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O Zaro Weber

Publications and source records attributed to O Zaro Weber.

3 recordsLinked to original sources

Which time-to-peak threshold best identifies penumbral flow? A comparison of perfusion-weighted magnetic resonance imaging and positron emission tomography in acute ischemic stroke.

BACKGROUND AND PURPOSE: In acute ischemic stroke, the hypoperfused but viable tissue is the main therapeutic target. In clinical routine, time-to-peak (TTP) maps are frequently used to estimate the hemodynamic compromise and to calculate the mismatch volume. We evaluated the accuracy of TTP maps to identify penumbral flow by comparison with positron emission tomography (PET). METHODS: Magnetic resonance imaging (MRI) and PET were performed in 11 patients with acute ischemic stroke (median 8 hours after stroke onset, 60 minutes between MRI and PET imaging). The volumes defined by increasing TTP thresholds (relative TTP delay of >2, >4, >6, >8, and >10 seconds) were compared with the volume of hypoperfusion (<20 mL/100 g per min) assessed by 15O-water PET. In a volumetric analysis, each threshold's sensitivity, specificity, and predictive values were calculated. RESULTS: The median hypoperfusion volume was 34.5 cm3. Low TTP thresholds included large parts of the hypoperfused but also large parts of normoperfused tissue (median sensitivity/specificity: 93%/60% for TTP >2) and vice versa (50%/91% for TTP >10). TTP >4 seconds best identifies hypoperfusion (84%/77%). The positive predictive values increased with the size of hypoperfusion. CONCLUSIONS: This first comparison of quantitative PET-CBF with TTP maps in acute ischemic human stroke indicates that the TTP threshold is crucial to reliably identify the tissue at risk; TTP >4 seconds best identifies penumbral flow; and TTP maps overestimate the extent of true hemodynamic compromise depending on the size of ischemia. Only if methodological restrictions are kept in mind, relative TTP maps are suitable to estimate the mismatch volume.

Adult↗

Age related signal decrease in functional magnetic resonance imaging during motor stimulation in humans.

Right handed healthy volunteers underwent functional magnetic resonance imaging (fMRI) examinations on a 1.5 Tesla MRI-scanner (Gyroscan ACS NT; Philips, Best, NL). Blood oxygen level dependent (BOLD) images were obtained using a three dimensional multi-shot echo planar imaging sequence employing a shifted echo technique (Principles of echo shifting with a train of observations). Finger tapping of the right hand was used as a task for motor stimulation. A total of 86 subjects was included into statistical analysis. Absolute and relative signal differences and cluster sizes of activation for the left motor cortex were obtained. In addition, Z-score, pooled Z-score and cross correlation activation maps were calculated and matched with high resolution anatomic images. A significant decrease with age could be detected for absolute and relative signal intensity differences for the whole group and for the male subgroup. Correlation analysis for the female subgroup also bore negative albeit non-significant correlation coefficients. An age-related decline of BOLD-contrast can be assumed to explain signal decrease. This age-related effect should be considered in clinical fMRI applications.

Adult↗

[Artifacts in MR Imaging due to ventilation tubes].

UNLABELLED: Artifacts in MR Imaging due to ventilation tubes. PURPOSE: MR examinations may be necessary in patients under artificial ventilation. Possible imaging artifacts originating from ventilation tubing made from silicone are demonstrated. MATERIALS AND METHODS: In silicone carbohydrate residues are bound to silicon atoms. In silicone gels they give strong signals in MR imaging. MR signals from more solid silicone rubber are only possible if the carbohydrate residues in the molecular chain retain a sufficient mobility. To investigate whether silicone tubes give signals in MR images, different tubes for ventilation made from silicone and polyester were examined at 1.5 T (Gyroscan ACS NT, Powertrak 6000 gradients) with MR imaging and spectroscopy (MRS: PRESS, TE = 20 ms; relaxation time measurements: MIXED sequence; imaging: FFE [gradient echo] and TSE sequences). RESULTS: Using short TE (</= 4 ms), tubes and sockets made from silicone could be imaged with FFE and SE sequences. An SE sequence with a short TE = 4 ms provided a sufficient signal intensity to depict the tube clearly besides brain tissue of a volunteer. When foldover occurred, the signal of the tube was projected onto the brain tissue. MR spectra confirmed that the image signal originated from the carbohydrate residues of the silicone molecule chains, not from residual water in the tube wall material. T(2) determinations indicate a multiexponential relaxation including a large component with a short TE (</= 15 ms). Tubes made from a polyester elastomere did not show up in MR images. CONCLUSION: In MR images acquired with very short echo times silicone in ventilation tubes may produce significant artifacts.

Adult↗