First Experiences with the World’s First MAGNETOM Vida

This review focuses on 8 critical questions regarding gadolinium deposition in the brain and body, with the answers and discussion therein important for future regulatory decisions and clinical practice. [...]

High-resolution, Anatomically-accurate Diffusion-weighted Imaging of Orbital and Sinonasal Lesions with RESOLVE

This paper reviews four recently published studies where RESOLVE was shown to be clinically effective in the diffusion-weighted imaging of sinonasal and optic pathologies. It also demonstrates the clinical value that RESOLVE brings to the detection and characterization of the diseases in these regions. [...]

The Assessment of Endolymphatic Hydrops with High-resolution 3D Real Inversion Recovery and 3D Fluid Attenuated Inversion Recovery Sequences

Endolymphatic hydrops in patients with Meniere’s disease can be visualized using MR imaging. This article compares 3D SPACE FLAIR and 3D real IR in terms of the imaging results. [...]

Critical Questions Regarding Gadolinium Deposition in the Brain and Body After Injections of the Gadolinium-Based Contrast Agents, Safety, and Clinical Recommendations in Consideration of the EMA’s Pharmacovigilance and Risk Assessment Committee Recommendation for Suspension of the Marketing Authorizations for 4 Linear Agents

This review focuses on 8 critical questions regarding gadolinium deposition in the brain and body, with the answers and discussion therein important for future regulatory decisions and clinical practice. [...]

Safety of the Gadolinium-Based Contrast Agents for Magnetic Resonance Imaging, Focusing in Part on Their Accumulation in the Brain and Especially the Dentate Nucleus

This review discusses first the background in terms of development of these agents and safety discussions therein, proceeds to a discussion of NSF and gadolinium deposition in the brain, and concludes with a discussion of the predictable future – specifically reassessment of the use of the linear GBCAs or a subset thereof. [...]

Application of Extracellular Gadolinium-based MRI Contrast Agents and the Risk of Nephrogenic Systemic Fibrosis

Presented is a review of nephrogenic systemic fibrosis and how this influences daily practice (in contrast enhanced magnetic resonance imaging), with specific clinical recommendations. Download PPTX-zip [...]

Accelerating Clinical MRI in the 21st Century

The established class of intravenous contrast media for magnetic resonance imaging is the gadolinium chelates, more generally referred to as the gadolinium-based contrast agents (GBCAs). [...]

Magnetic Resonance Imaging and Computed Tomography of the Brain – 50 Years of Innovation, With a Focus on the Future

The established class of intravenous contrast media for magnetic resonance imaging is the gadolinium chelates, more generally referred to as the gadolinium-based contrast agents (GBCAs). [...]

Compressed Sensing: a Paradigm Shift in MRI

In this article we share some of our experiences over the last few years with MR upgrades. [...]

syngo MR XA10 – Your New Work Environment for More Comfortable Scanning and Intuitive Image Processing

In this article we share some of our experiences over the last few years with MR upgrades. [...]

Case Series: Utilization of the Pediatric 16 Coil for 1.5T and 3T Systems

In this article we share some of our experiences over the last few years with MR upgrades. [...]

Case Series: Utilization of the Pediatric 16 Coil for 1.5T and 3T Systems

In this article we share some of our experiences over the last few years with MR upgrades. [...]

Long-term Experience with MR Upgrades

In this article we share some of our experiences over the last few years with MR upgrades. [...]

fit-Upgrade: A Success Story

The fit-upgrade for 1.5 and 3T systems remains an economically attractive approach for an aged MR system. By improving system performance and workflow, the number of examinations can be increased, together with improved image quality, with little effort. Download/View PDF [...]

First Experiences with the Whole-Body Dot Engine

Whole-body MRI is beneficial in many clinical scenarios including bone marrow, infectious and rheumatic diseases. The Whole-Body Dot Engine provides fast and robust image quality across all patients, with fewer errors or need for repeated examinations. It ensures that all stations of a multi-station examination are performed with a consistent FOV and spatial resolution while […] [...]

syngo WARP – Metal Artifact Reduction Techniques in Magnetic Resonance Imaging

The term WARP summarizes methods to minimize the impact of metal implants on MR image quality. This article introduces different techniques such as high bandwidth, VAT and SEMAC. [...]

Magnetic Resonance Neurography Evaluation in Children

The term WARP summarizes methods to minimize the impact of metal implants on MR image quality. This article introduces different techniques such as high bandwidth, VAT and SEMAC. [...]

RESOLVE: A Powerful Tool for Imaging the Pediatric Spine

The term WARP summarizes methods to minimize the impact of metal implants on MR image quality. This article introduces different techniques such as high bandwidth, VAT and SEMAC. [...]

MR Neurography – Diagnostic Criteria to Determine Lesions of Peripheral Nerves

MR Neurography is an excellent technique for visualization and evaluation of peripheral nerve disorders. In their article Philipp Bäumer et al. (Heidelberg University Hospital, Heidelberg, Germany) show high resolution intra-neural fascicular detail in both normal and abnormal states and cover different aspects including clinical indications, protocols, pitfalls, and useful applications. [...]

MAGNETOM Skyra: The Mannheim Perspective

For over one year the 3T MAGNETOM Skyra has been used for scientific projects and clinical imaging at the University Medical Center (UMM) Mannheim. The UMM Mannheim was the first site in the world to install the Skyra. [...]

Advantages of MSK Imaging at 3 Tesla with special focus on Spine and Tumor Imaging.

The clinical advantages of upgrading to higher field strength (3T) magnets, improving coil technology, and using larger bore-sizes are proving to be significant. Through 10 case studies, it is suggested that the use of 3T open bore system with TrueForm technology can improve the diagnostic potential, as well as widen the indications, of MRI. The cases illustrate advantages of musculoskeletal imaging with a special focus on spine and tumor imaging. [...]

Image Quality Improvement of Composed MR IMages by Applying a Modified Homomorphic Filter.

Currently when obtaining systematic aspects of diseases with MRI, acquiring information from large body regions requires large fields-of-view (FOV) and multi-channel coils. However, images with large FOVs are characterized by inhomogeneous signal. This becomes even more problematic at higher field strengths. By using a simple and robust post-processing approach, the signal inhomogeneity can be improved in times when large FOVs need to be obtained. [...]

Technical Considerations in Brain DWI

To provide imaged-guided instruction of technical considerations of diffusion-weighted imaging (DWI) for neuroradiologists. [...]

Introduction to Advanced Techniques in MR Neuroimaging

This article provides a comprehensive introduction to advanced techniques in neuroimaging, including fMRI, DTI, DWI, ASL, SWI. [...]

How Breast MRI Changed the Operative Management

MR diffusion-weighted imaging (DWI) is no longer just for brain applications. Whole body DWI is becoming a standard application in routine imaging. Whole body DWI has become as valuable as T2 contrast in tumor imaging and it allows characterization of tissue properties. This article provides responses to some of the more frequently asked questions including the background, application, and interpretation of whole body DWI and its calculated Apparent Diffusion Coefficient (ADC) images. [...]

Frequently Asked Questions: Diffusion Weighted Imaging (DWI)

MR diffusion-weighted imaging (DWI) is no longer just for brain applications. Whole body DWI is becoming a standard application in routine imaging. Whole body DWI has become as valuable as T2 contrast in tumor imaging and it allows characterization of tissue properties. This article provides responses to some of the more frequently asked questions including the background, application, and interpretation of whole body DWI and its calculated Apparent Diffusion Coefficient (ADC) images. [...]

Assessment and Classification of Peripheral Vascular Anomalies by Time-Resolved MRA using TWIST

Vascular malformations are complex lesions with a variety of clinical manifestations. Time-resolved MRA combined with parallel imaging and echo sharing schemes represents a reasonable alternative to more invasive DSA for the evaluation of VMs. Therefore, time-resolved MRA can play an important role in categorizing these lesions and determining their extent in order to correctly guide treatment. [...]

AutoAlign

Three series of scout images, to be used for slice positioning in a MR scan of the brain, are illustrated. The first is a typical scout (1), using 2D FLASH technique, with images acquired, as is common today, in the three orthogonal directions. These three directions (sagittal, coronal, and axial) are respective to the main magnetic field, but not to the anatomy of the patient. Note that the patient is less than perfectly positioned, a common occurrence in clinical practice, with the cause multifactorial. The second series of scout images (2) is acquired using a 3D VIBE scan, with the scan time however no longer than for the acquisition of the three scouts shown in (1), approximately 15 seconds. Illustrated are the images already after the initial iteration in slice positioning by the AutoAlign algorithm. The third series of scout images (3) is the final result from AutoAlign, which is produced automatically without user intervention. The axial images have been correctly chosen to span the brain from the vertex to the skull base, the plane of reference (alignment) has been chosen to be the equivalent of the AC-PC line (anterior commissure to posterior commissure), and the images are orthogonal to the coronal plane. [...]

Cerebral amyloid angiography using SWI

Compared to conventional T2*-weighted imaging, a susceptibility-weighted imaging technique is very sensitive in the detection of small bleedings and vascular malformations. This case report shows that SWI is a sensitive tool for the precise assessment of CAA. His findings show that by using SWI, multiple small cortical and subcortical bleedings can be depicted in detail and can show the extent of the severity of CAA better than with conventional T2*-weighted MRI only. [...]

RESOLVE, Multishot Echoplanar Diffusion Weighted Imaging

Scans were acquired at 1.5 T with a typical diffusion weighted echoplanar (EPI) scan sequence (A), and also with a RESOLVE work-in-progress (WIP) scan sequence (B). RESOLVE is a multi-shot technique that uses 2D navigator correction with readout-segmented EPI (ISMRM 2004, p442). Axial scans of the brain in a normal volunteer, at the level of the petrous apices, are presented. The conventional single shot sequence was acquired (with complete coverage of the brain) in 0:54 min:sec. The RESOLVE (multishot) scan was acquired in 3:02 min:sec. A parallel imaging factor of 2 was used for the single shot acquisition, with no parallel imaging employed with the multishot acquisition. Partial Fourier was employed in (A), resulting in a shorter scan time but also some image blurring when compared to (B). [...]

T1 SPACE for Improved Detection of Brain Metastases

T1 SPACE provides in a reasonable scan time a high resolution 3D acquisition of the brain, with improved detection of brain metastases when compared to MP-RAGE, and is advocated as the scan of choice at 3 T [...]

New Non-Contrast MR Techniques (for MR angiography and tissue perfusion)

NATIVE enables excellent non-contrast MR angiographic imaging, with reproducible results. This new software/scan approach is particularly important given that the use of intravenous contrast media has come under recent increased scrutiny. Of relevance, the gadolinium chelates (and specifically the less stable agents in this class), which are used as MR contrast agents, have been linked to a condition called Nephrogenic Systemic Fibrosis (NSF) that can occur in patients with renal insufficiency. [...]

syngo Native – Non Contrast MR Angiography Techniques

With the need to carefully consider the risk versus benefit of contrast agent administration, following the advent of Nephrogenic Systemic Fibrosis (NSF), as well as the need to perform cost effective MR studies, there is a demand for improved methods for performing MR angiography using intrinsic rather than extrinsic contrast mechanisms. [...]

syngo NATIVE TrueFISP in the Assessment of the Transplanted Kidney

When imaging patients with impaired renal function that have recently undergone transplant surgery, one approach is to use a completely non- invasive method, without the use of a gadolinium chelate, and thus without the potential risk of NSF. In this article the effectiveness of TrueFISP with selective inversion recovery preparation, now known as syngo NATIVE TrueFISP, is shown. This technique from a diagnostic point of view appears equivalent to low dose contrast-enhanced angiography, providing a low-risk method for the initial evaluation of the transplanted kidney. [...]

Improved Workflow and Performance for Contrast-Enhanced MR Angiography Sequences

Recent improvements in TWIST (dynamic contrast enhanced MRA) and more conventional non-dynamic contrast enhanced MRA are discussed. [...]

syngo TWIST for Dynamic Time-Resolved MR Angiography

3D dynamic imaging has been available since the late 90s. The speed of dynamic imaging was subsequently improved due to advances in gradient design, for example current 40 mT/m gradients. Since then, dynamic imaging has gone through several changes and improvements, including the implementation of parallel imaging, and more recently, the new k-space coverage now available with TWIST (a 4D MRA application). TWIST achieves significant improvements in temporal and spatial resolution and faster tracking of dynamic processes relative to the other versions of dynamic imaging introduced earlier. TWIST offers a practical, flexible, and elegant way to perform sub-second, time-sequential 3D measurements, both at 1.5 T and 3 T. This can be used in combination with contrast injection to provide dynamic clinical information, including the evaluation of abnormal vascular anatomy as well as vascular hemodynamics, and perfusion measurements. [...]

Let’s TWIST again: Temporal and Spatial High-Resolution 3D MR-Angiography of the Hand

Compared to conventional contrastenhanced MR angiography (MRA), which provides a spatial high-resolution threedimensional (3D) MRA data set of the vascular target region, MRA with TWIST (time-resolved angiography with stochastic trajectories) with its high temporal resolution offers an additional dynamic component. It presents a broad range of advantages for all vascular diagnostic questions where blood flow dynamics play a role. [...]

Whole-Body Oncologic Imaging with syngo TimCT

The article shows that the addition of syngo TimCT functionality makes whole-body MR oncologic evaluation a viable reality. Extended, whole-body anatomic coverage is now possible without off-isocenter artifacts or signal loss. In-plane image quality with the TimCT application is maintained in comparison to conventional MR. Non-breathhold technique did not limit diagnostic quality in the presented patients. Skull-base to upper thigh coverage was achieved in standard imaging times of 30–40 minutes. With the addition of DWI to conventional sequences, functional-anatomic information correlation is possible through the whole-body field of view. TimCT has removed the barriers to whole-body MR evaluation. [...]

Fat Suppression in the Abdomen

Due to the different chemical environment, hydrogen nuclei in water- and in fat-tissue have different values for some MRI-relevant parameters, mainly being the relaxation time and the resonance frequency (chemical shift). These differences can be used to selectively suppress/reduce the signal of fat bound protons.Thus relaxation-dependant and chemical shift-dependant methods can be used for fat suppression. [...]

Spectral Adiabatic Inversion Recovery (SPAIR) MR imaging of the Abdomen

SPAIR (Spectral Adiabatic Inversion Recovery) is a powerful technique for fat suppression which offers advantages over conventional fat suppression techniques. The technique is insensitive to B1 inhomogenities and only fat spins are suppressed/inverted. [...]

Revisiting Liver Imaging with VIBE

Volume Interpolated Breath-hold Examination (VIBE) offers three-dimensional multiphase image acquisition before and following contrast administration on a breath-hold time scale. The dynamic behavior of liver lesions and structures during the precontrast, arterial, portal venous, early equilibrium and 5-minute delayed equilibrium phases of enhancement allows more accurate characterization than static pre- and postcontrast analysis. [...]

Detection and Characterization of Focal Liver Lesions using Respiratory-Triggered Diffusion- Weighted MR Imaging (DWI)

Due to a number of technical challenges, the use of DWI was initially confined to the brain with its low incidence of movement artifacts and the high homogeneity and signal-to-noise ratio (SNR) of brain tissue. Physiological motion artifacts (e.g. motility of the bowel, cardiac pulsation, respiratory motions) and the heterogeneous composition of many extracranial organs had precluded the application of DWI in body imaging until a series of technologic advances such as the development of echo-planar imaging (EPI), high-gradient amplitudes, multichannel coils and parallel imaging techniques enabled the acquisition of high quality diffusion-weighted images of the body. [...]

Evaluation of a Modified Stejskal-Tanner Pulsing Scheme for DWI Allowing a Marked Reduction in Echo Time at 3 T

To evaluate a modified Stejskal-Tanner diffusion gradient pulsing scheme that achieves a markedly shorter TE, by applying diffusion encoding during the entire time between the two requisite radiofrequency pulses, with respect to SNR, overall diagnostic image quality, bulk susceptibility artifact, and resulting spatial distortions (which were quantified). [...]

syngo BLADE Motion Correction from Head to Toe

BLADE measures and corrects in-plane motion through periodically rotated overlapping parallel lines with enhanced reconstruction. syngo BLADE acquires multiple low resolution data sets and combines them to make one motion free, high quality image. This provides clear images in all slice orientations and body regions such as the head, spine, liver or knee. [...]

Diagnostic Relevant Reduction of Motion Artifacts in the Posterior Fossa by syngo BLADE Imaging

Although movement and pulsation artifacts are a frequent problem in daily routine, especially in the evaluation of pediatric patients, few articles on this topic can be found in the literature. Experience from Stuttgart shows that MR images of the posterior fossa, cerebellum and brain stem may be significantly impaired by artifacts from pulsatile flow of blood or cerebrospinal fluid even without inadvertent patient head movement. Sedation or general anesthesia rarely influence these pulsation or flow artifacts. However, accurate assessment of small brain lesions is essential in many pediatric patients, especially those with malignant brain tumors. BLADE reduces movement and pulsation artifacts in T2w FLAIR images without relevant loss of image quality. It therefore markedly improves depiction of small and low contrast brain lesions in the posterior fossa of pediatric patients. This can be crucial especially following surgery of malignant brain tumors. In the absence of major artifacts, in this study, lesions of all sizes were depicted with comparable quality by both techniques (BLADE vs conventional FSE technique). [...]

3D High Resolution MRI of the Knee at 3T Using a Moderately T2-weighted 3D-TSE-fs (syngo SPACE) sequence – Useful or Not?

3D High Resolution MRI of the Knee at 3T SPACE is a new approach to MRI of the knee at 3T. It allows high spatial resolution isotropic true 3-dimensional acquisition and subsequent reconstruction. Overall acquisition time is shorter than that of three separate 2-dimensional datasets and SNR for 1 mm reconstructions is similar to conventional 2D-TSE-fs. The identification of anatomical structures is in general equal or superior to conventional scans, with superior discrimination of relevant small ligamentous structures. A simple protocol comprising 1 mm SPACE reconstructions in all three orientations is extremely useful for clinical evaluation. The additional possibility of free 3- dimensional reconstruction depending on the specific clinical need may become useful for diagnosis in difficult cases or with complex anatomy, and in particular for presurgical planning, i.e. for traumatic ligamentous lesions or complex meniscal tears. [...]

MR/PET – Hybrid Imaging for the Next Decade

The clinical potential of combining information derived from MR and PET is evident and has resulted in the development of the world’s first whole-body molecular MR system. Thomas Beyer et al. (Tubingen University Hospital, Germany) describe in their article the history of combining PET with MRI, the rationale to do so, and the challenges that had to be overcome. [...]

32-Channel Head Coil Imaging at 3T

Advanced head coil design with 3T imaging substantially improves the available signal-to-noise ratio (SNR), making possible a substantial reduction in scan time, the use of advanced parallel imaging, high spatial resolution imaging (reduced voxel size in 3D acquisitions, whether for imaging of the brain itself or the vasculature) and implementation of innovative imaging techniques. [...]

ADVANCED CLINICAL BRAIN IMAGING AT 3 T

SNR and Parallel Imaging Improvements Offered by a 32 Channel Head Coil Design Advanced head coil design with 3 T imaging substantially improves the available signal-to-noise ratio (SNR), making possible a significant reduction in scan time, the use of advanced parallel imaging, high spatial resolution imaging (reduced voxel size in 3D acquisitions, whether for imaging of the brain itself or the vasculature) and implementation of innovative imaging techniques. The use of higher parallel imaging factors in conventional diffusion-weighted echoplanar imaging (EPI), together with the implementation of a fast spin echo (FSE) based BLADE diffusion-weighted scan is illustrated in patients with acute infarction (the latter free of bulk susceptibility artifact and geometric image distortion). [...]

Case Report: Cortical Dysplasia

This clinical case report details the use of a 32 channel head coil and 3 T for improved visualization of presumed cortical dysplasia in a pediatric patient. [...]

Large FOV Imaging at 3T with a 32-Channel Body Array Coil

This article shows the benefits of a 32-channel body coil for large field-of-view imaging in the abdomen and pelvis, including MR Angiography. The evolution of parallel imaging techniques has been very rapid, with realization of their full potential requiring development and utilization of MR systems with up to 32 receiver channels. [...]

Clinical Neurological Imaging on an Open Bore MRI System (MAGNETOM Espree)

An open bore MRI has the practical advantage of accommodating large or claustrophobic patients. Unfortunately, until the advent of the 1.5T MAGNETOM Espree, “open” was often synonymous with inferior image quality. However, in addition to the large 70 centimeter bore, the Espree system offers advanced coil combinations using the Total imaging matrix (Tim) and isocenter imaging technology. Together, these features allow for performance of advanced neuroimaging protocols in new clinical populations. [...]

TrueForm™ Technology (MAGNETOM Espree)

TrueForm magnet design is an innovation that produces a cylindrically optimized homogeneity volume instead of the conventional elliptical volume. TrueForm RF design includes innovative hardware technology as well as new application and processing features, which ensure uniform RF distribution in all body regions. [...]

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. [...]