High-resolution quantitative MRI of multiple sclerosis spinal cord lesions

Accurate actual flip angle imaging (AFI) in the presence of fat

PURPOSE

To investigate the effect of incomplete fat spoiling on the accuracy of B1 mapping with actual flip angle imaging (AFI) and to propose a method to minimize the errors using the chemical shift properties of fat.

THEORY AND METHODS

Diffusion-based dephasing is the main spoiling mechanism exploited in AFI. However, a very low diffusion in fat may make the spoiling insufficient, leading to ghosts in the B1 maps. As the errors retain the chemical-shift signature of fat, their impact can be minimized using chemical-shift-based fat signal removal from AFI acquisition modified to include multi-echo readout. The source of the errors and the proposed correction were studied in simulations and phantom and in-vivo imaging experiments.

RESULTS

Our results support that AFI artifacts are caused by the incomplete fat spoiling present in clinically attractive short TR acquisition regimes. The correction eliminated the ghosting and significantly improved the B1 mapping accuracy as well as the accuracy of R1 mapping performed with AFI-derived B1 maps.

CONCLUSIONS

The incomplete fat signal spoiling may be a source of AFI B1 mapping errors, especially in subjects with high fat content. Achieving complete fat spoiling requires longer TR, which is undesirable in clinical applications. The proposed approach based on fat signal removal can reduce errors without significant prolongation of the AFI pulse sequence. We propose that, when attaining complete fat spoiling is not feasible, AFI mapping should be performed in a multi-echo regime with appropriate fat separation or suppression to minimize these errors.

Hexahydrocurcumin attenuated demyelination and improved cognitive impairment in chronic cerebral hypoperfusion rats

Age-related white matter lesions (WML) frequently present vascular problems by decreasing cerebral blood supply, resulting in the condition known as chronic cerebral hypoperfusion (CCH). This study aimed to investigate the effect of hexahydrocurcumin (HHC) on the processes of demyelination and remyelination induced by the model of the Bilateral Common Carotid Artery Occlusion (BCCAO) for 29 days to mimic the CCH condition. The pathological appearance of myelin integrity was significantly altered by CCH, as evidenced by Transmission Electron Microscopy (TEM) and Luxol Fast Blue (LFB) staining. In addition, CCH activated A1-astrocytes and reactive-microglia by increasing the expression of Glial fibrillary acidic protein (GFAP), complement 3 (C3d) and pro-inflammatory cytokines. However, S100a10 expression, a marker of neuroprotective astrocytes, was suppressed, as were regenerative factors including (IGF-1) and Transglutaminase 2 (TGM2). Therefore, the maturation step was obstructed as shown by decreases in the levels of myelin basic protein (MBP) and the proteins related with lipid synthesis. Cognitive function was therefore impaired in the CCH model, as evidenced by the Morris water maze test. By contrast, HHC treatment significantly improved myelin integrity, and inhibited A1-astrocytes and reactive-microglial activity. Consequently, pro-inflammatory cytokines and A1-astrocytes were attenuated, and regenerative factors increased assisting myelin maturation and hence improving cognitive performance. In conclusion, HHC improves cognitive function and also the integrity of white matter in CCH rats by reducing demyelination, and pro-inflammatory cytokine production and promoting the process of remyelination.

Advanced spinal cord MRI in multiple sclerosis: Current techniques and future directions

Spinal cord magnetic resonance imaging (MRI) has a central role in multiple sclerosis (MS) clinical practice for diagnosis and disease monitoring. Advanced MRI sequences capable of visualizing and quantifying tissue macro- and microstructure and reflecting different pathological disease processes have been used in MS research; however, the spinal cord remains under-explored, partly due to technical obstacles inherent to imaging this structure. We propose that the study of the spinal cord merits equal ambition in overcoming technical challenges, and that there is much information to be exploited to make valuable contributions to our understanding of MS. We present a narrative review on the latest progress in advanced spinal cord MRI in MS, covering in the first part structural, functional, metabolic and vascular imaging methods. We focus on recent studies of MS and those making significant technical steps, noting the challenges that remain to be addressed and what stands to be gained from such advances. Throughout we also refer to other works that presend more in-depth review on specific themes. In the second part, we present several topics that, in our view, hold particular potential. The need for better imaging of gray matter is discussed. We stress the importance of developing imaging beyond the cervical spinal cord, and explore the use of ultra-high field MRI. Finally, some recommendations are given for future research, from study design to newer developments in analysis, and the need for harmonization of sequences and methods within the field. This review is aimed at researchers and clinicians with an interest in gaining an overview of the current state of advanced MRI research in this field and what is primed to be the future of spinal cord imaging in MS research.