Biomedical subjects

Jürgen Gieseke

Publications and source records attributed to Jürgen Gieseke.

At least 19 recordsLinked to original sources

PubMed2006

Intra-individual comparison of image contrast in SPIO-enhanced liver MRI at 1.5T and 3.0T.

The purpose of the study was to examine if the higher susceptibility at 3.0 Tesla (T) compared to 1.5 T will affect the contrast in MR imaging of the liver after application of superparamagnetic iron oxide particles (SPIO). The study was approved by our institutional review board and informed consent was obtained. Seventeen healthy volunteers were examined in a prospective, intra-individual comparative study within one day on a 1.5 T and a 3.0 T MRI system. T2 weighted TSE sequences were acquired after bolus injection of a SPIO contrast agent. Image contrast and signal to noise ratio (SNR) were compared between the field strengths. Image contrast was calculated between the liver tissue and the kidneys / spleen / muscles and fluids. The students'T-test was used for statistical analysis. No influence of the higher field strength could be observed on image contrast except for the liver / muscle contrast. This was due to a distinct SNR increase of the muscle tissue at 3.0 T as a result of their relaxation properties. The higher susceptibility at 3.0 T compared to 1.5 T does not translate into a stronger signal attenuation of the SPIO enhanced liver parenchyma.

Adult↗

PubMed2006

Female pelvis: MR imaging at 3.0 T with sensitivity encoding and flip-angle sweep technique.

This study had institutional review board approval; all 33 patients (mean age, 47 years +/- 16 [standard deviation]) gave informed consent. The aim was to prospectively evaluate the diagnostic image quality yielded by a 3.0-T T2-weighted turbo spin-echo magnetic resonance imaging sequence with a very short imaging time versus that yielded by a standard 3.0-T sequence at imaging of the female pelvis. Signal-to-noise ratio and delineation of gynecologic disorders were approximately equal between the two sequences. The majority of tissue contrasts were comparable, but contrast between fluid and muscle was significantly higher and motion artifacts were reduced (P < .001 for both) with the short imaging time sequence. The fast sequence maintained or improved image quality and thus seems to be advantageous for uncooperative patients.

Adolescent↗

PubMed2006

High spatial resolution contrast-enhanced MR angiography of the supraaortic arteries using the quadrature body coil at 3.0T: a feasibility study.

To examine whether the the increased signal-to-noise (S/N) available at 3.0T would permit the use of the quadrature body coil for high spatial resolution contrast-enhanced (CE) MR angiography (MRA), and whether the large FOV that was used in our routine 1.5T protocol would also be feasible at 3.0T. In a prospective study, 43 patients and five volunteers were examined on a clinical whole-body 3.0T MR unit (Intera, Philips Medical Systems, Best, The Netherlands) after institutional review board approval and informed consent. Three-dimensional CE MRA (T1 gradient echo-sequence with TR/TE = 5.7/1.93 msec.; acquisition time, 1:54 min.) using randomly segmented central k-space ordering (CENTRA) was acquired with the quadrature body coil, using over a FOV of 350 mm. A high-image matrix of 432x432 yielded a non-zero filled voxel size of 0.81 mm x 0.81 mm x 1.0 mm (0.66 mm(3)). For quantitative analysis, contrast ratios (CR) between vessels (S) and signal in surrounding tissue (ST) were calculated [(S-ST)/(S+ST)]. For qualitative analysis, image quality and presence of artifacts were rated by two radiologists in consensus on a five-point scale (1=excellent to 5=nondiagnostic). Digital subtraction angiography (DSA) served as the standard of reference in patients with vascular disease. In the five volunteers, 1.5T CE MRA using a phased array neurovascular coil was available for intraindividual comparison. 3.0T CE MRA was successfully performed in 48/48 subjects (100%). Mean CR+/- SD were 0.76 (139.30/182.42) and 0.87 (235.18/270.14) at 3.0T and 1.5T respectively . Mean image quality was 3.82+/-0.86. Intraindividual comparison between 1.5T and 3.0T CE MRA in the volunteers revealed no significant difference in image quality (4.2+/-0.74 vs 4.6+/-0.80; p>0.05). Vascular disease was correctly identified in 13/13 patients with DSA correlation. CE MRA of the supraaortic arteries is feasible at 3.0T using a large FOV of 350 mm. The signal gain at 3.0T enables high spatial resolution contrast-enhanced MR angiography by using the built-in quadrature body coil only.

Adult↗

PubMed2006

High-field-strength MR imaging of the liver at 3.0 T: intraindividual comparative study with MR imaging at 1.5 T.

PURPOSE: To prospectively evaluate whether magnetic resonance (MR) imaging of the liver at 3.0 T is comparable to that at 1.5 T with respect to image artifacts, image quality, and diagnostic utility in terms of detection and characterization of focal liver lesions in patients with these lesions. MATERIALS AND METHODS: Patients provided informed consent after the study had been explained, and the institutional review board approved the study protocol. An intraindividual comparative study was performed in 21 patients (12 men and nine women; mean age, 58.7 years; range, 36-76 years) with a total of 79 focal liver lesions (benign and malignant) who were examined at 1.5- and 3.0-T MR imaging within 1 week. The imaging protocol consisted of T2-weighted turbo spin-echo (SE) sequences with or without fat suppression, as well as T1-weighted gradient-echo (GRE) sequences with or without gadolinium-based contrast agent. All images were rated independently by two radiologists with respect to types of artifacts (susceptibility, motion, pulsation, image homogeneity, and electrodynamic effects) and in regard to detectability and characterization of focal liver lesions. A modified sign test was used for statistical analysis (alpha < .2). RESULTS: Motion artifacts were significantly more pronounced in non-fat-suppressed T2-weighted turbo SE images at 3.0 T (P = .03), whereas pulsation artifacts were more pronounced (P = .19) in precontrast T1-weighted GRE 1.5-T images. No statistically significant differences (P < .2) were observed for the remaining artifacts and sequences. Of the 79 index lesions, a total of 76 were prospectively identified at 1.5-T imaging and a total of 77 were identified at 3.0-T imaging. CONCLUSION: MR imaging of the liver at 3.0 T, compared with that at 1.5 T, is feasible with equivalent image quality and diagnostic utility in terms of detection and characterization of focal liver lesions.

Adult↗

PubMed2006

Higher sensitivity in the detection of inflammatory brain lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis using high field MRI: an intraindividual comparison of 1.5 T with 3.0 T.

The purpose of this study was to determine the sensitivities in the detection of inflammatory lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis at 3.0 T and 1.5 T. MR imaging of 40 patients at both field strengths was performed in separate sessions including contiguous axial slices of T2 turbo spin-echo (T2 TSE), fluid-attenuated-inversion-recovery (FLAIR) and pre- and postcontrast T1 spin-echo (T1 SE). Inflammatory lesions > 3 mm in size were counted and categorized according to their anatomic location. Lesion conspicuity was assessed on a five-point scale. At 3.0 T, 13% more white matter lesions could be identified on the FLAIR sequence and on the T2 TSE sequence. Compared to 1.5 T 7.5% more contrast-enhancing lesions were detected at 3.0 T. The higher detection rate at 3.0 T was significant for the infratentorial (p = 0.02) and juxtacortical (p < 0.01) region on the FLAIR as well as for the infratentorial (p = 0.03), juxtacortical (p = 0.02) and periventricular (p = 0.03) region on the T2 TSE sequence. The lesion conspicuity was significantly better at 3.0 T for FLAIR and T2 TSE sequences (p<0.01; p=0.01). In conclusion, high-field MRI at 3.0 T provides a significantly higher detection rate of inflammatory brain lesions especially in the infratentorial, juxtacortical and periventricular anatomic region.

Adolescent↗

PubMed2006

Imaging of inflammatory lesions at 3.0 Tesla in patients with clinically isolated syndromes suggestive of multiple sclerosis: a comparison of fluid-attenuated inversion recovery with T2 turbo spin-echo.

The aims of this study were to determine and compare the sensitivity of T2 turbo spin-echo (T2 TSE) and fluid-attenuated inversion recovery (FLAIR) sequences at 3.0 T in the detection of inflammatory lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis. Forty-nine patients were examined with a 3.0 T MRI system using 5 mm axial sections of T2 TSE (2:19 min), FLAIR (4:00 min) and pre- and postcontrast T1 spin-echo sequences (3:37 min). Brain lesions were counted and categorized according to their anatomic location. Patients were classified according to Barkhof MRI criteria for FLAIR and T2 TSE sequences. The FLAIR sequence detected more lesions in every anatomic region except for the infratentorial region. The higher sensitivity was significant for the total number of lesions (p<0.01), the juxtacortical (p<0.01), and the periventricular (p=0.01) region. A 9% increase of infratentorial lesions using the T2 TSE sequence was not significant. The higher sensitivity using the FLAIR sequence resulted in one additional MRI criterion in nine patients, whereas the better detection of infratentorial lesions using the T2 TSE sequence resulted in additional MRI criteria in three patients. In conclusion, FLAIR provides the highest sensitivity when compared with the T2 TSE, although T2 TSE still has a diagnostic relevance in terms of MRI criteria classification.

Adolescent↗

PubMed2006

Contrast-enhanced MR imaging of the breast at 3.0 and 1.5 T in the same patients: initial experience.

PURPOSE: To establish a pulse sequence for dynamic contrast material-enhanced magnetic resonance (MR) imaging of the breast at 3.0 T and to prospectively compare MR imaging at 3.0 T with MR imaging at 1.5 T in the same patients. MATERIALS AND METHODS: A prospective intraindividual internal review board-approved study was performed in 37 women with 53 lesions (25 breast cancers, 28 benign focal lesions) who underwent contrast-enhanced dynamic bilateral subtraction MR imaging twice, once at 1.5 T with a standard technique (voxel size, 1.44 mm3) and once at 3.0 T (voxel size, 0.45-0.72 mm3) with variable repetition time and flip angle settings. Written informed consent was obtained. Sagittal single breast high-spatial-resolution MR imaging was performed with active fat suppression. Image quality, number and features of enhancing lesions, and Breast Imaging Reporting and Data System categories were compared by using the Wilcoxon matched-pairs signed rank test and Student t test for matched pairs. Diagnostic confidence was compared by using a receiver operating characteristic (ROC) analysis. RESULTS: With repetition time prolonged to account for longer T1 relaxation times at 3.0 T and a flip angle of 60 degrees, enhancement rates at 3.0 T were substantially below those at 1.5 T. In two patients with benign lesions, enhancement was rated as insufficient to establish diagnosis. When parameter settings were kept equivalent, equivalent enhancement rates were observed with both systems. With these settings, 3.0-T MR imaging yielded homogeneous signal intensity over the entire field of view. No dielectric resonance effects were observed. Overall image quality scores for the dynamic series were slightly higher at 3.0 T (P<.01). A total of 49 lesions were prospectively identified with both systems. Owing to substantial patient motion at 1.5 T, two malignant lesions in one patient were visualized at 3.0 T only. At 3.0 T, differential diagnosis of enhancing lesions was possible with higher diagnostic confidence, as reflected by a larger area under the ROC curve (P<.05). CONCLUSION: Initial experiences indicate that contrast-enhanced MR imaging at 3.0 T is nearing readiness for clinical use.

Adult↗

PubMed2006

Subendocardial late gadolinium enhancement in two patients with anthracycline cardiotoxicity following treatment for Ewing's sarcoma.

Cardiotoxicity is a well-known consequence of anthracycline chemotherapy. We report CMR findings not previously described in two patients with anthracycline cardiotoxicity following treatment for Ewing's sarcoma. Subendocardial enhancement on late gadolinium contrast-enhanced CMR was present in both cases, with histological correlation in one case.

Adult↗

PubMed2005

Brain tumors: full- and half-dose contrast-enhanced MR imaging at 3.0 T compared with 1.5 T--Initial Experience.

PURPOSE: To prospectively and intraindividually compare the effect of magnetic resonance (MR) imaging at a higher magnetic field strength (3.0 T) on contrast-to-noise ratio (CNR) at different doses of a T1-shortening contrast agent in patients with contrast-enhancing brain lesions, with 1.5-T MR imaging as a reference standard. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained for all patient and volunteer studies. Twelve patients (six women, six men; mean age, 58 years; range, 29-76 years) with 12 enhancing brain lesions (11 patients with primary brain tumors and one with a solitary cerebral metastasis) underwent contrast material-enhanced MR imaging three times, on three separate days: once at 1.5 T with a full dose of 0.10 mmol/kg gadopentetate dimeglumine, once at 3.0 T with a full dose, and once at 3.0 T with half that dose, 0.05 mmol/kg. The same contrast-enhanced T1-weighted spin-echo images (repetition time msec/echo time msec, 500/12; section thickness, 5 mm; matrix, 256 x 205) were obtained at both 3.0 T and 1.5 T after prior optimization of parameters at 3.0 T. The number and conspicuity of enhancing brain lesions were assessed with blinded clinical image reading. Signal-to-noise ratio and CNR were determined with region of interest analysis of enhancing lesions and normal contralateral white matter. For 3.0 T with half the standard dose and with the full dose, CNR of lesions was intraindividually compared with CNR at 1.5 T with the full dose by using the Wilcoxon matched-pairs signed rank test. RESULTS: At 3.0 T and full dose, CNR was 2.8-fold higher than that at 1.5 T and full dose (P < .001). At the same time, higher lesion conspicuity at clinical image reading was observed. With only half the standard dose, MR imaging at 3.0 T still yielded higher CNR (1.3-fold higher) than that with full dose at 1.5 T (P < .01). CONCLUSION: With the same amount of contrast agent, MR imaging at 3.0 T offered a significantly higher CNR of enhancing cerebral lesions, compared with that at 1.5 T; even with the dose reduced by half, CNR was still higher at 3.0 T.

Adult↗

PubMed2005

MRI of the pelvis at 3 T: very high spatial resolution with sensitivity encoding and flip-angle sweep technique in clinically acceptable scan time.

OBJECTIVE: The higher signal at 3.0-T allows spatial resolution to be increased without loss in image quality. We evaluated a T2-weighted turbo spin-echo sequence with high spatial resolution (3T-HR) to determine whether this provides clinically useful pelvic MRI. MATERIALS AND METHODS: We designed a sequence with high spatial resolution (3T-HR) (0.45x0.46x4 mm) that was combined with parallel imaging and the variable refocusing angle technique (8.06 min). We examined 23 patients with gynecological disorders using 3T-HR and a standard sequence (3T-SP; 4.03 min; equivalent to 1.5 T). Two radiologists analyzed tissue contrast, signal to noise, detail delineation and artifact level. RESULTS: Tissue contrasts and signal to noise were rated equal. Motion artifacts occurred more often with 3T-SP despite the longer scanning time of 3T-HR. The higher spatial resolution provided additional information in four patients. In two patients small myomas were detected, in one patient a lymph node metastasis was apparent, and in one patient 3T-HR excluded tumor invasion. CONCLUSIONS: High spatial resolution pelvic studies with high image quality can be obtained at 3 T in acceptable scan time. The higher spatial resolution that is feasible at 3 T also provides more clinically relevant information.

Adolescent↗

PubMed2005

Coronary MR angiography at 3.0 T versus that at 1.5 T: initial results in patients suspected of having coronary artery disease.

PURPOSE: To prospectively evaluate the feasibility, image quality, and accuracy of coronary magnetic resonance (MR) angiography at 3.0 T in patients suspected of having coronary artery disease and to prospectively compare these results with those of coronary MR angiography performed at 1.5 T. MATERIALS AND METHODS: The study was approved by the institutional review board, and informed consent was obtained from all patients. Eighteen patients (11 men, seven women; mean age, 63 years; age range, 45-76 years) suspected of having coronary artery disease who were scheduled to undergo elective conventional coronary angiography (reference standard) were included. For coronary MR angiography at 3.0 and 1.5 T, a vector electrocardiographically gated three-dimensional segmented k-space gradient-echo imaging sequence was combined with real-time respiratory navigator gating and tracking. Signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), scores of image quality and sensitivity and specificity for the detection of coronary artery stenosis on a segment-by-segment basis were assessed at 3.0 and 1.5 T. Data were analyzed for statistical differences by using the Wilcoxon matched-pairs test and the McNemar test. RESULTS: The average increase in SNR at 3.0 T with respect to that at 1.5 T was 29.5% for the left coronary artery (LCA) and 31.2% for the right coronary artery (RCA) (P < .001), and the average increase in CNR was 21.8% for the LCA and 23.5% for the RCA (P < .001). Scores of image quality (P = .77) and diagnostic accuracy for the detection of coronary artery stenoses (sensitivity and specificity: 82% and 89%, respectively, at 3.0 T vs 82% and 88% at 1.5 T; P > .99) were identical or almost identical at both field strengths. CONCLUSION: Coronary MR angiography at 3.0 T is feasible in patients suspected of having coronary artery disease and yields significant increases in SNR and CNR, although current techniques do not result in significantly improved image quality and diagnostic accuracy compared with the quality and accuracy at 1.5 T. (c) RSNA, 2005.

Aged↗

PubMed2005

Sensitivity encoding (SENSE) for contrast-enhanced 3D MR angiography of the abdominal arteries.

PURPOSE: To assess sensitivity encoding (SENSE) for contrast-enhanced MR angiography (CE-MRA) of the abdominal arteries in comparison with standard MRA protocols. MATERIALS AND METHODS: In 22 patients MRA of the abdominal arteries was performed twice (once using a standard protocol, and once with the additional use of SENSE). In 10 patients all examination parameters were kept constant (TR/TE/FA = 3.8 msec/1.3 msec/30 degrees ), and a reduction in scan time from 22 to 11 seconds was realized with the use of SENSE. In 12 patients, using SENSE the acquisition matrix was increased from 208 to 416, keeping the scan time constant. Image quality was scored on a five-point scale by three radiologists. Additionally, ROI-based measurements of CNR were performed. RESULTS: For both protocols, image quality was significantly improved using SENSE. The time-reducing SENSE protocol yielded an average score of 4.2 points vs. 3.1 for the standard protocol. Using SENSE to increase the acquisition matrix, an average score of 4.3 was reached vs. 3.2 for the standard protocol (P < 0.05). The number of depictable small vessels and their bifurcations was significantly increased by either of the two SENSE protocols as compared to the standard imaging procedure. CONCLUSION: SENSE for MRA of the abdominal arteries significantly increases image quality and permits a substantial reduction in breath-hold time or a significantly improved spatial resolution.

Abdomen↗

PubMed2005

Blood flow quantification in adults by phase-contrast MRI combined with SENSE--a validation study.

PURPOSE: To evaluate the feasibility of rapid free-breathing phase-contrast MRI (PC-MRI) at different in-plane resolutions combined with sensitivity encoding (SENSE) for flow quantification in the great arteries in healthy adult volunteers. METHODS: In 13 volunteers (mean age 33.0 +/- 7.4 years), blood flow rates in the pulmonary artery (Qp), ascending aorta (Qs), and flow ratio Qp/Qs were determined by PC-MRI with SENSE reduction-factor 2 and 3 (SF-2, SF-3). Additionally, we used PC-MRI with higher spatial in-plane resolution (1.6 x 2.1 mm vs. 2.3 x 3.1 mm) with/without SF-3. Standard (= reference) PC-MRI, which used two excitations (NEX=2), was compared with PC-MRI sequences with NEX=1. RESULTS: Reduction of signal averages and application of SENSE accelerated flow measurements by a factor of 3.8 (5.5) using PC-MRI with SF-2 (SF-3): Scan time was 36 sec (SF-2) and 25 sec (SF-3) at average heart rate of 69/min. The mean Qp/Qs by reference PC-MRI was 1.03 +/- 0.07 (range, 0.89-1.16), and 1.0 +/- 0.11 (range, 0.86-1.24) by PC-MRI + SF-3, respectively. For blood flow rate through the pulmonary artery and aorta, and for Qp/Qs ratio, we found differences of -3% to +4%. The lower limits of agreement (mean - 2 SD) ranged between -14% and -21%, and upper limits (mean + 2 SD) between +9% and +30%, demonstrating clinically acceptable agreement with standard PC-MRI (Bland-Altman analysis). PC-MRI at higher in-plane resolution both with/without SENSE yielded slightly smaller aortic and pulmonary flows (mean differences 5% to 7%, p < 0.05). CONCLUSIONS. In adults, PC-MRI may be safely combined with SENSE to reduce scan time for a quantitative flow measurement in the great arteries to "30 seconds. High in-plane resolution was not advantageous.

Adult↗

PubMed2005

Sensitivity encoding for diffusion-weighted MR imaging at 3.0 T: intraindividual comparative study.

PURPOSE: To prospectively evaluate whether diffusion-weighted (DW) magnetic resonance (MR) imaging with sensitivity encoding (SENSE) at 3.0 T can help to improve image quality and confidence in and accuracy of diagnosis of ischemic lesions, compared with DW MR imaging with conventional phase encoding, in patients. MATERIALS AND METHODS: Patients provided informed consent after the study had been explained, and the institutional review board approved the study protocol. Eighty-five patients (46 male and 39 female patients; age range, 13-86 years; mean age, 52 years) underwent single-shot spin-echo echo-planar DW MR imaging at 3.0 T twice, in a randomized order: once with conventional phase encoding (repetition time msec/echo time msec, 4283/79) and once with SENSE (3141/69, with a reduction factor of three). With both, 128 x 128 matrix, 24 4-mm-thick sections, and two b values of 0 and 1000 sec/mm(2) were used. An eight-element SENSE-compatible receive-only surface coil was used; the built-in body coil served for radiofrequency transmission and generation of the coil sensitivity profile. SENSE and conventional phase encoding were compared for image quality, signal-to-noise ratio, relative signal intensity (SI), and lesion contrast. Two neuroradiologists read images. Diagnostic accuracy of and confidence in detection of apparent diffusion coefficient (ADC) lesions with conventional phase encoding and SENSE at MR imaging were compared; matched-pairs Wilcoxon signed rank test was used to test statistical significance. RESULTS: No major SENSE-related artifacts were seen. At MR imaging with SENSE, consistently and significantly (P < .001) higher image quality scores were achieved because of substantial reduction of image distortions and blurring. Lesion contrast was equivalent with both techniques. Diagnostic confidence for demonstration and exclusion of lesions was significantly (P < .001) higher at MR imaging with SENSE. In three patients, small microembolic lesions were only prospectively diagnosed at MR imaging with SENSE, whereas they were masked by adjacent susceptibility effects and therefore overlooked at MR imaging with conventional phase encoding. CONCLUSION: Parallel MR imaging with SENSE is feasible at 3.0 T. It significantly improves image quality, particularly by reducing or even preventing susceptibility-induced SI changes and image blurring. There was a significantly improved diagnostic confidence with which ADC changes were identified or excluded.

Adolescent↗

PubMed2004

Acute and subacute ischemic stroke at high-field-strength (3.0-T) diffusion-weighted MR imaging: intraindividual comparative study.

PURPOSE: To compare signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), image quality, and confidence in diagnosis between 1.5- and 3.0-T diffusion-weighted (DW) magnetic resonance (MR) imaging of ischemic stroke lesions. MATERIALS AND METHODS: The study design was approved by the institutional review board, and all patients gave informed consent. In a prospective intraindividual study, 25 patients who had clinical symptoms consistent with ischemic stroke underwent DW MR imaging at both 1.5 T and 3.0 T. The 3.0- or 1.5-T examination was performed immediately one after the other, in random order. Two readers in consensus recorded the presence and number of ischemic lesions and rated image quality and lesion conspicuity. The image SNR and the CNR of the ischemic lesions were quantified. Paired Student t and Wilcoxon matched-pairs signed rank tests were used to test for statistical significance. RESULTS: Image quality at 3.0-T DW MR imaging was consistently lower than that at 1.5-T DW MR imaging owing to greater image distortions (P < .05). Yet, overall SNR and lesion CNR at 3.0 T increased significantly; mean increases were 48.8% (P < .001) and 96.3% (P < .01), respectively. The higher overall SNR and lesion CNR translated into a significantly higher sensitivity in the detection of ischemic lesions at 3.0 T than at 1.5 T. Of the total of 48 lesions that were identified in 19 of the 25 patients, 47 (98%) were diagnosed at 3.0 T and 36 (75%) were diagnosed at 1.5 T. In addition, the conspicuity of the lesions that were visible with both systems was significantly higher at 3.0 T (P < .001). CONCLUSION: Although 3.0-T DW MR imaging generates greater image distortions, it yields increased SNR and CNR compared with DW MR imaging at 1.5 T. The increased CNR at 3.0 T translates into a significantly improved diagnostic confidence in the detection of focal apparent diffusion coefficient changes in the setting of subacute and acute ischemic stroke.

Acute Disease↗

PubMed2004

Noninvasive detection of steno-occlusive disease of the supra-aortic arteries with three-dimensional contrast-enhanced magnetic resonance angiography: a prospective, intra-individual comparative analysis with digital subtraction angiography.

BACKGROUND AND PURPOSE: Concomitant disease of the supra-aortic arteries can influence the outcome of surgical treatment of carotid artery stenosis. However, sensitivity and specificity data of noninvasive contrast-enhanced 3-dimensional (3D) magnetic resonance angiography (CE MRA) for the detection of steno-occlusive disease of the entire supra-aortic arteries including the circle of Willis remain unclear. We aimed to intra-individually compare high-spatial-resolution CE 3D MRA and digital subtraction angiography (DSA) for the assessment of steno-occlusive vascular disease of the supra-aortic arteries. METHODS: CE MRA and DSA of the supra-aortic arteries were prospectively performed in 50 consecutive patients. Intra-individual comparison of CE MRA and DSA was available in 833 arteries. High-spatial-resolution CE MRA comprised a measured voxel size of 0.81 mm x 0.81 mm x 1 mm (0.66 mm3). Steno-occlusive vascular disease of the 833 arteries was assessed independently by 2 radiologists according to the NASCET criteria. RESULTS: CE MRA had a sensitivity of 100% (73/73), a specificity of 99.3% (760/765), a positive predictive value of 93.6% (73/78), and a negative predictive value of 100% (760/760) by using a 70% to 99% threshold of arterial diameter stenosis. For detection of occlusion, sensitivity, specificity, PPV, and NPV value of CE MRA were 100%, respectively. CONCLUSIONS: Noninvasive high-spatial-resolution CE MRA is suited to replace diagnostic DSA for the detection of steno-occlusive disease of the supra-aortic arteries.

Adult↗

PubMed2004

Flow volume and shunt quantification in pediatric congenital heart disease by real-time magnetic resonance velocity mapping: a validation study.

BACKGROUND: Flow quantification in real time by phase-contrast MRI (PC-MRI) may provide unique hemodynamic information in congenital heart disease, but available techniques have important limitations. We sought to validate a novel real-time magnetic resonance flow sequence in children. METHODS AND RESULTS: In 14 pediatric patients (mean age 5.2+/-2.0 years) with cardiac left-to-right shunt, pulmonary (Q(p)) and aortic (Q(s)) flow rates were determined by nontriggered free-breathing real-time PC-MRI with single-shot echo-planar imaging combined with sensitivity encoding, which yielded 25 phase images per second at 2.7x2.7-mm in-plane resolution (field of view 30x34 cm2). Over a 9.5-second period that included 2 to 5 respiratory cycles, 16.6+/-2.6 subsequent stroke volumes (range 13 to 22) were acquired in each vessel. Results were compared with conventional retrospectively ECG-gated PC-MRI. Mean Q(p)/Q(s) by conventional PC-MRI was 1.91+/-0.64, and it was 1.94+/-0.68 (mean+/-SD) by real-time PC-MRI. For blood flow rate through pulmonary artery and aorta, we found differences of 2% to 3% (Bland-Altman analysis), with lower limits of agreement of -11% to -13% (mean-2 SD) and upper limits of 18% to 19% (mean+2 SD), which demonstrated good agreement between both methods. Mean difference for Q(p)/Q(s) was 1%, with limits of agreement ranging between -18% and 22% (mean+/-2 SD). High repeatability but some flow overestimation was observed in vitro (pulsatile flow phantom) with real-time PC-MRI, whereas conventional PC-MRI was accurate. Beat-to-beat stroke-volume variation was 6.1+/-2.3% in vivo and 3.7+/-0.3% in vitro. CONCLUSIONS: Beat-to-beat quantification of pulmonary and aortic flows and hence left-to-right shunt within a few seconds is reliable by nontriggered real-time PC-MRI with echo-planar imaging and sensitivity encoding. Good spatial/temporal resolution and a large field of view may render the sequence valuable for multiple applications in congenital heart disease.

Blood Circulation↗

PubMed2004

1H metabolite relaxation times at 3.0 tesla: Measurements of T1 and T2 values in normal brain and determination of regional differences in transverse relaxation.

PURPOSE: To measure 1H relaxation times of cerebral metabolites at 3 T and to investigate regional variations within the brain. MATERIALS AND METHODS: Investigations were performed on a 3.0-T clinical whole-body magnetic resonance (MR) system. T2 relaxation times of N-acetyl aspartate (NAA), total creatine (tCr), and choline compounds (Cho) were measured in six brain regions of 42 healthy subjects. T1 relaxation times of these metabolites and of myo-inositol (Ins) were determined in occipital white matter (WM), the frontal lobe, and the motor cortex of 10 subjects. RESULTS: T2 values of all metabolites were markedly reduced with respect to 1.5 T in all investigated regions. T2 of NAA was significantly (P < 0.001) shorter in the motor cortex (247 +/- 13 msec) than in occipital WM (301 +/- 18 msec). T2 of the tCr methyl resonance showed a corresponding yet less pronounced decrease (162 +/- 16 msec vs. 178 +/- 9 msec, P = 0.021). Even lower T2 values for all metabolites were measured in the basal ganglia. Metabolite T1 relaxation times at 3.0 T were not significantly different from the values at 1.5 T. CONCLUSION: Transverse relaxation times of the investigated cerebral metabolites exhibit an inverse proportionality to magnetic field strength, and especially T2 of NAA shows distinct regional variations at 3 T. These can be attributed to differences in relative WM/gray matter (GM) contents and to local paramagnetism.

Adult↗