3 Tesla MRI detects accelerated hippocampal volume reduction in postmenopausal women.

PURPOSE: To clarify age-related structural changes specific to hippocampal volume by hierarchizing according to age, gender, and menopausal status. Many studies report the neuroprotective effects of estrogen and age-related brain volume changes; however, there are no studies regarding age-related change specific to hippocampal volume in terms of age, gender, and menopausal status. MATERIALS AND METHODS: T1-weighted MR images were obtained in 412 healthy adults divided into eight groups according to age and gender, to analyze brain volume change focusing on hippocampal volume. RESULTS: Voxel-based morphometry (VBM) revealed significantly smaller gray matter volume in the hippocampus bilaterally in females aged in their fifties (51 of 59 females were at menopause) compared with females in their forties (3 of 46 females were at menopause). No significant difference was found, however, between female groups in their fifties versus sixties, or sixties versus seventies; or between male groups in their forties versus fifties, fifties versus sixties, or sixties versus seventies. In addition, VBM revealed significant hippocampal volume reduction bilaterally in all postmenopausal women compared with all premenopausal women. CONCLUSION: The results of the current study suggest that the menopause may be associated with hippocampal volume reduction.

Estimation of cell membrane permeability and intracellular diffusion coefficient of human gray matter.

The signal intensity of diffusion-weighted imaging (DWI) is sensitive to the intra- and extracellular diffusion coefficient of water and cell membrane permeability. We applied a method we proposed in previous papers to estimate noninvasively the membrane permeability and intracellular diffusion coefficient of normal human brain (gray matter) in 3 normal volunteers. We theoretically compared predicted signals and experiment results using a 1.5-tesla magnetic resonance (MR) imaging system. We acquired images using an echo planar imaging (EPI) sequence, applying motion-probing gradient (MPG) pulses in 3 directions. We periodically performed numerical simulations for various combinations of membrane permeability and intracellular diffusion coefficients using the finite-difference method. By minimizing the difference between signals obtained experimentally and those from numerical simulation, we could estimate membrane permeability (76+/-9 mm2/s mum) and intracellular diffusion coefficient (1.0+/-0.0 mm2/s) for the human brain. The estimated membrane permeability was the criterion value for diagnosing disease in gray matter.

Myelination progression in language-correlated regions in brain of normal children determined by quantitative MRI assessment.

OBJECTIVE: To investigate the myelination progression course in language-correlated regions of children with normal brain development by quantitative magnetic resonance imaging (MRI) analysis compared with histological studies. METHODS: The subjects were 241 neurologically intact neonates, infants and young children (128 boys and 113 girls) who underwent MRI between 2001 and 2007 at the University of Tokyo Hospital, ranging in age from 0 to 429 weeks corrected by postnatal age. To compare their data with adult values, 25 adolescents and adults (14 men and 11 women, aged from 14 to 83 years) were examined as controls. Axial T2-weighted images were obtained using spin-echo sequences at 1.5 T. Subjects with a history of prematurity, birth asphyxia, low Apgar score, seizures, active systemic disease, congenital anomaly, delayed development, infarcts, hemorrhages, brain lesions, or central nervous system malformation were excluded from the analysis. Seven regions of interest in language-correlated areas, namely Broca's area, Wernicke's area, the arcuate fasciculus, and the angular gyrus, as well as their right hemisphere homologous regions, and the auditory cortex, the motor cortex, and the visual cortex were examined. Signal intensity obtained by a region-of-interest methodology progresses from hyper- to hypointensity during myelination. We chose the inferior cerebellar peduncle as the internal standard of maturation. RESULTS: Myelination in all these seven language-correlated regions examined in this study shared the same curve pattern: no myelination was observed at birth, it reached maturation at about 1.5 years of age, and it continued to progress slowly thereafter into adult life. On the basis of scatter plot results, we put these areas into three groups: Group A, which included the motor cortex, the auditory cortex, and the visual cortex, myelinated faster than Group B, which included Broca's area, Wernicke's area, and the angular gyrus before 1.5 years old; Group C, consisting of the arcuate fasciculus, has similar degree of myelination as Group B before 1.5 years but then myelinated more slowly after 3 years of age. No gender or left-right differences between homologous regions were found. CONCLUSIONS: In this study, we determined the sequence of myelination of language-correlated regions in infants and children by quantitative MRI assessment. The higher cortical areas matured later than the primary cortical areas, and the arcuate fasciculus matured last. The observation that myelination reaches maturity after 18 months suggests that myelination may be a reason for the acceleration in vocabulary acquisition observed in children from that age. The slow pace of myelination also suggested the possibility of language development's continuation into early adult life. Myelination assessed by MRI was at least 1 month behind that assessed by histological staining. No gender or left-right hemisphere differences in myelination were noted.

[Quantitative assessment of wall motion in gated SPECT using the centerline method].

Evaluation of myocardial wall motion is an important assessment of heart function. Specific analysis programs in nuclear medicine, such as QGS (quantitative gated SPECT) analysis and p-FAST (perfusion-function assessment for myocardial SPECT), have been used to assess wall motion, but they have not evaluated it through a comparison of normal data. The centerline method, using left ventriculograms (LVG), evaluates regional wall motion quantitatively through a comparison of normal data and patient data, and abnormality of wall motion is expressed in units of standard deviation (SD) s from the mean motion in a reference population. However, angiography is an invasive inspection, wall motion analysis is usually in one direction, and the conventional centerline method is not a three-dimensional analysis. The purpose of this study was to apply the centerline method to nuclear medicine and examine the wall motion of subjects through a comparison of normal wall motion non-invasively and in a three-dimensional way. We arranged the analysis program using C language and inspected it using a dynamic cardiac phantom and computed tomography (CT) scanner. We made a polar map that indicated the mean and SD of normal wall motion. Our proposed method was able to assess the wall motion of subjects quantitatively through a comparison of normal wall motion in nuclear medicine.

Early myelination patterns in the central auditory pathway of the higher brain: MRI evaluation study.

OBJECTIVE: The purpose of this study was to use magnetic resonance imaging (MRI) to investigate the early myelination patterns of the central auditory pathway and then compare the data with past histological research. We observe the MRI signal intensity of the central auditory pathway and clarify the time course difference between MRI and previous histological research studies. METHODS: A total of 192 infants ranging in age from -4 to 224 corrected postnatal weeks were included in the study. Images were obtained using a 1.5 T MR unit. We chose three sites (medial geniculate body, auditory radiation, and splenium of the corpus callosum) of the central auditory pathway for analysis. Three cross sections were obtained perpendicular to the long axis of the brain and used to analyze the signal changes of the T1- and T2-weighted MRI by employing a region-of-interest (ROI) methodology that was corrected for postnatal age. RESULTS: At 10 corrected postnatal weeks, the medial geniculate body showed myelinated intensity changes on T2-weighted images. Auditory radiation showed myelinated intensity changes at 19 corrected postnatal weeks on the T1-weighted images and at 24 corrected postnatal weeks on the T2-weighted images. The splenium of the corpus callosum showed myelinated intensity changes at 16 corrected postnatal weeks on T1-weighted images and at 24 corrected postnatal weeks on T2-weighted images. CONCLUSIONS: As compared to the histological literature, the MRI documented signal intensity changes caused by myelination occurred approximately 3 weeks later for the medial geniculate body, 7-24 weeks later for the auditory radiation and 7-15 weeks later for the splenium of the corpus callosum. Since myelination is a process that occurs gradually, substantial changes of the myelin sheath makeup, a loss of water and the addition of lipids are more required in order to be detectable by MRI than myelin staining of histological study.

Customization of normal data base specific for 3-tesla MRI is mandatory in VSRAD analysis.

A voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) was used for quantitative analysis of parahippocampal atropy with 1.5-tesla (T) MRI in a voxel-wise manner. The analysis of images acquired under a different imaging condition provides an error factor that has a calculated value. Clinical application of 3T-MRI is necessary for establishing a normal data base (N-DB) specific for 3T-MRI data, which permits appropriate application of VSRAD. We established an N-DB specific for 3T-MRI for use in VSRAD. The "Z-score of the parahippocampal gyrus" was 0.79 +/- 0.32, and the N-DB of each age group did not have a big deflection when we analyzed a group of physically unimpaired persons in an N-DB specific for 3T-MRI. Therefore, we were able to confirm the validity of the customized N-DB. The "Z-score of the parahippocampal gyrus" was 1.62 +/- 0.47 for the N-DB of VSRAD. The numerical value was high for the group of physically unimpaired persons.

[Examination of tumor diameter measurement precision by RECIST].

Image evaluation with Response Evaluation Criteria in Solid Tumors (RECIST) evaluates the change in a measurable lesion as determined by ruler or micrometer caliper. However, there is no definition of the conditions thought to influence the precision of measurement. We therefore examined the effects on measurement precision by changing image amplification, WW, WL, and time phase. Moreover, to determine response rate, one-dimensional evaluation with RECIST was compared with the two-dimensional evaluation of World Health Organization (WHO) for a hepatocellular carcinoma. The results of measuring the object lesion for measured value variation were as follows. Under image conditions of 1 time expansion/ WW 150/ WL 100 was (4.92+/-1.94)%. Under image conditions of 1 time expansion/ WW 350/ WL 75 was (4.42+/-1.70)%. Under image conditions of 4 times expansion/ WW 150/ WL 100 was (2.52+/-0.82)%. Under image conditions of 4 times expansion/ WW 350/ WL 75 was (2.83+/-1.10)%. When an image was enlarged to 4 times, precision doubled. There was no a difference in comparing RECIST to WHO in terms of response rate. Thus the best method was considered to be RECIST because of its convenience.

MRI findings of the middle ear in infants.

CONCLUSIONS: While infants under the age of 1 year exhibited a high rate of abnormal intensities in the middle ear and mastoid cavities, older infants showed no abnormal intensities in these regions. From the signal intensity on T1- and T2-weighted MRI, the abnormal intensities in the middle ear cavity were considered to represent liquid effusion. Taken together with the findings of temporal bone CT, the abnormal intensities in the mastoid cavity were considered to represent bone marrow. OBJECTIVE: Histopathological studies of the temporal bone and tympanometry investigations have reported the presence of mesenchyme and liquid effusion in the middle ear cavity of infants. However, very few CT or MRI middle ear cavity findings of newborns and infants have been published, and none have included the mastoid cavity. We therefore performed an MRI study of the middle ear and mastoid cavities of infants under 2 years old (83 cases, 88 imaging series). SUBJECTS AND METHODS: MRI (1.5 T) was originally performed on suspicion of brain disorders in infants aged under 2 years. All MRI slices were studied and classified on the basis of the distribution of abnormal intensities in the middle ear and mastoid cavities. RESULTS: All the abnormal imaging appeared in infants under 1 year old, in particular, 74.24% (n=49) of abnormal imaging appeared in the first 20 weeks after birth.

Early myelination patterns in the brainstem auditory nuclei and pathway: MRI evaluation study.

OBJECTIVE: The purpose of this study is to investigate the early myelination patterns of brainstem auditory nuclei and pathway on magnetic resonance imaging compared with past histological research. We aimed to identify the time course difference in myelination of the brainstem auditory nuclei and pathway between magnetic resonance imaging and histological research results. METHODS: Subjects were 192 infants ranging in age from -4 to 224 corrected postnatal weeks. Images were obtained using a 1.5 T magnetic resonance unit. In four sites (cochlear nucleus, superior olivary nucleus, lateral lemniscus, inferior colliculus) of the brainstem auditory nuclei and pathway on four cross-sections obtained perpendicular to the long axis of the brainstem, signal changes of T1- and T2-weighted magnetic resonance images were analyzed using a region-of-interest methodology according to corrected postnatal age. RESULTS: The cochlear nucleus and superior olivary nucleus showed myelinated intensity change from -3 to 13 corrected postnatal weeks on T2-weighted images. The lateral lemniscus showed myelinated intensity change from -3 to 8 corrected postnatal weeks on T1-weighted images and from -1 to 13 corrected postnatal weeks on T2-weighted images. The inferior colliculus showed myelinated intensity change from -2 to 39 corrected postnatal weeks on T2-weighted images. CONCLUSIONS: Magnetic resonance imaging revealed the signal intensity change by myelination 11-18 weeks later than those reported in the histological literature. This time lag suggests that apart from histological research, the necessity for the milestones of auditory pathway maturation using MRI is suggested to evaluate the development of brainstem auditory pathway using MRI. This result suggests that myelination does not take place suddenly but happens gradually, so definite myelination, namely the complete change of myelin sheath ingredients, loss of water, and gain of lipids, is needed to be detected by magnetic resonance imaging.

[Utility of axial images in an early Alzheimer disease diagnosis support system (VSRAD)].

In recent years, voxel-based morphometry (VBM) has become a popular tool for the early diagnosis of Alzheimer disease. The Voxel-Based Specific Regional Analysis System for Alzheimer's Disease (VSRAD), a VBM system that uses MRI, has been reported to be clinically useful. The able-bodied person database (DB) of VSRAD, which employs sagittal plane imaging, is not suitable for analysis by axial plane imaging. However, axial plane imaging is useful for avoiding motion artifacts from the eyeball. Therefore, we created an able-bodied person DB by axial plane imaging and examined its utility. We also analyzed groups of able-bodied persons and persons with dementia by axial plane imaging and reviewed the validity. After using the DB of axial plane imaging, the Z-score of the intrahippocampal region improved by 8 in 13 instances. In all brains, the Z-score improved by 13 in all instances.

[Examination of an imaging method in early Alzheimer disease diagnosis support system (VSRAD)].

The use of voxel-based morphometry (VBM) has recently become a popular tool for the early diagnosis of Alzheimer disease. The Voxel-Based Specific Regional Analysis System for Alzheimer's Disease (VSRAD) is a clinically useful VBM that employs MRI. However, there has been insufficient information about the influence of the image pickup apparatus and imaging conditions in terms of the value calculated by the sensitivity correction. We therefore reviewed this problem in a volunteer who provided consent. We were able to confirm reproducibility under the same conditions. When changing the image pickup apparatus and conditions, the average Z-score of 0.18+/-0.21 became larger, and the change in Z-score increased when imaging was done in the axial plane. Further, the average Z-score of 0.06+/-0.21 for sensitivity correction use was high on average by 0.19+/-0.16 for phased-array uniformity enhancement (PURE) and low for surface coil intensity correction (SCIC).

[Distinguishing between occluded and low-flow vessels with PROPELLER DWI sequence: a phantom study].

PURPOSE: To evaluate the ability of periodically rotated overlapping parallel lines with enhanced reconstruction diffusion-weighted imaging (PROPELLER DWI) to distinguish between vessel occlusion and slow flow. MATERIALS AND METHODS: Using a flow phantom with various velocities (1.37 to 11.1 cm/s), the signal-intensity ratios of the phantom, with the intensity of no flow as baseline, were measured using the following imaging sequences: PROPELLER DWI, spin-echo T1-weighted imaging (SE T1WI), fast-spin-echo T2-weighted imaging (FSE T2WI), two-dimensional phase-contrast imaging (2D PC), and two-dimensional time-of-flight imaging (2D TOF). The b-factor of PROPELLER DWI was varied from 0 to 1000 s/mm(2). The velocity encoding of 2D PC was varied from 2 to 30 cm/s. RESULTS: At the lowest flow velocity (1.37 cm/s) , the signal-intensity ratio was 0.0075 for PROPELLER DWI (b-factor=1000 s/mm(2)), 1.8 for SE T1WI, 0.67 for FSE T2WI, 11 for 2D PC (velocity encoding=2 cm/s), and 1.4 for 2D TOF. The signal-intensity ratio was smallest for PROPELLER DWI, even when the reciprocals of the signal-intensity ratio of 2D PC or 2D TOF were considered. CONCLUSION: The results indicate that PROPELLER DWI provides the best signal intensity-ratio between vessel occlusion and slow flow. Although DWI with single-shot echo-planar imaging (EPI) or multi-shot EPI may have similarly high sensitivity for slow flow, these sequences do not have high spatial resolution or robustness to susceptibility artifacts. PROPELLER DWI would be a better choice for distinguishing between occluded and low-velocity arteries in the skull base or parasellar regions.

[Imaging characteristics of PROPELLER T2-weighted imaging].

As the PROPELLER sequence is a combination of the radial scan and fast-spin-echo (FSE) sequence, it can be considered an FSE sequence with a motion correlation. However, there are some differences between PROPELLER and FSE owing to differences in k-space trajectory. We clarified the imaging characteristics of PROPELLER T2-weighted imaging (T2WI) for different parameters in comparison with usual FSE T2WI. When the same parameters were used, PROPELLER T2WI showed a higher signal-to-noise ratio (SNR) and lower spatial resolution than usual FSE. Effective echo time (TE) changed with different echo train lengths (ETL) or different bandwidths on PROPELLER, and imaging contrast changed accordingly to be more effective.