Purpose To evaluate the reliability of ultrasound hepatorenal index (US-HRI) and magnetic resonance imaging proton density fat fraction (MRI-PDFF) techniques in the diagnosis of hepatic steatosis, with magnetic resonance spectroscopy proton density fat fraction (MRS-PDFF) as the reference standard. Materials and methods Fifty-two adult volunteers (30 men, 22 women; age, 31.5 ± 6.5 years) who had no history of kidney disease or viral/alcoholic hepatitis were recruited to undergo abdominal US, MRI, and MRS examinations. US-HRI was calculated from the average of three pairs of regions of interest (ROIs) measurements placed in the liver parenchyma and right renal cortex. On MRI, the six-point Dixon technique was employed for calculating proton density fat fraction (MRI-PDFF). An MRS sequence with a typical voxel size of 27 ml was chosen to estimate MRS-PDFF as the gold standard. The data were evaluated using Pearson’s correlation coefficient and receiver operating characteristic (ROC) curves. Results The Pearson correlation coefficients of US-HRI and MRI-PDFF with MRS-PDFF were 0.38 (p = 0.005) and 0.95 (p<0.001), respectively. If MRS-PDFF ≥5.56% was defined as the gold standard of fatty liver disease, the areas under the curve (AUCs), cut-off values, sensitivities and specificities of US-HRI and MRI-PDFF were 0.74, 1.54, 50%, 91.7% and 0.99, 2.75%, 100%, 88.9%, respectively. The intraclass correlation coefficients (ICCs) of US-HRI and MRI-PDFF were 0.70 and 0.85. Conclusion MRI-PDFF was more reliable than US-HRI in diagnosing hepatic steatosis.

The purpose of this study was to develop an optimizing program of scanning parameters for double inversion recovery (DIR) MRI. The optimization algorithm consists of the following steps: (1) obtaining the initial parameters (TR, TE, and T1 values of the two attenuated tissues); (2) iterative calculation for minimization of errors; and (3) determination of the optimized TI(1st) and TI(2nd). To evaluate the developed algorithm, we performed the phantom and simulation studies using the phantoms which were imitated T1 values of white and gray matters and cerebrospinal fluid. In addition, white matter attenuated inversion recovery (WAIR) and gray matter attenuated inversion recovery (GAIR) images were obtained by optimized scan parameters in one volunteer. The developed algorithm could calculate the optimized TI(1st) and TI(2nd) values at once. Results of summation of signal intensity (SI) of two attenuated tissues shows that the SI of the two tissues were well-attenuated using the theoretical values which were calculated using the developed algorithm. The correlation coefficient of the SI of the phantom of the gray matter between actual and simulation measurements was r=0.997. The SI obtained by actual measurements well correlated with the SI obtained by the simulation measurements. The WAIR and GAIR images in the volunteer were well enhanced gray or white matters. We thus conclude that it is possible to calculate the optimized parameters for the DIR-MRI using the developed algorithm.

No abstract

SummaryIt is important to optimize imaging parameters in 3D-double inversion recovery (DIR) magnetic resonance imaging (MRI) for detecting cortical micro lesions. However, inadequate parameters markedly raise blurring in 3D-DIR MRI. The purpose of this study was to evaluate the relationship between the blurring and refocus flip angle (RFA) in 3D-DIR MRI. White matter attenuated inversion recovery (WAIR) images as a test sample were obtained by 1.5T MRI with various RFA settings (30°, 40°, 60°, 100°, 140°, 180°, and variable refocus flip angle (VRFA)). Optimal RFA was evaluated using Schefféʼs method (Nakaya changing method) by five observers. The results of average preferences indicated that RFA settings of under the 60°of RFA or VRFA suppressed the blurring in 3D-DIR MRI. The yard sticks of RFAs of 30°and 40°were significantly higher than the yard sticks of other RFAs (p< 0.01). For detecting cortical microlesions, it is very important to obtain WAIR images with no blurring. Using low RFA or VRFA didnʼt cause significant differences of signal intensity between high-frequency region and lowfrequency region in k-space of 3D-DIR MRI. Therefore, it is recommended to set lower RFA (under 60°or VRFA) for suppressing blur in 3D-DIR MRI.

No abstract