Three-Dimensional Quantitative Magnetic Resonance Imaging of Epiphyseal Cartilage Vascularity Using Vessel Image Features: New Insights into Juvenile Osteochondritis Dissecans.

We introduce a quantitative measure of epiphyseal cartilage vascularity and examine vessel networks during human skeletal maturation. Understanding early morphological changes in the distal femoral condyle is expected to provide information on the pathogenesis of developmental diseases such as juvenile osteochondritis dissecans. METHODS: Twenty-two cadaveric knees from donors ranging from 1 month to 10 years of age were included in the study. Images of bone, cartilage, and vascularity were acquired simultaneously with a 3-dimensional gradient-recalled-echo magnetic resonance imaging (MRI) sequence. The secondary ossification center volume and total epiphysis cartilage volume ratio and articular-epiphyseal cartilage complex and epiphyseal cartilage widths were measured. Epiphyseal cartilage vascularity was visualized for 9 data sets with quantitative susceptibility mapping and vessel filtering, resulting in 3-dimensional data to inform vessel network segmentation and to calculate vascular density. RESULTS: Three distinct, non-anastomosing vascular networks (2 peripheral and 1 central) supply the distal femoral epiphyseal cartilage. The central network begins regression as early as 3 months and is absent by 4 years. From 1 month to 3 years, the ratio of central to peripheral vascular area density decreased from 1.0 to 0.5, and the ratio of central to peripheral vascular skeletal density decreased from 0.9 to 0.6. A narrow, peripheral vascular rim was present at 8 years but had disappeared by 10 years. The secondary ossification center progressively acquires the shape of the articular-epiphyseal cartilage complex by 8 years of age, and the central areas of the medial and lateral femoral condyles are the last to ossify. CONCLUSIONS: Using cadaveric pediatric knees, we provide quantitative, 3-dimensional measures of epiphyseal cartilage vascular regression during skeletal development using vessel image features. Central areas with both early vascular regression and delayed ossification correspond to predilection sites of juvenile osteochondritis dissecans in this limited case series. Our findings highlight specific vascular vulnerabilities that may lead to improved understanding of the pathogenesis and better-informed clinical management decisions in developmental skeletal diseases. CLINICAL RELEVANCE: This paradigm shift in understanding of juvenile osteochondritis dissecans etiology and disease progression may critically impact future patient management. Our findings highlight specific vascular vulnerabilities during skeletal maturation in a group of active young patients seen primarily by orthopaedic surgeons and sports medicine professionals.

Hippocampal sclerosis in temporal lobe epilepsy: findings at 7 T¹.

PURPOSE: To determine if ultrahigh-field-strength magnetic resonance (MR) imaging can be used to detect subregional hippocampal alterations. MATERIALS AND METHODS: Subjects provided written consent to participate in this prospective institutional review board-approved HIPAA-compliant study. T1- and T2-weighted 7-T brain MR images were acquired in 11 healthy subjects and eight patients with temporal lobe epilepsy (TLE). In all subjects, images were qualitatively examined for evidence of hippocampal atrophy, signal change, and malrotation with the Bernasconi definition, and digitations of the hippocampal heads were counted (agreement was measured with the κ statistic). Data were analyzed quantitatively with manual subregional hippocampal body segmentation. Subregional data in individual subjects with TLE were compared with data in control subjects to detect deviation from the control range for volume measures on each side and with asymmetry indexes. RESULTS: All eight patients with TLE had hippocampal abnormalities on the epileptogenic side. Subregional analysis revealed selective lateral Ammon horn atrophy in six patients and diffuse Ammon horn and dentate gyrus atrophy in one patient. Paucity of hippocampal digitations occurred on the epileptogenic side in all patients with TLE and also on the contralateral side in three patients (interrater κ value, 0.80). Hippocampal malrotation was observed in three patients with TLE and four control subjects. CONCLUSION: Ultrahigh-field-strength MR imaging permitted detection of selectively greater Ammon horn atrophy in patients with TLE and hippocampal sclerosis. Paucity of digitations is a deformity of the hippocampal head that was detected independent of hippocampal atrophy in patients with mesial TLE.

In vivo 1H NMR spectroscopy of the human brain at 9.4 T: initial results.

In vivo proton NMR spectroscopy allows non-invasive detection and quantification of a wide range of biochemical compounds in the brain. Higher field strength is generally considered advantageous for spectroscopy due to increased signal-to-noise and increased spectral dispersion. So far (1)H NMR spectra have been reported in the human brain up to 7 T. In this study we show that excellent quality short echo time STEAM and LASER (1)H NMR spectra can be measured in the human brain at 9.4 T. The information content of the human brain spectra appears very similar to that measured in the past decade in rodent brains at the same field strength, in spite of broader linewidth in human brain. Compared to lower fields, the T(1) relaxation times of metabolites were slightly longer while T(2) relaxation values of metabolites were shorter (<100 ms) at 9.4 T. The linewidth of the total creatine (tCr) resonance at 3.03 ppm increased linearly with magnetic field (1.35 Hz/T from 1.5 T to 9.4 T), with a minimum achievable tCr linewidth of around 12.5 Hz at 9.4 T. At very high field, B(0) microsusceptibility effects are the main contributor to the minimum achievable linewidth.

Transmit and receive transmission line arrays for 7 Tesla parallel imaging.

Transceive array coils, capable of RF transmission and independent signal reception, were developed for parallel, 1H imaging applications in the human head at 7 T (300 MHz). The coils combine the advantages of high-frequency properties of transmission lines with classic MR coil design. Because of the short wavelength at the 1H frequency at 300 MHz, these coils were straightforward to build and decouple. The sensitivity profiles of individual coils were highly asymmetric, as expected at this high frequency; however, the summed images from all coils were relatively uniform over the whole brain. Data were obtained with four- and eight-channel transceive arrays built using a loop configuration and compared to arrays built from straight stripline transmission lines. With both the four- and the eight-channel arrays, parallel imaging with sensitivity encoding with high reduction numbers was feasible at 7 T in the human head. A one-dimensional reduction factor of 4 was robustly achieved with an average g value of 1.25 with the eight-channel transmit/receive coils.