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Biomedical subjects

H Hatabu

Publications and source records attributed to H Hatabu.

At least 19 recordsLinked to original sources

Frequency and severity of air trapping at dynamic expiratory CT in patients with tracheobronchomalacia.

OBJECTIVE: The purpose of this study was to compare the frequency and severity of air trapping in patients with and without tracheobronchomalacia using dynamic expiratory volumetric CT. MATERIALS AND METHODS: The study group consisted of 20 subjects, including 10 patients with bronchoscopically proven tracheobronchomalacia and 10 control subjects of similar ages without tracheobronchomalacia. All 20 subjects underwent MDCT performed at the end of deep inspiration and during dynamic expiration. The images were analyzed at three lung levels, and the extent of air trapping was assessed visually using a 5-point scale. For each subject, a total air-trapping score was derived by summing the values for the three lung levels (possible range, 0-12). Statistical analysis was performed using the Mann-Whitney U test. RESULTS: In the tracheobronchomalacia group, 10 (100%) of 10 patients showed air trapping, with a median score of 5 (range, 2-12). In the control group, six (60%) of 10 subjects showed air trapping, with a median score of 2 (range, 0-3). The median total air-trapping score was significantly higher (p < 0.001) for the tracheobronchomalacia group compared with the control group. Excessive central airway collapse (expiratory reduction in cross-sectional area of > 50%) was seen on CT scans in all tracheobronchomalacia patients but in none of the control subjects. CONCLUSION: Air trapping was observed with a higher frequency and greater severity in patients with tracheobronchomalacia than in a control group of patients of similar ages without tracheobronchomalacia.

Adult↗

Pulmonary embolism in pregnant patients: a survey of practices and policies for CT pulmonary angiography.

OBJECTIVE: We surveyed the practices and policies of the radiology departments of the Society of Thoracic Radiology members regarding the use of CT pulmonary angiography in pregnant patients suspected of having pulmonary embolism. MATERIALS AND METHODS: Surveys were mailed electronically to the 403 members of the Society of Thoracic Radiology (403 addresses). Respondents were asked to send one response from each institution or department. Information gathered included use of CT angiography in relation to ventilation-perfusion imaging in pregnant patients, written policies, informed consent procedures, and modifications of standard protocols for dose reduction. RESULTS: Fifty-seven members responded; 43 (75%) reported that they perform CT angiography in pregnant patients suspected of having pulmonary embolism. Of the 43 respondents who perform CT angiography in pregnant patients, 23 (53%) generally perform CT angiography as the initial study rather than ventilation-perfusion scanning, 26 (60%) require informed consent from the patient, seven (16%) have a written policy concerning CT angiography in pregnant patients, and 17 (40%) modify standard imaging protocols for pregnant patients. The most common modification for dose reduction is decreasing the scanning area along the z-axis. CONCLUSION: Most respondents perform CT angiography in pregnant patients suspected of having pulmonary embolism, but their policies and practices vary considerably.

Angiography↗

Multiphase ECG-triggered 3D contrast-enhanced MR angiography: utility for evaluation of hilar and mediastinal invasion of bronchogenic carcinoma.

The purpose of this study was to evaluate the usefulness of cardiac synchronized magnetic resonance angiography [electrocardiographically (ECG)-triggered MRA] for improving image quality and detection of hilar and mediastinal invasion of bronchogenic carcinoma. Fifty patients, suspected of having hilar or mediastinal invasion of bronchogenic carcinoma, underwent contrast-enhanced computed tomography and MR imaging including conventional and ECG-triggered MRA. Twenty patients subsequently also underwent surgical resection. Vascular enhancement-to-background ratio (VBR), vascular enhancement-to-tumor ratio (VTR), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality scores of thoracic vessels obtained with both MRA techniques were determined and compared. In addition, the diagnostic accuracy of tumor invasion of pulmonary vessels was compared. VBRs and VTRs of both MRA techniques were not significantly different. ECG-triggered MRA significantly improved SNRs and CNRs (P < 0.05). Two readers judged that overall image quality of ECG-triggered MRA was better than that of conventional MRA (kappa > or = 0.41). In conclusion, ECG-triggered MRA improves the image quality and the detection of hilar and mediastinal invasion of bronchogenic carcinoma.

Adult↗

Dynamic observation of pulmonary perfusion using continuous arterial spin-labeling in a pig model.

The continuous arterial spin-labeling (CASL) method of perfusion MRI is used to observe pulmonary perfusion dynamically in an animal model. Specifically, a respiratory-triggered implementation of the CASL method is used with approximate spatial resolution of 0.9 x 1.8 x 5.0 mm (0.008 cc) and 2-minute temporal resolution. Perfusion MRI is performed dynamically during repeated balloon occlusion of a segmental pulmonary artery, as well as during pharmacological stimulation. A total of three Yorkshire pigs were studied. The results demonstrate the ability of the endogenous spin-labeling method to characterize the dynamic changes in pulmonary perfusion that occur during important physiological alterations.

Animals↗

Evaluation of regional pulmonary perfusion using ultrafast magnetic resonance imaging.

An ultrafast MR sequence was used to measure changes in signal intensity during the first pass of intravascular contrast through the pulmonary circulation. From this, mean transit time, relative blood volume, and relative blood flow were calculated. Data were collected in an isogravitational plane in six healthy subjects. A slight but significant gradient in transit time was present, with faster times at the lung apex. A significant decrease in blood volume, compared with the lung base, was also seen in the apex. Significant decreases in blood volume and blood flow, compared with central portions of the lung, were seen in the lung periphery. Six additional subjects were imaged along a gravitational plane. A significant gradient in transit time was seen, with faster transit in dependent regions of the lung. MRI is able to evaluate regional differences in pulmonary perfusion with high spatial and temporal resolution. Magn Reson Med 46:166-171, 2001.

Blood Volume↗

Pulmonary MR angiography with contrast agent at 4 Tesla: a preliminary result.

In this study, pulmonary MR angiography (MRA) using a tailored coil at 4 Tesla in conjunction with an intravenous injection of contrast agent is described. Three-dimensional gradient-echo images were obtained during the intravenous injection of 0.05, 0.1, and 0.2 mmol/kg body weight of gadodiamide to investigate the signal enhancement effect of the contrast agent in pulmonary arteries qualitatively and quantitatively. In the qualitative analysis, the subsegmental branches were visualized on every dose. In the quantitative analysis, the average contrast-to-noise ratios (CNRs) of the main pulmonary arteries increased in a dose-dependent manner. However, the CNRs of segmental arteries did not increase as the dose of contrast agent increased, as observed at 1.5 Tesla MRI. These observations demonstrate the feasibility of delineating the pulmonary vasculature using a contrast agent; however, our results also suggest possible high-field-related disabilities that need to be overcome before high-field (> or =4 Tesla) MRI can be used to full advantage.

Adult↗

Assessment of pulmonary perfusion using a subtracted HASTE image between diastole and systole.

The MR signal intensity change in the pulmonary parenchyma during the cardiac cycle was studied using HASTE sequence in volunteers. In addition, the potential to assess pulmonary perfusion abnormality by subtraction between diastolic and systolic HASTE images was tested in a pig model of pulmonary embolism. Signal intensity decreased in systole while it increased gradually in diastole. In a pig model with pulmonary embolism, subtracted images could identify the perfusion abnormality. Thus, subtraction of diastolic and systolic HASTE images has the potential to detect pulmonary perfusion abnormality. The technique may provide a new simple method for evaluating pulmonary perfusion.

Adult↗

Pulmonary ventilation: dynamic MRI with inhalation of molecular oxygen.

We have recently demonstrated a non-invasive technique to visualize pulmonary ventilation in humans with inhalation of molecular oxygen as a paramagnetic contrast agent. In the current study, T1 shortening of lung tissue by inhalation of oxygen was observed (P<0.001). The T1 values of lung tissue were also correlated with arterial blood oxygen pressure (PaO(2)) in a pig, resulting in excellent correlation (r(2)=0.997). Dynamic wash-in and wash-out MR ventilation images as well as dynamic wash-in wash-out signal intensity versus time curves were obtained. The mean wash-in decay constants were 26.8+/-10.5 s in the right lung, and 26.3+/-9.5 s in the left lung. The mean wash-out decay constants were 23.3+/-11.3 s in the right lung, and 20.8+/-10.5 s in the left lung. Dynamic assessment of pulmonary ventilation is feasible using oxygen-enhanced MR imaging, which could provide dynamic MR ventilation-perfusion imaging in combination with recently developed MR perfusion imaging technique, and thus a robust tool for the study of pulmonary physiology and pathophysiology.

Animals↗

Oxygen-enhanced magnetic resonance ventilation imaging of lung.

The oxygen-enhanced magnetic resonance (MR) ventilation imaging is a new technique, and the full extent of its physiological significance has not been elucidated. This review article includes background on (1) respiratory physiology; (2) mechanism and optimization of oxygen-enhanced MR imaging technique; (3) recent applications in animal and human models; and (4) merits and demerits of the technique in comparison with hyperpolarized noble gas MR ventilation imaging. Application of oxygen-enhanced MR ventilation imaging to patients with pulmonary diseases has been very limited. However, we believe that further basic studies, as well as clinical applications of this new technique will define the real significance of oxygen-enhanced MR ventilation imaging in the future of pulmonary functional imaging and its usefulness for diagnostic radiology.

Animals↗

Quantification of pulmonary perfusion with MR imaging: recent advances.

Recent advances in magnetic resonance pulmonary perfusion imaging are reviewed, focusing on magnetic resonance perfusion imaging using gadolinium contrasts agents or spin labeling of blood using naturally flowing spins as the source of intravascular signal. These recent developments in magnetic resonance imaging have made it possible to analyze data quantitatively which holds significant potential for clinical imaging of lung perfusion and opens windows to functional MR imaging of the lung. We believe that fast magnetic resonance functional imaging will play an important role in the assessment of pulmonary function and the pulmonary disease process.

Contrast Media↗

Structural basis for pulmonary functional imaging.

An understanding of fine normal lung morphology is important for effective pulmonary functional imaging. The lung specimens must be inflated. These include (a) unfixed, inflated lung specimen, (b) formaldehyde fixed lung specimen, (c) fixed, inflated dry lung specimen, and (d) histology specimen. Photography, magnified view, radiograph, computed tomography, and histology of these specimens are demonstrated. From a standpoint of diagnostic imaging, the main normal lung structures consist of airways (bronchi and bronchioles), alveoli, pulmonary vessels, secondary pulmonary lobules, and subpleural pulmonary lymphatic channels. This review summarizes fine radiologic normal lung morphology as an aid to effective pulmonary functional imaging.

Arteries↗

Hyperpolarized noble gas MR imaging of the lung: potential clinical applications.

Hyperpolarized noble gases are a new class of MR contrast agent. Since the first hyperpolarized gas MR images of the lung were reported, there has been considerable interest in using hyperpolarized gas to obtain high spatial and temporal resolution images of the air spaces of the lung. In addition to static images of lung ventilation, new techniques are being developed using hyperpolarized gas to obtain dynamic, diffusion and oxygen concentration images of the lung. In this article, we review the potential clinical applications of pulmonary hyperpolarized gas MRI and discuss the preliminary findings in a variety of lung diseases. Hyperpolarized gas MRI has the potential to provide a comprehensive morphologic and functional assessment of the lung.

Asthma↗

Oxygen-enhanced MR ventilation imaging of the lung: preliminary clinical experience in 25 subjects.

OBJECTIVE: The purpose of this study was to show the feasibility of oxygen-enhanced MR ventilation imaging in a clinical setting with correlation to standard pulmonary function tests, high-resolution CT, and (81m)Kr ventilation scintigraphy. SUBJECTS AND METHODS: Seven healthy volunteers, 10 lung cancer patients, and eight lung cancer patients with pulmonary emphysema were studied. A respiratory synchronized inversion-recovery single-shot turbo-spin-echo sequence (TE, 16; inversion time, 720 msec; interecho spacing, 4 msec) was used for data acquisition. The following paradigm of oxygen inhalation was used: 21% oxygen (room air), 100% oxygen, 21% oxygen. MR imaging data including maximum mean relative enhancement ratio and mean slope of relative enhancement were correlated with forced expiratory volume in 1 sec, diffusing lung capacity, high-resolution CT emphysema score, and mean distribution ratio of (81m)Kr ventilation scintigraphy. RESULTS: Oxygen-enhanced MR ventilation images were obtained in all subjects. Maximum mean relative enhancement ratio and mean slope of relative enhancement of lung cancer patients were significantly decreased compared with those of the healthy volunteers (p < 0.0001, p < 0.0001). The mean slope of relative enhancement in lung cancer patients with pulmonary emphysema was significantly lower than that of lung cancer patients without pulmonary emphysema (p < 0.0001). Maximum mean relative enhancement ratio (r(2) = 0.81) was excellently correlated with diffusing lung capacity. Mean slope of relative enhancement (r(2) = 0.74) was strongly correlated with forced expiratory volume in 1 sec. Maximum mean relative enhancement had good correlation with the high-resolution CT emphysema score (r(2) = 0.38). The maximum mean relative enhancement had a strong correlation with the distribution ratio (r(2) = 0.77). CONCLUSION: Oxygen-enhanced MR ventilation imaging in human subjects showed regional changes in ventilation, thus reflecting regional lung function.

Adult↗

Comparison of short inversion time inversion recovery (STIR) and fat-saturated (chemsat) techniques for background fat intensity suppression in cervical and thoracic MR imaging.

The purpose of this study was to compare short inversion time inversion recovery (STIR) fast spin-echo (FSE), and fat-saturated T2-weighted FSE sequences in terms of uniformity of fat suppression and lesion conspicuity for magnetic resonance (MR) imaging of the neck and thorax. STIR FSE and fat-saturated T2-weighted FSE images were scored for uniformity of fat suppression (n = 40) and lesion conspicuity (n = 35). Five-point rank score analyses were utilized by three experienced radiologists. The mean scores of STIR and fat-saturated FSE techniques for uniformity of fat suppression were 4.3 and 2.3, respectively (P < 0.0001). The mean scores of STIR and fat-saturated FSE techniques for lesion conspicuity were 4.2 and 3.5, respectively (P < 0.0001). Insufficient fat suppression was prominent in the mandible, supraclavicular region, anterior mediastinum, epipericardial fat, and subdiaphragmatic fat. In addition, fat-saturated T2-weighted FSE showed inadvertent water suppression in 25%. The STIR FSE technique was superior to the fat-saturated FSE technique for cervical and thoracic MR imaging.

Adolescent↗

Effect of respiratory phases on MR lung signal intensity and lung conspicuity using segmented multiple inversion recovery turbo spin echo (MIR-TSE).

The purpose of this study was to determine the effect of respiratory phase on signal intensity of the lung. Lung images were obtained from eleven healthy human volunteers using a multiple inversion recovery segmented turbo spin echo sequence (MIR-TSE). MIR exploits the difference in T(1) between different tissues to effectively null signal contributions from fat and muscle for improved visualization of the lung. The volunteers were asked to perform breath-holding on end inspiration or end expiration. There was a significant decrease in signal intensity of the lung with average SNR of 7.3 +/- 0.9 vs. 14.4 +/- 0.8 for coronal slices, and 9.5 +/-1.5 vs. 16.0 +/-2.4 for sagittal breath-hold images acquired during end inspiration compared with end expiration. It is concluded that MRI of the lungs should be performed during end expiration in order to optimize image quality.

Female↗

Noninvasive pulmonary perfusion imaging by STAR-HASTE sequence.

The STAR-HASTE sequence has been shown to be useful for perfusion imaging in areas that are plagued by magnetic susceptibility artifacts. Pulmonary perfusion imaging with this technique was attempted in this study. Quantitative analysis was also conducted, using an appropriate kinetic model in one subject. In six healthy subjects, gradual enhancement was observed in pulmonary artery to distal lung parenchyma when inflow time was increased. Our initial results suggest that noninvasive evaluation of pulmonary perfusion by magnetic resonance imaging without administration of an exogenous agent is possible.

Adult↗

Magnetic resonance imaging of the thorax. Past, present, and future.

Magnetic resonance imaging is a valuable modality of extreme flexibility for specific problem-solving capability in the thorax. This article reviews MR applications in the imaging of great vessels, which are currently the most important applications in the thorax; other established applications in the thorax; and pulmonary functional MR imaging.

Humans↗