Biomedical subjects

M D Rifkin

Publications and source records attributed to M D Rifkin.

158 records · Page 9Linked to original sources

PubMedDate not supplied

Femoral head avascular necrosis in sickle cell anemia: MR characteristics.

Since considerable expansion of hematopoietic marrow occurs in patients with sickle cell anemia (SCA), magnetic resonance images of 20 hips in 10 patients with known homozygous SCA were reviewed to determine a) if low signal hematopoietic marrow extended into the femoral capital epiphysis and b) if the MR characteristics of avascular necrosis (AVN) differed depending on the type of epiphyseal marrow. Our results revealed variable epiphyseal marrow type; mixed (fatty and hematopoietic) marrow (42%), fatty marrow (32%), hematopoietic marrow (16%) and hemosiderotic marrow (10%). AVN occurred irrespective of the underlying marrow. Segmental areas of low signal intensity in variable shapes (ring, band, crescent or large homogeneous area) was the most consistent MR manifestation of AVN in SCA. A low signal intensity peripheral rim surrounding a central zone, isointense with epiphyseal marrow on T1 and T2 weighted images, was most frequently observed similar to that described in patients without hemoglobinopathy. The notable difference, however, was of segmental areas within the same femoral head that demonstrated variable central zone signal on T2 weighted images. Further, while an increase in hip joint fluid is commonly seen with both early and advanced AVN in patients without hemoglobinopathy; it was increased in only one hip in patients with SCA. The observed differences in MR characteristics may be due to different pathophysiology of AVN in patients with SCA.

Adolescent↗

PubMedDate not supplied

Multiple spin-echo MR imaging of the body: image contrast and motion-induced artifact.

For a given TR and TE, image quality changes when the number of spin echoes obtained is varied. To investigate the importance of this in clinical imaging, a total of 4 patients and 9 volunteers had MRI examinations of the abdomen (n = 7) and/or pelvis (n = 8) which included at least 2 sequences with identical TR (2000 or 2500 ms), TE (80 ms) and other parameters, but with a different series of refocusing pulses. Sequences included single-echo (S), asymmetric and symmetric double-echo (AD and SD) and quadruple-echo (Q) techniques. Image contrast and severity of motion-induced artifact was measured via blind examination by 3 independent MRI radiologists and calculation of signal-difference, signal-difference-to-noise ratios and intensity of motion-induced "ghost artifact." The order of decreasing signal differences was S, SD, AD and Q, and all of three liver lesions were better seen with S than with SD techniques. These observations are consistent with signal loss from cumulative inaccuracies from multiple 180 degrees RF pulses. The order of increasing intensity of ghost artifact was Q, SD, AD and S, consistent with the beneficial motion artifact-reducing effects of even-echo rephasing. Knowledge of these effects of multi-echo imaging allows one to make informed decisions about imaging protocols rather than to simply obtain multiple echoes "because they are free."

Abdomen↗

PubMedDate not supplied

Marrow infarction in sickle cell anemia: correlation with marrow type and distribution by MRI.

Ischemic necrosis of bone is believed to occur exclusively in areas of predominantly fatty marrow. Sickle cell disease is unusual in that marrow infarction occurs in areas of active hematopoiesis. MR images of long bone obtained in ten patients with sickle cell anemia (SCA) were analyzed to correlate the distribution and appearance of marrow infarction with the type of marrow. While the hematopoietic marrow predominated in metaphyseal and diaphyseal regions of femurs and tibias, the fatty or mixed marrow was the most common pattern in epiphyses. Infarcts occurred in fatty as well as hematopoietic marrow. Marrow infarcts were isointense or minimally hyperintense on T1 weighted images with the hematopoietic marrow and therefore difficult to detect. On T2 weighted images, the infarcts showed very high signal. T2 weighted images are essential for detection of marrow infarction. Soft tissue changes seen as low signal on T1 and high signal on T2, may be secondary to intramuscular injections of analgesics or muscle ischemia occurring during sickle crisis.

Adult↗

PubMedDate not supplied

Characterization of benign and malignant tissues of the thyroid gland. An ultrasonic approach using RF waveform analysis and pattern recognition.

A physical basis was developed for an accurate noninvasive technique to differentiate malignant thyroid tumors from benign lesions based upon a frequency-dependent attenuation model. The research effort utilized RF waveform analysis via a minicomputer based digital processing system. Data collection was performed using a standard clinical B-Mode diagnostic instrument with a transducer specially designed for imaging the thyroid gland. Differences between the frequency spectra of the RF waveforms for benign and malignant pathologies could be demonstrated in accordance with the proposed model.

Diagnosis, Differential↗

PubMedDate not supplied

Improvement in signal-to-noise ratio and reduction of chemical shift and motion-induced artifacts by summation of gradient and spin echo data acquisition.

Narrow bandwidth magnetic resonance (MR) imaging allows an increase of signal-to-noise ratio (SNR) but causes increased chemical shift and motion-induced artifacts. To obtain MR images with SNR approximately equal to that obtained with narrow bandwidth but with less chemical shift and motion-induced artifact, we introduced triple readout gradient reversal centered around the spin echo. As a result, signals from two gradient echoes and a single spin echo can be collected and summed. Phantom, knee, shoulder, and abdominal MR images were obtained using a 1.5 T GE Signa System at sampling rates ranging from 10 to 60 kHz. Since the bandwidth per pixel was tripled, chemical shift misregistration was reduced by the same factor. The summation image of two gradient echoes and one spin echo had an SNR comparable with that of a single spin echo acquired within the same total sampling interval. Data acquisition at a high sampling ratio also minimizes the dispersion of T2* weighting among three echoes. In addition, summation of the three resulting images decreases motion artifact by effective averaging.

Abdomen↗

PubMedDate not supplied

Hepatocellular tumors with high signal on T1-weighted MR images: chemical shift MR imaging and histologic correlation.

We reviewed conventional and chemical shift MR images and histologic findings of seven proven primary hepatic masses that had higher signal than liver on T1-weighted images to determine if this necessarily indicates fat and if the presence of fat indicates malignancy. These seven masses included five hepatocellular carcinomas (HCCs), one focal nodular hyperplasia (FNH), and one fatty dysplastic nodule. An eighth solitary high signal mass without histologic proof had evidence of abundant fat on each of two chemical shift MR images 25 months apart. Only one of the five HCCs had chemical shift or histologic evidence of fat, while the FNH and dysplastic nodule each had both chemical shift and histologic confirmation of fat. The dysplastic nodule became more dysplastic and grew significantly within 14 months, but remained benign. The unproven fatty lesion decreased in size over 25 months and is therefore presumably benign. Although no statistical inferences can be drawn from this small correlative study, we have shown that HCC may have higher signal intensity than liver on T1-weighted images, whether or not it contains fat. Chemical shift techniques can confirm the presence of intratumoral fat and thus indicate a mass of hepatocellular origin, but the mass may be benign or malignant.

Biopsy↗

PubMedDate not supplied