Clinicians and radiologists should be aware of IFI in patients with hip or groin pain, and MRI should be obtained for the presence of the QFM edema/fatty replacement, narrowing of the IFS-QFS, and other features that may help in the clinical diagnosis of IFI for the proper diagnosis and treatment of the disease.
SUMMARY: CE-MRC has been in use for the past 15 years and was reported to be a useful method in the evaluation of CSF disorders and hydrocephalus. The use of CE-MRC in conjunction with other MR imaging techniques has been shown to be effective in selected cases for the evaluation of several disorders of cerebrospinal system. CE-MRC has certain advantages over other cisternographic studies with fewer side effects if performed properly. Although intrathecal Gd administration is not widely accepted yet, several recent studies have reported the safety of small-dose intrathecal gadolinium injection. In this review, we describe CE-MRC and review recent applications in several clinical conditions. ABBREVIATIONS: AC ϭ arachnoid cyst; AS ϭ aqueductal stenosis; CE ϭ contrast-material enhanced; CISS ϭ constructive interference in steady state; CTC ϭ CT
ABSTRACT. The aim of this prospective study was to evaluate the value of unenhanced (three-dimensional constructive interference in steady state (3D-CISS)) and contrastenhanced MR cisternography (CE-MRC) in detecting the localisation of cerebrospinal fluid (CSF) leak in patients with rhinorrhoea. 17 patients with active or suspected CSF rhinorrhoea were included in the study. 3D-CISS sequences in coronal and sagittal planes and fat-suppressed T 1 -weighted spin-echo sequences in three planes before and after intrathecal contrast media adminstration were obtained. Images were obtained of the cribriform plate and sphenoid sinus. In addition, high-resolution CT (HRCT) was performed in order to evaluate the bony elements. The leak was present in 9/17 patients with 3D-CISS and 10/17 patients with CE-MRC. The leak from the cribriform plate to the nasal cavity in six patients and from the sphenoid sinus in four patients was nicely shown by CE-MRC. Eight of those patients were surgically treated, but spontaneous regression of the symptoms in two precluded any intervention. The leak localisations shown with CE-MRC were fully compatible with surgical results. The sensitivities of HRCT, 3D-CISS and CE-MRC for showing CSF leakage were 88%, 76% and 100%, respectively. In conclusion, 3D-CISS is a non-invasive and reliable technique, and should be the first-choice method to localise CSF leak. CE-MRC is helpful in conditions when there is no leak or in complicated cases with a positive b2-transferrin measurement.
PC-MRI is helpful in confirming the AS. However, positive flow does not necessarily exclude the existence of AS. 3D-CISS sequence provides excellent cerebrospinal fluid-to-aqueduct contrast, allowing detailed study of the anatomic features of the aqueduct. MRC should be performed on patients who demonstrate suspected AS findings on PC-MRI and/or 3D-CISS sequences.
In this work, it is demonstrated that a dual-drive birdcage coil can be used to reduce the radiofrequency heating of metallic devices during magnetic resonance imaging. By controlling the excitation currents of the two channels of a birdcage coil, the radiofrequency current that is induced near the lead tip could be set to zero. To monitor the current, the image artifacts near the lead tips were measured. The electric field distribution was controlled using a dual-drive birdcage coil. With this method, the lead currents and the lead tip temperatures were reduced substantially [<0.3°C for an applied 4.4 W/kg SAR compared to >4.9°C using quadrature excitation], as demonstrated by phantom and animal experiments. The homogeneity of the flip angle distribution was preserved, as shown by volunteer experiments. The normalized root-mean-square error of the flip angle distribution was less than 10% for all excitations. The average specific absorption rate increased as a trade-off for using different excitation patterns. Magn Reson Med 69:845-852, 2013. V C 2012 Wiley Periodicals, Inc.
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