An analysis of three-dimensional movement of the mitral valve annulus (MVA) may address the question of geometrical change after mitral valve repair to preserve mitral annular function. Conventionally, annular contraction has been studied for this purpose. We investigated this geometrical change occurring in the anterior half of the MVA and discuss its clinical significance. Three-dimensional images of the MVA during systole were reconstructed from magnetic resonance images of eight normal subjects. The posterior half of the MVA exhibited translational motion. We assume that this portion, exhibiting translational motion as well as contraction, purely follows the motion of the left ventricular contraction. Compensating for the discrepancy between the motion of the aortic root and that of the posterior half of the MVA, the anterior half exhibited a flexible change in shape during systole, thus maintaining a sufficient left ventricular outflow tract (LVOT). The increase in the extent of displacement of the anterior MVA from the posterior half of the MVA during systole, which was 3.6 +/- 1.0 mm (mean +/- SD), indicates the annular flexibility. The preservation of annular flexibility may prevent LVOT obstruction. Further geometrical analysis of patients after mitral repair will clarify annular function as presented in this article.

Gadofluorine 8 is an innovative contrast agent that can distinguish between normal and tumorous lymph nodes in interstitial MR lymphography.

This study revealed the excellent suitability of the dendritic contrast agent Gadomer-17 for MR imaging of the lymphatic system (lymph nodes and lymph vessels).

Insertion of a rigid mitral prosthesis impairs the function of the mitral annulus and induces systolic narrowing of the left ventricular outflow tract (LVOT). To study this mechanism, we investigated dynamic changes in the left ventricular (LV) base, which consists of the mitral annulus and LVOT orifice. In seven patients with mechanical mitral valve prostheses and eight normal subjects, the image of the LV base was reconstructed three-dimensionally and its dynamic change during systole was studied. In the patients, the rigid prosthetic valve (=mitral annulus) tilted toward the left ventricle with a hinge point at the posterior mitral annulus during systole. The left ventricular base exhibited contraction, but the size of the prosthetic valve was constant. As a consequence, the prosthetic valve occupied more of the left ventricular base, which resulted in narrowing of the LVOT. In the normal subjects, the mitral annulus did not interfere with the region of the LVOT orifice during systole as the mitral annulus underwent both dorsiflexion and contraction. Thus, fixation of the mitral annulus induces an anti-physiologic motion of the annulus. Conscious preservation of annular flexibility in mitral valve surgery is important in avoiding potential dynamic LVOT obstruction.

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Carcinoma of the cervix is the fourth most common cancer in women. Accurate staging of the disease is essential in selecting optimal therapy. The clinical staging based on the criteria of the FIGO is inaccurate. With MRI an excellent imaging of the tumour spread within the cervix can be achieved, also tumour extension to the parametria and infiltration of the neighbouring structures as bladder and rectum. MRI is the method of choice in the preoperative staging of cervical cancer. Computed tomography and sonography have lower staging value compared to the MRI. An advantage of CT, compared with MRI, is the high accuracy in investigations of patients with ureteral obstruction and hydronephrosis. Both methods MRI and CT are comparable in assessing pelvic and paraaortic lymph node metastases.

No abstract

This paper presents the results of an experimental investigation with two different rotatory piezomotors in a closed 1.5 Tesla high-field MRI. The focus of the investigation was on testing the functionality of these motors within the MRI and to determining the image interference they caused. Materials and Methods: To obtain a differentiated estimate of the interference the motors were tested in both the passive (turned off, i.e. without current flow) and active (turned on, i.e. with , current flow) state during MRI scanning. Three different types of sequences were used for the test: Spin-Echo (SE), Gradient-Echo (GE) and Echo-Planar Imaging (EPI). A plastic container filled with a gadolinium-manganese solution was used for representation of the artefacts. The motors investigated were placed parallel to the container at predetermined distances during the expenment. Results and Conclusions' The results show that the motors investigated suffered no functional limitations in the magnetic field of the MRI but, depending on the type of motor, the measurement distance and the state of the motor, the motors had different effects on the sequence images. A motor in the off-state placed immediately next to the object to be measured mainly causes artefacts because of its material properties. If, on the other hand, the piezomotor is in the on-state images with strong noise result when the motor is immediately next to the object being measured. The images regain their normal quality when the motor is approximately, at a distance of l m from the object being investigated. Driving the motor inside the MRI, therefore, is only to be recommended during the pauses in scanning: this delivers artefact-free images if minimal, motor-specific distances are kept to. With regard to the three different types of sequences it was determined that the SE sequence was the least sensitive and the EPI sequence the most sensitive to • disturbance. The GE sequence showed only minimal differences to the SE sequence with regard to signal-to-noise ratios. Since it requires considerably shorter scan-times it can be considered to be the most effective type of sequence under these conditions.