Origin of a signal intensity loss artifact in fat-saturation MR imaging

Artifactual water signal intensity loss can be observed on fat-saturation magnetic resonance (MR) images of inhomogeneous regions such as the thorax. Magnetic effects of air inclusions on fat-saturation pulses were investigated as the possible origin of this artifact. Computer simulation results agreed well with observed production of water saturation by means of nominal fat suppression in MR imaging of phantoms and a representative clinical example.     

High signal intensity lesions of the chest in MR imaging

The majority of pathologic lesions in the lung and mediastinum have relatively long T1 and T2 relaxation times and consequently yield medium to low signal intensity on T1-weighted images. Pulmonary lesions with high signal intensity on T1-weighted images are unusual and raise a special group of diagnostic considerations. In the current study, a mass with a lesion/fat signal intensity ratio of greater than 0.7 on a T1-weighted sequence was considered high signal intensity. The nature of these masses was ganglioneuroma or ganglioneuroblastoma (n = 3), atrial lipoma (lipomatous atrophy of the interatrial septum) (n = 3), pheochromocytoma (n = 2), bronchogenic cyst (n = 2), lymphangioma (n = 1), teratoma (n = 1), and a variety of primary and metastatic tumors of the mediastinum and lung. A single pathologic structure of these lesions was not present, but rather several underlying tissue compositions were noted, including fat, subacute hemorrhage, myxoid material, and cellular composition with high cytoplasmic/nuclear ratio. Thus, high signal intensity lesions of the thorax on T1-weighted images should suggest a number of differential diagnoses.     

MR imaging of low signal intensity pulmonary lesions using flow-sensitive techniques

Various spin echo techniques can be used to define the nature of low signal intensity lesions of the lung. A pulmonary arteriovenous malformation and a chronic pulmonary hematoma had a similar appearance on standard spin echo magnetic resonance (MR) images. Both lesions demonstrated central absence of signal surrounded by a thin rim of tissue, suggesting a vascular lesion. For further characterization of these lesions, a rotating gated MR technique was used in which images are obtained at different points in the cardiac cycle, such that pulsatile flow alters signal intensity with velocity changes during the cardiac cycle. Phase images also discriminated flowing blood in the arteriovenous malformation from stationary lung tissues, whereas the hematoma was not distinguished from lung parenchyma. Rotating gated sequences and reconstructed phase images may be useful in determining the etiology of low signal intensity pulmonary lesions.     

Intrasubject reproducibility of functional MR imaging activation in language tasks

BACKGROUND AND PURPOSE: The purpose of this study was to examine the reproducibility of functional MR imaging (fMRI) activation (volume and laterality) within both inferior frontal and temporoparietal regions of interest for both receptive and expressive language tasks. METHODS: Ten healthy volunteers participated in fMRI experiments for 6 language tasks: verb generation, confrontation naming, semantic decision making, visual sentence comprehension, auditory sentence comprehension, and story listening. Each subject was scanned during 2 separate sessions separated by a minimum of 4 weeks. Laterality of activation was defined by laterality indices (LIs), which were calculated by 2 methods: one method based on the measured volume of activation and the other method based on the F statistic of the activation. Reproducibility was calculated by using concurrence ratios for the volume of activation (R(overlap), R(volume)) and test-retest correlation for LIs. RESULTS: All tasks generated reproducible LIs within at least one of the regions of interest, but verb generation produced the highest test-retest correlations (r = 0.99) within both regions of interest. Verb generation was associated with the highest average concurrence ratios within the inferior frontal region of interest (R(overlap) = 45.2; R(volume) = 70.9). In general, the concurrence ratios were lower within the temporoparietal region of interest compared with the inferior frontal region of interest. LIs calculated with F statistics were more reproducible than the LIs calculated by activation volume. CONCLUSION: fMRI is able to provide reproducible LIs in both inferior frontal and temporoparietal regions for assessing hemispheric dominance in language processing. The volume of activation, especially within the temporoparietal regions, is less reproducible than the laterality of activation, so the former should be used with caution.     

Timing of cortical activation: a latency-resolved event-related functional MR imaging study

BACKGROUND AND PURPOSE: The time course of cortical activations of different anatomic areas has been demonstrated to reflect, to some degree, the temporal dynamics of the brain network. The purpose of this study was to determine the temporal sequence of the hemodynamic response in the visual, supplemental motor (SMA), and primary motor cortical areas by using a visuomotor reaction time task. METHODS: The reaction times (RTs) of 26 right-handed subjects were recorded in response to a visual cue during an event-related functional MR imaging (fMRI) experiment. Statistical parametric mapping (SPM99) was used, and activation maps were produced for each subject. This was followed by a random-effects group analysis. Using a weighted least-squares approach, we recorded the time at onset of the hemodynamic response of the fMRI activation in four regions of interest: the right occipital (RO) and left occipital (LO) visual cortices, the SMA, and the left sensorimotor area (LM1). Linear regression analysis was done between the RTs and the mean latencies for the four areas. RESULTS: Using the group analysis, the results showed that the first regions to activate were the visual occipital cortices (RO and LO) with mean latency +/- standard error of mean (SEM) of 1.74 +/- 0.05 s and 1.85 +/- 0.08 s, respectively. The visual occipital areas were followed by the SMA of 2.07 +/- 0.16 s and finally the LM1 with a mean latency of 2.1 +/- 0.15 s. There were significant differences in the mean onset of latencies between RO and LO, RO and SMA, and RO and LM1 (P <.05). On performing regression analysis between the RTs and the mean latencies by using the group analysis, there was no significant correlation with any of the four areas. By using an individual subject analysis, the results again showed that the first regions to activate were the visual occipital cortices (RO and LO) with mean latency +/- SEM of 1.75 +/- 0.06 s and 1.84 +/- 0.12 s, respectively, followed by the SMA with a mean latency of 2.19 +/- 0.25 s and finally the LM1 of 2.26 +/- 0.38 s. There was no significant difference between the mean onset latencies. CONCLUSION: The onset of the hemodynamic response started first in the visual cortex (input) followed by the SMA and primary motor cortical area (output). The onset of activation showed no direct correlation with the overall RTs of the subjects, leading one to suggest that the peripheral motor unit may have a greater impact on RT than the central contribution.     

Functional MR imaging evidence of altered functional activation in metabolic syndrome

BACKGROUND AND PURPOSE:MetS is a cluster of risk factors associated with significant cardiovascular morbidity and mortality and diminished cognitive function. Given that little is known about the early signs of brain vulnerability related to persistent metabolic dysfunction, we set out to determine whether cognitively healthy middle-aged individuals with MetS exhibit an altered cerebrovascular response to a cognitive challenge relative to those without MetS.MATERIALS AND METHODS:Forty neurologically healthy adults aged 40–60 years (19 with MetS and 21 healthy controls) performed a 2-back verbal working memory task during fMRI. We compared BOLD responses between the 2 groups in 8 a priori regions of interest previously shown to be associated with the 2-back in patients with cardiovascular disease.RESULTS:Age, education level, sex distribution, cognitive and emotional functioning, and task performance (accuracy and reaction time) were not different between the groups. Compared with healthy controls, individuals with MetS demonstrated a lower 2-back–related BOLD response in the right superior frontal gyrus, right superior parietal lobule, and left inferior parietal lobule.CONCLUSIONS:This study provides preliminary evidence that cognitively intact middle-aged individuals with MetS exhibit significant alterations in cerebrovascular response to a cognitive challenge. Our results also demonstrate that fMRI may identify early brain changes associated with MetS.

The number of elderly patients with dementia is expected to quadruple during the next 50 years.¹ In addition, a great number of older adults are projected to develop milder forms of cognitive impairment.¹ This trend is alarming because cognition is the most important determinant of health status, quality of life, and functional ability in older age.² Diminished cognitive capacity causes significant psychological, social, and economic hardship and adversely impacts a person''s ability to benefit from treatment for other medical problems.³ Due to the current paucity of treatments for dementia, management of treatable factors that place the brain at risk for subsequent cognitive decline is the primary line of defense, especially in cases in which vascular factors play a key role.^4–7MetS refers to a clustering of risk factors (ie, hypertension, hyperglycemia, dyslipidemia, and obesity) associated with increased cardiovascular morbidity and mortality.⁸ Growing evidence suggests that MetS is also harmful to cognition and that the cluster may have predictive value for cognitive decline over and above that of its individual components.^9–16 Older patients with MetS score lower on cognitive tests than age-matched healthy adults, particularly on measures of processing speed and executive functioning,¹⁷ cognitive domains that are associated with vascular cognitive impairment. Several studies have shown that middle-aged individuals with MetS are at higher risk of developing dementia in late life,¹⁸ yet accurate prediction of individual cognitive trajectories is difficult due to the low sensitivity of paper-and-pencil screening tests to subtle changes in intellectual functioning. Neuroimaging studies have shown promise in identifying individuals at risk for subsequent cognitive decline because these studies revealed that MetS is associated with early alterations in the structural integrity of cerebral white matter.^19–21BOLD fMRI has the potential to contribute further to our understanding of early cerebrovascular changes related to persistent metabolic dysfunction. Alterations in the BOLD response to cognitive challenges have been shown in cognitively asymptomatic patients with MS, HIV infection, and genetic risk for AD.^22–27 BOLD fMRI performed during cognitive tasks, therefore, can help elucidate the complex relationship between metabolic and vascular health, cerebrovascular support for cognitive function, and behavioral performance. An accurate model of the relationship between cerebrovascular health and persistent metabolic dysfunction at midlife could prove instrumental in increasing the success of broader efforts to prevent and treat vascular cognitive impairment.To our knowledge, no studies have examined functional neuroimaging in MetS. Accordingly, the aim of this study was to test the hypothesis that middle-aged adults with MetS would show altered patterns of brain activation (ie, BOLD responses) during a verbal working memory task. The chosen task requires selective attention, executive ability, and psychomotor speed, cognitive abilities typically affected in vascular-related cognitive impairment. As such, they may have particular relevance for MetS.     

Optimization and evaluation of the signal intensity change in multisection oxygen-enhanced MR lung imaging.

The behavior of the signal intensity in MRI of human lungs was investigated during inhalation of pure oxygen. Nine volunteers were examined, five using a breath-hold and four using a non-breath-hold technique. Four coronal slices were acquired in each volunteer using an inversion recovery turbo spin-echo sequence. The inversion time of the sequence was optimized for maximum contrast. Breathing of pure oxygen and room air was alternated in the volunteers. Breath-hold and non-breath-hold cases were compared. Breathing pure oxygen lead to a statistically significant signal intensity increase (up to 18%) compared to breathing room air. In addition, T(1) maps were acquired during breathing 100% oxygen and room air. Inhalation of pure oxygen reduced the mean T(1) time of the lungs from 1280 (+/-85) msec to 1224 (+/-139) msec without breath-hold and from 1219 (+/-176) to 1074 (+/-92) msec with breath-hold. Therefore, an optimized sequence and measurement protocol provided significant signal intensity changes utilizing 100% oxygen. Magn Reson Med 43:860-866, 2000.     

MR imaging of the seminal vesicles--correlations between age, size and signal intensity]

MR findings of 82 cases without seminal vesicle lesions were retrospectively evaluated to assess the mutual correlations between age, size and signal intensity of the seminal vesicle. MR findings of 31 cases of carcinomatous invasion to the seminal vesicle were also evaluated as a control group for low signal intensity area-study. 1.5T superconductive unit (Toshiba 2000FX-II) was used to obtain T1-weighted (SE500/13) and T2-weighted (SE2500/80) images. Significant correlations were noted between age, short-axis diameter of the seminal vesicle and global signal intensity of the seminal vesicle on T2-weighted images. In the study of low signal intensity area on T2-weighted images, diffuse strand-like low signal intensity areas were occasionally seen in cases without seminal vesicle lesions. On the other hand, low signal intensity areas in cases of carcinomatous invasion to the seminal vesicle tended to be more localized and nodular. MR evaluation of cases without seminal vesicle lesions is important not only to delineate physiological changes of the seminal vesicle, but also to avoid erroneous MR-diagnosis of seminal vesicle lesions.     

Temporomandibular joint: morphology and signal intensity characteristics of the disk at MR imaging

Magnetic resonance (MR) imaging has been used in the temporomandibular joint (TMJ) primarily to define the disk position. This report examines altered morphology and signal intensity characteristics of the TMJ disk as they relate to the severity of internal derangement. Two hundred sixteen joints in 133 patients with a history of such derangement. were imaged with MR. Disk position, signal intensity, morphology, and the presence of osteoarthritis were determined for each joint. The normal disk was not anteriorly displaced and had a normal "bow-tie" shape. A grade 1 disk was anteriorly displaced and had a normal shape; a grade 2 disk was anteriorly displaced and had an abnormal shape. Forty (19%) joints were considered normal; none of these exhibited osteoarthritis. One hundred thirty-nine (64%) joints were grade 1; osteoarthritis was found in 17%. Thirty-seven (17%) were grade 2; osteoarthritis was found in 95%. All forty normal joints had high or intermediate signal intensity in the disk. Osteoarthritic joints had a higher percentage of disks with diminished intensity (P less than .0001). Severe or untreated osteoarthritis is known to be a complication of TMJ internal derangements; hence this grading system seems to correlate with the severity of internal derangement.     

Cerebral activation during multiplication: a functional MR imaging study of number processing

BACKGROUND AND PURPOSE: Current models of brain function propose that number processing involves the interaction of different neuronal networks. Our purpose was to use functional MR (fMR) imaging to elucidate the brain regions engaged by multiplication. METHODS: Eighteen adults underwent fMR imaging while performing matching, multiplication, and control tasks. For each task, three or four single-digit or low-value double-digit numbers were presented serially followed by a 12-second delay. A target stimulus then appeared and subjects made a judgement by pressing a button box that recorded responses. During the matching task, subjects judged whether the target stimulus matched one of the previous numbers. During the multiplication task, subjects judged whether the target stimulus was the product of the previous numbers. For the control task, the numbers were always zeros, and the subjects responded to a target stimulus that was always four zeros. Composite statistical parametric maps of the time course of activation comparing the control task with the matching and multiplication tasks, respectively, were generated and the significance of signal changes was estimated by randomization of statistical parametric maps. RESULTS: The matching and multiplication tasks resulted in activation (P < .005) in the medial superior frontal gyrus; the anterior cingulate gyrus; the intraparietal sulci, bilaterally; the right superior frontal sulcus bilaterally; the middle, inferior and precentral frontal gyri (left greater than right); the left basal ganglia; and the right lateral and inferior occipital gyri. There was a larger area of early activation in the right middle frontal gyrus during the matching task compared with the multiplication task, and there was a longer interval of activation in the left middle frontal gyrus during the multiplication task (10 seconds) than in the matching task (6 seconds). CONCLUSION: Multiplication and memory of numbers share an integrated network of brain regions. The left frontal lobe, an area also involved in memory and language processes, appears to play an important role in multiplication.     

Optimized activation of the primary sensorimotor cortex for clinical functional MR imaging

BACKGROUND AND PURPOSE: One application of functional MR imaging is to identify the primary sensorimotor cortex (M1 and S1) around the central sulcus before brain surgery. However, it has been shown that undesirable coactivation of nonprimary motor areas, such as the supplementary motor area and the premotor area, can interfere with the identification of the primary motor cortex, especially in patients with distorted anatomic landmarks. We therefore sought to design a simple functional MR imaging paradigm for selective activation of the primary sensorimotor cortex. METHODS: Different paradigms using finger tapping for motor activation were examined and compared with respect to the distribution of activated voxels in primary and nonprimary cortical areas. Studies were conducted in 14 healthy volunteers using a blood oxygen level-dependent multislice echo-planar imaging sequence. RESULTS: The most selective activation of the primary sensorimotor cortex was obtained with a paradigm combining right-sided finger tapping as the activation condition with left-sided finger tapping as the control condition. Analysis of the signal time course of primary and nonprimary areas revealed that the highly selective primary motor activation was due to it being restricted to contralateral finger movements, as opposed to the nonprimary motor areas, which were activated by ipsilateral, contralateral, and bilateral finger movements alike. CONCLUSION: When performing functional MR imaging to determine the location of the primary sensorimotor cortex, one should compare unilateral voluntary movements as the activation condition with contralateral movements as the control condition to accentuate activation of the primary motor area and to suppress undesirable coactivation of nonprimary motor areas.     

MR imaging in thyroid disorders: correlation of signal intensity with Graves disease activity

Thirty-six patients with a variety of thyroid disorders and eight healthy subjects were studied with T1- and T2-weighted magnetic resonance (MR) imaging. Solid benign nodules, malignant tumors, and inflammatory conditions were not distinguishable by thyroidal MR signal intensity, but almost all patients with Graves disease had a moderate to marked diffuse increase in signal intensity at both settings. Quantitative evaluation showed that in these patients, the thyroid-muscle signal intensity contrast ratio was linearly related to both the serum thyroxine (T4) level and the 24-hour radioactive iodine uptake. In three patients treated with iodine 131, this contrast ratio rose or fell in parallel with the serum T4 level and 24-hour radioactive iodine uptake. Either parenchymal changes or increased vascularity in Graves disease, or both, could produce these findings. In patients without Graves disease, signal intensity was not correlated with serum T4 levels. These findings suggest that MR signal intensity may reflect the activity of the stimulatory process in Graves disease and may therefore be a useful measure of thyroid function in this disorder, with both diagnostic and prognostic value.     

Articular cartilage: correlation of histologic zones with signal intensity at MR imaging

Zones of high and low signal intensity on magnetic resonance (MR) images of articular cartilage were correlated with the four histologic zones normally found in such cartilage. Grossly normal articular cartilage from knees and ankles of a fresh cadaver were used in the study. The three zones identified on MR images included a low-intensity zone near the articular surface, a zone of higher signal intensity next to that, and a second zone of low intensity that was deep to the two others. The location of the superficial low-intensity zone corresponded to dense, tangentially oriented layers of collagen in the superficial histologic zone. Higher signal intensity deep to the superficial low-intensity zone correlated with cartilage in the transitional zone. The deep low-intensity zone correlated with a combination of deep radiate and calcified cartilage and cortical bone. Results of this study indicate that, with high resolution, MR imaging may demonstrate three zones of differing signal intensity in articular cartilage. The superficial low-intensity zone may be a useful marker of the surface of normal articular cartilage.     

MR signal intensity of the optic radiation.

PURPOSETo determine whether a hyperintense layer adjacent to the lateral ventricle on T2-weighted MR images represents the optic radiation.METHODSWe reviewed 11 brain specimens from patients with nonneurologic diseases and MR images from 43 healthy volunteers. The MR images in a patient with cerebral infarction involving the lateral geniculate body were also reviewed to evaluate wallerian degeneration of the optic radiation.RESULTSThe external sagittal stratum, composed of the optic radiation, showed a pale layer in specimens stained by Bodian''s method. On high-power microscopic views of the specimens, the axons of the external sagittal stratum were large and separated by wide translucent spaces. In the volunteers, the external sagittal stratum appeared hyperintense on T2-weighted MR images and hypointense on T1-weighted images. The MR images in a patient with cerebral infarction showed hyperintensity within the layer corresponding to the external sagittal stratum.CONCLUSIONSThe hyperintense layer on T2-weighted images represents the external sagittal stratum, or optic radiation. The signal intensity of the external sagittal stratum reflects histologic characteristics of low axonal density.     

Reproducibility of visual activation in functional MR imaging and effects of postprocessing

BACKGROUND AND PURPOSE: Functional MR imaging studies of the brain should be interpreted in the context of their reproducibility. We assessed the reproducibility of visual activation measured by functional MR imaging and analyzed the effect of image transformation to standard space. METHODS: Seven healthy volunteers were studied twice with echo-planner functional MR imaging at 1.5 T during visual stimulation. The studies were separated by an interval of 2 to 7 days. Functional images were analyzed after spatial normalization to the space described by Talairach and Tournoux and/or after coregistration of the images of the second study with the images of the first study. The number of active voxels for each study was determined at three thresholds. In addition, the change in the center of the mass of activation, the mean change in signal intensity, and the mean t value within the activated area were measured. These reproducibility indexes were calculated for the spatially normalized and nonnormalized data for each subject. RESULTS: Variations in visual activation were observed between the two studies in the same individual as well as across subjects. There was no evidence of an effect from image transformation on reproducibility on any of the measures. CONCLUSION: Our findings show that the reproducibility of activation in functional MR imaging may be much more variable across subjects than suggested in previous studies. The use of different types of image transformation (coregistration, spatial normalization) does not significantly affect the reproducibility of visual activation.     

Correlation of functional MR imaging activation data with simple reaction times

PURPOSE: To determine the relationship between subject reaction times (RTs) and activation volume in the brain during visuomotor functional magnetic resonance (MR) imaging. MATERIALS AND METHODS: Twenty-four subjects performed a simple RT task during single-event functional MR imaging, and RTs were recorded. The six subjects with the fastest RTs were designated the fast RT group, and the six subjects with the slowest RTs were designated the slow RT group. The data were processed with noncorrected height threshold (P <.001) for individual comparisons and corrected height threshold (P <.05) for group comparisons (t tests). The activation volumes in both occipital lobes, the left sensorimotor cortex, and the supplemental motor cortices were compared for the two groups. RESULTS: The mean RT +/- SD was 342 msec +/- 20.15 for the fast RT group and 475 msec +/- 36.17 for the slow RT group (P <.0001). More voxels of activation were seen in the fast RT group than in the slow RT group in the occipital lobes, left sensorimotor cortices, and supplemental motor cortices on individual and group maps. This difference was statistically significant in the left sensorimotor (P =.03) and left visual (P =.05) cortices. In the right visual cortex, a trend toward more activation in the fast RT group was noted (P =.15). There was a negative correlation between RTs and activation volume in the left sensorimotor cortex (P =.048). CONCLUSION: There was a greater activation volume in motor and visual cortices in the fast RT group than in the slow RT group.