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Biomedical subjects

C Fellner

Publications and source records attributed to C Fellner.

At least 55 records · Page 3Linked to original sources
PubMed1997

MRI of inner ear and facial nerve pathology using 3D MP-RAGE and 3D CISS sequences.

The aim of this study was to evaluate 3D CISS, unenhanced 3D MP-RAGE and contrast enhanced 3D MP-RAGE for the diagnosis of neoplastic, vascular and inflammatory lesions of the cerebellopontine angle, the inner auditory canal, the labyrinth and the facial nerve 42 MR examinations were performed on a total of 38 patients (25 males, 13 females; aged 1-77 years, mean age 43 +/- 20 years) using a 1.5 T MR unit. A T2* weighted 3D CISS sequence (TR 14.65 ms, TE 21 ms, flip angle 65 degrees, voxel size 0.7 x 0.7 x 0.7 mm3) and a T1 weighted 3D MP-RAGE sequence (TR 12.5 ms, TE 5 ms, T1 300 ms, flip angle 15 degrees, voxel size 1.0 x 0.9 x 0.9 mm3) with and without contrast medium (gadolinium-DTPA, 0.1 mmol kg-1 body weight) were used. Results of contrast enhanced 3D MP-RAGE-pathological enhancement was found in the following lesions: schwannomas of the cerebellopontine angle (CPA) and the internal auditory canal (IAC), 4; schwannomas of the IAC, 7 and labyrinthine tumours, 3; posterior fossa lymphoma, 1; meatal meningioma, 1; acute labyrinthitis, 15 and neuritis of the seventh cranial nerve, 10. Results of 3D CISS-filling defects were found with the following lesions: schwannomas of the CPA, the IAC or labyrinth, 14; lymphoma, 1; meningioma, 1; labyrinthine fibrosis, 13 and scar in the IAC, 4. These results suggest that unenhanced and contrast enhanced 3D MP-RAGE and 3D CISS are complementary MR imaging modalities. T1 weighted 3D MP-RAGE is preferred to T1 weighted 2D (turbo) spin echo sequences because of the multiplanar reconstruction possibilities of 3D sequences, which are very useful in the case of the inner ear and facial nerve.

Acute Disease↗
PubMed1997

Comparison of spin-echo MR pulse sequences for imaging of the brain.

PURPOSE: To determine the value of the gradient- and spin-echo (GRASE) technique as compared with the fast spin-echo and conventional spin-echo techniques in MR imaging of the brain. METHODS: Sixty-six patients with ischemic and neoplastic brain lesions were examined with T2-weighted spin-echo, fast spin-echo, and GRASE sequences. Three independent observers evaluated the contrast characteristics of anatomic and pathologic structures and of artifacts. Quantitative image analysis included region-of-interest measurements of anatomic structures and lesions. RESULTS: The contrast of anatomic structures was superior in images obtained with conventional and fast spin-echo techniques as compared with those obtained with the GRASE technique. Extended lesions, such as tumors and territorial infarcts, were identified equally with all techniques. For delineation of small ischemic lesions, GRASE was slightly inferior to fast and conventional spin-echo sequences. Flow artifacts were considerably reduced with fast spin-echo and GRASE sequences. Chemical-shift artifacts were significantly reduced, but ringing artifacts were more pronounced with GRASE. CONCLUSION: Fast spin-echo remains the standard technique in MR imaging of the brain. However, GRASE might be useful in special cases, such as with uncooperative patients whose conventional or fast spin-echo images show severe motion artifacts.

Adult↗
PubMed1996

A T1-weighted rapid three-dimensional gradient-echo technique (MP-RAGE) in preoperative MRI of intracranial tumours.

Our purpose was to determine the value of a T1-weighted rapid three-dimensional gradient-echo technique in preoperative MRI of brain tumours. We examined 30 patients with intracranial tumours who underwent neurosurgery, using T1-weighted magnetisation-prepared rapid gradient-echo (MP-RAGE) and axial T1-weighted spin-echo (SE) sequences, both before and after contrast medium (Gd-DTPA). Signal and contrast behaviour of anatomical and pathological structures were assessed with regions-of-interest (ROI) and visual inspection. Imaging results were compared with operative results. In 5 cases tumours and anatomical structures were segmented in MP-RAGE data sets. The MP-RAGE sequence considerably improved delineation of grey and white matter and small anatomical structures (vessels, cranial nerves), and significantly reduced flow artefacts. Contrast behaviour of tumours was similar with both techniques. Correlation of imaging with the operative results confirmed the reliability of the MP-RAGE sequence. Segmentation of MP-RAGE data sets allows three-dimensional display, which enables one to document the relevant information on a few images in selected cases.

Adolescent↗
PubMed1996

Diagnostic potential of pseudo-dynamic MRI (CINE mode) for evaluation of internal derangement of the TMJ.

In addition to the patient's history and a thorough clinical investigation, magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) has been introduced to complete the findings for the diagnosis of internal derangement of the TMJ. However, 'dynamic information' is desirable to help us to understand the mechanism of internal derangement. This information is given for example by electronic axiography recording systems. The lack of any ability to assess joint function dynamically in MRI is a point of criticism. Using a computer-driven pseudodynamic MRI system (CINE mode) 'dynamic information' should be now available. In this investigation 21 patients with TMJ disorders were examined using both conventional static MRI and CINE mode. For the diagnosis of an anterior displaced disc with or without reduction in 18 cases (86%) it was only necessary to consider two static MRIs: a closed mouth position and a maximal open mouth position. Comparison showed there was no advantage in using CINE mode. Contrast and resolution of the static MRIs were shown to be better and so additional findings such as joint effusion and disc deformation could be diagnosed on static MRIs with greater certainty. Only in three (14%) cases was the dynamic information from CINE mode useful for the diagnosis of the displacement of the disc.

Adult↗
PubMed1996

MR-imaging of the TMJ: artefacts caused by dental alloys.

The aim of the study was to investigate the influence of dental alloys and their components on magnetic resonance imaging of the temporomandibular joint. A plaster and a water- filled acrylic resin phantom - representing the disc and the condyle of the TMJ - were used. Cylindrical crow-type samples of 13 alloys and 14 pure substances were investigated. All alloys were examined with regard to their magnetic susceptibility, using a vibrating sample magnetometer. Metallic artefacts appeared on spin-echo technique as distortions, and on gradient-echo technique signal loss could be observed. Precious alloys were shown to be diamagnetic. The non precious alloys we investigated were paramagnetic. Paramagnetic alloys with a magnetic molar-susceptibility Cmol > 2000 x10(-6) cm3/mol can produce clinically relevant artefacts.

Artifacts↗
PubMed1995

Turbo gradient-spin-echo (GRASE): first clinical experiences with a fast T2-weighted sequence in MRI of the brain.

The aim of this study was to obtain first clinical experiences with Turbo gradient-spin-echo (TGSE). This fast MRI technique is based on the GRASE sequence which combines the gradient-echo and the spin-echo technique. In 60 patients suffering from different brain pathologies, a T2-weighted TGSE sequence was compared to a conventional spin-echo sequence. Anatomical and pathological structures were evaluated visually by three independent observers; signal and contrast behavior was assessed in regions of interest. TGSE showed reduced signal-to-noise-ratios of anatomical structures except for cerebrospinal fluid. The contrast of tumors, infarctions, and hematomas was similar in both sequence types. Small microangiopathic and inflammatory lesions as well as basal ganglia degeneration presented with diminished contrast in TGSE. The TGSE sequence can already now be used to acquire T2-weighted images in additional orientations requiring extremely short measurement time. However, further improvements of image quality are necessary for routine use of TGSE.

Adolescent↗
PubMed1995

Renal arteries: evaluation with optimized 2D and 3D time-of-flight MR angiography.

PURPOSE: To compare two-dimensional (2D) and three-dimensional (3D) time-of-flight (TOF) techniques in magnetic resonance (MR) angiography of renal arteries. MATERIALS AND METHODS: In 46 patients, MR angiography was performed with 3D tilted optimized non-saturating excitation (TONE), 3D fast imaging with steady precession (FISP), and 2D fast low-angle shot (FLASH) during breath holding. Intraarterial angiography was used as a reference. MR angiograms were evaluated for stenoses, length of renal arteries, accessory arteries, venous overlap, and image quality. RESULTS: The 3D TONE sequence was best for detection of severe stenoses (sensitivity, 100%; specificity, 89%), delineation of accessory arteries, and image quality. Overlap of renal veins was the most important disadvantage of 2D FLASH. Decreased saturation effects, however, can be advantageous in 2D TOF imaging. CONCLUSION: Use of the 3D TONE sequence provided improved image quality and diagnostic value compared with 3D FISP technique. The 2D TOF sequence can be useful in combination with the 3D TONE sequence.

Adult↗
PubMed1995

Three-dimensional MP-RAGE--an alternative to conventional three-dimensional FLASH sequences for the diagnosis of viscerocranial tumours?

Imaging with three-dimensional (3D) sequences is a frequently used magnetic resonance (MR) technique in the assessment of ear, nose and throat (ENT) tumours near the skull base. Few reports on the contrast behaviour of 3D magnetization prepared rapid gradient echo (MP-RAGE) sequences and their application in ENT tumours exist in the published literature. This paper discusses whether 3D MP-RAGE is an alternative to conventional 3D gradient echo (3D GE) sequences for the diagnostic evaluation of the visceral cranum. Measurements were performed with a Magnetom SP 63 MR system (Siemens) at 1.5 T. 10 healthy volunteers were examined using 3D FLASH sequences with varied flip angles (90 degrees, 70 degrees, 40 degrees, 20 degrees, 10 degrees) and using 3D MP-RAGE to optimize the signal-to-noise ratio (SNR) of muscle, fat and gland tissue. After this optimization 25 patients with ENT tumours near the skull base were examined with 3D FLASH 40 degrees, 3D MP-RAGE 10 degrees (both before and after application of contrast medium) and with 3D FISP 70 degrees (without contrast medium). SNR and contrast-to-noise ratio (CNR) of tumour, inflammatory disease, brain (white and grey matter), compact bone, fat and muscle were calculated. The advantages of 3D MP-RAGE over 3D FLASH 40 degrees include decreased imaging time with decreased motion artifacts and a relatively high contrast between tumour and surrounding tissues. The tissue contrast yielded by the T1/T2* weighted 3D gradient echo sequence FISP with a flip angle of 70 degrees was not as good as that yielded by 3D MP-RAGE with and without contrast together. In conclusion a combination of contrast enhanced and unenhanced 3D MP-RAGE sequences is the technique of choice for the examination of ENT tumours near the base of the skull.

Adult↗
PubMed1994

True proton density and T2-weighted turbo spin-echo sequences for routine MRI of the brain.

Our aim was to evaluate the diagnostic reliability of turbo spin-echo (TSE) sequences compared to a conventional dual-echo spin-echo (SE) sequence in routine brain MRI at 1.0 T. The following demands were made on TSE sequences: acquisition time-reduction of at least 50% and true proton density (PD) contrast (low-signal cerebrospinal fluid). A conventional spin-echo and two single-echo TSE sequences were used in 150 patients, a dual-echo TSE sequence in addition in 50 patients. Demonstration of most anatomical structures and disorders was equivalent with TSE and SE sequences. Advantages of TSE were reduced flow artefacts on T2-weighted images, better lesion contrast on PD-weighted TSE images (especially in the dual-echo sequence) and acquisition time reduction to about 5 min (single-echo TSE) and 3:35 min (dual-echo TSE). Disadvantages of TSE were: reduced contrast of iron-containing substances such as haemosiderin and of areas of calcification. By virtue of the shorter acquisition time and diagnostic reliability dual-echo TSE proved the best sequence. If it is used with only one acquisition--whereby image quality but not diagnostic reliability is slightly decreased--acquisition time can be further reduced to 1:48 min. Application of a susceptibility-sensitive gradient-echo sequence, such as FLASH, compensates for the disadvantages mentioned above.

Artifacts↗
PubMed1976

The use of teaching stories in conjoint family therapy.

Two general factors have been singled out as being held in common by all types of psychotherapy: an educational, rational factor (often called "content") and a factor operative in the relationship between the therapist and his patient (often called "process"). In the field of family therapy, the non-educational aspects of intervention are sometimes presented in the form of "therapeutic, paradoxical communications" (Haley, Bateson, Jackson, Weakland) or the 'therapy of the absurd" (Whitaker, Malone). In the present paper, I wish to present a form of therapeutic communication, the teaching story, that embodies a unique mixture of both the educational and the paradox, or absurd.

Anecdotes as Topic↗
PubMedDate not supplied

Magnetic resonance of the disk of the temporomandibular joint. MR imaging protocol.

Disk displacement can be well detected using proton density-weighted and T2*-weighted two-dimensional gradient-echo sequences. In uncertain cases, especially if the bilaminar zone is not sufficiently represented, a contrast-enhanced T1-weighted spin-echo sequence should also be performed. Also in patients with disk degeneration and osteoarthritis of the temporomandibular joint, proton density-weighted and T2*-weighted two-dimensional gradient-echo sequences are of great diagnostic value. In this collective, however, T1-weighted contrast-enhanced spin-echo sequences should be generally performed, to demonstrate inflammatory reaction of the synovia.

Adolescent↗