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H Bosmans

Publications and source records attributed to H Bosmans.

At least 73 records · Page 4Linked to original sources

Focal liver lesions: fast T2-weighted MR imaging with half-Fourier rapid acquisition with relaxation enhancement.

PURPOSE: To compare the clinical usefulness of the half-Fourier rapid acquisition with relaxation enhancement (RARE) technique at T2-weighted magnetic resonance (MR) imaging of focal liver lesions with that of multishot RARE MR imaging and contrast material-enhanced helical computed tomography (CT). MATERIALS AND METHODS: Half-Fourier RARE and multishot RARE imaging and helical CT were performed in 48 patients with 102 focal liver lesions and in three patients with diffuse metastatic liver disease. Images were compared qualitatively and quantitatively for image quality, lesion conspicuity, and ability to help differentiate solid lesions from hemangiomas. RESULTS: All half-Fourier RARE images were free of respiratory artifact. In the 48 patients with 102 focal lesions, CT, half-Fourier RARE, and multishot RARE images depicted 101, 99, and 90 lesions (99%, 97%, and 88%), respectively. CT failed to depict focal lesions in one patient with diffuse metastatic liver disease. All techniques had high accuracy for distinction of hemangiomas from solid masses (areas under the receiver operating characteristic curves were between 0.96 and 0.99). CONCLUSION: Half-Fourier RARE MR imaging is a rapid and accurate technique for detection and characterization of focal liver lesions.

Adult↗

Characterisation of intracranial aneurysms with MR angiography.

The purpose of this study was to compare the accuracy of 3D time-of-flight (TOF) acquisitions in the characterisation of intracranial aneurysms. Fourteen patients with aneurysms proven on intra-arterial angiography were first studied with a 3D TOF acquisition. When the aneurysms were incompletely demonstrated, additional MR angiography (MRA) acquisitions were performed, including black-blood MRA, 2D TOF, phase-contrast and contrast-enhanced TOF.3D TOF MRA was sufficient for detection of the aneurysm in 13 of 14 cases and characterisation of the aneurysm was possible in 6. All the initial shortcomings of the TOF technique could be analysed and explained by means of additional MRA techniques. This study suggests that the combination of different MRA techniques offers new possibilities for noninvasive investigation of intracranial aneurysms.

Adult↗

Magnetic resonance angiography of supratentorial tumours: comparison with selective digital subtraction angiography.

We compared magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (IADSA) in the study of brain tumours and assessed the utility of gadolinium-enhanced MRA. We studied 17 patients with supratentorial brain tumors. The entire brain was imaged with multiple overlapping thin volume acquisitions. After IV injection of gadolinium-DTPA, a single thick-slab MRA acquisition was performed. Standard three-dimensional (3D-TOF) acquisitions (in six patients) and 3D-TOF with magnetization transfer prepulse and tilted optimisation nonsaturing radiofrequency excitation pulses (in 11 patients) were used. Displacement of the anterior cerebral artery, main stem and insular branches of the middle cerebral artery was seen well on unenhanced and contrast-enhanced MRA. Displacement of the lenticulostriate and anterior choroidal arteries was seen only once, after Gadolinium. Tumour encasement of the middle cerebral artery was demonstrated in one patient. Tumour vessels were seen in 2 of 8 cases before and 3 of 8 after gadolinium; Tumour hypervascularity was seen only after gadolinium, in 3 of 8 cases. Study of the veins was possible only on gadolinium-enhanced MRA. Displacement of the venous angle was seen in 4 of 7 patients in the frontal, and in all of 8 patients on the lateral projections. Early venous drainage was not seen. Patency of the dural venous sinuses was demonstrated in all patients, but in one neoplastic occlusion of a cortical vein was recognized.

Adult↗

Transverse arch hypoplasia predisposes to aneurysm formation at the repair site after patch angioplasty for coarctation of the aorta.

OBJECTIVES: This study used magnetic resonance imaging (MRI) to evaluate the morphology and pathophysiology of aneurysm formation after patch angioplasty for coarctation of the aorta. BACKGROUND: Late aneurysm formation at the repair site is a well known and frequent complication after patch angioplasty. However, because the underlying mechanisms remain unresolved, postoperative outcome is unpredictable and adequate follow-up difficult. METHODS: Seventy-three of 85 patients with patch angioplasty for coarctation of the aorta were screened for aneurysm formation. Magnetic resonance imaging was performed in all 33 patients with an aneurysm, and results were compared with those for 13 control patients and 10 normal subjects. Mean (+/- SD) time between operation and MRI was 12.0 +/- 2.0 years. Aneurysm was defined as the ratio of the diameter of the aorta at the repair site to the diaphragmatic aorta > or = 1.5. Hypoplasia of the transverse arch and recoarctation at the repair site were defined as a ratio < 0.9. Transverse arch ratios on MRI were compared with those on preoperative cineangiography and the pressure gradient between the patient's right and left arm. RESULTS: All 33 patients with an aneurysm had a hypoplastic transverse arch. The 13 patients with a normal ratio at the repair site had a normal transverse arch ratio (chi square, p < 0.0001). Logarithmic regression showed a significant negative correlation (r = 0.62) between the repair site and transverse arch ratios. A significant pressure difference between the patient's right and left arm was found in patients with versus those without aneurysm (p = 0.0009). No significant difference was found between transverse arch ratios on preoperative cineangiography and postoperative MRI (mean 0.014 +/- 0.1, p = 0.4). CONCLUSIONS: Aneurysm formation at the repair site is highly related to hypoplasia of the transverse arch. Sufficient catch-up growth of a hypoplastic transverse arch is rare after late patch angioplasty. Dynamic phenomena, such as flow acceleration and turbulence, originating in a narrow transverse arch, may contribute to aneurysm formation at the repair site after patch angioplasty.

Adolescent↗

Time-of-flight MR angiography of the brain: comparison of acquisition techniques in healthy volunteers.

OBJECTIVE: The saturation phenomenon that limits vessel visibility in unenhanced time-of-flight MR angiograms can be overcome by the injection of MR contrast agents that shorten the T1 of the blood. Unlike the situation with unenhanced MR angiographic acquisitions, in which the MR parameters must be carefully adjusted to reduce saturation effects, optimization procedures for contrast-enhanced MR angiography focus on the acquired shortening of the T1 of the blood and the time evolution of the T1 over the entire measurement. To improve the quality of contrast-enhanced time-of-flight MR angiographic acquisitions in the brain, we compared different acquisition techniques that exploit shortening of the T1 of the blood. SUBJECTS AND METHODS: High-resolution MR angiographic examinations were done with a 1-T MR system for 12 healthy volunteers. Doses of 0.1 and 0.2 mmol of gadopentetate dimeglumine per kilogram of body weight were injected on two separate days to allow for identical timing of the comparative studies after contrast material injection. The effects of dose of contrast material, MR parameters (TR and flip angle), method of injecting the contrast material (monophasic, biphasic, or continuous slow injection), and K-space acquisition schemes (regular schemes versus collecting the central K-space lines near the beginning or the end of the acquisition) were studied. RESULTS: Higher doses provided better MR angiograms. The flip angle and the TR had to be adjusted on the basis of the Ernst equation and therefore depended on an estimation of the averaged T1 value over the entire measurement. Comparison of the different K-space acquisition schemes confirmed that the evolution of the T1 of the blood over the entire measurement time is important, especially for longer measurements. There was no noticeable difference between the MR angiograms acquired with monophasic or biphasic injections. These injection schemes provided more detailed MR angiograms than did continuous slow injection over the entire measurement. CONCLUSION: Our results show that the quality of contrast-enhanced MR angiograms can be remarkably increased when acquisition techniques that exploit the short T1 of the blood are used.

Adult↗

The use of magnetic resonance angiography in stereotactic neurosurgery.

The authors discuss the advantages and disadvantages of the use of magnetic resonance (MR) angiography images in stereotactic neurosurgery. Current computer programs designed to assist the neurosurgeon in the planning of stereotactic neurosurgical interventions use intraarterial digital subtraction angiography images to visualize the blood vessels. Magnetic resonance angiography is a recent technique with a number of advantages over the digital subtraction method: it is less invasive and less prone to complications; it provides truly three-dimensional data sets that can be viewed from any direction; and it can visualize both stationary and flowing tissues with the same imaging device and localizer frame. Although digital subtraction images are still superior in contrast and vascular detail, state-of-the-art high-resolution MR angiography sequences provide sufficient vascular detail for planning surgery. Contrast-enhanced MR angiography images were acquired using adapted gradient-echo sequences to compensate for flow-induced distortions; postacquisition distortion correction was not necessary. Five methods to integrate and inspect a possible trajectory in the MR angiography data are discussed. Initial clinical experience with eight patients led to the conclusion that MR angiography is a valuable imaging modality that can be integrated reliably into a stereotactic neurosurgery planning procedure.

Adult↗

[Spiral CT of cerebral aneurysms].

Spiral CT was performed in 9 patients with 13 cerebral aneurysms known from angiography. All lesions were detected by spiral CT, the smallest lesion measuring 3 mm in diameter. The neck of the aneurysm and the anatomical relations could be determined very accurately in all cases. Advantages of spiral CT over magnetic resonance angiography include: the short examination time, the independence of flow rate and cardiac output, and the excellent visualisation of calcification, thrombus and the bony landmarks. Disadvantages are the necessity of iodinated contrast media, the long postprocessing and reconstruction time and the possibility of overlap from bone and venous blood.

Cerebral Angiography↗

On the problem of geometric distortion in magnetic resonance images for stereotactic neurosurgery.

In this paper, we discuss the issue of geometric distortion in magnetic resonance (MR) images used to plan stereotactic neurosurgical interventions. We analyze the process for the case of Fourier transform imaging and demonstrate that spatial misregistrations are fundamentally due to two causes: deviations of the magnetic field from its ideal value and blood flow. This enables us to relate the causes of geometric distortion to the MR imaging system, the patient and the stereotactic localizer frame. Based on the general model, we propose model refinements and discuss methods for the quantification and correction of all causes. The results of our calculations and experiments indicate that, using the proposed corrections, MRI and MR angiography should be considered valuable and reliable acquisition modalities for the planning of stereotactic neurosurgical interventions.

Brain↗

NMR imaging study of the pharmacodynamics of polylysine-gadolinium-DTPA in the rabbit and the rat.

The pharmacodynamics of polylysine-(Gd-DTPA) (Schering, Berlin, Germany), a new blood pooling contrast agent for MRI, were studied in the rabbit and the rat. Polylysine-(Gd-DTPA) is a compound with high LD50. Due to its high molecular weight (50.000) and physico-chemical properties, it remains in the vascular system; during the first hour, the plasma level is three times higher than for Gd-DTPA. MRI was performed at 1.5 T using a SE sequence with TR/TE = 300/15 or 20 msec. Signal intensities of muscle, liver and kidney were measured before and after intravenous injection of the contrast agent (0.1 mmol/kg) during 8 hours in the rat (n = 3) and up to 2 wk in the rabbit (n = 3). A dose response study in three additional rabbits confirmed that the 0.1 mmol/kg dose was optimal. The pharmacodynamics results show that the effects of polylysine-(Gd-DTPA) are similar in both the rabbit and the rat. The liver signal is enhanced by about 60% immediately after injection in both species. This enhanced signal decays to half its maximal value in about one hour, which makes the contrast agent useful for clinical applications at a dose of 0.1 mmol/kg. In the kidney medulla and cortex the signals are enhanced by much larger factors (about 3 to 4); it takes at least one day for the kidney to clear the contrast agent in both species.

Animals↗

Intracranial vascular lesions: optimization and clinical evaluation of three-dimensional time-of-flight MR angiography.

The clinical value of three-dimensional time-of-flight magnetic resonance (MR) angiography was prospectively evaluated in 26 patients with congenital intracranial vascular lesions; 12 had arteriovenous malformations (AVMs), and 14 had venous angiomas. In the initial phase of the study the entire region of interest was imaged with one large acquisition volume (60-120-mm-thick slab). Later, the angiograms were obtained with adjacent but slightly overlapping, 30-mm-thick slabs, which clearly improved vascular detail. Gadolinium enhancement slightly improved depiction of veins but not of arteries. MR angiograms were compared with available conventional angiograms and MR studies. The topography of the AVM nidus was equally well appreciated on the MR as on the conventional angiograms. However, in six of 12 patients the hyperdynamic afferent arteries were incompletely shown on MR angiograms because of incomplete rephrasing. In three patients, venous drainage was also incompletely visualized. Compared with conventional MR studies, MR angiography offered the same detection rate but better anatomic insight. Thirteen of the 14 venous angiomas were also identified on MR angiograms. Detailed imaging, however, necessitated gadolinium enhancement and thin-slab acquisition.

Brain Neoplasms↗

MR angiography with gadopentetate dimeglumine-polylysine: evaluation in rabbits.

Flow in high-resistance peripheral vessels of the extremities is characterized by a short period of positive flow during systole and almost no flow during diastole. Hence, time-of-flight sequences for MR angiography in high-resistance peripheral vessels are successful only when applied in a plane perpendicular to the vessel course. When applied in a plane parallel to the vessel, the method suffers from the rapid saturation of the inflowing spins. Gadopentetate dimeglumine-polylysine is a new T1 relaxation agent with blood-pooling capability that can be used to prevent blood saturation. In the present study it produced excellent angiograms in rabbits at a dose of 0.01-0.08 mmol/kg injected IV. Time-of-flight angiograms were acquired in a 1.5-T superconducting magnet with a three-dimensional fast imaging with steady precession sequence, 20,40/10/20 degrees (TR/TE/flip angle), with an acquisition volume of 200 x 200 x 60 mm, 64 partitions, and velocity compensation in the slice-selection and frequency-encoding directions. Arteries and veins smaller than 1 mm were visualized over the entire length of the posterior limbs. If ongoing studies confirm the low toxicity of this new agent, gadopentetate dimeglumine-polylysine could offer a totally new approach to MR angiography.

Animals↗

[Moyamoya. Diagnosis using MRI and NMR angiography].

A case of Moya-Moya disease confirmed by cerebral angiography in a 10-year-old girl is reported. Hypertrophic collateral circulation is easily visualized by MRI. MR angiography very accurately demonstrated the vascular obstruction and the collateral circulation. As MR angiography is not invasive, it promises to become a valuable alternative to conventional angiography in the diagnosis of Moya-Moya.

Arterial Occlusive Diseases↗

MRA review.

Magnetic resonance (MR) angiography is a rapidly evolving field in MR imaging, the main goal of which is a noninvasive tool for visualizing blood vessels. The acquisition of continuous images of the blood vessels, comparable to the conventional DSA images, as well as the functional evaluation of blood-flow velocities and flow patterns are the subject of continuing developments. The basic principles of the various techniques and their clinical applications are reviewed and the practical limitations in specific anatomic regions discussed. The review concludes with a survey of future developments.

Angiography↗

Axial vs sagittal T2-weighted brain MR images in the evaluation of multiple sclerosis.

Axial and sagittal proton density and T2-weighted MR images (TR 2,500-3,000 ms, TE 15-22 and 85-90 ms) were performed in 50 patients with multiple sclerosis (MS) on a 1.5 T superconductive system. The number of plaques on the axial and sagittal images in the periventricular white matter, the corpus callosum, the brain stem, the cerebellum, and the basal ganglia were counted separately by two independent observers. A total of 858 lesions (mean 17.40 +/- 21.57) were seen on the axial series and 1,196 (mean 24.32 +/- 26.22) on the sagittal scans. More lesions were visualized on sagittal images in the periventricular region (mean 18.79 +/- 21.69 versus 13.34 +/- 16.45; p less than 0.001) and the corpus callosum (mean 3.00 +/- 2.72 versus 0.57 +/- 1.19; p less than 0.001). In the brain stem more lesions were visualized on the axial images (mean 1.55 +/- 2.55 versus 0.87 +/- 1.20; p less than 0.05). In the cerebellum and basal ganglia, scans in the two planes were equivalent (p greater than 0.5). In three patients lesions were seen on the sagittal series, while the axial scans were normal. Sagittal T2-weighted images appear to demonstrate significantly more MS plaques than transverse images, especially in the periventricular region and the corpus callosum. This is explained by partial volume averaging, by the orientation of some cerebral structures (e.g., corpus callosum) with regard to the section plane, and by the longer diameter of the lesions in the axial plane.

Brain Diseases↗

Experimental Gd-DTPA polylysine enhanced MR angiography: sequence optimization.

Most MR angiography (MRA) techniques use macroscopic blood motion to characterize the flowing spins. A different approach is represented by the use of contrast enhancement of blood pooling agents. The intravenous injection of one of these agents, namely Gd-DTPA polylysine, produces a shortening of the blood T1 below the T1 values of fat and soft tissues. In this study on experimental MRA in rabbits, we used an imaging sequence with a 90 degrees saturation pulse and a 180 degrees inversion recovery pulse. Both the saturation and inversion recovery times were adjusted to suppress the signals of soft tissues and fat. The remaining ultrashort T1 blood was imaged with a projective velocity refocused spin echo or gradient echo sequence. Magnetic resonance angiography provided excellent vessel detail with a 30-60 s acquisition time. In addition, there was no need for further processing after image acquisition because the projection was obtained immediately. The disadvantages of the technique are the need for contrast medium injection and the nonselectivity of MRA.

Animals↗

Contrast-enhanced MRA of the brain.

Most sequences for MR angiography (MRA) used today exploit the macroscopic motion of the blood to differentiate vessels from the stationary tissues. An alternative approach to inflow based MRA is contrast enhanced MRA, in which relaxation agents are used to selectively shorten the T1 of the blood below the T1 value of the stationary tissues. We have evaluated cerebral Gd enhanced MRA, comparing it with conventional angiography and noncontrast inflow based MRA. Contrast/enhanced MRAs were obtained at 1.0 T with a 3D FISP sequence with TR/TE/alpha: 35-40 ms, 7-11 ms/TE/25 degrees. Contrast enhancement was obtained by a biphasic injection of a double dose of Gd-DOTA (0.2 mmol/kg) during image acquisition. With the described technique the conspicuity of both cerebral arteries and veins is improved compared to nonenhanced inflow MRA.

Angiography, Digital Subtraction↗