MRI技術(shù)進展及臨床應用學習教案

1、會計學1MRI技術(shù)進展技術(shù)進展(jnzhn)及臨床應用及臨床應用第一頁，共74頁。第1頁/共73頁第二頁，共74頁。第2頁/共73頁第三頁，共74頁。第3頁/共73頁第四頁，共74頁。第4頁/共73頁第五頁，共74頁。第5頁/共73頁第六頁，共74頁。第6頁/共73頁第七頁，共74頁。第7頁/共73頁第八頁，共74頁。第8頁/共73頁第九頁，共74頁。第9頁/共73頁第十頁，共74頁。lDiffusion-weighted EPI demonstrates acute stroke in parietal lobelSub-acute, chronic lesions appear isoin

2、tense or hypointense relative to acute lesionlFLAIR + DW-EPI used to differentiate new from old lesions陳舊陳舊(chnji)區(qū)區(qū)細胞毒性細胞毒性(d xn)水腫區(qū)水腫區(qū)第10頁/共73頁第十一頁，共74頁。Negative Enhancement Integral (NEI)rCBV灌注灌注(gunzh)成象研究成象研究第11頁/共73頁第十二頁，共74頁。Mean Time to Enhance (MTE, MTT)新浪潮軟件新浪潮軟件灌注灌注(gunzh)成象研究成象研究第12頁/共73

3、頁第十三頁，共74頁。 Patient Status: post surgery and radiotherapy for glioblastoma EPI imaging is added to conventional MR to generate CBV Maps CBV Map can differentiate recurrent tumor from necrotic tissue or edemaEdema orRecurrent Tumor?Recurrent tumornot seen on T2 or T1Recurrent TumorCBV MapT2T1新浪潮軟件新浪潮

4、軟件腦血流灌注腦血流灌注(gunzh)診斷術(shù)后腫瘤再發(fā)診斷術(shù)后腫瘤再發(fā)第13頁/共73頁第十四頁，共74頁。lSt. Lukes Hospital, Milwaukee, WI, Breger et al.Diffusion vs. DSCreveals tissue-at-riskNEI圖圖MTE圖圖第14頁/共73頁第十五頁，共74頁。 human brain mapping臨床應用臨床應用:功能區(qū)域定位功能區(qū)域定位刺激刺激(cj)反應程反應程度度手術(shù)計劃系統(tǒng)手術(shù)計劃系統(tǒng)非損傷性治療非損傷性治療第15頁/共73頁第十六頁，共74頁。AVM Patient presenting with A

5、VM in middle temporal lobe fMRI of auditory activation performed with EPI imaging Eloquent region involved with auditory reception indentified posterior and superior to AVM - avoided and preserved during subsequent treatmentAVMHospital of the University of Pennsylvaniaauditory receptionfMRI用于手術(shù)用于手術(shù)(

6、shush)計劃系統(tǒng)計劃系統(tǒng)聽覺中樞反射區(qū)聽覺中樞反射區(qū)第16頁/共73頁第十七頁，共74頁。 Provides the capability to obtain the apparent diffusion coefficient of Provides the capability to obtain the apparent diffusion coefficient of underlying tissue and exp (-bunderlying tissue and exp (-b* *ADC) to eliminate/reduce T2-shine ADC) to elimi

7、nate/reduce T2-shine through effectsthrough effectsADC Mapping - FuncTool99ADC Mapping - FuncTool99第17頁/共73頁第十八頁，共74頁。T1-PostFLAIRADCRelativeAnisotropyImage Courtesy of Dr. Tsuruda, University of Utah第18頁/共73頁第十九頁，共74頁。Clinical Applications of Real-time fMRIImage Courtesy of Dr. Jackson, Dr. Sawaya,

8、 Dr. LeedsMD Andersen Cancer Center, HoustonSurgical PlanningLeft-handfinger tapping第19頁/共73頁第二十頁，共74頁。第20頁/共73頁第二十一頁，共74頁。Speed, Performance and Reliability Dedicated CardioVascular MR Ultrafast Techniques Tissue Characterization Coronary Myocardial Perfusion Detection of Infarct Time resolved MR a

9、ngio Vessel Wall Imaging Interactive real time Flow quantification第21頁/共73頁第二十二頁，共74頁。23ECG-Gated Double IR FSEAddenbrookes Hosp., Cambridge, UK第22頁/共73頁第二十三頁，共74頁。MR High resolution image of aortic valveCardiac MorphologyECG-gated black blood FSEBlood & fat suppressed using Dbl/Trpl IRHigh reso

10、lution images of aortic valve, comparable to EchoNHLBI,GEMSEpstein et al.Echocardiography image of aortic valve第23頁/共73頁第二十四頁，共74頁。The most powerful system in the industry 第24頁/共73頁第二十五頁，共74頁。Clinical MR Ventricular Function / MorphologyLCE-NHLBI 16 sec breath-hold Full R-R coverage High spatial and

11、 temporal resolutionFASTCINE第25頁/共73頁第二十六頁，共74頁。Aortic Disease第26頁/共73頁第二十七頁，共74頁。Kerckhoff Heart Klinik, GermanyIdentification of fatty infiltration in the infarcted regionfat suppressedT1 breathhold第27頁/共73頁第二十八頁，共74頁。第28頁/共73頁第二十九頁，共74頁。Ultrafast Imaging of the Coronaries2D breathhold3D breathhol

12、d第29頁/共73頁第三十頁，共74頁。3D BreathholdLeft CoronaryRight CoronaryAortic RootLeft Circumflex第30頁/共73頁第三十一頁，共74頁。Left Coronary Artery StenosisUniversity Hospital, RotterdamConventional Angiography3D Breathhold MRAVolume Rendered第31頁/共73頁第三十二頁，共74頁。Kerckhoff Heart Klinik, GermanyClear Visualization of the C

13、oronaries2D Breathhold: 10 sec2D Breathhold TSE第32頁/共73頁第三十三頁，共74頁。Coronary MR Angiographywithout contrast agentERESA Imaging Center, Valencia, Spain第33頁/共73頁第三十四頁，共74頁。Ultrafast 3D imaging in 23 seconds Northwestern University, Chicago第34頁/共73頁第三十五頁，共74頁。Northwestern University, ChicagoUltrafast 3D

14、 imaging in 23 seconds第35頁/共73頁第三十六頁，共74頁。第36頁/共73頁第三十七頁，共74頁。Dynamic first-pass perfusionBreathhold T2pre-contrastPatient with SubendocardialInfarctLesion Detection and Myocardial Perfusion第37頁/共73頁第三十八頁，共74頁。Stenosis in a branch vesselof the circumflex coronary arteryMyocardial Viabilityfast and r

15、obustdetection of infarctsNorthwestern University, ChicagoWall Motion StudyViability Study第38頁/共73頁第三十九頁，共74頁。without ECG triggeringfree breathing第39頁/共73頁第四十頁，共74頁。第40頁/共73頁第四十一頁，共74頁。第41頁/共73頁第四十二頁，共74頁。高分辨率高分辨率 MRA MRA1024 ZIP 1024 ZIP 提供提供(tgng)(tgng)比比10241024采集更短采集更短的掃描時間和更小的信噪比損失的掃描時間和更小的信噪比損

16、失 n3DTOF MRA3DTOF MRAu512, 1024 ZIP512, 1024 ZIPu2x, 4x Through-2x, 4x Through-plane ZIPplane ZIPnImproves Improves ApparentApparent ResolutionResolution第42頁/共73頁第四十三頁，共74頁。512x192, thru-plane ZIP45/6.9 TR/TE, 20 x20 FOV120 SLICES, 9:17第43頁/共73頁第四十四頁，共74頁。imagingvolumeTrackervolume 跟跟 蹤蹤 區(qū)區(qū) 掃掃 描描 區(qū)區(qū)

17、第44頁/共73頁第四十五頁，共74頁。第45頁/共73頁第四十六頁，共74頁。400 micronresolution3D volume renderingCleveland Clinic第46頁/共73頁第四十七頁，共74頁。3D Pulmonary MR Angiography3D volumetric imaging in 3 seconds unbeatable in the industry!第47頁/共73頁第四十八頁，共74頁。Time Resolved 3D MR AngiographyVisualizes contrast arrival in 3Dfollowing co

18、ntrast injection第48頁/共73頁第四十九頁，共74頁。time第49頁/共73頁第五十頁，共74頁。3D Carotid MRA in 9 secs Panoramic array coil for extended coverage 第50頁/共73頁第五十一頁，共74頁。正常(zhngchng)門脈、腸系膜上靜脈FL3d 3.15/1.23, FA=25度，度，1.5mm, 64層，層，230*256， BW=490，TA=16s, MIP SubMIP第51頁/共73頁第五十二頁，共74頁。門脈高壓(goy)，靜脈曲張第52頁/共73頁第五十三頁，共74頁。 Movin

19、g TablePeripheral MR Angiographycourtesy of Dr. Terwey, Bremen第53頁/共73頁第五十四頁，共74頁。courtesy of Dr. Terwey, Bremen第54頁/共73頁第五十五頁，共74頁。疾病等。第55頁/共73頁第五十六頁，共74頁。第56頁/共73頁第五十七頁，共74頁。第57頁/共73頁第五十八頁，共74頁。第58頁/共73頁第五十九頁，共74頁。 臨床臨床(ln chun)應用應用 第59頁/共73頁第六十頁，共74頁。第60頁/共73頁第六十一頁，共74頁。nMRI但特異性較差。第61頁/共73頁第六十二頁，共74頁。膽總管膽總管下端下端(xi dun)嵌嵌頓結(jié)石頓結(jié)石第62頁/共73頁第六十三頁，共74頁。胰頭癌胰頭癌FS-Fl2d-T1WI HASTE-T2WI 第63頁/共73頁第六十四頁，共74頁。胰頭癌胰頭癌厚層厚層MRCP 薄層薄層(bo cn)斜冠狀斜冠狀MRCP