Journal of Magnetic Resonance Imaging最新文献

Background: A recent neurodevelopmental rat model, utilizing lactational exposure to polyriboinosinic-polyribocytidilic acid (Poly I:C) leads to mimics of behavioral phenotypes resembling schizophrenia-like symptoms in male offspring and depression-like symptoms in female offspring.

Purpose: To identify mechanisms of neuronal abnormalities in lactational Poly I:C offspring using quantitative MRI (qMRI) tools.

Study type: Prospective.

Animal model: Twenty Poly I:C rats and 20 healthy control rats, age 130 postnatal day.

Field strength/sequence: 7 T. Multiflip-angle FLASH protocol for T₁ mapping; multi-echo spin-echo T₂-mapping protocol; echo planar imaging protocol for diffusion tensor imaging.

Assessment: Nursing dams were injected with the viral mimic Poly I:C or saline (control group). In adulthood, quantitative maps of T₁, T₂, proton density, and five diffusion metrics were generated for the offsprings. Seven regions of interest (ROIs) were segmented, followed by extracting 10 quantitative features for each ROI.

Statistical tests: Random forest machine learning (ML) tool was employed to identify MRI markers of disease and classify Poly I:C rats from healthy controls based on quantitative features.

Results: Poly I:C rats were identified from controls with an accuracy of 82.5 ± 25.9% for females and 85.0 ± 24.0% for males. Poly I:C females exhibited differences mainly in diffusion-derived parameters in the thalamus and the medial prefrontal cortex (MPFC), while males displayed changes primarily in diffusion-derived parameters in the corpus callosum and MPFC.

Data conclusion: qMRI shows potential for identifying sex-specific brain abnormalities in the Poly I:C model of neurodevelopmental disorders.

Level of evidence: NA TECHNICAL EFFICACY: Stage 2.

Background: Pulmonary hypertension (PH) is a life-threatening. Differentiation pulmonary arterial hypertension (PAH) from pulmonary venous hypertension (PVH) is important due to distinct treatment protocols. Invasive right heart catheterization (RHC) remains the reference standard but noninvasive alternatives are needed.

Purpose/hypothesis: To evaluate 4D Flow MRI-derived 3D vortex energetics in the left pulmonary artery (LPA) for distinguishing PAH from PVH.

Study type: Prospective case-control.

Population/subjects: Fourteen PAH patients (11 female) and 18 PVH patients (9 female) diagnosed from RHC, 23 healthy controls (9 female).

Field strength/sequence: 1.5 T; gradient recalled echo 4D flow and balanced steady-state free precession (bSSFP) cardiac cine sequences.

Assessment: LPA 3D vortex cores were identified using the lambda2 method. Peak vortex-contained kinetic energy (vortex-KE) and viscous energy loss (vortex-EL) were computed from 4D flow MRI. Left and right ventricular (LV, RV) stroke volume (LVSV, RVSV) and ejection fraction (LVEF, RVEF) were computed from bSSFP. In PH patients, mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWR) and pulmonary vascular resistance (PVR) were determined from RHC.

Statistical tests: Mann-Whitney U test for group comparisons, Spearman's rho for correlations, logistic regression for identifying predictors of PAH vs. PVH and develop models, area under the receiver operating characteristic curve (AUC) for model performance. Significance was set at P < 0.05.

Results: PAH patients showed significantly lower vortex-KE (37.14 [14.68-78.52] vs. 76.48 [51.07-120.51]) and vortex-EL (9.93 [5.69-25.70] vs. 24.22 [12.20-32.01]) than PVH patients. The combined vortex-KE and LVEF model achieved an AUC of 0.89 for differentiating PAH from PVH. Vortex-EL showed significant negative correlations with mPAP (rho = -0.43), PCWP (rho = 0.37), PVR (rho = -0.64). In the PAH group, PVR was significantly negatively correlated with LPA vortex-KE (rho = -0.73) and vortex-EL (rho = -0.71), and vortex-KE significantly correlated with RVEF (rho = 0.69), RVSV, (rho = 0.70). In the PVH group, vortex-KE (rho = 0.52), vortex-EL significantly correlated with RVSV (rho = 0.58).

Data conclusion: These preliminary findings suggest that 4D flow MRI-derived LPA vortex energetics have potential to noninvasively differentiate PAH from PVH and correlate with invasive hemodynamic parameters.

Evidence level: 1 TECHNICAL EFFICACY: Stage 3.

Background: Multiparametric MRI (mpMRI) provides detailed insights into renal function, but the impact of anthropometric factors on renal imaging is not fully understood.

Purpose: To investigate regional correlations between mpMRI parameters and age, body mass index (BMI), and body surface area (BSA).

Study type: Prospective, cross-sectional observational study.

Population: Twenty-nine healthy volunteers (44.5 ± 18.3 years, 18 females) without a history of renal disease.

Field strength/sequence: 3-T, pseudo-continuous arterial spin labeling, multi-echo gradient-recalled echo, diffusion-weighted imaging, T₁ and T₂ mapping.

Assessment: Bilateral kidneys were segmented into nine concentric layers (outer cortex to inner regions) and nine equiangular sections (lower to upper pole). Key parameters (renal blood flow [RBF], $R_2^{*}$ , apparent diffusion coefficient [ADC], T₁ and T₂ maps) were correlated with age, BMI, and BSA. Differences in parameters between age and BMI groups were also evaluated.

Statistical tests: Spearman correlation, Mann-Whitney U test, and rank-biserial correlation coefficient for effect size. A P-value <0.05 was considered statistically significant.

Results: RBF correlated negatively with age in all regions and BMI in inner layers and lower pole. ADC negatively correlated with BMI (significance was not reached in layers 2, 7, 8; P-value = 0.06-0.12) and BSA in layers 1-7. T₁ negatively correlated with age in inner regions and lower medial pole. Significant positive correlations were found between age and $R_2^{*}$ (outermost layer, upper pole), age and T₂ (inner and cranial-caudal regions), as well as BMI and T₂ (except upper pole; P-value = 0.06). Significant differences between age groups were observed for RBF (all regions), $R_2^{*}$ (outermost and second innermost layers, central lateral region), T₁ (innermost layer), and T₂ (upper medial pole). Between BMI groups, ADC (middle layers, upper medial pole) and T₂ (outermost and inner layers, lower pole to lateral region) differed significantly.

Data conclusion: Intrarenal variance of mpMRI parameters correlated with age, BMI, and BSA.

Evidence level: 4 TECHNICAL EFFICACY: Stage 1.

Background: The global rise in kidney diseases underscores the need for reliable, noninvasive imaging biomarkers. Among these, renal cortical T1 has shown promise but further technical validation is still required.

Purpose: To evaluate the repeatability, reproducibility, and observer variability of kidney cortical T1 mapping in human volunteers without known renal disease.

Study type: Prospective.

Subjects: Three cohorts without renal disease: 1) 25 volunteers (median age 38 [interquartile range, IQR: 28-42] years, female N = 11) for scan-rescan assessments on GE 1.5 T and Siemens 1.5 T; 2) 29 volunteers (median age 29 [IQR: 24-40] years, female N = 15) for scan-rescan assessments on Siemens 3 T; and 3) 16 volunteers (median age 34 [IQR: 31-42] years, female N = 8) for cross-scanner reproducibility.

Field strength/sequences: 1.5 T and 3 T, a modified Look-Locker imaging (MOLLI) sequence with a balanced steady-state free precession (bSSFP) readout.

Assessment: Kidney cortical T1 data was acquired on GE 1.5 T scanner, Siemens 1.5 T and 3 T scanners. Within-scanner repeatability and inter/intra-observer variability: GE 1.5 T and Siemens 1.5 T, and cross-scanner manufacturer reproducibility: Siemens 1.5 T-GE 1.5 T.

Statistical tests: Bland Altman analysis, coefficient of variation (CoV), intra-class coefficient (ICC), and repeatability coefficient (RC).

Results: Renal cortical T1 mapping showed high repeatability and reliability across scanner field strengths and manufacturers (repeatability: CoV 1.9%-2.8%, ICC 0.79-0.88, pooled RC 73 msec; reproducibility: CoV 3.0%, ICC 0.75, RC 90 msec). The method also showed robust observer variability (CoV 0.6%-1.4%, ICC 0.93-0.98, RC 22-48 msec).

Data conclusion: Kidney cortical T1 mapping is a highly repeatable and reproducible method across MRI manufacturers, field strengths, and observer conditions.

Evidence level: 2 TECHNICAL EFFICACY: Stage 2.

Background: The Osteoarthritis Initiative (OAI) collected extensive imaging data, including Multi-Echo Spin-Echo (MESE) sequences for measuring knee cartilage T₂ relaxation times. Mono-exponential models are used in the OAI for T₂ fitting, which neglects stimulated echoes and B₁ inhomogeneities. Extended Phase Graph (EPG) modeling addresses these limitations but has not been applied to the OAI dataset.

Purpose: To assess how different fitting methods, including EPG-based and exponential-based approaches, affect the accuracy and reproducibility of cartilage T₂ in the OAI dataset.

Study type: Retrospective.

Population: From OAI dataset, 50 subjects, stratified by osteoarthritis (OA) severity using Kellgren-Lawrence grades (KLG), and 50 subjects without OA diagnosis during OAI duration were selected (each group: 25 females, mean ages ~61 years).

Field strength/sequence: 3-T, two-dimensional (2D) MESE sequence.

Assessment: Femoral and tibial cartilages were segmented from DESS images, subdivided into seven sub-regions, and co-registered to MESE. T₂ maps were obtained using three EPG-based methods (nonlinear least squares, dictionary matching, and deep learning) and three mono-exponential approaches (linear least squares, nonlinear least squares, and noise-corrected exponential). Average T₂ values within sub-regions were obtained. Pair-wise agreement among fitting methods was evaluated using the stratified subjects, while reproducibility using healthy subjects. Each method's T₂ accuracy and repeatability varying signal-to-noise ratio (SNR) were assessed with simulations.

Statistical tests: Bland-Altman analysis, Lin's concordance coefficient, and coefficient of variation assessed agreement, repeatability, and reproducibility. Statistical significance was set at P-value <0.05.

Results: EPG-based methods demonstrated superior T₂ accuracy (mean absolute error below 0.5 msec at SNR > 100) compared to mono-exponential methods (error > 7 msec). EPG-based approaches had better reproducibility, with limits of agreement 1.5-5 msec narrower than exponential-based methods. T₂ values from EPG methods were systematically 10-17 msec lower than those from mono-exponential fitting.

Data conclusion: EPG modeling improved agreement and reproducibility of cartilage T₂ mapping in subjects from the OAI dataset.

Evidence level: 3 TECHNICAL EFFICACY: Stage 1.

Background: Cardiac magnetic resonance elastography (MRE) shows promise in assessing the mechanofunctional properties of the heart but faces clinical challenges, mainly synchronization with cardiac cycle, breathing, and external harmonic stimulation.

Purpose: To determine the reproducibility of in vivo cardiac multifrequency MRE (MMRE) for assessing diastolic left ventricular (LV) stiffness and viscosity.

Study type: Prospective.

Subjects: This single-center study included a total of 28 participants (mean age, 56.6 ± 23.0 years; 16 male) consisting of randomly selected healthy participants (mean age, 44.6 ± 20.1 years; 9 male) and patients with aortic stenosis (mean age, 78.3 ± 3.8 years; 7 male).

Field strength/sequence: 3 T, 3D multifrequency MRE with a single-shot spin-echo planar imaging sequence.

Assessment: Each participant underwent two cardiac MMRE examinations on the same day. Full 3D wave fields were acquired in diastole at frequencies of 80, 90, and 100 Hz during a total of three breath-holds. Shear wave speed (SWS) and penetration rate (PR) were reconstructed as a surrogate for tissue stiffness and inverse viscous loss. Epicardial and endocardial ROIs were manually drawn by two independent readers to segment the LV myocardium.

Statistical tests: Shapiro-Wilk test, Bland-Altman analysis and intraclass correlation coefficient (ICC). P-value <0.05 were considered statistically significant.

Results: Bland-Altman analyses and intraclass correlation coefficients (ICC = 0.96 for myocardial stiffness and ICC = 0.93 for viscosity) indicated near-perfect test-retest repeatability among examinations on the same day. The mean SWS for scan and re-scan diastolic LV myocardium were 2.42 ± 0.24 m/s and 2.39 ± 0.23 m/s; the mean PR were 1.24 ± 0.17 m/s and 1.22 ± 0.14 m/s. Inter-reader variability showed good to excellent agreement for myocardial stiffness (ICC = 0.92) and viscosity (ICC = 0.85).

Data conclusion: Cardiac MMRE is a promising and reproducible method for noninvasive assessment of diastolic LV stiffness and viscosity.

Level of evidence: 2 TECHNICAL EFFICACY: 1.

Background: Intrinsic activation MR elastography (iMRE) uses cardiovascular pulsations to assess tissue viscoelastic properties. Applying it to focal liver lesions extends its capabilities.

Purpose: To assess the viscoelastic parameters of focal liver lesions measured by iMRE and compare its diagnostic performance with extrinsic MRE (eMRE) for differentiating malignant and benign lesions.

Study type: Prospective.

Population: A total of 55 participants underwent MRI with research MRE sequences; 32 participants with 17 malignant and 15 benign lesions underwent both iMRE and eMRE. FIELD STRENGTH/SEQUENCE: iMRE at ~1 Hz heart rate used a 3 T scanner with a modified four-dimensional (4D)-quantitative flow gradient-echo phase contrast and low-velocity encoding cardiac-triggered technique. eMRE employed a gradient-echo sequence at 30, 40, and 60 Hz.

Assessment: Liver displacements were measured using 4D-phase contrast and reconstructed via a nonlinear inversion algorithm to determine shear stiffness (SS) and damping ratio (DR). iMRE parameters were normalized to the corresponding values from the spleen. Lesions were manually segmented, and image quality was reviewed.

Statistical tests: Kruskal-Wallis, Mann-Whitney, Dunn's test, and areas under receiver operating characteristic curves (AUC) were assessed.

Results: SS was significantly higher in malignant than benign lesions with iMRE at 1 Hz (3.69 ± 1.31 vs. 1.63 ± 0.45) and eMRE at 30 Hz (3.76 ± 1.12 vs. 2.60 ± 1.26 kPa), 40 Hz (3.76 ± 1.12 vs. 2.60 ± 1.26 kPa), and 60 Hz (7.32 ± 2.87 vs. 2.48 ± 1.12 kPa). DR was also significantly higher in malignant than benign lesions at 40 Hz (0.36 ± 0.11 vs. 0.21 ± 0.01) and 60 Hz (0.89 ± 0.86 vs. 0.22 ± 0.09). The AUC were 0.86 for iMRE SS, 0.87-0.98 for eMRE SS, 0.47 for iMRE DR, and 0.62-0.86 for eMRE DR.

Data conclusion: Cardiac-activated iMRE can characterize liver lesions and differentiate malignant from benign lesions through normalized SS maps.

Level of evidence: 2 TECHNICAL EFFICACY: Stage 2.

Background: Women with premenstrual syndrome (PMS) are at increased risk for depression throughout their lives. White matter (WM) microstructure and inflammatory cytokine alterations have been proposed in its etiology.

Purpose: To investigate whether WM, assessed using diffusion tensor imaging (DTI), and inflammatory cytokine levels are altered in PMS, and to examine the relationships between WM microstructure, inflammatory cytokines, and symptom severity.

Study type: Prospective.

Subjects: Forty-two PMS patients and 58 healthy controls (HCs), categorized according to the daily record of severity of problems (DRSP).

Field strength/sequence: 3-T, echo planar imaging DTI.

Assessment: Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured by using tract-based spatial statistics (TBSS). Venous blood was collected to measure cytokines, including interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). Symptoms were assessed by using the DRSP.

Statistical tests: Two-sample t test or Mann-Whitney U test were used to compare the DRSP and cytokines. Abnormal DTI metrics in WM were extracted and the differences between groups were analyzed by using two sample t-tests. Spearman's correlation (r) was used to assess the relationship between DTI metrics, cytokines, and DRSP. A P-value <0.05 with FDR correction was considered statistically significant.

Results: Compared with HCs, PMS patients showed significantly lower FA in the corpus callosum and corona radiata, and significantly higher MD, AD, and RD in the corticospinal tract (CST), and significantly higher MD and RD in the anterior thalamic radiation (ATR). These differential metrics were significantly correlated with DRSP. Patients showed significantly higher IL-1β and TNF-α than HCs. Moreover, TNF-α correlated positively with MD, AD, and RD in both groups (r range, 0.256-0.315).

Data conclusion: Alterations of WM microstructure and IL-1β and TNF-α may be associated with PMS symptom severity, and TNF-α may correlate with DTI metrics of CST and ATR pathways.

Evidence level: 1 TECHNICAL EFFICACY: Stage 2.