Mark J. Carvlin

Gadolinium enhanced MR imaging of vascular stents.

The feasibility of obtaining in-plane magnetic resonance (MR) vascular images in the presence of a vascular stent and the value of infusing an MR contrast agent during imaging was assessed. Coronal and sagittal MR imaging at 1.5 T was performed on six dogs with tantalum aortic stents using single-section gradient echo (GRE) imaging and MR angiography techniques before and during intravenous infusion of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). In-plane gradient echo (GRE) imaging and MR angiography clearly showed flow within the stented vessel as increased signal, with a minimum amount of stent-related artifact. Infusion of Gd-DTPA significantly increased the signal of flowing blood and allowed for better delineation of the stented aortic lumina. Our results demonstrate that in-plane GRE imaging and MR angiography can potentially be used as noninvasive methods for evaluating vascular patency in the presence of MR-compatible endovascular devices. In addition, Gd-DTPA infusion during MR vascular imaging clearly enhances the definition of flowing blood in the lumina of stented vessels.

Evaluation of ferromagnetism and magnetic resonance imaging artifacts of the Strecker tantalum vascular stent

A woven tantalum vascular stent (Strecker stent) was tested for ferromagnetism at 4.7 T and underwent magnetic resonance imaging (MRI)in vitro andin vivo at 1.5 T to evaluate the production of magnetic susceptibility artifacts. No ferromagnetism was detected. Spin-echo, phase reconstruction, and gradient echo images revealed a low level of susceptibility artifacts bothin vitro andin vivo. Our findings demonstrate the feasibility of using MRI to evaluate blood vessels noninvasively following tantalum stent placement.

Acute Tubular Necrosis: Use of Gadolinium-DTPA and Fast MR Imaging to Evaluate Renal Function in the Rabbit

Sequential fast magnetic resonance (MR) images (repetition time = 33 ms, echo time = 7 ms, alpha = 22 degrees, one image every 12 s) were acquired using gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) (10 or 100 mumol/kg) to study perfusion and concentrating ability in normal rabbit kidneys and in kidneys with HgCl2-induced acute tubular necrosis (ATN). In normal rabbits receiving 100 mumol Gd-DTPA/kg a concentric region of decreased MR signal was observed. In sequential images the dark ring pattern migrated centripetally through the kidney moving from the corticomedullary junction to the inner medulla. The decrease in MR signal intensity occurred as a consequence of T2 relaxation (magnetic susceptibility) due to high concentration of Gd-DTPA within the tubules. This suggests that the dark ring pattern may serve as a qualitative feature indicative of the ability of the kidneys to concentrate. With the onset of HgCl2-induced ATN the pattern of enhancement due to Gd-DTPA administration changed markedly. Although the kidneys with ATN did continue to be perfused, the concentric dark ring pattern seen in normal kidneys receiving 100 mumol Gd-DTPA/kg was not observed. These results suggest that Gd-DTPA and fast imaging MR may provide a method of assessing perfusion and concentrating ability within the healthy or diseased kidney.

MRI characterization of 9L-glioma in rat brain at 4.7 Tesla

In vivo estimation of intracranial tumor progression is important in tumor treatment response studies in animal models. High resolution MR images at 4.7 T of 9L-gliomas stereotactically implanted in Fisher-344 rat brains were obtained. Due to elongation of T1 at higher fields, tissue contrast is diminished in T1-weighted images. However, normal anatomy and vasogenic edema are clearly discerned in T2-weighted images (echo times of greater than 50 ms and recycle times of greater than 2 sec). Tumor tissue is not always clearly delineated. Images obtained after administration of contrast agents (Gadolinium DTPA), with short TR (0.6 sec) selectively enhanced the tumorous tissue, with little effect upon normal tissue and edema. Good correlation of enhanced tumor lesions has been observed with histological examination of formalin fixed brains. Relaxation times (T1 and T2) of tumor and normal tissues were measured using stimulated-echo and multi-echo sequences, respectively. Serial images corresponding to tumor growth were recorded, from which tumor volume progression was monitored.

Gadolinium-DTPA Enhanced Dynamic MR Imaging in the Evaluation of Cisplatinum Nephrotoxicity

Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) enhanced dynamic magnetic resonance (MR) imaging was used to monitor the nephrotoxic effects of cis-platinum (cis-diamminedichloroplatinum; CDDP), a chemotherapeutic agent that produces damage in the proximal convoluted tubule. Ten New Zealand white rabbits (NZWs) were divided into two groups and were evaluated at two clinically relevant doses of CDDP. Group 1 (four NZWs) received CDDP intravenously at 125 mg/m2 over 1 h. Rabbits in Group 2 (six NZWs) were infused with CDDP at 40 mg/m2 each day for 5 consecutive days. Dynamic MR images were performed in the axial plane at 1.5 T using a gradient recalled acquisition in the steady state sequence with an echo time of 11 ms, a repetition time of 20 ms, and a flip angle of 10° after a bolus injection of Gd-DTPA 0.1 mmol/kg. Thirty-two sequential post Gd-DTPA images (5.12 s/image) were obtained over 2 min 45 s at a single location. All rabbits underwent baseline normal and serial post CDDP Gd-DTPA enhanced dynamic MR scans. Analysis of the alterations in the normal pattern of renal enhancement caused by CDDP was facilitated by using a stacked profile image and quantitative region of interest measurements of signal intensity. Normally, after the injection of Gd-DTPA, a dark band promptly appears in the outer cortex of the kidneys and migrates centripetally toward the papilla, reflecting the tubular concentration of Gd-DTPA. In Group 1 rabbits, nephrotoxicity due to CDDP was observed as early as 9 h after administration of the drug, with a complete disappearance of the dark band by 7 days. In Group 2 rabbits, the band disappeared gradually and reappeared 2–10 days after the completion of CDDP treatment, indicative of tubular damage and recovery with return of the concentrating ability of the kidney. These results illustrate the feasibility of using Gd-DTPA dynamic MR as a sensitive monitor of drug induced alterations of renal function.

Fluorinated blood substitute retention in the rat measured by fluorine-19 magnetic resonance imaging.

RATIONALE AND OBJECTIVESnEmulsions of perfluorocarbons (PFCs) have been tested as blood substitutes. However, evidence exists that there is long-term retention of some PFCs by the organs of the reticuloendothelial system (RES). The authors investigate organ retention of the blood substitute component, perfluorotripropylamine (FTPA), using fluorine-19 (19F) magnetic resonance imaging (MRI).nnnMETHODSnVarious dosages of an emulsion of FTPA were administered to five rats. At intervals up to 86 weeks after infusion, 19F MRI was used to measure the amount of FTPA in liver and spleen. The data were fit to both linear and exponential elimination models, and organ retention half-lives were calculated.nnnRESULTSnThe exponential half-lives for combined liver and spleen FTPA ranged from 110 to 190 days. Linear half-lives ranged from 175 to 300 days.nnnCONCLUSIONSnFTPA retained by the liver and spleen may be quantified by 19F MRI: The half-lives that were measured are longer than those reported previously for FTPA.

An extended-length coil design for peripheral MR angiography

Magnetic resonance angiography of the peripheral vascular system has been hampered by the limited view provided by available imaging coils. We have constructed an extended-length, split-saddle design radiofrequency (rf) coil for peripheral angiography. The two coil halves are inductively coupled, to each other and to the rf source. Details regarding the construction of the coil and comparison of the performance with the knee coil are described here. This coil provides the benefit of a larger field of view but with image quality comparable to that of a commercial knee coil.

Contrast-agent-enhanced magnetic resonance imaging: early detection of neoplastic lesions of the CNS

Even though the intrinsic soft tissue contrast sensitivity of magnetic resonance imaging (MRI) affords excellent visualization of anatomic detail, certain pathologic processes may be diagnosed earlier with the administration of a contrast-enhancing agent. At present there is one agent, gadopentetate dimeglumine, GdDTPA, that has received FDA approval for use in the MR scanning of the brain and spine in human patients. This paramagnetic chelate distributes throughout the extracellular fluid space as dictated by capillary permeability so that abnormal vascularity and sites of blood-CNS barrier breakdown are highlighted. Primary neoplastic disease, metastases, meningeal extension, residual and recurrent tumor have been found to be better distinguished in MR images acquired after administration of GdDTPA. Routine administration of GdDTPA for cranial imaging has resulted in the discovery of otherwise occult lesions in approximately 3 of patients. Although the clinical utility and high therapeutic safety index of the first approved magnetic resonance contrast agent, GdDTPA, have been well established, other contrast agents, having different physical, chemical and biological properties, may offer improved sensitivity and bio-specificity. Agents currently being evaluated in vivo include: low osmolal paramagnetic chelates, superparamagnetic particles, metalloporphyrins, liposome encapsulated agents, perfluorocarbons, intravascular macromolecular chelate complexes and labeled monoclonal antibodies. Concurrent with advances in the development of new compounds, innovations in scanning hardware, pulse sequence design and image post-processing are helping to extend the efficacy of contrast media. Additional clinical experience will indicate which contrast agents and which MR techniques can best facilitate the early detection of specific neoplastic lesions.