MRI: use of the inversion recovery pulse sequence

Zero-echo-time sequences in highly inhomogeneous fields

PURPOSE

Zero-echo-time (ZTE) sequences have proven a powerful tool for MRI of ultrashortT 2 $$ {T}_2 $$ tissues, but they fail to produce useful images in the presence of strong field inhomogeneities (14 000 ppm). Here we seek a method to correct reconstruction artifacts from non-Cartesian acquisitions in highly inhomogeneousB 0 $$ {\mathrm{B}}_0 $$ , where the standard double-shot gradient-echo approach to field mapping fails.

METHODS

We present a technique based on magnetic field maps obtained from two geometric distortion-free point-wise (SPRITE) acquisitions. To this end, we employ three scanners with varying field homogeneities. These maps are used for model-based image reconstruction with iterative algebraic techniques (ART). For comparison, the same prior information is fed also to widely used Conjugate Phase (CP) algorithms.

RESULTS

Distortions and artifacts coming from severeB 0 $$ {\mathrm{B}}_0 $$ inhomogeneities, at the level of the encoding gradient, are largely reverted by our method, as opposed to CP reconstructions. This holds even close to the limit where intra-voxel bandwidths (determined byB 0 $$ {\mathrm{B}}_0 $$ inhomogeneities, up to 1.2 kHz) are comparable to the encoding inter-voxel bandwidth (determined by the gradient fields, 625 Hz in this work).

CONCLUSION

We have benchmarked the performance of a new method for ZTE imaging in highly inhomogeneous magnetic fields. For example, this can be exploited for dental imaging in affordable low-field MRI systems, and can be expanded for arbitrary pulse sequences and extreme magnet geometries, as in, for example, single-sided MRI.

Enhancing fluid signal in driven-equilibrium short-TI inversion-recovery imaging with short TR times: A feasibility study

PURPOSE

Fluid-sensitive turbo spin echo (TSE) MRI with short-TI inversion-recovery preparation for fat suppression (STIR) plays a critical role in the diagnostics of the musculoskeletal system (e.g., close to metal implants). Potential advantages of 3D acquisitions, however, are difficult to exploit due to long acquisition times. Shortening the TR incurs a signal loss, and a driven-equilibrium (DE) extension reduces fluid signal even further.

METHODS

The phase of the flip-back pulse was changed by 180° relative to the conventional implementation (i.e., 90° along the positive x-axis (90°x) instead of -90°x). After signal modeling and numerical simulations, the modification was implemented in STIR-TSE sequences and tested on a clinical 3T system. Imaging was performed in the lumbar spine, and long-TR images without DE were acquired as reference. CSF SNR and fluid-muscle contrast were measured and compared between the sequences. Imaging was repeated in a metal implant phantom.

RESULTS

A shortening of TR by 43%-57% reduced the CSF SNR by 39%-59%. A conventional DE module further reduced SNR to 26%-40%, whereas the modified DE recovered SNR to 59%-108% compared with the long-TR acquisitions. Fluid-tissue contrast was increased by about 340% with the modified DE module compared with the conventional extension. Similar results were obtained in implant measurements.

CONCLUSIONS

The proposed DE element for TSE-STIR sequences has the potential to accelerate the acquisition of fluid-sensitive images. DE-STIR may work most efficiently for 3D acquisitions, in which no temporo-spatial interleaving of inversion and imaging pulses is possible.

Estimating axon radius using diffusion-relaxation MRI: calibrating a surface-based relaxation model with histology

Axon radius is a potential biomarker for brain diseases and a crucial tissue microstructure parameter that determines the speed of action potentials. Diffusion MRI (dMRI) allows non-invasive estimation of axon radius, but accurately estimating the radius of axons in the human brain is challenging. Most axons in the brain have a radius below one micrometer, which falls below the sensitivity limit of dMRI signals even when using the most advanced human MRI scanners. Therefore, new MRI methods that are sensitive to small axon radii are needed. In this proof-of-concept investigation, we examine whether a surface-based axonal relaxation process could mediate a relationship between intra-axonal T2 and T1 times and inner axon radius, as measured using postmortem histology. A unique in vivo human diffusion-T1-T2 relaxation dataset was acquired on a 3T MRI scanner with ultra-strong diffusion gradients, using a strong diffusion-weighting (i.e., b = 6,000 s/mm2) and multiple inversion and echo times. A second reduced diffusion-T2 dataset was collected at various echo times to evaluate the model further. The intra-axonal relaxation times were estimated by fitting a diffusion-relaxation model to the orientation-averaged spherical mean signals. Our analysis revealed that the proposed surface-based relaxation model effectively explains the relationship between the estimated relaxation times and the histological axon radius measured in various corpus callosum regions. Using these histological values, we developed a novel calibration approach to predict axon radius in other areas of the corpus callosum. Notably, the predicted radii and those determined from histological measurements were in close agreement.

Clinician's guide to the basic principles of MRI

MRI is an important and widely used imaging modality for clinical diagnosis. This article provides a concise discussion of the basic principles of MRI physics for non-radiology clinicians, with a general explanation of the fundamentals of signal generation and image contrast mechanisms. Common pulse sequences, tissue suppression techniques and use of gadolinium contrast with relevant clinical applications are presented. Knowledge of these concepts would provide an appreciation of how MR images are acquired and interpreted to facilitate interdisciplinary understanding between radiologists and referring clinicians.

Low field slice-selective ZTE imaging of ultra-short [Formula: see text] tissues based on spin-locking

Magnetic Resonance Imaging of hard biological tissues is very challenging due to small proton abundance and ultra-short [Formula: see text] decay times, especially at low magnetic fields, where sample magnetization is weak. While several pulse sequences, such as Ultra-short Echo Time (UTE), Zero Echo Time (ZTE) and SWeep Imaging with Fourier Transformation (SWIFT), have been developed to cope with ultra-short lived MR signals, only the latter two hold promise of imaging tissues with sub-millisecond [Formula: see text] times at low fields. All these sequences are intrinsically volumetric, thus 3D, because standard slice selection using a long soft radio-frequency pulse is incompatible with ultra-short lived signals. The exception is UTE, where double half pulses can perform slice selection, although at the cost of doubling the acquisition time. Here we demonstrate that spin-locking is a versatile and robust method for slice selection for ultra-short lived signals, and present three ways of combining this pulse sequence with ZTE imaging of the selected slice. With these tools, we demonstrate slice-selected 2D ex vivo imaging of the hardest tissues in the body at low field (260 mT) within clinically acceptable times.

Prepolarized MRI of hard tissues and solid-state matter

Prepolarized MRI (PMRI) is a long-established technique conceived to counteract the loss in signal-to-noise ratio (SNR) inherent to low-field MRI systems. When it comes to hard biological tissues and solid-state matter, PMRI is severely restricted by their ultra-short characteristic relaxation times. Here we demonstrate that efficient hard-tissue prepolarization is within reach with a special-purpose 0.26 T scanner designed for ex vivo dental MRI and equipped with suitable high-power electronics. We have characterized the performance of a 0.5 T prepolarizer module, which can be switched on and off in 200 μs. To this end, we have used resin, dental and bone samples, all with T 1 times of the order of 20 ms at our field strength. The measured SNR enhancement is in good agreement with a simple theoretical model, and deviations in extreme regimes can be attributed to mechanical vibrations due to the magnetic interaction between the prepolarization and main magnets.

An in vivo implementation of the MEX MRI for myelin fraction of mice brain

OBJECTIVE

Magnetization EXchange (MEX) sequence measures a signal linearly dependent on the myelin proton fraction by selective suppression of water magnetization and a recovery period. Varying the recovery period enables extraction of the percentile fraction of myelin bound protons. We aim to demonstrate the MEX sequence sensitivity to the fraction of protons associated with myelin in mice brain, in vivo.

METHODS

The cuprizone mouse model was used to manipulate the myelin content. Mice fed cuprizone (n = 15) and normal chow (n = 8) were imaged in vivo using MEX sequence. MR images were segmented into corpus callosum and internal capsule (white matter) and cortical gray matter, and fitted to the recovery equation. Results were analyzed with correlation to MWF and histopathology.

RESULTS

The extracted parameters show significant differences in the corpus callosum between the cuprizone and control groups. The cuprizone group exhibited reduced myelin fraction 26.5% (P < 0.01). The gray matter values were less affected, with 13.5% reduction (P < 0.05); no changes were detected in the internal capsule. Results were validated by MWF scans and good correlation to the histology analysis (R² = 0.685).

CONCLUSION

The results of this first in vivo implementation of the MEX sequence provide a quantitative measure of demyelination in brain white matter.

Controlling Through-Slice Chemical-Shift Artifacts for Improved Non-Fat-Suppressed Musculoskeletal Turbo-Spin-Echo Magnetic Resonance Imaging at 7 T

OBJECTIVES

Through-slice chemical shift artifacts in state-of-the-art turbo-spin-echo (TSE) images can be significantly more severe at 7 T than at lower field strengths. In musculoskeletal applications, these artifacts appear similar to bone fractures or neoplastic bone marrow disease. The objective of this work was to explore and reduce through-slice chemical shift artifacts in 2-dimensional (2D) TSE imaging at 7 T.

MATERIALS AND METHODS

This prospective study was approved by the local ethics board. The bandwidths of the excitation and refocusing radiofrequency (RF) pulses of a prototype 2D TSE sequence were individually modified and their effect on the slice profiles and relative slice locations of water and fat spins was assessed in an oil-water phantom. Based on these results, it was hypothesized that the combination of matched and increased excitation and refocusing RF pulse bandwidths ("MIB") of 1500 Hz would enable 2D TSE imaging with significantly reduced chemical shift artifacts compared with a state-of-the-art sequence with unmatched and moderate RF pulse bandwidths ("UMB") of 1095 and 682 Hz.A series of T1-weighted sagittal knee examinations in 10 healthy human subjects were acquired using the MIB and UMB sequences and independently evaluated by 2 radiologists. They measured the width of chemical shift artifacts at 2 standardized locations and graded the perceived negative effect of chemical shift artifacts on image quality in the bones and in the whole gastrocnemius muscle on a 5-point scale. Similar knee, wrist, and foot images were acquired in a single subject. Signal-to-noise ratios in the femoral bone marrow were computed between the UMB and MIB sequences.

RESULTS

Phantom measurements confirmed the expected spatial separation of simultaneously affected water and fat slices between 40% and 200% of the prescribed slice thickness for RF pulse bandwidths between 2500 and 500 Hz. Through-slice chemical shift artifacts at the bone-cartilage interface were significantly smaller with MIB than with UMB (location 1: 0.35 ± 0.20 mm vs 1.27 ± 0.27 mm, P < 0.001; location 2: 0.25 ± 0.13 mm vs 1.48 ± 0.46 mm, P < 0.001; intraclass correlation coefficient = 0.98). The negative effect of chemical shift artifacts on image quality was significantly smaller with MIB than with UMB (bone: 2 ± 0 vs 4 ± 1, P < 0.004 [both readers]; muscle: 3 ± 0 vs 2 ± 0, P < 0.004 [both readers]; κ = 0.69). The signal-to-noise ratio of the UMB and MIB sequences was comparable, with a ratio of 99 ± 7%. Images acquired using the UMB sequence displayed numerous artifactual hyperintensities and diffuse, as well as locally severe, fat signal loss in all examined regions, whereas the MIB sequence consistently yielded high image quality with bright T1-weighted fat signal and excellent depiction of fine tissue structures.

CONCLUSIONS

On 7 T systems, the selection of high and matched RF bandwidths for excitation and refocusing pulses for 2D TSE imaging without fat suppression showed consistently better image quality than state-of-the-art sequences with unmatched lower RF pulse bandwidths.

MRI for Dental Applications

Imaging of hard and soft tissue of the oral cavity is important for dentistry. However, medical computed tomography, cone beam computed tomography (CBCT), nor MRI enables soft and hard tissue imaging simultaneously. Some MRI sequences were shown to provide fast soft and hard tissue imaging of hydrogen, which increased the interest in dental MRI. Recently, MRI allowed direct visualization of cancellous bone, intraoral mucosa, and dental pulp despite that cortical bone and dental roots are indirectly visualized. MRI seems to be adequate for many indications that CBCT is currently used for: implant treatment and inflammatory diseases of the tooth.

The role of magnetization transfer in the observed contrast in T1 weighted imaging under clinical setups

In T₁ weighted magnetic resonance imaging of brain and spinal cord in the clinical setting, the white matter (WM) appears with greater intensity than the gray matter (GM). This contrast has been assigned to differences in T₁ values. In these experiments the RF pulses are too long to excite both the water and the species with restricted motion of the protons (SRMP). In in vitro studies using short RF pulses, the contrast is reversed, with greater intensity for the GM. These results raise the question of whether magnetization transfer (MT) plays a role in the contrast observed in the T₁ weighting experiments. In the present work we implemented selective saturation recovery alone and together with the conventional magnetization transfer contrast (MTC) method. The results confirm that a major factor that determines the characteristic WM/GM averaged intensity ratio observed in T₁ weighted imaging under clinical conditions is MT between the SRMP and water. When selective saturation recovery is combined with MTC, the SRMP yields spectral widths ranging from a few to tens of kilohertz, indicating that more than one type of SRMP is involved in the MT. The z-spectrum obtained with this combination is free of the effect of direct saturation of the water peak. Selective saturation recovery enables an independent measurement of the exchange time and T₁ , while the combination with MTC with complete saturation of the SRMP enables measurement of T₁ without the effect of MT. The latter measurement can be carried out on a timescale much shorter than T_1.

Use of chemical shift encoded magnetic resonance imaging (CSE-MRI) for high resolution fat-suppressed imaging of the brachial and lumbosacral plexuses

PURPOSE

In the era of increasingly complex surgical techniques for peripheral nerve repair, there is a need for high spatial resolution imaging of the neural plexuses in the body. We describe our experience with chemical shift encoded MRI and its implications for patient management.

MATERIALS AND METHODS

IDEAL water-fat separation is a chemical shift based method of homogeneously suppressing signal from fat, while maintaining adequate signal. This technique was used in clinical practice and the patient images reviewed.

RESULTS

IDEAL water-fat separation was shown to improve visualization of the brachial and lumbosacral plexuses with good fat suppression and high signal to noise ratio.

CONCLUSION

IDEAL water - fat separation is an excellent technique to use in the imaging of the brachial and lumbosacral plexuses as it balances the need for homogeneous fat suppression with maintenance of excellent signal to noise ratio.

Characteristics of hippocampal volumes in healthy Chinese from MRI

BACKGROUND/OBJECTIVES

The volume of hippocampus has been associated with a number of disorders and would be helpful in clinical and research practice. This study provided the normal data of hippocampal volumes in a healthy Chinese sample and assessed the possible effects of age, gender and side on it.

METHODS

Sixty-one normal participants with a broad age span from 6 to 82 years were enrolled in the study. The hippocampal volumes of them were obtained from oblique coronal MR images using inversion recovery (IR) sequence and normalized to adjust intersubject variation in head size.

RESULTS

The corrected volume in the right side of hippocampus was 2.204-2.944 cm(3), and 2.068-2.700 cm(3) in the left. There were no statistically significant differences among different age and gender groups (p>0.05). The volume of right hippocampus was larger than that of the left side (p<0.001).

CONCLUSIONS

We presented the volume range of hippocampus in healthy Chinese on MRI in this study. No age and gender effects were found on hippocampal volumes. Side-to-side asymmetry was obtained by statistical analysis.

A historical overview of magnetic resonance imaging, focusing on technological innovations

Magnetic resonance imaging (MRI) has now been used clinically for more than 30 years. Today, MRI serves as the primary diagnostic modality for many clinical problems. In this article, historical developments in the field of MRI will be discussed with a focus on technological innovations. Topics include the initial discoveries in nuclear magnetic resonance that allowed for the advent of MRI as well as the development of whole-body, high field strength, and open MRI systems. Dedicated imaging coils, basic pulse sequences, contrast-enhanced, and functional imaging techniques will also be discussed in a historical context. This article describes important technological innovations in the field of MRI, together with their clinical applicability today, providing critical insights into future developments.

Improved slice-selective adiabatic excitation

PURPOSE

The purpose of this work is to design an improved Slice-selective Tunable-flip AdiaBatic Low peak-power Excitation (STABLE) pulse with shorter duration and increased off-resonance immunity to make it suitable for use in a greater range of applications and at higher field strengths. An additional aim is to design a variant of this pulse to achieve B1 -insensitive, fat-suppressed excitation.

METHODS

The adiabatic SLR algorithm was used to generate a more uniform spectral pulse envelope for this improved radiofrequency pulse for adiabatic slice-selective excitation, called STABLE-2. Pulse parameters were adjusted to design a version of STABLE-2 with a spectral null centered on lipids.

RESULTS

In vivo images obtained of the human brain at 3 and 7 T demonstrate that STABLE-2 provides robust, uniform, slice-selective excitation over a range of B1 values. Phantom and in vivo knee images obtained at 3 T demonstrate the effectiveness of STABLE-2 for fat suppression.

CONCLUSIONS

STABLE-2 achieves B1 -insensitive slice-selective excitation while providing greater off-resonance immunity and a shorter pulse duration, when compared to the original STABLE pulse. In particular, the 9.8-ms STABLE-2 pulse provides slice selectivity over 120 Hz whereas the 21-ms STABLE pulse is limited to 80 Hz off-resonance. B1 -Insensitive fat-suppressed excitation may also be achieved by using a variant of this pulse.

Magnetic resonance imaging of the brain in children with headache: the clinical relevance with modern acquisition techniques

The aim of this study was to evaluate the frequency of abnormal findings in magnetic resonance imaging (MRI) in children with headache, the clinical relevance of these findings, and whether more sophisticated technologies also result in more relevant abnormal findings. The MRIs of 1004 children with age ranging from 1 to 17 years were retrospectively analyzed. Children who were investigated with established sequences (n = 419) were compared with those examined with state-of-the-art MRI acquisition technology (n = 585). In 216/1004 investigations, MRI was performed because of headache (74/216 with established sequences, 142/216 with state-of-the-art acquisition technology). In 114/216 (52.8%) patients with headache, the MRI was abnormal with relevant findings in 23/114 patients and findings without clinical relevance in 91/114 children. A higher incidence of abnormal findings than in previous reports was found but there was only limited clinical gain of information using modern sequences in children with headache.

Predicting and monitoring cancer treatment response with diffusion-weighted MRI

An imaging biomarker that would provide for an early quantitative metric of clinical treatment response in cancer patients would provide for a paradigm shift in cancer care. Currently, nonimage based clinical outcome metrics include morphology, clinical, and laboratory parameters, however, these are obtained relatively late following treatment. Diffusion-weighted MRI (DW-MRI) holds promise for use as a cancer treatment response biomarker as it is sensitive to macromolecular and microstructural changes which can occur at the cellular level earlier than anatomical changes during therapy. Studies have shown that successful treatment of many tumor types can be detected using DW-MRI as an early increase in the apparent diffusion coefficient (ADC) values. Additionally, low pretreatment ADC values of various tumors are often predictive of better outcome. These capabilities, once validated, could provide for an important opportunity to individualize therapy thereby minimizing unnecessary systemic toxicity associated with ineffective therapies with the additional advantage of improving overall patient health care and associated costs. In this report, we provide a brief technical overview of DW-MRI acquisition protocols, quantitative image analysis approaches and review studies which have implemented DW-MRI for the purpose of early prediction of cancer treatment response.

Effectiveness of the STIR turbo spin-echo sequence MR imaging in evaluation of lymphadenopathy in esophageal cancer

PURPOSE

We have investigated the utility of the STIR TSE sequence in the differentiation of benign from malignant mediastinal lymph nodes in patients with esophageal cancer.

PATIENTS AND METHODS

This study included 35 consecutive patients who were diagnosed as esophageal cancer and were undergone surgery. STIR TSE sequences were obtained as the ECG trigger. The signal intensity of the benign and malign lymph nodes, normal esophagus, and pathologic esophagus can be calculated on STIR sequence.

RESULTS

Pathologically, the number of total lymph nodes in 35 operated cases was 482. Approximately 152 lymph nodes were detected with MR imaging. Of these, 28 were thought to be malignant, and 124 were thought to be benign, although 32 were malignant and 120 were benign according pathological results. The ratio of benign lymph node intensity value to normal esophagus intensity value was 0.73±0.3. The ratio of malignant lymph node intensity value to normal esophagus intensity value ratio was 2.03±0.4. According to these results, the sensitivity of MR was 81.3%, the specificity was 98.3%.

CONCLUSION

We think that if motionless images can be obtained with MRI, we may be able to differentiate benign lymph nodes from malignant ones.

Singular extremals for the time-optimal control of dissipative spin 1/2 particles

We consider the time-optimal control by magnetic fields of a spin 1/2 particle in a dissipative environment. This system is used as an illustrative example to show the role of singular extremals in the control of quantum systems. We analyze a simple case where the control law is explicitly determined. We experimentally implement the optimal control using techniques of nuclear magnetic resonance. To our knowledge, this is the first experimental demonstration of singular extremals in quantum systems with bounded control amplitudes.

Fat suppression for 1H MRSI at 7T using spectrally selective adiabatic inversion recovery

Proton magnetic resonance spectroscopic imaging ((1)H MRSI) at 7T offers many advantages, including increased SNR and spectral resolution. However, technical difficulties associated with operating at high fields, such as increased B(1) and B(0) inhomogeneity, severe chemical shift localization error, and converging T(1) values, make the suppression of the broad lipid peaks which can obscure targeted metabolite signals, particularly challenging. Conventional short tau inversion recovery can successfully suppress fat without restricting the selected volume, but only with significant metabolite signal loss. In this work, we have designed two new pulses for frequency-selective inversion recovery that achieve B(1)-insensitive fat suppression without degrading the signal from the major metabolites of interest. The first is a spectrally selective adiabatic pulse to be used in a volumetric (1)H MRSI sequence and the second is a spatial-spectral adiabatic pulse geared toward multi-slice (1)H MRSI. Partial interior volume selection may be used in addition to the pulses, to exclude areas with severe B(0) inhomogeneity. Some differences in the spectral profile as well as degree of suppression make each pulse valuable for different applications. 7T phantom and in vivo data show that both pulses significantly suppress fat, while leaving most of the metabolite signal intact.

Rapid phase-modulated water excitation steady-state free precession for fat suppressed cine cardiovascular MR

BACKGROUND

The purpose of this article is to describe a steady-state free precession (SSFP) sequence for fat suppressed cine cardiovascular magnetic resonance (CMR). A rapid phase-modulated binomial water excitation (WE) pulse is utilized to minimize repetition time and acquisition time.

METHODS

Three different water-excitation pulses were combined with cine-SSFP for evaluation. The frequency response of each sequence was simulated and examined in phantom imaging studies. The ratio of fat to water signal amplitude was measured in phantoms to evaluate the fat suppression capabilities of each method. Six volunteers underwent CMR of the heart at 1.5T to compare retrospectively-gated cine-SSFP with and without water excitation. The ratio of fat to myocardium signal amplitude was measured for conventional cine-SSFP and phase-modulated WE-SSFP. The proposed WE-SSFP method was tested in one patient referred for CMR to characterize a cardiac mass.

RESULTS AND DISCUSSION

The measured frequency response in a phantom corresponded to the numerical Bloch equation simulation demonstrating the widened stop-band around the fat resonant frequency for all water-excitation pulses tested. In vivo measurements demonstrated that a rapid, phase-modulated water excitation pulse significantly reduced the signal amplitude ratio of fat to myocardium from 6.92 +/- 2.9 to 0.8 +/- 0.13 (mean +/- SD) without inducing any perceptible artifacts in SSFP cine CMR.

CONCLUSION

Fat suppression can be achieved in SSFP cine CMR while maintaining steady-state equilibrium using rapid, phase modulated, binomial water-excitation pulses.

Intracranial incidental findings on brain MR images in a pediatric neurology practice: a retrospective study

BACKGROUND AND PURPOSE

Previous studies have addressed the prevalence of incidental findings largely in healthy adult and pediatric populations. Our study aims to elucidate the prevalence of incidental findings in a pediatric neurology practice.

METHODS

We reviewed the charts of 1618 patients seen at a pediatric neurology practice at a tertiary care center from September 2003 to December 2005 for clinical data and incidental intracranial findings on brain magnetic resonance imaging reports. Incidental findings were divided into two categories: normal or abnormal variants. Clinical and demographic data were assessed for associations with incidental findings.

RESULTS

From 1618 charts reviewed, only 666 patients (41% of all patients) had brain MRIs ordered. One-hundred and seventy-one (171) patients (25.7% of all patients; 95% CI: 22.6, 29.0) had incidental findings. Of these, 113 (17.0%; 95% CI: 14.1, 19.8) were classified as normal-variants and 58 (8.7%; 95% CI: 6.6, 10.9) were classified as abnormal. The nature of incidental findings was not related to age group, sex or clinical diagnosis (p=0.29, p=0.31 and p=0.69 respectively). Two patients (0.3%; 95% CI: approximately 0.0, 0.7) required neurosurgical referral.

CONCLUSIONS

We report a high prevalence of and a low rate of referrals for incidental findings in comparison to previous studies. The present study may help guide management decisions and discussions with patients and families. Future studies should attempt to address issues of associations between primary or secondary diagnoses and intracranial incidental findings in a controlled, prospective fashion.

Enhancement of brain tumors in 0.23-T low-field MRI: comparison of edema attenuated inversion recovery (EDAIR) sequences with T1-weighted sequence

RATIONALE AND OBJECTIVES

The aim of this study is to explore whether edema attenuated inversion recovery (EDAIR) sequences could be used to improve tumor contrast in contrast-enhanced low-field 0.23-Tesla magnetic resonance imaging (MRI) using 0.1 mmol/kg of gadolinium-based contrast agent.

MATERIALS AND METHODS

Ten patients with brain tumors were examined by using the following contrast-enhanced sequences: T1-weighted spin echo, EDAIR with inversion time (TI) of 600 milliseconds, and EDAIR with TI of 800 milliseconds. Images were assessed both quantitatively and qualitatively.

RESULTS

Results suggest that tumor contrast enhancement in low-field MRI can be improved without increasing contrast agent dose. EDAIR 600 appears to be optimal in most cases.

CONCLUSIONS

This inversion recovery sequence could be applicable as an additional sequence in the imaging of metastases in low-field MRI, as well as imaging of any other enhancing brain tumors or lesions in low-field MRI.

Cerebral edema attenuated inversion recovery MR sequence in low magnetic field: a feasibility study

RATIONALE AND OBJECTIVES

Minimally invasive neurosurgery requires methods to specify surgical boundaries of target tissue, such as brain tumors. This study investigated technical possibilities and clinical usefulness of adapting edema attenuated inversion recovery (EDAIR) pulse sequences to suppress magnetic resonance signal from cerebral edema in brain tumor patients.

MATERIALS AND METHODS

A resistive 0.23-T magnetic resonance scanner with magnitude-encoded inversion recovery sequences was used. Twenty-eight separate scanning tests in 25 neurosurgical brain tumor patients were performed on the day before surgery. An inversion recovery sequence with several inversion times between 150 and 2,200 ms was tested. The same sequences were also used intraoperatively and postoperatively.

RESULTS

T(1) relaxation time of brain edema varied from case to case. An inversion recovery sequence with an inversion time of 400-800 milliseconds attenuated brain edema and seemed to help in demarcating gross brain tumor for surgical resection. These features were helpful for the evaluation of resectable tumor tissue particularly using neuronavigation techniques.

CONCLUSIONS

According to these preliminary findings, inversion recovery sequences supplement other imaging modalities and assist neurosurgeons in evaluating different surgical trajectories and in estimating brain tumor volume before craniotomy.

39K nuclear magnetic resonance and a mathematical model of K+ transport in human erythrocytes

(39)K nuclear magnetic resonance was used to measure the efflux of K(+) from suspensions of human erythrocytes [red blood cells (RBCs)], that occurred in response to the calcium ionophore, A23187 and calcium ions; the latter activate the Gárdos channel. Signals from the intra- and extracellular populations of (39)K(+) were selected on the basis of their longitudinal relaxation times, T (1), by using an inversion- recovery pulse sequence with the mixing time, tau(1), chosen to null one or other of the signals. Changes in RBC volume consequent upon efflux of the ions also changed the T (1) values so a new theory was implemented to obviate a potential artefact in the data analysis. The velocity of the K(+) efflux mediated by the Gárdos channel was 1.19+/-0.40 mmol (L RBC)(-1) min(-1) at 37 degrees C.

MR-based in vivo hippocampal volumetrics: 1. Review of methodologies currently employed

The advance of neuroimaging techniques has resulted in a burgeoning of studies reporting abnormalities in brain structure and function in a number of neuropsychiatric disorders. Measurement of hippocampal volume has developed as a useful tool in the study of neuropsychiatric disorders. We reviewed the literature and selected all English-language, human subject, data-driven papers on hippocampal volumetry, yielding a database of 423 records. From this database, the methodology of all original manual tracing protocols were studied. These protocols differed in a number of important factors for accurate hippocampal volume determination including magnetic field strength, the number of slices assessed and the thickness of slices, hippocampal orientation correction, volumetric correction, software used, inter-rater reliability, and anatomical boundaries of the hippocampus. The findings are discussed in relation to optimizing determination of hippocampal volume.

A fast FLAIR dual-echo technique for hippocampal T2 relaxometry: first experiences in patients with temporal lobe epilepsy

To evaluate the use of cerebrospinal fluid (CSF) signal nulling in MR T2 measurements of the hippocampus in normal control subjects and patients with temporal lobe epilepsy (TLE), dual-echo acquisitions covering the whole brain were used. T2 relaxation times were estimated in 12 standard Eurospin II MR test objects and in the hippocampi of 10 control subjects, using T2 maps constructed from conventional spin-echo (CSE), fast spin-echo (FSE), and fast FLAIR (FF) dual-echo sequences on a 1.5-T MR scanner. Hippocampal T2 values (HCT2) were measured on contiguous coronal 5-mm slices throughout the antero-posterior extent of each hippocampus in the 10 controls and 12 TLE patients, using both CSE and FF. Scan-rescan reproducibility in Eurospin II standard MR test objects was high for all sequences. There was a good correlation between T2 values from CSE, FF, and FSE sequences in test objects and in control hippocampi. In controls, the coefficient of variation of mean HCT2 values differed between slice positions, but was lowest for FF, followed by CSE data. The intrarater coefficient of reliability between repeated measurements in control subjects was lowest for FF HCT2, at 2.3%. The interrater coefficient of reliability for CSE HCT2 measurements in controls (4.8%) was slightly lower than the interrater coefficient for FF HCT2 (5.4%). HCT2 measurement with both CSE and FF identified abnormal values in the same 10 hippocampi of 12 patients. Hippocampal dual-echo T2 relaxometry using CSF nulling is reliable in control subjects, and identifies the abnormal hippocampi in patients with TLE. The increases in hippocampal T2 signal demonstrated using FF HCT2 measurements are unlikely to be partial volume effects from CSF.

3D interleaved water and fat image acquisition with chemical-shift correction

A new technique, 3D interleaved water and fat image acquisition with chemical-shift correction (3-DIWFAC), was developed to acquire 3D water and fat images in a single acquisition time and to combine the water and fat images to produce chemical-shift-free images. A 3D gradient-recalled-echo (GRE) sequence was implemented with a 1-3-3-1 binomial Shinnar-Le Roux spatial-spectral excitation, and with interleaved phase-encoding lines that alternate between water and fat excitations separated by half TR. Water-only and fat-only images were then realigned to remove chemical shift artifacts. Results from phantoms and human subjects demonstrated that the image contrast was the same as in the regular GRE sequence. With the chemical shift corrected, the shadow artifacts often seen at water and fat boundaries were removed. Since this sequence simultaneously provides water-only images showing cartilage and bone lesions, and water-fat images that depict soft tissue anatomy, it may be clinically useful in musculoskeletal imaging. Magn Reson Med 44:322-330, 2000.

Turbo STIR magnetic resonance imaging as a whole-body screening tool for metastases in patients with breast carcinoma: preliminary clinical experience

This study was undertaken to assess the utility of whole-body turbo short tau inversion recovery (STIR) magnetic resonance imaging (MRI) to detect metastases to liver, brain, and bone as a single examination in women with breast cancer. Seventeen patients with biopsy-proven breast cancer and suspected metastatic disease attending over a 12-month period referred for both conventional imaging and whole-body MRI were included in the study. Three patients were found to be free of metastases at both conventional and MR imaging. Appendicular or axial skeletal metastases were identified in 11 of 17 patients, with correlation between findings at whole-body MRI and scintigraphy in 15 of the 17 patients. Five patients had evidence of hepatic metastases on whole-body MRI, of which metastases were identified in only three patients at CT despite contrast enhancement. Four patients had brain abnormalities (metastases in three patients, meningioma in one patient) detected on both whole-body and dedicated brain MRI. Preliminary clinical experience suggests that turbo STIR whole-body MRI may represent a convenient and cost-effective method of total body screening for metastases in patients with breast carcinoma.