Spin echo 31P spectroscopic imaging in the human brain

Selective maximization of (31)P MR spectroscopic signals of in vivo human brain metabolites at 3T

PURPOSE

To develop a short TR, short TE, large flip angle (LFA), in vivo (31)P MR spectroscopy (MRS) technique at 3T that selectively maximizes the signal-to-noise ratio (SNR) of long T(1) human brain metabolites implicated in bipolar disorder.

MATERIALS AND METHODS

Two pulse sequences were evaluated for efficiency. Slice profiles acquired with the scaled, sinc-shaped, radiofrequency (RF) LFA pulses were compared to those acquired with Shinnar-Le Roux (SLR) RF LFA pulses. The SLR-based LFA pulse sequence was used to maximize the inorganic phosphate signal in a phantom, after which volunteer metabolite signals were selectively maximized and compared to their correlates acquired with conventional spin-echo methods.

RESULTS

The comparison of slice profiles acquired with sinc-shaped RF LFA pulses vs. SLR RF LFA pulses showed that SLR-based pulse sequences, with their improved excitation and slice profiles, yield significantly better results. In vivo LFA spin-echo MRS implemented with SLR pulses selectively increased the (31)P MRS signal, by as much as 93%, of human brain metabolites that have T(1) times longer than the TR of the acquisition.

CONCLUSION

The data show that the LFA technique can be employed in vivo to maximize the signal of long T(1) (31)P brain metabolites at a given TE and TR. LFAs ranging between 120 degrees and 150 degrees are shown to maximize the (31)P signal of human brain metabolites at 3T.

Spatial localization in nuclear magnetic resonance spectroscopy

The ability to select a discrete region within the body for signal acquisition is a fundamental requirement of in vivo NMR spectroscopy. Ideally, it should be possible to tailor the selected volume to coincide exactly with the lesion or tissue of interest, without loss of signal from within this volume or contamination with extraneous signals. Many techniques have been developed over the past 25 years employing a combination of RF coil properties, static magnetic field gradients and pulse sequence design in an attempt to meet these goals. This review presents a comprehensive survey of these techniques, their various advantages and disadvantages, and implications for clinical applications. Particular emphasis is placed on the reliability of the techniques in terms of signal loss, contamination and the effect of nuclear relaxation and J-coupling. The survey includes techniques based on RF coil and pulse design alone, those using static magnetic field gradients, and magnetic resonance spectroscopic imaging. Although there is an emphasis on techniques currently in widespread use (PRESS, STEAM, ISIS and MRSI), the review also includes earlier techniques, in order to provide historical context, and techniques that are promising for future use in clinical and biomedical applications.

Assessment of 3D proton MR echo-planar spectroscopic imaging using automated spectral analysis

For many clinical applications of proton MR spectroscopic imaging (MRSI) of the brain, diagnostic assessment is limited by insufficient coverage provided by single- or multislice acquisition methods as well as by the use of volume preselection methods. Additionally, traditional spectral analysis methods may limit the operator to detailed analysis of only a few selected brain regions. It is therefore highly desirable to use a fully 3D approach, combined with spectral analysis procedures that enable automated assessment of 3D metabolite distributions over the whole brain. In this study, a 3D echo-planar MRSI technique has been implemented without volume preselection to provide sufficient spatial resolution with maximum coverage of the brain. Using MRSI acquisitions in normal subjects at 1.5T and a fully automated spectral analysis procedure, an assessment of the resultant spectral quality and the extent of viable data in human brain was carried out. The analysis found that 69% of brain voxels were obtained with acceptable spectral quality at TE = 135 ms, and 52% at TE = 25 ms. Most of the rejected voxels were located near the sinuses or temporal bones and demonstrated poor B0 homogeneity and additional regions were affected by stronger lipid contamination at TE = 25 ms.

Delayed-focus pulses optimized using simulated annealing

Unlike prefocused pulses and shaped pulses based on the linear response theory, delayed-focus pulses (X.-L. Wu et al., 1991, Magn. Reson. Med. 20, 165--170) produce a selective spin echo after a predefined short delay without using a pi refocusing pulse. In this paper, a series of delayed-focus pulses of different flip angles are proposed based on optimization using Fourier series representation and simulated annealing. The resistance of these delayed-focus pulses to T(2) relaxation is also demonstrated using numerical simulation of Bloch equations.

Diffusion-weighted single-shot line scan imaging of the human brain

Single-shot line scan imaging (LSI) was adapted to diffusion-weighted (DW) MRI by replacing the initial 90 degrees radiofrequency pulse of the underlying high-speed stimulated echo sequence by a DW spin-echo preparation period. Implementation on a 2. 0 T whole-body MRI system yielded DW images of the human brain with b factors of 750 s mm(-2) and total imaging times of about 500 ms either for a single slice at 1.5 x 3.0 x 6 mm(3) resolution or simultaneously for up to seven slices at 3.75 x 3.75 x 8 mm(3) resolution. Isotropic DW images and maps of the trace of the diffusion tensor were calculated from four scans with different combinations of three orthogonal diffusion gradients. DW LSI combines high speed with robustness against image artifacts caused by motion (no phase ghosting) and tissue susceptibility differences (no signal losses, no geometric distortions). Because the latter is an important advantage over echo-planar imaging, DW LSI may find useful applications despite a limited signal-to-noise ratio. Magn Reson Med 42:772-778, 1999.

A practical double-tuned 1H/31P quadrature birdcage headcoil optimized for 31P operation

A double-tuned 1H/31P birdcage head coil for use with humans at 1.5 T is described. The coil was designed for proton-decoupled 31P excitation and reception and incorporated a number of practical features including optimized sensitivity for 31P, quadrature operation at 1H and 31P frequencies, and a radiofrequency (RF) mirror for improved B1 homogeneity. The design achieved similar B1 homogeneity at both 31P and 1H frequencies. Inductive matching was used to accommodate samples with large loading differences. A facile method for tuning and matching over a variety of sample loadings is presented, along with capacitively shortened bazookas for suppression of cable braid currents. The proton sensitivity, although down by approximately a factor of two compared with an optimized 1H birdcage head coil, was still ample for shimming and generation of scout images. Advantages of the design are discussed and proton-decoupled 31P spectra of human brain are presented.

Temporal and regional changes during focal ischemia in rat brain studied by proton spectroscopic imaging and quantitative diffusion NMR imaging

The early development of focal ischemia after permanent occlusion of the right middle cerebral artery (MCA) was studied in six rats using interleaved measurements by diffusion-weighted NMR imaging (DWI) of water and two variants of proton spectroscopic imaging (SI), multiecho SI (TE: 136, 272, 408 ms) and short TE SI (TE: 20 ms). Measurements on a 4.7-T NMR imaging system were performed between the control phase and approximately 6 h postocclusion. In the center of the ischemic lesion of all rats, the apparent diffusion coefficient (ADC) decreased rapidly to 84.4 +/- 4.2% (mean +/- SD) of the control values approximately 2 min postocclusion. Approximately 6 h postocclusion, the ADC was reduced to 67.1 +/- 5.9%. In contrast, large differences between the animals were observed for the temporal increase of lactate (Lac) in the ipsilateral hemisphere. The maximum Lac signal was reached in four rats after 0.5-1.5 h, and in two rats was not reached even after 6 h postocclusion. Six h postocclusion, SI spectra measured at a TE of 136 ms revealed a decrease in the CH3 signal of N-acetylaspartate (NAA) to 67 +/- 13% of the control values. Differences were observed between the spatial regions of decreased NAA and increased Lac. In the lesions, a T2 relaxation time of Lac of 292 +/- 40 ms, considering a J-coupling constant of 6.9 Hz, was measured. Furthermore, a prolongation of the T2 of the CH3 signal of creatine/phosphocreatine (Cr/PCr) was observed in the lesion, from 163 +/- 22 ms during control to 211 +/- 41 ms approximately 6 h postocclusion. The experiments proved that DWI and proton SI are valuable tools to provide complementary information on processes associated with brain infarcts.

Evaluation of 31P metabolite differences in human cerebral gray and white matter

31P NMR is commonly used to study brain energetics in health and disease. Due to sensitivity constraints, the NMR measurements are typically made in volumes that do not contain pure gray or white matter. For accurate evaluation of abnormalities in brain metabolite levels, it is necessary to consider the differences in normal levels of 31P metabolites in gray and white matter. In this study, voxels from a three-dimensional spectroscopic image acquisition were analyzed for their dependence on tissue type to assess differences in metabolite levels between gray and white matter. Specifically, gray matter was found to have significantly higher ratios of phosphocreatine (PCr) to gamma-ATP and PCr to the total 31P metabolite signal, whereas pH and the ratio of PCr to inorganic phosphate (Pi) were found to differ insignificantly between gray and white matter. Thus, tissue type can be an important factor to consider for alterations in bioenergetics by 31P NMR spectroscopic studies of the brain.

High spatial resolution and speed in MRSI

The in vivo applications of magnetic resonance spectroscopic imaging (MRSI) have expanded significantly over the past 10 years and have reached the point where clinical trials are underway for a number of different diseases. One of the limiting factors in the widespread use of this technology has been the lack of widely available tools for obtaining data which are localized to sufficiently small tissue volumes to make an impact upon diagnosis and treatment planning. This is especially difficult within the timeframe of a clinical MR examination, which requires that both anatomic and metabolic data are acquired and processed. Recent advances in the hardware and software associated with clinical scanners have provided the potential for improvements in the spatial and time resolution of imaging and spectral data. The two areas which hold the most promise in terms of MRSI data are the use of phased array coils and the implementation of echo planar k-space sampling techniques. These could have immediate impact for 1H MRSI and may prove valuable for future applications of 31P MRSI.

Clinical applications of magnetic resonance spectroscopy

Magnetic resonance spectroscopy (MRS) is a new tool for evaluation of patients with epilepsy, demonstrating abnormalities of energy and lipid metabolism ictally and, more recently, interictally. These metabolic abnormalities include increased inorganic phosphate, pH, and decreased phosphomonoesters as determined by 31P MRS, as well as decreased N-acetylaspartate determined by 1H MRS. Furthermore, increased lactic acid has been detected postictally. These metabolic changes appear to be confined to the region of seizure origination and can be detected interictally. Therefore, they can be used for lateralization of the epileptogenic focus. Ongoing research suggests that these abnormalities may also be useful in localization of the focus, demonstrating metabolic alterations in temporal lobe epilepsy (TLE) similar to those in neocortical epilepsy. However, further technical development will be required before the goal of using these techniques for localization of the epileptogenic focus can be realized. For TLE lobe epilepsy at least, the clinical utility of 1H MRS to lateralize the seizure focus has clearly been demonstrated by several centers. The consistent findings in TLE suggest that 1H MRS is ready to become part of the evaluation process of patients with medically refractory epilepsy being evaluated for seizure surgery.

Comparison of k-space sampling schemes for multidimensional MR spectroscopic imaging

For clinical 31P MR spectroscopic imaging (MRSI) studies, where signal averaging is necessary, some improvement of sensitivity and spatial response function may be achieved by acquiring data over a spherical k-space volume and varying the number of averages acquired in proportion to the desired spatial filter. Eight different k-space sampling schemes are compared through simulations that provide graphs of the spatial response functions (SRF), and tabulations of voxel volumes, relative signal-to-noise ratios (SNR), and relative data collection efficiencies (SNR per unit volume over the same time). All schemes were based on practical experiments, each of which could be implemented in the same length of time. The results show that in comparison with cubic k-space sampling with the same number of signal averages at each point, spherical and acquisition-weighted k-space sampling can be used to achieve reduced Gibbs ringing along the principal axes directions, and thus reduced contamination from adjacent tissue in these directions, without degradation of voxel volume or SNR.

Quantitative proton MR spectroscopic imaging of the human brain

Multislice proton MR spectroscopic images (SI) of the brain were quantitated, using the phantom replacement technique. In 16 normal volunteers, ranging in age from 5 to 74 years, average "whole brain" concentrations of choline (Cho), creatine (Cr), and N-acetylaspartate (NAA) were found to be 2.4 +/- 0.4, 7.9 +/- 1.3, and 11.8 +/- 1.0 (mM, mean +/- SD), respectively. These values are in good general agreement with those previously determined by single-voxel localization techniques. Cortical gray matter was found to have lower Cho and NAA levels, compared to those of white matter, corpus callosum, and basal ganglia. Cho was also found to increase significantly with age in several locations. Quantitative multislice proton Si is feasible in the clinical environment, and regional and age-dependent variations occur that must be accounted for when evaluating spectra from pathological conditions.

Asymmetry of temporal lobe phosphorous metabolism in schizophrenia: a 31phosphorous magnetic resonance spectroscopic imaging study

In vivo 31Phosphorous magnetic resonance spectroscopic imaging (31P MRSI) was performed on 18 chronic schizophrenic patients and 14 normal controls to determine if there was asymmetry of high-energy phosphorous metabolism in the temporal lobes of schizophrenic patients. Temporal lobe phosphorous metabolites were also correlated with severity of psychiatric symptomatology as assessed by the Brief Psychiatric Rating Scale (BPRS). Schizophrenics demonstrated significantly higher right relative to left temporal phosphocreatine/adenosine triphosphate (PCr/ATP), phosphocreatine/inorganic phosphate (PCr/Pi), and PCr as well as significantly lower right relative to left temporal ATP. There were no asymmetries of temporal lobe phosphorous metabolites in the control group. In addition, both left temporal PCr and the degree of asymmetry of temporal lobe PCr were highly correlated with the thinking disturbance subscale of the BPRS. This study provides further support for temporal lobe metabolic asymmetry in schizophrenia and its possible association with clinical symptoms.

Quantitative combined phosphorus and proton PRESS of the brains of newborn human infants

Techniques for quantitative, combined phosphorus and proton, point-resolved spectroscopy (PRESS) studies of newborn-infant brain have been developed. Phosphorus PRESS advantages include: voxel-shimming; rapid transmitter-pulse setting; novel use of brain-water as a localized quantitation reference; and reduced broad components. Proton spectra from 1-ml voxels and phosphorus spectra can both be acquired quantitatively within acceptable time. Cerebral lactate was consistently detected by proton PRESS and the normal concentration (approximately 3 mmol/kg wet weight) may be higher than in adult brain. Phosphorus PRESS provided metabolite peak-area ratios and concentrations comparable with those obtained using ISIS.

Parametric multiecho proton spectroscopic imaging: application to the rat brain in vivo

A parametric multiecho variant of proton spectroscopic imaging (SI) is presented using a multiecho SI sequence with uniform phase-encoding of all echoes within each echo train. The acquisition of SI data sets at different echo times (TE) increases the amount of information obtained within the same total measuring time as in standard SI measurements. The gain in information can be used: (a) to choose the most appropriate TE for each metabolite signal with respect to T2, spin coupling, or problems caused by peak overlap; (b) to measure the relaxation time T2 of metabolite signals with high spatial resolution; or (c) to improve the signal-to-noise ratio for metabolite signals with long T2 values by adding spectra calculated from consecutive echoes. The method was tested in vivo on healthy rat brain and applied to study metabolic changes in rat brain lesions.

31phosphorus magnetic resonance spectroscopy of the frontal and parietal lobes in chronic schizophrenia

In vivo 31Phosphorus magnetic resonance spectroscopic imaging (31P MRSI) was performed on 20 chronic schizophrenic patients and 16 normal controls to determine if there were specific changes in high energy phosphorus and phospholipid metabolism in the frontal lobes of schizophrenic patients. Phosphorous metabolites were assessed in each of the left and right frontal as well as the left and right parietal lobes. Frontal lobe phosphorous metabolites were also correlated with severity of psychiatric symptomatology as assessed by the Brief Psychiatric Rating Scale (BPRS). Schizophrenics demonstrated higher phosphodiesters (PDE) and lower phosphocreatine (PCr) in both the left and right frontal regions compared to controls. There was also lower left frontal inorganic phosphate (Pi) in the schizophrenic group. No group differences were noted in the left or right parietal regions. In addition, right frontal PDE and right frontal PCr were highly correlated with the hostility-suspiciousness and anxiety-depression subscales of the BPRS. This study provides further support for altered frontal lobe phosphorous metabolism in schizophrenia.

Short TE phosphorus spectroscopy using a spin-echo pulse

In vivo phosphorus spectroscopy requires very short acquisition delays in order to capture the signal from components with short transverse relaxation times (T2). The echo time typical of standard slice selective spin-echo pulses are too long for this application, so hard pulse, free induction decay (FID) acquisitions have frequently been used instead. With FID, however, there is an interval between the time of coherence and data acquisition (acquisition delay), with resulting baseline distortions. In this paper we describe the design of a new short TE, slice-selective, composite spin-echo pulse with echo times as short as 2.5 ms. With a long TR, fully relaxed, multislice spectra can be collected. This technique will be useful for assessing in vivo, changes in brain phospholipid activity associated with psychiatric and neurological diseases.

Reduced phase encoding in spectroscopic imaging

The effect of different spatial-encoding (k-space) sampling distributions are evaluated for magnetic resonance spectroscopic imaging (MRSI) using Fourier reconstruction. Previously, most MRSI studies have used square or cubic k-space functions, symmetrically distributed. These studies examine the conventional k-space distribution with spherical distribution, and 1/2 k-space acquisition, using computer simulation studies of the MRSI acquisition for three spatial dimensions and experimental results. Results compare the spatial response function, Gibbs ringing effects, and signal contamination for different spatial-encoding distribution functions. Results indicate that spherical encoding, in comparison with cubic encoding, results in a modest improvement of the response function with approximately equivalent spatial resolution for the same acquisition time. For spin-echo acquired data, reduced acquisition times can readily be obtained using 1/2 k-space methods, with a concomitant reduction in signal to noise ratio.

What might be the impact on neurology of the analysis of brain metabolism by in vivo magnetic resonance spectroscopy?

In vivo nuclear magnetic resonance spectroscopy (MRS) of the human brain is a recently developed technique which allows to assay noninvasively in vivo key molecules of brain metabolism. After a review of the origin of the signals detected by phosphorus and proton MRS of human brain, the impact of MRS on clinical neurology is examined. MRS of the brain does not purport to be a metabolic "biopsy", but unique applications for brain MRS are (1) quantitating the oxidative state of the brain and defining neuronal death, (2) assessing and mapping neuron damage, (3) evaluating membrane alterations, and (4) characterizing encephalopathies. In the near future brain MRS will be performed routinely after conventional MRI, as a valuable metabolic (and functional) complement to the anatomical evaluation of cerebral pathologies, particularly the toxic, metabolic and infectious encephalopathies.

Magnetic resonance imaging of human melanoma xenografts in vivo: proton spin-lattice and spin-spin relaxation times versus fractional tumour water content and fraction of necrotic tumour tissue

Proton nuclear magnetic resonance (1H-nmr) imaging is used routinely in clinical oncology to provide macroscopic anatomical information, whereas its potential to provide physiological information about tumours is not well explored. To evaluate the potential usefulness of 1H-nmr imaging in the prediction of tumour treatment resistance caused by unfavourable microenvironmental conditions, possible correlations between proton spin-lattice and spin-spin relaxation times (T1 and T2) and physiological parameters of the tumour microenvironment were investigated. Tumours from six human melanoma xenograft lines were included in the study. 1H-nmr imaging was performed at 1.5 T using spin-echo pulse sequences. T1- and T2-distributions were generated from the images. Fractional tumour water content and the fraction of necrotic tumour tissue were measured immediately after 1H-nmr imaging. Significant correlations across tumour lines were found for T1 and T2 versus fractional tumour water content (p < 0.001) as well as for T1 and T2 versus fraction of necrotic tumour tissue (p < 0.05). Tumours with high fractional water contents had high values of T1 and T2, probably caused by free water in the tumour interstitium. Fractional water content is correlated to interstitial fluid pressure in tumours, high interstitial fluid pressure being indicative of high vascular resistance. Tumours with high fractional water contents are thus expected to show regions with radiobiologically hypoxic cells as well as poor intravascular and interstitial transport of many therapeutic agents. T1 and T2 decreased with increasing fraction of necrotic tumour tissue, perhaps because complexed paramagnetic ions were released during development of necrosis. Viable tumour cells adjacent to necrotic regions are usually chronically hypoxic. Tumours with high fractions of necrotic tissue are thus expected to contain significant proportions of radiobiologically hypoxic cells. Consequently, quantitative 1H-nmr imaging has the potential to be developed as an efficient clinical tool in prediction of tumour treatment resistance caused by hypoxia and/or transport barriers for therapeutic agents. However, much work remains to be done before this potential can be adequately evaluated. One problem is that high fractional tumour water contents result in longer T1 and T2 whereas high fractions of necrotic tumour tissue result in shorter T1 and T2; i.e. the two parameters which are indicative of treatment resistance contribute in opposite directions. Another problem is that the correlations for T1 and T2 versus fraction of necrotic tumour tissue are not particularly strong.

Mapping of cerebral metabolites in rats by 1H magnetic resonance spectroscopic imaging. Distribution of metabolites in normal brain and postmortem changes

The goal of this study was to examine metabolic differences between cortex and basal ganglia in normal rat brain and to determine postmortem changes using in vivo 1H magnetic resonance spectroscopic imaging at 300 MHz. The resonances observed were: choline, creatine + phosphocreatine, N-acetyl aspartate (NAA), lactate (Lac), and three small resonances in the amino acid region which included resonances from aspartate + NAA (Asp), glutamine + NAA (Gln), and glutamate + GABA (Glu). A previously unassigned resonance was observed at 1.13 ppm in brain of rats anesthetized with pentobarbital. Spectroscopic images in normal brain demonstrated increased NAA and Gln and decreased Glu in cortex compared to basal ganglia. The major postmortem changes were an increase of Lac, Glu and Cho and a decrease of NAA and Asp. The rise in Lac was significantly higher in cortex than in basal ganglia.

Proton-decoupled 31P chemical shift imaging of the human brain in normal volunteers

Proton-decoupled, 31P three-dimensional (3-D) chemical shift imaging (CSI) spectra have been acquired from the entire human brain using a new dual tuned resonator. The resonator operates in quadrature mode to provide improved sensitivity, excellent B1 homogeneity and reduced power deposition at both frequencies. Proton-decoupled and fully NOE enhanced, 31P spectra were acquired from normal volunteers using Waltz-4 proton decoupling with continuous wave bi-level excitation applied through a second radio frequency channel. Well resolved peaks in the phosphomonoester (PME) and phosphodiester regions were obtained from nonlocalized FIDs and spectra localized with 3-D CSI without processing for resolution enhancement. pH measurements made over large regions of the brain using the P(i) resonance show no significant variations (6.9 +/- 0.02) for a single individual. The improved spectral resolution and sensitivity of the PME resonances results in more well defined metabolite images of the PME peak region.

Quantitation of in vivo phosphorus metabolites in human brain with magnetic resonance spectroscopic imaging (MRSI)

A method for quantitation of in vivo 31P metabolite concentrations in human brain with 31P magnetic resonance spectroscopic imaging (MRSI) is described. The method relies on comparison of brain and calibration phantom measurements, with corrections for coil loading and metabolite magnetic relaxation. Estimated metabolite concentrations for the centrum semiovale in 11 normal adults (mean +/- SD) were: phosphomonoesters = 3.0 +/- 0.7 mM, inorganic phosphate = 0.7 +/- 0.2 mM, phosphodiesters = 10.9 +/- 1.8 mM, phosphocreatine = 2.7 +/- 0.5 mM, and adenosine triphosphate = 2.9 +/- 0.3 mM. These values are similar to previous results obtained from single-volume localized spectroscopy.

Study of chronic schizophrenics using 31P magnetic resonance chemical shift imaging

Phosphorus-31 chemical shift imaging showed regional abnormalities of in vivo 31P NMR spectra in the brains of chronic schizophrenic patients. In the left temporal region, the level of % phosphodiesters (PDE) was increased and the level of % gamma alpha beta-ATP (obtained by summation of gamma-ATP, alpha-ATP, and beta-ATP) was decreased. In the basal ganglia, the levels of % PDE were decreased and the level of % phosphomonoesters was increased. The levels of % gamma alpha beta-ATP were increased in the right basal ganglia. The level of % phosphocreatine was decreased in the frontoparietal region. These findings may represent different patterns of dysfunction of membrane phospholipid bilayers and high-energy phosphate metabolism in the specific cerebral regions.

Phasing spin-echo-acquired 31P spectroscopic images using complex conjugate data reversal

A simple method has been developed for phasing 31P spectroscopic images acquired with short echo-time (1-2 ms) spin-echo sequences. The technique is based on reconstructing complete echoes in the time domain by the reversal of the complex conjugate of the data. After Fourier analysis, a magnitude reconstruction is used, which no longer broadens the lines. Advantages of the method compared to other phasing procedures are discussed.

Elevated lactate and alkalosis in chronic human brain infarction observed by 1H and 31P MR spectroscopic imaging

The goal of this study was to investigate lactate and pH distributions in subacutely and chronically infarcted human brains. Magnetic resonance spectroscopic imaging (MRSI) was used to map spatial distributions of 1H and 31P metabolites in 11 nonhemorrhagic subacute to chronic cerebral infarction patients and 11 controls. All six infarcts containing lactate were alkalotic (pHi = 7.20 +/- 0.04 vs. 7.05 +/- 0.01 contralateral, p less than 0.01). This finding of elevated lactate and alkalosis in chronic infarctions does not support the presence of chronic ischemia; however, it is consistent with the presence of phagocytic cells, gliosis, altered buffering mechanisms, and/or luxury perfusion. Total 1H and 31P metabolites were markedly reduced (about 50% on average) in subacute and chronic brain infarctions (p less than 0.01), and N-acetyl aspartate (NAA) was reduced more (approximately 75%) than other metabolites (p less than 0.01). Because NAA is localized in neurons, selective NAA reduction is consistent with pathological findings of a greater loss of neurons than glial cells in chronic infarctions.

Effect of photic stimulation on human visual cortex lactate and phosphates using 1H and 31P magnetic resonance spectroscopy

Previous animal and human studies showed that photic stimulation (PS) increased cerebral blood flow and glucose uptake much more than oxygen consumption, suggesting selective activation of anaerobic glycolysis. In the present studies, image-guided 1H and 31P magnetic resonance spectroscopy (MRS) was used to monitor the changes in lactate and high-energy phosphate concentrations produced by PS of visual cortex in six normal volunteers. PS initially produced a significant rise (to 250% of control, p less than 0.01) in visual cortex lactate during the first 6.4 min of PS, followed by a significant decline (p = 0.01) as PS continued. The PCr/Pi ratios decreased significantly from control values during the first 12.8 min of PS (p less than 0.05), and the pH was slightly increased. The positive P100 deflection of the visual evoked potential recorded between 100 and 172 ms after the strobe was significantly decreased from control at 12.8 min of PS (p less than 0.05). The finding that PS caused decreased PCr/Pi is consistent with the view that increased brain activity stimulated ATPase, causing a rise in ADP that shifted the creatine kinase reaction in the direction of ATP synthesis. The rise in lactate together with an increase in pH suggest that intracellular alkalosis, caused by the shift of creatine kinase, selectively stimulated glycolysis.

In vivo 7Li NMR imaging and localized spectroscopy of rat brain

Lithium-7 in vivo NMR spectroscopy and imaging techniques have been developed at 4.7 T for rat head. The pharmacokinetics of lithium (Li) uptake in rat head has been measured using STEAM localized spectroscopy for the whole brain, which showed relatively rapid uptake of Li and a steady level of Li from about 5 to 20 h. Localized spectroscopy on brain sections revealed no differences in Li concentration among the front, middle, and rear of the brain. The spin-lattice relaxation time showed a single exponential decay for the head. The spin-spin relaxation time for head showed a biexponential behavior. Using a 1H-7Li double coil assembly, 7Li images were generated for rat head, as was the corresponding 1H image for anatomic localization. The 7Li image (7-mm slice thickness, 4-mm in-plane resolution) recorded after the last dose in a multiple ip dose protocol shows the Li distribution in the head and neck. Based on 7Li images, the Li level in muscle was about twice that in the brain. Variations of 7Li intensity level across the brain were typically small.

1H spectroscopic imaging of rat brain at 7 tesla

1H magnetic resonance spectroscopic imaging has been used to obtain metabolite maps of the rat brain. The spin-echo-based technique has been evaluated with respect to water and lipid suppression and sensitivity. Metabolite maps were constructed for choline, creatine + phosphocreatine, amino acids, N-acetyl aspartate, and lactate. A spatial resolution of 3 x 3 mm (in plane) with 7-mm-thick slices was achieved routinely in 60-min (16 x 16 phase encodings) acquisitions. For higher intensity resonances, metabolite maps could be constructed in as little as 10 min. Results from phantoms and from rats under normal and focal ischemia conditions are presented.

Three-dimensional 1H spectroscopic imaging of cerebral metabolites in the rat using surface coils

Three dimensional metabolite maps of protonated metabolites were obtained using 1H magnetic resonance spectroscopic imaging at 7 T. Surface coils were used to increase sensitivity and spatial resolution significantly over a volume coil two-dimensional acquisition. Adiabatic pulses were employed to provide homogeneous B1 excitation and frequency selective refocusing over the volume of the rat brain. These techniques were employed to obtain three-dimensional spectroscopic imaging spectra from nominal voxel volumes of 9-30 microliters from rat brain. The improved spatial resolution and sensitivity are also demonstrated with studies of focal ischemia in the rat.

Phosphorus-31 MR spectroscopic imaging (MRSI) of normal and pathological human brains

The goals of this study were to evaluate 31P MR spectroscopic imaging (MRSI) for clinical studies and to survey potentially significant spatial variations of 31P metabolite signals in normal and pathological human brains. In normal brains, chemical shifts and metabolite ratios corrected for saturation were similar to previous studies using single-volume localization techniques (n = 10; pH = 7.01 +/- 0.02; PCr/Pi = 2.0 +/- 0.4; PCr/ATP = 1.4 +/- 0.2; ATP/Pi = 1.6 +/- 0.2; PCr/PDE = 0.52 +/- 0.06; PCr/PME = 1.3 +/- 0.2; [Mg2+]free = 0.26 +/- 0.02 mM.) In 17 pathological case studies, ratios of 31P metabolite signals between the pathological regions and normal-appearing (usually homologous contralateral) regions were obtained. First, in subacute and chronic infarctions (n = 9) decreased Pi (65 +/- 12%), PCr (38 +/- 6%), ATP (55 +/- 6%), PDE (47 +/- 9%), and total 31P metabolite signals (50 +/- 8%) were observed. Second, regions of decreased total 31P metabolite signals were observed in normal pressure hydrocephalus (NPH, n = 2), glioblastoma (n = 2), temporal lobe epilepsy (n = 2), and transient ischemic attacks (TIAs, n = 2). Third, alkalosis was detected in the NPH periventricular tissue, glioblastoma, epilepsy ipsilateral ictal foci, and chronic infarction regions; acidosis was detected in subacute infarction regions. Fourth, in TIAs with no MRI-detected infarction, regions consistent with transient neurological deficits were detected with decreased Pi, ATP, and total 31P metabolite signals. These results demonstrate an advantage of 31P MRSI over single-volume 31P MRS techniques in that metabolite information is derived simultaneously from multiple regions of brain, including those outside the primary pathological region of interest. These preliminary findings also suggest that abnormal metabolite distributions may be detected in regions that appear normal on MR images.

Phosphorus-31 magnetic resonance metabolite imaging in the human body

This work examines the feasibility of three-dimensional phosphorus-31 magnetic resonance spectroscopic imaging (31P MRSI) of metabolites in the human body using nonselective excitation with a single large circular surface coil for transmitting and receiving. The potential and limitations of this approach to clinical imaging are demonstrated on four selected examples: normal liver and heart, hematoma in the calf, and lymphoma in the groin. The obtained metabolite images showed anatomical detail and allowed differentiation of body organs and pathologic tissue from adjacent tissue. Three-dimensionally localized 31P spectra were reconstructed from nominal volumes of 4 to 15 cm3. These spectra showed characteristic resonances and metabolite intensity ratios for the tissue of origin demonstrating good three-dimensional localization. We conclude that surface coil 31P MRSI of body organs to map metabolite distributions is practically feasible with this approach, but due to experimental limitations, clinical utility requires technical improvements.

Spectroscopic imaging display and analysis

A system for display of magnetic resonance (MR) spectroscopic imaging (SI) data is described which provides for efficient review and analysis of the multidimensional spectroscopic and spatial data format of this technique. Features include the rapid display of spectra from selected image voxels, formation of spectroscopic images, spectral and image data processing operations, methods for correlating spectroscopic image data with high resolution 1H MR images, and hardcopy facilities. Examples are shown for 31P and 1H spectroscopic imaging studies obtained in human and rat brain.

Functional magnetic resonance imaging in medicine and physiology

Magnetic resonance imaging (MRI) is a well-established diagnostic tool that provides detailed information about macroscopic structure and anatomy. Recent advances in MRI allow the noninvasive spatial evaluation of various biophysical and biochemical processes in living systems. Specifically, the motion of water can be measured in processes such as vascular flow, capillary flow, diffusion, and exchange. In addition, the concentrations of various metabolites can be determined for the assessment of regional regulation of metabolism. Examples are given that demonstrate the use of functional MRI for clinical and research purposes. This development adds a new dimension to the application of magnetic resonance to medicine and physiology.