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Biomedical subjects

Fritz Schick

Publications and source records attributed to Fritz Schick.

At least 37 records · Page 2Linked to original sources

Role of proton MR for the study of muscle lipid metabolism.

1H-MR spectroscopy (MRS) of intramyocellular lipids (IMCL) became particularly important when it was recognized that IMCL levels are related to insulin sensitivity. While this relation is rather complex and depends on the training status of the subjects, various other influences such as exercise and diet also influence IMCL concentrations. This may open insight into many metabolic interactions; however, it also requires careful planning of studies in order to control all these confounding influences. This review summarizes various historical, methodological, and practical aspects of 1H-MR spectroscopy (MRS) of muscular lipids. That includes a differentiation of bulk magnetic susceptibility effects and residual dipolar coupling that can both be observed in MRS of skeletal muscle, yet affecting different metabolites in a specific way. Fitting of the intra- (IMCL) and extramyocellular (EMCL) signals with complex line shapes and the transformation into absolute concentrations is discussed. Since the determination of IMCL in muscle groups with oblique fiber orientation or in obese subjects is still difficult, potential improvement with high-resolution spectroscopic imaging or at higher field strength is considered. Fat selective imaging is presented as a possible alternative to MRS and the potential of multinuclear MRS is discussed. 1H-MRS of muscle lipids allows non-invasive and repeated studies of muscle metabolism that lead to highly relevant findings in clinics and patho-physiology.

Animals↗

Highly resolved free-breathing magnetic resonance cholangiopancreatography in the diagnostic workup of pancreaticobiliary diseases in infants and young children--initial experiences.

PURPOSE: A new generation of magnetic resonance imaging scanner offers a 3-dimensional magnetic resonance cholangiopancreatography (MRCP) with very high spatial resolution using a non-breath-hold technique with prospective navigator gating. The study aimed to investigate the new technology of the MRCP in infants with suspected pancreaticobiliary diseases. METHODS: Seven patients (4 girls, 3 boys; mean age, 2.8 years; range, 3 months to 5.6 years) were examined. All patients underwent magnetic resonance imaging examination using a 1.5-T whole-body scanner (Magnetom Avanto, Siemens Medical, Erlangen, Germany). For MRCP, a heavily T2-weighted (time to echo, 678 ms) 3-dimensional turbo spin echo in coronal plane was performed with the voxel size of 1 x 1 x 1.5 mm. To enable non-breath-holding imaging, a diaphragm navigator sequence was simultaneously carried out. The MRCP findings were compared prospectively with the endoscopic retrograde cholangiopancreatography and/or with the surgical findings in 6 of 7 cases. In 1 patient, the follow-up was considered reference standard. RESULTS: The high spatial resolution of the images without breathing artifacts allowed an excellent demonstration of all relevant pancreaticobiliary ducts and of the pathologic findings. All patients (n = 4) with choledocholithiasis were identified through MRCP. The finding of a high pancreaticobiliary junction (n = 3) was confirmed by endoscopic retrograde cholangiopancreatography in all cases. The length of the common channel ranged from 16 to 24 mm. In 1 patient, the long common channel was associated with a choledochal cyst. In a 1.7-year-old boy with recurrent abdominal pain and mild pancreatitis, the rare case of a gastric duplication with connection to the main pancreatic duct was diagnosed. A regular gastric wall with normal mucosa and parts of the duodenal wall with a circular layer of muscle (pylorus-like) were found in histology after surgical resection of the mass. CONCLUSION: The newly developed technique may be a reliable tool in the workup of pancreaticobiliary diseases in infants.

Biliary Tract↗

[Field perturbations by magnetic dipoles as a model for magnetically labelled cells in MRI].

UNLABELLED: Due to the creation of intense local magnetic fields, iron oxide nanoparticles are used as a contrast agent to produce signal loss in Magnetic Resonance Imaging (MRI) in regions where labelled cells have migrated. OBJECTIVE: To study effects of the intracellular distribution of magnetic moments on the extracellular magnetic field by means of numerical simulations. METHODS: Various geometries of intracellular particle distributions were scrutinized and the extracellular field distortions were computed. The total magnetic moment of a labelled cell was assigned to various magnetic subcompartments. The implications on the intravoxel frequency distribution and the static MR signal decay were assessed. RESULTS: The extracellular field perturbation was affected by the intracellular particle distribution only in close proximity to the labelled cell. With increasing distance from the labelled cell, the effects of the intracellular particle distribution were less pronounced. The intravoxel frequency distribution induced by a single labelled cell was non-lorentzian. CONCLUSION: The magnetic fields created by an iron loaded cell are sensitive to the intracellular distribution of nanoparticles only in close proximity to the cell. Far from the cell the field perturbation cannot be distinguished from the magnetic dipole field produced by a magnetic sphere with the same total magnetic moment.

Humans↗

Comparison of Gadolinium-BOPTA and Ferucarbotran-enhanced three-dimensional T1-weighted dynamic liver magnetic resonance imaging in the same patient.

OBJECTIVES: We sought to compare signal changes using Ferucarbotran and gadobenate dimeglumine (Gd-BOPTA) in dynamic 3D T1-weighted (T1w) GRE imaging of the liver. MATERIAL AND METHODS: Thirty patients were prospectively included in the study. All patients underwent 2 high-field magnetic resonance (MR) examinations: first with Gd-BOPTA (Gd) and then after a mean interval of 4 days with ferucarbotran (Feru). Dynamic MRI was obtained with a 3D T1w GRE sequence (TR 6.33, TE 2.31, flip angle 20 degrees ). Contrast enhanced scans were assessed before intravenous injection of the contrast agent (precontrast), and postcontrast during the arterial phase (30 seconds), portal venous phase (60 seconds), and equilibrium phase (120 seconds). The signal intensities (SIs) of liver, spleen, aorta, and portal vein were defined by region of interest measurements. Signal intensity changes (SICs) and percentage signal intensity change (PSIC) were calculated using the formulas SIC=(SI pre - SI post)/SI pre and PSIC=SIC x 100%. RESULTS: Positive signal enhancement was observed after intravenous injection of Feru during all dynamic measurements, whereas the mean SI values were lower compared with Gd. During the portal venous phase the mean SI of Gd was up to a factor of 2.1 higher (portal vein). The widest difference of SIC was observed during the equilibrium phase for liver parenchyma (Gd, 1.03; Feru, 0.24). The dynamic signal courses were similar for liver, portal vein and aorta. Different signal courses were obtained for the spleen. CONCLUSIONS: Feru-enhanced T1w dynamic images demonstrated significant signal increases for liver, vessels, and spleen but overall lower signal intensities than Gd-BOPTA. The dynamic signal courses of ferucarbotran were similar to that of Gd-BOPTA during ll perfusion phases except in the spleen. Thus, it may be possible to detect typical enhancement pattern of focal liver lesions with Feru-enhanced dynamic T1w MRI.

Adult↗

Relaxivity of Gadopentetate Dimeglumine (Magnevist), Gadobutrol (Gadovist), and Gadobenate Dimeglumine (MultiHance) in human blood plasma at 0.2, 1.5, and 3 Tesla.

OBJECTIVES: We sought to determine the relaxivity and accurate relaxation rates of Gd-DTPA, Gd-BT-DO3A, and Gd-BOPTA at 0.2, 1.5, and 3 T in human blood plasma. MATERIALS AND METHODS: Contrast media concentrations between 0.01 and 16 mM in human plasma were used for relaxation measurements. The R1 and R2 relaxation rates and r1 and r2 relaxivities were determined. RESULTS: Gd-BOPTA produced the highest relaxation rates and relaxivities at all field strengths. The r1 and r2 values for Gd-BOPTA were 107-131% and 91-244% higher than for Gd-DTPA, respectively, and 72-98% and 82-166% higher than for Gd-BT-DO3A. Higher field strengths resulted in lower values of R1, R2, and r1 for all contrast agents tested and of r2 for Gd-DTPA and Gd-BT-DO3A. A linear dependence of R1 and R2 on concentration was found for Gd-DTPA and Gd-BT-DO3A and a nonlinear dependence for Gd-BOPTA for concentrations larger than 1 mM. The r1 and r2 relaxivity of Gd-BOPTA increased with decreasing concentration. CONCLUSIONS: Gd-BOPTA demonstrates the highest longitudinal r1 at all field strengths, which is ascribable to weak protein interaction. The R2/R1 ratio increases at higher field strength only for Gd-BOPTA, hence very short echo times are required for Gd-BOPTA to benefit from the higher longitudinal relaxivity.

Contrast Media↗

Effects on MRI due to altered rf polarization near conductive implants or instruments.

In magnetic resonance imaging near metal parts variations in radio frequency (rf)-amplitude and of receive sensitivity must be considered. For loop structures, e.g., vascular stents, B1 produces rf eddy currents in accordance to Faraday's law; the B1-related electrical rf field E1 injects directly to elongated structures (e.g., wires). Locally, the rf magnetic field Bl,ind (induced B1) is superimposed onto the rf field from the transmitter coil, which near the metal can dominate spin excitation. Geometry and arrangement of the parts determine the polarization of B(1,ind). Components parallel to B0 are of special interest. A copper sheet (100 mm x 15 mm, 3 mm thick) and a 27 cm long copper wire were examined in a water phantom using the spin-echo (SE) technique. In addition to rf-amplitude amplification, rf-phase shift due to z components of B(1,ind) could be detected near the metallic objects. Periodic rf-amplitude instabilities had an amplified effect for phase-shifted regions. Phase-encoding artifacts occurred as distinct ghosts (TR=200 ms) or band-like smearing (TR=201 ms) from affected spin ensembles. SE phase imaging can potentially be used in interventional magnetic resonance imaging for background-free localization of metallic markers.

Algorithms↗

MR-guided radiofrequency ablation: do magnetic fields influence extent of coagulation in ex vivo bovine livers?

PURPOSE: To prospectively determine if static magnetic fields of magnetic resonance (MR) imagers affect radiofrequency (RF) ablation coagulation volume and shape. MATERIALS AND METHODS: Ex vivo RF ablations of bovine livers were performed with magnetic field strengths of 0.2, 1.5, and 3.0 T and were compared with ablations performed outside the magnetic field in a control group. Two MR-compatible monopolar RF devices (internally cooled single and cluster electrodes) were systematically tested. Length of long axis (y-axis), length of two short axes (x- and z-axes), and coagulation volume and shape measured outside and inside different magnetic fields were compared with the Dunnett test. Significance level was set to .05. RESULTS: For the single electrode, no significant difference was observed between length of short axes and coagulation volume and shape measured inside and outside the magnetic field. Mean x- and z-axis lengths were 2.3 and 2.6 cm, respectively, outside the magnetic field; 2.4 and 2.4 cm, respectively, at 0.2 T; 2.5 and 2.6 cm, respectively, at 1.5 T; and 2.2 and 2.5 cm, respectively, at 3.0 T. Differences between length of long axis, length of short axis perpendicular to static magnetic field, and coagulation volume and shape achieved with the cluster electrode inside and outside the magnetic field were not significant. Mean x- and z-axis lengths were 3.9 and 3.9 cm, respectively, outside the magnetic field; 3.7 and 3.8 cm, respectively, at 0.2 T; 4.0 and 4.3 cm, respectively, at 1.5 T; and 3.8 and 3.8 cm, respectively, at 3.0 T. Differences between ablations performed at 1.5 T and those performed in the control group with the cluster electrode were significant (P = .026). In this case, a difference of 4 mm in the length of the short axis parallel to the magnetic field was detected, but there was no significant difference in coagulation volume. CONCLUSION: No significant differences in coagulation volume and shape could be recorded between RF ablations performed outside and those performed inside the static magnetic field.

Animals↗

Alpha2-Heremans-Schmid glycoprotein/fetuin-A is associated with insulin resistance and fat accumulation in the liver in humans.

OBJECTIVE: The alpha(2)-Heremans-Schmid glycoprotein (AHSG; fetuin-A in animals) impairs insulin signaling in vitro and in rodents. Whether AHSG is associated with insulin resistance in humans is under investigation. In an animal model of diet-induced obesity that is commonly associated with hepatic steatosis, an increase in Ahsg mRNA expression was observed in the liver. Therefore, we hypothesized that the AHSG plasma protein, which is exclusively secreted by the liver in humans, may not only be associated with insulin resistance but also with fat accumulation in the liver. RESEARCH DESIGN AND METHODS: Data from 106 healthy Caucasians without type 2 diabetes were included in cross-sectional analyses. A subgroup of 47 individuals had data from a longitudinal study. Insulin sensitivity was measured by a euglycemic-hyperinsulinemic clamp, and liver fat was determined by (1)H magnetic resonance spectroscopy. RESULTS: AHSG plasma levels, adjusted for age, sex, and percentage of body fat, were higher in subjects with impaired glucose tolerance compared with subjects with normal glucose tolerance (P = 0.006). AHSG plasma levels were negatively associated with insulin sensitivity (r = -0.22, P = 0.03) in cross-sectional analyses. Moreover, they were positively associated with liver fat (r = 0.27, P = 0.01). In longitudinal analyses, under weight loss, a decrease in liver fat was accompanied by a decrease in AHSG plasma concentrations. Furthermore, high AHSG levels at baseline predicted less increase in insulin sensitivity (P = 0.02). CONCLUSIONS: We found that high AHSG plasma levels are associated with insulin resistance in humans. Moreover, AHSG plasma levels are elevated in subjects with fat accumulation in the liver. This is consistent with a potential role of AHSG as a link between fatty liver and insulin resistance.

Adipose Tissue↗

Interaction between grounding pads used for RF ablation therapy and magnetic resonance imaging.

OBJECTIVES: To characterize artifacts and imaging problems in the presence of conductive grounding pads for RF ablation therapy as well as potential heating problems due to induction of eddy currents in the pads. Strategies for avoidance of those problems are developed. MATERIALS AND METHODS: Underlying principles of interactions between grounding pads and MR imaging are reported. Influential parameters, e.g., orientation in relation to the magnetic field, shape of the grounding pad, sequence type (spin-echo versus gradient echo) and magnetic field strength (0.2 T, 1.5 T, 3 T) were varied in systematic phantom studies. Heating effects due to induced eddy currents were estimated theoretically and measured by infrared imaging in an adapted set-up. RESULTS: MR imaging artifacts are markedly dependent on the orientation and geometrical shape of the grounding pads. Visible signal extinction artifacts were more pronounced using spin-echo techniques than in gradient echo images and increased for higher field strengths. Suitable incisions in the grounding pad reduced eddy currents markedly and minimized image artifacts. Heating problems due to induced eddy currents by the RF transmitted for MR imaging were excluded by phantom measurements. CONCLUSIONS: Suitable positioning of the grounding pads and adaptation of their geometry provide clearly reduced artifacts in MR imaging.

Animals↗

Liver fat and insulin resistance are independently associated with the -514C>T polymorphism of the hepatic lipase gene.

CONTEXT: Liver fat predicts insulin resistance in humans. So far, there is not much information on genetic determinants of liver fat. Hepatic lipase is a liver-specific enzyme that regulates lipid metabolism. OBJECTIVE: First, our object was to investigate whether the functional -514C>T polymorphism of the hepatic lipase gene is associated with liver fat content and with insulin sensitivity. Second, because this polymorphism displays gene-nutrient interactions, we assessed gene-gene interactions with the Pro12Ala polymorphism of the peroxisome proliferator-activated receptor-gamma(2) on liver fat content and insulin sensitivity. DESIGN AND METHODS: Cross-sectional data from a total of 1070 nondiabetic subjects were analyzed. Insulin sensitivity was estimated from a 75-g oral glucose tolerance test. A subgroup of 115 subjects underwent measurements of liver fat. RESULTS: The -514C>T polymorphism of the hepatic lipase gene was associated with higher liver fat content (P = 0.005) and lower insulin sensitivity (P = 0.02), both after adjustment for age, gender, and percentage of body fat. This was independent of serum adiponectin concentrations (P = 0.01 and 0.03). However, there was an interaction of the -514C>T polymorphism with the Pro12Ala variant on liver fat (P = 0.09) and insulin sensitivity (P = 0.01). Subjects carrying the -514C>T polymorphism had higher liver fat content and were insulin resistant only before the background of the Pro/Pro genotype of the Pro12Ala polymorphism. CONCLUSIONS: The -514C>T polymorphism of the hepatic lipase gene is associated with higher liver fat content and lower whole-body insulin sensitivity. However, these effects are modulated by the common Pro12Ala polymorphism in peroxisome proliferator-activated receptor-gamma(2). These findings may be relevant for intervention strategies to prevent increase in liver fat content and insulin resistance.

Adult↗

Whole-body MRI at high field: technical limits and clinical potential.

This review seeks to clarify the most important implications of higher magnetic field strength for clinical examinations of the whole body. An overview is provided on the resulting advantages and disadvantages for anatomical, functional and biochemical magnetic resonance examinations in different regions of the body. It is demonstrated that susceptibility-dependent imaging, chemical shift selective (e.g., fat-suppressed) imaging, and spectroscopic techniques clearly gain from higher field strength. Problems due to shorter wavelength and higher radio frequency energy deposition at higher field strength are reported, especially in examinations of the body trunk. Thorax examinations provided sufficient homogeneity of the radio frequency field for common examination techniques in most cases, whereas abdominal and pelvic imaging was often hampered by undesired dielectric effects. Currently available and potential future strategies to overcome related limitations are discussed. Whole-body MRI at higher field strength currently leads to clearly improved image quality using a variety of established sequence types and for examination of many body regions. But some major problems at higher field strength have to be solved before high-field magnetic resonance systems can really replace the well-established and technically developed magnetic resonance systems operating at 1.5 T for each clinical application.

Equipment Design↗

Diagnosis of vascular rings and slings using an interleaved 3D double-slab FISP MR angiography technique.

BACKGROUND: Congenital upper airway obstruction and dysphagia may be caused by vascular rings and slings. Often, invasive and radiation-dependent diagnostic procedures are needed to clarify the diagnosis. OBJECTIVE: To evaluate the diagnostic utility of high-resolution, free-breathing three-dimensional double-slab fast imaging with steady precession magnetic resonance angiography (3D FISP MRA) in infants and children with respiratory upper airway obstruction and/or dysphagia for detection or exclusion of vascular rings and slings. MATERIALS AND METHODS: Eleven patients (median age 1.3 years; range 5.1 months to 15.8 years) were investigated prospectively with 3D FISP MRA and spin-echo techniques. Additional diagnostic data were available from surgery (n=7), cardiac catheterization (n=5), CT (n=2), barium swallow (n=3) and bronchoscopy/oesophagoscopy (n=4). RESULTS: In one case, diagnosis was missed with low-resolution spin-echo sequences, but high-resolution 3D FISP MRA revealed a double aortic arch. 3D FISP MRA accurately found (n=8) or excluded (n=3) vascular rings or slings in all patients. Using a five-level grading system for 3D FISP MRA image quality (1=non-diagnostic; 5=excellent), the mean grade was 4.3+/-0.7 with no significant grade difference between two independent observers (P=0.81). CONCLUSIONS: High-resolution 3D FISP MRA accurately defined or excluded vascular rings and slings in patients with respiratory symptoms and/or dysphagia. This technique may provide a non-invasive, radiation-free alternative without contrast agents for diagnosis of vascular rings and slings in free-breathing infants and children.

Adolescent↗

Standardized assessment of whole body adipose tissue topography by MRI.

PURPOSE: To assess standardized whole body adipose tissue topography in a cohort of subjects at an increased risk for type 2 diabetes and to compare fat distribution in subgroups regarding anthropometric (age, body mass index [BMI]) and metabolic parameters (insulin sensitivity). MATERIALS AND METHODS: A total of 80 volunteers (40 females, 40 males) underwent T1-weighted MR imaging of the entire body. Standardized adipose tissue (AT) profiles were calculated considering the different body structure of the participants. The measured data were interpolated to a defined number of sampling points enabling a direct comparison of the profiles independent on body structure. Resulting mean profiles and region-dependent standard deviations of four age groups and three BMI-groups were compared for females and males. Correlations between insulin sensitivity and body fat distribution were analyzed. RESULTS: Reliable adipose tissue profiles could be obtained from all volunteers. In BMI-matched subgroups, females show significant higher AT and subcutaneous abdominal AT (P < 0.05 both), but lower visceral AT (P < 0.01) compared to the males. Furthermore, visceral AT increases with age, as shown in the matched age groups. In both gender groups, insulin-resistant subjects are characterized by higher visceral adipose tissue (VAT) compared to insulin-sensitive subjects. In addition, profiles of insulin-resistant subjects show more AT in the shoulder/neck region but less AT in the upper extremities. CONCLUSION: Standardized assessment of whole body AT profiles based on T1-weighted MRI provides a reliable basis for interindividual comparison of the body fat distribution and allows a fast and reliable quantification of total body adipose tissue and the distribution of different AT components as subcutaneous and visceral fat in different body regions. Differences in standardized profiles might enable an early identification of people at risk of metabolic disorders, as not only the amount but also the distribution of AT is expected to play an essential role in the pathogenesis of metabolic diseases.

Adipose Tissue↗

Magnetic susceptibility effects on the accuracy of MR temperature monitoring by the proton resonance frequency method.

PURPOSE: To evaluate the error of MR temperature assessment based on the temperature-dependent Larmor frequency shift of water protons, which can result from susceptibility effects caused by the radiofrequency (RF) applicator. MATERIALS AND METHODS: Local frequency shifts due to RF applicator displacements were simulated numerically by means of a three-dimensional elementary dipole model. Experimental examinations using a water tank phantom equipped with a high-precision screw thread were applied to examine temperature and movement effects for five commercially available, MR-compatible RF applicators. Measurements were performed at 1.5 Tesla. RESULTS: For single-needle electrodes perpendicular to the external field, a distortion of 0.1 ppm and 0.2 ppm was recorded at a distance of 17.5 mm and 12.5 mm, respectively, to the needle shaft. Cluster applicators and umbrella-shaped applicators caused distortions of 0.1 ppm up to distances of 36 mm. Sinusoidal dependence on applicator orientation was found with the highest values for perpendicular orientation and the lowest values for orientation parallel to the magnetic field. With a single electrode oriented perpendicular to the field at a distance of 1.5 cm and 2.0 cm, a needle displacement of 5 mm led to an error in temperature measurement of 16.3 degrees C and 7.5 degrees C, respectively. CONCLUSION: In MR temperature measurement, displacement of the RF applicator by patient movement or breathing leads to significant errors that have to be taken into account when PRF temperature maps are used to monitor tumor ablation in the presence of paramagnetic applicators.

Catheter Ablation↗

Metal artifacts caused by gradient switching.

In metal parts, e.g., implants or instruments, eddy currents can be induced from gradient switching if positioned off-center inside the MR scanner. For the first time, a systematic analysis of related artifacts was performed. Current strength increases in conjunction with increasing size of the part, increasing electrical conductivity, distance from isocenter, and increasing gradient strengths. A xy-plane oriented copper ring (d(o) = 20 mm, d(i) = 15 mm, 2 mm thick) was examined at isocenter and at x = 15 cm, y = z = 0. Comparisons of xy-, xz-, and yz-slices, recorded for both possibilities to select encoding directions, revealed effects from ramp-down of the slice-selection and ramp-up of the read-out gradient. Near the metal part, temporary inhomogeneities were superimposed to the static field and spin-dephasing signal loss resulted, despite using spin-echo technique. Artifacts depended on excitation and read-out bandwidth. For an equivalent titanium ring, conductivity related effects could not be ascertained but distinct susceptibility effects occurred. MR compatibility of implants/instruments therefore requires both low susceptibility and low conductivity.

Artifacts↗

RF artifacts caused by metallic implants or instruments which get more prominent at 3 T: an in vitro study.

Metallic devices with high electrical conductivity inside or adjacent to the body might lead to marked alterations of the RF amplitude B1 in the tissue under investigation, especially at increased RF frequency, and if specific conditions for electromagnetic resonance are fulfilled. RF-metal interaction effects were investigated systematically at B0=0.2, 1.5 and 3 T analyzing correlated image artifacts for copper wires (d=1 mm, L=53 and 27 cm), and for following instruments and implants made of titanium or nitinol: biopsy needles, hip prostheses, vascular stents and aneurysm clips. The samples were examined in Gd-DTPA-doped 140 mM NaCl solution using spin-echo (SE) sequences with high readout bandwidth. Automatic transmitter adjustment V(T,auto) and manually reduced transmitter voltage VT were applied in order to detect B1 enhancement. At 0.2 T, beyond the shielding of the luminal region of the stents, no RF effects were observed. At 1.5 T, the copper wires caused distinct RF artifacts. At 3 T, RF artifacts also appeared for the hip prostheses and the biopsy needles. Stents with pronounced luminal shielding at lower field strength revealed marked B1 enhancement close to their outer surface.

Alloys↗

Radio frequency versus susceptibility effects of small conductive implants--a systematic MRI study on aneurysm clips at 1.5 and 3 T.

PURPOSE: Metallic implants cause enlarged artifacts in magnetic resonance (MR) images at higher magnetic fields, B0, due to their magnetic susceptibility. Interactions of conductive material with radio frequency (RF) pulses also change for higher field strengths, B0, due to the frequency dependence of resonance conditions. Systematic measurements on commercial aneurysm clips and simplified copper models were performed in order to investigate both phenomena at 1.5 and 3 T. MATERIALS AND METHODS: Six different commercial aneurysm clips made of titanium, straight copper wires and bent copper models were examined in Gd-DTPA-doped water. RF-related effects were measured by adapted 2D and 3D spin-echo sequences. For reliable differentiation from susceptibility-related effects, variable transmitter voltages were applied. In addition, RF-induced heating was controlled by an infrared (IR) camera. RESULTS: At 3 T, a significant RF-induced electric response could be demonstrated for the copper samples and more moderate for one of the commercial clips, dependent on the geometrical structure determining possible resonant RF coupling. Related RF effects could be distinguished from susceptibility artifacts: a signal enhancement at reduced transmitter voltages indicated locally amplified B1-field amplitudes. No significant heating effect could be measured by IR measurements. CONCLUSION: MR imaging was used to analyze possible RF-induced effects. At 3 T, resonant RF coupling even of small metallic implants has to be considered carefully. Despite a local enhancement of the RF amplitude, no significant RF-induced heating inside the surrounding fluid was found. A direct thermal endangering of patients seems to be unlikely, but extremely high B1-field amplitudes might occur adjacent to the metallic surface with potential nonthermal affection of tissue.

Artifacts↗

Magnetic resonance-guided percutaneous radiofrequency ablation of renal cell carcinomas: a pilot clinical study.

OBJECTIVE: The objective of this study was to assess the feasibility and efficacy of magnetic resonance imaging-(MRI) guided percutaneous radiofrequency (RF) ablation of renal cell carcinomas (RCC). SUBJECTS AND METHODS: Twelve patients with RCC (63 to 82 years old) were treated with RF ablation in an interventional 0.2-Tesla open MR unit. Tumor sizes varied from 1.6 cm to 3.9 cm in maximum diameter (tumor volumes 1.9 cm3 to 28.7 cm3). RF procedures were entirely performed in the MR suite. For positioning of the MR-compatible RF-electrode, near real-time MR fluoroscopy by means of rapid gradient echo sequences (acquisition time approximately 2 seconds) was used. Monitoring of ablation was obtained by intermittent imaging with T1- and T2-weighted spin echo sequences. RESULTS: Accurate placement of the RF electrodes was possible in all cases using near real-time MR fluoroscopy. Eleven of 12 patients were successfully treated within 1 single session; 1 patient had to be retreated for tumor relapse at 13 months follow up. Mean number of electrode repositionings under MR guidance during 1 session was 1.7; ablation time ranged between 12 and 28 minutes. Mean duration of 1 treatment session was 5 hours. Coagulation volumes ranged from 7.3 cm3 up to 30.2 cm3. All patients now appear to be disease-free with a mean follow up of 10.3 months (range, 3-23 months). CONCLUSION: MRI-guided RF ablation of RCC in an interventional MR unit is safe and feasible. Fast MR imaging is a convenient method for rapid positioning of MR-compatible RF electrodes. MR monitoring of ablation procedure with T2-weighted imaging allows for immediate assessment of coagulation extent.

Aged↗