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Biomedical subjects

Ronald L Wolf

Publications and source records attributed to Ronald L Wolf.

8 recordsLinked to original sources

Actinomycotic brain infection: registered diffusion, perfusion MR imaging and MR spectroscopy.

INTRODUCTION: Actinomycotic brain infection is caused by an organism of the Actinomyces genus. We report here one such case. METHODS: The methods used included coregistered diffusion, perfusion and spectroscopic magnetic resonance (MR) imaging. RESULTS: Decreased apparent diffusion coefficient, markedly elevated fractional anisotropy (FA) and reduced cerebral blood flow were observed. MR spectroscopy demonstrated elevated amino acids, acetate and succinate. CONCLUSION: Elevated FA values may be due to the microstructure of this special brain infection.

Actinomycosis↗

Artificial multiple sclerosis lesions on simulated FLAIR brain MR images: echo time and observer performance in detection.

The institutional review board approved the described HIPAA-compliant study, which was performed to prospectively evaluate observer performance in the detection of artificial multiple sclerosis (MS) lesions that were randomly distributed supra- and infratentorially on simulated fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) images obtained at different echo times (TEs). MR parametric maps were derived from mixed multi-echo inversion-recovery images obtained in a 40-year-old healthy male volunteer and in a patient with MS, both of whom gave informed consent. Pseudo-randomly distributed artificial MS lesions of varying size, number, and location were equally represented on the FLAIR images (11 000/100-200/2600 [repetition time msec/TE msec/inversion time msec]). Twelve images obtained in both regions at each of 11 TEs spaced 10 msec apart were rated by seven neuroradiologists by using a four-point scale. Observer performance in the detection of MS lesions on the FLAIR images, as estimated by using areas under the alternative free-response receiver operating characteristic curve, was highest and most consistent at the 100-msec TE, both supratentorially (93.0% +/- 8.6 [standard error of the mean]) and infratentorially (87.4% +/- 10.0).

Adult↗

Mineral volume and morphology in carotid plaque specimens using high-resolution MRI and CT.

OBJECTIVE: High-resolution MRI methods have been used to evaluate carotid artery atherosclerotic plaque content. The purpose of this study was to assess the performance of high-resolution MRI in evaluation of the quantity and pattern of mineral deposition in carotid endarterectomy (CEA) specimens, with quantitative micro-CT as the gold standard. METHODS AND RESULTS: High-resolution MRI and CT were compared in 20 CEA specimens. Linear regression comparing mineral volumes generated from CT (VCT) and MRI (VMRI) data demonstrated good correlation using simple thresholding (VMRI=-0.01+0.98VCT; R2=0.90; threshold=4xnoise) and k-means clustering methods (VMRI=-0.005+1.38VCT; R2=0.93). Bone mineral density (BMD) and bone mineral content (BMC [mineral mass]) were calculated for CT data and BMC verified with ash weight. Patterns of mineralization like particles, granules, and sheets were more clearly depicted on CT. CONCLUSIONS: Mineral volumes generated from MRI or CT data were highly correlated. CT provided a more detailed depiction of mineralization patterns and provided BMD and BMC in addition to mineral volume. The extent of mineralization as well as the morphology may ultimately be useful in assessing plaque stability.

Adult↗

Amplitude-modulated continuous arterial spin-labeling 3.0-T perfusion MR imaging with a single coil: feasibility study.

Written informed consent was obtained prior to all human studies after the institutional review board approved the protocol. A continuous arterial spin-labeling technique with an amplitude-modulated control was implemented by using a single coil at 3.0 T. Adiabatic inversion efficiency at 3.0 T, comparable to that at 1.5 T, was achieved by reducing the amplitude of radiofrequency pulses and gradient strengths appropriately. The amplitude-modulated control provided a good match for the magnetization transfer effect of labeling pulses, allowing multisection perfusion magnetic resonance imaging of the whole brain. Comparison of multisection continuous and pulsed arterial spin-labeling methods at 3.0 T showed a 33% improvement in signal-to-noise ratio by using the former approach.

Adult↗

Grading of CNS neoplasms using continuous arterial spin labeled perfusion MR imaging at 3 Tesla.

PURPOSE: To differentiate glioma grade based on blood flow measured using continuous arterial spin labeled (CASL) perfusion MRI, implemented at 3 Tesla for improved signal-to-noise ratio (SNR) and spin labeling effect. MATERIALS AND METHODS: CASL perfusion images were obtained preoperatively in 26 patients with brain neoplasms (19 high-grade gliomas (HGGs; WHO grades 3 and 4) and seven low-grade gliomas (LGGs; WHO grades 1 and 2)). The mean and maximum tumor blood flow (TBF and TBFmax) were calculated in the neoplasm, including surrounding infiltrating tumor vs. edema. Measures normalized to global CBF (nTBF and nTBFmax) were also obtained. RESULTS: Normalized measures of TBFmax provided the best distinction between HGG and LGG groups (Wilcoxon rank sum test, P = 0.01). Seventeen of 19 HGGs showed nTBFmax > 1.0, and 15 of 19 showed nTBFmax > 1.3. Four of seven LGGs showed nTBFmax < 1.0, and six of seven showed nTBFmax < 1.3. Absolute TBFmax also differed significantly between the HGG and LGG groups (P = 0.04). TBFmax in 11 of 17 HGGs was >50 mL/100 g/min (mean +/- SD = 94.9 +/- 71.7 mL/100 g/min). All but one LGGs showed TBFmax < or = 50 mL/100 g/min (mean +/- SD = 42.8 +/- 22.0 mL/100 g/min). CONCLUSION: CASL perfusion MRI provides a quantitative, noninvasive alternative to dynamic susceptibility contrast perfusion MR methods for evaluating gliomas.

Adult↗

Dialysis disequilibrium: another reversible posterior leukoencephalopathy syndrome?

Dialysis disequilibrium syndrome is a disorder of the central nervous system in patients on dialysis. The underlying etiology is thought to be primarily due to cerebral edema; however, neuroradiologic findings have not been described previously. We describe a patient who presented with new onset headaches and status epilepticus after beginning hemodialysis. Her neuroimaging studies revealed white matter changes in the posterior parietal and occipital lobes similar to those seen in patients with reversible posterior leukoencephalopathy syndrome (RPLS). This case suggests that dialysis disequilibrium syndrome and RPLS may represent a spectrum of disorders in which the underlying mechanism is vasogenic edema.

Adult↗

Susceptibility contrast and arterial spin labeled perfusion MRI in cerebrovascular disease.

PURPOSE: To directly compare dynamic susceptibility contrast (DSC) and continuous arterial spin labeled (CASL) magnetic resonance (MR) perfusion techniques in patients with known cerebrovascular disease, with the goals of identifying possible pitfalls in interpretation and determining potential for a complementary role in this setting. METHODS: DSC and CASL MR perfusion studies were performed and compared in 11 patients with acute and/or chronic cerebrovascular disease. Using an automated segmentation technique, Pearson correlation coefficients were generated for CASL perfusion measurements compared to DSC perfusion maps (time-to-peak [TTP], relative cerebral blood volume [rCBV], cerebral blood flow [rCBF], and mean transit time [MTT]) by hemisphere and vascular territory. RESULTS: TTP maps obtained using DSC perfusion MR correlated best both subjectively and objectively with CASL perfusion MR measurements when all patients studied were considered. If patients with a major transit delay were excluded, DSC rCBF correlated best with CASL CBF measurements. CONCLUSION: There may be a complementary role for CASL and DSC perfusion MR methods in cerebrovascular disease, especially in the setting of a marked transit delay.

Acute Disease↗

Multislice double inversion pulse sequence for efficient black-blood MRI.

Over the last several years there has been a rapidly growing interest in high-resolution MRI of the vascular wall to assess the extent of atherosclerotic lesions. Vessels of particular clinical relevance are the carotid and coronary arteries. Currently, the preferred imaging sequence for these studies is a "black-blood" technique based on the double-inversion scheme to null the blood signal. A critical drawback of the black-blood technique, however, has been its single-slice nature, as there is only one point in time during the recovery of the blood magnetization from inversion at which the signal is completely nulled. Consequently, the total scan time can become prohibitively long, particularly when an imaging protocol includes several series of these datasets. In this work, a multiple-slice double-inversion technique is described that can reduce the scan time by a factor of two or more. It is demonstrated in vivo with examples from carotid and coronary arteries that one can acquire multiple slices with sufficient nulling of blood, following a single set of inversion pulses.

Adult↗