A 3D high resolution MRI method for the visualization of cardiac fibro-fatty infiltrations

Modifications of the myocardial architecture can cause abnormal electrical activity of the heart. Fibro-fatty infiltrations have been implicated in various cardiac pathologies associated with arrhythmias and sudden cardiac death, such as arrhythmogenic right ventricular cardiomyopathy (ARVC). Here, we report the development of an MRI protocol to observe these modifications at 9.4 T. Two fixed ex vivo human hearts, one healthy and one ARVC, were imaged with an Iterative decomposition with echo asymmetry and least-square estimations (IDEAL) and a magnetization transfer (MT) 3D sequences. The resulting fat fraction and MT ratio (MTR) were analyzed and compared to histological analysis of the three regions (“ARVC triangle”) primarily involved in ARVC structural remodeling. In the ARVC heart, high fat content was observed in the “ARVC triangle” and the superimposition of the MTR and fat fraction allowed the identification of fibrotic regions in areas without the presence of fat. The healthy heart exhibited twice less fat than the ARVC heart (31.9%, 28.7% and 1.3% of fat in the same regions, respectively). Localization of fat and fibrosis were confirmed by means of histology. This non-destructive approach allows the investigation of structural remodeling in human pathologies where fibrosis and/or fatty tissue infiltrations are expected to occur.

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

Background & aims MRI-based proton density fat fraction (PDFF) and the ultrasound-derived controlled attenuation parameter (CAP) are non-invasive techniques for quantifying liver fat, which can be used to assess steatosis in patients with non-alcoholic fatty liver disease (NAFLD). This study compared both of these techniques to histopathological graded steatosis for the assessment of fat levels in a large pooled NAFLD cohort. Methods This retrospective study pooled N = 581 participants from two suspected NAFLD cohorts (mean age (SD) 56 (12.7), 60% females). Steatosis was graded according to NASH-CRN criteria. Liver fat was measured non-invasively using PDFF (with Liver MultiScan’s Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation method, LMS-IDEAL, Perspectum, Oxford) and CAP (FibroScan, Echosens, France), and their diagnostic performances were compared. Results LMS-IDEAL and CAP detected steatosis grade ≥ 1 with AUROCs of 1.00 (95% CI, 0.99–1.0) and 0.95 (95% CI, 0.91–0.99), respectively. LMS-IDEAL was superior to CAP for detecting steatosis grade ≥ 2 with AUROCs of 0.77 (95% CI, 0.73–0.82] and 0.60 (95% CI, 0.55–0.65), respectively. Similarly, LMS-IDEAL outperformed CAP for detecting steatosis grade ≥ 3 with AUROCs of 0.81 (95% CI, 0.76–0.87) and 0.63 (95% CI, 0.56–0.70), respectively. Conclusion LMS-IDEAL was able to diagnose individuals accurately across the spectrum of histological steatosis grades. CAP performed well in identifying individuals with lower levels of fat (steatosis grade ≥1); however, its diagnostic performance was inferior to LMS-IDEAL for higher levels of fat (steatosis grades ≥2 and ≥3). Trial registration ClinicalTrials.gov (NCT03551522); https://clinicaltrials.gov/ct2/show/NCT03551522. UMIN Clinical Trials Registry (UMIN000026145); https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000026145.

Assessment of bone marrow fat fractions in the mandibular condyle head using the iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) method

The prevalence of temporomandibular joint disorder (TMD) is gradually increasing, and magnetic resonance imaging (MRI) is becoming increasingly common as a modality used to diagnose TMD. Edema and osteonecrosis in the bone marrow of the mandibular condyle have been considered to be precursors of osteoarthritis, but these changes are not evaluated accurately and quantitatively on routine MRI. The iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) method, as a cutting-edge MRI technique, can separate fat and water using three asymmetric echo times and the three-point Dixon method. The purpose of this study was to analyze the quantitative fat fraction (FF) in the mandibular condyle head using the IDEAL-IQ method. Seventy-nine people who underwent MRI using IDEAL-IQ were investigated and divided into 1) the control group, without TMD symptoms, and 2) the TMD group, with unilateral temporomandibular joint (TMJ) pain. In both groups, the FF of the condyle head in the TMJ was analyzed by two oral and maxillofacial radiologists. In the TMD group, 29 people underwent cone-beam computed tomography (CBCT) and the presence or absence of bony changes in the condylar head was evaluated. The FF measurements of the condyle head using IDEAL-IQ showed excellent inter-observer and intra-observer agreement. The average FF of the TMD group was significantly lower than that of the control group (p < 0.05). In the TMD group, the average FF values of joints with pain and joints with bony changes were significantly lower than those of joints without pain or bony changes, respectively (p < 0.05). The FF using IDEAL-IQ in the TMJ can be helpful for the quantitative diagnosis of TMD.

Preliminary analysis of interaction of the fat fraction in the sacroiliac joint among sex, age, and body mass index in a normal Chinese population

Objective Iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron quantification (IDEAL-IQ) is a noninvasive and objective method used to quantitatively measure fat content. Although this technique has been used in the entire abdomen, IDEAL-IQ findings in the sacroiliac joint (SIJ) have rarely been reported. This preclinical study was performed to quantify the amount of fat in the SIJ in healthy volunteers by IDEAL-IQ. Methods From April to November 2017, 60 healthy volunteers with low back pain were included in this retrospective study. The participants were allocated into groups by age (15–30, 31–50, and ≥51 years), sex (male and female), and body mass index (BMI) (<18.5, 18.5–23.9, and ≥24.0 kg/m2). The iliac-side (Fi) and sacral-side (Fs) fat fractions were obtained in all groups. Two- and three-factor multivariate analyses were performed to analyze the effects of sex, age, and BMI on the Fi and Fs. Results The interaction among sex, age, and BMI had no statistically significant effect on the dependent variable. Both Fi and Fs were significantly influenced by age. Fs was significantly influenced by sex. Conclusion The IDEAL-IQ sequence can be used to quantitatively assess the SIJ fat content in healthy volunteers.

A Modified System of Nonlinear Fractional-Order Differential Equations in the Study of the Dynamics of Marital Relationships and their Behavioural Features

Urbanization and modernization have effects on marital relationships in Nigeria which led to high divorce rate among legitimate couples prompting unstable environment. This situation design and uses scientific means to study the dynamics of marital relationships and their behavioural features to check excesses in marriage and to promote stability. A modified system of nonlinear fractional-order differential equations was used to categorize people of different personalities and different Impact Factors of Memory, using different sets of parameters. The equations predict and interpret the features of the union of different individuals with external circumstance(s). Equations were adapted to a local environment where data collections were carried out to investigate factors affecting marriages. Data collected by the use of questionnaire validate the model. An Iterative Decomposition Method was adopted to solve the fractional system in which fractional derivatives were given in the Caputo sense; the obtained results were interpreted appropriately. The modified model shows the trajectory of the couple from the state of indifference and as the impact factor memory increases it affects their togetherness making the love between them to decay easily. Numerical simulation results were presented to show the effectiveness of the model and the accuracy of the statements established. Keywords: Differential model, dynamical system, impact factors of memory, iterative decomposition method, marital relationship

Almost Sure Local Well-Posedness for a Derivative Nonlinear Wave Equation

We study the derivative nonlinear wave equation $- \partial _{tt} u + \Delta u = |\nabla u|^2$ on $\mathbb{R}^{1 +3}$. The deterministic theory is determined by the Lorentz-critical regularity $s_L = 2$, and both local well-posedness above $s_L$ as well as ill-posedness below $s_L$ are known. In this paper, we show the local existence of solutions for randomized initial data at the super-critical regularities $s\geqslant 1.984$. In comparison to the previous literature in random dispersive equations, the main difficulty is the absence of a (probabilistic) nonlinear smoothing effect. To overcome this, we introduce an adaptive and iterative decomposition of approximate solutions into rough and smooth components. In addition, our argument relies on refined Strichartz estimates, a paraproduct decomposition, and the truncation method of de Bouard and Debussche.