Widespread extrahippocampal NAA/(Cr+Cho) abnormalities in TLE with and without mesial temporal sclerosis.

MR spectroscopy has demonstrated extrahippocampal NAA/(Cr+Cho) reductions in medial temporal lobe epilepsy with (TLE-MTS) and without (TLE-no) mesial temporal sclerosis. Because of the limited brain coverage of those previous studies, it was, however, not possible to assess differences in the distribution and extent of these abnormalities between TLE-MTS and TLE-no. This study used a 3D whole brain echoplanar spectroscopic imaging (EPSI) sequence to address the following questions: (1) Do TLE-MTS and TLE-no differ regarding severity and distribution of extrahippocampal NAA/(Cr+Cho) reductions? (2) Do extrahippocampal NAA/(Cr+Cho) reductions provide additional information for focus lateralization? Forty-three subjects (12 TLE-MTS, 13 TLE-no, 18 controls) were studied with 3D EPSI. Statistical parametric mapping (SPM2) was used to identify regions of significantly decreased NAA/(Cr+Cho) in TLE groups and in individual patients. TLE-MTS and TLE-no had widespread extrahippocampal NAA/(Cr+Cho) reductions. NAA/(Cr+Cho) reductions had a bilateral fronto-temporal distribution in TLE-MTS and a more diffuse, less well defined distribution in TLE-no. Extrahippocampal NAA/(Cr+Cho) decreases in the single subject analysis showed a large inter-individual variability and did not provide additional focus lateralizing information. Extrahippocampal NAA/(Cr+Cho) reductions in TLE-MTS and TLE-no are neither focal nor homogeneous. This reduces their value for focus lateralization and suggests a heterogeneous etiology of extrahippocampal spectroscopic metabolic abnormalities in TLE.

Advances in neuroimaging of traumatic brain injury and posttraumatic stress disorder.

Improved diagnosis and treatment of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are needed for our military and veterans, their families, and society at large. Advances in brain imaging offer important biomarkers of structural, functional, and metabolic information concerning the brain. This article reviews the application of various imaging techniques to the clinical problems of TBI and PTSD. For TBI, we focus on findings and advances in neuroimaging that hold promise for better detection, characterization, and monitoring of objective brain changes in symptomatic patients with combat-related, closed-head brain injuries not readily apparent by standard computed tomography or conventional magnetic resonance imaging techniques.

Accelerated 3D echo-planar spectroscopic imaging at 4 Tesla using modified blipped phase-encoding.

Whole-brain echo-planar spectroscopic imaging (EPSI) often substantially lengthens MRI/MRSI (magnetic resonance spectroscopic imaging) protocols. To halve acquisition time, application of a blipped phase-encoding (PE) gradient during the EPSI readout (RO) was previously suggested by PE of the even RO echoes in k-space at an interstitial location along k(PE), separated from the odd RO echoes, effectively reducing the number of PEs by a factor of 2. However, the approach is very susceptible to phase inconsistencies between even and odd RO echoes in the presence of B(0) inhomogeneities and gradient imbalance, leading to ghosting in the PE direction. In this work, the blipped PE gradient is placed in between pairs of even/odd RO gradient lobes to avoid these problems. This approach is demonstrated in a phantom and in normal human brain in vivo at 4T. While the proposed method allows substantial reduction in metabolite ghosting, it may be limited by the presence of a relatively large spurious signal at the Nyquist frequency.

Improved model-based magnetic resonance spectroscopic imaging.

Model-based techniques have the potential to reduce the artifacts and improve resolution in magnetic resonance spectroscopic imaging, without sacrificing the signal-to-noise ratio. However, the current approaches have a few drawbacks that limit their performance in practical applications. Specifically, the classical schemes use less flexible image models that lead to model misfit, thus resulting in artifacts. Moreover, the performance of the current approaches is negatively affected by the magnetic field inhomogeneity and spatial mismatch between the anatomical references and spectroscopic imaging data. In this paper, we propose efficient solutions to overcome these problems. We introduce a more flexible image model that represents the signal as a linear combination of compartmental and local basis functions. The former set represents the signal variations within the compartments, while the latter captures the local perturbations resulting from lesions or segmentation errors. Since the combined set is redundant, we obtain the reconstructions using sparsity penalized optimization. To compensate for the artifacts resulting from field inhomogeneity, we estimate the field map using alternate scans and use it in the reconstruction. We model the spatial mismatch as an affine transformation, whose parameters are estimated from the spectroscopy data.

Spectral phase-corrected GRAPPA reconstruction of three-dimensional echo-planar spectroscopic imaging (3D-EPSI).

MR spectroscopic (MRS) images from a large volume of brain can be obtained using a 3D echo-planar spectroscopic imaging (3D-EPSI) sequence. However, routine applications of 3D-EPSI are still limited by a long scan time. In this communication, a new approach termed "spectral phase-corrected generalized autocalibrating partially parallel acquisitions" (SPC-GRAPPA) is introduced for the reconstruction of 3D-EPSI data to accelerate data acquisition while preserving the accuracy of quantitation of brain metabolites. In SPC-GRAPPA, voxel-by-voxel spectral phase alignment between metabolite 3D-EPSI from individual coil elements is performed in the frequency domain, utilizing the whole spectrum from interleaved water reference 3D-EPSI for robust estimation of the zero-order phase correction. The performance of SPC-GRAPPA was compared with that of fully encoded 3D-EPSI and conventional GRAPPA. Analysis of whole-brain 3D-EPSI data reconstructed by SPC-GRAPPA demonstrates that SPC-GRAPPA with an acceleration factor of 1.5 yields results very similar to those obtained by fully encoded 3D-EPSI, and is more accurate than conventional GRAPPA.

Correction of local B0 shifts in 3D EPSI of the human brain at 4 T.

High-spatial-resolution acquisition (HR) was previously proposed for 3D echo-planar spectroscopic imaging (EPSI) in combination with a high-spatial-resolution water reference EPSI data set to minimize inhomogeneous spectral line broadening, allowing for local frequency shift (B(0) shift) correction in human brain metabolite maps at 1.5 T (Ebel A et al., Magn. Reson. Imaging 21:113-120, 2003). At a higher magnetic field strength, B(0), increased field inhomogeneities typically lead to increased line broadening. Additionally, increased susceptibility variations render shimming of the main magnetic field over the whole head more difficult. This study addressed the question whether local B(0)-shift correction still helps limit line broadening in whole-brain 3D EPSI at higher magnetic fields. The combination of HR and local B(0)-shift correction to limit line broadening was evaluated at 4 T. Similar to the results at 1.5 T, the approach provided a high yield of voxels with good spectral quality for 3D EPSI, resulting in improved brain coverage.

Effects of zero-filling and apodization on spectral integrals in discrete Fourier-transform spectroscopy of noisy data.

The influence of noise on the standard deviation of spectral integrals is examined. Calculations assuming discrete Fourier-transform data are compared with Monte-Carlo simulations. The effects of zero-filling and apodization are examined for free-induction-decay (FID) signals and for symmetric spin-echo signals in one and two dimensions, with particular attention to features not previously presented in the literature. Findings suggest that for mild apodization, the known sensitivity enhancement due to zero-filling in either the real or the imaginary part signal [E. Bartholdi, R.R. Ernst, Fourier spectroscopy and the causality principle, J. Magn. Reson., 11 (1973) 9-19] is maintained; however, for stronger apodization filters, this enhancement can be obliterated completely. It is shown that results obtained by analysis of one-dimensional signals can be readily applied to multi-dimensional data. Furthermore, zero-filling has a negligible effect for symmetric spin-echo signals with implications for signal averaging in magnetic resonance imaging and spectroscopic imaging.

Achieving sufficient spectral bandwidth for volumetric 1H echo-planar spectroscopic imaging at 4 Tesla.

Complete coverage of the in vivo proton metabolite spectrum, including downfield resonances, requires a spectral bandwidth of approximately 9 ppm. Spectral bandwidth of in vivo echo-planar spectroscopic imaging (EPSI) is primarily limited by gradient strength of the oscillating readout gradient, gradient slew rate, and limits on peripheral nerve stimulation for human subjects. Furthermore, conventional EPSI reconstruction, which utilizes even and odd readout echoes separately, makes use of only half the spectral bandwidth. In order to regain full spectral bandwidth in EPSI, it has previously been suggested to apply an interlaced Fourier transform (iFT), which uses even and odd echoes simultaneously. However, this method has not been thoroughly analyzed regarding its usefulness for in vivo 3D EPSI. In this Note, limitations of the iFT method are discussed and an alternative, cyclic spectral unwrapping, is proposed, which is based on prior knowledge of typical in vivo spectral patterns.

Sensitive and fast T1 mapping based on two inversion recovery images and a reference image.

We developed a fast method to obtain T1 relaxation maps in magnetic resonance imaging (MRI) based on two inversion recovery acquisitions and a reference acquisition, while maintaining high sensitivity by utilizing the full dynamic range of the MRI signal. Optimal inversion times for estimating T1 in the human brain were predicted using standard error propagation theory. In vivo measurements on nine healthy volunteers yielded T1 values of 1094+/-18 ms in gray matter and 746+/-40 ms in white matter, in reasonable agreement with literature values using conventional approaches. The proposed method should be useful for clinical studies because the T1 maps can be obtained within a few seconds.

Detection and correction of frequency instabilities for volumetric 1H echo-planar spectroscopic imaging.

Spectral quality in 1H magnetic resonance spectroscopic imaging (MRSI) critically depends on the stability of the main magnetic field. For echo-planar MRSI implemented at 3 T, temperature variation in the passive steel shims of the magnet system can lead to a significant drift in the resonance frequency. A method is presented that incorporates interleaved measurement of the instantaneous resonance frequency of a reference water signal into a volumetric MRSI sequence and allows correction for the drift during postprocessing. Results from normal human brain at 3 T indicate that the correction largely removes lineshape distortions, recovers metabolite signal loss, and improves spectral quality by reducing the width of spectral lines; however, particularly in inferior regions, other sources of distortion may be present that cause broadening of spectral lines.

Volumetric proton spectroscopic imaging of mild traumatic brain injury.

BACKGROUND AND PURPOSE: Poor clinical outcomes without notable neuroimaging findings after mild traumatic brain injury (MTBI) suggest diffuse tissue damage and altered metabolism not observable with conventional MR imaging and CT. In this study, MTBI-associated metabolic changes were assessed over the entire brain by using volumetric proton MR spectroscopic imaging (MRSI) and the findings related to injury and outcome assessments. METHODS: Fourteen subjects with mild closed head injury (Glasgow Coma Scale [GCS] scores of 13-15) underwent structural MR imaging and proton MRSI at 1.5 T within 1 month of injury. Distributions of N-acetylaspartate (NAA), total creatine (Cr), and total choline (Cho) were mapped over a wide region of the brain, and metabolite ratios were calculated for 25 regions without MR imaging abnormalities. Results were compared with data from 13 control subjects. RESULTS: Significant changes (P <.05) were found for some, but not all, brain regions for the average values from all MTBI subjects, with reduced NAA/Cr, increased Cho/Cr, and reduced NAA/Cho. Global NAA/Cho obtained from the sum of all sampled regions in two subjects was significantly reduced. Metabolite ratios were not significantly correlated with GCS score at admission or Glasgow Outcome Scale (GOS) score at 6 months after injury, although they were weakly correlated with GOS score at discharge. CONCLUSION: These results show evidence of widespread metabolic changes following MTBI in regions that appear normal on diagnostic MR images. Although the association with injury assessment and outcome is weak, this preliminary study demonstrates the applicability of volumetric proton MRSI for evaluating diffuse injury associated with MTBI.

Improved spectral quality for 3D MR spectroscopic imaging using a high spatial resolution acquisition strategy.

Spectral quality in (1)H MR spectroscopic imaging (MRSI) of the brain is often significantly degraded in regions subject to local magnetic susceptibility variations, which results in broadened and distorted spectral lineshapes. In this report, a modified acquisition strategy for volumetric echo-planar spectroscopic imaging (3D EPSI) is presented that extends the region of the brain that can be observed. The data are sampled at higher spatial resolution, then corrected for local B(0) shifts and reconstructed such that the final spatial resolution matches that of 3D EPSI data acquired with the conventional lower spatial resolution. Comparison of in vivo data obtained at 1.5 T with these two acquisition schemes shows that the high spatial resolution acquisition provides considerable reduction of spectral linewidths in many problematic brain regions, though with a reduction in signal-to-noise ratio by a factor of approximately 1.4 to 1.6 for the matrix sizes used in this study. However, the effect of the increased noise was largely offset by the improved spectral quality, leading to an overall improvement of the metabolite image quality obtained using automated spectral analysis.

Comparison of inversion recovery preparation schemes for lipid suppression in 1H MRSI of human brain.

To reduce contamination from subcutaneous lipid regions in MR spectroscopic imaging (MRSI) of whole brain, lipid signals are often suppressed using T(1) nulling methods. If a range of lipid T(1) values is present, the suppression efficiency will be improved using multiple inversion recovery (MIR) preparation. This study compared single IR (SIR) and double IR (DIR) applied with a volumetric MRSI sequence at 1.5 T based on experimental measurement of lipid T(1) and T(2) relaxation rates. At short and medium echo times (TEs), an approximately 28-47% improvement in lipid suppression was achieved with DIR compared to SIR. However, it also led to a loss of 37-43% in signal-to-noise ratio (SNR) for metabolites. Thus, SIR appears to be the better choice for suppressing lipid signals and maintaining metabolite sensitivity.