The goal of this protocol is to obtain high-quality diffusion weighted magnetic resonance imaging (DWI) of the rat spinal cord for noninvasive characterization of tissue microstructure. This protocol describes optimizations of the MRI sequence, radiofrequency coil, and analysis methods to enable DWI images free from artifacts.
Magnetic resonance imaging (MRI) is the state of the art approach for assessing the status of the spinal cord noninvasively, and can be used as a diagnostic and prognostic tool in cases of disease or injury. Diffusion weighted imaging (DWI), is sensitive to the thermal motion of water molecules and allows for inferences of tissue microstructure. This report describes a protocol to acquire and analyze DWI of the rat cervical spinal cord on a small-bore animal system. It demonstrates an imaging setup for the live anesthetized animal and recommends a DWI acquisition protocol for high-quality imaging, which includes stabilization of the cord and control of respiratory motion. Measurements with diffusion weighting along different directions and magnitudes (b-values) are used. Finally, several mathematical models of the resulting signal are used to derive maps of the diffusion processes within the spinal cord tissue that provide insight into the normal cord and can be used to monitor injury or disease processes noninvasively.
Magnetic resonance imaging (MRI) is a noninvasive tool that provides a window into the brain and spinal cord in both health and disease. MRI has revolutionized clinical diagnosis, but it is also a valuable tool for laboratory investigation. Animal models of neurological injury or disease provide a platform to understand the pathophysiology and accelerate discovery of therapies. In this report, we demonstrate the application of MRI to a rat model of spinal cord injury to investigate potential biomarkers of microstructural injury1 using diffusion tensor imaging (DTI). The potential discovery of imaging biomarkers will help in the diagnosis and management of patients with spinal cord injury. These markers are likely to play a role in discovery of therapies in preclinical models and enable observation or prognosis in their translation to the clinical setting.
DTI is a specialized form of MRI that measures microscopic motion of water molecules (i.e. diffusion). DTI has been particularly advantageous in the nervous system due to the presence of axons where diffusion is disproportionately faster along the axons than perpendicular to them, which provides information regarding their orientation and microstructural composition. Scalar indices derived from DTI, including a measure of the overall diffusion within the tissue, mean diffusivity (MD), and a measure of the orientation dependence of diffusion, fractional anisotropy (FA)2,3, have seen extensive applications in characterizing the microstructure of the nervous system in both health and disease4. These metrics have revealed microscopic tissue features that are invisible through most other MRI methods. Previous efforts demonstrated that DTI detects remote microstructural changes within the cervical cord following thoracic SCI in rats1. The DTI changes remote from the lesion likely reflect how the entire spinal cord responds to injury, and are potentially a marker of secondary injury.
Imaging the rat spinal cord in vivo presents several unique challenges. Most notably, the spinal cord is affected by respiratory motion and requires careful attention to minimize motion using several methods. In past studies, immobilization devices removed motion of the spinal column during scanning5. For imaging of the cervical cord, we utilize physical restraint in the form of a head holder and ear bars, which attenuates, but does not eliminate motion caused by respiration. Furthermore, we utilize a custom respiratory gating scheme to synchronize image acquisition with the respiratory cycle in an efficient manner. These modifications enable removal of the artifacts otherwise caused by the large-scale bulk motion caused by respiration6. DWI is highly sensitive to microscopic motion, including CSF flow and blood pulsation, and these smaller sources of motion contamination are also alleviated by the respiratory gating scheme. Additionally, the spinal cord has a small cross sectional area and represents only a fraction of the field of view. For cervical spine imaging, in which the spinal cord is situated deep within the body of the animal, a cylindrical radiofrequency coil with adequate signal penetration is needed to image the cervical spinal cord with high resolution. A reduction in the field of view is achieved by outer volume suppression (OVS), which also serves to cancel, or spoil, the signal from tissues outside of the spinal cord. This method, called spoiler gradients or outer volume suppression, also serves to reduce any contamination of residual animal motion, CSF flow, or blood pulsation within these tissues.
The arrangement of the spinal cord can also be exploited to simplify the imaging protocol. The spinal cord axons in the white matter (WM) are nearly all oriented parallel to the main axis of the spinal cord. Thus, whereas DWI of the brain requires measurements along at least 6 directions to ensure the results do not depend on the position within the magnet (a process called diffusion tensor imaging), measurements in the spinal cord can be acquired only along 2 directions parallel and perpendicular to the cord7,8, hereafter referred to as longitudinal and transverse, respectively. Thus, the diffusivity and other parameters are measured along the 2 directions separately and allow inferences into the microstructure of the tissue in both health and disease or injury.
NOTE: Ethics Statement: The Institutional Care and Use Committees (IACUC) of the Medical College of Wisconsin and the Clement J. Zablocki VA Medical Center approved all procedures.
1. Animal Preparation and Monitoring
2. MRI Scanning Parameters
NOTE: The procedures described here used a 9.4 T horizontal bore small animal system but are applicable to other field strengths of small animal MRI systems.
3. Image Processing
Proper procedures to minimize motion artifacts result in high-quality diffusion weighted images of the rat cervical spinal cord. Using custom respiratory gating (Figure 2), saturating unwanted signal from tissues outside the spine (Figures 3B & C), and magnetic field susceptibility distortion correction produces diffusion-weighted images such as those in Figures 4 and 5. Improper or un-gated images will lead to artifacts in the form of ghosting (Figure 3E), whereas correct gating is free of artifacts.
Visual inspection of the diffusion weighted images across the 12 slices reveals features of the spinal cord that relates to its microstructure. Specifically, faster diffusion in the tissue results in greater signal loss on diffusion weighted images, which is exacerbated with greater diffusion weighting (b-value). With diffusion weighting performed perpendicular to the spinal cord axis, white matter along the periphery of the cord appears bright, since the diffusion is slow and restricted perpendicular to the axons. In contrast, the gray matter within the central region of the cord appears darker, since it is composed of axons and cell bodies that are not all aligned along a single direction. In comparison, diffusion weighting in the parallel direction results in white matter with a darker appearance, since diffusion is fast along the axons, whereas gray matter is relatively brighter. It is important to note that the separate diffusion weighted images are shown for different b-values, since the parallel and perpendicular directions have the best contrast between white and gray matter at different b-values.
Combining all of the diffusion weighted images using mathematical formalisms allows maps of the diffusion parameters to be shown. The average signals from the white and gray matter are plotted against the diffusion weighting factor (b-value) for the parallel and perpendicular directions. This quantitative data reinforces the diffusion weighted images shown in Figure 4. Specifically, white matter has a strong dependence on the direction of the diffusion weighting (longitudinal or transverse), whereas gray matter is less dependent on the direction. Similarly, fitting of the signal at each voxel using the equation for diffusion kurtosis yields quantitative maps of diffusion parameters (Figure 6B), which highlight this same dependence. White matter has a high degree of anisotropy for both the diffusion (AID) and kurtosis measurements (AIK). Thus, transverse diffusion and kurtosis reveal the underlying microstructure of the spinal cord that is known from histological studies. These diffusion parameters, which are acquired in live, but anesthetized animals, reflect microscopic tissue properties such as axon density and diameter. Alterations in these measures caused by injury and disease will be useful for noninvasively evaluating the consequences of injury and the effects of promising therapies. Diffusion weighted imaging of the rat cervical spinal cord may therefore become a tool for preclinical studies of spinal cord injury and diseases of the spinal cord.
Figure 1: Design of the coil and holder for cervical spinal cord MRI. A custom quadrature volume coil (Doty Scientific Inc) was used to image the cervical spine with high sensitivity and uniformity. Anesthesia and medical air are delivered by the indicated gas ports into the nose cone, which fits comfortably around the nose of the rat. Exhaled and excess gas is captured by the exhaust line under slight vacuum. The head of the rat is secured with the bite bar placed around the incisors and the ear bars placed delicately within the ear canal. Other physiologic monitoring components, including the respiratory monitor and temperature probe are not shown.
Figure 2: Respiratory gating scheme. A typical respiratory trace (gray) and trigger (red) from the gating unit are shown schematically (A). In the typical implementation of gating (B), a single trigger is used to acquire all slices (vertical lines; 12 shown here) at times evenly-spaced within the repetition time (TR). If the TR exceeds the typical period, several slices may occur during a breath and be susceptible to motion (red). In the modified scheme (C), a subset of slices are acquired rapidly after the trigger (6 shown here) followed by a delay, with the other slices acquired after the subsequent trigger. Effectively, the TR is identical between the two schemes by rearranging the delays within the sequence.
Figure 3: MRI slice positioning, saturation bands, and motion control. Twelve axial slices were arranged on the scout image (A) with the most anterior slice positioned at a consistent distance from the intersection of the brainstem and cerebellum. Saturation bands (B) were added to eliminate unwanted signal outside the area of interest. An image without diffusion weighting (C) and one with diffusion weighting (D) with the custom gating scheme employed clearly show the anatomy of the cord and is free of artifacts. With the non-optimized gating scheme or improper respiratory gating, diffusion weighted images show artifacts (E) as a loss of signal within the cord, or multiple “ghosts” outside the cord that will corrupt subsequent analysis. Please click here to view a larger version of this figure.
Figure 4: Representative diffusion weighted images. Using the optimizations described in the text, high-quality diffusion weighted images were obtained with diffusion weighting applied transverse (A) and longitudinal (B) to the spinal cord main axis. Different b-values are shown for each direction that provide the best contrast between the white and gray matter for illustrative purposes. For each direction or b-value, all 12 slices were acquired in approximately 90 sec. Please click here to view a larger version of this figure.
Figure 5: Reversed phase-encode correction process. The left column shows a single slice imaged with the DWI sequence as outlined in this protocol (“blip up” image). The middle column shows the sequence acquired a second time with the “reverse blips” set to ‘on.’ Note how features that appear stretched in the first image appear compressed in the middle column. The right column shows the diffusion weighted images corrected using TOPUP. The top row is the non-diffusion weighted image, the middle row is an example with diffusion weighting applied in the transverse direction, and the bottom row is an example with diffusion weighting applied in the longitudinal direction. Please click here to view a larger version of this figure.
Figure 6: Computed maps of diffusivity and kurtosis. The normalized signal (image intensity) is plotted (A) as a function of diffusion weighting (b-value) for the transverse (T) and longitudinal (L) diffusion encoding direction. High-quality maps (B) of diffusivity (D), kurtosis (K), and anisotropy (AI) are calculated from the signal at each voxel and reveal unique features of the spinal cord tissue. Specifically, there is clear difference in parameters between the white and gray matter, as well as regional differences in the white matter regions. Please click here to view a larger version of this figure.
The techniques outlined here can provide high-quality diffusion weighted images of the rat spinal cord in vivo. Image quality depends on many factors, but the spinal cord has several unique issues that are important.
Motion is an important problem that if not corrected, will result in unusable images. Thus, it requires careful monitoring during the MRI session. If image artifacts are observed on the initial scan that are consistent with motion, stop the acquisition and take steps to eliminate the artifacts, since these are difficult to remove in post-processing. Ensure that the respiratory computer receives a strong, regular signal from the respiratory monitoring unit. The respiration belt may need to be adjusted for the correct tension that provides a consistent signal but does not restrict the animal’s breathing. Maintain the appropriate level of anesthesia at all times; 1.5–2.0% isofluorane has been used in our experience. Likewise, reduction in the overall movement of the animal and the spine is another important aspect to provide artifact-free images. Unlike the human spinal cord, which experiences significant motion caused by CSF pulsation related to the cardiac cycle, CSF pulsation in the rodent is predominantly associated with the respiratory cycle18. While it is difficult to fully eliminate all motion in the cord, it is particularly important to reduce the motion to the extent possible, which is often achieved through trial and error. Furthermore, rats with various neurological injuries or disorders may have abnormal respiratory rates or other physiological complications that may require adaption of the procedures outlined herein.
The modifications to the pulse sequence for respiratory gating, along with image reconstruction procedures tailored for this purpose, minimize the effects of distortion caused by inhomogeneous magnetic fields that cannot be removed by adjustments performed on the MRI system.
Similarly, image quality depends on the duration of imaging time. In our example, limiting the number of diffusion weighting along only two directions enabled a reduction in total imaging time. A limitation of this approach is that it is no longer compatible with full tensor analysis (DTI), which is the norm for many other studies. Alternatively, using fewer averages and more diffusion directions or b-values may allow for better characterization while maintaining the same acquisition time. Previous studies have shown that the 2-direction approach provides information consistent with the 6-direction (DTI) approach19, but care must be taken to ensure the slices (and diffusion directions) are oriented precisely along and perpendicular to the cord. However, acquiring multiple b-values allows for better characterization and mathematical fitting of kurtosis and is recommended over the use of a single b-value. Moreover, the full sequence was repeated with a reversed phase encode direction which reduces the effects of magnetic field susceptibility artifacts, and improves overall image quality through averaging. Finally, the image resolution used in our protocol provides clear separation of the white and gray matter. Images with higher resolution are possible, although this often comes at the expense of longer scan times or the potential for more artifacts.
Improvements in radiofrequency coils, pulse sequences, and post-processing methods will all have the effect of improving imaging of the spinal cord in future adaptations of this method. For example, surface coils may be beneficial for improved image quality similar to that observed in mice.20 These measures have a high likelihood of being useful as biomarkers for clinical diagnosis and management of spinal cord injuries.
The authors have nothing to disclose.
We thank Kyle Stehlik, Natasha Wilkins, and Matt Runquist for experimental assistance. Funded through the Research and Education Initiative Fund, a component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin, and the Craig H. Neilsen Foundation.
Name of Material/ Equipment | Company | Catalog Number | Comments/Description |
Small animal imaging RF coil | Doty | SAIP400-H-38-S | |
Respiratory gating system | SA Instruments | 1030 | |
MR scanner | Bruker | Biospec 94/30 USR |