Partial RF echo-planar imaging with the FAISE method. II. Contrast equivalence with spin-echo sequences

Fetal MRI: A Technical Update with Educational Aspirations

Fetal magnetic resonance imaging (MRI) examinations have become well-established procedures at many institutions and can serve as useful adjuncts to ultrasound (US) exams when diagnostic doubts remain after US. Due to fetal motion, however, fetal MRI exams are challenging and require the MR scanner to be used in a somewhat different mode than that employed for more routine clinical studies. Herein we review the techniques most commonly used, and those that are available, for fetal MRI with an emphasis on the physics of the techniques and how to deploy them to improve success rates for fetal MRI exams. By far the most common technique employed is single-shot T2-weighted imaging due to its excellent tissue contrast and relative immunity to fetal motion. Despite the significant challenges involved, however, many of the other techniques commonly employed in conventional neuro- and body MRI such as T1 and T2*-weighted imaging, diffusion and perfusion weighted imaging, as well as spectroscopic methods remain of interest for fetal MR applications. An effort to understand the strengths and limitations of these basic methods within the context of fetal MRI is made in order to optimize their use and facilitate implementation of technical improvements for the further development of fetal MR imaging, both in acquisition and post-processing strategies.

Lung Parenchymal Signal Intensity in MRI: A Technical Review with Educational Aspirations Regarding Reversible Versus Irreversible Transverse Relaxation Effects in Common Pulse Sequences

Lung parenchyma is challenging to image with proton MRI. The large air space results in ~l/5th as many signal-generating protons compared to other organs. Air/tissue magnetic susceptibility differences lead to strong magnetic field gradients throughout the lungs and to broad frequency distributions, much broader than within other organs. Such distributions have been the subject of experimental and theoretical analyses which may reveal aspects of lung microarchitecture useful for diagnosis. Their most immediate relevance to current imaging practice is to cause rapid signal decays, commonly discussed in terms of short T2* values of 1 ms or lower at typical imaging field strengths. Herein we provide a brief review of previous studies describing and interpreting proton lung spectra. We then link these broad frequency distributions to rapid signal decays, though not necessarily the exponential decays generally used to define T2* values. We examine how these decays influence observed signal intensities and spatial mapping features associated with the most prominent torso imaging sequences, including spoiled gradient and spin echo sequences. Effects of imperfect refocusing pulses on the multiple echo signal decays in single shot fast spin echo (SSFSE) sequences and effects of broad frequency distributions on balanced steady state free precession (bSSFP) sequence signal intensities are also provided. The theoretical analyses are based on the concept of explicitly separating the effects of reversible and irreversible transverse relaxation processes, thus providing a somewhat novel and more general framework from which to estimate lung signal intensity behavior in modern imaging practice.

Enhanced refocusing of fat signals using optimized multipulse echo sequences

Endogenous magnetic resonance contrast based on the localized composition of fat in vivo can provide functional information. We found that the unequal pulse timings of the Uhrig's dynamical decoupling multipulse echo sequences significantly alter the signal intensity compared to conventional, equal-spaced Carr-Purcell-Meiboom-Gill sequences. The signal increases and decreases depending on the tissue and sequence parameters, as well as on the interpulse spacings; particularly strong differences were observed in fatty tissues, which have a highly structured morphology and a wide range of chemical shifts and J-couplings. We found that the predominant mechanism for fat refocusing under multipulse echo sequences is the chemical structure, with stimulated echoes playing a pivotal role. As a result, specialized pulse sequences can be designed to optimize refocusing of the fat chemical shifts and J-couplings, where the degree of refocusing can be tailored to specific types of fats. To determine the optimal time delays, we simulated various Uhrig dynamical decoupling and Carr-Purcell-Meiboom-Gill pulse sequence timings, and these results are compared to experimental results obtained on excised and in vivo fatty tissue. Applications to intermolecular multiple quantum coherence imaging, where the improved echo refocusing translates directly into signal enhancements, are presented as well.

Carr-Purcell-Meiboom-Gill imaging of prostate cancer: quantitative T2 values for cancer discrimination

Quantitative, apparent T(2) values of suspected prostate cancer and healthy peripheral zone tissue in men with prostate cancer were measured using a Carr-Purcell-Meiboom-Gill (CPMG) imaging sequence in order to assess the cancer discrimination potential of tissue T(2) values. The CPMG imaging sequence was used to image the prostates of 18 men with biopsy-proven prostate cancer. Whole gland coverage with nominal voxel volumes of 0.54 x 1.1 x 4 mm(3) was obtained in 10.7 min, resulting in data sets suitable for generating high-quality images with variable T(2)-weighting and for evaluating quantitative T(2) values on a pixel-by-pixel basis. Region-of-interest analysis of suspected healthy peripheral zone tissue and suspected cancer, identified on the basis of both T(1)- and T(2)-weighted signal intensities and available histopathology reports, yielded significantly (P<.0001) longer apparent T(2) values in suspected healthy tissue (193+/-49 ms) vs. suspected cancer (100+/-26 ms), suggesting potential utility of this method as a tissue specific discrimination index for prostate cancer. We conclude that CPMG imaging of the prostate can be performed in reasonable scan times and can provide advantages over T(2)-weighted fast spin echo (FSE) imaging alone, including quantitative T(2) values for cancer discrimination as well as proton density maps without the point spread function degradation associated with short effective echo time FSE sequences.

Fast spectroscopic imaging strategies for potential applications in fMRI

Technical aspects of two general fast spectroscopic imaging (SI) strategies, one based on gradient echo trains and the other on spin echo trains, are reviewed within the context of potential applications in the field of functional magnetic resonance imaging (fMRI). Fast spectroscopic imaging of water may prove useful for identifying mechanisms underlying the blood oxygenation level dependence (BOLD) of the water signal during brain activation studies. Reasonably rapid mapping of changes in proton signals from brain metabolites, like lactate, creatine or even neurotransmitter associated metabolites like GABA, is substantially more challenging but technically feasible particularly as higher field strengths become available. Fast spectroscopic methods directed towards the 31P signals from phosphocreatine (PCr) and adenosine tri-phosphates (ATP) are also technically feasible and may prove useful for studying cerebral energetics within fMRI contexts.

Magnetic resonance imaging of sports injuries of the spine

Spinal injuries are relatively frequent events in professional athletes. Greater popularity of recreational athletic activities has increased the occurrence of sports-related spinal injuries in the general population. The demand of high-intensity sports places a constant load on the vertebral column. Several studies have demonstrated higher prevalence of spinal abnormalities in athletes than nonathletes. Direct correlation of the number and extent of injuries with the length in years of sports activity has been established. Diagnostic imaging, particularly magnetic resonance imaging (MRI), plays a crucial role in evaluating and detecting sports-related spinal injuries. Subtle bone marrow, soft-tissue, and spinal cord abnormalities, which may not be apparent on other imaging modalities, can be readily detected on MRI. Early detection often leads to prompt accurate diagnosis and expeditious management, in many cases avoiding unnecessary procedures. This article reviews the technical aspects of MRI for evaluation of the spine and the role of MRI in the assessment of sports-related spinal injuries.

Defining thresholds for changes in size of simulated T2-hyperintense brain lesions on the basis of qualitative comparisons

OBJECTIVE

Our purpose was to define thresholds below which trained reviewers cannot detect changes in the size of T2-hyperintense brain lesions.

MATERIALS AND METHODS

We generated T2-weighted brain MR images (TR/TE, 4000/80) with simulated hyperintense lesions derived from a real multiple sclerosis plaque. The size of the original multiple sclerosis lesion was varied by scaling up or down the lesion using a bicubic interpolation method. Three hundred seventy-eight composite images, in which two T2-weighted images containing lesions were paired, were presented to three equally trained neuroradiologists to define thresholds below which changes in original lesion size could not be detected. Stepwise logistic regression was used to evaluate the dependency of size thresholds on the original size of the lesion.

RESULTS

Thresholds ranged from a 5% to 15% increase in the original lesion diameter. For increases greater than 15%, all three reviewers detected the change in lesion size irrespective of the diameter of the original lesion. There was a dependency of the threshold on the diameter of the original lesion (p = 0.02).

CONCLUSION

Using an MR simulator, we can define thresholds below which changes in original lesion size cannot be reliably detected. These results may guide the design of clinical trials that rely on trained reviewers to assess change in lesion burden.

MR imaging in cervical spine trauma

Continual improvements in MR imaging, technology and MR imaging-compatible monitoring and fixation devices have allowed the incorporation of this relatively new imaging modality into standard algorithms for cervical spine trauma assessment. The ability of MR imaging to define the type of spinal cord injury, the cause and severity of spinal cord compression, and the stability of the spinal column is unmatched. The heavy reliance of the spinal surgeon on MR imaging for decisions regarding the type of therapy, the timing, the approach of surgical intervention, and for predicting patient outcome attests to the usefulness of this modality.

Accuracy for detection of simulated lesions: comparison of fluid-attenuated inversion-recovery, proton density--weighted, and T2-weighted synthetic brain MR imaging

OBJECTIVE

The objective of our study was to determine the effects of MR sequence (fluid-attenuated inversion-recovery [FLAIR], proton density--weighted, and T2-weighted) and of lesion location on sensitivity and specificity of lesion detection.

MATERIALS AND METHODS

We generated FLAIR, proton density-weighted, and T2-weighted brain images with 3-mm lesions using published parameters for acute multiple sclerosis plaques. Each image contained from zero to five lesions that were distributed among cortical-subcortical, periventricular, and deep white matter regions; on either side; and anterior or posterior in position. We presented images of 540 lesions, distributed among 2592 image regions, to six neuroradiologists. We constructed a contingency table for image regions with lesions and another for image regions without lesions (normal). Each table included the following: the reviewer's number (1--6); the MR sequence; the side, position, and region of the lesion; and the reviewer's response (lesion present or absent [normal]). We performed chi-square and log-linear analyses.

RESULTS

The FLAIR sequence yielded the highest true-positive rates (p < 0.001) and the highest true-negative rates (p < 0.001). Regions also differed in reviewers' true-positive rates (p < 0.001) and true-negative rates (p = 0.002). The true-positive rate model generated by log-linear analysis contained an additional sequence-location interaction. The true-negative rate model generated by log-linear analysis confirmed these associations, but no higher order interactions were added.

CONCLUSION

We developed software with which we can generate brain images of a wide range of pulse sequences and that allows us to specify the location, size, shape, and intrinsic characteristics of simulated lesions. We found that the use of FLAIR sequences increases detection accuracy for cortical-subcortical and periventricular lesions over that associated with proton density- and T2-weighted sequences.

Ultrafast pulse sequence techniques for cardiac magnetic resonance imaging

Cardiac magnetic resonance imaging is a rapidly emerging field that has seen tremendous advances in the past decade. Central to the development of effective imaging strategies has been the advent of high-performance gradient hardware and the exploitation of their speed characteristics through specialized pulse sequences well suited for cardiac imaging. These advances have facilitated unprecedented acquisition times that now approach echocardiographic frame rates, while maintaining excellent image quality. This article provides a detailed overview of advanced pulse sequence technology and approaches currently taken to maximize speed performance and image quality. In particular, segmented K-space techniques that include single-echo and multiecho spoiled gradient-echo imaging as well as steady-state free precession imaging are discussed. Finally, spiral and fast spin-echo techniques are explored. Examples of common applications of these pulse sequences are presented.

Dual-echo breathhold T(2)-weighted fast spin echo MR imaging of liver lesions

The purpose of this study was to develop a multi-shot dual-echo breathhold fast spin echo technique (DFSE) and compare it with conventional spin echo (T2SE) for T(2)-weighted MR imaging of liver lesions. The DFSE acquisition (EffTE1/EffTE2/TR = 66/143/2100 ms) imaged 5 sections per 17 s breathhold. T2SE imaging (TE1/TE2/TR = 60/120/2500 ms) required 16:55 (min:s) for 14 sections. Both techniques used a receive-only phased-array abdominal multicoil and provided 192 x 256 effective resolution. The results showed first and second echo relative DFSE/T2SE contrast values for 27 representative lesions (15 consecutive patients) were 1.08 +/- 0.05 and 1.16 +/- 0.09 (mean +/- STD mean), respectively. Corresponding CNR values were 1.12 +/- 0.09 and 0.97 +/- 0.12. Overall DFSE was comparable-to-superior to T2SE for lesion sizing and image artifact. DFSE lesion detection was inferior to T2SE's in several patient studies because of decreased conspicuity of lesions located near multicoil edges and because of poor breathhold-to-breathhold reproducibility and lack of breathholding. However both DFSE (and T2SE) provided lesion detection rated to be of diagnostic quality for all patient studies. In conclusion, we found that DFSE provides diagnostically useful dual-echo T(2)-weighted MR liver images in a greatly decreased acquisition time.

Density matrix simulations of the effects of J coupling in spin echo and fast spin echo imaging

A computer simulation has been used to calculate the effects of J coupling on the amplitudes of echoes produced by CPMG sequences. The program computes the evolution of the density matrix for different pulse intervals and can predict the signals obtainable from spin systems of any size and complexity. Results from the simulation confirm the prediction that a decrease in the effects of J coupling is largely responsible for the bright fat signal seen in fast spin echo imaging at high pulse rates. The effects of J coupling on CPMG echotrains are examined for A3B2 and A3B2C2 spin systems over a wide range of J coupling and chemical shift values and pulse spacings. The effects of J coupling on the point spread function obtained with fast spin echo imaging are also discussed.

Human rapid acquisition with relaxation enhancement imaging at 8 T without specific absorption rate violation

A standard fast imaging sequence, rapid acquisition with relaxation enhancement (RARE), has been applied to human magnetic resonance at 8 T. RARE is known for its speed, good contrast and high RF power content. Highly T2 weighted images, the hallmark of RARE imaging, were acquired from the human brain. It is demonstrated that while T2 values may be reduced at 8 T, high quality RARE images could still be acquired at this field strength. Most importantly however, it is demonstrated that RARE images could be acquired without violating specific absorption rate (SAR) guidelines. Since it is well known that T2 weighted images are of significant value in clinical diagnosis, the implementation of RARE at this field strength will provide ultra high field MRI (UHFMRI) with a valuable imaging protocol at this field strength without exceeding SAR limitations.

Usefulness of optimized gadolinium-enhanced fast fluid-attenuated inversion recovery MR imaging in revealing lesions of the brain

OBJECTIVE

The purpose of this study was to compare the contrast enhancement of lesions of the brain revealed by gadolinium-enhanced optimized fast fluid-attenuated inversion recovery (FLAIR) MR imaging with that of lesions on gadolinium-enhanced optimized T1-weighted spin-echo MR imaging.

SUBJECTS AND METHODS

Using computer simulations, we optimized the fast FLAIR parameters (TR, TEeff, and inversion time) and the T1-weighted spin-echo parameters (TR and TE) to provide maximum difference in signal intensity between enhancing lesions of the brain and white matter. Seventy-six consecutive patients referred for single-dose gadolinium-enhanced MR imaging of the brain underwent both optimized techniques, which were matched for spatial resolution, bandwidth, and number of excitations. The gadolinium-enhanced fast FLAIR and T -weighted spin-echo MR images were evaluated independently by two observers for number and size of enhancing lesions and for the degree of gray-white matter differentiation. Contrast-to-noise ratios were measured for enhancing lesions 1.0 cm or larger in diameter using 8 x 8 pixel regions of interest in the enhancing lesions and normal white matter.

RESULTS

The most revealing parameters for fast FLAIR MR imaging proved to be a TR of 1500 msec, an inversion time of 683 msec, and a TEeff of 16 msec. For T1-weighted spin-echo MR imaging, the optimized parameters were a TR of 550 msec and a TE of 16 msec. In 28 patients, we saw enhancing lesions of the brain with at least one MR imaging technique. More lesions were seen on the T1-weighted spin-echo sequence (n = 141) than on the fast FLAIR sequence (n = 94) (p < .03). Gray-white matter differentiation was significantly better on the fast FLAIR sequence (p < .001). Contrast-to-noise ratios of enhancing lesions were greater on the T1-weighted spin-echo sequence (p < .001).

CONCLUSION

In this study, optimized gadolinium-enhanced conventional T1-weighted spin-echo MR imaging proved superior to gadolinium-enhanced fast FLAIR MR imaging in revealing lesions of the brain.

Hepatic T2-weighted MRI: a prospective comparison of sequences, including breath-hold, half-Fourier turbo spin echo (HASTE)

The purpose of this study was to quantitatively compare the hepatic contrast characteristics of conventional spin-echo (CSE) and fast spin-echo (FSE) sequences with breath-hold T2-weighted images acquired with half-Fourier turbo spin echo (HASTE). Forty-five patients were examined with a phased-array surface coil. Nineteen patients had focal hepatic lesions, including eight malignant tumors, 10 cavernous hemangiomas, and one hepatic adenoma. Twenty-six patients had no focal hepatic lesions. T2-weighted images with comparable TE were acquired with CSE, FSE, and HASTE pulse sequences. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for liver, spleen, and lesions were measured. FSE demonstrated significantly better quantitative performance than CSE for liver-spleen CNR (P .0084). No statistically significant difference was demonstrated between FSE and CSE for liver or spleen SNR. FSE demonstrated clear scan time and resolution advantages over CSE. HASTE performed significantly poorer than CSE and FSE for liver-spleen CNR (P < .0001), liver SNR (P = .0002 for CSE and P < .0001 for FSE), and spleen SNR (P < .0001). Optimized FSE images with a short echo train length performed comparably to CSE images of equivalent TE. Liver-lesion CNR was suppressed on HASTE images, suggesting that long echo train length FSE sequences could diminish solid lesion detection compared to CSE and short echo train length FSE.

The sensitivity of low flip angle RARE imaging

It is demonstrated that the stability of the Carr-Purcell-Meiboom-Gill (CPMG) sequence reflects the existence of a steady state solution to the Bloch equations in the absence of T2 and T1 decay. The steady state theory is then used to evaluate the performance of low flip angle RARE imaging sequences with both constant and optimally varied refocusing flip angles. The theory is experimentally verified in phantoms and then optimized, single shot, low flip angle RARE is used to obtain artifact-free images from the brain of a normal volunteer.

Multislice T1-weighted hybrid RARE in CNS imaging: assessment of magnetization transfer effects and artifacts

Using a T1-weighted hybrid rapid acquisition with relaxation enhancement (RARE) MR sequence that implements an echo-to-view mapping scheme termed "low-high profile order," we evaluated signal intensity changes in different brain tissues as a function of number of slices, interslice gap, and echo train length (ETL). We also measured phase-encode and frequency-encode noise as well as blurring artifacts along the phase-encode direction as a function of ETL. Off-resonance magnetization transfer effects were demonstrated to be responsible for signal intensities changes in white matter and gray matter when using multislice techniques. These effects are amplified by increasing the number of slices and ETL. Due to the nature of the implemented echo-to-view mapping scheme, no on-resonance magnetization transfer effects were observed from the intraslice echo train. Selective background (white matter and gray matter) suppression in multislice T1-weighted hybrid RARE, secondary to off-resonance magnetization transfer effects, may provide better contrast resolution of enhancing central nervous system (CNS) lesions at much shorter scan time as compared to conventional spin-echo T1-weighted sequences. This improvement in contrast resolution as a function of ETL may be limited by worsening phase-encode noise and blurring artifacts.

Multisection T1-weighted hybrid-RARE: a pulse sequence for MR imaging of the entire liver during suspended respiration

It is shown that the maximum average-data-collection-speed (ADCS) of multisection 2D hybrid-RARE sequences is independent of TR and TEeff, and a monotonically increasing function of echo-train-length (ETL). This result was used in the design of an optimized T1-weighted hybrid-RARE sequence that produces 20 images of the abdomen in 31 s divided into four breath-hold periods. The resulting ADCS is 58 lines in k-space per second. Twenty-four subjects (2 healthy volunteers and 22 patients) were imaged with a protocol that also included: (a) breath-hold T1-weighted FLASH which acquires data at 34 lines in k-space per second (49 s scan time), and (b) T1-weighted conventional spin-echo (9:44 minutes scan time) with respiratory compensation. The experiments show that this T1-weighted-hybrid-RARE sequence has: (1) a level of T1 weighting that is comparable with the conventional sequences, (2) very low vulnerability to susceptibility artifacts, (3) high data acquisition efficiency, and (4) higher SNR than T1-weighted-FLASH. In conclusion, the T1-weighted-hybrid-RARE sequence described herein is an efficacious and reproducible technique for rapid imaging of the upper abdomen during suspended respiration.

Hepatic MR imaging: comparison of RARE derived sequences with conventional sequences for detection and characterization of focal liver lesions

BACKGROUND

We compared two T2-weighted turbo spin echo (TSE) sequences with a T2-weighted conventional SE (CSE) sequence to determine whether sequences derived from rapid acquisition with relaxation enhancement such as TSE could replace CSE for the detection and subsequent characterization of focal liver lesions.

METHODS

A total of 55 consecutive patients with 107 liver lesions underwent magnetic resonance imaging examinations at 1.5 Tesla, with a constant imaging protocol. TSE pulse sequences were acquired with eight echo trains (repetition time [TR], 4718 ms; echo time [TE], 90 ms; acquisition time [TA], 4.03 min; and a symmetric k-space ordering scheme) and 11 echo trains (TR, 4200 ms; TE, 140 ms; TA, 4.40 min; and an asymmetric k-space ordering scheme) and compared with CSE (TR, 2300 ms; TE, 45/90 ms; TA, 9.53 min). Images were analyzed qualitatively by scoring image quality and artifacts and counting focal liver lesions by independent reading with consensus obtained for discrepancies. Quantitative analysis was performed by measuring signal-to-noise (S/N), contrast-to-noise (C/N), and tumor-liver signal intensity (T/L) ratios.

RESULTS

T2-weighted TSE sequences provided better subjective image quality and reduced artifacts as compared with the T2-weighted CSE sequence. CSE and TSE sequences exhibited no statistically significant differences in liver S/N, lesion-liver C/N (CSE TE, 90 ms: 18.6 +/- 14.0; TSE TE, 90 ms: 16.5 +/- 12.9) and the detectability of focal liver lesions. Heavily T2-weighted TSE with a TE of 140 ms allowed correct characterization of focal liver lesions based on a T/L ratio of 3.0 in 84% of patients.

CONCLUSIONS

T2-weighted TSE sequences are as suited as CSE for the detection (TE, 90 ms), and appear to be superior for the characterization (TE, 140 ms), of focal hepatic lesions. Whether a single sequence, such as a double-echo TSE or a single-echo TSE sequence with a TE between 110 and 120 ms, might perform both functions as well or better than CSE is unknown. However, because of time savings, TSE eventually may be preferred over CSE.

Comparison of single-breath-hold fast spin-echo sequences with routine non-breath-hold techniques: application to MRI of renal masses

In 24 patients presenting with 55 renal lesions (mean size, 20.8 mm), single-breath-hold (SBH) fast spin-echo (FSE) techniques allowing T1 and T2 images to be produced within 20 and 23 sec, respectively, were compared with routine non-breath-hold (NBH) spin-echo (SE) T1 and NBH-FSE T2 sequences. Contrast-to-noise ratios (CNRs) measured from SBH-FSE T1 images were an average of 97% higher than their NBH counterparts (P = .0001) and allowed an improved lesion conspicuity in 80% of the cases (P = 0.0001). For T2 imaging, SBH-FSE and NBH-FSE sequences were not statistically different with respect to lesion conspicuity (P = .55) and CNR values (P = .19). This was observed despite a 35% average decrease in CNR of SBH-FSE compared to NBH-FSE images. By reducing respiratory motion artifacts while preserving SE-like image contrast, SBH-FSE techniques have the potential to replace routine NBH sequences for an optimal diagnosis of renal masses.

Fast 3D large-angle spin-echo imaging (3D FLASE)

A rapid steady-state 3D spin-echo imaging pulse sequence, based on the principle of nutating the spins by an angle greater than 90 degrees, has been designed and implemented on a clinical 1.5-T whole-body MR scanner. The pulse sequence, denoted fast large-angle spin-echo (FLASE), has been optimized for high-resolution imaging of tissues with short T2 and T2*. Features of FLASE include a minimum-phase Shinnar-Le Roux excitation pulse and distribution of phase- and slice-encoding gradients before and after the 180 degrees refocusing pulse to minimize the critical time delay between inversion and restoration of the residual longitudinal magnetization and for minimizing echo time. A Bloch equation analysis, corroborated by experimental data, shows FLASE signal-to-noise to be superior to its closest analog, 3D rapid spin-echo excitation (RASEE) (Jara et al., Magn Reson Medicine 29, 528 (1993)), and 3D gradient-recalled acquisition in steady state (GRASS). It is demonstrated that with judicious RF phase-cycling and steady state operation, FLASE can produce high-quality microimages free of intravoxel phase dispersion from susceptibility-induced background gradients. The performance of the method is exemplified with ultra high-resolution images of trabecular bone in vitro and in vivo in the human calcaneus and wrist at voxel sizes as low as 98 x 98 x 200 microns3. Finally, the contrast behavior of refocused FLASE can be altered by disrupting the steady state analogous to gradient echo imaging.

Coherence transfer by isotropic mixing in Carr-Purcell-Meiboom-Gill imaging: implications for the bright fat phenomenon in fast spin-echo imaging

It is well known that when compared to conventional spin-echo (CSE) imaging for equivalent effective echo times, fast spin-echo (FSE) imaging experiments yield higher signal intensities for coupled spin systems, such as that for lipid. One hypothesis put forth for this phenomenon is the removal of scalar coupling-based echo amplitude modulation by the FSE pi pulse train. This would result in the maintenance of signal intensity in the late echoes, with an overall increase in image signal when the multiecho train data is combined to form the image data. It will be shown that in images and spectra obtained from the final echo of a Carr-Purcell-Meiboom-Gill (CPMG) pi pulse train, an increase in signal in coupled spin systems occurs, when compared to conventional single-echo images and spectra at identical echo times. One- and two-dimensional spectroscopy experiments confirm that it is the generation of an isotropic mixing Hamiltonian by the pi pulse train in FSE that is responsible for the increased signal in images of a simple AX system and of corn oil, a model for human fat. This relative increase in signal is due to the maintenance of in-phase magnetization in the coupled spin systems by this Hamiltonian. In CSE, the weak coupling Hamiltonian allows development of antiphase coherences which, in the presence of the line broadening due to the imaging gradients, result in signal loss.

Brain imaging: reduced sensitivity of RARE-derived techniques to susceptibility effects

OBJECTIVE

Our goal was to evaluate the decreased sensitivity of RARE-derived pulse sequences to susceptibility effects.

MATERIALS AND METHODS

A variety of RARE-derived T2-weighted fast SE echo (FSE) sequences with echo trains from 6 to 16 were compared with conventional SE (CSE) sequences by means of MRI in phantoms (iron oxides), volunteers (n = 10), and patients (n = 13) with old hemorrhagic brain lesions. All experiments were performed on a 1.5 T clinical MR system (Magnetom SP 4000; Siemens AG, Erlangen, Germany) with constant imaging parameters. Contrast-to-noise ratios (CNRs) of tubes doped with iron oxides at different concentrations and brain areas with physiological iron deposition (red nucleus, substantia nigra) were calculated for CSE and FSE pulse sequences. Areas of old brain hemorrhage were analyzed for lesion conspicuity by blinded analysis with CSE as an internal standard.

RESULTS

CNR of iron oxide tubes (TE 90 ms, CSE 45.0 +/- 3.5, FSE 16 echo trains 28.5 +/- 3.1; p < or = 0.01) and iron-containing brain areas decreased with increasing echo trains of FSE sequences. A significantly lower number of old hemorrhagic brain lesions was visible in patients scanned with FSE sequences (6 echo trains: n = 28; 16 echo trains; n = 26) than CSE (n = 40).

CONCLUSION

Our results demonstrate that the sensitivity of RARE-derived techniques to susceptibility effects is significantly decreased compared with CSE. CSE sequences or GE sequences should still be preferred in patients with a history of seizures or intracranial hemorrhage.

MR image segmentation using vector decomposition and probability techniques: a general model and its application to dual-echo images

A general model is developed for segmenting magnetic resonance images using vector decomposition and probability techniques. Each voxel is assigned fractional volumes of q tissues from p differently weighted images (q < or = p + 1) in the presence of partial-volume mixing, random noise, and other tissues. Compared with the eigenimage method, fewer differently weighted images are needed for segmenting the q tissues, and the contrast-to-noise ratio in the calculated fractional volumes is improved. The model can produce composite tissue-type images similar to that of the probability methods, by comparing the fractional volumes assigned to different tissues on each voxel. A three-tissue (p = 2, q = 3) model is illustrated for segmenting three tissues from dual-echo images. It provides statistical analysis to the algebraic method. A three-compartment phantom is segmented for validation. Two clinical examples are presented.

Dual-echo interleaved echo-planar imaging of the brain

An interleaved echo-planar imaging (EPI) technique is described that provides images from 20 sections of the brain at two echo times (27 and 84 ms) in 1:05. Six echoes per image per repetition are collected in 24 repetitions of the pulse sequence. MR images of the brain obtained from five volunteers using the dual-echo EPI sequence, fast spin-echo (FSE), and conventional dual-echo spin-echo were evaluated qualitatively for diagnostic use and quantitatively for relative signal-to-noise ratio (SNR), contrast, and contrast-to-noise ratios (CNR).

Silicone-fat differentiation in the breast: exploiting the bright-fat phenomenon in fast spin-echo MR imaging

Selective suppression of silicone or fat with chemical shift-selective (CHESS) pulses is difficult because of the small chemical shift difference between the primary lipid signal and the primary silicone signal at 1.5 T. Differentiation of these chemically distinct species is, however, an important clinical task in assessing implant rupture and silicone migration in breast tissue. A method uniquely suited for silicone-fat differentiation with fast spin-echo (FSE) sequences is reported. It is based on the dependence of fat signal on echo spacing in FSE imaging and results show that it may provide a clinically robust method for silicone-fat differentiation in magnetic resonance imaging of the breast.

A comparison between fast and conventional spin-echo in the detection of multiple sclerosis lesions

Long repetition time (TR) spin-echo (SE) with T2- or proton density weighting is the sequence of choice to detect the brain lesions of multiple sclerosis (MS). Fast spin-echo (FSE) permits the generation of T2-weighted images with similar contrast to SE but in a fraction of the time. We compared the sensitivity of FSE and SE in the detection of the brain lesions of MS. Six patients with clinically definite MS underwent brain imaging with both dual echo (long TR, long and short echo time (TE) SE and dual echo FSE. The SE and FSE images were first reviewed independently and then compared. A total of 404 lesions was detected on SE and 398 on FSE. Slightly more periventricular lesions were detected using SE than FSE (145 vs 127), whereas more posterior cranial fossa lesions were detected by FSE (77 vs 57). With both SE and FSE the short TE images revealed more lesions than the long echo. These results suggest that FSE could replace SE as the long TR sequence of choice in the investigation of MS.

Tissue temperature monitoring for thermal interventional therapy: comparison of T1-weighted MR sequences

For thermal interventional therapy, near real-time monitoring of temperature changes in the treated area is desirable. In this study, various fast T1-weighted magnetic resonance (MR) imaging protocols were compared to determine the sensitivity and resolution of signal intensity for temperatures within the range of 36 degrees C-66 degrees C in gel phantoms and in vitro porcine liver specimens. The results showed that a T1-weighted fast spin-echo sequence with a TR of 100 msec had better temperature sensitivity and resolution than other sequences with comparable temporal resolutions. The longer imaging times required for fast spin-echo sequences with a TR of 300 msec did not improve temperature sensitivity. The methods introduced to evaluate temperature sensitivity and resolution should prove useful in selecting appropriate MR protocols for monitoring thermal treatment modalities such as interstitial laser therapy, focused ultrasound therapy, or radio-frequency heating.

MR monitoring during cryotherapy in the liver: predictability of histologic outcome

For well-controlled application of cryotherapy to focal liver lesions, real-time monitoring is necessary to limit the final necrotic effect in the treated area. In this study, near real-time magnetic resonance (MR) monitoring images of normal rabbit liver were obtained during the freezing procedure. The MR-monitored, freezing-induced lesions were followed with MR images for up to 3 weeks. Corresponding histologic samples were also obtained over the same time period. Our results indicate that MR images obtained during the freezing procedure can adequately depict the area of final necrosis. Furthermore, histologic changes at each stage of lesion development correlated well with MR signal intensities on follow-up images. With the development of an MR-compatible cryogen probe, MR imaging may prove to be a robust method for monitoring, controlling, and following up cryotherapy in the liver.