Ultra‐short echo time (UTE) MR imaging of the lung: Comparison between normal and emphysematous lungs in mutant mice

Purpose:

To investigate the utility of ultra‐short echo time (UTE) sequence as pulmonary MRI to detect non‐uniform disruption of lung architecture that is typical of emphysema.

Materials and Methods:

MRI of the lungs was conducted with a three‐dimensional UTE sequence in transgenic mice with severe emphysema and their wild‐type littermates in a 3 Tesla clinical MR system. Measurements of the signal intensity (SI) and transverse relaxation time (T2*) of the lung parenchyma were performed with various echo times (TEs) ranging from 100 μs to 2 ms.

Results:

Much higher SI of the lung parenchyma was observed at an UTE of 100 μs compared with longer TEs. The emphysematous lungs had reduced SIs and T2* than the controls, in particular at end‐expiratory phase. The results suggested that both SI and T2* in lung parenchyma measured with the method represent fractional volume of lung tissue.

Conclusion:

The UTE imaging provided MR signal from the lung parenchyma. Moreover, the UTE sequence was sensitive to emphysematous changes and may provide a direct assessment of lung parenchyma. UTE imaging has the potential to assist detection of localized pathological destruction of lung tissue architecture in emphysema. J. Magn. Reson. Imaging 2010;32:326–333. © 2010 Wiley‐Liss, Inc.     

T2* and proton density measurement of normal human lung parenchyma using submillisecond echo time gradient echo magnetic resonance imaging.

OBJECTIVE: To obtain T2* and proton density measurements of normal human lung parenchyma in vivo using submillisecond echo time (TE) gradient echo (GRE) magnetic resonance (MR) imaging. MATERIALS AND METHODS: Six normal volunteers were scanned using a 1.5-T system equipped with a prototype enhanced gradient (GE Signa, Waukausha, WI). Images were obtained during breath-holding with acquisition times of 7-16 s. Multiple TEs ranging from 0.7 to 2.5 ms were tested. Linear regression was performed on the logarithmic plots of signal intensity versus TE, yielding measurements of T2* and proton density relative to chest wall muscle. Measurements in supine and prone position were compared, and effects of the level of lung inflation on lung signal were also evaluated. RESULTS: The signal from the lung parenchyma diminished exponentially with prolongation of TE. The measured T2* in six normal volunteers ranged from 0.89 to 2.18 ms (1.43 +/- 0.41 ms, mean +/- S.D.). The measured relative proton density values ranged between 0.21 and 0.45 (0.29 +/- 0.08, mean +/- S.D.). Calculated T2* values of 1.46 +/- 0.50, 1.01 +/- 0.29 and 1.52 +/- 0.18 ms, and calculated relative proton densities of 0.20 +/- 0.03, 0.32 +/- 0.13 and 0.35 +/- 0.10 were obtained from the anterior, middle and posterior portions of the supine right lung, respectively. The anterior-posterior proton density gradient was reversed in the prone position. There was a pronounced increase in signal from lung parenchyma at maximum expiration compared with maximum inspiration. The ultrashort TE GRE technique yielded images demonstrating signal from lung parenchyma with minimal motion-induced noise. CONCLUSION: Quantitative in vivo measurements of lung T2* and relative proton density in conjunction with high-signal parenchymal images can be obtained using a set of very rapid breath-hold images with a recently developed ultrashort TE GRE sequence.     

Ultrashort echo time (UTE) MRI of the lung: Assessment of tissue density in the lung parenchyma

Nonuniform disruption of lung architecture is usually assessed by CT, which carries potential radiation risk. Here we report our use of a three‐dimensional ultrashort echo time MR method to image the lungs of normal mice at different positive end‐expiratory pressures in a 3‐T clinical MR system. The ultrashort echo time sequence in conjunction with a projection acquisition of the free induction decay could reduce the echo time to 100 μsec and provide a more inherent MR signal intensity from the lung parenchyma, which is usually invisible due to its short T*₂ in conventional MRI methods. The signal intensity and T*₂ was reduced as the positive end‐expiratory pressure became higher. Further, these parameters were highly correlated to the changes in lung volume (% lung expansion). The results indicated that the MR signal acquired at ultrashort echo time in the lung parenchyma represents interstitial tissue density including blood. The capability of acquiring sufficient MR signal would have implications for the direct assessment of parenchymal architecture in the lung. Therefore, ultrashort echo time imaging may have the potential to assist detection of early and localized pathological destruction of lung tissue architecture observed in various pulmonary disorders such as emphysema without incurring the risks of radiation exposure. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Lung parenchyma: magnetic susceptibility in MR imaging

Magnetic susceptibility effects in magnetic resonance (MR) imaging of normal lung parenchyma occur because of magnetic-field inhomogeneities induced by the microscopic heterogeneity of the lung. The effects on MR imaging of the lung are loss of signal from intravoxel phase dispersion (measured with T2') and a shift in the macroscopic resonant frequency from that of water toward that of air (delta v). These effects of MR imaging at 1.5 T were quantitated by measuring T2' decay and delta v at different locations in the lungs of two adult volunteers and one excised inflated human lung. The average T2' was 7 msec in the excised inflated specimen and 6.3 msec in normal in vivo lungs. There was a gravitational increase in T2' from nondependent to dependent lung. T2' increased to 35 msec in atelectatic lung tissue and to more than 140 msec in tumor. The macroscopic resonant lung frequency increased to 3.6 ppm more than that of mediastinal muscle. These values are important for developing MR pulse sequences appropriate for imaging lung parenchyma.     

Impact of lung volume on MR signal intensity changes of the lung parenchyma

PURPOSE: To test the hypothesis that, in magnetic resonance (MR) imaging of healthy individuals, equal relative changes in lung volume cause equal relative changes in MR signal intensity of the lung parenchyma. MATERIALS AND METHODS: In two experimental runs, 10 volunteers underwent spirometrically monitored MR imaging of the lungs, with MR images acquired at 10 incremental lung volumes ranging from total lung capacity to 10% above residual volume. Average signal intensity, signal variability, and signal intensity integrals were calculated for each volunteer and for each lung volume. The effect of lung volume on signal intensity was quantified using linear regression analysis complemented by the runs test. Slopes and intercepts of regression lines were compared with an analysis of covariance. Slopes of the lines of best fit for lung volumes and signal intensities from the two runs were compared to the slope of the line of identity. Comparisons between the two runs were visualized using Bland and Altman plots. RESULTS: The slopes of the 10 individual regression lines yielded no significant differences (F = 1.703, P = 0.101; F = 1.321, P = 0.239). The common slopes were -0.556 +/- 0.027 (P = 0.0001) for the first and -0.597 +/- 0.0031 (P = 0.0001) for the second experimental run. Both slopes displayed no significant nonlinearity (P = 0.419 and P = 0.067). There was a strong association between changes in lung volumes (rs = 0.991, P = 0.0001) and changes in signal intensity (rs = 0.889, P = 0.0001) in the two experimental runs. Lines of best fit for lung volume and signal intensities were not significantly different from the slope of the line of identity (P = 0.321 and P = 0.212, respectively). CONCLUSION: Equal changes in lung volume cause equal changes in MR signal intensity of the lung parenchyma. This linear and reproducible phenomenon could be helpful in comparing pulmonary MR signal intensity between individuals.     

Short echo time MR spectroscopic imaging of the lung parenchyma

PURPOSE: To perform short echo time MR spectroscopic imaging of the lung parenchyma on normal volunteers.MATERIALS AND METHODS: A short echo time projection-reconstruction spectroscopic imaging sequence was implemented on a commercial 1.5T whole body MRI scanner. Images and spectra of the lung parenchyma were obtained from five normal volunteers. Breath-held spectroscopic imaging was also performed.RESULTS: Spectroscopic imaging of short-T2* species allows visualization of different anatomic structures based upon their frequency shifts. A characteristic peak from the parenchyma was seen at three ppm from water frequency.CONCLUSION: Short echo time MR spectroscopic imaging of the lung parenchyma was demonstrated in normal volunteers. This method may improve proton imaging of the lungs and add specificity to the diagnosis of pulmonary disease.     

Rectal cancer: mesorectal lymph nodes at MR imaging with USPIO versus histopathologic findings--initial observations

PURPOSE: To compare histopathologic findings with appearances of mesorectal lymph nodes at magnetic resonance (MR) imaging with ultrasmall particles of iron oxide (USPIO) in rectal cancer. MATERIALS AND METHODS: Mesorectal lymph nodes in 12 patients with adenocarcinoma of the rectum were evaluated with USPIO and high-spatial-resolution MR imaging. Appearance and signal intensity of lymph nodes at T2- and T2*-weighted imaging were recorded before and after USPIO administration. Two radiologists visually assessed pattern of enhancement; interobserver agreement was tested with the kappa statistic. After total mesorectal excision, MR imaging of surgical specimens was performed, and it enabled node-by-node correlation with histopathologic findings. RESULTS: Appearances of 74 nodes at in vivo MR imaging were compared with histopathologic findings. Sixty-eight nodes were nonmalignant (34 were normal, 34 showed reactive changes); six nodes were malignant. Four patterns of USPIO uptake were demonstrated at T2*-weighted imaging: uniform low signal intensity, central low signal intensity, eccentric high signal intensity, and uniform high signal intensity. Two radiologists showed good interobserver agreement (kappa = 0.88, P <.01) in classification of nodes into these four categories. Sixty-five (96%) of 68 nonmalignant nodes showed uniform or central low-signal-intensity patterns; 16 (47%) of 34 reactive nodes showed central low-signal-intensity patterns. Compared with uniform low-signal-intensity pattern, central low-signal-intensity pattern was more commonly observed in reactive nodes (P <.01, chi(2) test; positive predictive value, 67%; 95% CI: 47%, 87%). Eccentric and uniform high-signal-intensity patterns were observed in lymph nodes that contained metastases larger than 1 mm in diameter. CONCLUSION: Mesorectal lymph nodes can be characterized by using USPIO and T2*-weighted MR imaging. Uniform and central low-signal-intensity patterns are features of nonmalignant nodes. Reactive nodes frequently show central low signal intensity at T2*-weighted imaging.     

T-cell homing to the pancreas in autoimmune mouse models of diabetes: in vivo MR imaging

PURPOSE: To evaluate the efficiency of T-cell labeling with anionic magnetic nanoparticles (AMNPs) and in vivo magnetic resonance (MR) imaging monitoring of T-cell homing to the pancreas. MATERIALS AND METHODS: In vivo MR images of pancreas were obtained with a 7-T MR system in 12 NOD (nonobese diabetic) mice at 11 and 20 days after injection of AMNP-loaded or unloaded T cells. Homing of loaded T cells in pancreatic lymph nodes was detected by the presence of a focal dark spot with T2* effect in a caudal area of the pancreas. Detection of loaded T cells in pancreatic islets was evaluated by comparison of histograms of MR signal intensity generated in whole pancreas in mice injected with loaded and unloaded T cells. Homing of loaded T cells was confirmed at transmission electronic microscopy (TEM). Fifty-six mice underwent all experiments. RESULTS: Focal dark spots with T2* effect were observed at 11 days in all three mice injected with loaded T cells and in none of the three mice injected with unloaded T cells. At 20 days, a more diffuse negative enhancement of the whole pancreas was noticed in one mouse injected with loaded T cells than in three mice injected with unloaded T cells. Presence of loaded T cells was confirmed with TEM. In vitro and in vivo tests confirmed that survival and function were not altered by loading. CONCLUSION: The ability of MR imaging to depict cell homing in living organisms at least 20 days after cell labeling was demonstrated, opening the way of follow-up in autoimmune diseases and cell therapy.     

MR imaging of pancreatic changes in patients with transfusion-dependent beta-thalassemia major.

OBJECTIVE: The aim of this study was to evaluate MR imaging changes of the pancreas in patients with transfusion-dependent beta-thalassemia major. SUBJECTS AND METHODS: Twenty patients with transfusion-dependent beta-thalassemia major were examined using MR imaging at 0.5 T, with spin-echo T1-weighted, fast spin-echo T2-weighted, and gradient-echo T2*-weighted sequences. Image analysis was performed to assess pancreas-to-fat signal intensity ratios for all pulse sequences. Pancreatic exocrine and endocrine function and serum ferritin levels were assessed. Twenty healthy volunteers underwent MR imaging with the same three sequences and served as a control group. RESULTS: The pancreas-to-fat signal intensity ratio was significantly decreased in 17 (85%) of the 20 patients on spin-echo T1-weighted images (p < .05), fast spin-echo T2-weighted images (p < .01), and gradient-echo T2*-weighted images (p < .01) when compared with the 20 volunteers in the control group. The pancreas-to-fat signal intensity ratio was significantly increased in three (15%) of the 20 patients on spin-echo T1-weighted images (p < .01) and fast spin-echo T2-weighted images (p < .05). In addition, in the 20 patients, we found a significant correlation between increased pancreas-to-fat signal intensity ratios and decreased serum trypsin levels (r = -.77, p < .01 for spin-echo T1-weighted sequences; r = -.75, p < .05 for fast spin-echo T2-weighted sequences; and r = -.74, p < .05 for gradient-echo T2*-weighted sequences). Likewise, for the 20 patients, we found a significant correlation between decreased pancreas-to-fat signal intensity ratios and increased serum ferritin levels for gradient-echo T2*-weighted images (r = -.65, p < .01). No correlation was found for the other clinical parameters evaluated. CONCLUSION: MR imaging revealed signal intensity changes in the pancreas of patients with transfusion-dependent beta-thalassemia major. Patients with a major impairment of the exocrine pancreatic function had higher signal intensity of the pancreas because of fatty replacement of the parenchyma.     

In vivo MR imaging of intravascularly injected magnetically labeled mesenchymal stem cells in rat kidney and liver

PURPOSE: To evaluate in vivo magnetic resonance (MR) imaging with a conventional 1.5-T system for depiction and tracking of intravascularly injected superparamagnetic iron oxide (SPIO)-labeled mesenchymal stem cells (MSCs). MATERIALS AND METHODS: This study was conducted in accordance with French law governing animal research and met guidelines for animal care and use. Rat MSCs were labeled with SPIO and transfection agent. Relaxation rates at 1.5 T, cell viability, proliferation, differentiation capacity, and labeling stability were assessed in vitro as a function of SPIO concentration. MSCs were injected into renal arteries of healthy rats (labeled cells in four, unlabeled cells in two) and portal veins of rats treated with carbon tetrachloride to induce centrolobular liver necrosis (labeled cells and unlabeled cells in two each). Follow-up serial T2*-weighted gradient-echo MR imaging and R2* mapping were performed. MR imaging findings were compared histologically. RESULTS: SPIO labeling caused a strong R2* effect that increased linearly with iron dose; R2* increase for cells labeled for 48 hours with 50 microg of iron per milliliter was 50 sec(-1) per million cells per milliliter. R2* was proportional to iron load of cells. SPIO labeling did not affect cell viability (P > .27). Labeled cells were able to differentiate into adipocytes and osteocytes. Proliferation was substantially limited for MSCs labeled with 100 microg Fe/mL or greater. Label half-life was longer than 11 days. In normal kidneys, labeled MSCs caused signal intensity loss in renal cortex. After labeled MSC injection, diseased liver had diffuse granular appearance. Cells were detected for up to 7 days in kidney and 12 days in liver. Signal intensity loss and fading over time were confirmed with serial R2* mapping. At histologic analysis, signal intensity loss correlated with iron-loaded cells, primarily in renal glomeruli and hepatic sinusoids; immunohistochemical analysis results confirmed these cells were MSCs. CONCLUSION: MR imaging can aid in monitoring of intravascularly administered SPIO-labeled MSCs in vivo in kidney and liver.     

Early radiation effects on the liver demonstrated on superparamegnetic iron oxide-enhanced T1-weighted MRI

Early radiation-induced liver injury during radiotherapy detected by a particulate reticuloendothelial MR contrast agent (superparamagnetic iron oxide; SPIO) is described in a patient with cholangiocarcinoma. The irradiated hepatic parenchyma appeared as a heterogeneous, less decreased signal intensity area than the nonirradiated area on MR images after SPIO administration. Resultant differences in signal intensity were better visualized on SPIO-enhanced T1-weighted images than SPIO-enhanced T2-weighted images, although SPIO-enhanced T2*-weighted fast field echo imaging was the most sensitive.     

Lung parenchyma: projection reconstruction MR imaging

Magnetic resonance (MR) imaging of lung parenchyma is limited by the low proton density and short T2 in the lung as well as the effects of susceptibility and motion. The MR imaging appearance of lung parenchyma was investigated with a pulse sequence that offers some solutions to these problems. This sequence employs projection reconstruction (PR) acquisition gradients and a section-selective excitation pulse designed to eliminate the need to refocus and to allow low-frequency k-space data to be collected with minimal delay. Echo times as short as 50 microseconds can be achieved, producing a proton-density-weighted image. An excised inflated lung specimen and specimens from human subjects with normal lungs (n = 3), pulmonary arteriovenous malformations (n = 1), bronchogenic carcinoma (n = 1), and bullous lung disease with lung metastases (n = 1) were examined. Signal intensity from lung parenchyma and visibility of pulmonary structures were superior on images obtained with the PR MR imaging technique compared with spin-echo images.     

MR evaluation of the glomerular homing of magnetically labeled mesenchymal stem cells in a rat model of nephropathy

PURPOSE: To assess renal glomerular homing of intravenously injected superparamagnetic iron oxide (SPIO)-labeled mesenchymal stem cells (MSCs) at in vivo and ex vivo magnetic resonance (MR) imaging in an experimental rat model of mesangiolysis. MATERIALS AND METHODS: Animal procedures were performed in accordance with protocols approved by Institutional Animal Care and Use Committee. Fourteen rats were divided into two groups: one pathologic (n = 10), with persistent mesangiolysis following simultaneous injection of OX-7 monoclonal antibody and puromycin aminonucleoside in which 10(7) SPIO- and DiI-labeled MSCs were injected, and one control (n = 4). In vivo and ex vivo MR imaging examinations were performed with 4.7- and 9.4-T spectrometers, respectively, and T2*-weighted sequences. In vivo signal intensity variations were measured in the liver and kidney before and 6 days after MSC injection. Intrarenal signal intensity variations were correlated with histopathologic data by means of colocalization of DiI fluorescence, alpha-actin, and Prussian blue stain-positive cells. Histologic differences between the glomerular homing of MSCs in different kidney portions were correlated to the areas of MR signal intensity decrease with nonparametric statistical tests. RESULTS: On in vivo images, signal intensity measurements of pathologic kidneys following MSC injection did not show any signal intensity decrease (P = .7), whereas a 34% +/- 14 (mean +/- standard deviation) signal intensity decrease was observed in the liver (P < .01), where a substantial number of labeled cells were trapped. On ex vivo images, pathologic kidneys showed focal cortical (glomerular) areas of signal intensity loss, which was absent in controls. The areas of low signal intensity correlated well with alpha-actin and Prussian blue stain- and DiI-positive areas (P < .01), which indicates that MSCs specifically home to injured tissue. No MSCs were detected in the kidneys of control animals. CONCLUSION: Intravenously injected MSCs specifically home to focal areas of glomerular damage and can be detected at ex vivo MR imaging.     

Volumetric interpolated contrast-enhanced MRA for the diagnosis of pulmonary embolism in an ex vivo system

PURPOSE: To implement a three-dimensional gradient-recalled echo (GRE) volumetric interpolated breath-hold examination (VIBE) sequence for pulmonary contrast-enhanced MRA (CE-MRA) in an experimental setup. MATERIALS AND METHODS: Eight porcine lungs were intubated, inflated inside a chest phantom, and examined at 1.5 T during slow perfusion (2-300 mL/minute). Three-dimensional-MRA was performed with and without contrast agent using three-dimensional-GRE (VIBE) with TR/TE = 4.5/1.9 msec, TA = 23 seconds, FOV = 390 mm, FA = 12 degrees /30 degrees, as well as a standard three-dimensional-GRE sequence and T2 fast spin-echo (FSE) sequences. Four of the eight lungs were embolized with autologous blood clots. By consensus readings, two observers evaluated the detectability of peripheral vessels, signal intensity over vessels and lung, and visualization of emboli. Digital subtraction angiograms served as a control to document vessel patency. RESULTS: Prior to contrast administration, three-dimensional-VIBE/12 degrees yielded the best results for lung parenchyma signal and visualization of small vessels (third-order, P < 0.01); however, no emboli were detected (due to lack of contrast). After administration of contrast agent, three-dimensional-GRE (VIBE) at FA = 30 degrees provided significantly better results (fifth-order branches, documentation of subsegmental occlusions [fourth order], P < 0.01). T2-FSE images documented water uptake into the lungs. Digitally subtracted angiography (DSA) confirmed the patency of seventh-order branches. CONCLUSION: This ex vivo study confirms the potential advantages of using a dual MR investigation for pulmonary embolism, combining three-dimensional-GRE (VIBE) at FA = 12 degrees to image lung parenchyma and at FA = 30 degrees for CE-MRA..     

In vivo and in vitro MR imaging of renal tumors: histopathologic correlation and pulse sequence optimization

Magnetic resonance (MR) imaging has given mixed results in the detection of renal masses. To identify the reasons for this and to determine the optimal pulse sequences for evaluating renal tumors, the authors imaged 12 primary renal tumors in vivo and 17 in vitro at 0.35 T. Histopathologic findings for each specimen were closely correlated with the MR images. Four of seven solid tumors imaged in vivo were isointense with surrounding normal renal parenchyma at all pulse sequences. The other three tumors were hyperintense in vivo at T2-weighted sequences. At heavily T2-weighted sequences eight solid tumors were hyperintense in vitro and four were hypointense. There was no correlation between signal intensity and specific tissue type or histologic pattern for solid tumors. The five cystic tumors were well seen both in vivo and in vitro on T2-weighted images. However, the signal intensity of the cyst fluid was an unreliable indicator of benignancy. SE MR imaging at 0.35 T has significant limitations in the detection of solid renal masses.     

MR imaging of solitary pulmonary lesion: emphasis on tuberculomas and comparison with tumors

The aim of this study was to determine whether solitary pulmonary tuberculoma and malignant tumor can be differentiated on the basis of magnetic resonance (MR) signal intensity. Twenty-eight patients with solitary pulmonary lesions were prospectively studied with MR imaging: T1-weighted, enhanced T1-weighted, proton density-weighted, and T2-weighted spin echo images were obtained. The confirmation methods used were computed tomography (CT)-guided biopsy in seven patients with lung cancer and four patients with tuberculosis; surgery in ten patients with lung cancer and five patients with tuberculosis; and laboratory data in two patients with tuberculosis. Morphologic features and MR signal intensity were examined in detail. As the test for detection of tuberculoma, signal difference on T2-weighted images was carefully analyzed. The signal intensity ratio of the nodule to thoracic muscle signal intensity was measured. The signal intensities obtained from the lung cancers and tuberculomas were variable on pre-and post-enhanced T1-weighted images and proton density-weighted images. Masses were hypointense in 2 of 17 patients with lung cancer and in 9 of 11 patients with tuberculoma on T2-weighted images (sensitivity 82%, specificity 89%, accuracy 87%). The mean signal intensity ratios of the tuberculomas to muscle were significantly lower than those of malignant tumors on T1-weighted, enhanced T1-weighted, proton density-weighted, and T2-weighted images (P < 0.0001). After gadolinium-DTPA enhancement, 2 malignant tumors and 7 tuberculomas showed a marginal rim enhancement pattern, whereas 15 malignant tumors and 2 tuberculomas revealed a diffuse enhancement. The results of MR imaging were consistent with those of CT in 84% of the patients. MR imaging is a helpful adjunctive method in terms of differentiating a tuberculoma from a malignant tumor.     

Magnetic resonance imaging of frozen tissues: temperature-dependent MR signal characteristics and relevance for MR monitoring of cryosurgery.

Previously, the magnetic resonance (MR) imaging appearance of frozen tissues created during cryosurgery has been described as a signal void. In this work, very short echo times (1.2 msec) allowed MR signals from frozen tissues to be measured at temperatures down to -35 degrees C. Ex vivo bovine liver, muscle, adipose tissue, and water were imaged at steady-state temperatures from -78 degrees to +6 degrees C. Signal intensity, T2*, and T1 were measured using gradient-echo imaging. Signal intensity and T2* decrease monotonically with temperature. In the future, these MR parameters may be useful for mapping temperatures during cryosurgery.     

MR imaging of traumatic lesions of the inferior alveolar nerve in patients with fractures of the mandible

BACKGROUND AND PURPOSE: The objective of this study was to assess whether MR imaging can image the neurovascular bundle in patients with fractures of the mandible. In addition, an attempt was made to evaluate whether MR images provide information regarding the continuity of the inferior alveolar nerve before surgery and regarding signal intensity changes after trauma. METHODS: We analyzed preoperative MR images of 23 patients with mandibular fractures. Object-oriented sagittal view proton density- and T1-weighted sequences (before and after the administration of contrast agent) were used not only in an attempt to obtain purely qualitative information regarding nerve continuity in the neurovascular bundle (inferior alveolar nerve, artery, vein) but also to perform quantitative region-of-interest measurements of signal intensities at four defined measurement sites. The measurements were compared with those obtained for a patient population with healthy mandibles. RESULTS: It was possible to interpret MR images in 21 cases. MR imaging findings showed that the neurovascular bundle had been cut in two patients and was intact in the remaining 19 patients. These MR imaging findings were confirmed intraoperatively in all cases. Although we found no significant signal intensity differences between patients with intact nerves and patients with cut nerves, we found significant differences between patients with mandibular fractures and patients with unremarkable mandibles. CONCLUSION: It is possible to diagnose the interruption of nerve continuity by using MR imaging. Signal intensity measurements in the neurovascular bundle provide no information regarding nerve continuity.     

Temporal dynamics of blood flow effects in half-Fourier fast spin echo (1)H magnetic resonance imaging of the human lungs

A cardiac-triggered half-Fourier single-shot turbo spin echo (HASTE) technique is currently the method of choice for MR imaging of the lung parenchyma without the use of exogenous contrast agents. In this study, we specifically examined the effects of the cardiac cycle on the HASTE signal intensity of the lungs. Images were obtained from six healthy human volunteers at an end expiration breath-hold using a HASTE sequence and a variable cardiac-triggered delay time. Analysis of the data sets showed a 30% decrease in the lung signal intensity during systole, and a 15% decrease during mid-diastole. These decreases correlate with phases of the cardiac cycle when the blood flow in the lungs is expected to be greatest. Misregistration artifacts, particularly from the pulmonary arteries and aorta, are worse during these periods of signal decrease. To minimize cardiac dependent signal losses, HASTE lung imaging should be performed after systole but before rapid filling of the ventricles.     

Differentiation of glioblastoma multiforme and single brain metastasis by peak height and percentage of signal intensity recovery derived from dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging

BACKGROUND AND PURPOSE: Glioblastoma multiforme (GBM) and single brain metastasis (MET) are the 2 most common malignant brain tumors that can appear similar on anatomic imaging but require vastly different treatment strategy. The purpose of our study was to determine whether the peak height and the percentage of signal intensity recovery derived from dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MR imaging could differentiate GBM and MET. MATERIALS AND METHODS: Forty-three patients with histopathologic diagnosis of GBM (n=27) or MET (n=16) underwent DSC perfusion MR imaging in addition to anatomic MR imaging before surgery. Regions of interest were drawn around the nonenhancing peritumoral T2 lesion (PTL) and the contrast-enhancing lesion (CEL). T2* signal intensity-time curves acquired during the first pass of gadolinium contrast material were converted to the changes in relaxation rate to yield T2* relaxivity (Delta R2*) curve. The peak height of maximal signal intensity drop and the percentage of signal intensity recovery at the end of first pass were measured for each voxel in the PTL and CEL regions of the tumor. RESULTS: The average peak height for the PTL was significantly higher (P=.04) in GBM than in MET. The average percentage of signal intensity recovery was significantly reduced in PTL (78.4% versus 82.8%; P=.02) and in CEL (62.5% versus 80.9%, P<.01) regions of MET compared with those regions in the GBM group. CONCLUSIONS: The findings of our study show that the peak height and the percentage of signal intensity recovery derived from the Delta R2* curve of DSC perfusion MR imaging can differentiate GBM and MET.