Clinical Proton MR Spectroscopy in Central Nervous System Disorders

PurposeFull‐slice magnetic resonance spectroscopic imaging at ≥7 T is especially vulnerable to lipid contaminations arising from regions close to the skull. This contamination can be mitigated by improving the point spread function via higher spatial resolution sampling and k‐space filtering, but this prolongs scan times and reduces the signal‐to‐noise ratio (SNR) efficiency. Currently applied parallel imaging methods accelerate magnetic resonance spectroscopic imaging scans at 7T, but increase lipid artifacts and lower SNR‐efficiency further. In this study, we propose an SNR‐efficient spatial‐spectral sampling scheme using concentric circle echo planar trajectories (CONCEPT), which was adapted to intrinsically acquire a Hamming‐weighted k‐space, thus termed density‐weighted‐CONCEPT. This minimizes voxel bleeding, while preserving an optimal SNR.Theory and MethodsTrajectories were theoretically derived and verified in phantoms as well as in the human brain via measurements of five volunteers (single‐slice, field‐of‐view 220 × 220 mm2, matrix 64 × 64, scan time 6 min) with free induction decay magnetic resonance spectroscopic imaging. Density‐weighted‐CONCEPT was compared to (a) the originally proposed CONCEPT with equidistant circles (here termed e‐CONCEPT), (b) elliptical phase‐encoding, and (c) 5‐fold Controlled Aliasing In Parallel Imaging Results IN Higher Acceleration accelerated elliptical phase‐encoding.ResultsBy intrinsically sampling a Hamming‐weighted k‐space, density‐weighted‐CONCEPT removed Gibbs‐ringing artifacts and had in vivo +9.5%, +24.4%, and +39.7% higher SNR than e‐CONCEPT, elliptical phase‐encoding, and the Controlled Aliasing In Parallel Imaging Results IN Higher Acceleration accelerated elliptical phase‐encoding (all P < 0.05), respectively, which lead to improved metabolic maps.ConclusionDensity‐weighted‐CONCEPT provides clinically attractive full‐slice high‐resolution magnetic resonance spectroscopic imaging with optimal SNR at 7T. Magn Reson Med 79:2874–2885, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

PurposePoorly characterized macromolecular (MM) and baseline artefacts are known to reduce metabolite quantitation accuracy in 1H MR spectroscopic imaging (MRSI). Increasing echo time (TE) and improvements in MM analysis schemes have both been proposed as strategies to improve metabolite measurement reliability. In this study, the influence of TE and two MM analysis schemes on MRSI reproducibility are investigated.MethodsAn experimentally acquired baseline was collected using an inversion recovery sequence (TI = 750 ms) and incorporated into the analysis method. Intrasubject reproducibility of MRSI scans, acquired at 3 Tesla, was assessed using metabolite coefficients of variance (COVs) for both experimentally acquired and simulated MM analysis schemes. In addition, the reproducibility of TE = 35 ms, 80 ms, and 144 ms was evaluated.ResultsTE = 80 ms was the most reproducible for singlet metabolites with COVs < 6% for total N‐acetyl‐aspartate, total creatine, and total choline; however, moderate multiplet dephasing was observed. Analysis incorporating the experimental baseline achieved higher Glu and Glx reproducibility at TE = 35 ms, and showed improvements over the simulated baseline, with higher efficacy for poorer data.ConclusionOverall, TE = 80 ms yielded the most reproducible singlet metabolite estimates. However, combined use of a short TE sequence and the experimental baseline may be preferred as a compromise between accuracy, multiplet dephasing, and T2 bias on metabolite estimates. Magn Reson Med 77:34–43, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

Patients with myotonic dystrophy type 1 (DM1) (n = 14) were compared with healthy controls (n = 13) using 3.0 T proton magnetic resonance spectroscopy (¹H-MRS) to investigate brain pathophysiology. ¹H-MRS imaging revealed reduced N-acetylaspartate to creatine ratio (NAA/Cr) in multiple brain regions (average 24%), suggesting diffuse brain abnormalities among patients with DM1. Single-voxel ¹H-MRS among patients with DM1 showed (1) reduced NAA in both the frontal cortex (23%) and frontal white matter (31%) and unaltered myo-inositol, suggesting neuronal abnormalities without significant gliosis; and (2) elevated glutamine in the frontal cortex (36%) and reduced glutamate in the frontal white matter (20%) among patients with DM1, suggesting abnormalities in the glutamatergic system in the brain of patients with DM1. We consider that these results reflect brain abnormalities that cannot be detected by neuropathological assessment in patients with DM1.