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N Wilke

Publications and source records attributed to N Wilke.

40 records · Page 3Linked to original sources

Regional myocardial blood volume and flow: first-pass MR imaging with polylysine-Gd-DTPA.

The authors investigated the utility of an intravascular magnetic resonance (MR) contrast agent, poly-L-lysine-gadolinium diethylenetriaminepentaacetic acid (DTPA), for differentiating acutely ischemic from normally perfused myocardium with first-pass MR imaging. Hypoperfused regions, identified with microspheres, on the first-pass images displayed significantly decreased signal intensities compared with normally perfused myocardium (P < .0007). Estimates of regional myocardial blood content, obtained by measuring the ratio of areas under the signal intensity-versus-time curves in tissue regions and the left ventricular chamber, averaged 0.12 mL/g +/- 0.04 (n = 35), compared with a value of 0.11 mL/g +/- 0.05 measured with radiolabeled albumin in the same tissue regions. To obtain MR estimates of regional myocardial blood flow, in situ calibration curves were used to transform first-pass intensity-time curves into content-time curves for analysis with a multiple-pathway, axially distributed model. Flow estimates, obtained by automated parameter optimization, averaged 1.2 mL/min/g +/- 0.5 (n = 29), compared with 1.3 mL/min/g +/- 0.3 obtained with tracer microspheres in the same tissue specimens at the same time. The results represent a combination of T1-weighted first-pass imaging, intravascular relaxation agents, and a spatially distributed perfusion model to obtain absolute regional myocardial blood flow and volume.

Animals↗

Use of an intravascular T1 contrast agent to improve MR cine myocardial-blood pool definition in man.

The feasibility of improving myocardial/blood pool contrast in MR cine images through use of an intravascular contrast agent (Ferumoxtran, Advanced Magnetics, Inc., Cambridge, MA) was tested in four subjects. The contrast-to-noise ratio (CNR) demonstrated a trend toward improvement in the short axis and improved significantly in the long axis cine by an average of 128% (P < .05). Image intensity gradients at the myocardial/blood pool interface increased significantly in both the short and long axis (P < .01). It is expected that larger image intensity gradients at the endocardial border should improve the capabilities of automated segmentation algorithms, reducing the uncertainty and need for manual editing.

Algorithms↗

Ultrasmall superparamagnetic iron oxide to enhance MRA of the renal and coronary arteries: studies in human patients.

OBJECTIVE: Our goal was to determine the feasibility of using an intravascular MR contrast agent to improve 3D MRA. MATERIALS AND METHODS: Three-dimensional TOF MRA was performed in nine patients both prior to and following the administration of an ultrasmall particle superparamagnetic iron oxide contrast agent (AMI 227). The lengths of both renal arteries were measured from the maximum intensity projection (MIP) images as well as the individual partitions. Seven of these patients also were studied by a 3D coronary artery MRA sequence. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements of the right coronary artery were determined both prior to and following the administration of AMI 227. Statistical analysis of both renal artery lengths and right coronary SNR and CNR was performed using a one tailed paired t test comparing pre- and postcontrast images. RESULTS: The renal artery lengths significantly increased (right and artery: 30%, p = 0.001; left renal artery: 25%, p < 0.008) when measured from the individual axial slice partitions. No significant increase in length was observed on the MIP images following contrast. In the right coronary artery, the SNR increased by an average of 80% (p = 0.008) and CNR increased by an average of 109% (p = 0.007). Increased background signal and superimposed venous structures reduced the measurable lengths of the renal arteries from the MIP images. CONCLUSION: These studies support the hypothesis that 3D MRA in the body will benefit from the use of intravascular contrast agents. Nevertheless, conventional MIP processing is unable to reveal the full advantage of the contrast improvement.

Contrast Media↗

Magnetic resonance first-pass perfusion imaging: overview and perspectives.

The data from clinical studies with quantitative MR first-pass perfusion imaging suggests that this technique outperforms SPECT--widely available clinical imaging tool--in sensitivity and specificity. Moreover, MRFP imaging may be combined with the assessment of global and segmental function of the heart and regional wall thickening, and in addition, performed with pharmacological stress agents. The inter- and intra-observer reproducibility of quantitative MRFP is comparable with clinically used nuclear medicine techniques. MRFP measurements can discern collateral myocardium and are able to identify small changes in myocardial blood flow and myocardial perfusion reserve (the ratio of stress blood flow over resting). MRFP imaging has been mainly used in context of coronary artery disease but many other exciting areas in clinical cardiology are awaiting of new insights that can be accomplished with this technique. Trials are needed to obtain the approval of the contrast agent (Gd-DTPA) and perfusion sequences by the Food and Drug Administration and to establish reimbursement procedures with the third-party insurance companies and health maintenance organizations.

Coronary Disease↗