The demand for higher diagnostic specificity has led to the increased use of "foreign" agents to increase tissue contrast and/or spectroscopic sensitivity in NMR studies. The primary agents used to enhance tissue contrast in NMR imaging are paramagnetic. They cause a decrease in the proton T1 of H2O leading to enhanced signal intensity. This effect depends on the large gyromagnetic ratio of the electron, the number of unpaired electrons, the concentration of paramagnetic ions, the number of coordinated water molecules, and the rate of exchange of water.
An alcoholic, hyponatremic woman developed central pontine myelinolysis (CPM) and improved from a decerebrate, comatose state to alertness and full ambulation. NMR, using inversion-recovery and spin-echo pulse sequences, was performed sequentially from 4 weeks to 8 months after onset of symptoms and revealed a well-defined lesion with prolonged relaxation times. The lesion was anatomically consistent with CPM and was initially also visualized by CT.
Magnetic resonance (MR) imaging has been shown to have greater sensitivity than X-ray CT in a broad range of intracranial pathologic processes. In regions in which CT is likely to suffer degradation of image quality due to a variety of bone artifacts, the advantages of MR are even more striking. Previous reports have emphasized the relative advantages of MR in studies of the posterior fossa. The present report documents the potential for similar advantages of MR in demonstration of middle fossa anatomy and in identification and characterization of temporal lobe lesions.
Twenty-one intracranial hemorrhagic lesions were imaged at 0.15 and 0.6 T using inversion recovery (IR), spin echo (SE), and multiple SE (Carr-Purcell-Meiboom-Gill, CPMG) pulse sequences. Two subarachnoid hemorrhages (SAH), nine acute intraparenchymal hemorrhages (IPH), ten chronic IPH, and one subdural hematoma were studied. Acute SAH could not be identified on the T1-weighted, IR images but was clearly seen on a T2-weighted, CPMG image. Acute (7 days or less) intraparenchymal hematoma showed signal intensity on IR and CPMG images similar to white matter.
The application of selective saturation (or solvent suppression) techniques in nuclear magnetic resonance (NMR) imaging offers the opportunity to significantly expand the range of NMR studies. Data acquired at 1.44 T are presented using a two-dimensional spin-echo sequence preceded by a selective (saturating) radiofrequency pulse. Individual water or lipid proton resonances were eliminated (greater than 90% reduction in signal intensity) resulting in images of H2O or -CH2- distribution with resolution and imaging time equivalent to conventional proton images.
Fluorinated anesthetics such as halothane preferentially partition into hydrophobic environments such as cell membranes. The 19F-NMR spectrum of halothane in a rat adenocarcinoma (with known altered lipid metabolism and membrane composition) shows an altered chemical shift pattern compared to the anesthetic in normal tissue. In eight tumor samples examined, the 19F-NMR spectra exhibit two distinct resonances, compared to a single resonance observed in normal tissues.
The proteins bovine serum albumin (BSA) and bovine immunoglobulin (IgG) have been labeled with paramagnetic gadolinium (III) and manganese (II) complexes using the bifunctional chelate approach. Diethylenetriaminepentaacetic acid (DTPA) and ethylenediaminetetraacetic acid (EDTA) were attached to several free amino groups on the proteins using cyclic anhydride forms of these ligands. The incorporation of the metal ions Gd+3 and Mn+2 into the chelating groups yielded highly paramagnetic proteins.
In vitro and in vivo 19F spectra and images were obtained using various clinically safe fluorinated compounds. Standard and chemical shift images were acquired in solutions of fluorinated anesthetics with the chemical shift images clearly separating signals arising from a mixture of halothane and methoxyflurane. The 19F images of halothane in rats were unsuccessful at anesthetic concentration. In vivo 19F nuclear magnetic resonance (NMR) images were acquired at 57.9 MHz in rats receiving chronic injections of 14% perfluorodecalin, 6% perfluorotripropylamine (Fluosol-DA).
The potential laboratory and clinical utility of proton chemical shift imaging (PCSI) was evaluated by studying fatty liver change in rats, which offered a simple animal model for tissue lipid buildup. There was excellent correlation between lipid group signal intensities from in vivo PCSI studies and liver triglyceride levels obtained from in vitro measurements (R = 0.97). The in vivo T1 relaxation time measurements in fatty liver tissue demonstrated two distinct populations of nonexchanging protons.
Magnetic resonance (MR) imaging has created considerable excitement in the medical community, largely because of its great potential to diagnose and characterize many different disease processes. However, it is becoming increasingly evident that, because MR imaging is similar to computed tomography (CT) scanning in identifying structural disorders and because it is more costly and difficult to use, this highly useful technique must be judged against CT before it can become an accepted investigative tool.
