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Biomedical subjects

S Saini

Publications and source records attributed to S Saini.

At least 271 records · Page 15Linked to original sources

Gallbladder bile in cholecystitis: in vitro MR evaluation.

Fifty-three samples of gallbladder bile were obtained at the time of cholecystectomy from patients with the clinical diagnosis of acute or chronic cholecystitis. Five bile samples from patients with clinically normal gallbladders also were obtained. Proton magnetic resonance (MR) relaxation times, protein content, and water content were determined for the bile samples, and the data were grouped according to pathologic diagnosis, which disclosed 11 cases of acute cholecystitis, 41 cases of chronic cholecystitis, and six normal gallbladders. There was no significant difference in the mean T1 and T2 values between the groups with acute and chronic cholecystitis. Patients with chronic cholecystitis were found to have more concentrated bile than those with acute cholecystitis. Protein content varied widely within both groups of patients. We conclude that T1 and T2 relaxation times do not reliably differentiate acute from chronic cholecystitis.

Bile↗

Pulse sequence optimization for MR imaging using a paramagnetic hepatobiliary contrast agent.

Paramagnetic agents enhance contrast between tissues in magnetic resonance (MR) imaging by altering tissue relaxation times. The effect of these changes on MR image intensity depends in part on the choice of operator-controlled pulse sequence parameters. With the newly described paramagnetic hepatobiliary contrast agent, iron(III) ethylenebis-(2-hydroxyphenylglycine), Fe(EHPG)-, an in vivo experimental analysis of pulse sequence optimization was performed on the rat. We compared the enhancement of the liver divided by background noise, EL/N, of standard inversion-recovery (IR) and spin-echo (SE) T1-weighted pulse sequences and several pulse sequences theoretically predicted to have improved EL/N. Optimization of the echo time (TE = TEmin) gave a substantial (greater than 60%) increase in EL/N over the standard IR and SE pulse sequences. Images obtained with optimized repetition rate and inversion time gave only a slight additional improvement. Within the uncertainties of our relaxation measurements, the measured changes in EL/N with pulse sequence optimization corresponded well with theoretical predictions. With the experimental and theoretical data, the importance of using a short echo time to obtain maximal T1 contrast in contrast-enhanced MR imaging and the relative merits of optimized SE versus IR pulse sequences for contrast-enhanced MR imaging are discussed.

Animals↗

High-resolution surface-coil imaging of lumbar disk disease.

Seventeen patients with lumbar disk disease were studied using a prototype magnetic resonance (MR) surface coil. The high signal-to-noise ratio achieved with the surface coil permitted increases in spatial resolution to 0.9 X 0.9 mm in-plane resolution with 5 mm slice thickness. The surface coil was also compatible with multiplanar, multiecho imaging techniques. The spatial resolution achieved in this study was nearly equivalent to that achieved by state-of-the-art computed tomographic (CT) scanners, and MR showed a superior range of soft-tissue contrast. One significant limitation of MR was its inability to demonstrate small calcifications. Nevertheless, MR imaging provided diagnostic information comparable to CT or myelography in a completely noninvasive manner. With further technical advances, MR is likely to become the initial procedure of choice for evaluating patients with suspected lumbar disk disease.

Humans↗

Magnetic resonance imaging of cavernous hemangioma of the liver: tissue-specific characterization.

Twenty-one patients with hepatic hemangioma, five with hepatic cysts, and 25 with primary or metastatic cancer involving the liver were studied by magnetic resonance imaging (MRI). Benign lesions (hemangiomas, cysts) were diagnosed noninvasively by CT, radionuclide studies, and/or sonography and confirmed by follow-up examinations more than 1 year later. Malignant lesions were confirmed by liver biopsy in every case. Identical multisection/multiecho techniques were used in all patients to obtain T1-and T2-weighted spin-echo (SE) and inversion-recovery (IR) images. MRI detected more hemangiomas than any other imaging technique. Of 30 hemangiomas, 25 were spherical or ovoid with a homogeneous appearance and smooth, well defined margins. Cancer tended to have a heterogeneous appearance and poorly defined margins. On T2-weighted SE images obtained with 2000 msec TR and 60, 120, or 180 msec TE, hemangiomas had significantly greater contrast-to-noise ratios (C/N) than liver cancer (p less than 0.001). The SE 2000/120 sequence provided the single most useful image for distinguishing hemangiomas from cancers. When morphologic criteria are used in conjunction with measured C/N, MRI correctly distinguished cavernous hemangiomas from liver cancer with 90% sensitivity, 92% specificity, and an overall accuracy of 90%. Cysts had a low signal intensity on SE 500/30 images and could often be distinguished from hemangiomas and cancers that were nearly isointense relative to liver. IR images were sensitive for lesion detection but provided no tissue-specific information. The data indicate that T2-weighted SE imaging may become the procedure of choice for distinguishing cavernous hemangioma from liver cancer.

Adenoma, Islet Cell↗

Magnetic resonance imaging of the heart using image planes oriented to cardiac axes: experience with 100 cases.

Electrocardiographically gated magnetic resonance images were acquired in 100 patients with a variety of cardiac diagnoses in planes oriented to intrinsic axes of the heart and aorta. The technique used combines patient positioning and alteration of magnetic gradient angle. Images in these planes appear to have advantages over conventional orthogonal images, both for display of cardiovascular anatomy and for evaluation of cardiac size and function.

Adolescent↗

Correlation of quantitative burn wound biopsy culture and surface swab culture to burn wound sepsis.

The present study includes seventeen patients with second and third degree fresh burns involving 15-50 per cent total body surface area (TBSA). Surface swabs and quantitative burn wound biopsy cultures were obtained during postburn weeks 1, 2 and 3 and correlation was studied. To obtain bacterial counts the technique described by Loebel et al. (1974) was used. The patients were divided in two groups depending upon burn body surface area involved. The first group includes five patients with burns between 15-29 per cent body surface area and the second group includes the rest of the twelve patients with burns between 30-50 per cent body surface area. No patient from group I showed any sign or symptom of sepsis whereas seven patients from group II developed sepsis and three died. These three patients showed positive blood culture at the time of death. Of the 48 cultures obtained in all the patients over 3 weeks, 7 cultures showed differences between swab and biopsy cultures. Genticyn was the most effective drug against Gram-negative organisms.

Adolescent↗

Percutaneous aspiration of hepatic cysts does not provide definitive therapy.

Follow-up of 13 patients who underwent radiologically guided percutaneous needle aspiration of simple liver cysts revealed cyst recurrence in all patients within 2 years. While still effective as a primary diagnostic maneuver, percutaneous aspiration seems to lack permanent therapeutic benefit. However, it may be used as a therapeutic trial to confirm the origin of the patient's symptoms. The possible role of intracystic instillation of sclerosing agents was not studied in this series.

Adult↗

Dynamic gadolinium-enhanced echo-planar MR imaging of the liver: effect of pulse sequence and dose on enhancement.

To develop guidelines for clinical magnetic resonance imaging of the liver, the authors undertook an animal study to investigate the effect of dose and pulse sequence on liver signal intensity in gadopentetate dimeglumine-enhanced echo-planar imaging. Serial imaging of the liver was performed in anesthetized rats after intravenous administration of five different doses (0.01, 0.05, 0.1, 0.2, and 0.5 mmol/kg) of contrast agent, with six different pulse sequences. The results show that gadopentetate dimeglumine-enhanced echo-planar images obtained during the perfusion phase can yield either positive (due to increased T1 relaxation rates) or negative (due to susceptibility-induced increased T2 relaxation rates) liver enhancement depending on choice of pulse sequence and dose. At the current clinically recommended dose of 0.1 mmol/kg, maximal liver signal enhancement was seen with a T1-weighted inversion-recovery sequence, while maximal liver signal diminution was seen with a T2*-weighted gradient-echo sequence. The authors conclude that gadopentetate dimeglumine-enhanced echo-planar imaging can provide T1, T2, and T2* contrast that may be exploited for both lesion detection and lesion characterization.

Animals↗

Contrast-enhanced MR imaging of the liver: comparison between Gd-BOPTA and Mangafodipir.

The purpose of the study was to evaluate the MR contrast agents gadolinium benzyloxypropionictetro-acetate (Gd-BOPTA) and Mangafodipir for liver enhancement and the lesion-liver contrast on T1W spin-echo (SE) and gradient-recalled-echo (GRE) images. Fifty-one patients (three groups of 17 patients each) with known or suspected liver lesions were evaluated with T1W SE (300/12) and GRE (77-80/2.3-2.5/80 degrees) images before and after intravenous (IV) Gd-BOPTA (0.1 or 0.05 mmol/kg) or Mangafodipir (5 mumol/kg) in phase II to III clinical trials. Quantitative analysis by calculating liver signal-to-noise ratio (SNR), lesion-liver contrast-to-noise ratio (CNR), and spleen-liver CNR was performed. Liver SNR and spleen-liver CNR were always significantly increased postcontrast. SNR was highest after application of 0.1 mmol/kg Gd-BOPTA (51.3 +/- 3.6, P < .05). CNR was highest after Mangafodipir (-22.6 +/- 2.7), but this was not significantly different from others (P = .07). Overall, GRE images were superior to SE images for SNR and CNR. Mangafodipir and Gd-BOPTA (0.1 mmol/kg) provide equal liver enhancement and lesion conspicuity postcontrast. By all criteria, contrast-enhanced T1-weighted GRE were comparable to SE images.

Adult↗