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The article is aimed at researching the infrastructure and infrastructural-transformational processes of the formation and development of the investment potential of the region. Infrastructure provision of investment processes in the Black Sea region is analyzed. The analysis showed that, in general, the region has a fairly strong infrastructure potential, which, if used efficiently, is an important basis for developing the investment potential of the economy. A comparative analysis of development of the region’s transport and logistics subsystem of investment potential showed that, despite the rather high performance indicators of enterprises in the region, there are some problems in the territories of the region related to the state of road surfaces, especially on roads of regional importance; reduction of service infrastructure and lower, compared to the average indicators’ values, functional characteristics of individual services. It is substantiated that the infrastructure potential of the region due to insufficient governmental support and certain transformations going on in the economy is not used thoroughly and requires the development of comprehensive strategic solutions to optimize and adapt to the needs of the region’s economic development in the long term.

Abstract Background Functional assessments of the heart by dynamic cardiovascular magnetic resonance (CMR) commonly rely on (i) electrocardiographic (ECG) gating yielding pseudo real-time cine representations, (ii) balanced gradient-echo sequences referred to as steady-state free precession (SSFP), and (iii) breath holding or respiratory gating. Problems may therefore be due to the need for a robust ECG signal, the occurrence of arrhythmia and beat to beat variations, technical instabilities (e.g., SSFP "banding" artefacts), and limited patient compliance and comfort. Here we describe a new approach providing true real-time CMR with image acquisition times as short as 20 to 30 ms or rates of 30 to 50 frames per second. Methods The approach relies on a previously developed real-time MR method, which combines a strongly undersampled radial FLASH CMR sequence with image reconstruction by regularized nonlinear inversion. While iterative reconstructions are currently performed offline due to limited computer speed, online monitoring during scanning is accomplished using gridding reconstructions with a sliding window at the same frame rate but with lower image quality. Results Scans of healthy young subjects were performed at 3 T without ECG gating and during free breathing. The resulting images yield T1 contrast (depending on flip angle) with an opposed-phase or in-phase condition for water and fat signals (depending on echo time). They completely avoid (i) susceptibility-induced artefacts due to the very short echo times, (ii) radiofrequency power limitations due to excitations with flip angles of 10° or less, and (iii) the risk of peripheral nerve stimulation due to the use of normal gradient switching modes. For a section thickness of 8 mm, real-time images offer a spatial resolution and total acquisition time of 1.5 mm at 30 ms and 2.0 mm at 22 ms, respectively. Conclusions Though awaiting thorough clinical evaluation, this work describes a robust and flexible acquisition and reconstruction technique for real-time CMR at the ultimate limit of this technology.

This work describes a novel technique for rapid and motion-robust whole-body magnetic resonance imaging (MRI). The method employs highly undersampled radial fast low angle shot (FLASH) sequences to cover large volumes by cross-sectional real-time MRI with automatic slice advancement after each frame. The slice shift typically amounts to a fraction of the slice thickness (e.g., 10% to 50%) in order to generate a successive series of partially overlapping sections. Joint reconstructions of these serial images and their respective coil sensitivity maps rely on nonlinear inversion (NLINV) with regularization to the image and sensitivity maps of a preceding frame. The procedure exploits the spatial similarity of neighboring sections. Whole-body scanning is accomplished by measuring multiple volumes at predefined locations, i.e., at fixed table positions, in combination with intermediate automatic movements of the patient table. Individual volumes may take advantage of different field-of-views, image orientations, spatial and temporal resolutions as well as contrasts. Preliminary proof-of-principle applications to healthy subjects at 3 T without cardiac gating and during free breathing yield high-quality anatomic images with acquisition times of less than 100 ms. Spin-density and T1 contrasts are obtained by spoiled FLASH sequences, while T2-type (i.e., T2/T1) contrast results from refocused FLASH sequences that generate a steady state free precession (SSFP) free induction decay (FID) signal. Total measuring times excluding vendor-controlled adjustment procedures are less than two minutes for a 100 cm scan that, for example, covers the body from head to thigh by three optimized volumes and more than 1,300 images. In conclusion, after demonstrating technical feasibility the proposed method awaits clinical trials., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-923/coif). DV and JF report that they are co-inventors of a patent describing the MRI method (Rapid Volume Coverage 2020) used in this study. The other authors have no conflicts of interest to declare., (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Introduction: Musculoskeletal problems in professional brass musicians are very common and often involve the muscles of the embouchure. In rare cases, embouchure dystonia (EmD), a task-specific movement disorder with a wide symptomatic and phenotypic variability, occurs. Following trumpeters and horn players, professional tuba players with and without EmD have now been studied using the latest real-time MRI technology to better understand the underlying pathophysiology., Materials and Methods: In the present study, the tongue movement patterns of 11 healthy professional artists and one subject suffering from EmD were compared. The tongue position in the anterior, intermediary and posterior oral cavity were converted into pixel positions based on seven previously generated profile lines, using the established software MATLAB. These data allow a structured comparison of tongue movement patterns between the patient and the healthy subjects, as well as between individual exercises. The main focus of the analysis was on an ascending 7-note harmonic series performed in different playing techniques (slurred, tongued, tenuto and staccato)., Results: Playing the ascending harmonics, a noticeable ascending tongue movement could be observed in the anterior part of the oral cavity in healthy tubists. In the posterior region, there was a slight decrease in oral cavity space. In the EmD patient, hardly any movement was observed at the tongue apex, but in the middle and posterior regions of the oral cavity there was an increase in size the higher the tone became. These distinct differences are relevant for the characterization and a better understanding of the clinical presentation of EmD. Concerning different playing techniques, it was apparent, that notes played slurred or staccato resulted in a larger oral cavity when compared to notes played tongued or tenuto, respectively., Conclusion: By using real-time MRI videos, the tongue movements of tuba players can be clearly observed and analyzed. The differences between healthy and diseased tuba players demonstrate the great effects of movement disorders in a small area of the tongue. In order to better understand the compensation of this motor control dysfunction, further studies should investigate further parameters of tone production in all brass players with a larger number of EmD patients additional to the observed movement patterns., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Nelkenstock, Iltis, Voit, Frahm, Passarotto and Altenmüller.)

This work is a proof-of-concept realization of a novel technique for rapid volumetric acquisition, reconstruction, and visualization of three-directional (3dir) flow velocities. The technique combines real-time 3dir phase-contrast (PC) flow magnetic resonance imaging (MRI) with real-time cross-sectional volume coverage. It offers a rapid examination without dependence on electrocardiography (ECG) or respiratory gating during a continuous image acquisition at up to 16 fps. Real-time flow MRI utilizes pronounced radial undersampling and a model-based nonlinear inverse reconstruction. Volume coverage is achieved by automatically advancing the slice position of each PC acquisition by a small percentage of the slice thickness. Post-processing involves the calculation of maximum intensity projections along the slice dimension resulting in six direction-selective velocity maps and a maximum speed map. Preliminary applications to healthy subjects at 3 T comprise mapping of the carotid arteries and cranial vessels at 1.0 mm in-plane resolution within 30 s as well as of the aortic arch at 1.6 mm resolution within 20 s. In conclusion, the proposed method for rapid mapping of 3dir flow velocities offers a quick assessment of the vasculature either to provide a first clinical survey or to plan for more detailed studies., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-22-1126/coif). DV and JF report that they are co-inventors of a patent describing the MRI method used here. The other authors have no conflicts of interest to declare., (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

This work describes a dynamic magnetic resonance imaging (MRI) technique for local scanning of the human body with use of a handheld receive coil or coil array. Real-time MRI is based on highly undersampled radial gradient-echo sequences with joint reconstructions of serial images and coil sensitivity maps by regularized nonlinear inversion (NLINV). For this proof-of-concept study, a fixed slice position and field-of-view (FOV) were predefined from the operating console, while a local receive coil (array) is moved across the body-for the sake of simplicity by the subject itself. Experimental realizations with a conventional 3 T magnet comprise dynamic anatomic imaging of the head, thorax and abdomen of healthy volunteers. Typically, the image resolution was 0.75 to 1.5 mm with 3 to 6 mm section thickness and acquisition times of 33 to 100 ms per frame. However, spatiotemporal resolutions and contrasts are highly variable and may be adjusted to clinical needs. In summary, the proposed FLASHlight MRI method provides a robust acquisition and reconstruction basis for future diagnostic strategies that mimic the usage of ultrasound. Necessary extensions for this vision require remote control of all sequence parameters by a person at the scanner as well as the design of more flexible gradients and magnets., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-22-648/coif). DV and JF report that they are co-inventors of a patent describing the MRI method used here. The other authors have no conflicts of interest to declare., (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Background: The aim of this study was to evaluate the reproducibility and clinical value of the novel single-shot T1 mapping method for rapid and accurate multi-slice coverage of the whole brain, described by Wang et al. 2015., Methods: At a field strength of 3 Tesla, T1 mappings of 139 patients (51 of them without pathologic findings) and two repeats of five volunteers were performed at 0.5 mm in-plane resolution. Mean T1 values were determined in 18 manually segmented regions-of-interest without pathologic findings. Reproducibility of the repeated scans was calculated using mean coefficient of variations. Pathologies were grouped and separately evaluated., Results: The mean age of the cohort was 49 (range 1-95 years). T1 relaxation times for ordinary brain and pathologies were in accordance with the literature values. Intra- and inter-subject reproducibility was excellent, and mean coefficient of variations were 2.4% and 3.8%, respectively., Discussion: The novel rapid T1 mapping method is a reliable magnetic resonance imaging technique for identifying and quantifying normal brain structures and may thus serve as a basis for assessing pathologies. The fast and parallel online calculation enables a comfortable use in everyday clinical practice. We see a possible clinical value in a large spectrum of diseases, which should be investigated in further studies.

Velum position was analysed as a function of vowel height in German tense and lax vowels preceding a nasal or oral consonant. Findings from previous research suggest an interdependence between vowel height and the degree of velum lowering, with a higher velum during high vowels and a more lowered velum during low vowels. In the current study, data were presented from 33 native speakers of Standard German who were measured via non-invasive high quality real-time magnetic resonance imaging. The focus was on exploring the spatiotemporal extent of velum lowering in tense and lax /a, i, o, ø/, which was done by analysing velum movement trajectories over the course of VN and VC sequences in CVNV and CVCV sequences by means of functional principal component analysis. Analyses focused on the impact of the vowel category and vowel tenseness. Data indicated that not only the position of the velum was affected by these factors but also the timing of velum closure. Moreover, it is argued that the effect of vowel height was to be better interpreted in terms of the physiological constriction location of vowels, i.e., the specific tongue position rather than phonetic vowel height.

Purpose: Diffusion-weighted imaging (DWI) is an essential element of almost every brain MRI examination. The most widely applied DWI technique, a single-shot echo-planar imaging DWI (EPI-DWI) sequence, suffers from a high sensitivity to magnetic field inhomogeneities. As an alternative, a single-shot stimulated echo acquisition mode diffusion-weighted MRI (STEAM-DWI) has recently been re-introduced after it became significantly faster. The aim of the study was to investigate the applicability of STEAM-DWI as a substitute to EPI-DWI in a daily routine of pediatric radiology., Methods: Retrospectively, brain MRI examinations of 208 children with both EPI-DWI and STEAM-DWI were assessed. Visual resolution and diagnostic confidence were evaluated, the extent of susceptibility artifacts was quantified, and contrast-to-noise ratio was calculated in case of diffusion restriction. Furthermore, the correlation of apparent diffusion coefficient values between STEAM-DWI and EPI-DWI was tested., Results: STEAM-DWI was inferior to EPI-DWI in visual resolution but with higher diagnostic confidence and lower artifact size. The apparent diffusion coefficient values of both sequences demonstrated excellent correlation. The contrast-to-noise ratio of STEAM-DWI was only half of that of EPI-DWI (58% resp. 112%)., Conclusion: STEAM-DWI is a robust alternative to EPI-DWI when increased susceptibility artifacts are to be expected. Drawbacks are a lower contrast-to-noise ratio and poorer visual resolution., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Jens Frahm and Dirk Voit are co-inventors of a patent and software describing the MRI technique used here for brain imaging. This does not alter our adherence to PLoS ONE policies on sharing data and materials. The other authors have declared that no competing interests exist.

Objective . Atherosclerosis is a leading cause of mortality and morbidity. Optical endoscopy, ultrasound, and X-ray offer minimally invasive imaging assessments but have limited sensitivity for characterizing disease and therapeutic response. Magnetic resonance imaging (MRI) endoscopy is a newer idea employing tiny catheter-mounted detectors connected to the MRI scanner. It can see through vessel walls and provide soft-tissue sensitivity, but its slow imaging speed limits practical applications. Our goal is high-resolution MRI endoscopy with real-time imaging speeds comparable to existing modalities. Methods . Intravascular (3 mm) transmit-receive MRI endoscopes were fabricated for highly undersampled radial-projection MRI in a clinical 3-tesla MRI scanner. Iterative nonlinear reconstruction was accelerated using graphics processor units connected via a single ethernet cable to achieve true real-time endoscopy visualization at the scanner. MRI endoscopy was performed at 6-10 frames/sec and 200-300  μ m resolution in human arterial specimens and porcine vessels ex vivo and in vivo and compared with fully sampled 0.3 frames/sec and three-dimensional reference scans using mutual information (MI) and structural similarity (3-SSIM) indices. Results . High-speed MRI endoscopy at 6-10 frames/sec was consistent with fully sampled MRI endoscopy and histology, with feasibility demonstrated in vivo in a large animal model. A 20-30-fold speed-up vs. 0.3 frames/sec reference scans came at a cost of ~7% in MI and ~45% in 3-SSIM, with reduced motion sensitivity. Conclusion . High-resolution MRI endoscopy can now be performed at frame rates comparable to those of X-ray and optical endoscopy and could provide an alternative to existing modalities, with MRI's advantages of soft-tissue sensitivity and lack of ionizing radiation., Competing Interests: JF and DV are coinventors of a patent and software owned by the Max-Planck-Society related to the real-time MRI technology. PAB is a coinventor of a patent related to MRI endoscopy held by Johns Hopkins University. The other authors declare no competing interests., (Copyright © 2021 Xiaoyang Liu et al.)

This work describes a new method for diffusion-weighted (DW) magnetic resonance imaging (MRI) without susceptibility artifacts. The technique combines a DW spin-echo module and a single-shot stimulated echo acquisition mode (STEAM) MRI readout with undersampled radial trajectories and covers a volume by a gapless series of cross-sectional slices. In a first step, optimal coil sensitivities for all slices are obtained from a series of non-DW acquisitions by nonlinear inverse reconstruction with regularization to the image and coil sensitivities of a directly neighboring slice. In a second step, these coil sensitivities are used to compute all series of non-DW and DW images by linear inverse reconstruction with spatial regularization to a neighboring image. Proof-of-principle applications to the brain (51 sections) and prostate (31 sections) of healthy subjects were realized for a protocol with two b-values and 6 gradient directions at 3 T. Including averaging the measuring times for studies of the brain at 1.0×1.0×3.0 mm 3 resolution (b =1,000 s mm -2 ) and prostate at 1.4×1.4×3.0 mm 3 resolution (b =600 s mm -2 ) were 2.5 min and 4.5 min, respectively. All reconstructions were accomplished online with use of a multi-GPU computer integrated into the MRI system. The resulting non-DW images, mean DW images averaged across directions and maps of the apparent diffusion coefficient confirm the absence of geometric distortions or false signal alterations and demonstrate diagnostic image quality. The novel method for DW STEAM MRI of a volume without susceptibility artifacts warrants extended clinical trials., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-871). The authors report that they are co-inventors of a pending patent “Diffusion-weighted MRI of a volume without susceptibility artifacts”., (2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Background: The embouchure of trumpet players is of utmost importance for tone production and quality of playing. It requires skilled coordination of lips, facial muscles, tongue, oral cavity, larynx and breathing and has to be maintained by steady practice. In rare cases, embouchure dystonia (EmD), a highly task specific movement disorder, may cause deterioration of sound quality and reduced control of tongue and lip movements. In order to better understand the pathophysiology of this movement disorder, we use real-time MRI to analyse differences in tongue movements between healthy trumpet players and professional players with embouchure dystonia., Methods: Real-time MRI videos (with sound recording) were acquired at 55 frames per second, while 10 healthy subjects and 4 patients with EmD performed a defined set of exercises on an MRI-compatible trumpet inside a 3 Tesla MRI system. To allow for a comparison of tongue movements between players, temporal changes of MRI signal intensities were analysed along 7 standardized positions of the tongue using a customised MATLAB toolkit. Detailed results of movements within the oral cavity during performance of an ascending slurred 11-note harmonic series are presented., Results: Playing trumpet in the higher register requires a very precise and stable narrowing of the free oral cavity. For this purpose the anterior section of the tongue is used as a valve in order to speed up airflow in a controlled manner. Conversely, the posterior part of the tongue is much less involved in the regulation of air speed. The results further demonstrate that healthy trumpet players control movements of the tongue rather precisely and stable during a sustained tone, whereas trumpet players with EmD exhibit much higher variability in tongue movements., Conclusion: Control of the anterior tongue in trumpet playing emerges as a critical feature for regulating air speed and, ultimately, achieving a high-quality performance. In EmD the observation of less coordinated tongue movements suggests the presence of compensatory patterns in an attempt to regulate (or correct) pitch. Increased variability of the anterior tongue could be an objective sign of dystonia that has to be examined in further studies and extended to other brass instruments and may be also a potential target for therapy options., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s). 2019.)

Real-time magnetic resonance imaging (MRI) or model-based MRI reconstructions of parametric maps require the solution of an ill-posed nonlinear inverse problem. Respective algorithms, e.g., the iteratively regularized Gauss-Newton method, implicitly combine datasets from multiple receive coils. Because these local coils may exhibit complex sensitivity profiles with rather different phase offsets, the numerical optimization may lead to phase singularities which in turn cause "black holes" in magnitude images. The purpose of this work is to develop a method for inverse reconstructions of multi-coil MRI data which avoids the generation of such spatially selective phase singularities. It is proposed to use volumetric body coil data and start the iterative reconstruction of multi-coil data with a reference image which offers proper phase information. In more detail, inverse reconstructions of multi-coil data are initialized with a complex "seed" image which is obtained by a Fast Fourier Transform (FFT) reconstruction of data from a single body coil element. This is accomplished at no additional cost as only very few body coil scans with identical conditions as the multi-coil acquisitions are needed as part of the regular prep scan period. The method is evaluated for anatomical real-time MRI and model-based phase-contrast flow MRI in real-time at 3 T. The proposed method overcomes phase singularities in all cases for arbitrary sets of receive coils. In conclusion, the automatic use of a single body coil reference image is simple, robust, and further improves the reliability of advanced MRI reconstructions from multi-coil data., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare., (2019 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Background: This paper describes the use of real-time magnetic resonance imaging to simultaneously obtain magnetic resonance imaging (MRI) videos in both a sagittal and coronal plane during the performance of a musical exercise in five advanced trombone players., Methods: Dual-slice recordings were implemented in a frame-interleaved manner with 20 ms acquisitions per frame to achieve two interleaved videos at a rate of 25 frames per second. A customized MATLAB toolkit was used for the extraction of line profiles from MRI videos to quantify tongue movements associated with exercise performance from both perspectives., Results: Across all subjects, the analyses revealed precise coupling of vertical movements of the dorsal tongue surface (DTS), viewed from a sagittal perspective, with reduction in the vertical and horizontal dimensions of the air channel formed between the DTS and the hard palate, viewed from a coronal perspective. The cross-correlation between these movements was very strong (mean R=0.967)., Conclusions: These results demonstrate the unique utility of this dual-slice technology in describing the coordination of complex tongue movements occurring in two planes (i.e., three directions) simultaneously, lending a deeper understanding of lingual motor control during trombone performance., Competing Interests: Conflicts of Interest: J Frahm holds a patent about the real-time MRI acquisition and reconstruction technique used here. The other authors have no conflicts of interest to declare.

Purpose: To develop a high-speed multislice T1 mapping method based on a single-shot inversion-recovery (IR) radial FLASH acquisition and a regularized model-based reconstruction., Methods: Multislice radial k-space data are continuously acquired after a single nonselective inversion pulse using a golden-angle sampling scheme in a spoke-interleaved manner with optimized flip angles. Parameter maps and coil sensitivities of each slice are estimated directly from highly undersampled radial k-space data using a model-based nonlinear inverse reconstruction in conjunction with joint sparsity constraints. The performance of the method has been validated using a numerical and experimental T1 phantom as well as demonstrated for studies of the human brain and liver at 3T., Results: The proposed method allows for 7 simultaneous T1 maps of the brain at 0.5 × 0.5 × 4 mm 3 resolution within a single IR experiment of 4 s duration. Phantom studies confirm similar accuracy and precision as obtained for a single-slice acquisition. For abdominal applications, the proposed method yields three simultaneous T1 maps at 1.25 × 1.25 × 6 mm 3 resolution within a 4 s breath hold., Conclusion: Rapid, robust, accurate, and precise multislice T1 mapping may be achieved by combining the advantages of a model-based nonlinear inverse reconstruction, radial sampling, parallel imaging, and compressed sensing.

Purpose: To develop generic optimization strategies for image reconstruction using graphical processing units (GPUs) in magnetic resonance imaging (MRI) and to exemplarily report on our experience with a highly accelerated implementation of the nonlinear inversion (NLINV) algorithm for dynamic MRI with high frame rates., Methods: The NLINV algorithm is optimized and ported to run on a multi-GPU single-node server. The algorithm is mapped to multiple GPUs by decomposing the data domain along the channel dimension. Furthermore, the algorithm is decomposed along the temporal domain by relaxing a temporal regularization constraint, allowing the algorithm to work on multiple frames in parallel. Finally, an autotuning method is presented that is capable of combining different decomposition variants to achieve optimal algorithm performance in different imaging scenarios., Results: The algorithm is successfully ported to a multi-GPU system and allows online image reconstruction with high frame rates. Real-time reconstruction with low latency and frame rates up to 30 frames per second is demonstrated., Conclusion: Novel parallel decomposition methods are presented which are applicable to many iterative algorithms for dynamic MRI. Using these methods to parallelize the NLINV algorithm on multiple GPUs, it is possible to achieve online image reconstruction with high frame rates.

Background: The accurate assessment of peripheral venous flow is important for the early diagnosis and treatment of disorders such as deep-vein thrombosis (DVT) which is a major cause of post-thrombotic syndrome or even death due to pulmonary embolism. The aim of this work is to quantitatively determine blood flow in deep veins during rest and muscular exercise using a novel real-time magnetic resonance imaging (MRI) method for velocity-encoded phase-contrast (PC) MRI at high spatiotemporal resolution., Methods: Real-time PC MRI of eight healthy volunteers and one patient was performed at 3 Tesla (Prisma fit, Siemens, Erlangen, Germany) using a flexible 16-channel receive coil (Variety, NORAS, Hoechberg, Germany). Acquisitions were based on a highly undersampled radial FLASH sequence with image reconstruction by regularized nonlinear inversion at 0.5×0.5×6 mm 3 spatial resolution and 100 ms temporal resolution. Flow was assessed in two cross-sections of the lower leg at the level of the calf muscle and knee using a protocol of 10 s rest, 20 s flexion and extension of the foot, and 10 s rest. Quantitative analyses included through-plane flow in the right posterior tibial, right peroneal and popliteal vein (PC maps) as well as signal intensity changes due to flow and muscle movements (corresponding magnitude images)., Results: Real-time PC MRI successfully monitored the dynamics of venous flow at high spatiotemporal resolution and clearly demonstrated increased flow in deep veins in response to flexion and extension of the foot. In normal subjects, the maximum velocity (averaged across vessel lumen) during exercise was 9.4±5.7 cm·s -1 for the right peroneal vein, 8.5±4.6 cm·s -1 for the right posterior tibial vein and 17.8±5.8 cm·s -1 for the popliteal vein. The integrated flow volume per exercise (20 s) was 1.9, 1.6 and 50 mL (mean across subjects) for right peroneal, right posterior tibial and popliteal vein, respectively. A patient with DVT presented with peak flow velocities of only about 2 cm·s -1 during exercise and less than 1 cm·s -1 during rest., Conclusions: Real-time PC MRI emerges as a new tool for quantifying the dynamics of muscle-induced flow in deep veins. The method provides both signal intensity changes and velocity information for the assessment of blood flow and muscle movements. It now warrants extended clinical trials to patients with suspected thrombosis., Competing Interests: J Frahm is co-inventor of a patent covering the real-time MRI technique used in this study. The other authors have no conflicts of interest to declare.

Background: This paper describes the use of real-time magnetic resonance imaging in visualizing and quantifying oral cavity motor strategies employed by 6 healthy, elite horn players and 5 horn players with embouchure dystonia., Methods: Serial images with an acquisition time of 33.3 ms were obtained from each performer during execution of an 11-note harmonic series encompassing 2.5 octaves on a magnetic resonance imaging-compatible horn. A customized MATLAB toolkit was employed for the extraction of line profiles from magnetic resonance imaging films allowing comparative analyses between elite and dystonic horn players., Results: The data demonstrate differing motor strategies, particularly in moving from the 6th through 9th harmonics. The elite horn player strategy features elevation and anterior displacement of the tongue during ascending sequences, whereas dystonic players showed significantly less movement. The elite horn players thus narrowed the air channel on higher notes, presumably affording faster airflow for vibration of the lips at higher frequencies., Conclusions: We postulate that failure to employ this strategy by dystonic horn players may require greater tension in the embouchure muscles to compensate for slower air speed. Though this may simply be an expression of or adaptation for dystonia, the possibility that it may be a contributing factor in the development of embouchure dystonia is suggested.

This prospective study of eight healthy volunteers evaluates peak flow velocities (PFV) in the ascending aorta using real-time phase-contrast magnetic resonance imaging (MRI) in comparison to cine phase-contrast MRI and echocardiography. Flow measurements by echocardiography and cine phase-contrast MRI with breath-holding were performed according to clinical standards. Real-time phase-contrast MRI at 40 ms temporal resolution and 1.3 mm in-plane resolution was based on highly undersampled radial fast low-angle shot (FLASH) sequences with image reconstruction by regularized nonlinear inversion (NLINV). Evaluations focused on the determination of PFV. Linear regressions and Bland-Altman plots were used for comparisons of methods. When averaged across subjects, real-time phase-contrast MRI resulted in PFV of 120±20 cm s(-1) (mean ± SD) in comparison to 122±16 cm s(-1) for cine MRI and 124±20 cm s(-1) for echocardiography. The maximum deviations between real-time phase-contrast MRI and echocardiography ranged from -20 to +14 cm s(-1) (cine MRI: -10 to +12 cm s(-1)). Thus, in general, real-time phase-contrast MRI of cardiac outflow revealed quantitative agreement with cine MRI and echocardiography. The advantages of real-time MRI are measurements during free breathing and access to individual cardiac cycles.

Auditory cortex (AC) contains several primary-like, or "core," fields, which receive thalamic input and project to non-primary "belt" fields. In humans, the organization and layout of core and belt auditory fields are still poorly understood, and most auditory neuroimaging studies rely on macroanatomical criteria, rather than functional localization of distinct fields. A myeloarchitectonic method has been suggested recently for distinguishing between core and belt fields in humans (Dick F, Tierney AT, Lutti A, Josephs O, Sereno MI, Weiskopf N. 2012. In vivo functional and myeloarchitectonic mapping of human primary auditory areas. J Neurosci. 32:16095-16105). We propose a marker for core AC based directly on functional magnetic resonance imaging (fMRI) data and pattern classification. We show that a portion of AC in Heschl's gyrus classifies sound frequency more accurately than other regions in AC. Using fMRI data from macaques, we validate that the region where frequency classification performance is significantly above chance overlaps core auditory fields, predominantly A1. Within this region, we measure tonotopic gradients and estimate the locations of the human homologues of the core auditory subfields A1 and R. Our results provide a functional rather than anatomical localizer for core AC. We posit that inter-individual variability in the layout of core AC might explain disagreements between results from previous neuroimaging and cytological studies., (© The Author 2014. Published by Oxford University Press.)

This paper describes the use of high-speed real-time (RT) magnetic resonance imaging (MRI) in quantifying very rapid motor function within the oropharyngeal cavity of six elite horn players. Based on simultaneous sound recordings, the efficacy of RT-MRI films at 30 and 100 frames per second (fps) was assessed for tongue movements associated with double tonguing performance. Serial images with a nominal temporal resolution of 10.0 and 33.3 ms were obtained by highly undersampled radial fast low-angle shot (FLASH) sequences (5 and 17 spokes, respectively) using complementary sets of spokes for successive acquisitions (extending over 9 and 5 frames, respectively). Reconstructions of high-speed images were obtained by temporally regularized nonlinear inversion (NLINV) as previously described. A customized MATLAB toolkit was developed for the extraction of line profiles from MRI films to quantify temporal phenomena associated with task performance. The analyses reveal that for the present setting, which required the use of a temporal median filter to optimize image quality, acquisition rates of 30 fps are inadequate to accurately detect tongue movements during double tonguing, but that rates of 100 fps do allow for a precise quantification of movement. These data for the first time demonstrate the extreme performance of elite horn players. High-speed RT-MRI offers so far unavailable opportunities to study the oropharyngeal movements during brass playing with future potential for teaching and the treatment of patients suffering from dystonia.

Cardiac structure, function and flow are most commonly studied by ultrasound, X-ray and magnetic resonance imaging (MRI) techniques. However, cardiovascular MRI is hitherto limited to electrocardiogram (ECG)-synchronized acquisitions and therefore often results in compromised quality for patients with arrhythmias or inabilities to comply with requested protocols-especially with breath-holding. Recent advances in the development of novel real-time MRI techniques now offer dynamic imaging of the heart and major vessels with high spatial and temporal resolution, so that examinations may be performed without the need for ECG synchronization and during free breathing. This article provides an overview of technical achievements, physiological validations, preliminary patient studies and translational aspects for a future clinical scenario of cardiovascular MRI in real time.

Background: While cardiovascular magnetic resonance (CMR) commonly employs ECG-synchronized cine acquisitions with balanced steady-state free precession (SSFP) contrast at 1.5 T, recent developments at 3 T demonstrate significant potential for T1-weighted real-time imaging at high spatiotemporal resolution using undersampled radial FLASH. The purpose of this work was to combine both ideas and to evaluate a corresponding real-time CMR method at 1.5 T with SSFP contrast., Methods: Radial gradient-echo sequences with fully balanced gradients and at least 15-fold undersampling were implemented on two CMR systems with different gradient performance. Image reconstruction by regularized nonlinear inversion (NLINV) was performed offline and resulted in real-time SSFP CMR images at a nominal resolution of 1.8 mm and with acquisition times of 40 ms., Results: Studies of healthy subjects demonstrated technical feasibility in terms of robustness and general image quality. Clinical applicability with access to quantitative evaluations (e.g., ejection fraction) was confirmed by preliminary applications to 27 patients with typical indications for CMR including arrhythmias and abnormal wall motion. Real-time image quality was slightly lower than for cine SSFP recordings, but considered diagnostic in all cases., Conclusions: Extending conventional cine approaches, real-time radial SSFP CMR with NLINV reconstruction provides access to individual cardiac cycles and allows for studies of patients with irregular heartbeat.