P5267Cardiac tissue characterization in patients with wilsons disease using magnetic resonance imaging

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Salatzki ◽  
J Heins ◽  
M H Cerci ◽  
E Schaub ◽  
K Hirschberg ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tissue Characterization ◽  
Circumferential Strain ◽  
Cardiac Tissue ◽  
T2 Mapping ◽  
Neurological Symptoms ◽  
Healthy Individuals ◽  
Resonance Imaging ◽  
Strain Measurements

Abstract Introduction Wilson's disease (WD) is a rare autosomal recessive copper disorder with limited excretion of excess copper into the bile. Primary symptoms are hepatic or neurological. However, the clinical range of WD is wide and can result in cardiac symptoms as well. Previous studies revealed a higher incidence of heart failure in WD patients compared to the rest of the population. Purpose Cardiac magnetic resonance imaging (CMR) is used to identify the typical features of several systemic disorders with excessive myocardial deposition of substrates. The aim of this study was to perform a cardiac tissue characterization in WD patients by using CMR and to identify subgroups of WD patients with reduced ejection fraction (EF). Methods Patients with known WD using Ferenci-Score were included in this prospective study. WD patients were referred to 1.5 Tesla CMR. The following CMR protocol was performed; Cine-images, T1-, T2- and T2*-Mapping, fast-SENC strain and late gadolinium enhancement (LGE). Fast-SENC strain measurements were compared with values from healthy individuals scanned at the center. Results 43 patients (age 38.7±12.8 years, 20 female, BMI 23.80 (17.4–33.1)) with WD could be identified and were evaluated with CMR. CMR revealed normal left ventricular (LV) EF (62.4±5.4%) and right ventricular (RV) EF (64.4±7.1%) overall. However, three patients (7%), who suffered primarily from neurological symptoms, were found to have mildly reduced LV-EF (46.5%, 51%, and 53.5%). Strain analysis revealed significantly reduced LV global circumferential strain (GCS) overall compared to healthy individuals (WD (%): −19.2 2.7; control (%): −20.71±1.5, p<0.05). Patients with primarily hepatic symptoms (WD-h) did not show reduced strain measurements compared to the control group. Patients suffering from primarily neurological symptoms (WD-n) showed significantly reduced LV GCS compared to healthy individuals (WD-n (%): −18.3±3.1; control (%): −20.7±1.5, p<0.05) and RV GCS (WD-n (%): −17.5±3.0; control (%): −19.2±1.8, p<0.05). Also, LV GCS in WD-n was significantly reduced compared to WD-h (WD-n (%): −18.3±3.1; WD-h (%): −20.0±2.0). Furthermore, there were no significant differences between the two subgroups, besides a significant thicker lateral wall in patients with WD-n (WD-n (mm): 7 (5–9); WD-h (mm): 6 (5–8), p<0.05). T1-, T2- and T2*-Mapping did not show any pathological pattern and were overall in the normal range (T1: 1020±30ms; T2: 52.9±3.0ms; T2*: 38.4±5.6ms). Epicardial LGE was present in 1 patient. Conclusion Cardiac tissue characterization was performed in WD patients using CMR. Reduced EF, LV and RV GCS have been detected in patients with primarily neurological symptoms. Cardiovascular autonomic dysfunction in this subgroup could be a reason for the reduced biventricular strain. It is unknown if reduced circumferential strain influences the prognosis of WD patients, which should be investigated in further studies.

scholarly journals 66 Heart and lung tissue characterization of COVID-19 pneumonia by T1 and T2 mapping magnetic resonance imaging

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Giovanni Camastra ◽  
Luca Arcari ◽  
Federica Ciolina ◽  
Massimiliano Danti ◽  
Luca Cacciotti ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tissue Characterization ◽  
T2 Mapping ◽  
Left Ventricular ◽  
Resonance Imaging ◽  
Native T1 ◽  
T1 And T2 ◽  
Lung Mri

Abstract Aims Coronavirus disease 2019 (COVID-19) is a respiratory tract infection which can lead to systemic involvement including myocardial injury, severe respiratory failure and death. Magnetic resonance imaging (MRI) could potentially offer advantages in providing tissue characterization of lung parenchyma and heart muscle in COVID-19. The aim of the present study was to describe data on heart and lung MRI in a cohort of patients hospitalized due to COVID-19 pneumonia. Methods and results n = 11 patients hospitalized with COVID-19 pneumonia underwent a comprehensive MRI examinations including lung and heart tissue mapping, findings were compared to those of an age- and sex-matched cohort of n = 11 individuals. Lung native T1 and T2 mapping assessments were performed by drawing a circular region of interest (ROI) with diameter of 2 cm in the parenchyma visualized from the cardiac four chamber long axis-oriented slice; vessels and areas of pleural effusion were carefully excluded. Myocardial native T1 and T2 mapping were assessed by drawing a ROI within the midventricular left ventricular (LV) septum. No patients had previous history of cardiovascular disease (including known coronary artery disease, heart failure, cardiomyopathy, atrial fibrillation). As compared to controls, patients with COVID-19 had similar cardiac function, higher mid-septum myocardial native T1 (1028 ms vs. 985, P = 0.05) and significantly higher lung native T1 and T2 within affected areas (1375 ms vs. 1201 ms, P = 0.016 and 70 ms vs. 30 ms, P &lt; 0.001 respectively), whereas non-significant differences were observed between remote lung areas of patients and controls (1238 ms vs. 1152 ms, P = 0.088 and 29 ms vs. 33 ms, P = 0.797 respectively). No significant associations were observed between cardiac and lung mapping findings. Conclusions In our cohort of patients with COVID-19, T1 and T2 mapping lung MRI identified pneumonia related abnormalities as compared to healthy controls, likely representing oedema and ongoing inflammation at the lung site. Myocardial native T1 was elevated suggesting the presence of cardiac involvement. A comprehensive MRI examination can be potentially used to assess multiorgan involvement in COVID-19.

scholarly journals Value CMR: Towards a Comprehensive, Rapid, Cost-Effective Cardiovascular Magnetic Resonance Imaging

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
El-Sayed H. Ibrahim ◽  
Luba Frank ◽  
Dhiraj Baruah ◽  
V. Emre Arpinar ◽  
Andrew S. Nencka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tissue Characterization ◽  
T2 Mapping ◽  
Cost Effective ◽  
Cine Imaging ◽  
Resonance Imaging ◽  
4D Flow ◽  
Scan Time

Cardiac magnetic resonance imaging (CMR) is considered the gold standard for measuring cardiac function. Further, in a single CMR exam, information about cardiac structure, tissue composition, and blood flow could be obtained. Nevertheless, CMR is underutilized due to long scanning times, the need for multiple breath-holds, use of a contrast agent, and relatively high cost. In this work, we propose a rapid, comprehensive, contrast-free CMR exam that does not require repeated breath-holds, based on recent developments in imaging sequences. Time-consuming conventional sequences have been replaced by advanced sequences in the proposed CMR exam. Specifically, conventional 2D cine and phase-contrast (PC) sequences have been replaced by optimized 3D-cine and 4D-flow sequences, respectively. Furthermore, conventional myocardial tagging has been replaced by fast strain-encoding (SENC) imaging. Finally, T1 and T2 mapping sequences are included in the proposed exam, which allows for myocardial tissue characterization. The proposed rapid exam has been tested in vivo. The proposed exam reduced the scan time from >1 hour with conventional sequences to <20 minutes. Corresponding cardiovascular measurements from the proposed rapid CMR exam showed good agreement with those from conventional sequences and showed that they can differentiate between healthy volunteers and patients. Compared to 2D cine imaging that requires 12-16 separate breath-holds, the implemented 3D-cine sequence allows for whole heart coverage in 1-2 breath-holds. The 4D-flow sequence allows for whole-chest coverage in less than 10 minutes. Finally, SENC imaging reduces scan time to only one slice per heartbeat. In conclusion, the proposed rapid, contrast-free, and comprehensive cardiovascular exam does not require repeated breath-holds or to be supervised by a cardiac imager. These improvements make it tolerable by patients and would help improve cost effectiveness of CMR and increase its adoption in clinical practice.

scholarly journals Predictors of Spondylolysis on Magnetic Resonance Imaging in Adolescent Athletes With Low Back Pain

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199546
Author(s):  
Takuji Yokoe ◽  
Takuya Tajima ◽  
Hiroshi Sugimura ◽  
Shinichirou Kubo ◽  
Shotarou Nozaki ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Low Back Pain ◽  
Back Pain ◽  
Magnetic Resonance ◽  
Neurological Symptoms ◽  
Low Back ◽  
Resonance Imaging ◽  
Advanced Imaging ◽  
Adolescent Athletes ◽  
Mri Scans

Background: Spondylolysis and undiagnosed mechanical low back pain (UMLBP) are the main causes of low back pain (LBP) in adolescent athletes. No studies have evaluated the difference in clinical and radiographic factors between these 2 conditions. Furthermore, it remains unclear which adolescent athletes with LBP should undergo advanced imaging examination for spondylolysis. Purpose: To compare the clinical and radiographic factors of adolescent athletes with spondylolysis and UMLBP who did not have neurological symptoms or findings before magnetic resonance imaging (MRI) evaluation and to determine the predictors of spondylolysis findings on MRI. Study Design: Cohort study, Level of evidence, 3. Methods: The study population included 122 adolescent athletes aged 11 to 18 years who had LBP without neurological symptoms or findings and who underwent MRI. Of these participants, 75 were ultimately diagnosed with spondylolysis, and 47 were diagnosed with UMLBP. Clinical factors and the following radiographic parameters were compared between the 2 groups: spina bifida occulta, lumbar lordosis (LL) angle, and the ratio of the interfacet distance of L1 to that of L5 (L1:L5 ratio, %). A logistic regression analysis was performed to evaluate independent predictors of spondylolysis on MRI scans. Results: Significantly more athletes with spondylolysis were male (82.7% vs 48.9%; P < .001), had a greater LL angle (22.8° ± 8.1° vs 19.3° ± 8.5°; P = .02), and had a higher L1:L5 ratio (67.4% ± 6.3% vs 63.4% ± 6.6%; P = .001) versus athletes with UMLBP. A multivariate analysis revealed that male sex (odds ratio [OR], 4.66; P < .001) and an L1:L5 ratio of >65% (OR, 3.48; P = .003) were independent predictors of positive findings of spondylolysis on MRI scans. Conclusion: The study findings indicated that sex and the L1:L5 ratio are important indicators for whether to perform MRI as an advanced imaging examination for adolescent athletes with LBP who have no neurological symptoms and findings.

Diffusion-Weighted Magnetic Resonance Imaging Procedure as a Cancer Diagnosis Application Tool

2017 ◽  
pp. 660-667
Author(s):  
I. Shirazu ◽  
Y. B Mensah ◽  
T. A Sackey ◽  
M. Boadu ◽  
E K Eduful ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brain Tumors ◽  
Tissue Characterization ◽  
Measured Signal ◽  
Resonance Imaging ◽  
Imaging Procedure ◽  
Tissue Organization ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging

Physical imaging technique described as Diffusion Weighted-Magnetic Resonance Imaging (DW-MRI) is based on classically principle of Brownian motion, where the molecules are thermal agitated and is highly influenced by the cellular availability of water. The aim of this study is to discuss the use of DW-MRI as a cancer diagnostic application tool using the basic physics principles as versus other available procedures and modalities in terms of accuracy and acceptability. Based on extravascular diffusion measurements where the measured signal is related to tissue cellularity, tissue organization and extracellular space tortuosity and on the intactness of cellular membranes that are intrinsically hydrophobic. The methodology involve the application of DW-MRI procedure, to qualitatively and quantitatively access DW-MR images to diagnose brain tumors, prostate and other organ cancers compared to other imaging modalities including other MRI procedures. It also include safety assessment and other consideration before, during and after imaging with MRI as compare to other radiological modalities. The results of the data of ten (10) MRI centers and 112 DW-MRI images and 99 other procedure and modalities were analysed, 34% were prostate cases, 27% were brain cases and 39% formed all other cases. In addition, DW-MRI compare to other single imaging procedure formed 53% of all diagnostic procedure that had 87% accurate predictability of prostate and brain cases. It can therefore concluded that DW-MRI is the best single imaging procedure that can be used to diagnose prostate cancers and brain tumors. It has a major advantage of non-ionizing radiation technique, with multiple planes image acquisitions, together with superior soft tissue contrast. In addition its perfusion allow for precise tissue characterization rather than merely 'macroscopic' imaging and superior visualization of both active parts of the brain during certain activities and understanding of the underlying networks. However, there are two outstanding challenges of DW-MRI scans in Ghana: it is expensive as compared to other modalities and not safe for patients with some metal implants. Despite these challenges, its advantages override its disadvantages and therefore it is recommended to clinicians as the first diagnostic tool to use in prostate cancer and brain tumor diagnoses.

scholarly journals The computer and magnetic resonance imaging in the early assessment of the clinical course of ischemic stroke

2019 ◽  
Vol 18 (2) ◽  
pp. 35-40
Author(s):  
R. Kh. Aldatov ◽  
V. A. Fokin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Intravenous Thrombolysis ◽  
Neurological Symptoms ◽  
Limiting Factor ◽  
Resonance Imaging ◽  
Early Assessment ◽  
Stage Of Development ◽  
The Moment

The most important benefit that imaging provides to a patient with ischemic stroke is the rapid identification of those patients who are most likely to benefit from emergency treatment. This group includes patients who suffer from severe neurological symptoms due to the occlusion of the main artery, and those who are candidates for recanalization by intravenous thrombolysis or intra-arterial intervention to remove blockage.Objective – to assess the sensitivity and significance of computed tomography and magnetic resonance imaging in early diagnosis of infarction foci.Material and methods. The results of radiologic studies of 89 patients with a clinical picture, suspected of acute ischemic cerebral circulation disorders, received in the first 24 hours from the moment of development of neurological symptoms were analyzed.Results. As a result of our study, it was shown that in the first group of patients received in the first 4.5 h from the moment of development of neurological symptoms of CT-signs of stroke were not detected in 16 (76 %) of 21 patients, while those received in the first 24 h from the moment of development of neurological symptoms of CT-signs of stroke were not detected in 14 (28 %) of 50 patients, determined by the symptom of strengthening of the artery, loss of differentiation between gray and white matter of the brain, smoothness of cortical furrows and the appearance of a zone of reduced densitometric density brain substances (<22HU). The difficulties of diagnosis in some patients on CT were the size and localization of ischemic areas (lacunar, stem strokes). In group II of 18 patients of the study, native MRI revealed signs of ischemic areas in 10 patients out of 10, complex CT and MRI to determined areas of hypoperfusion in 8 patients out of 8.Conclusion. CT is the most widely used imaging technique for cerebral infarction with high sensitivity to intracerebral hemorrhage, high specificity in ischemia, but low sensitivity to the detection of ischemic changes is a limiting factor. The data obtained confirm that MRI is a reliable method of diagnosing ischemic stroke. The most sensitive in the diagnosis of ischemic changes in the acute stage of development by using DWI (b1000).

AB1098 STRUCTURAL ELEMENTS OF THE KNEE ENTHESES ASSESSED IN HEALTHY SUBJECTS WITH ULTRA HIGH FIELD MRI (150 MICRONS).

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1838-1838
Author(s):  
D. Roche ◽  
C. Michel ◽  
P. Daudé ◽  
A. Le Troter ◽  
C. Chagnaud ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Healthy Subjects ◽  
High Field ◽  
T2 Mapping ◽  
Pulse Sequences ◽  
Structural Elements ◽  
Resonance Imaging ◽  
Ultra High Field ◽  
Mineralized Zone

Background:Fibrocartilaginous enthesis is composed of different histological zones which are commonly referred to the tendon distal extremity (a lamellar tissue with a low cell density, collagen and connective tissue), the fibrocartilaginous zone (with chondrocytes), a progressively mineralized zone and the bone. The MRI visualization of the water content of entheses is challenging given the very short relation time so that entheses has been very poorly assessed using MRI (1).Objectives:The main objective of the study was to assess the structural elements of the knee enthesis based on the quantitative T2* measurements using Ultra High Field (UHF) MRI.Methods:Twelve healthy subjects without any osteoarticular pathology were included in the study after they provided their informed consent. 3D gradient echo sequence with a 4.3 ms echo time and T2* mapping were performed. The lateral internal, external and crossed ligaments, patellar and quadricipital tendons were assessed. T2* measurements were performed specifically on the quadricipital tendon.Results:The quadricipital tendon and the bone trabeculation could be visualized on the UHF MR image. The T2* mapping analysis illustrated a large value (16.4 ± 4 ms) for the subchondral bone and much lower values for the trabecular bone (11 ± 4.5 ms) and the different zones of the keen entheses (7.7 ± 1.9 ms).Conclusion:Based on T2* measurements performed using UHF MRI, the different structural elements of the knee entheses were distinguished. This quantitative stratification could be used to assess changes in pathological conditions such as SpA and trauma.References:[1]Benjamin M, Bydder GM. Magnetic resonance imaging of entheses using ultrashort TE (UTE) pulse sequences. Journal of magnetic resonance imaging: JMRI. 2007;25(2):381-9.Disclosure of Interests:None declared

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