Magnetic resonance imaging of skeletal muscle. Prolongation of T1 and T2 subsequent to denervation

The changes seen in the T1 and T2 relaxation times, water content and size of the extracellular fluid spaces of rat muscle samples following 15 days of denervation were studied by in vitro proton NMR spectrometry (10 MHz). Two different skeletal muscle groups (gastrocnemius and soleus) were studied. Denervation led to longer T1 values: 548 +/- 61 msec vs. 486 +/- 16 msec (P less than .05) for the gastrocnemius and 581 +/- 27 msec vs. 521 +/- 25 msec (P less than .05) for the soleus. Similar increases in T2 were measured. The sizes of the extracellular fluid spaces of denervated muscle were significantly larger despite a minor increase in total water content. Overall, the relaxation times of skeletal muscle correlated better with the size of the extracellular fluid space than with the total water content.

Developmental changes in proton magnetic resonance relaxation times of cardiac and skeletal muscle

Proton magnetic resonance relaxation time measurements were used to study developmental changes in rabbit cardiac and skeletal muscles during the last days of gestation and at several postnatal times. Tissue water content decreased steadily during late fetal and early postnatal stages of development. During this period T1 and T2 for cardiac and skeletal muscles also decreased. The relaxation times stabilized after the 20th postnatal day, and at this juncture the T1 and T2 values for myocardium remained consistently higher than for skeletal muscle. The developmental changes in proton relaxation time probably represent changes in water distribution and mobility as well as macromolecular structure during muscle maturation.

NMR of skeletal muscle. Differences in relaxation parameters related to extracellular/intracellular fluid spaces

The relationships between the T1 and T2 relaxation times, tissue water content and extracellular fluid space of two types of skeletal muscle groups were studied in rabbits and rats by means of NMR proton spectroscopy (10 MHz). Although there was no significant difference in the total water content between muscles rich in type I (74.5 +/- .8%; soleus) or type II (75.0 +/- .7%; gastrocnemius) fibers, the respective T1 (521 +/- 25 vs. 486 +/- 16 millisecond; p less than .01) and T2 (39.5 +/- 1.8 vs. 36.5 +/- 1.0 millisecond; p less than .01) relaxation times were consistently prolonged. The longer relaxation times of the soleus as compared with the gastrocnemius muscle were related to a larger extracellular fluid space as measured by (35S) sulfate +34.5%; p less than .01). For this reason, it seems likely selective changes in these spaces will be detectable by NMR proton imaging.

Reflex inhibition of urethral sphincters to permit voiding in paraplegia

When the spinal motoneurons innervating the external sphincter of the urethra cannot be inhibited voluntarily due to lesions of the spinal cord, the normal capacity to relax this physiologic valve during micturition is lost. Even if contractions of the bladder occur, urinary outflow may be completely blocked at the sphincter, leading to distention of the bladder and the risk of urinary infection. A method is described for controllably relaxing the sphincter, which permits free outflow of urine in paraplegic cats. One pudendal nerve is sectioned, paralyzing half of the sphincter, but leaving the experimental animals entirely continent. The motoneurons supplying the other half of the sphincter are inhibited by means of spinal reflexes, eliminating active resistance to urethral flow. The simplicity of this approach suggests that it may prove equally effective in human paraplegia.

Application of the maximum likelihood principle to separate exponential terms in T2 relaxation of nuclear magnetic resonance

The method of maximum likelihood has been implemented for the estimation of multiple exponential components of T2 decay curves in spin echo NMR measurements on biologic tissues. Each Each component contributes an exponential term described by two parameters (initial amplitude and T2) to the T2 decay curve. The maximum likelihood method estimates the parameters and their standard errors for all terms simultaneously, avoiding the subjectivity inherent in methods such as graphical peeling. In the model used, it was assumed that water protons are compartmentalized and that the measured spin echo signals from the protons undergoing relaxation obey the Poisson distribution. A system of non-linear equations was derived and solved iteratively for the values of the exponential parameters which maximize the likelihood of obtaining the observed data under these assumptions. The approach was implemented for bi- and tri-exponential models on a MicroVAX II computer (Digital Equipment Corporation, Maynard, MA). Simulations of bi- and tri-exponential data, with and without system noise, were analyzed to assess the accuracy and reproducibility of the method. A subset of the simulations was repeated with non-linear least squares techniques and was compared to the results obtained with maximum likelihood. Rabbit muscle and gerbil brain samples were measured and analyzed with the maximum likelihood method. The simulations showed that within specific limits on relative sizes and relaxation rates of components, these parameters can be estimated with errors less than 5%. The comparison to non-linear least squares analysis showed that the maximum likelihood method is generally superior in estimating the parameters in difficult cases. The results from tissue measurements demonstrate that the method is effective even in cases where graphical peeling would clearly not yield reliable results.

Fast imaging of CSF flow/motion patterns using steady-state free precession (SSFP)

Using a rapid Fourier SSFP imaging technique, which is sensitive to slow flow (approximately 1 mm/sec) in the plane of the image, we obtained 135 brain MRI examinations. The CSF flow/motion patterns were mapped by two images with orthogonal in plane flow sensitivity directions. Analysis showed significant deviations from the "normal" pattern in ventricular enlargements because of obstruction (no evidence of CSF flow/motion) or in normal pressure hydrocephalus (complex, intensive flow pattern in lateral ventricles) suggesting a diagnostic potential for this fast imaging technique.

Myelinated and nonmyelinated nerves: comparison of proton MR properties

The magnetic resonance (MR) relaxation rates of protons were compared in the myelinated and nonmyelinated nerves of the garfish. The long, large olfactory nerve of the garfish, as an easily accessible source of nonmyelinated axons, is uniquely suited for such a comparison. The T1 and T2 measurements revealed distinct and consistent differences between nonmyelinated olfactory nerves and myelinated optic and oculomotor nerves. Comparisons between water content, lipid content, and relaxation rates indicated that the differences in MR properties represent complex differences in the distribution and physical environment of the constituent lipid and water protons.

Comparison of I-123 IMP cerebral uptake and MR spectroscopy following experimental carotid occlusion

Both I-123 IMP scintigraphy and MRI have been suggested as sensitive detectors of changes shortly after acute cerebral infarction. We compared the uptake of N-isopropyl I-123 p-iodoamphetamine (IMP) and MR spectroscopy of the brain after internal carotid artery ligation. Thirteen gerbils were lightly anesthetized with ether. After neck dissection, an internal carotid artery was occluded. After 2.8 hours, 100 muCi I-123 IMP was injected intravenously into the 13 experimental animals plus three controls. Seven gerbils remained asymptomatic while six developed hemiparesis. At 3 hours after ligation, the animals were killed. The brains were bisected and T1 and T2 relaxation times were determined for the right and left hemispheres by MR spectroscopy immediately after dissection. I-123 IMP uptake was then determined in the samples. Interhemispheric differences in uptake for I-123 IMP were 0.1 +/- 1.7% (SEM) in the control, 33.5 +/- 10% in the asymptomatic and 54.6 +/- 9.7% in the symptomatic animals. Significant differences were seen with I-123 IMP in 6/7 asymptomatic and 6/6 symptomatic animals. In conclusion, I-123 is more sensitive than T1 or T2 relaxation times for the detection of cerebral perfusion abnormalities. Prolongation in T1 and T2 relaxation times correlates closely with increased brain tissue water content and the development of symptoms, indicators of structural brain damage and probable infarction.

Wallerian degeneration demonstrated by magnetic resonance: spectroscopic measurements on peripheral nerve

Wallerian degeneration of rat sciatic nerves was induced by nerve section. Fifteen days later the degenerated nerves were compared with the intact contralateral nerves from the same animal. Histological sections showed the changes typical of wallerian degeneration: axonal degeneration and secondary demyelination. The freshly dissected nerves were analyzed by magnetic resonance (MR) spectroscopy at 10 MHz, and the water content was determined by dehydration. In the degenerated nerves there was a marked prolongation of both T1 and T2 relaxation times, accompanied by an increase of water content. The results demonstrate the sensitivity of MR for detection of secondary demyelination and disintegration of nerve structures. These results suggest that it should be possible to detect wallerian degeneration in MR images; this will have an important impact on neuropathological diagnosis of central and peripheral nervous system lesions.

Functional imaging of the brain

New neurophysiological methods such as 2-deoxy-D-glucose (2DG) autoradiography have stimulated rapid changes in emission imaging with radionuclides. It has been recognized that general imaging concepts and methods can be applied to many interactions of waves, particles, or fields within the body. X-ray computed tomography, single-photon emission computerized tomography, positron emission tomography, and nuclear magnetic resonance imaging have the potential to enable us to visually observe biochemical events and physiological processes in the brain, where our knowledge is limited and our eagerness to understand function is the greatest.

Flexor reflex control of the external sphincter of the urethra in paraplegia

In paraplegics and quadriplegics a profound paralysis of skeletal muscles occurs below the level of the spinal lesion. Unexplained in this state is the development of an overactive external urethral sphincter, which interferes with emptying of the bladder and may lead to infection of the urinary tract. Studies of cats show that the discharge of motoneurons causing this contraction has all the characteristics of a flexor reflex.