PCOM Library / Archive for "Hot Topics in Research"

Category: Hot Topics in Research

Findings from Structural MR Imaging in Military Traumatic Brain Injury

PJ Grier Brain, Hot Topics in Research, Neurosurgery, Radiology

Findings from Structural MR Imaging in Military Traumatic Brain Injury

To describe the initial neuroradiology findings in a cohort of military service members with primarily chronic mild traumatic brain injury (TBI) from blast by using an integrated magnetic resonance (MR) imaging protocol.

Materials and Methods

This study was approved by the Walter Reed National Military Medical Center institutional review board and is compliant with HIPAA guidelines. All participants were military service members or dependents recruited between August 2009 and August 2014. There were 834 participants with a history of TBI and 42 participants in a control group without TBI (not explicitly age- and sex-matched). MR examinations were performed at 3 T primarily with three-dimensional volume imaging at smaller than 1 mm3 voxels for the structural portion of the examination. The structural portion of this examination, including T1-weighted, T2-weighted, before and after contrast agent administrtion T2 fluid attenuation inversion recovery, and susceptibility-weighted images, was evaluated by neuroradiologists by using a modified version of the neuroradiology TBI common data elements (CDEs). Incident odds ratios (ORs) between the TBI participants and a comparison group without TBI were calculated.

The 834 participants were diagnosed with predominantly chronic (mean, 1381 days; median, 888 days after injury) and mild (92% [768 of 834]) TBI. Of these participants, 84.2% (688 of 817) reported one or more blast-related incident and 63.0% (515 of 817) reported loss of consciousness at the time of injury. The presence of white matter T2-weighted hyperintense areas was the most common pathologic finding, observed in 51.8% (432 of 834; OR, 1.75) of TBI participants. Cerebral microhemorrhages were observed in a small percentage of participants (7.2% [60 of 834]; OR, 6.64) and showed increased incidence with TBI severity (P < .001, moderate and severe vs mild). T2-weighted hyperintense areas and microhemorrhages did not collocate by visual inspection. Pituitary abnormalities were identified in a large proportion (29.0% [242 of 834]; OR, 16.8) of TBI participants.

Conclusion

Blast-related injury and loss of consciousness is common in military TBI. Structural MR imaging demonstrates a high incidence of white matter T2-weighted hyperintense areas and pituitary abnormalities, with a low incidence of microhemorrhage in the chronic phase.

 

Radiology; 278;1 (Ahead of Print), Gerard Riedy, MD, PhD , Justin S. Senseney, MS , Wei Liu, DSc , John Ollinger, PhD , Elyssa Sham, BA , Pavel Krapiva, MD , Jigar B. Patel, MD , Alice Smith, MD , Ping-Hong Yeh, PhD , John Graner, PhD , Dominic Nathan, PhD , Jesus Caban, PhD , Louis M. French, PsyD , Jamie Harper, MPH , Victoria Eskay, BA , John Morissette , Terrence R. Oakes, PhD. DOI: http://dx.doi.org/10.1148/radiol.2015150438

MRI compatible remote catheter navigation system with 3 degrees of freedom

PJ Grier Hot Topics in Research, Radiology

Magnetic resonance imaging compatible remote catheter navigation system with 3 degrees of freedom

 

To facilitate MRI-guided catheterization procedures, we present an MRI-compatible remote catheter navigation system that allows remote navigation of steerable catheters with 3 degrees of freedom.

Methods

The system consists of a user interface (master), a robot (slave), and an ultrasonic motor control servomechanism. The interventionalist applies conventional motions (axial, radial and plunger manipulations) on an input catheter in the master unit; this user input is measured and used by the servomechanism to control a compact catheter manipulating robot, such that it replicates the interventionalist’s input motion on the patient catheter. The performance of the system was evaluated in terms of MRI compatibility (SNR and artifact), feasibility of remote navigation under real-time MRI guidance, and motion replication accuracy.

Results

Real-time MRI experiments demonstrated that catheter was successfully navigated remotely to desired target references in all 3 degrees of freedom. The system had an absolute value error of <1 mm in axial catheter motion replication over 30 mm of travel and 3±2 for radial catheter motion replication over 180. The worst case SNR drop was observed to be <3 %; the robot did not introduce any artifacts in the MR images.

Conclusion

An MRI-compatible compact remote catheter navigation system has been developed that allows remote navigation of steerable catheters with 3 degrees of freedom. The proposed system allows for safe and accurate remote catheter navigation, within conventional closed-bore scanners, without degrading MR image quality.

M. A. Tavallaei, International Journal of Computer Assisted Radiology and Surgery, pp 1-9, First online: