Michiel Sprenger

Within-Subject Reproducibility of Visual Activation Patterns With Functional Magnetic Resonance Imaging Using Multislice Echo Planar Imaging

Within-subject reproducibility of visual brain activation using multislice echo planar functional magnetic resonance imaging (fMRI) was tested. Ten healthy subjects underwent fMRI with visual stimulation on three occasions: two studies in one scanning session (without repositioning); and a third study 1 h to 2 weeks later. Following a three-dimensional matching procedure, activation was measured and compared between sessions on a voxel-by-voxel basis. Data were filtered to full-width-at-half-maximum of 4.0 x 4.0 x 5.0 mm and a conservative Bonferroni-corrected significance threshold was applied to correlation maps. For reproducibility, change in centre of mass of the activated volume, a ratio of the number of pixels and a ratio of the number of overlapping pixels was calculated. Further, reproducibility was tested varying significance thresholds and at different filter widths. Average changes in centre of mass of the activated volume were 2.63 and 3.96 mm between Studies 1 and 2 and 1 and 3, respectively. The reproducibility of the number of activated voxels was 90% and 88% (Studies 1 and 2 and 1 and 3). The ratio of overlapping pixels was 74% between Studies 1 and 2 and 64% between Studies 1 and 3. Varying the significance threshold showed that at a certain range, the overlap reached a maximum, and increasing the filter widths increased reproducibility. It is concluded that fMRI with visual stimulation can be used to measure brain activity with reasonably good reproducibility on a routine clinical system equipped with echo planar imaging. Difficulties remain in separating the contribution of motion, repositioning errors, and true physiological changes.

Evaluation of magnetic resonance imaging for determination of left ventricular ejection fraction and comparison with angiography.

Left ventricular ejection fraction was measured by magnetic resonance imaging (MRI) and compared with standard monoplane left ventriculography in 46 patients with various cardiac diseases. Two different MRI strategies were used. In 28 patients (group 1), ejection fraction was determined using a single slice comparable with the right anterior oblique projection of the ventriculogram. Comparison of left ventricular ejection fraction yielded a poor correlation between single slice MRI (y) and ventriculography (x) (y = 28.7 + 0.47 x, r = 0.65). In 18 patients (group 2), a multiple contiguous slice MRI technique was used to allow ejection fraction and stroke volume determination by summing up the volumes of ventricular cavity intersections. Regression analysis showed a high correlation between multiple slice MRI (y) and ventriculography (x) (y = 7.2 + 0.88 x, r = 0.98). Also, correlation between MRI right (y) and left (x) ventricular stroke volumes was satisfactory, (y = -12.8 + 1.09 x, r = 0.83). It is concluded that the multiple slice imaging technique in MRI provides an accurate noninvasive means for quantification of left ventricular ejection fraction that can be extended to the determination of left ventricular volume.

Quantitative differentiation between BOLD models in fMRI

Several gradient‐echo fMRI blood oxygenation level‐dependent (BOLD) effects are described in the literature: extravascular spin dephasing around capillaries and veins, intravascular phase changes, and transverse relaxation changes of blood. This work considers a series of tissue compartmentalized models incorporating each of these effects, and tries to determine the model which is most consistent with the data. To isolate the different tissue contributions, a series of multi‐echo inversion recovery (IR) fMRI scans were performed. Visual stimulation experiments were performed at 1.5 T, one interleaved six‐echo and two IR six‐echo EPI scans (the latter to suppress gray matter (GM) and cerebrospinal fluid (CSF)). The tissue and vascular composition of activated areas was analyzed using independent spin‐echo IR MRI experiments and MR venography, respectively. This information was used to fit the multi‐echo fMRI data to the BOLD models. The activated areas almost always included a venous vessel visible on the venogram and consisted of GM and CSF. The fMRI signal changes were best described by extravascular dephasing effects in both GM and CSF around a venous vessel, in combination with intravascular effects. The role of spin dephasing around capillaries in GM appears to be insignificant. Magn Reson Med 45:233–246, 2001.

The functional basis of ocular dominance: functional MRI (fMRI) findings.

Changes in cortical metabolism and cerebral perfusion may be recorded non-invasively with functional magnetic resonance imaging (fMRI). In pilot experiments, using fMRI with photic stimulation, we found differences between activated areas when the left or the right eye was stimulated separately. In this study we investigated whether this could be explained by ocular dominance. We studied 26 healthy volunteers (mean age 23.3 +/- 3.5 years). Ocular dominance was determined by means of the near-far alignment test. fMRI-measurements consisted of a double-slice gradient echo sequence. Slices were acquired placed parallel on either side of the calcarine fissure. Visual stimulation was done with goggles with two LED matrices (red light, 8 Hz); each in front of one eye. In each subject, the left and right eye were stimulated separately and together, in a randomly alternating order. Twenty-two subjects showed activation, of whom eight subjects had a dominant left eye and 14 a dominant right eye. In general the size of the activated area was bigger upon stimulation of the dominant eye. The difference with the area upon stimulation of the non-dominant eye was statistically significant in the right eye dominant group. These results indicate that the dominant eye actually activates a larger area of the primary visual cortex than the non-dominant eye. This provides for the first time a functional basis for the concept of ocular dominance.

Value of gadolinium-diethylene-triamine pentaacetic acid dynamics in magnetic resonance imaging of acute myocardial infarction with occluded and reperfused coronary arteries after thrombolysis

The use of the paramagnetic contrast agent gadolinium-diethylene-triamine pentaacetic acid (DTPA) was evaluated in magnetic resonance imaging (MRI) of 18 patients with an acute myocardial infarction after thrombolysis. The patency of the infarct-related vessel was assessed by coronary angiography. At 58 +/- 9 hours after infarction MRI was performed before and after bolus injection of 0.1 mmol/kg gadolinium-DTPA. Myocardial signal intensities were measured using a circumferential profile. Normal and infarcted myocardium showed a maximum signal intensity enhancement of 35 and 66%, respectively. Signal intensity of infarcted relative to normal myocardium (I/N) increased from 1.06 +/- 0.16 before to a maximum of 1.39 +/- 0.13 after gadolinium-DTPA (p less than 0.001), whereas the contrast between normal myocardium and a pseudo-infarct region in 2 healthy volunteers did not change. Between patients with reperfused infarct-related vessels and occluded vessels without collaterals, maximum I/N did not differ. However, observing I/N as a function of time after injection of gadolinium-DTPA, the reperfusion group differed from the occlusion group on images acquired directly after injection (1.29 +/- 0.10 vs 1.14 +/- 0.05, p less than 0.02). Thus, gadolinium-DTPA enhanced the visualization of acute myocardial infarction on relatively longitudinal (T1)-weighted MR images and its dynamics seem of potential value for the noninvasive assessment of coronary artery reperfusion after thrombolysis.

Phase-Contrast Cine Mr Imaging of Normal Aqueductal CSF Flow Effect of Aging and Relation to CSF Void on Modulus MR

Cine phase-contrast MR imaging was used to study pulsatile CSF flow in the aqueduct in 11 young controls (mean age 30 years) and 9 old controls (mean age 69 years). A high-resolution gradient echo technique and an oblique imaging plane, perpendicular to the aqueduct, was used to avoid volume averaging. Phantom studies confirmed that the technique was accurate. Aqueductal velocity and flux in old controls was higher than in young controls, but the differences were not significant. For all controls together, the averaged peak velocity was 4.2 ± 1.5 cm/s in rostral and −7.8 ± 4.9 cm/s in caudal direction; for the flux it was 0.16 ± 0.10 cm3/s in rostral and −0.29 ± 0.19 cm3/s in caudal direction. Phase-contrast measurements were significantly related to flow-void on modulus MR images, but not with ventricular size or cortical atrophy. The present technique avoids underestimation of aqueductal flow, and therefore reveals higher aqueductal velocity and flux values than previous studies. Factors other than age or atrophy seem to determine aqueductal CSF flow.

Magnetic resonance imaging and quantitation of blood flow

Adequate supply of blood to the different organs is of vital importance for their metabolism and function. Decreased blood flow will lead to malfunction and is indicative of imminent or progressive disease, as for example in obstructive artheriosclerotic vascular disease. Viewed from the angle of prevention, diagnosis, and control or follow-up after treatment, quantitation of blood flow is of great importance. Preferably, in vivo flow measurements should be performed with noninvasive techniques that do not interfere with the flow pattern, do not carry the risks associated with invasive procedures and are least cumbersome to the patient.