MRI-monitored cryosurgery in the rabbit brain

The inability to observe the transient, irregular shape of the frozen region that develops during cryosurgery has inhibited the application of this surgical technique to the treatment of tumors in the brain and deep in visceral organs. We used proton NMR spin-echo and spoiled gradient-echo imaging to monitor the development of frozen lesions during cryosurgery in the rabbit brain and the resulting postervosurgical changes up to 4 hr after freezing. Spoiled gradient-echo images (TE = 14 ms; TR = 50 ms) were acquired during freezing and thawing at a rate of 15 s/slice. Although the frozen region itself is invisible in MR images, its presence is distinguished easily from the surrounding unfrozen soft tissue because of the large contrast difference between frozen and unfrozen regions. T₂-weighted spin-echo images (TE = 100 ms, TR = 2 s) obtained after thawing suggest that edema forms first at the margin of the region that was frozen (cryolesion) and then moves into the region's core. Histological examination showed complete necrosis in the cryolesion and a sharp transition to undamaged tissue at the margin of the lesion and its image. Blood-brain barrier (BBB) damage was investigated using gadolinium-DTPA. The region of edema in the T₂-weighted spin-echo images was coincident with the area of BBB damage in the Gd-DTPA-enhanced T₁-weighted spin-echo images (TE = 33 ms, TR = 400 ms) and both were distinguishable as areas of high signal relative to the surrounding normal tissue. The results of these experiments indicate that MR can both effectively monitor the cryosurgical freezing and thawing cycle and characterize the postcryosurgical changes in tissue during follow-up.     

Serial MR imaging of intracranial metastases after radiosurgery

Purpose: To evaluate the spatiotemporal evolution of radiosurgical induced changes both in metastases and in normal brain tissue adjacent to the lesions by serial magnetic resonance (MR) imaging. Methods and Materials: Thirty-five intracranial metastases of different primaries were treated in 25 patients by single high-dose radiosurgery. MR images acquired before radiosurgery were available in all patients. Sixty-three follow-up MR studies were performed in these patients including T₂- and contrast-enhanced T₁-weighted MR images. The average follow-up time was 9 ± 5 months (mean ± standard deviation [SD]). Based on contrast-enhanced T₁-weighted MR images, tumor response was radiologically classified in the following four groups: stable disease was assumed if the average tumor diameter after treatment did not show a tumor shrinkage of more than 50% and an increase of more than 25%, partial remission as a shrinkage of tumor size of more than 50%, a disappearance of contrast-enhancing tumor as a complete remission, and an increase of tumor diameter of more than 25% as tumor progress. Moreover, we analysed signal changes on T₂-weighted images in brain parenchyma adjacent to the enhancing metastases. Results: The overall mean survival time was 10.5 ± 7 months, with a 1-year actuarial survival rate of 40%. Stable disease, partial or complete remission of the metastatic tumor was observed in 22 patients (88%). Central or homogeneous loss of contrast enhancement appeared to be a good prognostic sign for stable disease or partial remission. This association was statistically significant (p < 0.05). Three patients (12%) suffered from tumor progression. In eight patients (32%) with stable disease or partial remission, signal changes on T₂-weighted images were observed in tissue adjacent to the contrast enhancing lesions. A progression of the high signal on T₂-weighted images was seen in seven of the eight patients between 3 and 6 months after therapy, followed by a signal regression 6–18 months after irradiation. Conclusion: MR imaging is a sensitive imaging tool to evaluate tumor response as well as the presence or absence of adjacent parenchymal changes following radiosurgery. Loss of homogeneous or central contrast enhancement on Gd-enhanced MR images appeared to be a good prognostic sign for tumor response. Tumor shrinkage seems not to be dependent on time. In addition, most cases of radiation induced changes in normal brain parenchyma observed on T₂-weighted images seem to be self limited.     

A new method for characterization of low grade gliomas using ultra low field magnetic resonance imaging

Low grade gliomas were studied with ultra low field magnetic resonance imaging (ULF MRI). The tumors exhibited high tissue contrast in both T₁ and T₂-weighted images as compared to normal brain tissue. Moreover they were sharply delineated towards the surrounding brain tissue. When compared with X-ray computed tomography the tumors were more readily detected and delineated by using ultra-low field magnetic imaging. A computerassisted classification procedure was used to define new regions of interest for relaxation time estimation. By using this procedure more accurate estimations of the T₁ and T₂ values were obtained.     

基于多弛豫信号补偿的快速磁共振T1ρ散布成像

定量磁共振成像（MRI）可量化组织特性,是科学研究和临床研究的重要工具.旋转坐标系下的自旋-晶格弛豫时间（T_1ρ）能反映水与大分子之间的低频交互作用,在3 T及以上的高场环境下,T_1ρ受水和不稳定质子之间化学交换的影响较大,通过测量弛豫率随自旋锁定场强度的变化而得到其分布情况（T_1ρ散布）,可用于分析和量化质子的交换过程,因此T_1ρ散布是一种重要的定量MRI技术.然而,获得不同自旋锁定场强下T_1ρ加权图像的时间过长,限制了其应用范围.针对这一问题,本研究提出一种基于多弛豫信号补偿策略的快速T_1ρ散布成像方法.该方法将不同锁定频率下的T_1ρ加权图像补偿到同一信号强度水平,并结合低秩与稀疏建立重建模型.实验结果表明,该方法在加速倍数高达7倍时仍获得了较好的重建结果.     

MR imaging findings in recurrent primary osseous Ewing sarcoma

The objective of this study was to determine the value of magnetic resonance (MR) imaging in diagnosing local recurrence of Ewing sarcoma. We retrospectively reviewed radiographs, Tc^99m-methylene diphosphonate (MDP) skeletal scintigraphy, computed tomography scans, and MR studies of 11 patients who had local recurrences of osseous Ewing sarcoma following initial responses to chemotherapy and local radiation. The MR images were compared to those of a control group of nine patients who had no evidence of relapse. T₁- and T₂-weighted MR images identified 9 of the 11 recurrences. Computed tomography was diagnostic in 4 of 6 cases evaluated, Tc^99m-MDP bone scintigraphy in 4 of 11 cases, and plain radiographs in 2 of 10. MR findings at relapse included changes in signal intensity, increased extent of abnormal marrow signal on T₁- and T₂-weighted images, and identification of a new soft tissue mass. These findings suggest that MR imaging is valuable in the routine follow-up of parimary osseous Ewing sarcoma.     

MR of an adrenal pseudocyst

We describe the appearance of an adrenal pseudocyst on MRI and CT. The MR characteristics of the lesion were noteworthy in that the lesion had two components with different imaging characteristics. The larger component was of low signal intensity on both T₁- and T₂-weighted images and might have been confused with an adrenal adenoma.     

Negative gastrointestinal contrast enhancement and image distortion induced by superparamagnetic particles at 0.02 Tesla

Gastrointestinal contrast enhancement and image distortion induced by superparamagnetic particles were evaluated in vitro and in rabbits at 0.02 Tesla. Test tubes containing 0.01–1.0 mg particles/ml were imaged in an oil or water bath in order to demonstrate the concentration-dependent signal void and image distortion in vitro at several pulse sequences. The lowest concentration of particles tested clearly decreased the signal intensity. Image distortion was observed when the concentration exceeded 0.07 mg/ml and was more pronounced on the T₂-weighted images. The in vitro T₂ relaxation time decreased from 122 ms to 56 ms with an increase in the particle concentration from 0.01 to 0.06 mg/ml. A loss of the GI-tract signal was observed in rabbits after the administration of 1 mg particles/kg, given as a 0.03 mg/ml suspension. At a dose of 20 mg/kg (0.6 mg/ml suspension) significant image distortion was observed.     

Superparamagnetic iron oxide particles and positive enhancement for myocardial perfusion studies assessed by subsecond T1-weighted MRI

Superparamagnetic iron oxide particles (SPIOs) are usually referred to as T₂ MR contrast agents, reducing signal intensity (SI) on T₂-weighted MR images (negative enhancement). This study reports the original use of SPIOs as T₁-enhancing contrast agents, primarily assessed in vitro, and then applied to an in vivo investigation of a myocardial perfusion defect. Using a strongly T₁-weighted subsecond MR sequence with SPIOs intravenous (IV) bolus injection, MR imaging of myocardial vascularization after reperfusion was performed, on a dog model of coronary occlusion followed by reperfusion. Immediately after the intravenous bolus injection of 20 μmol/kg of SPIOs, a positive signal intensity enhancement was observed respectively, in the right and left ventricular cavity and in the nonischemic left myocardium. Moreover, compared to normal myocardium, the remaining ischemic myocardial region (anterior wall of the left ventricle) appeared as a lower and delayed SI enhancing area (cold spot). Mean peak SIE in the nonischemic myocardium (posterior wall) was significantly higher than in the ischemic myocardium (anterior wall) (110 ± 23% vs. 74 ± 22%, Mann-Whitney test < 1%, n₁ = 6, n₂ − n₁ = 0, U > 2). In conclusion, the T₁ effect of SPIOs at low dose, during their first intravascular distribution, suggests their potential use as positive markers to investigate the regional myocardial blood flow and some perfusion defects such as the “no-reflow phenomenon”.     

Macroscopic tumor volume of malignant glioma determined by contrast-enhanced magnetic resonance imaging with and without magnetization transfer contrast

The purposes of this study were to compare the conspicuity and lesion volume of contrast-enhancing macroscopic malignant glioma determined by postcontrast magnetic resonance (MR) imaging with and without magnetization transfer (MT) saturation, and to discuss possible implications for radiotherapy planning. Nineteen patients (age 24–60 years) with histologically proven malignant glioma were prospectively examined by MR imaging. After the administration of gadolinium dimeglumine (0.1 mmol/kg body weight), the lesions were imaged with an MT-weighted FLASH (fast, low-angle shot) pulse sequence and with a conventional T₁-weighted spin-echo (SE) sequence without MT saturation. The mean tumor volumes of gliomas measured on MT-weighted FLASH images were significantly (p < .01) larger than those obtained from T₁-weighted SE images (45 ± 15 cm³ vs. 33 ± 10 cm³). The mean contrast-to-noise ratio of enhancing lesions on MT-weighted FLASH was 48 ± 14 compared with 30 ± 14 on SE images, representing a significant (p < .01) improvement. We conclude that the volume of contrast enhancement of malignant glioma identified on MT-weighted FLASH images represents the area of disrupted blood-brain barrier. If this volume of subtle contrast enhancement is caused by tumor infiltration and represents the boost target volume for stereotactic radiosurgery or brachytherapy, MT-weighted FLASH images would be better than T₁-weighted SE images to define these volumes. These improved delineation of areas at highest risk for recurrence following radiation therapy should enhance the efficacy of treatment planning for high-boost therapy.     

MRI of hepatic lymphoma

Thirteen patients with biopsy proven hepatic lymphoma (2 Hodgkin, 11 Non-Hodgkin) and a control group of 15 patients with hepatic metastases were analyzed quantitatively and qualitatively by MRI. Focal hepatic lymphoma was most reliably detected (eight of eight patients) and appeared hypointense relative to liver on T₁ weighted (CNR − 7.4 ± 2.3) and hyperintense on T₂ weighted (CNR + 8.4 ± 2.9) images. The mean T₁ and T₂ relaxation times of focal hepatic lymphoma (T₁ = 832 ± 234 msec, T₂ = 84 ± 16 ms) differed significantly from adjacent non-tumorous liver (T₁ = 420 ± 121 ms, T₂ = 51 ± 9 ms; p < 0.05), however CNR values and relaxation times were similar to those of hepatic metastases. Diffuse hepatic lymphoma (microscopic periportal infiltration) was undetectable by MRI in three patients by either morphologic features or quantitative criteria. A mixed pattern of hepatic lymphoma (focal lesions and diffuse infiltration) showed focal areas of slightly decreased signal intensity on T₁ weighted images (CNR = −1.7 ± 0.4) while T₂ weighted images revealed multiple regions of focal hyperintensity (CNR = +13.3 ± 8.4) superimposed on a diffusely hyperintense liver. Our experience demonstrates that either T₁ or T₂ weighted techniques are useful in detecting focal and that T₂ weighted techniques are useful in detecting mixed hepatic lymphoma. Conventional image derived relaxation time measurements and quantitative parameters were of no additional diagnostic value.     

Magnetization transfer MRI of mouse brain reveals areas of high neural density

Extending applications of magnetization transfer contrast (MTC) in magnetic resonance imaging (MRI) of the human central nervous system, this work quantitatively describes MTC of the murine brain. As a novel finding, complementing T₁- and T₂-weighted MRI, MTC allows for the distinction of densely packed gray matter from normal gray and white matter. Examples include the Purkinje cell layer and the granular cell layer in the mouse cerebellum as well as the delineation of the CA3 subfield of the hippocampus relative to surrounding hippocampal gray matter and white matter tracts such as the hippocampal fimbria. Using a kainate lesion model, the CA3 hyperintensities in MTC and T₁-weighted MRI are assigned to the densely packed somata of pyramidal cells.     

Retroperitoneal ancient schwannoma presenting as an adrenal incidentaloma: CT and MR findings

A 35-year-old woman was referred to our institution for additional examinations to evaluate bilateral suprarenal masses incidentally found on abdominal ultrasonographic images obtained during an annual medical health checkup. Our computed tomographic scans showed bilateral and well-circumscribed low-density suprarenal masses, while MRI revealed the tumors to be heterogeneous with low intensity on T₁-weighted images and high intensity on T₂-weighted images. A laparoscopic adrenalectomy was performed under the suspicion of a malignant tumor, such as a malignant fibrous histiocytoma. Pathologic findings indicated a retroperitoneal ancient schwannoma of two histologic types: Antoni A and Antoni B. We considered that elucidation of the characteristic features of a schwannoma would provide helpful preoperative information for diagnosis.     

Changes in MR signal intensity and contrast enhancement of therapeutically irradiated soft tissue

Increased MR signal intensity was observed on T₂-weighted, STIR, and Gadolinium-DTPA-enhanced T₁-weighted images of subcutaneous and muscular soft tissue in 9 of 10 children treated with combination chemotheraphy and radiation therapy (RT) for malignancy in the pelvis or an extremity. Total radiation doses ranged from 59.5 to 65 Gy. Eight of the patients with these changes received hyperfractionated RT (seven for Ewing sarcoma and one for perineal rhabdomyosarcoma); one was treated for pelvic hemangiopericytoma with once-daily fractions. Evidence of soft tissue damage became apparent as early as the sixth week of RT and was seen for up to 69 wk post-RT. There was no clear MR evidence of RT-induced soft tissue damage in one patient, who underwent hyperfractionated RT for pelvic rhabdomyosarcoma. Other MR findings in this group included evidence of bladder wall thickening in three of the seven patients given pelvic RT and increased T₁-weighted signal of irradiated marrow in nine patients. All patients had clinical evidence of skin, soft tissue, or epithelial radiation effects. Increased MR signal intensity secondary to RT-induced damage can be differentiated from widespread tumor by geometric borders that conform to the margins of the radiation field.     

Tissue characterization by image processing subtraction: windowing of specific T1 values.

A method for windowing specific T₁ values is presented. A 1.0 T imager with two routine pulse sequences was employed: A T₁-weighted spin echo (SE) sequence and a short tau inversion recovery STIR sequence (fat-suppressed IR). A T₁ window for fat was obtained by subtracting the STIR image from the SE image. Negative values were coded black. The method was tested on a normal human thigh, on a human liver with confirmed fatty infiltration, and on the livers of four live burbots. The fat-containing tissues of the two human volunteers were well depicted. The differences in fat concentration among the burbot livers were also clearly shown. The fat intensity seen in the images correlated well with the chemically measured fat concentration. This subtraction method for windowing T₁ values proved feasible for fat. The method could be used for tissues with other short T₁ values as well.     

In vivo NMR T2 relaxation of experimental brain tumors in the cat: a multiparameter tissue characterization.

Experimental gliomas (F98) were inoculated in cat brain for the systematic study of their in vivo T₂ relaxation time behavior. With a CPMG multi-echo imaging sequence, a train of 16 echoes was evaluated to obtain the transverse relaxation time and the magnetization M(0) at time T = 0. The magnetization decay curves were analyzed for biexponentiality. All tissues showed monoexponential T₂, only that of the ventricular fluid and part of the vital tumor tissue were biexponential. Based on these NMR relaxation parameters the tissues were characterized, their correct assignment being assured by comparison with histological slices. T₂ of normal grey and white matter was 74 ± 6 and 72 ± 6 msec, respectively. These two tissue types were distinguished through M(0) which for white matter was only 0.88 of the intensity of grey matter in full agreement with water content, determined from tissue specimens. At the time of maximal tumor growth and edema spread a tissue differentiation was possible in NMR relaxation parameter images. Separation of the three tissue groups of normal tissue, tumor and edema was based on T₂ with T_2(normal) < T_2(tumor) < T_2(edema). Using M(0) as a second parameter the differentiation was supported, in particular between white matter and tumor or edema. Animals were studied at 1–4 wk after tumor implantation to study tumor development. The magnetization M(0) of both tumor and peritumoral edema went through a maximum between the second and third week of tumor growth. T₂ of edema was maximal at the same time with 133 ± 4 msec, while the relaxation time of tumor continued to increase during the whole growth period, reaching values of 114 ± 12 msec at the fourth week. Thus, a complete characterization of pathological tissues with NMR relaxometry must include a detailed study of the developmental changes of these tissues to assure correct experimental conditions for the goal of optimal contrast between normal and pathological regions in the NMR images.     

Investigation of cerebral ischemia using magnetization transfer contrast (MTC) MR imaging

The effects of cerebral ischemia in rat brain were monitored as a function of time using proton MR imaging. Spinspin relaxation time (T₂), proton density, and magnetization transfer contrast (MTC) were measured by MR imaging at various time intervals during a 1-week period following the induction of ischemic damage. Ischemic injury was characterized by a maximization of both T₂ value and MTC appearance at 24 hr postischemic injury. These changes were accompanied by a gradual increase in MR observable water density over the first few days of ischemia. A reduction in the magnetization exchange rate between “free” and “bound” water protons as measured by MTC imaging is at least partially responsible for the elevation in T₂ values observed during ischemia, and may accompany breakdown of cellular structure.     

MR Imaging of metastatic pancreatic VIPoma

The MR findings in a 32-year-old man with pancreatic VIPoma and liver metastases are described. A 2-cm mass was present in the region of the tail of the pancreas that was best shown on T₁-weighted fat-suppressed images as a low-signal intensity mass. Multiple liver metastases were present that showed intense peripheral ring enhancement on immediate post gadolinium spoiled gradient echo images.     

Proton spectroscopy of human stroke: Assessment of transverse relaxation times and partial volume effects in single volume STEAM MRS

Proton T₂ relaxation times were measured in 13 stroke patients and 13 aged-matched normal subjects at 2.1 T. Spectra were acquired from an 8-cc volume using the STEAM sequence with echo times (TE) of 30.4 ms and 270.0 ms and repetition time of 2.8 s. Transverse relaxation times were estimated using two-point calculations. Percentage volume of infarct in the STEAM voxel was measured on spin-echo MRI encompassing the infarct and correlated with the peak amplitude of N-acetylated compounds (NA). T₂ values of NA, creatine, and choline resonances showed no significant difference between patients and controls. T₂ for lactate in patients was 780 ± 257 ms, respectively (mean ± SE, n = 7). In stroke patients, high inverse correlation was found between the absolute NA signal and partial volume of normal brain contributing to each spectrum (p < .001, r = 0.97). Together with unchanged T₂, this suggests that NAA largely disappears from infarcted tissue within 24 hr postinfarct.     

Construction of phase cycles of minimum cycle length: MakeCycle

A magnetic resonance imaging method is presented for imaging of heterogeneous broad linewidth materials. This method allows for distortionless relaxation weighted imaging by obtaining multiple phase encoded k-space data points with each RF excitation pulse train. The use of this method, turbo spin echo single-point imaging-(turboSPI), leads to decreased imaging times compared to traditional constant-time imaging techniques, as well as the ability to introduce spin-spin relaxation contrast through the use of longer effective echo times. Imaging times in turboSPI are further decreased through the use of low flip angle steady-state excitation. Two-dimensional images of paramagnetic doped agarose phantoms were obtained, demonstrating the contrast and resolution characteristics of the sequence, and a method for both amplitude and phase deconvolution was demonstrated for use in high-resolution turboSPI imaging. Three-dimensional images of a partially water-saturated porous volcanic aggregate (T(2L) approximately 200 ms, Deltanu(1/2) approximately 2500 Hz) contained in a hardened white Portland cement matrix (T(2L) approximately 0.5 ms, Deltanu(1/2) approximately 2500 Hz) and a water-saturated quartz sand (T(2) approximately 300 ms, T(2)(*) approximately 800 microseconds) are shown.     

Relaxivities of human liver and spleen ferritin

Ferritin, the iron-storing protein of mammals, is known to darken T₂-weighted magnetic resonance images. This darkening can be used to noninvasively measure an organ's iron content. Significant discrepancies exist between T₂ data obtained with ferritin-containing tissues and with aqueous solutions of horse spleen ferritin (HSF). The NMR properties of stable human ferritin have never been studied in aqueous solutions. Relaxometry results on human liver and spleen ferritin are reported here, showing that the relaxation induced in aqueous solutions by human ferritins is comparable to that induced by HSF. As a consequence, the differences between ferritin-containing human tissues and ferritin solutions cannot be attributed to different NMR properties of human and horse ferritins, but probably to a clustering of the protein in vivo.