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Newburn G, Condron P, Kwon EE, McGeown JP, Melzer TR, Bydder M, Griffin M, Scadeng M, Potter L, Holdsworth SJ, Cornfeld DM, Bydder GM. Diagnosis of Delayed Post-Hypoxic Leukoencephalopathy (Grinker's Myelinopathy) with MRI Using Divided Subtracted Inversion Recovery (dSIR) Sequences: Time for Reappraisal of the Syndrome? Diagnostics (Basel) 2024; 14:418. [PMID: 38396456 PMCID: PMC10888335 DOI: 10.3390/diagnostics14040418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/25/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Delayed Post-Hypoxic Leukoencephalopathy (DPHL), or Grinker's myelinopathy, is a syndrome in which extensive changes are seen in the white matter of the cerebral hemispheres with MRI weeks or months after a hypoxic episode. T2-weighted spin echo (T2-wSE) and/or T2-Fluid Attenuated Inversion Recovery (T2-FLAIR) images classically show diffuse hyperintensities in white matter which are thought to be near pathognomonic of the condition. The clinical features include Parkinsonism and akinetic mutism. DPHL is generally regarded as a rare condition. Methods and Results: Two cases of DPHL imaged with MRI nine months and two years after probable hypoxic episodes are described. No abnormalities were seen on the T2-FLAIR images with MRI, but very extensive changes were seen in the white matter of the cerebral and cerebellar hemisphere on divided Subtraction Inversion Recovery (dSIR) images. dSIR sequences may produce ten times the contrast of conventional inversion recovery (IR) sequences from small changes in T1. The clinical findings in both cases were of cognitive impairment without Parkinsonism or akinetic mutism. Conclusion: The classic features of DPHL may only represent the severe end of a spectrum of diseases in white matter following global hypoxic injury to the brain. The condition may be much more common than is generally thought but may not be recognized using conventional clinical and MRI criteria for diagnosis. Reappraisal of the syndrome of DPHL to include clinically less severe cases and to encompass recent advances in MRI is advocated.
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Affiliation(s)
- Gil Newburn
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
| | - Paul Condron
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland 1010, New Zealand
| | - Eryn E. Kwon
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland 1010, New Zealand
| | - Joshua P. McGeown
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
| | - Tracy R. Melzer
- Department of Medicine, University of Otago, Christchurch 8011, New Zealand
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand
| | - Mark Bydder
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
| | - Mark Griffin
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
- Insight Research Services Associated, Gold Coast 4215, Australia
| | - Miriam Scadeng
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland 1010, New Zealand
| | - Leigh Potter
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
| | - Samantha J. Holdsworth
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland 1010, New Zealand
| | - Daniel M. Cornfeld
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland 1010, New Zealand
| | - Graeme M. Bydder
- Mātai Medical Research Institute, Tairāwhiti Gisborne 4010, New Zealand; (G.N.); (M.S.); (S.J.H.)
- Department of Radiology, University of California San Diego, San Diego, CA 92093, USA
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Zampini MA, Sijbers J, Verhoye M, Garipov R. A preparation pulse for fast steady state approach in Actual Flip angle Imaging. Med Phys 2024; 51:306-318. [PMID: 37480220 DOI: 10.1002/mp.16624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/26/2023] [Accepted: 06/20/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Actual Flip angle Imaging (AFI) is a sequence used for B1 mapping, also embedded in the Variable flip angle with AFI for simultaneous estimation of T1 , B1 and equilibrium magnetization. PURPOSE To investigate the design of a preparation module for AFI to allow a fast approach to steady state (SS) without requiring the use of dummy acquisitions. METHODS The features of a preparation module with a B1 insensitive adiabatic pulse, spoiler gradients, and a recovery timeT r e c $T_{rec}$ were studied with simulations and validated via experiments and acquired with different k-space traveling strategies. The robustness of the flip angle of the preparation pulse on the acquired signal is studied. RESULTS When a 90° adiabatic pulse is used, the forthcomingT r e c $T_{rec}$ can be expressed as a function of repetition times and AFI flip angle only asTR 1 ( n + cos α ) / ( 1 - cos 2 α ) $\mathrm{TR_1}(n+\cos \alpha )/(1-\cos ^2\alpha )$ , where n represents the ratio between the two repetition times of AFI. The robustness of the method is demonstrated by showing that using the values further away from 90° still allows for a faster approach to SS than the use of dummy pulses. CONCLUSIONS The preparation module is particularly advantageous for low flip angles, as well as for AFI sequences that sample the center of the k-space early in the sequence, such as centric ordering acquisitions, and for ultrafast EPI-based AFI methods, thus allowing to reduce scanner overhead time.
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Affiliation(s)
- Marco Andrea Zampini
- MR Solutions Ltd., Ashbourne House, Guildford, Surrey, UK
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp, Belgium
| | - Jan Sijbers
- imec-Vision Lab, Department of Physics, University of Antwerp, Belgium
- μNEURO Research Centre of Excellence, University of Antwerp, Belgium
| | - Marleen Verhoye
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp, Belgium
- μNEURO Research Centre of Excellence, University of Antwerp, Belgium
| | - Ruslan Garipov
- MR Solutions Ltd., Ashbourne House, Guildford, Surrey, UK
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Ma YJ, Moazamian D, Port JD, Edjlali M, Pruvo JP, Hacein-Bey L, Hoggard N, Paley MNJ, Menon DK, Bonekamp D, Pravatà E, Garwood M, Danesh-Meyer H, Condron P, Cornfeld DM, Holdsworth SJ, Du J, Bydder GM. Targeted magnetic resonance imaging (tMRI) of small changes in the T 1 and spatial properties of normal or near normal appearing white and gray matter in disease of the brain using divided subtracted inversion recovery (dSIR) and divided reverse subtracted inversion recovery (drSIR) sequences. Quant Imaging Med Surg 2023; 13:7304-7337. [PMID: 37869282 PMCID: PMC10585510 DOI: 10.21037/qims-23-232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/11/2023] [Indexed: 10/24/2023]
Abstract
This review describes targeted magnetic resonance imaging (tMRI) of small changes in the T1 and the spatial properties of normal or near normal appearing white or gray matter in disease of the brain. It employs divided subtracted inversion recovery (dSIR) and divided reverse subtracted inversion recovery (drSIR) sequences to increase the contrast produced by small changes in T1 by up to 15 times compared to conventional T1-weighted inversion recovery (IR) sequences such as magnetization prepared-rapid acquisition gradient echo (MP-RAGE). This increase in contrast can be used to reveal disease with only small changes in T1 in normal appearing white or gray matter that is not apparent on conventional MP-RAGE, T2-weighted spin echo (T2-wSE) and/or fluid attenuated inversion recovery (T2-FLAIR) images. The small changes in T1 or T2 in disease are insufficient to produce useful contrast with conventional sequences. To produce high contrast dSIR and drSIR sequences typically need to be targeted for the nulling TI of normal white or gray matter, as well as for the sign and size of the change in T1 in these tissues in disease. The dSIR sequence also shows high signal boundaries between white and gray matter. dSIR and drSIR are essentially T1 maps. There is a nearly linear relationship between signal and T1 in the middle domain (mD) of the two sequences which includes T1s between the nulling T1s of the two acquired IR sequences. The drSIR sequence is also very sensitive to reductions in T1 produced by Gadolinium based contrast agents (GBCAs), and when used with rigid body registration to align three-dimensional (3D) isotropic pre and post GBCA images may be of considerable value in showing subtle GBCA enhancement. In serial MRI studies performed at different times, the high signal boundaries generated by dSIR and drSIR sequences can be used with rigid body registration of 3D isotropic images to demonstrate contrast arising from small changes in T1 (without or with GBCA enhancement) as well as small changes in the spatial properties of normal tissues and lesions, such as their site, shape, size and surface. Applications of the sequences in cases of multiple sclerosis (MS) and methamphetamine dependency are illustrated. Using targeted narrow mD dSIR sequences, widespread abnormalities were seen in areas of normal appearing white matter shown with conventional T2-wSE and T2-FLAIR sequences. Understanding of the features of dSIR and drSIR images is facilitated by the use of their T1-bipolar filters; to explain their targeting, signal, contrast, boundaries, T1 mapping and GBCA enhancement. Targeted MRI (tMRI) using dSIR and drSIR sequences may substantially improve clinical MRI of the brain by providing unequivocal demonstration of abnormalities that are not seen with conventional sequences.
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Affiliation(s)
- Ya-Jun Ma
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Dina Moazamian
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - John D. Port
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Myriam Edjlali
- Department of Radiology, APHP, Hôpitaux Raymond-Poincaré, Paris, France
- Laboratoire d’Imagerie Biomédicale Multimodale (BioMaps), Université Paris-Saclay, CEA, CNRS, Inserm, Service Hospitalier Frédéric Joliot, Orsay, France
| | - Jean-Pierre Pruvo
- Inserm, U1172-LilNCog-Lille Neuroscience & Cognition, Univ Lille, Lille, France
- UMS 2014-US 41-PLBS-Plateformes Lilloises en Biologie & Santé, Univ Lille, Lille, France
- Department of Neuroradiology, CHU Lille, Rue Emile Laine, Lille, France
| | - Lotfi Hacein-Bey
- Neuroradiology, Radiology Department, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Nigel Hoggard
- Academic Unit of Radiology, Department of Infection, Immunity and Cardiovascular Disease, The Medical School, University of Sheffield, Sheffield, UK
| | - Martyn N. J. Paley
- Academic Unit of Radiology, Department of Infection, Immunity and Cardiovascular Disease, The Medical School, University of Sheffield, Sheffield, UK
| | - David K. Menon
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - David Bonekamp
- Division of Radiology (E010), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Emanuele Pravatà
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano, Switzerland
- Faculty of Biomedical Sciences, Universita della Svizzera Italiana, Lugano, Switzerland
| | - Michael Garwood
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, MN, USA
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Helen Danesh-Meyer
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
- Eye Institute, Auckland, New Zealand
- Mātai Medical Research Institute, Tairāwhiti Gisborne, New Zealand
- Department of Anatomy and Medical Imaging and Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Paul Condron
- Mātai Medical Research Institute, Tairāwhiti Gisborne, New Zealand
- Department of Anatomy and Medical Imaging and Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Daniel M. Cornfeld
- Mātai Medical Research Institute, Tairāwhiti Gisborne, New Zealand
- Department of Anatomy and Medical Imaging and Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Samantha J. Holdsworth
- Mātai Medical Research Institute, Tairāwhiti Gisborne, New Zealand
- Department of Anatomy and Medical Imaging and Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jiang Du
- Department of Radiology, University of California San Diego, San Diego, CA, USA
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Bioengineering, University of California San Diego, San Diego, CA, USA
| | - Graeme M. Bydder
- Department of Radiology, University of California San Diego, San Diego, CA, USA
- Mātai Medical Research Institute, Tairāwhiti Gisborne, New Zealand
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Athertya JS, Akers J, Sedaghat S, Wei Z, Moazamian D, Dwek S, Thu M, Jang H. Detection of iron oxide nanoparticle (IONP)-labeled stem cells using quantitative ultrashort echo time imaging: a feasibility study. Quant Imaging Med Surg 2023; 13:585-597. [PMID: 36819276 PMCID: PMC9929408 DOI: 10.21037/qims-22-654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/17/2022] [Indexed: 01/12/2023]
Abstract
Background In this study, we investigated the feasibility of quantitative ultrashort echo time (qUTE) magnetic resonance (MR) imaging techniques in the detection and quantification of iron oxide nanoparticle (IONP)-labeled stem cells. Methods A stem cell phantom containing multiple layers of unlabeled or labeled stem cells with different densities was prepared. The phantom was imaged with quantitative UTE (qUTE) MR techniques [i.e., UTE-T1 mapping, UTE-T2* mapping, and UTE-based quantitative susceptibility mapping (UTE-QSM)] as well as with a clinical T2 mapping sequence on a 3T clinical MR system. For T1 mapping, a variable flip angle (VFA) method based on actual flip angle imaging (AFI) technique was utilized. For T2* mapping and UTE-QSM, multiple images with variable, interleaved echo times including UTE images and gradient recalled echo (GRE) images were used. For UTE-QSM, the phase information from the multi-echo images was utilized and processed using a QSM framework based on the morphology-enabled dipole inversion (MEDI) algorithm. The qUTE techniques were also evaluated in an ex vivo experiment with a mouse injected with IONP-labeled stem cells. Results In the phantom experiment, the parameters estimated with qUTE techniques showed high linearity with respect to the density of IONP-labeled stem cells (R2>0.99), while the clinical T2 parameter showed impaired linearity (R2=0.87). In the ex vivo mouse experiment, UTE-T2* mapping and UTE-QSM showed feasibility in the detection of injected stem cells with high contrast, whereas UTE-T1 and UTE-T2* showed limited detection. Overall, UTE-QSM demonstrated the best contrast of all, with other methods being subjected more to a confounding factor due to different magnetic susceptibilities of various types of neighboring tissues, which creates inhomogeneous contrast that behaves similar to IONP. Conclusions In this study, we evaluated the feasibility of a series of qUTE imaging techniques as well as conventional T2 mapping for the detection of IONP-labeled stem cells in vitro and ex vivo. UTE-QSM performed superior amongst other qUTE techniques as well as conventional T2 mapping in detecting stem cells with high contrast.
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Affiliation(s)
- Jiyo S. Athertya
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | | | - Sam Sedaghat
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Zhao Wei
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Dina Moazamian
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Sophia Dwek
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Mya Thu
- VisiCELL Medical Inc., San Diego, CA, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
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Evaluation of the degenerative lumbar osseous morphology using zero echo time magnetic resonance imaging (ZTE-MRI). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:792-800. [PMID: 35015138 DOI: 10.1007/s00586-021-07099-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/16/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine and compare the performance of zero echo imaging (ZTE) with conventional MRI sequences on lumbar osseous morphology in patients suspected with lumbar degeneration with multi-slice computed tomography (MSCT) as standard reference. METHODS 22 subjects with concerned lumbar degeneration were recruited. All subjects were scanned with ZTE sequence after routine conventional MR sequences on a 3.0 T system and also received MSCT examination. Image quality was assessed. The quantitative and qualitative parameters of lumbar osseous morphology on MSCT, ZTE and MRI images were evaluated by three musculoskeletal radiologists independently. Inter-reader and inter-modality reliability and the difference between the modalities were calculated. RESULTS There was no difference for the osseous parameters between modalities, including axial orientation (p = 0.444), IAD (p = 0.381), lateral recess (p = 0.370), pedicle width (p = 0.067), pedicle height (p = 0.056), and osteophyte grade (p = 0.052). The measurement of the foramina diameter was statistically different between conventional MRI and MSCT (p < 0.05) but not between the MSCT and ZTE (p = 0.660). Conventional MRI was more likely to miss cortical bone abnormalities. ZTE appeared blurrier in cortical bone than MSCT, especially in cases with severe lumbar degeneration. The inter-reader agreement between MSCT and ZTE-MRI was higher than between MSCT and conventional MRI. CONCLUSIONS ZTE-MRI could offer more cortical bone details than conventional MRI images and might be a valid alternative to CT for lumbar osseous morphology assessment to some extent.
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