Estimation of the magnitude of quadrupole relaxation enhancement in the context of magnetic resonance imaging contrast.

Magnetic Resonance Imaging (MRI) is one of the most powerful diagnostic tools providing maps of 1H relaxation times of human bodies. The method needs, however, a contrast mechanism to enlarge the difference in the relaxation times between healthy and pathological tissues. In this work, we discuss the potential of a novel contrast mechanism for MRI based on Quadrupole Relaxation Enhancement (QRE) and estimate the achievable value of QRE under the most favorable conditions. It has turned out that the theoretically possible enhancement factors are smaller than those of typical paramagnetic contrast agents, but in turn, the field-selectivity of QRE-based agents makes them extremely sensitive to subtle changes of the electric field gradient in the tissue. So far, QRE has been observed for solids (in most cases for 14N) as a result of very slow dynamics and anisotropic spin interactions, believed to be necessary for QRE to appear. We show the first evidence that QRE can be achieved in solutions of compounds containing a high spin nucleus (209Bi) as the quadrupole element. The finding of QRE in a liquid state is explained in terms of spin relaxation theory based on the stochastic Liouville equation. The results confirm the relaxation theory and motivate further exploration of the potential of QRE for MRI.

Detection and volume estimation of artificial hematomas in the subcutaneous fatty tissue: comparison of different MR sequences at 3.0 T.

In legal medicine, reliable localization and analysis of hematomas in subcutaneous fatty tissue is required for forensic reconstruction. Due to the absence of ionizing radiation, magnetic resonance imaging (MRI) is particularly suited to examining living persons with forensically relevant injuries. However, there is limited experience regarding MRI signal properties of hemorrhage in soft tissue. The aim of this study was to evaluate MR sequences with respect to their ability to show high contrast between hematomas and subcutaneous fatty tissue as well as to reliably determine the volume of artificial hematomas. Porcine tissue models were prepared by injecting blood into the subcutaneous fatty tissue to create artificial hematomas. MR images were acquired at 3T and four blinded observers conducted manual segmentation of the hematomas. To assess segmentability, the agreement of measured volume with the known volume of injected blood was statistically analyzed. A physically motivated normalization taking into account partial volume effect was applied to the data to ensure comparable results among differently sized hematomas. The inversion recovery sequence exhibited the best segmentability rate, whereas the T1T2w turbo spin echo sequence showed the most accurate results regarding volume estimation. Both sequences led to reproducible volume estimations. This study demonstrates that MRI is a promising forensic tool to assess and visualize even very small amounts of blood in soft tissue. The presented results enable the improvement of protocols for detection and volume determination of hemorrhage in forensically relevant cases and also provide fundamental knowledge for future in-vivo examinations.

Closed-form solution for T2 mapping with nonideal refocusing of slice selective CPMG sequences.

PURPOSE: T2 quantification with multiecho sequences is typically impaired by the contribution of stimulated echoes to the echo decay due to B1 + inhomogeneity and slice profile effects. In this work, a compact signal model based on the generating functions approach, which accounts for both sources of error, is presented. METHODS: The generating functions (GF) approach is used to obtain a closed solution to the evolution of the transverse magnetization in an echo train, however, not in the time domain, but in the transformed z-domain. The approach is generalized by the incorporation of flip angle distribution across the refocusing slice profiles. The approach is tested by fitting the model to simulated data as well as to phantom and in vivo measurements, followed by a comparison with the common monoexponential fitting approach. RESULTS: The fitting simulations indicate that T2 errors of up to 30% can be commonplace in a clinical setting using the monoexponential method. Conversely, the GF approach produced accurate results. Phantom and in vivo experiments showed a good agreement of the GF values with spectroscopic measurements and single-echo spin-echo sequences. CONCLUSION: A correction for stimulated echoes is necessary to compute comparable T2 values. The presented approach provides a solution to this issue.

Contrast of artificial subcutaneous hematomas in MRI over time.

In clinical forensic medicine, hematomas and other externally visible injuries build the basis for the reconstruction of events. However, dating of subcutaneous hematomas based on their external aspect is difficult. Magnetic resonance imaging (MRI) has proven its use in dating intracranial hemorrhage. Thus, the aim was to investigate if MRI can also be used for dating subcutaneous hematomas and to analyze an eventual influence of the hematoma shape. In 20 healthy volunteers (11 females, 9 males, aged 26.9 ± 3.8 years), 4 ml of autologous blood were injected subcutaneously in the thigh. The hematoma was scanned immediately after the injection, after 3 and 24 h and 3, 7, and 14 days using three sequences with different contrast. Data was analyzed by measuring signal intensities of the hematoma, the muscle, and the subcutaneous tissue over time, and the Michelson contrast coefficients between the tissues were calculated. In the analysis, hematoma shape was considered. Signal intensity of blood in the proton density-weighted sequence reached its maximum 3 h after the injection with a subsequent decrease, whereas the signal intensities of muscle and fatty tissue remained constant. The time course of the Michelson coefficient of blood versus muscle decreased exponentially with a change from hyperintensity to hypointensity at 116.9 h, depending on hematoma shape. In the other sequences, either variability was large or contrast coefficients stayed constant over time. The observed change of contrast of blood versus muscle permits a quick estimate of a hematoma's age. The consideration of the hematoma shape is expected to further enhance dating using MRI.

Age determination of soft tissue hematomas.

In clinical forensic medicine, the estimation of the age of injuries such as externally visible subcutaneous hematomas is important for the reconstruction of violent events, particularly to include or exclude potential suspects. Since the estimation of the time of origin based on external inspection is unreliable, the aim of this study was to use contrast in MRI to develop an easy-to-use model for hematoma age estimation. In a longitudinal study, artificially created subcutaneous hematomas were repetitively imaged using MRI over a period of two weeks. The hemorrhages were created by injecting autologous blood into the subcutaneous tissue of the thigh in 20 healthy volunteers. For MRI, standard commercially available sequences, namely proton-density-weighted, T2 -weighted and inversion recovery sequences, were used. The hematomas' MRI data were analyzed regarding their contrast behavior using the most suitable sequences to derive a model allowing an objective estimation of the age of soft tissue hematomas. The Michelson contrast between hematoma and muscle in the proton-density-weighted sequence showed an exponentially decreasing behavior with a dynamic range of 0.6 and a maximum standard deviation of 0.1. The contrast of the inversion recovery sequences showed increasing characteristics and was hypointense for TI = 200ms and hyperintense for TI =1000ms. These sequences were used to create a contrast model. The cross-validation of the model finally yielded limits of agreement for hematoma age determination (corresponding to ±1.96 SD) of ±38.7h during the first three days and ±54 h for the entire investigation period. The developed model provides lookup tables which allow for the estimation of a hematoma's age given a single contrast measurement applicable by a radiologist or a forensic physician. This is a first step towards an accurate and objective dating method for subcutaneous hematomas, which will be particularly useful in child abuse.

A time domain signal equation for multi-echo spin-echo sequences with arbitrary excitation and refocusing angle and phase.

Accurate T2 mapping using multi-echo spin-echo is usually impaired by non-ideal refocusing due to B1+ inhomogeneities and slice profile effects. Incomplete refocusing gives rise to stimulated echo and so called "T1-mixing" and consequently a non-exponential signal decay. Here we present a time domain formula that incorporates all relaxation and pulse parameters and enables accurate and realistic modelling of the magnetization decay curve. By pulse parameters here we specifically mean the actual refocusing angle and axis, and phase angle of both the excitation and refocusing pulse. The method used for derivation comprises the so called Generating functions approach with subsequent back-transformation to the time domain. The proposed approach was validated by simulations using realistic RF pulse shapes as well as by comparison to phantom measurements. Excellent agreement between simulations and measurements underpin the validity of the presented approach. Conclusively, we here present a complete time domain formula ready to use for accurate T2 mapping with multi-echo spin-echo sequences.

Dental age estimation: The chronology of mineralization and eruption of male third molars with 3T MRI.

Forensic age estimation has recently become an important topic due to a steady increase of cross border migration. Dental age assessment is one pillar of the forensic age estimation in living persons. Currently it is done by evaluating an orthopantomogram, which is generated using ionizing radiation. Nevertheless, the use of X-ray without medical indication is ethically questionable. Therefore, the aim of the study was to provide reference values for dental MRI to have an alternative radiation-free method for the assessment of dental age. In this cross-sectional study, 316 adolescent, male individuals were investigated. Two dentists evaluated the stage of mineralization and eruption of the third molars of the upper and lower jaws, according to the staging systems established by Demirjian and Olze. Following data analysis and the creation of reference tables, the likelihood ratios to be over specific age limits were calculated. In the mineralization evaluation mainly stages D-H were seen (range A-H); regarding eruption, all four stages (A-D) appeared. A significant difference between the teeth was only found for eruption stage A. However, the evaluation of participants who had all four third molars, showed partly different stages for the individual teeth as well for mineralization as for the eruption. Therefore, it seems to be important to include all available teeth in the age estimation. The likelihood ratios showed about 99% probability to be 18 years or older for stage H (mineralization), but only about 93% for stage D (eruption). In summary, it can be concluded that dental MRI holds promise as an alternative to conventional orthopantomogram based age assessment.

R1 dispersion contrast at high field with fast field-cycling MRI.

Contrast agents with a strong R1 dispersion have been shown to be effective in generating target-specific contrast in MRI. The utilization of this R1 field dependence requires the adaptation of an MRI scanner for fast field-cycling (FFC). Here, we present the first implementation and validation of FFC-MRI at a clinical field strength of 3 T. A field-cycling range of ±100 mT around the nominal B0 field was realized by inserting an additional insert coil into an otherwise conventional MRI system. System validation was successfully performed with selected iron oxide magnetic nanoparticles and comparison to FFC-NMR relaxometry measurements. Furthermore, we show proof-of-principle R1 dispersion imaging and demonstrate the capability of generating R1 dispersion contrast at high field with suppressed background signal. With the presented ready-to-use hardware setup it is possible to investigate MRI contrast agents with a strong R1 dispersion at a field strength of 3 T.

Time related changes of T1, T2, and T2(*)(2) of human blood in vitro.

In view of a potential future use for dating hemorrhage in forensic medicine the correlation of MR relaxation parameters with time was evaluated in blood samples. A systematic relationship could be valuable for using MRI for estimating the age of hemorrhage and soft tissue hematomas particularly in clinical forensic medicine. Relaxation times T1, T2, and T2(*) of venous blood samples from 6 volunteers were measured using 3T MRI regularly up to 30 days. The time progression of the relaxation parameters was systematically analyzed and examined for possible interrelations. T2 initially decreased to a minimum, and then increased again (range 24-97ms), while T1 started with a plateau phase followed by an almost linear decrease (range 333-2153ms). T2(*) remained relatively constant during the entire investigation period. The higher the initial T2 was, the lower was its minimum, and the greater was the decrease of the associated T1. The inter- and intra-individual variability was relatively large, one reason being very likely the metabolic differences in the blood samples. The observed characteristic changes in blood samples over time measured by quantitative MR techniques add objective information in view of an estimation of the age of hemorrhage. However, in vivo studies will be needed to verify the data with respect to influencing metabolic factors.

Assessment of fiducial markers to enable the co-registration of photographs and MRI data.

PURPOSE: To investigate the visualisation of novel external fiducial skin markers in photography and MRI. To co-register photographs and MR images, and additionally assess the spatial accuracy of these co-registrations with the view of future application in the investigation of forensically relevant soft tissue lesions. METHODS AND MATERIALS: Strand-shaped fiducial markers were secured externally over hematomas on the thigh of 10 volunteers. The region of interest was photographed and examined using MRI at 3T in oblique and transversal orientations and the visibility of the markers assessed. Markers provided 'control points' in both sets of images, enabling the computation of an affine transform to register oblique MR images to photographs. The fiducial registration error was evaluated by calculating the root-mean-square error of nine corresponding evaluation points visible in both modalities. RESULTS: Fiducial markers were clearly visualised in both photography and MRI. The co-registration of photographs and oblique MR images was achieved for all participants. The overall root-mean-square error for registrations was 1.18mm (TIRM) and 1.46mm (TSE2D with SPAIR fat-suppression). CONCLUSIONS: The proposed approach led to the successful visualisation of non-invasive fiducial markers using photography and MRI (TIRM and TSE2D (SPAIR) sequences). This visualisation, combined with an affine transformation process provided a simple, cost-effective way to accurately co-register photographs and MR images of subcutaneous hematomas located on the thigh. Further investigation of the novel markers and the proposed co-visualisation approach holds potential to improve not only the forensic documentation of soft tissue lesions, but to also improve certain clinical applications, including the area of dermatology.

Dental age estimation of living persons: Comparison of MRI with OPG.

The need for forensic age estimations in living adolescents is high mainly due to migration, particularly from countries where birth dates are not reliably documented. To date, the gold standard of dental age estimation is the evaluation of the mineralization and eruption stages of the third molars using an orthopantomogram (OPG). However, the use of ionizing radiation without medical indication is ethically controversial and not permitted in many countries. Thus, the aim of this study was to investigate if dental MRI can be used for the assessment of dental age with equally good results as when using an OPG. 27 healthy volunteers (19 ♀, 8 ♂, age range 13.6-23.1 years, median 18.9 years) underwent an MRI scan of the jaw after a clinically indicated OPG. Mineralization and eruption stages of the molars were independently analyzed on OPGs and MRI by two blinded dentists according to the staging system established by Demirjian and Olze, respectively. The results of OPG and MRI were compared and inter-rater agreement was determined. The developmental stages of the 262 evaluated molars could be clearly differentiated in MRI. For both, mineralization and eruption, there was a good correlation between MRI and OPG. Overall MRI tended to yield slightly lower stages than the OPG. Inter-rater agreement was moderate for mineralization and good regarding eruption. Although a validation of these results using modality-specific reference values is needed, dental MRI seems to be suitable for a use in dental age estimation.

Fast T2 mapping with improved accuracy using undersampled spin-echo MRI and model-based reconstructions with a generating function.

A model-based reconstruction technique for accelerated T2 mapping with improved accuracy is proposed using undersampled Cartesian spin-echo magnetic resonance imaging (MRI) data. The technique employs an advanced signal model for T2 relaxation that accounts for contributions from indirect echoes in a train of multiple spin echoes. An iterative solution of the nonlinear inverse reconstruction problem directly estimates spin-density and T2 maps from undersampled raw data. The algorithm is validated for simulated data as well as phantom and human brain MRI at 3T. The performance of the advanced model is compared to conventional pixel-based fitting of echo-time images from fully sampled data. The proposed method yields more accurate T2 values than the mono-exponential model and allows for retrospective undersampling factors of at least 6.Although limitations are observed for very long T2 relaxation times, respective reconstruction problems may be overcome by a gradient dampening approach. The analytical gradient of the utilized cost function is included as appendix. The source code is made available to the community.