Improved detectability of experimental allergic encephalomyelitis in excised swine spinal cords by high b-value q-space DWI

Antecedent Minor Trauma and Hyperacute Presentations in Childhood Transverse Myelitis

INTRODUCTION

Fibrocartilaginous embolism and spinal cord infarction may resemble transverse myelitis with antecedent minor trauma (sporting activity or minor falls) or with hyperacute (<12-hour) presentation.

METHODS

Diagnostic criteria for fibrocartilaginous embolism and spinal cord infarction were applied to a 10-year (2007-2016) cohort of children aged 1 month to 16 years with transverse myelitis and clinical, laboratory, neuroimaging, and outcome data compared between those with and without antecedent minor trauma.

RESULTS

Thirty-two children of median age 8.9 (range 2.7-15.8) years were included; 19 (59%) were female. Falls at home, school, or play (6 children, 60%), swimming (2, 20%), physical education (1, 10%), and caning (1, 10%) were antecedent events in 10 (31%) children. Six (19%) had hyperacute presentations. One patient met spinal cord infarction criteria; none had fibrocartilaginous embolism. Children with transverse myelitis and antecedent minor trauma had single, short spinal cord lesions (median 3 vertebral bodies) but without a specific neuroimaging lesion pattern. None had intervertebral disc abnormalities or brain involvement and were negative for myelin oligodendrocyte and aquaporin 4 antibodies. Twenty-five (86%) of 29 had cerebrospinal fluid inflammation, and 30 (94%) received immunotherapy. Thirty (97%) were followed for a median of 3.6 (0.1-10.2) years, with good outcome (modified Rankin Scale score 0-1) in the majority (80%). Four (75%) with hyperacute presentation had a good outcome (modified Rankin Scale score 0-1), but the patient with spinal cord infarction was the most disabled (modified Rankin Scale score 4).

CONCLUSION

Minor trauma or hyperacute presentations does not always indicate fibrocartilaginous embolism or spinal cord infarction. Children with minor trauma preceding transverse myelitis have a distinct clinicoradiologic syndrome, with good outcome following immunotherapy.

Diffusion Kurtosis Imaging maps neural damage in the EAE model of multiple sclerosis

Diffusion kurtosis imaging (DKI) is an imaging modality that yields novel disease biomarkers and in combination with nervous tissue modeling, provides access to microstructural parameters. Recently, DKI and subsequent estimation of microstructural model parameters has been used for assessment of tissue changes in neurodegenerative diseases and associated animal models. In this study, mouse spinal cords from the experimental autoimmune encephalomyelitis (EAE) model of multiple sclerosis (MS) were investigated for the first time using DKI in combination with biophysical modeling to study the relationship between microstructural metrics and degree of animal dysfunction. Thirteen spinal cords were extracted from animals with varied grades of disability and scanned in a high-field MRI scanner along with five control specimen. Diffusion weighted data were acquired together with high resolution T₂* images. Diffusion data were fit to estimate diffusion and kurtosis tensors and white matter modeling parameters, which were all used for subsequent statistical analysis using a linear mixed effects model. T₂* images were used to delineate focal demyelination/inflammation. Our results reveal a strong relationship between disability and measured microstructural parameters in normal appearing white matter and gray matter. Relationships between disability and mean of the kurtosis tensor, radial kurtosis, radial diffusivity were similar to what has been found in other hypomyelinating MS models, and in patients. However, the changes in biophysical modeling parameters and in particular in extra-axonal axial diffusivity were clearly different from previous studies employing other animal models of MS. In conclusion, our data suggest that DKI and microstructural modeling can provide a unique contrast capable of detecting EAE-specific changes correlating with clinical disability.

Single- and double-Diffusion encoding MRI for studying ex vivo apparent axon diameter distribution in spinal cord white matter

Mapping average axon diameter (AAD) and axon diameter distribution (ADD) in neuronal tissues non-invasively is a challenging task that may have a tremendous effect on our understanding of the normal and diseased central nervous system (CNS). Water diffusion is used to probe microstructure in neuronal tissues, however, the different water populations and barriers that are present in these tissues turn this into a complex task. Therefore, it is not surprising that recently we have witnessed a burst in the development of new approaches and models that attempt to obtain, non-invasively, detailed microstructural information in the CNS. In this work, we aim at challenging and comparing the microstructural information obtained from single diffusion encoding (SDE) with double diffusion encoding (DDE) MRI. We first applied SDE and DDE MR spectroscopy (MRS) on microcapillary phantoms and then applied SDE and DDE MRI on an ex vivo porcine spinal cord (SC), using similar experimental conditions. The obtained diffusion MRI data were fitted by the same theoretical model, assuming that the signal in every voxel can be approximated as the superposition of a Gaussian-diffusing component and a series of restricted components having infinite cylindrical geometries. The diffusion MRI results were then compared with histological findings. We found a good agreement between the fittings and the experimental data in white matter (WM) voxels of the SC in both diffusion MRI methods. The microstructural information and apparent AADs extracted from SDE MRI were found to be similar or somewhat larger than those extracted from DDE MRI especially when the diffusion time was set to 40 ms. The apparent ADDs extracted from SDE and DDE MRI show reasonable agreement but somewhat weaker correspondence was observed between the diffusion MRI results and histology. The apparent subtle differences between the microstructural information obtained from SDE and DDE MRI are briefly discussed.

From micro- to macro-structures in multiple sclerosis: what is the added value of diffusion imaging

Diffusion imaging has been instrumental in understanding damage to the central nervous system as a result of its sensitivity to microstructural changes. Clinical applications of diffusion imaging have grown exponentially over the past couple of decades in many neurological and neurodegenerative diseases, such as multiple sclerosis (MS). For several reasons, MS has been extensively researched using advanced neuroimaging techniques, which makes it an 'example disease' to illustrate the potential of diffusion imaging for clinical applications. In addition, MS pathology is characterized by several key processes competing with each other, such as inflammation, demyelination, remyelination, gliosis and axonal loss, enabling the specificity of diffusion to be challenged. In this review, we describe how diffusion imaging can be exploited to investigate micro-, meso- and macro-scale properties of the brain structure and discuss how they are affected by different pathological substrates. Conclusions from the literature are that larger studies are needed to confirm the exciting results from initial investigations before current trends in diffusion imaging can be translated to the neurology clinic. Also, for a comprehensive understanding of pathological processes, it is essential to take a multiple-level approach, in which information at the micro-, meso- and macroscopic scales is fully integrated.

Studying microstructure and microstructural changes in plant tissues by advanced diffusion magnetic resonance imaging techniques

As sessile organisms, plants must respond to the environment by adjusting their growth and development. Most of the plant body is formed post-embryonically by continuous activity of apical and lateral meristems. The development of lateral adventitious roots is a complex process, and therefore the development of methods that can visualize, non-invasively, the plant microstructure and organ initiation that occur during growth and development is of paramount importance. In this study, relaxation-based and advanced diffusion magnetic resonance imaging (MRI) methods including diffusion tensor (DTI), q-space diffusion imaging (QSI), and double-pulsed-field-gradient (d-PFG) MRI, at 14.1 T, were used to characterize the hypocotyl microstructure and the microstructural changes that occurred during the development of lateral adventitious roots in tomato. Better contrast was observed in relaxation-based MRI using higher in-plane resolution but this also resulted in a significant reduction in the signal-to-noise ratio of the T2-weighted MR images. Diffusion MRI revealed that water diffusion is highly anisotropic in the vascular cylinder. QSI and d-PGSE MRI showed that in the vascular cylinder some of the cells have sizes in the range of 6-10 μm. The MR images captured cell reorganization during adventitious root formation in the periphery of the primary vascular bundles, adjacent to the xylem pole that broke through the cortex and epidermis layers. This study demonstrates that MRI and diffusion MRI methods allow the non-invasive study of microstructural features of plants, and enable microstructural changes associated with adventitious root formation to be followed.

Mapping axonal density and average diameter using non-monotonic time-dependent gradient-echo MRI

White Matter (WM) microstructures, such as axonal density and average diameter, are crucial to the normal function of the Central Nervous System (CNS) as they are closely related with axonal conduction velocities. Conversely, disruptions of these microstructural features may result in severe neurological deficits, suggesting that their noninvasive mapping could be an important step towards diagnosing and following pathophysiology. Whereas diffusion based MRI methods have been proposed to map these features, they typically entail the application of powerful gradients, which are rarely available in the clinic, or extremely long acquisition schemes to extract information from parameter-intensive models. In this study, we suggest that simple and time-efficient multi-gradient-echo (MGE) MRI can be used to extract the axon density from susceptibility-driven non-monotonic decay in the time-dependent signal. We show, both theoretically and with simulations, that a non-monotonic signal decay will occur for multi-compartmental microstructures - such as axons and extra-axonal spaces, which were here used as a simple model for the microstructure - and that, for axons parallel to the main magnetic field, the axonal density can be extracted. We then experimentally demonstrate in ex-vivo rat spinal cords that its different tracts - characterized by different microstructures - can be clearly contrasted using the MGE-derived maps. When the quantitative results are compared against ground-truth histology, they reflect the axonal fraction (though with a bias, as evident from Bland-Altman analysis). As well, the extra-axonal fraction can be estimated. The results suggest that our model is oversimplified, yet at the same time evidencing a potential and usefulness of the approach to map underlying microstructures using a simple and time-efficient MRI sequence. We further show that a simple general-linear-model can predict the average axonal diameters from the four model parameters, and map these average axonal diameters in the spinal cords. While clearly further modelling and theoretical developments are necessary, we conclude that salient WM microstructural features can be extracted from simple, SNR-efficient multi-gradient echo MRI, and that this paves the way towards easier estimation of WM microstructure in vivo.

Diffusion MRI of the spinal cord: from structural studies to pathology

Diffusion MRI is extensively used to study brain microarchitecture and pathologies, and water diffusion appears highly anisotropic in the white matter (WM) of the spinal cord (SC). Despite these facts, the use of diffusion MRI to study the SC, which has increased in recent years, is much less common than that in the brain. In the present review, after a brief outline of early studies of diffusion MRI (DWI) and diffusion tensor MRI (DTI) of the SC, we provide a short survey on DTI and on diffusion MRI methods beyond the tensor that have been used to study SC microstructure and pathologies. After introducing the porous view of WM and describing the q-space approach and q-space diffusion MRI (QSI), we describe other methodologies that can be applied to study the SC. Selected applications of the use of DTI, QSI, and other more advanced diffusion MRI methods to study SC microstructure and pathologies are presented, with some emphasis on the use of less conventional diffusion methodologies. Because of length constraints, we concentrate on structural studies and on a few selected pathologies. Examples of the use of diffusion MRI to study dysmyelination, demyelination as in experimental autoimmune encephalomyelitis and multiple sclerosis, amyotrophic lateral sclerosis, and traumatic SC injury are presented. We conclude with a brief summary and a discussion of challenges and future directions for diffusion MRI of the SC. Copyright © 2016 John Wiley & Sons, Ltd.

Modeling of the diffusion MR signal in calibrated model systems and nerves

Diffusion NMR is a powerful tool for gleaning microstructural information on opaque systems. In this work, the signal decay in single-pulsed-field gradient diffusion NMR experiments performed on a series of phantoms of increasing complexity, where the ground truth is known a priori, was modeled and used to identify microstructural features of these complex phantoms. We were able to demonstrate that, without assuming the number of components or compartments, the modeling can identify the number of restricted components, detect their sizes with an accuracy of a fraction of a micrometer, determine their relative populations, and identify and characterize free diffusion when present in addition to the components exhibiting restricted diffusion. After the accuracy of the modeling had been demonstrated, this same approach was used to study fixed nerves under different experimental conditions. It seems that this approach is able to characterize both the averaged axon diameter and the relative population of the different diffusing components in the neuronal tissues examined.

q-Space diffusion MRI (QSI) of the disease progression in the spinal cords of the Long Evans shaker: diffusion time and apparent anisotropy

q-Space diffusion MRI (QSI) was used to study the spinal cords of Long Evans shaker (les) rats, a model of dysmyelination, and their age-matched controls at different maturation stages. Diffusion was measured parallel and perpendicular to the fibers of the spinal cords of the two groups and at different diffusion times. The results showed that QSI is able to detect the dysmyelination process that occurs in this model in the different stages of the disease. The differences in the diffusion characteristics of the spinal cords of the two groups were found to be larger when the diffusion time was increased from 22 to 100 ms. We found that the radial mean displacement is a much better parameter than the QSI fractional anisotropy (FA) to document the differences between the two groups. We observed that the degree of myelination affects the diffusion characteristics of the tissues, but has a smaller effect on FA. All of the extracted diffusion parameters that are affected by the degree of myelination are affected in a diffusion time-dependent fashion, suggesting that the terms apparent anisotropy, apparent fractional anisotropy and even apparent root-mean-square displacement (rmsD) are more appropriate.

Advanced MRI strategies for assessing spinal cord injury

Advanced magnetic resonance (MR) approaches permit the noninvasive quantification of macromolecular, functional, and physiological properties of biological tissues. In this chapter, we review the application of advanced MR techniques to the spinal cord. Macromolecular properties of the spinal cord can be studied using magnetization transfer (MT) MR, diffusion tensor imaging (DTI), Q-space diffusion spectroscopy, and selective detection of myelin water. The functional and metabolic status of the spinal cord can be studied using functional MRI (fMRI), perfusion imaging, and magnetic resonance spectroscopy (MRS). Finally, we consider the outlook for advanced MR studies in persons in whom metal hardware has been implanted to stabilize the cord. In spite of the spinal cord's diminutive size, its location deep within the body, and constant motion, recent work shows that the spinal cord can be studied using these advanced MR approaches.

White matter maturation in the brains of Long Evans shaker myelin mutant rats by ex-vivo QSI and DTI

The brains of Long Evans shaker (les) rats, a model of dysmyelination, and their age- matched controls were studied by ex-vivo q-space diffusion imaging (QSI) and diffusion tensor imaging (DTI). The QSI and DTI indices were computed from the same acquisition. The les and the control brains were studied at different stages of maturation and disease progression. The mean displacement, the probability for zero displacement and kurtosis were computed from QSI data while the fractional anisotropy (FA) and the eigenvalues were computed from DTI. It was found that all QSI indices detect the les pathology, at all stages of maturation, while only some of the DTI indices could detect the les pathology. The QSI mean displacement was larger in the les group as compared with their age-matched controls while the probability for zero displacement and the kurtosis were both lower all indicating higher degree of restriction in the control brains. Since all the DTI eigenvalues were higher in the les brains as compared to controls, the less efficient DTI measure for discerning the les pathology was found to be the FA. Clearly, the most sensitive DTI parameter to the les pathology is λ3, i.e., the minimal diffusivity. Since the QSI and DTI data were obtained from the same acquisition, despite the somewhat higher SNR of the QSI data compared to the DTI data, it seems that the higher diagnostic capacity of the QSI data in this experimental model of dysmyelination, originates mainly from the higher diffusing weighting of the QSI data.

High-level gait disorder: associations with specific white matter changes observed on advanced diffusion imaging

BACKGROUND AND PURPOSE

High-level gait disorder (HLGD) is a debilitating disorder causing mobility decline in the elderly. Although its clinical characteristics are well described, its anatomical and pathophysiological underpinnings are poorly understood. This study examined the anatomical distribution of white matter (WM) changes in patients with mild to moderate HLGD of the cautious/disequilibrium type, using advanced magnetic resonance imaging (MRI) methods.

METHODS

Thirteen patients with HLGD, 9 elderly and 13 middle-aged healthy controls were scanned using diffusion tensor imaging, Q-space imaging, and conventional MRI. The regions of significant differences between the HLGD group and the elderly control group were defined, and the mean fractional anisotropy and displacement values of these areas were extracted.

RESULTS

The HLGD patients had lower fractional anisotropy and higher displacement values in regions related to the motor system, including those along the corticospinal tract and the superior cerebellar peduncles, as well as in cognitive and affective-related areas, including the anterior limbs of the internal capsule and the genu of the corpus callosum.

CONCLUSIONS

The anatomical distribution associated with HLGD of the cautious/disequilibrium type involves WM pathways that convey motor-related, cognitive and affective-related functions. The underlying pathological process leading to these changes most probably includes demyelination.

WITHDRAWN: First observation of diffusion-diffraction pattern in neuronal tissue by double-pulsed-field-gradient NMR

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

Accurate noninvasive measurement of cell size and compartment shape anisotropy in yeast cells using double-pulsed field gradient MR

The accurate characterization of pore morphology is of great interest in a wide range of scientific disciplines. Conventional single-pulsed field gradient (s-PFG) diffusion MR can yield compartmental size and shape only when compartments are coherently ordered using q-space approaches that necessitate strong gradients. However, double-PFG (d-PFG) methodology can provide novel microstructural information even when specimens are characterized by polydispersity in size and shape, and even when anisotropic compartments are randomly oriented. In this study, for the first time, we show that angular d-PFG experiments can be used to accurately measure cellular size and shape anisotropy of fixed yeast cells employing relatively weak gradients. The cell size, as measured by light microscopy, was found to be 5.32 ± 0.83 µm, whereas the results from noninvasive angular d-PFG experiments yielded a cell size of 5.46 ± 0.45 µm. Moreover, the low compartment shape anisotropy of the cells could be inferred from experiments conducted at long mixing times. Finally, similar experiments were conducted in a phantom comprising anisotropic compartments that were randomly oriented, showing that angular d-PFG MR provides novel information on compartment eccentricity that could not be accessed using conventional methods. Angular d-PFG methodology seems to be promising for the accurate estimation of compartment size and compartment shape anisotropy in heterogeneous systems in general, and biological cells and tissues in particular.

Advanced MRI strategies for assessing spinal cord injury

Advanced magnetic resonance (MR) approaches permit the noninvasive quantification of macromolecular, functional, and physiological properties of biological tissues. In this chapter, we review the application of advanced MR techniques to the spinal cord. Macromolecular properties of the spinal cord can be studied using magnetization transfer (MT) MR, diffusion tensor imaging (DTI), Q-space diffusion spectroscopy, and selective detection of myelin water. The functional and metabolic status of the spinal cord can be studied using functional MRI (fMRI), perfusion imaging, and magnetic resonance spectroscopy (MRS). Finally, we consider the outlook for advanced MR studies in persons in whom metal hardware has been implanted to stabilize the cord. In spite of the spinal cord's diminutive size, its location deep within the body, and constant motion, recent work shows that the spinal cord can be studied using these advanced MR approaches.

Mean displacement map of spine and spinal cord disorders using high b-value q-space imaging-feasibility study

BACKGROUND

Q-space analysis is a new metric that uses multiple, high b-value, diffusion-weighted magnetic resonance (MR) data. This technique shows promising results as a tool to provide information complementary to that of other imaging techniques used on biological tissue in vivo.

PURPOSE

To investigate the use of a mean displacement (MDP) map of high b-value, q-space imaging (QSI) to characterize spinal and spinal cord lesions in vivo.

MATERIAL AND METHODS

Eight patients with spine or spinal cord disorders (two neurinomas, one myeloma, three cases of syringohydromyelia, and two cases of cervical spondylosis) were included. The MR imaging protocol consisted of conventional MR sequences, conventional diffusion-weighted imaging (DWI; b = 1000), and high b-value QSI with a maximum q value of 836.9 cm(-1). Apparent diffusion coefficient (ADC) maps of conventional DWI and MDP maps of QSI data were obtained and region-of-interest analyses for the lesions were performed.

RESULTS

MDP values of normal spinal cord, cerebrospinal fluid (CSF), and tumor parenchyma were 6.57 ± 0.52, 17.6 ± 2.75, and 8.49 ± 2.09, respectively (µm, mean ± standard deviation). In general, MDP maps were not well correlated with the corresponding ADC maps at the pathologic lesions. Spondylotic lesions tended to have higher MDP values than normal spinal cord, whereas syringohydromyelia produced MDP values slightly lower than those of CSF.

CONCLUSION

The heterogeneous MDP values were probably due to differences in tissues and pathologic structures. This technique has potential to provide additional clinical information to that obtained with conventional MR imaging.

A comparison of mean displacement values using high b-value Q-space diffusion-weighted MRI with conventional apparent diffusion coefficients in patients with stroke

RATIONALE AND OBJECTIVES

Q-space analysis using high b-value diffusion-weighted magnetic resonance (MR) data provides information on tissue microstructure in contrast to conventional MR imaging (MRI) based on low b-value diffusion-weighted imaging (DWI). The purpose of this study was to evaluate the use of mean displacement (MDP) map in stroke patients using q-space diffusion-weighted MRI (QSI).

MATERIALS AND METHODS

Twenty-one patients presenting with a total of 22 acute or subacute cerebral infarctions were included. MR protocol consisted of conventional MR sequences, DWI (b-value; 1000 s/mm(2)) and QSI (b-value; maximum 12,000 s/mm(2)). Apparent diffusion coefficient (ADC) maps of conventional DWI and MDP maps of QSI data were obtained and compared in the ischemic lesions and corresponding normal tissues.

RESULTS

Decreased ADC values were present in all lesions. There was no correlation between ADC and MDP values in the lesions (r = 0.21). MDP values of the lesions were 8.60 ± 1.26 μm (mean ± SD). Most of the lesions (16/22) had higher MDP values than normal brain tissue. Three lesions showed lower MDP values and three showed mixed MDP values.

CONCLUSIONS

The MDP maps using QSI data provides additional information for stroke patients compared to conventional DWI.

q-space and conventional diffusion imaging of axon and myelin damage in the rat spinal cord after axotomy

Parallel and perpendicular diffusion properties of water in the rat spinal cord were investigated 3 and 30 days after dorsal root axotomy, a specific insult resulting in early axonal degeneration followed by later myelin damage in the dorsal column white matter. Results from q-space analysis (i.e., the diffusion probability density function) obtained with strong diffusion weighting were compared to conventional anisotropy and diffusivity measurements at low b-values, as well as to histology for axon and myelin damage. q-Space contrasts included the height (return to zero displacement probability), full width at half maximum, root mean square displacement, and kurtosis excess of the probability density function, which quantifies the deviation from gaussian diffusion. Following axotomy, a significant increase in perpendicular diffusion (with decreased kurtosis excess) and decrease in parallel diffusion (with increased kurtosis excess) were found in lesions relative to uninjured white matter. Notably, a significant change in abnormal parallel diffusion was detected from 3 to 30 days with full width at half maximum, but not with conventional diffusivity. Also, directional full width at half maximum and root mean square displacement measurements exhibited different sensitivities to white matter damage. When compared to histology, the increase in perpendicular diffusion was not specific to demyelination, whereas combined reduced parallel diffusion and increased perpendicular diffusion was associated with axon damage.

From single-pulsed field gradient to double-pulsed field gradient MR: gleaning new microstructural information and developing new forms of contrast in MRI

One of the hallmarks of diffusion NMR and MRI is its ability to utilize restricted diffusion to probe compartments much smaller than the excited volume or the MRI voxel, respectively, and to extract microstructural information from them. Single-pulsed field gradient (s-PFG) MR methodologies have been employed with great success to probe microstructures in various disciplines, ranging from chemistry to neuroscience. However, s-PFG MR also suffers from inherent shortcomings, especially when specimens are characterized by orientation or size distributions: in such cases, the microstructural information available from s-PFG experiments is limited or lost. Double-pulsed field gradient (d-PFG) MR methodology, an extension of s-PFG MR, has attracted attention owing to recent theoretical studies predicting that it can overcome certain inherent limitations of s-PFG MR. In this review, we survey the microstructural features that can be obtained from conventional s-PFG methods in the different q regimes, and highlight its limitations. The experimental aspects of d-PFG methodology are then presented, together with an overview of its theoretical underpinnings and a general framework for relating the MR signal decay and material microstructure, affording new microstructural parameters. We then discuss recent studies that have validated the theory using phantoms in which the ground truth is well known a priori, a crucial step prior to the application of d-PFG methodology in neuronal tissue. The experimental findings are in excellent agreement with the theoretical predictions and reveal, inter alia, zero-crossings of the signal decay, robustness towards size distributions and angular dependences of the signal decay from which accurate microstructural parameters, such as compartment size and even shape, can be extracted. Finally, we show some initial findings in d-PFG MR imaging. This review lays the foundation for future studies, in which accurate and novel microstructural information could be extracted from complex biological specimens, eventually leading to new forms of contrast in MRI.

QSI and DTI of excised brains of the myelin-deficient rat

High b-value q-space diffusion imaging (QSI) and conventional DTI methodologies were used to study the MRI diffusion characteristics of excised brains of 21-day-old myelin-deficient (md) rats and their age-matched controls. Three different indices were calculated from the QSI data, i.e., Displacement, Probability and Kurtosis, for the purpose of evaluating the effect of the myelin sheaths on the MR diffusion characteristics in white matter (WM) ROIs of the md versus control brains. The examined WM ROIs were the corpus callosum, the external capsule, and the internal capsule. In all examined WM ROIs, significant differences were observed between the md and control brains for all QSI indices. These differences reveal that myelin sheaths surrounding the axons in WM ROIs mostly affect the component exhibiting restricted diffusion, which is manifested by low mean displacement values and high probability and kurtosis values. Such differences were found to be more pronounced in long diffusion times, i.e., Delta=200 ms. Conventional DTI performed with relatively low b-values (b<1500 s/mm2) was also used to study md versus control brains. Interestingly, the fractional anisotropy (FA) index, which was calculated from DTI data, did not reveal any significant difference between the groups in the examined WM ROIs. However, some distinctions were revealed by the three eigenvalues (lambda1, lambda2, and lambda3) obtained from the tensor analysis. These findings were supported by Voxel-based analysis using SPM. Finally, MRI-guided histology showed very good agreement between myelin-stained regions and regions with highly restricted diffusion detected by QSI.

Axial diffusivity is the primary correlate of axonal injury in the experimental autoimmune encephalomyelitis spinal cord: a quantitative pixelwise analysis

The dissociation between magnetic resonance imaging (MRI) and permanent disability in multiple sclerosis (MS), termed the clinicoradiological paradox, can primarily be attributed to the lack of specificity of conventional, relaxivity-based MRI measurements in detecting axonal damage, the primary pathological correlate of long-term impairment in MS. Diffusion tensor imaging (DTI) has shown promise in specifically detecting axonal damage and demyelination in MS and its animal model, experimental autoimmune encephalomyelitis (EAE). To quantify the specificity of DTI in detecting axonal injury, in vivo DTI maps from the spinal cords of mice with EAE and quantitative histological maps were both registered to a common space. A pixelwise correlation analysis between DTI parameters, histological metrics, and EAE scores revealed a significant correlation between the water diffusion parallel to the white matter fibers, or axial diffusivity, and EAE score. Furthermore, axial diffusivity was the primary correlate of quantitative staining for neurofilaments (SMI31), markers of axonal integrity. Both axial diffusivity and neurofilament staining were decreased throughout the entire white matter, not solely within the demyelinated lesions seen in EAE. In contrast, although anisotropy was significantly correlated with EAE score, it was not correlated with axonal damage. The results demonstrate a strong, quantitative relationship between axial diffusivity and axonal damage and show that anisotropy is not specific for axonal damage after inflammatory demyelination.

Three-dimensional water diffusion in impermeable cylindrical tubes: theory versus experiments

Characterizing diffusion of gases and liquids within pores is important in understanding numerous transport processes and affects a wide range of practical applications. Previous measurements of the pulsed gradient stimulated echo (PGSTE) signal attenuation, E(q), of water within nerves and impermeable cylindrical microcapillary tubes showed it to be exquisitely sensitive to the orientation of the applied wave vector, q, with respect to the tube axis in the high-q regime. Here, we provide a simple three-dimensional model to explain this angular dependence by decomposing the average propagator, which describes the net displacement of water molecules, into components parallel and perpendicular to the tube wall, in which axial diffusion is free and radial diffusion is restricted. The model faithfully predicts the experimental data, not only the observed diffraction peaks in E(q) when the diffusion gradients are approximately normal to the tube wall, but their sudden disappearance when the gradient orientation possesses a small axial component. The model also successfully predicts the dependence of E(q) on gradient pulse duration and on gradient strength as well as tube inner diameter. To account for the deviation from the narrow pulse approximation in the PGSTE sequence, we use Callaghan's matrix operator framework, which this study validates experimentally for the first time. We also show how to combine average propagators derived for classical one-dimensional and two-dimensional models of restricted diffusion (e.g. between plates, within cylinders) to construct composite three-dimensional models of diffusion in complex media containing pores (e.g. rectangular prisms and/or capped cylinders) having a distribution of orientations, sizes, and aspect ratios. This three-dimensional modeling framework should aid in describing diffusion in numerous biological systems and in a myriad of materials sciences applications.

The effect of the diffusion time and pulse gradient duration ratio on the diffraction pattern and the structural information estimated from q-space diffusion MR: experiments and simulations

q-Space diffusion MRI (QSI) provides a means of obtaining microstructural information about porous materials and neuronal tissues from diffusion data. However, the accuracy of this structural information depends on experimental parameters used to collect the MR data. q-Space diffusion MR performed on clinical scanners is generally collected with relatively long diffusion gradient pulses, in which the gradient pulse duration, delta, is comparable to the diffusion time, Delta. In this study, we used phantoms, consisting of ensembles of microtubes, and mathematical models to assess the effect of the ratio of the diffusion time and the duration of the diffusion pulse gradient, i.e., Delta/delta, on the MR signal attenuation vs. q, and on the measured structural information extracted therefrom. We found that for Delta/delta approximately 1, the diffraction pattern obtained from q-space MR data are shallower than when the short gradient pulse (SGP) approximation is satisfied. For long delta the estimated compartment size is, as expected, smaller than the real size. Interestingly, for Delta/delta approximately 1 the diffraction peaks are shifted to even higher q-values, even when delta is kept constant, giving the impression that the restricted compartments are even smaller than they are. When phantoms composed of microtubes of different diameters are used, it is more difficult to estimate the diameter distribution in this regime. Excellent agreement is found between the experimental results and simulations that explicitly account for the use of long duration gradient pulses. Using such experimental data and this mathematical framework, one can estimate the true compartment dimensions when long and finite gradient pulses are used even when Delta/delta approximately 1.

High b-value q-space diffusion-weighted MRI of the human cervical spinal cord in vivo: feasibility and application to multiple sclerosis

Q-space analysis is an alternative analysis technique for diffusion-weighted imaging (DWI) data in which the probability density function (PDF) for molecular diffusion is estimated without the need to assume a Gaussian shape. Although used in the human brain, q-space DWI has not yet been applied to study the human spinal cord in vivo. Here we demonstrate the feasibility of performing q-space imaging in the cervical spinal cord of eight healthy volunteers and four patients with multiple sclerosis. The PDF was computed and water displacement and zero-displacement probability maps were calculated from the width and height of the PDF, respectively. In the dorsal column white matter, q-space contrasts showed a significant (P < 0.01) increase in the width and a decrease in the height of the PDF in lesions, the result of increased diffusion. These q-space contrasts, which are sensitive to the slow diffusion component, exhibited improved detection of abnormal diffusion compared to perpendicular apparent diffusion constant measurements. The conspicuity of lesions compared favorably with magnetization transfer (MT)-weighted images and quantitative CSF-normalized MT measurements. Thus, q-space DWI can be used to study water diffusion in the human spinal cord in vivo and is well suited to assess white matter damage.

Crossing fibers, diffractions and nonhomogeneous magnetic field: correction of artifacts by bipolar gradient pulses

In recent years, diffusion tensor imaging (DTI) and its variants have been used to describe fiber orientations and q-space diffusion MR was proposed as a means to obtain structural information on a micron scale. Therefore, there is an increasing need for complex phantoms with predictable microcharacteristics to challenge different indices extracted from the different diffusion MR techniques used. The present study examines the effect of diffusion pulse sequence on the signal decay and diffraction patterns observed in q-space diffusion MR performed on micron-scale phantoms of different geometries and homogeneities. We evaluated the effect of the pulse gradient stimulated-echo, the longitudinal eddy current delay (LED) and the bipolar LED (BPLED) pulse sequences. Interestingly, in the less homogeneous samples, the expected diffraction patterns were observed only when diffusion was measured with the BPLED sequence. We demonstrated the correction ability of bipolar diffusion gradients and showed that more accurate physical parameters are obtained when such a diffusion gradient scheme is used. These results suggest that bipolar gradient pulses may result in more accurate data if incorporated into conventional diffusion-weighted imaging and DTI.

q-Space diffusion of myelin-deficient spinal cords

The apparent water diffusion anisotropy in white matter (WM) of excised spinal cords of myelin-deficient (md) rats and their age-matched controls was studied by high-b-value q-space diffusion MRS and MRI at different diffusion times. Non-monoexponential signal decay was observed at long diffusion times. The mean displacements in the md spinal cords were found to be higher than those of the controls. The apparent anisotropy (AA) of the fast-diffusing component was found to decrease more dramatically with the increase in diffusion time for the md spinal cords as compared with controls, whereas the AA of the slow-diffusing component in the controls was found to increase with the increase in diffusion time while that of the md cords decreased with the increase in diffusion time. When diffusion MRI was performed, similar diffusion anisotropy was extracted for the md and control spinal cords at diffusion times of 22 and 50 ms. Only at a diffusion time of about 200 ms was a significant difference obtained in the AA of the two groups. This originates from the much smaller increase in the mean displacement perpendicular to the fiber direction in the control group vs. the md group when the diffusion time was increased.

High b-value q-space diffusion MRS of nerves: structural information and comparison with histological evidence

High b-value q-space diffusion MRS was used to study the diffusion characteristics of formalin-fixed swine optic and sciatic nerves over a large range of diffusion times (3.7-99.3 ms). The very short diffusion time range was studied with a 1 ms resolution. The displacement distribution profiles obtained were fitted to a bi-Gaussian function, and structural parameters were extracted from the q-space diffusion MRS data. This structural information was correlated with axon sizes obtained by histological examination. It was found that high b-value q-space diffusion MRS can easily distinguish between the two nerve types. The root mean square displacements (rmsds) of both the slow and fast diffusing components of the optic nerves were found to be smaller than those of the sciatic nerves. When the rmsd was plotted against the square root of the diffusion time (t(d)(1/2)), it was found that all four components showed an increase in rmsd; this increase was significantly smaller than expected from the Einstein equation. However, the most restricted component is the slow diffusing component of the optic nerve. This is also the only diffusing component that shows a large change in the slope (i.e. a 'breaking point') of the plot of rmsd as a function of t(d)(1/2). This rmsd is very similar to the mean axon size of these optic nerves determined histologically. Such a change in slope was less apparent for the slow diffusing component of sciatic nerves, which showed a wider distribution of axon size in histological images. The fast diffusing components of both nerve types showed only a small gradual change in the slope of rmsd plotted against t(d)(1/2). These findings are discussed in the context of component assignment, origin of restriction, and relationships between the structural information extracted from q-space diffusion MRS and histological examination.

Indirect measurement of regional axon diameter in excised mouse spinal cord with q-space imaging: simulation and experimental studies

Q-space imaging (QSI), a diffusion MRI technique, can provide quantitative tissue architecture information at cellular dimensions not amenable by conventional diffusion MRI. By exploiting regularities in molecular diffusion barriers, QSI can estimate the average barrier spacing such as the mean axon diameter in white matter (WM). In this work, we performed ex vivo QSI on cervical spinal cord sections from healthy C57BL/6 mice at 400 MHz using a custom-designed uniaxial 50T/m gradient probe delivering a 0.6 microm displacement resolution capable of measuring axon diameters on the scale of 1 microm. After generating QSI-derived axon diameter maps, diameters were calculated using histology from seven WM tracts (dorsal corticospinal, gracilis, cuneatus, rubrospinal, spinothalamic, reticulospinal, and vestibulospinal tracts) each with different axon diameters. We found QSI-derived diameters from regions drawn in the seven WM tracts (1.1 to 2.1 microm) to be highly correlated (r(2)=0.95) with those calculated from histology (0.8 to 1.8 microm). The QSI-derived values overestimated those obtained by histology by approximately 20%, which is likely due to the presence of extra-cellular signal. Finally, simulations on images of synthetic circular axons and axons from histology suggest that QSI-derived diameters are informative despite diameter and axon shape variation and the presence of intra-cellular and extra-cellular signal. QSI may be able to quantify nondestructively changes in WM axon architecture due to pathology or injury at the cellular level.

Neuroimaging of demyelination and remyelination models

Small-animal magnetic resonance imaging is becoming an increasingly utilized noninvasive tool in the study of animal models of MS including the most commonly used autoimmune, viral, and toxic models. Because most MS models are induced in rodents with brains and spinal cords of a smaller magnitude than humans, small-animal MRI must accomplish much higher resolution acquisition in order to generate useful data. In this review, we discuss key aspects and important differences between high field strength experimental and human MRI. We describe the role of conventional imaging sequences including T1, T2, and proton density-weighted imaging, and we discuss the studies aimed at analyzing blood-brain barrier (BBB) permeability and acute inflammation utilizing gadolinium-enhanced MRI. Advanced MRI methods, including diffusion-weighted and magnetization transfer imaging in monitoring demyelination, axonal damage, and remyelination, and studies utilizing in vivo T1 and T2 relaxometry, provide insight into the pathology of demyelinating diseases at previously unprecedented details. The technical challenges of small voxel in vivo MR spectroscopy and the biologically relevant information obtained by analysis of MR spectra in demyelinating models is also discussed. Novel cell-specific and molecular imaging techniques are becoming more readily available in the study of experimental MS models. As a growing number of tissue restorative and remyelinating strategies emerge in the coming years, noninvasive monitoring of remyelination will be an important challenge in small-animal imaging. High field strength small-animal experimental MRI will continue to evolve and interact with the development of new human MR imaging and experimental NMR techniques.

The effect of the rotational angle on MR diffusion indices in nerves: is the rms displacement of the slow-diffusing component a good measure of fiber orientation?

In recent years, much effort has been made to increase our ability to infer nerve fiber direction through the use of diffusion MR. The present study examines the effect of the rotational angle (alpha), i.e. the angle between the diffusion sensitizing gradients and the main axis of the fibers in the nerves, on different NMR indices. The indices examined were the apparent diffusion coefficient (ADC), extracted from low b-values (b(max) approximately 1200 s/mm(2)), and the root mean square (rms) displacement of the fast and the slow-diffusing components extracted from high b-value q-space diffusion MR data. In addition, the effect of both the diffusion time and myelination was evaluated. We found that the most sensitive index to the rotational angle is the rms displacement of the slow-diffusing component extracted from the high b-value q-space diffusion MR experiment. For this component the rms displacement was nearly constant for alpha values ranging from -10 degrees to +80 degrees (where alpha=0 degrees is the z direction), but it changed dramatically when diffusion was measured nearly perpendicular to the nerve fiber direction, i.e., for alpha=90+/-10 degrees. The ADC and the rms displacement of the fast-diffusing component exhibited only gradual changes, with a maximal change at alpha=45+/-15 degrees. The sensitivity of the rms displacement of the slow-diffusing component to the rotational angle was found to be higher at longer diffusion times and in mature fully myelinated nerves. The relevance of these observations for determining the fiber direction is briefly discussed.

Accuracy of q-space related parameters in MRI: simulations and phantom measurements

The accuracy of q-space measurements was evaluated at a 3.0-T clinical magnetic resonance imaging (MRI) scanner, as compared with a 4.7-T nuclear magnetic resonance (NMR) spectrometer. Measurements were performed using a stimulated-echo pulse-sequence on n-decane as well as on polyethylene glycol (PEG) mixed with different concentrations of water, in order to obtain bi-exponential signal decay curves. The diffusion coefficients as well as the modelled diffusional kurtosis K(fit) were obtained from the signal decay curve, while the full-width at half-maximum (FWHM) and the diffusional kurtosis K were obtained from the displacement distribution. Simulations of restricted diffusion, under conditions similar to those obtainable with a clinical MRI scanner, were carried out assuming various degrees of violation of the short gradient pulse (SGP) condition and of the long diffusion time limit. The results indicated that an MRI system can not be used for quantification of structural sizes less than about 10 microm by means of FWHM since the parameter underestimates the confinements due to violation of the SGP condition. However, FWHM can still be used as an important contrast parameter. The obtained kurtosis values were lower than expected from theory and the results showed that care must be taken when interpreting a kurtosis estimate deviating from zero.

High b-value diffusion imaging of dementia: Application to vascular dementia and alzheimer disease

Alzheimer's disease (AD) and Vascular Dementia (VaD) are the most common types of dementia and are progressive diseases affecting millions of people. Despite the high sensitivity of MRI to neurological disorders it has not thus far been found to be specific for the detection of either of these pathologies. In the present study high b-value q-space diffusion-weighted MRI (DWI) was applied to VaD and AD. Controls (N=4), VaD patients (N=8) and AD patients (N=6) were scanned with high b-value DWI, which emphasizes the water component which exhibits restricted diffusion. VaD patients were found to present major WM loss while, in AD, the major pathology found was GM changes, as expected. Also, WM changes in VaD and AD were of a different pattern, more specific to frontal and temporal areas in AD and more widespread in VaD. This pattern of WM changes may be utilized as a diagnosis criterion. Conventional diffusion tensor imaging did not show significant changes between either of the groups and controls. These results demonstrate the potential of high b-value DWI in the diagnosis of dementia.

q-Space imaging using small magnetic field gradient

q-Space diffusion analysis is a method to obtain the probability density function of the translational displacement of diffusing water molecules. Several quantities can be extracted from the function that indicate a characteristic of the water diffusion in tissue, e.g., the mean displacement of the diffusion, probability for zero displacement, and kurtosis of the function. These quantities are expected to give information about the microstructure of tissues in addition to that obtained from the apparent diffusion coefficient (ADC); however, this method requires high q (i.e., high b) values, which are undesirable in practical applications of the method using clinical magnetic resonance (MR) imaging equipment. We propose a method to obtain certain quantities that indicate a characteristic of the diffusion and that uses low q-value measurements. The quantities we can obtain are the moments of translational displacement, R; the n-th order moment is defined as the average of Rn (n: integer). Kurtosis can also be calculated from the second and fourth moments. We tried to map the moments and kurtosis using clinical MR imaging equipment. We also estimated the inherent errors of the moments obtained. Our method requires precision in measuring spin echo signals and setting q values rather than using high q-value measurements. Although our results show that further error reductions are desired, our method is workable using ordinary clinical MR imaging equipment.

Toward accurate diagnosis of white matter pathology using diffusion tensor imaging

Diffusion tensor imaging (DTI) has been widely applied to investigate injuries in the central nervous system (CNS) white matter (WM). However, the underlying pathological correlates of diffusion changes have not been adequately determined. In this study the coregistration of histological sections to MR images and a pixel-based receiver operating characteristic (ROC) analysis were used to compare the axial (lambda( parallel)) and radial (lambda( perpendicular)) diffusivities derived from DTI and histological markers of axon (phosphorylated neurofilament, SMI-31) and myelin (Luxol fast blue (LFB)) integrity, respectively, in two different patterns of injury to mouse spinal cord (SC) WM. In contusion SC injury (SCI), a decrease in lambda( parallel) matched the pattern of axonal damage with high accuracy, but lambda( perpendicular) did not match the pattern of demyelination detected by LFB. In a mouse model of multiple sclerosis (MS), lambda( perpendicular) and lambda( parallel) did not match the patterns of demyelination or axonal damage, respectively. However, a region of interest (ROI) analysis suggested that lambda( perpendicular)-detected demyelination paralleled that observed with LFB, and lambda( parallel) decreased in both regions of axonal damage and normal-appearing WM (NAWM) as visualized by SMI-31. The results suggest that directional diffusivities may reveal abnormalities that are not obvious with SMI-31 and LFB staining, depending on the type of injury.

Spatial And Temporal Damage Evolution after Hemi-Crush Injury in Rat Spinal Cord Obtained by High b-Value q-Space Diffusion Magnetic Resonance Imaging

Spinal cord injury (SCI) is a major cause of disability for many living persons. Therefore, several experimental models and handful of techniques were developed to study and characterize the damage evolution following SCI. In the present study, high b-value q-space diffusion-weighted imaging (DWI) was used to follow the spatial and temporal damage evolution in excised rat spinal cords following hemi-crush injury. The DWI results were correlated with behavioral testing. It was found that the damage depends, as expected, on the severity of the insult. Significant spontaneous recovery was observed, six weeks following the insult, only for the mild hemi-crush injury but not following the severe injury. The damage was found to be more severe in the area caudal to the trauma site as compared to the rostral section of the cord.