In vivo measurement of myocardial mass using nuclear magnetic resonance imaging

To examine the accuracy of nuclear magnetic resonance imaging in measuring left ventricular mass, measurements of left ventricular mass made using this technique were compared with left ventricular weight in 10 mongrel dogs. Left ventricular myocardial volume was measured from five short-axis end-diastolic images that spanned the left ventricle. Left ventricular mass was calculated from left ventricular myocardial volume and compared with the left ventricular weight determined after formalin immersion-fixation. Linear regression analysis yielded the following relation in grams: left ventricular mass determined using nuclear magnetic resonance imaging = (0.94) (left ventricular weight) + 9.1 (r = 0.98, SEE = 6.1 g). The small overestimation of left ventricular weight by nuclear magnetic resonance imaging was judged to be secondary to both difficulty with proper border definition and partial volume effects. Hence, this imaging technique can be used to obtain accurate measurements of left ventricular mass in dogs in vivo.     

Regional pulmonary response to a methacholine challenge using hyperpolarized 3He magnetic resonance imaging

Background and objective: Spirometry is insensitive to small airway abnormalities in asthma. Our objective was to evaluate regional lung structure and function using hyperpolarized ³He magnetic resonance imaging (MRI) before, during and after a methacholine challenge (MCh). Methods: Twenty‐five asthmatics (mean age = 34 ± 11 years) and eight healthy volunteers (HV) (mean age = 33 ± 11 years) underwent spirometry, plethysmography and hyperpolarized ³He MRI prior to a MCh. MRI was repeated following the MCh and again 25 min after salbutamol administration. ³He MRI gas distribution was quantified using semiautomated segmentation of the ventilation defect percent (VDP). Tissue microstructure was measured using the ³He apparent diffusion coefficient (ADC). Analysis of variance with repeated measures was used to evaluate changes at each time point as well as to determine interactions between regions of interest (ROI) and subject group. Pearson's correlations were performed to evaluate associations between ³He MRI measurements and established clinical measures. Results: In asthmatics, but not HV, whole‐lung ADC was increased post‐MCh (P < 0.01). In asthmatics only, ADC was increased post‐MCh in posterior ROI (P < 0.01) and all ROI in the superior‐inferior direction (P < 0.01). VDP was increased in posterior and inferior ROI (P < 0.001). There was a correlation between VDP and specific airway resistance (r = 0.74, P < 0.0001), dyspnoea score (r = 0.66, P < 0.01) and fractional exhaled nitric oxide (r = 0.45, P < 0.05). Conclusions: We evaluated the regional pulmonary response to methacholine and salbutamol using ³He MRI and showed heterogeneous VDP and ADC consistent with bronchoconstriction and gas trapping, respectively, post‐MCh. These regional alterations resolved post‐salbutamol.     

重度颅内动脉狭窄活体高分辨磁共振成像初探

目的 观察症状性重度颅内动脉狭窄(SSIS)活体高分辨磁共振成像(HRMRI)的初探结果.方法 用3.0T MR扫描仪对5例SSIS患者进行HRMRI检查,盲法分析影像资料.结果 3例管壁呈典型的粥样硬化改变,呈偏心性增厚、大的脂质坏死核心、纤维帽破裂、不均匀强化.2例管壁为非粥样硬化可能性大,1例管腔内可见斜形隔膜与轻度增厚的管壁相连,增强后呈均匀强化;另1例管壁向心性明显增厚,增强后无强化.结论 SSIS的活体HRMRI成像是可行的,能够提供狭窄处的管壁信息,但仍需进一步研究其应用价值.     

In vivo detection of reperfused myocardium by nuclear magnetic resonance imaging

To assess the potential of in vivo nuclear magnetic resonance imaging for the detection of reperfused myocardium, in vivo T2-weighted spin echo images were obtained of dogs at 0.15 tesla. Imaging was done during 3 hours of coronary occlusion (group I), and during 3 hours of coronary occlusion followed by 1 hour of reperfusion (group II). On sacrifice, the hearts were drained of blood and imaged in situ to determine the effect of in vivo imaging on myocardial signal intensity. The hearts were then excised and imaged at 1.4 tesla to compare the effect of high resolution imaging on image quality. Of the six hearts in group I and the eight hearts in group II with a myocardial infarction and suitable image quality, four of the former hearts and six of the latter demonstrated a small but visible increase in infarct signal intensity at 3 hours of occlusion on the time to echo [TE] = 60 ms, single echo images. The T2 (transverse) relaxation time of the infarct (measured in vitro by spectrometer) increased by 13% when compared with normal tissue. In contrast, the reperfused infarct was more easily visualized, with signal intensity increasing by 31 +/- 17% and infarct T2 increasing by 20%. Imaged at 1.4 tesla, the excised hearts showed the infarct to be subendocardial during occlusion and extending transmurally with reperfusion. It is concluded that, although visualized, the increase in infarct signal intensity at 3 hours of coronary occlusion is small and this is consistent with the small increase in infarct signal intensity and T2 relaxation.(ABSTRACT TRUNCATED AT 250 WORDS)     

In vivo heating of pacemaker leads during magnetic resonance imaging.

AIMS: Magnetic resonance imaging (MRI) is well established as an important diagnostic tool in medicine. However, the presence of a cardiac pacemaker is usually regarded as a contraindication for MRI due to safety reasons. In this study, heating effects at the myocardium-pacemaker lead tip interface have been investigated in a chronic animal model during MRI at 1.5 Tesla. METHODS AND RESULTS: Pacemaker leads with additional thermocouple wires as temperature sensors were implanted in nine animals. Temperature increases of up to 20 degrees C were measured during MRI of the heart. Significant impedance and minor stimulation threshold changes could be seen. However, pathology and histology could not clearly demonstrate heat-induced damage. CONCLUSIONS: MRI may produce considerable heating at the lead tip. Changes of pacing parameters due to MRI could be seen in chronic experiments. Potential risk of tissue damage cannot be excluded even though no reproducible alterations at the histological level could be found.     

Real-time vascular interventional magnetic resonance imaging

Endovascular stent-graft placement is emerging as a promising alternative to medical and surgical treatment of patients with diseases of the descending thoracic and abdominal aorta. Precise placement of the stentgraft, which is currently performed under x-ray control, remains, however, challenging as there are several shortcomings to fluoroscopic guidance beyond that related to the harmful effect of radiation exposure and nephrotoxic contrast media. While transesophageal echocardiography and intravascular ultrasound have been used as adjunct imaging modalities during endovascular stent-graft procedures to overcome the limitations of angiography, these techniques have not mitigated the need for fluoroscopy.Magnetic resonance imaging (MRI) guidance of vascular interventional procedures offers several potential advantages over fluoroscopy-guided techniques, including image acquisition in any desired orientation, superior 3D soft-tissue contrast with simultaneous visualization of the interventional device, absence of ionizing radiation, and avoidance of nephrotoxic contrast media. Magnetic resonance imaging is often used for pre-operative diagnosis of aortic disease and can provide all relevant information for the planning of endovascular stent-graft procedures as well as for accurate and immediate post-interventional evaluation. However, visualization of interventional instruments by MRI has proven to be the chief obstacle. This article will review current approaches that have been developed for depicting vascular instruments by MRI and will also discuss the first experimental experiences with MRI-guided endovascular stent-graft placement in a swine model of aortic dissection.     

In vivo nuclear magnetic resonance imaging of myocardial perfusion using the paramagnetic contrast agent manganese gluconate

Previous nuclear magnetic resonance (NMR) imaging studies have indicated that coronary occlusion does not produce sufficient changes in standard tissue relaxation times to allow the detection of acute ischemia. To identify acute myocardial perfusion abnormalities, the use of the paramagnetic agent manganese gluconate combined with calcium gluconate (MnGlu/CaGlu) was investigated in canine models of acute coronary artery occlusion. In vitro studies showed that MnGlu/CaGlu was a more efficient relaxing agent than gadolinium-DTPA (relaxivity of 7.8 versus 5.1 s-1 mM-1) and demonstrated affinity for normal myocardium. The distribution of MnGlu/CaGlu as measured by manganese-54 tracer studies was proportional to myocardial blood flow in both normal and ischemic tissue. Hearts excised from dogs after coronary artery occlusion and administration of 0.035 mM/kg MnGlu/CaGlu were imaged ex vivo using a relatively spin-lattice relaxation time (T1)-weighted gradient reversal technique (repetition time [TR] 50 ms and echo time [TE] 9 ms). These images showed increased signal intensity in the normally perfused myocardium with a mean signal intensity ratio of hypoperfused to normal myocardium of 0.55 +/- 0.12 (mean +/- SD). In vivo images obtained in nine dogs after coronary artery occlusion and administration of the same dose of MnGlu/CaGlu demonstrated the region of hypoperfused myocardium in six dogs with a signal intensity ratio of hypoperfused to normal myocardium of 0.64 +/- 0.23 (p less than 0.05 versus control). When a higher dose of 0.1 mM/kg MnGlu/CaGlu was utilized and in vivo imaging was performed using a relatively spin-spin relaxation time (T2)-weighted (TR gated, TE 60 ms) spin-echo sequence in six dogs, the signal intensity of normal myocardium was decreased.(ABSTRACT TRUNCATED AT 250 WORDS)     

In vivo nuclear magnetic resonance chemical shift imaging by selective irradiation.

NMR images of preselected chemically shifted species can be obtained by selective irradiation of the remainder of the NMR chemical shift spectrum prior to application of a conventional NMR imaging sequence. The chemical-selective irradiation consists of narrow-bandwidth pi/2 or saturation radio-frequency pulses applied in the absence of imaging gradients. The technique permits substantial reductions in scan and reconstruction times over standard three- and four-dimensional Fourier transform chemical-shift-imaging methods, when images of few spectral peaks are desired. It is also suitable for the elimination of chemical shift artifacts in conventional high-field NMR imaging. In vivo applications of the technique to the head and limbs in a 1.5-T magnetic field yield 1H H2O and -CH2-images, with little detectable -CH2- in muscle and brain.     

In vivo magnetic resonance imaging of experimental thrombosis in a rabbit model

The process of atherosclerotic plaque disruption has been difficult to monitor because of the lack of an animal model and the limited ability to directly visualize the plaque and overlying thrombus in vivo. Our aim was to validate in vivo magnetic resonance imaging (MRI) of the thrombus formation after pharmacological triggering of plaque disruption in the modified Constantinides animal model of plaque disruption. Atherosclerosis was induced in 9 New Zealand White male rabbits (3 kg) with aortic balloon endothelial injury followed by a high cholesterol (1%) diet for 8 weeks. After baseline (pretrigger) MRI, the rabbits underwent pharmacological triggering with Russell's viper venom and histamine, followed by another MRI 48 hours later. Contiguous cross-sectional T2-weighted fast spin echo images of the abdominal aorta were compared by histopathology. In all animals, aortic wall thickening was present on the pretrigger MRI. On MRIs performed 48 hours after triggering, a histologically confirmed intraluminal thrombus was visualized in 6 (67%) of the 9 animals. MRI data correlated with the histopathology regarding aortic wall thickness (R=0.77, P<0.0005), thrombus size (R=0.82, P<0.0001), thrombus length (R=0.86, P<0.005), and anatomic location (R=0.98, P<0.0001). In vivo, MRI reliably determines the presence, location, and size of the thrombus in this animal model of atherosclerosis and plaque disruption. The combination of in vivo MRI and the modified Constantinides animal model could be an important research tool for our understanding of the pathogenesis of acute coronary syndromes.     

In vivo magnetomotive optical molecular imaging using targeted magnetic nanoprobes

Dynamic magnetomotion of magnetic nanoparticles (MNPs) detected with magnetomotive optical coherence tomography (MM-OCT) represents a new methodology for contrast enhancement and therapeutic interventions in molecular imaging. In this study, we demonstrate in vivo imaging of dynamic functionalized iron oxide MNPs using MM-OCT in a preclinical mammary tumor model. Using targeted MNPs, in vivo MM-OCT images exhibit strong magnetomotive signals in mammary tumor, and no significant signals were measured from tumors of rats injected with nontargeted MNPs or saline. The results of in vivo MM-OCT are validated by MRI, ex vivo MM-OCT, Prussian blue staining of histological sections, and immunohistochemical analysis of excised tumors and internal organs. The MNPs are antibody functionalized to target the human epidermal growth factor receptor 2 (HER2 neu) protein. Fc-directed conjugation of the antibody to the MNPs aids in reducing uptake by macrophages in the reticulo-endothelial system, thereby increasing the circulation time in the blood. These engineered magnetic nanoprobes have multifunctional capabilities enabling them to be used as dynamic contrast agents in MM-OCT and MRI.     

Current applications of magnetic resonance vascular imaging

A wide variety of MRI techniques is available for vascular imaging, each exploiting a different property of flowing blood to achieve contrast. These include spin-echo, which has been used for the diagnosis of aortic dissection and of great vessel anomalies, as well as for the evaluation of pulmonary flow in patients with pulmonary hypertension and pulmonary embolism. Spin echo excels in detecting infection and hematoma in the tissues around grafts and vessels. Phase display imaging has proven useful in differentiating signal of slow flow from that of intravascular thrombus. Imaging of peripheral vessels can be achieved with gradient refocused sequences, which provide bright intravascular signal over a wide range of flow velocities. These sequences may be combined with subtraction strategies to eliminate the signal from stationary tissues in order to generate an angiographic image. The advent of three-dimensional MR angiographic imaging techniques provides an effective way to display peripheral vessels. Early experience implies that MR angiography will play an important role in vascular imaging in the future, provided that the signal loss from turbulent flow can be minimized.     

Myocardial material property determination in the in vivo heart using magnetic resonance imaging

Objectives: To determine nonlinear material properties of passive, diastolic myocardium using magnetic resonance imaging (MRI) tissue-tagging, finite element analysis (FEA) and nonlinear optimization.Background: Alterations in the diastolic material properties of myocardium may pre-date the onset of or exist exclusive of systolic ventricular dysfunction in disease states such as hypertrophy and heart failure. Accordingly, significant effort has been expended recently to characterize the material properties of myocardium in diastole. The present study defines a new technique for determining material properties of passive myocardium using finite element (FE) models of the heart, MRI tissue-tagging and nonlinear optimization. This material parameter estimation algorithm is employed to estimate nonlinear material parameters in thein vivo canine heart and provides the necessary framework to study the full complexities of myocardial material behavior in health and disease.Methods and results: Material parameters for a proposed exponential strain energy function were determined by minimizing the least squares difference between FE model-predicted and MRI-measured diastolic strains. Six mongrel dogs underwent MRI imaging with radiofrequency (RF) tissue-tagging. Two-dimensional diastolic strains were measured from the deformations of the MRI tag lines. Finite element models were constructed from early diastolic images and were loaded with the mean early to late left ventricular and right ventricular diastolic change in pressure measured at the time of imaging. A nonlinear optimization algorithm was employed to solve the least squares objective function for the material parameters. Average material parameters for the six dogs wereE=28,722 ± 15,984 dynes/cm² andc=0.00182 ± 0.00232 cm²/dyne.Conclusion: This parameter estimation algorithm provides the necessary framework for estimating the nonlinear, anisotropic and non-homogeneous material properties of passive myocardium in health and disease in thein vivo beating heart.     

Measurement of left ventricular mass in vivo using gated nuclear magnetic resonance imaging

Alterations of left ventricular mass occur in a variety of congenital and acquired heart diseases. In vivo determination of left ventricular mass, using several different techniques, has been previously reported. Problems inherent in some previous methods include the use of ionizing radiation, complicated geometric assumptions and invasive techniques. We tested the ability of gated nuclear magnetic resonance imaging to determine in vivo left ventricular mass in animals. By studying both dogs (n = 9) and cats (n = 2) of various sizes, a broad range of left ventricular mass (7 to 133 g) was examined. With a 0.5 tesla superconducting nuclear magnetic resonance imaging system the left ventricle was imaged in the transaxial plane and multiple adjacent 10 mm thick slices were obtained. Endocardial and epicardial edges were manually traced in each computer-displayed image. The wall area of each image was determined by computer and the areas were summed and multiplied by the slice thickness and the specific gravity of muscle, providing calculated left ventricular mass. Calculated left ventricular mass was compared with actual postmortem left ventricular mass using linear regression analysis. An excellent relation between calculated and actual mass was found (r = 0.95; SEE = 13.1 g; regression equation: magnetic resonance mass = 0.95 X actual mass + 14.8 g). Intraobserver and interobserver reproducibility were also excellent (r = 0.99). Thus, gated nuclear magnetic resonance imaging can accurately determine in vivo left ventricular mass in anesthetized animals.     

Diagnosing enteroceles using dynamic magnetic resonance imaging

PURPOSE: Enteroceles are in part difficult to detect but a frequent finding in pelvic floor disorders. The aim of this study was to evaluate magnetic resonance colpocystorectography in the diagnosis of enteroceles. METHODS: In this prospective study 11 volunteers and 55 patients with pelvic floor descent were examined. In addition to magnetic resonance colpocystorectography, a dynamic cystoproctography was performed on 34 patients. Opacification of organs was used. An enterocele was assessed in relationship to the pubococcygeal reference line (magnetic resonance colpocystorectography) or the width of the rectovaginal space (dynamic cystoproctography). A clinical gynecologic examination served as reference. RESULTS: The clinical examination diagnosed an enterocele in 43, magnetic resonance colpocystorectography in 49, and dynamic cystoproctography in 14 cases. Magnetic resonance colpocystorectography further subdivided the enteroceles according to their contents (mesenteric fat or fluid, 12; small bowel, 32, large bowel, 3; and rectosigmoidocele, 2). Magnetic resonance colpocystorectography proved statistically significantly superior to dynamic cystoproctography (15 cases) and the reference. Sensitivity and specificity of magnetic resonance colpocystorectography were 100 percent each. It was able to reveal clinically missed enteroceles as being peritoneoceles associated with a rectocele or a uterovaginal prolapse (10 cases). CONCLUSION: Magnetic resonance colpocystorectography is a promising method for diagnosis of enteroceles, because hernial canal, sac, and contents are reliably identified.Presented at Radiology 1998, Birmingham, United Kingdom, June 1 to 3, 1998.     

超顺磁性氧化铁标记间充质干细胞心肌移植的磁共振成像研究

目的探讨应用磁共振（MR）进行干细胞活体心肌内成像的可行性。方法从猪骨髓抽取、分离、培养间充质干细胞（MSC）,用含超顺磁性氧化铁纳米颗粒（铁羧葡胺）的DMEM培养液孵育24h,并用二脒基苯基吲哚（DAPI）和PKH。进行荧光标记。然后将MSC经心外膜直接注入猪急性梗死心肌内,每头猪注射3点。根据每注射点细胞数量以及细胞是否铁标记,12头猪随机分成4组：2×10^6标记细胞组（n=3）、1×10^6标记细胞组（n=3）、5×10^5标记细胞组（n=3）和1×10^6未标记细胞组（n=3）。细胞移植后20—24h行猪心脏1．5TMR成像,1h后处死并根据MR成像图像切取心肌组织行普鲁士蓝染色和免疫荧光检查。结果（1）体外标记：普鲁士蓝染色见标记MSC内大量蓝色颗粒,标记率为100％,电镜证实含铁囊泡位于胞质内。（2）MR成像：注射铁标记细胞的三组（9头猪）进行活体心脏快速小角度翻转梯度回波（T2·WI—Flash 2d）序列成像,发现移植部位均呈明显的低信号,而且注射点信号缺失区的面积大小与回波时间和移植细胞数量有关;而快速自旋回波（T2WI—FSE）序列成像仅隐约可见低信号区甚至难以辨认,但显示梗死病灶和猪心脏结构比T2·WI-Flash 2d序列清晰。未标记细胞组（3头猪）的9个注射点心肌壁均未显示MR低信号区。（3）组织学检查：MR成像低信号区心肌病理学检查见普鲁士蓝染色、DAPI和PKH26三重阳性细胞存在。结论应用磁共振对超顺磁性氧化铁标记的干细胞进行活体心肌内成像是可行的。