MRI of normal and abnormal duodenum using Half-Fourier Single-Shot RARE and gadolinium-enhanced spoiled gradient echo sequences.

The objective of this research was two-fold: First, to describe the normal and abnormal MR appearances of the duodenum using combined Half-Fourier Acquisition Single Shot RARE (HASTE) and gadolinium-enhanced standard and fat suppressed spoiled gradient echo (SGE) sequences. The second objective was to assess the ability of these combined sequences to detect and characterize duodenal diseases. MR examinations were performed on fifty consecutive patients with no clinical history of duodenal diseases, who were 1) imaged with HASTE and gadolinium-enhanced standard and fat suppressed SGE sequences and 2) referred to MR examination for reasons other than duodenal diseases, and were reviewed retrospectively to determine the normal MR appearances of the duodenum. A second population of patients with abnormal duodenum who were imaged with the same MR sequences were included in the second part of this study. This population was composed of 20 consecutive patients with subsequently proven duodenal abnormalities, including: malrotation (2), diverticula (4), intussusception (1), sprue (1), polyps (2), neurofibroma (1), lymphoma (1), Zollinger Ellison syndrome (1), metastatic disease (1), Crohn's disease (1), and wall thickening and duodenitis (5). Normal measurements of the duodenum are described. Abnormalities of wall thickness and duodenal masses required combined HASTE and gadolinium-enhanced SGE images to evaluate well. Abnormalities of the bowel lumen (e.g., diverticula and intussusception), and developmental variants (e.g., malrotation), were sufficiently visualized on HASTE images alone. Bowel inflammation was best shown on gadolinium-enhanced fat suppressed SGE images. HASTE and gadolinium-enhanced fat suppressed SGE sequences are complementary techniques for the demonstration of normal and abnormal duodenum. The combined use of both sequences allows evaluation of different aspects of bowel diseases; abnormalities of position, lumen, and contents are well shown on HASTE, while inflammation is best shown on gadolinium enhanced fat suppressed SGE, and wall thickening and masses are best evaluated with the combined use of both techniques.     

A simplified formula for T1 contrast optimization for short-TR steady-state incoherent (spoiled) gradient echo sequences

There are certain instances in practical magnetic resonance imaging where T₁ changes by a small amount relative to a neighboring pixel or between scans for a given pixel. The source of these small changes in T₁ can be caused either by changes in tissue water content or by the uptake of a contrast agent. For short repetition time (TR) spoiled gradient echo imaging, we show that a robust and a simple, easy to use back-of-the-envelope expression for the flip angle that optimizes contrast under these conditions is given by √3θ_E in radians or (180/π)√6TR/T₁ in degrees. We show that for a TR/T₁ ratio of up to 0.3 and for a T₁ change of up to ±50%, this approximation to the optimal flip angle produces a contrast to within 6% of the theoretical maximum value and that these predictions are in good agreement with experiment.     

A comparison of fast spin echo and gradient field echo sequences

Optimal angle, fast repeat time, gradient field echo imaging techniques such as FISP (Fast Imaging with Steady Precession) and FLASH (Fast Low Angle Shot) often fail to discriminate disease from healthy tissue for two main reasons. First, T1 and T2 of the affected tissue may increase such that the ratio of T1 to T2 remains nearly unchanged, hence there is no contrast change with FISP. Second, T2 weighted gradient field echo images suffer severely from T2* signal and resolution loss leading to a reduction in C/N. Although FLASH imaging with two separate angles can, in principle, extract the longer T1 tumors, contrast is often not good. To overcome the inhomogeneity and contrast problems, we have implemented a FAst optimal angle spin-echo sequence with a short TE(FATE). For the first echo, FATE has the same contrast properties as FLASH with a slight decrease in signal intensity. The advantage is that the intensity of the signal does not suffer from T2* signal decay, hence improved contrast and disease detection via T2 weighted FATE images is possible. Contrast-to-noise in lesion detection is also considered for CE FAST (Contrast Enhanced Fast), a T2-weighted version of FISP, and HYBRID.     

T1 and T2 effects during radio-frequency pulses in spoiled gradient echo sequences

Finite pulse durations in diverse pulse schemes lead to the reduction of the magnitude of the magnetization vector due to T₁ and T₂ effects during the radio-frequency pulses. This paper presents an analysis of the steady state signal in the presence of relaxation effects during radio-frequency pulses in MRI spoiled gradient echo sequences. It is shown that minor attenuations of the magnetization vector can have dramatic consequences on the measured signal, and may thus entail a loss in SNR benefits at high static magnetic fields if a careful analysis is not performed. It is emphasized that it is the time-integrated magnetization vector trajectory that matters for these effects and not only the pulse duration. Some experimental results obtained on a phantom at 3 T verify this analysis.     

Magnetic resonance imaging of the abdominal aorta and iliac vessels using combined 3-D gadolinium-enhanced MRA and gadolinium-enhanced fat-suppressed spoiled gradient echo sequences.

This study evaluates a combined protocol consisting of breath hold immediate post gadolinium 3-D gradient echo MR angiography and blood pool phase gadolinium-enhanced breath hold 2-D fat-suppressed spoiled gradient echo (SGE) sequences in the examination of diseases of the abdominal aorta and iliac vessels. Thirty-two patients with suspected disease of the abdominal aorta, major aortic branches, or iliac vessels underwent MR angiographic study from January 1996 to January 1997. Examinations were performed on a 1.5 T MR imager using 2-D axial SGE, coronal 3-D fast imaging in steady state precession (3-D FISP) following bolus administration of 40 mL of gadolinium, and axial and coronal blood pool phase gadolinium-enhanced fat-suppressed SGE. Post-processed data, including 3-D reconstructions using maximum intensity projection (MIP), targeted MIP, and multiplanar reconstruction (MPR) were evaluated. MR findings in all patients were correlated as follows: surgery (13 patients), angiography (11 patients), contrast enhanced CT (3 patients), non-contrast enhanced CT (1 patient), color doppler US (2 patients), and previous MR study (2 patients). MR findings correlated closely with findings at surgery or other imaging studies in 31 of 32 patients. One patient had renal artery occlusion that was misinterpreted as mild stenosis. The following vascular diseases were present: aneurysm disease [10 patients: aortic aneurysm (8 patients), inflammatory aneurysm (2 patients)], thoracoabdominal aortic dissection (2 patients), arteriovenous fistula (1 patient), stenoses and/or occlusion of the abdominal aorta, major aortic branches and iliac vessels [12 patients: stenoses and/or occlusion of the abdominal aorta with stenoses of the iliac vessels (9 patients), renal artery stenosis (2 patients), occlusion of the abdominal aorta (1 patient)], and occluded artery to pancreatic transplant artery (1 patient). Five patients had normal studies. The 3-D FISP technique accurately defined the luminal contours of vessels, allowing precise depiction of vessel stenosis (i.e., renal artery stenosis or common iliac artery stenosis) and clear demonstration of relationship of aortic branch vessels (i.e., renal arteries) to underlying aortic pathology (i.e., aortic aneurysm or dissection). Blood pool phase gadolinium-enhanced fat-suppressed SGE images were useful in the evaluation of the external surface of vessel walls, and providing accurate measurement of aneurysm diameter and other associated vascular entities (i.e., inflammatory aneurysm, left-sided IVC). Targeted MIP or MPR reconstruction were important for assessing stenoses of medium sized vessels such as renal arteries and branches of the iliac arteries, and for identifying accessory arteries. The combination of immediate post gadolinium 3-D FISP and blood pool phase gadolinium-enhanced fat-suppressed SGE is useful in the evaluation of the abdominal aorta, major aortic branches and iliac vessels. Immediate post gadolinium 3-D FISP images provides diagnostically useful information regarding vessel luminal contour, while blood pool phase gadolinium-enhanced fat-suppressed SGE provides ancillary information on the vessel wall and surrounding tissue.     

Optimization of MRI parameters for the gradient echo method in fluorocarbon research

The problems of magnetic resonance imaging (MRI) of objects having a very wide spectrum of the nuclear magnetic resonance, where signals from all its lines are difficult to detect, have been investigated. It is proposed to carry out MRI using frequency-selective pulses. A method for setting optimally the pulse parameters and the start time of induction signal detection is described. The calculation results are compared with the MRI data obtained for a fluorocarbon compound.     

Generalized equation for describing the magnetization in spoiled gradient-echo imaging

The purpose of this study was to demonstrate a generalized equation for describing the magnetization in spoiled gradient-echo (SPGR) imaging in which the in-pulse relaxation and magnetization transfer (MT) effects are taken into account. First, the time-dependent Bloch equations for the two-pool exchange model with MT effect were reduced to an inhomogeneous linear differential equation, and then a simple equation was derived to solve it using a matrix operation. Second, the equations describing the magnetization before and after the radiofrequency (RF) pulse were derived based on the above solution for the RF-pulse excitation and evolution phases. Finally, a generalized equation describing the steady-state magnetization was derived. The validity of this equation was investigated by comparing with the transverse magnetization obtained by the regular Ernst equation and analytical solution in which the in-pulse transverse relaxation is considered. When the same assumption was made in our method, there were good agreements between them, indicating the validity of our method. The in-pulse transverse and longitudinal relaxations decreased the transverse magnetization compared to the case in which these effects were neglected, whereas MT increased it. In conclusion, we derived a generalized equation for describing the magnetization in SPGR imaging. This equation will provide a suitable basis for understanding the signal intensity in SPGR imaging and/or T₁ measurement using an SPGR sequence in cases in which the effect of in-pulse relaxation and/or MT cannot be neglected.     

Diffusion-weighted MRI in prostate cancer -- comparison between single-shot fast spin echo and echo planar imaging sequences

Diffusion-weighted (DW) MRI at 1.5 T was carried out in two groups of patients. MRI data were correlated with the biopsy and histopathology (where available). The performance of two sequences -- a single-shot FSE (14 patients) and a single-shot EPI (15 patients) -- was compared. Average ADC values from the normal peripheral zone (PZ), central gland (CG) and the tumour [prostate carcinoma (PCa)] were calculated from b values of 0 and 600. Tukey-Kramer test was used for statistical analysis. EPI produced higher values of ADC (10(-3) mm(2)/s) than FSE sequence: 1.992+/-0.208 vs. 1.573+/-0.270 in PZ (P<.001), 1.518+/-0.126 vs. 1.373+/-0.179 in CG and 1.214+/-0.254 vs. 0.993+/-0.158 in PCa (P<.01). In conclusion, both EPI and FSE sequences showed differences in ADC between normal PZ, CG and PCa; however, EPI produced significantly higher ADC values than FSE.     

Field strength influences on gradient recalled echo MRI signal compartment frequency shifts

Different trends of echo time dependent gradient recalled echo MRI signals in different brain regions have been attributed to signal compartments in image voxels. It remains unclear how variations in gradient recalled echo MRI signals change as a function of MRI field strength, and how data processing may impact signal compartment parameters. We used two popular quantitative susceptibility mapping methods of processing raw phase images (Laplacian and path-based unwrapping with V-SHARP) and expressed values in the form of induced frequency shifts (in Hz) in six specific brain regions at 3T and 7T. We found the frequency shift curves to vary with echo time, and a good overlap between 3T and 7T mean frequency shift curves was present. However, the amount of variation across participants was greater at 3T, and we were able to obtain better compartment model fits of the signal at 7T. We also found the temporal trends in the signal and compartment frequency shifts to change with the method used to process images. The inter-participant averaged trends were consistent between 3T and 7T for each quantitative susceptibility pipeline. However, signal compartment frequency shifts generated using different pipelines may not be comparable.     

Preoperative fast MRI of brain tumors using three-dimensional segmented echo planar imaging compared to three-dimensional gradient echo technique

The purpose of this study was to compare the diagnostic efficacy of a newly developed T(1)-weighted three-dimensional segmented echo planar imaging (3D EPI) sequence versus a conventional T(1)-weighted three dimensional spoiled gradient echo (3D GRE) sequence in the evaluation of brain tumors. Forty-four patients with cerebral tumors and infections were examined on a 1.0 T MR unit with 23 mT/m gradient strength. The total scan time for the T(1) 3D EPI sequence was 2 min 12 s, and for a conventional 3D GRE sequence it was 4 min 59 s. Both sequences were performed after administration of a contrast agent. The images were analyzed by three radiologists. Image assessment criteria included lesion conspicuity, contrast between different types of normal tissue, and image artifacts. In addition, signal-to-noise and contrast-to-noise-ratio (C/N) were calculated. The gray-white differentiation and C/N ratio of 3D EPI were found to be inferior to conventional 3D GRE images, but the difference was not statistically significant. In the qualitative comparison, lesion detection and conspicuity of 3D EPI images and conventional 3D GRE images were similar, but a tow-fold reduction of the scanning time was obtained. With the 3D EPI technique, a 50% scan time reduction could be achieved with acceptable image quality compared to conventional 3D GRE. Thus, the 3D EPI technique could replace conventional 3D GRE in the preoperative imaging of brain.     

Quantitative T2 mapping using accelerated 3D stack-of-spiral gradient echo readout

PurposeTo develop a rapid T₂ mapping protocol using optimized spiral acquisition, accelerated reconstruction, and model fitting.Materials and methodsA T₂-prepared stack-of-spiral gradient echo (GRE) pulse sequence was applied. A model-based approach joined with compressed sensing was compared with the two methods applied separately for accelerated reconstruction and T₂ mapping. A 2-parameter-weighted fitting method was compared with 2- or 3-parameter models for accurate T₂ estimation under the influences of noise and B₁ inhomogeneity. The performance was evaluated using both digital phantoms and healthy volunteers. Mitigating partial voluming with cerebrospinal fluid (CSF) was also tested.ResultsSimulations demonstrates that the 2-parameter-weighted fitting approach was robust to a large range of B₁ scales and SNR levels. With an in-plane acceleration factor of 5, the model-based compressed sensing-incorporated method yielded around 8% normalized errors compared to references. The T₂ estimation with and without CSF nulling was consistent with literature values.ConclusionThis work demonstrated the feasibility of a T₂ quantification technique with 3D high-resolution and whole-brain coverage in 2–3 min. The proposed iterative reconstruction method, which utilized the model consistency, data consistency and spatial sparsity jointly, provided reasonable T₂ estimation. The technique also allowed mitigation of CSF partial volume effect.     

Background gradient suppression in pulsed gradient stimulated echo measurements

Pulsed gradient spin echo (PGSE) experiments can be used to measure the probability distribution of molecular displacements. In homogeneous samples this reports on the molecular diffusion coefficient, and in heterogeneous samples, such as porous media and biological tissue, such measurements provide information about the sample's morphology. In heterogeneous samples however background gradients are also present and prevent an accurate measurement of molecular displacements. The interference of time independent background gradients with the applied magnetic field gradients can be removed through the use of bipolar gradient pulses. However, when the background gradients are spatially non-uniform molecular diffusion introduces a temporal modulation of the background gradients. This defeats simple bipolar gradient suppression of background gradients in diffusion related measurements. Here we introduce a new method that requires the background gradients to be constant over coding intervals only. Since the coding intervals are typically at least an order of magnitude shorter than the storage time, this new method succeeds in suppressing cross-terms for a much wider range of heterogeneous samples.     

Hemorrhagic cerebral metastases from thyroid cancer on T2*-weighted gradient echo MRI

We report a case of multiple hemorrhagic cerebral metastases from papillary thyroid cancer, with reference to T(2)*-weighted gradient echo (GRE) magnetic resonance imaging (MRI). Small metastatic nodules were recognized as round nodules with signal loss on T(2)*-weighted GRE MRI, and were more pronounced compared with other sequences. Lesions were later confirmed as hemorrhagic on T(1)- and T(2)-weighted MRI. T(2)*-weighted GRE MRI was a sensitive tool for early detection of metastases displaying hemorrhagic changes.     

Rapid whole-brain quantitative magnetization transfer imaging using 3D selective inversion recovery sequences

Selective inversion recovery (SIR) is a quantitative magnetization transfer (qMT) method that provides estimates of parameters related to myelin content in white matter, namely the macromolecular pool-size-ratio (PSR) and the spin-lattice relaxation rate of the free pool (R_1f), without the need for independent estimates of ∆B₀, B₁⁺, and T₁. Although the feasibility of performing SIR in the human brain has been demonstrated, the scan times reported previously were too long for whole-brain applications. In this work, we combined optimized, short-TR acquisitions, SENSE/partial-Fourier accelerations, and efficient 3D readouts (turbo spin-echo, SIR-TSE; echo-planar imaging, SIR-EPI; and turbo field echo, SIR-TFE) to obtain whole-brain data in 18, 10, and 7 min for SIR-TSE, SIR-EPI, SIR-TFE, respectively. Based on numerical simulations, all schemes provided accurate parameter estimates in large, homogenous regions; however, the shorter SIR-TFE scans underestimated focal changes in smaller lesions due to blurring. Experimental studies in healthy subjects (n = 8) yielded parameters that were consistent with literature values and repeatable across scans (coefficient of variation: PSR = 2.2–6.4%, R_1f = 0.6–1.4%) for all readouts. Overall, SIR-TFE parameters exhibited the lowest variability, while SIR-EPI parameters were adversely affected by susceptibility-related image distortions. In patients with relapsing remitting multiple sclerosis (n = 2), focal changes in SIR parameters were observed in lesions using all three readouts; however, contrast was reduced in smaller lesions for SIR-TFE, which was consistent with the numerical simulations. Together, these findings demonstrate that efficient, accurate, and repeatable whole-brain SIR can be performed using 3D TFE, EPI, or TSE readouts; however, the appropriate readout should be tailored to the application.     

Quantitative and qualitative assessment of articular cartilage in the goat knee with magnetization transfer imaging

We investigated the role of collagen in the magnetization transfer (MT) effect in contrast to other macromolecules. By means of phantoms made of collagen, chondroitin sulfate (CS) and albumin, MR parameters have been optimized in order to reduce the acquisition time and improve the sensitivity, as well as to minimize the contributions from CS and albumin to the MT induced signal attenuation. The same method was used to study cartilage ex vivo (bovine articular and nasal cartilage plugs) and in vivo (goat knee femoral chondyle). In phantom samples, the MT signal attenuation depended on the collagen concentration while contributions from the other macromolecules were found to be minimal. In average, analysis of MT images revealed a 25%, 35% and 30% signal attenuation in 10% w/v type I collagen gels, cartilage plugs, and cartilage from the weight-bearing areas of the goat knee, respectively. Biochemical data revealed that treatment of cartilage plugs with bacterial collagenase led to collagen depletion and correspondingly to a decrease of the MT response. In contrast, trypsin-induced proteoglycan loss in cartilage plugs did not alter the MT effect. A significant correlation was observed between the collagen content in these plugs and their respective MT ratios and the rate constant k for the exchange process bound versus free water. Finally, data obtained from in vivo MT measurement of the goat knee demonstrated that intra-articular injection of papain might not only cause degradation of proteoglycans but also a change in collagen integrity in a dose-dependent manner. We conclude that in vivo measurement of MT ratios gives quantitative and qualitative information on the collagen status and may be applied for the routine evaluation of normal and abnormal articular cartilage.     

An analysis of the intrinsic resonance offset dependence of magnetization generated by stimulated echo pulse sequences for noncoupled spins.

It is demonstrated that the basic radiofrequency pulse train used to generate stimulated echoes (90x-tau TE-90x-tau TM-90x-tau TE-Acq.) is in general characterized by strong amplitude and phase modulations of the transverse magnetization as a function of the resonance offset. Two dephasing techniques which eliminate the modulations are investigated both theoretically and experimentally, and a simple formula is derived for calculating the relative modulation across a spectrum as a function of gradient strength and duration, echo delay, and spectral linewidth.     

Atypical X-linked adrenoleukodystrophy: new MRI observations with FLAIR,magnetization transfer contrast,diffusion MRI,and proton spectroscopy

An 11-year-old boy with an atypical form of X-linked adrenoleukodystrophy is reported predominantly involving the frontal lobes, and later spreading to temporal lobes. Magnetization transfer contrast T1-weighted, and FLAIR images without intravenous paramagnetic contrast medium, clearly identified the leading edge of a central necrotic zone, as well as a splenial lesion. Zonal differences were identified on ADC maps of an echo-planar diffusion MRI sequence that the ADC value of central zone (2.06 x 10(-3) mm(2)/sec) was higher than that of the peripheral zone (1.67 x 10(-3) mm(2)/sec). On proton spectroscopy, besides changes in the peaks of NAA, choline, and myoinositol, prominent peaks between 0.9 and 1.4 ppm were shown belonging to macromolecules, probably to very long chain fatty acids, a diagnostic feature of adrenoleukodystrophy. In addition, a distinct and prominent glycine peak was observed at 3.50 ppm, reflecting excitotoxic brain damage.