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Biomedical subjects

C B Higgins

Publications and source records attributed to C B Higgins.

At least 127 records · Page 7Linked to original sources
PubMed1994

The use of contrast-enhanced magnetic resonance imaging to define ischemic injury after reperfusion. Comparison in normal and hypertrophied hearts.

RATIONALE AND OBJECTIVES: Magnetic resonance imaging (MRI) was used to demonstrate the infarction size in reperfused ischemic myocardium of normal and hypertrophied hearts, and to test the hypothesis that hypertrophied hearts manifest greater susceptibility to ischemia. METHODS: Normal rats (n = 11) and rats subjected to left ventricular hypertrophy (LVH) by aortic banding (n = 13) were studied. After 7 weeks, the left coronary artery was occluded for 25 minutes and reperfused for 1 hour before MRI. Electrocardiogram-gated spin-echo images were acquired before and after administration of 0.3 mmol/kg gadoteridol. To quantify the hyperintense area demarcated by gadoteridol, 3 transaxial images were acquired at different levels. Jeopardy and infarcted areas were measured in the same three slices postmortem using blue dye and triphenyltetrazolium chloride (TTC) stain, respectively. RESULTS: Before administration, there was no significant difference in signal intensity between nonischemic (0.42 +/- 0.03 arbitrary units) and ischemic (0.41 +/- 0.03) myocardium in either group. After gadoteridol injection, signal intensity of the reperfused injured region was higher than that of nonischemic myocardium (1.48 +/- 0.16 vs. 0.72 +/- 0.06, P < .05). Magnetic resonance delineation of the hyperintense area persisted for at least 30 minutes. The size of the hyperintense area was larger in LVH than in control hearts (25 +/- 5% vs. 7 +/- 3% of LV surface area, P < .05) and did relate closely to the area of myocardial infarction (r = .97), but not with the jeopardy area (r = .42). On TTC staining, the infarction size also was significantly greater in LVH than in normal group (18 +/- 5% vs. 5 +/- 2% of LV surface area, P < .05). The jeopardy areas of normal and LVH hearts showed no significant difference (46 +/- 2% vs. 47 +/- 3%). CONCLUSION: Magnetic resonance imaging confirms the concept that reperfused myocardial injury is larger in LVH than normal hearts after brief coronary occlusion. Contrast-enhanced MRI can define the size of reperfused myocardial injury. Thus, MRI is a suitable technique to assess conditions accentuating ischemic injury.

Animals↗
PubMed1994

Magnetic resonance imaging in adult congenital heart disease.

Some patients with congenital cardiac anomalies develop their first symptoms as adults, and many more will survive to adulthood with congenital lesions that have been treated surgically. Magnetic resonance imaging (MRI) currently provides sufficient morphological information to allow the anatomical diagnosis of congenital abnormalities involving the heart and the great arteries. Newer MR techniques have also been developed that provide functional information such as measurements of valve gradients, stroke volumes, regurgitant volumes, and shunt volumes. Cardiac evaluation utilizing MR techniques may soon replace cardiac catheterization for the preoperative diagnosis of congenital heart disease and its long-term follow-up.

Adult↗
PubMed1994

Effect of magnetic susceptibility contrast medium on myocardial signal intensity with fast gradient-recalled echo and spin-echo MR imaging: initial experience in humans.

PURPOSE: To show the effect of dysprosium diethylenetriaminepentaacetic acid bis-methylamine injection on the images of normal human myocardium. MATERIALS AND METHODS: T2-sensitive fast gradient-recalled echo (GRE) (repetition time [TR], 10.8 msec; echo time [TE], 4.2 msec) and spin-echo (SE) (TR, three RR intervals; TE, 60 msec) magnetic resonance (MR) imaging with driven equilibrium-preparation pulse was used to produce T2 contrast material enhancement. The contrast agent was injected into 12 healthy subjects at doses of 0.05, 0.1, 0.2, 0.4, and 0.6 mmol/kg. RESULTS: Driven equilibrium-prepared GRE images showed a transient decrease of myocardial signal intensity at doses of 0.2-0.6 mmol/kg. Postcontrast T2-weighted SE images showed a myocardial signal attenuation (30%-45% decrease) at a dose of 0.4 mmol/kg or higher. CONCLUSION: Dynamic MR imaging with a magnetic susceptibility contrast medium can be used to monitor the first pass of contrast media through human myocardium with a conventional MR imager and a fast GRE sequence.

Adult↗
PubMed1994

Quantification of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging.

BACKGROUND: Knowledge about the volume of collateral flow provides insight into the severity of coarctation of the aorta and may be critical in planning the operative approach. There is currently no method for the quantification of collateral flow in coarctation of the aorta. In this study, we applied velocity encoded cine magnetic resonance imaging (VENC-MR) to establish the flow pattern and volume of collateral flow in the descending thoracic aorta in normal subjects and patients with coarctation, introducing a new possibility to quantify the severity of the coarctation by determining the amount of collateral flow. METHODS AND RESULTS: VENC-MR was used to measure flow in the proximal and distal descending thoracic aorta in 10 normal subjects. In 23 patients with coarctation, flow was measured near the coarctation site and above the diaphragm. Patients were divided into a group with moderate to severe coarctation and a group with mild coarctation on the basis of clinical gradient between upper and lower extremities and the estimation of the gradient across the coarctation by Doppler echocardiography. The gradient across the coarctation and the degree of anatomic narrowing were also assessed by MR imaging. In normal volunteers, VENC-MR showed a 7 +/- 6% decrease in total flow, from proximal to distal aorta. The interobserver reproducibility was 3.9% to 4.9% (mean, 4.4%). In patients with moderate to severe coarctation, VENC-MR demonstrated an 83 +/- 50% increase in total flow from proximal to distal aorta, yielding a significant change compared with normal subjects (P < .01). Patients with mild coarctation showed a normal flow pattern and no significant change in total flow. There was a significant relation between the amount of flow increase in the distal aorta and the reduction in luminal diameter at the coarctation site (r = .94) as well as the clinical gradient (r = .84). CONCLUSIONS: This study shows the normal flow pattern in the descending thoracic aorta and its reversal in coarctation due to collateral flow. Thus, VENC-MR can measure collateral flow in coarctation and serves as a unique method for providing this important measurement of the severity of coarctation of the aorta.

Aorta, Thoracic↗
PubMed1994

Identification of myocardial reperfusion with echo planar magnetic resonance imaging. Discrimination between occlusive and reperfused infarctions.

BACKGROUND: The current treatment of many cases of acute myocardial infarction involves the use of thrombolytic agents. Evaluation of this therapy requires determination of the success of reperfusion and assessment of the presence and extent of infarction in the reperfused territory. The present study was designed to simulate in rat models several possible outcomes of reperfusion therapy: (1) successful reperfusion and absence of myocardial infarction, (2) successful reperfusion and presence of myocardial infarction, and (3) unsuccessful reperfusion. The usefulness of contrast-enhanced fast magnetic resonance (MR) imaging in defining the success of reperfusion was investigated. The dynamic effects were examined of low and high doses of gadolinium-BOPTA/dimeglumine (Gd-BOPTA/dimeg) on myocardial signal using MR inversion recovery echo planar imaging (IR-EPI) and gradient recalled echo planar imaging (GR-EPI), respectively. METHODS AND RESULTS: Rats were subjected to one of the following regimens: reperfused reversible myocardial injury (n = 9), reperfused irreversible myocardial injury (n = 9), and occlusive infarction (n = 9). MR echo planar images were acquired every 1 or 2 seconds before, during, and after administration of Gd-BOPTA/dimeg. In all groups, normal myocardial signal was sharply increased on IR-EPI and decreased on GR-EPI at the peak of the bolus, followed by a gradual decline to baseline. In animals subjected to reperfused reversible myocardial injury, normal and previously ischemic regions were indistinguishable during and after the passage of Gd-BOPTA/dimeg. On the other hand, enhancement of reperfused irreversibly injured myocardium was delayed but increased steadily to a higher level than normal myocardium on IR-EPI. The reperfused irreversibly injured myocardium was identified on IR-EPI as a zone of high signal (hot spot). On GR-EPI, signal loss in reperfused irreversibly injured myocardium was significantly less compared with normally perfused myocardium. In animals with occlusive infarctions, there was no change in signal intensity over the ischemic region on either IR-EPI or GR-EPI. Occlusive infarction was identified as zones of either low (cold spot) or high (hot spot) signal compared with normal myocardium, depending on MR pulse sequence and dose of the contrast medium. CONCLUSIONS: The transit of Gd-BOPTA/dimeg monitored by fast MR imaging techniques can be used to distinguish between reperfused reversibly and reperfused irreversibly injured myocardium and between occlusive and reperfused infarctions.

Animals↗
PubMed1994

MR features of arrhythmogenic right ventricular dysplasia.

Arrhythmogenic right ventricular dysplasia is defined as a primary disorder of the right ventricle characterized by partial or total replacement of muscle by adipose or fibrous tissue. Its diagnosis currently rests on techniques that accurately identify specific anatomic and functional abnormalities of the right ventricle. To date, none of these methods (except for autopsy) are specific for right ventricular dysplasia although angiography of the right ventricle is considered to be the current gold standard. MR imaging shows promise in clarifying the diagnosis of right ventricular dysplasia. This pictorial essay describes our current technique for examining the right ventricular myocardium in patients thought to have this disease and illustrates the spectrum of abnormalities encountered in these patients.

Adipose Tissue↗
PubMed1994

Breath-hold MR cine angiography of coronary arteries in healthy volunteers: value of multiangle oblique imaging planes.

OBJECTIVE: Breath-hold MR cine angiography was used to depict the coronary arteries in healthy volunteers. Multiangle oblique imaging planes were evaluated for feasibility in showing continuous segments of the proximal and middle portions of the left anterior descending and right coronary arteries. SUBJECTS AND METHODS: Eighteen healthy subjects were examined with a 1.5-T MR imager. Fat-suppressed fast gradient-echo images (TR = 9.8 msec, TE = 3.5 msec) were acquired with a 13-cm receive surface coil. A segmented k-space data acquisition was used to obtain images of the coronary arteries at several phases of the cardiac cycle within a single breath-hold. Multiangle double oblique images that were tangential and sequential to the epicardial surface of the left ventricle were used to show the left anterior descending artery, and oblique coronal images were used to show the right coronary artery. Images of consecutive slice locations were shown in a cine format, and the length of each major coronary artery that was continuously visualized was measured. RESULTS: The left main coronary artery, proximal left anterior descending artery, and right coronary artery were demonstrated in all subjects. The mid and distal portions of the left anterior descending artery and diagonal branches were visualized best on multiangle oblique imaging planes. Continuous segments (> 6 cm) of the left anterior descending artery and right coronary artery were imaged in 14 subjects (78%) and 12 subjects (67%), respectively. Cine display was useful for showing the continuity of the coronary arterial segments and also for distinguishing arteries from veins. CONCLUSION: Double oblique imaging planes were useful in showing long segments of left anterior descending and right coronary arteries on coronary MR angiograms. Further work is necessary to improve detection of the left circumflex artery.

Adult↗
PubMed1994

Valvular heart disease.

This article reviews existing magnetic resonance imaging techniques used to evaluate valvular heart disease. Specifically, this article discusses the capabilities of magnetic resonance imaging for (1) the detection and quantification of valvular regurgitation; (2) the detection and quantification of valvular stenosis; (3) the quantification of left ventricular dimension, function, and loading conditions with valvular heart disease; and (4) the monitoring of changes in valvular and ventricular function with time and with therapy.

Cineradiography↗
PubMed1993

Endogenous susceptibility contrast in myocardium during apnea measured using gradient recalled echo planar imaging.

Gradient recalled echo planar imaging was used to monitor changes in myocardial and left ventricular chamber blood intensity during apnea in rats. Significant signal loss in both blood (to 62 +/- 5% and 51 +/- 6% of baseline) and myocardium (to 79 +/- 2% and 76 +/- 3% of baseline) was observed at 45 and 90 s apnea while O2 saturation decreased from 98 +/- 1% to 62 +/- 7% and 36 +/- 9%, respectively. These results show that myocardial intensity is modulated by alterations in blood oxygenation.

Animals↗
PubMed1993

Measurement of T1 relaxation times of cardiac phosphate metabolites using BIR-4 adiabatic RF pulses and a variable nutation method.

T1 relaxation times of PCr and beta-ATP in human cardiac and skeletal muscle were evaluated using a variable nutation method. This allows T1 measurements with a constant TR and a significant reduction in acquisition time compared with the partial saturation method. Four 1D CSI datasets were obtained using 30 degrees, 45 degrees, 60 degrees, and 90 degrees BIR-4 adiabatic RF pulses within 40 min. The T1 of the phosphate phantom obtained with this method agreed with values obtained with the partial saturation method. The T1s of PCr and beta-ATP in heart are 3.98 +/- 0.18 s and 1.86 +/- 0.16 s (mean +/- SE). Our results demonstrated that T1 values in heart and skeletal muscle are not significantly different.

Adenosine Triphosphate↗
PubMed1993

Liver lesion detection: comparison between excitation-spoiling fat suppression and regular spin-echo at 1.5T.

The role of excitation-spoiling fat suppression (fatsat) imaging in the detection of liver lesions was assessed comparing short TR/TE and lont TR/TE spin-echo (SE) sequences with and without excitation-spoiling fat suppression in 25 patients at 1.5T. The study included patients with liver metastases (n = 21), primary liver cancer (n = 3), and hepatic adenoma (n = 1). Liver lesion detection and lesion-liver signal-to-noise ratios (SNR) were determined for the various imaging sequences in a prospective fashion. Liver lesion-liver SNR were highest for long TR/TE (2000-2500/70-80) fatsat images (12.7 +/- 4.8) compared to long TR/TE regular SE (2000-2500/70-80) images (8.8 +/- 5.6) [(p = ns) (not significant)], short TR/TE (200-400/15-20) fatsat images (-6.2 +/- 4.8) (p = 0.05), and short TR/TE regular SE images (-4.9 +/- 3.2) (p < 0.01). Lesion detection was greatest for long TR/TE fatsat (86) followed by long TR/TE regular SE (78) (p = 0.05), short TR/TE fatsat (65) (p < 0.01), and short TR/TE regular SE (60) (p < 0.01). The results of this study suggest that excitation-spoiling fat suppression may improve liver lesion detection and conspicuity.

Adolescent↗
PubMed1993

Assessment of left ventricular diastolic function in dilated cardiomyopathy with cine magnetic resonance imaging: effect of an angiotensin converting enzyme inhibitor, benazepril.

The effects of angiotensin converting-enzyme inhibitor, benazepril, on diastolic function in patients with dilated cardiomyopathy, with (n = 4) or without (n = 11) mitral regurgitation, were examined with the time-volume curve of the left ventricle derived from cine magnetic resonance images. Peak filling rate/end-systolic volume and ejection fraction were increased in the group without regurgitation (p < 0.01) but not in the group with regurgitation after treatment. There was a strong correlation between peak filling rate/end-systolic volume and ejection fraction (r = 0.89) and between the change in peak filling rate/end-systolic volume and that in ejection fraction after treatment (r = 0.74) in the group without regurgitation. These findings suggest that in some patients with dilated cardiomyopathy benazepril has favorable effects on diastolic function, which seem to be related to improvement in systolic function. This drug may not be as beneficial in patients with dilated cardiomyopathy complicated by mitral regurgitation.

Adult↗
PubMed1993

Velocity-encoded cine MRI in the evaluation of left ventricular diastolic function: measurement of mitral valve and pulmonary vein flow velocities and flow volume across the mitral valve.

Left ventricular diastolic function has been evaluated by means of analysis of the flow pattern through the mitral valve. Velocity-encoded cine magnetic resonance imaging (VEC-MR) is a new method for characterizing flow patterns in the heart. The feasibility of using VEC-MR to measure early diastolic (E) and atrial systolic (A) peak flow velocities and E/A ratios in the mitral inflow, as well as systolic (X), early diastolic (Y), and atrial systolic (Z) peak flow velocities and X/Y ratios in the pulmonary vein, was evaluated in 10 normal volunteers. The VEC-MR-derived velocities and indexes were compared with Doppler-derived results. Volumetric flow across the mitral valve was also used to measure stroke volume, cardiac output, and the left atrial contribution of left ventricular filling. VEC-MR yielded lower peak velocities than Doppler echocardiography. The velocities of the two measurements showed a significant linear correlation (Doppler E velocity = 1.30 x VEC-MR + 1.6 cm/sec, r = 0.68; Doppler A velocity = 1.83 x VEC-MR - 5.2 cm/sec, r = 0.83; and Doppler X velocity = 0.45 x VEC-MR + 0.09 cm/sec, r = 0.74). Consequently the E/A and X/Y ratios measured by these two methods showed statistically significant linear correlations with r values of 0.94 and 0.83. The volume of blood flow across the mitral valve measured by VEC-MR (5610 +/- 620 ml/min) was not statistically different from the cardiac output measured from the ascending aorta by VEC-MR (5670 +/- 590 ml/min) or by left ventricular cine magnetic resonance imaging (5440 +/- 614 ml/min). The left atrial contribution to left ventricular filling was 25.9 +/- 7.5%. Our results indicate that VEC-MR can be used not only for evaluation of left ventricular diastolic filling from the mitral valve and pulmonary vein flow velocities but also for quantitative measurement of the volume of blood flow across the mitral valve.

Adult↗