Yuan Le1, Kevin Glaser2, Matthew Murphy2, Yuxiang Zhou3, Jun Chen2, William Pavlicek1, Joseph M. Hoxworth3, Bradley D. Bolster Jr.4, John Huston III.2, Joel P. Felmlee2, and Richard L. Ehman2
1Radiology, Mayo Clinic Arizona, Scottsdale, AZ, United States, 2Radiology, Mayo Clinic, Rochester, MN, United States, 3Radiology, Mayo Clinic Arizona, Phoenix, AZ, United States, 4Siemens Medical Solutions USA, Inc., Salt Lake City, UT, United States
Synopsis
A spin-echo EPI MR Elastography sequence was optimized
so that multiple motion encoding gradient (MEG) cycles can be added to increase
the motion sensitivity. Volunteer tests showed that comparing with the original
one MEG version, optimized two or three MEG cycles provided higher Octahedral
Shear Strain Signal-to-Noise Ratio (OSS-SNR), which means higher stiffness
measurement precision. Global brain Images acquired with 2 and 3 MEG cycles are
in most cases comparable in stiffness and OSS-SNR while images with 1 MEG tend
to have a slightly lower OSS-SNR.
Introduction
Given the fact that brain
cannot be easily palpated, there is a great interest in studying the brain
mechanical properties using MR Elastography (MRE)1 in diseases such as Alzheimer’s, concussion/chronic
traumatic encephalopathy, Parkinson’s disease, meningioma, intracranial
pressure 1-5. The motion encoding
gradients (MEG) in MRE are designed to be sensitive to periodic motion. An
increase of MEG cycle numbers increases the motion sensitivity which enables
the use of lower motion amplitude and less patient discomfort. On the other
hand, the increase of MEG cycles requires longer TE, which decreases the signal
level and in turn has an impact on the motion detection. The purpose of this study is to develop
a modified spin-echo EPI MRE so that the number of MEG cycles can be optimized
for brain MRE applications. Materials and Methods
Figure 1 shows the spin-echo-EPI
MRE pulse sequence with three MEG cycles (2 MEG cycles before the 180o
refocusing RF pulse and 1 after the refocusing RF). There was a gap with the
length of half the MEG cycle in between (where we have the refocusing RF). Four
healthy volunteers were imaged for this study after obtained written informed
consent. All images were acquired on a clinical 3T MRI scanner (Prisma, Siemens
Healthineers, Erlangen, Germany) with a 20 channel head coil. The MRE driver setting was the same as in
previous studies3, 6.
The scan parameters were:
·
With 1 MEG: TR/TE=4800/46 ms;
·
With 2 MEG: TR/TE=4800/58 ms;
·
With 3 MEG: TR/TE=6400/87 ms.
For all images FOV=240 mm, matrix
size=72x72, bandwidth=1984 Hz/pixel. The frequency of the motion was 60 Hz. GRAPPA
factor=3. Slice thickness=3mm. 3D motion encoding was applied.
The stiffness and the
octahedral shear strain-based measure of SNR7 was estimated and
compared.Results
Figure 2 shows the magnitude image, stiffness
map, and the OSS-SNR maps of the center slice from one of the volunteers. With
the increase TE, and the magnitude image became more T2 weighted (the signal
magnitude decreased) and showed more distortion and susceptibility artifact. On
the other hand, the motion sensitivity increased and the stiffness map looked
better defined. The OSS-SNR maps showed a larger region of high OSS-SNR in the
image slice with more MEG cycles. Interestingly the OSS-SNR decreased in the
high OSS-SNR area when the MEG cycles increased from 2 to 3. Figure 3 shows that
the median stiffness measured with all three settings were very close. Figure 4
shows that the OSS-SNR values of the 2 MEG and 3 MEG images were very close, and
usually higher in 2 MEG images except in volunteer 2. Table 1 listed the
average OSS-SNR in these volunteers and also demonstrated that the OSS-SNR was
usually the highest with 2 MEG except in volunteer 2.Discussions
The images with 2 MEG cycles had a higher
average OSS-SNR than those with 1 or 3 MEG cycles in 3 of 4 volunteers,
indicating that under current brain MRE settings this combination (2 MEG cycles
and a TE of 58 ms) provided a better balance in motion sensitivity and image
signal amplitude. It was interesting that with 3 MEG cycles while in the center
of the brain the OSS-SNR increased in some regions, the OSS-SNR at the edge of
the brain, where the OSS-SNR was already relatively high with 1 or 2 MEGs,
actually decreased. We considered this as an indication that with more MEG
cycles and higher motion sensitivity, more phase wrapping in the phase images
happened in those regions, which in turn required more complicated phase
unwrapping algorithm and causes more error. Another factor that lowers the OSS-SNR is the signal intensity in the magnitude images decreased with the increased TE with 3 MEG cycles.Conclusions
The modified spin-echo EPI MR Elastography
technique provided more flexibility in prescribing the sequence based on the
need of the clinical application. Our results indicated that with the current
MRE settings 2 MEG cycles may provide the best motion sensitivity. On the other
hand, with 3 MEG cycles the longer TE provides images with more T2 effect.
Therefore if a T2 weighted magnitude image is desirable 3 MEG cycles may be a
better choice to get such images without sacrificing the motion sensitivity. Acknowledgements
No acknowledgement found.References
1. Litwiller,
D.V., et al., Magnetic Resonance
Elastography. Curr Med Imaging Rev, 2012. (8)(1): p. 46-55.
2. Murphy, M.C., et al., Measuring the characteristic topography of
brain stiffness with magnetic resonance elastography. PLoS One, 2013.
(8)(12): p. e81668.
3. Olivero, W.C., et al., Magnetic Resonance Elastography
Demonstrating Low Brain Stiffness in a Patient with Low-Pressure Hydrocephalus:
Case Report. Pediatr Neurosurg, 2016. (51)(5): p. 257-62.
4. Riek, K., et al., Magnetic resonance elastography reveals
altered brain viscoelasticity in experimental autoimmune encephalomyelitis.
Neuroimage Clin, 2012. (1)(1): p. 81-90.
5. Schregel, K., et al., Demyelination reduces brain parenchymal
stiffness quantified in vivo by magnetic resonance elastography. Proc Natl
Acad Sci U S A, 2012. (109)(17): p. 6650-5.
6. Arani, A., et al., Measuring the effects of aging and sex on
regional brain stiffness with MR elastography in healthy older adults.
Neuroimage, 2015. (111): p. 59-64.
7. McGarry, M.D., et al., An octahedral shear strain-based measure of
SNR for 3D MR elastography. Phys Med Biol, 2011. (56)(13): p. N153-64.