For sequential studies of patients with brain tumors, the authors have designed an automated registration procedure for intra- and interexamination alignment of magnetic resonance images. This was evaluated with artificially misregistered data and data from repeat studies of six healthy volunteers and six brain tumor patients. In a subset of cases, a manual procedure based on matching of neuroanatomic landmarks was also applied for comparison. The results showed that the technique is robust and reproducible, giving an accuracy in the range of 1-2 mm, which corresponded to the spatial resolution of the images. Subject motion between imaging sequences within the same study was negligible, although adjustments (one to two section thicknesses) were required in the z direction to correlate multisection and volume images and to allow accurate image segmentation. For alignment between sequential volunteer and patient examinations, translations of up to 22 mm and rotations in the x, y, and z axes of up to 9 degrees were required. This alignment procedure may be valuable in numerous aspects of treatment planning and patient follow-up.

Adult↗

PubMedDate not supplied

Surface coil MR imaging of the human brain with an analytic reception profile correction.

An analytic correction method was developed and applied to correct the signal intensity nonuniformity caused by the inhomogeneous reception profile of surface coils used--because of their higher sensitivity--for magnetic resonance imaging of the brain at 1.5 T. The reception profile was analytically modeled by using the Biot-Savart law. The correction considerably improved visual interpretation of the images by modeling and removing the dependence of signal intensity on distance from the coil. The method can be used for single or multiple coils of any planar geometry and in any orientation. Application of this technique allows imaging of the brain with surface coils, yielding increased resolution and signal-to-noise ratio, without the penalty of image nonuniformity.

Brain↗

PubMedDate not supplied

High resolution T2-weighted imaging of the human brain using surface coils and an analytical reception profile correction.

High spatial resolution T2-weighted MR images of the human brain were obtained at 1.5 T. An optimized fast spin-echo (FSE) sequence and 1.5 g/cm gradients were used to obtain T2-weighted images in 4 to 9 minutes with an in-plane resolution of .27 mm and slice thicknesses from 1.5 to 3 mm. Phased arrays of surface coils were used as receivers, providing increased sensitivity but image intensities dependent on the reception profile of the coils. This image nonuniformity was removed by analyzing the data with a theoretical intensity correction algorithm developed in this laboratory. The FSE sequences, the specialized phased arrays of surface coils, and the intensity correction algorithm allowed improved visualization of nerves within the inner auditory canals and surface anatomy of the cerebral cortex. It is expected that this technique will be useful for clinical applications that require high resolution imaging of small, superficial structures of the brain.

Algorithms↗

PubMedDate not supplied

Improved solvent suppression and increased spatial excitation bandwidths for three-dimensional PRESS CSI using phase-compensating spectral/spatial spin-echo pulses.

Dual phase-compensating spectral/spatial echo-planar (EP) spin-echo (SE) pulses were incorporated into the point resolved spectroscopy (PRESS) excitation sequence to improve water and lipid suppression for 1H chemical shift imaging (CSI) and to decrease the dependence of the PRESS box location upon chemical shift. The asymmetric EPSE pulses (either minimum or maximum phase in the chemical shift domain) were substituted for the two PRESS SE pulses to yield zero phase spectra. Three different pulses were designed and tested at 1.5 T. Pulse 1, targeted for brain CSI (TE > 85 msec), passed choline to lipid resonances, suppressed water, and rephased the methyl lactate doublet independently of TE. Pulse 2, targeted for general purpose shorter TE PRESS, possessed both high chemical shift and spatial domain bandwidths. Pulse 3, designed for prostate CSI, passed choline to citrate resonances while suppressing lipids and water. The three pulses possessed spatial bandwidths ranging between 3.3 and 5.0 kHz, more than three times higher than that offered by one-dimensional SE pulses of equivalent maximum B1 amplitude. Phantom and in vivo experimental results demonstrated that, for EPSE pulses 1 and 2, suppression factors higher than 10(4) were achieved. The increased spatial bandwidths resulted in less contamination by signals from outside the designated PRESS excited region and a significant improvement in the uniformity of metabolite intensities for voxels located near edges of the PRESS box.

Aged↗

PubMedDate not supplied

Volume MRI and MRSI techniques for the quantitation of treatment response in brain tumors: presentation of a detailed case study.

Patients with primary brain tumors may be considered for several different treatments during the course of their disease. Assessments of disease progression and response to therapy are typically performed by visual interpretation of serial MRI examinations. Although such examinations provide useful morphologic information, they are unable to reliably distinguish active tumor from radiation necrosis. This poses a particular problem in the assessment of response to localized radiation therapies such as gamma knife radiosurgery. In this paper, we present methodology for evaluating changes in tissue morphology and metabolism based on serial volumetric MRI and magnetic resonance spectroscopic imaging (MRSI) examinations. Registration and quantitative analysis of these data provide measurements of the temporal and spatial distributions of gadolinium enhancement and of N-acetylasparate, choline, creatine, and lactate/lipid. The key features of this approach and the potential clinical benefits are illustrated by a detailed analysis of six serial MRI/MRSI examinations and three serial 1-[F-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) studies on a patient with a recurrent anaplastic astrocytoma.

Adult↗

PubMedDate not supplied

Tropical pyomyositis in eastern Ecuador.

In the ten year period 1980-1989, 97 patients were treated for tropical pyomyositis at Hospital Vozandes Oriente in eastern Ecuador, accounting for 2.2% of surgical admissions. Operation records from an affiliated hospital in Quito showed that, high on the Andean plateau, pyomyositis accounted for only 0.1% of surgical admissions. Among the patient population of Ecuador's eastern tropical rain forest, persons who were members of an indigenous ethnic group were affected with pyomyositis twice as often as would be expected from their representation in the general population.

Abscess↗

PubMedDate not supplied

Treatment of snake bites by Bothrops species and Lachesis muta in Ecuador: laboratory screening of candidate antivenoms.

Bothrops xanthogrammus/asper, B. atrox and Lachesis muta are probably responsible for most cases of severe envenoming in Ecuador. In recent years, the most widely used antivenom ('Myn' Ronti, imported from Mexico) has proved clinically ineffective. There is an urgent need to identify an effective alternative for clinical testing. Five antivenoms with activity against Bothrops venoms were compared using standard World Health Organization rodent and in vitro assays: (i) 'Myn', Ronti Mexico SA ('B. atrox', 'Crotalus terrificus'), (ii) Instituto Butantan (Bothrops polyvalent, Brazil), (iii) Instituto Nacional de Hygiene y Medicina Tropical (Bothrops polyvalent, Ecuador), (iv) Instituto Nacional de Salud (B. asper, C. durissus and Lachesis muta, Colombia), and (v) Laboratorios Probiol (Bothrops, Lachesis and Crotalus, Colombia). The venoms against which these antivenoms were tested were Ecuadorian B. atrox, B. asper and B. xanthogrammus. Brazilian antivenom proved to be the most effective, followed by the Ecudorian and Colombian antivenoms. Mexican antivenom was completely ineffective in neutralizing the lethal effects of Ecuadorian Bothrops venoms. Monospecific Brazilian L. muta antivenom (Instituto Butantan) proved effective against Ecuadorian L. muta venom, but the Colombian polyspecific antivenoms did not. Clinical trials of Brazilian and Ecuadorian antivenoms are planned in the Amazon region of Ecuador in the near future.

Animals↗

PubMedDate not supplied

Three-dimensional magnetic resonance spectroscopic imaging of brain and prostate cancer.

Clinical applications of magnetic resonance spectroscopic imaging (MRSI) for the study of brain and prostate cancer have expanded significantly over the past 10 years. Proton MRSI studies of the brain and prostate have demonstrated the feasibility of noninvasively assessing human cancers based on metabolite levels before and after therapy in a clinically reasonable amount of time. MRSI provides a unique biochemical "window" to study cellular metabolism noninvasively. MRSI studies have demonstrated dramatic spectral differences between normal brain tissue (low choline and high N-acetyl aspartate, NAA) and prostate (low choline and high citrate) compared to brain (low NAA, high choline) and prostate (low citrate, high choline) tumors. The presence of edema and necrosis in both the prostate and brain was reflected by a reduction of the intensity of all resonances due to reduced cell density. MRSI was able to discriminate necrosis (absence of all metabolites, except lipids and lactate) from viable normal tissue and cancer following therapy. The results of current MRSI studies also provide evidence that the magnitude of metabolic changes in regions of cancer before therapy as well as the magnitude and time course of metabolic changes after therapy can improve our understanding of cancer aggressiveness and mechanisms of therapeutic response. Clinically, combined MRI/MRSI has already demonstrated the potential for improved diagnosis, staging and treatment planning of brain and prostate cancer. Additionally, studies are under way to determine the accuracy of anatomic and metabolic parameters in providing an objective quantitative basis for assessing disease progression and response to therapy.

Brain Neoplasms↗

PubMedDate not supplied

Single breath-holding scans of the abdomen using FISP and FLASH at 1.5 T.

Single breath-holding gradient echo techniques fast imaging with steady-state free precession (FISP) and fast low angle shot (FLASH) images were evaluated in the study of the abdomen in 16 patients (13 liver, two kidney, and one pancreas examinations). Gradient echo images were compared retrospectively with conventional spin echo images for image quality (depiction of pathology and representation of anatomic detail), and contrast characteristics were evaluated. All lesions were shown on gradient echo images, and in three of 16 cases gradient echo images were more diagnostic than spin echo images. On both FISP and FLASH images, most hepatic metastases were hyperintense relative to normal liver. The predicted flip angles for maximal contrast for the liver were modeled from signal intensity equations for FISP and FLASH and yielded predicted flip angles of approximately 40-55 degrees for FISP and 15-25 degrees for FLASH. Peak signal-to-noise ratio in liver of normal volunteers occurred at approximately 30 degrees for both FISP and FLASH. Single breath-holding gradient echo images are useful in the evaluation of abdominal structures and this study provides a framework for future work.

Abdominal Neoplasms↗

PubMedDate not supplied

Alignment of volume MR images and high resolution [18F]fluorodeoxyglucose PET images for the evaluation of patients with brain tumors.

PURPOSE: The goal of the study was to investigate the use of automated registration techniques for interpretation of volume MR and high resolution FDG-PET images that were obtained from patients with brain tumors. METHOD: Twenty-one patients with brain tumors were studied on one or more occasions using MRI and high resolution FDG-PET. The data were aligned using automated volume- and surface-matching algorithms. Composite images comprising the resliced pre- and postgadolinium spoiled GRE, T2-weighted SE, and PET data were constructed to correlate intensities of regions on the PET images with regions that corresponded to normal gray matter, white matter, and gadolinium enhancement. RESULTS: The accuracy of registration between the MR and PET images was estimated to be within 1-2 mm based upon the distance between surfaces of the outside of the head. In 12 of the 24 examinations, there were diagnoses of recurrent tumor, with only 5 of these exhibiting regions of higher FDG uptake than normal gray matter. For 19 of the 24 studies, the anatomic context provided by the registered MR images was found to be important in distinguishing recurrent tumor from necrosis based upon FDG uptake. CONCLUSION: The automated alignment was found to be an important factor in interpreting the high resolution PET images. This was particularly true for small lesions close to the cortex and for situations where FDG uptake had been reduced by prior treatment with radiation therapy.

Adult↗

PubMedDate not supplied

Ceftriaxone in the treatment of infections caused by Staphylococcus aureus in children.

Ceftriaxone is a new parenteral cephalosporin with a prolonged half-life and an expanded Gram-negative spectrum. Before it can be used as a single agent for infections of unknown etiology, its efficacy in treating infections caused by Gram-positive organisms, particularly Staphylococcus aureus, must be proven. Ceftriaxone was administered to 12 children for treatment of infections due to S. aureus alone or in the presence of other organisms. Sites of infection included soft tissue, respiratory tract, bone and joint. Patients received ceftriaxone at 68 to 100 mg/kg/day in two doses for 3 to 20 days. Clinical and bacteriologic responses were satisfactory in all patients. One patient experienced abdominal pain during infusion and another developed a skin rash. Five patients had platelet counts of 500,000/mm3 or greater; four had an eosinophil count of 7% or greater and one patient had transient neutropenia. These abnormalities resolved during or after therapy. Ceftriaxone was a safe and effective single antibiotic for the treatment of infections caused by S. aureus in children.

Adolescent↗

PubMedDate not supplied

ATC-4 waveguides may be field repairable.

Explore the source record for details and available documents.

Costs and Cost Analysis↗

PubMedDate not supplied

High-sensitivity coil array for head and neck imaging: technical note.

The purpose of this study was to develop coils for MR imaging of the head and neck region, with the aim of improving sensitivity and coverage. A head and neck phased array coil was constructed and compared with volume and temporomandibular joint surface coils for sensitivity and coverage in phantom studies. An algorithm was implemented to correct for the nonuniformity in the surface coil reception profile. Its application to high-resolution T2-weighted imaging in healthy volunteers was investigated.

Head↗