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Biomedical subjects

S Vinitski

Publications and source records attributed to S Vinitski.

At least 19 recordsLinked to original sources

Partial angle inversion recovery (PAIR) MR imaging: spin-echo and snapshot implementation.

The effects of varying the inversion or excitation RF pulse flip angles on image contrast and imaging time have been investigated in IR imaging theoretically, with phantoms and with normal volunteers. Signal intensity in an IR pulse sequence as a function of excitation, inversion and refocusing pulse flip angles was calculated from the solution to the Bloch equations and was utilized to determine the contrast behavior of a lesion/liver model. Theoretical and experimental results were consistent with each other. With the TI chosen to suppress the fat signal, optimization of the excitation pulse flip angle results in an increase in lesion/liver contrast or allows reduction in imaging time which, in turn, can be traded for an increased number of averages. This, in normal volunteers, improved spleen/liver contrast-to-noise ratio (9.0 vs. 5.7, n = 8, p less than 0.01) and suppressed respiratory ghosts by 33% (p less than 0.01). Reducing or increasing the inversion pulse from 180 degrees results in shorter TI needed to null the signal from the tissue of interest. Although this decreases the contrast-to-noise ratio, it can substantially increase the number of sections which can be imaged per given TR in conventional IR imaging or during breathold in the snapshot IR (turboFLASH) technique. Thus, the optimization of RF pulses is useful in obtaining faster IR images, increasing the contrast and/or increasing the number of imaging planes.

Abdomen

Polycythemia vera and myelofibrosis: correlation of MR imaging, clinical, and laboratory findings.

Magnetic resonance (MR) imaging was performed in 14 patients with biopsy-proved polycythemia vera (n = 4) or myelofibrosis (n = 10) to determine whether MR imaging findings can be correlated with the clinicopathologic diagnosis and established clinical parameters of severity (serum lactate dehydrogenase [LDH] and cholesterol levels) and chronicity (spleen size). Evaluation of marrow in the proximal femurs showed that patients could be categorized into three distinct groups based on anatomic patterns of normal fatty and abnormal low-signal-intensity (non-fatty) marrow in the femoral capital epiphysis (FCE) and greater trochanter (GT). Patients with nonfatty marrow in both the FCE and GT (n = 8) had significantly higher serum LDH (P less than .02) and lower serum cholesterol (P less than .02) levels than patients with fatty marrow in at least the GT (n = 6). Splenic volume, as measured from MR images, was significantly greater in the myelofibrosis group than in the polycythemia vera group (P less than .001). MR imaging provided a better understanding of these hematologic disorders and novel parameters for classification that are different from conventional histologic and laboratory data.

Adult

Magnetic resonance chemical shift imaging and spectroscopy of atherosclerotic plaque.

An in vivo magnetic resonance imaging (MRI) technique for identification and characterization of atherosclerotic plaque was assessed in animal and human models. Atherosclerosis was induced in the abdominal aorta of four rabbits by a combination of balloon denudation and a high cholesterol diet. In vivo conventional spin-echo and fat/water suppressed images of the rabbit aortae were obtained at 1.5 T. Chemical shift imaging (CSI) was achieved using a hybridization of selective excitation and modified Dixon techniques. These techniques were then used to obtain images of atherosclerotic lesions in the carotid arteries of four patients prior to endarterectomy. The MRI results were corroborated by histologic and high-resolution proton MR spectroscopic (8.5 T) analysis of rabbit aorta, human carotid endarterectomy, and six additional human superficial femoral and iliac atherectomy specimens. All animal and human lesions were classified as either fatty streaks or fibrotic plaque. When compared to conventional spin-echo images, fat suppression by CSI substantially improved the measured contrast-to-noise ratio between plaque and vessel lumen, and enhanced its discrimination from periadventitial fat. In contrast, water suppression eliminated visualization of plaque due to the negligible amount of isotropic (liquid-like) signal from the immobilized lesion lipids. Magnetic resonance spectroscopy corroborated the CSI results by demonstrating broad, ill-defined fat resonances characteristic of nonmobile lipids in both human and rabbit atherosclerotic lesions. These findings indicate that in vivo MRI of plaque is technically feasible and can be markedly improved using chemical shift imaging.

Animals

Liver and pancreas: improved spin-echo T1 contrast by shorter echo time and fat suppression at 1.5 T.

T1-weighted spin-echo magnetic resonance (MR) images have had limited soft-tissue contrast at 1.5 T. The authors investigated the effects of echo-time (TE) minimization and fat suppression on MR images of the liver and pancreas. Two sets of MR images were obtained with identical repetition times and other parameters. In 10 subjects with seven liver lesions, images with TEs of 20 and 12 msec were compared. In 18 additional subjects with seven liver lesions and five pancreatic carcinomas, images with identical TEs but with and without fat suppression were compared. Contrast-to-noise ratios (CNRs) were greater with a TE of 12 msec than with a TE of 20 msec for liver versus spleen (7.6 vs 4.9, P = .014) and liver versus lesion (6.9 vs 3.9, P = .031). In patients without fatty liver, CNR for six lesions versus liver was greater (9.5 vs 6.0, P = .014) with fat suppression. CNR between glandular pancreas and cancer was most conspicuous with fat suppression, but fat planes were less distinct. Minimization of TE improves T1-weighted images significantly. Fat suppression also improves CNR, but the disadvantages of fat suppression do not allow elimination of conventional T1-weighted images.

Fatty Liver

Comparison of Kaopectate with barium for negative and positive enteric contrast at MR imaging.

In an evaluation of safe, inexpensive, orally administered contrast agents for use at magnetic resonance imaging, different concentrations of the clay agents kaolin-pectate and attapulgite were compared in an in vitro phantom by performing spin-echo imaging with variable echo times to estimate T2 relaxation time. Additional phantoms containing from 0% to 100% attapulgite or barium preparations were compared by using spin-echo and spoiled-gradient-echo techniques to estimate T1, T2, and T2* relaxation times. In vivo spin-echo and gradient-echo images were obtained of 10 healthy volunteers and of five patients with pancreatic disease after oral administration of 12-16 oz of attapulgite preparation. T1 and T2 relaxation times obtained with use of attapulgite were slightly lower than those obtained with kaolin-pectate at both 50% and 25% concentrations. Compared with barium, attapulgite had shorter T1, T2, and T2* relaxation times, and concentration-dependent relaxivity was greater by nearly an order of magnitude. All subjects were able to drink the attapulgite, and the only complaints were of bad taste and mildly loose stools.

Barium Sulfate

Fatty liver. Chemical shift phase-difference and suppression magnetic resonance imaging techniques in animals, phantoms, and humans.

In vitro animal and human models were used to evaluate the potential of chemical shift magnetic resonance imaging (MRI) for assessing fatty liver. Phantoms of varying fat content were created from mayonnaise-agar preparations. Fatty liver was induced in eight rats by feeding them ethanol for three to six weeks (36% of total calories), whereas eight control rats were fed a normal diet. T1-weighted in-phase and opposed-phase MR images were obtained of the phantoms animals, and 28 human subjects. Additional images obtained in animals included long TR images with in-phase and opposed-phase technique, and hybrid chemical shift water and fat suppression. The rats were killed and histologic status was graded blindly by a hepatopathologist as normal, mild, moderate, or severe fatty change, for correlation with MR grading. Quantitative analysis of MR images included fat signal fraction for animals, and relative signal decrease between in-phase and opposed-phase images for phantom and human data. Phantom in-phase signal increased linearly with respect to fat content, whereas opposed-phase signal decreased linearly. MRI and histologic grading of rat livers were highly correlated, especially when based on water suppression images (r = 0.91, P = .0001). Opposed-phase images were also highly correlated, while fat suppression images were less effective. There was no overlap between MR-derived fat fractions for control (2.6%-5.7%) versus ethanol-fed rats (7.7%-17.9%, P = .0002). Human liver considered to be fatty by visual inspection (n = 8) had higher relative signal decrease than nonfatty liver (n = 22) (P less than .001). Phantom, animal, and human data demonstrate that comparison of T1-weighted in-phase and opposed-phase images is both practical and sensitive in the detection and grading of fatty liver.

Adult

MR imaging of pulmonary parenchyma and emboli by paramagnetic and superparamagnetic contrast agents.

Using experimentally induced pulmonary emboli in an animal model, three intravenously administered contrast agents, Gd-DTPA-albumin microspheres (8-15 microns, 0.2 M particles/mg protein, 39-106 micrograms Gd/mg, 50 mg/ml), Gd-DTPA-liposomes (15-30 microns, 130 micrograms/mg lipid, 6 mg Gd/ml) and superparamagnetic ferrosome, (60 nm, 100 mM iron and 20 mg lipid/ml) were examined for MR imaging. Gd-DTPA entrapped in lung capillaries did not enhance the signal intensity of lung parenchyma, but liposomes (5 ml) served as better Gd-DTPA carriers and increased the parenchymal signal intensity by up to a factor of 2.3. However, neither agent improved delineation of pulmonary emboli. Ferrosome decreased the intensity of lung parenchyma, improving detectability of pulmonary emboli by several factors.

Animals

Bone marrow findings on magnetic resonance images of the knee: accentuation by fat suppression.

Long TR/double spin-echo magnetic resonance images of the knee were obtained with and without the use of fat suppression techniques in seven patients with high signal intramedullary lesions. Comparison between images was performed qualitatively and quantitatively. Contrast-to-noise ratios between focal defects and surrounding fatty marrow were higher with fat suppression in all cases. The mean contrast-to-noise ratio for images obtained with fat suppression was 53.6, while for images obtained without fat suppression the mean contrast-to-noise ratio was 17.3 (p less than 0.01).

Adipose Tissue

Variable flip angle imaging and fat suppression in combined gradient and spin-echo (GREASE) techniques.

Conventional "proton density" and "T2-weighted" spin-echo images are susceptible to motion induced artifact, which is exacerbated by lipid signals. Gradient moment nulling can reduce motion artifact but lengthens the minimum TE, degrading the "proton density" contrast. We designed a pulse sequence capable of optimizing proton density and T2-weighted contrast while suppressing lipid signals and motion induced artifacts. Proton density weighting was obtained by rapid readout gradient reversal immediately after the excitation RF pulse, within a conventional spin-echo sequence. By analyzing the behavior of the macroscopic magnetization and optimizing excitation flip angle, we suppressed T1 contribution to the image, thereby enhancing proton density and T2-weighted contrast with a two- to four-fold reduction of repetition time. This permitted an increased number of averages to be used, reducing motion induced artifacts. Fat suppression in the presence of motion was investigated in two groups of 8 volunteers each by (i) modified Dixon technique, (ii) selective excitation, and (iii) hybrid of both. Elimination of fat signal by the first technique was relatively uniform across the field of view, but it did not fully suppress the ghosts originating from fat motion. Selective excitation, while sensitive to the main field inhomogeneity, largely eliminated the ghosts (0.21 +/- 0.05 vs. 0.29 +/- 0.06, p less than 0.01). The hybrid of both techniques combined with bandwidth optimization, however, showed the best results (0.17 +/- 0.04, p less than 0.001). Variable flip-angle imaging allows optimization of image contrast which, along with averaging and effective fat suppression, significantly improves gradient- and spin-echo imaging, particularly in the presence of motion.

Adipose Tissue

Optimization of gradient-echo imaging parameters for intracaval filters and trapped thromboemboli.

Flow-phantom magnetic resonance (MR) gradient-echo (GRE) imaging at 1.5 T was performed on a titanium Greenfield filter containing trapped blood clots with a high concentration of either deoxyhemoglobin (DHb) or methemoglobin (MHb), simulating acute and older thromboemboli, respectively. Flip angle, repetition time (TR), and echo time (TE) were varied, and a contrast-to-noise ratio between trapped clots and flowing fluid (clot-flow contrast) was determined for each set of imaging parameters. Use of very low flip angles (less than or equal to 10 degrees) rendered MHb clots indistinguishable from flowing fluid. In general, DHb clots displayed greater clot-flow contrast than MHb clots regardless of flip angle. With increasing TE values, T2* effect was observed with MHb clots, and magnetic susceptibility artifacts increased. Overall, optimum clot-flow contrast for imaging of both DHb and MHb clots was achieved with a flip angle of 45 degrees-60 degrees, a TR of 50 msec, and the shortest TE possible. Using GRE parameters similar to the optimum parameters determined in vitro, the authors imaged four patients with nickel-titanium Simon filters and one dog with a titanium Greenfield filter. MR imaging was successful in demonstrating filter location, caval patency, and the presence and extent of intraluminal thrombus.

Adult

Magnetic resonance imaging of bone marrow: diagnostic value in diffuse hematologic disorders.

Magnetic resonance imaging (MRI) has value in characterizing normal and abnormal bone marrow because of its ability to distinguish fat from other tissues. Due to this advantage, hematologic disorders resulting in alterations of the normal cellular and fatty marrow distribution can be appreciated. In this article, the role of MRI in diffuse hematologic disorders is emphasized. At birth, almost all marrow is cellular, but by age 25, cellular marrow is restricted to the axial skeleton and proximal femoral and humeral metaphysis. The remainder is fatty, consisting of 80% fat, 15% water, and 5% protein. With increased need for hematopoiesis, reconversion from fatty to cellular marrow occurs in many diffuse disease states. Diffuse diseases that affect bone marrow production are divided into four categories representing conditions that affect the pluripotent hematopoietic stem cell. These include stem cell failure resulting in aplastic anemia, uncontrolled stem cell proliferation as exemplified by polycythemia vera, stem cell dysplasia such as sickle cell anemia, and malignant transformations or replacement. The MRI appearance of these disorders is discussed in this article. The use of spin-echo (SE) sequences is the most common approach to bone marrow imaging. With T1-weighted SE images, fatty marrow will appear bright and cellular marrow, with lower fat content, will exhibit a lower density signal. With T2-weighted SE pulse sequences, contrast between fatty marrow and cellular marrow decreases. Contrast between fatty and cellular marrow is enhanced with chemical shift imaging, including Dixon out-of-phase imaging, as emphasized in this article. MRI presents a more global view of the bone marrow than biopsy material and should provide a better understanding of diffuse hematologic disease progression and resolution.

Bone Marrow

Recent advances in magnetic resonance imaging of the knee.

The examination of the knee has rapidly become the most important non-neurologic application of MR imaging. The widespread availability of high signal-to-noise knee coils has made routine imaging with T2-weighted sequences in both coronal and sagittal planes possible in 30 minutes. The spin-echo sequence remains the most important imaging technique, although many newer sequences have also been applied to the knee, with varying degrees of success. Important pitfalls in diagnosis, such as high signal intensity in the posterior horn of the medial meniscus and the transverse meniscal ligament, displaced buckethandle meniscal tears, and discoid menisci, can be recognized with experience. Common clinical problems that are encountered include meniscal cysts, osteonecrosis, and bone bruises. Detection of subtle injuries of the medial collateral ligament, patellar tendon, and anterior cruciate ligament requires careful observation. Intra-articular loose bodies can be reliably detected with MR imaging, and it should be recognized that localized pigmented villonodular synovitis can sometimes simulate the appearance of a loose body. MR imaging is a valuable noninvasive procedure that is complementary to arthroscopy in the evaluation of diseases of the knee.

Humans

Hybrid methods of chemical-shift imaging.

We propose a family of hybrid chemical-shift sequences which combines two physical principles for water/lipid separation to minimize artifacts introduced by B0 and B1 inhomogeneities. Hybrid sequences provide improved species discrimination over earlier methods without resorting to postprocessing while maintaining a multislice/multiecho capability.

Abdomen

Variable-flip-angle spin-echo MR imaging of the pelvis: more versatile T2-weighted images.

Dependence on T1 contrast can be reduced by changing the excitation flip angle. The authors compared T2-weighted spin-echo images (with 30 degrees and 90 degrees flip angles) of the male and female pelvis in 22 individuals. In six women imaged with a 1,000/80 sequence (repetition time msec/echo time msec), signal difference-to-noise ratios (SD/Ns) were higher with a 30 degree flip angle than with a 90 degree angle for urine/fat (mean, 15.2 vs -6.2; P less than .05) and endometrium/myometrium (13.8 vs 9.0, P less than .05). In eight additional examinations, a 1,000/80 sequence with a 30 degree flip angle and two signal averages had less motion artifact (1.2 vs 2.7, P less than .01) than a 2,000/80 sequence with a 90 degree angle and one signal average (4.5 minutes each); SD/Ns were similar. In a third series of experiments, contiguous sections without cross talk, obtained by interleaving two 1,000/100, 30 degrees-flip-angle acquisitions, had better contrast than contiguous sections obtained at 2,400/100 with a 90 degree flip angle (10 minutes each), with SD/Ns of urine/fat of 28.5 versus 16.1 (P less than .01) and SD/Ns of endometrium/myometrium of 15.5 versus 7.8 (P less than .05). Reducing the flip angle can improve examination time, contrast, or motion artifact suppression or eliminate cross talk in T2-weighted spin-echo MR imaging of the pelvis.

Female

Sampling bandwidth and fat suppression: effects on long TR/TE MR imaging of the abdomen and pelvis at 1.5 T.

In MR imaging, the sampling bandwidth is the rate at which the signal is digitized by the analog-to-digital converter. Reducing the sampling bandwidth can decrease noise in long TE images at the expense of increases in the artifacts of chemical-shift misregistration and motion. We compared 39 pairs of axial images with bandwidths of 32 kHz and 8-10 kHz. In 23 of these comparison studies (six female pelvis, seven male pelvis, 10 abdomen), all other variables were held constant, and in 16 comparisons (10 female pelvis, six male pelvis), signal from fat was suppressed in images with reduced bandwidth. Six patients with 11 liver lesions were included in those undergoing abdominal imaging. In three patients, fat was suppressed in images of the abdomen. The contrast-to-noise ratio was greater with reduced bandwidth for urine vs fat (24.5 vs 17.2; p less than .05) and central vs peripheral parts of the prostate gland (34.1 vs 22.7; p less than .02). In the abdomen, the contrast-to-noise ratio was increased between liver and right kidney (36.6 vs 25.2; p less than .01) and between liver and lesion (30.2 vs 18.2; p less than .005), but the motion-induced artifact was worse. An increase in chemical-shift misregistration did not affect the appearance of the internal structure of the uterus, prostate gland, or liver, but it made examination of the ovaries, seminal vesicles, and extrahepatic tissues difficult. The chemical-shift artifact in pelvic images could be eliminated by suppressing signal from fat with frequency-selective saturation pulses, but results were less satisfactory in the abdomen. When reduced bandwidth and fat suppression were combined, the contrast-to-noise ratio was improved for endometrium vs myometrium (22.9 vs 15.2; p less than .05) and central vs peripheral parts of the prostate gland (62.7 vs 28.5; p less than .02). Reduction of the sampling bandwidth is a promising technique for imaging the pelvis with small field of view and long TR/TE, but it currently appears less promising for images in the upper abdomen at 1.5 T. The increased chemical-shift artifact caused by reduced bandwidth can be eliminated by suppressing signal from fat.

Abdomen

Assessment of lung water by magnetic resonance in three types of pulmonary edema.

Pulmonary edema was produced in nine mongrel dogs by: (a) saline lavage; (b) intravenous injection of oleic acid; and (c) intravenous injection of propranolol followed by ureteral ligation. The resulting effect could be characterized by varying the protein concentration in the pulmonary edema fluid. After induction, all dogs were killed and 20 samples from each passively deflated lung were obtained. Proton T1 and T2 values were measured on a Praxis II NMR spectrometer operated at 10.7 MHz and 37 degrees C. The water content of all samples was determined gravimetrically. Correlation between T1 or T2 measured in vitro and the ratio of wet to dry weight was highly significant (r greater than 0.95, P less than 0.001) in each pathological state. Regression curves indicate that although all three types of pulmonary edema can be characterized by slightly different slopes, the differences are statistically insignificant. Moreover, the slopes of previous studies, when recast in the same format, are very similar to our findings despite the use of different magnetic field strengths and different animal models. This study indicates that quantitation of pulmonary edema is possible, but in vitro measurements do not give useful information for characterizing the etiology of pulmonary edema.

Animals

Low-artifact intravascular devices: MR imaging evaluation.

Flow-phantom magnetic resonance (MR) imaging, with use of both spin-echo (SE) and gradient-echo (GRE) techniques at 1.5 T, was performed on the percutaneous Greenfield (beta-III titanium alloy [TMA wire]), Amplatz (MP32-N alloy), and Simon nitinol filters and TMA wire facsimiles of the bird's nest, Gunther, new retrievable, and Amplatz vena caval filters. SE imaging allowed detection of thrombi as small as 5 X 5 mm trapped within the percutaneous Greenfield, Simon nitinol, and TMA-wire facsimile filters; with the MP32-N Amplatz filter, a larger volume of thrombus (10 X 20-mm clots) was necessary for clot detection. GRE imaging allowed detection of intraluminal tilting of the percutaneous Greenfield and facsimile Amplatz (TMA-wire) filters. GRE imaging was useful for demonstrating postfilter turbulence due to clots, which was greatest for the Amplatz filter. Imaging of facsimile vascular devices made of tantalum or TMA wire did not cause the severe "black-hole" MR artifacts typical of the stainless-steel devices. SE and GRE imaging were very useful for determining caval patency in two patients with previously placed Mobin-Uddin filters. Noninvasive MR evaluation of blood vessels in the presence of a variety of low-artifact intravascular devices appears feasible.

Blood Vessel Prosthesis