http://www.biomedcentral.com/bmcmedimaging/ The latest research articles published by BMC Medical Imaging 2009-10-16T00:00:00Z This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ Background: Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement between CT and autopsy regarding cranial fractures and especially the precision with which cranial fractures are recorded. Methods: The autopsy fracture diagnosis was compared to the diagnosis of two CT readings (reconstructed with Multiplanar and Maximum Intensity Projection reconstructions) by registering the fractures on schematic drawings. The extent of the fractures was quantified by merging 3-dimensional datasets from both the autopsy as input by 3D digitizer tracing and CT scan. Results: The results showed a good diagnostic agreement regarding fractures localised in the posterior fossa, while the fracture diagnosis in the medial and anterior fossa was difficult at the first CT scan reading. The fracture diagnosis improved during the second CT scan reading. Thus using two different CT reconstructions improved diagnosis in the medial fossa and at the impact points in the cranial vault. However, fracture diagnosis in the anterior and medial fossa and of hairline fractures in general still remained difficult. Conclusion: The study showed that the forensically important fracture systems to a large extent were diagnosed on CT images using Multiplanar and Maximum Intensity Projection reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis. http://www.biomedcentral.com/1471-2342/9/18 Christina Jacobsen Birthe Bech Niels Lynnerup BMC Medical Imaging 2009, 9:18 2009-10-16T00:00:00Z doi:10.1186/1471-2342-9-18 BMC Medical Imaging 1471-2342 9 18 2009-10-16T00:00:00Z XML Background: Normal aging involves a decline in cognitive function that has been shown to correlate with volumetric change in the hippocampus, and with genetic variability in the APOE-gene. In the present study we utilize 3D MR imaging, genetic analysis and assessment of verbal memory function to investigate relationships between these factors in a sample of 170 healthy volunteers (age range 46–77 years). Methods: Brain morphometric analysis was performed with the automated segmentation work-flow implemented in FreeSurfer. Genetic analysis of the APOE genotype was determined with polymerase chain reaction (PCR) on DNA from whole-blood. All individuals were subjected to extensive neuropsychological testing, including the California Verbal Learning Test-II (CVLT). To obtain robust and easily interpretable relationships between explanatory variables and verbal memory function we applied the recent method of conditional inference trees in addition to scatterplot matrices and simple pairwise linear least-squares regression analysis. Results: APOE genotype had no significant impact on the CVLT results (scores on long delay free recall, CVLT-LD) or the ICV-normalized hippocampal volumes. Hippocampal volumes were found to decrease with age and a right-larger-than-left hippocampal asymmetry was also found. These findings are in accordance with previous studies. CVLT-LD score was shown to correlate with hippocampal volume. Multivariate conditional inference analysis showed that gender and left hippocampal volume largely dominated predictive values for CVLT-LD scores in our sample. Left hippocampal volume dominated predictive values for females but not for males. APOE genotype did not alter the model significantly, and age was only partly influencing the results. Conclusion: Gender and left hippocampal volumes are main predictors for verbal memory function in normal aging. APOE genotype did not affect the results in any part of our analysis. http://www.biomedcentral.com/1471-2342/9/17 Martin Ystad Astri Lundervold Eike Wehling Thomas Espeseth Helge Rootwelt Lars Tjelta Westlye Martin Andersson Steinunn Adolfsdottir Jonn Terje Geitung Anders Fjell Ivar Reinvang Arvid Lundervold BMC Medical Imaging 2009, 9:17 2009-08-22T00:00:00Z doi:10.1186/1471-2342-9-17 BMC Medical Imaging 1471-2342 9 17 2009-08-22T00:00:00Z XML Background: It is of great clinical importance to exclude myocardial infarction in patients with suspected coronary artery disease who do not have stress-induced ischemia. The diagnostic use of myocardial perfusion single-photon emission computed tomography (SPECT) in this situation is sometimes complicated by attenuation artifacts that mimic myocardial infarction. Imaging in the prone position has been suggested as a method to overcome this problem. Methods: In this study, 52 patients without known prior infarction and no stress-induced ischemia on SPECT imaging were examined in both supine and prone position. The results were compared with cardiac magnetic resonance imaging (CMR) with delayed-enhancement technique to confirm or exclude myocardial infarction. Results: There were 63 defects in supine-position images, 37 of which disappeared in the prone position. None of the 37 defects were associated with myocardial infarction by CMR, indicating that all of them represented attenuation artifacts. Of the remaining 26 defects that did not disappear on prone imaging, myocardial infarction was confirmed by CMR in 2; the remaining 24 had no sign of ischemic infarction but 2 had other kinds of myocardial injuries. In 3 patients, SPECT failed to detect small scars identified by CMR. Conclusion: Perfusion defects in the supine position that disappeared in the prone position were caused by attenuation, not myocardial infarction. Hence, imaging in the prone position can help to rule out ischemic heart disease for some patients admitted for SPECT with suspected but not documented ischemic heart disease. This would indicate a better prognosis and prevent unnecessary further investigations and treatment. http://www.biomedcentral.com/1471-2342/9/16 Bo Heden Eva Persson Marcus Carlsson Olle Pahlm Hakan Arheden BMC Medical Imaging 2009, 9:16 2009-08-10T00:00:00Z doi:10.1186/1471-2342-9-16 BMC Medical Imaging 1471-2342 9 16 2009-08-10T00:00:00Z XML Background: The work presented here investigates parallel imaging applied to T1-weighted high resolution imaging for use in longitudinal volumetric clinical studies involving Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI) patients. This was in an effort to shorten acquisition times to minimise the risk of motion artefacts caused by patient discomfort and disorientation. The principle question is, "Can parallel imaging be used to acquire images at 1.5 T of sufficient quality to allow volumetric analysis of patient brains?" Methods: Optimisation studies were performed on a young healthy volunteer and the selected protocol (including the use of two different parallel imaging acceleration factors) was then tested on a cohort of 15 elderly volunteers including MCI and AD patients. In addition to automatic brain segmentation, hippocampus volumes were manually outlined and measured in all patients. The 15 patients were scanned on a second occasion approximately one week later using the same protocol and evaluated in the same manner to test repeatability of measurement using images acquired with the GRAPPA parallel imaging technique applied to the MPRAGE sequence. Results: Intraclass correlation tests show that almost perfect agreement between repeated measurements of both segmented brain parenchyma fraction and regional measurement of hippocampi. The protocol is suitable for both global and regional volumetric measurement dementia patients. Conclusion: In summary, these results indicate that parallel imaging can be used without detrimental effect to brain tissue segmentation and volumetric measurement and should be considered for both clinical and research studies where longitudinal measurements of brain tissue volumes are of interest. http://www.biomedcentral.com/1471-2342/9/15 Terri Lindholm Lisa Botes Eva-Lena Engman Anders Frank Tomas Jonsson Leif Svensson Per Julin BMC Medical Imaging 2009, 9:15 2009-08-03T00:00:00Z doi:10.1186/1471-2342-9-15 BMC Medical Imaging 1471-2342 9 15 2009-08-03T00:00:00Z XML Background: An important aspect in functional imaging research employing magnetic resonance imaging (MRI) is how participants perceive the MRI scanning itself. For instance, the knowledge of how (un)comfortable MRI scanning is perceived may help institutional review boards (IRBs) or ethics committees to decide on the approval of a study, or researchers to design their experiments. Methods: We provide empirical data from our lab gained from 70 neurologically healthy mainly student subjects and from 22 mainly elderly patients suffering from motor deficits after brain damage. All participants took part in various basic research fMRI studies using a 3T MRI scanner. Directly after the scanning, all participants completed a questionnaire assessing their experience with the fMRI procedure. Results: 87.2% of the healthy subjects and 77.3% of the patients rated the MRI procedure as acceptable to comfortable. In healthy subjects, males found the procedure more comfortable, while the opposite was true for patients. 12.1% of healthy subjects considered scanning durations between 30 and 60 min as too long, while no patient considered their 30 min scanning interval as too long. 93.4% of the healthy subjects would like to participate in an fMRI study again, with a significantly lower rate for the subjects who considered the scanning as too long. Further factors, such as inclusion of a diffusion tensor imaging (DTI) scan, age, and study duration had no effect on the questionnaire responses. Of the few negative comments, the main issues were noise, the restriction to keep still for the whole time, and occasional feelings of dizziness. Conclusion: MRI scanning in the basic research setting is an acceptable procedure for elderly and patient participants as well as young healthy subjects. http://www.biomedcentral.com/1471-2342/9/14 Andre Szameitat Shan Shen Annette Sterr BMC Medical Imaging 2009, 9:14 2009-07-31T00:00:00Z doi:10.1186/1471-2342-9-14 BMC Medical Imaging 1471-2342 9 14 2009-07-31T00:00:00Z XML Background: Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA. Methods: 176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded. Results: 22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial ≥ 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001). Conclusion: TIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events. http://www.biomedcentral.com/1471-2342/9/13 Katrin Holzer Suwad Sadikovic Lorena Esposito Angelina Bockelbrink Dirk Sander Bernhard Hemmer Holger Poppert BMC Medical Imaging 2009, 9:13 2009-07-30T00:00:00Z doi:10.1186/1471-2342-9-13 BMC Medical Imaging 1471-2342 9 13 2009-07-30T00:00:00Z XML Background: Position emission tomography (PET) imaging using [18F]-setoperone to quantify cortical 5-HT2A receptors has the potential to inform pharmacological treatments for geriatric depression and dementia. Prior reports indicate a significant normal aging effect on serotonin 5HT2A receptor (5HT2AR) binding potential. The purpose of this study was to assess the test-retest variability of [18F]-setoperone PET with a high resolution scanner (HRRT) for measuring 5HT2AR availability in subjects greater than 60 years old. Methods: Six healthy subjects (age range = 65–78 years) completed two [18F]-setoperone PET scans on two separate occasions 5–16 weeks apart. Results: The average difference in the binding potential (BPND) as measured on the two occasions in the frontal and temporal cortical regions ranged between 2 and 12%, with the lowest intraclass correlation coefficient in anterior cingulate regions. Conclusion: We conclude that the test-retest variability of [18F]-setoperone PET in elderly subjects is comparable to that of [18F]-setoperone and other 5HT2AR radiotracers in younger subject samples. http://www.biomedcentral.com/1471-2342/9/12 Tiffany Chow David Mamo Hiroyuki Uchida Sylvain Houle Gwenn Smith Bruce Pollock Benoit Mulsant BMC Medical Imaging 2009, 9:12 2009-07-06T00:00:00Z doi:10.1186/1471-2342-9-12 BMC Medical Imaging 1471-2342 9 12 2009-07-06T00:00:00Z XML Background: Until now there is a lack of carefully controlled studies with conventional MR imaging performed exclusively in concussion with short lasting loss of consciousness (LOC). Methods: A MR investigation was performed within 24 hours and after 3 months in 20 patients who had suffered a concussion with a verified loss of consciousness of maximally 5 minutes. As a control group, 20 age- and gender matched patients with minor orthopaedic injuries had a MR investigation using the same protocol. Results: In a concussion population with an average LOC duration of 1. 4 minutes no case with unequivocal intracranial traumatic pathology was detected. Conclusion: An ordinary concussion with short lasting LOC does not or only seldom result in a degree of diffuse axonal injury (DAI) that is visualized by conventional MR with field strength of 1.0 Tesla (T). Analysis of earlier MR studies in concussion using field strength of 1.5 T as well as of studies with diffusion tensor MR imaging (MR DTI) reveal methodological shortcomings, in particular use of inadequate control groups. There is, therefore, a need for carefully controlled studies using MR of higher field strength and/or studies with MR DTI exclusively in common concussion with LOC of maximally 5 minutes. http://www.biomedcentral.com/1471-2342/9/11 Harald Schrader Dalia Mickeviciene Rymante Gleizniene Sylvija Jakstiene Danguole Surkiene Lars Jacob Stovner Diana Obelieniene BMC Medical Imaging 2009, 9:11 2009-06-17T00:00:00Z doi:10.1186/1471-2342-9-11 BMC Medical Imaging 1471-2342 9 11 2009-06-17T00:00:00Z XML Background: In vivo preclinical imaging of spinal cord injury (SCI) in rodent models provides clinically relevant information in translational research. This paper uses multimodal magnetic resonance imaging (MRI) to investigate neurovascular pathology and changes in blood spinal cord barrier (BSCB) permeability following SCI in a mouse model of SCI. Methods: C57BL/6 female mice (n = 5) were subjected to contusive injury at the thoracic T11 level and scanned on post injury days 1 and 3 using anatomical, dynamic contrast-enhanced (DCE-MRI) and diffusion tensor imaging (DTI). The injured cords were evaluated postmortem with histopathological stains specific to neurovascular changes. A computational model was implemented to map local changes in barrier function from the contrast enhancement. The area and volume of spinal cord tissue with dysfunctional barrier were determined using semi-automatic segmentation. Results: Quantitative maps derived from the acquired DCE-MRI data depicted the degree of BSCB permeability variations in injured spinal cords. At the injury sites, the damaged barriers occupied about 70% of the total cross section and 48% of the total volume on day 1, but the corresponding measurements were reduced to 55% and 25%, respectively on day 3. These changes implied spatio-temporal remodeling of microvasculature and its architecture in injured SC. Diffusion computations included longitudinal and transverse diffusivities and fractional anisotropy index. Comparison of permeability and diffusion measurements indicated regions of injured cords with dysfunctional barriers had structural changes in the form of greater axonal loss and demyelination, as supported by histopathologic assessments. Conclusion: The results from this study collectively demonstrated the feasibility of quantitatively mapping regional BSCB dysfunction in injured cord in mouse and obtaining complementary information about its structural integrity using in vivo DCE-MRI and DTI protocols. This capability is expected to play an important role in characterizing the neurovascular changes and reorganization following SCI in longitudinal preclinical experiments, but with potential clinical implications. http://www.biomedcentral.com/1471-2342/9/10 Ilkan Tatar Peter Chou Mohamed Desouki Hanaa Sayed Mehmet Bilgen BMC Medical Imaging 2009, 9:10 2009-06-11T00:00:00Z doi:10.1186/1471-2342-9-10 BMC Medical Imaging 1471-2342 9 10 2009-06-11T00:00:00Z XML Background: Despite the large availability of 3T MR scanners and the potential of high field imaging, this technical platform has yet to prove its usefulness in the cardiac MR setting, where 1.5T remains the established standard. Global perfusion of the left ventricle, as well as the coronary flow reserve (CFR), can provide relevant diagnostic information, and MR measurements of these parameters may benefit from increased field strength. Quantitative flow measurements in the coronary sinus (CS) provide one method to investigate these parameters. However, the ability of newly developed faster MR sequences to measure coronary flow during a breath-hold at 3T has not been evaluated. Methods: The aim of this work was to measure CS flow using segmented phase contrast MR (PC MR) on a clinical 3T MR scanner. Parallel imaging was employed to reduce the total acquisition time. Global LV perfusion was calculated by dividing CS flow with left ventricular (LV) mass. The repeatability of the method was investigated by measuring the flow three times in each of the twelve volunteers. Phantom experiments were performed to investigate potential error sources. Results: The average CS flow was determined to 88 ± 33 ml/min and the deduced LV perfusion was 0.60 ± 0.22 ml/min·g, in agreement with published values. The repeatability (1-error) of the three repeated measurements in each subject was on average 84%. Conclusion: This work demonstrates that the combination of high field strength (3T), parallel imaging and segmented gradient echo sequences allow for quantification of the CS flow and global perfusion within a breath-hold. http://www.biomedcentral.com/1471-2342/9/9 Karin Markenroth Bloch Marcus Carlsson Hakan Arheden Freddy Stahlberg BMC Medical Imaging 2009, 9:9 2009-06-11T00:00:00Z doi:10.1186/1471-2342-9-9 BMC Medical Imaging 1471-2342 9 9 2009-06-11T00:00:00Z XML