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Magnetic Resonance Magnetic Resonance

Growth with Body MRI

H.-Hartziekenhuis Lier

40 oz/d tussen 8 en 21 uur

3-5 body mri/d

Aparte protocols voor

leverletsels / pancreas, mrcp

rectum, ovarium, cervix / uterus, pelvimetrie

anus / fistula

enteroclyse, prostaat

Body MRI

Technische uitdaging,

onderzoek gebeurt best

snel en robuust

Body MRI

Mentale uitdaging want…

overweldigende en vaak

verwarrende

Body MRI

Mentale uitdaging want…

overweldigende en vaak

verwarrende

Acronym Hell

Body MRI

or ... Heaven !

Overweldigend performant

en vlot in gebruik

Body MRI

Uitdaging

Contrast bolus timing

Ademhalings artifacten

Kwantitatieve beeldvorming

Lever MRI

Met welke TRICKS?

Oud acroniem voor Time Resolved Imaging of Contrast KineticS,

(Oorspronkelijk voor MR-angiografie)

Lever MRI

Magnetic Resonance

Nieuwe Zekerheid

in Lever MRI.

Met FREEZEit en

LiverLab1.

Magnetic Resonance

FREEZE-it is not an acronym but a commercial slogan

for applied accelaration techniques

FREEZE-it

• adds imaging speed and motion compensation for

higher quality diagnostic imaging of the liver

• TWIST-VIBE = ultimate TRICKS = speed

• STAR-VIBE = motion compensation

Magnetic Resonance

TWIST-VIBE Time resolved angiography With Stochastic (non

Cartesian) Trajectories

(K-space sampling technique, i.e. Keyhole-imaing,

increases temporal resolution without loss of

spatial resolution)

Volumetric Interpolated Breath-hold Examination

allows imaging the entire arterial phase of the liver

with multiple 3D datasets within seconds while

maintaining a high spatial resolution

6 s 3 s

Magnetic Resonance

TWIST-VIBE Time resolved angiography With Stochastic (non

Cartesian) Trajectories

(K-space sampling technique, i.e. Keyhole-imaing,

increases temporal resolution without loss of

spatial resolution)

Volumetric Interpolated Breath-hold Examination

allows imaging the entire arterial phase of the liver

with multiple 3D datasets within seconds while

maintaining a high spatial resolution

6 s 3 s

allows for detection of more lesions and more

accurate differential diagnosis

Magnetic Resonance

Star-VIBE combination of compressed sensing, parallel imaging and

golden-angle radial sampling (“stack of stars”)

central K-space points (defining image contrast) are sampled in

every line, allowing the low-resolution images from individual

lines to be compared for in-plane rotation and translation (which

can be corrected) and through-plane motion (which motivates

re-acquisition of that line of data)

a final high-resolution image is constructed once all the lines of

data are acquired

Magnetic Resonance

Star-VIBE combination of compressed sensing, parallel imaging and

golden-angle radial sampling (“stack of stars”)

central K-space points (defining image contrast) are sampled in

every line, allowing the low-resolution images from individual

lines to be compared for in-plane rotation and translation (which

can be corrected) and through-plane motion (which motivates

re-acquisition of that line of data). A final high-resolution image

is constructed once all the lines of data are acquired

Star-VIBE allows motion compensation and enables CE liver

imaging during free breathing

Conventional

StarVIBE2

TWIST-VIBE 2

Altijd het juiste contrast

in dynamicsche lever MRI.

StarVIBE2

Free-breathing contrast-

enhanced body imaging.

LiverLab1

Kwantitative lever imaging,

niet-invasief.

Nieuwe Zekerheid in Lever MRI

Oplossing – FREEZEit technologie en LiverLab1

University Hospital IKRN, Mannheim, Germany

FREEZEit

Magnetic Resonance

Some more terms

DIXON Not an acronym

implementation of Dixon’s method of acquiring in-

phase and out-of-phase images (i.e. 2 echoes) and

calculating water-only and fat-only images

Older concept, mid-80’s

Magnetic Resonance

Some more terms

DIXON Not an acronym

implementation of Dixon’s method of acquiring in-

phase and out-of-phase images (i.e. 2 echoes) and

calculating water-only and fat-only images

Older concept, mid-80’s

Magnetic Resonance

Some more terms

eDIXON Not an acronym

Implementation of Dixon’s method for quantification and evaluation of fat and iron

deposition in liver tissue = LiverLab

first step in monitoring early stages of liver diseases

enables non-invasive identification of patients with fatty liver and iron overload already

at an early disease stage, helps to minimize the need for biopsy

fat and iron screening part (First look Dixon) + two methods for evaluation: HISTO

(voxel based) and Multi-echo Dixon VIBE (image based), provides a clinical report

Magnetic Resonance

Some more terms

eDIXON Not an acronym

Implementation of Dixon method in quantification and evaluation of fat and iron

deposition in liver tissue = LiverLab

first step in monitoring early stages of liver diseases

enables non-invasive identification of patients with fatty liver and iron overload already

at an early disease stage, helps to minimize the need for biopsy

fat and iron screening part (First look Dixon) + two methods for evaluation: HISTO

(voxel based) and Multi-echo Dixon VIBE (image based), provides a clinical report

Magnetic Resonance

Some more terms

CAIPIRINHA

true acronym

Magnetic Resonance

Some more terms

CAIPIRINHA

true acronym

evolution of sense and grappa

Controlled Aliasing In Parallel Imaging Results In Higher Acceleration

dedicated sampling pattern to distribute k-space points more uniformly

to reduce pixel aliasing and overlap on reconstructed images

improved algorithm for reconstruction of datasets

single digit (<10 sec) breath-holds possible for 3D-T1 exams

higher SNR enables higher spatial resolution

higher PAT factors enabled with excellent image quality

reduced patient stress and increased patient compliance

CAIPIRINHA pattern with

acceleration in two directions

plus phase shift of alternate

Magnetic Resonance

Some more terms

CAIPIRINHA

true acronym

“software package for specific data acquisition technique”

Controlled Aliasing In Parallel Imaging Results In Higher Acceleration

can be combined with 3D T1 VIBE (allows for SPectral Attenuated

Inversion Recovery and spectral FS)

or 3D Dixon (Four contrasts: in phase, opposed phase, fat and water) in a

single short breath-hold

COMING UP NEXT: CAIPIRINHA-DIXON-TWIST-VIBE

(29 seconds free breathing, 14 high spatial resolution 3D datasets using

view sharing, temporal resolution 2,1 seconds)

Magnetic Resonance

Some more terms

Magnetic Resonance

Some more terms

Not an acronym

Magnetic Resonance

Some more terms

Not an acronym

Refers to Siemens name for PROPELLER

(Periodically Rotated Overlapping ParallEL Lines with

Enhanced Reconstruction)

(non-Cartesian k-space data acquisition, in small groups of

parallel lines through the center of k-space, the groups rotated

with respect to one-another)

used for motion correction in TSE sequences

Magnetic Resonance

Some more terms

Not an acronym

Refers to Siemens’ name for PROPELLER

(Periodically Rotated Overlapping ParallEL Lines with

Enhanced Reconstruction)

(non-Cartesian k-space data acquisition, in small groups of

parallel lines through the center of k-space, the groups rotated

with respect to one-another)

used for motion correction in TSE sequences

MR leverletsel in 7 min transversale haste T2-opnamen (48/27)

coronale haste-T2-opnamen zonder en met fatsat (2x48/23)

transversale ademhalingsgetriggerde TSE-T2-opnamen met fatsat (3 min, var)

transversale trufi-T2-opnamen (58/33)

transversale epi-diffusie opnamen (B0, 50, 300, 500, 800 en ADC-map = 3 min 51 sec)

transversale e-dixon-vibe-T1-opnamen (in, opp, F en W, segmentatie en report, 14/64)

transversale dynamische twist-vibe T1-opnamen voor, tijdens en laattijdig na intraveneuze

injectie van Gadolinium (3 x 4 fasen) (3 x 8+3,2+3,2+3,2=17,6 sec)

coronale vibe-dixon-T1 opnamen (in, opp, F, W) (13/72)

transversale vibe-T1-pnamen met fatsat (12/72)

MR prostaat in 15 min cor en sag BLADE-T2 opnamen (1min24/36 en 1min40/24)

trans q-TSE-T2 (3min17/28)

trans epi-diffusie (B0, B750 en B1000 en ADC-map = 3 min 51 sec)

trans q-TSE-T1 fat sat (1min12/24)

trans dynamische twist-vibe T1-opnamen voor, tijdens en laattijdig na intraveneuze injectie van

Gadolinium (40 fasen) (40x4,7=3min7)

cor en trans q-TSE-T1 fatsat (1min31/24 en 1min12/24)

MR enteroclyse in 6 min MR onderzoek uitgevoerd na perorale maagdarm voorbereiding met 2 liter mannitol oplossing

free breathing

cor haste-T2 (48/27)

cor trufi fat sat (48/27) en cor haste-T2 fatsat (48/27)

trans trufi (36/32) en trans haste (34/35)

trans vibe-dixon T1-gewogen (in, opp, F, W) (15/64)

coronale dynamische 2D flash-T1 na intraveneuze injectie van Buscopan en vervolgens

Gadolinium (10 fases, 7/19, free breathing)

trans en cor dixon-vibe-T1 (in, opp, F, W) (2x15/64)

Magnetic Resonance

Dank u voor uw aandacht!

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