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.     

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”.     

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.     

A study of T1-weighted 31phosphorus MR-spectroscopy from patients with focal and diffuse liver disease.

³¹P-MR-Spectroscopy was performed in 28 patients with focal (n = 23) and diffuse (n = 5) liver disease and in 18 healthy volunteers. The spectra were obtained with a whole body scanner operating at 1.5 T by using a surface coil. To get T₁-weighted ³¹P-spectra a short TR of 600 msec was taken, because T₁-weighted spectra of focal liver disease were more significantly different from spectra from healthy volunteers than density weighted ones. The VOI from patients with focal superficial alterations showed a mean volume of 172 ml, with diffuse liver disease 196 ml, and from volunteers 158 ml. Focal tumors filled up the VOI on an average of 70%. This investigation demonstrated that PME/β-ATP- and PDE/β-ATP-ratios were sensitive indicators for focal liver disease. As a result of this study we could establish a significant increase of PME/β-ATP- (0.75 ± 0.30) and PDE/β-ATP-ratios (1.68 ± 0.62) in patients with superficial focal liver metastases (n = 19) compared to the control group (PME/β-ATP: 0.49 ± 0.17, PDE/β-ATP: 1.24 ± 0.24; t-test: p < 0.02). Patients with a hemangioma (n = 1), liver infarction (n = 1), empyema of gallbladder (n = 1) and a hepatic involvement by a malignant lymphoma (n = 1) showed a similar increase of PME/β-ATP and/or PDE/β-ATP. Up to now spectral changes seemed to be non-specific. The ratios of ³¹P metabolites of the cirrhoses (n = 4) and the fatty liver (n = 1) did not show any characteristic changes versus the volunteers.     

MR quantification of muscle fatty replacement in McArdle''s disease

McArdle's disease is an energy-dependant disorder of skeletal muscle caused by the inability to break down glycogen. The aim of this study was to quantify fatty replacement in patients with McArdle's disease. Calf and thigh axial spin echo T₁-weighted magnetic resonance (MR) images (repetition time 500 ms, echo time 25 ms) were obtained at 0.5 T in nine patients with McArdle's disease (age 51 ± 16 years, range 26–74) and nine sex- and age-matched healthy subjects (age 52 ± 16 years, range 29–78) to quantify intramuscular fat. Regions of interest were drawn manually, encompassing the largest cross section of muscle. A fatty replacement index (IF) was determined from histograms of signal in the regions of interest in calf and thigh muscles. In normal subjects, IF = 3.6 ± 2.8% in calf and 4.9 ± 2.3% in thigh. In patients, IF = 11 ± 9.3% in calf and 13.5 ± 10.4% in thigh, significantly different from IF values in normal subjects (p = .03). IF correlated well with age in patients (p = .03). In older patients, up to 25% of the muscle volume was replaced by fat. Patients with McArdle's disease, usually weakly disabled, exhibit significant muscle fatty replacement on MR images. These findings suggest a progressive muscle loss over time related to the disease process.     

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.     

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.     

Nuclear magnetic resonance relaxometry of the normal heart: Relationship between collagen content and relaxation times of the four chambers

The use of nuclear magnetic resonance (NMR) relaxation time measurements for characterization of abnormal cardiac tissue depends upon knowledge of variations of relaxation times of normal myocardium and determinants of these variations. We calculated in vitro NMR T₁ and T₂ relaxation times of canine myocardium from the four cardiac chambers, and determined hydroxyproline concentration (as a measure of collagen) and percent water content of the samples. We found both water content and T₁ relaxation time of the right ventricle to be significantly greater than the left atrium (p < 0.05). T₂ relaxation time of the left ventricle was found to be shorter than each of the other three chambers (p < 0.05). There were significant correlations between the spin-lattice relaxation time and both percent water content (r = 0.58) and hydroxyproline concentration (r = 0.45). A significant correlation was also found between T₂ relaxation time and hydroxyproline concentration (r = 0.49). When T₁ and T₂ were adjusted for water and hydroxyproline content, there was no longer any evidence for significant interchamber differences for either T₁ or T₂. These data suggest that differences in NMR relaxation times exist among the four chambers of the normal canine heart. Furthermore, a major determinant of myocardial spin-lattice relaxation time is tissue water content while both collagen content and percent water content significantly contribute to variability in cardiac chamber T₂ relaxation times.     

Morphometry in temporal lobe epilepsy

We demonstrate a method for quantitating changes in volume and morphology of the temporal lobe in epilepsy. The temporal lobes of 10 neurologically normal subjects and six subjects with well defined left-sided mesial temporal epilepsy were studied. From high resolution T₁-weighted magnetic resonance images, the grey and white matter were manually segmented over a predetermined extent. The volumes of the grey and white matter were determined. Using the segmented images, the grey matter/CSF surface and the white matter/grey matter surface were reconstructed, allowing estimates of the surface area and calculation of indices of curvature for the two surfaces. The index of curvature was calculated for each vertex of a polygonal mesh that was fitted to the surfaces. An index of grey matter thickness (grey matter volume/white matter surface area) was also calculated. There was a significant bilateral decrease in the total volume (p < .01), grey matter volume (p < .001) and grey matter thickness index (p < .05) in epileptic subjects. In addition, there was a bilateral decrease in white matter surface area (p < .05) and a small left-sided decrease in white matter volume (p < .05) in epileptic subjects. The average distributions of indices of curvature for both surfaces differed significantly (p < .05) between normal and epileptic subjects. In the grey matter/CSF surface of normal subjects, a large peak corresponding to surface concavity was present. The amplitude of this peak was significantly lower in epileptic subjects (p < .05 for the right hemisphere; p < .001 for the left hemisphere).     

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.     

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.     

Establishing norms for age-related changes in proton T1 of human brain tissue in vivo

The goal of this study was to determine the expected normal range of variation in spin-lattice relaxation time (T₁) of brain tissue in vivo, as a function of age. A previously validated precise and accurate inversion recovery method was used to map T₁ transversely, at the level of the basal ganglia, in a study population of 115 healthy subjects (ages 4 to 72; 57 male and 58 female). Least-squares regression analysis shows that T₁ varied as a function of age in pulvinar nucleus (R² = 56%), anterior thalamus (R² = 51%), caudate (R² = 50%), frontal white matter (R² = 47%), optic radiation (R² = 39%), putamen (R² = 36%), genu (R² = 22%), occipital white matter (R² = 20%) (all p < 0.0001), and cortical gray matter (R² = 53%) (p < 0.001). There were no significant differences in T₁ between men and women. T₁ declines throughout adolescence and early adulthood, to achieve a minimum value in the fourth to sixth decade of life, then T₁ begins to increase. Quantitative magnetic resonance imaging provides evidence that brain tissue continues to change throughout the lifespan among healthy subjects with no neurologic deficits. Age-related changes follow a strikingly different schedule in different brain tissues; white matter tracts tend to reach a minimum T₁ value, and to increase again, sooner than do gray matter tracts. Such normative data may prove useful for the early detection of brain pathology in patients.     

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.     

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.     

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.     

Field-induced parameters of re-entrant magnets and concentrated spin glasses

We have used electron spin resonance measurements to derive the temperature and frequency dependences of the field-induced magnetization [M(T, f)] and anisotropy field [H_an (T)] in a number of amorphous alloys belonging to the series (Fe_pNi_1−p)₇₅P₁₆B₆Al₃. In re-entrant (p > p_c, the critical concentration for ferromagnetism) alloys at hi gh frequencies (f = 35 GHz, field ≈ 12 kOe) M reduces as T^3/2 at high T and as T below ≈ 40 K, the deviation from T^3/2 becoming more marked as p → p⁺_c. For p close to p_c, lowering the frequency first causes the T term to increase and ultimately ( ≈ 4 GHz) changes the variation of M with T to that discovered previously for concentrated spin glasses, namely M is constant at low T and drops linearly at high temperatures. For the re-entrants, the results are interpreted on the basis of a model which invokes an energy gap in the spin-wave spectrum, introduces a non-zero density of states of the gap energy and takes into consideration a low-q cut-off in the spin-wave integral in thelow-T (T) regime.In the concentrated spin glasses [M (0) - M (T)]/ M (0) is well represented by the function [exp (Δ / T) - 1]^-1, where Δ has values close to the corresponding Curie-Weiss temperatures θ_p but much larger than the respective spin glass transition temperatures T_SG. The temperature dependence of H_an is largely given by the function (1 - T/T^*), where T^* is equal to the zero-field freezing temperature for the re-entrants and T_SG for the spin glasses, respectively.     

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.     

Minimization of diffusive attenuation in T2-weighted NMR images of porous solids using turboSPI

This communication presents the results of T₂-weighted nuclear magnetic resonance imaging (MRI) of a water saturated porous volcanic rock using a fast single point imaging technique (turboSPI). Imaging porous materials with heterogeneously distributed mineral products, and air voids, using conventional imaging methods, which introduce T₂-weighting by increasing the time between the excitation and refocusing pulses, often results in high diffusive signal losses and susceptibility distortion. T₂-weighted images acquired of a water saturated porous rock using turboSPI with an effective echo time of 8.1 ms (actual inter-echo time of 0.9 ms) exhibit significantly decreased diffusive attenuation, compared to analogous images obtained with an inter-echo time of 8.1 ms.     

Pseudo-billiards

A new class of Hamiltonian dynamical systems with two degrees of freedom and kinetic energy of the form T = c₁|p₁| + c₂|p₂| (called “pseudo-billiards”) is studied. For any kind of interaction, the canonical equations can always be integrated on sequential time intervals; i.e. in principle all the trajectories can be found explicitly.

Depending on the potential, a dynamical system of this class can either be completely integrable or behave just as a usual non-integrable Hamiltonian system with two degrees of freedom: in its phase space there exist invariant tori, stochastic layers, domains of global chaos, etc. Pseudo-billiard models of both the types are considered.

If a potential of a pseudo-billiard system has critical points (equilibria), then trajectories close to these points (“loops”) can exist; they can be treated as images of self-localized objects with finite duration. Such a model (with quartic potential) is also studied.