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Biomedical subjects

Hsiao-Wen Chung

Publications and source records attributed to Hsiao-Wen Chung.

At least 19 recordsLinked to original sources

Tensor deflection (TEND) tractography with adaptive subvoxel stepping.

PURPOSE: To develop an adaptive subvoxel stepping scheme, as an adjunct to tensor deflection (TEND) tractography, that automatically adjusts the stepping size by considering the tensor linearity to properly trace fiber bundles in regions with different degrees of tensor anisotropy. MATERIALS AND METHODS: A theoretical investigation of the TEND algorithm was performed to assess the degree of deflection of the propagation vector toward the major eigenvector. Mathematically generated phantoms (one with curved fibers and the other with crossing fibers) at wide ranges of signal-to-noise ratio (SNR), and human brain images obtained in vivo were used to test the performance of the adaptive stepping algorithm. RESULTS: The degree of deflection was found to be inversely related to the stepping size. A small stepping size was advantageous for tracing single curved fiber bundles, whereas a large stepping size was beneficial for passing through fiber crossing regions. The performance of the adaptive stepping algorithm was superior to fixed stepping in both situations, leading to an approximately 0.17 voxel of deviation in curved fibers and a nearly 100% successful tracking rate in crossing fibers at typical SNR. Human brain images demonstrated similar results. CONCLUSION: The adaptive stepping algorithm is a helpful adjunct to TEND tractography.

Algorithms↗

Estimation of pulse wave velocity in main pulmonary artery with phase contrast MRI: preliminary investigation.

PURPOSE: To assess the feasibility and reproducibility of a noninvasive MRI method to measure pulse wave velocity (PWV) in the main pulmonary artery (MPA). MATERIALS AND METHODS: A total of 17 subjects without history of pulmonary diseases (38.2 +/- 18.4 years) participated in this study. Series of MR velocity maps of the MPA were acquired at 2 cm above the pulmonary valves using a two-dimensional phase-contrast sequence. Effective temporal resolution was 11 msec after interleaving two dynamic series with different values of electrocardiograph (ECG) trigger delay. PWV was derived as the rate of MPA flow variations per unit change in MPA cross-sectional area, during early systole. Seven healthy subjects underwent three repetitive examinations to investigate intrascan and interscan reproducibility. RESULTS: Flow vs. area was highly linear in the MPA during early systole, with Pearson's coefficients ranging from 0.982 to 0.999, rendering derivation of PWV with little difficulty. Average value of PWV in MPA was 1.96 +/- 0.27 m/second, in good agreement with literature values measured using invasive means. The percentage intra- and interscan differences were 5.46% and -10.86%, respectively. CONCLUSION: Phase-contrast MRI to noninvasively measure PWV in the MPA is feasible with good reproducibility.

Adult↗

Temporal correlation-based dynamic contrast-enhanced MR imaging improves assessment of complex pulmonary circulation in congenital heart disease.

A temporal correlation (TC) mapping method is proposed to help bolus chasing during dynamic contrast-enhanced (DCE) MRI of complex pulmonary circulation (CPC) in patients with congenital heart disease. DCE-MRI was performed on five healthy male subjects (23-24 years old) and 25 patients (nine males and 16 females, 0.25-44 years old), and TC maps were generated by performing pixel-based computation of cross-correlations to the pulmonary artery with a series of time shifts in all subjects. Qualitative and quantitative evaluations were performed in comparison with original DCE images. TC maps exhibited a better signal-to-noise ratio (SNR) by factors of 4.3 and 1.3 in the lung parenchyma, pulmonary veins, and superior artery/vein; a better intraparenchymal contrast-to-noise ratio (CNR) by factors of 1.5-5.4; and a significantly higher conspicuity in all regions except the pulmonary arteries when graded with a five-point score. TC maps evaluated by two experienced clinicians significantly added relevant information (P<0.001), and in some cases affected the final diagnosis. We conclude that TC maps facilitate bolus chasing for DCE-MRI by reducing recirculation effects and interframe fluctuations, and hence complements morphological imaging of CPC in patients with complex congenital heart disease.

Adolescent↗

PROPELLER-EPI with parallel imaging using a circularly symmetric phased-array RF coil at 3.0 T: application to high-resolution diffusion tensor imaging.

A technique integrating multishot periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) and parallel imaging is presented for diffusion echo-planar imaging (EPI) at high spatial resolution. The method combines the advantages of parallel imaging to achieve accelerated sampling along the phase-encoding direction, and PROPELLER acquisition to further decrease the echo train length (ETL) in EPI. With an eight-element circularly symmetric RF coil, a parallel acceleration factor of 4 was applied such that, when combined with PROPELLER acquisition, a reduction of geometric distortions by a factor substantially greater than 4 was achieved. The resulting phantom and human brain images acquired with a 256 x 256 matrix and an ETL of only 16 were visually identical in shape to those acquired using the fast spin-echo (FSE) technique, even without field-map corrections. It is concluded that parallel PROPELLER-EPI is an effective technique that can substantially reduce susceptibility-induced geometric distortions at high field strength.

Adult↗

Dynamic motion analysis of fetuses with central nervous system disorders by cine magnetic resonance imaging using fast imaging employing steady-state acquisition and parallel imaging: a preliminary result.

OBJECT: The authors present a novel cine magnetic resonance (MR) imaging, two-dimensional (2D) fast imaging employing steady-state acquisition (FIESTA) technique with parallel imaging. It achieves temporal resolution at less than half a second as well as high spatial resolution cine imaging free of motion artifacts for evaluating the dynamic motion of fetuses in utero. The information obtained is used to predict postnatal outcome. METHODS: Twenty-five fetuses with anomalies were studied. Ultrasonography demonstrated severe abnormalities in five of the fetuses; the other 20 fetuses constituted a control group. The cine fetal MR imaging demonstrated fetal head, neck, trunk, extremity, and finger as well as swallowing motions. Imaging findings were evaluated and compared in fetuses with major central nervous system (CNS) anomalies in five cases and minor CNS, non-CNS, or no anomalies in 20 cases. Normal motility was observed in the latter group. For fetuses in the former group, those with abnormal motility failed to survive after delivery, whereas those with normal motility survived with functioning preserved. The power deposition of radiofrequency, presented as specific absorption rate (SAR), was calculated. The SAR of FIESTA was approximately 13 times lower than that of conventional MR imaging of fetuses obtained using single-shot fast spin echo sequences. CONCLUSIONS: The following conclusions are drawn: 1) Fetal motion is no longer a limitation for prenatal imaging after the implementation of parallel imaging with 2D FIESTA, 2) Cine MR imaging illustrates fetal motion in utero with high clinical reliability, 3) For cases involving major CNS anomalies, cine MR imaging provides information on extremity motility in fetuses and serves as a prognostic indicator of postnatal outcome, and 4) The cine MR used to observe fetal activity is technically 2D and conceptually three-dimensional. It provides four-dimensional information for making proper and timely obstetrical and/or postnatal management decisions.

Encephalocele↗

Inclusion of biological factors in parallel-architecture normal-tissue complication probability model for radiation-induced liver disease.

PURPOSE: To include biologic factors in parallel-architecture normal-tissue complication probability (NTCP) model for radiation-induced liver disease (RILD) after three-dimensional conformal radiotherapy (3D-CRT) for gastric or hepatic cancer. METHODS AND MATERIALS: A total of 151 patients (89 with hepatocellular carcinoma and 62 with gastric cancer) who received 3D-CRT to the liver were included (isocenter dose range 33.0 to 66.0 Gy; mean 48.0 Gy). RILD was defined as grade 3 or higher liver toxicity according to Common Toxicity Criteria Version 2.0 of the National Cancer Institute within 4 months after 3D-CRT. Possible correlations of patient-related or dosimetric factors with RILD were tested. Maximum-likelihood analysis estimated NTCP model parameters for group and subgroups. Goodness-of-fit analysis estimated deviance of NTCP model parameters between subgroups. RESULTS: RILD developed in 25 patients. Hepatitis B virus carrier status (p < 0.001) was the only significant independent factor. The 4 parallel NTCP model parameters, mean functional reserve (V(50)), width of functional reserve distribution (sigma), dose damage to 50% of liver subunits (D(50)), and slope parameter for subunit dose-response (k), were respectively, 0.54, 0.14, 50 Gy, 0.18 (group); 0.53, 0.07, 50 Gy, 4.6 x 10(-7) (carriers); 0.59, 0.12, 25 Gy, 59.8 (noncarriers). In carrier-state subgroups, goodness-of-fit deviance with 1 subgroup's parameter set would have been worse in the other group. Across subgroups, patients with RILD all had liver fraction damage (f) greater than 0.4 compared with wider distribution for the whole group. CONCLUSIONS: RILD is described with a parallel-architecture NTCP model for HBV carriers and noncarriers with a threshold effect greater than 0.4. The main difference is in slope parameter for subunit dose-response.

Adult↗

Acute putaminal necrosis and white matter demyelination in a child with subnormal copper metabolism in Wilson disease: MR imaging and spectroscopic findings.

Wilson disease (WD) that manifests solely with acute and severe neurological damage in the absence of hepatic disease and Kayser-Fleischer ring of the cornea is rare and difficult to diagnose at the acute setting. This report describes unusual diffusion and proton spectroscopic magnetic resonance (MR) imaging findings in a 12-year-old boy with WD who presented with hemichorea and subnormal copper metabolism. The MR imaging findings of lactate accumulation, decrease of N-acerylaspartate/creatinine (NAA/Cr) ratio and markedly increased apparent diffusion coefficient (ADC) value of the asymmetrical edematous putaminal lesions in the early stage were suggestive of acute necrosis with anaerobic metabolism of glucose leading to poor clinical outcome at follow-up.

Child↗

Application of model-free analysis in the MR assessment of pulmonary perfusion dynamics.

Dynamic contrast-enhanced (DCE) MRI has been used to quantitatively evaluate pulmonary perfusion based on the assumption of a gamma-variate function and an arterial input function (AIF) for deconvolution. However, these assumptions may be too simplistic and may not be valid in pathological conditions, especially in patients with complex inflow patterns (such as in congenital heart disease). Exploratory data analysis methods make minimal assumptions on the data and could overcome these pitfalls. In this work, two temporal clustering methods--Kohonen clustering network (KCN) and Fuzzy C-Means (FCM)--were concatenated to identify pixel time-course patterns. The results from seven normal volunteers show that this technique is superior for discriminating vessels and compartments in the pulmonary circulation. Patient studies with five cases of acquired or congenital pulmonary perfusion disorders demonstrate that pathologies can be highlighted in a concise map that combines information of the mean transit time (MTT) and pulmonary blood volume (PBV). The method was found to provide greater insight into the perfusion dynamics that might be overlooked by current model-based analyses, and may serve as a basis for optimal hemodynamic quantitative modeling of the interrogated perfusion compartments.

Adult↗

PROPELLER EPI: an MRI technique suitable for diffusion tensor imaging at high field strength with reduced geometric distortions.

A technique suitable for diffusion tensor imaging (DTI) at high field strengths is presented in this work. The method is based on a periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) k-space trajectory using EPI as the signal readout module, and hence is dubbed PROPELLER EPI. The implementation of PROPELLER EPI included a series of correction schemes to reduce possible errors associated with the intrinsically higher sensitivity of EPI to off-resonance effects. Experimental results on a 3.0 Tesla MR system showed that the PROPELLER EPI images exhibit substantially reduced geometric distortions compared with single-shot EPI, at a much lower RF specific absorption rate (SAR) than the original version of the PROPELLER fast spin-echo (FSE) technique. For DTI, the self-navigated phase-correction capability of the PROPELLER EPI sequence was shown to be effective for in vivo imaging. A higher signal-to-noise ratio (SNR) compared to single-shot EPI at an identical total scan time was achieved, which is advantageous for routine DTI applications in clinical practice.

Algorithms↗

FLAIR diffusion-tensor MR tractography: comparison of fiber tracking with conventional imaging.

BACKGROUND AND PURPOSE: Partial volume with CSF is known to contaminate the quantification of white matter anisotropy depicted by diffusion tensor imaging (DTI). We hypothesized that the FLAIR technique helps to improve DTI white matter tractography in the normal adult brain by eliminating CSF partial volume effects. METHODS: Seven healthy adults aged 23-37 underwent both conventional and FLAIR DTI at 1.5T. Each subject was imaged five times. Neural fiber tractography was performed with both sequences by using two algorithms: a voxel-based method (EZ-tracing) with global seed points and another based on subvoxel tractography (tensor deflection) by using manual encircling of local seed points. Total volume of the fibers tracked was compared for the two types of images. RESULTS: Fiber tracking was substantially most successful on FLAIR DTI near the lateral ventricles and the sulci, where CSF partial volume effects were likely present. Minor false tracts on FLAIR images, possibly due to a reduced signal-to-noise ratio, were found in regions relatively free of CSF contamination; however, they did not affect tracking of major periventricular white matter bundles, such as those related to the corpus callosum or the corona radiata. When we excluded false tracts, the FLAIR technique depicted an average of 17% more fibers in volume than conventional DTI in the periventricular regions (P < .0005, paired Student t test). CONCLUSION: Despite the reduction of signal-to-noise ratio and longer imaging times, FLAIR improved tractography by eliminating CSF partial volume effects.

Adult↗

MR ventriculocisternography by using 3D balanced steady-state free precession imaging: technical note.

This study investigated the effects of flip angle setting in 3D balanced steady-state free precession (SSFP) imaging on CSF-parenchyma contrast and section aliasing artifacts. Theoretical derivations indicated that the extent of section aliasing artifacts decreased as the flip angle was lowered, at the expense of a sacrifice in CSF-parenchyma contrast. Experimental data agreed closely with theoretical predictions. A flip angle of about 40 degrees is therefore recommended for 3D balanced SSFP MR ventriculocisternography.

Artifacts↗

Hippocampal alterations in children with temporal lobe epilepsy with or without a history of febrile convulsions: evaluations with MR volumetry and proton MR spectroscopy.

BACKGROUND AND PURPOSE: The causal effect of early febrile convulsions (FC) on later-onset temporal lobe epilepsy (TLE) remains unclear. In this study, we sought to examine the hippocampal alterations in epileptic children with or without FC history by using MR spectroscopy and volumetry. METHODS: Fifty-five children ranging in age from 18 months to 15 years were enrolled in this study. Subjects were divided into three groups: the control group without either TLE or history of FC (n = 16), the TLE group with early history of FC (TLE + FC; n = 22), and the TLE group without FC history (n = 17). Measurement of hippocampal volume (HV) was performed on thin section T1-weighted images acquired with a 3D gradient echo MR image and normalized by the intracranial volume. Each individual subject had two measures of lateralization; one gives the smaller side of HV and the other the contralateral larger side of HV, assuming that the side with smaller HV is the possible primary site of seizure focus and the contralateral larger HV the secondary or normal site. Single-voxel proton MR spectroscopy of the hippocampi was performed, with metabolic ratio n-acetylaspartate (NAA)/choline (Cho) + creatine plus phosphocreatine (Cr) calculated and grouped separately as were with volumetry. RESULTS: The overall mean HV for the control group was 2.61 +/- 0.21 cm(3) at an average intracranial volume of 965 +/- 241 cm(3), and the asymmetry index for hippocampal volume was (2.32 +/- 1.58)%. The overall mean HV was 2.30 +/- 0.33 cm(3) for TLE + FC group and 2.34 +/- 0.33 cm(3) for TLE group. Mean HV differed significantly for the three groups (P < .01). When the small and large sides were analyzed separately, significant differences were found between control and TLE as well as between control and TLE + FC for the smaller side (P < .05), whereas for the larger side significant differences were found only between control and TLE + FC. In MR spectroscopic measurements, the mean NAA/(Cr + Cho) of bilateral hippocampi was 0.77 +/- 0.06 for control group, 0.62 +/- 0.12 for TLE + FC group, and 0.66 +/- 0.11 for TLE group. In terms of statistically significant difference between groups, spectroscopic results were similar to volumetric measurements, except that there was no significant interaction effect between groups and measures of asymmetrical indices (P = .272). CONCLUSION: Children with TLE and early history of FC tend to have lower hippocampal volumes and NAA/(Cr + Cho) ratios than do TLE children without FC history. The TLE + FC group seems to have increased vulnerability of the contralateral hippocampus as compared with TLE group. MR volumetry and spectroscopy are equally capable of showing the trends of hippocampal alternations in children with TLE with or without FC history.

Adolescent↗

Correlation of bone marrow lipid water content with bone mineral density on the lumbar spine.

STUDY DESIGN: Prospective study. OBJECTIVES: To assess the proton MR spectroscopy (1H MRS) of vertebral bone marrow and correlate the lipid water ratio (LWR) and spectral line width (LW) with bone mineral density (BMD) in female subjects. SUMMARY OF BACKGROUND DATA: The mechanism of bone marrow fat accumulation and bone mineral content is poorly understood. Proton MR spectroscopy was used to demonstrate the lipid and water spectra in the bone marrow. We try to assess the possible interaction between the bone marrow lipid content, aging, and BMD. METHODS: Proton MRS and BMD of the lumbar spine were performed in 52 female subjects (mean age, 58 years; SD, 10 years). They were 13 premenopausal and 39 postmenopausal women. The BMD (g/cm2) was measured using dual energy radiograph absorptiometry at the lumbar spine. Single voxel 1H MRS was measured at L3 vertebral body by stimulated echo-acquisition mode (STEAM) sequence and demonstrated two major peaks (lipid and water). Comparisons of the differences between the two subgroups were made. Pearson's correlation was also calculated to explore the association of 1H MRS measurements with age and BMD. Partial correlation was further conducted when controlling the variable such as age or BMD. RESULTS: BMD and LWR had statistically significant difference between the pre- and postmenopausal subgroups (P < 0.001), while lipid LW had a borderline difference and water LW had no difference. LWR was positively correlated with age (r = 0.52 and P < 0.0001) and negatively correlated with BMD (r = -0.40 and P = 0.003) for all the subjects. Lipid LW was negatively correlated with age (r = -0.32 and P = 0.0197) and positively correlated with BMD (r = 0.67 and P < 0.0001). When controlling for BMD effect, only LWR is statistically correlated with age (partial r = 0.39, P = 0.0045), while only the lipid LW is statistically correlated with BMD when controlling for age (partial r = 0.63, P < 0.0001). None of the correlations between water LW and age or BMD was significant. In the subgroups, only the lipid LW is significantly correlated with BMD (r = 0.78, P = 0.0016 in premenopausal women; r = 0.62, P < 0.0001 in postmenopausal women). CONCLUSION: The LWR had a positive correlation with the age, while the lipid LW had a positive correlation with BMD, even after controlling the age factor. The bone marrow lipid water content and metabolism acted as important roles in the internal environment of bone and influenced bone mineralization.

Absorptiometry, Photon↗

Fat and water separation in balanced steady-state free precession using the Dixon method.

In this work the feasibility of separating fat and water signals using the balanced steady-state free precession (SSFP) technique is demonstrated. The technique is based on the observation (Scheffler and Hennig, Magnetic Resonance in Medicine 2003;49:395-397) that at the nominal values of TE = TR/2 in SSFP imaging, phase coherence can be achieved at essentially only two orientations (0 degrees and 180 degrees ) relative to the RF pulses in the rotating frame, under the assumption of TR << T2, and independently of the SSFP angle. This property allows in-phase and out-of-phase SSFP images to be obtained by proper choices of the center frequency offset, and thus allows the Dixon subtraction method to be utilized for effective fat-water separation. The TR and frequency offset for optimal fat-water separation are derived from theories. Experimental results from healthy subjects, using a 3.0 Tesla system, show that nearly complete fat suppression can be accomplished.

Abdomen↗

Comparison of arterial spin labeling and first-pass dynamic contrast-enhanced MR imaging in the assessment of pulmonary perfusion in humans: the inflow spin-tracer saturation effect.

The flow-sensitive alternating inversion recovery (FAIR) and the first-pass dynamic contrast-enhanced MR imaging (CE-MRI) techniques have both been shown to be effective in the assessment of human pulmonary perfusion. However, no comprehensive comparison of the measurements by these two methods has been reported. In this study, healthy adults were recruited, with FAIR and CE-MRI performed for an estimation of the relative pulmonary blood flow (rPBF). Regions of interest were encircled from the right and left lungs, with right-to-left rPBF ratios calculated. Results indicated that, on posterior coronal slices, the rPBF ratios obtained with the FAIR technique agreed well with CE-MRI measurements (mean difference = -0.02, intraclass correlation coefficient RI = 0.78, 95% confidence interval = [0.67, 0.86]). On middle coronal slices, however, FAIR showed a substantially lower rPBF by up to 43% in the right lung compared with CE-MRI (mean difference = -0.38, RI = 0.34, 95% confidence interval = [-0.09, 0.68]). The location-dependent discrepancy between measurements by FAIR and CE-MRI methods is attributed to tracer saturation effects of arterial inflow when the middle coronal slice contains the in-plane-oriented right pulmonary artery, whereas the left lung rPBF is less affected due to oblique orientation of the left pulmonary artery. Intrasequence comparison on additional subjects using FAIR at different slice orientations supported the above hypothesis. It is concluded that FAIR imaging for pulmonary perfusion in the coronal plane provides equivalent rPBF information with CE-MRI only in the absence of tracer saturation effects; hence, FAIR should be carefully exercised to avoid misleading interpretations.

Adult↗

Supratentorial cerebrospinal fluid production rate in healthy adults: quantification with two-dimensional cine phase-contrast MR imaging with high temporal and spatial resolution.

A method for objectively determining supratentorial cerebrospinal fluid (CSF) production rate is described. The method employs cine phase-contrast magnetic resonance imaging with high temporal and spatial resolution at the level of the aqueduct of Sylvius. Automatic encircling of the aqueduct was accomplished by using a pulsatility-based segmentation approach. Results in 23 healthy adults (18 men, five women; age range, 21-39 years) yielded an average CSF production rate of 305 microL/min +/- 145 (standard deviation); this rate is in good agreement with literature-reported values obtained with invasive ventriculolumbar perfusion measurements. Average operator imprecision was 23.1% if automatic segmentation was not used. The proposed method is potentially an effective means for measuring supratentorial CSF production rate in humans.

Adult↗

Neuronal damage after ischemic injury in the middle cerebral arterial territory: deep watershed versus territorial infarction at MR perfusion and spectroscopic imaging.

PURPOSE: To determine the temporal patterns of neuronal injury between infarction subtypes and their possible association with changes in cerebral blood volume (CBV). MATERIALS AND METHODS: Twenty-five patients with ischemic injuries of middle cerebral arterial territories and receiving only conservative treatments were classified into territorial infarction (TI) (n = 16) and watershed infarction (WI) (n = 9) groups and were prospectively evaluated with longitudinal magnetic resonance (MR) examinations. Each patient underwent as many as five MR studies at various stroke stages following stroke symptom onset. Dynamic susceptibility-weighted contrast material-enhanced MR imaging was performed to yield the relative CBV (rCBV). Chemical shift imaging was used to measure the relative levels of N-acetylaspartate (NAA) and lactate of the ischemic brain tissue. Repeated-measures analysis of variance was used to examine the statistical significance in evolutional differences between TI and WI. RESULTS: For patients with TI, rCBV followed a progressively increasing pattern, from initial low values (0.46 +/- 0.28 [SD]) to peak high values (1.23 +/- 0.34) at early chronic stage. Relative NAA level decreased to 0.40 +/- 0.24 during acute stroke and was lost completely 4 days after ictus. Patients with WI showed consistently high rCBV throughout all stages, with residual relative NAA level (0.53 +/- 0.25) even at 1 month after symptom onset. Relative lactate level of patients with TI was significantly higher than that of patients with WI at the acute stage (P <.01). Differences in the temporal changes of both rCBV and brain metabolites between TI and WI were significant (P <.01). CONCLUSION: The different temporal patterns for stroke progression in TI and WI are associated with different evolutions of hemodynamics and neuronal injury.

Aspartic Acid↗