Human exposure to 4.0-Tesla magnetic fields in a whole-body scanner.

Details are given for the design, construction, properties, and performance of a large, highly homogeneous magnet designed to permit whole-body magnetic resonance imaging and spectroscopy at 4 T. The magnet has an inductance of 1289 H and a stored energy of 33.4 MJ at rated field. The health of a group of 11 volunteers who had varying degrees of exposure to this field was followed over a 12-month period and no change that could be associated with this exposure was detected. A mild level of sensory experiences, apparently associated with motion within the field of the magnet, was reported by some of the volunteers during some of their exposures. A questionnaire regarding sensory effects associated with magnetic resonance scanners and possibly caused by the static magnetic field of these instruments, was given to nine respondents who had experience within both 1.5-T scanners and this 4-T scanner and to another group of 24 respondents who had experience only within 1.5-T scanners. For the sensations of vertigo, nausea, and metallic taste there was statistically significant (p less than 0.05) evidence for a field-dependent effect that was greater at 4 T. In addition, there was evidence for motion-induced magnetophosphenes caused by motion of the eyes within the static field. These results indicate the practicality of experimental whole-body body scanners operating at 4 T and the possibility of mild sensory effects in humans associated with motion within a static magnetic field. The results also indicate the likelihood of a wide margin of safety for the exposure of noncompromised patients to the static fields of conventional magnetic resonance scanners operated at 1.5 to 2 T and below.

Rapid 31P spectroscopy on a 4-T whole-body system.

Initial 31P spectroscopy results from a 4-T whole-body system are reported. Localized spectra from the human head, liver, and calf were obtained using DRESS, slice-interleaved DRESS, and volume 3DFT spectroscopic imaging techniques. Substantial reductions in data acquisition times to 10 s-4 min were achieved relative to previous similar experiments at 1.5 T. Some gain in spectral resolution (as measured in ppm) was also realized in the head.

The fate of inorganic phosphate and pH in regional myocardial ischemia and infarction: a noninvasive 31P NMR study.

To determine the characteristic appearance of phosphorus (31P) nuclear magnetic resonance spectra in acute and chronic myocardial infarction in situ, cardiac-gated depth-resolved surface coil spectroscopy (DRESS) at 1.5 T was used to monitor 31P NMR spectra from localized volumes in the left anterior canine myocardium for up to 5 days following permanent occlusion of the left anterior descending coronary artery. Coronary occlusion initially produced regional ischemia manifested as significant reductions in the phosphocreatine (PCr) to inorganic phosphate (Pi) ratios and intracellular pH (P less than 0.05, Student's t test) in endocardially displaced spectra acquired in periods as short as 50 to 150 s postocclusion. Spectra acquired subsequently revealed either (i) restoration of near-normal phosphate metabolism sometime between 10 and about 50 min postocclusion or (ii) advancing ischemic phosphate metabolism at about an hour postocclusion, and/or (iii) maintenance of depressed PCr/Pi ratios for up to 5 days postocclusion with a return of the apparent pH to near normal values between 6 and 15 h postocclusion. Postmortem examination of animals exhibiting the first type of behavior revealed the existence of coronary collateral vessels. The last type of behavior indicates that Pi remains substantially localized in damaged myocardium for days following infarction. The location and size of infarctions were determined postmortem by staining excised hearts. The smallest infarctions detected by 31P DRESS weighed 4.9 and 7.5 g. The most acidic pH measured in vivo was 5.9 +/- 0.2. Infarctions aged 1/2 day to 5 days were characterized by elevated but broad Pi resonances at 5.1 +/- 0.2 ppm relative to PCr and significantly depressed PCr/Pi ratios (P less than 0.002, Student's t test) relative to preocclusion values. Contamination of Pi resonances by phosphomonoester (PM) components is a significant problem for preocclusion Pi and pH measurements. These results should be applicable to the detection and identification of human myocardial infarction using 31P NMR and DRESS.

The intrinsic signal-to-noise ratio in NMR imaging.

The fundamental limit for NMR imaging is set by an intrinsic signal-to-noise ratio (SNR) for a particular combination of rf antenna and imaging subjects. The intrinsic SNR is the signal from a small volume of material in the sample competing with electrical noise from thermally generated, random noise currents in the sample. The intrinsic SNR has been measured for a number of antenna-body section combinations at several different values of the static magnetic field and is proportional to B0. We have applied the intrinsic and system SNR to predict image SNR and have found satisfactory agreement with measurements on images. The relationship between SNR and pixel size is quite different in NMR than it is with imaging modalities using ionizing radiation, and indicates that the initial choice of pixel size is crucial in NMR. The analog of "contrast-detail-dose" plots for ionizing radiation imaging modalities is the "contrast-detail-time" plot in NMR, which should prove useful in choosing a suitable pixel array to visualize a particular anatomical detail for a given NMR receiving antenna.

Noninvasive detection and monitoring of regional myocardial ischemia in situ using depth-resolved 31P NMR spectroscopy.

Phosphorus (31P) NMR spectra showing the relative concentrations of phosphocreatine, ATP, and Pi were recorded noninvasively from localized regions in the left ventricles of dog hearts in situ by using depth-resolved surface-coil spectroscopy at 1.5 T. Proton (1H) NMR surface-coil imaging was used to position 31P NMR coils and to determine the location of depth-resolved volumes immediately prior to 31P examination. Occlusion of the left anterior descending coronary artery produced regional ischemia detected as changes in the ratios of phosphocreatine, ATP, and Pi and by changes in the pH measured from the spectra. Spectral changes were not typically observed in regions adjacent to ischemic myocardium. Reperfusion produced some recovery, and ventricular fibrillation resulted in deterioration in high-energy metabolites. The location and size of ischemic tissue was measured by single-photon-emission computed tomography (SPECT) and gamma-ray counting or by staining excised hearts. The technique should permit the long-term noninvasive monitoring of the metabolic response of the heart to pathologic processes and allow assessment of interventions.

Orbital magnetic resonance imaging.

Magnetic resonance images of the eye and orbit performed with surface coils at 1.5 tesla showed anatomic details superior to those of conventional third- and fourth-generation computed tomography.

Estimating radiofrequency power deposition in body NMR imaging.

Simple theoretical estimates of the average, maximum, and spatial variation of the radiofrequency power deposition (specific absorption rate) during hydrogen nuclear magnetic resonance imaging are deduced for homogeneous spheres and for cylinders of biological tissue with a uniformly penetrating linear rf field directed axially and transverse to the cylindrical axis. These are all simple scalar multiples of the expression for the cylinder in an axial field published earlier (Med. Phys. 8, 510 (1981]. Exact solutions for the power deposition in the cylinder with axial (Phys. Med. Biol. 23, 630 (1978] and transversely directed rf field are also presented, and the spatial variation of power deposition in head and body models is examined. In the exact models, the specific absorption rates decrease rapidly and monotonically with decreasing radius despite local increases in rf field amplitude. Conversion factors are provided for calculating the power deposited by Gaussian and sinc-modulated rf pulses used for slice selection in NMR imaging, relative to rectangular profiled pulses. Theoretical estimates are compared with direct measurements of the total power deposited in the bodies of nine adult males by a 63-MHz body-imaging system with transversely directed field, taking account of cable and NMR coil losses. The results for the average power deposition agree within about 20% for the exact model of the cylinder with axial field, when applied to the exposed torso volume enclosed by the rf coil. The average values predicted by the simple spherical and cylindrical models with axial fields, the exact cylindrical model with transverse field, and the simple truncated cylinder model with transverse field were about two to three times that measured, while the simple model consisting of an infinitely long cylinder with transverse field gave results about six times that measured. The surface power deposition measured by observing the incremental power as a function of external torso radius was comparable to the average value. This is consistent with the presence of a variable thickness peripheral adipose layer which does not substantially increase surface power deposition with increasing torso radius. The absence of highly localized intensity artifacts in 63-MHz body images does not suggest anomalously intense power deposition at localized internal sites, although peak power is difficult to measure.

Improved MR imaging of the orbit at 1.5 T with surface coils.

A method for obtaining localized high-resolution magnetic resonance (MR) images of the eye and orbit is demonstrated. The method uses modified surface receiver coils placed immediately adjacent to the anatomy to detect the MR signal. Surface coils provide enhanced sensitivity for imaging voxels close to the surface of the body while limiting the received patient-generated noise. The resulting improvement in signal-to-noise ratio allows for a reduction in the imaging voxel size to about 0.5 X 0.5 X 5 mm in scan times of 3.4-5 min. At this level of resolution, anatomic detail in the orbital region previously unobservable in MR images is seen.

Resistive NMR of intracranial hematomas.

Comparison between computed tomography and nuclear magnetic resonance imaging in 17 patients with intracranial hematomas indicates a distinct role for NMR in evaluating the stable patient with hematoma. NMR is useful for delineating the extent of the hematoma, the relationship of the hematoma to brain anatomy, and the presence of hematoma at a time when the hematoma is isodense on CT.

Cerebral NMR: diagnostic evaluation of brain tumors by partial saturation technique with resistive NMR.

One hundred and forty patients with cerebral neoplasms were examined in a 0.12-Tesla prototype resistive NMR proton imaging device by partial saturation technique. NMR was superior to CT in tumor and edema localization and equal to CT in tumor and edema detection. NMR, however, was not able to clearly separate tumor from edema, a separation that contrast enhanced CT achieved.

Cerebral magnetic resonance: comparison of high and low field strength imaging.

Low field strength (0.12 Tesla resistive) and high field strength (1.0, 1.4, or 1.5 Tesla superconductive) magnetic resonance imagers were compared for their ability to detect central nervous system lesions. Sixteen adult patients with known lesions and three normal volunteers were studied. Contrast-enhanced computed tomography was used as the standard. The data demonstrate that imaging at high magnetic field strength is superior to low field strength imaging for the detection and delineation of lesions. This finding can be explained by the superior signal-to-noise ratio achievable at the higher magnetic field strengths. High field MR imaging was also found to outperform CT in demonstrating anatomic details and relationships. It is predicted that the use of low saturation (e.g., long TR spin echo technique) will make the gain in contrast-to-noise ratio even more significant.

Anatomy and metabolism of the normal human brain studied by magnetic resonance at 1.5 Tesla.

Proton magnetic resonance (MR) images were obtained of the human head in magnetic fields as high as 1.5 Tesla (T) using slotted resonator high radio-frequency (RF) detection coils. The images showed no RF field penetration problems and exhibited an 11 (+/- 1)-fold improvement in signal-to-noise ratio over a .12-T imaging system. The first localized phosphorus 31, carbon 13, and proton MR chemical shift spectra recorded with surface coils from the head and body in the same instrument showed relative concentrations of phosphorus metabolites, triglycerides, and, when correlated with proton images, negligible lipid (-CH2-) signal from brain tissue on the time scale of the imaging experiment. Sugar phosphate and phosphodiester concentrations were significantly elevated in the head compared with muscle. This method should allow the combined assessment of anatomy, metabolism, and biochemistry in both the normal and diseased brain.

Nuclear magnetic resonance imaging: contrast-to-noise ratio as a function of strength of magnetic field.

The choice of the strength of the magnetic field for an imaging system based on the nuclear magnetic resonance of hydrogen is considered. It is shown by an analysis based on in vitro data that the quality, or contrast-to-noise ratio, of images based on T1 or T2 discrimination increases with field up to 1.5-2 T. After a brief discussion of potential high-field limitations, results are presented which show that images of the human head with excellent anatomic detail can be produced at 1.5 T or 64 MHz.

Measurement of regional changes in myocardial perfusion using dynamic computed tomography and contrast medium.

Changes in regional myocardial perfusion were measured using rapid sequence dynamic transmission tomography to detect differences in the initial distribution of contrast medium injected as an intravenous bolus. The experiments were carried out on 8 mongrel dogs instrumented with flow probes and vascular occluders around the coronary arteries. Flow reductions of 50 per cent or more were detected as regions of myocardium with less contrast enhancement than those with normal perfusion. Reactive hyperemia induced by transient ischemia was detected as areas of relatively increased contrast enhancement. These changes could be demonstrated on the images and quantitated using data depicting changes in HU (Hounsfield units) with time to develop an index of perfusion. The images obtained were of satisfactory quality and differences between the underperfused and normal myocardium were made more prominent by using dipyridamole infusions.

Giant intracranial aneurysms: rapid sequential computed tomography.

Giant intracranial aneurysms often present as mass lesions rather than with subarachnoid hemorrhage. Routine computed tomographic (CT) scans with contrast material will generally detect them, but erroneous diagnosis of basal meningioma is possible. Rapid sequential scanning (dynamic CT) after bolus injection of 40 ml of Renografin-76 can conclusively demonstrate an intracranial aneurysm, differentiating it from other lesions by transit-time analysis of the passage of contrast medium. In five patients, the dynamics of contrast bolus transit in aneurysms were consistently different from the dynamics in pituitary tumors, craniopharyngiomas, and meningiomas, thereby allowing a specific diagnosis. Dynamic CT was also useful after treatment of the aneurysms by carotid artery ligation and may be used as an alternative to angiographic evaluation in determining luminal patency or thrombosis.

[Evaluation of left ventricular morphology and function by cardiac computed tomographic examination].

Usefulness of cardiac computed tomography (CT) in the evaluation of left ventricular (LV) morphology and function was studied in clinical practice. One hundred and forty-nine adult cases of various heart diseases were examined by GE scanner with ungated scans covering whole LV and ECG-gated scans. In gating examination, "long-axial" and "short-axial" slices were scanned and end-diastolic area (EDA), end-systolic area (ESA) and "mean" area (MA) were obtained in each slices. 1) With regard to LV morphology, wall thickening in HCM and wall thinning and mural thrombus in myocardial infarction were easily visualized. 2) LV "mean" volume (LVMV) was easily calculated from the sum of sliced LV volume of ungated scans. The LVMV was well correlated with end-diastolic volume (EDV) obtained by LV angiocardiography (LVG) (r = 0.91), though the former was somewhat smaller than the latter. EDV by CT obtained after the correction with MA/EDA from gating examination showed a better correlation (r = 0.95) and both EDV showed almost the same value. 3) LV ejection fraction (EF) was calculated by exchanging ESA/EDA to ESV/EDV in "long-axial" and "short-axial" gated slices, and "long-axial" EF, "short-axial" EF and mean of both were well correlated with LVEF of LVG (r = 0.73-0.79). 4) LVEF calculated from "long-axial" EDA and ESA by application of "area-length" method was also correlated with EF of LVG (r = 0.68), but these EDV and ESV were smaller than those of LVG due to shorter long-diameter of LV in CT. 5) LV muscle volume was calculated from sum of sliced muscle volumes of ungated scans covering LV, and LV mass was easily evaluated from LV muscle volume and specific gravity of LV muscle. This LV mass was well correlated with that of LVG (r = 0.90) and the absolute values were almost the same.

Head and body imaging by hydrogen nuclear magnetic resonance.

A hydrogen (1H) nuclear magnetic resonance (NMR) imaging study of the normal head, thorax, and limbs is reported. The images are 10 to 15 mm thick transverse slices obtained in 2 to 4 min using a two-dimensional Fourier transform technique. Spatial resolution in the imaging plane is about 2 mm, enabling the optic nerve and many small blood vessels to be observed. Thorax scans show details of the cardiac chambers, aorta wall, and lungs without artefacts arising from physiological motion.