Fast‐spin‐echo imaging of inner fields‐of‐view with 2D‐selective RF excitations

Purpose:

To demonstrate the feasibility of two‐dimensional selective radio frequency (2DRF) excitations for fast‐spin‐echo imaging of inner fields‐of‐view (FOVs) in order to shorten acquisitions times, decrease RF energy deposition, and reduce image blurring.

Materials and Methods:

Fast‐spin‐echo images (in‐plane resolution 1.0 × 1.0 mm² or 0.5 × 1.0 mm²) of inner FOVs (40 mm, 16 mm oversampling) were obtained in phantoms and healthy volunteers on a 3 T whole‐body MR system using blipped‐planar 2DRF excitations.

Results:

Positioning the unwanted side excitations in the blind spot between the image section and the slice stack to measure yields minimum 2DRF pulse durations (about 6 msec) that are compatible with typical echo spacings of fast‐spin‐echo acquisitions. For the inner FOVs, the number of echoes and refocusing RF pulses is considerably reduced which compared to a full FOV (182 mm) reduces the RF energy deposition by about a factor of three and shortens the acquisition time, e.g., from 39 seconds to 12 seconds for a turbo factor of 15 or from 900 msec to 280 msec for a single‐shot acquisition, respectively. Furthermore, image blurring occurring for high turbo factors as in single‐shot acquisitions is considerably reduced yielding effectively higher in‐plane resolutions.

Conclusion:

Inner‐FOV acquisitions using 2DRF excitations may help to shorten acquisitions times, ameliorate image blurring, and reduce specific absorption rate (SAR) limitations of fast‐spin‐echo (FSE) imaging, in particular at higher static magnetic fields. J. Magn. Reson. Imaging 2010;31:1530–1537. © 2010 Wiley‐Liss, Inc.     

Effect of Gd‐EOB‐DTPA on T2‐weighted and diffusion‐weighted images for the diagnosis of hepatocellular carcinoma

Purpose:

To evaluate the effect of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd‐EOB‐DTPA) on T2‐weighted imaging (T2WI) and diffusion‐weighted imaging (DWI) for the diagnosis of hepatocellular carcinoma (HCC).

Materials and Methods:

The phantom signal intensity was measured. We also evaluated 72 patients including 30 patients with HCC. T2WI and DWI were obtained before and then 4 and 20 min after injecting the contrast medium. The signal to noise ratio (SNR), contrast to noise ratio (CNR), and apparent diffusion coefficient (ADC) were calculated in the tumor and liver parenchyma.

Results:

The phantom signal intensity increased on T2WI at a concentration of contrast medium less than 0.2 mmol/L but decreased when the concentration exceeded 0.4 mmol/L. SNR of the liver parenchyma on T2WI was significantly different between before and 4 min after injecting the contrast medium, while there were no significant differences between before and 4 and 20 min after injection. On T2WI, SNR, and CNR of HCC showed no significant differences at any time. SNR, CNR, and ADC of the liver parenchyma and tumor on DWI also showed no significant differences at any time.

Conclusion:

It is acceptable to perform T2WI and DWI after injection of Gd‐EOB‐DTPA for the diagnosis of HCC. J. Magn. Reson. Imaging 2010;32:229–234. © 2010 Wiley‐Liss, Inc.     

Comparison of diffusion‐weighted MRI and 2‐[fluorine‐18]‐fluoro‐2‐deoxy‐D‐glucose positron emission tomography (FDG‐PET) for detecting primary colorectal cancer and regional lymph node metastases

Purpose

To examine the usefulness of diffusion‐weighted MRI (DW‐MRI) for the detection of both primary colorectal cancer and regional lymph node metastases, and compare its performance with 2‐[fluorine‐18]‐fluoro‐2‐deoxy‐D‐glucose positron emission tomography (FDG‐PET) in the same patients.

Materials and Methods

We studied 25 patients with known colorectal cancer. All underwent both DW‐MRI and FDG‐PET studies. The images were retrospectively assessed by visual inspection and the imaging findings were compared with histopathological findings on surgical specimens.

Results

Of the 27 primary colorectal lesions surgically excised in 25 patients, 23 (85.2%) were true‐positive on both DW‐MRI and FDG‐PET. Two cancers were false‐negative on DW‐MRI but true‐positive on FDG‐PET, and two were false‐negative on both DW‐MRI and FDG‐PET. With respect to the detectability of metastatic lymph nodes, DW‐MRI and FDG‐PET manifested a sensitivity of 80% (8/10) and 30.0% (3/10), a specificity of 76.9% (10/13) and 100% (13/13), and an accuracy of 78.3% (18/23) and 69.6% (16/23), respectively.

Conclusion

DW‐MRI is inferior to FDG‐PET for the detection of primary lesions, but superior for the detection of lymph node metastases. J. Magn. Reson. Imaging 2009;29:336–340. © 2009 Wiley‐Liss, Inc.     

Phase‐sensitive,dual‐acquisition,single‐slab, 3D,turbo‐spin‐echo pulse sequence for simultaneous T2‐weighted and fluid‐attenuated whole‐brain imaging

Conventional T₂‐weighted turbo/fast spin echo imaging is clinically accepted as the most sensitive method to detect brain lesions but generates a high signal intensity of cerebrospinal fluid (CSF), yielding diagnostic ambiguity for lesions close to CSF. Fluid‐attenuated inversion recovery can be an alternative, selectively eliminating CSF signals. However, a long time of inversion, which is required for CSF suppression, increases imaging time substantially and thereby limits spatial resolution. The purpose of this work is to develop a phase‐sensitive, dual‐acquisition, single‐slab, three‐dimensional, turbo/fast spin echo imaging, simultaneously achieving both conventional T₂‐weighted and fluid‐attenuated inversion recovery–like high‐resolution whole‐brain images in a single pulse sequence, without an apparent increase of imaging time. Dual acquisition in each time of repetition is performed, wherein an in phase between CSF and brain tissues is achieved in the first acquisition, while an opposed phase, which is established by a sequence of a long refocusing pulse train with variable flip angles, a composite flip‐down restore pulse train, and a short time of delay, is attained in the second acquisition. A CSF‐suppressed image is then reconstructed by weighted averaging the in‐ and opposed‐phase images. Numerical simulations and in vivo experiments are performed, demonstrating that this single pulse sequence may replace both conventional T₂‐weighted imaging and fluid‐attenuated inversion recovery. Magn Reson Med 63:1422–1430, 2010. © 2010 Wiley‐Liss, Inc.     

Ischemia‐reperfusion injury in rat skeletal muscle assessed with T2‐weighted and dynamic contrast‐enhanced MRI

Pressure ulcers are localized areas of soft tissue breakdown due to mechanical loading. Susceptible individuals are subjected to pressure relief strategies to prevent long loading periods. Therefore, ischemia‐reperfusion injury may play an important role in the etiology of pressure ulcers. To investigate the inter‐relation between postischemic perfusion and changes in skeletal muscle integrity, the hindlimbs of Brown Norway rats were subjected to 4‐h ischemia followed by 2‐h reperfusion. Dynamic contrast‐enhanced MRI was used to examine perfusion, and changes in skeletal muscle integrity were monitored with T₂‐weighted MRI. The dynamic contrast‐enhanced MRI data showed a heterogeneous postischemic profile in the hindlimb, consisting of areas with increased contrast enhancement (14–76% of the hindlimb) and regions with no‐reflow (5–77%). For T₂, a gradual increase in the complete leg was observed during the 4‐h ischemic period (from 34 to 41 msec). During the reperfusion phase, a heterogeneous distribution of T₂ was observed. Areas with increased contrast enhancement were associated with a decrease in T₂ (to 38 msec) toward preischemic levels, whereas no‐reflow areas exhibited a further increase in T₂ (to 42 msec). These results show that reperfusion after prolonged ischemia may not be complete, thereby continuing the ischemic condition and aggravating tissue damage. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Phase enhancement for time‐of‐flight and flow‐sensitive black‐blood MR angiography

A magnitude‐based MR angiography method of standard time‐of‐flight (TOF) employing a three‐dimensional gradient‐echo sequence with flow rephasing is widely used. A recently proposed flow‐sensitive black‐blood (FSBB) method combining three‐dimensional gradient‐echo sequence with a flow‐dephasing gradient and a hybrid technique, called hybrid of opposite‐contrast, allow depiction of smaller blood vessels than does standard TOF. To further enhance imaging of smaller vessels, a new enhancement technique combining phase with magnitude is proposed. Both TOF and FSBB pulse sequences were used with only 0th‐order gradient moment nulling, and suitable dephasing gradients were added to increase the phase shift introduced mainly by flow. Magnitude‐based vessel‐to‐background contrast‐to‐noise ratios in TOF and FSBB were further enhanced to increase the dynamic range between positive and negative signals through the use of cosine‐function‐based filters for white‐ and black‐blood imaging. The proposed phase‐enhancement processing both improved visualization of slow‐flow vessels in the brains of volunteer subjects with shorter echo time in TOF, FSBB, and hybrid of opposite‐contrast and reduced wraparound artifacts with smaller b values without sacrificing vessel‐to‐background contrast in FSBB. This method of enhancement processing has excellent potential to become clinically useful. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Comprehensive quantification of signal‐to‐noise ratio and g‐factor for image‐based and k‐space‐based parallel imaging reconstructions

Parallel imaging reconstructions result in spatially varying noise amplification characterized by the g‐factor, precluding conventional measurements of noise from the final image. A simple Monte Carlo based method is proposed for all linear image reconstruction algorithms, which allows measurement of signal‐to‐noise ratio and g‐factor and is demonstrated for SENSE and GRAPPA reconstructions for accelerated acquisitions that have not previously been amenable to such assessment. Only a simple “prescan” measurement of noise amplitude and correlation in the phased‐array receiver, and a single accelerated image acquisition are required, allowing robust assessment of signal‐to‐noise ratio and g‐factor. The “pseudo multiple replica” method has been rigorously validated in phantoms and in vivo, showing excellent agreement with true multiple replica and analytical methods. This method is universally applicable to the parallel imaging reconstruction techniques used in clinical applications and will allow pixel‐by‐pixel image noise measurements for all parallel imaging strategies, allowing quantitative comparison between arbitrary k‐space trajectories, image reconstruction, or noise conditioning techniques. Magn Reson Med 60:895–907, 2008. © 2008 Wiley‐Liss, Inc.     

Super‐resolved spatially encoded single‐scan 2D MRI

Single‐scan MRI underlies a wide variety of clinical and research activities, including functional and diffusion studies. Most common among these “ultrafast” MRI approaches is echo‐planar imaging. Notwithstanding its proven success, echo‐planar imaging still faces a number of limitations, particularly as a result of susceptibility heterogeneities and of chemical shift effects that can become acute at high fields. The present study explores a new approach for acquiring multidimensional MR images in a single scan, which possesses a higher built‐in immunity to this kind of heterogeneity while retaining echo‐planar imaging's temporal and spatial performances. This new protocol combines a novel approach to multidimensional spectroscopy, based on the spatial encoding of the spin interactions, with image reconstruction algorithms based on super‐resolution principles. Single‐scan two‐dimensional MRI examples of the performance improvements provided by the resulting imaging protocol are illustrated using phantom‐based and in vivo experiments. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Test‐retest variability of VO2max using total‐capture indirect calorimetry reveals linear relationship of VO2 and Power

This study aimed to analyze the intra‐individual variation in VO_2max of human subjects using total‐capture and free‐flow indirect calorimetry. Twenty‐seven men (27 ± 5 year; VO_2max 49‐79 mL?kg^?1?min^?1) performed two maximal exertion tests (CPETs) on a cycle ergometer, separated by a 7 ± 2 day interval. VO₂ and VCO₂ were assessed using an indirect calorimeter (Omnical) with total capture of exhalation in a free‐flow airstream. Thirteen subjects performed a third maximal exertion test using a breath‐by‐breath calorimeter (Oxycon Pro). On‐site validation was deemed a requirement. For the Omnical, the mean within‐subject CV for VO_2max was 1.2 ± 0.9% (0.0%‐4.4%) and for ergometer workload P _max 1.3 ± 1.3% (0%‐4.6%). VO_2max values with the Oxycon Pro were significantly lower in comparison with Omnical (P < 0.001; t test) with mean 3570 vs 4061 and difference SD 361 mL?min^?1. Validation results for the Omnical with methanol combustion were ?0.05 ± 0.70% (mean ± SD; n = 31) at the 225 mL?min^?1 VO₂ level and ?0.23 ± 0.80% (n = 31) at the 150 mL?min^?1 VCO₂ level. Results using gas infusion were 0.04 ± 0.75% (n = 34) and ?0.99 ± 1.05% (n = 24) over the respective 500‐6000 mL?min^?1 VO₂ and VCO₂ ranges. Validation results for the Oxycon Pro in breath‐by‐breath mode were ‐ 2.2 ± 1.6% (n = 12) for VO₂ and 5.7 ± 3.3% (n = 12) for VCO₂ over the 1000‐4000 mL?min^?1 range. On a Visual analog scale, participants reported improved breathing using the free‐flow indirect calorimetry (score 7.6 ± 1.2 vs 5.1 ± 2.7, P = 0.008). We conclude that total capturing free‐flow indirect calorimetry is suitable for measuring VO₂ even with the highest range. VO_2max was linear with the incline in P _max over the full range.     

Hybrid of opposite‐contrast MR angiography (HOP‐MRA) combining time‐of‐flight and flow‐sensitive black‐blood contrasts

For the purpose of visualizing low‐flow as well as high‐flow blood vessels without using contrast agents, we propose a new technique called a hybrid of opposite‐contrast MR angiography (HOP‐MRA). HOP‐MRA is a combination of standard time‐of‐flight (TOF) using a full first‐order velocity‐compensation for white‐blood (WB) and flow‐sensitive black‐blood (FSBB) techniques, which use motion‐probing gradients to introduce intravoxel flow dephasing. A dual‐echo three‐dimensional gradient echo sequence was used to reduce both imaging time and misregistration. HOP‐MRA images were obtained using a simple‐weighted subtraction (SWS) or a frequency‐weighted subtraction (FWS) applying different spatial filtering for WB and BB images. We then assessed the relationships among the contrast‐to‐noise ratios (CNR) of the blood‐to‐background signals for those three images. In both volunteer and clinical brain studies, low‐flow vessels were well visualized and the background signal was well suppressed by HOP‐MRA compared with standard TOF‐ or BB‐MRA. The FWS was better than the SWS when whole‐maximum intensity projection was performed on a larger volume including with different types of tissue. The proposed HOP‐MRA was proven to visualize low‐flow to high‐flow vessels and, therefore, demonstrates excellent potential to become a clinically useful technique, especially for visualizing collateral vessels which is difficult with standard TOF‐MRA. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.