Quantitative estimation of brain white matter abnormalities in elderly subjects using magnetic resonance imaging

Twenty-five elderly subjects were examined with brain magnetic resonance imaging (MRI). The subjects were divided into two groups: those with Mini-Mental State Examination (MMSE) scores above 25, and those subjects with MMSE scores between 18 and 24. The degree of white matter abnormalities (WMA) (expressed as relative volumes) as well as the presence of cerebrovascular risk factors were evaluated in the two groups. We found that a) subjects with low MMSE scores had significantly larger relative volumes of WMA than the subjects with higher scores, b) a significant correlation (r_s = 0.53, p < 0.009) between MMSE scores and the relative volume of WMA was also established, and c) a weak significant correlation (r_s = −0.51, p < 0.05) between arterial blood pressure and WMA was found in the subjects with high MMSE scores. Besides these findings no other correlations between the presence of cerebrovascular risk factors and WMA were found in any of the groups.     

Magnetization transfer contrast (MTC) in FLASH MR imaging

Magnetization transfer between bound and free protons was used as a source of contrast in high speed MR imaging using the FLASH technique. Contrast in FLASH MR images was found to depend upon the reduced magnetization and the spin lattice relaxation rate of free protons in the presence of bound proton radio-frequency saturation. MTC FLASH imaging was thus used to estimate the variation with saturation frequency of free proton spin-lattice relaxation during magnetization transfer.     

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.     

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.     

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.     

Differentiation between intra-axial metastatic tumor progression and radiation injury following fractionated radiation therapy or stereotactic radiosurgery using MR spectroscopy, perfusion MR imaging or volume progression modeling

Objective

To determine the accuracy of magnetic resonance spectroscopy (MRS), perfusion MR imaging (MRP), or volume modeling in distinguishing tumor progression from radiation injury following radiotherapy for brain metastasis.

Methods

Twenty-six patients with 33 intra-axial metastatic lesions who underwent MRS (n=41) with or without MRP (n=32) after cranial irradiation were retrospectively studied. The final diagnosis was based on histopathology (n=4) or magnetic resonance imaging (MRI) follow-up with clinical correlation (n=29). Cho/Cr (choline/creatinine), Cho/NAA (choline/N-acetylaspartate), Cho/nCho (choline/contralateral normal brain choline) ratios were retrospectively calculated for the multi-voxel MRS. Relative cerebral blood volume (rCBV), relative peak height (rPH) and percentage of signal-intensity recovery (PSR) were also retrospectively derived for the MRPs. Tumor volumes were determined using manual segmentation method and analyzed using different volume progression modeling. Different ratios or models were tested and plotted on the receiver operating characteristic curve (ROC), with their performances quantified as area under the ROC curve (AUC). MRI follow-up time was calculated from the date of initial radiotherapy until the last MRI or the last MRI before surgical diagnosis.

Results

Median MRI follow-up was 16 months (range: 2-33). Thirty percent of lesions (n=10) were determined to be radiation injury; 70% (n=23) were determined to be tumor progression. For the MRS, Cho/nCho had the best performance (AUC of 0.612), and Cho/nCho >1.2 had 33% sensitivity and 100% specificity in predicting tumor progression. For the MRP, rCBV had the best performance (AUC of 0.802), and rCBV >2 had 56% sensitivity and 100% specificity. The best volume model was percent increase (AUC of 0.891); 65% tumor volume increase had 100% sensitivity and 80% specificity.

Conclusion

Cho/nCho of MRS, rCBV of MRP, and percent increase of MRI volume modeling provide the best discrimination of intra-axial metastatic tumor progression from radiation injury for their respective modalities. Cho/nCho and rCBV appear to have high specificities but low sensitivities. In contrast, percent volume increase of 65% can be a highly sensitive and moderately specific predictor for tumor progression after radiotherapy. Future incorporation of 65% volume increase as a pretest selection criterion may compensate for the low sensitivities of MRS and MRP.     

Magnetic resonance imaging of the normal and pathologic muscular system

Evaluation of the muscular system with magnetic resonance (MR) was conducted: (1) to assess the capability of MR to depict muscular abnormalities; (2) to evaluate the ability of MR to discriminate between various types of muscular pathologies based on relaxation parameters; and (3) to determine the optimal spin echo (SE) sequence that produced optimal contrast. Retrospective analysis was performed on 59 consecutive patients with a variety of muscular abnormalities. MR muscle analysis included visual inspection of contour and size; muscle intensity changes in relation to various TR/TE combinations; measurement of T1 and T2 relaxation and spin density; and calculation of percent contrast variation with different SE imaging combinations. Contour and size abnormalities were not reliable for detection of muscular pathology. For each individual subject intensity and relaxation times of all muscles involved by pathology differed from normal muscle. Although all pathologies caused increase in signal intensity of muscle, the alterations in relaxation times were variable. Fatty atrophy caused a decrease in T1 and increase in T2; while post-surgical changes, infection, acute intramuscular hemorrhage, and tumor invasion caused an increase in both T1 and T2. Percent contrast indicated that the optimum sequence for evaluation of fatty atrophy was a short (0.5 sec) repetition time (TR) and echo delay time (TE) of 56 msec, while for demonstration of the remaining muscular abnormalities, including post-surgical changes, infection, acute intramuscular hemorrhage, and tumor invasion, a long TR (TR = 2.0 sec) and TE (56 msec) was optimal. Differentiation between various benign and malignant muscular abnormalities (excluding fatty atrophy) was not possible using either quantitative intensity values or relaxation times.     

Automatic segmentation of brain white matter and white matter lesions in normal aging: comparison of five multispectral techniques

White matter loss, ventricular enlargement and white matter lesions are common findings on brain scans of older subjects. Accurate assessment of these different features is therefore essential for normal aging research. Recently, we developed a novel unsupervised classification method, named ‘Multispectral Coloring Modulation and Variance Identification’ (MCMxxxVI), that fuses two different structural magnetic resonance imaging (MRI) sequences in red/green color space and uses Minimum Variance Quantization (MVQ) as the clustering technique to segment different tissue types. Here we investigate how this method performs compared with several commonly used supervised image classifiers in segmenting normal-appearing white matter, white matter lesions and cerebrospinal fluid in the brains of 20 older subjects with a wide range of white matter lesion load and brain atrophy. The three tissue classes were segmented from T₁-, T₂-, T₂?- and fluid attenuation inversion recovery (FLAIR)-weighted structural MRI data using MCMxxxVI and the four supervised multispectral classifiers available in the Analyze package, namely, Back-Propagated Neural Networks, Gaussian classifier, Nearest Neighbor and Parzen Windows. Bland–Altman analysis and Jaccard index values indicated that, in general, MCMxxxVI performed better than the supervised multispectral classifiers in identifying the three tissue classes, although final manual editing was still required to deliver radiologically acceptable results. These analyses show that MVQ, as implemented in MCMxxxVI, has the potential to provide quick and accurate white matter segmentations in the aging brain, although further methodological developments are still required to automate fully this technique.     

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.     

NMR studies of brain C-glucose uptake and metabolism: Present status

One of the common features of epilepsy is a change in glucose metabolism at the site of seizure activity during and between seizures. The noninvasive in situ study of glucose transport and metabolism by NMR can potentially provide detailed information about this phenomena. In this short review, we will discuss the principles of ¹³C-glucose NMR studies of the brain and compare the advantages and disadvantages of this method to those of ¹⁸F-deoxyglucose studies using positron emission tomography (PET).     

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.     

F 2-FDG NMR imaging of the brain in rat

Images of the rat head reflecting glucose utilization were obtained using 2-fluoro-2-deoxy-D-glucose (2-FDG) and ¹⁹F nuclear magnetic resonance (NMR) imaging. Spatial heterogeneity of glucose utilization in the rat head was clearly demonstrated showing significantly higher glucose utilization in the brain as compared to the surrounding tissues. Although the potential adverse effects of the high doses of 2-FDG (400 mg/kg) needed to perform the study preclude immediate application of this technique to clinical quantitative glucose utilization studies, the present study shows potential for future development of glucose utilization imaging by NMR.     

Anoxia followed by hyperoxia: In vivo 31-P NMR of cat brain

In vivo ³¹P NMR spectroscopy was performed on a cat brain subjected to an extended period of anoxia followed by restoration of oxygen. High energy phosphate spectra were continuously obtained and pH measured. Following the onset of anoxia, phosphocreatine and ATP peaks decreased with a concomitant increase in inorganic phosphate. Following 34 min ventilation on 100% N₂, the animal was ventilated on 100% O₂. The spectral content progressively changed, inorganic phosphate decreased and ATP increased with the spectrum closely resembling that of control. Our results suggest that the absence of NMR detectable ATP signal cannot be interpreted as an irreversable change in cellular metabolic function.     

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.     

Varied MR appearance of autism: Fifty-three pediatric patients having the full autistic syndrome

Fifty-three autism patients ranging in age from 2 to 22 yr with a mean age of 9 yr were evaluated by MR imaging over a 3-yr study period. Sagittal, axial, and coronal spin-echo and short TI inversion recovery scans were performed on a 0.5 Tesla (Picker Inc., Cleveland, OH) system. Results were compared to 32 control patients age range 1 to 17 yr, mean 8.5 yr. MR scans were evaluated by three neuroradiologists. Measurements of midsagittal vermian height and AP diameter were performed. Subjective estimates were made of ventricular size, amygdala size, fourth ventricular size, and vermian shape. Results were correlated with clinical presentation, course, and lab analyses by a pediatric neurologist. MR findings did not present a single pattern capable of predicting the presence or severity of autism. The constellation of MR findings in this group of 53 patients was highly variable, thus we advise caution in the interpretation of MR images in autistic patients. Autism is a heterogeneous disease entity containing different clinical subgroups, which do not manifest similar radiologic pictures.     

On- and off-resonance spin-lock MR imaging of normal human brain at 0.1 T: possibilities to modify image contrast

The aim of the present investigation was to determine spin lock (SL) relaxation parameters for the normal brain tissues and thus, to provide basis for optimizing the imaging contrast at 0.1 T. 68 healthy volunteers were included. On-resonance spin lock relaxation time (T_1ρ) and off-resonance spin lock relaxation parameters (T_1ρ^off, M_e/M_o), MT parameters (T_1sat, M_s/M_o), and T₁, T₂ were determined for the cortical gray matter, and for the frontal and parietal white matters. The T_1ρ for the frontal and parietal white matters ranged from 110 to 133 ms and from 122 to 155 ms with locking field strengths from 50 μT to 250 μT, respectively. Accordingly, the values for the gray matter ranged from 127 to 155 ms. With a locking field strength of 50 μT, T_1ρ^off for the frontal and parietal white matters were from 114 to 217 ms and from 126 to 219 ms, and for the gray matter from 136 to 267 ms with the angle between the effective magnetic field (B_eff) and the z-axis (θ) ranging from 60° to 15°, respectively. The T_1ρ of the white and gray matters increased significantly with increasing locking field amplitude (p < 0.001). The T_1ρ^off decreased significantly with increasing θ (p < 0.001). T_1ρ and T_1ρ^off with θ ≥ 30° were statistically significantly shorter in the frontal than in the parietal white matters (p < 0.05). The duration, amplitude and θ of the locking pulse provide additional parameters to optimize contrast in brain SL imaging.     

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.     

Proton nuclear magnetic resonance spectra of brain tumors

Proton nuclear magnetic resonance (NMR) spectra were successfully measured in human brain tumor tissues and experimental rat brain tumors. The investigation was performed on clinical materials which consisted of tissue from one normal brain and 36 brain tumors. Normal rat brain tissue and rat glioma implanted in the brain were also analysed. NMR measurements were carried out at the resonance frequency of 99.54 MHz. The proton NMR spectrum of the normal brain consisted of one broad component and eight superimposed sharp peaks. The sharp peaks obtained from the brain tumors varied from those of the normal brain. A decrease in the signal intensity from N-acetyl aspartate was the most common finding in all tumors. Spectral patterns were similar within the same histological types, but varied among the different types. Therefore, ¹H-NMR spectra might indicate the metabolism characteristic of each tumor type which would be invaluable for clinical differential dagnosis of brain tumors.     

Magnetic resonance imaging of the menstrual cycle

This study examines the ability of magnetic resonance imaging (MRI) to monitor follicular and endometrial development during the menstrual cycle. MR scans, sonograms and hormonal levels of estradiol (E₂) and progesterone (P) obtained from five ovulatory volunteers were evaluated on approximately days 4, 8, 12, 16, 20 and 24 of the cycle. MRI reliably demonstrated folliculogenesis in all of the volunteers. Changes depicted in the endometrial and junctional zones of the uterus reflected physiologic events occurring during the normal cycle. Important implications exist for infertile women undergoing stimulated cycles and/or in-vitro fertilization.     

Magnetic resonance imaging as an adjunct to sonography in the evaluation of the female pelvis

Magnetic resonance imaging (MRI) of the pelvis is generally considered to be most beneficial in those cases where the pelvic sonogram is limited or equivocal. All cases that underwent both sonographic and MRI examinations at our institution for the evaluation of the female pelvis in the past two years were retrospectively reviewed. We reviewed the sonographic and MRI reports and the subsequent clinical management in the 41 cases that had both studies to assess whether MRI contributed to the clinical management decision. Both studies were interpreted independently based upon the known clinical and laboratory data available at the time. MRI was obtained in 21 cases because the sonogram was suboptimal or inconclusive. In the other 20 cases it was obtained for additional information, even though the sonogram was diagnostic. Of the 21 inconclusive sonographic studies, MRI established or clarified the diagnosis in all cases. Of the 20 studies where MRI was obtained for additional information, MRI added useful data that helped contribute to the clinical management of 11 patients. MRI is an important adjunct to pelvic sonography. It established, clarified, or added significant data in 78% of cases.