Sodium magnetic resonance imaging of diuresis: spatial and kinetic response.

Renal function is highly correlated with the sodium concentration gradient along the corticomedullary axis. The application of 3D high-resolution sodium magnetic resonance imaging (MRI) provided a means to quantify in vivo the spatial and temporal changes in renal tissue sodium concentration under normal and diuretic conditions. A detailed, pixel-by-pixel analysis of the intact rat kidney sodium MR images yielded a quantitative measure of the corticomedullary sodium gradient before and at early and later times after the administration of two distinct diuretic agents, furosemide and mannitol. Furosemide, a loop diuretic, induced a fivefold reduction in the cortical-outer medullary sodium gradient, whereas mannitol, an osmotic diuretic, did not affect this gradient. Both diuretics induced a 50% decrease in the sodium concentration of the inner medulla; however, mannitol exerted its effect twice as fast as furosemide with a 2.5-min exponential decay constant. These specific changes were attributed to the different mechanism of action and site of activity of each diuretic agent. Thus, high-resolution (23)Na MRI offers a unique, noninvasive tool for functional imaging of the kidney physiology.     

Quantitative sodium MR imaging of native versus transplanted kidneys using a dual-tuned proton/sodium (1H/23Na) coil: initial experience

Objectives

To compare sodium (²³Na) characteristics between native and transplanted kidneys using dual-tuned proton (¹H)/sodium MRI.

Methods

Six healthy volunteers and six renal transplant patients (3 normal function, 3 acute allograft rejection) were included. Proton/sodium MRI was obtained at 3 T using a dual-tuned coil. Signal to noise ratio (SNR), sodium concentration ([²³Na]) and cortico-medullary sodium gradient (CMSG) were measured. Reproducibility of [²³Na] measurement was also tested. SNR, [²³Na] and CMSG of the native and transplanted kidneys were compared.

Results

Proton and sodium images of kidneys were successfully acquired. SNR and [²³Na] measurements of the native kidneys were reproducible at two different sessions. [²³Na] and CMSG of the transplanted kidneys was significantly lower than those of the native kidneys: 153.5?±?11.9 vs. 192.9?±?9.6 mM (P?=?0.002) and 8.9?±?1.5 vs. 10.5?±?0.9 mM/mm (P?=?0.041), respectively. [²³Na] and CMSG of the transplanted kidneys with normal function vs. acute rejection were not statistically different.

Conclusions

Sodium quantification of kidneys was reliably performed using proton/sodium MRI. [²³Na] and CMSG of the transplanted kidneys were lower than those of the native kidneys, but without a statistically significant difference between patients with or without renal allograft rejection.

Key Points

? Dual-tuned proton/sodium RF coil enables co-registered proton and sodium MRI. ? Structural and sodium biochemical property can be acquired by dual-tuned proton/sodium MRI. ? Sodium and sodium gradient of kidneys can be measured by dual-tuned MRI. ? Sodium concentration was lower in transplanted kidneys than in native kidneys. ? Sodium gradient of transplanted kidneys was lower than for native kidneys.     

3D radial projection technique with ultrashort echo times for sodium MRI: clinical applications in human brain and skeletal muscle.

(23)Na MRI has the potential to noninvasively detect sodium (Na) content changes in vivo. The goal of this study was to implement (23)Na MRI in a clinical setting for neurooncological and muscular imaging. Due to the biexponential T(2) decay of the tissue Na signal with a short component, which ranges between 0.5-8 ms, the measurement of total Na content requires imaging techniques with echo times (TEs) below 0.5 ms. A 3D radial pulse sequence with a TE of 0.2 ms at a spatial resolution of 4 x 4 x 4 mm(3) was developed that allows the acquisition and presentation of Na images on the scanner. This sequence was evaluated in patients with low- and high-grade gliomas, and higher (23)Na MR signals corresponding to an increased Na content were found in the tumor regions. The contrast-to-noise ratio (CNR) between tumor and white matter increased from 0.8 +/- 0.2 to 1.3 +/- 0.3 with tumor grade. In patients with an identified muscular (23)Na channelopathy (Paramyotonia congenita (PC)), induced muscle weakness led to a signal increase of approximately 18% in the (23)Na MR images, which was attributed to intracellular Na(+) accumulation in this region.     

Vital signs and cognitive function are not affected by 23‐sodium and 17‐oxygen magnetic resonance imaging of the human brain at 9.4 T

Purpose:

To evaluate the effect of 23‐sodium (²³Na) and 17‐oxygen (¹⁷O) magnetic resonance imaging (MRI) at 9.4 (T) on vital signs and cognitive function of the human brain.

Materials and Methods:

Vital sign and cognitive function measurements from healthy volunteers (N = 14) positioned outside and at isocenter of a 9.4 T scanner before and after ²³Na and ¹⁷O MRI were compared for changes due to exposure to the static magnetic field and to the gradient switching and radiofrequency radiation during MRI.

Results:

Exposure to the 9.4 T static magnetic field and ²³Na and ¹⁷O MRI at 105.92 MHz and 54.25 MHz, respectively, did not have a statistically significant (P > 0.05) effect on the vital signs or cognitive function of healthy normal adults.

Conclusion:

²³Na and ¹⁷O MRI of the human brain at 9.4 T does not have any readily demonstrated health risks reflected in vital signs or change in cognitive performance. J. Magn. Reson. Imaging 2010;32:82–87. © 2010 Wiley‐Liss, Inc.     

In vivo sodium (23Na) imaging of the human kidneys at 7 T: Preliminary results

Objective

To evaluate the feasibility of in vivo ²³Na imaging of the corticomedullary ²³Na gradient and to measure ²³Na transverse relaxation times (T2*) in human kidneys.

Methods

In this prospective, IRB-approved study, eight healthy volunteers (4 female, 4 male; mean age 29.4?±?3.6 years) were examined on a 7-T whole-body MR system using a ²³Na-only spine-array coil. For morphological ²³Na-MRI, a 3D gradient echo (GRE) sequence with a variable echo time scheme (vTE) was used. T2* times were calculated using a multiecho 3D vTE-GRE approach. ²³Na signal-to-noise ratios (SNR) were given on a pixel-by-pixel basis for a 20-mm section from the cortex in the direction of the medulla. T2* maps were calculated by fitting the ²³Na signal decay monoexponentially on a pixel-by-pixel basis, using least squares fit.

Results

Mean corticomedullary ²³Na-SNR increased from the cortex (32.2?±?5.6) towards the medulla (85.7?±?16.0). The SNR increase ranged interindividually from 57.2 % to 66.3 %. Mean ²³Na-T2* relaxation times differed statistically significantly (P?<?0.001) between the cortex (17.9?±?0.8 ms) and medulla (20.6?±?1.0 ms).

Conclusion

The aim of this study was to evaluate the feasibility of in vivo ²³Na MRI of the corticomedullary ²³Na gradient and to measure the ²³Na T2* relaxation times of human kidneys at 7 T.

Key Points

? High field MR offers new insights into renal anatomy and physiology. ? ²³ Na MRI of healthy human kidneys is feasible at ultra-high field. ? Renal ²³ Na concentration increases from the cortex in the medullary pyramid direction. ? In vivo measurements of renal ²³ Na-T2* times are demonstrated at 7.0 T.     

Evaluation of sodium T1 relaxation times in human heart

PURPOSE: To evaluate the sodium longitudinal relaxation (T(1)) characteristics for myocardium and blood in humans. MATERIALS AND METHODS: Eleven healthy volunteers were examined by using a (23)Na heart surface coil at a 1.5 T clinical scanner equipped with a broadband spectroscopy option. (23)Na MR measurements were performed by using a three-dimensional spoiled gradient echo sequence (in-plane resolution, 3.5 mm x 7 mm; slice thickness, 24 mm; TE, 3.1 msec; bandwidth, 65 Hz/pixel; TR, 21 to 150 msec). RESULTS: Longitudinal T(1) relaxation time components were 31.6+/-7.0 msec and 31.1+/-7.5 msec for myocardium and blood, respectively. CONCLUSION: (23)Na T(1) relaxation times of myocardium and blood can be determined in humans. The results are in agreement with values obtained from animal studies.     

MR imaging of sodium in the human brain with a fast three-dimensional gradient-recalled-echo sequence at 4 T

RATIONALE AND OBJECTIVES: Sodium ions play a vital role in cellular homeostasis and electrochemical activity throughout the human body. However, the in vivo detection of sodium (23Na) with magnetic resonance (MR) techniques is hindered by the fast transverse relaxation, low tissue equivalent concentration, and small gyromagnetic ratio of sodium ions compared with protons (1H). The goals of this study were to acquire MR images of sodium in the whole human brain by using a fast three-dimensional gradient-recalled-echo sequence and to investigate the effect that restrictions on specific absorption ratio have on MR imaging of sodium at 4 T. MATERIALS AND METHODS: A three-dimensional gradient-recalled-echo sequence with short echo time was developed for MR imaging of sodium. Slab encoding was removed and a hard excitation pulse was used. Five healthy human volunteers were examined in a whole-body MR imager with the use of a custom transmit-and-receive birdcage coil. Fields of view were selected to cover the entire brain: 38 x 38 cm in the axial plane, with 24 sections of 5.8 mm each or 12 sections of 1.1 cm each. The in-plane acquisition matrix was 64 x 128, and voxel size was 0.2 cm(3). RESULTS: Sodium in white matter was depicted with an acceptable signal-to-noise ratio of 20-25. The echo time, and hence the signal-to-noise ratio, was limited by the MR imager's maximum allowable gradient strength. To keep the specific absorption ratio below 3 W/kg (the limit established by the Food and Drug Administration), it was necessary to prolong the repetition time to 30 msec. CONCLUSION: The MR imaging protocol used in this study provided acceptable visualization of sodium in the whole brain in a tolerable total acquisition time of 15 minutes.     

Assessment of renal function after conformal radiotherapy and intensity-modulated radiotherapy by functional 1 H-MRI and 23 Na-MRI

Purpose

Adjuvant radiochemotherapy (RCHT) improves survival of patients with locally advanced gastric cancer. Conventional three-dimensional conformal radiotherapy (3D-CRT) results in ablative doses to a significant amount of the left kidney, while image-guided intensity-modulated radiotherapy (IG-IMRT) provides excellent target coverage with improved kidney sparing. Few long-term results on IMRT for gastric cancer, however, have been published. Functional magnetic resonance imaging (fMRI) at 3.0?T including blood oxygenation-level dependent (BOLD) imaging, diffusion-weighted imaging (DWI) and, for the first time, ²³Na imaging was used to evaluate renal status after radiotherapy with 3D-CRT or IG-IMRT.

Patients and methods

Four disease-free patients (2 after 3D-CRT and 2 after IMRT; FU for all patients >?5?years) were included in this feasibility study. Morphological sequences, axial DWI images, 2D-gradient echo (GRE)-BOLD images, and ²³Na images were acquired. Mean values/standard deviations for (²³Na), the apparent diffusion coefficient (ADC), and R2* values were calculated for the upper/middle/lower parts of both kidneys. Corticomedullary ²³Na-concentration gradients were determined.

Results

Surprisingly, IG-IMRT patients showed no morphological alterations and no statistically significant differences of ADC and R2* values in all renal parts. Values for mean corticomedullary ²³Na-concentration matched those for healthy volunteers. Results were similar in 3D-CRT patients, except for the cranial part of the left kidney. This was atrophic and presented significantly reduced functional parameters (p?=?0.001??p?=?0.033). Reduced ADC values indicated reduced cell density and reduced extracellular space. Cortical and medullary R2* values of the left cranial kidney in the 3D-CRT group were higher, indicating more deoxygenated hemoglobin due to reduced blood flow/oxygenation. (²³Na) of the renal cranial parts in the 3D-CRT group was significantly reduced, while the expected corticomedullary ²³Na-concentration gradient was partially conserved.

Conclusions

Functional MRI can assess postradiotherapeutic renal changes. As expected, marked morphological/functional effects were observed in high-dose areas (3D-CRT), while, unexpectedly, no alteration in kidney function was observed in IG-IMRT patients, supporting the hypothesis that reducing total/fractional dose to the renal parenchyma by IMRT is clinically beneficial.     

Sodium-23 MR imaging of the kidney in guinea pig at 2.1 T, following arterial, venous, and ureteral ligation

In vivo 23Na magnetic resonance images of guinea pig kidney were obtained at 2.1 T using a spin-echo sequence with an echo time of 19 ms. The intact kidney showed a very strong signal intensity in the sodium image. The signal intensity of the kidney decreased to 55% after ligation of the renal artery together with the vein and the ureter. The total sodium content in the excised kidney after arterial occlusion, measured by flame photometry, was 24% higher than that in the intact kidney. The transverse relaxation time (T2) of the extracellular sodium in the isolated kidney decreased to one-third of that in the intact kidney. This shortening of T2 may be partly responsible for the decrease in the 23Na signal intensity from the kidney after arterial occlusion.     

Theoretical basis for sodium and potassium MRI of the human heart at 1.5 T

Knowledge of the extent and location of viable tissue is important to clinical diagnosis. In principle, sodium (²³Na) and potassium (³⁹K) MRI could noninvasively provide information about tissue viability. In practice, imaging of these nuclei is difficult because, compared with water protons (¹H), ²³Na and ³⁹K have lower MR sensitivities (9.2 and 0.051%, respectively), and lower in vivo concentrations (ca. 1000-fold). On the other hand, the relatively short T₁ relaxation times of ²³Na and ³⁹K (ca. 30 and 10 ms, respectively) suggest that optimized imaging pulse sequences may in part alleviate the weak signal of these nuclei. In this study, numerical simulations of high-speed imaging sequences were developed and used to maximize ²³Na and ³⁹K image signal-to-noise ratio (SNR) per unit time within the constraints of existing gradient hardware. The simulation demonstrated that decreasing receiver bandwidth at the expense of echo time (TE) results in a substantial increase in ²³Na and ³⁹K image SNR/time despite the short T₂ and T₂* of these nuclei. Referenced to the available ¹H signal on existing 1.5 T scanners, the simulation suggested that it should be possible to acquire three-dimensional ²³Na images of the human heart with 7 × 7 × 7 mm resolution and ³⁹K images with 26 × 26 × 26 mm resolution in 30 min. Experimentally in humans at 1.5 T, three-dimensional ²³Na images of the heart were acquired in 15 min with 6 × 6 × 12 mm resolution and signal-to-noise ratios of 11 and 7 in the left ventricular cavity and myocardium, respectively, which is very similar to the predicted result. The results demonstrate that by choosing imaging pulse sequence parameters that fully exploit the short relaxation times of ²³Na and ³⁹K, potassium MRI is improved but remains impractical, whereas sodium MRI improves to the point where ²³Na imaging of the human heart may be clinically feasible on existing 1.5 T scanners.     

Diffusion-weighted MRI in the evaluation of renal lesions: preliminary results

The purpose of this study was to evaluate the capability and the reliability of diffusion-weighted MRI in the evaluation of normal kidney and different renal lesions. 39 patients (10 normal volunteers and 29 patients with known renal lesions) underwent MRI of the kidneys by using a 1.5 T superconducting magnet. Axial fat suppressed turbo spin echo (TSE) T(2) and coronal fast field echo (FFE) T(1) or TSE T(1) weighted images were acquired for each patient. Diffusion-weighted (DW) images were obtained in the axial plane during breath-hold (17 s) with a spin-echo echo planar imaging (SE EPI) single shot sequence (repetition time (TR)=2883 ms, echo time (TE)=61 ms, flip angle=90 degrees ), with b value of 500 s mm(-2). 16 slices were produced with slice thickness of 7 mm and interslice gap of 1 mm. An apparent diffusion coefficient (ADC) map was obtained at each slice position. The ADC was measured in an approximately 1 cm region of interest (ROI) within the normal renal parenchyma, the detected renal lesions and the collecting system if dilated. ADC values in normal renal parenchyma ranged from 1.72 x 10(-3) mm(2) s(-1) to 2.65 x 10(-3) mm(2) s(-1), while ADC values in simple cysts (n=13) were higher (2.87 x 10(-3) mm(2) s(-1) to 4.00 x 10(-3) mm(2) s(-1)). In hydronephrotic kidneys (n=6) the ADC values of renal pelvis ranged from 3.39 x 10(-3) mm(2) s(-1) to 4.00 x 10(-3) mm(2) s(-1). In cases of pyonephrosis (n=3) ADC values of the renal pelvis were found to be lower than those of renal pelvis of hydronephrotic kidneys (0.77 x 10(-3) mm(2) s(-1) to 1.07 x 10(-3) mm(2) s(-1)). Solid benign and malignant renal tumours (n=7) showed ADC values ranging between 1.28 x 10(-3) mm(2) s(-1) and 1.83 x 10(-3) mm(2) s(-1). In conclusion diffusion-weighted MR imaging of the kidney seems to be a reliable way to differentiate normal renal parenchyma and different renal diseases. Clinical experience with this method is still preliminary and further studies are required.     

Hemodynamic effect of iodinated high-viscosity contrast medium in the rat kidney: a diffusion-weighted MRI feasibility study

RATIONALE AND OBJECTIVES: To assess the abilities of dynamic diffusion-weighted MRI to demonstrate the effects in vivo of a high-viscosity iodinated contrast agent on medullary and cortical blood flow in the rat kidney. METHODS: Dynamic diffusion-weighted, echoplanar MR images obtained from five b-value single-shot acquisitions and their isotropic apparent diffusion coefficient maps were obtained from nine rats anesthetized by pentobarbital sedation, before and after intravenous injection of a high-viscosity, dimeric iso-osmolar iodinated contrast medium (iodixanol), and compared with those obtained from four control rats that received saline. RESULTS: The mean baseline apparent diffusion coefficient values were 1.64 +/- 0.05 x 10(-3) mm2/s for the cortex and 1.75 +/- 0.06 x 10(-3) mm2/s for the medulla. In the iodixanol group, a significant decrease in renal diffusion was observed at 12 minutes and lasted at least until 24 minutes. The decrease in diffusion occurred earlier for the cortex and lasted less than for the medulla. There was no significant modification in diffusion over time in the control group. CONCLUSIONS: This preliminary experience in rats shows that dynamic diffusion-weighted MRI can be used to study noninvasively the in vivo renal hemodynamic response after injection of iodinated contrast.     

Optimization of ECG-triggered 3D (23)Na MRI of the human heart.

(23)Na MRI may allow distinction of normal and ischemically injured myocardium. The aim of this study was to optimize (23)Na MRI of the human heart by improvement of spatial resolution and ECG-triggering and to measure the signal/noise of blood and myocardium and the myocardium/blood signal ratios in a volunteer study. A spoiled gradient echo sequence was developed on a 1.5T scanner equipped with a (23)Na heart surface coil. 3D short axis ECG-triggered (23)Na MRI was performed in 10 healthy subjects. The signal/noise of myocardium and blood were 8.2 +/- 0.7 and 18.3 +/- 1.3, respectively, signal ratio myocardium/blood was 0.44 +/- 0.03. This value is in good agreement with the theoretical value of 0.45. ECG gated 3D (23)Na MRI of the human heart is feasible with sufficient spatial resolution and signal/noise ratio. Magn Reson Med 45:164-166, 2001.     

In vivo imaging of the neutron capture therapy agent BSH in mice using (10)B MRI.

Boron neutron capture therapy (BNCT) is an experimental cancer treatment modality requiring the targeting of (10)B-enriched compounds to the tumor, which is then irradiated by low-energy neutrons. One of the boron-containing compounds used for this purpose is the mercaptoborane Na(2)B(12)H(11)SH (BSH). The first in vivo MR images of (10)B-enriched BSH are presented here. BSH, injected into the tail vein of mice with implanted M2R melanoma xenografts, was imaged using 3D gradient echo (10)B MRI. (10)B NMR spectroscopy, localized mainly to the tumor by virtue of the use of a small surface coil, was applied to measure the T(1) (2.9 +/- 0.3 ms) and T(2) (1.75 +/- 0.25 ms) values of the (10)B signal. The MRI experiments detected levels of about 20 ppm (microg boron / g tissue) at 6 x 6 x 6 mm spatial resolution in a total scan time of 16 min. Magn Reson Med 46:13-17, 2001.     

Normal renal development investigated with fetal MRI

OBJECTIVE: To evaluate age-dependent changes in fetal kidney measurements with MRI. PATIENTS AND METHODS: Fetal MRI examinations were used to study the kidney length (218 fetuses), signal intensities of renal tissue, renal pelvis, and liver tissue on T2-weighted images (223 fetuses), and the whole-kidney apparent diffusion coefficient (107 fetuses). A 1.5 T superconducting unit with a phased array coil was used in patients from 16 to 39 weeks' gestation. The imaging protocol included T2-weighted single-shot fast spin-echo, T2-weighted balanced angiography and diffusion-weighted sequences. Slice thickness ranged from 3 to 5mm. RESULTS: Fetal kidney length as a function of gestational age was expressed by the linear regression: kidney length (mm)=0.190 x gestational age (d) -8.034 (R(2) = 0.883, p < 0.001). Paired t-test analysis showed a highly statistically significant difference between the ratio of renal tissue signal intensity to renal pelvis signal intensity and the ratio of liver signal intensity to renal pelvis signal intensity on T2-weighted images (t = -50.963, d.f. = 162, p < 0.001), with renal tissue hyperintense to liver tissue. The apparent diffusion coefficient in relation to gestational age was described by the equation: ADC (microm(2)/s) = 0.0302 x square (gestational age (d)) -14.202 x gestational age (d) +2,728.6 (R(2) = 0.225, p < 0.001). CONCLUSION: The length, signal intensity on T2-weighted images, and apparent diffusion coefficient of the fetal kidney change significantly with gestational age. The presented data may help in the prenatal diagnosis of renal anomalies.     

Plasma sodium-osmotic dissociation and hormonal interaction with drinking-induced hypervolemia at 2800 m altitude

PURPOSE: To study hormonal factors that may account for the dissociation between beverage-induced plasma sodium p[Na+] and osmotic p[Osm] concentrations that appear to refute the high theoretical correlation between p[Na+] and p[Osm]. METHODS: Ten men (24 +/- SD 3 yr of age) sat reclining (head up) for 12 h in a chamber (21-23 degrees C dry bulb, 25-33% relative humidity) at 2800 m (9184 ft, 539 mm Hg) altitude (ALT), and at 321 m (1053 ft, 732 mm Hg) on the ground (GND). During 1000-1030 hours they consumed 3 fluids (12 ml x kg(-1),X = 948 ml x d(-1)) with large differences in sodium and osmotic contents: AstroAde (AA) with 185 mEq x L(-1) Na+ and 283 mOsm x kg(-1), Performance 1 (Shaklee) (P1) with 22 mEq x L(-1) Na+ and 365 mOsm kg(-1), or H2O at ALT; and only H2O on the GND. RESULTS: After drinking: plasma volume (PV) increased at 1200 hours by 8.3% (p < 0.05) with AA but was not significantly (NS) changed in the other sessions (Xdelta = +0.9%, range -0.9 to 2.8%); p[Na+] and p[Osm] were unchanged. Urinary rates and free-water clearances were attenuated with AA and P1 vs. those with H2O. Correlations between and among p[Na+] and p[Osm] suggest that the pNa+ ion is more tightly controlled than pOsm; and that there was no clear hormonal response that could account for this dissociation from theoretical considerations. CONCLUSIONS: There is significant dissociation between plasma sodium and osmotic concentrations after fluid intake. Induction and maintenance of hypervolemia requires increased (near isotonic) drink Na+ osmols rather than increased non-ionic osmols.     

MR perfusion imaging of the kidney pre- and post-dipyridamole stress

Animal studies have demonstrated that renal MR contrast enhancement depends on the timing of image acquisition. Limited human studies have demonstrated effects of dipyidamole (DP) on total renal perfusion. This study assessed the effect of DP on total and regional renal perfusion using gated perfusion MRI for patients undergoing DP stress. Five subjects with no evidence of renal ischemia were examined at rest and after DP stress. Rest MRI images in the left kidney were acquired using electrocardiogram (ECG)-gated MR: turbo fast low-angle shot (FLASH); echo time (TE) = 12, repetition time (TR) = 6. flip angle = 12, inversion time (TI) = (100) 10 to 45 seconds after injection of gadopentetate dimeglumine. Stress was induced in the MRI scanner (DP, .56 mg/kg over 4 minutes) followed by stress MRI after a second bolus of gadopentetate dimeglumine in the same position and identical time intervals. MR signal in the whole left kidney and renal medulla and cortex pre- and post-DP demonstrated a 70% depression of total renal perfusion with relative preservation of cortical perfusion at the expense of medullary perfusion. Post-DP MR images demonstrated a decrease in cortical perfusion with an additional 29% depression of medullary perfusion (P < .001) with respect to cortical perfusion. Turbo FLASH MRI can provide adequate time and spatial resolution to demonstrate changes in renal perfusion. Depression of renal medullary perfusion after DP appears to be caused by the intrarenal effect of DP and may have clinical impact.     

Noninvasive quantification of total sodium concentrations in acute reperfused myocardial infarction using 23Na MRI.

The transport of sodium and potassium between the intra- and extracellular pools and the maintenance of the transmembrane concentration gradients are important to cell function and integrity. The early disruption of the sodium pump in myocardial infarction in response to the exhaustion of energy reserves following ischemia and reperfusion results in increased intracellular (and thus total) sodium levels. In this study a method for noninvasively quantifying myocardial sodium levels directly from sodium (23Na) MRI is presented. It was used to measure total myocardial sodium on a clinical 1.5T system in six normal dogs and five dogs with experimentally-induced myocardial infarction (MI). The technique was validated by comparing total sodium content measured by 23Na MRI with that measured by atomic absorption spectrophotometry (AAS) in biopsied tissue. Total sodium measured by 23Na MRI was significantly elevated in regions of infarction (81.3 +/- 14.3 mmol/kg wet wt, mean +/- SD) compared to noninfarcted myocardial tissue from both infarcted dogs (36.2 +/- 1.1, P < 0.001) and from normal controls (34.4 +/- 2.8, P < 0.0001). Myocardial tissue sodium content as measured by 23Na MRI did not vary regionally in the lateral, anterior, or inferior regions in normal hearts (ANOVA, P = NS). Sodium content measured by 23Na MRI agreed with the mean AAS estimates of 31.3 +/- 5.6 mmol/kg wet wt (P = NS) in normal hearts, and did not differ significantly from AAS measurements in MI (P = NS). Thus, local tissue sodium levels can be accurately quantified noninvasively using 23Na MRI in normal and acutely reperfused MI. The detection of regional myocardial sodium elevations may help differentiate viable from nonviable, infarcted tissue.     

Long component time constant of 23Na T*2 relaxation in healthy human brain.

Signal intensity in 23Na images is altered in pathologic conditions such as ischemia and may provide information regarding tissue viability complementary to MR diffusion and perfusion imaging. However, the multicomponent transverse relaxation of 23Na (spin 3/2) complicates the determination of tissue sodium concentration from 23Na images with nonzero echo-time. The purpose of this study was to measure the long component time constant of tissue sodium T*2 relaxation in the healthy human brain at 4 T. Multiecho gradient-echo 23Na images (10 echo-times ranging from 3.8-68.7 ms) were acquired in five healthy human volunteers. T*2 was quantified on a pixel-by-pixel basis using a nonnegative least squares fitting routine using 100 equally spaced bins between 0.5-99.5 ms and parametric maps were produced representing components between 0.5-3, 3.1-50, 50.1-98, and 98.1-99.5 ms. The long T*2 component of tissue sodium (average +/- standard deviation) varied between cortex (occipital = 22.0 +/- 2.4 ms), white matter (parietal = 18.2 +/- 1.9 ms), and subcortical gray matter (thalamus = 16.9 +/- 2.4 ms). These results demonstrate considerable regional variability and establish a foundation for future characterization of 23Na T*2 in conditions such as cerebral ischemia and cancer.     

Quantitative tissue sodium concentration mapping of the growth of focal cerebral tumors with sodium magnetic resonance imaging.

Tissue sodium concentration (TSC), as determined by in vivo 23Na magnetic resonance imaging (MRI) and the ex vivo classical 22Na radionuclide dilution assay (RDA), has been compared in a rat model of a focal glioma. The 23Na MRI method used a three-dimensional, twisted projection acquisition scheme at short echo time to minimize signal losses from relaxation of transverse magnetization. Calibration standards within the field of view allowed quantification of the sodium signal in terms of a TSC after correction for B1 nonuniformity and tissue water concentration. The 23Na MRI method measured focally increased TSC values in tumors that were equivalent statistically to the destructive 22Na RDA method. The noninvasive 23Na MRI method provided a quantitative means with which to monitor focal brain tumor growth.