Characterization of cerebral infarction by multicomponent analysis of transverse magnetization decay curves.

RATIONALE AND OBJECTIVES. Individual components of the transverse magnetization decay curve (TDC) were assessed for their ability to characterize ischemia in photochemically induced cerebral infarcts. METHODS. Fifty rats were randomly divided into equal-sized experimental and control groups, which were subdivided into groups studied at five different time points, ranging from 6 hours to 22 days. All the rats received transcalvarial irradiation with 560-nm light. Five rats in each time group also received a sensitizing dye before irradiation. In these latter animals, lesions of uniform size and location developed. Lesions were compared with tissue of similar volume and location from the contralateral cortex of the experimental animals and with tissue from both hemispheres of the control animals. TDCs of all the samples were measured and fit with mono- and bi-exponential functions. RESULTS. Unlike the control tissue, infarcted tissue displayed definitive two-component TDC behavior. The time course of the bi-exponential parameters yielded information unavailable from mono-exponential analyses. CONCLUSIONS. Bi-exponential analysis of TDCs may have diagnostic use as a more sensitive indicator of cerebral infarction than mono-exponential analyses.     

Biexponential diffusion tensor analysis of human brain diffusion data.

Several studies have shown that in tissues over an extended range of b-factors, the signal decay deviates significantly from the basic monoexponential model. The true nature of this departure has to date not been identified. For the current study, line scan diffusion images of brain suitable for biexponential diffusion tensor analysis were acquired in normal subjects on a clinical MR system. For each of six noncollinear directions, 32 images with b-factors ranging from 5 to 5000 s/mm2 were collected. Biexponential fits yielded parameter maps for a fast and a slow diffusion component. A subset of the diffusion data, consisting of the images obtained at the conventional range of b-factors between 5 and 972 s/mm2, was used for monoexponential diffusion tensor analysis. Fractional anisotropy (FA) of the fast-diffusion component and the monoexponential fit exhibited no significant difference. FA of the slow-diffusion biexponential component was significantly higher, particularly in areas of lower fiber density. The principal diffusion directions for the two biexponential components and the monoexponential solution were largely the same and in agreement with known fiber tracts. The second and third diffusion eigenvector directions also appeared to be aligned, but they exhibited significant deviations in localized areas.     

Simultaneous measurements of temperature and pH in vivo using NMR in conjunction with TmDOTP5-

NMR techniques for temperature and pH measurements have attracted increasing interest in recent years, motivated in part by the growing importance of medical hyperthermia for the treatment of cancer. The chemical shifts of thulium 1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetrakis(methylene phosphonate) (TmDOTP5-) have been studied as a function of temperature and pH. The results demonstrate that TmDOTP5- resonance shifts are highly sensitive to temperature (approximately 1.0 ppm/degrees C) and pH (approximately 3.2 ppm/pH unit) at clinically relevant field strengths. A new method is presented which utilizes two magnetically non-equivalent protons in TmDOTP5- for simultaneous NMR measurements of both temperature and pH. The difference in the chemical shift values of pairs of 1H resonances provides a temperature sensitivity of about 1.6 ppm/ degrees C. The technique is demonstrated in live rats undergoing ultrasound-induced hyperthermia therapy.     

MR line scan diffusion imaging of the brain in children

BACKGROUND AND PURPOSE: MR imaging of the self-diffusion of water has become increasingly popular for the early detection of cerebral infarction in adults. The purpose of this study was to evaluate MR line scan diffusion imaging (LSDI) of the brain in children. METHODS: LSDI was performed in four volunteers and 12 patients by using an effective TR/TE of 2736/89.4 and a maximum b value of 450 to 600 s/mm2 applied in the x, y, and z directions. In the volunteers, single-shot echo planar imaging of diffusion (EPID) was also performed. The patients (10 boys and two girls) ranged in age from 2 days to 16 years (average age, 6.6 years). Diagnoses included acute cerebral infarction, seizure disorder, posttraumatic confusion syndrome, complicated migraine, residual astrocytoma, encephalitis, hypoxia without cerebral infarction, cerebral contusion, and conversion disorder. In all patients, routine spin-echo images were also acquired. Trace images and apparent diffusion coefficient maps were produced for each location scanned with LSDI. RESULTS: In the volunteers, LSDI showed less chemical-shift and magnetic-susceptibility artifact and less geometric distortion than did EPID. LSDI was of diagnostic quality in all studies. Diffusion abnormalities were present in five patients. Restricted diffusion was present in the lesions of the three patients with acute cerebral infarction. Mildly increased diffusion was present in the lesions of encephalitis and residual cerebellar astrocytoma. No diffusion abnormalities were seen in the remaining seven children. CONCLUSION: LSDI is feasible in children, provides high-quality diffusion images with less chemical-shift and magnetic-susceptibility artifact and less geometric distortion than does EPID, and complements the routine MR examination.     

Trans-axillary first rib excision for thoracic outlet syndrome

AIM: Thoracic outlet syndrome (TOS) is a clinical diagnosis treatable by excision of the first rib. This study was undertaken to assess the alleviation of symptoms following trans-axillary rib excision in patients with a diagnosis of TOS suggested by a positive Elevated Arm Stress Test and, by inference, to estimate the prevalence of the syndrome. METHOD: A retrospective review of trans-axillary first rib excision was performed. No referrals were accepted from outwith the catchment area of our hospital. Post-operative symptomatic improvement was accepted as a confirmation of correct pre-operative diagnosis. RESULTS: Over six years, 52 rib resections were performed in 46 patients, mean age (+/- S.D.) 38.8 (+/- 10.6) years. The indications for surgery were principally neurological symptoms (n = 42 excisions), arterial compromise (n = 5) and venous compromise (n = 5). Symptoms had been present for a mean of 15.8 months prior to surgery. The median follow-up after surgery was 33 months. 42 patients (48 resections) showed immediate improvement in symptoms following surgery, although symptoms recurred in three patients (4 resections) between 6 and 8 months post-operatively. In the final two years of this study, 20 resections resulting in symptomatic improvement were performed, suggesting a prevalence for TOS of at least 10 per 100,000 per year. CONCLUSIONS: Thoracic outlet decompression was performed more frequently in this series than many previous reports, suggesting that TOS may be under-diagnosed.     

Phase-encode order and its effect on contrast and artifact in single-shot RARE sequences

Substantial manipulation of tissue contrast can be achieved by varying the order in which phase-encode values are applied to individual echoes within a 128-echo single-shot rapid acquisition relaxation enhanced (RARE) sequence. Appropriate ordering can then permit imaging of short T2 species like muscle and white matter with single-shot RARE. For sequential phase encoding with an arbitrary initial phase-encode value, the timing of the zero phase (ZP) encoded echo is found to be analogous to the echo time (TE) of standard spin-echo sequences. This is demonstrated qualitatively with human brain images and is verified quantitatively with NiCl2 phantoms by correlating the time constant for signal decay with ZP echo time, with transverse relaxation times T2, as obtained with a 128-echo Carr-Purcell-Meiboom-Gill (CPMG) imaging sequence. Banding artifacts accompanying the discontinuous traverse through K space are experimentally demonstrated in a rectangular phantom and expressions are developed for determining the dependence of this artifact on the phase-encode gradient increments and durations, the ZP echo number, echo spacing, and T2. Simulations based on the expressions are shown to be useful for characterizing the observed "banding" artifacts perpendicular to the phase-encode direction and for predicting the extent of tissue-tissue overlap to be expected with the use of this ultrafast rf echo planar imaging method.