Search PubMed⌕ Search

Biomedical subjects

W R Nitz

Publications and source records attributed to W R Nitz.

28 records · Page 2Linked to original sources

Stent appearance at contrast-enhanced MR angiography: in vitro examination with 14 stents.

PURPOSE: To evaluate signal intensity changes influencing assessment of stent patency at contrast material-enhanced magnetic resonance (MR) angiography. MATERIALS AND METHODS: By using an in vitro model, 14 stents-nine nitinol, one tantalum, two stainless steel, and two cobalt alloy-were investigated regarding their appearance at MR imaging. A vascular phantom consisting of tubes filled with 2.00 mmol/L gadopentetate dimeglumine in saline solution was studied in different orientations within the magnetic field. Imaging was performed with a fast three-dimensional gradient-echo sequence (4. 70/1.89 [repetition time msec/echo time msec]). Relative signal intensity reduction within the stents and the degree of artificial narrowing of the stent lumen were calculated. RESULTS: The stent lumen was visible within 13 stents. A total signal void inside the stent lumen appeared in only one cobalt alloy stent. Artificial narrowing of the diameter was less than 33% in 10 of 14 stents. The tantalum stent and four nitinol stents seemed best suited for contrast-enhanced MR angiography. A bandlike artifact occurred at the ends of the stents when positioned along the readout direction. CONCLUSION: To differentiate between artifacts and stenoses, knowledge of the degree of signal intensity reduction and artificial lumen narrowing within vascular stents is essential. Stent geometry, relative orientation to the magnetic field, and alloy composition influence signal intensity alteration within the stent lumen.

Contrast Media↗

Time-resolved contrast-enhanced MR angiography of renal artery stenosis: diagnostic accuracy and interobserver variability.

OBJECTIVE: The purpose of this study was to evaluate diagnostic accuracy and interobserver variability of time-resolved three-dimensional gadolinium-enhanced MR angiography in the detection of renal artery stenosis in comparison with intraarterial digital subtraction angiography as the standard of reference. SUBJECTS AND METHODS: Forty consecutive patients (age range, 25-81 years; mean, 62.9 +/- 11.9 years) with suspected renal artery stenosis underwent intraarterial digital subtraction angiography and gadolinium-enhanced MR angiography, performed on a 1.5-T system with fast low-angle shot three-dimensional imaging (3.8/1.49 [TR/TE], 25 degrees flip angle, 10-sec acquisition time, and 1.5-mm partition thickness). Three time-resolved phases were obtained in a single breath-hold. Digital subtraction angiography and gadolinium-enhanced MR angiography were evaluated by four observers who studied 80 main renal arteries and 19 accessory vessels to evaluate the degree of stenosis. A stenosis reducing the intraarterial diameter by more than 50% was regarded as hemodynamically significant. Interobserver variability was calculated. RESULTS: Only one gadolinium-enhanced MR angiography study was not of diagnostic quality, as a result of failure of the power injector. All main branches were of diagnostic quality in 38 (97.4%) of the remaining 39 gadolinium-enhanced MR angiography studies. Seventeen (89.5%) of 19 accessory renal arteries were depicted with gadolinium-enhanced MR angiography. The overall sensitivity for significant stenoses was 92.9%. The overall specificity was 83.4%, and the overall accuracy was 85.9%. Interobserver variability of gadolinium-enhanced MR angiography exceeded that of digital subtraction angiography. CONCLUSION: Time-resolved three-dimensional gadolinium-enhanced MR angiography is a useful noninvasive method of screening suspected renal artery stenosis because of its easy application, short examination time, and high sensitivity despite of its higher interobserver variability.

Adult↗

MRI detection of olfactory bulb and tract.

Thirty healthy volunteers underwent MRI with 3D MP-RAGE, 3D CISS and 2D turbo spin echo sequences to compare the detectability of olfactory fibers, bulb, tract, and sulcus. The overall detectability was slightly better using MP-RAGE compared with CISS. Both 3D sequences were superior to 2D turbo spin echo. We therefore recommend including the MP-RAGE sequence in an MR imaging protocol of the olfactory nerve.

Adolescent↗

MR imaging: acronyms and clinical applications.

The intention of this article is to provide an overview of all MR imaging techniques that are accessible on most of commercially available scanners and have the potential to be used in routine clinical applications. The techniques implemented by the major vendors are briefly explained, including a comparison of the commonly used acronyms. A classification scheme is introduced which provides a reasonable illustration of similarities and differences between various techniques. The imaging techniques are divided into two main groups, the spin-echo and gradient-echo sequences. Within each group is the basic sequence, those which require a preparation of the magnetization, those which use multiple echoes to fill the k-space and those which are performed in a single shot. For each technique the typical clinical applications are listed or the potential applications which have been published.

Abbreviations as Topic↗

Contrast mechanisms in MR imaging.

This paper is a brief introduction to tissue-specific parameters and the utilization of various MR imaging sequences to display these parameters in order to differentiate normal from pathologic tissue and function. The three dominant tissue-specific parameters discussed are proton density, longitudinal relaxation time T1, and transverse relaxation time T2. For the utilization of gradient-echo sequences, transverse relaxation time T2(*) is introduced, more dependent on the environment or tissue interfaces than on the tissue itself. Another tissue-specific parameter is the concentration of macromolecules and their hydration layers as targeted with magnetization transfer imaging. Still another tissue-specific parameter is the chemical environment. Functional parameters that influence the contrast are diffusion, perfusion, flow, or motion. The sequence-related utilization of these tissue-specific parameters start with magnetization preparation as in spectral suppression of fat signal, relaxation-dependent elimination of fat or cerebrospinal fluid (CSF) signal, simple inversion pulse, magnetization transfer saturation, or diffusion weighting. Possible contrast mechanisms for the tissue-specific parameters are discussed for each of the commonly used sequences, whether of spin-echo type or of gradient-echo type, with or without magnetization preparation, conventional single-echo acquisition, or contemporary multiecho acquisition.

Contrast Media↗

[Contrast medium-enhanced MR angiography of the pelvic and leg vessels with an automated table-feed technique].

PURPOSE: To evaluate contrast enhanced magnetic resonance angiography (ceMRA) with an automated table-feed technique in patients with arterio-occlusive disease for imaging of the pelvic and peripheral arteries. METHODS: Twenty-two patients underwent three-dimensional gadolinium-enhanced MR angiography in a three-step automatic table-feed technique on a Magnetom Symphony operating at 1.5 Tesla. Maximum intensity projection images (MIP) were generated from the subtracted and original studies. Image quality and venous contrast were evaluated by two groups of observers. 304 vessels (17 patients) were compared with DSA as the standard of reference. RESULTS: All examinations were performed without any technical problems. Diagnostic quality of the MIP of subtracted data sets was superior to that of the unsubtracted images. Venous overlay was 61% in the lower leg. In a total of 599 observations, a sensitivity of 96% (95%, 82%) and a specificity of 87% (88%, 99%) were high compared to DSA in the detection of significant stenoses > or = 50% (> or = 75%, occlusions). Interobserver correlation was good (linear correlation 0.9). CONCLUSION: Stepping-table digital subtraction contrast enhanced MRA is a promising technique in the diagnosis of peripheral arterio-occlusive disease.

Aged↗

MP RAGE: a three-dimensional, T1-weighted, gradient-echo sequence--initial experience in the brain.

The authors evaluated a recently developed sequence for magnetic resonance imaging of the brain. The three-dimensional, Fourier-transformed acquisitions require magnetization-prepared 180 degrees radio-frequency pulses and rapid gradient-echo (MP RAGE) sampling. The resulting T1-weighted images were compared with T1-weighted spin-echo (SE) images; both were obtained after paramagnetic contrast material was administered to 33 patients with known or suspected focal brain lesions. Image quality and contrast between gray and white matter were superior with the MP RAGE sequence compared with the T1-weighted SE sequence. The time for obtaining contiguous thin-section (1.3-2.5-mm) images was also comparable, with readily acquired multiplanar reformations obviating additional images. MP RAGE imaging depicted more focal lesions than did T1-weighted SE imaging and matched the number seen with T2-weighted SE imaging. Demonstration of paramagnetic contrast enhancement of lesions was comparable in most cases; however, three lesions showed greater enhancement on T1-weighted SE images and two others were seen only on the T1-weighted SE images. Thus, the MP RAGE sequence may provide an alternative to T1-weighted SE imaging.

Adult↗

Flow dynamics of cerebrospinal fluid: assessment with phase-contrast velocity MR imaging performed with retrospective cardiac gating.

To visualize the flow of cerebrospinal fluid (CSF) throughout the ventricles and subarachnoid space, measure mean and maximum CSF velocities, and quantitate CSF flow through the aqueduct of Sylvius, magnetic resonance (MR) imaging was performed with a sagittal technique that is flow-sensitive in the craniocaudal direction (along the readout axis) and a high-resolution axial technique sensitive to through-plane flow in three healthy subjects and 19 patients with known or suspected disorders of the CSF circulation. In both techniques, retrospective cardiac gating was used to cover the complete cardiac cycle. The sagittal technique was superior in overall assessment of CSF flow dynamics, including the motion of adjacent brain parenchyma. The high-resolution axial technique provided an accurate measurement of the rate of CSF flow through the aqueduct; only this technique provided sufficient accuracy to enable distinction between normal and hyperdynamic CSF flow. It is concluded that assessment of CSF flow dynamics is a useful adjunct to routine MR imaging in communicating and obstructive hydrocephalus.

Adult↗

Nuclear magnetic resonance velocity spectra of steady flow.

Nuclear magnetic resonance (NMR) velocity spectra are a compact way to represent the flow information in a velocity-resolved image set. Fully developed steady flow in long tubes gives NMR velocity spectra with average velocities which correlate well with the values derived from the flow rate. The ratio of average velocity to peak velocity correlates well with the Reynolds number. Tubes with compressed cross sections have velocity spectra similar to those of circular tubes. Tubes with irregular walls have velocity spectra in the entrance region that are markedly different from those from smooth-walled tubes.

Arteriosclerosis↗