Nineteen-channel receive array and four-channel transmit array coil for cervical spinal cord imaging at 7T

Spinal Cord Imaging in Multiple Sclerosis and Related Disorders

Spinal cord MRI plays an important role in the diagnosis and prognosis of multiple sclerosis (MS) and related disorders. The ANATOMICAL, pathologic, imaging and prognostic consideriations for the spinal cord for MS and the most important other demyelinating disorders, neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein-associated disease, are reviewed. Finally, differential diagnostic considerations of spinal cord MRI in MS and related disorders are discussed.

Upper end of the central canal of the human spinal cord: Quantitative anatomical study and 3D modeling

The upper end of the central canal of the human spinal cord has been repeatedly implicated in the pathogenesis of various diseases, yet its precise normal position in the medulla oblongata and upper cervical spinal cord remains unclear. The purpose of this study is to describe the anatomy of the upper end of the central canal with quantitative measurements and a three-dimensional (3D) model. Seven formalin-embalmed human brainstems were included, and the central canal was identified in serial axial histological sections using epithelial membrane antigen antibody staining. Measurements included the distances between the central canal (CC) and the anterior medullary fissure (AMF) and the posterior medullary sulcus (PMS). The surface and perimeter of the CC and the spinal cord were calculated, and its anterior-posterior and maximum lateral lengths were measured for 3D modeling. The upper end of the CC was identified in six specimens, extending from the apertura canalis centralis (ACC) to its final position in the cervical cord. Positioned on the midline, it reaches its final location approximately 15 mm below the obex. No specimen showed canal dilatation, focal stenosis, or evidence of syringomyelia. At 21 mm under the ACC in the cervical cord, the median distance from the CC to the AMF was 3.14 (2.54-3.15) mm and from the CC to the PMS was 5.19 (4.52-5.43) mm, with a progressive shift from the posterior limit to the anterior third of the cervical spinal cord. The median area of the CC was consistently less than 0.1 mm2. The upper end of the CC originates at the ACC, in the posterior part of the MO, and reaches its normal position in the anterior third of the cervical spinal cord less than 2 cm below the obex. Establishing the normal position of the upper end of this canal is crucial for understanding its possible involvement in cranio-cervical junction pathologies.

Calibration-free parallel transmission of the cervical, thoracic, and lumbar spinal cord at 7T

PURPOSE

To address the limitations of spinal cord imaging at ultra-high field (UHF) due to time-consuming parallel transmit (pTx) adjustments. This study introduces calibration-free offline computed universal shim modes that can be applied seamlessly for different pTx RF coils and spinal cord target regions, substantially enhancing spinal cord imaging efficiency at UHF.

METHODS

A library of channel-wise relativeB 1 + $$ {B}_1^{+} $$ maps for the cervical spinal cord (six datasets) and thoracic and lumbar spinal cord (nine datasets) was constructed to optimize transmit homogeneity and efficiency for these regions. A tailored B0 shim was optimized for the cervical spine to enhance spatial magnetic field homogeneity further. The performance of the universal shims was validated using absolute saturation basedB 1 + $$ {B}_1^{+} $$ mapping and high-resolution 2D and 3D multi-echo gradient-recalled echo (GRE) data to assess the image quality.

RESULTS

The proposed universal shims demonstrated a 50% improvement inB 1 + $$ {B}_1^{+} $$ efficiency compared to the default (zero phase) shim mode.B 1 + $$ {B}_1^{+} $$ homogeneity was also improved by 20%. The optimized universal shims achieved performance comparable to subject-specific pTx adjustments, while eliminating the need for lengthy pTx calibration times, saving about 10 min per experiment.

CONCLUSION

The development of universal shims represents a significant advance by eliminating time-consuming subject-specific pTx adjustments. This approach is expected to make UHF spinal cord imaging more accessible and user-friendly, particularly for non-pTx experts.

Whole-liver flip-angle shimming at 7 T using parallel-transmit kT -point pulses and Fourier phase-encoded DREAM B 1 + mapping

PURPOSE

To obtain homogeneous signal throughout the human liver at 7 T. Flip angle (FA) shimming in 7T whole-liver imaging was performed through parallel-transmit kT -point pulses based on subject-specific multichannel absoluteB 1 + $$ {\mathrm{B}}_1^{+} $$ maps from Fourier phase-encoded dual refocusing echo acquisition mode (PE-DREAM).

METHODS

The optimal number of Fourier phase-encoding steps for PE-DREAMB 1 + $$ {\mathrm{B}}_1^{+} $$ mapping was determined for a 7T eight-channel parallel-transmission system. FA shimming experiments were performed in the liver of 7 healthy subjects with varying body mass index. In these subjects, firstB 0 $$ {\mathrm{B}}_0 $$ shimming and Fourier PE-DREAMB 1 + $$ {\mathrm{B}}_1^{+} $$ mapping were performed. Subsequently, three small-flip-angle 3D gradient-echo scans were acquired, comparing a circularly polarized (CP) mode, a phase shim, and a kT -point pulse. Resulting homogeneity was assessed and compared with estimated FA maps and distributions.

RESULTS

Fourier PE-DREAM with 13 phase-encoding steps resulted in a good tradeoff betweenB 1 + $$ {\mathrm{B}}_1^{+} $$ accuracy and scan time. Lower coefficient of variation values (average [min-max] across subjects) of the estimated FA in the volume of interest were observed using kT -points (7.4 [6.6%-8.0%]), compared with phase shimming (18.8 [12.9%-23.4%], p < 0.001) and CP (43.2 [39.4%-47.1%], p < 0.001). kT -points delivered whole-liver images with the nominal FA and the highest degree of homogeneity. CP and phase shimming resulted in either inaccurate or imprecise FA distributions. Here, locations having suboptimal FA in the estimated FA maps corresponded to liver areas suffering from inconsistent signal intensity and T1 -weighting in the gradient-echo scans.

CONCLUSION

Homogeneous whole-liver 3D gradient-echo acquisitions at 7 T can be obtained with eight-channel kT -point pulses calculated based on subject-specific multichannel absolute Fourier PE-DREAMB 1 + $$ {\mathrm{B}}_1^{+} $$ maps.

An 8-channel Tx dipole and 20-channel Rx loop coil array for MRI of the cervical spinal cord at 7 Tesla

The quality of cervical spinal cord images can be improved by the use of tailored radiofrequency (RF) coil solutions for ultrahigh field imaging; however, very few commercial and research 7-T RF coils currently exist for the spinal cord, and in particular, those with parallel transmission (pTx) capabilities. This work presents the design, testing, and validation of a pTx/Rx coil for the human neck and cervical/upper thoracic spinal cord. The pTx portion is composed of eight dipoles to ensure high homogeneity over this large region of the spinal cord. The Rx portion is made up of twenty semiadaptable overlapping loops to produce high signal-to-noise ratio (SNR) across the patient population. The coil housing is designed to facilitate patient positioning and comfort, while also being tight fitting to ensure high sensitivity. We demonstrate RF shimming capabilities to optimize B1 + uniformity, power efficiency, and/or specific absorption rate efficiency. B1 + homogeneity, SNR, and g-factor were evaluated in adult volunteers and demonstrated excellent performance from the occipital lobe down to the T4-T5 level. We compared the proposed coil with two state-of-the-art head and head/neck coils, confirming its superiority in the cervical and upper thoracic regions of the spinal cord. This coil solution therefore provides a convincing platform for producing the high image quality necessary for clinical and research scanning of the upper spinal cord.

Flexible array coil for cervical and extraspinal (FACE) MRI at 3.0 Tesla

Objective.High-resolution MRI of the cervical spine (c-spine) and extraspinal neck region requires close-fitting receiver coils to maximize the signal-to-noise ratio (SNR). Conventional, rigid C-spine receiver coils do not adequately contour to the neck to accommodate varying body shapes, resulting in suboptimal SNR. Recent innovations in flexible surface coil array designs may provide three-dimensional (3D) bendability and conformability to optimize SNR, while improving capabilities for higher acceleration factors.Approach.This work describes the design, implementation, and preliminaryin vivotesting of a novel, conformal 23-channel receive-only flexible array for cervical and extraspinal (FACE) MRI at 3-Tesla (T), with use of high-impedance elements to enhance the coil's flexibility. Coil performance was tested by assessing SNR and geometry factors (g-factors) in a phantom compared to a conventional 21-channel head-neck-unit (HNU).In vivoimaging was performed in healthy human volunteers and patients using high-resolution c-spine and neck MRI protocols at 3T, including MR neurography (MRN).Main results.Mean SNR with the FACE was 141%-161% higher at left, right, and posterior off-isocenter positions and 4% higher at the isocenter of the phantom compared to the HNU. Parallel imaging performance was comparable for an acceleration factor (R) = 2 × 2 between the two coils, but improved forR= 3 × 3 with meang-factors ranging from 1.46-2.15 with the FACE compared to 2.36-3.62 obtained with the HNU. Preliminary human volunteer and patient testing confirmed that equivalent or superior image quality could be obtained for evaluation of osseous and soft tissue structures of the cervical region with the FACE.Significance.A conformal and highly flexible cervical array with high-impedance coil elements can potentially enable higher-resolution imaging for cervical imaging.

Feasibility of spinal cord imaging at 7 T using rosette trajectory with magnetization transfer preparation and compressed sensing

MRI is a valuable diagnostic tool to investigate spinal cord (SC) pathology. SC MRI can benefit from the increased signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) at ultra-high fields such as 7 T. However, SC MRI acquisitions with routine Cartesian readouts are prone to image artifacts caused by physiological motion. MRI acquisition techniques with non-Cartesian readouts such as rosette can help reduce motion artifacts. The purpose of this study was to demonstrate the feasibility of high-resolution SC imaging using rosette trajectory with magnetization transfer preparation (MT-prep) and compressed sensing (CS) at 7 T. Five healthy volunteers participated in the study. Images acquired with rosette readouts demonstrated reduced motion artifacts compared to the standard Cartesian readouts. The combination of multi-echo rosette-readout images improved the CNR by approximately 50% between the gray matter (GM) and white matter (WM) compared to single-echo images. MT-prep images showed excellent contrast between the GM and WM with magnetization transfer ratio (MTR) and cerebrospinal fluid normalized MT signal (MTCSF) = 0.12 ± 0.017 and 0.74 ± 0.013, respectively, for the GM; and 0.18 ± 0.011 and 0.58 ± 0.009, respectively, for the WM. Under-sampled acquisition using rosette readout with CS reconstruction demonstrated up to 6 times faster scans with comparable image quality as the fully-sampled acquisition.

8-channel Tx dipole and 20-channel Rx loop coil array for MRI of the cervical spinal cord at 7 Tesla

The quality of cervical spinal cord images can be improved by the use of tailored radiofrequency coil solutions for ultra-high field imaging; however, very few commercial and research 7 Tesla radiofrequency coils currently exist for the spinal cord, and in particular those with parallel transmit capabilities. This work presents the design, testing and validation of a pTx/Rx coil for the human neck and cervical/upper-thoracic spinal cord. The pTx portion is composed of 8 dipoles to ensure high homogeneity over this large region of the spinal cord. The Rx portion is made of 20 semi-adaptable overlapping loops to produce high Signal-to-noise ratio (SNR) across the patient population. The coil housing is designed to facilitate patient positioning and comfort, while being tight fitting to ensure high sensitivity. We demonstrate RF shimming capabilities to optimize B ₁ ⁺ uniformity, power efficiency and/or specific absorption rate (SAR) efficiency. B ₁ ⁺ homogeneity, SNR and g-factor was evaluated in adult volunteers and demonstrated excellent performance from the occipital lobe down to the T4-T5 level. We compared the proposed coil with two state-of-the-art head and head/neck coils, confirming its superiority in the cervical and upper-thoracic regions of the spinal cord. This coil solution therefore provides a convincing platform for producing the high image quality necessary for clinical and research scanning of the upper spinal cord.

Ultra-high field MRI: parallel-transmit arrays and RF pulse design

This paper reviews the field of multiple or parallel radiofrequency (RF) transmission for magnetic resonance imaging (MRI). Currently the use of ultra-high field (UHF) MRI at 7 tesla and above is gaining popularity, yet faces challenges with non-uniformity of the RF field and higher RF power deposition. Since its introduction in the early 2000s, parallel transmission (pTx) has been recognized as a powerful tool for accelerating spatially selective RF pulses and combating the challenges associated with RF inhomogeneity at UHF. We provide a survey of the types of dedicated RF coils used commonly for pTx and the important modeling of the coil behavior by electromagnetic (EM) field simulations. We also discuss the additional safety considerations involved with pTx such as the specific absorption rate (SAR) and how to manage them. We then describe the application of pTx with RF pulse design, including a practical guide to popular methods. Finally, we conclude with a description of the current and future prospects for pTx, particularly its potential for routine clinical use.

A patient-friendly 16-channel transmit/64-channel receive coil array for combined head-neck MRI at 7 Tesla

PURPOSE

To extend the coverage of brain coil arrays to the neck and cervical-spine region to enable combined head and neck imaging at 7 Tesla (T) ultra-high field MRI.

METHODS

The coil array structures of a 64-channel receive coil and a 16-channel transmit coil were merged into one anatomically shaped close-fitting housing. Transmit characteristics were evaluated in a B1+ -field mapping study and an electromagnetic model. Receive SNR and the encoding capability for accelerated imaging were evaluated and compared with a commercially available 7 T brain array coil. The performance of the head-neck array coil was demonstrated in human volunteers using high-resolution accelerated imaging.

RESULTS

In the brain, the SNR matches the commercially available 32-channel brain array and showed improvements in accelerated imaging capabilities. More importantly, the constructed coil array improved the SNR in the face area, neck area, and cervical spine by a factor of 1.5, 3.4, and 5.2, respectively, in regions not covered by 32-channel brain arrays at 7 T. The interelement coupling of the 16-channel transmit coil ranged from -14 to -44 dB (mean = -19 dB, adjacent elements <-18 dB). The parallel 16-channel transmit coil greatly facilitates B1+ field shaping required for large FOV neuroimaging at 7 T.

CONCLUSION

This new head-neck array coil is the first demonstration of a device of this nature used for combined full-brain, head-neck, and cervical-spine imaging at 7 T. The array coil is well suited to provide large FOV images, which potentially improves ultrahigh field neuroimaging applications for clinical settings.

A nine-channel transmit/receive array for spine imaging at 10.5 T: Introduction to a nonuniform dielectric substrate antenna

PURPOSE

The purpose of this study is to introduce a new antenna element with improved transmit performance, named the nonuniform dielectric substrate (NODES) antenna, for building transmit arrays at ultrahigh-field.

METHODS

We optimized a dipole antenna at 10.5 Tesla by maximizing the B 1 + -SAR efficiency in a phantom for a human spine target. The optimization parameters included permittivity variation in the substrate, substrate thickness, antenna length, and conductor geometry. We conducted electromagnetic simulations as well as phantom experiments to compare the transmit/receive performance of the proposed NODES antenna design with existing coil elements from the literature.

RESULTS

Single NODES element showed up to 18% and 30% higher B 1 + -SAR efficiency than the fractionated dipole and loop elements, respectively. The new element is substantially shorter than a commonly used dipole, which enables z-stacked array formation; it is additionally capable of providing a relatively uniform current distribution along its conductors. The nine-channel transmit/receive NODES array achieved 7.5% higher B 1 + homogeneity than a loop array with the same number of elements. Excitation with the NODES array resulted in 33% lower peak 10g-averaged SAR and required 34% lower input power than the loop array for the target anatomy of the spine.

CONCLUSION

In this study, we introduced a new RF coil element: the NODES antenna. NODES antenna outperformed the widely used loop and dipole elements and may provide improved transmit/receive performance for future ultrahigh field MRI applications.

MRI T2-Hyperintense Signal Structures in the Cervical Spinal Cord: Anterior Median Fissure versus Central Canal in Chiari and Control-An Exploratory Pilot Analysis

BACKGROUND AND PURPOSE

Cervical spine axial MRI T2-hyperintense fluid signal of the anterior median fissure and round hyperintense foci resembling either the central canal or base of the anterior median fissure are associated with a craniocaudad sagittal line, also simulating the central canal. On the basis of empiric observation, we hypothesized that hyperintense foci, the anterior median fissure, and the sagittal line are seen more frequently in patients with Chiari malformation type I, and the sagittal line may be the base of the anterior median fissure in some patients.

MATERIALS AND METHODS

Saggital line incidence and the incidence/frequency of hyperintense foci and anterior median fissure in 25 patients with Chiari I malformation and 25 contemporaneous age-matched controls were recorded in this prospective exploratory study as either combined (hyperintense foci+anterior median fissure in the same patient), connected (anterior median fissure extending to and appearing to be connected with hyperintense foci), or alone as hyperintense foci or an anterior median fissure. Hyperintense foci and anterior median fissure/patient, hyperintense foci/anterior median fissure ratios, and anterior median fissure extending to and appearing to be connected with hyperintense foci were compared in all, in hyperintense foci+anterior median fissure in the same patient, and in anterior median fissure extending to and appearing to be connected with hyperintense foci in patients with Chiari I malformation and controls.

RESULTS

Increased sagittal line incidence (56%), hyperintense foci (8.5/patient), and anterior median fissure (4.0/patient) frequency were identified in patients with Chiari I malformation versus controls (28%, 3.9/patient, and 2.7/patient, respectively). Increased anterior median fissure/patient, decreasing hyperintense foci/anterior median fissure ratio, and increasing anterior median fissure extending to and appearing to be connected with hyperintense foci/patient were identified in Chiari subgroups. A 21%-58% increase in observed anterior median fissure extending to and appearing connected to hyperintense foci in the entire cohort and multiple sagittal line subgroups compared with predicted occurred.

CONCLUSIONS

In addition to the anticipated increased incidence/frequency of sagittal line and hyperintense foci in patients with Chiari I malformation, an increased incidence and frequency of anterior median fissure and anterior median fissure extending to and appearing to be connected with hyperintense foci/patient were identified. We believe an anterior median fissure may contribute to a saggital line appearance in some patients with Chiari I malformation. While thin saggital line channels are usually ascribed to the central canal, we believe some may be due to the base of the anterior median fissure, created by pulsatile CSF hydrodynamics.

7 T imaging reveals a gradient in spinal cord lesion distribution in multiple sclerosis

We used 7 T MRI to: (i) characterize the grey and white matter pathology in the cervical spinal cord of patients with early relapsing-remitting and secondary progressive multiple sclerosis; (ii) assess the spinal cord lesion spatial distribution and the hypothesis of an outside-in pathological process possibly driven by CSF-mediated immune cytotoxic factors; and (iii) evaluate the association of spinal cord pathology with brain burden and its contribution to neurological disability. We prospectively recruited 20 relapsing-remitting, 15 secondary progressive multiple sclerosis participants and 11 age-matched healthy control subjects to undergo 7 T imaging of the cervical spinal cord and brain as well as conventional 3 T brain acquisition. Cervical spinal cord imaging at 7 T was used to segment grey and white matter, including lesions therein. Brain imaging at 7 T was used to segment cortical and white matter lesions and 3 T imaging for cortical thickness estimation. Cervical spinal cord lesions were mapped voxel-wise as a function of distance from the inner central canal CSF pool to the outer subpial surface. Similarly, brain white matter lesions were mapped voxel-wise as a function of distance from the ventricular system. Subjects with relapsing-remitting multiple sclerosis showed a greater predominance of spinal cord lesions nearer the outer subpial surface compared to secondary progressive cases. Inversely, secondary progressive participants presented with more centrally located lesions. Within the brain, there was a strong gradient of lesion formation nearest the ventricular system that was most evident in participants with secondary progressive multiple sclerosis. Lesion fractions within the spinal cord grey and white matter were related to the lesion fraction in cerebral white matter. Cortical thinning was the primary determinant of the Expanded Disability Status Scale, white matter lesion fractions in the spinal cord and brain of the 9-Hole Peg Test and cortical thickness and spinal cord grey matter cross-sectional area of the Timed 25-Foot Walk. Spinal cord lesions were localized nearest the subpial surfaces for those with relapsing-remitting and the central canal CSF surface in progressive disease, possibly implying CSF-mediated pathogenic mechanisms in lesion development that may differ between multiple sclerosis subtypes. These findings show that spinal cord lesions involve both grey and white matter from the early multiple sclerosis stages and occur mostly independent from brain pathology. Despite the prevalence of cervical spinal cord lesions and atrophy, brain pathology seems more strongly related to physical disability as measured by the Expanded Disability Status Scale.

Effect of radiofrequency shield diameter on signal-to-noise ratio at ultra-high field MRI

PURPOSE

In this work, we investigated how the position of the radiofrequency (RF) shield can affect the signal-to-noise ratio (SNR) of a receive RF coil. Our aim was to obtain physical insight for the design of a 10.5T 32-channel head coil, subject to the constraints on the diameter of the RF shield imposed by the head gradient coil geometry.

METHOD

We used full-wave numerical simulations to investigate how the SNR of an RF receive coil depends on the diameter of the RF shield at ultra-high magnetic field (UHF) strengths (≥7T).

RESULTS

Our simulations showed that there is an SNR-optimal RF shield size at UHF strength, whereas at low field the SNR monotonically increases with the shield diameter. For a 32-channel head coil at 10.5T, an optimally sized RF shield could act as a cylindrical waveguide and increase the SNR in the brain by 27% compared to moving the shield as far as possible from the coil. Our results also showed that a separate transmit array between the RF shield and the receive array could considerably reduce SNR even if they are decoupled.

CONCLUSION

At sufficiently high magnetic field strength, the design of local RF coils should be optimized together with the design of the RF shield to benefit from both near field and resonant modes.

Improving radiofrequency power and specific absorption rate management with bumped transmit elements in ultra-high field MRI

PURPOSE

In this study, we investigate a strategy to reduce the local specific absorption rate (SAR) while keeping B 1 + constant inside the region of interest (ROI) at the ultra-high field (B0 ≥ 7T) MRI.

METHODS

Locally raising the resonance structure under the discontinuity (i.e., creating a bump) increases the distance between the accumulated charges and the tissue. As a result, it reduces the electric field and local SAR generated by these charges inside the tissue. The B 1 + at a point that is sufficiently far from the coil, however, is not affected by this modification. In this study, three different resonant elements (i.e., loop coil, snake antenna, and fractionated dipole [FD]) are investigated. For experimental validation, a bumped FD is further investigated at 10.5T. After the validation, the transmit performances of eight-channel arrays of each element are compared through electromagnetic (EM) simulations.

RESULTS

Introducing a bump reduced the peak 10g-averaged SAR by 21, 26, 23% for the loop and snake antenna at 7T, and FD at 10.5T, respectively. In addition, eight-channel bumped FD array at 10.5T had a 27% lower peak 10g-averaged SAR in a realistic human body simulation (i.e., prostate imaging) compared to an eight-channel FD array.

CONCLUSION

In this study, we investigated a simple design strategy based on adding bumps to a resonant element to reduce the local SAR while maintaining B 1 + inside an ROI. As an example, we modified an FD and performed EM simulations and phantom experiments with a 10.5T scanner. Results show that the peak 10g-averaged SAR can be reduced more than 25%.

Ultra-high-field 7-T MRI in multiple sclerosis and other demyelinating diseases: from pathology to clinical practice

Magnetic resonance imaging (MRI) is essential for the early diagnosis of multiple sclerosis (MS), for investigating the disease pathophysiology, and for discriminating MS from other neurological diseases. Ultra-high-field strength (7-T) MRI provides a new tool for studying MS and other demyelinating diseases both in research and in clinical settings. We present an overview of 7-T MRI application in MS focusing on increased sensitivity and specificity for lesion detection and characterisation in the brain and spinal cord, central vein sign identification, and leptomeningeal enhancement detection. We also discuss the role of 7-T MRI in improving our understanding of MS pathophysiology with the aid of metabolic imaging. In addition, we present 7-T MRI applications in other demyelinating diseases. 7-T MRI allows better detection of the anatomical, pathological, and functional features of MS, thus improving our understanding of MS pathology in vivo. 7-T MRI also represents a potential tool for earlier and more accurate diagnosis.

Ultrahigh-resolution quantitative spinal cord MRI at 9.4T

PURPOSE

To present the results of the first human spinal cord in vivo MRI scans at 9.4T.

METHODS

A human brain coil was used to image the human spinal cord at 9.4T. All anatomical images were acquired with a T₂ *-weighted gradient-echo sequence. A comparison of the influence of four different B₀ shimming routines on the image quality was performed. Intrinsic signal-to-noise-ratio maps were determined using a pseudo-multiple replica approach. Measurements with different echo times were compared and processed to one multiecho data image combination image. Based on the multiecho acquisitions, T₂ *-relaxation time maps were calculated. Algorithmic spinal cord detection and gray matter/white matter segmentation were tested.

RESULTS

An echo time between 9 and 13.8 ms compromised best between gray matter/white matter contrast and image quality. A maximum in-plane resolution of 0.15 × 0.15 mm² was achieved for anatomical images. These images offered excellent image quality and made small structures of the spinal cord visible. The scanner vendor implemented B₀ shimming routine performed best during this work. Intrinsic signal-to-noise-ratio values of between 6600 and 8060 at the upper cervical spinal cord were achieved. Detection and segmentation worked reliably. An average T₂ *-time of 24.88 ms ± 6.68 ms for gray matter and 19.37 ms ± 8.66 ms for white matter was calculated.

CONCLUSION

The proposed human brain coil can be used to image the spinal cord. The maximum in-plane resolution in this work was higher compared with the 7T results from the literature. The 9.4T acquisitions made the small structures of the spinal cord clearly visible.

Technical Note: A custom-designed flexible MR coil array for spine radiotherapy treatment planning

PURPOSE

To assess the performance and optimize the MR image quality when using a custom-built flexible radiofrequency (RF) spine coil array fitted between the immobilization device and the patient for spine radiotherapy treatment planning.

METHODS

A 32 channel flexible custom-designed receive-only coil array has been developed for spine radiotherapy simulation for a 3 T Philips MR scanner. Coil signal-to-noise performance and interactions with standard vendor hardware were assessed. In four volunteers, immobilization molds were created with a dummy version of the array within the mold, and subjects were scanned using the custom array in the mold. Phantoms and normal volunteers were scanned with both the custom spine coil array and the vendor's FDA-approved in-table posterior coil array to compare performance.

RESULTS

The superior-inferior field of view for the custom spine array was ~30 cm encompassing at least 10 vertebrae. A noise correlation matrix showed at least 25 dB isolation between all coil elements. Signal-to-noise ratio (SNR) calculated on a phantom scan at the depth of the spinal cord was a factor of 3 higher with the form-fit spine array as compared to the vendor's posterior coil array. The body coil B₁ transmit map was equivalent with and without the spine array in place demonstrating that the elements are decoupled from the body coil. Volunteer imaging showed improved SNR as compared to the vendor's posterior coil array. The custom array permitted a high degree of acceleration making possible the acquisition of isotropic high-resolution 1.1 × 1.1 × 1.1 mm³ three-dimensional data set over a 30-cm section of the spine in less than 5 min.

CONCLUSION

The custom-designed form-fitting flexible spine coil array provided enhanced SNR and increased acceleration compared to the vendor's posterior array. Future studies will assess MR-based spinal cord imaging with the custom coil in comparison to CT myelogram.

Heritability of cervical spinal cord structure

OBJECTIVE

Measures of spinal cord structure can be a useful phenotype to track disease severity and development; this observational study measures the hereditability of cervical spinal cord anatomy and its correlates in healthy human beings.

METHODS

Twin data from the Human Connectome Project were analyzed with semiautomated spinal cord segmentation, evaluating test-retest reliability and broad-sense heritability with an AE model. Relationships between spinal cord metrics, general physical measures, regional brain structural measures, and motor function were assessed.

RESULTS

We found that the spinal cord C2 cross-sectional area (CSA), left-right width (LRW), and anterior-posterior width (APW) are highly heritable (85%-91%). All measures were highly correlated with the brain volume, and CSA only was positively correlated with thalamic volumes (p = 0.005) but negatively correlated with the occipital cortex area (p = 0.001). LRW was correlated with the participant's height (p = 0.00027). The subjects' sex significantly influenced these metrics. Analyses of a test-retest data set confirmed validity of the approach.

CONCLUSIONS

This study provides the evidence of genetic influence on spinal cord structure. MRI metrics of cervical spinal cord anatomy are robust and not easily influenced by nonpathological environmental factors, providing a useful metric for monitoring normal development and progression of neurodegenerative disorders affecting the spinal cord, including-but not limited to-spinal cord injury and MS.

A method for correcting breathing-induced field fluctuations in T2*-weighted spinal cord imaging using a respiratory trace

PURPOSE

Spinal cord MRI at ultrahigh field is hampered by time-varying magnetic fields associated with the breathing cycle, giving rise to ghosting artifacts in multi-shot acquisitions. Here, we suggest a correction approach based on linking the signal from a respiratory bellows to field changes inside the spinal cord. The information is used to correct the data at the image reconstruction level.

METHODS

The correction was demonstrated in the context of multi-shot T2*-weighted imaging of the cervical spinal cord at 7T. A respiratory trace was acquired during a high-resolution multi-echo gradient-echo sequence, used for structural imaging and quantitative T2* mapping, and a multi-shot EPI time series, as would be suitable for fMRI. The coupling between the trace and the breathing-induced fields was determined by a short calibration scan in each individual. Images were reconstructed with and without trace-based correction.

RESULTS

In the multi-echo acquisition, breathing-induced fields caused severe ghosting in images with long TE, which led to a systematic underestimation of T2* in the spinal cord. The trace-based correction reduced the ghosting and increased the estimated T2* values. Breathing-related ghosting was also observed in the multi-shot EPI images. The correction largely removed the ghosting, thereby improving the temporal signal-to-noise ratio of the time series.

CONCLUSIONS

Trace-based retrospective correction of breathing-induced field variations can reduce ghosting and improve quantitative metrics in multi-shot structural and functional T2*-weighted imaging of the spinal cord. The method is straightforward to implement and does not rely on sequence modifications or additional hardware beyond a respiratory bellows.

Spinal Cord Imaging in Amyotrophic Lateral Sclerosis: Historical Concepts-Novel Techniques

Amyotrophic lateral sclerosis (ALS) is the most common adult onset motor neuron disease with no effective disease modifying therapies at present. Spinal cord degeneration is a hallmark feature of ALS, highlighted in the earliest descriptions of the disease by Lockhart Clarke and Jean-Martin Charcot. The anterior horns and corticospinal tracts are invariably affected in ALS, but up to recently it has been notoriously challenging to detect and characterize spinal pathology in vivo. With recent technological advances, spinal imaging now offers unique opportunities to appraise lower motor neuron degeneration, sensory involvement, metabolic alterations, and interneuron pathology in ALS. Quantitative spinal imaging in ALS has now been used in cross-sectional and longitudinal study designs, applied to presymptomatic mutation carriers, and utilized in machine learning applications. Despite its enormous clinical and academic potential, a number of physiological, technological, and methodological challenges limit the routine use of computational spinal imaging in ALS. In this review, we provide a comprehensive overview of emerging spinal cord imaging methods and discuss their advantages, drawbacks, and biomarker potential in clinical applications, clinical trial settings, monitoring, and prognostic roles.

Development and evaluation of a 16-channel receive-only RF coil to improve 7T ultra-high field body MRI with focus on the spine

PURPOSE

A 16-channel receive (16Rx) radiofrequency (RF) array for 7T ultra-high field body MR imaging is presented. The coil is evaluated in conjunction with a 16-channel transmit/receive (16TxRx) coil and additionally with a 32-channel transmit/receive (32TxRx) remote body coil for RF transmit and serving as receive references.

METHODS

The 16Rx array consists of 16 octagonal overlapping loops connected to custom-built detuning boards with preamplifiers. Performance metrics like noise correlation, g-factors, and signal-to-noise ratio gain were compared between 4 different RF coil configurations. In vivo body imaging was performed in volunteers using radiofrequency shimming, time interleaved acquisition of modes (TIAMO), and 2D spatially selective excitation using parallel transmit (pTx) in the spine.

RESULTS

Lower g-factors were obtained when using the 16Rx coil in addition to the 16TxRx array coil configuration versus the 16TxRx array alone. Distinct signal-to-noise ratio gain using the 16Rx coil could be demonstrated in the spine region both for a comparison with the 16TxRx coil (>50% gain) in vivo and the 32TxRx coil (>240% gain) in a phantom. The 16Rx coil was successfully applied to improve anatomical imaging in the abdomen and 2D spatially selective excitation in the spine of volunteers.

CONCLUSION

The novel 16-channel Rx-array as an add-on to multichannel TxRx RF coil configurations provides increased signal-to-noise ratio, lower g-factors, and thus improves 7T ultra-high field body MR imaging.

Spinal cord MRI at 7T

Magnetic resonance imaging (MRI) of the human spinal cord at 7T has been demonstrated by a handful of research sites worldwide, and the spinal cord remains one of the areas in which higher fields and resolution could have high impact. The small diameter of the cord (∼1 cm) necessitates high spatial resolution to minimize partial volume effects between gray and white matter, and so MRI of the cord can greatly benefit from increased signal-to-noise ratio and contrasts at ultra-high field (UHF). Herein we review the current state of UHF spinal cord imaging. Technical challenges to successful UHF spinal cord MRI include radiofrequency (B1) nonuniformities and a general lack of optimized radiofrequency coils, amplified physiological noise, and an absence of methods for robust B0 shimming along the cord to mitigate image distortions and signal losses. Numerous solutions to address these challenges have been and are continuing to be explored, and include novel approaches for signal excitation and acquisition, dynamic shimming and specialized shim coils, and acquisitions with increased coverage or optimal slice angulations.

Spatiotemporal characterization of breathing-induced B0 field fluctuations in the cervical spinal cord at 7T

Magnetic resonance imaging and spectroscopy of the spinal cord stand to benefit greatly from the increased signal-to-noise ratio of ultra-high field. However, ultra-high field also poses considerable technical challenges, especially related to static and dynamic B₀ fields. Breathing causes the field to fluctuate with the respiratory cycle, giving rise to artifacts such as ghosting and apparent motion in images. We here investigated the spatial and temporal characteristics of breathing-induced B₀ fields in the cervical spinal cord at 7T.

We analyzed the magnitude and spatial profile of breathing-induced fields during breath-holds in an expired and inspired breathing state. We also measured the temporal field evolution during free breathing by acquiring a time series of fast phase images, and a principal component analysis was performed on the measured field evolution.

In all subjects, the field shift was largest around the vertebral level of C7 and lowest at the top of the spinal cord. At C7, we measured peak-to-peak field fluctuations of 36 Hz on average during normal free breathing; increasing to on average 113 Hz during deep breathing. The first principal component could explain more than 90% of the field variations along the foot-head axis inside the spinal cord in all subjects.

We further implemented a proof-of-principle shim correction, demonstrating the feasibility of using the shim system to compensate for the breathing-induced fields inside the spinal cord. Effective correction strategies will be crucial to unlock the full potential of ultra-high field for spinal cord imaging.

•

The B₀ field in the spinal cord fluctuates with the breathing cycle.

•

Average peak-to-peak ΔB₀ of 36/113 Hz at C7 during normal/deep breathing at 7T.

•

The first principal component explains more than 90% of the field variance.

•

Respiratory trace correlates well with field fluctuations during normal breathing.

•

Proof-of-principle correction using 2nd-order shims was demonstrated.

Optically controlled on-coil amplifier with RF monitoring feedback

PURPOSE

To develop a new optically controlled on-coil amplifier that facilitates safe use of multi-channel radiofrequency (RF) transmission in MRI by real-time monitoring of signal phase and amplitude.

METHODS

Monitoring was carried out with a 4-channel prototype system by sensing, down sampling, digitizing, and optically transmitting the RF transmit signal to a remote PC to control the amplifiers. Performance was evaluated with benchtop and 7 T MRI experiments.

RESULTS

Monitored amplitude and phase were stable across repetitions and had standard deviations of 0.061 μT and 0.0073 rad, respectively. The feedback system allowed inter-channel phase and B₁ amplitude to be adjusted within two iterations. MRI experiments demonstrated the feasibility of this approach to perform safe and accurate multi-channel RF transmission and monitoring at high field.

CONCLUSION

We demonstrated a 4-channel transceiver system based on optically controlled on-coil amplifiers with RF signal monitoring and feedback control. The approach allows the safe and precise control of RF transmission fields, required to achieve uniform excitation at high field. Magn Reson Med 79:2833-2841, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Modular transmit/receive arrays using very-high permittivity dielectric resonator antennas

PURPOSE

Dielectric resonator antenna (DRAs) are compact structures that exhibit low coupling between adjacent elements and therefore can be used as MRI transmit arrays. In this study, we use very high permittivity materials to construct modular flexible transceive arrays of a variable numbers of elements for operation at 7T.

METHODS

DRAs were constructed using rectangular blocks of ceramic (lead zirconate titanate, ε_r  = 1070) with the transverse electric (TE)₀₁ mode tuned to 298 MHz. Finite-difference time-domain simulations were used to determine the B₁ and specific absorption rate distributions. B1+ maps were acquired in a phantom to validate the simulations. Performance was compared to an equally sized surface coil. In vivo images were acquired of the wrist (four elements), ankle (seven elements), and calf muscle (16 elements).

RESULTS

Coupling between DRAs spaced 5 mm apart on a phantom was -18.2 dB compared to -9.1 dB for equivalently spaced surface coils. DRAs showed a higher B1+ intensity close to the antenna but a lower penetration depth compared to the surface coil.

CONCLUSION

DRAs show very low coupling compared to equally sized surface coils and can be used in transceive arrays without requiring decoupling networks. The penetration depth of the current DRA geometry means they are ideally suited to imaging of extremities. Magn Reson Med 79:1781-1788, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Fluid-Signal Structures in the Cervical Spinal Cord on MRI: Anterior Median Fissure versus Central Canal

BACKGROUND AND PURPOSE

Hyperintense fluid-signal anterior median fissure and hyperintense foci resembling the central canal are seen on cervical spine axial T2 MR imaging. They may also be associated with a channel-like T2-hyperintense craniocaudad line on sagittal images. We hypothesized that the hyperintense foci and the sagittal line may represent the base of the anterior median fissure.

MATERIALS AND METHODS

In this exploratory study, 358 cervical MR images were analyzed for recording and comparing the incidence/numbers of hyperintense foci, anterior median fissure, and sagittal line as hyperintense foci, anterior median fissure, and sagittal line per patient when present alone or together, both with and without the sagittal line.

RESULTS

Hyperintense foci were identified on 238/358 (66.5%) studies; an anterior median fissure, on 218/358 (60.9%). The hyperintense foci/anterior median fissure ratio was 3.7/2.3 (P = .00001). Anterior median fissures were seen alone less commonly than hyperintense foci were seen alone (P = .045). We identified increased anterior median fissure/patient in a hyperintense foci +anterior median fissure group compared with an anterior median fissure-only group (4.0 versus 3.2, P = .05), with similar hyperintense foci/patient in the hyperintense foci+anterior median fissure and hyperintense foci-only groups (5.5 versus 5.8, P = .35), and proportional distribution of both across the hyperintense foci+anterior median fissure subgroups (hyperintense foci/anterior median fissure ratio, 1.3). The sagittal line in 89 (24.9%) patients was associated with increased hyperintense foci and anterior median fissure/patient. Greater correlation of anterior median fissure/patient to sagittal line presence was seen in sagittal line subgroup analysis.

CONCLUSIONS

This exploratory analysis found an increased anterior median fissure per patient in conjunction with hyperintense foci presence, a proportional increase of both across the hyperintense foci+anterior median fissure group, and greater correlation of anterior median fissure per patient with the sagittal line. These findings suggest that anterior median fissure and hyperintense foci are structurally related, that hyperintense foci may commonly be the base of the anterior median fissure, and that the sagittal line is a manifestation primarily of an anterior median fissure, occasionally appearing as channels that may simulate the central canal.

SCT: Spinal Cord Toolbox, an open-source software for processing spinal cord MRI data

For the past 25 years, the field of neuroimaging has witnessed the development of several software packages for processing multi-parametric magnetic resonance imaging (mpMRI) to study the brain. These software packages are now routinely used by researchers and clinicians, and have contributed to important breakthroughs for the understanding of brain anatomy and function. However, no software package exists to process mpMRI data of the spinal cord. Despite the numerous clinical needs for such advanced mpMRI protocols (multiple sclerosis, spinal cord injury, cervical spondylotic myelopathy, etc.), researchers have been developing specific tools that, while necessary, do not provide an integrative framework that is compatible with most usages and that is capable of reaching the community at large. This hinders cross-validation and the possibility to perform multi-center studies. In this study we introduce the Spinal Cord Toolbox (SCT), a comprehensive software dedicated to the processing of spinal cord MRI data. SCT builds on previously-validated methods and includes state-of-the-art MRI templates and atlases of the spinal cord, algorithms to segment and register new data to the templates, and motion correction methods for diffusion and functional time series. SCT is tailored towards standardization and automation of the processing pipeline, versatility, modularity, and it follows guidelines of software development and distribution. Preliminary applications of SCT cover a variety of studies, from cross-sectional area measures in large databases of patients, to the precise quantification of mpMRI metrics in specific spinal pathways. We anticipate that SCT will bring together the spinal cord neuroimaging community by establishing standard templates and analysis procedures.

Denoising spinal cord fMRI data: Approaches to acquisition and analysis

Functional magnetic resonance imaging (fMRI) of the human spinal cord is a difficult endeavour due to the cord's small cross-sectional diameter, signal drop-out as well as image distortion due to magnetic field inhomogeneity, and the confounding influence of physiological noise from cardiac and respiratory sources. Nevertheless, there is great interest in spinal fMRI due to the spinal cord's role as the principal sensorimotor interface between the brain and the body and its involvement in a variety of sensory and motor pathologies. In this review, we give an overview of the various methods that have been used to address the technical challenges in spinal fMRI, with a focus on reducing the impact of physiological noise. We start out by describing acquisition methods that have been tailored to the special needs of spinal fMRI and aim to increase the signal-to-noise ratio and reduce distortion in obtained images. Following this, we concentrate on image processing and analysis approaches that address the detrimental effects of noise. While these include variations of standard pre-processing methods such as motion correction and spatial filtering, the main focus lies on denoising techniques that can be applied to task-based as well as resting-state data sets. We review both model-based approaches that rely on externally acquired respiratory and cardiac signals as well as data-driven approaches that estimate and correct for noise using the data themselves. We conclude with an outlook on techniques that have been successfully applied for noise reduction in brain imaging and whose use might be beneficial for fMRI of the human spinal cord.

(1) H MRS in the human spinal cord at 7 T using a dielectric waveguide transmitter, RF shimming and a high density receive array

Multimodal MRI is the state of the art method for clinical diagnostics and therapy monitoring of the spinal cord, with MRS being an emerging modality that has the potential to detect relevant changes of the spinal cord tissue at an earlier stage and to enhance specificity. Methodological challenges related to the small dimensions and deep location of the human spinal cord inside the human body, field fluctuations due to respiratory motion, susceptibility differences to adjacent tissue such as vertebras and pulsatile flow of the cerebrospinal fluid hinder the clinical application of (1) H MRS to the human spinal cord. Complementary to previous studies that partly addressed these problems, this work aims at enhancing the signal-to-noise ratio (SNR) of (1) H MRS in the human spinal cord. To this end a flexible tight fit high density receiver array and ultra-high field strength (7 T) were combined. A dielectric waveguide and dipole antenna transmission coil allowed for dual channel RF shimming, focusing the RF field in the spinal cord, and an inner-volume saturated semi-LASER sequence was used for robust localization in the presence of B1 (+) inhomogeneity. Herein we report the first 7 T spinal cord (1) H MR spectra, which were obtained in seven independent measurements of 128 averages each in three healthy volunteers. The spectra exhibit high quality (full width at half maximum 0.09 ppm, SNR 7.6) and absence of artifacts and allow for reliable quantification of N-acetyl aspartate (NAA) (NAA/Cr (creatine) 1.31 ± 0.20; Cramér-Rao lower bound (CRLB) 5), total choline containing compounds (Cho) (Cho/Cr 0.32 ± 0.07; CRLB 7), Cr (CRLB 5) and myo-inositol (mI) (mI/Cr 1.08 ± 0.22; CRLB 6) in 7.5 min in the human cervical spinal cord. Thus metabolic information from the spinal cord can be obtained in clinically feasible scan times at 7 T, and its benefit for clinical decision making in spinal cord disorders will be investigated in the future using the presented methodology. Copyright © 2016 John Wiley & Sons, Ltd.

Parallel transmission for ultrahigh-field imaging

The development of MRI systems operating at or above 7 T has provided researchers with a new window into the human body, yielding improved imaging speed, resolution and signal-to-noise ratio. In order to fully realise the potential of ultrahigh-field MRI, a range of technical hurdles must be overcome. The non-uniformity of the transmit field is one of such issues, as it leads to non-uniform images with spatially varying contrast. Parallel transmission (i.e. the use of multiple independent transmission channels) provides previously unavailable degrees of freedom that allow full spatial and temporal control of the radiofrequency (RF) fields. This review discusses the many ways in which these degrees of freedom can be used, ranging from making more uniform transmit fields to the design of subject-tailored RF pulses for both uniform excitation and spatial selection, and also the control of the specific absorption rate. © 2015 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.

Design and test of a double-nuclear RF coil for (1)H MRI and (13)C MRSI at 7T

RF coil operation at the ultrahigh field of 7T is fraught with technical challenges that limit the advancement of novel human in vivo applications at 7T. In this work, a hybrid technique combining a microstrip transmission line and a lumped-element L-C loop coil to form a double-nuclear RF coil for proton magnetic resonance imaging and carbon magnetic resonance spectroscopy at 7T was proposed and investigated. Network analysis revealed a high Q-factor and excellent decoupling between the coils. Proton images and localized carbon spectra were acquired with high sensitivity. The successful testing of this novel double-nuclear coil demonstrates the feasibility of this hybrid design for double-nuclear MR imaging and spectroscopy studies at the ultrahigh field of 7T.

Spinal Cord Anatomy and Clinical Syndromes

We review the anatomy of the spinal cord, providing correlation with key functional and clinically relevant neural pathways, as well as magnetic resonance imaging. Peripherally, the main descending (corticospinal tract) and ascending (gracilis or cuneatus fasciculi and spinothalamic tracts) pathways compose the white matter. Centrally, the gray matter can be divided into multiple laminae. Laminae 1-5 carry sensitive neuron information in the posterior horn, and lamina 9 carries most lower motor neuron information in the anterior horn. Damage to the unilateral corticospinal tract (upper motor neuron information) or gracillis-cuneatus fasciculi (touch and vibration) correlates with ipsilateral clinical findings, whereas damage to unilateral spinothalamic tract (pain-temperature) correlates with contralateral clinical findings. Damage to commissural fibers correlates with a suspended bilateral "girdle" sensory level. Autonomic dysfunction is expected when there is bilateral cord involvement.

Electrodynamics and radiofrequency antenna concepts for human magnetic resonance at 23.5 T (1 GHz) and beyond

OBJECTIVE

This work investigates electrodynamic constraints, explores RF antenna concepts and examines the transmission fields (B 1 (+) ) and RF power deposition of dipole antenna arrays for (1)H magnetic resonance of the human brain at 1 GHz (23.5 T).

MATERIALS AND METHODS

Electromagnetic field (EMF) simulations are performed in phantoms with average tissue simulants for dipole antennae using discrete frequencies [300 MHz (7.0 T) to 3 GHz (70.0 T)]. To advance to a human setup EMF simulations are conducted in anatomical human voxel models of the human head using a 20-element dipole array operating at 1 GHz.

RESULTS

Our results demonstrate that transmission fields suitable for (1)H MR of the human brain can be achieved at 1 GHz. An increase in transmit channel density around the human head helps to enhance B 1 (+) in the center of the brain. The calculated relative increase in specific absorption rate at 23.5 versus 7.0 T was below 1.4 (in-phase phase setting) and 2.7 (circular polarized phase setting) for the dipole antennae array.

CONCLUSION

The benefits of multi-channel dipole antennae at higher frequencies render MR at 23.5 T feasible from an electrodynamic standpoint. This very preliminary finding opens the door on further explorations that might be catalyzed into a 20-T class human MR system.

Grey matter involvement by focal cervical spinal cord lesions is associated with progressive multiple sclerosis

Background:

The in vivo relationship of spinal cord lesion features with clinical course and function in multiple sclerosis (MS) is poorly defined.

Objective:

The objective of this paper is to investigate the associations of spinal cord lesion features on MRI with MS subgroup and disability.

Methods:

We recruited 120 people: 25 clinically isolated syndrome, 35 relapsing–remitting (RR), 30 secondary progressive (SP), and 30 primary progressive (PP) MS. Disability was measured using the Expanded Disability Status Scale. We performed 3T axial cervical cord MRI, using 3D-fast-field-echo and phase-sensitive-inversion-recovery sequences. Both focal lesions and diffuse abnormalities were recorded. Focal lesions were classified according to the number of white matter (WM) columns involved and whether they extended to grey matter (GM).

Results:

The proportion of patients with focal lesions involving at least two WM columns and extending to GM was higher in SPMS than in RRMS ( p = 0.03) and PPMS ( p = 0.015). Diffuse abnormalities were more common in both PPMS and SPMS, compared with RRMS (OR 6.1 ( p = 0.002) and 5.7 ( p = 0.003), respectively). The number of lesions per patient involving both the lateral column and extending to GM was independently associated with disability ( p < 0.001).

Conclusions:

More extensive focal cord lesions, extension of lesions to GM, and diffuse abnormalities are associated with progressive MS and disability.

A 7T spine array based on electric dipole transmitters

PURPOSE

The goal of this study was to explore the feasibility of using an array of electric dipole antennas for RF transmission in spine MRI at high fields.

METHOD

A two-channel transmit array based on an electric dipole design was quantitatively optimized for 7T spine imaging and integrated with a receive array combining eight loop coils. Using B1+ mapping, the transmit efficiency of the dipole array was compared with a design using quadrature loop pairs. The radiofrequency energy deposition for each array was measured using a home-built dielectric phantom and MR thermometry. The performance of the proposed array was qualitatively demonstrated in human studies.

RESULTS

The results indicate dramatically improved transmit efficiency for the dipole design compared with the loop excitation. A gain of up to 76% was achieved within the spinal region.

CONCLUSION

For imaging of the spine, electric dipole-based transmitters provide an attractive alternative to the traditional loop-based design. Easy integration with existing receive array technology facilitates practical use at high fields.

SAR reduction in 7T C-spine imaging using a "dark modes" transmit array strategy

PURPOSE

Local specific absorption rate (SAR) limits many applications of parallel transmit (pTx) in ultra high-field imaging. In this Note, we introduce the use of an array element, which is intentionally inefficient at generating spin excitation (a "dark mode") to attempt a partial cancellation of the electric field from those elements that do generate excitation. We show that adding dipole elements oriented orthogonal to their conventional orientation to a linear array of conventional loop elements can lower the local SAR hotspot in a C-spine array at 7 T.

METHODS

We model electromagnetic fields in a head/torso model to calculate SAR and excitation B1 (+) patterns generated by conventional loop arrays and loop arrays with added electric dipole elements. We utilize the dark modes that are generated by the intentional and inefficient orientation of dipole elements in order to reduce peak 10g local SAR while maintaining excitation fidelity.

RESULTS

For B1 (+) shimming in the spine, the addition of dipole elements did not significantly alter the B1 (+) spatial pattern but reduced local SAR by 36%.

CONCLUSION

The dipole elements provide a sufficiently complimentary B1 (+) and electric field pattern to the loop array that can be exploited by the radiofrequency shimming algorithm to reduce local SAR.

MRI monitoring of pathological changes in the spinal cord in patients with multiple sclerosis

The spinal cord is a clinically important site that is affected by pathological changes in most patients with multiple sclerosis; however, imaging of the spinal cord with conventional MRI can be difficult. Improvements in MRI provide a major advantage for spinal cord imaging, with better signal-to-noise ratio and improved spatial resolution. Through the use of multiplanar MRI, identification of diffuse and focal changes in the whole spinal cord is now routinely possible. Corroborated by related histopathological analyses, several new techniques, such as magnetisation transfer, diffusion tension imaging, functional MRI, and proton magnetic resonance spectroscopy, can detect non-focal, spinal cord pathological changes in patients with multiple sclerosis. Additionally, functional MRI can reveal changes in the response pattern to sensory stimulation in patients with multiple sclerosis. Through use of these techniques, findings of cord atrophy, intrinsic cord damage, and adaptation are shown to occur largely independently of focal spinal cord lesion load, which emphasises their relevance in depiction of the true burden of disease. Combinations of magnetisation transfer ratio or diffusion tension imaging indices with cord atrophy markers seem to be the most robust and meaningful biomarkers to monitor disease evolution in early multiple sclerosis.

Neuroimaging to investigate multisystem involvement and provide biomarkers in amyotrophic lateral sclerosis

Neuroimaging allows investigating the extent of neurological systems degeneration in amyotrophic lateral sclerosis (ALS). Advanced MRI methods can detect changes related to the degeneration of upper motor neurons but have also demonstrated the participation of other systems such as the sensory system or basal ganglia, demonstrating in vivo that ALS is a multisystem disorder. Structural and functional imaging also allows studying dysfunction of brain areas associated with cognitive signs. From a biomarker perspective, numerous studies using diffusion tensor imaging showed a decrease of fractional anisotropy in the intracranial portion of the corticospinal tract but its diagnostic value at the individual level remains limited. A multiparametric approach will be required to use MRI in the diagnostic workup of ALS. A promising avenue is the new methodological developments of spinal cord imaging that has the advantage to investigate the two motor system components that are involved in ALS, that is, the lower and upper motor neuron. For all neuroimaging modalities, due to the intrinsic heterogeneity of ALS, larger pooled banks of images with standardized image acquisition and analysis procedures are needed. In this paper, we will review the main findings obtained with MRI, PET, SPECT, and nuclear magnetic resonance spectroscopy in ALS.