Launch of the world’s first 7 T MR platform intended for clinical use (Siemens)

Erlangen, Germany, May 31, 2015 — Siemens announced at the Toronto ISMRM (International Society for Magnetic Resonance in Medicine) meeting the launch of the world’s first 7 T MR platform intended for clinical use. Important advances include a new, light, actively shielded magnet with zero helium boil-off and dual operating modes, enabling rapid switching between research […] [...]

Case Report: Assessment of Renal Allograft Function with DTI and Tractography

This case report demonstrates that DTI and tractography is a promising way to quantitatively and visually assess renal allograft function after kidney transplantation. Download/View PDF   [...]

Tethered cord

Tethered cord. The end of medullary cone is not in the due position of normal  L1 level, while its position is on L5 level or lower at present. Fat deposition could be seen at the posterior part of spinal canal, on L5-S2 level, with extremely high signal on T1WI and slightly high signal on T2WI. […] [...]

Clinical Case: 3 Tesla MR Neurography-Guided Posterior Femoral Cutaneous Nerve Block

The high SNR available at 3T provides the ability to perform high-resolution MR neurography-guided perineural injections for highly accurate visualization of small nerve as well as needle targeting and perineural injection. This case report demonstrates how this techniques facilitates accurate targeting of the PFCN.  Download/View PDF [...]

fit-Upgrade: A Success Story

The fit-upgrade for 1.5 and 3T systems remains an economically attractive approach for an aged MR system. By improving system performance and workflow, the number of examinations can be increased, together with improved image quality, with little effort. Download/View PDF [...]

Acute and chronic vertebral compression fractures

An 83 year old woman with back pain. [...]

C3 burst fracture

A 77 year-old woman seen in the emergency room, following trauma, with cervical pain but no neurologic deficit. [...]

First Experiences with the Whole-Body Dot Engine

Whole-body MRI is beneficial in many clinical scenarios including bone marrow, infectious and rheumatic diseases. The Whole-Body Dot Engine provides fast and robust image quality across all patients, with fewer errors or need for repeated examinations. It ensures that all stations of a multi-station examination are performed with a consistent FOV and spatial resolution while […] [...]

Val M. Runge, MD – ASNR 2015 – Pearls and Pitfalls in Neuroradiology of Cerebrovascular Disease – The Essentials with MR and CT

This educational exhibit was presented at the ASNR 2015 meeting, with imaging performed on a 3 T Siemens Skyra MR system. The full reference for the exhibit is given below. Runge V, Smoker W, Valavanis A. Pearls and Pitfalls in Neuroradiology of Cerebrovascular Disease – The Essentials with MR and CT. ASNR 53rd Annual Meeting, […] [...]

Oligodendroglioma (WHO grade II)

A 30 year old man referred to Neurosurgery for a mass lesion (of the brain) revealed by imaging at an outside hospital. [...]

Medulloblastoma (posterior fossa PNET)

A 7 year-old boy who presents with nausea and vomiting. [...]

Val M. Runge, MD – ASNR 2015 – Simultaneous Multi-Slice (Slice Accelerated) Diffusion EPI

This educational exhibit was presented at the ASNR 2015 meeting, with imaging performed on a 3 T Siemens Skyra MR system. The full reference for the exhibit is given below. Runge V, Richter J, Beck T, Piccirelli M, Valavanis A. Simultaneous Multi-Slice (Slice Accelerated) Diffusion EPI. ASNR 53rd Annual Meeting, April 25-30, 2015, Chicago, Illinois […] [...]

Disk space infection (L2-3)

A 70 year-old woman with chronic kidney disease, on IV antibiotics for osteomyelitis. [...]

Metastasis (breast carcinoma)

A 64 year-old woman with a history of breast cancer, presenting with weakness [...]

Practical Considerations for the Evaluation of the Neuroforamina in Routine Spine Imaging at 3T. A Case Series

Pathologies of the neuroforamina are one of the most frequent indications for spine surgery. However, in standard MRI with axial and sagittal planes and relatively thick slices (>3 mm) the diagnostic information may be limited for proper evaluation of the nerve roots. Prof. Marc-André Weber et al. (University Hospital Heidelberg, Germany) share practical tips on […] [...]

Pituitary microadenoma (prolactinoma, treated)

A 31 year-old woman with long-standing infertility, who prior to treatment presented with galactorrhea, now on cabergoline. [...]

Pituitary macroadenoma, with invasion of the left cavernous sinus

A 58 year old woman presenting with a visual field defect (bitemporal hemianopsia) [...]

Parenchymal hemorrhage, late subacute

A 68 year-old woman several weeks following a stroke. [...]

Periventricular leukomalacia

A 3 year-old girl, product of in vitro fertilization (with a normal twin), delivered by c-section at 30 weeks. She is mildly developmentally delayed, with spastic diplegic/triplegic cerebral palsy. [...]

Metastases (renal cell, lumbar)

A 56 year-old man with back pain [...]

Cavernous malformation

A 60 year-old woman with myelopathic symptoms, status/post cervical decompression, with follow-up cervical MR revealing a lesion in the pons. [...]

Intraductal papilloma

A 60 year-old woman with myelopathic symptoms, status/post cervical decompression, with follow-up cervical MR revealing a lesion in the pons. [...]

Intraductal papillary carcinoma

A 60 year-old woman with myelopathic symptoms, status/post cervical decompression, with follow-up cervical MR revealing a lesion in the pons. [...]

Invasive lobular carcinoma

A 60 year-old woman with myelopathic symptoms, status/post cervical decompression, with follow-up cervical MR revealing a lesion in the pons. [...]

Subarachnoid hemorrhage

subarachnoid hemorrhage well seen on T2 fl2d coronal GRE, subarachnoid hemorrhage of unknown reason, may have small thrombosed cortical vein – very small, on pre-contrast T1, also likely small adjacent skull hemangioma, seen on both CT and MR Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

Silicone lymphadenopathy

A 60 year-old woman with myelopathic symptoms, status/post cervical decompression, with follow-up cervical MR revealing a lesion in the pons. [...]

Musculoskeletal Imaging at 3T with Simultaneous Use of Multipurpose Loop Coils

This paper shows how the simultaneous use of multipurpose loop coils in MRI allows high-resolution musculoskeletal studies with increased contrast and specificity for assessing muscles, tendons, ligaments, joints, and cartilage. Dr. Ferrer presents a number of different daily patient routine examinations, including specifically evaluation of the carpal bones, the thumb metacarpals, the metacarpals, the distal inter-phalangeal joints, the elbow and ankle. [...]

MRI Assessment of Articular Cartilage Repair

The evolution of sophisticated surgical repair procedures for the treatment of isolated, focal traumatic or degenerative cartialge lesions has created the need for accurate, non-invasive assessment of the repair tissue. MRI depicts well subchondral bone and bone marrow, allowing examination of repair tissue and its interface with parent cartilage and complications of repair surgeries such as graft hypertrophy and delamination. [...]

syngo WARP – Metal Artifact Reduction Techniques in Magnetic Resonance Imaging

The term WARP summarizes methods to minimize the impact of metal implants on MR image quality. This article introduces different techniques such as high bandwidth, VAT and SEMAC. [...]

MSK Imaging Tips and Tricks

Mark Lourensz from the MRI Department at St. Vincent’s Hospital in Melbourne, Australia shares tips and tricks on a broad range of musculoskeletal topics extending from standard joint MRI to whole limb tumor evaluation. Some of these may be common sense, but it doesn’t hurt to revisit the basics occasionally. [...]

Job’s Syndrome

Contrast-enhanced MR imaging is a particularly sensitive method for detecting soft-tissue masses, providing as well precise localization and definition of extent. In his case report, G. Hadjidekov et al. (Sofia, Bulgaria) presents a rare immunodeficiency disorder known as Job’s syndrome. The case shows the usefulness of MRI to analyze skin disorders and deeper soft-tissue masses in various locations. [...]

Bone and Soft Tissue Tumor Imaging: An Overview

Tumor imaging can be daunting, given the high stakes involved with a missed diagnosis or mis-diagnosis resulting in unnecessary further investigations, biopsies or even surgeries. In their article Marcus Pianta, Mark Lourensz et al. (St. Vincent’s Hospital, Fitzroy, Australia) describe their routine imaging protocol targeted to bone and soft tissue lesions, describe reporting and what the referring physicians need to know. [...]

MR Neurography – Diagnostic Criteria to Determine Lesions of Peripheral Nerves

MR Neurography is an excellent technique for visualization and evaluation of peripheral nerve disorders. In their article Philipp Bäumer et al. (Heidelberg University Hospital, Heidelberg, Germany) show high resolution intra-neural fascicular detail in both normal and abnormal states and cover different aspects including clinical indications, protocols, pitfalls, and useful applications. [...]

Toxoplasmosis

A 30 year-old woman with HIV [...]

ACOM aneurysm

A flow void is noted in the region of the anterior communicating artery (ACOM) on an axial T2-weighted image, with signal intensity corresponding to arterial flow on an axial source image from a 3D TOF MRA. CE MRA images further confirm the aneurysm, with the right A1 segment of the ACA noted to be very […] [...]

ACA aneurysm

Note the prominent pulsation artifact in the first image (a FSE T1-weighted scan at 3 T), seen propagating in the left-right dimension. On the post-contrast image (a short TE GRE scan), the aneurysm is well depicted, other than partial volume effects (due to the 4 mm slice thickness). This 2D scan is relatively immune to […] [...]

Ankylosing spondylitis, chronic disease

There is marked irregularity and sclerosis of the sacroiliac joints bilaterally. Fatty changes are noted as well, in the sacrum, bordering the joint. There is little edema within the bone adjacent to the sacroiliac joints. All are findings consistent with long standing disease. Part of the on-line supplement to Neuroradiology – The Essentials with MR […] [...]

Ankylosing spondylitis, hip disease

One-third of individuals with AS develop hip and shoulder involvement. Bilateral disease, with joint effusions and synovial enhancement are characteristic. Additional less common findings include subchondral bone marrow edema, erosive destruction, and fatty accumulation. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – […] [...]

Ankylosing spondylitis, sacroiliac joint disease

In this patient with long standing disease, joint space irregularity and adjacent fatty changes predominate. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

Ankylosing spondylitis, with bony ankylosis of the sacroiliac joints

In this 44-year-old patient, coronal images of the pelvis reveal fusion of the sacroiliac joints bilaterally. Sagittal images of the lumbar spine show vertebral body squaring and a bamboo like appearance due to diffuse ankylosis (and syndesmophytes). There is vertebral body fusion at multiple levels, with loss of disk space height and abnormal signal intensity […] [...]

Anterior and posterior fusion defects of C1

Note the well corticated margins and absence of a discrete fracture line. Such fusion defects are congenital in nature, and are primarily incidental findings. Incomplete posterior fusion can be seen in normal children up to the age of 10, with bony fusion typically occurring by age 5. Clefts of the posterior arch occur in 5% […] [...]

Cervical cord hemangioblastoma

Cervical cord hemangioblastoma, in a patient with von Hippel Lindau syndrome. A small enhancing intramedullary lesion is noted at C4, with mild accompanying vasogenic edema. 75% of spinal cord hemangioblastomas are sporadic, 25% occur in association with von Hippel Lindau syndrome. Spinal cord hemangioblastomas most commonly occur posteriorly within the cord, as in this patient. […] [...]

Chondrosarcoma of the cervical spine

The left lamina of C2 is involved by a focal mass lesion, which is slightly expansile in nature. A somewhat characteristic feature of the histologic diagnosis, reflecting hyaline cartilage, is the marked hyperintensity on the T2-weighted scan. There is moderate enhancement post-contrast, which as with the other findings (with the exception of the appearance on […] [...]

MR Tumor Staging for Treatment Decision in Case of Wilms Tumor

Nephroblastoma – also known as Wilms tumor – is the most frequent renal malignancy in childhood with the highest incidence of this tumor within the fourth year of life. 80% of patients are less than 5 years old, however it is a rare condition in neonates ([...]

Chronic dens fracture

A type II odontoid fracture is present, with non-union (pseudoarthosis). (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

DISH (diffuse idiopathic skeletal hyperostosis) in the cervical spine

In DISH (also known as Forestier disease) there is calcification and ossification of ligaments and entheses (the connective tissue between bone and a tendon or ligament) involving the vertebral column. Ossification of the anterior longitudinal ligament is common (and often marked), and may occur in conjunction with ossification of the posterior longitudinal ligament (OPLL). Both […] [...]

Imaging of Diseases of the Cranial Nerves: Tips and Tricks

This article focuses on common problems and pitfalls in MRI of pathologies of cranial nerves. It provides an introduction to helpful sequences and post processing techniques. To familiarize the reader with cranial nerve imaging, examples of the normal anatomy as well as typical pathological cases are shown. [...]

Epidural hematoma, spine, illustrating image composition

Composed sagittal T2-weighted, T1-weighted, and post-contrast T1-weighted images are presented. Each image is an automatically generated composition of two high-resolution independent cervicothoracic and thoracolumbar image acquisitions. The patient was on aspirin and Plavix, and presented with urinary retention and poor anal sphincter tone, consistent with a lesion compressing the conus medullaris. A predominantly deoxyhemoglobin epidural […] [...]

Advantages of MSK Imaging at 3 Tesla with special focus on Spine and Tumor Imaging.

The clinical advantages of upgrading to higher field strength (3T) magnets, improving coil technology, and using larger bore-sizes are proving to be significant. Through 10 case studies, it is suggested that the use of 3T open bore system with TrueForm technology can improve the diagnostic potential, as well as widen the indications, of MRI. The cases illustrate advantages of musculoskeletal imaging with a special focus on spine and tumor imaging. [...]

Hydatid cysts of the sacrum, ileum and L5

In the spine, with hydatid disease, there is typically slow resorption of trabeculae, without bony expansion, with a conglomeration of daughter cysts. This accounts for the multilocular appearance on MR, with high signal intensity on T2-weighted sequences. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement […] [...]

Hyperflexion injury with a clay-shoveler fracture

CT depicts an avulsion fracture of the spinous process of C6. MR reveals additional important findings, including the extensive posterior paraspinal muscular injury (edema), disruption of the interspinous ligament, compression fractures (marrow edema) involving multiple contiguous cervical and thoracic vertebral bodies, and extensive prevertebral edema as well as fluid (hemorrhage). Note that the cord appears […] [...]

Takotsubo Cardiomyopathy

This 70-year-old woman presented to the emergency room with acute onset of severe chest pain. No prior history of trauma. The pain started after a quarrel with her 45-year old daughter. The electrocardiogram did not reveal evidence of ischemic ST segment deviations. Creatinine kinase was of borderline value (10 U/L), but cardiac troponin T was elevated (2.15 µg/L). Coronary artery disease was ruled out by emergency coronary angiography. However, left ventricular angiography demonstrated apical ballooning with a reduced left ventricular ejection fraction. [...]

Ivory vertebra, metastatic prostate carcinoma

The ivory vertebra describes a dense sclerotic vertebral body on plain film or CT, with the correlate on MR being very low signal intensity on both T1- and T2-weighted sequences. L2 and S2 are involved in this fashion in the presented case, with additional metastatic lesions noted posteriorly in L1 and L3, together with mild […] [...]

Klippel-Feil

There is vertebral nonsegmentation at two levels, one involving a hemivertebra, together with a prominent scoliosis of the cervical spine. Also present is an anterior fusion defect of C1. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and […] [...]

Susceptibility-Weighted Imaging (syngo SWI) at 3T.

This is a pictorial review of susceptibility- weighted imaging (syngo SWI) using a MAGNETOM Trio system with software version syngo MR B15 and a 32-channel head coil at The Geelong Hospital, Victoria, Australia. syngo SWI is a 3D FLASH sequence that is flow compensated in slice, read and phase directions. [...]

Lipoma, tethered cord, hydromyelia, block vertebrae

The cord extends at least to the S1 level, with dilatation of the central canal within that portion visualized (hydromyelia). A small lipoma is noted within the bony spinal canal posteriorly at the S1 level. The axial scan at this level reveals the cord near its termination/posterior tethering, with the lipoma immediately contiguous bilaterally. Fusion […] [...]

Meningioma (WHO grade I, meningotheliomatous in type), cervical spine

A large, homogeneously enhancing, intradural extramedullary mass lesion is noted anteriorly within the thecal sac at the C2 level. There is prominent deformity and compression of the cord, long standing in nature, without evidence of edema or gliosis. Note the characteristic flat margin of the lesion along the dura. Part of the on-line supplement to […] [...]

Multiple myeloma

Back pain in a 58 year old woman [...]

Migrated disk fragment

There is mild loss of disk space height (and thus substance) at L5-S1. A left paracentral disk herniation is noted, at this level, together with superior migration. Note the slight hyperintensity of the superiorly migrated portion of the disk on the T2-weighted scan, consistent with a free fragment (which is also suggested by the extent […] [...]

Synovial cyst

Back pain in a 58 year old woman [...]

Multiple sclerosis, cervical and thoracic cord lesions

An enhancing cervical cord lesion is noted on sagittal and axial images, located at the C2 level, with an additional thoracic lesion (which did not enhance) depicted on a lower axial T2-weighted section. Neither lesion respects gray-white matter boundaries, as seen on the axial T2-weighted scans, a common finding for MR lesions of the cord. […] [...]

Tethered cord

Back pain in a 58 year old woman [...]

Hepatic Hemangioma

A 55 year old woman with an incidental finding on an MRI of the thoracic spine. [...]

Neurofibromatosis type 1

Dural ectasia and a lateral meningocele are present. Also noted are scalloped vertebrae and scoliosis. All are characteristic findings. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]

Acute cerebellar hemorrhage

Acute cerebellar hemorrhage, hypertensive. A large acute parenchymal hemorrhage is seen in the left cerebellar hemisphere, on sagittal, axial, and coronal reformatted images from a non-contrast CT exam. Note the vasogenic edema circumferential to this hematoma. Hemorrhage is also seen in the fourth ventricle on the axial image, with interstitial edema and ventricular enlargement noted […] [...]

Definition and Clarification of TR in Modern Imaging, with Emphasis on Cardiac Applications

As MR has evolved, the definition of TR has become quite complex, particularly with gated sequences. This article begins with an introduction to TR, covering its definition in spin echo and multislice fast spin echo sequences, and subsequently discusses in depth its definition in the plethora of cardiac gated sequences employed in modern imaging. [...]

Germinoma

A 22 year-old woman presents with a suprasellar mass on CT [...]

Acute infarction of the caudate head and lentiform nucleus

Both structures are supplied by the lateral lenticulostriate arteries, which originate from the MCA. The caudate nucleus is also supplied by the medial lenticulostriate arteries, which arise from the ACA. The recurrent artery of Heubner, which supplies the anteromedial caudate nucleus and the anteroinferior internal capsule, is the largest of the medial lenticulostriate arteries, and […] [...]

Oligoastrocytoma (WHO grade 2)

A 23 year old man presenting with a mass lesion on CT [...]

Acute lacunar infarction, posterior limb of the internal capsule

The patient was hypertensive, and presented for CT (which was negative) with acute hypoesthesia involving the left side of the body. The MR was obtained 15 hours later, and reveals a small acute lacunar infarct in the internal capsule on the right. Due to the ability to detect cytotoxic edema, with diffusion weighted imaging, MR […] [...]