Biomedical subjects

U Klose

Publications and source records attributed to U Klose.

At least 19 recordsLinked to original sources

PubMed2006

Error images for spectroscopic imaging by LCModel using Cramer-Rao bounds.

The results of spectroscopic imaging (SI) measurements are often presented as metabolic images. If the spectra quality is not sufficient, the calculated concentrations are biased and the metabolic images show an incorrect metabolite distribution. To simplify the quality analysis of spectra measured by SI, an error image, reflecting the accuracy of the computed concentrations, can be displayed along with the metabolite image. In this paper the relevance of Cramer-Rao bounds (CRBs) calculated by the LCModel program to describe errors in estimated concentrations is validated using spectra simulations. The relation between the average CRBs and standard deviations (STD) of metabolite concentrations from 100 simulated spectra for various signal to noise ratio and line broadening conditions is evaluated. A parameter for calculating error images for metabolite ratios is proposed and an effective way to display error images is shown. The results suggest that the average CRBs are strongly correlated with the standard deviations and hence that CRB values reflect the relative uncertainty of the calculated concentrations. The error information can be integrated directly into a metabolite image by displaying only those areas of the metabolite image with corresponding CRBs below a selected threshold or by mapping CRBs as a transparency of the metabolite image. The concept of error images avoids extensive examination of each SI spectrum and helps to reject low quality spectra.

Algorithms↗

PubMed2006

Fast 3D radiofrequency field mapping using echo-planar imaging.

An inhomogeneous radiofrequency (RF) magnetic field is an essential source of error for the quantification of MRI and MRS parameters. To correct for effects of RF inhomogeneities in 3D data sets, it is necessary to have knowledge of the 3D RF distribution in the sample. In this paper a method for fast 3D RF mapping is presented. The method is based on the simultaneous acquisition of a spin echo (SE) and a stimulated echo (STE) using echo-planar imaging (EPI). The acquisition of the 3D RF map using 64 partitions and TR = 500 ms requires 1.5 min. The use of the sequence in vivo is demonstrated by the calculation of the RF maps in the human brain at 3T. The comparison of calculated flip angles with the flip angles obtained by fitting signal behavior in the 3D stimulated-echo acquisition mode (STEAM)-EPI sequence and the analysis of errors due to spatially dependent T(1) values in the brain show that the accuracy of the calculated flip angles in the human brain is about 2 degrees.

Algorithms↗

PubMed2006

Progressive multifocal leukoencephalopathy: value of diffusion-weighted and contrast-enhanced magnetic resonance imaging for diagnosis and treatment control.

Progressive multifocal leukoencephalopathy (PML) is caused by the replication of JC virus in oligodendrocytes of immunocompromised patients. Diagnosis usually relies on the polymerase chain reaction (PCR)-based demonstration of JC virus DNA in the cerebrospinal fluid. As previous reports have suggested that some patients may benefit from antiviral therapy, non-invasive early diagnosis is highly desirable. Repetitive magnetic resonance imaging (MRI) examinations (two to nine) were obtained in seven patients (aged 40-67 years, six males, one female) with classical clinical and imaging findings of PML. Five patients had underlying hematological disorders and two acquired immune deficiency syndrome. PCR of the cerebrospinal fluid (CSF) specimen was positive for JC virus DNA in six patients. MRI sequences included T2-, T1- and diffusion-weighted (DW) images in all patients and diffusion-tensor imaging (DTI) in four cases. DTI was once performed at 3T, in the remaining patients at 1.5T. All patients received antiviral treatment with cidofovir in addition to the treatment of the underlying disorder. MRI showed areas of T2 hyperintensity with involvement of the subcortical U-fibers and restricted diffusion in all patients. Areas of diffusion abnormality correlated with disease progress. Contrast enhancement was encountered once after successful treatment and heralded clinical remission with virus elimination from the CSF. Hence, MRI including DW and contrast-enhanced images may be used to evaluate disease activity. Contrast enhancement may indicate an inflammatory response and thus herald immunologic virus elimination.

Adult↗

PubMed2004

Proton MR spectroscopy in succinic semialdehyde dehydrogenase deficiency.

Succinic semialdehyde dehydrogenase (SSADH) deficiency is a rare hereditary disorder of the CNS catabolism of gamma-aminobutyric acid (GABA), leading to accumulation of the metabolite 4-hydroxybutyrate (GHB). Here the authors report on 1.5 and 3.0 T proton MR spectroscopy in a patient with SSADH deficiency. A characteristic pattern with clearly elevated GABA levels and traces of GHB was found in both the white and the gray matter of the brain. In vivo spectroscopy may be useful for diagnosis and monitoring SSADH deficiency.

Adult↗

PubMed2004

Directional correlation in white matter tracks of the human brain.

PURPOSE: To describe a technique for the detection of distinct brain fibers in sets of magnetic resonance (MR) diffusion tensor imaging (DTI) data. MATERIALS AND METHODS: MR-DTI can be used for a tractography of brain fibers presuming a data set of high spatial resolution and high signal to noise. A less demanding technique for the visualization of discrete brain fiber bundles involves segmentation. By using a region-growing algorithm, those voxels that have a direction similar to that of the major eigenvector in neighboring voxels of a data set can be marked. It has been shown recently by Mori et al (1) that this technique can be successfully applied to data from a single slice of a mouse brain. In this study, the segmentation technique was applied with modifications to multislice DTI data from the human brain. RESULTS: A distinct segmentation of various brain fiber bundles could be achieved by the use of a two-step algorithm. In the first step, voxels within large fiber tracts-such as corticofugal tracts (e.g., corticospinal tract) and the optic radiation-were segmented by starting the region-growing algorithm in the corpus callosum (CC) and erasing this major structure from the data set. In the second step, remaining voxels were segmented by the same algorithm; this revealed a good assignment of the similarly oriented fibers derived by segmentation to the anatomically given brain lobes. This two-step procedure was successfully applied to DTI data of six healthy volunteers. CONCLUSION: The segmentation technique for DTI data proposed by Mori et al (1) for data from mouse brains can be applied to multislice data from the human brain by using a two-step algorithm including a masking of the major fiber tracts.

Anisotropy↗

PubMed2004

Experimental autoimmune encephalomyelitis (EAE): lesion visualization on a 3 Tesla clinical whole-body system after intraperitoneal contrast injection.

PURPOSE: To investigate the intravital visibility of CNS lesions in rats with experimental autoimmune encephalomyelitis (EAE), the animal correlate of multiple sclerosis, using a 3-Tesla (T) whole-body MR system. MATERIALS AND METHODS: Three healthy Dark Agouti (DA) rats and 16 DA rats with clinical signs of EAE were examined on a 3T whole body-system using a normal wrist coil. In total, 25 examinations were preformed using T2- and T1-weigthed images in transverse and sagittal orientation with a slice thickness of 2 mm or 1 mm (voxel size up to 0.2 x 0.2 x 1 mm). Sedation was achieved by intraperitoneal injection of ketamine and xylazine. In addition, T1-weighted images were obtained after the instillation of 1.0 ml of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) (0.5 mmol/ml) into the peritoneal cavity. RESULTS: T2- and T1-weighted images of the brain and spinal cord with high spatial and contrast resolution could be obtained in all animals. The anatomical details of the olfactory bulb glomeruli, cerebellum foliae, ventricles and corpus callosum were clearly visible. The EAE lesions presented as hyperintense areas in T2-weighted images and could be demonstrated in all clinically affected animals by MRI and histologically verified. In total, the 16 affected rats had 28 cerebral and 2 spinal cord lesions (range 1 to 4, median 2). Contrast enhancement was noted in 12 animals and ranked as severe in ten and moderate in two cases. No adverse effects were noted due to sedation or intraperitoneal contrast injection. CONCLUSIONS: The intravital demonstration of cerebral and spinal cord EAE lesions in rats is possible on a 3T whole-body MR scanner using a normal wrist coil. Intraperitoneal injection of ketamine/xylazine and contrast agent is an easy, safe and effective procedure in rats.

Adrenergic alpha-Agonists↗

PubMed2004

The influence of pulse and respiration on spinal cerebrospinal fluid pulsation.

RATIONALE AND OBJECTIVES: The aim of the study is to elucidate the location and amount of spinal cerebrospinal fluid pulsations and to differentiate and quantify the cardiac and the respiratory influence. MATERIALS AND METHODS: An echo planar imaging sequence was applied to 5 different levels of the spinal canal of 7 healthy volunteers. The amount of maximal flow and respiratory signal variation were determined by a time and frequency domain analysis, respectively. RESULTS: CSF pulsation was high in the anterior cervical and in the thoracolumbar spine. Respiratory influence rose by 19% at C1 and by 28% at T12. The systolic flow was elevated during late expiration and the diastolic upward movement was pronounced by early expiration. CONCLUSION: The pulsation in the lower spine seems to be related to a second motor of CSF movement because there is a rising respiratory influence and a reappearance of pulsation waves. Physiological spinal CSF pulsation contains a relevant respiratory component.

Adult↗

PubMed2003

Progressive multifocal leukoencephalopathy: analysis of lesion development with diffusion-weighted MRI.

Progressive multifocal leukoencephalopathy (PML), caused by replication of JC virus in oligodendrocytes of immunocompromised patients, is diagnosed by polymerase chain reaction-based demonstration of JC virus DNA. We investigated whether MRI might be used to assess disease activity. Diffusion-weighted imaging (DWI) was obtained in two patients with PML, in whom it was the only MRI sequence on which we could identify areas of progressive disease. The extent of abnormal diffusion appeared to correlate with the speed of clinical progression. DWI would thus seem to be of value in patients with PML.

Brain↗

PubMed2003

Comparison of quantitative shear wave MR-elastography with mechanical compression tests.

The mechanical properties of in vivo soft tissue are generally determined by palpation, ultrasound measurements (US), and magnetic resonance elastography (MRE). While it has been shown that US and MRE are capable of quantitatively measuring soft tissue elasticity, there is still some uncertainty about the reliability of quantitative MRE measurements. For this reason it was decided to determine in vitro how MRE measurements correspond with other quantitative methods of measuring characteristic elasticity values. This article presents the results of experiments with tissue-like agar-agar gel phantoms in which the wavelength of strain waves was measured by shear wave MR elastography and the resultant shear modulus was compared with results from mechanical compression tests with small gel specimens. The shear moduli of nine homogeneous gels with various agar-agar concentrations were investigated. The elasticity range of the gels covered the elasticity range of typical soft tissues. The systematic comparison between shear wave MRE and compression tests showed good agreement between the two measurement techniques.

Agar↗

PubMed2003

[Enhanced MR-angiography (CE-MRA) of the supraaortic arteries: dose reduction with a contrast agent of high relaxivity (Gd-BOPTA)].

PURPOSE: Reducing the amount of contrast medium in contrast-enhanced MR-angiography (CE-MRA) of the cervical vessels could lead to considerable cost reduction. This study investigates whether the amount of contrast medium possessing high relaxivity can be reduced without loss of diagnostic information. MATERIALS AND METHODS: In a prospective study the supraaortic vessels of 40 patients were examined on a 1.5 T MR-system using 10 or 20 ml Gd-BOPTA (MultiHance). The examinations were evaluated by measurement of the signal increase in the common carotid arteries in 38 patients. Furthermore, CE-MRA was rated by two independent observers, who were blinded to the amount of contrast medium and degree of stenosis. Rating criteria were quality of arterial contrast and image impression. RESULTS: Signal increase in the carotid artery was identical for 10 and 20 ml Gd-BOPTA in 12 patients with optimal bolus timing (10 ml: 454 +/- 58; 20 ml: 458 +/- 63). Signal intensities were significantly lower for 10 ml when bolus timing was suboptimal (281 +/- 80 vs 353 +/- 65; p < 0.02). The quality of the CE-MRA using 10 and 20 ml Gd- BOPTA was rated as identical by the observers, and the amount of contrast medium used could not be deduced from the images. CONCLUSION: Image quality and signal values of the carotid arteries did not differ in CE-MRA performed with either 10 ml or 20 ml Gd-BOPTA (MultiHance) as long as the examination is adequate. Thus, cost reduction can be achieved with a reduced standard dose of 10 ml Gd-BOPTA without loss of diagnostic information.

Aged↗

PubMed2002

Alterations in diffusion and perfusion in the pathogenesis of peritumoral brain edema in meningiomas.

Magnetic resonance perfusion and diffusion studies were undertaken to clarify the significance of ischemia in the pathogenesis of peritumoral brain edema in patients with meningiomas. Included in this study were 26 patients with 27 meningiomas and 5 gliomas. Perfusion-weighted imaging (PWI) was performed using a gradient-echo, echo-planar-imaging (EPI) sequence for calculation of the relative regional cerebral blood volume (rrCBV) and the relative regional cerebral blood flow index (rrCBFi). Furthermore, multi-slice spin-echo EPI sequences were applied in order to obtain anisotropic and isotropic diffusion-weighted imaging (DWI). Apparent diffusion coefficient (ADC) values were then calculated for peritumoral brain parenchyma from tumors, with and without edema, using various diffusion sensitivities. Meningiomas without edema demonstrated a minimal increase of perfusion parameters in the peritumoral brain tissue. In contrast, cases with brain edema had highly significant ( p<0.0005) lower rrCBV and rrCBFi. The edema index (EI) correlated strongly with the rrCBV. A fitting procedure resulted into the following mathematical relation: EI=0.1/rrCBV(2). The DWI showed a significantly larger ADC value within areas of brain edema, compared with the normal white matter (0.74 x 10(-3) vs 1.55 x 10(-3) mm(2)/s; p<0.0001). Increases in EI correlated with increases in ADC values. In 31% of the meningiomas associated with edema, areas with increased signal, probable ischemia, demonstrated significantly lower ADC values, in comparison with the rest of the edematous areas. These areas were confined to tissue immediately adjacent to the tumor. In general, the decrease in rrCBV in brain edema represents a consequence from, rather than a cause of, vasogenic edema. Ischemic alterations can be regarded as secondary, facultative phenomena in the pathogenesis of meningioma-related brain edema.

Adult↗

PubMed2002

Slow rhythmic oscillations in intracranial CSF and blood flow: registered by MRI.

Since Lundberg first described slow oscillations as so called B-waves during ICP-monitoring, similar oscillations have been found in various physiological systems. Thus, the detection of slow waves in intracranial CSF- and blood-flow with MR-techniques seemed very likely. We examined the interventricular CSF-flow and cerebral blood flow of 11 healthy volunteers with dynamic echo-planar imaging by simultaneous registration of respiration and peripheral pulse. The spectral analysis was restricted to slow waves, which were divided into B-waves (0.008-0.05 Hz), Mayer- or C-waves (0.05-0.15 Hz) and respiration-related waves (0.15-0.6 Hz). In the CSF, the integrated amplitude of B-waves accounted for 18.2%, Mayer- or C-waves for 26.9% and respiration-related waves for 55.0%. Proportional values were recorded in the artery and peripheral pulse. In the venous sinus, a higher percentage of B- and Mayer-/C-waves and a lower percentage of respiration related waves were found. In conclusion, with MR-EPI technique, slow rhythmic oscillations in the cerebral blood- and CSF-flow can be analysed non-invasively and independently from the cardiac cycle. The comparable distribution of slow waves in the pulse, arteries and CSF may reflect an origin in autoregulation, whereas divergent patterns like in the incompressible venous sinus may be of a passive origin.

Adolescent↗

PubMed2001

Reliable detection of macromolecules in single-volume 1H NMR spectra of the human brain.

In short echo time proton MR spectra of the brain, resonances from macromolecules are visible. The macromolecular resonances in the 0.5-2.0 ppm region can be affected by lipid contamination arising from fat-containing regions outside the selected volume of interest (VOI). This study demonstrates that considerable lipid contamination may remain in stimulated echo acquisition mode (STEAM) spectra even if the spoiling of unwanted coherences is sufficient and the VOI is placed 2 cm or more away from fat-containing regions. The observed contamination was attributed to residual remote out-of-volume excitation, although only very small out-of-slice ripples of less than 0.2% of the in-slice excitation were found in the calculated excitation profile of the RF pulses. Spatial presaturation of fat-containing regions led to a sufficient suppression of the contamination and enabled the detection of highly reproducible macromolecular resonances. Thus, in single-volume spectroscopy as well as in spectroscopic imaging (SI or CSI), the combination of volume selection and outer volume presaturation, each in three dimensions, is highly recommended to ensure accurate detection and reliable evaluation of even small pathological alterations in macromolecules, e.g., proteins or lipids, or other resonances in the 0.5-2.0 ppm region.

Artifacts↗

PubMed2001

T(2) selectivity: comparison between different kinds of RF pulses.

Techniques allowing characterization of specific T(2) species are used to perform MR imaging of structures whose signal intensity is poor on conventional methodologies. T(2)-selective pulses can be used to discriminate signals from tissues with different T(2) values. In case of soliton pulses, the magnetization from all the T(2) species is inverted, with the exception of specific T(2) structures which have both the longitudinal and the transverse magnetization nulled on resonance. Solitons have the drawback of being very long even if the selected T(2) value is in the order of tens of milliseconds. The aim of this paper is to examine whether it is possible to use pulses shorter then solitons keeping their T(2) selectivity, that is keeping null longitudinal magnetization, while accepting some residual transverse magnetization for structures with the selected T(2). Different kinds of inversion pulses were generated, all to select the same T(2) species. Pulses performance was analyzed by studying the dependence of the residual transverse magnetization on resonance from the length of the pulse. An exponential relationship between transverse magnetization and pulse length was found, which was not dependent on the pulse type.

Journal Article↗

PubMed2001

Ultrasonography and contrast-enhanced MRA in ICA-stenosis: is conventional angiography obsolete?

BACKGROUND: The standard techniques for the screening and staging of internal carotid artery (ICA) stenosis are Doppler (continuous wave) and Duplex sonography. For the imaging of ICA occlusive disease, magnetic resonance angiography (MRA) is replacing digital subtraction angiography (DSA). The purpose of this observational study was to assess whether contrast enhanced MRA (CE-MRA) combined with ultrasound provided sufficient information for the planning of surgical treatment. METHODS: CE-MRA was performed in 195 patients (mean age 67.5 years) with sonographic evidence of severe ICA stenosis. The MRA examination protocol contained a heavily T1-weighted contrast bolus enhanced 3D-gradient echo sequence. The degree of stenosis was estimated retrospectively by two experienced neuroradiologists who were blinded to the sonographic findings. RESULTS: The consistency of MRA and ultrasound was sufficient to plan thrombendarterectomy in 182/195 patients. The estimations of the degree of stenosis were congruent between MRA and ultrasound in 91% of 197 vessels with high-degree carotid artery stenosis. CE-MRA evaluation had a high interobserver agreement. In 3 cases ultrasound examination diagnosed a filiform ICA stenosis which was not visible with MRA. In all these cases, DSA and the intraoperative findings revealed very short (1-2 mm), high-grade, excentric stenosis. CE-MRA correctly detected patency in 5 patients with high-grade and low-flow carotid artery stenosis, which had been regarded as occluded by ultrasound. Conversely with, in CE-MRA two occluded vessels were falsely considered as open. CONCLUSION: The combination of sonography and CE-MRA is a powerful tool for the non-invasive presurgical evaluation of the carotid arteries. DSA should be reserved for selected cases.

Aged↗

PubMed2001

[Illustration of elasticity differences using MR-elastography].

Differences of elasticity in tissue phantoms with inclusions of different elasticity were mapped by means of MR elastography (MRE). This new magnetic resonance imaging technique is based on the phase shift of the MR signal by switching a motion sensitizing magnetic field gradient simultaneously with the coupling of a shear wave. Wave patterns showing snapshots of the shear wave that propagates through the investigated substance were depicted in tomographic phase images. It was investigated wether a visualization of differences in elasticity of soft tissues was possible on the basis of differences in the wavelength. For this purpose, tissue phantoms with cylindrical inclusions were produced from agar gels, with agar concentrations between 1.0 and 1.5%. The diameters of the inclusions were of the order of a few centimetres. For diameters as small as 4 cm, there were still distinct differences in the wavelength between the matrix and the inclusion. The results of our study suggest that this technique has the potential for future application as an additional imaging method for tumor detection.

Agar↗

PubMed2001

Proton MR spectroscopy with metabolite-nulling reveals elevated macromolecules in acute multiple sclerosis.

Proton magnetic resonance spectroscopy has shown elevated signals in the spectral region of lipids in acute multiple sclerosis lesions. The metabolite-nulling technique allows the separation of macromolecules from other metabolites, such as lactate, N-acetyl-aspartate, creatine, choline and myo-inositol. Using this technique in studies on multiple sclerosis patients, we were able to differentiate macromolecules biochemically in acute and chronic multiple sclerosis lesions. Ten patients with acute, contrast-enhancing multiple sclerosis lesions, 10 patients with chronic lesions and 10 healthy control subjects were investigated with a 1.5 T whole body system, using a stimulated echo acquisition mode (STEAM) sequence with metabolite-nulling and outer volume saturation. Metabolites and macromolecules were quantitated absolutely. The 0.9 and 1.3 parts per million (p.p.m.) resonances of the macromolecules were significantly elevated in acute lesions compared with chronic lesions and healthy controls (P < 0.001 for 0.9 p.p.m., P < 0.05 for 1.3 p.p.m.). The macromolecular resonances at 2.1 and 3.0 p.p.m. in acute and chronic lesions were normal. N-acetyl-aspartate was significantly reduced in acute and chronic lesions compared with controls (P < 0.05 and P < 0.01, respectively). Choline was significantly elevated in acute lesions compared with controls (P < 0.05). Up to now, elevated resonances at 0.9 and 1.3 p.p.m. in acute lesions have been interpreted as lipids. In metabolite-nulled spectra, the macromolecular resonances did not fit those of lipids and might have been due to proteins or polypeptides containing the amino acids alanine, threonine, valine, leucine and isoleucine. These account for approximately 40% of the amino acids of myelin proteolipid protein and for approximately 20% of myelin basic protein. The increased macromolecular resonances at 0.9 and 1.3 p.p.m. may be interpreted as biochemical markers of myelin fragments and may be used as reliable markers of acute multiple sclerosis lesions as they provide clear discrimination among acute and chronic lesions and controls.

Acute Disease↗

PubMed2000

Response-related fMRI analysis during encoding and retrieval revealed differences in cerebral activation by retrieval success.

The aim of the study was to identify cerebral activation associated with sufficient or insufficient encoding, and with correct or false recognition. Fourteen volunteers performed two paradigms: explicit learning of words; and later retrieval of previously presented words. Items were classified according to the subjects' recognition performance. Echo-planar MRI of blood-oxygen-level-dependent signal changes was performed during encoding and retrieval. Response-related fMRI-analysis was used to compare activation associated with the subjects' retrieval success. During encoding, there was a trend towards increased activation of the left medial cingulate gyrus and of the right fusiform gyrus for later hits (correctly identified, learned target words) in comparison with misses (non-identified targets). During recognition, signal intensities associated with false alarms (falsely identified distractors) were significantly higher in left and right extrastriate cortex than those associated with hits, misses and correct rejections of distractors. Activation in the anterior cingulate gyrus during retrieval was related to reaction time and might be associated with the preparation or performance of motor response. Increased activation during false alarms might reflect a source-monitoring deficit or an increased subjective familiarity with distractors that have been most intensively processed in extrastriate visual cortex.

Adult↗