AdcancedMR_DWI_Takahara.pptx
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1 Diffusion 総 復 習 基 本 的 なパラメータの 再 考 察 MPGとTE Low b value TE TRとlong T1 lesion TR>4000ms NEXとSNR MPGとTE T2WIにMPGをかけるとDWIになる 画 像 の 拡 散 強 調 度 は MPGの 間 隔 長 さ( 印 加 時 間 ) 強 さによる Motion Probing Gradient G 3 4 もっと 良 い 機 械 で 撮 ったら b 値 と 最 短 TEとの 関 係 b 値 と 最 短 TEとの 関 係 b (s/mm 2 ) TE 84ms 76ms 70ms 拡 散 強 調 度 は 下 がるが S/Nは 良 くなる b (s/mm 2 ) TE 84 70ms 76 60ms 70 52ms S/Nに 余 裕 が あるから スライス 厚 を 薄 くできる 5 6
2 Is shortest TE always best? Shortest TE is not always best at low b-value b=10, shortest TE (26ms) High b-value b=10, TE=60ms Long motion probing gradients cause echo time long Always have to use shortest TE value. Low b-value TE value can be decreased to even less than 30ms. In this situation, it may be better to keep the TE longer for better T2 contrast. Liver metastasis from breast carcinoma 堀江朋彦さん 東海大 の協力に感謝します 長いTRを用いることにより long T1 lesionの Saturationを抑制する 短いTRを用いると long T1 lesion (long T2 lesion) が 選択的に 抑制される T1 value at 1.5T [1] Selective suppression effect of long T1 lesion (cancer) due to short TR The use of a short TR value causes (selective) suppression of the signal intensity of lesions, which inherently have longer T1 values. For example, the T1 value of malignant hepatic lesions is relatively long, being around 1000ms at 1.5T (in contrast, that of the liver parenchyma is around 500ms)*. A 69 year old man with multiple HCC and cysts / Achieva 3.0T TX XL-torso coil TR5000 TR2000 NSA 3, packages 2, TA 1min 40s NSA 3, packages 3, TA 1min 20s Malignant hepatic lesion : around 1000ms Liver parenchyma: around 500ms Estimated T1 recovery % at 1.5T Lesion Parenchyma TR=2000ms 86% 98% TR=3000ms 95% 99% * Goldberg MA, et al AJR Am J Roentgenol May;160(5): * Goldberg MA, et al AJR Am J Roentgenol May;160(5):
3 1mm 1NSA 2mm 1NSA 3mm 1NSA ( 拡 散 強 調 画 像 のように)k-space 上 でなく 再 構 成 をした magnitude image 上 で 加 算 処 理 を 行 う 場 合 画 像 のSNRが 低 いと 理 論 値 通 りのSNR 向 上 効 果 が 得 られない これはSNR<2のときに 起 きる 元 のSNRが 悪 いと 加 算 によるSNR 向 上 はあまり 奏 功 しない 1mm 1NSA 1mm 4NSA 1mm 9NSA 元 のSNRが 良 い 場 合 DWIの 加 算 効 果 実 験 から 分 かること 5mm 1NSA 10mm 1NSA スライス 厚 2 倍 = 加 算 4 倍 スライス 厚 が 薄 いぶん Partial volume effectが 少 なくシャープな 画 像 1NEX MPG voxel SNR>3 voxel size SNR<3 SNR>3 MIP 5mm 1NSA 5mm 4NSA 中 村 智 哉 さん( 東 海 大 )の 実 験 に 感 謝 します SNR<3 SNR>3 MIP SNR 2 背 景 腫 瘍 背 景 信 号 抑 制 DWIBS Background Suppression ADC histogram analysis Full Volume ROI Kurtosis / Skewness ADC DWI IVIM imaging Computed DWI Low b-value DWI shortest TE Contents MPG 3 1 Whole body DWI Direct coronal SNR DWI Diffusion pre-pulse Readout segmented EPI, Propeller DWI
4 Estimate therapeutic response for bony lesion: - Increasing accuracy of ADC estimation by means of suitable b-value - Normalization of signal intensity between imaging stations - Use of registration and histogram analysis ADCのhistogram analysis PreTx Full Volume ROI PreTx PostTx 測定者の恣意を減らす Kurtosis / Skewness ADC値分布 histogram の形に注目 Padhani A, Koh DM, et al. Whole body diffusion MR imaging in cancer current status and research directions. Radiology, in press PreTx PreTx PostTx PostTx Skewness (歪度 わいど Positive Skewness Negative Skewness Padhani A, Koh DM, et al. Whole body diffusion MR imaging in cancer current status and research directions. Radiology, in press Philips の Oncology解析ツール ADC 梶原 直さん 東海大 の 協力に感謝します PostTx
5 梶原 直さん 東海大 の 協力に感謝します 梶原 直さん 東海大 の 協力に感謝します b=0 b=1000 ADC The lesion-to-spinal cord ratio (LSR) of cancer nodules was significantly higher than that of benign lesions, while there were no significant differences between them in relation to ADC. In the ROC analysis, LSR had a higher AUC than did ADC (0.911 vs 0.600) In order to see pure diffusion phenomena, ADC should be used; however, if the purpose of imaging is just to visualize malignant tumor, ADC is not essential. 位置ズレの問題はまだ残っている ADC LSR Prostate cancer; relative signal intensity (rsi) compared to average signal intensity of lesser pelvic space Large ROI as reference DWI T2WI (rsi >Av +3SD) ADC ADC(< 0.56 x 10-6) Yamazoe S et al. Relatiev signal intensity (rsi) map on diffusion-weighted imaging in the 29 diagnosis of prostate cancer. Magn Reson Med Sci. 2012;11(1):1-8. b=1000 b=2000 Katahira K, et al. Eur Radiol (2011) 21:
6 Computed DWI c2000 JMRI b=500 b=50 c Blackledge MD, et al. Radiology c1500 b=10 b=800 b=400 b=200
7 b=0 b=50 JMRI 2012 Cine MRI b=0 / b=50 Alternate display 制限時間１分間での読影 絞扼か否か よろしければ これを説明したYouTubeも御覧ください 撮影にはいろいろなノウハウがありますので もし及びい ただければ貴院に参りon-siteでお示しします 臨床画像 ４月臨時増刊号 Source image COR MPR Source image SAG MPR Conv. TRA DWI TRA MPR Single-shot T2WI SAG MPR Direct COR DWI
8 Whole Body DWI Readout segmented EPI with 2D navigator 腎臓のWLをあわせることにより 概ね平準化されて読影できる Data discarded and reacquire ABC Seminar 17/01/2008 Propeller DWI Propeller DWI 歯インプラント症例 EPI DWI EPI DWIの歪みが著しい インプラントを有する患者さん 動脈瘤クリップ 歯インプラント ＥＰＩで歪みが著しい場合に用いる 画像は高橋光幸さん 横浜栄共済病院 のご厚意による TR5000ms eff TE98ms FOV26cm b1000s/mm2 ALL Mf*Mp 140*192 2NEX (1:30) Propeller DWI TR6100ms eff TE84.5ms FOV24cm ETL 24 b1000s/mm2 ALL Mf*Mp 128*128 2NEX (3:40) 画像は高橋光幸さん 横浜栄共済病院 のご厚意による MSDE 180 RF 90 RF -90 RF motion sensitized gradients imsde echo time(teprep) スライドは米山正己さん 八重洲クリニック のご厚意による MSDE: based on a T2prep pulse Wang J et al: Improved Suppression of Plaque-Mimicking Artifacts in Black-Blood Carotid Atherosclerosis Imaging Using a Multislice Motion-Sensitized Driven-Equilibrium (MSDE) Turbo Spin-Echo (TSE) Sequence. MRM 58: , 2007 スライドは米山正己さん 八重洲クリニック のご厚意による
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low-b DWI IVIM,MSDE -- -- Makoto Obara Philips Electronics Japan Bfactor IVIM: Diffusion & Perfusion MSDE: Black Blood imaging IVIM: Diffusion & Perfusion MSDE: Black Blood imaging 40 2.5 * 10-3 mm 2 /sec
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Body DWI Tomohiro Mochizuki Philips Electronics Japan MR Application Specialist 画像提供 : 八重洲クリニック様 ( 東京 ) 防衛医科大学校病院様 ( 埼玉県 ) T2W T1W FLAIR 水分子の緩和の差を画像化 DWI 水分子の微小な拡散の差を画像化 Brown 運動 Brown 運動とは 微視的な水分子の不規則な運動
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脊椎 MRI における 各種脂肪抑制法の比較検討 公益財団法人星総合病院 放射線科渡邉美香 背景 MRI は低コントラスト分解能に優れ, 脊椎 MRI にお いては椎間板, 髄膜, 脊髄などの組織コントラストが高いことから病変の描出に最適である. 診断に有用な画像を撮像するためには脂肪抑制が欠かせない. しかし, 脊椎は磁場の不均一を生じやすい部位である. また, インプラント等の金属も磁場の不均一を生じやすく,
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