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Biomedical subjects

K A Buckwalter

Publications and source records attributed to K A Buckwalter.

44 records · Page 3Linked to original sources

Visualization of myocardial infarction and subsequent coronary reperfusion with MRI using a dog model.

Twelve anesthetized mongrel dogs underwent left thoracotomy with placement of a removable ligature around the left circumflex coronary artery. Following a 3 to 6 hour delay, ECG-gated spin-echo MRI was performed. The ligature was then removed reperfusing the heart, and after a 10-15 min period, MRI repeated. Finally, post-sacrifice images were obtained, and the hearts chemically stained for infarct evaluation. The MR images were subjectively and quantitatively evaluated for visibility of the endocardial border and of the injured myocardium, and for changes after reperfusion. The injured tissue was variably visible in vivo, the major limitation a result of motion blurring and artifact. The abnormal tissue was easily visible on MRI in 11 animals, and not clearly visible in one. The endocardial border was easily seen in 10 animals. The variation of calculated relaxation times was high for both normal and ischemic/infarcted myocardium in the beating hearts (normal: T1 = 566 +/- 288, T2 = 38 +/- 6; injured myocardium: T1 = 637 +/- 250, T2 = 41 +/- 12) in contrast, relatively stationary skeletal muscle measured in the same images had narrower ranges (T1 = 532 +/- 199, T2 = 28 +/- 2). Changes with reperfusion were seen, but not reliably. The infarcted or ischemic zones were easily visible on post-sacrifice images in all animals imaged. Post-sacrifice relaxation times were T1 = 564 +/- 69 msec, T2 = 39 +/- 3 msec for normal heart muscle, and 725 +/- 114, T2 = 47 +/- 5 for ischemic/infarcted tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Pitfall in MR imaging of lymphadenopathy after lymphangiography.

In two patients examined with magnetic resonance (MR) imaging after lymphangiography, opacified pelvic lymph nodes could not be distinguished from subcutaneous or retroperitoneal fat because of the short T1 and long T2 relaxation times of lymphangiographic contrast media. Opacified nodes removed from one patient had relaxation times similar to those of fat. Thus, assessment of lymphadenopathy with MR imaging should be performed before lymphangiography to obviate this potential pitfall.

Contrast Media↗

Gated cardiac MRI: ejection-fraction determination using the right anterior oblique view.

Fifteen adults underwent gated cardiac MR scans in the right anterior oblique position. End-diastolic and end-systolic images were acquired in an imaging plane parallel to the ventricular septum using spin-echo image acquisition on a 0.35-T system. Analysis of ventricular volumes and ejection fractions was performed using the area-length method. These results were correlated with ejection fractions obtained from angiocardiography. The linear regression line obtained for ejection fraction was y = 0.74x + 16 and the r value was 0.789, indicating a reasonable correlation between the two methods.

Adult↗

MRI in osteoarthritis of the hip: gradations of severity.

In a prospective study, 10 patients with well-documented osteoarthritis (O.A.) of the hips were imaged using spin-echo pulse sequences (TR = 0.5 to 1.5 s and TE = 28 to 60 ms). After analyzing the changes observed, an MR grading system for assessing severity of O.A. in the hips was developed. Using this grading system and an established grading system for osteoarthritis using roentgenograms (both systems use grades 0-4), two radiologists independently graded the MR studies and plain films separately, twice. The roentgenogram grading system was more accurate in predicting symptoms in the more severe cases, whereas the MR grading system was slightly more useful in the less severe cases. Our results show that MR can demonstrate a spectrum of changes of O.A. in the hips. Its ability to directly image articular cartilage makes it a powerful research and clinical tool.

Adult↗

Interpretations and treatment decisions based on MR angiography versus conventional arteriography in symptomatic lower extremity ischemia.

PURPOSE: To determine the frequency with which treatment plans based on findings at magnetic resonance angiography (MRA) match those based on findings at conventional x-ray arteriography (XRA) in the evaluation of symptomatic lower extremity ischemia. PATIENTS AND METHODS: Two-dimensional time-of-flight (TOF) MRA was performed in 42 patients undergoing XRA for evaluation of symptomatic lower extremity ischemia. The blind interpretations and treatment plans based on MRA findings were compared with those based on XRA findings, with use of XRA as the standard of reference. RESULTS: For identification of hemodynamically significant stenosis or occlusion, the sensitivity and specificity of MRA was 100% and 23% for iliac segments, 100% and 82% for common femoral segments, 89% and 67% for superficial femoral segments, 100% and 88% for popliteal segments, and 92% and 91% for tibioperoneal segments, respectively. The treatment plan based on MRA findings matched that based on XRA findings in 41% of patients. CONCLUSION: For evaluation of symptomatic lower extremity ischemia, two-dimensional TOF MRA cannot be considered a reliable substitute for XRA in patients who lack contraindications to XRA.

Angiography↗

A technique for magnetic resonance imaging of equine cadaver specimens.

We tested an adaptation of a technique for performing magnetic resonance (MR) imaging of human cadaver limbs in the horse. The forelimbs from a normal horse were collected, frozen, and sealed with a paraffin-polymer combination prior to imaging with either a high- or midfield magnetic resonance scanner. Each forelimb was defrosted, scanned, and refrozen on two separate occasions. A five-point scale was used to evaluate the quality of each set of sagittal and transverse, T1-weighted images of each digit. There was no difference in image quality between first and second scans of either specimen (p > 0.05). We conclude that this technique allows investigators to bank tissue specimens for future magnetic resonance imaging without significant loss of image quality.

Animals↗

Use of radiography, computed tomography and magnetic resonance imaging for evaluation of navicular syndrome in the horse.

Radiographic evaluation of navicular syndrome is problematic because of its inconsistent correlation with clinical signs. Scintigraphy often yields false positive and false negative results and diagnostic ultrasound is of limited value. Therefore, we assessed the use of computed tomography and magnetic resonance imaging in a horse with clinical and radiographic signs of navicular syndrome. Cadaver specimens were examined with spiral computed tomographic and high-field magnetic resonance scanners and images were correlated with pathologic findings. Radiographic changes consisted of bony remodeling, which included altered synovial fossae, increased medullary opacity, cyst formation and shape change. These osseous changes were more striking and more numerous on computed tomographic and magnetic resonance images. They were most clearly defined with computed tomography. Many osseous changes seen with computed tomography and magnetic resonance imaging were not radiographically evident. Histologically confirmed soft tissue alterations of the deep digital flexor tendon, impar ligament and marrow were identified with magnetic resonance imaging, but not with conventional radiography. Because of their multiplanar capability and tomographic nature, computed tomography and magnetic resonance imaging surpass conventional radiography for navicular imaging, facilitating earlier, more accurate diagnosis. Current advances in imaging technology should make these imaging modalities available to equine practitioners in the future.

Animals↗

Multisection CT: scanning techniques and clinical applications.

Multisection computed tomography (CT) was introduced in 1992 with the advent of dual-section-capable scanners and was improved in 1998 following the development of quad-section technology. With a recent increase in gantry speed from one to two revolutions per second, multisection CT scanners are now up to eight times faster than conventional single-section helical CT scanners. The benefits of quad-section CT relative to single-section helical CT are considerable. They include improved temporal resolution, improved spatial resolution in the z axis, increased concentration of intravascular contrast material, decreased image noise, efficient x-ray tube use, and longer anatomic coverage. These factors substantially increase the diagnostic accuracy of the examination. The multisection CT technique has enabled faster and superior evaluation of patients across a wide spectrum of clinical indications. These include isotropic viewing, musculoskeletal applications, use of multiplanar reformation in special situations, CT myelography, long coverage and multiphase studies, CT angiography, cardiac scoring, evaluation of brain perfusion, imaging of large patients, evaluation of acute chest pain or dyspnea, virtual endoscopy, and thin-section scanning with retrospective image fusing. Multisection CT is superior to single-section helical CT for nearly all clinical applications.

Equipment Design↗