Comparison of multiple sclerosis clinical subgroups using navigated spin echo diffusion-weighted imaging.

The apparent diffusion coefficient (ADC) of tissue provides an indication of the size, shape, and orientation of the water spaces in tissue. Thus, pathologic differences between lesions in multiple sclerosis (MS) patients with different clinical courses may be reflected by changes in ADC measurements in lesions and white matter. Twelve healthy subjects and 35 MS patients with a relapsing-remitting (n = 10), benign (n = 8), secondary progressive (n = 8) and primary progressive (n = 9) clinical course were studied. T2-weighted and post-gadolinium T1-weighted images were obtained using a 1.5 T Signa Echospeed magnetic resonance imaging (MRI) system. Diffusion-weighted imaging was implemented using a pulsed gradient spin echo (PGSE) sequence with diffusion gradients applied in turn along three orthogonal directions in order to obtain the average apparent diffusion coefficient (ADCav). Navigator echo correction and cardiac gating were used to reduce motion artifact. ADC maps were derived using a two point calculation based on the Stejskal-Tanner formula. Diffusion anisotropy was estimated using the van Gelderen formula to calculate an anisotropy index. MS lesions had a higher ADC and reduced anisotropy compared with normal appearing white matter. Highest ADC values were found in gadolinium enhancing lesions and non-enhancing hypointense lesions on T1-weighted imaging. MS white matter had a slightly higher ADC and lower anisotropy than white matter of healthy subjects. Lesion and white matter ADC values did not differ between patients with different clinical courses of MS. There was no correlation between lesion ADC and disability. Diffusion-weighted imaging with measurement of ADC using the PGSE method provides quantitative information on acute edematous MS lesions and chronic lesions associated with demyelination and axonal loss but does not distinguish between clinical subtypes of MS.     

Magnetization transfer of water T(2) relaxation components in human brain: implications for T(2)-based segmentation of spectroscopic volumes

Biexponential T(2) relaxation of the localized water signal can be used for segmentation of spectroscopic volumes. To assess the specificity of the components an iterative relaxation measurement of the localized water signal (STEAM, 12 echo times, geometric spacing from 30 ms to 2000 ms) was combined with magnetization transfer (MT) saturation (40 single lobe pulses, 12 ms duration, 1440 degrees nominal flip angle, 1 kHz offset, repeated every 30 ms). Voxels including CSF were examined in parietal cortex and periventricular parietal white matter (10 each), as well as 13 voxels in central white matter and 16 T(1)-hypointense non-enhancing multiple sclerosis lesions without CSF inclusion. Biexponential models (excluding myelin water) were fitted to the relaxation data. In periventricular VOIs the component of long T(2) (1736 +/- 168 ms) that is attributed to CSF was not affected by MT. In cortical VOIs this component had markedly shorter T(2)'s (961 +/- 239 ms) and showed both attenuation and prolongation with MT, indicating contributions from tissue. MS lesions and central WM showed a second tissue component of intermediate T(2) (160-410 ms). In white matter similar MT attenuation indicated strong exchange between the two tissue components, prohibiting segmentation. In MS lesions, however, markedly less MT of the intermediate component was found, which is consistent with decreased cellularity and exchange in a region that is large compared to diffusion motion.     

MR assessment of the brain maturation during the perinatal period: quantitative T2 MR study in premature newborns

The purpose of our study is to trace in vivo and during the perinatal period, the brain maturation process with exhaustive measures of the T2 relaxation time values. We also compared regional myelination progress with variations of the relaxation time values and of brain signal. T2 relaxation times were measured in 7 healthy premature newborns at the post-conceptional age of 37 weeks, using a Carr-Purcell-Meiboom-Gill sequence (echo time 60 to 150 ms), on a 2.35 Tesla Spectro-Imaging MR system. A total of 62 measures were defined for each subject within the brain stem, the basal ganglia and the hemispheric gray and white matter. The mean and standard deviation of the T2 values were calculated for each location. Regional T2 values changes and brain signal variations were studied. In comparison to the adult ones, the T2 relaxation time values of both gray and white matter were highly prolonged and a reversed ratio between gray and white matter was found. The maturational phenomena might be regionally correlated with a T2 value shortening. Significant T2 variations in the brainstem (p < 0.02), the mesencephalon (p < 0.05), the thalami (p < 0.01), the lentiform nuclei (p < 0.01) and the caudate nuclei (p < 0.02) were observed at an earlier time than they were visible on T2-weighted images. In the cerebral hemispheres, T2 values increased from the occipital white matter to parietal, temporal and frontal white matter (p < 0.05) and in the frontal and occipital areas from periventricular to subcortical white matter (p < 0.01). Maturational progress was earlier and better displayed with T2 measurements and T2 mapping. During the perinatal period, the measurements and analysis of T2 values revealed brain regional differences not discernible with T2-weighted images. It might be a more sensitive indicator for assessment of brain maturation.     

Prominent signal intensity of T1/T2 prolongation in subcortical white matter of the anterior temporal region on conventional screening MRI of late preterm infants with normal development

Purpose

This study discusses prominent signal intensity of T₁/T₂ prolongation of subcortical white matter within the anterior temporal region in premature infant brains that radiologists may encounter when interpreting conventional screening MRIs.

Materials and Methods

T₁- and T₂-weighted images of 69 preterm and term infants with no neurological abnormalities or developmental delays were evaluated retrospectively for areas of prominent signal intensity of T₁/T₂ prolongation in white matter. We measured signal intensities of anterior temporal white matter, deep temporal white matter, frontopolar white matter and subcortical white matter of the precentral gyrus. We accessed chronological changes in signal intensity in the anterior and deep temporal white matter. We also analyzed variance tests among the signal intensity ratios to the ipsilateral thalamus of white matter areas by gestational age.

Results

There was high frequency of prominent signal intensity of T₁/T₂ prolongation in the temporal tip, particularly at a gestational age of 36–38 weeks. Signal intensity ratio of the anterior temporal white matter was lower on T₁-weighted images and higher on T₂-weighted images, and the finding became less prominent with increasing gestational age. The signal intensity ratios of anterior temporal white matter at a gestational age of 36–37 weeks and 38–39 weeks were significantly different from other regions.

Conclusion

Prominent signal intensity of T₁/T₂ prolongation of subcortical white matter of the anterior temporal region is seen in normal premature infants, especially those at 36–39 gestational weeks. Although it is a prominent finding, radiologists should understand that these findings do not represent a pathological condition.     

Increased differentiation of intracranial white matter lesions by multispectral 3D-tissue segmentation: preliminary results

MRI is a very sensitive imaging modality, however with relatively low specificity. The aim of this work was to determine the potential of image post-processing using 3D-tissue segmentation technique for identification and quantitative characterization of intracranial lesions primarily in the white matter. Forty subjects participated in this study: 28 patients with brain multiple sclerosis (MS), 6 patients with subcortical ischemic vascular dementia (SIVD), and 6 patients with lacunar white matter infarcts (LI). In routine MR imaging these pathologies may be almost indistinguishable. The 3D-tissue segmentation technique used in this study was based on three input MR images (T(1), T(2)-weighted, and proton density). A modified k-Nearest-Neighbor (k-NN) algorithm optimized for maximum computation speed and high quality segmentation was utilized. In MS lesions, two very distinct subsets were classified using this procedure. Based on the results of segmentation one subset probably represent gliosis, and the other edema and demyelination. In SIVD, the segmented images demonstrated homogeneity, which differentiates SIVD from the heterogeneity observed in MS. This homogeneity was in agreement with the general histological findings. The LI changes pathophysiologically from subacute to chronic. The segmented images closely correlated with these changes, showing a central area of necrosis with cyst formation surrounded by an area that appears like reactive gliosis. In the chronic state, the cyst intensity was similar to that of CSF, while in the subacute stage, the peripheral rim was more prominent. Regional brain lesion load were also obtained on one MS patient to demonstrate the potential use of this technique for lesion load measurements. The majority of lesions were identified in the parietal and occipital lobes. The follow-up study showed qualitatively and quantitatively that the calculated MS load increase was associated with brain atrophy represented by an increase in CSF volume as well as decrease in "normal" brain tissue volumes. Importantly, these results were consistent with the patient's clinical evolution of the disease after a six-month period. In conclusion, these results show there is a potential application for a 3D tissue segmentation technique to characterize white matter lesions with similar intensities on T(2)-weighted MR images. The proposed methodology warrants further clinical investigation and evaluation in a large patient population.     

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.     

Prediction of total cerebral tissue volumes in normal appearing brain from sub-sampled segmentation volumes

The need for anatomical coverage and multi-spectral information must be balanced against examination and processing time to ensure high-quality, feasible imaging protocols for clinical research of cerebral development in normal-appearing brains. The focus of this study was to create and assess models to estimate total cerebral volumes of gray matter, white matter, and cerebrospinal fluid (CSF) from anatomically defined sub-samples of full clinical examinations. Pediatric patients (18F, 11M; aged 1.7 to 18.7, median 5.2 years) underwent a clinical imaging protocol consisting of 3 mm contiguous T1-, T2-, PD-, and FLAIR-weighted images after obtaining informed consent. Magnetic resonance imaging (MRI) sets were registered, RF-corrected, and then analyzed with a hybrid neural network segmentation and classification algorithm to identify normal brain parenchyma. The correlation between the image subsets and the total cerebral volumes of gray matter, white matter and CSF were examined through linear regression analyses. Five sub-sampled sets were defined and assessed in each patient to produce estimation models which were all significantly correlated (p < 0.001) with the total cerebral volumes of gray matter, white matter, and CSF. Volumes were estimated from as little as a single representative slice requiring minimal processing time, 27 min, but with an average estimation error of approximately 6%. Larger sub-samples of approximately three-quarters of the full cerebral volume required much more processing time, 2 h and 4 min, but produced estimates with an average error less than 2%. This study demonstrated that investigators can choose the amount of cerebrum sampled to optimize the acquisition and processing time against the degree of accuracy needed in the total cerebral volume estimates.     

Spiral MRSI and tissue segmentation of normal-appearing white matter and white matter lesions in relapsing remitting multiple sclerosis patients☆

PurposeTo evaluate the performance of novel spiral MRSI and tissue segmentation pipeline of the brain, to investigate neurometabolic changes in normal-appearing white matter (NAWM) and white matter lesions (WML) of stable relapsing remitting multiple sclerosis (RRMS) compared to healthy controls (HCs).MethodsSpiral 3D MRSI using LASER-GOIA-W [16,4] was undertaken on 16 RRMS patients and 9 HCs, to acquire MRSI data from a large volume of interest (VOI) 320 cm³ and analyzed using LCModel. MRSI data and voxel tissue segmentation were compared between the two cohorts using t-tests. Support vector machine (SVM) was used to classify tissue types and assessed by accuracy, sensitivity and specificity.ResultsCompared to HCs, RRMS demonstrated a statistically significant reduction in all mean brain tissues and increase in CSF volume. Within VOI, WM decreased (−10%) and CSF increased (41%) in RRMS compared to HCs (p < 0.001). MRSI revealed that total creatine (tCr) ratios of N-acetylaspartate and glutamate+glutamine in WML were significantly lower than NAWM-MS (−9%, −8%) and HCs (−14%, −10%), respectively. Myo-inositol/tCr in WML was significantly higher than NAWM-MS (14%) and HCs (10%). SVM of MRSI yielded accuracy, sensitivity and specificity of 86%, 95%, and 70%, respectively for HCs vs WML, which were higher than HC vs NAWM and WML vs NAWM models.ConclusionThis study demonstrates the benefit of MRSI in evaluating MS neurometabolic changes in NAWM. SVM of MRSI data in the MS brain may be suited for clinical monitoring and progression of MS patients. Longitudinal MRSI studies are warranted.     

Neurofibrillary tangles and plaques are not accompanied by white matter pathology in aged triple transgenic-Alzheimer disease mice

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that is the most common cause of dementia in aging populations. Although senile plaques and neurofibrillary tangles are well-established hallmarks of AD, changes in cerebral white matter correlate with cognitive decline and may increase the risk of the development of dementia. We used the triple transgenic (3xTg)-AD mouse model of AD, previously used to show that white matter changes precede plaque formation, to test the hypothesis that MRI detectable changes occur in the corpus callosum, external capsule and the fornix. T₂-weighted and diffusion tensor magnetic resonance imaging and histological stains were employed to assess white matter in older (11–17 months) 3xTg-AD mice and controls. We found no statistically significant changes in white matter between 3xTg-AD mice and controls, despite well-developed neurofibrillary tangles and beta amyloid immunoreactive plaques. Myelin staining was normal in affected mice. These data suggest that the 3xTg-AD mouse model does not develop MRI detectable white matter changes at the ages we examined.     

DTI-based segmentation and quantification of human brain lateral ventricular CSF volumetry and mean diffusivity: Validation,age, gender effects and biophysical implications

The human brain lateral ventricular (LV) cerebrospinal fluid (CSF) volume has been used as a neuroimaging marker of brain changes in health and disease. The LV CSF diffusivity may offer a useful quality assurance measure and become a potential noninvasive marker of deep brain temperature. In this work we sought to validate a method for human brain lateral ventricular (LV) cerebrospinal fluid (CSF) using diffusion tensor imaging (DTI) contrast to provide LV volume and corresponding DTI metrics. We compared LV volume obtained using DTI with that obtained using validated segmentations of the LV on T1-weighted data. DTI and T1-weighted data were acquired at 3 T on 49 healthy males and 56 age-matched females aged 18–59 years. We showed histogram distributions of LV DTI metrics to establish quality assurance measures. We also analyzed the age and gender effects of LV volume and diffusivity. LV volumes estimated using both T1-weighted and DTI correlated strongly in males and females (ICC = 0.99; median Dice index ~ 80%). The LV-to-intracranial volume percentage increased significantly with age only in males, using the DTI-based approach (r = 0.39; p = 0.005). LV CSF Mean diffusivity was greater in males than females ((~ 1.2%; p = 0.03). Mean diffusivity of lateral ventricular CSF decreased significantly with age in healthy adults (r = − 0.30; p = 0.02). Our results highlight the importance of age and gender-based analyses and the potential of LV diffusivity measures as a quantitative marker.     

Application of FT-based MMSE deconvolution method for cerebral blood flow measurement in patients with leukoaraiosis

Introduction

The bolus-tracking (BT) technique is the most popular perfusion-weighted (PW) dynamic susceptibility contrast MRI method used for estimating cerebral blood flow (CBF), cerebral blood volume and mean transit time. The BT technique uses a convolution model that establishes the input–output relationship between blood flow and the vascular tracer concentration. Singular value decomposition (SVD)- and Fourier transform (FT)-based deconvolution methods are popular and widely used for estimating PW MRI parameters. However, from the published literature, it appears that SVD is more widely accepted than other methods. In a previous article, an FT-based minimum mean-squared error (MMSE) technique was proposed and simulation experiments were performed to compare it with the well-established circular SVD (oSVD) method. In this study, the FT-based MMSE method has been used to estimate relative CBF (rCBF) in 13 patients with white matter lesions (WMLs) (leukoaraiosis), and results are compared with the widely used oSVD method.

Materials and Methods

Thirteen patients with leukoaraiosis were imaged on a 1.5-T Siemens whole-body scanner. After acquiring the localizer and structural scans consisting of FLAIR (fluid attenuated with inversion recovery), T₁-weighted and T₂-weighted images, perfusion study was implemented as part of the MRI protocol. For each patient and method, two values were calculated: (a) rCBF for normal white matter (NWM) ROI, obtained by dividing the average CBF value in NWM ROI with average CBF in gray matter (GM) ROI, and (b) rCBF for WML ROI, obtained by dividing the average CBF value in WML ROI with average CBF in GM ROI. Results for the two deconvolution methods were computed.

Results and Discussion

A significant (P<.05) decrease in estimated rCBF was observed in the WML in all the patients using the MMSE method, while for the oSVD method, the decrease was observed in all but one patient. Initial results suggest that the MMSE method is comparable to the oSVD method for estimating rCBF in NMW while it may be better than oSVD for estimating rCBF in lesions of low flow. Studies involving a larger patient population may be required to further validate the findings of this work.     

Magnetic resonance imaging in the diagnosis of the cranio-cervical manifestations of the mucopolysaccharidoses

Sixteen magnetic resonance (MR) studies were performed in eight patients with mucopolysaccharidosis (MPS). In patients with Hunter, Hurler, and Scheie syndromes, multiple areas of increased signal intensity were noted in the periventricular white matter. Computerized tomography (CT) frequently failed to demonstrate these white matter lesions. Other findings included spinal cord compression, hydrocephalus and airway obstruction due to soft tissue thickening around pharynx. In patients with Morquio syndrome, cervical spine dislocation, spinal cord compression and hydrocephalus were diagnosed by MR. MR was superior compared to CT, plain films and plain tomography, as the narrowing caused by bone and soft tissue changes were better seen with MR. Our experience suggests that MR should be the primary imaging modality for the detection of cranial abnormalities in patients with MPS. High resolution surface coil imaging may be preferable to invasive procedures such as myelography and CT with intrathecal contrast agents for the evaluation of cervical spine disease.     

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

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

Temporal and spatial assessment of normal cerebrospinal fluid dynamics with MR imaging

The purpose of this study was to measure normal cerebrospinal fluid (CSF) pulsations within the intracranial and upper cervical subarachnoid spaces and the ventricular system. Phase contrast cine MR sequences were performed in sagittal and axial planes on 13 volunteers with flow encoding in the craniocaudal direction. CSF pulsations displayed considerable variations in healthy subjects, depending both on measurements localization and subjects, with CSF peak velocities ranging from 0 to 7 cm/s. In the subarachnoid spaces, the highest velocities occurred in the anterior location and increased from the cerebellar pontine angle cisterns towards the lower cervical spaces. In the ventricular system, the highest velocities occurred through the aqueduct of Sylvius. CSF flow within the third ventricle seemed to reflect a circular motion. There was a caudal net CSF flow in the aqueduct whereas in the upper cervical spaces net CSF flow was caudal anteriorly and cranial laterally. Velocity profiles of CSF pulsations demonstrated arterial morphology. After the R wave, caudal systolic motion was first observed in the posterior subarachnoid spaces, soon after in the anterior subarachnoid spaces and later in the ventricular system. Considering the morphology of CSF pathways, three successively initiated phenomena may explain the temporal course of CSF motion: the systolic expansion of the main arteries at the base of the brain, the systolic expansion of the cerebrospinal axis and, finally, the systolic expansion of the choroid plexuses.     

Spatial normalization of multiple sclerosis brain MRI data depends on analysis method and software package

BackgroundSpatially normalizing brain MRI data to a template is commonly performed to facilitate comparisons between individuals or groups. However, the presence of multiple sclerosis (MS) lesions and other MS-related brain pathologies may compromise the performance of automated spatial normalization procedures. We therefore aimed to systematically compare five commonly used spatial normalization methods for brain MRI – including linear (affine), and nonlinear MRIStudio (LDDMM), FSL (FNIRT), ANTs (SyN), and SPM (CAT12) algorithms – to evaluate their performance in the presence of MS-related pathologies.Methods3 Tesla MRI images (T1-weighted and T2-FLAIR) were obtained for 20 participants with MS from an ongoing cohort study (used to assess a real dataset) and 1 healthy control participant (used to create a simulated lesion dataset). Both raw and lesion-filled versions of each participant's T1-weighted brain images were warped to the Montreal Neurological Institute (MNI) template using all five normalization approaches for the real dataset, and the same procedure was then repeated using the simulated lesion dataset (i.e., total of 400 spatial normalizations). As an additional quality-assurance check, the resulting deformations were also applied to the corresponding lesion masks to evaluate how each processing pipeline handled focal white matter lesions. For each normalization approach, inter-subject variability (across normalized T1-weighted images) was quantified using both mutual information (MI) and coefficient of variation (COV), and the corresponding normalized lesion volumes were evaluated using paired-sample t-tests.ResultsAll four nonlinear warping methods outperformed conventional linear normalization, with SPM (CAT12) yielding the highest MI values, lowest COV values, and proportionately-scaled lesion volumes. Although lesion-filling improved spatial normalization accuracy for each of the methods tested, these effects were small compared to differences between normalization algorithms.ConclusionsSPM (CAT12) warping, ideally combined with lesion-filling, is recommended for use in future MS brain imaging studies requiring spatial normalization.     

Age dependency of the regional cerebral blood volume (rCBV) measured with dynamic susceptibility contrast MR imaging (DSC)

The changes of the regional cerebral blood volume (rCBV) with age were studied using dynamic susceptibility contrast MRI (DSC). We examined an unselected, random sample of 71 consecutive patients referred for work-up of suspected intracranial tumors (35 normal examinations, 36 tumors) with a standard 1.5 T clinical MR system. Determination of the rCBV was performed with a T₂¹-weighted simultaneous dual (SD) FLASH sequence (TR/TE1/TE2/α = 32/25/16/10°, 55 images) after bolus injection of Gd-DTPA. Absolute quantification of the rCBV was achieved by normalizing the measured tissue concentration-time curves with the integrated arterial input function (AIF), which was simultaneously measured in the brain feeding arteries. The rCBV (mean ± SD) was 8.4 ± 2.9 ml/100 g and 4.2 ± 1.7 ml/100 g in gray and white matter, respectively, with a decline of about 3% and 6% per decade for white and gray matter, respectively. We conclude that DSC using a SD FLASH sequence allows the simultaneous measurement of the AIF and the tissue concentration-time curve and thus an absolute quantification of the rCBV, which is the basis for interperson comparisons and follow-up studies.     

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).     

Graded image segmentation of brain tissue in the presence of inhomogeneous radio frequency fields

Image segmentation is used increasingly to interpret MR spectroscopic data of the brain, using image contrast to identify gray matter (GM), white matter (WM), and cerebral spinal fluid (CSF). T(1)- or T(2)-weighted images are typically used, but poor shimming, susceptibility effects, and small variations in B(1) and receptivity cause difficulties in tissue identification. Quantitative imaging of T(1) can reduce many of these difficulties but is still subject to complications when B(1) has large variations like those observed with the surface coils often used for spectroscopy. In this study, B(1) imaging was implemented to support quantitative imaging of T(1) with either a surface coil or a volume coil. The T(1) observed by this method is a continuous function across mixtures of WM/GM and GM/CSF, and this function was measured and used to convert the images of T(1) to maps of percent GM, WM, and CSF.     

Development of T2-relaxation values in regional brain sites during adolescence

Brain tissue changes accompany multiple neurodegenerative and developmental conditions in adolescents. Complex processes that occur in the developing brain with disease can be evaluated accurately only against normal aging processes. Normal developmental changes in different brain areas alter tissue water content, which can be assessed by magnetic resonance (MR) T2 relaxometry. We acquired proton-density (PD) and T2-weighted images from 31 subjects (mean age±S.D., 17.4±4.9 years; 18 male), using a 3.0-T MR imaging scanner. Voxel-by-voxel T2-relaxation values were calculated, and whole-brain T2-relaxation maps constructed and normalized to a common space template. We created a set of regions of interest (ROIs) over cortical gray and white matter, basal ganglia, amygdala, thalamic, hypothalamic, pontine and cerebellar sites, with sizes of ROIs varying from 12 to 243 mm³; regional T2-relaxation values were determined from these ROIs and normalized T2-relaxation maps. Correlations between R2 (1/T2) values in these sites and age were assessed with Pearson's correlation procedures, and gender differences in regional T2-relaxation values were evaluated with independent-samples t tests. Several brain regions, but not all, showed principally positive correlations between R2 values and age; negative correlations emerged in the cerebellar peduncles. No significant differences in T2-relaxation values emerged between males and females for those areas, except for the mid pons and left occipital white matter; males showed higher T2-relaxation values over females. The findings indicate that T2-relaxation values vary with development between brain structures, and emphasize the need to correct for such age-related effects during any determination of potential changes from control values.     

Influence of the hepatobiliary contrast agent mangafodipir trisodium (Mn-DPDP) on the imaging properties of abdominal organs

To assess the influence of Mangafodipir Trisodium on the imaging properties of abdominal organs when using T₁-weighted gradient-echo (GE) and T₂-weighted turbo spin-echo (TSE) sequences, thirty patients with focal lesions in the liver were examined at a field strength of 1.5 T before and after intravenous administration of Mangafodipir Trisodium (dose: 5 μmol/kg of body weight).Administration of Mangafodipir Trisodium led to a significant increase in the signal intensity of the liver tissue (p < 0.001), the spleen (p < 0.01), the pancreas (p < 0.001), and the kidneys (p < 0.001) in the T₁-weighted GE sequence, while there was no relevant enhancement in fatty tissue and the musculature. In the T₂-weighted turbo spin-echo sequence, there was no relevant change in the signal following administration of a contrast agent. The contrast-to-noise ratio (C/N) between the lesions and the liver tissue increased significantly in the post-contrast T₁-weighted GE sequence (p < 0.001), while there was no change in the contrast-to-noise ratio in the post-contrast T₂-weighted turbo spin-echo sequence. The contrast-to-noise ratio of the plain T₂-weighted TSE sequence was significantly higher than that in the post-contrast T₁-weighted GE sequence (p < 0.001). Although Mangafodipir Trisodium was primarily developed as a hepatobiliary contrast agent for demonstration and differentiation of liver lesions, it also affects the signal levels in the pancreas, spleen, and kidneys in the T₁-weighted image. Awareness of this effect on the extrahepatic tissue makes it easier to interpret pathological findings in magnetic resonance imaging (MRI) of the abdomen.