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PubMedDate not supplied

Vertebral-basilar posterior cerebral territory stroke--delineation by proton nuclear magnetic resonance imaging.

We used three-dimensional proton NMR images to study ischemic infarction in the territory of the vertebral-basilar posterior cerebral circulation. The study includes sixteen cases, eight of which are presented in detail. In seven cases, the infarctions were secondary to demonstrable large artery occlusive disease -- vertebral, basilar, or posterior cerebral. In nine cases, the infarctions were secondary to what was presumably small vessel disease. In fifteen of the sixteen cases, NMR imaging could locate the infarct, inversion recovery and spin-echo pulse sequences being more sensitive than the saturation recovery pulse sequence. This efficiency rests on the high sensitivity of ischemic infarction to changes in T1 and T2 relaxation time, highlighted in the inversion recovery and spin-echo images, respectively. The additional advantages of the three-dimensional approach, and the lack of bone artifact, make NMR imaging superior to CT scanning in identifying areas of infarction in the territory of posterior cerebral circulation.

Adult↗
PubMed1992

Uses and limitations of spoiled gradient-refocused imaging in the evaluation of suspected intracranial tumors.

This article describes the use of a radiofrequency-spoiled gradient-recalled (SPGR) imaging pulse sequence in the evaluation of intracranial masses. This pulse sequence provides excellent anatomic detail with T1-weighted image contrast. Rapid, sequential, single-slice (two-dimensional) images of the brain can be obtained in patients who are unable to hold still for long periods of time. In addition, volumetric (three-dimensional) image data sets can be obtained that provide extremely thin (1- to 2-mm) sections of high detail and good signal-to-noise ratio for selected critical structures within the brain. Finally, because SPGR is also utilized for time-of-flight angiography, parenchymal information can be obtained simultaneously with cerebral blood vessel definition. One potential pitfall that the magnetic resonance radiologist must be aware of is the fact that, in many patients, the degree of contrast enhancement is greatly diminished on postgadolinium SPGR images compared with conventional spin-echo T1-weighted images. Comparison with a set of standard spin-echo postcontrast images or, potentially, the use of higher doses of gadolinium may solve this problem. In spite of this limitation, the selective utilization of SPGR imaging can yield additional useful information for evaluation and preoperative planning in patients with intracranial masses.

Brain Neoplasms↗
PubMedDate not supplied

Cerebrospinal fluid flow measured by phase-contrast cine MR.

PURPOSE: This prospective study was designed to establish the temporal and quantitative relationship between blood flow and cerebrospinal fluid (CSF) flow using a phase-contrast cine MR pulse sequence. METHODS: A cine phase-contrast MR pulse sequence using peripheral gating was used to measure CSF flow direction and velocity. Data were acquired continuously and interpolated into 16 images throughout the cardiac cycle. RESULTS: The timing of systolic CSF flow in the cervical subarachnoid space (SAS) correlated very closely to the brain arteriovenous blood flow difference during the cardiac cycle. This arteriovenous difference was a measure of brain expansion. Aqueduct CSF flow during the cardiac cycle differed from SAS flow in that systolic flow was delayed in comparison with systolic cervical SAS flow. The normal aqueductal oscillatory flow volume was 1.7 +/- .4 mL/min or 0.03 +/- 0.01 mL per cardiac cycle. This represented 14.5% +/- 3.1% of the total CSF flow and tissue displacement through the incisura which was 14.5 +/- 2.2 mL/min or 0.22 +/- 0.03 mL per cycle. CSF oscillatory flow volume in the cervical SAS was 39.0 +/- 4.0 mL/min or 0.65 +/- 0.08 mL per cycle. CONCLUSION: CSF flow can be measured. Results in healthy subjects show relatively low oscillatory flow through the aqueduct which is slightly out of phase (delayed) compared with SAS CSF flow.

Blood Flow Velocity↗
PubMed2003

In vivo intravascular MR imaging: transvenous technique for arterial wall imaging.

PURPOSE: To determine, in vivo, the potential for transvenous magnetic resonance (MR) imaging of the arterial wall and to assess appropriate MR pulse sequences for this method. MATERIALS AND METHODS: MR imaging was performed on 19 vessels (right renal artery, N = 9; left renal artery N = 2; external iliac artery, N = 4; abdominal aorta, N = 4) in nine swine. The animals were either low-density lipoprotein receptor knockout (N = 5) or Yucatan mini-pigs fed an atherogenic diet for 6 to 11 weeks (N = 4). The intravascular MR coil/guide wire (IVMRG) (Surgi-Vision, Gaithersburg, MD) was introduced via the external iliac vein into the inferior vena cava (IVC). The following electrocardiograph-gated MR pulse sequences were obtained: T1-weighted precontrast with and without fat saturation and T1-weighted postcontrast with fat saturation. Two observers scored wall signal and conspicuity and classified the vessel as normal, abnormal, or stented. Images were compared with histopathologic findings. RESULTS: The T1-weighted precontrast without fat saturation, T1-weighted precontrast with fat saturation, and T1-weighted postcontrast images correlated with histopathologic findings in 12 of 15 vessels, eight of 10 vessels, and 14 of 16 vessels, respectively. Abnormal histopathologic findings included: arterial wall thickening (N = 3), arterial dissection (N = 2), focal fibrous plaque (N = 2), adherent thrombus (N = 1). The T1-weighted postcontrast images were not compromised by artifacts and had the highest score for vessel wall signal and conspicuity. T1-weighted precontrast images were compromised by chemical shift artifact and poor blood suppression. Negligible artifacts were created by the platinum stent. CONCLUSION: The T1-weighted fat saturated postcontrast pulse sequence was superior to other sequences for transvenous MR imaging of the arterial wall.

Animals↗
PubMed1995

A modified imaging sequence for accurate T2 measurements using NMR microscopy.

A modified spin-echo pulse sequence is described that enables accurate T2 measurements to be made in NMR microimaging experiments. The modified sequence eliminates cumulative diffusion losses that lead to an underestimation of the T2 relaxation time using conventional spin-echo pulse sequences. The approach is theoretically justified and confirmed in comparative experiments on phantoms.

Humans↗
PubMed1994

[The role of magnetic resonance in characterizing focal liver lesions].

128 Magnetic resonance (MR) investigations of single or multifocal nodular liver lesions were retrospectively reviewed. All lesions had been identified, but not characterized, with ultrasonography (US). All the studies were performed with a 0.5-T superconductive magnet (Philips Gyroscan); spin-echo (SE) T1/proton density/T2-weighted and inversion recovery (IR) pulse sequences were used routinely. Characterization was attempted considering the following variables: a) lesion outline; b) the presence of some kind of capsular or pseudocapsular ring; c-d) homogeneity of signal intensity and its difference from surrounding liver parenchyma; e) possible central scar and its signal features; f) associated lesions (multifocal nodules, ascites, locoregional adenopathies, venous thrombosis). Diagnostic confirmation was obtained by means of biopsy (63 patients), of other imaging techniques (35 patients), or of clinical follow-up over 12 months at least (30 patients). Our results confirm high MR accuracy in the diagnosis of hemangioma (48/50 cases, 96% confidence) and even higher accuracy in focal fatty liver infiltration (9/9 cases, 100% confidence), thanks to some typical MR signal patterns on appropriate acquisition techniques--i.e., SE multiecho pulse sequences and IR sequences, respectively, with liver and fat signal nulling. Primary non-malignant focal liver lesions were identified mainly on a morphological basis (smooth roundish outline with/without capsular or pseudocapsular ring; central starlet scar; "basket" or "spoked wheel" patterns): these features allowed the correct identification of 5/7 focal nodular hyperplasia cases. On the other hand, in the absence of these typical morphological features and of specific MR signal changes, adenomas were misdiagnosed in all cases but one. The study of focal lesions in cirrhotic liver disease exhibited 66.6% confidence in the diagnosis of regenerating nodules, on the basis of their iso/hypointensity relative to liver on T2-weighted pulse sequences. Such a behavior seems to be due to intracellular iron loading, to small cell size and to thin vascular network, which are typical of cirrhotic regenerating areas. The diagnosis of hepatocellular carcinoma relies on both morphostructural features and possible associated lesions: in our series, 22/25 cases (88% confidence) were correctly identified. Indeed, this result was somehow influenced by the case history of the patients and by specific serologic indexes. Finally, MRI exhibited high sensitivity in the detection of focal liver involvement in neoplastic patients. However, the intrinsic range of variability and the lack of specificity of MR signal intensity, because of different histopathologic cell types, do not usually allow an unquestionable diagnosis to be made, especially for single lesions.

Biopsy↗
PubMed2004

Modeling (1H) exchange: an estimate of the error introduced in MRI by assuming the fast exchange limit in bolus tracking.

A simulation is presented which calculates the MRI signal expected from a model tissue for a given pulse sequence after a bolus injection of a contrast agent. The calculation assumes two physiologic compartments only, the intravascular and extravascular spaces. The determination of the concentration of contrast in each compartment as a function of time and position has been outlined in a previous publication (Moran and Prato, Magn Reson Med 2001;45:42-45). These contrast agent concentrations are used here to determine the NMR relaxation times as a function of time and position within the tissue. Knowledge of this simulated tissue 'map' of relaxation times as a function of time provides the information required to determine whether the proton exchange rate is fast or slow on the NMR timescale. Since with a bolus injection the concentration of contrast and hence the relaxation time may vary with position along the capillary, some segments of the capillary are allowed to be in fast exchange with the extravascular space, while others may be in slow exchange. Using this information, and parameters specific to a given tissue, the MRI signal for a given pulse sequence is constructed which correctly accounts for differences in proton exchange across the length of the capillary. It is shown that extravascular contrast agents show less signal dependence on water exchange, and thus may be more appropriate for quantitative imaging when using fast exchange assumptions. It is also shown that nondistributed compartment models can incorrectly estimate the water exchange that is occurring at the capillary level if exchange-minimizing pulse sequences are not used.

Algorithms↗
PubMed2005

Practical aspects of ROESY experiments for identification of bound waters in the cyclic tetrasaccharide.

ROESY pulse sequences are presented and evaluated to identify bound waters in the cyclic tetrasaccharide. The first experiment incorporated the double-pulsed field gradient spin-echo (DPFGSE) for selective water excitation at the initial portion of the pulse sequence. Although long, shaped pulses were used in DPFGSE to achieve the highly selective excitation of water resonance that is very close to resonances of the cyclic tetrasaccharide, the approach was not effective because of the loss of sensitivity. Concomitant use of long delays and moderate length of shaped pulses in the portion of DPFGSE gained more sensitivity. A simple approach incorporating spin-echo with long delays instead of DPFGSE also afforded a sensitive spectrum. Practical aspects of these ROESY experiments are illustrated using the cyclic tetrasaccharide cyclo-{-->6}-alpha-D-Glcp-(1-->3)-alpha-D-Glcp-(1-->6)-alpha-D-Glcp-(1-->3)-alpha-D-Glcp-(1-->).

Magnetic Resonance Spectroscopy↗
PubMed2000

Numerical studies of intermolecular multiple quantum coherences: high-resolution NMR in inhomogeneous fields and contrast enhancement in MRI.

A fast, efficient numerical algorithm is used to study intermolecular zero-quantum coherences (iZQCs) and double-quantum coherences (iDQCs) in two applications where the three-dimensional structure of the magnetization is important: high-resolution NMR in inhomogeneous fields and contrast enhancement in MRI. Simulations with up to 2 million coupled volume elements (256 x 256 x 32) show that iZQCs can significantly narrow linewidths in the indirectly detected dimension of systems with inhomogeneous fields and explore the effects of shape and orientation of the inhomogeneities. In addition, this study shows that MR images from iZQC and iDQC CRAZED pulse sequences contain fundamentally new contrast, and a modified CRAZED pulse sequence (modCRAZED) can isolate the contrast from chemically inequivalent spins.

Algorithms↗
PubMed2002

Measurement of temporal lobe T2 relaxation times using a routine diagnostic MR imaging protocol in epilepsy.

OBJECTIVE: To determine the applicability of a fast spin-echo (FSE) pulse sequence for T2 relaxation time measurements in diagnostic imaging of temporal lobe epilepsy (TLE) and in epilepsy research. To compare FSE T2-relaxometry to the measurements with multi-echo sequence and visual assessment of MR scans. METHODS: MR imaging and T2 relaxometry was performed with widely used 1.5 T scanner only. Fast dual-echo sequence (TE-14/85 ms) and multi-echo pulse sequence were used for T2 measurements. Normal ranges of T2 values in regions of interest in temporal lobe were estimated in 20 healthy controls. Sixty-five patients with intractable focal epilepsy were studied. Fifty-five patients had TLE, three multilobar focal epilepsy and seven extratemporal focal epilepsy. RESULTS: T2 measurements with the FSE showed good reproducibility in the test objects and control subjects. In one TLE case unilateral focal T2 changes were not identified visually. T2-relaxometry was more sensitive than visual inspection of MR scans in assessing bilateral hippocampal changes: there were 15 cases with abnormal bilateral T2 values. Visually bilateral changes were detected in six out of these 15 cases (40%). In six cases (40%) only unilateral changes were diagnosed visually, and in three cases (20%) bilateral changes were classified as probable with qualitative evaluation. T2 relaxation time measurement supplied additional objective data in cases with ambiguous hippocampal changes on visual assessment: T2-relaxometry confirmed hippocampal abnormalities in seven cases judged visually as probable. In four cases with the suspicion of hippocampal changes T2 values appeared to be normal. CONCLUSION: In TLE patients, images constructed from FSE sequences can be used to estimate T2 relaxation times easily and reliably. T2 measurements are an objective method to diagnose structural changes in the temporal lobe. T2-relaxometry is most helpful to assess bilateral hippocampal abnormalities, and thus might have an impact on estimating postsurgical outcome.

Adolescent↗
PubMedDate not supplied

MRI of pouch-related fistulas in ulcerative colitis after restorative proctocolectomy.

PURPOSE: Our purpose was to determine the value of MRI in diagnosing pouch-related fistulas in patients with ulcerative colitis and to compare pulse sequences with and without contrast enhancement in their performance of visualization. METHOD: Forty-four patients with pelvic symptoms after restorative proctocolectomy underwent MRI. All 26 patients with pouch-related fistulas were treated surgically; 18 patients with pouchitis were treated conservatively. MRI was performed at 1.0 T with T1-weighted FLASH sequences before and after administration of Gd-DTPA, T2-weighted and proton density-weighted turbo SE sequences, and a T2-weighted fat saturation sequence. Images were analyzed for the presence of fistula; pulse sequences were additionally compared for best visualization on a four point scale of diagnostic confidence. RESULTS: MRI detected 23 of 26 cases of fistulas; there were no false-positive diagnoses. Surgery revealed fistulas in three cases in which no pathology was found on MRI. Two patients had a short sinus tract at the pouch-anal anastomosis, and a third patient had a pouch-vaginal fistula. The Gd-enhanced FLASH sequence obtained the highest score, and second best was the T2-weighted fat saturation technique. CONCLUSION: MRI is a valuable technique for diagnosing pouch-related fistulas, However, there are limitations in detection of short sinus tracts and pouch-vaginal fistulas. Highest diagnostic confidence is obtained with a Gd-enhanced FLASH sequence, which might be helpful after pelvic surgery or if the fact saturation technique is equivocal.

Adult↗
PubMed1987

Localization grid for MR-guided biopsy.

A localization grid for use with magnetic resonance (MR)-guided biopsies was designed and evaluated. First, the signal intensities of various concentrations of Gd-DTPA in polyethylene tubes of different sizes and at various pulse sequences were evaluated. The optimal signal intensity on all pulse sequences was obtained with a concentration of 500 microM. A grid was then made with 5-mm-diameter polyethylene tubes filled with 500-microM Gd-DTPA. The grid has provided excellent localization for MR-guided biopsy and fluid aspiration.

Biopsy↗
PubMed2005

Correspondence between spin-dynamic phases and pulse program phases of NMR spectrometers.

Spin state selective experiments have become very useful tools in solution NMR spectroscopy, particularly in the context of TROSY line narrowing. However, the practical implementation of such pulse sequences is frequently complicated by unexpected instrument behavior. Furthermore, a literal theoretical analysis of sequences published with specific phase settings can fail to rationalize such experiments and can seemingly contradict experimental findings. In this communication, we develop a practical approach to this ostensible paradox. Spin-dynamic design, rationalization, and simulation of NMR pulse sequences, as well as their confident and reliable implementation across current spectrometer hardware platforms, require precise understanding of the underlying nutation axis conventions. While currently often approached empirically, we demonstrate with a simple but general pulse program how to uncover these correspondences a priori in the general case. From this, we deduce a correspondence table between the spin-dynamic phases used in NMR theory and simulation on the one hand and pulse program phases of current commercial spectrometers on the other. As a practical application of these results, we analyze implementations of the original (1)H-(15)N TROSY experiment and illustrate how steady-state magnetization can be predictably, rather than empirically, added to a desired component. We show why and under which circumstances a literal adoption of phases from published sequences can lead to incorrect results. We suggest that pulse sequences should be consistently given with spin-dynamically correct (physical) phases, rather than in spectrometer-specific (software) syntax.

Carbon Isotopes↗
PubMed2004

An algorithm to calculate the NMR signal of a multi spin-echo sequence with relaxation and spin-diffusion.

An algorithm to calculate NMR signals of a multi-echo pulse sequence with arbitrary position dependent B0 and B1 fields taking into account relaxation and spin-diffusion is presented. The multi-echo pulse sequence consists of an initial RF pulse ("90 degrees " RF pulse) and a series of L refocusing RF pulses with arbitrary phases and flip-angles. The calculation is exact and takes into account all the magnetization pathways that contribute to the signal on a predefined spatial grid. The theoretical prediction is verified experimentally using a high field NMR microscopy system. The algorithm was implemented in a simulation program in order to optimize the design of an inside-out MR intra-vascular catheter that is used for characterization of vessel wall tissue. Measured data obtained with the catheter are in good agreement with the theoretical prediction of the simulation.

Algorithms↗
PubMed2002

[Combination of low and high resolution T1-weighted sequences for improved evaluation of morphologic criteria in dynamic contrast enhanced MRI of the breast].

PURPOSE: Presentation of a new protocol for simultaneous acquisition of both low and high resolution T 1 -weighted images of breast lesions for dynamic contrast-enhanced MR mammography. Demonstration of possible diagnostic improvement with representative measurements in patients with suspected breast cancer by adding morphologic parameters from high resolution sequences to the analysis of the signal-time curve. MATERIALS AND METHODS: Dynamic MR imaging was performed with a 1.5 T system (Magnetom SONATA, Siemens Medical Systems, Germany) and the manufacturer's double-breast coil. Coronal T 1 -weighted 3D FLASH sequences (spatial resolution 1.25 x 1.25 mm 2; slice thickness 1.7 mm) were acquired once before and five times after administration of contrast medium (Gd-DTPA, 0.15 mmol/kg) injection. In addition, a high resolution T 1 -weighted 3D-FLASH sequence (spatial resolution, 0.63 x 0.63 mm 2) was obtained before administration of contrast medium and after the third post-contrast low-resolution sequence. Except for the acquisition matrix, all imaging parameters were identical for both 3D pulse sequences. To assure comparison of the measured signal intensities for both T 1 -weighted sequences, calibrating phantom measurements were performed using a dilution series of Gd-DTPA. RESULTS: Phantom measurements demonstrated similar signal intensities and enhancement pattern for both sequences. A combined protocol consisting of both pulse sequences can be employed and does not interfere with the signal-time curve analysis. By measuring one high resolution sequence 3:18 minutes after administration of contrast medium, morphologic features can be evaluated without interference from barely enhancing surrounding tissue. The overall study time is not increased. The improved spatial resolution slightly increases the severity of motion artifacts. CONCLUSION: The new protocol is a clever way to improve the measurement of morphologic features without relevant loss of dynamic information. It is superior to converting the entire investigation to high resolution sequences and does not add any costs by not extending or duplicating the investigation. How much the new protocol can improve the specificity or sensitivity of MR-mammography is currently investigated on a larger patient group.

Breast↗
PubMed1997

Motion suppression in MR imaging of the liver: comparison of respiratory-triggered and nontriggered fast spin-echo sequences.

OBJECTIVE: Our purpose was to compare the effectiveness of a respiratory-triggered fast spin-echo (RTFSE) pulse sequence and a nontriggered fast spin-echo pulse sequence for imaging liver masses. MATERIALS AND METHODS: Forty-one patients with suspected liver masses were imaged at 1.5 T with a fast spin-echo sequence and an RTFSE sequence designed to trigger data acquisition at end expiration. All other imaging parameters were identical. MR images were compared qualitatively for lesion detection and conspicuity, anatomic sharpness, vascular definition, phase artifacts, and overall image quality. Quantitative analysis was performed to obtain lesion-liver contrast and contrast-to-noise ratio (CNR) measurements of all liver masses. RESULTS: Thirty-three patients had liver masses. The RTFSE images showed superior anatomic sharpness in 83% of examinations and superior overall image quality in 85% of examinations. Lesion detection and conspicuity were superior for the RTFSE images in 53% of examinations and were similar for the two techniques in 38%. In 10 patients we detected more lesions on RTFSE images, and in one patient we detected more lesions on fast spin-echo images. In the remaining patients the number of lesions detected on RTFSE images was identical to the number detected on fast spin-echo images. Respiratory artifacts were less noticeable on the RTFSE images in 66% of examinations and on the fast spin-echo images in 14%. Quantitative analysis showed a 29% increase in mean relative lesion-liver contrast and a 34% increase in mean relative CNR for the RTFSE images. Mean lesion-liver contrast and CNR for the RTFSE images (152.6 +/- 100.9, 14.2 +/- 9.3) were superior to corresponding values for the fast spin-echo images (123.4 +/- 88.0, 10.9 +/- 7.4) (p < .0001). CONCLUSION: Compared with nontriggered fast spin-echo MR images, the RTFSE MR images were superior for our evaluation of liver masses. By acquiring data during a period of reduced respiratory motion, the RTFSE sequence produced images with sharper anatomic detail, equal or less phase ghosting, and measurable improvement in the lesion-liver contrast and CNR.

Artifacts↗
PubMed2004

Convection-compensating PGSE experiment incorporating excitation-sculpting water suppression (CONVEX).

We present a new diffusion experiment which provides simultaneous suppression of an on-resonance solvent peak and compensation for convection. The experiment, which we name CONVEX, exploits similarities between two functionally different pulse sequences to enable the same sequence to be used simultaneously for two different purposes. The CONVEX pulse sequence combines a double-echo PGSE with double excitation-sculpting water suppression, using unequal gradient pulse-pair amplitudes (g1 and g2) and unequal diffusion intervals (Delta1 and Delta2). Convection compensation is achieved by setting g1:g2 = Delta2:Delta1. The new experiment provides the spectral quality, flat baseline, and water-suppression power characteristic of excitation-sculpting experiments, combined with excellent compensation for convection. The resulting Stejskal-Tanner plots are linear over a greater range of signal attenuation than in the absence of water suppression. Possible applications include protein NMR; NMR of cellular or colloidal systems; and the monitoring of technological processes.

Journal Article↗
PubMedDate not supplied

Contrast in rapid MR imaging: T1- and T2-weighted imaging.

Partial saturation (PS) is an imaging technique that is useful in applications that require rapid image acquisitions (imaging time less than 1 min). Image contrast in PS imaging, as in other magnetic resonance methods, depends on the often conflicting effects of differences in proton density, T1, and T2. Previous analyses of pulse sequence optimization to maximize image contrast have assumed 90 degrees pulses and examined the effects of varying repetition times (TR) and echo times (TE). In this paper we present theoretical calculations and images made with a 0.6 T imager to show that the radiofrequency pulse tip angle alpha, and not the pulse sequence timing parameters, is the most important parameter for producing image contrast. For large tip angles (alpha greater than or equal to 60 degrees), contrast is primarily determined by differences in T1, but for small tip angles (alpha approximately equal to 25 degrees), contrast is primarily due to differences in T2. The T2-weighted images can be produced as quickly as T1-weighted images by using a small pulse angle and a long TE; it is not necessary to use a long TR to reduce the effects of T1 differences. Optimum pulse angles are calculated, and the potential advantages and disadvantages of T2-weighted and T1-weighted PS imaging are discussed.

Humans↗