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Biomedical subjects

C B Higgins

Publications and source records attributed to C B Higgins.

At least 253 records · Page 14Linked to original sources
PubMed1988

Acute myocardial ischemia: MR imaging with Mn-TP.

Cardiac-gated magnetic resonance (MR) imaging was performed in rats to determine the effects of manganese ethylenediaminetetraphosphonate (TP). Ten normal rats received Mn-TP in a dose of 50 mumol/kg through a tail-vein injection. Spin-echo MR images were obtained before and every 10 minutes after Mn-TP injection for 1 hour. Cardiac signal intensity (SI) increased more than 70% after Mn-TP injection and remained nearly unchanged 1 hour after injection. Myocardial T1 was 517 +/- 49 msec in eight control rats and 282 +/- 61 msec (P less than .001) in six rats 81 +/- 0 minutes after injection. Nine rats underwent occlusion of the left anterior descending coronary artery prior to MR imaging. Images were obtained before and 15, 30, and 60 minutes after Mn-TP injection. In normal myocardium, SI increased up to 82% and remained elevated for 1 hour. In ischemic myocardium, SI rose 11%, leading to a marked contrast between the two tissue zones. T1 was also different in the two regions: In normal tissue, it was 206 msec +/- 54; in ischemic tissue, 338 +/- 82 (P less than .001). With T1-weighted MR imaging, Mn-TP showed a potential for delineating the jeopardized area after acute myocardial ischemia.

Animals↗
PubMed1988

Mitral or aortic regurgitation: quantification of regurgitant volumes with cine MR imaging.

A new, rapid magnetic resonance (MR) imaging method, cine MR imaging, was used to determine the regurgitant fraction (RF) in patients with left-sided regurgitant lesions. Right and left ventricular stroke volumes were determined with cine MR imaging and a modified Simpson formula in ten healthy volunteers and 23 patients known to have either predominant mitral (n = 17) or aortic (n = 6) regurgitation. RFs evaluated at cine MR imaging were compared in healthy persons and patients with mild, moderate, or severe regurgitation demonstrated at angiography (n = 10) and Doppler echocardiography (n = 13). Cine MR imaging depicted regurgitant blood flow in all 29 regurgitant lesions in 23 patients as areas of low signal intensity within the regurgitant chamber. The RF was 4% +/- 7% in healthy subjects and 12% +/- 12% in those with mild, 35% +/- 14% in those with moderate, and 63% +/- 5% in those with severe regurgitation. The RFs determined by two observers were similar.

Adult↗
PubMed1988

Recurrent thyroid carcinoma: characteristics on MR images.

Magnetic resonance (MR) imaging was used in 32 patients, including eight with benign disease, after partial or total thyroidectomy to determine sensitivity and specificity of MR imaging in the detection of tumor recurrence, to compare signal intensities of scar versus recurrent tumor qualitatively and quantitatively, and to define the extent of recurrent tumor. Findings from surgery (n = 23), needle biopsy (n = 1), or clinical follow-up (n = 8) were used for verification. Of 24 patients with primary thyroid carcinoma, 15 had recurrence and nine had a normal postsurgical thyroid bed. Diagnosis from MR images was correct in 20 cases, but false positive in three and false negative in one. Local recurrence was characterized by low to medium intensity on short repetition time (TR)/short echo time (TE) images and medium to high intensity on long TR/long TE images. Scar in the normal postsurgical thyroid bed showed low intensity on both short and long TR/TE images. Local recurrence of thyroid carcinoma and lymph node metastasis produced positive contrast compared with muscle on short TR/short TE (31 + 19%) and long TR/long TE (85 + 30%) images; fibrosis produced negative contrast, particularly on long TR/long TE (-56, -80%) images. These results indicate the capability of MR imaging in the evaluation of recurrence of thyroid tumors and in the differentiation of abnormal tissue due to tumor recurrence from postoperative fibrosis by means of signal contrast relative to a reference tissue.

Adult↗
PubMed1988

MR imaging of the aorta after surgery for aortic dissection.

MR imaging is known to be an effective technique for the noninvasive diagnosis of thoracic aortic disease, but it has not been used to monitor the appearance of the aorta or the fate of the false lumen after surgery for aortic dissection. This study describes our initial experience with postsurgical MR imaging of aortic dissection (nine type A and two type B) to evaluate prognostically important features, including the status of residual false lumen. The most notable findings were (1) aneurysmal dilatation beyond the interposed graft (11/11 cases), (2) residual intimal flap (10/11 cases) with at least partial patency of the false lumen (10/10 cases), and (3) origin of a visceral vessel from the false lumen in persistently dissected abdominal aorta (6/9 cases). Evaluation of residual false lumen by double-spin-echo-intensity and phase-display techniques showed evidence of slow blood flow with variable amounts of thrombus in eight of 10 cases. Differentiation between signal within the false lumen due to slow flow and signal due to thrombus was facilitated by phase display. MR imaging can be used for noninvasive monitoring of the aorta after surgical repair of aortic dissection. Since the false lumen usually remains patent after surgical repair, such follow-up of its status seems necessary for identifying potential complications of the original dissection and/or the therapy.

Adult↗
PubMed1988

Quantification of regional myocardial function by rapid cine MR imaging.

The capability of rapid (cine) MR imaging to quantitate left ventricular function was assessed in 13 normal subjects and in 15 patients with ischemic heart disease and regional wall-motion abnormalities proved by echocardiography and/or by contrast ventriculography. Fifteen to 20 MR images/cardiac cycle were acquired by using partial flip angles, short repetition times, and gradient-refocused echoes. Regional wall motion was assessed qualitatively in the equatorial left ventricular section by using the cine display and quantitatively by measuring myocardial thickness at end-diastole and at end-systole in six left ventricular segments in this plane. In normal volunteers wall motion was normal in all segments. Heterogeneity of systolic wall thickening was observed in normal subjects, ranging from 33% +/- 17% in the posteroseptal segment to 66% +/- 29% in the posterior segment. Overall systolic wall thickening was 48% +/- 28%. From the cinematic display of MR images, abnormal wall motion was observed in 40 of 90 segments in patients with ischemic heart disease, which correlated well with results of echocardiography or contrast ventriculography. Twenty-one segments were hypokinetic, 15 were akinetic, and four were dyskinetic. In patients with ischemic heart disease, percentage systolic wall thickening was 43% +/- 31% in the segments with normal wall motion, 6% +/- 18% in hypokinetic segments, -4% +/- 24% in akinetic segments, and -13% +/- 25% in dyskinetic zones. Absolute systolic wall thickening was less than 2 mm in 31 of 40 abnormal segments and was greater than 2 mm in only three. Rapid acquisition, improved temporal resolution, and the capacity for cine display make this new MR technique potentially useful not only for qualitative assessment of cardiac wall motion, but also for quantification of regional myocardial function.

Adult↗
PubMed1988

Diagnosis of recurrent hyperparathyroidism: comparison of MR imaging and other imaging techniques.

Several reports have indicated good results with MR imaging of hyperparathyroidism. However, its use in recurrent hyperparathyroidism has not been assessed separately. Thirty patients with recurrent hyperparathyroidism were evaluated by MR with both T1- and T2-weighted images. Twenty-six and 23 of these patients, respectively, also had thallium-201 scintigraphy and high-resolution sonography. For the 28 patients who eventually had surgical exploration and histologic evidence of adenoma (21 cases) or hypoplasia (seven cases), MR accurately located abnormal parathyroid glands in 75% evaluated prospectively and 89% evaluated retrospectively. Scintigraphy located 68% prospectively and 76% retrospectively. Sonography detected 57% prospectively and 67% retrospectively. For patients undergoing three studies, the prospective and retrospective detection rate was significantly better (p less than .05) for MR compared with sonography but was not significantly different for MR and scintigraphy. MR detected three of four mediastinal adenomas evaluated prospectively and retrospectively. One false-positive case was seen with MR, one with scintigraphy, and one with sonography. Thus, MR can be used to locate abnormal parathyroid tissue at a rate equal to or better than scintigraphy or sonography.

Adenoma↗
PubMed1988

Coronary artery bypass grafts: evaluation of patency with cine MR imaging.

This report describes our first experiences in using cine MR imaging to assess the status of a coronary artery bypass graft (CABG). This technique uses a low flip angle, a fast repetition rate, and gradient-refocused echoes to produce images in which the signal of flowing blood within even small vascular structures (e.g., CABGs) is enhanced. Twenty-eight CABGs were evaluated by using both cine MR imaging and coronary angiography (as "gold standard"), and the MR images were interpreted blindly for determination of patency or occlusion of the CABGs. The sensitivity of cine MR imaging for determination of CABG patency was 93%, the specificity was 86%, and the overall predictive accuracy was 89%. Because cine MR imaging facilitates the identification of patent vascular structures by enhancing the signal intensity of flowing blood, this technique seems particularly attractive for noninvasively determining CABG patency.

Adult↗
PubMed1988

Malcolm Hanson memorial lecture. MR of the heart: anatomy, physiology, and metabolism.

During the initial years, the use of MR imaging focused on the display of normal and abnormal cardiac anatomy. ECG-gated spin-echo imaging provides high-quality static images that clearly depict cardiac anatomy and a variety of anatomic abnormalities. However, it is now becoming clear that, with the addition of recent innovations, MR also is capable of evaluating cardiovascular physiology. With the use of fast imaging techniques, we can acquire images with essentially high temporal resolution so that cardiac function can be quantitated. Moreover, the use of proton and 31P MR spectroscopy provides additional information, which should enable the sequential monitoring of both cardiac function and metabolism.

Heart↗
PubMed1988

Myocardial paramagnetic contrast agents for MR imaging.

Several different paramagnetic contrast agents have been investigated for use in myocardial MR imaging. Gd-DTPA, the most extensively studied agent, has been shown to improve the conspicuity of acute myocardial infarcts on MR images in experimental animals and humans. However, this agent is limited as a marker of perfusion because of its rapid elimination by renal excretion and equilibration within the extracellular fluid space. Future investigation of Gd-DTPA as a myocardial perfusion agent may involve rapid-scanning techniques to define time-dependent accumulation of the contrast agent in normal and ischemic myocardium during the first pass after IV injection. Nondiffusable paramagnetic agents and agents with prolonged retention in myocardium are being studied actively, but further tests of toxicity and metabolism are needed before clinical trials. Additional macromolecular-bound metal chelates will be tested in the future. It is hoped that these agents will allow detection of the jeopardized region of myocardium in the setting of acute ischemia, before the onset of myocardial edema.

Animals↗
PubMed1988

Measurement of regional myocardial blood flow in dogs by ultrafast CT.

We measured blood flow within each of eight segments of the left ventricular myocardium in dogs by an Ultrafast CT scanner. The results were compared with flow determined by radiolabeled microspheres. Computed tomography (CT) flow was measured by an intravenous injection of nonionic contrast agent done simultaneously with the left atrial injection of microspheres. We calculated flow from the CT data by obtaining CT number versus time curves for regions of interest in the myocardium and by using a formula that related flow to both the time and value of the peak enhancement. Measurements were obtained in five dogs at rest and during hyperperfusion induced by chromonar. Based on 169 regional measurements, the Ultrafast CT and microsphere-determined flows correlated moderately (r = 0.68) over a range of 0.4 to 8 mL/min/g. However, when the data were divided into resting and hyperperfusion (ie, 20 to 30 minutes after the injection of the chromonar) states, a significant (P less than .001) increase in regional flow was determined from the CT measurements. The conclusion was that Ultrafast CT can distinguish between low and high myocardial flow states in dogs and has considerable potential for evaluating coronary flow reserve.

Animals↗
PubMed1988

Diagnosis of prosthetic aortic graft infection by magnetic resonance imaging.

The accuracy of magnetic resonance imaging (MRI) in the diagnosis of prosthetic aortic graft infection was evaluated in 18 patients with history and findings suggestive of this complication. The prospective interpretation of MRI was compared with surgical findings. Sixteen patients had a graft infection verified at operation. Fourteen patients had infection of the retroperitoneal portion of the graft; two patients had an infection limited to one of the groins; no graft infection was found at surgical exploration in the remaining two patients. Perigraft infection was correctly diagnosed on the basis of MRI findings in 14 of 16 cases; findings were false negative in one case, questionable in another case, and correctly excluded graft infection in two of two cases. MRI also defined the extent of infection in 14 of 16 cases. MRI findings that supported the clinical suspicion of graft infection were perigraft fluid collections remaining more than 3 months after surgery. Furthermore, local inflammation was suggested by an increased signal intensity of adjacent muscle on T2-weighted images in some cases. CT scans were performed in 12 patients; these enabled a correct diagnosis in five and provided indeterminate or false information in seven. These results indicate that MRI is helpful in the diagnosis of aortic graft infection. Furthermore, MRI provides information about the extent of infection crucial for planning therapy.

Abscess↗
PubMed1988

[Left ventricular function and intra-cardiac blood flow: study using dynamic magnetic resonance tomography].

Cardiac function can be assessed using conventional spin-echo magnetic resonance imaging. However, long imaging times and poor temporal resolution have limited the clinical applicability of this technique. A new dynamic magnetic resonance pulse sequence avoids these shortcomings using lower flip angles, shorter repetition and echo times and gradient refocused echoes. The entire heart can thus be imaged with a temporal resolution of 60 ms within 20 min. Display of 15 images of the cardiac cycle in a movie loop allows excellent visual assessment of cardiac motion and intracardiac blood flow. Applications of this new technique include blood flow measurements, visualization of regurgitant or shunt blood flow in patients with valvular regurgitation or ventricular septal defect, assessment of regional wall thickening in patients with myocardial disease, and three-dimensional determination of ventricular and atrial volumes.

Blood Flow Velocity↗
PubMed1987

Regional left ventricular wall thickening by magnetic resonance imaging: evaluation in normal persons and patients with global and regional dysfunction.

Gated magnetic resonance imaging (MRI) provides excellent anatomic evaluation of the heart, but its capability for assessing cardiac physiology is less clear. Accordingly, regional left ventricular (LV) wall thickening was evaluated by multiphasic transverse images in 37 patients with a variety of myocardial diseases and in 9 normal subjects. Angiography and 2-dimensional echocardiography (2-D echo) were used for comparison. End-diastolic and end-systolic wall thickness, absolute systolic wall thickening and percent systolic wall thickening were determined in 7 regions. Mean systolic wall thickening in normal subjects was not significantly different among the regions. However, there was considerable individual variation in wall thickening, ranging from 18 to 100%. Patients with LV hypertrophy (n = 4), amyloid cardiomyopathy (n = 1), constrictive pericarditis (n = 5), and hypertrophic cardiomyopathy (n = 3) had absolute and percent systolic wall thickening within normal limits. Infarcted segments in patients with ischemic heart disease (n = 17) had reduced absolute and percent systolic wall thickening, often combined with diastolic wall thinning, whereas mean percent systolic wall thickening in adjacent normal myocardial regions was higher than in normal volunteers (p less than 0.001). In patients with coronary artery disease, MRI had a sensitivity and specificity of 93% in detecting regional wall motion abnormalities. Because sagittal images were not acquired, inferior wall motion abnormalities were not assessed by MRI due to parallel wall sectioning in transverse images.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomegaly↗
PubMed1987

Proton NMR spectroscopy in canine myocardial infarction.

Proton NMR spectroscopy was used to study the relationship between proton relaxation times and other resonances in the proton spectra, such as lipids, creatine, and choline/carnitine in subacute (8-day-old) myocardial infarctions. Eight mongrel dogs received operative ligation of the left anterior descending coronary artery (four were permanently occluded, four were occluded for 1 h and reperfused) and were sacrificed 8 days later so that tissue samples could be prepared for NMR spectroscopy. The results of this study indicate that (for the core of infarcted tissue) the lipids do not contribute directly to the increased bulk relaxation times associated with myocardial infarction and that the lipid peaks (2.3, 1.2, 0.8 ppm) and creatine peak (3.0 ppm) are more specific to the kind of infarct than to the relaxation times. Therefore, analysis of the proton spectrum of myocardial tissue may serve as a method for tissue characterization.

Animals↗
PubMed1987

Quantification of cardiac function by conventional and cine magnetic resonance imaging.

Magnetic resonance imaging (MRI) has been effective for depicting cardiac anatomy and is already established as a technique for the evaluation of some structural abnormalities of the heart and pericardium. With recent advances, MRI can now be used to quantitate cardiac function. Multiphasic ECG-gated spin-echo imaging has been used to quantitate right and left ventricular volumes and ejection fraction, left ventricular mass, and regional myocardial wall thickening. The new technique of cine MRI acquires frames during the cardiac cycle with a time resolution corresponding to 20 msec up to approximately 40 frames for an average cardiac cycle. This technique uses narrow flip angle (30 degrees) and gradient refocused echoes. Cine MRI has been used to measure ventricular volumes and ejection fraction and regional myocardial wall thickening. It is also sensitive to the detection of valvular regurgitation and can provide quantitation of regurgitant volume. This article reviews the current status of MRI for quantitating cardiac function.

Heart↗