T1 and T2 mapping Dotaz Zobrazit nápovědu
PURPOSE: To determine whether previously reported T1-weighted MR hyperintensities in the brains of patients with hepatic cirrhosis are accompanied by changes in T2. METHODS: We measured T1 and T2 in the brains of 10 patients with chronic liver disease and 7 age-matched healthy volunteers, using classic spin-echo sequences with multiple saturation recovery times and multiple echoes. RESULTS: Both T1 and T2 were shortened in the basal ganglia, cortex, and white matter of the patients, with the greatest shortening in the globus pallidus, where 1/T1 was increased by 0.76 s-1 or 74% and 1/T2 by 1.45 s-1 or 11%. CONCLUSIONS: The T1 changes were accompanied by T2 changes of greater magnitude that were not as visible because T2 is normally much shorter than T1, especially in the globus pallidus.
- MeSH
- alkoholická cirhóza jater * diagnóza MeSH
- dospělí MeSH
- jaterní cirhóza * diagnóza MeSH
- jaterní encefalopatie * diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- mapování mozku MeSH
- mozek patologie MeSH
- referenční hodnoty MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
Cardiac magnetic resonance imaging (CMR) is an indispensable part of the diagnostic algorithm in cardiology. CMR has become a gold standard in various disorders; moreover, it is well established also as a surrogate end-point in experimental and clinical studies. Particularly, the ability to directly display myocardial injury is a unique feature in comparison with other methods. The mapping of magnetic relaxation properties (T1, T2 and T2* relaxation times) are still relatively new techniques, but promising to improve the robustness of CMR and add new appropriate indications. The high potential of T1 mapping in the diagnostic of myocardial ischemic involvement has been highlighted in several experimental and clinical studies, but the use in clinical routine was limited due to the shortcomings in scanning and image evaluation. However, the quantitative technique of T1 mapping is now commercially available and its simple use, good reproducibility and limited subjectivity allow its incorporation into routine CMR protocols. This review article is aimed to summarise existing results and clinical experience with T1 mapping in patients with ischemic cardiac disease.
Závěrečná zpráva o řešení grantu Agentury pro zdravotnický výzkum MZ ČR
Nestr.
Although the cardio-vascular magnetic resonance imaging (CMRI) is already a widely used diagnostic method, the potential of this method as regards the achievement of quantitative parameters still has not been fully exploited.This is particularly because of technical problems, insufficient data quality or rather low reproducibility of quantitative values. Proposed project will deal with development, improvement and implementation of new methods of measurements, data correction and quantitative calculations for achieving a) parametric maps (post-contrast T1, T2 and T2* relaxation time maps, perfusion maps), b) characteristics of the myocardial wall deformation (strain) and heart motion synchronicity and also c) blood flow values. New CMRI methods shall be validated by clinical correlations (e.g. comparing with complementary modalities) and also using simulations with mathematical model which is already under development on the foreigner cooperation lab.
Zobrazování kardio-vaskulárního systému magnetickou rezonancí (CMRI) je dnes již hojně využívanou diagnostickou metodou, přesto z hlediska možnosti získání kvantitativních parametrů není ještě potenciál této metody zdaleka využit. V konkrétních případech tomu brání technické problémy, nedostatečná kvalita získaných dat či nízká reprodukovatelnost kvantitativních hodnot. Navrhovaný projekt se bude zabývat vývojem, optimalizací a implementací metodiky měření, korekcí dat i kvantitativních výpočtů a) parametrických map (post-kontrastních T1, T2 a T2* map relaxačních časů, obrazů perfúzních parametrů), b) charakteristik deformace srdeční stěny a synchronie srdeční akce, a také c) hodnot průtoku krve. Nové metodiky budou ověřeny CMRI jak klinickými korelacemi (např. s komplementárními modalitami), tak pomocí simulací na matematickém modelu srdce, který je vyvíjen na zahraničním spolupracujícím pracovišti.
- MeSH
- elektrofyziologické techniky kardiologické MeSH
- magnetická rezonanční tomografie MeSH
- myokard MeSH
- nemoci srdce diagnostické zobrazování MeSH
- rychlost toku krve MeSH
- teoretické modely MeSH
- zobrazování trojrozměrné MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- kardiologie
- NLK Publikační typ
- závěrečné zprávy o řešení grantu AZV MZ ČR
BACKGROUND: In Wilson's disease (WD), demyelination, rarefaction, gliosis, and iron accumulation in the deep gray matter cause opposing effects on T2 -weighted MR signal. However, the degree and interplay of these changes in chronically treated WD patients has not been quantitatively studied. PURPOSE: To compare differences in brain multiparametric mapping between controls and chronically treated WD patients with neurological (neuro-WD) and hepatic (hep-WD) forms to infer the nature of residual WD neuropathology. STUDY TYPE: Cross-sectional. POPULATION/SUBJECTS: Thirty-eight WD patients (28 neuro-WD, 10 hep-WD); 26 healthy controls. FIELD STRENGTH/SEQUENCE: 3.0T: susceptibility, T2 *, T2 , T1 relaxometry; 1.5T: T2 , T1 relaxometry. ASSESSMENT: The following 3D regions of interest (ROIs) were manually segmented: globus pallidus, putamen, caudate nucleus, and thalamus. Mean bulk magnetic susceptibility, T2 *, T2 , and T1 relaxation times were calculated for each ROI. STATISTICAL TESTS: The effect of group (neuro-WD, hep-WD, controls) and age was assessed using a generalized least squares model with different variance for each ROI and quantitative parameter. A general linear hypothesis test with Tukey adjustment was used for post-hoc between-group analysis; P < 0.05 was considered significant. RESULTS: Susceptibility values were higher in all ROIs in neuro-WD compared to controls and hep-WD (P < 0.001). In basal ganglia, lower T2 and T2 * were found in neuro-WD compared to controls (P < 0.01) and hep-WD (P < 0.05) at 3.0T. Much smaller intergroup differences for T2 in basal ganglia were observed at 1.5T compared to 3.0T. In the thalamus, increased susceptibility in neuro-WD was accompanied by increased T1 at both field strengths (P < 0.001 to both groups), and an increased T2 at 1.5T only (P < 0.001 to both groups). DATA CONCLUSION: We observed significant residual brain MRI abnormalities in neuro-WD but not in hep-WD patients on chronic anticopper treatment. Patterns of changes were suggestive of iron accumulation in the basal ganglia and demyelination in the thalamus; 3.0T was more sensitive for detection of the former and 1.5T of the latter abnormality. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:1829-1835.
BACKGROUND: Patients with chest pain, elevated troponin, and unobstructed coronary disease present a clinical dilemma. The purpose of this study was to investigate the incremental diagnostic value of cardiovascular magnetic resonance (CMR) in a cohort of patients with suspected acute coronary syndrome (ACS) and unobstructed coronary arteries. RESULTS: Data files of patients meeting the inclusion criteria in two cardiology centres were searched and analysed. The inclusion criteria included: 1) thoracic pain suspected with ACS; 2) a significant increase in the high-sensitive Troponin T value; 3) ECG changes; 4) coronary arteries without any significant stenosis; 5) a CMR examination included in the diagnostic process; 6) an uncertain diagnosis before the CMR exam; and 7) the absence of known CMR and contrast media contraindications. Special attention was paid to the benefits of CMR in determining the final diagnosis. In total, 136 patients who underwent coronary angiography for chest pain were analysed. The most frequent underlying causes were myocarditis (38%) and perimyocarditis (18%), followed by angiographically unrecognised acute myocardial infarction (18%) and Takotsubo cardiomyopathy (15%). The final diagnosis remained unclear in 6% of the patients. The contribution of CMR in determining the final diagnosis determination was crucial in 57% of the patients. In another 35% of the patients, CMR confirmed the suspicion and, only 8% of the CMR examinations did not help at all and had no influence on diagnosis or treatment. CONCLUSION: CMR provided a powerful incremental diagnostic value in the cohort of patients with suspected ACS and unobstructed coronary arteries. CMR is highly recommended to be incorporated as an inalienable part of the diagnostic algorithms in these patients.
- MeSH
- akutní koronární syndrom krev diagnostické zobrazování patofyziologie MeSH
- algoritmy MeSH
- angina pectoris krev diagnostické zobrazování patofyziologie MeSH
- biologické markery krev MeSH
- dospělí MeSH
- elektrokardiografie MeSH
- koronární angiografie * MeSH
- kritické cesty MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- nemoci koronárních tepen krev diagnostické zobrazování patofyziologie MeSH
- prediktivní hodnota testů MeSH
- prognóza MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- troponin T krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
The multimarker approach using Luminex technology represents a new tool for studying the pathogenesis of cardiovascular disease. Although many cardiac biomarkers in heart failure have been well established, the role and significance of their measurement in hypertensive patients is still questionable. The aim of our study was to evaluate the relationship of selected biomarkers in L-NAME-induced hypertension to the left ventricular remodeling in the two different periods of hypertension development. Four groups of 3-month-old male Wistar rats were investigated: (1) control 4 (placebo for 4 weeks), (2) control 7 (placebo for 7 weeks), (3) L-NAME 4 (40 mg/kg/day for 4 weeks), and (4) L-NAME 7 (40 mg/kg/day for 7 weeks). BNP, cTnI, TNF-α, and VEGF were measured using Rat CVD Panel 1 Kit (Milliplex® MAP). Cardiac troponin T was determined using Elecsys® Troponin T high sensitive immunoassay (Roche, Switzerland). Although the systolic blood pressure increases about 50% in L-NAME-induced hypertension in rat, both hypertrophy and fibrosis were expressed only slightly in this experiment. The levels of BNP, TNF-α, or VEGF did not differ significantly among groups. However, cardiac troponin T measured by high sensitive ELISA was significantly (P<0.05) increased in L-NAME 4 (0.229 μg/l versus 0.034 μg/l) and L-NAME-7 groups (0.366 μg/l versus 0.06 μg/l) in comparison with the controls. We conclude that the slightly increased cTnT levels could indicate ischemic damage of L-NAME-hypertensive heart. Importantly, to our best knowledge, this is the first study indicating that CVD rat panel may be a useful methodological tool in experimental cardiology.
- MeSH
- biologické markery krev MeSH
- hypertenze krev chemicky indukované patofyziologie MeSH
- imunoanalýza MeSH
- inhibitory enzymů MeSH
- krevní tlak účinky léků MeSH
- krysa rodu rattus MeSH
- natriuretický peptid typu B krev MeSH
- NG-nitroargininmethylester MeSH
- potkani Wistar MeSH
- synthasa oxidu dusnatého antagonisté a inhibitory MeSH
- TNF-alfa krev MeSH
- troponin I krev MeSH
- troponin T krev MeSH
- vaskulární endoteliální růstový faktor A krev MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Balaban and Dana C. Peters -- 2 Techniques for TI, T2, and Extracellular Volume Mapping, 15 -- Peter Kellman and Michael Manning -- 25 Coronary Artery and Sinus Velocity and Flow, 309 -- Jennifer Keegan and Dudley J. Halliday, Upasana Tayal, and Sanjay Prasad -- 32 T1 and T2 Mapping and Extracellular Volume in Cardiomyopathy Treibe I and James C. Moon -- 33 Cardiac Iron Loading and Myocardial T2*, 400 -- Mark A.
Third edition xxii, 618 stran : ilustrace, tabulky ; 28 cm
This practical reference enhances the understanding of cardiac physiology and the interpretation and diagnosis of cardiovascular disease. Nakladatelská anotace. Kráceno
PURPOSE: The quality and precision of post-mortem MRI microscopy may vary depending on the embedding medium used. To investigate this, our study evaluated the impact of 5 widely used media on: (1) image quality, (2) contrast of high spatial resolution gradient-echo (T1 and T2* -weighted) MR images, (3) effective transverse relaxation rate (R2* ), and (4) quantitative susceptibility measurements (QSM) of post-mortem brain specimens. METHODS: Five formaldehyde-fixed brain slices were scanned using 7.0T MRI in: (1) formaldehyde solution (formalin), (2) phosphate-buffered saline (PBS), (3) deuterium oxide (D2 O), (4) perfluoropolyether (Galden), and (5) agarose gel. SNR and contrast-to-noise ratii (SNR/CNR) were calculated for cortex/white matter (WM) and basal ganglia/WM regions. In addition, median R2* and QSM values were extracted from caudate nucleus, putamen, globus pallidus, WM, and cortical regions. RESULTS: PBS, Galden, and agarose returned higher SNR/CNR compared to formalin and D2 O. Formalin fixation, and its use as embedding medium for scanning, increased tissue R2* . Imaging with agarose, D2 O, and Galden returned lower R2* values than PBS (and formalin). No major QSM offsets were observed, although spatial variance was increased (with respect to R2* behaviors) for formalin and agarose. CONCLUSIONS: Embedding media affect gradient-echo image quality, R2* , and QSM in differing ways. In this study, PBS embedding was identified as the most stable experimental setup, although by a small margin. Agarose and Galden were preferred to formalin or D2 O embedding. Formalin significantly increased R2* causing noisier data and increased QSM variance.
- MeSH
- ethery MeSH
- fluorokarbony MeSH
- formaldehyd MeSH
- fosfáty MeSH
- kontrastní látky MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie přístrojové vybavení metody MeSH
- mapování mozku metody MeSH
- mozek diagnostické zobrazování patologie MeSH
- odběr biologického vzorku MeSH
- oxid deuteria MeSH
- pitva přístrojové vybavení metody MeSH
- počítačové zpracování obrazu MeSH
- poměr signál - šum MeSH
- sefarosa chemie MeSH
- senioři MeSH
- zalévání tkání přístrojové vybavení MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Optimální cílový tlak (MAP) pro resuscitaci septického šoku je předmětem diskusí. Cílem studie je zhodnotit účinek různých hodnot MAP na perfuzi/funkci splanchnických orgánů a metabolismus laktátu. Typ studie: Prospektivní randomizovaná klinická studie. Název a sídlo pracoviště: Anesteziologicko-resuscitační klinika, Fakultní nemocnice u sv. Anny v Brně. Materiál a metody: Pacienti v prvních 6 hodinách septického šoku byli rozděleni na 65 (G65) nebo 85 (G85) mm Hg MAP, který byl udržován infuzí tekutin a noradrenalinu. První skupina měření proběhla do 2 hodin od rozdělení (T1), kontrola za 6 hodin (T2). Metabolismus laktátu byl hodnocen pomocí exogenního laktátového testu (podáno 2,5 ml/kg 11,2% laktátu sodného). Byly sledovány tyto parametry: srdeční index (Cl), SvO2, gastrická tonometrie (pCO2gap), clearance ICG (ICG-PDR) a kreatininová clearance, produkce a clearance laktátu. Data jsou uvedena jako medián (rozsah) a hodnocena odpovídajícími neparametrickými testy. Výsledky: Do studie bylo zařazeno 16 pacientů - 8 v G65 a 8 v G85. Nebyl rozdíl v APACHE II a SOFA, pacienti v G65 byli vyššího věku než G85 (p = 0,065). Nebyly pozorovány rozdíly v dávce noradrenalinu, množství podaných tekutin, ani v hodnotách Cl a SvO2 mezi skupinami během celé studie. Hodnoty pCO2gap, ICG-PDR a kreatininové clearance se nelišily mezi skupinami v časech T1 ani T2. Nebyly zaznamenány rozdíly v produkci ani eleminaci laktátu, ale pacienti v G65 měli sklon ke zvýšení obratu laktátu meziTI aT2. Závěr: Resuscitace nemocných v septickém šoku na dvě rozdílné hodnoty MAP (65 a 85 mm Hg) neovlivňuje parametry globální hemodynamiky, lokální perfuze a/nebo funkce orgánů ani metabolismus laktátu.
The optimal target mean arterial pressure (MAP) in the resuscitation of septic shock is undetermined.The aim of this study was to assess the effect of different levels of MAP on splanchnic organ perfusion/function and lactate metabolism. Design: Prospective, randomized, clinical trial. Setting: St. Anna University Hospital, Brno, Department of Anaesthesia and Intensive Care. Materials and methods: Patients in the first 6 hours of septic shock were randomized to target MAP of 65 (G65) or 85 (G85) mm Hg.The target MAP was achieved by the admisnistration of fluids and norepinephrine. A set of measurements was taken during the first 2 hours of the study (T1) and repeated 6 hours later (T2). Lactate metabolism was assessed by the exogenous lactate challenge test (ELCT). Cardiac output (CO), SvO2, gastric tonometry (pCO2gap), clearance of ICG (ICG-PDR) and creatinine clearance were measured.The data are presented as medián (range); appropriate non-parametric tests were ušed. Results: 16 patients were included in the study - 8 in the G65 and 8 in the G85 groups. APACHE II and SOFA scores were comparable between the groups. Patients randomized to G65 tended to higher age than G85 (p = 0.065). No differences in the volume of infused fluids, norepinephrine dose, Cl and SvO2 were obser- ved during the study. Values of pCO2gap, ICG-PDR and creatinine clearance did not differ between the groups atT1 orT2. No differences in lactate production and elimination were recorded but the G65 patients tended to an increased lactate turnover between T1 and T2. Conclusion: Resuscitation of septic shock patients to different MAP level (65 or 85 mm Hg) did not influence the globál or splanchnic haemodynamics or lactate metabolism.
- MeSH
- financování vládou MeSH
- hemodynamika MeSH
- interpretace statistických dat MeSH
- krevní tlak genetika MeSH
- lidé MeSH
- noradrenalin terapeutické užití MeSH
- resuscitace metody trendy využití MeSH
- septický šok terapie MeSH
- směrnice pro lékařskou praxi jako téma normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
BACKGROUND AND OBJECTIVES: In multiple sclerosis (MS), slowly expanding lesions were shown to be associated with worse disability and prognosis. Their timely detection from cross-sectional data at early disease stages could be clinically relevant to inform treatment planning. Here, we propose to use multiparametric, quantitative MRI to allow a better cross-sectional characterization of lesions with different longitudinal phenotypes. METHODS: We analysed T1 and T2 relaxometry maps from a longitudinal cohort of MS patients. Lesions were classified as enlarging, shrinking, new or stable based on their longitudinal volumetric change using a newly developed automated technique. Voxelwise deviations were computed as z-scores by comparing individual patient data to T1, T2 and T2/T1 normative values from healthy subjects. We studied the distribution of microstructural properties inside lesions and within perilesional tissue. RESULTS AND CONCLUSIONS: Stable lesions exhibited the highest T1 and T2 z-scores in lesion tissue, while the lowest values were observed for new lesions. Shrinking lesions presented the highest T1 z-scores in the first perilesional ring while enlarging lesions showed the highest T2 z-scores in the same region. Finally, a classification model was trained to predict the longitudinal lesion type based on microstructural metrics and feature importance was assessed. Z-scores estimated in lesion and perilesional tissue from T1, T2 and T2/T1 quantitative maps carry discriminative and complementary information to classify longitudinal lesion phenotypes, hence suggesting that multiparametric MRI approaches are essential for a better understanding of the pathophysiological mechanisms underlying disease activity in MS lesions.
- MeSH
- dospělí MeSH
- fenotyp * MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- magnetická rezonanční tomografie MeSH
- mozek diagnostické zobrazování patologie MeSH
- multiparametrická magnetická rezonance MeSH
- progrese nemoci MeSH
- průřezové studie MeSH
- roztroušená skleróza * diagnostické zobrazování patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
