New Clinically Feasible 3T MRI Protocol to Discriminate Internal Brain Stem Anatomy

Fellows’ Journal Club

Track density imaging (TDI) is a novel MR imaging postprocessing technique based on high angular-resolution diffusion acquisitions that generate super-resolution images derived by whole-brain probabilistic streamline tractography. TDI and echo modulation curve T2 mapping were combined with simultaneous multisection acquisition to reveal anatomic detail at 7 canonical levels of the brain stem. Compared with conventional MR imaging contrasts, many individual brain stem tracts and nuclear groups were directly visualized for the first time at 3T.

Summary

Rostral midbrain. Upper row: A, Proton-density weighted. B, T2-weighted. C, DEC-DTI. D, Anatomic schematic. Bottom row: E, EMC PD map. F, EMC T2 map. G, stDEC-TDI. H, stTDI. The lower row novel contrast images better depict brain stem anatomy compared with the upper row conventional images. Notice the appreciable difference in the EMC T2 value between the red nuclei (31) and the substantia nigra (32) compared with that of the standard multi-spin-echo T2 image. The stDEC-TDI map shows the oculomotor nuclear complex (33) in green and the MLF (34) in light blue, whereas the DEC-DTI map in this region shows a uniform green.
Rostral midbrain. Upper row: A, Proton-density weighted. B, T2-weighted. C, DEC-DTI. D, Anatomic schematic. Bottom row: E, EMC PD map. F, EMC T2 map. G, stDEC-TDI. H, stTDI. The lower row novel contrast images better depict brain stem anatomy compared with the upper row conventional images. Notice the appreciable difference in the EMC T2 value between the red nuclei (31) and the substantia nigra (32) compared with that of the standard multi-spin-echo T2 image. The stDEC-TDI map shows the oculomotor nuclear complex (33) in green and the MLF (34) in light blue, whereas the DEC-DTI map in this region shows a uniform green.

Two new 3T MR imaging contrast methods, track density imaging and echo modulation curve T2 mapping, were combined with simultaneous multisection acquisition to reveal exquisite anatomic detail at 7 canonical levels of the brain stem. Compared with conventional MR imaging contrasts, many individual brain stem tracts and nuclear groups were directly visualized for the first time at 3T. This new approach is clinically practical and feasible (total scan time = 20 minutes), allowing better brain stem anatomic localization and characterization.

 

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New Clinically Feasible 3T MRI Protocol to Discriminate Internal Brain Stem Anatomy
Jeffrey Ross
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