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1
2
3 Topic
4 MRI
5 Phased array coil SNR
6
7 Saturation band
8
9 T1T2
10 T1T2
11 Localizer( ) T2WI + T1WI ( )
12 -
13
14
15
16
17 Option
18 PROPELLER BLADE BLADE
19 Blade (-) Blade (+)
20 SPACE (sampling perfection with application optimized contrasts using different flip angle evolutions) T2WI (4mm thickness) SPACE (1mm thickness)
21
22
23 MRI Staging II
24 staging 0 I Ia Ia1 3mm 7mm Ia2 3mm 5mm 7mm Ib Ia Ib1 4cm Ib2 4cm II 1/3 IIa IIa1 4cm IIa2 4cm IIb III 1/3 IIIa 1/3 IIIb IV IVa IV
25 Edvard Munch
26 MR staging 0 I Ia Ia1 3mm 7mm Ia2 3mm 5mm 7mm Ib Ia Ib1 4cm Ib2 4cm II 1/3 IIa IIa1 4cm IIa2 4cm IIb III 1/3 IIIa 1/3 IIIb IV IVa IV
27 1/3
28 1/3
29 Oblique axial Sagittal T2WI T2WI Axial Oblique Axial MRI 39-86%
30 Oblique Axial T2WI Sagittal
31 MRI dynamic MRI * * T2 ** *Yamashita Radiology 1992 *Seki AJR 1997 **Scheidler Radiology 1998 **Fujiwara Gynecol Oncol 2000
32 T2WI Gd T1WI Diffusion
33
34 staging Ia Ib staging 1/2 (1/2) II III IV IIIa III III III Iva IVb
35 T2WI or T2WI T2WI Shibutani Abdom Imaging 1999
36 Dynamic MRI PRE 20s 40s 60s 80s 100s 120s 180s
37 Dynamic MRI Yamashita, Radiology 1993
38 Manfredi et al. Radiology 2004 T2WI oblique Ax T2WI Sag Dynamic pre 40sec 120sec 180sec
39
40 (MDA Mullerian duct anomaly) Muller
41 (MDA Mullerian duct anomaly)
42
43 () *Troiano Radiology 2004
44 Wunderlich syndrome
45 Pitfall
46 Plica Palmatae Ax T2 ObAx T2
47
48
49 Size variation
50 Localizer HASTE, True FISP cor T2WI Sag + Axi T1WI Sag (or Axi) GRE T1WI Sag (or Axi) T1WI
51 T1WI T2WI T1WI T1WI
52 vs.
53 T1 (CHESS) Dixon (in-phase/opposed-phase) * STIR (short TI inversion recovery) signal SPAIR (Spectral Attenuated Inversion Recovery) IR pulse *Yamashita AJR 1994 *Yamashita Radiology 1994
54 STIR T1WI T2WI STIR
55 MR»»,»
56 »»,» T1WI T2WI, T1WI T1WI
57 Contents»»,»
58 Clear cell carcinoma T2WI T1WI GdT1
59 Clear cell carcinoma T2WI T1WI Gd-subtratction 49F
60 Pitfall T1WI T2WI
61 Contents»»,»
62 Mucinous bordeline tumor T1WI T2WI Gd T1WI
63 T1WI T2WI Gd T1WI
64 Contents»»,»
65 Uterine sarcoma T2WI T1WI Gd T1WI
66
67 topics
68 High resolution image on 3T 3T 1.5T Voxel size: mm Overall image quality and zonal appearance: 3T = 1.5T Tissue contrast at cervix and vagina: 3T > 1.5T Image inhomogeneity: 3T > 1.5T Kataoka M et al, JMRI, 2007
69 3T T1 T2 TR (msec) SAR (%)** 36.3± ± ± ±5.9 Total acq. time 4'47'' 3'52'' 2'54'' 1'57'' **SAR limit of 4.0W/kg in the body region corresponds to 100%.
70 Cervical cancer: 3T vs 1.5T 3T 1.5T
71 SWI susceptibility-weighted imaging
72 SWI
73 Brown ADC(Apparent Diffusion Coefficient) Courtesy of A.Yamamoto
74 1. Proton 2. Brown : :
75 77 F T2WI Fusion Image with DWI onto T2WI
76
77 ADC is a potential caner biomarker However there are several problems Biomarker ADC MRI b values Cutoff values
78
79 Well-differentiated (G1, pt1b) 35 y.o. T2WI fusion image ADC map Low grade tumor ADC value = 1.13 x 10-3 mm 2 /s Poorly-differentiated (G3, pt3a) 69 y.o. High grade tumor The ADC value = 0.62 x 10-3 mm 2 /s T2WI fusion image ADC map
80 ADC ADC overlap ADC = 1.05x10-3 cutoff Rechichi G et al. AJR 2011;197:
81 ADC ChemoRadiation 14 ADC MR Harry et al. Gynecologic Oncology (2008)
82
83 DCE-MRI
84 DCE (perfusion) MRI Curve analysis arrival time, slope, wash in speed Compartmental modeling analysis Ktrans, Kep, Ve
85 Dynamic contrast-enhanced MRI Curve analysis vascularity Sagittal T2WI Dynamic pre 40sec 120sec 180sec
86 Perfusion MRI using DCE-MR (Ktrans, Kep, Ve) Sequence: 3D Flash FOV: 300 x 300 mm Matrix: 192 x 173 TR/TE: 2.13/0.76ms 0.25 sec / slices, 180 sec (720 slices) Ktrans kep AIF Ve
87 Two- compartment model for contrast agent kinetics (Tofts 1999) Intravenous injection of CM Whole body extracellular space Leak Vessels (artery and vein) Red blood cells and plasma Leak(K trans ) *first pass in tumor: 12-45% Return Return(k ep ) Tumor extravascular, extracellular space (Ve) Tumor intracellular space Elimination of CM through the kidneys *low molecular weight contrast media do not cross cell membranes
88 Ktrans kep Ve
89 Ktrans
90 Sawlani R N et al. Radiology 2010;255:
91 Perfusion MRI Mayr NA, J Magn Reson Imaging. 2000;12:1027 Yamashita Y et al. Radiology 2000;216:8-3 DCE- MRI Zahra MA et al. Int. J. Radiation Oncology Biol.Phys., 2009:74;766
92 Take Home Message
93 Acknowledgements
94
Folie 1
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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