Cross-modality and in-vivo validation of 4D flow MRI evaluation of uterine artery blood flow in human pregnancy

OBJECTIVES

Clinical assessment of uterine artery (UtA) hemodynamics is currently limited to Doppler ultrasound (US) velocimetry. We have demonstrated previously the feasibility of applying four-dimensional (4D) flow magnetic resonance imaging (MRI) to evaluate UtA hemodynamics during pregnancy, allowing flow quantification of the entire course of the vessel. In this study, we sought to further validate the physiological relevance of 4D flow MRI measurement of UtA blood flow by exploring its association with pregnancy outcome relative to US-based metrics.

METHODS

Recruited into this prospective, cross-sectional study were 87 women with a singleton pregnancy who underwent 4D flow MRI between May 2016 and April 2019 to measure the UtA pulsatility index (MRI-PI) and blood flow rate (MRI-flow, in mL/min). UtA-PI was also measured using US (US-PI). The primary outcome was a composite (COMP) of pre-eclampsia (PE) and/or small-for-gestational-age (SGA) neonate, and secondary outcomes were PE and SGA neonate individually. We assessed the ability of MRI-flow, MRI-PI and US-PI to distinguish between outcomes, and evaluated whether MRI-flow changed as gestation progressed.

RESULTS

Following 4D flow postprocessing and exclusions from the analysis, 74 women had 4D flow MRI data analyzed for both UtAs. Of these, 18 developed a COMP outcome: three developed PE only, 11 had a SGA neonate only and four had both. A comparison of the COMP group vs the no-COMP group found no differences in maternal age, body mass index, nulliparity, gravidity or race. For 66 of the 74 subjects, US data were also available. In these subjects, both median MRI-PI (0.95 vs 0.70; P < 0.01) and median US-PI (0.95 vs 0.73; P < 0.01) were significantly increased in subjects in the COMP group compared with those in the no-COMP group. The UtA blood-flow rate, as measured by MRI, did not increase significantly from the second to the third trimester (median flow (interquartile range (IQR)), 543 (419-698) vs 575 (440-746) mL/min; P = 0.77), but it was significantly lower overall in the COMP compared with the no-COMP group (median flow (IQR), 486 (366-598) vs 624 (457-749) mL/min; P = 0.04). The areas under the receiver-operating-characteristics curves for MRI-flow, MRI-PI and US-PI in predicting COMP were not significantly different (0.694, 0.737 and 0.731, respectively; P = 0.87).

CONCLUSIONS

4D flow MRI can yield physiological measures of UtA blood-flow rate and PI that are associated with adverse pregnancy outcome. This may open up new avenues in the future to expand the potential of this technique as a robust tool with which to evaluate UtA hemodynamics in pregnancy. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Vertebral deformities and fractures are associated with MRI and pQCT measures obtained at the distal tibia and radius of postmenopausal women

SUMMARY

We investigated the association of postmenopausal vertebral deformities and fractures with bone parameters derived from distal extremities using MRI and pQCT. Distal extremity measures showed variable degrees of association with vertebral deformities and fractures, highlighting the systemic nature of postmenopausal bone loss.

INTRODUCTION

Prevalent vertebral deformities and fractures are known to predict incident further fractures. However, the association of distal extremity measures and vertebral deformities in postmenopausal women has not been fully established.

METHODS

This study involved 98 postmenopausal women (age range 60-88 years, mean 70 years) with DXA BMD T-scores at either the hip or spine in the range of -1.5 to -3.5. Wedge, biconcavity, and crush deformities were computed on the basis of spine MRI. Vertebral fractures were assessed using Eastell's criterion. Distal tibia and radius stiffness was computed using MRI-based finite element analysis. BMD at the distal extremities were obtained using pQCT.

RESULTS

Several distal extremity MRI and pQCT measures showed negative association with vertebral deformity on the basis of single parameter correlation (r up to 0.67) and two-parameter regression (r up to 0.76) models involving MRI stiffness and pQCT BMD. Subjects who had at least one prevalent vertebral fracture showed decreased MRI stiffness (up to 17.9 %) and pQCT density (up to 34.2 %) at the distal extremities compared to the non-fracture group. DXA lumbar spine BMD T-score was not associated with vertebral deformities.

CONCLUSIONS

The association between vertebral deformities and distal extremity measures supports the notion of postmenopausal osteoporosis as a systemic phenomenon.

Spin-echo micro-MRI of trabecular bone using improved 3D fast large-angle spin-echo (FLASE)

Fast large-angle spin echo (FLASE) is a common pulse sequence designed for quantitative imaging of trabecular bone (TB) microarchitecture. However, imperfections in the nonselective phase-reversal pulse render it prone to stimulated echo artifacts. The problem is further exacerbated at isotropic resolution. Here, a substantially improved RF-spoiled FLASE sequence (sp-FLASE) is described and its performance is illustrated with data at 1.5T and 3T. Additional enhancements include navigator echoes for translational motion sensing applied in a slice parallel to the imaging slab. Whereas recent work suggests the use of fully-balanced FLASE (b-FLASE) to be advantageous from a signal-to-noise ratio (SNR) point of view, evidence is provided here that the greater robustness of sp-FLASE may outweigh the benefits of the minor SNR gain of b-FLASE for the target application of TB imaging in the distal extremities, sites of exclusively fatty marrow. Results are supported by a theoretical Bloch equation analysis and the pulse sequence dependence of the effective T(2) of triglyceride protons. Last, sp-FLASE images are shown to provide detailed and reproducible visual depiction of trabecular networks in three dimensions at both anisotropic (137 x 137 x 410 microm(3)) and isotropic (160 x 160 x 160 microm(3)) resolutions in the human distal tibia in vivo.

Construction and calibration of a 50 T/m z-gradient coil for quantitative diffusion microimaging

q-Space imaging is capable of providing quantitative geometrical information of structures at cellular resolution. However, the size of restrictions that can be probed hinges on available gradient amplitude and places very high demands on gradient performance. In this work we describe the design and construction of a small, high-amplitude (50 T/m) z-gradient coil, interfaced with a commercial 9.4 T microimaging system. We also describe a method to calibrate the coil for quantitative measurements of molecular diffusion at very high-gradient amplitudes. Calibration showed linear current response up to 50 T/m, with a gain=1.255 T/m/A. The z-gradient coil was combined with the commercial x- and y-gradients for tri-axial imaging, and its performance was demonstrated by ADC maps of free water and by q-space experiments on water sequestered around polystyrene microspheres (4.5 microm diameter), which showed the expected diffraction peak. In addition, diffusion-weighted images of a fixed mouse spinal cord illustrated the capability of this coil for quantitative imaging of tissue microstructure.

Measurement of phosphorus content in normal and osteomalacic rabbit bone by solid-state 3D radial imaging

In osteomalacia decreased mineralization reduces the stiffness and static strength of bone. We hypothesized that hypomineralization in osteomalacic bone could be quantified by solid-state (31)P magnetic resonance imaging (SS-MRI). Hypomineralization was measured with a 3D radial imaging technique at 162 MHz (9.4T) in rabbit cortical bone of hypophosphatemic (HY) and normophosphatemic (NO) animals. The results were compared with those obtained by quantitative micro-CT (micro-CT) and (31)P solution NMR. 3D images of 277 microm isotropic voxel size were obtained in 1.7 hr with SNR approximately 9. Mineral content was lower in the HY relative to the NO group (SS-MRI: 9.48 +/- 0.4 vs. 11.15 +/- 0.31 phosphorus wet wt %, P < 0.0001; micro-CT: 1114.6 +/- 28.3 vs. 1175.7 +/- 23.5 mg mineral/cm(3); P = 0.003). T(1) was shorter in the HY group (47.2 +/- 3.5 vs. 54.1 +/- 2.7 s, P = 0.004), which suggests that relaxation occurs via a dipole-dipole (DD) mechanism involving exchangeable water protons, which are more prevalent in bone from osteomalacic animals.

General algorithm for automated off-center MRI

A general formula was derived that automatically modifies any MRI pulse sequence to realize arbitrary field-of-view (FOV) shifts. Unlike conventional techniques for implementing off-center MRI, the new method is completely automatic and can therefore be incorporated into the scanner hardware or software, thereby simplifying the development of MRI pulse sequences. The algorithm was incorporated into a visual pulse sequence programming environment, and several pulse sequences were programmed and tested at various off-center locations using the new technique. Unless there is significant background field inhomogeneity or gradient nonlinearity, research sequences employing the automatic technique need only be programmed and tested at the gradient isocenter, whereas with conventional methods, artifacts can sometimes depend on the position of the FOV.

Structural MRI of carotid artery atherosclerotic lesion burden and characterization of hemispheric cerebral blood flow before and after carotid endarterectomy

Collateral circulation plays a major role in maintaining cerebral blood flow (CBF) in patients with internal carotid artery (ICA) stenosis. CBF can remain normal despite severe ICA stenosis, making the benefit of carotid endarterectomy (CEA) or stenting difficult to assess. Before and after surgery, we assessed CBF supplied through the ipsilateral (stenotic) or contralateral ICA individually with a novel hemisphere-selective arterial spin-labeling (ASL) perfusion MR technique. We further explored the relationship between CBF and ICA obstruction ratio (OR) acquired with a multislice black-blood imaging sequence. For patients with unilateral ICA stenosis (n = 19), conventional bilateral labeling did not reveal interhemispheric differences. With unilateral labeling, CBF in the middle cerebral artery (MCA) territory on the surgical side from the ipsilateral supply (53.7 +/- 3.3 ml/100 g/min) was lower than CBF in the contralateral MCA territory from the contralateral supply (58.5 +/- 2.7 ml/100 g/min), although not statistically significant (p = 0.09). The ipsilateral MCA territory received significant (p = 0.02) contralateral supply (7.0 +/- 2.7 ml/100 g/min), while ipsilateral supply to the contralateral side was not reciprocated. After surgery (n = 11), ipsilateral supply to the MCA territory increased from 57.3 +/- 5.7 to 67.3 +/- 5.4 ml/100 g/min (p = 0.03), and contralateral supply to the ipsilateral MCA territory decreased. The best predictor of increased CBF on the side of surgery was normalized presurgical ipsilateral supply (r(2) = 0.62, p = 0.004). OR was less predictive of change, although the change in normalized contralateral supply was negatively correlated with OR(excess) (=OR(ipsilateral) - OR(contralateral)) (r(2) = 0.58, p = 0.006). The results demonstrate the effect of carotid artery stenosis on blood supply to the cerebral hemispheres, as well as the relative role of collateral pathways before surgery and redistribution of blood flow through these pathways after surgery. Unilateral ASL may better predict hemodynamic surgical outcome (measured by improved perfusion) than ICA OR.

Fast Low-Angle Dual Spin-Echo (FLADE): A new robust pulse sequence for structural imaging of trabecular bone

Mechanical strength and fracture resistance of trabecular bone (TB) are largely determined by the structural arrangement of individual trabeculae. Fast 3D spin-echo approaches are preferable to gradient echoes in that they are less sensitive to local induced gradients at the bone/marrow interface caused by magnetic susceptibility difference between the two tissues. FLASE is a 3D pulse sequence that serves this purpose. Here, we present a new pulse sequence dubbed FLADE (fast low-angle dual spin-echo) that overcomes some of the limitations inherent to FLASE, such as sensitivity to artifactual stimulated echoes. The double-echo sequence features a flip angle <90 degrees allowing for TR << T(1). The second phase-reversal pulse has the dual function of creating a second echo and restoring inverted longitudinal magnetization. The prolonged TR, made possible by sampling only half of k(z)-space, is used to collect navigator echoes in adjacent slabs for sensing subpixel translational displacements. FLADE is shown to provide SNR comparable to FLASE while having narrower point-spread function and being more robust to imperfections in the nonselective 180 degree pulses. Structural parameters derived from the in vivo images with the two pulse sequences are highly correlated, therefore suggesting that clinical data obtained with either pulse sequence can be merged.

Reproducibility and error sources of micro-MRI-based trabecular bone structural parameters of the distal radius and tibia

The mechanical competence of trabecular bone is significantly determined, next to material density, by its three-dimensional (3D) structure. Recent advances in micromagnetic resonance imaging (micro-MRI) acquisition and processing techniques allow the 3D trabecular structure to be analyzed in vivo at peripheral sites such as the distal radius and tibia. The practicality of micro-MRI-based noninvasive virtual bone biopsy (VBB) for longitudinal studies of patients hinges on the reproducibility of the derived structural parameters, which largely determine the size of the effect that can be detected at a given power and significance level. In this paper, the reproducibility of micro-MRI-derived trabecular bone structure measures was examined by performing repeat studies in six healthy subjects in whom the distal aspects of the radius and tibia were scanned with a 3D spin-echo sequence at 137 x 137 x 410 microm3 voxel size. Bone volume fraction (BV/TV) and digital topological analysis (DTA) structural parameters including the topological bone surface-to-curve ratio (SCR) and topological erosion index (TEI) were evaluated after subjecting the raw images to a cascade of processing steps. The average coefficient of variation was 4-7% and was comparable for the two anatomic sites and for all parameters measured. The reliability expressed in terms of the intraclass correlation coefficient ranged from 0.95 to 0.97 in the radius and 0.68 to 0.92 in the tibia. Error analysis based on simulations suggests involuntary patient motion, primarily rotation, to be the chief source of imprecision, followed by failure to accurately match the analysis volumes in repeat studies.

Multipoint mapping for imaging of semi-solid materials

Multipoint k-space mapping is a hybrid between constant-time (single-point mapping) and spin-warp imaging, involving sampling of a k-line segment of r points per TR cycle. In this work the method was implemented for NMR imaging of semi-solid materials on a 400 MHz micro-imaging system and two different k-space sampling strategies were investigated to minimize the adverse effects from relaxation-induced k-space signal modulation. Signal attenuation from T(2) decay results in artifacts whose nature depends on the k-space sampling strategy. The artifacts can be minimized by increasing the readout gradient amplitude, by PSF deconvolution or by oversampling in readout direction. Finally, implementation of a T(2) selective RF excitation demonstrates the feasibility of obtaining short-T(2) contrast even in the presence of tissues with long-T(2). The method's potential is illustrated with 3D proton images of short-T(2) materials such as synthetic polymers and bone.

A noncontact, nondestructive method for quantifying intratissue deformations and strains

The function of soft connective tissues is frequently characterized by quantifying tissue strain (e.g., during joint motion). Conventional techniques for quantifying tendon and ligament strain typically provide surface measures, using markers, stain lines or instrumentation that may influence the tissue. An alternative approach is to quantify intratendinous strain by applying texture correlation analysis to magnetic resonance (MR) images. This paper reports the accuracy and reproducibility of this approach by (1) assessing the reproducibility of MR images, (2) assessing texture correlation accuracy using simulated displacements, and (3) comparing texture correlation measures of displacement and strain from MR images to conventional techniques.

Water magnetic relaxation dispersion in biological systems: the contribution of proton exchange and implications for the noninvasive detection of cartilage degradation

Magnetic relaxation has been used extensively to study and characterize biological tissues. In particular, spin-lattice relaxation in the rotating frame (T(1rho)) of water in protein solutions has been demonstrated to be sensitive to macromolecular weight and composition. However, the nature of the contribution from low frequency processes to water relaxation remains unclear. We have examined this problem by studying the water T(1rho) dispersion in peptide solutions ((14)N- and (15)N-labeled), glycosaminoglycan solutions, and samples of bovine articular cartilage before and after proteoglycan degradation. We find in model systems and tissue that hydrogen exchange from NH and OH groups to water dominates the low frequency water T(1rho) dispersion, in the context of the model used to interpret the relaxation data. Further, low frequency dispersion changes are correlated with loss of proteoglycan from the extra-cellular matrix of articular cartilage. This finding has significance for the noninvasive detection of matrix degradation.

Digital topological analysis of in vivo magnetic resonance microimages of trabecular bone reveals structural implications of osteoporosis

Osteoporosis is a disease characterized by bone volume loss and architectural deterioration. The majority of work aimed at evaluating the structural implications of the disease has been performed based on stereologic analysis of histomorphometric sections. Only recently noninvasive imaging methods have emerged that provide sufficient resolution to resolve individual trabeculae. In this article, we apply digital topological analysis (DTA) to magnetic resonance microimages (mu-MRI) of the radius obtained at 137 x 137 x 350 microm3 voxel size in a cohort of 79 women of widely varying bone mineral density (BMD) and vertebral deformity status. DTA is a new method that allows unambiguous determination of the three-dimensional (3D) topology of each voxel in a trabecular bone network. The analysis involves generation of a bone volume fraction map, which is subjected to subvoxel processing to alleviate partial volume blurring, followed by thresholding and skeletonization. The skeletonized images contain only surfaces, profiles, curves, and their mutual junctions as the remnants of trabecular plates and rods after skeletonization. DTA parameters were compared with integral BMD in the lumbar spine and femur as well as MR-derived bone volume fraction (BV/TV). Vertebral deformities were determined based on sagittal MRIs of the spine with a semiautomatic method and the number of deformities counted after threshold setting. DTA structural indices were found the strongest discriminators of subjects with deformities from those without deformities. Subjects with deformities (n = 29) had lower topological surface (SURF) density (p < 0.0005) and surface-to-curve ratio (SCR; a measure of the ratio of platelike to rodlike trabeculae; p < 0.0005) than those without. Profile interior (PI) density, a measure of intact trabecular rods, was also lower in the deformity group (p < 0.0001). These data provide the first in vivo evidence for the structural implications inherent in postmenopausal osteoporosis accompanying bone loss, that is, the conversion of trabecular plates to rods and disruption of rods due to repeated osteoclastic resorption.

Trabecular bone volume fraction mapping by low-resolution MRI

Trabecular bone volume fraction (TBVF) is highly associated with the mechanical competence of trabecular bone. TBVF is ordinarily measured by histomorphometry from bone biopsies or, noninvasively, by means of high-resolution microcomputed tomography and, more recently, by micro-MRI. The latter methods require spatial resolution sufficient to resolve trabeculae, along with segmentation techniques that allow unambiguous assignment of the signal to bone or bone marrow. In this article it is shown that TBVF can be measured under low-resolution conditions by exploiting the attenuation of the MR signal resulting from fractional occupancy of the imaging voxel by bone and bone marrow, provided that a reference signal is available from a marrow volume devoid of trabeculation. The method requires accurate measurement of apparent proton density, which entails correction for various sources of error. Key among these are the spatial nonuniformity in the RF field amplitude and effects of the slice profile, which are determined by B(1) field mapping and numerical integration of the Bloch equations, respectively. By contrast, errors from variations in bone marrow composition (hematopoietic vs. fatty) between trabecular and reference site are predicted to be small and usually negligible. The method was evaluated in phantoms and in vivo in the distal radius and found to be accurate to 1% in marrow volume fraction. Finally, in a group of 12 patients of varying skeletal status, TBVF in the calcaneus was found to strongly correlate with integral bone mineral density of the lumbar vertebrae (r(2) = 0.83, p < 0.0001). The method may fail in large imaging objects such as the human trunk at high magnetic field where standing wave and RF penetration effects cause intensity variations that cannot be corrected. Magn Reson Med 46:103-113, 2001.

Cross-sectional study of osteopenia with quantitative MR imaging and bone densitometry

PURPOSE

To evaluation the cancellous bone-induced intravoxel spin dephasing rate (R2') and its relationship to bone mineral density and marrow fat and to examine these parameters as predictors of vertebral fracture status.

MATERIALS AND METHODS

R2' and R2, the rate constants for reversible and irreversible spin dephasing, and marrow fat fraction were measured in the lumbar vertebrae and proximal femur. One hundred thirty-nine subjects (mean age, 62.4 years +/- 11.4 [SD]; 33 men, 106 women) had spinal dual-energy x-ray absorptiometric bone mineral density (BMD) T scores ranging from +3 to -5. R2', BMD, and bone marrow composition as determinants of vertebral fracture status were examined.

RESULTS

Strongest single predictors of fracture status for BMD and R2' were the Ward triangle (r(2) = 0.48) and trochanter (r(2) = 0.37), respectively. Combined, the two parameters and sites increased fracture prediction (r(2) = 0. 62), whereas the combination of multiple BMD sites did not. Multivariate regression involving marrow fat fraction further improved fracture status prediction. R2' was correlated with BMD at all sites, although slopes differed by a factor of up to 2.5, which reflected differences in trabecular orientation relative to the static field. R2, the true transverse relaxation rate, was negatively correlated with marrow fat fraction. A non-age-related increase in marrow fat fraction in osteoporosis parallels earlier findings in animal models.

CONCLUSION

Cancellous bone marrow R2' measured in the proximal femur provides information, which, with BMD, improves prediction of vertebral fracture status.

High-speed spectroscopic imaging for cancellous bone marrow R(2)* mapping and lipid quantification

In this work an interleaved multiple-gradient-echo chemical shift imaging (IMGE-CSI) technique was designed, implemented and evaluated at 1.5 and 4T for high-resolution lipid quantification and R(2)* measurement in-vivo. The method is analogous to echo planar CSI but utilizes conventional gradient echoes, exploiting the principle of spectroscopic bandwidth extension by interleaving temporally offset gradient-echo trains. It is shown that IMGE-CSI is able to measure true fat volume fraction in oil/water mixtures with high accuracy, not possible with Dixon-type methods which approximate the spectrum as consisting of only two spectral components. Correlation of the CSI- derived volume fractions with volumetry afforded r(2) > 0.99 with a slope of 0.98. The method is shown to be able to quantify regional variations in bone marrow composition in vivo with a spatial resolution of 2.5 x 2.5 x 5 mm(3.) R(2)* was obtained by multi-line spectral curve fitting. For the measurement of R(2)* in cancellous bone marrow the method is shown to agree well with time-domain fitting techniques but is superior in instances where the marrow has both hematopoietic and fatty constituents. Finally, excellent inter-scan reproducibility (1% coefficient of variation for global means and medians) was achieved, yielding r(2) = 0.98 of the test-retest correlation for three scans in four test subjects. In conclusion, IMGE-CSI is found to enable highly accurate lipid quantification and measurement of cancellous bone marrow R(2)* at spatial resolutions and scan times typical of standard clinical protocols.

Postprocessing technique to correct for background gradients in image-based R*(2) measurements

Background static magnetic field gradients are a source of signal loss in gradient-echo imaging, as they typically result from discontinuity in the magnetic susceptibility at air-tissue boundaries. Moreover, these induced gradients severely compromise the measurement of R*(2), the effective transverse relaxation rate, which is of interest in many biomedical applications of MRI. Since the slice thickness is usually larger than the in-plane pixel dimensions, gradients parallel to the slice-select direction are of particular concern. In this work, a post-processing technique is introduced which attempts to correct the signal on the assumption that the background gradients are approximately linear across the voxel and the signal decay in the absence of these gradients is exponential. In this case, the time-domain signal is weighted by a sinc function characterized by the amplitude G(b) of the background gradient, which is typically not known a priori. The algorithm searches for the estimate of G(b) which yields the optimum fit of the corrected experimental data to an exponential. It is shown to be effective as long as this gradient is below a critical threshold. Evaluation in a phantom and in the human brain at 1.5 and 4 T demonstrates that this method can restore R(2)* in spite of the apparent rate constant exceeding the true value by up to 100%. Contrary to prospective correction techniques, the approach presented in this study does not prolong scan time.

Topological analysis of trabecular bone MR images

Recently, imaging techniques have become available which permit nondestructive analysis of the three-dimensional (3-D) architecture of trabecular bone (TB), which forms a network of interconnected plates and rods. Most osteoporotic fractures occur at locations rich in TB, which has spurred the search for architectural parameters as determinants of bone strength. In this paper, we present a new approach to quantitative characterization of the 3-D microarchitecture of TB, based on digital topology. The method classifies each voxel of the 3-D structure based on the connectivity information of neighboring voxels. Following conversion of the 3-D digital image to a skeletonized surface representation containing only one-dimensional (1-D) and two-dimensional (2-D) structures, each voxel is classified as a curve, surface, or junction. The method has been validated by means of synthesized images and has subsequently been applied to TB images from the human wrist. The topological parameters were found to predict Young's modulus (YM) for uniaxial loading, specifically, the surface-to-curve ratio was found to be the single strongest predictor of YM (r2 = 0.69). Finally, the method has been applied to TB images from a group of patients showing very large variations in topological parameters that parallel much smaller changes in bone volume fraction (BVF).

In vivo MR micro imaging with conventional radiofrequency coils cooled to 77 degrees K

Cryogenically cooled conventional surface coils are shown to provide significant signal-to-noise ratio (SNR) gains for MR micro imaging of tissue structure in vivo. Measurements are described which employ a simple, all-polyvinyl chloride (PVC) vacuum dewar capable of maintaining a bath of liquid nitrogen around the coil, within 5 mm of the tissue to be imaged. Images acquired in vivo at 64 MHz with a 2-cm diameter copper coil cooled to 77 K demonstrated a gain in SNR of approximately 2.7 +/- 0.3 relative to those obtained with the same coil at room temperature under otherwise identical conditions. This increase is consistent with the reduction in coil resistance and the minor contribution to overall resistance from the imaging object. The performance of the coil is illustrated with images from the human finger and rabbit eye and potential applications are discussed.

Relationship between cancellous bone induced magnetic field and ultrastructure in a rat ovariectomy model

The site-dependent variations in trabecular bone morphology were studied in the rat tibia by magnitude and phase difference three-dimensional nuclear magnetic resonance microscopy and image processing, and the implications of ovariectomy were evaluated. Specimens excised from the proximal tibial metaphysis in ovariectomized (n = 7) and intact control (n = 4) rats were imaged at 9.4T with their anatomic axes parallel to the direction of the magnetic field. An echo-offset 3D rapid spin-echo excitation pulse sequence was used to generate phase difference maps, from which the standard deviation of the phase difference, sigma(delta psi), was calculated. In addition, a fictitious rate constant, R2', was calculated from the slope of the exponential portion of the Fourier transform of the phase difference histogram. Trabecular bone volume fraction was also determined in the same volume of interest. The results show strong correlations between bone volume fraction and both sigma(delta psi) and R2', suggesting that these parameters could be useful for nondestructive assessment of trabecular bone volume.

Experimental evaluation of a surface charge method for computing the induced magnetic field in trabecular bone

The magnetic field induced in the pores of trabecular bone as a result of the susceptibility difference between bone and bone marrow was computed with the aid of magnetic surface charge models generated from images of trabecular bone specimens acquired at 78 and 63 microm resolution. The predicted field was compared with the values derived from 2D and 3D field maps obtained by echo-offset imaging techniques and excellent agreement was found between the two methods. Finally, from the slopes of regression between the experimental and computed fields, the absolute susceptibility of bone was nondestructively determined as -11.0 x 10(-6) (MKS), which is in close agreement with a reported value of -11.3 x 10(-6) obtained with powdered bone by means of a spectroscopic susceptibility matching technique (J. A. Hopkins and F. W. Wehrli, Magn. Reson. Med. 37, 494-500 (1997)).

In vivo micro-imaging using alternating navigator echoes with applications to cancellous bone structural analysis

In micro-magnetic resonance imaging of cancellous bone architecture, involuntary subject motion even on a sub-millimeter scale is detrimental and generally precludes accurate quantification of architectural parameters. In this work a navigator-assisted three-dimensional spin-echo technique is described and evaluated for imaging at 137 microm resolution in humans. The method is based on gradient navigator echoes following the spin-echo readout for sensing translational displacements alternately in x- and y-directions with a spatial resolution of 273 microm and a temporal resolution of 0.2 sec. The technique is shown to improve micro-images of the distal forearm significantly and to enhance accuracy and reproducibility of bone volume fraction, transverse contiguity, and tubularity, parameters introduced in prior work to characterize the trabecular network. It is further shown that a fourfold reduction in navigator sampling time, along with zero-filling, improves the accuracy of the navigator correction while reducing the minimum pulse repetition time or gradient heating. The data indicate that navigator-assisted micro-imaging is capable of effectively correcting sub-millimeter displacements in micro-imaging.

Effect of prostaglandin and bisphosphonate on cancellous bone volume and structure in the ovariectomized rat studied by quantitative three-dimensional nuclear magnetic resonance microscopy

The purpose of this work was to evaluate the potential of nuclear magnetic resonance microscopy (NMRM) in conjunction with a processing technique to monitor the effect of preventive agents in an ovariectomized (OVX) rat. Twenty-five female Sprague-Dawley rats were OVX at 6 months of age (except for the intact control group), allowed to lose bone for 60 days, and then treated for 60 days. During treatment, animals were administered vehicle, prostaglandin E2 (PGE2; 6 mg/kg), or alendronate (3 microg/kg) subcutaneously once a day. Subsequently, tibiae were harvested and the marrow removed. NMRM was carried out at 9.4 T, with the specimens immersed in 1.2 mM diethylenetriaminepentaacetic acid-gadolinium salt (Gd-DTPA) aqueous solution. A three-dimensional (3D) partial flip-angle pulse sequence was used, providing a 1283 array of (46 microm)3 isotropic voxels. Fifty of the 128 axial images in the 3D data set comprising approximately 2.4 mm volume distal to the growth plate were processed from each specimen using a probability-based method for determining bone volume fraction (BVF), tubularity, contiguity, as well as the mean trabecular plate thickness and separation. PGE2 and alendronate altered BVF consistently at all tibial regions. The effect of alendronate was to keep BVF about midway between intact and OVX, whereas PGE2 returned BVF to intact levels. The other parameters showed similar responses to treatment. The strongest discriminator was trabecular BVF, which could obviously differentiate the groups. The study establishes NMRM as a nondestructive histomorphometric method for the quantitative evaluation of drug response in a rat ovariectomy model.

New architectural parameters derived from micro-MRI for the prediction of trabecular bone strength

This article reviews recent progress in magnetic resonance microimaging of cancellous bone in vitro and in vivo from the perspective of the authors' laboratory. It is shown that in particular in vivo the key technical prerequisites to satisfy are: (i) achieving sufficient signal-to-noise ratio (SNR) to allow for adequate spatial resolution; (ii) the image processing algorithms have to be robust enough to provide accurate structural information in the limited spatial resolution regime, i.e., in the presence of inevitable partial volume blurring and noise. The practical lower limit of voxel size in vivo was found to be about 6 x 10(-3) mm3 in the radius, and about 10(-4) mm3 for small specimens in vitro with state-of-the-art equipment and scan times of 10 and 30 minutes, resp., and SNR approximately 10. Finally, data are presented highlighting the potential of these methods for predicting the bone's elastic modulus in vitro and fracture risk in vivo.

Measurement of R'2 in the presence of multiple spectral components using reference spectrum deconvolution

A method is described for measuring R'2, the RF reversible contribution to the effective transverse relaxation rate in yellow trabecular marrow, as a means to evaluate trabecular bone structure and density. The method exploits the similarity in spectral composition of the marrow and fat in subcutaneous tissue. Under these conditions the gradient echo envelope of the marrow signal can be regarded as a convolution of a function describing the bone marrow intravoxel line broadening (R'2) with a function expressing chemical shift modulation, which is obtained from the echo envelope of the subcutaneous fat signal in a reference region. Simple division of each of a series of echoes by the reference signal is shown to afford a smooth decay which can be fitted to a model to extract R'2. The method has been evaluated in the upper femur of test subjects and a strong correlation of the thus derived R'2 values with those obtained by the GESFIDE technique is demonstrated. The close correspondence in spectral composition of proximal femur marrow and subcutaneous fat is further illustrated by means of localized spectroscopy. The major potential error source is global inhomogeneity in the reference region which can lead to an underestimation of the demodulation-derived R'2.

Variable TE gradient and spin echo sequences for in vivo MR microscopy of short T2 species

Collagen-rich tissues such as skin or fibrous cartilage have very short T2 and thus, in order to be visible, demand a commensurate reduction in echo time. Whereas short echo time for imaging of humans is straightforward at large fields of view with currently available whole body gradient hardware, the problem is more challenging in the microscopic resolution regime (<100 microm). In this work a simple approach consisting of shortening the echo time dynamically toward the lower spatial frequencies is described for three-dimensional partial flip-angle gradient and spin-echo sequences. Microimages obtained in vivo at 50 microm resolution on a 1.5 T whole body scanner are shown to afford a signal-to-noise gain of over 100% in the dermis of the human skin. A point-spread function analysis indicates that the variable echo time gradient-echo sequence produces a unique not previously reported off-resonance artifact in the phase-encoding direction. The artifact results from the phase modulation occurring during the variable echo time and can manifest as both blurring and intensity fluctuations, as well as shifts of boundaries in the phase-encoding direction. However, for the on-resonance condition, the images are free from these artifacts and exhibit significantly improved signal-to-noise ratio.

Cancellous bone volume and structure in the forearm: noninvasive assessment with MR microimaging and image processing

PURPOSE

To develop and apply a method for the derivation of cancellous bone architectural parameters from in vivo magnetic resonance (MR) images of the distal radius and to evaluate these parameters as predictors of vertebral fracture status in osteopenia.

MATERIALS AND METHODS

MR images (137 x 137 x 500-micron3 voxel size) were acquired with a three-dimensional partial flip-angle spin-echo pulse sequence in the distal radius of 36 women. Subjects were classified as healthy or with osteoporosis on the basis of vertebral deformity and bone mineral density (BMD). Images rated as of adequate quality in 20 subjects were processed with a method that is applicable in the limited spatial resolution regime. The method relies on histogram deconvolution to obviate binary segmentation. Cancellous bone structure was treated as a quasi-regular lattice and analyzed with spatial autocorrelation, yielding parameters that quantify intertrabecular spacing, contiguity, and a measure of longitudinal alignment called tubularity.

RESULTS

Whereas neither BMD nor any of the structural parameters individually correlated significantly with vertebral deformity fraction, a simple function that involved tubularity and longitudinal spacing predicted deformity fraction well (r = .78, P < .005).

CONCLUSION

Histomorphometric parameters characterizing cancellous bone in the distal radius can be derived from in vivo MR microimages and are predictive of vertebral deformity.

Probability-based structural parameters from three-dimensional nuclear magnetic resonance images as predictors of trabecular bone strength

The mechanical competence of trabecular bone is a function of its apparent density and three-dimensional (3D) distribution. Three-dimensional structure is typically inferred from histomorphometry and stereology on a limited number of two-dimensional anatomic sections. In this work 3D nuclear magnetic resonance (NMR) images of anisotropic trabecular bone from the distal radius were analyzed in terms of a series of new structural parameters which are obtainable at relatively crude resolution, i.e., in the presence of substantial partial volume blurring. Unlike typical feature extraction techniques requiring image segmentation, the method relies on spatial autocorrelation analysis, which is based on the probability of finding bone at specified locations. The structural parameters were measured from high-resolution images (78x78x78 microm3 voxels) of 23 trabecular bone specimens from the distal radius. Maximum-likelihood bone volume fractions (BVF) were calculated for each voxel and a resolution achievable in vivo (156x156x391 microm3 voxels) was simulated by averaging BVF's from neighboring voxels. The parameters derived from the low-resolution images were found to account for 91% of the variation in Young's modulus. The results suggest that noninvasive assessment of the mechanical competence of trabecular bone in osteoporotic patients may be feasible.

Magnetic susceptibility measurement of insoluble solids by NMR: magnetic susceptibility of bone

Measurements of the volume magnetic susceptibility of solids using the classical Gouy balance approach are hampered by variations in apparent density of the packed powder. In this paper a quantitative NMR measurement of the volume magnetic susceptibility of powdered solids is described and the volume susceptibility of bone is reported. The technique is based on the measurement of changes in incremental linewidth (1/pi T2') induced in a marker fluid whose susceptibility can be predictably modified by changing the composition, such as by addition of a soluble diamagnetic compound. The spectroscopic linewidth of the marker fluid is determined by the susceptibility difference between the fluid and the suspended solid. Changes in the linewidth are accompanied by bulk magnetic susceptibility induced frequency shifts in the fluid resonance. Correlating the two dependencies allows measurement of the absolute volume susceptibility of the solid. The susceptibility of bovine rib bone was found to be -0.9 +/- 0.02 x -10(-6) (CGS) confirming previous estimates which suggested bone to be more diamagnetic than the marrow constituents. Knowledge of the susceptibility of bone is relevant in view of the growing interest in MRI osteodensitometric techniques.

Field strength and angle dependence of trabecular bone marrow transverse relaxation in the calcaneus

The contribution from reversible dephasing, R2', to the effective transverse relaxation rate, R2*, in trabecular bone marrow, is governed by the magnetic field inhomogeneity induced by the difference in diamagnetic susceptibility between bone and bone marrow and should, therefore, scale linearly with field strength. Measurement of R2' in the calcaneus at 1.5 and 4 T by means of the GESFIDE (gradient-echo sampling of free induction decay and echo) pulse sequence showed R2' to increase by a factor of 2.73 at the higher field, which is close to the ratio of the field strengths (2.67). At both field strengths, R2' dominates R2*, contributing more than 90% to the total relaxation rate at 4 T. The data further indicate large regional variations within the calcaneus and a notable dependence of R2' on the angle of the foot relative to the direction of the static field. The findings have implications on the choice of the calcaneal site for assessment of trabecular density.

A single-scan imaging technique for measurement of the relative concentrations of fat and water protons and their transverse relaxation times

A two-component chemical-shift-imaging technique is described from which fat and water images can be obtained in a single scan and in the presence of an inhomogeneous field. In addition, the method provides transverse relaxation rates R2 and R2' separately for each of the spectral components. The method is a combination and extension of the GESFIDE [gradient echo sampling of FID and echo, J. Ma and F. W. Wehrli, J. Magn. Reson. B 111, 61 (1996)] and the multipoint Dixon techniques. It is based on sampling the descending and ascending portions of a Hahn spin echo with a train of gradient echoes which are spaced at one-half of the chemical-shift modulation period. Processing of the complex echo data, involving an automated phase unwrapping algorithm, affords relative amplitudes and transverse relaxation rates of the two spectral components. An additional benefit of the method is its superior signal-to-noise ratio resulting from echo summation. Applications targeted and illustrated involve MRI osteodensitometry of trabecular bone in the presence of varying fractions of hematopoietic and fatty bone marrow.

In vivo MR microscopy of the human skin

The requirements for imaging the skin are dictated by the organ's layered structure, which extends only a few millimeters from the surface and thus demands extremely high resolution in this direction. While less critical, resolution in the remaining two dimensions determines whether the skin's accessory structures can be resolved. The problem is compounded by short transverse relaxation times, in particular of the dermis, the structure of most clinical interest. In this work images of the normal human skin were obtained in vivo at voxel sizes as small as 19 x 78 x 800 microm3, by means of customized 3D gradient and partial flip-angle spin-echo pulse sequences and very small transmit/receive coils on a 1.5T clinical imager equipped with high-power whole-body gradients. Structures resolved include hair follicles and the sublayers of the dermis. The very short time constant for the major component (91%) for transverse relaxation in the dermis (T2* approximately 10 ms) suggests the potential of substantial gains in achievable signal-to-noise ratio by shortening the echo time.

Fast 3D large-angle spin-echo imaging (3D FLASE)

A rapid steady-state 3D spin-echo imaging pulse sequence, based on the principle of nutating the spins by an angle greater than 90 degrees, has been designed and implemented on a clinical 1.5-T whole-body MR scanner. The pulse sequence, denoted fast large-angle spin-echo (FLASE), has been optimized for high-resolution imaging of tissues with short T2 and T2*. Features of FLASE include a minimum-phase Shinnar-Le Roux excitation pulse and distribution of phase- and slice-encoding gradients before and after the 180 degrees refocusing pulse to minimize the critical time delay between inversion and restoration of the residual longitudinal magnetization and for minimizing echo time. A Bloch equation analysis, corroborated by experimental data, shows FLASE signal-to-noise to be superior to its closest analog, 3D rapid spin-echo excitation (RASEE) (Jara et al., Magn Reson Medicine 29, 528 (1993)), and 3D gradient-recalled acquisition in steady state (GRASS). It is demonstrated that with judicious RF phase-cycling and steady state operation, FLASE can produce high-quality microimages free of intravoxel phase dispersion from susceptibility-induced background gradients. The performance of the method is exemplified with ultra high-resolution images of trabecular bone in vitro and in vivo in the human calcaneus and wrist at voxel sizes as low as 98 x 98 x 200 microns3. Finally, the contrast behavior of refocused FLASE can be altered by disrupting the steady state analogous to gradient echo imaging.

Method for image-based measurement of the reversible and irreversible contribution to the transverse-relaxation rate

A multislice NMR imaging pulse sequence capable of measuring both the reversible and irreversible contribution to the transverse-relaxation rate (R'2 and R2) in a single scan is described. The method, termed GESFIDE (gradient-echo sampling of FID and echo) is based on sampling the descending and ascending portions of a Hahn echo with a train of gradient echoes. R2 and R'2 are computed by exploiting the differential evolution of the transverse magnetization before and after the phase-reversal pulse. Salient features of the method are its insensitivity to RF pulse imperfections and its high precision and efficiency. Applications examined involve the characterization of magnetically inhomogeneous tissues and biomaterials such as trabecular bone marrow in the skeleton and brain iron.

Three-dimensional nuclear magnetic resonance microimaging of trabecular bone

The conventional approach to measuring structural parameters in trabecular bone rests on stereology from optical images, derived from sections of embedded bone. In order to provide data that are statistically representative of a sufficiently large volume, multiple sections need to be analyzed in each of the three orthogonal planes. In this work, an alternative technique is presented which is based on three-dimensional (3D) volumetric proton nuclear magnetic resonance (NMR) microimaging. The method presented provides from 9 x 9 x 4 mm3 volumes of defatted bone specimens in 15-20 minutes scan time at isotropic resolution corresponding to (78 microm)3 voxel size. Surface-rendered images of bovine and human trabecular bone are shown and an algorithm was developed and implemented for determining the orientation and magnitude of the principle axes of the mean intercept length tensor.

Osteoporosis: clinical assessment with quantitative MR imaging in diagnosis

PURPOSE

To determine if the magnetic resonance (MR) imaging effective transverse relaxation rate (R2*) of trabecular bone marrow is lowered in osteoporosis.

MATERIALS AND METHODS

R2* was measured in 146 women. Control subjects (n = 77; mean age, 46.6 years) had high mean spinal bone mineral densities (BMDs) and no vertebral deformities. Patients with spinal osteoporosis (n = 59; mean age, 59.7 years) had at least one thoracic vertebral deformity and/or low BMDs.

RESULTS

R2* was lower in patients for L-2 through L-5 (P < .001). Average R2* of L-3 through L-5 (R2*av) was the best discriminator (64.79 sec-1 +/- 1.18 [standard error] for control subjects vs 53.39 sec-1 +/- 1.24 for patients; P < .0001). R2*av decreased with age in control subjects. The difference in R2*av in a subset of 38 age-matched pairs of patients and control subjects was 8.25 sec-1 (P < .0001). Subjects with deformities had lower 52*av than did control subjects (52.3 sec-1 +/- 1.6 vs 62.5 sec-1 +/- 1.1, P < .0001). R2*av was correlated with mean BMD (r = .54, P < .0001).

CONCLUSION

Patients with osteoporosis have lower R2*s in vertebral marrow.

Quantitative analysis of trabecular microstructure by 400 MHz nuclear magnetic resonance imaging

A new approach for the quantitative analysis of trabecular microstructure, based on high-field proton nuclear magnetic resonance (NMR) imaging, is presented. NMR is ideal because it provides high contrast between the marrow proton signal and the bone, which appears with background intensity. Images from 1 cm3 defatted specimens of trabecular bone, suspended in water doped with 1 mM Gd(DTPA) to shorten T1 to about 300 ms, can be obtained at a resolution on the order of 30-50 microns and slice thickness of 150 microns, in 10 minutes at 400 MHz proton frequency. Digital image processing algorithms were designed and evaluated for the measurement of bone area fraction, perimeter length, mean trabecular thickness, and separation. Bone area fraction derived from the NMR images was found to be in excellent agreement with bone volume fraction measured independently (slope = 0.96, r2 = 0.924, p < 0.0001). Errors in the mean trabecular thickness and separation were < 6%. The effects of finite imaging slice thickness and signal-to-noise ratio (SNR) were also evaluated. The data suggest a resolution of 50 x 50 x 200 microns 3 and an SNR on the order of 10 to provide safe margins for precise and accurate structural analysis by means of the algorithms presented in this paper. The method allows simultaneous measurement at multiple locations within the specimen volume without the need for physical sectioning.

Determination of background gradients with diffusion MR imaging

A new magnetic resonance (MR) imaging technique, opposite-polarity pulsed-field-gradient technique, with which the effects of background magnetic field gradients can be separated from the effects of diffusion, is described. It is based on the processing of two sets of diffusion-weighted images, the acquisition parameters of which differ only in the polarity of the applied diffusion pulses. The two effects can be separated because the cross term (bc) of the gradient factor function is antisymmetric with respect to reversal of the sign of the applied diffusion pulses. The technique permits simultaneous measurement of the spatial distribution of both the diffusion constants and background magnetic field gradients, with the same spatial resolution as the parent images from which they were derived. The technique has been validated with a phantom in which the spatial distribution of susceptibility-induced background gradients is known, the results showing excellent agreement with theory. The technique was applied to two systems in which the spatial distribution of the background gradient is unknown. Sources of error in the measurement of background gradients and (unrestricted) diffusion constants are analyzed, including the effects of voxel size, partial volumes, and interactions between background and imaging gradients.

On the fractal nature of trabecular structure

Fractal analysis has recently been suggested [Med. Phys. 20, 1611-1619 (1993)] as a means to characterize the structure of cancellous bone by measuring the fractal dimension using a box counting algorithm. This work re-examines the possible fractal nature of such structures on nuclear magnetic resonance (NMR) images of cancellous bone by estimating the trabecular boundary length as a function of box size under various experimental conditions. On high-resolution images (pixel sizes on the order of 50 microns) and signal-to-noise ratios of 30, the trabecular boundary turns out to be a smooth surface relative to the achievable resolution and is thus nonfractal. The fractal dimension of the trabecular structure is undefined and can vary significantly as a function of image signal-to-noise ratio. The present work further indicates the "apparent" fractal dimension obtained by box counting to be a reflection of marrow pore size. In conclusion, the results indicate that, at the currently achievable resolution, the box counting algorithm is not suitable for fractal analysis on images of cancellous bone and that the fractal appearance of the trabecular network reported previously is artifactual.

A Bayesian approach to subvoxel tissue classification in NMR microscopic images of trabecular bone

NMR microscopy is currently being used as an investigational tool for the evaluation of micromorphometric parameters of trabecular bone as a possible means to assess its strength. Since, typically, the image voxel size is not significantly smaller than individual trabecular elements, partial volume blurring can be a major complication for accurate tissue classification. In this paper, a Bayesian segmentation technique is reported that achieves improved subvoxel tissue classification. Each voxel is subdivided either into eight subvoxels twice the original resolution, or up to four subvoxels along the transaxial direction and the subvoxels optimally classified as volume blurring, the likelihood for the number of marrow subvoxels in each voxel can be computed on the basis of its measured signal. To resolve the ambiguity of the location of the marrow subvoxels, a Gibbs distribution is introduced to model the interaction between the subvoxels. Neighboring subvoxel pairs with the same tissue label are encouraged, and pairs with distinct labels are penalized. The segmentation is achieved by maximizing the a posteriori probability of the label image using the block ICM (iterative conditional mode) algorithm. The potential of the proposed technique is demonstrated in real and synthetic NMR microscopic images.

Relationship between NMR transverse relaxation, trabecular bone architecture, and strength

Structure, biomechanical competence, and incremental NMR line broadening (R'2) of water in the intertrabecular spaces of cancellous bone were examined on 22 cylindrical specimens from the lumbar vertebral bodies of 16 human subjects 24-86 years old (mean, 60 years old). A strong association (r = 0.91; P < 0.0001) was found between Young's modulus of elasticity and R'2 for a wide range of values corresponding to cancellous bone of very different morphologic composition. NMR line broadening is caused by the inhomogeneity of the magnetic field induced as a consequence of the coexistence of two adjacent phases of different diamagnetic susceptibility--i.e., mineralized bone and water in the marrow spaces. Structural analyses performed by means of NMR microscopy and digital image processing indicated that the variation in R'2 is closely related to the trabecular microstructure. Mean trabecular plate density measured along the direction of the magnetic field was found to play a major role in predicting R'2 (r = 0.74; P < 0.0001). This behavior was confirmed when the plate density was varied in individual specimens, which was achieved by rotating the specimen, making use of the bone's structural anisotropy. It is concluded that the NMR transverse relaxation rate in human cancellous bone of the spine is significantly determined by trabecular structural parameters relevant to biomechanical strength. The results further underscore the important role played by the transverse trabeculae in contributing to cancellous bone strength. The work has implications on possible in vivo use of quantitative magnetic resonance for the assessment of fracture risk in osteoporotic patients.

Magnetic field distribution in models of trabecular bone

A magnetostatic model consisting of a tetragonal lattice of struts of diamagnetic material, mimicking vertebral trabecular bone, was developed. The model allows estimation of the magnetic field histogram within the lattice's unit cell as a function of geometric parameters. The field was computed analytically from the induced magnetic surface charge density on the faces of the struts. The contribution from the induced magnetic field to the effective transverse relaxation rate, R2', was obtained as the mean decay rate of the Fourier transformed histograms, for both fixed and randomly oriented lattices. The model predicts the field distribution to increase with both strut thickness and density, paralleling material density. Finally, significant changes in R2' are predicted at constant material density, in that the field distribution widens with simultaneously increasing strut number density and decreasing strut thickness.

High-resolution variable flip angle 3D MR imaging of trabecular microstructure in vivo

Two conceptually related variable-flip-angle 3D spin-echo pulse sequences were designed for imaging at voxel sizes of 2-5 x 10(-3) mm3 corresponding to pixel areas of less than 100 x 100 microns2 and section thicknesses on the order of 300-400 microns on a conventional 1.5 T MR imaging system equipped with 1 G/cm imaging field gradients, providing 12 sections in 10 min imaging time. The pulse sequences make use of the concept of restoring longitudinal magnetization inverted by the 180 degrees phase reversal pulse and are derivatives of pulse sequences previously dubbed "FATE" and "RASEE." It is shown that even in the small-voxel regime (< 10(-2) mm3 voxel size) and at echo times on the order of 10 ms, gradient echo images are sensitive to intrinsic fields causing artifactual boundary effects, including signal loss from intravoxel phase scrambling and spatial mismapping. At this resolution the variable flip-angle spin-echo pulse sequences are demonstrated to be better suited for imaging magnetically heterogeneous systems such as trabecular bone microstructure in vivo. These pulse sequences are found to be substantially less sensitive to distortions from magnetic dipole fields occurring at the boundaries of two phases of different magnetic permeability.

Potential role of nuclear magnetic resonance for the evaluation of trabecular bone quality

This paper discusses two novel applications of nuclear magnetic resonance (NMR) as an investigational tool for the assessment of cancellous bone microarchitecture. It further outlines extensions of the method for in vivo clinical evaluation of bone strength in patients with skeletal disorders such as osteoporosis. The first method relies on the hypothesis that the presence of two phases of different magnetic permeability, i.e., bone and bone marrow, causes a spatial nonuniformity of the magnetic field across the measurement volume. The resulting spread in resonance frequency shortens the decay time constant (T2*) of the time domain proton signal in bone marrow or its substitute (water). Increased trabecular spacing, such as it occurs in osteoporosis, reduces the spatial field inhomogeneity and thus prolongs T2*, which has been shown both in vitro and in vivo. Subjects with osteoporosis, characterized by either low bone mineral density and/or spine compression fractures, have T2* values that are significantly prolonged. The second method focuses on a direct measurement of micromorphometric parameters of cancellous bone, using the principles of proton NMR microscopy in conjunction with computer processing of the resulting digital images. Image contrast between the trabeculae and the intertrabecular space is based on the marrow protons providing a signal, as opposed to bone, which appears with background intensity. Once tissues have been classified (into bone and marrow), for example, by means of a histogram-based segmentation algorithm, bone area fraction, mean trabecular plate density (MTPD), and mean trabecular plate thickness (MTPT) can be computed without the need for further operator intervention.(ABSTRACT TRUNCATED AT 250 WORDS)