Assessment of liver fat quantification in the presence of iron

This study assesses the stability of magnetic resonance liver fat measurements against changes in T2* due to the presence of iron, which is a confound for accurate quantification. The liver T2* was experimentally shortened by intravenous infusion of a super paramagnetic iron oxide contrast agent. Low flip angle multiecho gradient echo sequences were performed before, during and after infusion. The liver fat fraction (FF) was calculated in co-localized regions-of-interest using T2* models that assumed no decay, monoexponential decay and biexponential decay. Results show that, when T2* was neglected, there was a strong underestimation of FF and with monoexponential decay there was a weak overestimation of FF. Curve-fitting using the biexponential decay was found to be problematic. The overestimation of FF may be due to remaining deficiencies in the model, although is unlikely to be important for clinical diagnosis of steatosis.     

Muscle and fat quantification in MRI gradient echo images using a partial volume detection method. Application to the characterization of pig belly tissue

Complete dissection is the current reference method to quantify muscle and fat tissue on pig carcasses. Magnetic resonance imaging (MRI) is an appropriate nondestructive alternative method that can provide reliable and quantitative information on pig carcass composition without losing the spatial information. We have developed a method to quantify the amount of fat tissue and muscle in gradient echo MR images. This method is based on the method proposed by Shattuck et al. [12]. It provides segmentation of pure tissue and partial volume voxels, which allows separation of muscle and fat tissue including the fine insertions of intermuscular fat. Partial volume voxel signal is expected to be proportional to the signals of pure tissue constituting them or at least to vary monotonously with the proportion of each tissue. However, it is not always the case with gradient echo sequence due to the chemical shift effect. We studied this effect on a fat tissue/muscle interface model with variable proportion of water in the fat tissue and variable TE. We found that at TE=8 ms, for a 0.2-T MRI system, the requirement of Shattuck's method were filled thanks to the presence of water in fat tissue. Moreover, we extended the segmentation method with a simple correction scheme to compute more accurately the proportions of each tissue in partial volume voxels. We used this method to evaluate the fat tissue and muscle on 24 pig bellies using a gradient echo sequence (TR 700 ms, TE 8 ms, slice thickness 8 mm, number of averages 8, flip angle 90 degrees , FOV 512 mm, matrix 512*512, Rect. FOV 4/8, 19 slices, space between slices 2 mm). The image analysis results were compared with dissection results giving a prediction error of the muscle content (mean=2.7 kg) of 88.9 g and of the fat content (mean=2.7 kg) of 115.8 g without correction of the chemical shift effect in the computation of partial volume fat content. The correction scheme improved these results to, respectively, 81.5 and 107.1 g.     

Chemical exchange saturation transfer MR imaging of articular cartilage glycosaminoglycans at 3 T: Accuracy of B0 Field Inhomogeneity corrections with gradient echo method

Glycosaminoglycan Chemical Exchange Saturation Transfer (gagCEST) is an important molecular MRI methodology developed to assess changes in cartilage GAG concentrations. The correction for B₀ field inhomogeneity is technically crucial in gagCEST imaging. This study evaluates the accuracy of the B₀ estimation determined by the dual gradient echo method and the effect on gagCEST measurements. The results were compared with those from the commonly used z-spectrum method. Eleven knee patients and three healthy volunteers were scanned. Dual gradient echo B₀ maps with different ?TE values (1, 2, 4, 8, and 10 ms) were acquired. The asymmetry of the magnetization transfer ratio at 1 ppm offset referred to the bulk water frequency, MTR_asym(1 ppm), was used to quantify cartilage GAG levels. The B₀ shifts for all knee patients using the z-spectrum and dual gradient echo methods are strongly correlated for all ?TE values used (r = 0.997 to 0.786, corresponding to ?TE = 10 to 1 ms). The corrected MTR_asym(1 ppm) values using the z-spectrum method (1.34% ± 0.74%) highly agree only with those using the dual gradient echo methods with ?TE = 10 ms (1.72% ± 0.80%; r = 0.924) and 8 ms (1.50% ± 0.82%; r = 0.712). The dual gradient echo method with longer ?TE values (more than 8 ms) has an excellent correlation with the z-spectrum method for gagCEST imaging at 3 T.     

Magnetic resonance imaging of soft-tissue tumors: Comparison with computed tomography

Twenty-seven patients with soft-tissue tumors were examined with a Picker 0.15-tesla resistive magnet and by computed tomography (CT). In all but one patient, MRI was better than or equal to CT in defining the anatomic extent of the tumor. We could determine whether major vascular structures were engulfed by the tumor in 80% of the MRI examinations but only in 62% of the CT scans. MRI and CT were equally effective in determining the presence or absence of bony invasion. The MRI images of all the tumors showed increased signal intensity relative to normal muscle when spin-echo (SE) sulse sequences with long repeat times were used (SE: echo time [TE], 60 ms; repetition time [TR], 2,000 ms). When T1 weighted pulse sequences were used (SE: TE, 30 ms; TR, 500 ms or inversion recovery: inversion time, 500 ms; TE, 40 ms; TR, 2,000 ms) the malignant tumors showed decreased signal intensity compared to normal muscle. Only lipomas showed high signal intensity on both T1 and T2 weighted pulse sequences.     

A modified multi-echo AFI for simultaneous B1 magnitude and phase mapping

To simultaneously acquire the B₁⁺ magnitude and B₁⁺ phase, a modified multi-echo actual flip-angle imaging (AFI) sequence is proposed. A multi-echo gradient echo sequence was integrated into every even TR of AFI to measure both magnitude and phase of B₁⁺. In addition, to increase the signal-to-noise ratio of the B₁⁺ phase, a double-angle multi-echo AFI sequence, in which the flip-angle of the RF pulses is α at the odd TR and 2α at the even TR is proposed. Images were simulated to evaluate the performance of this method under various imaging and physical parameters. The performance was compared to the spin echo based B₁⁺ mapping method in phantom and in vivo studies.     

Gadolinium-DTPA enhanced MR imaging of intramuscular abscesses

Sterile, chemical and bacterial abscesses were induced in the paraspinal muscles of 16 rats before obtaining magnetic resonance (MR) images using a 0.35-T resistive system. Abscess intensity, T1 and T2 values were recorded before and after the intravenous administration of Gd-DTPA (0.2 mmol/kg). The MR appearances of the abscesses were correlated with histologic sections. Both sterile and bacterial abscess were detected on MR images without the use of contrast medium, particularly on the T2-weighted spin echo sequence (TE/TR 56/2000 ms). However, the inflammatory zones of abscesses markedly enhanced in intensity with a corresponding decrease in T1 values after the administration of Gd-DTPA (TE/TR 28/500 ms). A clear distinction between the necrotic center and the cellular periphery of each abscesses was evident only after contrast enhancement (TE/TR 28/500 ms). Thus paramagnetic Gadolinium-DTPA was beneficial for defining the histologic components of abscesses on spin echo MR images.     

Cross-sectional investigation of correlation between hepatic steatosis and IVIM perfusion on MR imaging

The purpose of this study was to investigate the relationship between liver fat fraction (FF) and diffusion parameters derived from the intravoxel incoherent motion (IVIM) model. Thirty-six subjects with suspected nonalcoholic fatty liver disease underwent diffusion-weighted magnetic resonance imaging with 10 b-values and spoiled gradient recalled echo imaging with six echoes for fat quantification. Correlations were measured between FF, transverse relaxivity (R2), diffusivity (D) and perfusion fraction (f). The primary finding was that no significant correlation was obtained for D vs. FF or f vs. FF. Significant correlations were obtained for D vs. R2 (r=-0.490, P=.002) and f vs. D (r=-0.458, P=.005). The conclusion is that hepatic steatosis does not affect measurement of perfusion or diffusion and therefore is unlikely to confound the use of apparent diffusivity to evaluate hepatic fibrosis.     

Proton Spectroscopy of Human Brain with Very Short Echo Time Using High Gradient Amplitudes

In localized proton magnetic resonance spectroscopy very short echo times (TE) are achieved to diminish signal loss due to T₂ relaxation and to avoid phase distortions due to J-coupling. A sequence for single volume spectroscopy in human brain is described with a TE as low as 5 ms. Examinations were performed on a 1.5 T whole-body imager with actively shielded gradients. A self-designed stimulated echo acquisition mode (STEAM) sequence with very high amplitude spoiling gradients of 24 mT/m was used to take advantage of the whole potential of the gradient system. Optimization of TE was carried out by controlling spectral quality and localization in both phantom and volunteer measurements. Proton spectra of human brain were acquired in 21 healthy volunteers. Spectra of occipital white matter, parieto-occipital grey/white matter, and cerebellum revealed none or only small eddy current distortions at a TE of 5 ms. The volume of interest was 8–12 ml, repetition time was 1.5 s, and mixing time was 5 ms. Peak ratios of major metabolites referring to creatine were estimated and the relative standard deviations were calculated to determine interindividual reproducibility. The relative standard deviation of myo-inositol ranged from 6% to 11% within these brain regions whereas for glutamine and glutamate 7% to 16% were found.     

MRI with superparamagnetic iron oxide: efficacy in the detection and characterization of focal hepatic lesions

The purpose of this study was to evaluate the potential of superparamagnetic iron oxide particles (SPIO) as tissue specific contrast agent in magnetic resonance (MR) imaging in detection and characterization of focal hepatic lesions. We investigated 45 patients with focal hepatic lesions. T1-weighted SE (TR 650/TE 15 ms) and T2-weighted SE (TR 2015-2030/TE 45 and 90 ms) unenhanced images were obtained. After SPIO application we performed T1-weighted images with and T2-weighted images with and without fat suppression using the same image parameters. Liver signal intensity decreased by 74% (min 47%, max 83%) on T2-weighted images after application of the contrast agent. Benign lesions (FNH, adenoma) showed an average signal drop of 40% (min 20%, max 47%) whereas malignant lesions showed no significant change of signal intensity on post-contrast images. The mean tumor-to-liver contrast-to-noise ratio (C/N) was improved in all post-contrast sequences irrespective of the lesion type. An additional increase of tumor-to-liver contrast by use of fat suppression technique could be established in the slightly T2-weighted sequence (TE 45 ms). In metastases, divided in different size groups, we could determine a significant size relation of tumor-to-liver C/N. After SPIO application the number of detected lesions increased distinctly, especially small foci are more easily demonstrated. SPIO particles are a efficacious contrast agent for MR examinations of the liver. For tumor characterization T1- and T2-weighted pre- and post-contrast images are necessary. The T1-weighted sequences are helpful to differentiate benign lesions such as cysts and hemangiomas from malignant lesions. Detection and differential diagnoses of hepatic lesions are improved by use of the SPIO-particles.     

Magnetic resonance imaging of cortical bone with ultrashort TE pulse sequences

PurposeNormal adult cortical bone has a very short T₂ and characteristically produces no signal with pulse sequence echo times (TEs) routinely used in clinical practice. We wished to determine whether it was possible to use ultrashort TE (UTE) pulse sequences to detect signal from cortical bone in human subjects and use this signal to characterise this tissue.Subjects and MethodsSeven volunteers and 10 patients were examined using ultrashort TE pulse sequences (TE=0.07 or 0.08 ms). Short and long inversion as well as fat suppression pulses were used as preparation pulses. Later echo images were also obtained as well as difference images produced by subtracting a later echo image from a first echo image. Saturation pulses were used for T₁ measurement and sequences with progressively increasing TEs for T₂* measurement. Intravenous gadodiamide was administered to four subjects.ResultsSignal in cortical bone was detected with UTE sequences in children, normal adults and patients. This signal was usually made more obvious by subtracting a later echo image from the first provided that the signal-to-noise ratio was sufficiently high.Normal mean adult T₁s ranged from 140 to 260 ms, and mean T₂*s ranged from 0.42 to 0.50 ms. T₁ increased significantly with age (P<.01).Increased signal was observed after contrast enhancement in the normal volunteer and the three patients to whom it was administered.Reduction in signal from short T₂ components was seen in acute fractures, and increase in signal in these components was seen with new bone formation after fracture malunion. In a case of osteoporosis, bone cross-sectional area and signal level appeared reduced.ConclusionSignal can be detected from normal and abnormal cortical bone with UTE pulse sequences, and this can be used to measure its T₁ and T₂* as well as observe contrast enhancement. Difference images are of value in increasing the conspicuity of cortical bone and observing abnormalities in disease.     

Increasing the speed of relaxometry-based compartmental analysis experiments in STEAM spectroscopy

In this work we present a method for improving the speed of spin-spin relaxation time (T2) measurements for compartmental analysis in stimulated echo localized magnetic resonance spectroscopy without reducing the sampling density. The technique uses a progressive repetition time (TR) to compensate for echo time (TE) dependent variations in saturation effects that would otherwise modulate the received signal at short TRs. The method was validated in T2 studies on 10 young healthy subjects in spectroscopic voxels localized along either the right or left Sylvian fissure (2 x 2 x 1.5 cm3, 10 ms mixing time (TM), 2048 data points, 819.2 ms acquisition time). The TR was automatically adjusted so that TR-TM-TE/2 was kept constant as the TE was incremented. Compared to long TR T2 experiments, the progressive TR technique consistently replicated the T2 relaxation times and reference signals of the tissue water compartment while reducing the data acquisition time by more than 50%. The percent error was on average less than 2% for estimates of T2 and S(0) for the tissue water, an indication that the progressive TR technique is a useful method for determining the tissue water signal for internal referencing.     

Magnetization recovery for signal enhancement: a fast imaging DEFT-based technique

This paper describes the development and application of a new fast MRI technique based on the DEFT principle. The sequence named MAgnetization RecoverY for Signal Enhancement (MARYSE) is composed of two completely symmetric gradient echoes separated by a 180 degrees refocusing pulse. The RF pulse scheme, 90 degrees x-180 degrees y-90 degrees -x enables restoration of the transverse magnetization along the longitudinal axis, and consequently artificially increases R1 relaxation rate. In this sequence, the period between the excitation pulse and the restoring pulse (Tem: transverse magnetization evolution time) is very short (< 10 ms). This makes possible a significant increase in signal-to-noise ratio, even with a relatively short repetition time (20 ms). Simulations were performed for different values of Tem and TR at definite T1 and T2 and for different values of T1 and T2 at constant Tem and TR. Relevant signal enhancement for species with long relaxation time constants as compared to classical gradient echo and fast spin-echo imaging was expected. In vitro studies on a fat/water phantom confirmed this simulation. Application of MARYSE to mouse brain imaging permitted to visualize almost completely cerebrospinal fluid of the ventricles, a signal usually partially saturated in fast gradient echo imaging.     

Noninvasive analysis of water movement in rat testis using deuterium magnetic resonance imaging

To measure water movement in the testis without the effects from the blood-testis barrier, we performed in vivo deuterium magnetic resonance imaging (²H MRI) of rats administered with deuterated saline. Alcohol was injected into one testis of each animal and the other was administered with normal saline as a control. Dynamic ²H MRI was obtained at 2 T by FLASH pulse sequence (TR, 300 ms; TE, 10 ms; α = 90°) using a surface coil (3 cm in diameter). The variation in ²H signal intensity between the two testes as a function of time after deuterated saline injection was examined every 1.1 min up to 20 min. The signal intensity in the testis receiving the alcohol treatment was lower than that in the normal control. Thus, deuterium MRI can be used to analyze functional disorders of the testis.     

Hepatocellular lesions with increased iron uptake on superparamagnetic iron oxide-enhanced magnetic resonance imaging in cirrhosis or chronic hepatitis: comparison of four magnetic resonance sequences for lesion conspicuity

Purpose

The aim of this study was to determine the adequate MR sequence for the lesion conspicuity of hepatocellular lesions with increased iron uptake on superparamagnetic iron oxide (SPIO)-enhanced MRI.

Materials and Methods

SPIO-enhanced MRI was performed using a 1.5-T system. Among 25 patients with hypovascular hepatocellular nodules on contrast-enhanced dynamic CT (no early enhancement at arterial phase and hypoattenuation at equilibrium phase), 39 lesions with increased iron uptake on SPIO-enhanced MRI were evaluated. SPIO-enhanced MRI included (1) T1-weighted in-phase gradient recalled echo (GRE) images, (2) T2-weighted fast spin echo (FSE) images, (3) T2*-weighted GRE with moderate TE (7 ms) and (4) long TE (12 ms). The lesion-to-liver contrast-to-noise ratios of the hepatocellular nodule and the signal-to-noise ratio (SNR) of the hepatic parenchyma were calculated by one radiologist for a quantitative assessment. MR images were reviewed retrospectively by two independent radiologists to compare the subjective lesion conspicuity in each image set based on a four-point rating scale.

Result

The mean lesion-to-liver contrast-to-noise ratios with T2*-weighted GRE with moderate TE (7 ms) was highest (5.79±3.71) and was significantly higher than those with T1-weighted, in-phase images (3.79±3.23, P<.01), T2-weighted images (2.72±1.52, P<.001) and T2*-weighted GRE with long TE (12 ms) (3.93±2.69, P<.05). The subjective rating of lesion conspicuity was best on the T2*-weighted GRE with moderate TE (7 ms), followed by that on the T2*-weighted GRE with moderate TE (7 ms; P<.05).

Conclusion

T2*-weighted GRE sequence with moderate TE (7 ms) showed high lesion-to-liver contrast-to-noise ratios in hepatocellular lesions with increased iron uptake on SPIO-enhanced MRI, indicating better lesion conspicuity of hypointense hepatocellular nodules in cirrhosis or chronic hepatitis.     

The study of heat stress in tomato fruits by NMR microimaging.

The ripening of the tomato fruit was delayed for several days (average 5 days) by a 1-day heat treatment at 42 degrees C. Ethylene production increased during the first 3 h, but, after 6 h inhibition was almost total in tomato fruit incubated at 42 degrees C. However, recovery of ethylene production was rapid if fruits were returned to a temperature of 25 degrees C after heating. In NMR microimaging, three imaging pulse sequences with different repetition and echo times at 42 degrees C were used to obtain the proton density (TR = 6000 ms, TE = 15 ms), the T1 weighted image (TR = 1000 ms, TE = 15 ms) and the T2-weighted image (TR = 6000 ms, TE = 120 ms). After 12 h heating, the water in locular tissues began to show shorter T1 and T2 values. Though the tomatos were returned to 25 degrees C and preserved one more day, the water having a shorter T2 value in locular tissues, did not change. These results show that tomato fruit do not fully recover from heating even after one day, although ethylene production is recovered almost immediately. For this reason, we suggest that some denaturation event inside the tomato, which goes on after the end of heating, is the cause of the delay in tomato ripening.     

Magnetic resonance T21 measurements of the normal human lung in vivo with ultra-short echo times

The objective of this study was to measure T₂1 values of the normal human lung in vivo during breathhold using a rapid gradient-echo sequence with ultra-short echo times (TE). A sagittal slice of the right lung was imaged in six volunteers with various TE ranging from 0.5 ms to 5 ms using a clinical 1.5 Tesla MR scanner. T₂1 values were calculated in a region of interest in the dependent and non-dependent lung. In the dependent lung, T₂1 values of 1.1 ms ± 0.15 ms were measured, and in the non-dependent lung, 0.86 ms ± 0.11 (p < 0.01). T₂1 measurements of the normal human lung during breathhold are feasible with a clinical MR unit. The short T₂1 values require the use of very short TE times (<2.5 ms) in gradient-echo sequences to obtain adequate signal intensity from lung tissue.     

Large angle spin-echo imaging

A study was undertaken to assess the use of excitation flip angles greater than 90° for T₁ weighted spin-echo (SE) imaging with a single 180° refocusing pulse and short TR values. Theoretical predictions of signal intensity for SE images with excitation pulse angles of 90–180° were calculated based on the Bloch equations and then measured experimentally from MR images of MnCl₂ phantoms of various concentrations. Liver signal-to-noise ratios (SNR) and liver-spleen contrast-to-noise ratios (CNR) were measured from breathhold MR images of the upper abdomen in 16 patients using 90 and 110° excitation flip angles. The theoretical predictions showed significant improvements in SNR with excitation flip angles >90°, which were more pronounced at small TR values. The phantom studies showed reasonably good agreement with the theoretical predictions in correlating the excitation pulse angle with signal intensity. In the human imaging studies, the 110° excitation pulse angle resulted in a 7.4% (p < .01) increase in liver SNR and an 8.2% (p = .2) increase in liver-spleen CNR compared to the 90° pulse angle at TR = 275 ms. Increased signal intensity resulting from the use of large flip angle excitation pulses with a single echo SE pulse sequence was predicted and confirmed experimentally in phantoms and humans.     

Quantification of low fat contents: a comparison of MR imaging and spectroscopy methods at 1.5 and 3 T

Magnetic resonance spectroscopy (MRS) has long been considered the golden standard for non-invasive measurement of tissue fat content. With improved techniques for fat/water separation, imaging has become an alternative to MRS for fat quantification. Several imaging models have been proposed, but their performance relative to MRS at very low fat contents is yet not fully established. In this work, imaging and spectroscopy were compared at 1.5 T and 3 T in phantoms with 0-3% fat fraction (FF). We propose a multispectral model with individual a priori R₂ relaxation rates for water and fat, and a common unknown R₂′ relaxation. Magnitude and complex image reconstructions were also compared. Best accuracy was obtained with the imaging method at 1.5 T. At 3 T, the FFs were underestimated due to larger fat-water phase shifts. Agreement between measured and true FF was excellent for the imaging method at 1.5 T (imaging: FF_meas= 0.98 FF_true− 0.01%, spectroscopy: FF_meas= 0.77 FF_true+ 0.08%), and fair at 3 T (imaging: FF_meas= 0.91 FF_true− 0.19%, spectroscopy: FF_meas= 0.79 FF_true+ 0.02%). The imaging method was able to quantify FFs down to approx. 0.5%. We conclude that the suggested imaging model is capable of fat quantification with accuracy and precision similar to or better than spectroscopy and offers an improvement vs. a model with a common R₂* relaxation only.     

Sequence parameters of double spin-echo sequences affect quantification of citrate

Quantification of citrate by localized ¹H spectroscopy is usually performed using the water signal as reference, but the signal behavior of the J-coupled AB spin system of citrate after multipulse excitation is not as trivial as for uncoupled substances. The influence of the timing scheme of double spin-echo sequences and of the spatial flip angle distribution of (nonideal) refocusing pulses was analyzed systematically for the citrate resonances. Both single echo times of the double spin-echo sequence were varied between 20 ms and 250 ms in theoretical and experimental approaches. Relatively long total echo times (TE > 120 ms) provide high selectivity to citrate signals, since signals from triglycerides at 2.6 ppm are markedly reduced. Asymmetrical timing schemes of the double spin-echo sequence with one short single echo time of 20 ms and one longer single echo time of about 120 ms result in high integral signal from the central lines of citrate, whereas symmetrical timing leads to high sensitivity for total echo times TE near 100 ms. The integral citrate signals in spectra with relatively long echo times (TE > 120 ms) were found to depend markedly on the type of the refocusing pulses, affecting quantitative citrate measurements in vitro and in vivo.     

Dual-echo breathhold T(2)-weighted fast spin echo MR imaging of liver lesions

The purpose of this study was to develop a multi-shot dual-echo breathhold fast spin echo technique (DFSE) and compare it with conventional spin echo (T2SE) for T(2)-weighted MR imaging of liver lesions. The DFSE acquisition (EffTE1/EffTE2/TR = 66/143/2100 ms) imaged 5 sections per 17 s breathhold. T2SE imaging (TE1/TE2/TR = 60/120/2500 ms) required 16:55 (min:s) for 14 sections. Both techniques used a receive-only phased-array abdominal multicoil and provided 192 x 256 effective resolution. The results showed first and second echo relative DFSE/T2SE contrast values for 27 representative lesions (15 consecutive patients) were 1.08 +/- 0.05 and 1.16 +/- 0.09 (mean +/- STD mean), respectively. Corresponding CNR values were 1.12 +/- 0.09 and 0.97 +/- 0.12. Overall DFSE was comparable-to-superior to T2SE for lesion sizing and image artifact. DFSE lesion detection was inferior to T2SE's in several patient studies because of decreased conspicuity of lesions located near multicoil edges and because of poor breathhold-to-breathhold reproducibility and lack of breathholding. However both DFSE (and T2SE) provided lesion detection rated to be of diagnostic quality for all patient studies. In conclusion, we found that DFSE provides diagnostically useful dual-echo T(2)-weighted MR liver images in a greatly decreased acquisition time.