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Manganaro L, Capuani S, Gennarini M, Miceli V, Ninkova R, Balba I, Galea N, Cupertino A, Maiuro A, Ercolani G, Catalano C. Fetal MRI: what's new? A short review. Eur Radiol Exp 2023; 7:41. [PMID: 37558926 PMCID: PMC10412514 DOI: 10.1186/s41747-023-00358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/22/2023] [Indexed: 08/11/2023] Open
Abstract
Fetal magnetic resonance imaging (fetal MRI) is usually performed as a second-level examination following routine ultrasound examination, generally exploiting morphological and diffusion MRI sequences. The objective of this review is to describe the novelties and new applications of fetal MRI, focusing on three main aspects: the new sequences with their applications, the transition from 1.5-T to 3-T magnetic field, and the new applications of artificial intelligence software. This review was carried out by consulting the MEDLINE references (PubMed) and including only peer-reviewed articles written in English. Among the most important novelties in fetal MRI, we find the intravoxel incoherent motion model which allow to discriminate the diffusion from the perfusion component in fetal and placenta tissues. The transition from 1.5-T to 3-T magnetic field allowed for higher quality images, thanks to the higher signal-to-noise ratio with a trade-off of more frequent artifacts. The application of motion-correction software makes it possible to overcome movement artifacts by obtaining higher quality images and to generate three-dimensional images useful in preoperative planning.Relevance statementThis review shows the latest developments offered by fetal MRI focusing on new sequences, transition from 1.5-T to 3-T magnetic field and the emerging role of AI software that are paving the way for new diagnostic strategies.Key points• Fetal magnetic resonance imaging (MRI) is a second-line imaging after ultrasound.• Diffusion-weighted imaging and intravoxel incoherent motion sequences provide quantitative biomarkers on fetal microstructure and perfusion.• 3-T MRI improves the detection of cerebral malformations.• 3-T MRI is useful for both body and nervous system indications.• Automatic MRI motion tracking overcomes fetal movement artifacts and improve fetal imaging.
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Affiliation(s)
- Lucia Manganaro
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
| | - Silvia Capuani
- National Research Council (CNR),, Institute for Complex Systems (ISC) c/o Physics Department Sapienza University of Rome, Rome, Italy
| | - Marco Gennarini
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Valentina Miceli
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Roberta Ninkova
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Nicola Galea
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Angelica Cupertino
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Alessandra Maiuro
- National Research Council (CNR),, Institute for Complex Systems (ISC) c/o Physics Department Sapienza University of Rome, Rome, Italy
| | - Giada Ercolani
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
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Ercolani G, Capuani S, Antonelli A, Camilli A, Ciulla S, Petrillo R, Satta S, Grimm R, Giancotti A, Ricci P, Catalano C, Manganaro L. IntraVoxel Incoherent Motion (IVIM) MRI of fetal lung and kidney: Can the perfusion fraction be a marker of normal pulmonary and renal maturation? Eur J Radiol 2021; 139:109726. [PMID: 33895624 DOI: 10.1016/j.ejrad.2021.109726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 03/30/2021] [Accepted: 04/14/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To investigate the use of IntraVoxel Incoherent Motion (IVIM) MRI in the study of microstructural tissue changes occurring in fetal lung and kidney during gestation. METHODS 34 normal pregnancies were enrolled. Patients were divided into two groups based on gestational age (GA): group A (21-29 weeks) and group B (30-39 weeks). MR examinations were performed at 1.5T, with a standard fetal MR protocol including a Diffusion-Weighted Echo-Planar Imaging sequence with 10 different b-values (0, 10, 30, 50, 75, 100, 200, 400, 700, 1000s/mm2). For each fetus, two bilateral ROIs were manually placed in lung and renal parenchyma. Mean values of perfusion fraction f, pseudo-diffusion coefficient D* and diffusion coefficient D were obtained. The correlation between IVIM parameters and GA was investigated. RESULTS In renal ROIs a positive correlation between fkidney and GA (p < 0.005) was found; similarly flung showed a statistically significant correlation with GA (p < 0.001). F mean values were significantly higher in group B compared to group A in both renal (p = 0.0002) and lung (p = 0.018) ROIs. No correlation was found in D and D* as a function of GA. CONCLUSIONS The IVIM perfusion fraction f may be considered as a potential marker of pulmonary and renal maturation in relation to hemodynamic changes described in intrauterine life. Our results highlight that IVIM model is useful as an additional prenatal diagnostic tool to study lung and renal development.
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Affiliation(s)
- Giada Ercolani
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | - Silvia Capuani
- CNR ISC, Physics Department, "Sapienza" University of Rome, Italy
| | - Amanda Antonelli
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | - Arianna Camilli
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | - Sandra Ciulla
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | - Roberta Petrillo
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | - Serena Satta
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | | | - Antonella Giancotti
- Department of Gynecological-Obstetrical and Urological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | - Paolo Ricci
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy
| | - Lucia Manganaro
- Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, "Sapienza" University of Rome, Italy.
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Aertsen M, Diogo MC, Dymarkowski S, Deprest J, Prayer D. Fetal MRI for dummies: what the fetal medicine specialist should know about acquisitions and sequences. Prenat Diagn 2019; 40:6-17. [PMID: 31618472 DOI: 10.1002/pd.5579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 12/26/2022]
Abstract
Fetal MRI is an increasingly used tool in the field of prenatal diagnosis. While US remains the first line screening tool, as an adjuvant imaging tool, MRI has been proven to increase diagnostic accuracy and change patient counseling. Further, there are instances when US may not be sufficient for diagnosis. As a multidisciplinary field, it is important that every person involved in the referral, diagnosis, counseling and treatment of the patients is familiar with the basic principles, indications and findings of fetal MRI. The purpose of the current paper is to equip radiologists and non-radiologists with basic MRI principles and essential topics in patient preparation and provide illustrative examples of when fetal MRI may be used. This aims to aid the referring clinician in better selecting and improve patient counseling prior to arrival in the radiology department and, ultimately, patient care.
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Affiliation(s)
- Michael Aertsen
- Department of Imaging and Pathology, Clinical Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Mariana C Diogo
- Department of Image Guided Therapy, University Clinic for Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Steven Dymarkowski
- Department of Imaging and Pathology, Clinical Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Jan Deprest
- Academic Department of Development and Regeneration, Cluster Woman and Child, Group Biomedical Sciences, KU Leuven, Leuven, Belgium.,Institute for Women's Health, University College London, London, UK
| | - Daniela Prayer
- Department of Image Guided Therapy, University Clinic for Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
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Chalouhi GE, Millischer AÉ, Mahallati H, Siauve N, Melbourne A, Grevent D, Vinit N, Heidet L, Aigrain Y, Ville Y, Blanc T, Salomon LJ. The use of fetal MRI for renal and urogenital tract anomalies. Prenat Diagn 2019; 40:100-109. [PMID: 31736096 DOI: 10.1002/pd.5610] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 12/20/2022]
Abstract
Fetal anomalies are detected in approximately 2% of all fetuses and, among these, genitourinary tract abnormalities account for 30% to 50% of all structural anomalies present at birth. Although ultrasound remains the first line diagnostic modality, fetal MRI provides important additional structural and functional information, especially with the development of faster sequences and the use of functional sequences. The added value of MRI-based imaging is three-fold: (a) improvement of diagnostic accuracy by adequate morphological examination, (b) detection of additional anomalies, and (c) in addition, MRI has the potential to provide information regarding renal function. In this review, we describe the role of fetal MRI in the anatomical evaluation of renal and urogenital tract anomalies, and we also touch upon the contribution of functional MRI to the diagnostic workup of these conditions.
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Affiliation(s)
- Gihad E Chalouhi
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Division of Fetal Medicine, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon.,Université de Paris, Paris, France
| | - Anne-Élodie Millischer
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Houman Mahallati
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Department of Radiology, University of Calgary, Calgary, Canada
| | - Nathalie Siauve
- Imagerie Médicale, Hôpital Louis Mourier APHP, Colombes, France
| | - Andrew Melbourne
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - David Grevent
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Nicolas Vinit
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France
| | - Laurence Heidet
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Pediatric Nephrology Department, Hôpital Universitaire Necker-Enfants Malades, Sorbonne Paris Cité University, Paris, France
| | - Yves Aigrain
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France
| | - Yves Ville
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Thomas Blanc
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France.,INSERM U1151-CNRS UMR 8253, Université de Paris, Institut Necker-Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | - Laurent J Salomon
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Université de Paris, Paris, France
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5
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Manganaro L, Silvia B, Antonelli A, Rondoni V, Pusiol T, Scialpi M. Fetal biparametric MR imaging in the diagnosis of congenital mesoblastic nephroma. Turk J Urol 2018; 44:278-280. [PMID: 29733803 DOI: 10.5152/tud.2018.49696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/07/2018] [Indexed: 01/30/2023]
Affiliation(s)
- Lucia Manganaro
- Department of Radiological Sciences, Oncology and Anatomo-Patologic, Sapienza University of Rome, Rome, Italy
| | - Bernardo Silvia
- Department of Radiological Sciences, Oncology and Anatomo-Patologic, Sapienza University of Rome, Rome, Italy
| | - Amanda Antonelli
- Department of Radiological Sciences, Oncology and Anatomo-Patologic, Sapienza University of Rome, Rome, Italy
| | - Valeria Rondoni
- Department of Surgical and Biomedical Sciences, Division of Radiology 2, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy
| | - Teresa Pusiol
- Provincial Health Care Services, Institute of Anatomo-Patologic, Rovereto, Trento, Italy
| | - Michele Scialpi
- Department of Surgical and Biomedical Sciences, Division of Radiology 2, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy
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Faghihimehr A, Gharavi M, Mancuso M, Sreedher G. Fetal MR imaging in urogenital system anomalies. J Matern Fetal Neonatal Med 2018; 32:3487-3494. [DOI: 10.1080/14767058.2018.1465039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Mohammad Gharavi
- Department of Radiology, University of Maryland Medical Center, Baltimore, MD, USA
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7
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Faure A, Panait N, Panuel M, Alessandrini P, D'Ercole C, Chaumoitre K, Merrot T. Predicting postnatal renal function of prenatally detected posterior urethral valves using fetal diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient determination. Prenat Diagn 2017; 37:666-672. [DOI: 10.1002/pd.5063] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 03/29/2017] [Accepted: 04/21/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Alice Faure
- Aix-Marseille Université; Marseille France
- Paediatric Surgery Department; APHM, CHU Hopital Nord; Marseille France
| | - Nicoleta Panait
- Aix-Marseille Université; Marseille France
- Paediatric Surgery Department; APHM, CHU Hopital Nord; Marseille France
| | - Michel Panuel
- Aix-Marseille Université; Marseille France
- Medical Imaging Department; APHM, CHU Hopital Nord; Marseille France
| | - Pierre Alessandrini
- Aix-Marseille Université; Marseille France
- Paediatric Surgery Department; APHM, CHU Hopital Nord; Marseille France
| | - Claude D'Ercole
- Aix-Marseille Université; Marseille France
- Gynecologic & Obstetrical Department; APHM, CHU Hopital Nord; Marseille France
| | - Kathia Chaumoitre
- Aix-Marseille Université; Marseille France
- Medical Imaging Department; APHM, CHU Hopital Nord; Marseille France
| | - Thierry Merrot
- Aix-Marseille Université; Marseille France
- Paediatric Surgery Department; APHM, CHU Hopital Nord; Marseille France
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Ye J, Kumar BS, Li XB, Li HM, Zhou YW, Liu LQ. Clinical applications of diffusion-weighted magnetic resonance imaging in diagnosis of renal lesions - a systematic review. Clin Physiol Funct Imaging 2015; 37:459-473. [PMID: 26648310 DOI: 10.1111/cpf.12313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/21/2015] [Indexed: 01/07/2023]
Abstract
Diffusion-weighted magnetic resonance imaging (DW-MRI) is an established technique to detect the changes of the diffusion of water in biological tissues and reflect the pathophysiological process on the molecular level. It is a promising non-invasive imaging modality in detection of microstructural and functional changes in pathologies of kidney. To systematically review the research advancement of the DW-MRI in diagnosis of renal lesions, a systematic literature search was performed up to 8 October 2014 using the MEDLINE/PubMed and Embase databases for articles reporting on DW-MRI in diagnosis of renal lesions. Only articles with full data about DW-MRI application with potential implication in solving usually encountered clinical challenges about renal lesions were finally examined. The clinical application of DW-MRI allows a better understanding of some pathologic conditions of the kidney including renal insufficiency, renal artery stenosis, ureteral obstruction, foetal kidney disease, hydronephrosis and pyonephrosis. In addition, DW-MRI can also provide clinicians with the information of function evaluation of renal allograft and curative effect assessment of renal tumour. In summary, performance of renal DW-MRI, presuming that measurements are high quality, will further boost this modality, particularly for early detection of diffusion renal conditions, as well as more accurate characterization of renal lesions.
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Affiliation(s)
- Jing Ye
- Department of Imaging, Northern Jiangsu People's Hospital, Yangzhou, China
| | | | - Xiao-Bo Li
- Department of Neurology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Hong-Mei Li
- Department of Imaging, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Ying-Wen Zhou
- Department of Imaging, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Li-Qin Liu
- Department of Oncology, Northern Jiangsu People's Hospital, Yangzhou, China
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9
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Abstract
Fetal magnetic resonance imaging (MRI) is currently offered in a limited number of centers but is predominantly used for suspected fetal central nervous system abnormalities. This article concentrates on the role of the different imaging sequences and their value to clinical practice. It also discusses the future of fetal MRI.
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Affiliation(s)
- Elspeth Whitby
- Academic Unit of Reproductive and Developmental Medicine, Sheffield, UK.
| | - Peter Wright
- Medical Imaging and Medical Physics, Radiology, Royal Hallamshire Hospital, Sheffield, UK
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10
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Krishnamurthy U, Neelavalli J, Mody S, Yeo L, Jella PK, Saleem S, Korzeniewski SJ, Cabrera MD, Ehterami S, Bahado-Singh RO, Katkuri Y, Haacke EM, Hernandez-Andrade E, Hassan SS, Romero R. MR imaging of the fetal brain at 1.5T and 3.0T field strengths: comparing specific absorption rate (SAR) and image quality. J Perinat Med 2015; 43:209-20. [PMID: 25324440 PMCID: PMC5987203 DOI: 10.1515/jpm-2014-0268] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 09/09/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Our two objectives were to evaluate the feasibility of fetal brain magnetic resonance imaging (MRI) using a fast spin echo sequence at 3.0T field strength with low radio frequency (rf) energy deposition (as measured by specific absorption rate: SAR) and to compare image quality, tissue contrast and conspicuity between 1.5T and 3.0T MRI. METHODS T2 weighted images of the fetal brain at 1.5T were compared to similar data obtained in the same fetus using a modified sequence at 3.0T. Quantitative whole-body SAR and normalized image signal to noise ratio (SNR), a nominal scoring scheme based evaluation of diagnostic image quality, and tissue contrast and conspicuity for specific anatomical structures in the brain were compared between 1.5T and 3.0T. RESULTS Twelve pregnant women underwent both 1.5T and 3.0T MRI examinations. The image SNR was significantly higher (P=0.03) and whole-body SAR was significantly lower (P<0.0001) for images obtained at 3.0T compared to 1.5T. All cases at both field strengths were scored as having diagnostic image quality. Images from 3.0T MRI (compared to 1.5T) were equal (57%; 21/37) or superior (35%; 13/37) for tissue contrast and equal (61%; 20/33) or superior (33%, 11/33) for conspicuity. CONCLUSIONS It is possible to obtain fetal brain images with higher resolution and better SNR at 3.0T with simultaneous reduction in SAR compared to 1.5T. Images of the fetal brain obtained at 3.0T demonstrated superior tissue contrast and conspicuity compared to 1.5T.
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Affiliation(s)
- Uday Krishnamurthy
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Biomedical Engineering, College of Engineering, Wayne State University, Detroit, MI, USA
| | - Jaladhar Neelavalli
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Biomedical Engineering, College of Engineering, Wayne State University, Detroit, MI, USA
| | - Swati Mody
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lami Yeo
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Pavan K. Jella
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sheena Saleem
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Steven J. Korzeniewski
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan; USA
| | - Maria D. Cabrera
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Shadi Ehterami
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ray O. Bahado-Singh
- Department of Obstetrics and Gynecology, William Beaumont School of Medicine, Oakland University, Rochester, MI, USA
| | - Yashwanth Katkuri
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ewart M. Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Biomedical Engineering, College of Engineering, Wayne State University, Detroit, MI, USA
| | - Edgar Hernandez-Andrade
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sonia S. Hassan
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Roberto Romero
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI, USA
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan; USA
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
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11
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Abstract
Applications of diffusion-weighted (DW) magnetic resonance (MR) imaging outside the brain have gained increasing importance in recent years. Owing to technical improvements in MR imaging units and faster sequences, the need for noninvasive imaging without contrast medium administration, mainly in patients with renal insufficiency, can be met successfully by applying this technique. DW MR imaging is quantified by the apparent diffusion coefficient (ADC), which provides information on diffusion and perfusion simultaneously. By using a biexponential fitting process of the DW MR imaging data, these two entities can be separated, because this type of fitting process can serve as an estimate of both the perfusion fraction and the true diffusion coefficient. DW MR imaging can be applied for functional evaluation of the kidneys in patients with acute or chronic renal failure. Impairment of renal function is accompanied by a decreased ADC. Acute ureteral obstruction leads to perfusion and diffusion changes in the affected kidney, and renal artery stenosis results in a decreased ADC. In patients with pyelonephritis, diffuse or focal changes in signal intensity are seen on the high-b-value images, with increased signal intensity corresponding to low signal intensity on the ADC map. The feasibility and reproducibility of DW MR imaging in patients with transplanted kidneys have already been demonstrated, and initial results seem to be promising for the assessment of allograft deterioration. Overall, performance of renal DW MR imaging, presuming that measurements are of high quality, will further boost this modality, particularly for early detection of diffuse renal conditions, as well as more accurate characterization of focal renal lesions.
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Affiliation(s)
- Harriet C Thoeny
- Department of Radiology, Neuroradiology and Nuclear Medicine, University of Bern, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland.
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Manganaro L, Fierro F, Tomei A, La Barbera L, Savelli S, Sollazzo P, Sergi ME, Vinci V, Ballesio L, Marini M. MRI and DWI: feasibility of DWI and ADC maps in the evaluation of placental changes during gestation. Prenat Diagn 2011; 30:1178-84. [PMID: 21064115 DOI: 10.1002/pd.2641] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To establish if a correlation exists between apparent diffusion coefficient (ADC) values, obtained by diffusion-weighted imaging (DWI), and placental aging. METHOD The study is divided into a retrospective phase and a prospective one.In the first phase, 145 pregnant women underwent fetal magnetic resonance imaging (MRI) for suspected disorders in several organs. We performed DWI (b value 0, 200 and 700 s/mm(2)) in all the fetuses, evaluating the patients in whom the whole placenta was visible.In the prospective phase, 50 women (52 fetuses) underwent MRI. We performed, in the same patient, two echo-planar sequences with b values of 0, 200 and 700, and 50, 200 and 700 s/mm(2), including the whole placenta.The ADC maps were calculated for all fetuses, divided into three groups based on gestational age (GA): group I: 20-26 weeks' gestation, II: 27-33, III: 34-40. RESULTS In the retrospective phase, ADC values had a range from 1 to 2.4 mm(2)/s, showing a significant correlation between ADC values and GA.ADC values obtained by DWI with b value 0, 200 and 700 s/mm(2) had a range from 0.8 to 2.5 mm(2)/s, with an inverse correlation between ADC values and GA, whereas the ADC values with b value 50, 200 and 700 s/mm(2) did not show any statistical correlation (range: 1.5-1.7 mm(2)/s). CONCLUSION DWI with ADC maps can not be considered markers for placental aging because they are affected by perfusional and circulatory motion.
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Affiliation(s)
- Lucia Manganaro
- Department of Radiological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
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Triulzi F, Manganaro L, Volpe P. Fetal magnetic resonance imaging: indications, study protocols and safety. Radiol Med 2011; 116:337-50. [DOI: 10.1007/s11547-011-0633-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 09/02/2010] [Indexed: 12/17/2022]
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