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T M Grist

Publications and source records attributed to T M Grist.

At least 37 records · Page 2Linked to original sources
PubMed2000

Single breath-hold 3D contrast-enhanced method for assessment of cardiac function.

Cardiac MRI function measurements are typically performed using 2D sequences and require multiple breath-holds to image the entire heart. A single 3D acquisition using a T(1)-shortening agent has many potential advantages over techniques that acquire multiple 2D images, including more consistent contrast and precise slice coverage. However, 3D techniques currently require much longer than a single breath-hold to complete. It has been shown that for MR angiography undersampled projection reconstruction can acquire much higher resolution per unit time than Fourier imaging with acceptable artifacts. By employing a gated, undersampled projection technique, high-resolution 3D multiphase volumes of the heart can be acquired in a single breath-hold. Short repetition times result in good myocardial suppression and a temporal aperture of 60 ms.

Contrast Media↗
PubMed2000

Magnetic resonance angiography of aorto-iliac disease.

BACKGROUND: Four different techniques for aorto-iliac magnetic resonance angiography (MRA) were assessed for accuracy using a digital subtraction angiography (DSA) gold standard. Surgeons' confidence in their ability to generate treatment plans with MRA and DSA was assessed, in consultation with a radiologist. METHODS: Two different two-dimensional (2D) time-of-flight (TOF) sequences, a phase-contrast sequence, and a contrast-enhanced (CE) MRA sequence were used. Receiver operating characteristic (ROC) curves were plotted and areas (A(z)) calculated from radiologists' readings. Surgeons' confidence in their ability to utilize the images for treatment planning was assessed with a 5-point Likert scale. Thirty-six patients were evaluated. RESULTS: CE MRA had a sensitivity, specificity, and A(z) of.92,.93, and.96, respectively, for stenoses 50% or greater. CE MRA performed better than other sequences, but the improvement compared with gated 2D TOF was not statistically significant. Interobserver agreement for CE MRA and DSA yielded identical Kappa values. Surgeons were most confident in DSA, followed by CE MRA, which was significantly preferred to other techniques. CONCLUSIONS: CE MRA closely approximates DSA in terms of diagnostic accuracy. Surgeons considering treatment plans are confident in the CE MRA technique, relative to other MRA methods.

Adult↗
PubMed2000

Impact of MR angiography on the diagnosis and management of renal transplant dysfunction.

PURPOSE: To evaluate the impact of magnetic resonance angiography (MRA) on referring physicians' diagnoses and treatment of patients with renal transplant dysfunction. MATERIALS AND METHODS: Physicians of the renal transplant service at the authors' university hospital prospectively completed questionnaires before and after MRA was performed in the evaluation of renal transplants. The questionnaires asked physicians to estimate the probability (0%-100%) of their most likely diagnosis before and after receiving the imaging information. They were also asked to provide their anticipated and final treatment plans. The authors calculated the mean gain in diagnostic percentage confidence and the proportion of patients with changed initial diagnoses or anticipated management. A paired t test was used to assess statistical significance of the gains in diagnostic percentage confidence. RESULTS: Pre-MRA and post-MRA questionnaires were prospectively completed on 31 separate patients. The mean gain in diagnostic certainty percentage from MRA was 33% (95% CI, 19%-51%; P < .001). MRA changed physicians' initial diagnoses in 20 patients (65%; 95% CI, 47%-79%). Immediate clinical management changed in 16 patients (52%; 95% CI, 35%-68%). Invasive procedures were avoided in 12 patients (39%). CONCLUSION: MRA has considerable impact on referring physicians' diagnoses and treatment of patients with suspected renal allograft dysfunction.

Adult↗
PubMed2000

Real-time MR imaging-guided passive catheter tracking with use of gadolinium-filled catheters.

PURPOSE: To test the hypothesis that real-time magnetic resonance (MR) imaging-guided passive catheter tracking is feasible with use of dilute gadolinium (Gd)-filled catheters, to determine the optimal Gd concentration required for tracking, and to measure catheter tip tracking accuracy. MATERIALS AND METHODS: The authors tested a real-time, T1-weighted, two-dimensional, spoiled gradient-recalled echo MR imaging sequence suitable for tracking catheters. In a yogurt phantom, the authors placed 5-F catheters filled with 2%-12% Gd solutions. MR imaging was performed with and without use of a projection dephaser that suppressed background signal. The authors measured signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and enhancement ratio to determine the optimal Gd concentration for catheter depiction. Catheter tip tracking accuracy was measured in an acrylic phantom with use of linear regression analysis, with goodness of fit assessed statistically with the F test. RESULTS: Peak catheter SNR, CNR, and enhancement ratios were obtained with 4%-6% Gd concentrations. Tip tracking accuracy was determined to be +/- 0.41 mm (R2 = 0.99; P < .0001). MR imaging reconstructions were displayed up to 3.1 frames/sec. CONCLUSIONS: Accurate MR imaging-guided passive catheter tracking was feasible in real-time with use of dilute Gd-filled catheters. This technique may have application in MR imaging-guided endovascular procedures.

Catheterization↗
PubMed2000

MR-guided angioplasty of renal artery stenosis in a pig model: a feasibility study.

PURPOSE: To test the hypothesis that magnetic resonance (MR) imaging can guide the percutaneous treatment of renal artery stenosis in a pig model. MATERIALS AND METHODS: Ameroid constrictors were surgically placed around six renal arteries in four pigs. After 30-36 days, all stenoses were documented by conventional x-ray aortograms. MR-guided renal angioplasty was attempted for three stenoses. For these pigs, MR angiography was performed with use of contrast-enhanced three-dimensional (3D) techniques. The authors visualized catheters by filling them with dilute 4% gadolinium and imaging with two-dimensional (2D) and 3D MR fast spoiled gradient recalled echo techniques. Under MR guidance, the authors advanced a selective catheter into the affected renal artery and crossed the stenosis with a nitinol guide wire. Angioplasty was performed with a balloon catheter filled with dilute gadolinium. Stenosis and luminal diameter measurements were compared before and after angioplasty. RESULTS: After ameroid constrictor placement, four significant stenoses, one mild stenosis, and one occlusion developed. Under MR guidance, the authors achieved technical success in performing three of three (100%) attempted dilations. After MR-guided angioplasty, the mean reduction in stenosis was 35% and the mean increase in luminal diameter was 1.6 mm. CONCLUSION: Use of MR guidance for the angioplasty of renal artery stenosis in pigs is feasible.

Angioplasty, Balloon↗
PubMed1999

Contrast-enhanced MR angiography of the carotid bifurcation.

With contrast-enhanced MR angiographic techniques, a T1-shortening contrast agent is injected into the blood stream. Imaging during the first pass of the contrast agent permits acquisition of a high-contrast MR angiogram. Scan parameters such as flip angle, repetition time, echo time, and scan duration, and injection parameters, such as dose and rate, must be carefully chosen to achieve maximum contrast between blood vessels and stationary tissues. A critical parameter affecting image quality is the timing of the acquisition relative to the injection. If the collection of the center of k-space does not coincide with peak arterial concentration, artifacts, reduced SNR, and venous enhancement may result. Several techniques have been developed to address the timing issue. Post-processing techniques such as subtracting a pre-contrast image from a post-contrast angiogram can be used to improve image quality. Intravascular contrast agents that may also lead to improved image quality are currently being developed.

Angiography, Digital Subtraction↗
PubMed1999

Contrast-enhanced three-dimensional magnetic resonance angiography of the mesenteric vasculature.

The diagnosis and treatment of mesenteric occlusive disease is important due to the high morbidity and mortality associated with ischemia of the bowel. This article describes the application of magnetic resonance angiography (MRA) as a minimally invasive tool for diagnosing mesenteric and portal vascular disease. The techniques for three-dimensional (3D) contrast-enhanced MRA and flow measurement of the mesenteric circulation are described. Excellent image quality is obtained using sagittal contrast-enhanced 3D MRA of the aorta and proximal mesenteric vessels. Delineation of the small distal mesenteric branch vessels is still limited due to the finite spatial resolution of MRA. The application of MRA techniques to the diagnosis of mesenteric ischemia, revascularization, transplantation, and portal hypertension are demonstrated. Finally, the merits of various acquisition techniques and future contrast agents are discussed. MR angiography using intravenously administered contrast agents provides the clinician with a powerful, minimally invasive method for diagnosing mesenteric vascular disease.

Contrast Media↗
PubMed1999

Design and validation of a motion stage for in vitro MR experiments.

A computer-controlled motion stage was designed to facilitate motion studies and simulations of cardiac magnetic resonance (MR) experiments. The stage was constructed to move a phantom of up to 6 kg at velocities up to 15 cm/sec along a two-dimensional trajectory within an MR scanner. The operation of the motion stage was validated and found to be accurate to within 0.08 cm in displacement and 1.5 cm/sec in velocity (root-mean-square error). No image degradation was observed.J. Magn. Reson. Imaging 1999;10:972-977.

Artifacts↗
PubMed1999

Magnetic resonance angiography of renal arterial stenosis.

Recent developments in renal magnetic resonance angiography (MRA) have led to a significant improvement in the technical success rate and diagnostic accuracy of the methods. Specifically, three-dimensional contrast-enhanced MRA methods have been shown to provide a more reliable depiction of renal artery morphology than do older MRA techniques. In addition, preliminary work using adjunctive MRA techniques suggests that it is possible to determine the hemodynamic significance of renal artery disease using MRA and magnetic resonance imaging. MRA methods will therefore likely play an important role in the evaluation of patients with renovascular disease.

Contrast Media↗
PubMed1998

3D time-resolved contrast-enhanced MR DSA: advantages and tradeoffs.

The 3D TRICKS method for contrast-enhanced, time-resolved MR DSA has been recently described. In this paper, computer simulations are used to investigate the relative frame rate, temporal window, artery-vein temporal separation, contrast-to-noise ratio, and spatial resolution of TRICKS and conventional scans for breath-hold and non-breath-hold applications. For non-breath-hold applications, TRICKS can be configured to provide increased CNR or spatial resolution at an increased frame rate, but with a longer temporal window when compared with a series of conventional scans in which the central portion of k-space is sampled at the same rate as for the TRICKS scans. For breath-hold applications, TRICKS typically provides three images with 75% of the conventional single acquisition spatial resolution and is more tolerant of variations in contrast curve shape within the field of view.

Computer Simulation↗
PubMed1998

Coronary flow and flow reserve in canines using MR phase difference and complex difference processing.

Coronary artery disease continues to be the leading cause of death for adults in the United States. Magnetic resonance imaging (MR) has the potential to dramatically impact the diagnosis of heart disease by noninvasively providing a wide range of anatomic and physiologic information. Previous research has shown that coronary flow, one component of a complete examination, can be accurately measured in the left anterior descending artery in vivo. The current work validates MR flow measurements in canine circumflex arteries using transit time ultrasound as a standard. The circumflex artery experiences greater in-plane motion and is a more stringent test for flow measurement accuracy. This work also compares two methods of processing MR velocity data, phase difference and complex difference techniques, and examines the sources of error present in the animal validation model. Phase difference processing with a 30% magnitude threshold best matched the mean ultrasound flow values (30% PD = 1.04 x US + 1.49, r = 0.94), but it was very sensitive to vessel boundary identification. The complex difference process was less sensitive to vessel boundary identification and correlated well with the transit time ultrasound despite systematic underestimations. The reasons for the discrepancies are shown to stem from a number of possible sources including variability of the ultrasound standard, low signal-to-noise ratios in the MR images, sensitivity of the MR technique to vessel boundary identification, and motion artifacts in the images.

Animals↗
PubMed1998

X-ray digital subtraction angiography to magnetic resonance-digital subtraction angiography using three-dimensional TRICKS. Historical perspective and computer simulations: a review.

Seventeen years after the introduction of x-ray digital subtraction angiography (DSA), gadolinium-enhanced magnetic resonance (MR) angiography techniques have become available for the performance of MR-DSA. For the purposes of this article, we will consider this to include two-dimensional and three-dimensional approaches using time-resolved and non-time-resolved applications. Magnetic resonance-DSA is one in a historical progression of techniques which have aimed to produce less invasive forms of angiography. After outlining some historical milestones, several current issues regarding current methods for MR-DSA are discussed.

Angiography, Digital Subtraction↗
PubMed1998

Renal magnetic resonance angiography: an update.

Recent developments in renal magnetic resonance angiography have led to a significant improvement in the technical success rate and diagnostic accuracy of the methods. Specifically, three-dimensional contrast-enhanced magnetic resonance angiography methods have been shown to provide a more reliable depiction of renal artery morphology than older techniques. In addition, recent work has shown that variations of magnetic resonance angiography methods have several important attributes that may make it feasible to demonstrate the hemodynamic significance of a renal artery stenosis. Recent data show that magnetic resonance angiography methods may be used to predict patient outcome in response to revascularization therapy.

Journal Article↗
PubMed1998

Minimizing interference from magnetic resonance imagers during electrocardiography.

Magnetic resonance imaging (MRI) allows a physician to obtain images of internal organs noninvasively. Imaging a moving organ such as the heart requires a trigger so that successive scans can be synchronized. In the case of cardiac imaging this trigger is the electrocardiogram (ECG). When a patient is in an MRI scanner he/she is subjected to both static and dynamic magnetic fields which can cause interference in the ECG. The dynamic fields consist of 8- to 64-MHz radio frequency (RF) pulses and low-frequency magnetic gradient pulses with frequency components below 100 Hz. Conventional bandpass filters are only moderately effective because the passband allows magnetic gradient-induced interference to be superimposed on the ECG, causing distortion of the signal. This paper describes a technique which can be used to remove induced MRI gradient interference from an ECG recorded on a patient inside the bore of a MRI scanner. Induced signal from an external loop is subtracted from the ECG to minimize the low-frequency interference. The gradient induced low-frequency interference was reduced to approximately 20% of its magnitude when using conventional ECG amplifiers.

Animals↗
PubMed1998

Rapid in vivo measurement of single-kidney extraction fraction and glomerular filtration rate with MR imaging.

PURPOSE: To compare the accuracy of a noninvasive magnetic resonance (MR) imaging method to rapidly determine single-kidney glomerular filtration rate (GFR) relative to findings with an accepted standard of reference. MATERIALS AND METHODS: Simultaneous inulin and MR imaging measurements of renal excretory function were performed in six small swine. Renal extraction fraction of gadopentetate dimeglumine was determined with T1 measurements of flowing blood in the renal vein and in a systemic vessel 10-300 minutes after administration. These data were correlated with standard inulin-derived measurements of single-kidney GFR obtained during the same intervals as the MR imaging measurements. Gradient-echo (GRE) and echo-planar imaging were investigated for in vivo measurement of extraction fraction. RESULTS: The MR imaging-derived measurements of extraction fraction and single-kidney GFR were not significantly different from the inulin-determined measures (P > .18). The MR imaging extraction fraction and single-kidney GFR measurements correlated with inulin-derived measurements of the same parameters (r = .74 to .89, P < .0007). CONCLUSION: T1 measurement methods with GRE and echo-planar imaging are acceptable techniques with which to measure renal excretory function in a rapid and noninvasive manner in this model. Rapid measurements of single-kidney GFR should enable studies of the response of renal hemodynamics to pharmaceutical manipulation.

Animals↗
PubMed1998

Steady-state and dynamic MR angiography with MS-325: initial experience in humans.

PURPOSE: To evaluate the imaging performance and patient tolerance of a blood-pool contrast agent (MS-325) for magnetic resonance (MR) angiography. MATERIALS AND METHODS: Imaging of peripheral and carotid vessels was performed in seven healthy volunteers in a phase I clinical trial of the gadolinium chelate MS-325. Each volunteer received an intravenous injection of 0.05 mmol/kg MS-325 over 30 seconds. Dynamic (arterial phase) and steady-state (arterial-venous phase) three-dimensional gradient-echo MR angiograms were acquired during, immediately after, and approximately 50 minutes after injection. Images were ranked (1 [poor] to 5 [excellent]) for overall image quality, and signal-to-noise ratio (S/N) and contrast-to-noise ratio (C/N) were measured by using standard techniques. RESULTS: All volunteers tolerated the procedure well. The MS-325-enhanced studies demonstrated intense vascular signal. Mean peripheral arterial C/N was 12.9 +/- 4.8 (standard deviation), 78.8 +/- 29.4, 46.1 +/- 10.9, and 41.9 +/- 14.1 for the two-dimensional (2D) time-of-flight (TOF) and the contrast material-enhanced dynamic, early steady-state, and late steady-state images, respectively. Image quality of steady-state postcontrast images was statistically significantly (P < .02) higher than that of 2D TOF images. Image quality of early and late postcontrast images was similar, but a small (10%) decrease in C/N was noted from early to late images. CONCLUSION: MS-325 provides excellent vascular and selective arterial enhancement during dynamic MR angiography. The long blood residence time also allows acquisition of steady-state images of the arteries and veins with excellent spatial resolution.

Abdomen↗