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Patients with Crohn’s disease can develop intestinal strictures, containing various degrees of inflammation and fibrosis. Differentiation of the main component of a stricturing lesion is the key for defining the therapeutic management. We assessed for the first time the accuracy of magnetic resonance elastography in detecting intestinal fibrosis and predicting clinical course in patients with Crohn’s disease. This was a prospective study of adult patients with Crohn’s disease and magnetic resonance imaging examination, including magnetic resonance elastography, between April 2019 and February 2020. The association between the bowel stiffness value and the degree of fibrosis was evaluated. The relationship between the stiffness value and the occurrence of clinical events was also investigated. A total of 69 patients were included. The stiffness value measured by magnetic resonance elastography was correlated with the degree of fibrosis (p

International audience; Ventricular tachycardia (VT) is a life-threatening arrhythmia, which can be treated by catheter intervention. Accurate identification of the underlying reentrant circuit is often challenging, yet it is key to successful ablation of the VT. In practice, the cardiologist often uses electrocardiography (ECG) data provided by various catheter mapping techniques, including parameters acquired during sinus rhythm (voltage maps, presence of fragmented/late potentials) and during controlled pacing from different sites of the ventricle, so-called pace-mapping. A novel method is presented here to automatically extract the key information from pace-mapping data with automated detection of paced heartbeats from the surface ECG signals, using wavelet detection of pacing spikes and combined time/energy criteria, and automated delineation of paced beats, QRS peak, and QRS onset. This allows the generation of correlation gradient maps (indicating QRS morphology changes as the catheter is moved) and stimulus-to-QRS maps (sQRS, indicating the delay between pacing and activation of the healthy myocardium). The delineator is shown to be in good agreement with manual annotations from experts in a retrospective study of 18 VT ablation procedures. Paced-QRS detection had 95.2% sensitivity and 98.4% positive predictive value. Resulting sQRS maps had a mean absolute error of 11.1 ms, which was in the same range as the inter-observer errors (9.7 ms). The automatic processing drastically reduces the need for manual annotations. Therefore it makes it feasible to process and visualize, during the procedure, all the relevant parametric maps, which can be analyzed jointly to identify VT circuits and corresponding ablation targets.

Immer mehr Patienten mit aktiven implantierbaren medizinischen Geraten (AIMDs) benotigen Magnetresonanz(MR)-Untersuchungen. Die Hersteller sind dabei, die MR-Kompatibilitat ihrer AIMDs zu verbessern. Dafur werden verschiedenste Messmethoden und numerische Simulationen durchgefuhrt, um die Risiken in Bezug auf die Magnetresonanztomographie (MRT) zu evaluieren. Dieser Beitrag gibt einen Uberblick uber die verwendeten Testmethoden, welche die Interaktionen zwischen AIMDs mit Hochfrequenzfeldern und zeitveranderlichen magnetischen Feldgradienten untersuchen. Ein Literaturuberblick uber die bekannten Testmethoden fur Feldgradienten- und Hochfrequenzexposition von AIMDs mit Anschlussleitungen, insbesondere bei Neurostimulatoren, Cochlea-Implantaten und implantierten Arzneimittelpumpen, wird prasentiert. Der Stand der Technik und vielversprechende Verfahren werden diskutiert. ISO/TS 10974 beschreibt das Design von Hochfrequenz- und Gradienteninjektionsaufbauten fur konduktive Materialtests. Zur Messung der induzierten Spannungen und Strome durch Hochfrequenz- und Gradientenfelder sowie zur Uberwachung der AIMDs wahrend MR-Untersuchungen bei In-vitro-Tests wurde eine Vielzahl von Sensordesigns publiziert. Die Testmethoden sind so konservativ wie moglich ausgelegt und mussen den ungunstigsten Fall abdecken. Allerdings sind In-vitro-Messungen und Computersimulation weit davon entfernt, jede mogliche Konfiguration in ihrer Komplexitat und Einzigartigkeit zu erfassen. Fur sicherere MR-Untersuchungen werden in der rezentesten Forschung In-vivo-Testung vor der MR-Untersuchung, parallele Hochfrequenzsendetechniken und neue Sequenzen mit reduziertem Energieeintrag in der Anwesenheit von AIMDs vorgeschlagen.

International audience

International audience; Introduction: T1-based method is considered as the gold standard for extracellular volume fraction (ECV) mapping. This technique requires at least a 10 min delay after injection to acquire the post injection T1 map. Quantitative analysis of Dynamic Contrast Enhancement (DCE) images could lead to an earlier estimation of an ECV like parameter (2 min). The purpose of this study was to design a quantitative pixel-wise DCE analysis workflow to assess the feasibility of an early estimation of ECV.Methods: Fourteen patients with mitral valve prolapse were included in this study. The MR protocol, performed on a 3 T MR scanner, included MOLLI sequences for T1 maps acquisition and a standard SR-turboFlash sequence for dynamic acquisition. DCE data were acquired for at least 120 s. We implemented a full DCE analysis pipeline with a pre-processing step using an innovative motion correction algorithm (RC-REG algorithm) and a post-processing step using the extended Tofts Model (ECVETM). Estimated ECVETM maps were compared to standard T1-based ECV maps (ECVT1) with both a Pearson correlation analysis and a group-wise analysis.Results: Image and map quality assessment showed systematic improvements using the proposed workflow. Strong correlation was found between ECVETM, and ECVT1 values (r-square = 0.87).Conclusion: A DCE analysis workflow based on RC-REG algorithm and ETM analysis can provide good quality parametric maps. Therefore, it is possible to extract ECV values from a 2 min-long DCE acquisition that are strongly correlated with ECV values from the T1 based method.

International audience; Tongue contour extraction from real-time magnetic resonance images is a nontrivial task due to the presence of artifacts manifesting in form of blurring or ghostly contours. In this work, we present results of automatic tongue delineation achieved by means of U-Net auto-encoder convolutional neural network. We present both intra- and inter-subject validation. We used real-time magnetic resonance images and manually annotated 1-pixel wide contours as inputs. Predicted probability maps were post-processed in order to obtain 1-pixel wide tongue contours. The results are very good and slightly outperform published results on automatic tongue segmentation.

This paper tackles the problem of estimating exposure to static magnetic field (SMF) in magnetic resonance imaging (MRI) sites using a non-invasive approach. The proposed approach relies on a vision-based system to detect people's body parts and on a mathematical model to compute SMF exposure. A multi-view camera system was used to capture the MRI room, and a vision-based system was applied to detect body parts. The detected localization was then fed into a mathematical model to compute SMF exposure. In this study, we focused on exposure at the neck due to two main reasons. First, according to regulations, the limit of exposure at head and trunk for MR workers is higher than that for the general public. Second, it was easier to attach a dosimeter at the neck to perform measurements, which allowed a quantitative evaluation of our approach. This approach was applied to two scenarios simulating the daily movements of medical workers for which dosimeter measurements were also recorded. The results indicated that the proposed approach predicted occupational SMF exposure with reasonable accuracy compared with the dosimeter measurements. The proposed approach is a simple safe working procedure to estimate the exposure of MR workers at different parts of the body without wearing any marker detection. It can be applied to reduce occupational SMF exposure, without changes in workers' performances. For that reason, our non-invasive proposed method can be used as a simple safety tool to estimate occupational SMF exposure in MR sites. Bioelectromagnetics. 39:503-515, 2018.© 2018 Wiley Periodicals, Inc.

Background The relative modification of the myocardial volume between end-systole and end-diastole ([Formula: see text]) has already been assessed with different methods and falls in a range of 0.9–0.97 (mean value = 0.93). Purpose To estimate [Formula: see text] from the three longitudinal ([Formula: see text], circumferential ([Formula: see text]), and radial ([Formula: see text]) strains of the left ventricle using the formula: [Formula: see text] and to test whether this estimate of [Formula: see text] can be used as a marker of the echocardiography quality. Material and Methods Two hundred manuscripts, including a total of 34,690 patients or healthy volunteers, were identified in the Medline database containing values of [Formula: see text], [Formula: see text], and [Formula: see text] measured from echocardiography. Results The median value of was 0.93, in accordance with the literature, with no significant difference between patients or healthy volunteers ( P = 0.38). The proportion of studies with [Formula: see text] was 79%. When only considering groups of healthy volunteers, the studies failing this test had higher standard deviations for the three individual strains: 0.038 vs. 0.029 ( P = 0.02) for [Formula: see text]; 0.060 vs. 0.034 ( P –6) for [Formula: see text], and 0.243 vs. 0.101 ( P –14) for [Formula: see text]. Conclusion The median ratio of the left ventricular myocardial volumes between end-systole and end-diastole in the investigated studies was [Formula: see text]. The formula [Formula: see text] could be used to detect studies with inaccurate strain measurements.

OBJECTIVE We aimed to characterize the association between pretreatment lesional volume measured on diffusion-weighted images and functional outcome, and estimate the impact on thrombectomy efficacy for ischemic stroke with anterior proximal intracranial arterial occlusion. METHODS Anterior circulation ischemic stroke patients who had pretreatment diffusion-weighted imaging in the THRACE study were included. Lesional volume was semiautomatically segmented. Logistic regression was applied to model clinical outcome as a function of lesional volume. Outcomes included functional independence (modified Rankin Scale [mRS] 0-2), degree of disability (ordinal mRS 0-6), and mortality at 3 months. RESULTS Of 298 included patients, with median lesional volume 17.2ml (interquartile range [IQR], 9.2-51.8) and median mRS 2 (IQR, 1-4), 51.0% achieved functional independence. Increased lesional volume was an independent predictor for a lower probability of functional independence (odds ratio [OR], 0.90 [95% confidence interval {CI}, 0.81-0.99] per 10ml; p

Pretreatment ischemic location may be an important determinant for functional outcome prediction in acute ischemic stroke. In total, 143 anterior circulation ischemic stroke patients in the THRACE study were included. Ischemic lesions were semi-automatically segmented on pretreatment diffusion-weighted imaging and registered on brain atlases. The percentage of ischemic tissue in each atlas-segmented region was calculated. Statistical models with logistic regression and support vector machine were built to analyze the predictors of functional outcome. The investigated parameters included: age, baseline National Institutes of Health Stroke Scale score, and lesional volume (three-parameter model), together with the ischemic percentage in each atlas-segmented region (four-parameter model). The support vector machine with radial basis functions outperformed logistic regression in prediction accuracy. The support vector machine three-parameter model demonstrated an area under the curve of 0.77, while the four-parameter model achieved a higher area under the curve (0.82). Regions with marked impacts on outcome prediction were the uncinate fasciculus, postcentral gyrus, putamen, middle occipital gyrus, supramarginal gyrus, and posterior corona radiata in the left hemisphere; and the uncinate fasciculus, paracentral lobule, temporal pole, hippocampus, inferior occipital gyrus, middle temporal gyrus, pallidum, and anterior limb of the internal capsule in the right hemisphere. In conclusion, pretreatment ischemic location provided significant prognostic information for functional outcome in ischemic stroke.

Purpose To evaluate by cardiac magnetic resonance imaging (MRI) the impact of microvascular obstruction (MVO) on regional left ventricular (LV) wall characteristics and local remodeling after acute myocardial infarction (AMI). Materials and Methods In all, 114 AMI patients underwent cardiac MRI at 3T within 2–4 days (baseline) and at 6 months (follow-up) after reperfusion. Late gadolinium enhancement and cine sequences were performed. The impact of MVO (ie, presence and extent) on regional wall thickening (WT, %), end-diastolic wall thickness (EDWT, mm), and local cavity change (mm) of LV were quantitatively analyzed. Local cavity change, calculated as surface-to-surface distance from registered endocardial surface meshes of cine imaging datasets acquired initially and at follow-up, was used to assess local remodeling. Results MVO was detected in 69 patients (60.5%). WT was significantly lower when MVO was present (P 75% with further thinning by MVO presence; and EDWT decreased with increasing MVO transmural extent (P < 0.0001). LV cavity shrank in patients without MVO, whereas it dilated in those with MVO. Local cavity changes were not significantly different by a region-to-region analysis throughout the LV within each group (P = 0.57 and 0.74, respectively). Conclusion MVO has a significant adverse effect on LV wall characteristics and LV remodeling. Postinfarct remodeling seems to be globally mediated rather than locally mediated during the first 6 months. Level of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017.

Aims Our study assesses the value of electrograms (EGMs) characteristics to identify a ventricular tachycardia (VT) isthmus entrance in patients with post-infarct VT. Post-infarct VTs are mostly due to a re-entrant circuit. A pacemapping (PM) approach is able to localize the VT isthmus during sinus rhythm. Limited data are available about the role of local EGMs in defining VT isthmus location. Methods and results Twenty consecutive patients (70% male) referred for post-infarct VT catheter ablation were included in the present study. The VT isthmus was defined according to the PM method. At each recording site, 10 characteristics of the local EGM were assessed to predict the location of the VT isthmus entrance. In total, 924 EGMs were acquired, of which 127 were located in the VT isthmus entrance. Logistic regression analysis showed that bipolar voltage, number of EGM positive peaks, and sQRS interval were independently associated with VT isthmus entrance location. The ROC curve best fitted the model at the cut-off 0.1641 (sensitivity 72%, specificity 75.2%, positive predictive value 31.3%, negative predictive value 94.4%, area under the curve 0.78, P Conclusion Our study suggests that three EGM characteristics: bipolar voltage, number of positive peaks, and sQRS interval can successfully identify a VT isthmus entrance in post-infarct patients.

International audience; Objective: A novel method is developed to identify ablation targets for the catheter treatment of ventricular tachycardia (VT). Methods: The method is based on pace-mapping, which is a validated technique to determine the catheter ablation targets. Conventionally, it consists of stimulating the heart ventricle from various sites and comparing the resulting activation pathways to that of a clinical VT by the analysis of surface electrocardiograms (ECG). In this paper, a novel pace-mapping method is presented, which does not require a reference ECG recording of the VT. A three-dimensional correlation gradient map is reconstructed by semiautomatic analysis of ECG morphological changes within the network of pace-mapping sites. In these maps, abnormal points are identified by high correlation gradient values (i.e., corresponding to slow propagation of the electric influx, as in the core of the reentrant VT circuit). The relation between the conventional and reference-less method is described theoretically and evaluated in a retrospective study including 24 VT ablation procedures. Results: The “reference-less” method was able to identify normal points with a high accuracy (negative predictive value: NPV = 97%), and to detect more abnormal points, as predicted by the theory. Correlation gradients computed by the proposed method were significantly higher in ablation zones than in other zones of the ventricle (p

International audience; Purpose: Current electrocardiography (ECG) devices in MRI use non-conventional electrode placement, have a narrow bandwidth, and suffer from signal distortions including magnetohydrodynamic (MHD) effects and gradient-induced artifacts. In this work a system is proposed to obtain a high-quality 12-lead ECG.Methods: A network of N electrically independent MR-compatible ECG sensors was developed (N = 4 in this study). Each sensor uses a safe technology - short cables, preamplification/digitization close to the patient, and optical transmission - and provides three bipolar voltage leads. A matrix combination is applied to reconstruct a 12-lead ECG from the raw network signals. A subject-specific calibration is performed to identify the matrix coefficients, maximizing the similarity with a true 12-lead ECG, acquired with a conventional 12-lead device outside the scan room. The sensor network was subjected to radiofrequency heating phantom tests at 3T. It was then tested in four subjects, both at 1.5T and 3T.Results: Radiofrequency heating at 3T was within the MR-compatibility standards. The reconstructed 12-lead ECG showed minimal MHD artifacts and its morphology compared well with that of the true 12-lead ECG, as measured by correlation coefficients above 93% (respectively, 84%) for the QRS complex shape during steady-state free precession (SSFP) imaging at 1.5T (respectively, 3T).Conclusion: High-quality 12-lead ECG can be reconstructed by the proposed sensor network at 1.5T and 3T with reduced MHD artifacts compared to previous systems. The system might help improve patient monitoring and triggering and might also be of interest for interventional MRI and advanced cardiac MR applications.

Increasing numbers of patients with active implantable medical devices (AIMDs) require magnetic resonance (MR) examinations. The manufacturers are continuing to improve the MR compatibility of their AIMDs. To this end, a variety of measurement methods and numerical simulations are used to evaluate the risks associated with magnetic resonance imaging (MRI). In this article, test methods used to investigate interactions between AIMDs with radio frequency fields and time-varying magnetic gradient fields are reviewed. A literature review of known test methods for radio frequency and gradient field exposure of AIMDs with leads, in particular for neurostimulators, cochlear implants, and implanted infusion pumps, is presented. The state of the art and promising methods are discussed. ISO/TS 10974 describes the design of high frequency and gradient injection setups to test conductive materials. A large number of sensor designs have been published to measure the induced voltages and currents through radio frequency and gradient fields and for monitoring AIMDs during MR examinations in in vitro tests. The test methods should be planned to be as conservative as possible to cover the worst case scenario. However, in vitro measurements and computer simulation are far from being able to cover all possible configurations in their complexity and uniqueness. For safer MR examinations, current research recommends in vivo testing prior to MR, parallel radiofrequency transmission techniques, and new sequences with reduced energy input in the presence of AIMDs.

Background With ablation, the follow-up of preexcitation syndrome now is difficult to assess. The purpose was to collect data of children with a preexcitation syndrome studied on two separate occasions within a minimal interval of 1 year. Methods This is a retrospective chart review of 47 children initially aged 12 ± 4 years, who underwent two or more invasive electrophysiological studies (EPS) within 1–25 years of one another (6.3 ± 4.8) for occurrence of symptoms or new evaluation. Results Among initially symptomatic children (n = 25), four (19%) became asymptomatic and one presented life-threatening arrhythmia. Among asymptomatic children (n = 22), five became symptomatic (22.7%). Anterograde conduction disappeared in seven of 23 children with initially long accessory pathway-effective refractory period, but four of six had still induced atrioventricular reentrant tachycardia (AVRT). AVRT was induced at second EPS in three of 13 asymptomatic preexcitation syndrome with negative initial EPS. There were no spontaneous adverse events in the five children with criteria of malignancy at initial EPS; signs of malignancy disappeared in two. At multivariate analysis, AVRT at initial EPS was the only independent factor of symptomatic AVRT during follow-up. Absence of induced AVRT at initial EPS was the only factor of absence of symptoms and a negative study at the second EPS. Conclusions There were no significant changes of data in children after 6.3 ± 4.8 years of follow-up. Most children with spontaneous/inducible AVRTs at initial EPS had still inducible AVRT at second EPS. Induced AF conducted with high rate has a relatively low prognostic value for the prediction of adverse events.

Purpose: To compare three widely used methods for myocardial infarct (MI) sizing on late gadolinium-enhanced (LGE) magnetic resonance (MR) images: manual delineation and two semiautomated techniques (full-width at half-maximum [FWHM] and n-standard deviation [SD]). Materials and methods: 3T phase-sensitive inversion-recovery (PSIR) LGE images of 114 patients after an acute MI (2-4 days and 6 months) were analyzed by two independent observers to determine both total and core infarct sizes (TIS/CIS). Manual delineation served as the reference for determination of optimal thresholds for semiautomated methods after thresholding at multiple values. Reproducibility and accuracy were expressed as overall bias ± 95% limits of agreement. Results: Mean infarct sizes by manual methods were 39.0%/24.4% for the acute MI group (TIS/CIS) and 29.7%/17.3% for the chronic MI group. The optimal thresholds (ie, providing the closest mean value to the manual method) were FWHM30% and 3SD for the TIS measurement and FWHM45% and 6SD for the CIS measurement (paired t-test; all P > 0.05). The best reproducibility was obtained using FWHM. For TIS measurement in the acute MI group, intra-/interobserver agreements, from Bland-Altman analysis, with FWHM30%, 3SD, and manual were -0.02 ± 7.74%/-0.74 ± 5.52%, 0.31 ± 9.78%/2.96 ± 16.62% and -2.12 ± 8.86%/0.18 ± 16.12, respectively; in the chronic MI group, the corresponding values were 0.23 ± 3.5%/-2.28 ± 15.06, -0.29 ± 10.46%/3.12 ± 13.06% and 1.68 ± 6.52%/-2.88 ± 9.62%, respectively. A similar trend for reproducibility was obtained for CIS measurement. However, semiautomated methods produced inconsistent results (variabilities of 24-46%) compared to manual delineation. Conclusion: The FWHM technique was the most reproducible method for infarct sizing both in acute and chronic MI. However, both FWHM and n-SD methods showed limited accuracy compared to manual delineation. J. Magn. Reson. Imaging 2016;44:1206-1217.

International audience; Objective: Despite being routinely acquired during MRI examinations for triggering or monitoring purposes, electrocardiogram (ECG) signal recording and analysis remain challenging due to the inherent magnetic environment of an MRI scanner. The ECG signals are particularly distorted by the induction of electrical fields in the body by the MRI gradients. In this study, we propose a new hardware and software solution for the acquisition of ECG signal during MRI up to 3 T.Approach: Instead of restricting the sensor bandwidth to limit these gradient artifacts, the new sensor architecture has a higher bandwidth, higher sampling frequency and larger input dynamics, in order to acquire the ECG signals and the gradient artifacts more precisely. Signal processing based on a novel detection algorithm and blanking are then applied for improved artifact suppression.Main results: The proposed sensor allows the gradient artifacts to be acquired more precisely, and these artifacts are recorded with peak-to-peak amplitudes two orders of magnitude larger than for QRS complexes. The proposed method outperforms a state-of-the-art approach both in terms of signal quality (+9% 'SNR') and accuracy of QRS detection (+11%).Significance: The proposed hardware and software solutions open the way for the acquisition of high-quality of ECG gating in MRI, and improved diagnostic quality of ECG signals in MRI.

International audience; Purpose: To quantitatively evaluate a superresolution technique for 3D, one-millimeter isotropic diffusion-weighted imaging (DWI) of the whole breasts.Methods: Isotropic 3D DWI datasets are obtained using a combination of (i) a readout-segmented diffusion-weighted-echo-planar imaging (DW-EPI) sequence (rs-EPI), providing high in-plane resolution, and (ii) a superresolution (SR) strategy, which consists of acquiring 3 datasets with thick slices (3 mm) and 1-mm shifts in the slice direction, and combining them into a 1 × 1 × 1-mm3 dataset using a dedicated reconstruction. Two SR reconstruction schemes were investigated, based on different regularization schemes: conventional Tikhonov or Beltrami (an edge-preserving constraint). The proposed SR strategy was compared to native 1 × 1 × 1-mm3 acquisitions (i.e. with 1-mm slice thickness) in 8 healthy subjects, in terms of signal-to-noise ratio (SNR) efficiency, using a theoretical framework, Monte Carlo simulations and region-of-interest (ROI) measurements, and image sharpness metrics. Apparent diffusion coefficient (ADC) values in normal breast tissue were also compared.Results: The SR images resulted in an SNR gain above 3 compared to native 1 × 1 × 1-mm3 using the same acquisition duration (acquisition gain 3 and reconstruction gain >1). Beltrami-SR provided the best results in terms of SNR and image sharpness. The ADC values in normal breast measured from Beltrami-SR were preserved compared to low-resolution images (1.91 versus 1.97 ×10-3 mm2 /s, P = .1).Conclusion: A combination of rs-EPI and SR allows 3D, 1-mm isotropic breast DWI data to be obtained with better SNR than a native 1-mm isotropic acquisition. The proposed DWI protocol might be of interest for breast cancer monitoring/screening without injection.

International audience; Isotropic three-dimensional (3D) acquisition is a challenging task in magnetic resonance imaging (MRI). Particularly in cardiac MRI, due to hardware and time limitations, current 3D acquisitions are limited by low-resolution, especially in the through-plane direction, leading to poor image quality in that dimension. To overcome this problem, super-resolution (SR) techniques have been proposed to reconstruct a single isotropic 3D volume from multiple anisotropic acquisitions. Previously, local regularization techniques such as total variation have been applied to limit noise amplification while preserving sharp edges and small features in the images. In this paper, inspired by the recent progress in patch-based reconstruction, we propose a novel isotropic 3D reconstruction scheme that integrates non-local and self-similarity information from 3D patch neighborhoods. By grouping 3D patches with similar structures, we enforce the natural sparsity of MR images, which can be expressed by a low-rank structure, leading to robust image reconstruction with high signal-to-noise ratio efficiency. An Augmented Lagrangian formulation of the problem is proposed to efficiently decompose the optimization into a low-rank volume denoising and a SR reconstruction. Experimental results in simulations, brain imaging and clinical cardiac MRI, demonstrate that the proposed joint SR and self-similarity learning framework outperforms current state-of-the-art methods. The proposed reconstruction of isotropic 3D volumes may be particularly useful for cardiac applications, such as myocardial infarction scar assessment by late gadolinium enhancement MRI.

4. Conclusions: Combined respiratory and cardiac triggering improves the localization accuracy and spectral quality in cardiac1H-MRS dramatically leading to substantially increased spectral reproducibility. The best practical realization of double triggering turned out to be the use of the ECG amplitude when making use of the fact that it is modulated by respiration. In spite of the spectral quality achieved in most subjects, we still fail to record satisfactory spectra in a minority of subjects. The reasons for this are not understood at present but must be some particulars of either a given subject or the experimental setup. The cardiac1H-MR spectra contain quantifiable contributions from creatine, TMA, lipids, and probably taurine. It is possible that the spectral contributions of creatine are subject to dipolar coupling similar to the observations for skeletal muscle

Few studies have addressed the interaction between instruction content and saccadic eye movement control. To assess the impact of instructions on top-down control, we instructed 20 healthy volunteers to deliberately delay saccade triggering, to make inaccurate saccades or to redirect saccades--i.e. to glimpse towards and then immediately opposite to the target. Regular pro- and antisaccade tasks were used for comparison. Bottom-up visual input remained unchanged and was a gap paradigm for all instructions. In the inaccuracy and delay tasks, both latencies and accuracies were detrimentally impaired by either type of instruction and the variability of latency and accuracy was increased. The intersaccadic interval (ISI) required to correct erroneous antisaccades was shorter than the ISI for instructed direction changes in the redirection task. The word-by-word instruction content interferes with top-down saccade control. Top-down control is a time consuming process, which may override bottom-up processing only during a limited time period. It is questionable whether parallel processing is possible in top-down control, since the long ISI for instructed direction changes suggests sequential planning.

Exploiting redundancies between multiple images of an MRI examination can be formalized as the joint reconstruction of these images. The anatomy is preserved indeed so that specific constraints can be implemented (e.g. most of the features or spatial gradients should be in the same place in all these images) and only the contrast changes from one image to another need to be encoded. The application of this concept is particularly challenging in cardiovascular and body imaging due to the complex organ deformations, especially with the patient breathing. In this study a joint optimization framework is proposed for reconstructing multiple MR images together with a nonrigid motion model. The motion model takes into account both intra-image and inter-image motion and therefore can correct for most ghosting/blurring artifacts and misregistration between images. The framework was validated with free-breathing myocardial ${\rm T}_{2}$ mapping experiments from nine heart transplant patients at 1.5 T. Results showed improved image quality and excellent image alignment with the multi-image reconstruction compared to the independent reconstruction of each image. Segment-wise myocardial ${\rm T}_{2}$ values were in good agreement with the reference values obtained from multiple breath-holds (62.5 $\pm$ 11.1 ms against 62.2 $\pm$ 11.2 ms which was not significant with ${\rm p}=0.49$ ).

International audience; Respiratory motion is a source of artifacts in multimodality imaging such as PET/MR. Solutions include retrospective or prospective gating. They have however found limited use in clinical practice, since their increased overall acquisition duration to maintain overall image quality. More elaborate methods consist of using 4D MR datasets to extract spatial deformations in order to correct for the respiratory motion in PET. The main drawbacks of such approaches is the relatively long acquisition times associated with 4D MR imaging which is often incompatible with clinical PET/MR protocols. The objective of this work was to overcome these limitations by exploiting a generalized reconstruction by inversion of coupled systems (GRICS) approach. The methodology is based on a joint estimation of motion during the MR image reconstruction process, providing internal structure motion and associated deformation matrices for retrospective use in PET respiratory motion correction. This method was first validated on four MR volunteers and two PET/MR patient datasets by comparing GRICS generated MR images to 4D MR series obtained by retrospective gating. In a second step 4D PET datasets corresponding to acquired 4D MR images were simulated using the GATE Monte Carlo simulation platform. GRICS generated deformation matrices were subsequently used to correct respiratory motion in comparison to the 4D MR image based deformations both for the simulated and the two 4D PET/MR patient datasets. Results confirm that GRICS synchronized MR images correlate well with the acquired 4D MR series. Similarly, the use of GRICS for respiratory motion correction allows an equivalent percentage improvement on lesion contrast, position and size, considering the PET simulated tumors as well as PET real tumors. This work demonstrates the potential interest of using GRICS for PET respiratory motion correction in combined PET/MR using shorter duration acquisitions without the need for 4D MRI and associated specific MR sequences.

Background and purpose: Infarct topography has been suggested to predict functional outcome in ischemic stroke patients. However, little evidence could be found in regard to pretreatment imaging. We aimed to elucidate the impact of pretreatment infarct topography in predicting functional outcome in acute ischemic stroke. Methods: Our work is a sub-study of THRACE. 144 acute stroke patients assigned to receive intravenous thrombolysis plus mechanical thrombectomy were included. Infarct lesions were semi-automatically segmented on baseline diffusion weighted images. Regional lesion locations were decided according to automated anatomical labeling and JHU-WhiteMatter-labels atlases. A threshold was established in order to define, for each region, which percentage of infarction can predict poor clinical outcome (3 month-mRs 3-6) and then to define whether a region could be considered as infarcted. Finally, univariate and multivariate logistic analysis were performed. Results: In univariate analysis, basal ganglia, insula, inferior frontal and inferior parietal gyrus, temporal lobe, amygdala, internal capsule, corona radiata, superior longitudinal fasciculus, posterior thalamic radiation and uncinate fasciculus lesions were implicated in poor functional outcome in left-hemisphere stroke. Significant regions in right hemisphere were basal ganglia, temporal lobe, insula, amygdala, hippocampus and uncinate fasciculus. In multivariate analysis, eloquent regions for poor functional outcome were left internal capsule (OR=0.09), left inferior parietal gyrus (OR=0.03), right superior temporal gyrus (OR=0.09) and right amygdala (OR=0.03). Conclusion: Pretreatment infarct topography provides important prognostic value in functional outcome after acute ischemic stroke, and may optimize the individualized treatment decision-making.

International audience; Objective: We describe a new real-time filter to reduce artefacts on electrocardiogram (ECG) due to magnetic field gradients during MRI. The proposed filter is a least mean square (LMS) filter able to continuously adapt its step size according to the gradient signal of the ongoing MRI acquisition.Materials and methods: We implemented this filter and compared it, within two databases (at 1.5 and 3 T) with over 6000 QRS complexes, to five real-time filtering strategies (no filter, low pass filter, standard LMS, and two other filters optimized within the databases: optimized LMS, and optimized Kalman filter).Results: The energy of the remaining noise was significantly reduced (26 vs. 68%, p < 0.001) with the new filter vs. standard LMS. The detection error of our ventricular complex (QRS) detector was: 11% with our method vs. 25% with raw ECG, 35% with low pass filter, 17% with standard LMS, 12% with optimized Kalman filter, and 11% with optimized LMS filter.Conclusion: The adaptive step size LMS improves ECG denoising during MRI. QRS detection has the same F1 score with this filter than with filters optimized within the database.

The orientation of the heart in the chest impacts the shape and amplitude of surface ECG signals. It is also key information in electrocardiographic imaging (ECGI), where a model of the heart and torso is required. In this study we seek to analyze statistical relations between heart orientation and several easily available patient characteristics. Heart orientation data were obtained from an MRI database of 185 healthy adults. Relations with sex, height, weight (collected from case reports forms) and chest circumference (extracted from the images) were analyzed using univariate and multivariate linear regression. Chest circumference was found to be the best single predictor of heart orientation, and simple formulas were determined for its estimation. The proposed heart orientation statistical model might be used for selecting a torso/heart model from an existing database; this approach might allow ECGI techniques to be integrated into an ECG device.

International audience; Purpose: Segmentation of cardiac cine MRI data is routinely used for the volumetric analysis of cardiac function. Conventionally, 2D contours are drawn on short-axis (SAX) image stacks with relatively thick slices (typically 8 mm). Here, an acquisition/reconstruction strategy is used for obtaining isotropic 3D cine datasets; reformatted slices are then used to optimize the manual segmentation workflow.Methods: Isotropic 3D cine datasets were obtained from multiple 2D cine stacks (acquired during free-breathing in SAX and long-axis (LAX) orientations) using nonrigid motion correction (cine-GRICS method) and super-resolution. Several manual segmentation strategies were then compared, including conventional SAX segmentation, LAX segmentation in three views only, and combinations of SAX and LAX slices. An implicit B-spline surface reconstruction algorithm is proposed to reconstruct the left ventricular cavity surface from the sparse set of 2D contours.Results: All tested sparse segmentation strategies were in good agreement, with Dice scores above 0.9 despite using fewer slices (3-6 sparse slices instead of 8-10 contiguous SAX slices). When compared to independent phase-contrast flow measurements, stroke volumes computed from four or six sparse slices had slightly higher precision than conventional SAX segmentation (error standard deviation of 5.4 mL against 6.1 mL) at the cost of slightly lower accuracy (bias of -1.2 mL against 0.2 mL). Functional parameters also showed a trend to improved precision, including end-diastolic volumes, end-systolic volumes, and ejection fractions).Conclusion: The postprocessing workflow of 3D isotropic cardiac imaging strategies can be optimized using sparse segmentation and 3D surface reconstruction. Magn Reson Med 79:2665-2675, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

International audience; Objective: The objective of our study was to evaluate the diagnostic performance of qualitative 3-T proton MR spectroscopy (1H-MRS) for the characterization of musculoskeletal neoplasms.Subjects and methods: Proton MRS studies of 74 patients (76 lesions) with a histologically confirmed musculoskeletal neoplasm or neoplasms were prospectively included in this study. All studies were performed using a 3-T MRI scanner. Spectra were analyzed with conventional MRI software provided by the fabricant and with dedicated independent MRS software. Spectra were evaluated visually for the presence or absence of a choline peak at 3.2 ppm. The presence of a choline peak was considered indicative of malignancy. The influences of tumor origin and spectral quality on diagnostic performance were considered.Results: Diagnostic performance was similar with both software used (κ = 0.97). Qualitative 1H-MRS failed to differentiate benign from malignant bone tumors regardless of the application of quality criteria (best sensitivity and specificity, 50.0% and 61.5%, respectively). Diagnostic performance was better with soft-tissue lesions, but the specificity remained low (best sensitivity and specificity, 82.4% and 64.3%, respectively). The application of spectral quality criteria for the evaluation of soft-tissue tumors led to the exclusion of 35.4% of the evaluated spectra.Conclusion: Qualitative 3-T 1H-MRS cannot be used to characterize bone tumors. This technique has good sensitivity but poor specificity for the characterization of soft-tissue lesions.

International audience; To evaluate the added value of ULTRAFAST-MR sequence to an abbreviated FAST protocol in comparison with FULL protocol to distinguish benign from malignant lesions in a population of women, regardless of breast MR imaging indication. Materials and methods: From March 10th to September 22th, 2014, we retrospectively included a total of 70 consecutive patients with 106 histologically proven lesions (58 malignant and 48 benign) who underwent breast MR imaging for preoperative breast staging (n = 38), high-risk screening (n = 7), problem solving (n = 18), and nipple discharge (n = 4) with 12 time resolved imaging of contrast kinetics (TRICKS) acquisitions during contrast inflow interleaved in a regular high-resolution dynamic MRI protocol (FULL protocol). Two readers scored MR exams as either positive or negative and described significant lesions according to Bi-RADS lexicon with a TRICKS images (ULTRAFAST), an abbreviated protocol (FAST) and all images (FULL protocol). Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated for each protocol and compared with McNemar's test. Results: For all readers, the combined FAST-ULTRAFAST protocol significantly improved the reading with a specificity of 83.3% and 70.8% in comparison with FAST protocol or FULL protocol, respectively, without change in sensitivity. By adding ULTRAFAST protocol to FAST protocol, readers 1 and 2 were able to correctly change the diagnosis in 22.9% (11/48) and 10.4% (5/48) of benign lesions, without missing any malignancy, respectively. Both interpretation and image acquisition times for combined FAST-ULTRAFAST protocol and FAST protocol were shorter compared to FULL protocol (p < 0.001). Conclusion: Compared to FULL protocol, adding ULTRAFAST to FAST protocol improves specificity, mainly in correctly reclassifying benign masses and reducing interpretation and acquisition time, without decreasing sensitivity.

Background To evaluate the use of a nonrigid registration technique for detecting acute heart transplant rejection by MRI T2 quantification. Methods Myocardial T2 quantification was achieved in 279 consecutive examinations from 78 different patients. The protocol consisted of 10 successive black-blood fast spin echo sequences with varying echo times, and a postprocessing based on image registration and exponential fitting. An automatic nonrigid registration method was applied to correct for myocardium misalignment. Finally T2 values were compared with those obtained with a conventional rigid registration followed by manual correction. Results Nonrigid registration was feasible in 98% of the datasets and was judged of higher quality compared with conventional processing (P

International audience; OBJECT:The ability to manipulate image contrast and thus to obtain complementary information is one of the main advantages of MRI. Motion consistency within the whole data set is a key point in the context of multi contrast imaging. In cardiac and abdominal MRI, the acquisition strategy uses multiple breath-holds and often relies on acceleration methods that inherently suffer from a signal to-noise ratio loss. The aim of this work is to propose a free-breathing multi-contrast acquisition and reconstruction workflow to improve image quality and the subsequent data analysis.MATERIALS AND METHODS:We extended a previously proposed motion-compensated image reconstruction method for multi-contrast imaging. Shared information throughout the imaging protocol is now exploited by the image reconstruction in the form of an additional constraint based on image gradient sparsity. This constraint helps to minimize the amount of data needed for efficient non-rigid motion correction. T₁and T₂weighted images were reconstructed from free-breathing acquisitions in 4 healthy volunteers and in a phantom. The impact of multi-contrast motion correction was evaluated in a phantom in terms of precision and accuracy of T₁and T₂quantification.RESULTS:In the phantom, the proposed method achieved an accuracy of 97.5 % on the quantified parameters against 88.0 % before motion correction. In volunteers, motion inconsistency in T₁and T₂quantification were noticeably reduced within 5 min of free-breathing acquisition.CONCLUSION:An efficient, free-breathing, multi-contrast imaging method has been demonstrated that does not require prior assumptions about contrast and that is applicable to a wide range of examinations.

International audience; OBJECTIVE:To study the effects of calcium on the choline peak measurements with 1H MR spectroscopy.MATERIAL AND METHODS:The thigh muscles of two cadaveric specimens were prospectively evaluated on a 3 T MR unit before and after the injection of calcium carbonate (up to 0.4322 g). The choline peaks of 147 spectra from 10 different anatomic locations were quantitatively evaluated. The influence of the calcium concentration and its disposition with respect to the main magnetic field were considered. B0 phase maps were used to evaluate field inhomogeneities.RESULTS:The presence of calcium led to a 43 % underestimation of the choline peak and the choline concentration (p = 0.0002 and 0.0036). The mean choline concentrations before and after CaCO3 injection were 3.53 ± 1.72 mmol/l and 1.58 ± 0.63 mmol/l. The influence of calcium carbonate on the choline peak estimations was proportional to the calcium concentration. There was a significant position-dependent difference in the estimation of the choline peak amplitude (p

International audience; This study was designed retrospectively to assess the value of myocardial T2 to detect or predict ongoing acute heart rejection, in heart transplant patients, with a 1.5-T MRI magnet. One hundred and ninety-six myocardial T2 quantifications were performed on sixty consecutive heart transplant patients during routine follow- up. T2 values were assessed (i) with regard to the results of concomitant biopsies and (ii) with a Cox multivariate model for the prediction of subsequent rejections, defined by a ≥ grade 2 at biopsy or highly suspected in the absence of biopsy (>10% drop in ejection fraction with subsequent reversibility under treatment). T2 values were proposed as main covariate, after logit transformation andadjustment for other confounding parameters such as delay since graft surgery and delay before biopsy. T2 values were strongly linked (i) to the presence of rejection on concomitant biopsy (P < 0.0001) and (ii) to the risk of subsequent rejection on Cox multivariate model (P < 0.001). T2 values above 60 ms were associated with relative risk of rejection higher than 2.0 and rapidly increasing. In conclusion, myocardial T2 yields a high diagnostic and prognostic value for graft rejection in heart transplant patients.

Introduction Evaluate the capability of different Computed Tomography scanners to determine urinary stone compositions based on CT attenuation values and to evaluate potential differences between each model. Methods 241 human urinary stones were obtained and their biochemical composition determined. Four different CT scanners (Siemens, Philips, GEMS and Toshiba) were evaluated. Mean CT-attenuation values and the standard deviation were recorded separately and compared with a t-paired test. Results For all tested CT scanners, when the classification of the various types of stones was arranged according to the mean CT-attenuation values and to the confidence interval, large overlappings between stone types were highlighted. The t-paired test showed that most stone types could not be identified. Some types of stones presented mean CT attenuation values significantly different from one CT scanner to another. At 80 kV, the mean CT attenuation values obtained with the Toshiba Aquilion were significantly different from those obtained with the Siemens Sensation. On the other hand, mean values obtained with the Philips Brilliance were all significantly equal to those obtained with the Siemens Sensation and with the Toshiba Aquilion. At 120 kV mean CT attenuation values of uric acid, cystine and struvite stones obtained with the Philips model are significantly different from those obtained with the Siemens and the Toshiba but equal to those obtained with the GE 64. Conclusions According to our study, there is a great variability when different brands and models of scanners are compared directly. Furthermore, the CT scan analysis and HU evaluation appears to gather insufficient information in order to characterize and identify the composition of renal stones.

Background Standard laparoscopy is responsible for musculoskeletal problems because of surgeons anti-ergonomic positions. Robot-assisted laparoscopy seems to reduce these musculoskeletal disorders thanks to the surgeons seated position. The objective of this study is to evaluate the muscular strain and cognitive stress induced by these two techniques during real operations conducted on the pig. Methods Electromyographic activities, heart rate, physical and mental workloads (NASA Tlx and Borg CR-10) were recorded. Results Physical workload and perception of the effort invested was significantly greater during the standard laparoscopies (p

To develop an efficient motion-compensated reconstruction technique for free-breathing cardiac magnetic resonance imaging (MRI) that allows high-quality images to be reconstructed from multiple undersampled single-shot acquisitions. The proposed method is a joint image reconstruction and motion correction method consisting of several steps, including a non-rigid motion extraction and a motion-compensated reconstruction. The reconstruction includes a denoising with the Beltrami regularization, which offers an ideal compromise between feature preservation and staircasing reduction. Results were assessed in simulation, phantom and volunteer experiments. The proposed joint image reconstruction and motion correction method exhibits visible quality improvement over previous methods while reconstructing sharper edges. Moreover, when the acceleration factor increases, standard methods show blurry results while the proposed method preserves image quality. The method was applied to free-breathing single-shot cardiac MRI, successfully achieving high image quality and higher spatial resolution than conventional segmented methods, with the potential to offer high-quality delayed enhancement scans in challenging patients., Comment: 12 pages, 6 figures, accepted at MICCAI 2016

International audience; Objectives: To assess cardiac and vascular adaptations in long-distance male triathletes and the influence of an increased training volume on these parameters. Design: Case-control study using long-distance male triathletes (Tri) (n = 12) and an age-matched cohort of sedentary volunteers (Ctrl). Methods: All participants gave an informed consent and underwent a Cardiovascular Magnetic Resonance imaging (CMR) exam to measure left and right ventricle functional parameters, and aortic parameters (surface, strain, compliance, pulse wave velocity). This exam was repeated in the triathletes' group after an increased training volume of at least 2 h/week for six weeks. Results: Compared to control volunteers, triathletes presented at baseline a typical pattern of athlete's heart (higher end-diastolic, end-systolic and stroke volumes index, p ≤ 0.009, and lower cardiac rate, p = 0.015) but similar vascular characteristics except a trend towards an enlarged ascending aorta (surface 942 ± 106 vs 812 ± 127 mm 2 , p = 0.058). Between the two visits, the triathletes increased their weekly training time from 9.67 ± 2.43 (Tri1) to 12.15 ± 3.01 h (Tri2): no modifications were found regarding cardiac parameters, but compliance and distensibility of the ascending aorta increased, from 2.60 to 3.34 mm 2 /mmHg (p = 0.028) and from 3.36 to 4.40 × 10 −3 mmHg −1 (p = 0.048) respectively. Conclusions: Using CMR, we showed that vascular characteristics of the ascending aorta may vary along the sport season in endurance athletes. This remodelling could be considered as a physiological adaptation, but could eventually lead to an adverse vascular remodelling.

International audience

International audience; Goal: A novel magnetic resonance (MR) compatible accelerometer for respiratory motion sensing (MARMOT) is developed as a surrogate of the vendors' pneumatic belts. We aim to model and correct respiratory motion for free-breathing thoracic-abdominal MR imaging and to simplify patient installation.Methods: MR compatibility of MARMOT sensors was assessed in phantoms and its motion modeling/correction efficacy was demonstrated on 21 subjects at 3 T. Respiration was modeled and predicted from MARMOT sensors and pneumatic belts, based on real-time images and a regression method. The sensor accuracy was validated by comparing motion errors in the liver/kidney. Sensor data were also exploited as inputs for motion-compensated reconstruction of free-breathing cardiac cine MR images. Multiple and single sensor placement strategies were compared.Results: The new sensor is compatible with the MR environment. The average motion modeling and prediction errors with MARMOT sensors and with pneumatic belts were comparable (liver and kidney) and were below 2 mm with all tested configurations (belts, multiple/single MARMOT sensor). Motion corrected cardiac cine images were of improved image quality, as assessed by an entropy metric (p < 10-6), with all tested configurations. Expert readings revealed multiple MARMOT sensors were the best (p < 0.03) and the single MARMOT sensor was similar to the belts (nonsignificant in two of the three readers).Conclusion: The proposed sensor can model and predict respiratory motion with sufficient accuracy to allow free-breathing MR imaging strategy.Significance: It provides an alternative sensor solution for the respiratory motion problem during MR imaging and may improve the convenience of patient setup.

Object We describe a new real-time filter to reduce artefacts on electrocardiogram (ECG) due to magnetic field gradients during MRI. The proposed filter is a Least Mean Square (LMS) filter able to continuously adapt its step size according to the gradient signal of the ongoing MRI acquisition. Materials and methods We implemented this filter and compared it, within two databases (at 1.5 T and 3 T) with over 6000 QRS complexes, to five real-time filtering strategies (no filter, low pass filter, standard LMS, and two other filters optimized within the databases: optimized LMS, and optimized Kalman filter) Results The energy of the remaining noise was significantly reduced (26% vs 68%, p Fig. 1 ). Conclusion The adaptive step size LMS improves ECG denoising during MRI. QRS detection has the same F1 score with this filter than with filters optimized within the database.

Purpose: To assess cardiac function by means of a novel free-breathing cardiac magnetic resonance imaging (MRI) strategy. Materials and Methods: A stack of ungated 2D steady-state free precession (SSFP) slices was acquired during free breathing and reconstructed as cardiac cine imaging based on the generalized reconstruction by inversion of coupled systems (GRICS). A motion-compensated sliding window approach allows reconstructing cine movies with most motion artifacts cancelled. The proposed reconstruction uses prior knowledge from respiratory belts and electrocardiogram recordings and features a piecewise linear model that relates the electrocardiogram signal to cardiac displacements. The free-breathing protocol was validated in six subjects against a standard breath-held protocol. Results: Image sharpness, as assessed by the image gradient entropy, was comparable to that of breath-held images and significantly better than in uncorrected images. Volumetric parameters of cardiac function in the left ventricle (LV) and right ventricle (RV) were similar, including end-systolic volumes, end-diastolic volumes and mass, stroke volumes, and ejection fractions (with differences of 3% ± 2.4 in the LV and 2.9% ± 4.4 in the RV). The duration of the free-breathing protocol was nearly the same as the breath-held protocol. Conclusion: Free-breathing cine-GRICS enables accurate assessment of volumetric parameters of cardiac function with efficient correction of motion. J. Magn. Reson. Imaging 2012;340-351. © 2011 Wiley Periodicals, Inc.

BACKGROUND Hypertension is strongly associated with cognitive decline and a promising target for dementia prevention. Our aim was to investigate the association between different antihypertensive treatments and cognitive performance in elderly hypertensive patients presenting with subjective memory complaints. PATIENTS AND METHODS Three hundred and seventy-eight elderly hypertensive patients more than 60 years (mean age 70.4 ± 6.3 years) treated with at least one antihypertensive agent and presenting with subjective memory complaints but without dementia were prospectively recruited and underwent a combination of neuropsychological tests, brain magnetic resonance imaging with semiquantification of white matter hyperintensities, carotid echotracking, brachial endothelial function, and ambulatory blood pressure assessments. RESULTS None of the three composite scores (memory score, verbal fluency, and visual memory capacity) was found associated with blood pressure levels. On the other hand, age-adjusted and sex-adjusted analyses showed a significant and positive association between memory score and use of calcium channel blockers (CCBs) (users: +0.14 ± 0.09 versus nonusers: -0.12 ± 0.06; P = 0.016). Multivariate analyses also revealed that CCB use was significantly associated with a better memory score, independently of age, male sex, white matter hyperintensities, and carotid wall cross-sectional area, all of which were associated with worse memory scores. CONCLUSION In elderly hypertensive treated patients with subjective memory complaints, CCB use was associated with better memory performance independently of blood pressure level and macrovascular and microvascular alterations, suggesting a specific neuroprotective effect of this pharmacological class. Interventional controlled trials are required to confirm the specific protective effect of CCBs on cognitive decline.

Black Blood Fast Spin Echo imaging of the heart is usually performed during mid-diastolic rest. This is a direct consequence of the long inversion time required to suppress the blood signal, which is constrained by the T(1) of the blood, and of the heart rate. To overcome these constraints, and to acquire black blood images in the end-systolic rest period, a new approach is introduced aiming at adaptively predicting the best time to prepare and acquire MR signals. It is based on a RR interval prediction algorithm and on a cardiac cycle model. The proposed method was applied to 14 healthy volunteers and is compared to a simple alternative method using a fixed delay and to the standard black blood imaging method for imaging in the mid-diastolic rest period. Results show that the proposed method offers an increased robustness in terms of trigger delay error and image quality compared to the tested simple alternative. Also, it has been shown by qualitative analysis done by an experienced observer that the right ventricle, especially the thin right ventricle free wall, is better depicted with our method than with the standard mid-diastolic rest acquisition.

Purpose. To determine the impact of a joint PACS implementation at a university medical center and cancer center on the radiology practice profile. Materials and methods. In 5 radiology sections, patients, selected based on identifiable acute or chronic diseases, underwent US, CT or MRI. Data were collected on datasheets from each provider with regards to clinical history, availability of prior examinations, description of patient management during the different phases of the examination, duration of examinations, and satisfaction. Data obtained prior to PACS implementation and 6-12 months and 30-36 months after implementation were compared. Results . A total of 1098 datasheets were collected. Hard copy readings rapidly decreased. Comparison with prior examinations improved (+20.6% to 25.6%) as well as frequency of post-processing (+29%). The time required for image management was much more reduced for technologists (–75%) than for physicians (–23%). PACS implementation only temporarily improved the availability of radiology reports and the distribution of work between senior and junior radiologists. User satisfaction, initially high, progressively decreased due to saturation of the archival capabilities. Conclusion. PACS implementation in a large university center improves the efficiency of image acquisition but does not solve some of the inefficiencies of hospital organization.

Background and Purpose— Arterial stiffening and thickening and endothelial dysfunction may be associated with cognitive decline or white matter hyperintensities (WMH) independently of blood pressure level. We aimed to investigate, using an integrative approach, the relative contributions of structural and functional vascular factors to the degree of cognitive impairment (primary outcome) and the severity of WMH (secondary outcome) in elderly hypertensive patients with subjective memory complaints, a group prone to dementia. Methods— A prospective, dedicated, cross-sectional population of 198 elderly hypertensive patients (mean age 69.3±6.2 years) with subjective memory complaints underwent a full set of cognitive function assessments, brain MRI with semiquantification of WMH, carotid ultrasonography, carotid–femoral pulse wave velocity, brachial endothelial function, and plasma von Willebrand Factor measurements. Results— After adjustment for the usual cardiovascular risk factors, increased arterial stiffness (as assessed by pulse wave velocity) was significantly and independently associated with memory impairment in men. The severity of WMH was independently associated with increased carotid intima media thickness and stiffness (as assessed by augmentation index) as well as with increased age and plasma levels of von Willebrand Factor, a biomarker of endothelial dysfunction. Conclusions— Our data suggest that vascular abnormalities, independently of blood pressure levels, may play a role in the setting of subjective memory complaints as well as of WMH in elderly hypertensive patients. Arterial thickness and stiffness as well as endothelial function should be assessed simultaneously and may represent additional targets for the prevention of subjective memory complaints and WMH.

A reconstruction strategy is proposed for physiological motion correction, which overcomes many limitations of existing techniques. The method is based on a general framework allowing correction for arbitrary motion–nonrigid or affine, making it suitable for cardiac or abdominal imaging, in the context of multiple coil, arbitrarily sampled acquisition. A model is required to predict motion in the field of view at each sample time point, based on prior knowledge provided by external sensors. A theoretical study is carried out to analyze the influence of motion prediction errors. Small errors are shown to propagate linearly in that reconstruction algorithm, and thus induce a reconstruction residue that is bounded (stability). Furthermore, optimization of the motion model is proposed in order to minimize this residue. This leads to reformulating reconstruction as two inverse problems which are coupled: motion-compensated reconstruction (known motion) and model optimization (known image). A fixed-point multiresolution scheme is described for inverting these two coupled systems. This framework is shown to allow fully autocalibrated reconstructions, as coil sensitivities and motion model coefficients are determined directly from the corrupted raw data. The theory is validated with real cardiac and abdominal data from healthy volunteers, acquired in free-breathing. Magn Reson Med 60:146–157, 2008. © 2008 Wiley-Liss, Inc.

International audience; OBJECTIVE:To evaluate the performance of quantitative diffusion-weighted imaging (DWI) correlated with T2 signal in differentiating non-fatty benign from malignant tumors.MATERIAL AND METHODS:A total of 76 patients with a histologically confirmed non-fatty soft tissue tumors (46 benign and 30 malignant) were prospectively included in this ethics committee approved study. All patients signed an informed consent and underwent MRI with DWI with two b values (0 and 600). ADC values from the solid components of these tumors were obtained and were correlated with the lesion's signal intensity on T2-weighted fat-saturated sequences. ADC values were obtained from adjacent normal muscle to allow calculation of tumor/muscle ADC ratios.RESULTS:There were 58 hyperintense and 18 iso or hypointense lesions. All hypointense lesions were benign. The mean ADC values for benign and malignant tumors were 1.47 ± 0.54 × 10(-3) and 1.17 ± 0.38 × 10(-3) mm(2)/s respectively (p

International audience; OBJECTIVES:Blood pressure (BP) and its changes with antihypertensive therapy are key parameters when monitoring left ventricular (LV) remodeling. This dual cross-sectional and longitudinal MRI study aimed to determine whether this monitoring is enhanced by aortic stroke volume (SV) values provided by a phase-contrast sequence.METHODS:The study involved 334 MRI examinations from 247 study participants who had no significant cardiac disease (18-85 years old, 40% with hypertension) and among whom 48 had a 2-4-year MRI follow-up. Left ventricular hypertrophy and concentric geometry were: respectively assessed according to LV mass indexed to body surface area (g/m) and mass/end-diastolic volume ratio (concentric remodeling index); and correlated with vascular parameters involving BP and the indexed SV (ml/m) determined in the ascending aorta with a phase-contrast sequence.RESULTS:Stroke volume was highly variable, ranging from 22 to 74 ml/m. The best cross-sectional correlates were: mean BP × SV product, reflecting cardiac work, for LV mass (r = 0.21); and mean BP/SV ratio, reflecting arterial load, for concentric geometry (r = 0.29). These two SV-derived parameters led to more than two-fold enhancements in cross-sectional predictions compared with BP parameters alone, whereas their longitudinal changes over time paralleled those of concentric geometry (P = 0.003 for mean BP/SV) and LV mass (P = 0.006 for mean BP × SV), suggesting direct links with cardiac remodeling.CONCLUSION:The determination of aortic SV with a phase-contrast sequence leads to a significant enhancement in the characterization and monitoring of cardiac remodeling.