The MR Appearance of Volume Overload in the Lower Extremities

Meler, James D.; Solomon, Michael A.; Steele, Joseph R.; Yancy, Clyde W.; Parkey, Robert W.; Fleckenstein, James L.

doi:10.1097/00004728-199711000-00022

Cited by 7 publications

(9 citation statements)

References 13 publications

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“…Similar reticular patterns have been observed in patients with volume overload, e.g. cardiac failure or nephrotic syndrome (14), and in acute infectious cellulitis (15). It might be possible in most cases, however, to differentiate between the reticular pattern in volume overload patients and the honeycomb pattern in lymphedema patients, since the fat lobules in lymphedema are larger than in normal legs, partly as a result of fat neogenesis which is characteristic of lymphedema (10).…”

Section: Discussionsupporting

confidence: 68%

“…The dermal edematous thickening could be helpful in differentiating lymphedema from diseases with similar reticular subcutaneous features, e.g. in nephrotic syndrome and cardiac overload patients in whom dermal edema is not found (8, 14). However, such an assessment has to be made with caution since, in the present and other studies (8, 9), dermal edema has not been demonstrated in all lymphedema patients – the negative ones presumably being cases of clinical stage I or less severe stage II lymphedema.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

MR Imaging of Primary, Secondary, and Mixed Forms of Lymphedema

Åström¹,

Abdsaleh²,

Brenning

et al. 2001

Acta Radiologica

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

MR Imaging of Primary, Secondary, and Mixed Forms of Lymphedema

Åström¹,

Abdsaleh²,

Brenning

et al. 2001

Acta Radiologica

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“…MR-based measurements of local disruptions of tissue fluid distribution have proven clinical utility. 41,63,64 Our work extends this to measure systemic fluid depletion via localized measurement of tissue fluid distribution.…”

Section: Discussionmentioning

confidence: 78%

Dehydration assessment via a portable, single sided magnetic resonance sensor

Bashyam

Frangieh

et al. 2019

Magnetic Resonance in Med

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Undiagnosed dehydration compromises health outcomes across many populations. Existing dehydration diagnostics require invasive bodily fluid sampling or are easily confounded by fluid and electrolyte intake, environment, and physical activity limiting widespread adoption. We present a portable MR sensor designed to measure intramuscular fluid shifts to identify volume depletion. Methods: Fluid loss is induced via a mouse model of thermal dehydration (37°C; 15-20% relative humidity). We demonstrate quantification of fluid loss induced by hyperosmotic dehydration with multicomponent T2 relaxometry using both a benchtop NMR system and MRI localized to skeletal muscle tissue. We then describe a miniaturized (~1000 cm 3) portable (~4 kg) MR sensor (0.28 T) designed to identify dehydration-induced fluid loss. T2 relaxometry measurements were performed using a Carr-Purcell-Meiboom-Gill pulse sequence in ~4 min. Results: T2 values from the portable MR sensor exhibited strong (R 2 = 0.996) agreement with benchtop NMR spectrometer. Thermal dehydration induced weight loss of 4 to 11% over 5 to 10 h. Fluid loss induced by thermal dehydration was accurately identified via whole-animal NMR and skeletal muscle. The portable MR sensor accurately identified dehydration via multicomponent T2 relaxometry. Conclusion: Performing multicomponent T2 relaxometry localized to the skeletal muscle with a miniaturized MR sensor provides a noninvasive, physiologically relevant measure of dehydration induced fluid loss in a mouse model. This approach offers sensor portability, reduced system complexity, fully automated operation, and low cost compared with MRI. This approach may serve as a versatile and portable point of care technique for dehydration monitoring.

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“…In addition to these volumetry-based studies, numerous MR studies also examined the morphological MR appearance of lymphedema or phlebedema in the lower extremity [26 -28]. Meler et al reported a marked subcutaneous, perifascicular and even intramuscular fluid accumulation, but only used morphological MR sequences in patients with fluid overload [29]. However, to our knowledge no previous study quantitatively investigated the influence of gravitational interstitial fluid accumulation in tendinous tissue in the lower extremity.…”

Section: Musculoskeletal System 1007mentioning

confidence: 99%

Intradiurnal Fluctuations of Off-Resonance Saturation Effects in Healthy Human Achilles Tendons Assessed with a 3D Ultrashort Echo Time MRI Sequence at 3 Tesla

Grosse¹,

Syha²,

Partovi³

et al. 2015

Fortschr Röntgenstr

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Ziel:In dieser Studie an gesunden Probanden sollten die Auswirkungen des orthostatischen Ödems durch reduzierte körperliche Aktivität auf intratendinöse Magnetisierungstransfer-(MT-) Effekte (oder allgemeiner Off-Resonanz-Sättigungs-Ratios ("OSR")) und das Volumen der Achillessehne untersucht werden. Material und Methoden: Sieben gesunde Probanden wurden an drei aufeinander folgenden Tagen jeweils morgens und abends mittels einer 3D-Ultrashort-echo-time (UTE) Sequenz mit 2000 Hz Off-Resonanz-Sättigungspulsen zur Kalkulation von OSRWerten an einem 3 T Ganzkörper-MRT untersucht. Für eine möglichst exakte Volumenquantifizierung der Achillessehne in hochaufgelösten isotropen T2-SPACE Sequenzen kam ein neu entwickelter "Snake"-Konturerkennungsalgorithmus zum Einsatz. Zusätzlich wurden Einzelmessungs-Intraklassen-Korrelationskoeffizienten (engl. ICC) als quantitatives Reliabilitätsmaß zur Abschätzung der Test-Retest-Reliabilität berechnet. Ergebnisse: Sowohl für die OSR-Werte als auch das Sehnenvolumen konnte eine exzellente Reproduzierbarkeit mit ICC-Werten größer 0,96 bzw. 0,97 über die drei untersuchten aufeinander folgenden Messtage gezeigt werden. Bei der Betrachtung aller Messzeitpunkte wurde eine statistisch signifikante Abnahme der intratendinösen OSR-Werte (-4,1 ± 1,5 %; p = 0,001) am Abend gefunden, während das ermittelte Sehnenvolumen hier keine signifikante Änderung zeigte (p = 0,589). Schlussfolgerung: Die Ergebnisse dieser in-vivo Studie zeigen einen messbaren Einfluss des orthostatischen Ödems durch reduzierte körperliche Aktivität auf intratendinöse OSR-Werte aber nicht das Sehnenvolumen. Zusammen mit der aufzeigten exzellenten Reproduzierbarkeit sind diese Ergebnisse besonders für zukünftige Longitudinalstudien und die Untersuchung von zeitlichen Veränderungen der tendinösen Mikrostruktur von Bedeutung. Abstract !Purpose: The purpose of this study was to evaluate whether gravitational interstitial fluid accumulation in healthy subjects has an impact on off-resonance saturation ratios (OSR) or the volume of the Achilles tendon after a prolonged time of reduced levels of physical activity. Materials and Methods: 7 healthy volunteers were repeatedly investigated on 3 consecutive days on a 3 T whole body MR scanner using an ultrashort echo time (UTE) imaging sequence with a Gaussian off-resonance saturation pulse at a frequency offset of 2000 Hz to calculate OSR values. For accurate volumetric quantification of the Achilles tendon, a newly developed contour detection snake algorithm was applied on high-resolution isotropic T2-weighted SPACE sequence datasets. Single-measure intraclass correlation coefficients (ICC) were calculated to estimate test-retest reliability. Results: For OSR and tendon volume measurements on three consecutive days, excellent reproducibility could be achieved with ICC values above 0.96 and 0.97, respectively. Comparing the results of all three days, a statistically significant mean individual percentage decrease (-4.1 ± 1.5 %; p = 0.001) of calculated tendon OSR values was found f...

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The MR Appearance of Volume Overload in the Lower Extremities

Cited by 7 publications

References 13 publications

MR Imaging of Primary, Secondary, and Mixed Forms of Lymphedema

MR Imaging of Primary, Secondary, and Mixed Forms of Lymphedema

Dehydration assessment via a portable, single sided magnetic resonance sensor

Intradiurnal Fluctuations of Off-Resonance Saturation Effects in Healthy Human Achilles Tendons Assessed with a 3D Ultrashort Echo Time MRI Sequence at 3 Tesla

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