T1-weighted TurboFLASH Research Articles

Added Value of Contrast Medium in Whole-Body Hybrid Positron Emission Tomography/Magnetic Resonance Imaging: Comparison between Contrast-Enhanced and Non-Contrast-Enhanced Protocols

Objective: To compare the diagnostic ability and time efficiency of contrast-enhanced (CE) whole body fluorodeoxyglucose (FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) protocol and non-CE (NCE) protocol. Subjects and Methods: Ninety-three patients with known primary tumors underwent whole-body hybrid FDG PET/MRI during the follow-up of their malignancies with the use of NCE and CE protocols. The NCE PET/MRI protocol consisted of diffusion-weighted (b = 0 and 800 s/mm²) and T1-weighted Turbo Flash in the axial plane and T2-weighted HASTE sequence in the coronal planes (Σ = 25 min). The CE PET/MRI protocol was performed by acquiring axial serial CE 3D FS VIBE images in the upper abdomen, completing the whole body in the late phase in the axial plane (Σ = 30 min). Results: There was a statistically significant difference between the total number of lesions detected by the CE protocol (median 2, interquartile range (IQR) 0–14) and that detected by the NCE protocol (median 1, IQR 0–5; p < 0.001). More malignancies were detected in the abdomen (p < 0.001) and brain (p < 0.001) with the CE PET/MRI protocol, whereas no significant difference was present when comparing the 2 protocols in the detection of malignancies in the head and neck (p = 0.356), thorax (p = 0.09), lymph nodes (p = 0.196), and bone (p = 0.414). Conclusion: The CE FDG PET/MRI protocol enables fast and accurate detection of malignancies compared to the NCE FDG PET/MRI protocol, particularly in the upper abdomen and brain. Diagnostic ability and time efficiency can be increased with the proposed short CE protocol in place of the whole body PET/MRI protocol including both NCE and CE imaging sequences.

Effect of Flip Angle on the Correlation Between Signal Intensity and Different Concentrations of Iron Oxide Nanoparticles Using T1-Weighted Turbo-FLASH Inversion Recovery Sequence.

Background:Ultrasmall superparamagnetic iron oxide nanoparticles have been used as a blood pool contrast agent for magnetic resonance angiography and perfusion studies. Linear relationship between signal intensity (SI) and nanoparticle concentration is essential for perfusion measurement.Objectives:The aim of this study was to investigate the effect of different flip angles on maximum SI and the linear relationship between SI and different concentrations of iron oxide nanoparticles using T1-weighted Turbo-FLASH (fast low angle shot) inversion recovery sequence to find the optimum flip angle for perfusion measurement.Materials and Methods:This in vitro study was performed using carboxydextran coated iron oxide nanoparticles with 20 nm hydrodynamic size. Different concentrations of nanoparticles between 0 and 500 µmol Fe/L were prepared. MR imaging was performed using T1-weighted Turbo-FLASH inversion recovery sequence. Applied flip angles were 10-45º (interval of 5º). Then the maximum SI resulted by each concentration of nanoparticles was measured. Linear relationship between SI and nanoparticle concentration was evaluated regarding square correlations of 0.95 and 0.99. Coil non-uniformity was considered to obtain accurate SI of each image.Results:The maximum SI was obtained at the highest applied flip angle (45°). The linear relationship between SI and nanoparticle concentration was seen up to 112.21 and 98.83 μmol Fe/L for the short (10°) and the long (45°) flip angles, respectively (R2 = 0.95). These values were reduced up to 48.54 and 42.73 μmol Fe/L for these flip angles with R2 of 0.99.Conclusions:The maximum SI will be increased at higher flip angles with non-linear relationship between SI and nanoparticle concentration. The result shows that an increase in the flip angle leads to a decrease in the range of the linearity. The optimum flip angle which is suitable for perfusion measurement was obtained at 10º for our imaging parameters and sequence. The results of this study may be used in in vivo perfusion measurements.

T1-Weighted Brain Imaging With a 32-Channel Coil at 3T Using TurboFLASH BLADE Compared With Standard Cartesian k-Space Sampling

Motion artifacts often markedly degrade image quality in clinical scans. The BLADE technique offers an alternative k-space sampling scheme reducing the effect of patient related motion on image quality. The purpose of this study is the comparison of imaging artifacts, signal-to-noise (SNR), and contrast-to-noise ratio (CNR) of a new turboFLASH BLADE k-space trajectory with the standard Cartesian k-space sampling for brain imaging, using a 32-channel coil at 3T. The results from 32 patients included after informed consent are reported. This study was performed with a 32-channel head coil on a 3T scanner. Sagittal and axial T1-weighted FLASH sequences (TR/TE 250/2.46 milliseconds, flip angle 70-degree), acquired with Cartesian k-space sampling and T1-weighted turboFLASH sequences (TR/TE/TIsag/TIax 3200/2.77/1144/1056 milliseconds, flip angle 20-degree), using PROPELLER (BLADE) k-space trajectory, were compared. SNR and CNR were evaluated using a paired student t test. The frequency of motion artifacts was assessed in a blinded read. To analyze the differences between both techniques a McNemar test was performed. A P value <0.05 was considered statistically significant. From the blinded read, the overall preference in terms of diagnostic image quality was statistically significant in favor of the BLADE turboFLASH data sets, compared with standard FLASH for both sagittal (P < 0.0001) and axial (P < 0.0001) planes. The frequency of motion artifacts from the scalp was higher for standard FLASH sequences than for BLADE sequences on both axial (47%, P < 0.0003) and sagittal (69%, P < 0.0001) planes. BLADE was preferred in 100% (sagittal plane) and 80% (axial plane) of in-patient data sets and in 68% (sagittal plane) and 73% (axial plane) of out-patient data sets.The BLADE T1 scan did have lower SNRmean (BLADEax 179 +/- 98, Cartesianax 475 +/- 145, BLADEsag 171 +/- 51, and Cartesiansag 697 +/- 129) with P values indicating accordingly a statistically significant difference (Pax <0.0001, Psag < 0.0001), because of the fundamental difference in imaging approach (FLASH vs. turboFLASH). Differences for CNR were also statistically significant, independent of imaging plane (Pax = 0.001, Psag = 0.02). Results demonstrate that turboFLASH BLADE is applicable at 3T with a 32-channel head coil for T1-weighted imaging, with reduced ghost artifacts. This approach offers the first truly clinically applicable T1-weighted BLADE technique for brain imaging at 3T, with consistent excellent image quality.

“Resting” CBF in the epileptic baboon: Correlation with ketamine dose and interictal epileptic discharges

Photosensitive epileptic (SZ) baboons demonstrate different cerebral blood flow (CBF) activation patterns from asymptomatic controls (CTL) during intermittent light stimulation (ILS). This study compares "resting" CBF between PS and CTL animals, and CBF correlations with ketamine dose and interictal epileptic discharges (IEDs) between PS and CTL animals. Continuous intravenous ketamine was administered to eight PS and eight CTL baboons (matched for gender and weight), and maintained at subanesthetic doses (4.8-14.6 mg/kg/hr). Three resting H(2)(15)O-PET studies were attempted in each animal (CTI/Siemens HR+ scanner). Images were acquired in 3D mode (63 contiguous slices, 2.4mm thickness). PET images were co-registered with MRI images (3T Siemens Trio, T1-weighted 3D Turboflash sequence, TE/TR/TI=3.04/2100/785 ms, flip angle=13 degrees ). EEG was used to monitor depth of sedation and for quantification of IED rates. Regional CBF was compared between PS and CTL groups and correlations were analyzed for ketamine dose and IED rates. When subsets of animals of either group, receiving similar doses of ketamine were compared, PS animals demonstrated relative CBF increases in the occipital lobes and decreases in the frontal lobes. Correlation analyses with ketamine dose confirmed the frontal and occipital lobe changes in the PS animals. The negative correlations of CBF with ketamine dose and IED rate overlapped frontally. While frontal lobe CBF was also negatively correlated with IED rate, positive correlations were found in the parietal lobe. "Resting" CBF differs between PS and CTL baboons. Correlation analyses of CBF and ketamine dose reveal that occipital lobe CBF increases and frontal lobe in PS animals are driven by ketamine. While frontal lobe CBF decreases may be related to ketamine's propensity to activate IEDs, positive CBF correlations with IED rate suggest involvement of the parietal lobes in their generation.

Effect of Distal Embolization on Myocardial Perfusion Reserve After Percutaneous Coronary Intervention

Studies have shown that a subset of patients demonstrate persistent impairment in microcirculatory function after percutaneous coronary intervention (PCI). Distal embolization of plaque contents has been postulated as the main mechanism for this. We sought to investigate this further by evaluating PCI-induced changes in myocardial perfusion reserve index (MPRI) over time in segments with "distal-type" procedure-related myonecrosis using high-resolution quantitative cardiovascular magnetic resonance imaging. Forty patients undergoing PCI were studied with pre-PCI and 24-hour post-PCI delayed-enhancement magnetic resonance imaging and first-pass perfusion magnetic resonance imaging at rest and stress. Twenty patients underwent a third magnetic resonance imaging scan at 6 months. For perfusion imaging, 3 short-axis images were acquired during every heartbeat with a T1-weighted turboFLASH sequence. MPRI was calculated as the ratio of hyperemic to resting myocardial blood flow and subdivided according to the presence and location of new delayed hyperenhancement. Twenty-one patients demonstrated new distal hyperenhancement after PCI. Mean MPRI in revascularized myocardial segments not demonstrating new HE was significantly increased after the procedure (2.06 [95% CI, 1.99 to 2.13] before PCI and 2.52 [95% CI, 2.42 to 2.62] after PCI; P<0.001). In contrast, MPRI in segments with distal hyperenhancement was reduced after PCI (2.16 [95% CI, 1.95 to 2.37] before PCI; 2.00 [95% CI, 1.82 to 2.19] after PCI; mixed-model z=-4.82; P<0.001). Changes in mean MPRI 24 hours after PCI in segments upstream to new injury were not significantly different compared with perfusion changes in remote myocardium (z=-0.68; P=0.50). At 6 months after the procedure, mean MPRI in segments with new injury improved significantly compared with MPRI measured in these segments at 24 hours after PCI. MPRI is reduced in myocardial segments that demonstrate new distal irreversible injury at 24 hours after PCI. These reductions are confined to the segments with injury and do not affect the entire supply territory of the culprit vessel.

Dynamische Magnetresonanz-Nephrografie und -Urografie bei Kindern mit Harnwegserkrankungen

To evaluate an improved method of dynamic magnetic resonance (MR) nephrography with short acquisition time and compensation of breathing motion for assessment of renal excretion and split renal function in children with anomalies of the urinary tract. A protocol for dynamic MR nephrography was implemented using a T1-weighted navigator-gated TurboFLASH sequence (TR/TE 498 ms/1.25 ms, saturation recovery time 300 ms, flip angle 8 degrees ). After bolus injection of 0.05 mmol/kg gadolinium dimeglumine (Gd-DTPA), split renal function was determined from the contrast-medium excretion. In 20 patients (ages between 3 months and 14 years), dynamic MR nephrography and MAG3 radionuclide scintigraphy as the gold standard were performed. In all children, T1-weighted images were able to be recorded over 40 minutes at a nearly identical diaphragm position using the TurboFLASH sequence, thus allowing for exact region-of-interest analysis of the excretion and split renal function. The course of the contrast-medium concentration was able to be measured in the renal pelvis with good accuracy due to the high spatial resolution and the lack of breathing artifacts. Excellent correlation to the MAG3 scintigraphy was demonstrated for the excretion and split renal function (correlation coefficient: 0.975). Dynamic MR nephrography allows for reliable assessment of renal function in children with anomalies of the urinary tract with higher spatial resolution as compared to radionuclide scintigraphy.

Contrast-enhanced dynamic MR nephrography using the TurboFLASH navigator-gating technique in children

The purpose of this work was to test the feasibility of an MR examination protocol for the comprehensive assessment of renal morphology, excretion, and split renal function using a navigator-gated TurboFLASH sequence. A navigator-gated T1-weighted single-slice TurboFLASH sequence suitable for dynamic MR urography and nephrography was implemented. A protocol was developed, allowing for assessment of urinary excretion and split renal function by recording the renal clearance of a gadolinium (Gd) diethylenetriamine pentacetic acid (DTPA) bolus.

Contrast-enhanced dynamic MR nephrography using the TurboFLASH navigator-gating technique in children

The purpose of this work was to test the feasibility of an MR examination protocol for the comprehensive assessment of renal morphology, excretion and split renal function using a navigator-gated TurboFLASH sequence. A navigator-gated T1-weighted single-slice TurboFLASH sequence suitable for dynamic MR urography and nephrography was implemented. A protocol was developed allowing for assessment of urinary excretion and split renal function by recording the renal clearance of a gadolinium (Gd) diethylene-triamine-pentacetic-acid (DTPA) bolus. Ten patients aged between 14 months and 14 years (mean age 4.8+/-4.6 years) were evaluated with the following indications: pelvicalyceal dilatation (n=4), follow-up after pyeloplasty (n=1), duplex systems (n=3), large renal cyst (n=1), and renal insufficiency (n=1). Dynamic MR urography and MR split renal function were compared to MAG3 scintigraphy. Evaluation of morphology, excretion and function required 50-60 minutes examination time, plus 10 minutes for post-processing. The TurboFLASH sequence yielded image acquisition at nearly identical diaphragm positions allowing for accurate region-of-interest evaluation within the renal parenchyma and the urinary passage. Static and dynamic MR urography showed the morphology of the urinary tract and excretion with sufficient diagnostic imaging quality, and the results were in diagnostic compliance with scintigraphy. MRI and scintigraphy yielded similar results for split renal function with a correlation coefficient of R=0.968 determined by linear regression. Our conclusions were that the method is robust, easy to perform on a clinical 1.5 T MRI system, rapid to evaluate and post-process and, therefore, easy to incorporate into clinical routine. Compared to scintigraphy, the higher spatial resolution of the MR examination provides additional important information improving the management of the pediatric patients without the application of radioactive tracers.

Resting Myocardial Blood Flow Is Impaired in Hibernating Myocardium

Although impairment in perfusion reserve is well recognized in hibernating myocardium, there is substantial controversy as to whether resting myocardial blood flow (MBF) is reduced in such circumstances. Quantitative first-pass cardiovascular magnetic resonance (CMR) perfusion imaging allows absolute quantification of MBF. We hypothesized that MBF assessed at rest by quantitative CMR perfusion imaging is reduced in hibernating myocardium. Twenty-seven patients with 1 or 2-vessel coronary disease and at least 1 dysfunctional myocardial segment undergoing PCI were studied with preprocedure, early (24 hours), and late (9 months) postprocedure CMR imaging. First-pass perfusion images at rest were acquired in 3 short-axis planes by use of a T1-weighted turboFLASH sequence. In each slice, MBF was determined for 8 myocardial segments in mL . min(-1) . g(-1) by deconvolution of signal intensity curves with an arterial input function measured in the left ventricular blood pool. Cine MRI for assessment of global and segmental function and delayed enhancement MRI for detection of viability were also obtained. All coronary lesions were 80% to 95% stenosis in severity. Over all segments, mean MBF normalized by rate-pressure product ("corrected MBF") was 1.2+/-0.3 mL . min(-1) . g(-1) . (mm Hg . bpm/10(4))(-1) in segments without significant coronary stenosis and 0.7+/-0.2 mL . min(-1) . g(-1) . (mm Hg . bpm/10(4))(-1) in segments with coronary stenosis before PCI (mixed model controlling for slice and segment z=-23.9, P<0.001). Early after the procedure, the MBF was 1.2+/-0.2 mL . min(-1) . g(-1) . (mm Hg . bpm/10(4))(-1) in revascularized segments and 1.3+/-0.2 mL . min(-1) . g(-1) . (mm Hg . bpm/10(4))(-1) in nondiseased segments (z=-6.1, P<0.001). Late after PCI, the systolic wall thickening and end-diastolic wall thickness both increased significantly more (both P<0.001) in the myocardial segments subtended by severe coronary stenosis (8+/-17% to 40+/-19% and 6.5+/-1.1 to 9.3+/-2 mm, respectively) than in the myocardial segments supplied by nondiseased vessels. Mean MBF in dysfunctional segments with significantly improved contraction after revascularization was 0.8+/-0.2 mL . min(-1) . g(-1) . (mm Hg . bpm/10(4))(-1) before PCI and 1.2+/-0.2 mL . min(-1) . g(-1) . (mm Hg . bpm/10(4))(-1) after PCI (z=2.0, P=0.04). CMR perfusion imaging detects impaired resting MBF in hibernating myocardial segments.

Can pre-operative contrast-enhanced dynamic MR imaging for prostate cancer predict microvessel density in prostatectomy specimens?

The aim of this study was to correlate quantitative dynamic contrast-enhanced MRI (DCE MRI) parameters with microvessel density (MVD) in prostate carcinoma. Twenty-eight patients with biopsy-proven prostate carcinoma were examined by endorectal MRI including multiplanar T2- and T1-weighted spin-echo and dynamic T1-weighted turbo-FLASH MRI during and after intravenous Gd-DTPA administration. Microvessels were stained on surgical specimens using a CD31 monoclonal antibody. The MVD was quantified in hot spots by counting (MVC) and determining the area fraction by morphometry (MVAF). The DCE MRI data were analyzed using an open pharmacokinetic two-compartment model. In corresponding anatomic locations the time shift (Deltat) between the beginning of signal enhancement of cancer and adjacent normal prostatic tissue, the degree of contrast enhancement and the contrast exchange rate constant (k21) were calculated. The MVC and MVAF were elevated in carcinoma (p<0.001 and p=0.002, respectively) and correlated to k21 (r=0.62, p<0.001 and r=0.80, p<0.001, respectively). k21-values of carcinoma were significantly higher compared with normal peripheral but not central zone tissue. Deltat was longer in high compared with low-grade tumors (p=0.025). The DCE MRI can provide important information about individual MVD in prostate cancer, which may be helpful for guiding biopsy and assessing individual prognosis.

Accuracy of non-enhanced MRI to monitor histological lesion size during laser-induced interstitial thermotherapy

The purpose of this study was to assess the accuracy of non-enhanced MRI using a T1-weighted 2D turbo fast low-angle shot (FLASH) sequence during laser-induced interstitial thermotherapy (LITT) to determine histological lesion size of laser-induced hepatic lesions. The LITT was performed on pig liver samples at various power settings and durations. For MR monitoring during and after LITT a T1-weighted 2D turbo-FLASH sequence was applied. Lesions seen by MRI during and after LITT were correlated with histological lesion size. Histologically, a core zone of complete tissue ablation close to the tip of the applicator could be differentiated from an adjacent transitional zone showing incomplete necrosis. Magnetic resonance imaging right at the end of LITT (i.e., with maximum heating effects) grossly overestimated the core zone but accurately described the transitional zone. Magnetic resonance imaging after cooling of the tissue (therefore showing structural as opposed to thermal changes) exactly depicted the core zone of complete tissue ablation. Non-enhanced MRI using a T1-weighted 2D turbo FLASH sequence strongly overestimates the histological lesion size during LITT; however, structural changes of the tissue seen after cooling accurately define lesion size in LITT. For clinical purposes the lesion geometry seen during MR monitoring should therefore well extend the tumor margins.

Does a higher concentration of gadolinium chelates improve first-pass cardiac signal changes?

The purpose of this study was to evaluate first-pass cardiac signal changes with a higher concentrated gadolinium-chelate (gadobutrol) and its influence on bolus geometry. Phantom studies and in vivo first-pass cardiac studies were performed in rabbits (n = 8 experiments) under general anesthesia at 1.0 T using an ultrafast T1-weighted Turbo-fast low-angle shot (FLASH) sequence (TR/TE 4.7/1. 6 msec, alpha = 90 degrees ) with a time resolution of 870 msec. Gadobutrol was injected as an intravenous bolus at two concentrations (0.5 and 1.0 mol Gd/L) and five doses (0.3, 0.15, 0.1, 0.055, and 0.03 mmol Gd/kg bw). The blood-pool gadolinium compound gadopentetate dimeglumine-polylysine (0.15, 0.075, 0.05, and 0.015 mmol Gd/kg bw, 0.5 mol Gd/L) and the standard extracellular gadopentetate dimeglumine (0.1 and 0.05 mmol Gd/kg bw, 0.5 mol Gd/L) served as reference agents. Cardiac signal changes were calculated from serial signal intensity measurements. Maximum signal intensity changes and best peak profiles during first pass of the right and left ventricle were observed with a dose of 0.03 mmol Gd/kg bw gadobutrol using T1-weighted Turbo-FLASH. At the low application volumes used, the higher concentration of 1.0 mol Gd/L gadobutrol did not increase the degree of signal intensity changes or sharpen the bolus profile. First-pass cardiac signal changes using T1-weighted Turbo-FLASH with the new extracellular contrast agent gadobutrol are best observed at a dose of 0.03 mmol Gd/kg bw. There is no advantage to the concentrated formulation (1 mol Gd/L gadobutrol) when using small injection volumes. J. Magn. Reson. Imaging 1999;10:806-812.

Single breath-hold left ventricular volume measurement by 0.3-sec turbo fast low-angle shot MR imaging.

In this study, we measured global cardiac parameters during a single breath-hold using T1-weighted single-shot turbo fast low-angle shot (turboFLASH) MR imaging. Ten cardiac patients who had undergone cardiac catheterization were examined with MR imaging to evaluate cardiac function. On average, 10 slices, which covered enough of the heart to measure the left ventricular volume, were acquired in a single breath-hold. During the acquisition of each slice, T1-weighted turboFLASH MR imaging with inversion recovery of both end diastole and end systole was sequentially accomplished twice in the same R-R interval. The end-diastolic volume, end-systolic volume, and ejection fraction calculated from MR images were compared with data obtained from left ventriculography. In these 10 cardiac patients, the ejection fraction calculated from turboFLASH MR images showed a good correlation with the measurements from radiographic left ventriculography (r = .87). The inter- and intraobserver variabilities in calculating the ejection fraction were 7.8% and 4.7%, respectively. Single-shot turboFLASH MR imaging with inversion recovery can provide data for the quantification of the ejection fraction during a single breath-hold.

Noninvasive measurements of infarct size after thrombolysis with a necrosis-avid MRI contrast agent.

Gadophrin-2 is a new MRI contrast agent with high affinity for necrotic myocardium. The aim of the study was to evaluate whether noninvasive measurements of infarct size after thrombolysis are possible with gadophrin-2-enhanced MRI. Coronary artery thrombosis was induced in 3 groups of dogs by the copper-coil technique. Thrombolytic therapy together with aspirin and heparin was initiated after 90 minutes of occlusion. One day (group A), 2 days (group B), or 6 days (group C) after infarction, gadophrin-2 was injected intravenously (50 micromol. kg-1). In vivo T1-weighted segmented turbo-FLASH, in vivo T2-weighted segmented half-Fourier turbo spin echo (HASTE), and T1- and T2-weighted spin-echo MRI of the excised heart were performed 24 hours after gadophrin-2 injection. Regions of strong enhancement were observed on T1-weighted images. Planimetry of short-axis MR images and of corresponding triphenyltetrazolium chloride (TTC)-stained left ventricular (LV) slices showed a close correlation between the enhanced areas and TTC-negative areas for both in vivo (r2=0.98, P<0.0001; mean difference, 0.9+/-2.0% [SD] of the LV volume [LVV]) and postmortem (r2=0.99, P<0.0001; mean difference, 0.9+/-1.4% of LVV) measurements. T2-weighted images overestimated the infarct size by 8.1+/-5.4% of LVV. The mean infarct size was 10.8+/-11.6% of LVV (group A), 22.4+/-11.7% (group B), and 5.1+/-9.3% (group C). In this animal model, in vivo gadophrin-2-enhanced MRI could precisely determine infarct size after thrombolytic therapy. This technique may be very useful for the noninvasive evaluation of infarct size after reperfusion for AMI.

Renal metastasis. Detection and characterization on enhanced magnetic resonance imaging using an animal model.

A new animal model was developed in rabbits (renal metastasis using the VX-2 tumor line), and magnetic resonance (MR) imaging performed before and after intravenous gadoteridol injection to assess lesion conspicuity and characterization. Six New Zealand White rabbits with renal metastases were studied on a 1.5-tesla Siemens Vision MR unit. Iodinated contrast was given intravenously to the rabbits, before implantation, to visualize the kidneys under fluoroscopy. Using a 5/8-inch 25-gauge needle, 0.1 mL of minced, screened VX-2 tumor was injected percutaneously into each kidney at the corticomedullary junction. Animals were studied on day 7 after implantation. Baseline fast low-angle shot (FLASH) T1-weighted and fast spin echo T2-weighted breathhold scans were first obtained. Then, an additional precontrast turbo-FLASH T1-weighted scan was acquired. After these scans, 0.1 mmol/kg gadoteridol (gadolinium HP-D03A; ProHance) was injected intravenously at a rate of 1.5 mL/second. Dynamic breathhold turbo-FLASH T1 images were then obtained at 0, 6, 12, 19, 25, and 31 seconds after injection and at 1, 2, and 10 minutes after injection. The T1 multislice FLASH two-dimensional scan was repeated at 10 minutes after contrast. Imaging results were analyzed by region of interest measurement and correlated with tissue pathology. On dynamic T1-weighted turbo-FLASH scans, lesion conspicuity, specifically (SI(kidney)-SI(tumor)/noise), increased from 7 +/- 7 signal intensity precontrast to a maximum of 14 +/- 8 at 1 minute after contrast. This increase was statistically significant (P = 0.002). An initial rapid increase in tumor conspicuity occurred within the first 30 seconds after contrast, with the curve flattening thereafter. Lesion conspicuity on the precontrast T2-weighted scans was 9 +/- 10, not statistically different from results with either of the precontrast T1-weighted scan techniques. Using T1-weighted FLASH technique, lesion conspicuity increased from 10 +/- 5 precontrast to 31 +/- 12 postcontrast. As with turbo-FLASH, the improvement in tumor conspicuity after contrast on FLASH scans was statistically significant (P = 0.02). The difference between postcontrast FLASH scans and precontrast T2-weighted scans also was statistically significant, with postcontrast scans superior for lesion conspicuity (P = 0.01). Each tumor was confirmed on pathologic exam. This research establishes a model of metastasis to the kidney for use in imaging studies. The conspicuity of a small renal metastasis is shown to be improved on early dynamic imaging, as well as at 10 minutes after intravenous injection of 0.1 mmol/kg gadoteridol. Observation of dynamic signal intensity changes provides additional information regarding lesion characterization, supplementing that from precontrast scans.

Fast MR imaging of the liver: quantitative comparison of techniques.

To compare several techniques for fast magnetic resonance (MR) imaging of focal liver lesions. Ninety patients (37 men and 53 women, aged 19-92 years [mean, 54 years]) with 137 focal liver lesions (56 metastases, 13 hepatocellular carcinomas, 52 hemangiomas, 16 cysts) underwent MR imaging with rapid acquisition spin-echo (RASE), T1-weighted fast low-angle shot (FLASH), turboFLASH, segmented turboFLASH, and T2-weighted conventional and turbo spin echo (SE). Images were analyzed for spleen-to-liver and lesion-to-liver signal difference-to-noise ratios (SD/Ns). Turbo SE T2-weighted imaging had the highest SD/N for spleen-to-liver (P < .01) and for lesion-to-liver (P < .02) contrast. Segmented T1-weighted turboFLASH imaging had the second highest SD/N for spleen-to-liver (P < .001) contrast and was better overall than other T1-weighted sequences for depicting liver lesions (P < .01). Results at segmented turboFLASH imaging were second best for hemangiomas (P < .01). For metastases, no significant difference was found for results with the T1-weighted sequences. Segmented T1-weighted turboFLASH and turbo SE T2-weighted imaging hae advantages over conventional techniques for liver imaging.

4963344 Method to enhance NMR imaging using chelated paramagnetic ions

Cine voiding cystourethrogram was performed in 15 normal subjects using T1-weighted Turbo FLASH sequence. It showed the sequence of emptying of bladder, detrusor muscle contraction, opening of the sphincters, and various parts of urethra. It was found to be a good noninvasive test to study the dynamics of lower urinary tract with out disturbing the state of the physiology.

High‐dose applications of gadolinium chelates in magnetic resonance imaging

Administration of gadolinium chelates at doses greater than 0.1 mmol/kg IV can potentially improve both lesion detection and the assessment of tissue perfusion. Preliminary results are presented in clinical patients and two animal models. In human intracranial metastatic disease, administration of 0.3 (cumulative dose) mmol/kg gadoteridol (Gd HP-DO3A) has permitted detection of additional lesions not visualized at 0.1 mmol/kg. In a rabbit model of focal liver disease, 0.5 mmol/kg IV provided superior enhancement of both normal parenchyma and lesion rim compared to doses of 0.25 and 0.1. Dynamic imaging (T1-weighted turbo-FLASH) immediately following bolus injection of 0.5 mmol/kg permitted direct visualization (on unsubtracted images) of an acute perfusion defect in the cat brain not visible on conventional T1- and T2-weighted scans.

Strategies to improve contrast in turboFLASH imaging: Reordered phase encoding and K‐space segmentation

TurboFLASH (fast low-angle shot) sequences enable the acquisition of an image in a fraction of a second. However, unique to T1-weighted ultrafast imaging, the magnetization variation during image acquisition can produce artifacts along the phase-encoding direction. In this study, the signal behavior and nature of these artifacts were analyzed with various acquisition schemes to improve image contrast. The magnetization variation during image acquisition and its filtering effect on the image were simulated for three different approaches to T1-weighted turboFLASH imaging: standard turboFLASH with (a) monotonically ascending phase-encoding steps, (b) reordered phase encoding, and (c) k-space segmentation. Each of the modified data acquisition schemes has advantages. However, for subsecond imaging, reordered phase encoding produced improved image contrast over that of standard turboFLASH, and segmented k-space imaging gave superior tissue contrast compared with that of both standard and reordered turboFLASH, with imaging time that permits breath-hold studies.