MR of an adrenal pseudocyst

We describe the appearance of an adrenal pseudocyst on MRI and CT. The MR characteristics of the lesion were noteworthy in that the lesion had two components with different imaging characteristics. The larger component was of low signal intensity on both T₁- and T₂-weighted images and might have been confused with an adrenal adenoma.     

A rotating phantom for the study of flow effects in MR imaging

A common type of phantom used for the study of flow effects in MR imaging is the tube phantom, where a liquid passes through a set of tubes placed in the main magnetic field of an MR scanner. Among the disadvantages with this type of phantom are that a distribution of velocities is present in each tube, and that quantifications of flow effects using tube phantoms may be very time-consuming. In this work, we describe the design and the properties of a rotating wheel flow phantom used for quantification of the effects of flow through the imaging plane as well as in the imaging plane. The proposed phantom is constructed as a rotating gel-filled wheel, surrounded by static volumes filled with the same gel, and the evaluation of the information from rotating and static parts is made with a specially designed computer program. The phantom can be used as a plug flow phantom covering simultaneously an interchangeable velocity interval, which at present has the range −52 mm/s, +52 mm/s. It is shown that the phantom gives adequate information on the dependence of pixel content on first-order motion in MR modulus and phase images. Among the fields of application are rapid calibration of MR imaging units for flow determination using phase information, as well as testing of pulse sequence characteristics and verification of theoretical predictions concerning the flow dependence in MR images.     

Predictability of SNR and reader preference in clinical MR imaging

Fifty-four independent scans were performed in two volunteers covering one anatomic region in each (the brain and knee) with the purpose of ascertaining the agreement between predicted and measured signal-to-noise ratios (SNR). Systematically varied parameters were number of excitations (NEX), field of view (FOV), section thickness (d_z), and the number of phase-encoding steps (N_y). Correlation coefficients of measured versus predicted SNR were 0.82 and 0.86, respectively, in the anatomies studied. Significantly improved correlations were found for data subpopulations in which NEX was held constant. To assess the criteria guiding reader preference, a blinded study was performed in which radiologists were asked to rate images from least to most desirable. In order to quantitatively determine the criteria for reader preference, plots of mean rating versus SNR, voxel volume, and an image quality index [IQI = SNR/(voxel volume)] were performed. The latter was found to be a better predictor of reader preference than either SNR or spatial resolution alone. The data suggests T₁-weighted scan protocols yielding SNR of approximately 20 are preferable with any excess SNR being traded for smaller voxel size or shorter scan times.     

MR quantification of muscle fatty replacement in McArdle''s disease

McArdle's disease is an energy-dependant disorder of skeletal muscle caused by the inability to break down glycogen. The aim of this study was to quantify fatty replacement in patients with McArdle's disease. Calf and thigh axial spin echo T₁-weighted magnetic resonance (MR) images (repetition time 500 ms, echo time 25 ms) were obtained at 0.5 T in nine patients with McArdle's disease (age 51 ± 16 years, range 26–74) and nine sex- and age-matched healthy subjects (age 52 ± 16 years, range 29–78) to quantify intramuscular fat. Regions of interest were drawn manually, encompassing the largest cross section of muscle. A fatty replacement index (IF) was determined from histograms of signal in the regions of interest in calf and thigh muscles. In normal subjects, IF = 3.6 ± 2.8% in calf and 4.9 ± 2.3% in thigh. In patients, IF = 11 ± 9.3% in calf and 13.5 ± 10.4% in thigh, significantly different from IF values in normal subjects (p = .03). IF correlated well with age in patients (p = .03). In older patients, up to 25% of the muscle volume was replaced by fat. Patients with McArdle's disease, usually weakly disabled, exhibit significant muscle fatty replacement on MR images. These findings suggest a progressive muscle loss over time related to the disease process.     

Magnetic resonance imaging of the normal and pathologic muscular system

Evaluation of the muscular system with magnetic resonance (MR) was conducted: (1) to assess the capability of MR to depict muscular abnormalities; (2) to evaluate the ability of MR to discriminate between various types of muscular pathologies based on relaxation parameters; and (3) to determine the optimal spin echo (SE) sequence that produced optimal contrast. Retrospective analysis was performed on 59 consecutive patients with a variety of muscular abnormalities. MR muscle analysis included visual inspection of contour and size; muscle intensity changes in relation to various TR/TE combinations; measurement of T1 and T2 relaxation and spin density; and calculation of percent contrast variation with different SE imaging combinations. Contour and size abnormalities were not reliable for detection of muscular pathology. For each individual subject intensity and relaxation times of all muscles involved by pathology differed from normal muscle. Although all pathologies caused increase in signal intensity of muscle, the alterations in relaxation times were variable. Fatty atrophy caused a decrease in T1 and increase in T2; while post-surgical changes, infection, acute intramuscular hemorrhage, and tumor invasion caused an increase in both T1 and T2. Percent contrast indicated that the optimum sequence for evaluation of fatty atrophy was a short (0.5 sec) repetition time (TR) and echo delay time (TE) of 56 msec, while for demonstration of the remaining muscular abnormalities, including post-surgical changes, infection, acute intramuscular hemorrhage, and tumor invasion, a long TR (TR = 2.0 sec) and TE (56 msec) was optimal. Differentiation between various benign and malignant muscular abnormalities (excluding fatty atrophy) was not possible using either quantitative intensity values or relaxation times.     

MR findings of intestinal graft-versus-host disease

Graft-versus-host disease (GVHD) occurs as a complication of allogenic bone marrow transplantation (BMT). The disease is characterized by skin rash, jaundice, mucosal inflammation, and diarrhea. In this report, we describe magnetic resonance (MR) findings of intestinal GVHD, which is correlated with endoscopic biopsy. MR findings demonstrated generalized increased bowel wall thickness associated with substantial bowel wall enhancement with gadolinium chelate.     

Cardiac lipoma: Six-year follow-up with MRI characteristics, and a review of the literature

A total of 63 cardiac lipomas have been reported to date. Although most of these rare tumors cause no symptoms, a few can have a detrimental effect on myocardial function as well as displacing and encasing the coronary arteries. This case of a cardiac lipoma was initially seen in 1982. The lipoma was found to be nonresectable at surgery due to involvement of the coronary arteries. This neoplasm was characterized with magnetic resonance imaging in 1989 on a follow-up visit. Magnetic resonance imaging is shown to be superior to computed tomography for identifying the relationship of the lipoma to the coronary arteries. This is a significant factor in determining resectability.     

Magnetic resonance imaging of an infected urethral diverticulum: A case report

We present a case report of a urethral diverticulum where magnetic resonance imaging suggested infected contents of the urethral diverticulum besides providing superb detail of periurethral anatomy. The critical clinical question was answered.     

Comparison of MR perfusion imaging and microsphere measurements of regional cerebral blood flow in a rat model of middle cerebral artery occlusion

The purpose of this investigation was to correlate magnetic resonance (MR) perfusion measurements with absolute regional cerebral blood flow (rCBF) in a rat model of focal ischemia. The MR perfusion measurements were made using dynamic first-pass bolus tracking of a susceptibility contrast agent, whereas rCBF was measured using radioactive microspheres. Two simple MR perfusion parameters, the maximum change in ( ) and time delay to ( ), were derived from the signal intensity versus time curves on a pixel-to-pixel basis, without applying curve-fitting procedures or tracer kinetic theory. In each hemisphere, and were compared with the rCBF measurements in four selected regions of interest. Sixteen MR bolus tracking series were performed in 12 rats with occlusion of the middle cerebral artery. In all of the individual series there was a significant correlation (.0001 ≤ p ≤ .02) between and the microsphere rCBF measurements, with correlation coefficients ranging from .784 to .983. Pooling the data resulted in a correlation coefficient of .809 (p = .0001). There was a nonlinear correlation between the and rCBF. For both parameters there was considerable variation between different measurements regarding both the slope of the regression line and its intercept with the y-axis. Our results justify the use of as a relative measure of perfusion during acute cerebral ischemia. Because of the interindividual variation, calibration of MR perfusion measurements for the estimation of absolute flow values must be considered unreliable. The may have physiological relevance as a marker of collateral flow.     

Effects of radiation therapy on the human normal brain (white matter) visualized by MR imaging

Sequential MR imaging could provide information related to the pathological changes due to the application of external cytotoxic agents such as radiotherapy on the central nervous system. This paper describes the results of our attempt to demonstrate short-term changes associated with normal brain during and immediately following radiotherapy when the whole brain is irradiated for malignant conditions. No observable changes were found in the normal brain parenchyma in any of the patients (n = 8) in T₁-, T₂-, and proton-density-weighted images in the sequential scans in the first and second weeks and immediately following radiotherapy. Also, no changes were observed in the normal brain appearance at 2 mo (n = 6), up to 6 mo (n = 1), and up to 15 mo (n = 1) after completion of radiotherapy.     

The application of proton nuclear magnetic resonance imaging for the in vivo characterisation of chemically induced renal lesions in rats over a prolonged time study

Renal cortical and medullary spin-lattice (T₁) relaxation times were measured at various time points over a period of 56 days following the administration of a single i.p. injection of 100 mg/kg 2-bromoethanamine hydrobromide (BEA), 200 mg/kg hexachloro-1,3-butadiene (HCBD) or 100 mg/kg puromycin aminonucleoside (PAN) to male Wistar rats. Administration of a single injection of HCBD caused a dramatic, immediate rise in the cortical T₁ values above control values, and these levels remained elevated until, by Day 28 postinjection the levels were back to control values. Administration of BEA also caused an elevation in cortical T₁ values, but in this case these values remained above control values for the rest of the study. The administration of PAN did not produce any significant increases in cortical T₁ values until 14 days postinjection. The elevated T₁ values remained above control values for the rest of the study. These increases observed in cortical T₁ values appeared to be mirrored by decreases in medullary T₁ values. Increases in cortical T₁ values were accompanied by visual changes in the NMR images and enlargement of the kidneys. The histological findings were consistent with the NMR data, confirming that morphologically the tissues did show a full recovery by Day 28 in the HCBD-treated animals. This was not the case following injection of both BEA and PAN, where necrosis was not reversible and there was no recovery of the tissues.     

Changes in MR signal intensity and contrast enhancement of therapeutically irradiated soft tissue

Increased MR signal intensity was observed on T₂-weighted, STIR, and Gadolinium-DTPA-enhanced T₁-weighted images of subcutaneous and muscular soft tissue in 9 of 10 children treated with combination chemotheraphy and radiation therapy (RT) for malignancy in the pelvis or an extremity. Total radiation doses ranged from 59.5 to 65 Gy. Eight of the patients with these changes received hyperfractionated RT (seven for Ewing sarcoma and one for perineal rhabdomyosarcoma); one was treated for pelvic hemangiopericytoma with once-daily fractions. Evidence of soft tissue damage became apparent as early as the sixth week of RT and was seen for up to 69 wk post-RT. There was no clear MR evidence of RT-induced soft tissue damage in one patient, who underwent hyperfractionated RT for pelvic rhabdomyosarcoma. Other MR findings in this group included evidence of bladder wall thickening in three of the seven patients given pelvic RT and increased T₁-weighted signal of irradiated marrow in nine patients. All patients had clinical evidence of skin, soft tissue, or epithelial radiation effects. Increased MR signal intensity secondary to RT-induced damage can be differentiated from widespread tumor by geometric borders that conform to the margins of the radiation field.     

Approach to equilibrium in snapshot imaging

The snapshot FLASH sequence uses a subsecond scan time and a small flip angle in conjunction with nonsteady-state acquisition to produce high-contrast images with minimum motion artifacts. The magnetisation evolves towards an equilibrium state in the course of a scan and it is the form of this approach to equilibrium which determines the contrast and signal-to-noise ratio (SNR) obtained. The contrast obtained is strongly dependent on the phase encoding scheme used. If the flip angle is increased, and the resulting transverse coherences refocused, then the SNR is improved while the contrast is little changed.     

Wireless retrospective gating: Application to cine cardiac imaging

A new “wireless” method of cardiac imaging is introduced, which, unlike ECG triggering, allows imaging the heart at end-diastole, and greatly reduces smearing artifacts in the phase-encoding direction. It is an improvement over ECG-driven retrospective gating, in that patients with poor ECGs can be imaged. This method extends the applicability of cardiac imaging, and since it requires no physiological monitoring hardware, can be implemented easily on any MR imager. The images produced by this method are superior to those from ECG triggering, especially when viewed in a “cine” loop. The technique described herein is, furthermore, extendable to any area where periodic or quasi-periodic motion is a problem.     

Fiber-to-field angle dependence of proton nuclear magnetic relaxation in collagen

Longitudinal and transverse proton relaxation times were measured on pig tendon. For T₁, dispersion curves and more accurate measurements at 20 MHz are presented. Values of T₂ were obtained from CPMG pulse sequences, at 20 MHz. The dependence of relaxation times against the fiber-to-field angle was particularly investigated. Longitudinal relaxation rate was found to be almost orientation independent, and presented quadrupolar peaks between 1 and 4 MHz. On the contrary, transverse relaxation, that was well fitted by the sum of four exponentials, was highly orientation dependent. Deconvolution showed that the exponentials decaying most quickly are most orientation dependent. For those two fractions, a cross-relaxation model allowed explaining the fiber-to-field angle dependence, and the specially low rate corresponding to the magic angle of 55°. Finally, each decaying mode was assigned to a fraction of protons localized in the macromolecular structure and characterized by particular dynamics.     

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

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

Surface coil imaging of rat spine at 7.0 T

An inductively coupled surface coil for imaging the rat spine at 7 T is described. This planar circular probe was made from microwave substrate to limit the size of the coil and to minimize the magnetic susceptibility. The surface coil was used as a single transmit/receive coil and as a receive-only coil with a birdcage body coil for excitation. The signal-to-noise ratio (SNR) of the probe was compared to a 5-cm birdcage coil and exceeded the birdcage coil's SNR by three to six times at superficial structures. The main advantages of the probe are an improved SNR for superficial structures and a simple design and use. Images with 50 × 50 × 500 μm voxels were obtained of the rat spine with excellent anatomical detail.     

Determination of velum opening for french nasal vowels by magnetic resonance imaging

MRI techniques have been used to describe velum opening of French vowels. Data based on 18 joined axial slices of 4 mm thickness were recorded with four subjects. Differences in velum opening are calculated from areas measured in the tract between the lowered velum and the back pharynx wall. Results show that for all subjects, the back vowel / / has the smallest opening, while some variations are observed for the other vowels.     

Diffusion-weighted imaging in epilepsy

Diffusion-weighted imaging (DWI) is a relatively new magnetic resonance imaging (MRI) technique that can be used to probe the microenvironment of water. Contrast in DWI depends on properties different from traditional T₁ and T₂ constrast, and is derived from the translational motion of water molecules. Since it is reasonable to think that a change in the microenvironment of water might be reflected in a change in water diffusion characteristics, the quantitative assessment of the (apparent) diffusion coefficient ADCw may represent a unique means of assessing tissue status. DWI has already shown great utility in the study of cerebral ischemia in animal models and has proved useful in the early identification of cerebral ischemia in patients. More recent reports have indicated a potential for DWI in studying epilepsy. Here, we briefly review some of what is known about the measurement of ADCw in ischemia and compare these results with what has recently been reported for epilepsy. In this manner we hope to better understand the underlying mechanisms behind changes in water diffusion associated with specific pathologies.