P3099Lymphatic insufficiency increases cardiac edema after myocardial infarction as assessed by novel magnetic resonance TRAFFn and T2 relaxation times

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Yla-Herttuala ◽  
T Vuorio ◽  
S Laidinen ◽  
S Yla-Herttuala ◽  
T Liimatainen

Abstract Introduction The role of cardiac lymphatic system in myocardial infarction (MI) is still unclear. A new method to detect and characterize MI without contrast agent is a relaxation along a fictitious field in nth rotating frame (RAFFn). The RAFFn takes advantage of the fictitious magnetic field, which is produced by a fast sweep of an effective radio frequency field, to increase a spin locking field strength without increasing the specific absorption rate. MI is detected as increased RAFFn relaxation times and cardiac edema by an increased T2 relaxation time. We have shown earlier that MI size can be accurately measured by the RAFFn relaxation times. Purpose To study the effects of the lack of cardiac lymphatic system on MI and cardiac edema in a mouse model. Methods Transgenic (TG) mice expressing soluble decoy VEGF receptor 3 (sVEGFR3) thus blocking lymphatic vessel formation in the heart and wild type (WT) control mice were used. MI was induced in 13–17 week old TG (n=11) and WT (n=14) mice by ligating the left anterior descending coronary artery. The RAFFn (TRAFF2 and TRAFF4), a continuous wave T1ρ and a T2 relaxation times were acquired at time points 0, 3, 7 and 21 days after the MI at 9.4 T. Histological sections were stained with hematoxylin eosin and Sirius red to assess cellularity and MI area. An Area of difference (AOD) was determined by subtracting MI areas based on TRAFF2, TRAFF4 and T1ρ maps from MI area based on T2 maps. Results MI size based on the TRAFF4 and T2 relaxation time maps were larger at early time points 3 and 7 days post MI in the WT group compared to the TG group (Figure 1A-B, p<0.05). However, the MI size was significantly larger in the T2 relaxation time map in the TG group compared to the WT group at the last time point and interaction between the groups were significant as a function of time (Figure 1A-B, p<0.05). The AOD values, which reflect cardiac edema, increased in the TG group as a function of time (Figure 1C, p<0.001). TRAFF2, TRAFF4 (Figure 1D), T1ρ and T2 relaxation times increased significantly (≈50%, p<0.001) after the MI compared to remote areas in both groups. In the WT group, the lymphatic vessel network is fully functional and removes edema efficiently between days 3 and 21 after the MI, while in the TG group the MI area in T2 map is relative stable indicating insufficient edema removal, caused by the lymphatic deficiency and insufficient lymphangiogenesis in the TG group. The MIs were also verified based on Sirius red stained histology (Figure 1E). Figure 1 Conclusion Lymphatic deficiency increases cardiac edema (AOD values) 7–21 days after MI as compared to the WT group. Results support the importance of cardiac lymphatic vessels for healing after MI. Effects of the lymphatics on MI can be detected based on the MI size difference based on the TRAFFn and the T2 relaxation times. Acknowledgement/Funding Doctoral Programme of Molecular Medicine

2015 ◽  
Vol 3 (1) ◽  
pp. SA77-SA89 ◽  
Author(s):  
John Doveton ◽  
Lynn Watney

The T2 relaxation times recorded by nuclear magnetic resonance (NMR) logging are measures of the ratio of the internal surface area to volume of the formation pore system. Although standard porosity logs are restricted to estimating the volume, the NMR log partitions the pore space as a spectrum of pore sizes. These logs have great potential to elucidate carbonate sequences, which can have single, double, or triple porosity systems and whose pores have a wide variety of sizes and shapes. Continuous coring and NMR logging was made of the Cambro-Ordovician Arbuckle saline aquifer in a proposed CO2 injection well in southern Kansas. The large data set gave a rare opportunity to compare the core textural descriptions to NMR T2 relaxation time signatures over an extensive interval. Geochemical logs provided useful elemental information to assess the potential role of paramagnetic components that affect surface relaxivity. Principal component analysis of the T2 relaxation time subdivided the spectrum into five distinctive pore-size classes. When the T2 distribution was allocated between grainstones, packstones, and mudstones, the interparticle porosity component of the spectrum takes a bimodal form that marks a distinction between grain-supported and mud-supported texture. This discrimination was also reflected by the computed gamma-ray log, which recorded contributions from potassium and thorium and therefore assessed clay content reflected by fast relaxation times. A megaporosity class was equated with T2 relaxation times summed from 1024 to 2048 ms bins, and the volumetric curve compared favorably with variation over a range of vug sizes observed in the core. The complementary link between grain textures and pore textures was fruitful in the development of geomodels that integrates geologic core observations with petrophysical log measurements.


2021 ◽  
Vol 12 ◽  
Author(s):  
Chunxiang Zhang ◽  
Xin Zhao ◽  
Meiying Cheng ◽  
Kaiyu Wang ◽  
Xiaoan Zhang

Objectives: Synthetic MRI can obtain multiple parameters in one scan, including T1 and T2 relaxation time, proton density (PD), brain volume, etc. This study aimed to investigate the parameter values T1 and T2 relaxation time, PD, and volume characteristics of intraventricular hemorrhage (IVH) newborn brain, and the ability of synthetic MRI parameters T1 and T2 relaxation time and PD to diagnose IVH.Materials and methods: The study included 50 premature babies scanned with conventional and synthetic MRI. Premature infants were allocated to the case group (n = 15) and NON IVH (n = 35). The T1, T2, PD values, and brain volume were obtained by synthetic MRI. Then we assessed the impact of IVH on these parameters.Results: In the posterior limbs of the internal capsule (PLIC), genu of the corpus callosum (GCC), central white matter (CWM), frontal white matter (FWM), and cerebellum (each p &lt; 0.05), the T1 and T2 relaxation times of the IVH group were significantly prolonged. There were significant differences also in PD. The brain volume in many parts were also significantly reduced, which was best illustrated in gray matter (GM), cerebrospinal fluid and intracranial volume, and brain parenchymal fraction (BPF) (each p &lt; 0.001, t = −5.232 to 4.596). The differential diagnosis ability of these quantitative values was found to be excellent in PLIC, CWM, and cerebellum (AUC 0.700–0.837, p &lt; 0.05).Conclusion: The quantitative parameters of synthetic MRI show well the brain tissue characteristic values and brain volume changes of IVH premature infants. T1 and T2 relaxation times and PD contribute to the diagnosis and evaluation of IVH.


Neurology ◽  
2020 ◽  
Vol 95 (9) ◽  
pp. e1211-e1221 ◽  
Author(s):  
Julia R. Dahlqvist ◽  
Nanna S. Poulsen ◽  
Sofie T. Østergaard ◽  
Freja Fornander ◽  
Josefine de Stricker Borch ◽  
...  

ObjectiveWe followed up patients with facioscapulohumeral muscular dystrophy (FSHD) with sequential examinations over 2 years to investigate whether inflammatory lesions always precede fat replacement, if inflammation can be resolved without muscle degeneration, and if inflammatory lesions in muscle are always followed by fat replacement.MethodsIn this longitudinal study of 10 sequential MRI assessments over 2.5 years, we included 10 patients with FSHD. We used MRI with short TI inversion recovery to identify regions of interest (ROIs) with hyperintensities indicating muscle inflammation. Muscle T2 relaxation time mapping was used as a quantitative marker of muscle inflammation. Dixon sequences quantified muscle fat replacement. Ten healthy controls were examined with a magnetic resonance scan once for determination of normal values of T2 relaxation time.ResultsWe identified 68 ROIs with T2 elevation in the patients with FSHD. New ROIs with T2 elevation arising during the study had muscle fat content of 6.4% to 33.0% (n = 8) and 47.0% to 78.0% lesions that resolved (n = 6). ROIs with T2 elevation had a higher increase in muscle fat content from visits 1 to 10 (7.9 ± 7.9%) compared to ROIs with normal muscle T2 relaxation times (1.7 ± 2.6%; p < 0.0001). Severe T2 elevations were always followed by an accelerated replacement of muscle by fat.ConclusionsOur results suggest that muscle inflammation starts in mildly affected muscles in FSHD, is related to a faster muscle degradation, and continues until the muscles are completely fat replaced.ClinicalTrials.gov identifierNCT02159612.


2021 ◽  
Vol 9 (2) ◽  
pp. 232596712097998
Author(s):  
Hsin-Min Wang ◽  
Sandra J. Shultz ◽  
Scott E. Ross ◽  
Robert A. Henson ◽  
David H. Perrin ◽  
...  

Background: High anterior knee laxity (AKL) has been prospectively identified as a risk factor for anterior cruciate ligament (ACL) injuries. Given that ACL morphometry and structural composition have the potential to influence ligamentous strength, understanding how these factors are associated with greater AKL is warranted. Hypothesis: Smaller ACL volumes combined with longer T2* relaxation times would collectively predict greater AKL. Study Design: Cross-sectional study; Level of evidence, 3. Methods: College-aged active male (n = 20) and female (n = 30) participants underwent magnetic resonance imaging (MRI) and AKL testing. T2-weighted MRI scans were used to assess ACL volumes, and T2* relaxation times were used to assess ACL structural composition. AKL was measured via a commercial knee arthrometer. Forward stepwise linear regression with sex and weight (first step; suppressor variables) as well as ACL volume and T2* relaxation time (second step; independent variables) was used to predict AKL (dependent variable). Results: After initially adjusting for sex and weight ( R 2 = 0.19; P = .006), smaller ACL volumes combined with longer T2* relaxation times collectively predicted greater AKL ( R 2 = 0.52; P < .001; R 2 Δ = 0.32; P Δ < .001). A smaller ACL volume was the primary predictor of greater AKL ( R 2 Δ = 0.28; P < .001), with a longer T2* relaxation time trending toward a significant contribution to greater AKL ( R 2 Δ = 0.04; P = .062). After adjusting for ACL volume and T2* relaxation time, sex (partial r = 0.05; P = .735) and weight (partial r = 0.05; P = .725) were no longer significant predictors. Conclusion: AKL was largely predicted by ACL volume and to a lesser extent by T2* relaxation time (and not a person’s sex and weight). These findings enhance our understanding of how AKL may be associated with a structurally weaker ACL. The current study presents initial evidence that AKL is a cost-effective and clinically accessible measure that shows us something about the structural composition of the ACL. As AKL has been consistently shown to be a risk factor for ACL injuries, work should be done to continue to investigate what AKL may tell a clinician about the structure and composition of the ACL.


2020 ◽  
Vol 33 (2) ◽  
pp. 160-168
Author(s):  
Maike Kern ◽  
Timo A Auer ◽  
Uli Fehrenbach ◽  
Yasemin Tanyildizi ◽  
Thomas Picht ◽  
...  

Aim To investigate multivariable analyses for noninvasive association of the isocitrate dehydrogenase (IDH) mutational status in grade II and III gliomas including evaluation of T2 mapping-sequences. Methods Magnetic resonance imaging (MRI) examinations with histopathologically proven World Health Organization grade II and III gliomas were retrospectively enrolled. Multivariate receiver operating characteristics (ROC) analyses to associate IDH mutational status were performed containing quantitative T2 mapping analyses and qualitative characteristics (sex, age, localization, heterogeneity, oedema, necrosis and diameter). Relaxation times were calculated pixelwise by means of standardized ROI analyses. Interobserver variability also was tested. Results Out of 32 patients (mean age: 50.7 years; range: 32–83), nine had grade II gliomas and 24 grade III, while 59.5% showed a positive IDH mutated state (IDHm) and 40.5% were wildtype (IDHw). Multivariable ROC analyses were calculated for relaxation time and range, localization and age with a cumulative 0.955 area under the curve (AUC) ( p < 0.001), while central T2-relaxation time had by far the highest single variable sensitivity (AUC: 0.873; range: 0.762; age: 0.809; localization: 0.713). Age (cut off: 49 years; p = 0.031) and localization ( p = 0.014) were the only qualitative parameters found to be significant as IDHw gliomas were older and IDHm gliomas were preferentially located fronto-temporal. Conclusions This is the first study evaluating quantitative T2 mapping sequences for association of the IDH mutational status in grade II and III gliomas demonstrating an association between relaxation time and mutational status. Analyses of T2 mapping relaxation times may even be suitable for predicting the correct IDH mutational state. Prognostic accuracy increases significantly in predicting the correct mutational state when combing T2 relaxation time characteristics and the qualitative MRI features age and localization.


2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. i2-i2
Author(s):  
Bryan Allen ◽  
Michael Petronek ◽  
Varun Monga ◽  
Kellie Bodeker ◽  
Brian Smith ◽  
...  

Abstract Pharmacological ascorbate (P-AscH-; high dose intravenous infusions of vitamin C generating milli-molar plasma concentrations) has re-emerged as an anti-cancer therapy. Phase 1 clinical trials combining P-AscH- with chemotherapy and ionizing radiation demonstrate safety and promising clinical outcomes in a variety of malignancies. In a first-in-human trial, subjects with newly diagnosed glioblastoma (GBM) and undetectable MGMT promoter methylation were treated with P-AscH-, ionizing radiation, and temozolomide. Results demonstrate median progression-free survival (PFS) of 10 months and median overall survival (OS) of 23 months, comparing favorably to historical GBM patients expressing MGMT. P-AscH-‘s anti-cancer mechanism is dependent upon the presence of redox active labile iron. In the presence of redox active iron, the formation of hydrogen peroxide, which causes oxidative stress and eventual cell death, selectively forms in cancer cells. Treatment with P-AscH- increased cancer cells’ labile iron pool, further enhancing sensitivity to P-AscH-. We investigated the capability of MR imaging (T2* relaxation time) to measure the redox active iron and predict response to P-AscH-. T2* relaxation time is influenced by in-field inhomogeneities, such as redox active paramagnetic iron. The active phase 2 trial evaluating P-AscH-, radiation, and temozolomide for GBM, obtains T2* imaging prior to (baseline) and immediately after ascorbate infusion (NCT02344355). A preliminary analysis of the baseline scan for the first 15 subjects suggests those with faster GBM T2* relaxation times (≤ 58 ms) have more redox active labile iron pools as well as an improved median PFS (11.4 months) compared to those with slower T2* relaxation times (&gt; 58 ms; median PFS of 8.5 months). Pre-clinical studies evaluating the effectiveness of iron nano-particle supplementation in GBM animal models are on-going. (Supported by P01 CA217797, R01 CA169046, U01 CA140206, T32 CA078586, P30 CA086862, as well as the Gateway for Cancer Research grant G-17–1500.)


2000 ◽  
Vol 142 (6) ◽  
pp. 591-597 ◽  
Author(s):  
EV Nagy ◽  
J Toth ◽  
I Kaldi ◽  
J Damjanovich ◽  
E Mezosi ◽  
...  

BACKGROUND: Diplopia identifies patients with eye muscle involvement in Graves' ophthalmopathy (GO). OBJECTIVE: To identify clinical parameters that could eliminate the need for magnetic resonance imaging (MRI) to assess the activity of inflammation in the eye muscles of GO patients with diplopia. METHODS: In 43 patients with GO with recently developed diplopia, orbital ultrasound and MRI were performed. Muscle diameters and MRI T2 relaxation times were measured, and the amount of orbital connective tissue was calculated from MRI scans and compared with ultrasound readings, diplopia grades, degree of protrusion, ocular pressure, tear production, antibody levels and hormonal parameters of thyroid function. RESULTS: No correlation was found between diameters of 233 extraocular muscles measured by MRI and by ultrasound. For each of the four muscles, there was a diameter above which ultrasound was always unreliable. MRI data were used in further analysis. Of the muscles examined, the inferior rectuses were the most frequently enlarged - at least one, in 93% of cases. Medial, lateral and superior rectuses were enlarged in 59%, 37% and 34% of the orbits respectively. The pattern of muscle involvement of the two orbits tended to be symmetric (r=0.49, P=0.003), particularly for the medial rectuses (r=0.90, P=0.000). Proptosis correlated with the sum of the muscle diameters for a given eye (right eye: r=0.54, P=0.003; left eye: r=0.57, P=0.001), but it failed to correlate with the amount of orbital connective tissue. In 53% of the patients, normal T2 relaxation times were found in all eight muscles. There was only a weak correlation between muscle thickness and T2 relaxation time (r=0.49, P=0.003), indicating that muscle enlargement alone is not a sign of disease activity. The severity of diplopia was independent of T2 relaxation time. The amount of orbital connective tissue showed a negative correlation with the greatest T2 relaxation time for a given eye (r= -0.52, P=0.004); this suggests that disease types exist that have predominant muscle involvement and predominant connective tissue expansion. No correlation between connective tissue expansion and proptosis, diplopia grade, muscle thickness or disease duration was found - that is, connective tissue expansion is not a major factor in diplopia. Both muscle and connective tissue findings were independent of thyroid function. CONCLUSION: Ultrasound and MRI eye muscle diameter readings do not correlate, because of the inherent inaccuracy of orbital ultrasound. Muscle enlargement alone does not mean oedematous swelling and active disease. Neither ultrasound, nor any combination of 11 clinical and laboratory parameters provided the degree of information on muscles and connective tissue that was obtainable by MRI. In unclear cases of recently developed diplopia, before orbital decompression surgery, in the case of treatment failure or if, for any other reason, imaging is needed in GO, MRI is the method of choice.


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