Citations

PurposeTo investigate the feasibility of using MR elastography (MRE) for the evaluation of the stiffness of in vivo aortic wall.Materials and MethodsTo validate the experimental approach for imaging the aorta in vivo, a gel phantom with an embedded porcine aorta was imaged in the presence of fluid flow within the aorta. The potential changes in the elasticity of the vessel wall with changes in pressure were investigated. The feasibility of performing MRE of abdominal aorta was assessed in five volunteers (age, 22–40 years; body mass index, 21.5–25.2 kg/m2). The pulse‐gated cine MRE technique was used to study the wave propagation along the aorta throughout the cardiac cycle and provide estimates of aortic stiffness in diastole.ResultsIn the phantom study, the wave propagation was well visualized within the porcine aorta embedded in the gel phantom. An increase of the Young's modulus‐wall thickness (E*t) product with the increase in static pressure was observed. In the in vivo study, the waves were well visualized within the lumen of abdominal aorta in the five volunteers in diastolic phase, but they were not well visualized during systole.ConclusionMRE is feasible for noninvasively assessing the stiffness of the abdominal aorta and merits further investigation. J. Magn. Reson. Imaging 2013;38:1549–1553. © 2013 Wiley Periodicals, Inc.

Key Points Thalidomide and prednisone maintenance after transplantation improves progression-free but not overall survival.

AbstractMicrovasculature associated with the sciatic nerve was examined using high‐resolution micro‐CT scanning in one group of rats and surgical exploration in another. The results indicate that blood supply to the sciatic nerve is an “open‐ended” system in which the vessels run longitudinally within the epineurium and connect with external vasculature primarily at junction points. Although the range of vasculature found extended down to 4–5 μ, only a few isolated vessels of this size were found, with no capillary “mesh” as such, possibly because of the close proximity of the intrinsic vessel to nerve fibers within the epineurium. While the study did not include direct measurements of flow or nerve function, the “open‐ended” pattern of vasculature found has important implications regarding the relationship between the two. Specifically, the nerve is less vulnerable to a severe or complete disruption in blood supply than it would be under a close‐ended system such as that of the heart or brain, where a severe disruption can occur with the obstruction of only a single vessel. Indeed, the pattern of vasculature found, subject to further study of vasculature at the capillary level, suggests that flow within the intrinsic vessels may be in either direction, depending on circumstances, somewhat like flow within the circle of Willis in the cerebral circulation.

PurposeTo provide a fully automated algorithm for obtaining stiffness measurements from hepatic magnetic resonance elastography (MRE) images that are consistent with measurements performed by expert readers.Materials and MethodsAn initial liver contour was found using an adaptive threshold and expanded using an active contour to select a homogeneous area of the liver. The confidence map generated during the stiffness calculation was used to select a region of reliable wave propagation. The average stiffness within the automatically generated region of interest (ROI) was compared to measurements by two trained readers in a set of 88 clinical test cases ranging from healthy to severely fibrotic.ResultsThe stiffness measurements reported by the readers differed by −6.76% ± 22.8% (95% confidence) and had an intraclass correlation coefficient (ICC) of 0.972 (P < 0.05). The algorithm and the more experienced reader differed by 4.32% ± 14.9 with an ICC of 0.987.ConclusionThe automated algorithm performed reliably, even though MRE acquisitions often have motion artifacts present. The correlation between the automated measurements and those from the trained readers was superior to the correlation between the readers. J. Magn. Reson. Imaging 2013;38:371–379. © 2013 Wiley Periodicals, Inc.

We report the case of a 66-year-old woman with tumor-induced osteomalacia (TIO) caused by fibroblast growth factor 23 (FGF-23) secreting mesenchymal tumor localized in a lumbar vertebra and review other cases localized to the axial skeleton. She presented with nontraumatic low back pain and spontaneous bilateral femur fractures. Laboratory testing was remarkable for low serum phosphorus, phosphaturia, and significantly elevated serum FGF-23 level. Magnetic resonance imaging (MRI) of the lumbar spine showed a focal lesion in the L-4 vertebra which was hypermetabolic on positron emission tomography (PET) scan. A computed tomography (CT) guided needle biopsy showed a low grade spindle cell neoplasm with positive FGF-23 mRNA expression by reverse transcriptase polymerase chain reaction (RT-PCR), confirming the diagnosis of a phosphaturic mesenchymal tumor mixed connective tissue variant (PMTMCT). The patient elected to have surgery involving anterior resection of L-4 vertebra with subsequent normalization of serum phosphorus. Including the present case, we identified 12 cases of neoplasms localized to spine causing TIO. To our knowledge, this paper represents the first documented case of lumbar vertebra PMT causing TIO. TIO is a rare metabolic bone disorder that carries a favorable prognosis. When a lesion is identifiable, surgical intervention is typically curative.

AbstractThe brain operates through complex interactions in the flow of information and signal processing within neural networks. The ‘wiring’ of such networks, being neuronal or glial, can physically and/or functionally go rogue in various pathological states. Neuromodulation, as a multidisciplinary venture, attempts to correct such faulty nets. In this review, selected approaches and challenges in neuromodulation are discussed. The use of water‐dispersible carbon nanotubes has been proven effective in the modulation of neurite outgrowth in culture and in aiding regeneration after spinal cord injury in vivo. Studying neural circuits using computational biology and analytical engineering approaches brings to light geometrical mapping of dynamics within neural networks, much needed information for stimulation interventions in medical practice. Indeed, sophisticated desynchronization approaches used for brain stimulation have been successful in coaxing ‘misfiring’ neuronal circuits to resume productive firing patterns in various human disorders. Devices have been developed for the real‐time measurement of various neurotransmitters as well as electrical activity in the human brain during electrical deep brain stimulation. Such devices can establish the dynamics of electrochemical changes in the brain during stimulation. With increasing application of nanomaterials in devices for electrical and chemical recording and stimulating in the brain, the era of cellular, and even intracellular, precision neuromodulation will soon be upon us.