Distribution of late gadolinium enhancement in end-stage hypertrophic cardiomyopathy and dilated cardiomyopathy: Differential diagnosis and prediction of cardiac outcome

Background

The prognostic implications of late gadolinium enhancement (LGE) have been evaluated in ischemic and non-ischemic cardiomyopathies. The present study analyzed LGE distribution in patients with end-stage hypertrophic cardiomyopathy (ES-HCM) and with dilated cardiomyopathy (DCM), and tried to identify high risk patients in DCM.

Methods

Eleven patients with ES-HCM and 72 with DCM underwent cine- and LGE-cardiac magnetic resonance and ultrasound cardiography. The patient outcome was analyzed retrospectively for 5 years of follow-up.

Results

LGE distributed mainly in the inter-ventricular septum, but spread more diffusely into other left ventricular segments in patients with ES-HCM and in a certain part of patients with DCM. Thus, patients with DCM can be divided into three groups according to LGE distribution; no LGE (n = 24), localized LGE (localized at septum, n = 36), and extensive LGE (spread into other segments, n = 12). Reverse remodeling occurred after treatment in patients with no LGE and with localized LGE, but did not in patients with extensive LGE and with ES-HCM. The event-free survival rate for composite outcome (cardiac death, hospitalization for decompensated heart failure or ventricular arrhythmias) was lowest in patients with extensive LGE (92%, 74% and 42% in no LGE, localized LGE, and extensive LGE, p = 0.02 vs. no LGE), and was comparable to that in patients with ES-HCM (42%).

Conclusions

In DCM, patients with extensive LGE showed no functional recovery and the lowest event-free survival rate that were comparable to patients with ES-HCM. The analysis of LGE distribution may be valuable to predict reverse remodeling and to identify high-risk patients.     

Quantitative assessment of regional systolic and diastolic functions and temporal heterogeneity of myocardial contraction in patients with myocardial infarction using cine magnetic resonance imaging and Fourier fitting

Purpose

The objective of this study is to determine regional left ventricle (LV) function and temporal heterogeneity of LV wall contraction by analyzing regional time–volume curve (TVC) after Fourier fitting and to assess altered systolic and diastolic functions and temporal indices of myocardial contraction in infarcted segments in comparison with noninfarcted myocardium in patients with myocardial infarction (MI).

Methods

Steady-state cine magnetic resonance (MR) and late gadolinium-enhanced (LGE) MR images were acquired using a 1.5-T MR system in 60 patients with MI. Regional LV function was determined by analyzing regional TVC in 16 segments. The fitted regional TVC was generated by Fourier curve fitting with five harmonics. Regional LV ejection fraction (EF), peak ejection rate (PER), peak filling rate (PFR), time to end-systole and time to peak filling (TPF) were determined from TVC and the first derivative curve.

Results

On LGE MR imaging (MRI), MI was observed in 307 of 960 segments (32.0%). Regional EF and PER averaged in LGE segments were 49.3±14.5% and 2.83±0.65 end-diastolic volume (EDV)/s, significantly lower than those in normal segments (66.7±11.9% and 3.63±0.60 EDV/s, P<.001 and P<.01, respectively). In addition, regional PFR, an index of diastolic function, was significantly reduced in LGE segments (1.94±0.54 vs. 2.86±0.68 EDV/s, P<.01). Time to end-systole and TPF were significantly greater in LGE segments (380.2±57.6 and 169.3±45.4 ms) than in normal segments (300.9±55.1 and 132.3±43.0 ms, P<.01 and P<.01, respectively).

Conclusions

Analysis of regional TVC on cine MRI after Fourier fitting allows quantitative assessment of regional systolic and diastolic LV functions and temporal heterogeneity of LV wall contraction in patients with MI.     

Magnetic resonance imaging dynamic contrast enhancement (DCE) characteristics of healed myocardial infarction differ from viable myocardium

Purpose

To determine whether healed myocardial infarction alters dynamic contrast-enhancement (DCE) curve shapes as well as late gadolinium-enhancement (LGE).

Materials and methods

Twenty patients with chronic myocardial infarction underwent MR imaging at 1.5 T with blood and myocardial T1 measurements before and after contrast administration for forty minutes. Viable and infarcted myocardial partition coefficients were calculated using multipoint slope methods for ten different DCE sampling intervals and windows. Partition coefficients and coefficients of determination were compared with paired statistical tests to assess the linearity of DCE curve shapes over the 40 min time period.

Results

Calculated partition coefficients did not vary significantly between methods (p = 0.325) for viable myocardium but did differ for infarcted myocardium (p < 0.001), indicating a difference in infarcted DCE. There was a significant difference between viable and infarcted myocardial partition coefficients estimates for all methods with the exception of methods that included measurements during the first 10 min after contrast agent administration.

Conclusion

Myocardial partition coefficients calculated from a slope calculation vary in healed myocardial infarction based on the selection of samples due to non-linear DCE curve shapes. Partition coefficient calculations are insensitive to data sampling effects in viable myocardium due to linear DCE curve shapes.     

MRI findings in nonalcoholic steatohepatitis: correlation with histopathology and clinical staging

Purpose

To evaluate magnetic resonance imaging (MRI) findings of nonalcoholic steatohepatitis (NASH) and to determine the correlation of MRI findings with histopathology and Mayo End-Stage Liver Disease (MELD) score.

Materials and Methods

Thirty patients (18 males, 12 females; mean age: 57±8.9 years; age range: 35–71 years) with histopathologically proven NASH who underwent MRI examinations between January 2001 and October 2005 were included in the study. Two radiologists retrospectively reviewed all magnetic resonance (MR) examinations in consensus to evaluate the presence and extent of predetermined findings of NASH including liver steatosis, early patchy liver enhancement indicating inflammation and liver fibrosis. The findings detected on MRI were correlated and compared to histopathological findings and MELD score by using nonparametric Spearman correlation coefficient and Kruskal–Wallis analysis of variance.

Results

Liver steatosis was observed in 10 of 30 patients; early patchy liver enhancement, in 8 of 30 patients and liver fibrosis in 19 of 30 patients on MR images. Liver fibrosis was reticular in all these patients. There were statistically significant moderate correlations between MRI findings of liver steatosis and histopathologic grades of steatosis (r=0.43; P<.05), and between MRI findings of fibrosis and histopathologic stages of fibrosis (r=0.61; P<.001). Early patchy enhancement did not demonstrate statistically significant correlation with inflammation (P=.28). There was no statistically significant overall correlation between MRI findings of NASH and MELD score.

Conclusion

MRI findings of liver steatosis and fibrosis in NASH showed moderate correlations with histopathologic grades of steatosis and stages of fibrosis, but MRI findings of NASH did not demonstrate any significant correlations with MELD score.     

Guided e-MRI prostate biopsy can solve the discordance between Gleason score biopsy and radical prostatectomy pathology

Introduction

The aim of this study is to examine if guided prostate biopsies based on abnormalities detected by conventional and functional endorectal magnetic resonance imaging (MRI) yield a more reliable representation of the radical prostatectomy pathology and to identify probable preoperative clinical variables that stratified patients likely to harbor significant upgrading.

Patients and Methods

From April 2004 to April 2009, a review of N=70 patients records diagnosed with prostate cancer by a 3-6 core guided transrectal ultrasound (TRUS) prostate biopsy based on abnormalities detected by conventional and functional endorectal MRI and who subsequently underwent radical prostatectomy and exhibited a significant upgrading was conducted. Additionally, a multivariate analysis with a significant upgrading as the outcome was performed including the following parameters: prostate specific antigen (PSA) level, clinical stage, prostate size and duration from biopsy to radical prostatectomy.

Results

A significant upgrading was noted in only 8.5% of patients, with 1.4% exhibiting a significant downgrading and the rest 90.1% exhibiting an exact Gleason score match. No preoperative clinical variables that stratified patients likely to harbour significant upgrading were identified.

Conclusions

This type of biopsy method seems to solve the discordance between the biopsy Gleason score and radical prostatectomy pathology regardless of known preoperative clinical variables that can affect it.     

Early contrast enhancement of the liver: exact description of subphases using MRI

Purpose

The purpose of this study was to describe the subphases of early post-contrast enhancement of the liver, using vessel enhancement patterns, and correlate these findings with enhancement patterns of abdominal organs.

Materials and Methods

A total of 114 patients who underwent gadolinium-enhanced abdominal magnetic resonance imaging examinations constituted the final study group, of which 56 were women (age range, 3–94 years; mean, 50 years) and 58 were men (age range, 6–85 years; mean, 54 years). Early post-contrast sequences in all patients were evaluated retrospectively by two reviewers for the determination of the presence of contrast enhancement in predetermined major vessels of the abdomen and qualitative and quantitative extent of enhancement of the renal cortex, spleen, pancreas and liver. Based on the overall findings, subphases of early contrast enhancement of the liver were described and quantitative extent of enhancement of organs was correlated with subphases of early contrast enhancement of the liver. Mann–Whitney U test and one-way unbalanced analysis of variance tests were used for the comparisons.

Results

Early hepatic arterial phase was observed in 14/114 patients, mid-hepatic arterial phase in 23/114 patients, late hepatic arterial phase in 33/114 patients, splenic vein only hepatic arterial dominant phase in 20/114 patients and hepatic arterial dominant phase in 24/114 patients. There was an overall association between the subphases of enhancement and the quantitative extent of enhancement for all studied organs (P<.0001).

Conclusion

The evaluation of vessel and organ enhancement patterns has allowed the characterization of five different subphases in early post-contrast enhancement of the liver. The quantitative extent of enhancement of abdominal organs also demonstrated significant correlation with these five subphases.     

Occipital lobe's cortical thinning in ametropic amblyopia

Background and Purpose

The present study was designed to detect the abnormalities of the cortical thickness in children with ametropic amblyopia by a computer-aided MRI technique.

Methods

Nine children with ametropic amblyopia and eight age-matched normal controls underwent MRI brain scanning that was performed on a Siemens Avanto 1.5-T scanner, and standard T₁-weighted high-resolution anatomic scans of magnetization-prepared rapid gradient echo (MPRAGE) sequence were obtained. For the cortical thickness analysis, 3D MPRAGE images were processed with FreeSurfer software package (http://www.nmr.mgh.harvard.edu/freesurfer/), and the cortical thicknesses were compared between the patient group and the normal control group.

Results

The cortical thicknesses of the lingual and pericalcarine areas in the left hemisphere and of the cuneus, lateraloccipital and lingual areas in the right hemisphere in the amblyopic group were significantly thinner than those of the control group (P<.05).

Conclusion

The changes in cortical thickness of several occipital regions in amblyopic patients may be important in the diagnosis and treatment of this disease.     

Correlations between microstructural alterations and severity of cognitive deficiency in Alzheimer's disease and mild cognitive impairment: a diffusional kurtosis imaging study

Object

Diffusional kurtosis imaging (DKI), a natural extension of diffusion tensor imaging (DTI), can characterize non-Gaussian diffusion in the brain. We investigated the capability of DKI parameters for detecting microstructural changes in both gray matter (GM) and white matter (WM) in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) and sought to determine whether these DKI parameters could serve as imaging biomarkers to indicate the severity of cognitive deficiency.

Materials and Methods

DKI was performed on 18 AD patients and 12 MCI patients. Fractional anisotropy, kurtosis and diffusivity parameters in the temporal, parietal, frontal and occipital lobes were compared between the two groups using Mann–Whitney U test. The correlations between regional DKI parameters and mini-mental state examination (MMSE) score were tested using Pearson's correlation.

Results

In ADs, significantly increased diffusivity and decreased kurtosis parameters were observed in both the GM and WM of the parietal and occipital lobes as compared to MCIs. Significantly decreased fractional anisotropy was also observed in the WM of these lobes in ADs. With the exception of fractional anisotropy and radial kurtosis, all the five other DKI parameters exhibited significant correlations with MMSE score in both GM and WM.

Conclusion

Bearing additional information, the DKI model can provide sensitive imaging biomarkers for assessing the severity of cognitive deficiency in reference to MMSE score and potentially improve early detection and progression monitoring of AD based on characterizing microstructures in both the WM and especially the GM.     

Validation of an adapted MRI pulse sequence for quantification of fatty infiltration in muscle

Purpose

The long-term goal of our research is to develop a patient-specific biomechanical model of the supraspinatus muscle and tendon for analyzing the effects of fatty infiltration and pennation angle changes. One input of the model will be the amount and distribution of fat within the muscle. Therefore, the objective of this project was to adapt and validate a novel magnetic resonance imaging pulse sequence for quantifying the extent of fatty infiltration for the supraspinatus muscle.

Methods

Samples of incremental combinations of muscle and fat from a cow were prepared and scanned with our quantitative MR technique. The MR results were compared to actual fat measurements taken using a Soxtec extraction analyzer.

Results

The MR fat quantification results closely match those values determined by Soxtec analysis (R²=.98, root mean square deviation=4.9).

Conclusions

Our MR fat quantification protocol can be used to accurately quantify fatty infiltration in skeletal muscle. This ability to evaluate skeletal muscle tissue noninvasively will improve the efficacy of evaluation of fatty degeneration in assessing tissue quality preoperatively. This can be important in surgical planning of any musculoskeletal repairs, particularly rotator cuff tears.     

The use of T2*-weighted multi-echo GRE imaging as a novel method to diagnose hepatocellular carcinoma compared with gadolinium-enhanced MRI: a feasibility study

Background

The goal of the study was to assess a T2*-weighted MRI sequence for the ability to identify hepatocellular carcinoma (HCC).

Methods

Hepatic iron deposition, which is common in chronic liver disease (CLD), may increase the conspicuity of HCC on GRE imaging due to increased T2* signal decay in liver parenchyma. In this study, a breath-hold T2*-weighted MRI sequence was evaluated by a blinded observer for HCC and the results compared to a reference standard of gadolinium-enhanced MRI in these same patients. Forty-one patients (mean age 56.2 years; 17 females) were included in this approved, retrospective study.

Results

By the reference standard, 14 of 41 patients had a total of 25 HCCs. The sensitivity of the T2*-weighted MR sequence for identifying HCC, per lesion, was 60%, while the specificity was 100%. There was a significantly lower T2* value of liver parenchyma in patients with HCC identified by the T2*-weighted sequence than in those with HCCs which were not identified by the T2*-weighted sequence (27.8±2.2 vs. 21.9±2.1 ms; P=.02).

Conclusions

A T2*-weighted MRI sequence can identify HCC in patients with CLD. This technique may be beneficial for imaging of patients contraindicated for gadolinium.     

Magnetic resonance T1ρ imaging of osteoarthritis: a rabbit ACL transection model

Objective

The objective of this study was to develop quantitative T_1ρ-weighted magnetic resonance imaging methodology for the detection and characterization of cartilage degeneration in a rabbit anterior cruciate ligament (ACL) transection model.

Methods

The right knee ACLs of 18 adult female New Zealand white rabbits were transected. The left knee joint served as a sham control. The rabbits were euthanized at 3 (Group 1), 6 (Group 2) and 12 (Group 3) weeks postoperatively. High-resolution 3D fat-saturated spoiled gradient echo images and T_1ρ-weighted images were obtained in both the sagittal and axial planes at 3 T using a quadrature wrist coil. Following MR analysis, histological slides from the lateral femoral condyle cartilage were graded using the Mankin grading system.

Results

For all three groups, the average overall T_1ρ values were significantly higher in the ACL-transected knee compared to control knee, and the percentage differences in T_1ρ values between ACL-transected and control increased with the duration of time after transection. The average Mankin score for ACL-transected knees was higher than that for control for each time point, but this difference was statistically significant only for all groups combined.

Conclusions

This study demonstrates the feasibility of using T_1ρ-weighted imaging as a useful tool in the detection and quantification of cartilage damage in all knee compartments in an ACL-transected rabbit model of cartilage degeneration.     

Hepatic sarcoidosis: MR appearances in patients with chronic liver disease

Purpose

To describe the MR appearances of hepatic sarcoidosis in patients with chronic liver disease and correlate the results with clinical stage of disease as measured with the Mayo end-stage liver disease (MELD) score.

Materials and methods

Twenty patients with chronic liver disease and histopathological diagnosis of hepatic sarcoidosis who underwent MR imaging were included in this study. Two abdominal radiologists retrospectively reviewed all images for the presence of cirrhosis, imaging pattern of the liver, intrahepatic biliary dilatation, presence of areas of parenchymal atrophy, presence of splenic nodules and lymphadenopathy. Imaging findings were correlated with the MELD score.

Results

Of the patients, 14/20 had imaging findings of cirrhosis, 9/20 had a large macronodular pattern of liver cirrhosis and 5/20 had a diffuse pattern of liver cirrhosis. Peripheral wedge-shaped areas of parenchymal atrophy were observed in 10 patients. The combination of a central macronodular pattern and peripheral atrophy was observed in 9/20 patients. The pattern of cirrhosis had statistically significant correlation with the presence of wedge-shaped areas of parenchymal atrophy (p < 0.005). No statistically significant difference was revealed between the clinical score of patients who had imaging findings consistent with cirrhosis and those who did not.

Conclusion

MR imaging appearances of chronic sarcoid liver disease are diverse and do not appear to correlate with severity of clinical disease. Large central regenerative nodules and wedge-shaped areas of peripheral parenchymal atrophy are frequent findings and may help to suggest the diagnosis.     

Ultrasmall superparamagnetic iron oxides enhanced MR imaging in rats with experimentally induced endometriosis

Purpose

The purpose of our study was to evaluate the feasibility of magnetic resonance imaging (MRI) using ultrasmall superparamagnetic iron oxides (USPIO) in the detection of experimentally induced endometriosis.

Materials and methods

Endometriosis was surgically induced in rats by transplanting an autologous fragment of uterine tissue onto the inner surface of the abdominal wall, the posterior surface of the uterine body and the arterial cascades of the small intestines adjacent to mesenteric blood vessels. Six weeks later, MRI using Gd-DTPA and USPIO was performed for the evaluation of the ectopic uterine tissue (EUT). A scoring system was developed for image interpretation (0=absence, 1=probably absence, 2=probably presence and 3=presence). We defined MR index (MRIx) as the sum of T1-weighted and enhanced T1-weighted and T2-weighted image scores, and USPIO MRIx (MRIx^+USPIO) as the MRIx score plus the score of USPIO-enhanced T2-weighted image.

Results

The MRIx^+USPIO was also higher in the successfully autotransplanted group than in the failed group (6.19±1.72 versus 3.94±1.20, P<.001). There was also a significant linear relationship between MRIx^+USPIO and pathologic status (R²=0.494, P<.001). Thirty-one (64.6%) of the 48 implanted uterine tissues were histologically confirmed on pathologic review. The area of MRIx and MRIx^+USPIO in the detection of EUT more than 3 mm in size was 0.739 and 0.913, respectively.

Conclusion

Our results suggest that USPIO-enhanced MRI could be a novel diagnostic tool for diagnosis in experimentally induced peritoneal endometriosis.     

Two-dimensional spectroscopic imaging for pretreatment evaluation of prostate cancer: comparison with the step-section histology after radical prostatectomy

Purpose

To minimize user and vendor dependence of the spectrum processing of prostate spectra, to measure the ratio of choline (Cho) plus creatine (Cr) to citrate (Cit) in the prostate tissue of normal volunteers and cancer patients, and to compare the results with pathologic findings after radical prostatectomy.

Materials and methods

Four healthy volunteers and 13 patients with prostate cancer were measured. Measurements were performed using two-dimensional magnetic resonance spectroscopic imaging (MRSI) and endorectal coil. A standard vendor's spectrum processing approach has been modified. An original feature of this methodology was the combination of vendor-optimized and user-independent spectrum preprocessing in the scanner and user-independent quantitation in the environment of an MRUI software package. (Cho+Cr)/Cit ratio was used for the classification of prostate tissue. Results were compared with histopathology after radical prostatectomy.

Results

Eight of 13 cancer patients were classified as suspicious or very suspicious for cancer at spectroscopy, three were ambiguous for cancer and two patients were evaluated as false negative. A considerable overlap of metabolite ratios at various Gleason score was found.

Conclusion

The proposed spectrum processing has the potential to improve the accuracy and user independency of the (Cho+Cr)/Cit quantitation. This study confirmed the previous results that a considerable overlap of (Cho+Cr)/Cit ratios exists at various Gleason score levels.     

Quantitative liver iron measurement by magnetic resonance imaging: in vitro and in vivo assessment of the liver to muscle signal intensity and the R2* methods

Purpose

To evaluate the liver-to-muscle signal intensity and R2* methods to gain a transferable, clinical application for liver iron measurement.

Materials and Methods

Sixteen liver phantoms and 33 human subjects were examined using three 1.5-T MRI scanners from two different vendors. Phantom-to-muscle and liver-to-muscle signal intensity ratios were analyzed to determine MRI estimated phantom and hepatic iron concentration (M-PIC and M-HIC, respectively). R2* was calculated for the phantoms and the liver of human subjects. Seven patients' biochemical hepatic iron concentration was obtained.

Results

M-PIC and R2* results of three scanners correlated linearly to phantom iron concentrations (r=0.984 to 0.989 and r=0.972 to 0.981, respectively), and no significant difference between the scanners was found (P=.482 and P=.846, respectively) in vitro. The patients' R2* correlated linearly to M-HIC of the standard scanner (r=0.981). M-HIC values did not differ from those obtained from the biopsy specimens (P=.230). The difference in M-HIC was significant, but the difference in R2* was not significant between the scanners (P<.0001 and P=.505, respectively) in vivo.

Conclusion

Both methods, M-HIC and R2*, are reliable iron concentration indicators with linear dependence on iron concentration in vivo and in vitro. The R2* method was found to be comparable among different scanners. Transferability testing is needed for the use of the methods at various scanners.     

Responses of dopaminergic, serotonergic and noradrenergic networks to acute levo-tetrahydropalmatine administration in naïve rats detected at 9.4 T

Aim

The aim of this study was to understand the neuropharmacological characteristics of levo-tetrahydropalmatine (l-THP), a recently found potential treatment for drug addiction, and discover its neural correlates and sites of action.

Methods

High-field pharmacological magnetic resonance imaging (phMRI) was used to detect activation induced by acute l-THP administration in the naïve rat brain at dose levels of 5, 10, 20 and 40 mg/kg.

Results

Interestingly, the pharmacological profile of l-THP selectively binds to the receptors of the dopaminergic, serotonergic and noradrenergic systems. Using the phMRI method, it was demonstrated that l-THP selectively activated the key brain regions of the dopaminergic, serotonergic and noradrenergic systems in a dose-dependent manner.

Conclusion

Numerous studies suggest a critical role of monoamines in the behavioral, pharmacological and addictive properties of psychostimulants. It is suggested that l-THP holds great potential to be a therapeutic medication for drug addiction.     

White matter hyperintensities and dynamics of postural control

Background

White matter hyperintensities (WMHs) on MRI have been associated with age, cardiovascular risk factors and falls in the elderly. This study evaluated the relationship between WMHs and dynamics of postural control in older adults without history of falls.

Methods

We studied 76 community-living subjects without history of falls (age 64.5±7.3 years). Brain and WMH volume calculations and clinical rating were done on fluid-attenuation inversion recovery (FLAIR) and MP-RAGE MR images on 3 T. Balance was assessed from the center of pressure displacement using the force platform during 3 min of quiet standing using traditional and dynamic measures (using stabilogram-diffusion analysis). Gait speed was measured from 12-min walk.

Results

Age-adjusted periventricular and focal WMHs were associated with changes in certain dynamic balance measures, including reduced range of postural sway in anteroposterior direction (fronto-temporal WMHs, P=.045; parieto-occipital WMHs, P=.009) and more irregular long-term mediolateral fluctuations (P=.046). Normal walking speed was not affected by WMHs.

Conclusions

Periventricular and focal WMHs affect long-term dynamics of postural control, which requires engagement of feedback mechanisms, and may contribute to mobility decline in the elderly.     

MR T1ρ quantification of cartilage focal lesions in acutely injured knees: correlation with arthroscopic evaluation

Objective

Quantitative T₁ρ MRI has been suggested as a promising tool to detect changes in cartilage composition that are characteristic of cartilage damage and degeneration. The objective of this study was to evaluate the capability of MR T₁ρ to detect cartilage lesions as evaluated by arthroscopy in acutely ACL-injured knees and to compare with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) using clinical standard MRI.

Method

Ten healthy controls (mean age 35) with no ACL injury or history of osteoarthritis (OA) and 10 patients with acute ACL injuries (mean age 39) were scanned at 3 Tesla (3 T). ACL patients underwent ACL reconstruction, where focal lesions were graded according to an Outerbridge grading system during arthroscopic evaluation. Normalized MR T₁ρ values (T₁ρ z-scores normalized to control values in matched regions) in full thickness, and superficial and deep layers of cartilage were compared between defined sub-compartments with and without focal lesions. Intraclass (ICC) correlation and the root mean square coefficient of variation (RMS-CV) were performed to evaluate the inter-observer reproducibility of T₁ρ quantification. Sub-compartments of cartilage were also evaluated using WORMS scoring and compared to their Outerbridge score respectively.

Results

The inter-observer ICC and the RMS-CV of the sub-compartment T₁ρ quantification were 0.961 and 3.9%, respectively. The average T₁ρ z-scores were significantly increased in sub-compartments with focal lesions compared to those without focal lesions and to the control cohort (p < 0.05).

Conclusion

Our results indicate that T₁ρ provided a better diagnostic capability than clinical standard MRI grading in detecting focal cartilage abnormalities after acute injuries. Quantitative MRI may have great potential in detecting cartilage abnormalities and degeneration non-invasively, which are occult with standard morphological MRI.     

High spatial and angular resolution diffusion-weighted imaging reveals forniceal damage related to memory impairment

Introduction

Diffusion tensor imaging (DTI) measures in patients with multiple sclerosis (MS), particularly those measures associated with a specific white matter pathway, have consistently shown correlations with function. This study sought to investigate correlations between DTI measures in the fornix and common cognitive deficits in MS patients, including episodic memory, working memory and attention.

Materials and Methods

Patients with MS and group age- and sex-matched controls underwent high-resolution diffusion scanning (1-mm isotropic voxels) and cognitive testing. Manually drawn forniceal regions of interest were applied to individual maps of tensor-derived measures, and mean values of transverse diffusivity (TD), mean diffusivity (MD), longitudinal diffusivity (LD) and fractional anisotropy (FA) were calculated.

Results

In 40 patients with MS [mean age±S.D.= 42.55±9.1 years; Expanded Disability Status Scale (EDSS)=2.0±1.2; Multiple Sclerosis Functional Composite (MSFC) score=0.38±0.46] and 20 healthy controls (mean age±S.D.= 41.35±9.7 years; EDSS=0.0±0; MSFC score=0.74±0.24), we found that FA, MD and TD values in the fornix were significantly different between groups (P< .03), and patient performance on the Brief Visuospatial Memory Test-Revised (BVMT-R) was correlated with DTI measures (P< .03).

Discussion

These results are consistent with findings of axonal degeneration in MS and support the use of DTI as an indicator of disease progression.     

MRS study of the effects of minocycline on markers of neuronal and microglial integrity in ALS

Objective

Magnetic resonance spectroscopy (MRS) allows to monitor brain metabolites noninvasively in amyotrophic lateral sclerosis (ALS). The objective of this study was to use MRS to monitor the effect of minocycline treatment (200 mg/day) over a short period (6 weeks) on the brain metabolites in the precentral gyrus and brainstem in newly diagnosed ALS patients.

Methods

Ten ALS patients (not on riluzole treatment) were recruited and submitted to single-voxel proton MRS longitudinal examinations (1) before minocycline treatment, (2) 3 weeks and (3) 6 weeks after initiation of treatment.

Results

Results did not show the expected decrease of N-acetylaspartate/creatine (NAA/Cr) in the precentral gyrus, and an increased NAA/Cr ratio in the brainstem suggested neuronal recovery. The myo-inositol (mI)/Cr ratio was unchanged in the precentral gyrus, but increased in the brainstem, indicating a glial reaction.

Conclusions

MRS results suggest that minocycline treatment could be beneficial in the early stages of ALS.