Looking beyond the lumen does make all the difference.
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Aged↗
Biomedical subjects
General Leung
Publications and source records attributed to General Leung.
In vivo identification of complicated upper thoracic aorta and arch vessel plaque by MR direct thrombus imaging in patients investigated for cerebrovascular disease.
OBJECTIVE: The objective of this article was to assess the feasibility of MR direct thrombus imaging (MRDTI) to evaluate the prevalence and location of complicated upper thoracic aortic and arch vessel plaque in patients referred for evaluation of cerebrovascular disease. SUBJECTS AND METHODS: Patients referred for investigation of cerebrovascular disease by MRI were enrolled. Reasons for referral included transient ischemic attack/amaurosis fugax, acute infarct, remote infarct, or asymptomatic carotid disease. Of the 348 patients initially scanned, 17 were excluded from the analysis. The final patient population included 331 patients (199 men, 132 women; mean age, 67.7 years). Patients were scanned using MRDTI, a 3D, T1-weighted, fat-suppressed spoiled gradient echo that exploits the T1 shortening effects of methemoglobin, directly visualizing hemorrhage/thrombus in the vessel wall, thus identifying complicated plaque. Complicated plaque was defined as a high signal within the atherosclerotic plaque at least twice the signal intensity of muscle. RESULTS: Forty-three of 331 patients (13%) had complicated upper thoracic aortic atherosclerotic disease, arch vessel atherosclerotic disease, or both. The upper thoracic aorta was involved in 36 of 43 patients (83.7%), and the left subclavian artery was involved in 14 of 43 patients (32.6%). Both the right subclavian artery and the brachiocephalic artery were involved in one of 43 patients (2.3%). Complicated carotid plaque was seen in 25 of 43 patients (58.1%). CONCLUSION: MRDTI can be applied in the detection of complicated plaque in the upper thoracic aorta and arch vessels. Complicated plaque was identified in 13% of the patient population. The upper thoracic aorta was the most common site involved. This technique could be useful for the screening of asymptomatic at-risk patients.
Adult↗
Retrospective motion compensation using variable-density spiral trajectories.
PURPOSE: To develop a method of retrospectively correcting for motion artifacts using a variable-density spiral (VDS) trajectory. MATERIALS AND METHODS: Each VDS interleaf was designed to adequately sample the same center region of k-space. This central overlapping region can then be used to measure rigid body motion between the acquisition of each VDS interleaf. By applying appropriate phase shifts and rotations of the k-space data, rigid body motion artifacts can be removed, resulting in images with less motion corruption. RESULTS: Both phantom and volunteer experiments are shown, demonstrating the technique's ability to further reduce artifacts in images acquired with an already motion-resistant acquisition trajectory. Registration accuracy is highly dependent on the trajectory design parameters. This space was explored to find an optimal design of VDS trajectories for motion compensation. CONCLUSION: Using appropriately designed VDS trajectories, residual motion artifacts can be significantly reduced by retrospectively correcting for in-plane rigid body motion. An overlapping region of approximately 8% of the central region of k-space and approximately 70 interleaves were found to be near-optimal parameters for retrospective correction using VDS trajectories.
Artifacts↗
Microvessels in chronic total occlusions: pathways for successful guidewire crossing?
Arterial chronic total occlusions (CTO) are a common and clinically relevant problem in patients with coronary artery disease. Percutaneous coronary intervention (PCI) success rates in a wide range of CTO are low, primarily due to inability of guidewire crossing. The pathophysiology of CTO is poorly understood and limits our ability to introduce innovative therapies. Recent studies from our laboratory have suggested that microvessel formation within arterial CTO is a complex process with temporal and regional differences. Moreover, there is evidence from pilot studies that the presence of either microvessels or the particular extracellular matrix environment in the adjacent perivascular tissue can facilitate guidewire crossing and successful PCI. Currently, studies are underway in our experimental CTO model to delineate the pathophysiology of microvessel formation in CTO and its potential role in PCI.
Animals↗
MR pulse sequences: what every radiologist wants to know but is afraid to ask.
The use of magnetic resonance (MR) imaging is growing exponentially, in part because of the excellent anatomic and pathologic detail provided by the modality and because of recent technologic advances that have led to faster acquisition times. Radiology residents now are introduced in their 1st year of training to the MR pulse sequences routinely used in clinical imaging, including various spin-echo, gradient-echo, inversion-recovery, echo-planar imaging, and MR angiographic sequences. However, to make optimal use of these techniques, radiologists also need a basic knowledge of the physics of MR imaging, including T1 recovery, T2 and T2* decay, repetition time, echo time, and chemical shift effects. In addition, an understanding of contrast weighting is very helpful to obtain better depiction of specific tissues for the diagnosis of various pathologic processes.
Humans↗