MRI findings in nonalcoholic steatohepatitis: correlation with histopathology and clinical staging

Purpose

To evaluate magnetic resonance imaging (MRI) findings of nonalcoholic steatohepatitis (NASH) and to determine the correlation of MRI findings with histopathology and Mayo End-Stage Liver Disease (MELD) score.

Materials and Methods

Thirty patients (18 males, 12 females; mean age: 57±8.9 years; age range: 35–71 years) with histopathologically proven NASH who underwent MRI examinations between January 2001 and October 2005 were included in the study. Two radiologists retrospectively reviewed all magnetic resonance (MR) examinations in consensus to evaluate the presence and extent of predetermined findings of NASH including liver steatosis, early patchy liver enhancement indicating inflammation and liver fibrosis. The findings detected on MRI were correlated and compared to histopathological findings and MELD score by using nonparametric Spearman correlation coefficient and Kruskal–Wallis analysis of variance.

Results

Liver steatosis was observed in 10 of 30 patients; early patchy liver enhancement, in 8 of 30 patients and liver fibrosis in 19 of 30 patients on MR images. Liver fibrosis was reticular in all these patients. There were statistically significant moderate correlations between MRI findings of liver steatosis and histopathologic grades of steatosis (r=0.43; P<.05), and between MRI findings of fibrosis and histopathologic stages of fibrosis (r=0.61; P<.001). Early patchy enhancement did not demonstrate statistically significant correlation with inflammation (P=.28). There was no statistically significant overall correlation between MRI findings of NASH and MELD score.

Conclusion

MRI findings of liver steatosis and fibrosis in NASH showed moderate correlations with histopathologic grades of steatosis and stages of fibrosis, but MRI findings of NASH did not demonstrate any significant correlations with MELD score.     

Extrinsic multiecho phase-contrast SSFP: evaluation on cardiac output measurements

Multiecho phase-contrast steady-state free precession (PC-SSFP) is a recently introduced sequence for flow quantification. In this multiecho approach, a phase reference and a velocity-encoded readout were acquired at different echo times after a single excitation. In this study, the sequence is validated in vitro for stationary flow. Subsequently, the sequence was evaluated on cardiac output measurements in vivo for through-plane flow in comparison to regular single gradient echo velocity quantification [phase-contrast spoiled gradient echo (PC-GE)]. In vitro results agreed with regular flow meters (RMS 0.1 cm/s). Cardiac output measurements with multiecho PC-SSFP on 10 healthy subjects gave on average the same results as the standard PC-GE. However, the limits of repeatability of PC-SSFP were significantly larger than those of PC-GE (2 l/min and 0.5 l/min, respectively, P=.001). The multiecho approach introduced some specific problems in vivo. The difference in echo times made the velocity maps sensitive for water-fat shifts and B(0)-drifts, which in turn made velocity offset correction problematic. Also, the addition of a single bipolar gradient cancelled the flow compensated nature of the SSFP sequence. In combination with the prolonged TR, this resulted in flow artifacts caused by high and pulsatile through-plane flow, affecting repeatability. Given the significantly lower repeatability of PC-SSFP, cardiac output in turn is less reliable, thus impairing the use of multiecho PC-SSFP.     

Enhancing the discrimination accuracy between metastases, gliomas and meningiomas on brain MRI by volumetric textural features and ensemble pattern recognition methods

Three-dimensional (3D) texture analysis of volumetric brain magnetic resonance (MR) images has been identified as an important indicator for discriminating among different brain pathologies. The purpose of this study was to evaluate the efficiency of 3D textural features using a pattern recognition system in the task of discriminating benign, malignant and metastatic brain tissues on T1 postcontrast MR imaging (MRI) series. The dataset consisted of 67 brain MRI series obtained from patients with verified and untreated intracranial tumors. The pattern recognition system was designed as an ensemble classification scheme employing a support vector machine classifier, specially modified in order to integrate the least squares features transformation logic in its kernel function. The latter, in conjunction with using 3D textural features, enabled boosting up the performance of the system in discriminating metastatic, malignant and benign brain tumors with 77.14%, 89.19% and 93.33% accuracy, respectively. The method was evaluated using an external cross-validation process; thus, results might be considered indicative of the generalization performance of the system to "unseen" cases. The proposed system might be used as an assisting tool for brain tumor characterization on volumetric MRI series.     

Elliptical magnetic resonance spectroscopic imaging with GRAPPA for imaging brain tumors at 3 T

Magnetic Resonance Spectroscopic Imaging (MRSI) is a technique for imaging spatial variation of metabolites and has been very useful in characterizing biochemical changes associated with disease as well as response to therapy in malignant pathologies. This work presents a self-calibrated undersampling to accelerate 3D elliptical MRSI and an extrapolation-reconstruction algorithm based on the GRAPPA method. The accelerated MRSI technique was tested in three volunteers and five brain tumor patients. Acceleration allowed larger spatial coverage and consequently, less lipid contamination in spectra, compared to fully sampled acquisition within the same scantime. Metabolite concentrations measured from the accelerated acquisitions were in good agreement with measurements obtained from fully sampled MRSI scans.     

Noise estimation in single- and multiple-coil magnetic resonance data based on statistical models

Noise estimation is a challenging task in magnetic resonance imaging (MRI), with applications in quality assessment, filtering or diffusion tensor estimation. Main noise estimators based on the Rician model are revisited and classified in this article, and new useful methods are proposed. Additionally, all the surveyed estimators are extended to the noncentral chi model, which applies to multiple-coil MRI and some important parallel imaging algorithms for accelerated acquisitions. The proposed new noise estimation procedures, based on the distribution of local moments, show better performance in terms of smaller variance and unbiased estimation over a wide range of experiments, with the additional advantage of not needing to explicitly segment the background of the image.     

Accounting for nonspecific enhancement in neuronal tract tracing using manganese enhanced magnetic resonance imaging

Manganese enhanced MRI (MEMRI) is an emerging technique for tracing neuronal pathways in vivo. However, manganese may leak into blood vessels or cerebrospinal fluid (CSF) after local injection and can be circulated to and taken up by brain regions that may not have connections to the targeted pathways. Comparing enhancement time courses after intranasal injection with intravenous infusion of MnCl₂ in rats, the early enhancements in the pituitary gland (Pit) and hippocampus indicate the contrasts in those regions in the olfactory tract-tracing experiment were caused by such systemic effects. Since the Pit has easy access to manganese from the blood and its signal is proportional to other brain regions after intravenous infusion, it was used as an internal reference for the systemic effects. Applying intensity normalization by the Pit signal to tract-tracing data from the olfactory bulb led to reduced contrast in the hippocampus. These results demonstrate that nonspecific enhancements in MEMRI tract-tracing studies may have to be taken into account and that normalization by the Pit signal can compensate these effects.     

Spin echo SPI methods for quantitative analysis of fluids in porous media

Fluid density imaging is highly desirable in a wide variety of porous media measurements. The SPRITE class of MRI methods has proven to be robust and general in their ability to generate density images in porous media, however the short encoding times required, with correspondingly high magnetic field gradient strengths and filter widths, and low flip angle RF pulses, yield sub-optimal S/N images, especially at low static field strength. This paper explores two implementations of pure phase encode spin echo 1D imaging, with application to a proposed new petroleum reservoir core analysis measurement.In the first implementation of the pulse sequence, we modify the spin echo single point imaging (SE-SPI) technique to acquire the k-space origin data point, with a near zero evolution time, from the free induction decay (FID) following a 90° excitation pulse. Subsequent k-space data points are acquired by separately phase encoding individual echoes in a multi-echo acquisition. T₂ attenuation of the echo train yields an image convolution which causes blurring. The T₂ blur effect is moderate for porous media with T₂ lifetime distributions longer than 5 ms. As a robust, high S/N, and fast 1D imaging method, this method will be highly complementary to SPRITE techniques for the quantitative analysis of fluid content in porous media.In the second implementation of the SE-SPI pulse sequence, modification of the basic measurement permits fast determination of spatially resolved T₂ distributions in porous media through separately phase encoding each echo in a multi-echo CPMG pulse train. An individual T₂ weighted image may be acquired from each echo. The echo time (TE) of each T₂ weighted image may be reduced to 500 μs or less. These profiles can be fit to extract a T₂ distribution from each pixel employing a variety of standard inverse Laplace transform methods. Fluid content 1D images are produced as an essential by product of determining the spatially resolved T₂ distribution. These 1D images do not suffer from a T₂ related blurring.The above SE-SPI measurements are combined to generate 1D images of the local saturation and T₂ distribution as a function of saturation, upon centrifugation of petroleum reservoir core samples. The logarithm mean T₂ is observed to shift linearly with water saturation. This new reservoir core analysis measurement may provide a valuable calibration of the Coates equation for irreducible water saturation, which has been widely implemented in NMR well logging measurements.     

Nearly 10-fold enhancements in intermolecular H double-quantum NMR experiments by nuclear hyperpolarization

Intermolecular Multiple-Quantum Coherences (iMQCs) can yield interesting NMR information of high potential usefulness in spectroscopy and imaging – provided their associated sensitivity limitations can be overcome. A recent study demonstrated that ex situ dynamic nuclear polarization (DNP) could assist in overcoming sensitivity problems for iMQC-based experiments on ¹³C nuclei. In the present work we show that a similar approach is possible when targeting the protons of a hyperpolarized solvent. It was found that although the DNP procedure enhances single-quantum ¹H signals by about 600, which is significantly less than in optimized low-γ liquid-state counterparts, the non-linear dependence of iMQC-derived signals on polarization can yield very large enhancements approaching 10⁶. Cleary no practical amount of data averaging can match this kind of sensitivity gains. The fact that DNP endows iMQC-based ¹H NMR spectra with a sensitivity that amply exceeds that of their thermally polarized single-quantum counterpart, is confirmed in a number of simple single-scan 2D imaging experiments.     

Distortion-free magnetic resonance imaging in the zero-field limit

MRI is a powerful technique for clinical diagnosis and materials characterization. Images are acquired in a homogeneous static magnetic field much higher than the fields generated across the field of view by the spatially encoding field gradients. Without such a high field, the concomitant components of the field gradient dictated by Maxwell’s equations lead to severe distortions that make imaging impossible with conventional MRI encoding. In this paper, we present a distortion-free image of a phantom acquired with a fundamentally different methodology in which the applied static field approaches zero. Our technique involves encoding with pulses of uniform and gradient field, and acquiring the magnetic field signals with a SQUID. The method can be extended to weak ambient fields, potentially enabling imaging in the Earth’s field without cancellation coils or shielding. Other potential applications include quantum information processing and fundamental studies of long-range ferromagnetic interactions.     

磁性纳米颗粒在生物医学领域中的应用

磁性纳米颗粒作为一种新型纳米材料,在许多领域,特别是在生物医药、生物工程等方面具有广阔的应用前景.本文着重论述了近年来磁性纳米颗粒在生物分离、靶向给药、热疗以及磁共振成像对比剂等方面的应用,并对其应用前景进行了展望.