Short T2 imaging using a 3D double adiabatic inversion recovery prepared ultrashort echo time cones (3D DIR-UTE-Cones) sequence

Ultra-High Contrast MRI: Using Divided Subtracted Inversion Recovery (dSIR) and Divided Echo Subtraction (dES) Sequences to Study the Brain and Musculoskeletal System

Divided and subtracted MRI is a novel imaging processing technique, where the difference of two images is divided by their sum. When the sequence parameters are chosen properly, this results in images with a high T1 or T2 weighting over a small range of tissues with specific T1 and T2 values. In the T1 domain, we describe the implementation of the divided Subtracted Inversion Recovery Sequence (dSIR), which is used to image very small changes in T1 from normal in white matter. dSIR has shown widespread changes in otherwise normal-appearing white matter in patients suffering from mild traumatic brain injury (mTBI), substance abuse, and ischemic leukoencephalopathy. It can also be targeted to measure small changes in T1 from normal in other tissues. In the T2 domain, we describe the divided echo subtraction (dES) sequence that is used to image musculoskeletal tissues with a very short T2*. These tissues include fascia, tendons, and aponeuroses. In this manuscript, we explain how this contrast is generated, review how these techniques are used in our research, and discuss the current challenges and limitations of this technique.

Fast dual-echo estimation of apparent long T2 fraction using ultrashort echo time magnetic resonance imaging in tibialis tendons and its osteoporosis-related differences in women

Background

Tendon and bone comprise a critical interrelating unit. Bone loss, including that seen with osteopenia (OPe) or osteoporosis (OPo), may be associated with a reduction in tendon quality, though this remains incompletely investigated. Clinical magnetic resonance imaging (MRI) sequences cannot directly detect signals from tendons because of the very short T2. Clinical MRI may detect high-graded abnormalities by changes in the adjacent structures like bone. However, ultrashort echo time MRI (UTE-MRI) can capture high signals from all tendons. To determine if the long T2 fraction, as measured by a dual-echo UTE-MRI sequence, is a sensitive quantitative technique to the age- and bone-loss-related changes of the lower leg tendons.

Methods

This is a cross-sectional study conducted between January 2018 to February 2020 in the lower legs of 14 female patients with OPe [72±6 years old, body mass index (BMI) =25.8±6.2 kg/m2] and 31 female patients with OPo (73±6 years old, BMI=22.0±3.8 kg/m2), as well as 30 female subjects with normal bone (Normal, 35±18 years old, BMI =23.2±4.3 kg/m2), were imaged on a 3T clinical scanner using a dual-echo 3D Cones UTE sequence. We defined the apparent long T2 signal fraction (aFrac-LongT2) of tendons as the ratio between the signal at the second echo time (TE =2.2 ms) to the UTE signal. The average aFrac-LongT2 and the cross-sectional area were calculated for the anterior tibialis tendons (ATTs) and the posterior tibialis tendons (PTTs). The Kruskal-Wallis rank test was used to compare the differences in aFrac-LongT2 and the cross-sectional area of the tendons between the groups.

Results

The aFrac-LongT2 of the ATTs and PTTs were significantly higher in the OPo group compared with the Normal group (22.2% and 34.8% in the ATT and PTT, respectively, P<0.01). The cross-sectional area in the ATTs was significantly higher for the OPo group than in the Normal group (Normal/OPo difference was 28.7, P<0.01). Such a difference for PTTs did not reach the significance level. Mean aFrac-LongT2 and cross-sectional area in the OPe group were higher than the Normal group and lower than the OPo group. However, the differences did not show statistical significance, likely due to the higher BMI in the OPe group.

Conclusions

Dual-echo UTE-MRI is a rapid quantification technique, and aFrac-LongT2 values showed significant differences in tendons between Normal and OPo patients.

Whole knee joint mapping using a phase modulated UTE adiabatic T1ρ (PM-UTE-AdiabT1ρ ) sequence

PURPOSE

To develop a 3D phase modulated UTE adiabatic T1ρ (PM-UTE-AdiabT1ρ ) sequence for whole knee joint mapping on a clinical 3 T scanner.

METHODS

This new sequence includes six major features: (1) a magnetization reset module, (2) a train of adiabatic full passage pulses for spin locking, (3) a phase modulation scheme (i.e., RF cycling pair), (4) a fat saturation module, (5) a variable flip angle scheme, and (6) a 3D UTE Cones sequence for data acquisition. A simple exponential fitting was used for T1ρ quantification. Phantom studies were performed to investigate PM-UTE-AdiabT1ρ 's sensitivity to compositional changes and reproducibility as well as its correlation with continuous wave-T1ρ measurement. The PM-UTE-AdiabT1ρ technique was then applied to five ex vivo and five in vivo normal knees to measure T1ρ values of femoral cartilage, meniscus, posterior cruciate ligament, anterior cruciate ligament, patellar tendon, and muscle.

RESULTS

The phantom study demonstrated PM-UTE-AdiabT1ρ 's high sensitivity to compositional changes, its high reproducibility, and its strong linear correlation with continuous wave-T1ρ measurement. The ex vivo and in vivo knee studies demonstrated average T1ρ values of 105.6 ± 8.4 and 77.9 ± 3.9 ms for the femoral cartilage, 39.2 ± 5.1 and 30.1 ± 2.2 ms for the meniscus, 51.6 ± 5.3 and 29.2 ± 2.4 ms for the posterior cruciate ligament, 79.0 ± 9.3 and 52.0 ± 3.1 ms for the anterior cruciate ligament, 19.8 ± 4.5 and 17.0 ± 1.8 ms for the patellar tendon, and 91.1 ± 8.8 and 57.6 ± 2.8 ms for the muscle, respectively.

CONCLUSION

The 3D PM-UTE-AdiabT1ρ sequence allows volumetric T1ρ assessment for both short and long T2 tissues in the knee joint on a clinical 3 T scanner.

Bone Biomarkers Based on Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is increasingly used to evaluate the microstructural and compositional properties of bone. MRI-based biomarkers can characterize all major compartments of bone: organic, water, fat, and mineral components. However, with a short apparent spin-spin relaxation time (T2*), bone is invisible to conventional MRI sequences that use long echo times. To address this shortcoming, ultrashort echo time MRI sequences have been developed to provide direct imaging of bone and establish a set of MRI-based biomarkers sensitive to the structural and compositional changes of bone. This review article describes the MRI-based bone biomarkers representing total water, pore water, bound water, fat fraction, macromolecular fraction in the organic matrix, and surrogates for mineral density. MRI-based morphological bone imaging techniques are also briefly described.

Evaluation of gadolinium deposition in cortical bone using three-dimensional ultrashort echo time quantitative susceptibility mapping: A preliminary study

The aim of the current study was to investigate the feasibility of three-dimensional ultrashort echo time quantitative susceptibility mapping (3D UTE-QSM) for the assessment of gadolinium (Gd) deposition in cortical bone. To this end, 40 tibial bovine cortical bone specimens were divided into five groups then soaked in phosphate-buffered saline (PBS) solutions with five different Gd concentrations of 0, 0.4, 0.8, 1.2, and 1.6 mmol/L for 48 h. Additionally, eight rabbits were randomly allocated into three groups, consisting of a normal-dose macrocyclic gadolinium-based contrast agent (GBCA) group (n = 3), a high-dose macrocyclic GBCA group (n = 3), and a control group (n = 2). All bovine and rabbit tibial bone samples underwent magnetic resonance imaging (MRI) on a 3-T clinical MR system. A 3D UTE-Cones sequence was utilized to acquire images with five different echo times (i.e., 0.032, 0.2, 0.4, 0.8, and 1.2 ms). The UTE images were subsequently processed with the morphology-enabled dipole inversion algorithm to yield a susceptibility map. The average susceptibility was calculated in three regions of interest in the middle of each specimen, and the Pearson's correlation between the estimated susceptibility and Gd concentration was calculated. The bone samples soaked in PBS with higher Gd concentrations exhibited elevated susceptibility values. A mean susceptibility value of -2.47 ± 0.23 ppm was observed for bovine bone soaked in regular PBS, while the mean QSM value increased to -1.75 ± 0.24 ppm for bone soaked in PBS with the highest Gd concentration of 1.6 mmol/L. A strong positive correlation was observed between Gd concentrations and QSM values. The mean susceptibility values of rabbit tibial specimens in the control group, normal-dose GBCA group, and high-dose GBCA group were -4.11 ± 1.52, -3.85 ± 1.33, and -3.39 ± 1.35 ppm, respectively. In conclusion, a significant linear correlation between Gd in cortical bone and QSM values was observed. The preliminary results suggest that 3D UTE-QSM may provide sensitive noninvasive assessment of Gd deposition in cortical bone.

Ultrashort echo time pulse sequences for visualization of deep peripheral fasciae and epimysium in porcine models with histologic correlations

Background

The deep peripheral fascia and epimysium are vital for muscle and tendon support, but their tight proton composition results in hypointense signals in conventional spin echo sequences. Ultrashort echo time (UTE) magnetic resonance imaging (MRI), using microsecond TE values, may visualize these structures. The purpose of this study was to evaluate whether UTE pulse sequence with a three-dimensional cone trajectory (3D UTE), with or without fat suppression (FS), can be used to visualize the fascia and epimysium using porcine lower legs as an example.

Methods

The anterior soft tissues of porcine lower legs were dissected and partially separated into distinct layers to expose the deep peripheral fascia, epimysium, and muscle. Axial 3D UTE and 3D UTE FS imaging using dual-echo acquisition and echo subtraction were performed both before and after dissection. Prior to dissection, the thickness, signal-to-noise ratios (SNRs), and contrast-to-noise ratios (CNRs) of structures believed to be deep peripheral fascia and epimysium were measured in both 3D UTE and 3D UTE FS. Post-dissection images were also analyzed to measure the SNRs and CNRs for the deep peripheral fascia and epimysium. Histological evaluations were carried out to verify the identities of the deep peripheral fascia and epimysium, as well as their thickness, and these measurements were compared to imaging findings.

Results

In pre-dissection images obtained with 3D UTE and 3D UTE FS, both the deep peripheral fascia and epimysium exhibited high signal intensity. In the subtraction images, the mean thickness of the deep fascia was 0.87 mm, and that of the epimysium was 0.80 mm when imaged with 3D UTE. This is compared to measurements of 0.77 and 0.22 mm in 3D UTE FS, respectively. Histological analyses confirmed the thickness of the deep peripheral fascia and epimysium as 0.65 and 0.14 mm, respectively. In the post-dissection images, the deep fascia continued to display high signal intensity when compared with adjacent soft tissues, consistent with the histological findings. Meanwhile, the epimysium showed very low CNRs.

Conclusions

3D UTE and 3D UTE FS can be used to visualize the deep peripheral fascia with high signal intensity and contrast but are insufficient to show signal intensity in the epimysium.

Nonaqueous magnetization following adiabatic and selective pulses in brain: T1 and cross-relaxation dynamics

Inversion pulses are commonly employed in MRI for T 1 $$ {T}_1 $$ -weighted contrast and relaxation measurements. In the brain, it is often assumed that adiabatic pulses saturate the nonaqueous magnetization. We investigated this assumption using solid-state NMR to monitor the nonaqueous signal directly following adiabatic inversion and compared this with signals following hard and soft inversion pulses. The effects of the different preparations on relaxation dynamics were explored. Inversion recovery experiments were performed on ex vivo bovine and porcine brains using 360-MHz (8.4 T) and 200-MHz (4.7 T) NMR spectrometers, respectively, using broadband rectangular, adiabatic, and sinc inversion pulses as well as a long rectangular saturation pulse. Analogous human brain MRI experiments were performed at 3 T using single-slice echo-planar imaging. Relaxation data were fitted by mono- and biexponential decay models. Further fitting analysis was performed using only two inversion delay times. Adiabatic and sinc inversion left much of the nonaqueous magnetization along B 0 $$ {B}_0 $$ and resulted in biexponential relaxation. Saturation of both aqueous and nonaqueous magnetization components led to effectively monoexponential T 1 $$ {T}_1 $$ relaxation. Typical adiabatic inversion pulses do not, as has been widely assumed, saturate the nonaqueous proton magnetization in white matter. Unequal magnetization states in aqueous and nonaqueous ¹ H reservoirs prepared by soft and adiabatic pulses result in biexponential T 1 $$ {T}_1 $$ relaxation. Both pools must be prepared in the same magnetization state (e.g., saturated or inverted) in order to observe consistent monoexponential relaxation.

The signal intensity variation of multiple sclerosis (MS) lesions on magnetic resonance imaging (MRI) as a potential biomarker for patients' disability: A feasibility study

Introduction

Although many lesion-based MRI biomarkers in multiple sclerosis (MS) patients were investigated, none of the previous studies dealt with the signal intensity variations (SIVs) of MS lesions. In this study, the SIVs of MS lesions on direct myelin imaging and standard clinical sequences as possible MRI biomarkers for disability in MS patients were assessed.

Methods

Twenty seven MS patients were included in this prospective study. IR-UTE, FLAIR, and MPRAGE sequences were employed on a 3T scanner. Regions of interest (ROIs) were manually drawn within the MS lesions, and the cerebrospinal fluid (CSF) and signal intensity ratios (SIR) were calculated from the derived values. Variations coefficients were determined from the standard deviations (Coeff 1) and the absolute differences (Coeff 2) of the SIRs. Disability grade was assessed by the expanded disability status scale (EDSS). Cortical/gray matter, subcortical, infratentorial, and spinal lesions were excluded.

Results

The mean diameter of the lesions was 7.8 ± 1.97 mm, while the mean EDSS score was 4.5 ± 1.73. We found moderate correlations between the EDSS and Coeff 1 and 2 on IR-UTE and MPRAGE images. Accordingly, Pearson's correlations on IR-UTE were R = 0.51 (p = 0.007) and R = 0.49 (p = 0.01) for Coeff 1 and 2, respectively. For MPRAGE, Pearson's correlations were R = 0.5 (p = 0.008) and R = 0.48 (p = 0.012) for Coeff 1 and 2, respectively. For FLAIR, only poor correlations could be found.

Conclusion

The SIVs of MS lesions on IR-UTE and MPRAGE images, assessed by Coeff 1 and 2, could be used as novel potential MRI biomarkers for patients' disability.

Making the invisible visible-ultrashort echo time magnetic resonance imaging: Technical developments and applications

Magnetic resonance imaging (MRI) uses a large magnetic field and radio waves to generate images of tissues in the body. Conventional MRI techniques have been developed to image and quantify tissues and fluids with long transverse relaxation times (T2s), such as muscle, cartilage, liver, white matter, gray matter, spinal cord, and cerebrospinal fluid. However, the body also contains many tissues and tissue components such as the osteochondral junction, menisci, ligaments, tendons, bone, lung parenchyma, and myelin, which have short or ultrashort T2s. After radio frequency excitation, their transverse magnetizations typically decay to zero or near zero before the receiving mode is enabled for spatial encoding with conventional MR imaging. As a result, these tissues appear dark, and their MR properties are inaccessible. However, when ultrashort echo times (UTEs) are used, signals can be detected from these tissues before they decay to zero. This review summarizes recent technical developments in UTE MRI of tissues with short and ultrashort T2 relaxation times. A series of UTE MRI techniques for high-resolution morphological and quantitative imaging of these short-T2 tissues are discussed. Applications of UTE imaging in the musculoskeletal, nervous, respiratory, gastrointestinal, and cardiovascular systems of the body are included.

Zero-TE MRI: principles and applications in the head and neck

Zero echo-time (ZTE) MRI is a novel imaging technique that utilizes ultrafast readouts to capture signal from short-T2 tissues. Additional sequence advantages include rapid imaging times, silent scanning, and artifact resistance. A robust application of this technology is imaging of cortical bone without the use of ionizing radiation, thus representing a viable alternative to CT for both rapid screening and "one-stop-shop" MRI. Although ZTE is increasingly used in musculoskeletal and body imaging, neuroimaging applications have historically been limited by complex anatomy and pathology. In this article, we review the imaging physics of ZTE including pulse sequence options, practical limitations, and image reconstruction. We then discuss optimization of settings for ZTE bone neuroimaging including acquisition, processing, segmentation, synthetic CT generation, and artifacts. Finally, we examine clinical utility of ZTE in the head and neck with imaging examples including malformations, trauma, tumors, and interventional procedures.

Lower Macromolecular Content in Tendons of Female Patients with Osteoporosis versus Patients with Osteopenia Detected by Ultrashort Echo Time (UTE) MRI

Tendons and bones comprise a special interacting unit where mechanical, biochemical, and metabolic interplays are continuously in effect. Bone loss in osteoporosis (OPo) and its earlier stage disease, osteopenia (OPe), may be coupled with a reduction in tendon quality. Noninvasive means for quantitatively evaluating tendon quality during disease progression may be critically important for the improvement of characterization and treatment optimization in patients with bone mineral density disorders. Though clinical magnetic resonance imaging (MRI) sequences are not typically capable of directly visualizing tendons, ultrashort echo time MRI (UTE-MRI) is able to acquire a high signal from tendons. Magnetization transfer (MT) modeling combined with UTE-MRI (i.e., UTE-MT-modeling) can indirectly assess macromolecular proton content in tendons. This study aimed to determine whether UTE-MT-modeling could detect differences in tendon quality across a spectrum of bone health. The lower legs of 14 OPe (72 ± 6 years) and 31 OPo (73 ± 6 years) female patients, as well as 30 female participants with normal bone (Normal-Bone, 36 ± 19 years), are imaged using UTE sequences on a 3T MRI scanner. Institutional review board approval is obtained for the study, and all recruited subjects provided written informed consent. A T1 measurement and UTE-MT-modeling are performed on the anterior tibialis tendon (ATT), posterior tibialis tendon (PTT), and the proximal Achilles tendon (PAT) of all subjects. The macromolecular fraction (MMF) is estimated as the main measure from UTE-MT-modeling. The mean MMF in all the investigated tendons was significantly lower in OPo patients compared with the Normal-Bone cohort (mean difference of 24.2%, p < 0.01), with the largest Normal-Bone vs. OPo difference observed in the ATT (mean difference of 32.1%, p < 0.01). Average MMF values of all the studied tendons are significantly lower in the OPo cohort compared with the OPe cohort (mean difference 16.8%, p = 0.02). Only the PPT shows significantly higher T1 values in OPo patients compared with the Normal-Bone cohort (mean difference 17.6%, p < 0.01). Considering the differences between OPo and OPe groups with similar age ranges, tendon deterioration associated with declining bone health was found to be larger than a priori detected differences caused purely by aging, highlighting UTE-MT MRI techniques as useful methods in assessing tendon quality over the course of progressive bone weakening.

Correlation between the elastic modulus of anterior cruciate ligament (ACL) and quantitative ultrashort echo time (UTE) magnetic resonance imaging

Conventional magnetic resonance imaging (MRI) often acquires no signal in anterior cruciate ligament (ACL) due to the short apparent transverse relaxation time of ACL. Ultrashort echo time (UTE) MRI is capable of imaging ACL with high signal which enables quantitative ACL assessment. This study aimed to investigate the correlations of the mechanical and microstructural properties of human ACL specimens with quantitative three-dimensional UTE Cones (3D-UTE-Cones) MRI measures. ACL specimens were harvested from cadaveric knee joints of 13 (50.9 ± 21.1 years old, 11 males and 2 female) donors. Specimens were scanned using a series of quantitative 3D-UTE-Cones T₂ * (UTE-T₂ *), T₁ (UTE-T₁ ), Adiabatic T_1ρ (UTE-Adiab-T_1ρ ), and magnetization transfer (UTE-MT) sequences in a wrist coil on a clinical 3T scanner. ACL elastic modulus was measured using a uniaxial tensile mechanical test. Histomorphometry analysis was performed to measure the average fascicle specific surface, fascicle size, and number of cells per unit area. Spearman's rank correlations of UTE-MRI biomarkers with mechanical and histomorphometry measures were investigated. The elastic modulus of ACL showed significant moderate correlations with UTE-Adiab-T_1ρ (R = -0.59, p = 0.01), macromolecular fraction from MT modeling (R = 0.54, p = 0.01), magnetization transfer ratio (R = 0.53, p = 0.01), UTE-T2* (R = -0.53, p = 0.01), and average fascicle specific surface (R = 0.54, p = 0.01). UTE-MRI showed nonsignificant correlations with histomorphometry measures. UTE-MRI biomarkers may be useful noninvasive tools for the ACL mechanical assessment.

Ultrashort Echo Time Magnetic Resonance Imaging Techniques: Met and Unmet Needs in Musculoskeletal Imaging

This review article summarizes recent technical developments in ultrashort echo time (UTE) magnetic resonance imaging of musculoskeletal (MSK) tissues with short-T2 relaxation times. A series of contrast mechanisms are discussed for high-contrast morphological imaging of short-T2 MSK tissues including the osteochondral junction, menisci, ligaments, tendons, and bone. Quantitative UTE mapping of T1, T2*, T1ρ, adiabatic T1ρ, magnetization transfer ratio, MT modeling of macromolecular proton fraction, quantitative susceptibility mapping, and water content is also introduced. Met and unmet needs in MSK imaging are discussed. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 3.

Fat unsaturation measures in tibial, subcutaneous and breast adipose tissue using short and long TE MRS at 3 T

Fat unsaturation and poly-unsaturation measures can be obtained in vivo with magnetic resonance spectroscopy (MRS) through the olefinic (≈5.4 ppm) and diallylic (≈2.8 ppm) resonances, respectively. Long echo time (TE) MRS sequences have been previously optimized for olefinic/methylene (≈1.3 ppm) or olefinic/methyl (≈0.9 ppm) measures. The objectives of this work, using a Point RESolved Spectroscopy (PRESS) sequence, are to: 1) Investigate olefinic, methyl and methylene resonance decay in subcutaneous, tibial, and breast adipose tissue to determine if a direct comparison of unsaturation measures can be made without correction for T₂ losses. 2) Assess intra-individual fat unsaturation and poly-unsaturation measures in the three adipose tissues. 3) Estimate correction factors for olefinic to methylene ratios to compensate for J-coupling and T₂ relaxation losses that take place when increasing PRESS TE from 40 ms to 200 ms (previously optimized long-TE). 4) Investigate the utility of an inversion recovery for resolving the olefinic resonance from water in adipose tissue. PRESS spectra were acquired from the three adipose regions (breast in female only) in healthy volunteers at 3 T. It was found that olefinic and methyl signal decays faster in breast tissue compared to in tibial bone marrow. Poly-unsaturation measures (diallylic/methylene) differ for tibial bone marrow compared to subcutaneous and breast adipose tissue, with average values of 1.7 ± 0.4, 2.2 ± 0.4, and 2.3 ± 0.8%, respectively. PRESS (TE = 40 ms) with an inversion recovery resolves the olefinic and water resonances in breast tissue with a signal to noise ratio approximately six times greater than that using PRESS with a TE of 200 ms. Stimulated Echo Acquisition Mode (STEAM) with a TE of 20 ms (mixing time of 20 ms) was also combined with IR to resolve the olefinic resonance from that of water is spinal bone marrow.

Three-Dimensional Printed Anatomic Models Derived From Magnetic Resonance Imaging Data: Current State and Image Acquisition Recommendations for Appropriate Clinical Scenarios

Three-dimensional (3D) printing technologies have been increasingly utilized in medicine over the past several years and can greatly facilitate surgical planning thereby improving patient outcomes. Although still much less utilized compared to computed tomography (CT), magnetic resonance imaging (MRI) is gaining traction in medical 3D printing. The purpose of this study was two-fold: 1) to determine the prevalence in the existing literature of using MRI to create 3D printed anatomic models for surgical planning and 2) to provide image acquisition recommendations for appropriate clinical scenarios where MRI is the most suitable imaging modality. The workflow for creating 3D printed anatomic models from medical imaging data is complex and involves image segmentation of the regions of interest and conversion of that data into 3D surface meshes, which are compatible with printing technologies. CT is most commonly used to create 3D printed anatomic models due to the high image quality and relative ease of performing image segmentation from CT data. As compared to CT datasets, 3D printing using MRI data offers advantages since it provides exquisite soft tissue contrast needed for accurate organ segmentation and it does not expose patients to unnecessary ionizing radiation. MRI, however, often requires complicated imaging techniques and time-consuming postprocessing procedures to generate high-resolution 3D anatomic models needed for 3D printing. Despite these challenges, 3D modeling and printing from MRI data holds great clinical promises thanks to emerging innovations in both advanced MRI imaging and postprocessing techniques. EVIDENCE LEVEL: 2 TECHNICAL EFFICATCY: 5.

Magnetic Resonance T2 * Is Increased in Patients With Early-Stage Achilles and Patellar Tendinopathy

BACKGROUND

T₂ * mapping has proven useful in tendon research and may have the ability to detect subtle changes at an early stage of tendinopathy.

PURPOSE

To investigate the difference in T₂ * between patients with early tendinopathy and healthy controls, and to investigate the relationship between T₂ * and clinical outcomes, tendon size, and mechanical properties.

STUDY TYPE

Prospective cross-sectional.

SUBJECTS

Sixty-five patients with early tendinopathy and 25 healthy controls.

FIELD STRENGTH/SEQUENCE

Three Tesla, ultrashort time to echo magnetic resonance imaging.

ASSESSMENT

Tendon T₂ * was quantified using a monoexponential fitting algorithm. Clinical symptoms were evaluated using the Victorian Institute of Sports Assessment-Achilles/Patella (VISA-A/VISA-P). In vivo mechanical properties were measured using an ultrasound-based method that determined force and deformation simultaneously in tendons of patellar tendinopathy patients.

STATISTICAL TESTS

A generalized linear model adjusted for age was applied to investigate the difference between patients and controls. In the two patient groups, linear regressions were applied to investigate the association between T₂ * and tendon size, clinical outcomes, and biomechanical properties.

RESULTS

There was a significant difference in T₂ * between patients and healthy controls (204.8 [95% CI: 44.5-365.0] μsec, P < 0.05). There was a positive correlation between tendon size and T₂ * for both Achilles (r = 0.72; P < 0.05) and patellar tendons (r = 0.53; P < 0.05). There was no significant correlation between VISA-A and T₂ * (r = -0.2; P = 0.17) or VISA-P and T₂ * (r = -0.5; P = 0.0504). Lastly, there was a negative correlation between modulus and T₂ * (r = -0.51; P < 0.05).

DATA CONCLUSIONS

T₂ * mapping can detect subtle structural changes that translate to altered mechanical properties in early-phase tendinopathy. However, T₂ * did not correlate with clinical scores in patients with early-phase Achilles and patellar tendinopathy. Thus, T₂ * mapping may serve as a tool for early detection of structural changes in tendinopathy but does not necessarily describe the clinical severity of disease.

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY STAGE: 2.

Brain ultrashort T2 component imaging using a short TR adiabatic inversion recovery prepared dual-echo ultrashort TE sequence with complex echo subtraction (STAIR-dUTE-ES)

Long T₂ water contamination is a major challenge with direct in vivo UTE imaging of ultrashort T₂ components in the brain since water contributes most of the signal detected from white and gray matter. The Short TR Adiabatic Inversion Recovery prepared Ultrashort TE (STAIR-UTE) sequence can significantly suppress water signals and simultaneously image ultrashort T₂ components. However, the TR used may not be sufficiently short to allow the STAIR preparation to completely suppress all the water signals in the brain due to specific absorption rate (SAR) limitations on clinical MR scanners. In this study, we describe a STAIR prepared dual-echo UTE sequence with complex Echo Subtraction (STAIR-dUTE-ES) which improves water suppression for selective ultrashort T₂ imaging compared with that achieved with the STAIR-UTE sequence. Numerical simulations showed that the STAIR-dUTE-ES technique can effectively suppress water signals and allow accurate quantification of ultrashort T₂ protons. Volunteer and Multiple Sclerosis (MS) patient studies demonstrated the feasibility of the STAIR-dUTE-ES technique for selective imaging and quantification of ultrashort T₂ components in vivo. A significantly lower mean UltraShort T₂ Proton Fraction (USPF) was found in lesions in MS patients (5.7 ± 0.7%) compared with that in normal white matter of healthy volunteers (8.9 ± 0.6%). The STAIR-dUTE-ES sequence provides robust water suppression for volumetric imaging and quantitation of ultrashort T₂ component. The reduced USPF in MS lesions shows the clinical potential of the sequence for diagnosis and monitoring treatment in MS.

Feasibility of an Inversion Recovery-Prepared Fat-Saturated Zero Echo Time Sequence for High Contrast Imaging of the Osteochondral Junction

PURPOSE

The osteochondral junction (OCJ) region-commonly defined to include the deep radial uncalcified cartilage, tidemark, calcified cartilage, and subchondral bone plate-functions to absorb mechanical stress and is commonly associated with the pathogenesis of osteoarthritis. However, magnetic resonance imaging of the OCJ region is difficult due to the tissues' short transverse relaxation times (i.e., short T₂ or T₂*), which result in little or no signal with conventional MRI. The goal of this study is to develop a 3D adiabatic inversion recovery prepared fat saturated zero echo time (IR-FS-ZTE) sequence for high-contrast imaging of the OCJ.

METHOD

An IR-FS-ZTE MR sequence was developed to image the OCJ on a clinical 3T MRI scanner. The IR-FS-ZTE sequence employed an adiabatic inversion pulse followed by a fat saturation pulse that suppressed signals from the articular cartilage and fat. At an inversion time (TI) that was matched to the nulling point of the articular cartilage, continuous ZTE imaging was performed with a smoothly rotating readout gradient, which enabled time-efficient encoding of the OCJ region's short T₂ signal with a minimal echo time (TE) of 12 μs. An ex vivo experiment with six cadaveric knee joints, and an in vivo experiment with six healthy volunteers and three patients with OA were performed to evaluate the feasibility of the proposed approach for high contrast imaging of the OCJ. Contrast-to-noise ratios (CNRs) between the OCJ and its neighboring femoral and tibial cartilage were measured.

RESULTS

In the ex vivo experiment, IR-FS-ZTE produced improved imaging of the OCJ region over the clinical sequences, and significantly improved the contrast compared to FS-ZTE without IR preparation (p = 0.0022 for tibial cartilage and p = 0.0019 for femoral cartilage with t-test). We also demonstrated the feasibility of high contrast imaging of the OCJ region in vivo using the proposed IR-FS-ZTE sequence, thereby providing more direct information on lesions in the OCJ. Clinical MRI did not detect signal from OCJ due to the long TE (>20 ms).

CONCLUSION

IR-FS-ZTE allows direct imaging of the OCJ region of the human knee and may help in elucidating the role of the OCJ in cartilage degeneration.

Bright ultrashort echo time SWIFT MRI signal at the osteochondral junction is not located in the calcified cartilage

In this study, we aimed to precisely localize the hyperintense signal that is generated at the osteochondral junction when using ultrashort echo time magnetic resonance imaging (MRI) and to investigate the osteochondral junction using sweep imaging with Fourier transformation (SWIFT) MRI. Furthermore, we seek to evaluate what compositional properties of the osteochondral junction are the sources of this signal. In the study, we obtained eight samples from a tibial plateau dissected from a 68-year-old male donor, and one additional osteochondral sample of bovine origin. The samples were imaged using high-resolution ultrashort echo time SWIFT MRI and microcomputed tomography (μCT) scans. Localization of the bright signal in the osteochondral junction was performed using coregistered data sets. Potential sources of the signal feature were examined by imaging the bovine specimen with variable receiver bandwidths and by performing variable flip angle T1 relaxation time mapping. The results of the study showed that the hyperintense signal was found to be located entirely in the deep noncalcified articular cartilage. The intensity of this signal at the interface varied between the specimens. Further tests with bovine specimens indicated that the imaging bandwidth and T1 relaxation affect the properties of the signal. Based on the present results, the calcified cartilage has low signal intensity even in SWIFT imaging. Concomitantly, it appears that the bright signal seen in ultrashort echo time imaging resides within the noncalcified cartilage. Furthermore, the most likely sources of this signal are the rapid T1 relaxation of the deep cartilage and the susceptibility-induced effects arising from the calcified tissues.

Assessment of mechanical properties of articular cartilage with quantitative three-dimensional ultrashort echo time (UTE) cones magnetic resonance imaging

Conventional magnetic resonance imaging (MRI) is not capable of detecting signal from the deep cartilage due to its short transverse relaxation time (T2). Moreover, several quantitative MRI techniques are significantly influenced by the magic angle effect. The combinations of ultrashort echo time (UTE) MRI with magnetization transfer (UTE-MT) and Adiabatic T_1ρ (UTE-AdiabT_1ρ) imaging allow magic angle-insensitive assessments of all regions of articular cartilage. The purpose of this study was to investigate the correlations between quantitative three-dimensional UTE MRI biomarkers and mechanical properties of human tibiofemoral cartilage specimens. In total, 40 human tibiofemoral cartilage specimens were harvested from three male and four female donors (64 ± 18 years old). Cartilage samples were scanned using a series of quantitative 3D UTE Cones T₂* (UTE-T₂*), T₁ (UTE-T₁), UTE-AdiabT_1ρ, and UTE-MT sequences in a standard knee coil on a clinical 3T scanner. UTE-MT data were acquired with a series of MT powers and frequency offsets to calculate magnetization transfer ratio (MTR), as well as macromolecular fraction (MMF) and macromolecular T₂ (T₂mm) through modeling. Cartilage stiffness and Hayes elastic modulus were measured using indentation tests. Correlations of 3D UTE Cones MRI measurements in the superficial layer, deep layer, and global regions of interest (ROIs) with mechanical properties were investigated. Cartilage mechanical properties demonstrated highest correlations with UTE measures of the superficial layer of cartilage. AdiabT_1ρ, MTR, and MMF in superficial layer ROIs showed significant correlations with Hayes elastic modulus (p < 0.05, R = -0.54, 0.49, and 0.66, respectively). These UTE measures in global ROIs showed significant, though slightly lower, correlations with Hayes elastic modulus (p < 0.05, R = -0.37, 0.52, and 0.60, respectively). Correlations between other UTE MRI measurements (T₂*, T₁, and T₂mm) and mechanical properties were non-significant. The 3D UTE-AdiabT_1ρ and UTE-MT sequences were highlighted as promising surrogates for non-invasive assessment of cartilage mechanical properties. MMF from UTE-MT modeling showed the highest correlations with cartilage mechanics.

Three-dimensional Yarnball k-space acquisition for accelerated MRI

PURPOSE

To introduce an efficient sampling technique named Yarnball, which may serve as a direct alternative to 3D Cones.

METHODS

Yarnball evolves through 3D k-space with increasing loop size, and the differential equations defining this flexible trajectory are presented in detail. The sampling efficiencies of Yarnball and 3D Cones were compared through point spread function analysis and simulated imaging (which highlights undersampling in the absence of other scanning effects). The feasibility of Yarnball implementation was demonstrated for fully sampled T₁ -weighted images of the human head at 3 T.

RESULTS

The mostly large 3D loops of the Yarnball trajectory facilitate rapid sampling under peripheral nerve stimulation constraint, an advantage that increases with readout duration (T_RO ). Point spread function analysis yielded 89% (T_RO = 2 ms) and 77% (T_RO = 10 ms) of Yarnball voxels with magnitude less than 0.01% of the point spread function peak. For 3D Cones, these values were only 52% and 29%. The 3D-Cones technique required 1.4 times (T_RO = 2 ms) and 1.8 times (T_RO = 10 ms) more trajectories than Yarnball to produce simulated images of a sphere free from undersampling artifact. For a prolate spheroidal (head-like) object, 1.75 times and 2.6 times more trajectories were required for 3D Cones. Yarnball produced 0.72 mm (1/2k_max ) isotropic T₁ -weighted human brain images free from undersampling artifact in only 98 seconds at 3 T.

CONCLUSION

Yarnball demonstrated greater k-space sampling efficiency than directly comparable 3D Cones, and may have value wherever 3D Cones has been considered. Yarnball may also have value in the context of rapid T₁ -weighted brain imaging.

Volumetric imaging of myelin in vivo using 3D inversion recovery-prepared ultrashort echo time cones magnetic resonance imaging

Direct myelin imaging is promising for characterization of multiple sclerosis (MS) brains at diagnosis and in response to therapy. In this study, a 3D inversion recovery-prepared ultrashort echo time cones (IR-UTE-Cones) sequence was used for both morphological and quantitative imaging of myelin on a clinical 3 T scanner. Myelin powder phantoms with different myelin concentrations were imaged with the 3D UTE-Cones sequence and it showed a strong correlation between concentrations and UTE-Cones signals, demonstrating the ability of the UTE-Cones sequence to directly image myelin in the brain. Quantitative myelin imaging with multi-echo IR-UTE-Cones sequences show similar T₂ * values for a D₂ O-exchanged myelin phantom (T₂ * = 0.33 ± 0.04 ms), ex vivo brain specimens (T₂ * = 0.20 ± 0.04 ms) and in vivo healthy volunteers (T₂ * = 0.254 ± 0.023 ms), further confirming the feasibility of 3D IR-UTE-Cones sequences for direct myelin imaging in vivo. In ex vivo MS brain study, signal loss is observed in MS lesions, which was confirmed with histology. For the in vivo study, the lesions in MS patients also show myelin signal loss using the proposed direct myelin imaging method, demonstrating the clinical potential for MS diagnosis. Furthermore, the measured IR-UTE-Cones signal intensities show a significant difference between normal-appearing white matter in MS patients and normal white matter in volunteers, which cannot be found in clinical used T₂ -FLAIR sequences. Thus, the proposed 3D IR-UTE-Cones sequence showed clinical potential for MS diagnosis with the capability of direct myelin detection of the whole brain.

3D UTE bicomponent imaging of cortical bone using a soft-hard composite pulse for excitation

PURPOSE

To evaluate 3D UTE bicomponent imaging of cortical bone ex vivo and in vivo using a newly designed soft-hard composite pulse for excitation.

METHODS

Chemical shift artifacts, presenting as fat-water oscillation or combination-induced signal oscillation, significantly reduce the accuracy of quantitative UTE bicomponent analysis of cortical bone. To achieve fat suppression for more reliable bicomponent analysis, a newly developed soft-hard excitation pulse was used with UTE imaging and compared with a single rectangular pulse excitation without and with a conventional fat saturation (FatSat) module. These 3 sequences were applied to 8 bovine bone samples without marrow fat, 3 bovine bone samples with marrow fat, and tibial midshafts of 5 healthy human volunteers. Bicomponent analyses were performed in both ex vivo and in vivo studies.

RESULTS

The soft-hard pulse provided comparable fat suppression, but much reduced bone signal attenuation compared with the FatSat module. Better bicomponent T 2 ∗ fitting was also achieved with the soft-hard excitation pulse because it greatly reduced chemical shift artifacts and outperformed the single rectangular pulse without or with FatSat. Although the FatSat module reduced fat signals and related fat-water oscillation, the water signals were significantly attenuated with more than 40% reduction due to direction saturation. For the inner layer of tibial midshaft in healthy volunteers, fitting errors increased from 3.78% for the soft-hard pulse to 11.43% and 5.16%, respectively, for the single rectangular pulse without and with the FatSat module.

CONCLUSION

The 3D UTE sequence with a new soft-hard excitation pulse allows more reliable bicomponent imaging of cortical bone.

Myelin Imaging in Human Brain Using a Short Repetition Time Adiabatic Inversion Recovery Prepared Ultrashort Echo Time (STAIR-UTE) MRI Sequence in Multiple Sclerosis

Background Water signal contamination is a major challenge for direct ultrashort echo time (UTE) imaging of myelin in vivo because water contributes most of the signals detected in white matter. Purpose To validate a new short repetition time (TR) adiabatic inversion recovery (STAIR) prepared UTE (STAIR-UTE) sequence designed to suppress water signals and to allow imaging of ultrashort T2 protons of myelin in white matter using a clinical 3-T scanner. Materials and Methods In this prospective study, an optimization framework was used to obtain the optimal inversion time for nulling water signals using STAIR-UTE imaging at different TRs. Numeric simulation and phantom studies were performed. Healthy volunteers and participants with multiple sclerosis (MS) underwent MRI between November 2018 and October 2019 to compare STAIR-UTE and a clinical T2-weighted fluid-attenuated inversion recovery sequence for assessment of MS lesions. UTE measures of myelin were also performed to allow comparison of signals in lesions and with those in normal-appearing white matter (NAWM) in patients with MS and in normal white matter (NWM) in healthy volunteers. Results Simulation and phantom studies both suggest that the proposed STAIR-UTE technique can effectively suppress long T2 tissues with a broad range of T1s. Ten healthy volunteers (mean age, 33 years ± 8 [standard deviation]; six women) and 10 patients with MS (mean age, 51 years ± 16; seven women) were evaluated. The three-dimensional STAIR-UTE sequence effectively suppressed water components in white matter and selectively imaged myelin, which had a measured T2* value of 0.21 msec ± 0.04 in the volunteer study. A much lower mean UTE measure of myelin proton density was found in MS lesions (3.8 mol/L ± 1.5), and a slightly lower mean UTE measure was found in NAWM (7.2 mol/L ± 0.8) compared with that in NWM (8.0 mol/L ± 0.8) in the healthy volunteers (P < .001 for both comparisons). Conclusion The short repetition time adiabatic inversion recovery-prepared ultrashort echo time sequence provided efficient water signal suppression for volumetric imaging of myelin in the brain and showed excellent myelin signal contrast as well as marked ultrashort echo time signal reduction in multiple sclerosis lesions and a smaller reduction in normal-appearing white matter compared with normal white matter in volunteers. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Messina and Port in this issue.

Exponential subtraction in 3D ultrashort echo time imaging to visualize short T2 tissues in tibia

BACKGROUND

Short T2 tissues can be directly visualized by dual-echo ultrashort echo time imaging with weighted subtraction. As a type of post-processing method, exponential subtraction of ultrashort echo time images with an optimal exponential factor is expected to provide improved positive short T2 contrast.

PURPOSE

To test the feasibility and effectiveness of exponential subtraction in three-dimensional ultrashort echo time imaging and to determine the optimal exponential factor.

MATERIAL AND METHODS

A dual-echo three-dimensional ultrashort echo time sequence was implemented on a 3-T MRI system. Exponential subtraction was performed on dual three-dimensional ultrashort echo time images of the tibia of seven healthy volunteers with exponential factors in the range of 1.00-3.00 in increments of 0.01. The regions of interest, including cortical bone, marrow, and muscle, were depicted on subtracted images of different exponential factors. Contrast-to-noise ratio values were calculated from these regions of interest and then used to assess the optimal exponential factor. To determine intra-observer agreement regarding region of interest selection, paired intra-observer measurements of regions of interest in all direct subtraction images were conducted with a one-week interval and the paired measurements were assessed using Bland-Altman analysis and paired-samples t-test.

RESULTS

Cortical bone can be better visualized by using exponential subtraction in three-dimensional ultrashort echo time imaging; the suggested optimal exponential factor is 1.99-2.03 in the tibia. Paired measurements showed excellent intra-observer agreement.

CONCLUSION

It is feasible to visualize cortical bone of the tibia using exponential subtraction in three-dimensional ultrashort echo time imaging. Compared with weighted subtraction images, exponential subtraction images with an optimal exponential factor provide enhanced visualization of short T2 tissues.

Immersion of Achilles tendon in phosphate-buffered saline influences T1 and T2 * relaxation times: An ex vivo study

Robust mapping of relaxation parameters in ex vivo tissues is based on hydration and therefore requires control of the tissue treatment to ensure tissue integrity and consistent measurement conditions over long periods of time. One way to maintain the hydration of ex vivo tendon tissue is to immerse the samples in a buffer solution. To this end, various buffer solutions have been proposed; however, many appear to influence the tissue relaxation times, especially with prolonged exposure. In this work, ovine Achilles tendon tissue was used as a model to investigate the effect of immersion in phosphate-buffered saline (PBS) and the effects on the T₁ and T₂^* relaxation times. Ex vivo samples were measured at 0 (baseline), 30 and 67 hours after immersion in PBS. Ultrashort echo time (UTE) imaging was performed using variable flip angle and echo train-shifted multi-echo imaging for T₁ and T₂^* estimation, respectively. Compared with baseline, both T₁ and T₂^* relaxation time constants increased significantly after 30 hours of immersion. T₂^* continued to show a significant increase between 30 and 67 hours. Both T₁ and T₂^* tended to approach saturation at 67 hours. These results exemplify the relevance of stringently controlled tissue preparation and preservation techniques, both before and during MRI experiments.

Magnetic Resonance Imaging of Hard Tissues and Hard Tissue Engineered Bio-substitutes

Magnetic resonance imaging (MRI) is a non-invasive diagnostic imaging tool based on the detection of protons into the tissues. This imaging technique is remarkable because of high spatial resolution, strong soft tissue contrast and specificity, and good depth penetration. However, MR imaging of hard tissues, such as bone and teeth, remains challenging due to low proton content in such tissues as well as to very short transverse relaxation times (T₂). To overcome these issues, new MRI techniques, such as sweep imaging with Fourier transformation (SWIFT), ultrashort echo time (UTE) imaging, and zero echo time (ZTE) imaging, have been developed for hard tissues imaging with promising results reported. Within this article, MRI techniques developed for the detection of hard tissues, such as bone and dental tissues, have been reviewed. The main goal was thus to give a comprehensive overview on the corresponding (pre-) clinical applications and on the potential future directions with such techniques applied. In addition, a section dedicated to MR imaging of novel biomaterials developed for hard tissue applications was given as well.

Trabecular bone imaging using a 3D adiabatic inversion recovery prepared ultrashort TE Cones sequence at 3T

PURPOSE

To investigate direct imaging of trabecular bone using a 3D adiabatic inversion recovery prepared ultrashort TE cones (3D IR-UTE-Cones) sequence.

METHODS

The proposed 3D IR-UTE-Cones sequence used a broadband adiabatic inversion pulse together with a short TR/TI combination to suppress signals from long T2 tissues such as muscle and marrow fat, followed by multispoke UTE acquisition to detect signal from short T2 water components in trabecular bone. The feasibility of this technique for robust suppression of long T2 tissues was first demonstrated through numerical simulations. The proposed IR-UTE-Cones sequence was applied to a hip agarose bone phantom and to 6 healthy volunteers for morphologic and quantitative T 2 ∗ and proton density mapping of trabecular bone.

RESULTS

Numeric simulation suggests that the IR technique with a short TR/TI combination provides sufficient suppression of long T2 tissues with a wide range of T1 s. High contrast imaging of trabecular bone can be achieved ex vivo and in vivo, with fitted T 2 ∗ values of 0.3-0.45 ms and proton densities of 5-9 mol/L.

CONCLUSION

The 3D IR-UTE-Cones sequence with a short TR/TI combination provides robust suppression of long T2 tissues and allows both selective imaging and quantitative ( T 2 ∗ and proton density) assessment of short T2 water components in trabecular bone in vivo.

To measure T1 of short T2 species using an inversion recovery prepared three-dimensional ultrashort echo time (3D IR-UTE) method: A phantom study

PURPOSE

To demonstrate the feasibility of a new method for measuring T₁ of short T₂ species based on an adiabatic inversion recovery-prepared three-dimensional ultrashort echo time Cones (3D IR-UTE-Cones) sequence.

METHODS

T₁ values for short T₂ species were quantified using 3D IR-UTE-Cones data acquired with different repetition times (TRs) and inversion times (TIs). An inversion efficiency factor Q was introduced into the fitting model to accurately calculate T₁ values for short T₂ species. Experiments were performed on twelve MnCl₂ aqueous solution phantoms with a wide range of T₁ values and T₂* values on a 3 T clinical MR system to verify the efficacy of the proposed method. For comparison, a variable flip angle UTE (VFA-UTE) sequence, a variable TR UTE (VTR-UTE) sequence, and a conventional 2D IR fast spin echo (IR-FSE) sequence were also used to quantify T₁ values of those phantoms. T₁ values were compared between all performed sequences.

RESULTS

The proposed 3D IR-UTE-Cones method provided higher contrast images of short T₂ phantoms and measured much shorter T₁ values than the VFA-UTE, VTR-UTE and 2D IR-FSE methods. T₁ values as short as 2.95 ms could be measured by the 3D IR-UTE-Cones sequence. The 3D IR-UTE-Cones methods with different TRs were applied to different ranges of T₁ measurement, and the scan time was significantly decreased by using 5 TIs along the recovery curves to perform fitting with comparable accuracy.

CONCLUSION

The 3D IR-UTE-Cones sequence could accurately measure short T₁ values while providing high contrast images of short T₂ species.

Rotator Cuff Tendon Assessment in Symptomatic and Control Groups Using Quantitative MRI

BACKGROUND

Relatively weak correlations between patient symptoms and rotator cuff tendon (RCT) tearing have been reported; however, the relationship between symptoms and tendinosis has been less well-studied.

PURPOSE/HYPOTHESIS

To use quantitative MRI to assess the bilateral RCTs in shoulders of both patients with unilateral symptomatic tendinopathy and control subjects. We hypothesized that quantitative MRI measures would differ between symptomatic patients and controls.

STUDY TYPE

Prospective imaging study.

POPULATION/SUBJECTS

In all, 48 shoulders from 24 subjects (mean age, 32.8 years), including 14 patients with unilateral symptomatic tendinopathy and 10 asymptomatic controls.

FIELD STRENGTH/SEQUENCE

3T/3D ultrashort echo time Cones sequence with magnetization transfer preparation (UTE-Cones-MT) and Carr-Purcell-Meiboom-Gill.

ASSESSMENT

Macromolecular fraction (MMF) and T₂ relaxation were measured in four regions of the superior RCT, including all-segments, and lateral-third, bursal-sided, and articular-sided segments. The Western Ontario Rotator Cuff (WORC) index and visual analog scale were assessed.

STATISTICAL TESTS

Three shoulder groups were evaluated, including symptomatic shoulders, contralateral asymptomatic shoulders in patients, and asymptomatic controls. MMF and T₂ values were compared between groups using a bootstrap-based comparison of means.

RESULTS

Significant differences were found in both MMF and T₂ values between symptomatic and control RCTs when analyzing all-segments (P = 0.027 and P = 0.006, respectively) and articular-sided segments (both P = 0.001). Significant differences between asymptomatic RCTs in patients and control RCTs were also found, including MMF in all four anatomic regions analyzed (P = 0.024-0.044), as well as T₂ in all-segments (P = 0.003), bursal-sided segments (P = 0.021), and articular-sided segments (P = 0.002). No significant differences in MMF (P = 0.420-0.950) or T₂ (P = 0.380-0.910) were seen between ipsilateral symptomatic and contralateral asymptomatic RCTs in patients.

DATA CONCLUSION

Symptomatic RCTs showed significantly lower MMF values and higher T₂ values compared with control RCTs. In patients with unilateral symptomatic tendinopathy, the contralateral shoulder can demonstrate asymptomatic tendinopathy, which can be quantified using MMF or T₂ .

EVIDENCE LEVEL

2 TECHNICAL EFFICACY: Stage 2. J. Magn. Reson. Imaging 2020;52:864-872.

Correlations of cortical bone microstructural and mechanical properties with water proton fractions obtained from ultrashort echo time (UTE) MRI tricomponent T2* model

Mechanical and microstructural evaluations of cortical bone using ultrashort echo time magnetic resonance imaging (UTE-MRI) have been performed increasingly in recent years. UTE-MRI acquires considerable signal from cortical bone and enables quantitative bone evaluations. Fitting bone apparent transverse magnetization (T2*) decay using a bicomponent model has been regularly performed to estimate bound water (BW) and pore water (PW) in the quantification of bone matrix and porosity, respectively. Human cortical bone possesses a considerable amount of fat, which appears as MRI T2* signal oscillation and can subsequently lead to BW overestimation when using a bicomponent model. Tricomponent T2* fitting model has been developed to improve BW and PW estimations by accounting for fat contribution in the MRI signal. This study aimed to investigate the correlations of microstructural and mechanical properties of human cortical bone with water pool fractions obtained from a tricomponent T2* model. 135 cortical bone strips (~4 × 2 × 40 mm³ ) from tibial and femoral midshafts of 37 donors (61 ± 24 years old) were scanned using ten sets of dual-echo 3D-UTE-Cones sequences (TE = 0.032-24.0 ms) on a 3 T MRI scanner for T2* fitting analyses. Average bone porosity and pore size were measured using microcomputed tomography (μCT) at 9 μm voxel size. Bone mechanical properties were measured using 4-point bending tests. Using a tricomponent model, bound water fraction (Frac_BW ) showed significant strong (R = 0.70, P < 0.01) and moderate (R = 0.58-0.62, P < 0.01) correlations with porosity and mechanical properties, respectively. Correlations of bone microstructural and mechanical properties with water pool fractions were higher for tricomponent model results compared with the bicomponent model. The tricomponent T2* fitting model is suggested as a useful technique for cortical bone evaluation where the MRI contribution of bone fat is accounted for.

Whole-Brain Myelin Imaging Using 3D Double-Echo Sliding Inversion Recovery Ultrashort Echo Time (DESIRE UTE) MRI

Background Signal contamination from long T2 water is a major challenge in direct imaging of myelin with MRI. Nulling of the unwanted long T2 signals can be achieved with an inversion recovery (IR) preparation pulse to null long T2 white matter within the brain. The remaining ultrashort T2 signal from myelin can be detected with an ultrashort echo time (UTE) sequence. Purpose To develop patient-specific whole-brain myelin imaging with a three-dimensional double-echo sliding inversion recovery (DESIRE) UTE sequence. Materials and Methods The DESIRE UTE sequence generates a series of IR images with different inversion times during a single scan. The optimal inversion time for nulling long T2 signal is determined by finding minimal signal on the second echo. Myelin images are generated by subtracting the second echo image from the first UTE image. To validate this method, a prospective study was performed in phantoms, cadaveric brain specimens, healthy volunteers, and patients with multiple sclerosis (MS). A total of 20 healthy volunteers (mean age, 40 years ± 13 [standard deviation], 10 women) and 20 patients with MS (mean age, 58 years ± 8; 15 women) who underwent MRI between November 2017 and February 2019 were prospectively included. Analysis of variance was performed to evaluate the signal difference between MS lesions and normal-appearing white matter in patients with MS. Results High signal intensity and corresponding T2* and T1 of the extracted myelin vesicles provided evidence for direct imaging of ultrashort-T2 myelin protons using the UTE sequence. Gadobenate dimeglumine phantoms with a wide range of T1 values were selectively suppressed with DESIRE UTE. In the ex vivo brain study of MS lesions, signal loss was observed in MS lesions and was conformed with histologic analysis. In the human study, there was a significant reduction in normalized signal intensity in MS lesions compared with that in normal-appearing white matter (0.19 ± 0.10 vs 0.76 ± 0.11, respectively; P < .001). Conclusion The double-echo sliding inversion recovery ultrashort echo time sequence can generate whole-brain myelin images specifically with a clinical 3-T scanner. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Port in this issue.

Water proton density in human cortical bone obtained from ultrashort echo time (UTE) MRI predicts bone microstructural properties

PURPOSE

To investigate the correlations between cortical bone microstructural properties and total water proton density (TWPD) obtained from three-dimensional ultrashort echo time Cones (3D-UTE-Cones) magnetic resonance imaging techniques.

MATERIALS AND METHODS

135 cortical bone samples were harvested from human tibial and femoral midshafts of 37 donors (61 ± 24 years old). Samples were scanned using 3D-UTE-Cones sequences on a clinical 3T MRI and on a high-resolution micro-computed tomography (μCT) scanner. TWPD was measured using 3D-UTE-Cones MR images. Average bone porosity, pore size, and bone mineral density (BMD) were measured from μCT images at 9 μm voxel size. Pearson's correlation coefficients between TWPD and μCT-based measures were calculated.

RESULTS

TWPD showed significant moderate correlation with both average bone porosity (R = 0.66, p < 0.01) and pore size (R = 0.57, p < 0.01). TWPD also showed significant strong correction with BMD (R = 0.71, p < 0.01).

CONCLUSIONS

The presented 3D-UTE-Cones imaging technique allows assessment of TWPD in human cortical bone. This quick UTE-MRI-based technique was capable of predicting bone microstructure differences with significant correlations. Such correlations highlight the potential of UTE-MRI-based measurement of bone water proton density to assess bone microstructure.

An Update in Qualitative Imaging of Bone Using Ultrashort Echo Time Magnetic Resonance

Bone is comprised of mineral, collagenous organic matrix, and water. X-ray-based techniques are the standard approach for bone evaluation in clinics, but they are unable to detect the organic matrix and water components in bone. Magnetic resonance imaging (MRI) is being used increasingly for bone evaluation. While MRI can non-invasively assess the proton pools in soft tissues, cortical bone typically appears as a signal void with clinical MR techniques because of its short T2*. New MRI techniques have been recently developed to image bone while avoiding the ionizing radiation present in x-ray-based methods. Qualitative bone imaging can be achieved using ultrashort echo time (UTE), single inversion recovery UTE (IR-UTE), dual-inversion recovery UTE (Dual-IR-UTE), double-inversion recovery UTE (Double-IR-UTE), and zero echo time (ZTE) sequences. The contrast mechanisms as well as the advantages and disadvantages of each technique are discussed.

T1 measurement of bound water in cortical bone using 3D adiabatic inversion recovery ultrashort echo time (3D IR-UTE) Cones imaging

PURPOSE

We describe the measurement of bound water T₁ ( T 1 BW ) of cortical bone in vitro and in vivo with a 3D adiabatic inversion recovery ultrashort echo time (IR-UTE) Cones sequence using a clinical 3T scanner.

METHODS

A series IR-UTE data from 6 repetition times (TRs) with 5 inversion times (TIs) at each TR were acquired from 12 human tibial bone specimens, and data from 4 TRs with 5 TIs at each TR were acquired from the tibial midshafts of 8 healthy volunteers. The pore water nulling point was calculated from exponential fitting of the inversion recovery curve at each TR. Bone specimens and volunteers were then scanned again with the calculated nulling point at each TR. T 1 BW was derived through exponential fitting of data from IR-UTE images acquired at different TRs using the calculated pore water nulling point for each TR.

RESULTS

In vitro pore water nulling TIs were 141.3 ± 11.6, 123.4 ± 8.9, 101.3 ± 6.2, 88.9 ± 5.3, 74.8 ± 4.2, and 59.2 ± 3.9 ms for the 6 TRs of 500, 400, 300, 250, 200, and 150 ms, respectively. In vivo pore water nulling TIs were 132.8 ± 12.8, 110.3 ± 10.0, 80.0 ± 7.2, and 63.9 ± 5.4 ms for the 4 TRs of 400, 300, 200, and 150 ms, respectively. Excellent exponential fitting was achieved for IR-UTE imaging of bound water with pore water nulled at each TR. The mean T 1 BW was 106.9 ± 6.3 ms in vitro and 112.3 ± 16.4 ms in vivo.

CONCLUSION

Using the 3D IR-UTE Cones with a variable TR/TI approach, T 1 BW of cortical bone was calculated after complete nulling of pore water signals.

Age-related decrease in collagen proton fraction in tibial tendons estimated by magnetization transfer modeling of ultrashort echo time magnetic resonance imaging (UTE-MRI)

Clinical magnetic resonance imaging (MRI) sequences are not often capable of directly visualizing tendons. Ultrashort echo time (UTE) MRI can acquire high signal from tendons thus enabling quantitative assessments. Magnetization transfer (MT) modeling combined with UTE-MRI—UTE-MT-modeling—can indirectly assess macromolecular protons in the tendon. This study aimed to determine if UTE-MT-modeling is a quantitative technique sensitive to the age-related changes of tendons. The legs of 26 young healthy (29 ± 6 years old) and 22 elderly (75 ± 8 years old) female subjects were imaged using UTE sequences on a 3T MRI scanner. Institutional review board approval was obtained, and all recruited subjects provided written informed consent. T1 and UTE-MT-modeling were performed on anterior tibialis tendons (ATT) and posterior tibialis tendons (PTT) as two representative human leg tendons. A series of MT pulse saturation powers (500–1500°) and frequency offsets (2–50 kHz) were used to measure the macromolecular fraction (MMF) and macromolecular T2 (T2_MM). All measurements were repeated by three independent readers for a reproducibility study. MMF demonstrated significantly lower values on average in the elderly cohort compared with the younger cohort for both ATT (decreased by 16.8%, p = 0.03) and PTT (decreased by 23.0%, p < 0.01). T2_MM and T1 did not show a significant nor a consistent difference between the young and elderly cohorts. For all MRI parameters, intraclass correlation coefficient (ICC) was higher than 0.98, indicating excellent consistency between measurements performed by independent readers. MMF serving as a surrogate measure for collagen content, showed a significant decrease in elderly leg tendons. This study highlighted UTE-MRI-MT techniques as a useful quantitative method to assess the impact of aging on human tendons.

Improved volumetric myelin imaging in human brain using 3D dual echo inversion recovery-prepared UTE with complex echo subtraction

PURPOSE

Inversion recovery-based UTE (IR-UTE) sequences have been proposed to directly image myelin with extremely short T 2 ∗ (~0.3 ms). In this study, we demonstrate the feasibility of complex echo subtraction to improve 3D IR-UTE imaging of myelin in white matter of the brain in vivo.

METHODS

In IR-UTE imaging, long T₂ components in white matter (i.e., water) are suppressed using an adiabatic inversion recovery preparation pulse. Dual echo UTE data acquisition and magnitude echo subtraction are used to suppress the residual white matter and gray matter signals, providing high myelin contrast. Complex echo subtraction may further improve the myelin contrast by reducing the residual long T₂ water signal contamination caused by regional T₁ variations. To verify the efficacy of the complex subtraction technique, in vivo experiments were performed with 5 non-symptomatic healthy volunteers and 5 multiple sclerosis patients on a 3T clinical MR system. Signal enhancement between the complex subtraction and the magnitude subtraction was introduced to evaluate the improvement.

RESULTS

The complex subtraction improved myelin contrast over the magnitude subtraction in both healthy and patient groups, with more fine myelin structures being revealed. The foci of the demyelinated lesion were more clearly detected by complex subtraction. An average signal enhancement of up to 135.9% was achieved with the complex subtraction over the magnitude subtraction.

CONCLUSION

The complex echo subtraction improves 3D IR-UTE morphologic imaging of myelin in white matter of the brain.

Volumetric mapping of bound and pore water as well as collagen protons in cortical bone using 3D ultrashort echo time cones MR imaging techniques

Cortical bone assessment using magnetic resonance imaging (MRI) has recently received great attention in an effort to avoid the potential harm associated with ionizing radiation-based techniques. Ultrashort echo time MRI (UTE-MRI) techniques can acquire signal from major hydrogen proton pools in cortical bone, including bound and pore water, as well as from the collagen matrix. This study aimed to develop and evaluate the feasibility of a technique for mapping bound water, pore water, and collagen proton densities in human cortical bone ex vivo and in vivo using three-dimensional UTE Cones (3D-UTE-Cones) MRI. Eight human tibial cortical bone specimens (63 ± 19 years old) were scanned using 3D-UTE-Cones sequences on a clinical 3 T MRI scanner and a micro-computed tomography (μCT) scanner. Total, bound, and pore water proton densities (TWPD, BWPD, and PWPD, respectively) were measured using UTE and inversion recovery UTE (IR-UTE) imaging techniques. Macromolecular proton density (MMPD), a collagen representation, was measured using TWPD and macromolecular fraction (MMF) obtained from two-pool UTE magnetization transfer (UTE-MT) modeling. The correlations between proton densities and μCT-based measures were investigated. The 3D-UTE-Cones techniques were further applied on ten young healthy (34 ± 3 years old) and five old (78 ± 6 years old) female volunteers to evaluate the techniques' feasibility for translational clinical applications. In the ex vivo study, PWPD showed the highest correlations with bone porosity and bone mineral density (BMD) (R = 0.79 and - 0.70, p < 0.01). MMPD demonstrated moderate to strong correlations with bone porosity and BMD (R = -0.67 and 0.65, p < 0.01). MMPD showed strong correlation with age in specimens from female donors (R = -0.91, p = 0.03, n = 5). The presented comprehensive 3D-UTE-Cones imaging protocol allows quantitative mapping of protons in major pools of cortical bone ex vivo and in vivo. PWPD and MMPD can serve as potential novel biomarkers to assess bone matrix and microstructure, as well as bone age- or injury-related variations.

Short-T2 MRI: Principles and recent advances

Among current modalities of biomedical and diagnostic imaging, MRI stands out by virtue of its versatile contrast obtained without ionizing radiation. However, in various cases, e.g., water protons in tissues such as bone, tendon, and lung, MRI performance is limited by the rapid decay of resonance signals associated with short transverse relaxation times T₂ or T₂*. Efforts to address this shortcoming have led to a variety of specialized short-T₂ techniques. Recent progress in this field expands the choice of methods and prompts fresh considerations with regard to instrumentation, data acquisition, and signal processing. In this review, the current status of short-T₂ MRI is surveyed. In an attempt to structure the growing range of techniques, the presentation highlights overarching concepts and basic methodological options. The most frequently used approaches are described in detail, including acquisition strategies, image reconstruction, hardware requirements, means of introducing contrast, sources of artifacts, limitations, and applications.

Assessing cortical bone mechanical properties using collagen proton fraction from ultrashort echo time magnetization transfer (UTE-MT) MRI modeling

Cortical bone shows as a signal void when using conventional clinical magnetic resonance imaging (MRI). Ultrashort echo time MRI (UTE-MRI) can acquire high signal from cortical bone, thus enabling quantitative assessments. Magnetization transfer (MT) imaging combined with UTE-MRI can indirectly assess protons in the organic matrix of bone. This study aimed to examine UTE-MT MRI techniques to estimate the mechanical properties of cortical bone. A total of 156 rectangular human cortical bone strips were harvested from the tibial and femoral midshafts of 43 donors (62 ± 22 years old, 62 specimens from females, 94 specimens from males). Bone specimens were scanned using UTE-MT sequences on a clinical 3 T MRI scanner and on a micro-computed tomography (μCT) scanner. A series of MT pulse saturation powers (400°, 600°, 800°) and frequency offsets (2, 5, 10, 20, 50 kHz) was used to measure the macromolecular fraction (MMF) utilizing a two-pool MT model. Failure mechanical properties of the bone specimens were measured using 4-point bending tests. MMF from MRI results showed significant strong correlations with cortical bone porosity (R = -0.72, P < 0.01) and bone mineral density (BMD) (R = +0.71, P < 0.01). MMF demonstrated significant moderate correlations with Young modulus, yield stress, and ultimate stress (R = 0.60-0.61, P < 0.01). These results suggest that the two-pool UTE-MT model focusing on the organic matrix of bone can potentially serve as a novel tool to detect the variations of bone mechanical properties and intracortical porosity.

Fat suppression for ultrashort echo time imaging using a novel soft-hard composite radiofrequency pulse

PURPOSE

To design a soft-hard composite pulse for fat suppression and water excitation in ultrashort echo time (UTE) imaging with minimal short T₂ signal attenuation.

METHODS

The composite pulse contains a narrow bandwidth soft pulse centered on the fat peak with a small negative flip angle (-α) and a short rectangular pulse with a small positive flip angle (α). The fat magnetization experiences both tipping-down and -back with an identical flip angle and thus returns to the equilibrium state, leaving only the excited water magnetization. Bloch simulations, as well as knee, tibia, and ankle UTE imaging studies, were performed to investigate the effectiveness of fat suppression and corresponding water signal attenuation. A conventional fat saturation (FatSat) module was used for comparison. Signal suppression ratio (SSR), defined as the ratio of signal difference between non-fat-suppression and fat-suppression images over the non-fat-suppression signal, was introduced to evaluate the efficiency of the composite pulse.

RESULTS

Numerical simulations demonstrate that the soft-hard pulse has little saturation effect on short T₂ water signals. Knee, tibia, and ankle UTE imaging results suggest that comparable fat suppression can be achieved with the soft-hard pulse and the FatSat module. However, much less water saturation is induced by the soft-hard pulse, especially for short T₂ tissues, with SSRs reduced from 71.8 ± 6.9% to 5.8 ± 4.4% for meniscus, from 68.7 ± 5.5% to 7.7 ± 7.6% for bone, and from 62.9 ± 12.0% to 4.8 ± 3.2% for the Achilles tendon.

CONCLUSION

The soft-hard composite pulse can suppress fat signals in UTE imaging with little signal attenuation on short T₂ tissues.

Significant correlations between human cortical bone mineral density and quantitative susceptibility mapping (QSM) obtained with 3D Cones ultrashort echo time magnetic resonance imaging (UTE-MRI)

PURPOSE

Quantitative susceptibility mapping (QSM) MRI is a tool that can characterize changes in susceptibility, an intrinsic property which is associated with compositional changes in the tissue. Current QSM estimation of cortical bone is challenging because conventional clinical MRI cannot acquire signal in cortical bone. This study aimed to implement Cones 3D ultrashort echo time MRI (UTE-MRI) for ex vivo QSM measurements in human tibial cortical bone, investigating the correlations of QSM with volumetric intracortical bone mineral density (BMD).

MATERIALS AND METHODS

Nine tibial midshaft cortical bone specimens (25 mm long specimens cut at the mid-point of tibial shaft, 67 ± 20 years old, 5 women and 4 men) were scanned on a clinical 3 T MRI scanner for QSM measurement. The specimens were also scanned on a high-resolution micro-computed tomography (μCT) scanner for volumetric BMD estimation. QSM and μCT results were compared at approximately nine regions of interest (ROIs) per specimen.

RESULTS

Average 3D UTE-MRI QSM showed significantly strong correlation with volumetric BMD (R = -0.82, P < 0.01) and bone porosity (R = 0.72, P < 0.01). Combining all data points together (77 ROIs), QSM showed significant moderate to strong correlation with volumetric BMD after correction for interdependencies in specimens (R = -0.70, P < 0.01). The corrections were required because the data points were not independent in each specimen. Similarly, the correlation between QSM and porosity was significant (R = 0.68, P < 0.01).

CONCLUSIONS

These results suggest that the Cones 3D UTE-MRI QSM technique can potentially serve as a novel and accurate tool to assess intracortical bone mineral density whilst avoiding ionizing radiation.

Ultrashort echo time magnetic resonance imaging (UTE-MRI) of cortical bone correlates well with histomorphometric assessment of bone microstructure

Ultrashort echo time magnetic resonance imaging (UTE-MRI) techniques have been increasingly used to assess cortical bone microstructure. High resolution micro computed tomography (μCT) is routinely employed for validating the MRI-based assessments. However, water protons in cortical bone may reside in micropores smaller than the detectable size ranges by μCT. The goal of this study was to evaluate the upper limit of UTE-MRI and compare its efficacy to μCT at determining bone porosity ex vivo. This study investigated the correlations between UTE-MRI based quantifications and histomorphometric measures of bone porosity that cover all pores larger than 1 μm. Anterior tibial midshaft specimens from eleven donors (51 ± 16 years old, 6 males, 5 females) were scanned on a clinical 3 T-MRI using UTE magnetization transfer (UTE-MT, three power levels and five frequency offsets) and UTE-T2* sequences. Two-pool MT modeling and bi-component exponential T2* fitting were performed on the MRI datasets. Specimens were then scanned by μCT at 9 μm voxel size. Histomorphometry was performed on hematoxylin and eosin (H&E) stained slides imaged at submicron resolution. Macromolecular fraction from MT modeling, bi-component T2* fractions, and short component T2* showed strong correlations (R > 0.7, p < 0.01) with histomorphometric total and large-pores (>40 μm) porosities as well as with μCT-based porosity. UTE-MRI could also assess small pores variations with moderate correlations (R > 0.5, p < 0.01). The UTE-MRI techniques can detect variations of bone porosity comprised of pores below the range detectable by μCT. Such fine pore variations can contribute differently to the development of bone diseases or to the bone remodeling process, however, this needs to be investigated. In scanned specimens, major porosity changes were from large pores, therefore the μCT employment was likely adequate to validate UTE-MRI biomarkers.

Fat suppression for ultrashort echo time imaging using a single-point Dixon method

PURPOSE

In ultrashort echo time (UTE) imaging, fat suppression can improve short T₂ * contrast but can also reduce short T₂ * signals. The conventional two-point Dixon (2p-Dixon) method does not perform well due to short T₂ * decay. In this study, we propose a new method to suppress fat for high contrast UTE imaging of short T₂ tissues, utilizing a single-point Dixon (1p-Dixon) method.

METHODS

The proposed method utilizes dual-echo UTE imaging, where UTE is followed by the second TE, chosen flexibly. Fat is estimated by applying a 1p-Dixon method to the non-UTE image after correction of phase errors, which is used to suppress fat in the UTE image. In vivo ankle and knee imaging were performed at 3 T to evaluate the proposed method.

RESULT

It was observed that fat and water signals in tendons were misestimated by the 2p-Dixon method due to signal decay, while the 1p-Dixon method showed reliable fat and water separation not affected by the short T₂ * signal decay. Compared with the conventional chemical shift based fat saturation technique, the 1p-Dixon based approach showed much stronger signal intensities in the Achilles, quadriceps, and patellar tendons, with significantly improved contrast to noise ratios (CNRs) of 11.8 ± 2.2, 16.0 ± 1.6, and 26.8 ± 1.3 with the 1p-Dixon method and 0.6 ± 0.2, 4.6 ± 1.0, and 17.5 ± 1.4 with regular fat saturation, respectively.

CONCLUSION

The proposed 1p-Dixon based fat suppression allows more flexible selection of imaging parameters and more accurate fat and water separation over the conventional 2p-Dixon in UTE imaging. Moreover, the proposed method provides much improved CNR for short T₂ tissues over the conventional fat saturation method.

Ultrashort Echo Time Quantitative Susceptibility Mapping (UTE-QSM) of Highly Concentrated Magnetic Nanoparticles: A Comparison Study about Different Sampling Strategies

The ability to accurately and non-invasively quantify highly concentrated magnetic nanoparticles (MNPs) is desirable for many emerging applications. Ultrashort echo time quantitative susceptibility mapping (UTE-QSM) has demonstrated the capability to detect high iron concentrations. In this study, we aimed to investigate the effect of different sampling trajectories on the accuracy of quantification based on MNPs acquired through UTE-QSM. A phantom with six different MNP concentrations was prepared for UTE-QSM study with different UTE sampling trajectories, including radial acquisition, continuous single point imaging (CSPI), and Cones with four different gradient stretching factors of 1.0, 1.2, 1.4, and 1.6. No significant differences were found in QSM values derived from the different UTE sampling strategies, suggesting that the UTE-QSM technique could be accelerated with extended Cones sampling.

Protein aggregation linked to Alzheimer's disease revealed by saturation transfer MRI

The goal of this study was to develop a molecular biomarker for the detection of protein aggregation involved in Alzheimer's disease (AD) by exploiting the features of the water saturation transfer spectrum (Z-spectrum), the CEST signal of which is sensitive to the molecular configuration of proteins. A radial-sampling steady-state sequence based ultrashort echo time (UTE) readout was implemented to image the Z-spectrum in the mouse brain, especially the contributions from mobile proteins at the frequency offsets for the composite protein amide proton (+3.6 ppm) and aliphatic proton (-3.6 ppm) signals. Using a relatively weak radiofrequency (RF) saturation amplitude, contributions due to strong magnetization transfer contrast (MTC) from solid-like macromolecules and direct water saturation (DS) were minimized. For practical measure of the changes in the mobile protein configuration, we defined a saturation transfer difference (ΔST) by subtracting the Z-spectral signals at ±3.6 ppm from a control signal at 8 ppm. Phantom studies of glutamate solution, protein (egg white) and hair conditioner show the capability of the proposed scheme to minimize the contributions from amine protons, DS, and MTC, respectively. The ST signal at ±3.6 ppm of the cross-linked bovine serum albumin (BSA) solutions demonstrated that the ΔST signal can be used to monitor the aggregation process of the mobile proteins. High-resolution ΔST images of AD mouse brains at ±3.6 ppm of mouse brains showed significantly reduced ΔST (-3.6) signal compared to the age-matched wild-type (WT) mice. Thus, this signal has potential to serve as a molecular biomarker for monitoring protein aggregation in AD.

Whole knee joint T1 values measured in vivo at 3T by combined 3D ultrashort echo time cones actual flip angle and variable flip angle methods

PURPOSE

To measure T1 relaxations for the major tissues in whole knee joints on a clinical 3T scanner.

METHODS

The 3D UTE-Cones actual flip angle imaging (AFI) method was used to map the transmission radiofrequency field (B1 ) in both short and long T2 tissues, which was then used to correct the 3D UTE-Cones variable flip angle (VFA) fitting to generate accurate T1 maps. Numerical simulation was carried out to investigate the accuracy of T1 measurement for a range of T2 values, excitation pulse durations, and B1 errors. Then, the 3D UTE-Cones AFI-VFA method was applied to healthy volunteers (N = 16) to quantify the T1 of knee tissues including cartilage, meniscus, quadriceps tendon, patellar tendon, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), marrow, and muscles at 3T.

RESULTS

Numerical simulation showed that the 3D UTE-Cones AFI-VFA technique can provide accurate T1 measurements (error <1%) when the tissue T2 is longer than 1 ms and a 150 μs excitation RF pulse is used and therefore is suitable for most knee joint tissues. The proposed 3D UTE-Cones AFI-VFA method showed an average T1 of 1098 ± 67 ms for cartilage, 833 ± 47 ms for meniscus, 800 ± 66 ms for quadriceps tendon, 656 ± 43 ms for patellar tendon, 873 ± 38 ms for ACL, 832 ± 49 ms for PCL, 379 ± 18 ms for marrow, and 1393 ± 46 ms for muscles.

CONCLUSION

The 3D UTE-Cones AFI-VFA method allows volumetric T1 measurement of the major tissues in whole knee joints on a clinical 3T scanner.

Collagen proton fraction from ultrashort echo time magnetization transfer (UTE-MT) MRI modelling correlates significantly with cortical bone porosity measured with micro-computed tomography (μCT)

Intracortical bone porosity is a key microstructural parameter that determines bone mechanical properties. While clinical MRI visualizes the cortical bone with a signal void, ultrashort echo time (UTE) MRI can acquire high signal from cortical bone, thus enabling quantitative assessments. Magnetization transfer (MT) imaging combined with UTE-MRI can indirectly assess protons in the bone collagenous matrix, which are inversely related to porosity. This study aimed to examine UTE-MT MRI techniques to evaluate intracortical bone porosity. Eighteen human cortical bone specimens from the tibial and fibular midshafts were scanned using UTE-MT sequences on a clinical 3 T MRI scanner and on a high-resolution micro-computed tomography (μCT) scanner. A series of MT pulse saturation powers (500°, 1000°, 1500°) and frequency offsets (2, 5, 10, 20, 50 kHz) were used to measure the macromolecular fraction (MMF) and macromolecular T2 (T2MM ) using a two-pool MT model. The measurements were made on 136 different regions of interest (ROIs). ROIs were selected at three cortical bone layers (from endosteum to periosteum) and four anatomical sites (anterior, mid-medial, mid-lateral, and posterior) to provide a wide range of porosity. MMF showed moderate to strong correlations with intracortical bone porosity (R = -0.67 to -0.73, p < 0.01) and bone mineral density (BMD) (R = +0.46 to +0.70, p < 0.01). Comparing the average MMF between cortical bone layers revealed a significant increase from the endosteum towards the periosteum. Such a pattern was in agreement with porosity reduction and BMD increase towards the periosteum. These results suggest that the two-pool UTE-MT technique can potentially serve as a novel and accurate tool to assess intracortical bone porosity.

3D adiabatic T1ρ prepared ultrashort echo time cones sequence for whole knee imaging

PURPOSE

To develop a 3D adiabatic T1ρ prepared ultrashort echo time cones (3D AdiabT1ρ UTE-Cones) sequence for whole knee imaging on a clinical 3T scanner.

METHODS

A train of adiabatic full passage pulses were used for spin locking, followed by time-efficient multispoke UTE acquisition to detect signals from both short and long T2 tissues in the whole knee joint. A modified signal model was proposed for multispoke UTE data fitting. The feasibility of this 3D AdiabT1ρ UTE-Cones technique was demonstrated through numerical simulation, phantom, and ex vivo knee sample studies. The 3D AdiabT1ρ UTE-Cones technique was then applied to 6 in vivo knee joints of healthy volunteers to measure T1ρ values of quadriceps tendon, patellar tendon, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), meniscus, patellar cartilage, and muscle.

RESULTS

Numerical simulation, phantom and ex vivo knee sample studies demonstrated the feasibility of whole knee imaging using the proposed multispoke 3D AdiabT1ρ UTE-Cones sequence. The healthy volunteer knee study demonstrated an averaged T1ρ of 13.9 ± 0.7 ms for the quadriceps tendon, 9.7 ± 0.8 ms for the patellar tendon, 34.9 ± 2.8 ms for the ACL, 21.6 ± 1.4 ms for the PCL, 22.5 ± 1.9 ms for the meniscus, 44.5 ± 2.4 ms for the patellar cartilage, and 43.2 ± 1.1 ms for the muscle.

CONCLUSION

The 3D AdiabT1ρ UTE-Cones sequence allows volumetric T1ρ assessment of both short and long T2 tissues in the knee joint on a clinical 3T scanner.