Longitudinal brain imaging of five malignant glioma patients treated with bevacizumab using susceptibility-weighted magnetic resonance imaging at 7 T

Malignant glioma is a rare tumor type characterized by prominent vascular proliferation. Antiangiogenic therapy with the monoclonal antibody bevacizumab is considered as a promising therapeutic strategy, although the effect on tumor vascularization is unclear. High-field susceptibility-weighted imaging (SWI) visualizes the microvasculature and may contribute to the investigation of antiangiogenic therapy responses in gliomas. We prospectively studied five adult malignant glioma patients treated with bevacizumab-containing regimens. In each patient, we performed three 7-T SWI and T1-weighted imaging investigations (baseline and 2 and 4 weeks after the start of bevacizumab treatment). In addition, we imaged a postmortem brain of a patient with glioblastoma using 7-T SWI and performed detailed histopathological analysis. We observed almost total resolution of brain edema in three of five patients after initiation of bevacizumab therapy. In one case with rapid increase of the lesion size despite bevacizumab therapy, SWI showed progressive increase of irregular hypointense structures, most likely corresponding to increasing amounts of pathological microvasculature. In one case with progressive neurological decline, 7-T images showed multiple intratumoral microhemorrhages after the first bevacizumab application. Correlation of postmortem neuroimaging with histopathology confirmed that SWI-positive structures correspond to tumor vasculature. The experience from our case series indicates that longitudinal 7-T SWI seems to be an appropriate method for investigation of changes in brain tumor vascularization over time under antiangiogenic therapy.     

Three-dimensional susceptibility-weighted imaging at 3 T using various image analysis methods in the estimation of grading intracranial gliomas

Object

Although three-dimensional (3D), high-spatial resolution susceptibility-weighted imaging (SWI) appears to be valuable in the evaluation of central nervous system gliomas, several evaluation methods are proposed in the literature. The purpose of this study was to evaluate the use of 3D SWI for grading intracranial gliomas with various analysis methods.

Materials and Methods

Twenty-three patients suspected of having gliomas participated in this study. SWI was performed in addition to conventional MR sequences. In 15 cases, post-gadolinium enhanced SWI was also obtained. Imaging evaluation criteria were conventional grade, hypointensity ratio in the tumor-dominant structure of hypointensity on SWI (hemorrhage or vascular structure) and presence of abnormal enhancement surrounding the tumor.

Results

Mean grading scores of conventional grade showed no statistically significant difference among WHO grades. Mean grading scores of hypointensity ratios in the tumor were higher for WHO Grades 3 and 4 than for lower grade tumors (P=.05, Mann–Whitney U test). Hemorrhagic foci were more frequently seen in the higher grade tumor. Post-contrast susceptibility-weighted images of five of 11 WHO Grade 3 and 4 cases showed bright enhancement surrounding the tumor, suggesting a breakdown of the blood–brain barrier.

Conclusions

SWI at 3 T may be a useful method to analyze the structural characteristics of gliomas and to evaluate pathology in vivo. Assessment of hypointensity ratios in the glioma was the most preferable method in grading glioma. However, more studies, specifically concerning a suitable method for image analysis, are needed to establish SWI at 3 T as a useful tool in clinical routine.     

The role of voxel aspect ratio in determining apparent vascular phase behavior in susceptibility weighted imaging

Susceptibility weighted imaging (SWI) uses apparent phase contrast to enhance the contrast-to-noise ratio (CNR) in the magnitude image. In theory, the apparent phase will depend on the aspect ratio when both venous blood and parenchyma occupy the same voxel. To demonstrate the maximal expected effect of the external field from a vein, we model the vein as an infinitely long cylinder perpendicular to the main magnetic field. The results show that the apparent phase of a voxel in the image is a function of resolution, vessel size and, to a lesser degree, vessel center within the voxel. The simulations explain why a negative-phase mask has worked in SWI processing of high-resolution images collected in the transverse direction, despite the expected positive-phase behavior for vessels perpendicular to the main field. The predicted phase behavior from the simulations is in good agreement with that observed from human brain datasets.     

Fast 3D coronary artery contrast-enhanced magnetic resonance angiography with magnetization transfer contrast, fat suppression and parallel imaging as applied on an anthropomorphic moving heart phantom

A magnetic resonance sequence for high-resolution imaging of coronary arteries in a very short acquisition time is presented. The technique is based on fast low-angle shot and uses fat saturation and magnetization transfer contrast prepulses to improve image contrast. GeneRalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) is implemented to shorten acquisition time. The sequence was tested on a moving anthropomorphic silicone heart phantom where the coronary arteries were filled with a gadolinium contrast agent solution, and imaging was performed at varying heart rates using GRAPPA. The clinical relevance of the phantom was validated by comparing the myocardial relaxation times of the phantom's homogeneous silicone cardiac wall to those of humans. Signal-to-noise ratio and contrast-to-noise ratio were higher when parallel imaging was used, possibly benefiting from the acquisition of one partition per heartbeat. Another advantage of parallel imaging for visualizing the coronary arteries is that the entire heart can be imaged within a few breath-holds.     

Susceptibility weighted imaging in detecting hemorrhage in acute cervical spinal cord injury

Background and Purpose

Susceptibility weighted imaging (SWI) is sensitive to deoxyhemoglobin and blood products such as hemosiderin in detecting microbleeds in the brain. However, there are no studies on SWI in the spine cord injury so far. The purpose of this study was to evaluate the role of SWI in detecting hemorrhage in acute cervical spinal cord injury (SCI).

Materials and Methods

Twenty-three patients with a history of acute cervical spine trauma were studied. High-resolution SWI, gradient-echo (GRE) T2* weighted-image (T2*WI) and conventional magnetic resonance imaging (MRI) were performed on all patients within 15 days of the onset of injury. On the basis of the MRI findings, the patients were classified into four patterns: normal cord, spinal cord edema, spinal cord contusion and spinal cord hemorrhage. Quantitative analysis was performed by calculating and comparing the signal ratio of the hemorrhage to normal spinal cord on the same slice of T2*WI and SWI. All patients were clinically evaluated in follow-up. Twenty volunteers were also scanned as a control group.

Results

Out of 23 patients with a history of acute cervical spine trauma, 4 patients showed normal spinal cord on both conventional MRI and SWI, 8 had only spinal cord edema and 5 had contusion on conventional MRI, but SWI showed hemorrhage in 2 of the 5 patients with spinal contusion on conventional MRI; the other 6 patients had intraspinal hemorrhage on conventional MRI, and SWI proved hemorrhage in all these 6 patients. There was a significant difference between the signal ratios of hemorrhage to normal tissue on T2*WI and SWI (Z=2.34, P=.02).

Conclusion

Susceptibility weighted imaging is more sensitive than conventional MRI in detecting hemorrhage in acute cervical SCI. This technique could prove to be a useful tool in the routine evaluation of cervical SCI patients.     

Magnetic resonance of brain tumors: considerations of imaging contrast on the basis of relaxation measurements

Proton spin-lattice and spin-spin relaxation times have been measured in surgically-removed normal CNS tissues and a variety of tumors of the brain. All measurements were made at 20 MHz and 37 degrees C. Between grey and white matter from autopsy human or canine specimens significant differences in T1 or T2 were observed, with greater differences seen in T1. Such discrimination was reduced in samples obtained from live brain-tumor patients due to lengthening in T1 and T2 of white matter near tumorous lesions. Edematous white matter showed T1 and T2 values higher than those of autopsy disease-free white matter. Compared to normal CNS tissues, most brain tumors examined in this study demonstrated elevated T1 and T2 values. Exceptions, however, did exist. No definitive correlation was indicated on a T1 or T2 basis which allowed a distinction to be made between benign and malignant states. Furthermore, considerable variation in relaxation times occurred from tumor to tumor of the same type, suggesting that within a tumor type there are important differences in physiology, biology, and/or pathologic state. Such variation caused partial overlap in relaxation times among certain tumor types and hence may limit the capability of magnetic resonance imaging (MR) alone for the diagnosis of specific disease. Nonetheless, this study predicts that on the basis of T1 or T2 differences most brain tumors are readily detectable by MR via saturation recovery or inversion recovery with appropriate selections of pulse-spacing parameters. In general, tumors can be discriminated against white matter better than grey matter and contrast between glioma and grey matter is usually superior to that between meningioma and grey matter. This work did not consider tissue-associated proton density which should be addressed together with T1 and T2 for a complete treatment of MR contrast.     

Diffusion-weighted imaging of the brain at 7 T with echo-planar and turbo spin echo sequences: preliminary results

Ultra-high-field clinical MRI scanners (e.g., 7 T and above) are becoming increasingly prevalent and can potentially enhance diagnostic ability through higher contrast, resolution and/or sensitivity. Diffusion-weighted MRI is a highly valued component in today's radiological exam and may benefit from the enhanced signal-to-noise ratio provided by high field with the appropriate imaging strategy. The most common diffusion pulse sequence readout (echo-planar imaging (EPI)) has been widely employed for in vivo human 7 T diffusion tensor imaging (DTI). In this article, we present results of brain DTI at 7 T with two diffusion-weighted imaging pulse sequence readouts: echo-planar imaging (EPI-DTI) and turbo spin echo (TSE-DTI). Results indicate that analogous coverage, quality and resolution typical of lower field (2 mm) can be obtained by properly processed EPI-DTI at 7 T, and, with some reduction in efficiency and sharpness, TSE-DTI at 7 T. Furthermore, 7 T TSE-DTI shows promise in obtaining higher-resolution results in targeted acquisitions of specific brain areas.     

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.     

Two-dimensional ultrashort echo time imaging using a spiral trajectory

Tissues with very short transverse relaxation time (T2) cannot be detected using conventional magnetic resonance (MR) sequences due to the rapid decay of excited MR signals. In this work, a multiecho sequence employing half-pulse excitation and spiral sampling was developed for ultrashort echo time (UTE) imaging of tissues with short T2. Spiral readout gradients were measured and precompensated to reduce gradient distortions due to eddy currents and gradient anisotropy. The effects of spatial blurring due to fast signal decay were investigated experimentally through spiral UTE (SUTE) imaging of rubber bands with different spiral sampling duration. The unwanted long T2 signals were suppressed through the use of an inversion pulse and nulling, and/or subtraction of a later echo image from the initial one. This technique has been applied to imaging of the short T2 components in brain white matter, knee cartilage, bone and carotid vessel wall of normal volunteers at 1.5 T. Preliminary results show high spatial resolution and excellent image contrast for a variety of short T2 tissues in the human body under a relatively short scan time. A quantitative comparison was also made between radial UTE and SUTE in terms of signal-to-noise ratio efficiency.     

Prognosticating brain tumor patient survival after laser thermotherapy: Comparison between neuroradiological reading and semi-quantitative analysis of MRI data

Background and purposeGiven increasing interest in laser interstitial thermotherapy (LITT) to treat brain tumor patients, we explored if examining multiple MRI contrasts per brain tumor patient undergoing surgery can impact predictive accuracy of survival post-LITT.Materials and methodsMRI contrasts included fluid-attenuated inversion recovery (FLAIR), T1 pre-gadolinium (T1pre), T1 post-gadolinium (T1Gd), T2, diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), susceptibility weighted images (SWI), and magnetization-prepared rapid gradient-echo (MPRAGE). The latter was used for MRI data registration across preoperative to postoperative scans. Two ROIs were identified by thresholding preoperative FLAIR (large ROI) and T1Gd (small ROI) images. For each MRI contrast, a numerical score was assigned based on changing image intensity of both ROIs (vs. a normal ROI) from preoperative to postoperative stages. The fully-quantitative method was based on changing image intensity across scans at different stages without any human intervention, whereas the semi-quantitative method was based on subjective criteria of cumulative trends across scans at different stages. A fully-quantitative/semi-quantitative score per patient was obtained by averaging scores for each MRI contrast. A standard neuroradiological reading score per patient was obtained from radiological interpretation of MRI data. Scores from all 3 methods per patient were compared against patient survival, and re-examined for comorbidity and pathology effects.ResultsPatient survival correlated best with semi-quantitative scores obtained from T1Gd, ADC, and T2 data, and these correlations improved when biopsy and comorbidity were included.ConclusionThese results suggest interfacing neuroradiological readings with semi-quantitative image analysis can improve predictive accuracy of patient survival.     

Ultrasonic contrast agents in transcranial perfusion sonography (TPS) for follow-up of patients with high grade gliomas

PURPOSE: The aim of this study was to evaluate brain perfusion differences in patients with high grade gliomas after partial tumor resection and irradiation/chemotherapy between tumor and non-tumor hemisphere by transcranial perfusion sonography (TPS) employing a contrast burst imaging (CBI) technique. METHODS: Six patients with glioblastoma (WHO Grade IV) in the temporoparietal region within the defined axial diencephalic scanning plane were examined by TPS during follow-up. All subjects had an adequate acoustic temporal bone window. Transtemporal insonation on brain tumor and non-tumor hemisphere was performed with a bolus-injection of sulphur hexafluoride-based contrast agent (10 mg i.v., 5mg/ml--SonoVue, Bracco, Altana, Switzerland). Recorded images were analysed off-line by Quanticon Software (3D-Echotech, Munich, Germany) and time intensity curve parameters [area under the curve (AUC, dB s), peak intensity (PI, dB), time to peak (TTP, s)] in five regions of interest (ROI) [thalamus anterior, thalamus posterior, nucleus lentiformis, white matter, whole hemisphere] were evaluated. Statistical analyses were performed. RESULTS: Perfusion differences between brain tumor and non-tumor hemispheres were detected with contrast burst imaging (CBI) technique with a significantly greater mean AUC (5343.69 dB s vs. 4625.04 dB s, p<0.028) and a significantly prolonged TTP (32.72 s vs. 28.91 s, p<0.046) in the tumor hemisphere. CONCLUSION: Within our study population, TTP and AUC seem to be the most robust parameters for the evaluation of cerebral perfusion differences assessed by transcranial perfusion sonography with CBI technique. We hypothesize that these results correlate with microvascular changes due to treatment regimens, such as microvessel necrosis after irradiation and chemotherapy. Above that, TPS may be of value for the long-term follow-up of brain tumor therapy concept.     

Visualizing the lateral habenula using susceptibility weighted imaging and quantitative susceptibility mapping

The habenulae consist of a pair of small nuclei which bridge the limbic forebrain and midbrain monoaminergic centers. They are implicated in major depressive disorders due to abnormal phasic response when provoked by a conditioned stimulus. The lateral habenula (Lhb) is believed to be involved in dopamine metabolism and is now a target for deep brain stimulation, a treatment which has shown promising anti-depression effects. We imaged the habenulae with susceptibility weighted imaging (SWI) and quantitative susceptibility mapping (QSM) in order to localize the lateral habenula. Fifty-six healthy controls were recruited for this study. For the quantitative assessment, we traced the structure to compute volume from magnitude images and mean susceptibility bilaterally for the habenula on QSM. Thresholding methods were used to delineate the Lhb habenula on QSM. SWI, true SWI (tSWI), and QSM data were subjectively reviewed for increased Lhb contrast. SWI, QSM, and tSWI showed bilateral signal changes in the posterior location of the habenulae relative to the anterior location, which may indicate increased putative iron content within the Lhb. This signal behavior was shown in 41/44 (93%) subjects. In summary, it is possible to localize the lateral component of the habenula using SWI and QSM at 3 T.     

Effect of a gadodiamide contrast agent on the reliability of brain tissue T1 measurements

To determine whether brain spin-lattice relaxation time (T1) can routinely be measured after contrast-agent injection, we measured T1 by a precise and accurate inversion-recovery (PAIR) method in five brain tumor patients, before and again after contrast-agent injection. The T1 in at least 20 regions of interest (ROIs) was measured in each patient, avoiding areas of contrast enhancement visible by conventional MR imaging. Contrast-agent injection reduced T1 in 51 regions of interest in white matter by less than 1% (not significant), and in 50 regions of interest in gray matter by less than 2% (p = 0.001). Pixel-by-pixel plots demonstrate that T1 is reduced substantially in extra-parenchymal tissues, but not in brain tissues. Therefore, T1 mapping with the precise and accurate inversion-recovery method can routinely be done after contrast injection. Our results suggest that the precise and accurate inversion-recovery method is not sensitive to the T1 of blood in the presence of an intact blood-brain barrier, although a substantial T1 reduction does occur in the absence of a blood-brain barrier.     

大鼠中风模型的超小氧化铁粒子神经血管成像(英文)

现今诱导血管增生剂在中风后的治疗效应引起了人们的关注.这项工作的一个目的是用短时脑中动脉栓塞大鼠中风模型(MCAO)和磁化率加权成像(SWI)的核磁共振成像(MRI)方法,监测在中风后半月形损伤区新生成的旁侧血管.P904是法国格尔伯实验室生产的超小超顺磁氧化铁粒子弛豫试剂(USPIO).它在低剂量减少T1弛豫时间,适中剂量时减少T2*弛豫时间.实验动物被随机分为3组:中风Sildenafil治疗组(n=6)、中风无治疗对照组(n=5)和无中风无治疗对照组(n=1).在P904注入前后分别进行MRI成像.磁化率加权成像的时间点是:栓塞手术前、栓塞手术后24小时、栓塞手术后两周和四周.结果表明,术后两周,在治疗组中中风严重的动物的缺血区的周边显示了MRI可见的新生血管.结论:在短时脑中动脉栓塞大鼠中风模型中,使用超小超顺磁氧化铁粒子弛豫试剂和7 T高分辨磁化率加权成像能够监测半月形损伤区新生血管的形成.     

Detecting sub-voxel microvasculature with USPIO-enhanced susceptibility-weighted MRI at 7 T

BackgroundSusceptibility weighted imaging (SWI) combines phase with magnitude information to better image sub-voxel veins. Recently, it has been extended to image very small sub-voxel arteries and veins by injecting intravenously the ultra-small superparamagnetic iron oxide, Ferumoxytol.ObjectiveTo determine practical experimental imaging parameters for sub-voxel cerebral vessels at 7 T.MethodsSix Wistar-Kyoto rats aged 7–13 weeks were imaged. For a given spatial resolution, SWI was acquired pre- and post- Ferumoxytol with doses of 2, 4, 6 and 8 mg/kg and echo times (TEs) of 5, 10 and 15 ms at each dose. The spatial resolutions of 62.5 × 125 × 250 μm³ (acquisition time of 7.5 min) and 62.5 × 62.5 × 125 μm³ (30 min) were used. Both SWI and quantitative susceptibility mapping (QSM) data were analyzed. Contrast-to-noise ratio (CNR) was measured and used to determine the optimal practical imaging parameters for detection of small cortical penetrating arteries.ResultsFor a given spatial resolution with an aspect ratio (frequency: phase: slice) of 2:4:8 relative to the vessel size, we found the TE-dose index (TE x dose) must be at least 40 ms·mg/kg for both SWI and QSM to reveal the most vessels. The higher the TE-dose index, the better the image quality for both SWI and QSM up to 60 ms·mg/kg.ConclusionsThere is an optimal TE-dose index for improved visualization of sub-voxel vessels. Choosing the smallest TE and the largest allowed dose made it possible to run the sequence efficiently. In practice, the aspect ratio of 2:4:8 and the TE-dose index ranging from 40 to 60 ms·mg/kg provided the optimal and most practical solution.     

Comparative evaluation of magnetization transfer MR imaging and in-vivo proton MR spectroscopy in brain tuberculomas

We have compared and analyzed the value of in vivo proton MR spectroscopy (PMRS) and T1 weighted magnetization transfer (MT) MR imaging in tissue characterization of brain tuberculomas. We studied 33 cases of proven intracranial tuberculomas with in vivo PMRS and T1 weighted MT MR imaging. MT ratios from the rim and core of the tuberculomas were calculated and compared with metabolites seen on PMRS. Final diagnosis of tuberculoma was based on histopathology (n = 26) and/or associated tuberculous meningitis (n = 7) in all the cases. Out of the 33 patients who underwent both PMRS and T1 weighted MT MR imaging, spectroscopy showed only lipids at 0.9 ppm, 1.3 ppm, 2.0 ppm, and 2.80 ppm in 26 cases while lipids at 0.9 ppm, 1.3 ppm, 2.0 ppm and 2.80 ppm along with choline at 3.22 ppm was seen in remaining 7 patients. MT ratios from the core or solid necrosis varied from 21-29% while from the rim or cellular region varied from 16-24%. MT ratios from all the 33 lesions were consistent with tuberculomas while PMRS showed choline along with lipids in 7 predominantly cellular lesions simulating a neoplasm. We conclude that T1 weighted MT MR imaging appears to be more consistent in the tissue characterization of brain tuberculomas.     

内源性蛋白质分子成像的研究进展

酰氨质子转移（amide proton transfer, APT）成像是一种新的分子MRI技术,它可用来测量组织中内源性蛋白质. 理论上,APT-MRI信号强度主要取决于游离蛋白质的酰氨质子浓度以及交换速度,而酰氨质子交换速度与组织pH有关. 因此,APT-MRI技术已经被用于无创性中风pH成像（通常pH降低）和肿瘤蛋白质含量成像（通常蛋白质量提高）. 近期对大鼠的实验表明,APT-MRI技术可用来区分放射性坏死和胶质瘤. 该综述文章简要地介绍了APT成像的基本原理以及它在动物模型与临床中风和肿瘤成像中的应用.     

High resolution simultaneous imaging of intracranial and extracranial arterial wall with improved cerebrospinal fluid suppression

PurposeTo develop a technique for three dimensional (3D) high resolution joint imaging of intracranial and extracranial arterial walls with improved cerebrospinal fluid (CSF) suppression and good blood suppression based on T1 weighted sampling perfection with application optimized contrast using different angle evolutions (T1w-SPACE) and to compare this technique (hereafter, iSPACE) with alternating with nutation for tailored excitation (DANTE) prepared SPACE sequence (DANTE-SPACE) for their CSF suppression performance around the mid cerebral arteries (MCA) and blood suppression at carotid arteries.Materials and methodsEight volunteers and twelve patients were prospectively recruited in this institutional review board approved study. A custom designed 32-channel coil set covering the intracranial and extracranial arteries was used for signal reception. Imaging was performed in each subject using DANTE-SPACE and iSPACE. Signal-to-noise ratios (SNR) of the vessel walls at the MCA and carotid arteries, and contrast-to-noise ratios (CNR) between vessel wall and CSF at the MCA and between vessel wall and lumen at carotid arteries from the two sequences were compared.ResultsIn volunteers, contrast between CSF and white matter (surrogate for vessel wall signal) at the M2 segments in iSPACE was 67.9% higher than in DANTE-SPACE. At the carotid region, the SNR of vessel wall in iSPACE was 11.6% higher than DANTE-SPACE while the CNR in iSPACE was 13% higher than DANTE-SPACE. In patients, images with 0.6 mm isotropic resolution were obtained in 7.5 min. iSPACE showed 70.9% improvement in CNR between plaque and CSF at the M2 segments compared to DANTE-SPACE.ConclusionSimultaneous extracranial and intracranial arterial wall imaging using iSPACE improved CSF suppression significantly at the M2 segment of MCA while blood suppression was comparable to DANTE-SPACE. The technique achieved 3D images with 0.6 mm isotropic spatial resolution and took 7.5 min using a custom made coil set. Using this technique, intracranial plaque visualization was improved with no observable image SNR degradation.     

3D spin-lock imaging of human gliomas

We investigated whether the simultaneous use of paramagnetic contrast medium and 3D on-resonance spin lock (SL) imaging could improve the contrast of enhancing brain tumors at 0.1 T. A phantom containing serial concentrations of gadopentetate dimeglumine (Gd-DTPA) in cross-linked bovine serum albumin (BSA) was imaged. Eleven patients with histologically verified glioma were also studied. T₁-weighted 3D gradient echo images with and without SL pulse were acquired before and after a Gd-DTPA injection. SL effect, contrast, and contrast-to-noise ratio (CNR) were calculated for each patient. In the glioma patients, the SL effect was significantly smaller in the tumor than in the white and gray matter both before (p = 0.001, p = 0.025, respectively), and after contrast medium injection (p < 0.001, p < 0.001, respectively). On post-contrast images, SL imaging significantly improved tumor contrast (p = 0.001) whereas tumor CNR decreased slightly (p = 0.024). The combined use of SL imaging and paramagnetic Gd-DTPA contrast agent offers a modality for improving tumor contrast in magnetic resonance imaging (MRI) of enhancing brain tumors. 3D gradient echo SL imaging has also shown potential to increase tissue characterization properties of MR imaging of human gliomas.     

In vivo measurement of tissue damage, oxygen saturation changes and blood flow changes after experimental traumatic brain injury in rats using susceptibility weighted imaging

Traumatic brain injury (TBI) is a prevalent disease, and many TBI patients experience disturbed cerebral blood flow (CBF) after injury. Moreover, TBI is difficult to quantify with conventional imaging modalities. In this paper, we utilized susceptibility weighted imaging (SWI) as a means to monitor functional blood oxygenation changes and to quantify CBF changes in animals after trauma. In this study using six rats, brain trauma was induced by a weight drop model and the brain was scanned over four time points: pre trauma, and 4 h, 24 h and 48 h post trauma. Five rats survived and one died after trauma. A blood phase analysis using filtered SWI phase images suggested that three rats recovered after 48 h and two rats deteriorated. SWI also suggested that CBF decreased by up to 26%. The CBF change is in agreement with the results of arterial spin labeling methods conducted in this study and with previously published results. Furthermore, SWI revealed an enlargement of the major venous vasculature in deep brain structures, in accordance with the location of diffuse axonal injury. Compared with the traditional, invasive, clinical monitoring of cerebral vascular damage and reduction in blood flow, this method offers a novel, safe and noninvasive approach to quantify changes in oxygen saturation and CBF and to visualize structural changes in blood vasculature after TBI.