Claustrophobia in MRI: the role of cognitions

Purpose

This study aimed to investigate the role of cognitive and behavioural factors in the experience of claustrophobia in the context of magnetic resonance imaging (MRI) scanners.

Materials and Methods

One hundred and thirty outpatients attending an MRI unit completed questionnaires before and after their scans. Specific measures of experience in the scanner included subjective anxiety, panic symptoms, strategies used to stay calm and negative cognitions (such as ‘I will suffocate’ and ‘I am going to faint in here’). Other general measures used included anxiety, depression, health anxiety and fears of restriction and suffocation.

Results

The amount of anxiety experienced during the scan was related to the perceived amount of time spent having physical symptoms of panic. Cognitions reported concerned the following: suffocation, harm caused by the machine and lack of perceived control. The number of strategies patients used to cope in the machine was also a related factor. Neither position in the scanner, nor head coil use nor previous experience of being in the scanner was related to levels of anxiety.

Conclusion

The cognitions identified here may be used to construct a measure to identify those unable to enter the scanner or those most likely to become claustrophobic whilst undergoing the procedure and to further inform future brief, effective interventions.     

A study of the effects of patient anxiety,perceptions and equipment on motion artifacts in magnetic resonance imaging

We investigated to see if motion artifacts (MA) occurring in magnetic resonance imaging (MRI) are related to prescan anxiety measures and test the feasibility of identifying patients at risk for the development of MA before scanning. Furthermore, to determine a possible influence of constructional differences between a 1.5 and a 0.5 tesla scanner on the frequency of MA. Two hundred and ninety-seven first time MRI patients were surveyed before and after imaging with anxiety and attitude questionnaires. Frequency and impact on diagnostic quality of MA were documented. 12.8% of all scans showed MA not related to normal body pulsations. In 6.4% the diagnostic quality was impaired. Constructional differences did not influence the frequency of MA. Also, anxiety as determined with the most common anxiety measuring instrument was not related to the development of MA. Concern about the technical apparatus identified 70.6% of all individuals developing MA. Patients at risk for the development of MA can be identified prior to scanning. It seems necessary to further develop reliable methods to detect them and to evaluate strategies to prevent MA.     

Active control of the volume acquisition noise in functional magnetic resonance imaging: method and psychoacoustical evaluation.

Functional magnetic resonance imaging (fMRI) provides a noninvasive tool for observing correlates of neural activity in the brain while a subject listens to sound. However, intense acoustic noise is generated in the process of capturing MR images. This noise stimulates the auditory nervous system, limiting the dynamic range available for displaying stimulus-driven activity. The noise is potentially damaging to hearing and is distracting for the subject. In an active noise control (ANC) system, a reference sample of a noise is processed to form a sound which adds destructively with the noise at the listener's ear. We describe an implementation of ANC in the electromagnetically hostile and physically compact MRI scanning environment. First, a prototype system was evaluated psychoacoustically in the laboratory, using the electrical drive to a noise-generating loudspeaker as the reference. This system produced 10-20 dB of subjective noise-reduction between 250 Hz and 1 kHz, and smaller amounts at higher frequencies. The system was modified to operate in a real MR scanner where the reference was obtained by recording the acoustic scanner noise. Objective reduction by 30-40 dB of the most intense component in scanner noises was realized between 500 Hz and 3500 Hz, and subjective reduction of 12 dB and 5 dB in tests at frequencies of 600 Hz and at 1.9 kHz, respectively. Although the benefit of ANC is limited by transmission paths to the cochlea other than air-conduction routes from the auditory meatus, ANC achieves worthwhile attenuation even in the frequency range of maximum bone conduction (1.5-2 kHz). ANC should, therefore, be generally useful during auditory fMRI.     

Economic impact of replacing CT with MR imaging for refractory epilepsy

Purpose: To evaluate the economic costs of using computed tomography (CT) vs. magnetic resonance (MR) imaging in the preoperative evaluation of refractory epilepsy patients. Methods: Preoperative CT and MR imaging findings from 117 patients who underwent surgery for medically refractory epilepsy during a 3.5-year period were reviewed. Cost savings were based on the paradigm that intracranial electroencephalogram monitoring (costing about $50,000) would have been necessary for preoperative localization of the epileptogenic zone in those patients without positive imaging findings. Savings attributed to replacing CT with MR were based on patients with positive MR and normal CT. A similar paradigm was used to calculate savings for replacing MR with CT. National savings were based solely on patients with neoplasms or vascular lesions because paradigms for other lesions vary considerable depending on institutional philosophy. Results: Replacing CT with MR imaging would have eliminated preoperative intracranial electrode procedures in 29 of 117 patients, with potential savings of $1,450,000 at our institution. In the 37 patients with neoplastic or vascular substrates, MR would have eliminated 10 invasive electrode procedures with estimated savings of $0.5 million institutionally and $3 to $4 million per year nationally. There were no cases to support replacing MR with CT. Conclusion: Replacing CT with MR decreases health costs associated with preoperative evaluation of intractable epilepsy requiring surgical amelioration.     

激光扫描实时共聚焦显微成像系统设计

共聚焦扫描显微镜已成为生物医学和材料科学领域研究中非常有价值的一种工具.本文给出了一种反射型激光扫描共聚焦显微成像系统的系统结构和具体设计.采用多面体转镜进行水平扫描,摆镜进行垂直扫描.利用商品透镜设计了光学扫描中继系统,采用光电倍增管作为激发出的荧光探测器,同时给出了数据采集和扫描同步控制系统的组成与设计.利用CODE V优化光学扫描系统以获得尽可能小的扫描光斑尺寸和较大的视场,并综合考虑了采样频率、扫描速度和探测器对整个系统性能的影响,从而给出了该型共聚焦显微成像系统的相互匹配的设计参量.分析结果表明:共聚焦扫描系统设计合理可行|从光学扫描系统到PMT探测单元的各项技术指标得到优化,满足实时探测的要求|该系统具有适应性强,易升级,低成本的技术特点,同时可达到同类商品的技术性能.     

Ultra-fast imaging

The relatively long scan times with currently available technology restrict the range of MRI applications, increase the cost of scanning by limiting throughput, and lead to image artifacts from patient motion during scans. Ultrafast imaging, in several guises, is now poised for introduction into clinical practice. With the Instascan method, a descendant of the echo-planar technique, complete MR images may be obtained hundreds to thousands of times faster than in conventional approaches and now yield spatial resolution and contrast directly comparable to standard MRI. "Single-shot" imaging methods, such as Instascan, are utilized in the study of dynamic processes, in the direct evaluation of motion (as in diffusion sensitive imaging), and in dramatic new applications, including the interactive control of intraparenchymal laser surgery. Improvements to the small flip-angle method, FLASH, have also pushed scan times into the subsecond domain; this method may be implemented on presently available imaging equipment but yields contrast behavior different from the traditional spin-echo techniques and displays signal-to-noise ratios significantly lower than single-shot imaging. Ultimately, incorporating ultra-fast MR imaging techniques into the armamentarium of the radiologist will likely require changes to many aspects of the MRI practice, from expanded involvement with the scan process to management of the increased data load, and may lead to dramatic changes in the scope of the MRI practice.     

激光扫描实时共聚焦显微成像系统设计

共聚焦扫描显微镜已成为生物医学和材料科学领域研究中非常有价值的一种工具.本文给出了一种反射型激光扫描共聚焦显微成像系统的系统结构和具体设计.采用多面体转镜进行水平扫描,摆镜进行垂直扫描.利用商品透镜设计了光学扫描中继系统,采用光电倍增管作为激发出的荧光探测器,同时给出了数据采集和扫描同步控制系统的组成与设计.利用COD...     

基于IEC标准的日本滨松SHR22000全身用PET扫描仪性能测试

SHR22000是日本滨松光子学株式会社开发的人体全身用正电子发射断层扫描仪. 扫描仪具有32层探测器环, 二维采集可形成63个切片, 病人孔径为60cm, 单个体位数据采集时间为3—5min.扫描仪的轴向视野为22.5cm, 经5个体位可以完成全身扫描, 视野中轴10mm处平均横向分辨率可达到3.2mm. 本文依照国际标准IEC 61675-1(亦即GB/T18988.1-2003)规定的各项指标对该扫描仪的空间分辨率、灵敏度、散射和计数率特性以及复原系数进行了测试, 并给出结果数据.     

Preoperative fast MRI of brain tumors using three-dimensional segmented echo planar imaging compared to three-dimensional gradient echo technique

The purpose of this study was to compare the diagnostic efficacy of a newly developed T(1)-weighted three-dimensional segmented echo planar imaging (3D EPI) sequence versus a conventional T(1)-weighted three dimensional spoiled gradient echo (3D GRE) sequence in the evaluation of brain tumors. Forty-four patients with cerebral tumors and infections were examined on a 1.0 T MR unit with 23 mT/m gradient strength. The total scan time for the T(1) 3D EPI sequence was 2 min 12 s, and for a conventional 3D GRE sequence it was 4 min 59 s. Both sequences were performed after administration of a contrast agent. The images were analyzed by three radiologists. Image assessment criteria included lesion conspicuity, contrast between different types of normal tissue, and image artifacts. In addition, signal-to-noise and contrast-to-noise-ratio (C/N) were calculated. The gray-white differentiation and C/N ratio of 3D EPI were found to be inferior to conventional 3D GRE images, but the difference was not statistically significant. In the qualitative comparison, lesion detection and conspicuity of 3D EPI images and conventional 3D GRE images were similar, but a tow-fold reduction of the scanning time was obtained. With the 3D EPI technique, a 50% scan time reduction could be achieved with acceptable image quality compared to conventional 3D GRE. Thus, the 3D EPI technique could replace conventional 3D GRE in the preoperative imaging of brain.     

Characterization of the gafchromic EBT3 films for dose distribution measurements in stereotactic radiotherapy

Radiochromic film dosimetry is a promising technique, but at this time there are some artefacts, including non-uniformity, energy dependence and scanner artefacts. Accurate dosimetry with radiochromic films requires characterizing the film as well as the scanning and analysis procedures. In this work, the performance of the EBT3 films in combination with the EPSON Dual Lens Perfection V700 scanner for dose distribution measurements in stereotactic radiotherapy has been evaluated. It has been shown that it was necessary to perform 20 blank scans to obtain the stability of the scanner. In order to reduce the uncertainties due to the non-uniformity of the scan field, it was then decided to use the 12 × 12 cm² central part of the scanner bed. Regarding EBT3 films, intra-sheet and inter-sheet uniformity of unexposed EBT3 films in terms of pixel value has been found to be respectively 0.27% (1 SD) and 0.15% (1 SD). No significant energy dependence has been observed above 30 keV and no angular dependence has been found.     

The effect of magnetic resonance imaging on human cognition

Potential effects of MRI exposure on aspects of human cognition were investigated out of concern that possible safety hazards associated with the procedure may exist. One hundred and fifty-seven volunteer subjects were randomly assigned to either an imaged, sham-imaged or nonimaged control condition. The following psychological tests were administered in a double blind procedure at pretreatment, post-treatment and follow-up time periods: the Wechsler Adult Intelligence Scale-Revised (Digit Span, Block Design and Digit Symbol), the Wechsler Memory Scale Paired Associate Learning test, the Benton Revised Visual Retention test, the Vandenberg Mental Rotation test, the Sternberg memory scanning paradigm and the State Anxiety Inventory. The overall analysis of results indicated that MRI at 0.15 T has no significant effect upon the cognitive functions assessed.     

Study on fast linear scanning for a new laser scanner

In the field of lidar system design, there is a need for laser scanners that offer fast linear scanning, are small size and have small a rotational inertia moment. Currently, laser scanners do not meet the above needs. A new laser scanner based on two amplified piezoelectric actuators is designed in this paper. The laser scanner has small size, high mechanical resonance frequencies and a small rotational inertia moment. The size of the mirror is 20 mm×15 mm. To achieve fast linear scanning performance, an open-loop controller is designed to compensate the hysteresis behavior and to restrain oscillations that are caused by the mechanical resonances of the scanner's mechanical structure. By comparing measured scanning waveforms, nonlinearities and scan line images between the uncontrolled and controlled scanner, it was found that the scanning linearity of linear scanning was improved The open-loop controlled laser scanner realizes linear scanning at 250 Hz with optical scan angle of ±12 mrad.     

Effects of radiation therapy on the human normal brain (white matter) visualized by MR imaging

Sequential MR imaging could provide information related to the pathological changes due to the application of external cytotoxic agents such as radiotherapy on the central nervous system. This paper describes the results of our attempt to demonstrate short-term changes associated with normal brain during and immediately following radiotherapy when the whole brain is irradiated for malignant conditions. No observable changes were found in the normal brain parenchyma in any of the patients (n = 8) in T₁-, T₂-, and proton-density-weighted images in the sequential scans in the first and second weeks and immediately following radiotherapy. Also, no changes were observed in the normal brain appearance at 2 mo (n = 6), up to 6 mo (n = 1), and up to 15 mo (n = 1) after completion of radiotherapy.     

基于快速扫描光学延迟线谐振扫描的相位调制方法

提出利用快速扫描光学延迟线(Rapid Scanning Optical Delay Line,RSOD)作为光学相干层析成像(Optical Coherence Tomography,OCT)系统的相位调制器,并采用正弦驱动方式(谐振扫描)来提高扫描频率,进而实现高频相位调制的方法.介绍了基于RSOD相位调制器的干涉信号包络解调方法,分析了大振镜低频率线性驱动、小振镜高频线性驱动和大振镜高速正弦驱动三种实施方案对OCT性能的影响,并针对谐振扫描方案中轴向扫描的非线性提出了图像畸变定量校正的方法.结果表明:RSOD大振镜谐振扫描的模式能够兼顾系统成像速度、成像范围以及系统信噪比的要求,是一种行之有效的相位调制方法.     

Simulating the effects of time-varying magnetic fields with a realistic simulated scanner

Transient magnetic fields induce changes in magnetic resonance (MR) images ranging from small, visually undetectable effects (caused, for instance, by neuronal currents) to more significant ones, such as those created by the gradient fields and eddy currents. Accurately simulating these effects may assist in correcting or optimising MR imaging for many applications (e.g., diffusion imaging, current density imaging, use of magnetic contrast agents, neuronal current imaging, etc.). Here we have extended an existing MR simulator (POSSUM) with a model for changing magnetic fields at a very high-resolution time-scale. This simulator captures a realistic range of scanner and physiological artifacts by modeling the scanner environment, pulse sequence details and subject properties (e.g., brain geometry and air-tissue boundaries).     

Video camera and light system for application in magnetic resonance scanners

The direct observation and simultaneous recording of subject behavior, e.g. facial movements, during MR imaging is necessary for a variety of functional imaging studies involving phenomena such as emotions, humor, mood, etc. Such observation is also valuable for the monitoring of very ill or young patients. We describe a color video camera and light system which works within the functioning scanner. The camera acquires high resolution video sequences during conventional T(1)-weighted and functional T(2)*-weighted imaging. When fixed to the head coil artefacts during the MRI-acquisition were insignificant. The video allows observation of the face detailed enough to permit FACS scoring of facial expressions. We therefore propose that it can be applied for a wide variety of studies needing visual feedback of subject behavior.     

A digital transducer and digital microphone using an optical technique

A transducer is devised to measure pressure, displacements or angles by optical means. This transducer delivers a digital output without relying on interferometry techniques or analogue-to-digital converters. This device is based on an optical scanner and an optical detector. An inter-digital photoconductive detector (IDPC) is employed that delivers a series of pulses, whose number depends on the scan length. A pre-objective scanning configuration is used that allows for the possibility of a flat image plane. The optical scanner provides scanning of IDPC and the generated scan length is proportional to the measurand.     

MR assessment of spinal metastases using the late 26 sequence

Ninety-two patients with suspected spinal involvement by systemic cancer underwent MR examinations using both conventional and phase-contrast (LATE 26) spin-echo pulse sequences. MR imaging was considered positive for metastatic disease in 73 cases. Implants were extradural in 69 patients and intradural in 4 patients. Nineteen cases had no MRI evidence of metastases and the abnormalities suspected were shown to be due to either inflammatory or degenerative changes. MR appearances during and after chemo- and/or radiotherapy were studied in 5 patients. The impact of the LATE 26 sequence in the assessment of metastatic spinal disease is evaluated.     

An empirical investigation of motion effects in eMRI of interictal epileptiform spikes

We recently developed a functional neuroimaging technique called encephalographic magnetic resonance imaging (eMRI). Our method acquires rapid single-shot gradient-echo echo-planar MRI (repetition time=47 ms); it attempts to measure an MR signal more directly linked to neuronal electromagnetic activity than existing methods. To increase the likelihood of detecting such an MR signal, we recorded concurrent MRI and scalp electroencephalography (EEG) during fast (20-200 ms), localized, high-amplitude (>50 μV on EEG) cortical discharges in a cohort of focal epilepsy patients. Seen on EEG as interictal spikes, these discharges occur in between seizures and induced easily detectable MR magnitude and phase changes concurrent with the spikes with a lag of milliseconds to tens of milliseconds. Due to the time scale of the responses, localized changes in blood flow or hemoglobin oxygenation are unlikely to cause the MR signal changes that we observed. While the precise underlying mechanisms are unclear, in this study, we empirically investigate one potentially important confounding variable — motion. Head motion in the scanner affects both EEG and MR recording. It can produce brief “spike-like” artifacts on EEG and induce large MR signal changes similar to our interictal spike-related signal changes. In order to explore the possibility that interictal spikes were associated with head motions (although such an association had never been reported), we had previously tracked head position in epilepsy patients during interictal spikes and explicitly demonstrated a lack of associated head motion. However, that study was performed outside the MR scanner, and the root-mean-square error in the head position measurement was 0.7 mm. The large inaccuracy in this measurement therefore did not definitively rule out motion as a possible signal generator. In this study, we instructed healthy subjects to make deliberate brief (<500 ms) head motions inside the MR scanner and imaged these head motions with concurrent EEG and MRI. We compared these artifactual MR and EEG data to genuine interictal spikes. While per-voxel MR and per-electrode EEG time courses for the motion case can mimic the corresponding time courses associated with a genuine interictal spike, head motion can be unambiguously differentiated from interictal spikes via scalp EEG potential maps. Motion induces widespread changes in scalp potential, whereas interictal spikes are localized and have a regional fall-off in amplitude. These findings make bulk head motion an unlikely generator of the large spike-related MR signal changes that we had observed. Further work is required to precisely identify the underlying mechanisms.     

Calibration procedure for a laser triangulation scanner with uncertainty evaluation

Most of low cost 3D scanning devices that are nowadays available on the market are sold without a user calibration procedure to correct measurement errors related to changes in environmental conditions. In addition, there is no specific international standard defining a procedure to check the performance of a 3D scanner along time. This paper aims at detailing a thorough methodology to calibrate a 3D scanner and assess its measurement uncertainty. The proposed procedure is based on the use of a reference ball plate and applied to a triangulation laser scanner. Experimental results show that the metrological performance of the instrument can be greatly improved by the application of the calibration procedure that corrects systematic errors and reduces the device's measurement uncertainty.