As a noninvasive method, functional magnetic resonance imaging can provide metabolism and biochemical information in vivo. In recent years, it has been gradually applied to the diagnosis of breast diseases, and the diagnostic specificity of benign and malignant breast tumors has since become improved significantly. In this review, we introduce the functional magnetic resonance imaging of breast.
Breast Neoplasms ; diagnosis ; pathology ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Magnetic Resonance Angiography ; methods ; Magnetic Resonance Imaging ; methods ; Magnetic Resonance Spectroscopy ; methods

OBJECTIVETo discuss the feasibility and clinical value of high-resolution magnetic resonance vessel wall imaging (HRMR VWI) for intracranial arterial stenosis.

DATE SOURCESWe retrieved information from PubMed database up to December 2015, using various search terms including vessel wall imaging (VWI), high-resolution magnetic resonance imaging, intracranial arterial stenosis, black blood, and intracranial atherosclerosis.

STUDY SELECTIONWe reviewed peer-reviewed articles printed in English on imaging technique of VWI and characteristic findings of various intracranial vasculopathies on VWI. We organized this data to explain the value of VWI in clinical application.

RESULTSVWI with black blood technique could provide high-quality images with submillimeter voxel size, and display both the vessel wall and lumen of intracranial artery simultaneously. Various intracranial vasculopathies (atherosclerotic or nonatherosclerotic) had differentiating features including pattern of wall thickening, enhancement, and vessel remodeling on VWI. This technique could be used for determining causes of stenosis, identification of stroke mechanism, risk-stratifying patients, and directing therapeutic management in clinical practice. In addition, a new morphological classification based on VWI could be established for predicting the efficacy of endovascular therapy.

CONCLUSIONSThis review highlights the value of HRMR VWI for discrimination of different intracranial vasculopathies and directing therapeutic management.

Carotid Stenosis ; diagnosis ; Cerebral Angiography ; methods ; Humans ; Intracranial Arteriosclerosis ; diagnosis ; Magnetic Resonance Angiography ; methods

In this paper, signal-to-noise ratio (SNR) and signal different-to-noise ratio (SDNR) methods were used to compare image quality using two different radiofrequency coils. The two coil types included an eight-element phased-array coil and a quadrature birdcage head coil with endcap and the comparison studies performed on a uniform cylindrical phantom and volunteer respectively. The results showed phased-array coil have advantages and proved effectiveness of the method in the evaluation and selection of coils.
Adult ; Cerebral Angiography ; methods ; Humans ; Magnetic Resonance Angiography ; methods ; Male ; Signal-To-Noise Ratio

Angiography ; methods ; Coronary Angiography ; methods ; Coronary Vessels ; pathology ; Humans ; Magnetic Resonance Angiography ; methods ; Mucocutaneous Lymph Node Syndrome ; diagnosis ; diagnostic imaging

BACKGROUNDBalanced steady-state free precession MR angiography (b-SSFP MRA) has shown great promise in diagnosing renal artery stenosis (RAS) as a non-contrast MR angiography (NC-MRA) method. However, results from related studies are inconsistent. The purpose of this meta-analysis was to assess the accuracy of b-SSFP MRA compared to contrast-enhanced MR angiography (CE-MRA) in diagnosing RAS.

METHODSEnglish and Chinese studies that were published prior to September 4, 2013 and that assessed b-SSFP MRA diagnostic performance in RAS patients were reviewed. Quality of the literature was assessed independently by two observers. The statistical analysis was adopted by the software of Meta-Disc version 1.4. Using the heterogeneity test, a statistical effect model was chosen to calculate different pooled weighted values. The receiver operator characteristic (ROC) space and Spearman correlation coefficient were to explore threshold effect. Sensitivity analysis and the publication bias were performed to demonstrate if the pooled estimates were stable and reliable. We produced forest plots to calculate the pooled values and corresponding 95% confidence interval (CI) of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and constructed a summary receiver operating characteristic curve (SROC) to calculate the area under the curve (AUC).

RESULTSA total of 10 high quality articles were used in this meta-analysis. The studies showed a high degree of heterogeneity. The "shoulder-arm" shape in the ROC plot and the Spearman correlation coefficient between the log(SEN) and log(1-SPE) suggested that there was a threshold effect. Sensitivity analysis demonstrated that the actual combined effect size was equal to the theoretical combined effect size. The publication bias was low after quality evaluation of the literature and the construction of a funnel plot. The pooled sensitivity was 0.88 (95% CI, 0.83-0.91) and pooled specificity was 0.94 (95% CI, 0.93-0.95); pooled PLR was 14.57 (95% CI, 9.78-21.71]) and pooled NLR was 0.15 (95% CI, 0.11-0.20). The AUC was 0.964 3.

CONCLUSIONIn contrast to CE-MRA, the b-SSFP MRA is more accurate in diagnosing RAS, and may be able to replace other diagnostic methods in patients with renal insufficiency.

Angiography ; methods ; Contrast Media ; Humans ; Magnetic Resonance Angiography ; Renal Artery Obstruction ; diagnosis

In the examination of 3D DCE-MRA, it is the key of success or failure to measure and compute the delaying scan time accurately. Now, the timing technique used widely in clinic is test injection bolus, which is limited by inadequate perfectibility, limited spatial resolution and technique complexity. In this article is presented a technique in which contrast arrival is detected in the targeted vasculature in real time using MR fluoroscopy. Upon detection the operator triggers a 3D MR angiographic acquisition which uses an elliptical centric view order. It is shown that the view order intrinsically provides a high degree of venous suppression, a high degree of immunity to motion effects and a high degree of spatial resolution. The reliability of fluoroscopic triggering in bolus detection is shown to be over 95%. The technique provides high quality contrast-enhanced MR angiograms for many vascular regions.
Contrast Media ; Fluoroscopy ; methods ; Humans ; Image Enhancement ; methods ; Imaging, Three-Dimensional ; Magnetic Resonance Angiography ; methods

BACKGROUNDA new lacunar infarction model was recently established in beagle dogs through proximal middle cerebral artery (MCA) occlusion by thrombus. This study aimed to characterize the model by multimodal magnetic resonance imaging (MRI) and to investigate its potential role for the future stroke research.

METHODSThe left proximal MCA was embolized with an autologous thrombus in six beagles. Diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) were performed every half hour during the first six hours after occlusion, followed by three time points at 12 hours, 24 hours, and one week. Perfusion-weighted imaging (PWI) and magnetic resonance angiography (MRA) were carried out at six hours, 24 hours and one week. The PWI-DWI mismatch ratio was defined as (PWI-DWI)/DWI ischemic volume.

RESULTSLacunar infarcts induced by MCA occlusion were located in the left caudate nucleus and internal capsule. All the lesions could be detected within two hours by DWI. Lesion volume on DWI increased in a time dependent manner, from (87.19 ± 67.16) mm(3) at one hour up to (368.98 ± 217.05) mm(3) at 24 hours (P = 0.009), while that on PWI gradually decreased from (7315.00 ± 2054.38) mm(3) at six hours to (4900.33 ± 1319.71) mm(3) at 24 hours and (3334.33 ± 1195.11) mm(3) at one week (P = 0.002). The mismatch ratio was 41.93 ± 22.75 at six hours after ischemia, showing "extensive mismatch", and decreased to 18.10 ± 13.74 at 24 hours (P = 0.002). No MCA recanalization was observed within 24 hours after MCA occlusion.

CONCLUSIONSLacunar infarction induced by proximal MCA occlusion could be detected early by DWI and was characterized by extensive PWI-DWI mismatch. Multimodal MRI is useful to demonstrate the natural evolution of PWI-DWI mismatch. This ischemic model could be further used for investigating early thrombolysis in lacunar stroke showing extensive mismatch.

Animals ; Diffusion Magnetic Resonance Imaging ; methods ; Dogs ; Infarction, Middle Cerebral Artery ; complications ; Magnetic Resonance Angiography ; methods ; Male ; Stroke, Lacunar ; diagnosis

OBJECTIVETo evaluate the value of oblique-sagittal black-blood contrast-enhanced magnetic resonance imaging (OB-CEMRI) in atherosclerotic carotid artery (CA) assessment before carotid endarterectomy (CEA).

METHODSTwenty-five patients with symptomatic atherosclerotic stenosis in the carotid artery (involving 26 arteries) were scheduled for CEA. OB-CEMRI and digital subtraction angiography (DSA) were conducted within 1 week prior to CEA, and two radiologists independently assessed the location of maximal lumen stenosis, plaque rupture, degree of maximal lumen stenosis and plaque involvement on DSA and OB-CEMRI images. The differences of DSA and the OB-CEMRI in analyzing the plaque conditions were assessed in comparison with matched histological sections of the excised specimens.

RESULTSCompared with the corresponding histological specimens, both DSA (κ=0.807) and OB-CEMRI (κ=0.812) showed a good consistency in defining the location of the maximal lumen stenosis. OB-CEMRI showed a better performance in detecting plaque rupture with higher sensitivity (90.0%) and specificity (83.3%) than DSA (40.0% and 66.7%, respectively). No significant difference was found between DSA and the OB-CEMRI in evaluating the degree of maximal lumen stenosis [(77.33∓3.79)% vs (76.02∓3.95)%, P=0.648]. Compared with the histological examination, OB-CEMRI appeared to underestimate the stenosis. The plaque extent on OB-CEMRI was larger than that on DSA (18.96∓4.96 mm vs 14.80∓3.78 mm, P=0.004), and similar to that by histological examination (18.13∓4.57 mm, P=0.506).

CONCLUSIONSOB-CEMRI allows noninvasive and objective detection of the location of the maximal lumen stenosis, plaque rupture, and plaque extent, though with a lower accuracy than DSA in the assessment of the maximal lumen stenosis. OB-CEMRI combined with DSA offers a more reliable means for preoperative evaluation of the carotid artery plaques for CEA.

Aged ; Angiography, Digital Subtraction ; Carotid Artery Diseases ; pathology ; Carotid Stenosis ; Endarterectomy, Carotid ; methods ; Female ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged

The value of combined application of both ECG-gated cine MRA and 3D-CEMRA in the detection of large intracranial aneurysms was evaluated and the findings were compared with those of conventional MRA and DSA. Twenty-four patients with 26 large intracranial aneurysms underwent MRI and DSA. All these aneurysms, diameter from 15 to 39 mm, were located at internal cerebral artery (n=12), vertebral artery (n=3), basilar artery (n=4), anterior cerebral artery (n=2), middle cerebral artery (n=2), anterior communicate artery (n=2) and posterior communicate artery (n=1). Thirteen cases of hematoma or cavernoma were studied as control group. All patients were examined on GE 1.5T MR system. ECG-gated cine MRA was performed with 2D multi-phase fast gradient-recalled echo sequence in a single section. All the images were analyzed with signal intensity VS time curve for differentiating intraaneurysmal blood flow from static tissue. The results were analyzed by statistic "t" test. 3D-CEMRA was performed with spoiled gradient-recalled echo and one dose of Gd-DTPA. All data was processed with multi-plannar reformat (MPR) and tomography for the demonstration of aneurysms in detail. All 26 aneurysms were demonstrated successfully by combined application of both cine MRA and 3D-CEMRA. Compared to DSA and conventional 3D-MOTSA, its sensitivity and specificity figures were both 100%. Cine MRA could differentiate the blood flow from the static tissue. The intensity VS time curves of intraaneurysmal blood flow offered fluctuating form and average signal change between systole and diastole period was about 89.8 +/- 37.4; However, under the control group, intraaneurysmal thrombus or cerebral hemorrhage or cavernomas had no significant signal change and the curves offered steady form with the average signal change being about 8.2 +/- 6.3. There was statistically significant difference between the intraaneurysmal blood flow and static tissue (P=0.025, <0.05). 3D-CEMRA was very useful in demonstrating the aneurysmal size, intraaneurysmal thrombus formation, neck and the detailed relationship of the aneurysm to the surrounding structures. It was concluded that the combined application of both cine MRA and 3D-CEMRA might be a valuable clinical tool for the detection of large intracranial aneurysms.
Angiography, Digital Subtraction ; Contrast Media ; Evaluation Studies ; Image Enhancement ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional/methods ; Intracranial Aneurysm/*diagnosis ; Magnetic Resonance Angiography/*methods ; *Magnetic Resonance Imaging, Cine

BACKGROUNDAbout 50% of the cerebral ischemia events are induced by intracranial and extracranial atherosclerosis. This study aimed to evaluate the feasibility and accuracy for displaying atherosclerotic plaques in carotid arteries and analyzing their ingredients by using high-resolution new magnetic resonance imaging (MRI) techniques.

METHODSTotally, 49 patients suspected of extracranial carotid artery stenosis were subjected to cranial MRI scan and magnetic resonance angiography (MRA) examination on carotid arteries, and high-resolution bright-blood and black-blood MRI analysis was carried out within 1 week. Digital subtraction angiography (DSA) examination was carried out for 16 patients within 1 month.

RESULTSTotally, 103 plaques were detected in the 49 patients, which were characterized by localized or diffusive thickening of the vessel wall, with the intrusion of crescent-shaped abnormal signal into lumens. Fibrous cap was displayed as isointensity in T1-weighted image (T1WI) and hyperintensities in proton density weighted image (PDWI) and T2-weighted image (T2WI), lipid core was displayed as isointensity or slight hyperintensities in T1WI, isointensity, hyperintensities or hypointensity in PDWI, and hypointensity in T2WI. Calcification in plaques was detected in 11 patients. Eight patients were detected with irregular plaque surface or ulcerative plaques, which were characterized by irregular intravascular space surface in the black-blood sequences, black hypointensity band was not detected in three-dimensional time-of-flight, or the hypointensity band was not continuous, and intrusion of hyperintensities into plaques can be detected. Bright-blood and black-blood techniques were highly correlated with the diagnosis of contrast-enhanced MRA in angiostenosis degree, Rs = 0.97, P < 0.001. In comparison to DSA, the sensitivity, specificity, and accuracy of MRI diagnosis of stenosis for ≥50% were 88.9%, 100%, and 97.9%, respectively.

CONCLUSIONSHigh-resolution bright-blood and black-blood sequential MRI analysis can accurately analyze ingredients in atherosclerotic plaques. Determined by DSA, MRI diagnosis of stenosis can correctly evaluate the serious degree of arteriostenosis.

Adult ; Aged ; Angiography, Digital Subtraction ; Carotid Artery Diseases ; diagnosis ; Carotid Stenosis ; Female ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Plaque, Atherosclerotic ; diagnosis ; Sensitivity and Specificity