Intervertebral disc height loss demonstrates the threshold of major pathological changes during degeneration.

PURPOSE: Quantitative MRI techniques were utilized to study intervertebral disc degeneration. Main focus was to develop a novel approach to quantify disc height loss associated with disc degeneration. Currently there is no universally accepted metric of degeneration based on measurement of disc height. Such quantitative imaging methods would complement qualitative visual assessment methods currently used and offer a valuable diagnostic tool. METHODS: 51 adult participants took part in this MRI study. T2 weighted images were used to obtain disc height index (DHI) and also a semi-quantitative metric based on relative voxel intensities. For DHI, each disc was given a score based on standard deviations from the mean DHI of healthy discs. Diffusion Weighted MRI was used to assess morphological changes in the nucleus pulposus. Conventional Pfirrmann classification was used as the gold standard to assess these quantitative approaches. RESULTS: At deviations of up to 1.5σ below normative disc height, levels of apparent diffusion coefficient (ADC) and normalized T2 intensity were maintained. Once disc compression reached 1.5σ, there was a massive drop in ADC and normalized T2 intensity. Pfirrmann degeneration scores also increased after the 1.5σ mark. CONCLUSIONS: This study provides new, unbiased quantitative imaging tools to assess disc degeneration. We observed that these quantitative MRI measures indicate a threshold beyond which major pathological changes take place concurrently. Combined information from DHI, ADC and T2 images construct a set of novel biomarkers that could be used to identify degenerating discs that are approaching the threshold and possibly intervene before major pathologic changes occur.

Association between intervertebral disc degeneration and endplate perfusion studied by DCE-MRI.

PURPOSE: The goal of this study was to study the association between solute transport mechanisms in cartilaginous disc endplates and the degeneration of intervertebral discs. Intervertebral disc degeneration is a multi-factorial process. It is suspected that poor nutrient delivery to discs might be a factor leading to degeneration. Several studies suggest that defects in disc endplates could lead to poor transport of nutrients. An imaging technique assessing endplate perfusion could be a valuable tool in investigating disc degeneration. There is currently no universally accepted technique assessing endplate perfusion in vivo. METHODS: Nine adult patients exhibiting varying levels of intervertebral disc degeneration were included. MRI was used to study the association between blood perfusion in 90 lumbar disc endplates and disc degeneration in 45 lumbar discs. Solute transport mechanism through endplates was assessed indirectly by dynamic contrast enhanced (DCE) MRI. T2-weighted MRI was used for conventional Pfirrmann classification. RESULTS: A positive association was observed between Pfirrmann grades and endplate DCE-MRI enhancement. A differential enhancement between cranial and caudal endplates was also observed, which increased with Pfirrmann grades. This differential enhancement was also dependent on the lumbar level. CONCLUSIONS: Increased MRI signal enhancement in the cartilaginous endplates of degenerated discs might indicate damage to the subchondral bone of the vertebral bodies. The endplate enhancement characteristic could aid in understanding the pathophysiology of disc degeneration and planning treatment more effectively.

Changes in perfusion and diffusion in the endplate regions of degenerating intervertebral discs: a DCE-MRI study.

PURPOSE: Dynamic contrast-enhanced MRI (DCE-MRI) was used to investigate the associations between intervertebral disc degeneration and changes in perfusion and diffusion in the disc endplates. METHODS: 56 participants underwent MRI scans. Changes in DCE-MRI signal enhancement in the endplate regions were analyzed. Also, a group template was generated for the endplates and enhancement maps were registered to this template for group analysis. RESULTS: DCE-MRI enhancement changed significantly in cranial endplates with increased degeneration. A similar trend was observed for caudal endplates, but it was not significant. Group-averaged enhancement maps revealed major changes in spatial distribution of endplate perfusion and diffusion with increasing disc degeneration especially in peripheral endplate regions. CONCLUSIONS: Increased enhancement in the endplate regions of degenerating discs might be an indication of ongoing damage in these tissues. Therefore, DCE-MRI could aid in understanding the pathophysiology of disc degeneration. Moreover, it could be used in the planning of novel treatments such as stem cell therapy.

Quantitative analysis of the efficacy of gradient table correction on improving the accuracy of fiber tractography.

PURPOSE: Several groups suggested that the gradient table of a DTI data set should be reoriented to compensate for head motion. Although the effects of this correction were demonstrated qualitatively, its efficacy was not demonstrated quantitatively to date. The main goal of this study was to investigate the efficacy of gradient table correction on improving the accuracy of fiber tractography. METHODS: First, the effects of gradient table correction on the estimation of fractional anisotropy (FA) maps and the primary diffusion direction were quantified and compared with the inherent uncertainty in the estimation process. Then, the effects of gradient table correction on tractography were quantified. RESULTS: The corrections in FA values were only a fraction of the typical values seen in major fasciculi and inter-subject variance. The corrections to the primary diffusion direction were also much smaller than the uncertainty inherent in the estimation of its direction. However, the directional estimates were biased due to head motion and deviated fiber tracking. CONCLUSIONS: Corrections to FA values were negligible and are not expected to affect group comparisons. However, a small but consistent bias was introduced to the estimates of primary diffusion direction, which might affect brain connectivity analyses based on fiber tracking.

Dynamic tracking of scaphoid, lunate, and capitate carpal bones using four-dimensional MRI.

A preliminary exploration of technical methodology for dynamic analysis of scaphoid, capitate, and lunate during unconstrained movements is performed in this study. A heavily accelerated and fat-saturated 3D Cartesian MRI acquisition was used to capture temporal frames of the unconstrained moving wrist of 5 healthy subjects. A slab-to-volume point-cloud based registration was then utilized to register the moving volumes to a high-resolution image volume collected at a neutral resting position. Comprehensive in-silico error analyses for different acquisition parameter settings were performed to evaluate the performance limits of several dynamic metrics derived from the registration parameters. Computational analysis suggested that sufficient volume coverage for the dynamic acquisitions was reached when collecting 12 slice-encodes at 2.5mm resolution, which yielded a temporal resolution of and 2.6 seconds per volumetric frame. These acquisition parameters resulted in total in-silico errors of 1.9°±1.8° and 3°±4.6° in derived principal rotation angles within ulnar-radial deviation and flexion-extension motion, respectively. Rotation components of the carpal bones in the radius coordinate system were calculated and found to be consistent with earlier 4D-CT studies. Temporal metric profiles derived from ulnar-radial deviation motion demonstrated better performance than those derived from flexion/extension movements. Future work will continue to explore the use of these methods in deriving more complex dynamic metrics and their application to subjects with symptomatic carpal dysfunction.

Optimization of hyperparameters for SMS reconstruction.

PURPOSE: Simultaneous multi-slice (SMS) imaging accelerates MRI data acquisition by exciting multiple image slices with a single radiofrequency pulse. Overlapping slices encoded in acquired signal are separated using a mathematical model, which requires estimation of image reconstruction kernels using calibration data. Several parameters used in SMS reconstruction impact the quality and fidelity of final images. Therefore, finding an optimal set of reconstruction parameters is critical to ensure that accelerated acquisition does not significantly degrade resulting image quality. METHODS: Gradient-echo echo planar imaging data were acquired with a range of SMS acceleration factors from a cohort of five volunteers with no known neurological pathology. Images were collected using two available phased-array head coils (a 48-channel array and a reduced diameter 32-channel array) that support SMS. Data from these coils were identically reconstructed offline using a range of coil compression factors and reconstruction kernel parameters. A hybrid space (k-x), externally-calibrated coil-by-coil slice unaliasing approach was used for image reconstruction. The image quality of the resulting reconstructed SMS images was assessed by evaluating correlations with identical echo-planar reference data acquired without SMS. A finger tapping functional MRI (fMRI) experiment was also performed and group analysis results were compared between data sets reconstructed with different coil compression levels. RESULTS: Between the two RF coils tested in this study, the 32-channel coil with smaller dimensions clearly outperformed the larger 48-channel coil in our experiments. Generally, a large calibration region (144-192 samples) and small kernel sizes (2-4 samples) in ky direction improved image quality. Use of regularization in the kernel fitting procedure had a notable impact on the fidelity of reconstructed images and a regularization value 0.0001 provided good image quality. With optimal selection of other hyperparameters in the hybrid space SMS unaliasing algorithm, coil compression caused small reduction in correlation between single-band and SMS unaliased images. Similarly, group analysis of fMRI results did not show a significant influence of coil compression on resulting image quality. CONCLUSIONS: This study demonstrated that the hyperparameters used in SMS reconstruction need to be fine-tuned once the experimental factors such as the RF receive coil and SMS factor have been determined. A cursory evaluation of SMS reconstruction hyperparameter values is therefore recommended before conducting a full-scale quantitative study using SMS technologies.

Highly accelerated projection imaging with coil sensitivity encoding for rapid MRI.

PURPOSE: Rapid magnetic resonance imaging (MRI) acquisition is typically achieved by acquiring all or most lines of k-space after one radio frequency (RF) excitation. Parallel imaging techniques can further accelerate data acquisition by acquiring fewer phase-encoded lines and utilizing the spatial sensitivity information of the RF coil arrays. The goal of this study was to develop a new MRI data acquisition and reconstruction technique that is capable of reconstructing a two-dimensional (2D) image using highly undersampled k-space data without any special hardware. Such a technique would be very efficient, as it would significantly reduce the time wasted during multiple RF excitations or phase encoding and gradient switching periods. METHODS: The essence of this new technique is to densely sample a small number of projections, which should be acquired at an angle other than 0° or multiples of 45°. This results in multiple rays passing through a voxel and provides new and independent measurements for each voxel. Then the images are reconstructed using the unique information coming from these projections combined with RF coil sensitivity profiles. The feasibility of this new technique was investigated with realistic simulations and experimental studies using a phantom and compared with conventional nonuniform fast Fourier transform technique. Eigenvalue analysis and error calculations were conducted to find optimal projection angles and minimum requirements for dense sampling. RESULTS: Reconstruction of 64 × 64 images was done using a single projection from simulated data under different noise levels. Simulated reconstruction was also tested with two projections to assess the improvement. Experimental phantom images were reconstructed at higher resolution using 4, 8, and 16 projections. Cross-sectional profiles illustrate that the new technique resolved compartment boundaries clearly. CONCLUSIONS: Simulations demonstrated that only a single k-space line might be sufficient to reconstruct a 2D image using this new technique. Experimental results showed that this is a promising new technique for fast imaging. Using the information from the simulations and fast imaging parameters published in the literature, it could be predicted that a two-dimensional image could be acquired in about 10 ms. One of the major advantages of this new technique is that it does not require any additional hardware and can be implemented on a conventional scanner with an eight-channel coil.