In vivo determination of multiexponential T2 relaxation in the brain of patients with multiple sclerosis

Poor Self-Reported Sleep is Associated with Prolonged White Matter T2 Relaxation in Psychotic Disorders

Background

Schizophrenia (SZ) and bipolar disorder (BD) are characterized by white matter (WM) abnormalities, however, their relationship with illness presentation is not clear. Sleep disturbances are common in both disorders, and recent evidence suggests that sleep plays a critical role in WM physiology. Therefore, it is plausible that sleep disturbances are associated with impaired WM integrity in these disorders. To test this hypothesis, we examined the association of self-reported sleep disturbances with WM transverse (T2) relaxation times in patients with SZ spectrum disorders and BD with psychotic features.

Methods

28 patients with psychosis (17 BD-I, with psychotic features and 11 SZ spectrum disorders) were included. Metabolite and water T2 relaxation times were measured in the anterior corona radiata at 4T. Sleep was evaluated using the Pittsburgh Sleep Quality Index.

Results

PSQI total score showed a moderate to strong positive correlation with water T2 (r = 0.64, p<0.001). Linear regressions showed that this association was specific to sleep disturbance but was not a byproduct of exacerbation in depressive, manic, or psychotic symptoms. In our exploratory analysis, sleep disturbance was correlated with free water percentage, suggesting that increased extracellular water may be a mechanism underlying the association of disturbed sleep and prolonged water T2 relaxation.

Conclusion

Our results highlight the connection between poor sleep and WM abnormalities in psychotic disorders. Future research using objective sleep measures and neuroimaging techniques suitable to probe free water is needed to further our insight into this relationship.

Rapid whole brain 3D T2 mapping respiratory-resolved Double-Echo Steady State (DESS) sequence with improved repeatability

PURPOSE

To propose a quantitative 3D double-echo steady-state (DESS) sequence that offers rapid and repeatable T2 mapping of the human brain using different encoding schemes that account for respiratory B0 variation.

METHODS

A retrospective self-gating module was firstly implemented into the standard DESS sequence in order to suppress the respiratory artifact via data binning. A compressed-sensing trajectory (CS-DESS) was then optimized to accelerate the acquisition. Finally, a spiral Cartesian encoding (SPICCS-DESS) was incorporated to further disrupt the coherent respiratory artifact. These different versions were compared to a standard DESS sequence (fully DESS) by assessing the T2 distribution and repeatability in different brain regions of eight volunteers at 3 T.

RESULTS

The respiratory artifact correction was determined to be optimal when the data was binned into seven respiratory phases. Compared to the fully DESS, T2 distribution was improved for the CS-DESS and SPICCS-DESS with interquartile ranges reduced significantly by a factor ranging from 2 to 12 in the caudate, putamen, and thalamus regions. In the gray and white matter areas, average absolute test-retest T2 differences across all volunteers were respectively 3.5 ± 2% and 3.1 ± 2.1% for the SPICCS-DESS, 4.6 ± 4.6% and 4.9 ± 5.1% for the CS-DESS, and 15% ± 13% and 7.3 ± 5.6% for the fully DESS. The SPICCS-DESS sequence's acquisition time could be reduced by half (<4 min) while maintaining its efficient T2 mapping.

CONCLUSION

The respiratory-resolved SPICCS-DESS sequence offers rapid, robust, and repeatable 3D T2 mapping of the human brain, which can be especially effective for longitudinal monitoring of cerebral pathologies.

Nonparametric D-R1-R2 distribution MRI of the living human brain

Diffusion-relaxation correlation NMR can simultaneously characterize both the microstructure and the local chemical composition of complex samples that contain multiple populations of water. Recent developments on tensor-valued diffusion encoding and Monte Carlo inversion algorithms have made it possible to transfer diffusion-relaxation correlation NMR from small-bore scanners to clinical MRI systems. Initial studies on clinical MRI systems employed 5D D-R₁ and D-R₂ correlation to characterize healthy brain in vivo. However, these methods are subject to an inherent bias that originates from not including R₂ or R₁ in the analysis, respectively. This drawback can be remedied by extending the concept to 6D D-R₁-R₂ correlation. In this work, we present a sparse acquisition protocol that records all data necessary for in vivo 6D D-R₁-R₂ correlation MRI across 633 individual measurements within 25 min-a time frame comparable to previous lower-dimensional acquisition protocols. The data were processed with a Monte Carlo inversion algorithm to obtain nonparametric 6D D-R₁-R₂ distributions. We validated the reproducibility of the method in repeated measurements of healthy volunteers. For a post-therapy glioblastoma case featuring cysts, edema, and partially necrotic remains of tumor, we present representative single-voxel 6D distributions, parameter maps, and artificial contrasts over a wide range of diffusion-, R₁-, and R₂-weightings based on the rich information contained in the D-R₁-R₂ distributions.

Regional brain tissue changes in patients with cystic fibrosis

BACKGROUND

Cystic fibrosis (CF) patients present with a variety of symptoms, including mood and cognition deficits, in addition to classical respiratory, and autonomic issues. This suggests that brain injury, which can be examined with non-invasive magnetic resonance imaging (MRI), is a manifestation of this condition. However, brain tissue integrity in sites that regulate cognitive, autonomic, respiratory, and mood functions in CF patients is unclear. Our aim was to assess regional brain changes using high-resolution T1-weighted images based gray matter (GM) density and T2-relaxometry procedures in CF over control subjects.

METHODS

We acquired high-resolution T1-weighted images and proton-density (PD) and T2-weighted images from 5 CF and 15 control subjects using a 3.0-Tesla MRI. High-resolution T1-weighted images were partitioned to GM-tissue type, normalized to a common space, and smoothed. Using PD- and T2-weighted images, whole-brain T2-relaxation maps were calculated, normalized, and smoothed. The smoothed GM-density and T2-relaxation maps were compared voxel-by-voxel between groups using analysis of covariance (covariates, age and sex; SPM12, p < 0.001).

RESULTS

Significantly increased GM-density, indicating tissues injury, emerged in multiple brain regions, including the cerebellum, hippocampus, amygdala, basal forebrain, insula, and frontal and prefrontal cortices. Various brain areas showed significantly reduced T2-relaxation values in CF subjects, indicating predominant acute tissue changes, in the cerebellum, cerebellar tonsil, prefrontal and frontal cortices, insula, and corpus callosum.

CONCLUSIONS

Cystic fibrosis subjects show predominant acute tissue changes in areas that control mood, cognition, respiratory, and autonomic functions and suggests that tissue changes may contribute to symptoms resulting from ongoing hypoxia accompanying the condition.

Cellular water distribution, transport, and its investigation methods for plant-based food material

Heterogeneous and hygroscopic characteristics of plant-based food material make it complex in structure, and therefore water distribution in its different cellular environments is very complex. There are three different cellular environments, namely the intercellular environment, the intracellular environment, and the cell wall environment inside the food structure. According to the bonding strength, intracellular water is defined as loosely bound water, cell wall water is categorized as strongly bound water, and intercellular water is known as free water (FW). During food drying, optimization of the heat and mass transfer process is crucial for the energy efficiency of the process and the quality of the product. For optimizing heat and mass transfer during food processing, understanding these three types of waters (strongly bound, loosely bound, and free water) in plant-based food material is essential. However, there are few studies that investigate cellular level water distribution and transport. As there is no direct method for determining the cellular level water distributions, various indirect methods have been applied to investigate the cellular level water distribution, and there is, as yet, no consensus on the appropriate method for measuring cellular level water in plant-based food material. Therefore, the main aim of this paper is to present a comprehensive review on the available methods to investigate the cellular level water, the characteristics of water at different cellular levels and its transport mechanism during drying. The effect of bound water transport on quality of food product is also discussed. This review article presents a comparative study of different methods that can be applied to investigate cellular water such as nuclear magnetic resonance (NMR), bioelectric impedance analysis (BIA), differential scanning calorimetry (DSC), and dilatometry. The article closes with a discussion of current challenges to investigating cellular water.

Rapid simultaneous high-resolution mapping of myelin water fraction and relaxation times in human brain using BMC-mcDESPOT

A number of central nervous system (CNS) diseases exhibit changes in myelin content and magnetic resonance longitudinal, T₁, and transverse, T₂, relaxation times, which therefore represent important biomarkers of CNS pathology. Among the methods applied for measurement of myelin water fraction (MWF) and relaxation times, the multicomponent driven equilibrium single pulse observation of T₁ and T₂ (mcDESPOT) approach is of particular interest. mcDESPOT permits whole brain mapping of multicomponent T₁ and T₂, with data acquisition accomplished within a clinically realistic acquisition time. Unfortunately, previous studies have indicated the limited performance of mcDESPOT in the setting of the modest signal-to-noise range of high-resolution mapping, required for the depiction of small structures and to reduce partial volume effects. Recently, we showed that a new Bayesian Monte Carlo (BMC) analysis substantially improved determination of MWF from mcDESPOT imaging data. However, our previous study was limited in that it did not discuss determination of relaxation times. Here, we extend the BMC analysis to the simultaneous determination of whole-brain MWF and relaxation times using the two-component mcDESPOT signal model. Simulation analyses and in-vivo human brain studies indicate the overall greater performance of this approach compared to the stochastic region contraction (SRC) algorithm, conventionally used to derive parameter estimates from mcDESPOT data. SRC estimates of the transverse relaxation time of the long T₂ fraction, T_2,l, and the longitudinal relaxation time of the short T₁ fraction, T_1,s, clustered towards the lower and upper parameter search space limits, respectively, indicating failure of the fitting procedure. We demonstrate that this effect is absent in the BMC analysis. Our results also showed improved parameter estimation for BMC as compared to SRC for high-resolution mapping. Overall we find that the combination of BMC analysis and mcDESPOT, BMC-mcDESPOT, shows excellent performance for accurate high-resolution whole-brain mapping of MWF and bi-component transverse and longitudinal relaxation times within a clinically realistic acquisition time.

Mono-Exponential Fitting in T2-Relaxometry: Relevance of Offset and First Echo

INTRODUCTION

T2 relaxometry has become an important tool in quantitative MRI. Little focus has been put on the effect of the refocusing flip angle upon the offset parameter, which was introduced to account for a signal floor due to noise or to long T2 components. The aim of this study was to show that B1 imperfections contribute significantly to the offset. We further introduce a simple method to reduce the systematic error in T2 by discarding the first echo and using the offset fitting approach.

MATERIALS AND METHODS

Signal curves of T2 relaxometry were simulated based on extended phase graph theory and evaluated for 4 different methods (inclusion and exclusion of the first echo, while fitting with and without the offset). We further performed T2 relaxometry in a phantom at 9.4T magnetic resonance imaging scanner and used the same methods for post-processing as in the extended phase graph simulated data. Single spin echo sequences were used to determine the correct T2 time.

RESULTS

The simulation data showed that the systematic error in T2 and the offset depends on the refocusing pulse, the echo spacing and the echo train length. The systematic error could be reduced by discarding the first echo. Further reduction of the systematic T2 error was reached by using the offset as fitting parameter. The phantom experiments confirmed these findings.

CONCLUSION

The fitted offset parameter in T2 relaxometry is influenced by imperfect refocusing pulses. Using the offset as a fitting parameter and discarding the first echo is a fast and easy method to minimize the error in T2, particularly for low to intermediate echo train length.

T2 relaxation time alterations underlying neurocognitive deficits in alcohol-use disorders (AUD) in an Indian population: A combined conventional ROI and voxel-based relaxometry analysis

Long-term heavy alcohol consumption has traditionally been associated with impaired cognitive abilities, such as deficits in abstract reasoning, problem solving, verbal fluency, memory, attention, and visuospatial processing. The present study aimed at exploring these neuropsychological deficits in alcohol-use disorders (AUD) in an Indian population using the Postgraduate Institute Battery of Brain Dysfunction (PGIBBD) and their possible correlation with alterations in T2 relaxation times (T2-RT), using whole-brain voxel-based relaxometry (VBR) and conventional region of interest (ROI) approach. Multi-echo T2 mapping sequence was performed on 25 subjects with AUD and 25 healthy controls matched for age, education, and socioeconomic status. Whole-brain T2-RT measurements were conducted using VBR and conventional ROI approach. The study was carried out on a 3T whole-body MR scanner. Post processing for VBR and ROI analysis was performed using SPM 8 software and vendor-provided software, respectively. A PGIBBD test battery was conducted on all subjects to assess their cognitive abilities, and the results were reported as raw scores. VBR and ROI results revealed that AUD subjects showed prolonged T2-RTs in cerebellum bilaterally, parahippocampal gyrus bilaterally, right anterior cingulate cortex, left superior temporal gyrus, left middle frontal gyrus, and left calcarine gyrus. A significant correlation was also observed between the neuropsychological test raw scores and alterations in T2-RT in AUD subjects. Our results are consistent with previous studies suggesting tissue disruption or gliosis or demyelination as a possible reason for prolonged T2-RTs. This damage to brain tissue, which is evident as prolonged T2-RT, could possibly be associated with impaired cognitive abilities noticeable in AUD subjects.

Characterizing the microstructural basis of "unidentified bright objects" in neurofibromatosis type 1: A combined in vivo multicomponent T2 relaxation and multi-shell diffusion MRI analysis

Introduction

The histopathological basis of “unidentified bright objects” (UBOs) (hyperintense regions seen on T2-weighted magnetic resonance (MR) brain scans in neurofibromatosis-1 (NF1)) remains unclear. New in vivo MRI-based techniques (multi-exponential T2 relaxation (MET2) and diffusion MR imaging (dMRI)) provide measures relating to microstructural change. We combined these methods and present previously unreported data on in vivo UBO microstructure in NF1.

Methods

3-Tesla dMRI data were acquired on 17 NF1 patients, covering 30 white matter UBOs. Diffusion tensor, kurtosis and neurite orientation and dispersion density imaging parameters were calculated within UBO sites and in contralateral normal appearing white matter (cNAWM). Analysis of MET2 parameters was performed on 24 UBO–cNAWM pairs.

Results

No significant alterations in the myelin water fraction and intra- and extracellular (IE) water fraction were found. Mean T2 time of IE water was significantly higher in UBOs. UBOs furthermore showed increased axial, radial and mean diffusivity, and decreased fractional anisotropy, mean kurtosis and neurite density index compared to cNAWM. Neurite orientation dispersion and isotropic fluid fraction were unaltered.

Conclusion

Our results suggest that demyelination and axonal degeneration are unlikely to be present in UBOs, which appear to be mainly caused by a shift towards a higher T2-value of the intra- and extracellular water pool. This may arise from altered microstructural compartmentalization, and an increase in ‘extracellular-like’, intracellular water, possibly due to intramyelinic edema. These findings confirm the added value of combining dMRI and MET2 to characterize the microstructural basis of T2 hyperintensities in vivo.

•

We examine MRI white matter T2-weighted hyperintense lesions, “UBOs” in NF1.

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Myelin water and intra- and extracellular water fractions are unchanged in UBOs.

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Diffusivity is higher, while mean kurtosis and neurite density are lower in UBOs.

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The combined measures suggest that UBOs may arise from intramyelinic edema.

•

Combining diffusion MRI and multi-exponential T2 relaxation has added value.

Clinical and imaging metrics for monitoring disease progression in patients with multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease of the CNS leading to clinical disability in 250,000-350,000 young adults in the USA and Europe. The disease affects both white matter (WM) and gray matter (GM) tissues of the brain and spinal cord. While WM disease is easily quantified using currently available magnetic resonance imaging (MRI) techniques, identification and quantification of GM disease present a daily challenge. Nonconventional brain and spinal cord MRI techniques, including magnetization transfer, MRI spectroscopy and diffusion tensor imaging, have improved our understanding of MS pathology in the deep GM. The sensitivity of high-resolution MRI obtained at a high magnetic field will improve the detection of spinal cord and brain cortical GM disease. The appropriate use of the above-mentioned techniques has the potential to more accurately explain the level of disability in MS patients.

Quantitative MR imaging: physical principles and sequence design in abdominal imaging

Quantitative magnetic resonance (MR) imaging seeks to quantify fundamental biologic and MR-inducible tissue properties, in contrast to the routine application of MR imaging in the clinic, in which differences in MR parameters are used to generate contrast for subsequent subjective image analysis. Fundamental parameters that are commonly quantified by using MR imaging include proton density, diffusion, T1 relaxation, T2 and T2* relaxation, and magnetization transfer. Applications of these MR imaging-quantifiable parameters to abdominal imaging include oncologic imaging, evaluation of diffuse liver disease, and assessment of splenic, renal, and pancreatic disease. An understanding of the inherent physical principles underlying the basic quantitative parameters as well as the commonly used pulse sequences requisite to their derivation is critical, as this field is rapidly growing and its use will likely continue to expand in the clinic. The full potential of quantitative MR imaging applied to abdominal imaging has yet to be realized, but the myriad applications reported to date will undoubtedly continue to grow.

Measuring the absolute water content of the brain using quantitative MRI

Methods for quantitative imaging of the brain are presented and compared. Highly precise and accurate mapping of the absolute water content and distribution, as presented here, requires a significant number of corrections and also involves mapping of other MR parameters. Here, either T(1) and T(2)(*) or T(2) is mapped, and several corrections involving the measurement of temperature, transmit and receive B(1) inhomogeneities and signal extrapolation to zero TE are applied. Information about the water content of the whole brain can be acquired in clinically acceptable measurement times (10 or 20 min). Since water content is highly regulated in the healthy brain, pathological changes can be easily identified and their evolution or correlation with other manifestations of the disease investigated. In addition to voxel-based total water content, information about the different environments of water can be gleaned from qMRI. The myelin water fraction can be extracted from the fit of very high-SNR multiple-echo T(2) decay curves with a superposition of a large number of exponentials. Diseases involving de- or dysmyelination can be investigated and lead to novel observations regarding the water compartmentalisation in tissue, despite the limited spatial coverage. In conclusion, quantitative MRI is emerging as an unparalleled tool for the study of the normal and diseased brain, replacing the customary time-space environment of the sequential mixed-contrast MRI with a multi-NMR-parametric space in which tissue microscopy is increasingly revealed.

Reproducibility of myelin water fraction analysis: a comparison of region of interest and voxel-based analysis methods

This study compared region of interest (ROI) and voxel-based analysis (VBA) methods to determine the optimal method of myelin water fraction (MWF) analysis. Twenty healthy controls were scanned twice using a multi-echo T(2) relaxation sequence and ROIs were drawn in white and grey matter. MWF was defined as the fractional signal from 15 to 40 ms in the T(2) distribution. For ROI analysis, the mean intensity of voxels within an ROI was fit using non-negative least squares. For VBA, MWF was obtained for each voxel and the mean and median values within an ROI were calculated. There was a slightly higher correlation between Scan 1 and 2 for the VBA method (R(2)=0.98) relative to the ROI method (R(2)=0.95), and the VBA mean square difference between scans was 300% lower, indicating VBA was the most consistent between scans. For the VBA method, mean MWF was found to be more reproducible than median MWF. As the VBA method is more reproducible and gives more options for visualization and analysis of MWF, it is recommended over the ROI method of MWF analysis.

3 T MRI relaxometry detects T2 prolongation in the cerebral normal-appearing white matter in multiple sclerosis

MRI at 3 T has increased sensitivity in detecting overt multiple sclerosis (MS) brain lesions; a growing body of data suggests clinically relevant damage occurs in the normal-appearing white matter (NAWM). We tested a novel pulse sequence to determine whether 3 T MRI spin-spin relaxometry detected damage in NAWM of MS patients (n=13) vs. age-matched normal controls [(NL) (n=11)]. Baseline characteristics of the MS group were: age (mean+/-SD) 42.5+/-5.4 (range 33-51 years), disease duration 9.0+/-6.4 (range 1-22 years), Expanded Disability Status Scale score 2.5+/-1.7 (range 1-6.5). Brain MRI measures, obtained at 3 T, included global and regional NAWM transverse relaxation rate [R2 (=1/T2)], derived from 3D fast spin-echo T2 prepared images, and global white matter volume fraction derived from SPGR images. The regional NAWM areas investigated were the frontal lobe, parietal lobe, and the genu and splenium of the corpus callosum. Mean NAWM R2 was lower (indicating T2 prolongation) in MS than NL in the whole brain (p=0.00047), frontal NAWM (p=0.00015), parietal NAWM (p=0.0069) and callosal genu (p=0.0019). Similarly, R2 histogram peak position was lower in NAWM in MS than NL in the whole brain (p=0.019). However, the normalized WM volume fractions were similar in both MS and NL (p>0.1). This pilot study suggests that a novel 3D fast spin-echo pulse sequence at 3 T, used to derive R2 relaxation maps, can detect tissue damage in the global and regional cerebral NAWM of MS patients that is missed by conventional lesion and atrophy measures. Such findings may represent demyelination, inflammation, glial proliferation and axonal loss.

MR relaxation in multiple sclerosis

This article provides an overview of relaxation times and their application to normal brain and brain and cord affected by multiple sclerosis. The goal is to provide readers with an intuitive understanding of what influences relaxation times, how relaxation times can be accurately measured, and how they provide specific information about the pathology of MS. The article summarizes significant results from relaxation time studies in the normal human brain and cord and from people who have multiple sclerosis. It also reports on studies that have compared relaxation time results with results from other MR techniques.

Gleaning multicomponent T1 and T2 information from steady-state imaging data

The driven-equilibrium single-pulse observation of T(1) (DESPOT1) and T(2) (DESPOT2) are rapid, accurate, and precise methods for voxelwise determination of the longitudinal and transverse relaxation times. A limitation of the methods, however, is the inherent assumption of single-component relaxation. In a variety of biological tissues, in particular human white matter (WM) and gray matter (GM), the relaxation has been shown to be more completely characterized by a summation of two or more relaxation components, or species, each believed to be associated with unique microanatomical domains or water pools. Unfortunately, characterization of these components on a voxelwise, whole-brain basis has traditionally been hindered by impractical acquisition times. In this work we extend the conventional DESPOT1 and DESPOT2 approaches to include multicomponent relaxation analysis. Following numerical analysis of the new technique, renamed multicomponent driven equilibrium single pulse observation of T(1)/T(2) (mcDESPOT), whole-brain multicomponent T(1) and T(2) quantification is demonstrated in vivo with clinically realistic times of between 16 and 30 min. Results obtained from four healthy individuals and two primary progressive multiple sclerosis (MS) patients demonstrate the future potential of the approach for identifying and assessing tissue changes associated with several neurodegenerative conditions, in particular those associated with WM.

Evaluation of delayed neuronal and axonal damage secondary to moderate and severe traumatic brain injury using quantitative MR imaging techniques

BACKGROUND AND PURPOSE

Traumatic brain injury (TBI) is a classic model of monophasic neuronal and axonal injury, in which tissue damage mainly occurs at the moment of trauma. There is some evidence of delayed progression of the neuronal and axonal loss. Our purpose was to test the hypothesis that quantitative MR imaging techniques can estimate the biologic changes secondary to delayed neuronal and axonal loss after TBI.

MATERIALS AND METHODS

Nine patients (age, 11-28 years; 5 male) who sustained a moderate or severe TBI were evaluated at a mean of 3.1 years after trauma. We applied the following techniques: bicaudate (BCR) and bifrontal (BFR) ventricle-to-brain ratios; T2 relaxometry; magnetization transfer ratio (MTR); apparent diffusion coefficient (ADC); and proton spectroscopy, by using an N-acetylaspartate/creatine (NAA/Cr) ratio measured in normal-appearing white matter (NAWM) and the corpus callosum (CC). The results were compared with those of a control group.

RESULTS

BCR and BFR mean values were significantly increased (P < or = .05) in patients due to secondary subcortical atrophy; increased T2 relaxation time was observed in the NAWM and CC, reflecting an increase in water concentration secondary to axonal loss. Increased ADC mean values and reduced MTR mean values were found in the NAWM and CC, showing damage in the myelinated axonal fibers; and decreased NAA/Cr ratio mean values were found in the CC, indicating axonal loss.

CONCLUSIONS

These quantitative MR imaging techniques could noninvasively demonstrate the neuronal and axonal damage in the NAWM and CC of human brains, secondary to moderate or severe TBI.

The effects of interferon beta-1a on proton MR spectroscopic imaging in patients with multiple sclerosis, a controlled study, preliminary results

To evaluate the effects of interferon beta-1a(INFbeta-1a) on brain metabolites in patients with multiple sclerosis (MS), we performed Magnetic Resonance Spectroscopy Imaging (MRSI) on five patients treated with INFbeta-1a (Rebif 44 microg), and on five untreated patients. Six healthy volunteers were used as controls. Patients were evaluated at the beginning, in the first, third, sixth, and twelfth month. There were no significant differences in normal appearing white matter (NAWM) metabolite peaks of the control group and patients with MS. However, in white matter lesions (WML) and NAWM there was significant differences between the basal and the other months' metabolic peaks (p < 0.05) in the treatment group although no differences emerged in the untreated group. These data suggest that INFbeta-1a has a favorable effect on restoration of metabolites in MS lesions.

Investigating exchange and multicomponent relaxation in fully-balanced steady-state free precession imaging

PURPOSE

To investigate the effect of chemical exchange and multicomponent relaxation on the rapid T(2) mapping method, DESPOT2 (driven equilibrium single pulse observation of T(2)) and the steady-state free precession (SSFP) sequence upon which it is based. Although capable of rapid T(2) determination, an assumption implicit of the method is single-component relaxation. In many biological tissues (such as white and gray matter), it is well established that the T(2) decay curve is more accurately described by the summation of more than one relaxation species.

MATERIALS AND METHODS

The effects of exchange were first incorporated into the general SSFP magnetization expressions and its effect on the measured SSFP signal investigated using Bloch-McConnell simulations. Corresponding imaging experiments were performed to support the presented theory.

RESULTS

Simulations show the measured multicomponent SSFP signal may be expressed as a linear summation of signal from each species under usual imaging conditions where the repetition time is much less than T(2). Imaging experiments performed using dairy cream demonstrate strong agreement with the presented theory. Finally, using a dairy cream model, we demonstrate quantification of multicomponent relaxation from multiangle SSFP data for the first time, showing good agreement with reference spin-echo values.

CONCLUSION

SSFP and DESPOT2 may provide a new method for investigating multicomponent systems, such as human brain, and disease processes, such as multiple sclerosis.

MR evidence of long T2 water in pathological white matter

PURPOSE

To describe what, if any, specific long T(2)-related abnormalities occur in the white matter of subjects with either phenylketonuria (PKU) or multiple sclerosis (MS).

MATERIALS AND METHODS

The 48-echo T(2) relaxation data (maximum TE = 1.12 sec) were acquired from 15 PKU subjects, 20 MS subjects, and 15 healthy volunteers. Regions of interest were drawn in diffuse white matter hyperintensities (DiffWM), lesions, normal-appearing white matter (NAWM), and normal white matter. Long T(2) maps (200 msec < T(2) < 800 msec) were created for each subject.

RESULTS

A new water reservoir with a markedly prolonged T(2) peak was identified in DiffWM and NAWM in 12 out of 15 subjects with PKU and a long T(2) signal was also seen in 23/97 lesions in 50% of subjects with MS. Additionally, a long T(2) component was observed in the corticospinal tracts of 10 healthy volunteers. The characteristics of the long T(2) signal were unique for each subject group. Potential sources of this signal include vacuolation and increases in extracellular water.

CONCLUSION

This study supports the usefulness of increasing the data acquisition window of the multiecho T(2) relaxation sequence to better characterize the T(2) decay from pathological brain.

Standardized structural magnetic resonance imaging in multicentre studies using quantitative T1 and T2 imaging at 1.5 T

The ability to acquire MRI data with consistent tissue contrast at multiple time points, and/or across different imaging centres has become increasingly important as the number of large longitudinal and multicentre studies has grown. Here, the use of quantitative magnetic resonance relaxation times measurement, or, voxel-wise determination of the intrinsic longitudinal and transverse relaxation times, T1 and T2 respectively, for standardizing the structural imaging component of such studies is reported. To demonstrate the ability to standardize across multiple time-points and imaging centres, T1 and T2 maps of seven healthy volunteers were acquired using the rapid DESPOT1 and DESPOT2 (driven equilibrium single pulse observation of T1 and T2) mapping techniques at three centres across the United Kingdom (each centre utilizing scanners from competing manufacturers and/or with varying gradient performance). An average coefficient of variation of the estimates of T1 and T2 was found to be approximately 6.5% and 8%, respectively, across the three centres and comparable to that achieved between repeated imaging sessions performed at the same centre. With a total combined imaging time of less than 12 min for whole-brain approximately 1.2 mm isotropic voxel T1 and T2 maps, quantitative voxel-wise T1 and T2 mapping represents an attractive and easy-to-implement approach for signal intensity standardization and normalization. Further, as T1 and T2 are related to tissue microstructure and biochemistry, quantitative images provide additional diagnostic information that can be compared between patient and control populations, for example through voxel-based analysis techniques.

Long T2 water in multiple sclerosis: what else can we learn from multi-echo T2 relaxation?

Multi-echo T(2) measurements are invaluable in studying brain pathology in multiple sclerosis (MS). In addition to information about myelin water and total water content, the T(2) distribution has the potential to detect additional water reservoirs arising from other sources such as inflammation or edema. The purpose of this study was to better define the T(2) distribution in MS lesions and normal appearing white matter (NAWM) with particular emphasis on the characterisation of longer T(2) components. Magnetisation transfer (MT), T(1) and 48-echo T(2) relaxation data were acquired in 20 MS subjects and regions of interest were drawn in lesions and NAWM. Twenty-seven out of 107 lesions exhibited signal with a markedly prolonged T(2) (200-800 ms). Lesions with a Long-T(2) signal also exhibited a longer geometric mean T(2) (GMT(2)), increased water content (WC), higher T(1), reduced magnetisation transfer ratio (MTR) and decreased myelin water fraction (MWF) than lesions without a Long-T(2) signal. Those subjects with Long-T(2) lesions had a significantly longer disease duration than subjects without this lesion subtype. A strong correlation was observed between T(1) and Long-T(2) fraction, while a slightly weaker relationship was found for GMT(2), MTR and MWF with Long-T(2) fraction. A potential source of the Long-T(2) signal is an increase in extracellular water. This study supports the usefulness of increasing the data acquisition window of the multi-echo T(2) relaxation sequence to better characterise the T(2) decay in MS.

The effect of varying echo spacing within a multiecho acquisition: better characterization of long T2 components

A 48-echo pulse sequence with five different echo-spacing combinations was examined to determine how one can most effectively measure the T2 relaxation characteristics of cerebral tissue containing a long T2 component. For each scan, the first 32 echoes had an echo spacing of 10 ms, while the spacing for Echoes 33-48 (DeltaTE2) was 10, 20, 30, 40 or 50 ms. In an in vivo study using 10 normal volunteers, it was found that the resolution of T2 distribution peaks for both myelin water (approximately 20 ms) and intracellular/extracellular (IE) water (approximately 80 ms) improved as DeltaTE2 increased. The geometric mean T2 values of the main peak agreed within the error for all DeltaTE2 values. A phantom study simulated T2 relaxation distributions that are expected in the brains of patients with demyelinating diseases. For phantoms in which the T2 values of the IE and lesion (200-500 ms) water compartments were separated by at least a factor of 3, each compartment in the distribution was better resolved when DeltaTE2=40 or 50 ms. On the basis of these results, we recommend the use of extended DeltaTE2 values for imaging patients with lesions, without the risk of losing valuable short T2 information.

Investigating the effect of exchange and multicomponentT1 relaxation on the short repetition time spoiled steady-state signal and the DESPOT1T1 quantification method

PURPOSE

To examine the spoiled steady-state (spoiled gradient-recalled echo sequence [SPGR]) signal arising from two-compartment systems and the role of experimental parameters, in particular TR for resolving signal from each compartment.

MATERIALS AND METHODS

Using Bloch-McConnell simulations, we examined the SPGR signal from two-component systems in which T(1) is much greater than the mean residence time (tau(m)) of proton spins in each component. Specifically, we examined the role of TR on the ability to resolve each components signal, as well as the influence of experimental parameters on derived DESPOT1 T(1) values.

RESULTS

Results revealed that when TR < or = 0.01 tau(m), the measured SPGR signal may be modeled as a summation of signal from each species using a no-exchange approximation. Additionally, under this short TR condition, the driven equilibrium single pulse observation of T(1) (DESPOT1) mapping approach provides T(1) values preferentially biased toward the short or long T(1) species, depending on the choice of flip angles.

CONCLUSION

The ability to model the SPGR signal using a no-exchange approximation may permit the quantification multicomponent T(1) relaxation in vivo. Additionally, the ability to preferentially weight the DESPOT1 T(1) value toward the short or long T(1) may provide a useful window into these components.

Novel MR contrasts to reveal more about the brain

Twenty percent of patients with refractory focal epilepsy have an undetermined etiologic basis for their epilepsy despite extensive investigation, including optimal MR imaging. Surgical treatment of this group is associated with a less favorable postoperative outcome. Even with improvements in imaging techniques, a proportion of these patients will remain "MR imaging-negative." It is likely, however, that some of the discrete macroscopic focal lesions that are currently occult will be identified by imaging techniques interrogating different microstructural characteristics. Furthermore, these methods may provide pathologic specificity when used in combination. The description and application of these techniques in epilepsy are the focus of this article.

Multi-exponential analysis of magnitude MR images using a quantitative multispectral edge-preserving filter

A solution for discrete multi-exponential analysis of T(2) relaxation decay curves obtained in current multi-echo imaging protocol conditions is described. We propose a preprocessing step to improve the signal-to-noise ratio and thus lower the signal-to-noise ratio threshold from which a high percentage of true multi-exponential detection is detected. It consists of a multispectral nonlinear edge-preserving filter that takes into account the signal-dependent Rician distribution of noise affecting magnitude MR images. Discrete multi-exponential decomposition, which requires no a priori knowledge, is performed by a non-linear least-squares procedure initialized with estimates obtained from a total least-squares linear prediction algorithm. This approach was validated and optimized experimentally on simulated data sets of normal human brains.

Biexponential T2 relaxation time analysis of the brain: correlation with magnetization transfer ratio

RATIONALE AND OBJECTIVES

To measure T2 relaxation times of normal white and gray matter using a novel CPMG sequence and investigate if any correlation exists between magnetization transfer ratio (MTR) and T2 relaxation-related parameters.

MATERIALS AND METHODS

Seventeen normal volunteers participated on this study. A single-slice 32-echo sequence was used to calculate the T2 relaxation time of frontal and occipital white matter and cortical gray matter. T2 relaxation analysis included monoexponential and biexponential fitting whereas an F test was used to determine if biexponential fitting was statistically more accurate than monoexponential fitting. Short and long T2 constants were calculated as well as the signal fractions of each pool. MTR calculations were based on a three-dimensional gradient echo (3D FFE) proton density weighted sequence with and without an on-resonance composite prepulse. MTR and T2 relaxation times were calculated and linear regression analysis was applied.

RESULTS

Biexponential fitting was more accurate comparing with monoexponential fitting in all WM and GM regions (F > 2.47, P < 0.01). Mean values of short T2 constant for frontal white matter (fWM), occipital white matter (oWM) and gray matter (GM) were 8.10, 9.36, and 22.23 milliseconds, respectively, whereas the mean values of long T2 constant were 85.1, 93.02, and 118.72 milliseconds, respectively. Mean restricted water percentages (RWP)-corresponding to the signal fraction of the protons with short T2-for the fWM, oWM, and GM were 22.01%, 23.36%, and 18.7%. Mean free water percentages (FWP)-corresponding to the signal fraction of the protons with long T2-for the fWM, oWM and GM were 77.99%, 76.64%, and 81.3%. Mean MTR values for fWM, oWM and GM were 68.4%, 68.2%, and 61.3%, respectively. No significant correlation was found in fWM and oWM between MTR and RWP, short and long T2 components while a moderate correlation existed in GM between MTR and RWP (r = 0.57; P = 0.02), MTR and short T2 component (r = -0.69; P = 0.004) and MTR and long T2 component (r = -0.62; P = 0.012).

CONCLUSIONS

Two proton pools with different T2 decay characteristics can be separated in normal gray and white matter when using a multiecho sequence with short echo spacing. MTR and T2 relaxation times were significantly correlated in gray matter and the combination of both types of measurements may be helpful in studying myelin related disorders.

Normal-appearing white matter in multiple sclerosis has heterogeneous, diffusely prolonged T(2)

T(2) relaxation in normal-appearing white matter (NAWM) of multiple sclerosis (MS) patients was reexamined using more complete sampling and analysis of decay curves, and to assess focal vs. diffuse abnormalities. Nine MS patients and 10 controls were scanned using a single-slice 32-echo pulse sequence with a 10-ms echo spacing. Decay curves from outlined white and gray matter structures were analyzed using non-negative least-squares (NNLS). Resulting T(2) distributions were each summarized by the geometric mean T(2), T(2). Different white matter structures had different mean (over the subjects in a group) T(2). Mean T(2) in NAWM was always greater than that of controls. Differences were not caused by a few voxels with extreme T(2) (i.e., focal lesions), but rather by shifts of the entire T(2) distribution (diffuse prolongation). This T(2) increase suggests diffuse myelin or axonal pathology.

Numerical tissue characterization in MS via standardization of the MR image intensity scale

Image intensity standardization is a recently developed postprocessing method that is capable of correcting the signal intensity variations in MR images. We evaluated signal intensity of healthy and diseased tissues in 10 multiple sclerosis (MS) patients based on standardized dual fast spin-echo MR images using a numerical postprocessing technique. The main idea of this technique is to deform the volume image histogram of each study to match a standard histogram and to utilize the resulting transformation to map the image intensities into standard scale. Upon standardization, the coefficients of variation of signal intensities for each segmented tissue (gray matter, white matter, lesion plaques, and diffuse abnormal white matter) in all patients were significantly smaller (2.3-9.2 times) than in the original images, and the same tissues from different patients looked alike, with similar intensity characteristics. Numerical tissue characterizability of different tissues in MS achieved by standardization offers a fixed tissue-specific meaning for the numerical values and can significantly facilitate image segmentation and analysis.

Variations in T1 and T2 relaxation times of normal appearing white matter and lesions in multiple sclerosis

OBJECTIVE

To investigate the variation in T1 and T2 relaxation times of normal appearing white matter (NAWM) and lesions in multiple sclerosis (MS) throughout the brain.

BACKGROUND

The magnetic resonance imaging (MRI) sequence fast FLAIR (fluid attenuated inversion recovery) has demonstrated overall increased lesion detection when compared to conventional or fast spin echo (FSE) but fewer lesions in the posterior fossa and spinal cord. The reasons for this are unknown, but may be due to variations in the T1 and T2 relaxation times within NAWM and MS lesions.

METHOD

Ten patients and 10 controls underwent MRI of the brain which involved FSE, fast FLAIR and the measurement of T1 and T2 relaxation times.

RESULTS

Of 151 lesions analysed (22 infra-tentorial, 129 supra-tentorial), eight were missed by the fast FLAIR sequence. T1 and T2 relaxation times in normal controls were longer in the infra-tentorial, than supra-tentorial, region. Patient NAWM relaxation times were prolonged compared with control values in both regions. Lesions demonstrated longer relaxation times than either control white matter or patient NAWM in both regions, however this difference was less marked infra-tentorially. The eight posterior fossa lesions not visible on the fast FLAIR sequence were characterised by short T1 and T2 relaxation times which overlapped with the patient NAWM for both T1 and T2 and with control values for T2 relaxation times.

CONCLUSION

Both lesion and NAWM relaxation time characteristics vary throughout the brain. The T1 and T2 relaxation times of infra-tentorial lesions are closer to the relaxation times of local NAWM than supra-tentorial lesions, resulting in reduced contrast between posterior fossa lesions and the background NAWM. Consequently the characteristics of some lesions overlap with those of NAWM resulting in reduced conspicuity. By utilising this information, it may be possible to optimise fast FLAIR sequences to improve infra-tentorial lesion detection.

In vivo magnetic resonance imaging and relaxometry study of a porous hydrogel implanted in the trapezius muscle of rabbits

In vivo magnetic resonance imaging (MRI) and relaxometry were performed to assess noninvasively the tissue reaction and the biological integration of hydrogels made of poly[N-(2-hydroxypropyl) methacrylamide] (PHPMA) after implantation in the trapezius muscle of rabbits. The benefits of incorporating RGD peptide sequences in the polymer backbone were also investigated. The histological status of each implant was probed by the trend of their transversal relaxation times, T(2), while their biocompatibility was evaluated by analyzing the host tissue response through the evolution of the relaxation times of the adjacent muscle tissue. MR results showed the good acceptability of both hydrogels by the host tissue. The transversal relaxation curves of each implant exhibited two distinct phases as a function of implantation time: (1) a monoexponential phase, dominated by the influx of fluids inside the implants; and (2) a biexponential phase related to the infiltration of cells and the granulation tissue formation within the porous structure of each polymer. These MR findings were correlated with the results of conventional histological analyses. The present study demonstrates the effectiveness of MR methods in noninvasively monitoring the biocompatibility and histological status of implanted porous biomaterials.

Multiple sclerosis: magnetization transfer MR imaging of white matter before lesion appearance on T2-weighted images

PURPOSE

To determine the evolution of magnetization transfer (MT) in white matter regions before and after plaque development in patients with multiple sclerosis (MS).

MATERIALS AND METHODS

In a 5-year longitudinal evaluation, 30 patients with MS underwent conventional magnetic resonance (MR) imaging, MT MR imaging, and clinical assessment. Cross-sectional data in 12 healthy subjects were also collected. Semiautomated lesion classification with use of T2-weighted MR images was used to measure the time course of the MT ratio (calculated with MR data acquired without and with MT saturation) in every voxel and to help analyze the relationship with the status of lesions depicted on T2-weighted images.

RESULTS

There was a significant (P <.001) temporal decline in lesion MT ratio after lesion appearance on T2-weighted images. A significant (P <. 001) progressive decline in MT ratio was also present in voxels that later became lesions, prior to initial detection on T2-weighted images. Even 1(1/2) years prior to lesion appearance, the MT ratio (33.3%) in regions destined to become such lesions was significantly (P <.001) lower than that in both white matter in healthy subjects (41.3%) and other normal-appearing white matter in patients with MS (38.1%).

CONCLUSION

The MT ratio reveals progressive focal abnormalities in MS that antedate by up to 2 years the appearance of lesions on T2-weighted MR images.

Proton MR spectroscopy in clinically isolated syndromes suggestive of multiple sclerosis

The concentration of the metabolite N-acetyl aspartate (NAA), thought to be a marker of axonal loss or damage, has been shown to be reduced in lesions, as demonstrated by high signal areas on T2-weighted MRI, and in normal-appearing white matter (NAWM) in established multiple sclerosis (MS). The stage of the disease when these changes first appear is not known. To try to determine this we studied 20 patients with clinically isolated syndromes, many of whom will be at the earliest clinical stages of MS, and 20 age- and sex-matched controls with single-voxel proton magnetic spectroscopy (MRS). MRS was performed using a General Electric 1.5T Signa EchoSpeed scanner (TR 3000 ms, TE 30 ms, PRESS). Absolute metabolite concentrations were determined using the LCModel fitting software. No significant reduction of NAA concentration was evident in the NAWM of the patients (patients: median 7.3 mM; controls: median 7.7 mM; P=0.19). There was, however, a significantly lower concentration of NAA in lesions (median 6.6 mM, P=0.015). Absolute values of choline-containing compounds, creatine and myo-inositol were significantly raised in the lesions (P=0.007, P=0.011 and P=0.002 respectively). The low NAA in lesions is consistent with axonal loss, damage or dysfunction occurring focally at the earliest clinical phase of the disease. The lack of any significant reduction in NAA in patient NAWM demonstrates that more widespread axonal changes are not yet detectable at this early clinical stage. A larger cohort and follow-up will be necessary to determine whether or not MRS findings have any prognostic significance for individual patients or sub-groups. This will also enable the clarification of the time course, pathogenesis and pathophysiological significance of the development of the low NAA, which is found in the NAWM of many patients with established MS.

T2 relaxation of the parotid gland of patients affected by pleomorphic adenoma

The T2 behavior of parotid gland tissue was investigated in 11 patients affected by pleomorphic adenoma. A protocol that was previously set up to define acquisition and post-processing procedures, reaching an accuracy of 2.5% in phantoms and an in vivo long term reproducibility of 0.9-8.5%, was used for the evaluations. The measurements were carried out on a whole body, superconducting imager, using a neck coil as a receiver. Some reference gel samples were imaged together with the patient and used to correct T2 results. The sequence protocol was a multispin-echo, 16 echoes. Signals were fitted with mono and biexponential decay models and an automatic choice of the best model was performed using the two chisquared comparison. Two T2 maps (T2 monoexponential or short T2 component, and long T2 component) and chisquared maps were then produced. Pathologic and normal tissues showed a dominant monoexponential decay with a good level of biexponentiality (16%-27% of total fitted pixels) due to partial volume effects from the liquid content. Concerning the biexponentiality, no significant differences were found between the fitted pixel fraction of normal and pathologic tissue, because the T2 long component of the lesion was related both to the edema and saliva content, but probably the increase in the first compensated the decrease in the second. Chisquared maps showed that most of the lesions presented a monoexponential core surrounded by a biexponential border probably due to a solid component similar to normal tissue with partial volume effects from saliva content. Ninety-five percent confidence intervals for normal tissue were 69.40-87.80 ms (monoexponential relaxation), 38.19-44.67 ms and 285.84-691.28 ms (short and long components of biexponential relaxation). For pathologic tissue they resulted 172.17-275.83 ms, 53.86-89.98 ms and 442.10-814.58 ms. The monoexponential component, mostly present in the core of the lesion, was the parameter that better characterized pathologic tissue. A comparison was performed between normal tissue of patients and normal tissue of volunteers, whose statistics was collected in a previous study with the same evaluation protocol. Results showed no significant differences in the biexponential fitted fractions and the comparison of relaxation times. We conclude that, for tissue characterization, a multiexponential analysis should be carried out in order to improve accuracy and to obtain more reliable results. Moreover, other than relaxation calculations, a topographical analysis of relaxation distribution, using for instance the chisquared maps, might in the future give us more useful information on tissue structure.

Multivariate image analysis of magnetic resonance images with the direct exponential curve resolution algorithm (DECRA). Part 2: Application to human brain images

Owing to the heterogeneity of living tissues, it is challenging to quantify tissue properties using magnetic resonance imaging. Within a single voxel, contributions to the signal may result from several types of 1H nuclei with varied chemical (e.g., -CH2-, -OH) and physical environments (e.g., tissue density, compartmentalization). Therefore, mixtures of 1H environments are prevalent. Furthermore, each unique type of 1H environment may possess a unique and characteristic spin-lattice relaxation time (T1) and spin-spin relaxation time (T2). A method for resolving these unique exponentials is introduced in a separate paper (Part 1. Algorithm and Model System) and uses the direct exponential curve resolution algorithm (DECRA). We present results from an analysis of images of the human head comprising brain tissues.

Contribution of T2 relaxation time mapping in the evaluation of cryptogenic temporal lobe epilepsy

In this study we compared the results of visual analysis of MR imaging with T2 relaxation time mapping of the mesial structures in a group of 97 patients with cryptogenic temporal lobe epilepsy. All patients underwent a clinical neurological examination, neuropsychological investigation, prolonged video-EEG monitoring, SPECT imaging, MR imaging, and T2 relaxation time mapping. T2 relaxation times were estimated with a Carr-Purcell-Meiboom-Gill pulse sequence with 48 echoes (15 to 720 ms). The mean T2 relaxation time value was 118.5 +/- 2 ms in the hippocampi and 120.3 +/- 1.9 ms in the amygdala of 21 healthy subjects used as controls. T2 relaxation mapping revealed mesial temporal sclerosis in 91.8% of the patients (often involving both the hippocampus and the amygdala) and evidenced bilateral involvement in 44.6% of the patients against 72.2 and 6.2%, respectively, for MR imaging. The ipsilateral and contralateral hippocampal T2 relaxation time values did significantly correlate with seizure frequency and the contralateral hippocampal T2 relaxation time value with the duration of epilepsy. In conclusion, this quantitative method is highly sensitive for the detection of mesial temporal sclerosis and permits a better evaluation of the apparently normal contralateral mesial structures.

Quantitative T2 imaging of plant tissues by means of multi-echo MRI microscopy

A method for quantitative T2 imaging is presented which covers the large range of T2 values in plants (5 to 2000 ms) simultaneously. The transverse relaxation is characterized by phase-sensitive measurement of many echo images in a multi-echo magnetic resonance imaging sequence. Up to 1000 signal-containing echo images can be measured with an inter-echo time of 2.5 ms at 0.47 T. Separate images of water density and of T2 are obtained. Results on test samples, on the cherry tomato and on the stem of giant hogweed are presented. The effects of field strength, spatial resolution and echo time on the observed T2 values is discussed. The combination of a relatively low magnetic field strength, short echo time and medium pixel resolution results in excellent T2 contrast and in images hardly affected by susceptibility artifacts. The characterization of transverse relaxation by multi-echo image acquisition opens a new route for studies of water balance in plants.

High-resolution in vivo measurements of transverse relaxation times in rats at 7 Tesla

A multi-echo imaging sequence suitable for high-resolution and accurate in vivo transverse relaxation time (T2) mapping has been implemented. The sequence was tested on phantoms and was used to measure T2 values in vivo in the rat brain, muscle, and fat at 7 T. Brain T2 maps are shown and regional variations in brain T2 are reported (41.8 ms in cortex, 47.9 ms in hippocampus). Results are compared to literature values obtained at lower field in vivo as well as high-field T2 measurements on excised rat tissues. The reported T2 values are generally smaller compared to lower-field-strength literature values. A discussion of the possible causes of these field effects on T2 is included (dipolar interaction, fast chemical exchange, and diffusion in susceptibility gradients).

Value of magnetic resonance imaging in assessing efficacy in clinical trials of multiple sclerosis therapies

Magnetic resonance imaging (MRI) has become an important technique for monitoring the effectiveness of putative treatments for multiple sclerosis (MS) because of its high sensitivity, objectivity, and noninvasive nature. Its importance as a surrogate measure of disease, however, is an issue that is more difficult to validate than might seem to be the case. In this review, we describe the role of MRI in the assessment of putative therapies for MS. New magnetic resonance techniques and methods of image analyses aimed at better demonstrating the nature and extent of disease are discussed, and the role of MRI in published MS therapeutic trials is examined. MRI is a frequently used secondary outcome measure for putative treatment strategies for MS. Although it is sensitive to changes in the inflammatory component of the MS disease process, poor correlation has been noted between MRI findings and long-term patient outcome. There is a widespread expectation that new magnetic resonance techniques--such as fluid-attenuated inversion recovery, magnetization transfer imaging, and magnetic resonance spectroscopy--will ultimately be useful for characterization of pathologic changes within the MS lesion and more generally of the MS disease process. Whether magnetic resonance changes seen in experimental therapies predict the long-term clinical course of the disease remains to be determined.

MR multispectral analysis of multiple sclerosis lesions

Although quantification of the lesion burden from serial MR examinations of patients with multiple sclerosis (MS) is a common technique to assess disease activity in clinical trials, pathologic change may occur within a lesion without a corresponding change in volume. Therefore, measures of lesion volume and composition may improve the sensitivity of detecting disease activity. A new technique has been developed that provides information about the intensity composition of MS lesions in standard spin-echo MR examinations. The new technique is based on the multispectral "feature space" intensity distributions of the lesions and normal tissues. Analysis of MR examinations of materials with known T1 and T2 times showed that feature space position from spin-echo examinations is largely determined from proton density (rho), T2, and the interecho delay. Information about intensity composition was obtained by reducing the multidimensional intensity distribution to one dimension while minimizing the loss of information. This technique was used to analyze eight lesions in standard spin-echo MR examinations of three patients with MS. Lesion distributions were compared between examinations by first calibrating the examinations based on the intensity distributions of cerebrospinal fluid (CSF), an internal reference tissue. Many of the lesion distributions had a distinctive peak at low intensity, corresponding to normal-appearing white matter (WM). Within the lesion distributions, increases in high intensity peaks generally were accompanied by reductions in the WM peak. Serial analysis of the lesion distributions revealed some dramatic fluctuations, even when lesion volume remained constant.

Imaging of remyelination

Now that the concept of remyelination is gaining acceptance in MS, there is a need for a paraclinical marker to monitor remyelination in MS, for example to study the effect of therapeutical interventions. At present there is no known imaging marker for remyelination. While positron emission tomography (PET) has ample sensitivity and specificity, an appropriate tracer is locking and spatial resolution is poor. Magnetic resonance (MR) imaging has superior sensitivity and spatial resolution, but the standard techniques lack specificity. Conventional T2-weighted images will most probably still appear abnormal in an area of remyelination. Among several newer MR techniques that are more specific, magnetization transfer contrast is the best candidate with regards to imaging remyelination. There is a strong need for an appropriate animal model and for histopathological confirmation to be able to further develop both PET and MR.

In vivo measurement of T2 distributions and water contents in normal human brain

Using a 32-echo imaging pulse sequence, T2 relaxation decay curves were acquired from five white- and six gray-matter brain structures outlined in 12 normal volunteers. The water contents of white and gray matter were 0.71 (0.01) and 0.83 (0.03) g/ml, respectively. All white-matter structures had significantly higher myelin water percentages (signal percentage with T2 between 10 and 50 ms) than all gray-matter structures. The range in geometric mean T2 of the main peak for both white and gray matter was from 70 to 86 ms. T2 distributions from the posterior internal capsules and splenium of the corpus callosum were significantly wider (width is related to water environment inhomogeneity) than those from any other white- or gray-matter structures. Thus, quantitative measurement and analysis of T2 relaxation reveals differences in brain tissue water environments not discernible on conventional MR images. These differences may make short T2 components reliable markers for normal myelin.

Unraveling diffusion constants in biological tissue by combining Carr-Purcell-Meiboom-Gill imaging and pulsed field gradient NMR

A diffusion-weighted multi-spin-echo pulse sequence is presented, which allows for simultaneous measurement of T2, the fractional amplitude, and the diffusion constant of different fractions. Monte Carlo simulations demonstrate an improvement of this sequence with respect to the accuracy of diffusion constant and fractional amplitude for slow exchange. Examples are shown for a simple phantom containing two fractions. In addition, experiments on cat brain in healthy condition and following occlusion of the middle cerebral artery show that the fractional amplitude and the diffusion constant of cerebral spinal fluid and normal brain tissue can be analyzed within each pixel with acceptable accuracy.

Quantitative volumetric magnetization transfer analysis in multiple sclerosis: estimation of macroscopic and microscopic disease burden

Magnetization transfer imaging (MTI) has been shown to be sensitive to both macroscopic and microscopic disease in multiple sclerosis (MS). In this study three-dimensional MTI was used to estimate the global burden of disease in large volumes of brain tissue. MTI was performed in 15 MS patients and 11 normal controls. In seven MS patients MTI was performed on two different occasions. MTI data were displayed as magnetization transfer ratio (MTR) histograms and analyzed. The peak height of the histograms, presumably reflecting the residual amount of normal brain tissue, was lower in MS patients as compared with normal controls (P < 0.001), and was found to correlate with the duration of disease (P < 0.05). A decrease of the MTR histogram peak height was observed in the course of the disease (P < 0.01). These findings suggest that in MS, volumetric MTI provides quantitative information reflecting the global burden of disease.

Magnetic resonance imaging of the brain: blood partition coefficient for water: application to spin-tagging measurement of perfusion

We describe the use of relative proton density imaging to obtain spatially resolved measurements of the brain:blood partition coefficient for water. Values of relative proton density and apparent-T1 were calculated by performing a multidimensional nonlinear least squares fit of progressive saturation image data. Correction for magnetic field inhomogeneity was included. The partition coefficient was calculated by dividing the relative proton density of brain by the relative proton density of blood water. Results obtained from healthy volunteers demonstrate significant spatial variation in the partition coefficient in brain. Direct measurement of this parameter eliminates a source of error in the calculation of regional perfusion using arterial spin-tagging techniques.

Magnetisation transfer ratios and transverse magnetisation decay curves in optic neuritis: correlation with clinical findings and electrophysiology

Conventional MRI sequences do not permit the distinction between the different pathological characteristics (oedema, demyelination, gliosis, axonal loss) of the multiple sclerosis plaque. Magnetisation transfer imaging and transverse magnetisation decay curve (tMDC) analysis may be more specific. These techniques have been applied to the optic nerves in 20 patients with optic neuritis and the results correlated with clinical and visual evoked potential (VEP) findings. tMDC analysis failed to identify separate intracellular and extracellular water compartments within the optic nerve but gave a measure of transverse relaxation time (T2) without the confounding effects of CSF in the nerve sheath. Both T2 and magnetisation transfer ratio (MTR) were abnormal after an episode of optic neuritis. T2 did not correlate with visual function or with VEP latency or amplitude. There was a significant correlation between MTR reduction and prolongation of VEP latency: this increased latency may reflect an effect of myelin loss on MTR. Longer lesions were associated with worse visual outcome, implying that the overall extent of pathological involvement is likely to influence the degree of functional deficit.

In vivo characterization of cytotoxic intracellular edema by multicomponent analysis of transverse magnetization decay curves

RATIONALE AND OBJECTIVES

We investigated the multicompartmental nature of T2 decay in a specific white matter edema model.

METHODS

Triethyltin (TET) intoxication was produced in six male New Zealand White rabbits. Images were obtained over the 23-day study duration using a 64-echo Carr-Purcell-Meiboom-Gill (CPMG) sequence (repetition time = 3000 msec, echo time = 20 msec). T2 decay curves were extracted from 0.7 x 0.7 x 3.0 mm3 voxels in the corpus callosum and contiguous white matter tracts, cortex, thalamic nuclei, hypothalamic nuclei, and the masseter muscles. The curves were fit with biexponential functions.

RESULTS

Increased signal intensity in the corpus callosum was evident 2-3 days after the first TET injection. At this time, a substantial slowly relaxing component appeared in the decay curves of the corpus callosum and, to a lesser extent, in the thalamus and hypothalamus. Changes in the rabbits' body weight, general physical condition, and neurologic state paralleled the growth and regression of the second, slowly relaxing component.

CONCLUSION

The appearance and regression of a slowly decaying second component in the T2 decay curve is consistent with the formation and shrink-age of intracellular vesicles in the intramyelin sheaths of central white matter.

Magnetization transfer and T2 relaxation components in tissue

T2 relaxation makes an important contribution to tissue contrast in magnetic resonance (MR) imaging. Many tissues are known to exhibit multicomponent T2 relaxation that suggests some compartmental segregation of mobile protons on a T2 timescale. Magnetization transfer (MT) is another relaxation mechanism that can be used to produce tissue contrast in MR imaging. The MT process depends strongly on water-macromolecular interactions. To investigate the relationship between multicomponent T2 relaxation and the MT process, multiecho T2 measurements have been combined with MT measurements for freshly excised samples of cardiac muscle, striated muscle, and white matter. For muscle, short T2 components show greater MT than long T2 components, consistent with the belief that they represent distinct water environments. For white matter, quantitative MT measurements were identical for the two major T2 components, apparently because of exchange between the T2 compartments on a time-scale characteristic of the MT experiment. Implications for accurate modeling of MT in tissue and the use of MT for MR image contrast are discussed.