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Biomedical subjects

John Haselgrove

Publications and source records attributed to John Haselgrove.

7 recordsLinked to original sources

Direct comparison of two methods to measure T1: in vitro and in vivo values by echo-planar imaging and by segmented k-space imaging.

We test a hypothesis that proton T(1) is accurately measured independent of the physics inherent to the method. We used two well-validated but quite different imaging methods to measure T(1) in phantoms and in humans; an echo-planar imaging T-one measurement (EPITOME) method, and a segmented k-space acquisition precise and accurate inversion recovery (TurboPAIR) method. Agreement between the methods was generally excellent; the square of the correlation coefficient (r(2)) in phantoms was 0.9996. The r(2) in brain tissue of volunteers was 0.79 overall, and 0.85 if cortical gray matter and corpus callosum were excluded. Nevertheless, small but significant differences were observed between methods in vivo and T(1) measurements were sensitive to tissue type, although measurements could be made comparable. The major difference between the methods is that EPITOME takes 97 s to image 15 slices at low resolution, while TurboPAIR takes 240 s to image one slice at high resolution.

Adult↗

Brain T1 in young children with sickle cell disease: evidence of early abnormalities in brain development.

Measurement of tissue spin lattice relaxation time (T(1)) has been used to characterize brain development in healthy children. Here we report the first study of brain T(1) in young children with sickle cell disease (SCD). The T(1) in 10 tissue samples was measured by established techniques; 46 SCD patients under the age of 4 years were compared to 267 controls, including 55 well children under the age of 4 years. A model was developed to predict the relationship between age and brain T(1) in controls, then we compared patient T(1) to healthy normal T(1). Most white matter and gray matter tissues in infant patients (<2 years old), had T(1) values significantly higher than normal. For example, 15.0% of patient caudate T(1) values were above the upper bound of the 95% confidence interval for controls, but only 2.5% of normal values are expected to be this high (p = 0.0003). Among infant patients, brain T(1) was significantly higher than normal in every tissue (p < 0.01) except cortical gray matter. However, patient T(1) values declined rapidly to values lower than normal by about age 4. Our findings imply that patients follow an abnormal developmental trajectory beginning early in infancy.

Anemia, Sickle Cell↗

Pediatric perfusion imaging using pulsed arterial spin labeling.

PURPOSE: To test the feasibility of pediatric perfusion imaging using a pulsed arterial spin labeling (ASL) technique at 1.5 T. MATERIALS AND METHODS: ASL perfusion imaging was carried out on seven neurologically normal children and five healthy adults. The signal-to-noise ratio (SNR) of the perfusion images along with T1, M(0), arterial transit time, and the temporal fluctuation of the ASL image series were measured and compared between the two age groups. In addition, ASL perfusion magnetic resonance (MR) was performed on three children with neurologic disorder. RESULTS: In the cohort of neurologically normal children, a 70% increase in the SNR of the ASL perfusion images and a 30% increase in the absolute cerebral blood flow compared to the adult data were observed. The measures of ASL SNR, T1, and M(0) were found to decrease linearly with age. Transit time and temporal fluctuation of the ASL perfusion image series were not significantly different between the two age groups. The feasibility of ASL in the diagnosis of pediatric neurologic disease was also illustrated. CONCLUSION: ASL is a promising tool for pediatric perfusion imaging given the unique and reciprocal benefits in terms of safety and image quality.

Adult↗

Flow volume asymmetry in the right aortic arch in children with magnetic resonance phase encoded velocity mapping.

BACKGROUND: The right aortic arch is not uncommon in pediatrics. Flow dynamics in this type of aortic arch, which is important for cardiac energetics, organ perfusion, and Doppler flow calculations, have not been defined. Although there are complex secondary flow patterns, bulk axial flow makes up most of the energy use. METHODS: We examined 14 children with a right aortic arch by using through-plane phase-encoded magnetic resonance velocity mapping in the ascending and descending aorta to determine flow volume symmetry and velocity. The aortic cross section was divided into 4 quadrants aligned along the long axis of the aorta. Significance was defined as a P value <.05. RESULTS: In the ascending aorta, the posterior right quadrant demonstrated significantly greater blood flow than the other quadrants across the entire cardiac cycle (28% vs 23%-25%) and at the point of maximum flow (29% vs 22%-25%). Flow asymmetry was also present in the descending aorta; there was significantly more flow in the posterior quadrants than the anterior quadrants in total flow across the cardiac cycle (28% vs 21%-23%) and at the point of maximum flow (27%-28% vs 20%-24%). The time to maximum flow was significantly shorter in the ascending than the descending aorta (18% vs 24% of the cardiac cycle). In 10 of 14 patients, maximum velocity occurred in the right half of both the ascending and descending aorta. Flow reversal at end-systole was haphazard, occurring in all quadrants. CONCLUSION: Flow volume asymmetry exists in the ascending and descending portions of the right aortic arch, which has implications for cardiac energetics, organ perfusion, and Doppler scanning flow calculations. This information may be useful in designing improved aortic surgical reconstructions in cases of congenital heart disease.

Analysis of Variance↗

Diffusion tensor imaging of the hippocampal formation in temporal lobe epilepsy.

BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) is a noninvasive technique that can be used to assess the integrity of cerebral tissue. The purpose of this study was to assess DTI measurements in the hippocampal formation (HF) and to investigate the role of DTI in lateralizing the seizure focus in temporal lobe epilepsy (TLE). METHODS: We evaluated 12 patients with unilateral TLE and 14 healthy subjects. We collected diffusion-weighted images along six different directions with a b value of 1000 s/mm(2), as well as an image acquired without diffusion weighting (b = 0 s/mm(2)). A 1.5-T imager was used to acquire 17 (3-mm) coronal sections covering the temporal lobes. We compared the mean diffusivity (trace D) and fractional anisotropy (FA) from symmetrical voxels by sampling the anterior HF bilaterally. We compared measurements with the EEG, high-resolution MR imaging, and clinical information. RESULTS: The patient group had significantly increased diffusivity and decreased FA in the HF ipsilateral to the seizure focus, as compared with values in the contralateral HF. When compared with healthy subjects, patients had significantly higher mean diffusivity in the ipsilateral HF; ipsilateral FA values were lower and did not reach statistical significance. Measurements in the contralateral HF did not show differences. Left-right and absolute diffusivity indices lateralized the abnormal HF in eight and five of 12 patients, respectively. CONCLUSION: Abnormal DTI measurements and the epileptogenic HF are associated in unilateral TLE. This finding may reflect hippocampal sclerosis and may aid in presurgical evaluation.

Adult↗

Clinical protocol. Gene therapy of Canavan disease: AAV-2 vector for neurosurgical delivery of aspartoacylase gene (ASPA) to the human brain.

This clinical protocol describes virus-based gene transfer for Canavan disease, a childhood leukodystrophy. Canavan disease, also known as Van Bogaert-Bertrand disease, is a monogeneic, autosomal recessive disease in which the gene coding for the enzyme aspartoacylase (ASPA) is defective. The lack of functional enzyme leads to an increase in the central nervous system of the substrate molecule, N-acetyl-aspartate (NAA), which impairs normal myelination and results in spongiform degeneration of the brain. No effective treatment currently exists; however, virus-based gene transfer has the potential to arrest or reverse the course of this otherwise fatal condition. This procedure involves neurosurgical administration of approximately 900 billion genomic particles (approximately 10 billion infectious particles) of recombinant adeno-associated virus (AAV) containing the aspartoacylase gene (ASPA) directly to affected regions of the brain in each of 21 patients with Canavan disease. Pre- and post-delivery assessments include a battery of noninvasive biochemical, radiological, and neurological tests. This gene transfer study represents the first clinical use of AAV in the human brain and the first instance of viral gene transfer for a neurodegenerative disease.

Amidohydrolases↗

Nonuniform flow dynamics in the aorta of normal children: a simplified approach to measurement using magnetic resonance velocity mapping.

PURPOSE: To determine regional flow dynamics in the normal aorta (Ao) in children. Understanding flow dynamics in children is important in cardiovascular energetics, in designing improved aortic reconstructions by crafting the surgery to mimic normal aortic flow, and in Doppler flow calculations. The objective of this study was to determine regional flow dynamics in the normal Ao in children. MATERIALS AND METHODS: We performed magnetic resonance velocity mapping on 13 subjects (ages 7.2 +/- 6.2 years) with normal Aos to determine flow dynamics in four equal quadrants in the ascending (AAo) and descending aorta (DAo) aligned along the long axis of the Ao. Statistical significance was set at P <.05. RESULTS: In the AAo, the left posterior quadrant displayed significantly less blood flow (16% +/- 5%) than the other quadrants (26-29%) over the cardiac cycle. In the DAo, both anterior quadrants carried significantly less blood flow (20% and 21%) than the posterior quadrants (27% and 32%). At maximum flow (15% +/- 5% into the cardiac cycle for the AAo; 27% +/- 15% for the DAo), there was significantly more flow in the right posterior quadrant (28% +/- 2%) than other quadrants (22-23%) in the AAo. In the DAo, both posterior quadrants had significantly higher flow rates (27% and 30%) than the anterior quadrants (21% and 22%). Maximum velocity in both the AAo and the DAo occurred in the left posterior quadrant in 10/13 at 16-24% into the cardiac cycle. At end-systole, a short flow reversal was noted in the posterior quadrants in the AAo in 11/13; in the DAo, this occurred in the anterior quadrants in 10/13. CONCLUSION: Flow dynamics in the normal Ao in children are not symmetrical; the flow distributions are asymmetric in both the AAo and the DAo throughout systole, including flow reversal related to the dicrotic notch. These results may help improve Ao surgery.

Analysis of Variance↗