CHAP 11 Contrast Enhanced MRI - Perfusion. CHAP 11 Contrast Enhanced MRI - Perfusion
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1 CHAP 11 Contrast Enhanced MRI - Perfusion Contrast agents Paramagnetic / superparamagnetic Relaxivity Water exchange Susceptibility effect Brain perfusion pathologies Perfusion measurement T2* (DSC-MRI) T1 (DCE-MRI) CHAP 11 Contrast Enhanced MRI - Perfusion Contrast agents Paramagnetic / superparamagnetic Relaxivity Water exchange Susceptibility effect Brain perfusion pathologies Perfusion measurement T2* (DSC-MRI) T1 (DCE-MRI)
2 Principles of Contrast Agent Endogenous contrast properties (T1, T2, T2* etc.) Use of exogenous contrast to modify relaxation properties of selected tissues
3
4 Contrast agents - basic principles Paramagnetic ions
5 Superparamagnetic Iron Oxide Particles Gd 3 +
6 Paramagnetic CA
7 Metal chelate use of biocompatible ligand O H H O O Gd O N N H CH 3 O N N O O H 3 C N H O O CHAP 11 Contrast Enhanced MRI - Perfusion Contrast agents Paramagnetic / superparamagnetic Relaxivity Water exchange Susceptibility effect Brain perfusion pathologies Perfusion measurement T2* (DSC-MRI) T1 (DCE-MRI)
8 Contrast Agent Relaxivity in vitro 1/T 1,2 [CA] (mm) Contrast Agent Relaxivity in vitro
9 In vivo CA effects Paramagnetic chelates enhance contrast in T1-w images
10 CHAP 11 Contrast Enhanced MRI - Perfusion Contrast agents Paramagnetic / superparamagnetic Relaxivity Water exchange Susceptibility effect Brain perfusion pathologies Perfusion measurement T2* (DSC-MRI) T1 (DCE-MRI) Water exchange effects =k 1 + k 2
11
12 Slow/fast exchange
13 Susceptibility induced relaxation contrast agent always unevenly distributed in vivo (multiple intra- extracellular compartments) local susceptibility differences both in blood and interstitium enhanced T2/T2* relaxation CHAP 11 Contrast Enhanced MRI - Perfusion Contrast agents Paramagnetic / superparamagnetic Relaxivity Water exchange Susceptibility effect Brain perfusion pathologies Perfusion measurement T2* (DSC-MRI) T1 (DCE-MRI)
14 Perfusion imaging imaging alteration of blood supply Perfusion imaging: Stroke Ischemic area (e.g. Heart Myocardium) Cancer and Angiogenesis (Tumors) Etc. All areas where we have Microvascular Alterations Perfusion: Blood Supply
15 Perfusion: Blood Supply Perfusion: Blood Supply
16 Cancer & Angiogenesis Angiogenesis in tumors: high vascular density and abnormal vascular morphology Folkman J, Sci Am 1996
17 CHAP 11 Contrast Enhanced MRI - Perfusion Contrast agents Paramagnetic / superparamagnetic Relaxivity Water exchange Susceptibility effect Brain perfusion pathologies Perfusion measurement T2* (DSC-MRI) T1 (DCE-MRI) Quantitative Perfusion Measurements
18 Perfusion Model and Absolute Value Theoretical considerations General expression of the tissue perfusion (tracer diffusion)
19 Quantitative Perfusion Measurement Diffusible Tracer Theory
20 CHAP 11 Contrast Enhanced MRI - Perfusion Contrast agents Paramagnetic / superparamagnetic Relaxivity Water exchange Susceptibility effect Brain perfusion pathologies Perfusion measurement T2* (DSC-MRI) T1 (DCE-MRI) Dynamic Susceptibility Enhanced Perfusion measurement
21 Bolus Perfusion Imaging Concentration-Time curve Conc. Data Fit T0 MTT Perfusion MR
22 Parametric perfusion maps Glioblastoma (high grade) T2-weighted T1-weighted w/ Gd CBV map
23 Oligoastrocytom (low grade) T2-weighted MRI CBV map Glioma grading from ncbv
24 Comprehensive Stroke Examination FLAIR GraSE DWI-I ADC NI (rcbv) TTP MTT MRA FLAIR GraSE DWI-I ADC ~ 24 hours Perfusion: Kidneys Parametric maps of a T2W TSE Kidney Perfusion acquisition in a pig using 2 mg Fe/kg b.w ClariScan (Nycomed- Amersham). Top: MTT Bottom: rrbv
25 Breast MRI: Post-contrast Imaging 3D T1W FFE SENSE Body Coil SENSE Factor mm*0.64mm 68 slices of 2.2mm slices Proset 1331 Scantime: 1:53 minutes CHAP 11 Contrast Enhanced MRI - Perfusion Contrast agents Paramagnetic / superparamagnetic Relaxivity Water exchange Susceptibility effect Brain perfusion pathologies Perfusion measurement T2* (DSC-MRI) T1 (DCE-MRI)
26 Dynamic Contrast Enhanced Perfusion measurement
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