MRI of the anal canal: Correlation with histologic examination

The purpose of this study was to correlate the MRI features of the anal canal with histologic findings. T₁- and T₂-weighted MR images of nine anal canals were obtained after fixation in 10% formalin. In three specimens, imaging was repeated after removal of histologic layers with a dissecting microscope. Corresponding histologic slices were stained with hematoxylin-eosin, Masson trichrome, and periodic acid-Schiff. Four layers were visualized on T₂-weighted images. An inner layer of high signal intensity and a second layer of low signal intensity corresponded to the mucosa as well as mucous secretions and to the submucosa. The high signal intensity layer vanished at the distal part of the anal canal in accordance with the lack of mucus-secreting epithelium below the level of the dentate line. A third layer of intermediate signal intensity corresponded to the internal sphincter. A fourth layer of low signal intensity corresponded to the longitudinal muscle and external sphincter. T₂-weighted MRI is capable of showing the internal architecture of the wall of the anal canal. In particular, the internal sphincter can be differentiated from the external sphincter and longitudinal muscle.     

Study of brain anatomy with high-field MRI: recent progress

Recent developments in high-field magnetic resonance imaging technology have led to improved contrast and resolution and are opening up new possibilities for the study of human brain anatomy. In particular, techniques sensitized to magnetic susceptibility contrast provide particular advantages at high field that have allowed visualization of brain structures that have been difficult to detect with conventional technology. In this review, some of these developments and techniques will be discussed, and an attempt will be made to interpret magnetic susceptibility contrast based on recent studies.     

Vocal fundamental frequency measures as a reflection of tumor response to chemotherapy in patients with advanced laryngeal cancer

The fundamental frequency (F₀) characteristics of 19 male patients with advanced laryngeal cancer, treated with cisplatin-based chemotherapy as part of a Larynx Preservation Protocol (LPP), were measured before each of three cycles of chemotherapy received before definitive radiotherapy (RT). In these select patients, for whom chemotherapy resulted in 50% decrease in the tumor bulk, it was found that mean F₀ was essentially unaffected by the disease and did not change over the course of chemotherapy, although the cycle of their treatment could be differentiated by both speaking F₀ variability (pitch sigma) and F₀ perturbation (fitter). Although these measures failed to distinguish between those patients showing a complete response (CR) (no measurable disease) versus a partial (PR) (residual) tumor response at the primary disease site, the significant changes observed in both groups indicate that frequency variation measures could prove valuable in the documentation of tumor response to nonsurgical therapeutic intervention if the voice is directly affected. Additional assessment of 15 age- and disease-matched patients who showed minimal or no primary response to the chemotherapy showed no significant change in any of the frequency measures after one chemotherapy cycle, suggesting that vocal improvement seen in the successful chemotherapy patients was not due to postbiopsy healing or other systemic influence unassociated with tumor reduction.     

Quantitation of normal canine hippocampus formation volume: Correlation of MRI with gross histology

The hippocampal formation possesses an important role in the development and maintenance of short-term memory. In this study, magnetic resonance imaging (MRI) and gross histology were used to quantify the volume of the hippocampal formation in canines. High resolution MRI, using 1 mm thick slices and an intraplanar resolution of 0.35 mm was performed at 2.0 T both in vivo and in vitro following in situ fixation. The volumes of the hippocampal formations were determined from MR images and compared to those obtained from one mm thick gross histologic sections. The average volume of the canine hippocampal formation, measured from in vivo and in vitro MR images was 476.0 ± 79.5 and 467.3 ± 53.7 mm³, respectively. Determined from gross histology, the volume of the hippocampal formation was 463.6 ± 24.1 mm³. Quantitation of the canine hippocampal formation using in vivo MRI showed good correlation with in vitro MRI and histology, verifying the reliability and reproducibility of in vivo MRI measurements. High resolution MRI using 1 mm thick slices through the whole canine hippocampal formation is necessary for accurate volume determination of a structure of this size.     

Microtesla MRI of the human brain combined with MEG

One of the challenges in functional brain imaging is integration of complementary imaging modalities, such as magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI). MEG, which uses highly sensitive superconducting quantum interference devices (SQUIDs) to directly measure magnetic fields of neuronal currents, cannot be combined with conventional high-field MRI in a single instrument. Indirect matching of MEG and MRI data leads to significant co-registration errors. A recently proposed imaging method--SQUID-based microtesla MRI--can be naturally combined with MEG in the same system to directly provide structural maps for MEG-localized sources. It enables easy and accurate integration of MEG and MRI/fMRI, because microtesla MR images can be precisely matched to structural images provided by high-field MRI and other techniques. Here we report the first images of the human brain by microtesla MRI, together with auditory MEG (functional) data, recorded using the same seven-channel SQUID system during the same imaging session. The images were acquired at 46 microT measurement field with pre-polarization at 30 mT. We also estimated transverse relaxation times for different tissues at microtesla fields. Our results demonstrate feasibility and potential of human brain imaging by microtesla MRI. They also show that two new types of imaging equipment--low-cost systems for anatomical MRI of the human brain at microtesla fields, and more advanced instruments for combined functional (MEG) and structural (microtesla MRI) brain imaging--are practical.     

Comparing behavioral and physiological measures of combination tones: Sex and race differences

Both distortion-product otoacoustic emissions (DPOAEs) and performance in an auditory-masking task involving combination tones were measured in the same frequency region in the same ears. In the behavioral task, a signal of 3.6?kHz (duration 300?ms, rise/fall time 20?ms) was masked by a 3.0-kHz tone (62?dB SPL, continuously presented). These two frequencies can produce a combination tone at 2.4?kHz. When a narrowband noise (2.0-2.8?kHz, 17?dB spectrum level) was added as a second masker, detection of the 3.6-kHz signal worsened by 6-9?dB (the Greenwood effect), revealing that listeners had been using the combination tone at 2.4?kHz as a cue for detection at 3.6?kHz. Several outcomes differed markedly by sex and racial background. The Greenwood effect was substantially larger in females than in males, but only for the White group. When the magnitude of the Greenwood effect was compared with the magnitude of the DPOAE measured in the 2.4?kHz region, the correlations typically were modest, but were high for Non-White males. For many subjects, then, most of the DPOAE measured in the ear canal apparently is not related to the combination-tone cue that is masked by the narrowband noise.     

MRI of blood volume with superparamagnetic iron in choroidal melanoma treated with thermotherapy

Functional magnetic resonance imaging (MRI) with a new intravascular contrast agent, monocrystalline iron oxide nanoparticles (MION), was applied to assess the effect of transpupillary thermotherapy in a rabbit model of choroidal melanoma. 3D-spoiled gradient recalled sequences were used for quantitative assessment of blood volume. The MRI-parameters were 5/22/35 degrees (time of repetition (TR)/echo delay (TE)/flip angle (FA)) for T(1)- and 50/61/10 degrees for T(2)-weighted sequences. Images were collected before and at different times after MION injection. In all untreated tissues studied, MION reduced the T(2)-weighted signal intensity within 0.5 h and at 24 h (all p <== 0.012), whereas no significant changes were detected in treated tumors. T(1)-weighted images also revealed differences of MION-related signal changes between treated tumors and other tissues, yet at lower sensitivity and specificity than T(2). The change of T(2)-weighted MRI signal caused by intravascular MION allows early distinction of laser-treated experimental melanomas from untreated tissues. Further study is necessary to determine whether MRI can localize areas of tumor regrowth within tumors treated incompletely.     

Correlation between enhancing lesion number and volume on standard and triple dose gadolinium-enhanced brain MRI scans from patients with multiple sclerosis.

We investigated the correlations between numbers and volumes of multiple sclerosis (MS) lesions enhancing on standard dose (SD) and triple dose (TD) gadolinium (Gd)-enhanced brain magnetic resonance imaging (MRI) scans, to clarify whether the measurement of enhancing lesion volumes or the use of TD MRI give additional information which can not be obtained by counting enhancing lesions on SD scans. SD and TD Gd-enhanced brain MRI scans were obtained every month for three months from 40 MS patients. The numbers of total and new enhancing lesions were counted, and the total volumes of enhancing lesions were measured from each of the four scans obtained with the two techniques. Univariate correlations between enhancing lesion numbers and volumes were assessed. The numbers of total and new enhancing lesions seen either on SD or TD scans were significantly correlated (r = 0.91 and 0.93, respectively). The numbers and volumes of total enhancing lesions were significantly correlated on both SD (r = 0.90), and TD (r = 0.89) scans. Moderate correlations were found between the total number of enhancing lesions on SD scans and the average difference between TD and SD scans for total enhancing lesion number (r = 0.66), and between the number of new enhancing lesions on SD scans and the average difference between TD and SD scans for new enhancing lesion number (r = 0.50). Our findings indicate that, both on SD and TD MRI, the counts and the volumes of total and new enhancing lesions are highly correlated, and that lesion counting may suffice to monitor MS activity. On the contrary, this study confirms the usefulness of TD MRI for a more complete assessment of the acute changes occurring in MS patients.     

Prostate cancer: comparison of pre-operative 0.35 T MRI with whole-mount histopathology.

Magnetic resonance imaging of the prostate was performed in eight patients prior to radical prostatectomy. The results of the imaging studies were then directly compared to histopathologic findings from whole-mount histologic sections. Magnetic resonance imaging identified 82% of cancers greater than 5 mm in minimal diameter. Cancers were identified as areas of decreased signal intensity compared to the high signal intensity peripheral zone on long TR/TE sequences. Cancers were best detected when they involved the middle level of the gland and the posterior half of the prostate. Of the individual tumors identified by imaging, the amount of tumor involvement was underestimated by 37% and overestimated by 22% by MRI. We conclude that magnetic resonance imaging can identify prostate cancer, but has limitations as a screening modality and in accurately assessing the amount of involvement of the prostate gland by cancer.     

A newborn piglet study of moderate hypoxic-ischemic brain injury by 1H-MRS and MRI

Cerebral hypoxia-ischemia (HI) is an important cause of perinatal brain damage in the term newborn. The areas most affected are the parasagittal regions of the cerebral cortex and, in severe situations, the basal ganglia. The aim of this study was to show that the newborn piglet model can be used to produce neuropathology resulting from moderate HI insult and to monitor damage for 7 days. Two acute cerebral HI were induced in newborn Large White piglets by reducing the inspired oxygen fraction to 4% and occluding the carotid arteries. Newborn piglets were resuscitated, extubated and monitored for 7 days. (31)P magnetic resonance spectroscopy (MRS) offers the ability to monitor the severity of the HI insults. Lactate (Lac) was detected in the HI group at 2 h, 3 days and 5 days after insult by (1)H MRS. Lac/n-acetylaspartate and Lac/choline and Lac/creatine ratios increased significantly (p < 0.01) in the HI group 2 h after HI insults and remained high over 7 days. For the HI group, mean T(2) values increased significantly in the parietal white matter (subcortical) for 5 days after HI insult [117.5 (+/-7.4) to 158.5 (+/-19.2) at T+3 days, 167.7 (+/-15.4) at T+5 days and 160.9 (+/-10.1) at T+7 days (p < 0.01)]. This newborn piglet model of moderate HI brain injury with reproducible cerebral damage could be use as reference for the study of neuroprotective strategy for a period of 7 days.     

Correlation study between intravoxel incoherent motion MRI and dynamic contrast-enhanced MRI in head and neck squamous cell carcinoma: Evaluation in primary tumors and metastatic nodes

ObjectiveTo correlate intravoxel incoherent motion (IVIM) imaging and dynamic contrast-enhanced (DCE) MRI in head and neck squamous cell carcinoma (HNSCC).MethodsForty untreated patients with HNSCC were included retrospectively in the study. Perfusion fraction f, diffusion coefficient D and perfusion-related diffusion coefficient D* were extracted by bi-exponential fitting of IVIM data. Semi-quantitative DCE-MRI parameters, including positive enhancement integral (PEI) and maximum slope of increase (MSI), were calculated. The relationships between all variables were assessed by Spearman's test for correlation.Results27 primary tumors (PTs) and 23 lymph nodes (LNs) were analyzed. The residual sum of squares (RSS), used to assess the fit quality, was significantly different between PTs and LNs, with the last showing lower values. In LNs, D* and the product D* × f were positively related to both nPEI and nMSI, while no significant correlation was found in PTs.ConclusionEvident relationships between D* and D* × f and DCE-MRI perfusion measurements were found in LNs, while no significant association emerged in PTs. This presumably is due to the poorer agreement between the experimental data and curve fitting for PTs, as compared to LNs. Additional work is warranted to improve the reliability of the IVIM parameter estimations in primary HNSCCs.     

Optimizing brain MRI protocols in the follow-up of patients with multiple sclerosis T2-weighted MRI of the brain after the administration of gadopentetate dimeglumine

The aim of our study was to determine whether T2-weighted (T2w) MRI of the brain could be performed immediately after the administration of gadopentetate dimeglumine (gadolinium DTPA) in patients with multiple sclerosis (MS) without a loss in image quality or diagnostic reliability. Sixteen patients with clinically diagnosed MS were included in the study. Twenty-four patients with various cerebral pathologies (14 patients with multiple lacunar lesions) were examined in order to exclude masking of T2 hyperintense lesions other than MS lesions. Images of 10 patients without pathological changes served as a control condition for the qualitative analysis. In these 50 patients, T1w and T2w MRI was performed before and after the administration of gadolinium DTPA. Signal intensities were measured within T2 hyperintense cerebral lesions, in T1-enhancing lesions and in normal appearing brain tissue on T2w turbo spin-echo (TSE) sequences. Both quantitative and qualitative analysis did not show significant differences between T2w pre- and postcontrast series. T2w MRI performed prior to and after the administration of gadolinium DTPA provides similar information in patients with MS. With a TR of 3.2 s, not a single lesion was obscured on T2w postcontrast series. Acquisition of T2w MR images immediately after the administration of gadolinium DTPA allows for shorter examination time and assures sufficient time for contrast enhancement in cerebral lesions with a disrupted blood-brain barrier.     

Isolating mechanisms that influence measures of the precedence effect: theoretical predictions and behavioral tests

This study tests how peripheral auditory processing and spectral dominance impact lateralization of precedence effect (PE) stimuli consisting of a pair of leading and lagging clicks. Predictions from a model whose parameters were set from established physiological results were tested with specific behavioral experiments. To generate predictions, an auditory nerve model drove a binaural, cross correlation computation whose outputs were summed across frequency using weightings derived from past physiological studies. The model predicted that lateralization (1) depends on stimulus center frequency and the inter-stimulus delay (ISD) between leading and lagging clicks for narrowband clicks and (2) changes differently with lead click level for different ISDs. Behaviorally, subjects lateralized narrowband and wideband click pairs whose stimulus parameters were chosen based on modeling results to test how peripheral processing and frequency dominance contribute to lateralization of PE stimuli. Behavioral results (including unique measures with the lead attenuated relative to the lag) suggest that peripheral interactions between leading and lagging clicks on the basilar membrane and strong weighting of cues around 750 Hz influence lateralization of paired clicks with short ISDs. When combined with auditory nerve adaptation, which emphasizes onset information, lateralization of PE click pairs with a short ISD can be well predicted.     

Multifunctional nanoparticle platforms for in vivo MRI enhancement and photodynamic therapy of a rat brain cancer

A paradigm for brain cancer detection, treatment, and monitoring is established. Multifunctional biomedical nanoparticles (30–60 nm) containing photosensitizer externally deliver reactive oxygen species (ROS) to cancer cells while simultaneously enhancing magnetic resonance imaging (MRI) contrast providing real-time tumor kill measurement. Plasma residence time control and specific cell targeting are achieved. A 5 min treatment in rats halted and even reversed in vivo tumor growth after 3–4 days post-treatment.     

Post-pneumonectomy evaluation of the chest: a prospective comparative study of MRI with CT

A comparative study of 11 pneumonectomized patients was undertaken in order to evaluate the respective advantages and drawbacks of MRI and CT in post-operative follow-up. Nine patients were healthy at the time of the study and two presented with tumor recurrence. MR examination included 500/40 ms axial, and frontal 800/40-80 ms or 1300/60-120 ms nongated spin echo sequences. MRI was slightly more efficient in identifying vascular stump and main nodal stations, and detected better than CT tumoral and metastatic spread in cancer recurrences. It was as informative as CT in evaluating postpneumonectomy space and bronchial stump. It was noncontributory in the detection of calcifications. Although clips were visible with MRI, their location was less definite than with CT, a potential pitfall when radiotherapy is planned.     

Assessment of cerebral blood perfusion reserve with acetazolamide using 3D spiral ASL MRI: Preliminary experience in pediatric patients

PurposeTo demonstrate the clinical feasibility of a new non-Cartesian cylindrically-distributed spiral 3D pseudo-continuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI) pulse sequence in pediatric patients in quantifying cerebral blood flow (CBF) response to an acetazolamide (ACZ) vasodilator challenge.Materials and methodsMRI exams were performed on two 3 Tesla Philips Ingenia systems using 32 channel head coil arrays. After local institutional review board approval, the 3D spiral-based pCASL technique was added to a standard brain MRI exam and evaluated in 13 pediatric patients (average age: 11.7 ± 6.4 years, range: 1.4–22.2 years). All patients were administered ACZ for clinically indicated reasons. Quantitative whole-brain CBF measurements were computed pre- and post-ACZ to assess cerebrovascular reserve.Results3D spiral pCASL data were successfully reconstructed in all 13 cases. In 11 patients, CBF increased 2.8% to 93.2% after administration of ACZ. In the two remaining patients, CBF decreased by 2.4 to 6.0% after ACZ. The group average change in CBF due to ACZ was approximately 25.0% and individual changes were statistically significant (p < 0.01) in all patients using a paired t-test analysis. CBF perfusion data were diagnostically useful in supporting conventional MR angiography and clinical findings.Conclusion3D cylindrically-distributed spiral pCASL MRI provides a robust approach to assess cerebral blood flow and reserve in pediatric patients.     

Spin-lock MRI with amplitude- and phase-modulated adiabatic waveforms: an MR simulation study

INTRODUCTION: Image contrast between tissue types can be generated based on their T1/T2 ratio using spin-lock MRI techniques. An interesting application of such a concept would be to generate contrast in tissue with tissue relaxation times modified using exogenous contrast agents. An amplitude-modulated adiabatic waveform has been shown in the past to perform spin-lock MRI. However, implementation of this waveform may not prove to be efficient and practical in research or a clinical setup due to high radiofrequency power deposition. Recent advancement in software and hardware MR technology allows implementation of amplitude- and phase-modulated adiabatic waveforms on MR systems. The aim of this work was to explore role of adiabatic waveforms in performing rho imaging and demonstrate that amplitude- and phase-modulated waveforms [e.g., hyperbolic secant, B1 independent rotation-4 (BIR-4) waveforms] can be used to distinguish materials that differ in T1/T2 ratio. METHODS AND RESULTS: MR simulation was performed using computer routines implemented in MATLAB environment (Mathworks, Natick, MA). Modified Bloch equations with trapezoidal, hyperbolic secant and BIR-4 waveforms were used to perform MR simulation. Trapezoidal waveforms were only used for comparison to other waveforms. Gadolinium DTPA (Gad-DTPA) (T1/T2 approximately 1) and manganese chloride (MnCl(2)) (T1/T2 approximately 10) were used as examples of contrast agents due to their routine use in clinical and research setups and more importantly because they provide good examples of materials differing in T1/T2 ratios. Results of spin locking using trapezoidal waveform agree very well with the previously published results, thereby validating the computer routines used in this MR simulation. Plots of M(rho) (magnetization vector in rho domain) vs. offset frequency show distinct curves for these materials differing in T1/T2 for the three waveforms. BIR-4 waveform demonstrated a 40% difference in M(rho) ( approximately 150 Hz) for the materials. Rate of spin lock with hyperbolic secant waveform was rapid compared to other waveforms. DISCUSSION: MR simulation using contrast agents Gad-DTPA and MnCl(2) provided a useful way to demonstrate that amplitude- and phase-modulated adiabatic waveforms can be used to perform spin-lock imaging. Future work involves implementation of these waveforms on MR scanners and performing in vivo imaging to generate tissue contrast based on relaxation times ratio.     

Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI

Purposes

To evaluate the diagnostic value of diffusion-weighted MRI (DWI) and combination of conventional MRI and DWI to predict metastatic axillary lymph nodes in breast cancer.

Materials and methods

Two hundred fifty-two breast cancer patients with 253 axillae were included. The morphological parameters on axial T2-weighted images without fat saturation and apparent diffusion coefficient (ADC) values were retrospectively analyzed. An independent t-test/chi-square test and receiver operating characteristics (ROC) curve analysis were used.

Results

On conventional MRI, short and long axis length, maximal cortical thickness, relative T2 value, loss of fatty hilum (p < 0.001 for each), and eccentric cortical thickening (p < 0.003) were statistically significantly different between the metastatic and nonmetastatic groups. The short axis to long axis ratio was not a statistically significant parameter. The ADC value was significantly different between the 2 groups, with an AUC that was higher than that of conventional MR parameters (AUC, 0.815; threshold, ≤ 0.986 × 10–3 mm²/sec; sensitivity, 75.8%; specificity, 83.9%). Using the adopted thresholds for each parameter, a total number of findings suggesting malignancy of 4 or higher was determined as the threshold, with high specificity (90.1%).

Conclusion

Using conventional MRI and DWI, we can evaluate the axilla in breast cancer with high specificity.     

Prolonged T1 in patients with liver cirrhosis: an in vivo MRI study

Fifteen patients with liver cirrhosis and two control groups were examined. The first control group consisted of 7 healthy volunteers, and the second group of 17 patients with nonfocal liver diseases. The T1 and T2 relaxation times were calculated from signal intensities read out from a region of interest centrally located in the liver. T1 relaxation time was longer in the patients with liver cirrhosis than in the two reference groups. Ten patients had a liver biopsy taken prior to the MRI study. No correlation was found between histopathology and the measured relaxation times.