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Biomedical subjects

H H Quick

Publications and source records attributed to H H Quick.

At least 19 recordsLinked to original sources

Geometrical optimization of a phased array coil for high-resolution MR imaging of the carotid arteries.

The geometry of an RF phased-array receiving coil for high-resolution MRI of the carotid artery, particularly the bifurcation, was optimized with respect to signal-to-noise ratio (SNR). A simulation tool was developed to determine homogeneity, sensitivity, and SNR for a given imaging situation. The algorithm takes into account the coil geometry, the parameters of the measured object, and the imaging parameters of the pulse sequence. The coil with the optimum geometry was implemented as a receive-only coil for 1.5 T and comparative SNR measurements with different coils were performed. The experimental SNR measurements verified the simulations. The optimized carotid artery phased array offered the best SNR over the desired field of view. In vivo high-resolution MRI of the carotid arteries of healthy volunteers and patients with known stenosis was conducted with the optimized phased array coil. The capability of the phased array coil for resolving components within the carotid artery walls is demonstrated. Magn Reson Med 50:439-443, 2003.

Carotid Artery, Common↗

Endourethral MRI.

Although high-resolution MRI with phased array pelvic, endorectal, and endovaginal coils has dramatically enhanced the ability to visualize abnormalities of the female urethra and periurethral tissues, controversy still remains about the anatomy of this region. This study introduces an endourethral approach for ultra-high-resolution MRI of the female urethra and the periurethral tissues. To this end, two different radiofrequency (RF) receiver coil designs for an endourethral insertion have been developed: a single-loop coil and a phased array/quadrature coil. Both designs feature a flexible coil circuit, small loss tuning and matching directly at the coil, active decoupling, and the integration of a lambda/4 coaxial choke to decrease unbalanced currents and limit potential RF heating effects. Effective reduction of the mutual inductance between the two coils of the phased array design was achieved by introducing a metallic "paddle" to steer the flux between the coils. The performance of the coils has been evaluated in female human cadaver studies and in an in vivo pig experiment. The novel endourethral approach enabled a dramatic increase of the signal-to-noise ratio (SNR) at the region of interest (ROI). High-resolution MR images of the female urethra have been acquired with a spatial resolution down to 78 x 78 microm. Histologic correlation was achieved for the MR images generated. The achieved high local SNR and resulting high spatial resolution will add valuable information to the discussion of female urethral anatomy. Magn Reson Med 45:138-146, 2001.

Animals↗

Whole-body MR imaging in 30 seconds with real-time true FISP and a continuously rolling table platform: feasibility study.

A technique for whole-body magnetic resonance (MR) imaging in only 30 seconds was developed on the basis of a rolling table platform with integrated surface coils and real-time true fast imaging with steady-state precession. In five patients, all hepatic and pulmonary lesions with a diameter exceeding 8 mm were detected by using thoracic and abdominal helical computed tomography as the reference method. Whole-body MR imaging with real-time true fast imaging with steady-state precession is feasible and may be suitable for tumor screening and staging.

Adult↗

Reduction of resonant RF heating in intravascular catheters using coaxial chokes.

The incorporation of RF coils into the tips of intravascular devices has been shown to enable the localization of catheters and guidewires under MR guidance. Furthermore, such coils can be used for endoluminal imaging. The long cable required to connect the coil with the scanner input inadvertently acts as a dipole antenna which picks up RF energy from the body coil during transmit. Currents are induced on the cable which can lead to localized heating of surrounding tissue. Cables of various lengths were measured to determine if a resonance in the heating as a function of cable length could be found. Coaxial chokes with a length of lambda/4 were added to coaxial cables to reduce the amplitude of the currents induced on the cable shield. A 0.7-mm diameter triaxial cable, small enough to fit into a standard intravascular device, was developed and measured both with and without a coaxial choke. It is demonstrated that resonant heating does occur and that it can be significantly reduced by avoiding a resonant length of cable and by including coaxial chokes on the cable.

Catheterization, Central Venous↗

TE-switched double-contrast enhanced visualization of vascular system and instruments for MR-guided interventions.

A visualization principle for MR-guided vascular interventions based on the concerted use of two contrast agents is introduced. The first contrast agent, consisting of small paramagnetic iron oxide particles, was administered intravenously to shorten T(1), and even more so T *(2), of the blood for extended time periods. The second agent, a monomeric gadolinium complex, was added to a solution in an interventional device, such as a percutaneous-transluminal-angioplasty (PTA) balloon, to reduce T(1) with only minor additional effects on T *(2). With appropriate T(1)- and T *(2)-weighting the vascular tree (TE <3 ms) and the device (TE > or =8 ms) could be selectively imaged (TR <20 ms). Potentially, both images could be simultaneously updated in the subsecond range. Whereas a visualization of thin structures like guidewires was found to require pulse-sequence optimization, a successful visualization of a PTA balloon in a swine aorta in vivo was possible with standard sequences.

Angioplasty, Balloon, Coronary↗

Temperature mapping of magnetic resonance-guided laser interstitial thermal therapy (LITT) in lymphangiomas of the head and neck.

BACKGROUND AND OBJECTIVE: Lymphangiomas of the tongue and neck are uncommon benign congenital lymphatic tumors. These vascular lesions are difficult to treat, frequently recur, and can cause patients significant morbidity. Treatment may also be complicated by adjacent vital anatomic structures. Magnetic resonance (MR)-controlled laser-induced interstitial thermotherapy (LITT) has been proven to be a noninvasive safe treatment. Real-time monitoring of tissue temperature with thermosensitive sequences allows controlled coagulation necrosis. STUDY DESIGN/MATERIALS AND METHODS: LITT was performed in a lymphangioma specimen ex vivo. In four patients (eight procedures) with lymphangiomas of the tongue and neck, MR-guided LITT was performed with a percutaneous approach in a multiapplicator technique. The laser system consisted of a titanium catheter and a protective catheter. The dome of the fiber end had a diameter of 1.4 mm with an active length of 20 mm. Temperature sensitive sequences were used in a 0.5 T open-configured MR scanner with the proton frequency shift technique to map the spatial and temporal distribution of Nd:YAG laser effects (7 Watts, 30 pulses per second, 10 minutes/location). Postoperative MR follow-up was performed at 1 week and at 3 months. In three patients, partial resection of the tumor was performed 6 months after LITT. RESULTS: In three patients, MR clearly showed a diminished tumor volume. All four patients reported subjective amelioration and in three patients former functional problems, such as speech and swallowing were improved. MR thermometry allowed accurate demarcation of changes by heat and distinction of affected tumor volume (3.0 cm +/- 0.3 cm). The histology of the patients 6 months after LITT showed laser-induced fibrosis of former lymphatic tissue. CONCLUSION: The results suggest that LITT can be performed safely with tissue preserving of vital structures and can be effective in the treatment of deep tumors, such as lymphangiomas. However, given the nature of the lesion, the potential for recurrence exists no matter what modality is chosen.

Adult↗

Interventional MRA and intravascular imaging.

Several attributes make magnetic resonance imaging (MRI) attractive for guidance of intravascular therapeutic procedures, including high soft tissue contrast, imaging in arbitrary oblique planes, lack of ionizing radiation, and the ability to provide functional information, such as flow velocity or flow volume per unit time, in conjunction with morphologic information. For MR guidance of vascular interventions to be safe, the interventionalist must be able to visualize catheters and guidewires relative to the vascular system and surrounding tissues. A number of approaches for rendering instruments visible in an MR environment have been developed, including both passive and active techniques. Passive techniques depend on contrast agents or susceptibility artifacts that enhance the appearance of the catheter in the image itself, whereas active techniques rely on supplemental hardware built into the catheter, such as a radiofrequency (RF) coil. Additionally, the ability to introduce an RF coil mounted on a catheter presents the opportunity to obtain high-resolution images of the vessel wall. These images can provide the capability to distinguish and identify various plaque components. The additional capabilities of MRI could potentially open up new applications within the purview of vascular interventions beyond those currently performed under X-ray fluoroscopic guidance.

Angioplasty, Balloon↗

Toward MRI-guided coronary catheterization: visualization of guiding catheters, guidewires, and anatomy in real time.

The success of x-ray fluoroscopy-guided coronary catheterization depends in part on the ability to obtain simultaneous and real-time visualization of the guidewire, guiding catheter, and anatomy of the chest. The hypothesis explored in this paper is that magnetic resonance imaging (MRI) could provide this ability. This hypothesis was tested with loopless antennas used as the guidewire and a guiding catheter and two surface coils, each connected to four different receiver channels of a GE 1.5-T CV/I MRI scanner. Experiments were conducted on six healthy dogs. Intravascular antennas were inserted in the right carotid artery and maneuvered in the aorta while running a fast gradient-echo sequence (TR/TE 5/1.3 msec, flip angle 7 degrees). Real-time projection images of the chest anatomy, together with the guidewire and guiding catheter, were obtained. Positioning of the MRI guiding catheter either in the descending aorta, ascending aorta, or heart was achieved easily. This study represents a step toward MRI-guided coronary catheterization.

Animals↗

[Whole-body MRA on a rolling table platform (AngioSURF)].

PURPOSE: Development of a technique for whole-body MR angiography based on a rolling table platform and integration of a surface coil. MATERIAL AND METHODS: The developed rolling table platform AngioSURF (System for Unlimited Rolling Field-of-view) with integrated surface coil can be mounted on top of the original patient table of a Siemens Symphony System. Data acquisition was performed with a standard body array surface coil. The system was tested on three volunteers and one patient with angiographically documented vascular pathology. Data acquisition was performed with a 3D-FLASH-sequence (TR/TE 2.1/0.7 ms, flip angle: 20 degrees, FOV 40 x 40 cm, 80 partitions, matrix 512 x 420 with zero interpolation). Five data sets were collected in immediate succession during continuous injection of a paramagnetic contrast agent. Time of acquisition per data set was 10 seconds. Table repositioning was performed manually within 3 seconds. Thus the total acquisition time amounted to 72 seconds. RESULTS: No problems with handling occurred in any of the four cases. The excellent image quality enables detailed assessment of the displayed vascular territories. CONCLUSIONS: The rolling table platform with integrated surface coil (AngioSURF) allows diagnostic display of the arterial vascular system from supraaortic vessels to the distal trifurcation arteries in only 72 seconds.

Angiography↗

Ligating clips for three-dimensional MR angiography at 1.5 T: in vitro evaluation.

Artifact size on three-dimensional (3D) magnetic resonance (MR) angiograms and safety of various vascular clips (15 titanium and three absorbable polydioxanone clips) were assessed. All evaluated clips were completely safe. Biodegradable clips rendered no artifacts; titanium clips were associated with susceptibility effects. Artifact size was dependent on clip size, clip orientation, echo time, and degree of k-space coverage. In the presence of titanium vascular clips, fast 3D MR angiography should be performed with the shortest echo time and full k-space coverage.

Artifacts↗

Real-time projection MR angiography: feasibility study.

Intraarterial injections of small doses of gadopentetate dimeglumine were combined with a fast spoiled-gradient-echo magnetic resonance (MR) sequence to obtain real-time projection angiographic images of the rabbit aorta and canine coronary arteries. Arterial filling and washout, as well as venous and perfusion phases, were clearly displayed, demonstrating that arterial fluoroscopy in which an MR technique is used is feasible.

Adult↗

High-resolution intravascular magnetic resonance imaging: monitoring of plaque formation in heritable hyperlipidemic rabbits.

BACKGROUND: The individual makeup of atherosclerotic plaque has been identified as a dominant prognostic factor. With the use of an intravascular magnetic resonance (MR) catheter coil, we evaluated the effectiveness of high-resolution MR in the study of the development of atherosclerotic lesions in heritable hyperlipidemic rabbits. METHODS AND RESULTS: Sixteen hyperlipidemic rabbits were investigated at the ages of 6, 12, 24, and 36 months. The aorta was studied with digital subtraction angiography and high-resolution MR with the use of a surface coil and an intravascular coil that consisted of a single-loop copper wire integrated in a 5F balloon catheter. Images were correlated with histological sections regarding wall thickness, plaque area, and plaque components. Digital subtraction angiography revealed no abnormalities in the 6- and 12-month-old rabbits and only mild stenoses in the 24- and 36-month-old rabbits. High-resolution imaging with surface coils resulted in an in-plane resolution of 234x468 microm. Delineation of the vessel wall was not possible in younger rabbits and correlated only poorly with microscopic measurements in the 36-month-old rabbits. Intravascular images achieved an in-plane resolution of 117x156 microm. Increasing thickness of the aortic wall and plaque area was observed with increasing age. In the 24- and 36-month-old animals, calcification could be differentiated from fibrous and fatty tissue on the basis of the T2-fast spin echo images, as confirmed by histological correlation. CONCLUSIONS: Atherosclerotic evolution of hyperlipidemic rabbits can be monitored with high-resolution intravascular MR imaging. Image quality is sufficient to determine wall thickness and plaque area and to differentiate plaque components.

Animals↗

Autoperfused balloon catheter for intravascular MR imaging.

An intravascular magnetic resonance (MR) imaging catheter for high-resolution imaging of vessel walls was developed. The catheter design is based on an autoperfusion balloon catheter that allows passive perfusion of blood during balloon inflation. The blood enters a central lumen through multiple sideholes of the catheter shaft proximal to the balloon. A remotely tuned, matched, and actively decoupled, expandable single-loop radiofrequency coil was mounted onto the balloon to receive intravascular MR signals. The autoperfusion rate through the catheter was determined experimentally relative to perfusion pressure. The catheter concept was evaluated in vitro on human femoral artery specimens and in vivo in the internal carotid artery of two pigs. The proposed catheter design allowed for maintained blood perfusion during the acquisition of high-resolution intravascular images. During perfusion, image quality remained unaffected by flow, motion, and pulsatility artifacts. The availability of an autoperfused intravascular catheter design can be considered an important step toward high-resolution atherosclerotic plaque imaging in critical vessels such as the carotid and coronary arteries.

Animals↗

Single-loop coil concepts for intravascular magnetic resonance imaging.

Compared with other coil designs that have been investigated for intravascular use, the single-loop coil can be designed with a very small diameter for insertion into small vessels and with a longitudinal extent over several centimeters for multislice imaging. If it designed to be expandable inside the target vessel, then it combines these features with increased signal-to-noise ratio (SNR) and penetration depth. Expandable single-loop coils that are capable of meeting these requirements were developed and integrated into two different commercial catheter-based delivery systems: a self-expandable, single-loop made from NiTinol and a single-loop coil mounted on an inflatable balloon. The influence of a small-diameter coaxial cable for remote tuning and matching on the coil performance was investigated. Calculations showed the dependence of the signal on the separation between the conductors. The comparison of both catheter approaches in in vitro flow experiments and in an in vivo pig experiment revealed the influence of pulsatile flow on image quality during intravascular imaging with these designs.

Animals↗

Vascular stents as RF antennas for intravascular MR guidance and imaging.

Stent deployment is used to improve the immediate and long-term results of vascular interventions in various vascular sites. X-ray angiography as an imaging modality is often limited in providing an accurate assessment with regard to vessel size, plaque calcification, or stent deployment. In this study, the potential of using the stent endoprothesis as a radiofrequency (RF) receive-only probe for MR guidance and lesion imaging was investigated. Three different principles were developed to visualize stents actively, the first employing the stent as a loop antenna, the second employing the stent in an electrical dipole configuration, and the third employing the stent in a hybrid configuration as a coaxial line antenna. The three configurations resulted in different signal characteristics. Based on two of these antenna configurations, stent deployment devices were built and evaluated in in vitro as well as in vivo sheep experiments. Active stent visualization allows real-time MR guidance through the vessel tree and monitoring of stent deployment. In addition, the stent antenna may become useful for high resolution imaging of the vessel wall. Magn Reson Med 42:738-745, 1999.

Animals↗

In vitro image characteristics of an abdominal aortic stent graft: CTA versus 3D MRA.

Percutaneous stent-grafting is increasingly employed as a less invasive alternative to surgery for the treatment of infrarenal abdominal aortic aneurysms. It requires long-term imaging follow-up, to document the structural integrity of the device, to exclude perigraft channels and endograft leakages, as well as the shrinkage of the aneurysmal sac. The expectation of severe stent induced artifacts and safety concerns have prevented 3D MRA from being used. The purpose of this in vitro study was to investigate the imaging characteristics of a bifurcated stent graft with 3D MRA (3D Fourier transform fast spoiled GRE) at 1.5 T in comparison to those of CTA. Measurement of the stent wall thickness and luminal diameter were made on a agar gel embedded stent graft at five locations on both CTA and MRA images. The stent graft was depicted as a dark ring on MR images. Wall thickness measurements at the five locations of the stent graft overestimated the true stent thickness, while luminal diameters were slightly underestimated. Measurement differences between MR and CT were not statistically significant (P = 0.67; P = 0.85). Artifacts emanating from the platinum markers were considerably less severe on the MR-images. A wider area of signal loss was seen only at the insertion of the iliac stent leg into the aortic stent portion due to the overlap of two radio-opaque platinum markers. 3D MRA images should permit a comprehensive assessment of the arterial lumen, and of perivascular tissues.

Aortic Aneurysm, Abdominal↗

Three-dimensional MR angiography of a nitinol-based abdominal aortic stent graft: assessment of heating and imaging characteristics.

OBJECTIVE: To assess heating- and 3D MRA imaging characteristics of a commonly used aortic stent graft in a 1.5T MR-environment. MATERIALS AND METHODS: A bifurcated stent graft (Vanguard; Boston Scientific, Oakland, N. J.) was evaluated in vitro regarding localized heating effects as well as imaging appearance using fast 3D GRE sequences. To quantitate stent related artifacts, stent wall thickness and luminal diameters were measured. Subsequently eight patients were imaged three months following placement of an aortic stentgraft with 3D MRA. Images were assessed for the presence of stent leaks, luminal patency, and stent configuration. RESULTS: There were no temperature changes associated with the stent during scanning. Wall thickness measurements overestimated true stent thickness, resulting in minimal underestimation of luminal diameters on 3D MRA images. In vivo imaging confirmed these results. Stent patency was confirmed in all 8 patients. CONCLUSION: Contrast-enhanced 3D MRA appears well suited for the evaluation of the abdominal and pelvic vasculature following aortic implantation of a Vanguard stent.

Aged↗

Plain and covered stent-grafts: in vitro evaluation of characteristics at three-dimensional MR angiography.

PURPOSE: To evaluate the characteristics of various plain and covered stents as regards demonstration of the contained lumen with simulated contrast material-enhanced fast three-dimensional (3D) magnetic resonance (MR) angiography. MATERIALS AND METHODS: Six stents (Easy Wallstent, Cragg, Palmaz, Cragg EndoPro System 1, Corvita, Passager) were implanted in plastic tubes and integrated into a closed-tubing circuit driven by a pulsatile roller flow pump. The circulating water was spiked with gadopentetate dimeglumine. Three-dimensional MR angiograms were obtained with an echo time of 1.4 or 2.1 msec and with partial (0.5 signal acquired) or full (one signal acquired) k-space sampling. The size of the stent-associated artifact was determined relative to the tube diameter. RESULTS: The Easy Wallstent and Palmaz stent caused complete obliteration of the stent lumen with all sequences. The Cragg, Cragg EndoPro System 1, and Passager stents allowed good visualization of the stent lumen. The Corvita stent demonstrated major artifacts. The magnitude of the stent-associated artifact was related to the echo time (P < .01) but not to the type of k-space sampling (P = .35). CONCLUSION: The luminal patency of selected plain and covered stents can be assessed with contrast-enhanced 3D MR angiography.

Blood Vessels↗