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Myocardial blood flow measurements in rats with simple pulsing contrast echocardiography.

Relationship between contrast intensity and ultrasound (US) pulsing interval has been utilized to quantify myocardial blood flow (MBF) during myocardial contrast echocardiography (MCE). We tested if an MCE method employing a simple pulsing sequence during intravenous contrast infusion has the ability to quantify MBF in rats. We performed MCE in 17 rats using a 5- to 12-MHz broadband transducer during microbubble infusion via the femoral vein. Acoustic density (AD) from the anterior wall of the left ventricle imaged in the short axis plane was plotted against the frame number after shortening the pulsing interval (PI) from 1:20 to 1:1 end-systolic ECG gating. The relation between AD and frame number was fitted to a decay function. The rate of the AD decay was decreased during dipyridamole infusion, but was increased by causing coronary stenosis. The AD during long PI imaging remained unchanged during the interventions. Estimated MBF by MCE after correction by heart rate exhibited a close correlation (r = 0.83) with the present "gold standard" of colored microsphere-derived MBF. Thus, the decay rate of the contrast intensity obtained with the high-frequency transducer after abrupt shortening of PI during intravenous microbubble infusion may provide for noninvasive measurement of MBF in rats.

Animals↗

Delineation of liver necrosis using double contrast-enhanced MRI.

The purpose of this study was to demonstrate the potential usefulness of the combination of gadolinium and dysprosium to enhance the different between normal and necrotic liver tissue. Small regions of acute necrosis were induced by injecting 200-300 microliters of 95% alcohol into the liver of 26 rats. MRI was performed 24 hours after necrosis induction, before and immediately after injection of one or both contrast agents. Using a mixed T1/T2-weighted sequence, the signal intensity of (SI) of the normal liver was reduced by 70%, whereas the necrotic regions had more than a 50% increase in SI after double contrast. The region that was enhanced corresponded largely with the region of necrosis as observed postmortem. The lesion size, when identified, was largely underestimated using either of the agents along, albeit using the common pulse sequences. The double contrast effect of simultaneous administration of gadolinium and dysprosium allows accurate delineation of liver necrosis.

Animals↗

Continual NMR cardiography without gating: M-mode MR imaging.

A magnetic resonance (MR) pulse sequence was designed and implemented to examine the heart continually without gating, at rates in excess of 256 images in 7 seconds. The results are analogous to those of M-mode ultrasound, allowing interactive exploration of cardiac dynamics and flow in real time with full three-dimensional freedom of view. The technique is based on designed two-dimensional excitation pulses in which the magnetic field gradient is not constant, as in section-selection pulses, but varies in time to define a trajectory that results in a specified (eg, cylindric) region of excitation. The technique was implemented on a 1.5-T clinical imager with no special hardware and was tested on phantoms and volunteers. In human subjects, details of valve motion, intracardiac flow, and wall motion could be observed from moment to moment along optimal lines of sight selected interactively, with or without flow compensation and without gating. The momentary physiologic changes in chamber volumes and blood pool replenishment that occur during rhythm disturbances, the Valsalva maneuver, and simple breathing and breath-holding were readily demonstrated.

Adult↗

Cinematic study of temporomandibular joint motion using ultra-fast magnetic resonance imaging.

Magnetic Resonance Images (MRI) of the temporomandibular joint (TMJ) are usually performed to study the opening/closing movements of the mandible and have up to now been pseudodynamic step-by-step images simulating condylar motion by post-processing reconstruction. The aim of this study was: 1. to optimize a TMJ cine-imaging method to give a better clinical result than the step-by-step methods; 2. to develop an ultra-fast MRI Gradient Echo (GE) sequence for this purpose; and 3. to analyze condylar movements in the sagittal, coronal and para-axial planes during border mandibular displacements and chewing. Both TM joints were studied in six asymptomatic volunteers. The method involved a compromise between in-plane resolution, slice thickness, signal-to-noise ratio and time resolution. Routine clinical use was found to be a GE pulse sequence providing three images per second with an isometric voxel resolution of approximately two millimeters in ridge. This did not allow visualization of the disk. Using this sequence enabled real and simultaneous condylar displacement observation in the three planes of space and therefore contributed to a better functional diagnosis of pathologic TMJ motions.

Adolescent↗

Spatial localization in nuclear magnetic resonance spectroscopy.

The ability to select a discrete region within the body for signal acquisition is a fundamental requirement of in vivo NMR spectroscopy. Ideally, it should be possible to tailor the selected volume to coincide exactly with the lesion or tissue of interest, without loss of signal from within this volume or contamination with extraneous signals. Many techniques have been developed over the past 25 years employing a combination of RF coil properties, static magnetic field gradients and pulse sequence design in an attempt to meet these goals. This review presents a comprehensive survey of these techniques, their various advantages and disadvantages, and implications for clinical applications. Particular emphasis is placed on the reliability of the techniques in terms of signal loss, contamination and the effect of nuclear relaxation and J-coupling. The survey includes techniques based on RF coil and pulse design alone, those using static magnetic field gradients, and magnetic resonance spectroscopic imaging. Although there is an emphasis on techniques currently in widespread use (PRESS, STEAM, ISIS and MRSI), the review also includes earlier techniques, in order to provide historical context, and techniques that are promising for future use in clinical and biomedical applications.

Algorithms↗

Dynamic three-dimensional magnetic resonance abdominal angiography and perfusion: implementation and preliminary experience.

Implementation of and preliminary experience with an ultra-fast partial-Fourier radiofrequency (RF) spoiled gradient-echo sequence for gadolinium-enhanced imaging are presented. Three-dimensional angiograms can be acquired in less than 6 seconds. Repetition of the acquisition allows the three-dimensional visualization of several distinct vascular phases. Feasibility is demonstrated in three healthy volunteers. The trade-offs among spatial resolution, temporal resolution, and spatial coverage as well as the technical aspects of gadolinium-enhanced pulse sequences are discussed.

Abdomen↗

MR imaging of the spine at 3T.

There are many advantages and challenges associated with 3T imaging of the spine. The increase in SNR allows for optimization of diagnostic quality and improved clinical efficiency. PI techniques merge well with high-field technology, which minimizes many of the challenges that are associated with 3T systems. The increase in chemical shift, pulsatile flow, and susceptibility artifact can be mediated with manipulation of imaging parameters. One major challenge that plagued 3T imaging of the spine was the decrease in fluid contrast that was associated with the lengthened T1 relaxation times. This has been resolved essentially for non-contrast spine imaging by using T1 FLAIR, which delineates soft tissue, CSF, disc, and bone interfaces exquisitely well. The optimal postcontrast T1 sequence may not exist yet. Clinical experience dictates that with a combination of T1 FLAIR with or without fat saturation (in one plane) and T1 FSE(in the other plane) no significant enhancing pathology will be missed. Despite the challenges, 3T imaging of the spine provides many improvements over 1.5T systems. These advances can be maximized by use of still evolving technologies and pulse sequence designs.

Artifacts↗

[Role of MR in characterizing expansive lesions of the adrenal gland].

Five patients with adrenal tumors (20 metastases, 12 adenomas, 8 myelolipomas, 6 primary tumors, 4 pheochromocytomas, and 1 hyperplasia) were studied by means of MRI with SE sequences. Twenty of them underwent dynamic study with GE sequences after i.v. injection of paramagnetic contrast media. Sixteen of 20 metastases exhibited low signal intensity on T1 and high signal on T2. One patient had low signal on both T1 and T2. Two lesions in patients with melanoma showed high signal in T1; in 1 case, the lesion exhibited a hemorrhagic area. Signal from adenomas was low in T1- and T2-weighted pulse sequences in 10/12 patients, while in the extant 2 cases signal was higher in T2. Myelolipomas had hyperintense signal on T1-weighted images in 5 cases and isointense signal with the renal cortex in the extant 3 cases. Pheochromocytomas and primary tumors appeared hypointense on T1 and hyperintense on T2. In 3 CT questionable cases, MRI showed the adrenal origin of the lesion. Dynamic study with GE sequences after Gd-DTPA injection showed low enhancement and fast washout in adenomas, while malignant lesions had higher enhancement and slower washout. In our study, MRI allowed to correctly characterize 11/12 adenomas, with only 1 false negative in a metastatic lesion.

Adrenal Gland Neoplasms↗

Quantitative evaluation of metal artifact reduction techniques.

PURPOSE: To develop a technique to quantify artifact, and to use it to compare the effectiveness of several approaches to metal artifact reduction, including view angle tilting and increasing the slice select and image bandwidths (BWs), in terms of metal artifact reduction, noise, and blur. MATERIALS AND METHODS: Nonmetallic replicas of two metal implants (stainless steel and titanium/chromium-cobalt femoral prostheses) were fabricated from wax, and MR images were obtained of each component immersed in water. The differences between the images of each metal prosthesis and its wax counterpart were measured. The contributions from noise and blur were isolated, resulting in a measure of the metal artifact. Several off-resonance artifact reduction techniques were assessed in terms of metal artifact reduction capability, as well as signal to noise ratio and blur. RESULTS: Increasing the image BW from +/-16 kHz to +/-64 kHz was found to reduce the artifact by an average of 60%, while employing view angle tilting (VAT) alone was found to reduce the artifact by an average of 63%. The metal artifact reduction sequence (MARS), which combines several susceptibility artifact reduction techniques, resulted in the least amount of image distortion, reducing the artifact by an average of 79%. CONCLUSION: The results indicate that while VAT alone (with an image BW of +/-16 kHz) resulted in the smallest amount of total energy and no reduction in the signal-to-noise ratio compared to a conventional spin-echo pulse sequence, MARS resulted in significantly less artifact and dramatically less blur.

Artifacts↗

Improving tissue classification in MRI: a three-dimensional multispectral discriminant analysis method with automated training class selection.

PURPOSE: To improve the reliability, accuracy, and computational efficiency of tissue classification with multispectral sequences [T1, T2, and proton density (PD)], we developed an automated method for identifying training classes to be used in a discriminant function analysis. We compared it with a supervised operator-dependent method, evaluating its reliability and validity. We also developed a fuzzy (continuous) classification to correct for partial voluming. METHOD: Images were obtained on a 1.5 T GE Signa MR scanner using three pulse sequences that were co-registered. Training classes for the discriminant analysis were obtained in two ways. The operator-dependent method involved defining circular ROIs containing 5-15 voxels that represented "pure" samples of gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF), using a total of 150-300 voxels for each tissue type. The automated method involved selecting a large number of samples of brain tissue with sufficiently low variance and randomly placed throughout the brain ("plugs"), partitioning these samples into GM, WM, and CSF, and minimizing the amount of variance within each partition of samples to optimize its "purity." The purity of the plug was estimated by calculating the variance of 8 voxels in all modalities (T1, T2, and PD). We also compared "sharp" (discrete) measurements (which classified tissue only as GM, WM, or CSF) and "fuzzy" (continuous) measurements (which corrected for partial voluming by weighting the classification based on the mixture of tissue types in each voxel). RESULTS: Reliability was compared for the operator-dependent and automated methods as well as for the fuzzy versus sharp classification. The automated sharp classifications consistently had the highest interrater and intrarater reliability. Validity was assessed in three ways: reproducibility of measurements when the same individuals were scanned on multiple occasions, sensitivity of the method to detecting changes associated with aging, and agreement between the automated segmentation values and those produced through expert manual segmentation. The sharp automated classification emerged as slightly superior to the other three methods according to each of these validators. Its reproducibility index (intraclass r) was 0.97, 0.98, and 0.98 for total CSF, total GM, and total WM, respectively. Its correlations with age were 0.54, -0.61, and -0.53, respectively. Its percent agreement with the expert manually segmented tissue for the three tissue types was 93, 90, and 94%, respectively. CONCLUSION: Automated identification of training classes for discriminant analysis was clearly superior to a method that required operator intervention. A sharp (discrete) classification into three tissue types was also slightly superior to one that used "fuzzy" classification to produce continuous measurements to correct for partial voluming. This multispectral automated discriminant analysis method produces a computationally efficient, reliable, and valid method for classifying brain tissue into GM, WM, and CSF. It corrects some of the problems with reliability and computational inefficiency previously observed for operator-dependent approaches to segmentation.

Adult↗

Visualisation of enantiomers via insertion of a BIRD module in X-H correlation experiments in chiral liquid crystal solvent.

Several 13C-1H NMR techniques are derived simplifying the visualisation of enantiomers in chiral ordering solvents. They proceed through various heteronuclear 2D experiments where a bilinear rotation decoupling sequence (BIRD) is inserted in the middle of the t1 evolution period. In this way, the small couplings are refocused while the large couplings are preserved. The methods allow extracting precise values of one-bond carbon-proton residual dipolar couplings for each enantiomer out of unresolved proton-coupled 13C or carbon-coupled 1H spectra. Illustrative examples are analysed and discussed using various pulse sequences.

Algorithms↗

Magnetic resonance imaging of the retroperitoneum.

The results of magnetic resonance imaging (MRI) examinations in 50 patients with histological or clinical diagnoses of retroperitoneal disorders and 20 normal volunteers are presented. An increase in relaxation time (T1) was recognised in most pathological conditions except for four liposarcomas and one adrenal cortical neoplasm and one metastatic lesion of the same gland. Inversion recovery (IR) provided the best tissue contrast, enabling the detection of small lesions. Flow-dependent sequences and sagittal imaging planes were particularly helpful in the evaluation of aortic aneurysms. Ferric ammonium citrate used as an oral paramagnetic contrast agent and a short T1 inversion recovery sequence gave encouraging initial results in recognising bowel loops. Gadolinium-DTPA injected intravenously provided tumour enhancement, indicating vascular perfusion and demarcating tumour margins. An attempt to eliminate motion artefacts was carried out in 15 volunteers and six patients either by a new software system (respiratory ordered phase encoding) or by using short T1 inversion-recovery to suppress the high signal from fat. The same pulse sequence results were useful in demonstrating subcutaneous fistulous tracts by eliminating the adjacent fat. The actual role of MRI in the investigation of the retroperitoneum in view of current technical developments is discussed.

Abscess↗

Hyperpolarized 13C MR angiography using trueFISP.

A (13)C-enriched water-soluble compound (bis-1,1-(hydroxymethyl)-1-(13)C-cyclopropane-D(8)), with a (13)C-concentration of approximately 200 mM, was hyperpolarized to approximately 15% using dynamic nuclear polarization, and then used as a contrast medium (CM) for contrast-enhanced magnetic resonance angiography (CE-MRA). The long relaxation times (in vitro: T(1) approximately 82 s, T(2) approximately 18 s; in vivo: T(1) approximately 38 s, T(2) approximately 1.3 s) are ideal for steady-state free precession (SSFP) imaging with a true fast imaging and steady precession (trueFISP) pulse sequence. It was shown both theoretically and experimentally that the optimal flip angle was 180 degrees. CE-MRA was performed in four anesthetized live rats after intravenous injection of 3 ml CM. The angiograms covered the thoracic/abdominal region in two of the animals, and the head-neck region in the other two. Fifteen consecutive images were acquired in each experiment, with a flip-back pulse at the end of each image acquisition. In the angiograms, the vena cava (SNR approximately 240), aorta, renal arteries, carotid arteries (SNR approximately 75), jugular veins, and several other vessels were visible. The SNR in the cardiac region was 500. Magnetization was preserved from one image acquisition to the next using the flip-back technique (SNR(cardiac) approximately 10 in the 15th image).

Animals↗

Stochastic excitation and Hadamard correlation spectroscopy with bandwidth extension in RF FT-EPR.

The application of correlation spectroscopy employing stochastic excitation and the Hadamard transform to time-domain Fourier transform electron paramagnetic resonance (FT-EPR) spectroscopy in the radiofrequency (RF) band is described. An existing, time-domain FT-EPR spectrometer system with a Larmor frequency (L(f)) of 300 MHz was used to develop this technique by incorporating a pseudo-random pulse sequence generator to output the maximum length binary sequence (MLBS, 10- and 11-bit). Software developed to control the EPR system setup, acquire the signals, and post process the data, is outlined. The software incorporates the Hadamard transform algorithm to perform the required cross-correlation of the acquired signal and the MLBS after stochastic excitation. To accommodate the EPR signals, bandwidth extension was accomplished by sampling at a rate many times faster than the RF pulse repetition rate, and subsequent digital signal processing of the data. The results of these experiments showed that there was a decrease in the total acquisition time, and an improved free induction decay (FID) signal-to-noise (S/N) ratio compared to the conventional coherent averaging approach. These techniques have the potential to reduce the RF pulse power to the levels used in continuous wave (CW) EPR while retaining the advantage of time-domain EPR methods. These methods have the potential to facilitate the progression to in vivo FT-EPR imaging of larger volumes.

Animals↗

The utility of contrast media in MRI at 0.02 T. A preliminary report.

The effect of 0.1 mmol gadolinium-DTPA on ultralow field magnetic resonance (MR) images of intracranial neoplasms was studied on 20 patients. Tumors that characteristically were enhanced markedly on computed tomography (CT) (meningiomas, acoustic neuromas) demonstrated moderate to marked contrast enhancement with inversion recovery sequences and with saturation recovery sequences with a short repetition time. Standard spin-echo sequences failed to show any contrast effect. The enhancement of gliomas and metastases was weak and often absent. Contrast enhancement, when present, was helpful in delineating the tumor from surrounding edema but the differentiation of living from necrotic tumor was not successful because of low signal intensity. The low effect of gadolinium-DTPA at 0.02 T may be due to a relatively higher T2 weighting of available pulse sequences. The relaxing effect of macromolecules may also change the proportional effect of paramagnetic substances in an ultralow magnetic field.

Adult↗

Detection of focal liver lesions with superparamagnetic iron oxide: value of STIR and SE imaging.

OBJECTIVE: We assessed the value of superparamagnetic iron oxide (SPIO) particles on the detection of focal liver lesions by MRI. MATERIALS AND METHODS: Twenty patients with one to five focal liver lesions, primarily detected with ultrasonography and/or contrast-enhanced CT, were evaluated further with unenhanced and iron oxide-enhanced MRI at 1.0 T. Superparamagnetic iron oxide particles were administered intravenously as a slow infusion. Then T1-, T2-, and proton density-weighted SE images were obtained. In addition, the performance of a short TI inversion recovery (STIR) sequence was evaluated. RESULTS: The iron oxide contrast medium had marked effects on liver signal-to-noise (S/N) and tumor-to-liver contrast-to-noise (C/N) ratios but only minimal effects on tumor S/N ratios in cases of malignant tumor foci. Lesion-to-liver contrast, expressed as differences between the tumor and liver S/N ratios, improved very significantly after SPIO infusion with all four pulse sequences. Contrast enhancement of the liver parenchyma was best in T2-weighted SE images, but the tumor-to-liver C/N values were highest with the postcontrast STIR sequence. The SPIO enhancement revealed a number of additional focal lesions (31%), also foci under 1 cm in diameter. In three benign focal lesions, SPIO infusion produced a definite reduction in the S/N ratio of the lesions in contrast to the minimal change measured in malignant foci. The favorable performance of the STIR sequence contradicts the disappointing results previously obtained at 0.6 T. CONCLUSION: Superparamagnetic iron oxide is a promising new contrast medium for MR examinations of the liver, increasing the conspicuity and reducing the detectability threshold of focal hepatic lesions.

Adult↗

The role of GABAergic inhibition in shaping the response size and duration selectivity of bat inferior collicular neurons to sound pulses in rapid sequences.

Natural sounds, such as vocal communication sounds of many animal species typically occur as sequential sound pulses. Therefore, the response size of auditory neurons to a sound pulse would be inevitably affected when the sound pulse is preceded and succeeded by another sound pulse (i.e., forward and backward masking). The present study presents data to show that increasing strength of GABAergic inhibition relative to excitation contributes to decreasing response size and sharpening of duration selectivity of bat inferior collicular (IC) neurons to sound pulses in rapid sequences. The response size in number of impulses and duration selectivity of IC neurons were studied with a pulse train containing 9 sound pulses. A family of duration tuning curves was plotted for IC neurons using the number of impulses discharged to each presented sound pulse against pulse duration. Our data show that the response size of IC neurons progressively decreased and duration selectivity increased when determined with sequentially presented sound pulses. This variation in the response size and duration selectivity of IC neurons with sequentially presented sound pulses was abolished or reduced during bicuculline and GABA application. Bicuculline application increased the response size and broadened the duration tuning curve of IC neurons while GABA application produced opposite results. Possible mechanisms underlying increasing strength of GABAergic inhibition with sequentially presented sound pulses are presented. Biological significance of these findings in relation to acoustic signal processing is also discussed.

Acoustic Stimulation↗

Treatment of venous malformations with an intense pulsed light source (IPLS) technology: A retrospective study.

BACKGROUND AND OBJECTIVE: The intense pulsed light source (IPLS) technology provides an innovative concept in the treatment of vascular lesions. We investigated the effectiveness of IPLS in the treatment of venous malformations. STUDY DESIGN/MATERIALS AND METHODS: A retrospective study of 11 patients with venous malformations (VMA) treated with IPLS was initiated. Clinical VMA characteristics recorded were size and location. Data collected included treatment parameters (filters, pulse duration, fluence, and pulse sequencing), % clearance, and side effects (e.g., swelling, blisters, crusting, pain, altered pigmentation, and scarring). RESULTS: Good and very good (70-100%) clearance was achieved in 8 malformations smaller than 100 cm(2). Especially small lesions needed only 2-3 treatments. Three VMA larger than 100 cm(2) could be cleared well in an average of 18 sessions. The most frequently used parameters were the 590 nm filter in long pulse mode, triple pulses, and fluences at an average of 80.4 J/cm(2). Side effects included prolonged erythema in 23.6, swelling in 17.9%, crusting in 4.7%. Bleeding, hypo-, hyperpigmentation, and scarring were rare (0.9% respectively). CONCLUSION: IPLS presents an effective method for treating VMA, especially small malformations, with a justifiable rate of side effects when optimal parameters are chosen.

Adolescent↗