Spin-Echo planar spectroscopic imaging for fast lipid characterization in bone marrow

Lipid characterization of bone marrow in vivo with proton magnetic resonance spectroscopy was performed using Spin-Echo Planar Spectroscopic Imaging sequences. The methods are shown capable of rapidly generating two-dimensional chemical shift imaging data sets suitable for measuring lipid indices that reflect unsaturation levels among triglycerides, as demonstrated in oil phantoms and bone marrow from a healthy volunteer. The volume coverage, spatial resolution, acquisition speed, and spectral characteristics of Spin-Echo Planar Spectroscopic Imaging should make it attractive for clinical studies of diseases affecting normal lipid chemical composition.

Legg-Calvé-Perthes disease: MR imaging evaluation during manual positioning of the hip--comparison with conventional arthrography

PURPOSE

To evaluate the use of magnetic resonance (MR) imaging during manual positioning of the hip, or multipositional MR imaging, in an open-magnet configuration to study femoral head containment, articular congruency, and femoral head deformity in Legg-Calvé-Perthes disease.

MATERIALS AND METHODS

In 12 children with advanced Legg-Calvé-Perthes disease, multipositional MR imaging and conventional arthrography were compared in the assessment of containment, femoroacetabular congruency, and femoral head deformity. Images of the hips in several positions were compared subjectively and objectively.

RESULTS

MR imging correlated well with arthrography for overall subjective assessment of severity of disease (r = 0.71, P = .01), with good interobserver agreement (kappa = 0.65, P < .001). MR images demonstrated all cases of hinge abduction shown arthrographically. However, MR imaging failed to depict one case of femoral head flattening. MR imaging correlated well with arthrography in the objective evaluation of joint fluid and lateral subluxation (r = 0.80, P < .01). MR imaging correlated poorly with arthrography in the measurement of sphericity of the femoral head.

CONCLUSION

Multipositional MR imaging with an open-magnet configuration was comparable to arthrography for demonstration of femoral head containment and congruency of the articular surfaces of the hip. In the evaluation of deformity, it performed less well.

Partial wavelet encoding: a new approach for accelerating temporal resolution in contrast-enhanced MR imaging

We propose a new approach using wavelet encoding to improve temporal resolution in contrast-enhanced magnetic resonance (MR) imaging. Exploiting the unique property of wavelets localized in space and frequency, we construct an efficient encoding scheme to capture signal changes due to contrast agent uptake, which in general is spatially localized with low- and mid-range frequency components. On the basis of space-frequency analysis, we describe mathematical formulations of our method and discuss its theoretical advantages over Fourier-based phase-encoding methods (the keyhole and reduced-encoding imaging by generalized-series reconstruction [RIGR] techniques). The results obtained in computer simulations and a phantom study demonstrate the feasibility and practical advantages of our approach.

MR line scan diffusion imaging of the brain in children

BACKGROUND AND PURPOSE

MR imaging of the self-diffusion of water has become increasingly popular for the early detection of cerebral infarction in adults. The purpose of this study was to evaluate MR line scan diffusion imaging (LSDI) of the brain in children.

METHODS

LSDI was performed in four volunteers and 12 patients by using an effective TR/TE of 2736/89.4 and a maximum b value of 450 to 600 s/mm2 applied in the x, y, and z directions. In the volunteers, single-shot echo planar imaging of diffusion (EPID) was also performed. The patients (10 boys and two girls) ranged in age from 2 days to 16 years (average age, 6.6 years). Diagnoses included acute cerebral infarction, seizure disorder, posttraumatic confusion syndrome, complicated migraine, residual astrocytoma, encephalitis, hypoxia without cerebral infarction, cerebral contusion, and conversion disorder. In all patients, routine spin-echo images were also acquired. Trace images and apparent diffusion coefficient maps were produced for each location scanned with LSDI.

RESULTS

In the volunteers, LSDI showed less chemical-shift and magnetic-susceptibility artifact and less geometric distortion than did EPID. LSDI was of diagnostic quality in all studies. Diffusion abnormalities were present in five patients. Restricted diffusion was present in the lesions of the three patients with acute cerebral infarction. Mildly increased diffusion was present in the lesions of encephalitis and residual cerebellar astrocytoma. No diffusion abnormalities were seen in the remaining seven children.

CONCLUSION

LSDI is feasible in children, provides high-quality diffusion images with less chemical-shift and magnetic-susceptibility artifact and less geometric distortion than does EPID, and complements the routine MR examination.

Multi-component apparent diffusion coefficients in human brain

The signal decay with increasing b-factor at fixed echo time from brain tissue in vivo has been measured using a line scan Stejskal-Tanner spin echo diffusion approach in eight healthy adult volunteers. The use of a 175 ms echo time and maximum gradient strengths of 10 mT/m allowed 64 b-factors to be sampled, ranging from 5 to 6000 s/ mm2, a maximum some three times larger than that typically used for diffusion imaging. The signal decay with b-factor over this extended range showed a decidedly non-exponential behavior well-suited to biexponential modeling. Statistical analyses of the fitted biexponential parameters from over 125 brain voxels (15 x 15 x 1 mm3 volume) per volunteer yielded a mean volume fraction of 0.74 which decayed with a typical apparent diffusion coefficient around 1.4 microm2/ms. The remaining fraction had an apparent diffusion coefficient of approximately 0.25 microm2/ms. Simple models which might explain the non-exponential behavior, such as intra- and extracellular water compartmentation with slow exchange, appear inadequate for a complete description. For typical diffusion imaging with b-factors below 2000 s/mm2, the standard model of monoexponential signal decay with b-factor, apparent diffusion coefficient values around 0.7 microm2/ms, and a sensitivity to diffusion gradient direction may appear appropriate. Over a more extended but readily accessible b-factor range, however, the complexity of brain signal decay with b-factor increases, offering a greater parametrization of the water diffusion process for tissue characterization.

MR imaging of pelvic floor continence mechanisms in the supine and sitting positions

OBJECTIVE

Our goal was to determine the anatomic differences in pelvic floor anatomy for continent women and women with stress incontinence using MR imaging and to assess whether these anatomic differences depend on the position of the subject during imaging.

SUBJECTS AND METHODS

Eight continent volunteers and eight women with stress incontinence underwent MR imaging in the supine and sitting positions. For imaging, we used an open-configuration 0.5-T magnet. T2-weighted images were obtained in the midline sagittal plane with subjects at rest and at maximal pelvic floor strain in 5 sec using a modified fast spin-echo sequence. In the axial plane, thin-section T2-weighted images were obtained with subjects at rest using a standard fast spin-echo technique. Images were evaluated for mobility of the urethra and bladder neck and for integrity of the vagina, levator ani, and supporting fascia.

RESULTS

Pelvic floor laxity and abnormalities of the supporting fascia were more common in incontinent women than in continent women. Both descent of the bladder neck when subjects strained and the posterior urethrovesical angle were not significantly greater when subjects were measured in the sitting position (p < .1).

CONCLUSION

Changes of pelvic floor laxity related to incontinence can be seen with subjects in both the supine and the sitting positions but are increased in the sitting position.

Optimization of chemical shift selective suppression of fat

Strategies to optimize flip angles for chemical shift selective fat suppression are discussed. Mathematical models for fat suppression in spoiled gradient recalled acquisition, spin echo, and RARE, which incorporate steady state conditions and multiple spectral components of fat, are developed. The optimal suppression flip angle is found to be larger than that determined with a single fat component model by more than 10 degrees due to contributions from unflipped components such as olefinic and glycerol protons that lie outside the suppression band.

Developing epiphysis: MR imaging characteristics and histologic correlation in the newborn lamb

PURPOSE

To correlate magnetic resonance (MR) signal characteristics of developing regions at the ends of bones with the histologic findings.

MATERIALS AND METHODS

In 36 newborn lamb epiphyses (including cartilage of the epiphysis and physis, and bone of the secondary ossification center and juxtaphyseal metaphysis), signal intensity and thickness of cartilaginous regions seen on MR images were correlated with architecture and thickness of zones shown in corresponding histologic sections. Possible effects of T2, magnetization transfer, fat or water content, chemical shift, and anisotropy on differences in regional signal intensity were evaluated.

RESULTS

MR imaging depicted five regions between the secondary ossification center and the metaphysis corresponding histologically to (a) zone of provisional calcification of the secondary ossification center, (b) physis of the secondary ossification center, (c) epiphyseal cartilage, (d) physis, and (e) zone of provisional calcification. The thickness of regions shown on T1- and T2-weighted images correlated with that of histologic zones (r = .9). T2 signal intensity and relaxation time were greater in physeal than in epiphyseal cartilage (P < .01). No regional differences due to fat or water content, magnetization transfer, chemical shift, or anisotropy were found.

CONCLUSION

MR imaging findings differentiate epiphyseal and physeal regions and correlate with histologic findings. T2 is slower in physeal than in epiphyseal cartilage, probably reflecting differences in water binding.

Diffusion-weighted MR imaging in hypertensive encephalopathy: clues to pathogenesis

PURPOSE

Hypertensive encephalopathy, a complex of cerebral disorders, including headache, seizures, visual disturbances, and other neurologic manifestations, is associated with a variety of conditions in which blood pressure rises acutely. It has been ascribed to either exuberant vasospasm with ischemia/infarction or breakthrough of autoregulation with interstitial edema. Diffusion-weighted MR imaging may be used to determine whether the edema in hypertensive encephalopathy is cytotoxic or vasogenic in origin.

METHODS

Diffusion-weighted imaging was performed using the double line scan diffusion imaging technique on a 1.5-T MR system. Seven patients with hypertensive encephalopathy were imaged within 1 day of the onset of their symptoms. Apparent diffusion coefficient maps as well as low and high b-factor images were acquired. The two-tailed paired Student's t-test was used to compare the apparent diffusion coefficients in edematous brain regions with those of normal white matter.

RESULTS

In all cases the apparent diffusion coefficient maps of the patients with hypertensive encephalopathy showed increased signal in regions corresponding to increased T2 signal on standard T2-weighted (low b-factor) images. Quantitative apparent diffusion coefficients in regions of abnormal T2 signal were 1.36 +/- 0.14 microm2/ms, compared with 0.80 +/- 0.05 microm2/ms in normal white matter. Diffusion-weighted (high b-factor) T2-weighted images did not show abnormal signal.

CONCLUSION

Diffusion-weighted MR imaging shows that the edema in hypertensive encephalopathy is of vasogenic origin and does not represent ischemia or infarction. This finding may have therapeutic implications.

Tissue temperature monitoring with multiple gradient-echo imaging sequences

The inherent sensitivity of multiple gradient-echo sequences to the chemical shift is exploited to rapidly map muscle water frequency shifts caused by ultrasonic heating. The use of multiple echoes is shown to offer several advantages over single gradient-echo approaches previously proposed for temperature measurement. An increase in the effective bandwidth significantly reduces aliasing problems observed with single gradient-echo methods in high temperature applications. Of greater significance is the improved immunity to intrascan motion found for multi-echo versus single echo gradient methods, making the former more attractive for clinical applications. Finally, a sensitivity to the presence of multiple spectral components unavailable with single gradient-echo methods is obtained.

Rapid tip tracking with MRI by a limited projection reconstruction technique

To rapidly track invasive devices within MRI systems, a novel approach using a limited projection reconstruction technique is presented. Our method exploits the difference between images reconstructed from a limited number of projections and serves to depict the tip of a needle during its advancement. This method was implemented on a standard MRI system with a radial fast-spin-echo sequence and examined in phantom studies. We demonstrated that the proposed method could track the tip every 300 msec and the tip depicted by the present technique was consistently displaced along the needle by a small distance (5 mm).

MRI of laser-induced interstitial thermal injury in an in vivo animal liver model with histologic correlation

Laser-induced interstitial thermal therapy (LITT) is a preferred method of minimally invasive therapy. MRI is a noninvasive method by which to monitor the thermal effects of LITT. To properly control such effects, changes in MRI parameters during and after LITT should be correlated with changes in the tissue. T1-weighted fast spin echo (FSE) MRI (1 image/10 seconds) at 1.5 T monitored LITT in vivo in rabbit liver (n = 6) using an interstitial bare delivery fiber (600-microm diameter; 3.0 W; 1,064 nm; 150 seconds). During laser irradiation, MRI signal intensity decreased around the fiber tip; after irradiation, this hypointensity proved reversible and permanent lesions were evident. The lesions had hyperintense margins that were brighter than surrounding normal tissue (P < .001); the tissue in these bright regions was mapped to tissue necrosis characterized by the presence of thermally damaged ghost red blood cells amid generally normal hepatocytes. T1-FSE identified the spatial extent of the LITT lesions.

Non-Fourier encoding with multiple spin echoes

The advantages and limitations of multiple spin-echo sequences for non-Fourier encoding are investigated. Complications caused by improper encoding of alternate magnetization pathways due to imperfect refocusing pulses are analyzed. It is shown that mirror image ghosts result if the encoding RF pulse matrix is real-valued. These ghosts can be avoided as long as the rows of the RF pulse matrix are conjugate symmetric, which implies that spatial profiles are real valued. Non-Fourier encoding using bases derived from wavelet, Hadamard, and other real-valued orthogonal functions does not result in a mirror ghost artifact. A RARE sequence for non-Fourier encoding has been implemented on a clinical imaging system and successfully applied for brain imaging.

Temperature monitoring of ultrasonically heated muscle with RARE chemical shift imaging

The ability to monitor tissue temperature in ultrasonically heated rabbit muscle is demonstrated using a chemical shift imaging approach based on the rapid acquisition with relaxation enhancement (RARE) fast imaging method [Hennig et al., Magn. Reson. Med. 3, 823-833 (1986)] applied in a line scan format. A three echo sequence with a 16 Hz spectral resolution with 64 ms echo readouts and 78 ms echo spacings is shown capable of measuring relevantly small water frequency shifts in phantoms. Applied to the in vivo model of ultrasonically heated rabbit muscle, water resonance frequencies at the ultrasonic focal point were found to be linearly related to temperature with a slope of -0.007 +/- 0.001 ppm/degree C (N = 6 studies). Measurements of the frequency shift in unheated tissue located away from the ultrasonically heated tissue varied by approximately 0.011 ppm over the course of the experiments, leading to an estimated temperature accuracy of +/- 1.6 degrees C in vivo.

RARE imaging of PCr in human forearm muscles

Rapid acquisition with relaxation enhancement (RARE) sequences have been used to map the 31P phosphocreatine (PCr) signal in human forearms at 4.7 T. Signal-to-noise levels of approximately 10 were achieved from the major muscle groups in 5.5-minute scan times with a spatial resolution of 4 x 2 x 2 cm3. Exercise caused demonstrable reductions in PCr signal from activated muscles, which correlated with affected muscle groups in T2-weighted proton images. RARE imaging of the PCr signal at 4.7 T is feasible and, with technically achievable improvements in signal-to-noise ratio, should prove useful in studying energy metabolism in muscle and other organs.

In vivo bone marrow lipid characterization with line scan Carr-Purcell-Meiboom-Gill proton spectroscopic imaging

Line scan Carr-Purcell-Meiboom-Gill spectroscopic imaging sequences have been used to extract lipid chemical composition indices in healthy adult bone marrow in the knee at 1.5 T. Since several spectroscopic echo readouts follow each excitation, the information acquired reflects a balance between spectral T2 decay processes and spectral resolution. To examine this balance in detail, data sets with two different echo spacings and spectral resolutions have been acquired to compare the information available from each in studies of bone marrow. Oils for which high field (7 T) proton spectra were recorded were used to evaluate the accuracy of lipid chemical composition indices extracted from the line scan Carr-Purcell-Meiboom-Gill spectroscopic imaging methods at 1.5 T. The extension of the method to fast spectroscopic imaging of bone marrow with multiple echoes is demonstrated.

Multiecho approaches to spectroscopic imaging of the brain

Spectroscopic imaging (SI) with nuclear magnetic resonance (NMR) is one of the most powerful tools available for studying brain chemistry in vivo. Both proton (1H) and phosphorus (31P) NMR offer valuable biochemical information that can in principle be mapped throughout the entire brain, thereby enhancing our understanding of brain function. With the exception of protons from tissue water and the triglycerides of adipose tissue, however, nuclei contributing to the NMR signals of living tissue are in relatively small (millimolar) concentrations. The low concentration of metabolite nuclei reduces the overall sensitivity of conventional SI techniques, making high-quality metabolite mapping a lengthy procedure. This problem has led to the development and testing of nonconventional methods for reducing SI scan times, including techniques based on the collection of multiple spin-echoes. The extent to which multiecho methods can be used to decrease SI scan times and maintain high-quality metabolite mapping depends on several factors. These include the spectral transverse relaxation times, the spectral resolution required, and J-coupling interactions. We have discussed these various technical aspects of multiecho SI methods as applied to 1H and 31P spectroscopic imaging of the living brain.

Database prescan: a time-efficient alternative to brain MRI autoprescan

The purpose of this study was to determine the feasibility of database prescan as an alternative to conventional autoprescan in pediatric brain MRI. Autoprescan parameters [receiver levels and transmit gain (TG)] were analyzed prospectively in 236 pediatric brain MRI studies. Paired t test and linear regression analysis were performed to determine predictability of autoprescan parameters by database-generated parameters. Signal-to-noise ratio, image quality, and potential time efficiency of database-generated parameters were assessed. No statistical difference (P = .13) and a high correlation between the TG of the axial fast spin echo (FSE) proton density (PD) and axial FSE T2-weighted sequences (r = .92) was seen. Strong correlations were noted between the TG of the sagittal T1-weighted and the TG of the axial FSE PD (r = .79), axial FSE T2-weighted (r = .81), and contrast-enhanced T1-weighted (r = .78) sequences. The receiver levels did not change significantly between sequences. Quantitative and qualitative analyses revealed no differences in the signal-to-noise ratios of the autoprescan and the database-predicted prescan parameters. Implementation of database prescan could improve time efficiency by 28 to 33%. Autoprescan parameters can be predicted by using database-generated information while preserving the diagnostic image quality of the study. Incorporation of database prescan into commercial MRI systems could improve MRI time efficiency and patient throughput.

Multi-echo 31P spectroscopic imaging of ATP: a scan time reduction strategy

Spectroscopic imaging of 31P metabolites and adenosine triphosphate (ATP) in particular with multiple spin echoes may prove useful for reducing data acquisition times. The usual T2 decay processes that degrade multi-echo spectroscopic imaging methods, however, are further compounded by J-coupling modulations in the case of ATP. We determine how these modulations affect multi-echo spectroscopic imaging k-space data and produce systematic spatial misregistrations of the ATP resonances. The specific J-coupling modulations of ATP are determined to identify echo-spacing effects in multi-echo spectroscopic imaging of ATP and to determine appropriate post-processing correction schemes to address the spatial misregistration problem. An in vivo demonstration of the technique that offers a threefold reduction in scan time compared to conventional SI methods is provided and compared with the conventional SI approach.

MR appearance and spectral features of injected ethanol in the liver: implication for fast MR-guided percutaneous ethanol injection therapy

PURPOSE

Our goal was to evaluate several fast MR strategies for monitoring ethanol distributions so that percutaneous ethanol injection might be guided with MRI.

METHOD

Fast RF spoiled GRE sequences (SPGR) and T2-weighted rapid acquisition with relaxation enhancement (RARE) sequences with and without spectroscopic-quality water suppression techniques were assessed for their ability to depict the distribution of injected ethanol in ex vivo pig liver. A line scan Carr-Purcell-Meiboom-Gill spectroscopic imaging sequence was used to validate observations and measure spectral relaxation characteristics of the ethanol signal in liver. Injected deuterated ethanol was also tested as an alternative possibility to depict the distribution of ethanol.

RESULTS

The water-suppressed T2-weighted RARE sequence depicted the distribution of ethanol better than other sequences. Deuterated ethanol appeared as a signal void on all sequences.

CONCLUSION

Water-suppressed T2-weighted RARE sequences could be useful to rapidly monitor MR-guided PEI.

A multiparameter analysis of sickle erythrocytes in patients undergoing hydroxyurea therapy

During 24 weeks of hydroxyurea treatment, we monitored red blood cell (RBC) parameters in three patients with sickle cell disease, including F-cell and F-reticulocyte profiles, distributions of delay times for intracellular polymerization, sickle erythrocyte adherence to human umbilical vein endothelial cells in a laminar flow chamber, RBC phthalate density profiles, mean corpuscular hemoglobin concentration and cation content, reticulocyte mean corpuscular hemoglobin concentration, 1H-nuclear magnetic resonance transverse relaxation rates of packed RBCs, and plasma membrane lateral and rotational mobilities of band 3 and glycophorins. Hydroxyurea increases the fraction of cells with sufficiently long delay times to escape the microcirculation before polymerization begins. Furthermore, high pretreatment adherence to human umbilical vein endothelial cells of sickle RBCs decreased to normal after only 2 weeks of hydroxyurea treatment, preceding the increase in fetal hemoglobin levels. The lower adhesion of sickle RBCs to endothelium would facilitate escape from the microcirculation before polymerization begins. Hydroxyurea shifted several biochemical and biophysical parameters of sickle erythrocytes toward values observed with hemoglobin SC disease, suggesting that hydroxyurea moderates sickle cell disease toward the milder, but still clinically significant, hemoglobin SC disease. The 50% reduction in sickle crises documented in the Multicenter Study of Hydroxyurea in Sickle Cell Disease is consistent with this degree of erythrocyte improvement.

MR imaging of the female pelvic floor in the supine and upright positions

The goal of this study was to determine whether a .5-T open configuration magnet system could be used to evaluate the female pelvic floor support structures and their functional changes in the upright and supine positions. We evaluated five normal volunteers with full bladders in the supine and sitting positions. Multiple measurements were obtained, including distance between symphysis and urethra, bladder neck to fixed pubococcygeal line, and posterior urethrovesical angle. The pelvic floor was evaluated for integrity of the urethra, vagina, and supporting ligaments. High quality, interpretable images were obtained for all five patients in both positions. Most of the pelvic floor structures were stable, with the exception of the posterior urethrovesical angle, which increased in the sitting position. We conclude that the vertically open configuration magnet system shows promise for evaluation of the female pelvic floor, including urinary stress incontinence and prolapse.

Citrate signal enhancement with a homonuclear J-refocusing modification to double-echo PRESS sequences

The citrate signal at field strengths of whole body imagers arises from two sets of two strongly coupled methylene protons. This causes citrate spectra acquired with standard in vivo localization schemes like the double-echo point resolved echo spectroscopy (PRESS) sequence to have complicated dependencies on timing parameters. A homonuclear J-refocused version of the double-echo PRESS sequence that has previously been shown to completely remove J-modulations from weakly coupled AX systems is considered for its potential in acquiring signal from the strongly coupled AB system of citrate. An analytic solution to the problem is derived with the density matrix formalism and verified both numerically and experimentally for 7 T conditions. The general expression for the AB signal is applied to study the 1.5 T citrate signal where a substantial signal enhancement over conventional double-echo PRESS sequences is predicted and verified for echo times in the 150 to 300 ms range.

Line scan diffusion imaging

A novel line scan diffusion imaging sequence (LSDI) is introduced. LSDI is inherently insensitive to motion artifacts and high quality diffusion maps of the brain can be obtained rapidly without the use of head restraints or cardiac gating. Results from a stroke study and abdominal diffusion images are presented. The results indicate that it is feasible to use the LSDI technique for clinical evaluation of acute ischemic stroke. In contrast to echo-planar diffusion imaging, LSDI does not require modified gradient hardware and can be implemented on conventional scanners. Thus, LSDI should dramatically increase the general availability of robust clinical diffusion imaging.