Update on myelin imaging in neurological syndromes.

PURPOSE OF REVIEW: Myelin water imaging (MWI) is generally regarded as the most rigorous approach for noninvasive, in-vivo measurement of myelin content, which has been histopathologically validated. As such, it has been increasingly applied to neurological diseases with white matter involvement, especially those affecting myelin. This review provides an overview of the most recent research applying MWI in neurological syndromes. RECENT FINDINGS: Myelin water imaging has been applied in neurological syndromes including multiple sclerosis, Alzheimer's disease, Huntington's disease, traumatic brain injury, Parkinson's disease, cerebral small vessel disease, leukodystrophies and HIV. These syndromes generally showed alterations observable with MWI, with decreased myelin content tending to correlate with lower cognitive scores and worse clinical presentation. MWI has also been correlated with genetic variation in the APOE and PLP1 genes, demonstrating genetic factors related to myelin health. SUMMARY: MWI can detect and quantify changes not observable with conventional imaging, thereby providing insight into the pathophysiology and disease mechanisms of a diverse range of neurological syndromes.

In vivo multiecho T2 relaxation measurements using variable TR to decrease scan time.

Multiecho T2 relaxation measurements to determine geometric mean T2 (GMT2) and myelin water fraction (MWF) are lengthy, resulting in increased motion artefacts from patient discomfort and reduced patient compliance. The goal of this study was to shorten the acquisition time for multiecho T2 measurements without affecting T1 weighting by varying TR across k-space. Six phantoms and 10 healthy volunteers were imaged with both a constant TR and a variable TR multiecho T2 sequence. T1 weighting was determined by TR at the center of k-space; for variable TR measurement, TR was shortened linearly from the center to the edges of k-space. Phantoms showed excellent agreement for proton density and GMT2 between constant and variable TR measurements. No significant differences were found in proton density or MWF for any of the brain structures between the two measurements. The average GMT2 over all structures between the two experiments was not significantly different. In summary, with the variable TR approach, scan time was reduced by >20%, with minimal loss of image resolution and no significant affect on proton density, MWF or GMT2.