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Slator PJ, Cromb D, Jackson LH, Ho A, Counsell SJ, Story L, Chappell LC, Rutherford M, Hajnal JV, Hutter J, Alexander DC. Non-invasive mapping of human placenta microenvironments throughout pregnancy with diffusion-relaxation MRI. Placenta 2023; 144:29-37. [PMID: 37952367 DOI: 10.1016/j.placenta.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/13/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION In-vivo measurements of placental structure and function have the potential to improve prediction, diagnosis, and treatment planning for a wide range of pregnancy complications, such as fetal growth restriction and pre-eclampsia, and hence inform clinical decision making, ultimately improving patient outcomes. MRI is emerging as a technique with increased sensitivity to placental structure and function compared to the current clinical standard, ultrasound. METHODS We demonstrate and evaluate a combined diffusion-relaxation MRI acquisition and analysis pipeline on a sizable cohort of 78 normal pregnancies with gestational ages ranging from 15 + 5 to 38 + 4 weeks. Our acquisition comprises a combined T2*-diffusion MRI acquisition sequence - which is simultaneously sensitive to oxygenation, microstructure and microcirculation. We analyse our scans with a data-driven unsupervised machine learning technique, InSpect, that parsimoniously identifies distinct components in the data. RESULTS We identify and map seven potential placental microenvironments and reveal detailed insights into multiple microstructural and microcirculatory features of the placenta, and assess their trends across gestation. DISCUSSION By demonstrating direct observation of micro-scale placental structure and function, and revealing clear trends across pregnancy, our work contributes towards the development of robust imaging biomarkers for pregnancy complications and the ultimate goal of a normative model of placental development.
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Affiliation(s)
- Paddy J Slator
- Cardiff University Brain Research Imaging Centre, School of Psychology, Maindy Road, Cardiff, CF24 4HQ, UK; School of Computer Science and Informatics, Cardiff University, Cardiff, UK; Centre for Medical Image Computing and Department of Computer Science, University College London, London, UK.
| | - Daniel Cromb
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Laurence H Jackson
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Alison Ho
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Lisa Story
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Lucy C Chappell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Mary Rutherford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Jana Hutter
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing and Department of Computer Science, University College London, London, UK
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Hutter J, Ho A, Jackson LH, Slator PJ, Chappell LC, Hajnal JV, Rutherford MA. An efficient and combined placental T 1 -ADC acquisition in pregnancies with and without pre-eclampsia. Magn Reson Med 2021; 86:2684-2691. [PMID: 34268807 DOI: 10.1002/mrm.28809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/15/2021] [Accepted: 03/26/2021] [Indexed: 11/07/2022]
Abstract
PURPOSE To provide a new approach to jointly assess microstructural and molecular properties of the human placenta in vivo fast and efficiently and to present initial evidence in cohorts of healthy pregnancies and those affected by pre-eclampsia. METHODS Slice and diffusion preparation shuffling, built on the previously proposed ZEBRA method, is presented as a robust and fast way to obtain T 1 and apparent diffusivity coefficient (ADC) values. Joint modeling and evaluation is performed on a cohort of healthy and pre-eclamptic participants at 3T. RESULTS The datasets show the ability to obtain robust and fast T 1 -ADC measurements. Significant decay over gestation in T 1 (-11 ms/week, P < . 05 ) and a trend toward significance in ADC (-0.23 mm/ s 2 /week, P = .08) values can be observed in a control cohort. Values for the pre-eclamptic pregnancies show a negative trend for both ADC and T 1 . CONCLUSIONS The presented sequence allows the simultaneous acquisition of 2 of the most promising quantitative parameters to study placental insufficiency-identified individually as relevant in previous studies-in under 2 minutes. This allows dynamic assessment of physiological processes, reduced inconsistency in spatial comparisons due to reduced motion artefacts and opens novel avenues for analysis. Initial results in pre-eclamptic placentas, with depicted changes in both ADC and T 1 , illustrate its potential to identify cases of placental insufficiency. Future work will focus on expanding the field-of-view using multi-band acceleration techniques and the expansion to larger and more diverse patient groups.
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Affiliation(s)
- Jana Hutter
- Center for Medical Engineering, King's College London, London, UK
- Center for the Developing Brain, School of Biomedical Engineering and Imaging, King's College London, London, UK
| | - Alison Ho
- Academic Women's Health Department, King's College London, London, UK
| | - Laurence H Jackson
- Center for Medical Engineering, King's College London, London, UK
- Center for the Developing Brain, School of Biomedical Engineering and Imaging, King's College London, London, UK
| | - Paddy J Slator
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Lucy C Chappell
- Academic Women's Health Department, King's College London, London, UK
| | - Joseph V Hajnal
- Center for Medical Engineering, King's College London, London, UK
- Center for the Developing Brain, School of Biomedical Engineering and Imaging, King's College London, London, UK
| | - Mary A Rutherford
- Center for Medical Engineering, King's College London, London, UK
- Center for the Developing Brain, School of Biomedical Engineering and Imaging, King's College London, London, UK
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Jasmin NH, Thin MZ, Johnson RD, Jackson LH, Roberts TA, David AL, Lythgoe MF, Yang PC, Davidson SM, Camelliti P, Stuckey DJ. Myocardial Viability Imaging using Manganese-Enhanced MRI in the First Hours after Myocardial Infarction. Adv Sci (Weinh) 2021; 8:e2003987. [PMID: 34105284 PMCID: PMC8188227 DOI: 10.1002/advs.202003987] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/08/2021] [Indexed: 05/19/2023]
Abstract
Early measurements of tissue viability after myocardial infarction (MI) are essential for accurate diagnosis and treatment planning but are challenging to obtain. Here, manganese, a calcium analogue and clinically approved magnetic resonance imaging (MRI) contrast agent, is used as an imaging biomarker of myocardial viability in the first hours after experimental MI. Safe Mn2+ dosing is confirmed by measuring in vitro beating rates, calcium transients, and action potentials in cardiomyocytes, and in vivo heart rates and cardiac contractility in mice. Quantitative T1 mapping-manganese-enhanced MRI (MEMRI) reveals elevated and increasing Mn2+ uptake in viable myocardium remote from the infarct, suggesting MEMRI offers a quantitative biomarker of cardiac inotropy. MEMRI evaluation of infarct size at 1 h, 1 and 14 days after MI quantifies myocardial viability earlier than the current gold-standard technique, late-gadolinium-enhanced MRI. These data, coupled with the re-emergence of clinical Mn2+ -based contrast agents open the possibility of using MEMRI for direct evaluation of myocardial viability early after ischemic onset in patients.
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Affiliation(s)
- Nur Hayati Jasmin
- UCL Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonLondonWC1E 6DDUK
- School of Medical ImagingFaculty of Health SciencesUniversiti Sultan Zainal AbidinKuala Terengganu21300Malaysia
| | - May Zaw Thin
- UCL Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonLondonWC1E 6DDUK
| | - Robert D. Johnson
- School of Biosciences and MedicineUniversity of SurreyGuildfordGU2 7XHUK
| | - Laurence H. Jackson
- School of Biomedical Engineering & Imaging SciencesKing's College LondonLondonSE1 7EHUK
| | - Thomas A. Roberts
- School of Biomedical Engineering & Imaging SciencesKing's College LondonLondonSE1 7EHUK
| | - Anna L. David
- UCL Elizabeth Garrett Anderson Institute for Women's HealthLondonWC1E 6BTUK
| | - Mark F. Lythgoe
- UCL Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonLondonWC1E 6DDUK
| | - Philip C. Yang
- Division of Cardiovascular MedicineDepartment of MedicineStanford UniversityStanfordCA94305USA
| | - Sean M. Davidson
- The Hatter Cardiovascular InstituteUniversity College London67 Chenies MewsLondonWC1E 6HXUK
| | - Patrizia Camelliti
- School of Biosciences and MedicineUniversity of SurreyGuildfordGU2 7XHUK
| | - Daniel J. Stuckey
- UCL Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonLondonWC1E 6DDUK
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Slator PJ, Hutter J, Marinescu RV, Palombo M, Jackson LH, Ho A, Chappell LC, Rutherford M, Hajnal JV, Alexander DC. Data-Driven multi-Contrast spectral microstructure imaging with InSpect: INtegrated SPECTral component estimation and mapping. Med Image Anal 2021; 71:102045. [PMID: 33934005 PMCID: PMC8543043 DOI: 10.1016/j.media.2021.102045] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/08/2021] [Accepted: 03/16/2021] [Indexed: 11/19/2022]
Abstract
Unsupervised learning technique for spectroscopic analysis of quantitative MRI. Shares information across voxels to improve estimation of multi-dimensional or single-dimensional spectra. Spectral maps are dramatically improved compared to existing approaches. Can potentially identify and map tissue environments; in placental diffusion-relaxometry MRI we demonstrate that it identifies components that correspond to distinct tissue types.
We introduce and demonstrate an unsupervised machine learning technique for spectroscopic analysis of quantitative MRI experiments. Our algorithm supports estimation of one-dimensional spectra from single-contrast data, and multidimensional correlation spectra from simultaneous multi-contrast data. These spectrum-based approaches allow model-free investigation of tissue properties, but require regularised inversion of a Laplace transform or Fredholm integral, which is an ill-posed calculation. Here we present a method that addresses this limitation in a data-driven way. The algorithm simultaneously estimates a canonical basis of spectral components and voxelwise maps of their weightings, thereby pooling information across whole images to regularise the ill-posed problem. We show in simulations that our algorithm substantially outperforms current voxelwise spectral approaches. We demonstrate the method on multi-contrast diffusion-relaxometry placental MRI scans, revealing anatomically-relevant sub-structures, and identifying dysfunctional placentas. Our algorithm vastly reduces the data required to reliably estimate spectra, opening up the possibility of quantitative MRI spectroscopy in a wide range of new applications. Our InSpect code is available at github.com/paddyslator/inspect.
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Affiliation(s)
- Paddy J Slator
- Centre for Medical Image Computing, Department of Computer Science, University College London, UK.
| | - Jana Hutter
- Centre for the Developing Brain, Kings College London, London, UK; Biomedical Engineering Department, Kings College London, London, UK
| | - Razvan V Marinescu
- Centre for Medical Image Computing, Department of Computer Science, University College London, UK
| | - Marco Palombo
- Centre for Medical Image Computing, Department of Computer Science, University College London, UK
| | - Laurence H Jackson
- Centre for the Developing Brain, Kings College London, London, UK; Biomedical Engineering Department, Kings College London, London, UK
| | - Alison Ho
- Women's Health Department, King's College London, London, UK
| | - Lucy C Chappell
- Women's Health Department, King's College London, London, UK
| | - Mary Rutherford
- Centre for the Developing Brain, Kings College London, London, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, Kings College London, London, UK; Biomedical Engineering Department, Kings College London, London, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Computer Science, University College London, UK
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Roberts TA, van Amerom JFP, Uus A, Lloyd DFA, van Poppel MPM, Price AN, Tournier JD, Mohanadass CA, Jackson LH, Malik SJ, Pushparajah K, Rutherford MA, Razavi R, Deprez M, Hajnal JV. Author Correction: Fetal whole heart blood flow imaging using 4D cine MRI. Nat Commun 2020; 11:6413. [PMID: 33318490 PMCID: PMC7736858 DOI: 10.1038/s41467-020-20353-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Thomas A Roberts
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.
| | - Joshua F P van Amerom
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Alena Uus
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - David F A Lloyd
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.,Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK
| | - Milou P M van Poppel
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.,Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK
| | - Anthony N Price
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Jacques-Donald Tournier
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Chloe A Mohanadass
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Laurence H Jackson
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Shaihan J Malik
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Kuberan Pushparajah
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.,Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK
| | - Mary A Rutherford
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.,Centre for the Developing Brain, King's College London, London, SE1 7EH, UK
| | - Reza Razavi
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.,Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK
| | - Maria Deprez
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Joseph V Hajnal
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
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Roberts TA, van Amerom JFP, Uus A, Lloyd DFA, van Poppel MPM, Price AN, Tournier JD, Mohanadass CA, Jackson LH, Malik SJ, Pushparajah K, Rutherford MA, Razavi R, Deprez M, Hajnal JV. Fetal whole heart blood flow imaging using 4D cine MRI. Nat Commun 2020; 11:4992. [PMID: 33020487 PMCID: PMC7536221 DOI: 10.1038/s41467-020-18790-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 09/10/2020] [Indexed: 12/26/2022] Open
Abstract
Prenatal detection of congenital heart disease facilitates the opportunity for potentially life-saving care immediately after the baby is born. Echocardiography is routinely used for screening of morphological malformations, but functional measurements of blood flow are scarcely used in fetal echocardiography due to technical assumptions and issues of reliability. Magnetic resonance imaging (MRI) is readily used for quantification of abnormal blood flow in adult hearts, however, existing in utero approaches are compromised by spontaneous fetal motion. Here, we present and validate a novel method of MRI velocity-encoding combined with a motion-robust reconstruction framework for four-dimensional visualization and quantification of blood flow in the human fetal heart and major vessels. We demonstrate simultaneous 4D visualization of the anatomy and circulation, which we use to quantify flow rates through various major vessels. The framework introduced here could enable new clinical opportunities for assessment of the fetal cardiovascular system in both health and disease.
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Affiliation(s)
- Thomas A Roberts
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.
| | - Joshua F P van Amerom
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Alena Uus
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - David F A Lloyd
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK
| | - Milou P M van Poppel
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK
| | - Anthony N Price
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Jacques-Donald Tournier
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Chloe A Mohanadass
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Laurence H Jackson
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Shaihan J Malik
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Kuberan Pushparajah
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK
| | - Mary A Rutherford
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Centre for the Developing Brain, King's College London, London, SE1 7EH, UK
| | - Reza Razavi
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
- Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK
| | - Maria Deprez
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Joseph V Hajnal
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK
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Uus A, Zhang T, Jackson LH, Roberts TA, Rutherford MA, Hajnal JV, Deprez M. Deformable Slice-to-Volume Registration for Motion Correction of Fetal Body and Placenta MRI. IEEE Trans Med Imaging 2020; 39:2750-2759. [PMID: 32086200 PMCID: PMC7116020 DOI: 10.1109/tmi.2020.2974844] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
In in-utero MRI, motion correction for fetal body and placenta poses a particular challenge due to the presence of local non-rigid transformations of organs caused by bending and stretching. The existing slice-to-volume registration (SVR) reconstruction methods are widely employed for motion correction of fetal brain that undergoes only rigid transformation. However, for reconstruction of fetal body and placenta, rigid registration cannot resolve the issue of misregistrations due to deformable motion, resulting in degradation of features in the reconstructed volume. We propose a Deformable SVR (DSVR), a novel approach for non-rigid motion correction of fetal MRI based on a hierarchical deformable SVR scheme to allow high resolution reconstruction of the fetal body and placenta. Additionally, a robust scheme for structure-based rejection of outliers minimises the impact of registration errors. The improved performance of DSVR in comparison to SVR and patch-to-volume registration (PVR) methods is quantitatively demonstrated in simulated experiments and 20 fetal MRI datasets from 28-31 weeks gestational age (GA) range with varying degree of motion corruption. In addition, we present qualitative evaluation of 100 fetal body cases from 20-34 weeks GA range.
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Ho AEP, Hutter J, Jackson LH, Seed PT, Mccabe L, Al-Adnani M, Marnerides A, George S, Story L, Hajnal JV, Rutherford MA, Chappell LC. T2* Placental Magnetic Resonance Imaging in Preterm Preeclampsia: An Observational Cohort Study. Hypertension 2020; 75:1523-1531. [PMID: 32336233 PMCID: PMC7682790 DOI: 10.1161/hypertensionaha.120.14701] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Placental dysfunction underlies the cause of pregnancies complicated by preeclampsia. The use of placental magnetic resonance imaging to provide an insight into the pathophysiology of preeclampsia and thus assess its potential use to inform prognosis and clinical management was explored. In this prospective observational cohort study, 14 women with preterm preeclampsia and 48 gestation-matched controls using 3-Tesla magnetic resonance imaging at median of 31.6 weeks (interquartile range [IQR], 28.6-34.6) and 32.2 weeks (IQR, 28.6-33.8), respectively, were imaged. The acquired data included T2-weighted images and T2* maps of the placenta, the latter an indicative measure of placental oxygenation. Placentae in women with preeclampsia demonstrated advanced lobulation, varied lobule sizes, high granularity, and substantial areas of low-signal intensity on T2-weighted imaging, with reduced entire placental mean T2* values for gestational age (2 sample t test, t=7.49) correlating with a reduction in maternal PlGF (placental growth factor) concentrations (Spearman rank correlation coefficient 0.76) and increased lacunarity values (t=3.26). Median mean T2* reduced from 67 ms (IQR, 54-73) at 26.0 to 29.8 weeks' gestation to 38 ms (IQR, 28-40) at 34.0 to 37.9 weeks' gestation in the control group. In women with preeclampsia, median T2* was 23 ms (IQR, 20-23) at 26.0 to 29.8 weeks' gestation and remained low (22 ms [IQR, 20-26] at 34.0-37.8 weeks' gestation). Histological features of maternal vascular malperfusion were only found in placentae from women with preeclampsia. Placental volume did not differ between the control group and women with preeclampsia. Placental magnetic resonance imaging allows both objective quantification of placental function in vivo and elucidation of the complex mechanisms underlying preeclampsia development.
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Affiliation(s)
- Alison E P Ho
- From the Department of Women and Children's Health, School of Life Course Sciences (A.E.P.H., P.S., L.S., L.C.C.), King's College London, United Kingdom
| | - Jana Hutter
- Centre for the Developing Brain (J.H., L.H.J., L.M., J.V.H., M.A.R.), King's College London, United Kingdom.,Biomedical Engineering Department (J.H., L.H.J., J.V.H.), King's College London, United Kingdom
| | - Laurence H Jackson
- Centre for the Developing Brain (J.H., L.H.J., L.M., J.V.H., M.A.R.), King's College London, United Kingdom.,Biomedical Engineering Department (J.H., L.H.J., J.V.H.), King's College London, United Kingdom
| | - Paul T Seed
- From the Department of Women and Children's Health, School of Life Course Sciences (A.E.P.H., P.S., L.S., L.C.C.), King's College London, United Kingdom
| | - Laura Mccabe
- Centre for the Developing Brain (J.H., L.H.J., L.M., J.V.H., M.A.R.), King's College London, United Kingdom
| | - Mudher Al-Adnani
- Department of Cellular Pathology, Guy's and St Thomas' Hospital, London, United Kingdom (M.A.-A., A.M., S.G.)
| | - Andreas Marnerides
- Department of Cellular Pathology, Guy's and St Thomas' Hospital, London, United Kingdom (M.A.-A., A.M., S.G.)
| | - Simi George
- Department of Cellular Pathology, Guy's and St Thomas' Hospital, London, United Kingdom (M.A.-A., A.M., S.G.)
| | - Lisa Story
- From the Department of Women and Children's Health, School of Life Course Sciences (A.E.P.H., P.S., L.S., L.C.C.), King's College London, United Kingdom
| | - Joseph V Hajnal
- Centre for the Developing Brain (J.H., L.H.J., L.M., J.V.H., M.A.R.), King's College London, United Kingdom.,Biomedical Engineering Department (J.H., L.H.J., J.V.H.), King's College London, United Kingdom
| | - Mary A Rutherford
- Centre for the Developing Brain (J.H., L.H.J., L.M., J.V.H., M.A.R.), King's College London, United Kingdom
| | - Lucy C Chappell
- From the Department of Women and Children's Health, School of Life Course Sciences (A.E.P.H., P.S., L.S., L.C.C.), King's College London, United Kingdom
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9
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Harteveld AA, Hutter J, Franklin SL, Jackson LH, Rutherford M, Hajnal JV, van Osch MJP, Bos C, De Vita E. Systematic evaluation of velocity-selective arterial spin labeling settings for placental perfusion measurement. Magn Reson Med 2020; 84:1828-1843. [PMID: 32141655 PMCID: PMC7384055 DOI: 10.1002/mrm.28240] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 01/15/2023]
Abstract
Purpose Placental function is key for successful human pregnancies. Perfusion may be a sensitive marker for the in vivo assessment of placental function. Arterial spin labeling (ASL) MRI enables noninvasive measurement of tissue perfusion and it was recently suggested that ASL with velocity‐selective (VS) labeling could be advantageous in the placenta. We systematically evaluated essential VS‐ASL sequence parameters to determine optimal settings for efficient placental perfusion measurements. Methods Eleven pregnant women were scanned at 3T using VS‐ASL with 2D multislice echo planar imaging (EPI)‐readout. One reference VS‐ASL scan was acquired in all subjects; within subgroups the following parameters were systematically varied: cutoff velocity, velocity encoding direction, and inflow time. Visual evaluation and region of interest analyses were performed to compare perfusion signal differences between acquisitions. Results In all subjects, a perfusion pattern with clear hyperintense focal regions was observed. Perfusion signal decreased with inflow time and cutoff velocity. Subject‐specific dependence on velocity encoding direction was observed. High temporal signal‐to‐noise ratios with high contrast on the perfusion images between the hyperintense regions and placental tissue were seen at ~1.6 cm/s cutoff velocity and ~1000 ms inflow time. Evaluation of measurements at multiple inflow times revealed differences in blood flow dynamics between placental regions. Conclusion Placental perfusion measurements are feasible at 3T using VS‐ASL with 2D multislice EPI‐readout. A clear dependence of perfusion signal on VS labeling parameters and inflow time was demonstrated. Whereas multiple parameter combinations may advance the interpretation of placental circulation dynamics, this study provides a basis to select an effective set of parameters for the observation of placenta perfusion natural history and its potential pathological changes.
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Affiliation(s)
- Anita A Harteveld
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jana Hutter
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Suzanne L Franklin
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.,C.J. Gorter Center for high field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Laurence H Jackson
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Mary Rutherford
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Joseph V Hajnal
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Matthias J P van Osch
- C.J. Gorter Center for high field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Clemens Bos
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Enrico De Vita
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
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10
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Shangaris P, Loukogeorgakis SP, Subramaniam S, Flouri C, Jackson LH, Wang W, Blundell MP, Liu S, Eaton S, Bakhamis N, Ramachandra DL, Maghsoudlou P, Urbani L, Waddington SN, Eddaoudi A, Archer J, Antoniou MN, Stuckey DJ, Schmidt M, Thrasher AJ, Ryan TM, De Coppi P, David AL. Publisher Correction: In Utero Gene Therapy (IUGT) Using GLOBE Lentiviral Vector Phenotypically Corrects the Heterozygous Humanised Mouse Model and Its Progress Can Be Monitored Using MRI Techniques. Sci Rep 2019; 9:20214. [PMID: 31874968 PMCID: PMC6930216 DOI: 10.1038/s41598-019-55754-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Panicos Shangaris
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK.
- UCL Institute of Child Health, UCL, London, United Kingdom.
| | | | | | - Christina Flouri
- Department of Medical and Molecular Genetics, KCL, London, United Kingdom
| | | | - Wei Wang
- Department of Translational Oncology, National Centre for Tumour Diseases, Heidelberg, Germany
| | | | - Shanrun Liu
- Biochemistry and Molecular Genetics, UAB, Birmingham, Alabama, United States
| | - Simon Eaton
- UCL Institute of Child Health, UCL, London, United Kingdom
| | - Nahla Bakhamis
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK
| | | | | | - Luca Urbani
- UCL Institute of Child Health, UCL, London, United Kingdom
| | - Simon N Waddington
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK
- Wits/SAMRC Antiviral Gene Therapy Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ayad Eddaoudi
- UCL Institute of Child Health, UCL, London, United Kingdom
| | - Joy Archer
- Central Diagnostic Services, Queen's Vet School Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Michael N Antoniou
- Department of Medical and Molecular Genetics, KCL, London, United Kingdom
| | - Daniel J Stuckey
- Centre for Advanced Biomedical Imaging, UCL, London, United Kingdom
| | - Manfred Schmidt
- Department of Translational Oncology, National Centre for Tumour Diseases, Heidelberg, Germany
| | | | - Thomas M Ryan
- Biochemistry and Molecular Genetics, UAB, Birmingham, Alabama, United States
| | - Paolo De Coppi
- UCL Institute of Child Health, UCL, London, United Kingdom
| | - Anna L David
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK
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11
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Garcia-Canadilla P, Dejea H, Bonnin A, Balicevic V, Loncaric S, Zhang C, Butakoff C, Aguado-Sierra J, Vázquez M, Jackson LH, Stuckey DJ, Rau C, Stampanoni M, Bijnens B, Cook AC. Complex Congenital Heart Disease Associated With Disordered Myocardial Architecture in a Midtrimester Human Fetus. Circ Cardiovasc Imaging 2019; 11:e007753. [PMID: 30354476 DOI: 10.1161/circimaging.118.007753] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND In the era of increasingly successful corrective interventions in patients with congenital heart disease (CHD), global and regional myocardial remodeling are emerging as important sources of long-term morbidity/mortality. Changes in organization of the myocardium in CHD, and in its mechanical properties, conduction, and blood supply, result in altered myocardial function both before and after surgery. To gain a better understanding and develop appropriate and individualized treatment strategies, the microscopic organization of cardiomyocytes, and their integration at a macroscopic level, needs to be completely understood. The aim of this study is to describe, for the first time, in 3 dimensions and nondestructively the detailed remodeling of cardiac microstructure present in a human fetal heart with complex CHD. METHODS AND RESULTS Synchrotron X-ray phase-contrast imaging was used to image an archival midgestation formalin-fixed fetal heart with right isomerism and complex CHD and compare with a control fetal heart. Analysis of myocyte aggregates, at detail not accessible with other techniques, was performed. Macroanatomic and conduction system changes specific to the disease were clearly observable, together with disordered myocyte organization in the morphologically right ventricle myocardium. Electrical activation simulations suggested altered synchronicity of the morphologically right ventricle. CONCLUSIONS We have shown the potential of X-ray phase-contrast imaging for studying cardiac microstructure in the developing human fetal heart at high resolution providing novel insight while preserving valuable archival material for future study. This is the first study to show myocardial alterations occur in complex CHD as early as midgestation.
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Affiliation(s)
- Patricia Garcia-Canadilla
- Institute of Cardiovascular Science (P.G.-C., A.C.C.), University College London, United Kingdom.,Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (P.G.-C., C.Z., C.B., B.B.)
| | - Hector Dejea
- Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (H.D., A.B., M.S.).,Institute for Biomedical Engineering, ETH Zurich, Zurich, Switzerland (H.D., M.S.)
| | - Anne Bonnin
- Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (H.D., A.B., M.S.)
| | - Vedrana Balicevic
- Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia (V.B., S.L.)
| | - Sven Loncaric
- Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia (V.B., S.L.)
| | - Chong Zhang
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (P.G.-C., C.Z., C.B., B.B.)
| | - Constantine Butakoff
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (P.G.-C., C.Z., C.B., B.B.)
| | - Jazmin Aguado-Sierra
- Barcelona Supercomputing Center-Centro Nacional de Supercomputación, Campus Nord Universitat Politecnica de Catalunya, Barcelona, Spain (J.A.-S., M.V.)
| | - Mariano Vázquez
- Barcelona Supercomputing Center-Centro Nacional de Supercomputación, Campus Nord Universitat Politecnica de Catalunya, Barcelona, Spain (J.A.-S., M.V.).,IIIA-CSIC, Bellaterra, Spain (M.V.)
| | - Laurence H Jackson
- Division of Medicine, Centre for Advanced Biomedical Imaging (L.H.J., D.J.S.), University College London, United Kingdom
| | - Daniel J Stuckey
- Division of Medicine, Centre for Advanced Biomedical Imaging (L.H.J., D.J.S.), University College London, United Kingdom
| | - Cristoph Rau
- Diamond Manchester Imaging Branchline (I13-2), Diamond Lightsource, Oxford, United Kingdom (C.R.)
| | - Marco Stampanoni
- Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (H.D., A.B., M.S.).,Institute for Biomedical Engineering, ETH Zurich, Zurich, Switzerland (H.D., M.S.)
| | - Bart Bijnens
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain (P.G.-C., C.Z., C.B., B.B.).,Institución Catalana de Investigación y Estudios Avanzados, Barcelona, Spain (B.B.)
| | - Andrew C Cook
- Institute of Cardiovascular Science (P.G.-C., A.C.C.), University College London, United Kingdom
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12
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Hutter J, Harteveld AA, Jackson LH, Franklin S, Bos C, van Osch MJP, O'Muircheartaigh J, Ho A, Chappell L, Hajnal JV, Rutherford M, De Vita E. Perfusion and apparent oxygenation in the human placenta (PERFOX). Magn Reson Med 2019; 83:549-560. [PMID: 31433077 PMCID: PMC6825519 DOI: 10.1002/mrm.27950] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 07/18/2019] [Accepted: 07/25/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE To study placental function-both perfusion and an oxygenation surrogate ( T 2 * )-simultaneously and quantitatively in-vivo. METHODS Fifteen pregnant women were scanned on a 3T MR scanner. For perfusion measurements, a velocity selective arterial spin labeling preparation module was placed before a multi-echo gradient echo EPI readout to integrate T 2 * and perfusion measurements in 1 joint perfusion-oxygenation (PERFOX) acquisition. Joint motion correction and quantification were performed to evaluate changes in T 2 * and perfusion over GA. RESULTS The optimized integrated PERFOX protocol and post-processing allowed successful visualization and quantification of perfusion and T 2 * in all subjects. Areas of high T 2 * and high perfusion appear to correspond to placental sub-units and show a systematic offset in location along the maternal-fetal axis. The areas of highest perfusion are consistently closer to the maternal basal plate and the areas of highest T 2 * closer to the fetal chorionic plate. Quantitative results show a strong negative correlation of gestational age with T 2 * and weak negative correlation with perfusion. CONCLUSIONS A strength of the joint sequence is that it provides truly simultaneous and co-registered estimates of local T 2 * and perfusion, however, to achieve this, the time per slice is prolonged compared to a perfusion only scan which can potentially limit coverage. The achieved interlocking can be particularly useful when quantifying transient physiological effects such as uterine contractions. PERFOX opens a new avenue to elucidate the relationship between maternal supply and oxygen uptake, both of which are central to placental function and dysfunction.
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Affiliation(s)
- Jana Hutter
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Anita A. Harteveld
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Laurence H. Jackson
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Suzanne Franklin
- C.J. Gorter Center for High Field MRIDepartment of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Clemens Bos
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Matthias J. P. van Osch
- C.J. Gorter Center for High Field MRIDepartment of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Jonathan O'Muircheartaigh
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Alison Ho
- Academic Women's Health DepartmentKing's College LondonLondonUnited Kingdom
| | - Lucy Chappell
- Academic Women's Health DepartmentKing's College LondonLondonUnited Kingdom
| | - Joseph V. Hajnal
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Mary Rutherford
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Enrico De Vita
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
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13
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Shangaris P, Loukogeorgakis SP, Subramaniam S, Flouri C, Jackson LH, Wang W, Blundell MP, Liu S, Eaton S, Bakhamis N, Ramachandra DL, Maghsoudlou P, Urbani L, Waddington SN, Eddaoudi A, Archer J, Antoniou MN, Stuckey DJ, Schmidt M, Thrasher AJ, Ryan TM, De Coppi P, David AL. In Utero Gene Therapy (IUGT) Using GLOBE Lentiviral Vector Phenotypically Corrects the Heterozygous Humanised Mouse Model and Its Progress Can Be Monitored Using MRI Techniques. Sci Rep 2019; 9:11592. [PMID: 31406195 PMCID: PMC6690943 DOI: 10.1038/s41598-019-48078-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/29/2019] [Indexed: 02/06/2023] Open
Abstract
In utero gene therapy (IUGT) to the fetal hematopoietic compartment could be used to treat congenital blood disorders such as β-thalassemia. A humanised mouse model of β-thalassemia was used, in which heterozygous animals are anaemic with splenomegaly and extramedullary hematopoiesis. Intrahepatic in utero injections of a β globin-expressing lentiviral vector (GLOBE), were performed in fetuses at E13.5 of gestation. We analysed animals at 12 and 32 weeks of age, for vector copy number in bone marrow, peripheral blood liver and spleen and we performed integration site analysis. Compared to noninjected heterozygous animals IUGT normalised blood haemoglobin levels and spleen weight. Integration site analysis showed polyclonality. The left ventricular ejection fraction measured using magnetic resonance imaging (MRI) in treated heterozygous animals was similar to that of normal non-β-thalassemic mice but significantly higher than untreated heterozygous thalassemia mice suggesting that IUGT ameliorated poor cardiac function. GLOBE LV-mediated IUGT normalised the haematological and anatomical phenotype in a heterozygous humanised model of β-thalassemia.
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Affiliation(s)
- Panicos Shangaris
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK.
- UCL Institute of Child Health, UCL, London, United Kingdom.
| | | | | | - Christina Flouri
- Department of Medical and Molecular Genetics, KCL, London, United Kingdom
| | | | - Wei Wang
- Department of Translational Oncology, National Centre for Tumour Diseases, Heidelberg, Germany
| | | | - Shanrun Liu
- Biochemistry and Molecular Genetics, UAB, Birmingham, Alabama, United States
| | - Simon Eaton
- UCL Institute of Child Health, UCL, London, United Kingdom
| | - Nahla Bakhamis
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK
| | | | | | - Luca Urbani
- UCL Institute of Child Health, UCL, London, United Kingdom
| | - Simon N Waddington
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK
- Wits/SAMRC Antiviral Gene Therapy Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ayad Eddaoudi
- UCL Institute of Child Health, UCL, London, United Kingdom
| | - Joy Archer
- Central Diagnostic Services, Queen's Vet School Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Michael N Antoniou
- Department of Medical and Molecular Genetics, KCL, London, United Kingdom
| | - Daniel J Stuckey
- Centre for Advanced Biomedical Imaging, UCL, London, United Kingdom
| | - Manfred Schmidt
- Department of Translational Oncology, National Centre for Tumour Diseases, Heidelberg, Germany
| | | | - Thomas M Ryan
- Biochemistry and Molecular Genetics, UAB, Birmingham, Alabama, United States
| | - Paolo De Coppi
- UCL Institute of Child Health, UCL, London, United Kingdom
| | - Anna L David
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK
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14
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Jackson LH, Price AN, Hutter J, Ho A, Roberts TA, Slator PJ, Clough JR, Deprez M, McCabe L, Malik SJ, Chappell L, Rutherford MA, Hajnal JV. Respiration resolved imaging with continuous stable state 2D acquisition using linear frequency SWEEP. Magn Reson Med 2019; 82:1631-1645. [PMID: 31183892 PMCID: PMC6682494 DOI: 10.1002/mrm.27834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/04/2019] [Accepted: 05/09/2019] [Indexed: 01/31/2023]
Abstract
Purpose To investigate the potential of continuous radiofrequency (RF) shifting (SWEEP) as a technique for creating densely sampled data while maintaining a stable signal state for dynamic imaging. Methods We present a method where a continuous stable state of magnetization is swept smoothly across the anatomy of interest, creating an efficient approach to dense multiple 2D slice imaging. This is achieved by introducing a linear frequency offset to successive RF pulses shifting the excited slice by a fraction of the slice thickness with each successive repeat times (TR). Simulations and in vivo imaging were performed to assess how this affects the measured signal. Free breathing, respiration resolved 4D volumes in fetal/placental imaging is explored as potential application of this method. Results The SWEEP method maintained a stable signal state over a full acquisition reducing artifacts from unstable magnetization. Simulations demonstrated that the effects of SWEEP on slice profiles was of the same order as that produced by physiological motion observed with conventional methods. Respiration resolved 4D data acquired with this method shows reduced respiration artifacts and resilience to non‐rigid and non‐cyclic motion. Conclusions The SWEEP method is presented as a technique for improved acquisition efficiency of densely sampled short‐TR 2D sequences. Using conventional slice excitation the number of RF pulses required to enter a true steady state is excessively high when using short‐TR 2D acquisitions, SWEEP circumvents this limitation by creating a stable signal state that is preserved between slices.
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Affiliation(s)
- L H Jackson
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - A N Price
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - J Hutter
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - A Ho
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom.,Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
| | - T A Roberts
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - P J Slator
- Centre for Medical Image Computing, University College London, London, United Kingdom
| | - J R Clough
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - M Deprez
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - L McCabe
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - S J Malik
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - L Chappell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
| | - M A Rutherford
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - J V Hajnal
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
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15
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Slator PJ, Hutter J, Palombo M, Jackson LH, Ho A, Panagiotaki E, Chappell LC, Rutherford MA, Hajnal JV, Alexander DC. Combined diffusion-relaxometry MRI to identify dysfunction in the human placenta. Magn Reson Med 2019; 82:95-106. [PMID: 30883915 PMCID: PMC6519240 DOI: 10.1002/mrm.27733] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/04/2019] [Accepted: 01/27/2019] [Indexed: 12/25/2022]
Abstract
Purpose A combined diffusion‐relaxometry MR acquisition and analysis pipeline for in vivo human placenta, which allows for exploration of coupling between T2* and apparent diffusion coefficient (ADC) measurements in a sub 10‐minute scan time. Methods We present a novel acquisition combining a diffusion prepared spin echo with subsequent gradient echoes. The placentas of 17 pregnant women were scanned in vivo, including both healthy controls and participants with various pregnancy complications. We estimate the joint T2*‐ADC spectra using an inverse Laplace transform. Results T2*‐ADC spectra demonstrate clear quantitative separation between normal and dysfunctional placentas. Conclusions Combined T2*‐diffusivity MRI is promising for assessing fetal and maternal health during pregnancy. The T2*‐ADC spectrum potentially provides additional information on tissue microstructure, compared to measuring these two contrasts separately. The presented method is immediately applicable to the study of other organs.
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Affiliation(s)
- Paddy J Slator
- Centre for Medical Image Computing and Department of Computer Science, University College London, London, United Kingdom
| | - Jana Hutter
- Biomedical Engineering Department, King's College London, London, United Kingdom.,Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Marco Palombo
- Centre for Medical Image Computing and Department of Computer Science, University College London, London, United Kingdom
| | - Laurence H Jackson
- Biomedical Engineering Department, King's College London, London, United Kingdom.,Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Alison Ho
- Women's Health Department, King's College London, London, United Kingdom
| | - Eleftheria Panagiotaki
- Centre for Medical Image Computing and Department of Computer Science, University College London, London, United Kingdom
| | - Lucy C Chappell
- Women's Health Department, King's College London, London, United Kingdom
| | - Mary A Rutherford
- Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Joseph V Hajnal
- Biomedical Engineering Department, King's College London, London, United Kingdom.,Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Daniel C Alexander
- Centre for Medical Image Computing and Department of Computer Science, University College London, London, United Kingdom
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16
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Slator PJ, Hutter J, Marinescu RV, Palombo M, Young AL, Jackson LH, Ho A, Chappell LC, Rutherford M, Hajnal JV, Alexander DC. InSpect: INtegrated SPECTral Component Estimation and Mapping for Multi-contrast Microstructural MRI. Lecture Notes in Computer Science 2019. [DOI: 10.1007/978-3-030-20351-1_59] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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17
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Roberts TA, Price AN, Jackson LH, Taylor V, David AL, Lythgoe MF, Stuckey DJ. Direct comparison of high-temporal-resolution CINE MRI with Doppler ultrasound for assessment of diastolic dysfunction in mice. NMR Biomed 2017; 30:e3763. [PMID: 28643891 PMCID: PMC5638074 DOI: 10.1002/nbm.3763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 08/24/2023]
Abstract
Diastolic dysfunction is a sensitive early indicator of heart failure and can provide additional data to conventional measures of systolic function. Transmitral Doppler ultrasound, which measures the one-dimensional flow of blood through the mitral valve, is currently the preferred method for the measurement of diastolic function, but the measurement of the left ventricular volume changes using high-temporal-resolution cinematic magnetic resonance imaging (CINE MRI) is an alternative approach which is emerging as a potentially more robust and user-independent technique. Here, we investigated the performance of high-temporal-resolution CINE MRI and compared it with ultrasound for the detection of diastolic dysfunction in a mouse model of myocardial infarction. An in-house, high-temporal-resolution, retrospectively gated CINE sequence was developed with a temporal resolution of 1 ms. Diastolic function in mice was assessed using a custom-made, open-source reconstruction package. Early (E) and late (A) left ventricular filling phases were easily identifiable, and these measurements were compared directly with high-frequency, pulsed-wave, Doppler ultrasound measurements of mitral valve inflow. A repeatability study established that high-temporal-resolution CINE MRI and Doppler ultrasound showed comparable accuracy when measuring E/A in normal control mice. However, when applied in a mouse model of myocardial infarction, high-temporal-resolution CINE MRI indicated diastolic heart failure (E/A = 0.94 ± 0.11), whereas ultrasound falsely detected normal cardiac function (E/A = 1.21 ± 0.11). The addition of high-temporal-resolution CINE MRI to preclinical imaging studies enhances the library of sequences available to cardiac researchers and potentially identifies diastolic heart failure early in disease progression.
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Affiliation(s)
- Thomas A. Roberts
- Centre for Advanced Biomedical ImagingUniversity College LondonLondonUK
| | - Anthony N. Price
- Division of Imaging Sciences and Biomedical EngineeringKing's College LondonLondonUK
| | | | - Valerie Taylor
- Centre for Advanced Biomedical ImagingUniversity College LondonLondonUK
| | - Anna L. David
- Institute for Women's HealthUniversity College LondonLondonUK
| | - Mark F. Lythgoe
- Centre for Advanced Biomedical ImagingUniversity College LondonLondonUK
| | - Daniel J. Stuckey
- Centre for Advanced Biomedical ImagingUniversity College LondonLondonUK
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18
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Speidel A, Stuckey DJ, Chow LW, Jackson LH, Noseda M, Abreu Paiva M, Schneider MD, Stevens MM. Multimodal Hydrogel-Based Platform To Deliver and Monitor Cardiac Progenitor/Stem Cell Engraftment. ACS Cent Sci 2017; 3:338-348. [PMID: 28470052 PMCID: PMC5408339 DOI: 10.1021/acscentsci.7b00039] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Indexed: 05/17/2023]
Abstract
Retention and survival of transplanted cells are major limitations to the efficacy of regenerative medicine, with short-term paracrine signals being the principal mechanism underlying current cell therapies for heart repair. Consequently, even improvements in short-term durability may have a potential impact on cardiac cell grafting. We have developed a multimodal hydrogel-based platform comprised of a poly(ethylene glycol) network cross-linked with bioactive peptides functionalized with Gd(III) in order to monitor the localization and retention of the hydrogel in vivo by magnetic resonance imaging. In this study, we have tailored the material for cardiac applications through the inclusion of a heparin-binding peptide (HBP) sequence in the cross-linker design and formulated the gel to display mechanical properties resembling those of cardiac tissue. Luciferase-expressing cardiac stem cells (CSC-Luc2) encapsulated within these gels maintained their metabolic activity for up to 14 days in vitro. Encapsulation in the HBP hydrogels improved CSC-Luc2 retention in the mouse myocardium and hind limbs at 3 days by 6.5- and 12- fold, respectively. Thus, this novel heparin-binding based, Gd(III)-tagged hydrogel and CSC-Luc2 platform system demonstrates a tailored, in vivo detectable theranostic cell delivery system that can be implemented to monitor and assess the transplanted material and cell retention.
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Affiliation(s)
- Alessondra
T. Speidel
- British Heart Foundation Centre of Research Excellence, Department of Materials, Department of Bioengineering, Institute for Biomedical
Engineering, and National Heart and Lung Institute, Imperial
College London, London, SW7 2AZ, United Kingdom
| | - Daniel J. Stuckey
- British Heart Foundation Centre of Research Excellence, Department of Materials, Department of Bioengineering, Institute for Biomedical
Engineering, and National Heart and Lung Institute, Imperial
College London, London, SW7 2AZ, United Kingdom
- Centre
for
Advanced Biomedical Imaging (CABI), University
College London, London WC1E 6DD, United Kingdom
| | - Lesley W. Chow
- British Heart Foundation Centre of Research Excellence, Department of Materials, Department of Bioengineering, Institute for Biomedical
Engineering, and National Heart and Lung Institute, Imperial
College London, London, SW7 2AZ, United Kingdom
| | - Laurence H. Jackson
- Centre
for
Advanced Biomedical Imaging (CABI), University
College London, London WC1E 6DD, United Kingdom
| | - Michela Noseda
- British Heart Foundation Centre of Research Excellence, Department of Materials, Department of Bioengineering, Institute for Biomedical
Engineering, and National Heart and Lung Institute, Imperial
College London, London, SW7 2AZ, United Kingdom
| | - Marta Abreu Paiva
- British Heart Foundation Centre of Research Excellence, Department of Materials, Department of Bioengineering, Institute for Biomedical
Engineering, and National Heart and Lung Institute, Imperial
College London, London, SW7 2AZ, United Kingdom
| | - Michael D. Schneider
- British Heart Foundation Centre of Research Excellence, Department of Materials, Department of Bioengineering, Institute for Biomedical
Engineering, and National Heart and Lung Institute, Imperial
College London, London, SW7 2AZ, United Kingdom
| | - Molly M. Stevens
- British Heart Foundation Centre of Research Excellence, Department of Materials, Department of Bioengineering, Institute for Biomedical
Engineering, and National Heart and Lung Institute, Imperial
College London, London, SW7 2AZ, United Kingdom
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Jackson LH, Vlachodimitropoulou E, Shangaris P, Roberts TA, Ryan TM, Campbell-Washburn AE, David AL, Porter JB, Lythgoe MF, Stuckey DJ. Non-invasive MRI biomarkers for the early assessment of iron overload in a humanized mouse model of β-thalassemia. Sci Rep 2017; 7:43439. [PMID: 28240317 PMCID: PMC5327494 DOI: 10.1038/srep43439] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/23/2017] [Indexed: 01/19/2023] Open
Abstract
β-thalassemia (βT) is a genetic blood disorder causing profound and life threatening anemia. Current clinical management of βT is a lifelong dependence on regular blood transfusions, a consequence of which is systemic iron overload leading to acute heart failure. Recent developments in gene and chelation therapy give hope of better prognosis for patients, but successful translation to clinical practice is hindered by the lack of thorough preclinical testing using representative animal models and clinically relevant quantitative biomarkers. Here we demonstrate a quantitative and non-invasive preclinical Magnetic Resonance Imaging (MRI) platform for the assessment of βT in the γβ0/γβA humanized mouse model of βT. Changes in the quantitative MRI relaxation times as well as severe splenomegaly were observed in the heart, liver and spleen in βT. These data showed high sensitivity to iron overload and a strong relationship between quantitative MRI relaxation times and hepatic iron content. Importantly these changes preceded the onset of iron overload cardiomyopathy, providing an early biomarker of disease progression. This work demonstrates that multiparametric MRI is a powerful tool for the assessment of preclinical βT, providing sensitive and quantitative monitoring of tissue iron sequestration and cardiac dysfunction- parameters essential for the preclinical development of new therapeutics.
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Affiliation(s)
- Laurence H Jackson
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | | | | | - Thomas A Roberts
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - Thomas M Ryan
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adrienne E Campbell-Washburn
- Laboratory of Imaging Technology, Biochemistry and Biophysics Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD, USA
| | - Anna L David
- Institute for Women's Health, University College London, London, UK
| | - John B Porter
- Department of Haematology, University College London, London, UK
| | - Mark F Lythgoe
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - Daniel J Stuckey
- Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
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Haag JE, Jackson LH. The acceptance of chaplains in mental hospitals. Am Benedictine Rev 2001; 32:328-35. [PMID: 11614159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Jackson LH. Memories of a war nurse: Princess Mary's R.A.F. Nursing Service in Europe. Hist Nurs Bull 2001; 2:28-36. [PMID: 11613862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Nelson JD, Kusmiesz H, Jackson LH, Woodman E. Treatment of Salmonella gastroenteritis with ampicillin, amoxicillin, or placebo. Pediatrics 1980; 65:1125-30. [PMID: 7375236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
In a randomized, prospective, double-blind study infants and children with uncomplicated Salmonella gastroenteritis were treated with ampicillin (15 patients), amoxicillin (15 patients), or placebo (14 patients). The dosage of antibiotics was 100 mg/kg/day in four equally divided doses given for five days. There was no significant benefit from antibiotic therapy on the duration of diarrhea (means 8.8, 7.3, and 7.2 days, respectively) or on the duration of recovery of Salmonella from stool cultures (means 41.3, 37.0, and 20.9 days, respectively). Bacteriologic relapse was not observed in placebo-treated patients but eight patients given ampicillin (53%) and eight given amoxicillin (53%) had relapse (P = .003). Salmonella isolated in relapse were still susceptible in vitro to the antibiotics. Of the 16 patients with bacteriologic relapse six (38%) had concomitant recurrence of diarrhea. It is concluded that ampicillin or amoxicillin therapy provides no benefit to patients with uncomplicated Salmonella gastroenteritis and substantially increases the risk of bacteriologic and symptomatic relapse.
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Abstract
The emergence of ampicillin-resistant Haemophilus as a clinical problem in otitis media necessitates a search for alternative, effective therapy. An orally absorbable cephalosporin derivative, cefaclor, is equally effective in vitro against ampicillin-susceptible and -resistant Haemophilus and against other bacteria that cause acute otitis media. Two dosage schedules of cefaclor (40 and 60 mg/kg/day) were evaluated in 95 infants with acute otitis media. Bacterial origin was determined by a culture of tympanocentesis fluid. Success rates using the smaller dosage were inferior to those using the larger dosage. Results of therapy for pneumococcal and Haemophilus infection with 60 mg/kg/day were comparable to those previously found with amoxicillin trihydrate or with combinations of trisulfapyrimadines with erythromycin or penicillin V. One patient with an ampicillin-resistant Haemophilus infection responded well to cefaclor and did not have a relapse. Cefaclor was well tolerated and caused an acceptably low incidence of minor, adverse effects. Cefaclor deserves further testing as a candidate for preferred status as a single-drug treatment of acute otitis media.
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Abstract
One-hundred seventy-four infants and children with acute diarrhea were treated as ambulatory patients with either ampicillin (100 mg/kg/day orally in four divided doses) or trimethoprim sulfamethoxazole (10 mg TMP and 50 mg SMX/KG/day orally in two divided doses). There were 65 patients with shigellosis. Responses of those treated with TMP/SMX and of those with susceptible Shigella treated with ampicillin were comparable. Patients with resistant organisms failed to respond to ampicillin. All Shigella, including ampicillin-resistant strains, were suseptible in vitro to TMP/SMX, and patients with ampicillin-resistant strains responded favorably to treatment with TMP/SMX. TMP/SMX appears to be the best, currently available drug for the treatment of shigellosis.
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Howard JE, Nelson JD, Clahsen J, Jackson LH. Otitis media of infancy and early childhood. A double-blind study of four treatment regimens. Am J Dis Child 1976; 130:965-70. [PMID: 8980 DOI: 10.1001/archpedi.1976.02120100055008] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A double-blind, randomized trial of four antimicrobial regimens was conducted in 383 infants and children with acute otitis media. The drugs used were penicillin V, amoxicillin trihydrate, erythromycin estolate, and erythromycin estolate with trisulfapyrimidines. Aspiration of middle ear fluid for culture was done before treatment and repeated during treatment if fluid persisted. Etiologic bacteria were most commonly pneumococci (31%) or Haemophilus sp (22%), and an additional 5% of patients had both organisms. Amoxicillin was the most effective in promoting initial response in pneumococcal infection. For Haemophilus infections, the cure rates with amoxicillin and the erythromycin-trisulfapyrimidines mixture were significantly better than with the other two regimens, and serous otitis did not occur during the follow-up period; however, new episodes of otitis were comparable in the four groups. Amoxicillin and the erythromycin estolate-trisulfapyrimidines combination appear to be somewhat more effective than penicillin V or erythromycin estolate.
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Abstract
Twenty-eight infants and children hospitalized for severe shigellosis were treated orally either with ampicillin trihydrate (100 mg/kg/day administered in divided doses every six hours) or with trimethoprim-sulfamethoxazole (trimethoprim, 10 mg; sulfamethoxazole, 50 mg/kg/day in divided doses every 12 hours) for five days. Four patients with ampicillin-resistant shigellae continued to have diarrhea and positive stool cultures during therapy. Patients with susceptible shigellae treated with ampicillin and all patients treated with trimethoprim-sulfamethoxazole responsed promptly and comparably within an average of 1.6 and 1.7 days, respectively, until stool cultures were negative, and 3.1 and 2.9 days, respectively, until diarrhea stopped. Patients with ampicillin-resistant shigellae responded to treatment with trimethoprim-sulfamethoxazole. It is concluded that trimethoprim-sulfamethoxazole is the best currently available drug for treatment of shigellosis in areas where multiple antibiotic resistance of shigellae is common.
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Jackson LH. The Preputial Glands of British Muridae. J Anat 1938; 72:458-61. [PMID: 17104713 PMCID: PMC1252400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Affiliation(s)
- L H Jackson
- Department of Zoology, University College of North Wales, Bangor
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