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Biomedical subjects

C D Claussen

Publications and source records attributed to C D Claussen.

At least 163 records · Page 9Linked to original sources

[Variability in the MR tomographic determination of myocardial function and perfusion parameters in health subjects].

PURPOSE: The aim of the study was to evaluate myocardial function and perfusion patterns using magnetic resonance imaging in normal subjects. MATERIALS AND METHODS: 22 healthy volunteers were examined. Cine-mode acquisitions along all three axes of the heart were generated and perfusion was measured on a mid-ventricular short-axis view. Myocardial wall thickening was scored and contrast enhancement during the first pass was analysed. RESULTS: For myocardial wall thickening increasing values from base (24-86%) to apex (63-106%) were found. Contrast enhancement patterns showed regional variability. In addition marked individual differences were detectable. CONCLUSION: Perfusion patterns should be interpreted only in combination with functional parameters. Standard values for perfusion measurements cover very large range as a result of the high individual variability.

Adult↗

[Cardiac multidetector-row CT: first clinical results of retrospectively ECG-gated spiral with optimized temporal and spatial resolution].

PURPOSE: The significantly improved temporal and spatial resolution of Multidetector-Row CT opens up new possibilities for cardiac imaging. A method with retrospectively ECG-gated spiral acquisition is presented. MATERIALS AND METHODS: A total of 10 patients underwent cardiac CT on a fast multi-slice CT system with 4 simultaneously acquired slices and 0.5 s rotation time (Siemens Somatom Volume Zoom). Continuous spiral data of the entire heart volume (5 studies precontrast for calcium scoring, 5 studies with contrast) were acquired together with the patient's ECG and reconstructed with dedicated spiral algorithms providing 250 ms temporal resolution. Three-dimensional image data sets were built up from overlapping slices that were reconstructed in an arbitrary, user-defined phase of the heart cycle (e.g., diastolic phase). To evaluate the capability of the method for functional imaging, complete image volumes were reconstructed from the same spiral data set in different phases of the heart cycle. RESULTS: Within a single breath-hold, a spiral data set of the entire heart volume could be acquired. Typical scan times for standard examinations with 3-mm slice width were 12-17 s, and for high-resolution CT angiographies of the coronary arteries with 1.25-mm slice width about 25-35 s. Motion-free reconstruction of the heart and coronary arteries with high spatial resolution were possible in the diastolic phase of the heart cycle. Multiphase reconstructions from the same spiral scan data set were possible. CONCLUSIONS: Fast multi-slice spiral CT with retrospectively ECG-gated spiral reconstruction is well suited for three-dimensional and functional imaging of the heart, especially for high-resolution imaging of calcified coronary plaques and CT-angiography of the coronary arteries.

Coronary Angiography↗

[Multislice spiral CT of the paranasal sinuses: first experiences using various parameters of radiation dosage].

PURPOSE: To evaluate the potential of multislice CT in the diagnosis of the paranasal sinuses. METHODS: Dose measurements were performed exposing an Alderson Rando phantom in a four-slice spiral CT (MS-CT) while applying a variety of scan parameters. Additionally, 30 consecutive patients underwent a transversal examination by the MS-CT using 1/1/3.5/0.5 mm spiral parameters and an additional transversal or coronal scan on a conventional single slice spiral CT (SS-CT) with 2/3/1 mm. Coronal reformations of the MS-CT were compared with the primary coronal SS-CT, or coronal reformations of the transversal SS-CT, respectively, with regard to image quality and depiction of relevant anatomical details of the region. RESULTS: Superficial exposure values at the level of the eye lenses as well as for the thyroid gland were superior for MS-CT (3.62 mGy, and 0.12 mGy, resp.) as compared to SS-CT (2.96 mGy, and 0.07 mGy). Image quality was equal or superior for MS-CT as compared to SS-CT in all but one case. Drawbacks of SS-CT, such as dental amalgam artifacts, stair step artifacts or partial volume artifacts did not notably affect the coronal reformations of MS-CT. CONCLUSION: MS-CT seems to have the potential to replace primary coronal CT of the paranasal sinuses without any loss of image quality, but may even improve the overall diagnostic value. Radiation doses may still have to be reduced.

Humans↗

[Pulsed spray lysis with reteplase in peripheral arterial occlusions--technique and initial results].

PURPOSE: Urokinase followed by rt-PA are the most frequently used drugs approved for thrombolysis in peripheral arteries in the USA and Europe. We wanted to test the safety and efficacy of low-dose reteplase administered by pulsed spray technique. MATERIALS AND METHODS: 10 patients with acute or subacute occlusion of a peripheral artery (n = 8) or graft (n = 2) were treated (history 8 +/- 17 days; occlusion length 4-60 cm, mean 23 cm). Reteplase was administered as an intra-arterial (i.a.) bolus (0.5 U/10 cm of occlusion length) followed by pulsed spray lysis (1 U/h for the first 2 h, then 0.5 U/h). The catheter was placed into the occlusion. In addition the patients received heparin (i.a.) and aspirin (oral). The site of puncture was closed with a percutaneous suturing system prior to discontinuation of heparin treatment. RESULTS: A total dose of 3.3 +/- 1.2 U reteplase was administered. The primary success rate was 7/10. Two distal embolizations and two bleeding complications were observed (one minor bleeding at the site of puncture and one rupture of the suture which had to be treated surgically). CONCLUSION: With regard to our limited data, low-dose i.a. reteplase seems to be safe and effective. Two bleeding complications were observed which both occurred at the site of puncture. Discontinuation of heparin treatment prior to sheath removal is recommended. Fibrinolysis with reteplase may be an alternative to urokinase or rt-PA.

Aged↗

[Influence of histopathological factors on dynamic MR mammography].

AIM: To assess the histopathological background of enhancement mechanisms in dynamic MR mammography studies. METHODS: The dynamic MR mammography (MRM) examinations were done with a 1.5 T MR imager (Magnetom Vision, Siemens) using a double breast coil and a coronal FLASH-3D sequence. Enhancement data were acquired during 9 minutes post contrast medium injection (Gd-DTPA 0.2 mmol/kg). Acquisition time was 87 sec/slab. Early enhancement at the first post contrast measurement (E1) and slope of wash-out (SE2-L) were calculated. In immunohistology, proliferation was assessed by the monoclonal antibody Ki 67, capillaries were stained by a CD 31 antibody. Of a total of 48 operated patients, 58 lesions and 46 surrounding tissues were evaluated. RESULTS: Cellularity, capillary density and proliferation showed statistically significant correlations with E1 (p < 0.01). In multiple regression analysis, E1 was significantly associated only with high cellularity (p = 0.002) and the combination of high cellularity and high microvessel density (p = 0.002); a negative slope of wash out was significantly associated only with malignant histology (p = 0.027). CONCLUSIONS: Our findings indicate a direct influence of cellularity and microvessel density on early enhancement. The expression of the proliferation marker Ki 67 was not an independent predictor for contrast enhancement.

Adult↗

[Percutaneous radiofrequency ablation of hepatic neoplasms using a "cluster" electrode--first clinical results].

PURPOSE: To evaluate feasibility, safety and efficacy of percutaneous radiofrequency ablation (RFA) of hepatic neoplasms using a clustered electrode. MATERIAL AND METHODS: Percutaneous, CT-guided RFA using a clustered electrode was performed in 12 patients with a total of 15 hepatic neoplasms (2.0-6.0 cm in diameter). RESULTS: A total of 17 percutaneous RFA was performed. The mean total procedure time was 2.0 h (1.5-2.5 h). Placement of the clustered electrode within the neoplasms using a inter- or subcostal approach under local anesthesia was possible in all cases. Complications related to percutaneous treatment and technical problems were not encountered. Diameter of the ablated areas ranged between 3.0-7.0 cm. Technical success was observed in 13 of 15 neoplasms (86.6%). During a mean follow-up of 7.25 months (range 3-12 months) 8 of 12 neoplasms showed a complete necrosis. CONCLUSION: Percutaneous RFA using a clustered electrode is a feasible, safe and effective procedure for the treatment of hepatic neoplasms up to 6 cm in size.

Adult↗

[High resolution multislice CT of the lung: comparison with sequential HRCT slices].

PURPOSE: To compare the image quality of high-resolution (HR) spiral CT scans from a multislice CT scanner with sequential HRCT scans from a singleslice CT scanner. MATERIALS AND METHODS: 20 patients with diffuse lung disease received a high-resolution spiral CT on a multislice scanner (4 slices) and 5 HRCT single slices (1 mm) on a singleslice scanner. Scan parameters of the multislice scanner were: Collimation 4 x 1 mm, pitch 6, slice thickness 1 mm. 5 HRCT slices were compared to the corresponding HR spiral CT slices using a 5-point scale by 5 radiologists with regard to the image quality and the number of artifacts. The evaluation was performed with a multivariate analysis (MANOVA test). RESULTS: Overall impression of image quality, noise, central vessels and bronchi, and all pathological changes were not significantly different between the two CT methods. Sequential HRCT scans were considered to be significantly better than HR spiral CT scans for spatial resolution (p = 0.02), depiction of peripheral vessels (p = 0.02), and of small bronchi (p = 0.05), and significantly worse for depiction of interlobar septa (p < 0.001). Diagnostically relevant differences were found in only 2.2%. Breathing and heartbeat artifacts each were 3 times higher in the sequential HRCT technique than in the multislice-spiral technique (p < 0.0001). CONCLUSION: HR spiral CT scans performed on a multislice CT scanner provide significantly less artifacts and an equal diagnostic image quality compared to sequential HRCT scans performed on a singleslice CT scanner. Multislice spiral CT in HR technique may replace the common scanning technique with conventional spiral CT and additional HRCT scans for diffuse lung diseases.

Adult↗

Dynamic MR imaging of liver metastases with Gd-EOB-DTPA.

PURPOSE: To assess liver and lesion enhancements by dynamic MR imaging after bolus injection of the hepatobiliary contrast agent gadolinium ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) in patients with liver metastases and to compare the effect of different doses. MATERIAL AND METHODS: A randomized double-blinded trial with doses of 12.5, 25 and 50 micromol/kg Gd-EOB-DTPA was performed in 35 patients with liver metastases. Liver enhancement, tumor enhancement and liver lesion contrast-to-noise (C/N) ratios were calculated from breath-hold gradient echo images (100/5/80 degrees) recorded precontrast and at different times up to 10 min postcontrast. RESULTS: Normal liver showed a characteristic enhancement pattern, with a rapid enhancement in the first 45 s postcontrast and a slight but significant further increase up to 600 s. The initial enhancement in the lesions was also pronounced, but the enhancement was slightly decreased after 240 s postcontrast. At dose levels of 12.5 and 25 micromol/kg Gd-EOB-DTPA, C/N ratios significantly increased compared to baseline from 90 to 600 s. Postcontrast C/N-values obtained using 50 micromol/kg Gd-EOB-DTPA were not significantly increased, except for the examinations 480 s postcontrast. CONCLUSION: In liver metastases, C/N ratios obtained with doses of 12.5 and 25 micromol/kg Gd-EOB-DTPA were slightly superior to 50 micromol/kg Gd-EOB-DTPA. This finding is probably due to a more pronounced extracellular effect of the contrast medium at higher doses.

Adult↗

Fat- and water-selective MR cine imaging of the human heart: assessment of right ventricular dysplasia.

RATIONALE AND OBJECTIVES: The purpose of this study was to develop and implement MR sequences for chemical shift-selective breath-hold cine imaging of the heart. Fibroadipose conversion of myocardium in cases suspected of right ventricular dysplasia should be revealed in fat- and water-selective MR images of high quality. METHODS: Frequency-selective saturation of one chemical shift component was applied in modified k-space-segmented, electrocardiography-gated sequences, allowing high-quality cine imaging of the human heart in a single breath-hold. Phantom studies and human examinations in eight normal subjects (aged 24-62 years) and in seven patients (aged 31-47 years) with suspected right ventricular dysplasia were performed. The patients showed suspicious findings, such as a dyskinetic and dilated right ventricle combined with ventricular arrhythmia, and underwent MR imaging after exclusion of other possible reasons (eg, coronary artery disease or pulmonary hypertension). RESULTS: High selectivity to the desired chemical shift component was confirmed by test measurements in a phantom containing water and lipids. In the human subjects, minor problems with magnetic field inhomogeneities appeared in the thoracic walls only. Four patients with suspected right ventricular dysplasia showed clearly abnormal signal behavior of the right myocardial wall in both fat- and water-selective cine images. Bright transmural structures were exhibited in fat-selective images, but the origin of the fat (epicardium or infiltrated myocardium) was often difficult to assess. CONCLUSIONS: Right ventricular areas with fibrosis and fatty degeneration often show normal signal intensity in standard T1-weighted images but can be differentiated from normal tissue by the new chemical shift-selective breath-hold cine techniques.

Adipose Tissue↗

Magnetic resonance osteodensitometry in human heel bones: correlation with quantitative computed tomography using different measuring parameters.

RATIONALE AND OBJECTIVES: Density of trabecular bone structures in human heel bones was assessed by 3D magnetic resonance (MR) gradient echo imaging (GEI) with multiple echoes. Different spatial resolutions were applied to investigate the influence of the pixel size on signal characteristics in GEI and to find suitable measuring parameters for a maximum correlation between GEI and bone mineral density obtained by quantitative computed tomography (QCT). METHODS: Thirty-five patients aged 31 to 65 years with suspected osteoporosis underwent MR and QCT examinations of the heel bones. The MR protocol included 3D GEI with three echo times (TE1 = 9.3, TE2 = 27.9, and TE3 = 46.5 ms) and isotropic pixel sizes of (0.6 mm)3, (1.2 mm)3, and (2.4 mm)3. Several subregions in the heel bones were analyzed. For determination of signal reduction with increasing TE, signal intensity ratios were calculated pixelwise from images with TE2/TE1 and TE3/TE1. RESULTS: All examinations showed that the T2*-related signal decrease was more pronounced for lower spatial resolution. In the dorsal part of the heel bones, the correlation between signal ratios in GEI and QCT-based bone mineral density values was between r = -0.86 for a spatial resolution of (0.6 mm)3 and r = -0.73 for (2.4 mm)3. Areas with low trabecular density in the ventral part of the heel bones showed clearly lower correlation coefficients (-0.65 < r < -0.67). CONCLUSIONS: Spatial resolution in 3D GEI clearly influences the T2*-related signal characteristics. Despite measuring different physical properties of spongy bone by GEI and QCT, a relatively high correlation between GEI with small pixel sizes and QCT was obtained in the dorsal part of the heel bones, but not in the ventral part with partly thickened trabeculae and irregular distribution. However, standardized measuring protocols with preferably small pixel sizes (as low as [0.6 mm]3) should be applied, and correlation curves must be determined, dependent on the actual bone marrow site, before clinical routine MR osteodensitometry becomes possible.

Absorptiometry, Photon↗

Human fetal lung fibroblasts: in vitro study of repetitive magnetic field exposure at 0.2, 1.0, and 1.5 T.

PURPOSE: To evaluate whether repetitive exposure to magnetic fields of 0.2, 1.0, and 1.5 T affect the growth of human fetal lung fibroblasts (HFLFs). MATERIALS AND METHODS: Cultured HFLFs were exposed to static magnetic fields of 0.2, 1.0, and 1.5 T for 1 h/d for 5 consecutive days. Control groups were kept under identical environmental conditions, apart from the magnetic field, during the experiments. Cell cycle analysis for synchronously and nonsynchronously growing cells was performed. Population doublings (PDs) were calculated. To rule out midterm effects, proliferation kinetics of the cells were analyzed for 21 days. RESULTS: Cell cycle analysis of synchronized and nonsynchronized cells did not reveal statistically significant differences between the exposed and control cells. The PDs did not indicate any growth modulation during exposure. Proliferation kinetics did not provide any hint of midterm growth modulation effects of repetitive magnetic field exposure. CONCLUSION: Repetitive magnetic field exposure does not exert any growth-modulating effect on overall cell growth and cell cycle distribution of cultured HFLFs. Midterm effects due to magnetic field exposure were not found.

Cell Cycle↗

[Corticosteroid injections of the sacroiliac joint during magnetic resonance: preliminary results].

PURPOSE: The aim of this study was to evaluate the advantages of MRguided injections of corticosteroids into the sacroiliac joints (SIJ) in patients suffering from refractory sacroiliitis despite appropriate oral therapy. MATERIALS AND METHODS: At a lowfield open MR, we performed twentyfour infiltrations in 12 patients suffering from persistent buttock pain. Clinical followup and laboratory findings were evaluated every 4 up to 6 weeks. A subjective rating using a dolorimetry scale (0= no pain, up to=10 for most severe pain) was assessed prior to intervention and at three months followup. Morphological changes of the SIJ were examined on a 1.5 Tesla imager before and three months after steroid injections. RESULTS: Adequate positioning of the needle was obtained in all but one case due to a software defect. Clinical improvement was observed in 10 patients with a mean painfree period of 9.6 months. Dolorimetry index decreased from 7.6 +/- 1.5 to 2.9 +/- 1.5. Nonsteroidal antiinflammatory drugs could be discontinued in 4 patients and reduced in 4 others. CONCLUSION: We therefore conclude that MRguided injection of the SIJ is feasible and could be preferred to more conventional methods when technical equipment is available.

Adult↗

Long-term effects of repetitive exposure to a static magnetic field (1.5 T) on proliferation of human fetal lung fibroblasts.

The aim of the study was to assess the effects of repetitive exposures to a static magnetic field (1.5 T) on human fetal lung fibroblast (HFL) proliferation. HFL were exposed three times a week for 1 hr to a static magnetic field for 3 weeks. Cells were subcultured every week. Population doublings (PD) and cumulative population doublings (CPD) were calculated weekly. Colony formation assays, bromodeoxyuridine enzyme-linked immunosorbent assay, and cell cycle analysis were performed weekly. After the third week, proliferation kinetics were assessed. Over a period of 3 weeks no statistically significant differences between the PD and CPD of exposed and control cells could be detected. Clonogenic activity, DNA synthesis, cell cycle, and proliferation kinetics were not altered by magnetic field exposure. The data do not provide evidence that repetitive exposures to a static magnetic field (1.5 T) exert effects on HFL proliferation.

Cell Division↗