Showing papers by "Joseph H. Rapp published in 2001"

Structure of Plaque at Carotid Bifurcation High-Resolution MRI With Histological Correlation

Abstract: Background and Purpose— The composition of carotid atherosclerosis was visualized by using 3D MRI at high resolution with 200-μm3 voxels. Magnetic resonance signal characteristics were correlated with plaque components, including collagenous cap, necrotic core, and calcification, to define resolution and other requirements for future clinical carotid MRI. Methods— Twenty-one en bloc carotid endarterectomy specimens were imaged ex vivo by 3D gradient-echo MRI by using a 1.5-T clinical scanner with repetition time, echo time, and flip angle of 40 ms, 18 ms, and 20°, respectively. Plaques were placed in Gd-saline and imaged in a solenoid radiofrequency coil. For quantitative tissue-specific signal analysis, techniques were developed to match tissue sections analyzed by MRI and histology. Results— Three-dimensional imaging resolved complex morphological features not visualized by density- or T2-weighted 2D spin-echo imaging. The collagenous cap, necrotic core, and areas of focal calcification showed differing...

Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging.

Abstract: BACKGROUND AND PURPOSE: Intraprocedural transcranial Doppler sonography has identified multiple microembolic events during and immediately after carotid endarterectomy (CEA) or angioplasty, yet the rate of clinically evident stroke is small. To determine the significance of the transcranial Doppler sonography findings, we examined patients by use of diffusion-weighted imaging and fluid-attenuated inversion recovery MR imaging before and immediately after CEA for evidence of clinically silent ischemic events. METHODS: Twenty-five patients with atherosclerotic disease of the carotid arteries underwent diffusion-weighted imaging and fluid-attenuated inversion recovery MR imaging performed, on average, 3 days before and 12 hours after CEA. Diffusion-weighted images were acquired in three orthogonal directions at b = 900. Pre- and postoperative neurologic examinations were performed by the same physician. RESULTS: After endarterectomy, 4.0% of the patients (one of 25 patients) showed a single, cortical focus of restricted diffusion and new fluid-attenuated inversion recovery hyperintensity, measuring CONCLUSION: The use of diffusion-weighted imaging may serve to improve conspicuity of clinically silent infarcts after CEA. An important next step is to determine the risk factors that predispose to detectable parenchymal ischemic events.

Assessing Structure-Property Relations of Diseased Tissues Using Nanoindentation and FTIR

Abstract: Disease processes are often associated with changes in tissue composition. For example, in atherosclerosis lipid and calcification are often found in the artery wall, whereas in healthy arteries the tissue microstructure is dominated by highly organized collagen. Such variations in composition likely result in changes in the material properties of the tissue. However, this relationship has not been fully investigated in atherosclerotic vessels. Using a combination of nanoindentation and spectroscopic techniques, our goal was to assess how changes in tissue composition affect the tissue’s mechanical properties. Fourier Transform Infrared Spectroscopy (FTIR) was used to assess the biochemical composition of the tissue samples, such as the lipid and calcium content of fibrous tissues in diseased arteries. Nanoindentation was used to measure the local mechanical properties of the same tissue samples. This information was then correlated by position in the sample to assess the contributions of different constituents to the overall structure-property relations of these tissues.