Segmentation of the human spinal cord

Segmenting the spinal cord contour is a necessary step for quantifying spinal cord atrophy in various diseases. Delineating gray matter (GM) and white matter (WM) is also useful for quantifying GM atrophy or for extracting multiparametric MRI metrics into specific WM tracts. Spinal cord segmentation in clinical research is not as developed as brain segmentation, however with the substantial improvement of MR sequences adapted to spinal cord MR investigations, the field of spinal cord MR segmentation has advanced greatly within the last decade. Segmentation techniques with variable accuracy and degree of complexity have been developed and reported in the literature. In this paper, we review some of the existing methods for cord and WM/GM segmentation, including intensity-based, surface-based, and image-based methods. We also provide recommendations for validating spinal cord segmentation techniques, as it is important to understand the intrinsic characteristics of the methods and to evaluate their performance and limitations. Lastly, we illustrate some applications in the healthy and pathological spinal cord. One conclusion of this review is that robust and automatic segmentation is clinically relevant, as it would allow for longitudinal and group studies free from user bias as well as reproducible multicentric studies in large populations, thereby helping to further our understanding of the spinal cord pathophysiology and to develop new criteria for early detection of subclinical evolution for prognosis prediction and for patient management. Another conclusion is that at the present time, no single method adequately segments the cord and its substructure in all the cases encountered (abnormal intensities, loss of contrast, deformation of the cord, etc.). A combination of different approaches is thus advised for future developments, along with the introduction of probabilistic shape models. Maturation of standardized frameworks, multiplatform availability, inclusion in large suite and data sharing would also ultimately benefit to the community.     

In situ and minimally invasive breast cancer: morphologic and kinetic features on contrast-enhanced MR imaging

Purpose: This retrospective study was undertaken to investigate the morphologic and dynamic features of in situ and minimally invasive breast cancer on contrast-enhanced (c.-e.) MR imaging and to examine possible associations to pathology features. Material and methods: A total of 71 patients underwent MR imaging. T1-weighted FLASH-3D images were obtained before and after intravenous administration of Gd-DTPA. Histopathologic analysis of 78 lesions revealed ductal carcinoma in situ (DCIS)n=50 and DCIS with microinvasionn=28. MR features were correlated with histopathologic findings. Results: Enhancement in DCIS was focal (73%), diffuse (10%) or ductal (17%). No enhancement occurred in two cases (4%). In 65% enhancement speed was classified as delayed. There was a tendency toward a more ill-defined (83 vs. 43%) enhancement pattern in high grade DCIS and a more ductal (29 vs. 12%) and faster (50 vs. 29%) enhancement in comedo type DCIS. However, significant differences in the enhancement behaviour could neither be demonstrated between high grade and non high grade DCIS nor between comedo and non comedo type DCIS. No significant differences were noted between pure and microinvasive DCIS. Conclusion: In this retrospective analysis the majority (96%) of DCIS lesions show contrast enhancement. However, in only about 50% of DCIS the criteria of a so-called ‘typical’ enhancement behaviour was fulfilled, that means strong, early, focal ill-circumscribed or ductal. Enhancement that follows a duct is often associated with malignancy, however this feature was only present in 17% of the cases. c.-e. MR imaging allowed the detection of 25 additional foci of DCIS. Therefore malignant in situ lesions can be present with atypical enhancement, and should be taken into consideration in high-risk patients in particular.     

Overestimation of grey matter atrophy in glioblastoma patients following radio(chemo)therapy

Objective

Brain atrophy has the potential to become a biomarker for severity of radiation-induced side-effects. Particularly brain tumour patients can show great MRI signal changes over time caused by e.g. oedema, tumour progress or necrosis. The goal of this study was to investigate if such changes affect the segmentation accuracy of normal appearing brain and thus influence longitudinal volumetric measurements.

Materials and methods

T1-weighted MR images of 52 glioblastoma patients with unilateral tumours acquired before and three months after the end of radio(chemo)therapy were analysed. GM and WM volumes in the contralateral hemisphere were compared between segmenting the whole brain (full) and the contralateral hemisphere only (cl) with SPM and FSL. Relative GM and WM volumes were compared using paired t tests and correlated with the corresponding mean dose in GM and WM, respectively.

Results

Mean GM atrophy was significantly higher for full segmentation compared to cl segmentation when using SPM (mean ± std: ΔV_GM,full = − 3.1% ± 3.7%, ΔV_GM,cl = − 1.6% ± 2.7%; p < 0.001, d = 0.62). GM atrophy was significantly correlated with the mean GM dose with the SPM cl segmentation (r = − 0.4, p = 0.004), FSL full segmentation (r = − 0.4, p = 0.004) and FSL cl segmentation (r = -0.35, p = 0.012) but not with the SPM full segmentation (r = − 0.23, p = 0.1).

Conclusions

For accurate normal tissue volume measurements in brain tumour patients using SPM, abnormal tissue needs to be masked prior to segmentation, however, this is not necessary when using FSL.

     

High-resolution MR imaging of the rat spinal cord in vivo in a wide-bore magnet at 17.6 Tesla

The objective was to demonstrate the feasibility and to evaluate the performance of high-resolution in vivo magnetic resonance (MR) imaging of the rat spinal cord in a 17.6-T vertical wide-bore magnet. A probehead consisting of a surface coil that offers enlarged sample volume suitable for rats up to a weight of 220 g was designed. ECG triggered and respiratory-gated gradient echo experiments were performed on a Bruker Avance 750 wide-bore spectrometer for high-resolution imaging. With T^*₂ values between 5 and 20 ms, good image contrast could be obtained using short echo times, which also minimizes motion artifacts. Anatomy of healthy spinal cords and pathomorphological changes in traumatically injured rat spinal cord in vivo could be visualized with microscopic detail. It was demonstrated that imaging of the rat spinal cord in vivo using a vertical wide-bore high-magnetic-field system is feasible. The potential to obtain high-resolution images in short scan times renders high-field imaging a powerful diagnostic tool.Volker C. Behr and Thomas Weber contributed equally to this work.     

In situ and minimally invasive breast cancer: morphologic and kinetic features on contrast-enhanced MR imaging

PURPOSE: This retrospective study was undertaken to investigate the morphologic and dynamic features of in situ and minimally invasive breast cancer on contrast-enhanced (c.-e.) MR imaging and to examine possible associations to pathology features. MATERIAL AND METHODS: A total of 71 patients underwent MR imaging. T1-weighted FLASH-3D images were obtained before and after intravenous administration of Gd-DTPA. Histopathologic analysis of 78 lesions revealed ductal carcinoma in situ (DCIS) n = 50 and DCIS with microinvasion n = 28. MR features were correlated with histopathologic findings. RESULTS: Enhancement in DCIS was focal (73%), diffuse (10%) or ductal (17%). No enhancement occurred in two cases (4%). In 65% enhancement speed was classified as delayed. There was a tendency toward a more ill-defined (83 vs. 43%) enhancement pattern in high grade DCIS and a more ductal (29 vs. 12%) and faster (50 vs. 29%) enhancement in comedo type DCIS. However, significant differences in the enhancement behaviour could neither be demonstrated between high grade and non high grade DCIS nor between comedo and non comedo type DCIS. No significant differences were noted between pure and microinvasive DCIS. CONCLUSION: In this retrospective analysis the majority (96%) of DCIS lesions show contrast enhancement. However, in only about 50% of DCIS the criteria of a so-called 'typical' enhancement behaviour was fulfilled, that means strong, early, focal ill-circumscribed or ductal. Enhancement that follows a duct is often associated with malignancy, however this feature was only present in 17% of the cases. c.-e. MR imaging allowed the detection of 25 additional foci of DCIS. Therefore malignant in situ lesions can be present with atypical enhancement, and should be taken into consideration in high-risk patients in particular.     

Estimation of metabolite <Emphasis Type="Italic">T</Emphasis><Subscript>1</Subscript> relaxation times using tissue specific analysis,signal averaging and bootstrapping from magnetic resonance spectroscopic imaging data

Object A novel method of estimating metabolite T ₁ relaxation times using MR spectroscopic imaging (MRSI) is proposed. As opposed to conventional single-voxel metabolite T ₁ estimation methods, this method investigates regional and gray matter (GM)/white matter (WM) differences in metabolite T ₁ by taking advantage of the spatial distribution information provided by MRSI. Material and methods The method, validated by Monte Carlo studies, involves a voxel averaging to preserve the GM/WM distribution, a non-linear least squares fit of the metabolite T ₁ and an estimation of its standard error by bootstrapping. It was applied in vivo to estimate the T ₁ of N-acetyl compounds (NAA), choline, creatine and myo-inositol in eight normal volunteers, at 1.5 T, using a short echo time 2D-MRSI slice located above the ventricles. Results WM-T _1,NAA was significantly (P < 0.05) longer in anterior regions compared to posterior regions of the brain. The anterior region showed a trend of a longer WM T ₁ compared to GM for NAA, creatine and myo-Inositol. Lastly, accounting for the bootstrapped standard error estimate in a group mean T ₁ calculation yielded a more accurate T ₁ estimation. Conclusion The method successfully measured in vivo metabolite T ₁ using MRSI and can now be applied to diseased brain.     

Accurate quantification methods to evaluate cervical cord atrophy in multiple sclerosis patients

Object: Automatic accurate measurement techniques are needed to increase reproducibility in the quantification of cervical cord area (CCA) with magnetic resonance (MR) imaging in the assessment of central nervous system (CNS) atrophy in multiple sclerosis (MS) patients. Materials and methods: Two segmentation methods were implemented: (1) spatial mean brightness level estimation (SMBLE), and (2) partial-volume modeling (PVM). These were evaluated with the inclusion of spinal cord inclination and/or partial-volume-effect corrections. An averaged manually segmented set was considered as reference. Thirty MR studies were used to compare the different methods. A set of 15 MS patients and 15 control subjects within a two-year longitudinal study were used to evaluate cord atrophy with the best method. Statistical evaluation was made by using an intraclass correlation coefficient and Bland–Altman comparisons. Results: Partial-volume modeling with spinal cord inclination correction and partial-volume spinal-cord contour contribution estimation was the most accurate method. The longitudinal test showed a 4% decrease in CCA in MS patients with no significant reduction in control subjects. Conclusion: The automatic PVM cord-segmentation approach, taking into consideration the spinal-cord inclination and partial-volume treatment, provides reproducibility and increased accuracy in the evaluation of cord atrophy, allowing the monitoring of changes in MS patients.     

A pilot study of myoelectrically controlled FES of upper extremity

Functional electrical stimulation (FES) of upper limbs can be used for the recovery of some hand functions on patients with CNS lesions. This study deals with the control of FES by means of myoelectrical activity detected from voluntarily activated paretic muscles. The specific aim of this paper is to evaluate the accuracy of myoelectrical control in terms of produced force and movement. For this purpose, a specific device called myoelectrical controlled functional electrical stimulator (MeCFES) has been developed and applied to six tetraplegic patients with a spinal cord lesion and one stroke hemiplegic patient. Residual myoelectric signals from the paretic wrist extensor (m. extensor carpi radialis, ECR) have been used to control stimulation of either the wrist extension (i.e., the same muscle) or thumb flexion. A tracking test based on a visual feedback of the produced force or movement compared to a reference target trajectory was used to quantify control accuracy. A comparison was made between the tracking performances of each subject with and without the MeCFES and the learning process for two of the subjects were observed during consecutive sessions. Results showed that the wrist extension was improved in three out of five C5 SCI patients and the thumb flexion was largely increased in one incomplete C3 SCI patient. The hemiplegic patient showed limited thumb control with the MeCFES but indicated the possibility of a carry over effect. It was found that a low residual natural force resulted in a less accurate movement but also with a large increase (up to ten times) of the muscle output. On the contrary, persons with a medium residual force obtained a smaller amplification of muscle force with a higher tracking accuracy     

Enhancement characteristics of hepatic focal nodular hyperplasia and its scar by dynamic magnetic resonance imaging

Rationale and objectives: To determine the relationship between the lesion and the scar enhancement characteristics in a series of hepatic Focal Nodular Hyperplasia (FNH) lesions studied with dynamic MR imaging.Methods: Nine patients with FNH were studied. The slice showing the largest scar was selected for the dynamic single slice T1-weighted Gradient-echo sequence before and after contrast administration (15 images, one every 20 s). Analysis was performed with ROI measurements in the lesion and the scar. Signal-intensity and enhancement curves were obtained from both structures.Results: Dynamic MRI showed the typical homogeneous early enhancement of the lesion with delayed enhancement of the scar. The scar enhanced early and vigorously in all cases. Two patterns of enhancement curves were defined. In the parallel pattern, both curves started early, quickly reaching a plateau maintained over time (77.8%). In the divergent pattern the curve of the scar was above the curve of the FNH (22.2%). after the maximum slope was reached, with progressive separation of the curves.Conclusion: There is a hypervascular scar enhancement within FNH lesions with either a parallel or divergent course after the maximum early enhancement.     

Topography of brain sodium accumulation in progressive multiple sclerosis

Object

Sodium accumulation is involved in neuronal injury occurring in multiple sclerosis (MS). We aimed to assess sodium accumulation in progressive MS, known to suffer from severe neuronal injury.

Materials and methods

3D-²³Na-MRI was obtained on a 3T-MR-scanner in 20 progressive MS patients [11 primary-progressive (PPMS) and nine secondary-progressive (SPMS)] and 15 controls. Total sodium concentrations (TSC) within grey matter (GM), normal-appearing white matter (WM) and lesions were extracted. Statistical mapping analyses of TSC abnormalities were also performed.

Results

Progressive MS patients presented higher GM–TSC values (48.8 ± 3.1 mmol/l wet tissue vol, p < 0.001) and T₂lesions-TSC values (50.9 ± 2.2 mmol/l wet tissue vol, p = 0.01) compared to GM and WM of controls. Statistical mapping analysis showed TSC increases in PPMS patients confined to motor and somatosensory cortices, prefrontal cortices, pons and cerebellum. In SPMS, TSC increases were associated with areas involving: primary motor, premotor and somatosensory cortices; prefrontal, cingulate and visual cortices; the corpus callosum, thalami, brainstem and cerebellum. Anterior prefrontal and premotor cortices TSC were correlated with disability.

Conclusion

Sodium accumulation is present in progressive MS patients, more restricted to the motor system in PPMS and more widespread in SPMS. Local brain sodium accumulation appears as a promising marker to monitor patients with progressive MS.     

Designing feedback-based contrast enhancement for in vivo imaging

Objective: Nonlinear feedback interactions induced by the spins themselves have recently been introduced as novel MRI contrast enhancement mechanisms sensitive to small differences in MR parameters. Developing feedback-based contrast enhancement into a useful tool for in vivo imaging requires improved techniques that are robust to inhomogeneity and sensitive to subtle anatomical/physiological variations. Materials and methods: Three different imaging methods combining the radiation damping feedback field with the distant dipolar field, applied radio-frequency (RF) fields, and local dipole fields, respectively, were designed and tested through numerical simulations on simple phantoms. These methods were demonstrated experimentally on live guppy fish, developing frog embryos, and blood in in vitro tissue samples by microimaging at 14.1 T. Results: The developed feedback-based methods yielded images that identified distinct morphological features with superior contrast compared with conventional MR images and those acquired under radiation damping only. Positive contrast due to evolution under radiation damping and local dipole fields was also observed in SPIOs and blood. Conclusion: Approaches to enhancing feedback-based contrast were successfully designed and demonstrated in vitro and in vivo. The newly devised methods were less sensitive to field inhomogeneity and prolonged evolution under the feedback fields, allowing for better visualization of contrast in vivo.     

In vivo mouse spinal cord imaging using echo-planar imaging at 11.75 T

Object To evaluate the feasibility of mouse spinal cord MR imaging using echo-planar imaging (EPI). Materials and methods Optimized multi-shot spin-echo-EPI sequences were compared to conventional spin-echo (c-SE) at 11.75 T and used for high-spatially resolved acquisitions and relaxation-time measurements. Results Good quality images were obtained, with clear delineation of gray and white matter. Acquisition-time gain factor was up to 6 (vs. c-SE) and resolution up to 74 × 94 μm² was achieved. T ₁ and T ₂ relaxation times were reliably measured. Conclusion High-temporally and spatially resolved mouse spinal cord EPI imaging is feasible. This technique should greatly benefit to long acquisition-time experiments (diffusion imaging) and imaging of rapidly-evolving pathologies. V. Callot and G. Duhamel equally contributed to this work.     

Evaluation of a suture electrode for direct bladder stimulation in a lower motor neuron lesioned animal model.

The purpose of this study was to evaluate a "suture" type electrode for direct bladder stimulation in an animal model of a lower motor neuron lesion. During an initial surgery, five male cats were instrumented under anesthesia using multistranded, 316 LVM, stainless-steel, wire electrodes implanted on the bladder wall serosa above the trigone area. Electrodes were constructed with a needle attached to the end that was removed after suturing the electrode in place. Additional instrumentation included urinary bladder catheters (tubes) for pressure recording and filling, and hook type electrodes for leg and pelvic floor electromyography recording. Chronic bladder filling and stimulation studies were conducted in tethered animals three to four weeks following surgery. To test these electrodes in a spinal cord injury model, a lower motor neuron lesion was performed including the sacral cord and complete nerve roots at L6 and below. These animals were evaluated during weeks 3 and 10 after injury. Direct bladder stimulation induced active contractions and voiding both before and after spinal cord injury. Effective stimulation parameters consisted of 40 pulses per s, 300 micros to 1 ms pulse duration, a stimulation period from 3 to 4 s, and a stimulation current from 10 to 40 mA. Fluoroscopy revealed an open membranous urethra during stimulation and following stimulation. A small diameter penile urethra was observed to limit flow. Postmortem evaluation of the suture electrode revealed no abnormalities such as corrosion, migration into the bladder lumen or displacement. These findings indicate that suture electrodes are suitable and effective for short-term implantation in the lower motor neuron animal model.     

Retrospective analysis for evaluation of the value of contrast-enhanced MRI in patients treated with breast conservative therapy

Purpose The aim of this study was to assess the value of contrast-enhanced (c.-e.) MRI in the follow-up of patients with conservatively treated breast cancer since detection and exclusion of malignancy may interfere significantly with posttherapeutic changes within the treated breast. Material and methods A total of 207 patients with a history of limited surgery and radiation therapy underwent MR imaging, 40 patients were examined 0–12 months and 167 patients were examined later than 12 months after radiotherapy. Suspicious or indeterminate findings were suggested by clinical examination or conventional imaging in 80 studies. In 127 women, MRI was performed within breast tissue that was difficult to assess due to scarring or dense breast tissue. Results Recurrent carcinoma was confirmed in 27 patients by surgical biopsy. All 27 carcinomas, except for one with a slow signal increase, demonstrated early rise of signal intensity on dynamic T1-weighted contrast enhanced images. During the first year after therapy, the diagnostic accuracy could not be improved by additional use of c.-e. MRI. Differentiation between posttherapeutic changes and recurrent carcinoma was frequently not possible because of strong and sometimes early and ill-circumscribed enhancement. Later than 12 months after therapy enhancement decreased significantly, thus the false positive calls could be reduced from 49 (conventional imaging) to 12 (conventional imaging plus MRI). A total of 12 of 26 recurrences and multifocality in 4/5 cases were diagnosed by MR imaging alone at this time interval. Conclusion In the first year after therapy, c.-e. MRI is only indicated in selected cases. The results later than 12 months emphasize that c.-e. MRI may contribute significant additional information. It allows better distinction of posttherapeutic fibrosis from recurrent carcinoma and proved to be able to detect recurrent disease more sensitive and at an earlier stage.     

A double-blind study to evaluate the efficacy and tolerability of a higher dose (0.3 mmol per kg bw) of gadodiamide injection as a contrast medium for MRI

Gadodiamide injection was administered intravenously to 48 patients with known or suspected central nervous system (CNS) lesions undergoing magnetic resonance imaging (MRI). Two parallel groups were examined to evaluate the efficacy and safety of single doses of 0.1 and 0.3mmol per kg bw. The principal measures of efficacy were diagnostic yield of MR images, the overall contrast enhancement and the contrast index (CI). Adverse events and serum bilirubin level were the main safety parameters. Nineteen patients in each dose group displayed contrast enhancement of the MR image (1.5 T Siemens Gyroscan MR unit;T ₁ TR/TE=560–650/15–25 ms;T ₂:TR/TE=2200–3100/22–90 ms). The CI increased by 47.3% in the 0.1 mmol/kg bw group and by 86.5% in the 0.3 mmol per kg bw group compared to the pre-contrast scan. Four patients in the 0.1 mmol per kg bw group and seven in the 0.3 mmol per kg bw group had their management changed by new information from the post-contrast scan and four patients in each dose group had their diagnosis altered following the post-contrast scan. Two patients in the 0.3 mmol per kg bw group experienced injection-associated discomfort. There were no other adverse events reported during the 24 h follow-up period. No clinically significant changes in serum bilirubin or other parameters of blood chemistry or haematology were observed. The study demonstrates that the safety profile of gadodiamide injection 0.3 mmol per kg bw is similar to that of 0.1 mmol per kg bw and that, at both doses, gadodiamide injection is a safe and effective contrast medium for use in patients undergoing MRI on the CNS. Slightly more patients had an improvement in diagnostic yield with the 0.3 mmol per kg bw dose and the CI was increased to a greater extent in this group, showing that when greater contrast is required the higher dose of gadodiamide injection may be considered. Further studies in selected patient groups, and with the use of different doses in the same patient are necessary to evaluate the diagnostic value of higher doses.     

Assessment of the myelin water fraction in rodent spinal cord using T2-prepared ultrashort echo time MRI

Objective

Multi-component T2 relaxation allows for assessing the myelin water fraction in nervous tissue, providing a surrogate marker for demyelination. The assessment of the number and distribution of different T2 components for devising exact models of tissue relaxation has been limited by T2 sampling with conventional MR methods.

Materials and methods

A T2-prepared UTE sequence was used to assess multicomponent T2 relaxation at 9.4 T of fixed mouse and rat spinal cord samples and of mouse spinal cord in vivo. For in vivo scans, a cryogenically cooled probe allowed for 78-µm resolution in 1-mm slices. Voxel-wise non-negative least square analysis was used to assess the number of myelin water-associated T2 components.

Results

More than one myelin water-associated T2 component was detected in only 12 % of analyzed voxels in rat spinal cords and 6 % in mouse spinal cords, both in vivo and in vitro. However, myelin water-associated T2 values of individual voxels varied between 0.1 and 20 ms. While in fixed samples almost no components below 1 ms were identified, in vivo, these contributed 14 % of the T2 spectrum. No significant differences in MWF were observed in mouse spinal cord in vivo versus ex vivo measurements.

Conclusion

Voxel-wise analysis methods using relaxation models with one myelin water-associated T2 component are appropriate for assessing myelin content of nervous tissue.

     

Mapping fine-scale anatomy of gray matter,white matter,and trigeminal-root region applying spherical deconvolution to high-resolution 7-T diffusion MRI

Objectives

We assessed the use of high-resolution ultra-high-field diffusion magnetic resonance imaging (dMRI) to determine neuronal fiber orientation density functions (fODFs) throughout the human brain, including gray matter (GM), white matter (WM), and small intertwined structures in the cerebellopontine region.

Materials and methods

We acquired 7-T whole-brain dMRI data of 23 volunteers with 1.4-mm isotropic resolution; fODFs were estimated using constrained spherical deconvolution.

Results

High-resolution fODFs enabled a detailed view of the intravoxel distributions of fiber populations in the whole brain. In the brainstem region, the fODF of the extra- and intrapontine parts of the trigeminus could be resolved. Intrapontine trigeminal fiber populations were crossed in a network-like fashion by fiber populations of the surrounding cerebellopontine tracts. In cortical GM, additional evidence was found that in parts of primary somatosensory cortex, fODFs seem to be oriented less perpendicular to the cortical surface than in GM of motor, premotor, and secondary somatosensory cortices.

Conclusion

With 7-T MRI being introduced into clinical routine, high-resolution dMRI and derived measures such as fODFs can serve to characterize fine-scale anatomic structures as a prerequisite to detecting pathologies in GM and small or intertwined WM tracts.

     

Investigation of blood-brain barrier permeability to magnetite-dextran nanoparticles (MD3) after osmotic disruption in rats

The permeability of experimentally disrupted blood-brain barrier (BBB) to superparamagnetic nanoparticles (MD3) was studied in rats. BBB opening was induced by intracarotid injection of mannitol. One hundred eighty rats were used for the study. Rats were examined at two time points, 30 minutes and 12 hours after intracarotid mannitol injection. Different preparations intravenously injected 30 minutes before rat sacrifice were used for characterization of BBB disruption. BBB integrity was determined with^99mTc-diethylenetriamine pentaacetic acid (DTPA) and^99mTc-albumin. Iron oxide-glucose particles (12-nm mean diameter),^99mTc-labeled lecithin-cholesterol liposomes of three different sizes (50, 100, and 200 nm), and polyethylene glycol (PEG)-coated^99mTc liposomes (50 nm) were used for investigations of the dependence of BBB permeability on particle system size or surface. Magnetite-dextran nanoparticles (MD3) were evaluated as superparamagnetic contrast agent to monitor with magnetic resonance imaging (MRI) the BBB breakdown.In vitro T₁ and T₂ relaxation times of the brain tissue were measured at 40 MHz and 37°C, and T₂-weighted MR images were acquired at 0.5 T. After intracarotid mannitol infusion, as expected, the BBB breakdown was immediate and temporary as judged by soluble molecule diffusion. MD3 nanoparticles crossed the BBB 12 hours after intravenous mannitol injection, at a time when brain permeability for molecules or small particles returns to normal. Magnetite crystals were found in cytoplasmic vesicles of glial cells. On MRI, signal intensity decreased after injection of MD3, even 12 hours after mannitol injection. This particularity could be useful in the study of focal pathological lesions accompanied by BBB permeability modifications. In such conditions, superparamagnetic particle contrast agents could be caught by the BBB, allowing the observation of impaired BBB areas without detectable cellular lesions. V. Rousseau was supported by a grant from the city of Angers.     

Clinical implications of skeletal muscle blood-oxygenation-level-dependent (BOLD) MRI

Blood-oxygenation-level-dependent (BOLD) contrast in magnetic resonance (MR) imaging of skeletal muscle mainly depends on changes of oxygen saturation in the microcirculation. In recent years, an increasing number of studies have evaluated the clinical relevance of skeletal muscle BOLD MR imaging in vascular diseases, such as peripheral arterial occlusive disease, diabetes mellitus, and chronic compartment syndrome. BOLD imaging combines the advantages of MR imaging, i.e., high spatial resolution, no exposure to ionizing radiation, with functional information of local microvascular perfusion. Due to intrinsic contrast provoked via changes in hemoglobin oxygen saturation, it is a safe and easy applicable procedure on standard whole-body MR devices. Therefore, BOLD MR imaging of skeletal muscle is a potential new diagnostic tool in the clinical evaluation of vascular, inflammatory, and muscular pathologies. Our review focuses on the current evidence concerning the use of BOLD MR imaging of skeletal muscle under pathological conditions and highlights ways for future clinical and scientific applications.     

Linear microstrip surface coil for MR imaging of the rat spinal cord at 4.7 T

A new design of RF coil based on a quasi-transverse electromagnetic field is described. The coil was developed for the acquisition of MR images of the rat spinal cord at 4.7 T. Different materials for the construction of the coil were tested, and the best results were obtained with Teflon. The design of the microstrip coil enables the investigator to change the length of the coil in a longitudinal direction and yields a relatively high signal-to-noise ratio due to the restricted field of view. Low RF field penetration depth also helps in suppressing motion artifacts generated by, e.g., breathing or heartbeats.