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Lebenatus A, Tesch K, Rudolph W, Naujokat H, Koktzoglou I, Edelman RR, Graessner J, Jansen O, Salehi Ravesh M. Evaluation of Lower Leg Arteries and Fibular Perforators before Microsurgical Fibular Transfer Using Noncontrast-Enhanced Quiescent-Interval Slice-Selective (QISS) Magnetic Resonance Angiography. J Clin Med 2023; 12:1634. [PMID: 36836170 PMCID: PMC9964888 DOI: 10.3390/jcm12041634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
(1) Background: Preoperative imaging of the lower leg arteries is essential for planning fibular grafting. The aim of this study was to evaluate the feasibility and clinical value of non-contrast-enhanced (CE) Quiescent-Interval Slice-Selective (QISS)-magnetic resonance angiography (MRA) for reliably visualizing the anatomy and patency of the lower leg arteries and for preoperatively determining the presence, number, and location of fibular perforators. (2) Methods: The anatomy and stenoses of the lower leg arteries and the presence, number, and location of fibular perforators were determined in fifty patients with oral and maxillofacial tumors. Postoperative outcomes of patients after fibula grafting were correlated with preoperative imaging, demographic, and clinical parameters. (3) Results: A regular three-vessel supply was present in 87% of the 100 legs. QISS-MRA was able to accurately assign the branching pattern in patients with aberrant anatomy. Fibular perforators were found in 87% of legs. More than 94% of the lower leg arteries had no relevant stenoses. Fibular grafting was performed in 50% of patients with a 92% success rate. (4) Conclusions: QISS-MRA has the potential to be used as a preoperative non-CE MRA technique for the diagnosis and detection of anatomic variants of lower leg arteries and their pathologies, as well as for the assessment of fibular perforators.
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Affiliation(s)
- Annett Lebenatus
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Karolin Tesch
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Wiebke Rudolph
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Hendrik Naujokat
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL 60201, USA
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Robert R. Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL 60201, USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | | | - Olav Jansen
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Mona Salehi Ravesh
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
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Lee PK, Yoon D, Sandberg JK, Vasanawala SS, Hargreaves BA. Volumetric and multispectral DWI near metallic implants using a non-linear phase Carr-Purcell-Meiboom-Gill diffusion preparation. Magn Reson Med 2022; 87:2650-2666. [PMID: 35014729 DOI: 10.1002/mrm.29153] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE DWI near metal implants has not been widely explored due to substantial challenges associated with through-slice and in-plane distortions, the increased encoding requirement of different spectral bins, and limited SNR. There is no widely adopted clinical protocol for DWI near metal since the commonly used EPI trajectory fails completely due to distortion from extreme off-resonance ranging from 2 to 20 kHz. We present a sequence that achieves DWI near metal with moderate b-values (400-500 s/mm2 ) and volumetric coverage in clinically feasible scan times. THEORY AND METHODS Multispectral excitation with Cartesian sampling, view angle tilting, and kz phase encoding reduce in-plane and through-plane off-resonance artifacts, and Carr-Purcell-Meiboom-Gill (CPMG) spin-echo refocusing trains counteract T2* effects. The effect of random phase on the refocusing train is eliminated using a stimulated echo diffusion preparation. Root-flipped Shinnar-Le Roux refocusing pulses permits preparation of a high spectral bandwidth, which improves imaging times by reducing the number of excitations required to cover the desired spectral range. B1 sensitivity is reduced by using an excitation that satisfies the CPMG condition in the preparation. A method for ADC quantification insensitive to background gradients is presented. RESULTS Non-linear phase refocusing pulses reduces the peak B1 by 46% which allows RF bandwidth to be doubled. Simulations and phantom experiments show that a non-linear phase CPMG pulse pair reduces B1 sensitivity. Application in vivo demonstrates complementary contrast to conventional multispectral acquisitions and improved visualization compared to DW-EPI. CONCLUSION Volumetric and multispectral DW imaging near metal can be achieved with a 3D encoded sequence.
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Affiliation(s)
- Philip K Lee
- Radiology, Stanford University, Stanford, California, USA.,Electrical Engineering, Stanford University, Stanford, California, USA
| | - Daehyun Yoon
- Radiology, Stanford University, Stanford, California, USA
| | | | | | - Brian A Hargreaves
- Radiology, Stanford University, Stanford, California, USA.,Electrical Engineering, Stanford University, Stanford, California, USA.,Bioengineering, Stanford University, Stanford, California, USA
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3
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Salehi Ravesh M, Lebenatus A, Bonietzki A, Hensler J, Koktzoglou I, Edelman RR, Graessner J, Jansen O, Both M. High-resolution, non-contrast-enhanced magnetic resonance angiography of the wrist, hand and digital arteries using optimized implementation of Cartesian quiescent interval slice selective (QISS) at 1.5 T. Magn Reson Imaging 2021; 78:58-68. [PMID: 33582146 PMCID: PMC7979532 DOI: 10.1016/j.mri.2021.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/09/2021] [Accepted: 02/09/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Non-contrast-enhanced (CE) magnetic resonance angiography (MRA) techniques are of considerable interest for diagnosing vascular diseases in the upper extremities owing to the possibility of repeated examinations, sufficient coverage of the measurement volume, and because possible side effects of administering iodine- or gadolinium-based contrast agents and radiation exposure can be avoided. The aim of this study was to investigate the feasibility of an optimized electrocardiogram (ECG) triggered Cartesian quiescent interval slice selective (QISS) technique for MRA of hand arteries. MATERIAL AND METHODS Both hands of 20 healthy volunteers (HVs) were examined using an optimized QISS-MRA pulse sequence at 1.5 Tesla. The wrist and hand arterial trees were divided into 36 segments. Cross-sectional areas (CSA) of all arterial segments were measured. For the technical evaluation of the pulse sequence, the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were computed and six imaging artifacts were graded. Two experienced observers used an ordinal scoring system to assess the image quality of each arterial segment. Interobserver agreement was determined. RESULTS The median CSA was 7.3 mm2 in the ulnar and radial artery, 3.2 mm2 in the four common digital arteries, and 1.5 mm2 in five proper digital arteries. The median SNR and CNR of the third common proper arteries were 45.9 and 20.3, respectively. None of the arterial segments were contaminated by venous enhancement. The image quality of arterial segments for both hands was considered as diagnostic in 87.2% of all 1440 segments. An interobserver agreement of 0.67 for both hands was determined for image quality of arterial segments using a five-grade scoring system. Optimized QISS-MRA allows as the first MRA technique the classification of superficial palmar arch (SPA) and deep palmar arch (DPA) variants. 5 new SPA and 6 new DPA variants could be classified using QISS-MRA in comparison with previous studies using CE computed tomography angiography and using fixed cadaver hands. CONCLUSIONS By using this optimized 2D Cartesian QISS-MRA protocol, contrast agent-free angiography of the wrist and hand arteries provided a high in-plane spatial resolution and an excellent visualization of small digital arteries.
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Affiliation(s)
- Mona Salehi Ravesh
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany.
| | - Annett Lebenatus
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Alexandra Bonietzki
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Johannes Hensler
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA; University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Robert R Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Olav Jansen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
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Ghosh A, Liu Y, Artemov D, Gracias DH. Magnetic Resonance Guided Navigation of Untethered Microgrippers. Adv Healthc Mater 2021; 10:e2000869. [PMID: 32691952 PMCID: PMC7854825 DOI: 10.1002/adhm.202000869] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/25/2020] [Indexed: 12/22/2022]
Abstract
Microsurgical tools offer a path to less invasive clinical procedures with improved access, reduced trauma, and better recovery outcomes. There are a variety of rigid and flexible endoscopic devices that have significantly advanced diagnostics and microsurgery. However, they rely on wires or tethers for guidance and operation of small end-effector tools. While untethered physiologically responsive microgrippers have been previously shown to excise tissue from deep gastrointestinal locations in animal models, there are challenges associated with guiding them along paths and moving them to specific locations. In this communication, the magnetic dipole moment of untethered thermally responsive grippers is optimized for efficient coupling to external magnetic resonance (MR) fields. Gripper encapsulation in a millimeter sized wax pellet reduces the friction with the surrounding tissue and MR Navigation (MRN) of a 700 µm sized microgripper is realized within narrow channels in tissue phantoms and in an ex vivo porcine esophagus. The results show convincing proof-of-concept evidence that it is possible to sequentially image, move, and guide a submillimeter functional microsurgical tool in tissue conduits using a commercial preclinical MR system, and when combined with prior demonstrations of physiologically responsive in vivo biopsy are an important step towards the clinical translation of untethered microtools.
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Affiliation(s)
- Arijit Ghosh
- Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Yizhang Liu
- Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Dmitri Artemov
- Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, MD 21287, USA
| | - David H. Gracias
- Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Materials Science and Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Chemistry, Johns Hopkins University, Baltimore, MD 21218, USA
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Jang H, McMillan AB, Ma Y, Jerban S, Chang EY, Du J, Kijowski R. Rapid single scan ramped hybrid-encoding for bicomponent T2* mapping in a human knee joint: A feasibility study. NMR IN BIOMEDICINE 2020; 33:e4391. [PMID: 32761692 PMCID: PMC7584401 DOI: 10.1002/nbm.4391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 06/20/2020] [Accepted: 07/21/2020] [Indexed: 05/03/2023]
Abstract
The purpose of this study is to determine the feasibility of using a single scan ramped hybrid-encoding (RHE) method for rapid bicomponent T2* analysis of the human knee joint. The proposed method utilizes RHE to acquire ultrashort echo time (UTE) and subsequent gradient echo images at 16 different echo times ranging between 40 μs and 30 ms in a single scan. In the proposed RHE technique, UTE imaging was followed by acquisition of 14 gradient recalled echo images, where an additional UTE image was obtained within the first readout by oversampling single point imaging (SPI) encoding. The single scan RHE method with a 9-minute scan time was performed on human cadaveric knee joints from six donors and in vivo knee joints from four healthy volunteers at 3 T. A bicomponent signal model was used to characterize the short T2* and long T2* water components. Mean bicomponent T2* parameters for patellar tendon, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and meniscus were calculated. In the experimental results, the RHE technique provided bicomponent T2* parameter estimations of tendon, ACL, PCL and meniscus, which were similar to previously reported values in the literature. In conclusion, the proposed single scan RHE technique provides rapid bicomponent T2* analysis of the human knee joint with a total scan time of less than 9 minutes.
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Affiliation(s)
- Hyungseok Jang
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
- Corresponding Author: Hyungseok Jang, Ph.D., University of California, San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103-8226, Phone (858) 246-2225,
| | - Alan B McMillan
- Department of Radiology, University of Wisconsin Madison, Madison, WI 53705, USA
| | - Yajun Ma
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
| | - Saeed Jerban
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
| | - Eric Y Chang
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA 92037, USA
| | - Jiang Du
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
| | - Richard Kijowski
- Department of Radiology, University of Wisconsin Madison, Madison, WI 53705, USA
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Mastrogiacomo S, Dou W, Jansen JA, Walboomers XF. Magnetic Resonance Imaging of Hard Tissues and Hard Tissue Engineered Bio-substitutes. Mol Imaging Biol 2020; 21:1003-1019. [PMID: 30989438 DOI: 10.1007/s11307-019-01345-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Magnetic resonance imaging (MRI) is a non-invasive diagnostic imaging tool based on the detection of protons into the tissues. This imaging technique is remarkable because of high spatial resolution, strong soft tissue contrast and specificity, and good depth penetration. However, MR imaging of hard tissues, such as bone and teeth, remains challenging due to low proton content in such tissues as well as to very short transverse relaxation times (T2). To overcome these issues, new MRI techniques, such as sweep imaging with Fourier transformation (SWIFT), ultrashort echo time (UTE) imaging, and zero echo time (ZTE) imaging, have been developed for hard tissues imaging with promising results reported. Within this article, MRI techniques developed for the detection of hard tissues, such as bone and dental tissues, have been reviewed. The main goal was thus to give a comprehensive overview on the corresponding (pre-) clinical applications and on the potential future directions with such techniques applied. In addition, a section dedicated to MR imaging of novel biomaterials developed for hard tissue applications was given as well.
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Affiliation(s)
- Simone Mastrogiacomo
- Department of Biomaterials, Radboud University Medical Center, Philips van Leijdenlaan 25, 6525 EX, Nijmegen, The Netherlands.
- Laboratory of Functional and Molecular Imaging, NINDS, National Institutes of Health, Building 10, 5S261, Bethesda, MD, 20892, USA.
| | - Weiqiang Dou
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
- GE Healthcare, MR Research, Beijing, People's Republic of China
| | - John A Jansen
- Department of Biomaterials, Radboud University Medical Center, Philips van Leijdenlaan 25, 6525 EX, Nijmegen, The Netherlands
| | - X Frank Walboomers
- Department of Biomaterials, Radboud University Medical Center, Philips van Leijdenlaan 25, 6525 EX, Nijmegen, The Netherlands
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Weiger M, Pruessmann KP. Short-T 2 MRI: Principles and recent advances. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2019; 114-115:237-270. [PMID: 31779882 DOI: 10.1016/j.pnmrs.2019.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/14/2019] [Accepted: 07/26/2019] [Indexed: 06/10/2023]
Abstract
Among current modalities of biomedical and diagnostic imaging, MRI stands out by virtue of its versatile contrast obtained without ionizing radiation. However, in various cases, e.g., water protons in tissues such as bone, tendon, and lung, MRI performance is limited by the rapid decay of resonance signals associated with short transverse relaxation times T2 or T2*. Efforts to address this shortcoming have led to a variety of specialized short-T2 techniques. Recent progress in this field expands the choice of methods and prompts fresh considerations with regard to instrumentation, data acquisition, and signal processing. In this review, the current status of short-T2 MRI is surveyed. In an attempt to structure the growing range of techniques, the presentation highlights overarching concepts and basic methodological options. The most frequently used approaches are described in detail, including acquisition strategies, image reconstruction, hardware requirements, means of introducing contrast, sources of artifacts, limitations, and applications.
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Affiliation(s)
- Markus Weiger
- Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland.
| | - Klaas P Pruessmann
- Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland
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8
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Jang H, Lu X, Carl M, Searleman AC, Jerban S, Ma Y, von Drygalski A, Chang EY, Du J. True phase quantitative susceptibility mapping using continuous single-point imaging: a feasibility study. Magn Reson Med 2018; 81:1907-1914. [PMID: 30325058 DOI: 10.1002/mrm.27515] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE In this study, we explore the feasibility of a new imaging scheme for quantitative susceptibility mapping (QSM): continuous single-point imaging (CSPI), which uses a pure phase encoding strategy to achieve true phase imaging and improve QSM accuracy. METHODS The proposed CSPI is a modification of conventional SPI to allow acquisition of multiple echoes in a single scan. Immediately following a phase encoding gradient, the free induction decay is continuously sampled with extremely high temporal resolution to obtain k-space data at a fixed spatial frequency (i.e., at a fixed k-space coordinate). By having near-0 readout duration, CSPI results in a true snapshot of the transverse magnetization at each TE. Additionally, parallel imaging with autocalibration is utilized to reduce scan time, and an optional temporal averaging strategy is presented to improve signal-to-noise ratio for objects with low proton density or short T2* decay. The reconstructed CSPI images were input to a QSM framework based on morphology enabled dipole inversion. RESULT In an experiment performed using iron phantoms, susceptibility estimated using CSPI showed high linearity (R2 = 0.9948) with iron concentration. Additionally, reconstructed CSPI phase images showed much reduced ringing artifact compared with phase images obtained using a frequency encoding strategy. In an ex vivo experiment performed using human tibia samples, estimated susceptibilities ranged from -1.6 to -2.1 ppm, in agreement with values reported in the literature (ranging from -1.2 to -2.2 ppm). CONCLUSION We have demonstrated the feasibility of using CSPI to obtain true phase images for QSM.
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Affiliation(s)
- Hyungseok Jang
- Department of Radiology, University of California San Diego, San Diego, California
| | - Xing Lu
- Department of Radiology, University of California San Diego, San Diego, California.,Institute of Electrical Engineering, Chinese Academy of Science, Beijing, China
| | | | - Adam C Searleman
- Department of Radiology, University of California San Diego, San Diego, California
| | - Saeed Jerban
- Department of Radiology, University of California San Diego, San Diego, California
| | - Yajun Ma
- Department of Radiology, University of California San Diego, San Diego, California
| | - Annette von Drygalski
- Department of Medicine, Division of Hematology/Oncology, University of California, San Diego, California
| | - Eric Y Chang
- Department of Radiology, University of California San Diego, San Diego, California.,Radiology Service, VA San Diego Healthcare System, San Diego, California
| | - Jiang Du
- Department of Radiology, University of California San Diego, San Diego, California
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