Rudolf Stollberger

Diffusion tensor imaging using single-shot SENSE-EPI.

SENSitivity Encoding (SENSE) greatly enhances the quality of diffusion‐weighted echo‐planar imaging (EPI) by reducing blurring and off‐resonance artifacts. Such improvement would also be desirable for diffusion tensor imaging (DTI), but measures derived from the diffusion tensor can be extremely sensitive to any kind of image distortion. Whether DTI is feasible in combination with SENSE has not yet been explored, and is the focus of this study. Using a SENSE‐reduction factor of 2, DTI scans in eight healthy volunteers were carried out with regular‐ and high‐resolution acquisition matrices. To further improve the stability of the SENSE reconstruction, a new coil‐sensitivity estimation technique based on variational calculus and the principles of matrix regularization was applied. With SENSE, maps of the trace of the diffusion tensor and of fractional anisotropy (FA) had improved spatial resolution and less geometric distortion. Overall, the geometric distortions were substantially removed and a significant resolution enhancement was achieved with almost the same scan time as regular EPI. DTI was even possible without the use of quadrature body coil (QBC) reference scans. Geometry‐factor‐related noise enhancement was only discernible in maps generated with higher‐resolution matrices. Error boundaries for residual fluctuations in SENSE reconstructions are discussed. Our results suggest that SENSE can be combined with DTI and may present an important adjunct for future neuroimaging applications of this technique. Magn Reson Med 48:128–136, 2002.

Improved diffusion-weighted single-shot echo-planar imaging (EPI) in stroke using sensitivity encoding (SENSE)

Diffusion‐weighted single‐shot EPI (sshEPI) is one of the most important tools for the diagnostic assessment of stroke patients, but it suffers from well known artifacts. Therefore, sshEPI was combined with SENSitivity Encoding (SENSE) to further increase EPIs potential for stroke imaging. Eight healthy volunteers and a consecutive series of patients (N = 8) with suspected stroke were examined with diffusion‐weighted SENSE‐sshEPI using different reduction factors (1.0 ≤ R ≤ 3.0). Additionally, a high‐resolution diffusion‐weighted SENSE‐sshEPI scan was included. All examinations were diagnostic and of better quality than conventional sshEPI. No ghostings or aliasing artifacts were discernible, and EPI‐related image distortions were markedly diminished. Chemical shift artifacts and eddy current‐induced image warping were still present, although to a markedly smaller extent. Measured direction‐dependent diffusion‐coefficients and isotropic diffusion values were comparable to previous findings but showed less fluctuation. We have demonstrated the technical feasibility and clinical applicability of diffusion‐weighted SENSE‐sshEPI in patients with subacute stroke. Because of the faster k‐space traversal, this novel technique is able to reduce typical EPI artifacts and increase spatial resolution while simultaneously remaining insensitive to bulk motion. Magn Reson Med 46:548–554, 2001.

Magnetic resonance diffusion tensor imaging for characterizing diffuse and focal white matter abnormalities in multiple sclerosis

High‐resolution diffusion tensor imaging (DTI) was performed in 14 patients with clinically definite multiple sclerosis (MS) and the trace of the diffusion tensor (〈D〉) and the fractional anisotropy (FA) were determined in normal appearing white matter (NAWM) and in different types of focal MS lesions. A small but significant increase of the 〈D〉 in NAWM compared to control white matter ((840 ± 85) × 10–6 mm2/sec vs. (812 ± 59) × 10–6 mm2/sec; P < 0.01) was found. In addition, there was a significant decrease in the FA of normal‐appearing regions containing well‐defined white matter tracts, such as the genu of the internal capsule. In non‐acute lesions, the 〈D〉 of T1‐hypointense areas was significantly higher than that of T1‐isointense lesions ((1198 ± 248) × 10–6 mm2/sec vs. (1006 ± 142) × 10–6 mm2/sec; P < 0.001), and there was a corresponding inverse relation of FA. Diffusion characteristics of active lesions with different enhancement patterns were also significantly different. DTI with a phase navigated interleaved echo planar imaging technique may be used to detect abnormalities of isotropic and anisotropic diffusion in the NAWM and selected fiber tracts of patients with MS throughout the entire brain, and it demonstrates substantial differences between various types of focal lesions. Magn Reson Med 44:583–591, 2000.

Automated unwrapping of MR phase images applied to BOLD MR-venography at 3 Tesla

To improve the diagnostic value of BOLD MR‐Venography by removing artifacts related to phase wrapping, particularly in regions of large background susceptibilities at high magnetic field strengths.

Diffusion‐weighted imaging of the spinal cord: Interleaved echo‐planar imaging is superior to fast spin‐echo

To compare and evaluate two novel diffusion‐weighted sequences, based either on fast spin‐echo (FSE) or interleaved echo‐planar imaging (EPI) methods, as potential tools for investing spinal cord abnormalities.

Magnetic Resonance Imaging and Spectroscopy Findings After Focal Status Epilepticus

Summary: The etiology of cerebral abnormalities after focal status epilepticus (SE) is unknown. Possible causes include hypoxia and the excessive release of excitatory amino acids. Magnetic resonance imaging (MRI) of a 21–year‐old patient with “cryptogenic” continuous motor seizures showed swelling and signal hyperintensity of the contralateral panetotemporal cortex, the thalamus, and the ipsilateral cerebellum on T2‐weighted images. These regions are connected by glutamatergic pathways. Proton magnetic resonance spectroscopy (MRS) of the cortical lesion yielded a signal peak at the resonance frequency of 2.29 ppm, suggesting a focal increase of glutamate or its degradation product glutamine. At 3–month follow‐up, structural alterations had disappeared, but the N‐acetylaspartatelcholine ratio was still reduced in the previously abnormal area. These findings are the first to demonstrate the contribution of MRS to pathophysiologic studies of focal SE in humans and, in combination with the pattern of imaging abnormalities, support a major role of glutamate for seizure‐related brain damage.

Nonlinear anisotropic diffusion filtering for multiscale edge enhancement

Nonlinear anisotropic diffusion filtering is a procedure based on nonlinear evolution partial differential equations which seeks to improve images qualitatively by removing noise while preserving details and even enhancing edges. However, well known implementations are sensitive to parameters which are necessarily tuned to sharpen a narrow range of edge slopes; otherwise, edges are either blurred or staircased. In this work, nonlinear anisotropic diffusion filters have been developed which sharpen edges over a wide range of slope scales and which reduce noise conservatively with dissipation purely along feature boundaries. Specifically, the range of sharpened edge slopes is widened as backward diffusion normal to level sets is balanced with forward diffusion tangent to level sets. Also, noise is reduced by selectively altering the balance toward diminishing normal backward diffusion and particularly toward total variation filtering. The theoretical motivation for the proposed filters is presented together with computational results comparing them with other nonlinear anisotropic diffusion filters on both synthetic images and magnetic resonance images.

Segmentation of wall and plaque in in vitro vascular MR images.

Atherosclerosis leads to heart attack and stroke, which are major killers in the western world. These cardiovascular events frequently result from local rupture of vulnerable atherosclerotic plaque. Non-invasive assessment of plaque vulnerability would dramatically change the way in which atherosclerotic disease is diagnosed, monitored, and treated. In this paper, we report a computerized method for segmentation of arterial wall layers and plaque from high-resolution volumetric MR images. The method uses dynamic programming to detect optimal borders in each MRI frame. The accuracy of the results was tested in 62 T1-weighted MR images from six vessel specimens in comparison to borders manually determined by an expert observer. The mean signed border positioning errors for the lumen, internal elastic lamina, and external elastic lamina borders were −0.1 ± 0.1, 0.0 ± 0.1, and −0.1 ± 0.1 mm, respectively. The presented wall layer segmentation approach is one of the first steps towards non-invasive assessment of plaque vulnerability in atherosclerotic subjects.

Nonlinear anisotropic diffusion filters for wide range edge sharpening

Nonlinear anisotropic diffusion filtering is a procedure based on nonlinear evolution partial differential equations which seeks to improve images qualitatively by removing noise while preserving details and even enhancing edges. However, well known implementations are sensitive to parameters which are necessarily tuned to sharpen a narrow range of edge slopes; otherwise, edges are either blurred or staircased. In this work, nonlinear anisotropic diffusion filters have been developed which sharpen edges over a wide range of slopes and which reduce noise conservatively with dissipation purely along feature boundaries. Specifically, the range of sharpened edge slopes is widened as backward diffusion normal to level sets is balanced with forward diffusion tangent to level sets. Also, noise is reduced by selectively altering the balance toward diminishing normal backward diffusion and particularly toward total variation filtering. The theoretical motivation for the proposed filters is presented together with computational results comparing them with other nonlinear anisotropic diffusion filters on both phantom images and magnetic resonance images.

Magnetic resonance imaging and spectroscopy of progressive cerebral involvement in Kearns Sayre Syndrome

Kearns Sayre Syndrome (KSS) belongs to the group of so called mitochondrial encephalopathies. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) may have the potential to noninvasively detect and monitor disease specific cerebral involvement, as we wish to demonstrate in a patient whom we have followed for 3.5 years. At first presentation with incomplete external ophthalmoplegia, ptosis, pigmentary retinopathy and impaired hearing MRI demonstrated ill defined areas of symmetric T2-prolongation in the dorsal parts of the mesencephalon, the pons and in both cerebellar hemispheres. While the patients clinical symptoms deteriorated, including the onset of dysphagia, signal abnormalities spread downwards into the medulla oblongata involving the glossopharyngeal nuclei and supratentorially into the white matter. Proton MRS performed with the PRESS sequence (TR/TE 1500/136 ms) in the area of white matter damage showed a doublet at 1.33 ppm, which is characteristic for the presence of lactate. Our findings suggest MRI abnormalities to increase in parallel with neurologic progression of KSS and confirm the utility of 1H-MRS in supporting mitochondrial respiratory chain insufficiency as the underlying cause of parenchymal alterations.