Biomedical subjects

V M Runge

Publications and source records attributed to V M Runge.

At least 127 records · Page 7Linked to original sources

PubMedDate not supplied

High-dose gadoteridol in MR imaging of intracranial neoplasms.

Twelve patients with a high suspicion of brain metastases by previous clinical or radiologic examinations were studied in a phase III investigation with magnetic resonance (MR) imaging at 1.5 T after a bolus intravenous injection of 0.1 mmol/kg gadoteridol followed at 30 minutes by a second bolus injection of 0.2 mmol/kg gadoteridol. All lesions were best demonstrated (showed greatest enhancement) at the 0.3-mmol/kg (cumulative) dose, with image analysis confirming signal intensity enhancement in the majority of cases after the second gadoteridol injection. More lesions were detected with the 0.3-mmol/kg dose than with the 0.1-mmol/kg dose, and more lesions were detected with the 0.1-mmol/kg dose than on precontrast images. In this limited clinical trial, high-dose gadoteridol injection (0.3-mmol/kg cumulative dose) provided improved lesion detection on MR images specifically in intracranial metastatic disease.

Adult↗

PubMedDate not supplied

Contrast-enhanced MR angiography.

Magnetic resonance (MR) angiography, although still in its infancy, is recognized as a valuable diagnostic tool. Investigation of the utility of contrast media as applied to MR angiography is, to no surprise, preliminary. In restricted instances, with present techniques, contrast media-enhanced MR angiography can provide additional valuable diagnostic information. Inspection of two-dimensional images (as opposed to three-dimensional projections) and comparison of MR images before and after administration of contrast agent are particularly important. Improved visualization of intracranial aneurysms, arteriovenous malformations, venous anomalies, and arterial occlusions has been demonstrated on three-dimensional time-of-flight MR angiograms after intravenous administration of a gadolinium chelate, relative to studies performed before administration of the contrast agent.

Animals↗

PubMedDate not supplied

Efficacy and safety of gadopentetate dimeglumine in the evaluation of patients with a suspected tumor of the extracranial head and neck.

The clinical efficacy and safety of gadopentetate dimeglumine as a paramagnetic contrast agent for magnetic resonance (MR) imaging of the extracranial head and neck was evaluated in a multicenter trial involving 60 patients. Patients with signs and/or symptoms of a tumor in the nasopharynx, oropharynx, hypopharynx, larynx, or neck were studied. T1-weighted images were obtained before and after injection of gadopentetate dimeglumine, 0.1 mmol/kg, at a rate of 10 mL/min. No lesions were seen on the pre- or postinjection images of five of the 60 patients. Postinjection lesion enhancement was present in 53 of the remaining 55 (96%) patients. The absence of postinjection lesion enhancement in one of the two remaining patients was useful information. Postinjection impressions differed from preinjection diagnosis in 22 of 60 (37%) patients. Additional information was obtained from postinjection relative to preinjection images in 38 of 60 (63%) patients. Four adverse experiences were reported in three of 60 (5%) patients. Two mild (chest wall pain and headache) and one moderate (nausea) adverse experiences were considered by the authors to be unrelated to the studied drug. One severe adverse experience was reported. This patient had a seizure, considered by the investigator to be remotely related to the study drug and attributed to the abrupt withdrawal of anticonvulsant medications. The data indicate that gadopentetate dimeglumine is safe and efficacious in the evaluation of patients with extracranial head and neck lesions.

Adolescent↗

PubMedDate not supplied

Contrast-enhanced MR imaging of the liver.

Postcontrast images with a 0.1 mmol/kg dose of a gadolinium chelate with extracellular distribution, when acquired dynamically during breath holding, can improve both differential diagnosis and lesion recognition in liver MR imaging. Initial results at 0.3 mmol/kg, compared with 0.1 mmol/kg, suggest a substantial improvement in lesion identification at the high dose, as assessed by using signal intensity difference divided by noise. Of the gadolinium chelates with predominantly renal excretion, only gadoteridol is presently approved in the United States at the high dose, with limited clinical evaluation for liver imaging performed to date. For linear chelates, such as gadopentetate dimeglumine and gadodiamide injection, the degree to which release of free gadolinium ion occurs is a possible issue because of lower in vivo stability (42,43). Preliminary results with hepatobiliary gadolinium chelates and iron particulate agents are favorable with regard to efficacy, although these agents remain in clinical trials.

Animals↗

PubMedDate not supplied

Gadoteridol dose dependence in MR imaging of a liver abscess model.

A necrotic liver abscess model was studied with magnetic resonance (MR) imaging at 1.5 T before and after intravenous administration of gadoteridol at doses of 0.1, 0.25, and 0.5 mmol/kg in 24 rabbits. Enhancement characteristics and lesion delineation were assessed with both breath-hold and non-breath-hold imaging techniques. Lesion delineation, as assessed both by signal intensity measurements and evaluations by two image readers blinded to imaging technique, was greatest on high-dose (0.5 mmol/kg) breath-hold images. Lesion rim enhancement was seen consistently only on postcontrast images obtained at a dose of 0.5 mmol/kg and progressed with time after injection of contrast material.

Animals↗

PubMedDate not supplied

Repeat cerebral blood volume assessment with first-pass MR imaging.

The feasibility of performing multiple first-pass studies with dynamic, contrast material-enhanced magnetic resonance (MR) imaging was evaluated in a cat model of acute middle cerebral artery (MCA) ischemia. Two dynamic series of SSFP (steady-state free precession) images were acquired in each animal (n = 5) with a conventional 1.5-T imager. The initial first-pass study was acquired at 60 minutes after MCA occlusion, and the second study at 70 minutes, with each performed during an intravenous bolus injection of a 0.5 mmol/kg dose of gadoteridol. In both first-pass studies, differentiation of normal and ischemic gray and white matter was highly statistically significant. At a threshold of P < .01, no statistically significant difference in the peak signal intensity between the first and second studies was noted. A difference between the two studies in the recovery to baseline was seen, presumably due to T1 effects. First-pass MR studies can be repeated within the time frame of a single clinical examination, expanding their utility.

Animals↗

PubMedDate not supplied

MR imaging detection of cerebral metastases with a single injection of high-dose gadoteridol.

The utility of a single high-dose (0.3 mmol/kg) injection of gadoteridol, a gadolinium chelate, in the detection of brain metastases on magnetic resonance images was studied. Patients (n = 29) with a high suspicion for brain metastases at clinical examination and by history were imaged on two occasions--separated by more than 24 hours and less than 7 days--with a 0.1 mmol/kg contrast agent dose used for the first study and a 0.3 mmol/kg dose for the second. In patients (n = 15) with confirmed brain metastases by clinical, radiologic, and/or histologic criteria, 40 lesions were detected at the 0.3 mmol/kg dose by a single reader blinded to contrast agent dose, compared with 33 lesions at 0.1 mmol/kg, a 21% increase. Three of 15 patients (20%) demonstrated an increase in the number of lesions detected at the higher dose. Region-of-interest analysis of signal intensity measurements showed that lesion contrast (relative to normal brain) improved from 54% at 0.1 mmol/kg to 92% at 0.3 mmol/kg. A 0.3 mmol/kg dose of gadoteridol, administered in a single injection, permits identification of brain metastases not detected at 0.1 mmol/kg. Such information can influence the choice of therapy.

Adolescent↗

PubMedDate not supplied

Principles of contrast enhancement in the evaluation of brain diseases: an overview.

Intravenous contrast media are widely used in MR imaging of the brain. Clinical utility is high in both neoplastic and non-neoplastic disease. The agents approved to date are all gadolinium chelates, with extracellular distribution and renal excretion. The agents differ in regard to the maximum dose that can be administered and the theoretical safety margin. When administered at the same dose, the efficacy of the different available agents is comparable. Described in the following review article are the diagnostic use of contrast media and the patterns of enhancement encountered in neoplastic disease, infection, vascular disorders, and diseases of white matter. Only in congenital brain disease, when acute abnormalities are not suspected clinically and neoplastic disease is not a question, is contrast enhancement not indicated. The gadolinium chelates play a major role in the evaluation of patients by MR with known or suspected brain disease. These agents improve both the sensitivity and specificity of the examination. In many cases, lesions cannot be identified before contrast administration. Lesion delineation, assessment of lesion activity, and differential diagnosis are all improved, in general, with the addition of postcontrast scans. The scope of applications continues to expand as the modality and clinical experience matures.

Brain Diseases↗

PubMedDate not supplied

Fast imaging and other motion artifact reduction schemes: a pictorial overview.

Since 1982, a number of techniques have been introduced for the purpose of reducing motion artifacts in magnetic resonance imaging. These are reviewed with an emphasis on effectiveness and clinical practicality. Physical restraints, data averaging, and gradient moment nulling are widely used at present. Fast imaging techniques, particularly with the advent of saturation pulses (to diminish arterial and venous pulsation artifacts), may be utilized in the future to obtain diagnostic quality abdominal and pelvic images during breath holding.

Abdomen↗

PubMedDate not supplied

Paramagnetic NMR contrast agents. Development and evaluation.

Paramagnetic ions could be theoretically used as NMR contrast agents because of their effect upon T1. However, the toxicity of these ions prevents their application. By the formation of appropriate chemical complexes with these ions, the toxicity of these agents can be substantially reduced while maintaining the paramagnetic effect. Two potential NMR contrast agents, one for oral use and one for intravenous administration, were developed and evaluated both in vitro and in vivo. The effect upon T1 in vitro of these paramagnetic compounds was determined using a JEOL FX-90Q NMR spectrometer. These agents were evaluated in vivo in dogs with a Technicare 0.3 tesla superconducting magnet system and in rabbits with the Aberdeen 0.04 tesla resistive NMR imager. Using calculated T1 NMR images, a nontoxic dose of gadolinium oxalate provided visualization of the gastrointestinal tract. Intravenous administration of chromium EDTA provided enhancement of the kidneys, ureters, and bladder, thereby potentially allowing for the evaluation of renal function with magnetic resonance imaging. Stable paramagnetic complexes can serve as effective, nontoxic, oral and intravenous NMR contrast agents.

Administration, Oral↗

PubMedDate not supplied

A comparison of two MR hepatobiliary gadolinium chelates: Gd-BOPTA and Gd-EOB-DTPA.

PURPOSE: Two gadolinium chelates with partial hepatobiliary excretion, Gd-BOPTA and Gd-EOB-DTPA, and one gadolinium chelate with exclusively renal excretion, Gd-HP-DO3A, were compared on MRI at 1.5 T. The time course of enhancement for normal liver, gallbladder, spleen, kidney, and muscle was specifically examined in the rhesus monkey. METHOD: Four animals were evaluated with each agent for a total of 12 MR studies. Breath-hold and non-breath-hold T1 weighted scans were acquired prior to and 1, 2, 3, 4, 5, 15, 30, 45, 60, 75, and 90 min after intravenous contrast medium injection. The same contrast dose, 0.1 mmol/kg, was used for all studies. Images were analyzed by region-of interest measurements. RESULTS: Both hepatobiliary gadolinium chelates achieved sustained enhancement of normal liver parenchyma, superior in magnitude to that following Gd-HP-DO3A injection. On sans 45-90 min following injection, liver enhancement with Gd-BOPTA was superior to that with Gd-EOB-DTPA. This difference was, however, not statistically significant. Liver enhancement decreased more rapidly on delayed scans with Gd-EOB-DTPA than with Gd-Bopta, a result that was statistically significant. Excretion of contrast agent into the gallbladder was noted with both hepatobiliary agents but not with Gd-HP-DO3A. CONCLUSION: Enhancement of normal liver parenchyma peaks at a later time after injection with Gd-BOPTA than with Gd-EOB-DTPA. However, the maximum percent enhancement is comparable when (as in the current evaluation) the two agents are compared at the same dose (0.1 mmol/kg). This finding supports the choice of optimal imaging time post contrast agent administration (for delayed scans) in clinical trials of 20-45 min post injection with Gd-EOB-DTPA and 60-120 min post injection with Gd-BOPTA.

Animals↗

PubMedDate not supplied

Artifacts due to residual magnetization in three-dimensional magnetic resonance imaging.

An artifact is identified in magnetic resonance images produced by the three-dimensional FLASH technique, which features a short repetition time TR. The artifact is caused by differential spoiling of transverse magnetization by the phase-encoding gradients. The image intensity in different slices becomes altered, especially for short TR and large flip angle, which are conditions for achieving strong T1-weighted contrast. The effectiveness of spoiler gradient and rephasing gradients in suppressing the artifact is evaluated experimentally in images of a uniform phantom. Spoiler gradients that are incremented in amplitude cause even more slices to deviate in intensity, and are therefore less effective than in two-dimensional techniques. Rephasing gradients make the slices uniformly intense, but also enhance the intensity of tissues that have longer T2. The further addition of constant spoiler gradients has reduced this intensity increase by one-half and allowed for an intensity difference between white matter and gray matter comparable to without a rephasing gradient.

Diagnostic Errors↗

PubMedDate not supplied

Cerebral infarction: assessment of patterns using ultra-fast MR contrast imaging.

We describe a rapid MR imaging technique, applying functional analysis to images obtained during the tissue transit of injected contrast material into the cerebral circulation, which has potential for assessment of the altered hemodynamics in cerebral ischemia. This technique utilized turbo-FLASH imaging maximizing the T1 relaxivity properties of gadopentetate dimeglumine with positive contrast enhancement.

Cerebral Infarction↗

PubMedDate not supplied

Cerebral hemodynamics and cerebral blood volume: MR assessment using gadolinium contrast agents and T1-weighted Turbo-FLASH imaging.

PURPOSE: To assess the degree and regional pattern of first-pass brain enhancement using dynamic MR imaging. MATERIALS AND METHODS: Ultrafast MR imaging (1.06-second acquisition time per image) was performed in 19 healthy subjects following a bolus IV injection of a gadolinium contrast agent; 36 patients with suspected pathology were studied using the same protocol. RESULTS: Calculated percent blood volumes were 4.9% for right cortical gray matter, 4.8% for left cortical gray matter, and 2.6% for white matter. Subtraction images were obtained that depicted the first pass "blood pool" pattern of enhancement (gray and white matter) which was significant. CONCLUSION: Preliminary evidence suggests utility for cerebral "blood pool" imaging, especially if reduced image acquisition times can be achieved.

Adult↗

PubMedDate not supplied

Magnetic resonance imaging in ischemic injury after heart transplantation in rats.

Magnetic resonance imaging with and without gadolinium (Gd)-DTPA has been shown to enable detection of coronary occlusive ischemic injury and heart transplant rejection. This study was performed to examine findings on magnetic resonance images associated with ischemic injury after heart transplantation in rats. Magnetic resonance imaging was performed immediately before death in 22 rats, between 1 and 90 days after isogeneic (Lewis grafts, Lewis host; or Fischer graft, Fischer host) heterotopic heart transplantation. Ischemic injury, characterized histologically by cellular infiltration or myocyte necrosis, correlated inversely with graft duration. It was graded as moderate to severe in 5 of 5 rats killed at 1 to 2 days, and in 0 of 9 animals killed at greater than or equal to 30 days. T2-weighted myocardial signal intensity (TR = 2.3 seconds; TE = 90 milliseconds) correlated inversely with graft duration and was significantly greater in grafts with moderate or severe histologic abnormalities than in grafts with absent or minimal changes. GD-DTPA-induced myocardial enhancement was judged on T1-weighted images (TR = 0.5 seconds, TE = 25 milliseconds). Areas of intense enhancement were present in all seven grafts with severe histologic abnormalities, but in only 3 of 15 grafts with absent to moderate histologic abnormalities. In conclusion, after heart transplantation in rats, ischemic injury causes increased T2-weighted signal intensity and Gd-DTPA-induced T1-weighted signal enhancement--findings similar to those described in transient coronary occlusive ischemia and in graft rejection. Abnormalities seen on magnetic resonance images during the first few posttransplant weeks may represent ischemic injury rather than rejection.

Animals↗

PubMedDate not supplied

Half-Fourier MR imaging of CNS disease.

Three MR imaging techniques were compared in 37 CNS examinations. In each case, postprocessing of a single data set in three different ways was used for comparison. Eleven of the 37 patients had a clinical diagnosis of multiple sclerosis. The primary purpose of this investigation was to evaluate the quality of the half-Fourier imaging technique. With half-Fourier imaging, scan time can be reduced by approximately half without compromising spatial resolution. In T2-weighted examinations at 1.0 T (with present instrumentation), application of the half-Fourier technique leads to a decrease in lesion detectability in patients with multiple sclerosis: this is because there is a reduction in the signal difference-to-noise ratio of 32 +/- 11%. For T2-weighted screening of the CNS on high-field MR systems, with the exception of multiple sclerosis, half-Fourier imaging may offer a suitable compromise by decreasing scan time while preserving spatial resolution. Application of the half-Fourier method to T1-weighted techniques also results in diagnostic-quality images.

Central Nervous System Diseases↗

PubMedDate not supplied

MR imaging of middle cranial fossa arachnoid cysts: temporal lobe agenesis syndrome revisited.

MR studies in eight patients with extraaxial arachnoid cysts in the middle cranial fossa were reviewed in order to identify any associated structural defect in the ipsilateral temporal lobe. The study was prompted by the original theory that agenesis of the temporal lobe is the primary factor in the development of these cysts. Authors of subsequent studies proposed that the cysts are a consequence of embryological malformation of the meninges only and that the adjacent temporal lobe is compressed. Our findings suggest that middle cranial fossa cysts are associated with temporal lobe hypogenesis, and also that compression of the temporal lobe is an infrequent accompaniment.

Adolescent↗

PubMedDate not supplied

Difficulties in diagnosing congenital posterior fossa fluid collections after shunting procedures.

The differential diagnosis of retrocerebellar fluid collections in infants is important because of the prognostic implications. Usually the diagnoses are easy; however, shunting of the lateral ventricles or of the fluid collections may alter the appearance of the lesions, precluding accurate diagnosis. Under such circumstances a careful study of all the sequential radiologic studies is necessary.

Cerebellum↗