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@ARTICLE{Schneider:142128,
      author       = {T. M. Schneider and A. Nagel$^*$ and M. Zorn and A.
                      Wetscherek$^*$ and M. Bendszus and M. Ladd$^*$ and S.
                      Straub$^*$},
      title        = {{Q}uantitative susceptibility mapping and 23 {N}a
                      imaging-based in vitro characterization of blood clotting
                      kinetics.},
      journal      = {NMR in biomedicine},
      volume       = {31},
      number       = {6},
      issn         = {0952-3480},
      address      = {New York, NY},
      publisher    = {Wiley},
      reportid     = {DKFZ-2018-02358},
      pages        = {e3926},
      year         = {2018},
      abstract     = {Blood clotting is a fundamental biochemical process in
                      post-hemorrhagic hemostasis. Although the varying appearance
                      of coagulating blood in T1 - and T2 -weighted images is
                      widely used to qualitatively determine bleeding age, the
                      technique permits only a rough discrimination of coagulation
                      stages, and it remains difficult to distinguish acute and
                      chronic hemorrhagic stages because of low T1 - and T2
                      -weighted signal intensities in both instances. To
                      investigate new biomedical parameters for magnetic resonance
                      imaging-based characterization of blood clotting kinetics,
                      sodium imaging and quantitative susceptibility mapping (QSM)
                      were compared with conventional T1 - and T2 -weighted
                      imaging, as well as with biochemical hemolysis parameters.
                      For this purpose, a blood-filled spherical agar phantom was
                      investigated daily for 14 days, as well as after 24 days
                      at 7 T after initial preparation with fresh blood. T1 - and
                      T2 -weighted sequences, a three-dimensional (3D) gradient
                      echo sequence and a density-adapted 3D radial projection
                      reconstruction pulse sequence for 23 Na imaging were
                      applied. For hemolysis estimations, free hemoglobin and free
                      potassium concentrations were measured photometrically and
                      with the direct ion-selective electrode method,
                      respectively, in separate heparinized whole-blood samples
                      along the same timeline. Initial mean susceptibility was low
                      (0.154 ± 0.020 ppm) and increased steadily during the
                      course of coagulation to reach up to 0.570 ± 0.165 ppm.
                      The highest total sodium (NaT) values (1.02 ± 0.06
                      arbitrary units) in the clot were observed initially,
                      dropped to 0.69 ± 0.13 arbitrary units after one day and
                      increased again to initial values. Compartmentalized sodium
                      (NaS) showed a similar signal evolution, and the NaS/NaT
                      ratio steadily increased over clot evolution. QSM depicts
                      clot evolution in vitro as a process associated with
                      hemoglobin accumulation and transformation, and enables the
                      differentiation of the acute and chronic coagulation stages.
                      Sodium imaging visualizes clotting independent of
                      susceptibility and seems to correspond to clot integrity. A
                      combination of QSM and sodium imaging may enhance the
                      characterization of hemorrhage.},
      cin          = {E020},
      ddc          = {610},
      cid          = {I:(DE-He78)E020-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29694688},
      doi          = {10.1002/nbm.3926},
      url          = {https://inrepo02.dkfz.de/record/142128},
}