Cardiac amyloidosis: MR imaging findings and T1 quantification, comparison with control subjects

In cardiac amyloidosis an interstitial deposition of amyloid fibrils causes concentric thickening of the atrial and ventricular walls. We describe the results of tissue characterization of the myocardium by T1 quantification and MRI findings in a patient with cardiac amyloidosis. The T1 time of the myocardium was elevated compared to that in individuals without amyloidosis. The T1 time of the myocardium was 1387 +/- 63 msec (mean value obtained from four measurements +/- standard deviation [SD]) in the patient with cardiac amyloidosis, while the reference value obtained from the myocardium of 10 individuals without known myocardial disease was 1083 +/- 33 msec (mean value +/- SD). In combination with other MR findings suggestive of amyloidosis, such as homogeneous thickening of the ventricular and atrial walls, thickening of the valve leaflets, restrictive filling pattern, and reduction of systolic function, T1 quantification may increase diagnostic confidence.     

Magnetic resonance imaging of skeletal muscle. Prolongation of T1 and T2 subsequent to denervation

The changes seen in the T1 and T2 relaxation times, water content and size of the extracellular fluid spaces of rat muscle samples following 15 days of denervation were studied by in vitro proton NMR spectrometry (10 MHz). Two different skeletal muscle groups (gastrocnemius and soleus) were studied. Denervation led to longer T1 values: 548 +/- 61 msec vs. 486 +/- 16 msec (P less than .05) for the gastrocnemius and 581 +/- 27 msec vs. 521 +/- 25 msec (P less than .05) for the soleus. Similar increases in T2 were measured. The sizes of the extracellular fluid spaces of denervated muscle were significantly larger despite a minor increase in total water content. Overall, the relaxation times of skeletal muscle correlated better with the size of the extracellular fluid space than with the total water content.     

MR imaging relaxation times of abdominal and pelvic tissues measured in vivo at 3.0 T: preliminary results

PURPOSE: To measure T1 and T2 relaxation times of normal human abdominal and pelvic tissues and lumbar vertebral bone marrow at 3.0 T. MATERIALS AND METHODS: Relaxation time was measured in six healthy volunteers with an inversion-recovery method and different inversion times and a multiple spin-echo (SE) technique with different echo times to measure T1 and T2, respectively. Six images were acquired during one breath hold with a half-Fourier acquisition single-shot fast SE sequence. Signal intensities in regions of interest were fit to theoretical curves. Measurements were performed at 1.5 and 3.0 T. Relaxation times at 1.5 T were compared with those reported in the literature by using a one-sample t test. Differences in mean relaxation time between 1.5 and 3.0 T were analyzed with a two-sample paired t test. RESULTS: Relaxation times (mean +/- SD) at 3.0 T are reported for kidney cortex (T1, 1,142 msec +/- 154; T2, 76 msec +/- 7), kidney medulla (T1, 1,545 msec +/- 142; T2, 81 msec +/- 8), liver (T1, 809 msec +/- 71; T2, 34 msec +/- 4), spleen (T1, 1,328 msec +/- 31; T2, 61 msec +/- 9), pancreas (T1, 725 msec +/- 71; T2, 43 msec +/- 7), paravertebral muscle (T1, 898 msec +/- 33; T2, 29 msec +/- 4), bone marrow in L4 vertebra (T1, 586 msec +/- 73; T2, 49 msec +/- 4), subcutaneous fat (T1, 382 msec +/- 13; T2, 68 msec +/- 4), prostate (T1, 1,597 msec +/- 42; T2, 74 msec +/- 9), myometrium (T1, 1,514 msec +/- 156; T2, 79 msec +/- 10), endometrium (T1, 1,453 msec +/- 123; T2, 59 msec +/- 1), and cervix (T1, 1,616 msec +/- 61; T2, 83 msec +/- 7). On average, T1 relaxation times were 21% longer (P <.05) for kidney cortex, liver, and spleen and T2 relaxation times were 8% shorter (P <.05) for liver, spleen, and fat at 3.0 T; however, the fractional change in T1 and T2 relaxation times varied greatly with the organ. At 1.5 T, no significant differences (P >.05) in T1 relaxation time between the results of this study and the results of other studies for liver, kidney, spleen, and muscle tissue were found. CONCLUSION: T1 relaxation times are generally higher and T2 relaxation times are generally lower at 3.0 T than at 1.5 T, but the magnitude of change varies greatly in different tissues.     

Black-blood T2* technique for myocardial iron measurement in thalassemia

PURPOSE: To compare the effectiveness and reproducibility of a new black-blood sequence vs. a conventional bright-blood gradient-echo T2* sequence for myocardial iron overload measurement in thalassemia. MATERIALS AND METHODS: Twenty thalassemia patients were studied. Black-blood sequence images were acquired in diastole after a double inversion recovery (DIR) preparation pulse. Bright-blood sequence images were acquired in both early systole and late diastole. The data were randomized and the T2* analysis was performed blindly by two independent observers. RESULTS: The T2* values from the black-blood sequence were comparable to those of the conventional bright-blood sequence (25.7 +/- 12.9 msec vs. 26.4 +/- 14.2 msec in early systole, P = 0.44; and 25.2 +/- 13.1 msec in late diastole, P = 0.41). The coefficient of variation (CV) for black-blood image T2* analysis was 4.1% compared with 8.9% (early systole P = 0.03) and 7.8% (late diastole P = 0.05) for bright-blood image analysis. CONCLUSION: The black-blood T2* technique yields high-contrast myocardial images, provides clearly depicted myocardial borders, and avoids blood signal contamination of the myocardium while yielding improvements in interobserver variability.     

Quantitative apparent diffusion coefficients and T2 relaxation times in characterizing contrast enhancing brain tumors and regions of peritumoral edema

PURPOSE: To investigate the potential value and relationship of in vivo quantification of apparent diffusion coefficients (ADCs) and T2 relaxation times for characterizing brain tumor cellularity and tumor-related edema. MATERIALS AND METHODS: A total of 26 patients with newly diagnosed gliomas, meningiomas, or metastases underwent diffusion-weighted and six-echo multisection T2-preparation imaging. Regions of interest (ROIs) were drawn on conventional MR images to include tumor (as defined by contrast agent enhancement) and immediate and peripheral edema. Areas of necrosis were excluded. Median values of ADCs and T2 in the ROIs were calculated. RESULTS: ADCs for gliomas were similar to those for meningiomas or metastases in all regions. Tumor T2 values for gliomas (159.5+/-30.6 msec) were significantly higher than those for meningiomas or metastases (125.0+/-31.1 msec; P=0.005). Immediate-edema T2 values for meningiomas or metastases (226.0+/-44.1 msec) were significantly higher than those for gliomas (203.5+/-32.8 msec; P=0.033). Peripheral-edema T2 values for gliomas (219.5+/-41.9 msec) were similar to those for meningiomas or metastases (202.5+/-26.5 msec; P=0.377). Both immediate- and peritumoral-edema ADCs and T2 values were significantly higher than those in tumor for both tumor types. ADCs and T2 values from all regions correlated significantly for gliomas (r=0.95; P<0.0001) and for meningiomas or metastases (r=0.81; P<0.0001). CONCLUSION: The higher immediate-edema T2 values for nonglial tumors than for gliomas suggest tumor-related edema (vasogenic vs. infiltrated) can be further characterized by using T2 values. There were significant correlations between ADC and T2 values.     

心脏MR初始T＿1值及组织追踪技术在心肌淀粉样变和肥厚型心肌病的初步应用价值

目的:探讨磁共振初始T₁值及组织追踪技术(CMR-TT)在鉴别心肌淀粉样变(CA)和肥厚型心肌病(HCM)中的价值。方法:对14名CA患者、16名HCM患者及16名健康受试者行3.0T心脏磁共振检查,测量基底部、乳头肌部及心尖部心肌初始T₁值,采用CMR-TT技术测量左心室三维(3D)整体纵向应变(GLS)、周向应变(GCS)及径向应变(GRS),描绘左心室心肌应变曲线。采用受试者操作特征曲线(ROC)评估初始T₁值及各应变指标对CA和HCM的鉴别诊断价值。结果:CA组总体、基底部、乳头肌部、心尖部心肌初始T₁值[分别为(1455.68±153.23)ms、(1446.97±170.53)ms、(1442.31±151.92)ms、(1468.31±141.83)ms]高于HCM组[分别为(1329.14±40.19)ms、(1329.45±46.14)ms、(1330.04±41.49)ms、(1327.41±46.55)ms],差异有统计学意义(P均<0.001)。CMR-TT应变分析结果...     

1H metabolite relaxation times at 3.0 tesla: Measurements of T1 and T2 values in normal brain and determination of regional differences in transverse relaxation

PURPOSE: To measure 1H relaxation times of cerebral metabolites at 3 T and to investigate regional variations within the brain. MATERIALS AND METHODS: Investigations were performed on a 3.0-T clinical whole-body magnetic resonance (MR) system. T2 relaxation times of N-acetyl aspartate (NAA), total creatine (tCr), and choline compounds (Cho) were measured in six brain regions of 42 healthy subjects. T1 relaxation times of these metabolites and of myo-inositol (Ins) were determined in occipital white matter (WM), the frontal lobe, and the motor cortex of 10 subjects. RESULTS: T2 values of all metabolites were markedly reduced with respect to 1.5 T in all investigated regions. T2 of NAA was significantly (P < 0.001) shorter in the motor cortex (247 +/- 13 msec) than in occipital WM (301 +/- 18 msec). T2 of the tCr methyl resonance showed a corresponding yet less pronounced decrease (162 +/- 16 msec vs. 178 +/- 9 msec, P = 0.021). Even lower T2 values for all metabolites were measured in the basal ganglia. Metabolite T1 relaxation times at 3.0 T were not significantly different from the values at 1.5 T. CONCLUSION: Transverse relaxation times of the investigated cerebral metabolites exhibit an inverse proportionality to magnetic field strength, and especially T2 of NAA shows distinct regional variations at 3 T. These can be attributed to differences in relative WM/gray matter (GM) contents and to local paramagnetism.     

T 1 rho-relaxation mapping of human femoral-tibial cartilage in vivo

PURPOSE: To demonstrate the in vivo feasibility of measuring spin-lattice relaxation time in the rotating frame (T(1rho)); and T(1rho)-dispersion in human femoral cartilage. Furthermore, we aimed to compute the baseline T(1rho)-relaxation times and spin-lock contrast (SLC) maps on healthy volunteers, and compare relaxation times and signal-to-noise ratio (SNR) with corresponding T(2)-weighted images. MATERIALS AND METHODS: All MR imaging experiments were performed on a 1.5 T GE Signa scanner (GEMS, Milwaukee, WI) using a custom built 15-cm transmit-receive quadrature birdcage radio-frequency (RF) coil. The T(1rho)-prepared magnetization was imaged with a single-slice two-dimensional fast spin-echo (FSE) pulse sequence preencoded with a three-pulse cluster consisting of two hard 90 degrees pulses and a low power spin-lock pulse. T(1rho)-dispersion imaging was performed by varying the spin-lock frequency from 100 to 500 Hz in five steps in addition to varying the length of the spin-lock pulse. RESULTS: The average T(1rho)-relaxation times in the weight-bearing (WB) and nonweight-bearing (NWB) regions of the femoral condyle were 42.2 +/- 3.6 msec and 55.7 +/- 2.3 msec (mean +/- SD, N = 5, P < 0.0001), respectively. In the same regions, the corresponding T(2)-relaxation times were 31.8 +/- 1.5 msec and 37.6 +/- 3.6 msec (mean +/- SD, N = 5, P < 0.0099). T(1rho)-weighted images have approximately 20%-30% higher SNR than the corresponding T(2)-weighted images for similar echo time. The average SLC in the WB region of femoral cartilage was 30 +/-4.0%. Furthermore, SLC maps provide better contrast between fluid and articular surface of femoral-tibial joint than T(1rho)-maps. The T(1rho)-relaxation times varied from 32 msec to 42 msec ( approximately 31%) in the WB and 37 msec to 56 msec ( approximately 51%) in NWB regions of femoral condyle, respectively, in the frequency range 0-500 Hz (T(1rho)-dispersion). CONCLUSION: The feasibility of performing in vivo T(1rho) relaxation mapping in femoral cartilage at 1.5T clinical scanner without exceeding Food and Drug Administration (FDA) limits on specific absorption rate (SAR) of RF energy was demonstrated.     

Gd-DTPA bolus tracking in the myocardium using T1 fast acquisition relaxation mapping (T1 FARM).

MRI methods currently used for bolus tracking in the myocardium, such as saturation recovery turbo-fast low-angle shot (FLASH) (srTFL), are limited by signal intensity (SI) saturation at high contrast agent (CA) concentrations. By using T1 fast acquisition relaxation mapping (T1 FARM), a Gd-DTPA bolus (0.075 vs. 0.025 mmol/kg) may be injected without causing saturation. This study tested the feasibility of in vivo T1 FARM bolus tracking under rest/stress conditions in seven beagles with multiple permanently occluded branches of the left anterior descending (LAD) coronary artery. Although it underestimated the myocardial perfusion reserve (MPR) measured ex vivo using radioactive microspheres (mean +/- SEM; 3.60 +/- 0.26), the MPR determined upon application of the modified Kety model (1.86 +/- 0.10) enabled distinction between normal and infarcted tissue. The partition coefficient (lambda) estimated at rest and stress using the modified Kety model underestimated ex vivo radioactive measurements in infarcted tissue (0.25 +/- 0.01 vs. 0.26 +/- 0.01 vs. 0.79 +/- 0.08 ml/g, P < 0.0001) yet was accurate in normal tissue (0.28 +/- 0.01 vs. 0.30 +/- 0.01 vs. 0.33 +/- 0.01 ml/g, P = NS). Thus, although unsuitable for myocardial viability assessment, T1 FARM bolus tracking shows potential for assessment of myocardial perfusion.     

Oxygen-enhanced magnetic resonance ventilation imaging of the human lung at 0.2 and 1.5 T.

Lung ventilation imaging using inhaled oxygen as a contrast medium was performed using both a 0.2 and a 1.5 T clinical magnetic resonance (MR) scanner in eight volunteers. Signal-to-noise-ratios (SNRs) of the ventilation images as well as T1 values of the lung acquired with inhalation of 100% oxygen and room air were calculated. The SNR was 9.7 +/- 3.0 on the 0.2 T MR system and 69.5 +/- 28.8 on the 1.5 T system (P < 0.001). The mean T1 value on the 0.2 T MR system with subjects breathing room air was 632 +/- 54 msec; with 100% oxygen, it was 586 +/- 41 msec (P < 0.01). At 1.5 T, the mean values were 904 +/- 99 msec and 790 +/- 114 msec, respectively (P < 0.0001). We conclude that MR oxygen-enhanced ventilation imaging of the lung is feasible with an open configured 0.2 T MR system.     

In vivo magnetic resonance (MR) study of fatty liver: importance of intracellular ultrastructural alteration for MR tissue parameters change.

Fatty liver is thought to have a shorter T1 relaxation time than normal liver tissue, due to the accumulation of triglyceride. Previous studies regarding T1 and T2 relaxation times, however, show widely different results. In order to elucidate the mechanism responsible for the changes and diversity of relaxation times in fatty liver, we created two animal models in 14 rabbits, one acute form (N = 6) and the other chronic form (N = 8). Four rabbits were taken as a control group. Tissue relaxation times and the magnetization transfer (MT) effect of the liver tissue in these two models were measured. The results were correlated with biochemical analysis of water and fat content and histological examination, including findings in light microscopy and electron microscopy. Although the fatty ratio in both forms of fatty liver was similar, their tissue relaxation rate and MT effect were significantly different. The acute form showed prolongation of both T1 and T2 relaxation times (512 +/- 51 msec vs. 710 +/- 95 msec and 39 +/- 1.8 msec vs. 48 +/- 3.7 msec, respectively) and a decrease of the MT effect (50 +/- 5.1% vs. 38 +/- 6.3%), compared to those of the control group and preinduction liver. The chronic form showed shorter T1 and T2 values (526 +/- 36 msec vs. 406 +/- 56 msec and 36 +/- 1.6 msec vs. 33 +/- 2.3 msec, respectively) and a stronger MT effect (21 +/- 0.9% vs. 26 +/- 2.3%). In acute form fatty liver, electron microscopic examination revealed dramatic subcellular changes, such as vesicular transformation, a markedly increased amount of smooth endoplasmic reticulum (SER), and disruption of the crista. These changes were not found in the chronic form fatty liver. From this study, we concluded that the ultrastructural alteration in the subcellular organelles of hepatocyte might play a crucial role for the chameleonic presentation of MR tissue parameters in fatty liver.     

Normalized left ventricular volumes and function in thalassemia major patients with normal myocardial iron

PURPOSE: To determine the reference range in thalassemia major (TM) for left ventricular (LV) function. MATERIALS AND METHODS: We used cardiovascular magnetic resonance (CMR) to measure heart volumes and function in 81 TM patients with normal myocardial T2* measurements (T2* > 20 msec) and by inference without excess myocardial iron. Forty age- and gender-matched healthy controls were also studied. RESULTS: Resting LV volumes and function normalized to body surface area differed significantly between TM patients and controls. The lower limit and the mean for ejection fraction (EF) were higher in TM patients (males 59 vs. 55%, mean 71% vs. 65%; females 63 vs. 59%, mean 71% vs. 67%; both P < 0.001). The upper limit and mean for end-diastolic volume index were higher in TM patients (males 152 vs. 105 mL/m(2), mean 97 vs. 84 mL/m(2); females 121 vs. 99 mL/m(2), mean 87 vs. 79 mL/m(2); both P < 0.05). In TM patients the cardiac index (P < 0.001) was increased. CONCLUSION: At rest, TM patients with a normal myocardial T2* have different "normal" values for LV volume and function parameters compared to controls, and this has the potential to lead to a misdiagnosis of cardiomyopathy. We present new reference "normal" ranges in TM to alleviate this problem.     

Correlation of MR changes with Doppler US measurements of blood flow in exercising normal muscle.

Muscle data from phosphorus-31 magnetic resonance (MR) spectroscopy and hydrogen-1 MR imaging and popliteal artery data from duplex Doppler ultrasound were compared during an exercise test of the anterior compartment of the leg, in nine healthy volunteers. Significant variations (mean +/- standard deviation) were observed at the end of exercise versus rest in intracellular pH (pHi) (6.32 +/- 0.02 vs 7.02 +/- 0.04, P < .001), T2 (38.2 msec +/- 2.3 vs 29.5 msec +/- 1.1, P < .001), and popliteal output (652 mL/min +/- 232 vs 149 mL/min +/- 65, P < .001). These variables showed the following significant correlations at the end of exercise: T2 and pHi (r = -.784, P < .01), T2 and popliteal output (r = .737, P < .03), and pHi and popliteal output (r = -.902, P < .001). However, during recovery, the T2 curve was significantly different from those of pHi and popliteal output. This suggests that even if circulatory conditions play a role in the maximum T2 variation during exercise, they do not directly explain T2 changes. Furthermore, the correlations involving pHi suggest the role of the metabolism of exercising muscle in transcapillary fluid movement.     

Myocardial collagen concentration and nuclear magnetic resonance relaxation times in the spontaneously hypertensive rat.

In order to test the hypothesis that the increased myocardial collagen concentration in the older, spontaneously hypertensive (SH) rat is associated with altered T2 and T1, we performed in vitro studies of 70 left ventricles from 8-, 22-, and 33-week-old SH and Wistar-Kyoto (WKY) rats. We also measured the left ventricle/body weight (LV/BW) ratio (as a measure of hypertrophy), left ventricular water and fat content, and hydroxyproline concentration (as a measure of collagen). The LV/BW ration was not significantly different between 8-week-old SH rats and WKY rats but was significantly greater in SH rats than in WKY rats at 22 and 33 weeks of age. Comparing SH rats with WKY rats at 22 weeks of age, no significant difference existed in T1, T2, water content, or hydroxyproline concentration. However, at 33 weeks of age in SH rats compared with WKY rats, hydroxyproline concentration was significantly greater (4.3 +/- 0.6 mg/g, respectively; P less than .0005), water content was significantly greater (77.1% +/- 0.3% vs. 76.2% +/- 0.3%, respectively; P less than .0001), and T2 and T1 were significantly longer (T2: 52.6 +/- 2.1 msec vs. 48.6 +/- 2.2 msec, respectively; P less than .0001; T1: 656 +/- 14 msec vs. 619 +/- 12 msec, respectively; P less than .0001). In all SH rats combined, T2 and hydroxyproline concentration were significantly correlated (r = .63; P less than .0001). Thus, in SH rats, myocardial hypertrophy precedes increased collagen deposition. These data suggest that estimation of magnetic resonance relaxation times may permit noninvasive identification of increased myocardial collagen deposition independent from changes in myocardial hypertrophy.     

Regional myocardial blood flow, edema formation, and magnetic relaxation times during acute myocardial ischemia in the canine

This study was designed to measure early changes in myocardial perfusion after acute coronary occlusion, and to examine the relationships among blood flow, myocardial edema, and magnetic relaxation times of ex vivo myocardial tissue. In ten dogs, the left anterior descending coronary artery was occluded for 4 hours prior to sacrifice of the animals. Regional myocardial blood flow was measured using radiolabeled microspheres (15 micron), which were injected into the left atrium 5 minutes prior to sacrifice. Multiple subendocardial tissue samples from the left ventricular free wall were obtained for measurement of magnetic relaxation times, percent water content and tissue radioactivity. Mild, moderate, and severe ischemia were defined as reductions in myocardial blood flow to 30% to 50%, 15% to 30%, and less than or equal to 15% of control, respectively. Myocardial water content was increased with mild ischemia (79.6 +/- 0.7%), moderate ischemia (79.9 +/- 0.4%), and severe ischemia (80.3 +/- 0.6%), all P less than .005 vs. control. T1 relaxation times rose with mild (544 +/- 10 msec, P less than .005 vs. control), moderate (543 +/- 11 msec, P less than .005 vs. control), and severe ischemia (574 +/- 10 msec, P less than .001 vs. control). T2 relaxation times behaved in a similar manner, being prolonged in the mildly, moderately, and severely ischemic groups (38.3 +/- 0.3, 38.1 +/- 0.3 and 38.2 +/- 0.3 msec, respectively; all P less than .001 vs. control).(ABSTRACT TRUNCATED AT 250 WORDS)     

Quantitative assessment of myocardial T2 relaxation times in cardiac amyloidosis

Purpose

To evaluate cardiac MRI (CMR) in the diagnosis of cardiac amyloidosis by comparing the T2 relaxation times of left ventricular myocardium in a pilot patient group to a normal range established in healthy controls.

Materials and Methods

Forty‐nine patients with suspected amyloidosis‐related cardiomyopathy underwent comprehensive CMR examination, which included assessment of myocardial T2 relaxation times, ventricular function, resting myocardial perfusion, and late gadolinium enhancement (LGE) imaging. T2‐weighted basal, mid, and apical left ventricular slices were acquired in each patient using a multislice T2 magnetization preparation spiral sequence. Slice averaged T2 relaxation times were subsequently calculated offline and compared to the previously established normal range.

Results

Twelve of the 49 patients were confirmed to have cardiac amyloidosis by biopsy. There was no difference in mean T2 relaxation times between the amyloid cases and normal controls (51.3 ± 8.1 vs. 52.1 ± 3.1 msec, P = 0.63). Eleven of the 12 amyloid patients had abnormal findings by CMR, eight having LGE involving either ventricles or atria and four demonstrating resting subendocardial perfusion defects.

Conclusion

CMR is a potentially valuable tool in the diagnosis of cardiac amyloidosis. However, calculation of myocardial T2 relaxation times does not appear useful in distinguishing areas of amyloid deposition from normal myocardium. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.     

T1rho MR imaging of the human wrist in vivo

RATIONALE AND OBJECTIVES: The purpose of this study was (a) to demonstrate the feasibility of computing T1rho maps of, and T1rho dispersion in, human wrist cartilage at MR imaging in vivo and (b) to compare T1rho and T2 weighting in terms of magnitude of relaxation times and signal intensity contrast. MATERIALS AND METHODS: T2 and T1rho magnetic resonance images of wrist joints in healthy volunteers (n = 5) were obtained with a spin-echo sequence and a fast spin-echo sequence pre-encoded with a spin-lock pulse cluster. A 1.5-T clinical imager was used (Signa; GE Medical Systems, Milwaukee, Wis) with a 9.5-cm-diameter transmit-receive quadrature birdcage coil tuned to 63.75 MHz. RESULTS: T1rho relaxation times at a spin-lock frequency of 500 Hz vary from 40.5 msec +/- 0.85 to 56.6 msec +/- 4.83, and T2 relaxation times vary from 28.1 msec +/- 1.88 to 34.5 msec +/- 2.63 (mean +/- standard error of the mean, n = 5, P < .016) in various regions of the wrist. T1rho dispersion was observed in the range of spin-lock frequencies studied. T1rho-weighted images not only have higher signal-to-noise ratios but also show better fluid and fat signal suppression than T2-weighted images. CONCLUSION: It was possible to perform T2- and T1rho-weighted MR imaging of human wrist cartilage in vivo with standard clinical imagers. The higher signal-to-noise ratio and improved contrast between cartilage and surrounding fat achieved with T1rho imaging may provide better definition of lesions and accurate quantitation of small changes in cartilage degeneration.     

Coronary MR imaging: breath-hold capability and patterns, coronary artery rest periods, and beta-blocker use

PURPOSE: To prospectively evaluate breath-hold capability and patterns, coronary artery rest periods, and beta-blocker use in coronary magnetic resonance (MR) imaging. MATERIALS AND METHODS: Ethics committee approval and informed consent were obtained. In 210 consecutive patients (mean age, 61.8 years +/- 10.3 [standard deviation]; 146 men, 64 women), breath-hold patterns and maximal capability were assessed at expiration with dynamic navigator MR imaging (temporal resolution, 1 second). Left coronary artery (LCA) and right coronary artery (RCA) rest periods were determined at transverse cine imaging (steady-state free precession, retrospective gating, 40 phases per cycle). Before and after beta-blockade, rest periods were assessed in 25 additional patients (mean age, 61.4 years +/- 7.1; 20 men, five women). Differences were tested within groups with paired Student t test and between groups with unpaired Student t test (continuous variables) and chi(2) test (categoric variables). Pearson correlation was used to test the relationship between rest period and heart rate. RESULTS: Four distinct breath-hold patterns, characterized by diaphragmatic motion, were identified: pattern 1, steady plateau (55% of patients); 2, initial drift followed by plateau (12%); 3, continuous drift (19%); and 4, irregular, unsteady behavior (14%). Mean breath-hold capability with patterns 1 and 2 was 29 seconds +/- 13 (range, 10-64 seconds). The rest period of LCA was longer than that of RCA (163 msec +/- 75 vs 123 msec +/- 60; P < .01) and began earlier in the cardiac cycle (521 msec +/- 149 vs 540 msec +/- 160; P < .01); In a minority of patients, LCA rest period began later (21%) or was shorter (14%). With no pharmacologic intervention, correlation between rest period duration and heart rate was weak (LCA, r = -0.52; RCA, r = -0.38; P < .01). However, beta-blockade significantly lowered heart rate (61.3 beats/min +/- 7.2 vs 82.6 beats/min +/- 12.5, P < .001) and increased rest duration (LCA, 201.8 msec +/- 83.6 vs 111.8 msec +/- 44.55; RCA, 134.8 msec +/- 57.3 vs 83.1 msec +/- 35.8; P < .001). CONCLUSION: In 33% of patients (patterns 3 and 4), breath-hold pattern was unsuitable for high-spatial-resolution breath-hold MR imaging. LCA and RCA rest periods showed large variability in starting point and duration, with no correlation to heart rate.     

Whole-brain T1 mapping in multiple sclerosis: global changes of normal-appearing gray and white matter

PURPOSE: To prospectively investigate whether T1 changes in normal-appearing white matter (WM) and normal-appearing gray matter (GM) in multiple sclerosis (MS) are global or regional and their relationship to disease type. MATERIALS AND METHODS: The institutional ethics review board approved study; written informed consent was obtained. Whole-brain T1 maps were obtained in 67 patients with MS and 24 healthy control subjects with three-dimensional fast low-angle shot flip angle-array method, with correction for B(1) imperfections. Analysis of variance was performed on T1 histogram parameters of global normal-appearing WM and GM. Regional mean T1 values were analyzed with a multilevel approach. Multiple linear regression analysis was performed to investigate associations with clinical disability and overall atrophy. For patients, T2 lesion load was determined. RESULTS: T1 histograms of normal-appearing WM had significantly higher peak positions for patients with MS (792 msec +/- 36 in secondary progressive [SP] MS) than for control subjects (746 msec +/- 23) and were significantly broader and lower (all P < .001). Histograms for cortical normal-appearing GM were significantly shifted (peak positions, 1263 msec +/- 44 in control subjects and 1355 msec +/- 62 in patients with SP MS) (P < .001). Histogram peak positions were significantly higher in SP MS than in relapsing-remitting (RR) and primary progressive MS (P < .05). In SP disease, at least 31% of normal-appearing WM and 20% of cortical normal-appearing GM were affected. In MS, T1 was significantly elevated in all normal-appearing WM and cortical normal-appearing GM regions (all P < .01) but was elevated only in the thalamus in deep GM (P < .05). Cortical T1 histogram peak position was associated with clinical disability; T2 lesion load was not. CONCLUSION: Results suggest that a global disease process affects large parts of both normal-appearing WM and GM in MS and effects are worse for SP MS than for RR MS.