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.     

Magnetization transfer contrast (MTC) and long repetition time spin-echo MR imaging in multiple sclerosis

Purpose: To study whether application of magnetization transfer contrast (MTC) improves visibility and detection of multiple sclerosis (MS) lesions on long repetition time (TR) conventional spin-echo (CSE) or fast spin-echo (FSE) magnetic resonance (MR) imaging.Material and methods: In 20 patients and 5 controls, MR images were obtained using long repetition time CSE and FSE sequences with and without MTC. Signal-to-noise ratios of normal appearing white matter (NAWM) and selected lesions, and contrast-to-noise ratios between lesions and NAWM, were calculated. Lesions were counted and total lesion volume was measured in a blinded fashion for each sequence.Results: In controls, MT effect in white matter (16.3% vs. 12.2%) was higher for CSE than for FSE (p < 0.01). Application of MTC to either CSE or FSE resulted in a significantly lower decrease in signal intensity of NAWM in patients compared to white matter in controls (p < 0.01). Furthermore, in patients signal intensity of lesions was less decreased than signal intensity of NAWM (p < 0.01). Compared to sequences without MTC, contrast-to-noise ratios were significantly higher on both CSE (10.9%) and FSE (6.3%) when MTC was applied (p < 0.01). Despite better visibility, the number of lesions detected on either sequences did not increase when MTC was applied. For CSE with MTC, we found an almost equal number of lesions and for FSE with MTC, we found even less lesions (p < 0.01). Total lesion volume did not change significantly when MTC was applied.Conclusion: Although contrast between lesions and NAWM improved when magnetization transfer contrast was applied, this did not increase detection of MS lesions on either CSE or FSE MR imaging.     

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.     

Novel MR image contrast mechanisms in epilepsy

A range of magnetic resonance (MR) parameters are introduced, which can give rise to image contrast by using suitable pulse sequences, and that can be measured quantitatively. Their relationship to tissue pathology is given as far as possible. Techniques for their measurement, and results from multiple sclerosis, stroke, and epilepsy are given. The parameters are proton density, T₁, T₂, transverse magnetisation decay, which gives estimates of extracellular water and myelin concentrations, magnetisation transfer ratio and T_1sat, and diffusion (including trace and anisotropy measured from the tensor matrix).     

Phase detection and contrast loss in magnetic resonance imaging

Several recent articles have assessed the relative efficiency of nuclear magnetic resonance (NMR) pulse sequences. One consideration that has received little attention is the effect on image contrast of displaying images without information on the sign of the reconstructed signals. The radiofrequency receivers currently used on most NMR imaging systems are quadrature detectors that preserve both the magnitude and sign of the NMR signal. Usually, however, sign or phase information is not used in the final image presentation. We point out that in imaging sequences that may have negative signals, such as inversion recovery, this loss of sign information produces a reduction in contrast between some tissues in an NMR image. We discuss the tissue parameters and interpulse delay times that result in contrast loss in inversion recovery and indicate the extent of contrast loss. We point out that for some tissues with unequal hydrogen spin densities, the region of contrast loss coincides with the region where maximum contrast would occur if sign information were preserved.     

Approach to equilibrium in snapshot imaging

The snapshot FLASH sequence uses a subsecond scan time and a small flip angle in conjunction with nonsteady-state acquisition to produce high-contrast images with minimum motion artifacts. The magnetisation evolves towards an equilibrium state in the course of a scan and it is the form of this approach to equilibrium which determines the contrast and signal-to-noise ratio (SNR) obtained. The contrast obtained is strongly dependent on the phase encoding scheme used. If the flip angle is increased, and the resulting transverse coherences refocused, then the SNR is improved while the contrast is little changed.     

MR imaging of hand and wrist with a dedicated 0.1-T low-field imaging system

We describe the first results of a new magnetic resonance imaging (MRI) system specially developed for hand and wrist imaging. The system uses a small resistive water-cooled magnet with a vertical magnetic field of 0.1 T in an air gap of 15 cm. The console is based on a microcomputer with a vector signal processor and an image-processing board. There is actually no Faraday cage. For the whole hand, the in-plane spatial resolution is less than 1 mm in the 128 × 128-pixels format for typical slice thicknesses of 3 to 5 mm. Solenoidal volume coils for fingers were developed, giving, in the same matrix format, an in-plane high spatial resolution of 0.22 mm for a typical slice thickness of 3 mm.     

Comparison of agarose and cross-linked protein gels as magnetic resonance imaging phantoms

Measurements of the magnetic field dependence of spin-lattice relaxation rates and the response of the water-proton signal intensity to off-resonance radio frequency fields show that the commonly used agarose phantom provides a less faithful representation for the magnetic response of tissue than does a cross-linked protein system. The origin of these differences lies in the structure and intramolecular dynamics of the macromolecular system used to make the gel. These distinctions will also cause differences in the magnetic response of the water spin system when paramagnetic relaxation agents or contrast agents are incorporated. Use of a thermally cross-linked bovine serum albumin phantom is suggested.     

A rotating phantom for the study of flow effects in MR imaging

A common type of phantom used for the study of flow effects in MR imaging is the tube phantom, where a liquid passes through a set of tubes placed in the main magnetic field of an MR scanner. Among the disadvantages with this type of phantom are that a distribution of velocities is present in each tube, and that quantifications of flow effects using tube phantoms may be very time-consuming. In this work, we describe the design and the properties of a rotating wheel flow phantom used for quantification of the effects of flow through the imaging plane as well as in the imaging plane. The proposed phantom is constructed as a rotating gel-filled wheel, surrounded by static volumes filled with the same gel, and the evaluation of the information from rotating and static parts is made with a specially designed computer program. The phantom can be used as a plug flow phantom covering simultaneously an interchangeable velocity interval, which at present has the range −52 mm/s, +52 mm/s. It is shown that the phantom gives adequate information on the dependence of pixel content on first-order motion in MR modulus and phase images. Among the fields of application are rapid calibration of MR imaging units for flow determination using phase information, as well as testing of pulse sequence characteristics and verification of theoretical predictions concerning the flow dependence in MR images.     

RF interference suppression in a cardiac synchronization system operating in a high magnetic field NMR imaging system

An electrocardiographic (ECG) unit suitable for cardiac-synchronized nuclear magnetic resonance imaging in high magnetic fields is presented. The unit includes lossy transmission lines as ECG leads in order to supress radio frequency (RF) interference in the electrocardiogram. The unit's immunity to RF interference is demonstrated.     

Effects of radiation therapy on the human normal brain (white matter) visualized by MR imaging

Sequential MR imaging could provide information related to the pathological changes due to the application of external cytotoxic agents such as radiotherapy on the central nervous system. This paper describes the results of our attempt to demonstrate short-term changes associated with normal brain during and immediately following radiotherapy when the whole brain is irradiated for malignant conditions. No observable changes were found in the normal brain parenchyma in any of the patients (n = 8) in T₁-, T₂-, and proton-density-weighted images in the sequential scans in the first and second weeks and immediately following radiotherapy. Also, no changes were observed in the normal brain appearance at 2 mo (n = 6), up to 6 mo (n = 1), and up to 15 mo (n = 1) after completion of radiotherapy.     

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.     

NMR imaging of white button mushroom (Agaricus bisporis) at various magnetic fields

Nuclear magnetic resonance (NMR) and magnetic resonance imaging (MRI) have been applied to visualize physiological phenomena in plants and agricultural crops. Imaging sequences that result in contrast of a combination of parameters (e.g., proton density, ) cannot be used for a correct and unique interpretation of the results. In this study multiecho imaging together with monoexponential T₂ decay fitting was applied to determine reliable proton density and T₂ distributions over a mushroom. This was done at three magnetic field strengths (9.4, 4.7, and 0.47 T) because susceptibility inhomogeneities were suspected to influence the T₂ relaxation times negatively, and because the inflences of susceptibility inhomogeneities increase with a rise in magnetic field strength. Electron microscopy was used to understand the different T₂'s for the various tissue types in mushrooms. Large influences of the tissue ultrastructure on the observed T₂ relaxation times were found and explained. Based on the results, it is concluded that imaging mushrooms at low fields (around or below 0.47T) and short echo times has strong advantages over its high-field counterpart, especially with respect to quantitative imaging of the water balance of mushrooms. These conclusions indicate general validity whenever NMR imaging contrast is influenced by susceptibility inhomogeneities.     

Predictability of SNR and reader preference in clinical MR imaging

Fifty-four independent scans were performed in two volunteers covering one anatomic region in each (the brain and knee) with the purpose of ascertaining the agreement between predicted and measured signal-to-noise ratios (SNR). Systematically varied parameters were number of excitations (NEX), field of view (FOV), section thickness (d_z), and the number of phase-encoding steps (N_y). Correlation coefficients of measured versus predicted SNR were 0.82 and 0.86, respectively, in the anatomies studied. Significantly improved correlations were found for data subpopulations in which NEX was held constant. To assess the criteria guiding reader preference, a blinded study was performed in which radiologists were asked to rate images from least to most desirable. In order to quantitatively determine the criteria for reader preference, plots of mean rating versus SNR, voxel volume, and an image quality index [IQI = SNR/(voxel volume)] were performed. The latter was found to be a better predictor of reader preference than either SNR or spatial resolution alone. The data suggests T₁-weighted scan protocols yielding SNR of approximately 20 are preferable with any excess SNR being traded for smaller voxel size or shorter scan times.     

Selection of pulse sequences producing maximum tissue contrast in magnetic resonance imaging

The importance of spin density [N(H)] and spin-lattice (T₁) and spin-spin (T₂) relaxation in the characterization of tissue by nuclear magnetic resonance (NMR) is clearly recognized. This work considers which optimized pulse sequences provide the best tissue discrimination between a given pair of tissues. The effects of tissue spin density and machine-imposed minimum rephasing echo times (TE_MIN) for achieving maximum signal tissue contrast are discussed. A long TE_MIN sacrifices T₁-dependent contrast in saturation recovery (SR) and inversion recovery (IR) pulse sequences so that spin-echo (SE) becomes the optimum sequence to provide tissue contrast, due to T₂ relaxation. Pulse sequences providing superior performance may be selected based on spin density and T₁ and T₂ ratios for a given pair of tissues. Selection of the preferred pulse sequence and interpulse delay times to produce maximum tissue contrast is strongly dependent on knowledge of tissue spin densities as well as T₁ and T₂ characteristics. As the spin density ratio increases, IR replaces SR as the preferred sequence and SE replaces IR and SR as the pulse sequence providing superior contrast. To select the optimal pulse sequence and interpulse delay times, an accurate knowledge of tissue spin density, T₁ and T₂ must be known for each tissue.     

Evaluation of the role of magnetization transfer imaging in prostate: a preliminary study

Results of the preliminary study on the evaluation of the role of magnetization transfer imaging (MTI) of prostate in men who had raised prostate-specific antigen (PSA) (>4 ng/ml) or abnormal digital rectal examination (DRE) are reported. MT ratio (MTR) was calculated for 20 patients from the hyper- (normal) and hypo-intense regions (area suspicious of malignancy as seen on T2-weighted MRI) of the peripheral zone (PZ) and the central gland (CG) at 1.5 T. In addition, MTR was calculated for three healthy controls. Mean MTR was also calculated for the whole of the PZ (including hyper- and hypo-intense area) in all patients. Out of 20 patients, biopsy revealed malignancy in 12 patients. Mean MTR value (8.29+/-3.49) for the whole of the PZ of patients who were positive for malignancy on biopsy was statically higher than that observed for patients who were negative for malignancy (6.18+/-3.15). The mean MTR for the whole of the PZ of controls was 6.18+/-1.63 and is similar to that of patients who were negative for malignancy. Furthermore, for patients who showed hyper- (normal portion) and hypo-intense (region suspicious of malignancy) regions of the PZ, the MTR was statistically significantly different. These preliminary results reveal the potential role of MT imaging in the evaluation of prostate cancer.     

1D spectroscopic imaging with rf echo planar (SIRFEN) methods

A recently developed rf echo planar imaging method has been modified to rapidly generate spectroscopic information along one in-plane axis and spatial information along the other. The method allows the production of one-dimensional chemical shift images (1D CSIs) in acquisition times of 18 sec or less. A specific phase-encode-reordering algorithm provides convenient manipulation of T₂ weighting, yielding partial suppression of short T₂ species like muscle water. The method is demonstrated in phantoms and in vivo with 1D CSIs of human brain and limbs. Abnormal fat distribution is demonstrated in the calf of a patient with aggressive fibromatosis. The advantages of short acquisition times obtainable with SIRFEN are offset by limited spectral resolution, suggesting that primary applications will be confined to rapid spatial mapping of major spectral components.     

Regional differences in rat brain displayed by fast MRI with superparamagnetic contrast agents

Gradient echo images of coronal sections through the brains of normal rats have been recorded at 2.0 T both before and at various times after intravenous bolus administrations of a superparamagnetic iron oxide suspension. The decrease in NMR signal due to the transit of the contrast agent has been quantified as a function of time. The image immediately following the injection can be subtracted from that pre-contrast to reveal regional differences related to blood flow.     

Perfusion MR imaging and proton MR spectroscopic imaging in differentiating necrotizing cerebritis from glioblastoma multiforme

We describe a lesion with the magnetic resonance imaging (MRI) characteristics of a glioblastoma mutiforme and demonstrate how perfusion MRI and proton MR spectroscopic imaging can be used to differentiate necrotizing cerebritis from what appeared to be a high-grade glioma. A 43-year-old woman presented to her physician complaining of progressive visual disturbance and headache for several weeks. Conventional MRI demonstrated a parietal peripherally enhancing mass with central necrosis and moderate to severe surrounding T2 hyperintensity, suggesting an infiltrating high-grade glioma. However, advanced imaging, including dynamic susceptibility contrast MRI (DSC MRI) and magnetic resonance spectroscopic imaging (MRSI), suggested a nonneoplastic lesion. The DSC MRI data demonstrated no hyperperfusion within the lesion and surrounding T2 signal abnormality, and the MRSI data showed overall decrease in metabolites in this region, except for lactate. Because of the aggressive appearance to the lesion and the patients' worsening symptoms, a biopsy was performed. The pathologic diagnosis was necrotizing cerebritis. After the commencement of steroid therapy, imaging findings and patient symptoms improved. This report will review the utility of advanced imaging for differentiating inflammatory from neoplastic appearing lesions on conventional imaging.     

An optimized multislice acquisition sequence for the inversion-recovery MR imaging

An optimized multislice data acquisition scheme for inversion-recovery MR imaging is proposed and experimental results are presented. In this new scheme, instead of forming a set of multislice inversion-recovery sequences in series for a given phase encoding step, 180° inversion pulses corresponding to different slices are interwoven with the spin echo data acquisition sequence in an optimal way depending on the desired inversion-recovery time. For example, between the 180° inversion RF pulse and the spin-echo imaging sequence, a number of imaging and inversion sequences are inserted with different slice combinations, i.e., long inversion-recovery time is effectively utilized for the other slice pre-inversion and data acquisition. With the optimized sequence, imaging time has been reduced by as much as a factor of four compared with the existing methods.