Yasuhiro Hiai

A novel tract imaging technique of the brainstem using phase difference enhanced imaging: normal anatomy and initial experience in multiple system atrophy

ObjectivesTo develop a new tract imaging technique for visualising small fibre tracts of the brainstem and for detecting the abnormalities in multiple system atrophy of the cerebellar type (MSA-C) using a phase difference enhanced (PADRE) imaging technique, in which the phase difference between the target and surrounding tissue is selectively enhanced.MethodsTwo neuroradiologists compared the high-spatial-resolution PADRE imaging, which was acquired from six healthy volunteers, three patients with MSA-C, and 7 patients with other types of neurodegenerative diseases involving the brainstem or cerebellum.ResultsVarious fine fibre tracts in the brainstem, the superior and inferior cerebellar peduncles, medial lemniscus, spinothalamic tract, medial longitudinal fasciculus, central tegmental tract, corticospinal tract and transverse pontine fibres, were identified on PADRE imaging. PADRE imaging from MSA-C demonstrated the disappearance of transverse pontine fibres and significant atrophy of the inferior cerebellar peduncles, while the superior cerebellar peduncles were intact. PADRE imaging also demonstrated that the transverse pontine fibres and inferior cerebellar peduncle were not involved in the other neurodegenerative diseases.ConclusionPADRE imaging can offer a new form of tract imaging of the brainstem and may have the potential to reinforce the clinical utility of MRI in differentiating MSA from other conditions.

Delineation of Optic Radiation and Stria of Gennari on High-resolution Phase Difference Enhanced Imaging

RATIONALE AND OBJECTIVES Phase difference enhanced (PADRE) imaging technique can selectively enhanced the phase difference between the target and surrounding tissue. Our purpose is to assess the delineations of the optic radiation and primary visual cortex (stria of Gennari) using PADRE. MATERIALS AND METHODS The subjects were 6 healthy volunteers. Axial and coronal high-spatial resolution PADRE images were acquired covering the entire optic radiation using a 3T magnetic resonance system. Two radiologists evaluated the PADRE and susceptibility-weighted imaging (SWI)-like images for the delineation of four layers at the optic radiation (tapetum, internal sagittal stratum, external sagittal stratum, and adjacent white matter) on the basis of the anatomic appearances of the cadaveric specimens stained with Bodians method and Kluver-Barrera method. The radiologists also assessed the delineations of the stria of Gennari on PADRE and SWI-like images. RESULTS In all 6 healthy subjects, the PADRE images clearly identified the four layers at the optic radiation, as well as the stria of Gennari, which were difficult to appreciate in SWI-like images. The anatomic appearances of the optic radiation on PADRE images were more similar to those seen in the specimens stained with Kluver-Barrera method than with Bodians method. CONCLUSION The PADRE technique can delineate the four layers at the optic radiation and the stria of Gennari; the differences in myelin densities can also be enhanced. The PADRE technique may have the potential to reinforce the clinical utility of MRI in the diagnosis of diseases that affect the optic radiation and primary visual cortex.

MRA of intracranial aneurysms embolized with platinum coils: a vascular phantom study at 1.5T and 3T.

To analyze the influence of matrix and echo time (TE) of three‐dimensional time‐of‐flight (3D TOF) magnetic resonance angiography (MRA) on the depiction of residual flow in aneurysms embolized with platinum coils at 1.5T and 3T.

Diagnosis of intracranial hemorrhagic lesions: Comparison between 3D-SWAN (3D T2*-weighted imaging with multi-echo acquisition) and 2D-T2*-weighted imaging

Background 3D-susceptibility-weighted angiography (SWAN) can produce high-resolution images that yield excellent susceptibility-weighted contrast at a relatively short acquisition time. Purpose To compare SWAN- and 2D-T2*-weighted gradient-echo images (T2*-WI) for their sensitivity in the depiction of cerebral hemorrhagic lesions. Material and Methods We subjected 75 patients with suspected cerebral hemorrhagic lesions to SWAN and T2*-WI at 3T. We first measured the contrast-to-noise ratio (CNR) using an agar phantom that contained different concentrations of superparamagnetic iron oxide (SPIO). The acquisition time for SWAN and T2*-WI was similar (182 vs. 196 s). Neuroradiologists compared the two imaging methods for lesion detectability and conspicuity. Results The CNR of the phantom was higher on SWAN images. Of the 75 patients, 50 were found to have a total of 278 cerebral hemorrhagic lesions (microbleeds, n = 229 [82.4%]; intracerebral hemorrhage, n = 18 [6.5%]; superficial siderosis, n = 13 [4.7%]; axonal injuries, n = 8 [2.9%]; subarachnoid hemorrhage [SAH] or brain contusion, n = 3 each [1.0%]; subdural hematoma, n = 2 [0.7%]; cavernous hemangioma or dural arterteriovenous fistula, n = 1 each [0.4%]). In none of the lesions was the SWAN sequence inferior to T2*-WI with respect to lesion detectability and conspicuity. In fact, SWAN yielded better lesion conspicuity in patients with superficial siderosis and SAH: it detected significantly more lesions than T2*-WI (P < 0.01) and it was particularly useful for the detection of microbleeds and lesions near the skull base. Conclusion SWAN is equal or superior to standard T2*-WI for the diagnosis of various cerebral hemorrhagic lesions. Because its acquisition time is reasonable it may replace T2*-WI.

Computed radiography utilizing laser-stimulated luminescence: Detectability of simulated low-contrast radiographic objects

Threshold contrasts of low-contrast objects with computed radiography (CR) images were compared with those of blue and green emitting screen-film systems by employing the 18-alternative forced choice (18-AFC) procedure. The dependence of the threshold contrast on the incident X-ray exposure and also the object size was studied. The results indicated that the threshold contrasts of CR system were comparable to those of blue and green screen-film systems and decreased with increasing object size, and increased with decreasing incident X-ray exposure. The increase in threshold contrasts was small when the relative incident exposure decreased from 1 to 1/4, and was large when incident exposure was decreased further.

3D TOF MRA of Intracranial Aneurysms at 1.5 T and 3 T. Influence of Matrix, Parallel Imaging, and Acquisition Time on Image Quality-A Vascular Phantom Study

RATIONALE AND OBJECTIVES A 3-T magnetic resonance imaging system provides a better signal-to-noise ratio and inflow effect than 1.5 T in three-dimensional time-of-flight (3D TOF) magnetic resonance angiography (MRA). The purpose of this study is to analyze the influence of matrix, parallel imaging, and acquisition time on image quality of 3D TOF MRA at 1.5 and 3 T, and to illustrate whether the combination of larger matrixes with parallel imaging technique is feasible, by evaluating the visualization of simulated intracranial aneurysms and aneurysmal blebs using a vascular phantom with pulsatile flow. MATERIALS AND METHODS An anthropomorphic vascular phantom was designed to simulate the various intracranial aneurysms with aneurysmal bleb. The vascular phantom was connected to an electromagnetic flow pump with pulsatile flow, and we obtained 1.5- and 3-T MRAs altering the parameters of 3D TOF sequences, including acquisition time. Two radiologists evaluated the depiction of simulated aneurysms and aneurysmal blebs. RESULTS The aneurysmal blebs were not sufficiently visualized on the high-spatial resolution 1.5-T MRA (matrix size of 384 x 256 or 512 x 256), even with longer acquisition time (9 or 18 min). At 3 T with acquisition time of 4.5 min using parallel imaging technique, however, the depiction of aneurysmal blebs was significantly better for the high-spatial resolution sequence than for the standard resolution sequence. For the high-spatial resolution sequence, the longer acquisition times did not improve the depiction of aneurysmal blebs in comparison with 4.5 min at 3 T. CONCLUSIONS For 3D TOF MRA, the combination of the large matrix with parallel imaging technique is feasible at 3 T, but not at 1.5 T.

Handedness: dependent asymmetrical location of the human primary gustatory area, area G.

In magnetoencephalogram studies, the primary gustatory area, area G, is not always seen in the same coronal plane in both hemispheres. We investigated possible asymmetry in right-handed and left-handed individuals by functional MRI. Group analyses revealed a significant difference in the antero-posterior coordinates of the area G between the right and left hemispheres in the right-handed group, but not in the left-handed group, indicating significant morphometric asymmetry in the former group and ambiguous morphometric asymmetry in the latter. However, in left-handed individuals with motor speech areas detected in the right hemisphere, area G was more posteriorly located in the right than in the left hemisphere. These findings suggest that the motor speech area contributes to the asymmetric location of area G.

Internal Structures of the Globus Pallidus in Patients with Parkinson's Disease: Evaluation with Phase Difference-enhanced Imaging.

Purpose: The medial medullary lamina (MML) separates the medial globus pallidus (GPm) from the lateral. The aim of this study was to assess the changes in appearance of MML related to age using the phase difference-enhanced (PADRE) imaging and to determine whether PADRE can depict the MML in the patients with Parkinson’s disease (PD). Materials and Methods: We enrolled 20 patients with PD and 50 normal control subjects (NC). First, for the visualization of the MML in the NC, we compared the PADRE, susceptibility-weighted imaging (SWI)-like images and T2weighted imaging (WI) by using multiple comparison. The grading methods are as follows: grade 1; MML was not delineated, grade 2; less than half of MML was delineated, grade 3; more than half of MML was delineated and grade 4; whole MML was clearly delineated. We determined grade 3 and 4 as good depiction, delineating the GPm. Then, we evaluated patients with PD using the same method. Results: In NC, the delineation of MML was good in 84% of cases on PADRE, but only 34% of cases showed a good depiction on SWI-like images (average grading score 3.31 vs 2.11, P < 0.05). No MML was delineated in all cases on T2WI. Although younger subjects tended to show whole MML clearly, a part of MML tends to be obscured with age on PADRE. In patients with PD the depiction of MML on PADRE was also good in 90% of cases. Conclusion: The PADRE technique facilitates the depiction of the MML within globus pallidus (GP) on a broad range of age NC and patients with PD and it is superior to SWI-like images and T2WI.

Signal intensity of superficial white matter on phase difference enhanced imaging as a landmark of the perirolandic cortex.

Background The superficial white matter (SWM), which fills the space between the deep white matter and the cortex, has not been well characterized. Purpose To determine whether the assessment of the relative signal intensity (SI) of the SWM in the precentral and postcentral gyri on phase difference enhanced (PADRE) images contributes in establishing anatomical landmark. Material and Methods The study population consisted of 43 normal subjects (28 women, 15 men; mean age, 52.9 years; age range, 22–90 years). By the consensus of two observers, the precentral gyri, postcentral gyri, and superior frontal cortex (SFC) were identified based on the established anatomical methods. The SI of the SWM in the precentral and postcentral gyri on PADRE images was divided into three grades in comparison with that of the SFC: Grade I, isointense; Grade II, slightly hypointense; and Grade III, markedly hypointense. Results The SWM in the precentral and postcentral gyri showed hypointensity on PADRE images. In the SI analyses of the PADRE images, the Grade I, Grade II, and Grade III appearances were found in one (1%), 20 (23%), and 65 (76%) of the 86 precentral gyri (43 subjects), respectively, and in one (1%), 23 (27%), and 62 (72%) of the 86 postcentral gyri, respectively. Conclusion On PADRE images, the perirolandic SWM showed hypointensity compared to other cerebral cortices, which probably reflects differences in the concentrations of the nerve fibers, as well as the higher myelin content. PADRE may be useful for the identification of the central sulcus by assessing the SI of the SWM.

Positional lumbar imaging using a positional device in a horizontally open-configuration MR unit—Initial experience

To evaluate whether positional MR images of the lumbar spine, obtained with a horizontally open‐configuration MR unit, demonstrate positional changes of the dural sac, and to assess whether there are significant differences in positional changes between healthy volunteers and patients with chronic low back pain.