Rapid T1 estimation using tagged magnetization-prepared gradient-echo MR imaging

A technique for estimation of the longitudinal relaxation time of a large homogeneous object with an acquisition time of 4 s or less was developed by combining spatially selective rf tagging pulses with a T1-weighted magnetization-prepared gradient-echo sequence. Multiple 5-mm-wide tagged areas are laid orthogonal to the imaging section of interest. The contrast between each tag and the untagged regions differs because each tag is produced at a different time. The T1 value is determined from the nulling time at which tagged and untagged areas have no contrast.

Histology of normal haemopoiesis: bone marrow histology. I

Images

Assessment of the hematopoietic system in ruminants

The hemic system is examined to evaluate clinical signs referable to the hemic system, establish a data base, or monitor the course of disease processes. Clinical signs of hemic disorders include pale mucous membranes, icterus, hemorrhage, hemoglobinuria, and tachycardia. Compared to other species, ruminants have small red blood cells, respond to anemia by releasing stippled red blood cells, commonly become neutropenic during acute bacterial sepsis, and fail to develop marked neutrophilia or left shift in response to inflammation.

Endothelial cells and hematopoiesis: a light microscopic study of fetal, normal, and pathologic human bone marrow in plastic-embedded sections

The origin and morphological identity of hematopoietic progenitor cells, as well as their precursor, the pleuripotential hematopoietic stem cell (HSC), has not been established. Our studies of 2 microns sectioned undecalcified plastic-embedded bone marrow (BM) from healthy human fetuses; normal adults; patients with acute myeloblastic leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic granulocytic leukemia (CGL) in various stages (chronic, accelerated, acute blastic phase, and after autografting); and patients recovering from therapy-induced marrow hypoplasia suggest that proliferative hematopoietic zones exist near the endosteum (endosteal marrow) and the vascular endothelium (capillary and sinus-lining endothelium) and a maturational zone distal to these regions. In some of these areas, morphologically recognizable hematopoietic cells were seen and interpreted as emerging and maturing in a sequential progression, suggesting an origin from the endosteal or endothelial progenitors. In other loci, early hematopoietic cells were seen in close contact with the endosteal or vascular endothelial (VE) cells. This latter relationship suggested that these areas of cellular contact were important and represented sites of cell to cell interaction that may be associated with the liberation of growth factors by endosteal and endothelial cells and their action on hematopoietic progenitor cells. Following treatment-induced hypoplasia, the endosteal and VE cells were seen to modulate, transform, and migrate into the surrounding empty and edematous marrow space as fibroblasts. Later, as hemopoietic regeneration began, clusters of regenerating hematopoietic cells were seen adjacent to bone trabecule (BT) and near the vascular endothelium. We postulate that endosteal and VE cells are the equivalent of embryonal-stage, undifferentiated mesenchyme and, under the appropriate regulatory influence, are capable of modulation and transformation (differentiation) into stromal (fibroblast-like) cells and precursors of hematopoietic cells in normal (physiologic) and stressed (pathologic) conditions. Recently, human endothelial cells have been shown to express a large number of cell surface antigens in common with hematopoietic (myeloid and lymphoid) cells. It is also possible that, in some situations, the VE cells act to establish a microenvironment and liberate growth factor(s), enabling pleuripotential and progenitor cell differentiation into mature hematopoietic cells adjacent to the vascular endothelium. Indeed, vascular endothelium has been shown to elaborate growth factors that participate in normal hematopoiesis.

The microcirculation of bone and marrow in the diaphysis of the rat hemopoietic long bones

The nature of the microcirculation of the diaphyseal portion of long bones and the adjacent bone marrow is poorly understood. The purpose of this study was to describe the blood supply in the diaphyseal cortex and the relationship of the bone vascular circulation to that of the bone marrow in the growing rat. India ink-gelatin was infused in the arterial system of 3-month-old rats and the vascularization was determined from histological sections. In some studies the periosteal circulation was blocked but the nutrient and metaphyseal arteriole systems were left intact. In the growing rat, most of the vascular flow appears to be centripetally through the diaphyseal cortex and this appears to be the primary blood supply for the adjacent bone marrow. The India ink traversed the cortex and entered the marrow through osteal canals at the endocortical surface. At the marrow-endocortical bone surface interface, ink exiting from the osteal canals filled the adjacent marrow sinusoids in what appeared as "bush-like" structures. From the bone marrow the ink appeared to drain into the central vein. Some arterioles from the nutrient system were found to penetrate the inner two thirds of the cortical bone and then re-enter the bone marrow. The centripetal flow of blood and the importance of the cortical flow for perfusion of the hemopoietic tissue was further documented when periosteal flow was obstructed. In this situation, the cortical bone and adjacent bone marrow were not perfused while the nutrient system and central vein were filled with ink.(ABSTRACT TRUNCATED AT 250 WORDS)

Age-related marrow changes in the pelvis: MR and anatomic findings

Short repetition time magnetic resonance images of the pelvis in 70 subjects (aged 1 day to 24 years) without history of bone marrow disease were retrospectively analyzed for the distribution and appearance of red and yellow marrow. The signal intensity and degree of mottling of marrow in six anatomic regions of the pelvis were observed and were assigned a grade. Anatomic correlation was provided with gross and microscopic examination of bone marrow biopsy specimens taken from selected pelvic sites in cadavers of children. Marrow signal intensity increased in all pelvic regions except the acetabulum from birth to age 24 years. Marrow heterogeneity was most prominent in the acetabulum at all ages. Patterns of bone marrow signal intensity and heterogeneity are recognized for four age groups: the infant, child, adolescent, and young adult. Regional and age-related differences in the signal intensity of pelvic marrow correlate with the percentage of fat seen microscopically in marrow.

The microvasculature of the human bone marrow correlated with the distribution of hematopoietic cells. A computer-assisted three-dimensional reconstruction study

Surgical specimens of ordinary bone marrow from eight patients were submitted to computer-assisted three-dimensional reconstruction from resin-embedded, semi-thin serial sections. This was undertaken with the aim of contributing to a better understanding of hematopoietic microenvironment by establishing the basic architecture of the bone marrow, particularly the microvasculature and its relation to the hematopoietic cell series. The basic vascular structure was found to consist of mutually intertwining sinuses and hematopoietic cords (or compartments), the latter with an arteriole running along the axis. This allowed to define the unitary structure of the bone marrow as a hematopoietic cord with a central arteriole and surrounded by sinuses. Here granulopoietic cells were distributed mostly along the wall of the central arteriole. Erythropoietic cells, located mainly around the sinus wall, proved to be forming a continuous network of cord instead of separate "islands" as usually assumed, justifying a designation of "erythroblastic cords". Megakaryocytes were positioned in close vicinity to the sinus wall. These findings appear not only to be helpful in analyzing factors involved in the in vivo hematopoiesis of man, but also to visualize the importance of structural studies of bone marrow.

In vivo relationship between marrow T2* and trabecular bone density determined with a chemical shift-selective asymmetric spin-echo sequence

Magnetic field inhomogeneities due to differences in susceptibility between trabecular bone and bone marrow result in a reduction in T2*. The authors previously quantified the relationship between the relaxation rate enhancement per unit change in bone density, delta R2*, using dried, excised vertebral bodies immersed in saline. In the present study, they investigated the precision and reproducibility of such measurements in vitro and found that the short-term precision ranges from 2% to 11%, while the long-term precision error, which may be governed by the placement of the region of interest, can vary up to 50%. A chemical shift-selective asymmetric spin-echo sequence was used to assess T2* changes in the saturated fat component of bone marrow in vivo. It was shown that the marrow fat relaxation rate increases as the surrounding trabecular bone density increases and that the delta R2* of the marrow fat component was 0.20 sec-1/mg/cm3. The results also indicate that the distribution of T2* varies with image resolution. Both in vitro and in vivo, characteristics of the relaxation time distribution such as the mean, standard deviation, and skewness decrease as image resolution decreases, the degree of variation depending on the density of the surrounding trabecular network.

Magnetization transfer contrast imaging of the human leg at 0.1 T: a preliminary study

Magnetization transfer contrast imaging is an MR technique that capitalizes on interactions between the protons of mobile and macromolecularly bound water molecules. Studies to date, conducted primarily on 4.7 T and 1.5 T MR systems, have yielded results unique from conventional T1- and T2-weighted imaging studies. In this study, performed on a 0.1 T device, a section of lower leg was imaged in 20 normal human subjects and one patient with muscular dystrophy, using both a standard 500/22 gradient-echo sequence and a 500/22 gradient-echo sequence combined with off-resonance radio frequency irradiation designed to elicit magnetization transfer contrast. Results of the two techniques were compared. Our findings suggest that magnetization transfer contrast imaging is feasible at 0.1 T, and that this technique allows reproducible tissue characterization and improves contrast between certain tissues.

Normal childhood developmental patterns in skull bone marrow by MR imaging

To establish the normal developmental pattern of skull bone marrow in children by MR imaging, sagittal T1-weighted MR skull images of 324 normal children (newborn to 18 years) were reviewed. Bone marrow intensity was assigned four gradations as compared with that of muscle and fat on the same image. Bone marrow became isointense with fat (yellow marrow) at a mean age +/- S.E.M. (in years) of 8.5 +/- 0.24 in sphenoid, 9.1 +/- 0.29 in mandible, 9.3 +/- 0.28 in hard palate, 9.7 +/- 0.26 in frontal, 11.0 +/- 0.26 in squamous occiput, 11.5 +/- 0.28 in parietal, and 11.9 +/- 0.24 in basiocciput. There is a strong correlation between age and marrow intensity by Spearman analysis (p < 0.001): hard palate 0.64, mandible 0.61, parietal 0.42, sphenoid 0.70, cervical spine 0.50, basi-occiput 0.58 and occiput 0.52. Two consistent overall patterns of red-yellow marrow conversion were observed. Bone marrow became isointense with fat prior to pneumatization of the paranasal sinuses. Marrow conversion in the bones of the face occurred before those of the calvarium in a specific pattern. There was no significant sex difference in the pattern or rate of marrow conversion. These normative data are necessary to evaluate the immature skull by MR imaging in disease states.

Magnetization transfer contrast (MTC) imaging of skeletal muscle at 0.26 Tesla--changes in signal intensity following exercise

Magnetization transfer contrast (MTC) imaging of skeletal muscle before and after exercise has been studied in normal volunteers at 0.26 Tesla. A saturation pulse was applied over a range of offset frequencies immediately before a gradient recall echo sequence. Substantial signal loss was observed in all muscles. After exercise, selective saturation resulted in a significant increase of contrast between active and less active muscle, a phenomenon attributable to an increase in extracellular water content. MTC imaging provides a more sensitive method to detect changes in water distribution in human skeletal muscle.

Quantitative study of the susceptibility difference between trabecular bone and bone marrow: computer simulations

Inherent differences in tissue magnetic susceptibility produce inhomogeneities in the static magnetic field which give rise to an additional dephasing of the transverse magnetization in gradient-echo images. The enhanced dephasing of the signal results in an increase of the apparent relaxation rate 1/T2* and a corresponding decrease in signal intensity. These effects have been used to explain the regional loss of marrow signal intensity in the appendicular skeleton, where in the presence of trabecular bone in the proximal tibia there is an enhanced loss of signal compared to the tibial shaft where there is no trabeculation. It has been postulated that differences in tissue magnetic susceptibility arising due to the marrow--trabeculae interface give rise to magnetic field inhomogeneities and a reduced T2*. In this study computer simulations are used to determine whether susceptibility differences comparable to that between trabecular bone and tissue relate to the reduction of tissue T2* and whether the reduction in T2* is also related to the concentration and magnitude of susceptibility differences. In addition the effects of the spatial distribution of these particulate discontinuities in susceptibility on the measured relaxation time T2* are also estimated. This model demonstrates that 1/T2* increases as the number density and magnitude of such susceptibility differences increase. In a pixel of linear dimension L consisting of material simulating tissue water, the presence of circular point susceptibility differences of dimension 0.001 L with magnetic susceptibility equivalent to trabecular bone, 1/T2*, increases at a rate of 1.60 x 10(-2) s-1/N for N ranging from 25-2500. Differences in magnetic susceptibility that are less than that between soft tissue and trabecular bone are also modeled and the simulations demonstrate that differences in magnetic susceptibility, much lower than that between trabecular bone and tissue equivalent interfaces, also produce a relaxation rate enhancement in gradient-echo images.

Quantitation of the susceptibility difference between trabecular bone and bone marrow: experimental studies

In this study we quantify the effects of different relaxation mechanisms on the signal intensity in gradient-echo images of tissue such as bone marrow in the presence of trabecular bone. The susceptibility difference between trabecular bone and soft tissue produces distortions in the magnetic lines of force which induce strong inhomogeneities in the static magnetic field. Diffusion of tissue protons in such magnetic field gradients produce a shortening of the transverse relaxation time T2, while the dephasing of the transverse magnetization due to susceptibility differences produces a shortening of the apparent relaxation time T2* as demonstrated in gradient-echo images. We have used specimens of dried human vertebrae with different bone densities immersed in either saline to simulate tissue water or an emulsion of oil and water to simulate bone marrow to quantify these relaxation mechanisms in vitro. We have measured the MR relaxation times T1, T2, and T2* of protons within the trabecular spaces and correlated their variations with trabecular bone density. We have found that in vitro, at 1.5 T, the relaxation times T1 and T2 do not show significant variations with bone density and there are no significant contributions to the transverse relaxation rate due to the diffusion of tissue water in the magnetic field gradients. However, the relaxation rate, 1/T2*, of saline in the presence of trabecular bone increases at a rate of 0.2 s-1/mg/cc due to the dephasing of the transverse magnetization in the magnetic field inhomogeneities. Similar bone density-related T2* variations were observed for fat protons within the trabeculae where the chemical-shift-induced modulations of signal intensity in an oil-water emulsion have been separated from the susceptibility-induced relaxation effects. In addition, we have verified these effects in vivo and quantified in vivo variations in fat and water relaxation rates of bone marrow in the epiphysis and diaphysis in the appendicular skeleton of normal volunteers and found that both fat and water T2* are shorter in the epiphysis compared to the diaphysis, which correlates well with previous observations.

Epiphyseal marrow in infancy: MR imaging

Hypointense epiphyseal marrow on T1-weighted magnetic resonance images often suggests disease. To determine whether hypointense marrow sometimes represents normal red marrow in a recently ossified epiphyseal center, the authors studied 38 infants without known marrow disease. Patients with hypointense epiphyseal marrow on T1-weighted images were younger (3.9 months +/- 3.2) than those with hyperintense marrow (9.6 months +/- 3.9) (P less than .001). T1-weighted imaging and histologic correlation were also performed in animals. The signal was hypointense and the marrow was red in the epiphyseal centers of all newborn animals, while all 6-week-old animals had hyperintense signal and yellow marrow. The authors conclude that hypointense marrow on T1-weighted images represents normal red marrow in a recently formed ossification center in newborn rabbits and lambs, and the same is probably true in humans. Epiphyseal marrow becomes hyperintense within a few months of development of the secondary center of ossification.

Quantitative differences in the histology of the attachment zones of the meniscal horns in the knee joint of man

The attachment zones of the meniscal horns of 7 dissecting room cadavers were examined by routine histology. All the knees were devoid of gross pathological change and no discoid menisci were included. Significant differences are reported in the thickness of the zones of uncalcified fibrocartilage and cortical calcified tissue (calcified fibrocartilage and underlying lamellar bone) and in the percentage of bone:bone marrow. There was a thicker zone of uncalcified fibrocartilage and a greater quantity of calcified tissue at the horns of the lateral than the medial meniscus. The differences in uncalcified fibrocartilage were largely attributable to the posterior horns, but the variations in calcified tissue mainly reflected differences between the anterior horns. It is suggested that the greater mobility of the lateral meniscus and the blending of its anterior horn with the anterior cruciate ligament are important factors accounting for the quantitative differences in the meniscal attachment zones.

Developing spinal column: gadolinium-enhanced MR imaging

Enhancement characteristics of the normally developing spinal column were examined in magnetic resonance (MR) images obtained in 58 children aged 7 days to 9 years. With a 1.5-T imager, short-repetition-time spin-echo images were obtained before and after the administration of 0.1 mmol/kg gadopentetate dimeglumine. Enhancement of normal bone marrow was seen in all patients aged less than 7 years; it was marked only in patients aged less than 2 years. Enhancement of normal cartilage, seen in all patients aged less than 1 1/2 years, may be the most striking feature of enhanced MR images of the infant spine. Enhancement of both bone marrow and cartilage in children appears to be due to the unusual prominence of vasculature, associated with permeability of the capillary endothelium and a plentiful extravascular space. Although marked and diffuse enhancement of vertebral bodies in adults is often thought to indicate a pathologic marrow state, caution must be used before the same criteria are applied to children.

The quantitative study of lumbar vertebral bone marrow using T1 mapping and image analysis techniques: methodology and preliminary results

A method of quantifying lumbar vertebral bone marrow using pixel by pixel T1 mapping of spin echo magnetic resonance images is described. The accuracy and precision of the relaxation time measurements is confirmed by studies with the EEC Concerted Research Project, test object no. 5. The T1 data from all the pixels sampled from lumbar vertebral marrow are displayed as a histogram. By "thresholding" relative to normal control data the spatial distribution of high or low T1 pixels can be demonstrated. The approach is superior to that of the conventional region of interest method for quantifying and analysing relaxation time data, and allows tissue heterogeneity to be studied. Studies in patients with aplastic anaemia and acute leukaemia have been performed.

Anatomic and experimental basis for the insertion of a screw at the first sacral vertebra

The authors present the anatomic and experimental basis of an original technique for screwing at the first sacral level employed in lumbosacral fusion. The anatomic studies were based on specimens from the anatomy museum, frozen sections of the sacrum and CT examinations with three-dimensional reconstruction and assessment of the density of the different structures of S1 in Hounsfield units (HU). The findings were that the ala and lateral portions of S1 contain yellow marrow forming what amounts to a fatty sphere bounded by the cortical bone of the sacroiliac joint, the linea terminalis and the spongy bone of the pedicles and of the body of S1. The experimental study was made by avulsion of sacral screws (system of Cotrel Dubousset), each of 7mm diameter. No screw perforated the sacral cortex. Three directions were tested. The insertion of a screw through the pedicle and body of S1 is advised, with the point of insertion below and lateral to the articular process of S1 and an oblique course forward and inward at an angle of 10 degrees to the sagittal plane. This internal obliquity is limited by the posterior prominence of the iliac ala.

[Magnetic resonance tomographic screening studies of the bone marrow with gradient echo sequences: (I) the contrast relations of phase-identical and phase-shifted gradient echo sequences. Studies on probands and pathological-anatomical preparations]

Anatomical specimens and normal persons were studied by gradient echo MR imaging to determine the influence of different echo times (TE) on bone marrow contrast. First of all, six normal persons were studied to determine specific echo times for in-phase and opposed-phase states. Using different sequences bone marrow contrast in isolated femoral bones was determined and compared to results of pathological exams. Red bone marrow had no signal on opposed-phase images; contrast between red and yellow marrow was higher on opposed-phase than on in-phase images. Bone marrow lesions can be expected to be visualised with high signal on opposed-phase images; this technique should be especially suited for MR imaging of bone marrow.

Comparative anatomic study of anterior and posterior iliac crests as donor sites

Ten fixed human cadaver iliums from elderly persons were studied to compare the amounts of graft material present in the anterior and posterior ilium. Average intracortical volume of surgically accessible marrow space was 15.75 mL for the anterior and 39.24 mL for the posterior ilium. Comparison of marrow volume underlying equal surface areas revealed values of 8.4 mL for the anterior and 14.8 mL for the posterior ilium. The average total volume of compressed cancellous bone obtained was 12.87 mL for the anterior and 30.31 mL for the posterior ilium. The ratio of cortical bone window surface area to resultant immediately accessible graft material was 1:0.49 for the anterior and 1:0.75 for the posterior ilium. These results confirm the greater availability of cancellous bone in the posterior ilium.

Bone marrow perfusion evaluated with gadolinium-enhanced dynamic fast MR imaging in a dog model

The authors studied, in a dog model, the feasibility of using gadolinium-enhanced dynamic magnetic resonance (MR) imaging to noninvasively monitor bone marrow perfusion of the proximal femur. With a gradient-recalled acquisition, sequential images of 10 hips in five healthy dogs were obtained for 14 minutes after an intravenous bolus injection of 0.2 mmol of gadopentetate dimeglumine per kilogram. The study was repeated after unilateral arterial embolization of major femoral vessels. Radiolabeled microspheres were injected before and after vessel occlusion. After unilateral embolization, statistically significant differences in enhancement were observed between embolized and control sides (eg, 31% vs 83% average peak enhancement in the femoral neck). There was a high correlation (r = .81 [average]) between the MR data and the microsphere blood flow measurements. The postembolization data indicate that contrast-enhanced fast MR imaging may allow early detection of abnormal bone marrow flow. This technique may be valuable in evaluating patients at risk for avascular necrosis of the femoral head, especially in posttraumatic cases.

Bone marrow: ultrasmall superparamagnetic iron oxide for MR imaging

An ultrasmall superparamagnetic iron oxide (USPIO) preparation was evaluated as a potential intravenous contrast agent for magnetic resonance (MR) imaging of bone marrow. One hour after administration of USPIO (40, 80, and 160 mumols of iron per kilogram body weight) in rats and rabbits, T1 and T2 relaxation times were, respectively, approximately 30%, 50%, and 65% lower than precontrast relaxation times. Maximum decrease in relaxation times of marrow occurred within 1-24 hours after intravenous administration; thereafter, relaxation times slowly returned to normal within 7 days. In vivo MR imaging of rabbits and rats confirmed that USPIO decreases signal intensity of red and yellow marrow. The decrease was most marked with gradient echo pulse sequences. An animal model of intramedullary tumor demonstrated the potential of USPIO to enable differentiation between tumor and normal red marrow. USPIO-enhanced MR imaging improves detection of smaller tumors and allows differentiation of tumor deposits from islands of hyperplastic or normal red marrow.

Adaptation of diaphyseal structure to aging and decreased mechanical loading in the adult rat: a densitometric and histomorphometric study

Nine-month-old female rats were subjected to right hindlimb immobilization or served as controls for 0, 2, 10, 18, and 26 weeks. They were double-labeled with bone markers prior to sacrifice. Experimental unloading was produced by immobilizing the right limb against the abdomen with an elastic bandage. Single-photon absorptiometry was performed on the intact femurs; static and dynamic histomorphometry were performed on 20-micron thick toluidine blue-stained, undecalcified cross sections of the tibial shafts. Changes in the continuously immobilized tibiae were compared to those in both tibiae of age-matched controls. Unloading shut off nearly all periosteal bone formation and accelerates bone marrow expansion over that which occurs in age-related controls. The effect of unloading appeared to be mediated by recruiting fewer osteoblasts which showed inhibited activity. Furthermore, unloading increased endocortical percentage eroded surface. These histological changes lowered cortical bone mass by inhibiting diaphyseal cross sectional expansion and enlarging the bone marrow cavity. The results support Frost's suggestion that decrease mechanical usage depresses bone modeling-dependent bone gain by decreasing activation of modeling in the formation mode. It also stimulates bone remodeling-dependent bone loss by increasing activation of remodeling in the resorption mode.