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Biomedical subjects

U Klose

Publications and source records attributed to U Klose.

At least 37 records · Page 2Linked to original sources

Detection of a relation between respiration and CSF pulsation with an echoplanar technique.

The flow of cerebrospinal fluid (CSF) through the aqueduct was studied with an echoplanar imaging technique. Images (1024) of a slice perpendicular to the aqueduct were acquired with a repetition time of 107 msec and a flip angle of 90 degrees. This imaging technique is very sensitive for flow into the selected slice, although a quantitative assessment of flow velocities is not possible. Simultaneously with the image data acquisition, data from a pulse oximeter and a respiration belt were recorded. For each data point, a delay time to the preceding cardiac pulse was determined from the recorded pulse wave. The signal intensities could then be assigned to the cardiac cycle. Each cardiac interval was assigned to one of eight respiratory phases, and an average signal curve during the cardiac interval was calculated for each respiration phase. The evaluation showed to signal maxima within the cardiac interval, which could be identified as a downward flow at 10% and an upward flow at 80% of the cardiac pulse interval by measurements with additional saturation pulses. In examinations of 22 healthy volunteers, an influence of respiration on the flow through the aqueduct was found. In spite of interindividual variability, comparable effects could be observed in all volunteers. In the late expiration phase the caudally directed flow was at its maximum, whereas the cranially directed flow was maximal in the post-inspiration phase.

Adult↗

The concreteness effect: evidence for dual coding and context availability.

The term concreteness effect refers to the observation that concrete nouns are processed faster and more accurately than abstract nouns in a variety of cognitive tasks. Two models have been proposed to explain the neuronal basis of the concreteness effect. The dual-coding theory attributes the advantage to the access of a right hemisphere image based system in addition to a verbal system by concrete words. The context availability theory argues that concrete words activate a broader contextual verbal support, which results in faster processing, but do not access a distinct image based system. We used event-related fMRI to detect the brain regions that subserve to the concreteness effect. We found greater activation in the lower right and left parietal lobes, in the left inferior frontal lobe and in the precuneus during encoding of concrete compared to abstract nouns. This makes a single exclusive theory unlikely and rather suggests a combination of both models. Superior encoding of concrete words in the present study may result from (1) greater verbal context resources reflected by the activation of left parietal and frontal associative areas, and (2) the additional activation of a non-verbal, perhaps spatial imagery-based system, in the right parietal lobe.

Adult↗

Relaxation effects on transverse magnetization using RF pulses long compared to T(2).

The transverse relaxation effects which occur during the application of optimized slice-selective Shinnar-Le Roux pulses are studied. The behavior of both longitudinal and transverse magnetization is examined, focusing the attention on changes which affect the absorption and dispersion components. Besides the reduction in amplitude, the absorption component was found to be unaffected by transverse relaxation times, whereas the dispersion component was strongly distorted. A comparison between the distortion components from pulses having same length but different bandwidths is given.

Magnetic Resonance Spectroscopy↗

Interindividual variation of cerebral activation during encoding and retrieval of words.

The aim of the present study was to compare the cerebral activation associated with encoding and retrieval in individual subjects with the average activation in the same group of subjects. Twelve volunteers performed two paradigms: 1) intentional encoding of words, and 2) recognition of learned words intermixed with new distracters. Echo-planar magnetic resonance imaging (MRI) of BOLD signal changes was used to compare cerebral activation between active and resting conditions. During encoding, activation of the left precentral gyrus related to the motor response was observed in some subjects. Averaged data showed increased activation of the left precentral gyrus, the supplementary motor area (SMA), the left inferior frontal gyrus and in the left temporo-occipital junction. During recognition, motor response-related activity was found in the precentral cortex and SMA in most subjects. Activation in other brain areas showed considerable interindividual variation. In the entire group, recognition showed activation of the left dorsolateral prefrontal cortex, the precentral gyrus, the SMA, and the temporo-occipital junction. The total amount and the distribution of task-related cerebral activation varies considerably between individuals and might correspond to individual preferences of cognitive strategies. The investigation of these interindividual variations will be an exciting scientific challenge in the near future.

Adult↗

MR imaging and (1)H spectroscopy of brain metabolites in hepatic encephalopathy: time-course of renormalization after liver transplantation.

PURPOSE: To evaluate changes in hydrogen 1 magnetic resonance (MR) spectroscopic findings in overt or subclinical hepatic encephalopathy (HE) after liver transplantation and to compare these changes with clinical outcomes and basal ganglia high signal intensity (BGH). MATERIALS AND METHODS: Twenty-two patients scheduled for liver transplantation and 17 healthy control subjects were examined with (1)H MR spectroscopy and standard nonenhanced MR imaging. Eight patients underwent complete MR imaging and (1)H spectroscopic examinations before liver transplantation and at 3-4-week, 12-28-week, and 10-12-month follow-up after liver transplantation. RESULTS: Before liver transplantation, typical (1)H spectroscopic changes-decreased myo-inositol (mI)/creatine (Cr) and choline (Cho)/Cr ratios and an elevated glutamine and glutamate (Glx)/Cr ratio-were found in 21 patients. Eighteen patients had BGH at T1-weighted imaging. Three to 7 months after liver transplantation, the mI/Cr and Glx/Cr ratios were within the normal range in five of eight and eight of eight patients, respectively, without any residual signs of subclinical or overt HE; however, at MR imaging, seven patients still had BGH. CONCLUSION: After successful liver transplantation, renormalization of HE-specific brain metabolite changes is detected at (1)H spectroscopy and precedes the disappearance of BGH. The neuropsychologic signs of subclinical or overt HE follow the changes seen at (1)H spectroscopy rather than those seen at MR imaging.

Adult↗

Role of hydrodynamic processes in the pathogenesis of peritumoral brain edema in meningiomas.

OBJECT: In a prospective study, 28 patients with 32 intracranial meningiomas were examined to determine the role of hydrodynamic interaction between tumor and surrounding brain tissue in the pathogenesis of peritumoral brain edema. METHODS: Gadolinium-diethylenetriamine pentaacetic acid (Gd-DPTA), an extracellular contrast agent used for routine clinical imaging, remains strictly extracellular without crossing an intact blood-brain barrier. Therefore, it is well suited for investigations of hydrodynamic extracellular mechanisms in the development of brain edema. Spin-echo T1-weighted magnetic resonance images were acquired before and after intravenous administration of 0.2 mmol/kg Gd-DPTA. Additional T1-weighted imaging was performed 0.6, 3.5, and 6.5 hours later. No significant Gd-DPTA diffused from tumor into peritumoral brain tissue in 12 meningiomas without surrounding brain edema. In contrast, in 17 of 20 meningiomas with surrounding edema, contrast agent in peritumoral brain tissue was detectable after 3.5 hours and 6.5 hours. In three of 20 meningiomas with minimum surrounding edema (<5 cm3), contrast agent effusion was absent. After 3.5 hours and 6.5 hours strong correlations of edema volume and the maximum distance of contrast spread from the tumor margin into adjacent brain parenchyma (r = 0.84 and r = 0.87, respectively, p < 0.0001) indicated faster effusion in larger areas of edema. CONCLUSIONS: The results of this study show that significant contrast agent effusion from the extracellular space of the tumor into the interstitium of the peritumoral brain tissue is only found in meningiomas with surrounding edema. This supports the hypothesis that hydrodynamic processes play an essential role in the pathogenesis of peritumoral brain edema in meningiomas.

Adult↗

Activation of human language processing brain regions after the presentation of random letter strings demonstrated with event-related functional magnetic resonance imaging.

This study addresses the question, to what extent the processing of meaningless random letter strings involves classical language related brain regions. Using event-related functional magnetic resonance imaging (fMRI), which allows random stimulus presentation, we could demonstrate activation in the left inferior frontal gyrus, the left superior temporal gyrus, left parietal and occipital regions after the presentation of random letter strings compared to real words. The activation in these classical language related brain areas reflects an intense lexical evaluation process of the meaningless stimuli. Real words contrasted with random letter strings activated the left angular gyrus, bilateral precuneus and the left posterior cingulate gyrus, which may reflect the access of higher semantic associations.

Adult↗

Functional MRI of cerebral activation during encoding and retrieval of words.

The aims of the present study were to identify the cerebral structures associated with encoding and retrieval of verbal material. To circumvent the inherent disadvantages of the conventional block designs used in functional magnetic resonance imaging (MRI), an event-related design compared activation related to randomly intermixed old and new words during recognition. To support the validity of results, both nonparametric analyses in regions of interest (ROI) and statistical parametric mapping (SPM 96) were used. Twelve healthy volunteers, ages 22-35 years, performed three tasks: intentional encoding of words, recognition of old (previously learned) words, and discrimination between words and nonwords, a task to control for visual input and motor output during recognition. Echo-planar magnetic resonance imaging of blood-level, oxygen-dependent, task-related changes was used to compare cerebral activity under active and resting conditions as well as to detect event-related activity within blocks of trials. Comparable results were obtained following nonparametric statistical analysis of selected ROI and SPM. Encoding of words was associated with increased activity in the left inferior frontal gyrus, including Broca's area and in the left parietal association cortex. Event-related data analysis revealed activation of the right medial frontal gyrus, the right anterior cingulate gyrus, and parietal association cortices during recognition of previously presented words. In the lexical decision task, words in comparison with nonwords were associated with activation of the left parietal association cortex. The right medial frontal gyrus, the right anterior cingulate gyrus, and the right parietal association cortex are likely to be involved in episodic memory functions during recognition of previously presented verbal material. The comparison of event-related activation occurring within one trial block instead of among several trial blocks may significantly improve the performance of memory studies.

Adult↗

Optimized Shinnar-Le Roux RF 180 degrees pulses in fast spin-echo measurements.

Optimized Shinnar-Le Roux (SLR) pulses have very good slice profiles with no sidelobes and very small out-of-slice ripples with nearly constant amplitude. In multislice fast spin-echo (FSE) imaging, a better slice definition changes the stimulated echo (STE) and magnetization transfer (MT) contribution on contrast and signal. We investigated the effects of STE and MT on signal and contrast enhancement when optimized 180 degrees SLR pulses are used in multislice FSE measurements. From the results obtained in both phantom and volunteer studies, it can be inferred that using optimized 180 degrees SLR pulses with band-widths larger than that of the conventional 180 degrees sinc-pulse allows significant signal improvement and contrast enhancement.

Algorithms↗

Echo planar perfusion imaging with high spatial and temporal resolution: methodology and clinical aspects.

The purpose of the present study was to analyse specific advantages of calculated parameter images and their limitations using an optimized echo-planar imaging (EPI) technique with high spatial and temporal resolution. Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) was performed in 12 patients with cerebrovascular disease and in 13 patients with brain tumours. For MR imaging of cerebral perfusion an EPI sequence was developed which provides a temporal resolution of 0.68 s for three slices with a 128 x 128 image matrix. To evaluate DSC-MRI, the following parameter images were calculated pixelwise: (1) Maximum signal reduction (MSR); (2) maximum signal difference (delta SR); (3) time-to-peak (Tp); and (4) integral of signal-intensity-time curve until Tp (SInt). The MSR maps were superior in the detection of acute infarctions and delta SR maps in the delineation of vasogenic brain oedema. The time-to-peak (Tp) maps seemed to be highly sensitive in the detection of poststenotic malperfused brain areas (sensitivity 90%). Hyperperfused areas of brain tumours were detectable down to a diameter of 1 cm with high sensitivity (> 90%). Distinct clinical and neuroradiological conditions revealed different suitabilities for the parameter images. The time-to-peak (Tp) maps may be an important advantage in the detection of post-stenotic "areas at risk", due to an improved temporal resolution using an EPI technique. With regard to spatial resolution, a matrix size of 128 x 128 is sufficient for all clinical conditions. According to our results, a further increase in matrix size would not improve the spatial resolution in DSC-MRI, since the degree of the vascularization of lesions and the susceptibility effect itself seem to be the limiting factors.

Adult↗

Improvement of the acquisition of a large amount of MR images on a conventional whole body system.

Modern whole body MR systems are equipped with echo-planar-imaging capability, which allows the measurement of a single slice in a fraction of a second or of thousands of images in few minutes. A considerable restriction to the acquisition of series containing large amounts of images in patient examinations is the time-consuming data handling time of the images at conventional systems, which includes the time to insert the images into the systems database. We propose the arrangement of several images on a new image with a large matrix size like a mosaic. The handling time depends mostly on the number of images without consideration of their matrix size. Therefore, image handling is strongly reduced by the use of such mosaic images.

Data Collection↗

Elimination of residual lipid contamination in single volume proton MR spectra of human brain.

Short echo time 1H NMR spectra of the human brain reveal signals from various metabolites. In addition, resonances from macromolecules are present that may provide further useful information in several brain diseases. The detection of all these signals is possible if excellent volume selection is obtained; even small lipid contamination from surrounding fat tissue leads to strong spectral contamination. It affects the macromolecule resonances in the 0.5 to 2.0 ppm region and some adjacent metabolite signals and jeopardizes their quantitative analysis. This paper demonstrates how spatial contamination from insufficiently dephased signals can be recognized, analysed, and removed in localized STEAM spectroscopy of the brain.

Adipose Tissue↗

Dynamic pattern of brain activation during sequencing of word strings evaluated by fMRI.

An impaired ability to recite highly automated word strings (e.g., the names of the months of the year) in reverse order concomitant with preserved production of the conventional sequence has been considered a salient sign of frontal lobe dysfunction. Using functional magnetic resonance imaging (fMRI), the spatial and temporal pattern of brain activation during covert performance of these tasks was evaluated in healthy subjects. As compared to the response obtained during forward recitation, re-sequencing of the word string yielded additional activation of the bilateral middle and inferior frontal gyri, the posterior parietal cortex and the left anterior cingulate gyrus. The prefrontal responses are in accordance with the clinical findings referred to. However, the set of activated areas, as a whole, presumably reflects contribution of the various components of the working memory system to the sequencing of word strings. During successive periods of task administration, subjects showed a linear increase of production speed. Analysis of corresponding dynamic changes of regional hemodynamic responses revealed a significant increase at the level of the left inferior parietal cortex and a decrease within the mesial aspect of the left superior frontal gyrus. Presumably, the former finding reflects increasing demands on the phonological short-term memory store, due to faster updating of its content under increased word production rate. Decreasing activation within the superior frontal gyrus might indicate contribution of this area to the initiation of the cognitive processes subserving the sequencing of verbal items. These findings demonstrate the capability of fMRI as a powerful tool for the analysis of dynamic brain activation.

Adult↗

[The significance of morphological changes in the brain-tumor border area for the pathogenesis of brain edema in meningiomas: magnetic resonance tomographic and intraoperative studies].

PURPOSE: The aim of the study was to verify a possible correlation between macroscopic changes of the brain-tumor interface (BTI) and the development of a peritumoral brain edema in meningiomas. METHODS: 27 meningiomas were investigated in this prospective study using an optimized inversion-recovery (IR) sequence. After i.v. administration of 0.2 mmol Gd-DTPA/kg axial and coronary images were acquired (slice thickness = 2 mm). The distances of signal altered cortex and obliterations of the subarachnoid space (SAS) were measured at the BTI and related to the pial tumor circumference (cortical-index and SAS-index). Intraoperatively the BTI was divided into the following categories: 0: SAS not obliterated, 1: SAS partially obliterated, 2: direct contact between tumor and white matter, 3: tumor infiltration into brain. RESULTS: Edema-associated meningiomas showed a significantly (p = 0.0001) increased SAS-index (0.47 vs. 0.07) and cortical index (0.45 vs. 0.0) compared to cases without edema. Intraoperatively 95% of meningiomas with brain edema showed SAS-obliterations, compared to 50% of cases without an edema. CONCLUSIONS: Arachnoid adhesions at the BTI with obliteration of the SAS seem to play an essential role in the induction of brain edema in meningiomas.

Adult↗

[Optimization of numerical measurement parameters for ECG-triggered MRI snapshot-FLASH myocardial perfusion studies].

BACKGROUND AND AIMS: In MR examinations of myocardial perfusion by the use of Snapshot-FLASH sequences it is of major importance that the achievable signal difference between pre- and normal postcontrast myocardium be maximized. METHODS: In ECG-triggered Snapshot-FLASH sequences the signal intensity of the myocardium depends on the flip angle alpha, the inversion time TI and the trigger delay TD (both depending on the cardiac frequency f) for unchanged slice thickness (SL), matrix size (MA), repetition time (TR) and echo time (TE). Therefore a simulation of the signal behavior of pre- and postcontrast myocardium based on Bloch's equations was performed by varying the flip angle alpha, TI and TD for different cardiac frequencies in order to determine an optimized combination of the measurement parameters. RESULTS: In normal heart rates (50-70 beats/min) maximal signal differences between pre- and normal postcontrast myocardium can be reached for inversion times TI = 170-200 ms and a flip angle alpha = 11 degrees. For higher heart rates again alpha = 11 degrees and TI = 200-220 ms with shortened TD (TD = 0 for f > 90 beats/min) were found to be optimal. The calculated values were semiquantitatively confirmed in phantom and volunteer measurements. CONCLUSIONS: The described method allows cardiac frequency dependent optimization of the Snapshot-FLASH measurement parameters alpha, TI and TD in order to reach a maximum in signal contrast between normal and malperfused myocardium.

Computer Graphics↗

[MR proton spectroscopy to monitor the concentration changes in cerebral metabolites following a TIPS placement].

BACKGROUND AND AIMS: In chronic liver dysfunction with portal hypertension the risk of variceal bleeding can be lowered by intrahepatic portosystemic shunting (TIPS). Although less pronounced than in surgical shunting, hepatic encephalopathy (HE) is a well-known undesired side effect. In cerebral proton MR spectroscopy (MRS), HE can be detected by a specific pattern of brain metabolite changes (increase of glutamine/glutamate (Glx) and decrease of myo-inositol (ml) and choline (Cho)). The aim of this study was to examine whether, after TIPS implantation, there is a correlation of the reduction of the portosystemic pressure gradient (PSPG) and the cerebral metabolite changes and their correspondence to the clinical status. METHODS: We examined 10 cirrhotic patients (Child B, C) before and 3-20 days after TIPS implantation. Clinical examination was performed by a senior hepatologist. Localized MR spectra were acquired in parieto-occipital gray/white matter using a short echo time (TE = 5 ms) STEAM sequence. RESULTS: After TIPS we found an increase of Glx/(Cr + PCr) of 13%-40% and a decrease of ml(Cr + PCr) of 6%-46% with a positive (Glx: r = 0.71) respectively negative (ml: r = -0.59) correlation to the reduction of the PSPG. 7/10 patients with a reduction of the PSPG of more than 9 mmHg (9-17 mmHg) showed a clinical impairment of their HE. CONCLUSIONS: Short echo time cerebral MRS allows detection of finest HE specific metabolite changes and can therefore contribute positively to an individually optimized reduction of the PSPG during TIPS implantation.

Adult↗

[The characteristic values in the MR study of cerebral blood flow with high spatial and temporal resolution].

PURPOSE: Different parameters for the evaluation of perfusion studies with dynamic MR measurements after the administration of paramagnetic contrast agent were compared. METHOD: An echo planar imaging (EPI) sequence was developed that allows dynamic multi-slice data acquisition. Evaluations of the measurements were performed by calculating parameter maps. Phenomenological quantities such as maximal signal reduction and time to peak as well as derived quantities such as approximations of the regional cerebral blood volume were used as parameters. Patients with a low grade astrocytoma, with an acute cerebral infarction and with stenoses of the carotid arteries were examined. RESULTS: On comparison of the derived parameters with the phenomenological parameters no major differences were found in qualitative comparisons of the parameter maps. The comparison of relative parameter values in selected regions within the datasets of 20 patients show a high correspondence between phenomenological and derived parameter values. CONCLUSIONS: Using EPI measurement techniques with high temporal resolution, parameter maps of simple values like maximal signal reduction and time-to-peak are sufficient to visualize relative differences of perfusion within the selected slices. However, the calculation of relative rCBV and rCBF values might be helpful for the detailed characterization of signal courses in selected regions.

Acute Disease↗

Activation of cortical and cerebellar motor areas during executed and imagined hand movements: an fMRI study.

Brain activation during executed (EM) and imagined movements (IM) of the right and left hand was studied in 10 healthy right-handed subjects using functional magnetic resonance imagining (fMRI). Low electromyographic (EMG) activity of the musculi flexor digitorum superficialis and high vividness of the imagined movements were trained prior to image acquisition. Regional cerebral activation was measured by fMRI during EM and IM and compared to resting conditions. Anatomically selected regions of interest (ROIs) were marked interactively over the entire brain. In each ROI activated pixels above a t value of 2.45 (p<0.01) were counted and analyzed. In all subjects the supplementary motor area (SMA), the premotor cortex (PMC), and the primary motor cortex (M1) showed significant activation during both EM and IM; the somatosensory cortex (S1) was significantly activated only during EM. Ipsilateral cerebellar activation was decreased during IM compared to EM. In the cerebellum, IM and EM differed in their foci of maximal activation: Highest ipsilateral activation of the cerebellum was observed in the anterior lobe (Larsell lobule H IV) during EM, whereas a lower maximum was found about 2-cm dorsolateral (Larsell lobule H VII) during IM. The prefrontal and parietal regions revealed no significant changes during both conditions. The results of cortical activity support the hypothesis that motor imagery and motor performance possess similar neural substrates. The differential activation in the cerebellum during EM and IM is in accordance with the assumption that the posterior cerebellum is involved in the inhibition of movement execution during imagination.

Adult↗