In Vitro of MR Imaging of the Resected Normal Gastric Wall: Radiologic-Histologic Correlation

PURPOSE: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. MATERIALS AND METHODS: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. RESULTS: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediate low-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05), and T2TSE was the best for submucosa and the distinction between this and muscle (p<0.05). Both T1FLASH and T2TSE provided the best overall image quality (p<0.05). CONCLUSION: In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality.

Sequential Changes of Fresh and Fixed Specimen on MRI: Optimal Time Interval and Fixatives for Good Correlation with in Vivo State

PURPOSE: With the development of MR Imaging techniques, MRI and MR spectroseopy can be used to evaluatespecimens both in vivo and in vitro. For extracted tissue specimens we wished to obtain MR images which correlatedwell with images obtained in vive; the purpose of this study was to determine which fixatives and time intervalbest facilitated this objective. MATERIALS AND METHODS: After in vivo MR imaging, sample tissues of liver, renalcortex and renal medulla were obtained from ten healthy rabbits. Each tissue sample was placed in 75% ethanol, 10%formalin, and 0.9% normal saline and MR scans of each sample were performed at 30 minutes, 11/2, 3, 6, and 12hours after resection. Signal intensities of the images were measured and their sequential changes were evaluated. RESULTS: On T1WI, signal intensities of both tissue specimens fixed in formalin and ethanol and untreatedspecimens increased significantly during the first 30 minutes. The increased signal intensity then seen for 12hours was greater than on T2WI. On T2WI, signal ntensities of tissue specimens fixed in formalin and ethanol anduntreated specimens showed no significant changes within the first 30 minutes; after that, they showed less signalintensity change for 12 hours than on T1WI. CONCLUSION: To obtain MR images with the same signal intensities as invivo tissue, MRI of tissue specimens in the untreated state should be performed as soon as possible afterresection. On T2WI, signal intensities of tissue specimens were more similar to in vivo tissue than on T1WI.