Luna A. Diffusion MRI outside the brain: a case-based review and clinical applications / A.Luna, R.Ribes, J.A.Soto. - Berlin; Heidelberg, 2012. - xxi, 400 p.: ill. (some col.). - Incl. bibl. ref. - Ind.: p.395-400. - ISBN 78-3-642-21051-8  Место хранения:   054 | Международный томографический центр CO РАН | Новосибирск

Оглавление / Contents

1 Diffusion-Weighted Imaging: Acquisition and Biophysical Basis ........................................................ 1 Javier Sánchez-González and Javier Lafuente-Martínez 1.1 Diffusion-Weighted Imaging: Physical Basis and Types of Acquisition .................................... 1 1.2 Fat Suppression Techniques .............................. 7 1.2.1 Advanced Fat Suppression Techniques ................. 11 1.3 Motion Control ......................................... 11 1.4 Non-Single-Shot EPI Acquisition ........................ 11 Further Reading ............................................. 15 2 How to Identify and Avoid Artifacts on DWI .................. 17 Javier Sánchez-González 2.1 Optimization of Signal to Noise Ratio .................. 17 2.2 Geometrical Distortion Artifacts ....................... 22 2.3 Motion Artifacts ....................................... 22 2.4 Eddy Currents Artifacts ................................ 22 2.5 Fat Suppression Artifacts .............................. 22 2.6 Dielectric Shielding Artifacts ......................... 28 2.7 Tips in DWI Sequence Design for Body Applications ...... 28 Further Reading ............................................. 31 3 Quantification and Postprocessing of DWI .................... 33 Javier Sánchez-González and Antonio Luna 3.1 Biophysical Basis ...................................... 33 3.2 Estimation of Quantitative Data ........................ 33 3.2.1 ADC and eADC Estimation with Two and Multiple b-Values ........................................ 33 3.2.2 Multiexponential Modeling of Diffusion .......... 35 3.2.3 Diffusion Tensor Imaging ........................ 37 3.3 DWI Analysis and Postprocessing ........................ 39 3.3.1 Diffusion Registration .......................... 39 3.3.2 DWI Analysis and Postprocessing ................. 39 3.3.3 ADC Analysis .................................... 41 Further Reading ............................................. 48 4 DWI at 3 T: Advantages, Disadvantages, Pitfalls, and Advanced Clinical Applications .......................... 51 Javier Sánchez-González and Antonio Luna 4.1 DWI at 3T .............................................. 51 4.1.1 Advanced Clinical Applications at 3 T Magnets ....... 52 4.2 Pitfalls in DWI ........................................ 66 4.2.1 T2 Shine-Through ................................ 66 4.2.2 T2 Dark-Through ................................. 66 4.2.3 Restriction of Normal Structures ................ 68 4.2.4 Iron Overload ................................... 68 4.2.5 Nonmalignant Lesions with Apparent Restrictions on DWI ............................ 68 4.2.6 Tumors with Low Cellular Density ............... 70 4.3 Conclusions ............................................ 72 Further Reading ............................................. 72 5 DWI of the Liver ............................................ 75 Antonio Luna and Luis Luna 5.1 Background ............................................. 75 5.2 DWI: Basic Concepts .................................... 75 5.3 DWI: Basic Sequence Design ............................. 75 5.4 Quantification ......................................... 80 5.5 Other Techniques ....................................... 81 5.6 Clinical Applications in Liver Disease ................. 81 5.6.1 Focal Liver Lesion Detection .................... 81 5.6.2 Characterization of Focal Liver Lesions ......... 83 5.6.3 Benign Focal Liver Lesions ...................... 84 5.6.4 Malignant Focal Liver Lesions ................... 85 5.6.5 Focal Liver Lesions in the Cirrhotic Liver ...... 86 5.6.6 Monitoring Response to Treatment ................ 90 5.6.7 Diffuse Liver Disease ........................... 90 5.7 Conclusions ............................................ 96 Further Reading ............................................. 96 6 Diffusion-Weighted MR Imaging of the Pancreas ............... 99 Jorge A. Soto, German A. Castrillon, Stephan Anderson, and Nagaraj Holalkere 6.1 Introduction ........................................... 99 6.2 Pancreatic Cancer ..................................... 100 6.3 Cystic Masses ......................................... 100 6.4 Other Applications .................................... 100 6.5 Biliary Tract ......................................... 101 Case 6.1: Mass-Forming Focal Pancreatitis ............ 102 Case 6.2: Pancreatic Ductal Adenocarcinoma ........... 104 Case 6.3: Serous Cystadenoma ......................... 106 Case 6.4: Pancreatic Pseudocyst ...................... 108 Case 6.5: Von Hippel Lindau Disease with Simple Pancreatic Cysts. .......................... 110 Case 6.6: Mucinous Суstadenoma ....................... 112 Case 6.7: Intraductal Papillary Mucinous Neoplasm .... 114 Case 6.8: Sclerosing Pancreatitis and Peripancreatic Collection ................................. 116 Case 6.9: Hilar Cholangiocarcinoma ................... 118 Case 6.10: Acute Cholecystitis ........................ 120 Further Reading ............................................ 122 7 Diffusion-Weighted MR Imaging of the Renal and Adrenal Glands ..................................................... 123 Nagaraj Holalkere, Stephan Anderson, and Jorge A. Soto 7.1 Introduction .......................................... 123 7.2 Technique ............................................. 123 7.3 Renal DWI ............................................. 124 7.4 Adrenal DWI ........................................... 125 Case 7.1: Papillary Cell Carcinoma ................... 126 Case 7.2: Cystic Clear Cell Carcinoma ................ 128 Case 7.3: Hemorrhagic Renal Cyst ..................... 130 Case 7.4: Lymph Node Metastasis ...................... 132 Case 7.5: Alternative to Contrast-Enhanced MR Imaging .................................... 134 Case 7.6: Recurrent Renal Cancer ..................... 136 Case 7.7: Adrenal Metastatic Lesion .................. 137 Case 7.8: Lipid Rich Adrenal Adenoma ................. 139 Case 7.9: Adrenal Hematoma ........................... 141 Case 7.10: Collision Tumor ............................ 142 Further Reading ............................................ 144 8 Diffusion-Weighted Imaging of Prostate, Bladder, and Retroperitoneum ............................................ 145 Joan C. Vilanova, Roberto Garcia-Figueiras, Joaquim Barceló, and Antonio Luna 8.1 DWI of Prostate ....................................... 145 8.1.1 Biophysical Basis .............................. 145 8.1.2 Technical Adjustments .......................... 145 8.1.3 DWI of the Prostate at 3 T ..................... 146 8.1.4 Benign Conditions .............................. 146 8.1.5 Cancer Detection ............................... 147 8.1.6 Cancer Localization ............................ 147 8.1.7 Tumoral Grading and Local Staging (T-Staging) .. 148 8.1.8 N and M Staging ................................ 148 8.1.9 Posttreatment Monitorization, Detection of Recurrence, and Prediction of Response to Treatment ...................................... 148 8.1.10 Diffusion Tensor Imaging (DTI) ................. 149 8.2 Applications of DWI in Bladder Cancer ................. 150 8.3 Assessment of the Retroperitoneum with DWI ............ 150 Case 8.1: Evaluation of Prostatic Cancer with DWI at 3 T Magnet? .................... 151 Case 8.2: Chronic Prostatitis ........................ 154 Case 8.3: Central Gland Prostate Cancer .............. 156 Case 8.4: Bilateral Peripheral Prostate Cancer ....... 158 Case 8.5: Seminal Vesicles Infiltration .............. 160 Case 8.6: Monitorization of Response to Hormonal Therapy in a Patient with Prostate Cancer and Metastatic Pelvic Lymph Nodes .......... 162 Case 8.7: Local Recurrence After Brachytherapy ....... 164 Case 8.8: Local Recurrence After Radical Prostatectomy .............................. 166 Case 8.9: Bladder Carcinoma .......................... 169 Case 8.10: Recurrent Retroperitoneal Leiomyosarcoma ... 172 Further Reading ............................................ 174 9 Use of DWI in Female Pelvis ................................ 177 German A. Castrillon, Stephan Anderson, Nagaraj Holalkere, and Jorge A. Soto 9.1 Introduction .......................................... 177 9.2 Normal Appearance of Uterus and Cervix on DWI ......... 177 9.3 Clinical Applications ................................. 178 9.3.1 Cervical Carcinoma ............................. 178 9.3.2 Endometrial Cancer ............................ 178 9.3.3 Myometrium ..................................... 179 9.3.4 Characterization of Ovarian Masses ............. 180 9.3.5 Assessment of Peritoneal Spread of Ovarian Carcinoma ...................................... 180 9.3.6 Vagina and Vulva ............................... 180 Case 9.1: Residual Cervical Carcinoma ................ 181 Case 9.2: Characterization of Endometrial Adenocarcinoma ............................. 183 Case 9.3: Early Endometrial Adenocarcinoma ........... 185 Case 9.4: Adenomyosis ................................ 187 Case 9.5: Uterine Leiomyoma .......................... 189 Case 9.6: Adnexal Endometrioma ....................... 191 Case 9.7: Ovarian Fibroma ............................ 193 Case 9.8: Didelphus Uterus and Ovarian Dermoid Tumor ...................................... 195 Case 9.9: Ovarian Carcinoma .......................... 197 Case 9.10: Vulvar Sarcoma ............................. 199 Further Reading ............................................ 200 10 DWI of the Breast .......................................... 203 Joaquim Barceló, Joan C. Vilanova, and Antonio Luna 10.1 Introduction .......................................... 203 10.2 Quantification in Breast DWI .......................... 203 10.3 Assessment of Breast Lesions .......................... 204 10.4 Technical Considerations of Breast DWI ................ 205 10.5 Breast Cancer: Monitorization and Prediction of Response to Treatment with DWI ..................... 206 10.6 Breast Cancer: Screening and Staging with DWI ......... 206 Case 10.1: Invasive Ductal Carcinoma ................. 208 Case 10.2: Pure Mucinous Carcinoma ................... 210 Case 10.3: Ductal Carcinoma In Situ .................. 211 Case 10.4: Fibroadenoma .............................. 214 Case 10.5: Borderline Phyllodes Tumor ................ 215 Case 10.6: Infiltrating Lobulillar Carcinoma ......... 217 Case 10.7: Invasive Lobulillar Carcinoma - IVIM Approach .................................. 219 Case 10.8: Post-treatment Monitorization of Lobulillar Carcinoma ...................... 222 Case 10.9: Post-treatment Monitorization of Multifocal Infiltrating Ductal Carcinoma .. 225 Case 10.10: Recurrent Invasive Ductal Carcinoma ....... 227 Further Reading ............................................ 228 11 Diffusion-Weighted Imaging of the Gastrointestinal Tract and Peritoneum ....................................... 231 German A. Castrillon, Stephan Anderson, Jorge A. Soto, and Antonio Luna 11.1 Malignant Lesions of GI Tract on DWI .................. 231 11.1.1 Colorectal Carcinoma ........................... 232 11.1.2 Stomach ........................................ 232 11.1.3 Small Bowel Tumors ............................. 233 11.1.4 Esophagus ...................................... 234 11.2 Inflammatory Diseases ................................. 234 11.2.1 Acute Appendicitis ............................. 235 11.2.2 Acute Diverticulitis ........................... 236 11.2.3 Colitis and Enteritis .......................... 236 11.2.4 Epiploic Appendagitis and Omental Infarction ... 236 11.3 Evaluation of the Peritoneum .......................... 237 Case 11.1: Colon Carcinoma ........................... 238 Case 11.2: Gastric Carcinoma ......................... 240 Case 11.3: Gastric Lymphoma .......................... 240 Case 11.4: Duodenal Non-Hodgkin Lymphoma ............. 243 Case 11.5: Esophageal Carcinoma ...................... 245 Case 11.6: Acute Appendicitis ........................ 246 Case 11.7: Acute Diverticulitis with Abscess Formation ................................. 247 Case 11.8: Crohn's Disease - Active Inflammation ..... 249 Case 11.9: Crohn's Disease: Fibrostenotic Stage ...... 250 Case 11.10: Peritoneal Metastases of Ovarian Carcinoma ................................. 252 Further Reading ............................................ 253 12 Diffusion-Weighted Imaging of Anorectal Region ............. 255 Lidia Alcalá, Teodoro Martín, and Antonio Luna 12.1 Technical Considerations .............................. 255 12.2 Clinical Applications ................................. 255 12.2.1 Rectal Cancer Detection ........................ 255 12.2.2 Rectal Cancer Staging .......................... 256 12.2.3 Prediction of Rectal Cancer Outcome and Early Detection of Tumor Response .................... 256 12.2.4 Posttreatment Restaging and Detection of Recurrence ..................................... 257 12.2.5 Applications of DWI in Other Rectal Tumors ..... 257 12.2.6 Inflammatory Conditions ........................ 258 12.2.7 Evaluation of Fistula-In-Ano ................... 258 12.3 Conclusions ........................................... 258 Case 12.1: T1-Stage Concurrent Carcinomatous Rectal Polyps .................................... 259 Case 12.2: Detection of Mesorectal Lymphadenopathies Using DWI ................................. 261 Case 12.3: Prediction of Response to Neoadjuvant Treatment ................................. 263 Case 12.4: Mucinous Adenocarcinoma of the Rectum with Poor Response to Treatment ........... 265 Case 12.5: Diagnosis and Monitoring of Presacral Recurrence of Rectal Carcinoma ............ 267 Case 12.6: Cystic Retrorectal Hamartoma or Tailgut Cyst ...................................... 269 Case 12.7: Monitorization of Response to Treatment with Imatinib of a Rectal GIST ............ 270 Case 12.8: Perirectal Abscess Secondary to Postsurgical Dehiscence of Sutures ........ 273 Case 12.9: Complicated Acute Diverticulitis .......... 275 Case 12.10: Crohn's Disease and Perianal Fistulas ..... 276 Further Reading ............................................ 277 13 Diffusion-Weighted Imaging in the Evaluation of Lung, Mediastinum, Heart, and Chest Wall ......................... 279 Antonio Luna, Teodoro Martín, and Javier Sánchez González 13.1 Introduction .......................................... 279 13.2 Technical Considerations .............................. 279 13.3 Clinical Applications ................................. 280 13.3.1 Detection of Pulmonary Nodules ................. 280 13.3.2 Pulmonary Nodule Characterization .............. 280 13.3.3 Lung Cancer Evaluation ......................... 280 13.3.4 Staging of NSCLC with DWI ...................... 281 13.3.5 Mediastinum .................................... 282 13.3.6 Pleural Disease ................................ 282 13.3.7 Hyperpolarized Gases DWI ....................... 282 13.3.8 Chest Wall ..................................... 282 13.3.9 Cardiac DWI and DTI ............................ 283 13.4 Conclusions ........................................... 283 Case 13.1: Synchronization on Chest DWI .............. 284 Case 13.2: Pulmonary Metastasis of Renal Cell Carcinoma ................................. 286 Case 13.3: Solitary Benign Lung Nodule in an Asymptomatic Patient ...................... 288 Case 13.4: Histological Grading and Prediction of Response and Posttreatment Monitorization of Lung Adenocarcinoma ..... 290 Case 13.5: Distinction of Central Bronchogenic Carcinoma and Peripheral Obstructive Atelectasis ............................... 292 Case 13.6: Staging and Posttreatment Monitorization of Small Cell Lung Carcinoma .............. 294 Case 13.7: Exudative Pleural Effusion ................ 297 Case 13.8: Chronic and Occult Acute Rib Fractures .... 299 Case 13.9: Pericardial Neuroblastoma ................. 301 Case 13.10: Ex Vivo DTI of a Pig Heart ................ 303 Further Reading ............................................ 305 14 Role of DWI in the Evaluation of Tumors of the Head and Neck and in the Assessment of Lymph Nodes .............. 307 Inmaculada Rodriguez, Teodoro Martín, and Antonio Luna 14.1 DWI in Head and Neck Regions .......................... 307 14.1.1 Technical Aspects and Field-Strength ........... 307 14.1.2 Characterization of Benign and Malignant Tumors ......................................... 308 14.1.3 Salivary Gland Tumors .......................... 309 14.1.4 Monitoring and Predicting Response to Treatment ...................................... 309 14.1.5 Detection of Recurrence ........................ 310 14.2 Evaluation of Lymph Nodes With DWI .................... 310 14.2.1 Evaluation of Cervical Lymph Nodes ............. 310 14.2.2 DWI of Lymph Nodes in Chest, Abdomen, and Pelvis ......................................... 311 Case 14.1: Intraorbital Metastasis from Retroperitoneal Leiomyosarcoma ............ 312 Case 14.2: Oropharynx Cancer with Nodal Metastases ... 314 Case 14.3: Superficial Giant Neurofibroma ............ 317 Case 14.4: Cervical Esophageal Cancer ................ 319 Case 14.5: Recurrent Lingual Carcinoma ............... 321 Case 14.6: Cellulitis and Sialadenitis of Parotid Gland with Abscess Formation .............. 325 Case 14.7: Nodal and Local Recurrence of Parotid Squamous Cell Carcinoma ................... 327 Case 14.8: Posttreatment Monitorization and Prediction of Response to Treatment of Occult Cavum Carcinoma with Metastatic Cervical Lymph Nodes ...................... 329 Case 14.9: Nodal Metastasis in the Neck from Squamous Cell Carcinoma ................... 333 Case 14.10: Vertebral, Nodal, and Peritoneal Metastases of Surgically Removed Endometrial Cancer ........................ 335 Further Reading ............................................ 337 15 Musculoskeletal Applications of DWI ........................ 339 Joan C. Vilanova, Sandra Baleato, and Elda Balliu 15.1 DWI Sequences ......................................... 339 15.2 Clinical Applications ................................. 340 15.2.1 Bone Marrow Assessment ......................... 340 15.2.2 Evaluation of the Spine ........................ 340 15.2.3 Soft-tissue Tumors ............................. 340 15.2.4 Postreatment Monitorization .................... 341 15.2.5 Infection and Inflammation ..................... 342 15.2.6 Bone Ischemia and Trauma ....................... 342 15.2.7 Cartilage ...................................... 342 15.3 New Approaches to DWI of the Musculoskeletal System ... 342 Case 15.1: Bone Plasmacytoma ......................... 343 Case 15.2: Benign Vertebral Fracture ................. 346 Case 15.3: Spondylodiscitis .......................... 348 Case 15.4: Liposclerosing Myxofibrous Tumor .......... 350 Case 15.5: Chronic Popliteal Cyst .................... 352 Case 15.6: Recurrent Malignant Soft Tissue Tumor ..... 354 Case 15.7: Postsurgical Follow-up of Degenerative Disk Disease .............................. 356 Case 15.8: Diabetic Osteomyelitis and Neuropathic Foot ...................................... 358 Case 15.9: Pelvic Abscesses Secondary to Symphysis Pubis Septic Arthritis and Osteomyelitis .. 360 Case 15.10: Rheumatoid Arthritis ...................... 362 Further Reading ............................................ 364 16 Whole-Body Applications of DWI ............................. 365 Joan C. Vilanova, Sandra Baleato, Joaquim Barceló, and Antonio Luna 16.1 General and Technical Considerations .................. 365 16.2 Oncological Applications ... 366 16.3 Comparison of WB-DWI to PET and PET-CT ................ 367 16.4 Non Oncological Applications .......................... 368 Case 16.1: Multifocal Bone Tuberculosis .............. 369 Case 16.2: Bone Metastases from Breast Cancer ........ 372 Case 16.3: Bone and Lymph Node Metastases from Prostate Cancer ........................... 374 Case 16.4: Multiple Myeloma .......................... 376 Case 16.5: Bone Metastases from Unknown Primary ...... 378 Case 16.6: Liver and Bone Metastases from Lung Cancer .................................... 380 Case 16.7: Search for the Primary Neoplasm in a Patient with Hepatic Metastases ........... 382 Case 16.8: Staging and Posttreatment Monitorization of Non-Hodgkin Lymphoma in a Pregnant Woman ..................................... 385 Case 16.9: Unique Spleen Metastasis from Rectal Cancer .................................... 387 Case 16.10: Neurofibromatosis Type 1 .................. 389 Further Reading ............................................ 392 Index ......................................................... 395