Phase-contrast helium-3 MRI of aerosol deposition in human airways.

One of the key challenges in the study of health-related aerosols is predicting and monitoring sites of particle deposition in the respiratory tract. The potential health risks of ambient exposure to environmental or workplace aerosols and the beneficial effects of medical aerosols are strongly influenced by the site of aerosol deposition along the respiratory tract. Nuclear medicine is the only current modality that combines quantification and regional localization of aerosol deposition, and this technique remains limited by its spatial and temporal resolutions and by patient exposure to radiation. Recent work in MRI has shed light on techniques to quantify micro-sized magnetic particles in living bodies by the measurement of associated static magnetic field variations. With regard to lung MRI, hyperpolarized helium-3 may be used as a tracer gas to compensate for the lack of MR signal in the airways, so as to allow assessment of pulmonary function and morphology. The extrathoracic region of the human respiratory system plays a critical role in determining aerosol deposition patterns, as it acts as a filter upstream from the lungs. In the present work, aerosol deposition in a mouth-throat phantom was measured using helium-3 MRI and compared with single-photon emission computed tomography. By providing high sensitivity with high spatial and temporal resolutions, phase-contrast helium-3 MRI offers new insights for the study of particle transport and deposition.

Neural basis of sensitive skin: an fMRI study.

BACKGROUND/PURPOSE: About 50% of women declare themselves to have sensitive skin. However, sensitive skin still appears to be a questionable problem not corresponding to a specific physiological pattern. To objectivate the neural basis of sensitive skin, we measured cerebral response to cutaneous provocative tests in self-perceived sensitive and non-sensitive skin subjects using functional magnetic resonance imaging (fMRI). METHODS: Subjects were divided into two groups according to their self-perceived characterization by using a dedicated questionnaire about their skin reactivity. Event-related fMRI was used to measure cerebral activation associated with skin discomfort induced by a simultaneous split-face application of lactic acid and of its vehicle. RESULTS AND DISCUSSION: In both groups, skin discomfort due to lactic acid increased activity in the primary sensorimotor cortex contralateral to application site and in a bilateral fronto-parietal network including parietal cortex, prefrontal areas around the superior frontal sulcus, and the supplementary motor area. However, activity was significantly larger in the sensitive skin group. Most remarkably, in the sensitive skin group only, activity spreaded into the ipsilateral primary sensorimotor cortex and the bilateral peri-insular secondary somatosensory area. Our results demonstrate that, compared with control subjects, self-perceived sensitive skin subjects have a specific cerebral activation during skin irritative test, which allows us to hypothesize that self-perceived sensitive skin is intrinsically linked to a specific neurophysiologic pattern for these subjects. CONCLUSION: This study demonstrates that fMRI is an effective objective method for measuring cerebral processes underlying skin reactivity and contributes to a better understanding of the neural basis of the sensitive skin phenomenon.

In vitro validation of computational fluid dynamic simulation in human proximal airways with hyperpolarized 3He magnetic resonance phase-contrast velocimetry.

Computational fluid dynamics (CFD) and magnetic resonance (MR) gas velocimetry were concurrently performed to study airflow in the same model of human proximal airways. Realistic in vivo-based human airway geometry was segmented from thoracic computed tomography. The three-dimensional numerical description of the airways was used for both generation of a physical airway model using rapid prototyping and mesh generation for CFD simulations. Steady laminar inspiratory experiments (Reynolds number Re = 770) were performed and velocity maps down to the fourth airway generation were extracted from a new velocity mapping technique based on MR velocimetry using hyperpolarized (3)He gas. Full two-dimensional maps of the velocity vector were measured within a few seconds. Numerical simulations were carried out with the experimental flow conditions, and the two sets of data were compared between the two modalities. Flow distributions agreed within 3%. Main and secondary flow velocity intensities were similar, as were velocity convective patterns. This work demonstrates that experimental and numerical gas velocity data can be obtained and compared in the same complex airway geometry. Experiments validated the simulation platform that integrates patient-specific airway reconstruction process from in vivo thoracic scans and velocity field calculation with CFD, hence allowing the results of this numerical tool to be used with confidence in potential clinical applications for lung characterization. Finally, this combined numerical and experimental approach of flow assessment in realistic in vivo-based human airway geometries confirmed the strong dependence of airway flow patterns on local and global geometrical factors, which could contribute to gas mixing.

Relation between cerebral blood flow and metabolism explained by a model of oxygen exchange.

The cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRo(2)) are major determinants of the contrast in functional magnetic resonance imaging and optical imaging. However, the coupling between CBF and CMRo(2) during cerebral activation remains controversial. Whereas most of the previous models tend to show a nonlinear coupling, experimental studies have led to conflicting conclusions. A physiologic model was developed of oxygen transport through the blood-brain barrier (BBB) for dynamic and stationary states. Common model simplifications are proposed and their implications for the CBF/CMRo(2) relation are studied. The tissue oxygen pool, the BBB permeability, and the hemoglobin dissociation curve are physiologic parameters directly involved in the CBF/CMRo(2) relation. We have been shown that the hypothesis of a negligible tissue oxygen pool, which was admitted by most of the previous models, implies a tight coupling between CBF and CMRo(2). By relaxing this hypothesis, a real uncoupling was allowed that gives a more coherent view of the CBF/CMRo(2) relation, in better agreement with the hypercapnia data and with the variability reported in experimental works for the relative changes of those two variables. This also allows a temporal mismatch between CBF and CMRo(2), which influences the temporal shape of oxygenation at the capillary end.

A collagen-based sealant to prevent in vivo reformation of epidural scar adhesions in an adult rat laminectomy model.

OBJECT: The authors investigated the effect of a collagen-based sealant, Gel Amidon Oxydé (GAO), in preventing the reformation of epidural scar adhesions in an adult rat model of laminectomy. METHODS: Thirty-two adult Sprague-Dawley rats underwent a complete L5-6 laminectomy, after which the dura mater was exposed and the left adjacent L-4 and L-5 nerve roots were exposed. The surgical wound was then closed; 1 month later it was reopened. The epidural scar adhesions that developed were observed and carefully removed, leaving clean dura and nerve roots reexposed. In 16 experimental rats, GAO was placed onto the reexposed dura and around the nerve roots before it polymerized. No treatment was performed in 16 control rats. Postoperatively, all rats were healthy and without neurological deficit. The incisions healed within 1 week regardless of the treatment with the GAO. Three months after reoperation, magnetic resonance imaging revealed that important epidural adhesions were present in the control rats but not in the experimental rats. These findings were then confirmed by gross anatomical examination in which a white tissue layer was found over the dura without adhesions in the experimental animals, whereas significant epidural scar adhesions were demonstrated in the controls. Histological evaluation of the laminectomy site also showed that the peridural space in the experimental rats was larger than that in the controls. CONCLUSIONS: The authors found that GAO may be a safe and effective antiscarring adhesion biomaterial in vivo. When placed into the laminectomy site, GAO may prove beneficial in preventing the formation and reformation of epidural scar adhesions in humans.

Advances in MR imaging of the skin.

MR imaging of the skin is challenging because of the small size of the structures to be visualized. By increasing the gradient amplitude and/or duration, skin layers can be visualized with a voxel size of the order of 20 microm, clearly the smallest obtained for in vivo images in a whole-body imager. Currently, the gradient strength of most commercial systems enables acquisition of such a small voxel size, and the main difficulty has thus become to achieve sufficient detection sensitivity. The signal-to-noise ratio (SNR) can be increased either by increasing the magnetic field strength or by minimizing noise with small coils; cooling copper coils or superconducting coils can enhance the SNR by a factor of 3 or more. MR imaging, because of the large number of parameters it is able to measure, can provide more than the microscopic architecture of the skin: physical parameters such as relaxation times, magnetization transfer or diffusion, and chemical parameters such as the water and fat contents or phosphorus metabolism. In spite of the amount of information they have provided to date, MR imaging and spectroscopy have had limited clinical applications, mainly because cutaneous pathologies are easily accessible to the naked eye and surgery. However, MR technologies indeed represent powerful research tools to study normal and diseased skin.

Velocity-selective RF pulses in MRI.

A family of velocity-selective pulses consisting of a series of RF hard pulses followed by bipolar gradients was designed. The succession of required pulses was deduced using a k-space approach within a small tip-angle approximation. Fourier transform of the desired velocity excitation determined the flip-angle series, and the corresponding position in the generalized k-space identified the bipolar-gradient first moments. Spins from any velocity class can be selected. To illustrate this approach we designed and experimentally tested a velocity-slice selection that is analogous to standard spatial-slice selection but involves excitation of spins moving at a chosen velocity (velocity-slice center) and within a given interval (velocity-slice thickness). The assumed approximation does not limit the design to small angles, because velocity selection still holds for angles up to 90 degrees. Velocity slices were experimentally selected, centered on velocities ranging from -1 m s(-1) to 1 m s(-1) with a velocity-slice thickness of 0.4 m s(-1). The experimental velocity-slice profile was assessed and the flow was quantified.

Phase-contrast velocimetry with hyperpolarized 3He for in vitro and in vivo characterization of airflow.

This paper describes a technique that combines radial MRI and phase contrast (PC) to map the velocities of hyperpolarized gases ((3)He) in respiratory airways. The method was evaluated on well known geometries (straight and U-shaped pipes) before it was applied in vivo. Dynamic 2D maps of the three velocity components were obtained from a 10-mm slice with an in-plane spatial resolution of 1.6 mm within 1 s. Integration of the in vitro through-plane velocity over the slice matched the input flow within a relative precision of 6.4%. As expected for the given Reynolds number, a parabolic velocity profile was obtained in the straight pipe. In the U-shaped pipe the three velocity components were measured and compared to a fluid-dynamics simulation so the precision was evaluated as fine as 0.025 m s(-1). The technique also demonstrated its ability to visualize vortices and localize characteristic points, such as the maximum velocity and vortex-center positions. Finally, in vivo feasibility was demonstrated in the human trachea during inhalation.

Calculation of left ventricle relative pressure distribution in MRI using acceleration data.

Measurements of pressure variations within the cardiac chambers could provide important information for clinical assessments of cardiovascular function. In this work an MRI method for evaluating spatial distributions of intracardiac relative pressure is presented. We first calculated pressure gradients from MR maps of blood acceleration by applying the NS equation. We then used an original algorithm to compute pressure distribution in a region of interest (ROI) by minimizing the pressure gradient curl so that the result in a given pixel is independent of the integration path. The method was assessed in five healthy volunteers by means of MR 2D maps of the blood acceleration in the left ventricle (LV) during ejection and filling phases. The pressure variations calculated from acceleration mapping fit the known physiological variations better than those based on velocity maps acquired in the same volunteers. Furthermore, the optimization algorithm presented here produced the same results as iterative algorithms proposed by other authors, but in much less time and without requiring adjustable parameters or boundary conditions.

MR imaging of the metacarpophalangeal joints of the fingers: evaluation of 38 patients with chronic joint disability.

OBJECTIVE: To report the MR imaging findings of painful injured metacarpophalangeal (MCP) joints of the fingers. DESIGN AND PATIENTS: MR imaging of 39 injured MCP joints in 38 patients was performed after a mean delay of 8.8 months. The MR images were obtained with the fingers in extended and flexed positions using T2-weighted and T1-weighted sequences before and after intravenous injection of a gadolinium compound. Ten patients were treated surgically. Mean clinical follow-up was 1.8 years. RESULTS: Tears of the collateral ligaments were the most common lesion (30/39), most being radial in location. Contrast-enhanced axial T1-weighted images with the MCP joint in a flexed position showed these lesions optimally. Ten tears were partial and 20 were complete. In 13 patients, MR images showed 17 associated lesions including injuries of the extensor hood (10/17), interosseous tendon (3/17), palmar plate (3/17), and an osteochondral lesion (1/17). Sagittal MR images were essential to highlight palmar plate tears. CONCLUSION: Partial or complete tears of the collateral ligaments are prevalent MR imaging findings in patients with chronic disability resulting from injuries to the MCP joints. Although conservative treatment generally is sufficient for isolated injuries of the collateral ligaments, surgical repair is often required in cases of more extensive injuries. MR imaging may clearly delineate associated lesions of and about the MCP joints.

Estimation of left ventricular performance through temporal pressure variations measured by MR velocity and acceleration mappings.

PURPOSE: To describe a method for assessing pressure variation vs. time (dp/dt) using blood flow acceleration measured by MRI, and to demonstrate its applicability in estimating left ventricular (LV) function. MATERIALS AND METHODS: The method was tested in vitro using a pulsatile phantom, and a strong correlation was found between transducer and MRI determinations of dp/dt (r = 0.98). Selected aortic flow parameters were then measured in 10 patients and the results were compared with transducer measurements of the LV dp/dt. RESULTS: The correlation coefficients for the reference estimations of global myocardial function and MRI were 0.59 for aortic velocity, 0.74 for aortic acceleration, and 0.86 for aortic dp/dt. CONCLUSION: MR measurements of velocity and acceleration within the ascending aorta offer a noninvasive method for determining indices, such as the aortic dp/dt, that are closely correlated with the global myocardial contractility function.

Brain processing of visual sexual stimuli in healthy men: a functional magnetic resonance imaging study.

The brain plays a central role in sexual motivation. To identify cerebral areas whose activation was correlated with sexual desire, eight healthy male volunteers were studied with functional magnetic resonance imaging (fMRI). Visual stimuli were sexually stimulating photographs (S condition) and emotionally neutral photographs (N condition). Subjective responses pertaining to sexual desire were recorded after each condition. To image the entire brain, separate runs focused on the upper and the lower parts of the brain. Statistical Parametric Mapping was used for data analysis. Subjective ratings confirmed that sexual pictures effectively induced sexual arousal. In the S condition compared to the N condition, a group analysis conducted on the upper part of the brain demonstrated an increased signal in the parietal lobes (superior parietal lobules, left intraparietal sulcus, left inferior parietal lobule, and right postcentral gyrus), the right parietooccipital sulcus, the left superior occipital gyrus, and the precentral gyri. In addition, a decreased signal was recorded in the right posterior cingulate gyrus and the left precuneus. In individual analyses conducted on the lower part of the brain, an increased signal was found in the right and/or left middle occipital gyrus in seven subjects, and in the right and/or left fusiform gyrus in six subjects. In conclusion, fMRI allows to identify brain responses to visual sexual stimuli. Among activated regions in the S condition, parietal areas are known to be involved in attentional processes directed toward motivationally relevant stimuli, while frontal premotor areas have been implicated in motor preparation and motor imagery. Further work is needed to identify those specific features of the neural responses that distinguish sexual desire from other emotional and motivational states.

Recurrent glomus tumors of fingertips: MR imaging evaluation.

PURPOSE: To determine the magnetic resonance (MR) imaging findings in recurrent glomus tumors of the fingertips. MATERIALS AND METHODS: Twenty-four consecutive patients with recurrent pain after previous excision of a glomus tumor of the fingertip underwent MR imaging studies and surgery. T1-weighted spin-echo MR images were obtained in each patient before and after intravenous injection of contrast material; T2-weighted spin-echo and three-dimensional gradient-recalled echo images were also obtained. MR angiography was performed in four patients. Postsurgical histopathologic analysis revealed recurrent glomus tumors in 22 patients. Signal intensity, enhancement, and margins of the scar tissue and the recurrent tumors at MR were assessed. RESULTS: The postsurgical scars were depicted in 21 (88%) of 24 patients with all sequences but were best demonstrated on gradient-recalled echo MR images. Seven patients had undergone multiple surgical procedures and had extensive scar tissue and, in one case, a neuroma. In all patients, MR imaging revealed a nodule compatible with the diagnosis of a recurrent glomus tumor. In 13 (54%) of 24 patients, the nodule had typical features of a glomus tumor. In eight (33%) of 24 patients, the tumors had low signal intensity or isointensity compared with the nail bed on T2-weighted images. In six (25%) of 24 patients, the tumors had faint enhancement after intravenous gadolinium chelate administration. The margins of the tumors were blurred by scar tissue in nine of 24 cases. CONCLUSION: MR imaging can aid in the evaluation of recurrent glomus tumors.