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The reduced T2 (spin-spin) relaxation times (T2obs less than 200 ms) measured on pure fluids on our 0.35T magnetic resonance imagers stimulated an investigation into this phenomenon. The cause for the short T2obs of fluids was found to be translational molecular self-diffusion of hydrogen nuclei through the pulsed slice-selective magnetic gradient in the imagers. Similar reductions in biological tissue T2obs were also attributed to molecular self-diffusion.

Paramagnetic nitroxyl-containing compounds have been useful as contrast agents in magnetic resonance imaging (MRI) experiments in animals. Preliminary information on the metabolic fate, pharmacokinetic behavior, stability in tissues, and chemical reduction of two prototypic nitroxides, PCA and TES, is presented. In the dog TES was eliminated more rapidly than PCA. More than 80 % of the dose of both nitroxides was recovered in urine within 6 hours. Nitroxides were reduced in vivo to their corresponding hydroxylamines. No other metabolite was observed. Measured reducing activity in tissue homogenates was greater in liver or kidney than in brain, lung or heart. In each tissue PCA was more stable than TES. PCA was also more resistant to reduction by ascorbic acid at physiologic pH. These preliminary results favor the use of PCA, a pyrrolidinyl nitroxide, over TES, a piperidinyl nitroxide, for MRI contrast enhancement.

A unique occurrence of gastric carcinoma within a paraesophageal hernia is reported. The radiologist must carefully examine the distorted gastric anatomy to look for a second lesion.

Complexes of paramagnetic ions that are tissue-, organ- or tumor-specific will supplement routine magnetic resonance imaging, help assess organ perfusion, and in some cases assess specific organ function. Studies are described in animals and man and the results suggest that dilute iron solutions may be useful for contrast-enhancement of the gastrointestinal tract; that ferrioxamine B, a stable ferric iron complex, appears to permit identification of focal blood-brain-barrier defects and to assess renal excretory function; and that gadolinium-DTPA can produce contrast-enhancement of a variety of lesions. In addition, gadolinium-DTPA can detect a breakdown in the blood-brain-barrier and can delineate functioning myocardium in the setting of acute ischemia.

The effects of an intravenously administered nitroxyl spin label (PCA) on the magnetic resonance imaging (MRI) appearance and relaxation times of acute canine myocardial infarctions were studied. Twenty-four hours after ligation of the left anterior descending coronary artery (LAD), animals were either sacrificed immediately (three dogs) or injected with 3.0 mmol/kg of PCA prior to sacrifice (six dogs). The PCA group dogs were sacrificed at either 5 minutes postinjection (three dogs) or 15 minutes postinjection (three dogs). Magnetic resonance imaging (0.35 T) using spin-echo techniques demonstrated high signal intensity in the infarct relative to normal myocardium in all three groups. In the control group, the T1 and T2 relaxation times were longer in infarcted compared with normal myocardium, but only the measure in T2 reached statistical significance (P less than .05). PCA produced infarct-avid T1 shortening in the six dogs that received it. Contrast in the group sacrificed at 15 minutes postcontrast administration was greater than that in the control group due to T1 shortening in the infarct. Thus, PCA produces differential effects on normal and infarcted myocardium. Between 5 and 15 minutes after IV administration, it causes greater changes in the infarct due to prolonged retention in this region.

Gadolinium (Gd)-DTPA complex was assessed as a nuclear magnetic resonance (NMR) contrast-enhancing agent by experimentally imaging normal and diseased animals. After intravenous injection, Gd-DTPA, a strongly paramagnetic complex by virtue of unpaired electrons, was rapidly excreted into the urine of rats, producing an easily observable contrast enhancement on NMR images in kidney parenchyma and urine. Spin-echo intensity of urine within the renal pelvis increased from 2263 to 4414 units; intensity of renal parenchyma increased from 2901 to 3893 after administration of 0.1 mmol/kg Gd-DTPA. Sterile soft-tissue abscesses demonstrated an obvious rim pattern of enhancement. A focus of radiation-induced brain damage in a canine model was only faintly detectable on spin-echo NMR images before contrast administration; after 0.5 mmol/kg Gd-DTPA administration, the lesion intensity increased from 3867 to 5590. In comparison, the normal brain with an intact blood-brain barrier remained unchanged in NMR characterization. Gd-DTPA is a promising new NMR contrast enhancer for the clinical assessment of renal function, of inflammatory lesions, and of focal disruption of the blood-brain barrier.

Contrast-enhancing agents for demonstrating abnormalities of the blood-brain barrier may extend the diagnostic utility of proton nuclear magnetic resonance (NMR) imaging. "TES," a nitroxide stable free radical derivative, was tested as a central nervous system contrast enhancer in dogs with experimentally induced unilateral cerebritis or radiation cerebral damage. After intravenous injection of TES, the normal brain showed no change in NMR appearance, but areas of disease demonstrated a dramatic increase (up to 45%) in spin-echo intensity and a decrease in T1 relaxation times. The areas of disease defined by TES enhancement were either not evident on the nonenhanced NMR images or were better defined after contrast administration. In-depth tests of toxicity, stability, and metabolism of this promising NMR contrast agent are now in progress.

Nuclear magnetic resonance imaging of the hydrogen nucleus provides a unique noninvasive display of proton dynamics in biologic tissues and fluids as well as internal anatomy in a sectional imaging format. No ionizing radiation is utilized. Our experience with NMR imaging of the brain in 14 pediatric patients is presented and compared with computed tomography. The major advantages of NMR over CT include its greater sensitivity to blood flow, edema, hemorrhage, and myelinization and its lack of beam-hardening artifacts. In addition, the potential for tissue characterization exists by determination of T1 and T2 relaxation times and of mobile proton density. Disadvantages of NMR over CT include its failure to demonstrate calcification and bone detail and longer data acquisition times.

We examined the magnetic resonance properties of 12 paramagnetic piperidinyl nitroxyls in water and plasma solutions. Paramagnetic contributions to proton relaxation times were measured using 10.7 and 100 MHz spectrometers. Proton relaxation enhancement from nitroxyls increased with ascending molecular weight, in plasma solutions versus equimolar aqueous solutions, and with measurements at 10.7 MHz compared to 100 MHz. Relaxation rates were observed to approximately double at 10.7 MHz compared to 100 MHz and from water to plasma solutions. The data indicate that proton spin-lattice relaxation enhancement is magnetic field-dependent, and increases using nitroxyls of large molecular weight and with chemical substitutents that increase the microviscosity of solvent water molecules. The development of nitroxyls for diagnostic MRI will be aided by understanding these in vitro physical characteristics and trends.

A case of anomalous inferior vena cava with azygos continuation first diagnosed by computed tomography (CT) and later confirmed by venography is presented. In addition to identifying the dilated azygos vein in the chest, CT can determine the direction of flow in the vein by means of a bolus contrast medium injection. Once this is established, a search for the etiology of the dilated vein can be directed to the appropriate anatomic area.

The origin of nuclear magnetic resonance signal is reminded in this paper. Different ways of increasing the contrast in magnetic resonance imaging are presented, especially modifications of tissues relaxation times by the use of paramagnetic ions or nitroxides. The potential of these substances is illustrated by several examples of application in the animal.

A clinical dilemma in patients with cystic fibrosis is the determination of the nature of linear areas of decreased aeration in the lungs. It is difficult using chest roentgenograms or even computed tomography to differentiate atelectasis, mucoid impacted bronchi, or peribronchial inflammatory disease from normal pulmonary vascularity. Magnetic resonance imaging is a noninvasive sensitive means that provides the distinction. Pulmonary vessels are easily identified, because with the spin-echo sequence that we use, the rapidly flowing blood within the vessels has no signal intensity. In contradistinction, mucoid-impacted bronchi appear as high-intensity linear branching structures. Peribronchial inflammatory disease appears as curvilinear areas of high intensity, representing inflammatory edema, around central lucencies representing bronchi.

Chelation of the rare-earth element gadolinium (Gd) with diethylenetriaminepentaacetic acid (DTPA) results in a strongly paramagnetic, stable complex that is well tolerated in animals. The strongly paramagnetic gadolinium complex reduces hydrogen-proton relaxation times even in low concentrations (less than 0.01 mmol/L). The pharmacokinetic behavior of intravenously delivered Gd-DTPA is similar to the well known iodinated contrast agents used in urography and angiography; excretion is predominantly through the kidneys with greater than 90% recovery in 24 hr. The intravenous LD50 of the meglumine salt of Gd-DTPA is 10 mmol/kg for the rat; in vivo there is no evidence of dissociation of the gadolinium ion from the DTPA ligand. The combination of strong proton relaxation, in-vivo stability, rapid urinary excretion, and high tolerance favors the further development and the potential clinical application of gadolinium-DTPA as a contrast enhancer in magnetic resonance imaging.

By varying slice-selective gradients in successive data acquisitions, the first in vitro measurements of molecular self-diffusion coefficients were performed in a magnetic resonance imager at 0.35 Tesla. Reasonably accurate measurements were found by the MRI method in comparison with 2.3 T NMR spectrometer measurements on the same samples, and in comparison to reported literature values. Thus, in addition to T1, T2, mobile proton density, flow velocity, magnetic susceptibility, and chemical shift, molecular self-diffusion coefficients are now added to the list of biophysical parameters measurable by magnetic resonance imaging in the noninvasive characterization of biological systems.

Nitroxyl spin labels have been shown to be effective in vivo contrast agents for magnetic resonance imaging (MRI) of the central nervous system, myocardium, and urinary tract. A new pyrrolidine nitroxyl contrast agent (PCA) with better resistance to in vivo metabolic inactivation than previously tested agents was studied for its potential to enhance subcutaneous neoplasms in an animal model. Twenty-two contrast enhancement trials were performed on a total of 15 animals 4-6 weeks after implantation with human renal adenocarcinoma. Spin echo imaging was performed using a .35 T animal imager before and after intravenous administration of PCA in doses ranging from 0.5 to 3mM/kg. The intensity of tumor tissue in the images increased an average of 35% in animals receiving a dose of 3 mM/kg. The average enhancement with smaller doses was proportionately less. Tumor intensity reached a maximum within 15 min of injection. The average intensity difference between tumor and adjacent skeletal muscle more than doubled following administration of 3 mM/kg of PCA. Well-perfused tumor tissue was more intensely enhanced than adjacent poorly perfused and necrotic tissue.

Magnetic resonance imaging of the cardiovascular system offers great promise in the detection and characterization of the anatomic, physiologic, and biochemical consequences of atherosclerosis. This review will focus on the potential applications of MRI for evaluating atherosclerosis of the abdominal aorta and iliofemoral vessels.

Delineation of the gastrointestinal tract in magnetic resonance imaging (MRI) remains a problem. Ferric ammonium citrate is paramagnetic, producing a high MRI signal intensity by virtue of its spin-lattice (T1) relaxation rate enhancement properties. Water is diamagnetic, producing a low MRI signal intensity, especially with short TR and TE times. To compare efficacy for gastrointestinal contrast alteration, ferric ammonium citrate was administered to 18 patients and water was given to 10 patients. Spin-echo imaging at 0.35T was performed after administration of these agents. Ferric ammonium citrate produced high signal intensity within the esophagus, stomach, duodenum, and small intestine that aided in the differentiation of the gastrointestinal tract from adjacent tumors, vessels, and viscera. Delineation of the gut wall was superior using ferric ammonium citrate compared to that produced by water. Delineation of the margins of the pancreas, liver, and kidney from adjacent gastrointestinal tract was also better with ferric ammonium citrate. Optimal distinction between bowel and fat was better with water. Longer TE times (75 to 200 ms) may allow improved contrast between gut and intrabdominal fat using ferric ammonium citrate.