Dynamic hysteresis between gradient echo and spin echo attenuations in dynamic susceptibility contrast imaging

Perfusion measurements using dynamic susceptibility contrast imaging provide additional information about the mean vessel size of microvasculature when supplemented with a dual gradient echo (GE) – spin echo (SE) contrast. Dynamic increase in the corresponding transverse relaxation rate constant changes, ΔR_2GE and ΔR_2SE, forms a loop on the (Δ, ΔR_2GE) plane, rather than a reversible line. The shape of the loop and the direction of its passage differentiate between healthy brain and pathological tissue, such as tumour and ischemic tissue. By considering a tree model of microvasculature, the direction of the loop is found to be influenced mainly by the relative arterial and venous blood volume, as well as the tracer bolus dispersion. A parameter Λ is proposed to characterize the direction and shape of the loop, which might be considered as a novel imaging marker for describing the pathology of cerebrovascular network. Magn Reson Med 69:981–991, 2013. © 2012 Wiley Periodicals, Inc.     

Study of gradient echo (GRE) Dixon image using low-field MRI scanner for examination of metastatic bone marrow tumors: comparison of double and single echo sequences

We evaluated the gradient echo (GRE) Dixon method in metastatic bone tumors using a low-field MRI scanner (0.2 Tesla). This method is characterized by the double echo sequence of in-phase and opposed-phase. Studies were carried out on a phantom, 14 healthy volunteers, and clinical examples (33 vertebral bodies) using the T(1)-weighted spin echo, T(2)-weighted turbo spin echo, and GRE Dixon methods. Further, we obtained addition and subtraction images from the double echo sequence. In the clinical examples, the contrast-to-noise ratio (CNR) of the subtraction images (51.3+/-24.1) was significantly better than that of the T(1)-SE images (6.7+/-3.1, p<0.0001). For the examination of metastatic bone marrow tumors using a low-field MRI scanner (0.2 Tesla), subtraction images are thought to be the most effective.     

Fat quantification with IDEAL gradient echo imaging: correction of bias from T(1) and noise.

Quantification of hepatic steatosis is a significant unmet need for the diagnosis and treatment of patients with nonalcoholic fatty liver disease (NAFLD). MRI is capable of separating water and fat signals in order to quantify fatty infiltration of the liver (hepatic steatosis). Unfortunately, fat signal has confounding T(1) effects and the nonzero mean noise in low signal-to-noise ratio (SNR) magnitude images can lead to incorrect estimation of the true lipid percentage. In this study, the effects of bias from T(1) effects and image noise were investigated. An oil/water phantom with volume fat-fractions ranging linearly from 0% to 100% was designed and validated using a spoiled gradient echo (SPGR) sequence in combination with a chemical-shift based fat-water separation method known as iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL). We demonstrated two approaches to reduce the effects of T(1): small flip angle (flip angle) and dual flip angle methods. Both methods were shown to effectively minimize deviation of the measured fat-fraction from its true value. We also demonstrated two methods to reduce noise bias: magnitude discrimination and phase-constrained reconstruction. Both methods were shown to reduce this noise bias effectively from 15% to less than 1%.     

MR gradient echo imaging of intravascular blood oxygenation: T2* determination in the presence of flow

The T₂* relaxation time of blood varies with its oxygen saturation. To evaluate the feasibility of imaging intravascular blood oxygenation in humans using a conventional 1.5T MR system, we have implemented a method to measure T₂* of blood despite the presence of pulsatile flow. The method was tested in a) stationary and flow phantoms, b) blood samples at different levels of oxygen saturation, and c) a human hypoxia model. Our results demonstrate the ability of cardiac-triggered, flow compensated gradient echo imaging to obtain reproducible T₂* measurements of flowing blood in vivo.     

Cartilage imaging at 3.0T with gradient refocused acquisition in the steady-state (GRASS) and IDEAL fat-water separation

PURPOSE: To demonstrate the feasibility of evaluating the articular cartilage of the knee joint at 3.0T using gradient refocused acquisition in the steady-state (GRASS) and iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) fat-water separation. MATERIALS AND METHODS: Bloch equation simulations and a clinical pilot study (n = 10 knees) were performed to determine the influence of flip angle of the IDEAL-GRASS sequence on the signal-to-noise ratio (SNR) of cartilage and synovial fluid and the contrast-to-noise ratio (CNR) between cartilage and synovial fluid at 3.0T. The optimized IDEAL-GRASS sequence was then performed on 30 symptomatic patients as part of the routine 3.0T knee MRI examination at our institution. RESULTS: The optimal flip angle was 50 degrees for IDEAL-GRASS cartilage imaging, which maximized contrast between cartilage and synovial fluid. The IDEAL-GRASS sequence consistently produced high-quality fat- and water-separated images of the knee with bright synovial fluid and 0.39 x 0.67 x 1.0 mm resolution in 5 minutes. IDEAL-GRASS images had high cartilage SNR and high contrast between cartilage and adjacent joint structures. The IDEAL-GRASS sequence provided excellent visualization of cartilage lesions in all patients. CONCLUSION: The IDEAL-GRASS sequence shows promise for use as a morphologic cartilage imaging sequence at 3.0T.     

Contrast-enhanced MR imaging of metastatic brain tumor at 3 tesla: utility of T(1)-weighted SPACE compared with 2D spin echo and 3D gradient echo sequence.

We evaluated the newly developed whole-brain, isotropic, 3-dimensional turbo spin-echo imaging with variable flip angle echo train (SPACE) for contrast-enhanced T(1)-weighted imaging in detecting brain metastases at 3 tesla (T). Twenty-two patients with suspected brain metastases underwent postcontrast study with SPACE, magnetization-prepared rapid gradient-echo (MP-RAGE), and 2-dimensional T(1)-weighted spin echo (2D-SE) imaging at 3T. We quantitatively compared SPACE, MP-RAGE, and 2D-SE images by using signal-to-noise ratios (SNRs) for gray matter (GM) and white matter (WM) and contrast-to-noise ratios (CNRs) for GM-to-WM, lesion-to-GM, and lesion-to-WM. Two blinded radiologists evaluated the detection of brain metastases by segment-by-segment analysis and continuously-distributed test. The CNR between GM and WM was significantly higher on MP-RAGE images than on SPACE images (P<0.01). The CNRs for lesion-to-GM and lesion-to-WM were significantly higher on SPACE images than on MP-RAGE images (P<0.01). There was no significant difference in each sequence in detection of brain metastases by segment-by-segment analysis and the continuously-distributed test. However, in some cases, the lesions were easier to detect in SPACE images than in other sequences, and also the vascular signals, which sometimes mimic lesions in MP-RAGE and 2D-SE images, were suppressed in SPACE images. In detection of brain metastases at 3T magnetic resonance (MR) imaging, SPACE imaging may provide an effective, alternative approach to MP-RAGE imaging for 3D T(1)-weighted imaging.     

Comparison of echo planar imaging, gradient echo and fast spin echo MR scans of knee menisci.

In order to reduce the acquisition time, we compared a three-dimensional multi-shot echo-planar imaging (EPI) sequence with fat-suppression with two widely used sequences, the fat-suppressed gradient echo (GRE) and the proton-density weighted turbo spin-echo (FSE) in imaging the menisci of the knee. Sixty patients with various indications were studied prospectively with MRI. The menisci were imaged in the sagittal plane with all three sequences using a 1T MR scanner with 15mT/m gradients. The signal-to-noise ratio (SNR) of bone (b), cartilage (c), and meniscus (m) as well as contrast-to-noise ratio (CNR) and relative contrast (ReCon) between menisci and cartilage and between bone and cartilage were measured. A qualitative analysis was performed on grading of meniscal pathology (0-IV). The imaging accuracy of meniscal pathology was assessed compared to arthroscopy in 13 patients. The EPI provided the highest SNR in cartilage and meniscus (p<0.001), the highest CNR and the highest ReCon between bone and cartilage (p< or =0.001). MR grading of meniscal abnormalities showed overestimation compared to GRE and FSE. The EPI sequence could not be included in the routine protocol in imaging the menisci since the overestimation of meniscal abnormalities could lead to unnecessary arthroscopy.     

Gradient and stimulated echo (GRASTE) imaging.

As a modification of single-shot stimulated echo acquisition mode (STEAM) MRI, a gradient and stimulated echo (GRASTE) sequence is presented that acquires multiple gradient echoes in addition to each stimulated echo. While "contiguous" GRASTE exploits all stimulated echoes for the central part of k-space and the gradient echoes for outer lines, "interleaved" GRASTE assigns all echoes of a particular readout interval to directly neighboring lines. Phase distortions may be corrected by the reference signals of a single readout interval without phase encoding. Experimental results obtained for the human brain demonstrate that contiguous GRASTE yields up to 30% better SNR per acquisition time than conventional single-shot STEAM due to a better efficiency and maintains most of its robustness. Interleaved GRASTE can improve the SNR by a factor of 2 because of the possibility of using larger flip angles in the readout interval. However, its more pronounced sensitivity to off-resonance effects requires short echo trains.     

Myocardial first pass perfusion: steady-state free precession versus spoiled gradient echo and segmented echo planar imaging.

The imaging sequences used in first pass (FP) perfusion to date have important limitations in contrast-to-noise ratio (CNR), temporal and spatial resolution, and myocardial coverage. As a result, controversy exists about optimal imaging strategies for FP myocardial perfusion. Since imaging performance varies from subject to subject, it is difficult to form conclusions without direct comparison of different sequences in the same subject. The purpose of this study was to directly compare the saturation recovery SSFP technique to other more commonly used myocardial first pass perfusion techniques, namely spoiled GRE and segmented EPI. Differences in signal-to-noise ratio (SNR), CNR, relative maximal upslope (RMU) of signal amplitude, and artifacts at comparable temporal and spatial resolution among the three sequences were investigated in computer simulation, contrast agent doped phantoms, and 16 volunteers. The results demonstrate that SSFP perfusion images exhibit an improvement of approximately 77% in SNR and 23% in CNR over spoiled GRE and 85% SNR and 50% CNR over segmented EPI. Mean RMU was similar between SSFP and spoiled GRE, but there was a 58% increase in RMU with SSFP versus segmented EPI.     

MR imaging of the cavernous sinus: value of spin echo and gradient recalled echo images

A detailed evaluation of the MR appearance of the pituitary gland-cavernous sinus junction has not been described. In a series of coronal T1-weighted spin echo images without and with IV gadolinium, we noted the variable size and signal intensity of cavernous venous spaces adjacent to the pituitary gland and the inconsistent visualization of the dural membrane just lateral to the gland. Correlation of coronal T1-weighted spin echo and gradient recalled echo images (the latter with high-signal-intensity vascular structures) proved to be an effective means of identifying cavernous venous spaces, connective tissue and cranial nerves, and the lateral margins of the pituitary gland, and of differentiating tumor tissue from cavernous venous spaces. Further work is needed to develop criteria to distinguish cavernous sinus compression from actual tumor invasion.     

Fast interactive real-time magnetic resonance imaging of cardiac masses using spiral gradient echo and radial steady-state free precession sequences

RATIONALE AND OBJECTIVES: Cardiac and respiratory controlled MR-imaging is the gold standard for imaging of cardiac masses. However, this technique may be limited in patients with dyspnoe or arrhythmia. The aim of this study was the evaluation of an interactive MR-approach for the detection and localization of cardiac masses. METHODS: Interactive real-time spiral gradient-echo (spiralGE) and radial steady-state-free-precession (radialSSFP) MR-imaging was performed during free-breathing and without cardiac triggering in 15 patients with 14 intracardiac or paracardiac masses. Standard cardiac triggered segmented k-space breath-hold steady-state-free-precession cine MR-imaging was used as the reference MR-imaging technique. Two groups of investigators blinded to clinical data were ask to rank image quality and to identify cardiac masses on real-time MR-images. RESULTS: Image quality was superior using radialSSFP when compared with spiralGE. Using radialSSFP all masses were correctly detected while 6 of 14 masses were missed on spiralGE. Mean real-time MR-imaging time was less than 3 minutes for both techniques. CONCLUSION: Interactive real-time radialSSFP MR-imaging allows for accurate and fast detection of cardiac masses without the need of cardiac or respiratory triggering.     

Improved efficiency in 2DFT magnetization-prepared rapid gradient echo imaging: application to abdominal imaging.

The incorporation of the phase offset multi planar (POMP) technique into breathheld magnetization-prepared gradient echo imaging is discussed as a means for improving imaging efficiency without sacrificing resolution, contrast, or SNR improvement. The phase encoding order necessary to preserve the centric approach is described. When combined with interleaving, the POMP technique enables four 256 x 256 images to be acquired in a 12-s breathhold, doubling the efficiency of the original technique. This scan efficiency is compared with that of other T1-weighted 2DFT methods.     

扩散加权平面回波成像在肝占位性病变中的应用探讨

目的　探讨扩散加权平面回波成像在肝占位性病变中的应用,以及表面扩散系数（ＡＤＣ）评估肝占位病变的价值。方法　对４８ 例共有５８ 个肝占位病灶患者进行了扩散加权平面回波成像。５８ 个肝占位病灶中肝癌３０ 个,肝血管瘤１６ 个,肝囊肿１２ 个。应用不同梯度因子ｂ 值的扩散图像拟合出ＡＤＣ图,并获取ＡＤＣ值。结果　肝癌、肝血管瘤和肝囊肿的平均ＡＤＣ 值分别为：（１－２５±０－５１）×１０－ ３ ｍｍ２／ｓ、（１－７５ ±０－６０） ×１０－３ ｍｍ２／ｓ 和（３－１５ ±０－４３） ×１０－３ ｍｍ２／ｓ,三者存在着显著性差异（Ｐ＜０－０１） 。结论　扩散加权平面回波成像对肝癌、肝血管瘤和肝囊肿的鉴别诊断具有一定的价值,但不适宜对小病灶作定性诊断。     

Siderotic regenerating nodules in liver cirrhosis--evaluation by gradient echo (FLASH) imaging 1.5T

In three patients with histologically proven liver cirrhosis, a large number of small, low-intensity nodule(SLIN)s was clearly seen on gradient echo(GRE) images which are sensitive to field inhomogeneity. A histological study revealed that the SLINs corresponded to the regenerating nodules, laden with iron, of liver cirrhosis. As TE was prolonged, the SLINs increased in size in all three cases and fused with each other in one of three cases on GRE images. This phenomenon suggests that the magnetic susceptibility effect due to iron included in the regenerating nodules is the cause for the regenerating nodules shown as SLINs on GRE images, and that one SLIN does not always correspond to one regenerating nodule. We conclude that GRE images should be considered important for diagnosis of regenerating nodules in liver cirrhosis.     

Moment and direction of the spoiler gradient for effective artifact suppression in RF-spoiled gradient echo imaging.

Radiofrequency (RF) -spoiled gradient echo sequences were developed with the aim to produce images with T(1) weighted contrast within short acquisition time. Over the past two decades, this type of sequence has proven to be a robust technique and represents a reliable workhorse in clinical MRI. This study presents an analysis of ghost artifacts, which appear occasionally in RF-spoiled gradient echo images. It is demonstrated that the artifacts result from intrinsically emerging signal oscillations, which can be damped down by the application of spoiler gradients.