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Comparison of MR imaging sequences for liver and head and neck interventions: is there a single optimal sequence for all purposes?

RATIONALE AND OBJECTIVES: To compare the appropriate pulse sequences for interventional device guidance during magnetic resonance (MR) imaging at 0.2 T and to evaluate the dependence of sequence selection on the anatomic region of the procedure. MATERIALS AND METHODS: Using a C-arm 0.2 T system, four interventional MR sequences were applied in 23 liver cases and during MR-guided neck interventions in 13 patients. The imaging protocol consisted of: multislice turbo spin echo (TSE) T2w, sequential-slice fast imaging with steady precession (FISP), a time-reversed version of FISP (PSIF), and FISP with balanced gradients in all spatial directions (True-FISP) sequences. Vessel conspicuity was rated and contrast-to-noise ratio (CNR) was calculated for each sequence and a differential receiver operating characteristic was performed. RESULTS: Liver findings were detected in 96% using the TSE sequence. PSIF, FISP, and True-FISP imaging showed lesions in 91%, 61%, and 65%, respectively. The TSE sequence offered the best CNR, followed by PSIF imaging. Differential receiver operating characteristic analysis also rated TSE and PSIF to be the superior sequences. Lesions in the head and neck were detected in all cases by TSE and FISP, in 92% using True-FISP, and in 84% using PSIF. True-FISP offered the best CNR, followed by TSE imaging. Vessels appeared bright on FISP and True-FISP imaging and dark on the other sequences. CONCLUSION: In interventional MR imaging, no single sequence fits all purposes. Image guidance for interventional MR during liver procedures is best achieved by PSIF or TSE, whereas biopsies in the head and neck are best performed using FISP or True-FISP sequences.

Adult↗

[A short TE gradient-echo sequence using asymmetric sampling].

We have developed a gradient-echo pulse sequence with a short TE less than 4 msec using a data set of asymmetric off-center sampling with a broad bandwidth. The use of such a short TE significantly reduces T2* de-phasing effect even in a two-dimensional mode, and by collecting an off-center echo, motion-induced phase dispersion is also considerably decreased. High immunity of this sequence to these dephasing effects permits clear visualization of anatomical details near the skull base where large local field inhomogeneities and rapid blood flow such as in the internal carotid artery are present.

Brain↗

Fast spin-echo imaging of the abdomen during breath-holding: an alternative to RASE and other fast imaging techniques.

We have developed a rapidly acquired T1-weighted spin-echo pulse sequence that uses gradient echo-like parameters of TR 70 ms, TE 10 ms, NEX-1 (SE 70/10/1) with large pulse angles, and presaturation. This sequence yields two images of the abdomen during a comfortable breath-hold of 9 s. Preliminary phantom studies with this sequence demonstrated that peak signal-to-noise ratios occurred at pulse angles of 120 degrees and 135 degrees. Compared to this rapidly acquired sequence, a conventional T1-weighted spin-echo sequence of TR 140 ms, TE 10 ms, NEX-4 demonstrated 2.8 times the signal-to-noise ratio, 2.6 times the liver-spleen contrast-to-noise ratio but only 1.6 times the contrast-to-artifact ratio. When normalized for the imaging time, however, there was little difference in the signal-to-noise and contrast-to-noise ratios, although the SE 70/10/1 demonstrated 2.0 times the contrast-to-artifact ratio. We conclude that for abdominal imaging the SE 70/10/1 is an excellent alternative to RASE and other fast imaging techniques, and, although there are inherently low signal-to-noise ratios, it may be particularly useful when coupled with a paramagnetic contrast agent.

Abdomen↗

Multiple short-echo (2.5-ms) quantitation of in vivo sodium T2 relaxation.

The MR behavior of the sodium-23 nucleus in vivo is a complex problem which has generated considerable interest over the last 20 years. Early studies on excised tissue samples revealed that the sodium nucleus exhibited a two-component T2 relaxation. This biexponential T2 relaxation was characterized by a short component with a T2 = 0.7-4.8 ms, and a long component with a T2 = 7.0-26.0 ms. We have developed a 3D pulse sequence capable of performing multiple Hahn echo in vivo sodium-23 imaging at echo times as short as 2.5 ms. This sequence obtains the shorter spin echo times by presaturating the spins outside of the desired imaging region, allowing the use of nonselective rf pulses. Using this sequence we have been able to quantify the long and short T2 components of normal brain tissue, vitreous humor of the eye, and a rabbit VX-2 carcinoma. We found that gray matter and white matter of normal brain have a monoexponential T2 relaxation with T2 = 17.6 +/- 2.4 ms. The vitreous humor T2 relaxation is also monoexponential with T2 = 56.8 +/- 2.1 ms. However, we find that some of the rabbit VX2 carcinomas exhibit a biexponential T2 decay with a short component of 3.3 +/- 4.6 ms and a long component of 22.0 +/- 9.0 ms.

Absorption↗

Human imaging of phosphorus in cortical and trabecular bone in vivo.

Phosphorus was imaged in vivo in human cortical and trabecular bone and the T(1) and T(2) (*) were measured. An ultrashort TE (UTE) pulse sequence (TE = 70 microm) was used with half pulse excitation and radial mapping of k-space from the center out. T(2) (*) was measured using multiple echo times and T(1) was measured both by saturation recovery and by a method using different RF pulse amplitudes. Seven normal subjects (32-85 years) were examined. Phosphorus was imaged, with a true in-plane resolution of 2.9 x 2.9 mm and a signal-to-noise ratio (SNR) of 19:1, in both cortical and trabecular bone. The mean T(2) (*) value was 207 +/- 12 micros, and the mean T(1) value was 8.6 +/- 3.0 sec. Images and measurements were obtained in realistic times on a clinical MR system. This may provide a new approach to characterizing disease of bone.

Adult↗

Use of amplitude and frequency transformations to generate adiabatic pulses of wide bandwidth and low RF power deposition.

An amplitude transformation of adiabatic pulses stated previously [Baum et al., Phys. Rev. A 32, 3435-3447 (1985)] is generalized using the Bloch equations. Both amplitude and frequency transformations are used to create new adiabatic pulses of wide bandwidth and low RF power deposition. Several adiabatic pulses (including the tanh/tan pulse used for construction of BIR-4, SSAP, and BISEP pulses) are transformed into new pulses. These new pulses are demonstrated numerically and experimentally to operate at a significantly lower RF power level while maintaining the same performance or over a wider bandwidth while using the same RF power. They are expected to be useful for in vivo NMR experiments, especially for applications involving wide frequency dispersion and pulse sequences composed of many adiabatic half-passage pulses.

Magnetic Resonance Imaging↗

Pulsed-field-gradient measurements of time-dependent gas diffusion.

Pulsed-field-gradient NMR techniques are demonstrated for measurements of time-dependent gas diffusion. The standard PGSE technique and variants, applied to a free gas mixture of thermally polarized xenon and O2, are found to provide a reproducible measure of the xenon diffusion coefficient (5.71 x 10(-6) m2 s-1 for 1 atm of pure xenon), in excellent agreement with previous, non-NMR measurements. The utility of pulsed-field-gradient NMR techniques is demonstrated by the first measurement of time-dependent (i.e., restricted) gas diffusion inside a porous medium (a random pack of glass beads), with results that agree well with theory. Two modified NMR pulse sequences derived from the PGSE technique (named the Pulsed Gradient Echo, or PGE, and the Pulsed Gradient Multiple Spin Echo, or PGMSE) are also applied to measurements of time dependent diffusion of laser polarized xenon gas, with results in good agreement with previous measurements on thermally polarized gas. The PGMSE technique is found to be superior to the PGE method, and to standard PGSE techniques and variants, for efficiently measuring laser polarized noble gas diffusion over a wide range of diffusion times.

Magnetic Resonance Spectroscopy↗

Visualization of subthalamic nuclei with cortex attenuated inversion recovery MR imaging.

There is a significant amount of interest in studying the thalamus because of its central location in the brain and its role as a gatekeeper to higher centers of cognition. Imaging and measuring of the individual subnuclei of the thalamus has proven extremely difficult in MR because of the contrast-to-noise (CNR) of the MR sequences used. This report describes a novel MR pulse sequence known as cortex attenuated inversion recovery (CAIR), which increases the CNR in images and allows the individual subnuclei of the thalamus to be visualized by selectively nulling the gray matter in the brain using an inversion recovery sequence with an inversion time of 700 ms at 1.5 T.

Adult↗

Spectra of data sampled at frequency-modulated rates in application to cardiovascular signals: Part 2. Evaluation of Fourier transform algorithms.

For three direct Fourier transform algorithms we quantified the influence of pulse frequency modulation (PFM) on the spectral estimation of pulse amplitude modulation (PAM). The simulation study is based on sinusoid functions sampled according to a pulse sequence which is the output of an integral pulse frequency modulator (IPFM). One algorithm exactly reproduces the theoretical spectrum derived in Part 1. The other two, including the classical FFT, scale all PFM-induced components in a different way, and in addition, generate higher modulating frequency harmonics. For a PFM depth below 30%, the sum of spurious PFM components is almost linearly dependent on this modulation depth, for all three algorithms. Dividing the effect of PFM in a 'harmonic' and 'aliasing' distortion, we found that the FFT has a relatively high harmonic distortion, compared to an algorithm that takes into account the non-uniform character of the data. In the cardiovascular (worst) case of 30% modulation in heart rate (PFM) at a frequency of 0.1 Hz, the FFT spectrum of beat-to-beat systolic blood pressure variations contains approximately 20% of spurious components caused solely by the modulation in time occurrences of the blood pressure samples. The 'non-uniform' algorithm performs twice as well in this case.

Algorithms↗

Magic-echo phase-encoding solid imaging with improved time resolution.

The magic-echo phase-encoding solid imaging (MEPSI) sequence is based on the magic-echo pulse sequence for the refocusing of the dipolar interaction and on pure phase-encoding for spatial resolution in all dimensions. MEPSI has many advantages; however, as a consequence of pure phase-encoding, it is very time-consuming. In the following, two strategies are proposed to decrease the time necessary for the acquisition of an image by a factor of 2 per dimension.

Magnetic Resonance Spectroscopy↗

3D-T1rho-relaxation mapping of articular cartilage: in vivo assessment of early degenerative changes in symptomatic osteoarthritic subjects.

RATIONALE AND OBJECTIVES: To determine the in vivo feasibility of quantifying early degenerative changes in patellofemoral joint of symptomatic human knee using spin-lattice relaxation time in the rotating frame (T(1rho)) magnetic resonance imaging (MRI). MATERIALS AND METHODS: All the MRI experiments were performed on a 1.5 T whole-body GE Signa clinical scanner using a custom built 15-cm diameter transmit-receive quadrature birdcage radiofrequency coil. The T(1rho)-prepared magnetization was imaged with a three-dimensional gradient-echo pulse sequence pre-encoded with a three-pulse cluster consisting of two hard 90 degrees pulses and a low power spin-lock pulse. Quantitative T(1rho) relaxation maps of asymptomatic (n = 8 males), and six symptomatic human volunteers (four men, two women) were computed using a appropriate signal expression. RESULTS: All six symptomatic volunteers showed elevation in T(1rho) relaxation times when compared with asymptomatic subjects. In symptomatic population, the T(1rho) relaxation times varied from 63 +/- 4 ms to 95 +/- 12 ms (mean +/- standard deviation) depending on the degree of cartilage degeneration. The increase in T(1rho) of symptomatic population was statistically significant (n = 6, P <.002) when compared with corresponding asymptomatic population. However, in asymptomatic population the relaxation times varied only from approximately 45 to 55 ms (n = 8, age range 22-45 years). CONCLUSION: Preliminary results demonstrated the in vivo feasibility of quantifying early biochemical changes in symptomatic osteoarthritis subjects employing T(1rho)-weighted MRI on a 1.5 T clinical scanner. This study on limited number of symptomatic population shows that T(1rho)-weighted MRI provides a noninvasive marker for quantitation of early degenerative changes of cartilage in vivo. However, further studies are needed to correlate early osteoarthritis determined from arthroscopy with T(1rho) in a large symptomatic population.

Adult↗

Scanning for the scanner: FMRI of audition by read-out omissions from echo-planar imaging.

Echo-planar imaging (EPI) generates considerable acoustic noise by rapidly oscillating gradients. In functional magnetic resonance imaging (FMRI), unshielded EPI sounds activate the auditory system inasmuch as it is responsive. Instead of attenuating EPI noise, our goal was to utilize it for auditory FMRI by omitting read-outs from the pulse sequence's gradient train. Read-out gradient pulses are the primary noise determinant of EPI introducing its peak sound level and fundamental frequency peak which inversely relates to twice the echo spacing. Using model-driven analyses, we demonstrate that withholding read-outs from EPI is suited to reliably evoke hemodynamic blood oxygenation level-dependent (BOLD) signal modulations bilaterally in the auditory cortex of normal hearing subjects (n=60). To investigate the utility of EPI read-out omissions for auditory FMRI at an individual subject's level, we compare traditional Family-Wise-Error-Rate (FWER)-corrected maximum height thresholding to spatial mixture modeling (SMM). With the latter, appropriate bilateral auditory activations were confirmed in 95% of the individuals, whereas FWER-based voxel thresholding detected such activations in up to 72%. We illustrate the applicability of this novel EPI modification for clinical diagnostic purposes and report on a patient with bilateral large vestibular aqueducts (LVAs) and severe binaural sensorineural hearing loss (SNHL). In this particular case, read-out omissions from EPI were used to assert residual audition prior to cochlear implantation (CI). Requiring no specific task compliance or sophisticated stimulation equipment other than the scanner on its own, FMRI by read-out omissions lends itself to auditory investigations and to quickly probe audition.

Acoustic Stimulation↗

Multi-component T1 relaxation and magnetisation transfer in peripheral nerve.

We report here a study of longitudinal relaxation (T1) and magnetisation transfer (MT) in peripheral nerve. Amphibian sciatic nerve was maintained in vitro and studied at a magnetic field strength of 3 T. A CPMG pulse sequence was modified to include either a saturation pulse to measure T1 relaxation or an off-resonance RF irradiation pulse to measure MT. The resulting transverse relaxation (T2) spectra yielded four components corresponding to three nerve compartments, taken to result from myelinic, axonal, and inter-axonal water, and a fourth corresponding to the buffer solution water in which the nerve sample was bathed. Each nerve component was analysed for T1 relaxation and MT. All three nerve T2 components exhibited unique T1 relaxation and MT characteristics, providing further support for the assignment of the components to unique physical compartments of water. Numerical investigation of T1sat measurements of each of the three nerve T2 components indicates that while the two shorter-lived exhibit similar steady-state magnetisation transfer ratios (MTRs), their respective MT properties are quite different. Simulations demonstrate that mobile water exchange between these two components is not necessary to explain their similar steady-state MTR. In the context of the assignment of these two components to signal from myelinic and axonal water, this is to say that these two microanatomical regions of nerve may exhibit similar steady-state MTR characteristics despite possessing widely different MT exchange rates. Therefore, interpreting changes in MTR solely to reflect a change in degree of myelination could lead to erroneous conclusions.

Animals↗

Magnetic resonance cholangiopancreatography.

Magnetic resonance (MR) cholangiopancreatography is a new, noninvasive method of assessing the biliary tract and pancreatic duct. MRCP sequences are based on heavily T2-weighted pulse sequences, resulting in the bile ducts and pancreatic duct having very high signal intensity. Preliminary results indicate that the results of MRCP in most biliary tract diseases are similar to those of more invasive techniques of direct cholangiography, such as, endoscopic retrograde cholangiopancreatography.

Bile Ducts↗

Magnetic resonance imaging of brain tumors: measurement of T1. Work in progress.

Longitudinal relaxation times (T1) of 20 brain tumors were calculated in vivo using a whole-body magnetic resonance unit with a 0.15-T resistive magnet. Images employing standard inversion recovery pulse sequences with different intervals between the 180 degrees pulse and selective excitation pulses were compared on every point of the 256 X 256 pixel matrix. Tumor, white matter, and gray matter were sampled from each patient from the computed T1 image for T1 measurement. Astrocytomas, neurinomas, and metastatic tumors showed longer T1 values than did meningiomas. Lipomas had the shortest T1s. It is concluded that it is difficult to predict histological types of brain tumors by the measurement of T1 alone because of the wide variation in relaxation times, but measurement of T1 can be helpful in differentiating brain tumors when additional information about the patient's condition is known.

Adolescent↗

MR imaging of motion with spatial modulation of magnetization.

A novel magnetic resonance imaging technique provides direct imaging of motion by spatially modulating the degree of magnetization prior to imaging. The preimaging pulse sequence consists of a radio-frequency (RF) pulse to produce transverse magnetization, a magnetic field gradient to "wrap" the phase along the direction of the gradient, and a second RF pulse to mix the modulated transverse magnetization with the longitudinal magnetization. The resulting images show periodic stripes due to the modulation. Motion between the time of striping and image formation is directly demonstrated as a corresponding displacement of the stripes. This technique can be used to study heart wall motion, to distinguish slowly moving blood from thrombus, and to study the flow of blood and cerebrospinal fluid.

Adult↗

Contrast-enhanced abdominal MR angiography: optimization of imaging delay time by automating the detection of contrast material arrival in the aorta.

PURPOSE: To improve gadolinium-enhanced magnetic resonance (MR) angiogram quality by automatically synchronizing acquisition of central k-space image data with the arterial phase of contrast material bolus infusion. MATERIALS AND METHODS: A spin-echo pulse sequence with orthogonal 90 degrees and 180 degrees pulses was used to monitor signal in a single 4 x 4 x 12-cm voxel that encompassed a segment of aorta. An increase in signal that corresponded to the arrival of gadolinium was used to trigger three-dimensional, spoiled gradient-echo abdominal MR angiography in 50 adult patients. RESULTS: Arterial signal intensity increased 28-fold with automatic compared to 19-fold with manual triggering (P < .05) at an approximate dose of 0.3 mmol/kg. Automatic triggering with a lower dose (approximately 0.2 mmol/kg) resulted in 20-fold arterial enhancement, which is comparable with enhancement after manual triggering at the high dose. In addition, venous enhancement was less (1.5-fold) with automatic than with manual (3.5-fold) triggering at the same dose (P < .05). CONCLUSION: Automatic triggering results in improved arterial-tovenous contrast. It increases arterial enhancement or enables MR angiograms to be obtained with less contrast material. The authors now routinely use this technique for aortorenal imaging with a gadolinium-based contrast material dose of 20 mmol (40 mL) in patients who weigh more than 50 kg and 10 mmol (20 mL) in patients who weigh less than 50 kg.

Abdomen↗

In vitro MR microscopy of the hippocampus in Alzheimer's disease.

We used MR microscopy at 7 tesla to identify the anatomy of the degenerating hippocampus in Alzheimer's disease (AD), which we then correlated with the histopathologic findings in the same specimens. The specimens studied were resected postmortem from 13 patients with confirmed AD and from nine age-matched controls. We imaged the specimens in the coronal plane using either three-dimensional Fourier encoding or single-slice Carr, Purcell, Meiboom, Gill (CPMG) spin echo sequences. On all specimens imaged with the CPMG pulse sequence, we calculated the T2 relaxation times for subfields within the hippocampus. Histologic sections were taken from each specimen and compared with the corresponding MR image. Using histologic boundaries, we quantified the number of neuritic plaques and neurofibrillary tangles in each hippocampal subfield. We measured the area, morphometric characteristics, and width of identifiable signal variant regions on each image and compared these measurements with the histopathologic findings. The mean cross-sectional area of the hippocampus in AD was decreased by 31% compared with the control group. This atrophy was highly correlated with tangle counts within the hippocampus, but not with plaque counts. The width of the gray matter in hippocampal area CA1, as identified by MR, correlated with the total area of the hippocampus. An age-related decrease in the size of a low-signal region that corresponds histologically to input projections comprising part of the perforant pathway was identified. Measurements of the T2 relaxation times of hippocampal subfields showed little regional variability and were not accurate indicators of disease presence or severity (p > 0.05).

Aged↗