Cardiac Magnetic Resonance Spectroscopy: Potential Clinical Applications

Neubauer, Stefan

doi:10.1007/s000590050037

Cited by 9 publications

(5 citation statements)

References 39 publications

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“…In the past decade, MR spectroscopy (MRS) has become a reliable clinical tool for the diagnosis of selected diseases (1–7). An important feature of any diagnostic tool is its reproducibility.…”

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confidence: 99%

Reproducibility of localized 2D correlated MR spectroscopy

Binesh

Yue

Fairbanks

et al. 2002

Magnetic Resonance in Med

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The test-retest reliability of two-dimensional (2D) correlated spectroscopy (COSY) was studied on a whole-body 1.5T MRI scanner. Single-voxel localized 2D proton spectra were recorded in vitro as well as in vivo using a recently implemented localized chemical shift correlated spectroscopic (L-COSY) sequence. A total of 40 in vitro and 40 human brain (10 volunteers, four times each) 2D L-COSY spectra were recorded. The coefficients of variation (CVs) of selected brain metabolites (raw volume integrals) recorded in 10 healthy volunteers were less than 9% for creatine, choline, and N-acetyl aspartate, and less than 17% for myo-inositol, glutamine/glutamate, aspartate, and threonine/lactate. The 2D metabolite ratios and the raw volume integrals of 2D diagonal and cross peaks in healthy human brain were very well reproduced. The intraclass correlation coefficients were greater than 0.4 (P < 0.05) for the major metabolites, indicating that the 2D peak volumes were stable enough within individuals to detect reliable differences between normal subjects. In the past decade, MR spectroscopy (MRS) has become a reliable clinical tool for the diagnosis of selected diseases (1-7). An important feature of any diagnostic tool is its reproducibility. Many studies on the reproducibility of one-dimensional (1D) 1 H MRS have reported the ratios and absolute concentrations of the metabolites (8 -13). Although these studies have shown small errors (3-6%) in the measurement of metabolites in vitro (8,9), the in vivo studies showed higher coefficients of variation (7-26%) in a maximum of only five metabolites (9 -13). Severe overlap of brain metabolites is a major hindrance in 1D MRS.Localized and nonlocalized versions of 2D MRS were reported a decade ago (14 -18); however, only recently have 2D proton spectra been recorded in healthy human subjects and patients with brain tumors (19 -25). Compared to 1D MRS, 2D MR spectra allow less ambiguous assignment of several metabolite resonances in human brain and prostate (25)(26)(27). In a previous study (25), the resonances caused by glutamine/glutamate (Glx) were clearly separated from the dominant singlet resulting from N-acetyl aspartate (NAA) and myo-inositol (mI) in the human brain. Even though identification of "free" aspartate (Asp) was not possible with 1D MRS, the peaks were separated from NAA in 2D MRS (25). 2D cross peaks caused by phosphoethanolamine and ethanolamine (PE), phosphoryl choline (PCh), threonine and lactate (Thr/Lac), and ␥-aminobutyric acid (GABA) were also identified in the 2D L-COSY spectra of the brain. However, to date there has been no report on the reproducibility of 2D MRS. The goal of this work was to investigate the reproducibility of 2D peak volumes and 2D metabolite ratios recorded in phantom solutions and healthy brain using the L-COSY sequence (25). MATERIALS AND METHODS A 1.5 T GE Horizon (5.8) MRI/MRS scanner (GE MedicalSystems, Waukesha, WI) with echo-speed gradients was used with a body coil for transmission and a 3-inch surface coil for reception. ...

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confidence: 99%

Reproducibility of localized 2D correlated MR spectroscopy

Binesh

Yue

Fairbanks

et al. 2002

Magnetic Resonance in Med

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“…MRI is an excellent noninvasive imaging method for evaluation of cardiac morphology and function (Kim et al 2000). Besides excellent morphological assessment of the heart, this unique technique offers opportunity to study myocardial metabolism providing important insights about biochemistry of the diabetic heart (Neubauer 2000; Scheuermann-Freestone et al 2003; Szczepaniak et al 2003). Using the new and well validated technique of delayed-enhancement we can now diagnosed small subendocardial infarction that may be hidden to other methods such as ECG, SPECT (Wagner et al 2003a) and PET (Klein et al 2002; Kuhl et al 2006).…”

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confidence: 99%

Silent myocardial infarction in women with type II diabetes mellitus and microalbuminuria

Ömerovic

Brohall²,

Müller³

et al. 2008

TCRM

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Introduction:The aim of this study was to investigate whether asymptomatic women with diabetes mellitus (DM) without previous history of ischemic heart disease (IHD) and normal electrocardiogram (ECG) have suffered silent myocardial infarction (MI). Methods: The study population consisted of 64-years old women with DM and albuminuria (n = 15) and aged-and body mass index-matched controls (n = 16). The patients were selected after screening of 240 women with previously known or unknown DM. The individuals with previous history of IHD and ECG suggesting the presence of IHD were excluded. All subjects were investigated with magnetic resonance imaging (MRI). Results: MRI investigation has revealed the presence of subendocardial MI in the two DM women (13%). No MI was detected in the control group. MR coronary angiography detected the presence of signifi cant stenosis in the proximal segment of left anterior descending (LAD) coronary artery in one DM woman. This patient developed unstable angina 1 week after the MRI investigation. The conventional angiography has confi rmed the presence of signifi cant stenosis in LAD demanding invasive revascularization by percutaneous coronary angioplasty. No difference was found in indices of left ventricular (LV) systolic function while diastolic function was disturbed in the DM group. There was a tendency for increased LV mass in the DM group. No difference was found in the LV volumes. Conclusion: Clinically signifi cant proportion of the women with DM and albuminuria without previous history of IHD have had silent MI. MRI screening of these high risk female patient is valuable diagnostic tool which may increase diagnostic accuracy and improve prognosis in DM patients with IHD.

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“…Subsequently, 31 P MRS was extended to small and large animal models with transmural differentiation mainly by means of detection coils placed on the epicardial surface (for example, see [1,45,[63][64][65][66]), and lower resolution, less well-localized spectra were obtained in humans using extrathoracic coils [41]. High-quality transmurally localized spectra can be obtained from the heart in animal and human subjects using high-field (4 Tesla or greater) spectrometry [6,39].…”

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confidence: 99%

The Use of Magnetic Resonance Methods in Translational Cardiovascular Research

From

Uğurbil

2009

J. of Cardiovasc. Trans. Res.

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Magnetic resonance methods are widely applicable to research questions posed in translational cardiovascular studies. The main intent of this review was to offer the cardiovascular translational research scientist a "menu" of magnetic resonance (MR) approaches that can be applied to answering research questions posed in a variety of experimental situations including those involving the use of human subjects. Obviously, this menu is not comprehensive and many other topics could have been selected for emphasis. However, we hope that the material presented encompasses a broad enough slice of the field to stimulate thinking about the possible applications of MR methods to specific research questions.

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Cardiac Magnetic Resonance Spectroscopy: Potential Clinical Applications

Cited by 9 publications

References 39 publications

Reproducibility of localized 2D correlated MR spectroscopy

Reproducibility of localized 2D correlated MR spectroscopy

Silent myocardial infarction in women with type II diabetes mellitus and microalbuminuria

The Use of Magnetic Resonance Methods in Translational Cardiovascular Research

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