Magnetization-prepared Rapid Gradient Echo Research Articles

Non-Enhanced MR Imaging of Cerebral Aneurysms: 7 Tesla versus 1.5 Tesla

PurposeTo prospectively evaluate 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) in comparison to 1.5 Tesla TOF MRA and 7 Tesla non-contrast enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of unruptured intracranial aneurysms (UIA).Material and MethodsSixteen neurosurgical patients (male n = 5, female n = 11) with single or multiple UIA were enrolled in this trial. All patients were accordingly examined at 7 Tesla and 1.5 Tesla MRI utilizing dedicated head coils. The following sequences were obtained: 7 Tesla TOF MRA, 1.5 Tesla TOF MRA and 7 Tesla non-contrast enhanced MPRAGE. Image analysis was performed by two radiologists with regard to delineation of aneurysm features (dome, neck, parent vessel), presence of artifacts, vessel-tissue-contrast and overall image quality. Interobserver accordance and intermethod comparisons were calculated by kappa coefficient and Lin's concordance correlation coefficient.ResultsA total of 20 intracranial aneurysms were detected in 16 patients, with two patients showing multiple aneurysms (n = 2, n = 4). Out of 20 intracranial aneurysms, 14 aneurysms were located in the anterior circulation and 6 aneurysms in the posterior circulation. 7 Tesla MPRAGE imaging was superior over 1.5 and 7 Tesla TOF MRA in the assessment of all considered aneurysm and image quality features (e.g. image quality: mean MPRAGE7T: 5.0; mean TOF7T: 4.3; mean TOF1.5T: 4.3). Ratings for 7 Tesla TOF MRA were equal or higher over 1.5 Tesla TOF MRA for all assessed features except for artifact delineation (mean TOF7T: 4.3; mean TOF1.5T 4.4). Interobserver accordance was good to excellent for most ratings.Conclusion7 Tesla MPRAGE imaging demonstrated its superiority in the detection and assessment of UIA as well as overall imaging features, offering excellent interobserver accordance and highest scores for all ratings. Hence, it may bear the potential to serve as a high-quality diagnostic tool for pretherapeutic assessment and follow-up of untreated UIA.

Altered Structural Connectome in Temporal Lobe Epilepsy

To study differences in the whole-brain structural connectomes of patients with left temporal lobe epilepsy (TLE) and healthy control subjects. This study was approved by the institutional review board, and all individuals gave signed informed consent. Sixty-direction diffusion-tensor imaging and magnetization-prepared rapid acquisition gradient-echo (MP-RAGE) magnetic resonance imaging volumes were analyzed in 24 patients with left TLE and in 24 healthy control subjects. MP-RAGE volumes were segmented into 1015 regions of interest (ROIs) spanning the entire brain. Deterministic white matter tractography was performed after voxelwise tensor calculation. Weighted structural connectivity matrices were generated by using the pairwise density of connecting fibers between ROIs. Graph theoretical measures of connectivity networks were compared between groups by using linear models with permutation testing. Patients with TLE had 22%-45% reduced (P < .01) distant connectivity in the medial orbitofrontal cortex, temporal cortex, posterior cingulate cortex, and precuneus, compared with that in healthy subjects. However, local connectivity, as measured by means of network efficiency, was increased by 85%-270% (P < .01) in the medial and lateral frontal cortices, insular cortex, posterior cingulate cortex, precuneus, and occipital cortex in patients with TLE as compared with healthy subjects. This study suggests that TLE involves altered structural connectivity in a network that reaches beyond the temporal lobe, especially in the default mode network.

Novel 3D-CT evaluation of carotid stent volume: greater chronological expansion of stents in patients with vulnerable plaques

Although self-expanding carotid stents may dilate gradually, the degrees of residual stenosis have been quantified by the NASCET criteria, which is too simple to reflect the configuration of the stented artery. We measured the volumes of the stent lumens chronologically by 3D-CT in patients after carotid artery stenting (CAS), and analyzed the correlations between the volume change and medical factors. Fourteen patients with carotid artery stenosis were treated using self-expanding, open-cell stents. All patients underwent preoperative plaque MRI (magnetization-prepared rapid acquisition gradient-echo, MPRAGE) and chronological 3D-CT examinations of their stents immediately after their placement and 1 day, 1 week, and 1 month after the procedure. The volume of the stent lumen was measured using a 3D workstation. The correlations between stent volume and various factors including the presence of underlying diseases, plaque characteristics, and the results of the CAS procedure were analyzed. Stent volume gradually increased in each case and had increased by 1.04-1.55 (mean, 1.25)-fold at 1 postoperative month. The presence of underlying medical diseases, plaque length, the degree of residual stenosis immediately after CAS, and plaque calcification did not have an impact on the change in stent volume. On the other hand, the stent volume increase was significantly larger in the patients with vulnerable plaques that demonstrated high MPRAGE signal intensity (P < 0.05). A 3D-CT examination is useful for precisely measuring stent volume. Self-expanding stents in carotid arteries containing vulnerable plaques expand significantly more than those without such plaques in a follow-up period.

Quantitative contrast ratio comparison between T1 (TSE at 1.5T, FLAIR at 3T), magnetization prepared rapid gradient echo and subtraction imaging at 1.5T and 3T.

Creating contrast between normal anatomy and pathology is the main goal of imaging. Here we compare contrast ratios of enhancing brain lesions at 1.5T between T1 TSE, magnetization prepared rapid gradient echo (MPRAGE) and subtraction and at 3T between T1 FLAIR, MPRAGE and subtraction. Contrast ratio between enhancing lesions and normal contralateral brain was measured for above mentioned sequences during the same imaging session. A total of 27 exams on 25 patients were evaluated. A total of 90 enhancing brain lesions were utilized. Of these 46 were <5 mm diameter. Taking all lesions into account there was a small but statistically significant improvement in contrast ratio at 1.5T with MPRAGE compared to T1 TSE and at 3T for T1 FLAIR compared to MPRAGE. However, there was no statistically significant difference between these sequences for lesions 5 mm or less in diameter. However, subtraction provided a marked and statistically significant improvement in contrast ratio for both all lesions and including only lesions 5 mm or less in diameter. Our data indicate that for small lesions at 1.5T there is no significant difference in contrast ratio (CR) between T1 TSE and MPRAGE or at 3T between T1 FLAIR and MPRAGE despite the MPRAGE having the advantage of much thinner slices and a higher matrix. However, subtraction provided a markedly improved CR for all lesions at 1.5T and 3T regardless of lesion size. Subtraction should be considered for clinical use to improve detection of small or subtle enhancing lesions.

7 Tesla MPRAGE Imaging of the Intracranial Arterial Vasculature: Nonenhanced versus Contrast-Enhanced

To intraindividually compare the delineation of intracranial arterial vasculature in nonenhanced versus contrast-enhanced magnetization prepared rapid gradient echo (MPRAGE) imaging at 7 Tesla (T). Sixteen subjects were examined on a 7 T whole-body magnetic resonance system (Magnetom 7T) equipped with a 32-channel transmit/receive head coil. MPRAGE imaging was performed pre- and postcontrast after the application of 0.1 mmol/kg bodyweight gadobutrol. For qualitative analysis, the delineation of the intracranial arteries, overall image quality, and image impairment were assessed in the nonenhanced and contrast-enhanced datasets using a 5-point scale (5 = excellent to 1 = nondiagnostic). Additionally, contrast ratios (CR) of the middle cerebral artery in correlation to surrounding gray matter in nonenhanced and postcontrast images were obtained. For statistical analysis a Wilcoxon signed-rank test was applied. Nonenhanced MPRAGE imaging offered an excellent delineation of the central vessel segments of the anterior circulation (mean anterior circulation 4.6) and a moderate- to high-quality assessment of the vessels of the posterior circulation (mean posterior circulation 3.9). Vessel delineation was improved in all assessed segments in the contrast-enhanced datasets, except for the cavernous segment of the internal carotid artery. Quantitative analysis revealed a mild, nonsignificant increase in CR mean values of the M1 segment (CRnonenhanced 0.67; CRcontrast-enhanced 0.69). Our results demonstrate the high diagnostic value of nonenhanced 7 T MPRAGE imaging for the assessment of the intracranial arterial vasculature, with improved assessment of the peripheral segments because of the application of a contrast agent.

Computer-Aided Detection of Metastatic Brain Tumors Using Magnetic Resonance Black-Blood Imaging

The objective of this study was to develop a computer-aided detection system for automated brain metastases detection using magnetic resonance black-blood imaging and compare its applicability with conventional magnetization-prepared rapid gradient echo (MP-RAGE) imaging. Twenty-six patients with brain metastases were imaged with a contrast-enhanced, 3-dimensional, whole-brain magnetic resonance black-blood pulse sequence. Approval from the institutional review board and informed consent from the patients were obtained. Preprocessing steps included B1 inhomogeneity correction and brain extraction. The computer-aided detection system used 3-dimensional template matching, which measured normalized cross-correlation coefficient to generate possible metastases candidates. An artificial neural network was used for classification after various volume features were extracted. The same detection procedure was tested with contrast-enhanced MP-RAGE, which was also acquired from the same patients. The performance of the proposed detection method was measured by the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity values. In the black-blood case, detection process displayed an AUROC of 0.9355, a sensitivity value of 81.1%, and a specificity value of 98.2%. Magnetization-prepared rapid gradient echo data showed an AUROC of 0.6508, a sensitivity value of 30.2%, and a specificity value of 99.97%. The results demonstrate that accurate automated detection of metastatic brain tumors using contrast-enhanced black-blood imaging sequence is possible compared with using conventional contrast-enhanced MP-RAGE sequence.

Contrast-Enhanced 3-Dimensional SPACE Versus MP-RAGE for the Detection of Brain Metastases

The aim of this study was to compare the detection of brain metastases at 3 T using a 32-channel head coil with 2 different 3-dimensional (3D) contrast-enhanced sequences, a T1-weighted fast spin-echo-based (SPACE; sampling perfection with application-optimized contrasts using different flip angle evolutions) sequence and a conventional magnetization-prepared rapid gradient-echo (MP-RAGE) sequence. Seventeen patients with 161 brain metastases were examined prospectively using both SPACE and MP-RAGE sequences on a 3-T magnetic resonance system. Eight healthy volunteers were similarly examined for determination of signal-to-noise ratio (SNR) values. Parameters were adjusted to equalize acquisition times between the sequences (3 minutes and 30 seconds). The order in which sequences were performed was randomized. Two blinded board-certified neuroradiologists evaluated the number of detectable metastatic lesions with each sequence relative to a criterion standard reading conducted at the Gamma Knife facility by a neuroradiologist with access to all clinical and imaging data. In the volunteer assessment with SPACE and MP-RAGE, SNR (10.3 ± 0.8 vs 7.7 ± 0.7) and contrast-to-noise ratio (0.8 ± 0.2 vs 0.5 ± 0.1) were statistically significantly greater with the SPACE sequence (P < 0.05). Overall, lesion detection was markedly improved with the SPACE sequence (99.1% of lesions for reader 1 and 96.3% of lesions for reader 2) compared with the MP-RAGE sequence (73.6% of lesions for reader 1 and 68.5% of lesions for reader 2; P < 0.01). A 3D T1-weighted fast spin echo sequence (SPACE) improves detection of metastatic lesions relative to 3D T1-weighted gradient-echo-based scan (MP-RAGE) imaging when implemented with a 32-channel head coil at identical scan acquisition times (3 minutes and 30 seconds).

Evaluation of Enhancement Effects as a Function of the Molarity of Gd-Based Contrast Media at 3.0 and 1.5 T: Based on the T1 Effective Pulse Sequence Parameter

The purpose of this study was to evaluate the alterations of diluted molarity of contrast media to emit the maximum signal intensity by changing the parameters of pulse sequences. The phantom was developed by diluting the magnetic resonance imaging (MRI) T1 contrast medium. The phantom images were obtained by 1.5 and 3.0 T MRI systems. We conducted Pearson’s analysis to reveal the correlation of the signal-to-noise ratio (SNR)90%, the change of the concentration range of the contrast media which shows over 90% SNR, with changing the parameters of T1 effect pulse sequences in both 1.5 and 3.0 T imaging. As the flip angle increased, the SNR increased for all contrast media in magnetization-prepared rapid gradient echo and two-dimensional fast low angle shot pulse sequences at 1.5 and 3.0 T. Although the SNR increased until 30°, the SNR was almost the same over 30° in volumetric interpolated breath-hold examination at 1.5 and 3.0 T. The minimum contrast molarity of the representing SNR90% was decreased according to the increasing time to repeat in spin echo. The present study revealed that the high concentration technique of contrast media on three pulse sequences (VIBE, MPRAGE, and 2D FLASH) could be useful to obtain images with better SNR.

Double reading for gross tumor volume assessment in radiotherapy planning

Background/Objective: The precise definition of the gross tumor volume (GTV) that takes into account intra- and interobserver variability is necessary for high-precision radiotherapy (RT) techniques. The purpose of this study was to demonstrate the practical GTV assessment by a “double reading” approach. Methods: Pretreatment magnetic resonance (MR) imaging, including the post-contrast 3D magnetization-prepared rapid-gradient echo (MP-RAGE) sequence (section thickness 1.0 mm) was performed on a 3T superconducting imager in 50 patients with glioblastoma. MR images were transferred to a RT planning system (RTPS) that provides many opportunities for GTV contouring, e.g., at diagnosis, surgical navigation, and RT deliberations. Independent 2 observers preliminarily contoured the GTV on MR images. After planning-CT scanning, CT images with a 1.0 mm slice interval were transferred to the RTPS, registered with the diagnostic images, and then the preliminarily-contoured strictures were copied onto the CT images and used for GTV assessment. The practical GTV on the planning CT was determined by integrating the interpretations and adding information on postoperative changes. The interobserver variability in GTV contouring was assessed by Bland-Altman analysis and the concordance index. Results: There was substantial interobserver variability in GTV contouring (95% limits of agreement: -29.4%, 16.8%). The mean interobserver concordance rate for the GTV was 82.1% (range 56.5-91.2%). The practical GTVs were significantly larger than the preliminarily-contoured GTVs by both observers ( p < 0.01). Conclusions: Considering interobserver variability, “double reading” is necessary for practical GTV assessment. This approach for volume assessment may facilitate the standardization of treatments, not only of RT but also of surgery and chemotherapy.

P4‐190: Monoacylglycerol lipase contributes to pathogenesis of Alzheimer's disease

between aging, health, cognition and lifestyle (Schaie, 2005). The sample included 111 participants, Mage 1⁄4 67 (age range 52 84), imaged on 3 occasions over 4 years. In our sample, there were 32 APOE e4 carriers and 79 APOE e4 noncarriers. Magnetization prepared rapid gradient echo (MPRAGE) imaging was performed on a Philips 3.0 TAchieva scanner. Cortical reconstruction and volumetric segmentation was performedwith the longitudinal pipeline of the FreeSurfer image analysis suite version 5.1.0 (http:// surfer.nmr.mgh.harvard.edu/). Cortical thickness values for each of the 68 parcels defined by the Desikan parcellation (Desikan et al., 2006) were extracted by subject and timepoint. We fit a linear mixed effects model for each parcel that included fixed effects of intercept, age, and APOE e4 carrier status, and the interaction of age andAPOE e4 carrier status to predict slope in cortical thickness of each parcel.Results: The mean estimated cortical thickness at age 60 (intercept) was thinner for APOE e4 carriers than APOE e4 non-carriers in the left inferior parietal parcel and left and right frontal pole. Slope differences (age X e4 carrier status interaction) were found in: left temporal pole and superior frontal regions, and right transverse temporal and caudal anterior cingulate (Figure 1). In all regions except the right transverse temporal, APOE e4 carriers had a steeper rate of decline than non-carriers.Conclusions: The APOE 4 allelemodulatesmean thickness and rates of change both in areas associated with normal aging and in areas associated with progression to AD.

MP2RAGE Multiple Sclerosis Magnetic Resonance Imaging at 3 T

Lesion detection and characterization in multiple sclerosis (MS) are an essential part of its clinical diagnosis and an important research field. In this pilot study, we applied the recently introduced two inversion-contrast magnetization-prepared rapid gradient echo sequence (MP2RAGE) to patients with early-stage MS. The MP2RAGE is a 3-dimensional (3D) magnetization-prepared rapid gradient echo derivative providing homogeneous T1 weighting and simultaneous T1 mapping. The MP2RAGE performance was compared with that of 2 clinical routine sequences (2D fluid-attenuated inversion recovery [FLAIR] and 3D magnetization-prepared rapid gradient echo [MP-RAGE]) and 2 state-of-the art clinical research sequences (the 3D FLAIR-SPACE [sampling perfection with application-optimized contrasts by using different flip-angle evolutions], a fluid-attenuated variable flip-angle fast spin echo technique, and the 3D double-inversion recovery SPACE). A cohort of 10 early-stage female MS patients (age, 31.6 ± 4.7 years; disease duration, 3.8 ± 1.9 years; median expanded disability status scale score, 1.75) and 10 age- and gender-matched controls were enrolled after approval of the local institutional review board was obtained. Multiple sclerosis lesions were identified and assigned to brain locations and tissue types by two experienced physicians in all 5 contrasts. Subsequently, lesions were manually delineated for comparison and statistical analysis of lesion count, volume and quantitative measures. The results show that the 3D T1-weighted high-resolution MP2RAGE contrast provides a sensitive means for MS lesion assessment. The additional quantitative T1 relaxation time maps obtained with the MP2RAGE provide further potential diagnostic and prognostic information that could help (a) to better discriminate lesion subtypes and (b) to stage and predict the activity and the evolution of MS. Results also indicate that the T2-weighted double-inversion recovery and FLAIR-SPACE contrasts are attractive complements to the MP2RAGE for lesion detection.

Simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) imaging for carotid atherosclerotic disease evaluation.

A simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) MR imaging technique is proposed to detect both luminal stenosis and hemorrhage in atherosclerosis patients in a single scan. Thirteen patients with diagnosed carotid atherosclerotic plaque were admitted after informed consent. All scans were performed on a 3T MR imaging system with SNAP, 2D time-of-flight and magnetization-prepared 3D rapid acquisition gradient echo sequences. The SNAP sequence utilized a phase sensitive acquisition, and was designed to provide positive signals corresponding to intraplaque hemorrhage and negative signals corresponding to lumen. SNAP images were compared to time-of-flight images to evaluate lumen size measurements using linear mixed models and the intraclass correlation coefficient. Intraplaque hemorrhage identification accuracy was evaluated by comparing to magnetization-prepared 3D rapid acquisition gradient echo images using Cohen's Kappa. Diagnostic quality SNAP images were generated from all subjects. Quantitatively, the lumen size measurements by SNAP were strongly correlated (intraclass correlation coefficient = 0.96, P < 0.001) with those measured by time-of-flight. For intraplaque hemorrhage detection, strong agreement (κ = 0.82, P < 0.001) was also identified between SNAP and magnetization-prepared 3D rapid acquisition gradient echo images. In conclusion, a SNAP imaging technique was proposed and shows great promise for imaging both lumen size and carotid intraplaque hemorrhage with a single scan.

Detection of Small Metastatic Brain Tumors

Early and accurate diagnosis of small metastatic brain tumors may affect outcomes and treatment strategies. For this reason, 3-dimensional (3D) thin-section imaging is preferred. However, with conventional contrast-enhanced (CE) 3D imaging, such as magnetization-prepared rapid gradient echo (MP-RAGE), many visually enhanced vessels may mimic small metastatic tumors, hindering tumor detection. CE black-blood single-slab 3D turbo-spin echo imaging (BB-ssTSE) was recently developed, which uses variable refocusing flip angles and flow-sensitizing gradient schemes, to enhance metastatic brain tumors while selectively suppressing blood vessels. The purpose of this work was to investigate the efficiency of the proposed CE BB-ssTSE in detecting small metastatic brain tumors as compared with conventional MP-RAGE. Numerical comparisons of MP-RAGE and BB-ssTSE were performed by simulation studies to investigate the signal/contrast behaviors of flowing blood and stationary CE tumors. For in vivo studies, we enrolled 35 patients (18 women; mean age, 58.1 years) with breast or lung cancer who underwent brain magnetic resonance imaging. After administering a double dose of contrast medium, whole-brain 2-dimensional T1-weighted imaging followed by high-resolution isotropic 3D BB-ssTSE and MP-RAGE was performed at 3.0 T. Two reviewers independently evaluated the presence of metastatic brain tumors using: (1) MP-RAGE; (2) BB-ssTSE; and (3) MP-RAGE + BB-ssTSE sequentially in 3 review sessions, 2 weeks apart. The lesions were classified by size into 2 groups: large (≥5 mm) and small (<5 mm). Both reviewers marked all tumors detected at each session. Another reviewer combined the results of the 2 reviewers and compared the detection rates of metastatic brain tumors between BB-ssTSE and MP-RAGE by using follow-up imaging. Intraclass correlation coefficients between the 2 reviewers were measured. Numerical simulations showed that the proposed BB-ssTSE effectively attenuated the signal intensity of flowing blood over the entire echo train, resulting in CE tumor-to-white matter contrast comparable with conventional MP-RAGE. The combined evaluation of MP-RAGE + BB-ssTSE showed 242 tumors in 28 patients. Of these, 153 lesions were <5 mm. MP-RAGE found 111 small metastatic brain tumors, BB-ssTSE found 150, and MP-RAGE + BB-ssTSE found 153. Significantly, more small tumors were detected by BB-ssTSE than MP-RAGE (P = 0.001, Wilcoxon signed-rank test). All large tumors were detected similarly by both MP-RAGE and BB-ssTSE. By combined results for MP-RAGE + BB-ssTSE, sensitivities for detection of small metastatic tumors were 72.5% for MP-RAGE and 98.0% for BB-ssTSE (P < 0.0001, McNemar test). Intraclass correlation coefficients between the 2 reviewers were 0.826 for MP-RAGE and 0.954 for BB-ssTSE. Compared with conventional MP-RAGE, the proposed CE BB-ssTSE imaging, which enhances tumors while selectively suppressing blood vessels, leads to significantly better detection of small metastatic brain tumors <5 mm.

頸動脈プラークMRIにおける 3D-TSE法(SPACE法)の有用性

In the carotid artery plaque diagnosis, it is said that properties evaluation is important. For this inspection, it is general to use electrocardiogram (ECG)-trigger-dark blood (DB)-fat suppression (fs)-turbo spin echo (TSE)-T1 weighted image (T1WI), T2WI, and magnetization prepared rapid gradient echo (MPRAGE) methods though many problems still remain. This time, a comparative study of the carotid artery plaque diagnosis that used the sampling perfection with application optimized contrasts was made. This used different flip angle evolutions method sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE) method that was 3 dimension (3D) imaging procedure that used variable flip angle with the law so far. The subjects were normal volunteers, handmade phantoms changed by T1 and T2 value, and the five patients on five cases who had taken carotid endoarterectomy (CEA) (male, mean 70.6 yr). Findings by the pathologist were obtained for the CEA enforcement patient. There is an excellent result in the contrast ratio by phantom, the signal intensity ratio of a clinical patient, and the comparison with pathological findings. The SPACE method can solve various problems, be evaluated by a properties evaluation of the plaque, a grasp of the range, and an arbitrary section, and be devised as a useful imaging procedure.

Segmentation of carotid plaque using multicontrast 3D gradient echo MRI

To evaluate the performance of automatic segmentation of atherosclerotic plaque components using solely multicontrast 3D gradient echo (GRE) magnetic resonance imaging (MRI). A total of 15 patients with a history of recent transient ischemic attacks or stroke underwent carotid vessel wall imaging bilaterally with a combination of 2D turbo spin echo (TSE) sequences and 3D GRE sequences. The TSE sequences included T1-weighted, T2-weighted, and contrast-enhanced T1-weighted scans. The 3D GRE sequences included time-of-flight (TOF), magnetization-prepared rapid gradient echo (MP-RAGE), and motion-sensitized driven equilibrium prepared rapid gradient echo (MERGE) scans. From these images, the previously developed morphology-enhanced probabilistic plaque segmentation (MEPPS) algorithm was retrained based solely on the 3D GRE sequences to segment necrotic core (NC), calcification (CA), and loose matrix (LM). Segmentation performance was assessed using a leave-one-out cross-validation approach via comparing the new 3D-MEPPS algorithm to the original MEPPS algorithm that was based on the traditional multicontrast protocol including 2D TSE and TOF sequences. Twenty arteries of 15 subjects were found to exhibit significant plaques within the coverage of all imaging sequences. For these arteries, between new and original MEPPS algorithms, the areas per slice exhibited correlation coefficients of 0.86 for NC, 0.99 for CA, and 0.80 for LM; no significant area bias was observed. The combination of 3D imaging sequences (TOF, MP-RAGE, and MERGE) can provide sufficient contrast to distinguish NC, CA, and LM. Automatic segmentation using 3D sequences and traditional multicontrast protocol produced highly similar results.

Correspondence of human visual areas identified using functional and anatomical MRI in vivo at 7 T

To study the correspondence of anatomically and functionally defined visual areas (primary visual cortex, V1, and motion selective area V5/human MT+) by using structural magnetic resonance imaging (MRI) and functional MRI (fMRI) in vivo at 7 T. Four subjects participated in this study. High-resolution (≈0.4 mm isotropic) anatomical MRI was used to identify cortical regions based on their distinct cortical lamination. The optimal contrast for identifying heavily myelinated layers within gray matter was quantitatively assessed by comparing T(1)-weighted magnetization-prepared rapid gradient echo (MPRAGE) and T(2)*-weighted, 3D fast-low angle shot (FLASH) imaging. Retinotopic mapping was performed using GE-based fMRI at 1.5 mm isotropic resolution to identify functional areas. T(2)*-weighted FLASH imaging was found to provide a significantly higher contrast-to-noise ratio, allowing visualization of the stria of Gennari in every slice of a volume covering the occipital cortex in each of the four subjects in this study. The independently derived boundary of V1, identified in the same subjects using retinotopic mapping by fMRI, closely matched the border of anatomically defined striate cortex in the human brain. Evidence of banding was also found within the functionally defined V5 area; however, we did not find a good correlation of this area, or the functionally identified subregion (MT), with the banded area. High-resolution T(2)*-weighted images acquired at 7 T can be used to identify myelinated bands within cortical gray matter in reasonable measurement times. Regions where a myelinated band was identified show a high degree of overlap with the functionally defined V1 area.

Tailored excitation in 3D with spiral nonselective (SPINS) RF pulses

Brain images acquired at 3T often display central brightening with spatially varying tissue contrast, caused by inhomogeneity in the transmit radiofrequency fields used for excitation. Tailored radiofrequency pulses can provide mitigation of radiofrequency field inhomogeneity, but previous designs have been unsuitable for 3D imaging in rapid pulse sequences. This article presents a nonselective pulse design based on a short (1 ms) 3D spiral k-space trajectory that covers low spatial frequencies. The resulting excitations are optimized to produce a uniform excitation within a specified volume of interest covering the whole brain. B1 mapping and pulse calculation times were reduced by optimizing in only five slices within the brain. The method has been tested with both single and parallel transmission: in phantom experiments, normalized root-mean-square error in excitation was 0.022 for single and 0.020 for parallel transmission. The corresponding results in vivo were 0.066 and 0.055 respectively. A pilot brain imaging study using the proposed pulses for excitation within the Alzheimer's disease neuroimaging initiative magnetization prepared rapid gradient echo (MP-RAGE) protocol, yielded excellent image quality with improved signal to noise ratio in peripheral brain regions and enhanced uniformity of contrast compared with standard excitation. Greatest performance enhancement was achieved using parallel transmission, but single channel transmission offers significant improvement over standard excitation pulses.

Susceptibility-resistant variable-flip-angle turbo spin echo imaging for reliable estimation of cortical thickness: A feasibility study

The thickness of the human cerebral cortex, which provides valuable information in the studies of normal and abnormal neuroanatomy, is commonly estimated using high-resolution, volumetric magnetization-prepared rapid gradient echo (MP-RAGE) magnetic resonance imaging due to its strong T1-weighted contrast and high signal-to-noise ratio. However, the accuracy of cortical thickness estimates using MP-RAGE is potentially contaminated by susceptibility-induced signal loss particularly at regions in close proximity to air-filled cavities. The purpose of this work is to investigate the feasibility of susceptibility-resistant variable-flip-angle (VFA) three-dimensional turbo/fast spin echo imaging for reliable estimation of cortical thickness of the human brain, wherein 1) radio-frequency (RF) pulse refocuses susceptibility-induced spin de-phasing, 2) the VFA refocusing pulse train is applied for a tissue-specific prescribed signal evolution along the echo train, 3) the desired T1-weighted contrast is achieved by composite restore pulses at the end of the refocusing pulse train, and 4) blood signals are suppressed using the VFA scheme combined with increasing moments of flow-sensitizing gradients while dura mater signals are attenuated due to short T2 relaxation time, which alleviates potential failure in brain segmentation. Numerical simulations of the Bloch equation are performed in both MP-RAGE and the proposed method for comparison. In vivo studies are performed in 14 healthy volunteers at 3 T. Image processing is then performed using the Freesurfer, resulting in mean and standard deviations of cortical thickness for the entire cortical surfaces. Statistical analysis demonstrates that particularly in the inferior prefrontal and temporal regions heavily affected by susceptibility-induced signal loss conventional MP-RAGE, if compared with the proposed method, significantly under-estimates cortical thickness. It is expected that the proposed pulse sequence, which is resistant to susceptibility-induced signal loss and attenuates the signal intensity of blood and dura mater, can be a potentially promising alternative to conventional MP-RAGE in reliably estimating cortical thickness for the entire brain.

Intraoperative magnetic resonance imaging findings during deep brain stimulation surgery

Deep brain stimulation (DBS) is an established neurosurgical technique used to treat a variety of neurological disorders, including Parkinson disease, essential tremor, dystonia, epilepsy, depression, and obsessive-compulsive disorder. This study reports on the use of intraoperative MR imaging during DBS surgery to evaluate acute hemorrhage, intracranial air, brain shift, and accuracy of lead placement. During a 46-month period, 143 patients underwent 152 DBS surgeries including 289 lead placements utilizing intraoperative 1.5-T MR imaging. Imaging was supervised by an MR imaging physicist to maintain the specific absorption rate below the required level of 0.1 W/kg and always included T1 magnetization-prepared rapid gradient echo and T2* gradient echo sequences with selected use of T2 fluid attenuated inversion recovery (FLAIR) and T2 fast spin echo (FSE). Retrospective review of the intraoperative MR imaging examinations was performed to quantify the amount of hemorrhage and the amount of air introduced during the DBS surgery. Intraoperative MR imaging revealed 5 subdural hematomas, 3 subarachnoid hemorrhages, and 1 intraparenchymal hemorrhage in 9 of the 143 patients. Only 1 patient experiencing a subarachnoid hemorrhage developed clinically apparent symptoms, which included transient severe headache and mild confusion. Brain shift due to intracranial air was identified in 144 separate instances. Intraoperative MR imaging can be safely performed and may assist in demonstrating acute changes involving intracranial hemorrhage and air during DBS surgery. These findings are rarely clinically significant and typically resolve prior to follow-up imaging. Selective use of T2 FLAIR and T2 FSE imaging can confirm the presence of hemorrhage or air and preclude the need for CT examinations.

Quantification of Gd-DTPA concentration in neuroimaging using T 1 3D MP-RAGE sequence at 3.0 T

Purpose To propose a simple and accurate quantitative method based on the linear relationship between magnetic resonance (MR) signal enhancement (Δ SI= SI postcontrast− SI precontrast) and gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) concentration ( C) by using T 1-weighted three-dimensional magnetization-prepared rapid acquisition gradient-echo (T 1 3D MP-RAGE) sequence for the in vivo measurement of Gd-DTPA concentration in real-time neuroimaging at 3.0 T. Methods Phantom experiment was carried out to study the linear fitting of signal intensity change vs. Gd-DTPA concentration (Δ SI– C) curve. A goodness-of-fit test was performed to compare the accuracy between the proposed method and the conventional method based on longitudinal relaxation rate ( R 1=1/ T 1) measurement. The influences on the goodness of fit ( R 2) and the signal-to-noise ratio (SNR) by sequence parameters were explored. Six human subjects with different brain tumors, who underwent a Gd-DTPA-enhanced MRI, were enrolled for in vivo application of the novel method. Results A good linear relationship between Δ SI and Gd-DTPA concentration existed over the concentration range of 0–1 mM ( R 2=0.985). The linearity of the Δ SI– C curve was as good as that of the 1/ T 1– C curve ( R 2=0.988). Concentrations calculated by both methods had a strong correlation ( R 2=0.920). An improved linearity of the Δ SI– C curve and an increased SNR can be achieved using sequences with a shorter inversion time (TI) and a higher flip angle. The concentration range of Gd-DTPA in human brain tumors was within the quantitative scope of 0–1 mM. Conclusions The proposed quantitative method based on Δ SI measurement is accurate and applicable for real-time neuroimaging at 3.0 T.