Biomedical subjects

A Bücker

Publications and source records attributed to A Bücker.

At least 19 recordsLinked to original sources

PubMed1998

MR-guided interstitial cryotherapy of the liver with a novel, nitrogen-cooled cryoprobe.

The purpose of the study was to test a newly developed, MR-compatible, liquid nitrogen-cooled cryoprobe. The probe has an outer diameter of 3.5 mm and was specifically developed for percutaneous, MR-guided, interstitial cryotherapy. The probe was inserted percutaneously into the livers of 10 rabbits. The cryotherapy procedure was monitored with a surface coil in a 1.5 Tesla magnet using a gradient echo sequence. Follow-up examinations were performed 3 and 7 days after the freezing procedure using T1- and T2-weighted spin echo sequences. At 7 days the animals were sacrificed and the cryolesions were examined histologically. The cryoprobe enabled artifact-free MR imaging of the "iceball" formation during freezing of the rabbit liver. After 1 min of freezing, the iceball at the tip of the probe showed an average maximum diameter of 10.8 mm. No bleeding complications were observed during or after the freezing procedure. Histologic examination 7 days after cryotherapy confirmed that the liver lesions were the same size as had been predicted by the images of the acute iceball. This new, percutaneously inserted, MR-compatible, liquid-nitrogen cooled cryoprobe allows accurate, artifact-free MR imaging of interstitial cryotherapy.

Animals↗

PubMed1998

[Interventional MR tomography: equipment concepts].

Interventional MRI is one of the most recent developments of clinical MR imaging. Because of the development of open MR systems and very compact high-field systems, a number of interventional procedures are already possible today under MR control and will be tested in experimental and clinical investigations. The currently commercially available systems differ with respect to their static magnetic field strength, their gradient systems and patient access. In addition, there are differences concerning their space requirements and costs. All systems have components facilitating interventional procedures. In this article we discuss the advantages and shortcomings of these commercially available systems and look at future developments in interventional MR equipment.

Equipment Design↗

PubMed1998

Plasma protein binding of gyrase inhibitors.

Plasma protein binding of a wide range of gyrase inhibitors in clinical practice or trials has been determined by ultrafiltration to determine structure-protein binding relationships. The protein binding was independent of overall lipophilicity. In particular, the "western" part of the "quinolone" skeleton, consisting of a heterocyclus at position 7 and varying substituents at position 8, strongly influences the extent of protein binding, indicating that this part interacts with the plasma protein. In contrast, substituents in position N1 do not show an effect on the protein binding in this series of compounds.

Adsorption↗

PubMed1998

[Experimental evaluation of superparamagnetic iron oxide particles in pulmonary MR angiography].

PURPOSE: Initial experimental results of contrast-enhanced pulmonary MR angiography using the new superparamagnetic iron oxide blood pool agent FeO-BPA. METHOD: Pulmonary MRA was performed in 7 domestic pigs using a cardiac-triggered coronal T1-weighted FFE-Sequence before and up to 90 minutes after contrast injection obtained on a 1.5 T magnet with a standard gradient equipment. A dose of 4 mg Fe/kg bodyweight was used for MRA. The images were qualitatively assessed and compared with X-ray i.v.-DSA. RESULTS: The injection of FeO-BPA allows the acquisition of unsaturated in-plane images of the pulmonary vascular tree down to the first order subsegmental branches including vessel diameters of approximately 1.5 mm. In the normal non-occluded vasculature, no signal void is seen in the TE range of 2.8-5.5 ms secondary to exceeding susceptibility effects which are caused by the iron oxide accumulation. Even 90 minutes after injection of FeO-BPA, assessment of the pulmonary vasculature is still satisfactory. CONCLUSIONS: In the animal experiment, the use of the blood pool agent FeO-BPA provides detailed pulmonary angiograms even on a magnet with a conventional gradient system. The major advantage is the comfortable diagnostic window of > 1.5 hours which also portends its utility for future MR-guided pulmonary interventions.

Angiography, Digital Subtraction↗

PubMed1998

[MRI-guided percutaneous nephrostomy of the contrast-enhanced, nondilated upper urinary tract: initial experimental results].

PURPOSE: To evaluate technique and practicability of MR-guided percutaneous nephrostomy (MRPCN) in an animal model. METHODS: In three domestic pigs, a unilateral percutaneous nephrostomy tube was placed into the nondilated collecting system using exclusively MR-guidance with a standard 1.5 T scanner. The urinary tract was visualized by intravenous injection of Gd-DTPA and low-dose furosemide. The entire interventional procedure was controlled using a T1-weighted "dual stack" 2 D TFE sequence in two orthogonal planes. RESULTS: In all three animals, the puncture needle was safely directed into the nondilated target calyx. Even slight deviations of the needle from the optimal path were readily detected on both MR image planes which enabled immediate correction. This technique successfully achieved a "first attempt" puncture of the targeted calyx in each animal. Over a nitinol guidewire a 5 F catheter was placed into the renal pelvis. Its dysprosium labelled tip was accurately delineated on contrast-enhanced MR images. CONCLUSIONS: Percutaneous nephrostomy under MR guidance is a very feasible technique for puncturing the nondilated pelvicalyceal system. This procedure offers some advantages over the current standard modalities.

Animals↗

PubMed1998

[A new MR-(and CT-) compatible bone biopsy system: first clinical results].

PURPOSE: To describe the development and clinical evaluation of a new, hand-powered or alternatively motor-driven, MRI and CT compatible percutaneous bone biopsy system. MATERIALS AND METHODS: A new coaxial drill system (Cook Europe A/S) was designed for percutaneous, MR-guided bone biopsies and powered either by hand or an optional motor (10-250 rotations/minute using 6 bar [88.2 PSI] compressed air). The system has been used in 23 patients. Fourteen procedures were performed in a 1.5 T MR scanner (Philips-Gyroscan ACS-NT) which has an attached C-arm (Philips-BV 212-Angio) in case fluoroscopy is required, and 9 procedures in a CT scanner (Siemens-Somatom Plus). RESULTS: Driven by hand or by the pneumatic motor unit, the system achieved safe and accurate MR-guided access to all of the lesions and was even able to penetrate osteosclerotic lesions. MR- or CT-guided percutaneous biopsy yielded a correct diagnosis in all but 5 cases. No procedural complications occurred. CONCLUSION: MR-guided percutaneous bone biopsy performed with the new coaxial drill system was found to be safe and reliable, and suitable for obtaining histological specimens from skeletal lesions even when covered with thick cortical or sclerotic bone.

Biopsy↗

PubMed1998

[Real-time MRI with radial k-radial scanning technique for control of angiographic interventions].

PURPOSE: To test the feasibility of real-time MR controlled guidance of field-inhomogeneity catheters in vitro and in vivo as a first step to MR-guided angiographic interventions. METHODS: Applying a combination of radial scanning with the sliding window reconstruction technique, a frame rate of 23 low resolution images per second was achieved. Field inhomogeneity catheters were steered through a flow phantom and into the renal arteries of a pig. RESULTS: It was possible to visualize flow or, respectively, vessels and to depict catheter movements. This enabled real-time MR-guidance of the catheter into the renal arteries of the flow phantom and into those of the pig. CONCLUSIONS: The new technique yields a sufficiently high temporal resolution for MR-guidance of catheters through vessels.

Angiography↗

PubMed1998

[Stent placement with real time MRI guidance: initial animal experiment experiences].

PURPOSE: The aim of this study was to test the feasibility of iliac artery stent placement under MR guidance with real-time MR radial scanning in an animal model. MATERIALS AND METHODS: The experiments were performed on three pigs in a 1.5 T scanner. Radial scanning with a gradient echo technique (TR 8.4 ms, TE 3.6 ms, flip angle 10 degrees) was used. A dedicated backprojector performed the reconstruction of the raw data in real-time. The resulting MR-images were displayed on LCD screens beside the magnet. The sliding window reconstruction technique allowed image acquisition at a frame rate of 16 images per second. MR-compatible self-expanding stents with a diameter of 8 mm and a length of 3 cm were placed into the left iliac artery. Their positions were verified by digital subtraction angiography (DSA) and compared to MRI. RESULTS: All stents were successfully placed. Stent positions as monitored by real-time MR were identical to those seen on DSA images. The time needed for exact positioning of the scan plane ranged from 15 to 30 minutes. Stent placement itself took 8 minutes on average. CONCLUSION: Radial scanning applied together with the sliding window reconstruction technique allows placement of stents in iliac arteries under real-time MR control.

Angioplasty, Balloon↗

PubMed1998

Device visualization for interventional MRI using local magnetic fields: basic theory and its application to catheter visualization.

This paper addresses one of the major problems in Interventional magnetic resonance imaging (MRI): the visualization of interventional devices. For visualization locally induced magnetic fields are used, which disturb the homogeneity of the main magnetic field of the MR scanner. This results in signal loss in the vicinity of the device due to intravoxel dephasing, and leads to a disturbance of the phase image. The local fields are established by a low current in a closed copper loop along the device. This method will be introduced as a means for catheter visualization. The basic theory behind this method is presented. Simulations are performed to determine the effect of intravoxel dephasing, without interfering effects like susceptibility or radio-frequency artifacts. Scanned and simulated data is used to verify the theoretical consideration. Different configurations of wire loops are discussed and two types of catheter visualization scans are proposed. Results from a pig study show that this methods holds promise for intravascular interventions under MRI guidance.

Animals↗

PubMed1998

Gadolinium-enhanced excretory MR urography after low-dose diuretic injection: comparison with conventional excretory urography.

PURPOSE: To evaluate the clinical utility and morphologic accuracy of gadolinium-enhanced excretory magnetic resonance (MR) urography after low-dose diuretic injection and to correlate the results with those of conventional urography. MATERIALS AND METHODS: In 71 patients with urologic symptoms, excretory MR urography was performed after intravenous injection of 5-10 mg furosemide and, 30-60 seconds later, 0.1 mmol of gadopentetate dimeglumine per kilogram of body weight. The MR urograms were interpreted by three radiologists, who were blinded to the clinical outcome, and subsequently compared with conventional urograms. RESULTS: Injection of furosemide before contrast material led to rapid, uniform gadolinium distribution inside a sufficiently distended collecting system such that there was no excessive concentration of gadolinium in the urine. In patients with normal or moderately reduced excretory function, this effect allowed complete visualization of the urinary tract within 5-20 minutes of contrast material injection while minimizing gadolinium-related endoluminal T2* effects. The clinical course helped verify almost all MR urographic results. The MR urographic technique was significantly superior to conventional urography in the assessment of the ureters and bladder (P < .0001). Delineation of small caliceal abnormalities is still problematic. The best depiction of the pelvicaliceal system was obtained with fat-suppressed MR imaging, although it was still slightly inferior to conventional urography (P < .05). CONCLUSION: Gadolinium-enhanced excretory MR urography performed after low-dose diuretic injection is a promising and accurate alternative to conventional excretory urography for imaging the morphology of the urinary tract.

Adult↗

PubMed1998

Abdominal MR angiography performed using blood pool contrast agents: comparison of a new superparamagnetic iron oxide nanoparticle and a linear gadolinium polymer.

OBJECTIVE: We evaluated and compared two different experimental blood pool contrast agents for abdominal MR angiography in an animal model. MATERIALS AND METHODS: In seven pigs, coronal T1-weighted three-dimensional fast field-echo images were obtained on a conventional 1.5-T MR imaging system before and after i.v. injection of the ultrasmall superparamagnetic iron oxide agent FeO-BPA. In another seven pigs, MR angiograms were acquired using the gadolinium polymer WIN 22181. Enhanced images were obtained 5-210 min after injection of FeO-BPA and 1-120 min after injection of WIN 22181. RESULTS: Both blood pool agents yielded detailed angiograms of the abdominal vascular tree when imaging lasted 2 min. In-plane running vessels were imaged without saturation effects and with equivalent maximum signal-to-noise ratios. Half the maximum signal-to-noise ratio was reached 150 min after injection of FeO-BPA, whereas this interval was approximately 70 min for the gadolinium polymer. Because of these different imaging half-life periods, the effective diagnostic window provided by FeO-BPA was six to eight times longer than that of WIN 22181. In the liver, the vascular T1 shortening and the parenchymal T2* effect of FeO-BPA complemented each other, resulting in an optimal contrast-to-noise ratio significantly higher than that achieved with WIN 22181. This "double-contrast effect" in the liver was especially helpful when obtaining detailed MR portograms. CONCLUSION: The blood pool agents FeO-BPA and WIN 22181 can be used to produce high-quality abdominal MR angiograms on standard MR imaging equipment. The contrast-to-noise ratio of hepatic vessels is best on iron oxide-enhanced images because of a T1-T2* synergistic effect in the liver. The longer diagnostic window provided by FeO-BPA coupled with the option of in-plane imaging suggests the usefulness of FeO-BPA in future MR imaging-guided vascular interventions.

Abdomen↗

PubMed1997

Catheter visualization using locally induced, actively controlled field inhomogeneities.

A new technique for visualization of interventional devices using MR is presented. A prototype catheter was equipped with a thin copper wire loop, leading from the proximal end to the tip and back. A small current (10-150 mA) through these two parts of a wire induces a local magnetic field along the catheter. Introduction of this catheter into the main magnetic field of the MR imager locally disturbs the homogeneity of the magnetic field. Image locations within the locally induced fields appear dark due to signal loss, and the extent of this effect can be varied during the procedure by simply adjusting the current. Different dedicated wire configurations allow visualization of the catheter in its whole length or in parts, i.e., with markers for balloons. Fast gradient echo sequences that provide a bright signal from inflowing blood are used for rapid imaging.

Animals↗

PubMed1997

Radiological assessment of artificial bone defects in the floor of the maxillary sinus.

OBJECTIVE: To compare dental radiographs and axial high resolution (HR) CT scans for the identification of artificial bone defects between the maxillary sinus and the roots of the adjacent teeth and to evaluate the accuracy of HR-CT. METHODS: Artificial bone defects of different dimensions were produced in the antral floor adjacent to 40 roots of 23 premolars and molars in 21 human autopsy specimens of the posterior maxilla. Periapical radiographs were obtained together with 1 mm axial HR-CT scans. The macroscopic and radiological findings of both sets of images were compared. Histological sections were prepared corresponding to the CT scans and the accuracy of the scans evaluated by measurement of five parameters. RESULTS: None of the artificial bone defects could be identified on the dental radiographs. In contrast 62.5% of the antral bone defects could be identified in the axial HR-CT scans. Identification of their margins depended on the location on the tooth root, adjacent bone morphology and visualization of the periodontal ligament space. When the periodontal ligament space was visualised identification of an antral floor between 0.2 and 0.5 mm thick was feasible. CONCLUSION: In certain clinical situations HR-CT is appropriate for identifying antral bone detects between the maxillary sinus and the roots of the adjacent teeth.

Alveolar Process↗

PubMed1997

[Preoperative spiral CT cholangiography with 3-dimensional surface reconstruction: the anatomical imaging potentials, limits and application strategies].

PURPOSE: Evaluation of CT cholangiography compared to i.v. cholangiography concerning its diagnostic value before laparoscopic cholecystectomy and optimisation of CT cholangiography. METHOD: I.v. and CT cholangiographies of 54 patients were retrospectively evaluated by two radiologists. The time interval between contrast infusion and CT was correlated with the assessment of CT cholangiographies to detect the optimal timing for CT scanning. RESULTS: CT cholangiography was judged to be generally better than i.v. cholangiography. The optimal time interval for CT scanning is between 30 min and 60 min post contrast infusion. CONCLUSION: CT cholangiography should replace the conventional tomograms if i.v. cholangiography does not yield sufficient depiction of the biliary tree. It should be performed within 60 min post contrast infusion. Complete abolishment of i.v. cholangiography is not warranted. This is due to the fact that conventional cholangiography can sufficiently delineate the biliary tree and thereby reduce x-ray exposure and cost compared to initial performance of CT cholangiography.

Adult↗

PubMed1997

[Catheter visualization in MR-tomography: initial experimental results with field-inhomogeneity catheters].

PURPOSE: To assess the feasibility of a new developed field inhomogeneity catheter for interventional MR imaging in vivo. MATERIALS AND METHODS: Three different prototypes of a field inhomogeneity catheter were investigated in 6 pigs. The catheters were introduced in Seldinger technique via the femoral vessels over a guide wire on an interventional MR system (Philips Gyroscan NT combined with a C-arm fluoroscopy unit [Philips BV 212]). Catheters were placed in veins and arteries. The catheter position was controlled by a fast gradient echo sequence (Turbo Field Echo [TEE]). RESULTS: Catheters were introduced over a guide wire without complications in all cases. Using the field inhomogeneity concept, catheters were easily visualised in the inferior vena cava and the aorta by the fast gradient echo technique on MR in all cases. Although aortic branches were successfully cannulated, the catheters were not displayed by the TFE technique due to the complex and tortuous anatomy. All animals survived the experiments without complications. CONCLUSION: MR guided visualization of a field inhomogeneity catheter is a simple concept which can be realised on each MR scanner and may allow intravascular MR guided interventions in future.

Animals↗

PubMed1997

[Flow direction-sensitive spin-echo MR angiography].

New blood pool contrast agents yield a significant shortening of T1 of blood. Consequently, the usual techniques of time-of-flight and phase-contrast angiographies cannot produce angiograms sensitive to one flow direction, even if saturation slabs are applied. It was our aim to test the hypothesis of displaying arterial and venous flow selectively with a specially designed spin echo sequence even after administration of contrast agents. Parallel slice selective 90-degree and 180-degree pulses were applied. The distance between slices could be varied. It was attempted to obtain MR angiographies that were flow sensitive for one direction only. We performed flow phantom studies without the use of contrast media and first in vivo experiments in pigs after administration of iron oxide particles. With our modified spin echo sequence unidirectional flow can be displayed, whereas stationary tissue is totally suppressed. There are no special demands for the hardware and no additional postprocessing needs to be performed. The locally off-centred 90-degree and 180-degree pulses are responsible for this. Exclusively, protons excited by the 90-degree pulse and flowing into the slice of the 180-degree pulse will be refocused and only such protons will give rise to signal in the images.

Animals↗

PubMed1997

[T1-weighted excretory MR urography using GD-DTPA after low-dose diuretic administration].

PURPOSE: Assessment of the morphology of the urinary tract by gadolinium (Gd)-enhanced T1-weighted MR-urography (MRU) and precontrast diuretic injection. METHODS: MRU was performed in 5 patients using Gd-DTPA-enhanced coronal T1-weighted 3D-gradient-echo sequences with different spatial resolution. Prior to contrast injection, 10 mg of furosemide were administered intravenously. RESULTS: Secondary to the precontrast furosemide injection, the increase of the renal excretion rate allows complete visualisation of the entire collecting system within 10 minutes following Gd injection. Maximum intensity projections provide a three-dimensional overview of the ureters separate from the bladder. To achieve detailed anatomic imaging of the calices, both optimal distension and high resolution sequences are prerequisites which cannot be realized by means of survey urograms only. CONCLUSIONS: Contrast-enhanced excretory MRU performed after injection of a diuretic offers a rapid approach to visualising the morphology of the nondilated urinary tract. Imaging of caliceal details must be done with high-resolution 3D-gradient-echo sequences.

Adult↗

PubMed1997

[Cava filter placement under MRI control. Experimental in vitro and in vivo studies].

PURPOSE: An instrument has been developed for the introduction of caval filters which can be used with MRI; it has been investigated in in vitro and in in vivo experiments. MATERIAL AND METHOD: The ferromagnetic components of a commercially available instrument for the femoral introduction of the MR-eye Tulip IVC filter were changed for similar, non-ferromagnetic parts and the lock and dilator marked with dysprosium oxide rings. The instrument was used in a flow phantom and in animal experiments (two domestic pigs) in order to insert filters under MRI control on a 1.5 T Philips Gyroscan with integrated mobile digital subtraction angiography. RESULTS: Both in vitro and in vivo, the introducer, catheter and caval filter could be identified by MRI and positioned under MRI control. The position of the filter as indicated by MRI corresponded with radiological and macroscopic findings in all cases (5 phantoms, 2 pigs). CONCLUSION: The early experimental results indicate that percutaneous introduction of caval filters with placement under MRI control is possible.

Animals↗