Sensorimotor training and neural reorganization after stroke: a case series.

BACKGROUND AND PURPOSE: Impaired hand function decreases quality of life after stroke. The purpose of this study was to pilot a novel 2-week upper extremity sensorimotor training program. This case series describes the training program and highlights outcome measures used for documenting behavioral change and neural reorganization. CASE DESCRIPTION: Behavioral/performance changes were identified via sensorimotor evaluation. Activity-induced neural reorganization was examined using sensory functional magnetic resonance imaging, diffusion tensor tractography, and brain volume measurement. Participant 1 was a 75-year-old right-handed man 1 year post-right hemisphere stroke, with severe sensory impairment across domains in his left hand; he reported limited left-hand/arm use. Participant 2 was a 63-year-old right-handed woman who had experienced a left hemisphere stroke 9 months earlier, resulting in mild sensory impairment across domains in her right hand, as well as mild motor deficit. INTERVENTION: Participants were trained 4 hours per day, 5 days per week for 2 weeks. Training tasks required sensory discrimination of temperature, weights, textures, shapes, and objects in the context of active exploration with the involved hand. Random multimodal feedback was used. OUTCOMES: Both participants had improved scores on the Wolf Motor Function Test after training. Participant 1 had no measurable change in sensory function, while participant 2 improved in touch perception, proprioception, and haptic performance. Sensory functional magnetic resonance imaging suggested neural reorganization in both participants; participant 1 had a small increase in brain volume, while superior thalamic radiation white matter connectivity was unchanged in either participant. DISCUSSION: Participating in sensorimotor training focused on sensory discrimination during manual manipulation was feasible for both participants. Future research to determine efficacy and identify optimal measures of sensory function and neural reorganization is recommended. VIDEO ABSTRACT AVAILABLE: (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A38) for more insights from the authors.

Retrobulbar vasculature using 7-T magnetic resonance imaging with dedicated eye surface coil.

PURPOSE: To determine the resolution and utility of using a dedicated, single-loop eye coil at 7 T to image the posterior ocular structures and vascular anatomy. METHODS: Imaging was performed on eight subjects (age range 26-54 years, four female, four male) with 7 T using a transmit head coil for excitation and a dedicated 5-cm eye surface receive coil. Acquisition parameters at 7 T for 3D spoiled gradient echo (3D-SPGR) sequences were optimized. RESULTS: It was possible to delineate the retina, sclera, and choroid, and fine details within the anterior and posterior segments of the eye. Retro-orbital and posterior ocular anatomy remained well visualized despite motion and susceptibility artifacts of anterior ocular structures. The ophthalmic arteries and their first-order branches were consistently visualized and improved with registration and summation of repeat scans. Furthermore, the central retinal vessels could be visualized. Intravenous gadolinium contrast reagent did not noticeably improve image quality. CONCLUSIONS: High-resolution 7-T MRI with a dedicated eye coil can provide unique high-resolution noninvasive images of retro-orbital and posterior ocular structural and vascular anatomy and is able to resolve structures as small as the central retina vein.

Functional connectivity during language processing in acute cocaine withdrawal: a pilot study.

Recent research revealed decreased access to semantic and associative networks in acute cocaine withdrawal. In autism, such behavioral outcomes are associated with decreased functional connectivity using functional magnetic resonance imaging. Therefore, we wished to determine whether connectivity is also decreased in acute cocaine withdrawal. Eight subjects in acute cocaine withdrawal were compared to controls for connectivity in language areas while performing a task involving categorization of words according to semantic and phonological relatedness. Acute withdrawal subjects had significantly less overall connectivity during semantic relatedness, and a trend towards less connectivity during phonological relatedness. Of potential future interest is whether this might serve as an imaging marker for treatment in patients.

Eccentric rehabilitation induces white matter plasticity and sensorimotor recovery in chronic spinal cord injury.

Experience-dependent white matter plasticity offers new potential for rehabilitation-induced recovery after neurotrauma. This first-in-human translational experiment combined myelin water imaging in humans and genetic fate-mapping of oligodendrocyte lineage cells in mice to investigate whether downhill locomotor rehabilitation that emphasizes eccentric muscle actions promotes white matter plasticity and recovery in chronic, incomplete spinal cord injury (SCI). In humans, of 20 individuals with SCI that enrolled, four passed the imaging screen and had myelin water imaging before and after a 12-week (3 times/week) downhill locomotor treadmill training program (SCI + DH). One individual was excluded for imaging artifacts. Uninjured control participants (n = 7) had two myelin water imaging sessions within the same day. Changes in myelin water fraction (MWF), a histopathologically-validated myelin biomarker, were analyzed in a priori motor learning and non-motor learning brain regions and the cervical spinal cord using statistical approaches appropriate for small sample sizes. PDGFRα-CreERT2:mT/mG mice, that express green fluorescent protein on oligodendrocyte precursor cells and subsequent newly-differentiated oligodendrocytes upon tamoxifen-induced recombination, were either naive (n = 6) or received a moderate (75 kilodyne), contusive SCI at T9 and were randomized to downhill training (n = 6) or unexercised groups (n = 6). We initiated recombination 29 days post-injury, seven days prior to downhill training. Mice underwent two weeks of daily downhill training on the same 10% decline grade used in humans. Between-group comparison of functional (motor and sensory) and histological (oligodendrogenesis, oligodendroglial/axon interaction, paranodal structure) outcomes occurred post-training. In humans with SCI, downhill training increased MWF in brain motor learning regions (postcentral, precuneus) and mixed motor and sensory tracts of the ventral cervical spinal cord compared to control participants (P < 0.05). In mice with thoracic SCI, downhill training induced oligodendrogenesis in cervical dorsal and lateral white matter, increased axon-oligodendroglial interactions, and normalized paranodal structure in dorsal column sensory tracts (P < 0.05). Downhill training improved sensorimotor recovery in mice by normalizing hip and knee motor control and reducing hyperalgesia, both of which were associated with new oligodendrocytes in the cervical dorsal columns (P < 0.05). Our findings indicate that eccentric-focused, downhill rehabilitation promotes white matter plasticity and improved function in chronic SCI, likely via oligodendrogenesis in nervous system regions activated by the training paradigm. Together, these data reveal an exciting role for eccentric training in white matter plasticity and sensorimotor recovery after SCI.

Postprocessing correction for distortions in T2* decay caused by quadratic cross-slice B0 inhomogeneity.

Relaxometric measurement of the effective transverse relaxation rate R2* plays an important role in the quantitative evaluation of brain function, perfusion, and tissue iron content. However, accurate measurement of R2* is prone to macroscopic background field inhomogeneity. In clinical applications and systems, postprocessing correction techniques are more flexible in implementation than unsupported protocol or hardware modifications. The current postprocessing correction approach assumes the cross-slice background field inhomogeneity can be approximated by a linear gradient and corrects for a sinc modulation function. The importance of the high-order terms in background field inhomogeneity has increased with the fast development of high- and ultrahigh-field scanners in recent years. In this study, we derived an analytical expression of the free induction decay signal modulation in the presence of a quadratic cross-slice background field inhomogeneity. The proposed quadratic correction method was applied to phantom and volunteer studies and demonstrated to be superior to the classic monoexponential model, monoexponential-plus-constant model, and the linear sinc correction method in recovering background field inhomogeneity-induced. R2* overestimations with visual inspection of R2* parametric maps and a statistical model selection technique. We also tabulated 7-T T2*/R2* measurements of several human brain structures and MnCl(2) solutions with various concentrations for fellow researchers' reference.

Hypertonic saline attenuates cord swelling and edema in experimental spinal cord injury: a study utilizing magnetic resonance imaging.

OBJECTIVE: To use magnetic resonance imaging (MRI) to characterize secondary injury immediately after spinal cord injury (SCI), and to show the effect of hypertonic saline on MRI indices of swelling, edema, and hemorrhage within the cord. DESIGN: A prospective, randomized, placebo-controlled study. SETTING: Research laboratory. SUBJECTS: Twelve adult Long-Evans female rats. INTERVENTIONS: Rats underwent a unilateral 12.5 mm SCI at vertebral level C5. Animals were administered 0.9% NaCl (n = 6) or 5% NaCl (n = 6) at 1.4 mL/kg intravenously every hour starting 30 minutes after SCI. Immediately after SCI, rats were placed in a 4.7T Bruker MRI system and images were obtained continuously for 8 hours using a home-built transmitter/receiver 3 cm Helmholtz coil. Rats were killed 8 hours after SCI. MEASUREMENTS AND MAIN RESULTS: Quantification of cord swelling and volumes of hypointense and hyperintense signal within the lesion were determined from MRI. At 36 minutes after SCI, significant swelling of the spinal cord at the lesion center and extending rostrally and caudally was demonstrated by MRI. Also, at this time point, a hypointense core was identified on T1, PD, and T2 weighted images. Over time this hypointense core reduced in size and in some animals was no longer visible by 8 hours after SCI, although histopathology demonstrated presence of red blood cells. A prominent ring of T2-weighted image hyperintensity, characteristic of edema, surrounded the hypointense core. At the lesion center, this rim of edema occupied the entire unilateral injured cord and in all animals extended to the contralateral side. Administration of HS resulted in increased serum [Na], attenuation of cord swelling, and decreased volume of hypointense core and edema at the last time points. CONCLUSIONS: We were able to use MRI to detect rapid and acute changes in the evolution of tissue pathophysiology, and show potentially beneficial effects of hypertonic saline in acute cervical SCI.

7 Tesla MR imaging of the human eye in vivo.

PURPOSE: To develop a protocol which optimizes contrast, resolution and scan time for three-dimensional (3D) imaging of the human eye in vivo using a 7 Tesla (T) scanner and custom radio frequency (RF) coil. MATERIALS AND METHODS: Initial testing was conducted to reduce motion and susceptibility artifacts. Three-dimensional FFE and IR-TFE images were obtained with variable flip angles and TI times. T(1) measurements were made and numerical simulations were performed to determine the ideal contrast of certain ocular structures. Studies were performed to optimize resolution and signal-to-noise ratio (SNR) with scan times from 20 s to 5 min. RESULTS: Motion and susceptibility artifacts were reduced through careful subject preparation. T(1) values of the ocular structures are in line with previous work at 1.5T. A voxel size of 0.15 x 0.25 x 1.0 mm(3) was obtained with a scan time of approximately 35 s for both 3D FFE and IR-TFE sequences. Multiple images were registered in 3D to produce final SNRs over 40. CONCLUSION: Optimization of pulse sequences and avoidance of susceptibility and motion artifacts led to high quality images with spatial resolution and SNR exceeding prior work. Ocular imaging at 7T with a dedicated coil improves the ability to make measurements of the fine structures of the eye.

MRI-based methodology to monitor the impact of positional changes on the airway caliber in obstructive sleep apnea patients.

PURPOSE: To develop a non-invasive MRI-based methodology to visually and quantitatively assess the impact of head and chest rotations on the airway caliber. METHODS: An MRI table set-up was developed for independent rotations of the head and chest along B0 field and tested for feasibility using phantom scans. The accuracy of the head and chest rotations was validated with ten volunteer scans. A 3T MRI protocol was optimized to image the regions of interest (ROIs) that were the retropalatal (RP) and retroglossal (RG) sections of the upper airway. A workflow for data analysis was developed to assess the changes of the airway caliber following the independent head and chest rotations. RESULTS: A prototype MRI table setup was established with two separate plates each supporting and rotating the head or chest independently. Subject positioning and image acquisition were finished within seven minutes for each position. Thus, each subject MRI was set up with seven positions and completed for less than one hour. The implemented angles were within 0.3-degree deviation from the targeted angles. The data analysis workflow provided 2D and 3D visualization and quantification with the measurements of cross-sectional area, lateral and anterior-posterior distances of the ROIs. Sharp contrast of the airway and its surrounding tissues facilitated an automatic approach to ROI placement to minimize subjectivity. CONCLUSIONS: The 3T MRI data acquisition and analysis methodology could reliably assess the impact of head and chest rotations on the upper airway caliber to identify the optimal position for obstructive sleep apnea patients.

Longitudinal comparison of two severities of unilateral cervical spinal cord injury using magnetic resonance imaging in rats.

Magnetic resonance imaging (MRI) should be a powerful tool for characterization of spinal cord pathology in animal models. We evaluated the utility of medium-field MRI for the longitudinal assessment of progression of spinal cord injury (SCI) in a rat model. Thirteen adult rats were subjected to a 6.25 or 25 g-cm unilateral cervical SCI, and underwent MRI and behavioral tests during a 3-week study period. MRI was also performed post-mortem. Quantification of cord swelling, hypointense and hyperintense signal, and lesion length were the most valuable parameters to determine and were highly correlated to behavioral and histopathological measures. Immediately after injury, MRI showed loss of gray matter-white matter differentiation, presence of scattered hyperintense signal and local hypointense signal, and cord swelling in both groups. At 7 days after injury, the spinal cord in the 25 g-cm group was significantly larger than that of the 6.25 g-cm group (p = 0.02). Contrast enhancement of the lesion was seen at 24 h in the 6.25 g-cm group, and at 24 h and 7 days in the 25 g-cm group. The volume of hypointense signal, representing hemorrhage, throughout the lesion region was significantly larger in the 25 g-cm compared to the 6.25 g-cm group at both 14 and 21 days after SCI (p,

Functional connectivity in an fMRI study of semantic and phonological processes and the effect of L-Dopa.

We describe an fMRI experiment examining the functional connectivity (FC) between regions of the brain associated with semantic and phonological processing. We wished to explore whether L-Dopa administration affects the interaction between language network components in semantic and phonological categorization tasks, as revealed by FC. We hypothesized that L-Dopa would decrease FC due to restriction of the semantic network. During two test sessions (placebo and L-Dopa) each participant performed two fMRI runs, involving phonological and semantic processing. A number of brain regions commonly activated by the two tasks were chosen as regions if interest: left inferior frontal, left posterior temporal and left fusiform gyri, and left parietal cortex. FC was calculated and further analyzed for effects of either the drug or task. No main effect for drug was found. A significant main effect for task was found, with a greater average correlation for the phonological task than for the semantic task. These findings suggest that language areas are activated in a more synchronous manner for phonological than for semantic tasks. This may relate to the fact that phonological processes are mediated to a greater extent within language areas, whereas semantic tasks likely require greater interaction outside of the language areas. Alternatively, this may be due to differences in the attentional requirements of the two tasks.

Clinical magnetic resonance imaging of brain tumors at ultrahigh field: a state-of-the-art review.

With the advancement of the magnetic resonance (MR) technology, the whole-body ultrahigh field MR system operated from 7 to 9.4 T becomes feasible for the routine patient imaging in clinical settings. The associated potentials and challenges from the perspectives of technology, physics, and biology as well as clinical application of the ultrahigh field MR systems are different from those systems operated at 3 T, 1.5 T, or lower field strength. In this article, we will present our initial experiences of brain tumor imaging using the 7 and 8 T whole-body MR systems at the Ohio State University Medical Center and provide a brief overview pertinent to the ultrahigh field clinical MR systems.

Effects of static and radiofrequency magnetic field inhomogeneity in ultra-high field magnetic resonance imaging.

To characterize the severe static (B(0)) and radiofrequency (B(1)) magnetic field inhomogeneity in ultra-high field (> or =7 T) magnetic resonance imaging, gradient echo (GE) and spin echo (SE) images of in vivo and postmortem human brains were acquired. The B(0) and B(1) inhomogeneity were experimentally mapped and/or numerically simulated, and correlated with the image artifacts. Whereas B(0) inhomogeneity affects predominantly GE images near air/tissue interfaces, B(1) inhomogeneity affects SE images more severely and shows non-intuitive patterns. Mapping of the B(0) and B(1) inhomogeneity is important in characterizing image artifacts. This will help develop better B(0) and B(1) inhomogeneity correction methods.

Growth of benign and malignant schwannoma xenografts in severe combined immunodeficiency mice.

OBJECTIVES: Models for the development of new treatment options in vestibular schwannoma (VS) treatment are lacking. The purpose of this study is to establish a quantifiable human VS xenograft model in mice. STUDY DESIGN AND METHODS: Both rat malignant schwannoma cells (KE-F11 and RT4) and human malignant schwannoma (HMS-97) cells were implanted near the sciatic nerve in the thigh of severe combined immunodeficiency (SCID) mice. Additionally, human benign VS specimens were implanted in another set of SCID mice. Three-dimensional tumor volumes were calculated from magnetic resonance images over the next 6 months. RESULTS: Mice implanted with malignant schwannoma cells developed visible tumors within 2 weeks. Imaging using a 4.7-tesla magnetic resonance imaging and immunohistopathologic examination identified solid tumors in all KE-F11 and HMS-97 xenografts, whereas RT4 xenografts consistently developed cystic schwannomas. VS xenografts demonstrated variability in their growth rates similar to human VS. The majority of VS xenografts did not grow but persisted throughout the study, whereas two of 15 xenografts grew significantly. Histopathologic examination and immunohistochemistry confirmed that VS xenografts retained their original microscopic and immunohistochemical characteristics after prolonged implantation. CONCLUSIONS: This study describes the first animal model for cystic schwannomas. Also, we demonstrate the use of high-field magnetic resonance imaging to quantify VS xenograft growth over time. The VS xenografts represent a model complimentary to Nf2 transgenic and knockout mice for translational VS research.

Experimental treatment of Epstein-Barr virus-associated primary central nervous system lymphoma.

Primary central nervous system lymphoma (PCNSL) that arises in immune-deficient patients is an aggressive B-cell neoplasm that is universally associated with the EBV. Patients with EBV(+) PCNSL face a particularly poor prognosis with median survival times of 2-12 months despite aggressive management with radiation therapy. We have developed a preclinical model of EBV(+) PCNSL to explore strategies that specifically target EBV-infected B lymphoblasts in vivo. Stereotactic implantation of EBV-transformed human lymphoblastoid B-cell lines into the caudate nucleus of the nude rat resulted in lethal CNS tumor burden manifested by the onset of focal neurological symptoms within 21 days. Histological evaluation at autopsy revealed a multifocal, perivascular human EBV(+) lymphoblastic B-cell infiltrate that displayed a latency type III EBV gene expression profile similar to PCNSL that develops in some immune-deficient patients. Radiation (1600 cGy) of lymphoblastoid B-cell lines resulted in up-regulation of the EBV thymidine kinase (EBV-TK) transcript and sensitization of these cells to drug-induced apoptosis using nucleoside analogs. Enhanced expression of EBV-TK mRNA in EBV(+) PCNSL tumors by radiation therapy occurred in a dose-dependent fashion. In vivo trials using the nude rat PCNSL model demonstrated significantly improved mean survival time (MST) with single fraction whole-brain radiotherapy (WBRT) and antiviral therapy consisting of zidovudine (AZT) and ganciclovir (GCV; MST 41.3 +/- 3.3 days; P = 0.05), compared with either antiviral therapy (MST 32.1 +/- 1.1 days) or WBRT alone (MST 22 +/- 0.8 days). We found constitutive and abundant EBV-TK mRNA expression in a stereotactic core biopsy specimen from a solid organ transplant patient with EBV(+) PCNSL. Withdrawal of immunosuppression did not result in disease regression. This patient achieved a complete response after therapy with high-dose AZT and GCV in the absence of WBRT, and remains in remission on oral maintenance AZT/GCV therapy 3 years after diagnosis. These results suggest that antiviral therapies can be effectively explored in vivo using a preclinical animal model of human EBV(+) PCNSL with subsequent translation to patients with EBV(+) PCNSL.

Frontoparietal white matter integrity predicts haptic performance in chronic stroke.

Frontoparietal white matter supports information transfer between brain areas involved in complex haptic tasks such as somatosensory discrimination. The purpose of this study was to gain an understanding of the relationship between microstructural integrity of frontoparietal network white matter and haptic performance in persons with chronic stroke and to compare frontoparietal network integrity in participants with stroke and age matched control participants. Nineteen individuals with stroke and 16 controls participated. Haptic performance was quantified using the Hand Active Sensation Test (HASTe), an 18-item match-to-sample test of weight and texture discrimination. Three tesla MRI was used to obtain diffusion-weighted and high-resolution anatomical images of the whole brain. Probabilistic tractography was used to define 10 frontoparietal tracts total; Four intrahemispheric tracts measured bilaterally 1) thalamus to primary somatosensory cortex (T-S1), 2) thalamus to primary motor cortex (T-M1), 3) primary to secondary somatosensory cortex (S1 to SII) and 4) primary somatosensory cortex to middle frontal gyrus (S1 to MFG) and, 2 interhemispheric tracts; S1-S1 and precuneus interhemispheric. A control tract outside the network, the cuneus interhemispheric tract, was also examined. The diffusion metrics fractional anisotropy (FA), mean diffusivity (MD), axial (AD) and radial diffusivity (RD) were quantified for each tract. Diminished FA and elevated MD values are associated with poorer white matter integrity in chronic stroke. Nine of 10 tracts quantified in the frontoparietal network had diminished structural integrity poststroke compared to the controls. The precuneus interhemispheric tract was not significantly different between groups. Principle component analysis across all frontoparietal white matter tract MD values indicated a single factor explained 47% and 57% of the variance in tract mean diffusivity in stroke and control groups respectively. Age strongly correlated with the shared variance across tracts in the control, but not in the poststroke participants. A moderate to good relationship was found between ipsilesional T-M1 MD and affected hand HASTe score (r = - 0.62, p = 0.006) and less affected hand HASTe score (r = - 0.53, p = 0.022). Regression analysis revealed approximately 90% of the variance in affected hand HASTe score was predicted by the white matter integrity in the frontoparietal network (as indexed by MD) in poststroke participants while 87% of the variance in HASTe score was predicted in control participants. This study demonstrates the importance of frontoparietal white matter in mediating haptic performance and specifically identifies that T-M1 and precuneus interhemispheric tracts may be appropriate targets for piloting rehabilitation interventions, such as noninvasive brain stimulation, when the goal is to improve poststroke haptic performance.

Use of ultra-high-resolution data for temporal bone dissection simulation.

OBJECTIVES: For the past 5 years, our group has been developing a virtual temporal bone dissection environment for training otologic surgeons. Throughout the course of our development, a recurring challenge is the acquisition of high-resolution, multimodal, and multi-scale data sets that are used for the visual as well as haptic (sense of touch) display. This study presents several new techniques in temporal bone imaging and their use as data for surgical simulation. METHODS: At our institution (OSU), we are fortunate to have a high-field (8 Tesla) magnetic resonance imaging (MRI) research magnet that provides an order of magnitude higher resolution compared to clinical 1.5T MRI scanners. Magnetic resonance imaging has traditionally been superb at delineating soft tissue structure, and certainly, the 8T unit does indeed do this at a resolution of 100-200 microm(3). To delineate the bony structure of the mastoid and middle ear, computed tomography (CT) has traditionally been used because of the high signal-to-noise ratio delineating bone signal from air and soft tissue. We have partnered with researchers at other institutions (CCF) to make use of a "microCT" that provides a resolution of 214 x 214 x 390 micrometers of bony structure. RESULTS: This report provides a description of the 2 methodologies and presentation of the striking image data capable of being generated. See images presented. CONCLUSIONS: Using these 2 new and innovative imaging modalities, we provide an order of magnitude greater resolution to the visual and haptic display in our temporal bone dissection simulation environment.

MR imaging visualization of the cerebral microvasculature: a comparison of live and postmortem studies at 8 T.

SUMMARY: In this study, we compared 8-T gradient-echo MR images of the microvasculature in the live human brain with images of the unembalmed and embalmed postmortem brain. Small vessels were well visualized in the live brain and even better seen in the unembalmed postmortem brain, but they could not be visualized in the embalmed postmortem brain. These findings are important for direct comparisons of the microvasculature on 8-T MR images and on histologic sections.

Susceptibility-based imaging of glioblastoma microvascularity at 8 T: correlation of MR imaging and postmortem pathology.

BACKGROUND AND PURPOSE: Imaging methods are currently being optimized in an attempt to assess and monitor angiogenesis in vivo. The purpose of this investigation was to determine whether areas of apparently increased tumor vascularity, as identified on 8-T gradient-echo (GE) imaging of a known glioblastoma multiforme (GBM), corresponds to foci of increased microvascularity on histopathologic analysis. METHODS: We performed postmortem in situ, high-resolution GE 8-T MR imaging of the brain in a 53-year-old woman with GBM. Ten histopathologic specimens in the region of the tumor bed were studied by using hematoxylin-eosin and reticulin stains. MR and histopathologic results were assessed and compared for microvascular size and density. RESULTS: 8-T GE images showed small, penetrating vessels in the gray matter and white matter. The images, however, were partly inhomogeneous as a result of local magnetic field inhomogeneities adjacent to the skull base and aerated paranasal sinus structures. 8-T MR images demonstrated serpiginous areas of signal intensity loss, which were thought to represent areas of increased microvascularity. Areas of lower microvascularity in the tumor bed corresponded to areas of lower vascularity on histopathologic sections with smaller vessel diameters. There was concurrence between vascular size predicted by histopathologic analysis and 8-T MR imaging in nine of nine biopsy samples. Vascular density agreed in seven of nine biopsy samples. CONCLUSION: Our pilot data suggest that microvascularity in GBM can be identified by use of high-resolution, GE, 8-T MR imaging.

Visualization of microvascularity in glioblastoma multiforme with 8-T high-spatial-resolution MR imaging.

We used 8-T high-spatial-resolution gradient-echo MR imaging to directly visualize microvascularity in pathologically proved glioblastoma multiforme. Images were compared with 1.5-T high-spatial-resolution fast spin-echo T2-weighted images and digital subtraction angiograms. Preliminary data indicate that 8-T high-spatial-resolution MR imaging may enable the identification of areas of abnormal microvascularity in glioblastoma multiforme that are not visible with other routine clinical techniques.

Three-dimensional numerical simulations of susceptibility-induced magnetic field inhomogeneities in the human head.

Three-dimensional numerical simulations of the static magnetic field in the human head were carried out to assess the field inhomogeneity due to magnetic susceptibility differences at tissue interfaces. We used a finite difference method and magnetic permeability distributions obtained by segmentation of computed tomography images. Computations were carried out for four models, consisting of the head and the neck; the head, neck, and shoulders; the head, neck, and thorax; and the head tilted backwards, including the neck and the shoulders. Considerable magnetic field inhomogeneities were observed in the inferior frontal lobes and inferior temporal lobes, particularly near the sphenoid sinus and the temporal bones. Air/tissue interfaces at the shoulders were found to induce substantial magnetic field inhomogeneities in the occipital lobes and the cerebellum, whereas air/tissue interfaces in the lungs appeared to have less influence on the magnetic field in the brain. Tilting the head backwards could significantly reduce the field inhomogeneities superior to the planum sphenoidale as well as in the occipital lobes and the cerebellum.