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Theory of spin echo in restricted geometries under a step-wise gradient pulse sequence.

A closed matrix form solution of the Bloch-Torrey equation is presented for the magnetization density of spins diffusing in a bounded region under a steady gradient field and for the Stejskal-Tanner gradient pulse sequence, assuming straightforward generalization to any step-wise gradient profile. The solution is expressed in terms of the eigenmodes of the diffusion propagator in a given geometry with appropriate boundary conditions (perfectly reflecting or relaxing walls). Applications to rectangular, cylindrical, and spherical geometries are discussed. The relationship with the multiple propagator approach is established and an alternative step-wise gradient discretization procedure is suggested to handle arbitrary gradient waveforms.

Magnetic Resonance Spectroscopy↗

MR myelography using heavily T2-weighted fast spin-echo pulse sequences with fat presaturation.

A new method for generating myelogramlike images of the thecal sac by MR imaging is presented. The method is based on suppressing background signal by using heavily T2-weighted fast spin-echo pulse sequences and obliterating fat signal by presaturation. The resulting slices are then projected into a composite image using a standard maximum intensity projection (MIP) algorithm. The technique is implemented with commercially available hardware and software and yields reproducible high-quality images of the lumbar thecal sac, which show excellent definition of the thecal margins, nerve roots, and nerve root sheaths. This method could replace conventional lumbar myelography and postmyelographic CT studies.

Adult↗

[Pulse sequences and visualization of instruments].

While initially advocated primarily for intrasurgical visualization (e.g., craniotomy), interventional MRI rapidly evolved into roles in image-guided localization for needle-based procedures, and thermal ablation of cancer. In this contest, MRI pulse sequences and scanning methods serve one of four primary roles: (1) speed improvement, (2) device localization, (3) anatomy/lesion differentiation and (4) temperature sensitivity. The first part of this manuscript deals with passive visualization of MR-compatible needles and the effects of field strength, sequence design, and orientation of the needle relative to the static magnetic field of the scanner. Issues and recommendations are given for low-field as well as high-field scanners. The second part contains methods reported to achieve improved acquisition efficiency over conventional phase encoding (wavelets, locally focused imaging, singular value decomposition and keyhole imaging). Finally, the last part of the manuscript reports the current status of thermosensitive sequences and their dependence on spinlattice relaxation time (T1), were diffusion coefficient (D) and proton chemical shift (delta).

Animals↗

Comparison of in-phase and out-of-phase gradient recalled echo T1-weighted pulse sequence for MR imaging of malignant liver masses following administration of paramagnetic gadolinium-chelate.

BACKGROUND: The purpose of this study was to compare the performance of in-phase and out-of-phase gradient recalled echo (GRE) pulse sequences on paramagnetic contrast-enhanced magnetic resonance (MR) imaging of malignant liver lesions. METHODS: Fifty patients (27 women, 23 men; mean age = 50 +/- 27 years) with known or suspected focal liver lesions, nine of whom had a fatty liver, were examined at 1.5 T before and 60 min after injection of gadobenate dimeglumine at a dose of 0.05 or 0.1 mmol/kg using two GRE techniques: echo time of 2.3 ms (out-of-phase) or 4.6 ms (in-phase). Liver signal-to-noise ratio (SNR) and lesion-liver contrast-to-noise ratio (CNR) were calculated. RESULTS: In patients with a nonfatty liver, liver SNR increased from 26 +/- 9 to 41 +/- 17 on in-phase images and from 28 +/- 8 to 45 +/- 14 on out-of-phase images. In patients with a fatty liver, in-phase images provided significantly higher (p < 0.01) liver SNR than did out-of-phase images predose (34 +/- 8 on in-phase vs. 21 +/- 8 on out-of-phase) and postdose (44 +/- 13 on in-phase vs. 33 +/- 14 on out-of-phase). In patients with a nonfatty liver, lesion-liver CNR was similar on in-phase and out-of-phase images, predose and postdose. In patients with fatty liver, lesion-liver CNR was significantly (p < 0.01) lower on out-of-phase images on predose and postdose images. CONCLUSION: In-phase GRE imaging is recommended for imaging focal liver lesions on paramagnetic contrast-enhanced MR imaging in patients with fatty infiltration of the liver.

Adult↗

Techniques, coils, pulse sequences, and contrast enhancement in pediatric musculoskeletal MR imaging.

The first half of this article emphasizes the basic techniques involved in performing MR imaging of the pediatric musculoskeletal system. These include patient preparation, sedation issues, immobilization, coil selection, and pulse sequences. The second half of this article provides a detailed discussion of the use of Gadolinium and its enhancement characteristics in the normal developing musculoskeletal system, and its pathologic states are given.

Adolescent↗

A comparison of pulse sequences in the detection of post-traumatic bone marrow abnormalities at low field strength MRI.

OBJECTIVE AND PATIENTS: One hundred and forty-one patients with recent joint trauma, aged 12-71 years, were imaged on a 0.2-T dedicated MRI system and evaluated for bone bruises. The most beneficial sequences were compared. DESIGN: The diagnosis of post-traumatic bone marrow abnormalities was established in 20 of 141 patients on the basis of decreased signal intensity on T1-weighted SE and GRE sequences and increased signal intensity on T2-weighted TSE and fat-suppressed IRGE sequences. Signal changes within the bone marrow were evaluated and statistically correlated with normal bone. RESULTS: The highest signal alteration was found on T1-weighted SE and GRE sequences, followed by IRGE, which detected smaller differences in signal intensity. T2-weighted TSE imaging showed the least contrast. The areas with bone marrow changes were approximately equal in size on T1-weighted SE and T2-weighted TSE sequences. The same areas depicted on IRGE and GRE sequences proved to be significantly larger (P < 0.01). CONCLUSION: Using a 0.2-T dedicated system T1-weighted SE, T1-weighted GRE and IRGE sequences were most effective in detecting conspicuous bone marrow alteration, while the T2-weighted TSE sequence was inferior. GRE and IRGE imaging showed areas about 4 times larger depicting bone marrow changes. On suspicion of bone bruise, a protocol including GRE and IRGE pulse sequences could be most beneficial.

Adolescent↗

MRI of the brain stem using fluid attenuated inversion recivery pulse sequences.

Heavily T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences with inversion times of 2000-2500 ms and echo times of 130-200 ms were used to image the brain stem of a normal adult and five patients. These sequences produce high signal from many white matter tracts and display high lesion contrast. The corticospinal and parietopontine tracts, lateral and medial lemnisci, superior and inferior cerebellar peduncles, medial longitudinal fasciculi, thalamo-olivary tracts and the cuneate and gracile fasciculi gave high signal and were directly visualised. The oculomotor and trigeminal nerves were demonstrated within the brain stem. Lesions not seen with conventional T2-weighted spin echo sequences were seen with high contrast in patients with infarction, multiple sclerosis, sarcoidosis, shunt obstruction and metastatic tumour. The anatomical detail and high lesion contrast given by the FLAIR pulse sequence appear likely to be of value in diagnosis of disease in the brain stem.

Adult↗

3D fast FLAIR: a CSF-nulled 3D fast spin-echo pulse sequence.

Since its introduction, the fluid attenuated inversion recovery (FLAIR) sequence has found many applications in the central nervous system (CNS), because of its heavy T2 weighting and excellent cerebrospinal fluid (CSF) suppression. More recently fast spin-echo based variants have been developed that greatly reduce scan time; such sequences are often referred to as "fast FLAIR." We present what we believe to be the first implementation of FLAIR using a three dimensional (3D) fast spin-echo-based pulse sequence, which combines the cerebrospinal fluid suppression and good lesion contrast of two-dimensional fast FLAIR with the advantages of a three-dimensional sequence such as higher signal-to-noise ratio (SNR) per unit time, thinner slices (giving reduced partial volume effect) and the ability to reformat the data in an arbitrary plane.

Brain↗

T2 quantitation of human articular cartilage in a clinical setting at 1.5 T: implementation and testing of four multiecho pulse sequence designs for validity.

RATIONALE AND OBJECTIVES: Evaluation of the T2 relaxation time of articular cartilage holds great potential for quantitative assessment of internal changes of the cartilage matrix. The purpose of the present study was to assess the validity of multiecho-based cartilage T2 quantitation in a clinical MRI setting at 1.5 T. METHODS: Four multisection multiecho sequence variants dedicated for quantitative T2 mapping of human articular cartilage were implemented on a 1.5 T whole-body imager and tested for accuracy in CuSO4-agarose gel phantoms and human patellar cartilage. Sequence design was varied to minimize errors in T2 quantitation due to stimulated echoes. RESULTS: As compared with single spin-echo experiments, the apparent T2 values calculated from the multiecho sequence variants showed mean deviations ranging from +26% to -32% (phantoms) and from +42% to -18% (cartilage). The patellar cartilage T2 covered a range from about 25 milliseconds to 55 milliseconds, with longer T2 values observed in the more superficial layers. In cartilage, best results were obtained from the sequence design using improved section profiles and a spoiler gradient scheme for suppression of stimulated echoes. CONCLUSIONS: Our results revealed a clear dependence of apparent T2 relaxation times on the pulse sequence design, emphasizing that the "true" T2 is hard to find. In addition, the effect on the apparent T2 values resulting from the specific modification of any sequence variant varied according to the respective tissue's properties. Therefore, the acquisition technique in conjunction with the specific tissue on which T2 mapping is performed need to be reported in detail and should kept consistent to allow large-scale comparisons and monitoring of treatment strategies, e.g., in osteoarthritis.

Cartilage, Articular↗

Pulse sequence optimization for use with a biopsy needle in MRI.

The purpose of this study was to assess the degree of conspicuity and amount of field distortion caused by a biopsy needle designed specifically for use in MRI studies. Toward this, a number of pulse sequences including spin and field echo were used. Parameters such as field of view, strength of read gradient, direction of read gradient, echo time and slice thickness were varied. The effect of these manipulations on needle visualization was studied. Partial voluming errors with thicker slices decreased needle conspicuity. Smaller field of view improved needle visualization as a result of magnification effect. Shallow read gradient strengths also increased needle conspicuity. Increased image artifacts were noted on field-echo sequences compared to spin echo. This effect increased with longer echo times. This reflects T2* effects on field-echo images.

Biopsy, Needle↗

FRODO pulse sequences: a new means of eliminating motion, flow, and wraparound artifacts.

Magnetic resonance images of the spine, chest, abdomen, and pelvis are commonly degraded by ghost artifacts. The authors have developed a new technique named FRODO (Flow and Respiratory artifact Obliteration with Directed Orthogonal pulses) to suppress these artifacts. Signal from tissues responsible for the artifacts is eliminated by use of radio frequency pulses specifically optimized for high selectivity to saturate proton magnetization over one or more independently defined slabs (large rectangular volumes) of tissue. Ghost artifacts from pulsatile flow in the heart and blood vessels, as well as from respiratory motion and swallowing, are suppressed. Additional applications of this technique include elimination of intraluminal signal in blood vessels and suppression of wraparound artifact along the phase-encoding axis. Preliminary clinical experience suggests that the FRODO technique, in conjunction with other flow compensation methods, may provide a definitive solution to the problem of motion in spine imaging. FRODO pulse sequences may also prove useful for imaging of blood vessels, heart, abdomen, and other areas where motion, flow, or wraparound artifacts limit image quality.

Abdomen↗

[New techniques and pulse sequences in MRI of the liver].

PURPOSE: The MRI techniques which have contributed to increasing utilization of MRI for abdominal imaging are described and recent advances addressed. METHODS: For breath-hold examinations of the abdomen, two basic techniques are required: array coil technology and fast and ultrafast pulse sequences providing T1 and T2 contrast. RESULTS: Circular polarized array coils render high signal-to-noise ratios (SNR) within large imaging volumes. With fast gradient-echo sequences the liver can be scanned with or without fat saturation within one breath-hold. When adequate parameters are selected, T2-weighted fast (turbo) spin-echo sequences allow high contrast between normal liver tissue and focal liver lesions, even if breath-hold acquisition is applied. Moreover, good soft tissue contrast can also be achieved with ultrafast single-shot sequences. Based on this sequence type, MRCP with a 512 matrix could be performed. The "TRUE FISP" allows for high resolution visualisation of vessels without contrast media. Three-dimensional T1-weighted sequences allow for scanning the upper abdomen with a slice thickness of 3 mm within one breath-hold. Diffusion-weighted sequences contribute to the characterisation of focal liver lesions. DISCUSSION: Modern MRI technology including phase-array coils and high-performance gradient systems made it possible to perform all examinations in breath-hold techniques, reducing motion artifacts.

Humans↗

Optimal pulsing sequences for MR contrast agents.

Chelates of paramagnetic metals have been developed for use as contrast agents for MRI. Several such agents are cleared by biliary excretion and significantly reduce proton T1 and T2 of liver and bile. These influences on proton-relaxation rates also influence the choice of pulsing sequences. In studies on rabbits, with and without contrast agents, the influence of repetition time (TR) and echo-delay time (TE) are demonstrated. Excellent liver images were obtained with an imaging time of 20 sec using TR = 80 msec, TE = 10 msec, and two excitations. The effects of such contrast agents are best imaged at short TR and short TE.

Animals↗

MR lymphography with iron oxide particles: dose-response studies and pulse sequence optimization in rabbits.

Superparamagnetic iron oxide (SPIO) particles are a promising contrast agent for MR lymphography. The effect of SPIO on MR imaging of normal lymph nodes and the impact of the size of the dose have not yet been investigated in detail. Therefore, we performed dose-response and pulse sequence optimization studies. MR images of the iliac lymph nodes of 15 normal rabbits were obtained at 1.5 T with 12 different spin-echo (SE) and gradient-echo (GRE) sequences before and after SPIO administration. The contrast agent was injected into a femoral lymph vessel at five different doses (0.02-2.0 mumol Fe/animal). The dose that reduced signal intensity by half (ED50) was determined for each sequence, and images were evaluated qualitatively. Doses of 0.2 and 1.0 mumol Fe caused a complete signal loss throughout the lymph node. In this dose range, proton density-weighted SE sequences showed a profound signal loss (ED50, 0.132 mumol Fe), and lymph nodes were sharply demarcated. The GRE sequences (ED50, 0.027-0.070 mumol Fe) and the T2-weighted SE sequence (ED50, 0.014 mumol Fe) showed an even more pronounced signal loss but insufficient anatomic resolution. Underdosing (less than or equal to 0.1 mumol Fe) caused only a focal signal loss in the lymph nodes. Oversaturation (2.0 mumol Fe for SE sequences, greater than or equal to 1.0 mumol Fe for GRE sequences) led to image distortion and did not allow assessment of lymph node morphology. Our results show that optimal contrast enhancement of normal lymph nodes with SPIO can be achieved in the dose range of 0.2-1.0 mumol Fe on proton density-weighted SE sequences. Our results may serve as a basis for further development of noninvasive MR lymphography.

Animals↗

An optimized pulse sequence for isotropically weighted diffusion imaging.

Single-shot echo-planar imaging is becoming the most widely used technique for magnetic resonance diffusion imaging, since it enables measurement of diffusion coefficients in human brain without motion artifacts. However, its reliability is limited by geometrical distortions due to eddy currents. In this report, an isotropically weighted echo-planar pulse sequence, optimized to give the maximum signal-to-noise ratio in the computed trace image and designed to produce inherently low distortions, is presented. It is also shown how the residual translational distortion can be easily characterized and removed by postprocessing. A full characterization of the distortion artifact involves a few measurements on a phantom, in order to estimate the distortion as a function of slice orientation, which can then be used to correct any slice orientation. Results of applying the image translation correction to data collected from a patient are presented.

Artifacts↗

MR pulse sequences: what every radiologist wants to know but is afraid to ask.

The use of magnetic resonance (MR) imaging is growing exponentially, in part because of the excellent anatomic and pathologic detail provided by the modality and because of recent technologic advances that have led to faster acquisition times. Radiology residents now are introduced in their 1st year of training to the MR pulse sequences routinely used in clinical imaging, including various spin-echo, gradient-echo, inversion-recovery, echo-planar imaging, and MR angiographic sequences. However, to make optimal use of these techniques, radiologists also need a basic knowledge of the physics of MR imaging, including T1 recovery, T2 and T2* decay, repetition time, echo time, and chemical shift effects. In addition, an understanding of contrast weighting is very helpful to obtain better depiction of specific tissues for the diagnosis of various pathologic processes.

Humans↗

Do T2-weighted pulse sequences help with the differential diagnosis of enhancing lesions in dynamic breast MRI?

In this study, our purpose was to determine whether T2-weighted images are a useful diagnostic adjunct for lesion characterization in dynamic breast MRI. On a 1.5-T system, 205 enhancing benign and malignant breast tumors were examined. The standardized protocol consisted of a T2-weighted turbo spin echo (TSE) pulse sequence with and without spectral fat suppression (SPIR), followed by a two-dimensional dynamic series with subtraction postprocessing. In 59 cases, T2*-weighted gradient-echo images also were obtained. Two independent radiologists visually rated the lesions (101 malignant, 104 benign) as having either a low or a high signal with respect to the adjacent glandular tissue. To assess age dependency of lesion enhancement velocities and T2-TSE signal intensities, we compared the results for patients at or below the age of 50 (group A), between 40 and 50 (group B), and beyond the age of 50 (group C). In T2-weighted TSE images, breast cancers were iso- or hypointense with respect to breast parenchyma in 87% of cases, whereas fibroadenomas were hyperintense in 71%. Visual assessment of lesion appearance in T2-weighted TSE images allowed to distinguish between fibroadenomas and breast cancers, with a respective sensitivity, specificity, positive predictive value, and negative predictive value of 72%, 75%, 46%, and 90% for young patients; 94%, 66%, 78%, and 89% for the patients between 40 and 50; and 89%, 62%, 85%, and 68% for the patients over 50 years of age. No significant difference was found for the distribution of signal intensities of lesions in T2*-weighted images or in fat-suppressed images. In a contrast-enhancing breast lesion, careful analysis of T2-weighted TSE images can improve differential diagnosis. The accuracy of this criterion varies with age.

Adult↗

Detection of hepatocellular carcinoma and its metastases with various pulse sequences using superparamagnetic iron oxide (SHU-555-A).

BACKGROUND: To identify the most useful combinations of various pre- and postcontrast magnetic resonance (MR) image sequences in detecting hepatocellular carcinoma (HCC) and its intrahepatic metastases before and after injection of SHU-555-A. METHODS: Thirty-eight lesions in 16 patients were evaluated before and after administration of SHU-555-A by using fast spin echo (FSE), gradient echo (GRE), and echo planar (EP) imaging sequences using a 1.5-Tesla superconducting MR system. The signal intensity ratio (SIR) and contrast-to-noise ratio (CNR) of the lesions, signal-to-noise ratios, and other parameters were calculated. RESULTS: Tumors were better detected after injection of SHU-555-A on all pulse sequences except on out-of-phase T1-weighted (T1W)-GRE sequences. Tumor detectability was higher for precontrast EP imaging and T2*-weighted (T2*W)-GRE sequences, whereas detectability at postcontrast was higher for T2*W-GRE, proton-density-weighted-FSE, and in-phase T1W-GRE sequences. The SIR and CNR at precontrast were highest for EP imaging, and those at postcontrast were highest for T2*W-GRE. CONCLUSION: SHU-555-A will increase the detectability of HCC and its liver metastases. T1W- and T2*W-GRE sequences would be the sequences of choice.

Carcinoma, Hepatocellular↗