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Biomedical subjects

L E Crooks

Publications and source records attributed to L E Crooks.

At least 55 records · Page 3Linked to original sources

Cardiac imaging using gated magnetic resonance.

To overcome the limitations of magnetic resonance (MR) cardiac imaging using nongated data acquisition, three methods for acquiring a gating signal, which could be applied in the presence of a magnetic field, were tested: an air-filled plethysmograph, a laser-Doppler capillary perfusion flowmeter, and an electrocardiographic gating device. The gating signal was used for timing of MR imaging sequences (IS). Application of each gating method yielded significant improvements in structural MR image resolution of the beating heart, although with both plethysmography and laser-Doppler velocimetry it was difficult to obtain cardiac images from the early portion of the cardiac cycle due to an intrinsic delay between the ECG R wave and peripheral detection of the gating signal. Variations in the temporal relationship between the R wave and plethysmographic and laser-Doppler signals produced inconsistencies in the timing of IS. Since the ECG signal is virtually free of these problems, the preferable gating technique is IS synchronization with an electrocardiogram. The gated images acquired with this method provide sharp definition of internal cardiac morphology and can be temporarily referenced to end diastole and end systole or intermediate points.

Animals↗

Hepatic tumors: magnetic resonance and CT appearance.

The magnetic resonance (MR) features of primary and metastatic hepatic tumors were analyzed and compared with CT findings in 28 patients. MR images were obtained on a 0.35-Tesla superconducting magnet using a variety of spin echo and inversion recovery imaging techniques. The normal liver appeared homogeneous and of moderate intensity. Tumors typically appeared as masses of increased intensity on spin echo images and diminished intensity on inversion recovery images. Tumors had prolonged T1 and T2 times, which varied in different types of tumors and within regions of a single tumor. A specific T1 and/or T2 time could not be ascribed to any tumor. Tumor intensity varied greatly depending on the imaging techniques employed, becoming isointense with normal liver on some imaging sequences. MR and CT detected lesions equally well, but internal architecture and the relationship of tumors to hepatic vascular structures were better displayed on MR.

Adenoma↗

High-resolution magnetic resonance imaging. Technical concepts and their implementation.

In magnetic resonance (MR) imaging manipulating spatial resolution, contrast resolution, and imaging time separately results in improvement in some parameters without degradation of others. The authors have found that MR imaging of the head with a repetition time TR = 2.0 seconds produces images with high signal-to-noise levels and excellent sensitivity to demyelinating disease and brain water content. In the body, a long TR yields large signal levels that permit delineation of low-intensity structures such as patent vessels and bone. The long TR technique can be used in a high-resolution mode (256 X 256 data acquisition elements, each 0.8 X 0.8 mm) while maintaining image times of 50 or 100 sec/section. For normal resolution (1.7 X 1.7 mm), imaging time is 25 or 50 sec/section. It is concluded that the combination of slow-imaging techniques with simultaneous multisection imaging will prove practical for clinical MR.

Brain↗

Cerebral abnormalities: use of calculated T1 and T2 magnetic resonance images for diagnosis.

The potential clinical importance of T1 and T2 relaxation times in distinguishing normal and pathologic tissue with magnetic resonance (MR) is discussed and clinical examples of cerebral abnormalities are given. T1 and T2 values may be used in three ways: (a) Relative values, obtained by an analysis of intensity images with varying dependence on T1 and T2, may be used if absolute values for T1 and T2 are not required for diagnosis. (b) If an absolute value is desired, the numerical values for the relaxation times may be generated using a region of interest on the intensity images. (c) In cases in which both T1 and T2 change may require a calculated image to indicate the contribution of each to the signal intensity, the numerical value may be used to generate analogue images of T1 or T2 calculations. Five patients with cerebral infarction, 15 with multiple sclerosis, two with Wilson disease, and four with tumors were imaged. Hemorrhagic and ischemic cerebrovascular accidents were distinguished using the spin echo technique. In the patients with multiple sclerosis, lesions had prolonged T1 and T2 times, but the definition of plaque was limited by spatial resolution. No abnormalities in signal intensity were seen in the patient with Wilson disease who was no longer severely disabled; abnormal increased signal intensity in the basal ganglia was found in the second patient with Wilson disease. Four tumors produced abnormal T1 and T2 relaxation times but these values alone were not sufficient for tumor characterization.

Brain Diseases↗

Magnetic resonance imaging of the pericardium: normal and pathologic findings.

Twenty normal subjects and ten patients with pericardial abnormalities underwent ECG-gated magnetic resonance (MR) imaging of the thorax using a 0.35-tesla superconducting system. The patients with pericardial abnormalities were also evaluated with serial chest radiographs, ultrasound, computed tomography, and/or angiography. ECG gating was necessary to identify the normal pericardium, which was visualized as a 1- to 2-mm-wide curvilinear structure of low signal intensity. Pericardial thickening in constrictive pericarditis was clearly delineated on gated MR images. Pericardial inflammation caused a marked increase in signal intensity as well as thickening of the pericardium. Pericardial effusions and pericardial adhesions were also demonstrated. A simple pericardial cyst and a complex pericardial mass were identified and differentiated from pericardial fat and diaphragmatic eventration. MR appears to be an important modality for the evaluation of pericardial disease.

Adult↗

Multisection sagittal and coronal magnetic resonance imaging of the mediastinum and hila. Work in progress.

Sagittal or coronal thoracic magnetic resonance (MR) images were obtained in 7 individuals - 4 normal subjects and 3 patients with thoracic masses. In 2 of the abnormal cases, sagittal or coronal MR provided significant anatomic information that was either less evident or invisible on transaxial MR or computed tomographic (CT) images or CT reformations. In the third abnormal patient, a pretracheal lymph node was more clearly seen on transaxial images than on coronal images.

Adult↗

Magnetic resonance imaging: effects of magnetic field strength.

Magnetic resonance images of the head, abdomen, and pelvis of normal adult men were obtained using varying magnetic field strength, and measurements of T1 and T2 relaxations and of signal-to-noise (SN) ratios were determined. The T1 relaxation of gray matter, white matter, and muscle increases and T2 decreases with field strength, while T1 of fat remains relatively constant and T2 increases. As a consequence, for any one spin echo sequence, gray/white matter contrast decreases and muscle/fat contrast increases with field. SN levels rise rapidly up to 3.0 kgauss and then change more slowly, actually dropping for muscle. The optimum field for magnetic resonance imaging depends on tissue type, body part, and imaging sequence, so that it does not have a unique value. Magnetic resonance systems that operate in the 3.0-5.0 kgauss range achieve most or all of the gains that can be achieved by higher magnetic fields.

Abdomen↗

Magnetic resonance of the brain: the optimal screening technique.

Seventy consecutive patients were examined with magnetic resonance (MR) and computed tomography (CT) of the brain. Each study was independently reviewed. Focal abnormalities were detected by one or both modalities in 51 patients. Neoplastic, infectious, vascular, demyelinating, metabolic, and congenital disorders of the brain were included. The MR pulse sequence that best detected these abnormalities was a spin-echo multisection technique that used a long interval between RF excitations (TR = 1500 or 2000 msec). Forty-eight of 51 patients showed focal lesions with this technique. A supplementary MR pulse sequence with a short TR (500 msec) was useful in helping to characterize certain lesions with a long T1 relaxation component, but in 10 of 26 positive cases in which this sequence was added it would have missed the abnormality had it been the sole sequence used. MR missed focal lesions in 3 of 51 patients. These were lesions that required thin-section (1.5 mm) CT techniques. Two were intrasellar, and one was an intracanalicular neurinoma. In 17 of 48 patients, CT missed the focal lesion seen with MR. Based on this experience, it is concluded that the long TR multisection spin-echo sequence is the optimal MR screening technique for detection of most brain abnormalities, and is more sensitive than CT. Currently, CT remains the screening modality of choice when high-resolution, thin-section studies in the pituitary, inner ear, and orbital regions are indicated.

Brain Diseases↗

Analytical tools for magnetic resonance imaging.

The response of different magnetic resonance (MR) techniques to tissue parameters - T1, T2, and N(H) - is a determinant of clinical efficacy. The large possible number of imaging techniques and range of variable parameters for each make it difficult to perform exhaustive evaluations in a single patient or even in animal models. In addition, changes in operating magnetic field strength change the relaxation times sufficiently so that the efficacy of a technique at a given field does not imply similar results at another field value. Tools are demonstrated that permit the evaluation of the efficacy of any model of response to tissue parameters, and also allow the investigation of the effects of changing magnetic field. Global maps of signal difference between tissues as well as calculated images are obtainable from a minimally sufficient data set. These tools serve as an important adjunct to experimental work.

Electron Spin Resonance Spectroscopy↗

Magnetic resonance imaging strategies for heart studies.

Given a suitable trigger signal, cardiac synchronized magnetic resonance (MR) imaging is simple to implement; however, single section techniques are not efficacious, especially when the heart rate sets the repetition interval. We demonstrate multi-section, double, and single-echo imaging, any of which rapidly covers the cardiac volume; 3-D modes capable of achieving very thin sections; and cycled multi-section imaging capable of efficaciously providing dynamic data on heart motion. These modes form a complementary, powerful set of options for clinical work.

Heart↗

Magnetic resonance imaging of the lymph nodes: comparison with CT.

This retrospective study of 144 patients was made to (a) assess the potential of magnetic resonance (MR) for demonstrating lymph nodes using spin-echo technique, (b) compare the MR results with those of CT, and (c) determine the optimal pulse-sequence interval (TR) and echo-delay time (TE) for imaging lymph nodes. The reported CT findings on normal lymph nodes were compared with MR findings in 60 patients who underwent MR imaging of the neck (20 patients), chest (20 patients), abdomen (10 patients), and pelvis (10 patients) for conditions other than lymph node disease. The results showed that CT is presently better than MR for imaging neck and abdominal lymph nodes less than 13 mm in diameter. The ability of MR to demonstrate normal-size (less than 10 mm) lymph nodes in the chest was comparable to that of CT. In addition, MR scans of 84 patients with proven abnormal lymph nodes (8 neck, 49 chest, and 27 abdomen and pelvis) were assessed: in 72 patients, these nodes had also been imaged by CT. MR and CT gave similar results with abnormal lymph nodes (greater than 13 or 15 mm), but MR displayed these nodes better because of its excellent soft-tissue contrast resolution. MR can clearly differentiate abnormal lymph nodes from normal fat, muscle, vessels, adult thymus, thyroid, and diaphragmatic crura, as well as from primary tumor and lymphoceles. Optimal demonstration of lymph nodes with MR required two sequences: one with a short TR and one with a long TR and long TE. Preliminary results indicate that MR holds great promise for the demonstration of lymph nodes in every part of the body.

Adolescent↗

Nuclear magnetic resonance: principles of blood flow imaging.

Nuclear magnetic resonance (NMR) imaging with spin-echo techniques defines vascular structures with superb anatomic detail. Contrast agents are not necessary as there is intrinsic contrast between flowing blood and the vascular wall. The signal intensity from blood within the vessel lumen varies with the sequence of gradient and radiofrequency pulses used to generate the image as well as with the velocity of blood flow. Appropriate imaging techniques can optimize anatomic detail, distinguish slow from rapidly flowing blood, and serve to identify marked impairment or complete obstruction of flow in an artery or vein. Some examples of these principles in the intracranial circulation are illustrated.

Adolescent↗

Multiplane magnetic resonance imaging of the heart and major vessels: studies in normal volunteers.

The feasibility of magnetic resonance imaging for defining anatomy of internal cardiac structures and major blood vessels was assessed in 14 normal subjects. Both electrocardiogram-gated and standard spin-echo images were obtained. The R-R interval determined the pulse repetition times in gated sequences. Gated images provided better visualization of internal cardiac morphology and of upper mediastinal vessels than did nongated images. Trabecular detail and components of the mitral valve could be resolved. All segments of the left ventricular wall could be evaluated by combining axial, coronal, and sagittal images. Gated acquisition of magnetic resonance images did not increase imaging time; five transverse slices of the left ventricle were obtained in 6.0-8.5 min. The good image quality, ease of gated acquisition, large field of view, capability of direct imaging in multiple planes, and noninvasiveness of the technique suggest that it will be an important imaging method in cardiovascular disease.

Adult↗

Nuclear magnetic resonance imaging in multiple sclerosis.

Ten patients with definite multiple sclerosis underwent hydrogen nuclear magnetic resonance imaging with a 3.5 kilogauss superconducting magnet, using the inversion recovery and spin-echo techniques of signal acquisition. Results were compared with high-resolution x-ray computed tomography. Spin-echo images demonstrated abnormal regions as areas of variably increased signal intensity. The contrast between abnormal and normal white matter improved as the intervals between sequential radiofrequency pulses and between pulse administration and signal sampling were increased. Inversion recovery images demonstrated abnormal areas as regions of decreased signal intensity but did not visualize lesions as well as spin-echo imaging. Spin-echo and inversion recovery imaging each demonstrated more extensive abnormalities than did computed tomography.

Adult↗

Nuclear magnetic resonance imaging of acute myocardial infarction in dogs: alterations in magnetic relaxation times.

Nuclear magnetic resonance (NMR) imaging was used to study 24-hour-old acute myocardial infarctions in 8 dogs. Images and measurements of excised hearts were obtained in a 6.5 ml bore-resistive NMR imager (0.35 Tesla). Spin echo NMR imaging in each instance demonstrated the area of infarction as a region of increased signal intensity compared with that in normal myocardium. The T1 and T2 values of the area of infarction were greater than those of normal myocardium in all dogs. For each dog the T1 value was greater for the infarct region; however, the group mean value for T1 (ms) of the infarct region (728 +/- 94) was not significantly greater than that for the normal region (650 +/- 87). The T2 value (ms) was discriminate for all dogs, and the mean value for the infarct region (48 +/- 2) was significantly different (p less than 0.01) from the value for normal myocardium (42 +/- 1). The percent water content of the infarct (79 +/- 1%) was significantly greater (p less than 0.01) than that of normal regions (76 +/- 1%). The linear relationship between T2 value and percent water content showed a good correlation coefficient (r = 0.90; p less than 0.01). NMR imaging detects acute myocardial infarction as a positive image without contrast media. Increased signal intensity of the infarct is related to increased hydrogen density and increased T2 relaxation time.

Animals↗

Clinical efficiency of nuclear magnetic resonance imaging.

Advances in imaging technique have improved the efficiency of clinical nuclear magnetic resonance (NMR) imaging, and will allow total patient examination time that equals or is more favorable than that of x-ray computed tomography (CT). The whole head can be examined with NMR in a 6.5-minute imaging time with a spatial resolution of 1.7 mm. Fifteen sections in the body can be similarly imaged. Quantitative T2 ("spin-spin" relaxation time) information, as well as estimates of T1 ("spin-lattice" relaxation time) can be obtained in this time. Quantitative T1 information requires an additional procedure.

Brain Neoplasms↗