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    ABSTRACT: Purpose: The use of tailored RF excitation pulses for prospective correction of non-linear motion-induced phase patterns is shown to enable diffusion-weighted (DW) fast spin echo (FSE) imaging in vivo. Echo-planar imaging (EPI) remains the most used sequence for DW imaging. Despite being highly sensitive to field inhomogeneities, EPI is robust to motion-induced phase shifts. FSE sequences are much less sensitive to field inhomogeneities, but require precise control of the transverse magnetization phase, which is hard to achieve with DW. Real time measurements and correction of phase ramps due to rigid-body motion had been proposed, but performance remained unsatisfactory because of non-linear phase patterns related to pulsatile motion. Methods: Reproducible non-linear phase components are calibrated using 2D-EPI navigators and tailored RF excitation pulses designed. Real time correction of rigid-body motion was not yet implemented. Results: Phase correction was confirmed with full signal DW-FSE images obtained on co-operative subjects. Full diffusion tensor acquisitions were obtained and color-coded maps displaying principal fiber directionality calculated. Results were consistent with corresponding EPI acquisitions except for absence of spatial distortions. Conclusion: Combining the proposed method with real time compensation of rigid-body motion has the potential to allow high quality, distortion free diffusion imaging throughout the brain.
    No preview · Article · Feb 2014 · Magnetic Resonance in Medicine
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    ABSTRACT: Patent ductus arteriosus (PDA) remains common in preterm newborns, but uncertainty over optimal management is perpetuated by clinicians' inability to quantify its true haemodynamic impact. Our aim was to develop a technique to quantify ductal shunt volume and the effect of PDA on systemic blood flow volume in neonates. Phase contrast MRI sequences were optimized to quantify left ventricular output (LVO) and blood flow in the distal superior vena cava (SVC) (below the azygos vein insertion), descending aorta (DAo) and azygos vein. Total systemic flow was measured as SVC + DAo - azygos flow. Echo measures were included and correlated to shunt volumes. 75 infants with median (range) corrected gestation 33(+6) (26(+4) -38(+6) ) weeks were assessed. PDA was present in 15. In 60 infants without PDA, LVO matched total systemic flow (mean difference 2.06 ml/kg/min, repeatability index 13.2%). In PDA infants, ductal shunt volume was 7.9-74.2% of LVO. Multiple linear regression analysis correcting for gestational age showed that there was a significant association between ductal shunt volume and decreased upper and lower body flow (p = 0.01 and p < 0.001). However, upper body blood flow volumes were within the control group 95% confidence limits in all 15 infants with PDA, and lower body flow volumes within the control group limits in 12 infants with PDA. Echocardiographic assessment of reversed diastolic flow in the descending aorta had the strongest correlation with ductal shunt volume. We have demonstrated that quantification of shunt volume is feasible in neonates. In the presence of high volume ductal shunting the upper and lower body flow volume are somewhat reduced, but levels remain within or close to the normal range for preterm infants. Copyright © 2013 John Wiley & Sons, Ltd.
    Full-text · Article · Sep 2013 · NMR in Biomedicine
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    ABSTRACT: White matter injury and abnormal maturation are thought to be major contributors to the neurodevelopmental disabilities observed in children and adolescents who were born preterm. Early detection of abnormal white matter maturation is important in the design of preventive, protective, and rehabilitative strategies for the management of the preterm infant. Diffusion-weighted magnetic resonance imaging (d-MRI) has become a valuable tool in assessing white matter maturation and injury in survivors of preterm birth. In this review, we aim to (1) describe the basic concepts of d-MRI; (2) evaluate the methods that are currently used to analyse d-MRI; (3) discuss neuroimaging correlates of preterm brain injury observed at term corrected age; during infancy, adolescence and in early adulthood; and (4) explore the relationship between d-MRI measures and subsequent neurodevelopmental performance. References for this review were identified through searches of PubMed and Google Scholar before March 2013. The impact of premature birth on cerebral white matter can be observed from term-equivalent age through to adulthood. Disruptions to white matter development, identified by d-MRI, are related to diminished performance in functional domains including motor performance, cognition and behaviour in early childhood and in later life. d-MRI is an effective tool for investigating preterm white matter injury. With advances in image acquisition and analysis approaches, d-MRI has the potential to be a biomarker of subsequent outcome and to evaluate efficacy of clinical interventions in this population.
    No preview · Article · Aug 2013 · Neuroradiology
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