| 1. |
- Cronqvist, Mats, et al.
(författare)
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Diffusion and perfusion MRI in patients with ruptured and unruptured intracranial aneurysms treated by endovascular coiling: complications, procedural results, MR findings and clinical outcome.
- 2005
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Ingår i: Neuroradiology. - : Springer Science and Business Media LLC. - 1432-1920 .- 0028-3940. ; 47:11, s. 855-873
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Tidskriftsartikel (refereegranskat)abstract
- Our purpose was to evaluate treatment safety as well as complications frequency and management in endovascular coiling of intracerebral aneurysms using MR diffusion and perfusion imaging. In this prospective study, 77 MR examinations were performed in conjunction with 43 procedures in 40 patients, 14 patients presented with ruptured and 26 with unruptured aneurysms. Mean time interval between treatment and post-procedure MRI was 29 and 25 h for the ruptured and unruptured aneurysm group, respectively. Peri-procedural complications, including five major events and five minor transient events, occurred in 10/43 procedures (23%), necessitating thrombolytic therapy in two patients and angioplasty in one, all three within the unruptured aneurysm group. Fifty-one new lesions were found on post-treatment DWI and 47 of them were regarded as of ischemic origin. Most lesions were small (< 3 mm), ipsilateral to the treated aneurysm and asymptomatic (37/40 patients). Sixty-seven percent of the lesions were found in the ruptured and 33% in the unruptured aneurysm group. The ischemic lesions did occur more frequently in patients treated for aneurysm of large neck size and according to the remodelling technique. The overall morbidity and mortality rates were 14.6 and 7.3% whereas morbidity and mortality rates related to the technique were only 2.6 and 0%, respectively. Silent embolism seems to be more common than clinically evident and partially related to patient presentation, heparinazation and treatment strategy. The capability to depict early complications and analyse their potential causes by using MR with DWI has been of great importance in our modification and improvement of therapeutic protocols, evaluations and strategies.
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| 2. |
- Wirestam, Ronnie
(författare)
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Nuclear magnetic resonance and microcirculation: The influence of pulsatile brain-tissue motion on measurements of intravoxel incoherent motion and assessment of haemodynamics using exo- and endogenous tracers
- 1997
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this project, the potential of magnetic resonance (MR) imaging and spectroscopy in studies of microcirculation and haemodynamics was evaluated. The spatial and temporal characteristics of human pulsatile brain-tissue movements in healthy individuals, relevant for the understanding of the cerebrospinal-fluid (CSF) circulation and the pathogenesis of hydrocephalus, were thoroughly investigated. Abnormal motion patterns in brain tissue and CSF were demonstrated in patients with intracranial tumours, and navigator echoes were shown to reduce motion artifacts in phase images. Intravoxel phase dispersion, caused by a spatial distribution of brain-tissue velocities, was shown to act as a source of uncertainty in gradient-sensitised MR imaging of intravoxel incoherent motion (IVIM). The diffusion coefficient was considerably overestimated if measured during inappropriate periods in the cardiac cycle, a finding which may also prove important in IVIM-encoded echo-planar imaging (EPI). Using IVIM-sensitive EPI, the perfusion fraction in patients with acute ischaemic stroke was shown to be considerably smaller in the infarct region than in normal tissue in the contralateral hemisphere. In a deuterium MR spectroscopy study, the D2O washout in animals, after intratissue injection, displayed a pronounced injection-volume dependence as well as a non-physiological component of signal decay. The reproducibility was reasonable in subcutaneous tissue, but rather poor in heterogeneous tumours. In a dynamic susceptibility-contrast MR imaging study, the first passage of an exogenous tracer (Gd-DTPA- BMA) was monitored in the normal human brain, and reasonable regional cerebral blood volume (rCBV) values were observed. The rCBV and the perfusion fraction in white matter showed a promising tendency to correlate. Finally, functional MR imaging (fMRI) studies of cortical activation were initiated in a typical clinical environment, and it was verified that cortical activation is observable both at 1.0 T and 1.5 T. Investigations of the field-strength dependence might, to some extent, provide information on the origin of the fMRI contrast in gradient-echo imaging.
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| 3. |
- Brynolfsson, Patrik, et al.
(författare)
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Combining phase and magnitude information for contrast agent quantification in dynamic contrast-enhanced MRI using statistical modeling
- 2015
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Ingår i: Magnetic Resonance in Medicine. - : Wiley-Blackwell. - 0740-3194 .- 1522-2594. ; 74:4, s. 1156-1164
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to investigate, using simulations, a method for improved contrast agent (CA) quantification in DCE-MRI.Methods: We developed a maximum likelihood estimator that combines the phase signal in the DCE-MRI image series with an additional CA estimate, e.g. the estimate obtained from magnitude data. A number of simulations were performed to investigate the ability of the estimator to reduce bias and noise in CA estimates. Noise levels ranging from that of a body coil to that of a dedicated head coil were investigated at both 1.5T and 3T.Results: Using the proposed method, the root mean squared error in the bolus peak was reduced from 2.24 to 0.11 mM in the vessels and 0.16 to 0.08 mM in the tumor rim for a noise level equivalent of a 12-channel head coil at 3T. No improvements were seen for tissues with small CA uptake, such as white matter.Conclusion: Phase information reduces errors in the estimated CA concentrations. A larger phase response from higher field strengths or higher CA concentrations yielded better results. Issues such as background phase drift need to be addressed before this method can be applied in vivo.
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| 4. |
- Garpebring, Anders, et al.
(författare)
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Uncertainty estimation in dynamic contrast-enhanced MRI
- 2013
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Ingår i: Magnetic Resonance in Medicine. - : Wiley-Blackwell. - 0740-3194 .- 1522-2594. ; 69:4, s. 992-1002
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Tidskriftsartikel (refereegranskat)abstract
- Using dynamic contrast-enhanced MRI (DCE-MRI), it is possible to estimate pharmacokinetic (PK) parameters that convey information about physiological properties, e.g., in tumors. In DCE-MRI, errors propagate in a nontrivial way to the PK parameters. We propose a method based on multivariate linear error propagation to calculate uncertainty maps for the PK parameters. Uncertainties in the PK parameters were investigated for the modified Kety model. The method was evaluated with Monte Carlo simulations and exemplified with in vivo brain tumor data. PK parameter uncertainties due to noise in dynamic data were accurately estimated. Noise with standard deviation up to 15% in the baseline signal and the baseline T1 map gave estimated uncertainties in good agreement with the Monte Carlo simulations. Good agreement was also found for up to 15% errors in the arterial input function amplitude. The method was less accurate for errors in the bolus arrival time with disagreements of 23%, 32%, and 29% for Ktrans, ve, and vp, respectively, when the standard deviation of the bolus arrival time error was 5.3 s. In conclusion, the proposed method provides efficient means for calculation of uncertainty maps, and it was applicable to a wide range of sources of uncertainty.
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| 5. |
- Wirestam, Ronnie, et al.
(författare)
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Comparison of quantitative dynamic susceptibility-contrast MRI perfusion estimates obtained using different contrast-agent administration schemes at 3 T
- 2010
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Ingår i: European Journal of Radiology. - : Elsevier BV. - 0720-048X .- 1872-7727. ; 75:1, s. E86-E91
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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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| 6. |
- Olsson, Emma, et al.
(författare)
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MRI-Based Quantification of Magnetic Susceptibility in Gel Phantoms : Assessment of Measurement and Calculation Accuracy
- 2018
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Ingår i: Radiology research and practice. - : Hindawi Limited. - 2090-1941 .- 2090-195X. ; 2018
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Tidskriftsartikel (refereegranskat)abstract
- The local magnetic field inside and around an object in a magnetic resonance imaging unit depends on the magnetic susceptibility of the object being magnetized, in combination with its geometry/orientation. Magnetic susceptibility can thus be exploited as a source of tissue contrast, and susceptibility imaging may also become a useful tool in contrast agent quantification and for assessment of venous oxygen saturation levels. In this study, the accuracy of an established procedure for quantitative susceptibility mapping (QSM) was investigated. Three gel phantoms were constructed with cylinders of varying susceptibility and geometry. Experimental results were compared with simulated and analytically calculated data. An expected linear relationship between estimated susceptibility and concentration of contrast agent was observed. Less accurate QSM-based susceptibility values were observed for cylindrical objects at angles, relative to the main magnetic field, that were close to or larger than the magic angle. Results generally improved for large objects/high spatial resolution and large volume coverage. For simulated phase maps, accurate susceptibility quantification by QSM was achieved also for more challenging geometries. The investigated QSM algorithm was generally robust to changes in measurement and calculation parameters, but experimental phase data of sufficient quality may be difficult to obtain in certain geometries.
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| 7. |
- Wirestam, Ronnie, et al.
(författare)
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Regional cerebral blood flow distributions in normal volunteers: dynamic susceptibility contrast MRI compared with 99mTc-HMPAO SPECT
- 2000
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Ingår i: Journal of Computer Assisted Tomography. - 1532-3145. ; 24:4, s. 526-530
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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. |
- Ambarki, Khalid, et al.
(författare)
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Accuracy of Parenchymal Cerebral Blood Flow Measurements Using Pseudocontinuous Arterial Spin-labeling in Healthy Volunteers
- 2015
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Ingår i: American Journal of Neuroradiology. - 0195-6108 .- 1936-959X. ; 36:10, s. 1816-1821
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The arterial spin-labeling method for CBF assessment is widely available, but its accuracy is not fully established. We investigated the accuracy of a whole-brain arterial spin-labeling technique for assessing the mean parenchymal CBF and the effect of aging in healthy volunteers. Phase-contrast MR imaging was used as the reference method. MATERIALS AND METHODS: Ninety-two healthy volunteers were included: 49 young (age range, 20-30 years) and 43 elderly (age range, 65-80 years). Arterial spin-labeling parenchymal CBF values were averaged over the whole brain to quantify the mean pCBF(ASL) value. Total. CBF was assessed with phase-contrast MR imaging as the sum of flows in the internal carotid and vertebral arteries, and subsequent division by brain volume returned the pCBF(PCMRI) value. Accuracy was considered as good as that of the reference method if the systematic difference was less than 5 mL/min/100 g of brain tissue and if the 95% confidence intervals were equal to or better than +/- 10 mL/min/100 g. RESULTS: pCBF(ASL) correlated to pCBF(PCMRI) (r = 0.73; P < .001). Significant differences were observed between the pCBF(ASL) and pCBF(PCMRI) values in the young (P = .001) and the elderly (P < .001) volunteers. The systematic differences (mean 2 standard deviations) were -4 +/- 14 mL/min/100 g in the young subjects and 6 +/- 12 mL/min/100 g in the elderly subjects. Young subjects showed higher values than the elderly subjects for pCBF(PCMRI) (young, 57 +/- 8 mL/min/100 g; elderly, 54 +/- 7 mL/min/100 g; P = .05) and pCBF(ASL) (young, 61 +/- 10 mL/min/100 g; elderly, 48 +/- 10 mL/min/100 g; P < .001). CONCLUSIONS: The limits of agreement were too wide for the arterial spin-labeling method to be considered satisfactorily accurate, whereas the systematic overestimation in the young subjects and underestimation in the elderly subjects were close to acceptable. The age-related decrease in parenchymal CBF was augmented in arterial spin-labeling compared with phase-contrast MR imaging.
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| 9. |
- Ahlgren, André, et al.
(författare)
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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
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Ingår i: Magnetic Resonance in Medicine. - : Wiley. - 1522-2594 .- 0740-3194. ; 77:6, s. 2203-2214
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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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