) between tissue pairs, and the time-intensity curve. Comparative qualitative analyses were also conducted using an MR image evaluation tool. Comparison of the pre- and post-contrast enhancement images showed that the SNRs measured from the uterus and the endometrial cancer (SNRuterus and SN Rec) were relatively higher and more optimized for the contrast-enhanced 3D-THRIVE and 2D-SPIR images than they were for the pre-contrast 2D-TSE images (p 0.05). The time-intensity curve was obtained with the 3D-THRIVE sequence and provided data that enabled a differentiation between malignant tumors and normal tissue. The overall image quality, artifacts, and lesion definition and representation were superior for contrast-enhanced 3D-THRIVE images compared to pre- and post-contrast enhancement of 2D-TSE and 2D-SPIR images (p < 0.05). In conclusion, 3D-THRIVE images had better image quality than 2D-TSE and SPIR images. In addition to 3D-THRIVE being an alternative to 2D-TSE and SPIR in terms of endometrial cancer characterization and staging, it also provides superior data for the differentiation between malignant tumors and normal tissue.

Measurement of brown adipose tissue mass using a novel dual-echo magnetic resonance imaging approach: A validation study

ObjectiveThe aim of this study was to evaluate and validate magnetic resonance imaging (MRI) for the visualization and quantification of brown adipose tissue (BAT) in vivo in a rat model. We hypothesized that, based on differences in tissue water and lipid content, MRI could reliably differentiate between BAT and white adipose tissue (WAT) and could therefore be a possible alternative for 18F-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET), the current gold standard for non-invasive BAT quantification. Materials/MethodsEleven rats were studied using both 18FDG-PET/CT and MRI (1.5T). A dual echo (in-and-out-of-phase) sequence was used, both with and without spectral presaturation inversion recovery (SPIR) fat suppression (DUAL-SPIR) to visualize BAT, after which all BAT was surgically excised. The BAT volume measurements obtained via 18FDG-PET/CT and DUAL-SPIR MR were quantitatively compared with the histological findings. All study protocols were reviewed and approved by the local ethics committee. ResultsThe BAT mass measurements that were obtained using DUAL-SPIR MR subtraction images correlated better with the histological findings (P=0.017, R=0.89) than did the measurements obtained using 18FDG-PET/CT (P=0.78, R=0.15), regardless of the BAT metabolic activation state. Additionally, the basic feasibility of the DUAL-SPIR method was demonstrated in three human pilot subjects. ConclusionsThis study demonstrates the potential for MRI to reliably detect and quantify BAT in vivo. MRI can provide information beyond that provided by 18FDG-PET imaging, and its ability to detect BAT is independent of its metabolic activation state. Additionally, MRI is a low-cost alternative that does not require radiation.

Spectral Presaturation Inversion Recovery MR Imaging Sequence after Gadolinium Injection to Differentiate Fibrotic Scar Tissue and Neoplastic Strands in the Mesorectal Fat in Patients Undergoing Restaging of Rectal Carcinoma after Neoadjuvant Chemo- and Radiation Therapy

To retrospectively assess the value of spectral presaturation by inversion-recovery (SPIR) magnetic resonance (MR) imaging sequence after gadolinium injection to differentiate fibrotic scar tissue and tumoral infiltration within the mesorectal fat in patients with rectal carcinoma undergoing MR restaging after neoadjuvant chemo- and radiation therapy (CRT). Forty-three consecutive patients (mean age, 65.8 years; range, 46-85 years; male:female, 29:14) with locally advanced rectal carcinoma underwent CRT followed by surgery. MR imaging was performed before and after completion of CRT by using T2-weighted turbo spin-echo and T1-weighted SPIR sequences before and after gadolinium injection, and MR images were assessed by two radiologists in consensus. Logistic regression was conducted to test the significance of the MR image findings with histology. After CRT the disease was either limited to the rectal wall (n = 18 patients) or presented perirectal infiltration (n = 25) on histology. In 21 patients, mesorectal enhancing strands were observed. Reticular-shaped enhancing strands reaching the mesorectal fascia presented the highest correlation with tumor infiltration of the mesorectal fat (OR 130.33, 95% CI: 4.1-4220.29; logistic regression), whereas linear-shaped enhancing strands either reaching or not reaching the mesorectal fascia (OR 0.25 or 0.1, 95% CI: 0.024-2.6 or 0.01-1.07) revealed the lowest correlation. Reticular-shaped enhancing strands on SPIR MR imaging after gadolinium injection are associated with tumor infiltration of the mesorectal fat.

Nebulized liposomal gadobenate dimeglumine contrast formulation for magnetic resonance imaging of larynx and trachea

BackgroundTo develop a lipid-stabilized contrast formulation containing gadobenate dimeglumine for clear visualization of the mucosal surfaces of the larynx and trachea for early diagnosis of disease by magnetic resonance imaging.MethodsThe contrast formulation was prepared by loading gadobenate dimeglumine into egg phosphotidylcholine, cholesterol, and sterylamine nanoliposomes using the dehydration-rehydration method. The liposomal contrast formulation was ultrasonically nebulized, and the deposition and coating pattern on explanted pig laryngeal and tracheal segments was examined by inductively coupled plasma atomic emission spectroscopy. The sizes of the nebulized droplets were characterized by photon correlation spectroscopy. The contrast-enhanced mucosal surface images of the larynx and trachea were obtained in a 3.0T magnetic resonance scanner using a T1-weighted spectral presaturation inversion recovery sequence.ResultsVarious cationic liposome formulations were compared for their stabilization effects on the droplets containing gadobenate dimeglumine. The liposomes composed of egg phosphotidylcholine, cholesterol, and sterylamine in a molar ratio of 1:1:1 were found to enable the most efficient nebulization and the resulting droplet sizes were narrowly distributed. They also resulted in the most even coating on the laryngeal and tracheal lumen surfaces and produced significant contrast enhancement along the mucosal surface. Such contrast enhancement could help clearer visualization of several disease states, such as intraluminal protrusions, submucosal nodules, and craters.ConclusionThis lipid-stabilized magnetic resonance imaging contrast formulation may be useful for improving mucosal surface visualization and early diagnosis of disease originating in the mucosal surfaces of the larynx and trachea.

Contrast-enhanced MR myelography in spontaneous intracranial hypotension: description of an artefact imitating CSF leakage

In contrast-enhanced (CE) MR myelography, hyperintense signal outside the intrathecal space in T1-weighted sequences with spectral presaturation inversion recovery (SPIR) is usually considered to be due to CSF leakage. We retrospectively investigated a hyperintense signal at the apex of the lung appearing in this sequence in patients with SIH (n = 5), CSF rhinorrhoea (n = 2), lumbar spine surgery (n = 1) and in control subjects (n = 6). Intrathecal application of contrast agent was performed in all patients before MR examination, but not in the control group. The reproducible signal increase was investigated with other fat suppression techniques and MR spectroscopy. All patients and controls showed strongly hyperintense signal at the apex of the lungs imitating CSF leakage into paraspinal tissue. This signal increase was identified as an artefact, caused by spectroscopically proven shift and broadening of water and lipid resonances (1-2 ppm) in this anatomical region. Only patients with SIH showed additional focal enhancement along the spinal nerve roots and/or in the spinal epidural space. In conclusion CE MR myelography with spectral selective fat suppression shows a reproducible cervicothoracic artefact, imitating CSF leakage. Selective water excitation technique as well as periradicular and epidural contrast collections may be helpful to discriminate between real pathological findings and artefacts.

Fat-suppressed t2* sequences for routine 3.0-tesla lumbar spine magnetic resonance imaging: a preliminary report

Clear depiction of the ligamentum flavum on routine lumbar magnetic resonance imaging (MRI) is essential in accurately describing the extent of degenerative disease. In routine, noncontrast evaluations, focal fatty deposition or hemangiomas can be difficult to distinguish from malignant foci on fast spin-echo (FSE) T2-weighted images. To describe the use of T2* fast field echo (T2FFE) in combination with spectral presaturation inversion recovery (SPIR) fat suppression for noncontrast, routine lumbar spine outpatient MR imaging at 3.0 Tesla (3T). An axial gradient echo (GE) T2FFE sequence was combined with SPIR fat suppression (T2FFE-SPIR), via a 3T Philips Intera (Philips Medical Systems, Best, The Netherlands) scanner, and added to the routine, noncontrast lumbar MRI examinations, which included sagittal FSE T1-weighted (T1WI), T2-weighted (T2WI), short-tau inversion recovery (STIR), and axial FSE T2WI. The sequence was performed in over 500 patients over a 1-year period, without intravenous contrast, and with slice thickness and planes of section identical to the axial FSE T1WI and T2WI images. The sequence typically lasted about 4.5-6 min. The use of T2FFE-SPIR enabled visualization of the ligamentum flavum in degenerative disease, and the exclusion of focal fatty lesions on FSE T2WI. Other benefits included: the identification of malignant foci, the uncommon detection of hemorrhage, and the elimination of spurious flow voids. Several brief examples are provided to demonstrate the utility of this technique. The addition of T2FFE-SPIR to routine, noncontrast protocols in outpatients could provide further confidence in the visualization of the ligamentum flavum in degenerative disease, and can exclude malignancy in T2-bright areas of focal fatty marrow. Larger studies would be helpful to evaluate the accuracy of this technique versus FSE techniques in depicting degenerative, malignant, or inflammatory disorders.

MR imaging of the normal appendix and acute appendicitis

To describe the MR appearance of the normal appendix and the MR imaging characteristics of acute appendicitis with correlation to pathological severity. A total of 20 volunteers participated in this study to demonstrate normal appendices by MR imaging. A total of 37 consecutive patients with clinically diagnosed acute appendicitis were also scanned. T1-weighted (T1WI) spin-echo images, T2-weighted (T2WI) fast spin-echo, and fat-suppressed spectral presaturation inversion recovery T2-weighted (T2SPIR) fast spin-echo images were obtained. The MR criteria for considering acute appendicitis were as follows: 1) thickening of the appendiceal wall with high intensity on T2WI or T2SPIR; 2) dilated lumen filled with high intensity material on T2WI or T2SPIR; and 3) increased intensity of periappendiceal tissue on T2WI or T2SPIR. The visibility of a normal appendix on MR imaging was 90% (18/20). It appeared as a cord-like structure of medium intensity without fluid collection in the lumen. A total of 30 cases with clinically diagnosed acute appendicitis had positive MR findings and all except one were pathologically proven. The one had cecal diverticulitis. These cases demonstrated filled lumen, with a hypointense wall on T1WI and slightly hyperintense on T2WI or T2SPIR. MR findings correlated well with pathological severity, especially a thicker wall, periappendiceal high intensity, and ascites were useful for suspecting severe appendicitis. Correct diagnosis of acute appendicitis was obtained with MRI, and correlated well with its pathological severity. MRI is a powerful alternative for diagnosing acute appendicitis especially for the patients in whom the radiation is major concern.

The deep infrapatellar bursa: prevalence and morphology on routine magnetic resonance imaging of the knee.

To evaluate the presence, location, and dimensions of the deep infrapatellar bursa on routine magnetic resonance (MR) imaging of the knee. The study group consisted of 213 knees in 204 consecutive individuals who had undergone routine MR imaging examination of the knee within a 365-day period. Magnetic resonance examinations consisted of T1-, proton-density-, and T2-weighted sagittal; spectral presaturation inversion recovery coronal; and T2*-weighted transverse sequences. Exclusion criteria were previous knee arthroscopy or surgery or the presence of a mass lesion infiltrating the infrapatellar fat pad. The presence, location, and dimensions of the deep infrapatellar bursa were studied. The bursa was also analyzed with regard to knee joint synovial effusion (absent, mild, or marked). The deep infrapatellar bursa was detected in 68% of the knees, most commonly on the lateral paramedian sagittal MR images. There was no statistically significant difference between male and female subjects or between the knee sides with regard to the detection of the deep infrapatellar bursa (P > 0.05). No correlation was found between synovial effusion and the presence of the deep infrapatellar bursa. The mean anteroposterior and craniocaudal dimensions of the deep infrapatellar bursa on sagittal T2-weighted MR images were 2.1-2.7 mm and 7.3-9.1 mm, respectively, on its lateral, central, or medial location within the sagittal MR image stack. An awareness of the dimensions and location of the deep infrapatellar bursa is important in distinguishing it from pathologic lesions (eg, bursitis).