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      On the Subjective Acceptance during Cardiovascular Magnetic Resonance Imaging at 7.0 Tesla

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          Abstract

          Purpose

          This study examines the subjective acceptance during UHF-CMR in a cohort of healthy volunteers who underwent a cardiac MR examination at 7.0T.

          Methods

          Within a period of two-and-a-half years (January 2012 to June 2014) a total of 165 healthy volunteers (41 female, 124 male) without any known history of cardiac disease underwent UHF-CMR. For the assessment of the subjective acceptance a questionnaire was used to examine the participants experience prior, during and after the UHF-CMR examination. For this purpose, subjects were asked to respond to the questionnaire in an exit interview held immediately after the completion of the UHF-CMR examination under supervision of a study nurse to ensure accurate understanding of the questions. All questions were answered with “yes” or “no” including space for additional comments.

          Results

          Transient muscular contraction was documented in 12.7% of the questionnaires. Muscular contraction was reported to occur only during periods of scanning with the magnetic field gradients being rapidly switched. Dizziness during the study was reported by 12.7% of the subjects. Taste of metal was reported by 10.1% of the study population. Light flashes were reported by 3.6% of the entire cohort. 13% of the subjects reported side effects/observations which were not explicitly listed in the questionnaire but covered by the question about other side effects. No severe side effects as vomiting or syncope after scanning occurred. No increase in heart rate was observed during the UHF-CMR exam versus the baseline clinical examination.

          Conclusions

          This study adds to the literature by detailing the subjective acceptance of cardiovascular magnetic resonance imaging examinations at a magnetic field strength of 7.0T. Cardiac MR examinations at 7.0T are well tolerated by healthy subjects. Broader observational and multi-center studies including patient cohorts with cardiac diseases are required to gain further insights into the subjective acceptance of UHF-CMR examinations.

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          Most cited references48

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          MRI magnetic field stimulates rotational sensors of the brain.

          Vertigo in and around magnetic resonance imaging (MRI) machines has been noted for years [1, 2]. Several mechanisms have been suggested to explain these sensations [3, 4], yet without direct, objective measures, the cause is unknown. We found that all of our healthy human subjects developed a robust nystagmus while simply lying in the static magnetic field of an MRI machine. Patients lacking labyrinthine function did not. We use the pattern of eye movements as a measure of vestibular stimulation to show that the stimulation is static (continuous, proportional to static magnetic field strength, requiring neither head movement nor dynamic change in magnetic field strength) and directional (sensitive to magnetic field polarity and head orientation). Our calculations and geometric model suggest that magnetic vestibular stimulation (MVS) derives from a Lorentz force resulting from interaction between the magnetic field and naturally occurring ionic currents in the labyrinthine endolymph fluid. This force pushes on the semicircular canal cupula, leading to nystagmus. We emphasize that the unique, dual role of endolymph in the delivery of both ionic current and fluid pressure, coupled with the cupula's function as a pressure sensor, makes magnetic-field-induced nystagmus and vertigo possible. Such effects could confound functional MRI studies of brain behavior, including resting-state brain activity. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            Whole-body imaging at 7T: preliminary results.

            The objective of this study was to investigate the feasibility of whole-body imaging at 7T. To achieve this objective, new technology and methods were developed. Radio frequency (RF) field distribution and specific absorption rate (SAR) were first explored through numerical modeling. A body coil was then designed and built. Multichannel transmit and receive coils were also developed and implemented. With this new technology in hand, an imaging survey of the "landscape" of the human body at 7T was conducted. Cardiac imaging at 7T appeared to be possible. The potential for breast imaging and spectroscopy was demonstrated. Preliminary results of the first human body imaging at 7T suggest both promise and directions for further development.
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              Human cardiac 31P magnetic resonance spectroscopy at 7 tesla

              Purpose Phosphorus magnetic resonance spectroscopy (31P-MRS) affords unique insight into cardiac energetics but has a low intrinsic signal-to-noise ratio (SNR) in humans. Theory predicts an increased 31P-MRS SNR at 7T, offering exciting possibilities to better investigate cardiac metabolism. We therefore compare the performance of human cardiac 31P-MRS at 7T to 3T, and measure T1s for 31P metabolites at 7T. Methods Matched 31P-MRS data were acquired at 3T and 7T, on nine normal volunteers. A novel Look-Locker CSI acquisition and fitting approach was used to measure T1s on six normal volunteers. Results T1s in the heart at 7T were: phosphocreatine (PCr) 3.05 ± 0.41s, γ-ATP 1.82 ± 0.09s, α-ATP 1.39 ± 0.09s, β-ATP 1.02 ± 0.17s and 2,3-DPG (2,3-diphosphoglycerate) 3.05 ± 0.41s (N = 6). In the field comparison (N = 9), PCr SNR increased 2.8× at 7T relative to 3T, the Cramer-Ráo uncertainty (CRLB) in PCr concentration decreased 2.4×, the mean CRLB in PCr/ATP decreased 2.7× and the PCr/ATP SD decreased 2×. Conclusion Cardiac 31P-MRS at 7T has higher SNR and the spectra can be quantified more precisely than at 3T. Cardiac 31P T1s are shorter at 7T than at 3T. We predict that 7T will become the field strength of choice for cardiac 31P-MRS. Magn Reson Med 72:304–315, 2014. © 2013 The Authors. Magnetic Resonance in Medicine Published by Wiley Periodicals, Inc. on behalf of International Society of Medicine in Resonance. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                26 January 2015
                2015
                : 10
                : 1
                : e0117095
                Affiliations
                [1 ]Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck-Center for Molecular Medicine, Berlin, Germany
                [2 ]Experimental and Clinical Research Center (ECRC), a joint cooperation between the Charité Medical Faculty and the Max-Delbrueck-Center for Molecular Medicine, Berlin, Germany
                [3 ]HELIOS Klinikum Berlin-Buch, Dept. of Cardiology and Nephrology, 13125 Berlin, Germany
                University Hospital Essen, GERMANY
                Author notes

                Competing Interests: The authors declare that they have no competing interests with the exception of (i) Christof Thalhammer is currently a contractor and Ph.D. student with Siemens Corporate Technology, München, Germany, and (ii) Thoralf Niendorf and Jan Rieger are founders of MRI.TOOLS GmbH, Berlin, Germany. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: SK KP AG CO OW LW CT TH JR AE JSM TN. Performed the experiments: AE SK KP AG CO OW LW CT TH JR. Analyzed the data: SK KP AG CO OW LW CT TH JR AE JSM TN. Contributed reagents/materials/analysis tools: SK KP AG CO OW LW CT TH JR AE HM JSM TN. Wrote the paper: TN SK KP AG CO OW LW CT TH JR AE JSM HM. Helped to draft the questionnaire: JSM. Performed the medical informed consent discussion including a basic clinical examination prior to the UHF-CMR session: HM.

                Article
                PONE-D-14-36399
                10.1371/journal.pone.0117095
                4306482
                25621491
                7239d22a-668b-4bc5-9d87-754b098cbb03
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 13 August 2014
                : 18 December 2014
                Page count
                Figures: 3, Tables: 6, Pages: 18
                Funding
                This work was supported (in part, C.O.) by the DZHK (German Centre for Cardiovascular Research) and by the BMBF (Federal Ministry of Education and Research). This work was funded (in part, A.G.) by the Helmholtz Alliance ICEMED—Imaging and Curing Environmental Metabolic Diseases, through the Initiative and Network Fund of the Helmholtz Association (ICEMED-Project 1210251). L.W. received support by the BMBF (Federal Ministry of Education and Research, “KMU-innovativ”: Medizintechnik MED-373-046). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Custom metadata
                All the relevant data for this study is available from the http://figshare.com database ( figshare.com/s/205e6d4a552511e4856c06ec4bbcf141, http://dx.doi.org/10.6084/m9.figshare.1206313.

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