Use of Multiplied, Added, Subtracted and/or FiTted Inversion Recovery (MASTIR) pulse sequences.

The group of Multiplied, Added, Subtracted and/or fiTted Inversion Recovery (MASTIR) pulse sequences in which usually two or more inversion recovery (IR) images of different types are combined is described, and uses for this type of sequence are outlined. IR sequences of different types can be multiplied, added, subtracted, and/or fitted together to produce variants of the MASTIR sequence. The sequences provide a range of options for increasing image contrast, demonstrating specific tissues and fluids of interest, and suppressing unwanted signals. A formalism using the concept of pulse sequences as tissue property filters is used to explain the signal, contrast and weighting of the pulse sequences with both univariate and multivariate filter models. Subtraction of one magnitude reconstructed IR image from another with a shorter TI can produce very high T1 dependent positive contrast from small increases in T1. The reverse subtracted IR sequence can provide high positive contrast enhancement with gadolinium chelates and iron deposition which decrease T1. Additional contrast to that arising from increases in T1 can be produced by supplementing this with contrast arising from concurrent increases in ρm and T2, as well as increases or decreases in diffusion using subtraction IR with echo subtraction and/or diffusion subtraction. Phase images may show 180º differences as a result of rotating into the transverse plane both positive and negative longitudinal magnetization. Phase images with contrast arising in this way, or other ways, can be multiplied by magnitude IR images to increase the contrast of the latter. Magnetization Transfer (MT) and susceptibility can be used with IR sequences to improve contrast. Selective images of white and brown adipose tissue lipid and water components can be produced using different TIs and in and out-of-phase TEs. Selective images of ultrashort and short T2 tissue components can be produced by nulling long T2 tissue components with an inversion pulse and subtraction of images with longer TEs from images with ultrashort TEs. The Double Echo Sliding IR (DESIRE) sequence provides images with a wide range of TIs from which it is possible to choose values of TI to achieve particular types of tissue and/or fluid contrast (e.g., for subtraction with different TIs, as described above, and for long T2 tissue signal nulling with UTE sequences). Unwanted tissue and fluid signals can be suppressed by addition and subtraction of phase-sensitive (ps) and magnitude reconstructed images. The sequence also offers options for synergistic use of the changes in blood and tissue ρm, T1, T2/T2*, D* and perfusion that can be seen with fMRI of the brain. In-vivo and ex-vivo illustrative examples of normal brain, cartilage, multiple sclerosis, Alzheimer's disease, and peripheral nerve imaged with different forms of the MASTIR sequence are included.

Pulse sequences as tissue property filters (TP-filters): a way of understanding the signal, contrast and weighting of magnetic resonance images.

This paper describes a quantitative approach to understanding the signal, contrast and weighting of magnetic resonance (MR) images. It uses the concept of pulse sequences as tissue property (TP) filters and models the signal, contrast and weighting of sequences using either a single TP-filter (univariate model) or several TP-filters (the multivariate model). For the spin echo (SE) sequence using the Bloch equations, voxel signal intensity is plotted against the logarithm of the value of the TPs contributing to the sequence signal to produce three TP-filters, an exponential ρm-filter, a low pass T1-filter and a high pass T2-filter. Using the univariate model which considers signal changes in only one of ρm, T1, or T2 at a time, the first partial derivative of signal with respect to the natural logarithm of ρm, T1 or T2 is the sequence weighting for each filter (for small changes in each TP). Absolute contrast is then the sequence weighting multiplied by the fractional change in TP for each filter. For large changes in TPs, the same approach is followed, but using the mean slope of the filter as the sequence weighting. These approaches can also be used for fractional contrast. The univariate TP-filter model provides a mathematical framework for converting conventional qualitative univariate weighting as used in everyday clinical practice into quantitative univariate weighting. Using the multivariate model which considers several TP-filters together, the relative contributions of each TP to overall sequence and image weighting are expressed as sequence and imaging weighting ratios respectively. This is not possible with conventional qualitative weighting which is univariate. The same approaches are used for inversion recovery (IR), pulsed gradient SE, spoiled gradient echo (SGE), balanced steady state free precession, ultrashort echo time and other pulse sequences. Other TPs such as susceptibility, chemical shift and flow can be included with phase along the Y axis of the TP-filter. Contrast agent effects are also included. In the text TP-filters are distinguished from k-space filters, signal filters (S-filters) which are used in imaging processing as well as to describe windowing the signal width and level of images, and spatial filters. The TP-filters approach resolves many of the ambiguities and inconsistencies associated with conventional qualitative weighting and provides a variety of new insights into the signal, contrast and weighting of MR images which are not apparent using qualitative weighting. The TP-filter approach relates the preparation component of pulse sequences to voxel signal, and contrast between two voxels. This is complementary to k-space which relates the acquisition component of pulse sequences to the spatial properties of MR images and their global contrast.

Accurate T1 mapping of short T2 tissues using a three-dimensional ultrashort echo time cones actual flip angle imaging-variable repetition time (3D UTE-Cones AFI-VTR) method.

PURPOSE: To develop an accurate T1 measurement method for short T2 tissues using a combination of a 3-dimensional ultrashort echo time cones actual flip angle imaging technique and a variable repetition time technique (3D UTE-Cones AFI-VTR) on a clinical 3T scanner. METHODS: First, the longitudinal magnetization mapping function of the excitation pulse was obtained with the 3D UTE-Cones AFI method, which provided information about excitation efficiency and B1 inhomogeneity. Then, the derived mapping function was substituted into the VTR fitting to generate accurate T1 maps. Numerical simulation and phantom studies were carried out to compare the AFI-VTR method with a B1 -uncorrected VTR method, a B1 -uncorrected variable flip angle (VFA) method, and a B1 -corrected VFA method. Finally, the 3D UTE-Cones AFI-VTR method was applied to bovine bone samples (N = 6) and healthy volunteers (N = 3) to quantify the T1 of cortical bone. RESULTS: Numerical simulation and phantom studies showed that the 3D UTE-Cones AFI-VTR technique provides more accurate measurement of the T1 of short T2 tissues than the B1 -uncorrected VTR and VFA methods or the B1 -corrected VFA method. The proposed 3D UTE-Cones AFI-VTR method showed a mean T1 of 240 ± 25 ms for bovine cortical bone and 218 ± 10 ms for the tibial midshaft of human volunteers, respectively, at 3 T. CONCLUSION: The 3D UTE-Cones AFI-VTR method can provide accurate T1 measurements of short T2 tissues such as cortical bone. Magn Reson Med 80:598-608, 2018. © 2018 International Society for Magnetic Resonance in Medicine.

Sources of systematic error in proton density fat fraction (PDFF) quantification in the liver evaluated from magnitude images with different numbers of echoes.

The purpose of this work was to investigate sources of bias in magnetic resonance imaging (MRI) liver fat quantification that lead to a dependence of the proton density fat fraction (PDFF) on the number of echoes. This was a retrospective analysis of liver MRI data from 463 subjects. The magnitude signal variation with TE from spoiled gradient echo images was curve fitted to estimate the PDFF using a model that included monoexponential R2 * decay and a multi-peak fat spectrum. Additional corrections for non-exponential decay (Gaussian), bi-exponential decay, degree of fat saturation, water frequency shift and noise bias were introduced. The fitting error was minimized with respect to 463 × 3 = 1389 subject-specific parameters and seven additional parameters associated with these corrections. The effect on PDFF was analyzed, notably the dependence on the number of echoes. The effects on R2 * were also analyzed. The results showed that the inclusion of bias corrections resulted in an increase in the quality of fit (r2 ) in 427 of 463 subjects (i.e. 92.2%) and a reduction in the total fitting error (residual norm) of 43.6%. This was largely a result of the Gaussian decay (57.8% of the reduction), fat spectrum (31.0%) and biexponential decay (8.8%) terms. The inclusion of corrections was also accompanied by a decrease in the dependence of PDFF on the number of echoes. Similar analysis of R2 * showed a decrease in the dependence on the number of echoes. Comparison of PDFF with spectroscopy indicated excellent agreement before and after correction, but the latter exhibited lower bias on a Bland-Altman plot (1.35% versus 0.41%). In conclusion, correction for known and expected biases in PDFF quantification in liver reduces the fitting error, decreases the dependence on the number of echoes and increases the accuracy.

Yet more evidence that myelin protons can be directly imaged with UTE sequences on a clinical 3T scanner: Bicomponent T2* analysis of native and deuterated ovine brain specimens.

PURPOSE: UTE sequences with a minimal nominal TE of 8 µs have shown promise for direct imaging of myelin protons (T2 , < 1 ms). However, there is still debate about the efficiency of 2D slice-selective UTE sequences in exciting myelin protons because the half excitation pulses used in these sequences have a relatively long duration (e.g., 0.3-0.6 ms). Here, we compared UTE and inversion-recovery (IR) UTE sequences used with either hard or half excitation pulses (durations 32 µs or 472 µs, respectively) for imaging myelin in native and deuterated ovine brain at 3T. METHODS: Freshly frozen ovine brains were dissected into ∼2 mm-thick pure white matter and ∼3 to 8 mm-thick cerebral hemisphere specimens, which were imaged before and/or after different immersion time in deuterium oxide. RESULTS: Bicomponent T2* analysis of UTE signals obtained with hard excitation pulses detected an ultrashort T2 component (STC) fraction (fS ) of 0% to 10% in native specimens, and up to ∼86% in heavily deuterated specimens. fS values were significantly affected by the TIs used in IR-UTE sequences with either hard or half excitation pulses in native specimens but not in heavily deuterated specimens. The STC T2* was in the range of 150 to 400 µs in all UTE and IR-UTE measurements obtained with either hard or half excitation pulses. CONCLUSION: Our results further support myelin protons as the major source of the ultrashort T2* signals seen on IR-UTE images and demonstrate the potential of IR-UTE sequences with half excitation pulses for directly imaging myelin using clinical scanners. Magn Reson Med 80:538-547, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Multisite, multivendor validation of the accuracy and reproducibility of proton-density fat-fraction quantification at 1.5T and 3T using a fat-water phantom.

PURPOSE: To evaluate the accuracy and reproducibility of quantitative chemical shift-encoded (CSE) MRI to quantify proton-density fat-fraction (PDFF) in a fat-water phantom across sites, vendors, field strengths, and protocols. METHODS: Six sites (Philips, Siemens, and GE Healthcare) participated in this study. A phantom containing multiple vials with various oil/water suspensions (PDFF:0%-100%) was built, shipped to each site, and scanned at 1.5T and 3T using two CSE protocols per field strength. Confounder-corrected PDFF maps were reconstructed using a common algorithm. To assess accuracy, PDFF bias and linear regression with the known PDFF were calculated. To assess reproducibility, measurements were compared across sites, vendors, field strengths, and protocols using analysis of covariance (ANCOVA), Bland-Altman analysis, and the intraclass correlation coefficient (ICC). RESULTS: PDFF measurements revealed an overall absolute bias (across sites, field strengths, and protocols) of 0.22% (95% confidence interval, 0.07%-0.38%) and R2 > 0.995 relative to the known PDFF at each site, field strength, and protocol, with a slope between 0.96 and 1.02 and an intercept between -0.56% and 1.13%. ANCOVA did not reveal effects of field strength (P = 0.36) or protocol (P = 0.19). There was a significant effect of vendor (F = 25.13, P = 1.07 × 10-10 ) with a bias of -0.37% (Philips) and -1.22% (Siemens) relative to GE Healthcare. The overall ICC was 0.999. CONCLUSION: CSE-based fat quantification is accurate and reproducible across sites, vendors, field strengths, and protocols. Magn Reson Med 77:1516-1524, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Ultrasound Elastography and MR Elastography for Assessing Liver Fibrosis: Part 1, Principles and Techniques.

OBJECTIVE: The purpose of this article is to provide an overview of ultrasound and MR elastography, including a glossary of relevant terminology, a classification of elastography techniques, and a discussion of their respective strengths and limitations. CONCLUSION: Elastography is an emerging technique for the noninvasive assessment of mechanical tissue properties. These techniques report metrics related to tissue stiffness, such as shear-wave speed, magnitude of the complex shear modulus, and the Young modulus.

Ultrasound Elastography and MR Elastography for Assessing Liver Fibrosis: Part 2, Diagnostic Performance, Confounders, and Future Directions.

OBJECTIVE: The purpose of the article is to review the diagnostic performance of ultra-sound and MR elastography techniques for detection and staging of liver fibrosis, the main current clinical applications of elastography in the abdomen. CONCLUSION: Technical and instrument-related factors and biologic and patient-related factors may constitute potential confounders of stiffness measurements for assessment of liver fibrosis. Future developments may expand the scope of elastography for monitoring liver fibrosis and predict complications of chronic liver disease.

Magnetic resonance imaging of the pulleys of the flexor tendons of the toes at 11.7 T.

OBJECTIVE: We obtained high-resolution 11.7-T MR images of the pulleys of the flexor tendons in cadaveric toe specimens. A detailed understanding of toe pulley anatomy as seen with MR is likely to be of benefit in recognizing disease and the effects of trauma. MATERIAL AND METHODS: Six cadaveric toes were imaged with an 11.7-T small-bore MR imaging system using optimized coils. Two-dimensional dual-echo SE scans were obtained in three planes (40 × 40 × 400-µm(3) voxel size, TE = 7/14 ms, TR = 3,500 ms, fat saturation). Three-dimensional spoiled gradient echo scans were obtained (90-150 µm(3) isotropic voxel size, TE = 6 ms, TR = 25 ms, with and without fat saturation). Specimen orientation was with the long axis of the toe either parallel or perpendicular to B0. RESULTS: All the annular (A) pulleys were demonstrated in the great and lesser toes. The A2 pulley in the great and lesser toes and the A4 pulley in the lesser toes were the most substantial pulleys. The A5 pulley, which has not previously been described in the toes, was demonstrated. The cruciform pulleys were also seen and were smaller and thinner. Three tissue layers were seen, and there was evidence of different fiber directions in annular pulleys producing different magic angle effects. CONCLUSION: Detailed anatomy of the pulley system of the flexor tendons was seen on the 11.7-T MR images showing new features and providing a basis for image interpretation. Similarities and differences between the pulley systems in the toes and the fingers were identified.

Rotator cuff tendon ultrastructure assessment with reduced-orientation dipolar anisotropy fiber imaging.

OBJECTIVE: The anisotropic fibrous structure of collagen can significantly affect MRI signal intensity. Use of this magic angle effect as a contrast mechanism has been previously termed "dipolar anisotropy fiber imaging." The goal of this pilot study was to use a reduced-orientation version of dipolar anisotropy fiber imaging to study rotator cuff tendon internal fiber structure. CONCLUSION: The reduced-orientation dipolar anisotropy fiber imaging technique can be used to delineate the complex contributions and ultrastructure of the rotator cuff.

Ultrashort echo time (UTE) magnetic resonance imaging of the short T2 components in white matter of the brain using a clinical 3T scanner.

White matter of the brain contains a majority of long T2 components as well as a minority of short T2 components. These are not detectable using clinical magnetic resonance imaging (MRI) sequences with conventional echo times (TEs). In this study we used ultrashort echo time (UTE) sequences to investigate the ultrashort T2 components in white matter of the brain and quantify their T2*s and relative proton densities (RPDs) (relative to water with a proton density of 100%) using a clinical whole body 3T scanner. An adiabatic inversion recovery prepared dual echo UTE (IR-dUTE) sequence was used for morphological imaging of the ultrashort T2 components in white matter. IR-dUTE acquisitions at a constant TR of 1000 ms and a series of TIs were performed to determine the optimal TI which corresponded to the minimum signal to noise ratio (SNR) in white matter of the brain on the second echo image. T2*s of the ultrashort T2 components were quantified using mono-exponential decay fitting of the IR-dUTE signal at a series of TEs. RPD was quantified by comparing IR-dUTE signal of the ultrashort T2 components with that of a rubber phantom. Nine healthy volunteers were studied. The IR-dUTE sequence provided excellent image contrast for the ultrashort T2 components in white matter of the brain with a mean signal to noise ratio of 18.7 ± 3.7 and a contrast to noise ratio of 14.6 ± 2.4 between the ultrashort T2 white matter and gray matter in a 4.4 min scan time with a nominal voxel size of 1.25 × 1.25 × 5.0mm(3). On average a T2* value of 0.42 ± 0.08 ms and a RPD of 4.05 ± 0.88% were demonstrated for the ultrashort T2 components in white matter of the brain of healthy volunteers at 3T.

Dipolar anisotropy fiber imaging in a goat knee meniscus.

This study describes a method of utilizing unaveraged dipolar effects to characterize and compute collagen fiber tracks using magnetic resonance imaging. The technique yields information about fiber structure with some similarities to what can be obtained in brain using diffusion tensor imaging, but relies on a completely different physical mechanism, namely, unaveraged homonuclear dipolar interactions. The method is probably only appropriate for highly ordered collagen rich tissues. A goat knee meniscus was embedded in a spherical epoxy ball and the magnetic resonance signal intensity was examined as a function of sample orientation to a 3T static field using a three-dimensional gradient echo sequence. Unaveraged dipolar interactions caused a sixfold signal variation with orientation. After correction for coil sensitivity and registration of the images, a principal dipolar direction was computed for each voxel. The data were analyzed and viewed as dipolar direction and standard deviation (anisotropy) maps. Circumferential fibers within the meniscus were visualized as fiber tracks grown using diffusion tensor imaging software. The acronym dipolar anisotropy fiber imaging is proposed for this technique. Magn Reson Med, 2011. © 2010 Wiley-Liss, Inc.

Ultrashort TE T1rho (UTE T1rho) imaging of the Achilles tendon and meniscus.

In this study, we report the use of a novel ultrashort echo time T(1)rhoT(1) sequence that combines a spin-lock preparation pulse with a two-dimensional ultrashort echo time sequence of a nominal echo time 8 microsec. The ultrashort echo time-T(1)rho sequence was employed to quantify T(1)rho in short T(2) tissues including the Achilles tendon and the meniscus. T(1)rho dispersion was investigated by varying the spin-lock field strength. Preliminary results on six cadaveric ankle specimens and five healthy volunteers show that the ultrashort echo time-T(1)rho sequence provides high signal and contrast for both the Achilles tendon and the meniscus. The mean T(1)rho of the Achilles tendon ranged from 3.06 +/- 0.51 msec for healthy volunteers to 5.22 +/- 0.58 msec for cadaveric specimens. T(1)rho increased to 8.99 +/- 0.24 msec in one specimen with tendon degeneration. A mean T(1)rho of 7.98 +/- 1.43 msec was observed in the meniscus of the healthy volunteers. There was significant T(1)rho dispersion in both the Achilles tendon and the meniscus. Mean T(1)rho increased from 2.06 +/- 0.23 to 7.85 +/- 0.74 msec in normal Achilles tendon and from 7.08 +/- 0.64 to 13.42 +/- 0.93 msec in normal meniscus when the spin-lock field was increased from 250 to 1,000 Hz.

Neural resources associated with perceptual judgment across sensory modalities.

Electrophysiological and brain imaging studies have shown that different populations of neurons contribute to perceptual decision making. Perceptual judgment is a complicated process that has several subprocesses, including the final step of a discrete choice among available possibilities. Using the psychophysical paradigm of difference scaling combined with functional magnetic resonance imaging, we identify an area within a distributed representation that is consistently invoked in perceptual decision. Difference judgments based on visual (color, form, and motion) cues and auditory cues show that a population of neurons in the posterior banks of the intraparietal sulcus (PIPS) is consistently activated for perceptual judgment across visual attributes and sensory modalities, suggesting that those neurons in PIPS are associated with perceptual judgment.

Effects of hyperoxia on human sensorimotor cortex activity produced by electrical stimulation of the median nerve: a functional magnetic resonance imaging study.

This study investigated the effect of hyperoxia on sensorimotorcortical activity resulting from electrical stimulation of the median nerve, using functional magnetic resonance imaging (fMRI). Nine volunteers underwent stimulation at 5 and 100 Hz while breathing 21% FIO(2) (fraction of inspired oxygen) or 100% FIO(2). fMRI data were correlated with a stimulus predictor curve, transformed into Talairach space and averaged by group. Normoxic (21% FIO(2)) and hyperoxic (100% FIO(2)) sensorimotor activation volumes were compared using Student's t-test. There were no significant differences between the primary somatosensory/primary motor/Brodmann area 40 (SI/MI/Ba40) and secondary somatosensory cortex (SII) activation volumes for normoxia and hyperoxia. (P>0.05). There was no difference between SI/MI/Ba40 and SII activations at 5 and 100 Hz. In contrast to results previously reported for primary visual cortex (V1), hyperoxia did not enhance sensorimotor cortical activation in area SI/MI/Ba40 or SII. These results indicate that there is regional heterogeneity of the fMRI response to hyperoxia in the cerebral cortex.