Simple correction method for k-space trajectory deviations in MRI

STUDY OBJECTIVES: Recently, pulmonologists have performed thoracoscopy under local anesthesia using rigid thoracoscopes or flexible bronchoscopes. The latter allow greater access within the pleural cavity but are difficult to manipulate. The Olympus LTF semiflexible fiberoptic thoracoscope combines features of both instruments, having a solid body and a flexible terminal section. In the first study with this instrument, we evaluated ease of use and compared diagnostic yield with closed needle biopsy. PATIENTS: Twenty-four patients with pleural effusion were investigated. SETTING: Scottish University Hospital. DESIGN: Thoracoscopy was performed in the bronchoscopy suite after premedication with atropine and papaveretum. Following a standard Abram's needle biopsy, the LTF thoracoscope was inserted through a flexible introducer (Olympus Optical Co Ltd; Tokyo, Japan). The pleura was inspected and biopsy specimens were taken of suspicious areas. RESULTS: The final diagnosis was malignant pleural effusion in 16 of 24 patients. Ten of 16 were positive by Abram's biopsy, giving a sensitivity of 62%. Thirteen of 16 were positive by fiberoptic thoracoscopy, giving an improved sensitivity of 81%. The LTF thoracoscope was easy to use for pulmonologists experienced in rigid thoracoscopy and flexible bronchoscopy. Excellent views of the pleura were obtained from a single entry point. The procedure was well tolerated and no complications were encountered. CONCLUSION: The LTF thoracoscope allows excellent pleural access but a larger biopsy channel (currently 2 mm) might increase the accuracy of diagnosis.     

Polar sampling in k-space: reconstruction effects

Magnetic resonance images are most commonly computed by taking the inverse Fourier transform of the k-space data. This transformation can potentially create artifacts in the image, depending on the reconstruction algorithm used. For equally spaced radial and azimuthal k-space polar sampling, both gridding and convolution backprojection are applicable. However, these algorithms potentially can yield different resolution, signal-to-noise ratio, and aliasing characteristics in the reconstructed image. Here, these effects are analyzed and their tradeoffs are discussed. It is shown that, provided the modulation transfer function and the signal-to-noise ratio are considered together, these algorithms perform similarly. In contrast, their aliasing behavior is different, since their respective point spread functions (PSF) differ. In gridding, the PSF is composed of the mainlobe and ringlobes that lead to aliasing. Conversely, there are no ringlobes in the convolution backprojection PSF, thus radial aliasing effects are minimized. Also, a hybrid gridding and convolution backprojection reconstruction is presented for radially nonequidistant k-space polar sampling.     

Improved activation maps via the elimination of motion effects through time-domain mixing of data in conventional gradient echo functional MRI

To date, most functional imaging centers have relied on ultrafast imaging approaches such as echo-planar imaging (EPI) techniques for acquiring functional brain activation data. These methods require specialized hardware and are not yet installed widely on clinical MR imagers, thus limiting the application of functional MR imaging at many sites. EPI is used to limit motion artifacts and to collect multiple images under different task paradigms in order to distinguish reliably true signal changes from noise. However, it suffers from poor signal to noise ratio because of the high sampling bandwidth employed. This work presents an approach for increasing the efficiency of functional studies that use conventional gradient echo imaging. In this approach, small numbers of image data sets are acquired and recombined to generate composite datasets with minimized motion artifacts. The technique is introduced, and several algorithms for combining the data are explored. A receiver operator characteristic analysis and in vivo studies are performed to examine the efficacy of this approach for improving functional MR imaging studies.     

Clinical applications of functional MRI in neuropsychiatry

Clinical neuroimaging is due for yet another sea change as functional neuroimaging becomes increasingly powerful and available. Functional magnetic resonance imaging (fMRI) is perhaps the most promising of the emerging techniques. The following review helps us understand the physics, strengths, limitations, and promise of fMRI. The authors are all affiliated with the Brain Imaging Center at McLean Hospital and with the Departments of Neurology (Dr. Levin) and Psychiatry (Dr. Renshaw) at Harvard Medical School.     

Spatiotemporal imaging of human brain activity using functional MRI constrained magnetoencephalography data: Monte Carlo simulations

The goal of our research is to develop an experimental and analytical framework for spatiotemporal imaging of human brain function. Preliminary studies suggest that noninvasive spatiotemporal maps of cerebral activity can be produced by combining the high spatial resolution (millimeters) of functional MRI (fMRI) with the high temporal resolution (milliseconds) of electroencephalography (EEG) and magnetoencephalography (MEG). Although MEG and EEG are sensitive to millisecond changes in mental activity, the ability to resolve source localization and timing is limited by the ill-posed "inverse" problem. We conducted Monte Carlo simulations to evaluate the use of MRI constraints in a linear estimation inverse procedure, where fMRI weighting, cortical location and orientation, and sensor noise statistics were realistically incorporated. An error metric was computed to quantify the effects of fMRI invisible ("missing") sources, "extra" fMRI sources, and cortical orientation errors. Our simulation results demonstrate that prior anatomical and functional information from MRI can be used to regularize the EEG/MEG inverse problem, giving an improved solution with high spatial and temporal resolution. An fMRI weighting of approximately 90% was determined to provide the best compromise between separation of activity from correctly localized sources and minimization of error caused by missing sources. The accuracy of the estimate was relatively independent of the number and extent of the sources, allowing for incorporation of physiologically realistic multiple distributed sources. This linear estimation method provides an operator-independent approach for combining information from fMRI, MEG, and EEG and represents a significant advance over traditional dipole modeling.     

MRI of the heart: morphological and functional aspects

The performances of cardiac magnetic resonance imaging have been recently improved by the possibility of obtaining functional information by means of gradient echo sequences. Cavity volumetry and wall thickness and mass measurements are now possible. Ultrarapid sequences are useful for the analysis of myocardial perfusion and methods for measuring blood flow and temporal labelling of the ventricular wall open up new prospects for functional evaluation of the heart. In clinical practice, MRI can be useful for the exploration of cardiac parietal and intracavitary masses, constrictive pericarditis, hypertrophic and restrictive cardiomyopathy and cardiac malformations. Assessment of valvular and coronary heart disease is based on new techniques and is currently under evaluation.     

The supraorbital keyhole approach to supratentorial aneurysms: concept and technique

BACKGROUND: Anterior surgical approaches to the base of the brain have always required relatively large craniotomies, most larger than the lesion itself. Especially in aneurysm surgery, the size of the lesion is not always proportionate to the extent of brain exposure. The improvement of surgical techniques and diagnostic imaging, as well as the introduction of neuroendoscopy and new surgical instruments, enable us now to treat various intracranial lesions through small keyholes. In particular, cerebral aneurysms, because of their anatomic characteristics, are apt to be treated by the keyhole approach. The supraorbital keyhole approach has the broadest field of indications, although its technical aspects have not yet been evaluated. METHODS: The concept and technique of the supraorbital keyhole approach are presented in detail. We conducted a retrospective study in which we evaluated the technical aspects of the supraorbital keyhole approach considering the indications, limitations, and complications of this approach as well as new instrumentation in surgery of supratentorial aneurysms. RESULTS: The use of 139 supraorbital keyhole approaches for 197 aneurysms is described. Multiple aneurysms have been treated by one approach in 38 patients. Clipping of the aneurysm was performed in 94% and wrapping in 6% of patients. Eighteen aneurysms were contralateral to the approach. In four patients, intraoperative accidental aneurysm rupture occurred. There were no approach-related complications. CONCLUSIONS: The supraorbital keyhole approach offers equal surgical possibilities with less intraoperative accidental rupture and less approach-related morbidity as conventional approaches in the treatment of supratentorial aneurysms.     

The cranial MRI in severe cerebral palsy: a comparative study with clinical data

The magnetic resonance examination was performed in 38 patients with severe cerebral palsy (CP; 15 males and 23 females) who had both motor delay (unable to move anywhere) and mental retardation (I. Q or D. Q below 30). Neuroimaging findings were compared with the CP type, etiology, and grade of understanding of language. Cranial magnetic resonance imagings (MRI) in CP were divided into five types. Type 1 : nine predominantly showed cyst-liked ventricles and periventricular hyperintensity on T2-weighted imaging (PVH) and only scarred basal ganglia and thalamus were visible. All suffered from neonatal asphyxia and the clinical type was rigospastic tetraplegia (RST). Type 2: eleven predominantly showed PVH and hyperintensity on T2-weighted (HT2) in basal ganglia and thalamus. All suffered from neonatal asphyxia and the clinical type was RST or rigospastic diplegia. Type 3: five showed PVH and three had cortical atrophy. All suffered from neonatal asphyxia and the clinical type was spastic diplegia. Type 4: four predominantly showed HT 2 in putamen and thalamus. Three had cortical atrophy. All suffered from neonatal asphyxia. The clinical type was athetotic CP (ATH). Type 5: nine predominantly showed HT 2 in globus pallidus. Four had cortical atrophy and two had hippocampal atrophy. All suffered from neonatal jaundice and the clinical type was ATH. All patients who suffered from neonatal asphyxia and spastic CP had MRI in PVH. All patients who suffered from neonatal asphyxia and ATH showed HT 2 in putamen and thalamus. Almost patients who suffered neonatal jaundice and ATH showed HT 2 in globus pallidus. With athetotic CP, cases with atrophy of the cerebral cortex or/and hippocampus were lower grade of understanding of language than no atrophy of both. The result of studies of MRI are in agreement with neuropathological findings.     

Modeling hemodynamic response for analysis of functional MRI time-series

The standard Gaussian function is proposed for the hemodynamic modulation function (HDMF) of functional magnetic resonance imaging (fMRI) time-series. Unlike previously proposed parametric models, the Gaussian model accounts independently for the delay and dispersion of the hemodynamic responses and provides a more flexible and mathematically convenient model. A suboptimal noniterative scheme to estimate the hemodynamic parameters is presented. The ability of the Gaussian function to represent the HDMF of brain activation is compared with Poisson and Gamma models. The proposed model seems valid because the lag and dispersion values of hemodynamic responses rendered by the Gaussian model are in the ranges of their previously reported values in recent optical and fMR imaging studies. An extension of multiple regression analysis to incorporate the HDMF is presented. The detected activity patterns exhibit improvements with hemodynamic correction. The proposed model and efficient parameter estimation scheme facilitated the investigation of variability of hemodynamic parameters of human brain activation. The hemodynamic parameters estimated over different brain regions and across different stimuli showed significant differences. Measurement of hemodynamic parameters over the brain during sensory or cognitive stimulation may reveal vital information on physiological events accompanying neuronal activation and functional variability of the human brain, and should lead to the investigation of more accurate and complex models.     

The enhancing effects of anxiety on arousal in sexually dysfunctional and functional women.

Effects of anxiety on sexual arousal were examined to determine if sexually dysfunctional and functional women exhibit different patterns of physiological and subjective response. 32 Ss viewed 2 videotape conditions: an anxiety-evoking and neutral-control preexposure stimulus, each paired with a sexual arousal-evoking stimulus. Anxiety preexposure enhanced the rate and magnitude of genital arousal for both dysfunctional and functional Ss in relation to the neutral condition. Despite increased genital responses, both groups reported less subjective sexual arousal after anxiety preexposure. Functional Ss exhibited greater physiological but not subjective arousal than dysfunctional Ss in both conditions. Results are discussed in terms of desynchronous patterns of sexual response, mechanisms by which sympathetic activation enhances sexual arousal, and implications for treatment of sexual dysfunction in women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of functional knee braces on speed in collegiate basketball players

Knee braces are worn by many athletes following injury. The purpose of this study was to determine whether two functional knee braces (noncustom design) significantly affected straight line and successive turning trial running times in noninjured collegiate basketball players. Twenty-five coed basketball players completed 2 days of running trials. Subjects ran three full lengths of a basketball court and 10 lengths between the baseline and the foul line first without wearing a brace, then wearing either a DonJoy GoldPoint brace or an Omni OS-5 brace, and finally wearing the other brace. The results indicated no significant difference (p < .05) in straight line or successive turning running times when the two braces were compared with the nonbraced condition and when the two braces were compared with each other. The results implied that speed was not significantly affected by a functional knee brace in noninjured collegiate basketball players.     

Use of rank order data in functional measurement.

8 paid Ss estimated average value of angle pairs using magnitude estimations or graphic ratings. These numerical response data followed a simple averaging model. Functional scaling yielded a linear relation between subjective and objective angle. The numerical data were then reduced to rank orders, and J. B. Kruskal's monotone analysis of variance (MONANOVA) procedure was applied. This allowed a reconstruction of the original metric information from the strictly ordinal information, illustrating the power of MONANOVA in scaling. Limitations of MONANOVA in testing the underlying model are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability of individual functional MRI brain mapping of language.

The use of individual brain mapping for a single case study implicitly assumes that the pattern of activation obtained in a single session represents the subject's functional neuroanatomy. It is therefore essential to estimate the potential variability of brain activation in individuals. To this purpose, the authors compared the pattern of activation determined by statistical parametric mapping (SPM 99) in 9 subjects who repeated 3 verbal tasks in 3 separate sessions. In each subject for each task, the authors examined the intersession variability of the volume of activation in a set of regions classically implicated in language processing. Their results show that reproducibility of functional MRI brain mapping for language within subject varies as a function of the activation task and the region of interest for language. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Object shape processing in the visual system evaluated using functional MRI

We used functional MRI (fMRI) to determine the cortical regions activated during processing of visual object shape in humans in six men and three women, using a paradigm with a baseline condition of simple shape detection and an activated condition of object/nonobject shape discrimination. Eight of the nine subjects studied showed significant signal changes. Seven of eight showed changes in the occipital lobes (five bilateral, two right only, one left only). All eight subjects with signal changes exhibited changes in the parietal lobes bilaterally. In the occipitotemporal gyri, there were signal changes bilaterally in seven subjects and unilaterally, on the right, in one. Activation-related fMRI signal increases were also present in the posterior superior and middle temporal gyri in seven of the subjects, with four showing bilateral signal changes, two showing signal changes on the left only, and one only on the right. The data strongly suggest that processing of object shape information in humans activates both the ventral and dorsal visual processing pathways ("what" and "where" pathways), described previously both in humans and in nonhuman primates.     

Preoperative cortical localization with functional MRI for use in stereotactic radiosurgery

Accurate localization of the lesion with respect to functionally significant brain is essential to safe stereotactic radiosurgical dose planning. We report the use of functional MR imaging in 3 patients to identify critical areas of surrounding brain and to provide assistance with dose planning, especially with regard to shaping the peripheral isodose around the lesion. We used a functional MRI system employing a conventional 1.5-tesla MRI unit that can detect decreases in deoxyhemoglobin concentration occurring with performance of specific tasks. Two of the patients had supratentorial arteriovenous malformations and 1 patient had a recurrent parasagittal meningioma. Functional MRI provided information on the location of speech, motor, and sensory cortex in these patients. Radiosurgical dose plans were constructed that kept these cortical areas outside of the 30% isodose curves. We believe that the safety of supratentorial parenchymal radiosurgery will be enhanced by the localization of critical brain regions around the target.     

Statistical methods for detecting activated regions in functional MRI of the brain

Two statistical tests for detecting activated pixels in functional MRI (fMRI) data are presented. The first test (t-test) is the optimal solution to the problem of detecting a known activation signal in Gaussian white noise. The results of this test are shown to be equivalent to the cross-correlation method that is widely used for activation detection in fMRI. The second test (F test) is the optimal solution when the measured data are modeled to consist of an unknown activation signal that lies in a known lower dimensional subspace of the measurement space with added Gaussian white noise. A model for the signal subspace based on a truncated trigonometric Fourier series is proposed for periodic activation-baseline imaging paradigms. The advantage of the second method is that it does not assume any information about the shape or delay of the activation signal, except that it is periodic with the same period as the activation-baseline pattern. The two models are applied to experimental echo-planar fMRI data sets and the results are compared.     

Increased cerebral blood volume in HIV-positive patients detected by functional MRI

OBJECTIVE: To study changes in cerebral hemodynamics related to HIV infection. BACKGROUND: Cerebral injury is a well-known manifestation of HIV infection. Physiologic changes in the HIV brain may precede structural changes and may be detected by functional MRI (fMRI). METHODS: Dynamic contrast fMRI was used to measure the cerebral blood volume (CBV) in 13 patients infected with HIV and in 7 healthy control subjects. RESULTS: Significant increases in dynamic CBV were found in the deep (p < 0.001) and cortical gray matter (p < 0.05) of HIV-positive (HIV+) patients. Patients with definite cognitive impairment showed significantly greater increases in CBV in the deep gray matter (DGM) compared with those without impairment. In one patient with rapidly progressive cognitive impairment, these abnormalities reversed and paralleled clinical improvement after initiation of zidovudine monotherapy. CONCLUSIONS: This study supports the hypothesis that HIV infection is associated with significant cerebral hemodynamic changes, particularly in the DGM, that may contribute to cognitive dysfunction in AIDS. Functional MRI may be useful for early detection of cerebral injury and for the assessment of novel therapies.     

Theory and clinical application of functional MRI: 3D-functional brain mapping

Functional magnetic resonance imaging (fMRI) was performed using a clinical 1.5 T MR scanner. Normal volunteers and patients with several neurological disorders were studied with somatosensory stimulation using sponge at right hand and visual stimulation using checkerboard pattern. Both fMR images by gradient echo echo planar imaging and three dimensional gradient echo images were studied. Reconstructed 3 dimensional functional brain mapping was superimposed on 3D anatomical images. Apparent signal increase was observed at contra lateral sensorimotor cortex and secondary sensory cortex with sponge stimulation. In the case of left homonymous hemianopia due to cerebral infarction, increasing signal was only observed surrounding left calcarine fissure by using stimulation of all visual field. In conclusion, fMRI and 3-D functional brain mapping has extremely high potentiality to examine pathophysiology of various neurological disorders.