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Sökning: AMNE:(MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Radiologi och bildbehandling) > Ståhlberg Freddy

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1.
  • Björkman-Burtscher, Isabella, et al. (författare)
  • Proton MR spectroscopy and preoperative diagnostic accuracy: an evaluation of intracranial mass lesions characterized by stereotactic biopsy findings
  • 2000
  • Ingår i: AJNR. - 1936-959X. ; 21:1, s. 84-93
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND PURPOSE: MR imaging has made it easier to distinguish among the different types of intracranial mass lesions. Nevertheless, it is sometimes impossible to base a diagnosis solely on clinical and neuroradiologic findings, and, in these cases, biopsy must be performed. The purpose of this study was to evaluate the hypothesis that proton MR spectroscopy is able to improve preoperative diagnostic accuracy in cases of intracranial tumors and may therefore obviate stereotactic biopsy. METHODS: Twenty-six patients with intracranial tumors underwent MR imaging, proton MR spectroscopy, and stereotactic biopsy. MR spectroscopic findings were evaluated for the distribution pattern of pathologic spectra (NAA/Cho ratio < 1) across the lesion and neighboring tissue, for signal ratios in different tumor types, and for their potential to improve preoperative diagnostic accuracy. RESULTS: Gliomas and lymphomas showed pathologic spectra outside the area of contrast enhancement while four nonastrocytic circumscribed tumors (meningioma, pineocytoma, metastasis, and germinoma) showed no pathologic spectra outside the region of enhancement. No significant correlation was found between different tumor types and signal ratios. MR spectroscopy improved diagnostic accuracy by differentiating infiltrative from circumscribed tumors; however, diagnostic accuracy was not improved in terms of differentiating the types of infiltrative or circumscribed lesions. CONCLUSION: MR spectroscopy can improve diagnostic accuracy by differentiating circumscribed brain lesions from histologically infiltrating processes, which may be difficult or impossible solely on the basis of clinical or neuroradiologic findings.
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2.
  • Larsson, Elna-Marie, et al. (författare)
  • MR-undersökning av hjärnan vid 3 tesla. Högre magnetfältsstyrka ger bättre morfologisk och funktionell bild
  • 2005
  • Ingår i: Läkartidningen. - 0023-7205. ; 102:7, s. 3-460
  • Tidskriftsartikel (refereegranskat)abstract
    • 3T MRI offers improved morphological and functional studies of the brain compared with the more commonly used field strength 1.5T. Clinical 3T MRI of the brain is beneficial for high resolution morphological imaging, MR angiography, diffusion-MRI including diffusion tensor imaging, perfusion-MRI, functional MRI (fMRI), and MR spectroscopy. The performance is enhanced by the combination with powerful magnetic field gradients.
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3.
  • Wirestam, Ronnie, et al. (författare)
  • Comparison of quantitative dynamic susceptibility-contrast MRI perfusion estimates obtained using different contrast-agent administration schemes at 3 T
  • 2010
  • Ingår i: European Journal of Radiology. - : Elsevier BV. - 0720-048X .- 1872-7727. ; 75:1, s. E86-E91
  • Tidskriftsartikel (refereegranskat)abstract
    • Absolute cerebral perfusion parameters were obtained by dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) carried out using different contrast-agent administration protocols. Sixteen healthy volunteers underwent three separate DSC-MRI examinations each, receiving single-dose (0.1 mmol/kg b.w.) gadobutrol, double-dose gadobutrol and single-dose gadobenate-dimeglumine on different occasions. DSC-MRI was performed using single-shot gradient-echo echo-planar imaging at 3 T. The arterial input functions (AIFs) were averages (4-9 pixels) of arterial curves from middle cerebral artery branches, automatically identified according to standard criteria. Absolute estimates of cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) were calculated without corrections for non-linear contrast-agent (CA) response in blood or for different T2* relaxivities in tissue and artery. Perfusion estimates obtained using single and double dose of gadobutrol correlated moderately well, while the relationship between estimates obtained using gadobutrol and gadobenate-dimeglumine showed generally lower correlation. The observed degree of CBV and CBF overestimation, compared with literature values, was most likely caused by different T2* relaxivities in blood and tissue in combination with partial-volume effects. The present results showed increased absolute values of CBV and CBF at higher dose, not predicted by the assumption of a quadratic response to contrast-agent concentration in blood. This indicates that the signal components of measured AIFs were not purely of arterial origin and that arterial signal components were more effectively extinguished at higher CA dose. This study also indicates that it may not be completely straightforward to compare absolute perfusion estimates obtained with different CA administration routines. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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4.
  • Carlsson, Marcus, et al. (författare)
  • Cardiac output and cardiac index measured with cardiovascular magnetic resonance in healthy subjects, elite athletes and patients with congestive heart failure
  • 2012
  • Ingår i: Journal of Cardiovascular Magnetic Resonance. - 1097-6647. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Cardiovascular Magnetic Resonance (CMR) enables non-invasive quantification of cardiac output (CO) and thereby cardiac index (CI, CO indexed to body surface area). The aim of this study was to establish if CI decreases with age and compare the values to CI for athletes and for patients with congestive heart failure (CHF). Methods: CI was measured in 144 healthy volunteers (39 +/- 16 years, range 21-81 years, 68 females), in 60 athletes (29 +/- 6 years, 30 females) and in 157 CHF patients with ejection fraction (EF) below 40% (60 +/- 13 years, 33 females). CI was calculated using aortic flow by velocity-encoded CMR and is presented as mean +/- SD. Flow was validated in vitro using a flow phantom and in 25 subjects with aorta and pulmonary flow measurements. Results: There was a slight decrease of CI with age in healthy subjects (8 ml/min/m(2) per year, r(2) = 0.07, p = 0.001). CI in males (3.2 +/- 0.5 l/min/m(2)) and females (3.1 +/- 0.4 l/min/m(2)) did not differ (p = 0.64). The mean +/- SD of CI in healthy subjects in the age range of 20-29 was 3.3 +/- 0.4 l/min/m(2), in 30-39 years 3.3 +/- 0.5 l/min/m(2), in 40-49 years 3.1 +/- 0.5 l/min/m(2), 50-59 years 3.0 +/- 0.4 l/min/m(2) and >60 years 3.0 +/- 0.4 l/min/m(2). There was no difference in CI between athletes and age-controlled healthy subjects but HR was lower and indexed SV higher in athletes. CI in CHF patients (2.3 +/- 0.6 l/min/m(2)) was lower compared to the healthy population (p < 0.001). There was a weak correlation between CI and EF in CHF patients (r(2) = 0.07, p < 0.001) but CI did not differ between patients with NYHA-classes I-II compared to III-IV (n = 97, p = 0.16) or patients with or without hospitalization in the previous year (n = 100, p = 0.72). In vitro phantom validation showed low bias (-0.8 +/- 19.8 ml/s) and in vivo validation in 25 subjects also showed low bias (0.26 +/- 0.61 l/min, QP/QS 1.04 +/- 0.09) between pulmonary and aortic flow. Conclusions: CI decreases in healthy subjects with age but does not differ between males and females. We found no difference in CI between athletes and healthy subjects at rest but CI was lower in patients with congestive heart failure. The presented values can be used as reference values for flow velocity mapping CMR.
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5.
  • Carlsson, Marcus, et al. (författare)
  • Quantification and visualization of cardiovascular 4D velocity mapping accelerated with parallel imaging or k-t BLAST: head to head comparison and validation at 1.5 T and 3 T
  • 2011
  • Ingår i: Journal of Cardiovascular Magnetic Resonance. - 1097-6647. ; 13:55
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Three-dimensional time-resolved (4D) phase-contrast (PC) CMR can visualize and quantify cardiovascular flow but is hampered by long acquisition times. Acceleration with SENSE or k-t BLAST are two possibilities but results on validation are lacking, especially at 3 T. The aim of this study was therefore to validate quantitative in vivo cardiac 4D-acquisitions accelerated with parallel imaging and k-t BLAST at 1.5 T and 3 T with 2D-flow as the reference and to investigate if field strengths and type of acceleration have major effects on intracardiac flow visualization. Methods: The local ethical committee approved the study. 13 healthy volunteers were scanned at both 1.5 T and 3 T in random order with 2D-flow of the aorta and main pulmonary artery and two 4D-flow sequences of the heart accelerated with SENSE and k-t BLAST respectively. 2D-image planes were reconstructed at the aortic and pulmonary outflow. Flow curves were calculated and peak flows and stroke volumes (SV) compared to the results from 2D-flow acquisitions. Intra-cardiac flow was visualized using particle tracing and image quality based on the flow patterns of the particles was graded using a four-point scale. Results: Good accuracy of SV quantification was found using 3 T 4D-SENSE (r(2) = 0.86, -0.7 +/- 7.6%) and although a larger bias was found on 1.5 T (r(2) = 0.71, -3.6 +/- 14.8%), the difference was not significant (p = 0.46). Accuracy of 4D k-t BLAST for SV was lower (p < 0.01) on 1.5 T (r(2) = 0.65, -15.6 +/- 13.7%) compared to 3 T (r(2) = 0.64, -4.6 +/- 10.0%). Peak flow was lower with 4D-SENSE at both 3 T and 1.5 T compared to 2D-flow (p < 0.01) and even lower with 4D k-t BLAST at both scanners (p < 0.01). Intracardiac flow visualization did not differ between 1.5 T and 3 T (p = 0.09) or between 4D-SENSE or 4D k-t BLAST (p = 0.85). Conclusions: The present study showed that quantitative 4D flow accelerated with SENSE has good accuracy at 3 T and compares favourably to 1.5 T. 4D flow accelerated with k-t BLAST underestimate flow velocities and thereby yield too high bias for intra-cardiac quantitative in vivo use at the present time. For intra-cardiac 4D-flow visualization, however, 1.5 T and 3 T as well as SENSE or k-t BLAST can be used with similar quality.
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6.
  • Hedström, Erik, et al. (författare)
  • Effects of gadolinium contrast agent on aortic blood flow and myocardial strain measurements by phase-contrast cardiovascular magnetic resonance
  • 2010
  • Ingår i: Journal of Cardiovascular Magnetic Resonance. - 1097-6647. ; 12
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Quantitative blood flow and aspects of regional myocardial function such as myocardial displacement and strain can be measured using phase-contrast cardiovascular magnetic resonance (PC-CMR). Since a gadolinium-based contrast agent is often used to measure myocardial infarct size, we sought to determine whether the contrast agent affects measurements of aortic flow and myocardial displacement and strain. Phase-contrast data pre and post contrast agent was acquired during free breathing using 1.5T PC-CMR. Results: For aortic flow and regional myocardial function 12 and 17 patients were analysed, respectively. The difference pre and post contrast agent was 0.03 +/- 0.16 l/min for cardiac output, and 0.1 +/- 0.5 mm for myocardial displacement. Linear regression for myocardial displacement (MD) after and before contrast agent (CA) showed MDpostCA = 0.95MD(preCA)+0.05 (r = 0.95, p < 0.001). For regional myocardial function, the contrast-to-noise ratios for left ventricular myocardial wall versus left ventricular lumen were pre and post contrast agent administration 7.4 +/- 3.3 and 4.4 +/- 8.9, respectively (p < 0.001). The contrast-to-noise ratios for left ventricular myocardial wall versus surrounding tissue were pre and post contrast agent administration -16.9 +/- 22 and -0.2 +/- 6.3, respectively (p < 0.0001). Conclusions: Quantitative measurements of aortic flow yield equal results both in the absence and presence of gadolinium contrast agent. The total examination time may thereby be reduced when assessing both viability and quantitative flow using PC-CMR, by assessing aortic flow post contrast agent administration. Phase-contrast information for myocardial displacement is also assessable both in the absence and presence of contrast agent. However, delineation of the myocardium may be difficult or impossible post contrast agent due to the lower image contrast. Acquisition of myocardial displacement should therefore be performed pre contrast agent using current PC-CMR sequences.
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7.
  • Wirestam, Ronnie, et al. (författare)
  • Regional cerebral blood flow distributions in normal volunteers: dynamic susceptibility contrast MRI compared with 99mTc-HMPAO SPECT
  • 2000
  • Ingår i: Journal of Computer Assisted Tomography. - 1532-3145. ; 24:4, s. 526-530
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Relative regional cerebral blood flow (rCBF) at rest was measured in 44 volunteers using both dynamic susceptibility contrast (DSC) MRI and (99m)Tc-HMPAO SPECT on the same day. METHOD: In MRI, a Gd-DTPA-BMA contrast agent bolus (0.3 mmol/kg body wt) was monitored with a simultaneous dual FLASH pulse sequence (time resolution 1.5 s). MRI-based rCBF images were calculated by singular value decomposition-based deconvolution of the measured tissue concentration-time curve with an arterial input function from a small artery within the imaging slice. In the SPECT investigation, 900 MBq of (99m)Tc-HMPAO was injected intravenously. Relative rCBF in gray matter in the thalamus and in frontal white matter was determined. RESULTS: The ratio of relative rCBF in gray matter to relative rCBF in white matter was 2.21 +/- 0.57 using MRI and 2.24 +/- 0.54 using SPECT (mean +/- SD). CONCLUSION: Relative rCBF maps from DSC MRI and (99m)Tc-HMPAO SPECT showed good agreement, and the MRI-based rCBF ratio correlated with the corresponding SPECT-based ratio (r = 0.79, p < 0.0000006).
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8.
  • Szczepankiewicz, Filip, et al. (författare)
  • Tensor-valued diffusion encoding for diffusional variance decomposition (DIVIDE) : Technical feasibility in clinical MRI systems
  • 2019
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Microstructure imaging techniques based on tensor-valued diffusion encoding have gained popularity within the MRI research community. Unlike conventional diffusion encoding—applied along a single direction in each shot—tensor-valued encoding employs diffusion encoding along multiple directions within a single preparation of the signal. The benefit is that such encoding may probe tissue features that are not accessible by conventional encoding. For example, diffusional variance decomposition (DIVIDE) takes advantage of tensor-valued encoding to probe microscopic diffusion anisotropy independent of orientation coherence. The drawback is that tensor-valued encoding generally requires gradient waveforms that are more demanding on hardware; it has therefore been used primarily in MRI systems with relatively high performance. The purpose of this work was to explore tensor-valued diffusion encoding on clinical MRI systems with varying performance to test its technical feasibility within the context of DIVIDE. We performed whole-brain imaging with linear and spherical b-tensor encoding at field strengths between 1.5 and 7 T, and at maximal gradient amplitudes between 45 and 80 mT/m. Asymmetric gradient waveforms were optimized numerically to yield b-values up to 2 ms/μm 2 . Technical feasibility was assessed in terms of the repeatability, SNR, and quality of DIVIDE parameter maps. Variable system performance resulted in echo times between 83 to 115 ms and total acquisition times of 6 to 9 minutes when using 80 signal samples and resolution 2×2×4 mm 3 . As expected, the repeatability, signal-to-noise ratio and parameter map quality depended on hardware performance. We conclude that tensor-valued encoding is feasible for a wide range of MRI systems—even at 1.5 T with maximal gradient waveform amplitudes of 33 mT/m—and baseline experimental design and quality parameters for all included configurations. This demonstrates that tissue features, beyond those accessible by conventional diffusion encoding, can be explored on a wide range of MRI systems.
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9.
  • Nilsson, C, et al. (författare)
  • Circadian variation in human cerebrospinal fluid production measured by magnetic resonance imaging
  • 1992
  • Ingår i: American Journal of Physiology: Regulatory, Integrative and Comparative Physiology. - 1522-1490. ; 262:1, s. 20-24
  • Tidskriftsartikel (refereegranskat)abstract
    • Recent advances in magnetic resonance imaging have made it possible to visualize and quantify flow of cerebrospinal fluid (CSF) in the brain. The net flow of CSF through the cerebral aqueduct was used to measure CSF production in six normal volunteers at different times during a 24-h period. CSF production varied greatly both intra- and interindividually. The average CSF production in each time interval showed a clear tendency to circadian variation, with a minimum production 30% of maximum values (12 +/- 7 ml/h) approximately 1800 h and a nightly peak production approximately 0200 h of 42 +/- 2 ml/h. The total CSF production during the whole 24-h period, calculated as an average of all measurements, was 650 ml for the whole group and 630 ml for repeated measurements in each time interval in one of the volunteers.
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10.
  • Ahlgren, André, et al. (författare)
  • A linear mixed perfusion model for tissue partial volume correction of perfusion estimates in dynamic susceptibility contrast MRI: : Impact on absolute quantification, repeatability, and agreement with pseudo-continuous arterial spin labeling
  • 2017
  • Ingår i: Magnetic Resonance in Medicine. - : Wiley. - 1522-2594 .- 0740-3194. ; 77:6, s. 2203-2214
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The partial volume effect (PVE) is an important source of bias in brain perfusion measurements. The impact of tissue PVEs in perfusion measurements with dynamic susceptibility contrast MRI (DSC-MRI) has not yet been well established. The purpose of this study was to suggest a partial volume correction (PVC) approach for DSC-MRI and to study how PVC affects DSC-MRI perfusion results.METHODS: A linear mixed perfusion model for DSC-MRI was derived and evaluated by way of simulations. Twenty healthy volunteers were scanned twice, including DSC-MRI, arterial spin labeling (ASL), and partial volume measurements. Two different algorithms for PVC were employed and assessed.RESULTS: Simulations showed that the derived model had a tendency to overestimate perfusion values in voxels with high fractions of cerebrospinal fluid. PVC reduced the tissue volume dependence of DSC-MRI perfusion values from 44.4% to 4.2% in gray matter and from 55.3% to 14.2% in white matter. One PVC method significantly improved the voxel-wise repeatability, but PVC did not improve the spatial agreement between DSC-MRI and ASL perfusion maps.CONCLUSION: Significant PVEs were found for DSC-MRI perfusion estimates, and PVC successfully reduced those effects. The findings suggest that PVC might be an important consideration for DSC-MRI applications. Magn Reson Med, 2016. © 2016 Wiley Periodicals, Inc.
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