Time-resolved lower extremity MRA with temporal interpolation and stochastic spiral trajectories: preliminary clinical experience.

PURPOSE: To assess added value of a new time-resolved technique with temporal interpolation and stochastic spiral trajectory through k-space and parallel imaging (TR-MRA) to conventional bolus chase MRA (BC-MRA) for infragenual peripheral artery evaluation. MATERIALS AND METHODS: An institutional review board-approved retrospective review of peripheral arterial disease patients was performed. Infragenual TR-MRA and BC-MRA were performed in 26 patients over four months. Two readers individually assessed image quality, diagnostic confidence, and stenosis severity and length in 13 defined below knee segments, first with BC-MRA alone, and then with a combined BC-MRA and TR-MRA reading (BC+TR-MRA). Perceived contribution of TR-MRA was rated by each reader. The reference standard was a consensus reading of both sequences. Catheter angiographic (CA) correlation was available in 6 patients. RESULTS: A total of 646 infragenual segments in 51 extremities were evaluated. Image quality and diagnostic confidence were superior for BC+TR-MRA compared with BC-MRA alone (P < 0.001). Adding TR-MRA improved sensitivity (85.7% versus 80.7%; P < 0.05) and diagnostic accuracy (88.1% versus 85.4%; P < 0.05) for hemodynamically significant stenosis. Venous contamination (0% versus 13.1% segments) and motion (0.9% versus 8.0%) were decreased for BC+TR-MRA versus BC-MRA alone, P < 0.01. For BC+TR-MRA, TR-MRA was rated more useful than BC-MRA in 30/51 legs (58.8%). TR-MRA identified retrograde flow in 5 segments. Where available, there was high concordance between CA and BC+TR-MRA (91.6%) for stenosis. CONCLUSION: Adding TR-MRA with temporal interpolation and stochastic spiral trajectories to bolus chase MRA improves image quality, diagnostic confidence and accuracy. It provides hemodynamic information and minimizes venous contamination and patient motion.

Time-resolved dynamic contrast-enhanced MR urography for the evaluation of ureteral peristalsis: initial experience.

PURPOSE: To determine the feasibility of time-resolved dynamic contrast-enhanced magnetic resonance urography (MRU) for the evaluation of ureteral peristalsis using a data-sharing 3D gradient echo sequence with spiral k-space filling. MATERIALS AND METHODS: Eight patients (M=3, F=5, mean 48.1 years) were referred for MRU for the evaluation for renal mass (n=3), hematuria (n=2), urinary tract tuberculosis (n=1), postoperative bladder cancer (n=1), and postoperative ureteric reimplantation (n=1). Dynamic MRU was performed for 120 seconds at 1.5T after intravenous furosemide and gadolinium administration using an oblique sagittal, time-resolved T1 3D gradient echo sequence with 1 second effective temporal resolution. Study quality was assessed based on artifacts and extent of ureteric visualization. Frequency of peristalsis from the renal pelvis to urinary bladder was evaluated for each subject. RESULTS: A total of 16 ureters were examined. Image quality was good in four ureters, satisfactory in 11 ureters, and poor in one ureter. Mean peristaltic frequency was 3.5 waves per minute (range, 2.5-6.5 waves/minute) in normal ureters (n=11). Five ureters were considered abnormal (one urinary tract tuberculosis and four postsurgical ureters), and all had decreased or no peristalsis (0-1.5 waves per minute). CONCLUSION: MRU using a time-resolved, data-sharing 3D contrast-enhanced technique is able to demonstrate ureteral peristalsis and permits quantification of ureteral peristaltic frequency.

Neuronal expression of myeloperoxidase is increased in Alzheimer's disease.

Myeloperoxidase, a heme protein expressed by professional phagocytic cells, generates an array of oxidants which are proposed to contribute to tissue damage during inflammation. We now report that enzymatically active myeloperoxidase and its characteristic amino acid oxidation products are present in human brain. Further, expression of myeloperoxidase is increased in brain tissue showing Alzheimer's neuropathology. Consistent with expression in phagocytic cells, myeloperoxidase immunoreactivity was present in some activated microglia in Alzheimer brains. However, the majority of immunoreactive material in brain localized with amyloid plaques and, surprisingly, neurons including granule and pyramidal neurons of the hippocampus. Confirming neuronal localization of the enzyme, several neuronal cell lines as well as primary neuronal cultures expressed myeloperoxidase protein. Myeloperoxidase mRNA was also detected in neuronal cell lines. These results reveal the unexpected presence of myeloperoxidase in neurons. The increase in neuronal myeloperoxidase expression we observed in Alzheimer disease brains raises the possibility that the enzyme contributes to the oxidative stress implicated in the pathogenesis of the neurodegenerative disorder.