Delayed reduction of tissue water diffusion after myocardial ischemia

On the Origins of Diffusion MRI Signal Changes in Stroke

Magnetic resonance imaging (MRI) is a leading diagnostic technique especially for neurological studies. However, the physical origin of the hyperintense signal seen in MR images of stroke immediately after ischemic onset in the brain has been a matter of debate since it was first demonstrated in 1990. In this article, we hypothesize and provide evidence that changes in the glial cells, comprising roughly one-half of the brain's cells and therefore a significant share of its volume, accompanying ischemia, are the root cause of the MRI signal change. Indeed, a primary function of the glial cells is osmoregulation in order to maintain homeostasis in the neurons and nerve fibers for accurate and consistent function. This realization also impacts our understanding of signal changes in other tissues following ischemia. We anticipate that this paradigm shift will facilitate new and improved models of MRI signals in tissues, which will, in turn, impact clinical utility.

Comparison of diffusion tensor imaging by cardiovascular magnetic resonance and gadolinium enhanced 3D image intensity approaches to investigation of structural anisotropy in explanted rat hearts

BACKGROUND

Cardiovascular magnetic resonance (CMR) can through the two methods 3D FLASH and diffusion tensor imaging (DTI) give complementary information on the local orientations of cardiomyocytes and their laminar arrays.

METHODS

Eight explanted rat hearts were perfused with Gd-DTPA contrast agent and fixative and imaged in a 9.4T magnet by two types of acquisition: 3D fast low angle shot (FLASH) imaging, voxels 50 × 50 × 50 μm, and 3D spin echo DTI with monopolar diffusion gradients of 3.6 ms duration at 11.5 ms separation, voxels 200 × 200 × 200 μm. The sensitivity of each approach to imaging parameters was explored.

RESULTS

The FLASH data showed laminar alignments of voxels with high signal, in keeping with the presumed predominance of contrast in the interstices between sheetlets. It was analysed, using structure-tensor (ST) analysis, to determine the most (v1(ST)), intermediate (v2(ST)) and least (v3(ST)) extended orthogonal directions of signal continuity. The DTI data was analysed to determine the most (e1(DTI)), intermediate (e2(DTI)) and least (e3(DTI)) orthogonal eigenvectors of extent of diffusion. The correspondence between the FLASH and DTI methods was measured and appraised. The most extended direction of FLASH signal (v1(ST)) agreed well with that of diffusion (e1(DTI)) throughout the left ventricle (representative discrepancy in the septum of 13.3 ± 6.7°: median ± absolute deviation) and both were in keeping with the expected local orientations of the long-axis of cardiomyocytes. However, the orientation of the least directions of FLASH signal continuity (v3(ST)) and diffusion (e3(ST)) showed greater discrepancies of up to 27.9 ± 17.4°. Both FLASH (v3(ST)) and DTI (e3(DTI)) where compared to directly measured laminar arrays in the FLASH images. For FLASH the discrepancy between the structure-tensor calculated v3(ST) and the directly measured FLASH laminar array normal was of 9 ± 7° for the lateral wall and 7 ± 9° for the septum (median ± inter quartile range), and for DTI the discrepancy between the calculated v3(DTI) and the directly measured FLASH laminar array normal was 22 ± 14° and 61 ± 53.4°. DTI was relatively insensitive to the number of diffusion directions and to time up to 72 hours post fixation, but was moderately affected by b-value (which was scaled by modifying diffusion gradient pulse strength with fixed gradient pulse separation). Optimal DTI parameters were b = 1000 mm/s(2) and 12 diffusion directions. FLASH acquisitions were relatively insensitive to the image processing parameters explored.

CONCLUSIONS

We show that ST analysis of FLASH is a useful and accurate tool in the measurement of cardiac microstructure. While both FLASH and the DTI approaches appear promising for mapping of the alignments of myocytes throughout myocardium, marked discrepancies between the cross myocyte anisotropies deduced from each method call for consideration of their respective limitations.

Model-based reconstruction of undersampled diffusion tensor k-space data

The practical utility of diffusion tensor imaging, especially for 3D high-resolution spin warp experiments of ex vivo specimens, has been hampered by long acquisition times. To accelerate the acquisition, a compressed sensing framework that uses a model-based formulation to reconstruct diffusion tensor fields from undersampled k-space data was presented and evaluated. Accuracies in brain specimen white matter fiber orientation, fractional anisotropy, and mean diffusivity mapping were compared with alternative methods achievable using the same scan time via reduced image resolution, fewer diffusion encoding directions, standard compressed sensing, or asymmetrical sampling reconstruction. The efficiency of the proposed approach was also compared with fully sampled cases across a range of the number of diffusion encoding directions. In general, the proposed approach was found to reduce the image blurring and noise and to provide more accurate fiber orientation, fractional anisotropy, and mean diffusivity measurements compared with the alternative methods. Moreover, depending on the degree of undersampling used and the diffusion tensor imaging parameter examined, the measurement accuracy of the proposed scheme was equivalent to fully sampled diffusion tensor imaging datasets that consist of 33-67% more encoding directions and require proportionally longer scan times. The findings show model-based compressed sensing to be promising for improving the resolution, accuracy, or scan time of diffusion tensor imaging.

Diffusion imaging of the in vivo heart using spin echoes--considerations on bulk motion sensitivity

Cardiac diffusion MRI based on stimulated-echo acquisition mode (STEAM) techniques is hampered by its inherent low signal-to-noise ratio (SNR) efficiency. Diffusion imaging using standard spin-echo (SE) techniques, on the other hand, offers higher SNRs but has been considered impractical for the beating heart due to excessive signal attenuation from cardiac bulk motion. In this work the effect of systolic cardiac motion on different diffusion-encoding schemes was studied in detail. Numerical simulations based on in vivo motion data (acquired by MRI tagging techniques) demonstrate an up to 10-fold decrease in bulk motion sensitivity of the diffusion encoding if the first-order moment of the diffusion-encoding gradients is nullified. It is shown that the remaining systolic phase pattern on the myocardium does not influence the magnitude images if the spatial resolution is chosen to be higher than 4 mm. Given these relatively low resolution requirements, we obtained in vivo diffusion-weighted (DW) short-axis images from four healthy volunteers using an SE-based diffusion-encoding sequence with excitation and refocusing in orthogonal planes for field of view (FOV) reduction. The results showed no significant signal loss due to cardiac motion, and the direction of the principal eigenvalues was found to be in good agreement with known myocardial fiber orientation.

Acute myocardial infarction: tissue characterization with T1rho-weighted MR imaging--initial experience

Acute myocardial injury was evaluated in 21 patients by using a contrast material-enhanced T1rho-weighted cine turbo field-echo magnetic resonance (MR) imaging sequence and a delayed-enhancement sequence. In 12 of 21 patients, conventional T1-weighted contrast-enhanced cine turbo field-echo MR images were also collected for direct comparison with T1rho-weighted images. Delayed-enhancement technique distinctly characterized irreversible injury (percentage enhancement, 588% +/- 344). With T1rho weighting, percentage enhancement of irreversibly injured myocardium was 68% +/- 41, compared with 23% +/- 24 without T1rho weighting (P <.006). The addition of T1rho weighting to contrast-enhanced cine turbo field-echo MR sequences may offer a new contrast enhancement mechanism for characterization of acutely infarcted myocardium.

Remodeling of cardiac fiber structure after infarction in rats quantified with diffusion tensor MRI

Structural remodeling of myocardium after infarction plays a critical role in functional adaptation. Diffusion tensor magnetic resonance imaging (DTMRI) provides a means for rapid and nondestructive characterization of the three-dimensional fiber architecture of cardiac tissues. In this study, microscopic structural changes caused by MI were evaluated in Fischer 344 rats 4 wk after infarct surgery. DTMRI studies were performed on 15 excised, formalin-fixed rat hearts of both infarct (left anterior descending coronary artery occlusion, n = 8) and control (sham, n = 7) rats. Infarct myocardium exhibited increased water diffusivity (41% increase in trace values) and decreased diffusion anisotropy (37% decrease in relative anisotropy index). The reduced diffusion anisotropy correlated negatively with microscopic fiber disarray determined by histological analysis (R = 0.81). Transmural courses of fiber orientation angles in infarct zones were similar to those of normal myocardium. However, regional angular deviation of the diffusion tensor increased significantly in the infarct myocardium and correlated strongly with microscopic fiber disarray (R = 0.86). These results suggest that DTMRI may provide a valuable tool for defining structural remodeling in diseased myocardium at the cellular and tissue level.

MR imaging measurement of compartmental water diffusion in perfused heart slices

Myocardial tissue slices were isolated from the left ventricular free wall (7 slices) and left ventricular papillary muscle (3 slices) of New Zealand White male rabbits (n = 4) and were subsequently superfused with a modified St. Thomas' Hospital cardioplegic solution at 19 degrees C. The diffusion-weighted images were obtained with a 600-MHz nuclear magnetic resonance spectrometer using diffusion gradient b-values that ranged from 166 to 6,408 s/mm(2); the apparent diffusion coefficient of water in the tissues were subsequently calculated. All of the tissue samples that were studied exhibited nonmonoexponential diffusion. Data from seven slices were mathematically fitted by a biexponential expression with a fast diffusion component of 0.72 +/- 0.07 x 10(-3) mm(2)/s, and a slow diffusion component of 0.060 +/- 0.033 x 10(-3) mm(2)/s. The fast component dominated the calculated apparent diffusion coefficient of the tissue, composed of 82 +/- 3% of the overall diffusion-dependent signal decay. Thus myocardial tissue exhibits characteristics consistent with multiple compartments of diffusion. This work has important implications for myocardial diffusion tensor imaging, as well as the changes in diffusion that have been reported following myocardial ischemia.