Simultaneous time-of-flight MR angiography and quantitative susceptibility mapping with key time-of-flight features.

A technique for combined time-of-flight (TOF) MR angiography (MRA) and quantitative susceptibility mapping (QSM) was developed with key features of standard three-dimensional (3D) TOF acquisitions, including multiple overlapping thin slab acquisition (MOTSA), ramped RF excitation, and venous saturation. The developed triple-echo 3D TOF-QSM sequence enabled TOF-MRA, susceptibility-weighted imaging (SWI), QSM, and R2* mapping. The effects of ramped RF, resolution, flip angle, venous saturation, and MOTSA were studied on QSM. Six volunteers were scanned at 3 T with the developed sequence, conventional TOF-MRA, and conventional SWI. Quantitative comparison of susceptibility values on QSM and normalized arterial and venous vessel-to-background contrasts on TOF and SWI were performed. The ramped RF excitation created an inherent phase variation in the raw phase. A generic correction factor was computed to remove the phase variation to obtain QSM without artifacts from the TOF-QSM sequence. No statistically significant difference was observed between the developed and standard QSM sequence for susceptibility values. However, maintaining standard TOF features led to compromises in signal-to-noise ratio for QSM and SWI, arising from the use of MOTSA rather than one large 3D slab, higher TOF spatial resolution, increased TOF background suppression due to larger flip angles, and reduced venous signal from venous saturation. In terms of vessel contrast, veins showed higher normalized contrast on SWI derived from TOF-QSM than the standard SWI sequence. While fast flowing arteries had reduced contrast compared with standard TOF-MRA, no statistical difference was observed for slow flowing arteries. Arterial contrast differences largely arise from the longer TR used in TOF-QSM over standard TOF-MRA to accommodate additional later echoes for SWI. In conclusion, although the sequence has a longer TR and slightly lower arterial contrast, provided an adequate correction is made for ramped RF excitation effects on phase, QSM may be performed from a multiecho sequence that includes all key TOF features, thus enabling simultaneous TOF-MRA, SWI, QSM, and R2* map computation.

Quantifying cerebral microbleeds using quantitative susceptibility mapping from magnetization-prepared rapid gradient-echo.

T1-weighted magnetization-prepared rapid gradient-echo (MPRAGE) is commonly included in brain studies for structural imaging using magnitude images; however, its phase images can provide an opportunity to assess microbleed burden using quantitative susceptibility mapping (QSM). This potential application for MPRAGE-based QSM was evaluated using in vivo and simulated measurements. Possible factors affecting image quality were also explored. Detection sensitivity was evaluated against standard multiecho gradient echo (MEGE) QSM using 3-T in vivo data of 15 subjects with a combined total of 108 confirmed microbleeds. The two methods were compared based on the microbleed size and susceptibility measurements. In addition, simulations explored the detection sensitivity of MPRAGE-QSM at different representative magnetic field strengths and echo times using microbleeds of different size, susceptibility, and location. Results showed that in vivo microbleeds appeared to be smaller (× 0.54) and of higher mean susceptibility (× 1.9) on MPRAGE-QSM than on MEGE-QSM, but total susceptibility estimates were in closer agreement (slope: 0.97, r2: 0.94), and detection sensitivity was comparable. In simulations, QSM at 1.5 T had a low contrast-to-noise ratio that obscured the detection of many microbleeds. Signal-to-noise ratio (SNR) levels at 3 T and above resulted in better contrast and increased detection. The detection rates for microbleeds of minimum one-voxel diameter and 0.4-ppm susceptibility were 0.55, 0.80, and 0.88 at SNR levels of 1.5, 3, and 7 T, respectively. Size and total susceptibility estimates were more consistent than mean susceptibility estimates, which showed size-dependent underestimation. MPRAGE-QSM provides an opportunity to detect and quantify the size and susceptibility of microbleeds of at least one-voxel diameter at B0 of 3 T or higher with no additional time cost, when standard T2*-weighted images are not available or have inadequate spatial resolution. The total susceptibility measure is more robust against sequence variations and might allow combining data from different protocols.

MR Susceptibility Separation for Quantifying Lesion Paramagnetic and Diamagnetic Evolution in Relapsing-Remitting Multiple Sclerosis.

BACKGROUND: Multiple sclerosis (MS) lesion evolution may involve changes in diamagnetic myelin and paramagnetic iron. Conventional quantitative susceptibility mapping (QSM) can provide net susceptibility distribution, but not the discrete paramagnetic and diamagnetic components. PURPOSE: To apply susceptibility separation (χ separation) to follow lesion evolution in MS with comparison to R2*/R2 '/QSM. STUDY TYPE: Longitudinal, prospective. SUBJECTS: Twenty relapsing-remitting MS subjects (mean age: 42.5 ± 9.4 years, 13 females; mean years of symptoms: 4.3 ± 1.4 years). FIELD STRENGTH/SEQUENCE: Three-dimensional multiple echo gradient echo (QSM and R2* mapping), two-dimensional dual echo fast spin echo (R2 mapping), T2-weighted fluid attenuated inversion recovery, and T1-weighted magnetization prepared gradient echo sequences at 3 T. ASSESSMENT: Data were analyzed from two scans separated by a mean interval of 14.4 ± 2.0 months. White matter lesions on fluid-attenuated inversion recovery were defined by an automatic pipeline, then manually refined (by ZZ/AHW, 3/25 years' experience in MRI), and verified by a radiologist (MN, 25 years' experience in MS). Susceptibility separation yielded the paramagnetic and diamagnetic susceptibility content of each voxel. Lesions were classified into four groups based on the variation of QSM/R2* or separated into positive/negative components from χ separation. STATISTICAL TESTS: Two-sample paired t tests for assessment of longitudinal differences. Spearman correlation coefficients to assess associations between χ separation and R2*/R2 '/QSM. Significant level: P < 0.005. RESULTS: A total of 183 lesions were quantified. Categorizing lesions into groups based on χ separation demonstrated significant annual changes in QSM//R2*/R2 '. When lesions were grouped based on changes in QSM and R2*, both changing in unison yielded a significant dominant paramagnetic variation and both opposing yielded a dominant diamagnetic variation. Significant Spearman correlation coefficients were found between susceptibility-sensitive MRI indices and χ separation. DATA CONCLUSION: Susceptibility separation changes in MS lesions may distinguish and quantify paramagnetic and diamagnetic evolution, potentially providing additional insight compared to R2* and QSM alone. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

Signal-to-noise ratio penalties from a loss of stimulated echoes when using slab-selective excitation in three-dimensional fast spin echo imaging with long echo trains.

Three-dimensional fast spin echo imaging with long echo trains combines high resolution with reasonable acquisition times and reduced specific absorption rate due to low refocusing flip angles. Typically, an entire volume is encoded (nonselective excitation) or localization can be performed with slab select excitation, which uses a long 90° pulse for precise localization, followed by a preliminary nonselective 180° pulse bounded by spoiler gradients to destroy signal outside of the volume of interest. Subsequent flip angles in the train are nonselective and identical between the two methods. The inclusion of the initial selective pulse and spoiler gradients results in a signal-to-noise ratio (SNR) penalty for slab selection, beyond the slice-averaging dependence, arising from a loss of stimulated echoes. SNR differences are explored using Bloch equation simulations of a T2-weighted 96 echo train sequence with varying parameters including T2, T1, and B1+ and compared with phantom and in vivo brain, neck, and knee experiments. In vivo SNR measurements in the three regions showed a maximum decrease of selective SNR by 29% (gastrocnemius muscle), 25% (pons), and 22% (globus pallidus), despite similar experimental parameters to nonselective experiments. Decreased SNR was compounded by B1+ variation affecting prescribed flip angles with further smaller reductions with T2 and T1 times. In conclusion, the elimination of coherences via the preliminary nominal 180° pulse and spoiler gradients in addition to the extended echo timing from the long excitation pulse resulted in a reduction in SNR compared with the nonselective case. Consideration of the required SNR and chosen anatomy as well as sequence restrictions should be weighed before choosing slab-selective excitation.

Inline dual-echo T2 quantification in brain using a fast mapping reconstruction technique.

T2 mapping from 2D proton density and T2-weighted images (PD-T2) using Bloch equation simulations can be time consuming and introduces a latency between image acquisition and T2 map production. A fast T2 mapping reconstruction method is investigated and compared with a previous modeling approach to reduce computation time and allow inline T2 maps on the MRI console. Brain PD-T2 images from five multiple sclerosis patients were used to compare T2 map reconstruction times between the new subtraction method and the Euclidean norm minimization technique. Bloch equation simulations were used to create the lookup table for decay curve matching in both cases. Agreement of the two techniques used Bland-Altman analysis for investigating individual subsets of data and all image points in the five volumes (meta-analysis). The subtraction method resulted in an average reduction of computation time for single slices from 134 s (minimization method) to 0.44 s. Comparing T2 values between the subtraction and minimization methods resulted in a confidence interval ranging from -0.06 to 0.06 ms (95% of values were within ± 0.06 ms between the techniques). Using identical reconstruction code based on the subtraction method, inline T2 maps were produced from PD-T2 images directly on the scanner console. The excellent agreement between the two methods permits the subtraction technique to be interchanged with the previous method, reducing computation time and allowing inline T2 map reconstruction based on Bloch simulations directly on the scanner.

Quantitative Susceptibility Mapping Changes Relate to Gait Issues in Parkinson's Disease.

BACKGROUND: Quantitative susceptibility mapping (QSM) demonstrates elevated iron content in Parkinson's disease (PD) patients within the basal ganglia, though it has infrequently been studied in relation to gait difficulties including freezing of gait (FOG). Our purpose was to relate QSM of basal ganglia and extra-basal ganglia structures with qualitative and quantitative gait measures in PD. METHODS: This case-control study included PD and cognitively unimpaired (CU) participants from the Comprehensive Assessment of Neurodegeneration and Dementia study. Whole brain QSM was acquired at 3T. Region of interests (ROIs) were drawn blinded manually in the caudate nucleus, putamen, globus pallidus, pulvinar nucleus of the thalamus, red nucleus, substantia nigra, and dentate nucleus. Susceptibilities of ROIs were compared between PD and CU. Items from the FOG questionnaire and quantitative gait measures from PD participants were compared to susceptibilities. RESULTS: Twenty-nine participants with PD and 27 CU participants were included. There was no difference in susceptibility values in any ROI when comparing CU versus PD (p > 0.05 for all). PD participants with gait impairment (n = 23) had significantly higher susceptibility in the putamen (p = 0.008), red nucleus (p = 0.01), and caudate nucleus (p = 0.03) compared to those without gait impairment (n = 6). PD participants with FOG (n = 12) had significantly higher susceptibility in the globus pallidus (p = 0.03) compared to those without FOG (n = 17). Among quantitative gait measures, only stride time variability was significantly different between those with and without FOG (p = 0.04). CONCLUSION: Susceptibilities in basal ganglia and extra-basal ganglia structures are related to qualitative measures of gait impairment and FOG in PD.

Myelin water fraction mapping from multiple echo spin echoes and an independent B1+ map.

PURPOSE: Myelin water fraction (MWF) is often obtained from a multiple echo spin echo (MESE) sequence using multi-component T2 fitting with non-negative least squares. This process fits many unknowns including B1+ to produce a T2 spectrum for each voxel. Presented is an alternative using a rapid B1+ mapping sequence to supply B1+ for the MWF fitting procedure. METHODS: Effects of B1+ errors on MWF calculations were modeled for 2D and 3D MESE using Bloch and extended phase graph simulations, respectively. Variations in SNR and relative refocusing widths were tested. Human brain experiments at 3 T used 2D MESE and an independent B1+ map. MWF maps were produced with the standard approach and with the use of the independent B1+ map. Differences in B1+ and mean MWF in specific brain regions were compared. RESULTS: For 2D MESE, MWF with the standard method was strongly affected by B1+ misestimations arising from limited SNR and response asymmetry around 180°, which decreased with increasing relative refocusing width. Using an independent B1+ map increased mean MWF and decreased coefficient of variation. Notable differences in vivo in 2D MESE were in areas of high B1+ such as thalamus and splenium where mean MWF increased by 88% and 31%, respectively (P < 0.001). Simulations also demonstrated the advantages of this approach for 3D MESE when SNR is <500. CONCLUSION: For 2D MESE, because of increased complexity of decay curves and limited SNR, supplying B1+ improves MWF results in peripheral and central brain regions where flip angles differ substantially from 180°.

T2 quantification in brain using 3D fast spin-echo imaging with long echo trains.

PURPOSE: Three-dimensional fast spin-echo (FSE) sequences commonly use very long echo trains (>64 echoes) and severely reduced refocusing angles. They are increasingly used in brain exams due to high, isotropic resolution and reasonable scan time when using long trains and short interecho spacing. In this study, T2 quantification in 3D FSE is investigated to achieve increased resolution when comparing with established 2D (proton-density dual-echo and multi-echo spin-echo) methods. METHODS: The FSE sequence design was explored to use long echo trains while minimizing T2 fitting error and maintaining typical proton density and T2 -weighted contrasts. Constant and variable flip angle trains were investigated using extended phase graph and Bloch equation simulations. Optimized parameters were analyzed in phantom experiments and validated in vivo in comparison to 2D methods for eight regions of interest in brain, including deep gray-matter structures and white-matter tracts. RESULTS: Phantom and healthy in vivo brain T2 measurements showed that optimized variable echo-train 3D FSE performs similarly to previous 2D methods, while achieving three-fold-higher slice resolution, evident visually in the 3D T2 maps. Optimization resulted in better T2 fitting and compared well with standard multi-echo spin echo (within the 8-ms confidence limits defined based on Bland-Altman analysis). CONCLUSION: T2 mapping using 3D FSE with long echo trains and variable refocusing angles provides T2 accuracy in agreement with 2D methods with additional high-resolution benefits, allowing isotropic views while avoiding incidental magnetization transfer effects. Consequently, optimized 3D sequences should be considered when choosing T2 mapping methods for high anatomic detail.

Characterization of B1+ field variation in brain at 3 T using 385 healthy individuals across the lifespan.

PURPOSE: The transmit field B1+ at 3 T in brain affects the spatial uniformity and contrast of most image acquisitions. Here, B1+ spatial variation in brain at 3 T is characterized in a large healthy population. METHODS: Bloch-Siegert B1+ maps were acquired at 3 T from 385 healthy subjects aged 5-90 years on a single MRI system. After transforming all B1+ maps to a standard brain atlas space, region-of-interest analysis was performed, and intersubject voxel-wise coefficient of variation was calculated across the whole brain. The B1+ variability due to age and brain size was studied separately in males and females, along with B1+ variability due to nonideal transmit calibration. RESULTS: The voxel-based mean coefficient of variation was 4.0% across all subjects, and the difference in B1+ between central (left thalamus) and outer regions (left frontal gray matter) was 24.2% ± 2.3%. The least intersubject variability occurred in central regions, whereas regions toward brain edges increased markedly in variation. The B1+ variability with age was mostly attributed to lifespan changes in CSF volume (which alters brain conductivity) and head orientation. Larger brain size correlated with more B1+ inhomogeneity (p < .001). Varying head position and anatomy resulted in an inaccurate transmit calibration. CONCLUSION: In standard atlas space, intersubject B1+ variability at 3 T was relatively small in a large population aged 5-90 years. The B1+ varied with age-related changes of CSF volume and head orientation, as well as differences in brain size and transmit calibration.

Multisite reproducibility of quantitative susceptibility mapping and effective transverse relaxation rate in deep gray matter at 3 T using locally optimized sequences in 24 traveling heads.

Iron concentration in the human brain plays a crucial role in several neurodegenerative diseases and can be monitored noninvasively using quantitative susceptibility mapping (QSM) and effective transverse relaxation rate (R2 *) mapping from multiecho T2 *-weighted images. Large population studies enable better understanding of pathologies and can benefit from pooling multisite data. However, reproducibility may be compromised between sites and studies using different hardware and sequence protocols. This work investigates QSM and R2 * reproducibility at 3 T using locally optimized sequences from three centers and two vendors, and investigates possible reduction of cross-site variability through postprocessing approaches. Twenty-four healthy subjects traveled between three sites and were scanned twice at each site. Scan-rescan measurements from seven deep gray matter regions were used for assessing within-site and cross-site reproducibility using intraclass correlation coefficient (ICC) and within-subject standard deviation (SDw) measures. In addition, multiple QSM and R2 * postprocessing options were investigated with the aim to minimize cross-site sequence-related variations, including: mask generation approach, echo-timing selection, harmonizing spatial resolution, field map estimation, susceptibility inversion method, and linear field correction for magnitude images. The same-subject cross-site region of interest measurements for QSM and R2 * were highly correlated (R2 ≥ 0.94) and reproducible (mean ICC of 0.89 and 0.82 for QSM and R2 *, respectively). The mean cross-site SDw was 4.16 parts per billion (ppb) for QSM and 1.27 s-1 for R2 *. For within-site measurements of QSM and R2 *, the mean ICC was 0.97 and 0.87 and mean SDw was 2.36 ppb and 0.97 s-1 , respectively. The precision level is regionally dependent and is reduced in the frontal lobe, near brain edges, and in white matter regions. Cross-site QSM variability (mean SDw) was reduced up to 46% through postprocessing approaches, such as masking out less reliable regions, matching available echo timings and spatial resolution, avoiding the use of the nonconsistent magnitude contrast between scans in field estimation, and minimizing streaking artifacts.

Bloch modelling enables robust T2 mapping using retrospective proton density and T2-weighted images from different vendors and sites.

T2 quantification is commonly attempted by applying an exponential fit to proton density (PD) and transverse relaxation (T2)-weighted fast spin echo (FSE) images. However, inter-site studies have noted systematic differences between vendors in T2 maps computed via standard exponential fitting due to imperfect slice refocusing, different refocusing angles and transmit field (B1+) inhomogeneity. We examine T2 mapping at 3T across 13 sites and two vendors in healthy volunteers from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database using both a standard exponential and a Bloch modelling approach. The standard exponential approach resulted in highly variable T2 values across different sites and vendors. The two-echo fitting method based on Bloch equation modelling of the pulse sequence with prior knowledge of the nominal refocusing angles, slice profiles, and estimated B1+ maps yielded similar T2 values across sites and vendors by accounting for the effects of indirect and stimulated echoes. By modelling the actual refocusing angles used, T2 quantification from PD and T2-weighted images can be applied in studies across multiple sites and vendors.

R2* and quantitative susceptibility mapping in deep gray matter of 498 healthy controls from 5 to 90 years.

Putative MRI markers of iron in deep gray matter have demonstrated age related changes during discrete periods of healthy childhood or adulthood, but few studies have included subjects across the lifespan. This study reports both transverse relaxation rate (R2*) and quantitative susceptibility mapping (QSM) of four primary deep gray matter regions (thalamus, putamen, caudate, and globus pallidus) in 498 healthy individuals aged 5-90 years. In the caudate, putamen, and globus pallidus, increases of QSM and R2* were steepest during childhood continuing gradually throughout adulthood, except caudate susceptibility which reached a plateau in the late 30s. The thalamus had a unique profile with steeper changes of R2* (reflecting additive effects of myelin and iron) than QSM during childhood, both reaching a plateau in the mid-30s to early 40s and decreasing thereafter. There were no hemispheric or sex differences for any region. Notably, both R2* and QSM values showed more inter-subject variability with increasing age from 5 to 90 years, potentially reflecting a common starting point in iron/myelination during childhood that diverges as a result of lifestyle and genetic factors that accumulate with age.

xQSM: quantitative susceptibility mapping with octave convolutional and noise-regularized neural networks.

Quantitative susceptibility mapping (QSM) provides a valuable MRI contrast mechanism that has demonstrated broad clinical applications. However, the image reconstruction of QSM is challenging due to its ill-posed dipole inversion process. In this study, a new deep learning method for QSM reconstruction, namely xQSM, was designed by introducing noise regularization and modified octave convolutional layers into a U-net backbone and trained with synthetic and in vivo datasets, respectively. The xQSM method was compared with two recent deep learning (QSMnet+ and DeepQSM) and two conventional dipole inversion (MEDI and iLSQR) methods, using both digital simulations and in vivo experiments. Reconstruction error metrics, including peak signal-to-noise ratio, structural similarity, normalized root mean squared error and deep gray matter susceptibility measurements, were evaluated for comparison of the different methods. The results showed that the proposed xQSM network trained with in vivo datasets achieved the best reconstructions of all the deep learning methods. In particular, it led to, on average, 32.3%, 25.4% and 11.7% improvement in the accuracy of globus pallidus susceptibility estimation for digital simulations and 39.3%, 21.8% and 6.3% improvements for in vivo acquisitions compared with DeepQSM, QSMnet+ and iLSQR, respectively. It also exhibited the highest linearity against different susceptibility intensity scales and demonstrated the most robust generalization capability to various spatial resolutions of all the deep learning methods. In addition, the xQSM method also substantially shortened the reconstruction time from minutes using MEDI to only a few seconds.

Amide signal intensities may be reduced in the motor cortex and the corticospinal tract of ALS patients.

OBJECTIVES: The aim of the study is to assess amide concentration changes in ALS patients compared with healthy controls by using quantitative amide proton transfer (APT) and multiparameter magnetic resonance imaging, and testing its correlation with clinical scores. METHODS: Sixteen ALS patients and sixteen healthy controls were recruited as part of the Canadian ALS Neuroimaging Consortium, and multimodal magnetic resonance imaging was performed at 3 T, including APT and diffusion imaging. Lorentz fitting was used to quantify the amide effect. Clinical disability was evaluated using the revised ALS functional rating scale (ALSFRS-R), and its correlation with image characteristics was assessed. The diagnostic performance of different imaging parameters was evaluated with receiver operating characteristic analysis. RESULTS: Our results showed that the amide peak was significantly different between the motor cortex and other gray matter territories within the brain of ALS patients (p < 0.001). Compared with controls, amide signal intensities in ALS were significantly reduced in the motor cortex (p < 0.001) and corticospinal tract (p = 0.046), while abnormalities were not detected using routine imaging methods. There was no significant correlation between amide and ALSFRS-R score. The diagnostic accuracy of the amide peak was superior to that of diffusion imaging. CONCLUSIONS: This study demonstrated changes of amide signal intensities in the motor cortex and corticospinal tract of ALS patients. KEY POINTS: • The neurodegenerative disease amyotrophic lateral sclerosis (ALS) has a lack of objective imaging indicators for diagnosis and assessment. • Analysis of amide proton transfer imaging revealed changes in the motor cortex and corticospinal tract of ALS patients that were not visible on standard magnetic resonance imaging. • The diagnostic accuracy of the amide peak was superior to that of diffusion imaging.

Curved multiplanar reformatting provides improved visualization of hippocampal anatomy.

There is a growing body of literature studying changes in hippocampal subfields in a variety of different neurological conditions, but this work has mainly focused on the hippocampal body given challenges in visualization of hippocampal anatomy in the head and tail when sectioned in the typical coronal image plane. Curved multiplanar reformatting (CMPR) is an image reconstruction method that can improve visualization of complex three-dimensional structures. The objective of this study was to determine whether CMPR could facilitate visualization of the human hippocampal anatomy along the entire caudal-rostral axis. CMPR was applied to high-resolution magnetic resonance imaging acquired ex vivo on four cadaveric hippocampal specimens at 4.7 T (T2-weighted, 0.2 × 0.2 × 0.5 mm3 ). CMPR provided clear visualization of the classic "interlocking C" appearance of the dentate gyrus and cornu ammonis along the entire caudal-rostral axis including the head and tail, which otherwise show complex anatomy on the standard coronal slices. CMPR facilitated visualization of hippocampal anatomy providing the impetus to develop simplified approaches to delineate subfields along the entire hippocampus including the usually neglected head and tail.

On the value of QSM from MPRAGE for segmenting and quantifying iron-rich deep gray matter.

PURPOSE: Quantitative susceptibility mapping (QSM) has been employed for both iron evaluation and segmentation of deep gray matter (DGM), but QSM sequences are not typically used in standard brain volumetric studies, which use T1-weighted magnetization-prepared rapid acquisition with gradient echo (MPRAGE) with short TE. Here, QSM produced directly from standard MPRAGE phase ( QSMMPRAGE ) is evaluated for segmentation and quantification of highly iron-rich DGM regions. METHODS: Simulations were used to explore quality and possible limitations. In addition, QSM from a standard multi-echo gradient-echo ( QSMGRE ) was compared to QSMMPRAGE in 40 healthy adults at 3T. DGM structures with weak contrast on MPRAGE magnitude were evaluated for improving segmentation with QSMMPRAGE , with focus on the iron-rich globus pallidus (GP). Furthermore, susceptibility quantification was assessed on six DGM nuclei and compared to standard QSMGRE . RESULTS: Limited by TE and signal-to-noise ratio, only iron-rich regions like GP and dentate nucleus produced adequate contrast on QSMMPRAGE , confining applications to such regions. QSMMPRAGE improved GP segmentation with mean Dice scores raised by 9.0%, and mean volumetric differences reduced by 9.7%. Simulations suggested that phase contrast-to-noise ratio (CNR) should be above 3.0 to attain segmentation improvement. For quantification purposes, higher CNR is required, and typical QSMMPRAGE provided comparable estimates to QSMGRE in large iron-rich DGM nuclei. CONCLUSION: Despite the short TE of standard MPRAGE, QSMMPRAGE can improve GP segmentation over the use of MPRAGE magnitude alone and roughly quantify high-iron regions in DGM. Thus, reconstructing QSMMPRAGE can be a useful addition to volumetric studies that rarely include standard QSMGRE .

Rapid quantitative susceptibility mapping of intracerebral hemorrhage.

BACKGROUND: Quantitative susceptibility mapping (QSM) offers a means to track iron evolution in hemorrhage. However, standard QSM sequences have long acquisition times and are prone to motion artifact in hemorrhagic patients. PURPOSE: To minimize motion artifact and acquisition time by performing rapid QSM in intracerebral hemorrhage (ICH) using single-shot echo planar imaging (EPI). STUDY TYPE: Prospective method evaluation. POPULATION/SUBJECTS: Forty-five hemorrhages were analyzed from 35 MRI exams obtained between February 2016 and March 2019 from 27 patients (14 male / 13 female, age: 71 ± 12 years) with confirmed primary ICH. FIELD STRENGTH/SEQUENCE: 3T; susceptibility-weighted imaging (SWI) with 4.54-minute acquisition and 2D single-shot gradient EPI with 0.45-minute acquisition. ASSESSMENT: Susceptibility maps were constructed from both methods. Measurement of ICH area and mean magnetic susceptibility were made manually by three independent observers. Motion artifacts were quantified using the magnitude signal ratio of artifact-to-brain tissue to classify into three categories: mild or no artifact, moderate artifact, or severe artifact. The cutoff for each category was determined by four observers. STATISTICAL TESTS: Pearson's correlation coefficient and paired t-test using α = 0.05 were used to compare results. Inter- and intraclass correlation was used to assess observer variability. RESULTS: Using 45 hemorrhages, the ICH regions measured on susceptibility maps obtained from EPI and SWI sequences had high correlation coefficients for area (R2 ≥ 0.97) and mean magnetic susceptibility (R2 ≥ 0.93) for all observers. The artifact-to-tissue ratio was significantly higher (P < 0.01) for SWI vs. EPI, and the standard deviation for the SWI method (SD = 0.05) was much larger than EPI (SD = 0.01). All observers' measurements showed high agreement. DATA CONCLUSION: Single-shot EPI-QSM enabled rapid measurement of ICH area and mean magnetic susceptibility, with reduced motion as compared with more standard SWI. EPI-QSM requires minimal additional acquisition time and could be incorporated into iron tracking studies in ICH. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2020;51:712-718.

T1 and T2 quantification from standard turbo spin echo images.

PURPOSE: To extract longitudinal and transverse (T1 and T2 ) relaxation maps from standard MRI methods. METHODS: Bloch simulations were used to model relative signal amplitudes from standard turbo spin-echo sequences: proton density weighted, T2 -weighted, and either T2 -weighted fluid attenuated inversion recovery or T1 -weighted images. Simulations over a range of expected parameter values yielded a look-up table of relative signal intensities of these sequences. Weighted images and flip angle maps were acquired in 8 subjects at 3 T using both single and multislice acquisitions. The T1 and T2 maps were fit by comparing the weighted images to the look-up table, given the measured flip angles. Results were compared with inversion recovery and multi-echo spin-echo experiments. RESULTS: A region analysis showed that relaxation maps computed from single-slice proton density, T2 and T1 weighting provided a mean T1 error of 4% in gray matter and 11% in white matter, and a mean T2 error of 3% and 4%, respectively, in comparison to reference measurements. In multislice acquisitions that are optimized to reduce cross-talk and incidental magnetization transfer, the mean T1 error was 7% in gray matter and 1% in white matter, and the mean T2 errors were 3% and 4%, respectively. The best T1 results were achieved using proton density, T2 and T1 weighting rather than the fluid attenuated inversion recovery, although T2 maps were largely unaffected by this choice. Incidental magnetization transfer reduced T1 accuracy in standard interleaved multislice acquisitions. CONCLUSION: Through exact sequence modeling and separate flip angle measurement, T2 and T1 may be quantified from a turbo spin-echo brain protocol with proton density, T2 , and T1 weighting.

Quantitative Susceptibility Mapping for Following Intracranial Hemorrhage.

Purpose To follow the evolution of intracranial hemorrhage (ICH) by using quantitative susceptibility mapping (QSM). Materials and Methods Thirty-six patients with ICH confirmed at CT were enrolled to follow ICH evolution on day 2, 7, and 30 after symptom onset between August 2013 and April 2017. QSM was reconstructed from MRI gradient-echo phase images acquired at 1.5 T or 3.0 T. ICH regions were manually drawn on two-dimensional sections of co-registered CT and MR images independently by two raters. The ICH areas and mean values were compared between CT and MRI by using Bland-Altman plots and Pearson correlation. QSM time evolution of ICH was assessed by using paired t tests and was compared with conventional T2-weighted fluid-attenuated inversion recovery, or T1-weighted or T2*-weighted magnitude intensities. Results Significant reductions in ICH susceptibility were found between day 2 and day 7 (P < .001) and between day 7 and day 30 (P = .003), corresponding to different disease stages. The ICH areas measured at CT and QSM were linearly correlated (r2 = 0.98). The mean CT attenuation and mean susceptibility of ICH were linearly correlated (r2 = 0.29). Excellent intra- and interobserver reproducibility were found for QSM (intraclass correlation coefficient, 0.987 and 0.966, respectively). Conclusion Longitudinal evolution of intracranial hemorrhage (ICH) by using quantitative susceptibility mapping (QSM) demonstrated susceptibility differences in different disease stages, which was not found at conventional MRI; therefore, QSM may assist in quantitatively following ICH iron content.

Limitations of skipping echoes for exponential T2 fitting.

BACKGROUND: Exponential fitting of multiecho spin echo sequences with skipped echoes is still commonly used for quantification of transverse relaxation (T2 ). PURPOSE: To examine the efficacy of skipped echo methods for T2 quantification against computational modeling of the exact signal decay. STUDY TYPE: Prospective comparison of methods. SUBJECTS/PHANTOM: Eight volunteers were imaged at 4.7T, six volunteers at 1.5T, and phantoms ([MnCl2 ] = 68-270 mM). FIELD STRENGTH/SEQUENCE: 1.5T and 4.7T; multiple-echo spin echo. ASSESSMENT: Exponential fitting for T2 using all echoes, skipping the first echo or skipping all odd echoes, compared with Bloch simulations. Resulting T2 values were examined over a range of T2 (10-150 msec), refocusing flip angles (90-270°), and echo train lengths (ETL = 6-32). STATISTICAL TESTS: Shapiro-Wilk tests and Q-Q plots were used to check for normality of data. Paired sample t-tests and Wilcoxon rank tests were used to compare fitting models using α = 0.05. Multiple comparisons were accounted for with Bonferroni correction. RESULTS: In examined regions of interest, typical incorrect estimation of T2 ranged from 23-39% for exponential fitting of all echoes, or 15-32% for skipped echo methods. In vivo, T2 estimation error was reduced to as little as 10% with skipped echo methods using 180° refocusing and ETL = 8, although error varied due to refocusing angle, T2 , and ETL. In vivo, skipped echo T2 values were significantly different than all echo exponential fitting (P < 0.004), but also were significantly different from reference values (P < 0.002, except frontal white matter). Simulations showed skipping the first echo was the most effective form of exponential fitting, in particular for T2 <50 msec and ETL = 8, with potential to reduce T2 errors to 10%, depending on refocusing angle and T2 . DATA CONCLUSION: Skipping echoes is insufficient for avoiding stimulated echo contamination. Resulting T2 errors depend on a complicated interplay of T2 , refocusing angle, and ETL. Modeling of the multiecho sequence is recommended. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1432-1440.