A A Desai1, M K Strother2, C C Faraco2, V L Morgan2, T R Ladner2, L M Dethrage2, L C Jordan3, M J Donahue4. 1. From the Departments of Radiology and Radiological Sciences (A.A.D., M.K.S., C.C.F., V.L.M., T.R.L., L.M.D., M.J.D.) aditi.desai@vanderbilt.edu. 2. From the Departments of Radiology and Radiological Sciences (A.A.D., M.K.S., C.C.F., V.L.M., T.R.L., L.M.D., M.J.D.). 3. Pediatrics (L.C.J.). 4. From the Departments of Radiology and Radiological Sciences (A.A.D., M.K.S., C.C.F., V.L.M., T.R.L., L.M.D., M.J.D.) Division of Pediatric Neurology, Psychiatry (M.J.D.) Neurology (M.J.D.), Vanderbilt University School of Medicine, Nashville, Tennessee Department of Physics and Astronomy (M.J.D.), Vanderbilt University, Nashville, Tennessee.
Abstract
BACKGROUND AND PURPOSE: Blood oxygenation level-dependent MR imaging is increasingly used clinically to noninvasively assess cerebrovascular reactivity and/or language and motor function. However, many patients have metallic implants, which will induce susceptibility artifacts, rendering the functional information uninformative. Here, we calculate and interpret blood oxygenation level-dependent MR imaging artifact impact arising from surgically implanted hardware. MATERIALS AND METHODS: A retrospective analysis of all blood oxygenation level-dependent MRIs (n = 343; B0 = 3T; TE = 35 ms; gradient echo EPI) acquired clinically (year range = 2006-2014) at our hospital was performed. Blood oxygenation level-dependent MRIs were most commonly prescribed for patients with cerebrovascular disease (n = 80) or patients undergoing language or motor localization (n = 263). Artifact volume (cubic centimeters) and its impact on clinical interpretation were determined by a board-certified neuroradiologist. RESULTS: Mean artifact volume associated with intracranial hardware was 4.3 ± 3.2 cm(3) (range = 1.1-9.4 cm(3)). The mean artifact volume from extracranial hardware in patients with cerebrovascular disease was 28.4 ± 14.0 cm(3) (range = 6.1-61.7 cm(3)), and in patients with noncerebrovascular disease undergoing visual or motor functional mapping, it was 39.9 (3)± 27.0 cm(3) (range = 6.9-77.1 cm(3)). The mean artifact volume for ventriculoperitoneal shunts was 95.7 ± 39.3 cm(3) (range = 64.0-139.6 cm(3)). Artifacts had no-to-mild effects on clinical interpretability in all patients with intracranial implants. Extracranial hardware artifacts had no-to-moderate impact on clinical interpretability, with the exception of 1 patient with 12 KLS-Martin maxDrive screws with severe artifacts precluding clinical interpretation. All examined ventriculoperitoneal shunts resulted in moderate-to-severe artifacts, limiting clinical interpretation. CONCLUSIONS: Blood oxygenation level-dependent MR imaging yields interpretable functional maps in most patients beyond a small (30-40 cm(3)) artifact surrounding the hardware. Exceptions were ventriculoperitoneal shunts, particularly those with programmable valves and siphon gauges, and large numbers of KLS-Martin maxDrive screws.
BACKGROUND AND PURPOSE: Blood oxygenation level-dependent MR imaging is increasingly used clinically to noninvasively assess cerebrovascular reactivity and/or language and motor function. However, many patients have metallic implants, which will induce susceptibility artifacts, rendering the functional information uninformative. Here, we calculate and interpret blood oxygenation level-dependent MR imaging artifact impact arising from surgically implanted hardware. MATERIALS AND METHODS: A retrospective analysis of all blood oxygenation level-dependent MRIs (n = 343; B0 = 3T; TE = 35 ms; gradient echo EPI) acquired clinically (year range = 2006-2014) at our hospital was performed. Blood oxygenation level-dependent MRIs were most commonly prescribed for patients with cerebrovascular disease (n = 80) or patients undergoing language or motor localization (n = 263). Artifact volume (cubic centimeters) and its impact on clinical interpretation were determined by a board-certified neuroradiologist. RESULTS: Mean artifact volume associated with intracranial hardware was 4.3 ± 3.2 cm(3) (range = 1.1-9.4 cm(3)). The mean artifact volume from extracranial hardware in patients with cerebrovascular disease was 28.4 ± 14.0 cm(3) (range = 6.1-61.7 cm(3)), and in patients with noncerebrovascular disease undergoing visual or motor functional mapping, it was 39.9 (3)± 27.0 cm(3) (range = 6.9-77.1 cm(3)). The mean artifact volume for ventriculoperitoneal shunts was 95.7 ± 39.3 cm(3) (range = 64.0-139.6 cm(3)). Artifacts had no-to-mild effects on clinical interpretability in all patients with intracranial implants. Extracranial hardware artifacts had no-to-moderate impact on clinical interpretability, with the exception of 1 patient with 12 KLS-Martin maxDrive screws with severe artifacts precluding clinical interpretation. All examined ventriculoperitoneal shunts resulted in moderate-to-severe artifacts, limiting clinical interpretation. CONCLUSIONS: Blood oxygenation level-dependent MR imaging yields interpretable functional maps in most patients beyond a small (30-40 cm(3)) artifact surrounding the hardware. Exceptions were ventriculoperitoneal shunts, particularly those with programmable valves and siphon gauges, and large numbers of KLS-Martin maxDrive screws.
Authors: Michael J J Kim; Andrei I Holodny; Bob L Hou; Kyung K Peck; Chaya S Moskowitz; Dmitry L Bogomolny; Philip H Gutin Journal: AJNR Am J Neuroradiol Date: 2005-09 Impact factor: 3.825
Authors: Manus J Donahue; Hans Hoogduin; Peter C M van Zijl; Peter Jezzard; Peter R Luijten; Jeroen Hendrikse Journal: NMR Biomed Date: 2010-12-03 Impact factor: 4.044
Authors: Emanuel Kanal; A James Barkovich; Charlotte Bell; James P Borgstede; William G Bradley; Jerry W Froelich; J Rod Gimbel; John W Gosbee; Ellisa Kuhni-Kaminski; Paul A Larson; James W Lester; John Nyenhuis; Daniel Joe Schaefer; Elizabeth A Sebek; Jeffrey Weinreb; Bruce L Wilkoff; Terry O Woods; Leonard Lucey; Dina Hernandez Journal: J Magn Reson Imaging Date: 2013-01-23 Impact factor: 4.813
Authors: Mark Jenkinson; Christian F Beckmann; Timothy E J Behrens; Mark W Woolrich; Stephen M Smith Journal: Neuroimage Date: 2011-09-16 Impact factor: 6.556
Authors: Jennifer M Watchmaker; Blaise deB Frederick; Matthew R Fusco; Larry T Davis; Meher R Juttukonda; Sarah K Lants; Howard S Kirshner; Manus J Donahue Journal: Neurosurgery Date: 2019-01-01 Impact factor: 4.654