Multispectral diffusion-weighted MRI of the instrumented cervical spinal cord: a preliminary study of 5 cases

Koch, Kevin M.; Bhave, Sampada; Kaushik, S. Sivaram; Nencka, Andrew S.; Budde, Matthew D.

doi:10.1007/s00586-019-06239-z

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Each slice package was oriented orthogonal to the local spinal cord axis. Both DW-MSI and DW-FOCUS images were acquired with 2.5 × 2.5 mm in plane resolution, using echo times of 56 ms and repetition times of 4 s. A single b = 0 image was acquired and 3 orthogonal diffusion-weighted images were acquired with a b-value of 600 m/s 2 , which was previously found to be suitable for DW imaging of the spinal cord using DW-MSI (22). In instrumented CSM subjects, only a single FOCUS-DW slice package was acquired for artifact demonstration purposes at an instrumented level.…”

Section: Image Acquisitionsmentioning

confidence: 99%

“…More recently, Lee et al (21) proposed a 3D-MSI approach by developing carefully matched MSI-specific radiofrequency pulses for diffusion sensitization. In the present report, we utilize the 2D approach of Koch et al ( 16), which has recently been demonstrated in preliminary applications for spinal cord imaging (22), assessment of soft tissue pathology near total hip replacements (23), and quantitatively assessed utilizing standardized phantoms (24).…”

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confidence: 99%

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Diffusion-weighted MRI of the spinal cord in cervical spondylotic myelopathy after instrumented fusion

et al. 2023

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IntroductionThis study investigated tissue diffusion properties within the spinal cord of individuals treated for cervical spondylotic myelopathy (CSM) using post-decompression stabilization hardware. While previous research has indicated the potential of diffusion-weighted MRI (DW-MRI) markers of CSM, the metallic implants often used to stabilize the decompressed spine hamper conventional DW-MRI.MethodsUtilizing recent developments in DW-MRI metal-artifact suppression technologies, imaging data was acquired from 38 CSM study participants who had undergone instrumented fusion, as well as asymptomatic (non-instrumented) control participants. Apparent diffusion coefficients were determined in axial slice sections and split into four categories: a) instrumented levels, b) non-instrumented CSM levels, c) adjacent-segment (to instrumentation) CSM levels, and d) non-instrumented control levels. Multi-linear regression models accounting for age, sex, and body mass index were used to investigate ADC measures within each category. Furthermore, the cord diffusivity within CSM subjects was correlated with symptom scores and the duration since fusion procedures.ResultsADC measures of the spinal cord in CSM subjects were globally reduced relative to control subjects (p = 0.005). In addition, instrumented levels within the CSM subjects showed reduced diffusivity relative to controls (p = 0.003), while ADC within non-instrumented CSM levels did not statistically deviate from control levels (p = 0.107).DiscussionMulti-spectral DW-MRI technology can be effectively employed to evaluate cord diffusivity near fusion hardware in subjects who have undergone surgery for CSM. Leveraging this advanced technology, this study had identified significant reductions in cord diffusivity, relative to control subjects, in CSM patients treated with conventional metallic fusion instrumentation.

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Section: Image Acquisitionsmentioning

confidence: 99%

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confidence: 99%

Diffusion-weighted MRI of the spinal cord in cervical spondylotic myelopathy after instrumented fusion

et al. 2023

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“…Because of its low SNR efficiency, initial demonstration of 2D DW‐MSI was limited to low b‐values of 150–300 s/mm 2 , slice coverage of one to four slices, and required six averages in scan times of 4.5 to 6 minutes. In the spine, 2D DW‐MSI achieved a greater b‐value of 600 s/mm 2 , but was still limited to three slices 25 . Furthermore, a high RF BW is required to excite spins near the metal, but the 2D DW‐MSI approach used a relatively small bin BW of 600 Hz.…”

Section: Introductionmentioning

confidence: 99%

“…In the spine, 2D DW-MSI achieved a greater b-value of 600 s/ mm 2 , but was still limited to three slices. 25 Furthermore, a high RF BW is required to excite spins near the metal, but the 2D DW-MSI approach used a relatively small bin BW of 600 Hz. This limitation is due to peak B 1 amplitude constraints from the 180° refocusing pulse used for diffusion encoding and increases imaging time to maintain adequate spectral coverage.…”

Section: Introductionmentioning

confidence: 99%

Volumetric and multispectral DWI near metallic implants using a non‐linear phase Carr‐Purcell‐Meiboom‐Gill diffusion preparation

Lee

Yoon

Sandberg

et al. 2022

Magnetic Resonance in Med

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Purpose DWI near metal implants has not been widely explored due to substantial challenges associated with through‐slice and in‐plane distortions, the increased encoding requirement of different spectral bins, and limited SNR. There is no widely adopted clinical protocol for DWI near metal since the commonly used EPI trajectory fails completely due to distortion from extreme off‐resonance ranging from 2 to 20 kHz. We present a sequence that achieves DWI near metal with moderate b‐values (400–500 s/mm2) and volumetric coverage in clinically feasible scan times. Theory and Methods Multispectral excitation with Cartesian sampling, view angle tilting, and kz phase encoding reduce in‐plane and through‐plane off‐resonance artifacts, and Carr‐Purcell‐Meiboom‐Gill (CPMG) spin‐echo refocusing trains counteract T2* effects. The effect of random phase on the refocusing train is eliminated using a stimulated echo diffusion preparation. Root‐flipped Shinnar‐Le Roux refocusing pulses permits preparation of a high spectral bandwidth, which improves imaging times by reducing the number of excitations required to cover the desired spectral range. B1 sensitivity is reduced by using an excitation that satisfies the CPMG condition in the preparation. A method for ADC quantification insensitive to background gradients is presented. Results Non‐linear phase refocusing pulses reduces the peak B1 by 46% which allows RF bandwidth to be doubled. Simulations and phantom experiments show that a non‐linear phase CPMG pulse pair reduces B1 sensitivity. Application in vivo demonstrates complementary contrast to conventional multispectral acquisitions and improved visualization compared to DW‐EPI. Conclusion Volumetric and multispectral DW imaging near metal can be achieved with a 3D encoded sequence.

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Diffusion-weighted MRI of total hip arthroplasty for classification of synovial reactions: A pilot study

Gao¹,

Tan²,

Neri³

et al. 2023

Magnetic Resonance Imaging

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Multispectral diffusion-weighted MRI of the instrumented cervical spinal cord: a preliminary study of 5 cases

Cited by 4 publications

References 23 publications

Diffusion-weighted MRI of the spinal cord in cervical spondylotic myelopathy after instrumented fusion

Diffusion-weighted MRI of the spinal cord in cervical spondylotic myelopathy after instrumented fusion

Volumetric and multispectral DWI near metallic implants using a non‐linear phase Carr‐Purcell‐Meiboom‐Gill diffusion preparation

Diffusion-weighted MRI of total hip arthroplasty for classification of synovial reactions: A pilot study

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