Michael Deimling

Fast and precise T1 imaging using a TOMROP sequence

Proton spin-lattice (T1) relaxation time images were computed from a data set of 32 gradient-echo images acquired with a fast TOMROP (T One by Multiple Read Out Pulses) sequence using a standard whole-body MR imager operating at 64 MHz. The data acquisition and analysis method which permits accurate pixel-by-pixel estimation of T1 relaxation times is described. As an example, the T1 parameter image of a human brain is shown demonstrating an excellent image quality. For white and gray brain matter, the measured longitudinal relaxation processes are adequately described by a single-component least-squares fit, while more than one proton component has to be considered for fatty tissue. A quantitative analysis yielded T1 values of 547 +/- 36 msec and 944 +/- 73 msec for white and gray matter, respectively.

Three‐dimensional delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) for in vivo evaluation of reparative cartilage after matrix‐associated autologous chondrocyte transplantation at 3.0T: Preliminary results

To use a 3D gradient‐echo (GRE) sequence with two flip angles for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) to evaluate relative glycosaminoglycan content of repair tissue after matrix‐associated autologous chondrocyte transplantation (MACT).

Non‐contrast‐enhanced perfusion and ventilation assessment of the human lung by means of fourier decomposition in proton MRI

Assessment of regional lung perfusion and ventilation has significant clinical value for the diagnosis and follow‐up of pulmonary diseases. In this work a new method of non‐contrast‐enhanced functional lung MRI (not dependent on intravenous or inhalative contrast agents) is proposed. A two‐dimensional (2D) true fast imaging with steady precession (TrueFISP) pulse sequence (TR/TE = 1.9 ms/0.8 ms, acquisition time [TA] = 112 ms/image) was implemented on a 1.5T whole‐body MR scanner. The imaging protocol comprised sets of 198 lung images acquired with an imaging rate of 3.33 images/s in coronal and sagittal view. No electrocardiogram (ECG) or respiratory triggering was used. A nonrigid image registration algorithm was applied to compensate for respiratory motion. Rapid data acquisition allowed observing intensity changes in corresponding lung areas with respect to the cardiac and respiratory frequencies. After a Fourier analysis along the time domain, two spectral lines corresponding to both frequencies were used to calculate the perfusion‐ and ventilation‐weighted images. The described method was applied in preliminary studies on volunteers and patients showing clinical relevance to obtain non‐contrast‐enhanced perfusion and ventilation data. Magn Reson Med, 2009.

Assessment of cerebral blood volume with dynamic susceptibility contrast enhanced gradient-echo imaging

Objective Dynamic susceptibility contrast (DSC) enhanced MRI was used to study relative cerebral blood volume (rCBV). Materials and Methods We examined 15 healthy subjects and 47 patients with vascular stenosis or occlusion, with brain infarctions, and with cerebral neoplasms. During bolus injection of Gd-diethylenetriamine pentaacetic acid, a series of rapid T2*-weighted fast low angle shot two-dimensional images were recorded from the same slice. From these images, changes in signal intensity during bolus passage were computed pixel-by-pixel and converted into contrast agent concentration curves. Applying the principles of indicator dilution theory, images of rCBV were calculated. Results and Conclusion Regions of infarctions show almost zero rCBV. In patients with high-grade vascular stenosis or occlusion a bolus delay in comparison to the unaffected side and an increased mean transit time can be observed. Some of the affected areas show an increased rCBV, which is a well-known physiological mechanism that takes place to compensate for the reduced cerebral blood pressure. In brain tumors, rCBV imaging reveals focal or homogeneous areas of increased blood volume. This can even be observed in low-grade astrocytomas with unaffected blood-brain barrier. In CBV imaging, the effects of radiotherapy on tumor tissue can be monitored as a significant decrease of rCBV in tumor tissue after therapy.

Optimization and evaluation of the signal intensity change in multisection oxygen-enhanced MR lung imaging.

The behavior of the signal intensity in MRI of human lungs was investigated during inhalation of pure oxygen. Nine volunteers were examined, five using a breath‐hold and four using a non‐breath‐hold technique. Four coronal slices were acquired in each volunteer using an inversion recovery turbo spin‐echo sequence. The inversion time of the sequence was optimized for maximum contrast. Breathing of pure oxygen and room air was alternated in the volunteers. Breath‐hold and non‐breath‐hold cases were compared. Breathing pure oxygen lead to a statistically significant signal intensity increase (up to 18%) compared to breathing room air. In addition, T1 maps were acquired during breathing 100% oxygen and room air. Inhalation of pure oxygen reduced the mean T1 time of the lungs from 1280 (±85) msec to 1224 (±139) msec without breath‐hold and from 1219 (±176) to 1074 (±92) msec with breath‐hold. Therefore, an optimized sequence and measurement protocol provided significant signal intensity changes utilizing 100% oxygen. Magn Reson Med 43:860–866, 2000.

Diffusion-weighted imaging of tumor recurrencies and posttherapeutical soft-tissue changes in humans

Abstract The aim of this study was to examine soft tissue tumor recurrences and posttherapeutic soft tissue changes in humans with a diffusion-weighted steady-state free precession (SSFP) sequence. Twenty-four patients with 29 pathologies of the pelvis or the extremities were examined. The lesions were classified as follows: group 1, recurrent viable tumors (n = 10); group 2, postoperative hygromas (n = 7); and group 3, posttherapeutic reactive inflammatory muscle changes (n = 12). The sequence protocol in these patients consisted of short tau inversion recovery images, T2-weighted spin-echo (SE), pre- and postcontrast T1-weighted SE images and the diffusion-weighted SSFP sequence. The signal loss on diffusion-weighting was evaluated visually on a four-grade scale and quantitatively. The signal intensities were measured in regions of interest and a regression analysis was performed. Statistical analyses was performed utilizing the Students t-test. The signal loss was significantly higher for hygromas and edematous muscle changes than for recurrent tumors (p < 0.001) indicating higher diffusion of water protons. The regression coefficient was –0.11 (mean) for tumors. Hygromas had a significantly higher signal loss than inflammatory edematous muscle changes (p < 0.01). The regression coefficients were –0.29 (mean) for hygromas and –0.22 (mean) for edematous muscle changes. The SSFP sequence seems to be a suitable method for diffusion-weighted imaging of the musculoskeletal system in humans. These preliminary results suggest that the signal loss and the regression coefficients can be used to characterize different types of tissue.

Magnetic resonance lung function – a breakthrough for lung imaging and functional assessment? A phantom study and clinical trial

BackgroundChronic lung diseases are a major issue in public health. A serial pulmonary assessment using imaging techniques free of ionizing radiation and which provides early information on local function impairment would therefore be a considerably important development. Magnetic resonance imaging (MRI) is a powerful tool for the static and dynamic imaging of many organs. Its application in lung imaging however, has been limited due to the low water content of the lung and the artefacts evident at air-tissue interfaces. Many attempts have been made to visualize local ventilation using the inhalation of hyperpolarized gases or gadolinium aerosol responding to MRI. None of these methods are applicable for broad clinical use as they require specific equipment.MethodsWe have shown previously that low-field MRI can be used for static imaging of the lung. Here we show that mathematical processing of data derived from serial MRI scans during the respiratory cycle produces good quality images of local ventilation without any contrast agent. A phantom study and investigations in 85 patients were performed.ResultsThe phantom study proved our theoretical considerations. In 99 patient investigations good correlation (r = 0.8; p ≤ 0.001) was seen for pulmonary function tests and MR ventilation measurements. Small ventilation defects were visualized.ConclusionWith this method, ventilation defects can be diagnosed long before any imaging or pulmonary function test will indicate disease. This surprisingly simple approach could easily be incorporated in clinical routine and may be a breakthrough for lung imaging and functional assessment.

High-resolution cartilage imaging of the knee at 3 T: Basic evaluation of modern isotropic 3D MR-sequences

PURPOSE To evaluate qualitative and quantitative image quality parameters of isotropic three-dimensional (3D) cartilage-imaging magnetic resonance (MR)-sequences at 3T. MATERIALS AND METHODS The knees of 10 healthy volunteers (mean age, 24.4±5.6 years) were scanned at a 3T MR scanner with water-excited 3D Fast-Low Angle Shot (FLASH), True Fast Imaging with Steady-state Precession (TrueFISP), Sampling Perfection with Application-optimized Contrast using different flip-angle Evolutions (SPACE) as well as conventional and two individually weighted Double-Echo Steady-State (DESS) sequences. The MR images were evaluated qualitatively and quantitatively (signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), SNR efficiency, CNR efficiency). Quantitative parameters were compared by means of a Tukey-test and sequences were ranked according to SNR/CNR, SNR/CNR efficiency and qualitative image grading. RESULTS The highest SNR was measured for SPACE (34.0±5.6), the highest CNR/CNR efficiency (cartilage/fluid) for the individually weighted DESS (46.9±18.0/2.18±0.84). SPACE, individually weighted and conventional DESS were ranked best with respect to SNR/CNR and SNR/CNR efficiency. The DESS sequences also performed best in the qualitative evaluation. TrueFISP performed worse, FLASH worst. The individually weighted DESS sequences were generally better than the conventional DESS with the significant increase of cartilage-fluid contrast (46.9±18.0/31.9±11.4 versus 22.0±7.3) as main advantage. CONCLUSION Individually weighted DESS is the most promising candidate; all tested sequences performed better than FLASH.

MR cisternography: a new method for the diagnosis of CSF fistulae

The aim of this study was to compare a new MRI method for detecting the existence of cerebrospinal fluid (CSF) fistulae, i. e. MR cisternography, with CT cisternography. In a prospective study, 30 patients with post-traumatic CSF fistulae were examined. The MR examinations were performed with a 1.0-T whole-body MR system, using two T2*-weighted sequences, a 3D PSIF (time-inversed fast imaging with steady-state precession, FISP) and a 3D constructive interference steady-state (CISS) sequence. The results of MRI and CT cisternography were compared with the surgical findings. The sensitivity in detecting CSF fistulae with MR cisternography (PSIF: 89.9 %; CISS: 93.6 %) was higher than with CT cisternography (72.3 %). The sensitivity of CT cisternography at detecting CSF fistulae in patients with a size of dural lesion less than 2 mm or in patients with multiple dural lesions is significantly lower compared with the MR method. Although the localization of CSF fistulae always proved possible with MR cisternography, this could only be accomplished wih CT in 70 % of cases. The MR cisternography technique is a new examination method with a higher sensitivity for the detection of CSF fistulae than CT cisternography. The CISS technique is superior compared with PSIF and should be used in patients with high-flow CSF fistulas.

Rapid estimation of cartilage T2 based on double echo at steady state (DESS) with 3 Tesla.

The double‐echo‐steady‐state (DESS) sequence generates two signal echoes that are characterized by a different contrast behavior. Based on these two contrasts, the underlying T2 can be calculated. For a flip‐angle of 90°, the calculated T2 becomes independent of T1, but with very low signal‐to‐noise ratio. In the present study, the estimation of cartilage T2, based on DESS with a reduced flip‐angle, was investigated, with the goal of optimizing SNR, and simultaneously minimizing the error in T2. This approach was validated in phantoms and on volunteers. T2 estimations based on DESS at different flip‐angles were compared with standard multiecho, spin‐echo T2. Furthermore, DESS‐T2 estimations were used in a volunteer and in an initial study on patients after cartilage repair of the knee. A flip‐angle of 33° was the best compromise for the combination of DESS‐T2 mapping and morphological imaging. For this flip angle, the Pearson correlation was 0.993 in the phantom study (∼20% relative difference between SE‐T2 and DESS‐T2); and varied between 0.429 and 0.514 in the volunteer study. Measurements in patients showed comparable results for both techniques with regard to zonal assessment. This DESS‐T2 approach represents an opportunity to combine morphological and quantitative cartilage MRI in a rapid one‐step examination. Magn Reson Med, 2009.