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C A Mistretta

Publications and source records attributed to C A Mistretta.

At least 37 records · Page 2Linked to original sources
PubMed1999

Contrast-enhanced MR angiography of the carotid bifurcation.

With contrast-enhanced MR angiographic techniques, a T1-shortening contrast agent is injected into the blood stream. Imaging during the first pass of the contrast agent permits acquisition of a high-contrast MR angiogram. Scan parameters such as flip angle, repetition time, echo time, and scan duration, and injection parameters, such as dose and rate, must be carefully chosen to achieve maximum contrast between blood vessels and stationary tissues. A critical parameter affecting image quality is the timing of the acquisition relative to the injection. If the collection of the center of k-space does not coincide with peak arterial concentration, artifacts, reduced SNR, and venous enhancement may result. Several techniques have been developed to address the timing issue. Post-processing techniques such as subtracting a pre-contrast image from a post-contrast angiogram can be used to improve image quality. Intravascular contrast agents that may also lead to improved image quality are currently being developed.

Angiography, Digital Subtraction↗
PubMed1998

A rapid 2D time-resolved variable-rate k-space sampling MR technique for passive catheter tracking during endovascular procedures.

A new, fast, 2D MR imaging technique allowing passive catheter visualization adequate for use as a tool for guiding the movement of a catheter during endovascular procedures is described. This imaging technique samples low spatial frequencies more often than high spatial frequencies; it also uses both k-space view sharing and temporal interpolation. Unlike other techniques for passive visualization that exploit magnetic-susceptibility-induced artifacts, we have adopted a strategy that takes advantage of the T1-shortening effect of paramagnetic contrast agents, such as Gd-DTPA and a projection dephaser. This not only permits visualization of the entire catheter length but also minimizes the risk of intravascular heating. Using this method, a temporal frame rate of up to eight images per second and a tip localization accuracy of +/- 1mm (root mean square difference) can be achieved.

Angioplasty, Balloon↗
PubMed1998

3D time-resolved contrast-enhanced MR DSA: advantages and tradeoffs.

The 3D TRICKS method for contrast-enhanced, time-resolved MR DSA has been recently described. In this paper, computer simulations are used to investigate the relative frame rate, temporal window, artery-vein temporal separation, contrast-to-noise ratio, and spatial resolution of TRICKS and conventional scans for breath-hold and non-breath-hold applications. For non-breath-hold applications, TRICKS can be configured to provide increased CNR or spatial resolution at an increased frame rate, but with a longer temporal window when compared with a series of conventional scans in which the central portion of k-space is sampled at the same rate as for the TRICKS scans. For breath-hold applications, TRICKS typically provides three images with 75% of the conventional single acquisition spatial resolution and is more tolerant of variations in contrast curve shape within the field of view.

Computer Simulation↗
PubMed1998

Coronary flow and flow reserve in canines using MR phase difference and complex difference processing.

Coronary artery disease continues to be the leading cause of death for adults in the United States. Magnetic resonance imaging (MR) has the potential to dramatically impact the diagnosis of heart disease by noninvasively providing a wide range of anatomic and physiologic information. Previous research has shown that coronary flow, one component of a complete examination, can be accurately measured in the left anterior descending artery in vivo. The current work validates MR flow measurements in canine circumflex arteries using transit time ultrasound as a standard. The circumflex artery experiences greater in-plane motion and is a more stringent test for flow measurement accuracy. This work also compares two methods of processing MR velocity data, phase difference and complex difference techniques, and examines the sources of error present in the animal validation model. Phase difference processing with a 30% magnitude threshold best matched the mean ultrasound flow values (30% PD = 1.04 x US + 1.49, r = 0.94), but it was very sensitive to vessel boundary identification. The complex difference process was less sensitive to vessel boundary identification and correlated well with the transit time ultrasound despite systematic underestimations. The reasons for the discrepancies are shown to stem from a number of possible sources including variability of the ultrasound standard, low signal-to-noise ratios in the MR images, sensitivity of the MR technique to vessel boundary identification, and motion artifacts in the images.

Animals↗
PubMed1998

X-ray digital subtraction angiography to magnetic resonance-digital subtraction angiography using three-dimensional TRICKS. Historical perspective and computer simulations: a review.

Seventeen years after the introduction of x-ray digital subtraction angiography (DSA), gadolinium-enhanced magnetic resonance (MR) angiography techniques have become available for the performance of MR-DSA. For the purposes of this article, we will consider this to include two-dimensional and three-dimensional approaches using time-resolved and non-time-resolved applications. Magnetic resonance-DSA is one in a historical progression of techniques which have aimed to produce less invasive forms of angiography. After outlining some historical milestones, several current issues regarding current methods for MR-DSA are discussed.

Angiography, Digital Subtraction↗
PubMed1998

Steady-state and dynamic MR angiography with MS-325: initial experience in humans.

PURPOSE: To evaluate the imaging performance and patient tolerance of a blood-pool contrast agent (MS-325) for magnetic resonance (MR) angiography. MATERIALS AND METHODS: Imaging of peripheral and carotid vessels was performed in seven healthy volunteers in a phase I clinical trial of the gadolinium chelate MS-325. Each volunteer received an intravenous injection of 0.05 mmol/kg MS-325 over 30 seconds. Dynamic (arterial phase) and steady-state (arterial-venous phase) three-dimensional gradient-echo MR angiograms were acquired during, immediately after, and approximately 50 minutes after injection. Images were ranked (1 [poor] to 5 [excellent]) for overall image quality, and signal-to-noise ratio (S/N) and contrast-to-noise ratio (C/N) were measured by using standard techniques. RESULTS: All volunteers tolerated the procedure well. The MS-325-enhanced studies demonstrated intense vascular signal. Mean peripheral arterial C/N was 12.9 +/- 4.8 (standard deviation), 78.8 +/- 29.4, 46.1 +/- 10.9, and 41.9 +/- 14.1 for the two-dimensional (2D) time-of-flight (TOF) and the contrast material-enhanced dynamic, early steady-state, and late steady-state images, respectively. Image quality of steady-state postcontrast images was statistically significantly (P < .02) higher than that of 2D TOF images. Image quality of early and late postcontrast images was similar, but a small (10%) decrease in C/N was noted from early to late images. CONCLUSION: MS-325 provides excellent vascular and selective arterial enhancement during dynamic MR angiography. The long blood residence time also allows acquisition of steady-state images of the arteries and veins with excellent spatial resolution.

Abdomen↗
PubMed1998

Contrast-enhanced 3D MR DSA of the carotid artery bifurcation: preliminary study of comparison with unenhanced 2D and 3D time-of-flight MR angiography.

PURPOSE: To compare the delineation of stenosis at the carotid artery bifurcation on three-dimensional (3D) magnetic resonance (MR) digital subtraction angiographic (DSA) images with that on two-dimensional (2D) and 3D time-of-flight (TOF) MR angiographic images. MATERIALS AND METHODS: Twenty-six patients with 29 carotid artery bifurcations and symptoms of cerebral ischemia underwent 3D MR DSA. A time-resolved series was generated with 3D MR DSA after the bolus injection of gadodiamide. The resolution for a carotid artery examination was 0.4 x 0.4 x 1.0 mm, with volumes reconstructed at 4.5-second intervals. The 3D MR DSA images were compared with contemporaneously acquired unenhanced 2D and 3D TOF images. Two observers ranked the 2D and 3D TOF MR angiographic and 3D MR DSA images according to the following: (a) stenosis delineation, (b) internal carotid artery delineation, (c) intravascular signal intensity, and (d) diagnostic confidence. RESULTS: The mean ranking for diagnostic confidence was 1.10 (1 = best technique, 3 = worst technique) for 3D MR DSA. Compared with the pooled 2D TOF and 3D TOF ranks, the 3D MR DSA rank was significantly better (P < .01). Similar levels of statistical significance were found for the other criteria. CONCLUSION: Three-dimensional MR DSA improves the delineation of carotid arterial stenosis by virtually eliminating saturation effects and reducing intravoxel dephasing. Surface morphology and nearly occluded vessels ("string sign") were easily identified. Confidence in identifying carotid arterial occlusions was also very high with this technique.

Angiography, Digital Subtraction↗
PubMed1998

MR angiography: basic principles and theory.

The most commonly used MR angiography techniques are categorized as time-of-flight, phase-contrast, or contrast-enhanced methods. When the basic principles of the various MR angiographic methods are understood, the techniques can be used to achieve high-quality angiograms. This article describes the physical principles and theory of some of the most widely used MR angiographic methods.

Contrast Media↗
PubMed1997

Dispersion in magnetization transfer contrast at a given specific absorption rate due to variations of RF pulse parameters in the magnetization transfer preparation.

The effects of RF pulse parameters on magnetization transfer contrast (MTC) were investigated using a magnetization prepared segmented fast gradient echo sequence. MTC was found not to be uniquely determined by the specific absorption rate (SAR). RF pulse parameters (RF amplitude, number of RF pulses and RF duration) also affect MTC. There can be 40% variation in MTC due to differences in RF parameters at SAR = 1 W/kg for a 70-kg subject. Increasing the number of RF pulses is a more efficient way to increase MTC than increasing RF amplitude. This phenomenon is likely caused by the fact that the time scale for magnetization transfer between the free and restricted proton pools is on the same order or longer than the duration of the MT pulse. Accordingly, increase in the MT pulse duration by increasing the number of RF pulses in the MT pulse allows more effective magnetization transfer. Such information can be used as a guide to select RF pulse parameters for a magnetization transfer (MT) pulse. An off-resonance MT pulse designed under this guide for coronary MR angiography improved the depiction of distal vessels.

Animals↗
PubMed1996

Frequency response of multi-phase segmented k-space phase-contrast.

A theoretical analysis of the temporal frequency response of multi-phase segmented k-space phase-contrast was developed. This includes the effects of both segment duration and the number of cardiac phases that are reconstructed. An increase in the number of views per segment and the corresponding increase in segment duration results in an increased smoothing or low-pass filtering of the time-resolved flow waveform. Reconstruction of all intermediate cardiac phases makes the Nyquist sampling frequency independent of the number of views per segment. This analysis was verified experimentally using a multi-phase phase-contrast segmented k-space MR pulse sequence. This sequence reconstructs all intermediate cardiac phases and uses fractional segments at the end of the cardiac cycle if an entire segment does not fit. The use of fractional segments increases the portion of the cardiac cycle over which data are acquired.

Coronary Circulation↗
PubMed1996

Time-resolved contrast-enhanced 3D MR angiography.

An MR angiographic technique, referred to as 3D TRICKS (3D time-resolved imaging of contrast kinetics) has been developed. This technique combines and extends to 3D imaging several previously published elements. These elements include an increased sampling rate for lower spatial frequencies, temporal interpolation of k-space views, and zero-filling in the slice-encoding dimension. When appropriately combined, these elements permit reconstruction of a series of 3D image sets having an effective temporal frame rate of one volume every 2-6 s. Acquiring a temporal series of images offers advantages over the current contrast-enhanced 3D MRA techniques in that it I) increases the likelihood that an arterial-only 3D image set will be obtained. II) permits the passage of the contrast agent to be observed, and III) allows temporal-processing techniques to be applied to yield additional information, or improve image quality.

Contrast Media↗
PubMed1996

Imaging characteristics of x-ray capillary optics in digital mammography.

Computed radiography (CR) has shown promise in digital mammographic screening due to its good low spatial frequency MTF and its relatively wide exposure latitude. The CR image format has not gained acceptance clinically because of reduced high spatial frequency resolution as compared to film-screen images. X-ray capillary optics, aligned between the breast and CR phosphor imaging plate, will capture primary x-ray photons almost exclusively. Due to the very small angle of acceptance, scattered photons angled more than about 1.6 x 10(-3) radians from primary trajectory will not be accepted at the capillary optic entrance. The virtual elimination of detected scatter means almost 100% of the possible primary contrast should be visible in the image. In addition, the image can be magnified without focal spot blurring. Effective resolution of CR images can be increased by a factor equal to that magnification. Clinical implementation of future capillary optics are expected to be either in the form of a large, stationary, post-patient optic that accepts primary from the entire breast or a fan-shaped optic that is scanned across the breast. Measurements of a test capillary optic showed a reduction of scatter fraction to 0.018. Images of a lucite contrast detail phantom revealed a corresponding increase in image contrast when compared to anti-scatter grid and no grid methods. Spectral transmission measurements using a high-purity germanium detector showed good primary transmission (45%-50%) in the mammographic energy range. The MTF measurements of both stationary and scanned capillary optics showed improvement at the 5% MTF level to 8.4 mm-1 for scanned optics and 9.2 mm-1 for stationary optics representing a 68% and 84% respective increase over the CR MTF without magnification or capillary optics.

Capillary Action↗
PubMed1996

MR angiography with three-dimensional MR digital subtraction angiography.

We have developed a time-resolved, contrast-enhanced, volume-imaging technique for magnetic resonance (MR) angiography, known as three-dimensional (3D) MR digital subtraction angiography (DSA). This technique greatly improves MR angiogram quality because it combines the injection of a contrast agent with the ability to image the temporal passage of this agent and, thereby, obviates the need for timing scans or other complicated synchronization schemes. Three-dimensional MR DSA also represents a potential improvement in the sense that, relative to DSA and computed tomography (CT) angiography, the contrast agent is less toxic. Additionally, unlike CT angiography, images may be acquired during the passage of the contrast agent. Therefore, 3D MR DSA shows the sequential passage of contrast through the arterial and venous system, followed by uptake in various organs. Unlike conventional DSA, 3D MR DSA imaging acquires full volume datasets, which allows subsequent reprojection and reformatting. Because images are obtained at approximately 2-6 s time intervals using a temporal aperture on the order of several seconds, motion (such as respiration) causes only a temporary disruption of image quality, similar to that observed in MR fluoroscopy. These temporal characteristics also make the proposed sequence insensitive to variations in the shape and timing of the contrast-pass curve. Although the individual time-resolved images will have somewhat decreased signal-to-noise ratio (SNR) relative to nontime-resolved scans collected in the same acquisition time, the SNR improvement due to the gadolinium appears to accommodate this trade-off. Additionally, if motion between successive images is small, then the full suite of temporal processing schemes, previously investigated in connection with DSA and time-resolved two-dimensional (2D) MR, such as mask mode subtraction, simple matched filtering and Eigen filtering, can be used to obtain composite images. These derived images generally have an increased SNR or negligible venous signal if an arterial-phase image is not obtained in the early time-resolved images. In summary, 3D MR DSA will significantly advance MR angiography because of the following intrinsic advantages: (1) improved signal-to-noise, (2) scan orientation may be chosen independently of the direction of blood flow, (3) uniform vascular signal, even from regions of complex flow, (4) minimization of motion artifacts, (5) greatly reduced sensitivity to variation in the shape and timing of the contrast bolus, (6) ability to be reformatted or reprojected, and (7) ability to apply a variety of temporal postprocessing techniques.

Angiography, Digital Subtraction↗
PubMed1995

Coronary MRI with a respiratory feedback monitor: the 2D imaging case.

The inability to return the heart to the same position for all breath-holds during 2D coronary MR imaging can result in imaging different locations than desired. This can lead to problems such as (i) missing a whole vessel, or a part of it, (ii) misaligning segments of vessels imaged in different breath-holds, and (iii) degrading image quality when a single slice is acquired in multiple breath-holds. To reduce inconsistencies in the breath-hold level, we designed a respiratory feedback monitor (RFM) that uses a bellows to monitor the circumference of the subject's chest. When the circumference of the subject's chest is within preset limits, an audio signal alerts subjects to hold their breath at that position. Use of the RFM significantly reduces the problems caused by inconsistent breath-holds and the number of breath-holds for an examination in 2D coronary MR imaging.

Adult↗
PubMed1995

Respiratory blur in 3D coronary MR imaging.

3D MR imaging of coronary arteries has the potential to provide both high resolution and high signal-to-noise ratio, but it is very susceptible to respiratory artifacts, especially respiratory blurring. Resolution loss caused by respiratory blurring in 3D coronary imaging is analyzed theoretically and verified experimentally. Under normal respiration, the width for any Gaussian point spread function is increased to a new value that is at least several millimeters (about 3-4 mm). In vivo studies were performed to compare respiratory pseudo-gated 3D acquisition with breath-hold 2D acquisition. On average, the overall quality of a pseudo-gated 3D image is worse than that of the corresponding breath-hold 2D image (P = 0.005). In most cases, respiratory blur caused coronary arteries in pseudo-gated 3D data to have lower resolution than in breath-hold 2D data.

Adult↗
PubMed1995

Measurements of capillary x-ray optics with potential for use in mammographic imaging.

Capillary optic arrays are bundles of hollow glass capillaries which guide x rays in a manner similar to the way fiber optics guide light. Focused postpatient capillary optic arrays have the potential to significantly improve both contrast and resolution of mammographic images compared to conventional antiscatter grids. Contrast can be improved by the nearly total scatter rejection of the optic. Effective resolution can be improved by geometric magnification without increased focal spot blurring. The best results were found for borosilicate glasses, with transmissions in excess of 60% for 22-cm-long fibers. To evaluate the scatter rejection properties, the transmission of off-axis radiation was measured. Transmission drops to < 1% at an angular displacement of 2.7 mrad. Transmission of a bulk capillary array dropped to near zero if the source was at an angle of 2.5 mrad. This implies excellent scatter rejection capabilities. To evaluate whether unchanneled photons might still reach the detector, absorption measurements were also performed on fibers and arrays. Absorption was found to be adequate for scatter rejection. All of the data agreed well with numerical simulations. Performance calculations for two potential optics geometries gave promising results.

Biophysical Phenomena↗
PubMed1994

A regional convolution kernel algorithm for scatter correction in dual-energy images: comparison to single-kernel algorithms.

Single kernel scatter correction algorithms are based on the model that the scatter field can be predicted by convolution of the primary intensity (Iprim) with a spatially invariant scatter point-spread function (PSF). Practical limitations (Iprim unknown) suggest the substitution of the total detected intensity (Idet) for Iprim as the source image in the convolution. In regions of high scatter fraction (SF), Idet is a poor approximation of Iprim, thereby causing an overestimation of scatter originating in the region. This contributes to errors in estimating detected scatter in the mediastinum and neighboring regions. A technique using a regionally variable point-spread function that significantly reduces RMS error in estimation of the primary image as compared to the single PSF method is investigated. The regionally variable convolution method employs a larger PSF in the mediastinum and a smaller PSF in the lungs to reduce the error in estimating the scatter throughout the image. The method to allow for patient differences has also been expanded and various implementations of these methods have been compared. Results show that the dual-kernel algorithm is always more effective than an equivalent single-kernel algorithm. The dual-kernel algorithm using a predicted scatter fraction curve gives an overall RMS error in the primary of as low as 20.8% which is equivalent to 8.7% RMS error in the scatter. The dual-kernel method using a predicted scatter fraction curve approaches the accuracy of the single-kernel method using patient specific scatter measurements. Because using individual scatter measurements is a less desirable method for clinical use, we feel that the dual-kernel algorithm which uses two regions specific convolution kernels and a variable scatter fraction curve is the preferable method.

Algorithms↗