MRI

Published clinical studies are expanding the diagnostic limits of multislice CT and other modalities for cardiovascular applications. A meta-analysis in the November Radiology offers a powerful argument in favor of its use for diagnosing lower extremity disease. Other, more preliminary, studies suggest that multislice and dual-source CT will eventually help evaluate in-stent restenosis and the quantification of left ventricular function. New applications are emerging for cardiac MR, echocardiography, and PET/CT as well.

Researchers have discovered a unique biomarker for neural progenitor and stem cells detectable with 3T proton MR spectroscopy. It noninvasively establishes the presence of the cells and their decreasing prominence with age in the brains of children, adolescents, and adult humans.

Imaging advocates fear the adoption of a bundled approach to Medicare reimbursement for contrast media, radiopharmaceuticals, and the technical component of medical imaging could lead to substantial payment cuts from the Hospital Outpatient Prospective Payment System.

Incidental findings in brain MR imaging of asymptomatic subjects show a high prevalence of low-risk meningiomas and small aneurysms. Researchers suggest a review of management guidelines for such findings, with an eye toward reducing radiological intervention.

Long-standing suspicions about noncontrast T1-weighted MRI’s usefulness as a biomarker for multiple sclerosis have been confirmed in a study showing that hyperintense plaques revealed with the technique are associated with brain atrophy, disability, and an advancing course for the disease.

Independent diagnostic testing facilities have only until the end of the year to dissolve imaging equipment leasing arrangements with referring physicians to comply with new rules in the 2008 Medicare Physician Fee Schedule that becomes effective Jan. 1.

The competition is fierce on the way to Wimbledon-just how fierce has been elucidated by British researchers who found a significant number of spinal abnormalities in otherwise healthy adolescent tennis players.

Despite its widespread use as a tool that provides rapid diagnosis at a relatively low cost without the need for bulky equipment or ionizing radiation, ultrasound faces mounting competition from modalities such as CT and MRI, which combine short acquisition times with the ability to rapidly generate multiplanar and 3D images. That may change with volume ultrasound, a technique that lets clinicians and sonographers scan the patient and rapidly analyze data from a volume of interest.

Conventional static MR angiography techniques create high-spatial-resolution structural studies but fail to image physiological information inherent in the delivery of blood or contrast. MR scanner gradient enhancements now enable repetitive data capture over time in the attempt to depict vascular dynamics and physiology in a method similar to that routinely used with conventional catheter x-ray angiography.

For the first time, researchers have combined functional and anatomic MR imaging to reveal abnormalities in both physiological states in a well-defined subgroup of schizophrenic patients with chronic auditory hallucinations. With the potential to visually pinpoint abnormalities, MRI could prove useful as a diagnostic and follow-up tool to evaluate treatment for people with the disorder, according to lead investigator Dr. Luis Marti-Bonmati, chief of MR at Dr. Peset University Hospital in Valencia, Spain.

Breast MR is approaching celebrity status. A raft of expert opinions, notably from the American Cancer Society, has established MR in public and professional minds as a leading means to diagnose cancer among patients at high risk and possibly even among patients in the general population.

Three-D reconstructions are routinely used in the imaging of many organ systems. Not only do referring physicians and patients like the volume-rendered images, but radiologists are finding the inclusion of coronal and sagittal reformats imperative to making the most confident diagnoses. The use of advanced imaging over the last year has become important in several organs, mainly the heart/chest (Figure 1) and the abdomen/pelvis.

Mountaineering and climbing have been popular sports for many decades. The recent advent of artificial climbing walls and improved safety equipment have transformed the sport and brought it to a wider audience than ever. Such innovations allow individuals to climb safely in any weather conditions.

A spate of European studies within the last year contributes to the evidence that MRI may soon replace scintigraphy and x-ray to detect bony metastases and soft-tissue involvement.

Of the 6000 scientific abstracts submitted to the RSNA this year, four major areas dominate, according to Dr. Gerald Dodd III, chair of the RSNA's scientific program committee.

The Deficit Reduction Act that went into effect in January pulled the rug out this year from under the vendors of CT equipment and flattened the rebound that makers of MR scanners had hoped for in 2007. That could be good news for anyone looking to buy a new CT or MR scanner in the coming months.

Researchers in Belgium have found that MR elastography is more accurate than a blood test commonly used in the noninvasive staging of liver fibrosis. The study adds weight to clinical literature that suggests MR elastography could replace biopsy.

MRI is the study of choice in the overall evaluation of the temporomandibular joint.1 The modality is reported to be 95% accurate in assessing the position and configuration of the TMJ disc and 93% accurate in assessing osseous changes.2 MRI provides detailed multiplanar evaluation of the soft tissues and osseous structures that form the TMJ, and assessment in various degrees of opening provides an opportunity to evaluate the joint for internal derangement, the most common abnormality that affects it.

The European Commission announced today that it will postpone and amend legislation that would pose a serious threat to the use of MRI in patient care and scientific research.

The application of a scleral buckle (note, this is a procedure, not an implant), or “scleral buckling,” is a surgical technique used to repair retinal detachments. It was first used experimentally by ophthalmic surgeons in 1937. By the early 1960s, scleral buckling had become the method of choice when the development of new materials, particularly silicone, offered surgeons new opportunities for improving their outcomes.

In a kind of YouTube meets “Who Wants to be a Millionaire,” Siemens Medical Solutions is planning a contest to give an MR scanner to a needy community hospital.

Researchers using coronary CT angiography have replicated ex vivo and intravascular ultrasound studies that have characterized plaque into its various components and shown a predisposition for plaque to form in low shear stress areas.

Peer-reviewed research published in October offered an eye-opener for anyone who thinks that cardiac imaging is all about measuring coronary artery occlusions. Variety spiced the most notable imaging research of the month. Studies produced fresh insight into the relevance of renal artery calcium, delayed enhancement and the prediction of post-myocardial infarction left ventricular remodeling, initial imaging assessments of acute stroke, coronary flow reserve and diabetes, aortic dissection, and Turner syndrome, as well as, of course, coronary artery imaging.

Contrary to conventional wisdom, a new study suggests the small number of NSF cases known today may be just the tip of the iceberg. In fact, the disease appears to be prevalent -- of “epidemic” proportions -- in hemodialysis patients, according to rheumatologists at Massachusetts General Hospital.

Functional magnetic resonance imaging has helped University of Washington researchers discover that too much connectivity between the language-processing regions of the brains of dyslexic children may contribute to reading disabilities. Follow-up scans produced functional evidence that these abnormal connectivity patterns were mitigated after only three weeks of specialized reading training.

MRI practice restrictions introduced this year in Slovakia may spread in April 2008 to all 27 countries in the European Commission, if the EC governing body does not delay a controversial regulation aimed at protecting workers from harmful exposure to electromagnetic fields.

The assessment of myocardial perfusion reserve at 3T MRI is clinically feasible and is desirable because of its superior signal-to-noise ratio, spatial resolution, and temporal resolution, according to a preliminary study presented at the annual meeting of the North American Society for Cardiac Imaging. Researchers used a nonuniformity correction method to reduce artifacts that degraded the quality of previous first-pass perfusion protocols for 3T cardiac MR.

Optimized high-field MR angiography sequences that eliminate the need for contrast agents could replace conventional contrast-enhanced MRA for evaluation of major arteries and veins of the thoracic region, according to two studies presented Oct. 6 at the 2007 North American Society for Cardiac Imaging meeting in Washington, DC.

Earlier this month I was struck by a news story about the suicide rate among 10- to 24-year-olds. It had fallen in the U.S. by 28% between 1990 and 2003. Then, it suddenly rose 8% in 2004.

Using clinical skin tests rather than biopsies for diagnosis, Massachusetts General Hospital researchers have found that nephrogenic systemic fibrosis struck 13% of all hemodialysis patients and 30% of hemodialysis patients who underwent gadolinium-enhanced MRI.