Localized proton MR spectroscopy of citrate in vitro and of the human prostate in vivo at 1.5 T

Citrate is a secretory product of the normal prostate, a lack of citrate in prostate tissue is expected to be pathognomonic for adenocarcinoma. In the present study proton AB-signal characteristics of citrate at low field strength of 1.5 T were investigated by volume selective spectroscopic and theoretical methods. The nonappearance of fast phase modulation of the J-coupled system at low field strength in vivo is verified by measurements of sodium citrate solution. In vivo localized spectroscopy of small volume elements of (2 cm)³ with the double spin-echo method within the prostatic gland provides citrate signal reception even using a Helmholtz coil with 170-mm diameter. Volume selective proton spectra with different echo times are presented which are comparable to spectra acquired by former authors with endorectal coils.     

In vivo proton MR spectroscopy of primary tumours,nodal and recurrent disease of the extracranial head and neck

Benign and malignant neoplasms as well as metastatic lymph nodes of 39 patients were examined using localized single voxel magnetic resonance spectroscopy (MRS) [repetition time (TR) 1500, echo time (TE) 135) at 1.5 T. New techniques with simultaneous correction of motion artefacts during the acquisition, three-dimensional saturation pulses, respiratory triggering and smaller volume of interest (VOI) size, were applied. Ratios of peak areas under the choline (Cho) and creatine (Cr) resonances were estimated in all cases and compared with those from samples of normal tissue. Ninety one spectra were acquired in 39 patients, 63 of which were suitable for further evaluation. The smallest VOI was 0.40 cm³. The Cho/Cr ratios in all malignant neoplasms (mean: 5.2, range: 1.7–17.8) were significantly elevated relative to those in the normal muscle structures (mean: 0.9, range: 0.2–1.4), while those in the benign neoplasms were elevated (mean: 24.4, range: 1.4–59.7) with respect to those in the malignant ones. The average Cho/Cr ratio in the metastatic lymph nodes was significantly higher (mean: 4.8, range: 3.3–5.6) than that for benign lymphoid hyperplasia (mean: 2.2, range: 1.0–3.0). MRS measurements were able to differentiate recurrent disease from post-therapeutic tissue changes in 11 out of 13 patients.     

Quantification of choline compounds in human hepatic tumors by proton MR spectroscopy at 3 T.

The quantification of choline-containing compounds (Cho) in hepatic tumors by (1)H MR spectroscopy (MRS) is of great interest because such compounds have been linked to malignancy. In this study, a practical external phantom replacement method for the absolute quantification of hepatic metabolites is demonstrated. We performed experiments at 3 T using a body coil, and used an external phantom containing choline chloride for calibration. We first tested the quantification strategy to confirm its suitability in vivo using a phantom of known concentration and normal brain tissue. The results obtained after coil loading and T(1) and T(2) effects were corrected for were consistent with the known concentration and previously published values. To demonstrate its feasibility, we applied the technique to liver studies conducted on five normal volunteers and four patients with hepatocellular carcinoma, and one patient (also in the latter group) who had undergone post-transcatheter arterial chemoembolization (TACE). The Cho concentrations in the four patients were estimated to be 3.4, 6.3, 7.4, and 14.0 mM, respectively. These values are substantially higher than those obtained from the healthy volunteers (1.3 +/- 0.9 mM (mean +/- SD)). The results indicate that the proposed method is accurate and requires fewer tedious procedures for MRS; therefore, it may be a promising technique for evaluating response to treatment in liver cancer.     

Role of MR spectroscopy and diffusion-weighted imaging in diagnosis of orbital masses

Purpose

To assess the value of (MRI), (DWI) and (MRS) in the diagnosis of different orbital masses and differentiation between benign and malignant masses.

Localized proton MR spectroscopy of the brain in children

Small-voxel (3.0–8.0 cm³), magnetic resonance (MR) imaging–guided proton MR spectroscopy was performed in 54 patients (aged 6 days to 19 years) with intracranial masses (n = 16), neurodegenerative disorders (n = 34), and other neurologic diseases (n = 4) and in 23 age-matched control subjects without brain disease. A combined short TE (18 msec) stimulatedecho acquisition mode (STEAM) and long TE (135 and/or 270 msec) spin-echo point-resolved spatially localized spectroscopy (PRESS) protocol, using designed radio-frequency pulses, was performed at 1.5 T. STEAM spectra revealed short T2 and/or strongly coupled metabolites; prominent resonances were obtained from N-acetyl aspartate (NAA), choline-containing compounds (Cho), and total creatine (tCr). Lactate was well resolved with the long TE PRESS sequence. Intracranial tumors were readily differentiated from cerebrospinal fluid (CSF) collections. All tumors showed low NAA, high Cho, and reduced tCr levels. Neurodegenerative disorders showed low or absent NAA levels and enhanced mobile lipid, glutamate and glutamine, and inositol levels, consistent with neuronal loss, gliosis, demyelination, and amino acid neuro-toxicity. Preliminary experience indicates that proton MR spectroscopy can contribute in the evaluation of central nervous system abnormalities of infants and children.     

Diffusion-weighted imaging and proton MR spectroscopy in the characterization of acute disseminated encephalomyelitis

Introduction Acute disseminated encephalomyelitis (ADEM) is usually a monophasic illness characterized by multiple lesions involving gray and white matter. Quantitative MR techniques were used to characterize and stage these lesions. Methods Eight patients (seven males and one female; mean age 19 years, range 5 to 36 years) were studied using conventional MRI (T2- and T1-weighted and FLAIR sequences), diffusion-weighted imaging (DWI) and proton magnetic resonance spectroscopy (MRS). Apparent diffusion coefficient (ADC) values and MRS ratios were calculated for the lesion and for normal-appearing white matter (NAWM). Three patients were imaged in the acute stage (within 7 days of the onset of neurological symptoms) and five in the subacute stage (after 7 days from the onset of symptoms). Results ADC values in NAWM were in the range 0.7–1.24×10⁻³ mm/s² (mean 0.937 ± 0.17 mm/s²). ADC values of ADEM lesions in the acute stage were in the range 0.37–0.68×10⁻³ mm/s² (mean 0.56 ± 0.16 mm/s²) and 1.01–1.31×10⁻³ mm/s² (mean 1.24 ± 0.13 mm/s²) in the subacute stage. MRS ratios were obtained for all patients. NAA/Cho ratios were in the range 1.1–3.5 (mean 1.93 ± 0.86) in the NAWM. NAA/Cho ratios within ADEM lesions in the acute stage were in the range 0.63–1.48 (mean 1.18 ± 0.48) and 0.29–0.84 (mean 0.49 ± 0.22) in the subacute stage. The ADC values, NAA/Cho and Cho/Cr ratios were significantly different between lesions in the acute and subacute stages (P < 0.001, P < 0.027, P < 0.047, respectively). ADC values were significantly different between lesions in the acute (P < 0.009) and subacute stages (P < 0.005) with NAWM. In addition, NAA/Cho and Cho/Cr ratios were significantly different between lesions in the subacute stage and NAWM (P < 0.006, P < 0.007, respectively). Conclusion ADEM lesions were characterized in the acute stage by restricted diffusion and in the subacute stage by free diffusion and a decrease in NAA/Cho ratios. Restricted diffusion and progressive decrease in NAA/Cho ratios may help in staging the disease.     

正常人脑不同区域^1H磁共振波谱研究

目的：应用１Ｈ磁共振波谱技术研究正常人脑内化合物的含量和分布。材料和方法：应用１．５Ｔ磁共振仪对１８例正常人脑进行１Ｈ波谱测试，测量的感兴趣区包括大脑皮层、白质、丘脑和小脑，所用序列为激励回波探测序列（ｓｔｉｍｕｌａｔｅｄｅｃｈｏａｑｕｉｓｉｔｉｏｎｍｏｄｅ，ＳＴＥＡＭ）。结果：１Ｈ磁共振波谱可以检测出脑内许多化合物，如Ｎ－乙酰门冬氨酸（ＮＡＡ）、含胆碱类化合物（Ｃｈｏ）、肌酸和磷酸肌酸（Ｃｒ＋Ｐｃｒ）、谷氨酸和谷氨酰胺（Ｇｌｕ＋Ｇｌｎ）、脂质、乳酸等。各化合物的浓度在脑的不同区域存在着差异。ＮＡＡ／Ｃｈｏ比值在灰质最高，小脑最低。Ｃｒ／Ｃｈｏ比值在小脑最高、白质最低。设定肌酸的浓度在灰质和小脑为１０ｍｍｏｌ／Ｌ，在白质和丘脑为１１ｍｍｏｌ／Ｌ，计算ＮＡＡ的绝对浓度为１３～２３ｍｍｏｌ／Ｌ，并且灰质的含量高于小脑和丘脑。结论：１Ｈ磁共振波谱技术可无创性检测出脑组织中与能量代谢、氨基酸、脂肪酸及神经递质有关的化合物，并可定量测定，有助于研究生理和疾病时脑生化改变。     

MR imaging and proton spectroscopy of the brain in posttraumatic cortical blindness

Magnetic resonance (MR) imaging and localized proton MR spectroscopy of the occipital lobes were performed in a patient with cortical blindness following brain trauma. Computed tomography (CT) scans and MR images of the visual cortex were normal in the acute stage. Six weeks after the trauma, MR images showed cortical lesions in both occipital lobes, while the spectra showed elevated lactate and decreased N-acetyl aspartate levels relative to those of healthy volunteers. One year later, visual acuity had improved and follow-up studies revealed an increase in the ratios of N-acetyl aspartate to choline and creatine. These results demonstrate that parenchymal lesions may develop in brain regions that appear normal at CT and MR imaging during the acute stage after trauma. Metabolic changes can be observed in these areas by means of localized proton MR spectroscopy.     

3D -FLASH序列动态MR增强扫描技术在乳腺疾病中的应用

目的 探讨3D-FLASH动态增强扫描在乳腺疾病检查中的应用价值. 方法 将108例经病理证实的乳腺疾病患者作为研究对象,均为女性,年龄35～76岁,平均47岁,使用Siemens 1.0T超导磁共振扫描仪和双环极阵列乳腺线圈.均先常规平扫,静脉注射造影剂Gd-DTPA(0.1 mmol/kg体重)后,三维-快速小角度激发(3D-FLASH)序列获得双侧乳腺轴位动态增强图像并进行减影. 结果 108例中,良性病变62例,乳腺癌46例,术前MRI诊断符合率81.5%. 结论 3D-FLASH序列动态增强是乳腺病变中最有价值的检查序列.     

MRI and in vivo proton MR spectroscopy in a racemose cysticercal cyst of the brain

Racemose cysticercal cyst is the subarachnoid manifestation of the larvae of Taenia solium. On MRI the cysts may resemble other cystic masses. We report the magnetic resonance spectroscopy (MRS) features of a case on in vivo proton spectroscopy and discuss its role in the diagnosis of intracranial cysts of parasitic aetiology.     

Combined apparent diffusion coefficient value (ADC) and 1H magnetic resonance spectroscopy (MRS) in breast lesions: Benefits and limitations

Objective

This study aimed to assess the diagnostic value of a combined imaging protocol of diffusion-weighted MRI, apparent diffusion coefficient (ADC) values, and MR spectroscopy(MRS) in discriminating benign and malignant breast lesions.

Localized proton MR spectroscopy of the human kidney in vivo by means of short echo time STEAM sequences

In order to obtain proton magnetic resonance spectra from the normal human kidney in vivo, we employed a STEAM sequence with delay times TE= 10 ms and TM = 30 ms. Signals are attenuated during STEAM sequences by J-coupling effects and by macroscopic movement of the sample. The combination of short echo times and respiratory triggering ensured that the kidney was stationary during the pulse sequence, and allowed us to detect strongly coupled resonances between 3 and 4.2 ppm. Analysis of spectra of extracts of bovine kidneys suggested that the renal MR-visible metabolites could include the osmolytes betaine, myo-inositol, and glycerophosphocholine. Four volunteers were subjected to overnight dehydration followed by rehydration, and we found that these signals increased significantly after dehydration, and decreased significantly 4 h after rehydration, thus supporting the assignment of the resonances as osmotically active metabolites.     

High spatial resolution 3D MR cholangiography with high sampling efficiency technique (SPACE): comparison of 3T vs. 1.5T

Purpose

The aim of this study was to evaluate image quality of 3D MR cholangiography (MRC) using high sampling efficiency technique (SPACE) at 3 T compared with 1.5 T.

Methods and materials

An IRB approved prospective study was performed with 17 healthy volunteers using both 3 and 1.5 T MR scanners. MRC images were obtained with free-breathing navigator-triggered 3D T2-weighted turbo spin-echo sequence with SPACE (TR, >2700 ms; TE, 780 ms at 3 T and 801 ms at 1.5 T; echo-train length, 121; voxel size, 1.1 mm × 1.0 mm × 0.84 mm). The common bile duct (CBD) to liver contrast-to-noise ratios (CNRs) were compared between 3 and 1.5 T. A five-point scale was used to compare overall image quality and visualization of the third branches of bile duct (B2, B6, and B8). The depiction of cystic duct insertion and the highest order of bile duct visible were also compared. The results were compared using the Wilcoxon signed-ranks test.

Results

CNR between the CBD and liver was significantly higher at 3 T than 1.5 T (p = 0.0006). MRC at 3 T showed a significantly higher overall image quality (p = 0.0215) and clearer visualization of B2 (p = 0.0183) and B6 (p = 0.0106) than at 1.5 T. In all analyses of duct visibility, 3 T showed higher scores than 1.5 T.

Conclusion

3 T MRC using SPACE offered better image quality than 1.5 T. SPACE technique facilitated high-resolution 3D MRC with excellent image quality at 3 T.     

MR imaging of the internal auditory canal and inner ear at 3T: comparison between 3D driven equilibrium and 3D balanced fast field echo sequences

OBJECTIVE: To compare the use of 3D driven equilibrium (DRIVE) imaging with 3D balanced fast field echo (bFFE) imaging in the assessment of the anatomic structures of the internal auditory canal (IAC) and inner ear at 3 Tesla (T). MATERIALS AND METHODS: Thirty ears of 15 subjects (7 men and 8 women; age range, 22-71 years; average age, 50 years) without evidence of ear problems were examined on a whole-body 3T MR scanner with both 3D DRIVE and 3D bFFE sequences by using an 8-channel sensitivity encoding (SENSE) head coil. Two neuroradiologists reviewed both MR images with particular attention to the visibility of the anatomic structures, including four branches of the cranial nerves within the IAC, anatomic structures of the cochlea, vestibule, and three semicircular canals. RESULTS: Although both techniques provided images of relatively good quality, the 3D DRIVE sequence was somewhat superior to the 3D bFFE sequence. The discrepancies were more prominent for the basal turn of the cochlea, vestibule, and all semicircular canals, and were thought to be attributed to the presence of greater magnetic susceptibility artifacts inherent to gradient-echo techniques such as bFFE. CONCLUSION: Because of higher image quality and less susceptibility artifacts, we highly recommend the employment of 3D DRIVE imaging as the MR imaging choice for the IAC and inner ear.     

Detection and quantification of breast tumor necrosis with MR imaging: value of the necrosis-avid contrast agent Gadophrin-3

RATIONALE AND OBJECTIVES: The authors evaluated the use of T1-weighted magnetic resonance (MR) imaging with Gadophrin-3 enhancement and of plain T2-weighted MR imaging to detect and quantify breast tumor necrosis. MATERIALS AND METHODS: Twenty EMT-6 tumors (mouse mammary sarcoma), implanted into the mammary fat pad of BALB/c-AnNCrl mice, underwent MR imaging with plain T2-weighted and T1-weighted fast field echo sequences before and 24 hours after injection of Gadophrin-3, a new necrosis-avid contrast agent. Tumor necrosis on MR images was quantified by means of a dedicated segmentation program and was correlated with histologic findings. RESULTS: In all tumors a central necrosis was revealed by histopathologic analysis, and central enhancement was seen with Gadophrin-3 on T1-weighted images. Small tumors (diameter, < 1 cm) showed an inhomogeneous central enhancement, whereas larger tumors (diameter, > 1 cm) enhanced mainly in the periphery of necrotic tissue. Plain T2-weighted images showed a hyperintense central area in only three of 20 cases with a large central necrosis. CONCLUSION: Gadophrin-3-enhanced T1-weighted images are superior to plain T2-weighted images for the detection of necrosis in a murine tumor xenograft model.     

Radiologists' performance in the detection of benign and malignant masses with 3D automated breast ultrasound (ABUS)

Objectives

To retrospectively evaluate the detection performance of benign and malignant breast masses using 3D volume data obtained by ABUS and to determine lesion variables which affect detectability.

Methods

Between November and December of 2007, bilateral whole breast US images were obtained using ABUS in 67 consecutive women who were scheduled to undergo US-guided needle biopsy due to suspicious breast masses. Twenty-four invasive ductal cancers in 23 breasts, 46 benign breast lesions in 44 breasts and 38 normal breasts were included. Three breast radiologists (experience range, 8-16 years) who did not perform the examinations and were blinded to the histology independently reviewed the ABUS data of the 105 breasts to detect suspicious solid masses with pathology as the standard of reference. Sensitivity and specificity in detecting benign and malignant masses were calculated, and lesion characteristics affecting detectability were analyzed.

Results

Sensitivities for benign and malignant mass detections were 65.2% (30/46), 95.8% (23/24) for reader 1 (p = 0.007), 66.7% (31/46), 87.5% (21/24) for reader 2 (p = 0.087), and 56.3% (24/46), 91.7% (22/24), for reader 3 (p = 0.001), respectively. Logistic analysis showed that mass size (odds ratio, 95% CI; 1.12, 1.02-1.24), surrounding tissue changes (odds ratio, 95% CI; 0.11, 0.02-0.47), and shape of the mass (odds ratio, 95% CI; 3.12, 1.02-9.55) were the variables associated with detectability at ABUS.

Conclusion

In reader studies using ABUS data, significantly higher sensitivity was noted for malignant breast masses than for benign masses.     

Gender and age groups interactions in the quantification of bone marrow fat content in lumbar spine using 3T MR spectroscopy: A multivariate analysis of covariance (Mancova)

Introduction

There is an age-related conversion of red to yellow bone marrow in the axial skeleton, with a gender-related difference less well established. Our purpose was to clarify the variability of bone marrow fat fraction (FF) in the lumbar spine due to the interaction of gender and age groups.

Methods

44 healthy volunteers (20 males, 30–65 years old and 24 females, 30–69 years old) underwent 3T magnetic resonance spectroscopy (MRS) and conventional MRI examination of the lumbar spine; single-voxel spectrum was acquired for each vertebral body (VB). After controlling body mass index (BMI), a two-way between-groups multivariate analysis of covariance (MANCOVA) assessed the gender and age group differences in FF quantification for each lumbar VB.

Results

There was a significant interaction between gender and age group, p = .017, with a large effect size (partial η² = .330). However the interaction explained only 33% of the observed variance. Main effects were not statistically significant. BMI was non-significantly related to FF quantification.

Conclusions

Young males showed a high FF content, which declined in the 4th decade, then increased the next 3 decades to reach a FF content just below the initial FF means. Females’ FF were low in the 3rd decade, depicted an accelerated increase in the 4th decade, then a gradual increase the next 3 decades to reach a FF content similar to males’ values. Our findings suggest that quantification of bone marrow FF using MRS might be used as a surrogate biomarker of bone marrow activity in clinical settings.     

Dynamic 13C−1H nuclear polarization of lipid methylene resonances applied to broadband proton-decoupled in vivo 13C MR spectroscopy of human breast and calf tissue

Dynamic nuclear polarization of the coupled ¹³C?^lH spin system was studied for optimizing the signal-to-noise ratio of in vivo ¹³C MR spectra. In particular, the truncated driven and transient nuclear Overhauser effect (NOE) of the proton-decoupled ¹³C resonances from methylene carbons in vegetable oil and in human calf tissue was observed. Maximum in vivo NOE enhancements n = 1.5 and 0.9 were found, respectively. Theoretical fits to the data yield ¹³C?¹ cross-relaxation times in the order of 0.6 s. Significant signal enhancement over the whole in vivo ¹³C chemical shift range is obtained with minimum expense utilizing the NOE of the dipolar coupled ¹³C?¹ spin system in addition to proton-decoupling. NOE-enhanced proton-decoupled in vivo ¹³C MR spectra were acquired within 17 min in volunteer examinations from the human breast and the calf. These spectra show well-resolved resonances of carbons in lipids and several other cellular compounds.     

(1)H MR spectroscopy of inflammation, infection and ischemia of the brain

Different pathologic patterns in multiple sclerosis (MS) are reflected by alterations of metabolites in (1)H MR spectroscopy of the brain. Elevated choline (Cho), lactate (Lac), lipids and macromolecules are reliable markers for acute demyelination regardless of the clinical entity (also in acute disseminated encephalomyelitis). N-acetyl-aspartate (NAA) is a suitable marker for neuronal integrity. It is reduced in acute MS lesions and in normal appearing white matter, even distant to acute and chronic-lesions. Recovery from reduced NAA levels to subnormal values during remyelination, and varying time courses of NAA in normal appearing white matter during relapsing remitting disease indicate the value of this spectroscopic marker for monitoring activity and recovery. Inositol (Ins) is increased in chronic MS lesions being a marker for astrocytic gliosis. In viral disease, Cho and Ins are always increased, whereas a reduction of NAA mostly reflects an advanced or a detoriated clinical state. In bacterial brain abscesses, numerous amino acids, lipids and Lac can be elevated. In ischemia, especially the Lac/NAA in comparison with perfusion and diffusion weighted imaging seems to be a new measure for areas of metabolic need, and may help to better characterise the penumbra of the stroke and the final infarct size.