Mapping of brain metabolite distributions by volumetric proton MR spectroscopic imaging (MRSI).

Distributions of proton MR-detected metabolites have been mapped throughout the brain in a group of normal subjects using a volumetric MR spectroscopic imaging (MRSI) acquisition with an interleaved water reference. Data were processed with intensity and spatial normalization to enable voxel-based analysis methods to be applied across a group of subjects. Results demonstrate significant regional, tissue, and gender-dependent variations of brain metabolite concentrations, and variations of these distributions with normal aging. The greatest alteration of metabolites with age was observed for white-matter choline and creatine. An example of the utility of the normative metabolic reference information is then demonstrated for analysis of data acquired from a subject who suffered a traumatic brain injury. This study demonstrates the ability to obtain proton spectra from a wide region of the brain and to apply fully automated processing methods. The resultant data provide a normative reference for subsequent utilization for studies of brain injury and disease.

Comprehensive processing, display and analysis for in vivo MR spectroscopic imaging.

Image reconstruction for magnetic resonance spectroscopic imaging (MRSI) requires specialized spatial and spectral data processing methods and benefits from the use of several sources of prior information that are not commonly available, including MRI-derived tissue segmentation, morphological analysis and spectral characteristics of the observed metabolites. In addition, incorporating information obtained from MRI data can enhance the display of low-resolution metabolite images and multiparametric and regional statistical analysis methods can improve detection of altered metabolite distributions. As a result, full MRSI processing and analysis can involve multiple processing steps and several different data types. In this paper, a processing environment is described that integrates and automates these data processing and analysis functions for imaging of proton metabolite distributions in the normal human brain. The capabilities include normalization of metabolite signal intensities and transformation into a common spatial reference frame, thereby allowing the formation of a database of MR-measured human metabolite values as a function of acquisition, spatial and subject parameters. This development is carried out under the MIDAS project (Metabolite Imaging and Data Analysis System), which provides an integrated set of MRI and MRSI processing functions. It is anticipated that further development and distribution of these capabilities will facilitate more widespread use of MRSI for diagnostic imaging, encourage the development of standardized MRSI acquisition, processing and analysis methods and enable improved mapping of metabolite distributions in the human brain.

MR angiography of the foot and ankle.

To better understand the use of magnetic resonance angiography (MRA) in evaluating peripheral vascular disease, the authors studied arteries in the foot and ankle. Twenty patients with arterial occlusive disease of the lower extremity were studied with two-dimensional time-of-flight MRA, and the results were compared with those of 10 conventional x-ray arteriograms, four digital subtraction arteriograms, and three intraoperative arteriograms. The studies were reviewed and rated by three radiologists blinded to the patients' clinical history. Also, the first 16 patients were examined with MRA before and after intravenous injection of gadopentetate dimeglumine. The mean confidence levels for the reviewers' interpretations of the MRA studies were significantly higher than those for the conventional arteriograms for the medial plantar, lateral plantar, and plantar arch arteries of the feet (P < or = .005). Postcontrast MRA images were inferior to precontrast images because of overlapping of veins and arteries. Time-of-flight MRA without gadolinium can serve as a useful complementary study for evaluating patients with peripheral vascular disease in the foot and ankle.

The usefulness of a contrast agent and gradient-recalled acquisition in a steady-state imaging sequence for magnetic resonance imaging-guided noninvasive ultrasound surgery.

RATIONALE AND OBJECTIVES: The ability of magnetic resonance imaging to detect small temperature elevations from focused ultrasound surgery beams was studied. In addition, the value of a contrast agent in delineating the necrosed tissue volume was investigated. MATERIALS AND METHODS: Gradient-recalled acquisition in a steady state (GRASS) T1-weighted images were used to follow the temperature elevation and tissue changes during 2-minute sonications in the thigh muscles of 10 rabbits. The effects of the treatment on the vascular network was investigated by injecting a contrast agent bolus before or after the sonication. RESULTS: The signal intensity decreased during the sonication, and the reduction was directly proportional to the applied power and increase in temperature. The signal intensity returned gradually back to baseline after the ultrasound was turned off. Injection of the contrast agent increased the signal intensity in muscle, but not in the necrosed tissue. The dimensions of the delineated tissue volume were the same as measured from the T2-weighted fast-spin-echo images and postmortem tissue examination. CONCLUSIONS: These results indicate that magnetic resonance imaging can be used to detect temperature elevations that do not cause tissue damage and that contrast agent can be used to delineate the necrosed tissue volume.

Metallic postoperative artifacts on cervical MR.

Spectroscopy of cervical diskectomy specimens obtained from sheep demonstrated that metallic susceptibility artifacts are produced by microscopic amounts of nickel, copper, and zinc. Sufficient quantities of metals to produce artifacts are deposited only by contact of metal drill bits and suction tips. If these instruments do not come in contact during surgery, susceptibility artifacts are not observed.

On-line monitoring of ultrasonic surgery with MR imaging.

Ultrasonic surgery was performed in rabbits and dogs under the guidance of magnetic resonance (MR) imaging. Two different MR techniques were used to guide the ultrasound beam. T2-weighted images showed lesion formation within a few minutes after sonication. T1-weighted GRASS (gradient-recalled acquisition in the steady state) images were sensitive to temperature elevations, permitting monitoring of lesion creation with MR imaging. Short TR T1-weighted GRASS images were not as helpful in detecting temperature elevation because of a reduction in signal-to-noise ratio. T2-weighted fast spin-echo images were compared with conventional T2-weighted spin-echo images. The former produced high-quality images in a fraction of the imaging time. This study shows that it is possible to monitor and guide ultrasonic surgery with MR imaging.

Tissue thermometry during ultrasound exposure.

In order to quantify ultrasound therapy it is important to measure the tissue temperature during the treatment. Invasive probes induce several artifacts in ultrasound fields. The magnitude of these artifacts is probe dependent. Several different probes were evaluated for hyperthermia purposes in this study. An alternative noninvasive method to evaluate the temperature elevations and tissue damage is to use magnetic resonance imaging. The fast imaging sequences used in this study are marginally useful for monitoring hyperthermia. However, these imaging sequences can be utilized to guide and monitor ultrasound surgery.

MRI-guided noninvasive ultrasound surgery.

In this study, the feasibility of using magnetic resonance imaging (MRI) to detect tissue necrosis induced by focussed ultrasound beams was investigated. It was shown that lesions produced in dog's thigh muscle in vivo were clearly visible in T2-weighted images and that the lesion dimensions measured from the images correlated with the postmortem measurements of the visible tissue damage. It was also shown that the sonications can be done in the magnet and that the lesions are visible immediately after the sonications with increasing image contrast as a function of time. These results showed that MRI can be used to direct and monitor on-line noninvasive ultrasound surgery. This may have a major impact in future patient treatments.

MR lymphography with iron oxide compound AMI-227: studies in ferrets with filariasis.

OBJECTIVE: The purpose of this study was to assess the MR lymphographic potential of AMI-227 to reduce the signal intensity of hyperplastic inflammatory lymph nodes by using ferrets with filariasis as the animal model. Both interstitial and IV modes of administration were studied. MATERIALS AND METHODS: Twelve ferrets were infected with the filaria Brugia malayi and six control ferrets were injected with super-paramagnetic iron oxide AMI-227, either interstitially or IV. Signal intensities of the left popliteal lymph node, left hamstring muscle, and left inguinal fat were measured before, 48 hr after, and up to 138 days after contrast injection with the use of both spin-echo and gradient-echo techniques. The signal intensity data were statistically analyzed. The lymph nodes, liver, spleen, and lungs were studied with light and electron microscopy. RESULTS: Forty-eight hours after the interstitial injection of AMI-227, the signal intensities of the ipsilateral popliteal nodes of the infected and control ferrets were significantly reduced (p less than .0005) without significant changes in the signal intensities of the surrounding tissues on both spin-echo and gradient-echo MR images. No nodal signal reduction occurred with the IV route of injection in ferrets. Light microscopy revealed iron to be localized within nodal marginal zones exclusively. Lymphatic trunks were visualized after interstitial injection. Signal reduction persisted to our end point at 138 days. CONCLUSION: AMI-227 shows regional specificity with significant enhancement of nodal structures and demonstrates potential as an interstitial MR lymphographic agent.