Pulse sequence and timing of contrast‐enhanced MRI for assessing blood–brain barrier disruption after transcranial focused ultrasound in the presence of hemorrhage

Purpose:

To optimize the timing of contrast‐enhanced magnetic resonance imaging (MRI) that best indicates blood–brain barrier (BBB) disruption induced by focused ultrasound (FUS) along with an ultrasound contrast agent (UCA) and to verify that the contrast‐enhanced spin‐echo MRI sequence can indicate the degree and location of BBB disruption in the presence of hemorrhage better than a gradient‐echo sequence.

Materials and Methods:

Sonication was applied to 12 rat brains with four different doses of UCA to cause variable degrees of hemorrhage. Two imaging sequences were performed to acquire T1‐weighted (T1W) images at two time‐points after the administration of a T1‐shortening contrast agent. The contrast enhancement at the sonicated regions was quantified and correlated against Evans blue (EB) staining.

Results:

The spin‐echo T1W images at 10 minutes post–contrast enhancement showed the best correlation with EB staining in both quantity of EB extravasation (r = 0.812; P < 0.01) and spatial distribution (r = 0.528, P < 0.01). This capability was more robust than the gradient‐echo sequence.

Conclusion:

Our results suggest that contrast‐enhanced T1W spin‐echo sequence acquired in the early phase post–contrast enhancement should be considered to monitor the degree and location of BBB disruption under the possibility of hemorrhage induced by FUS. J. Magn. Reson. Imaging 2010;31:1323–1330. © 2010 Wiley‐Liss, Inc.     

Association between contrast‐enhanced MR images and blood–brain barrier disruption following transcranial focused ultrasound

Purpose:

To investigate the correlation between the contrast‐enhanced magnetic resonance imaging (MRI) signal and the duration of blood–brain barrier (BBB) disruption induced by focused ultrasound (FUS).

Materials and Methods:

FUS was applied to 45 rat brains in the presence of microbubbles, and these rats were scanned on a 3T MRI system at several timepoints. The rat brains were then studied using contrast‐enhanced spin echo T1‐weighted images. At the same time, BBB disruption was evaluated based on Evans blue (EB) extravasation. The relationship between the normalized signal intensity change of the MRI and EB extravasation was analyzed by least‐squares linear regression and the calculation of correlation coefficients.

Results:

When MRI enhancement was quantitatively evaluated by EB extravasation, a strong correlation between the normalized signal intensity change of the MRI and EB extravasation was identified during BBB disruption after sonication. However, the correlation coefficient decreased as BBB closure occurred after sonication ended.

Conclusion:

The contrast‐enhanced MRI signal can potentially be used to evaluate the amount of chemotherapeutic agents entering the targeted tissue, but the accuracy of the assessment will be affected by the time interval since sonication. J. Magn. Reson. Imaging 2010;32:593–599. © 2010 Wiley‐Liss, Inc.     

Fast T2*-weighted MRI of the prostate at 3 Tesla

Purpose:

To describe a rapid T2*‐weighted (T2*W), three‐dimensional (3D) echo planar imaging (EPI) sequence and its application in mapping local magnetic susceptibility variations in 3 Tesla (T) prostate MRI. To compare the sensitivity of T2*W EPI with routinely used T1‐weighted turbo‐spin echo sequence (T1W TSE) in detecting hemorrhage and the implications on sequences sensitive to field inhomogeneities such as MR spectroscopy (MRS).

Materials and Methods:

B₀ susceptibility weighted mapping was performed using a 3D EPI sequence featuring a 2D spatial excitation pulse with gradients of spiral k‐space trajectory. A series of 11 subjects were imaged using 3T MRI and combination endorectal (ER) and six‐channel phased array cardiac coils. T1W TSE and T2*W EPI sequences were analyzed quantitatively for hemorrhage contrast. Point resolved spectroscopy (PRESS MRS) was performed and data quality was analyzed.

Results:

Two types of susceptibility variation were identified: hemorrhagic and nonhemorrhagic T2*W‐positive areas. Post‐biopsy hemorrhage lesions showed on average five times greater contrast on the T2*W images than T1W TSE images. Six nonhemorrhage regions of severe susceptibility artifact were apparent on the T2*W images that were not seen on standard T1W or T2W images. All nonhemorrhagic susceptibility artifact regions demonstrated compromised spectral quality on 3D MRS.

Conclusion:

The fast T2*W EPI sequence identifies hemorrhagic and nonhemorrhagic areas of susceptibility variation that may be helpful in prostate MRI planning at 3.0T. J. Magn. Reson. Imaging 2011;33:902–907. © 2011 Wiley‐Liss, Inc.     

Differentiation of well‐differentiated hepatocellular carcinomas from other hepatocellular nodules in cirrhotic liver: Value of SPIO‐enhanced MR imaging at 3.0 Tesla

Purpose

To determine the diagnostic value of superparamagnetic iron oxide (SPIO)‐enhanced MRI for the differentiation of well‐differentiated hepatocellular carcinomas (WD‐HCCs) from other hepatocellular nodules in cirrhotic liver.

Materials and Methods

This study included 114 patients with 216 histologically confirmed hepatocellular nodules, i.e., 23 dysplastic nodules (DNs), 37 WD‐HCCs, and 156 moderately or poorly differentiated HCCs (MD‐/PD HCCs), who underwent SPIO‐enhanced MRI at 3.0T. MRI included T2‐weighted fast‐spin echo and T2*‐weighted gradient recalled echo (GRE) sequences before and after administration of ferucarbotran. The contrast‐to‐noise ratio (CNR) of the lesion was calculated. Reviewers analyzed signal intensity (SI) of the nodules and their enhancement features on SPIO‐enhanced images. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the diagnosis of WD‐HCC were also calculated.

Results

The mean CNR of WD‐HCC was significantly higher than that of DN on T2*‐weighted image. Incomplete high SI on SPIO‐enhanced T2*‐weighted images were seen in 56.8% of WD‐HCC. The most prevalent enhancement features of WD‐HCCs on SPIO‐enhanced T2*‐weighted images, were iso SI with high SI foci [32.5% (12/37)] and homogenous subtle high SI [24.3% (9/37)]. Alternatively, 22 of 23 DNs (95.7%) showed low‐ or iso SI, and 145 of 156 (94.9%) MD‐/PD HCCs showed strong high SI. When iso SI with high SI foci or subtle homogenous high SI nodule was considered as diagnostic criteria for WD‐HCC, we could identify 56.8% of the WD‐HCCs but only 4.4% of the DNs and 3.2% of the MD‐/PD HCCs.

Conclusion

WD‐HCCs have characteristic enhancement features that differentiate them from DNs and MD‐/PD HCCs on SPIO‐enhanced 3.0T MRI. The lesion conspicuity was better on T2*‐weighted images than that on T2‐weighted images. J. Magn. Reson. Imaging 2009;29:328–335. © 2009 Wiley‐Liss, Inc.     

Detecting blood–brain barrier disruption within minimal hemorrhage following transcranial focused ultrasound: A correlation study with contrast‐enhanced MRI

Focused ultrasound combined with an intravascular ultrasound contrast agent can induce transient disruption of the blood–brain barrier, and the blood–brain barrier disruption can be detected by contrast‐enhanced MRI. There is, however, no study investigating the ability of various MR methods to detect focused ultrasound–induced blood–brain barrier disruption within minimal hemorrhage. Sonication was applied to 15 rat brains with four different doses of ultrasound contrast agent (0, 10, 30, or 50 μL/kg), and contrast‐enhanced T1‐weighted spin echo, gradient echo images, and longitudinal relaxation rate mapping along with effective transverse relaxation time–weighted and susceptibility‐weighted images were acquired. Volume‐of‐interest–based and threshold‐based analyses were performed to quantify the contrast enhancement, which was then correlated with the ultrasound contrast agent dose and with the amount of Evans blue extravasation. Both effective transverse relaxation time–weighted and susceptibility‐weighted images did not detect histology‐proved intracranial hemorrhage at 10 μL/kg, but MRI failed to detect mild intracranial hemorrhage at 30 μL/kg. All tested sequences showed detectable contrast enhancement increasing with ultrasound contrast agent dose. In correlating with Evans blue extravasation, the gradient echo sequence was slightly better than the spin echo sequence and was comparable to longitudinal relaxation rate mapping. In conclusion, both gradient echo and spin echo sequences were all reliable in indicating the degree of focused ultrasound–induced blood–brain barrier disruption within minimal hemorrhage. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.     

T2*-weighted MR angiography substantially increases the detection of hemorrhage in the wall of brain abscess: implications in clinical interpretation

Introduction

The purpose of the present study was to identify the true prevalence of hemorrhage in the abscess using T2*-weighted angiography (SWAN) imaging and to study its influence on diffusion tensor imaging (DTI) metrics.

Methods

Fifteen patients of brain abscess underwent conventional, SWAN, and DT imaging on a 3-T MRI followed by its confirmation with histology. DTI metrics were quantified by region-of-interest analysis on hemorrhagic and non-hemorrhagic regions of the abscess wall. Prussian blue staining was performed on excised abscess walls to confirm hemorrhage on histology.

Results

Eleven of 15 patients showed evidence of hemorrhage on both Prussian blue staining as well as SWAN imaging. Fractional anisotropy (FA) and linear anisotropy (CL) values were significantly higher, while spherical anisotropy was significantly lower in hemorrhagic compared to non-hemorrhagic regions of the abscess wall.

Conclusion

Hemorrhage in the abscess wall is a common feature and may not always indicate neoplasm. The presence of intracellular iron in addition to concentrically laid collagen fibers may have synergistic effect on FA and CL values in the abscess wall. Inclusion of SWAN to MRI protocol will define the true prevalence of hemorrhage in brain abscess.     

In vivo MR quantification of superparamagnetic iron oxide nanoparticle leakage during low-frequency-ultrasound-induced blood-brain barrier opening in swine

Purpose:

To verify that low‐frequency planar ultrasound can be used to disrupt the BBB in large animals, and the usefulness of MRI to quantitatively monitor the delivery of superparamagnetic iron oxide (SPIO) nanoparticles into the disrupted regions.

Materials and Methods:

Two groups of swine subjected to craniotomy were sonicated with burst lengths of 30 or 100 ms, and one group of experiment was also performed to confirm the ability of 28‐kHz sonication to open the BBB transcranially. SPIO nanoparticles were administered to the animals after BBB disruption. Procedures were monitored by MRI; SPIO concentrations were estimated by relaxivity mapping.

Results:

Sonication for 30 ms created shallow disruptions near the probe tip; 100‐ms sonications after craniotomy can create larger and more penetrating openings, increasing SPIO leakage ～3.6‐fold than 30‐ms sonications. However, this was accompanied by off‐target effects possibly caused by ultrasonic wave reflection. SPIO concentrations estimated from transverse relaxation rate maps correlated well with direct measurements of SPIO concentration by optical emission spectrometry. We have also shown that transcranial low‐frequency 28‐kHz sonication can induce secure BBB opening from longitudinal MR image follow up to 7 days.

Conclusion:

This study provides valuable information regarding the use low‐frequency ultrasound for BBB disruption and suggest that SPIO nanoparticles has the potential to serve as a thernostic agent in MRI‐guided ultrasound‐enhanced brain drug delivery. J. Magn. Reson. Imaging 2011;. © 2011 Wiley Periodicals, Inc.     

Low‐intensity pulsed ultrasound increases cellular uptake of superparamagnetic iron oxide nanomaterial: Results from human osteosarcoma cell line U2OS

Purpose:

To determine whether low‐intensity pulsed ultrasound (LIPUS) is able to facilitate the uptake of a superparamagnetic iron oxide (SPIO) nanomaterial by cells that do not express high endocytosis capacity.

Materials and Methods:

The human osteosarcoma cell line U2OS and a silica‐coated SPIO functionalized peripherally with amines groups (overall diameter 8 nm) were used in this study. Adherent U2OS cells were labeled with SPIO by incubating with culture media containing the SPIO at 4.5 μg[Fe]/mL. LIPUS with the same parameters as those used in clinical application to accelerate bone fracture healing (1.5 MHz, duty cycle 1:4, spatial‐average temporal‐average intensity 30 mW/cm²) was applied to the cells at the beginning of the labeling process for 0, 0.5, 1, or 3 hours. The total incubation time with SPIO was 12 hours. SPIO labeling efficiency was evaluated with Prussian blue staining and a blueness measurement method, and magnetic resonance imaging (MRI) of cell pellets via measuring areas of SPIO‐induced signal void.

Results:

Both Prussian blue staining and in vitro MRI demonstrated that LIPUS application increased the SPIO nanomaterial labeling efficiency for U2OS cells in an exposure‐duration‐dependent manner.

Conclusion:

This study is a “proof of concept” that LIPUS can facilitate the cellular take‐up of SPIO nanomaterial. J. Magn. Reson. Imaging 2010;31:1508–1513. © 2010 Wiley‐Liss, Inc.     

Comparison of ferucarbotran‐enhanced fluid‐attenuated inversion‐recovery echo‐planar,T2‐weighted turbo spin‐echo,T2*‐weighted gradient‐echo,and diffusion‐weighted echo‐planar imaging for detection of malignant liver lesions

Purpose:

To compare the diagnostic accuracy of superparamagnetic iron oxide (SPIO)‐enhanced fluid‐attenuated inversion‐recovery echo‐planar imaging (FLAIR EPI) for malignant liver tumors with that of T2‐weighted turbo spin‐echo (TSE), T2*‐weighted gradient‐echo (GRE), and diffusion‐weighted echo‐planar imaging (DW EPI).

Materials and Methods:

SPIO‐enhanced magnetic resonance imaging (MRI) that included FLAIR EPI, T2‐weighted TSE, T2*‐weighted GRE, and DW EPI sequences was performed using a 3 T system in 54 consecutive patients who underwent surgical exploration with intraoperative ultrasonography. A total of 88 malignant liver tumors were evaluated. Images were reviewed independently by two blinded observers who used a 5‐point confidence scale to identify lesions. Results were correlated with results of histopathologic findings and surgical exploration with intraoperative ultrasonography. The accuracy of each MRI sequence was measured with jackknife alternative free‐response receiver operating characteristic analysis. The sensitivity of each observer with each MRI sequence was compared with McNemar's test.

Results:

Accuracy values were significantly higher with FLAIR EPI sequence (0.93) than with T2*‐weighted GRE (0.80) or DW EPI sequences (0.80) (P < 0.05). Sensitivity was significantly higher with the FLAIR EPI sequence than with any of the other sequences.

Conclusion:

SPIO‐enhanced FLAIR EPI sequence was more accurate in the diagnosis of malignant liver tumors than T2*‐weighted GRE and DW EPI sequences. SPIO‐enhanced FLAIR EPI sequence is helpful for the detection of malignant liver tumors. J. Magn. Reson. Imaging 2010;31:607–616. ©2010 Wiley‐Liss, Inc.     

Effect of superparamagnetic iron oxide on tumor‐to‐liver contrast at T2*‐weighted gradient‐echo MRI: Comparison between 3.0T and 1.5T MR systems

Purpose

To compare 3.0T and 1.5T MR systems in terms of the effect of superparamagnetic iron oxide (SPIO) on tumor‐to‐liver contrast in T2*‐weighted gradient‐echo MRI.

Materials and Methods

SPIO‐enhanced gradient‐echo MR images of the liver with four different TEs (3, 5.3, 6.5, and 8.5 msec) were obtained by means of 1.5T and 3.0T systems. Quantitative analyses of relative signal intensities (SIs) and relative tumor contrast and qualitative analyses of image quality and lesion conspicuity of the liver were performed in 22 patients, 16 of whom had malignant liver tumors.

Results

With both 1.5T and 3.0T, at TE = 8.4 msec, the relative SI of liver and relative tumor contrast were significantly (P < 0.01) lower and higher, respectively, than that for any of the other TEs. There were no significant differences in the relative SI of the liver, relative tumor contrast, image quality, and tumor conspicuity for the same TE between the 1.5T and 3.0T systems.

Conclusion

Our results showed that the effect of SPIO on tumor‐to‐liver contrast at T2*‐weighted gradient‐echo imaging was similar for the 1.5T and 3.0T systems, and that the 8.4‐msec TE was optimal of the four TEs used in this study at 3.0T. J. Magn. Reson. Imaging 2009;29:595–600. © 2009 Wiley‐Liss, Inc.     

Quantitative micro-SPECT/CT for detecting focused ultrasound-induced blood–brain barrier opening in the rat

IntroductionFocused ultrasound has been discovered to be able to locally and reversibly increase the permeability of the blood–brain barrier (BBB). The purpose of this study was to investigate the feasibility of micro-single photon emission computed tomography/ computed tomography (micro-SPECT/CT) and 99mTc diethylenetriamine pentaacetate (99mTc-DTPA) for identifying disruption of the BBB induced by focused ultrasound in a rat model. We also assessed the amount of radiotracer that had crossed the BBB using various intensity levels of ultrasound energy.MethodsImmediately after sonication, three Sprague–Dawley rats were scanned for 2 h to determine the optimum time for data acquisition. Static SPECT with 1.5-h acquisition time was then performed in 12 rats sonicated with focused ultrasound pressure amplitudes of 0.78–2.45 MPa. Radiotracer and blue dye were used for lesion delineation. SPECT images were evaluated quantitatively and compared to results of histology and autoradiography. Terminal deoxynucleotidyl transferase biotin-desoxyuridine 5'-triphosphate (dUTP) nick end labeling staining was used to examine hemorrhage and tissue damage.ResultsThe disruption to nondisruption radioactivity ratio showed a gradual increase from dynamic SPECT images, reaching a peak at 1.5 h post injection. The extent and intensity of radioactivity showed a good correlation with autoradiographic distribution and blue dye staining. SPECT measures correlated significantly with quantitative autoradiographic results (r²=0.90). According to SPECT findings, high acoustic powers allowed the delivery of larger amounts of radiotracer [0.001±0.002%ID (percent injected dose) under 0.78 MPa vs. 0.036±0.022%ID under 2.45 MPa]. Brain hemorrhage and tissue damage occurred at pressure amplitudes higher than 1.9 MPa.ConclusionsOur data demonstrate the usefulness of ^99mTc-DTPA micro-SPECT/CT for detecting focused ultrasound-induced BBB disruption in the rat. This method may be used in vivo in combination with quantitative analysis for evaluating the amount of BBB opening.     

Detection of hepatocellular carcinoma (HCC) using super paramagnetic iron oxide (SPIO)‐enhanced MRI: Added value of diffusion‐weighted imaging (DWI)

Purpose:

To evaluate whether diffusion‐weighted imaging (DWI) improves the detection of hepatocellular carcinoma (HCC) on super paramagnetic iron oxide (SPIO)‐enhanced MRI.

Materials and Methods:

This retrospective study group consisted of 30 patients with 50 HCC nodules who underwent MRI at 1.5 Tesla. Two combined MR sequence sets were compared for detecting HCC: SPIO‐enhanced MRI (axial T2‐weighted fast spin‐echo (FSE) and T1‐/T2*‐weighted fast field echo (FFE) scanned before and after administration of ferucarbotran) and SPIO‐enhanced MRI + DWI (SPIO‐enhanced MRI with axial DWI scanned before and after administration of ferucarbotran). Three blinded readers independently reviewed for the presence of HCC on a segment‐by‐segment basis using a four‐point confidence scale. The performance of the two combined MR sequence sets was evaluated using receiver operating characteristic (ROC) analysis.

Results:

The average area under the ROC curve (Az) of the three readers for the SPIO‐enhanced MRI + DWI set (0.870 ± 0.046) was significantly higher that that for the SPIO‐enhanced MRI set (0.820 ± 0.055) (P = .025). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detection of HCC were 66.0%, 98.0%, 90.0%, and 91.4%, respectively, for the SPIO‐enhanced MRI set, and 70.0%, 98.6%, 92.9%, and 92.4%, respectively, for the SPIO‐enhanced MRI + DWI set.

Conclusion:

The SPIO‐enhanced MRI + DWI set outperformed the SPIO‐enhanced MRI set for depicting HCC. J. Magn. Reson. Imaging 2010; 31: 373–382. © 2010 Wiley‐Liss, Inc.     

Age-related regional brain T2-relaxation changes in healthy adults

Purpose:

To determine normal T2‐relaxation values from different brain areas in healthy adults, assess age‐related T2‐relaxation changes in those sites, and evaluate potential gender‐related T2‐relaxation value differences.

Materials and Methods:

We performed proton‐density and T2‐weighted imaging in 60 healthy adults (male: 38, age range = 31–64 years, mean age ± SD = 46.1 ± 9.3 years; female: 22, age range = 37–66 years, mean age ± SD = 49.5 ± 8.3 years), using a 3.0 Tesla MRI scanner. T2‐relaxation values were calculated voxel‐by‐voxel from proton‐density and T2‐weighted images, and whole‐brain T2‐relaxation maps were constructed and normalized to a common space. A set of regions‐of‐interest were outlined within the basal ganglia, limbic, frontal, parietal, temporal, occipital, thalamic, hypothalamic, cerebellar, and pontine regions using mean background images derived from normalized and averaged T2‐weighted images of all individuals, and regional T2‐relaxation values were determined from these regions‐of‐interest and normalized T2‐relaxation maps. Pearson's correlations were calculated between T2‐relaxation values and age, and male–female differences evaluated with independent‐samples t‐tests.

Results:

T2‐relaxation values typically increased with age in multiple brain sites; only a few regions showed declines, including the putamen and ventral pons. Sex‐related differences in T2‐relaxation values appeared in basal ganglia, frontal, temporal, occipital, and cerebellar regions; males showed higher values over females in these sites.

Conclusion:

Establishment of normative adult T2‐relaxation values over different brain areas, with age and sex as co‐factors, offers baseline values against which disease‐related tissue changes can be assessed. J. Magn. Reson. Imaging 2012;300‐308. © 2011 Wiley Periodicals, Inc.     

A quantitative pressure and microbubble‐size dependence study of focused ultrasound‐induced blood‐brain barrier opening reversibility in vivo using MRI

Focused ultrasound in conjunction with the systemic administration of microbubbles has been shown to open the blood‐brain barrier (BBB) selectively, noninvasively and reversibly. In this study, we investigate the dependence of the BBB opening's reversibility on the peak‐rarefactional pressure (0.30–0.60 MPa) as well as the microbubble size (diameters of 1–2, 4–5, or 6–8 μm) in mice using contrast‐enhanced T₁‐weighted (CE‐T₁) MR images (9.4 T). Volumetric measurements of the diffusion of Gd‐DTPA‐BMA into the brain parenchyma were used for the quantification of the BBB‐opened region on the day of sonication and up to 5 days thereafter. The volume of opening was found to increase with both pressure and microbubble diameter. The duration required for closing was found to be proportional to the volume of opening on the day of opening, and ranged from 24 h, for the smaller microbubbles, to 5 days at high peak‐rarefactional pressures. Overall, larger bubbles did not show significant differences. Also, the extent of BBB opening decreased radially towards the focal region until the BBB's integrity was restored. In the cases where histological damage was detected, it was found to be highly correlated with hyperintensity on the precontrast T₁ images. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.     

Prostate cancer vs. post‐biopsy hemorrhage: Diagnosis with T2‐ and diffusion‐weighted imaging

Purpose:

To assess the value of quantitative T2 signal intensity (SI) and apparent diffusion coefficient (ADC) to differentiate prostate cancer from post‐biopsy hemorrhage, using prostatectomy as the reference.

Materials and Methods:

Forty‐five men with prostate cancer underwent prostate magnetic resonance imaging (MRI), including axial T1‐weighted imaging (T1WI), T2WI, and single‐shot echo‐planar image (SS EPI) diffusion‐weighted imaging. Two observers measured, in consensus, normalized T2 signal intensity (SI) (nT2, relative to muscle T2 SI), ADC, and normalized ADC (nADC, relative to urine ADC) on peripheral zone (PZ) tumors, benign PZ hemorrhage, and non‐hemorrhagic benign PZ. Tumor maps from prostatectomy were used as the reference. Mixed model analysis of variance was performed to compare parameters among the three tissue classes, and Pearson's correlation coefficient was utilized to assess correlation between parameters and tumor size and Gleason score. Receiver‐operating characteristic (ROC)‐curve analysis was used to determine the performance of nT2, ADC, and nADC for diagnosis of prostate cancer.

Results:

nT2, ADC, and nADC were significantly lower in tumor compared with hemorrhagic and non‐hemorrhagic benign PZ (P < 0.0001). There was a weak but significant correlation between ADC and Gleason score (r = ?0.30, P = 0.0119), and between ADC and tumor size (r = ?0.40, P = 0.0027), whereas there was no correlation between nT2 and Gleason score and tumor size. The areas under the curve to distinguish tumor from benign hemorrhagic and non‐hemorrhagic PZ were 0.97, 0.96, and 0.933 for nT2, ADC, and nADC, respectively.

Conclusion:

Quantitative T2 SI and ADC/nADC values may be used to reliably distinguish prostate cancer from post‐biopsy hemorrhage. J. Magn. Reson. Imaging 2010;31:1387–1394. © 2010 Wiley‐Liss, Inc.

     

MR imaging findings of small bowel hemorrhage: Two cases of mural involvement and one of perimural

Purpose

To demonstrate the MR appearance of small bowel wall hemorrhage.

Materials and Methods

A search was performed of the clinical information system (CIS) and the abdominal MRI databases of our institution for patients diagnosed with bowel hemorrhage on MRI between January 1, 2000, and July 31, 2008. All patients were imaged using a protocol that included noncontrast T1‐ and T2‐weighted images and postgadolinium gradient echo images.

Results

Two male patients, 44 and 55 years of age, were identified with small bowel mural hemorrhage, one in the duodenum and one in the jejunum. A third patient, a 66‐year‐old man, was identified with perimural hematoma. The following imaging features were observed: for mural hemorrhage, mural‐based increased signal intensity (SI) in the bowel wall on fat suppressed T1‐weighted images, variable increased SI on T2‐weighted images and no appreciable enhancement on the postcontrast T1‐weighted image; perimural hemorrhage exhibited normal thickness low SI wall on T2‐weighted single shot images, with ill‐defined material surrounding the bowel. SI features of this material, was similar to mural‐based abnormality.

Conclusion

In two patients with small bowel wall hemorrhage, the wall showed increased thickness with increased SI on noncontrast T1‐weighted images and lack of enhancement on postgadolinium images. Perimural hematoma showed an intact normal thickness wall that was low SI on T2 with surrounding material that was high SI on noncontrast T1‐weighted images and did not enhance. J. Magn. Reson. Imaging 2009;29:1185–1189. © 2009 Wiley‐Liss, Inc.     

Evaluation of pressure‐driven brain infusions in nonhuman primates by intra‐operative 7 tesla MRI

Purpose:

To characterize the effects of pressure‐driven brain infusions using high field intra‐operative MRI. Understanding these effects is critical for upcoming neurodegeneration and oncology trials using convection‐enhanced delivery (CED) to achieve large drug distributions with minimal off‐target exposure.

Materials and Methods:

High‐resolution T2‐weighted and diffusion‐tensor images were acquired serially on a 7 Tesla MRI scanner during six CED infusions in nonhuman primates. The images were used to evaluate the size, distribution, diffusivity, and temporal dynamics of the infusions.

Results:

The infusion distribution had high contrast in the T2‐weighted images. Diffusion tensor images showed the infusion increased diffusivity, reduced tortuosity, and reduced anisotropy. These results suggested CED caused an increase in the extracellular space.

Conclusion:

High‐field intra‐operative MRI can be used to monitor the distribution of infusate and changes in the geometry of the brain's porous matrix. These techniques could be used to optimize the effectiveness of pressure‐driven drug delivery to the brain. J. Magn. Reson. Imaging 2012; 36:1339–1346. © 2012 Wiley Periodicals, Inc.     

Reliability of two techniques for assessing cerebral iron deposits with structural magnetic resonance imaging

Purpose

To test the reliability of two computational methods for segmenting cerebral iron deposits (IDs) in the aging brain, given that its measurement in magnetic resonance imaging (MRI) is challenging due to the similar effect produced by other minerals, especially calcium, on T2*‐weighted sequences.

Materials and Methods

T1‐, T2*‐weighted, and fluid‐attenuated inversion recovery (FLAIR) MR brain images obtained at 1.5T from 70 subjects in their early 70s who displayed a wide range of brain IDs were analyzed. The first segmentation method used a multispectral approach based on the fusion of two or more structural sequences registered and mapped in the red/green color space followed by Minimum Variance Quantization. The second method employed a combined thresholding, size and shape analysis using T2*‐weighted images augmented with visual information from T1‐weighted data.

Results

Both segmentation techniques had high intra‐ and interobserver agreement (95% confidence interval [CI] = ± 57 voxels in a range from 0 to 1800), which decreased in subjects with significant microbleeds and/or IDs. However, the thresholding method was more observer dependent in identifying microbleeds and IDs boundaries than the multispectral approach.

Conclusion

Both techniques proved to be in agreement and have good intra‐ and interobserver reliability. However, they have limitations, specifically with regard to automation and observer independence, so further work is required to develop fully user‐independent methods of identifying cerebral IDs. J. Magn. Reson. Imaging 2011;33:54–61. © 2010 Wiley‐Liss, Inc.     

Visualization of cerebral microbleeds with dual‐echo T2*‐weighted magnetic resonance imaging at 7.0 T

Purpose:

To assess the visualization of cerebral microbleeds with dual echo T2*‐weighted imaging at 7.0 T magnetic resonance imaging (MRI).

Materials and Methods:

Ten consecutive participants (eight men, two women, mean age 54 ± 12 years) with vascular disease or risk factors from the second manifestations of arterial disease (SMART) study were included. Dual‐echo T2*‐weighted scans (echo time: 2.5/15.0 msec) were made for all participants at 7.0 T MRI. The number of visible microbleeds and the diameter of the microbleeds were recorded on minimal intensity projection images of both echoes.

Results:

The first echo image shows dark microbleeds against a homogeneous, more hyperintense signal of the brain tissue without contrast for veins and basal ganglia. In eight patients microbleeds were observed, with a total of 104 microbleeds. Of these, 88 (84.6%) were visible on the first and 102 (98.0%) on the second echo. The mean diameter of the microbleeds was 1.24 mm for the first echo and 2.34 mm for the second echo.

Conclusion:

T2*‐weighted imaging at two echo times at 7.0 T combines the advantages of the first and second echo. Microbleeds visible on the first echo show large contrast with the surrounding tissue, even in the presence of paramagnetic ferritin. The second echo enables visualization of smaller microbleeds than the first echo. J. Magn. Reson. Imaging 2010;32:52–59. © 2010 Wiley‐Liss, Inc.     

Detection of hypoxic-ischemic brain injury with 3D-enhanced T2* weighted angiography (ESWAN) imaging

Objective

To demonstrate the use of 3D-enhanced T2* weighted angiography (ESWAN) imaging for the observation and quantification of the evolution of brain injury induced by a recently developed model of hypoxic-ischemic brain injury (HI/R) in neonatal piglets.

Methods

For these experiments, newborn piglets were subjected to HI/R injury, during which ESWAN scanning was performed, followed by H&E staining and immunohistochemistry of AQP-4 expression.

Results

In the striatum, values from T2* weighted magnetic resonance imaging (MRI) increased and reached their highest level at 3 days post injury, whereas T2* values increased and peaked at 24 h in the subcortical region. The change in T2* values was concordant with brain edema. Phase values in the subcortical border region were not dependent on time post-injury. Magnitude values were significantly different from the control group, and increased gradually over time in the subcortical border region. Susceptibility-weighted images (SWI) indicated small petechial hemorrhages in the striatum and thalamus, as well as dilated intramedullary veins.

Conclusion

SWI images can be used to detect white and gray matter microhemorrhages and dilated intramedullary veins. The T2*, phase, and magnitude map can also reflect the development of brain injury. Our data illustrate that ESWAN imaging can increase the diagnostic sensitivity and specificity of MRI in neonatal hypoxic-ischemic encephalopathy.