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Magnetic resonance (MR) can offer a unique window on the structure/function relationships in the brain, by utilizing the established link between tissue function, metabolism, and hemodynamics. This report focuses on recent applications of MR-based cerebral blood volume (CBV) imaging in humans. Our methodology uses high-speed "single-shot" or echo planar imaging techniques, which provide the necessary temporal resolution for mapping the rapid cerebral transit of contrast agents. These MR CBV mapping techniques have been used to study normal human brain task activation and in the clinical study of patients with brain tumors. In the latter, positron emission tomography imaging was used for functional metabolic and CBV correlation. Susceptibility contrast CBV imaging should allow us to improve our understanding of the relationship between the detailed physiology and morphology of the microvascular bed and functional attributes of the brain. These techniques can be applied to understanding fundamental questions of cognitive neuroscience and can aid in improving diagnostic sensitivity and specificity in various neuropathologies.

Cardiac MRI studies often show susceptibility artifacts along the inferoapical myocardial margin in both human and in vivo animal experiments at field strengths of 1.5T and greater. This study was designed to determine the cause of these artifacts in porcine myocardium at 3T. Gradient echo images were obtained under various anatomic and physiologic conditions to systematically study potential sources of local susceptibility gradients. Lung resection in the open-chested, euthanized swine was the only intervention that eliminated the artifact. The data suggest that in the porcine model, the heart-lung interface is the primary cause of these artifacts. Magn Reson Med 45:341-345, 2001.

This paper presents a flow-sensitive alternating inversion recovery (FAIR) method for measuring human myocardial perfusion at 1.5 T. Slice-selective/non-selective IR images were collected using a double-gated IR echoplanar imaging sequence. Myocardial perfusion was calculated after T1 fitting and extrapolation of the mean signal difference SI(Sel - SI(NSel). The accuracy of the method was tested in a porcine model using graded intravenous adenosine dose challenge. Comparison with radiolabeled microsphere measurements showed a good correlation (r = 0.84; mean error = 20%, n = 6) over the range of flows tested (0.9-7 ml/g/min). Applied in humans, this method allowed for the measurement of resting myocardial flow (1.04+/-0.37 ml/g/min, n = 11). The noise in our human measurements (SE(flow) = 0.2 ml/g/min) appears to come primarily from residual respiratory motion. Although the current signal-to-noise ratio limits our ability to measure small fluctuations in resting flow accurately, the results indicate that this noninvasive method has great promise for the quantitative assessment of myocardial flow reserve in humans.

Functional imaging techniques are well established in both the nuclear medicine and positron emission tomography (PET) communities. While the informational content of these images can be high, limited availability (PET) and low spatial resolution limit their clinical applications. Magnetic resonance (MR) imaging can provide both functional and anatomic information, in part because of the large number of intrinsic parameters that affect MR image contrast. These include proton density (r), relaxation times T1 and T2, chemical shift, flow, magnetic susceptibility, diffusion, and others. While not functions of tissue per se, each of these parameters can be exploited to assess various functional activities of the body. This is best illustrated by MR angiography, where both time-of-flight and phase contrast methods depend on velocity (cardiovascular function) to provide contrast and thereby to represent vascular anatomy. Similarly, it can be argued that a positive gadolinium-diethylenetriaminopentoacetic acid (Gd-DTPA) central nervous system (CNS) examination reflects abnormal function (or integrity) of the blood-brain barrier.

The Arthritis Foundation's Quality of Life Action Plan (Brady et al., 1993) is a strategic planning document that provides direction for service and education initiatives through the year 2000. This plan is a guide for the fulfillment of the quality of life aspect of the Arthritis Foundation's Mission Statement: "To support research to find the cure for and prevention of arthritis and to improve the quality of life for those affected by arthritis." The plan is based on documented needs and challenges that affect the quality of life of people with arthritis, with a focus on physical, psychosocial, and economic issues. This article provides a review of these issues and describes the types of services that the Arthritis Foundation provides to help people with arthritis effectively deal with these problems.

The time resolution of echoplanar imaging (EPI) allows the acquisition of imagesor = 100 ms, thus eliminating motion-related artifacts of the abdomen. Physical limitations are restrictions in signal-to-noise ratio and spatial resolution. Breath-held acquisitions are recommended to avoid spatial misregistrations and to ensure a defined slice position. Clinical studies have demonstrated the usefulness of EPI for the detection and characterization of focal liver lesions. The development of clinical strategies of EPI for abdominal imaging requires the administration of gastrointestinal contrast agents as in computed tomography. Current clinically approved CT contrast agents appear to be applicable for abdominal EPI because of their long relaxation times.

A synthetic blood pool imaging agent labeled with 99mTc is reported.The agent, methoxypolyethylene glycol-poly-L-lysyl-diethylenetriaminepentaacetate monoamide was synthesized from a covalent graft copolymer of methoxypolyethylene glycol succinate (molecular weight 5.1 kD) and poly-L-lysine (molecular weight average 35.6 kD) with subsequent modification of the product with diethylenetriamineacetyl residues. The polymer was formulated into a kit that contained Sn(II) and sodium acetate for radiolabeling with 99mTc. Biodistribution studies were performed in rats. Blood-pool imaging and blood clearance determination was carried out in rabbits and in a rhesus monkey.The 99mTc-labeled agent [specific activity greater than 3.7 GBq/mg; radiochemical purity more than 98% by thin-layer and high-performance liquid chromatography (HPLC)] demonstrated remarkable stability in solution (pH 5.5-6.5) with no radioactive products of degradation detectable by HPLC even at 24 hr postlabeling. The agent exhibited prolonged circulation in the blood with a half-life of 31.5 hr in rabbits. Biodistribution in rats showed a lack of substantial accumulation of the agent in the reticuloendothelial system. Sequential acquisitions were performed in a rhesus monkey. The 99mTc-labeled polymer kit was compared with the 99mTc-red blood cells (RBCs) labeled in vitro. Both methods produced similar heart-to-lung ratios. The ratios remained essentially unchanged for up to 15 hr postinjection.The 99mTc-labeled methoxypolyethylene glycol-poly-L-lysyl-diethylenetriamine pentaacetate monoamide is an attractive alternative to radiolabeled RBCs for blood pool imaging applications.

The purpose of the present study was to investigate the clinical application of echoplanar MR imaging compared to conventional MR imaging in the detection of focal liver lesions. A total of three conventional and 12 echoplanar pulse sequences were acquired in 35 patients with focal liver lesions. Motion artifacts were eliminated because of short acquisition times of 32 ms subsequently improving signal-to-noise. A single-shot spin-echo technique with a TE of 26 ms provided the highest liver signal-to-noise ratio (p0.05) of all sequences acquired. Contrast-to-noise ratios for a single-shot SE technique with echo times of 50-100 ms were as high as 10-40.

Who is in control of treatment is an issue clinicians address on a daily basis. This represents an ethical dilemma, which sets the principle of autonomy in direct conflict with the principle of beneficence. This article advocates giving autonomy precedence over beneficence to achieve patient control of treatment. Patient control of treatment is essential in chronic disease because the patient is the expert in his or her own goals and values, the sick role is inappropriate in chronic disease and may have devastating emotional consequences, and in actuality the patient is the health care provider.

Lead atoms, present as a trace additive in a series of premixed H 2 –N 2 –O 2 flames, were excited to the 7 3 P o 1 state by 405.8 nm radiation from a nitrogen-pumped dye laser. Rate constants for spin-orbit relaxation to the 7 3 P o 0 state were obtained separately for collisions with atomic hydrogen and for collisions with the bulk flame gas, by measuring the relative intensities of fluorescence at 364.0 and 368.3 nm as a function of distance from the reaction zone in each flame. For hydrogen atoms the rate constant is typically 1 x 10 -9 cm 3 molecule -1 s -1 , decreasing with increasing temperature; for the bulk flame gas the rate constant is typically 1 x 10 -11 cm 3 molecule -1 s -1 , increasing with increasing temperature. Numerical calculations for model systems, with the use of Morse and Lennard-Jones potentials to describe the interaction of the colliding species, show that the negative temperature coefficient found for atomic hydrogen can be attributed to the crossing of attractive potential curves, corresponding to bound excited states of PbH.

Magnetic resonance imaging (MRI) techniques provide a versatile method of manipulating soft tissue contrast in the extremities. Different pulse sequence techniques are discussed with respect to the optimization of contrast differences between muscle, marrow, and abnormal tissue.

The authors briefly review the principles of NMR imaging and illustrate and discuss results from their initial applications of inversion-recovery and spin-echo NMR imaging pulse sequences in humans with diverse pathophysiologies of stroke.

During the past few years major improvements have been made in MR systems resulting in increased S/N, which is now being traded for more rapid imaging times. As discussed, there are three general strategies to decrease acquisition time and more will likely surface. Gradient-echo imaging, which has provided the most clinical experience to date, can be used for rapid imaging, functional studies and unique contrast mechanisms such as susceptibility imaging. While the contrast mechanisms and ultimate clinical utility require further study, it seems likely that gradient-echo imaging will become a routine part of clinical MR imaging.

Magnetic resonance (MR) imaging has created considerable excitement in the medical community, largely because of its great potential to diagnose and characterize many different disease processes. However, it is becoming increasingly evident that, because MR imaging is similar to computed tomography (CT) scanning in identifying structural disorders and because it is more costly and difficult to use, this highly useful technique must be judged against CT before it can become an accepted investigative tool. At present MR imaging has demonstrated diagnostic superiority over CT in a limited number of important, mostly neurologic, disorders and is complementary to CT in the diagnosis of certain other disorders. For most of the remaining organ systems its usefulness is not clear, but the lack of ionizing radiation and MR's ability to produce images in any tomographic plane may eventually prove to be advantageous. The potential of MR imaging to display in-vivo spectra, multinuclear images and blood-flow data makes it an exciting investigative technique. At present, however, MR imaging units should be installed only in medical centres equipped with the clinical and basic research facilities that are essential to evaluate the ultimate role of this technique in the care of patients.

The demand for higher diagnostic specificity has led to the increased use of "foreign" agents to increase tissue contrast and/or spectroscopic sensitivity in NMR studies. The primary agents used to enhance tissue contrast in NMR imaging are paramagnetic. They cause a decrease in the proton T1 of H2O leading to enhanced signal intensity. This effect depends on the large gyromagnetic ratio of the electron, the number of unpaired electrons, the concentration of paramagnetic ions, the number of coordinated water molecules, and the rate of exchange of water. Spectroscopic enhancement has relied primarily on attempt at isotopic enrichment (usually C-13), which causes a direct increase in signal.

Major advances have been made in the diagnosis of MS by using NMR imaging, suggesting that this noninvasive method will permit staging of MS lesions and that conclusions from newer therapeutic trials may be drawn more accurately than heretofore possible.

Magnetic resonance imaging was used to study the skeletal involvement in a series of twenty-four patients with Gaucher disease. Many sites in the marrow of these patients were characterized by an abnormally low signal intensity that reflected shortened T1 and markedly shortened T2 values in the replaced marrow. The abnormality was non-homogeneous in distribution. In the lower extremity, the proximal (femoral) areas were more frequently affected than the distal (tibial) sites. The epiphyses were generally spared unless the involvement of bone was extensive. Lack of epiphyseal involvement on the magnetic resonance images generally precluded any suspicion of osteonecrosis. The extent of involvement, as suggested by the magnetic resonance data, appeared to correlate well with the occurrence of musculoskeletal complications. Magnetic resonance imaging is more sensitive than computerized tomography in demonstrating the extent of abnormalities in patients with Gaucher disease, and it may have prognostic value.

The feasibility of determining the mass of both viable and infarcted myocardium from tomographic images of thallium-201 distribution in the heart was studied in two normal dogs and ten dogs with acute infarction. Twenty-four hours after occlusion, thallium-201 was injected and 10 min later the hearts were removed and transaxial emission computed tomograms were obtained. Using the computer, an operator defined the epi- and endocardial surfaces of the left ventricle and the area of infarction in each tomogram. The computer then calculated values for total left-ventricular mass (TLVM) infarcted mass (IM) and the percentage of the left ventricle infarcted (% LVI). The calculated values were compared with measured weights, and good correlation was found between them: for TLVM, r = 0.87; for IM, r = 0.90; and for %LVI, r = 0.87. Good interobserver and intra-observer correlations were also found. Thallium-201 emission computed tomography offers a potential means to measure both myocardial mass and acute myocardial injury.

We report the results obtained at 0.6 T with the use of surface coils in 77 patients who presented with obvious or suspected thoracic myelopathy. There were 16 patients with primary tumors diagnosed for the first time, 9 patients with residual tumors, 17 with metastatic neoplasms, 13 with hydrosyringomyelia, 5 with vertebral fracture and secondary pathology involving the cord, 5 with thoracic disc protrusions, 2 with multiple sclerosis, 2 with arteriovenous malformations, 2 with cystic arachnoiditis, and 6 with a variety of congenital abnormalities (low tethered cord, intradural lipoma, lipomyelomeningocele). The significantly improved signal to noise ratios provided by surface coils allow high quality thin section imagning which, combined with the high tissue contrast resolution obtainable with suitable pulse sequences, makes MR the preferred initial imaging technique over myelography and CT myelography. In an interesting spectrum of lesions, MR can obviate the need for traditional invasive procedures.

Accurate determination of relaxation times has become increasingly important in efforts to determine the diagnostic specificity of nuclear magnetic resonance (NMR) imaging. Techniques used in NMR imaging, not routinely employed in conventional NMR spectroscopy, can significantly affect the resulting relaxation time determinations. For the saturation recovery (SR) approach of T1 measurement used in our laboratory, these include selective excitation to define the image plane and magnetization refocusing for NMR signal acquisition. Computer modeling of the Bloch equations shows that errors well over 50% can be made in image derived T1 measurements if the conventional SR relation between signal intensity and the 90-90 degrees interpulse delay, tr, is used. However, corrected expressions can be derived for the actual pulse and gradient sequence used by our imaging system, and phantom data acquired in imaging experiments have verified the validity of these equations. This allows for the correction of T1 data to compensate for systematic bias introduced during imaging procedures and suggests a means whereby errors introduced by radio frequency inhomogeneities across the imaging volume can be reduced.

Perivascular abscess in the aortic root is a serious complication of infective endocarditis and is recognized infrequently with noninvasive techniques. This report describes a patient with sepsis who was imaged with 67Ga and magnetic resonance (MR) in order to locate a site of infection. The 67Ga image showed increased activity in the substernal region. Magnetic resonance correctly detected the multilocular aortic root abscess, which had extended into the interatrial septum. The combination of the sensitive 67Ga with the high-resolution MR image provided a useful method to locate aortic root abscesses and to identify contiguous spread.

In this chapter, we have briefly reviewed the techniques of in vivo NMR spectroscopy and chemical shift imaging. These techniques are complementary, and both are of great potential clinical significance. Most of the data presented here is limited to 31P and 1H NMR, but with additional refinements, 13C and 19F NMR will likely be studied in the near future.

The Intisar "D" reef oil field was discovered by Occidental in October 1967; the discovery well tested 75,000 b/d. The prospect was based on reflection seismic data, which indicated the presence of an isolated reef. Three such prospects were drilled previously with varying degrees of success. The Paleocene of the Sirte basin is characterized by carbonate rocks and shales deposited in an epeiric sea. The Intisar reefs grew in a late Paleocene embayment bounded on three sides by carbonate banks. Three distinct stages of organic development are recognized. The Intisar "D" reef is roughly circular in plan and approximately 5 km in diameter. Its maximum thickness is 1,262 ft (385 m). The reef is coral and algal with grain-and mud-supported biomicrites. Porosity averages 22% and is mostly solution and intergranular. Measured permeability is as high as 500 md and averages 87 md. The main reservoir is remarkably homogeneous without noticeable layering typical of other reefs in the area. The reef was full to spill point with a maximum oil column of 995 ft (291 m). The 40° API gravity oil has a paraffinic base and is low in sulfur. The original gas/oil ratio (GOR) was 509 cu ft/bbl. Original stock tank oil in place is estimated at 1.8 billion bbl. The field currently produces 200,000 b/d oil from 13 wells; 11 water-injection and 7 gas-injection wells are used. Cumulative oil production as of September 30, 1978, totaled 777 million bbl. Ultimate recovery efficiency is expected to approach 75%. No pressure support was expected. Supplemental recovery operations began early and include pressure maintenance by both water and gas injection. The reservoir pressure is now maintained at the 4,000-psi level, high enough for miscible gas displacement.

Coded-aperture imaging (CAI) and multiple-view pinhole imaging (PI) of the thyroid were compared in a prospective study in 136 consecutive patients. Following 10 mCi of pertechnetate, 200K-count pinhole images were obtained in the anterior, RAO, and LAO projections, and CAI data were obtained in the anterior position. Four coronal tomographic sections were reconstructed by computer. Five observers read the studies separately, and ROC curves were constructed. Based on 109 pairs of studies, the ROC curves revealed similar performance for all observers for both techniques. When four observers compared the studies subjectively they rated the CAI more useful in 36% of cases, the PI in 6%, and the two equal in 58%. The advantages offered by the tomograms included improved contrast, accurate size representation of the gland at all depths, freedom frm pinhole-type distortion, and faster data acquisition. The major disadvantage to tomography was the 2-hr computer-processing time required. It this can be reduced, CAI offers sufficient advantages over conventional pinhole imaging to warrant its routine use.

The combination of gated cardiac imaging with the magnetic resonance parameters of flow void and tissue characterization forms the basis for a powerful noninvasive technique for imaging the cardiovascular system. Images constructed in planes orthogonal to the axis of the heart allow cardiac structures to be reproducibly detected in serial studies and measured. The data acquisition techniques used at Massachusetts General Hospital are presented, along with examples of their application in a variety of cardiac diseases. Future prospects are illustrated with flow-encoded images and with surface coil techniques.

No reliable, noninvasive technique is currently available for the early detection of cardiac transplant rejection. In this study, pulse nuclear magnetic resonance (NMR) spectroscopy was used (20 MHz) to detect cardiac allograft rejection in rats. Proton spin-lattice relaxation time (T1), proton spin-spin relaxation time (T2), and water content were measured in both recipient and donor hearts at 2, 4, 6, and 8 days after transplantation. Pathologic specimens were scored on a 0 to 4+ scale of increasing evidence of rejection by light microscopy. Three kinds of heterotopic transplants were performed for a total of 90: (1) Lewis rats received Lewis rat isografts, (2) Lewis rats received Brown Norway rat allografts, and (3) Lewis rats received cyclosporin A-treated allografts (15 mg/kg/day). T1 in group 2 was significantly higher than that in group 1 as early as day 2 (670 + 25 vs 616 + 11 msec, p less than .001), when histologic scores were not different. T2 in group 2 was also higher than that in group 1 (48.0 +/- 5.0 vs 41.1 +/- 2.6, p less than .005). T1 and T2 in group 2 increased from day 4 and correlated well with the water content of the hearts (r = .70 and r = .75, respectively). Cyclosporin A completely suppressed the increase of T1 and T2 in group 2. Treatment with cyclosporin also suppressed the histologic rejection scores. Our data suggest that proton relaxation time measurement may be a sensitive technique for detecting the onset of rejection and examining the therapeutic effects of cyclosporin. NMR imaging, which highlights T1 and T2 separately, should provide a sensitive noninvasive means of assessing myocardial graft rejection.

Coded-aperture imaging of the heart combines the advantages of tomography with good sensitivity, high resolution, and accurate size scaling. Since the images are multiplexed, the method may be adapted to small, portable cameras for bed-side use without sacrificing image resolution. A new coded aperture designed especially for cardiac imaging has been constructed and tested. This aperture incorporates significant improvements over previous designs. Longitudinal tomograms are calculated at 1-cm intervals using a modified ART algorithm. Experimental lateral resulution at 140 keV with a portable scintillation camera is 3.8 mm FWHM at 4 cm, and 7.8 mm FWHM at 12 cm. Dpth resolution determined from a sloping line source is 1.1 cm FWHM at 4 cm, and 2.9 cm at 12 cm. The calculated point-source sensitivities in air at 4 cm and 12 cm, respectively, are 20 and 8 cps/microCi. Images of good diagnostic quality have been obtained in phantoms and in a dog model of acute myocardial infarction, using thallium-201, technetium-99m pyrophosphate, and gated ventricular blood-pool imaging with Tc-labeled red blood cells. Preliminary studies in humans confirm the good results in animals.

To establish the effect of the paramagnetic contrast agent gadolinium diethylenetriaminepentaacetic acid ([Gd]DTPA) on myocardial magnetic resonance relaxation parameters T1 and T2, and its relationship to myocardial perfusion, we administered [Gd] DTPA 0.2 mM/kg to two groups of dogs. Group I had severe, resting myocardial ischemia induced by coronary occlusion, followed in 2 min by [Gd]DTPA infusion and heart excision 1 min later. Group II had a variable reduction in blood flow. In Group II the coronary vasodilator dipyridamole was infused to enhance blood flow to the normal myocardium before [Gd]DTPA was given. In Group I [Gd]DTPA caused a significant difference in T1 between the normal and severely ischemic zones; changes in T1 correlated with the severity of myocardial ischemia. Although vasodilatation delivered more Gd-DTPA to the normal myocardium in Group II, the lack of further decrease in T1 suggested that it was cleared more rapidly. Thus, [Gd]DTPA permits the detection and characterization of severe, resting myocardial ischemia by magnetic resonance techniques. Using the experimental techniques described in this study, less severe flow differences caused by vasodilatation and resultant hyperemia are not detected.

An estimated total of over 20,000 feet of Palaeozoic sediments accumulated in the Bonaparte Gulf Basin. The thickest known continuous section is that in Bonaparte No. 1 Well, abandoned at 10,530 feet in Upper Devonian sandstone and shale. Rocks of the Basin margins are mainly sandstones and limestones (in part reef), whereas a thick shale section has been discovered in the deeper parts. Data from recent seismic surveys indicate that the seaward extension of the Basin is considerable and that a thick pile of sediments is preserved there.The Bonaparte Gulf Basin formed as a result of subsidence of the north-eastern part of the Kimberley Block along fault lines associated with the Halls Creek Mobile Zone. This zone borders the south-eastern margin of the Basin and trends north-east. One basement block, represented by the presentday Pincombe Range, remained relatively high. The Bonaparte Gulf Basin can be divided into two subsidiary basins, the Carlton Basin to the west and north-west and the Burt Range Basin in the east and south-east. The Pincombe Range separates the two.Marine sediments were deposited in the Carlton Basin during the Middle and Upper Cambrian, Lower Ordovician, Upper Devonian and Lower Carboniferous epochs. Angular unconformities have been mapped between the Lower Ordovician and Upper Devonian rocks, and between Upper Devonian and Lower Carboniferous rocks. In the Burt Range Basin, deposition began in the Upper Devonian and continued with minor breaks through the Lower Carboniferous. Faults along the south-eastern margin were active through this period and affected the character of the sediments.Permian sediments are widely distributed and lie with unconformity on older units.