Assessing white matter microstructure of the newborn with multi-shell diffusion MRI and biophysical compartment models.

Brain white matter connections have become a focus of major interest with important maturational processes occurring in newborns. To study the complex microstructural developmental changes in-vivo, it is imperative that non-invasive neuroimaging approaches are developed for this age-group. Multi-b-value diffusion weighted imaging data were acquired in 13 newborns, and the biophysical compartment diffusion models CHARMED-light and NODDI, providing new microstructural parameters such as intra-neurite volume fraction (νin) and neurite orientation dispersion index (ODI), were developed for newborn data. Comparative analysis was performed and twenty ROIs in the white matter were investigated. Diffusion tensor imaging and both biophysical compartment models highlighted the compact and oriented structure of the corpus-callosum with the highest FA and νin values and the smallest ODI values. We could clearly differentiate, using the FA, νin and ODI, the posterior and anterior internal capsule representing similar cellular structure but with different maturation (i.e. partially myelinated and absence of myelin, respectively). Late maturing regions (external capsule and periventricular crossroads of pathways) had lower νin values, but displayed significant differences in ODI. The compartmented models CHARMED-light and NODDI bring new indices corroborating the cellular architectures, with the lowest νin, reflecting the late maturation of areas with thin non-myelinated fibers, and with highest ODI indicating the presence of fiber crossings and fanning. The application of biophysical compartment diffusion models adds new insights to the brain white matter development in vivo.

Improving T2 -weighted imaging at high field through the use of kT -points.

PURPOSE: At high magnetic field strengths (B(0) ≥ 3 T), the shorter radiofrequency wavelength produces an inhomogeneous distribution of the transmit magnetic field. This can lead to variable contrast across the brain which is particularly pronounced in T(2) -weighted imaging that requires multiple radiofrequency pulses. To obtain T(2) -weighted images with uniform contrast throughout the whole brain at 7 T, short (2-3 ms) 3D tailored radiofrequency pulses (kT -points) were integrated into a 3D variable flip angle turbo spin echo sequence. METHODS: The excitation and refocusing "hard" pulses of a variable flip angle turbo spin echo sequence were replaced with kT -point pulses. Spatially resolved extended phase graph simulations and in vivo acquisitions at 7 T, utilizing both single channel and parallel-transmit systems, were used to test different kT -point configurations. RESULTS: Simulations indicated that an extended optimized k-space trajectory ensured a more homogeneous signal throughout images. In vivo experiments showed that high quality T(2) -weighted brain images with uniform signal and contrast were obtained at 7 T by using the proposed methodology. CONCLUSION: This work demonstrates that T(2) -weighted images devoid of artifacts resulting from B(1)(+) inhomogeneity can be obtained at high field through the optimization of extended kT -point pulses.

Dielectric pads and low- B1+ adiabatic pulses: complementary techniques to optimize structural T1 w whole-brain MP2RAGE scans at 7 tesla.

PURPOSE: To evaluate the combination of low-B1 (+) adiabatic pulses and high permittivity (εr ≈ 165) dielectric pads effectiveness to reproducibly improve the inversion efficiency for whole-brain MP2RAGE scans, at ultra-high field. MATERIALS AND METHODS: Two low-B1 (+) adiabatic pulses, HS8 and TR-FOCI, were compared with the conventional HS1 adiabatic pulse in MP2RAGE acquisitions of four subjects at 7 Tesla. The uniform MP2RAGE images were qualitatively assessed for poor inversion artifacts by trained observers. Each subject was rescanned using dielectric pads. Eight further subjects underwent two MP2RAGE scan sessions using dielectric pads and the TR-FOCI adiabatic pulse. RESULTS: The HS8 and TR-FOCI pulses improved inversion coverage in all subjects compared with the HS1 pulse. However, in subjects whose head lengths are large (≥136 mm) relative to the coil's z-coverage, the B1 (+) field over the cerebellum was insufficient to cause inversion. Dielectric pads increase the B1 (+) field, by ∼50%, over the cerebellum, which in conjunction with the TR-FOCI pulse, reproducibly improves the inversion efficiency over the whole brain for subjects with head lengths ≤155 mm. Minor residual inversion artifacts were present in three of eight subjects (head lengths ≥155 mm). CONCLUSION: The complementary techniques of low-B1 (+) adiabatic RF pulses and high permittivity dielectric pads allow whole-brain structural T1 w images to be reliably acquired at ultra-high field. J. Magn. Reson. Imaging 2014;40:804-812. © 2013 Wiley Periodicals, Inc.

Phase contrast ultrashort TE: A more reliable technique for measurement of high-velocity turbulent stenotic jets.

Accurate measurement of peak velocity is critical to the assessment of patients with stenotic valvular disease. Conventional phase contrast (PC) methods for imaging high-velocity jets in aortic stenosis are susceptible to intravoxel dephasing signal loss, which can result in unreliable measurements. The most effective method for reducing intravoxel dephasing is to shorten the echo time (TE); however, the amount that TE can be shortened in conventional sequences is limited. A new sequence incorporating velocity-dependent slice excitation and ultrashort TE (UTE) centric radial readout trajectories is proposed that reduces TE from 2.85 to 0.65 ms. In a high-velocity stenotic jet phantom, a conventional sequence had >5% flow error at a flow rate of only 400 mL/s (velocity >358 cm/s), whereas the PC-UTE showed excellent agreement (<5% error) at much higher flow rates (1080 mL/s, 965 cm/s). In vivo feasibility studies demonstrated that by measuring velocity over a shorter time the PC-UTE approach is more robust to intravoxel dephasing signal loss. It also has less inherent higher-order motion encoding. This sequence therefore demonstrates potential as a more robust method for measuring peak velocity and flow in high-velocity turbulent stenotic jets.

Aortic valve stenotic area calculation from phase contrast cardiovascular magnetic resonance: the importance of short echo time.

BACKGROUND: Cardiovascular magnetic resonance (CMR) can potentially quantify aortic valve area (AVA) in aortic stenosis (AS) using a single-slice phase contrast (PC) acquisition at valve level: AVA = aortic flow/aortic velocity-time integral (VTI). However, CMR has been shown to underestimate aortic flow in turbulent high velocity jets, due to intra-voxel dephasing. This study investigated the effect of decreasing intra-voxel dephasing by reducing the echo time (TE) on AVA estimates in patients with AS. METHOD: 15 patients with moderate or severe AS, were studied with three different TEs (2.8 ms/2.0 ms/1.5 ms), in the main pulmonary artery (MPA), left ventricular outflow tract (LVOT) and 0 cm/1 cm/2.5 cm above the aortic valve (AoV). PC estimates of stroke volume (SV) were compared with CMR left ventricular SV measurements and PC peak velocity, VTI and AVA were compared with Doppler echocardiography. CMR estimates of AVA obtained by direct planimetry from cine acquisitions were also compared with the echoAVA. RESULTS: With a TE of 2.8 ms, the mean PC SV was similar to the ventricular SV at the MPA, LVOT and AoV0 cm (by Bland-Altman analysis bias +/- 1.96 SD, 1.3 +/- 20.2 mL/-6.8 +/- 21.9 mL/6.5 +/- 50.7 mL respectively), but was significantly lower at AoV1 and AoV2.5 (-29.3 +/- 31.2 mL/-21.1 +/- 35.7 mL). PC peak velocity and VTI underestimated Doppler echo estimates by approximately 10% with only moderate agreement. Shortening the TE from 2.8 to 1.5 msec improved the agreement between ventricular SV and PC SV at AoV0 cm (6.5 +/- 50.7 mL vs 1.5 +/- 37.9 mL respectively) but did not satisfactorily improve the PC SV estimate at AoV1 cm and AoV2.5 cm. Agreement of CMR AVA with echoAVA was improved at TE 1.5 ms (0.00 +/- 0.39 cm2) versus TE 2.8 (0.11 +/- 0.81 cm2). The CMR method which agreed best with echoAVA was direct planimetry (-0.03 cm2 +/- 0.24 cm2). CONCLUSION: Agreement of CMR AVA at the aortic valve level with echo AVA improves with a reduced TE of 1.5 ms. However, flow measurements in the aorta (AoV 1 and 2.5) are underestimated and 95% limits of agreement remain large. Further improvements or novel, more robust techniques are needed in the CMR PC technique in the assessment of AS severity in patients with moderate to severe aortic stenosis.

Robust T1-weighted structural brain imaging and morphometry at 7T using MP2RAGE.

PURPOSE: To suppress the noise, by sacrificing some of the signal homogeneity for numerical stability, in uniform T1 weighted (T1w) images obtained with the magnetization prepared 2 rapid gradient echoes sequence (MP2RAGE) and to compare the clinical utility of these robust T1w images against the uniform T1w images. MATERIALS AND METHODS: 8 healthy subjects (29.0 ± 4.1 years; 6 Male), who provided written consent, underwent two scan sessions within a 24 hour period on a 7T head-only scanner. The uniform and robust T1w image volumes were calculated inline on the scanner. Two experienced radiologists qualitatively rated the images for: general image quality; 7T specific artefacts; and, local structure definition. Voxel-based and volume-based morphometry packages were used to compare the segmentation quality between the uniform and robust images. Statistical differences were evaluated by using a positive sided Wilcoxon rank test. RESULTS: The robust image suppresses background noise inside and outside the skull. The inhomogeneity introduced was ranked as mild. The robust image was significantly ranked higher than the uniform image for both observers (observer 1/2, p-value = 0.0006/0.0004). In particular, an improved delineation of the pituitary gland, cerebellar lobes was observed in the robust versus uniform T1w image. The reproducibility of the segmentation results between repeat scans improved (p-value = 0.0004) from an average volumetric difference across structures of ≈ 6.6% to ≈ 2.4% for the uniform image and robust T1w image respectively. CONCLUSIONS: The robust T1w image enables MP2RAGE to produce, clinically familiar T1w images, in addition to T1 maps, which can be readily used in uniform morphometry packages.

MRI phase contrast velocity and flow errors in turbulent stenotic jets.

PURPOSE: To clarify the use of MRI phase contrast (PC), as an alternative to Doppler echocardiography, when measuring high-velocity turbulent jets associated with stenotic valvular disease. MATERIALS AND METHODS: In vivo PC aortic stroke volume (SV) was compared with ventricular SV in 31 patients with moderate to severe aortic stenosis (AS). Two in vitro pipe experiments were conducted to evaluate errors in steady stenotic and nonstenotic turbulent flows. RESULTS: The average in vivo error in SV was -24% in the left-ventricular (LV) outflow tract (LVOT) and -41% in the aortic root. Errors were most prominent in patients with the highest Doppler peak velocities. In vitro nonstenotic flow experiments showed accurate flow measurement with an average error of 1.8%. Significant errors were found in the in vitro stenotic flow, which reduced with shorter echo times (TE): average error -166/-67/-25/-13/-8.8% for TEs of 4.8/4.0/3.3/2.2/2.0 msec. In both the in vivo and in vitro stenotic experiments the errors were associated with signal loss in the flow-compensated magnitude image. CONCLUSION: Signal loss is associated with flow errors in stenotic jets. Current clinically available PC pulse sequences with TE >2 msec may not accurately quantify flow for severe lesions.