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Biomedical subjects

James F Glockner

Publications and source records attributed to James F Glockner.

At least 19 recordsLinked to original sources

Renal MR and CT angiography: current concepts.

During the past decade, noninvasive CTA and MRA imaging techniques have replaced catheter angiography for evaluation of the renal arteries. This article reviews techniques for optimizing renal MRA and CTA, assesses the advantages and limitations of MRA and CTA, and provides the current indications for renal vascular imaging including renal artery stenosis screening. New and future developments in these rapidly evolving techniques are also discussed.

Angiography↗

The porcine remnant kidney model of chronic renal insufficiency.

BACKGROUND: The purpose of the present study was to develop and characterize a porcine model of chronic renal insufficiency created by renal artery embolization. METHODS: The model was created using 42 castrated juvenile male pigs (7-8 months old) in two parts (pilot (N = 10) group, definitive (N = 26) group, and control group (N = 6). In the pilot group, the embolization procedure was optimized with respect to the size of polyvinyl acrylide (PVA) particles, coils, and amount of kidney embolized. The animals were followed serially for 4 weeks after the embolization procedure to determine the renal function and hypertensive response. In the definitive group, these results were extended to later time points and a left total nephrectomy and a right partial nephrectomy (remnant) were performed and these animals were followed for 28 to 84 days. RESULTS: The kidney function after the embolization was characterized by acute deterioration in renal function, followed by improvement, and "stable" chronic renal insufficiency with statistically significant elevation in creatinine and BUN being observed until day 42. The mean arterial blood pressure remained significantly elevated until day 7 after which it began to decrease to pre-embolization value. The remnant kidney developed fibrosis in the tublointerstitial compartment as it hypertrophied and increased its weight which remained significantly elevated after embolization. CONCLUSIONS: A reproducible remnant kidney model of chronic renal insufficiency in pigs was developed. In this model, stable renal insufficiency develops by 4 weeks that lasts until 12 weeks.

Angiography↗

Myocardial tagging and strain analysis at 3 Tesla: comparison with 1.5 Tesla imaging.

PURPOSE: To determine whether imaging at 3 T could improve and prolong the tag contrast compared to images acquired at 1.5 T in normal volunteers, and whether such improvement would translate into the ability to perform strain measurements in diastole. MATERIALS AND METHODS: Normal volunteers (N = 13) were scanned at 1.5 T (GE Signa CV/i) and 3.0 T (GE VH/i). An ECG-triggered, segmented k-space, spoiled-gradient-echo grid-tagged sequence was used during cine acquisition. Tag contrast was determined by the difference of the mean signal intensity (SI) of the tagline to the mean SI of the myocardium divided by the standard deviation (SD) of the noise (CNR(tag)). Matched short-axis (SA) slices were analyzed. Strain measurements were performed on images using a 2D strain analysis software program (harmonic phase (HARP)). RESULTS: The average CNR(tag) over the cardiac cycle was superior at 3 T compared to 1.5 T for all slices (3 T: 23.4 +/- 12.1, 1.5 T: 9.8 +/- 8.4; P < 0.0001). This difference remained significant at cycle initiation, end-systole, and the end R-R interval (at cycle termination: 3 T = 14.0 +/- 11.0 vs. 1.5 T = 4.4 +/- 3.5; P < 0.01). Strain measures were obtainable only in early systole for 1.5 T images, but were robust throughout the entire R-R interval for 3 T images. CONCLUSION: Imaging at 3 T had a significant benefit for myocardial tag persistence through the cardiac cycle. The improvement allowed strain analysis to be performed into diastole.

Adult↗

Undersampled elliptical centric view-order for improved spatial resolution in contrast-enhanced MR angiography.

Although contrast-enhanced MR angiography (CE-MRA) has been successfully developed into a routine clinical imaging technique, there is still need for improved spatial resolution in a given acquisition time. Undersampled projection reconstruction (PR) techniques maintain spatial resolution with reduced scan times, and the elliptical centric (EC) view order provides high quality arterial phase images without venous contamination. In this work, we present a hybrid elliptical centric-projection reconstruction (EC-PR) technique to provide spatial resolution improvement over standard EC in a given time. The k-space sampling was performed by undersampling the periphery of the k(Y)-k(Z) phase encoding plane of an EC view order in a PR like manner. The sampled views were maintained on a rectilinear grid, and thus reconstructed by standard 3DFT. The non-sampled views were compensated either by zero-filling or performing a 2D homodyne reconstruction. Compared to a fully sampled k-space, the EC-PR sequence acquired in the same scan time provides a resolution improvement of about two, as shown by point spread function analysis and phantom experiments. The hypothesis that EC-PR provides improved resolution while retaining diagnostically adequate SNR was tested in 11 CE-MRA studies of the popliteal and carotid arteries and shown to be true (P < 0.03).

Carotid Arteries↗

Combination of 2D sensitivity encoding and 2D partial fourier techniques for improved acceleration in 3D contrast-enhanced MR angiography.

Sensitivity encoding (SENSE) and partial Fourier (PF) techniques both reduce MRI acquisition time. Two-dimensional SENSE uses coil sensitivities to unfold aliasing in the phase/slice-encoding plane. One-dimensional PF and homodyne reconstruction are routinely applied in the frequency/phase-encoding plane to compensate for nonsampled k-space of the presumed real magnetization. Recently, a modified 3D elliptical centric acquisition was proposed to facilitate 2D-PF and homodyne reconstruction on an undersampled phase/slice-encoding plane. In this work we hypothesized that this 2D-PF technique can be combined with 2D-SENSE to achieve a greater acceleration factor than what each method can provide separately. Reconstruction of data whereby SENSE and PF are applied along the same axes is described. Contrast-enhanced MR angiography (CE-MRA) results from experiments using four receiver coils in phantom and volunteer studies are shown. In 11 volunteer studies, the SENSE-PF-homodyne technique using sevenfold acceleration (4x SENSE, 1.7x PF) consistently provided high-diagnostic-quality images with near 1-mm isotropic resolution in acquisition times of <20 s.

Contrast Media↗

Isolated supravalvular pulmonary artery ridge in a 70-year-old man.

Transthoracic echocardiography allows noninvasive assessment of the structure and function of the great vessels of the heart. We report a case of a 70-year-old man who had an isolated, mildly obstructive, supravalvular pulmonary artery ridge that was detected incidentally with transthoracic echocardiography. This report confirms the utility of transthoracic echocardiography in the detection of this condition and discusses quantification of this rare anomaly.

Aged↗

Contrast-enhanced MR angiography of the peripheral vasculature with a continuously moving table and modified elliptical centric acquisition.

This study was approved by the institutional review board and was HIPAA compliant. All subjects provided written informed consent, and subject confidentiality was protected. The purpose of this study was to prospectively evaluate the feasibility of integrating a modified elliptical centric (EC) acquisition with a continuously moving table technique to acquire high-spatial-resolution contrast material-enhanced magnetic resonance (MR) angiograms of the peripheral vasculature. Incorporation of two-dimensional homodyne reconstruction modified the EC view order, allowing improved spatial resolution per unit time while retaining the advantage of venous suppression intrinsic to the EC technique. Spatial resolution was dynamically improved when the table reached the distal-most station. The modified view order provided improved spatial resolution in phantom examinations compared with that in standard examinations. Peripheral MR angiograms were generated in a group of 13 volunteers (eight women; five men; age range, 51-72 years; mean age, 58.5 years +/- 7.9 [standard deviation]) at 1.5 T. Four arterial regions were evaluated on a five-point scale (scores ranged from 0 to 4; a score of 4 was considered excellent); venous suppression was also evaluated. The mean arterial scores exceeded 3.0 for all regions. There was no venous signal or only superficial venous signal in 10 of the 13 cases.

Aged↗

Dual-velocity continuously moving table acquisition for contrast-enhanced peripheral magnetic resonance angiography.

Acquisition of MR angiographic data of the peripheral vasculature during continuous table motion offers certain advantages over fixed station approaches, such as the elimination of wasted time moving between stations and the ability to form a seamless image of the extended field of view. However, it has recently been demonstrated that there is an approximate twofold reduction in contrast bolus velocity as it moves from the thighs to the calves. This can potentially cause a mismatch of the moving table with the contrast peak, resulting in the table outpacing the contrast bolus distally. In this work we describe a modification to the continuous table motion technique allowing two table velocities: a high (ca. 3.6 cm/sec) velocity from the abdomen to the thighs and a low (ca. 1.6 cm/sec) velocity distally. Implications of the nonconstant velocity on k-space sampling are described, and it is shown that lateral resolution is improved for the low-velocity region. Correction for table deceleration during the transition time between high and low velocities is demonstrated. Contrast-enhanced studies in 15 volunteers are free of table-motion-related artifact and suggest improved depiction of the contrast bolus distally.

Aged↗

Variable field of view for spatial resolution improvement in continuously moving table magnetic resonance imaging.

An approach is described in which the field of view (FOV) along the Y (right/left) phase encoding direction can be dynamically altered during a continuously moving table (CMT) coronal acquisition for extended FOV MRI. We hypothesize that with this method, regions of the anatomy exhibiting significantly different lateral widths can be imaged with a matching local FOV(Y), thereby improving local lateral spatial resolution. k-space raw data from the variable-FOV CMT acquisition do not allow simple Fourier reconstruction due to the presence of a mixture of phase encodes sampled at different Deltak(Y) intervals. In this work, we employ spline interpolation to reregister the mixed data set onto a uniformly sampled k-space grid. Using this interpolation scheme, we present phantom and peripheral contrast-enhanced MR angiography results demonstrating an approximate 45% improvement in local lateral spatial resolution for continuously moving table acquisitions.

Algorithms↗

Continuously moving table MRI with SENSE: application in peripheral contrast enhanced MR angiography.

An integration of SENSitivity Encoding (SENSE) with continuously moving table (CMT) MRI for extended field-of-view (FOV) acquisitions is described. In this work, the approach in which receiver coils are attached to the object and move in synchrony with the scanner table is considered. Technical issues dealing with the implementation of SENSE-CMT are addressed, including coil calibration, correction for non-uniform magnetic gradients, and specific reconstruction steps. An explanation of combining SENSE with gradient non-linearity correction is given, as the latter becomes necessary in CMT acquisitions where a large sampling FOV is used. It is hypothesized that SENSE can provide at least a 2-fold improvement in lateral spatial resolution compared to non-accelerated CMT acquisitions. The hypothesis is tested in phantoms, where the effectiveness of both SENSE and gradient non-linearity correction to improve spatial resolution is shown. The SENSE-CMT technique is further demonstrated in vivo with contrast-enhanced MR angiography of the peripheral vasculature.

Equipment Design↗

Ventricular septal hamartoma mimicking hypertrophic cardiomyopathy in a 41-year-old woman presenting with paroxysmal supraventricular tachycardia.

We report an unusual case of cardiac hamartoma involving the ventricular septum. The patient presented with palpitations and exertional chest pain. Echocardiography indicated a large homogeneous mass occupying the superior two-thirds of the ventricular septum. This report confirms the use of transthoracic echocardiography as a screening tool in the diagnosis and management of an uncommon case of a benign cardiac tumor.

Adult↗

3 Tesla MR imaging provides improved contrast in first-pass myocardial perfusion imaging over a range of gadolinium doses.

PURPOSE: To compare myocardial enhancement during first-pass myocardial perfusion imaging at 3.0 Tesla (T) and 1.5T. MATERIALS AND METHODS: First-pass myocardial perfusion imaging was performed on twelve normal subjects at 3T and 1.5T using an interleaved notched saturation recovery gradient echo pulse sequence. Subjects received either 0.10 mmol/kg for both scans (group 1), 0.075 mmol/kg for both scans (group 2), or 0.075 mmol/kg for the 3T scan and 0.10 mmol/kg for the 1.5T scan (group 3). RESULTS: Contrast enhancement was significantly greater at 3T than at 1.5T for the 12 subjects whether enhancement was normalized to baseline signal intensity (2.58 +/- 0.76 vs. 1.52 +/- 0.37, p < 0.0001) or to noise (57.6 +/- 19.7 vs. 14.7 +/- 7.8, p < 0001). For each of the three groups, contrast enhancement was significantly greater at 3T versus 1.5T (p < 0.0001, p < 0.001, p < 0.008 when normalized to baseline signal; p < 0.0001 for all groups when normalized to noise). CONCLUSION: 3T improves contrast in first-pass myocardial perfusion imaging at either 0.10 mmol/kg or 0.075 mmol/kg.

Adult↗

Adventitial remodeling with increased matrix metalloproteinase-2 activity in a porcine arteriovenous polytetrafluoroethylene grafts.

BACKGROUND: We hypothesized the source of early proliferating cells contributing to venous stenosis formation in a porcine hemodialysis grafts is the adventitia and media, and migration of these cells is greatest within the first two weeks following graft placement, resulting in increased matrix metalloproteinase-2 (MMP-2) activity. METHODS: Polytetrafluoroethylene grafts from the iliac artery to the ipsilateral iliac vein were placed in 23 pigs and 5-Bromo-2'-deoxyuridine (BrdU) was given at 24 and 48 hours after surgery to assess cell proliferation and migration. Angiography and magnetic resonance angiography was performed. Animals were euthanized on day three (N= 6), day seven, (N= 5), day 14 (N= 6), and days 19 to 26 (N= 6) after graft placement, and stenotic tissue and unaffected contralateral iliac vein were removed for zymography and immunostaining. RESULTS: Migration of cells derived from the adventitia and media peaked at day 14. Adventitial diameter of the stenotic vein decreased, while the intima to media ratio increased. MMP-2 activity peaks at day seven in the adventitia and days 19 to 26 in the intima. CONCLUSION: These results confirm our hypothesis that the source of cells resulting in venous stenosis formation is derived from the adventitia and media, with cell migration being greatest within the first two weeks after graft placement with translocation of these cells into the intima at four weeks. MMP-2 activity peaks at day seven in the adventitia and again at days 19 to 26 in the intima. A key to limiting venous stenosis formation may lie in inhibiting MMP-2 by adventitial and medial targeting.

Animals↗

Time-resolved 3D contrast-enhanced MRA of an extended FOV using continuous table motion.

A method is presented for acquiring 3D time-resolved MR images of an extended (>100 cm) longitudinal field of view (FOV), as used for peripheral MR angiographic runoff studies. Previous techniques for long-FOV peripheral MRA have generally provided a single image (i.e., with no time resolution). The technique presented here generates a time series of 3D images of the FOV that lies within the homogeneous volume of the magnet. This is achieved by differential sampling of 3D k-space during continuous motion of the patient table. Each point in the object is interrogated in five consecutive 3D image sets generated at 2.5-s intervals. The method was tested experimentally in eight human subjects, and the leading edge of the bolus was observed in real time and maintained within the imaging FOV. The data revealed differential bolus velocities along the vasculature of the legs.

Algorithms↗

CT urography and MR urography.

CT urography and MR urography are an evolving concept and developing technique. As the technology matures, CT urography will combine the ultimate diagnostic capabilities of intravenous urography and CT. In the near future, many intravenous urograms will be replaced by CT urography to evaluate patients with hematuria and other genitourinary conditions. MR urography currently serves as an alternative imaging technique to intravenous urography and CT urography for children and pregnant women and for patients with contraindications to iodinated contrast media.

Contrast Media↗