Increased differentiation of intracranial white matter lesions by multispectral 3D-tissue segmentation: preliminary results

MRI is a very sensitive imaging modality, however with relatively low specificity. The aim of this work was to determine the potential of image post-processing using 3D-tissue segmentation technique for identification and quantitative characterization of intracranial lesions primarily in the white matter. Forty subjects participated in this study: 28 patients with brain multiple sclerosis (MS), 6 patients with subcortical ischemic vascular dementia (SIVD), and 6 patients with lacunar white matter infarcts (LI). In routine MR imaging these pathologies may be almost indistinguishable. The 3D-tissue segmentation technique used in this study was based on three input MR images (T(1), T(2)-weighted, and proton density). A modified k-Nearest-Neighbor (k-NN) algorithm optimized for maximum computation speed and high quality segmentation was utilized. In MS lesions, two very distinct subsets were classified using this procedure. Based on the results of segmentation one subset probably represent gliosis, and the other edema and demyelination. In SIVD, the segmented images demonstrated homogeneity, which differentiates SIVD from the heterogeneity observed in MS. This homogeneity was in agreement with the general histological findings. The LI changes pathophysiologically from subacute to chronic. The segmented images closely correlated with these changes, showing a central area of necrosis with cyst formation surrounded by an area that appears like reactive gliosis. In the chronic state, the cyst intensity was similar to that of CSF, while in the subacute stage, the peripheral rim was more prominent. Regional brain lesion load were also obtained on one MS patient to demonstrate the potential use of this technique for lesion load measurements. The majority of lesions were identified in the parietal and occipital lobes. The follow-up study showed qualitatively and quantitatively that the calculated MS load increase was associated with brain atrophy represented by an increase in CSF volume as well as decrease in "normal" brain tissue volumes. Importantly, these results were consistent with the patient's clinical evolution of the disease after a six-month period. In conclusion, these results show there is a potential application for a 3D tissue segmentation technique to characterize white matter lesions with similar intensities on T(2)-weighted MR images. The proposed methodology warrants further clinical investigation and evaluation in a large patient population.     

Preoperative fast MRI of brain tumors using three-dimensional segmented echo planar imaging compared to three-dimensional gradient echo technique

The purpose of this study was to compare the diagnostic efficacy of a newly developed T(1)-weighted three-dimensional segmented echo planar imaging (3D EPI) sequence versus a conventional T(1)-weighted three dimensional spoiled gradient echo (3D GRE) sequence in the evaluation of brain tumors. Forty-four patients with cerebral tumors and infections were examined on a 1.0 T MR unit with 23 mT/m gradient strength. The total scan time for the T(1) 3D EPI sequence was 2 min 12 s, and for a conventional 3D GRE sequence it was 4 min 59 s. Both sequences were performed after administration of a contrast agent. The images were analyzed by three radiologists. Image assessment criteria included lesion conspicuity, contrast between different types of normal tissue, and image artifacts. In addition, signal-to-noise and contrast-to-noise-ratio (C/N) were calculated. The gray-white differentiation and C/N ratio of 3D EPI were found to be inferior to conventional 3D GRE images, but the difference was not statistically significant. In the qualitative comparison, lesion detection and conspicuity of 3D EPI images and conventional 3D GRE images were similar, but a tow-fold reduction of the scanning time was obtained. With the 3D EPI technique, a 50% scan time reduction could be achieved with acceptable image quality compared to conventional 3D GRE. Thus, the 3D EPI technique could replace conventional 3D GRE in the preoperative imaging of brain.     

Application of fuzzy c-means segmentation technique for tissue differentiation in MR images of a hemorrhagic glioblastoma multiforme

The application of a raw data-based, operator-independent MR segmentation technique to differentiate boundaries of tumor from edema or hemorrhage is demonstrated. A case of a glioblastoma multiforme with gross and histopathologic correlation is presented. The MR image data set was segmented into tissue classes based on three different MR weighted image parameters (T₁-, proton density-, and T₂-weighted) using unsupervised fuzzy c-means (FCM) clustering algorithm technique for pattern recognition. A radiological examination of the MR images and correlation with fuzzy clustering segmentations was performed. Results were confirmed by gross and histopathology which, to the best of our knowledge, reports the first application of this demanding approach. Based on the results of neuropathologic correlation, the application of FCM MR image segmentation to several MR images of a glioblastoma multiforme represents a viable technique for displaying diagnostically relevant tissue contrast information used in 3D volume reconstruction. With this technique, it is possible to generate segmentation images that display clinically important neuroanatomic and neuropathologic tissue contrast information from raw MR image data.     

Field-map correction in read-out segmented echo planar imaging for reduced spatial distortion in prostate DWI for MRI-guided radiotherapy applications

Diffusion-weighted echo planar imaging (DW-EPI) suffers from geometric distortion due to low phase-encoding bandwidth. Read-out segmented echo planar imaging (RS-EPI) reduces distortion but residual distortion remains in extreme cases. Additional corrections need to be applied, especially for radiotherapy applications where a high degree of accuracy is needed. In this study the use of magnetic field map corrections are assessed in DW-EPI and RS-EPI, to reduce geometric uncertainty for MRI-guided radiotherapy applications. Magnetic field maps were calculated from gradient echo images and distortion corrections were applied to RS-EPI images. Distortions were assessed in a prostate phantom by comparing to the known geometry, and in vivo using a modified Hausdorff distance metric using a T2-weighted spin echo as ground truth. Across 10 patients, field map-corrected RS-EPI reduced maximum distortion by 5 mm on average compared to DW-EPI (σ = 1.9 mm). Geometric distortions were also reduced significantly using field mapping with RS-EPI, compared to RS-EPI alone (p ≤ 0.05). The increased geometric accuracy of these techniques can potentially allow diffusion-weighted images to be fused with other MR or CT images for radiotherapy treatment purposes.     

MR imaging of radiation osteitis in the sacroiliac joints

The purpose of this study was to analyze magnetic resonance (MR) images of radiation osteitis of sacroiliac joints, retrospectively. Seven patients with radiation osteitis, which was diagnosed by pelvic plain radiographs and CT images, underwent MRI. T(1)-weighted spin echo images and T(2)-weighted fast spin echo images were obtained in all patients. Four patients were examined after gadolinium injection. Major signal changes of radiation osteitis were distributed on the iliac side. T(1)-weighted images showed diffuse low intensity both in sacral and iliac sides. T(2)-weighted images showed very low intensity adjacent to sacroiliac joints, but mixed intensity was illustrated apart from joints, and high intensity in the peripheral areas. Radiation osteitis showed slight to mild, but irregular enhancement in four patients after gadolinium administration. MRI can illustrate abnormal bone change distribution and is useful for diagnosing this entity by characteristic intensity patterns on T(1)-weighted images with and without gadolinium and T(2)-weighted image. However, the diagnosis of accompanied insufficiency fractures in the area of radiation osteitis is occasionally difficult with conventional MRI.     

MR signal change in venous thrombus relates organizing process and thrombolytic response in rabbit

Venous thrombus is subsequently organized and replaced by fibrous connective tissue. However, the sequential changes in venous thrombi are not reliably detected by current noninvasive diagnostic techniques. The purpose of this study is to reveal whether magnetic resonance (MR) can detect venous thrombus, define thrombus age and predict thrombolytic responses. Thrombus in the rabbit jugular vein was imaged with a 1.5-T MR system at 4 h and at 1, 2 and 4 weeks using three-dimensional (3D) fast asymmetric spin echo T2-weighted (T2W) and 3D-gradient echo T1-weighted (T1W) sequences. The jugular veins were histologically assessed at each time point. Magnetic resonance imaging (MRI) was also performed in vivo before and 30 min after tissue plasminogen activator (t-PA) administration. The thrombi in MRI were comparable in size to histological sections. The signal intensity (SI) of thrombi at 4 h was heterogeneously high or low on T2W or T1W images, respectively. The SI of thrombi on T2W images decreased time-dependently, but increased on T1W images at 1 and 2 weeks. Morphological analysis showed time-dependent decreases in erythrocyte, platelet and fibrin areas and time-dependent increases in smooth muscle cell, macrophage, collagen and iron areas. The t-PA administration significantly decreased thrombus volume at 4 h but not at 1, 2 and 4 weeks. Venous thrombosis can be reliably and noninvasively detected by MRI. Measurement of SI might support assessments of thrombus age and thrombolytic response.     

Hepatic alveolar echinococcosis: MRI findings

The purpose of this study was to describe the magnetic resonance imaging (MRI) appearance of hepatic alveolar echinococcosis (HAE) on T(1)-weighted, T(2)-weighted and postgadolinium images. A total of 13 lesions were demonstrated in 13 patients. All patients underwent MR examination at 1 T imager. MR examinations included precontrast T(1)-weighted breathing averaged spin echo (SE), breath-hold spoiled gradient echo, T(2)-weighted TSE sequences with and without fat suppression, and T(1)-weighted breath-hold spoiled gradient echo (SGE) sequence following i.v. after gadolinium administration. All lesions were confirmed with histopathology. HAE hepatic lesions revealed geographic patterns of variable signal intensities on noncontrast T(1)- and T(2)-weighted images. Slightly hyperintense, iso- and hypointense signal on T(1)-weighted images corresponded to calcified regions, which appeared hypo-isointense signal on T(2)-weighted images. Necrotic areas were hypointense signal on T(1)-weighted and hyperintense signal on T(2)-weighted images. On postgadolinium images, lesions did not reveal enhancement. Dilatation of intrahepatic bile ducts distal to HAE abscesses were observed in five patients and portal vein invasion or compression was observed in four patients, lobar atrophy of the liver was coexistent finding in cases with portal vein compression. The MRI appearance of HAE abscesses included large irregularly marginated masses with heterogenous signal on T(1)- and T(2)-weighted images and lack of enhancement with gadolinium.     

Handcrafted fuzzy rules for tissue classification

This article proposes a handcrafted fuzzy rule-based system for segmentation and identification of different tissue types in magnetic resonance (MR) brain images. The proposed fuzzy system uses a combination of histogram and spatial neighborhood-based features. The intensity variation from one type of tissue to another is gradual at the boundaries due to the inherent nature of the MR signal (MR physics). A fuzzy rule-based approach is expected to better handle these variations and variability in features corresponding to different types of tissues. The proposed segmentation is tested to classify the pixels of the T2-weighted axial MR images of the brain into three primary tissue types: white matter, gray matter and cerebral-spinal fluid. The results are compared with those from manual segmentation by an expert, demonstrating good agreement between them.     

An automatic cerebellum extraction method in T1-weighted brain MR images using an active contour model with a shape prior

Purpose

The objective of this paper was to automatically segment the cerebellum from T1-weighted human brain magnetic resonance (MR) images.

Materials and Methods

The proposed method constructs a cerebellum template using five sets of 3-T MR imaging (MRI) data, which are used to determine the initial position and the shape prior of the cerebellum for the active contour model. Our formulation includes the active contour model with shape prior, which thereby maintains the shape of the template. The proposed active contour model is sequentially applied to sagittal-, coronal- and transverse-view images. To evaluate the proposed method, it is applied to BrainWeb data and a 3-T MRI data set and compared with FreeSurfer with respect to performance assessment metrics.

Results

The segmented cerebellum was compared with the results from FreeSurfer. Using the manually segmented cerebellum as reference, we measured the average Jaccard coefficients of the proposed method, which were 0.882 and 0.885 for the BrainWeb data and 3-T MRI data set, respectively.

Conclusion

We presented the active contour model with shape prior for extracting the cerebellum from T1-weighted brain MR images. The proposed method yielded a robust and accurate segmentation result.     

Optimizing T2-weighted magnetic resonance sequences for surface coil microimaging of the eye with regard to lid, eyeball and head moving artifacts

PURPOSE: To acquire high-resolution magnetic resonance (MR) images, we developed a new blinking artifact reduced pulse (BARP) sequence with a surface coil specialized for microscopic imaging (47 mm in diameter). MATERIALS AND METHODS: To reduce eye movement, we ascertained that the subjects' eyes were kept open and fixated to the target in the 1.5-T MR gantry. To reduce motion artifacts from blinking, we inserted rest periods for blinking (1.5 s within every 5 s) during MR scanning (T2-weighted fast spin echo; repetition time, 5 s; echo time, 100 ms; echo train, 11; matrix, 256 x 128; field of view, 5 cm; 1-mm thickness x 30 slices). Three scans (100 s x 3) were performed for each normal subject, and they were added together after automatic adjustment for location to reduce quality loss caused by head motion. RESULTS: T2-weighted MR images were acquired with a high resolution and a high signal-to-noise ratio. Motion artifacts were reduced with BARP, as compared with those with random blinking. Intraocular structures such as the iris and ciliary muscles were clearly visualized. Because the whole eye can be covered with a 1-mm thickness by this method, three-dimensional maps can easily be generated from the obtained images. CONCLUSION: The application of BARP with a surface coil of the human eye might become a useful and widely adopted procedure for MR microimaging.     

Evaluation of the inner ear by 3D fast asymmetric spin echo (FASE) MR imaging: phantom and volunteer studies

The 3D fast asymmetric spin echo (FASE) method combines the half-Fourier technique and 3D fast spin echo (FSE) sequence. The advantage of this method is that it maintains the same spatial resolution as FSE while markedly reducing the imaging time. The purpose of the present study was to evaluate the usefulness of the 3D FASE technique in displaying the inner ear structure using phantom and volunteer studies. 3D FSE sequence images were obtained for comparison, and the optimum 3D FASE sequence was investigated on a 1.5T MR scanner. The results of phantom experiments showed increased signal-to-noise ratio (SNR) with prolonging repetition time (TR) on both 3D FASE and 3D FSE sequences. Although the SNR of 3D FASE images was 20-25% lower than that of 3D FSE images with the same TR, the SNR per minute with 3D FASE was about twice that with 3D FSE. On 3D FASE images, a higher spatial resolution was obtained with 2- or 4-shot images than with single-shot images. However, no significant difference was observed between 2-shot and 4-shot images. In the volunteer study, 3D FASE images using a TR of 5000 ms and an effective echo time (TEeff) of 250 ms showed a high SNR and spatial resolution and provided excellent contrast between cerebrospinal fluid and nerves in the internal auditory canal. The highest contrast was achieved in the 2-shot/2 number of excitations sequence. 3D FASE provides the same image quality as 3D FSE with a significant reducing in imaging time, and gives strong T2-weighted images. This method enables detailed visualization of the tiny structures of the inner ear.     

MR imaging findings of infectious cholangitis

The purpose of this study was to evaluate the appearance of infectious cholangitis on MRI. The MR images of 13 patients (9 women, 4 men; age range, 14-79 years) with clinically confirmed infectious cholangitis, who represent our complete 9.5 year experience with this entity, were retrospectively evaluated. All MR studies were performed at 1.5 T and included: in-phase and out-of-phase T(1)-weighted spoiled gradient echo (SGE), T(2)-weighted fat-suppressed echo train spin echo, single shot T(2)-weighted sequences, and serial postgadolinium T(1)-weighted SGE sequences without and with fat-suppression. The biliary ductal system was evaluated regarding presence of dilatation, stenosis, wall irregularities, wall thickening, and gadolinium enhancement of duct walls. The liver parenchyma was evaluated regarding focal signal abnormalities on precontrast and serial postgadolinium images. Biliary ductal dilatation was observed in 100% of patients. Mild to moderate thickening of bile duct walls combined with increased enhancement on postgadolinium images was observed in 92% of patients. The liver parenchyma showed periportal or wedge-shaped areas of hyperintense signal on T(2)-weighted images in 69% of patients. On T(1)-weighted images, 54% of patients showed areas of hypointense signal and 15% of patients showed wedge-shaped hyperintense areas. Areas with increased enhancement on immediate postgadolinium SGE were observed in 58% of patients, and in 42% of patients increased enhancement persisted on 2 min postgadolinium fat-suppressed images. Distinctive MRI findings on pre- and postgadolinium images are appreciated for infectious cholangitis.     

An energy minimization method for MS lesion segmentation from T1-w and FLAIR images

In this paper, we extend the multiplicative intrinsic component optimization (MICO) algorithm to multichannel MR image segmentation, with focus on segmentation of multiple sclerosis (MS) lesions. The MICO algorithm was originally proposed by Li et al. in Ref. [1] for normal brain tissue segmentation and intensity inhomogeneity correction of a single channel MR image, which exhibits desirable advantages over other methods for MR image segmentation and intensity inhomogeneity correction in terms of segmentation accuracy and robustness. In this paper, we extend the MICO algorithm to multi-channel MR image segmentation and enable the segmentation of MS lesions. We assign different weights for different channels to control the impact of each channel. The weighted channels allow the enhancement of the impact of the FLAIR image on the segmentation of MS lesions by assigning a larger weight to the FLAIR image channel than the other channels. With the inherent mechanism of estimation of the bias field, our method is able to deal with the intensity inhomogeneity in the input multi-channel MR images. In the application of our method, we only use T1-w and FLAIR images as the input two channel MR images. Experimental results show promising result of our method.     

Ovarian Brenner tumors: MR imaging characteristics

This study describes the appearance of Brenner tumors on MR imaging and compares quantitative signal intensity measurements of Brenner tumors with that of other ovarian tumors. A search of pathologic and MR records disclosed patients who had MRIs showing Brenner tumors prior to surgical excision. Patients (21) with other surgically proven ovarian masses were randomly selected for comparison. MR imaging was performed at 1.5 T with phased array multicoils and fast spin echo T2-weighted images. Region-of-interest measurements of signal intensity (SI) were made to calculate signal intensity ratios (SIR = mass SI/muscle SI). Brenner tumors showed significantly lower SIR than other tumors on T2-weighted images (p = 0 .004) and similar SIR on T1-weighted images. Brenner tumors show lower signal intensity on T2-weighted images than other non-fibrous ovarian tumors. This lower signal intensity may result from the extensive fibrous content of these tumors.     

Conventional high resolution versus fast T(2)-weighted MR imaging of the heart: assessment of reperfusion induced myocardial injury in an animal model

Cardiac image quality in terms of spatial resolution and signal contrast was assessed for conventional and newly developed T(2)-weighted fast spin-echo imaging with high k-space segmentation. The capability in revealing regional myocardial edema and cellular damage was examined by a porcine model using histopathologic correlation. Twelve porcine hearts were excised from slaughtered animals and instantly perfused with 1000 mL cold cardioplegic solution. After 4 h of cold ischemia the hearts were reperfused for one hour using a "Langendorff" perfusion model followed by MR imaging at 1.5 Tesla. Three additional pig hearts served as controls and were studied by MR directly after harvesting. Histopathological analysis of regional tissue changes was performed macro- and microscopically. Short axis T(2)-weighted (3000/45 and 90) high quality fast spin-echo (FSE) images were recorded without cardiac action and signal intensity was correlated with histology. These images also served as gold standard for evaluation of newly developed faster sequences allowing measuring times shorter than 20 s. Fast T(2)-weighted imaging comprised single-slice fast spin echo (moderate echo train length of 23 echoes, FSE(m)), and multi-slice single-shot half-Fourier fast spin-echo (71 echoes, FSE(HASTE)) sequences, supplemented by versions with inversion recovery preparation (FSE(m)IR and FSE(HASTE)IR). Systolic function after reperfusion was restored in 10 porcine hearts. Tissue alterations included myocardial edema and contraction band necrosis which was found to be most severe in myocardium with maximum T(2) SI. Especially FSE(m) and FSE(m)IR sequences allowed differentiation of all categories of tissue damage on a high level of significance. In contrast, single-shot FSE(HASTE) and FSE(HASTE)IR sequences did not provide sufficient image quality to discriminate moderate and severe myocardial damage (p > 0.05). Different degrees of myocardial injury after ischemia and reperfusion can be staged by MR imaging, especially using conventional high resolution T(2)-weighted FSE sequences. The animal study indicates that fast T(2)-weighted FSE(m) and FSE(m)IR sequences lead to superior image quality and diagnostic accuracy compared to FSE(HASTE) and FSE(HASTE)IR imaging.     

3D spin-lock imaging of human gliomas

We investigated whether the simultaneous use of paramagnetic contrast medium and 3D on-resonance spin lock (SL) imaging could improve the contrast of enhancing brain tumors at 0.1 T. A phantom containing serial concentrations of gadopentetate dimeglumine (Gd-DTPA) in cross-linked bovine serum albumin (BSA) was imaged. Eleven patients with histologically verified glioma were also studied. T₁-weighted 3D gradient echo images with and without SL pulse were acquired before and after a Gd-DTPA injection. SL effect, contrast, and contrast-to-noise ratio (CNR) were calculated for each patient. In the glioma patients, the SL effect was significantly smaller in the tumor than in the white and gray matter both before (p = 0.001, p = 0.025, respectively), and after contrast medium injection (p < 0.001, p < 0.001, respectively). On post-contrast images, SL imaging significantly improved tumor contrast (p = 0.001) whereas tumor CNR decreased slightly (p = 0.024). The combined use of SL imaging and paramagnetic Gd-DTPA contrast agent offers a modality for improving tumor contrast in magnetic resonance imaging (MRI) of enhancing brain tumors. 3D gradient echo SL imaging has also shown potential to increase tissue characterization properties of MR imaging of human gliomas.     

A fast screening protocol for carotid plaques imaging using 3D multi-contrast MRI without contrast agent

PurposeTo implement a fast (~ 15 min) MRI protocol for carotid plaque screening using 3D multi-contrast MRI sequences without contrast agent on a 3 Tesla MRI scanner.Materials and methods7 healthy volunteers and 25 patients with clinically confirmed transient ischemic attack or suspected cerebrovascular ischemia were included in this study. The proposed protocol, including 3D T1-weighted and T2-weighted SPACE (variable-flip-angle 3D turbo spin echo), and T1-weighted magnetization prepared rapid acquisition gradient echo (MPRAGE) was performed first and was followed by 2D T1-weighted and T2-weighted turbo spin echo, and post-contrast T1-weighted SPACE sequences. Image quality, number of plaques, and vessel wall thicknesses measured at the intersection of the plaques were evaluated and compared between sequences.ResultsAverage examination time of the proposed protocol was 14.6 min. The average image quality scores of 3D T1-weighted, T2-weighted SPACE, and T1-weighted magnetization prepared rapid acquisition gradient echo were 3.69, 3.75, and 3.48, respectively. There was no significant difference in detecting the number of plaques and vulnerable plaques using pre-contrast 3D images with or without post-contrast T1-weighted SPACE. The 3D SPACE and 2D turbo spin echo sequences had excellent agreement (R = 0.96 for T1-weighted and 0.98 for T2-weighted, p < 0.001) regarding vessel wall thickness measurements.ConclusionThe proposed protocol demonstrated the feasibility of attaining carotid plaque screening within a 15-minute scan, which provided sufficient anatomical coverage and critical diagnostic information. This protocol offers the potential for rapid and reliable screening for carotid plaques without contrast agent.     

Skeletal muscle lymphoma: MRI evaluation.

The magnetic resonance imaging (MRI) features of two cases of malignant lymphoproliferative disease involving skeletal muscle are presented. In both cases involved muscles were quantitatively and subjectively hypointense to fat on T1-weighted spin echo images, hypointense or isointense on T2-weighted spin echo images, and hyperintense on short tau inversion recovery (STIR) images. The findings suggest that lymphoproliferative disease should be considered as an etiology of a skeletal muscle lesion that is hypointense or isointense to fat on T2-weighted spin echo magnetic resonance images.     

Exophytic benign tumors of the liver: appearance on MRI.

The purpose of our study was to determine the MR imaging appearance of exophytic benign liver tumors on precontrast and postgadolinium images. We reviewed our 9.5 year experience with MRI of the liver with dynamic gadolinium enhanced imaging to identify four patients with five histologically proven exophytic benign liver tumors. The histological diagnoses were cavernous hemangioma (2), focal nodular hyperplasia (FNH) (1), and hepatocellular adenoma (HCA) (2 exophytic adenomas in a patient with adenomatosis of the liver). All MRI studies were performed at 1.5 T and included: in-phase and out-of-phase T1-weighted spoiled gradient echo (SGE), T2-weighted fat-suppressed echo train spin echo, single shot T2-weighted sequences, and serial postgadolinium T1-weighted SGE sequences without and with fat-suppression. Prospective interpretations were reviewed and retrospective consensus readings of all MR images were performed assessing location, size, origin, morphology, visibility of the connection to the liver, signal characteristics on precontrast T1-weighted and T2-weighted images, and enhancement patterns on serial postgadolinium images. Three of the five tumors were pedunculated and connected to the liver by a thin stalk, which was prospectively identified in one patient. On precontrast and serial postgadolinium images, all exophytic tumors showed signal characteristics comparable to imaging features of standard intraparenchymal benign liver tumors. Our findings illustrate that the characteristic T1, T2, and postgadolinium imaging findings of these tumors permit correct identification of their liver origin despite their exophytic location, even if their connection with liver is not visualized.     

Gadolinium-DTPA enhanced MR imaging of intramuscular abscesses

Sterile, chemical and bacterial abscesses were induced in the paraspinal muscles of 16 rats before obtaining magnetic resonance (MR) images using a 0.35-T resistive system. Abscess intensity, T1 and T2 values were recorded before and after the intravenous administration of Gd-DTPA (0.2 mmol/kg). The MR appearances of the abscesses were correlated with histologic sections. Both sterile and bacterial abscess were detected on MR images without the use of contrast medium, particularly on the T2-weighted spin echo sequence (TE/TR 56/2000 ms). However, the inflammatory zones of abscesses markedly enhanced in intensity with a corresponding decrease in T1 values after the administration of Gd-DTPA (TE/TR 28/500 ms). A clear distinction between the necrotic center and the cellular periphery of each abscesses was evident only after contrast enhancement (TE/TR 28/500 ms). Thus paramagnetic Gadolinium-DTPA was beneficial for defining the histologic components of abscesses on spin echo MR images.