Functional Studies Using NMR

210 Pages·1987·6.77 MB·English

by  V. Ralph McCready (auth.), V. Ralph McCready MSc, MRCP, FRCR, Martin Leach MSc, PhD, Peter J. Ell MD, MSc, PD, MRCP, FRCR (eds.)

Functional Studies
UsingNMR
Edited by
V. Ralph McCready, Martin Leach and Peter J. Ell
With 146 Figures
Springer-Verlag
London Berlin Heidelberg New York
Paris Tokyo
V. Ralph McCready, MSc, MRCP, FRCR
Consultant in Nuclear Medicine, Ultrasound and NMR, Royal Marsden
Hospital, Downs Road, Sutton, Surrey, UK
Martin Leach, MSc, PhD
Lecturer in Medical Physics (NMR) , Joint Department of Physics,
Institute of Cancer Research and Royal Marsden Hospital, Downs
Road, Sutton, Surrey, UK
Peter J. Ell, MD, MSc, PD, MRCP, FRCR
Director, Institute of Nuclear Medicine, The Middlesex Hospital
Medical School, Mortimer Street, London, UK
ISBN-13: 978-1-4471-1412-3 e-ISBN-13: 978-1-4471-1410-9
DOl: 10.1007/978-1-4471-1410-9
library of Congress Cataloging-in-Publication Data
Functional Studies using NMR.
"This volume is based on a series oflectures delivered at a one-day teaching symposium on
functional and metabolic aspects of NMR measurements held at the Middlesex Hospital
Medical School on September 1st 1985 as part of the European Nuclear Medicine Society
congress" - Pref.
Includes bibliographies and index.
1. Nuclear magnetic resonance spectroscopy - Congresses. 2. Magnetic resonance imaging
-Congresses. 3. Metabolism-Congresses. I. McCready, V.R.II. Leach, M.O. (Martin
Osmund),1952- . III. Ell, Peter Josef. IV. European Nuclear Medicine Society. [DNLM:
1. Metabolism - congresses. 2. Nuclear Magnetic Resonance - congresses. QU 25 F979
1985] QP519.9.N83F86 1986 616.07'5786-22121
The work is subject to copyright. All rights are reserved, whether the whole or part of the
material is concerned, specifically those of translation, reprinting, re-use of illustrations,
broadcasting, reproduction by photocopying, machine or similar means, and storage in
databanks.
© Springer-Verlag Berlin Heidelberg 1987
Softcover reprint of the hardcover I st edition 1987
The use of general descriptive names, trade marks, etc. in this publication, even if the
former are not to be taken as a sign that such names, as understood by the Trade Marks and
Merchandise Marks Act, may accordingly be used freely by anyone.
Product liability: The publisher can give no guarantee for information about drug dosage
and application thereof contained in this book. In every individual case the respective user
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Filmset by Tradeset, Welwyn Garden City, Hertfordshire.
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Preface
This volume is based on a series of lectures delivered at a one-day teach
ing symposium on functional and metabolic aspects of NMR measure
ments held at the Middlesex Hospital Medical School on 1st September
1985 as a part of the European Nuclear Medicine Society Congress.
Currently the major emphasis in medical NMR in vivo is on its poten
tial to image and display abnormalities in conventional radiological im
ages, providing increased contrast between normal and abnormal tissue,
improved definition of vasculature, and possibly an increased potential
for differential diagnosis. Although these areas are undeniably of major
importance, it is probable that NMR will continue to complement con
ventional measurement methods. The major potential benefits to be de
rived from in vivo NMR measurements are likely to arise from its use as
an instrument for functional and metabolic studies in both clinical re
search and in the everyday management of patients. It is to this area that
this volume is directed.
Although most of the areas of work described are as yet at an early
stage of development, it is evident that NMR is a powerful and many fa
ceted tool for investigating function and metabolism 4t vivo. It combines
cr
high quality anatomical imaging, at times surpassing the resolution of
scanners, with the potential for using functional and specific agents in a
manner akin to nuclear medicine whilst providing multiple parameters
for studying tissue changes and for discriminating tissue type. NMR spec
troscopy gives the potential to study cellular metabolism in localised reg
ions of tissue. Functional NMR imaging methods allow the measurement
of blood flow, currently providing results similar to Doppler ultrasound,
but offering the possibility of being extended to measure organ perfusion.
It is also possible to monitor organ function with high resolution using
NMR, for example, in cardiac function measurements.
This book is intended to provide the backgroundinformationrequired
for the reader who is not familiar with NMR, whilst also providing an up
to-date summary of advances and current work in the areas of interest in
metabolic, physiological and functional studies.
We are particularly grateful to the contributing authors who have given
such an exciting and comprehensive treatment to the different areas
vi Preface
covered by this volume and who ensured that the symposium was a con
siderable success.
Sutton, England v. Ralph McCready
June 1986 Martin Leach
Peter J. Ell
Contents
1. The Relationsbip Between NMR and Other Functional
Measurement Techniques
V. Ralph McCready .............................. 1
Introduction ................................... 1
Blood Flow .................................... 2
Tissue Metabolism ............................... 7
Tissue Characterisation ............................ 9
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11
2. The Physical Basis of NMR Studies Measuring
Physiological Function and Metabolism
M.O. Leach ................................... 15
Introduction ................................... 15
Physical Basis of NMR ............................ 15
Imaging and Spatial Localisation of NMR Spectra .. . . . . . . . .. 26
Functional Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 32
Instrumentation ................................. 35
Siting and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 37
3. Functional Imaging Using NMR
R. Bachus, E. Mueller, H. Koenig, G. Braeckle,
H. Weber and E.R. Reinhardt ........................ 43
NMR Image Parameters ........................... 43
Contrast Optimised Images ......................... 47
Flow Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 49
Cardiac Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 55
23Na Imaging ................................... 58
Fast Imaging ................................... 60
viii Contents
4. NMR Spectroscopy: Application to Metabolic Research
A.N. Stevens ................................... 61
Introduction ................................... 61
Fundamentals of NMR Spectroscopy ................... 61
Clinically Useful NMR Nuclei ... . . . . . . . . . . . . . . . . . . . .. 65
In Vivo Studies ................................. 70
Conclusion .................. .. :............... 81
5. Functional Magnetic Resonance Imaging of the Heart
and Large Vessels
R.E. Coupland and P. Mansfield ...................... 85
Introduction ................................... 85
Method ...................................... 85
Imaging Details and Procedure ....................... 86
Results and Conclusions ........................... 86
6. Functional Studies of the Cardiovascular System Using Magnetic
Resonance Imaging
S. Richard Underwood ............................ 91
Introduction ................................... 91
Imaging Techniques .............................. 91
Clinical Applications .............................. 93
Relaxation Parameters ............................ 97
Magnetic Resonance Angiography . . . . . . . . . . . . . . . . . . . .. 99
F10w Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 101
The Future .................................... 103
7. Paramagnetic Pharmaceuticals for Functional Studies
L.D. Hall and P. G. Hogan . . . . . . . . . . . . . . . . . . . . . . . . .. 107
Introduction ................................... 107
Paramagnetic Metal Species ......................... 109
Ferromagnetic Metal Species ........................ 117
Stable Free Radicals .............................. 118
Oxygen and Oxygen Carriers ........................ 120
Magnetic Susceptibility Agents ..... ...... '............ 122
Density Substitution Agents ........ ... -. . . . . . . . . . . . . . 122
8. Clinical Use of Intravenous Gadolinium-DTPA in
Magnetic Resonance Imaging of the Central Nervous System
G.M. Bydder, H.P. Niendorfandl.R. Young . ............. 129
Introduction ................................... 129
Contents ix
Paramagnetic Contrast Agents ....................... 129
Effects of Paramagnetic Contrast Agents on NMR
Parameters .................................. 130
Results of Paramagnetic Contrast Agents in Clinical
Studies ..................................... 132
Toxicity ...................................... 144
Conclusion .................................... 144
9. Tissue Characterisation by NMR
Margaret A. Foster ............................... 147
Introduction ................................... 147
The NMR Parameters ............................. 148
Possibilities for Tissue Characterisation . . . . . . . . . . . . . . . . . . 157
10. The Influence of NMR Parameters on Imaging
P. Pfannenstiel, G. Bielke, S. Meindl, W. von Seelen and
H. P. Higer .................................... 167
Introduction ................................... 167
Qualitative Evaluation with Appropriate Pulse Sequences 167
Quantitative Evaluation and Image Synthesis .............. 176
Tissue Characterisation ............................ 178
Future Considerations ............................. 181
11. A Correlative Approach to Nuclear Medicine
and NMR Imaging
M. P. Sandler, M. V. Kulkarni, J.A. Patton, C. Leon Partain
and A. Everette James Jr. ........................... 183
Introduction ................................... 183
Central Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Neck ........................................ 185
Thorax ....................................... 190
Abdomen ..................................... 193
Skeleton ...................................... 197
Conclusion .................................... 198
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Contributors
R. Bachus, PhD
Research Scientist, Siemens AG., Medical Division, Henkestr. 127,
D-8520 Erlangen, West Germany
G. Bielke, PhD
NMR Department, Deutsche Klinik fur Diagnostik, Aukammallee 33,
D-6200 Wiesbaden, West Germany
G. Braeckle, PhD
Research Scientist, Siemens AG., Medical Division, Henkestr. 127,
D-8520 Erlangen, West Germany
G.M. Bydder, MRCP
Senior Lecturer, Royal Postgraduate Medical School, University of
London, Hammersmith Hospital, Ducane Road, London, UK
R.E. Coupland, MD, PhD, DSc
Professor of Human Morphology, Department of Human Morphology,
University of Nottingham Medical School, Clifton Boulevard,
Nottingham, UK
MargaretA. Foster, BSc, MSc, PhD
Senior Lecturer, Department of Bio-Medical Physics and
Bio-Engineering, University of Aberdeen, Foresterhill, Aberdeen, UK
L.D. Hall, BSc, PhD, FRSC, FRS(Can)
Herchel Smith Professor of Medicinal Chemistry, Laboratory for
Medicinal Chemistry, University of Cambridge School of Clinical
Medicine, Level 4, Radiotherapeutic Centre, Addenbrooke's Hospital,
Hills Road, Cambridge, UK
H.P. Higer, MD
NMR Department, Deutsche Klinik fur Diagnostik, Aukammallee 33,
D-6200 Wiesbaden, West Germany
xii Contributors
P.G. Hogan, BSc
Laboratory for Medicinal Chemistry, University of Cambridge School of
Clinical Medicine, Level 4, Radiotherapeutic Centre, Addenbrooke's
Hospital, Hills Road, Cambridge, UK
A. Everette James Jr., MD
Professor of Radiology and Medical Administration, Chairman,
Department of Radiology and Radiological Sciences, Vanderbilt
University Medical Center, Nashville, Tennessee, 37232, USA
H. Koenig, PhD
Research Scientist, Siemens AG., Medical Division, Henkestr. 127,
D-8520 Erlangen, West Germany
M.V. Kulkarni, MD
Associate Professor of Radiology, Director, Magnetic Resonance
Imaging, University of Texas, Health Sciences Center at Houston, 6431
Fannin 2.124 M.S.B. Houston, Texas, 77030, USA
M.O. Leach, PhD
Lecturer in Medical Physics (NMR), Department of Physics, Royal
Marsden Hospital, Downs Road, Sutton, Surrey, UK
P. Mansfield, BSc, PhD,
Professor of Physics, Department of Physics, University of Nottingham,
University Park, Nottingham, UK
V. Ralph McCready, MRCP, FRCP
Consultant in Charge, Department of Nuclear Medicine, Royal Marsden
Hospital, Downs Road, Sutton, Surrey, UK
S. Meindl, Dipl. Phys.
NMR Department, Deutsche Klinik fur Diagnostik, Aukammallee 33,
D-6200 Wiesbaden, West Germany
E. Mueller, PhD
Research Scientist, Siemens AG., Medical Division, Henkestr. 127,
D-8520 Erlangen, West Germany
H.P. Niendorf, MD
Schering, Postfach 65 0311, D-lOOO Berlin 65, West Germany
C. Leon Partain, MD, PhD
Professor, Radiology and Biomedical Engineering, Director, Nuclear
Medicine and Magnetic Resonance Imaging, Vanderbilt University
Medical Center, Nashville, Tennessee, 37232, USA
J.A. Patton, PhD
Associate Professor of Radiology, Associate Director, Nuclear Medicine
and Magnetic Resonance Imaging, Vanderbilt University Medical
Center, Nashville, Tennessee, 37232, USA