On using T2 to assess extrinsic magnetic field inhomogeneity effects on T2* measurements in myocardial siderosis in thalassemia

Magnetic resonance T₂* has been validated as a noninvasive means of assessing myocardial iron overload. However, the effect on myocardial T₂* of factors such as shimming, variations in capillary geometry, and susceptibility in relation to the effects of iron has not been fully clarified. Since T₂ is not affected by extrinsic magnetic field inhomogeneity and has different sensitivity to capillary geometry, investigation into the in vivo relationship between myocardial T₂* and T₂ measurements can shed light on this important issue. This study was performed in 136 thalassemia patients. The myocardial T₂ and T₂* thresholds for normality created identical no‐iron‐overload and iron‐overloaded patient groups. In the no‐iron group, there was no correlation between myocardial T₂ and T₂*. In the iron‐overloaded patients, there was a linear correlation (R² = 0.89) between myocardial T₂* and T₂ measurements, which indicates that the iron deposition is the dominant factor in determining these two relaxation values in this scenario. Magn Reson Med, 2009. © 2008 Wiley‐Liss, Inc.     

On the theoretical basis of perfusion measurements by dynamic susceptibility contrast MRI.

A quantitative analysis was undertaken to calibrate the perfusion quantification technique based on tracking the first pass of a bolus of a blood pool contrast agent. A complete simulation of the bolus passage, of the associated changes in the T2 and T2* signals, and of the data processing was performed using the tracer dilution theory, an analytical theory of the MR signal from living tissues and numerical simulations. The noise was excluded in the simulation in order to analyze the ultimate accuracy of the method. It is demonstrated that the relationship between the contrast agent concentration and the associated changes in the transverse relaxation rate shows essentially different forms in studied tissue and in the reference artery. This effect results in systematic deviations of the measured blood flow, blood volume, and the residue function obtained with conventional processing from their true values. The error depends on the microvascular composition, the properties of the contrast agent, and the weights of the various compartments in the total signal. The results show that dynamic susceptibility contrast MRI can reach the goal of absolute perfusion quantification only with additional input from measurements of the microvascular architecture. Alternatively, the method can be used to provide such information if the perfusion is quantified by another modality.     

B1-insensitive T2 preparation for improved coronary magnetic resonance angiography at 3 T.

At 3 T, the effective wavelength of the RF field is comparable to the dimension of the human body, resulting in B1 standing wave effects and extra variations in phase. This effect is accompanied by an increase in B0 field inhomogeneity compared to 1.5 T. This combination results in nonuniform magnetization preparation by the composite MLEV weighted T2 preparation (T2 Prep) sequence used for coronary magnetic resonance angiography (MRA). A new adiabatic refocusing T2 Prep sequence is presented in which the magnetization is tipped into the transverse plane with a hard RF pulse and refocused using a pair of adiabatic fast-passage RF pulses. The isochromats are subsequently returned to the longitudinal axis using a hard RF pulse. Numerical simulations predict an excellent suppression of artifacts originating from B1 inhomogeneity while achieving good contrast enhancement between coronary arteries and surrounding tissue. This was confirmed by an in vivo study, in which coronary MR angiograms were obtained without a T2 Prep, with an MLEV weighted T2 Prep and the proposed adiabatic T2 Prep. Improved quantitative and qualitative coronary MRA image measurement was achieved using the adiabatic T2 Prep at 3 T.     

Human imaging at 9.4 T using T2*‐, phase‐, and susceptibility‐weighted contrast

The effect of susceptibility differences on an MR image is known to increase with field strength. Magnetic field inhomogeneities within the voxels influence the apparent transverse relaxation time T₂*, while effects due to different precession frequencies between voxels caused by local field variations are evident in the image phase, and susceptibility‐weighted imaging highlights the veins and deep brain structures. Here, these three contrast mechanisms are examined at a field strength of 9.4 T. The T₂* maps generated allow the identification of white matter structures not visible in conventional images. Phase images with in‐plane resolutions down to 130 μm were obtained, showing high gray/white matter contrast and allowing the identification of internal cortical structures. The susceptibility‐weighted images yield excellent visibility of small venous structures and attain an in‐plane resolution of 175 μm. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.     

Precision in measurements of perfusion and microvascular permeability with T1-weighted dynamic contrast-enhanced MRI.

Dynamic contrast-enhanced MRI is used to estimate microvascular parameters by tracer kinetics analysis. The time for the contrast agent to travel from the artery to the tissue of interest (bolus arrival time (BAT)) is an important parameter that must be measured in such studies because inaccurate estimates or neglect of BAT contribute to inaccuracy in model fitting. Furthermore, although the precision with which these parameters are estimated is very important, it is rarely reported. To address these issues, two investigations were undertaken. First, simulated data were used to validate an independent method for estimation of BAT. Second, the adiabatic approximation to the tissue homogeneity model was fitted to experimental data acquired in prostate and muscle tissue of 22 patients with prostate cancer. A bootstrap error analysis was performed to estimate the precision of parameter estimates. The independent method of estimating BAT was found to be more accurate and precise than a model-fitting approach. Estimated precisions for parameters measured in the prostate gland were 14% for extraction fraction (median coefficient of variation), 19% for blood flow, 28% for permeability-surface area product, 35% for volume of the extravascular-extracellular space, and 36% for blood volume. Techniques to further reduce uncertainty are discussed.     

Characterization of T2* heterogeneity in human brain white matter

Recent in vivo MRI studies at 7.0 T have demonstrated extensive heterogeneity of T₂* relaxation in white matter of the human brain. In order to study the origin of this heterogeneity, we performed T₂* measurements at 1.5, 3.0, and 7.0 T in normal volunteers. Formalin‐fixed brain tissue specimens were also studied using T₂*‐weighted MRI, histologic staining, chemical analysis, and electron microscopy. We found that T₂* relaxation rate (R₂* = 1/T₂*) in white matter in living human brain is linearly dependent on the main magnetic field strength, and the T₂* heterogeneity in white matter observed at 7.0 T can also be detected, albeit more weakly, at 1.5 and 3.0 T. The T₂* heterogeneity exists also in white matter of the formalin‐fixed brain tissue specimens, with prominent differences between the major fiber bundles such as the cingulum (CG) and the superior corona radiata. The white matter specimen with substantial difference in T₂* has no significant difference in the total iron content, as determined by chemical analysis. On the other hand, evidence from histologic staining and electron microscopy demonstrates these tissue specimens have apparent difference in myelin content and microstructure. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Estimation of liver T*2 in transfusion‐related iron overload in patients with weighted least squares T*2 IDEAL

MRI imaging of hepatic iron overload can be achieved by estimating T₂* values using multiple‐echo sequences. The purpose of this work is to develop and clinically evaluate a weighted least squares algorithm based on T₂* Iterative Decomposition of water and fat with Echo Asymmetry and Least‐squares estimation (IDEAL) technique for volumetric estimation of hepatic T₂* in the setting of iron overload. The weighted least squares T₂* IDEAL technique improves T₂* estimation by automatically decreasing the impact of later, noise‐dominated echoes. The technique was evaluated in 37 patients with iron overload. Each patient underwent (i) a standard 2D multiple‐echo gradient echo sequence for T₂* assessment with nonlinear exponential fitting, and (ii) a 3D T₂* IDEAL technique, with and without a weighted least squares fit. Regression and Bland–Altman analysis demonstrated strong correlation between conventional 2D and T₂* IDEAL estimation. In cases of severe iron overload, T₂* IDEAL without weighted least squares reconstruction resulted in a relative overestimation of T₂* compared with weighted least squares. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

R2* imaging of transfusional iron burden at 3T and comparison with 1.5T

PURPOSE: To determine normative R2* values in the liver and heart at 3T, and establish the relationship between R2* at 3T and 1.5T over a range of tissue iron concentrations. MATERIALS AND METHODS: A total of 20 healthy control subjects and 14 transfusion-dependent patients were scanned at 1.5T and 3T. At each field strength R2* imaging was performed in the liver and heart. RESULTS: Normative R2* values in the liver were estimated from the control group to be 39.2 +/- 9.0 second(-1) at 1.5T and 69.1 +/- 21.9 second(-1) at 3T. Normative cardiac values were estimated as 23.4 +/- 2.2 second(-1) at 1.5T and 30.0 +/- 3.7 second(-1) at 3T. The combined R2* data from patients and control subjects exhibited a linear relationship between 3T and 1.5T. In the liver, the line of best fit to the 3T vs. 1.5T data had a slope of 2.00 +/- 0.06 and an intercept of -11 +/- 4 second(-1). In the heart, it had a slope of 1.88 +/- 0.14 and an intercept of -15 +/- 4 second(-1). CONCLUSION: These preliminary data suggest that the iron-dependent component of R2* scales linearly with field strength over a wide range of tissue iron concentrations. The incidence of susceptibility artifacts may, however, also increase with field strength.     

Simultaneously monitoring both T(1) and T(2)* signal intensities on a bolus injection of Gd-DTPA may distinguish infarcted myocardium

PURPOSE: To determine whether injured myocardium may be identified by simultaneously monitoring contrast-induced T(1) and T(2)* signal intensity time-course changes with an interleaved T(1)-T(2)* imaging sequence. MATERIALS AND METHODS: Gadolinium-diethylene triamine pentaacetic acid (0.05 mmol/ kg) was injected as a bolus into ex vivo pig hearts, and simultaneous T(1) and T(2)* time-courses were obtained during the first pass. RESULTS: Observing contrast-enhanced R(1) or R(2)* rates (1/T(1) or 1/T(2)* times, respectively) early after contrast injection did not fully differentiate viable from nonviable myocardium. T(2)* recovery at maximal T(1) signal intensity, measured using simultaneous T(1) and T(2)* imaging, displayed a significantly different percentage recovery (P < 0.05) among normal (30.5 +/- 2.4% of baseline value), reperfused infarcted (63 +/- 7.2%), and low-reflow infarcted (90 +/- 2.8%) myocardium. CONCLUSION: Simultaneously monitoring both T(1) and T(2)* signal intensities may help in the assessment of myocardial injury.     

Estimate of vascular permeability and cerebral blood volume using Gd-DTPA contrast enhancement and dynamic T2*-weighted MRI

PURPOSE: To develop a numerical approach for estimation of vascular permeability from dynamic T2*-weighted imaging, a technique routinely used to measure cerebral blood volume (CBV) and flow in gliomas. MATERIALS AND METHODS: This study describes a process for estimating both the gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) transvascular transfer constant and CBV from dynamic T2*-weighted images. The algorithm was applied to data from the brains of 12 patients with grade IV gliomas. The stability of the method was assessed. Estimates of CBV by this technique were compared to those of the conventional method. RESULTS: The algorithm was found to be insensitive to noise and to generate stable voxel-by-voxel estimates of permeability and CBV. CONCLUSION: Using a single imaging acquisition, the three most important vascular properties, CBV, cerebral blood flow (CBF), and permeability, can be estimated. This approach may have potential in clinical evaluation of patients with brain tumor or acute ischemic stroke.     

T2* measurement of the knee articular cartilage in osteoarthritis at 3T

Purpose:

To measure reproducibility, longitudinal and cross‐sectional differences in T2* maps at 3 Tesla (T) in the articular cartilage of the knee in subjects with osteoarthritis (OA) and healthy matched controls.

Materials and Methods:

MRI data and standing radiographs were acquired from 33 subjects with OA and 21 healthy controls matched for age and gender. Reproducibility was determined by two sessions in the same day, while longitudinal and cross‐sectional group differences used visits at baseline, 3 and 6 months. Each visit contained symptomological assessments and an MRI session consisting of high resolution three‐dimensional double‐echo‐steady‐state (DESS) and co‐registered T2* maps of the most diseased knee. A blinded reader delineated the articular cartilage on the DESS images and median T2* values were reported.

Results:

T2* values showed an intra‐visit reproducibility of 2.0% over the whole cartilage. No longitudinal effects were measured in either group over 6 months. T2* maps revealed a 5.8% longer T2* in the medial tibial cartilage and 7.6% and 6.5% shorter T2* in the patellar and lateral tibial cartilage, respectively, in OA subjects versus controls (P < 0.02).

Conclusion:

T2* mapping is a repeatable process that showed differences between the OA subject and control groups. J. Magn. Reson. Imaging 2012;35:1422–1429. © 2012 Wiley Periodicals Inc.     

增强MRI时间-信号增强率曲线对肾上腺肿瘤的鉴别价值

目的 :以肿瘤的时间 信号增强率曲线作为诊断标准 ,进一步证实Gd DTPA动态增强MRI检查技术对肾上腺肿瘤的鉴别诊断价值。方法 :3 6例共 41个肾上腺肿瘤 ,腺瘤 19例共 19个 ,非腺瘤 17例共 2 2个。所有肿瘤均先行常规SE序列T1 W和T2 W成像 ,选定肿瘤中心层面定位后 ,再利用屏气快速多层面破坏性梯度回波序列 (FMPSPGR)行轴位扫描 ,先平扫 ,再以同样条件行MRI动态增强检查 ,即静注Gd DTPA ,自注药后 0 .5min开始扫描 ,之后分别在 60min内共 17个时间点 ,以同等条件延时扫描 ,观察病变的增强程度 ,并分别测量其实质部分的信号值。计算肿瘤的信号比、最大信号增加比、增强率 ,再根据随时间延时肿瘤增强率的变化绘制曲线 ,比较肾上腺肿瘤间的时间 信号增强率曲线有无差异 ,并明确其对肾上腺肿瘤的鉴别诊断价值。结果 :Ⅰ型时间 信号增强率曲线具有高度特异性 ,只有大多数神经源性肿瘤符合此增强特点 ,对区分腺瘤与其它类型的非腺瘤无诊断价值 ;以Ⅲ型或Ⅳ型曲线为标准诊断恶性肿瘤的准确率均不高 ,有 5 0 %的恶性肿瘤无法确诊 ;而以Ⅱ型时间 信号增强率曲线为标准较前 3种曲线更有助于肾上腺肿瘤的鉴别诊断 ,即以早期增强 ,延时 9min内肿瘤增强率下降程度超过肿瘤最大增强率的 5 0 %为诊断腺瘤的标准 ,敏     

Relationship between contrast enhancement on fluid-attenuated inversion recovery MR sequences and signal intensity on T2-weighted MR images: visual evaluation of brain tumors

PURPOSE: To investigate the relationship between the degree of contrast enhancement in fluid-attenuated inversion recovery (FLAIR) sequences and tumor signal intensity on T2-weighted images. MATERIALS AND METHODS: A total of 96 patients suspected of having brain tumors were examined by MR imaging, and whenever a brain tumor with an enhancing part larger than the slice thickness was demonstrated on postcontrast T1-weighted images, postcontrast FLAIR images were additionally acquired. The tumor signal intensity on the T2-weighted images was visually classified as follows: equal or lower compared with normal cerebral cortex (group 1), higher than normal cortex (group 2), and as high as cerebrospinal fluid (CSF) (group 3). When a lesion contained several parts with different signal intensities on T2-weighted images, we assessed each part separately. In each group, we visually compared pre- and postcontrast FLAIR images and assessed whether tumor contrast enhancement was present. When contrast enhancement was present on FLAIR sequence, the degree of contrast enhancement in T1-weighted and FLAIR sequences was visually compared. RESULTS: Postcontrast T1-weighted images showed 46 enhancing lesions, including 48 parts, in 31 MR examinations. FLAIR images of the lesion-parts in group 1 (N=18) did not show significant contrast enhancement. In group 2 (N=12), all the parts were enhanced in FLAIR sequences, and three parts were enhanced more clearly in the FLAIR sequences than in the T1-weighted sequences. In group 3 (N=18), all the parts were enhanced equally or more clearly in the FLAIR sequences than in the T1-weighted sequences. CONCLUSION: The signal intensity in FLAIR sequences is largely influenced by both T1 and T2 relaxation time; there is a close relationship between the signal intensity of brain tumors on T2-weighted images and the degree of contrast enhancement on FLAIR sequences. When tumors have higher signal intensity than normal cortex on T2-weighted images, additional postcontrast FLAIR imaging may improve their depiction.     

Effect of ovariectomy on magnetic resonance T2* in rat femur

Measurements have been made in the rat femur in vivo and ex vivo by using an asymmetric spin echo technique of T_2′, the susceptibility contribution to T₂*. The trabecular spacing in this study in rat bone is considerably less than in previous studies in the human. A significant increase in T_2′ was seen in vivo 3 mm proximal to the growth plate with ovariectomy (a model of osteopenia), from 8.1 ± 0.7 to 10.0 ± 0.6 ms. Parallel changes in trabecular bone mineral density measured by quantitative computed tomography were found. T_2′ was higher in living bones than in the same bones measured post mortem.     

Multiecho reconstruction for simultaneous water-fat decomposition and T2* estimation

PURPOSE: To describe and demonstrate the feasibility of a novel multiecho reconstruction technique that achieves simultaneous water-fat decomposition and T2* estimation. The method removes interference of water-fat separation with iron-induced T2* effects and therefore has potential for the simultaneous characterization of hepatic steatosis (fatty infiltration) and iron overload. MATERIALS AND METHODS: The algorithm called "T2*-IDEAL" is based on the IDEAL water-fat decomposition method. A novel "complex field map" construct is used to estimate both R2* (1/T2*) and local B(0) field inhomogeneities using an iterative least-squares estimation method. Water and fat are then decomposed from source images that are corrected for both T2* and B(0) field inhomogeneity. RESULTS: It was found that a six-echo multiecho acquisition using the shortest possible echo times achieves an excellent balance of short scan and reliable R2* measurement. Phantom experiments demonstrate the feasibility with high accuracy in R2* measurement. Promising preliminary in vivo results are also shown. CONCLUSION: The T2*-IDEAL technique has potential applications in imaging of diffuse liver disease for evaluation of both hepatic steatosis and iron overload in a single breath-hold.     

Comparing T2 weighted images/diffusion weighted imaging and T2 weighted images/dynamic contrast enhanced MRI for endometrial carcinoma myometrial invasion

Objectives

To evaluate accuracy of combined T2 and diffusion weighted images (DWI) in comparison to combined T2WI and dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) for assessment of the depth of myometrial invasion.