BACKGROUND Back pain and sciatica are common complaints that often require imaging for accurate diagnosis and management.Conventional lumbar magnetic resonance imaging(MRI)protocols typically include sagittal and axia...BACKGROUND Back pain and sciatica are common complaints that often require imaging for accurate diagnosis and management.Conventional lumbar magnetic resonance imaging(MRI)protocols typically include sagittal and axial T1 and T2 sequences;however,these may miss certain pathologies.The addition of coronal short tau inversion recovery(STIR)sequences offers the potential to enhance the detection of both spinal and extra-spinal abnormalities,thereby improving clinical decisionmaking and patient outcomes.AIM To evaluate the impact of adding coronal STIR sequences to routine lumbar MRI in diagnosing back pain and sciatica.METHODS We prospectively analyzed data from patients aged 6 and older presenting with back pain or sciatica who underwent lumbar spine MRI at our institution.The standardized MRI protocol utilized included sagittal and axial T1 and T2 sequences,complemented by a coronal STIR sequence.Data on structural abnormalities were collected,reviewed,and analyzed using counts,percentages,and Fisher's exact test for categorical variables.RESULTS Our cohort comprised 274 patients(115 males,159 females;mean age 44.91 years).Notably,39 patients exhibited abnormalities across all sequences,while 72.63%showed normal findings on the coronal STIR sequence.Importantly,30.29%of cases were diagnosed as normal without the coronal STIR,and 36 patients with normal T1 and T2 sequences presented abnormalities on the coronal STIR.The coronal STIR sequence successfully identified 26 spinal and 10 non-spinal pathologies,including 17 cases of sacroiliitis,with a significant association(P<0.0001)between sacroiliitis diagnosis and abnormalities visible solely on this sequence.CONCLUSION Integrating coronal STIR into routine lumbar MRI enhances detection of hidden spinal and extra-spinal pathologies,improves patient management,and offers a cost-effective,practical upgrade with significant diagnostic and clinical value.展开更多
Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the p...Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days （National Institutes of Health Stroke Scale） and 90 days （modified Rankin Scale） to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.展开更多
The diagnosis of the recurrent optic neuritis is commonly established clinically,and sometimes it could be challenging because the involved optic nerve does not always show significant enhancement on conventional cont...The diagnosis of the recurrent optic neuritis is commonly established clinically,and sometimes it could be challenging because the involved optic nerve does not always show significant enhancement on conventional contrast enhanced-T1 weighted imaging（CE-T1W1）.In this paper,we reported a middle-aged female with early diagnosis of recurrent optic neuritis using contrast-enhanced T2 fluid-attenuated inversion recovery imaging（CET2FLAIR）.The involved optic nerve presented evident enhancement on CE-T2FLAIR and no enhancement on CE-T1W1.This case suggested that the CE-T2FLAIR may be a useful diagnostic tool specifically for the recurrent optic neuritis in clinical practice.展开更多
The diagnosis of sporadic Creutzfeldt-Jakob disease （sCJD） is extremely difficult. Diffusion-weighted imaging has been shown to be the most sensitive technique for the detection of signal alterations in sCJD patient...The diagnosis of sporadic Creutzfeldt-Jakob disease （sCJD） is extremely difficult. Diffusion-weighted imaging has been shown to be the most sensitive technique for the detection of signal alterations in sCJD patients. The present study analyzed the diagnostic value of diffusion-weighted imaging and fluid-attenuated inversion recovery sequence in the early stage of sCJD in one female patient and correlated the clinical symptoms during disease course and magnetic resonance manifestations. Thalamic and basal ganglia hyperintensities were observed on magnetic resonance images in a very early stage, i.e., when the clinical typical manifestations of the disease were not present. With the progression of the disease, cortical and basal ganglia hyperintensities were observed on magnetic resonance images, showing an obvious cerebral atrophy. These findings suggest that diffusion-weighted imaging and fluid-attenuated inversion recovery sequence are helpful in diagnosing sCJD.展开更多
Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. ...Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. WB-DWI was performed by using short TI inversion recovery echo-planar imaging sequence with free breathing and built-in body coil. Axial T2- weighted imaging images of the same location were used as reference. The results of WB-DWI were compared with pathological results and other imaging modalities. The mean apparent diffusion coefficient （ADC） values of different kinds of lymph nodes were compared. Results WB-DWI was positive in all 18 cases with lymphoma, 5 cases with metastatic lymph nodes and 4 of 8 eases with benign lymphadenopathy. The mean ADC value of lymphomatous, metastatic and benign lymph nodes was （0.87 ± 0.17） × 10^3, （0.98± 0.09） × 10^3 and （1.20 ± 0.10） × 10^3 mm^2/s. There was significant difference in ADC value between benign lymph nodes and other two groups （P 〈 0.01）. The sensitivity, specificity and accuracy of WB-DWI in diagnosis of lymphoma were 100% （18/18）, 30.8% （4/13） and 71.0% （22/31）. When an ADC value of 1.08 × 10^-3 mm^2/s was used as the threshold value for differentiating malignant from benign lymph nodes, the best results were obtained with sensitivity of 87.8% and specificity of 91.3%. Sixteen of eighteen cases （88.9%） of lymphoma were accurately staged in accordance with clinical staging. Conclusions WB-DWI is a sensitive, but less specific technique for diagnosis of lymphoma. It is difficult to differentiate lymphnmatous from metastatic lymph nodes using WB-DWI. However, it is a valuable imaging modality for staging of patients with malignant lymphoma.展开更多
BACKGROUND Synthetic magnetic resonance imaging(MRI)MAGnetic resonance imaging compilation(MAGiC)is a new MRI technology.Conventional T1,T2,T2-fluidattenuated inversion recovery(FLAIR)contrast images,quantitative imag...BACKGROUND Synthetic magnetic resonance imaging(MRI)MAGnetic resonance imaging compilation(MAGiC)is a new MRI technology.Conventional T1,T2,T2-fluidattenuated inversion recovery(FLAIR)contrast images,quantitative images of T1 and T2 mapping,and MAGiC phase sensitive inversion recovery(PSIR)Vessel cerebrovascular images can be obtained simultaneously through post-processing at the same time after completing a scan.In recent years,studies have reported that MAGiC can be applied to patients with acute ischemic stroke.We hypothesized that the synthetic MRI vascular screening scheme can evaluate the degree of cerebral artery stenosis in patients with acute ischemic stroke.AIM To explore the application value of vascular images obtained by synthetic MRI in diagnosing acute ischemic stroke.METHODS A total of 64 patients with acute ischemic stroke were selected and examined by MRI in the current retrospective cohort study.The scanning sequences included traditional T1,T2,and T2-FLAIR,three-dimensional time-of-flight magnetic resonance angiography(3D TOF MRA),diffusion-weighted imaging(DWI),and synthetic MRI.Conventional contrast images(T1,T2,and T2-FLAIR)and intracranial vessel images(MAGiC PSIR Vessel]were automatically reconstructed using synthetic MRI raw data.The contrast-to-noise ratio(CNR)values of traditional T1,T2,and T2-FLAIR images and MAGiC reconstructed T1,T2,and T2-FLAIR images in DWI diffusion restriction areas were measured and compared.MAGiC PSIR Vessel and TOF MRA images were used to measure and calculate the stenosis degree of bilateral middle cerebral artery stenosis areas.The consistency of MAGiC PSIR Vessel and TOF MRA in displaying the degree of vascular stenosis with computed tomography angiography(CTA)was compared.RESULTS Among the 64 patients with acute ischemic stroke,79 vascular stenosis areas showed that the correlation between MAGiC PSIR Vessel and CTA(r=0.90,P<0.01)was higher than that between TOF MRA and CTA(r=0.84,P<0.01).With a degree of vascular stenosis>50%assessed by CTA as a reference,the area under the receiver operating characteristic(ROC)curve of MAGiC PSIR Vessel[area under the curve(AUC)=0.906,P<0.01]was higher than that of TOF MRA(AUC=0.790,P<0.01).Among the 64 patients with acute ischemic stroke,39 were scanned for traditional T1,T2,and T2-FLAIR images and MAGiC images simultaneously,and CNR values in DWI diffusion restriction areas were measured,which were:Traditional T2=21.2,traditional T1=-6.7,and traditional T2-FLAIR=11.9;and MAGiC T2=7.1,MAGiC T1=-3.9,and MAGiC T2-FLAIR=4.5.CONCLUSION The synthetic MRI vascular screening scheme for patients with acute ischemic stroke can accurately evaluate the degree of bilateral middle cerebral artery stenosis,which is of great significance to early thrombolytic interventional therapy and improving patients’quality of life.展开更多
Objective To investigate effect of MR field strength on texture features of cerebral T2 fluid attenuated inversion recovery(T2-FLAIR)images.Methods We acquired cerebral 3 D T2-FLAIR images of thirty patients who were ...Objective To investigate effect of MR field strength on texture features of cerebral T2 fluid attenuated inversion recovery(T2-FLAIR)images.Methods We acquired cerebral 3 D T2-FLAIR images of thirty patients who were diagnosed with ischemic white matter lesion(WML)with MR-1.5 T and MR-3.0 T scanners.Histogram texture features which included mean signal intensity(Mean),Skewness and Kurtosis,and gray level co-occurrence matrix(GLCM)texture features which included angular second moment(ASM),Contrast,Correlation,Inverse difference moment(IDM)and Entropy,of regions of interest located in the area of WML and normal white matter(NWM)were measured by ImageJ software.The texture parameters acquired with MR-1.5 T scanning were compared with MR-3.0 T scanning.Results The Mean of both WML and NWM obtained with MR-1.5 T scanning was significantly lower than that acquired with MR-3.0 T(P<0.001),while Skewness and Kurtosis between MR-1.5 T and MR-3.0 T scanning showed no significant difference(P>0.05).ASM,Correlation and IDM of both WML and NWM acquired with MR-1.5 T revealed significantly lower values than those with MR-3.0 T(P<0.001),while Contrast and Entropy acquired with MR-1.5 T showed significantly higher values than those with MR-3.0 T(P<0.001).Conclusion MR field strength showed no significant effect on histogram textures,while had significant effect on GLCM texture features of cerebral T2-FLAIR images,which indicated that it should be cautious to explain the texture results acquired based on the different MR field strength.展开更多
Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic reso...Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) sequence. Methods Nine patients with refractory temporal lobe epilepsy, 21 patients with non-refractory temporal lobe epilepsy, and 13 normal volunteers underwent FAIR MR scanning. The relative cerebral blood flow (rCBF) in bilateral hemispheres and mesial temporal lobes were measured. And we also calculated the asymmetry index (AI) values. Results The AI values of bilateral hemispheres in refractory and non-refractory epilepsy patients were both significantly different from those of volunteers (P=0.012 and 0.029, respectively). There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers (P=0.049), while no significant difference between refractory epilepsy patients and volunteers. Conclusions The hypoperfusion pattern of interictal refractory temporal lobe epilepsy patients is different from that of non-refractory patients. Although the hypoperfusion tends to extend out of temporal lobes in all patients, the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion, which may be valuable for evaluating prognosis.展开更多
文摘BACKGROUND Back pain and sciatica are common complaints that often require imaging for accurate diagnosis and management.Conventional lumbar magnetic resonance imaging(MRI)protocols typically include sagittal and axial T1 and T2 sequences;however,these may miss certain pathologies.The addition of coronal short tau inversion recovery(STIR)sequences offers the potential to enhance the detection of both spinal and extra-spinal abnormalities,thereby improving clinical decisionmaking and patient outcomes.AIM To evaluate the impact of adding coronal STIR sequences to routine lumbar MRI in diagnosing back pain and sciatica.METHODS We prospectively analyzed data from patients aged 6 and older presenting with back pain or sciatica who underwent lumbar spine MRI at our institution.The standardized MRI protocol utilized included sagittal and axial T1 and T2 sequences,complemented by a coronal STIR sequence.Data on structural abnormalities were collected,reviewed,and analyzed using counts,percentages,and Fisher's exact test for categorical variables.RESULTS Our cohort comprised 274 patients(115 males,159 females;mean age 44.91 years).Notably,39 patients exhibited abnormalities across all sequences,while 72.63%showed normal findings on the coronal STIR sequence.Importantly,30.29%of cases were diagnosed as normal without the coronal STIR,and 36 patients with normal T1 and T2 sequences presented abnormalities on the coronal STIR.The coronal STIR sequence successfully identified 26 spinal and 10 non-spinal pathologies,including 17 cases of sacroiliitis,with a significant association(P<0.0001)between sacroiliitis diagnosis and abnormalities visible solely on this sequence.CONCLUSION Integrating coronal STIR into routine lumbar MRI enhances detection of hidden spinal and extra-spinal pathologies,improves patient management,and offers a cost-effective,practical upgrade with significant diagnostic and clinical value.
基金supported by the National Natural Science Foundation of China,No.81371521
文摘Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days （National Institutes of Health Stroke Scale） and 90 days （modified Rankin Scale） to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.
文摘The diagnosis of the recurrent optic neuritis is commonly established clinically,and sometimes it could be challenging because the involved optic nerve does not always show significant enhancement on conventional contrast enhanced-T1 weighted imaging（CE-T1W1）.In this paper,we reported a middle-aged female with early diagnosis of recurrent optic neuritis using contrast-enhanced T2 fluid-attenuated inversion recovery imaging（CET2FLAIR）.The involved optic nerve presented evident enhancement on CE-T2FLAIR and no enhancement on CE-T1W1.This case suggested that the CE-T2FLAIR may be a useful diagnostic tool specifically for the recurrent optic neuritis in clinical practice.
文摘The diagnosis of sporadic Creutzfeldt-Jakob disease （sCJD） is extremely difficult. Diffusion-weighted imaging has been shown to be the most sensitive technique for the detection of signal alterations in sCJD patients. The present study analyzed the diagnostic value of diffusion-weighted imaging and fluid-attenuated inversion recovery sequence in the early stage of sCJD in one female patient and correlated the clinical symptoms during disease course and magnetic resonance manifestations. Thalamic and basal ganglia hyperintensities were observed on magnetic resonance images in a very early stage, i.e., when the clinical typical manifestations of the disease were not present. With the progression of the disease, cortical and basal ganglia hyperintensities were observed on magnetic resonance images, showing an obvious cerebral atrophy. These findings suggest that diffusion-weighted imaging and fluid-attenuated inversion recovery sequence are helpful in diagnosing sCJD.
文摘Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. WB-DWI was performed by using short TI inversion recovery echo-planar imaging sequence with free breathing and built-in body coil. Axial T2- weighted imaging images of the same location were used as reference. The results of WB-DWI were compared with pathological results and other imaging modalities. The mean apparent diffusion coefficient （ADC） values of different kinds of lymph nodes were compared. Results WB-DWI was positive in all 18 cases with lymphoma, 5 cases with metastatic lymph nodes and 4 of 8 eases with benign lymphadenopathy. The mean ADC value of lymphomatous, metastatic and benign lymph nodes was （0.87 ± 0.17） × 10^3, （0.98± 0.09） × 10^3 and （1.20 ± 0.10） × 10^3 mm^2/s. There was significant difference in ADC value between benign lymph nodes and other two groups （P 〈 0.01）. The sensitivity, specificity and accuracy of WB-DWI in diagnosis of lymphoma were 100% （18/18）, 30.8% （4/13） and 71.0% （22/31）. When an ADC value of 1.08 × 10^-3 mm^2/s was used as the threshold value for differentiating malignant from benign lymph nodes, the best results were obtained with sensitivity of 87.8% and specificity of 91.3%. Sixteen of eighteen cases （88.9%） of lymphoma were accurately staged in accordance with clinical staging. Conclusions WB-DWI is a sensitive, but less specific technique for diagnosis of lymphoma. It is difficult to differentiate lymphnmatous from metastatic lymph nodes using WB-DWI. However, it is a valuable imaging modality for staging of patients with malignant lymphoma.
基金Wu Jieping Medical Foundation,No.320.6750.2020-11-22.
文摘BACKGROUND Synthetic magnetic resonance imaging(MRI)MAGnetic resonance imaging compilation(MAGiC)is a new MRI technology.Conventional T1,T2,T2-fluidattenuated inversion recovery(FLAIR)contrast images,quantitative images of T1 and T2 mapping,and MAGiC phase sensitive inversion recovery(PSIR)Vessel cerebrovascular images can be obtained simultaneously through post-processing at the same time after completing a scan.In recent years,studies have reported that MAGiC can be applied to patients with acute ischemic stroke.We hypothesized that the synthetic MRI vascular screening scheme can evaluate the degree of cerebral artery stenosis in patients with acute ischemic stroke.AIM To explore the application value of vascular images obtained by synthetic MRI in diagnosing acute ischemic stroke.METHODS A total of 64 patients with acute ischemic stroke were selected and examined by MRI in the current retrospective cohort study.The scanning sequences included traditional T1,T2,and T2-FLAIR,three-dimensional time-of-flight magnetic resonance angiography(3D TOF MRA),diffusion-weighted imaging(DWI),and synthetic MRI.Conventional contrast images(T1,T2,and T2-FLAIR)and intracranial vessel images(MAGiC PSIR Vessel]were automatically reconstructed using synthetic MRI raw data.The contrast-to-noise ratio(CNR)values of traditional T1,T2,and T2-FLAIR images and MAGiC reconstructed T1,T2,and T2-FLAIR images in DWI diffusion restriction areas were measured and compared.MAGiC PSIR Vessel and TOF MRA images were used to measure and calculate the stenosis degree of bilateral middle cerebral artery stenosis areas.The consistency of MAGiC PSIR Vessel and TOF MRA in displaying the degree of vascular stenosis with computed tomography angiography(CTA)was compared.RESULTS Among the 64 patients with acute ischemic stroke,79 vascular stenosis areas showed that the correlation between MAGiC PSIR Vessel and CTA(r=0.90,P<0.01)was higher than that between TOF MRA and CTA(r=0.84,P<0.01).With a degree of vascular stenosis>50%assessed by CTA as a reference,the area under the receiver operating characteristic(ROC)curve of MAGiC PSIR Vessel[area under the curve(AUC)=0.906,P<0.01]was higher than that of TOF MRA(AUC=0.790,P<0.01).Among the 64 patients with acute ischemic stroke,39 were scanned for traditional T1,T2,and T2-FLAIR images and MAGiC images simultaneously,and CNR values in DWI diffusion restriction areas were measured,which were:Traditional T2=21.2,traditional T1=-6.7,and traditional T2-FLAIR=11.9;and MAGiC T2=7.1,MAGiC T1=-3.9,and MAGiC T2-FLAIR=4.5.CONCLUSION The synthetic MRI vascular screening scheme for patients with acute ischemic stroke can accurately evaluate the degree of bilateral middle cerebral artery stenosis,which is of great significance to early thrombolytic interventional therapy and improving patients’quality of life.
文摘Objective To investigate effect of MR field strength on texture features of cerebral T2 fluid attenuated inversion recovery(T2-FLAIR)images.Methods We acquired cerebral 3 D T2-FLAIR images of thirty patients who were diagnosed with ischemic white matter lesion(WML)with MR-1.5 T and MR-3.0 T scanners.Histogram texture features which included mean signal intensity(Mean),Skewness and Kurtosis,and gray level co-occurrence matrix(GLCM)texture features which included angular second moment(ASM),Contrast,Correlation,Inverse difference moment(IDM)and Entropy,of regions of interest located in the area of WML and normal white matter(NWM)were measured by ImageJ software.The texture parameters acquired with MR-1.5 T scanning were compared with MR-3.0 T scanning.Results The Mean of both WML and NWM obtained with MR-1.5 T scanning was significantly lower than that acquired with MR-3.0 T(P<0.001),while Skewness and Kurtosis between MR-1.5 T and MR-3.0 T scanning showed no significant difference(P>0.05).ASM,Correlation and IDM of both WML and NWM acquired with MR-1.5 T revealed significantly lower values than those with MR-3.0 T(P<0.001),while Contrast and Entropy acquired with MR-1.5 T showed significantly higher values than those with MR-3.0 T(P<0.001).Conclusion MR field strength showed no significant effect on histogram textures,while had significant effect on GLCM texture features of cerebral T2-FLAIR images,which indicated that it should be cautious to explain the texture results acquired based on the different MR field strength.
文摘Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) sequence. Methods Nine patients with refractory temporal lobe epilepsy, 21 patients with non-refractory temporal lobe epilepsy, and 13 normal volunteers underwent FAIR MR scanning. The relative cerebral blood flow (rCBF) in bilateral hemispheres and mesial temporal lobes were measured. And we also calculated the asymmetry index (AI) values. Results The AI values of bilateral hemispheres in refractory and non-refractory epilepsy patients were both significantly different from those of volunteers (P=0.012 and 0.029, respectively). There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers (P=0.049), while no significant difference between refractory epilepsy patients and volunteers. Conclusions The hypoperfusion pattern of interictal refractory temporal lobe epilepsy patients is different from that of non-refractory patients. Although the hypoperfusion tends to extend out of temporal lobes in all patients, the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion, which may be valuable for evaluating prognosis.
