Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine最新文献

Purpose: Alzheimer's disease (AD) is a progressive neurodegenerative disorder influenced by genetic factors, with a long preclinical phase characterized by subtle alterations in brain microstructure. Although the apolipoprotein E ε4 allele is a well-established genetic risk factor, AD is increasingly recognized as a polygenic condition. However, how polygenic risk manifests in white matter (WM) microstructure and cognition remains unclear. This study aims to investigate the associations between AD polygenic risk scores (ADPRS), WM microstructure, and cognitive performance in clinically asymptomatic adults.

Methods: Data from 36400 individuals (aged 45-83 years) in the UK Biobank were analyzed. Diffusion tensor imaging and neurite orientation dispersion and density imaging metrics were extracted from 48 WM tracts. General linear models were used to examine associations between ADPRS, WM integrity, and 10 cognitive measures. Mediation analyses were conducted to test whether WM microstructure mediated the relationship between ADPRS and cognitive performance.

Results: Higher ADPRS was significantly associated with reduced fractional anisotropy and intracellular volume fraction, and with increased mean, axial, and radial diffusivity, as well as isotropic volume fraction across limbic and association fibers, particularly in the cingulum hippocampus, fornix, posterior thalamic radiation, and superior fronto-occipital fasciculus. Higher ADPRS was also associated with poorer cognitive performance, most prominently on tests of executive function (Trail Making Test B), episodic memory (Paired Associate Learning), and processing speed (Symbol Digit Substitution). Mediation analysis revealed that WM microstructural alterations, especially increased radial diffusivity and reduced fractional anisotropy in the posterior thalamic radiation, partially mediated the association between ADPRS and cognitive performance, accounting for up to 4.88% of the total effect.

Conclusion: ADPRS is linked to selective WM microstructural alterations and subtle cognitive difference in clinically asymptomatic adults. WM microstructural changes partially mediate the association between ADPRS and cognitive performance.

Purpose: MR cholangiopancreatography (MRCP) often suffers from signal loss because of concentrated bile. Gradient-and-spin-echo (GRASE) MRCP reduces this effect but is limited by breath-holding. We developed MRCP with centric order encoding (MRCP-CORE), a novel free-breathing sequence with shorter TE using centric k-space trajectory, T2 preparation, and velocity encoding, and evaluated its ability to visualize gallbladder.

Methods: In this prospective, single-center study, we enrolled 100 consecutive patients who underwent 3 MRCP sequences (MRCP-CORE, conventional MRCP, and GRASE MRCP) on a 3T system. Two blinded radiologists independently assessed the visibility of anatomical structures, artifacts, and overall image quality. SNR, contrast-to-noise ratio, and contrast ratio of the periductal tissue and gallbladder were measured. The Friedman test was used for comparisons; Jonckheere-Terpstra analysis tested the association between the gallbladder visibility and quantitative metrics.

Results: Ninety-nine patients (mean age, 68.5 ± 10.9 years; 52 men, 47 women) were evaluated. MRCP-CORE showed significantly higher SNR than conventional and GRASE MRCP (20.9 vs. 17.3 vs. 15.8; P < 0.001). Gallbladder visibility was significantly higher with MRCP-CORE than via conventional MRCP (P = 0.02) and comparable to that via GRASE MRCP (P = 1.00). No significant differences in artifact and overall image quality were observed among sequences. Trend analysis revealed gallbladder visibility was significantly influenced by bile concentration in conventional MRCP (P < 0.001), but not in MRCP-CORE (P = 0.12) or GRASE MRCP (P = 0.43).

Conclusion: MRCP-CORE enhanced gallbladder depiction compared with conventional MRCP, offering a robust free-breathing alternative to breath-hold GRASE MRCP.

This case report shows that paramagnetic rim lesions (PRLs), markers of chronic active lesions in multiple sclerosis, vary in visibility depending on scan-parameters of susceptibility-weighted imaging (SWI). Routine SWI for microbleed detection with low flip angle (FA) failed to depict PRLs, while longer TE and higher FA improved visibility. Phase images consistently visualized PRLs. These findings underscore the need to optimize TE and FA, as suboptimal SWI settings may hinder PRL detection.

Purpose: To evaluate whether periodically rotated overlapping parallel lines with enhanced reconstruction-diffusion-weighted imaging (PROPELLER-DWI) combined with deep learning-based reconstruction (DLR) improves head and neck DWI, we conducted a primary comparison of PROPELLER-DWI with DLR at varying strengths and without DLR, and a secondary comparison of DLR-processed PROPELLER-DWI with DLR-processed single-shot echo-planar imaging (EPI)-DWI.

Methods: Ten healthy adults (8 males, 2 females) participated in the study. PROPELLER-DWI and single-shot EPI-DWI images were acquired using a 3-Tesla MRI system (Discovery MR750w; GE Healthcare, Waukesha, WI, USA) with various recon deep-learning strength (DLS) values: off (DLS-Off), low (DLS-L), medium (DLS-M), and high (DLS-H). We measured the SNR and contrast ratio on DWI images and value of coefficient of variation (CV) on apparent diffusion coefficient (ADC) maps for a quantitative evaluation. For a qualitative evaluation, we visually evaluated the overall image quality, degree of geometric distortion, and magnetic susceptibility artifacts.

Results: The SNRs for PROPELLER and EPI-DWI improved with the increase in the DLS level, with DLS-H showing a significantly higher SNR than DLS-Off. ADC maps demonstrated lower CVs at higher DLS levels, significantly lower in DLS-H than DLS-Off. The qualitative evaluation revealed that PROPELLER-DWI with DLR (at all DLS levels: -L, -M, and -H) provided significantly better overall image quality than that without DLR. In addition, PROPELLER-DWI demonstrated significantly higher qualitative scores across all evaluation items (i.e., overall image quality, geometric distortion, and magnetic susceptibility artifacts) compared with EPI-DWI.

Conclusion: In head and neck DWI, PROPELLER-based acquisition with DLR enabled the acquisition of visually superior image quality. This approach is clinically useful for the head and neck radiology.

The optimal TR for prostate diffusion-weighted imaging (DWI) remains unclear. Given prostate cancers' shorter T1/T2 relaxation times versus benign tissues, TR adjustment may improve contrast. We evaluated 56 clinically significant cancers in 33 patients, comparing synthetic DWI (b-value = 2000 s/mm²) at TR500/1000/1500/2000 ms against conventional TR6000 ms. Assessments included contrast ratio, apparent SNR, lesion conspicuity score, DWI scores based on Prostate Imaging Reporting and Data System (PI-RADS) v2.1, and background suppression. TR6000 showed significantly lower contrast ratio but higher apparent SNR compared with shorter TRs. TR1000-2000 showed higher lesion conspicuity score than TR500, while TR1500-6000 had higher DWI scores than TR500. TR500-1500 provided better background suppression than TR2000/6000. For optimal balance of contrast and noise, TR1000 or TR1500 is recommended for prostate DWI, potentially enhancing prostate cancer detection in clinical practice.

Purpose: To develop and evaluate short-TR acquisition time-of-flight (STRA-TOF) MR angiography (MRA), which combines an optimized STRA with deep learning-based reconstruction to achieve scan-time reduction while maintaining image quality in the visualization of intracranial arteries.

Methods: Ten healthy volunteers and 3 patients with moyamoya disease were examined using 3D TOF MRA with the clinical moyamoya protocol and 2 STRA-TOF protocols employing 4-slab (STRA4) and 9-slab (STRA9) configurations. STRA-TOF employed a TR of approximately 10 ms with variable-density Poisson-disc sampling and unrolled deep learning reconstruction. Bloch equation simulations validated the theoretical basis for STRA. Quantitative assessment included SNR and contrast-to-noise ratio measurements. Two radiologists independently evaluated image quality using a 3-point scale across 9 vascular territories and overall image quality, with blinded assessment. Statistical analysis was performed using the Friedman test with post hoc Wilcoxon signed-rank tests.

Results: STRA-TOF achieved approximately a 50% reduction in scan time compared with conventional protocols. Both STRA sequences demonstrated significantly higher SNR and contrast-to-noise ratio than conventional TOF (P < 0.001). Overall image quality scores were higher for STRA4 and STRA9 compared with conventional TOF in both readers. Across the 9 vascular territories, both readers consistently rated STRA sequences equal to or superior to conventional TOF, particularly for distal branches. In the small patient cohort with moyamoya disease (n = 3), STRA-TOF demonstrated feasibility for visualizing complex arterial pathology, including stenotic vessels, collateral circulation, and postsurgical vascular changes.

Conclusion: STRA-TOF achieved approximately a 50% reduction in scan time while maintaining or improving image quality compared with conventional 3D TOF MRA. This technique addresses the fundamental scan-time limitations of the conventional method, with potential for significant clinical benefits in terms of patient comfort, workflow efficiency, and improved access to intracranial artery evaluation.

Purpose: The primary objective of this study was to determine the relationship between Wingate test, athletic performance, and MRI parameters in athletes. Additionally, we examined whether there were significant differences in these parameters between athletes and non-athletes during dorsiflexion exercises.

Methods: Twenty-two male athletes and 9 non-athletes performed dorsiflexion exercises with a 4-kg load. MRI scans, including T2* mapping and diffusion tensor imaging, were conducted pre-exercise, immediately after exercise, and 30 minutes post-exercise. Quantitative parameters, including T2* values, fractional anisotropy, mean diffusivity, and eigenvalues (λ2, λ3), were analyzed. Wingate test results and athletics scoring based on the 2022 World Athletics Scoring Tables were used to evaluate anaerobic power and sprint performance.

Results: MRI parameters, particularly T2* changes and λ3, showed significant correlations with Wingate test results and athletic performance. Pre-exercise λ3, reflecting muscle fiber orientation and thickness, emerged as a key predictor of athletic performance alongside T2* changes and Wingate power. The integration of MRI-derived metrics with Wingate test results improved the prediction of athletic scores compared to Wingate power alone. Although differences between athletes and non-athletes in T2* and λ2 were observed, these findings serve as supplementary evidence supporting the role of MRI in identifying muscle characteristics critical for athletic performance.

Conclusion: MRI-derived parameters combined with performance tests can provide valuable insights into muscle recovery, structure, and athletic performance, with potential for predicting athlete scores and optimizing training strategies.

Purpose: To develop a fast and precise method for searching rectangular regions in brain tumor images.

Methods: The authors propose a new method for searching rectangular tumor regions in brain MR images. The proposed method consisted of a segmentation network and a fast search method with a user-controllable search metric. As the segmentation network, the U-Net whose encoder was replaced by the EfficientNet was used. In the fast search method, summed-area tables were used for accelerating sums of voxels in rectangular regions. Use of the summed-area tables enabled exhaustive search of the 3D offset (3D full search). The search metric was designed for giving priority to nearly isotropic rectangles over undesirable thin rectangles, and assigning better values for higher tumor fractions even if they exceeded target tumor fractions. The proposed computation and metric were compared with those used in a conventional method using the Brain Tumor Image Segmentation dataset.

Results: When the 3D full search was used, the proposed computation (8 seconds) was 100-500 times faster than the conventional computation (11-40 minutes). When the user-controllable parts of the search metrics were changed variously, the tumor fractions of the proposed metric were higher than those of the conventional metric. In addition, the conventional metric preferred undesirable thin rectangles whereas the proposed metric preferred nearly isotropic rectangles.

Conclusion: The proposed method is promising for implementing fast and precise search of rectangular tumor regions, which is useful for brain tumor diagnosis using MRI systems. The proposed computation reduced processing times of the 3D full search, and the proposed metric improved the quality of the assigned rectangular tumor regions.

Purpose: Aortopathy, characterized by aortic dilatation caused by cystic medial necrosis, typically develops in adulthood but has been observed at a young age in patients with tetralogy of Fallot. We hypothesized that some patients with tetralogy of Fallot or double-outlet right ventricle experience early-onset aortic disturbed flow. This study aimed to identify and analyze the causes of disturbed flow using 4D flow MRI.

Methods: This study included 24 patients who underwent 4D flow MRI at our institution between January 2022 and September 2024. MRI and cardiac catheterization were performed during follow-up. 4D flow MRI was used to detect disturbed flow and investigate its underlying causes.

Results: The mean age of patients with tetralogy of Fallot or double-outlet right ventricle was 12 years (range, 1 to 37 years). Of the 24 participants, 11 (46%) exhibited disturbed flow. Patients with disturbed flow had significantly higher Valsalva Z-scores (4.7 ± 3.1 vs. 2.4 ± 1.4, P = 0.013) and a significantly narrower left ventricular outflow tract-ascending aorta angle (113.5 ± 11.6 vs. 127.1 ±  6.7°, P = 0.002). Wall shear stress and energy loss were not significantly different between the 2 groups.

Conclusion: Aortic disturbed flow may occur in patients with tetralogy of Fallot or double-outlet right ventricle, regardless of age, suggesting an association with the left ventricular outflow tract-ascending aorta angle. The occurrence of disturbed flow at a young age should be noted as it may contribute to the future progression of aortopathy.