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T K Foo

Publications and source records attributed to T K Foo.

At least 37 records · Page 2Linked to original sources

Automated detection of bolus arrival and initiation of data acquisition in fast, three-dimensional, gadolinium-enhanced MR angiography.

Automatic triggering of magnetic resonance (MR) angiography with detection of a contrast material bolus was evaluated. Signal intensity changes with time were tracked in a prescribed tracking or monitoring volume by a parallel signal processing unit that automatically started data acquisition once user-defined thresholds were exceeded. This technique, referred to as MR Smartprep, was reliable and avoided the inconsistencies of manual timing.

Adult↗

Quantification of coronary artery volume flow rate using fast velocity-encoded cine MR imaging.

OBJECTIVE: Breath-hold velocity-encoded cine (VENC) MR imaging has been proposed as a method for measuring coronary blood flow. However, most studies have measured velocity rather than volume flow rate in the coronary arteries. The purpose of this study was to measure volume flow rate in the coronary artery of dogs using high-speed gradients and to compare MR flow measurements with those obtained with a sonographic flowmeter. MATERIALS AND METHODS: Fast VENC MR images were obtained with a high-speed-gradient 1.5-T MR system in seven anesthetized dogs before and after administration of dipyridamole. Images were acquired on double oblique planes perpendicular to the left anterior descending arteries with a slice thickness of 5 mm, a field of view of 20 x 10 cm, a velocity window of +/- 1 m/sec, an average imaging time of 21 sec, a TR/TE of 11/5, and a temporal resolution of 44 msec. RESULTS: Coronary flow measured with VENC MR imaging correlated well with flow measured by the flowmeter (r = .95, slope = 0.97, n = 88). Interobserver variability in measuring coronary flow volume was 8%. CONCLUSION: Fast VENC MR imaging with high-speed gradients can provide accurate quantification of volume flow rate in coronary arteries.

Animals↗

Coronary flow reserve: noninvasive measurement in humans with breath-hold velocity-encoded cine MR imaging.

PURPOSE: To measure coronary vasodilator reserve with breath-hold velocity-encoded cine magnetic resonance (MR) imaging. MATERIALS AND METHODS: Eight healthy adult volunteers underwent 1.5-T MR imaging. Velocity-encoded cine images were acquired at seven to 13 temporal phases in 25 seconds, with k-space segmentation and view-sharing reconstruction (+/- 1 m/sec velocity-encoding value) (repetition time msec/echo time msec = 16/9). Flow velocity in the left anterior descending (LAD) artery was measured twice before and twice after administration of dipyridamole (0.56 mg per kilogram of body weight). RESULTS: Peak diastolic coronary flow velocity in the LAD artery was 14.8 cm/sec +/- 1.9 (mean +/- standard deviation) in the baseline state. It increased significantly (P< .01) to 46.3 cm/sec +/- 10.2 after dipyridamole administration, with an average coronary reserve of 3.14 +/- 0.59. Interstudy and interobserver reproducibilities for measurement of peak diastolic velocity were, respectively, 9.5% +/- 1.6 and 7.0% +/- .2.5 in the baseline state and 6.8% +/- 2.2 and 3.4% +/- 1.5 after dipyridamole administration. CONCLUSION: Breath-hold velocity-encoded cine MR imaging provided reproducible assessment of coronary flow reserve in humans.

Adult↗

Optimized gradient waveforms for spiral scanning.

Spiral scanning gradient waveforms can be optimized with respect to blurring from off-resonance effects by minimizing the readout time. This is achieved by maximizing the gradient amplitude during the scan so that the edge of k-space is reached as quickly as possible. Gradient hardware constraints are incorporated by considering a circuit model for the gradient coil and amplifier. The optimized gradient waveforms are determined by a set of coupled differential equations. The resulting solutions have shorter readout time than solutions that do not consider the circuit model.

Acceleration↗

Improved ejection fraction and flow velocity estimates with use of view sharing and uniform repetition time excitation with fast cardiac techniques.

PURPOSE: To improve the accuracy of ventricular volume estimates and effective temporal resolution in fast cardiac acquisitions. MATERIALS AND METHODS: Data sets at intermediate temporal phases were generated by means of sharing of views from two temporally adjacent data sets. A simulated model was used, and studies with patients and volunteers were conducted. View sharing was implemented in both fast gradient-echo and fast phase-contrast cine acquisitions; breath holding was used when possible. RESULTS: Uniform repetition time (TR) radio-frequency (RF) excitation allowed a better assessment of the end-diastolic ventricular volume. In addition, view sharing provided a better estimate of end-systolic ventricular volume in cases in which rapid changes in volume occurred at or about the temporal boundary of the source images. View sharing also provided a much smoother representation of dynamic cardiac motion when viewed in a cine loop. CONCLUSION: View sharing and uniform TR RF excitation improve the accuracy of end-systolic and end-diastolic ventricular volume measurements by improving the effective temporal resolution.

Adult↗

Detection of pulmonary embolism: comparison of contrast-enhanced spiral CT and time-of-flight MR techniques.

We compared the conspicuity of acute pulmonary emboli with contrast-enhanced spiral computed tomography (CT) and two- and three-dimensional time-of-flight magnetic resonance (MR) techniques. Seven dogs who received experimental pulmonary emboli and one control were imaged with spiral CT and with 2-D (FMPVAS and FASTCARD) and 3-D time-of-flight MR. Blinded, independent, prospective evaluations of the CT and MR images by two MR radiologists and two chest radiologists were then compared to the location of the emboli as determined by subsequent pathologic evaluation of the excised lungs. Embolus/blood contrast-to-noise ratios (CNRs) were calculated on both MR and CT images for pulmonary emboli that could be identified. Fifty emboli ranging from 1.0 to 5.5 mm (mean, 2.7, +/- 0.14 SEM) in diameter and from 3.0 to 60 mm (mean, 28.1 +/- 1.9 SEM) in length were found in the seven embolized dogs on pathologic examination. Three of the four radiologists identified more thrombi on CT images than they did on their best MR pulse sequence (FASTCARD) and with greater confidence. The fourth radiologist identified an equal percentage of clot on CT and FASTCARD images with confidence slightly greater on FASTCARD MR than on spiral CT. Mean CNR for the best MR technique was 43.4 (+/- 3.9 SEM) and for CT was 20.7 (+/- 1.3 SEM). In general, pulmonary emboli were detected more accurately on contrast-enhanced spiral CT than on MR. This occurred although the embolus/blood CNR was higher on MR than on CT. Better pulmonary embolus conspicuity on CT images was attributed to better spatial resolution and fewer artifacts on CT than on MR. One MR radiologist performed equally well with both spiral CT and FASTCARD techniques, suggesting that experience may be a factor in performance.

Animals↗

Single breath-hold pulmonary magnetic resonance angiography. Optimization and comparison of three imaging strategies.

RATIONALE AND OBJECTIVES: Ultrafast gradient-recalled-echo techniques for obtaining high-quality pulmonary magnetic resonance angiograms within a single breath-hold were optimized. METHODS: Fourteen subjects were imaged with both the body coil and a phased-array surface coil, using three gradient-recalled-echo pulse sequences: 1) two-dimensional sequential; 2) two-dimensional interleaved; and 3) volumetric acquisitions. Image quality was assessed with varied flip angle, receiver bandwidth, slice thickness/number, and matrix size. Cardiac compensation diminished ghost artifacts in the interleaved sequence. Individual sagittal sections and maximum intensity projections were reviewed. RESULTS: Pulmonary magnetic resonance angiograms acquired with volumetric and two-dimensional interleaved gradient-recalled-echo pulse sequences benefit greatest from intravenous gadolinium and result in greater pulmonary arterial visualization than traditional time-of-flight techniques. Phased-array coils result in improved vessel detection. CONCLUSIONS: High-quality breath-held pulmonary magnetic resonance angiography can be obtained with an intravenous contrast-enhanced gradient-recalled-echo acquisition; however, image quality is dependent on the pulse sequence.

Adult↗

Inversion in the steady state: contrast optimization and reduced imaging time with fast three-dimensional inversion-recovery-prepared GRE pulse sequences.

PURPOSE: To evaluate the differences in contrast between 1-second delay and zero delay (for magnetization recovery) before the preparation radio-frequency pulse in three-dimensional, inversion-recovery (IR) fast gradient-echo (GRE) acquisitions. MATERIALS AND METHODS: Mathematical simulations and measurements of brain image contrast were performed with healthy volunteers and 10 patients. RESULTS: The zero-delay sequence generated T1-weighted contrast similar to that obtained with 1-second delay but was accompanied by a substantial reduction in imaging time. However, the zero delay prohibits full recovery of the longitudinal magnetization. Hence, the signal null characteristic of IR experiments is not easily observed, since it occurs (as a function of tissue T1) at very short inversion times (< 150 msec). CONCLUSION: T1-weighted contrast comparable with that of magnetization-prepared rapid GRE sequences with a 1-second delay and preparation time (TP) of 600-700 msec can be achieved in less time by using a zero delay and a shorter TP (400-500 msec).

Brain↗

Silicone breast implant rupture: comparison between three-point Dixon and fast spin-echo MR imaging.

OBJECTIVE: This study was designed to compare the three-point Dixon technique with our present MR protocol incorporating T2-weighted fast spin echo and fast spin echo with water suppression to detect ruptured silicone breast implants. SUBJECTS AND METHODS: Eighty-two symptomatic women with silicone breast implants were examined with both the three-point Dixon technique and fast spin-echo MR sequences. Of these patients, 41 had surgery to remove their implants. Four radiologists reviewed the images from only those patients who had surgery and graded each for rupture by using a scale of 1-5. Receiver-operating-characteristic analysis was performed. RESULTS: Of 81 implants removed, 18 were ruptured. Silicone implant ruptures were identified more frequently on the fast spin-echo sequence than on the three-point Dixon sequence, with areas under the ROC curves of .95 and .84, respectively. Although the difference was not statistically significant, the sensitivity for detecting silicone implant rupture was 89% for the fast spin-echo sequence and 61% for the three-point Dixon sequence. The specificity was 97% for both sequences. CONCLUSION: Silicone implant ruptures were detected more frequently with fast spin-echo MR sequences than with the three-point Dixon technique, although the difference was not significant. The greater spatial resolution used for the fast spin-echo sequence partially accounts for the difference in detection of implant ruptures in this study.

Breast↗

Evaluation of malignant biliary obstruction: efficacy of fast multiplanar spoiled gradient-recalled MR imaging vs spin-echo MR imaging, CT, and cholangiography.

OBJECTIVE: Although CT and cholangiography have proven value in the detection of biliary obstruction, determining the extent of biliary tumors and imaging small pancreatic or ampullar tumors remain problematic. We hypothesized that the superior contrast resolution of MR, coupled with contrast-enhanced breath-hold imaging, might increase the sensitivity for tumor detection and improve the depiction of the point of obstruction in patients with malignant biliary disease. SUBJECTS AND METHODS: Twenty-one MRI studies were performed prospectively in patients with malignant biliary obstruction by obtaining breath-hold contrast-enhanced fast multiplanar spoiled gradient-recalled (FMPSPGR) images at 0 and 10 min, conventional spin-echo T1-weighted images, and fast spin-echo T2-weighted images. Findings on MR images were correlated with findings on CT scans (15 cases) and/or cholangiograms (14 cases) by two observers. All MR images, CT scans, and cholangiograms were reviewed to evaluate tumor detection, visualization of dilated bile ducts, and conspicuity of the obstructing tumor. A four-point scale (1 = excellent tumor depiction and conspicuity, 4 = tumor not detected) was used for evaluation. Contrast-to-noise ratios for tumor and bile were calculated for the three MR pulse sequences. RESULTS: The contrast-enhanced FMPSPGR images and CT scans provided excellent depiction of the dilated biliary tree in 95% and 93% of examinations, respectively, with both techniques superior to fast spin-echo and T1-weighted images (p < .005). Tumor detection was best with the immediate FMPSPGR MR images (20/21), compared with fast spin-echo MR images (16/21) (p = .04), T1-weighted MR images (16/21) (p = .04), CT scans (12/15) (p > .05), and cholangiograms (13/14) (p > .05). Of 13 examinations showing proximal biliary obstruction, the mean score for tumor conspicuity was best with the immediate enhanced FMPSPGR MR images (1.38 +/- .65), compared with T1-weighted MR images (2.38 +/- 1.3) and fast spin-echo MR images (2.08 +/- 1.0) (p < .05), but it was not different from the delayed FMPSPGR MR images (1.75 +/- 1.1) or CT scans (1.9 +/- 0.99) (p > .05). For five of six cholangiocarcinomas, the immediate and delayed enhanced FMPSPGR MR images showed excellent tumor conspicuity owing to their enhancement with gadopentetate dimeglumine. Data for contrast-to-noise ratios of tumor showed that the immediate FMPSPGR MR images (15.8 +/- 10.2) were superior to T1-weighted images (6.3 +/- 3.5, p < .01), but were not different from fast spin-echo images (13.5 +/- 6.7) or delayed FMPSGR images (11.5 +/- 8.9). For eight examinations in patients with distal biliary obstruction, the mean score for tumor conspicuity was greater with the immediate FMPSPGR MR images (1.38 +/- 0.52), compared with fast spin-echo images (3.25 +/- 0.71, p < .005), T1-weighted images (2.63 +/- 1.06, p < .05), and delayed FMPSPGR MR images (2.60 +/- 1.5, p < .05), but was similar to that with CT scans (1.40 +/- 0.89, p > .05). Data for contrast-to-noise ratios of tumor showed an advantage for the immediate FMPSPGR MR images (12.0 +/- 7.7) over T1-weighted images (4.0 +/- 2.6, p < .01) and delayed FMPSPGR images (4.3 +/- 2.6, p < .025), but no difference from fast spin echo images (6.6 +/- 8.8, p = .05). CONCLUSION: Contrast-enhanced FMPSPGR MR imaging is sensitive for the detection of tumors causing biliary obstruction. For proximal obstruction, it may be particularly effective for detecting and defining tumor extent of hilar cholangiocarcinomas because of their enhancement with gadopentetate dimeglumine. For cases of distal obstruction, this technique showed improved tumor detection and conspicuity compared with T1- and fast spin-echo T2-weighted images, but showed no advantage over CT.

Biliary Tract Neoplasms↗

Breath-hold MR cine angiography of coronary arteries in healthy volunteers: value of multiangle oblique imaging planes.

OBJECTIVE: Breath-hold MR cine angiography was used to depict the coronary arteries in healthy volunteers. Multiangle oblique imaging planes were evaluated for feasibility in showing continuous segments of the proximal and middle portions of the left anterior descending and right coronary arteries. SUBJECTS AND METHODS: Eighteen healthy subjects were examined with a 1.5-T MR imager. Fat-suppressed fast gradient-echo images (TR = 9.8 msec, TE = 3.5 msec) were acquired with a 13-cm receive surface coil. A segmented k-space data acquisition was used to obtain images of the coronary arteries at several phases of the cardiac cycle within a single breath-hold. Multiangle double oblique images that were tangential and sequential to the epicardial surface of the left ventricle were used to show the left anterior descending artery, and oblique coronal images were used to show the right coronary artery. Images of consecutive slice locations were shown in a cine format, and the length of each major coronary artery that was continuously visualized was measured. RESULTS: The left main coronary artery, proximal left anterior descending artery, and right coronary artery were demonstrated in all subjects. The mid and distal portions of the left anterior descending artery and diagonal branches were visualized best on multiangle oblique imaging planes. Continuous segments (> 6 cm) of the left anterior descending artery and right coronary artery were imaged in 14 subjects (78%) and 12 subjects (67%), respectively. Cine display was useful for showing the continuity of the coronary arterial segments and also for distinguishing arteries from veins. CONCLUSION: Double oblique imaging planes were useful in showing long segments of left anterior descending and right coronary arteries on coronary MR angiograms. Further work is necessary to improve detection of the left circumflex artery.

Adult↗

Comparison of lesion enhancement on spin-echo and gradient-echo images.

PURPOSE: To compare lesion enhancement after injection of gadopentetate dimeglumine on spin-echo and gradient-echo T1-weighted images. METHODS: A total of 48 contrast-enhancing intracranial lesions were evaluated using a spin-echo and two gradient-echo T1-weighted pulse sequences. Percent contrast, contrast-to-noise, and signal-to-noise measurements were made on the spin-echo T1-weighted, three-dimensional gradient-echo, and multiplanar gradient-echo sequences. RESULTS: The measurements were somewhat different for the following categories of lesions: extraaxial, intraaxial with edema, and intraaxial without edema. The latter group provided the greatest diagnostic challenge: three of 19 such lesions 1 cm in size or smaller could not be identified on three-dimensional gradient-echo images, and one could not be identified on multi-planar gradient-echo images. The spin-echo T1-weighted sequence demonstrated significantly higher percent contrast (P < .05) and greater contrast to noise (P < .03) than either gradient-echo sequence for these small intraaxial lesions without edema. For extraaxial and intraaxial lesions with edema, percent C was similar for spin-echo T1-weighted and three-dimensional gradient-echo images, while contrast to noise was greater for spin-echo T1-weighted images. This reflected greater tissue noise with gradient-echo sequences. CONCLUSION: The T1-weighted spin-echo sequence was preferred for detecting the full spectrum of contrast-enhancing lesions of the central nervous system.

Adolescent↗

Measurement of brain activity with bolus administration of contrast agent and gradient-echo MR imaging.

This study was performed to measure changes in cerebral blood volume (CBV) associated with visual activation by use of bolus administration of contrast agent and conventional, clinically configured magnetic resonance (MR) hardware and software. Fast gradient-recalled acquisition in the steady state technique was used to study five healthy subjects during visual activation and a control dark state. MR images were obtained every 2.048 seconds for 2 minutes. A bolus of gadopentetate dimeglumine was injected during visual stimulation and darkness. Cine images produced from the series of rapid images clearly depicted arterial, capillary, and venous phases. Analysis of serial concentration maps derived from the rapid images revealed expected differences between the relative CBV of gray matter and that of white matter, as well as significantly increased relative CBV in calcarine cortex during visual activation versus the control state (mean increase, 15.24%; range, 6.41%-27.78%; P < .05). These results confirm those reported in echo-planar imaging studies and demonstrate that brain function can be assessed with the bolus method by means of MR imaging hardware and software with conventional clinical configurations.

Blood Volume↗

Abdominal MR imaging: comparison of T2-weighted fast and conventional spin-echo, and contrast-enhanced fast multiplanar spoiled gradient-recalled imaging.

T2-weighted fast and conventional spin-echo (SE) and dynamic gadolinium-enhanced fast multiplanar spoiled gradient-recalled (FMPSPGR) images in 26 patients (18 with hepatic masses and eight with no detected abnormality) were compared to determine the efficacy of the newer pulse sequences (fast SE and FMPSPGR) in abdominal imaging. FMPSPGR allows for breath-hold magnetic resonance imaging of the liver. The contrast-to-noise ratio (C/N) of the hepatic lesions was calculated for each sequence and was superior in fast SE compared with that in conventional SE in 16 of 18 patients. Lesion detection was 90% with fast SE and was 85% and 80% for conventional SE and contrast material-enhanced FMPSPGR sequences, respectively. Of the T2-weighted sequences, fast SE showed consistently sharper anatomic structures and less respiratory and cardiac motion artifact. Thus, fast SE (with its superior C/N and shorter imaging time) and gadolinium-enhanced FMPSPGR images, when combined, demonstrate potential value as routine sequences in abdominal imaging.

Abdomen↗

Evaluation of left ventricular volume and mass with breath-hold cine MR imaging.

Left ventricular (LV) volumes and mass were evaluated in 10 healthy volunteers with breath-hold cine magnetic resonance (MR) imaging. The results were compared with those obtained with conventional cine MR imaging. The breath-hold studies showed no ghosting artifact, and cardiac edges were clearly identified because of the reduced blurring. Measurements of LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), and LV mass obtained with breath-hold cine MR imaging showed close correlation with those obtained with conventional cine MR imaging (r = .98, .97, and .99, respectively). The interobserver variabilities for LVEDV, LVESV, and LV mass determined with breath-hold cine MR imaging (4.0%, 8.0%, and 3.7%, respectively) were equal to or less than those determined with conventional cine MR imaging (4.0%, 8.6%, and 5.0%, respectively). The authors conclude that breath-hold cine MR imaging is highly useful because an accurate assessment of cardiac function is obtained in less than 5 minutes.

Adult↗

Patellofemoral joint: identification of abnormalities with active-movement, "unloaded" versus "loaded" kinematic MR imaging techniques.

A positioning device was used to apply a "load" to stress the patellofemoral joint during active-movement, kinematic magnetic resonance (MR) imaging. Twenty-three symptomatic patellofemoral joints were studied by using "unloaded" versus "loaded" techniques. With the unloaded technique, seven joints were normal, nine had lateral subluxation, three had lateral tilt, and four had medial subluxation. With the loaded technique, one was normal, 13 had lateral subluxation, four had lateral tilt, and five had medial subluxation. The active-movement, loaded kinematic MR imaging technique provides improved ability to identify patellofemoral joint abnormalities.

Adolescent↗

Thoracic cardiovascular anomalies in children: evaluation with a fast gradient-recalled-echo sequence with cardiac-triggered segmented acquisition.

A fast gradient-recalled-echo sequence with cardiac-triggered segmented acquisition (fastcard) was compared with a standard T1-weighted spin-echo sequence with cardiac gating and respiratory compensation in the evaluation of pediatric patients with thoracic cardiovascular anomalies. Twenty patients aged 1 week to 24 years (median age, 9 months) with various abnormalities underwent magnetic resonance (MR) imaging. In 18 patients, MR imaging was performed with both gated spin-echo and fastcard. Two observers rated the clinical utility of each sequence. Fastcard images were superior to spin-echo images in 10 patients, equivalent in seven, and inferior in one. Two additional patients with suspected pulmonary vascular lesions were accurately evaluated with the fastcard technique. The fastcard technique provides superior demonstration of thoracic cardiovascular structures and turbulent flow and enables imaging in multiple phases of the cardiac cycle.

Adolescent↗

Pulmonary angiography with MR imaging: preliminary clinical experience.

PURPOSE: To study the accuracy of magnetic resonance (MR) pulmonary angiography in 20 patients in whom pulmonary embolism (PE) was clinically suspected. MATERIALS AND METHODS: Fourteen patients (group 1) were recruited for the MR pulmonary angiography study before they underwent conventional pulmonary angiography (CPA) based on clinical findings. Six patients (group 2) did not undergo CPA but were considered to have PE on the basis of findings in other studies. MR venography was performed at the time of MR pulmonary angiography in 13 patients. RESULTS: MR pulmonary angiography had a sensitivity of 92%-100% and specificity of 62% for detection of PE. Performance of MR pulmonary arteriography and MR venography in a single examination to demonstrate thrombus in both the arterial and deep venous systems was proved feasible. CONCLUSION: This report describes an early clinical implementation of new MR pulmonary angiographic techniques. Further advances to improve specificity by enhancing sensitivity to slow flow and increasing spatial resolution are necessary before routine clinical use of MR pulmonary angiography is justified.

Adult↗