Journal Of Magnetic Resonance Imaging[JOURNAL]
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200 papers
Editorial for "A Quantitative Modification of VI-RADS for Bladder Cancer at the Ureteral Orifice: A Reader Study on MRI With Varying Experience Levels".
Muglia VF, Reis RB
J Magn Reson Imaging · 2026 Jul · PMID 42403046 · Publisher ↗
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RF Noise Artifacts From a High Frequency Spinal Cord Stimulation System: A Retrospective Imaging Cohort With Illustrative Cases.
Stinson EG, Hubbard AJ, Kleinow JE … +4 more , Kramer EA, Trzasko JD, Shu Y, Edmonson HA
J Magn Reson Imaging · 2026 Jul · PMID 42402451 · Publisher ↗
Unexpected RF noise artifact "followed" a patient with an implanted spinal cord stimulator to multiple MR systems. Subsequent testing and clinical scanning showed no artifact, implying that the artifact originated from t...
Unexpected RF noise artifact "followed" a patient with an implanted spinal cord stimulator to multiple MR systems. Subsequent testing and clinical scanning showed no artifact, implying that the artifact originated from the implanted device. MR exams (n = 173) performed over a two-year period in patients (n = 122) who had implanted spinal cord stimulators from the same manufacturer were reviewed for artifacts and device models. RF noise artifacts were observed in ~50% of exams in patients with a specific model of spinal cord stimulator, but only ~1%-8% of exams in other models from the same manufacturer. We hope that by describing this artifact, health care professionals can avoid service costs and scheduling delays.
Editorial for "Association Between HIV Infection Duration and Left Ventricular Concentric Remodeling and Myocardial Fibrosis: A Cross-Sectional Study Using Cardiac MRI".
Ghugre NR
J Magn Reson Imaging · 2026 Jul · PMID 42402009 · Publisher ↗
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Editorial for "Effect of Visualized Respiratory Training on Patient Cooperation and Image Quality in Gadoxetic Acid Disodium-Enhanced Liver MRI: A Randomized Controlled Trial".
Mehta T, Heiberger C, Liddell R
J Magn Reson Imaging · 2026 Jul · PMID 42402008 · Publisher ↗
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Editorial for "Association of Iron and Myelin Alterations in the Contralesional Dentate Nucleus and Thalamus With Functional Outcome in Acute Ischemic Stroke: A Susceptibility Source Separation Study".
Chen Y, Wang D
J Magn Reson Imaging · 2026 Jul · PMID 42402004 · Publisher ↗
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Editorial for "Association Between Deep Gray Matter Iron Deposition Dysregulation and Cognitive Performance in Type 2 Diabetes Mellitus Patients: A Quantitative Susceptibility Mapping Study".
Uchida Y
J Magn Reson Imaging · 2026 Jul · PMID 42394404 · Publisher ↗
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Association Between Deep Gray Matter Iron Deposition Dysregulation and Cognitive Performance in Type 2 Diabetes Mellitus Patients: A Quantitative Susceptibility Mapping Study.
Wang K, Wang J, Diao Z … +3 more , Tan X, Qiu S, An J
J Magn Reson Imaging · 2026 Jul · PMID 42394389 · Publisher ↗
BACKGROUND: Type 2 diabetes (T2DM) heightens cognitive impairment risk, yet the mechanisms remain unclear. Hyperglycemia-induced iron dysregulation in deep gray matter (DGM) nuclei may be a crucial mechanism. PURPOSE: To...
BACKGROUND: Type 2 diabetes (T2DM) heightens cognitive impairment risk, yet the mechanisms remain unclear. Hyperglycemia-induced iron dysregulation in deep gray matter (DGM) nuclei may be a crucial mechanism. PURPOSE: To investigate DGM iron deposition in T2DM using Quantitative Susceptibility Mapping (QSM) and determine its association with cognitive function. STUDY TYPE: Prospective. POPULATION: One hundred and fifteen T2DM patients (59.13% male, 53.04 ± 10.12 years) and 176 healthy controls (29.55% male, 50.18 ± 9.41 years). FIELD STRENGTH/SEQUENCE: 3 T; 3D T1-weighted and 3D multi-echo gradient-echo sequences. ASSESSMENT: The magnetic susceptibility of eight bilateral DGM nuclei was quantitatively assessed via QSM. Comprehensive evaluations were conducted for all participants, covering demographic and clinical characteristics, and a battery of multidimensional neuropsychological tests. STATISTICAL TESTS: Group differences in DGM magnetic susceptibility were assessed using two-sample t-tests. Partial correlation and multiple linear regression analyses were performed to examine associations between regional susceptibility and both cognitive and clinical variables. Mediation and moderation analyses were conducted to examine the relationships between various clinical factors, DGM susceptibility, and cognitive function. A corrected p < 0.05 was considered statistically significant. RESULTS: T2DM patients showed significantly increased magnetic susceptibility in the thalamus, putamen, substantia nigra, and right red nucleus, while the caudate nucleus showed reduced susceptibility. Iron content in the caudate nucleus positively correlated with MoCA (r = 0.193) and CDT (r = 0.196), whereas putamen iron deposition negatively correlated with AVLT-immediate (r = -0.211) and AVLT-delay (r = -0.187) and positively correlated with GPT-L (r = 0.22). Substantia nigra susceptibility partially mediated the effect of age on MoCA scores (β = -0.008), and diabetes status moderated the age-related rate of iron accumulation in the substantia nigra (interaction coefficient = 0.770). Age, diabetic status, sex, and BMI were significant factors influencing brain iron deposition. DATA CONCLUSION: Dysregulated brain iron metabolism in T2DM is associated with cognitive dysfunction. Iron accumulation in the substantia nigra may mediate age-related cognitive decline, and T2DM significantly accelerates this age-dependent iron deposition. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 2.
Association of Iron and Myelin Alterations in the Contralesional Dentate Nucleus and Thalamus With Functional Outcome in Acute Ischemic Stroke: A Susceptibility Source Separation Study.
Wan H, Fu Y, Zhang S … +4 more , Zhang G, Li Y, Zhu W, Wang Y
J Magn Reson Imaging · 2026 Jul · PMID 42393438 · Publisher ↗
BACKGROUND: Susceptibility alterations in deep gray matter (DGM) nuclei after acute ischemic stroke (AIS) may relate to impaired functional independence. However, conventional quantitative susceptibility mapping (QSM) ca...
BACKGROUND: Susceptibility alterations in deep gray matter (DGM) nuclei after acute ischemic stroke (AIS) may relate to impaired functional independence. However, conventional quantitative susceptibility mapping (QSM) cannot separate paramagnetic iron-related from diamagnetic myelin-related sources, potentially obscuring relevant pathophysiological alterations. PURPOSE: To apply χ-separation to disentangle paramagnetic susceptibility (χ) and diamagnetic susceptibility (χ) in DGM nuclei after AIS and assess associations with 3-month functional independence. STUDY TYPE: Prospective. POPULATION: 82 AIS patients (52 M/30 F) and 82 healthy controls (49 M/33 F). FIELD STRENGTH/SEQUENCE: 3 T; 3D multi-echo gradient-echo sequence for QSM and χ-separation reconstruction. ASSESSMENT: χ and χ were measured in the caudate, putamen, globus pallidus, substantia nigra, red nucleus, thalamus, and dentate nucleus. Contralesional nuclei were analyzed in patients. Group differences and 3-month outcome associations were assessed. Functional independence was defined as modified Rankin Scale score 0-2, and poor outcome as 3-6. STATISTICAL TESTS: Linear mixed-effects models, analysis of covariance, logistic regression, receiver operating characteristic analysis; p < 0.05 was significant. RESULTS: Compared with healthy controls, patients showed higher χ in all seven nuclei, including the dentate nucleus (84.065 ± 15.086 vs. 76.172 ± 11.387 ppb) and thalamus (30.633 [28.036, 34.454] vs. 28.867 [26.749, 31.804] ppb), and higher χ in the caudate, putamen, red nucleus, thalamus, and dentate nucleus (dentate nucleus: -18.916 ± 6.496 vs. -22.220 ± 5.002 ppb). Poor 3-month outcome was independently associated with higher dentate nucleus χ (OR, 1.07; 95% CI, 1.03-1.11), higher dentate nucleus χ (OR, 1.14; 95% CI, 1.04-1.26), and higher thalamus χ (OR, 1.22; 95% CI, 1.08-1.38). The combined model, incorporating conventional model factors (age, sex, stroke subtype, NIHSS score, and infarct volume) and χ-separation metrics, outperformed the conventional model (AUC, 0.862 vs. 0.757). DATA CONCLUSION: χ-separation revealed iron- and myelin-related susceptibility alterations in contralesional DGM nuclei after AIS. Susceptibility metrics in the dentate nucleus and thalamus were associated with poor 3-month functional outcome. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 1.
A Quantitative Modification of VI-RADS for Bladder Cancer at the Ureteral Orifice: A Reader Study on MRI With Varying Experience Levels.
Guo E, Chen L, Li Y … +10 more , Fan P, Xie Y, Fan X, Ma L, Li X, Yang Y, Huang H, Xu L, Sun H, Zhang G
J Magn Reson Imaging · 2026 Jul · PMID 42388066 · Publisher ↗
BACKGROUND: While the current Vesical Imaging Reporting and Data System (VI-RADS) provides a valuable tool for evaluating bladder cancer, it is not tailored to the ureteral orifices and primarily relies on subjective eva...
BACKGROUND: While the current Vesical Imaging Reporting and Data System (VI-RADS) provides a valuable tool for evaluating bladder cancer, it is not tailored to the ureteral orifices and primarily relies on subjective evaluation. PURPOSE: To identify significant parameters from MRI for diagnosing muscle-invasive bladder cancer (MIBC) at the ureteral orifice, and to evaluate their incremental value to VI-RADS for readers of varying experience. STUDY TYPE: Retrospective. POPULATION: Development cohort: 81 patients with ureteral orifice bladder tumors (mean age, 68 ± 9; 60 men). External validation cohort: 34 patients (mean age, 63 ± 5; 22 men). FIELD STRENGTH/SEQUENCE: 3.0 T; fast spin-echo T2-weighted imaging, single-shot echo planar diffusion-weighted imaging, 3D spoiled gradient echo T1-weighted dynamic contrast-enhanced imaging. ASSESSMENT: Four radiologists of varying experience independently assigned VI-RADS scores. Quantitative parameters (tumor length, tumor contact length [TCL], stalk width [SW], and K) and qualitative parameters were assessed. Pathology was the reference standard. STATISTICAL TESTS: Intraclass correlation coefficient, weighted κ analysis, independent samples t-test, Mann-Whitney U test, chi-square test, receiver operating characteristic curve analysis, univariate and multivariate logistic regression, 1000 bootstrap resamples, DeLong's test, and McNemar's test with Bonferroni correction. Significance was defined as p < 0.05, with p < 0.008 for multiple comparisons. RESULTS: Multivariate analysis identified TCL (odds ratio [OR] = 1.12) and stalk width (OR = 1.74) as independent predictors. In both cohorts, the TCL + SW-modified VI-RADS significantly improved sensitivity over the original VI-RADS for diagnosing MIBC at the ureteral orifice in two junior radiologists. The TCL + SW-modified VI-RADS did not significantly improve sensitivity compared with the TCL-modified VI-RADS in either cohort (p = 0.25-0.50). DATA CONCLUSION: The integration of TCL and stalk width into the VI-RADS improves diagnostic performance for MIBC at the ureteral orifice, particularly for less-experienced radiologists. Nevertheless, external validation in larger, multicenter cohorts is required. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2.
Editorial for "Integrating nnU-Net Segmentation and Clinical-Radiomics for Multicenter Prediction of Soft Tissue Sarcoma Grade and Ki-67 Expression".
Chen S, Feng X
J Magn Reson Imaging · 2026 Jul · PMID 42388047 · Publisher ↗
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Structural MRI Volumetry Index for Differentiation of Progressive Supranuclear Palsy From Parkinson's Disease and Multiple System Atrophy by Automatic Segmentation: A Comparison With Magnetic Resonance Parkinsonism Index.
Jia M, You H, Liu Z … +4 more , Wang Y, Wang H, Li M, Feng F
J Magn Reson Imaging · 2026 Jul · PMID 42381593 · Publisher ↗
BACKGROUND: Although Parkinson's disease (PD) and Parkinsonism-Plus syndromes (PPS) exhibit distinct brain atrophy, current clinical differentiation heavily relies on manual, plane-specific 2D metrics, which are labor-in...
BACKGROUND: Although Parkinson's disease (PD) and Parkinsonism-Plus syndromes (PPS) exhibit distinct brain atrophy, current clinical differentiation heavily relies on manual, plane-specific 2D metrics, which are labor-intensive and observer-dependent. To fill this gap, this study developed an automated, software-independent metric-the parkinsonism volumetric index (PDSVI)-calculated as [(pons volume × third ventricle volume)/(midbrain volume × thalamus volume) × 10]. PURPOSE: To evaluate the performance of PDSVI in precisely differentiating progressive supranuclear palsy (PSP) from PD, multiple system atrophy cerebellar (MSA-C) and parkinsonian (MSA-P) types. STUDY TYPE: Retrospective. POPULATION: 246 PD, 108 PSP, 63 MSA-C, 63 MSA-P (N = 480, 253 males and 227 females; mean age: 63.3 ± 9.2 years) and 252 healthy controls (HC) (134 males and 118 females; mean age: 64.9 ± 8.2 years). FIELD STRENGTH/SEQUENCE: 3 T, 3D inversion-prepared fast spoiled gradient echo sequence T1-weighted Imaging. ASSESSMENT: Manual magnetic resonance parkinsonism index (MRPI) was measured by two raters. Automated brain volumetry was performed using a pre-trained cascaded VB-Net. Patients were randomly assigned to training (n = 320) and internal validation (n = 160) cohorts via 2:1 stratified randomization. Diagnostic performance of manual MRPI, pons/midbrain volume ratio, and PDSVI were assessed. STATISTICAL TESTS: Diagnostic performance was assessed via receiver operating characteristic (ROC) curve analysis and DeLong's test; p < 0.05 was considered statistically significant. RESULTS: In internal validation cohort, ROC analysis showed that PDSVI distinguished PSP from non-PSP (AUC = 0.897), PD (0.873), MSA-P (0.950), MSA-C (0.939), and HC (0.909), comparable to manual MRPI (AUCs: 0.909, 0.886, 0.923, 0.984 and 0.862, p values: 0.760, 0.786, 0.492, 0.092, 0.287, respectively). DATA CONCLUSION: This study proposes a fully automated, 3D-T1-derived parameter that, while exhibiting lower sensitivity compared to the manual MRPI, provides comparable overall diagnostic performance among PSP, PD, MSA, and healthy controls. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2.
Integrating nnU-Net Segmentation and Clinical-Radiomics for Multicenter MRI-Based Assessment of Soft Tissue Sarcoma Grade and Ki-67 Expression.
Li J, Zhu Y, Chen H … +11 more , Zhang L, Li X, Zhou J, Zhang K, Huang J, Yang X, Zhang J, Li Y, Wang W, Tao J, Wang S
J Magn Reson Imaging · 2026 Jun · PMID 42378640 · Publisher ↗
BACKGROUND: Histological grade and Ki-67 expression are prognostic risk factors in patients with soft tissue sarcoma (STS). These assessments require biopsy, which may be affected by tumor heterogeneity and is invasive....
BACKGROUND: Histological grade and Ki-67 expression are prognostic risk factors in patients with soft tissue sarcoma (STS). These assessments require biopsy, which may be affected by tumor heterogeneity and is invasive. PURPOSE: To develop an automated MRI-based pipeline to assess STS grade and Ki-67 expression. STUDY TYPE: Retrospective. POPULATION: 186 patients with pathological confirmation of STS (89 low-grade, 97 high-grade; 87 low Ki-67 expression, 99 high Ki-67 expression) across three hospitals, with 130 and 56 patients in the training and validation cohorts. FIELD STRENGTH/SEQUENCE: 1.5 T and 3.0 T/Fat-suppressed T2-weighted imaging, fat-suppressed gadolinium-enhanced T1-weighted imaging, and diffusion-weighted imaging. ASSESSMENT: An automatic STS segmentation model was developed and compared with manual segmentations. Clinical-imaging signature (CS) models were developed to distinguish STS grade and Ki-67 expression using: (i) structural MRI (T1WI and T2WI) radiomics features, (ii) structural MRI and ADC radiomics features, and (iii) structural MRI and ADC radiomics features combined with clinical information and MRI semantic features. The diagnostic performance of radiologists (with 6, 8, and 38 years' experience) for assessing grade and Ki-67 expression was evaluated with and without the assistance of the best-performing models. STATISTICAL TESTS: Dice coefficient, Cohen's κ and weighted κ, chi-square test or Fisher's exact test, logistic regression analyses, decision curve analysis, area under the receiver operating characteristic curve (AUC), and DeLong's test. A p value < 0.05 was considered significant. RESULTS: The segmentation model achieved good segmentation performance (0.80 in extremity cases and 0.73 in trunk cases). LR and SVM CS models showed the best performance for grading and Ki-67 assessment, respectively. (AUC in validation cohort: 0.846 and 0.742). Using the model significantly improved the diagnostic performance of the two more-junior radiologists for grade (AUC: 0.720-0.832 and 0.735-0.835) and Ki-67 expression (AUC: 0.665-0.717 and 0.659-0.741). DATA CONCLUSION: The CS model may assess STS grade and Ki-67 expression and improve the diagnostic performance of less-experienced radiologists. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: 2.
Optimization of Respiratory Training Methods for Cardiac Magnetic Resonance Imaging.
Ma Z, Zhang X, Li G … +6 more , Yuan S, Yan G, Wang Z, Zhao Y, Wang J, Yin X
J Magn Reson Imaging · 2026 Jun · PMID 42366921 · Publisher ↗
BACKGROUND: In cardiac MRI, poor breath-holding may lead to suboptimal image quality. However, the effect of different breath-hold methods on image quality remains unknown. PURPOSE: To explore the effect of respiratory t...
BACKGROUND: In cardiac MRI, poor breath-holding may lead to suboptimal image quality. However, the effect of different breath-hold methods on image quality remains unknown. PURPOSE: To explore the effect of respiratory training with different breath-holding methods and identify the optimal technique for reducing respiratory motion artifacts in cardiac MRI. STUDY TYPE: Prospective. POPULATION: A total of 93 patients undergoing cardiac MRI (64 men and 29 women; mean age of 48.9 ± 13.7 years). FIELD STRENGTH/SEQUENCES: 3T, single-shot fast spin-echo sequence, fast imaging employing steady-state acquisition sequence, first-pass perfusion sequence (fast gradient echo), and late gadolinium enhancement sequence (phase-sensitive myocardial delayed enhancement). ASSESSMENT: All patients undergoing cardiac MRI were divided into three groups: mouth-breathing, nasal-breathing, and nose-clip. Respiratory-gated monitoring diagrams, examination duration, and subjective and objective image quality assessments were compared. STATISTICAL TESTS: One-way ANOVA, Chi-square test, Kruskal-Wallis H test, Kappa test. Statistical significance was set at p < 0.05. RESULTS: Evaluation of the cardiac MRI respiratory-gated monitoring diagrams showed that the probability of good breath-holding in the nose-clip group was 96.7%, significantly higher than in the mouth-breathing (64.5%) and nasal-breathing groups (75.0%). There was no significant difference in examination duration among groups. Myocardial noise in the mouth-breathing group was significantly higher than those in the other two groups (24.2 [18.3, 32.5] vs. 15.8 [12.5, 23.9]/19.2 [13.7, 24.4]); blood pool noise was significantly higher than in the nasal-breathing group (34.6 [22.6, 42.9] vs. 24.9 [18.4, 33.8]). However, CNR did not significantly differ among the three groups (p = 0.07). Subjective image quality scores were higher in the nose-clip group than those in the other two groups (26 [86.7%] versus 16 [51.6%]/18 [56.3%]). DATA CONCLUSION: Optimized respiratory training can enhance breath-holding performance and image quality in patients undergoing cardiac MRI. The use of a nose clip for assisted breath-holding was found to be the most effective method. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 2.
Editorial for "Voxel-Wise Radiomics Habitat Analysis of Post-Treatment Gliomas for Noninvasive Differentiation of True Progression and Pseudoprogression".
Taoka T
J Magn Reson Imaging · 2026 Jun · PMID 42348404 · Publisher ↗
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Multiparametric Quantitative MRI of Peripheral Nerves to Differentiate Demyelinating From Axonal Polyneuropathies.
Fajardo JE, Truong VB, Xuan Y … +6 more , Benitez SE, Vo ML, Hu B, Dortch RD, Li J, Chen Y
J Magn Reson Imaging · 2026 Jun · PMID 42348395 · Publisher ↗
BACKGROUND: Differentiating demyelinating from axonal polyneuropathies helps for accurate diagnosis and treatment. However, the current clinical tools lack sensitivity to confirm demyelination in peripheral nerves, parti...
BACKGROUND: Differentiating demyelinating from axonal polyneuropathies helps for accurate diagnosis and treatment. However, the current clinical tools lack sensitivity to confirm demyelination in peripheral nerves, particularly for proximal nerves. HYPOTHESIS: Multiparametric quantitative MRI (qMRI) of peripheral nerves can differentiate demyelination from axonal loss. STUDY TYPE: Retrospective. SUBJECTS: Twenty patients with Charcot-Marie-Tooth type-1 (CMT1, demyelinating, females = 12), 12 patients with CMT2 (axonal, females = 6), 25 patients with hereditary neuropathy with liability to pressure palsies (HNPP, a cohort who often has intermediate changes between the two classifications, females = 17), and 25 healthy controls (HC, females = 14). FIELD-STRENGTH/SEQUENCES: 3 T; 3D gradient-echo and spin-echo echo-planar-imaging-based diffusion tensor imaging. ASSESSMENT: Multiparametric qMRI maps were computed for magnetization transfer ratio (MTR), MT saturation index (MTsat), T*, T, proton density (PD), fractional anisotropy (FA), mean/axial/radial diffusivities (MD, AD, RD), and fascicular volume (fVol). STATISTICAL TESTS: Descriptive statistics were performed for group comparisons for each qMRI parameter. Receiver operating characteristic (ROC) analysis with logistic regression was performed to stratify patients. A composite qMRI score, as the CMT Imaging Score (CMTIS), was developed to reflect disease severity using the CMT Neuropathy Score version-2 (CMTNSv2) as a clinical reference. The statistical significance level was set at p < 0.05. RESULTS: CMT1 showed significantly increased fVol versus HCs (3733.7 ± 1426.9 mm vs. 1614.4 ± 286.32 mm), while CMT2 demonstrated reduced T* (25.24 ± 3.27 ms vs. 29.97 ± 4.28 ms). Both CMT1 and CMT2 exhibited reduced FA (0.32 ± 0.08 and 0.39 ± 0.11 vs. 0.54 ± 0.06), MTsat (2.24% ± 0.35% and 2.66% ± 0.34% vs. 3.07% ± 0.39%), and AD (1925.2 ± 216.6 μm/s and 1972.5 ± 197.4 μm/s vs. 2183.6 ± 178.7 μm/s), along with elevated T (1689.1 ± 196.9 ms and 1435.1 ± 171.7 ms vs. 1305.4 ± 120.7 ms) and RD (1177.2 ± 192.9 μm/s and 1065.9 ± 196.6 μm/s vs. 843.3 ± 101.1 μm/s), with larger abnormalities in CMT1. ROC analyses demonstrated strong discrimination of CMT1 and CMT2 (area under curves [AUCs]: 0.95 and 0.85 for sciatic; 0.89 and 0.73 for tibial nerves). CMTIS correlated strongly with CMTNSv2 (r = 0.67 sciatic; r = 0.72 tibial; r = 0.79 combined). DATA CONCLUSIONS: Multiparametric qMRI identified distinct imaging signatures of inherited demyelinating (CMT1) versus axonal (CMT2) polyneuropathies. The CMTIS showed strong potential as a monitoring biomarker in patients with inherited polyneuropathy. EVIDENCE LEVEL: 3. STAGE OF TECHNOLOGY EFFICACY: 3.
Mapping Fatty Acid Composition in the Human Knee: Short-Term Repeatability at 3T.
Martel D, Adlung A, Busi B … +6 more , Bernadin R, Shah Y, Kirsch T, Kijowski R, Madelin G, Ruiz A
J Magn Reson Imaging · 2026 Jun · PMID 42348313 · Publisher ↗
BACKGROUND: Alterations in periarticular lipid composition are implicated in musculoskeletal diseases, yet short-term reliability of MRI-based triglyceride composition mapping in the knee is not fully established. PURPOS...
BACKGROUND: Alterations in periarticular lipid composition are implicated in musculoskeletal diseases, yet short-term reliability of MRI-based triglyceride composition mapping in the knee is not fully established. PURPOSE: To evaluate 1-week repeatability of proton-density fat fraction (PDFF) and triglyceride fatty-acid composition-saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA)-in periarticular knee tissues. STUDY TYPE: Prospective. POPULATION: Ten healthy adults (5 female, 5 male; age 32 ± 8 years; BMI 23.5 ± 2.4 kg/m). FIELD STRENGTH/SEQUENCE: 3T; 12-echo 3D spoiled gradient-echo acquisition for chemical shift-encoded fat quantification and a proton density-weighted SPACE sequence for segmentation (0.6 mm isotropic). ASSESSMENT: Participants underwent repeated MRI 1 week apart. Femoral and tibial bone marrow, patella, Hoffa's fat pad, prefemoral fat pad, quadriceps fat pad, posterior fat pad, and subcutaneous adipose tissue were segmented and rigidly aligned. Voxelwise spectral fitting was used to estimate PDFF and fatty acid composition, including SFA, MUFA, and PUFA components. Repeatability metrics included bias, within-subject standard deviation (wSD), within-subject coefficient of variation (wCV%), coefficient of repeatability, and intraclass correlation coefficient (ICC). STATISTICAL TESTS: Paired t-tests assessed systematic differences (α = 0.05); ICCs used a two-way random-effects, absolute-agreement model (ICC(2,1)). RESULTS: PDFF showed lowest variability across all regions (wCV: 1.5%-5.9%; ICC: 0.33-0.96). SFA demonstrated similar stability (wCV: 2.4%-12.6%; ICC: 0.19-0.87). MUFA exhibited anatomy-dependent reliability (wCV: 4.1%-21.1%; ICC: 0.17-0.97), with highest repeatability in subcutaneous adipose tissue (ICC: 0.97) and Hoffa's fat pad (ICC: 0.85). PUFA displayed the greatest variability (wCV: 3.6%-52.8%; ICC: 0.10-0.94), with the greatest instability in periarticular fat pads. No paired comparisons were significant (all p > 0.05; range p = 0.14-0.98). Regional ordering remained consistent across sessions. DATA CONCLUSION: A 12-echo chemical shift-encoded MRI protocol provides repeatable PDFF and SFA measurements over 1 week. MUFA reliability varies by tissue, while PUFA remains least stable. EVIDENCE LEVEL: 2 (Prospective cohort). TECHNICAL EFFICACY STAGE: 2 (Reproducibility/feasibility evaluation).
Performance of Free-Running Cardiac and Respiratory Motion-Resolved Whole-Heart 5D MRI in Congenital Heart Disease Patients Using a Gadolinium Enhanced Fast-Interrupted Steady-State Sequence.
Roy CW, Vogeli E, Megalo A … +11 more , Dirbach F, Bastiaansen JAM, Yerly J, Mueller M, Rodrigues D, Ledoux JB, Schwitter J, Prša M, Tenisch E, Rutz T, Stuber M
J Magn Reson Imaging · 2026 Jun · PMID 42340157 · Publisher ↗
BACKGROUND: The performance of 5D imaging in CHD has been previously demonstrated using ferumoxytol rather than gadolinium. PURPOSE: To evaluate the performance of gadolinium enhanced 5D MRI relative to 2D and 3D MRI in...
BACKGROUND: The performance of 5D imaging in CHD has been previously demonstrated using ferumoxytol rather than gadolinium. PURPOSE: To evaluate the performance of gadolinium enhanced 5D MRI relative to 2D and 3D MRI in CHD patients. STUDY TYPE: Retrospective. SUBJECTS: 45 consecutive CHD patients referred for clinically indicated MRI who underwent 2D, 3D, and 5D MRI. FIELD STRENGTH/SEQUENCE: 2D bSSFP CINE, 3D bSSFP, and 5D FISS at 1.5 T. ASSESSMENT: Scan time (2D, 3D, and 5D), left and right ventricular (LV, RV) end diastolic and end systolic volumes (LVEDV, RVEDV, LVESV, and RVESV, respectively), ejection fraction (LVEF, RVEF) for 2D versus 5D, and image quality on a 4-point Likert scale (3D vs. 5D). STATISTICAL TESTS: Paired comparisons were made using a paired t-test or Wilcoxon signed rank test. Agreement between measurements was evaluated with Bland-Altman analysis including the bias and 95% limits of agreement. RESULTS: Scan time for 5D (6:18 [0]) was significantly shorter than 2D (7:16 [4:39]) and 3D (6:55 [1:30]) MRI. 5D measurements were strongly correlated with 2D measurements of LVEDV (R = 0.94), LVESV (R = 0.83), LVEF (R = 0.51), (R = 0.85), RVESV (R = 0.80), and RVEF (R = 0.66) but with significant biases. Sharpness of the coronary arteries were significantly higher for 3D (RCA: 36.8% ± 10.2%, LAD: 40.5% ± 10.5%) than 5D (RCA: 24.3% ± 7.5%, LAD: 31.7% ± 8.7%), but longer vessel segments were visible using 5D (LAD: 6.9 ± 2.5) than 3D (LAD: 5.3 ± 2.9 mm) acquisitions. The grades for 5D (R1: 3 [1], R2: 2.5 [0.5], R3: 3 [0.6]) were significantly higher than 3D (R1: 3 [1], R2: 2.5 [1], R3: 2 [1]). DATA CONCLUSION: Gadolinium-enhanced 5D MRI may provide an efficient and simplified acquisition for CHD patients, with multiple quantitative parameters from 5D being not significantly different from those from reference standard 2D and 3D MRI. EVIDENCE LEVEL: 4 STAGE OF TECHNICAL EFFICACY: 1.
Effect of Visualized Respiratory Training on Patient Cooperation and Image Quality in Gadoxetic Acid Disodium-Enhanced Liver MRI: A Randomized Controlled Trial.
Mei L, Luo X, Wang B … +5 more , Wang J, Huang C, Hu X, Li Q, Zhang W
J Magn Reson Imaging · 2026 Jun · PMID 42334016 · Publisher ↗
BACKGROUND: Respiratory motion artifacts impair diagnostic accuracy in gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced liver MRI. Conventional verbal pre-scan breathing training often yields inconsistent patient cooperati...
BACKGROUND: Respiratory motion artifacts impair diagnostic accuracy in gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced liver MRI. Conventional verbal pre-scan breathing training often yields inconsistent patient cooperation and image quality, creating an urgent clinical need for optimized training methods. PURPOSE: To evaluate the impact of a visualized respiratory training method integrated into clinical workflow on patient cooperation, image quality, and examination efficiency for Gd-EOB-DTPA-enhanced liver MRI. STUDY TYPE: Prospective, single-center, randomized controlled trial. POPULATION: One hundred and eighty-four patients (135 males; mean age 53.5 ± 13.3 years) scheduled for first-time Gd-EOB-DTPA-enhanced liver MRI. FIELD STRENGTH/SEQUENCE: 3 T; Dynamic contrast-enhanced imaging was performed with a 3D fast spoiled gradient-echo sequence, covering pre-contrast, arterial, portal venous, transitional, and hepatobiliary phases. ASSESSMENT: Primary outcome was patient cooperation rate assessed by blinded MRI technologists. Secondary outcomes included motion artifact scores (rated by three blinded radiologists), Signal-to-Noise Ratio (SNR), Contrast-to-Noise Ratio (CNR), transient severe motion (TSM) incidence, and examination duration. STATISTICAL TESTS: Student's t-test, Mann-Whitney U test, Chi-square test, and Gamma correlation; two-tailed p < 0.05 indicated significance. RESULTS: The experimental group (85 patients) had a significantly higher full cooperation rate (56.5% [48/85] vs. 27.3% [27/99], OR = 3.46, 95% CI: 1.87, 6.40, γ = 0.406), significantly lower motion artifact scores in arterial/portal venous/transitional phases, and significantly higher arterial and transitional phase SNR/CNR. The experimental group also showed significantly shorter preparation time (14.40 ± 2.36 vs. 16.16 ± 2.20 min; mean difference: -1.76 min; 95% CI: -2.42, -1.101). Scanning time did not differ significantly between groups (24.60 ± 1.60 vs. 24.89 ± 2.21 min; p = 0.329). TSM incidence did not differ significantly between groups (1.18% vs. 5.05%, p = 0.219). DATA CONCLUSION: Visualized respiratory training significantly improves patient cooperation, image quality, and workflow efficiency in Gd-EOB-DTPA-enhanced liver MRI, with no additional resource requirements supporting its routine clinical adoption. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 1.
Impact of Different Degrees of Liver Iron Concentration on MRI Feature Assessment and LI-RADS v2018 Category Assignment for Hepatocellular Carcinoma.
Cao S, Jianwen L, Su X … +4 more , Gao X, Li Q, Zhang J, Guo R
J Magn Reson Imaging · 2026 Jun · PMID 42334007 · Publisher ↗
BACKGROUND: Hepatocellular carcinoma (HCC) in high-risk patients can be diagnosed by imaging alone, avoiding biopsy. However, whether liver iron concentration (LIC) affects MRI diagnostic performance remains uncertain. P...
BACKGROUND: Hepatocellular carcinoma (HCC) in high-risk patients can be diagnosed by imaging alone, avoiding biopsy. However, whether liver iron concentration (LIC) affects MRI diagnostic performance remains uncertain. PURPOSE: To investigate the impact of different degrees of LIC on MRI feature assessment and LI-RADS v2018 category assignment in high-risk HCC patients. STUDY TYPE: Retrospective. POPULATION: One hundred sixty-three consecutive HCC patients (mean age, 55.73 ± 9.65 years; 152 male) with 167 lesions. FIELD STRENGTH/SEQUENCE: 3.0 T. Protocol followed LI-RADS with extra sequences (R*, PDFF). Contrast agents included gadoxetate disodium (49 lesions), gadobenate dimeglumine (114 lesions), and Magnevist (4 lesions). ASSESSMENT: According to hepatic R* values, patients were divided into three groups: non-iron overload (80 lesions), mild (54 lesions), and moderate-to-extreme (33 lesions). Three observers independently evaluated LI-RADS v2018 major, ancillary, and LR-M features, categories, and T1 signal. STATISTICAL TESTS: ANCOVA/Kruskal-Wallis H test, chi-square/Fisher's exact tests, and logistic regression. A two-sided p < 0.05 was considered statistically significant. RESULTS: The incidences of T1 iso-/hyperintensity, nonperipheral "washout", enhancing "capsule" and HBP hypointensity differed significantly among groups. Moderate-to-severe hepatic iron overload independently influenced T1 iso-/hyperintensity (OR = 14.38 [95% CI: 4.08-50.70]) and nonperipheral "washout" (OR = 0.14 [95% CI: 0.05-0.41]). Hepatic iron overload was independently associated with enhancing "capsule" (mild: OR = 0.34 [95% CI: 0.16-0.72]); moderate-to-severe: (OR = 0.15 [95% CI: 0.06-0.37]). HBP hypointensity was influenced by Child-Pugh class B (OR = 14.51 [95% CI: 1.13-185.88]), total bilirubin (OR = 0.09 [95% CI: 0.83-0.97]), albumin (OR = 1.49 [95% CI: 1.18-1.89]), PLT (OR = 0.99 [95% CI: 0.98-1.00]) and moderate-to-severe hepatic iron overload (OR = 0.01 [95% CI: 0.00-0.25]). Proportions of LR-4 and LR-5 differed significantly among groups, and only moderate-to-severe hepatic iron overload was associated with LR-5 assignment (OR = 0.08 [95% CI: 0.02-0.28]). CONCLUSION: Hepatic iron overload, especially moderate-to-extreme, may affect the visual assessment of selected MRI features and alter LI-RADS v2018 category assignment. TECHNICAL EFFICACY STAGE: 2.
Postprandial Changes in Thoracic Aortic Flow Detected by 4D Flow MRI May Influence Study Results.
Balks MF, Quest L, Stroth A … +9 more , Reiber A, Ulloa P, Kirschke N, Sieren MM, Graessner J, Kooijman H, Barkhausen J, Frydrychowicz A, Oechtering TH
J Magn Reson Imaging · 2026 Jun · PMID 42333994 · Publisher ↗
BACKGROUND: While there is a growing body of data using 4D flow MRI to distinguish between normal and abnormal blood flow values in the thoracic aorta, the extent of physiological variation or lack thereof is potentially...
BACKGROUND: While there is a growing body of data using 4D flow MRI to distinguish between normal and abnormal blood flow values in the thoracic aorta, the extent of physiological variation or lack thereof is potentially undervalued. Physiological processes such as postprandial changes to hemodynamics might influence data, normal values, follow-up studies, and data compared between study sites. PURPOSE: To determine the influence of food intake on flow parameters in the thoracic aorta of young healthy volunteers by 4D flow MRI. STUDY TYPE: Prospective. SUBJECTS: 20 young healthy (10 male, 10 female) volunteers were recruited for this study. FIELD STRENGTH/SEQUENCE: 3T/4D flow MRI (three-dimensional time-resolved phase-contrast spoiled gradient-echo with three-directional velocity-encoding). Technical parameters were chosen according to consensus recommendations, including the use of a respiratory navigator, included a 10 mm respiratory navigator window, retrospective ECG gating, VENC 180-200 cm/s, voxel size 2.5 × 2.5 × 2.0-2.5 mm, temporal resolution 41 ms and parallel imaging with acceleration factor of 4. Acquisition time was 10.3 ± 2.4 min. ASSESSMENT: Volunteers' thoracic aorta was imaged after fasting (food ≥ 6 h, liquid ≥ 2 h) and after a meal challenge to detect changes in aortic hemodynamics (stroke volume, flow, and velocity). STATISTICAL TESTS: Statistics included calculation of relative difference (RD), two-tailed paired t-test, and Pearson coefficient. p < 0.05 was considered significant. RESULTS: 4D flow MRI detected statistically significant postprandial increases in stroke volume (pre: 93 ± 18 mL; post: 99 ± 24 mL, RD = 5 ± 13%), peak flow (pre: 433 ± 95 mL/s; post: 467 ± 95 mL/s, RD = 9 ± 14%), peak average velocity (pre: 73 ± 18 cm/s; post: 78 ± 16 cm/s, RD = 8 ± 11%), and maximum velocity (pre: 118 ± 24 cm/s; post: 131 ± 23 cm/s, RD = 11 ± 11%); values given for ascending aorta. 74% of individuals presented with postprandial increase in peak flow and velocities throughout the thoracic aorta. DATA CONCLUSION: Food intake triggers a small but significant increase in stroke volume, flow, and velocity in the aorta in young healthy individuals. Depending on the study question and potential longitudinal comparisons, one may consider introducing a fasting period prior to 4D flow MRI to avoid measurements at peak postprandial hyperemia. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 3, diagnostic thinking.
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