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ECR 2003 / C-1077
High-resolution venographic BOLD imaging of the human brain
Congress:
ECR 2003
Poster Number:
C-1077
Type:
Scientific
Keywords:
Authors:
J. R. Reichenbach
1
, C. Fitzek
2
, D. Sauner
2
, H.-J. Mentzel
1
, W. A. Kaiser
1
;
1
Jena/DE,
2
DE
DOI:
10.1594/ECR03/C-1077
DOI-Link:
https://dx.doi.org/10.1594/ECR03/C-1077
Fig. 1:
Figure 2. Projection image over 9 mm of the venous vasculature in the central...
Fig. 2:
Figure 3. Visualization of cortical veins derived from BOLD venographic...
Fig. 3:
Figure 4. (a) Venogram of a 18-year-old female patient with a developmental...
Fig. 4:
Figure 4. (b) Contrast-enhanced ToF MR angiography.
Fig. 5:
Figure 5. (a) The high-resolution 3D BOLD venography (TR/TE/FA=67/40/25, FoV...
Fig. 6:
Figure 5. (b) With the single-shot EPI sequence (TE/FA=52/90, FoV=128 mm,...
Fig. 7:
Figure 6. Developmental venous anomaly. (a) FLAIR-image. (b) T2w image. (c) T1w...
Fig. 8:
Figure 7. MS patient. (a) Axial T2w image (7000/112/2) and (b)...
Fig. 9:
Figure 8. Patient with glioblastoma multiforme. (a) T1w TSE image after...
Fig. 10:
Figure 9. 67-year-old male patient with small cell carcinoma of the lung and...
Fig. 11:
Figure 10. 44-year-old male patient with a histologically confirmed...
Results
The following images are intended to illustrate the potential of the technique. The images are also representative of the highly detailed venous vascular information that can be obtained with BOLD venography in clinical applications. The findings suggest that the smallest vessels visible on the images have a diameter of about 100-200 m, as has been inferred from comparison with radiographic atlases.
Figure 2 shows a typical venogram of a volunteer, which was processed by using the phase mask prior to the mIP operation. The image demonstrates exquisite detail for small deep white matter veins and cortical veins in the brain.
Figure 3 shows the result of visualizing cortical veins derived from BOLD venographic imaging followed by multi-scale vessel enhancement. Figures 4-10 illustrate some clinical cases, such as venous anomalies, multiple cavernomas, brain metastases or brain tumors.
Figure 4a shows a case of a 18-year-old female patient with a developmental venous anomaly (DVA) located in the right fronto-temporal lobe. Compared to conventional T1-weighted spin echo images on which the lesion was seen after application of a contrast agent (image not shown), the DVA was well delineated on the unenhanced venogram. A contrast-enhanced ToF MR angiography revealed also the DVA, however, not as clearly as the BOLD venography (
Figure 4b).
Figure 5 shows a case of a 66-year-old male patient with multiple cavernoma. Running the high-resolution 3D BOLD venographic sequence resulted in images with highly improved detail recognizability and better margin definition (
Figure 5a) compared to a single-shot EPI sequence (
Figure 5b).
Figure 6 shows the case of a 48-year old woman with an 12-year history of remitting-relapsing multiple sclerosis and a contrast-media-enhancing vessel in the pons in the vicinity of a multiple sclerosis plaque. The vessel was suspected to be a DVA. High-resolution BOLD MR-venography visualized the typical morphology of a DVA and hence could clarify the benign nature of the finding.
Figure 7 shows the case of a MS patient. The BOLD venogram clearly shows the curve shape of a vein which is running along the center of the MS plaque.
Figure 8 shows a patient with a glioblastoma multiforme. The T1w TSE image after contrast medium reveals a diffuse enhancement without a clear delineation of intralesional tumor vessels, whereas the T2w FLAIR highlights the surrounding brain edema of the tumorous area (Figures 8a and b). With the BOLD venography (Figures 8c and d) large peripheral venous vessels are clearly seen whose locations coincide with bright structures on the T1w image in Figure 8a. The dark structures within the tumor are most likely veins and the slightly more hypodense region may represent the locally increased microvascularity of the tumor. The adjacent slice reveals further details of the tumor which are neither seen on the T1w image nor on the FLAIR image. The slightly hyperdense central region within the tumor may be necrotic tissue, whereas the more hypodense surrounding regions may again represent highly vascularized tumor tissue. The perilesional edema is also clearly seen.
Figure 9 shows the case of a 67-year-old man with small cell carcinoma of the lung and cerebral metastasis. The BOLD venography (Figure 9d) delineates small vessels which are visible within the lesion as well as at the circumference of the metastasis. Of note is that the vessel representation corresponds closely to the enhancement pattern seen in the contrast-enhanced high-resolution 3D T1w gradient-echo data set (Figure 9c).
Figure 10 shows the case of a 44-year-old male patient with a histologically proven glioblastoma grade IV. The patient was examined at two different field strengths of 1.5 T and 3 T, respectively. The post-contrast 3 T IR-RARE (Figure 10a) and 3 T MP-RAGE (Figure 10b) images show a multifocal lesion with enhancing smaller solid components and one larger lesion with rim enhancement. On the contrast-enhanced BOLD venographic images at 1.5 T (c) and 3 T (d) several different features can be distinguished: hyperintense regions containing dark tubular structures, tubular structures surrounding the tumor, regions with rim enhancement surrounding isointense central regions and a prominent hypointense inhomogeneous region in one part of the tumor. Note that the larger portion of the tumor shows no susceptibility effect in its central low enhancing component.
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