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H Marcos

Publications and source records attributed to H Marcos.

5 recordsLinked to original sources

Contrast-enhanced magnetic resonance angiography: technical considerations for optimized clinical implementation.

Contrast-enhanced magnetic resonance angiography (CE MR angiography) has benefited from advancements in MR imaging speed, pulse sequence design, and dedicated equipment and algorithms for its performance. These improvements have greatly expanded the number of options available to the operator and enabled the application of CE MR angiography to a broader range of clinical applications. In this article, the various timing options, pulse sequence innovations, and contrast administration concerns related to clinical CE MR angiography are reviewed. Pertinent issues related to multiphase and multistation bolus chase CE MR angiography also will be discussed.

Contrast Media↗

Dynamic contrast-enhanced magnetic resonance imaging in oncology.

Dynamic contrast-enhanced MRI (DCE-MRI) is the acquisition of sequential images during the passage of a contrast agent within a tissue of interest. The current gadolinium chelate agents enable visualization of lesion vasculature and, due to their small size, can be used to assess vascular permeability. Recent studies demonstrated that the temporal evolution of gadolinium-induced signal intensity changes within a tumor reflects the angiogenic properties of the tumor. These can be quantified and are related to vascular density and other angiogenic characteristics of lesions, such as the level of vascular endothelial growth factor. DCE-MRI provides noninvasive characterization of antiangiogenic response of tumor during therapeutic intervention to monitor and predict response. This article reviews the fundamental pathophysiological basis of DCE-MRI and the technical aspects necessary for successful implementation DCE-MRI. The role of DCE-MRI in tumor detection, characterization, and therapy monitoring is reviewed.

Contrast Media↗

Hepatic MR angiography: a multiobserver comparison of visualization methods.

OBJECTIVE: MR angiography (MRA) is an established diagnostic method; however, controversy remains over the best technique for display. In this study, we compared five methods of depicting hepatic MRA, including a novel skeletonization approach, using receiver operator characteristic (ROC) curves, interobserver variability (kappa values), and speed of interpretation. SUBJECTS AND METHODS: Twenty-one patients scheduled for isolated liver perfusion therapy for metastatic disease underwent contrast-enhanced three-dimensional MRA to determine vascular anatomy. Vascular anatomy was validated at the time of surgery. We displayed the image data, using five techniques: maximum intensity projection, targeted maximum intensity projection, isointensity surface (isosurface), connected isointensity surface (connected isosurface), and ordered region growing skeleton (skeleton). Four observers, blinded to the surgical results, interpreted each technique in random order without patient identifiers. Areas under the ROC curves, kappa values of interobserver variability, and time to interpret each display were compared. RESULTS: Skeletonized MRA had the highest area under the ROC curve (A(z), 0.90 +/- 0.04) compared with the other techniques (p < 0.013). Kappa scores of agreement were also highest for skeletonized MRA (0.75 +/- 0.04) and had no overlap at the 95% confidence level compared with other techniques. Compared with source images, all visualization methods were faster to interpret, but the skeleton technique was more quickly (p = 0.04) interpreted than the other techniques. CONCLUSION: Skeletonized MRA with the skeleton connectivity algorithm is a semi-automated method of displaying complex arterial anatomy. Compared with other techniques, it is more accurate, more consistent among observers, and slightly faster to interpret. Skeletonization should be applicable to CT angiography and MRA.

Female↗

Addressee co-operation and request reformulation in young children.

The purpose of the present study was to show that children under age 3;0 are capable of reformulating requests in different ways depending on how their addressee responds to the request. This adaptive ability is considered to be an indication of the use of both communicative and conversational skills. Children from French-speaking families were observed at two developmental thresholds: the end of the prelinguistic period (1;6) and the start of the linguistic period (2;6). The verbal and nonverbal outputs of the two groups of 12 children (1;6 and 2;6) were compared in three object request situations: the adult immediately complies with the request (satisfaction), the adult asks a clarification question (clarification), and the adult refuses to comply with the request (refusal). The ways in which the children adapted to each situation were found to be similar at the two ages considered. In the clarification situation, vocal productions and their repairs were more numerous, whereas in the refusal situation, non-reformulations and gazes to and from the requested object and addressee predominated. The discussion deals with the significance of these results in the development of communicative and conversational skills in children.

Child Development↗