Chronic liver diseases often result in the development of liver fibrosis and ultimately, cirrhosis. Treatment strategies and prognosis differ greatly depending on the severity of liver fibrosis, thus liver fibrosis staging is clinically relevant. Traditionally, liver biopsy has been the method of choice for fibrosis evaluation. Because of liver biopsy limitations, noninvasive methods have become a key research interest in the field. Elastography enables the noninvasive measurement of tissue mechanical properties through observation of shear-wave propagation in the tissue of interest. Increasing fibrosis stage is associated with increased liver stiffness, providing a discriminatory feature that can be exploited by elastographic methods. Ultrasonographic (US) and magnetic resonance (MR) imaging elastographic methods are commercially available, each with their respective strengths and limitations. Here, the authors review the technical basis, acquisition techniques, and results and limitations of US- and MR-based elastography techniques. Diagnostic performance in the most common etiologies of chronic liver disease will be presented. Reliability, reproducibility, failure rate, and emerging advances will be discussed. RSNA, 2018 Online supplemental material is available for this article.
Neurological disorders are one of the most important public health concerns in developed countries. Established brain imaging techniques such as magnetic resonance imaging (MRI) and x-ray computerised tomography (CT) have been essential in the identification and diagnosis of a wide range of disorders, although usually are insufficient in sensitivity for detecting subtle pathological alterations to the brain prior to the onset of clinical symptoms-at a time when prognosis for treatment is more favourable. The mechanical properties of biological tissue provide information related to the strength and integrity of the cellular microstructure. In recent years, mechanical properties of the brain have been visualised and measured non-invasively with magnetic resonance elastography (MRE), a particularly sensitive medical imaging technique that may increase the potential for early diagnosis. This review begins with an introduction to the various methods used for the acquisition and analysis of MRE data. A systematic literature search is then conducted to identify studies that have specifically utilised MRE to investigate the human brain. Through the conversion of MRE-derived measurements to shear stiffness (kPa) and, where possible, the loss tangent (rad), a summary of results for global brain tissue and grey and white matter across studies is provided for healthy participants, as potential baseline values to be used in future clinical investigations. In addition, the extent to which MRE has revealed significant alterations to the brain in patients with neurological disorders is assessed and discussed in terms of known pathophysiology. The review concludes by predicting the trends for future MRE research and applications in neuroscience.
The noninvasive measurement of the mechanical properties of brain tissue using magnetic resonance elastography (MRE) has emerged as a promising method for investigating neurological disorders. To date, brain MRE investigations have been limited to reporting global mechanical properties, though quantification of the stiffness of specific structures in the white matter architecture may be valuable in assessing the localized effects of disease. This paper reports the mechanical properties of the corpus callosum and corona radiata measured in healthy volunteers using MRE and atlas-based segmentation. Both structures were found to be significantly stiffer than overall white matter, with the corpus callosum exhibiting greater stiffness and less viscous damping than the corona radiata. Reliability of both local and global measures was assessed through repeated experiments, and the coefficient of variation for each measure was less than 10%. Mechanical properties within the corpus callosum and corona radiata demonstrated correlations with measures from diffusion tensor imaging pertaining to axonal microstructure.
Purpose To develop data acquisition and image reconstruction methods to enable high-resolution 1H MR spectroscopic imaging (MRSI) of the brain, using the recently proposed subspace-based spectroscopic imaging framework called SPICE (SPectroscopic Imaging by exploiting spatiospectral CorrElation). Theory and Methods SPICE is characterized by the use of a subspace model for both data acquisition and image reconstruction. For data acquisition, we propose a novel spatiospectral encoding scheme that provides hybrid data sets for determining the subspace structure and for image reconstruction using the subspace model. More specifically, we use a hybrid chemical shift imaging (CSI)/echo-planar spectroscopic imaging (EPSI) sequence for two-dimensional (2D) MRSI and a dual-density, dual-speed EPSI sequence for three-dimensional (3D) MRSI. For image reconstruction, we propose a method that can determine the subspace structure and the high-resolution spatiospectral reconstruction from the hybrid data sets generated by the proposed sequences, incorporating field inhomogeneity correction and edge-preserving regularization. Results Phantom and in vivo brain experiments were performed to evaluate the performance of the proposed method. For 2D MRSI experiments, SPICE is able to produce high SNR spatiospectral distributions with an approximately 3 mm nominal in-plane resolution from a 10-min acquisition. For 3D MRSI experiments, SPICE is able to achieve an approximately 3 mm in-plane and 4 mm through-plane resolution in about 25 min. Conclusion Special data acquisition and reconstruction methods have been developed for high-resolution 1H-MRSI of the brain using SPICE. Using these methods, SPICE is able to produce spatiospectral distributions of 1H metabolites in the brain with high spatial resolution, while maintaining a good SNR. These capabilities should prove useful for practical applications of SPICE.
Purpose To develop an acquisition scheme for generating magnetic resonance elastography (MRE) displacement data with whole-brain coverage, high spatial resolution, and adequate signal-to-noise ratio (SNR) in a short scan time. Theory and Methods A 3D multislab, multishot acquisition for whole-brain MRE with 2.0 mm isotropic spatial resolution is proposed. The multislab approach allowed for the use of short repetition time to achieve very high SNR efficiency. High SNR efficiency allowed for a reduced acquisition time of only six minutes while the minimum SNR needed for inversion was maintained. Results The mechanical property maps estimated from whole-brain displacement data with nonlinear inversion (NLI) demonstrated excellent agreement with neuroanatomical features, including the cerebellum and brainstem. A comparison with an equivalent 2D acquisition illustrated the improvement in SNR efficiency of the 3D multislab acquisition. The flexibility afforded by the high SNR efficiency allowed for higher resolution with a 1.6 mm isotropic voxel size, which generated higher estimates of brainstem stiffness compared with the 2.0 mm isotropic acquisition. Conclusions The acquisition presented allows for the capture of whole-brain MRE displacement data in a short scan time, and may be used to generate local mechanical property estimates of neuroanatomical features throughout the brain.
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