T2*-weighted and arterial spin labeling MRI of calf muscles in healthy volunteers and patients with chronic exertional compartment syndrome: preliminary experience.

OBJECTIVE: The purpose of our study was to assess temporal changes with exercise in T2* and arterial spin labeling signals in patients with chronic exertional compartment syndrome of the anterior compartment of the lower leg and in control subjects using T2* mapping and arterial spin labeling MRI. SUBJECTS AND METHODS: This prospective study was approved by the institutional research ethics board. Ten control subjects (five women and five men; mean age, 29.0 years) and nine patients with chronic exertional compartment syndrome (three women and six men; mean age, 33.7 years) gave informed written consent and underwent MRI of the calf muscles using an axial T2*-weighted multiecho gradient-recalled echo and a flow-sensitive alternating inversion recovery sequence with echo-planar imaging readouts before (baseline) and 3, 6, 9, 12, and 15 minutes after exercise. T2* and arterial spin labeling signal changes (DeltaT2* and DeltaASL, respectively) over time were calculated relative to the baseline examination. DeltaT2* and DeltaASL between patients and control subjects were compared using the Student's t test. RESULTS: In both patients and control subjects, DeltaT2* and DeltaASL showed a peak at 3 minutes after exercise, followed by a decrease over time. The maximum DeltaT2* was 26% and 29% for patients and control subjects, respectively. The maximum DeltaASL was 183% and 224% for patients and control subjects, respectively. After 15 minutes, arterial spin labeling signal returned to baseline; however, T2* remained elevated (8% in patients; 10% in control subjects). No statistically significant differences between patients and control subjects in postexercise DeltaT2* and DeltaASL were found (p = 0.21-0.98). CONCLUSION: After calf muscle exercise, no statistically significant differences in T2* relaxation times or arterial spin labeling signal, indicative of differences in muscle oxygenation and perfusion status, were found between patients with chronic exertional compartment syndrome and control subjects.

Mapping cerebrovascular reactivity using blood oxygen level-dependent MRI in Patients with arterial steno-occlusive disease: comparison with arterial spin labeling MRI.

BACKGROUND AND PURPOSE: Blood oxygen level-dependent MRI (BOLD MRI) of hypercapnia-induced changes in cerebral blood flow is an emerging technique for mapping cerebrovascular reactivity (CVR). BOLD MRI signal reflects cerebral blood flow, but also depends on cerebral blood volume, cerebral metabolic rate, arterial oxygenation, and hematocrit. The purpose of this study was to determine whether, in patients with stenoocclusive disease, the BOLD MRI signal response to hypercapnia is directly related to changes in cerebral blood flow. METHODS: Thirty-eight patients with stenoocclusive disease underwent mapping of CVR by both BOLD MRI and arterial spin labeling MRI. The latter technique was used as a reference standard for measurement of cerebral blood flow changes. RESULTS: Hemispheric CVR measured by BOLD MRI was significantly correlated with that measured by arterial spin labeling MRI for both gray matter (R=0.83, P<0.0001) and white matter (R=0.80, P<0.0001). Diagnostic accuracy (area under receiver operating characteristic curve) for BOLD MRI discrimination between normal and abnormal hemispheric CVR was 0.90 (95% CI=0.81 to 0.98; P<0.001) for gray matter and 0.82 (95% CI=0.70 to 0.94; P<0.001) for white matter. Regions of paradoxical CVR on BOLD MRI had a moderate predictive value (14 of 19 hemispheres) for spatially corresponding paradoxical CVR on arterial spin labeling MRI. Complete absence of paradoxical CVR on BOLD MRI had a high predictive value (31 of 31 hemispheres) for corresponding nonparadoxical CVR on arterial spin labeling MRI. CONCLUSIONS: Arterial spin labeling MRI confirms that, even in patients with stenoocclusive disease, the BOLD MRI signal response to hypercapnia predominantly reflects changes in cerebral blood flow.

Characterizing blood volume fraction (BVF) in a VX2 tumor.

OBJECTIVES: Neovascular proliferation of a tumor's blood supply is an important precursor of malignant growth. Evaluation of blood volume may provide useful information for the characterization, prognosis and response of tumors to therapy. The purpose of this study was to determine and compare the blood volume of tumor tissue measured noninvasively by MRI and microbubble contrast ultrasound imaging. MATERIALS AND METHODS: Twenty-two rabbits injected with VX2 tumors were studied. The blood volume fraction in tumor and muscle tissue was obtained from MRI T(1)-weighted images using a blood-pool agent, Clariscan, and by ultrasound using Definity and pulse inversion imaging. RESULTS AND CONCLUSIONS: Similar results were obtained from MRI and ultrasound. Estimation of the blood volume in tissue in the rim of a VX2 tumor 1.5 to 5.0 cm in diameter relative to that in the surrounding muscle was (mean+/-S.D.) 3.31+/-1.43 by MRI and 2.99+/-1.83 by ultrasound. The blood volume in the tissue relative to the total tissue volume (relative blood volume fraction) measured by MRI was 13+/-4.1% in tumor versus 4+/-1.4% in muscle (P<.01). Our data also suggested that, compared to the distribution volume of an extracellular contrast agent, Gd-DTPA, Clariscan as an intravascular agent demonstrated high-quality depictions of vascular structure of the tumor.

Pulsatile motion effects on 3D magnetic resonance angiography: implications for evaluating carotid artery stenoses.

In-plane carotid artery motion during a 3D MR angiography (MRA) scan can significantly degrade the resulting image resolution. This study characterizes the effect of cardiac pulsatility on 3D contrast-enhanced (CE) MRA with elliptical centric acquisitions using a point-spread function (PSF) analysis. Internal carotid artery (ICA) motion was collected from volunteers and patients using both MR and ultrasound (US) scans. After measuring the carotid artery motion displacement, a simulation was performed which calculated the blurring effects for three different protocols: nongated and two different cardiac gating schemes. The motion sensitivity of each protocol was evaluated for different spatial resolutions. The selection of optimal imaging parameters for a given scan time was investigated. The final results showed that cardiac-gated acquisitions only over a limited region of k-space high spatial frequencies are more time-efficient than cardiac gating for the entire k-space, as it allows for higher resolutions to be achieved and for capturing the arterial phase with low spatial frequencies. Selecting the optimal gating parameters depends directly on the motion characteristics of each individual. Our initial clinical experience is presented, and the need for a real-time tool that characterizes motion behavior for each individual as a prescan protocol is discussed.

Musculoskeletal MRI at 3.0 T: relaxation times and image contrast.

OBJECTIVE: The purpose of our study was to measure relaxation times in musculoskeletal tissues at 1.5 and 3.0 T to optimize musculoskeletal MRI methods at 3.0 T. MATERIALS AND METHODS: In the knees of five healthy volunteers, we measured the T1 and T2 relaxation times of cartilage, synovial fluid, muscle, marrow, and fat at 1.5 and 3.0 T. The T1 relaxation times were measured using a spiral Look-Locker sequence with eight samples along the T1 recovery curve. The T2 relaxation times were measured using a spiral T2 preparation sequence with six echoes. Accuracy and repeatability of the T1 and T2 measurement sequences were verified in phantoms. RESULTS: T1 relaxation times in cartilage, muscle, synovial fluid, marrow, and subcutaneous fat at 3.0 T were consistently higher than those measured at 1.5 T. Measured T2 relaxation times were reduced at 3.0 T compared with 1.5 T. Relaxation time measurements in vivo were verified using calculated and measured signal-to-noise results. Relaxation times were used to develop a high-resolution protocol for T2-weighted imaging of the knee at 3.0 T. CONCLUSION: MRI at 3.0 T can improve resolution and speed in musculoskeletal imaging; however, interactions between field strength and relaxation times need to be considered for optimal image contrast and signal-to-noise ratio. Scanning can be performed in shorter times at 3.0 T using single-average acquisitions. Efficient higher-resolution imaging at 3.0 T can be done by increasing the TR to account for increased T1 relaxation times and acquiring thinner slices than at 1.5 T.

Optimized spiral imaging for measurement of myocardial T2 relaxation.

Microcirculation oxygen levels and blood volumes should be reflected in measurements of myocardial T(2) relaxation. This work describes the optimization of a spiral imaging strategy for robust myocardial T(2) measurement to minimize the standard deviation of T(2) measurement (sigmaT(2)). Theoretical and experimental studies of blurring at muscle/blood interfaces enabled the derivation of parameter sets which reduce sigma T(2) to the level of 5%. T(2) relaxation mapping within healthy volunteers provided estimation of residual sigmaT(2) within the optimized technique. The standard deviation in T(2) measurement across regions of interest (ROIs) in different locations is about 9%. The standard deviation in T(2) measurement in an ROI across different time points is about 5%.