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Biomedical subjects

J Listerud

Publications and source records attributed to J Listerud.

33 records · Page 2Linked to original sources

Magnetic resonance angiography of the pelvis and lower extremities. Works in progress.

Two-dimensional time-of-flight (TOF) magnetic resonance angiography (MRA) of the lower extremities has recently been rediscovered as a technique that can be used to find small vessels in the foot and leg for surgical revascularization in patients with severe peripheral vascular disease. The purpose of this article is to acquaint the reader with some of the common problems that may be encountered in this imaging technique and to show their derivations and solutions were applicable. In addition, the authors show receiver operator curve analysis of one radiologist's ability to determine the location and patency of arteries using this technique to be outstanding (AZ, 0.9737). This represents a promising new technique for imaging the arterial system in patients with severe peripheral vascular disease.

Blood Vessels↗

Thin-section, three-dimensional Fourier transform, steady-state free precession MR imaging of the brain.

The authors evaluated a three-dimensional Fourier transform implementation of a very short repetition time (TR) (24 msec), steady-state free precession (SSFP) pulse sequence for clinical imaging of the brain and compared it with a conventional two-dimensional Fourier transform long TR/echo time (TE) spin-echo sequence. First, the optimal flip angle of 10 degrees for generating images with contrast similar to that of long TR/TE spin-echo images was determined. Then, 29 patients with suspected brain lesions were studied with both techniques. Although the SSFP images did not exhibit the magnetic susceptibility artifacts that plague other rapid-imaging techniques, the conspicuity of most parenchymal lesions was often less than that on the spin-echo images. Also, the visibility of paramagnetic effects, such as the low signal intensity of brain iron, was less obvious at SSFP imaging. These substantial limitations may relegate the SSFP sequence to an adjunctive role, perhaps mainly demonstration of the cystic nature of mass lesions, because of its extreme sensitivity to slow flow.

Adolescent↗

First principles of fast spin echo.

Fast spin echo (FSE), a variant of the rapid acquisition with refocused echoes pulse sequence, is now being widely considered as an alternative to conventional spin echo for proton density and T2-weighted imaging. Although the medical experience with this sequence is relatively limited, relevant aspects of the technique have been well understood in the context of spectroscopic applications for many years. This article attempts to portray the subject in an appropriate historical context. Such a viewpoint promotes a deeper understanding of the artifacts, determinants of contrast, and future evolution of FSE. Hopefully, this may not only be of benefit in the design of optimal clinical imaging protocols for current state of the art but may also be of use in fashioning the criteria by which new developments in this field may be judged.

Artifacts↗

Common artifacts encountered in thoracic magnetic resonance imaging: recognition, derivation, and solutions.

The article discusses the many types of thoracic magnetic resonance imaging artifacts, their derivations, and their current solutions. Magnetic resonance imaging artifacts of the thorax can be divided into two major categories. First, there are machine-related artifacts related to the machine's hardware: the intrinsic magnetic field, chemical shift, magnetic susceptibility, radio frequency leaks, metal artifacts, B1-homogeneity, gradient coils, truncation, aliasing, zipper artifacts, artifacts related to the surface coil profiles, pulse profiles, and crosstalk. Second, there are artifacts related to motion: voluntary patient motion, involuntary motion, and physiologic motions. Each one of these artifacts, and their solutions, will be discussed.

Artifacts↗

Popliteal artery hemodynamics: MR imaging-US correlation.

Temporally resolved velocity measurements in the popliteal arteries of 11 healthy subjects were obtained by means of magnetic resonance (MR) imaging with use of the Fourier flow-encoding technique. Excellent agreement with corresponding Doppler ultrasonography (US) data (r = .97, slope = 0.99, intercept = -1.5 cm/sec) was demonstrated over the entire velocity range from 50 to -20 cm/sec. The method was rapid and its implementation straightforward. Further, MR imaging was shown to provide the intraluminal velocity distribution relevant for the determination of true flow rates, not obtainable with Doppler US.

Adult↗

Postoperative lumbar spine: contrast-enhanced chemical shift MR imaging.

A modified fat-suppression pulse sequence (consisting of combined frequency-selective fat presaturation followed by a spin-echo acquisition when fat and water magnetization vectors have opposite phase) was used to optimize the conspicuity of intravenous enhancement by gadopentetate dimeglumine on magnetic resonance images in 10 patients previously operated on for lumbar discogenic disease as well as in two patients with herniated disks who had not previously undergone surgery. This technique produced the greatest degree of fat suppression in the phantom study. In six of the patients who had previously undergone surgery, epidural enhancement was more obvious on the fat-suppressed images than on conventional spin-echo images, while in four patients, enhancement was equivalent. The herniated disks in two patients not previously operated on were not enhanced with either technique. Contrast enhancement was universally distinguishable from fat signal and from nonenhancing water-containing tissue on the fat-suppressed images obtained after contrast material administration. This technique may reduce the need for precontrast imaging. Furthermore, postoperative enhancement of nerve roots was more obvious on fat-suppressed images in seven of eight patients. This finding might represent previously undiagnosed degrees of arachnoidal inflammation, which may be a factor in the failed back syndrome.

Adipose Tissue↗

Combined chemical-shift and phase-selective imaging for fat suppression: theory and initial clinical experience.

Incomplete fat suppression with a chemical-shift-selective (CHESS) or phase-selective (Dixon) technique is partially due to the olefinic fat component, which precesses at the same frequency as water. The authors developed a new method of fat suppression--the opposed-fat saturation (OP-ES) sequence--that combines both techniques to obtain superior fat saturation. Fat suppression was verified in phantom studies, which showed that the CHESS portion can eliminate most of the aliphatic fat signal except for a small residual component because of steady state effects and magnetic field imperfections. This residual component is cancelled by the olefinic fat with the phase-selective opposed portion of the sequence. Furthermore, this sequence was superior to another hybrid technique, chopper Dixon in combination with CHESS. When used in 10 healthy volunteers, the OP-FS sequence showed consistently better suppression of the subcutaneous and retroperitoneal fat compared with CHESS alone. Additional advantages for clinical abdominal imaging include its compatibility with respiratory compensation, use of a single excitation, and ease of implementation with gradient-echo imaging. Preliminary application in 10 patients illustrated other potential advantages, including clarification of fat-containing diseases and increasing conspicuity of some lesions.

Adipose Tissue↗

First principles of magnetic resonance angiography.

For several years, magnetic resonance imaging (MRI) has shown promise as a noninvasive tool for the study of the vascular system. One interesting format, so-called MR angiography, produces results resembling conventional x-ray angiographic images. This article lays a solid, rigorous foundation for an intuitive understanding of these effects without the use of advanced mathematical concepts. The current state of the art in data acquisition and postprocessing is illustrated. Finally, relevant hemodynamic concepts are introduced, in order to characterize the physiology of complex blood flow at bifurcations. MR angiography is particularly sensitive to artifacts associated with complex flow. The article ends with a call to investigate these phenomena, because they will directly affect the success of MR angiography as a technique.

Angiography↗

Hydrogen ultrathin phase-encoded spectroscopy (HUPSPEC).

This paper describes a new clinical spectroscopy pulse program, hydrogen ultrathin phase-encoded spectroscopy. This sequence combines high spatial resolution with magnitude hydrogen spectroscopy. A linear volume is spatially frequency encoded with a conventional readout gradient and phase encoded spectrally by incrementing the timing of acquisition. The pulse sequence is implemented on a whole-body MRI scanner and supports several standard scanner options, including autoprescanning, offset of the center of field of view in the frequency-encoding direction, and oblique imaging. Some preliminary experimental experience is reported, demonstrating the possibility of observing the spectral linewidths of fat and water in marrow, and of observing the spectral linewidths of fat and water in marrow, and of observing multiline spectra. Combination of the technique with water suppression methods in a sequence called WASHUP is also discussed.

Adult↗

The correction of nonuniform signal intensity profiles in magnetic resonance imaging.

The increasing use of digital image data in Radiology has opened the door to the routine use of numerical image-enhancement techniques. Of course, numerical image processing cannot put information into the image which is not already there. However, if some means can be found to separate diagnostic image information from noise or artifact, the diagnostic information can be extracted with post-processing. The diagnostic quality of an exam may be enhanced by such numerical manipulations, even though technically, the information content of the digitized image is reduced.

Algorithms↗

Magnetic resonance imaging and magnetic resonance spectroscopy of bone tumors and bone marrow disease.

The authors have made use of an integrated magnetic resonance imaging/spectroscopy (MRI/MRS) examination to study seven patients with a variety of bone tumors. The spatial localization method used in the 31P portion of the examination was surface coil localization and a one-dimensional chemical shift imaging method (3 cases). The authors found that the precision of spatial localization was critical in many of these cases, since most of these bone tumors were surrounded by muscle tissue that contained high concentrations of phosphocreatine (PCr). For this reason, they suggest that the metabolite ratios should be referenced to the adenosine triphosphate (beta-NTP) resonance rather than PCr. The phosphate monoester (PME) to beta-NTP ratio was elevated as compared with normal muscle in all of the bone tumors studied. The authors found that all of these tumors exhibited pHs between 7.0 and 7.2, which are similar to the values found for normal muscle. They also show the feasibility of using a line-selective proton chemical shift imaging sequence with high spatial resolution for investigating changes in the fatty composition of bone marrow. This method is illustrated in an example of a patient with advanced avascular necrosis in the femoral heads.

Adolescent↗

AUR memorial Award. Induced alignment of flowing sickle erythrocytes in a magnetic field. A preliminary report.

Deoxygenated sickle erythrocytes in static suspension align perpendicular to a magnetic field. To assess the importance of this observation to MRI of sickle-cell disease, an in vitro flow apparatus was devised and the orientation of sickle erythrocytes flowing through a 0.38 T magnetic field was investigated. We showed a significant perpendicular alignment of fully deoxygenated sickle erythrocytes flowing at 3 to 4 mm/minute (P less than .001). These results suggest that deoxygenated erythrocytes in a sickle-cell patient could orient perpendicular to a magnetic field, and therefore that MRI of such patients could possibly result in worsening of vaso-occlusive complications. Further studies are needed to assess the possible hazards of MRI of sickle-cell disease, especially at high field strengths.

Anemia, Sickle Cell↗

Conventional and fast spin-echo MR imaging: minimizing echo time.

Magnetic resonance imaging is frequently complicated by the presence of motion and susceptibility gradients. Also, some biologic tissues have short T2s. These problems are particularly troublesome in fast spin-echo (FSE) imaging, in which T2 decay and motion between echoes result in image blurring and ghost artifacts. The authors reduced TE in conventional spin-echo (SE) imaging to 5 msec and echo spacing (E-space) in FSE imaging to 6 msec. All magnetic gradients (except readout) were kept at a maximum, with data sampling as fast as 125 kHz and only ramp waveforms used. Truncated sinc radio-frequency pulses and asymmetric echo sampling were also used in SE imaging. Short TE (5.8 msec) SE images of the upper abdomen were compared with conventional SE images (TE = 11 msec). Also, FSE images with short E-space were compared with conventional FSE images in multiple body sites. Short TE significantly improved the liver-spleen contrast-to-total noise ratio (C/N) (7.9 vs 4.1, n = 9, P < .01) on T1-weighted SE images, reduced the intensity of ghost artifacts (by 34%, P < .02), and increased the number of available imaging planes by 30%. It also improved delineation of cranial nerves and reduced susceptibility artifacts. On short E-space FSE images, spine, lung, upper abdomen, and musculoskeletal tissues appeared crisper and measured spleen-liver C/N increased significantly (6.9 vs 4.0, n = 12, P < .01). The delineation of tissues with short T2 (eg, cartilage) and motion artifact suppression were also improved. Short TE methods can improve image quality in both SE and FSE imaging and merit further clinical evaluation.

Abdomen↗

Pulmonary MR angiography utilizing phased-array surface coils.

Magnetic resonance angiography of the pulmonary vasculature was evaluated in 12 subjects using breath-hold gradient echo scans and surface coils at 1.5 T. Flow-compensated GRASS, spoiled GRASS (SPGR), and WARP-SPGR sequences were utilized. Comparisons were made among flip angles of 10-60 degrees, slice thicknesses of 3-10 mm, and body coil as well as Helmholtz pair and phased-array multiple coils. With 30-40 contiguous slices encompassing the lung, intrathoracic vasculature was segmented using a UNIX/X-windows based package dubbed VIDA. Three-dimensional anatomy was visualized by a brightest voxel projection algorithm, following reduction of chest wall pixel intensities by an operator-interactive module. Both SPGR (30 degrees flip angle, 4 mm slice thickness) and WARPSPGR (15 degrees flip angle, 5 mm slice thickness) in combination with phased-array multiple coils provided the most satisfactory images, based upon observations by three radiologists and signal-to-noise ratio measurements. The MR angiograms visualized vessels as distal as sixth to seventh order branches. The technique was successfully applied to three patients with pulmonary embolism. The results of this study demonstrate that the pulmonary vascular tree can be imaged by MR angiography combining a high resolution technique utilizing phased-array multiple coils, fast gradient echo sequences with breath-holding, and postprocessing of the volumetric image data. The technique is attractive since it is noninvasive and provides a full three-dimensional portrayal of the pulmonary vasculature.

Humans↗