Multiple-slice spin lock imaging of head and neck tumors at 0.1 Tesla: exploring appropriate imaging parameters with reference to T2-weighted spin-echo technique.

RATIONALE AND OBJECTIVES: Spin lock imaging has been shown to be useful in characterizing head and neck tumors. The purposes of this study were to explore and develop multiple-slice spin lock gradient-echo (SL-GRE) sequences for head and neck imaging and to compare the tumor contrast on SL images to spin-echo (SE) T2-weighted images at 0.1 T. METHODS: On the basis of measured relaxation times of tumors and head and neck tissues, the authors evaluated with signal equations the effect of imaging parameters on tissue contrast produced by the SL-GRE sequence. In the clinical study, 34 patients with pathologically verified head and neck tumors were imaged with multiple-slice SL-GRE (repetition time 1500 ms/echo time 30 ms) out-of-phase fat/water sequences and compared with T2-weighted SE (repetition time 1500 ms/echo time 120 ms) sequences. The conspicuity of tumors was evaluated by calculating the contrast-to-noise ratios (CNRs). RESULTS: The combination of a short echo time of 30 ms and the length of locking pulses in the range of 10 to 35 ms produced optimal CNRs for head and neck tumor imaging. The measured CNRs and subjective evaluation for tumor detection were satisfactory with both imaging sequences. However, the CNRs between tumors and salivary gland tissues were significantly greater with the SL sequence than with the T2-weighted sequence. CONCLUSIONS: The multiple-slice SL-GRE technique provides image contrast comparable to that of SE T2-weighted imaging for head and neck tumors at 0.1 T. With short locking pulse lengths and echo times, wide anatomic coverage and reduced motion and susceptibility artifacts can be achieved. The out-of-phase SL technique is useful in imaging salivary gland tumors.

3D spin-lock imaging of human gliomas.

We investigated whether the simultaneous use of paramagnetic contrast medium and 3D on-resonance spin lock (SL) imaging could improve the contrast of enhancing brain tumors at 0.1 T. A phantom containing serial concentrations of gadopentetate dimeglumine (Gd-DTPA) in cross-linked bovine serum albumin (BSA) was imaged. Eleven patients with histologically verified glioma were also studied. T1-weighted 3D gradient echo images with and without SL pulse were acquired before and after a Gd-DTPA injection. SL effect, contrast, and contrast-to-noise ratio (CNR) were calculated for each patient. In the glioma patients, the SL effect was significantly smaller in the tumor than in the white and gray matter both before (p = 0.001, p = 0.025, respectively), and after contrast medium injection (p < 0.001, p < 0.001, respectively). On post-contrast images, SL imaging significantly improved tumor contrast (p = 0.001) whereas tumor CNR decreased slightly (p = 0.024). The combined use of SL imaging and paramagnetic Gd-DTPA contrast agent offers a modality for improving tumor contrast in magnetic resonance imaging (MRI) of enhancing brain tumors. 3D gradient echo SL imaging has also shown potential to increase tissue characterization properties of MR imaging of human gliomas.

Determination of T1rho values for head and neck tissues at 0.1 T: a comparison to T1 and T2 relaxation times.

In order to optimize head and neck magnetic resonance (MR) imaging with the spin-lock (SL) technique, the T1rho relaxation times for normal tissues were determined. Furthermore, T1rho was compared to T1 and T2 relaxation times. Ten healthy volunteers were studied with a 0.1 T clinical MR imager. T1rho values were determined by first measuring the tissue signal intensities with different locking pulse durations (TL), and then by fitting the signal intensity values to the equation with the least-squares method. The T1rho relaxation times were shortest for the muscle and tongue, intermediate for lymphatic and parotid gland tissue and longest for fat. T1rho demonstrated statistically significant differences (p < 0.05) between all tissues, except between muscle and tongue. T1rho values measured at locking field strength (B1L) of 35 microT were close to T2 values, the only exception being fat tissue, which showed T1rho values much longer than T2 values. Determination of tissue relaxation times may be utilized to optimize image contrast, and also to achieve better tissue discrimination potential, by choosing appropriate imaging parameters for the head and neck spin-lock sequences.

T1 rho dispersion imaging of head and neck tumors: a comparison to spin lock and magnetization transfer techniques.

The potential of T1 rho dispersion, spin lock (SL), and magnetization transfer (MT) techniques to differentiate benign and malignant head and neck tumors was evaluated. Twenty-four patients with pathologically verified head and neck tumors were studied with a .1-T MR imager. T1 rho dispersion effect was defined as 1 -(intensity with lower locking field amplitude/intensity with higher locking field amplitude). T1 rho dispersion effects were higher for malignant than benign tumors (P = .001). With T1 rho dispersion effect .14 as the threshold, sensitivity for detecting a malignant tumor was 91%, specificity was 77%, and accuracy was 83%. A strong correlation between T1 rho dispersion effects and SL effects and between T1 rho dispersion effects and MT effects in the head and neck tumors was found (r = .87, P < .001 and r = .90, P < .001, respectively). High T1 rho dispersion effects are not specific indicators of malignancy, because chronic infections, some benign tumors, and malignancies may overlap. Low T1 rho dispersion effect values are characteristic of a benign tumor.

Improvement of brain lesion detection at 0.1 T by simultaneous use of Gd-DTPA and magnetization transfer imaging.

Imaging parameters were optimized at 0.1 T to improve contrast-to-noise ratios (CNR) when combining magnetization transfer (MT) imaging and the use of paramagnetic contrast medium. This was accomplished by imaging a phantom containing serial concentrations of Gd-DTPA in cross-linked bovine serum albumin. With the use of simulations, the dependence of CNR on imaging parameters was studied. Conventional and MT images were obtained from 10 brain tumor patients with single and triple doses of Gd-DTPA. Simulations demonstrated the importance of TR in postcontrast sequences. The CNR in MT images is less sensitive to TR than in conventional images. A significant CNR improvement caused by MT remains at longer TR when there is no contrast enhancement without MT. The clinical results indicate that a single dose of Gd-DTPA combined with MT cannot replace imaging with a triple dose. However, MT significantly improved the CNR after single and triple Gd-DTPA-doses on T1-weighted and proton-density images.

Spin lock and magnetization transfer imaging of head and neck tumors.

PURPOSE: To evaluate and compare the spin lock and magnetization transfer techniques in the differentiation of benign and malignant head and neck tumors at magnetic resonance (MR) imaging. MATERIALS AND METHODS: Forty consecutive patients with histologically verified head and neck tumors (20 malignant and 20 benign tumors, including five infections) were studied with a 0.1-T MR unit. The spin lock and magnetization transfer effects were defined as 1-(signal intensity with stronger preparation pulse/signal intensity with weaker preparation pulse). RESULTS: A strong correlation between the spin lock and magnetization transfer effects was found (r = 85, P < .001). With a spin lock effect of 0.48 and a magnetization transfer effect of 0.32 as the thresholds, sensitivity for detecting a malignant tumor was 95% and 94%, respectively, and specificity was 60% and 65%. CONCLUSION: Low spin lock and magnetization transfer effects are characteristic of benign tumors. High spin lock and magnetization transfer effects were associated with malignancy, but there were overlapping values for salivary gland infections, some benign tumors, and malignancies. The spin lock technique seems to be an effective method for generating magnetization transfer-based contrast in the head and neck tumors.

Spin lock magnetic resonance imaging in the differentiation of hepatic haemangiomas and metastases.

Spin lock (SL) imaging technique, generating T1 rho-weighted images, was applied to the differentiation of hepatic haemangiomas from metastatic focal liver lesions. 17 haemangiomas and 16 metastases in 32 patients were imaged at the field-strength of 0.1 T using a multiple slice SL technique and a conventional gradient-echo (GRE) sequence with identical timing parametres. Spin lock effects of the hepatic lesions and different abdominal tissues were calculated. Images with adequate coverage of the liver and of good quality with few motion induced artefacts were acquired. A definite, statistically significant, difference was found between the SL-effects of hepatic haemangiomas and a liver metastases. Haemangiomas showed an SL effect of 46.6 +/- 3.4% and metastases of 56.2 +/- 5.8% (mean +/- SD, p < 0.0001). The multiple slice SL technique showed potential in distinguishing haemangiomas from metastatic liver lesions and should be considered as an alternative to the conventional T2 and magnetization transfer (MT) based methods.

T1 rho dispersion imaging of diseased muscle tissue.

T1 rho dispersion, or the frequency dependence of T1 relaxation in the rotating frame, was used for in vivo muscle tissue characterization in 13 patients with primary skeletal muscle disease and in eight normal subjects for comparison. T1 rho dispersion measurements represent a new approach to magnetic resonance tissue characterization, possibly reflecting the macromolecular constituents of tissue. A definite, statistically significant, difference was found between the relative T1 rho dispersion values of normal and diseased muscle tissue. T1 rho dispersion measurements and images may increase the accuracy of identification of diseased muscles. Early identification of affected muscles is important for accurate diagnosis by muscle biopsy.

Magnetization transfer imaging of the abdomen at 0.1 T: detection of hepatic neoplasms.

Magnetization transfer (MT) techniques have been proposed as a method of increasing contrast in MR images. To evaluate the feasibility of MT imaging of the abdomen at 0.1 T and to assess the clinical utility of this technique, the authors studied tissue contrast with a gradient-echo pulse sequence and an MT sequence in four normal volunteers, and in 17 patients with known primary or secondary neoplasms of the liver. The MT technique increased contrast between the liver and other tissues such as spleen, skeletal muscle and subcutaneous fat. The technique also produced increased contrast between hepatic tumors and normal liver parenchyma in gradient-echo images.

Synergistic enhancement of MRI with Gd-DTPA and magnetization transfer.

Magnetization transfer (MT) between protons of macromolecules and protons of water molecules is a recently introduced mechanism for tissue contrast in MR imaging. The MT effect is strong in tissues where there is an efficient cross relaxation between macromolecular protons and water protons and where this interaction is the dominant source of relaxation. Paramagnetic ions shorten relaxation times and decrease the MT effect. These two facts led to the assumption that, in the case of contrast enhanced MRI, the combination of the T1-weighted imaging method and the MT technique may yield increased contrast, compared with standard methods. The synergistic effect is demonstrated in this work with studies of egg white samples and by imaging three patients with different brain pathologies. The lesion-to-white matter contrasts, with standard T1-weighted sequences with and without the MT effect, were compared before and after the introduction of Gd-DTPA. In each case the synergistic effect of T1 weighting and MT improved the contrast enhancement provided with Gd-diethylenetriamine pentaacetic acid.

Magnetization transfer contrast imaging of the human leg at 0.1 T: a preliminary study.

Magnetization transfer contrast imaging is an MR technique that capitalizes on interactions between the protons of mobile and macromolecularly bound water molecules. Studies to date, conducted primarily on 4.7 T and 1.5 T MR systems, have yielded results unique from conventional T1- and T2-weighted imaging studies. In this study, performed on a 0.1 T device, a section of lower leg was imaged in 20 normal human subjects and one patient with muscular dystrophy, using both a standard 500/22 gradient-echo sequence and a 500/22 gradient-echo sequence combined with off-resonance radio frequency irradiation designed to elicit magnetization transfer contrast. Results of the two techniques were compared. Our findings suggest that magnetization transfer contrast imaging is feasible at 0.1 T, and that this technique allows reproducible tissue characterization and improves contrast between certain tissues.

Magnetic resonance of diseased skeletal muscle: combined T1 measurement and chemical shift imaging.

Magnetic resonance examinations of skeletal muscle with differential T1 relaxation time measurements were performed in 19 patients with muscular dystrophies and congenital myopathies, and in eight control subjects. A field echo chemical shift imaging technique was used. T1 values of muscular tissue were measured from the primary composite images, and differential T1 values were calculated separately from water and fat images. Longitudinal relaxation times of skeletal muscle were significantly increased in both dystrophies and myopathies. The results of differential relaxation time measurements suggest that intramuscular fat reduces the abnormal increase in T1 of diseased muscle tissue. When characterizing diseases of skeletal muscle by T1 relaxation time measurements, the contribution of secondary fatty infiltration must be considered.

A method for T1 rho imaging.

The spin lattice relaxation time (T1) is dependent on the strength of the polarizing magnetic field. The relaxation at low field strengths provides information from the processes at macromolecular level. However, the decrease of the polarizing magnetic field decreases the signal-to-noise ratio that determines the resolution of magnetic resonance images. In this report we describe a method for T1 rho imaging. The method possesses the relaxation time contrast of low field strengths with signal-to-noise ratio provided by the higher polarizing field. The relaxation time T1 rho is obtained under spin lock conditions. The spin system relaxes toward thermal equilibrium along the locking field. This process is analogous to the spin lattice relaxation at low field strength and characterized by the time constant T1 rho. T1 rho and T1 rho-dispersion may provide new imaging parameters for noninvasive tissue characterization.

Intracranial hematomas studied by MR imaging at 0.17 and 0.02 T.

The contrast in magnetic resonance (MR) images relies mainly on the relaxation time differences between the tissues. The relative differences in relaxation times T1 are bigger at lower field strengths, although the absolute values of T1 are smaller. A shorter T1 is also advantageous for the contrast of the T2 and proton density weighted images because of the more complete recovery of the spin system during the repetition time TR. Scrutiny of the clinical results of MR shows some unsolved problems in the specificity of diagnosing fresh intracranial hematomas. Low field MR imaging at 0.02 T seems to offer new vistas in this sense. Fresh subdural hematoma was more easily detected and differentiated at 0.02 T than at 0.17 T. The T2 of fresh intracranial hematomas was rather short compared with cerebrospinal fluid and edema and, unlike T1, was not highly dependent on magnetic field strength. The different visualization of acute versus late intracerebral hematoma and the changes during the resorption were demonstrated in follow-up studies of two patients at 0.17 T and of one at 0.02 T. In one patient the same lesion was imaged successively at both field strengths, showing the divergent contrast in the inversion recovery images at 0.02 and 0.17 T.

A method for chemical shift imaging: demonstration of bone marrow involvement with proton chemical shift imaging.

A new method for chemical shift imaging is described. In this method the spin-echo signals are collected with the field gradient switched on, which reduces the imaging time considerably. A human bone marrow pathology is demonstrated by proton chemical shift imaging.