Neural correlate of vernier acuity tasks assessed by functional MRI (FMRI).

Vernier acuity refers to the ability to discern a small offset within a line. However, while Vernier acuity has been extensively studied psychophysically, its neural correlates are uncertain. Based upon previous psychophysical and electrophysiologic data, we hypothesized that extrastriate areas of the brain would be involved in Vernier acuity tasks, so we designed event-related functional MRI (fMRI) paradigms to identify cortical regions of the brain involved in this behavior. Normal subjects identified suprathreshold and subthreshold Vernier offsets. The results suggest a cortical network including frontal, parietal, occipital, and cerebellar regions subserves the observation, processing, interpretation, and acknowledgment of briefly presented Vernier offsets.

Decreased cortical activation in response to a motion stimulus in anisometropic amblyopic eyes using functional magnetic resonance imaging.

PURPOSE: Motion perception abnormalities and extrastriate abnormalities have been suggested in amblyopia. Functional MRI (fMRI) and motion stimuli were used to study whether interocular differences in activation are detectable in motion-sensitive cortical areas in patients with anisometropic amblyopia. METHODS: We performed fMRI at 1.5 T 4 control subjects (20/20 OU), 1 with monocular suppression (20/25), and 2 with anisometropic amblyopia (20/60, 20/800). Monocular suppression was thought to be form fruste of amblyopia. The experimental stimulus consisted of expanding and contracting concentric rings, whereas the control condition consisted of stationary concentric rings. Activation was determined by contrasting the 2 conditions for each eye. RESULTS: Significant fMRI activation and comparable right and left eye activation was found in V3a and V5 in all control subjects (Average z-values in L vs R contrast 0.42, 0.43) and in the subject with monocular suppression (z = 0.19). The anisometropes exhibited decreased extrastriate activation in their amblyopic eyes compared with the fellow eyes (zs = 2.12, 2.76). CONCLUSIONS: Our data suggest motion-sensitive cortical structures may be less active when anisometropic amblyopic eyes are stimulated with moving rings. These results support the hypothesis that extrastriate cortex is affected in anisometropic amblyopia. Although suggestive of a magnocellular defect, the exact mechanism is unclear.

Fetal posterior fossa volume: assessment with MR imaging.

PURPOSE: To retrospectively determine the relationship between posterior fossa volume (PFV) and estimated gestational age (EGA) and/or femur length (FL) during pregnancy for the purpose of developing a normal growth curve. MATERIALS AND METHODS: Advance institutional review board approval was obtained for this HIPAA-compliant study, and the need for parent informed consent was waived. A cross-sectional retrospective study was performed to measure PFV on in vivo magnetic resonance (MR) images obtained in 76 fetuses of 18-36 weeks gestation who had a morphologically normal CNS. Because this was a retrospective series, MR imaging techniques varied slightly, but all fetuses underwent imaging at contiguous 3-5-mm intervals in at least two orthogonal planes, with repetition time msec/echo time msec, 5-12/62-95; number of signals acquired, one; flip angle, 150 degrees -180 degrees; and matrix, 128-192 x 256. Posterior fossa areas were manually traced on half-Fourier rapid acquisition with relaxation enhancement in utero fetal MR images by one observer. PFVs were then calculated by manually summing areas from the contiguous sections and multiplying the total area by the section thickness. An average PFV (APFV) across orthogonal planes was calculated for each fetus, and the relationship between APFV and EGA was mathematically modeled. Coronal, transverse, and sagittal views were compared with correlations and Bland-Altman plots. Two additional observers repeated the measurements for a small subset of fetuses (n = 5). Paired t test analyses were also performed to determine significant differences between sagittal, transverse, and coronal measurements, as well as to determine preliminary intraobserver and interobserver variability of measurements in a subset of cases. RESULTS: The relationship between APFV (in cubic centimeters) and EGA (in weeks) was well described by a single exponential function [APFV = 0.689 exp(EGA/9.10)]. APFV doubling time was 6.31 weeks. Root-mean-square variation of values around the model line was 1.63 cm(3). There was no statistically significant intra- or interobserver variation (P > .16 for all fetuses) at preliminary analysis. No correlation between APFV and FL could be found. CONCLUSION: The normal fetal PFV growth curve generated in this study may have potential as a model for clinical application.

Spatial and temporal characteristics of physiological noise in fMRI at 3T.

RATIONALE AND OBJECTIVES: Physiological noise in blood oxygen level-dependent functional magnetic resonance imaging (BOLD fMRI) has been shown to have characteristics similar to the BOLD signal itself, suggesting that it may have a vascular dependence. In this study, we evaluated the influence of physiological noise in fMRI as revealed by the differences in vasculature sensitivity of gradient-echo echo-planar imaging (GE-EPI) and spin-echo EPI (SE-EPI). MATERIALS AND METHODS: The contribution of physiological noise to the fMRI signal during activation of the visual cortex was assessed by comparing its temporal characteristics with respect to echo time (TE), using both GE-EPI and SE-EPI. The correlation of the noise in fMRI with apparent diffusion coefficient (ADC) and the number of components required to describe its variance, as determined by principal-component analysis (PCA), were also assessed. RESULTS: The SE-EPI data were less affected by a TE-dependence of noise, in contrast to the apparent physiological noise in GE-EPI. Voxel-wise analysis revealed that total apparent noise increased as ADC values increased, and the relationship was different for GE-EPI and SE-EPI. PCA revealed that while the number of components characterizing the noise in SE-EPI data increased in a TE-dependent manner, approaching that of white noise at long echo time, the number of components from GE-EPI data was TE-independent. CONCLUSIONS: The difference in sensitivities to physiological noise between SE-EPI and GE-EPI suggests that extravascular BOLD processes around draining veins contribute significantly to physiological noise in BOLD fMRI, and the suppression of this noise component may enhance SE-EPI BOLD sensitivity at higher fields.

The impact of aortic arch geometry on flow dynamics using a simplified approach with magnetic resonance velocity mapping.

BACKGROUND: We sought to determine, in vivo, the impact of aortic arch geometry on flow dynamics, which affects overall cardiovascular energetics and has implications for organ perfusion and Doppler flow calculations. METHODS: Twenty-seven patients (13 with left and 14 with right aortic arches) underwent magnetic resonance phase-encoded velocity mapping in the ascending and descending aorta. The cross-sectional area were divided into 4 equal quadrants aligned along the long axis of the aorta for analysis. Significance P < .05. RESULTS: In the ascending aorta, there was a significantly higher total flow throughout the cardiac cycle in the posterior and leftward quadrant of right aortic arch than left aortic arch (P = .007) that was compensated for by significantly lower flow in anterior and rightward quadrant of right aortic arch than left aortic arch (P = .02). In the right aortic arch, maximum velocity (100 +/- 14 cm/second) occurred in 7/9 patients in the right half while in left aortic arch, maximum velocity (107 +/- 20 cm/second) occurred in 13/15 in the left half. In the descending aorta, whether left aortic arch or right aortic arch, the posterior half appeared to have greater flow than the anterior half. CONCLUSION: Right aortic arch geometry impacts flow dynamics in the ascending aorta whereas it is not altered in the descending aorta, where flow is predominantly in the posterior half. The sidedness of the aortic arch determined the location of maximum velocity. Alternatively, this also may suggest that hemodynamics could have played a role in the development of right aortic arch in certain individuals.

Recognition of objects in non-canonical views: a functional MRI study.

BACKGROUND: The neural correlate of object recognition in non-canonical views is uncertain, but there is evidence for involvement of neural pathways, possibly separate from those used for object recognition in canonical views. METHODS: Boxcar functional MRI (fMRI) techniques were used to detect neural activity while eight normal subjects were instructed to identify digital photographs of objects in non-canonical and canonical orientations. RESULTS: The right angular gyrus, the left inferior temporal gyrus, and the right cerebellum showed significant fMRI activity during non-canonical as opposed to canonical viewing. CONCLUSIONS: Subjects recognizing objects in non-canonical orientations engage in a process separate from, or in addition to, the process used in recognizing objects in canonical orientations.

Application of spatial modulation of magnetization (SPAMM) to children: the effect of image resolution on tagging pattern.

BACKGROUND AND OBJECTIVE: Spatial modulation of magnetization (SPAMM) is a valuable magnetic resonance imaging technique for studying ventricular biomechanics. In order to track the intersection points of the stripes to calculate regional wall motion and strain, the stripe spacing should be at most half the wall thickness, yet sufficiently larger than the image pixel size in order that the stripes be well resolved. These conflicting requirements, that the grid spacing be much smaller than the wall thickness yet much larger than the pixel size, are relatively easy to meet in adult subjects but are difficult in children because of their small size. The purpose of this study was to delineate the effect of pixel size relative to SPAMM grid spacing on the stripe pattern produced by SPAMM with application towards its use in children and to present a new approach to the analysis of these images. METHODS: We performed SPAMM imaging on a 1.5 Telsa Siemen's Vision MR system on a phantom, using an artificial ECG (R-R interval = 450 ms for triggering), holding the pixel size constant and varying the degree of stripe spacing. We used both square (1 mm) and rectangular (1 mm by 2 mm) pixels. We express the ratio of grid to pixel size as the ratio of the center-center spacing of the grid lines to the horizontal pixel size. We retrospectively reviewed the SPAMM images on 10 patients with a ratio of grid to pixel size approximately 4:1 and 10 with a ratio of grid to pixel size approximately 8:1. We further performed SPAMM imaging in four patients with different grid to pixel size ratios in the same patient. Finally, we tested a new algorithm to track the signal intense regions rather than the signal poor intersection points of the grid lines, which were compared on three ventricles with SPAMM tagging. RESULTS: In a phantom, the effect of decreasing the separation between stripes while keeping the resolution of the image constant changed the stripe pattern from a series of two parallel lines perpendicular to each other to a "checkerboard" pattern. With a relative grid:pixel ratio of 8:1 as used with adult studies, the dark bands and the crossing points are well defined. As the ratio decreases from 8:1 to 6:1, the black band is less well resolved. When the resolution is reduced further to a grid:pixel ratio of 4:1, the image appears to be a checkerboard of white and dark squares. This occurred with both square and rectangular pixels. The effect in vivo is similar. When the ratio is approximately 8:1, all patients demonstrated a stripe pattern as a set of parallel lines perpendicular to each other. When the ratio was approximately 4:1, all patients demonstrated the stripe pattern as checkerboard. This was found to be the case in the same patient, whether varying the pixel size by changing the field of view or matrix or by changing the grid spacing. We also found that tracking the signal intense regions was equivalent to tracking the signal poor intersection points of the grid, and this approach was much easier to implement. CONCLUSION: With decreasing ratio of grid spacing to pixel size, SPAMM stripe patterns change from a set of parallel lines perpendicular to each other to a "checkerboard" pattern. This effect has implications for tracking techniques to determine strain and wall motion. At smaller ratios, as is needed sometimes in children, it is easier to track the signal intense regions rather than the "intersection" points of the stripes. Both these approaches to tracking are equivalent.

Decreased lateral geniculate nucleus activation in retrogeniculate hemianopia demonstrated by functional magnetic resonance imaging at 4 Tesla.

Functional magnetic resonance imaging (fMRI) can detect lateral geniculate nucleus (LGN) activation. We studied LGN function in 5 patients with retrogeniculate homonymous hemianopia using fMRI at 4.0 Tesla during binocular visual stimulation. Decreased activation of visual cortex and LGN on the side of the lesion was observed in all 5 patients. These findings suggest that retrogeniculate lesions are associated with decreased activation of the LGN, due to retrograde degeneration or a functional decrease caused by decreased feedback from ipsilateral visual cortex.

Age-related, regional, hemispheric, and medial-lateral differences in myelin integrity in vivo in the normal adult brain.

BACKGROUND AND PURPOSE: Clinical validation of magnetization transfer (MT) imaging is important for investigating clinical disease and organization of normal brain function. We determined whether an in vivo quantitative measure sensitive to white matter is distributed in functionally important ways. METHODS: Axial 1.5-T MR images with and those without MT were obtained. MT ratios (MTRs) were computed for 33 regions of interest (ROIs) in 27 healthy adults (aged 18-69 years) without evidence of cognitive or radiographic abnormalities. Three tests of reliability yielded coefficients above 0.97. MTRs for the whole brain, groups of structures, and individual ROIs were calculated. Low standard errors confirmed the consistency of the technique. RESULTS: Age, education, sex, and hand dominance were not correlated with whole-brain MTR (mean = 37.35, SD = 1.25), but age was associated with the cerebellum and some lobes at a trend level. MTRs were as follows, in descending order: corpus callosum, cingulate, white matter, brain stem, subcortical nuclei, and cerebellum. MTRs were selectively higher in the prefrontal lobe versus the posterior frontal lobe and in the lateral temporal lobe versus medial temporal lobe. MTR was higher in the left hemisphere than in the right hemisphere for the whole brain, frontal and temporal lobes, and lenticular nuclei. CONCLUSION: MT imaging showed selective age, medial-lateral, and hemispheric differences, giving evidence of normal aging effects on the white matter in the absence of T2- weighted hyperintensities. These differences support neurocognitive theories of the organization of brain function. MT imaging appears to be a robust technique for use in cognitive neuroscience.

Direct comparison of two methods to measure T1: in vitro and in vivo values by echo-planar imaging and by segmented k-space imaging.

We test a hypothesis that proton T(1) is accurately measured independent of the physics inherent to the method. We used two well-validated but quite different imaging methods to measure T(1) in phantoms and in humans; an echo-planar imaging T-one measurement (EPITOME) method, and a segmented k-space acquisition precise and accurate inversion recovery (TurboPAIR) method. Agreement between the methods was generally excellent; the square of the correlation coefficient (r(2)) in phantoms was 0.9996. The r(2) in brain tissue of volunteers was 0.79 overall, and 0.85 if cortical gray matter and corpus callosum were excluded. Nevertheless, small but significant differences were observed between methods in vivo and T(1) measurements were sensitive to tissue type, although measurements could be made comparable. The major difference between the methods is that EPITOME takes 97 s to image 15 slices at low resolution, while TurboPAIR takes 240 s to image one slice at high resolution.

Brain T1 in young children with sickle cell disease: evidence of early abnormalities in brain development.

Measurement of tissue spin lattice relaxation time (T(1)) has been used to characterize brain development in healthy children. Here we report the first study of brain T(1) in young children with sickle cell disease (SCD). The T(1) in 10 tissue samples was measured by established techniques; 46 SCD patients under the age of 4 years were compared to 267 controls, including 55 well children under the age of 4 years. A model was developed to predict the relationship between age and brain T(1) in controls, then we compared patient T(1) to healthy normal T(1). Most white matter and gray matter tissues in infant patients (<2 years old), had T(1) values significantly higher than normal. For example, 15.0% of patient caudate T(1) values were above the upper bound of the 95% confidence interval for controls, but only 2.5% of normal values are expected to be this high (p = 0.0003). Among infant patients, brain T(1) was significantly higher than normal in every tissue (p < 0.01) except cortical gray matter. However, patient T(1) values declined rapidly to values lower than normal by about age 4. Our findings imply that patients follow an abnormal developmental trajectory beginning early in infancy.

Diffusion tensor imaging of the hippocampal formation in temporal lobe epilepsy.

BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) is a noninvasive technique that can be used to assess the integrity of cerebral tissue. The purpose of this study was to assess DTI measurements in the hippocampal formation (HF) and to investigate the role of DTI in lateralizing the seizure focus in temporal lobe epilepsy (TLE). METHODS: We evaluated 12 patients with unilateral TLE and 14 healthy subjects. We collected diffusion-weighted images along six different directions with a b value of 1000 s/mm(2), as well as an image acquired without diffusion weighting (b = 0 s/mm(2)). A 1.5-T imager was used to acquire 17 (3-mm) coronal sections covering the temporal lobes. We compared the mean diffusivity (trace D) and fractional anisotropy (FA) from symmetrical voxels by sampling the anterior HF bilaterally. We compared measurements with the EEG, high-resolution MR imaging, and clinical information. RESULTS: The patient group had significantly increased diffusivity and decreased FA in the HF ipsilateral to the seizure focus, as compared with values in the contralateral HF. When compared with healthy subjects, patients had significantly higher mean diffusivity in the ipsilateral HF; ipsilateral FA values were lower and did not reach statistical significance. Measurements in the contralateral HF did not show differences. Left-right and absolute diffusivity indices lateralized the abnormal HF in eight and five of 12 patients, respectively. CONCLUSION: Abnormal DTI measurements and the epileptogenic HF are associated in unilateral TLE. This finding may reflect hippocampal sclerosis and may aid in presurgical evaluation.

Pediatric perfusion imaging using pulsed arterial spin labeling.

PURPOSE: To test the feasibility of pediatric perfusion imaging using a pulsed arterial spin labeling (ASL) technique at 1.5 T. MATERIALS AND METHODS: ASL perfusion imaging was carried out on seven neurologically normal children and five healthy adults. The signal-to-noise ratio (SNR) of the perfusion images along with T1, M(0), arterial transit time, and the temporal fluctuation of the ASL image series were measured and compared between the two age groups. In addition, ASL perfusion magnetic resonance (MR) was performed on three children with neurologic disorder. RESULTS: In the cohort of neurologically normal children, a 70% increase in the SNR of the ASL perfusion images and a 30% increase in the absolute cerebral blood flow compared to the adult data were observed. The measures of ASL SNR, T1, and M(0) were found to decrease linearly with age. Transit time and temporal fluctuation of the ASL perfusion image series were not significantly different between the two age groups. The feasibility of ASL in the diagnosis of pediatric neurologic disease was also illustrated. CONCLUSION: ASL is a promising tool for pediatric perfusion imaging given the unique and reciprocal benefits in terms of safety and image quality.

Decreased activation of the lateral geniculate nucleus in a patient with anisometropic amblyopia demonstrated by functional magnetic resonance imaging.

Although postmortem morphological changes in the lateral geniculate nucleus (LGN) have been reported in human amblyopia, LGN function during monocular viewing by amblyopic eyes has not been documented in humans. We used functional magnetic resonance imaging (fMRI) to study monocular visual activation of the LGN in a patient with anisometropic amblyopia. Four normal subjects, a patient with optic neuritis and a patient with anisometropic amblyopia were studied with fMRI at 1.5 T during monocular checkerboard stimulation. Activated areas in the LGN and visual cortex were identified after data processing (motion correction and spatial normalization) with SPM99. In the 4 normal subjects, comparable activation of the LGN and visual cortex was obtained by stimulation of either the right or left eye. In the patient with unilateral optic neuritis, activation of the LGN and visual cortex was markedly decreased when the affected eye was stimulated. Similarly, decreased activation of the LGN as well as the visual cortex by the affected eye was demonstrated in the patient with anisometropic amblyopia. Our preliminary results suggest that activation of the LGN is diminished during monocular viewing by affected eyes in anisometropic amblyopia. fMRI appears to be a feasible method to study LGN activity in human amblyopia.

Flow volume asymmetry in the right aortic arch in children with magnetic resonance phase encoded velocity mapping.

BACKGROUND: The right aortic arch is not uncommon in pediatrics. Flow dynamics in this type of aortic arch, which is important for cardiac energetics, organ perfusion, and Doppler flow calculations, have not been defined. Although there are complex secondary flow patterns, bulk axial flow makes up most of the energy use. METHODS: We examined 14 children with a right aortic arch by using through-plane phase-encoded magnetic resonance velocity mapping in the ascending and descending aorta to determine flow volume symmetry and velocity. The aortic cross section was divided into 4 quadrants aligned along the long axis of the aorta. Significance was defined as a P value <.05. RESULTS: In the ascending aorta, the posterior right quadrant demonstrated significantly greater blood flow than the other quadrants across the entire cardiac cycle (28% vs 23%-25%) and at the point of maximum flow (29% vs 22%-25%). Flow asymmetry was also present in the descending aorta; there was significantly more flow in the posterior quadrants than the anterior quadrants in total flow across the cardiac cycle (28% vs 21%-23%) and at the point of maximum flow (27%-28% vs 20%-24%). The time to maximum flow was significantly shorter in the ascending than the descending aorta (18% vs 24% of the cardiac cycle). In 10 of 14 patients, maximum velocity occurred in the right half of both the ascending and descending aorta. Flow reversal at end-systole was haphazard, occurring in all quadrants. CONCLUSION: Flow volume asymmetry exists in the ascending and descending portions of the right aortic arch, which has implications for cardiac energetics, organ perfusion, and Doppler scanning flow calculations. This information may be useful in designing improved aortic surgical reconstructions in cases of congenital heart disease.

Functional magnetic resonance imaging and its clinical utility in patients with visual disturbances.

Functional magnetic resonance imaging (fMRI) is a powerful, non-invasive technique for mapping human brain function. Because of the robust signal intensity changes associated with visual stimuli, fMRI is particularly useful for studying visual cortex (including both striate and extrastriate cortex). Also, activation of the lateral geniculate nuclei has been successfully demonstrated by fMRI. Therefore, fMRI may be potentially useful in patients with visual deficits by providing a non-invasive method for assessing the afferent visual pathways and higher cortical areas. Although there have been several reviews on fMRI, few have highlighted its clinical applicability in patients with visual disturbances. Our article will review fMRI principles and methodology, then focus on the possible applications and limitations of this technique in clinical ophthalmology.

Clinical protocol. Gene therapy of Canavan disease: AAV-2 vector for neurosurgical delivery of aspartoacylase gene (ASPA) to the human brain.

This clinical protocol describes virus-based gene transfer for Canavan disease, a childhood leukodystrophy. Canavan disease, also known as Van Bogaert-Bertrand disease, is a monogeneic, autosomal recessive disease in which the gene coding for the enzyme aspartoacylase (ASPA) is defective. The lack of functional enzyme leads to an increase in the central nervous system of the substrate molecule, N-acetyl-aspartate (NAA), which impairs normal myelination and results in spongiform degeneration of the brain. No effective treatment currently exists; however, virus-based gene transfer has the potential to arrest or reverse the course of this otherwise fatal condition. This procedure involves neurosurgical administration of approximately 900 billion genomic particles (approximately 10 billion infectious particles) of recombinant adeno-associated virus (AAV) containing the aspartoacylase gene (ASPA) directly to affected regions of the brain in each of 21 patients with Canavan disease. Pre- and post-delivery assessments include a battery of noninvasive biochemical, radiological, and neurological tests. This gene transfer study represents the first clinical use of AAV in the human brain and the first instance of viral gene transfer for a neurodegenerative disease.

Nonuniform flow dynamics in the aorta of normal children: a simplified approach to measurement using magnetic resonance velocity mapping.

PURPOSE: To determine regional flow dynamics in the normal aorta (Ao) in children. Understanding flow dynamics in children is important in cardiovascular energetics, in designing improved aortic reconstructions by crafting the surgery to mimic normal aortic flow, and in Doppler flow calculations. The objective of this study was to determine regional flow dynamics in the normal Ao in children. MATERIALS AND METHODS: We performed magnetic resonance velocity mapping on 13 subjects (ages 7.2 +/- 6.2 years) with normal Aos to determine flow dynamics in four equal quadrants in the ascending (AAo) and descending aorta (DAo) aligned along the long axis of the Ao. Statistical significance was set at P <.05. RESULTS: In the AAo, the left posterior quadrant displayed significantly less blood flow (16% +/- 5%) than the other quadrants (26-29%) over the cardiac cycle. In the DAo, both anterior quadrants carried significantly less blood flow (20% and 21%) than the posterior quadrants (27% and 32%). At maximum flow (15% +/- 5% into the cardiac cycle for the AAo; 27% +/- 15% for the DAo), there was significantly more flow in the right posterior quadrant (28% +/- 2%) than other quadrants (22-23%) in the AAo. In the DAo, both posterior quadrants had significantly higher flow rates (27% and 30%) than the anterior quadrants (21% and 22%). Maximum velocity in both the AAo and the DAo occurred in the left posterior quadrant in 10/13 at 16-24% into the cardiac cycle. At end-systole, a short flow reversal was noted in the posterior quadrants in the AAo in 11/13; in the DAo, this occurred in the anterior quadrants in 10/13. CONCLUSION: Flow dynamics in the normal Ao in children are not symmetrical; the flow distributions are asymmetric in both the AAo and the DAo throughout systole, including flow reversal related to the dicrotic notch. These results may help improve Ao surgery.

Evaluation of iron overload by single voxel MRS measurement of liver T2.

PURPOSE: To overcome the difficulty of poor signal-to-noise ratio of magnetic resonance imaging (MRI) in evaluating heavy iron overload by using a single voxel magnetic resonance spectroscopy (MRS) technique. MATERIALS AND METHODS: A single voxel STEAM pulse sequence with a minimum TE of 1.5 msec and a sampling volume of 36.6 cm(3) was developed and applied to 1/T2 measurement of the liver in 14 patients with thalassemia whose liver iron concentration was determined through biopsy. RESULTS: The iron level ranged from 0.23 to 37.15 mg Fe/g dry tissue with a median value of 18.06. In all cases, strong MR signals were obtained. 1/T2 was strongly correlated with the liver iron concentration (r = 0.95, P < 0.00005). CONCLUSION: The single voxel MRS measurement of T2 in liver iron overload overcomes the difficulty of lack of detectable signals in conventional MRI when the iron level is high. There is an excellent correlation between the iron level and 1/T2.