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Martin R Prince

Publications and source records attributed to Martin R Prince.

At least 19 recordsLinked to original sources
PubMed2007

3D contrast-enhanced MR angiography.

Safe, fast, accurate contrast arteriography can be obtained utilizing gadolinium (Gd) and 3D MR data acquisition for diagnosing vascular diseases. Optimizing contrast enhanced MRA (CE MRA), however, requires understanding the complex interplay between Gd injection timing, the Fourier mapping of 3D MR data acquisition and a multitude of parameters determining resolution, anatomic coverage, and sensitivity to motion artifacts. It is critical to time the bolus peak to coincide with central k-space data acquisition, which dominates image contrast. Oversampling the center of k-space allows reconstruction of multiple 3D acquisitions in rapid succession to time-resolve the passage of the contrast bolus. Parallel imaging increases resolution, shortens scan time and compresses the center of k-space into a shorter period of time, thereby minimizing motion and timing artifacts. Absence of ionizing radiation allows MRA to be repeated and combined with additional sequences to more fully characterize anatomy, flow, and physiology. Utilizing stepping table technology and thigh compression, whole body MRA is possible with a single contrast injection. As MR technology continues to advance, CE MRA becomes better and simpler to perform, increasing its efficacy in the diagnosis and management of vascular diseases.

Artifacts↗
PubMed2006

The value of specific MRI features in the evaluation of suspected placental invasion.

OBJECTIVE: The objective of this study was to determine imaging features that may help predict the presence of placenta accreta, placenta increta or placenta percreta on prenatal MRI scanning. SUBJECTS AND METHODS: A retrospective review of the prenatal MR scans of 10 patients with a diagnosis of placenta accreta, placenta increta or placenta percreta made by pathologic and clinical reports and of 10 patients without placental invasion was performed. Two expert MRI readers were blinded to the patients' true diagnosis and were asked to score a total of 17 MRI features of the placenta and adjacent structures. The interrater reliability was assessed using kappa statistics. The features with a moderate kappa statistic or better (kappa > .40) were then compared with the true diagnosis for each observer. RESULTS: Seven of the scored features had an interobserver reliability of kappa > .40: placenta previa (kappa = .83); abnormal uterine bulging (kappa = .48); intraplacental hemorrhage (kappa = .51); heterogeneity of signal intensity on T2-weighted (T2W) imaging (kappa = .61); the presence of dark intraplacental bands on T2W imaging (kappa = .53); increased placental thickness (kappa = .69); and visualization of the myometrium beneath the placenta on T2W imaging (kappa = .44). Using Fisher's two-sided exact test, there was a statistically significant difference between the proportion of patients with placental invasion and those without placental invasion for three of the features: abnormal uterine bulging (Rater 1, P = .005; Rater 2, P = .011); heterogeneity of T2W imaging signal intensity (Rater 1, P = .006; Rater 2, P = .010); and presence of dark intraplacental bands on T2W imaging (Rater 1, P = .003; Rater 2, P = .033). CONCLUSIONS: MRI can be a useful adjunct to ultrasound in diagnosing placenta accreta prenatally. Three features that are seen on MRI in patients with placental invasion appear to be useful for diagnosis: uterine bulging; heterogeneous signal intensity within the placenta; and the presence of dark intraplacental bands on T2W imaging.

Case-Control Studies↗
PubMed2006

Superficial femoral artery occlusive disease severity correlates with MR cine phase-contrast flow measurements.

PURPOSE: To evaluate how cine phase-contrast (PC) flow data correlate with the severity of peripheral vascular disease (PVD). MATERIALS AND METHODS: Flow waveforms were obtained in 48 patients proximal and distal to superficial femoral artery (SFA) disease using the 2D cine PC technique with velocity encoding (venc) = 100 cm/second. Flow data were correlated with SFA disease severity and compared with data from nine healthy volunteers. RESULTS: Of 96 arterial segments in 48 patients, 26 were patent or only mildly stenotic, 35 had moderate-to-severe stenosis, and 35 were occluded. The flow patterns tended to become low-resistant below severe stenoses or occlusion. The mean peak flow velocity above/below SFA lesions was significantly higher in patients with severe disease (1.9 +/- 1.0, P = 0.01) or occlusion (2.0 +/- 1.0, P = 0.003) compared to normal volunteers (1.4 +/- 0.6). The delay in peak velocity below the lesions showed a significant positive correlation with lesion severity (r = 0.65, P < 0.001). The mean flow volume ratio above/below SFA lesions was greater in patients with occluded vessels compared to normal volunteers (3.9 and 2.3 respectively; P = 0.04). CONCLUSION: Cine PC flow waveform changes across atherosclerotic lesions correlate with disease severity. This may help determine which lesions are hemodynamically significant.

Aged↗
PubMed2006

Effects of gadopentetate dimeglumine and gadodiamide on serum calcium, magnesium, and creatinine measurements.

PURPOSE: To investigate the in vivo effects of gadodiamide (Gd-DTPA-BMA) and gadopentetate dimeglumine (Gd-DTPA) on the laboratory measurements of serum calcium, magnesium, and creatinine. MATERIALS AND METHODS: Medical records from 1993 to 2004 were reviewed to identify inpatients for whom laboratory data were available regarding serum calcium, creatinine, and magnesium levels before and within one day after gadodiamide and gadopentetate dimeglumine enhanced MRI. Patients who underwent both gadolinium (Gd)-enhanced MRI and iodinated contrast-enhanced examinations on separate days within a six-month period were also identified to compare changes in serum creatinine. RESULTS: Serum creatinine did not increase in 2788 cases following gadopentetate dimeglumine and gadodiamide injection. By comparison, serum creatinine increased from 1.21 to 1.28 mg/dL following iodinated contrast, and there were 20 cases (2.6%) of contrast-induced nephrotoxicity (P < 0.01). Gadopentetate dimeglumine did not affect serum calcium or magnesium measurements. Following 1157 gadodiamide-enhanced examinations, measured serum calcium spuriously dropped from 8.65 to 8.33 mg/dL (P < 0.0001) and 34 patients had spurious critical hypocalcemia (<6 mg/dL). Of 60 patients with high-dose gadodiamide injection and renal insufficiency, 36.7% (N = 22) had spurious critical hypocalcemia immediately post MRI. In 216 patients with renal insufficiency, the mean serum magnesium level increased slightly from 1.69 to 1.77 mEq/L following gadodiamide injection (P < 0.0001). CONCLUSION: Gd-based contrast agents are safe for MRI and MR angiography (MRA), and do not induce nephrotoxicity. However, gadodiamide interferes with serum calcium and magnesium measurements-particularly at high doses and/or with renal insufficiency.

Calcium↗
PubMed2006

Breath-hold 3D steady-state free precession coronary MRA compared with conventional X-ray coronary angiography.

PURPOSE: To evaluate the use of breath-hold three-dimensional (3D) steady-state free precession (SSFP) coronary magnetic resonance angiography (MRA) in patients with coronary artery disease (CAD) in comparison with conventional coronary x-ray angiography (XRA). MATERIALS AND METHODS: Twenty-eight patients with suspected CAD were examined with the use of a breath-hold 3D-SSFP-MRA sequence and conventional XRA. To assess the accuracy of MRA, two clinicians who were blinded to patient information independently reviewed the MRA and XRA data, which were presented in a randomized order. To identify discrepancies between MRA and XRA, and assess features of coronary lesions on MRA, two additional clinicians examined MRA and XRA data that were presented side by side, divided into proximal, mid, and distal segments, and compared them segment by segment. RESULTS: The sensitivity and specificity for diagnosing significant coronary stenoses (> 50% diameter narrowing) were 64% and 94%, respectively. At sites of coronary lesions identified on XRA, bright signals and enlarged vessel profiles, in addition to the characteristic narrow lumen, were frequently observed on MRA. CONCLUSION: Breath-hold SSFP coronary MRA has good specificity but inconclusive sensitivity in diagnosing significant coronary stenoses, and provides important image features for depicting coronary lesions.

Adult↗
PubMed2006

Automatic algorithm for correcting motion artifacts in time-resolved two-dimensional magnetic resonance angiography using convex projections.

Time-resolved contrast enhanced magnetic resonance angiography (MRA) may suffer from involuntary patient motion. It is noted that while MR signal change associated with motion is large in magnitude and has smooth phase variation in k-phase, signal change associated with vascular enhancement is small in magnitude and has rapid phase variation in k-space. Based upon this observation, a novel projection onto convex sets (POCS) algorithm is developed as an automatic iterative method to remove motion artifacts. The presented POCS algorithm consists of high-pass phase filtering and convex projections in both k-space and image space. Without input of detailed motion knowledge, motion effects are filtered out, while vasculature information is preserved. The proposed method can be effective for a large class of nonrigid motions, including through-plane motion. The algorithm is stable and converges quickly, usually within five iterations. A double-blind evaluation on a set of clinical MRA cases shows that a completely unsupervised version of the algorithm produces significantly better rank scores (P=0.038) when compared to angiograms produced manually by an experienced radiologist.

Algorithms↗
PubMed2006

Cardiac fat navigator-gated steady-state free precession 3D magnetic resonance angiography of coronary arteries.

Motion artifacts and the lack of accurate detection of cardiac motion present a major challenge for high-resolution cardiac MRI. Recently a multidimensional cardiac fat navigator was proposed to provide a fast and direct measurement of bulk cardiac motion. The objective of this study was to demonstrate the feasibility of employing the cardiac fat navigator in balanced steady-state free precession (SSFP) free-breathing 3D coronary MRA (CMRA). The cardiac fat navigator echo is optimized to provide both motion monitoring and epicardial fat suppression. Steady-state magnetization preparation, which is needed for SSFP CMRA, is optimized by comparing three preparation schemes: alpha/2, linear ramp with 20 RF pulses (20LR), and Kaiser ramp with six RF pulses (6KR). The present preliminary human study shows that the 6KR preparation provides better image quality than both the alpha/2 (P<0.0025) and the 20LR preparations (P<0.025) for free-breathing SSFP 3D CMRA (N=11).

Adipose Tissue↗
PubMed2006

Reduction of reconstruction time for time-resolved spiral 3D contrast-enhanced magnetic resonance angiography using parallel computing.

Time-resolved 3D MRI with high spatial and temporal resolution can be achieved using spiral sampling and sliding-window reconstruction. Image reconstruction is computationally intensive because of the need for data regridding, a large number of temporal phases, and multiple RF receiver coils. Inhomogeneity blurring correction for spiral sampling further increases the computational work load by an order of magnitude, hindering the clinical utility of spiral trajectories. In this work the reconstruction time is reduced by a factor of >40 compared to reconstruction using a single processor. This is achieved by using a cluster of 32 commercial off-the-shelf computers, commodity networking hardware, and readily available software. The reconstruction system is demonstrated for time-resolved spiral contrast-enhanced (CE) peripheral MR angiography (MRA), and a reduction of reconstruction time from 80 min to 1.8 min is achieved.

Algorithms↗
PubMed2006

Expanding role of MR angiography in clinical practice.

MRA has higher accuracy, less operator dependence, a larger field-of-view, three-dimensionality and superior contrast resolution than ultrasonography. Additionally, MRA offers a safer alternative to the patient than CTA as neither ionizing radiation nor iodinated contrast agents are used. Contrast-enhanced MRA with extra cellular contrast agents is fast and flow-independent, offers substantially higher spatial and temporal resolution compared to non-contrast techniques and has become the standard of practice. The highly accurate but static anatomical road-map thus generated can be supplemented with time-resolved MRA and blood flow measurement techniques for a more comprehensive assessment of systemic vascular disease. In the context of burgeoning technological advances with rapid translation into clinical MRA practice, this review explores the current position of MRA and the potential role for the new and exciting blood-pool contrast agents for diagnosing and characterizing vascular disease. Blood-pool agents offer the potential to take MRA to the next level by combining first-pass arterial phase imaging with steady state high-resolution images that exploit the persistent high intravascular enhancement generated by blood-pool agents and which is significantly greater than with extra cellular agents. Additional benefits derive from the ability to characterize plaque and to detect internal bleeding. These advantages place MRA in a prime position to comprehensively and non-invasively evaluate both vascular anatomy and function with anticipated further expansion into more and more clinical applications.

Contrast Media↗
PubMed2006

Peripheral MR angiography.

Peripheral MR Angiography is rapidly developing and becoming the standard method for evaluating peripheral vascular disease. MRA allows accurate and detailed assessment of peripheral vasculature without requiring arterial catheterization, nephrotoxic contrast, or ionizing radiation. Latest improvements in this area include time-resolved MR angiography, stepping table bolus chase 3D MR angiography, fluoro-triggering, sub-systolic thigh compression to eliminate venous contamination, and parallel imaging. This article reviews these advances, describes how to use them effectively and how to avoid common pitfalls.

Artifacts↗
PubMed2005

Diagnostic accuracy of time-resolved 2D projection MR angiography for symptomatic infrapopliteal arterial occlusive disease.

OBJECTIVE: Our objective was to evaluate the diagnostic accuracy of time-resolved 2D projection MR angiography in detecting calf and pedal artery occlusive disease. MATERIALS AND METHODS: Time-resolved MR angiography of calf and pedal arteries was performed on 59 symptomatic legs of 52 patients using the head coil and bolus injections of 6 mL of gadolinium contrast medium. Selective X-ray digital subtraction angiography was performed within 30 days after MR angiography. Calf and pedal arteries were divided into 10 segments. X-ray digital subtraction angiography and MR angiography images were retrospectively interpreted by three expert observers, who graded segments as having no significant stenosis, significant stenosis (> 50%), or occlusion. The accuracy of MR angiography interpretations was compared with the accuracy of consensus X-ray digital subtraction angiography interpretations as the standard of reference. Arterial segments with discrepant grading on X-ray digital subtraction angiography and MR angiography were reviewed again to determine the reasons for disagreement. RESULTS: Arterial phase MR angiography images free of venous contamination were obtained in every case. The agreement between MR angiography and X-ray digital subtraction angiography in depicting infrapopliteal arterial disease was fair to good (kappa = 0.44-0.92). Overall sensitivity and specificity were 83% and 87%, respectively, for detecting significant stenosis of calf and pedal arteries and 86% and 93%, respectively, for detecting occlusions. Accuracy was higher in the larger vessels-for example, calf (84%) compared with foot (71%). In 21% (22/105) of the segments graded differently on MR angiography than on X-ray digital subtraction angiography, it was believed that MR angiography was more likely to be correct than X-ray digital subtraction angiography because of visualization of late-filling arteries on MR angiography that did not opacify on X-ray digital subtraction angiography. CONCLUSION: Time-resolved 2D projection MR angiography accurately evaluates calf and pedal arteries without degradation from venous contamination.

Adult↗
PubMed2004

Soft tissue enhancement on time-resolved peripheral magnetic resonance angiography.

PURPOSE: To evaluate the incidence and locations of soft tissue enhancement on time-resolved two-dimensional projection magnetic resonance angiography (MRA) of the calf and foot. MATERIALS AND METHODS: Time-resolved two-dimensional projection MRA of the knee, calf, and foot, performed at 1.5 Tesla using the head coil, was retrospectively reviewed in 326 patients. Soft tissue enhancement of the foot was identified and graded by blinded review. Subsequently, patient medical records were reviewed to determine the presence or absence of diabetes, cellulitis, gangrene, and ulceration of the foot and presence of neuropathic joints. RESULTS: Enhancing spots were identified in 228 patients. For those feet without clinical abnormalities, diabetic patients had an average of 1.2 enhancing spots per foot, while nondiabetics had only 0.6 (P < 0.001). Higher-grade lesions were more prevalent in diabetics and in heavier patients. Of 64 patients with follow-up, 8 (13%) developed cellulitis (N = 4) or ulceration (N = 4) at the location of an enhancing spot, including 5 diabetic and 3 nondiabetic patients. CONCLUSION: Pedal soft tissue enhancement frequently occurs on time-resolved gadolinium (Gd):MRA of the feet. The etiology is uncertain, but the high frequency in diabetic patients and observation of progression to cellulitis/ulceration suggest this soft tissue enhancement may identify sites of subclinical pedal soft tissue injury.

Adult↗
PubMed2004

Three-dimensional MR angiography in imaging platinum alloy stents.

PURPOSE: To evaluate visualization inside platinum stents with three-dimensional contrast-enhanced magnetic resonance angiography (CE-MRA). MATERIALS AND METHODS: Breath-hold three-dimensional gadolinium (Gd) MRA was performed on 18 patients with 22 platinum stents in the renal (n = 18), celiac (n = 1), superior mesenteric (n = 1), and iliac (n = 2) arteries. Electronic calibers were used to measure the lumen diameter within the stent and just distal to the stent to calculate percent stenosis. MRA accuracy was determined from the difference between percent stenosis measured on MRA and digital subtracted angiography (DSA). The patients were imaged at flip angles of 45 degrees , 60 degrees , 75 degrees , 90 degrees , and 150 degrees . RESULTS: MRA demonstrated the stent lumen in all of the patients, with a mean difference between MRA and DSA of 21%. For stents oriented parallel to B0 (iliac arteries) the difference was only 10%, as compared to 22% for stents perpendicular to B0. The flip angle with the best agreement between MRA and DSA was 75 degrees (16%). CONCLUSION: The lumen of a platinum stent can be imaged with three-dimensional CE-MRA, although grading of restenosis has limited accuracy. The best results were obtained with a flip angle of 75 degrees and for stents in the iliac arteries parallel to B0.

Aged↗
PubMed2004

Multiprocessor scheduling implementation of the simultaneous multiple volume (SMV) navigator method.

The simultaneous multiple volume (SMV) approach in navigator-gated MRI allows the use of the whole motion range or the entire scan time for the reconstruction of final images by simultaneously acquiring different image volumes at different motion states. The motion tolerance range for each volume is kept small, thus SMV substantially increases the scan efficiency of navigator methods while maintaining the effectiveness of motion suppression. This article reports a general implementation of the SMV approach using a multiprocessor scheduling algorithm. Each motion state is regarded as a processor and each volume is regarded as a job. An efficient scheduling that completes all jobs in minimal time is maintained even when the motion pattern changes. Initial experiments demonstrated that SMV significantly increased the scan efficiency of navigator-gated MRI.

Algorithms↗
PubMed2004

High temporal and spatial resolution 4D MRA using spiral data sampling and sliding window reconstruction.

Contrast-enhanced magnetic resonance angiography (CE-MRA) requires high spatial resolution to demonstrate detailed vasculature and high temporal resolution to capture the contrast bolus. Sparse bright voxels in MRA permit substantial undersampling in MRI data acquisition, allowing simultaneous high temporal and spatial resolution. We developed a time-resolved 3D MRA technique using the efficient spiral sampling trajectory, and performed off-resonance corrections using inhomogeneity field maps. View sharing and sliding window reconstruction were utilized to generate high temporal resolution. High-resolution 3D angiograms were generated at 1-2 s per frame, with a 5-8 ml gadolinium dose, in patients with vascular disease.

Arteriosclerosis↗
PubMed2004

Renal MR angiography.

The high accuracy of renal MR angiography makes it well suited for diagnosing renal vascular disease. A comprehensive examination includes three-dimensional gadolinium MR angiography to assess lumenal anatomy and functional techniques to assess the hemodynamic significance of any stenosis identified. Postprocessing is critical to provide reformations, maximum intensity projections, and optional volume-rendered images to display arteries in an angiographic format for optimal demonstration of any vascular lesions. It is important to review source images to avoid missing pathologic findings. As MR imaging continues to develop, the renal MR angiography examination will likely expand to include extensive functional information about creatinine clearance, flow, and response to pharmacologic agents as well as spectroscopy, diffusion, perfusion, phase contrast, and other techniques.

Animals↗