Magnetic resonance imaging
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We retrospectively compared the diagnostic accuracy of abdominal ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) studies performed on the same individual to determine the relative performance of these modalities in the evaluation of disease processes, arising from different intra-abdominal organ systems. We retrospectively reviewed all procedure codes accrued by our abdominal imaging section during a 1-year period to determine how many patients underwent all three imaging procedures in our institution within a 2-week interval. These cases were then further evaluated to determine: (1) the primary organ system of disease involvement, (2) the final diagnosis, and (3) the imaging modality that provided the most accurate information upon which appropriate medical management was based. ⋯ Ultrasound, CT, and MR imaging correctly diagnosed the disease process in 3 of 12 (25%), 3 of 12 (25%), and 10 of 12 (83%) patients, respectively, with liver disease; 2 of 9 (22%), 6 of 9 (66%), and 9 of 9 (100%) patients, respectively, with pancreatic disease; 17 of 17 (100%), 8 of 17 (47%), and 10 of 17 (58%) patients, respectively, with gallbladder and biliary disease; 2 of 8 (25%), 5 of 8 (63%), and 5 of 8 (63%) patients, respectively, with renal disease; 0 of 3 (0%), 2 of 3 (66%), and 3 of 3 (100%) patients, respectively, with adrenal disease; and 8 of 12 (75%), 12 of 12 (100%), and 12 of 12 (100%) patients with free intraperitoneal fluid. Our results provide new information, regarding the relative benefits of ultrasound, CT, and MRI for the investigation of abdominal diseases at our institution. This initial data suggests that ultrasound provides the most accurate diagnoses in the investigation of gallbladder disease; MRI provides the most accurate diagnoses in the investigation of hepatic, adrenal, and pancreatic disease; and either CT or MRI may be the most appropriate first imaging study for the detection of renal disease.
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Comparative Study
Reduced susceptibility effects in perfusion fMRI with single-shot spin-echo EPI acquisitions at 1.5 Tesla.
Arterial spin labeling (ASL) perfusion contrast is not based on susceptibility effects and can therefore be used to study brain function in regions of high static inhomogeneity. As a proof of concept, single-shot spin-echo echo-planar imaging (EPI) acquisition was carried out with a multislice continuous ASL (CASL) method at 1.5T. ⋯ The results demonstrate improved functional sensitivity and efficiency of the spin-echo CASL approach as compared with gradient-echo EPI techniques, and a trend of improved sensitivity as compared with spin-echo EPI approach in the brain regions affected by the susceptibility artifact. ASL images, either with or without subtraction of the control, provide a robust alternative to blood oxygenation level dependant (BOLD) methods for activation imaging in regions of high static field inhomogeneity.