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PubMed2005

Age-related cerebral white matter changes and pulse-wave encephalopathy: observations with three-dimensional MRI.

Our purpose was to investigate leukoaraïosis (LA) using three-dimensional MR imaging combined with advanced image-processing technology to attempt to group signal abnormalities according to their etiology. Coronal T2-weighted fast fluid-attenuated inversion-recovery (FLAIR) sequences and three-dimensional T1-weighted fast spoiled gradient recalled echo sequences were used to examine cerebral white matter changes in 75 elderly people with memory complaint but no dementia. They were otherwise healthy, community-dwelling subjects. Three subtypes of LA were defined on the basis of their shape, geography and extent: the so-called subependymal/subpial LA, perivascular LA and "bands" along long white matter tracts. Subependymal changes were directly contiguous with ventricular spaces. They showed features of "water hammer" lesions with ventricular systematisation and a more frequent location around the frontal horns than around the bodies (P=.0008). The use of cerebrospinal fluid (CSF) contiguity criterion allowed a classification of splenial changes in the subpial group. Conversely, posterior periventricular lesions in the centrum ovale as well as irregular and extensive periventricular lesions were not directly contiguous with CSF spaces. The so-called perivascular changes showed features of small-vessel-associated disease; they surrounded linear CSF-like signals that followed the direction of perforating vessels. Distribution of these perivascular changes appeared heterogeneous (P ranging from .04 to 5.10(-16)). These findings suggest that subependymal/subpial LA and subcortical LA may be separate manifestations of a single underlying pulse-wave encephalopathy.

Aged↗
PubMed2006

The imaging appearance of Creutzfeldt-Jakob disease caused by the E200K mutation.

The E200K mutation on chromosome 20 can cause familial Creutzfeldt-Jakob disease (CJD). Patients with this mutation are clinically similar to those with sporadic CJD, but their imaging features are not well documented. We report here the quantitative and qualitative evaluation of the magnetic resonance (MR) imaging characteristics of this unique group of patients using three-dimensional spoiled gradient recalled (SPGR) echo images, diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurements, MR spectroscopy and a fluid-attenuated inversion recovery (FLAIR) sequence. The SPGR and ADC data were analyzed with SPM99. ANCOVA and regression models were used for a region-of-interest (ROI) analysis of ADC and metabolic ratios. CJD patients had a decreased fraction of gray matter and an increased fraction of cerebrospinal fluid (P=.001) in the cortex and cerebellum and increased ADC values in the cortex (P<.001). Focal decreases of ADC were found in the putamen via ROI analysis (548+/-83 vs. 709+/-9 microm(2)/s, P=.02). N-acetyl aspartate (NAA) was generally reduced, with the NAA/Cho ratio lowest in the cingulate gyrus. Qualitative assessment revealed hyperintensities on FLAIR, DWI or both in the putamen (three out of four patients), caudate (three out of four patients) and thalamus. These results provide a framework for future study of patients with genetically defined familial CJD.

Brain↗
PubMed2005

IRIS: a database surveying known human immune system genes.

We have compiled an online database of known human defense genes: the Immunogenetic Related Information Source (IRIS). As of October 1, 2004, there are 1562 immune genes recorded in IRIS, representing 7% of the human genome. This resource contains searchable information including chromosomal location, sequence data, and a curated functional annotation for each entry. We used IRIS as a basis for analyzing the composition and characteristics of the immune genome, such as gene clustering, polymorphism, and relationship to disease. High protein sequence similarity correlated inversely with distance between immune genes, consistent with clustering of duplicated loci. We also found that, even though some immune genes exhibit high levels of polymorphism, such as MHC class I, the range of levels of polymorphism in immune genes is similar to that of nonimmune genes. Approximately 20% of immune genes have a known disease association. IRIS is available online at .

Databases, Genetic↗
PubMed1994

Longitudinal stress fractures of the tibia: MRI features in two cases.

Longitudinal stress fractures of the tibia are a recognized but unusual finding in long distance runners. Two cases are presented in which the diagnosis on plain films and scintigraphy (in one case) was not evident. Both patients were referred for MRI. Coronal short tau inversion recovery (STIR) sequences demonstrated extensive hyperintense longitudinal intramedullary signal changes in the tibia. T1-weighted spin-echo scans showed corresponding but less extensive regions of reduced signal intensity. In one case, enhancement of this area was seen following i.v. dimeglumine-gadopentetate (Gd-DTPA). Adjacent soft-tissue abnormality and periosteal reaction was seen in one case but in neither patient was a fracture line identified. Thin section CT with sagittal reformats demonstrated an irregular intracortical longitudinal lucent fracture line which was distinct from the nutrient foramen, establishing the diagnosis.

Adult↗
PubMed1986

A description of a low field resistive magnetic resonance imaging system and its application in imaging midline central nervous system pathology.

A commercial low field magnetic resonance imaging (MRI) system installed in the Royal Infirmary, Edinburgh at the end of 1983 has since been used for the clinical investigation of over 1000 patients. This system uses an interlaced saturation recovery and inversion recovery pulse sequence which yields four types of clinical image. AT1 weighted image has been found to be the most sensitive for the detection of pathology. Several examples of pathology with negative X-ray computed tomography examinations including three examples of a syrinx and two cases of tonsillar herniation have been demonstrated using this system. It is suggested that the system could provide a routine clinical service for imaging the central nervous system.

Brain↗
PubMed1996

Gadolinium-DTPA enhanced echoplanar MR imaging of the liver: preliminary observations.

This study describes our preliminary experience with dynamic gadopentetate dimeglumine enhanced echoplaner MR imaging (EPI) in fifteen patients with focal liver lesions. Lesion diagnosis was established by histology (n = 3) or typical imaging characteristics (exclusive of the EPI study) combined with clinical follow up (n = 12). Dynamic gadopentetate dimeglumine (0.1 mmol/kg) enhanced MR imaging was performed on a commercially available 1.5 T EPI equipped MR system using a single-excitation fat-suppressed inversion recovery pulse sequence. The choice of an IR sequence allowed nulling of the lesion signal by varying T1 prior to enhancement creating the optimal conditions for qualitative inspection of the enhancement profile. Intershot delay (defined as TR) ranged from 1-5s. Image analysis was performed qualitatively by two radiologists. Benign and malignant lesions displayed temporal enhancement profiles compatible with characteristic findings expected with conventional imaging modalities. Further refinements in our technique and expanded system capabilities will allow dynamic imaging of the entire liver with improved temporal resolution over conventional sequences.

Contrast Media↗
PubMed1999

Magnetic resonance imaging in the assessment of cervical nodal metastasis in oral squamous cell carcinoma.

OBJECTIVE: The accurate pre-operative assessment of cervical lymph nodes is a well recognized problem in the management of patients with oral squamous cell carcinoma. Imaging techniques have improved the accuracy of staging but cannot determine if nodal enlargement is due to reactive changes or malignant involvement. We assessed the diagnostic performance of magnetic resonance imaging (MRI) in detecting metastatic disease within the neck in oral cancer patients. MATERIALS AND METHODS: A retrospective study was performed on 58 patients treated for oral squamous cell carcinoma. All patients had pre-operative MR imaging including axial and coronal short tau inversion recovery (STIR) sequences and pre- and post-gadolinium axial T1 weighted sequences. Nineteen patients had bilateral neck dissections giving 77 sides of neck for study. MR images were reviewed for nodal involvement at each anatomical level within the neck and correlated with findings at histology. RESULTS: Twenty-seven of the 77 sides of neck contained histologically positive nodes (35.1%). MRI sensitivity was 66.7% and specificity 68%. There was a false-negative rate of 20.9% and false-positive rate of 47.1%. Some enlarged, histologically positive nodes were not detected by MRI. Furthermore, in five cases the only histological evidence of nodal malignancy was the presence of a micrometastasis (<3 mm tumour deposit). MRI detected two of these. CONCLUSION: MRI lacks sufficient sensitivity and specificity to replace elective neck dissection for both staging and prognostic purposes.

Adult↗
PubMed2003

Perturbed folding kinetics of circularly permuted RNAs with altered topology.

The folding pathway of the Tetrahymena ribozyme correlates inversely with the sequence distance between native interactions, or contact order. The rapidly folding P4-P6 domain has a low contact order, while the slowly folding P3-P7 region has a high contact order. To examine the role of topology and contact order in RNA folding, we screened for circular permutants of the ribozyme that retain catalytic activity. Permutants beginning in the P4-P6 domain fold 5 to 20 times more slowly than the wild-type ribozyme. By contrast, 50% of a permuted RNA that disjoins a non-native interaction in P3 folds tenfold faster than the wild-type ribozyme. Hence, the probability of rapidly folding to the native state depends on the topology of tertiary domains.

Animals↗
PubMed2001

MRI-FLAIR images of the head show corticospinal tract alterations in ALS patients more frequently than T2-, T1- and proton-density-weighted images.

In some patients with amyotrophic lateral sclerosis (ALS), T2-weighted and proton-density-weighted magnetic resonance imaging (MRI) shows hyperintense or hypointense signals at the corticospinal tract. Fluid-attenuated inversion recovery (FLAIR) sequences increase the sensitivity of MRI to detect cortical and subcortical tissue changes. In 31 ALS patients and 33 controls, we studied the frequency and the extent of signal abnormalities in FLAIR images compared to T2-, T1- and proton-density-weighted images. Hyperintense signals at the corticospinal tract were significantly more frequent in FLAIR images than in all other tested sequences. In FLAIR images of ALS patients only, distinct hyperintense signals at the subcortical precentral gyrus (five patients), the centrum semiovale (eight patients), the crus cerebri (nine patients) and the pons (four patients) as well as mild hyperintense signals in the medulla oblongata (three patients) were seen. More frequently, but not exclusively in ALS patients, FLAIR images showed mild hyperintense signals at the subcortical precentral gyrus (15 patients vs. 1 control). Quantitative analysis confirmed the significant difference between ALS patients and controls at the subcortical precentral gyrus in FLAIR images. In T1-weighted images, the corticospinal tract at the capsula interna was hypointense in significantly more controls than ALS patients. Also this difference was confirmed in the quantitative analysis. Similar to previous results, MR image alterations did correlate poorly to clinical data of upper motor neuron affliction.MR images of the head, including FLAIR images, provide additional information regarding corticospinal tract involvement in ALS patients. Because of an overlap with physiological findings, they have to be interpreted cautiously, with the exception of hyperintense signals at the subcortical precentral gyrus.

Adult↗
PubMed2002

White matter T(1) relaxation time histograms and cerebral atrophy in multiple sclerosis.

T(1) relaxation time (T(1)) provides a quantitative magnetic resonance imaging (MRI) parameter for evaluating tissue damage in the brain. We aimed to measure T(1) in the white matter of patients with multiple sclerosis (MS) and study relationships with cerebral atrophy, T(2) lesion load and clinical parameters. Twenty-six patients with relapsing-remitting MS and sixteen healthy controls were scanned with dual-echo T(2)-weighted, 3-dimensional (3-D) magnetization-prepared rapid acquisition gradient echo and whole brain, multi-slice inversion recovery (IR) sequences. White matter masks were defined on axial T(1) map slices using semi-automated seed growing and normalized 'total white matter' T(1) histograms generated. Atrophy data was obtained using the Cavalieri method of modern design stereology. T(2) lesion volume was also determined using seed growing.T(1) histogram-derived measures (median, peak height, peak position and standard deviation) in MS patients were significantly different (p < 0.0001) from controls. Median T(1) correlated significantly with supratentorial (r = 0.42, p = 0.036), lateral ventricle (r = 0.55, p = 0.004), and T(2) lesion volumes (r = 0.84, p < 0.0001), but not with clinical parameters. Total white matter T(1) provides a robust, quantitative measure of global disease burden in MS, and also correlates significantly with cerebral atrophy. Serial studies are required to determine its potential role as a surrogate marker of disease progression.

Adult↗
PubMed2003

Magnetic resonance imaging identifies cytoarchitectonic subtypes of the normal human cerebral cortex.

BACKGROUND: Magnetic Resonance Imaging (MRI) allows a detailed "in vivo" macroscopic study of the human brain; previously, it has been demonstrated that Fluid Attenuated Inversion Recovery (FLAIR) sequence shows higher signal intensity of cortices belonging to limbic structures. PURPOSE: To measure and compare signal intensities (SI) of cytoarchitectonically different cortical regions. METHODS: In 22 adult subjects, without psychiatric or neurological diseases, FLAIR sequence was performed in coronal slices, perpendicular to the main hippocampal axis. Signal intensity was measured, with a region-of-interest (ROI) function, in 12 different cortical regions. We compared these values and grouped the cortices into five groups: (1) limbic cortices, (2) paralimbic agranular cortices, (3) paralimbic granular cortices, (4) parietal-type neopallium, (5) frontal-type neopallium. A t-test for comparison of paired samples was performed, considering p</=0.05 as statistically significant. RESULTS: We found statistically significant differences amongst the different groups, with the exception of groups 1 and 2, which did not show differences between them. No statistically significant differences were found among cortices belonging to the same group. CONCLUSION: Structural characteristics of the cerebral cortex cause changes in its signal intensity. Magnetic resonance imaging (FLAIR sequence) allows discrimination of different cytoarchitectonic areas of the human cerebral cortex.

Adult↗
PubMed1985

Magnetic resonance imaging in a routine clinical setting.

The results of magnetic resonance imaging (MRI) examinations in the first 1,000 consecutive patients who were studied by this technique at our institution were reviewed to determine the disease states encountered, the sensitivity and accuracy of results, and the value of the examination as compared with computed tomography and other imaging procedures. The MRI device was a 0.15-tesla resistive magnet that used a variety of saturation recovery, spin echo, and inversion recovery pulse sequences to produce images. MRI was found equal to or superior to other imaging techniques in most cases. Exceptions included organs or body regions that are prone to excessive respiratory or vascular motion, lesions that necessitate exquisite spatial resolution for diagnosis, and lesions in which angulation of the viewing plane is necessary for optimal depiction. Fresh blood and calcification within a lesion were also difficult to detect with use of MRI.

Adolescent↗
PubMed2002

Human l1 retrotransposition is associated with genetic instability in vivo.

Retrotransposons have shaped eukaryotic genomes for millions of years. To analyze the consequences of human L1 retrotransposition, we developed a genetic system to recover many new L1 insertions in somatic cells. Forty-two de novo integrants were recovered that faithfully mimic many aspects of L1s that accumulated since the primate radiation. Their structures experimentally demonstrate an association between L1 retrotransposition and various forms of genetic instability. Numerous L1 element inversions, extra nucleotide insertions, exon deletions, a chromosomal inversion, and flanking sequence comobilization (called 5' transduction) were identified. In a striking number of integrants, short identical sequences were shared between the donor and the target site's 3' end, suggesting a mechanistic model that helps explain the structure of L1 insertions.

5' Flanking Region↗
PubMed2000

Bayesian estimation of relaxation times T(1) in MR images of irradiated Fricke-agarose gels.

The authors present a novel method for processing T(1)-weighted images acquired with Inversion-Recovery (IR) sequence. The method, developed within the Bayesian framework, takes into account a priori knowledge about the spatial regularity of the parameters to be estimated. Inference is drawn by means of Markov Chains Monte Carlo algorithms. The method has been applied to the processing of IR images from irradiated Fricke-agarose gels, proposed in the past as relative dosimeter to verify radiotherapeutic treatment planning systems. Comparison with results obtained from a standard approach shows that signal-to noise ratio (SNR) is strongly enhanced when the estimation of the longitudinal relaxation rate (R1) is performed with the newly proposed statistical approach. Furthermore, the method allows the use of more complex models of the signal. Finally, an appreciable reduction of total acquisition time can be obtained due to the possibility of using a reduced number of images. The method can also be applied to T(1) mapping of other systems.

Bayes Theorem↗
PubMed1997

Fast flair imaging of the brain using the fast spin-echo and gradient spin-echo technique.

The purpose of this study was to compare the gradient spin-echo (GRASE) to the fast spin-echo (FSE) implementation of fast fluid-attenuated inversion recovery (FLAIR) sequences for brain imaging. Thirty patients with high signal intensity lesions on T2-weighted images were examined on a 1.5 T MR system. Scan time-minimized thin-section FLAIR-FSE and FLAIR-GRASE sequences were obtained and compared side by side. Image assessment criteria were lesion conspicuity, contrast between different types of normal tissue, image quality, and artifacts. In addition, contrast ratios and contrast-to-noise ratios were determined. Compared to FSF, the GRASE technique allowed a 17% reduction in scan time but conspicuity of small lesions in particular was significantly lower on FLAIR-GRASE images because of higher image noise and increased artifacts. Gray-white differentiation was slightly worse on FLAIR-GRASE. Physiological ferritin deposition appeared slightly darker on FLAIR-GRASE images and susceptibility artifacts were stronger. Fatty tissue was less bright with FLAIR-GRASE. With current standard hardware equipment, the GRASE technique is not an adequate alternative to FSE for the implementation of fast FLAIR sequences in routine clinical MR brain imaging.

Brain↗
PubMed2000

Improved MR imaging for patients with metallic implants.

Pediatric oncology patients with large metallic prostheses were imaged with one of two MR imaging techniques: 1) the "tilted view-angle" technique, 2) or a higher readout bandwidth technique. The tilted view-angle method uses an additional gradient in the slice selection direction during readout. The high bandwidth technique increases the readout bandwidth and shortens the echo time (TE). High bandwidth and short echo times were implemented in both T(1)-weighted (T(1)W) turbo spin echo and turbo short tau inversion recovery (STIR) sequences. Both imaging techniques reduced the size of metal-induced image artifacts. The tilted view-angle method reduced the artifact to a greater degree but had inherent shortcomings. The reformatted images were blurred and shifted. The area of interest was often moved outside of the field of view, unless parameters were adjusted on the basis of a pre-scan calculation. The high readout bandwidth, short echo technique required no special preparation and reduced metal artifacts without image blurring. The combination of high-bandwidth, shorter echo turbo STIR and T(1)W turbo spin echo sequences with subtraction of pre- from post-contrast images allowed effective fat suppression without local field inhomogeneity affects. This greatly improved our ability to evaluate suspected disease near metallic implants in pediatric cancer patients.

Adolescent↗
PubMed1995

Magnetic resonance imaging after frontal sinus surgery with fat obliteration.

The obliteration of the frontal sinus via an osteoplastic approach is performed with the aim of achieving a permanent 'switching off' by final and conclusive clearing out. For this, freshly harvested abdominal fat has shown itself to be the best clinically. It is possible to demonstrate the vitality of fat transplanted into the frontal sinus without an operation, i.e. by a macroscopical and histological examination using magnetic resonance imaging (MRI). The magnetic resonance examinations were carried out on a supraconductive 0.5 T Magnet (Gyroscan T.S.II, Philips Medicine Systems, Eindhoven, Netherlands) with a quadrature (square) head spool. We produced T1-weighted spin echo images (TR: 450-550 ms; TE: 20-25 ms), T2-weighted fast spin echo images or in double-echo technique in transverse orientation (Turbo SE or TR: 2000-2500 ms; TE: 50-90 ms) and short tau inversion recovery (STIR) sequences for fat suppression (TJ: 140 ms; TR: 1400 ms; TE: 30 ms). The fat implanted into the frontal sinus of 11 patients aged 22-65 years, having undergone an osteoplastic frontal sinus operation with obliteration, was examined post-operatively by MRI. Objectives were the time-dependent distribution of portions of vital fatty or connective tissue, the eventual development of necroses or cysts as well as recurrences, inflammatory complications or re-epithelization of the frontal sinus four to 24 months post-operatively. In only six out of 11 cases was vital fatty tissue found. Fatty necrosis occurred five times, whereas in four cases a transformation into granulation tissue and in one case into connective tissue could be seen. All 11 patients were complaint-free. Long-term observations are needed to see if differences in the recurrence rate of frontal sinus disease are dependent on whether the implanted fat remains vital or necrosed and transformed.

Adipose Tissue↗
PubMed2004

Resistance, capacitance, and electrode kinetic effects in Fourier-transformed large-amplitude sinusoidal voltammetry: emergence of powerful and intuitively obvious tools for recognition of patterns of behavior.

Large-amplitude sinusoidal ac voltammetric techniques, when analyzed in the frequency domain using the Fourier transform-inverse Fourier transform sequence, produce the expected dc and fundamental harmonic ac responses in addition to very substantial second, third, and higher ac harmonics that arise from the presence of significant nonlinearity. A full numerical simulation of the process, Red right arrow over left arrow Ox + e(-), incorporates terms for the uncompensated resistance (R(u)), capacitance of the double layer (C(dl)), and slow electron transfer kinetics (in particular, the reversible potential (E degrees ), rate constant (k(0)), and charge transfer coefficient (alpha) from the Butler-Volmer model). Identification of intuitively obvious patterns of behavior (with characteristically different sensitivity regimes) in dc, fundamental, and higher harmonic terms enables simple protocols to be developed to estimate R(u), C(dl), E degrees , k(0), and alpha. Thus, if large-amplitude sinusoidal cyclic voltammograms are obtained for two concentrations of the reduced species, data obtained from analysis of the recovered signals provide initial estimates of parameters as follows: (a) the dc cyclic component provides an estimate of E degrees (because the R(u) and k(0) effects are minimized); (b) the fundamental harmonic provides an estimate of C(dl) (because it has a high capacitance-to-faradaic current ratio); and (c) the second harmonic provides an estimate of R(u), k(0), and alpha (because the C(dl) effect is minimized). Methods of refining the initial estimates are then implemented. As a check on the fidelity of the parameters (estimated on the basis of an essentially heuristic approach that solely utilizes the dc, fundamental, and second harmonic voltammograms), comparison of the predicted simulated and experimental third (or higher) harmonic voltammograms can be made to verify that agreement between theory and experiment has been achieved at a predetermined level. The use of the heuristic pattern recognition approach to evaluate the oxidation of ferrocene at a platinum electrode (a reversible process) in the very high resistance solvent dichloromethane (0.1 M Bu(4)NPF(6)) and the reduction of [Fe(CN(6))](3)(-) at a glassy carbon electrode (a quasi-reversible process) in much lower resistance but higher capacitance conditions found in aqueous (0.5 M KCl) media is described and verifies the inherent advantages of employing large-amplitude sinusoidal techniques in quantitative studies of electrode processes.

Journal Article↗