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Biomedical subjects

L Kaufman

Publications and source records attributed to L Kaufman.

At least 307 records · Page 17Linked to original sources

Peripheral vascular disease: correlation of MR imaging and angiography.

The capability of magnetic resonance (MR) imaging for detecting aortic, iliac, and femoral stenoses and occlusions was evaluated. Multisection spin-echo studies at 0.35 tesla were obtained of the infrarenal aorta to the femoral bifurcation in 24 patients, all of whom had undergone intraarterial angiography within 14 days of imaging. Transaxial MR images were compared with the angiograms. Arterial stenoses and occlusions in these vessels detected by MR imaging correlated with angiographic findings in 91% of the instances. Protrusional atherosclerotic plaques and occlusions and stenoses in the aortoiliac region were demonstrated accurately on MR images; complications of previous vascular surgery, such as aneurysms at sites of previous anastomoses or endarterectomy, were also identified. Due to the limited spatial resolution, MR images failed to demonstrate some femoral stenoses. MR imaging may be used for evaluation of aortoiliac vascular disease and for follow-up study after surgical revascularization. However, the limited spatial resolution, noncomposite display of the aortoiliofemoral circulation, and lack of evaluation of peripheral runoff provided by current MR imaging techniques militate against its replacing angiography prior to vascular intervention.

Angiography↗

Inner volume MR imaging: technical concepts and their application.

Although cross-sectional magnetic resonance examination of the head and body is useful for screening large regions of tissue, subsectional regions of the head and body often need to be examined. Orthogonally directed, selectively irradiated planes with different flip angles produce a spatially limited signal region from which two- or three-dimensional volume images can be reconstructed. Images with limited fields-of-view can be acquired in reduced imaging time. We present a general description of this technique. These subsectional or "inner volume" images eliminate respiratory motion artifacts by excluding moving tissues from the imaged volume. A result of this technique is a high signal from rapid pulsatile blood flow, produced without cardiac gating the pulse sequence.

Blood Flow Velocity↗

Hydrogen MR imaging of the head at 0.35 T and 0.7 T: effects of magnetic field strength.

To determine whether hydrogen magnetic resonance imaging at 0.7 T provides added clinical value over imaging at 0.35 T, images of the heads of patients with various intracranial disorders were obtained at these field strengths. Measurements of tissue contrast (C), signal-to-noise (S/N) ratio, and T1 and T2 relaxation times were determined. For a given spin-echo sequence with equal imaging time, resolution, and data sampling window, the product C X S/N was somewhat lower for the lower field strength. Under conditions of imaging with equal chemical shift artifact, C X S/N at 0.35 T was equal to or greater than that measured at 0.7 T. With an increase in field strength, T1 of pathologic areas and surrounding normal tissues increased, resulting in a corresponding loss of absolute signal level and decrease in contrast. Lesions were equally well seen at both 0.35 T and 0.7 T. The increased T1 and decreased C X S/N for higher magnetic fields--when measured with a fixed imaging time, resolution, chemical shift, and sequence--suggest that such field strengths may not improve tissue contrast, diagnostic ability, or clinical throughput when compared with lower field strength systems.

Brain↗

MR imaging of the aorta with three-dimensional vessel reconstruction: validation by angiography.

Longitudinal vascular structures are difficult to observe on the standard abdominal transaxial magnetic resonance (MR) image sections. To display the information in a three-dimensional reconstruction, an algorithm was written to identify blood flow in a series of transaxial MR sections and was applied to reconstructing images of the aorta and iliac arteries in 12 patients with aortic aneurysm, dissection, or aortoiliac atherosclerosis. Results were validated by angiography. In all patients, the outline of the flow channel in the reconstructed image followed closely the outline of the lumen on angiograms. In aortic dissection, the MR images showed the two lumens more completely than did the angiograms, and in atherosclerosis, sites of vascular stenosis were correctly identified on MR images. The technique is valuable in providing anatomic information as well as functional information on cross-sectional areas and relative flow velocities.

Aortic Dissection↗

MR imaging of blood vessels using three-dimensional reconstruction: methodology.

Multisection, dual-echo magnetic resonance (MR) transaxial images of blood vessels contain both anatomic and qualitative information about flow. Even so, the images are produced as a series of two-dimensional tomographic sections from which full visualization of connected structures is difficult. A computer algorithm was developed that automatically detects flowing blood based on pixel intensity and calculated T2 and provides reconstructed views of vessels while analyzing and displaying flow characteristics. Images of abdominal vessels, aortic aneurysms, and the heart were encoded by flow and color to demonstrate depth. In addition, these data were reconstructed to derive a more accurate assessment of patency. With this technique, transaxial images can be used to analyze flow patterns, determine patent areas, and visualize all levels of vessels in a single image.

Blood Flow Velocity↗

Histamine threshold and nasal hyperreactivity in non specific allergic rhinopathy.

The authors studied the histamine threshold (endpoint concentration for a 100% pressure gradient increase at a flow of 0.25 liter/second) in a group of 29 patients suffering from non specific allergic rhinopathy and a control group of 15 normal subjects. The result of the nasal challenge was measured with two different methods of rhinomanometry: the passive anterior rhinomanometry (P.A.R.) and the active anterior rhinomanometry (A.A.R.). There existed a slightly significant difference (P less than or equal to 0.05) in histamine threshold between the patient and the control group. The 21 in duplo performed histamine challenges showed the very good reproducebility of the method. Finally, the A.A.R. method turned out to be slightly more sensitive than the P.A.R.-method.

Aerosols↗

Signal to noise in derived NMR images.

The NMR image is dependent on multiple tissue parameters: hydrogen density, relaxation times T1 and T2, and flow. From the acquired intensity images, T1, T2, and hydrogen images may be produced. The signal/noise of these derived images is critically dependent on the choice of acquisition parameters. Using the calculated T1, T2, and hydrogen images, intensity images may be calculated at arbitrary values of TE and TR, some of which (for example, short TE or TR) may be physically unacquirable.

Brain↗

Somatotopic organization of the human somatosensory cortex revealed by neuromagnetic measurements.

The primary projection areas in the human somatosensory cortex activated by electrical stimulation of the digits of the hand and the ankle were localized by measuring the magnetic field outside the head contralateral to the side of stimulation. Most of the spatial variation in the amplitude of the field component normal to the scalp could be accounted for by representing each source as a single current dipole in a spherical conducting medium with solely concentric variations in electrical conductivity, although the fit of this model to the data showed some statistically significant deviations. Based on the best-fitting parameter values of the model, we found that the projection areas of the thumb, the index finger, the little finger and the ankle were located at successively more medial positions along the primary somatosensory cortex, at an average depth of 2.2 cm from the scalp surface.

Brain Mapping↗

Evaluation of commercial reagents to identify the exoantigens of Blastomyces dermatitidis, Coccidioides immitis, and Histoplasma species cultures.

Commercially available individual serologic reagents (Nolan/Scott Biological Laboratories, Inc.) and an "exoantigen identification system" (a kit supplied by Immuno-Mycologics, Inc.) were evaluated at two laboratories for their possible application in the microimmunodiffusion test to identify Blastomyces dermatitidis, Coccidioides immitis, and Histoplasma species. Both laboratories accurately identified all the cultures, and comparison of the results obtained with the commercial products and those established with the conventional methods performed by a third control laboratory demonstrated full agreement. The use of these two commercial products is recommended for the immunologic identification of cultures suspected of being B. dermatitidis, C. immitis, and Histoplasma species. It was observed, however, that the exoantigen reactions for four B. dermatitidis and two C. immitis isolates were much sharper and more readable with the individual reagents than the reactions observed with the kit.

Antigens, Fungal↗

Rapid and reliable method for production of a specific Paracoccidioides brasiliensis immunodiffusion test antigen.

Previously published methods to produce Paracoccidioides brasiliensis antigens for serological tests have yielded antigens of inconsistent quality and have involved the use of special semisynthetic media and growth periods of 1 to 3 months to yield suitable reagents. A simple procedure that uses commercially available potato glucose agar and either SABHI broth (Difco Laboratories) or Trypticase soy broth (BBL Microbiology Systems) inoculated with the mycelial form of P. brasiliensis consistently yielded high-titer antigens in 2 weeks or less. This new method permits the almost exclusive production of an antigen identical to the specific E antigen described by Yarzabal (Yarzabal et al., Sabouradia 14:275-280, 1976) and the apparently equivalent specific antigen 1 described by Restrepo and Moncada (A. Restrepo and L. H. Moncada, Appl. Microbiol. 28:138-144, 1974). In the immunodiffusion test, the rapidly produced antigen demonstrated a sensitivity of 90% by detecting antibody in sera from 103 of 114 proven cases of paracoccidioidomycosis. The specificity of this antigen was 100% because none of 139 sera from patients with heterologous mycotic diseases demonstrated diagnostic precipitins against the P. brasiliensis antigen. In the complement fixation tests, the rapidly produced antigen was not as suitable as the one prepared by the method of Restrepo-Moreno and Schneidau (A. Restrepo-Moreno and J. D. Schneidau, Jr., J. Bacteriol. 93:1741-1748, 1967).

Animals↗

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↗