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Biomedical subjects

R Venkatesan

Publications and source records attributed to R Venkatesan.

At least 37 records · Page 2Linked to original sources

An absolute measurement of brain water content using magnetic resonance imaging in two focal cerebral ischemic rat models.

Magnetic resonance imaging (MRI) was utilized to obtain absolute estimates of regional brain water content (W), and results were compared with those obtained with conventional wet/dry measurements. In total, 31 male Long-Evans rats were studied and divided into two groups based on the surgical procedures used to induce cerebral focal ischemia: suture (n = 18) and three-vessel ligation (TVL: n = 13) groups. Both relative spin density and T1 were extracted from the acquired MR images. After correcting for radiofrequency field inhomogeneities, T2* signal decay, and temperature effects, in vivo regional brain water content, in absolute terms, was obtained by normalizing the measured relative brain spin density of animals to that of a water phantom. A highly linear relationship between MR-estimated brain water content based on the normalized spin density and wet/dry measurements was obtained with slopes of 0.989 and 0.986 for the suture (r = 0.79) and TVL (r = 0.83) groups, respectively. Except for the normal subcortex of the TVL group (P < 0.02) and the normal hemisphere of the suture group (P < 0.003), no significant differences were observed between MR-estimated and wet/dry measurements of brain water content. In addition, a highly linear relationship between MR-measured R1 (= 1/T1) and 1/W of wet/dry measurements was obtained. However, slopes of the linear regression lines in the two groups were significantly different (P < 0.02), indicating that different R1 values were associated with the same water content depending on the model. These results show that an absolute measurement of in vivo regional brain water content can be obtained with MRI and potentially serves as a noninvasive means to monitor different therapeutic interventions for the management of brain edema subsequent to stroke and head trauma.

Animals↗

Noise in polymer gel measurements using MRI.

With the development of conformal radiotherapy, particularly intensity modulated radiation therapy (IMRT), there is a clear need for multidimensional dosimeters. A commercial polymerizing gel, BANG-2 gel (MGS Research, Inc., Guilford, CT), has recently been developed that shows potential as a multi-dimensional dosimeter. This study investigates and characterizes the noise and magnetic resonance (MR) artifacts from imaging BANG-2 gels. Seven cylindrical vials (4 cm diam, 20 cm length) were irradiated end on in a water bath and read using MRI (B0=1.5 T, TE=20 ms/100 ms, TR=3000 ms). The gel calibration compared the measured depth-dose distributions in water against the change in solvent-proton R2 relaxivity of the gel. A larger vial (13 cm diam, 14 cm length) was also irradiated to test the calibration accuracy in a vial of sufficient volume for dose distribution measurements. The calibration curve proved accurate to within 1.3% in determining the depth dose measured by the larger vial. An investigation of the voxel-to-voxel (IXIX 3 mm3) noise and sensitivity response curve showed that the voxel-to-voxel variation dominated the dose measurement uncertainty. The voxel-to-voxel standard deviation ranged from 0.2 Gy for the unirradiated gel to 0.7 Gy at 20 Gy. Slice-to-slice R2 magnitude deviations were also observed corresponding to 0.2 Gy. These variations limited the overall accuracy of the gel dose measurements and warrant an investigation of more accurate MR readout sequences.

Calibration↗

Effects of fluid management on edema volume and midline shift in a rat model of ischemic stroke.

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the effects of fluid management on brain water content (BW) and midline shift (MLS) after a focal cerebral ischemic insult. METHODS: A suture model was used to induce focal cerebral ischemia for 90 minutes (n=44). The rats were randomly assigned to 3 groups 2. 5 hours after reperfusion: dehydration (n=24), control (n=8), or hydration (n=12). BW was obtained with the wet-dry weight method 24 hours after middle cerebral artery (MCA) occlusion. In addition, MRI were obtained (n=31) 24 hours after the onset of ischemia so that the ratio of hemispheric volumes ipsilateral (IH) and contralateral (CH) to the infarct and the extent of MLS could be obtained. RESULTS: Across the range from moderate dehydration to intravascular volume expansion with isotonic saline, BW of the IH increased linearly as a function of change in body weight (r(2)=0.89), whereas few changes in relation to body weight were observed in CH, indicating a preferential effect of fluid management on the infarcted hemisphere. Furthermore, the hemispheric volume ratio (IH/CH) and MLS also increased in relation to changes in body weight. However, paradoxical increases in BW, IH/CH, and extent of MLS were observed in comparison with controls when severe dehydration was produced with high-dose mannitol. CONCLUSIONS: Changes in ischemic BW by fluid management correlated closely with changes in body weight except when high-dose mannitol was used. Mannitol, as a dehydrating agent, may be associated with bimodal effects, with a high dose aggravating ischemic BW.

Animals↗

Accuracy of T1 measurements at high temporal resolution: feasibility of dynamic measurement of blood T1 after contrast administration.

The purpose of this work was to optimize a technique to measure blood T1 dynamically after contrast agent administration with a high temporal resolution. This technique uses a 90 degrees prepared gradient-echo sequence and has a temporal resolution of one T1 measurement per cardiac cycle. The non-ideal excitation slice profiles on the estimation of T1 were evaluated by theoretical simulations and used to obtain corrected blood T1 values. The technique was validated on phantom and in vivo pig studies, which demonstrated significant improvement on the accuracy of the dynamic T1 measurement method after slice profile correction. This technique may find important applications in studying the dynamic blood T1 after injection of various contrast agents. J. Magn. Reson. Imaging 1999;10:576-581.

Animals↗

High-resolution, multiple gradient-echo functional MRI at 1.5 T.

A multiple gradient echo, high resolution imaging method is proposed to better visualize different sources of activation in functional magnetic resonance imaging (fMRI) experiments. Eight echoes are collected from 30 ms to 205 ms with an echo spacing of 25 ms. All echoes show significant activation, but each echo reveals its own pattern of activation. From this variability, it appears that large vessel contributions can be separated from small vessel contributions using a fuzzy cluster analysis across echo times. The results demonstrate the importance of a multiple gradient echo data acquisition approach in localizing various vascular contributions to brain activation in fMRI.

Adult↗

Evaluation of polymer gels and MRI as a 3-D dosimeter for intensity-modulated radiation therapy.

BANG gel (MGS Research, Inc., Guilford, CT) has been evaluated for measuring intensity-modulated radiation therapy (IMRT) dose distributions. Treatment plans with target doses of 1500 cGy were generated by the Peacock IMRT system (NOMOS Corp., Sewickley, PA) using test target volumes. The gels were enclosed in 13 cm outer diameter cylindrical glass vessels. Dose calibration was conducted using seven smaller (4 cm diameter) cylindrical glass vessels irradiated to 0-1800 cGy in 300 cGy increments. Three-dimensional maps of the proton relaxation rate R2 were obtained using a 1.5 T magnetic resonance imaging (MRI) system (Siemens Medical Systems, Erlangen, Germany) and correlated with dose. A Hahn spin echo sequence was used with TR = 3 s, TE = 20 and 100 ms, NEX = 1, using 1 x 1 x 3 mm3 voxels. The MRI measurements were repeated weekly to identify the gel-aging characteristics. Ionization chamber, thermoluminescent dosimetry (TLD), and film dosimetry measurements of the IMRT dose distributions were obtained to compare against the gel results. The other dosimeters were used in a phantom with the same external cross-section as the gel phantom. The irradiated R2 values of the large vessels did not precisely track the smaller vessels, so the ionization chamber measurements were used to normalize the gel dose distributions. The point-to-point standard deviation of the gel dose measurements was 7.0 cGy. When compared with the ionization chamber measurements averaged over the chamber volume, 1% agreement was obtained. Comparisons against radiographic film dose distribution measurements and the treatment planning dose distribution calculation were used to determine the spatial localization accuracy of the gel and MRI. Spatial localization was better than 2 mm, and the dose was accurately determined by the gel both within and outside the target. The TLD chips were placed throughout the phantom to determine gel measurement precision in high- and low-dose regions. A multidimensional dose comparison tool that simultaneously examines the dose-difference and distance-to-agreement was used to evaluate the gel in both low-and high-dose gradient regions. When 3% and 3 mm criteria were used for the comparisons, more than 90% of the TLD measurements agreed with the gel, with the worst of 309 TLD chip measurements disagreeing by 40% of the criteria. All four MRI measurement session gel-measured dose distributions were compared to evaluate the time behavior of the gel. The low-dose regions were evaluated by comparison with TLD measurements at selected points, while high-dose regions were evaluated by directly comparing measured dose distributions. Tests using the multidimensional comparison tool showed detectable degradation beyond one week postirradiation, but all low-dose measurements passed relative to the test criteria and the dose distributions showed few regions that failed.

Biophysical Phenomena↗

Increased-contrast, high-spatial-resolution, diffusion-weighted, spin-echo, echo-planar imaging.

An insertable head gradient coil with a maximum gradient amplitude of 45 mT/m and a rise time of 150 musec along all three major axes was used to collect high-spatial-resolution, single-shot, spin-echo, echo-planar, diffusion-weighted magnetic resonance images with b values ranging from 0 to 2,200 sec/mm2. Improvements in spatial resolution allowed better visualization of large white matter tracts and their relation to adjacent anatomic structures. Excellent contrast and anatomic detail were revealed for most structures in the brain when a sufficient number of acquisitions were collected.

Adult↗

Accurate determination of spin-density and T1 in the presence of RF-field inhomogeneities and flip-angle miscalibration.

A method is presented for the accurate extraction of relative spin-density (rho0) and spin-lattice relaxation time (T1) in the presence of RF-field inhomogeneities and flip-angle miscalibration. The method requires collecting images at several flip-angles with a three-dimensional, spoiled steady-state, gradient-echo imaging sequence. Results show that the predominant effect of an overestimated flip-angle is to shift the T1 estimate to a higher value, whereas reductions in the normalized RF-field from unity cause rho0 and T1 distributions to be skewed toward lower values. Phantom and in vivo results demonstrate that the proposed method overcomes both of these systematic errors. The method was shown to be valid for up to a 50% reduction in RF sensitivity. A self-consistency argument was used to validate the absence of systematic errors in the extracted rho0 and T1 values over a large number of voxels. This made it possible to obtain a very precise estimate of muscle T1 at 1.5 T, yielding a 95% confidence interval of (1077.7 +/- 3.5) ms.

Algorithms↗

Quantitative regional brain water measurement with magnetic resonance imaging in a focal ischemia model.

Therapeutic approaches to cerebral edema require an understanding of both the magnitude and location of changes in brain water content. It is desirable to have a sensitive, accurate means of measuring brain water noninvasively so that effective therapies for cerebral edema in stroke, head trauma, and other conditions can be investigated. In this work, a three-dimensional magnetic resonance imaging technique that is able to provide both spin density and T1 simultaneously is described. This method was used to quantitate regional changes in brain water content in a rat model of focal cerebral ischemia. Brain water contents estimated from both relative spin density and relative T1 measurements made in vivo were compared with ex vivo measurements of relative tissue water content based on the wet-dry technique. Correlation coefficients of 0.95 and 0.98 were obtained between the wet-dry measurements and magnetic resonance measurements of T1 and spin density, respectively. Notably, the slope of the relationship between T1 and tissue water content changed dramatically after the injection of a paramagnetic contrast agent while precontrast and postcontrast spin density measurements remained essentially invariant. In addition, a plot of absolute spin density (obtained by normalizing spin density from agar gelatin phantoms of different water contents to the spin density of a sample of 100% water) was linearly related to wet-dry measurements with a slope of 0.99 (R2 = 0.99).

Animals↗

Small vessels in the human brain: MR venography with deoxyhemoglobin as an intrinsic contrast agent.

To assess a magnetic resonance (MR) imaging method for depicting small veins in the brain, a three-dimensional, long echo time, gradient-echo sequence that depended on the paramagnetic property of deoxyhemoglobin was used. Veins with diameters smaller than a pixel were depicted. This MR imaging method is easy to implement and may prove helpful in the evaluation of venous diseases.

Brain↗

beta-Thalassaemia mutations and their linkage to beta-haplotypes in Tamil Nadu in southern India.

A study for screening of beta-thalassaemia mutations by the Amplification Refractory Mutation System (ARMS) and haplotyping by Polymerase Chain Reaction (PCR) was undertaken because there was a paucity of data in Tamil Nadu in Southern India and to initiate a comprehensive prenatal diagnosis programme. A total of 294 alleles were analysed to study the nature of the mutations, of which 146 were beta-thalassaemia alleles. Only four types of beta-thalassaemia mutations were recorded. Of these, 128 alleles were of the variant IVS-1 nt 5 (G-->C). Thirteen had the mutation codon 41/42 (del TCTT), four had the mutation codon 8/9 (insert G) and one had the 619 bp deletion at the 3' end of the gene. The most common mutation, IVS-1 nt 5 (G-->C), was strongly associated with a single haplotype although the association was not absolute. The population of Tamil Nadu in Southern India seems to be ideal for initiating a prenatal diagnosis programme based on direct detection of mutation by ARMS coupled with RFLP linkage analysis.

Alleles↗

The spectrum of beta-thalassaemia mutations on the Indian subcontinent: the basis for prenatal diagnosis.

The beta-thalassaemia mutations in 702 unrelated carriers originating from seven different regions of the Indian subcontinent have been characterized using allele specific priming of the polymerase chain reaction (PCR). It was possible to identify the mutations in 688 (98%) of the individuals studied. Eleven different mutations were identified, of which five common ones accounted for 93.6%; namely the ones at IVS-1 position 5 (G-C), codons 8/9 (+G), IVS-1 position 1 (G-T), codons 41/42 (-CTTT) and the 619 bp deletion at the 3' end of the gene. The mutations at IVS-2 position 1 (G-A) and codon 30 (G-C), previously undescribed in Asian Indians, were found in two and six individuals respectively. Some regional variation in the distribution of beta-thalassaemia alleles was noted. These findings should prove useful for the development of a first trimester prenatal diagnosis programme based on direct detection of mutations.

Alleles↗

Results of hemodialysis & hemoperfusion in the treatment of acute arsenic ingestion.

Hemodialysis and charcoal hemoperfusion have been used in the last few years for the treatment of acute toxin ingestion. We used these methods to treat a patient with a known ingestion of 1.3 grams of arsenic trioxide. We measured blood and urine levels of arsenic prior to and after dialytic therapy in addition to before and after conventional chelation therapy. The blood and urine levels showed no significant change with any therapy and clinically he lapsed into prolonged coma. In view of the lack of laboratory and clinical response, we feel that hemodialysis and hemoperfusion may not be indicated in acute massive ingestion. Supportive care to maintain blood pressure and urinary output may be all there is to offer. In recent years both hemodialysis and hemoperfusion have been introduced as treatment of accidental or deliberate drug or toxin ingestion. (1-4) There have been previous reports on the supposedly successful treatment of arsenic ingestion with hemodialysis. (5-6) We report our experience with a massive ingestion of arsenic trioxide. This patient received treatment with conventional chelating agents, standard hemodialysis, as well as hemoperfusion, without evidence of significant removal of arsenic or clinical benefit.

Adult↗

The monitoring of renal dysfunction in renal emphysema by dual radiopharmaceutical scintiscanning.

Followup renal scintiscans using two radiopharmaceuticals were performed in a patient with renal emphysema. This allowed us to more accurately determine whether the emphysematous pyelonephritis was responding to antibiotic therapy or whether surgical intervention was indicated. Both Ga-67 citrate and a cortical agent (Tc-99m dimethylsuccinate) were used. A reciprocal relationship in the renal uptake of these two agents indicates the response of therapy and the degree of improvement of renal cortical function.

Citrates↗

Magnetic resonance imaging of the brain with gadopentetate dimeglumine-DTPA: comparison of T1-weighted spin-echo and 3D gradient-echo sequences.

Short TR, short TE, high resolution, 3D gradient-recalled echo (GRE) imaging was evaluated for lesion detection in the brain. High resolution 3D GRE data acquisition was used to reduce partial volume effects and flow artifacts, to better visualize smaller structures, to minimize signal losses caused by field inhomogeneities, and to allow better image reformatting. Spin-echo (SE) and 3D GRE approaches were compared for lesion detection after the administration of an MR contrast agent, gadopentetate dimeglumine. Preliminary clinical studies demonstrated that the signal-to-noise ratio (SNR) in each slice of the GRE scan was worse than that of the SE scan because of the much thicker slices acquired with the SE technique. However, by averaging two adjacent 3D slices, the SNR of the two methods was essentially equivalent. In the averaged GRE slices, large lesions were seen just as well as in the SE images. More importantly, small lesions were better visualized in the thin 3D GRE images than in the thick SE images for the lesions studied in this work and the protocols used. These observations were confirmed by theoretical simulations.

Adolescent↗

Theory and application of static field inhomogeneity effects in gradient-echo imaging.

The influence of local static magnetic field inhomogeneities on gradient-echo imaging is discussed and the underlying theoretical aspects are reviewed. A high-resolution approach is suggested to suppress image distortion and restore signal loss due to spin dephasing. Acquisition of three-dimensional data sets not only overcomes part of the limitations associated with gradient echoes but also makes it possible to extract local information about the strength or direction of background gradients and relative susceptibility changes between different tissues. Applications of the suggested approach in the human brain for anatomical imaging as well as for extraction of physical and physiological parameters are presented and discussed.

Artifacts↗

Detection of BOLD changes by means of a frequency-sensitive trueFISP technique: preliminary results.

A new method is introduced to detect magnetic field modulation arising from brain activation-induced BOLD effects. This approach uses a two-dimensional high-bandwidth, high-resolution conventional gradient-echo steady-state imaging sequence known as TrueFISP. The ability to visualize changes in oxygen saturation comes from the fact that the method is sensitive to the local field. As is well known, as the oxygen saturation changes so does the local field associated with the venous blood. We demonstrate that it is possible to visualize not only venous blood with this approach on a macroscopic level for major veins, but also to measure conventional oscillatory like signal changes during activated and resting states. Unfortunately, the method has two major drawbacks. First, a long TR is needed to maximize signal changes and, second, the field must be very well shimmed or numerous experiments need to be run to find the activation, as the signal response is sensitive to the starting frequency in the resting state. Nevertheless, these images can be compared directly with anatomical images collected with the same method without the need for distortion correction.

Brain↗