Simultaneous imaging of radiation-induced cerebral microbleeds, arteries and veins, using a multiple gradient echo sequence at 7 Tesla

J Magn Reson Imaging. 2015 Aug;42(2):269-79. doi: 10.1002/jmri.24802. Epub 2014 Dec 4.

Abstract

Background: The purpose of this study was to implement and evaluate the utility of a multi-echo sequence at 7 Tesla (T) for simultaneous time-of-flight (TOF) MR-angiography (MRA) and susceptibility-weighted imaging (SWI) of radiation-induced cerebral microbleeds (CMBs), intracranial arteries, and veins.

Methods: A four-echo gradient-echo sequence was implemented on a 7T scanner. The first echo was used to create TOF-MRA images, while the remaining echoes were combined to visualize CMBs and veins on SWI images. The sequence was evaluated on eight brain tumor patients with known radiation-induced CMBs. Single-echo images were also acquired to visually and quantitatively compare the contrast-to-noise ratio (CNR) of small- and intermediate-vessels between acquisitions. The number of CMBs detected with each acquisition was also quantified. Statistical significance was determined using a Wilcoxon signed-rank test.

Results: Compared with the single-echo sequences, the CNR of small and intermediate arteries increased 7.6% (P < 0.03) and 9.5% (P = 0.06), respectively, while the CNR of small and intermediate veins were not statistically different between sequences (P = 0.95 and P = 0.46, respectively). However, these differences were not discernible by visual inspection. Also the multi-echo sequence detected 18.3% more CMBs (P < 0.008) due to higher slice resolution.

Conclusion: The proposed 7T multi-echo sequence depicts arteries, veins, and CMBs on a single image to facilitate quantitative evaluation of radiation-induced vascular injury.

Keywords: 7T; SWI; TOF-MRA; microbleeds; multi-echo; radiation effects.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Injuries / etiology
  • Brain Injuries / pathology
  • Cerebral Arteries / pathology*
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / pathology*
  • Cerebral Veins / pathology*
  • Echo-Planar Imaging / methods
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods
  • Magnetic Resonance Angiography / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Radiation Injuries / etiology
  • Radiation Injuries / pathology*
  • Radiotherapy, Conformal / adverse effects
  • Reproducibility of Results
  • Sensitivity and Specificity