Publication for the Philips MRI Community ISSUE 48-2013/1 Multiva 1.5T demonstrates outstanding value and performance Radiology Center Trier (Germany) sees excellent image quality in routine and high-end applications with Multiva 1.5T Publication for the Philips MRI Community Issue 48 2013 /1 Clinical excellence High performance 3.0T spine imaging with Ingenia at AZ sint-jan university of Michigan uses MR enterography in IBD patients Qscan optimizes Ingenia 3.0T protocols for MsK imaging Productivity and efficiency Five common MRI exams at less than 8 minutes in umc utrecht This article is part of FieldStrength issue 48 2013/1
User experiences Multiva 1.5T demonstrates outstanding value and performance Christof Walter, MD, is a radiologist at Radiology Center Trier, and lecturer at University Trier. Educated at University Dusseldorf, Dr. Walter s main clinical work is in neuroradiology and vascular and whole body MRI. His research subjects include MR angiography, cerebral perfusion imaging and whole body MRI. I believe Multiva offers the best value for the money in the market today. Radiology Center Trier (Germany) sees excellent image quality in routine and high-end applications with Multiva 1.5T In 2012 Radiology Center Trier moved to a newly built department in a 180-bed hospital, and installed the world s first Philips Multiva 1.5T MR system in November. With a private practice for outpatients as well as inpatients referred from the hospital, the center scans about 20 patients a day on Multiva, mainly for neuroradiology, oncology and MR angiography. The center also operates Philips CT, digital mammography and an Intera 1.5T MR system. FieldStrength 2
User experiences Multiva combines well-established MR features with new technical solutions designed by Philips, and that improves image quality, patient comfort and satisfaction of technologists and radiologists. Christof Walter, MD, is co-owner of the Radiology Center. The best value-to-cost ratio I could get is with the Multiva system, and that s why I decided to buy it, he says. I believe Multiva offers the best value for the money in the market today. Routine and advanced clinical applications can be performed with high image quality, all at a very reasonable cost, and we can be very competitive. The image quality is so brilliant, and I think that s the most important requirement for an MRI system. High performance, great value Dr. Walter says this wonderful image quality is a huge advantage in both routine and high-end scanning. Even in our routine applications, such as neuroradiology and MSK, I can answer so many questions with sophisticated methods like diffusion, perfusion, T2*, ASL (arterial spin labeling), even 4D angiography. Those are all routinely done on this machine. In knee scans, we get a beautiful visualization of the cartilage, even the tiny lesions. In the wrist, we can visualize very small ligaments. Our orthopedic colleagues were amazed seeing such brilliant images with a 1.5T scanner. In higher-end techniques such as mdixon, the surface coils really improve the image quality and speed of the examination. And I believe whole body and oncology image quality are excellent and examination times may soon become comparable to whole body CT. Multiva s high performance has been demonstrated since its installation. Already in our first results of MR angiography in carotid and peripheral arteries, we saw really outstanding image quality, Dr. Walter says. Both our colleagues and conservative angiologists agreed. In peripheral MRA, we can see the lower leg arteries down to the foot, which is really good. Our whole-body examinations have very high resolution. We can do high-end examinations of the upper abdomen in about 20 minutes. This is not yet as fast as CT, but the MR exam also includes T2 images with and without fat suppression, and in multi-planar exams also dynamic T1, mdixon, and MR angiography all in about 20 minutes. Dr. Walter has also collaborated with the University of Trier on research in brain perfusion, fmri, diffusion tensor imaging, and other types of imaging. So, with Multiva we do routine scanning, we can do advanced scanning like abdominal imaging which is comparable to CT and we can even do research, without extra cost. FlexStream speeds up workflow Multiva s FlexStream technology provides up to 40% reduction in patient and coil set up times. Our technologists are fully satisfied with the FlexStream concept, with the coil handling and the patient comfort, says Dr. Walter. The time it takes to change the patient has significantly decreased, even with our older patients. It s not necessary to move all the coils from one point to another. For example, a knee 3 Supplement to FieldStrength - Issue 48-2013/1
T2 TSE 5 mm 3D FFE 0.7 mm 3D FFE 0.7 mm post contrast TOF original image MIP of TOF-MRA MIP of TOF-MRA Dural AV fistula using different MR techniques A 76-year-old male with pulsatile tinnitus, headache and bruit symptoms getting worse the last few weeks and a normal neurological examination underwent an MRI exam on Multiva 1.5T using the head coil. The transverse T2 TSE and 3D FFE images show high flow signal in the transverse sinus. On the post-contrast 3D FFE image small dural connections are seen between the branches of the middle meningeal artery and the transverse sinus. The TOF-MRA images show high arterial flow in the transverse and sigmoid sinus. The TOF-MIP images show feeders of branches of the middle meningeal artery draining into the transverse and sigmoid sinus. demonstrates early arterial contrast enhancement of the right transverse and sigmoid sinus in comparison to the left side. Diagnosis is a dural arterial-venous fistula between a branch of the right ECA and the right transverse sinus. The diagnosis was confirmed by intra-arterial DSA. With Multiva you can do routine scanning, advanced scanning and research, without extra cost. FieldStrength 4
In knee scans, we get a beautiful visualization of even tiny lesions in the cartilage. In the wrist, we can visualize very small ligaments. exam can be performed after a spine exam without having to remove the posterior coil from the table you can just put the knee coil on the table. It s easy for the techs and it s very comfortable for the patient. Multiva proves to be stable, reliable, competitive The Multiva system is very stable and very reliable, says Dr. Walter. We have had no problems from the installation in November until today. It s running all the time without any issues, and it s very reliable. We can leave on Friday and know that on Monday we can start scanning immediately. And the design is very nice. When I visited the factory in Suzhou, China for a demo, I saw the machine and I thought, WOW! We use all the coils available with Multiva. The flexible 8-channel SENSE MSK coils offer outstanding image quality in all examinations of joints, he adds. The 16-channel Knee coil performs particularly well because of the great image quality. It s just brilliant. And for ASL we can use the neurovascular coil that comes with the scanner. Dr. Walter believes that his practice is able to compete on the local market because of the Multiva system. Multiva combines well-established MR features with new technical solutions, and that improves image quality, patient comfort and satisfaction of the technologists and radiologists. T1 TSE post contrast T1 TSE pre contrast T1 TSE post contrast Schwannoma A 25-year-old female complained of ambiguous symptoms in the lower abdomen. Clinical examination and ultrasound revealed a mass in the lower abdomen beneath the right kidney with contact to the spine. The patient then underwent an MRI exam on Multiva 1.5T using the Posterior coil and neurovascular coil. Multiva s advanced coil technology enables the simultaneous examination of the whole spine. The examination can be extended to the abdomen without the necessity of a renewed examination. The MR images show a homogenous contrast-enhancing mass in the right lower abdomen. It extends into the right neuroforamen L2/3 and has contact to the nerve root L2 right. The whole spine images help to exclude another neurogenic lesion in the remaining spine. The diagnosis schwannoma was confirmed by operation and histology. 1 Supplement to FieldStrength - Issue 48-2013/1