[Physical parameters in the use of MRI tomography. Limitation due to physiologic reactions and guidelines. Radiation Protection Commission]

Increased Time Rate of Change of Gradient Fields: Effect on Peripheral Nerve Stimulation at Clinical MR Imaging

PURPOSE

To increase gradient stimulation from 100% to a fixed 120% level and to assess patient acceptance of the degree of peripheral nerve stimulation (PNS) at magnetic resonance (MR) imaging.

MATERIALS AND METHODS

Two hundred ten patients underwent MR imaging of various body regions according to clinical indications. An additional three-dimensional fast low-angle shot sequence with the 120% stimulation level was performed. A patient questionnaire was distributed after MR imaging to document the presence, degree, and location of PNS. Degree was measured with an 11-point scale (score range, 0-10). Age was analyzed between the sexes for significant statistical differences. Furthermore, correlation between location of examination and location and degree of stimulation was performed. To determine stimulation discomfort relative to other factors typically present at MR imaging, the degree of discomfort due to room temperature, size of magnet bore, acoustic noise, examination time, and heating sensation was determined for comparison, as well.

RESULTS

Thirty-five (16.7%) patients reported a stimulation sensation during imaging in one or more locations, while six (2.9%) felt very uncomfortable local stimulation (score of 8-10). No significant difference between male and female patients regarding age, sex, and appearance or degree of stimulation sensation could be detected. No significant correlation between location of examination and location and degree of stimulation was recorded. Compared with other side effects, PNS was considered relatively unimportant.

CONCLUSION

The 120% gradient stimulation level seems acceptable for routine clinical imaging with this gradient system, since only 2.9% of patients experienced very uncomfortable local stimulation.

Relationships between diffusion tensor and q-space MRI

Fundamental relationships between diffusion tensor (DT) and 3D q-space MRI are derived which establish conditions when these two complementary MR methods are equivalent. It is shown that the displacement distribution measured by q-space MRI in both the large displacement (i.e., large r) and the long-wavelength (i.e., small q) limits is the same 3D Gaussian displacement distribution assumed in DT-MRI. In these limiting cases, q-space MR yields a dispersion tensor that is identical to the effective DT, D, measured in DT-MRI. An experiment is then proposed to measure D using q-space methods. These findings establish that the effective DT, measured in DT-MRI, characterizes molecule motions on a coarse length-scale. Finally, the feasibility of and requirements for performing 3D q-space MRI on a clinical scanner are considered.

Electromyography in MRI--first recordings of peripheral nerve activation caused by fast magnetic field gradients

Prior studies on the evaluation of stimulation by MRI were based on the subjective feeling of the volunteers. A wide variety of stimulation thresholds between the subjects was observed. In order to exclude subjective perception levels as a cause of this variation, we developed a method to investigate the activation of peripheral nerves after gradient switching by electromyography (EMG) within the MR-imager. Five healthy volunteers were positioned in the MR-scanner with the bridge of the nose at isocenter. The amplitude of sinusoidal pulse trains of the anterior-posterior gradient (rise-times: 200 or 300 micros, various numbers of oscillations) was increased stepwise. Four surface electrodes were placed on the region where a muscle-twitch was reported. Electric activity of the muscle during stimulation experiments was recorded with an MR-compatible electro-physiologic amplifier. Stimulation thresholds were defined by the appearance of an EMG-signal. Thresholds were sharp and consistent with the report of the subjects.