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Biomedical subjects

K O Lovblad

Publications and source records attributed to K O Lovblad.

9 recordsLinked to original sources

Multiresolution fuzzy clustering of functional MRI data.

Recent developments in the analysis of functional MRI data reveal a shift from hypothesis-driven statistical tests to unsupervised strategies. One of the most promising approaches is the fuzzy clustering algorithm (FCA), whose potential to detect activation patterns has already been demonstrated. But the FCA suffers from three drawbacks: first the computational complexity, second the higher sensitivity to noise and third the dependence on the random initialization. With the multiresolution approach presented here, these weak points are significantly improved, as is demonstrated in our tests with simulated and real functional MRI data.

Algorithms↗

Acute leukoencephalopathy after inhalation of a single dose of heroin.

We describe extended and repeat magnetic resonance (MR) examinations in the case of a 16-year-old male who developed acute left-sided sensorimotor hemiplegia after a single dose of inhaled heroin. MRI revealed symmetrical hyperintense signals in T 2 -weighted images and massive diffusion disorders in the diffusion weighted images predominantly in parieto-occipital subcortical white matter and both ventral globi pallidi with preservation of U fibers and no brain oedema. MR spectroscopy data were compatible with combined hypoxic and mitochondrial damage resulting in axonal injury without demyelination. Normal values and variations had been obtained from spectra of five age-matched subjects. This is the first reported MR follow-up study of leukoencephalopathy occurring acutely after a first inhaled dose of heroin. We postulate that toxic spongiform leukoencephalopathy in heroin addicts may be the outcome of a complex mechanism directly triggered by heroin and causing mitochondrial as well as hypoxic injury in specific and limited areas of white matter.

Acute Disease↗

Diffusion weighted MR imaging on a low-field open magnet. Comparison with findings at 1.5T in 18 patients with cerebral ischemia.

Diffusion-weighted MR imaging (DWI) is particularly sensitive for the detection of acute stoke. Until recently, DWI was performed with EPI technology. We compared 18 patients with clinical suspicion of acute stroke on a standard 1.5T unit and an open low-field MR scanner. Eighteen patients with 20 lesions of acute stroke were studied retrospectively with DWI and ADC mapping on both systems. The technique used was a rotating fast-spin echo T2 at low-field and an EPI sequence at 1.5T. Both examinations were performed within 24 hours and analyzed by two neuroradiologists. We obtained the same results on DWI sequences on both systems, regarding high intensity lesions on DWI. Interpretation of the ADC maps proved to be difficult on low-field MR near the lateral ventricles (3/18). We experienced the same difficulty of interpretation at low and high field in the cerebellum, in the temporal fossa and in cortex situated near bone, due to susceptibility artifacts. Chronic lesions were better visualized at low than at high field. In our opinion, DWI on a low-field open MR scanner is a good technique to evaluate subacute stroke and was as reliable as when performed on a 1.5T MR system.

Adult↗

Asymptomatic grotesque deformities of the cervical spine. An occupational hazard in railway porters.

STUDY DESIGN: A case report. OBJECTIVE: To illustrate an extremely rare occurrence of chronic, occupational, low-grade trauma leading to asymptomatic grotesque cervical spine deformities in railroad station porters. SUMMARY OF BACKGROUND DATA: Occupational trauma causing spinal deformities has been described in relation to thoracic and lumbar spines in miners. To the authors' knowledge, this is the first reported case of asymptomatic cervical spinal deformity in railway porters as a result of chronic occupational trauma. METHODS: A magnetic resonance imaging study was performed on both patients. RESULTS: The magnetic resonance images showed advanced degenerative changes in the cervical spine causing obvious deformities, along with apparently normal cord signal intensity. CONCLUSIONS: Chronic, occupational, low-grade trauma of the cervical vertebral region is extremely unusual in industrialized countries. Nevertheless, in view of the increasing mobility of people in general and of the labor force in particular, this complication of an occupational exposure deserves attention as an unusual cause of cervical spinal deformity.

Adult↗

Functional burst imaging.

A quiet magnetic resonance (MR) imaging technique for detecting changes in cerebral activity functions is presented. This single-shot method, functional Burst imaging (FBI), combines elements of Burst imaging with an offset technique known as asymmetric spin echo (ASE). The FBI sequence has the unique feature of being nearly silent, because of the low number of gradient switching steps involved. Furthermore, this approach has the key advantage that it can be implemented on conventional MR systems. Established auditory and visual paradigms were used to evaluate whether FBI can detect changes in cerebral activity using a 1.5 Tesla MR system. In a second set of experiments, the FBI technique was used to evaluate cerebral activity changes during different sleep stages in humans. The results obtained demonstrate that the FBI sequence provides an alternative approach for functional imaging of brain activity in primary and secondary sensory areas of the human brain. Furthermore, in using this quiet MR technique, it was possible to scan continuously during different stages of human sleep without acoustic noise perturbation.

Acoustic Stimulation↗

Line scan diffusion imaging: characterization in healthy subjects and stroke patients.

OBJECTIVE: Our objective was to evaluate a new scanning method, MR line scan diffusion imaging, and assess the apparent diffusion coefficient in the brains of healthy subjects and stroke patients. SUBJECTS AND METHODS: Line scan diffusion imaging without cardiac gating or head restraints was implemented on low- (0.5 T) and medium- (1.5 T) field-strength scanners with conventional hardware. Diffusion-weighted images were obtained in six healthy subjects and eight stroke patients. Unidirectional diffusion encoding was used for fast localization of stroke lesions. For further characterization, orthogonal diffusion encoding was applied, and the trace of the apparent diffusion coefficient was calculated. Single-shot diffusion-weighted echoplanar imaging served as the reference standard. For healthy subjects, imaging was repeated four times on each scanner. Mean and relative precision of the apparent diffusion coefficient trace values were calculated for each pixel. In stroke lesions and adjacent normal tissue, apparent diffusion coefficient trace values were determined. RESULTS: In the 108 scans obtained, line scan diffusion imaging proved to be robust, virtually free of artifact (independent of slice location and orientation), reproducible, and rapid for localization of a stroke. Scan time for 14 slices at 7-mm thickness was 8 min at 0.5 T and 7 min at 1.5 T. Image qualities with line scan diffusion imaging and single-shot diffusion-weighted echoplanar imaging were comparable. At 1.5 T, precision was essentially the same for line scan diffusion imaging (4.3%) and echoplanar imaging (4.7%). With line scan diffusion imaging at 0.5 T and 1.5 T, normal paraventricular apparent diffusion coefficient trace values averaged 0.71 microm2/msec, and with echoplanar imaging these values averaged 0.69 microm2/msec. In acute lesions apparent diffusion coefficient trace values were low, and in chronic lesions these values were high. CONCLUSION: Line scan diffusion imaging on low- and medium-field-strength MR scanners equipped with conventional hardware was reliable and practical for measuring brain apparent diffusion values, which can be applied to the early diagnosis, and hence timely management, of stroke.

Adult↗

Half-Fourier BURST imaging on a clinical scanner.

A modified BURST imaging technique with a nearly twofold reduction in acquisition time, improved signal-to-noise ratio and clear improvement of the image quality is introduced. The method applies half-Fourier reconstruction and can be implemented on a standard clinical scanner. This approach allows the collection of single-shot magnetization prepared images of the human brain with a matrix size of 112 x 128 within 86-250 ms. The signal-to-noise properties of the pulse sequence are analyzed and compared with a standard BURST experiment.

Brain↗

Hypersomnia following paramedian thalamic stroke: a report of 12 patients.

Paramedian thalamic stroke (PTS) is a cause of organic hypersomnia, which in the absence of systematic sleep-wake studies has been attributed to disruption of ascending activating impulses and considered a "dearoused" state. However, an increasing mount of data suggests a role of the thalamus in sleep regulation and raises the possibility that a sleep disturbance contributes to hypersomnia in PTS. We evaluated 12 patients with magnetic resonance imaging-proven isolated PTS and hypersomnia with 10 to >20 hours of sleep behavior per day. Nocturnal polysomnographic findings paralleled the severity of hypersomnia. All subjects had increased stage 1 NREM sleep, reduced stage 2 NREM sleep, and reduced numbers of sleep spindles. In patients with severe hypersomnia, slow-wave (stages 3-4) NREM sleep was often reduced, but there were no major REM sleep alterations. Daytime sleep behavior was associated mostly with stage 1 sleep by electroencephalogram; there was no correlation between hypersomnia and results of nap tests. We conclude that hypersomnia following PTS is accompanied by deficient arousal during the day and insufficient spindling and slow-wave sleep production at night. These observations support the hypothesis of a dual role of the paramedian thalamus as "final common pathway' for both maintenance of wakefulness and promotion of NREM sleep.

Adolescent↗