Magnetic Resonance Phase Research Articles

Quantitative susceptibility mapping (QSM) as a means to measure brain iron? A post mortem validation study

Quantitative susceptibility mapping (QSM) is a novel technique which allows determining the bulk magnetic susceptibility distribution of tissue in vivo from gradient echo magnetic resonance phase images. It is commonly assumed that paramagnetic iron is the predominant source of susceptibility variations in gray matter as many studies have reported a reasonable correlation of magnetic susceptibility with brain iron concentrations in vivo. Instead of performing direct comparisons, however, all these studies used the putative iron concentrations reported in the hallmark study by Hallgren and Sourander (1958) for their analysis. Consequently, the extent to which QSM can serve to reliably assess brain iron levels is not yet fully clear. To provide such information we investigated the relation between bulk tissue magnetic susceptibility and brain iron concentration in unfixed (in situ) post mortem brains of 13 subjects using MRI and inductively coupled plasma mass spectrometry. A strong linear correlation between chemically determined iron concentration and bulk magnetic susceptibility was found in gray matter structures (r = 0.84, p < 0.001), whereas the correlation coefficient was much lower in white matter (r = 0.27, p < 0.001). The slope of the overall linear correlation was consistent with theoretical considerations of the magnetism of ferritin supporting that most of the iron in the brain is bound to ferritin proteins. In conclusion, iron is the dominant source of magnetic susceptibility in deep gray matter and can be assessed with QSM. In white matter regions the estimation of iron concentrations by QSM is less accurate and more complex because the counteracting contribution from diamagnetic myelinated neuronal fibers confounds the interpretation.

Magnetic resonance 4D flow analysis of cerebrospinal fluid dynamics in Chiari I malformation with and without syringomyelia

To analyse cerebrospinal fluid (CSF) hydrodynamics in patients with Chiari type I malformation (CM) with and without syringomyelia using 4D magnetic resonance (MR) phase contrast (PC) flow imaging. 4D-PC CSF flow data were acquired in 20 patients with CM (12 patients with presyrinx/syrinx). Characteristic 4D-CSF flow patterns were identified. Quantitative CSF flow parameters were assessed at the craniocervical junction and the cervical spinal canal and compared with healthy volunteers and between patients with and without syringomyelia. Compared with healthy volunteers, 17 CM patients showed flow abnormalities at the craniocervical junction in the form of heterogeneous flow (n = 3), anterolateral flow jets (n = 14) and flow vortex formation (n = 5), most prevalent in patients with syringomyelia. Peak flow velocities at the craniocervical junction were significantly increased in patients (-15.5 ± 11.3 vs. -4.7 ± 0.7 cm/s in healthy volunteers, P < 0.001). At the level of C1, maximum systolic flow was found to be significantly later in the cardiac cycle in patients (30.8 ± 10.3 vs. 22.7 ± 4.1%, P < 0.05). 4D-PC flow imaging allowed comprehensive analysis of CSF flow in patients with Chiari I malformation. Alterations of CSF hydrodynamics were most pronounced in patients with syringomyelia.

Automated Motion Estimation for 2-D Cine DENSE MRI

Cine displacement encoding with stimulated echoes (DENSE) is a magnetic resonance (MR) method that directly encodes tissue displacement into MR phase images. This technique has successfully interrogated many forms of tissue motion, but is most commonly used to evaluate cardiac mechanics. Currently, motion analysis from cine DENSE images requires manually delineated anatomical structures. An automated analysis would improve measurement throughput, simplify data interpretation, and potentially access important physiological information during the MR exam. In this paper, we present the first fully automated solution for the estimation of tissue motion and strain from 2-D cine DENSE data. Results using both simulated and human cardiac cine DENSE data indicate good agreement between the automated algorithm and the standard semi-manual analysis method.

Mapping magnetic susceptibility anisotropies of white matter in vivo in the human brain at 7T

High-resolution magnetic resonance phase- or frequency-shift images acquired at high field show contrast related to magnetic susceptibility differences between tissues. Such contrast varies with the orientation of the organ in the field, but the development of quantitative susceptibility mapping (QSM) has made it possible to reproducibly image the intrinsic tissue susceptibility contrast. However, recent studies indicate that magnetic susceptibility is anisotropic in brain white matter and, as such, needs to be described by a symmetric second-rank tensor( ̅χ). To fully determine the elements of this tensor, it would be necessary to acquire frequency data at six or more orientations. Assuming cylindrical symmetry of the susceptibility tensor in myelinated white matter fibers, we propose a simplified method to reconstruct the susceptibility tensor in terms of a mean magnetic susceptibility, MMS=(χ(//)+2 χ(⊥))/3 and a magnetic susceptibility anisotropy, MSA=χ(//)-χ(⊥), where χ(//) and χ(⊥) are susceptibility parallel and perpendicular to the white matter fiber direction, respectively. Computer simulations show that with a practical head rotation angle of around 20°-30°, four head orientations suffice to reproducibly reconstruct the tensor with good accuracy. We tested this approach on whole brain 1 × 1 × 1 mm(3) frequency data acquired from five healthy subjects at 7 T. The frequency information from phase images collected at four head orientations was combined with the fiber direction information extracted from diffusion tensor imaging (DTI) to map the white matter susceptibility tensor. The MMS and MSA were quantified for regions in several large white matter fiber structures, including the corona radiata, posterior thalamic radiation and corpus callosum. MMS ranged from -0.037 to -0.053 ppm (referenced to CSF being about zero). MSA values could be quantified without the need for a reference and ranged between 0.004 and 0.029 ppm, in line with the expectation that the susceptibility perpendicular to the fiber is more diamagnetic than the one parallel to it.

Volumetric BOLD fMRI simulation: from neurovascular coupling to multivoxel imaging

BackgroundThe blood oxygenation-level dependent (BOLD) functional magnetic resonance imaging (fMRI) modality has been numerically simulated by calculating single voxel signals. However, the observation on single voxel signals cannot provide information regarding the spatial distribution of the signals. Specifically, a single BOLD voxel signal simulation cannot answer the fundamental question: is the magnetic resonance (MR) image a replica of its underling magnetic susceptibility source? In this paper, we address this problem by proposing a multivoxel volumetric BOLD fMRI simulation model and a susceptibility expression formula for linear neurovascular coupling process, that allow us to examine the BOLD fMRI procedure from neurovascular coupling to MR image formation.MethodsSince MRI technology only senses the magnetism property, we represent a linear neurovascular-coupled BOLD state by a magnetic susceptibility expression formula, which accounts for the parameters of cortical vasculature, intravascular blood oxygenation level, and local neuroactivity. Upon the susceptibility expression of a BOLD state, we carry out volumetric BOLD fMRI simulation by calculating the fieldmap (established by susceptibility magnetization) and the complex multivoxel MR image (by intravoxel dephasing). Given the predefined susceptibility source and the calculated complex MR image, we compare the MR magnitude (phase, respectively) image with the predefined susceptibility source (the calculated fieldmap) by spatial correlation.ResultsThe spatial correlation between the MR magnitude image and the magnetic susceptibility source is about 0.90 for the settings of TE = 30 ms, B0 = 3 T, voxel size = 100 micron, vessel radius = 3 micron, and blood volume fraction = 2%. Using these parameters value, the spatial correlation between the MR phase image and the susceptibility-induced fieldmap is close to 1.00.ConclusionOur simulation results show that the MR magnitude image is not an exact replica of the magnetic susceptibility source (spatial correlation ≈ 0.90), and that the MR phase image conforms closely with the susceptibility-induced fieldmap (spatial correlation ≈ 1.00).

Validation of transit time flow measurement in coronary artery bypass surgery using 3-Tesla magnetic resonance phase contrast imaging

Objectives: Validation of intra-operative transit time flow measurement in coronary artery bypass surgery with the help of 3-Tesla magnetic resonance (MR) phase contrast imaging.

Computational Fluid Dynamics and Its Impact on Flow Measurements Using Phase-Contrast MR-Angiography

Rationale and Objectives: Computational fluid dynamic (CFD) simulations are discussed with respect to their potential for quality assurance of flow quantification using commercial software for the evaluation of magnetic resonance phase contrast angiography (PCA) data. Materials and Methods: Magnetic resonance phase contrast angiography data was evaluated with the Nova software. CFD simulations were performed on that part of the vessel system where the flow behavior was unexpected or non-reliable. The CFD simulations were performed with in-house written software. Results: The numerical CFD calculations demonstrated that under reasonable boundary conditions, defined by the PCA velocity values, the flow behavior within the critical parts of the vessel system can be correctly reproduced. Conclusion: CFD simulations are an important extension to commercial flow quantification tools with regard to quality assurance.

Diagnostic Challenges and Pitfalls in MR Imaging with Hepatocyte-specific Contrast Agents

The use of gadolinium-based hepatocyte-specific contrast agents (HSCAs) has increased markedly since their introduction, and hepatocellular phase imaging performed with an HSCA is now a key part of the standard magnetic resonance (MR) imaging work-up for focal liver lesions. An understanding of the mechanisms of action of HSCAs helps ensure their effective use. The optimal delay for hepatocellular phase image acquisition differs between the two currently available HSCAs, gadoxetic acid and gadobenate dimeglumine, and MR imaging protocols must be adjusted accordingly. In addition, familiarity with typical and atypical appearances of benign and malignant focal liver lesions at HSCA-enhanced hepatocellular phase MR imaging, along with knowledge of the processes that are most likely to produce atypical appearances, is required to achieve optimal diagnostic accuracy.

A new method for quantification of false lumen thrombosis in aortic dissection using magnetic resonance imaging and a blood pool contrast agent

False lumen thrombosis after aortic dissection is a major predictor of prognosis. First pass computed tomography (CT) and magnetic resonance (MR) imaging are used routinely, where the image acquisition is timed to the arrival of contrast in the proximal unaffected aorta. Delayed phase imaging is difficult to refine because flow rates in the false lumen are often very slow and highly variable between patients. Blood pool contrast agents bind to albumin and become homogenously distributed in the intravascular circulation, allowing accurate imaging of areas where flow is low. We compared first pass MR and CT with a delayed phase MR acquisition using a blood pool agent to assess whether this more accurately quantified false lumen thrombosis. Patients with medically treated chronic type B aortic dissection and evidence of false lumen thrombosis on previous CT imaging underwent first pass CT, first pass MR, and delayed phase MR with blood pool agent. Absence of false lumen contrast enhancement was quantified to assess the apparent differences in thrombosis. Phase-contrast MR data were also obtained to assess the affect of flow velocity on false lumen contrast enhancement, and direct thrombus MR images were used to confirm the presence of thrombus. Twelve patients were recruited. No difference was seen in apparent thrombus volume between first pass CT and first pass MR imaging (146.9 cm(3) [SD, 88.6] vs 187.6 cm(3) [SD, 136.1], P = .1119; R(2) = .67 [95% confidence interval (CI), r = .46-.95], P = .0012). In all patients, the volume of thrombus derived from first pass acquisitions was greater than the volume derived from delayed phase MR imaging with blood pool agent: first pass CT (paired t test, P = .0007; mean difference = 83.4 cm(3) [95% CI, 44.1-122.6]) and first pass MR (paired t test, P = .0009; mean difference = 124.0 cm(3) [95% CI, 63.2-184.9]). The difference in thrombus volume between first pass and delayed phase MR imaging with blood pool agent correlated significantly with the mean velocity of flow in the false lumen, with lower flow related to a greater difference (R(2) = .61, P = .0028 [95% CI, r = -.94--.37]). Direct thrombus MR images were able to correctly discriminate between thrombus and blood and matched the area of contrast absence on delayed phase MR with blood pool agent images. First pass techniques to assess false lumen thrombosis in aortic dissection consistently overestimate the apparent thrombus volume by five to six times. This has implications for interpretation of cohort studies and clinical trials that use false lumen thrombosis as an outcome measure. We recommend delayed phase MR imaging with a blood pool agent when accurate assessment of false lumen thrombosis is required.

Ramp-Preserving Denoising for Conductivity Image Reconstruction in Magnetic Resonance Electrical Impedance Tomography

In magnetic resonance electrical impedance tomography, among several conductivity image reconstruction algorithms, the harmonic B(z) algorithm has been successfully applied to B(z) data from phantoms and animals. The algorithm is, however, sensitive to measurement noise in B(z) data. Especially, in in vivo animal and human experiments where injection current amplitudes are limited within a few milliampere at most, measured B(z) data tend to have a low SNR. In addition, magnetic resonance (MR) signal void in outer layers of bones and gas-filled organs, for example, produces salt-pepper noise in the MR phase and, consequently, B(z) images. The B(z) images typically present areas of sloped transitions, which can be assimilated to ramps. Conductivity contrasts change ramp slopes in B(z) images and it is critical to preserve positions of those ramps to correctly recover edges in conductivity images. In this paper, we propose a ramp-preserving denoising method utilizing a structure tensor. Using an eigenvalue analysis, we identified local regions of salt-pepper noise. Outside the identified local regions, we applied an anisotropic smoothing to reduce noise while preserving their ramp structures. Inside the local regions of salt-pepper noise, we used an isotropic smoothing. After validating the proposed denoising method through numerical simulations, we applied it to in vivo animal imaging experiments. Both numerical simulation and experimental results show significant improvements in the quality of reconstructed conductivity images.

Comparison of arterial and venous coronary artery bypass flow measurements using 3-T magnetic resonance phase contrast imaging

Comparison of arterial and venous coronary artery bypass flow measurements using 3-T magnetic resonance (MR) phase contrast in correlation with intraoperative Doppler flow measurements. Fifty-six coronary bypasses (right coronary artery n=18, left internal mammary artery to left anterior descending artery n=16, marginal artery n=7, circumflex artery n=7, diagonal artery n=6, left anterior descending artery n=1, and right internal mammary artery to right coronary artery n=1) were studied in 27 asymptomatic patients. In this prospective study, each bypass was studied intra-operatively using Doppler flow measurement. Within one week post surgery, patients were studied using a 3-T MR scanner (Magnetom Verio, Siemens, Erlangen, Germany) using velocity encoded phase-contrast flow measurements. Intraoperative Doppler flow measurements demonstrated regular flow patterns in all vascular territories supplied. All bypasses were patent on MRI and flow measurement results were as follows: median flow 60ml/min (interquartile range (IQR): 37.5-78.5ml/min). For comparison, the corresponding median intraoperative flow was 58ml/min (IQR: 41-80ml/min) (p<0.001; R=0.44). Linear regression analysis demonstrated a significant correlation for venous bypasses (p=0.0002; R=0.48), but not for arterial bypasses (p=0.09; R=0.24). This study demonstrated that MR flow measurements of venous bypass grafts agreed more with Doppler than arterial bypass grafts. However, bypass patency was confirmed for all patients. In the future, this technique may be used for non invasive coronary bypass graft follow-up.

Detection of Pancreatic Carcinoma and Liver Metastases with Gadoxetic Acid–enhanced MR Imaging: Comparison with Contrast-enhanced Multi–Detector Row CT

To intraindividually compare gadoxetic acid-enhanced magnetic resonance (MR) imaging with contrast material-enhanced multi-detector row computed tomography (CT) in detection of pancreatic carcinoma and liver metastases. The ethics committee approved this retrospective study with waiver of informed consent. This study included 100 patients (53 men, 47 women; mean age, 67.8 years) consisting of 54 patients with pathologically confirmed pancreatic carcinoma (mean size, 33 mm) and 46 without a pancreatic lesion. Sixty-two liver metastases (mean size, 10 mm) in 15 patients with pancreatic carcinoma were diagnosed at pathologic examination or multimodality assessment. Three readers blinded to the final diagnosis interpreted all MR (precontrast T1- and T2-weighted and gadoxetic acid-enhanced dynamic and hepatocyte phase MR images) and tetraphasic dynamic contrast-enhanced CT images and graded the presence (or absence) of pancreatic carcinoma and liver metastasis on patient-by-patient and lesion-by-lesion bases. Receiver operating characteristic analysis, McNemar test, and Fisher test were performed to compare the diagnostic performance of CT and MR imaging. No significant differences were observed between CT and MR images in depiction of pancreatic carcinoma. However, MR imaging had greater sensitivity in depicting liver metastasis than did CT for two of the three readers in the MR imaging-versus-CT analysis (85% vs 69%, P = .046) and for all three readers in the lesion-by-lesion analysis (92%-94% vs 74%-76%, P = .030-.044). Gadoxetic acid-enhanced MR imaging was equivalent to dynamic contrast-enhanced CT in depicting pancreatic carcinoma and had better sensitivity for depicting liver metastases, suggesting the usefulness of gadoxetic acid-enhanced MR imaging for evaluation of patients with pancreatic carcinoma.

Bilateral filtering of magnetic resonance phase images

High-pass filtering is required for the removal of background field inhomogeneities in magnetic resonance phase images. This high-pass filtering smooths across boundaries between areas with large differences in phase. The most prominent boundary is the surface of the brain where areas with large phase values inside the brain are located close to areas outside the brain where the phase is, on average, zero. Cortical areas, which are of great interest in brain MRI, are therefore often degraded by high-pass filtering. Here, we propose the use of the bilateral filter for the high-pass filtering step. The bilateral filter is essentially a Gaussian filter that stops smoothing at boundaries. We show that the bilateral filter improves image quality at the brain's surface, without sacrificing contrast within the brain.

SU‐E‐I‐128: Evaluation of Magnetic Resonance Phase Data of Projection and 2‐D FLASH Acquisition to Estimate the AIF

Purpose: Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE‐ MRI) is a technique that non‐invasively collects data related to the vasculature of tissue. Quantitative information is derived from the time course concentration of contrast agent in a supplying vessel, known as the arterial input function (AIF). The AIF should have a high temporal resolution, but it often compromises spatial resolution. The phase of MRI signal varies linearly with the concentration of a contrast agent, is independent of the hematocrit and is expected to have an increased signal to noise ratio (SNR) when compared to magnitude based data. The use of phase data from projection images satisfies the requirement for high temporal resolution and may be used to reconstruct a 2D image if projected along different axes. Methods: Data was collected using a 7.0 T Bruker MRI system. 1‐D Projection and 2‐D FLASH images were collected on a phantom for varying concentrations of Gadolinium. Phase information was determined directly from the free induction decay (FID) and unwrapped where appropriate. Results: Calibration of the phase data (2‐D FLASH acquisition) verified that the phase increased linearly with the concentration of contrast agent with a slope of (1.183 ± 0.015) rad/mM. A small phase drift was present ((0.014± 0.019) rad/100 min), but had neglible impact on the calibration curve. The concentration of contrast agent as determined from the projection data was in good agreement with the 2D analysis with a slope of (1.187 ± 0.027) rad/mM. Conclusions: Projection based imaging will significantly increase the temporal resolution of DCE‐MRI studies. The linear relationship between the phase and concentration of contrast agent was consistent between the 2‐D FLASH and projection acquisitions. The results of this study suggest that projection based imaging may be used to accurately estimate the AIF.

New MR sequences in daily practice: susceptibility weighted imaging. A pictorial essay

BackgroundSusceptibility-weighted imaging (SWI) is a relatively new magnetic resonance (MR) technique that exploits the magnetic susceptibility differences of various tissues, such as blood, iron and calcification, as a new source of contrast enhancement. This pictorial review is aimed at illustrating and discussing its main clinical applications.MethodsSWI is based on high-resolution, three-dimensional (3D), fully velocity-compensated gradient-echo sequences using both magnitude and phase images. A phase mask obtained from the MR phase images is multiplied with magnitude images in order to increase the visualisation of the smaller veins and other sources of susceptibility effects, which are displayed at best after post-processing of the 3D dataset with the minimal intensity projection (minIP) algorithm.ResultsSWI is very useful in detecting cerebral microbleeds in ageing and occult low-flow vascular malformations, in characterising brain tumours and degenerative diseases of the brain, and in recognizing calcifications in various pathological conditions. The phase images are especially useful in differentiating between paramagnetic susceptibility effects of blood and diamagnetic effects of calcium. SWI can also be used to evaluate changes in iron content in different neurodegenerative disorders.ConclusionSWI is useful in differentiating and characterising diverse brain disorders.

Non invasive assessment of renal artery using dual MRA techniques compared with invasive renal angiography in cases of renovascular hypertension

Renal artery stenosis (RAS) is one of the leading causes of secondary hypertension, and can result in refractory hypertension or ischemic renal failure. RAS is present in 0.5–5% of all hypertensive patients. It became even more important to diagnose it in the time of intervention. Direct Angiography is the Gold Standard for evaluation of renal artery stenosis and severity. It cannot be used as a screening test because of its invasiveness, high cost and use of nephrotoxic gents. Different non invasive techniques have evolved for the evaluation of renal artery including; captopril renography, computed tomography (CT) angiography, magnetic resonance (MR) angiography and ultrasound (US) Doppler. Recently, the advent of CE 3D MRA appears to be a new promising approach. To evaluate the diagnostic value of both contrast enhanced magnetic resonance angiography (CE MRA) and phase contrast MRA (PC MRA) techniques in cases of renal artery stenosis as compared to conventional angiography. Thirty patients (22 males and 8 females), with mean age 37 years (range 23–72 years). All with suspected renal artery stenosis were evaluated using both CE MRA and PC MRA techniques. All were subsequently subjected to conventional renal angiography. CE MRA alone compared to direct Angiography (Gold standard) had a 91% sensitivity and 87% specificity. PC MRA had overall 50% sensitivity and 25% specificity. PC MRA alone was unable to differentiate mild stenosis from normal and could not distinguish severe stenosis from total occlusion. Combining both MRA techniques yielded 100% specificity 94% positive and 100% negative predictive values. The combined approach of non-invasive CE MRA and PC MRA techniques achieves a very high specificity, PPV and NPV for the detection of renal arterial pathomorphologic features as compared to standard renal angiography. Adding PC MRA to CE MRA helps to differentiate between mild and moderate stenoses as well as moderate and sever arterial stenotic lesions. So, CE MRA is a morphological test while PC MRA helps in grading the arterial stenoses.

Phase contrast imaging in neonates

Magnetic resonance phase images can yield superior gray and white matter contrast compared to conventional magnitude images. However, the underlying contrast mechanisms are not yet fully understood. Previous studies have been limited to high field acquisitions in adult volunteers and patients. In this study, phase imaging in the neonatal brain is demonstrated for the first time. Compared to adults, phase differences between gray and white matter are significantly reduced but not inverted in neonates with little myelination and iron deposits in their brains. The remaining phase difference between the neonatal and adult brains may be due to a different macromolecule concentration in the unmyelinated brain of the neonates and thus a different frequency due to water macromolecule exchange. Additionally, the susceptibility contrast from brain myelination can be separately studied in neonates during brain development. Therefore, magnetic resonance phase imaging is suggested as a novel tool to study neonatal brain development and pathologies in neonates.

Quantitative imaging of intrinsic magnetic tissue properties using MRI signal phase: An approach to in vivo brain iron metabolism?

Quantitative susceptibility mapping (QSM) based on gradient echo (GRE) magnetic resonance phase data is a novel technique for non-invasive assessment of magnetic tissue susceptibility differences. The method is expected to be an important means to determine iron distributions in vivo and may, thus, be instrumental for elucidating the physiological role of iron and disease-related iron concentration changes associated with various neurological and psychiatric disorders. This study introduces a framework for QSM and demonstrates calculation of reproducible and orientation-independent susceptibility maps from GRE data acquired at 3T. The potential of these susceptibility maps to perform anatomical imaging is investigated, as well as the ability to measure the venous blood oxygen saturation level in large vessels, and to assess the local tissue iron concentration. In order to take into account diamagnetic susceptibility contributions induced by myelin, a correction scheme for susceptibility based iron estimation is demonstrated. The findings suggest that susceptibility contrast, and therewith also phase contrast, are not only linked to the storage iron concentration but are also significantly influenced by other sources such as myelin. After myelin correction the linear dependence between magnetic susceptibilities and previously published iron concentrations from post mortem studies was significantly improved. Finally, a comparison between susceptibility maps and processed phase images indicated that caution should be exercised when drawing conclusions about iron concentrations when directly assessing processed phase information.

Comprehensive four-dimensional phase-contrast flow assessment in hemi-Fontan circulation: systemic-to-pulmonary collateral flow quantification

Precise lung perfusion quantification is essential for evaluation of patients with hemi-Fontan surgery. It is possible for two-dimensional cardiac magnetic resonance phase contrast flow (two-dimensional flow) to evaluate non-invasively the systemic-to-pulmonary collateral blood flow. This case report intends to illustrate the benefit of four-dimensional flow over the current two-dimensional flow in the comprehensive assessment of hemi-Fontan patients.

Differentiation between diamagnetic and paramagnetic cerebral lesions based on magnetic susceptibility mapping

Identification of calcifications and hemorrhages is essential for the etiological diagnosis of cerebral lesions. The purpose of this work was to develop a robust method for characterization of para- and diamagnetic intracerebral lesions based on clinical gradient-echo magnetic resonance phase data acquired at 1.5 Tesla. The magnetic susceptibility distribution of biological tissue produces a distinct magnetic field pattern, which is directly reflected in gradient-echo magnetic resonance phase images. Compared to brain parenchyma, iron-laden tissues are more paramagnetic, whereas mineralized tissues usually possess more diamagnetic susceptibilities. Magnetic resonance phase data were inverted to the underlying susceptibility distribution utilizing additional geometrical information about the lesions, which was obtained from the gradient-echo magnitude signal void corresponding to the lesions. Clinical magnetic resonance exams of three patients with multiple brain lesions (total n = 70) were processed and evaluated. For one patient, the results were validated by an additionally available computed tomography scan. Numerical simulations were conducted to evaluate the robustness of the method. The obtained susceptibility maps showed impressive delineation of lesions, vessels, and potentially iron-laden tissue. Compensation of the nonlocal field perturbations was clearly discernable on the susceptibility maps. In all cases, discrimination of para- from diamagnetic lesions was achieved and the results were confirmed by the additional computed tomography. The numerical simulations demonstrated that robust determination of the total magnetic moment of lesions is possible. Thus, the proposed method is able to yield quantitative values for the minimum magnetic susceptibility of lesions. A method has been developed for noninvasive, semiautomatic characterization of brain lesions based on magnetic resonance imaging data. Initial clinical results demonstrated that the proposed technique can be applied to diagnosis of lesions with calcifications or hemorrhages. If confirmed by larger studies, it bears the potential to obviate the need for confirmation with computed tomography.