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Biomedical subjects

A M Uluğ

Publications and source records attributed to A M Uluğ.

12 recordsLinked to original sources

Appearance of meningiomas on diffusion-weighted images: correlating diffusion constants with histopathologic findings.

BACKGROUND AND PURPOSE: Malignant and atypical meningiomas are prone to recurrence and aggressive growth, which affects treatment planning and prognostication. Investigators have used diffusion-weighted imaging and apparent diffusion coefficient (ADC) maps to compare tumor grade and cellularity with the histopathologic findings of intraaxial primary brain neoplasms. The purpose of this study was to determine whether the signal characteristics of meningiomas on diffusion-weighted images correlate with the average diffusion constant (Dav) from ADC maps and histopathologic findings and whether the Dav can reliably distinguish benign from malignant and atypical meningiomas. METHODS: Seventeen patients (13 women and four men; average age, 55 years) with meningiomas were prospectively studied using routine MR imaging and diffusion-weighted imaging with a single-shot gradient-echo echo-planar pulse sequence (6000/100 [TR/TE]) and b values of 0 and 1000. Signal characteristics on routine MR and diffusion-weighted images were compared with the histopathologic findings after resection by using World Health Organization criteria. Dav values were calculated within the tumor mass from ADC maps before resection. RESULTS: Four meningiomas were malignant or atypical (World Health Organization grades II and III). Dav values were lower than normal brain values (average, 0.52 +/- 0.12 x 10(-5) cm2/s; range, 0.45-0.69 x 10(-5) cm2/s) and were hyperintense on diffusion-weighted images and hypointense on ADC maps. Thirteen meningiomas were benign. Dav values were higher than normal brain values (average, 1.03 +/- 0.29 x 10(-5) cm2/s; range, 0.62-1.8 x 10(-5) cm2/s). On diffusion-weighted images and ADC maps, most were isointense. Five benign meningiomas had very high Dav values, bright signal on ADC maps, and distinct histopathologic findings, including microcysts, necrotic infarct, and organizing intratumoral hemorrhage. The difference in Dav values between malignant and benign meningiomas was statistically significant (P < .00029). CONCLUSION: Albeit a small sample size, meningiomas with low Dav tended to be malignant or highly atypical (P < .00029) whereas meningiomas with the highest Dav had increased water content due to either a specific histologic subtype of meningioma or the presence of associated pathologic abnormality.

Adult↗

Orientation-independent diffusion imaging without tensor diagonalization: anisotropy definitions based on physical attributes of the diffusion ellipsoid.

Diffusion tensor imaging can provide a complete description of the diffusion process in tissue. However, this description is not unique but is orientation dependent, and, to quantify properly the intrinsic orientation-independent diffusion properties of the tissue, a set of three rotationally invariant quantities is needed. Instead of using the tensor eigenvalues for this, we define a new set consisting of scaled invariants that have the proper magnitude of actual diffusion constants and that are directly related to the physical attributes of the diffusion ellipsoid, namely, its average radius, surface, and volume. Using these three physical invariants, a new family of anisotropy measures is defined that are normalized between zero (isotropic) and one (completely anisotropic). Because rotational invariants are used, this approach does not require tensor diagonalization and eigenvalue determination and is therefore not susceptible to potential artifacts induced during these number manipulations. The relationship between the new anisotropy definitions and existing orientation-independent anisotropy indices obtained from eigenvalues is discussed, after which the new approach is evaluated for a group of healthy volunteers.

Anisotropy↗

Single-shot diffusion-weighted trace imaging on a clinical scanner.

The single-shot trace-weighted acquisition scheme for isotropic diffusion imaging suggested by Mori and van Zijl (Magn. Reson. Med. 33, 41-52 (1995)) was implemented on a clinical scanner in combination with echo-planar imaging. The results on phantoms and seven volunteers show that good-quality multiplanar isotropic diffusion-weighted images can be obtained within seconds and absolute Dav images within 10-40 s, depending on the number of gradient strengths used. However, care has to be taken in using this type of multi-bipolar-gradient sequence to avoid measurement of artifactual diffusion constants due to background gradient interference. It is outlined how to test for this interference and how to optimize for the correct experiment.

Adult↗

Quantitative assessment of blood flow, blood volume and blood oxygenation effects in functional magnetic resonance imaging.

The ability to measure the effects of local alterations in blood flow, blood volume and oxygenation by nuclear magnetic resonance has stimulated a surge of activity in functional MRI of many organs, particularly in its application to cognitive neuroscience. However, the exact description of these effects in terms of the interrelations between the MRI signal changes and the basic physiological parameters has remained an elusive goal. We here present this fundamental theory for spin-echo signal changes in perfused tissue and validate it in vivo in the cat brain by using the physiological alteration of hypoxic hypoxia. These experiments show that high-resolution absolute blood volume images can be obtained by using hemoglobin as a natural intravascular contrast agent. The theory also correctly predicts the magnitude of spin-echo MRI signal intensity changes on brain activation and thereby provides a sound physiological basis for these types of studies.

Animals↗

Diffusion imaging of human breast.

It is shown that diffusion-weighted imaging is possible in the human breast. Diffusion constants were measured in the breast parenchyma of four volunteers with no known breast lesions. The apparent diffusion constant of water measured in regions of interest chosen in normal human breast fibroglandular tissue was 1.64 +/- 0.19 x 10(-5) cm2/S and that measured in the area of fatty breast tissue was 0.32 +/- 0.18 x 10(-5) cm2/S. The resulting images indicate that fibroglandular tissue and fat can be clearly distinguished in diffusion-weighted as well as in absolute diffusion images of the breast. Potential future applications of this technology for the study of breast pathologies are suggested.

Adipose Tissue↗

Multiple tuning of birdcage resonators.

A theoretical framework is presented for designing birdcage resonators for MRI and MR spectroscopy. The analogy between the birdcage problem and the phonon problem in solid-state physics is used to achieve multiple tuning. Allowing that the capacitances in the columns of the cage assume unequal values, it is possible to achieve multiple tuning and simultaneously preserve the sinusoidal current distribution necessary to set a homogeneous magnetic field. Given the physical dimensions of the columns and branches of the cage as well as the desired resonant frequencies, the corresponding values of the capacitances can be calculated exactly. Closed-form expressions for the capacitances are given in terms of the mutual inductances and the desired resonant frequencies. A detailed analysis for a symmetrical low-pass birdcage is presented. The expressions for the resonant frequencies reduce to those given by other authors when only nearest-neighbor mutual inductances are included.

Algorithms↗

Absolute quantitation of diffusion constants in human stroke.

BACKGROUND AND PURPOSE: Animal studies have shown that MR diffusion imaging can outline acute ischemic regions before irreversible damage (infarction) occurs. To study evolution of ischemic lesions in humans, it is therefore important to quantify absolute diffusion constants (D values), but quantitation has not been reproducible among different clinics. These problems are explained, and a method for reproducible quantitation is suggested. METHODS: Diffusion-weighted and absolute diffusion images were acquired, and the absolute apparent diffusion constants in three orthogonal spatial directions (Dxx, Dyy, and Dzz) were measured. These were combined to calculate images of the orientation-independent apparent diffusion parameter Dav = 1/3 Trace[D] = 1/3(Dxx + Dyy + Dzz). Values of the individual diffusion constants and Dav were evaluated in 6 patients and 6 normal volunteers. RESULTS: Patient data show that comparison of diffusion constants between contralateral and ipsilateral hemispheres after ischemia may give results varying by more than 100% depending on orientation. Findings in normal-appearing regions containing a mixture of gray and white matter in patients (n = 5) and in normal volunteers (n = 6) show that Dav = (0.92+/-0.11) x 10(-3) mm2/s, with a small intersubject variation, whereas Dxx, Dyy, and Dzz vary strongly. Hemispheric ratios (ipsilateral/contralateral [I/C]) in these subjects were (I/C)Dav = 1.00+/-0.05, (I/C)Dxx = 1.02+/-0.15, (I/C)Dyy = 1.07+/-0.24, and (I/C)Dzz = 0.96+/-0.28. The individual subjects in this group all had an (I/C)Dav within 10% of unity, while the other three ratios showed intersubject variations as large as 100%. CONCLUSIONS: (I/C)Dav ratios are a reliable means to quantitate changes in absolute diffusion constants for the study of stroke evolution independent of tissue orientation, gradient orientation, and diffusion time. The use of these ratios will enable reproducible intersubject and interclinic quantitation.

Acute Disease↗

Correction of motional artifacts in diffusion-weighted images using a reference phase map.

A method of correcting motional artifacts in diffusion-weighted images is described. Motion causes changes in the phase of the k-space NMR signal and thereby introduces positional shifts (or ghosts) in the spatial domain. By correcting the phase of the NMR signal before Fourier transformation, the image sharpness is greatly enhanced. The new method measures the phases of the NMR signal once and stores this phase information in a phase map. Subsequent images with motional artifacts are corrected during postprocessing using this reference phase map.

Artifacts↗

Clinical use of diffusion-tensor imaging for diseases causing neuronal and axonal damage.

Diffusion-tensor imaging is an emerging technique that can supply microscopic structural information about tissue in vivo. With this technique it is possible to measure the amount of anisotropy of water diffusion within tissues and to assess the degree to which directionally ordered tissues have lost their normal integrity. This study was performed in four patients to evaluate the feasibility of applying this technique in clinical situations in which there is known or suspected damage to white matter tracts.

Adolescent↗

Diffusion-negative stroke: a report of two cases.

Diffusion-weighted MR imaging is generally thought to be highly sensitive for the diagnosis of acute stroke. We report two cases of hyperacute stroke with absence of changes on diffusion-weighted images within 4 hours of symptom onset. Follow-up studies, performed 4 days later, showed infarction in regions compatible with the clinical presentation and (in one case) with the initial perfusion deficit. These cases indicate that normal findings on diffusion-weighted images in patients with suspected cerebral ischemia do not rule out impending infarction.

Acute Disease↗

Diffusion changes in the aging human brain.

BACKGROUND AND PURPOSE: Quantifying changes in the human brain that occur as part of normal aging may help in the diagnosis of diseases that affect the elderly and that cause structural changes in the brain. We sought to assess diffusion changes that are inherently related to brain structure during aging. METHODS: MR scans were obtained from 11 healthy volunteers and 27 patients (ages 26 to 86 years [53.4 +/- 17.0 years]). Images acquired from the patients either showed no abnormalities, contained minimal periventricular white matter changes, or revealed focal lesions. Maps of the average diffusion constant (D(av)) were calculated for each subject. Changes in D(av) were determined with distribution analysis (histogram) for the entire brain and compared with region-of-interest measurements from the periventricular white matter and thalamus. RESULTS: Mean D(av) of the entire brain (0.74 +/- 0.02 x 10(-5) cm2/s) showed weaker age dependency compared with the periventricular white matter D(av)(0.76 +/- 0.04 x 10(-5) cm2/s). The D(av) of the thalamus D(av) (0.75 +/- 0.03 x 10(-5) cm2/s) had no age dependency. The age-dependent changes of entire brain D(av) may be significant for subjects older than 60 years compared with younger subjects. CONCLUSION: In this study, we observed minimal changes in the D(av) of the entire brain with aging. The mean D(av) of the human brain is nearly constant throughout most of adulthood.

Adult↗

Quantitative proton MR spectroscopic imaging in acute disseminated encephalomyelitis.

Serial MR imaging and quantitative proton MR spectroscopic imaging (MRSI) findings of a 4-year-old boy with acute disseminated encephalomyelitis (ADEM) are reported. Over a 2-month period characterized by an initial illness and two relapses, each with full recovery, MR imaging exhibited the appearance and disappearance of multifocal lesions throughout the CNS that correlated only partly with the neurologic impairment. During one relapse, MRSI revealed low levels of N-acetylaspartate (NAA) within the regions of prolonged T2 signal intensity. All other metabolites were normal. At follow-up, the MR imaging and MRSI abnormalities had fully resolved. MRSI might play an important role in the diagnosis of ADEM, as well as in the elucidation of underlying pathophysiologic processes in this poorly defined disorder of children. This case demonstrates that reduced levels of NAA are not always associated with neuronal loss, irreversible tissue damage, or poor neurologic outcome.

Aspartic Acid↗