MRI技術(shù)進(jìn)展及臨床應(yīng)用

1、1會計(jì)學(xué)MRI技術(shù)進(jìn)展及臨床應(yīng)用技術(shù)進(jìn)展及臨床應(yīng)用lDiffusion-weighted EPI demonstrates acute stroke in parietal lobelSub-acute, chronic lesions appear isointense or hypointense relative to acute lesionlFLAIR + DW-EPI used to differentiate new from old lesions陳舊區(qū)陳舊區(qū)細(xì)胞毒性細(xì)胞毒性水腫區(qū)水腫區(qū)Negative Enhancement Integral (NEI)rCBV灌注成象研究灌

2、注成象研究Mean Time to Enhance (MTE, MTT)新浪潮軟件新浪潮軟件灌注成象研究灌注成象研究 Patient Status: post surgery and radiotherapy for glioblastoma EPI imaging is added to conventional MR to generate CBV Maps CBV Map can differentiate recurrent tumor from necrotic tissue or edemaEdema orRecurrent Tumor?Recurrent tumornot see

3、n on T2 or T1Recurrent TumorCBV MapT2T1新浪潮軟件新浪潮軟件腦血流灌注診斷術(shù)后腫瘤再發(fā)腦血流灌注診斷術(shù)后腫瘤再發(fā)lSt. Lukes Hospital, Milwaukee, WI, Breger et al.Diffusion vs. DSCreveals tissue-at-riskNEI圖圖MTE圖圖 human brain mapping臨床應(yīng)用臨床應(yīng)用:功能區(qū)域定位功能區(qū)域定位刺激反應(yīng)程度刺激反應(yīng)程度手術(shù)計(jì)劃系統(tǒng)手術(shù)計(jì)劃系統(tǒng)非損傷性治療非損傷性治療AVM Patient presenting with AVM in middle temporal

4、 lobe fMRI of auditory activation performed with EPI imaging Eloquent region involved with auditory reception indentified posterior and superior to AVM - avoided and preserved during subsequent treatmentAVMHospital of the University of Pennsylvaniaauditory receptionfMRI用于手術(shù)計(jì)劃系統(tǒng)用于手術(shù)計(jì)劃系統(tǒng)聽覺中樞反射區(qū)聽覺中樞反射區(qū)

5、 Provides the capability to obtain the apparent diffusion Provides the capability to obtain the apparent diffusion coefficient of underlying tissue and exp (-bcoefficient of underlying tissue and exp (-b* *ADC) to ADC) to eliminate/reduce T2-shine through effectseliminate/reduce T2-shine through eff

6、ectsADC Mapping - FuncTool99ADC Mapping - FuncTool99T1-PostFLAIRADCRelativeAnisotropyImage Courtesy of Dr. Tsuruda, University of UtahClinical Applications of Real-time fMRIImage Courtesy of Dr. Jackson, Dr. Sawaya, Dr. LeedsMD Andersen Cancer Center, HoustonSurgical PlanningLeft-handfinger tappingS

7、peed, Performance and Reliability Dedicated CardioVascular MR Ultrafast Techniques Tissue Characterization Coronary Myocardial Perfusion Detection of Infarct Time resolved MR angio Vessel Wall Imaging Interactive real time Flow quantification22ECG-Gated Double IR FSEAddenbrookes Hosp., Cambridge, UK

8、MR High resolution image of aortic valveCardiac Morphology ECG-gated black blood FSE Blood & fat suppressed using Dbl/Trpl IR High resolution images of aortic valve, comparable to EchoNHLBI,GEMSEpstein et al.Echocardiography image of aortic valveThe most powerful system in the industry Clinical

9、MR Ventricular Function / MorphologyLCE-NHLBI 16 sec breath-hold Full R-R coverage High spatial and temporal resolutionFASTCINEAortic DiseaseKerckhoff Heart Klinik, GermanyIdentification of fatty infiltration in the infarcted regionfat suppressedT1 breathholdUltrafast Imaging of the Coronaries2D bre

10、athhold3D breathhold3D BreathholdLeft CoronaryRight CoronaryAortic RootLeft CircumflexLeft Coronary Artery StenosisUniversity Hospital, RotterdamConventional Angiography 3D Breathhold MRAVolume RenderedKerckhoff Heart Klinik, GermanyClear Visualization of the Coronaries2D Breathhold: 10 sec2D Breath

11、hold TSECoronary MR Angiographywithout contrast agentERESA Imaging Center, Valencia, SpainUltrafast 3D imaging in 23 seconds Northwestern University, ChicagoNorthwestern University, ChicagoUltrafast 3D imaging in 23 secondsDynamic first-pass perfusionBreathhold T2pre-contrastPatient with Subendocard

12、ialInfarctLesion Detection and Myocardial PerfusionStenosis in a branch vesselof the circumflex coronary arteryMyocardial Viabilityfast and robustdetection of infarctsNorthwestern University, ChicagoWall Motion StudyViability Studywithout ECG triggeringfree breathing高分辨率高分辨率 MRAMRA1024 ZIP 1024 ZIP

13、提供比提供比10241024采集更短采集更短的掃描時(shí)間和更小的信噪比損失的掃描時(shí)間和更小的信噪比損失n3DTOF MRA3DTOF MRAu512, 1024 ZIP512, 1024 ZIPu2x, 4x Through-2x, 4x Through-plane ZIPplane ZIPnImproves Improves ApparentApparent ResolutionResolution512x192, thru-plane ZIP45/6.9 TR/TE, 20 x20 FOV120 SLICES, 9:17imagingvolumeTrackervolume 跟跟 蹤蹤 區(qū)區(qū)

14、掃掃 描描 區(qū)區(qū)400 micronresolution3D volume renderingCleveland Clinic3D Pulmonary MR Angiography3D volumetric imaging in 3 seconds unbeatable in the industry!Time Resolved 3D MR AngiographyVisualizes contrast arrival in 3Dfollowing contrast injectiontime3D Carotid MRA in 9 secs Panoramic array coil for ex

15、tended coverage 正常門脈、腸系膜上靜脈FL3d 3.15/1.23, FA=25度，度，1.5mm, 64層，層，230*256， BW=490，TA=16s, MIP SubMIP門脈高壓，靜脈曲張 Moving TablePeripheral MR Angiographycourtesy of Dr. Terwey, Bremencourtesy of Dr. Terwey, Bremen 臨床應(yīng)用臨床應(yīng)用 膽總管膽總管下端嵌下端嵌頓結(jié)石頓結(jié)石胰頭癌胰頭癌FS-Fl2d-T1WI HASTE-T2WI 胰頭癌胰頭癌厚層厚層MRCP 薄層斜冠狀薄層斜冠狀MRCP 胰頭癌胰頭癌

16、動脈期動脈期門脈期門脈期延遲期延遲期PROBE-SI 1500/14424 x 24 14.4 min頻譜頻譜NAACrChoMixChoroidGlxNAACrlac頻 譜Visualization: Spectroscopic Imaging 膽膽 堿堿/ 肌肌 酸酸頻譜成像Image generously provided by J. Kurhanewicz, H. Hricak,D. Vigneron, and S. Nelson, UCSF. Provides the capability to obtain the apparent diffusion Provides the c

17、apability to obtain the apparent diffusion coefficient of underlying tissue and exp (-bcoefficient of underlying tissue and exp (-b* *ADC) to ADC) to eliminate/reduce T2-shine through effectseliminate/reduce T2-shine through effectsADC Mapping - FuncTool99ADC Mapping - FuncTool99Clinical Application

18、s of Real-time fMRIImage Courtesy of Dr. Jackson, Dr. Sawaya, Dr. LeedsMD Andersen Cancer Center, HoustonSurgical PlanningLeft-handfinger tappingMR High resolution image of aortic valveCardiac Morphology ECG-gated black blood FSE Blood & fat suppressed using Dbl/Trpl IR High resolution images of aortic valve, comparable to EchoNHLBI,GEMSEpstein et al.Echocardiography image of aortic