Magnetic Resonance Imaging (MRI) to Study Striatal Iron Accumulation in a Rat Model of Parkinson’s Disease

Abnormal accumulation of iron is observed in neurodegenerative disorders. In Parkinson’s disease, an excess of iron has been demonstrated in different structures of the basal ganglia and is suggested to be involved in the pathogenesis of the disease. Using the 6-hydroxydopamine (6-OHDA) rat model of Parkinson’s disease, the edematous effect of 6-OHDA and its relation with striatal iron accumulation was examined utilizing in vivo magnetic resonance imaging (MRI). The results revealed that in comparison with control animals, injection of 6-OHDA into the rat striatum provoked an edematous process, visible in T2-weighted images that was accompanied by an accumulation of iron clearly detectable in T2*-weighted images. Furthermore, Prussian blue staining to detect iron in sectioned brains confirmed the existence of accumulated iron in the areas of T2* hypointensities. The presence of ED1-positive microglia in the lesioned striatum overlapped with this accumulation of iron, indicating areas of toxicity and loss of dopamine nerve fibers. Correlation analyses demonstrated a direct relation between the hyperintensities caused by the edema and the hypointensities caused by the accumulation of iron.     

BIPHASIC MYELINATION AND THE FATTY ACID COMPOSITION OF CEREBROSIDES AND CHOLESTEROL ESTERS IN THE DEVELOPING CENTRAL NERVOUS SYSTEM OF THE DOMESTIC PIG

Abstract— The chemical composition of four parts of the CNS (cerebrum, cerebellum, brain stem and spinal cord) was determined in 107 pigs at 11 stages of fetal and postnatal development and also in 6 adults. In cerebrum, cerebellum and brain stem, but not in spinal cord, the rate of increase in weight and the rates of change in lipid content slowed down for a period of about 10 days before and after birth. Cholesterol esters and desmosterol were only found in progressively decreasing amounts during the fetal stages of development and together with DNA these were exceptions to the general increases in the tissue concentrations and total amounts of other components during the period studied.
The onset of myelination, as measured by calculated daily increases in tissue contents of cerebroside took place between 70 and 80 days conceptual age and there were two peaks of activity, the first occurring 2 weeks before and the second 3 weeks after birth. Unlike the rate curve for total spinal cord weight the biphasic accumulation of DNA was not synchronous with myelin lipid accretion and the earlier prenatal DNA peak probably denotes proliferation of oligodendrocytes. The two phases of myelination are discussed in relation to an observed generalized pause in development immediately before and after birth.
Fatty acid analysis of cerebrosides indicated that, in spinal cord, chain elongation and desaturation are associated with myelination and continue with increasing activity until maturity. Consequently there was a progressive decrease in the proportion of saturated fatty acids. The fatty acid components of cholesterol esters in the developing pig were shown to be similar to those found during development in the CNS of other species but different from those found in demyelinating conditions.     

Development of Bifunctional Gadolinium-Labeled Superparamagnetic Nanoparticles (Gd-MnMEIO) for In Vivo MR Imaging of the Liver in an Animal Model

Liver tumors are common and imaging methods, particularly magnetic resonance imaging (MRI), play an important role in their non-invasive diagnosis. Previous studies have shown that detection of liver tumors can be improved by injection of two different MR contrast agents. Here, we developed a new contrast agent, Gd-manganese-doped magnetism-engineered iron oxide (Gd-MnMEIO), with enhancement effects on both T1- and T2-weighted MR images of the liver. A 3.0T clinical MR scanner equipped with transmit/receiver coil for mouse was used to obtain both T1-weighted spoiled gradient-echo and T2-weighted fast spin-echo axial images of the liver before and after intravenous contrast agent injection into Balb/c mice with and without tumors. After pre-contrast scanning, six mice per group were intravenously injected with 0.1 mmol/kg Gd-MnMEIO, or the control agents, i.e., Gd-DTPA or SPIO. The scanning time points for T1-weighted images were 0.5, 5, 10, 15, 20, 25, and 30 min after contrast administration. The post-enhanced T2-weighted images were then acquired immediately after T1-weighted acquisition. We found that T1-weighted images were positively enhanced by both Gd-DTPA and Gd-MnMEIO and negatively enhanced by SPIO. The enhancement by both Gd-DTPA and Gd-MnMEIO peaked at 0.5 min and gradually declined thereafter. Gd-MnMEIO (like Gd-DTPA) enhanced T1-weighted images and (like SPIO) T2-weighted images. Marked vascular enhancement was clearly visible on dynamic T1-weighted images with Gd-MnMEIO. In addition, the T2 signal was significantly decreased at 30 min after administration of Gd-MnMEIO. Whereas the effects of Gd-MnMEIO and SPIO on T2-weighted images were similar (p = 0.5824), those of Gd-MnMEIO and Gd-DTPA differed, with Gd-MnMEIO having a significant T2 contrast effect (p = 0.0086). Our study confirms the feasibility of synthesizing an MR contrast agent with both T1 and T2 shortening effects and using such an agent in vivo. This agent enables tumor detection and characterization in single liver MRI sections.     

Compression-induced deep tissue injury examined with magnetic resonance imaging and histology.

The underlying mechanisms leading to deep tissue injury after sustained compressive loading are not well understood. It is hypothesized that initial damage to muscle fibers is induced mechanically by local excessive deformation. Therefore, in this study, an animal model was used to study early damage after compressive loading to elucidate on the damage mechanisms leading to deep pressure ulcers. The tibialis anterior of Brown-Norway rats was loaded for 2 h by means of an indenter. Experiments were performed in a magnetic resonance (MR)-compatible loading device. Muscle tissue was evaluated with transverse relaxation time (T2)-weighted MRI both during loading and up to 20 h after load removal. In addition, a detailed examination of the histopathology was performed at several time points (1, 4, and 20 h) after unloading. Results demonstrated that, immediately after unloading, T2-weighted MR images showed localized areas with increased signal intensity. Histological examination at 1 and 4 h after unloading showed large necrotic regions with complete disorganization of the internal structure of the muscle fibers. Hypercontraction zones were found bilateral to the necrotic zone. Twenty hours after unloading, an extensive inflammatory response was observed. The proposed relevance of large deformation was demonstrated by the location of damage indicated by T2-weighted MRI and the histological appearance of the compressed tissues. Differences in damage development distal and proximal to the indenter position suggested a contribution of perfusion status in the measured tissue changes that, however, appeared be to reversible.     

T1-weighted and T2-weighted MRI image synthesis with convolutional generative adversarial networks

BackgroundThe objective of this study was to propose an optimal input image quality for a conditional generative adversarial network (GAN) in T1-weighted and T2-weighted magnetic resonance imaging (MRI) images.Materials and methodsA total of 2,024 images scanned from 2017 to 2018 in 104 patients were used. The prediction framework of T1-weighted to T2-weighted MRI images and T2-weighted to T1-weighted MRI images were created with GAN. Two image sizes (512 × 512 and 256 × 256) and two grayscale level conversion method (simple and adaptive) were used for the input images. The images were converted from 16-bit to 8-bit by dividing with 256 levels in a simple conversion method. For the adaptive conversion method, the unused levels were eliminated in 16-bit images, which were converted to 8-bit images by dividing with the value obtained after dividing the maximum pixel value with 256.ResultsThe relative mean absolute error (rMAE ) was 0.15 for T1-weighted to T2-weighted MRI images and 0.17 for T2-weighted to T1-weighted MRI images with an adaptive conversion method, which was the smallest. Moreover, the adaptive conversion method has a smallest mean square error (rMSE) and root mean square error (rRMSE), and the largest peak signal-to-noise ratio (PSNR) and mutual information (MI). The computation time depended on the image size.ConclusionsInput resolution and image size affect the accuracy of prediction. The proposed model and approach of prediction framework can help improve the versatility and quality of multi-contrast MRI tests without the need for prolonged examinations.     

Texture Analysis of T2-Weighted MR Images to Assess Acute Inflammation in Brain MS Lesions

Brain blood barrier breakdown as assessed by contrast-enhanced (CE) T1-weighted MR imaging is currently the standard radiological marker of inflammatory activity in multiple sclerosis (MS) patients. Our objective was to evaluate the performance of an alternative model assessing the inflammatory activity of MS lesions by texture analysis of T2-weighted MR images. Twenty-one patients with definite MS were examined on the same 3.0T MR system by T2-weighted, FLAIR, diffusion-weighted and CE-T1 sequences. Lesions and mirrored contralateral areas within the normal appearing white matter (NAWM) were characterized by texture parameters computed from the gray level co-occurrence and run length matrices, and by the apparent diffusion coefficient (ADC). Statistical differences between MS lesions and NAWM were analyzed. ROC analysis and leave-one-out cross-validation were performed to evaluate the performance of individual parameters, and multi-parametric models using linear discriminant analysis (LDA), partial least squares (PLS) and logistic regression (LR) in the identification of CE lesions. ADC and all but one texture parameter were significantly different within white matter lesions compared to within NAWM (p < 0.0167). Using LDA, an 8-texture parameter model identified CE lesions with a sensitivity Se = 70% and a specificity Sp = 76%. Using LR, a 10-texture parameter model performed better with Se = 86% / Sp = 84%. Using PLS, a 6-texture parameter model achieved the highest accuracy with Se = 88% / Sp = 81%. Texture parameter from T2-weighted images can assess brain inflammatory activity with sufficient accuracy to be considered as a potential alternative to enhancement on CE T1-weighted images.     

MR Imaging Features of Gadofluorine-Labeled Matrix-Associated Stem Cell Implants in Cartilage Defects

Objectives

The purpose of our study was to assess the chondrogenic potential and the MR signal effects of GadofluorineM-Cy labeled matrix associated stem cell implants (MASI) in pig knee specimen.

Materials and Methods

Human mesenchymal stem cells (hMSCs) were labeled with the micelle-based contrast agent GadofluorineM-Cy. Ferucarbotran-labeled hMSCs, non-labeled hMSCs and scaffold only served as controls. Chondrogenic differentiation was induced and gene expression and histologic evaluation were performed. The proportions of spindle-shaped vs. round cells of chondrogenic pellets were compared between experimental groups using the Fisher''s exact test. Labeled and unlabeled hMSCs and chondrocytes in scaffolds were implanted into cartilage defects of porcine femoral condyles and underwent MR imaging with T1- and T2-weighted SE and GE sequences. Contrast-to-noise ratios (CNR) between implants and adjacent cartilage were determined and analyzed for significant differences between different experimental groups using the Kruskal-Wallis test. Significance was assigned for p<0.017, considering a Bonferroni correction for multiple comparisons.

Results

Collagen type II gene expression levels were not significantly different between different groups (p>0.017). However, hMSC differentiation into chondrocytes was superior for unlabeled and GadofluorineM-Cy-labeled cells compared with Ferucarbotran-labeled cells, as evidenced by a significantly higher proportion of spindle cells in chondrogenic pellets (p<0.05). GadofluorineM-Cy-labeled hMSCs and chondrocytes showed a positive signal effect on T1-weighted images and a negative signal effect on T2-weighted images while Ferucarbotran-labeled cells provided a negative signal effect on all sequences. CNR data for both GadofluorineM-Cy-labeled and Ferucarbotran-labeled hMSCs were significantly different compared to unlabeled control cells on T1-weighted SE and T2*-weighted MR images (p<0.017).

Conclusion

hMSCs can be labeled by simple incubation with GadofluorineM-Cy. The labeled cells provide significant MR signal effects and less impaired chondrogenesis compared to Ferucarbotran-labeled hMSCs. Thus, GadoflurineM-Cy might represent an alternative MR cell marker to Ferucarbotran, which is not distributed any more in Europe or North America.     

T1-Weighted Sodium MRI of the Articulator Cartilage in Osteoarthritis: A Cross Sectional and Longitudinal Study

Structural magnetic resonance imaging (MRI) has shown great utility in diagnosing soft tissue burden in osteoarthritis (OA), though MRI measures of cartilage integrity have proven more elusive. Sodium MRI can reflect the proteoglycan content of cartilage; however, it requires specialized hardware, acquisition sequences, and long imaging times. This study was designed to assess the potential of a clinically feasible sodium MRI acquisition to detect differences in the knee cartilage of subjects with OA versus healthy controls (HC), and to determine whether longitudinal changes in sodium content are observed at 3 and 6 months. 28 subjects with primary knee OA and 19 HC subjects age and gender matched were enrolled in this ethically-approved study. At baseline, 3 and 6 months subjects underwent structural MRI and a 0.4ms echo time 3D T1-weighted sodium scan as well as the knee injury and osteoarthritis outcome score (KOOS) and knee pain by visual analogue score (VAS). A standing radiograph of the knee was taken for Kellgren-Lawrence (K-L) scoring. A blinded reader outlined the cartilage on the structural images which was used to determine median T1-weighted sodium concentrations in each region of interest on the co-registered sodium scans. VAS, K-L, and KOOS all significantly separated the OA and HC groups. OA subjects had higher T1-weighted sodium concentrations, most strongly observed in the lateral tibial, lateral femoral and medial patella ROIs. There were no significant changes in cartilage volume or sodium concentration over 6 months. This study has shown that a clinically-feasible sodium MRI at a moderate 3T field strength and imaging time with fluid attenuation by T1 weighting significantly separated HCs from OA subjects.     

Corticospinal tract-sparing intensity-modulated radiotherapy treatment planning

Aim

To establish intensity-modulated radiotherapy (IMRT) planning procedures that spare the corticospinal tract by integrating diffusion tensor tractography into the treatment planning software.

Background

Organs at risk are generally contoured according to the outline of the organ as demonstrated by CT or MRI. But a part of the organ with specific function is difficult to protect, because such functional part of the organ cannot be delineated on CT or conventional sequence of MRI.

Methods

Diagnostic and treatment planning images of glioblastoma patients who had been treated by conventional 3-dimensional conformal radiotherapy were used for re-planning of IMRT. Three-dimensional fiber maps of the corticospinal tracts were created from the diffusion tensors obtained from the patients before the surgery, and were blended with the anatomical MR images (i.e. gadolinium-enhanced T1-weighted images or T2-weighted images). DICOM-formatted blended images were transferred and fused to the planning CT images. Then, IMRT plans were attempted.

Results

The corticospinal tracts could be contoured as organs at risk (OARs), because the blended images contained both anatomical information and fiber-tract maps. Other OARs were contoured in a way similar to that of ordinary IMRT planning. Gross tumor volumes, clinical target volumes, planning target volumes, and other OARs were contoured on the treatment planning software, and IMRT plans were made.

Conclusions

IMRT plans with diminished doses to the corticospinal tract were attained. This technique enabled us to spare specific neuron fibers as OARs which were formerly “invisible” and to reduce the probability of late morbidities.     

Development of cutaneous innervation in the chick: ultrastructural and quantitative analysis (author's transl)

In the chick, at the thoracic level, the dorsal branches of spinal nerves form at 4 days of incubation (stage 25) and reach the skin between 5 1/2 and 6 days (stages 28-29). At 6 days, the growing nervous peripheral processes ("axons") form large bundles (200-1,000 fibers). At 10 days, young Schwann cells divide the bundles into groups of axons. The perineurium and endoneurium differentiate between 10 and 14 days (but epineurium is formed after hatching). At 14 days of incubation, the adult pattern of cutaneous innervation is established. At this same stage, myelogenesis begins but develops mainly after hatching : 1% of the axons is myelinated at 16 days of incubation, 4% at hatching, 40% in 6-week old chickens and 60% in adults. Thus, less than 10% of myelinated axons of the adult are already myelinated at hatching. Two modes of myelogenesis were observed: 1) early myelination, starting in the embryo around axons measuring about 1 micrometer in diameter: 2) delayed myelination, occurring in the older chickens after an increase in axon diameter. These observations suggest that there is, in the development of chick skin innervation, a critical stage (14-15 days of incubation) apparently corresponding to the stabilization of cutaneous nerve supply.     

Effect of the CSF1R inhibitor PLX3397 on remyelination of corpus callosum in a cuprizone-induced demyelination mouse model

Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system (CNS). Despite introducing multiple immunomodulatory approaches for MS, there are still major concerns about possible ways for improving remyelination in this disease. Microglia exert essential roles in regulation of myelination processes, and interaction between colony-stimulating factor 1 (CSF1) with its receptor CSF1R is considered as a key regulator of microglial differentiation and survival. The aim of this study was to investigate possible roles for a CSF1R inhibitor PLX3397 in recovery of central myelination processes. Chronic demyelination was induced in mice by addition of 0.2% cuprizone to the chow for 12 weeks. Next, animals were undergoing a diet containing 290 mg/kg PLX3397 to induce microglial ablation. The PLX3397 treatment caused a significant decrease in the rate of expression for the CSF1/CSF1R axis, and a reduction in the protein expressions for the microglial marker Iba-1 and for the oligodendrocyte marker Olig-2. Findings from Luxol fast blue (LFB) staining and transmission electron microscopy (TEM) showed an increase in the rate of myelination for the mice receiving PLX3397. The rate of destruction in the nerve fibers and the extent of the gaps formed between layers of myelin sheaths was also reduced after the treatment with PLX3397. In addition, animals experienced an improvement in recovery of motor deficit after receiving PLX3397 (for all P < 0.05). It could be concluded that PLX3397 could retain myelination in the MS model possibly through regulation of the myelin environment.     

Magnetic resonance urography by virtual reality modelling

PURPOSE: The purpose of this study was to create a 3D visualization of the urinary tract by a novel virtual reality approach, and to evaluate the usefulness of this method for papillary classification as compared with 2D urogram obtained by maximum intensity projection (MIP). MATERIALS AND METHODS: In one healthy pig, magnetic resonance urography was performed using a T1-weighted 3D gradient echo pulse sequence. Post-processing was performed by means of an MIP algorithm and by using 3D virtual reality modelling, followed by manual classification of papillae as being either simple or compound. RESULTS: The 2D MIP urogram demonstrated 6 simple and 6 compound papillae, whereas the 3D urogram demonstrated 5 simple and 7 compound papillae. In both urograms, some papillae were unsuccessfully classified. CONCLUSION: The possibility of using virtual reality devices allowed 3D rotation and offered additional diagnostic information. However, further studies should reveal its feasibility in diseased kidneys.     

Fluid collection within the synovial sheath of the tendon of the flexor hallus longus muscle in the tarsal joint of rats: an anatomic variant detectable with magnetic resonance imaging

Magnetic resonance (MR) images of the right tarsal joint of 22 normal male Han:Wistar rats were acquired using a 4.7 T magnet. An intermediate-high signal area associated with the tendon of the flexor hallus longus muscle was noticed in three rats on T2-weighted images. These areas appeared as an intermediate-high signal on lightly T2-weighted images, but appeared as an iso-signal to muscle structure on proton density weighted images. Histology preparations showed that such areas were caused by a sizable fluid collection within the synovial sheath of the tendon of the flexor hallus longus muscle, with all other joint structures appearing normal. This anatomic variant could be potentially regarded as a lesion on T2-weighted MR images, such as inflamed tissue with oedema, especially when the spatial resolution and/or signal-to-noise ratio are not optimal.     

fMRI mapping of cortical centers following visual stimulation in postnatal pigs of different ages

Classical studies have demonstrated that the visual centers in primates consist of cortical areas V1, V2 and V4 and their branches. However, nothing is known about how these visual areas change in postnatal development. In the present studies, therefore, pigs aged 2, 4, and 6 months old, were stimulated visually with a colored checker board and the active sites in the cortex, cerebellum and brainstem recorded using functional magnetic resonance imaging (fMRI). In pigs aged 2 months old, visual stimulation induced an increase in activation of sites in the V2 and V4 cortical areas, as well as in the areas of the inferior aspect of the parietal and middle aspect of the temporal cortices, but not in the medial and caudal occipital cortex (V1 area). At 4 months old, the V1 area was also activated, and by 6 months old, an inferior sector in the prefrontal cortex was also activated. As the pigs aged, functional active sites were further demonstrated in the cerebellum and the brainstem, which probably had to do with action memory, and the control of the ocular muscles, respectively. It is concluded that the visual pathway of the pig mainly involves cortical areas that mature at 6 months of age.     

Neuroparacoccidioidomycosis (NPCM): Magnetic Resonance Imaging (MRI) Findings

Objective

To describe the magnetic resonance imaging (MRI) patterns of the central nervous system (CNS) involvement by neuroparacoccidioidomycosis (NPCM).

Methods

Between January 1999 and March 2011, a review of MRI data analysis from 8 cases of NPCM was performed. The following MRI characteristics were examined by an experienced neuroradiologist: topography of lesions, aspects on T1- and T2-weighted images (WI), contrast enhancement, diffusion and spectroscopy.

Results

All patients had evidence of paracoccidioidomycosis infection outside the nervous system. Regarding CNS involvement, five patients had only supratentorial lesions; three had infra- and supratentorial ones. Meningeal extension occurred in three patients. The lesions were predominantly hyperintense on T1WI. At T2WI, a hypointense component was present in five cases as well as a perilesional abnormal white matter. A ring-enhancement pattern was seen in five cases. Spectroscopy was performed in three patients and showed an increased lipid peak in all of them. In one case, there was also an increased choline peak.

Conclusion

NPCM is rare, and MRI may help its differentiation from other inflammatory lesions. However, the presence of active infection outside CNS and some imaging characteristics should point to this diagnosis.     

Magnetic resonance image attributes of the ovarian follicle wall during development and regression

We analyzed image characteristics in T(1)-, T(2)-, and diffusion-weighted in vitro magnetic resonance (MR) images acquired at predefined stages of the ovarian cycle in 36 heifers to test the hypothesis that MR image attributes of the follicle wall reflect the physiologic status of ovarian follicles (viable, atretic, dominant, subordinate). Numerical pixel values (NPV), standard deviation of pixel values (heterogeneity), and area under the curve were used to assess images of follicle walls. Pixel values of the wall were used to calculate a regression line from which intercept, slope, and coefficient of determination were calculated. In T(1) images, NPV of dominant follicles were less likely to fit a regression line at the preovulatory phase than at any other phase (P < 0.1). Preovulatory dominant follicles had lower area under the curve in diffusion-weighted images than early and late static dominant follicles of the anovulatory wave (P < 0.02). Subordinate follicles in the presence of a preovulatory dominant follicle had lower mean NPV in T(1)- and T(2)-weighted images and lower intercepts in T(1)-weighted images than subordinate follicles of the anovulatory wave (P < 0.02). Early atresia of dominant follicles was identified at the late static phase by greater area, mean NPV, and slope in T(2)-weighted images (P < 0.02). Preovulatory dominant follicles had poor fit of NPV to a regression line in T(1)-weighted images and lower area under the curve in diffusion images. Atretic follicles had brighter walls with more acute transitions from follicular fluid to stroma in T(2)-weighted images and more heterogeneous walls in diffusion images. The MR image attributes of the follicle wall reflected the physiologic status of dominant and largest subordinate follicles.     

Noninvasive magnetic resonance imaging of the development of individual colon cancer tumors in rat liver

Monitoring tumor development is essential for the understanding of mechanisms involved in tumor progression and to determine efficacy of therapy. One of the evolving approaches is longitudinal noninvasive magnetic resonance imaging (MRI) of tumors in experimental models. We applied high-resolution MRI at 7 Tesla to study the development of colon cancer tumors in rat liver. MRI acquisition was triggered to the respiratory cycle to minimize motion artifacts. A special radio frequency (RF) coil was designed to acquire detailed T1-weighted and T2-weighted images of the liver. T2-weighted images identified hyperintense lesions representing tumors with a minimum diameter of 2 mm, enabling the determination of growth rates and morphological aspects of individual tumors. It is concluded that high-resolution MRI using a dedicated RF coil and triggering to the respiratory cycle is an excellent tool for quantitative and morphological analysis of individual diffusely distributed tumors throughout the liver. However, at present, MRI requires expensive equipment and expertise and is a time-consuming methodology. Therefore, it should preferably be used for dedicated applications rather than for high-throughput assessment of total tumor load in animals.     

Integrin-linked kinase is required for laminin-2-induced oligodendrocyte cell spreading and CNS myelination

Early steps in myelination in the central nervous system (CNS) include a specialized and extreme form of cell spreading in which oligodendrocytes extend large lamellae that spiral around axons to form myelin. Recent studies have demonstrated that laminin-2 (LN-2; alpha2beta1gamma1) stimulates oligodendrocytes to extend elaborate membrane sheets in vitro (cell spreading), mediated by integrin alpha6beta1. Although a congenital LN-2 deficiency in humans is associated with CNS white matter changes, LN-2-deficient (dy/dy) mice have shown abnormalities primarily within the peripheral nervous system. Here, we demonstrate a critical role for LN-2 in CNS myelination by showing that dy/dy mice have quantitative and morphologic defects in CNS myelin. We have defined the molecular pathway through which LN-2 signals oligodendrocyte cell spreading by demonstrating requirements for phosphoinositide 3-kinase activity and integrin-linked kinase (ILK). Interaction of oligodendrocytes with LN-2 stimulates ILK activity. A dominant negative ILK inhibits LN-2-induced myelinlike membrane formation. A critical component of the myelination signaling cascade includes LN-2 and integrin signals through ILK.     

Comparison of Different Magnetic Resonance Cholangiography Techniques in Living Liver Donors Including Gd-EOB-DTPA Enhanced T1-Weighted Sequences

Objectives

Preoperative evaluation of potential living liver donors (PLLDs) includes the assessment of the biliary anatomy to avoid postoperative complications. Aim of this study was to compare T2-weighted (T2w) and Gd-EOB-DTPA enhanced T1-weighted (T1w) magnetic resonance cholangiography (MRC) techniques in the evaluation of PLLDs.

Materials and Methods

30 PLLDs underwent MRC on a 1.5 T Magnetom Avanto (Siemens, Erlangen, Germany) using (A) 2D T2w HASTE (Half Fourier Acquisition Single Shot Turbo Spin Echo) fat saturated (fs) in axial plane, (B) 2D T2w HASTE fs thick slices in coronal plane, (C) free breathing 3D T2w TSE (turbo spin echo) RESTORE (high-resolution navigator corrected) plus (D) maximum intensity projections (MIPs), (E) T2w SPACE (sampling perfection with application optimized contrasts using different flip angle evolutions) plus (F) MIPs and (G) T2w TSE BLADE as well as Gd-EOB-DTPA T1w images without (G) and with (H) inversion recovery. Contrast enhanced CT cholangiography served as reference imaging modality. Two independent reviewers evaluated the biliary tract anatomy on a 5-point scale subjectively and objectively. Data sets were compared using a Mann-Whitney-U-test. Kappa values were also calculated.

Results

Source images and maximum intensity projections of 3D T2w TSE sequences (RESTORE and SPACE) proved to be best for subjective and objective evaluation directly followed by 2D HASTE sequences. Interobserver variabilities were good to excellent (k = 0.622–0.804).

Conclusions

3D T2w sequences are essential for preoperative biliary tract evaluation in potential living liver donors. Furthermore, our results underline the value of different MRCP sequence types for the evaluation of the biliary anatomy in PLLDs including Gd-EOB-DTPA enhanced T1w MRC.