Spatial misregistration of vascular flow during MR imaging of the CNS: cause and clinical significance

Spatial misregistration of signal recovered from flowing spins within vascular structures is a common phenomenon seen in MR imaging of the CNS. The condition is displayed as a bright line or dot offset from the true anatomic location of the lumen of the imaged vessel. Its origin is the time delay between application of the phase- and frequency-encoding gradients used to locate spins within the plane of section. The principal condition necessary for the production of spatial misregistration is flow oblique to the axis of the phase-encoding gradient. Flow-related enhancement (entry slice phenomenon), even-echo rephasing, and gradient-moment nulling contribute to the production of the bright signal of spatial misregistration. Familiarity with the typical appearance of flow-dependent spatial misregistration permits confirmation of a vessel's patency; identification of the direction of flow; estimation of the velocity of flow; and differentiation of this flow artifact from atheromas, dissection, intraluminal clot, and artifacts such as chemical shift.     

Spatial misregistration of vascular flow during MR imaging of the CNS: cause and clinical significance

Spatial misregistration of signal recovered from flowing spins within vascular structures is a common phenomenon seen in MR imaging of the CNS. The condition is displayed as a bright line or dot offset from the true anatomic location of the lumen of the imaged vessel. Its origin is the time delay between application of the phase- and frequency-encoding gradients used to locate spins within the plane of section. The principal condition necessary for the production of spatial misregistration is flow oblique to the axis of the phase-encoding gradient. Flow-related enhancement (entry slice phenomenon), even-echo rephasing, and gradient-moment nulling contribute to the production of the bright signal of spatial misregistration. Familiarity with the typical appearance of flow-dependent spatial misregistration permits confirmation of a vessel's patency; identification of the direction of flow; estimation of the velocity of flow; and differentiation of this flow artifact from atheromas, dissection, intraluminal clot, and artifacts such as chemical shift.     

Chemical shift artifact in clinical magnetic resonance images at 0.35 T

A thin, low-intensity line, which partially surrounds many structures on magnetic resonance imaging (MRI), is an artifact due to the phenomenon of chemical shift and should not be mistaken for a normal or abnormal morphologic structure. This artifact can be recognized by its characteristic appearance perpendicular to the direction of the frequency-encoding gradient at the interface of tissues with different chemical shift properties. Confinement within or extension beyond this thin, low-intensity line cannot be used as a criterion for staging neoplasms. Once recognized, the chemical shift artifact should not impede the use of MRI for clinical imaging at 0.35 T.     

Use of standard gradients with compound oblique angulation for optimal quantitative MR flow imaging in oblique vessels

The earliest described phase-modulation techniques for flow quantification by MR imaging require a phase image obtained by modifying one of the imaging gradients and a reference phase image obtained without the modified gradient. However, by using the same gradients that are used for routine two-dimensional Fourier transform imaging, both anatomic and velocity-encoded images can be obtained in one scan. Although convenient, this technique is sensitive to flow both within and perpendicular to the imaging plane. Consequently, significant errors occur in the measurement of flow in vessels oblique to the image plane. To determine the relative accuracy and practicality of quantitatively measuring flow in oblique vessels, we used standard sequence gradients with routine orthogonal plane imaging and direct compound oblique plane imaging. Phantom studies of flow in a vessel aligned along the z axis showed a significant linear correlation (r = .999; p less than .05) between the spin phase and spin velocity. However, studies of flow at relatively low physiologic rates (12-17 cm/sec) in vessels angled 0-30 degrees off axis showed that obliquities of as little as 10 degrees result in significant quantification errors. This is due to a larger phase shift per unit velocity along the frequency-encoding direction vs along the slice-select direction and to a mixture of velocities within a voxel that is oblique to the flow direction. In most instances, resolution of these errors can be achieved satisfactorily only by electronic plane rotation with compound oblique angulation so that the image plane and vessel are perpendicular. When so used, this technique potentially might provide important adjunctive quantitative flow data in oblique vessels during routine clinical imaging.     

A comparison of default and reduced bandwidth MR imaging of the spine at 1.5 T

The value of a reduced bandwidth MR imaging technique was tested prospectively in 51 spinal MR examinations by using default (16 kHz) bandwidth, 2000/30, 90 (TR/TEs) and 600/30, and reduced (8 kHz) bandwidth, 2000/48, 92 and 600/30, techniques at 1.5 T. Bandwidth reduction was used to maintain the signal-to-noise ratio for a reduced scan time. Concerns have been raised as to the effect of bandwidth reduction at high field, since a savings in time or an increased signal-to-noise ratio occur at the expense of increased chemical shift misregistration artifact. However, when appreciable, the chemical shift-related artifact in the spine was typically located in the frequency-encoding direction at the vertebral body/disk space interface or the dural sac/epidural fat interface in the lower lumbosacral region and was easily distinguished from pathologic lesions. There were no missed diagnoses with the reduced bandwidth technique. This study suggests that chemical shift-related artifact will rarely be confused with pathology by an experienced reader and suggests a clinical role for the bandwidth technique to decrease scanning time in uncooperative patients or to allow acquisition of additional imaging planes in a reasonable time.     

Chemical shift artifact along the section-select axis.

Chemical shift artifact (CSA), familiar to radiologists along the frequency-encoding axis, also occurs along the section-select axis. The authors observed a case in which CSA mimicked a renal mass. Subsequent retrospective analysis of 50 abdominal magnetic resonance (MR) imaging studies was performed to assess occurrence of CSA adjacent to the upper and lower renal poles. CSA along the section-select axis was observed in 76% of cases and adjacent to 39% of all renal poles imaged. CSA along the section-select axis is common in abdominal MR imaging and may occasionally mimic disease.     

Correlation of laminated MR appearance of articular cartilage with histology, ascertained by artificial landmarks on the cartilage.

The object of this study was to correlate the laminae of articular cartilage on magnetic resonance (MR) imaging with histologic layers. T1- and fast spin-echo T2-weighted images of articular cartilage with artificial landmarks were obtained under high gradient echo strength (25 mT/m) conditions and a voxel size of 78 x 156 x 2000 microm. Images were also obtained with a) changed frequency-encoding directions; b) changed readout gradient strength; and c) a varied number of phase-encoding steps. T2 mapping was performed with angular variations. Artificial landmarks allowed accurate comparison between the laminae on MR images and the histologic zones. No alterations of the laminae were noted by changing the frequency gradient direction. Altering readout gradient strengths did not show a difference in the thickness of the laminae, and increasing the phase-encoding steps resulted in a more distinct laminated appearance, ruling out chemical shift, susceptibility, and truncation artifacts. The T2 mapping profile showed an anisotropic angular dependency from the magic angle effect. In conclusion, the laminated appearance of articular cartilage on spin-echo and fast spin-echo MR images correlated with the histologic zones rather than MR artifacts.     

Magnetic field strength dependence of chemical shift artifacts

The dependence of proton MRI chemical shift artifacts on main magnetic field strength was investigated using three MR whole body systems from 0.3 to 1.5 T with both permanent and superconducting magnet designs. The magnetic field gradients varied from 0.09 to 1.0 gauss/cm. The image bandwidth varied from 8.54 to 32 kHz. Both phantoms and normal volunteers were studied. The chemical shift misregistration error in hertz was determined by the main magnetic field strength of the system which was proportional to the Larmor frequency. The actual image error in millimeters was determined by a combination of the shift in hertz as well as by the amplitude of the magnetic field gradients applied to form the image. Steeper gradients mapped a given shift in hertz onto a smaller millimeter displacement. The higher field strength systems tended to use steeper magnetic field gradients, but this increase was not enough to offset the higher absolute shift in hertz due to the higher Larmor frequencies. In general, the chemical shift in millimeters tended to increase with the increasing field strength despite the steeper imaging gradients. Based on these findings, strategies for minimizing the chemical shift artifact may be developed.     

Evaluation of platybasia with MR imaging

BACKGROUND AND PURPOSE: Platybasia, or abnormal obtuseness of the basal angle, was first measured on plain skull images. At present, evaluation of the brain and skull more commonly involves CT and MR imaging. We evaluated a new MR imaging method of evaluating platybasia. METHODS: We retrospectively evaluated midline sagittal MR images in 200 adults and 50 children. The basal angle of the skull base was measured by using two methods: The standard MR imaging technique measured the angle formed by two lines-one joining the nasion and the center of the pituitary fossa connected by a line joining the anterior border of the foramen magnum and center of the pituitary fossa. The modified technique measured the angle formed by a line across the anterior cranial fossa and dorsum sellae connecting a line along the clivus. RESULTS: With the standard MR imaging technique, we obtained mean angles of 129 degrees +/- 6 degrees for adults and 127 degrees +/- 5 degrees for children, compared with 135.3 degrees (composite mean) in previous series. The modified technique produced values of 117 degrees +/- 6 degrees for adults and 114 degrees +/- 5 degrees for children, which were significantly lower that those of standard MR imaging and traditional radiography (P <.05). CONCLUSION: Both the standard and modified MR imaging techniques produced basal angles lower than those previously reported with standard radiography. The modified technique uses clearly featured landmarks that can be reproduced consistently on midline sagittal T1 images. This technique and its corresponding values can be used as the new standard for evaluating the basal angle.     

Histochemical characterization and functional significance of the hyperintense signal on MR images of the posterior pituitary

MR imaging of the pituitary fossa characteristically shows a well-circumscribed area of high signal intensity in the posterior lobe on T1-weighted images. We used a combination of high-field MR, electron microscopy, and histologic techniques in experimental animals to determine whether the hyperintensity of the posterior lobe might be functionally related to hormone neurosecretory processes, and to attempt to establish its chemical nature. Histologic sections of a dog's pituitary gland processed with lipid-specific markers showed intense staining in the posterior lobe but not in the anterior lobe, thus documenting the location of fat in the posterior pituitary. Administration of vasoactive drugs known to influence vasopressin secretion to anesthetized cats produced changes in the volume of high-intensity signal in the posterior pituitary. Subsequent electron microscopy showed a significant increase in posterior lobe glial cell lipid droplets and neurosecretory granules in dehydration-stimulated cats. The data suggest that the pituitary hyperintensity represents intracellular lipid signal in the glial cell pituicytes of the posterior lobe or neurosecretory granules containing vasopressin. The volume of the signal may, in turn, reflect the functional state of hormonal release from the neurohypophysis.     

Syrinx-like artifacts on MR images of the spinal cord

Magnetic resonance (MR) imaging of the spinal cord frequently demonstrates, especially on sagittal sections, a central stripe that mimics a true syrinx. This syrinx-like manifestation of a truncation artifact occurs in objects having a width of only a few pixels and was demonstrated by calculations verified with phantom MR images. Healthy volunteers and two patients with a syrinx and cervical spondylosis, respectively, underwent MR imaging. By increasing the number of phase-encoding steps, decreasing the field of view, and switching phase- and frequency-encoding axes, the syrinx-like artifact can be eliminated.     

Chemical shift: the artifact and clinical tool revisited.

The chemical shift phenomenon refers to the signal intensity alterations seen in magnetic resonance (MR) imaging that result from the inherent differences in the resonant frequencies of precessing protons. Chemical shift was first recognized as a misregistration artifact of image data. More recently, however, chemical shift has been recognized as a useful diagnostic tool. By exploiting inherent differences in resonant frequencies of lipid and water, fatty elements within tissue can be confirmed with dedicated chemical shift MR pulse sequences. Alternatively, the recognition of chemical shift on images obtained with standard MR pulse sequences may corroborate the diagnosis of lesions with substantial fatty elements. Chemical shift can aid in the diagnosis of lipid-containing lesions of the brain (lipoma, dermoid, and teratoma) or the body (adrenal adenoma, focal fat within the liver, and angiomyolipoma). In addition, chemical shift can be implemented to accentuate visceral margins (e.g., kidney and liver).     

Anterior and posterior lobes of the pituitary gland: assessment by 1.5 T MR imaging

Pituitary glands of 60 normal volunteers (30 men 20-36 years old, and 30 women 18-42 years old) were studied by 1.5 T magnetic resonance (MR) imaging. The T1-weighted images (T1WI) [repetition time (TR) = 400 ms; echo time (TE) = 25 ms] were obtained in the coronal, sagittal, and axial planes. Proton density (PD)/T2-weighted images (PDWI/T2WI) (TR = 2,000 ms; TE = 25/100 ms) were obtained in the sagittal plane using 3 mm slice thickness. On T1WIs of all subjects the posterior part (PP) of the pituitary fossa showed the highest signal, which was indistinguishable from fatty tissue. This study reveals that this region of high signal intensity (PP) corresponds to the posterior lobe and not intrasellar fat because its shape, size, and position are compatible with the posterior lobe; its signal intensity differs from that of fatty tissue on PDWI and T2WI; the absence of an intrinsic chemical shift artifact (CSA) characteristic of fat; and due to CSA, a dorsum with fatty marrow is shifted relative to the PP (or may be made to merge with it). Regarding the differentiation of the two lobes of the pituitary gland on MR, the morphology of the anterior and posterior lobes was evaluated and great variation found. Appreciation of normal is particularly important in evaluating coronal images for small pituitary lesions.     

Analysis of flow effects in echo-planar imaging

The effects on the phase of spins moving during echo-planar imaging (EPI) acquisition were studied. Standard single-shot and interleaved multishot blipped EPI acquisitions were considered, assuming either high gradient strength and slew rates or standard gradient strength and slew rates. A spiral k-space trajectory was also considered. Flow components in the section-select and phase- and frequency-encoding directions were analyzed separately. While the effect of flow in the section-select direction is identical to that in a standard two-dimensional Fourier transform (2DFT) acquisition, flow in the phase- or frequency-encoding directions can have substantial effects on the image, different from that in 2DFT imaging. The magnitude of these effects, which include displacement, distortion, and/or ghosting of vascular structures, is analyzed and predicted for a given velocity and direction of flow, the specific acquisition sequence, and the strength and slew rate of the gradients. For example, 50-cm/sec flow along the phase-encoding direction can cause a blurring of 1.25 cm full width at half maximum for blipped EPI with high-strength gradients, assuming a 40-cm field of view and 64 × 64 matrix.     

Presacral dermoid cyst with scanty fat component: usefulness of chemical shift and diffusion-weighted MR imaging.

We present a case of a dermoid cyst located at the presacral space. Although CT and conventional MR (T1- and T2-weighted images) demonstrated a non-specific cystic mass with little evidence of calcification or fat, chemical shift and diffusion-weighted MR imaging suggested the presence of small amount of fat and abundant keratinoid substance within the tumor, respectively. Pre-operative diagnosis of dermoid cyst was made. The tumor was surgically resected and the diagnosis was confirmed. Chemical shift and diffusion-weighted MR imaging are useful in the diagnosis of dermoid cyst with little evidence of calcification and fat.     

Paraovarian adrenal rest with MRI features characteristic of an adrenal adenoma

We report MR and sonographic imaging features of an incidentally detected paraovarian adrenal rest in a 44-year-old woman who was being evaluated for menorrhagia. This is the first report of chemical shift imaging identifying the presence of lipid within an adrenal rest as well as rapid washout of contrast. Both of these MR characteristics are typically seen with an adrenal adenoma.     

Continuously moving table 3D MRI with lateral frequency-encoding direction.

A method is presented for 3D MRI in an extended field of view (FOV) based on continuous motion of the patient table and an efficient acquisition scheme. A gradient-echo MR pulse sequence is applied with lateral (left-right (L/R)) frequency-encoding direction and slab selection along the direction of motion. Compensation for the table motion is achieved by a combination of slab tracking and data alignment in hybrid space. The method allows fast k-space coverage to be achieved, especially when a short sampling FOV is chosen along the direction of table motion, as is desirable for good image quality. The method can be incorporated into different acquisitions schemes, including segmented k-space scanning, which allows for contrast variation with the use of magnetization preparation. Head-to-toe images of volunteers were obtained with good quality using 3D spoiled gradient-echo sequences. As an example of magnetization-prepared imaging, fat/water separated images were acquired using chemical shift selective (CHESS) presaturation pulses.     

Localized imaging using stimulated echoes

Stimulated-echo localized spectroscopy was combined with phase- and frequency-encoding gradients to obtain "zoom" or magnified images of specific organs in situ. The technique requires neither surface coils nor an imaging coil arrangement that exclusively isolates the target organ. This technique can be readily applied to conventional spectrometer imagers that have limited computational capabilities.     

Metallic artefacts in MR imaging: effects of main field orientation and strength

AIM: To determine the effect of metallic implant positioning on magnetic resonance (MR) imaging artefacts, and to determine the optimal imaging parameters for minimization of metallic artefacts. MATERIALS AND METHODS: In a phantom and in three joints with non-ferromagnetic metallic implants imaged at 1.5 and/or at 0.2 T, we examined the influence of the static magnetic field (B(0)) strength and orientation, frequency-encoding direction, and type of imaging sequence on metallic artefacts. RESULTS: The impact of artefacts caused by metallic objects depends mainly on the relationship between the anatomy of interest and the orientation of the object relative to the direction of B(0). The main field strength plays a less important role, but its orientation depends on the type of MR imager. CONCLUSION: MR artefacts can be easily minimized by optimally positioning patients with metallic implants in the magnet. Knowledge of how this influences MR imaging is helpful in patient selection and guiding limb positioning.     

Elimination of oblique flow artifacts in magnetic resonance imaging.

We present an analysis of how flow oblique to the frequency-encoding direction generates displacement artifacts in MR imaging and show that for flow which has constant velocity between the start of the phase encoding and the center of the echo it is possible to eliminate these artifacts by gradient moment nulling in the phase-encoding direction. However, unlike the standard moment nulling calculations for flow compensating the frequency-encode and slice-selection gradients, the phase-encoding first moment must be nulled specifically with respect to the echo center. Limitations of this method imposed by finite gradient strengths are analyzed. In 3D volume acquisitions with two axes phase encoded it is possible to correct for oblique flow in all directions, and this is demonstrated in images of a human volunteer. Correction for oblique flow displacement artifacts may be particularly useful in quantitative flow and angiographic applications.