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Detection of focal liver lesions with superparamagnetic iron oxide: value of STIR and SE imaging.

OBJECTIVE: We assessed the value of superparamagnetic iron oxide (SPIO) particles on the detection of focal liver lesions by MRI. MATERIALS AND METHODS: Twenty patients with one to five focal liver lesions, primarily detected with ultrasonography and/or contrast-enhanced CT, were evaluated further with unenhanced and iron oxide-enhanced MRI at 1.0 T. Superparamagnetic iron oxide particles were administered intravenously as a slow infusion. Then T1-, T2-, and proton density-weighted SE images were obtained. In addition, the performance of a short TI inversion recovery (STIR) sequence was evaluated. RESULTS: The iron oxide contrast medium had marked effects on liver signal-to-noise (S/N) and tumor-to-liver contrast-to-noise (C/N) ratios but only minimal effects on tumor S/N ratios in cases of malignant tumor foci. Lesion-to-liver contrast, expressed as differences between the tumor and liver S/N ratios, improved very significantly after SPIO infusion with all four pulse sequences. Contrast enhancement of the liver parenchyma was best in T2-weighted SE images, but the tumor-to-liver C/N values were highest with the postcontrast STIR sequence. The SPIO enhancement revealed a number of additional focal lesions (31%), also foci under 1 cm in diameter. In three benign focal lesions, SPIO infusion produced a definite reduction in the S/N ratio of the lesions in contrast to the minimal change measured in malignant foci. The favorable performance of the STIR sequence contradicts the disappointing results previously obtained at 0.6 T. CONCLUSION: Superparamagnetic iron oxide is a promising new contrast medium for MR examinations of the liver, increasing the conspicuity and reducing the detectability threshold of focal hepatic lesions.

Adult↗

Cerebral perfusion MRI with arterial spin labeling technique at 0.5 Tesla.

PURPOSE: Our aim was to evaluate the feasibility of cerebral perfusion MRI using an arterial spin labeling technique at 0.5 T. METHOD: We performed perfusion imaging with a flow-sensitive alternating inversion recovery (FAIR) sequence in a total of 37 patients with cerebral infarction. RESULTS: FAIR perfusion images demonstrated areas of pathological perfusion corresponding (13 patients) or not corresponding (15 patients) to the infarcted area on MR images. Among 19 patients in whom comparison between FAIR perfusion imaging and regional cerebral blood flow single photon emission CT was available, the two studies correlated well in 15 patients. CONCLUSION: Our results indicate that the FAIR technique allows reliable cerebral perfusion imaging at 0.5 T.

Adolescent↗

Identification of new loci involved in adhesion of Listeria monocytogenes to eukaryotic cells. European Listeria Genome Consortium.

Insertional mutagenesis was performed with Tn1545 in the genetic background of an inIAB deletion mutant to identify new adhesion determinants in Listeria monocytogenes. Four insertion mutants defective in adhesion to eukaryotic cells were identified. Insertion sites were cloned by inverse-PCR and sequenced. The genetic organization of insertion regions was further analysed by screening and sequencing DNA fragments from a HindIII library and by searching databases. Three adhesion-defective mutants each had one copy of Tn1545 inserted into their chromosome. The insertion sites were different in the three mutants: (i) upstream from two ORFs in tandem, similar to dfp and priA of Bacillus subtilis, respectively; (ii) within an ORF encoding a putative 126 amino-acid-polypeptide with no significant similarity to any known protein; (iii) within an ORF similar to a B. subtilis ORF with no known function, just upstream from an operon similar to an ABC (ATP-binding cassette) transporter operon from B. subtilis. The excisants obtained from these mutants using the excision reporter plasmid pTCR9 recovered full adhesion capacity. A fourth mutant was the most severely defective in adhesion. It had five Tn1545 insertions, one of which was upstream from dfp and priA, and another of which was upstream from ami, a gene encoding a surface-exposed autolysin with a C terminus similar to that of InIB. Ami was clearly involved because an ami null mutant constructed in an EGDdeltainIA-F background was adhesion-defective. Thus new regions involved in the adhesion of L. monocytogenes to eukaryotic cells were identified. Further study is required to define more accurately the roles of these regions in the adhesion process itself.

Bacterial Adhesion↗

Fixed-point quantum search.

The quantum search algorithm consists of an iterative sequence of selective inversions and diffusion type operations, as a result of which it is able to find a state with desired properties (target state) in an unsorted database of size N in only sqrt[N] queries. This is achieved by designing the iterative transformations in a way that each iteration results in a small rotation of the state vector in a two-dimensional Hilbert space that includes the target state; if we choose the right number of iterative steps, we will stop just at the target state. This Letter shows that by replacing the selective inversions by selective phase shifts of pi/3, the algorithm preferentially converges to the target state irrespective of the step size or number of iterations. This feature leads to robust search algorithms and also to new schemes for quantum control and error correction.

Journal Article↗

Diagnosis of osteoid osteoma using STIR magnetic resonance imaging.

Two patients with osteoid osteomas were evaluated with magnetic resonance imaging at 1.5 T using both conventional spin-echo (SE) and short TI inversion-recovery (STIR) sequences. On plain films the classic findings of a radiolucent nidus with a dense surrounding reactive zone of sclerosis were absent. The diagnosis was suspected on observing the presence of marked marrow oedema in the involved bone. Conventional SE images were unimpressive in detecting the bone marrow changes. Increased signal intensity indicating bone marrow oedema was striking on the STIR images and facilitated diagnosis. In cases of suspected osteoid osteoma which do not demonstrate the classic radiologic features, adding the STIR sequence to conventional SE magnetic resonance sequences to enhance detection of bone marrow change is recommended.

Adult↗

Early diffusion-weighted magnetic resonance imaging findings in neonatal herpes encephalitis.

Neonatal herpes encephalitis is usually caused by herpes simplex virus type 2 and results in significant morbidity and mortality. Imaging diagnosis with ultrasound, computed tomography scan and conventional magnetic resonance imaging may be normal in the early course of the disease. In this case diffusion-weighted magnetic resonance imaging detected the disease process earlier and better than the conventional T2-weighted or fluid-attenuated inversion recovery imaging sequences. The use of diffusion-weighted magnetic resonance imaging in neonatal herpes encephalitis proved to be a useful tool in the early stage of the disease.

Acyclovir↗

Comparison of transrectal ultrasound and magnetic resonance imaging in the staging of prostate cancer.

A group of 32 patients with a histological diagnosis of prostate cancer underwent transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) to stage the disease. TRUS was more sensitive in the detection of tumour and in the detection of direct extracapsular spread. MRI was more sensitive in the detection of tumour involvement of the seminal vesicles and bladder base. MRI allowed the detection of lymphadenopathy and bone metastases in the lumbosacral spine and pelvis. During MRI the short tau inversion recovery (STIR) sequence was found to be particularly useful for the detection of tumour spread. TRUS and MRI are complementary investigations and for the accurate staging of prostatic malignancy both investigations should be used.

Bone Neoplasms↗

Comparing white matter lesions on T2 and FLAIR MRI in the Sydney Older Persons Study.

There is suggestion that magnetic resonance imaging (MRI) fluid-attenuated inversion recovery (FLAIR) sequence may be more accurate than T2 images in detecting white matter lesions (WML) in older people. Comparative ratings of these two image sequences have not been directly investigated in very old individuals to date. We compared the ratings of periventricular and deep WML on these two sequences in a sample of 111 community dwellers (mean age 85.5 years) using semiquantitative methods. Periventricular WML were as commonly detected on T2 as on FLAIR but were more severely rated on the latter sequence. No such bias was observed for the deep WML. With one exception, correlations between the two sets of measures were significant at the P < 0.001 level (range: 0.34-0.75). Intrarater reliability coefficients were moderate to excellent for most ratings. These results suggest that ratings performed on T2-weighted images to detect WML in very old individuals are very comparable with those performed on FLAIR images although FLAIR may allow a finer grading of periventricular lesions. Absence of FLAIR does not preclude the identification of WML in this population. These findings have clinical and epidemiological relevance where the acquisition of supplementary MRI data may not always be possible.

Aged↗

Neuroimaging of focal cortical dysplasia.

Focal cortical dysplasia (FCD) is a common cause of pharmacoresistant epilepsy that is amenable to surgical resective treatment. The identification of structural FCD by magnetic resonance imaging (MRI) can contribute to the detection of the epileptogenic zone and improve the outcome of epilepsy surgery. MR epilepsy protocols that include specific T1 and T2 weighted, and fluid-attenuated inversion recovery (FLAIR) sequences give complementary information about the characteristic imaging features of FCD; focal cortical thickening, blurring of the gray-white junction, high FLAIR signal, and gyral anatomical abnormalities. Novel imaging techniques such as magnetic resonance spectroscopy (MRS), magnetization transfer imaging (MTI), and diffusion tensor imaging (DTI) can improve the sensitivity of MR to localize the anatomical lesion. Functional/metabolic techniques such as positron emission tomography (PET), ictal subtraction single photon emission computed tomography (SPECT), functional MRI (fMRI), and magnetic source imaging (MSI) have the potential to visualize the metabolic, vascular, and epileptogenic properties of the FCD lesion, respectively. Identification of eloquent areas of cortex, to assist in the surgical resection plan, can be obtained non-invasively through the use of fMRI and MSI. Although a significant number of FCD lesions remain unidentified using current neuroimaging techniques, future advances should result in the identification of an increasing number of these cortical malformations.

Cerebral Cortex↗

Fitness in soil and rhizosphere of Pseudomonas fluorescens C7R12 compared with a C7R12 mutant affected in pyoverdine synthesis and uptake.

Fluorescent pseudomonads have evolved an efficient strategy of iron uptake based on the synthesis of the siderophore pyoverdine and its relevant outer membrane receptor. The possible implication of pyoverdine synthesis and uptake on the ecological competence of a model strain (Pseudomonas fluorescens C7R12) in soil habitats was evaluated using a pyoverdine minus mutant (PL1) obtained by random insertion of the transposon Tn5. The Tn5 flanking DNA was amplified by inverse PCR and sequenced. The nucleotide sequence was found to show a high level of identity with pvsB, a pyoverdine synthetase. As expected, the mutant PL1 was significantly more susceptible to iron starvation than the wild-type strain despite its ability to produce another unknown siderophore. As with the wild-type strain, the mutant PL1 was able to incorporate the wild-type pyoverdine and five pyoverdines of foreign origin, but at a significantly lower rate despite the similarity of the outer membrane protein patterns of the two strains. The survival kinetics of the wild-type and of the pyoverdine minus mutant, in bulk and rhizosphere soil, were compared under gnotobiotic and non-gnotobiotic conditions. In gnotobiotic model systems, both strains, when inoculated separately, showed a similar survival in soil and rhizosphere, suggesting that iron was not a limiting factor. In contrast, when inoculated together, the bacterial competition was favorable to the pyoverdine producer C7R12. The efficient fitness of PL1 in the presence of the indigenous microflora, even when coinoculated with C7R12, is assumed to be related to its ability to uptake heterologous pyoverdines. Altogether, these results suggest that pyoverdine-mediated iron uptake is involved in the ecological competence of the strain P. fluorescens C7R12.

Journal Article↗

Low-field magnetic resonance imaging of bone marrow in the lumbar spine, pelvis, and femur in the adult dog.

The purpose of this study was to describe the appearance of normal bone marrow in seven adult dogs using low-field (0.3T) magnetic resonance (MR) imaging. The areas imaged included the lumbar spine, pelvis, and femur. T1-weighted, fast spin-echo T2-weighted, and short tau (T1) inversion recovery (STIR) sequences were obtained at all locations. Histopathology was performed on sections from the sixth lumbar vertebral body, the wing of the ilium, and the femur (head and neck, mid-diaphysis, and condyle) for evaluation of cellularity and fat content. The lumbar spine and pelvic marrow MR images were similar in all dogs. The lumbar vertebral bone marrow was uniform, intermediate signal intensity, and isointense to muscle on all sequences. There was variation between dogs in the bone marrow distribution with MR imaging of the femur. In the proximal and mid-diaphysis of the femur there was patchy high-signal intensity on T1- and T2-weighted images, and hypointense foci on the STIR images. The distal femoral metaphysis had a variable pattern ranging from intermediate-to-high signal on T1- and T2-weighted images and intermediate-to-low signal on STIR images. The femoral condyles were uniformly high signal on T1- and T2-weighted images and hypointense on STIR images. Histopathologically there was a normal variation in the bone marrow cellularity. The marrow was normocellular (25-75% cellularity) for all sites examined except the femoral condyles, which were hypocellular (<25% cellularity).

Adipose Tissue↗

Confirmation of target localization and dosimetry for 3D conformal radiotherapy treatment planning by MR imaging of a ferrous sulfate gel head phantom.

A detailed methodology has been developed to verify the three-dimensional (3D) radiation dose mapping of conformal therapy radiation treatment planning by FeMRI dosimetry. A phantom that consisted of a human skull filled with a 1-mM solution of ferrous sulfate and 0.1-N sulfuric acid gelled with 7.5% (by weight) gelatin was employed. With a spherical target volume in the head phantom, five noncoplanar conformal beams were designed through the use of a 3D treatment planning system developed in-house. The phantom was irradiated with a 6-MV linear accelerator to a total dose of 25 Gy delivered to the periphery of the target volume. The phantom and a set of calibration vials were scanned simultaneously in a GE 1.5T MR imager with six different multiscan inversion-recovery pulse sequences. The values of T1 were evaluated on a pixel-by-pixel basis through the use of custom-built software on a UNIX workstation and were converted to dose using calibration data. Comparisons of dose distributions between those measured by FeMRI and those calculated by 3D treatment planning show good agreement.

Biophysical Phenomena↗

Derivation of high enterotoxin B-producing mutants of Staphylococcus aureus from the parent strains.

Certain pH-sensitive (membrane) mutants of Staphylococcus aureus, strains 14458 and 778, produce significantly more type-B enterotoxin (SEB) than the parent type. Some carbohydrate mutants (car) from these parent strains also are superior to the parent in SEB formation. By isolating car mutants from high-SEB-producing membrane mutants, it is possible to derive a double mutant producing from six to 50 times as much SEB as the parent type. Inversion of the sequence by isolating pH-sensitive mutants from car mutants does not yield clones with strikingly higher SEB production than the parent strain. The successful isolation sequence (pH-sensitive mutant first and car mutants derived from it) is relatively simple and virtually assures detection of a truly high-SEB-producing clone. The total number of clones whose direct assay for SEB formation is necessary for detection of a high-producing mutant is on the order of 50 to 60.

Enterotoxins↗

Characterization of IS1547, a new member of the IS900 family in the Mycobacterium tuberculosis complex, and its association with IS6110.

Unlike classically defined insertion sequence (IS) elements, which are delimited by their inverted terminal repeats, some IS elements do not have inverted terminal repeats. Among this group of atypical IS elements, IS116, IS900, IS901, and IS1110 have been proposed as members of the IS900 family of elements, not only because they do not have inverted terminal repeats but also because they share other features such as homologous transposases and particular insertion sites. In this study, we report a newly identified IS sequence, IS1547, which was first identified in a clinical isolate of Mycobacterium tuberculosis. Its structure, insertion site, and putative transposase all conform with the conventions of the IS900 family, suggesting that it is a new member of this family. IS1547 was detected only in isolates of the M. tuberculosis complex, where it had highly polymorphic restriction fragment length polymorphism patterns, suggesting that it may be a useful genetic marker for identifying isolates of the M. tuberculosis complex and for distinguishing different strains of M. tuberculosis. ipl is a preferential locus for IS6110 insertion where there are eight known different insertion sites for IS6110. Surprisingly, the DNA sequence of ipl is now known to be a part of IS1547, meaning that IS1547 is a preferential site for IS6110 insertion.

Amino Acid Sequence↗

Involvement of the adc operon and manganese homeostasis in Streptococcus gordonii biofilm formation.

Pioneer oral bacteria, including Streptococcus gordonii, initiate the formation of oral biofilms on tooth surfaces, which requires differential expression of genes that recognize unique environmental cues. An S. gordonii::Tn917-lac biofilm-defective mutant was isolated by using an in vitro biofilm formation assay. Subsequent inverse PCR and sequence analyses identified the transposon insertion to be near the 3' end of an open reading frame (ORF) encoding a protein homologous to a Streptococcus pneumoniae repressor, AdcR. The S. gordonii adc operon, consisting of the four ORFs adcR, adcC, adcB, and adcA, is homologous to the adc operon of S. pneumoniae, which plays a role in zinc and/or manganese transport and genetic competence in S. pneumoniae. AdcR is a metal-dependent repressor protein containing a putative metal-binding site, AdcC contains a consensus-binding site for ATP, AdcB is a hydrophobic protein with seven hydrophobic membrane-spanning regions, and AdcA is a lipoprotein permease with a putative metal-binding site. The three proteins (AdcC through -A) are similar to those of the binding-lipoprotein-dependent transport system of gram-positive bacteria. Reverse transcriptase PCR confirmed that adcRCBA are cotranscribed as an operon in S. gordonii and that the transposon insertion in S. gordonii adcR::Tn917-lac had resulted in a polar mutation. Expression of adcR, measured by the beta-galactosidase activity of the adcR::Tn917-lac mutant, was growth phase dependent and increased when the mutant was grown in media with high levels of manganese (>1 mM) and to a lesser extent in media with zinc, indicating that AdcR may be a regulator at high levels of extracellular manganese. A nonpolar inactivation of adcR generated by allelic replacement resulted in a biofilm- and competence-defective phenotype. The biofilm-defective phenotype observed suggests that AdcR is an active repressor when synthesized and acts at a distant site(s) on the chromosome. Thus, the adc operon is involved in manganese acquisition in S. gordonii and manganese homeostasis and appears to modulate sessile growth in this bacterium.

ATP-Binding Cassette Transporters↗

Inflammation in ankylosing spondylitis: a systematic description of the extent and frequency of acute spinal changes using magnetic resonance imaging.

BACKGROUND: Magnetic resonance imaging (MRI) is increasingly used to detect inflammation in the spine of patients with ankylosing spondylitis (AS). OBJECTIVES: To detect differentially the presence and extent of inflammation in the three spinal segments of patients with AS by MRI. METHODS: In 38 patients with active AS, acute spinal lesions were assessed by T(1) weighted, gadolinium enhanced, spin echo MRI (T(1)/Gd-DTPA) and short tau inversion recovery (STIR) sequences. MRI was quantified by the validated scoring system ASspiMRI-a. Acute spinal lesions were detected in the whole spine and in each spinal segment. One vertebral unit (VU) was defined as the region between two virtual lines drawn through the middle of each vertebral body. RESULTS: A greater number of inflammatory spinal lesions were found by the STIR sequence than by Gd-DTPA: inflammation was present in 30.6% of the VUs as assessed by STIR, compared with 26.8% of the same VUs assessed by T(1)/Gd-DTPA. Inflammation was found more commonly in the thoracic spine (TS) than in the cervical (CS) or the lumbar spine (LS) with both techniques. When STIR was used, spinal inflammation in the CS, the TS, and LS was detected in 10/38 (26%), 28/38 (74%), and 9/38 (24%) patients, respectively. The VU T7/8 was found to be the VU most often affected by both techniques (27.8% by T(1)/Gd-DTPA and 34.5% by STIR). CONCLUSIONS: Spinal inflammation is a common manifestation in patients with AS, and appears more frequently in the TS. The scoring system ASspiMRI-a can be used for evaluation of acute spinal changes in AS.

Acute Disease↗

Intravascular lymphoma: magnetic resonance imaging correlates of disease dynamics within the central nervous system.

BACKGROUND: Intravascular lymphoma (IVL) is a rare non-Hodgkin's lymphoma with relative predilection for the central nervous system. In the absence of extraneural manifestations, the disease is not recognised until autopsy in the majority of cases underlining the need for new clinical markers. METHODS: This is a retrospective series of five patients with IVL seen at a single institution over three years. An advanced magnetic resonance imaging (MRI) protocol was performed at various time points prior to diagnosis and during treatment. RESULTS: MRI revealed multiple lesions scattered throughout the cerebral hemispheres; the brainstem, cerebellum, and spinal cord were less frequently involved. On initial presentation, hyperintense lesions were seen on diffusion weighted images suggestive of ischaemia in three of four patients in whom the images were obtained at that time point. In four patients lesions were also identifiable as hyperintense areas on fluid attenuated inversion recovery (FLAIR) sequences. Initial contrast enhancement was encountered in three cases. Diffusion weighted imaging lesions either vanished or followed the typical pattern of an ischaemic small vessel stroke with evolution of abnormal FLAIR signal followed by enhancement with gadolinium in the subacute stage and tissue loss in the chronic stage. Diffusion weighted imaging and FLAIR abnormalities proved to be partially reversible, correlating with the response to chemotherapy. CONCLUSION: We provide the first detailed description of the dynamic pattern of diffusion weighted MRI in IVL. These patterns in combination with systemic findings may facilitate early diagnosis and serve as a new tool to monitor treatment response.

Adult↗

Noninvasive measurement of extraction fraction and single-kidney glomerular filtration rate with MR imaging in swine with surgically created renal arterial stenoses.

PURPOSE: To test whether magnetic resonance (MR) imaging enables accurate measurement of extraction fraction (EF) in swine with unilateral renal ischemia and to evaluate effects of renal arterial stenosis on EF and single-kidney glomerular filtration rate. MATERIALS AND METHODS: High-grade unilateral renal arterial stenoses were surgically created in eight pigs. Direct measurements of renal venous and arterial inulin concentration provided reference standard estimates of single-kidney EF. Pigs were imaged with a 1.5-T imager to estimate EF, renal blood flow, and glomerular filtration rate. A breath-hold inversion-recovery spiral sequence was used to measure T1 of blood in the infrarenal inferior vena cava and renal veins after intravenous administration of gadopentetate dimeglumine, and these data were used to calculate EF. Cine-phase contrast material-enhanced imaging of the renal arteries provided quantitative renal blood flow measurements. Bilateral single-kidney glomerular filtration rate was then determined: glomerular filtration rate = renal blood flow x (1 - hematocrit level) x EF. RESULTS: A statistically significant linear correlation was found between EF, as determined with MR imaging, and inulin (r = 0.77). As compared with kidneys without renal arterial stenosis, kidneys with renal arterial stenosis showed 50% (0.14/0.28) EF reduction (P <.01) and 59% glomerular filtration rate reduction (P <.01). CONCLUSION: MR imaging shows promise for in vivo measurement of EF and glomerular filtration rate, which may be useful in assessing the clinical importance of renal arterial stenosis.

Animals↗