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Ferromagnetic exchange between the three Mn ions in the complex [Mn3(Hcht)2(bpy)4](ClO4)3 leads to a spin ground state of S = 7; single crystal studies reveal the temperature and sweep rate dependent hysteresis loops expected for a single-molecule magnet.
We have used Fourier transform nuclear magnetic resonance methods to measure the spin-lattice and transverse relaxation times at 220 MHz of the choline N-methyl and the fatty-acid alpha-carbonyl, allyl, vinyl, methylene, and methyl protons of sonicated egg-yolk lecithin. Over the temperature range investigated the T(1) values were, in general, similar to, but different from, one another, suggesting that the relaxation rates of all of the fatty-acid protons are not determined solely by spin-diffusion to a heat sink. Arrhenius plots of the T(1) data gave activation energies similar to those for the barriers to internal rotation in alkanes. The values of the transverse relaxation rate, T(2), showed a relatively large variation among the proton resonances; about 20% of the methylene protons had a T(2) of 56 msec, while the remaining protons relaxed according to a distribution of values all shorter than 20 msec. Such a distribution of relaxation times is envisioned to arise from a distribution of correlation times stemming from complex motions in which extended angular excursions of the fatty acid chain are coupled to trans-->gauche conformational transitions.
BACKGROUND: Contrast-enhanced magnetic resonance imaging (ceMRI) allows for the detection of ischemic heart disease. Aim of this prospective study was to show feasibility, practicability and safety of adenosine stress ceMRI in routine outpatients with a mobile scanner. METHODS: Consecutive patients were scanned in six different cardiac outpatient centers with a 1.5 T mobile ceMRI scanner. First-pass wash-in patterns of gadolinium chelate were evaluated after three minutes of adenosine infusion. After a second bolus of gadolinium chelate myocardial late enhancement (MLE) images of the left ventricle were acquired to visualize myocardial necrosis. RESULTS: Five hundred seventy-four patients were enrolled to the study. No major complications during examination and adenosine infusion were observed. One hundred seventy-three minor complications as temporary atrio-ventriculare blockade, mild chest pain or dyspnea and nausea were noticed. None of the complications led to further special treatment CONCLUSION: This ceMRI protocol is suitable for application in outpatient settings. CeMRI stress testing using a mobile scanner in an outpatient setting is feasible and safe.
OBJECTIVES: To evaluate ultrasonography (US) of salivary glands in primary Sjögren's syndrome (SS) and to compare US with parotid magnetic resonance (MR) imaging and MR sialography. METHODS: US examination of parotid, submandibular and sublingual glands was performed on 27 patients with primary SS, 27 healthy controls and 27 symptomatic controls without SS. The results were compared with parotid MR imaging and MR sialography and the clinical features of the patients. RESULTS: Salivary gland abnormalities, parenchymal inhomogeneity or adipose degeneration, were visualized in 21 (78%) SS patients, in one healthy control and in two symptomatic controls by US. Eighteen (67%) patients had changes in the parotid and submandibular glands and 8 (30%) changes in the sublingual glands. In the comparison, MR sialography was found to be the most sensitive method (96%), followed by MR imaging (81%) and US (78%), in detecting glandular changes. The specificity of US was 94%. The US and MR results were related to anti-Ro/SSA positivity but not to saliva secretion. The focus scores were related only to parotid MR imaging findings. CONCLUSIONS: US, MR imaging and MR sialography with modern technology have reached such a good accuracy in visualizing glandular structural changes that they are promising alternatives to the conventional invasive examinations in the diagnostics of SS.
Magnetic resonance imaging (MRI) may be more sensitive than mammography for detecting breast cancer and may have an adjunctive role in assessing patients with early-stage disease for breast conservation treatment. This study was performed to analyze the impact of breast MRI on the clinical management of 83 patients being considered for breast conservation treatment. Eighty-three consecutive cases of patients undergoing breast MRI during standard workup and evaluation for breast conservation treatment from 1993 to 1996 were retrospectively reviewed. Records were reviewed for patient and tumor characteristics, mammographic findings, MRI findings, timing of MRI study, findings from MRI-guided surgery (when done), and whether the patient underwent breast conservation treatment. MRI definitely altered management in 15 patients (18%), may have affected management in 4 patients (5%), and did not change management in 64 patients (77%). Thirteen patients underwent additional surgery because of MRI findings; the positive predictive value for MRI-guided surgery was 38% (5 of 13). Ultimately, 82% of the patients received breast conservation treatment. No predictive factor was identified to characterize the patients most likely to have management affected by MRI findings. These findings suggest that breast MRI may be useful in the evaluation of patients with early-stage breast cancer for breast conservation treatment. A larger study population and outcome data will be required to confirm these findings and to define those patients most likely to benefit from breast MRI.
We herein report the results of a prospective study to define the role of diskography in the diagnosis of low back pain in an emerging era of magnetic resonance imaging (MRI). The study involved 32 patients (78 disks) with a clinical diagnosis of lumbar disk herniation; all were studied by computed tomography-diskography (CT-D), and 25 (51 disks) were also examined using MRI. The disks were graded on these studies according to a staging scheme modified from Modic. Ten of the patients (13 disks) having both CT-D and MRI underwent exploratory surgery, and the staging at surgery served as the standard against which the evaluative studies were judged. Surgical staging was compatible with the CT-D and MRI results in five disks, while in another five disks it was compatible only with the CT-D results. In the remaining three disks, both CT-D and MRI misidentified the stages. In six disks, CT-D more accurately defined the stage of disease than did MRI, whereas MRI was more precise than CT-D in only one disk. While having documented the value of CT-D as a source of information, particularly when surgery is contemplated, and as an effective means of staging disk herniation, we recommend MRI as the ideal screening test for lumbar radiculopathy and low back pain, reserving diskography for problematic cases.
This study characterizes the appearance of periosteal reaction by magnetic resonance imaging (MRI), and evaluates the efficacy of MRI versus computed tomography (CT), and plain film radiography (PF) in detecting early, experimentally induced periostitis. Acute Staphylococcus aureus osteomyelitis was induced in 30 legs of 20 New Zealand white rabbits. The rabbits were then imaged with MR, contrast-unenhanced CT, and PF 4 days after infection. Histologically, periosteal elevation was present in 27 cases. Periosteal ossification was seen in 23 cases, and cellular reaction without ossification in 4 cases. Periosteal reaction was demonstrated by PF in 21 (78%) and by CT in 20 (74%) cases. Evidence of periostitis was seen by MR in all 27% (100%) cases. MR resulted in two false-positive diagnoses. Multiple concentric, alternating high and low signal arcs demonstrated by MR in 19 (70%) cases represented periosteal ossification surrounded by fibrous or granulation tissue. These findings demonstrate the ability of MR to detect periostitis despite the absence of periosteal ossification. MR was more sensitive than CT (P less than .05) or PF (P less than .05) in the detection of experimentally induced periostitis.
RATIONALE AND OBJECTIVES: At many institutions, three-dimensional magnetic resonance imaging (MRI) is routinely used for examination of the knee. Multiplanar reconstruction (MPR) is a method of displaying three-dimensional datasets. The authors assessed the usefulness of MPR for evaluating knee MRI datasets by comparing readers' performance using MPR and conventional film MRIs. METHODS: Eight patients with internal derangement of the knee were studied. All had MRI datasets acquired in the sagittal plane using a three-dimensional gradient-echo fast imaging with steady-state precession (FISP) sequence. Arthroscopic surgery after MRI confirmed the presence of 6 anterior cruciate ligament (ACL) tears, 11 meniscal tears, and 5 normal menisci in this group. Four blinded readers, experienced in MRI of the knee, evaluated the images. The MRI datasets were then loaded onto a three-dimensional workstation and interpreted by the same readers using MPR. The MRI findings were correlated with arthroscopy. RESULTS: For diagnosis of tears of the ACL, sensitivity was 96% and specificity was 100% for both films and MPR. For detecting meniscal tears, sensitivity was 55% and specificity was 90%, using the filmed images, versus 64% and 85%, respectively, with MPR. These differences were not statistically significant by the sign test. Total time (technologist processing time plus radiologist reading time) for MPR was greater than for film interpretation by a factor of 1.12 (P < .05), and radiologist reading time for MPR was greater by a factor of 1.88 (P < .05). CONCLUSIONS: For sagittal three-dimensional FISP MRI datasets, real-time MPR is comparable with film interpretation for evaluation of ACL and meniscal injuries, but it increases the time required for diagnosis.
RATIONALE AND OBJECTIVES: The authors studied the effect of contrast dose, use of magnetization transfer (MT), and temporal delay on the visualization of contrast enhancement with gadoteridol (Gd HP-DO3A) in a canine brain abscess model. METHODS: Alpha streptococcus brain abscesses were studied in five dogs at 1.5 tesla (T) 1 and 5 days after implantation. Scans were performed 1, 11, and 21 minutes after contrast was administered, using an initial dose of 0.1 mmol/kg. A supplemental contrast injection of 0.2 mmol/kg was given (for a cumulative dose of 0.3 mmol/kg), with scans repeated at 31, 41, and 51 minutes. RESULTS: Lesion conspicuity on day 1 was greater at high-contrast doses (0.3 mmol/kg) compared with standard doses (0.1 mmol/kg), regardless of whether imaging was performed without (0.89 +/- 0.02 compared with 0.26 +/- 0.08) or with (0.97 +/- 0.04 compared with 0.28 +/- 0.06) MT. High-dose, MT, and a delay after contrast was injected all produced a statistically significant improvement. On blinded review of films obtained 11 and 14 minutes after injection, enhancement of the lesion could not be identified with certainty in two of five dogs at a dose of 0.1 mmol/kg, regardless of whether MT was used. Enhancement was seen consistently in all lesions at 0.3 mmol/kg. On day 5, results were comparable, with greater absolute enhancement. CONCLUSIONS: In early brain infection, high-contrast doses (0.3 mmol/kg), MT, and a moderate delay after injection all improve visualization of lesion enhancement.
RATIONALE AND OBJECTIVES: To investigate the origin of posterior pituitary high intensity (PPHI) seen on T1-weighted magnetic resonance (MR) images. METHODS: Six rabbits, including four rabbits deprived of drinking water for 4 days and two control rabbits, were examined by MR imaging. Plasma vasopressin levels were sequentially measured by radioimmunoassay. Pituitary glands were immunostained with guinea pig anti-rabbit vasopressin antibody, and ultrathin sections of Epon/Araldite-embedded specimens were observed with a transmission electron microscope. RESULTS: In control rabbits, PPHI was noted on T1-weighted MR images, and the posterior pituitary lobe was positively immunostained with anti-vasopressin antibody. At the ultrastructural level, nerve terminals contained numerous neurosecretory granules bearing vasopressin. Conversely, plasma vasopressin levels gradually increased and PPHI was absent in 4-day dehydrated rabbits. The posterior lobe was scarcely stained with anti-vasopressin antibody, and neurosecretory granules were rarely observed. However, a number of small dispersed vesicles, possibly derived from the fragmentation of neurosecretory granule envelopes, were seen in the nerve terminal. CONCLUSIONS: Posterior pituitary high signal seen on T1-weighted MR images is attributed to neurosecretory granules bearing vasopressin.
RATIONALE AND OBJECTIVES: The authors evaluate the accuracy of magnetic resonance (MR) imaging with body coil and endorectal surface coil techniques in the staging of cervical carcinomas and compare these results with those obtained with clinical staging (International Federation of Gynecology and Obstetrics [FIGO] classification) and postsurgical histopathology. METHODS: Fifteen patients (average age, 48.6 years) with biopsy-proved cervical cancer were included in the study. After clinical staging (FIGO classification), MR imaging with body coil (BCMR) and subsequently with endorectal surface coil (ECMR) was performed. Using a 1.5-Tesla unit, axial and sagittal proton density weighted and spin echo T2-weighted and fast spin echo T2-weighted sequences were obtained with body and endorectal surface coil. During imaging analysis, special attention was paid to the uterine zones, the vaginal fornix, and the parametrial tissue. Ten patients were treated surgically (postsurgical histopathology was considered the gold standard), five patients, all clinically staged IIIb, underwent primary radiation therapy. RESULTS: Clinical staging with FIGO classification was accurate in 12 of 15 patients, and understaged in 2 and overstaged in 1 patient. Body coil MR showed accurate staging in 13 of 15 patients. Using this technique, understaging of 2 patients, both with only minimal tumor infiltration depth (< 8 mm), was performed. Endorectal surface coil MR was accurate in 14 of 15 patients missing minimal parametrial tumor infiltration in 1 patient. Histopathology (n = 10) revealed 3 patients with tumor stage T1b, 2 with stage T2a, and 5 patients with stage T2b. CONCLUSIONS: Although suggested by only a small number of patients, ECMR appears to be the most accurate modality for staging cervical carcinomas but seems to be unreliable in the detection of minimal tumor infiltration.
RATIONALE AND OBJECTIVES: An ex vivo study and a clinical, prospective, patient study were undertaken to evaluate the feasibility of magnetic resonance (MR) colonography with a 1.0-T system. METHODS: An ex vivo colon model was scanned. A cleaned pig colon was prepared with six simulated sessile polyps (diameters of 4-12 mm) and one simulated pedunculated polyp (diameter of 5 mm). Subsequently, five patients (aged 39-81 years; four women, one man) were examined with MR colonography, immediately followed by endoscopic colonoscopy. After preparation for colonoscopy, the colon was filled with a Gd-DTPA/water solution (1:100). A breath-hold 3D gradient-echo sequence was acquired in both the prone and supine positions and after intravenous Gd-DTPA administration. Images were analyzed interactively by using multiplanar projections, maximum-intensity projection, and a virtual endoscopic view. The MR results were compared with the findings of the fiberoptic endoscopy. RESULTS: All seven simulated lesions of the colon model could be detected by MR imaging. In one patient, an advanced colon cancer as well as an additional small polyp was depicted. In the other four patients, single polyps with a diameter of 1 to 2.5 cm and a large adenoma were visualized by MR colonography. Contrast enhancement of the polyps was noted only after subtraction. CONCLUSIONS: The 1.0-T system is feasible for MR colonography. Reduced requirements for hardware could contribute to establish the novel technique as a screening method for colorectal polyps.
Integrated analyses of human anatomical and functional measurements offer a powerful paradigm for human brain mapping. Magnetoencephalography (MEG) and EEG provide excellent temporal resolution of neural population dynamics as well as capabilities for source localization. Anatomical magnetic resonance imaging (MRI) provides excellent spatial resolution of head and brain anatomy, whereas functional MRI (fMRI) techniques provide an alternative measure of neural activation based on associated hemodynamic changes. These methodologies constrain and complement each other and can thereby improve our interpretation of functional neural organization. We have developed a number of computational tools and techniques for the visualization, comparison, and integrated analysis of multiple neuroimaging techniques. Construction of geometric anatomical models from volumetric MRI data allows improved models of the head volume conductor and can provide powerful constraints for neural electromagnetic source modeling. These approaches, coupled to enhanced algorithmic strategies for the inverse problem, can significantly enhance the accuracy of source-localization procedures. We have begun to apply these techniques for studies of the functional organization of the human visual system. Such studies have demonstrated multiple, functionally distinct visual areas that can be resolved on the basis of their locations, temporal dynamics, and differential sensitivity to stimulus parameters. Our studies have also produced evidence of internal retinotopic organization in both striate and extrastriate visual areas but have disclosed organizational departures from classical models. Comparative studies of MEG and fMRI suggest a reasonable but imperfect correlation between electrophysiological and hemodynamic responses. We have demonstrated a method for the integrated analysis of fMRI and MEG, and we outline strategies for improvement of these methods. By combining multiple measurement techniques, we can exploit the complementary strengths and transcend the limitations of the individual neuro-imaging methods.
PURPOSE: Our goal was to evaluate the use of the magnetization transfer ratio (MTR) in the detection of diffuse axonal injury (DAI) resulting from traumatic brain injury in a swine model. METHOD: DAI was created by applying a nonimpact, coronal plane, rotational acceleration to the heads of miniature swine (n = 4). GE imaging was performed with and without off-resonance MT saturation. Histologic correlation of axonal injury with MRI was performed 7 days postinjury. Thirty-one subcortical white matter regions and 10 deep white matter regions were selected for the direct comparison of histologic data and MTR measurements. RESULTS: Nineteen of 41 examined locations exhibited histologic evidence of axonal injury. The mean MTR in regions with axonal damage was significantly less than in regions without axonal damage. These changes were observed both in regions demonstrating high signal intensity on T2-weighted images (T2WI) (p <0.0001, n = 6) and in regions with no signal intensity change on T2WI (p < 0.05, n = 13). CONCLUSION: These results suggest that the measurement of MTR may have the potential for evaluation axonal damage in DAI following traumatic brain injury even when conventional T2WI does not demonstrate the lesion.
A combination of high-resolution nuclear magnetic resonance (NMR) and high-performance liquid chromatography (HPLC)-NMR spectroscopic methods has been used to analyse urine from humans and rats treated with the anticancer drug ifosfamide. It was possible to detect a range of abnormal endogenous metabolites in urine after ifosfamide administration to human subjects undergoing cancer therapy and to relate the metabolic perturbations to the nephrotoxic effects of the drug. Changes observed by 1H NMR included increases in levels of urinary glucose, glycine, alanine, histidine, lactate, acetate, succinate, and trimethylamine-N-oxide and decreases in the levels of hippurate and citrate. Additional evidence was gained that ifosfamide-induced nephrotoxicity might be related to the level of oxidation of the coadministered drug mesna. By using both directly coupled continuous-flow 31P HPLC-NMR spectroscopy to determine the retention times of the phosphorus-containing metabolites and, subsequently, stop-flow 1H HPLC-NMR of the urine, it was possible to isolate and identify on-line the metabolites ifosfamide mustard, 4-hydroxy-ifosfamide, 2-dechloroethylifosfamide, and the parent compound itself. These studies illustrate the potential of combining 1H NMR spectroscopy of biofluids and HPLC-NMR spectroscopy for the investigation of drug metabolism and toxicity in humans and animals.
Although radial tear of the annulus fibrosus can be detected on T2-weighted and Gd-DTPA-enhanced magnetic resonance (MR) images, the association between the annular tear on MR images and the symptomatic discs is unclear. The purpose of this study was to investigate the relationship between T2-weighted, gadolinium-DTPA-enhanced MR images and pain response through discography in patients with chronic low back pain. A total of 56 lumbar discs from 23 patients with chronic low back pain (13 to 47 years old) underwent MR imaging (T2-weighted, gadolinium-DTPA-enhanced MR images) followed by provocative discography. The sensitivity, specificity, positive predictive value, and negative predictive value of T2-weighted and gadolinium-DTPA-enhanced MR images in detecting the symptomatic discs were calculated. The sensitivity, specificity, positive predictive value, and negative predictive value of T2-weighted images in detecting the symptomatic disc were 94%, 71%, 59%, and 97%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of gadolinium-DTPA-enhanced images were 71%, 75%, 56%, and 86%, respectively. The high sensitivity and the high negative predictive value of T2-weighted MR imaging in detecting the symptomatic disc indicated that MR imaging can be a useful screening tool in avoiding unnecessary discography in patients with chronic low back pain.
Epidermoid cyst of the ovary is a very rare tumor. There have been only 21 case reports of it previously. We describe the computed tomography (CT) and magnetic resonance (MR) findings of 2 cases of ovarian epidermoid cyst. To our knowledge, this is the first report describing CT and MR findings of epidermoid cysts of the ovary, and ruptured epidermoid cyst of the ovary has never been reported.
RATIONALE AND OBJECTIVES: To test utility and specific properties of a commercially available MRI compatible power drill for MR guided transcortical bone biopsy. METHODS: In 17 patients MR-guided bone biopsy was performed in an open low-field scanner (0.2 T), using a piezoelectrically powered drilling machine. Target lesions were osteoblastic in four and nonsclerosed intramedullary in 13 cases. Titanium drills sized 3 to 4 mm and an outer cannula were coaxially used for power assisted cortical trephination. For intramedullary lesion sampling, spring loaded biopsy guns and sharpened cannulas were additionally applied in seven and fluid aspiration in two patients, respectively. RESULTS: The piezoelectric device proved to be fully MR compatible. Trephination and subsequent biopsy was successful in all patients without major complications. The drilling procedure could entirely be performed inside the magnet in case of a lateral approach (n = 11). The net drilling time averaged 7.8 minutes for trephination of nonimpaired diaphyseal bone, but was up to 50 minutes in case of thickened femoral bone. Procedures were complicated by frequent drill loosening, drill obstruction by cortical bone (n = 4) and impaired periosteal grip (n = 5) with damage to the outer cannula (n = 3). CONCLUSIONS: The piezoelectric power drill can be applied safely in a low-field MRI environment and is a valuable tool to facilitate transcortical bone biopsy.