Functional mapping of the human visual cortex at 4 and 1.5 tesla using deoxygenation contrast EPI

The effects of photic stimulation on the visual cortex of human brain were studied by means of gradient-echo echo-planar imaging (EPI). Whole-body 4 and 1.5 T MRI systems, equipped with a small z axis head gradient coil, were used. Variations of image intensity of up to 28% at 4 T, and up to 7% at 1.5 T, were observed in primary visual cortex, corresponding to an increase of blood oxygenation in regions of increased neural activity. The larger effects at 4 T are due to the increased importance of the susceptibility difference between deoxygenated and oxygenated blood at high fields.

Diffusion and perfusion magnetic resonance imaging in brain tumors

The article reviews recent progress made in the field of diffusion and perfusion magnetic resonance (MR) imaging and presents possible applications in brain tumors. Diffusion, a new parameter, provides useful data to assess tissue structure and function. Perfusion MR imaging gives results that are somewhat similar to those obtained with classic non-MR imaging methods, but it offers several potential advantages.

Theoretical principles of perfusion imaging. Application to magnetic resonance imaging

Perfusion magnetic resonance imaging (MRI) offers relative safety (no ionizing radiation), high spatial/temporal resolution, multi-orientation imaging capability, and relative low cost when compared with sophisticated techniques, such as positron emission tomography (PET). Several methods have been recently proposed to image perfusion. Some techniques mimic conventional nuclear medicine principles, but use radioactively inert tracers. Other approaches directly use blood as an endogenous natural tracer. Such methods are totally noninvasive, and offer original insights, for instance by monitoring variations in blood oxygenation in human brain cortex during activation tasks. These methods are presented and compared. Emphasis is given on advantages and drawbacks, and potential clinical applications.

The capillary network: a link between IVIM and classical perfusion

MR measurements based on motion encoding gradients, such as intravoxel incoherent motion imaging, could provide, in principle, information on flowing blood volume and blood velocity. This note shows that, in addition, the knowledge of the capillary network organization may provide a link between these measurements and those obtained by conventional and MR perfusion techniques based on tracer uptake by tissues.

Diffusion MR imaging: clinical applications

Water self-diffusion, a recently discovered source of contrast on MR images, has already shown promise for some clinical applications. Most studies have been of the brain, essentially for technical reasons. Diffusion is useful in distinguishing the different components of brain tumors (cystic regions, edema, necrosis) from the tumor core itself. Recent studies have shown that diffusion is anisotropic in brain white matter (i.e., dependent on the fiber tract's orientation in space), offering new insights into myelin disorders. Diffusion is also dramatically altered in the minutes following ischemic injury in the cat brain, which may have tremendous impact for the diagnosis and management of hyperacute stroke. With ultrafast acquisition schemes, diffusion imaging has also been used outside the CNS, for instance, in the eye and kidney. Future applications include diffusion-localized spectroscopy and temperature imaging. This article reviews recent progress in this field and suggests potential applications.

Echo-planar time course MRI of cat brain oxygenation changes

When deoxygenated, blood behaves as an effective susceptibility contrast agent. Changes in brain oxygenation can be monitored using gradient-echo echo-planar imaging. With this technique, difference images also demonstrate that blood oxygenation is increased during periods of recovery from respiratory challenge.

MR color mapping of myelin fiber orientation

Diffusion of water in brain white matter has been shown to be anisotropic: Water mobility is lower when measured perpendicular to the fiber direction rather than parallel to it. This feature was used to produce images of the myelin fiber orientation. Coronal and sagittal MR diffusion images were obtained in volunteers using an echo-planar imaging sequence sensitized to molecular diffusion in perpendicular directions. Color-coded images of myelin orientation were then generated by combining these images together. The orientation of the white matter tracts was found to be in excellent agreement with known anatomy. Myelin fiber orientation mapping may offer a new perspective to evaluate white matter disorders.

Intravoxel incoherent motion imaging using spin echoes

The purpose of this paper is to review the basic principles of diffusion measurement with spin echoes. These principles can be combined with those of MR imaging to generate maps of diffusion coefficients. Diffusion imaging can be extended to imaging of other intravoxel incoherent motions (IVIM), such as blood microcirculation. Some of the technical problems encountered when implementing IVIM imaging are presented.

Echo-planar imaging of diffusion and perfusion

Use of the Stejskal-Tanner sequence for performing diffusion images in the human brain tends to be complicated by the presence of artifacts caused by voluntary or involuntary, sometimes pulsatile, motion. We describe the implementation of the technique of echo-planar diffusion imaging, which avoids these artifacts and allows reproducible quantitative values of the diffusion coefficient to be measured in vivo. The effects of perfusion are easily visible in a phantom containing a gel. The results for human brain show a significant "perfusion fraction" in grey matter, consistent with an extracellular, possibly microvascular, volume of about 10%.

Noninvasive temperature imaging using diffusion MRI

Efficacy and safety considerations for cancer therapy with hyperthermia require accurate temperature measurements throughout the heated volume. We report the use of molecular diffusion, whose temperature dependence is well known. A dedicated hyperthermia applicator was built, combining a MRI gradient coil and a rf coil. Diffusion and derived temperature images were obtained with a 1 x 2 mm pixel size on a polyacrylamide gel phantom using a clinical 1.5-T whole body MRI system. Temperatures determined from these images using 1 cm2 regions of interest were found to be within 0.2 degrees C of those recorded from the thermocouples and fiber-optic probes placed inside the gel.

Imaging of diffusion and microcirculation with gradient sensitization: design, strategy, and significance

Recent developments in the use of magnetic resonance (MR) to measure and image diffusion and blood microcirculation ("perfusion") are summarized. After a brief description of the effects of diffusion and perfusion on the MR signal, the different methods (conventional spin-echo, stimulated-echo, gradient-echo, and echo-planar imaging) that have been proposed and used to image and measure diffusion and perfusion by gradient sensitization are presented, along with their advantages and limitations. The difficulties of diffusion/perfusion imaging related to both hardware and software are then discussed. Special attention is given to specific problems encountered with in vivo studies and data analysis. Finally, the potential biologic and clinical applications are outlined, and some examples are presented.

Molecular diffusion nuclear magnetic resonance imaging

This review summarizes the work performed during the last 40 years in the field of diffusion measurement by nuclear magnetic resonance (NMR), with emphasis on biomedical diffusion imaging. Measuring molecular displacements in biological tissues in vivo has an enormous potential, but remains technically challenging. After a review of the nature of the diffusion process, the basic principles of diffusion measurements with NMR are introduced, followed by a presentation of various diffusion imaging methods. The paper covers many previously resolved theoretical and technical issues and new problems that are more specific to clinical diffusion imaging, such as the calculation of diffusion effects in the presence of multiple magnetic field gradient pulses, the elimination of motion artifacts, and the meaning of anisotropic or restricted diffusion in relation to tissue microdynamics and microstructure. The concept of diffusion imaging is then extended to blood microcirculation imaging. Finally, the current and potential clinical applications of these techniques are described.

Echo-planar imaging of intravoxel incoherent motion

The recently established single-shot technique of echo-planar imaging of intravoxel incoherent motion (IVIM) for determining and imaging the variations of microscopic motions of water has been applied to studies of water perfusion in phantoms and to in vivo studies of diffusion and perfusion in cat and human brains. The phantom results demonstrate that perfusion levels comparable with those found in vivo have easily observable and reproducible effects on signal amplitude that are consistent with previous IVIM theory. Reliable measurements of the diffusion coefficient in various types of brain tissue have been obtained. The results for white matter are consistent with the existence of anisotropic diffusion in oriented bundles of myelinated nerve fibers. The results for gray matter can be fitted to the IVIM theory and suggest a value of up to 14% for the fraction of the signal contributed by randomly perfusing fluid in normal cerebral cortex.

Functional magnetic resonance imaging in medicine and physiology

Magnetic resonance imaging (MRI) is a well-established diagnostic tool that provides detailed information about macroscopic structure and anatomy. Recent advances in MRI allow the noninvasive spatial evaluation of various biophysical and biochemical processes in living systems. Specifically, the motion of water can be measured in processes such as vascular flow, capillary flow, diffusion, and exchange. In addition, the concentrations of various metabolites can be determined for the assessment of regional regulation of metabolism. Examples are given that demonstrate the use of functional MRI for clinical and research purposes. This development adds a new dimension to the application of magnetic resonance to medicine and physiology.

Magnetic resonance imaging of perfusion

Recent developments have shown that diffusion and blood microcirculation (perfusion) could be imaged and measured noninvasively by MRI. The purpose of this presentation is to overview the different approaches that use B0 field gradients to monitor diffusion/perfusion. The principles of these different methods are discussed together with their limitations and their potential applications.

In vivo NMR diffusion spectroscopy: 31P application to phosphorus metabolites in muscle

Apparent diffusion coefficients (Da) of individual metabolites can be studied in vivo by diffusion NMR spectroscopy using an echo sequence sensitized to molecular motion. The methods are based on the echo attenuation due to phase dispersion resulting from incoherent displacement during the diffusion time. As the displacement of metabolites by diffusion in vivo can be affected by compartment size, temperature, adsorption processes, etc., the presented methods are potentially useful in studying such phenomena in vivo. Here, the methods are applied to phosphocreatine in the rat quadriceps muscle. It is demonstrated that the displacement of phosphocreatine resembles free diffusion for short diffusion times but becomes limited as a result of boundaries due to compartmentation for longer diffusion times. The limit of the displacement indicates an apparent average size of 44 microns of the compartment in the direction of the diffusion gradient. As the gradient was applied approximately parallel (angle less than 25 degrees) to the muscle fiber, this result indicates that phosphocreatine moves freely in the cytosol but is limited by the boundaries of the muscle cells. Error analyses are performed with regard to motion artifacts and gradient performance. The methods were tested extensively for distilled water and free metabolites.

Effects of intravoxel incoherent motions (IVIM) in steady-state free precession (SSFP) imaging: application to molecular diffusion imaging

A theoretical analysis of the effects of diffusion and perfusion in steady-state free precession (SSFP) imaging sequences sensitized to intravoxel incoherent motions by magnetic field gradients is presented and supported by phantom studies. The capability of such sequences to image diffusion and perfusion quickly was recently demonstrated. The possible residual effects of T1 and T2 in diffusion measurements are evaluated, as are the effects of the sequence design and the acquisition parameters (repetition time, flip angle, gradient pulses). It is shown theoretically and confirmed by experiments on phantoms that diffusion coefficients can be directly measured from SSFP images when large enough diffusion gradient pulses are used.

Temperature mapping with MR imaging of molecular diffusion: application to hyperthermia

Efficacy and safety considerations for hyperthermia (HT) cancer therapy require accurate temperature measurements throughout the heated volume. Noninvasive thermometry methods have been proposed, including magnetic resonance (MR) imaging based on the temperature dependence of the relaxation time T1. However, the temperature accuracy achieved to date with T1 measurements does not fulfill the HT requirements (1 degree C/cm). The authors propose to use molecular diffusion, for which temperature dependence is well known. Molecular diffusion is more sensitive than T1 and can be determined with high accuracy with MR imaging. Diffusion and derived temperature images were obtained with a 2 X 2-mm pixel size in a polyacrylamide gel phantom heated inside the head coil of a clinical 0.5-T whole-body MR imaging system by means of a modified clinical HT device made compatible with the system. Temperatures determined from these images with 0.8-cm2 regions of interest were found to be within 0.5 degrees C of those recorded with thermocouples placed inside the gel. The utility of this method in clinical hyperthermia is enhanced by its potential to also help monitor blood perfusion.

Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging

Intravoxel incoherent motion (IVIM) imaging is a method the authors developed to visualize microscopic motions of water. In biologic tissues, these motions include molecular diffusion and microcirculation of blood in the capillary network. IVIM images are quantified by an apparent diffusion coefficient (ADC), which integrates the effects of both diffusion and perfusion. The aim of this work was to demonstrate how much perfusion contributes to the ADC and to present a method for obtaining separate images of diffusion and perfusion. Images were obtained at 0.5 T with high-resolution multisection sequences and without the use of contrast material. Results in a phantom made of resin microspheres demonstrated the ability of the method to separately evaluate diffusion and perfusion. The method was then applied in patients with brain and bone tumors and brain ischemia. Clinical results showed significant promise of the method for tissue characterization by perfusion patterns and for functional studies in the evaluation of the microcirculation in physiologic and pathologic conditions, as, for instance, in brain ischemia.

Intravoxel incoherent motion imaging using steady-state free precession

IVIM MR imaging is a method which generates images of diffusion and perfusion in vivo. Until now, intravoxel incoherent motion (IVIM) images have been obtained using spin-echo sequences with extragradient pulses, resulting in long acquisition times (typically 2 x 8 min 32 s). A new method is proposed here, using steady-state free precession (SSFP), which allows IVIM images to be obtained in a couple of minutes. Phantom studies showed that the sensitivity of SSFP to IVIMs is much greater than that of spin echoes. In vivo images are shown.

MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders

Molecular diffusion and microcirculation in the capillary network result in a distribution of phases in a single voxel in the presence of magnetic field gradients. This distribution produces a spin-echo attenuation. The authors have developed a magnetic resonance (MR) method to image such intravoxel incoherent motions (IVIMs) by using appropriate gradient pulses. Images were generated at 0.5 T in a high-resolution, multisection mode. Diffusion coefficients measured on images of water and acetone phantoms were consistent with published values. Images obtained in the neurologic area from healthy subjects and patients were analyzed in terms of an apparent diffusion coefficient (ADC) incorporating the effect of all IVIMs. Differences were found between various normal and pathologic tissues. The ADC of in vivo water differed from the diffusion coefficient of pure water. Results were assessed in relation to water compartmentation in biologic tissues (restricted diffusion) and tissue perfusion. Nonuniform slow flow of cerebrospinal fluid appeared as a useful feature on IVIM images. Observation of these motions may significantly extend the diagnostic capabilities of MR imaging.