Magnetic resonance imaging of the brain

MRI of brain and brain stem
Brain MRI
ICD-10-PCSB030ZZZ
ICD-9-CM88.91
OPS-301 code3-800, 3-820

Magnetic resonance imaging of the brain uses magnetic resonance imaging (MRI) to produce high quality two-dimensional or three-dimensional images of the brain and brainstem without the use of ionizing radiation (X-rays) or radioactive tracers.

History

The first MR images of a human brain were obtained in 1978 by two groups of researchers at EMI Laboratories led by Ian Robert Young and Hugh Clow.[1] In 1986, Charles L. Dumoulin and Howard R. Hart at General Electric developed MR angiography,[2] and Denis Le Bihan obtained the first images and later patented diffusion MRI.[3] In 1988, Arno Villringer and colleagues demonstrated that susceptibility contrast agents may be employed in perfusion MRI.[4] In 1990, Seiji Ogawa at AT&T Bell labs recognized that oxygen-depleted blood with dHb was attracted to a magnetic field, and discovered the technique that underlies Functional Magnetic Resonance Imaging (fMRI).[5]

In the early 1990s, Peter Basser and Le Bihan, working at NIH, and Aaron Filler, Franklyn Howe, and colleagues developed diffusion tensor imaging (DTI).[6][7][8][9] Joseph Hajnal, Young and Graeme Bydder described the use of FLAIR pulse sequence to demonstrate high signal regions in normal white matter in 1992.[10] In the same year, John Detre, Alan P. Koretsky and coworkers developed arterial spin labeling.[11] In 1997, Jürgen R. Reichenbach, E. Mark Haacke and coworkers at Washington University developed Susceptibility weighted imaging.[12]

The first study of the human brain at 3.0 T was published in 1994,[13] and in 1998 at 8 T.[14] Studies of the human brain have been performed at 9.4 T (2006)[15] and up to 10.5 T (2019).[16]

Paul Lauterbur and Sir Peter Mansfield were awarded the 2003 Nobel Prize in Physiology or Medicine for their discoveries concerning MRI.

This axial T2-weighted (CSF white) MR scan shows a normal brain at the level of the lateral ventricles.

The record for the highest spatial resolution of a whole intact brain (postmortem) is 100 microns, from Massachusetts General Hospital. The data was published in NATURE on 30th of October 2019.[17][18]

Applications

One advantage of MRI of the brain over computed tomography of the head is better tissue contrast,[19] and it has fewer artifacts than CT when viewing the brainstem. MRI is also superior for pituitary imaging.[20] It may however be less effective at identifying early cerebritis.[21]

In the case of a concussion, an MRI should be avoided unless there are progressive neurological symptoms, focal neurological findings or concern of skull fracture on exam.[22] In the analysis of a concussion, measurements of Fractional Anisotropy, Mean Diffusivity, Cerebral Blood Flow, and Global Connectivity can be taken to observe the pathophysiological mechanisms being made while in recovery.[23]

In analysis of the fetal brain, MRI provides more information about gyration than ultrasound.[24]

MRI is sensitive for the detection of brain abscess.[25]

A number of different imaging modalities or sequences can be used with imaging the nervous system:

  • T1-weighted (T1W) images: Cerebrospinal fluid is dark. T1-weighted images are useful for visualizing normal anatomy.
  • T2-weighted (T2W) images: CSF is light, but fat (and thus white matter) is darker than with T1. T2-weighted images are useful for visualizing pathology.[26]
  • Diffusion-weighted images (DWI): DWI uses the diffusion of water molecules to generate contrast in MR images.
  • Proton density (PD) images: CSF has a relatively high level of protons, making CSF appear bright. Gray matter is brighter than white matter.[27]
False color MRI by applying red to T1, green to PD and blue to T2.

See also

References

  1. ↑ Information, Reed Business (1978). "Britain's brains produce first NMR scans". New Scientist: 588.
  2. ↑ "Blood-flow checker". Popular Science: 12. 1987.
  3. ↑ Le Bihan D, Breton E (1987). "Method to Measure the Molecular Diffusion and/or Perfusion Parameters of Live Tissue". US Patent # 4,809,701.
  4. ↑ Villringer A, Rosen BR, Belliveau JW, Ackerman JL, Lauffer RB, Buxton RB, Chao YS, Wedeen VJ, Brady TJ (February 1988). "Dynamic imaging with lanthanide chelates in normal brain: contrast due to magnetic susceptibility effects". Magnetic Resonance in Medicine. 6 (2): 164–74. doi:10.1002/mrm.1910060205. PMID 3367774. S2CID 41228095.
  5. ↑ Faro SH, Mohamed FB (2010-01-15). Bold fMRI. a guide to functional imaging for neuroscientists. Springer. ISBN 978-1-4419-1328-9. Retrieved 10 June 2015.
  6. ↑ Howe FA, Filler AG, Bell BA, Griffiths JR (December 1992). "Magnetic resonance neurography". Magnetic Resonance in Medicine. 28 (2): 328–38. doi:10.1002/mrm.1910280215. PMID 1461131. S2CID 36417513.
  7. ↑ Filler AG, Howe FA, Hayes CE, Kliot M, Winn HR, Bell BA, Griffiths JR, Tsuruda JS (March 1993). "Magnetic resonance neurography". Lancet. 341 (8846): 659–61. doi:10.1016/0140-6736(93)90422-d. PMID 8095572. S2CID 24795253.
  8. ↑ Filler A (October 2009). "Magnetic resonance neurography and diffusion tensor imaging: origins, history, and clinical impact of the first 50,000 cases with an assessment of efficacy and utility in a prospective 5000-patient study group". Neurosurgery. 65 (4 Suppl): A29-43. doi:10.1227/01.neu.0000351279.78110.00. PMC 2924821. PMID 19927075.
  9. ↑ Basser PJ (2010). "Invention and Development of Diffusion Tensor MRI (DT-MRI or DTI) at the NIH". Diffusion MRI. Oxford University Press. pp. 730–740. doi:10.1093/med/9780195369779.003.0047. ISBN 9780195369779.
  10. ↑ Hajnal JV, De Coene B, Lewis PD, Baudouin CJ, Cowan FM, Pennock JM, Young IR, Bydder GM (July 1992). "High signal regions in normal white matter shown by heavily T2-weighted CSF nulled IR sequences". Journal of Computer Assisted Tomography. 16 (4): 506–13. doi:10.1097/00004728-199207000-00002. PMID 1629405. S2CID 42727826.
  11. ↑ Koretsky AP (August 2012). "Early development of arterial spin labeling to measure regional brain blood flow by MRI". NeuroImage. 62 (2): 602–7. doi:10.1016/j.neuroimage.2012.01.005. PMC 4199083. PMID 22245338.
  12. ↑ Reichenbach JR, Venkatesan R, Schillinger DJ, Kido DK, Haacke EM (July 1997). "Small vessels in the human brain: MR venography with deoxyhemoglobin as an intrinsic contrast agent". Radiology. 204 (1): 272–7. doi:10.1148/radiology.204.1.9205259. PMID 9205259.
  13. ↑ Mansfield P, Coxon R, Glover P (May 1994). "Echo-planar imaging of the brain at 3.0 T: first normal volunteer results". Journal of Computer Assisted Tomography. 18 (3): 339–43. doi:10.1097/00004728-199405000-00001. PMID 8188896. S2CID 20221062.
  14. ↑ Robitaille PM, Abduljalil AM, Kangarlu A, Zhang X, Yu Y, Burgess R, Bair S, Noa P, Yang L, Zhu H, Palmer B, Jiang Z, Chakeres DM, Spigos D (October 1998). "Human magnetic resonance imaging at 8 T". NMR in Biomedicine. 11 (6): 263–5. doi:10.1002/(SICI)1099-1492(199810)11:6<263::AID-NBM549>3.0.CO;2-0. PMID 9802467.
  15. ↑ Vaughan T; DelaBarre L; Snyder C; Tian J; Akgun C; Shrivastava D; Liu W; Olson C; Adriany G; et al. (December 2006). "9.4T human MRI: preliminary results". Magn Reson Med. 56 (6): 1274–82. doi:10.1002/mrm.21073. PMC 4406343. PMID 17075852.
  16. ↑ Sadeghi‐Tarakameh, Alireza; DelaBarre, Lance; Lagore, Russell L.; Torrado‐Carvajal, Angel; Wu, Xiaoping; Grant, Andrea; Adriany, Gregor; Metzger, Gregory J.; Van de Moortele, Pierre‐Francois; Ugurbil, Kamil; Atalar, Ergin (2019-11-21). "In vivo human head MRI at 10.5T: A radiofrequency safety study and preliminary imaging results". Magnetic Resonance in Medicine. 84 (1): 484–496. doi:10.1002/mrm.28093. hdl:11693/53263. ISSN 0740-3194. PMC 7695227. PMID 31751499. S2CID 208226414.
  17. ↑ "100-Hour-Long MRI of Human Brain Produces Most Detailed 3D Images Yet".
  18. ↑ "Team publishes on highest resolution brain MRI scan".
  19. ↑ Ebel K, Benz-Bohm G (1999). Differential diagnosis in pediatric radiology. Thieme. pp. 538–. ISBN 978-3-13-108131-5. Retrieved 18 July 2011.
  20. ↑ Bradley WG, Brant-Zawadzki M, Cambray-Forker J (2001-01-15). MRI of the brain. Surendra Kumar. ISBN 978-0-7817-2568-2. Retrieved 24 July 2011.
  21. ↑ Roos KL, Tunkel AR (2010). Bacterial infections of the central nervous system. Elsevier Health Sciences. pp. 69–. ISBN 978-0-444-52015-9. Retrieved 18 July 2011.
  22. ↑ American Medical Society for Sports Medicine (24 April 2014), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Medical Society for Sports Medicine, retrieved 29 July 2014
  23. ↑ Churchill Nathan W., Hutchison Michael G., Richards Doug, Leung General, Graham Simon J., Schweizer Tom A. (2017). "The first week after concussion: Blood flow, brain function and white matter microstructure". NeuroImage: Clinical. 14: 480–489. doi:10.1016/j.nicl.2017.02.015. PMC 5334547. PMID 28280686.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  24. ↑ Garel C (2004). MRI of the fetal brain: normal development and cerebral pathologies. Springer. ISBN 978-3-540-40747-8. Retrieved 24 July 2011.
  25. ↑ Rath, Tanya J.; Hughes, Marion; Arabi, Mohammad; Shah, Gaurang V. (2012). "Imaging of Cerebritis, Encephalitis, and Brain Abscess". Neuroimaging clinics of North America. Elsevier BV. 22 (4): 585–607. doi:10.1016/j.nic.2012.04.002. ISSN 1052-5149. PMID 23122258.
  26. ↑ Butler P, Mitchell AW, Ellis H (2007-11-19). Applied Radiological Anatomy for Medical Students. Cambridge University Press. pp. 12–. ISBN 978-0-521-81939-8. Retrieved 18 July 2011.
  27. ↑ Tofts, Paul (2005-09-01). Quantitative MRI of the Brain: Measuring Changes Caused by Disease. John Wiley and Sons. pp. 86–. ISBN 978-0-470-86949-9. Retrieved 18 July 2011.
  28. ↑ Chowdhury R, Wilson I, Rofe C, Lloyd-Jones G (2010-04-19). Radiology at a Glance. John Wiley and Sons. pp. 95–. ISBN 978-1-4051-9220-0. Retrieved 18 July 2011.
  29. ↑ Granacher RP (2007-12-20). Traumatic brain injury: methods for clinical and forensic neuropsychiatric assessment. CRC Press. pp. 247–. ISBN 978-0-8493-8138-6. Retrieved 18 July 2011.
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