Double line scan diffusion imaging

The role of diffusion tensor imaging in the diagnosis, prognosis, and assessment of recovery and treatment of spinal cord injury: a systematic review

OBJECTIVEDiffusion tensor imaging (DTI) is an MRI tool that provides an objective, noninvasive, in vivo assessment of spinal cord injury (SCI). DTI is significantly better at visualizing microstructures than standard MRI sequences. In this imaging modality, the direction and amplitude of the diffusion of water molecules inside tissues is measured, and this diffusion can be measured using a variety of parameters. As a result, the potential clinical application of DTI has been studied in several spinal cord pathologies, including SCI. The aim of this study was to describe the current state of the potential clinical utility of DTI in patients with SCI and the challenges to its use as a tool in clinical practice.METHODSA search in the PubMed database was conducted for articles relating to the use of DTI in SCI. The citations of relevant articles were also searched for additional articles.RESULTSAmong the most common DTI metrics are fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. Changes in these metrics reflect changes in tissue integrity. Several DTI metrics and combinations thereof have demonstrated significant correlations with clinical function both in model species and in humans. Its applications encompass the full spectrum of the clinical assessment of SCI including diagnosis, prognosis, recovery, and efficacy of treatments in both the spinal cord and potentially the brain.CONCLUSIONSDTI and its metrics have great potential to become a powerful clinical tool in SCI. However, the current limitations of DTI preclude its use beyond research and into clinical practice. Further studies are needed to significantly improve and resolve these limitations as well as to determine reliable time-specific changes in multiple DTI metrics for this tool to be used accurately and reliably in the clinical setting.

Comparison of single-shot echo-planar and line scan protocols for diffusion tensor imaging

RATIONALE AND OBJECTIVES

Both single-shot diffusion-weighted echo-planar imaging (EPI) and line scan diffusion imaging (LSDI) can be used to obtain magnetic resonance diffusion tensor data and to calculate directionally invariant diffusion anisotropy indices, ie, indirect measures of the organization and coherence of white matter fibers in the brain. To date, there has been no comparison of EPI and LSDI. Because EPI is the most commonly used technique for acquiring diffusion tensor data, it is important to understand the limitations and advantages of LSDI relative to EPI.

MATERIALS AND METHODS

Five healthy volunteers underwent EPI and LSDI diffusion on a 1.5 Tesla magnet (General Electric Medical Systems, Milwaukee, WI). Four-mm thick coronal sections, covering the entire brain, were obtained. In addition, one subject was tested with both sequences over four sessions. For each image voxel, eigenvectors and eigenvalues of the diffusion tensor were calculated, and fractional anisotropy (FA) was derived. Several regions of interest were delineated, and for each, mean FA and estimated mean standard deviation were calculated and compared.

RESULTS

Results showed no significant differences between EPI and LSDI for mean FA for the five subjects. When intersession reproducibility for one subject was evaluated, there was a significant difference between EPI and LSDI in FA for the corpus callosum and the right uncinate fasciculus. Moreover, errors associated with each FA measure were larger for EPI than for LSDI.

CONCLUSION

Results indicate that both EPI- and LSDI-derived FA measures are sufficiently robust. However, when higher accuracy is needed, LSDI provides smaller error and smaller inter-subject and inter-session variability than EPI.

Basic principles of diffusion-weighted imaging

In diffusion-weighted MRI (DWI), image contrast is determined by the random microscopic motion of water protons. During the last years, DWI has become an important modality in the diagnostic work-up of acute ischemia in the CNS. There are also a few promising reports about the application of DWI to other regions in the human body, such as the vertebral column or the abdomen. This manuscript provides an introduction into the basics of DWI and Diffusion Tensor imaging. The potential of various MR sequences in concert with diffusion preparation are discussed with respect to acquisition speed, spatial resolution, and sensitivity to bulk physiologic motion. More advanced diffusion measurement techniques, such as high angular resolution diffusion imaging, are also addressed.

Slab scan diffusion imaging

For maximum robustness of a diffusion-weighted MR imaging sequence, it is desirable to use a single-shot imaging method. This article introduces a new single-shot imaging approach that combines the advantages of multiple spin-echoes with the technique of line scan diffusion imaging. A slab volume, which can be spatially encoded with fewer phase encodes than a regular field of view, is selected with 2D selective pulses. With the shorter echo train, the sensitivity to field inhomogeneities and chemical shift is thus greatly diminished. Further reduction is achieved by interleaving short gradient echo trains with refocusing spin-echo pulses. Optimized slice-selective RF pulses that produce flip angles close to 180 degrees are used to minimize the stimulated echo component. Motion-related phase shifts, which change polarity with each spin-echo excitation, will give rise to artifacts that are avoidable by processing even and odd spin-echoes separately. As with line scan diffusion imaging, the complete field of view is acquired by sequential scanning. Since with each shot several lines of data are collected, a considerable improvement over line scan diffusion imaging in terms of scanning speed is achieved. Diffusion data obtained in phantoms and normal subjects demonstrate the feasibility of this novel approach.

Burst excitation for quantitative diffusion imaging with multiple b-values

A quantitative imaging sequence has been developed to exploit the intrinsic sensitivity of Burst NMR data to molecular diffusion. In the scan time of a single spin echo experiment, it is possible to acquire many images of the same slice, with a different T(2) and diffusion weighting. Under favorable conditions, it is possible to obtain both the diffusion coefficient and T(2) from the same experiment; or, by correcting for T(2) relaxation using a control image, more precise diffusion coefficients may be measured. The quantitative values in rat brain are in agreement with those from conventional experiments. The major gains of this method are the potentially reduced scan time, the higher number of acquired images corresponding to different diffusion weightings, the reduced sensitivity to inter-scan motion artifact and to local variations in magnetic susceptibility, and an automatic co-registration between T(2) and diffusion images. Problems with the sequence include a lower signal-to-noise ratio than is achievable with diffusion-weighted spin-echo imaging, the limitation of measuring only in-plane components of diffusion and, at present, single-slice acquisition.

Diffusion-weighted single-shot line scan imaging of the human brain

Single-shot line scan imaging (LSI) was adapted to diffusion-weighted (DW) MRI by replacing the initial 90 degrees radiofrequency pulse of the underlying high-speed stimulated echo sequence by a DW spin-echo preparation period. Implementation on a 2. 0 T whole-body MRI system yielded DW images of the human brain with b factors of 750 s mm(-2) and total imaging times of about 500 ms either for a single slice at 1.5 x 3.0 x 6 mm(3) resolution or simultaneously for up to seven slices at 3.75 x 3.75 x 8 mm(3) resolution. Isotropic DW images and maps of the trace of the diffusion tensor were calculated from four scans with different combinations of three orthogonal diffusion gradients. DW LSI combines high speed with robustness against image artifacts caused by motion (no phase ghosting) and tissue susceptibility differences (no signal losses, no geometric distortions). Because the latter is an important advantage over echo-planar imaging, DW LSI may find useful applications despite a limited signal-to-noise ratio. Magn Reson Med 42:772-778, 1999.

Diffusion-weighted imaging with navigated interleaved echo-planar imaging and a conventional gradient system

PURPOSE

To demonstrate the technical feasibility and precision of a navigated diffusion-weighted (DW) MR imaging method with interleaved echo-planar imaging and test its diagnostic sensitivity for detection of ischemic stroke.

MATERIALS AND METHODS

Apparent diffusion coefficient (ADC) measurements were performed in phantoms, and six healthy adult volunteers were examined to determine intrasubject (precision) and intersubject (reference range) variations in absolute ADC and relative ADC (rADC) measurements. DW imaging maps and lesion rADC values were also obtained in 34 consecutive stroke patients to evaluate the sensitivity and reliability of DW-interleaved echo-planar imaging for detection of ischemic brain damage.

RESULTS

Phantom and volunteer ADC values were in excellent agreement with published data. The intrasubject variation of rADC was 6.2%. The ADC precision ranged from 6.5% in the subcortical white matter in the frontal lobe to 12.9% in the head of the caudate nucleus. Interleaved echo-planar imaging enabled rapid acquisition of high-quality images of the entire brain without substantial artifacts. Within the 1st week, the sensitivity of DW-interleaved echo-planar imaging for detection of acute infarction was 90% (18 of 20 true-positive studies) and independent of lesion location.

CONCLUSION

DW-interleaved echo-planar imaging with phase navigation and cardiac triggering is robust, reliable, and fast. With high sensitivity for detection of early ischemic infarction, it is useful for examining stroke patients by using MR systems with conventional gradient hardware.

Single-shot line scan imaging using stimulated echoes

A new high-speed MRI method is described for single-shot line scan imaging (LSI) based on stimulated echoes (STE). To allow for multislice imaging, the technique comprises a series of slice-selective preparation pulses (each corresponding to the first RF pulse of a STE sequence), a slab-selective refocusing pulse (second RF pulse), and multiple line-selective read pulses (third RF pulses). An alternative version employs packages of two slice-selective pulses followed by multiple line-selective read pulses. Experimental applications deal with human brain imaging on a clinical MRI system at 2.0 T. The technique offers user-selectable trade-offs between volume coverage (1-15 sections) and in-plane spatial resolution (1-5 mm linear pixel dimension) within total acquisition times of less than 500 ms. Although LSI yields a lower signal-to-noise ratio than Fourier imaging, single-shot LSI with STEs is free from resonance offset effects (e.g., magnetic field inhomogeneities and susceptibility differences) that are typical for echo-planar imaging. Moreover, the technique exhibits considerable robustness against motion and provides access to arbitrary fields-of-view, i.e., localized imaging of inner volumes without aliasing artifacts due to phase wrapping.