Magnetic Resonance in Medical Sciences最新文献

{"title":"Diffusion Tensor Imaging Can Discriminate the Primary Cell Type of Intracranial Metastases for Patients with Lung Cancer.","authors":"Sabriye Sennur Bilgin,&nbsp;Mehmet Ali Gultekin,&nbsp;Ismail Yurtsever,&nbsp;Temel Fatih Yilmaz,&nbsp;Dilek Hacer Cesme,&nbsp;Melike Bilgin,&nbsp;Atakan Topcu,&nbsp;Mehmet Besiroglu,&nbsp;Haci Mehmet Turk,&nbsp;Alpay Alkan,&nbsp;Mehmet Bilgin","doi":"10.2463/mrms.mp.2020-0183","DOIUrl":"https://doi.org/10.2463/mrms.mp.2020-0183","url":null,"abstract":"<p><strong>Purpose: </strong>Histopathological differentiation of primary lung cancer is clinically important. We aimed to investigate whether diffusion tensor imaging (DTI) parameters of metastatic brain lesions could predict the histopathological types of the primary lung cancer.</p><p><strong>Methods: </strong>In total, 53 patients with 98 solid metastatic brain lesions of lung cancer were included. Lung tumors were subgrouped as non-small cell carcinoma (NSCLC) (n = 34) and small cell carcinoma (SCLC) (n = 19). Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) values were calculated from solid enhanced part of the brain metastases. The association between FA and ADC values and histopathological subtype of the primary tumor was investigated.</p><p><strong>Results: </strong>The mean ADC and FA values obtained from the solid part of the brain metastases of SCLC were significantly lower than the NSCLC metastases (P < 0.001 and P = 0.003, respectively). ROC curve analysis showed diagnostic performance for mean ADC values (AUC=0.889, P = < 0.001) and FA values (AUC = 0.677, P = 0.002). Cut-off value of > 0.909 × 10^-3 mm²/s for mean ADC (Sensitivity = 80.3, Specificity = 83.8, PPV = 89.1, NPV = 72.1) and > 0.139 for FA values (Sensitivity = 80.3, Specificity = 54.1, PPV = 74.2, NPV= 62.5) revealed in differentiating NSCLC from NSCLC.</p><p><strong>Conclusion: </strong>DTI parameters of brain metastasis can discriminate SCLC and NSCLC. ADC and FA values of metastatic brain lesions due to the lung cancer may be an important tool to differentiate histopathological subgroups. DTI may guide clinicians for the management of intracranial metastatic lesions of lung cancer.</p>","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 3","pages":"425-431"},"PeriodicalIF":3.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/af/mrms-21-425.PMC9316134.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25427571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast Enhancement of the Normal Infundibular Recess Using Heavily T2-weighted 3D FLAIR.","authors":"Iichiro Osawa,&nbsp;Eito Kozawa,&nbsp;Yuya Yamamoto,&nbsp;Sayuri Tanaka,&nbsp;Taira Shiratori,&nbsp;Akane Kaizu,&nbsp;Kaiji Inoue,&nbsp;Mamoru Niitsu","doi":"10.2463/mrms.mp.2021-0021","DOIUrl":"https://doi.org/10.2463/mrms.mp.2021-0021","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the present study was to evaluate contrast enhancement of the infundibular recess in the normal state using heavily T2-weighted 3D fluid-attenuated inversion recovery (FLAIR) (HT2-FLAIR).</p><p><strong>Methods: </strong>Twenty-six patients were retrospectively recruited. We subjectively assessed overall contrast enhancement of the infundibular recess between postcontrast, 4-hour (4-h) delayed postcontrast, and precontrast HT2-FLAIR images. We also objectively conducted chronological and spatial comparisons by measuring the signal intensity (SI) ratio (SIR). Chronological comparisons were performed by comparing SI of the infundibular recess/SI of the midbrain (SIR_IR-MB). Spatial comparisons were conducted by comparing SI on postcontrast HT2-FLAIR/SI on precontrast HT2-FLAIR (SIR_Post-Pre) of the infundibular recess with that of other cerebrospinal fluid (CSF) spaces, including the superior part of the third ventricle, lateral ventricles, fourth ventricle, and interpeduncular cistern.</p><p><strong>Results: </strong>In the subjective analysis, all cases showed contrast enhancement of the infundibular recess on both postcontrast and 4-h delayed postcontrast HT2-FLAIR, and showed weaker contrast enhancement of the infundibular recess on 4-h delayed postcontrast HT2-FLAIR than on postcontrast HT2-FLAIR. In the objective analysis, SIR_IR-MB was the highest on postcontrast images, followed by 4-h delayed postcontrast images. SIR_Post-Pre was significantly higher in the infundibular recess than in the other CSF spaces.</p><p><strong>Conclusion: </strong>The present results demonstrated that the infundibular recess was enhanced on HT2-FLAIR after an intravenous gadolinium injection. The infundibular recess may be a potential source of the leakage of intravenously administered gadolinium into the CSF.</p>","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 3","pages":"469-476"},"PeriodicalIF":3.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/37/mrms-21-469.PMC9316133.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38976040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion MR Imaging with T2-based Water Suppression (T2wsup-dMRI).","authors":"Tokunori Kimura,&nbsp;Kousuke Yamashita,&nbsp;Kouta Fukatsu","doi":"10.2463/mrms.mp.2021-0007","DOIUrl":"https://doi.org/10.2463/mrms.mp.2021-0007","url":null,"abstract":"<p><strong>Purpose: </strong>This study proposes and assesses a new diffusion MRI (dMRI) technique to solve problems related to the quantification of parameter maps (apparent diffusion coefficient [ADC] or mean diffusivity [MD], fractional anisotropy [FA]) and misdrawing of fiber tractography (FT) due to cerebrospinal fluid (CSF)-partial volume effects (PVEs) for brain tissues by combining with the T2-based water suppression (T2wsup) technique.</p><p><strong>Methods: </strong>T2wsup-diffusion-weighted imaging (DWI) images were obtained by subtracting those images from the acquired multi-b value (b) DWI images after correcting the signal intensities of multiecho time (TE) images using long TE water signal-dominant images. Quantitative parameter maps and FT were obtained from minimum data points and were compared with those using the standard (without wsup) DWI method, and partly compared with those obtained using other alternative DWI methods of applying fluid attenuation inversion recovery (FLAIR), non-b-zero (NBZ) by theoretical or noise-added simulation and MR images.</p><p><strong>Results: </strong>In the T2wsup-dMRI method, the hyperintense artifacts due to CSF-PVEs in MRI data were dramatically suppressed even at lower b (≲ 500 s/mm²) while keeping the tissue SNR. The quantitative parameter map values became precisely close to the pure tissue values precisely even in water (CSF) PVE voxels in healthy brain tissues (T2 ≲ 100 ms). Furthermore, the fiber tracts were correctly connected, particularly at the fornix in closest contact to the CSF.</p><p><strong>Conclusion: </strong>Solving the problem of CSF-PVE in the current dMRI technique using our proposed T2wsup-dMRI technique is easy, with higher SNR than those obtained with FLAIR or NBZ methods when applying to healthy brain tissues. The proposed T2wsup-dMRI could be useful in clinical settings, although further optimization of the pulse sequence and processing techniques and clinical assessments are required, particularly for long T2 lesions.</p>","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 3","pages":"499-515"},"PeriodicalIF":3.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/7f/mrms-21-499.PMC9316139.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39218783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating Liver Hemangioma from Metastatic Tumor Using T2-enhanced Spin-echo Imaging with a Time-reversed Gradient-echo Sequence in the Hepatobiliary Phase of Gadoxetic Acid-enhanced MR Imaging.","authors":"Yukihisa Takayama,&nbsp;Akihiro Nishie,&nbsp;Daisuke Okamoto,&nbsp;Nobuhiro Fujita,&nbsp;Yoshiki Asayama,&nbsp;Yasuhiro Ushijima,&nbsp;Tomoharu Yoshizumi,&nbsp;Masami Yoneyama,&nbsp;Kousei Ishigami","doi":"10.2463/mrms.mp.2020-0151","DOIUrl":"https://doi.org/10.2463/mrms.mp.2020-0151","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the utility of T2-enhanced spin-echo imaging using the time-reversed gradient echo sequence (T2FFE imaging) in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI (Gd-EOB-MRI) for differentiating hemangiomas from metastatic tumors.</p><p><strong>Methods: </strong>A total of 61 patients with 133 liver lesions, including 37 hemangiomas and 96 metastatic tumors, were scanned by Gd-EOB-MRI. Four data sets were independently analyzed by two readers: (1) 3D fat-suppressed T2-weighted imaging (FS-T2WI) alone; (2) the combination of 3D FS-T2WI and T2FFE imaging in the HBP of Gd-EOB-MRI; (3) the combination of 3D FS-T2WI, diffusion-weighted imaging (DWI) with the b-value of 1000 s/mm² and the apparent diffusion coefficient (ADC); and (4) a dynamic study of Gd-EOB-MRI. After classifying the lesion sizes as ≤ 10 mm or > 10 mm, we conducted a receiver-operating characteristic analysis to compare diagnostic accuracies among the four data sets for differentiating hemangiomas from metastatic tumors.</p><p><strong>Results: </strong>The areas under the curves (AUCs) of the four data sets of two readers were: (1) ≤ 10 mm (0.85 and 0.91) and > 10 mm (0.88 and 0.97), (2) ≤ 10 mm (0.94 and 0.94) and > 10 mm (0.96 and 0.95), (3) ≤ 10 mm (0.90 and 0.87) and > 10 mm (0.89 and 0.95), and (4) ≤ 10 mm (0.62 and 0.67) and > 10 mm (0.76 and 0.71), respectively. Data sets (2) and (3) showed no significant differences in AUCs, but both showed significantly higher AUCs compared to that of (4) regardless of the lesion size (P < 0.05).</p><p><strong>Conclusion: </strong>The combination of 3D FS-T2WI and T2FFE imaging in the HBP of Gd-EOB-MRI achieved an accuracy equivalent to that of the combination of 3D FS-T2WI, DWI, and ADC and might be helpful in differentiating hemangiomas from metastatic tumors.</p>","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 3","pages":"445-457"},"PeriodicalIF":3.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/70/mrms-21-445.PMC9316131.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Use of Texture Features and Morphological Classification Based on Dynamic Contrast-enhanced MR Imaging: Differentiating Benign and Malignant Breast Masses with High Negative Predictive Value.","authors":"Shigeharu Ohyu,&nbsp;Mitsuhiro Tozaki,&nbsp;Michiro Sasaki,&nbsp;Hisae Chiba,&nbsp;Qilin Xiao,&nbsp;Yasuko Fujisawa,&nbsp;Yoshiaki Sagara","doi":"10.2463/mrms.mp.2020-0160","DOIUrl":"https://doi.org/10.2463/mrms.mp.2020-0160","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the diagnostic performance of the texture features of dynamic contrast-enhanced (DCE) MRI for breast cancer diagnosis in which the discriminator was optimized, so that the specificity was maximized via the restriction of the negative predictive value (NPV) to greater than 98%.</p><p><strong>Methods: </strong>Histologically proven benign and malignant mass lesions of DCE MRI were enrolled retrospectively. Training and testing sets consist of 166 masses (49 benign, 117 malignant) and 50 masses (15 benign, 35 malignant), respectively. Lesions were classified via MRI review by a radiologist into 4 shape types: smooth (S-type, 34 masses in training set and 8 masses in testing set), irregular without rim-enhancement (I-type, 60 in training and 14 in testing), irregular with rim-enhancement (R-type, 56 in training and 22 in testing), and spicula (16 in training and 6 in testing). Spicula were immediately classified as malignant. For the remaining masses, 298 texture features were calculated using a parametric map of DCE MRI in 3D mass regions. Masses were classified into malignant or benign using two thresholds on a feature pair. On the training set, several feature pairs and their thresholds were selected and optimized for each mass shape type to maximize specificity with the restriction of NPV > 98%. NPV and specificity were computed using the testing set by comparison with histopathologic results and averaged on the selected feature pairs.</p><p><strong>Results: </strong>In the training set, 27, 12, and 15 texture feature pairs are selected for S-type, I-type, and R-type masses, respectively, and thresholds are determined. In the testing set, average NPV and specificity using the selected texture features were 99.0% and 45.2%, respectively, compared to the NPV (85.7%) and specificity (40.0%) in visually assessed MRI category-based diagnosis.</p><p><strong>Conclusion: </strong>We, therefore, suggest that the NPV of our texture-based features method described performs similarly to or greater than the NPV of the MRI category-based diagnosis.</p>","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 3","pages":"485-498"},"PeriodicalIF":3.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/79/mrms-21-485.PMC9316135.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39111436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special Issue on 4D Flow MRI in Magnetic Resonance in Medical Sciences","authors":"M. Markl","doi":"10.2463/mrms.con.2022-2000","DOIUrl":"https://doi.org/10.2463/mrms.con.2022-2000","url":null,"abstract":"4D flow MRI has emerged as a versatile imaging technique for the in vivo measurement of cardiac and vascular 3D hemodynamics. The feasibility of 4D flow MRI was initially demonstrated by 3D visualizations of dynamic changes in blood flow patterns and their associations with different cardiovascular abnormalities, e.g., the impact of heart valve disease on deranged flow in the aorta and pulmonary artery. The continued evolution of 4D flowMRI over the past two decades comprised a shift from qualitative imaging of flow patterns toward a focus on quantitative analysis workflows, including standardized flow parameters (peak velocity, net flow, etc.) and also advanced hemodynamics measures, such as wall shear stress, to investigate the role of abnormal hemodynamics at play in vessel wall remodeling. In tandem with the development of reliable quantitative imaging parameters, there has been a focus on making 4D flow MRI faster and easier to use in the clinical setting. Novel acceleration techniques such as compressed sensing, and more recently, deep learning concepts, have reduced scan times to less than 5 minutes, a significant improvement from imaging sessions that, once regularly, take 20–30 minutes. In addition, interpretation of 4D flow MRI no longer requires a dedicated research team. Post-processing workflows have been streamlined; visualization and analysis of data have become more straightforward and are now readily integrated with commercially available software solutions for cardiovascular image analysis.","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 1","pages":"257 - 257"},"PeriodicalIF":3.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48661930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EIC Remarks for a Special 20th Anniversary Issue of MRMS","authors":"T. Obata","doi":"10.2463/mrms.e.2021-3000","DOIUrl":"https://doi.org/10.2463/mrms.e.2021-3000","url":null,"abstract":"Magnetic Resonance in Medical Sciences (MRMS), the official journal of the Japanese Society of Magnetic Resonance in Medicine (JSMRM), has reached the milestone of Vol. 20. To celebrate the occasion, we have invited a group of researchers who have made certain outstanding contributions over the years to write a review article for this special 20th anniversary issue. We sincerely thank the authors for their contributions and believe that you will find the reviews informative as they contain a lot about the recent state of the art. For the 20th anniversary, I would like to present here a short history of the journal and talk about some of the major contributors to MRMS over the years. MRMSwas first published in 2002 under the leadership of Professor Kazuro Sugimura, the 1st Editor-in-Chief (EIC). His mission was to create an internationally recognized journal published by JSMRM for all active MR scientists and engineers. At first, MRMS was unfamiliar to people in the field of MR, but under the 2nd EIC, Dr. TsuneyaWatabe, the editorial committee endeavored to raise the profile of the journal. Happily, the number of submissions has gradually increased over time. At about the time Dr. Shigeki Aoki was selected as the 3rd EIC, MRMS succeeded in acquiring an Impact Factor (IF), and from that time, the number of submissions has significantly increased. Although there have been some fluctuations, the IF has been on an upward trend with the most recent value, announced in June 2021, being 2.471 (Fig. 1). We are extremely grateful for the contributions of both the authors who submit important research and the reviewers who volunteer their time to review and comment on those submissions. From here, I would like to introduce some of the major contributions.","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 1","pages":"1 - 5"},"PeriodicalIF":3.0,"publicationDate":"2022-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48196401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Commemoration of the 20th Anniversary of MRMS","authors":"Shigeki Aoki","doi":"10.2463/mrms.con.2021-1000","DOIUrl":"https://doi.org/10.2463/mrms.con.2021-1000","url":null,"abstract":"Congratulations to Magnetic Resonance in Medical Sciences (MRMS) on its 20th anniversary! As the third Editor-in-Chief, serving from 2008 to 2018, I am delighted to celebrate this momentous occasion. My first involvement with the Japanese Journal of Magnetic Resonance in Medicine (in Japanese) was in 1986 when I published my first paper on Gd-relaxometry in rats. I still remember how happy and proud I was that my first paper had been published in a medical journal. Around the year 2006, a few years after MRMS was established, I became a member of the editorial board. Since then, I have been involved in constructing and improving the platform for peer review within the J-STAGE system: the first phase was the introduction of online submission in December 2009; the second phase was moving over to ScholarOne in October 2011; and the third phase began in 2015 when MRMS outsourced peer review management to Medical Tribune.","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 1","pages":"7 - 8"},"PeriodicalIF":3.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42314602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical Background for 4D Flow MR Imaging.","authors":"Masaki Terada,&nbsp;Yasuo Takehara,&nbsp;Haruo Isoda,&nbsp;Tetsuya Wakayama,&nbsp;Atsushi Nozaki","doi":"10.2463/mrms.rev.2021-0104","DOIUrl":"https://doi.org/10.2463/mrms.rev.2021-0104","url":null,"abstract":"<p><p>Recently, the hemodynamic assessments with 3D cine phase-contrast (PC) MRI (4D flow MRI) have attracted considerable attention from clinicians. Unlike 2D cine PC MRI, the technique allows for cardiac phase-resolved data acquisitions of flow velocity vectors within the entire FOV during a clinically viable period. Thus, the method has enabled retrospective flowmetry in the spatial and temporal axes, which are essential to derive hemodynamic parameters related to vascular homeostasis and those to the progression of the pathologies. Accelerations in imaging are critical for this technology to be clinically viable; however, a high SNR or velocity-to-noise ratio (VNR) is also vital for accurate flow measurements. In this chapter, the technologies enabling this difficult balance are discussed.</p>","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 2","pages":"267-277"},"PeriodicalIF":3.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/90/mrms-21-267.PMC9680548.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39790225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Applications of 4D Flow MRI in the Portal Venous System.","authors":"Thekla H Oechtering,&nbsp;Grant S Roberts,&nbsp;Nikolaos Panagiotopoulos,&nbsp;Oliver Wieben,&nbsp;Scott B Reeder,&nbsp;Alejandro Roldán-Alzate","doi":"10.2463/mrms.rev.2021-0105","DOIUrl":"https://doi.org/10.2463/mrms.rev.2021-0105","url":null,"abstract":"<p><p>Evaluation of the hemodynamics in the portal venous system plays an essential role in many hepatic pathologies. Changes in portal flow and vessel morphology are often indicative of disease.Routinely used imaging modalities, such as CT, ultrasound, invasive angiography, and MRI, often focus on either hemodynamics or anatomical imaging. In contrast, 4D flow MRI facilitiates a more comprehensive understanding of pathophysiological mechanisms by simultaneously and noninvasively acquiring time-resolved flow and anatomical information in a 3D imaging volume.Though promising, 4D flow MRI in the portal venous system is especially challenging due to small vessel calibers, slow flow velocities, and breathing motion. In this review article, we will discuss how to account for these challenges when planning and conducting 4D flow MRI acquisitions in the upper abdomen. We will address patient preparation, sequence acquisition, postprocessing, quality control, and analysis of 4D flow data.In the second part of this article, we will review potential clinical applications of 4D flow MRI in the portal venous system. The most promising area for clinical utilization is the diagnosis and grading of liver cirrhosis and its complications. Relevant parameters acquired by 4D flow MRI include the detection of reduced or reversed flow in the portal venous system, characterization of portosystemic collaterals, and impaired response to a meal challenge. In patients with cirrhosis, 4D flow MRI has the potential to address the major unmet need of noninvasive detection of gastroesophageal varices at high risk for bleeding. This could replace many unnecessary, purely diagnostic, and invasive esophagogastroduodenoscopy procedures, thereby improving patient compliance with follow-up. Moreover, 4D flow MRI offers unique insights and added value for surgical planning and follow-up of multiple hepatic interventions, including transjugular intrahepatic portosystemic shunts, liver transplantation, and hepatic disease in children. Lastly, we will discuss the path to clinical implementation and remaining challenges.</p>","PeriodicalId":18119,"journal":{"name":"Magnetic Resonance in Medical Sciences","volume":"21 2","pages":"340-353"},"PeriodicalIF":3.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/9e/mrms-21-340.PMC9680553.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39861589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}