Biomedical subjects

Michael O Zenge

Publications and source records attributed to Michael O Zenge.

5 recordsLinked to original sources

PubMed2006

The predisposition to inspiratory upper airway collapse during partial neuromuscular blockade.

RATIONALE: Partial neuromuscular transmission failure by acetylcholine receptor blockade (neuromuscular blockade) or antibody-mediated functional loss (myasthenia gravis), even with a magnitude of muscle weakness that does not evoke respiratory symptoms, can evoke dysphagia and decreased inspiratory airflow, and increases the risk of susceptible patients to develop severe pulmonary complications. OBJECTIVES: To assess whether impaired neuromuscular transmission predisposes individuals to inspiratory upper airway collapse, we assessed supraglottic airway diameter and volume by respiratory-gated magnetic resonance imaging, upper airway dilator muscle function (genioglossus force and EMG), and changes in lung volume, respiratory timing, and peripheral muscle function before, during, and after partial neuromuscular blockade in healthy, awake volunteers. MEASUREMENTS AND MAIN RESULTS: Partial neuromuscular blockade (train-of-four [TOF] ratio: 0.5 and 0.8) was associated with the following: (1) a decrease of inspiratory retropalatal and retroglossal upper airway volume to 66 +/- 22 and 82 +/- 12% of baseline, which was significantly more intense in the retropalatal area; (2) an attenuation of the normal increase in anteroposterior upper airway diameter during forced inspiration to 74 +/- 18% of baseline; (3) a decrease in genioglossus activity during maximum voluntary tongue protrusion to 39 +/- 19% (TOF, 0.5) and 73 +/- 29% (TOF, 0.8) of baseline; and (4) no effects on upper airway size during expiration, lung volume, and respiratory timing. CONCLUSIONS: Thus, impaired neuromuscular transmission, even to a degree insufficient to evoke respiratory symptoms, markedly impairs upper airway dimensions and function. This may be explained by an impairment of the balance between upper airway dilating forces and negative intraluminal pressure generated during inspiration by respiratory "pump" muscles.

Adult↗

PubMed2006

Feasibility of real-time magnetic resonance-guided stent-graft placement in a swine model of descending aortic dissection.

AIMS: To evaluate the pre-clinical feasibility of real-time magnetic resonance imaging (rtMRI) to guide stent-graft placement for experimental aortic dissection (AD) and to alleviate disadvantages of ionising radiation and nephrotoxic contrast media. Endovascular stent-graft placement for thoracic aortic disease is usually performed under X-ray guidance. The feasibility of rtMRI-guided stent-graft placement is currently not known. METHODS AND RESULTS: By using a catheter-based technique, dissections of the descending thoracic aorta were successfully created in eight domestic pigs. Subsequent implantation of commercially available, nitinol-based stent-grafts was performed entirely under rtMRI guidance. By pre-interventional MRI, the mean minimal true-lumen diameter was 0.9 (0.825-0.975) cm. rtMRI permitted not only the successful and safe device navigation within the true lumen from the iliac arteries to the thoracic aorta, but also the precise positioning and deployment of the stent-graft and safe withdrawal of the delivery catheter in seven of eight pigs. This was achieved without any other complications. After the stent-graft placement, MRI demonstrated complete obliteration of the false lumen, which was confirmed at autopsy. All stent-grafts were well expanded resulting in an increase in the size of the true-lumen diameter to 2.05 (1.925-2.1) cm (P=0.066 vs. baseline). CONCLUSION: In experimental AD, rtMRI-guided endovascular stent-graft placement is feasible and safe and has the potential for mitigating radiation and contrast-related side effects. Additionally, it allows not only pre-interventional diagnosis and detailed anatomic diagnosis, but also permits immediate post-interventional, anatomical, and functional delineation of procedure success that may serve as a baseline for future comparison during follow-up.

Aortic Dissection↗

PubMed2006

High-resolution continuously acquired peripheral MR angiography featuring partial parallel imaging GRAPPA.

Continuously-moving-table MRI, in contrast to traditional multistation techniques, potentially can improve the scan time efficiency of whole-body applications and provide seamless images of an extended field of view (FOV). Contrast-enhanced MR angiography (CE-MRA) in particular requires high spatial resolution and at the same time has rigid scan time constraints due to the limited arterial contrast window. In this study a reconstruction method for continuously acquired 3D data sets during table movement was combined with a self-calibrated partial parallel imaging algorithm (generalized autocalibrating partially parallel acquisitions (GRAPPA)). The method was applied to peripheral CE-MRA and compared with a standard continuously-moving-table MRA protocol. The gain in scan time was used to increase the data acquisition matrix and decrease the slice thickness. The method was evaluated in five healthy volunteers and applied to one patient with peripheral arterial occlusive disease (PAOD). The protocols were intraindividually compared with respect to the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in selected vessel segments, as well as overall vessel depiction. The combination of the continuously-moving-table technique with parallel imaging enabled the acquisition of seamless peripheral 3D MRA with increased resolution and an overall crisper appearance.

Algorithms↗

PubMed2005

Interventional magnetic resonance angiography with no strings attached: wireless active catheter visualization.

Active instrument visualization strategies for interventional MR angiography (MRA) require vascular instruments to be equipped with some type of radiofrequency (RF) coil or dipole RF antenna for MR signal detection. Such visualization strategies traditionally necessitate a connection to the scanner with either coaxial cable or laser fibers. In order to eliminate any wire connection, RF resonators that inductively couple their signal to MR surface coils were implemented into catheters to enable wireless active instrument visualization. Instrument background to contrast-to-noise ratio was systematically investigated as a function of the excitation flip angle. Signal coupling between the catheter RF coil and surface RF coils was evaluated qualitatively and quantitatively as a function of the catheter position and orientation with regard to the static magnetic field B0 and to the surface coils. In vivo evaluation of the instruments was performed in interventional MRA procedures on five pigs under MR guidance. Cartesian and projection reconstruction TrueFISP imaging enabled simultaneous visualization of the instruments and vascular morphology in real time. The implementation of RF resonators enabled robust visualization of the catheter curvature to the very tip. Additionally, the active visualization strategy does not require any wire connection to the scanner and thus does not hamper the interventionalist during the course of an intervention.

Animals↗

PubMed2005

Whole-body magnetic resonance imaging featuring moving table continuous data acquisition with high-precision position feedback.

A novel setup for whole-body MR imaging with moving table continuous data acquisition has been developed and evaluated. The setup features a manually positioned moving table platform with integrated phased-array surface radiofrequency coils. A high-precision laser position sensor was integrated into the system to provide real-time positional data that were used to compensate for nonlinear manual table translation. This setup enables continuous 2D and 3D whole-body data acquisition during table movement with surface coil image quality. The concept has been successfully evaluated with whole-body steady-state free precession (TrueFISP) anatomic imaging in five healthy volunteers. Seamless coronal and sagittal slices of continually acquired whole-body data during table movement were accurately reconstructed. The proposed strategy is potentially useful for a variety of applications, including whole-body metastasis screening, whole-body MR angiography, large field-of-view imaging in short bore systems, and for moving table applications during MR-guided interventions.

Algorithms↗