Common bile duct anteroposterior movement synchronized with inferior vena cava pulsation observed by cine magnetic resonance imaging

Purpose

To reveal the phenomenon of common bile duct (CBD) anteroposterior movement caused by inferior vena cava (IVC) pulsation depending on the cardiac cycle using cine magnetic resonance imaging.

Materials and Methods

A breath-hold trans-axial cine segmented true fast imaging with steady-state precession (trueFISP) sequence was prospectively performed on 11 healthy volunteers to observe CBD anteroposterior movement and IVC pulsation during the cardiac cycle. Changes in IVC anterior–posterior diameter and CBD location were compared using Pearson rank correlation analysis.

Results

Nine (81.8%) of 11 CBDs moved back and forth in synchronicity with IVC anterior wall motion depending on the cardiac cycle; the mean maximum and minimum IVC diameters were 16.2±2.7 and 12.9±3.1 mm, respectively. Two (18.2%) of 11 CBDs and IVC walls did not move; the mean unchanged IVC diameter was 5.3±2.1 mm. There were significant correlations between the mean change in IVC diameter and distance of CBD anteroposterior movement (2.7±2.1 and 1.8±1.4 mm, respectively, r=0.911, P<.05).

Conclusion

Many CBDs move back and forth in synchronicity with IVC pulsation depending on the cardiac cycle.     

3D sensitivity encoded ellipsoidal MR spectroscopic imaging of gliomas at 3T

Purpose

The goal of this study was to implement time efficient data acquisition and reconstruction methods for 3D magnetic resonance spectroscopic imaging (MRSI) of gliomas at a field strength of 3T using parallel imaging techniques.

Methods

The point spread functions, signal to noise ratio (SNR), spatial resolution, metabolite intensity distributions and Cho:NAA ratio of 3D ellipsoidal, 3D sensitivity encoding (SENSE) and 3D combined ellipsoidal and SENSE (e-SENSE) k-space sampling schemes were compared with conventional k-space data acquisition methods.

Results

The 3D SENSE and e-SENSE methods resulted in similar spectral patterns as the conventional MRSI methods. The Cho:NAA ratios were highly correlated (P<.05 for SENSE and P<.001 for e-SENSE) with the ellipsoidal method and all methods exhibited significantly different spectral patterns in tumor regions compared to normal appearing white matter. The geometry factors ranged between 1.2 and 1.3 for both the SENSE and e-SENSE spectra. When corrected for these factors and for differences in data acquisition times, the empirical SNRs were similar to values expected based upon theoretical grounds. The effective spatial resolution of the SENSE spectra was estimated to be same as the corresponding fully sampled k-space data, while the spectra acquired with ellipsoidal and e-SENSE k-space samplings were estimated to have a 2.36–2.47-fold loss in spatial resolution due to the differences in their point spread functions.

Conclusion

The 3D SENSE method retained the same spatial resolution as full k-space sampling but with a 4-fold reduction in scan time and an acquisition time of 9.28 min. The 3D e-SENSE method had a similar spatial resolution as the corresponding ellipsoidal sampling with a scan time of 4:36 min. Both parallel imaging methods provided clinically interpretable spectra with volumetric coverage and adequate SNR for evaluating Cho, Cr and NAA.     

Respiratory variation of the extrahepatic bile duct: evaluation with deep inspiratory and expiratory MRCP

Purpose

The purpose of the study was to evaluate the respiratory variation of the extrahepatic bile duct in morphology including shape, length and duct diameter on the breath-hold magnetic resonance cholangiopancreatography (MRCP) obtained during deep inspiration and deep expiration in patients with or without biliary diseases.

Materials and Methods

This study included 102 patients with or without biliary diseases. Breath-hold MRCP was obtained twice during the end-inspiration and the end-expiration. MRCP images were evaluated for the length, maximal diameter and “bowing” of the extrahepatic bile duct.

Results

In the normal group, the mean maximal diameter of the extrahepatic bile duct was significantly larger on the end-inspiratory MRCP (8.0±2.0 mm) than on the end-expiratory MRCP (7.3±1.8 mm) (P<.0001), while it was not significantly different in the dilated group. In the normal group, 25 (39%) of 65 patients had an increase in the mean maximal diameter of more than 1 mm at the end-inspiration, whereas 4 (11%) of 37 patients in the dilated group had it. The bowing of the extrahepatic bile duct on the end-inspiratory MRCP was observed in 60 (92%) of 65 normal patients, while it was seen in 22 (60%) of 37 patients with biliary dilatation (P<.0001).

Conclusion

Deep inspiratory and expiratory MRCP demonstrated the respiratory variations of the extrahepatic bile duct in the shape (bowing), length and maximal duct diameter in patients with nondilated bile ducts. Awareness of this normal phenomenon will be important for the correct interpretation of MRCP in patients with or without biliary diseases.     

Central neurocytoma: proton MR spectroscopy and diffusion weighted MR imaging findings

Purpose

To present proton magnetic resonance spectroscopy and diffusion-weighted imaging (DWI) findings of central neurocytoma (CN).

Methods and Materials

Imaging findings of seven patients with the histopathological diagnosis of CN (five male and two female; age range, 21–28 years of age) were evaluated retrospectively. In addition to conventional magnetic resonance imaging features, we also assessed the metabolite ratios and tumor normalized apparent diffusion coefficient (NADC), which was calculated by dividing the tumor apparent diffusion coefficient (ADC) values by normal ADC. Approval from our institutional review board was obtained for this review.

Results

The tumor choline/creatine ratios were 5.17±2.38, while N-acetyl aspartate/choline and N-acetyl aspartate/creatine ratios were 0.33±0.15 and 1.84±1.38, respectively. On DWI, tumors had heterogeneous hyperintense appearances when compared with the contralateral parietal lobe white matter and tumor NADC values were 0.63±0.05.

Conclusion

Significantly increased choline/creatine and decreased N-acetyl aspartate/choline ratios with lower NADC values in CN resemble high-grade gliomas and complicate the diagnosis. Familarity its physiologic features would help to presurgical diagnosis of ventricular and exraventricular CNs.     

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.     

Dynamic contrast-enhanced MRI and MR diffusion imaging to distinguish between glandular and stromal prostatic tissues

Purpose

To compare peak enhancement (PE), determined from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and the magnetic resonance (MR) directionally-averaged apparent diffusion coefficient () in glandular versus stromal prostatic tissues and, with this comparison, to infer if the hypothesis that gadolinium-DTPA (Gd-DTPA) does not enter healthy glands or ducts is plausible.

Materials and Methods

MRI, MR spectroscopic imaging, DCE MRI and MR diffusion were evaluated in 17 untreated subjects with suspected or proven prostate cancer. PE and were compared in glandular-ductal tissues [normal peripheral zone and glandular benign prostatic hyperplasia (BPH)] and stromal-low ductal tissues (central gland/mixed BPH and stromal BPH).

Results

The glandular-ductal tissues had lower PE [125±6.4 (% baseline)] and higher [1.57±0.15 (s/10⁻³ mm²)] than the stromal-low ductal tissues [PE=132±5.5 (% baseline) (P<.0008), =1.18±0.20 (s/10⁻³ mm²) (P<1×10⁻⁸)]. A statistical model based upon stepwise regression was generated and completely separated the tissue types: ductal Measure = 448+669× (s/10⁻³ mm²)−10.7×PE (1/%), R²=1.0 and P<8×10⁻¹⁰.

Conclusions

The very different MR results in the glandular-ductal versus stromal-low ductal tissues suggest that these tissues have different underlying structure. These results support the hypothesis that Gd-DTPA does not enter healthy prostatic glands or ducts. This may explain the higher PE and lower that previously have been reported in prostate cancer versus healthy tissue.     

Imaging features of small (≤ 3 cm) pancreatic solid tumors on gadoxetic-acid-enhanced MR imaging and diffusion-weighted imaging: an initial experience

Objective

The objective was to determine imaging features that distinguish small (≤3cm) solid pancreatic adenocarcinoma, neuroendocrine tumor (NET) and solid pseudopapillary tumor (SPT) on gadoxetic-acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighed imaging (DWI).

Materials and methods

Twenty-four adenocarcinomas, 10 NETs and 8 SPTs were retrospectively included. Two radiologists analyzed morphologic features, signal intensity of the tumors on MR images including DWI (b=800) and dynamic enhancement pattern with consensus. Tumor-to-parenchyma ratio and tumor apparent diffusion coefficients (ADCs) were quantitatively assessed.

Results

All adenocarcinomas had an ill-defined margin and irregular shape, and more frequently had pancreatic duct dilatation compared with other tumors (P<.05). All SPTs and all but one of the adenocarcinomas (95.8%) had no arterial enhancement with progressively increased enhancement, whereas seven NETs (70%) had arterial enhancement with progressively decreased enhancement (P<.01). The mean value of tumor-to-parenchyma ratio on arterial and portal phases was significantly higher for NETs, and the mean value of tumor ADCs was significantly lower for SPTs than for other tumors (P<.05).

Conclusions

Gadoxetic-acid-enhanced MRI may aid in differentiation between small adenocarcinomas, NETs and SPTs based on morphologic features with dynamic enhancement pattern in adenocarcinomas, dynamic enhancement pattern with tumor-to-parenchyma ration on arterial and portal phases in NETs, and dynamic enhancement pattern with lower ADC value in SPTs.     

Diffusion-weighted imaging (DWI) of the spleen in patients with liver cirrhosis and portal hypertension

Objective

The purpose of this study was to assess the influence of liver cirrhosis and portal hypertension on diffusion coefficients of the spleen.

Material and Methods

We retrospectively evaluated 50 patients with liver cirrhosis and 50 patients without any history of liver disease who underwent magnetic resonance imaging of the upper abdomen, including echo planar diffusion-weighted imaging using b values of 50, 300 and 600 mm²/s. Spleen apparent diffusion coefficient (ADC), liver ADC, muscle ADC and normalized spleen ADC (defined as the ratio of spleen ADC to muscle ADC) were compared between cirrhotic patients and patients in the control group and correlated with Child–Pugh stages. Reproducibility was assessed by measuring interclass correlation coefficient (n = 11). Additionally, in eight patients, ADC measurements were performed 1 day before and 3 days after transjugular intrahepatic portosystemic shunt (TIPSS) implantation.

Results

Compared with control subjects, patients with cirrhosis and portal hypertension had significantly higher spleen ADCs (P = .0001). There was a statistically significant correlation between Child–Pugh grade and spleen ADC (Pearson correlation coefficient, observer 1 r = 0.6, P = .0001; observer 2 r = 0.5, P = .0001). After TIPSS implantation, we observed a reduction in spleen ADC values. Spleen ADC measurements showed a high reproducibility (interclass correlation coefficient 0.75, P = .001).

Conclusion

Our data suggest that different stages of liver cirrhosis and portal hypertension correlate with ADC values of the spleen. Furthermore, ADC values of the spleen decrease after TIPSS implantation. Further studies are required to understand the potential clinical values of these observations.     

A comparative study at 3 T of sequence dependence of T2 quantitation in the knee

Objective

T₂ mapping has been used widely in detecting cartilage degeneration in osteoarthritis. Several scanning sequences have been developed in the determination of T₂ relaxation times of tissues. However, the derivation of these times may vary from sequence to sequence. This study seeks to evaluate the sequence-dependent differences in T₂ quantitation of cartilage, muscle, fat and bone marrow in the knee joint at 3 T.

Methods

Three commercial phantoms and 10 healthy volunteers were studied using 3 T MR. T₂ relaxation times of the phantoms, cartilage, muscle, subcutaneous fat and marrow were derived using spin echo (SE), multiecho SE (MESE), fast SE (FSE) with varying echo train length (ETL), spiral and spoiler gradient (SPGR) sequences. The differences between these times were then evaluated using Student's t test. In addition, the signal-to-noise ratio (SNR) efficiency and coefficient of variation of T₂ from each sequence were calculated.

Results

The average T₂ relaxation time was 36.38±5.76 ms in cartilage and 34.08±6.55 ms in muscle, ranging from 27 to 45 ms in both tissues. The times for subcutaneous fat and marrow were longer and more varying, ranging from 41 to 143 ms and from 42 to 160 ms, respectively. In FSE acquisition, relaxation time significantly increases as ETL increases (P<.05). In cartilage, the SE acquisition yields the lowest T₂ values (27.52±3.10 ms), which is significantly lower than those obtained from other sequences (P<.002). T₂ values obtained from spiral acquisition (38.27±6.45 ms) were higher than those obtained from MESE (34.35±5.62 ms) and SPGR acquisition (31.64±4.53 ms). These differences, however, were not significant (P>.05).

Conclusion

T₂ quantification can be a valuable tool for the diagnosis of degenerative disease. Several different sequences exist to quantify the relaxation times of tissues. Sequences range in scan time, SNR efficiency, reproducibility and two- or three-dimensional mapping. However, when choosing a sequence for quantitation, it is important to realize that several factors affect the measured T₂ relaxation time.     

Exchange-mediated contrast in CEST and spin-lock imaging

Purpose

Magnetic resonance images of biological media based on chemical exchange saturation transfer (CEST) show contrast that depends on chemical exchange between water and other protons. In addition, spin–lattice relaxation rates in the rotating frame (R_1ρ) are also affected by exchange, especially at high fields, and can be exploited to provide novel, exchange-dependent contrast. Here, we evaluate and compare the factors that modulate the exchange contrast for these methods using simulations and experiments on simple, biologically relevant samples.

Methods

Simulations and experimental measurements at 9.4 T of rotating frame relaxation rate dispersion and CEST contrast were performed on solutions of macromolecules containing amide and hydroxyl exchanging protons.

Results

The simulations and experimental measurements confirm that both CEST and R_1ρ measurements depend on similar exchange parameters, but they manifest themselves differently in their effects on contrast. CEST contrast may be larger in the slow and intermediate exchange regimes for protons with large resonant frequency offsets (e.g. > 2 ppm). Spin-locking techniques can produce larger contrast enhancement when resonant frequency offsets are small (< 2 ppm) and exchange is in the intermediate-to-fast regime. The image contrasts scale differently with field strength, exchange rate and concentration.

Conclusion

CEST and R_1ρ measurements provide different and somewhat complementary information about exchange in tissues. Whereas CEST can depict exchange of protons with specific chemical shifts, appropriate R_1ρ-dependent acquisitions can be employed to selectively portray protons of specific exchange rates.     

Examiner repeatability of patellar cartilage T2 values

Aim

The purpose of this study was to evaluate the intra- and interexaminer resegmentation precision of patellar cartilage T₂ mapping measurements in healthy subjects.

Materials and Methods

T₂-weighted images of patellar cartilage for 10 subjects were acquired. Two individuals manually segmented patellar cartilage at each slice location twice, once on each of two separate days. Bulk average and zonal T₂ values for the superficial, middle, and deep layers of cartilage were calculated. The root mean square (RMS) and coefficient of variation (COV) were calculated using the repeated measurements of each slice of each subject by each examiner.

Results

The intraexaminer bulk T₂ differences were 0.2±1.0 ms, with an RMS error of 0.7 ms and a COV of 1.9%. The differences of interexaminer bulk T₂ values was 1.0±1.4 ms, with an RMS error of 1.2 ms and a COV of 3.3%. The superficial zone of cartilage had the highest zonal variability of T₂ values. The average interexaminer T₂ values for the superficial, middle and deep zones were 42.2±5.6, 38.1±5.3 and 31.9±4.6 ms, respectively.

Conclusion

The interexaminer variability of calculated T₂ values highlights the difficulty of interpreting significant differences of T₂ values which are similar in magnitude. The repeatability measurements of patellar cartilage T₂ values were less than reported intersession T₂ repeatability.     

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.     

Noncontrast MRI with diffusion-weighted imaging as the sole imaging modality for detecting liver malignancy in patients with high risk for hepatocellular carcinoma

Purpose

To compare the diagnostic performance of the noncontrast MRI including DWI to the standard MRI for detecting hepatic malignancies in patients with chronic liver disease.

Materials and methods

We included 135 patients with 136 histologically-confirmed hepatocellular carcinomas (HCCs), 12 cholangiocarcinomas, and 34 benign lesions (≤ 2.0 cm), and 22 patients with cirrhosis but no focal liver lesion who underwent 3.0 T liver MRI. Noncontrast MRI set (T1- and T2-weighted images and DWI) and standard MRI set (gadoxetic acid-enhanced and noncontrast MRI) were analyzed independently by three observers to detect liver malignancies using receiver operating characteristic analysis.

Results

The Az value of the noncontrast MRI (mean, 0.906) was not inferior to that of the combined MRI (mean, 0.924) for detecting malignancies by all observers (P > 0.05). For each observer, no significant difference was found in the sensitivity and specificity between the two MRI sets for detecting liver malignancies and distinguishing them from benign lesions (P > 0.05), whereas negative predictive value was higher with the combined MRI than with the noncontrast MRI (P = 0.0001). When using pooled data, the sensitivity of the combined MRI (mean 94.8%) was higher than that of the noncontrast MRI (mean, 91.7%) (P = 0.001), whereas specificity was equivalent (78.6% vs 77.5%).

Conclusion

Noncontrast MRI including DWI showed reasonable performance compared to the combined gadoxetic acid-enhanced and noncontrast MRI set for detecting HCC and cholangiocarcinoma and differentiating them from benign lesions in patients with chronic liver disease.     

Potential clinical factors affecting hepatobiliary enhancement at Gd-EOB-DTPA-enhanced MR imaging

Objective

The objective was to clarify the clinical factors that might affect the degree of hepatic parenchymal enhancement at gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging.

Materials and Methods

A total of 84 patients with (n=63) and without chronic liver disease (n=21) underwent Gd-EOB-DTPA-enhanced MR imaging. Contrast-enhanced MR images of hepatobiliary phase (HP) were obtained at 20 min after Gd-EOB-DTPA administration. The relative enhancement (RE) of liver parenchyma at 20 min HP was calculated from region of interest measurements at each patient. Then, these results were correlated with various clinical parameters using Pearson correlation coefficient or Spearman rank correlation coefficient. Furthermore, the predictor of the degree of hepatic parenchymal enhancement was determined using multiple regression analysis.

Results

The presence or absence of chronic liver disease (P=.002), ascites (P=.005) and splenomegaly (P=.027), and the values of prothrombin activity (P=.008), total bilirubin (T-Bil) (P=.001), albumin (P=.001), aspartate aminotransferase (AST) (P=.002) and cholinesterase (P=.007) were significantly correlated with the RE of liver parenchyma at 20 min HP. Among these parameters, increases of T-Bil (P=.011 to .028) and AST (P=.018 to .049) were predictors of decreased hepatic parenchymal enhancement.

Conclusions

Hepatic parenchymal enhancement of Gd-EOB-DTPA was affected by various clinical parameters. Impaired hepatobiliary enhancement may be predicted by routine biochemical tests, such as T-Bil and AST.     

Using Gd-EOB-DTPA-enhanced 3-T MRI for the differentiation of infiltrative hepatocellular carcinoma and focal confluent fibrosis in liver cirrhosis

Purpose

The purpose of the study was to determine significant imaging features to differentiate between infiltrative hepatocellular carcinoma (HCC) and confluent fibrosis (CF) in liver cirrhosis using Gd-EOB-DTPA-enhanced 3-T magnetic resonance imaging.

Material and methods

Nineteen infiltrative HCCs and eight CFs were included. We evaluated the difference in imaging findings and apparent diffusion coefficient (ADC) between the two entities. We compared T2-weighted image (WI) and hepatobiliary phase (HBP) in terms of the clarity of the lesion outer margin.

Results

Seventeen infiltrative HCCs showed lobulated margin, while focal CFs showed either straight (n = 3) or irregular margins (n = 5) (P = .001). All infiltrative HCCs had intact or bulging contours, and all focal CFs showed capsular retraction (P = .001). Fourteen infiltrative HCCs and two focal CFs showed arterial enhancement (P = .035). The ADC of infiltrative HCCs was significantly lower than that of CFs (P = .001). Satellite nodules were noted in 10 infiltrative HCCs. In terms of outer margin clarity, infiltrative HCCs showed a more distinct margin on HBP than on T2-WI (P = .005), while these two sequences were not significantly different in focal CFs (P = 1.000).

Conclusion

HBP improved the imaging characteristics of infiltrative HCC, allowing it to be distinguished from focal CF. Infiltrative HCC showed lower ADC values than focal CF. Lobular configuration, contour bulging, enhancement pattern, associated satellite nodules and portal vein thrombosis were still found to be highly suggestive MR findings for infiltrative HCC.     

Voxel- and atlas-based analysis of diffusion tensor imaging may reveal focal axonal injuries in mild traumatic brain injury -- comparison with diffuse axonal injury

Background

The diagnosis and management of mild traumatic brain injury (MTBI) continue to be subjects of debate, with varying opinions regarding the extent to which tissue-based impairments versus the impacts of other stressors cause ongoing disability. Detecting areas of the brain with abnormalities that can explain symptoms and behavior in patients with MTBI is important in order to confirm the diagnosis of MTBI.

Methods

In this study, we calculated diffusion maps from results of diffusion tensor imaging (DTI) performed in an apparently healthy control group. We then compared these maps with those of patients with MTBI (MTBI group) or diffuse axonal injury (DAI group). All diffusion maps were normalized to the International Consortium for Brain Mapping atlas for atlas-based analysis and were segmented and normalized by the Diffeomorphic Anatomical Registration Through Exponentiated Lie tool in SPM8 to reduce misregistration.

Results

All diffusion measures in the DAI group were lower than in the control group. There were significant differences in the body and splenium of the corpus callosum, fornix and right cerebral peduncle in the DAI group compared with the control group (P<.001). The MTBI group had higher axial diffusivity than the control group in the right corticospinal tract, left medial lemniscus, left inferior cerebellar peduncle, bilateral anterior limb of the internal capsule, right anterior corona radiata, bilateral cingulum (cingulate gyrus) and left superior frontooccipital fasciculus (P<.05).

Conclusions

Voxel- and atlas-based analysis of DTI might suggest that patients with MTBI have focal axonal injury and that the pathophysiology is significantly different from that of DAI. These findings will help in the diagnosis of patients with MTBI.     

Measurement of regional cerebral glucose uptake by magnetic resonance spin-lock imaging

Purpose

The regional uptake of glucose in rat brain in vivo was measured at high resolution using spin-lock magnetic resonance imaging after infusion of the glucose analogue 2-deoxy-d-glucose (2DG). Previous studies of glucose metabolism have used ¹³C-labeled 2DG and NMR spectroscopy, ¹⁸F-labeled fluorodeoxyglucose (FDG) and PET, or chemical exchange saturation transfer (CEST) MRI, all of which have practical limitations. Our goal was to explore the ability of spin-lock sequences to detect specific chemically-exchanging species in vivo and to compare the effects of 2DG in brain tissue on CEST images.

Methods

Numerical simulations of R_1p and CEST contrasts for a variety of sample parameters were performed to evaluate the potential specificity of each method for detecting the exchange contributions of 2DG. Experimental measurements were made in tissue phantoms and in rat brain in vivo which demonstrated the ability of spin-lock sequences for detecting 2DG.

Results

R_1p contrast acquired with appropriate spin-lock sequences can isolate the contribution of exchanging protons in 2DG in vivo and appears to have better sensitivity and more specificity to 2DG–water exchange effects than CEST.

Conclusion

Spin-lock imaging provides a novel approach to the detection and measurement of glucose uptake in brain in vivo.     

Effect of ovariectomy on contrast agent diffusion into lumbar intervertebral disc: a dynamic contrast-enhanced MRI study in female rats

Purpose

The purpose was to study the effect of estrogen deficiency on contrast agent diffusion into intervertebral disc in a rat model.

Materials and Methods

Seven-month-old female Sprague–Dawley rats were used. Fourteen rats had ovariectomy, and nine rats had sham surgery. Magnetic resonance imaging (MRI) of sagittal midsection of lumbar spine was performed with a 1.5-T magnet. Dynamic MRI was performed after a bolus injection of Gd-DOTA (0.3 mmol/kg) through tail vein. Eight hundred images were acquired at 0.6 s per acquisition. Regions of interests were drawn over three discs per rat. Maximum enhancement (E_max) and enhancement slope (E_slope) were evaluated. MRI was carried out at baseline and 8 weeks postsurgery.

Result

All disc enhancements demonstrated an initial fast wash-in phase followed by a second slower wash-in phase. For initial wash-in phase, E¹_max and E¹_slope of all rats remained unchanged at the two time points. For second wash-in phase, E²_max and E²_slope of control rats remained unchanged, while with ovariectomized rats, E²_max showed reduction at 8 weeks (4.5%±5.6%) compared to baseline (10.3%±6.3%, P=.037), and E²_slope was lower at 8 weeks (0.015±0.017) than the baseline (0.029±0.022), although it was not statistically significant (P=.101).

Conclusion

Ovariectomy induced detectable decrease in second wash-in phase of contrast agent into lumbar disc.     

Prediction of early response to radiotherapy of uterine carcinoma with dynamic contrast-enhanced MR imaging using pixel analysis of MR perfusion imaging

Purpose

To assess the predictability of the response to radiotherapy of uterine carcinoma, this study retrospectively analyzed dynamic contrast-enhanced magnetic resonance images (DCE-MRI) taken before radiotherapy.

Materials and Methods

Forty-two patients with uterine carcinoma were studied, of whom 22 had adenocarcinoma and 20 had squamous cell carcinoma (SCC). In DCE-MRI analysis, two parameters, SIe and R_down, were measured. SIe is a median value for the degree of signal intensity change in all selected pixels in the tumor at 1–2 min after contrast agent injection. R_down is the ratio of the number of down-sloped pixels to that of all selected pixels 3–7 min after injection. The tumor volume reduction rate (TVRR) was measured by MRI-based volumetry in pre- and post-radiotherapy transverse T2-weighted images.

Results

Overall, TVRR was significantly correlated to both SIe (r=0.37, P=.015) and R_down (r=0.73, P<.0001). In the separate patient groups, SIe but not R_down was significantly different between the adenocarcinoma and SCC patients (t=3.64, P<.001). TVRR was not correlated to SIe in any group. TVRR was significantly correlated to R_down in adenocarcinoma patients (r=0.78, P<.001) but not in SCC patients.

Conclusion

SIe may reflect differences in histological characteristics. R_down may be useful for predicting the response to radiotherapy of uterine carcinoma.     

Ex vivo study of carotid endarterectomy specimens: quantitative relaxation times within atherosclerotic plaque tissues

Purpose

Previous studies reporting relaxation times within atherosclerotic plaque have typically used dedicated small-bore high-field systems and small sample sizes. This study reports quantitative T₁, T₂ and T₂^? relaxation times within plaque tissue at 1.5 T using spatially co-matched histology to determine tissue constituents.

Methods

Ten carotid endarterectomy specimens were removed from patients with advanced atherosclerosis. Imaging was performed on a 1.5-T whole-body scanner using a custom built 10-mm diameter receive-only solenoid coil. A protocol was defined to allow subsequent computation of T₁, T₂ and T₂^? relaxation times using multi-flip angle spoiled gradient echo, multi-echo fast spin echo and multi-echo gradient echo sequences, respectively. The specimens were subsequently processed for histology and individually sectioned into 2-mm blocks to allow subsequent co-registration. Each imaging sequence was imported into in-house software and displayed alongside the digitized histology sections. Regions of interest were defined to demarcate fibrous cap, connective tissue and lipid/necrotic core at matched slice-locations. Relaxation times were calculated using Levenberg-Marquardt's least squares curve fitting algorithm. A linear-mixed effect model was applied to account for multiple measurements from the same patient and establish if there was a statistically significant difference between the plaque tissue constituents.

Results

T₂ and T₂^? relaxation times were statistically different between all plaque tissues (P=.026 and P=.002 respectively) [T₂: lipid/necrotic core was lower 47±13.7 ms than connective tissue (67±22.5 ms) and fibrous cap (60±13.2 ms); T₂^?: fibrous cap was higher (48±15.5ms) than connective tissue (19±10.6 ms) and lipid/necrotic core (24±8.2 ms)]. T₁ relaxation times were not significantly different (P=.287) [T₁: Fibrous cap: 933±271.9 ms; connective tissue (1002±272.9 ms) and lipid/necrotic core (1044±304.0 ms)]. We were unable to demarcate hemorrhage and calcium following histology processing.

Conclusions

This study demonstrates that there is a significant difference between qT₂ and qT₂^? in plaque tissues types. Derivation of quantitative relaxation times shows promise for determining plaque tissue constituents.