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R R Edelman

Publications and source records attributed to R R Edelman.

At least 73 records · Page 4Linked to original sources

EPISTAR MRI: multislice mapping of cerebral blood flow.

A method is described for multislice EPISTAR that perfectly compensates magnetization transfer effects. Inflowing arterial spins are labeled with a 360 degrees adiabatic pulse. Two control tags are applied sequentially at the same location as the labeling pulse, each with a 180 degrees adiabatic pulse so the total RF irradiation, frequency shift, and bandwidth of the labeling and control pulses are identical. Therefore, magnetization transfer effects are the same as for the labeling pulse and cancel with image subtraction for all slices. The method also eliminates tagging of venous spins and concern about asymmetric magnetization transfer effects.

Adult↗

Oxygen enhanced MR ventilation imaging of the lung.

The current work is a continuation of a new MRI technique that was proposed for the non-invasive assessment of regional lung ventilation using inhaled molecular oxygen as a T1 contrast agent. Several improvements of this technique are described in this work. The signal-to-noise ratio in the ventilation-scan images was optimized using a centrically reordered single-shot RARE sequence with a short effective echo time and short inter-echo spacing. The contrast-to-noise ratio was improved using an optimized inversion delay time. The optimized MR-ventilation-scan was successfully performed in healthy volunteers and in an animal model with airway obstruction. The experimental results demonstrate the feasibility and clinical potential of the MR ventilation imaging technique for assessment of regional pulmonary function.

Airway Obstruction↗

AUTO-SMASH: a self-calibrating technique for SMASH imaging. SiMultaneous Acquisition of Spatial Harmonics.

Recently a new fast magnetic resonance imaging strategy, SMASH, has been described, which is based on partially parallel imaging with radiofrequency coil arrays. In this paper, an internal sensitivity calibration technique for the SMASH imaging method using self-calibration signals is described. Coil sensitivity information required for SMASH imaging is obtained during the actual scan using correlations between undersampled SMASH signal data and additionally sampled calibration signals with appropriate offsets in k-space. The advantages of this sensitivity reference method are that no extra coil array sensitivity maps have to be acquired and that it provides coil sensitivity information in areas of highly non-uniform spin-density. This auto-calibrating approach can be easily implemented with only a small sacrifice of the overall time savings afforded by SMASH imaging. The results obtained from phantom imaging experiments and from cardiac studies in nine volunteers indicate that the self-calibrating approach is an effective method to increase the potential and the flexibility of rapid imaging with SMASH.

Adult↗

[Diffusion-weighted imaging in acute stroke].

Magnetic resonance imaging represents today the most important tool in neuroradiology for both clinical practice and research. MRI allows imaging of the human body in 2 or 3 dimensions with variable tissue contrast. The natural diffusion of tissue protons can now be used as a supplementary contrast mechanism. Different MRI techniques can be used to obtain clinically useful diffusion-weighted images. These techniques all require the use of strong gradient pulses in order to obtain the diffusion contrast. In the current article, the most important physical principles of diffusion measurement are presented. After a short introduction into the basic physical principles, we will present the prerequisites and limitations of clinically relevant applications today. Finally a few select examples of clinical use of these techniques in the acute diagnosis of stroke will be presented.

Acute Disease↗

Can the IVIM model be used for renal perfusion imaging?

OBJECTIVE: Renal perfusion imaging may provide information about the hemodynamic significance of a renal artery stenosis and could improve noninvasive characterization when combined with angiography. It was proposed previously that diffusion sequences could provide useful perfusion indices based on the intravoxel incoherent motion (IVIM) model. Owing to motion artifacts, diffusion imaging has been restricted to relatively immobile organs like the brain. With the availability of single-shot echo-planar imaging (EPI) our purpose was to evaluate the IVIM model in renal perfusion. METHODS AND MATERIAL: Eight volunteers underwent diffusion-sensitive magnetic resonance (MR) imaging of the kidneys using a spin echo (SE) EPI sequence. The diffusion coefficients determined by a linear regression analysis and fits to the IVIM function were calculated. RESULTS AND CONCLUSION: Our preliminary experience does not support the possibility of obtaining perfusion information using the IVIM model in the kidneys.

Artifacts↗

Coronary MR angiography.

Coronary MR angiography is a new noninvasive diagnostic method in rapid evolution. It has the potential to combine structural information with functional assessment of coronary blood flow. Advances in technology will undoubtedly lead to enhanced resolution, improved accuracy, and shorter scan times. It is certain that coronary MR angiography will be a prominent diagnostic clinical tool in the years to come.

Coronary Angiography↗

[First clinical results of ultrafast, contrast-enhanced 2-phase 3D-angiography of the abdomen].

PURPOSE: To assess the utility of breath-hold abdominal ultrafast three-dimensional (3D) gadolinium-enhanced dual-phase magnetic resonance angiography (MRA). MATERIAL AND METHODS: 125 patients with various abdominal pathologies were imaged using a breath-hold ultrafast gadolinium-enhanced dual-phase 3D-MRA technique. RESULTS: 119 (95%) of 125 MRA's were of good or excellent quality. The sensitivity in the detection of renal artery stenoses as well as stenoses of the celiac trunk and the superior mesenteric artery was 100%. Accessory renal arteries (n = 9) and replaced hepatic arteries (n = 4) were reliably detected by MRA. In 24 (71%) of 34 cases MR-angiographic delineation of the spleno-portal system and hepatic veins was superior compared to conventional angiography. CONCLUSION: Breath-hold gadolinium-enhanced dual-phase 3D-MRA has the potential to replace conventional angiography in the abdomen.

Abdomen↗

Fetal fast MR imaging: reproducibility, technical quality, and conspicuity of anatomy.

PURPOSE: To evaluate the normal appearance of fetal anatomy, the conspicuity of fetal organs, the reproducibility of images, and the limitations to image quality with the use of half-Fourier, single-shot rapid acquisition with relaxation enhancement (RARE) magnetic resonance (MR) imaging. MATERIALS AND METHODS: Fifty-four fetuses of 49 pregnancies underwent MR imaging with the half-Fourier, single-shot RARE technique. Two reviewers attempted to identify 47 organs and anatomic regions in each fetus. Organ or region conspicuity, image quality, and the limitations of image quality were graded. RESULTS: Fetal anatomy was well depicted in fetuses over 20 weeks in gestational age. Fetal imaging was limited by gestational age of 20 weeks or less usually owing to the small size of the organ or region being evaluated and, less frequently, by motion. CONCLUSION: Half-Fourier, single-shot RARE MR imaging provided a detailed and reproducible evaluation of normal fetal anatomy, which can be used as a standard of reference in MR imaging of fetal anomalies.

Artifacts↗

Coronary arteries: breath-hold, gadolinium-enhanced, three-dimensional MR angiography.

The feasibility of three-dimensional (3D), single breath-hold, gadolinium-enhanced magnetic resonance (MR) coronary angiography was investigated. A 3D spoiled gradient-echo imaging technique was used to image the passage of intravenously injected paramagnetic contrast agent through the coronary vasculature in four healthy subjects. Image contrast depended solely on the injected contrast agent. 3D acquisition allowed retrospective reformation and display with maximum intensity projection and rendering algorithms.

Adult↗

Diaphragmatic and cardiac motion during suspended breathing: preliminary experience and implications for breath-hold MR imaging.

PURPOSE: To investigate and quantify motion of the diaphragm and heart during suspended breathing at end inspiration and end expiration. MATERIALS AND METHODS: In 10 healthy adult volunteers, line scanning was performed to monitor the position of the diaphragm during a breath hold at end inspiration and end expiration, with a spatial and temporal resolution of 0.25 mm and 200 msec, respectively. Electrocardiographically gated, turbo fast low-angle shot (FLASH) magnetic resonance (MR) imaging was performed to monitor movement of the diaphragm and heart. RESULTS: During a breath hold, the diaphragm moved upward. At end expiration, the velocity of the diaphragm during suspended breathing was constant (mean, 0.15 mm/sec). At end inspiration, motion of the diaphragm during suspended breathing was more complex (range, 0.1-7.9 mm/sec). During a 20-second breath hold, mean displacement of the diaphragm was 25% of that during normal breathing. FLASH MR imaging revealed variations in the position of the heart during a breath hold. During suspended respiration, the heart did not return to the same position on consecutive heartbeats and, consequently, the margins of the heart typically moved inward. CONCLUSION: Breath holding does not eliminate motion of the diaphragm. Changes in the motion of the diaphragm and transthoracic pressure during a breath hold result in complex movement of the heart and may cause blurring during breath-hold MR imaging.

Adult↗

Line scan diffusion imaging: characterization in healthy subjects and stroke patients.

OBJECTIVE: Our objective was to evaluate a new scanning method, MR line scan diffusion imaging, and assess the apparent diffusion coefficient in the brains of healthy subjects and stroke patients. SUBJECTS AND METHODS: Line scan diffusion imaging without cardiac gating or head restraints was implemented on low- (0.5 T) and medium- (1.5 T) field-strength scanners with conventional hardware. Diffusion-weighted images were obtained in six healthy subjects and eight stroke patients. Unidirectional diffusion encoding was used for fast localization of stroke lesions. For further characterization, orthogonal diffusion encoding was applied, and the trace of the apparent diffusion coefficient was calculated. Single-shot diffusion-weighted echoplanar imaging served as the reference standard. For healthy subjects, imaging was repeated four times on each scanner. Mean and relative precision of the apparent diffusion coefficient trace values were calculated for each pixel. In stroke lesions and adjacent normal tissue, apparent diffusion coefficient trace values were determined. RESULTS: In the 108 scans obtained, line scan diffusion imaging proved to be robust, virtually free of artifact (independent of slice location and orientation), reproducible, and rapid for localization of a stroke. Scan time for 14 slices at 7-mm thickness was 8 min at 0.5 T and 7 min at 1.5 T. Image qualities with line scan diffusion imaging and single-shot diffusion-weighted echoplanar imaging were comparable. At 1.5 T, precision was essentially the same for line scan diffusion imaging (4.3%) and echoplanar imaging (4.7%). With line scan diffusion imaging at 0.5 T and 1.5 T, normal paraventricular apparent diffusion coefficient trace values averaged 0.71 microm2/msec, and with echoplanar imaging these values averaged 0.69 microm2/msec. In acute lesions apparent diffusion coefficient trace values were low, and in chronic lesions these values were high. CONCLUSION: Line scan diffusion imaging on low- and medium-field-strength MR scanners equipped with conventional hardware was reliable and practical for measuring brain apparent diffusion values, which can be applied to the early diagnosis, and hence timely management, of stroke.

Adult↗

Turbo spin-echo diffusion-weighted MR of ischemic stroke.

PURPOSE: Our objective was to determine whether a multisection technique, diffusion-weighted half-Fourier single-shot turbo spin-echo (HASTE) imaging, can compensate for the drawbacks common to other diffusion-weighted techniques; specifically, the need for echo-planar technology and the presence of susceptibility artifacts in areas close to the skull base. METHODS: Forty subjects who were referred to the stroke service with signs of acute (less than 24 hour) neurologic dysfunction were included in this prospective study. MR imaging of the brain was performed with diffusion-weighted echo-planar and diffusion-weighted HASTE sequences. The images obtained with both sequences were analyzed for the presence of hyperintensities corresponding to ischemic lesions as well as for the presence of image artifacts and distortions. RESULTS: Diffusion-weighted HASTE images showed areas of hyperintensity corresponding to the infarcts present on diffusion-weighted echo-planar imaging studies without distortion or susceptibility artifacts in all the patients who had a stroke. Twelve patients had no acute ischemic lesions; of these, five had other findings, six had normal findings, and in one patient, a hyperintensity seen on diffusion-weighted echo-planar images proved to be an artifact on diffusion-weighted HASTE images. CONCLUSIONS: Diffusion-weighted HASTE is equal to diffusion-weighted echo-planar imaging in the detection of early ischemia. Because of the absence of significant image distortions and other artifacts, diffusion-weighted HASTE permits fast multiplanar imaging in artifact-prone regions, such as the posterior fossa and the inferior frontal and temporal lobes. Diffusion imaging can be performed on conventional systems with strengths of 1.5 T that do not have echo-planar imaging capabilities.

Acute Disease↗

Prefrontal cortex fMRI signal changes are correlated with working memory load.

We investigated whether a nonspatial working memory (WM) task would activate dorsolateral prefrontal cortex (DLPFC) and whether activation would be correlated with WM load. Using functional magnetic resonance imaging we measured regional brain signal changes in 12 normal subjects performing a continuous performance, choice reaction time task that requires WM. A high WM load condition was compared with a non-WM choice reaction time control condition (WM effect) and a low WM load condition (load effect). Significant changes in signal intensity occurred in the DLPFC, frontal motor regions and the intraparietal sulcus (IPS) in both comparisons. These findings support the role of DLPFC and IPS in WM and suggest that signal changes in DLPFC correlate with WM load.

Adult↗

Enlargement of human cerebral ischemic lesion volumes measured by diffusion-weighted magnetic resonance imaging.

We aimed to determine the frequency and time course of the enlargement of ischemic cerebral lesions following human stroke and to study the effect of the state of perfusion on lesion enlargement. Acute lesion volumes were measured on diffusion-weighted magnetic resonance images and compared with lesion volumes measured on T2-weighted images at 7 days or later. Forty-four measurements were performed between 2 and 53 hours after stroke onset in 28 patients. Thirteen patients also had magnetic resonance perfusion imaging performed. In 12 (43%) of 28 patients the initial lesion volume increased by 20% or more. The number of studies showing enlargement of the ischemic lesion volume ranged from 12 (43%) of 28 at or after 2 hours to 10 (38%) of 26 at or after 6 hours, 5 (33%) of 15 at or after 24 hours, and 2 (33%) of 6 at or after 48 hours. In 7 of the 10 patients in whom the hypoperfusion volume acutely exceeded the volume of the abnormality on diffusion-weighted images, lesion volume increased by 20% or more. This study provided evidence that substantial enlargement of human cerebral ischemic lesion volumes can occur beyond the first 6, 12, or 24 hours after onset. A mismatch acutely between the region of hypoperfusion (larger) and the region of diffusion abnormality (smaller) may be predictive of ischemic lesion enlargement.

Adult↗

Ischemic lesion volumes in acute stroke by diffusion-weighted magnetic resonance imaging correlate with clinical outcome.

Diffusion-weighted magnetic resonance imaging detects ischemic injury within minutes after onset, and has been used to demonstrate drug efficacy in animal models of stroke. In 50 patients diagnosed with acute ischemic stroke (<24-hour duration) within the middle cerebral artery territory, lesion volume was measured by diffusion-weighted imaging. Thirty-four patients also had volumes measured by T2-weighted imaging chronically (median time, 7.5 weeks; mean, 15.9 weeks). Clinical severity was measured by the National Institutes of Health Stroke Scale Score and the Barthel index. Acute lesion volumes correlated with the acute stroke scale score (r = 0.56), the chronic stroke scale score (r = 0.63), and chronic lesion volumes (r = 0.84). Chronic volumes correlated with the chronic stroke scale score (r = 0.86) and the Barthel index (r = -0.60). When only cortically based lesions were considered, the correlations relating acute lesion volume measured by diffusion-weighted imaging (r = 0.61) and chronic lesion volume measured by T2-weighted imaging (r = 0.90) to the chronic stroke scale score were higher. These results provide evidence that lesion volumes determined by diffusion-weighted imaging acutely may be predictive of clinical severity and outcome, and may support a role for diffusion-weighted imaging in the assessment of acute stroke therapies in clinical trials.

Adult↗

Prospective adaptive navigator correction for breath-hold MR coronary angiography.

Current MR coronary angiography (MRCA) methods use breath-holding to minimize respiratory motion. A major limitation to this technique is misregistration between imaging slices due to breath-hold variability. Prospective adaptive correction of image location using real-time navigator measurement of diaphragm position is a potential method for improving slice registration in breath-hold MRCA. Ten subjects underwent MRCA using an ECG-gated, fat-suppressed, segmented k-space, gradient-echo sequence. Transverse and coronal images were acquired using standard breath-holding with and without prospective navigator correction. Breath-hold MRCA with prospective navigator correction resulted in a 47% reduction in craniocaudal slice registration error compared to standard breath-holding (0.9 +/- 0.2 mm versus 1.7 +/- 0.4 mm, P = 0.04). Prospective adaptive navigator correction of image location significantly improves slice registration for breath-hold MRCA and is a promising motion correction technique for cardiac MR.

Adult↗