Takumi Ogawa¹, Kayoko Abe², Yutaka Hamatani¹, Yasuhiro Goto¹, Masami Yoneyama³, Quin Lu⁴, Isao Shiina¹, Kazuo Kodaira¹, Mana Kato¹, Michinobu Nagao², and Shuji Sakai^2
1Department of Radiological Services, Tokyo Woman's Medical University, Tokyo, Japan, ²Department of Diagnostic imaging & Nuclear Medicine, Tokyo Woman's Medical University, Tokyo, Japan, ³Philips Japan, Tokyo, Japan, ⁴Philips Healthcare NA, San Francisco, CA, United States

Double Echo Steady-State (DESS) with water-selective excitation is a useful sequence to depict small nerves such as intracranial nerves, it would also be promising for visualizing lumbar nerves. Recently, accelerated qDESS sequence combined with compressed sensing sensitivity encoding (Compressed SENSE) has been proposed for further rapid knee morphological and quantitative imaging. In this study, we evaluate the feasibility of the accelerated qDESS sequence for visualization and quantification of the lumbosacral plexus within a short scan time.

Daichi Murayama¹, Masami Yoneyama², Takayuki Sakai¹, Hajime Yokota³, Shigehiro Ochi¹, and Atsuya Watanabe^4,5
1Department of Radiology, Eastern Chiba Medical Center, Chiba, Japan, ²Philips Japan, Tokyo, Japan, ³Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan, ⁴Orthopaedic Surgery, Eastern Chiba Medical Center, Chiba, Japan, ⁵General Medical Services, Graduate School of Medicine, Chiba University, Chiba, Japan

We developed a new prepulse scheme, D²SDE, inspired by filter-probe double diffusion scheme for improved visualization of MR Neurography in the lumbosacral and sciatic nerves. This technique may be useful for arriving at an accurate diagnosis of lumbosacral plexus pathology.

Yutaka Hamatani¹, Kayoko Abe², Yasuhiro Goto¹, Masami Yoneyama³, Quin Lu⁴, Isao Shiina¹, Kazuo Kodaira¹, Takumi Ogawa¹, Mana Kato¹, Michinobu Nagao², and Shuji Sakai^2
1Department of Radiological Services, Tokyo Women's Medical University, Tokyo, Japan, ²Department of Diagnostic imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan, ³Philips Japan, Tokyo, Japan, ⁴Philips Healthcare NA, San Francisco, CA, United States

Accelerated quantitative double echo steady state (qDESS), which is combined with Compressed SENSE is expected to improve visualization of the cervical nerve roots and brachial plexus. The purpose of this study was to optimize flip angle (FA) and spatial resolution (3D voxel size) of accelerated qDESS to visualize the small nerve roots and brachial plexus in the cervical spine. As a result, a combination of FA: 35 degree and voxel size: 0.8mm3 was the most appropriate parameters to demonstrate them while suppressing the background signals including the muscles, blood vessels, and cerebrospinal fluid.

Takayuki Sada¹, Hajime Yokota², Ryuna Kurosawa¹, Takafumi Yoda¹, Koji Matsumoto¹, Takashi Namiki³, Masami Yoneyama³, Guillaume Gilbert⁴, Yoshitada Masuda¹, and Takashi Uno^2
1Department of Radiology, Chiba university hospital, Chiba, Japan, ²Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan, ³Philips Japan, Tokyo, Japan, ⁴Philips Canada, Mississauga, ON, Canada

Magnetization transfer (MT) has been conventionally used for the determination of myelin. However, the problem with the MT is that it reflects bound water that is not related to myelin. Inhomogeneous Magnetization Transfer (ihMT) can act specifically on myelin, it has been reported to be a useful method for quantifying myelin in brain and spinal cord regions. In this study, we compared conventional MT and ihMT for the brachial plexus, and ihMT might be able to reflect more accurate information about myelin than MT.  

Jianxiu Lian*¹, Liyang Zhao*², Zhiwei Shen¹, Xiaofang Xu¹, Zhigang Peng², and Xiaona Li^2
1Philips Healthcare, Beijing, China, ²The Third Hospital of Hebei Medical University, Shijiazhuang, China

Quantifying the functional parameters of brachial plexus injury can provide more valuable information for clinic. This article aims to apply diffusion tensor imaging (DTI)to brachial plexus injury and reveal the pathological causes of the disease from Magnetic Resonance Imaging (MRI). Our study revealed that patients with brachial plexus injury had higher FA and lower ADC values when compared with the healthy control, and FA showed the better diagnostic efficiency (AUC:0.763; sensitivity: 94.1%; specificity: 44.1%).

Kun Ou¹, Hui Gao¹, Weiyn Vivian Liu², and Kun Zhang^1
1First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China, ²GE Healthcare, Beijing, China

Actual contact surface between the extraforaminal nerve root and the adjacent structures is commonly missing on the conventional MR scanning, possibly leading to misdiagnosis. In our study, the detection rate of nerve root compression was significantly higher on the 3D-FIESTA-C images than T2WI. The shortest distance between the extraforaminal nerve root and the disc of L4/5 and L5/S1 in the healthy group was significantly longer than that in the lumbar disc herniation (LDH) group. The spatial relationship between nerve roots and surrounding tissues could be better described using 3D-FIESTA-C sequence and was helpful for the detection of nerve root compression.

Yi Xiao¹, Sixian Hu¹, Chunchao Xia¹, Zhenlin Li¹, Xiaoyong Zhang², and Chuntang Ling^3
1Radiology, West China Hospital Of Sichuan University, Chengdu, China, ²Clinical Science, Philips Healthcare, Chengdu, China, ³Application, Philips Healthcare, Chongqing, China

This study presents an accelerated brachial Plexus MR imaging technique using deep learning constrained compressed SENSE reconstruction (CS-AI-SENSE). The results showed that CS-AI-SENSE could enable comparable diagnostic image quality to the conventional SENSE-accelerated 3D T2-TSE approaches while significantly reduced the data acquisition time, which has potential to enhance the workflow of brachial Plexus MR examinations in clinics. 

Jianxiu Lian*¹, Luyao Duan*², Zhiwei Shen¹, Xiaofang Xu¹, Zhigang Peng², and Xiaoman Yu^2
1Philips Healthcare, Beijing, China, ²The Third Hospital of Hebei Medical University, Shijiazhuang, China

T2 mapping can provide quantitative parameter T2 values without radiation and damage, which can be used to quantitatively evaluate tissue inflammation and edema. The aim of this study was to evaluate patients with brachial plexus injury by using T2 mapping. And results showed that the T2 value would be prolonged when brachial plexus injured, and the T2 value would be shortened as patients recovers.

Haonan Zhang¹, Renwang Pu¹, and Qingwei Song^1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Dalian, China

The 3D-NerveVIEW sequence with suppression of lipid and blood signals and a long echo time can obtain high-quality images for visualization of brachial plexus, while the long scan time may limit its clinical application. Compressed SENSE (CS) is a newly developed technique in MRI that enables accelerated acquisition with maintained image quality. By comparing results of 3D-NerveVIEW for brachial plexus imaging with acceleration by the conventional SENSE and the advanced CS with dierent acceleration factors. We found that the 3D-NerveVIEW for brachial plexus imaging with a CS acceleration factor of 6 can obtained favorable images within signicantly reduced scan time.

Meng-Ze Zhang¹, Han-Qiang Ou-Yang^1,2,3, Dan Jin¹, Chun-Jie Wang¹, Jian-Fang Liu¹, Qiang Zhao¹, Xian-Chang Zhang⁴, Xiao-Guang Liu^1,2,3, Zhong-Jun Liu^1,2,3, Ning Lang¹, Xing-Wen Sun¹, Liang Jiang^1,2,3, and Hui-Shu Yuan^1
1Peking University Third Hospital, Beijing, China, ²Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China, ³Beijing Key Laboratory of Spinal Disease Research, Beijing, China, ⁴MR collaboration, Siemens Healthineers Ltd, Beijing, China

This study compared the sensitivity of diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) to detect cervical spondylotic myelopathy (CSM) at an early stage. The results showed that NODDI-based indicators can distinguish patients with CSM without T2-weighted increased signal intensity from healthy controls during internal validation, while DTI-based indicators cannot. These findings suggest that NODDI is a promising method to detect CSM at an early stage.

Ka-Loh Li¹, Daniel Lewis², Xiaoping Zhu¹, Timothy Cootes¹, and Alan Jackson^1
1Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom, ²Department of Neurosurgery, Salford Royal NHS Foundation Trust, Manchester, United Kingdom

Quantifying blood-brain barrier permeability in normal-appearing brain through dynamic contrast-enhanced MRI (DCE-MRI) is challenging. We evaluated a new method, which combines the hybrid first-pass Patlak-plot (FP-PP) model with a high spatiotemporal resolution DCE approach termed LEGATOS. Dual-temporal resolution DCE-MRI data in twelve patients with neurofibromatosis type II (NF2) imaged at 1.5T were analyzed, and estimates of K^trans within normal-appearing grey matter (NAGM) and white matter (NAWM) were compared. This new method permitted high-spatial resolution assessment of low-level permeability in normal-appearing brain and in our NF2 patient cohort a significant positive correlation between tumor volume and NAGM/NAWM K^trans values was observed. 

Takafumi Yoda¹, Hajime Yokota², Takayuki Sada¹, Ryuna Kurosawa¹, Koji Matsumoto¹, Takashi Namiki³, Masami Yoneyama³, Guillaume Gilbert⁴, Yoshitada Masuda¹, and Takashi Uno^2
1Department of Radiology, Chiba University Hospital, Chiba, Japan, ²Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan, ³Philips Japan, Tokyo, Japan, ⁴Philips Canada, Mississauga, ON, Canada

The purpose of this study is to find the parameters that provide the optimal trade-off in Signal-to-noise-ratio (SNR) and contrast-to-noise ratio (CNR) for 3D ihMT m-FFE (3D-ihMT) and to explore the feasibility of that for the segmentability of gray and white matters in the cervical spinal cord compared with 2D ihMT m-FFE (2D-ihMT). We recommend a Flip angle of 7 and TFE factor of 5 as an optimal trade-off between segmentability and artifact level, at least 16 nr repetitions are required for robust segmentation. The segmentability of 3D-ihMT could be increased to a level close to that of 2D-ihMT.

Yue Wu¹, Weiwei Wang¹, Shiman Wu¹, Qing Li², Zhenwei Yao¹, and Zengyi Ma^3
1Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China, ²MR Collaborations, Siemens Healthineers Ltd., Shanghai, China, ³Department of Neurosurgery, National Center for Neurological Disorders (NCND), Shanghai Pituitary Tumor Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

Cushing's disease(CD) has significantly more white matter hyperintensities and enlarged perivascular spaces, compare to same-aged healthy subjects.   Age, diabetes, hypokalemia was significantly related with white matter hyperintensities in CD. The gray matter volume of CD patients was significantly smaller than the healthy subjects. Compared with patients with type 2 diabetes alone, the mean age of CD with diabetes were younger with shorter course of disease, but with more severe white matter damage. the severity of white matter hyperintensities were ranked as belowed: CD with type 2 diabetes, CD without type 2 diabetes, type 2 diabetes.  

Tomasz Pieciak¹, Guillem París¹, Dani Beck^2,3, Ivan I. Maximov^3,4, Antonio Tristán-Vega¹, Rodrigo de Luis-García¹, Lars T. Westlye^2,3,5, and Santiago Aja-Fernández^1
1Laboratorio de Procesado de Imagen (LPI), Universidad de Valladolid, Valladolid, Spain, ²Department of Psychology, University of Oslo, Oslo, Norway, ³NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway, ⁴Western Norway University of Applied Sciences, Bergen, Norway, ⁵KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway

The free-water (FW) volume fraction $$$f$$$ is a sensitive diffusion MRI biomarker correlated with microstructural alterations in the human brain. This paper studies the variations in the FW volume fraction $$$f$$$ in healthy human brain white matter (WM) across the lifespan from a set of 248 female and 140 male subjects. Our study reveals positive nonlinear correlations of the volume fraction $$$f$$$ with age over the WM regions and suggests a heteroscedastic nature and age-dependent intra-region-of-interest variability of $$$f$$$ across the lifespan.

Yihua Wang¹, Lijun Wang¹, Xiaoxiao Zhang², and Ailian Liu^1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China, Beijing, China

Facial nerve MRI is a clinical challenge that it is difficult to differentiate parotid gland tumors from facial nerve on conventional imaging. It is great demand to develop new diagnostic technology to accurately display peripheral nerve and tumor for avoiding intraoperative injury. In this study, 3 dimension fast field echo imaging(T2WI-3D-FFE) is potentially a valuable sequence in displaying the intraparotid facial nerve and localizing the tumor.