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PubMed2005

Time-resolved echo-shared parallel MRA of the lung: observer preference study of image quality in comparison with non-echo-shared sequences.

The aim of this study was to evaluate the image quality of time-resolved echo-shared parallel MRA of the lung. The pulmonary vasculature of nine patients (seven females, two males; median age: 44 years) with pulmonary disease was examined using a time-resolved MRA sequence combining echo sharing with parallel imaging (time-resolved echo-shared angiography technique, or TREAT). The sharpness of the vessel borders, conspicuousness of peripheral lung vessels, artifact level, and overall image quality of TREAT was assessed independently by four readers in a side-by-side comparison with non-echo-shared time-resolved parallel MRA data (pMRA) previously acquired in the same patients. Furthermore, the SNR of pulmonary arteries (PA) and veins (PV) achieved with both pulse sequences was compared. The mean voxel size of TREAT MRA was decreased by 24% compared with the non-echo-shared MRA. Regarding the sharpness of the vessel borders, conspicuousness of peripheral lung vessels, and overall image quality the TREAT sequence was rated superior in 75-76% of all cases. If the TREAT images were preferred over the pMRA images, the advantage was rated as major in 61-71% of all cases. The level of artifacts was not increased with the TREAT sequence. The mean interobserver agreement for all categories ranged between fair (artifact level) and good (overall image quality). The maximum SNR of TREAT did not differ from non-echo-shared parallel MRA (PA: TREAT: 273+/-45; pMRA: 280+/-71; PV: TREAT: 273+/-33; pMRA: 258+/-62). TREAT achieves a higher spatial resolution than non-echo-shared parallel MRA which is also perceived as an improved image quality.

Adolescent↗
PubMed1999

Treatment of port-wine stains with a noncoherent pulsed light source: a retrospective study.

OBJECTIVE: We investigated whether a noncoherent intense pulsed light source (IPLS) would be effective in therapy of port-wine stains (PWSs). DESIGN: To evaluate the efficacy in treatment of PWSs with IPLS, a retrospective study was initiated. SETTING: The data were collected by physicians working in private practices and departments of university hospitals and medical centers, respectively. PATIENTS: A total of 37 randomly selected patients with a total of 40 PWSs were included in the study. Clinical PWS characteristics recorded were color and location of the PWS. INTERVENTIONS: All patients were treated with IPLS. MAIN OUTCOME MEASURES: Data collected included treatment parameter (filters, pulse duration, fluence, and pulse sequencing), percentage of clearance, and side effects (purpura, blisters, crusting, altered pigmentation, and scarring). RESULTS: Good and complete (70%-100%) clearance was achieved in 28 of 40 PWSs treated with IPLS. The average number of treatment sessions in PWSs reaching 100% clearance included 4.0 for pink PWSs and 1.5 for red PWSs. The average number of sessions for purple PWSs reaching good clearance (70%-99%) was 4.2 sessions. Parameters used most frequently were 515- and 550-nm cut-off filters, pulse duration of 2.5 to 5.0 milliseconds, and fluences of 24 to 60 J/cm2. Side effects included purpura in 133 (76%), superficial blisters in 14 (8%), and crusting in 35 (20%). Transient pigmentation changes were seen in 10.8% of patients (hypopigmentation in 3 [8.1%], hyperpigmentation in 1 [2.7%]). No scarring was observed. CONCLUSION: Intense pulsed light source presents an effective and safe method for treating PWSs, especially purple PWSs.

Adolescent↗
PubMed1998

Delineation of maxillofacial cutaneous lesions by means of high-resolution magnetic resonance imaging.

To evaluate the use of high-resolution magnetic resonance imaging (MRI) for the differentiation of skin tumors in the maxillofacial region, 60 patients (25 female) were examined in a 1.5-T whole-body MR imager with a 2.5-cm surface coil. Plain transverse T1-(TR 500 ms, TE 25 ms), T2-(2200 ms, TE 80 ms), fat-(TR 500 ms, TE 28 ms), and water-suppressed (TR 500 ms, TE 38 ms) SE sequences were used. Following the application of the paramagnetic contrast agent Gd-DTPA, transverse T-weighted and fat suppression sequences were repeated. Before and after contrast administration, tumor signal intensities and percent contrast enhancement were determined by a ROI technique. All tumors were classified by standard histologic technique and evaluated with regard to their response to contrast medium. Quantitative evaluation was performed by three independent radiologists. Additionally, signal- and contrast-to-noise ratios were calculated for each tumor type. All MRI findings were compared with histology. Significant contrast enhancement occurred in most tumors; malignant tumors displayed inhomogeneous enhancement. The optimal pulse sequences for tumor delineation are plain T1-weighted, water-suppressed, and contrast-enhanced fat-suppressed sequences. Tumors could not be specified by signal intensities or percent contrast enhancement, and CNR did not allow for malignant lesions to be differentiated from benign tumors. High-resolution MRI proved to be an adequate method for imaging skin tumors and their inner structure. Tumor typing was not possible by either contrast-administration or modification of sequence parameters. In this regard, further innovations in contrast agent design seem to be necessary.

Adult↗
PubMed1985

Cardiac transplantations in dogs: evaluation with MR.

To assess the potential of magnetic resonance (MR) imaging as an early predictor of cardiac transplant rejection, electrocardiogram-gated (ECG-gated) MR imaging was performed in 12 dogs with heterotopic cardiac transplants. Twenty-two examinations were performed in vivo, and ten postmortem examinations were performed immediately after the dogs were killed. Examinations were performed from 3 days to 14 weeks after transplantation. A 0.35-T superconducting magnet was used with the spin-echo pulse sequence. There was a significant increase (P less than .02 to P less than .001) in T2 relaxation times and intensity values for the transplanted hearts compared with native hearts at all time intervals after transplantation. T1 relaxation times of native and transplanted hearts showed no significant difference on the in vivo ECG-gated studies. However, T1 values calculated on post-mortem studies were significantly longer (P less than .005) in the transplanted compared with the native hearts. With longer pulse repetition and echo delay times, there was an increase in the contrast between the rejecting transplanted heart and the native heart. Thus, ECG-gated MR imaging using the spin-echo technique displays cardiac allograft rejection in vivo. The rejected myocardium in vivo is characterized by a prolonged T2 relaxation time.

Animals↗
PubMed1997

Posterolateral rotatory instability of the elbow: usefulness of MR imaging in diagnosis.

PURPOSE: To evaluate the efficacy of magnetic resonance (MR) imaging in the assessment of the normal and abnormal ulnar band of the lateral collateral ligament for diagnosis of posterolateral rotatory instability. MATERIALS AND METHODS: In nine symptomatic patients and nine asymptomatic subjects, MR imaging was performed with three-dimensional gradient-recalled and fast spin-echo sequences. The nine patients had clinical symptoms suggestive of subtle elbow instability. RESULTS: The components of the lateral collateral ligament were identified; tears of the ulnar band were noted in all symptomatic patients. The anterior fibers of the lateral collateral ligament, including the annular ligament, were intact. All symptomatic patients subsequently underwent surgical exploration and reconstruction. Positive clinical findings were demonstrated at examination performed while the patients were under anesthesia. All tears of the ulnar band were confirmed. CONCLUSION: With use of appropriate pulse sequences, MR imaging is an effective tool in the preoperative, noninvasive diagnosis of posterolateral rotatory instability.

Adolescent↗
PubMed2003

Application of optimal control theory to the design of broadband excitation pulses for high-resolution NMR.

Optimal control theory is considered as a methodology for pulse sequence design in NMR. It provides the flexibility for systematically imposing desirable constraints on spin system evolution and therefore has a wealth of applications. We have chosen an elementary example to illustrate the capabilities of the optimal control formalism: broadband, constant phase excitation which tolerates miscalibration of RF power and variations in RF homogeneity relevant for standard high-resolution probes. The chosen design criteria were transformation of I(z)-->I(x) over resonance offsets of +/- 20 kHz and RF variability of +/-5%, with a pulse length of 2 ms. Simulations of the resulting pulse transform I(z)-->0.995I(x) over the target ranges in resonance offset and RF variability. Acceptably uniform excitation is obtained over a much larger range of RF variability (approximately 45%) than the strict design limits. The pulse performs well in simulations that include homonuclear and heteronuclear J-couplings. Experimental spectra obtained from 100% 13C-labeled lysine show only minimal coupling effects, in excellent agreement with the simulations. By increasing pulse power and reducing pulse length, we demonstrate experimental excitation of 1H over +/-32 kHz, with phase variations in the spectra <8 degrees and peak amplitudes >93% of maximum. Further improvements in broadband excitation by optimized pulses (BEBOP) may be possible by applying more sophisticated implementations of the optimal control formalism.

Algorithms↗
PubMed1998

Study of susceptibility-induced artefacts in GRASE with different echo train length.

The aim of this study was to evaluate the sensitivity of gradient-and-spin-echo (GRASE) sequences to susceptibility effects. GRASE sequences with 21 and 33 echoes per echo train were compared with a T2-weighted FSE sequence with an echo train length of 5 by means of MRI in phantoms, volunteers (n = 10), and patients (n = 19) with old hemorrhagic brain lesions. All experiments were performed on a 1.0-T clinical MR system (Impact Expert, Siemens AG, Erlangen, Germany) with constant imaging parameters. Contrast-to-noise ratios (CNRs) of tubes doped with iron oxides at different concentrations, of brain areas with physiological iron deposition (red nucleus, substantia nigra), and of areas of old brain hemorrhage were calculated for FSE and GRASE pulse sequences. Areas of old brain hemorrhage were also qualitatively analyzed for the degree of visible susceptibility effects by blinded reading. The CNR of iron oxide tubes and iron-containing brain areas decreased with increasing echo trains of GRASE sequences. The CNR of GRASE sequences decreased when compared with CNR of their FSE counterparts (GRASE 21 echo trains 23.8 +/- 0.8, FSE 5 echo trains 26.7 +/- 0.9; p </= 0.01). Qualitative analysis confirmed these measurements. FSE with an ETL of 5 demonstrated significantly stronger susceptibility effects than their GRASE counterpart with an ETL of 21. The results demonstrate that GRASE sequences do not necessarily compensate for the reduced sensitivity of FSE to susceptibility effects. The complex signal behavior of GRASE makes conventional SE, gradient echo, or FSE sequences containing shorter echo trains preferable when patients with intracranial hemorrhage are clinically evaluated.

Adult↗
PubMedDate not supplied

Chemical shift selective magnetic resonance imaging of the optic nerve in patients with acute optic neuritis.

Optic neuritis is often the first manifestation of multiple sclerosis (MS). Sixteen patients with acute optic neuritis and one patient with benign intracranial hypertension (BIH) were investigated by magnetic resonance imaging, using a chemical shift selective double spin echo sequence. In 3 of the 16 patients, abnormalities were seen. In one patient with bilateral symptoms, signal hyperintensity and swelling of the right side of the chiasm were found. In another patient the optic nerve was found diffusely enlarged with only a marginally increased signal in the second echo. In the third patient an area of signal hyperintensity and swelling was seen in the left optic nerve. In the patient with BIH the subarachnoid space which surrounds the optic nerves was enlarged. Even using this refined pulse sequence, avoiding the major artefact in imaging the optic nerve, the chemical shift artefact, lesions were only shown in 3/16 (19%) of the patients with optic neuritis. Nevertheless, the presented chemical shift selective double spin echo sequence may be of great value for detection of retrobulbar lesions.

Acute Disease↗
PubMed1987

Gradient reversal technique and its applications to chemical-shift-related NMR imaging.

The chemical-shift effect often degrades slice selectivity thereby degrading the contrast and spatial resolutions in a high-field NMR imaging. We propose a new pulse sequence which can compensate for this chemical-shift effect during slice selection. This technique provides correct slice definition as well as clear separation between water and lipid protons in high-field proton NMR imaging. Particular applications of this technique are 2D imaging with a thin-slice selection and chunk 3D imaging, where correction of the chemical-shift effect in slice selection is important. Another interesting application of the technique is chemical-shift-selective (CHESS) imaging. This technique does not require spectral-selective rf pulses and it takes advantage of the chemical-shift effect during slice selection. The latter is found to be useful for human in vivo chemical-shift imaging in high-field NMR. In this paper, the theoretical derivation of the proposed gradient reversal technique, its applications, and related experimental results are presented.

Humans↗
PubMed1994

Perflubron as an oral contrast agent for MR imaging: results of a phase III clinical trial.

PURPOSE: To assess perflubron for magnetic resonance (MR) imaging in the abdomen and pelvis in a multicenter trial. MATERIALS AND METHODS: MR images were obtained in 127 subjects before and after ingestion of perflubron with T1-, proton-density-, and T2-weighted sequences at 0.38, 1.0, or 1.5 T. Postcontrast images were compared with baseline images, and percentage of additional bowel darkened, distinction of bowel from adjacent tissue, and change in image artifact were graded. RESULTS: Perflubron increased the bowel darkening in over 92% of subjects with all sequences and field strengths. It improved definition of the left lobe of the liver and body and tail of the pancreas in 67%, 29%, and 42% of subjects, respectively, and of the uterus and bladder in 80% and 76%. Abnormal tissue was more conspicuous in 69% of subjects. Highest scores were achieved when the upper abdomen was imaged 5-30 minutes and the pelvis 10-40 minutes after ingestion. No image artifacts or side effects were attributed to perflubron. CONCLUSION: Perflubron is safe, and its efficacy was unaffected by pulse sequences, magnetic field strength, or time delay.

Abdomen↗
PubMedDate not supplied

Comparison of CT and three MR sequences for detecting and categorizing early (48 hours) hemorrhagic transformation in hyperacute ischemic stroke.

BACKGROUND AND PURPOSE: Our goal was to compare the sensitivity of CT and three MR sequences in detecting and categorizing early (48 hours) hemorrhagic transformation (HT) in hyperacute ischemic stroke. METHODS: Twenty-five consecutive patients with hyperacute ischemic stroke (<6 hours) without MR signs of cerebral bleeding at admission were included. Twenty-one underwent thrombolytic therapy. A standardized follow-up protocol, performed 48 hours after admission, combined brain CT scan and MR examination (1.5 T) including fast spin-echo-fluid-attenuated inversion recovery (FSE-FLAIR), echo-planar spin-echo (EPI-SE) T2-weighted, and EPI-gradient-recalled echo (GRE) T2*-weighted sequences. Both CT scans and MR images were obtained within as short a time span as possible between techniques (mean delay, 64 minutes). CT scans and MR images were independently rated as negative or positive for bleeding and categorized for bleeding severity (five classes) by two blinded observers. Prevalence of positive cases, intra- and interobserver agreement, and shifts in bleeding categorization between respective modalities and sequences were assessed. RESULTS: Twelve patients (48%) were rated positive for HT on the basis of findings of at least one technique or sequence. From this subset of bleeding patients, seven (58%) had positive CT findings, nine (75%) had positive FSE-FLAIR and EPI-SE T2-weighted findings, and 12 (100%) had positive EPI-GRE T2*-weighted findings. CT had lower intra- and interobserver agreement for positivity than did MR imaging. Among the seven patients with positive CT and MR findings, only two had convergent ratings for bleeding category based on findings of two modalities. The five remaining had upward grading from CT to MR, which varied according to pulse sequence. CONCLUSION: MR imaging depicted more hemorrhages and had higher intra- and interobserver agreement than did CT. The EPI-GRE T2*-weighted sequence demonstrated highest sensitivity. Equivocal upward shifts in bleeding categorization were observed from CT to MR imaging and between MR images.

Acute Disease↗
PubMed1996

Perflubron as a gastrointestinal MR imaging contrast agent in the pediatric population.

OBJECTIVE: To evaluate the safety and efficacy of orally administered perflubron for bowel recognition on MR imaging in a pediatric population. MATERIALS AND METHODS: A multicenter trial evaluated 39 pediatric subjects before and after ingestion of perflubron with T1-, proton-density, and T2-weighted sequences through the abdomen and/or pelvis. Post-contrast images were compared with pre-contrast images. Safety was evaluated through assessment of adverse events, clinical laboratory parameters, and vital signs. RESULTS: With regard to efficacy analysis, improvement in the percent of bowel darkened was observed for 85 % of the subjects on T1-weighted images and for 95 % of the subjects on proton-density and T2-weighted images. For images of the abdominal region, the percent of bowel darkened was improved for 90-92 % of the subjects across pulse sequences. Improvement rates for the images of the pelvic region ranged from 71 % to 100 %. For at least 75 % of the subjects, proton-density and T2-weighted images of the body and tail of the pancreas, left lobe of the liver, mesenteric fat, and pathological tissue were improved relative to predosing images. Twenty-three percent of the subjects experienced some adverse effects, most of which were minor and related to the digestive system. Clinical laboratory and vital sign evaluations revealed no trends associated with the administration of perflubron. CONCLUSION: Perflubron is a relatively safe and effective gastrointestinal MR contrast agent in the pediatric population.

Abdomen↗
PubMed2006

Investigation of atherosclerotic plaques with MRI at 3 T using ultrasmall superparamagnetic particles of iron oxide.

This study aims to investigate the uptake of the experimental ultrasmall superparamagnetic particles of iron oxide (USPIO) contrast agent DDM43/34 (Schering AG, Berlin, Germany) by aortic atherosclerotic plaques using magnetic resonance imaging (MRI) at 3 T. Six Watanabe heritable hyperlipidemic rabbits were injected with USPIO at doses of 0.1-1.0 mmol/kg Fe. Parasagittal magnetic resonance angiography (MRA) scans were acquired using 3D gradient-echo sequences before and after USPIO administration, then again after 6 h, 1 day, 2 days and 5 days. At later time points, when the USPIO concentration was too low to enhance blood signal, additional MRA scans were acquired during the infusion of gadopentate dimeglumine (Magnevist; Schering AG). In the images, widespread susceptibility artifacts demonstrated readily detectable USPIO uptake in the liver, bone marrow and lymphatic vessels. Surprisingly, however, no such effects could be associated specifically with the aortic vessel wall, in contrast to previous studies that showed strong uptake with similar pulse sequences. Histological analysis was performed on aortic slices from two animals, demonstrating that aortic plaques were active but showed very little USPIO uptake, consistent with MRI findings. We conclude that, despite the exciting potential of plaque detection using USPIO, some caution is advised since the absence of susceptibility effects does not necessarily imply the absence of plaque, even at 3 T, which offers increased sensitivity to susceptibility. Future work will investigate the dependence of such results on stage of plaque development, magnetic field strength and choice of contrast agent.

Animals↗
PubMed2001

Functional, dynamic, and anatomic MR urography: feasibility and preliminary findings.

RATIONALE AND OBJECTIVES: The authors assessed the feasibility of using magnetic resonance (MR) urography to acquire functional, dynamic, and anatomic information in human subjects with normal and hydronephrotic kidneys. MATERIALS AND METHODS: In subjects known to have or suspected of having hydronephrosis, split renal filtration fractions were measured with a customized magnetization-prepared, inversion-prepared gradient-recalled echo sequence to determine the T1 of flowing blood in the inferior vena cava and aorta before and after contrast medium administration and in the renal veins and arteries after contrast medium administration. Multiple timed sets of coronal fast spoiled gradient-echo 70 degrees flip-angle images were acquired before and after contrast medium administration to derive MR renograms from changes in the signal intensity of the cortex and medulla. Precontrast T2-weighted images were obtained with a three-dimensional fast spoiled gradient-echo maximum intensity projection pulse sequence, and postcontrast T1 maximum intensity projection images were also obtained to depict the renal anatomy. RESULTS: Split filtration fraction differentiated normal from hydronephrotic kidneys. MR renograms depicted vascular, tubular, and ductal phases and differentiated between normal and hydronephrotic kidneys (P < .05, n = 20). Contrast medium dose correlated with the peak of the cortical signal intensity curves on the renogram (r = 0.7, P < .0005; n = 20). The sensitivities for the visual determination of hydronephrosis and unilateral delayed excretion of contrast material were both 100%, and the specificities were 64% and 85%, respectively. CONCLUSION: The preliminary findings show promise for the use of MR urography in the comprehensive assessment of renal function, dynamics, and anatomy.

Adult↗
PubMed1988

STIR MR imaging of the orbit.

Fifteen patients with CT-documented orbital lesions were evaluated with MR imaging at 1.5 T with both conventional spin-echo (SE) and short inversion time inversion recovery (STIR) sequences. Fat signal was reliably nulled at inversion times of approximately 120-200 msec in all cases, thereby allowing clear detection of all retrobulbar lesions and normal structures on STIR images as markedly hyperintense relative to fat. All lesions were also clearly depicted on SE images; in fact, short repetition time/short echo time SE sequences were at least as useful as STIR images for illustrating anatomic structures and mass lesions, and in a much shorter scanning time. Separation of optic nerve from perioptic subarachnoid space was clear on SE images, but often difficult or impossible on STIR images owing to the relatively high intensity of normal optic nerves on STIR images. The synergism of relaxation prolongation with STIR actually resulted in loss of information, as any ability to separate the effects of T1 from T2 on signal intensity was impossible when STIR was the sole pulse sequence. We believe that more information is obtained with standard SE sequences than with STIR sequences, and therefore SE remains the method of choice for orbital MR imaging.

Adolescent↗
PubMed1996

Proton detection of choline and lactate in EMT6 tumors by spin-echo-enhanced selective multiple-quantum-coherence transfer.

An extension of the Sel-MQC pulse sequence--SEE-SelMQC (spin-echo-enhanced selective multiple-quantum coherence transfer)--that completely suppresses lipid and water in tissues containing mobile lipid in a single scan and detects 1H resonances of multiple metabolites is described. As in the Sel-MQC lactate-editing experiments [Q. He et al., J Magn. Reson. B 106,203 (1995)], SEE-SelMQC acquires lactate from its ZQ --> DQ coherence-transfer pathway; in addition, the method recovers signal from other metabolites by selective generation of additional spin echoes using extra frequency-selective pulses and gradients. This method introduces no loss of lactate signal intensity beyond the 50% that is lost through the multiple-quantum coherence-transfer process. The spatial distributions of choline and lactate with a phantom and in vivo, in subcutaneously implanted murine EMT6 tumors, have been simultaneously mapped.

Animals↗
PubMed2005

Temperature dependence of nuclear magnetization and relaxation.

The temperature dependences of nuclear magnetization and relaxation rates are reviewed theoretically and experimentally in order to quantify the effects of temperature on NMR signals acquired by common imaging techniques. Using common sequences, the temperature dependences of the equilibrium nuclear magnetization and relaxation times must each be considered to fully understand the effects of temperature on NMR images. The temperature dependence of the equilibrium nuclear magnetization is negative because of Boltzmann's distribution for all substances at all temperatures, but the combined temperature dependences of the equilibrium magnetization and relaxation can be negative, weak or positive depending on the temperature (T), echo time (T(E)), repetition time (T(R)), and the temperature dependences of the relaxation times T(1)(T) and T(2)(T) in a pulse sequence. As a result, the magnitude of the NMR signal from a given substance can decrease, increase or stay somewhat constant with increasing temperature. Nuclear thermal coefficients are defined and predictions for spin echo and other simple sequences are verified experimentally using a number of substances representing various thermal and NMR properties.

Animals↗
PubMed1991

Dynamic gadolinium-enhanced rapid acquisition spin-echo MR imaging of the liver.

Rapid acquisition spin-echo (RASE) magnetic resonance (MR) imaging allows for coverage of the entire liver with highly T1-weighted SE images during a single 23-second breath-holding period. The RASE sequence was implemented in conjunction with rapid intravenous injection of gadopentetate dimeglumine to enable performance of dynamic contrast material-enhanced MR imaging of the liver. Prospective evaluation of 24 patients with 62 liver lesions 1 cm or greater in diameter was performed. Images obtained with RASE were devoid of respiratory-related ghost artifacts or edge blurring. The dynamic contrast-enhanced RASE technique resulted in contrast-to-noise and contrast-to-artifact values and time efficiency measures significantly greater (P less than .05) than those obtained with use of conventional T1- and T2-weighted pulse sequences, indicating a higher likelihood for lesion detectability. Lesion conspicuity was maximal during or immediately following bolus administration of gadopentetate dimeglumine, with lesions often becoming obscured at delayed postcontrast imaging.

Adult↗