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Mri Presentation
Mri Presentation
Mri Presentation
Tissue characterization
• Physics to understand tissue characterization with MRI
• Contrast-materials
Tissue Characterization • Clinical application
with
Cardiac Magnetic Resonanace Imaging
www.magnet.fsu.edu
MR Principle •
•
Precession frequency (MHz)
Larmour Equation
• Atom structure • Net Magnetic Vector (NMV)
• W0=B0 x gyro magnetic ratio
• Central nucleus: proton, neutron • External magnetic field (B0)
• Strength of magnetic field • Hydrogen 63.86MHz under 1.5 T
• Orbiting electrons
•1 tesla = 10,000 gauss • Resonance
• Atom movement • Alignment • Precession frequency at 90 degree to the B0
• Precession •Parallel www-mrsrl.stanford.edu
•antiparallel • Radiofrequency band, RF pulse
• MR active nucleus
• Alignment to an applied magnetic field • Excitation
• Magnetic momentum of nucleus • Change direction of NMV
• Only nuclei with odd number • In phase
• Ex) Hydrogen 1 • Free Induction Decay
Phosphorous 31 • Relaxation – exponential process
• T1 Recovery (spin lattice relaxation)
• T2 decay (spin spin relaxation)
• Dephasing
B0 • T1 & T2 time : 63%
• Different T1 and T2 in fat and water
• Receiver Coil
• Signal : voltage induced
media.nasaexplores.com www.hull.ac.uk
1
2007-11-27
www.revisemri.com
www.revisemri.com
Contrast Agents
• Extracellular Contrast Agents
• Basic contrast by body contents of • Blood-Pool Contrast Agents
• 1H, 23Na, 31P, Hyperpolarized 13C-urea • Intracellular Contrast Agents
• Necrosis-Avid or Multipurpose Contrast Agents
• Contrast Agents • Plaque- and Thrombus-Specific Contrast Agents
• Molecular Imaging Contrast Agents
• Paramagnetic metal
• Gadolinium (Gd3+),
Manganese (Mn2+),
Dysprosium
(Dy3+), iron (Fe3+)
• Intrinsic paramagnetic effect by hemoglobin
• Superparamegnetic, ferromagnetic agents www.mritutor.org
• Fe3O4
www.bloodpoolagents.com
www.nature.com
Yonsei University College of Medicine Yonsei University College of Medicine
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2007-11-27
DE-MRI:
HCMP: Myocardial Enhancement
Clinical applications
Mechanism and histology
• Subendocardial infarction •
• Focal increased collagen
content
• LV thrombus • Moon et al., 2004
• Other than fibrosis
• No reflow zones • Knaapen et al., 2005
• Clinical Implication
• Nonischemic cardiomyopathy • P
Prognostic
ti significance
i ifi
• Shirani et al., 2000
• Myocarditis and infiltrative cardiomyopathies • Sudden death
• Moon et al., 2003
• Monitoring therapeutic interventions • Functional correlation
• Correlation inversely
• Choudhury et al., 2002
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2007-11-27
F/57
Dyspnea
C-angio: Normal
Myocarditis
• Inflammation in
biopsy in DCM
patients: 22%
• Endomyocardial
y
Biopsy: sample
error, variability in
pathologic
evaluation,
potentially risky
CMR in myocarditis
• Enhancement in 88% of patients
• Active myocarditis in 19/21 LGE biopsy
• Active myocarditis in 1/11 non-LGE biopsy
• 3 months f/u
• LGE decrease 9% to 3%
• LVEF increase 47% to 60%
Mahrholdt et al. Circ 2004
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2007-11-27
A B C
D E
16-15
M/40
F/63
6
6 2
5
3
1 2
3
4
5
4
5
2007-11-27
AJR 2005;184:249–254
Yonsei University College of Medicine Yonsei University College of Medicine RadioGraphics 2006; 26:795–810
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2007-11-27
M/66
•Chest pain (2 months)
•Hx:Hypertension (3
years)
•Echocardiography
-R/O RCMP,
-Enlarged LA chamber
with
ith reduced
d d EF=42%
EF 42%
-TR II~III, MR I
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2007-11-27
Example of type IV-V lesion in internal carotid artery (lipid-rich necrotic core was detected
by histology)
Choudhury et al. Nat Rev Drug Discov 2004;3:913 Novel VCAM-1 peptide affinity
ligand from phage display
conjugated to magentofluorescent
nanoparticle in VCAM-1 expression
in murine atherosclerosis
Kelly et al. Circ Res 2005;96:327 Kelly et al. Circ Res 2005;96:327
Kelly et al. Circ Res 2005;96:327
Kelly et al. Circ Res 2005;96:327
Hardy et al. Magn Reson Med 1992;28:54
Yonsei University College of Medicine Yonsei University College of Medicine
Thank you !