Bone marrow imaging using STIR at 0.5 and 1.5 T.

We retrospectively examined MR images in 82 patients to evaluate the usefulness of short inversion time inversion recovery (STIR) in bone marrow imaging at 0.5 and 1.5 T. The study included 56 patients at 1.5 T and 26 patients at 0.5 T with a variety of pathologic bone marrow lesions (principally oncological), and compared the contrast and image quality of STIR imaging with spin-echo short repetition time/echo time (TR/TE), long TR/TE, and gradient-echo sequences. The pulse sequences were adjusted for optimal image quality, contrast, and fat nulling. STIR appears especially useful for the evaluation of red marrow (e.g., spine), where contrast between normal and infiltrated marrow is greater than with either gradient-echo or T1-weighted images. STIR is also extremely sensitive for evaluation of osteomyelitis, including soft tissue extent. In more peripheral (yellow) marrow, T1-weighted images are usually as sensitive as STIR. Limitations of STIR include artifacts, in particular motion artifact that at high field strength necessitates motion compensation. At 0.5 T, however, motion compensation is usually not necessary. Also, because of extreme sensitivity to water content, STIR may overstate the margins of a marrow lesion. With these limitations in mind, STIR is a very effective pulse sequence at both 0.5 and 1.5 T for evaluation of marrow abnormalities.     

Detection of fatty acid composition of trabecular bone marrow by localized iDQC MRS at 3 T: A pilot study in healthy volunteers

BackgroundAlthough a growing body of research shows that the bone marrow adipose tissue (BMAT) may play an essential role in bone inflammation and energy metabolism, available noninvasive methods for distinguishing different fatty acids in BMAT are still limited, in spite of their potential to provide novel biomarkers for bone related diseases.PurposeTo assess the ability of a localized intermolecular double quantum coherence (iDQC) spectroscopy sequence to resolve more fatty acid peaks than conventional MR spectroscopy (MRS), like polyunsaturated fatty acids (PUFA), from the human BMAT in the presence of trabecular bone; To preliminarily investigate whether the fatty acids composition is different between different regions and groups.ResultsCompared with conventional MRS results, additional four fatty acids peaks were well resolved using the proposed method in human BMAT in the presence of trabecular bone. In addition, a different fat composition was found between distal femur and proximal tibia: fat was more unsaturated (vinyl, *p < 0.01; diallylic, *p < 0.01) in distal femur bone marrow than in proximal tibia, and this higher unsaturation level was caused by PUFA (r = 0.67, diallylic, *p < 0.01). No significant difference in fatty acid composition were found either between left and right legs, or between female and male in the healthy young subjects studied.ConclusionThis study demonstrated that the unsaturated fatty acids information of human BMAT in the presence of trabecular bone can be clearly identified with the localized iDQC at 3 T. The resolved peaks, especially PUFA, may serve as additional diagnostic biomarkers for BMAT related diseases in the future.     

Paranasal sinus mucocele: unusual MR manifestations at 1.5 T

The classic MR appearance of paranasal sinus mucoceles is due to its cystic composition. We present two cases of paranasal sinus mucocele that exhibit atypical signal characteristics. The morphology of this lesion, rather than its signal intensity, is paramount in establishing this diagnosis.     

Quantifying cortical bone free water using short echo time (STE-MRI) at 1.5 T

PurposeThe purpose of our study was to use Dual-TR STE-MR protocol as a clinical tool for cortical bone free water quantification at 1.5 T and validate it by comparing the obtained results (MR-derived results) with dehydration results.MethodsHuman studies were compliant with HIPPA and were approved by the institutional review board. Short Echo Time (STE) MR imaging with different Repetition Times (TRs) was used for quantification of cortical bone free water T₁ (T₁free) and concentration (ρ_free). The proposed strategy was compared with the dehydration technique in seven bovine cortical bone samples. The agreement between the two methods was quantified by using Bland and Altman analysis. Then we applied the technique on a cross-sectional population of thirty healthy volunteers (18F/12M) and examined the association of the biomarkers with age.ResultsThe mean values of ρ_free for bovine cortical bone specimens were quantified as 4.37% and 5.34% by using STE-MR and dehydration techniques, respectively. The Bland and Altman analysis showed good agreement between the two methods along with the suggestion of 0.99% bias between them. Strong correlations were also reported between ρ_free (r² = 0.62) and T_1free and age (r² = 0.8). The reproducibility of the method, evaluated in eight subjects, yielded an intra-class correlation of 0.95.ConclusionSTE-MR imaging with dual-TR strategy is a clinical solution for quantifying cortical bone ρ_free and T_1free.     

Metastasizing chordoma in early childhood: Report of a case at 1.5 T

We present here the first report of an extraskeletal metastasizing presacral chordoma found in a child. MRI of this large lesion showed heterogeneous signal intensity on both the SE 550/30 and on SE 2440/100 images. MRI demonstrated this mass to be separate from the sacrum and provided nonionizing cross-sectional imaging prior to attempted surgical resection.     

MR Imaging of total hip arthroplasty: comparison among sequences to study the sciatic nerve at 1.5 T

Purpose

This study was done to test a series of MR sequences for evaluating the sciatic nerve after total hip arthroplasty (THA).

Material and Methods

The study protocol was approved by the institutional review board. Informed consent was obtained from all patients. Twenty-five patients (11 men and 14 women mean age: 62.3±5.7 years) with THA were included in this prospective study. MRI protocol included sequences that were preliminarily tailored for nerve imaging in patients with THA: proton density (PD)-weighted turbo SE, T1-weighted turbo SE (TSE) 3 mm thickness, T1-weighted turbo SE (TSE) 6 mm thickness, T1-weighted turbo SE with high bandwidth (TSE hBW), T2- weighted TSE, T2-weighted with fat saturation and short-tau inversion recovery (STIR). For each sequence, we evaluated the visibility of the sciatic nerve using a semiquantitative score (0=total masking; 1=insufficient visibility; 2=sufficient visibility; 3=optimal visibility). The sum of the scores given to each sequence was divided by the maximal sum, obtaining a percentage visibility index. Friedman and sign tests were used for statistical analysis.

Results

MR examination time was approximately 40 min. No patients reported pain, heat or symptoms related to nerve stimulation. The visibility index ranged between 88% and 70% for the first four sequences. The T1-weighted TSE hBW sequence had the best visibility index (P<.05). The visibility indexes of the first four sequences were significantly higher (P<.004, sign test) than those of the remaining three sequences.

Conclusion

The sciatic nerve could be studied at 1.5 T in patients following THA. The nerve is better visualized with T1-weighted TSE hBW sequences. On T2-weighted sequences and STIR, the visibility of the nerve is low.     

MR imaging of experimental and clinical thrombi at 1.5 T

We have previously reported that the T1 and T2 of experimental clots at 0.47 T varies considerably depending upon the method used in their preparation. However, these studies, while relevant to midfield imaging, may not reflect accurately the behavior of such thrombi at higher field strengths. Accordingly, we studied the T1 and T2 at 1.5 T of experimental thrombi prepared by several methods and compared these results with the relaxation times of clinical deep venous thrombi measured in situ in patients. The relationship between the T2 values for the different clot preparation methods was different at 1.5 T than at 0.47 T. The combined use of thrombin and epsilon-amino caproic acid produced thrombi with T1 and T2 indistinguishable from clinical deep venous thrombi.     

T2* measurements in human brain at 1.5, 3 and 7 T

Measurements have been carried out in six subjects at magnetic fields of 1.5, 3 and 7 T, with the aim of characterizing the variation of T2* with field strength in human brain. Accurate measurement of T2* in the presence of macroscopic magnetic field inhomogeneity is problematic due to signal decay resulting from through-slice dephasing. The approach employed here allowed the signal decay due to through-slice dephasing to be characterized and removed from data, thus facilitating an accurate measurement of T2* even at ultrahigh field. Using double inversion recovery turbo spin-echo images for tissue classification, an analysis of T2* relaxation times in cortical grey matter and white matter was carried out, along with an evaluation of the variation of T2* with field strength in the caudate nucleus and putamen. The results show an approximately linear increase in relaxation rate R2* with field strength for all tissues, leading to a greater range of relaxation times across tissue types at 7 T that can be exploited in high-resolution T2*-weighted imaging.     

Feasibility of fast MR imaging of the liver at 1.5 T

A phantom with T1 and T2 relaxation times encompassing normal liver and liver lesions was constructed to evaluate fast magnetic resonance pulse sequences using TR from 21-100 milliseconds, TE 12-60 milliseconds and flip angles from 5 degrees-90 degrees. Ten of these fast MR sequences were then selected and compared with conventional spin-echo sequences in normal volunteers (n = 3) and in patients with liver lesions (n = 6). Subjectively, the fast MR sequences eliminated motion artefacts. Objectively, 8 of 10 fast sequences had signal-to-noise ratios comparable to spin-echo imaging whereas only 2 of 10 had contrast-to-noise ratios that were similar to spin-echo imaging. This preliminary study, performed at 1.5 Tesla, does not show any clear-cut advantage of fast imaging over spin-echo imaging in the detection of liver lesions. The use of a liver tissue equivalent phantom provides a rapid, practical approach in evaluation of fast scans.     

The quantitative 19F-imaging of albumin at 1.5 T: a potential in-vivo tool

19F-MR-imaging has been used to quantitate albumin concentration in a phantom at 1.5 T. The experimentally derived relationship between albumin concentration and the T1 relaxation time of a fluorinated marker, tetrafluorosuccinic acid (TFSA) was used to calculate the albumin concentration from a quantitative 19F T1 map acquired using a gradient echo sequence. There was close correlation between calculated and actual BSA concentrations (r = 0.99, SE = 0.15). The potentially interfering effect of paramagnetic species on T1 relaxation times was also investigated. Relaxivity data show that albumin concentration measurements should be performed prior to any contrast agent administration.     

Prolonged bone marrow T1-relaxation in patients with polycythemia vera

In vitro as well as in vivo studies have shown prolonged T1 relaxation times in patients with acute leukemia. The mechanism behind this finding is not known. In order to evaluate if this was specific for leukemia we examined eight patients with polycythemia vera, representing a condition with a rather benign bone marrow neoplasia. In this group of patients we found prolonged T1 relaxation times but normal T2 relaxation times. This may indicate that the prolonged T1 relaxation time seen in leukemic bone marrow is not due to the malignant cell per se.     

Quantitative NumART2* mapping in functional MRI studies at 1.5 T

Quantitative mapping of the effective transverse relaxation time, T₂* and proton density was performed in a motor activation functional MRI (fMRI) study using multi-echo, echo planar imaging (EPI) and NumART₂* (Numerical Algorithm for Real time T₂*). Comparisons between NumART₂* and conventional single echo EPI with an echo time of 64 ms were performed for five healthy participants examined twice. Simulations were also performed to address specific issues associated with the two techniques, such as echo time-dependent signal variation. While the single echo contrast varied with the baseline T₂* value, relative changes in T₂* remained unaffected. Statistical analysis of the T₂* maps yielded fMRI activation patterns with an improved statistical detection relative to conventional EPI but with less activated voxels, suggesting that NumART₂* has superior spatial specificity. Two effects, inflow and dephasing, that may explain this finding were investigated. Particularly, a statistically significant increase in proton density was found in a brain area that was detected as activated by conventional EPI but not by NumART₂* while no such changes were observed in brain areas that showed stimulus correlated signal changes on T₂* maps.     

A comparative study of myo-inositol quantification using LCmodel at 1.5 T and 3.0 T with 3 D 1H proton spectroscopic imaging of the human brain

Myo-inositol is a strongly coupled system and resonates at four chemical shift positions. At 1.5 T, only the singlet component at 3.57 ppm is detected. However, at 3 T this resonance is resolved into its components at 3.55 ppm and 3.61 ppm. Due to the increased spectral resolution and signal-to-noise ratio, it is anticipated that the quantification of myo-inositol should improve at 3 T. Using data from normal controls and the LCmodel quantification procedure, we found that the quantification precision, reproducibility and detection sensitivity of myo-inositol is significantly better at 3 T relative to 1.5 T.     

Absence of harmful effects of magnetic resonance exposure at 1.5 T in utero during the third trimester of pregnancy: a follow-up study

In this study the possible adverse effects of in utero exposure to magnetic resonance (MR) conditions at 1.5 Tesla were examined. Thirty-five children between 1 and 3 years of age, and nine children between 8 and 9 years of age, that were exposed to MR during the third trimester of pregnancy, were checked for possible adverse effects in a follow-up study. Data on pregnancy and birth, the results of a neurological examination at 3 months, their medical documentary with emphasis on eye and ear functioning, and a questionnaire answered by their mothers were collected and evaluated. In five children abnormal test results were observed, that had no relation to the MR exposure. No harmful effects of prenatal MR exposure in the third trimester of pregnancy were detected in this study.     

Radiotherapy effects on vertebral bone marrow: Easily recognizable changes in T2 relaxation times

The effect of localized radiotherapy on vertebral bone marrow was demonstrated in two patients using quantitative MRI studies with pixel-by-pixel measurement of T₂ relaxation times with generation of T₂ images. Conventional T₁-weighted spin-echo images were obtained as well. Irradiated vertebral bone marrow was found to have longer T₂ relaxation times than the neighboring nonirradiated bone marrow. These changes corresponded to the increased signal intensity on T₁-weighted images and to the field of radiotherapy and were noted 2.5 to 32 mo after radiotherapy. Radiologists should be aware of the increased T₂ relaxation times in irradiated bone marrow to correctly assess spinal disorders in irradiated patients. The reported T₂ changes may reflect the abundance of adipose cells that proliferate in bone marrow after radiotherapy, or may indicate an additional histological change, such as bone marrow necrosis or edema. Conclusive histological proof remains to be obtained.     

MRI anatomy of the rat kidney at 1.5 T in different states of hydration

The objective of this study was to determine correlation between structural anatomy and surface coil spin-echo MR imaging of the rat kidney and the effect of hydration state on MR signal intensities of the cortex and medulla. Twelve rats were studied in a pilot study with a 3-inch surface coil in a 1.5 T magnet under five different states of hydration. Serum and urine osmolality measurements were obtained immediately prior to each scan. Signal intensity measurements were made from both T₁- and T₂-weighted images of the cortex and medulla of both kidneys in each state of hydration. Gross and histological anatomy of the rat kidneys was correlated with the MR images. Four distinct layers were detected in vivo on MRI images of the rat kidney; these correlated with the histological layers. T₁-weighted cortico-medullary differentiation was most pronounced at 48 h dehydration; T₂ cortico-medullary differentiation was greatest at 72 h of dehydration. We concluded that different parts of the mammalian nephron can be identified by MR imaging and that cortico-medullary differentiation is affected by the hydration state of the animal.     

Breath-hold T2-weighted sequences of the liver: a comparison of four techniques at 1.0 and 1.5 T.

T2-weighted images are considered the most sensitive for lesion detection at high field; however, long imaging time is problematic. Accordingly, the authors compared four breath-hold T2 or T2* weighted sequences comprising T2*-weighted FLASH, T2*-weighted PSIF, T2-weighted rapid spin echo (RASE), and T2-weighted Turbo-FLASH (Turbo) in 20 different healthy volunteers, 10 at 1.0 T and 10 at 1.5 T with reference to regular T2-weighted spin echo. Images were evaluated quantitatively by liver signal to noise (S/N) and spleen-liver signal difference to noise (SD/N) ratios and qualitatively for presence of artifacts and image quality. Data were evaluated for 1.0 T and 1.5 T separately and combined. In the combined evaluation, T2*-FLASH had good S/N (23.1 + 5.1) but low SD/N (2.9 + 1.7) and suffered from susceptibility artifacts. T2* PSIF had good S/N (28.1 + 10.0) and moderate SD/N (6.0 + 2.4), but occasionally had heterogeneous signal intensity. Flow signal void was an attractive feature. T2 RASE had very low S/N (4.4 + 1.9) and low SD/N (2.3 + 1.1) and suffered from flow artifacts. T2-Turbo had good S/N (24.6 + 8.6) and SD/N (8.9 + 2.5). Flow signal void was present, but small matrix size decreased image quality. The results of our study suggest that T2*-PSIF and T2-Turbo have good S/N and SD/N and fair image quality which may be clinically useful for breath-hold T2-weighted sequences of the liver.     

Fast spoiled gradient-recalled MR imaging of thoracic aortic dissection: Preliminary clinical experience at 1.5 T

The purpose of this study was to evaluate fast spoiled gradient-recalled (FSPGR) magnetic resonance (MR) imaging in the diagnosis of thoracic aortic dissection (TAD). Twenty-eight patients with suspected TAD underwent MR imaging with FSPGR and either cine or cardiac-gated spin-echo MR techniques. The average scanning time for the FSPGR images was approximately 1 min. Three readers interpreted the FSPGR images for the presence or absence of TAD. An ROC analysis was done. At a specificity of 90%, the sensitivity ranged from 52% to 90% for the three readers. Pulsatility artifacts and mural thrombus were causes of false-positive and false-negative readings. The areas under the ROC curves (A_z) ranged from 0.85 to 0.97 for the three readers. There was a statistically significant difference in the A_z values for two of the experienced readers (p = .02). The correct type of dissection was determined in only 65% of the true-positive diagnoses. FSPGR has a very limited role in screening and for rapid evaluation of the unstable patient. The results are reader dependent and susceptible to pulsatility artifacts. Determination of the type of dissection is limited. With a suspected thoracic aortic dissection, therefore, additional imaging sequences should be obtained to maximize accuracy.     

In vivo 1H spectroscopic studies of human gastrocnemius muscle at 1.5 T

In vivo high resolution 1H magnetic resonance spectra are observed from the gastrocnemius muscle in 12 normal volunteers. The gross spectral features do not appear to significantly change from individual to individual. However, the number and the relative amplitudes of the resonances from the fatty acid chains are found to exhibit significant variation from normal to normal. The spectra observed on different occasions in the same individual exhibit very little variation. Our studies indicate that it is preferable to use the spin echo sequence with a long echo time to observe water-suppressed proton spectra from the muscle tissue.