Folie 1

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1 low-b DWI IVIM,MSDE Makoto Obara Philips Electronics Japan

2 Bfactor

3 IVIM: Diffusion & Perfusion MSDE: Black Blood imaging

4 IVIM: Diffusion & Perfusion MSDE: Black Blood imaging

5 * 10-3 mm 2 /sec * 10-3 mm 2 Denis Le Bihan, Radiology 1998; 168:

6 * 10-3 mm 2 /sec

7 RF Gz G δ Acquisition

8 RF Gz G δ Acquisition Diffusion time

9 Diffusion time( ): ms

10 Diffusion time( ): ms 2.5 * 10-3 mm 2 /sec x <x 2 >=2D*

11 Diffusion time( ): ms 2.5 * 10-3 mm 2 /sec x x = 16-22μm <x 2 >=2D*

12 Diffusion time( ): ms 2.5 * 10-3 mm 2 /sec x x = 16-22μm 10 m <x 2 >=2D*

13 (40 D = 2.5 *10-3 [mm 2 /sec]

14 (40 D = 2.5 *10-3 [mm 2 /sec] ADC = *10-3 [mm 2 /sec] ADC

15 Kurtosis Diffusion Kurtosis Imaging (DKI)

16 S = exp (-bd) JMRI 31: (2010)

17 S = exp (-bd) (D=0.9) (D=1.5)

18 S = exp (-bd) Bfactor

19 b=700 b=1000 b=2000 Bfactor

20 noise B

21 noise

22 S = exp (-bd) Log(S) = -bd Log

24 B-200 Low B

25 D* = 10 D =

26 Perfusion model Denis Le Bihan, Radiology 1998; 168: Perfusion Pseudo Diffusion D* Low B (<200)

27 Diffusion S diffusion =exp(-bd) Perfusion S perfusion =exp(-bd*)

28 Perfusion Volume < 5% Diffusion f: perfusion fraction S = (1-f) exp(-bd) + f exp(-bd*)

29 S = (1-f) exp(-bd) + f exp(-bd*) Perfusion f = D* = 8.4 D = 0.71 Perfusion f = 0.22 D* = 57 D = 0.71

31 :

32 :

33 :

36 S = Sss exp (-bd) exp(-te/t2) T1 D T2

37 S = Sss exp (-bd) exp(-te/t2) IVIM T1,T2 T1,T2 T1,T2

38 D* D* SD

39 D* Low B

40 f & D Perfusion Diffusion D f Perfusion / (Diffusion Perfusion D*

41 f & D

42 f & D D(4):0.767 D(2):0.765

43 B B=600 D = B=1000 D=0.714 B D

44 B B=600 B=1000 B 600 Slow diffusion

45 B B=600 B=1000 B=600 Slow diffusion B=1000

46 B: TR: TE: Matrix: high B nsa: Scan time: Parameter: 0, 200, *128 *1 45sec f, D (8points*) *128 *1 2min f, D*, D 8points: 0, 25, 50, 75, 100, 250, 500, (8points*) *128 *2 2min45sec f, D*, D

47 IVIM: Diffusion & Perfusion MSDE: Black Blood imaging

48 MSDE: Motion Sensitized Driven Equilibrium

49 μm/sec 10μm/sec B= B<200 cm/sec B=3-20

50 Low B で反応する組織 RF G RF EPI Acquisition EPI Acquisition Low-b (b=8) Black Blood imaging Basic Diffusion Sequence Courtesy: Kurashiki Central Hospital

51 Sequence design Concept RF G RF EPI Acquisition EPI Acquisition Low-b (b=8) Black Blood imaging Basic Diffusion Sequence RF Gz S* Acquisition (3D, TSE, TFE) MSDE (Diffusion Prepulse)

52 MSDE: Motion Sensitized Driven Equilibrium Initially called Diffusion Prepulse RF Gz S* True FISP (bffe) High image quality Fast imaging 3D imaging Proc. Intl. Soc. Mag. Reson. Med. 14 (2006) 651 Proc. Intl. Soc. Mag. Reson. Med. 14 (2006) 652

53 MSDE flow suppression theory Static spin Moving spin v φ = 0 φ = γm 1 v

54 MSDE flow suppression theory Laminar flow v Phase dispersion within a voxel Velocity gradient cause phase dispersion and voxel signal is reduced as same as IVIM theory.

55 MSDE vs Conventional (DIR) BB Conventional MSDE Through plane flow Volume Acquisition Conventional MSDE in plane flow Magnetic Resonance in Medicine 58: (2007) Conventional MSDE Post CE acquisition 55

56 imsde: improved MSDE Combined MLEV T2Prep & bipolar gradients concept Wider applications: larger FOV, 3.0T RF G MSDE imsde

57 MSDE: Motion Sensitized Driven Equilibrium Improved MSDE (imsde) RF G MSDE imsde imsde Jinnan Wang

58 imsde: improved MSDE RF G MSDE imsde JOURNAL OF MAGNETIC RESONANCE IMAGING 31: (2010)

59 imsde: improved MSDE RF G MSDE imsde

60 Many Applications thanks to imsde International Publication List (Japan Only) Obara M (Philips), ISMRM 2008 Obara M (Philips), ISMRM 2009 Nagao E (Kyushu Univ.), ISMRM 2009 Ito D (Tohoku Univ.), ISMRM 2009 Nakayama T (Kyushu Univ.), SMRM 2010 Nagao E (Kyushu Univ.), AJNR 2011 Yoneyama M (Yaesu Clinic), ISMRM 2011 Kanoto M et al (Yamagata Univ.), JCAT 2012 Yoneyama M (Yaesu Clinic), ISMRM 2012 Kikuchi K (Kyushu Univ.) RSNA 2012 Kanoto M et al (Yamagata Univ.), AJNR in Pre. Kanoto M et al (Yamagata Univ.), MRI in Pre. Neurovascular Compression Yamagata Univ. Kanoto M et al, JCAT 2012 Vessel Wall Tohoku Univ. Ito D et al, ISMRM 2009 Meta screening Kyushu Univ. Nagao E et al, AJNR 2011 SHINKEI Yaesu Clinic Yoneyama M et al, ISMRM 2011

61 imsde application: brain metastasis screening MSDE-TSE MPRAGE(standard) Easier to diagnose! (1) AJNR Am J Neuroradiol 32: Apr 2011 imsde

62 Whole Brain BBI imsde-thrive: 2min30sec MPRAGE 62

63 : 3D SHINKEI 63

64 : 3D SHINKEI 64

65 Bright Blood imaging Courtesy: Kurashiki Central Hospital

66 imsde application: low limb venography TRANCE (Systolic Phase) MSDE-TRANCE (Systolic Phase) Courtesy: Kurashiki Central Hospital 66

67 High B への試み RF Gz RF Gz S* Acquisition (3D, TSE, TFE) S* MSDE(B=10) (Diffusion Prepulse) Acquisition (3D, TSE, TFE) DSDE(B=500) (Diffusion Prepulse)

68 High B への試み 1mm isotropic B factor=500 scan time=5min

69 Bfactor

頸部 PPllaaqquuee 性状評価検討 Black Blood PPU M2D BB pulse delay

頸部 PPllaaqquuee 性状評価検討 Black Blood PPU M2D BB pulse delay 頸部 PPllaaqquuee 性状評価検討 Black Blood PPU M2D BB pulse delay (CAS).,MRI,. VISTA (Volume Isotropic TSE Acquisition) Refocusing angle T1, T2 Start up echo T1 Flow compensation T1 Dual SAT (REST ) TR, TE, FA