다중혈관 관상동맥 환자에서 y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적

https://www.cell.com/cell-metabolism/pdf/S1550-4131(11)00420-7.pdf

Brain energy metabolism: focus on astrocyte-neuron metabolic cooperation

Proton NMR chemical shift and J-coupling values are presented for 35 metabolites that can be detected by in vivo or in vitro NMR studies of mammalian brain. Measurements were obtained using high-field NMR spectra of metabolites in solution, under conditions typical for normal physiological temperature and pH. This information is presented with an accuracy that is suitable for computer simulation of metabolite spectra to be used as basis functions of a parametric spectral analysis procedure. This procedure is verified by the analysis of a rat brain extract spectrum, using the measured spectral parameters. In addition, the metabolite structures and example spectra are presented, and clinical applications and MR spectroscopic measurements of these metabolites are reviewed.

http://pfeifer.phas.ubc.ca/refbase/files/Govindaraju-NMRBiomed-2000-13-129.pdf

Proton NMR chemical shifts and coupling constants for brain metabolites.

Functional brain imaging with positron emission tomography and magnetic resonance imaging has been used extensively to map regional changes in brain activity. The signal used by both techniques is based on changes in local circulation and metabolism (brain work). Our understanding of the cell biology of these changes has progressed greatly in the past decade. New insights have emerged on the role of astrocytes in signal transduction as has an appreciation of the unique contribution of aerobic glycolysis to brain energy metabolism. Likewise our understanding of the neurophysiologic processes responsible for imaging signals has progressed from an assumption that spiking activity (output) of neurons is most relevant to one focused on their input. Finally, neuroimaging, with its unique metabolic perspective, has alerted us to the ongoing and costly intrinsic activity within brain systems that most likely represents the largest fraction of the brain's functional activity.

Brain Work and Brain Imaging

Continuing improvements in analytical technology along with an increased interest in performing comprehensive, quantitative metabolic profiling, is leading to increased interest pressures within the metabolomics community to develop centralized metabolite reference resources for certain clinically important biofluids, such as cerebrospinal fluid, urine and blood. As part of an ongoing effort to systematically characterize the human metabolome through the Human Metabolome Project, we have undertaken the task of characterizing the human serum metabolome. In doing so, we have combined targeted and non-targeted NMR, GC-MS and LC-MS methods with computer-aided literature mining to identify and quantify a comprehensive, if not absolutely complete, set of metabolites commonly detected and quantified (with today's technology) in the human serum metabolome. Our use of multiple metabolomics platforms and technologies allowed us to substantially enhance the level of metabolome coverage while critically assessing the relative strengths and weaknesses of these platforms or technologies. Tables containing the complete set of 4229 confirmed and highly probable human serum compounds, their concentrations, related literature references and links to their known disease associations are freely available at http://www.serummetabolome.ca.

/pdf/the-human-serum-metabolome-52a86bwnf3.pdf

The Human Serum Metabolome

Multislice imaging with adiabatic pulses using transverse Hadamard encoding

Purpose
Multi-coil (MC) magnetic field modeling has emerged as a viable alternative to conventional field generation based on spherical harmonic shapes, and an active MC community is forming. Although all MC applications share the same modeling concept, the specific MC designs can largely differ as a result of disparities in region of interest (eg, human versus rodent), intended MR application (eg, B0 shimming versus spatial encoding), or other experimental constraints (eg, available bore space or integration with radiofrequency technology). To date, a lack of detailed information on existing MC designs complicates the assessment and precludes a meaningful comparison.

Methods
Here, we suggest that future publications involving the MC technique not only report the benefits for the application at hand, but also include an explicit description of the MC wire pattern used.

Results
This public multi-coil information (PUMCIN) policy represents a voluntary commitment to promoting free public access to the details necessary for reproducing and benefiting from MC research.

Conclusions
The PUMCIN policy is expected to initiate a paradigm shift with respect to the way MC innovation is reported. By setting an example, we hope to encourage the evolving MC community to maximize the benefits for science and society by embracing it. Magn Reson Med, 2016. © 2016 International Society for Magnetic Resonance in Medicine.

/pdf/the-public-multi-coil-information-pumcin-policy-2n2hjr85bd.pdf

The public multi-coil information (PUMCIN) policy.

PURPOSE The robust and reliable utilization of proton magnetic resonance spectroscopic imaging (MRSI) at high fields is hampered by several key technical difficulties, including contamination from extracranial lipids. To that end, this work presents novel lipid suppression sequences for proton MRSI in the human brain utilizing elliptical localization with pulsed second-order fields (ECLIPSE). METHODS Two lipid suppression methods were implemented with the ECLIPSE gradient insert. One method is a variable power, 4-pulse sequence optimized to achieve outer volume suppression (OVS) and compared against a standard, 8-slice OVS method. The second ECLIPSE method is implemented as an inversion recovery (IR) sequence with elliptical inner volume selection (IVS) and compared against a global IR method. RESULTS The ECLIPSE-OVS sequence provided a 116-fold mean lipid suppression (range, 104-134), whereas an optimized 8-slice OVS sequence achieved 15-fold suppression (range, 13-18). Furthermore, the superior ECLIPSE-OVS suppression was achieved at 30% of the radiofrequency (RF) power required by 8-slice OVS. The ECLIPSE-based IR sequence suppressed skull lipids by 155-fold (range, 122-257), compared to 16-fold suppression (range, 14-19) achieved with IR. CONCLUSION OVS and IVS executed with ECLIPSE provide robust and effective lipid suppression at reduced RF power with high immunity to variations in B1 and T1 .

Robust outer volume suppression utilizing elliptical pulsed second order fields (ECLIPSE) for human brain proton MRSI.

Purpose Spatial encoding and shimming in MRI have traditionally been performed using dedicated coils that generate orthogonal spherical harmonic fields. The recently introduced multi-coil hardware has proven that MRI-relevant magnetic fields can also be created by a generic set of localized coils producing non-orthogonal fields. As a step towards establishing a purely multi-coil-based MRI field generation system, the feasibility of performing conventional Cartesian k-space encoding and echo-planar imaging (EPI), as well as concurrent encoding and shimming is demonstrated in this study. Methods We report the use of Dynamic Multi-Coil Technique (DYNAMITE) for combined Cartesian encoding and shimming, and EPI using a 48-channel multi-coil system. Experiments were performed on phantom objects and biological specimens in a 9.4 T pre-clinical scanner. Cartesian Fourier-encoded MRI and EPI were implemented whereby the magnetic fields required for encoding of the three orthogonal spatial dimensions were entirely based on linear combinations of multi-coil fields. Furthermore, DYNAMITE imaging was augmented by concurrent DYNAMITE shimming with the same hardware. Results DYNAMITE-based MR and echo-planar images were indistinguishable from those acquired with the conventional linear imaging gradients provided by the scanner. In experiments with concurrent DYNAMITE shimming and imaging, shim challenges that would result in extreme spatial distortion and signal loss were corrected very effectively with more than 92% signal recovery in case of extreme Z2 shim challenge that resulted in complete signal dephasing in most slices. Conclusions We demonstrate the first successful implementation of combined DYNAMITE imaging and shimming and show the feasibility of performing EPI with DYNAMITE hardware. Our results substantiate the potential of multi-coil hardware as a full-fledged imaging and shimming system, with additional potential benefits of reduced echo-time and risk of peripheral nerve stimulation while performing EPI.

Combined imaging and shimming with the dynamic multi‐coil technique

Purpose

Tailored excitation (TEx) based on interspersing multiple radio frequency pulses with linear gradient and higher-order shim pulses can be used to obtain uniform flip angle in the presence of large radio frequency transmission (B ) inhomogeneity. Here, an implementation of dynamic, multislice tailored excitation using the recently developed multi-coil nonlinear shim hardware (MC-DTEx) is reported.



Methods

MC-DTEx was developed and tested both in a phantom and in vivo at 7 T, and its efficacy was quantitatively assessed. Predicted outcomes of MC-DTEx and DTEx based on spherical harmonic shims (SH-DTEx) were also compared.



Results

For a planned 30 flip angle, in a phantom, the standard deviation in excitation improved from 28% (regular excitation) to 12% with MC-DTEx. The SD in in vivo excitation improved from 22 to 12%. The improvements achieved with experimental MC-DTEx closely matched the theoretical predictions. Simulations further showed that MC-DTEx outperforms SH-DTEx for both scenarios.



Conclusion

Successful implementation of multislice MC-DTEx is presented and is shown to be capable of homogenizing excitation over more than twofold B variations. Its benefits over SH-DTEx are also demonstrated. A distinct advantage of MC hardware over SH shim hardware is the absence of significant eddy current effects, which allows for a straightforward, multislice implementation of MC-DTEx. Magn Reson Med, 2015. © 2015 Wiley Periodicals, Inc.

Robin A. de Graaf

Papers

Multislice imaging with adiabatic pulses using transverse Hadamard encoding

The public multi-coil information (PUMCIN) policy.

Robust outer volume suppression utilizing elliptical pulsed second order fields (ECLIPSE) for human brain proton MRSI.

Combined imaging and shimming with the dynamic multi‐coil technique

Dynamic multi‐coil tailored excitation for transmit B1 correction at 7 Tesla