Magnetic resonance imaging and67ga scan versus computed tomography in the staging and in the monitoring of mediastinal malignant lymphoma: a prospective pilot study

Purpose: To assess the potential value of magnetic resonance imaging (MRI) combined with⁶⁷Ga single-photon emission computed tomography (SPECT) versus computed tomography (CT) in the staging and in the monitoring of mediastinal malignant lymphoma. Materials and methods: Twenty-three patients, referred to our institute for the evaluation of lymphoma, underwent CT,⁶⁷Ga scan, and MRI between April 1993 and February 1996 at sequential intervals. The tests studied (MRI,^67Ga, and CT) were performed according to the following schedule: 1) before start of therapy; 2) after four courses of chemotherapy; and 3) 2, 6, 12, and 18 months after the end of treatment. Results: All patients studied at the time of diagnosis had abnormal gallium accumulation in the mediastinum as well as pathologic CT and pathologic signal intensity at MRI. Six months after the end of treatment full consistency was found between the results of MRI and SPECT, whereas during treatment and 2 months after the end of therapy MRI and⁶⁷Ga scan were not in agreement in nine patients. In the 23 patients in follow-up, in CT there were nine false-positive and three false-negative findings; in SPECT three false negatives; in MRI one false positive and one false negative. Conclusion: MRI can give morphologic information similar to CT, even superior due to multiplanarity and with major precision in the distinction between fibrosis and active disease. MRI is thus an alternative to CT. The association with SPECT allows a great diagnostic accuracy in the positive and negative predictive value.     

Magnetic resonance imaging differentiation of adrenal masses at 1.5 t: t2-weighted images,chemical shift imaging,and gd-dtpa dynamic studies

The purpose of our study was to assess the potential role of spin-echo (SE), chemical shift, and gadolinium-enhanced magnetic resonance imaging (MRI) in the differentiation of adrenal masses.Seventy-two adrenal masses (26 nonhyperfunctioning adenomas, 16 aldosterone-secreting adenomas and 6 other different benign cortical masses, 18 pheochromocytomas, and 6 malignant masses) in 63 patients were evaluated with spin-echo sequences, chemical shift imaging (CSI) and gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) dynamic studies. Ratios and indices of signal intensity for all examined MRI methods were calculated and examined for significance of difference between different types of adrenal masses.Quantitative magnetic resonance evaluation of adrenal masses showed significant differences (at least<0.01) between nonhyperfunctioning adenomasvs. pheochromocytomas orvs. malignant lesions orvs. aldosterone-secreting adenomas and between pheochromocytomasvs. malignant lesions. The most specific indicators of adrenal mass character proved to be the CSI ratio based on opposed-phase and in-phase two-dimensional fast low-angle shot (FLASH) images, reflecting lipid content in the lesion, and Gd-DTPA dynamic studies ratios reflecting contrast agent inflow and washout in the lesion: Wo_max/last and Dyn_1.2–3.2. There was no overlap of CSI ratio between adenomas and pheochromocytomas. The overlap of ranges of CSI ratio between nonhyperfunctioning adenomas and aldosterone-secreting adenomas was only 18.5%. There was no overlap of Wo_max/last ratio between adenomas and pheochromocytomas, or adenomas and malignant lesions. The overlap of ranges of Dyn_{1.2– 3.2} ratio between pheochromocytomas and malignant lesions was only 17.6%.MRI enables good visualization and specific characterization of adrenal masses. The optimal MRI protocol for the adrenal region is presented.Address for correspondence: Imaging Department, Warsatv Province Hospital, ul. Kondratowicza 8, 03-285 Warsaw, Poland.     

Pannus-induced destruction of joint cartilage and subchondral bone. Visualization and staging by MRI

To investigate whether characterization and reliable staging of pannus-induced cartilage destructions in the knee could be achieved by magnetic resonance imaging (MRI), we examined 13 patients with arthritis, 2 patients with osteoarthritis (OA) and 5 healthy controls. A regional staging of bone and cartilage erosions was performed by two independent observers. In each of six regions, pannus-induced cartilage erosions were staged 0 (not present), 1 (present, but not penetrating), or 2 (penetrating).Pannus-induced cartilage erosions were demonstrated by MRI in 11 patients with arthritis and in no controls or OA patients. In the 11 patients, synovial masses overlying joint cartilage and a corresponding thinning of the cartilage, reflecting degradation, could be precisely delimited following gadolinium-DTPA I.V. Eight patients had bone erosions on MRI, either marginal caused by direct synovial invasion and/or in continuity with cartilage destructions caused by overlying pannus. By contrast, only two patients had radiographic erosions. The kappa values of interobserver variation with respect to regional presence or absence of bone and cartilage erosions were 0.94 and 0.92, respectively, indicating almost full concordance.     

Transient global brain ischemia in the rat: spatial distribution, extension, and evolution of lesions evaluated by magnetic resonance imaging

A newly-developed model of transient global ischemia in the rat was evaluated by magnetic resonance imaging (MRI) in terms of localization of brain lesions, their extent and severity, and temporal evolution. Such a model, consisting of bilateral occlusion of common carotid arteries for 10 minutes and mild hypoxia (15% O₂) for 20 minutes induces delayed neuronal degeneration, necrosis, and gliosis (detected histologically and immunohistochemically). Ischemia was assessed by full suppression of spontaneous electroencephalographic activity. A “hybrid” T₂-/diffusion-weighted MR sequence enhancing more effectively the contrast between injured and intact tissues as compared to T₂-weighted MRI was used at 24, 48, 72, and 96 hours and at 7 days postischemia. Twenty hypoxic-ischemic rats showed a considerable variability in brain damage. In 8, there were no MRI-detectable lesions at any interval. In the other 12 rats, the severity and extension of neuronal damage varied markedly, but the lesions were always localized (monolaterally in 8 and bilaterally in 4 rats) in the occipital, temporal, or parietal cerebral cortex. Mainly, they were of intermediate severity or were severe (as assessed by MRI hyperintensity) and were accompanied by usually less severe lesions in the thalamus and/or caudate putamen. The hippocampus was affected moderately or severely in 4 of 12 rats. In most cases, there was at 48 hours a considerable growth in severity and/or extension of lesions, which usually remained stable at later intervals. In conclusion, MRI allowed us to follow brain lesions during the first week in this relatively simple and noninvasive model of transient global ischemia.     

MR imaging of focal liver lesions: comparison between turbo spin-echo and conventional spin-echo pulse sequences

The aim of this study was to compare conventional spin-echo (CSE)T ₂-weighted (T2W) images with turbo spin-echo (TSE) T2W pulse sequences in their ability to detect focal liver lesions. Seventy-eight consecutive patients with focal liver lesions were entered into this study. All patients were imaged using the gradient-echo (GE) sequence with the breath-hold technique forT ₁-weighted (T1W) images, and CSE and TSE sequences for T2W images. Qualitative evaluation included lesion detection (number of lesions detected) and conspicuity (extent of visualization of lesional borders); quantitative evaluation included the signal-to-noise (S/N) ratio and the contrast-to-noise (C/N) ratio. TSE showed the best performance in terms of lesion detection; however, the difference between TSE and CSE was significant only in the case of benign cysts (p<0.01). Conspicuity was higher with TSE and CSE, and lower with GE. The S/N and C/N ratios of the two T2W sequences were also comparable, and better than those of GE. However, the combined use of GE and TSE resulted in improved lesion detection. The results show that, because the acquisition time is greatly reduced with TSE sequences, these should be considered as first-line approach to magnetic resonance imaging of the liver for the study of focal lesions.     

Effects of riluzole on the evolution of focal cerebral ischemia: a magnetic resonance imaging study

The aim of this study was to investigate the effects of riluzole on the lesion induced by a permanent middle cerebral artery occlusion (MCAO) in rats. Riluzole at 4 or 8 mg/kg i.v. significantly reduced the cortical ischemic brain damage. With the most effective dose of 8 mg/kg, the time evolution of the lesion was assessed by T₂-weighted magnetic resonance imaging (MRI) repeated on the same animals after MCAO. MRI obtained at 24, 48, and 72 hours after MCAO showed a progressive increase of the ischemic lesion, except in the cortex of the riluzole-treated rats (8 mg/kg i.v.). Furthermore, there was no difference between lesion volumes as measured by MRI or by histology. This study indicates that MRI may be a valuable method to quantifyin vivo the neuroprotective profile of a drug.     

Long-term follow-up of patients with acute myocarditis by magnetic resonance imaging

Magnetic resonance imaging (MRI) reveals cardiac signal intensity changes in patients with acute myocarditis; however, the natural history of these changes and their relationship to individual outcomes are unknown. The relationship of MRI findings to long-term outcome was studied by serial MRI studies in 16 patients with acute myocarditis who were followed for 30±4 (SE) months. Myocardial contrast enhancement was monitored using contrast-enhanced T1-weighted fast spin-echo images. Left ventricular ejection fraction was measured with gradient-echo sequences. Clinical symptoms were scored. The results were compared to a control group of 26 age-matched, healthy volunteers. Myocardial contrast enhancement, which was markedly increased in the early course of the disease, decreased at 4 weeks and remained within the normal range in most patients after 30 months. Contrast enhancement 4 weeks after onset of symptoms was predictive for the functional and clinical long-term outcome. Contrast-enhanced MRI may be a useful, noninvasive tool for long-term follow-up of patients with acute myocarditis. Furthermore, relatively early MRI findings may predict longer-term outcomes. Electronic Publication     

Detection of colorectal liver metastases: prospective comparison of unenhanced and ferumoxides-enhanced magnetic resonance imaging at 1.5 T, dual-phase spiral CT, and spiral CT during arterial portography

The purpose of this study was to compare the efficacy of unenhanced and ferumoxides-enhanced magnetic resonance imaging with that of dual-phase spiral CT and spiral CT during arterial portography (CTAP) for the detection of colorectal liver metastases. Fourteen patients with liver metastases candidates for partial hepatectomy were examined with dual-phase spiral CT, unenhanced and ferumoxides-enhanced MR imaging at 1.5 T, and spiral CTAP. Imaging tests were read blinded, prospectively, quantitating number of lesions excepting CTAP which used US to exclude cysts. Subsequent intraoperative US and pathologic findings were correlated with preoperative imaging results. At surgery, 36 lesions 0.5–13 cm in diameter (mean ±standard deviation, 2.9±2.1 cm) were identified. Dual-phase spiral CT depicted 21/36 (58%); precontrast MR imaging, 19/36 (53%); ferumoxides-enhanced MR imaging, 30/36 (83%); and spiral CTAP, 34/36 (94%) lesions. Ferumoxides-enhanced MR imaging was significantly more sensitive than spiral CT and unenhanced MR imaging (P<0.01). The difference in sensitivity between ferumoxides-enhanced MR imaging and spiral CTAP was not statistically significant (P>0.1). Spiral CTAP, however, depicted nine false-positive lesions (2 hemangiomas, 7 perfusion defects). The positive predictive value was 79% for spiral CTAP and 100% for combined pre- and postcontrast MR imaging. We conclude that ferumoxides-enhanced MR imaging is superior to unenhanced MR imaging and biphasic spiral CT for depiction of colorectal liver metastases. Further investigation is needed to clarify whether MR imaging with use of ferumoxides might replace spiral CTAP for preoperative evaluation of liver resection candidates. Recipient of a Cum Laude award for a scientific exhibit at the 1997 ESMRMB annual meeting.     

Clinical role of diffusion-weighted imaging: neonatal studies

The application of diffusion-weighted imaging to the early diagnosis of neonatal cerebral infarction and hypoxic ischemic encephalopathy is illustrated. Diffusion-weighted images showed early infarction before conventional imaging in both cases. These were subsequently seen with conventional imaging on follow-up. In four cases of grades I and II hypoxic-ischemic encephalopathy (HIE) no abnormality was seen with either diffusion-weighted or conventional imaging. In four other cases of grades II and III HIE, much more extensive changes were seen with diffusion-weighted imaging than with conventional imaging. Follow-up scans with conventional imaging confirmed the abnormalities in the two surviving infants. Diffusion-weighted imaging may be particularly useful for the early diagnosis of ischemic-anoxic injury in infants.     

The role of endorectal coil MRI in preoperative staging and decision-making for the treatment of clinically localized prostate cancer

Introduction  The optimal management of newly diagnosed prostate cancer requires individualization of the treatment plan based upon the most accurate clinical characterization of tumor location and extent of disease. The role of imaging in prostate cancer staging continues to evolve. In this review, we address the utility of endorectal coil magnetic resonance imaging (eMRI) in both local staging and its ability to facilitate the decision in choosing one treatment strategy over another after the initial diagnosis of localized prostate cancer. Materials and methods  Using the PubMed database and reference lists of key articles, we identified studies addressing the use of eMRI in tumor characterization and risk stratification in patients undergoing treatment for clinically localized prostate cancer. Results  The findings identified within 54 selected studies were incorporated into a summary discussing the current limitations in cancer staging and the role eMRI plays in both the preoperative assessment and clinical decision-making in an attempt to improve our ability to individualize management approaches and tailor treatment. Conclusion  eMRI allows for more accurate local staging by complementing the existing clinical variables through improvements in spatial characterization of the prostatic zonal anatomy and molecular changes. These improvements in tumor staging enhance our ability to individualize treatment selection and tailor the approach to maximize cancer control while minimizing treatment related morbidity.     

Gadofluorine 8: initial experience with a new contrast medium for interstitial MR lymphography

Rationale and objectives: Differential diagnosis of malignant and benign lymph nodes is still a problem in lymphographic imaging modalities. Plain magnetic resonance imaging (MRI) and computed tomography (CT) are inadequate for detecting metastases in normal-sized lymph nodes and for differentiating enlarged nodes. Therefore it is important to have a contrast agent that accumulates in healthy lymphatic tissue but does not accumulate in metastatic deposits.Methods: The lymphographic constrast agent Gadofluorine 8 (Schering AG, Berlin, Germany) is a lipophilic but water-soluble gadolinium complex. Lymphographic effects were investigated in guinea pigs, dogs, and tumor-bearing rabbits after interstitial (subcutaneous or intracutaneous) injection. MR imaging was performed using T₁-weighted gradient-echo sequences until 120 min after administration.Results: After interstitial injection Gadofluorine 8 accumulates in regional, lymph nodes, resulting in a pronounced increase in signal intensity in the lymph nodes. Differentiation between normal and metastatic lymph nodes was achieved.Conclusions: Gadofluorine 8 is an innovative contrast agent that can distinguish between normal and tumorous lymph nodes in interstitial MR lymphography.     

Role of magnetic resonance methods in the evaluation of prostate cancer: an Indian perspective

The challenges in detection, localization, and staging of prostate cancer have prompted the investigation of the role of various magnetic resonance (MR) methodologies in a large cohort of men prior to biopsy. The identification of suspicious areas of malignancy was carried out using magnetic resonance imaging (MRI), magnetic resonance spectroscopic imaging (MRSI) and diffusion-weighted imaging (DWI). Our data shows that apparent diffusion coefficient (ADC) may be a reliable marker to differentiate normal, benign, and malignant prostate tissues similar to the metabolite ratio. Also, the combined use of MRSI and DWI improves the diagnosis of prostate cancer. In this review, we present our experience on the use of MRI, MRSI and DWI methods in the assessment of prostate cancer in Indian men. Further, analysis of the comparison of the ADC and the metabolite ratio values reported in the literature across various patient populations are presented. An erratum to this article can be found at     

Preliminary characterization of an experimental breast cancer cells brain metastasis mouse model by MRI/MRS

PURPOSE: Chemotherapy increases survival in breast cancer patients. Consequently, cerebral metastases have recently become a significant clinical problem, with an incidence of 30-40% among breast carcinoma patients. As this phenomenon cannot be studied longitudinally in humans, models which mimic brain metastasis are needed to investigate its pathogenesis. Such models may later be used in experimental therapeutic approaches. MATERIAL AND METHODS/RESULTS: We report a model in which 69% of the animals (9/13 BALB/c nude mice) developed MR-detectable abnormal masses in the brain parenchyma within a 20 to 62-day time window post intra-carotid injection of 435-Br1 human cells. The masses detected in vivo were either single (7 animals) or multiple (2 animals). Longitudinal MR (MRI/MRS) studies and post-mortem histological data were correlated, revealing a total incidence of experimental brain metastases of 85% in the cases studied (11/13 animals). ADC maps perfectly differentiated edema and/or CSF areas from metastasis. Preliminary MRS data also revealed additional features: decrease in N-acetyl aspartate (NAA) was the first MRS-based marker of metastasis growth in the brain (micrometastasis); choline-containing compounds (Cho) rose and creatine (Cr) levels decreased as these lesions evolved, with mobile lipids and lactate also becoming visible. Furthermore, MRS pattern recognition-based analysis suggested that this approach may help to discriminate different growth stages. CONCLUSIONS: This study paves the way for further in vivo studies oriented towards detection of different tumor progression states and for improving treatment efficiency.     

超导核磁共振成像磁屏蔽技术的进展

本文对超导核磁共振成像磁屏蔽技术的发展过程，几种屏蔽方式的比较、研究的问题和发展趋势等进行了概括性的论述。     

Mri and mrs of human tendon xanthoma at 1.5 t: Anin vivo study

We studied a xanthomatous Achilles tendon and a normal Achilles tendon with the proton magnetic resonance imaging (MRI) and spectroscopy (MRS) at 1.5 T in a standard head coil. TheT ₂ maps and the localized proton spectra of the Achilles tendon were reconstructed. The normal tendon revealed no MR signal, whereas the xanthomatous tendon image consisted of variable signal intensities, for which the value ofT ₂ was significantly shorter (p=0.0002) than that of adipose tissue. The proton spectrum of this tendon xanthoma showed an increased water peak and unsaturated olefinic group intensity compared with the spectrum of the normal Achilles tendon area. The complex cholesterol molecule itself cannot be proven directly in a xanthomatous tendon, but its presence can be revealed with the help of the increased methyl and methylene groups of the fatty acids of the cholesteryl esters. This and other typical features describedin vitro for atheromatous tissue can be detectedin vivo in xanthomas.Additional reprints of this chapter may be obtained from the Reprints Department, Chapman & Hall, One Penn Plaza, New York, NY 10119.     

Characterization of pheochromocytomas using quantitati analysis of the parameter T2 of the mass (T2-QMRI)

The usefullness of MR imaging in the characterization of pheochromocytomas was evaluated in 9 patients with 13 pheochromocytomas and 1 paraganglioma. In two patients the tumors were multiple and in one, extra-adrenal. Two patients conformed to MEN2 syndrome. Adrenal masses were characterized using several parameters: (a) visual inspection of the signal intensities in T1-, T2-, and Gd-DTPA-enhanced T1-weighted images; (b) observed signal intensity and observed signal intensity ratios (adrenal mass/liver, adrenal mass/retroperitoneal fat and adrenal mass/ subcutaneous fat) in the T2-weighted images; (c) calculated T2 relaxation times and calculated T2 relaxation time ratios (adrenal mass/liver, adrenal mass/retroperitoneal fat and adrenal mass/subcutaneous fat) of the adrenal masses.All pheochromocytomas had a T2 relaxation time greater than 82 ms with a maximum value of 134.3 ms. These values were calculated using T2 quantitative analysis methods based on in-house designed mathematical routines (T2-QMRI). The signal intensities of the tumor on T2-weighted spin-echo images were extremely high.As a conclusion of this preliminary report it is postulated that T2 quantitative MRI examination (T2-QMRI) is an accurate method for the diagnosis and characterization of pheochromocytomas because it gives positive diagnostic results whether the pheochromocytoma is secreting or nonfunctioning. It can also detect extra-adrenal pheochromocytomas (paragangliomas). Comparative studies with other adrenal tumors is essential to assess accuracy of this method for characterizing these tumors.Address for correspondence: Areteion University Hospital, Radiology Department, VasSofias 76 st, 11528 Athens, Greece. Additional reprints of this chapter may be obtained from the Reprints Department, Chapman & Hall, One Venn Plaza, New York, NY 10119.     

Cardiac activation mapping by MRI

To establish cardiac MRI as a tool for noninvasive evaluation of activation patterns, 10 healthy volunteers were examined by cine segmented turboFLASH imaging sequences. Sequence modifications for low signal blood-pool appearance were applied, i.e., bilateral spatial saturation for segmented turboFLASH imaging. Pixelwise calculation of first-harmonic Fourier phase values (displayed as color-encoded maps) reveal either anterior septal or left ventricular free-wall sites as areas of earliest phase spreading towards posterior paraseptal sites in segmented turboFLASH scans. Phase scatter is lower in unsaturated than spatially presaturated segmented turboFLASH studies. Phase standard deviation in areas of endocardial displacement is higher in basal than apical slice positions in these scans. Early results indicate that first-harmonic Fourier phase analysis of cardiac-segmented turboFLASH MRI cine studies may provide a tool for noninvasive studies of cardiac activation sequence.     

Water household of the common carp,Cyprinus carpio, when submitted to an osmotic challenge, as determined by diffusion-weighted magnetic resonance imaging at 7 T

In vivo diffusion-weighted magnetic resonance imaging (MRI) was used to determine the effects of an osmotic challenge (1% NaCl) to a freshwater fish, the common carp (Cyprinus carpio). The imaged region covered organs such as the swimbladder, the liver, the kidney, the intestine, the spinal cord, and muscle tissue. A striking difference between salt-treated and control fish was found in the liver. The apparent diffusion coefficient value of livers from control fish was (0.39±0.16) 10⁻⁹ m²/s and of salt-treated fish was (1.23±0.14) 10⁻⁹ m²/s, which points to an increase in extracellular water content. These results were partially confirmed by a decrease in dry/wet weight ratio of the liver tissue. We also found increased levels of stress proteins in liver tissue. TheQ factor of the applied radiofrequency coil dropped dramatically when we performed experiments with salt-exposed fish, indicating an increased conductivity resulting from the increased ion concentration and osmolarity of the fish. The data on plasma osmolarity of salt-exposed fish confirm a significant osmolarity increase upon salt exposure (from 334 to 430 mOsm/kg) and exceeded the osmolarity of the salt water (324 mOsm/kg), indicating that carp tend to cope with an increased salinity by increasing the internal osmolarity (hyperosmotic regulation). These data demonstrate that diffusion-weighted MRI might be a useful and noninvasive tool in the study of osmotic challenges of aquatic organisms.     

Rat cerebral ischemia induced with photochemical occlusion of proximal middle cerebral artery: a stroke model for MR imaging research

A stroke model in rats with photochemically induced thrombosis (PIT) of proximal cerebral middle artery (MCA) is introduced for magnetic resonance imaging (MRI) study. Thirty-seven rats subjected to surgical and optical procedures for inducing the PIT models were scanned using a 1.5-T scanner with T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and contrast-enhanced perfusion-weighted imaging (PWI) at 1 h and 24 h after MCA occlusion. The penumbra evolution and PWI-derived parameters including relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) were monitored; and the relative lesion size (RLS) was compared with the final RLS on the gold standard triphenyl tetrazolium chloride (TTC) staining at 24 h. The results showed that the focal cerebral ischemic lesions were detectable in all rats with different MR approaches. The lesion on PWI at 1 h and on all MR images at 24 h was matched well with that seen on TTC staining; the peri-infarct area decreased from 6.2 ± 7.2% of the brain volume at 1 h to 0.3 ± 5.6% at 24 h. Compared to that in the contralateral hemisphere, rCBV in ischemic region was 52.6 ± 21.4 and 40.0 ± 15.8% (p > 0.05), and rCBF was 64.6 ± 11.2 and 47.3 ± 11.1% (p < 0.05) at 1 h and 24 h respectively. The present PIT model in rats has been successfully adopted for MRI research, which might be feasible for certain stroke studies and should be beneficial for the evaluation on effects of potential diagnostic and therapeutic approaches.     

Measurements of left ventricular dimensions using real-time acquisition in cardiac magnetic resonance imaging: comparison with conventional gradient echo imaging

This study investigates the use of real-time acquisition in cardiac magnetic resonance imaging (MRI) for measurements of left ventricular dimensions in comparison with conventional gradient echo acquisition. Thirty-one subjects with a variety of left ventricular morphologies to represent a typical clinical population were studied. Short-axis data sets of the left ventricle (LV) were acquired using a conventional turbo-gradient echo and an ultrafast hybrid gradient echo/echo planar sequence with acquisition in real-time. End-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF) and left ventricular mass (LV mass) were measured. The agreement between the two acquisitions and interobserver, intraobserver and interstudy variabilities were determined. The bias between the two methods was 5.86 ml for EDV, 0.23 ml for ESV and 0.94% for EF. LV mass measurements were significantly lower with the real-time method (mean bias 14.38 g). This is likely to be the result of lower spatial resolution and chemical shift artefacts with the real-time method. Interobserver, intraobserver and interstudy variabilities were low for all parameters. In conclusion, real time acquisition in MRI can provide accurate and reproducible measurements of LV dimensions in subjects with normal as well as abnormal LV morphologies, but LV mass measurements were lower than with conventional gradient echo imaging. Presented in abstract form at the International Society of Magnetic Resonance in Medicine meeting in Denver, Colorado in April 2000.