Nobuo Kashiwagi¹, Yuichi Yamashita², Hitoshi Watanabe³, Hisashi Tanaka¹, Katsusuke Kyotani², Hiroto Takahashi¹, Chisato Matsuo¹, Takehisa Sakisuka¹, Azusa Miura¹, Masahiro Fujiwara¹, Atsuko Arisawa ¹, and Noriyuki Tomiyama^1
1Osaka University Graduate School of Mediine, Suita, Japan, ²Canon Medical Systems Corporation, Otawara, Japan, ³Department of Radiology, Yukoukai General Hospital, Ibaraki, Japan

Using deep learning reconstruction, we developed an ultrafast lumbar MRI protocol with a total acquisition time of 1 minute 53 seconds. Compared with the standard MRI protocol, the interprotocol agreement for the classification of degenerative lumbar changes was almost perfect or substantial agreement with weighted kappa values of 0.72 to 0.84. The two protocols showed 100% concordance for the detection of clinically significant pathologies. Our preliminary study demonstrated that the ultrafast lumbar MRI protocol adequately preserved diagnostic equivalency with the standard protocol, suggesting that it could be an alternative protocol for restless patients and in an emergency setting.

 

Aiming Lu¹, Carrie M Carr¹, Norbert G Campeau¹, Steven A Messina¹, and David F Kallmes^1
1Radiology, Mayo Clinic, Rochester, MN, United States

Zero TE (ZTE) sequences have been demonstrated to be capable of achieving CT-like images of the skull and C-spine. To obtain high-resolution images of the skull and c-spine, two separate acquisitions are often performed. Although in general cortical bone, soft tissue and air could be differentiated based on the signal intensity, fatty tissues and connective tissues can be problematic due to the chemical shift artifacts and/or having similar signals to that of cortical bones. This work demonstrated that with optimized protocol and advanced post-processing, ZTE MRI allows for high quality skull and C-spine images in a single acquisition.

Shao-Chieh Lin¹, Chun-Jung Juan², Yi-Jui Liu³, Chun-Wen Chen⁴, Chien-Yuan Wang⁵, Wu-Chung Shen⁶, Der-Yang Cho⁷, and Kai-Yuan Cheng^8
1Ph.D. program in Electrical and Communication Engineering, Feng Chia University, Taichung, Taiwan, ²Department of Medical Imaging, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, ³Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, ⁴Department of Radiology, Taichung Armed Forces General Hospital, Taichung, Taiwan, ⁵Department of Orthopedics, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, ⁶Department of Medical Imaging, China Medical University Hospital, Taichung, Taiwan, ⁷Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan, ⁸Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan

Lumbar vertebral osteoporosis (LvOPO) in women is clinically important. It is affected by mixed causes, including but not limited to the aging, lumbar vertebral fat fraction (LvFF), and estrogen. In the current study, the LvOPO in women was diagnosed by a newly proposed hybrid scoring system, i.e., the LvOPO score (LvOPOS). By integrating the independent predictors including age, LvFF, and menopause-MR interval (MMI), the LvOPOS achieved an AUC higher than the LvFF (0.802), age (0.794), and MMI (0.788). Our results provide a new insight in diagnosing the LvOPO specific to women with relevant to both clinical and MR features.

LiLan Wu¹, JianJun Zhou², and Pu-Yeh Wu^3
1Department of Radiology, Fudan University Affiliated Zhongshan Hospital Xiamen Branch, Xiamen, China, ²Department of Radiology, Fudan University Affiliated Zhongshan Hospital, Shanghai, China, ³GE Healthcare, Beijing, China

This study aims to investigate whether human lumbar IDD can be detected using R2*, UTE-T2* and T1rho mapping. We systematically compared the efficacy of R2*, UTE-T2* and T1rho values in the diagnosis of early IDD. Specifically, we found that T1rho value is superior to UTE-T2* and R2* values for diagnosis of the early IVD, while UTE-T2* value is optimal for diagnosis of advanced IVD. Overall, we concluded that R2* and UTE-T2* mapping provides another promising method for quantitatively evaluated lumbar IDD, and T1rho mapping can be considered an effective tool for distinguishing IDD at earlier stage of the degenerative process

Shuai Zhang¹, Xiangtao Lin², Ximing Wang², Xiang Feng³, and Rui Diao^2
1School of Medicine, Shandong First Medical University, School of Medicine, Shandong First Medical University, Jinan, China, ²Department of Radiology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China, ³MR Scientific Marketing, Diagnosis Imaging, Siemens Healthcare Ltd, Beijing, China

Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. Postmortem magnetic resonance imaging was performed on 55 fetuses (gestational ages, 17–42 weeks) by using three-dimensional T2-weighted sequences. The volumes of interest were manually outlined for the cervical, thoracic, lumbar, and L1–L5 centrum ossification centers (COCs), and the COC volumes (COCVs) were calculated. The cervical, thoracic, and lumbar COCVs showed a positive relationship with gestational age.The cervical, thoracic, lumbar, and L1–L5 COCVs show good correlation with gestational age in the second and third trimesters. 

Qizheng Wang¹, Siyuan Qin¹, Yang Zhang², Enlong Zhang³, Xiaoying Xing¹, Min-Ying Su², and Ning Lang^1
1Radiology, Peking University Third Hospital, Beijing, China, ²Center for Functional Onco-Imaging, Irvine, CA, United States, ³Radiology, Peking University International Hospital, Beijing, China

A new evaluating system based on tumor immunohistochemistry and preoperative MRI features in spinal giant cell tumor of bone to predicting overall survival of total en bloc spondylectomy patients with over 2 years follow up. The largest lesion diameter (>4.2 cm) and the vertebral compression were  independent predictors of postoperative recurrence. According to Kaplan-Meier survival analysis, the cystic change in the lesion and the degree of compression ≥50% suggest a worse clinical outcome. The expression levels of vascular endothelial growth factor and p53 gene have no obvious clinical significance on the survival outcome. H3F3A was positively expressed in our cohort.

Yu Song¹, Qingwei qing Song², Yingkun Guo¹, Gang Ning¹, and Xuesheng Li^1
1Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China, ²Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China

Compressed SENSE (CS) is a cutting-edge signal acquisition and processing innovation technology based on applied mathematics. By directly collecting the compressed signal, the amount of sampled data is greatly reduced, and the optimal acceleration factor can be passed. The realization of the method can shorten the clinical magnetic resonance scanning time while ensuring the spatial resolution.

Yinqi Liu¹, Huiting Deng¹, Weiyin Liu², and Kun Zhang^1,3
1Department of Radiology, First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China, ²MR Research, GE Healthcare, Beijing, China, ³College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, China

Chronic low back pain (CLBP) has been reported to be associated with low back dysfunction with the characteristics of decreased cross-section area (CSA) of paraspinal muscles and increased adipose content. In our study, T2 value at L4/L5 multifidus muscle was significantly higher in LBP group than in HCs. The multifidus muscle is the most medial in the low back extensor group and has the maximum strain stress when spinal movement and balance maintenance, so it might easily cause the abnormality of the low back muscle group. T2 mapping could be a good predictor of detecting minimal variation of multifidus muscles.

Jin Liu¹, Yajun Ma², Jianwei Liao¹, Xiaojun Chen¹, Wei Li¹, Lin Yao¹, Zhihai Su³, Long Qian⁴, Jiang Du², and Shaolin Li^1
1Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China, ²Department of Radiology, University of California, San Diego, CA, United States, ³Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China, ⁴MR Research, GE Healthcare, Guangzhou, China

Ultrashort echo time magnetization transfer (UTE-MT) sequence can quantify magnetization transfer ratio (MTR) values of short T2 tissues, which has potential to evaluate early disc degeneration. The current study aims to assess the feasibility of UTE-MT quantification of cartilaginous endplate for evaluation of early disc degeneration. In addition, the latent associations between the UTE-MTR and grade of disc degeneration, age, gender, the oswestry disability index (ODI) were evaluated, respectively. Our results demonstrated that the UTE-MT sequence is feasible to quantify cartilaginous endplate in lumbar spine. UTE-MTR may be a potentially useful biomarker in the assessment of early lumbar disc degeneration.

Zeng Xiao min¹, Huang Yi long², Nie Li sha³, and He Bo^1
1The First Affiliated Hospital of Kunming Medical University, Kunming, China, ²The First Affiliated Hospital of Kunming Medical University, kunming, China, ³GE healthcare, China, Beijing, China

This study analyzed the relationship between the cross-sectional area (CSA), effective lateral relaxation rate (R2* value), fat fraction (FF value) of lumbar paraspinal muscles of patients with chronic low back pain (CLBP group) and asymptomatic control group (Control group). The multifidus muscle and erector spinae muscle at the central level of the L4/L5 intervertebral disc were the target muscles.BOLD and IDEAL-IQ provided a new idea for imaging evaluation of lumbar paraspinal muscles. Our study concluded that BOLD and IDEAL-IQ are feasible to evaluate the changes of lumbar muscle morphology and function in patients with CLBP.

Amir Masoud Afsahi¹, Zhao Wei¹, Michael Carl², Saeed Jerban¹, Hyungseok Jang¹, Nicole Le¹, Jiang Du¹, Eric Y. Chang^1,3, and Ya-Jun Ma^1
1Department of Radiology, University of California, San Diego, San Diego, CA, United States, ²GE HealthCare, San Diego, CA, United States, ³Radiology Service, Veterans Affairs, San Diego Healthcare System, San Diego, CA, United States

To explore the application of a 3D slab-selective UTE sequence as a superior technique to 3D ZTE at 3T field strength and to compare with 3D CT as a gold standard in Lumbar spinal bone assessment.

Kaiwen Yang¹, Baofa Luo¹, Yilong Huang¹, Lisha Nie², and Bo He^1
1Medical imaging department, The First Affiliated Hospital of Kunming Medical University, Kunming, China, ²GE Healthcare,MR Research China, Beijing, China

Based on functional MRI, the current study aims to explore the pathological morphology, fat infiltration and the expression of TNF-α in paraspinal muscles of discogenic low back pain(DLBP）. And to further explore the relation of rehabilitation exercise on paraspinal muscles and intervertebral discs in rats. It is concluded that rehabilitation exercise can reduce the content of TNF-α in serum and paraspinal muscles, relieve the symptoms of DLBP in rats, and improve paraspinal muscle dysfunction.

Yongye Chen¹, Enlong Zhang ², Qizheng Wang ¹, Huishu Yuan¹, Huishu Yuan¹, Hongqing Zhuang¹, and Ning Lang^1
1Peking University Third Hospital, Beijing, China, ²Peking University International Hospital, Beijing, China

The imaging methods used to evaluate the efficacy of radiosurgery in spinal metastases have certain limitations. DCE-MRI can help determine the vascularity and hemodynamics of tumors in vivo, and can be used to evaluate local tumor response. Twenty-seven patients with 39 lesions were included. Post-treatment Kep, ΔKtrans and ΔKep in the non-progressive disease group were significantly lower than the corresponding values in progressive disease group. Post-treatment Ve and ΔVe in the non-progressive disease group were significantly higher than that of the progressive disease group. ΔKtrans had the highest diagnostic efficiency, with an AUC of 0.821.

Xiaoqing Liang¹, Weiyin Vivian Liu², Yitong Li¹, and Xiaoming Li^3
1Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²MR Research, GE Healthcare, Beijing, China, ³1Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Synthetic MRI has become a recent research hotspot due to its advantages of short-time acquiring multiple sets of weighted images and quantitative maps in one time. Synthetic MRI has been successfully used for the diagnosis of many cerebral diseases, but its feasibility and stability in other tissues and lesions need to be further studied. The current study demonstrates that the utility of synthetic MRI is slightly better than conventional T2 mapping in diagnosing intervertebral disc degeneration. In addition, one-time MAGiC scan on lumbar vertebrae should be concerned for clinical diagnosis.

Yan Xiong¹, Weiyin Vivian Liu ², Fan He¹, Yanan Wang¹, Yao Zhang¹, Shuang Hu¹, and Xiaoming Li^1
1Wuhan Tongji Hospital, Wuhan, China, ²MR Research, GE Healthcare, Beijing, China

 Mineral bone disease (MBD) has an extremely high incidence in patients with chronic kidney disease (CKD) and significantly affects the prognosis and quality of life of patients. However, the current diagnostic methods are difficult to determine the type and severity of CKD-MBD. In our study, histogram analysis of IDEAL-IQ showed kurtosis and R2* could distinguish bone marrow changes in patients with CKD at different stages in indication of altered skeletal health and bi-component analysis of UTE images demonstrated short T2* value possibly in reflection of trabecular bone was highly correlated with blood biochemical indicators.

Takafumi Yoda¹, Satoshi Maki², Koji Matsumoto¹, Hajime Yokota³, Yoshitada Masuda¹, and Takashi Uno^3
1Department of Radiology, Chiba University Hospital, Chiba, Japan, ²Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan, ³Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan

The Differentiating between osteoporotic vertebral fractures (OVFs) and malignant vertebral compression fractures (MVFs) due to spinal metastasis is a challenging problem for the spine surgeons and the radiologists. We evaluated the performance of our CNN model in differentiating between OVFs and MVFs on short-TI inversion recovery (STIR) and T1-weighted (T1WI) images compared with the performance of three spine surgeons. The sensitivity, specificity, and accuracy of the CNN on both STIR and T1WI were equal to or better than those of the three spine surgeons.

Zhilin Ji¹, Weiqiang Dou², Yuefen Zou¹, Yin Shi¹, Yu Zheng¹, and Hongyuan Ding^1
1The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, ²GE Healthcare, MR Research China, Beijing, P.R. China, Beijing, China

In this study, we aimed to investigate the feasibility of ultra-short echo time (UTE) imaging for assessing the cartilage endplate (CEP) damage and evaluate the relationship between the grading of CEP and lumbar disc degeneration. UTE images with short and long TEs were performed on patients with low back pain. The resultant subtracted UTE images between short and long TEs showed well structural CEP clearly. Strong correlation was observed between CEP degree based on UTE imaging and lumbar intervertebral disc degeneration. With these findings, UTE imaging might thus be considered an effective tool to assess the CEP damage in clinic.

Xiaoqing Liang¹, Weiyin Vivian Liu², and Xiaoming Li^1
1Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²MR Research,GE Healthcare, Beijing, China

    Lumbar intervertebral disc (IVD) and lumbar facet joint (LFJ) are the primary and important load-bearing structures in spine. Any abnormality of the anterior IVD and the two posterior LFJs may lead to spinal instability and low back pain (LBP). The current study demonstrates that LFJ degeneration occurs earlier and progresses more slowly than IVD degeneration. Histogram analysis of T2 and T2* values is feasible for detecting and grading IVD but not LFJ degeneration.

Xing Yin¹, Xin Zhao¹, Liying Zhang¹, Qingna Xing¹, Rui Yuan², and Zhijun Niu^3
1Radiology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²Ultrasound, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ³Obstetrics and Gynecology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China

In the last few years, fetal magnetic resonance (MR) has been more and more used in the obstetrics and gynecology. We measure the height and length of each lumbar vertebra body ossification center and the height of each intervertebral gap, and our results show a good linear correlation between normal lumbar vertebra body ossification center development and gestational age in vivo

Xiaolin Guo^1,2, lixia Qian², Yueluan Jiang³, and Zhongshuai Zhang^4
1Medical Imaging, Shanxi Medical University, Taiyuan, China, ²Department of Radiology, Shanxi Bethune Hospital, Taiyuan, China, ³MR Scientific Marketing, Diagnosis Imaging, Siemens Healthineers China, Beijing, China, ⁴MR Scientific Marketing, Diagnosis Imaging, Siemens Healthineers China, Shanghai, China

Advanced DWI techniques, diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM), can complement physiological information to morphological information that was obtained with conventional MRI This study investigated the application of DKI and IVIM in diagnosis of active sacroiliitis with ankylosing spondylitis.