Anteroposterior perfusion heterogeneity in human hippocampus measured by arterial spin labeling MRI

Perfusion-mechanics coupling of the hippocampus

The hippocampus is a highly scrutinized brain structure due to its entanglement in multiple neuropathologies and vulnerability to metabolic insults. This study aims to non-invasively assess the perfusion-mechanics relationship of the hippocampus in the healthy brain across magnetic resonance imaging sequences and magnetic field strengths. In total, 17 subjects (aged 22-35, 7 males/10 females) were scanned with magnetic resonance elastography and arterial spin labelling acquisitions at 3T and 7T in a baseline physiological state. No significant differences in perfusion or stiffness were observed across magnetic field strengths or acquisitions. The hippocampus had the highest vascularity within the deep grey matter, followed closely by the caudate nucleus and putamen. We discovered a positive perfusion-mechanics correlation in the hippocampus across both 3T and 7T groups, with a highly significant correlation overall (R = 0.71, p = 0.0019), which was not observed in the caudate nucleus, a similarly vascular region. Furthermore, we supported our hypothesis that increased perfusion in the hippocampus would lead to greater pulsatile displacement in a small cohort (n = 10). Given that the hippocampus is an exceptionally vulnerable structure, with perfusion deficits often seen in diseases related to learning and memory, our results suggest a unique mechanistic link between metabolic health and stiffness biomarkers in this key region for the first time.

Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging

PURPOSE

To investigate cerebral blood flow (CBF) characteristics before and after hemodialysis initiation and their longitudinal associations with global cognitive function in older adults.

METHODS

A cohort of 17 older end-stage renal disease patients anticipating standard thrice-weekly hemodialysis and a group of 11 age- and sex-matched healthy control volunteers were recruited for brain perfusion imaging studies using arterial spin labeling. Hemodialysis patients participated in a prospective longitudinal study using brain magnetic resonance imaging and global cognitive assessment using the Modified Mini-Mental State Examination (3MS) at two time points: baseline, 2.9 ± 0.9 months before, and follow-up, 6.4 ± 2.4 months after hemodialysis initiation. Healthy controls were imaged once using the same protocol. CBF analyses were performed globally in grey and white matter and regionally in the hippocampus and orbitofrontal cortex. Covariate-adjusted linear mixed-effects models were used for statistical analyses (significance: p < 0.05; marginal significance: p < 0.1).

RESULTS

At baseline, global and regional CBF was significantly higher in hemodialysis patients than in healthy controls. However, after approximately 6 months of hemodialysis, CBF declined substantially in hemodialysis patients, and became comparable to those in healthy controls. Specifically, in the hemodialysis patients, CBF declined non-significantly globally for grey and white matter and significantly regionally in the hippocampus and orbitofrontal cortex. Marginally significant associations were observed between 3MS scores and regional CBF measurements in the hippocampus and orbitofrontal cortex at baseline and follow-up, and between longitudinal changes.

CONCLUSION

The significant decline in CBF after hemodialysis initiation and the observed association between longitudinal changes in regional CBF and 3MS scores suggest that decreased brain perfusion may contribute to the observed cognitive decline.

7T bone perfusion imaging of the knee using arterial spin labeling MRI

PURPOSE

To evaluate the feasibility of arterial spin labeling (ASL) imaging of epiphyseal bone marrow in the distal femoral condyle of the knee at 7T MRI.

METHODS

The knees of 7 healthy volunteers were imaged with ASL using a 7T whole body MRI scanner and a 28-channel knee coil. ASL imaging used a flow-sensitive alternating inversion recovery method for labeling and a single-shot fast spin echo sequence for image readout. ASL imaging with a single oblique transverse slice was performed at 2 slice positions in the distal femoral condyle. Blood flow was measured in 2 regions of interest: the epiphyseal bone marrow and the overlying patellofemoral cartilage. To analyze perfusion SNR, 200 noise images were also acquired using the same ASL imaging protocol with RF pulses turned off.

RESULTS

Knee bone marrow perfusion imaging was successfully performed with all volunteers. The overall mean of blood flow in the knee bone marrow was 32.90 ± 2.41 mL/100 g/min, and the blood flow was higher at the more distal slice position. We observed significant B₀ and B 1 + inhomogeneities, which need to be addressed in the future to improve the quality of ASL imaging and increase the reliability of knee bone marrow perfusion measurements.

CONCLUSION

Bone marrow perfusion imaging of the distal femoral condyle is feasible using ASL at 7T. Further technical development is needed to improve the ASL method to overcome existing challenges.

High resolution continuous arterial spin labeling of human cerebral perfusion using a separate neck tagging RF coil

For standard clinical applications, ASL images are typically acquired with 4–8 mm thick slices and 3–4 mm in-plane resolution. However, in this paper we demonstrate that high-resolution continuous arterial spin labeling (CASL) perfusion images can be acquired in a clinically relevant scan time using current MRI technology. CASL was implemented with a separate neck coil for labeling the arterial blood on a 4.7T MRI using standard axial 2D GE-EPI. Typical-resolution to high-resolution (voxels of 95, 60, 45, 27, or 7 mm³) images were compared for qualitative and quantitative cerebral blood flow analysis (CBF) in nine healthy volunteers (ages: 24–32 years). The highest resolution (1.5x1.5x3 = 7 mm³) CASL implementation yielded perfusion images with improved cortex depiction and increased cortical CBF measurements (53 ± 8 ml/100g/min), consistent with reduced partial volume averaging. The 7 mm³ voxel images were acquired with 6 cm brain coverage in a clinically relevant scan of 6 minutes. Improved spatial resolution facilitates CBF measurement with reduced partial volume averaging and may be valuable for the detection of perfusion deficits in small lesions and perfusion measurement in small brain regions.

Quantitative single breath-hold renal arterial spin labeling imaging at 7T

PURPOSE

To evaluate the feasibility of quantitative single breath-hold renal arterial spin labeling (ASL) imaging at 7T.

METHODS

A single-shot fast spin echo FAIR (flow-sensitive alternating inversion recovery) method was used to perform two studies. First, a multi-delay perfusion study was performed to estimate the spin labeling temporal bolus width achievable with a local transceiver array coil at 7T. Second, with a conservatively defined bolus width, a quantitative perfusion study was performed using the single subtraction approach. To address issues of B1+ inhomogeneity/efficiency and excessive short-term specific absorption rates, various strategies were used, such as dynamic radiofrequency shimming and optimization.

RESULTS

A conservative temporal bolus width of 600 ms determined from the multi-delay study was applied for single-subtraction imaging to measure the renal blood flow in the cortex and medulla: 303 ± 31.8 and 91.3 ± 15.2 (mL/100 g/min), respectively. The estimated spatial and temporal signal-to-noise ratios of renal perfusion measurements were 3.8 ± 0.7 and 2.4 ± 0.6 for the cortex, and 2.2 ± 0.6 and 1.4 ± 0.2 for the medulla.

CONCLUSION

With proper management of field strength specific challenges, quantitative renal ASL imaging can be achieved at 7T within a single breath-hold. Magn Reson Med 79:815-825, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Inflow-vascular space occupancy (iVASO) reproducibility in the hippocampus and cortex at different blood water nulling times

PURPOSE

Inflow-vascular space occupancy (iVASO) measures arterial cerebral blood volume (aCBV) using accurate blood water nulling (inversion time [TI]) when arterial blood reaches the capillary, i.e., at the arterial arrival time. This work assessed the reproducibility of iVASO measurements in the hippocampus and cortex at multiple TIs.

METHODS

The iVASO approach was implemented at multiple TIs in 10 healthy volunteers at 3 Tesla. aCBV values were measured at each TI in the left and right hippocampus, and the cortex. Reproducibility of aCBV measurements within scans (same day) and across sessions (different days) was assessed using the intraclass correlation coefficient (ICC).

RESULTS

Overall hippocampal aCBV was significantly higher than cortical aCBV, likely due to higher gray matter volume. Hippocampal ICC values were high at short TIs (≤914 ms; intrascan values = 0.80-0.96, interscan values = 0.61-0.91). Cortically, high ICC values were observed at intermediate TIs of 914 (intra: 0.93, inter: 0.87) and 1034 ms (intra: 0.96, inter: 0.86). The ICC values were comparable to established contrast-based CBV measures.

CONCLUSION

iVASO measurements are reproducible within and across sessions. TIs for iVASO measurements should be chosen carefully, taking into account heterogeneous arterial arrival times in different brain regions. Magn Reson Med 75:2379-2387, 2016. © 2015 Wiley Periodicals, Inc.

Increased hippocampal blood volume and normal blood flow in schizophrenia

Neuroimaging studies have provided compelling evidence for abnormal hippocampal activity in schizophrenia. Most studies made inferences about baseline hippocampal activity using a single hemodynamic parameter (e.g., blood volume or blood flow). Here we studied several hemodynamic measures in the same cohort to test the hypothesis of increased hippocampal activity in schizophrenia. We used dynamic susceptibility contrast- (DSC-) magnetic resonance imaging (MRI) to assess blood volume, blood flow, and mean transit time in the hippocampus of 15 patients with chronic schizophrenia and 15 healthy controls. Left and right hippocampal measurements were combined for absolute measures of cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT). We found significantly increased hippocampal CBV, but normal CBF and MTT, in schizophrenia. The uncoupling of CBV and CBF could be due to several factors, including antipsychotic medication, loss of cerebral perfusion pressure, or angiogenesis. Further studies need to incorporate several complementary imaging modalities to better characterize hippocampal dysfunction in schizophrenia.

Theoretical and experimental evaluation of multi-band EPI for high-resolution whole brain pCASL Imaging

Multi-band echo planar imaging (MB-EPI), a new approach to increase data acquisition efficiency and/or temporal resolution, has the potential to overcome critical limitations of standard acquisition strategies for obtaining high-resolution whole brain perfusion imaging using arterial spin labeling (ASL). However, the use of MB also introduces confounding effects, such as spatially varying amplified thermal noise and leakage contamination, which have not been evaluated to date as to their effect on cerebral blood flow (CBF) estimation. In this study, both the potential benefits and confounding effects of MB-EPI were systematically evaluated through both simulation and experimentally using a pseudo-continuous arterial spin labeling (pCASL) strategy. These studies revealed that the amplified noise, given by the geometry factor (g-factor), and the leakage contamination, assessed by the total leakage factor (TLF), have a minimal impact on CBF estimation. Furthermore, it is demonstrated that MB-EPI greatly benefits high-resolution whole brain pCASL studies in terms of improved spatial and temporal signal-to-noise ratio efficiencies, and increases compliance with the assumptions of the commonly used single blood compartment model, resulting in improved CBF estimates.

Anterior-posterior cerebral blood volume gradient in human subiculum

The human hippocampal formation is characterized by anterior-posterior gradients of cell density, neurochemistry, and hemodynamics. In addition, some functions are associated with specific subfields (subiculum, CA1-4, dentate gyrus) and regions (anterior and posterior). We performed contrast-enhanced, high-resolution T1-weighted 3T steady state (SS) imaging to investigate cerebral blood volume (CBV) gradients of the hippocampal formation. We studied 14 healthy subjects and found significant CBV gradients (anterior > posterior) in the subiculum but not in other hippocampal subfields. Since CBV is a marker of basal metabolism, these results indicate a greater baseline activity in the anterior compared with the posterior subiculum. This gradient might be related to the role of the subiculum as the main outflow station of the hippocampal formation and might have implications for the mechanisms of neuropsychiatric disorders.