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The Art of Radiology
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Clinical Applications of Magnectic Resonance
Spectroscopy
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NAA ( N-acetyl aspartate ) 2.02 ppm in neuron & axon
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Creatine 3.02ppm, 3.94ppm
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Myo-inositol ( ml ) 3.56-4.06 ppm
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Proton MR spectroscopy (1H MRS)
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Commonly detectable Brain Metabolites at low field strength ( 1.5T)
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1H MRS has the following steps:
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Parameters characterizing the metabolite resonance peak
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Approaches for interpretation of 1H MR spectra
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Typical 1H MR Spectroscopic neoplastic profile demonstrates:
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The most often used pulse sequences are:
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Spectroscopic localization methods
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Single-Voxel MRS Studies of Alzheimer’s Disease(Neurology 2001; 57: 626-632)
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Single-Voxel MRS Studies of Alzheimer’s Disease
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Single-Voxel MRS Studies of Alzheimer’s Disease
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Single-Voxel MRS Studies of Down Syndrome ( Am J Psychiatry 1999; 156: 1879-1886)
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Single-Voxel MRS Studies of Ts65Dn Mouse---Down Syndrome Model (NeuroReport 2000; 11: 445-448)
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Single-Voxel MRS Studies of Ts65Dn Mouse---Down Syndrome Model
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3D H MRSI is utilized for:
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MRS of Brain Abscess
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Abscess
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Abscess in vitro 1 H MRS
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Lipid 0.9 – 1.3 ppm
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MRS vs. DWI & ADC map
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MRS vs. DWI & ADC map
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MRS vs. DWI & ADC map
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Anaerobic vs. Aerobicin vivo 1H MRS
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MRS vs. DWI & ADC map
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Brain abscess
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1H MRS Study of Breast Cancer
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1H MRS Study of Breast Cancer
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1H MRS Study of Breast Cancer
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1H MRS Study of Breast Cancer
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1H MRS Study of Breast Cancer
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1H MRS Study of Brain Cancer
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Localization of Spectroscopic Voxel for a Patient with Metastatic Squamous Cell Carcinoma
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Proton Spectra of a Patient with Metastatic Squamous Cell Carcinoma
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Localization of Spectroscopic Voxel for a Patient with Squamous Cell Carcinoma
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Proton Spectra of a Patient with Squamous Cell Carcinoma
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Changes of Cho/Water Ratio for Head and Neck Tumor Patients
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Discriminating Neoplastic and Non-neoplastic Thyroid Lesions Using 1H MRS
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Proton spectra from neoplastic thyroid lesion and normal-appearing contralateral region
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Significant difference in Cho/Water ratio between neoplastic (3.36 2.55, n=22) and non-neoplastic (0.16 0.11,
n=7) thyroid lesions
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Results
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1H MRS Study of a child with NKH(Non Ketotic Hyperglycinemia)
(J Neuroimaging 2001; 11: 209-212)
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WM proton spectra at 10 and 13 months(TE/TR 270/2000)
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Correlation of plasma and brain glycine levels
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1H MRS Study of a child with ADEM(Acute Disseminated Encephalomyelitis)
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In vivo 1H MRS study of a rat model of autism(Physiol Behav 2002; 75: 403-410)
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PRESS (TE/TR 40/2000), 0.2 cc voxel size
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Significant decrease of NAA/Cr in autistic rats
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Significant increase of Cho/Cr in autistic rats
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Significant increase of mI/Cr in autistic rats
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1H MRS study of autistic human subjects(PRESS, TE/TR 40/2000)
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1H MRS study of autistic human subjects(PRESS, TE/TR 40/2000)
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1H MRS study of autistic human subjects(PRESS, TE/TR 40/2000)
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1H Spectra from Healthy Controls
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DIFFUSION MRI IMAGING
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-History-
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Diffusion Weighted Image
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-Diffusion contrast-
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-Principles -Velocities and methods of measurement
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-Principles -About the b factor
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-Principles -About ADC
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-Principles -Isotropic and Anisotropic diffusion
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Diffusion weighted image
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APPLICATIONS
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ROLE OF DIFFUSION IN DIFFERENTIATING BENIGN VERSUS
MALIGNANT FRACTURE
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ADC and rCBV Maps of a Patient with CNS Lymphoma
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Perfusion imaging
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Definitions
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Principles
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Some more Definitions
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Principles
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Cerebral blood perfusion by bolus tracking
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Applications of Perfusion MRI
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Perfusion Imaging: Findings in Infarction
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Findings with Perfusion Imaging for Infarction
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Alzheimer’s disease
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Findings with Perfusion imaging for Neurophysiology and pharmacology
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Findings with Perfusion imaging for Neuro-oncology
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Neuro-oncology
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Eg2 Diffused tumor:Abnormal capillary density
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Diffusion-Tensor Imaging: Executive Function in
Subcortical Ischemic Vascular Disease and Mild Cognitive
Impairment
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Diffusion-Tensor Imaging
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DTI Basics – Water Diffusion
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DTI Scalar Parameters
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DTI Scalar Maps
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DTI Basics – White Matter Integrity
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Why study frontal systems in SIVD & MCI?
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DTI TRACTOGRAPHYVisualization of Fibers at Risk for Neuronal Tract
Injury in Early MS by Streamtube Diffusion Tractography at 3 Tesla
at three patient
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Background – Neuronal Tract Degeneration in Early MS
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Goals/Question
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Strategy
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3T Pulse Parameters
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T2-weighted magnetic resonance (MR)
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Dynamic Contrast-enhanced MR Imaging
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Diffusion-weighted Imaging
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Diffusion-weighted Imaging
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MR Spectroscopy
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MR Spectroscopy
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MR SPECTROSCOPY
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IMAGING OF LYMPH NODE AND BONE METASTASIS
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