The kidneys are the most important organs to maintain homeostasis. In the assessment of renal functional disorders laboratory tests offer only indirect hints on location of the disease; radionuclide nephrography is hampered by low spatial resolution and radiologic methods provide only limited quantitative information. The MRI technique with fast pulse sequences and renally eliminated contrast agent has the capability of combining both anatomic and functional information. This article gives an overview on functional MRI of the kidneys with its possibilities and limitations. The clinical application of functional MRI allows a better understanding of some pathologic conditions such as urinary tract obstruction, renal insufficiency, effects of extracorporeal shock wave lithotripsy, different states of hydration, effects of drugs, vascular disorders, and effects of transplantation.
Serial assessment of serum protein S100B may improve detection of asymptomatic acute brain injury in patients undergoing radiofrequency catheter ablation of AF. In our study, the incidence of these events was 1.7% when evaluated only by DW-MRI, but the incidence increased to 5% after employing the more sensitive biomarker-based approach.
The aim of this study was to evaluate the feasibility of MR gastrography, based on 3D MRI following the oral administration of Gd-DOTA-enriched blueberry juice, in order to depict alterations of the gastric wall. The stomachs of three volunteers and three patients were examined on a 1.5-T MR system. Following ingestion of 400 ml of blueberry juice spiked with 2 ml of Gd-DOTA, each subject underwent 3D MR imaging in three positions: 45 degrees left lateral decubitus, supine, and 45 degrees right lateral decubitus. In each position, a coronal 3D SPGR acquisition consisting of 60 continuous 2-mm slices was acquired over a 35-s breathhold (TR/TE = 4.0/1.8 ms, 40 degrees flip angle, 0.5 excitations, voxel size of 1.25 x 1.66 x 2.00 mm). Multiplanar reformats (MPR), maximum intensity projections (MIP), surface shaded displays (SSD), and virtual intraluminal endoscopic views (VIE) were calculated. Magnetic resonance gastroscopy was tolerated well by all subjects without adverse effects. Based on the 3D MRI data sets acquired in various patient positions, all regions of the stomach and the proximal duodenum were visualized to good advantage. Whereas MPR and MIP provided a morphologic overview, SSD and VIE images permitted analysis of the gastric mucosa. Normal mucosa could be differentiated from the course and irregular pattern characterizing carcinomatous infiltration. The 3D SPGR data sets acquired following ingestion of oral Gd-DOTA-spiked blueberry juice permits exoscopic and virtual endoscopic viewing of the stomach.
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