Investigative Radiology September 2013

Detection of Myocardial Ischemia by Automated, Motion-Corrected, Color-Encoded Perfusion Maps Compared With Visual Analysis of Adenosine Stress Cardiovascular Magnetic Resonance Imaging at 3 T [...]

Case Report: syngo TimCT – MR Angiography in Clinical Routine

Studies at the University Medical Center in Mannheim, Germany show that the continuous moving table MRA approach is a major improvement in imaging the lower extremities in a clinical setting as it combines an easy, fast and robust workflow with good clinical results and is applicable to a broad range of patients. [...]

Investigative Radiology July 2013

Highly Accelerated T1-Weighted Abdominal Imaging Using 2-Dimensional Controlled Aliasing in Parallel Imaging Results in Higher Acceleration. [...]

Case Report: Fast Joint Imaging at 1.5 Tesla with a Combination of the Quadrature Knee and Body Matrix Coil in Case of Severe Knee Pain of an Obese Patient

Knee MRI is challenging in both obese patients and patients in pain, requiring in some cases special coil setups as imaging is impossible with a conventional closed knee coil. In the presented case, a flexible coil setup is demonstrated in combination with open-bore MR technology. This illustrates the benefit of such setups in the diagnosis of knee pain in obese patients. [...]

Case Report: Knee MR Imaging of Haemarthrosis in a Case of Haemophilia A

Imaging pediatric joints is often still a domain of x-ray and ultrasound. However, the application of MRI is of growing importance, not only because of its excellent soft tissue contrast but also because of its capability to early and precisely detect bone destruction. In this case, Prof. Marc-André Weber (University of Heidelberg, Germany) reports on the imaging findings of a 14-year-old male with known hemophilia A. [...]

Tips for T2-weighted TSE Shoulder Imaging with Spectral Fat Saturation

Robust fat saturation can be achieved by different approaches including the application of inversion recovery sequences or advanced fat suppression pulses such as SPAIR. However, in some cases, such as the musculoskeletal imaging of the shoulder, the combination of a T2- weighted turbo spin echo (TSE) sequence with a conventional spectral fat saturation pulse is needed. When imaging obese or very tall patients, the shoulder has to be positioned off-center in many MR exams and therefore several factors will affect image quality with spectral fat saturation. This article provides tips on patient positioning and sequence set-up that will help you to achieve high quality spectral fat saturation. [...]

Traumatic Lesion of the Left Brachial Plexus

To diagnose peripheral neurologic deficits, imaging of the vertebral disks alone may not be sufficient. Depending on the clinical symptoms, the nerve roots themselves need to be evaluated in detail. In the presented case of a traumatic lesion of the brachial plexus, Markus Lentschig, MD (MR and PET/CT Center, Bremen, Germany) presents his 1.5 T imaging protocol for the evaluation of the cervical nerve roots and brachial plexus. [...]

Assessment of Tumor Extension and Improved Localization for Planning and Nerve Sparing Radical Prostatectomy

The potential of state-of-the-art MRI at 3 T, in prostate imaging without the use of an endorectal coil, is discussed in this article. Two clinical cases are presented, with MRI in each instance able to improve both therapy planning and surgical outcome. [...]

Nonsecretory Multiple Myeloma MRI Monitoring of Therapy Response

Multiple myeloma is a malignant hematologic disorder characterized by the infiltration of neoplastic plasma cells into bone marrow. Detection of medullary involvement is best accomplished with the aid of MRI. Visualization of myeloma burden at baseline and during therapy is beneficial for improved patient management and accurate prognostic evaluation. Therefore, whole-body imaging protocols are mandatory, especially for assessment of myeloma infiltration in all bone marrow cavities (medullary involvement) as well as for diagnosis of extramedullary involvement. [...]

Whole-Body MRI for Accurate Assessment of Tumor Load of Bone Metastases Originating from Breast Carcinoma

With breast carcinoma, detection of metastases and estimation of tumor load is of high relevance for patient-individualized therapy regimes. This article presents two cases that show the advantages of MRI for imaging bone metastases originating from breast cancer. In both cases, there was the high clinical suspicion of tumor recurrence with metastastic spread. The patients underwent therefore combined whole- body 18F FDG PET/CT and whole-body MRI for tumor staging with special focus on the brain, liver and bone marrow. [...]

Case Reports: Tumor Detection by Diffusion-Weighted MRI and ADC-Mapping with Correlation to PET/CT Results

Early and accurate estimation of metastatic spread is essential for a patient-adapted, efficient therapy regime. In this context, whole-body and multi-step MRI have already helped to improve the diagnostic accuracy of staging examinations. As a further step, it is known that cancer is also often characterized by higher cellularity and therefore restriction of water diffusion. Diffusion-weighted imaging (DWI) with high b-values has therefore been applied to image metastases in order to help improve the diagnostic accuracy of MRI. The working-group of Schlemmer et al., Department of Radiology, University of Tuebingen, Germany, have compared the findings with results of 18F-FDG PET/CT exams. [...]

Case Report: Metastases from Neuroendocrine Carcinoma: Value of Diffusion-Weighted MR Imaging Compared to 68Ga-DOTATOC PET-CT

Neuroendocrine tumors may be challenging to diagnose. Diffusion-weighted MR imaging (DWI) plays an important role in the accurate detection of liver lesions, which may be occult onconventional MRI and especially CT. In the presented case, the suspicion of diffuse hepatic spread is also supported by the additionally performed 68Ga-DOTATOC PET. The article shows, that DWI […] [...]

Nodular Lesions in Diffuse Liver Disease

Richard C. Semelka, MD Professor University of North Carolina Department of Radiology   *Video: latest on nephrogenic systemic fibrosis (nsf) [...]

Contrast Agents: Optimization of Contrast-enhanced MRA

Ulrike I Attenberger, MD Department of Clinical Radiology and Nuclear Medicine University Medical Center Mannheim Mannheim, Germany  View Presentation [...]

Continuous Table Movement in MR Angiography – syngo Tim CT

Harald Kramer, MD Department of Clinical Radiology University Hospitals Munich – Grosshadern Munich, Germany [...]

Updates regarding GE, Omniscan, and Henrik Thomsen, MD Lawsuits

Henrik S. Thomsen M.D. Professor and Chairman Copenhagen University Hospital Department of Diagnostic Radiology Herlev, Denmark [...]

Latest on Nephrogenic Systemic Fibrosis (NSF)

Val M. Runge, M.D. Editor-in-Chief, Investigative Radiology   *Video: latest on nephrogenic systemic fibrosis (nsf) [...]

Contrast Agents: Nephrogenic Systemic Fibrosis (NSF)

Henrik S. Thomsen M.D. Professor and Chairman Copenhagen University Hospital Department of Diagnostic Radiology Herlev, Denmark [...]

Magnets, Spins, and Resonances: An introduction to the Basics of Magnetic Resonance

This 193 page essay describes in easily understandable language the basic principles of MR. It starts with a short excursion through MR physics. The essay then proceeds to a discussion of spin relaxation and echoes, which leads to the section dedicated to the resultant observed signal and generation of the final image. The wide range of tissue contrasts that can be achieved, how fast images are generated, and the actual components that make up an MR system, are all then discussed in turn. [...]

Magnets, Flows and Artifacts: Basics, Techniques, and Applications of Magnetic Resonance

This 133 page essay describes in easily understandable language several important topics encompassing overall image quality and then specifically the impact of flow. It starts with a short discussion of image quality and important factors therein. Flow and motion are then discussed in depth. The essay continues with the topics of saturation and chemical shift, which are important in a discussion of image quality and flow effects. Functional imaging, fast imaging techniques, and the detection and avoidance of image artifacts, are all then discussed in turn. [...]

Compressed Sensing: A Great Opportunity to Shift the Paradigm of Cardiac MRI to Real-Time

Cardiac MRI is particularly well suited to benefit from a group of novel image reconstruction methods known as compressed sensing that promise to speed up data acquisition. This article provides a brief introduction to the topic. [...]

MR Protocols

The goals of this series of MR imaging protocols are to: Offer protocols that are state of the art for newer equipment and contrast agents to enable clinicians to use MR imaging technologies to their fullest capabilities Provide an important educational service to radiologists and radiology technologists by presenting optimized approaches for the acquisition of highly diagnostic images of the central nervous system (CNS), body, and vasculature using newer-generation MR scanners, sequences, and acquisition parameters Demonstrate how protocols should be modified to take into account the different physicochemical properties of the currently available MR contrast agents Suggested protocols specific to General Electric (GE), Siemens, and Philips MR systems are included, with these protocols developed based on the consensus of 3 panels of experts with experience on each platfor [...]

Allergic Reactions to Gadolinium Chelates

“to date no prospective well-designed study has ever shown a significant difference in the reported adverse reaction rates among the available gadolinium chelates, either for nuisance reactions, such as headache or nausea, or for serious adverse events, such as anaphylaxis” [...]

Contrast Media Updates

Magnetic resonance contrast agents, in particular the gadolinium-based agents, are very safe and lack the nephrotoxicity (when injected intravenously) associated with iodinated contrast media. Minor adverse effects occur infrequently and include nausea, taste perversion, and hives. Whereas these agents cannot be differentiated on the basis of mild adverse effects, they do differ in regard to chelate stability, with clinical lab abnormalities known with the less stable agents. The issue of nephrogenic systemic fibrosis (NSF) and its relationship to the gadolinium chelates, and specifically their in vivo stability, is discussed in depth in the text that follows, together with recommendations for clinical practice. [...]

MR Safety

There are two types of forces exerted on a ferrous (iron) object when brought in close proximity to an MR magnet: rotational and translational. The rotational force (torque) is that which causes a ferrous object to turn and align with the direction of the magnetic field. Rotational forces are strongest at the isocenter of the magnet. [...]

25 Years of Contrast in MRI, a Focus on the Patient (presented at the ECR 2013)

25 Years of Contrast in MRI, a Focus on the Patient (presented at the ECR 2013) View/Downloads PDF [...]

Nephrogenic Systemic Fibrosis (ACR Manual on Contrast Media v7)

Nephrogenic Systemic Fibrosis (ACR Manual on Contrast Media v7) [...]

Update on GE, Omniscan, and NSF, Jeff Gerth

Update on GE, Omniscan, and NSF, Jeff Gerth View/Download PDF [...]

Gadolinium Chelates with Extracellular Distribution

Gadolinium Chelates with Extracellular Distribution View/Download PDF [...]

The ACR Manual on Contrast Media

The ACR Manual on Contrast Media View/Download PDF [...]

The ESUR Manual on Contrast Media

The ESUR Manual on Contrast Media View/Download PDF [...]

Recognition and treatment of acute contrast reactions

Recognition and treatment of acute contrast reactions William H. Bush Jr., MD, FACR, and Arthur J. Segal, MD, FACR. Reprinted from Applied Radiology, Vol. 38, No. 12, Pages 16-21, Copyright 2009, with permission from Anderson Publishing Ltd. [...]

Contrast Agents: Safety Profile

Contrast Agents: Safety Profile View/Download PDF [...]