Alina Schneider

Purpose: Simultaneous PET‐MRI improves inflammatory cardiac disease diagnosis. However, challenges persist in respiratory motion and mis‐registration between free‐breathing 3D PET and 2D breath‐held MR images. We propose a free‐breathing non‐rigid motion‐compensated 3D T₂‐mapping sequence enabling whole‐heart myocardial tissue characterization in a hybrid 3T PET‐MR system and provides non‐rigid respiratory motion fields to correct also simultaneously acquired PET data.Methods: Free‐breathing 3D whole‐heart T₂‐mapping was implemented on a hybrid 3T PET‐MRI system. Three datasets were acquired with different T₂‐preparation modules (0, 28, 55 ms) using 3‐fold undersampled variable‐density Cartesian trajectory. Respiratory motion was estimated via virtual 3D image navigators, enabling multi‐contrast non‐rigid motion‐corrected MR reconstruction. T₂‐maps were computed using dictionary‐matching. Approach was tested in phantom, 8 healthy subjects, 14 MR only and 2 PET‐MR patients with suspected cardiac disease and compared with spin echo reference (phantom) and clinical 2D T₂‐mapping (in‐vivo).Results: Phantom results show a high correlation (R² = 0.996) between proposed approach and gold standard 2D T₂ mapping. In‐vivo 3D T₂‐mapping average values in healthy subjects (39.0 ± 1.4 ms) and patients (healthy tissue) (39.1 ± 1.4 ms) agree with conventional 2D T₂‐mapping (healthy = 38.6 ± 1.2 ms, patients = 40.3 ± 1.7 ms). Bland–Altman analysis reveals bias of 1.8 ms and 95% limits of agreement (LOA) of −2.4‐6 ms for healthy subjects, and bias of 1.3 ms and 95% LOA of −1.9 to 4.6 ms for patients.Conclusion: Validated efficient 3D whole‐heart T₂‐mapping at hybrid 3T PET‐MRI provides myocardial inflammation characterization and non‐rigid respiratory motion fields for simultaneous PET data correction. Comparable T₂ values were achieved with both 3D and 2D methods. Improved image quality was observed in the PET images after MR‐based motion correction.

To assess the clinical performance of the three-dimensional, free-breathing, Magnetization Transfer Contrast Bright-and-black blOOd phase-SensiTive (MTC-BOOST) sequence in adult congenital heart disease (ACHD). In this prospective study, participants with ACHD undergoing cardiac MRI between July 2020 and March 2021 were scanned with the clinical T2-prepared balanced steady-state free precession sequence and proposed MTC-BOOST sequence. Four cardiologists scored their diagnostic confidence on a four-point Likert scale for sequential segmental analysis on images acquired with each sequence. Scan times and diagnostic confidence were compared using the Mann-Whitney test. Coaxial vascular dimensions at three anatomic landmarks were measured, and agreement between the research sequence and the corresponding clinical sequence was assessed with Bland-Altman analysis. The study included 120 participants (mean age, 33 years ± 13 [SD]; 65 men). The mean acquisition time of the MTC-BOOST sequence was significantly lower compared with that of the conventional clinical sequence (9 minutes ± 2 vs 14 minutes ± 5; P < .001). Diagnostic confidence was higher for the MTC-BOOST sequence compared with the clinical sequence (mean, 3.9 ± 0.3 vs 3.4 ± 0.7; P < .001). Narrow limits of agreement and mean bias less than 0.08 cm were found between the research and clinical vascular measurements. The MTC-BOOST sequence provided efficient, high-quality, and contrast agent-free three-dimensional whole-heart imaging in ACHD, with shorter, more predictable acquisition time and improved diagnostic confidence compared with the reference standard clinical sequence.Keywords: MR Angiography, Cardiac Supplemental material is available for this article. Published under a CC BY 4.0 license.

Die Hysterektomie stellt eine sehr häufig durchgeführte Operation dar. Trotz bewiesener Nachteile der abdominalen Hysterektomie im Vergleich zur vaginalen Hysterektomie wird die abdominale Hysterektomie oft indiziert, obwohl die laparoskopisch assistierte Hysterektomie als zusätzliche Alternative zur Verfügung steht. Fragestellung: Wie hoch sind die Komplikationsraten bei der laparoskopisch assistierten vaginalen Hysterektomie und haben sie sich den Komplikationsraten der reinen vaginalen Hysterektomie angeglichen? Material und Methodik: Zwischen Juli 1994 und Juni 2003 wurden die Krankenakten aller Patientinnen, die sich einer vaginalen oder laparoskopisch assistierten vaginalen Hysterektomie ohne gleichzeitige Deszensuskorrektur in einer Ausbildungsklinik unterzogen hatten, retrospektiv ausgewertet. Studienendpunkte waren die Operationsdauer, die Rate intraoperativer Komplikationen und die Raten größerer und kleinerer postoperativer Komplikationen. Zur statistischen Auswertung wurde der exakte Test nach Fisher, der Student-t-Test und der Mann-Whitney U-Test verwendet. Ergebnisse: Patientinnen, die sich einer laparoskopisch assistierten vaginalen Hysterektomie unterzogen hatten (n = 929), waren signifikant älter, hatten einen ungünstigeren BMI, eine schwerere Gebärmutter und häufigere Zusatzoperationen als Patientinnen, die rein vaginal operiert worden waren (n = 735) (p < 0,001). Trotzdem unterschieden sich die Komplikationsraten nicht. Im Zusammenhang mit der laparoskopisch assistierten vaginalen Hysterektomie kam es zu signifikant weniger Revisionen und Temperaturerhöhungen durch Stumpfinfiltrate (p < 0,05). Schlussfolgerung: In dieser Untersuchungsreihe war die Rate intra- und postoperativer Komplikationen niedrig und unterschied sich nicht signifikant vom rein vaginalen Vorgehen. Background: Despite the proven advantages of vaginal hysterectomies compared to abdominal hysterectomies the latter is still very common for the therapy of benign disorders, although it could be replaced by laparoscopically assisted vaginal hysterectomy. The aim of this study is to describe the rate of complications in laparoscopically assisted vaginal hysterectomy in a teaching hospital and to compare it with the rate of complications in vaginal hysterectomies. Methods: Between July 1994 and June 2003 hospital records of patients who underwent hysterectomy (classical vaginal or laparoscopically assisted vaginal) without vaginal repair were evaluated retrospectively. Study end points were duration of surgery, hemoglobin difference, rate of intra- and postoperative complications. Fisher's exact test, Student's t-test, and Mann-Whitney U test were used for analysis. Results: Patients who underwent laparoscopically assisted vaginal hysterectomy (n = 929) were significantly older, had a higher BMI, and a higher uterine weight than patients undergoing vaginal hysterectomy (n = 735) (p < 0.001). Adnexal pathology was more often associated with a laparoscopic approach. The rate of complications did not differ between the groups, despite more difficult cases occurring in the group of laparoscopically assisted vaginal hysterectomies. Laparoscopically assisted vaginal hysterectomy was significantly associated with a lower incidence of fever related to operative site (p < 0.05), and a lower incidence of re-operation (p < 0.05). Conclusion: In this study the rate of intra- and postoperative complications in laparoscopically assisted vaginal hysterectomies was low and did not differ from that of vaginal hysterectomies in our teaching hospital.