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Sample records for 3-dimensional cardiovascular magnetic

  1. Heat pulse propagation in chaotic 3-dimensional magnetic fields

    del-Castillo-Negrete, D

    2014-01-01

    Heat pulse propagation in $3$-D chaotic magnetic fields is studied by solving the parallel heat transport equation using a Lagrangian-Green's function (LG) method. The LG method provides an efficient and accurate technique that circumvents limitations of finite elements and finite difference methods. The main two problems addressed are: (i) The dependence of the radial transport on the magnetic field stochasticity (controlled by the amplitude of the perturbation, $\\epsilon$); and (ii) The role of reversed shear configurations on pulse propagation. In all the cases considered there are no magnetic flux surfaces. However, radial transport is observed to depend strongly on $\\epsilon$ due to the presence of high-order magnetic islands and Cantori that act as quasi-transport barriers that preclude the radial penetration of heat pulses within physically relevant time scale. The dependence of the magnetic field connection length, $\\ell_B$, on $\\epsilon$ is studied in detail. The decay rate of the temperature maximum...

  2. Heat pulse propagation in chaotic 3-dimensional magnetic fields

    del-Castillo-Negrete, D.; Blazevski, D.

    2014-01-01

    Heat pulse propagation in $3$-D chaotic magnetic fields is studied by solving the parallel heat transport equation using a Lagrangian-Green's function (LG) method. The LG method provides an efficient and accurate technique that circumvents limitations of finite elements and finite difference methods. The main two problems addressed are: (i) The dependence of the radial transport on the magnetic field stochasticity (controlled by the amplitude of the perturbation, $\\epsilon$); and (ii) The rol...

  3. Initial magnetic field configurations for 3-dimensional simulations of astrophysical jets

    Jorgensen, M.; R. Ouyed; Christensen, M.

    2001-01-01

    We solve, and provide analytical expressions, for current-free magnetic configurations in the context of initial setups of 3-dimensional simulations of astrophysical jets involving an accretion disk corona in hydrostatic balance around a central object. These configurations which thread through the accretion disk and its corona preserve the initial hydrostatic state. This work sets stage for future 3-dimensional jet simulations (including disk rotation and mass-load) where launching, accelera...

  4. Observation of a New Magnetic Response in 3-Dimensional Split Ring Resonators under Normal Incidence

    Chiam, S. Y.; Bettiol, A. A.; Bahou, M.; Han, J; Moser, H. O.; Watt, F

    2008-01-01

    So far, research in the field of metamaterials has been carried out largely with arrays of flat, 2-dimensional structures. Here, we report a newly identified magnetic resonance in Split Cylinder Resonators (SCRs), a 3-dimensional version of the Split Ring Resonator (SRR), which were fabricated with the Proton Beam Writing technique. Experimental and numerical results indicate a hitherto unobserved 3-dimensional resonance mode under normal incidence at about 26 THz, when the SCR depth is appro...

  5. Clinical advantage and limitation of the 3-dimensional magnetic resonance imaging of the brain

    The authors discuss practical techniques of 3-dimensional magnetic resonance images. Raw data for 3-dimensional MRI were acquired using a 3D turbo-FLASH sequence. The data were processed in the following three ways; 1) volume rendering of all the raw data, 2) segmentation of the brain from other tissue using other software and the volume rendering of all the raw data, and 3) reconstruction of 2-dimensional image of the arbitrary orientation (oblique-oblique and curvature) using multi-planar reconstruction (MPR). In addition to these basic techniques, a surgical window technique, maximum intensity projection (MIP), and skin marking using fatty acid gel in capsules can provide the following unique images; 1) surface images of the skin, skull and brain, 2) images of the arteries and the main cortical vein superimposed on the brain-surface images, and 3) surgical images simulating craniotomy. The drawbacks of 3-dimensional MRI at present are twofold; 1)it requires mini-computers, which is not always available at every clinical site, and 2) the time necessary for data processing and image reconstruction depends on the performance of the computer, but in any case the segmentation of the brain from other soft tissue is a time-consuming job, one which generally takes several hours. However, it is expected that these present limitations of 3-dimentional MRI are only temporary because fast and high cost-performance computers for this specific purpose (image processing) have recently become available. The authors stress that the most important factor which drives the development of a high cost-performance system for 3-dimensional MRI is the demand from clinicians, who realize the advantages of 3-dimensional MRI. (author)

  6. Cardiovascular magnetic resonance of the right ventricle

    Alpendurada, Francisco Diogo

    2013-01-01

    Introduction: Whilst most of the attention has been devoted to the left ventricle in cardiovascular disease, the right ventricle has been somewhat neglected. In the last decades, there has been a renewal of interest in the right ventricle, in part driven by advances in cardiovascular imaging. Methods: Cardiovascular magnetic resonance is arguably the best imaging modality for the study of the right ventricle. In this research thesis, cardiovascular magnetic resonance w...

  7. Society for Cardiovascular Magnetic Resonance guidelines for reporting cardiovascular magnetic resonance examinations

    van Rossum Albert C; Raman Subha V; McConnell Michael V; Lawson Mark A; Higgins Charles B; Friedrich Matthias G; Bogaert Jan G; Bluemke David; Hundley W Gregory; Flamm Scott; Kramer Christopher M; Nagel Eike; Neubauer Stefan

    2009-01-01

    Abstract These reporting guidelines are recommended by the Society for Cardiovascular Magnetic Resonance (SCMR) to provide a framework for healthcare delivery systems to disseminate cardiac and vascular imaging findings related to the performance of cardiovascular magnetic resonance (CMR) examinations.

  8. Cardiovascular magnetic resonance in systemic hypertension

    Maceira Alicia M; Mohiaddin Raad H

    2012-01-01

    Abstract Systemic hypertension is a highly prevalent potentially modifiable cardiovascular risk factor. Imaging plays an important role in the diagnosis of underlying causes for hypertension, in assessing cardiovascular complications of hypertension, and in understanding the pathophysiology of the disease process. Cardiovascular magnetic resonance (CMR) provides accurate and reproducible measures of ventricular volumes, mass, function and haemodynamics as well as uniquely allowing tissue char...

  9. 3-Dimensional modelling of chick embryo eye development and growth using high resolution magnetic resonance imaging.

    Goodall, Nicola; Kisiswa, Lilian; Prashar, Ankush; Faulkner, Stuart; Tokarczuk, Paweł; Singh, Krish; Erichsen, Jonathan T; Guggenheim, Jez; Halfter, Willi; Wride, Michael A

    2009-10-01

    Magnetic resonance imaging (MRI) is a powerful tool for generating 3-dimensional structural and functional image data. MRI has already proven valuable in creating atlases of mouse and quail development. Here, we have exploited high resolution MRI to determine the parameters necessary to acquire images of the chick embryo eye. Using a 9.4 Tesla (400 MHz) high field ultra-shielded and refrigerated magnet (Bruker), MRI was carried out on paraformaldehyde-fixed chick embryos or heads at E4, E6, E8, and E10. Image data were processed using established and custom packages (MRICro, ImageJ, ParaVision, Bruker and mri3dX). Voxel dimensions ranged from 62.5 microm to 117.2 microm. We subsequently used the images obtained from the MRI data in order to make precise measurements of chick embryo eye surface area, volume and axial length from E4 to E10. MRI was validated for accurate sizing of ocular tissue features by direct comparison with previously published literature. Furthermore, we demonstrate the utility of high resolution MRI for making accurate measurements of morphological changes due to experimental manipulation of chick eye development, thereby facilitating a better understanding of the effects on chick embryo eye development and growth of such manipulations. Chondroitin sulphate or heparin were microinjected into the vitreous cavity of the right eyes of each of 3 embryos at E5. At E10, embryos were fixed and various eye parameters (volume, surface area, axial length and equatorial diameter) were determined using MRI and normalised with respect to the un-injected left eyes. Statistically significant alterations in eye volume (p < 0.05; increases with chondroitin sulphate and decreases with heparin) and changes in vitreous homogeneity were observed in embryos following microinjection of glycosaminoglycans. Furthermore, in the heparin-injected eyes, significant disturbances at the vitreo-retinal boundary were observed as well as retinal folding and detachment

  10. Cardiovascular magnetic resonance in carotid atherosclerotic disease

    Chen Huijun; Wang Jinnan; Li Rui; Ferguson Marina S; Kerwin William S; Dong Li; Canton Gador; Hatsukami Thomas S; Yuan Chun

    2009-01-01

    Abstract Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR) of the carotid vessel wall is one promi...

  11. Editorial Commentary: Single-Image Slice Magnetic Resonance Imaging Assessments Do Not Predict 3-Dimensional Muscle Volume.

    Brand, Jefferson C

    2016-01-01

    No single-image magnetic resonance imaging (MRI) assessment-Goutallier classification, Fuchs classification, or cross-sectional area-is predictive of whole-muscle volume or fatty atrophy of the supraspinatus or infraspinatus. Rather, 3-dimensional MRI measurement of whole-muscle volume and fat-free muscle volume is required and is associated with shoulder strength, which is clinically relevant. Three-dimensional MRI may represent a new gold standard for assessment of the rotator cuff musculature using imaging and may help to predict the feasibility of repair of a rotator cuff tear as well as the postoperative outcome. Unfortunately, 3-dimensional MRI assessment of muscle volume is labor intensive and is not widely available for clinical use. PMID:26743416

  12. Myocardial tissue tagging with cardiovascular magnetic resonance

    Bluemke David A; Osman Nael F; Cheng Susan; Shehata Monda L; Lima João AC

    2009-01-01

    Abstract Cardiovascular magnetic resonance (CMR) is currently the gold standard for assessing both global and regional myocardial function. New tools for quantifying regional function have been recently developed to characterize early myocardial dysfunction in order to improve the identification and management of individuals at risk for heart failure. Of particular interest is CMR myocardial tagging, a non-invasive technique for assessing regional function that provides a detailed and compreh...

  13. Cardiovascular magnetic resonance in pulmonary hypertension

    Bradlow William M; R Gibbs J Simon; Mohiaddin Raad H

    2012-01-01

    Abstract Pulmonary hypertension represents a group of conditions characterized by higher than normal pulmonary artery pressures. Despite improved treatments, outcomes in many instances remain poor. In recent years, there has been growing interest in the use of Cardiovascular Magnetic Resonance (CMR) in patients with pulmonary hypertension. This technique offers certain advantages over other imaging modalities since it is well suited to the assessment of the right ventricle and the proximal pu...

  14. Quantitative cardiovascular magnetic resonance for molecular imaging

    Lanza Gregory M; Caruthers Shelton D; Winter Patrick M; Wickline Samuel A

    2010-01-01

    Abstract Cardiovascular magnetic resonance (CMR) molecular imaging aims to identify and map the expression of important biomarkers on a cellular scale utilizing contrast agents that are specifically targeted to the biochemical signatures of disease and are capable of generating sufficient image contrast. In some cases, the contrast agents may be designed to carry a drug payload or to be sensitive to important physiological factors, such as pH, temperature or oxygenation. In this review, examp...

  15. Cardiovascular magnetic resonance imaging - a pictorial review

    Vijay Dahya; Spottiswoode, Bruce S.

    2010-01-01

    Cardiovascular magnetic resonance imaging (CMR) is a powerful problem-solving tool and arguably offers the most comprehensive assessment of cardiac morphology and function, as well as the opportunity of rebuilding the bridge between cardiologists and radiologists. The role of CMR-trained imaging physicists is also valuable, and many CMR centres harmoniously incorporate these three sub-specialty fields. This paper comprises an overview of several CMR techniques, outlining both the strengths...

  16. Cardiovascular magnetic resonance imaging - a pictorial review

    Vijay Dahya

    2010-12-01

    Full Text Available Cardiovascular magnetic resonance imaging (CMR is a powerful problem-solving tool and arguably offers the most comprehensive assessment of cardiac morphology and function, as well as the opportunity of rebuilding the bridge between cardiologists and radiologists. The role of CMR-trained imaging physicists is also valuable, and many CMR centres harmoniously incorporate these three sub-specialty fields. This paper comprises an overview of several CMR techniques, outlining both the strengths and limitations of the modality.

  17. Metal organic framework derived magnetically separable 3-dimensional hierarchical Ni@C nanocomposites: Synthesis and adsorption properties

    Song, Yixuan; Qiang, Tingting; Ye, Ming; Ma, Qiuyang; Fang, Zhen

    2015-12-01

    Design an effective absorbent that has high surface area, and perfect recyclable is imperative for pollution elimination. Herein, we report a facile two-step strategy to fabricate magnetically separable 3-dimensional (3D) hierarchical carbon-coated nickel (Ni@C) nanocomposites by calcinating nickel based metal organic framework (Ni3(OH)2(C8H4O4)2(H2O)4). SEM and TEM images illuminate that the nanocomposites were constructed by 8 nm nickel nanoparticle encapsulated in 3D flake like carbon. The specific surface area of the obtained nanocomposites is up to 120.38 m2 g-1. Room temperature magnetic measurement indicates the nanocomposites show soft magnetism property, which endows the nanocomposites with an ideal fast magnetic separable property. The maximum adsorption capacity of the nanocomposites for rhodamine B is 84.5 mg g-1. Furthermore, the nanocomposites also exhibit a high adsorption capacity for heavy metal ions. The adsorbent can be very easily separated from the solution by using a common magnet without exterior energy. The as-prepared Ni@C nanocomposites can apply in waste water treatment on a large-scale as a new adsorbent with high efficiency and excellent recyclability.

  18. Open and disconnected magnetic field lines within coronal mass ejections in the solar wind: Evidence for 3-dimensional reconnection

    Gosling, J. T.; Birn, J.; McComas, D. J.; Phillips, J. L.; Hesse, M.

    1995-01-01

    Measurements of suprathermal electron fluxes in the solar wind at energies greater than approximatley 80 eV indicate that magnetic field lines within coronal mass ejections. CMEs, near and beyond 1 AU are normally connected to the Sun at both ends. However, a preliminary reexamination of events previously identified as CMEs in the ISEE 3 data reveals that about 1/4 of all such events contain limited regions where field lines appear to be either connected to the Sun at only one end or connected to the outer heliosphere at both ends. Similar intervals of open and disconnected field lines within CMEs have been identified in the Ulysses observations. We believe that these anomalous field topologies within CMEs are most naturally interpreted in terms of 3-dimensional reconnection behind CMEs close to the Sun. Such reconnection also provides a natural explanation both for the flux rope topology of many CMEs as well as the coronal loops formed during long-duration solar soft X ray events. Although detailed numerical simulations of 3-dimensional reconnection behind CMEs are not yet available, such simulations have been done for the qualitatively similar geometry that prevails within the geomagnetic tail. Those simulations of plasmoid formation in the geomagnetic tail do produce the mixture of field topologies within plasmoids discussed here for CMEs.

  19. Complications after liver transplantation: evaluation with magnetic resonance imaging, magnetic resonance cholangiography, and 3-dimensional contrast-enhanced magnetic resonance angiography in a single session

    To evaluate a comprehensive magnetic resonance imaging (MRI) protocol as noninvasive diagnostic modality for simultaneous detection of parenchymal, biliary, and vascular complications after liver transplantation. Fifty-two liver transplant recipients suspected to have parenchymal, biliary, and (or) vascular complications underwent our MRI protocol at 1.5T unit using a phased array coil. After preliminary acquisition of axial T1w and T2w sequences, magnetic resonance cholangiography (MRC) was performed through a breath-hold, thin- and thick-slab, single-shot T2w sequence in the coronal plane. Contrast-enhanced magnetic resonance angiography (CEMRA) was obtained using a 3-dimensional coronal spoiled gradient-echo sequence, which enabled acquisition of 32 partitions 2.0 mm thick. A fixed dose of 20 ml gadobenate dimeglumine was administered at 2 mL/s. A post-contrast T1w sequence was also performed. Two observers in conference reviewed source images and 3-dimensional reconstructions to determine the presence of parenchymal, biliary, and vascular complications. MRI findings were correlated with surgery, endoscopic retrograde cholangiography (ERC), biopsy, digital subtraction angiography (DSA), and imaging follow-up. MRI revealed abnormal findings in 32 out of 52 patients (61%), including biliary complications (anastomotic and nonanastomotic strictures, and lithiasis) in 31, vascular disease (hepatic artery stenosis and thrombosis) in 9, and evidence of hepatic abscess and hematoma in 2. ERC confirmed findings of MRC in 30 cases, but suggested disease underestimation in 2. DSA confirmed 7 magnetic resonance angiogram (MRA) findings, but suggested disease overestimation in 2. MRI combined with MRC and CEMRA can provide a comprehensive assessment of parenchymal, biliary, and vascular complications in most recipients of liver transplantation. (author)

  20. Complications after liver transplantation: evaluation with magnetic resonance imaging, magnetic resonance cholangiography, and 3-dimensional contrast-enhanced magnetic resonance angiography in a single session

    Boraschi, P.; Donati, F.; Gigoni, R. [Pisa Univ. Hospital, Second Dept. of Radiology, Pisa (Italy)], E-mail: p.boraschi@do.med.unipi.it; Salemi, S. [Univ. of Pisa, Diagnostic and Interventional Radiology, Pisa (Italy); Urbani, L.; Filipponi, F. [Univ. of Pisa, Liver Transplant Unit of the Dept. of Oncology, Transplants and Advanced Technologies in Medicine, Pisa (Italy); Falaschi, F. [Pisa Univ. Hospital, Second Dept. of Radiology, Pisa (Italy); Bartolozzi, C. [Univ. of Pisa, Diagnostic and Interventional Radiology, Pisa (Italy)

    2008-12-15

    To evaluate a comprehensive magnetic resonance imaging (MRI) protocol as noninvasive diagnostic modality for simultaneous detection of parenchymal, biliary, and vascular complications after liver transplantation. Fifty-two liver transplant recipients suspected to have parenchymal, biliary, and (or) vascular complications underwent our MRI protocol at 1.5T unit using a phased array coil. After preliminary acquisition of axial T{sub 1}w and T{sub 2}w sequences, magnetic resonance cholangiography (MRC) was performed through a breath-hold, thin- and thick-slab, single-shot T{sub 2}w sequence in the coronal plane. Contrast-enhanced magnetic resonance angiography (CEMRA) was obtained using a 3-dimensional coronal spoiled gradient-echo sequence, which enabled acquisition of 32 partitions 2.0 mm thick. A fixed dose of 20 ml gadobenate dimeglumine was administered at 2 mL/s. A post-contrast T{sub 1}w sequence was also performed. Two observers in conference reviewed source images and 3-dimensional reconstructions to determine the presence of parenchymal, biliary, and vascular complications. MRI findings were correlated with surgery, endoscopic retrograde cholangiography (ERC), biopsy, digital subtraction angiography (DSA), and imaging follow-up. MRI revealed abnormal findings in 32 out of 52 patients (61%), including biliary complications (anastomotic and nonanastomotic strictures, and lithiasis) in 31, vascular disease (hepatic artery stenosis and thrombosis) in 9, and evidence of hepatic abscess and hematoma in 2. ERC confirmed findings of MRC in 30 cases, but suggested disease underestimation in 2. DSA confirmed 7 magnetic resonance angiogram (MRA) findings, but suggested disease overestimation in 2. MRI combined with MRC and CEMRA can provide a comprehensive assessment of parenchymal, biliary, and vascular complications in most recipients of liver transplantation. (author)

  1. Cardiovascular magnetic resonance in carotid atherosclerotic disease

    Chen Huijun

    2009-12-01

    Full Text Available Abstract Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR of the carotid vessel wall is one promising modality in the evaluation of patients with carotid atherosclerotic disease. Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis. Although carotid vessel wall CMR has not been widely used to screen for carotid atherosclerotic disease, many trials support its potential for this indication. This review summarizes the current state of knowledge regarding carotid vessel wall CMR and its potential clinical application for management of carotid atherosclerotic disease.

  2. Cardiovascular magnetic resonance in hypertrophic cardiomyopathy

    Shiozaki, Afonso Akio; Parga, Jose Rodrigues; Arteaga, Edmundo; Rochitte, Carlos Eduardo [Sao Paulo Univ. (USP), SP (Brazil). Instituto do Coracao. Setor de Tomografia Computarizada e Ressonancia Magnetica Cardiovascular]. E-mail: rochitte@incor.usp.br; Kim, Raymond J. [Duke Cardiovascular Magnetic Resonance Center, Durham, NC (United States); Tassi, Eduardo Marinho [Diagnosticos da America S.A., Rio de Janeiro, RJ (Brazil). Sector of Cardiovascular Magnetic Resonance and Computed Tomography

    2007-03-15

    Hypertrophic cardiomyopathy (HCM) is the most frequent genetic cardiac disease that causes sudden death in young people, with an incidence of 1:500 adults. The routinely used criteria for worst prognosis have limited sensitivity and specificity. Thus, the estimated risk of evolving to dilated cardiomyopathy or sudden death is somewhat inaccurate, leading to management uncertainty of HCM patients. Therefore, an accurate noninvasive method for the diagnosis of HCM with prognostic value is of great importance. In the last years, Cardiovascular Magnetic Resonance (CMR) emerged not only as a diagnostic tool, but also as a study with prognostic values, by characterizing myocardial fibrosis with great accuracy in HCM patients. Additionally, CMR identifies the types of hypertrophy, analyses the ventricular function, estimates the intraventricular gradient and allows the determination of differential diagnosis. Moreover, CMR can uniquely access myocardial fibrosis in HCM. (author)

  3. Cardiovascular Magnetic Resonance in Marfan syndrome

    Dormand, Helen; Mohiaddin, Raad H

    2013-01-01

    This review provides an overview of Marfan syndrome with an emphasis on cardiovascular complications and cardiovascular imaging. Both pre- and post-operative imaging is addressed with an explanation of surgical management. All relevant imaging modalities are discussed with a particular focus on cardiovascular MR.

  4. Cardiovascular magnetic resonance with an MR compatible pacemaker

    Bhandiwad Anita R; Cummings Kristopher W; Crowley Michael; Woodard Pamela K

    2013-01-01

    Abstract Magnetic resonance imaging (MRI) within FDA guidelines for the MRI-conditional pacemaker precludes placing the heart at the center of the magnet’s bore. This in effect appears to preclude cardiovascular MR. In this manuscript, we describe a protocol for cardiovascular MR of patients with a Revo pacemaker system while operating within FDA guidelines, and the first US case of cardiovascular MR in a patient with a Revo MRI-conditional pacing system despite position constraints.

  5. Cardiovascular magnetic resonance in pericardial diseases

    Francone Marco

    2009-05-01

    Full Text Available Abstract The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the epidemiology of constrictive pericarditis has been noted. Accurate decision making is crucial taking into account the significant morbidity and mortality caused by complicated pericardial diseases, and the potential benefit of therapeutic interventions. Imaging herein has an important role, and cardiovascular magnetic resonance (CMR is definitely one of the most versatile modalities to study the pericardium. It fuses excellent anatomic detail and tissue characterization with accurate evaluation of cardiac function and assessment of the haemodynamic consequences of pericardial constraint on cardiac filling. This review focuses on the current state of knowledge how CMR can be used to study the most common pericardial diseases.

  6. Image Quality of the 3 Dimensional Phase-Contrast Technique in an Intracranial Magnetic Resonance Angiography with Artifacts Caused by Orthodontic Devices: A Comparison with 3 Dimensional Time-of-Flight Technique

    To evaluate the degree of image distortion caused by orthodontic devices during a intracranial magnetic resonance angiography (MRA), and to determine the effectiveness of the 3 dimensional phase-contrast (3D PC). Subjects were divided into group A (n = 20) wearing a home-made orthodontic device, and group B (n = 10) with an actual orthodontic device. A 3.0T MR scanner was used, applying 3D time-of-flight (TOF) and 3D PC. Two board-certified radiologists evaluated images independently based on a four point scale classifying segments of the circle of Willis. Magnetic susceptibility variations and contrast-to-noise ratio (CNR) on maximum intensity projection images were measured. In group A, scores of the 3D TOF and 3D PC were 2.84 ± 0.1 vs. 2.88 ± 0.1 (before) and 1.8 ± 0.4 vs 2.83 ± 0.1 (after wearing device), respectively. In group B, the scores of 3D TOF and 3D PC were 1.86 ± 0.43 and 2.81 ± 0.15 (p = 0.005), respectively. Magnetic susceptibility variations showed meaningful results after wearing the device (p = 0.0001). CNRs of the 3D PC before and after wearing device were 142.9 ± 6.6 vs. 140.8 ± 7.2 (p = 0.7507), respectively. In the 3D TOF, CNRs were 324.8 ± 25.4 vs. 466.3 ± 41.7 (p = 0.0001). The 3D PC may be a solution method for distorted images by magnetic susceptibility in the intracranial MRA compared with 3D TOF.

  7. Late gadolinium enhanced cardiovascular magnetic resonance in Becker muscular dystrophy

    Varghese, A; Pennell, D J

    2004-01-01

    Becker muscular dystrophy is a rare cause of dilated cardiomyopathy. A case of Becker muscular dystrophy is reviewed in which cardiovascular magnetic resonance showed previously unreported findings of extensive mid-myocardial late gadolinium enhancement. Similar detection of late gadolinium enhancement in conjunction with other uses of cardiovascular magnetic resonance may contribute significantly to the diagnosis and management of patients with this unusual and important diagnosis.

  8. Interventional cardiovascular magnetic resonance: still tantalizing

    Saikus Christina E; Kocaturk Ozgur; Guttman Michael A; Faranesh Anthony Z; Ratnayaka Kanishka; Lederman Robert J

    2008-01-01

    Abstract The often touted advantages of MR guidance remain largely unrealized for cardiovascular interventional procedures in patients. Many procedures have been simulated in animal models. We argue these opportunities for clinical interventional MR will be met in the near future. This paper reviews technical and clinical considerations and offers advice on how to implement a clinical-grade interventional cardiovascular MR (iCMR) laboratory. We caution that this reflects our personal view of ...

  9. 3-DIMENSIONAL MAGNETIC-RESONANCE-IMAGING OF THE INNER-EAR IN IDIOPATHIC SUDDEN SENSORINEURAL HEARING-LOSS

    ALBERS, FWJ; DEMUYNCK, KMNP; CASSELMAN, JW

    1994-01-01

    Five patients with idiopathic sudden sensorineural hearing loss (ISSHL) were examined by a combination of high-resolution computed tomography and special magnetic resonance imaging techniques. By three-dimensional constructive interference in steady state magnetic resonance imaging excellent visuali

  10. Cardiovascular magnetic resonance in wet beriberi

    Giri Shivraman; Smith Sakima; Velez Michael R; Essa Essa; Raman Subha V; Gumina Richard J

    2011-01-01

    Abstract The clinical presentation of beriberi can be quite varied. In the extreme form, profound cardiovascular involvement leads to circulatory collapse and death. This case report is of a 72 year-old male who was admitted to the Neurology inpatient ward with progressive bilateral lower extremity weakness and parasthesia. He subsequently developed pulmonary edema and high output cardiac failure requiring intubation and blood pressure support. With the constellation of peripheral neuropathy,...

  11. Cardiovascular magnetic resonance physics for clinicians: part I

    Ridgway John P

    2010-01-01

    Abstract There are many excellent specialised texts and articles that describe the physical principles of cardiovascular magnetic resonance (CMR) techniques. There are also many texts written with the clinician in mind that provide an understandable, more general introduction to the basic physical principles of magnetic resonance (MR) techniques and applications. There are however very few texts or articles that attempt to provide a basic MR physics introduction that is tailored for clinician...

  12. Cardiovascular magnetic resonance findings in a case of Danon disease

    Kosieradzka Agnieszka; Walczak Ewa; Kuch Marek; Kownacki Lukasz; Piotrowska-Kownacka Dorota; Fidzianska Anna; Krolicki Leszek

    2009-01-01

    Abstract Danon disease is a rare X-linked dominant lysosomal glycogen storage disease that can lead to severe ventricular hypertrophy and heart failure. We report a case of Danon disease with cardiac involvement evaluated with cardiovascular magnetic resonance, including late gadolinium enhancement and perfusion studies.

  13. High field magnetic resonance imaging of rodents in cardiovascular research.

    Vanhoutte, Laetitia; Gerber, Bernhard L; Gallez, Bernard; Po, Chrystelle; Magat, Julie; Jean-Luc, Balligand; Feron, Olivier; Moniotte, Stéphane

    2016-07-01

    Transgenic and gene knockout rodent models are primordial to study pathophysiological processes in cardiovascular research. Over time, cardiac MRI has become a gold standard for in vivo evaluation of such models. Technical advances have led to the development of magnets with increasingly high field strength, allowing specific investigation of cardiac anatomy, global and regional function, viability, perfusion or vascular parameters. The aim of this report is to provide a review of the various sequences and techniques available to image mice on 7-11.7 T magnets and relevant to the clinical setting in humans. Specific technical aspects due to the rise of the magnetic field are also discussed. PMID:27287250

  14. Technical competence in cardiovascular magnetic resonance and computed tomography; Competencia tecnica em ressonancia e tomografia cardiovascular

    Fernandes, Juliano Lara; Shiozaki, Afonso Akio; Azevedo Filho, Clerio Francisco de; Rochitte, Carlos Eduardo; Pinto, Ibraim Marciarelli Francisco; Lopes, Marly Maria Uellendahl; Schvartzman, Paulo Roberto, E-mail: jlaraf@fcm.unicamp.br [Universidade de Campinas (UNICAMP/GERT) SP (Brazil). Grupo de Estudo em Ressonancia e Tomografia Cardiovascular

    2009-10-15

    Cardiovascular magnetic resonance and computed tomography have evolved as very practical and useful techniques applied in clinical cardiology. Due to their rapid acceptance in the cardiology community and widespread use, training of both cardiologists and radiologists on this subspecialty has not been homogeneous so far. This in part explains significant differences observed in the diverse background found in today’s practicing physicians who execute these exams. In order to guide training facilities as well as both payers, contractors and general cardiologists ordering the exam, this document provides a minimum standard that should be accomplished by all physicians who pursue education in the field and for those who already practice in it. The clinical competences listed in this statement are by no means thorough but should be required by all those involved in cardiovascular magnetic resonance and computed tomography as the customary requirements for current and future practitioners. (author)

  15. Exploration of the structural features and magnetic behaviour in a novel 3-dimensional interpenetrating Co(II)-based framework

    Soumyabrata Goswami; Amit Kumar Mondal; Sanjit Konar

    2015-02-01

    A new Co(II)-based three-dimensional (3D) framework having the molecular formula [Co(C4O4)(4-bpmh))H2O)2]n·2nH2O·2nMeOH·(1)(4-bpmh = N, N-bis-pyridin-4-ylmethylene-hydrazine) has been synthesized using a mixed ligand system and characterized by elemental analysis, IR spectroscopy, thermogravimetric analysis, single crystal X-ray diffraction and variable temperature magnetic study. The framework is constructed by the bridging squarate (C4O2−4) and N, N-bis-pyridin-4-ylmethylene-hydrazine (4-bpmh) ligands and interpenetration of the 2D grid-like frameworks at definite angles gives rise to 2D→3D inclined polycatenation with sql/Shubnikov tetragonal plane net topology. Extensive non-covalent interactions (H-bonding as well as $\\cdots$ interactions) are also observed which stabilises the 3D arrangement. Additionally, complex 1 contains 1D channels of large dimensions (10.91 × 11.78 Å2) that runs along the b-axis. Variable temperature DC magnetic susceptibility study reveals dominant spin–orbit coupling effect typical of the 4T1g ground state of octahedral high-spin Co(II) ion at a higher temperature range.

  16. Technical competence in cardiovascular magnetic resonance and computed tomography

    Cardiovascular magnetic resonance and computed tomography have evolved as very practical and useful techniques applied in clinical cardiology. Due to their rapid acceptance in the cardiology community and widespread use, training of both cardiologists and radiologists on this subspecialty has not been homogeneous so far. This in part explains significant differences observed in the diverse background found in today’s practicing physicians who execute these exams. In order to guide training facilities as well as both payers, contractors and general cardiologists ordering the exam, this document provides a minimum standard that should be accomplished by all physicians who pursue education in the field and for those who already practice in it. The clinical competences listed in this statement are by no means thorough but should be required by all those involved in cardiovascular magnetic resonance and computed tomography as the customary requirements for current and future practitioners. (author)

  17. Cardiovascular magnetic resonance physics for clinicians: part II

    Biglands John D; Radjenovic Aleksandra; Ridgway John P

    2012-01-01

    Abstract This is the second of two reviews that is intended to cover the essential aspects of cardiovascular magnetic resonance (CMR) physics in a way that is understandable and relevant to clinicians using CMR in their daily practice. Starting with the basic pulse sequences and contrast mechanisms described in part I, it briefly discusses further approaches to accelerate image acquisition. It then continues by showing in detail how the contrast behaviour of black blood fast spin echo and bri...

  18. The diagnosis of hypertrophic cardiomyopathy by cardiovascular magnetic resonance

    Noureldin Radwa A; Liu Songtao; Nacif Marcelo S; Judge Daniel P; Halushka Marc K; Abraham Theodore P; Ho Carolyn; Bluemke David A

    2012-01-01

    Abstract Hypertrophic cardiomyopathy (HCM) is the most common genetic disease of the heart. HCM is characterized by a wide range of clinical expression, ranging from asymptomatic mutation carriers to sudden cardiac death as the first manifestation of the disease. Over 1000 mutations have been identified, classically in genes encoding sarcomeric proteins. Noninvasive imaging is central to the diagnosis of HCM and cardiovascular magnetic resonance (CMR) is increasingly used to characterize morp...

  19. Dressler's syndrome demonstrated by late gadolinium enhancement cardiovascular magnetic resonance

    Kovac Jan; Khoo Jeffrey; Steadman Christopher D; McCann Gerry P

    2009-01-01

    Abstract A 49-year old patient presented late with an anterolateral ST-elevation myocardial infarction and was treated with rescue angioplasty to an occluded left anterior descending artery. Her recovery was complicated by low-grade pyrexia and raised inflammatory markers. Cardiovascular magnetic resonance 5 weeks after the acute presentation showed transmural infarction and global late gadolinium enhancement of the pericardium in keeping with Dressler's syndrome.

  20. Feasibility of perfusion cardiovascular magnetic resonance in paediatric patients

    Kellenberger Christian; Schwitter Juerg; Buechel Emanuela; Balmer Christian; Bauersfeld Urs

    2009-01-01

    Abstract Aims As coronary artery disease may also occur during childhood in some specific conditions, we sought to assess the feasibility and accuracy of perfusion cardiovascular magnetic resonance (CMR) in paediatric patients. Methods and results First-pass perfusion CMR studies were performed under pharmacological stress with adenosine and by using a hybrid echo-planar pulse sequence with slice-selective saturation recovery preparation. Fifty-six perfusion CMR examinations were performed in...

  1. T2-weighted cardiovascular magnetic resonance in acute cardiac disease

    Eitel Ingo; Friedrich Matthias G

    2011-01-01

    Abstract Cardiovascular magnetic resonance (CMR) using T2-weighted sequences can visualize myocardial edema. When compared to previous protocols, newer pulse sequences with substantially improved image quality have increased its clinical utility. The assessment of myocardial edema provides useful incremental diagnostic and prognostic information in a variety of clinical settings associated with acute myocardial injury. In patients with acute chest pain, T2-weighted CMR is able to identify acu...

  2. Iatrogenic intrapericardial diaphragmatic hernia diagnosed by cardiovascular magnetic resonance

    Entrikin Daniel W; Chughtai Haroon L; Drafts Brandon C

    2010-01-01

    Abstract Intrapericardial diaphragmatic hernias are very uncommon and are most typically caused by high-force blunt trauma. Other iatrogenic causes such as prior surgical formation of a pericardial window have been described, but are exceedingly rare. We present a case of an intrapericardial diaphragmatic hernia in a patient with a prior pericardial window in which the diagnosis was unclear using conventional imaging modalities, but was established using cardiovascular magnetic resonance.

  3. Value of black blood T2* cardiovascular magnetic resonance

    Carpenter John Paul; Smith Gillian C; He Taigang; Alam Mohammed H; Firmin David N; Pennell Dudley J

    2011-01-01

    Abstract Purpose To assess whether black blood T2* cardiovascular magnetic resonance is superior to conventional white blood imaging of cardiac iron in patients with thalassaemia major (TM). Materials and methods We performed both conventional white blood and black blood T2* CMR sequences in 100 TM patients to determine intra and inter-observer variability and presence of artefacts. In 23 patients, 2 separate studies of both techniques were performed to assess interstudy reproducibility. Resu...

  4. Quantification of myocardial perfusion by cardiovascular magnetic resonance

    Jerosch-Herold Michael

    2010-01-01

    Abstract The potential of contrast-enhanced cardiovascular magnetic resonance (CMR) for a quantitative assessment of myocardial perfusion has been explored for more than a decade now, with encouraging results from comparisons with accepted "gold standards", such as microspheres used in the physiology laboratory. This has generated an increasing interest in the requirements and methodological approaches for the non-invasive quantification of myocardial blood flow by CMR. This review provides a...

  5. Heart valve disease: investigation by cardiovascular magnetic resonance

    Myerson Saul G

    2012-01-01

    Abstract Cardiovascular magnetic resonance (CMR) has become a valuable investigative tool in many areas of cardiac medicine. Its value in heart valve disease is less well appreciated however, particularly as echocardiography is a powerful and widely available technique in valve disease. This review highlights the added value that CMR can bring in valve disease, complementing echocardiography in many areas, but it has also become the first-line investigation in some, such as pulmonary valve di...

  6. Visualization of coronary venous anatomy by cardiovascular magnetic resonance

    Crean Andrew; Plein Sven; Younger John F; Ball Stephen G; Greenwood John P

    2009-01-01

    Abstract Background Coronary venous imaging with whole-heart cardiovascular magnetic resonance (CMR) angiography has recently been described using developmental pulse sequences and intravascular contrast agents. However, the practical utility of coronary venous imaging will be for patients with heart failure in whom cardiac resynchronisation therapy (CRT) is being considered. As such complementary information on ventricular function and myocardial viability will be required. The aim of this s...

  7. Review of Journal of Cardiovascular Magnetic Resonance 2009

    Neubauer S; Mohiaddin RH; Manning WJ; Kilner PJ; Firmin DN; Pennell DJ; Prasad SK

    2010-01-01

    Abstract There were 56 articles published in the Journal of Cardiovascular Magnetic Resonance in 2009. The editors were impressed with the high quality of the submissions, of which our acceptance rate was about 40%. In accordance with open-access publishing, the articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. We have therefore chosen to briefly summarise the papers in this article for quick reference for our readers in broad...

  8. Review of Journal of Cardiovascular Magnetic Resonance 2011

    Pennell Dudley J; Carpenter John; Firmin David N; Kilner Philip J; Mohiaddin Raad H; Prasad Sanjay K

    2012-01-01

    Abstract There were 83 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2011, which is an 11% increase in the number of articles since 2010. The quality of the submissions continues to increase. The editors had been delighted with the 2010 JCMR Impact Factor of 4.33, although this fell modestly to 3.72 for 2011. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenc...

  9. Multidirectional flow analysis by cardiovascular magnetic resonance in aneurysm development following repair of aortic coarctation

    Stalder Aurelien F

    2008-06-01

    Full Text Available Abstract Aneurysm formation is a life-threatening complication after operative therapy in coarctation. The identification of patients at risk for the development of such secondary pathologies is of high interest and requires a detailed understanding of the link between vascular malformation and altered hemodynamics. The routine morphometric follow-up by magnetic resonance angiography is a well-established technique. However, the intrinsic sensitivity of magnetic resonance (MR towards motion offers the possibility to additionally investigate hemodynamic consequences of morphological changes of the aorta. We demonstrate two cases of aneurysm formation 13 and 35 years after coarctation surgery based on a Waldhausen repair with a subclavian patch and a Vosschulte repair with a Dacron patch, respectively. Comprehensive flow visualization by cardiovascular MR (CMR was performed using a flow-sensitive, 3-dimensional, and 3-directional time-resolved gradient echo sequence at 3T. Subsequent analysis included the calculation of a phase contrast MR angiography and color-coded streamline and particle trace 3D visualization. Additional quantitative evaluation provided regional physiological information on blood flow and derived vessel wall parameters such as wall shear stress and oscillatory shear index. The results highlight the individual 3D blood-flow patterns associated with the different vascular pathologies following repair of aortic coarctation. In addition to known factors predisposing for aneurysm formation after surgical repair of coarctation these findings indicate the importance of flow sensitive CMR to follow up hemodynamic changes with respect to the development of vascular disease.

  10. Cardiovascular magnetic resonance parameters of atherosclerotic plaque burden improve discrimination of prior major adverse cardiovascular events

    Bansilal Sameer

    2009-04-01

    Full Text Available Abstract Aims Patients with prior major cardiovascular or cerebrovascular events (MACE are more likely to have future recurrent events independent of traditional cardiovascular disease risk factors. The purpose of this study was to determine if patients with traditional risk factors and prior MACE had increased cardiovascular magnetic resonance (CMR plaque burden measures compared to patients with risk factors but no prior events. Methods and Results Black blood carotid and thoracic aorta images were obtained from 195 patients using a rapid extended coverage turbo spin echo sequence. CMR measures of plaque burden were obtained by tracing lumen and outer vessel wall contours. Patients with prior MACE had significantly higher MR plaque burden (wall thickness, wall area and normalized wall index in carotids and thoracic aorta compared to those without prior MACE (Wall thickness carotids: 1.03 ± 0.03 vs. 0.93± 0.03, p = 0.001; SD wall thickness carotids: 0.137 ± 0.0008 vs. 0.102 ± 0.0004, p Conclusion A greater plaque burden and plaque eccentricity is prevalent among patients with prior MACE.

  11. Review of Journal of Cardiovascular Magnetic Resonance 2012

    Pennell, Dudley J; Baksi, A. John; Carpenter, John Paul; Firmin, David N; Kilner, Philip J; Mohiaddin, Raad H; Prasad, Sanjay K.

    2013-01-01

    There were 90 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2012, which is an 8% increase in the number of articles since 2011. The quality of the submissions continues to increase. The editors are delighted to report that the 2011 JCMR Impact Factor (which is published in June 2012) has risen to 4.44, up from 3.72 for 2010 (as published in June 2011), a 20% increase. The 2011 impact factor means that the JCMR papers that were published in 2009 and 2010 were...

  12. Review of Journal of Cardiovascular Magnetic Resonance 2009.

    Pennell, DJ; Firmin, DN; Kilner, PJ; Manning, WJ; Mohiaddin, RH; Neubauer, S.; Prasad, SK

    2010-01-01

    There were 56 articles published in the Journal of Cardiovascular Magnetic Resonance in 2009. The editors were impressed with the high quality of the submissions, of which our acceptance rate was about 40%. In accordance with open-access publishing, the articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. We have therefore chosen to briefly summarise the papers in this article for quick reference for our readers in broad areas of...

  13. Review of Journal of Cardiovascular Magnetic Resonance 2014

    Pennell, D J; Baksi, A. J.; Prasad, S. K.; Raphael, C. E.; Kilner, P. J.; Mohiaddin, R. H.; Alpendurada, F.; Babu-Narayan, S V; Schneider, J.; Firmin, D. N.

    2015-01-01

    There were 102 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2014, which is a 6 % decrease on the 109 articles published in 2013. The quality of the submissions continues to increase. The 2013 JCMR Impact Factor (which is published in June 2014) fell to 4.72 from 5.11 for 2012 (as published in June 2013). The 2013 impact factor means that the JCMR papers that were published in 2011 and 2012 were cited on average 4.72 times in 2013. The impact factor undergoe...

  14. Review of journal of cardiovascular magnetic resonance 2010

    Pennell, Dudley J; Firmin, David N; Kilner, Philip J; Manning, Warren J; Mohiaddin, Raad H; Prasad, Sanjay K.

    2011-01-01

    There were 75 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2010, which is a 34% increase in the number of articles since 2009. The quality of the submissions continues to increase, and the editors were delighted with the recent announcement of the JCMR Impact Factor of 4.33 which showed a 90% increase since last year. Our acceptance rate is approximately 30%, but has been falling as the number of articles being submitted has been increasing. In accordance w...

  15. Review of Journal of Cardiovascular Magnetic Resonance 2011

    Pennell, Dudley J; Carpenter, John Paul; Firmin, David N; Kilner, Philip J; Mohiaddin, Raad H; Prasad, Sanjay K.

    2012-01-01

    There were 83 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2011, which is an 11% increase in the number of articles since 2010. The quality of the submissions continues to increase. The editors had been delighted with the 2010 JCMR Impact Factor of 4.33, although this fell modestly to 3.72 for 2011. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by hig...

  16. Review of Journal of Cardiovascular Magnetic Resonance 2013

    Pennell, Dudley John; Baksi, Arun John; Kilner, Philip John; Mohiaddin, Raad Hashem; Prasad, Sanjay Kumar; Alpendurada, Francisco; Babu-Narayan, Sonya Vidya; Neubauer, Stefan; Firmin, David Nigel

    2014-01-01

    There were 109 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2013, which is a 21% increase on the 90 articles published in 2012. The quality of the submissions continues to increase. The editors are delighted to report that the 2012 JCMR Impact Factor (which is published in June 2013) has risen to 5.11, up from 4.44 for 2011 (as published in June 2012), a 15% increase and taking us through the 5 threshold for the first time. The 2012 impact factor means that...

  17. Review of Journal of Cardiovascular Magnetic Resonance 2009

    Pennell, DJ; Firmin, DN; Kilner, PJ; Mohiaddin, RH; Neubauer, S.; Prasad, SK; Manning, Warren J

    2010-01-01

    There were 56 articles published in the Journal of Cardiovascular Magnetic Resonance in 2009. The editors were impressed with the high quality of the submissions, of which our acceptance rate was about 40%. In accordance with open-access publishing, the articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. We have therefore chosen to briefly summarise the papers in this article for quick reference for our readers in broad areas of...

  18. Review of journal of cardiovascular magnetic resonance 2010

    Kilner Philip J; Firmin David N; Pennell Dudley J; Manning Warren J; Mohiaddin Raad H; Prasad Sanjay K

    2011-01-01

    Abstract There were 75 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2010, which is a 34% increase in the number of articles since 2009. The quality of the submissions continues to increase, and the editors were delighted with the recent announcement of the JCMR Impact Factor of 4.33 which showed a 90% increase since last year. Our acceptance rate is approximately 30%, but has been falling as the number of articles being submitted has been increasing. In acc...

  19. Review of journal of cardiovascular magnetic resonance 2010.

    Pennell, Dudley J; Firmin, David N; Kilner, Philip J; Manning, Warren J; Mohiaddin, Raad H; Prasad, Sanjay K

    2011-01-01

    There were 75 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2010, which is a 34% increase in the number of articles since 2009. The quality of the submissions continues to increase, and the editors were delighted with the recent announcement of the JCMR Impact Factor of 4.33 which showed a 90% increase since last year. Our acceptance rate is approximately 30%, but has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. Last year for the first time, the Editors summarized the papers for the readership into broad areas of interest or theme, which we felt would be useful to practitioners of cardiovascular magnetic resonance (CMR) so that you could review areas of interest from the previous year in a single article in relation to each other and other recent JCMR articles 1. This experiment proved very popular with a very high rate of downloading, and therefore we intend to continue this review annually. The papers are presented in themes and comparison is drawn with previously published JCMR papers to identify the continuity of thought and publication in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication. PMID:21914185

  20. Review of journal of cardiovascular magnetic resonance 2010

    Kilner Philip J

    2011-09-01

    Full Text Available Abstract There were 75 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR in 2010, which is a 34% increase in the number of articles since 2009. The quality of the submissions continues to increase, and the editors were delighted with the recent announcement of the JCMR Impact Factor of 4.33 which showed a 90% increase since last year. Our acceptance rate is approximately 30%, but has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. Last year for the first time, the Editors summarized the papers for the readership into broad areas of interest or theme, which we felt would be useful to practitioners of cardiovascular magnetic resonance (CMR so that you could review areas of interest from the previous year in a single article in relation to each other and other recent JCMR articles 1. This experiment proved very popular with a very high rate of downloading, and therefore we intend to continue this review annually. The papers are presented in themes and comparison is drawn with previously published JCMR papers to identify the continuity of thought and publication in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.

  1. Review of Journal of Cardiovascular Magnetic Resonance 2009.

    Pennell, D J; Firmin, D N; Kilner, P J; Manning, W J; Mohiaddin, R H; Neubauer, S; Prasad, S K

    2010-01-01

    There were 56 articles published in the Journal of Cardiovascular Magnetic Resonance in 2009. The editors were impressed with the high quality of the submissions, of which our acceptance rate was about 40%. In accordance with open-access publishing, the articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. We have therefore chosen to briefly summarise the papers in this article for quick reference for our readers in broad areas of interest, which we feel will be useful to practitioners of cardiovascular magnetic resonance (CMR). In some cases where it is considered useful, the articles are also put into the wider context with a short narrative and recent CMR references. It has been a privilege to serve as the Editor of the JCMR this past year. I hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication. PMID:20302618

  2. Review of Journal of Cardiovascular Magnetic Resonance 2009

    Neubauer S

    2010-03-01

    Full Text Available Abstract There were 56 articles published in the Journal of Cardiovascular Magnetic Resonance in 2009. The editors were impressed with the high quality of the submissions, of which our acceptance rate was about 40%. In accordance with open-access publishing, the articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. We have therefore chosen to briefly summarise the papers in this article for quick reference for our readers in broad areas of interest, which we feel will be useful to practitioners of cardiovascular magnetic resonance (CMR. In some cases where it is considered useful, the articles are also put into the wider context with a short narrative and recent CMR references. It has been a privilege to serve as the Editor of the JCMR this past year. I hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.

  3. Cardiovascular magnetic resonance activity in the United Kingdom: a survey on behalf of the british society of cardiovascular magnetic resonance

    Dargie Henry J

    2011-10-01

    Full Text Available Abstract Background The indications, complexity and capabilities of cardiovascular magnetic resonance (CMR have rapidly expanded. Whether actual service provision and training have developed in parallel is unknown. Methods We undertook a systematic telephone and postal survey of all public hospitals on behalf of the British Society of Cardiovascular Magnetic Resonance to identify all CMR providers within the United Kingdom. Results Of the 60 CMR centres identified, 88% responded to a detailed questionnaire. Services are led by cardiologists and radiologists in equal proportion, though the majority of current trainees are cardiologists. The mean number of CMR scans performed annually per centre increased by 44% over two years. This trend was consistent across centres of different scanning volumes. The commonest indication for CMR was assessment of heart failure and cardiomyopathy (39%, followed by coronary artery disease and congenital heart disease. There was striking geographical variation in CMR availability, numbers of scans performed, and distribution of trainees. Centres without on site scanning capability refer very few patients for CMR. Just over half of centres had a formal training programme, and few performed regular audit. Conclusion The number of CMR scans performed in the UK has increased dramatically in just two years. Trainees are mainly located in large volume centres and enrolled in cardiology as opposed to radiology training programmes.

  4. Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy

    Pauly John M

    2008-04-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR can provide quantitative data of the myocardial tissue utilizing high spatial and temporal resolution along with exquisite tissue contrast. Previous studies have correlated myocardial scar tissue with the occurrence of ventricular arrhythmia. This study was conducted to evaluate whether characterization of myocardial infarction by CMR can predict cardiovascular events in patients with ischemic cardiomyopathy (ICM. Results We consecutively studied 86 patients with ICM (LVEF Conclusion Quantification of the scar volume and scar percentage by CMR is superior to LVEDV, LVESV, and LVEF in prognosticating the future likelihood of the development of cardiovascular events in patients with ICM.

  5. 3 - Dimensional Body Measurement Technology

    ZHOU Xu-dong; LI Yan-mei

    2002-01-01

    3 - dimensional body measurement technology, the basis of developing high technology in industry, accelerates digital development of aplparel industry. This paper briefly introduces the history of 3 - dimensional body measurement technology, and recounts the principle and primary structure of some types of 3 - dimensional automatic body measurement system. With this understanding, it discusses prospect of 3- dimensional CAD and virtual technology used in apparel industry.

  6. 3-Dimensional Magnetic Resonance Spectroscopic Imaging at 3 Tesla for Early Response Assessment of Glioblastoma Patients During External Beam Radiation Therapy

    Purpose: To evaluate the utility of 3-dimensional magnetic resonance (3D-MR) proton spectroscopic imaging for treatment planning and its implications for early response assessment in glioblastoma multiforme. Methods and Materials: Eighteen patients with newly diagnosed, histologically confirmed glioblastoma had 3D-MR proton spectroscopic imaging (MRSI) along with T2 and T1 gadolinium-enhanced MR images at simulation and at boost treatment planning after 17 to 20 fractions of radiation therapy. All patients received standard radiation therapy (RT) with concurrent temozolomide followed by adjuvant temozolomide. Imaging for response assessment consisted of MR scans every 2 months. Progression-free survival was defined by the criteria of MacDonald et al. MRSI images obtained at initial simulation were analyzed for choline/N-acetylaspartate ratios (Cho/NAA) on a voxel-by-voxel basis with abnormal activity defined as Cho/NAA ≥2. These images were compared on anatomically matched MRSI data collected after 3 weeks of RT. Changes in Cho/NAA between pretherapy and third-week RT scans were tested using Wilcoxon matched-pairs signed rank tests and correlated with progression-free survival, radiation dose and location of recurrence using Cox proportional hazards regression. Results: After a median follow-up time of 8.6 months, 50% of patients had experienced progression based on imaging. Patients with a decreased or stable mean or median Cho/NAA values had less risk of progression (P<.01). Patients with an increase in mean or median Cho/NAA values at the third-week RT scan had a significantly greater chance of early progression (P<.01). An increased Cho/NAA at the third-week MRSI scan carried a hazard ratio of 2.72 (95% confidence interval, 1.10-6.71; P=.03). Most patients received the prescription dose of RT to the Cho/NAA ≥2 volume, where recurrence most often occurred. Conclusion: Change in mean and median Cho/NAA detected at 3 weeks was a significant predictor of

  7. 3-Dimensional Magnetic Resonance Spectroscopic Imaging at 3 Tesla for Early Response Assessment of Glioblastoma Patients During External Beam Radiation Therapy

    Muruganandham, Manickam; Clerkin, Patrick P. [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Smith, Brian J. [Department of Biostatistics, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Anderson, Carryn M.; Morris, Ann [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Capizzano, Aristides A.; Magnotta, Vincent [Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); McGuire, Sarah M.; Smith, Mark C.; Bayouth, John E. [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Buatti, John M., E-mail: john-buatti@uiowa.edu [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States)

    2014-09-01

    Purpose: To evaluate the utility of 3-dimensional magnetic resonance (3D-MR) proton spectroscopic imaging for treatment planning and its implications for early response assessment in glioblastoma multiforme. Methods and Materials: Eighteen patients with newly diagnosed, histologically confirmed glioblastoma had 3D-MR proton spectroscopic imaging (MRSI) along with T2 and T1 gadolinium-enhanced MR images at simulation and at boost treatment planning after 17 to 20 fractions of radiation therapy. All patients received standard radiation therapy (RT) with concurrent temozolomide followed by adjuvant temozolomide. Imaging for response assessment consisted of MR scans every 2 months. Progression-free survival was defined by the criteria of MacDonald et al. MRSI images obtained at initial simulation were analyzed for choline/N-acetylaspartate ratios (Cho/NAA) on a voxel-by-voxel basis with abnormal activity defined as Cho/NAA ≥2. These images were compared on anatomically matched MRSI data collected after 3 weeks of RT. Changes in Cho/NAA between pretherapy and third-week RT scans were tested using Wilcoxon matched-pairs signed rank tests and correlated with progression-free survival, radiation dose and location of recurrence using Cox proportional hazards regression. Results: After a median follow-up time of 8.6 months, 50% of patients had experienced progression based on imaging. Patients with a decreased or stable mean or median Cho/NAA values had less risk of progression (P<.01). Patients with an increase in mean or median Cho/NAA values at the third-week RT scan had a significantly greater chance of early progression (P<.01). An increased Cho/NAA at the third-week MRSI scan carried a hazard ratio of 2.72 (95% confidence interval, 1.10-6.71; P=.03). Most patients received the prescription dose of RT to the Cho/NAA ≥2 volume, where recurrence most often occurred. Conclusion: Change in mean and median Cho/NAA detected at 3 weeks was a significant predictor of

  8. Non-cardiovascular findings in clinical cardiovascular magnetic resonance imaging in children

    Ghadimi Mahani, Maryam [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Morani, Ajaykumar C. [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Lu, Jimmy C.; Dorfman, Adam L. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, Ann Arbor, MI (United States); Fazeli Dehkordy, Soudabeh [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Providence Hospital and Medical Centers, Department of Graduate Medical Education, Southfield, MI (United States); Jeph, Sunil [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Geisinger Medical Center, Department of Radiology, Danville, PA (United States); Agarwal, Prachi P. [University of Michigan Health System, Department of Radiology, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States)

    2016-04-15

    With increasing use of pediatric cardiovascular MRI, it is important for all imagers to become familiar with the spectrum of non-cardiovascular imaging findings that can be encountered. This study aims to ascertain the prevalence and nature of these findings in pediatric cardiovascular MRIs performed at our institution. We retrospectively evaluated reports of all cardiovascular MRI studies performed at our institute from January 2008 to October 2012 in patients younger than18 years. Most studies (98%) were jointly interpreted by a pediatric cardiologist and a radiologist. We reviewed the electronic medical records of all cases with non-cardiovascular findings, defined as any imaging finding outside the cardiovascular system. Non-cardiovascular findings were classified into significant and non-significant, based on whether they were known at the time of imaging or they required additional workup or a change in management. In 849 consecutive studies (mean age 9.7 ± 6.3 years), 145 non-cardiovascular findings were found in 140 studies (16.5% of total studies). Overall, 51.0% (74/145) of non-cardiovascular findings were in the abdomen, 30.3% (44/145) were in the chest, and 18.6% (27/145) were in the spine. A total of 19 significant non-cardiovascular findings were observed in 19 studies in individual patients (2.2% of total studies, 47% male, mean age 5.9 ± 6.7 years). Significant non-cardiovascular findings included hepatic adenoma, arterially enhancing focal liver lesions, asplenia, solitary kidney, pelvicaliectasis, renal cystic diseases, gastric distention, adrenal hemorrhage, lung hypoplasia, air space disease, bronchial narrowing, pneumomediastinum and retained surgical sponge. Non-cardiovascular findings were seen in 16.5% of cardiovascular MRI studies in children, of which 2.2% were clinically significant findings. Prevalence and nature of these non-cardiovascular findings are different from those reported in adults. Attention to these findings is important

  9. Multi-color magnetic particle imaging for cardiovascular interventions

    Haegele, Julian; Vaalma, Sarah; Panagiotopoulos, Nikolaos; Barkhausen, Jörg; Vogt, Florian M.; Borgert, Jörn; Rahmer, Jürgen

    2016-08-01

    Magnetic particle imaging (MPI) uses magnetic fields to visualize the spatial distribution of superparamagnetic iron oxide nanoparticles (SPIOs). Guidance of cardiovascular interventions is seen as one possible application of MPI. To safely guide interventions, the vessel lumen as well as all required interventional devices have to be visualized and be discernible from each other. Until now, different tracer concentrations were used for discerning devices from blood in MPI, because only one type of SPIO could be imaged at a time. Recently, it was shown for 3D MPI that it is possible to separate different signal sources in one volume of interest, i.e. to visualize and discern different SPIOs or different binding states of the same SPIO. The approach was termed multi-color MPI. In this work, the use of multi-color MPI for differentiation of a SPIO coated guide wire (Terumo Radifocus 0.035″) from the lumen of a vessel phantom filled with diluted Resovist is demonstrated. This is achieved by recording dedicated system functions of the coating material containing solid Resovist and of liquid Resovist, which allows separation of their respective signal in the image reconstruction process. Assigning a color to the different signal sources results in a differentiation of guide wire and vessel phantom lumen into colored images.

  10. Cardiothoracic Applications of 3-dimensional Printing.

    Giannopoulos, Andreas A; Steigner, Michael L; George, Elizabeth; Barile, Maria; Hunsaker, Andetta R; Rybicki, Frank J; Mitsouras, Dimitris

    2016-09-01

    Medical 3-dimensional (3D) printing is emerging as a clinically relevant imaging tool in directing preoperative and intraoperative planning in many surgical specialties and will therefore likely lead to interdisciplinary collaboration between engineers, radiologists, and surgeons. Data from standard imaging modalities such as computed tomography, magnetic resonance imaging, echocardiography, and rotational angiography can be used to fabricate life-sized models of human anatomy and pathology, as well as patient-specific implants and surgical guides. Cardiovascular 3D-printed models can improve diagnosis and allow for advanced preoperative planning. The majority of applications reported involve congenital heart diseases and valvular and great vessels pathologies. Printed models are suitable for planning both surgical and minimally invasive procedures. Added value has been reported toward improving outcomes, minimizing perioperative risk, and developing new procedures such as transcatheter mitral valve replacements. Similarly, thoracic surgeons are using 3D printing to assess invasion of vital structures by tumors and to assist in diagnosis and treatment of upper and lower airway diseases. Anatomic models enable surgeons to assimilate information more quickly than image review, choose the optimal surgical approach, and achieve surgery in a shorter time. Patient-specific 3D-printed implants are beginning to appear and may have significant impact on cosmetic and life-saving procedures in the future. In summary, cardiothoracic 3D printing is rapidly evolving and may be a potential game-changer for surgeons. The imager who is equipped with the tools to apply this new imaging science to cardiothoracic care is thus ideally positioned to innovate in this new emerging imaging modality. PMID:27149367

  11. Value of black blood T2* cardiovascular magnetic resonance

    Carpenter John Paul

    2011-03-01

    Full Text Available Abstract Purpose To assess whether black blood T2* cardiovascular magnetic resonance is superior to conventional white blood imaging of cardiac iron in patients with thalassaemia major (TM. Materials and methods We performed both conventional white blood and black blood T2* CMR sequences in 100 TM patients to determine intra and inter-observer variability and presence of artefacts. In 23 patients, 2 separate studies of both techniques were performed to assess interstudy reproducibility. Results Cardiac T2* values ranged from 4.5 to 43.8 ms. The mean T2* values were not different between black blood and white blood acquisitions (20.5 vs 21.6 ms, p = 0.26. Compared with the conventional white blood diastolic acquisition, the coefficient of variance of the black blood CMR technique was superior for intra-observer reproducibility (1.47% vs 4.23%, p Conclusions Black blood T2* CMR has superior reproducibility and reduced imaging artefacts for the assessment of cardiac iron, in comparison with the conventional white blood technique, which make it the preferred technique for clinical practice.

  12. Feasibility of perfusion cardiovascular magnetic resonance in paediatric patients

    Kellenberger Christian

    2009-01-01

    Full Text Available Abstract Aims As coronary artery disease may also occur during childhood in some specific conditions, we sought to assess the feasibility and accuracy of perfusion cardiovascular magnetic resonance (CMR in paediatric patients. Methods and results First-pass perfusion CMR studies were performed under pharmacological stress with adenosine and by using a hybrid echo-planar pulse sequence with slice-selective saturation recovery preparation. Fifty-six perfusion CMR examinations were performed in 47 patients. The median age was 12 years (1 month-18 years, and weight 42.8 kg (2.6-82 kg. General anaesthesia was required in 18 patients. Mean examination time was 67 ± 19 min. Diagnostic image quality was obtained in 54/56 examinations. In 23 cases the acquisition parameters were adapted to patient's size. Perfusion CMR was abnormal in 16 examinations. The perfusion defects affected the territory of the left anterior descending coronary artery in 11, of the right coronary artery in 3, and of the circumflex coronary artery in 2 cases. Compared to coronary angiography, perfusion CMR showed a sensitivity of 87% (CI 52-97% and a specificity of 95% (CI 79-99%. Conclusion In children, perfusion CMR is feasible and accurate. In very young children (less than 1 year old, diagnostic image quality may be limited.

  13. Alterations in vascular function in primary aldosteronism: a cardiovascular magnetic resonance imaging study

    Mark, P. B.; Boyle, S; Zimmerli, L U; McQuarrie, E.P.; Delles, C.; Freel, E. M.

    2014-01-01

    Introduction: Excess aldosterone is associated with increased cardiovascular risk. Aldosterone has a permissive effect on vascular fibrosis. Cardiovascular magnetic resonance imaging (CMR) allows study of vascular function by measuring aortic distensibility. We compared aortic distensibility in primary aldosteronism (PA), essential hypertension (EH) and normal controls and explored the relationship between aortic distensibility and pulse wave velocity (PWV). Methods: We studied PA (n=14)...

  14. Cardiovascular magnetic resonance of quinticuspid aortic valve with aortic regurgitation and dilated ascending aorta

    Zhang Zhaoqi; Zhang Lijun; Meng Yanfeng; Wang Yongmei; Yang Xiaoming

    2009-01-01

    Abstract We report a rare case of a quinticuspid aortic valve associated with regurgitation and dilation of the ascending aorta, which was diagnosed and post-surgically followed up by cardiovascular magnetic resonance and dual source computed tomography.

  15. Cardiovascular magnetic resonance physics for clinicians: part I

    Ridgway John P

    2010-11-01

    Full Text Available Abstract There are many excellent specialised texts and articles that describe the physical principles of cardiovascular magnetic resonance (CMR techniques. There are also many texts written with the clinician in mind that provide an understandable, more general introduction to the basic physical principles of magnetic resonance (MR techniques and applications. There are however very few texts or articles that attempt to provide a basic MR physics introduction that is tailored for clinicians using CMR in their daily practice. This is the first of two reviews that are intended to cover the essential aspects of CMR physics in a way that is understandable and relevant to this group. It begins by explaining the basic physical principles of MR, including a description of the main components of an MR imaging system and the three types of magnetic field that they generate. The origin and method of production of the MR signal in biological systems are explained, focusing in particular on the two tissue magnetisation relaxation properties (T1 and T2 that give rise to signal differences from tissues, showing how they can be exploited to generate image contrast for tissue characterisation. The method most commonly used to localise and encode MR signal echoes to form a cross sectional image is described, introducing the concept of k-space and showing how the MR signal data stored within it relates to properties within the reconstructed image. Before describing the CMR acquisition methods in detail, the basic spin echo and gradient pulse sequences are introduced, identifying the key parameters that influence image contrast, including appearances in the presence of flowing blood, resolution and image acquisition time. The main derivatives of these two pulse sequences used for cardiac imaging are then described in more detail. Two of the key requirements for CMR are the need for data acquisition first to be to be synchronised with the subject's ECG and to be

  16. Cardiovascular magnetic resonance physics for clinicians: part I.

    Ridgway, John P

    2010-01-01

    There are many excellent specialised texts and articles that describe the physical principles of cardiovascular magnetic resonance (CMR) techniques. There are also many texts written with the clinician in mind that provide an understandable, more general introduction to the basic physical principles of magnetic resonance (MR) techniques and applications. There are however very few texts or articles that attempt to provide a basic MR physics introduction that is tailored for clinicians using CMR in their daily practice. This is the first of two reviews that are intended to cover the essential aspects of CMR physics in a way that is understandable and relevant to this group. It begins by explaining the basic physical principles of MR, including a description of the main components of an MR imaging system and the three types of magnetic field that they generate. The origin and method of production of the MR signal in biological systems are explained, focusing in particular on the two tissue magnetisation relaxation properties (T1 and T2) that give rise to signal differences from tissues, showing how they can be exploited to generate image contrast for tissue characterisation. The method most commonly used to localise and encode MR signal echoes to form a cross sectional image is described, introducing the concept of k-space and showing how the MR signal data stored within it relates to properties within the reconstructed image. Before describing the CMR acquisition methods in detail, the basic spin echo and gradient pulse sequences are introduced, identifying the key parameters that influence image contrast, including appearances in the presence of flowing blood, resolution and image acquisition time. The main derivatives of these two pulse sequences used for cardiac imaging are then described in more detail. Two of the key requirements for CMR are the need for data acquisition first to be to be synchronised with the subject's ECG and to be fast enough for the subject

  17. Review of Journal of Cardiovascular Magnetic Resonance 2013.

    Pennell, Dudley John; Baksi, Arun John; Kilner, Philip John; Mohiaddin, Raad Hashem; Prasad, Sanjay Kumar; Alpendurada, Francisco; Babu-Narayan, Sonya Vidya; Neubauer, Stefan; Firmin, David Nigel

    2014-01-01

    There were 109 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2013, which is a 21% increase on the 90 articles published in 2012. The quality of the submissions continues to increase. The editors are delighted to report that the 2012 JCMR Impact Factor (which is published in June 2013) has risen to 5.11, up from 4.44 for 2011 (as published in June 2012), a 15% increase and taking us through the 5 threshold for the first time. The 2012 impact factor means that the JCMR papers that were published in 2010 and 2011 were cited on average 5.11 times in 2012. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication. PMID:25475898

  18. Review of Journal of Cardiovascular Magnetic Resonance 2011.

    Pennell, Dudley J; Carpenter, John Paul; Firmin, David N; Kilner, Philip J; Mohiaddin, Raad H; Prasad, Sanjay K

    2012-01-01

    There were 83 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2011, which is an 11% increase in the number of articles since 2010. The quality of the submissions continues to increase. The editors had been delighted with the 2010 JCMR Impact Factor of 4.33, although this fell modestly to 3.72 for 2011. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, we remain very pleased with the progress of the journal's impact over the last 5 years. Our acceptance rate is approximately 25%, and has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors feel it is useful to summarize the papers for the readership into broad areas of interest or theme, which we feel would be useful, so that areas of interest from the previous year can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication. PMID:23158097

  19. Review of Journal of Cardiovascular Magnetic Resonance 2014.

    Pennell, D J; Baksi, A J; Prasad, S K; Raphael, C E; Kilner, P J; Mohiaddin, R H; Alpendurada, F; Babu-Narayan, S V; Schneider, J; Firmin, D N

    2015-01-01

    There were 102 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2014, which is a 6% decrease on the 109 articles published in 2013. The quality of the submissions continues to increase. The 2013 JCMR Impact Factor (which is published in June 2014) fell to 4.72 from 5.11 for 2012 (as published in June 2013). The 2013 impact factor means that the JCMR papers that were published in 2011 and 2012 were cited on average 4.72 times in 2013. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality papers to JCMR for publication. PMID:26589839

  20. Review of Journal of Cardiovascular Magnetic Resonance 2012.

    Pennell, Dudley J; Baksi, A John; Carpenter, John Paul; Firmin, David N; Kilner, Philip J; Mohiaddin, Raad H; Prasad, Sanjay K

    2013-01-01

    There were 90 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2012, which is an 8% increase in the number of articles since 2011. The quality of the submissions continues to increase. The editors are delighted to report that the 2011 JCMR Impact Factor (which is published in June 2012) has risen to 4.44, up from 3.72 for 2010 (as published in June 2011), a 20% increase. The 2011 impact factor means that the JCMR papers that were published in 2009 and 2010 were cited on average 4.44 times in 2011. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is approximately 25%, and has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication. PMID:24006874

  1. Review of Journal of Cardiovascular Magnetic Resonance 2011

    Pennell Dudley J

    2012-11-01

    Full Text Available Abstract There were 83 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR in 2011, which is an 11% increase in the number of articles since 2010. The quality of the submissions continues to increase. The editors had been delighted with the 2010 JCMR Impact Factor of 4.33, although this fell modestly to 3.72 for 2011. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, we remain very pleased with the progress of the journal's impact over the last 5 years. Our acceptance rate is approximately 25%, and has been falling as the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors feel it is useful to summarize the papers for the readership into broad areas of interest or theme, which we feel would be useful, so that areas of interest from the previous year can be reviewed in a single article in relation to each other and other recent JCMR articles [1]. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.

  2. Whole body cardiovascular magnetic resonance imaging to stratify symptomatic and asymptomatic atherosclerotic burden in patients with isolated cardiovascular disease

    Weir-McCall, Jonathan R.; Duce, Suzanne L.; Gandy, Stephen J.; Matthew, Shona Z.; Martin, Patricia; Cassidy, Deirdre B.; McCormick, Lynne; Belch, Jill J. F.; Struthers, Allan D.; Helen M Colhoun; Houston, J. Graeme

    2016-01-01

    Background: The aim of this study was to use whole body cardiovascular magnetic resonance imaging (WB CVMR) to assess the heart and arterial network in a single examination, so as to describe the burden of atherosclerosis and subclinical disease in participants with symptomatic single site vascular disease. Methods: 64 patients with a history of symptomatic single site vascular disease (38 coronary artery disease (CAD), 9 cerebrovascular disease, 17 peripheral arterial disease (PAD)) underwen...

  3. Whole body cardiovascular magnetic resonance imaging to stratify symptomatic and asymptomatic atherosclerotic burden in patients with isolated cardiovascular disease

    Weir-McCall, Jonathan R.; Duce, Suzanne L.; Gandy, Stephen J.; Matthew, Shona Z.; Martin, Patricia; Cassidy, Deirdre B.; McCormick, Lynne; Belch, Jill J. F.; Struthers, Allan D.; Helen M Colhoun; Houston, J. Graeme

    2016-01-01

    Background The aim of this study was to use whole body cardiovascular magnetic resonance imaging (WB CVMR) to assess the heart and arterial network in a single examination, so as to describe the burden of atherosclerosis and subclinical disease in participants with symptomatic single site vascular disease. Methods 64 patients with a history of symptomatic single site vascular disease (38 coronary artery disease (CAD), 9 cerebrovascular disease, 17 peripheral arterial disease (PAD)) underwent ...

  4. 3-dimensional polymer gel dosimetry

    Recently developed techniques in conformal radiotherapy demand special properties of radiation dosimeters. Polymer gel dosimeter evaluated by nuclear magnetic resonance (NMR) is promising tool which can be used for measuring rather complicated 3-dimensional dose distributions with required precision of ± 5 %. This system is based on radiation-induced polymerisation and cross-linking of acrylic monomers which are uniformly dispersed in aqueous gel. The formation of cross-linked polymers in the irradiated regions of the gel increases the NMR relaxation rates of neighbouring water protons. BANG-2 type polymer gel was prepared. The composition of gel dosimeter was as follows: 3 % N,N'-methylene-bisacrylamide, 3 % acrylic acid, 1 % sodium hydroxide, 5 % gelatine, and 88 % water, where all percentages are by weight. The dosimeters in glass vessels were homogeneously irradiated by 60Co gamma photons in a Gammacell 220 unit and by 4 MV, 6 MV and 18 MV X ray photons on Varian Clinac 600C and 2100 C linear accelerators by doses in the range of 0-50 Gy. Evaluation of dosimeters was performed on Siemens EXPERT 1 T and Siemens VISION 1,5 T scanners. Multi-echo CPMG sequence with 16 echoes was used for the evaluation of T2-relaxation times in irradiated gel dosimeters. The dependence of 1/T2 response of dosimeters was studied on following factors: absorbed dose, energy of applied radiation, temperature during NMR evaluation, time since irradiation to NMR evaluation and strength of the magnetic field. An exponential dependence of 1/T2 response on absorbed dose in the range of 0-50 Gy was observed, in the range 0-10 Gy the data could be fitted by a linear function. There was observed no dependence of 1/T2 response on: energy (for three different photon energies used in this study), strength of magnetic field of NMR scanner, time from irradiation of the dosimeters to NMR evaluation. Increase of gel dosimeter 1/T2 response with the decrease of the temperature during NMR evaluation

  5. Cardiovascular magnetic resonance imaging findings in children with myocarditis

    Liu Guiying; Yang Xi; Su Ying; Xu Jimin; Wen Zhaoying

    2014-01-01

    Background Myocarditis is a common,potentially life-threatening disease that presents a wide rang of symptoms in children,as an important underlying etiology of other myocardial diseases such as dilated and arrhythmogenic right ventricular cardiomyopathy.The incidence of nonfatal myocarditis is probably greater than that of the one actually diagnosed,which is the result of the challenges of establishing the diagnosis in standard clinical settings.Currently,no single clinical or imaging finding confirms the diagnosis of myocarditis with absolute certainty.Historically,clinical exam,electrocardiogram (ECG),serology and echocardiography had an unsatisfactory diagnostic accuracy in myocarditis.Endomyocardial biopsy remains as a widely accepted standard,but may not be suitable for every patient,especially for those with less severe disease.Our aim was to find the changes in cardiovascular magnetic resonance (CMR) imaging of children with myocarditis diagnosed by clinical criteria.Methods We studied 25 children (18 male,7 female; aged from 5-17 years) with diagnosed myocarditis by clinical criteria.CMR included function analyses,T2-weighted imaging,T1-weighted imaging before and after i.v.gadolinium injection (early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE)).Results The T2 ratio was elevated in 21 children (84%,11 in anterolateral (44%),5 in inferolateral (20%),and 5 in septum (20%)),EGE was present in 9 children (36%,3 in anterolateral (12%),4 in inferolateral (20%),and 2 in septum (8%)),and LGE was present in 5 children (20%,2 in anterolateral (8%),1 in inferolateral (4%),1 in septum (4%),and 1 in midwall of left ventricular (LV) wall).In 9 children (36%),two (or more) out of three sequences (T2,EGE,LGE) were abnormal.Conclusions The CMR findings in children with clinically diagnosed myocarditis vary within the groups,including regional or global myocardial signal increase in T2-weighted images,EGE and LGE in T1

  6. Cardiovascular magnetic resonance imaging of hypoplastic left heart syndrome in children

    Cardiovascular magnetic resonance imaging (CMR) plays an important complementary role to echocardiography and conventional angiography in the evaluation of hypoplastic left heart syndrome. This imaging modality is particularly useful for assessing cardiovascular postsurgical changes, extracardiac vascular anatomy, ventricular and valvular function, and a variety of complications. The purpose of this article is to provide a contemporary review of the role of CMR in the management of untreated and surgically palliated hypoplastic left heart syndrome in children. (orig.)

  7. Cardiovascular magnetic resonance at 3.0T: Current state of the art

    Gharib Ahmed M; Sharma Puneet; Delfino Jana G; Oshinski John N; Pettigrew Roderic I

    2010-01-01

    Abstract There are advantages to conducting cardiovascular magnetic resonance (CMR) studies at a field strength of 3.0 Telsa, including the increase in bulk magnetization, the increase in frequency separation of off-resonance spins, and the increase in T1 of many tissues. However, there are significant challenges to routinely performing CMR at 3.0T, including the reduction in main magnetic field homogeneity, the increase in RF power deposition, and the increase in susceptibility-based artifac...

  8. Dobutamine stress cardiovascular magnetic resonance at 3 Tesla

    Klein C

    2008-10-01

    Full Text Available Abstract Purpose The assessment of inducible wall motion abnormalities during high-dose dobutamine-stress cardiovascular magnetic resonance (DCMR is well established for the identification of myocardial ischemia at 1.5 Tesla. Its feasibility at higher field strengths has not been reported. The present study was performed to prospectively determine the feasibility and diagnostic accuracy of DCMR at 3 Tesla for depicting hemodynamically significant coronary artery stenosis (≥ 50% diameter stenosis in patients with suspected or known coronary artery disease (CAD. Materials and methods Thirty consecutive patients (6 women (66 ± 9.3 years were scheduled for DCMR between January and May 2007 for detection of coronary artery disease. Patients were examined with a Philips Achieva 3 Tesla system (Philips Healthcare, Best, The Netherlands, using a spoiled gradient echo cine sequence. Technical parameters were: spatial resolution 2 × 2 × 8 mm3, 30 heart phases, spoiled gradient echo TR/TE: 4.5/2.6 msec, flip angle 15°. Images were acquired at rest and stress in accordance with a standardized high-dose dobutamine-atropine protocol during short breath-holds in three short and three long-axis views. Dobutamine was administered using a standard protocol (10 μg increments every 3 minutes up to 40 μg dobutamine/kg body weight/minute plus atropine if required to reach target heart rate. The study protocol included administration of 0.1 mmol/kg/body weight Gd-DTPA before the cine images at rest were acquired to improve the image quality. The examination was terminated if new or worsening wall-motion abnormalities or chest pain occurred or when > 85% of age-predicted maximum heart rate was reached. Myocardial ischemia was defined as new onset of wall-motion abnormality in at least one segment. In addition, late gadolinium enhancement (LGE was performed. Images were evaluated by two blinded readers. Diagnostic accuracy was determined with coronary

  9. Isometric stress in cardiovascular magnetic resonance - a simple and easily replicable method of assessing cardiovascular differences not apparent at rest

    Mortensen, Kristian H.; Jones, Alexander; Steeden, Jennifer A.; Taylor, Andrew M.; Muthurangu, Vivek [UCL Centre for Cardiovascular MR, UCL Institute of Cardiovascular Science, Level 6 Old Nurses Home, Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London (United Kingdom)

    2016-04-15

    Isometric exercise may unmask cardiovascular disease not evident at rest, and cardiovascular magnetic resonance (CMR) imaging is proven for comprehensive resting assessment. This study devised a simple isometric exercise CMR methodology and assessed the hemodynamic response evoked by isometric exercise. A biceps isometric exercise technique was devised for CMR, and 75 healthy volunteers were assessed at rest, after 3-minute biceps exercise, and 5-minute of recovery using: (1) blood pressure (BP) and (2) CMR measured aortic flow and left ventricular function. Total peripheral resistance (SVR) and arterial compliance (TAC), cardiac output (CO), left ventricular volumes and function (ejection fraction, stroke volume, power output), blood pressure (BP), heart rate (HR), and rate pressure product were assessed at all time points. Image quality was preserved during stress. During exercise there were increases in CO (+14.9 %), HR (+17.0 %), SVR (+9.8 %), systolic BP (+22.4 %), diastolic BP (+25.4 %) and mean BP (+23.2 %). In addition, there were decreases in TAC (-22.0 %) and left ventricular ejection fraction (-6.3 %). Age and body mass index modified the evoked response, even when resting measures were similar. Isometric exercise technique evokes a significant cardiovascular response in CMR, unmasking physiological differences that are not apparent at rest. (orig.)

  10. Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Post Processing

    Schulz-Menger, J.; Bluemke, D.A.; Bremerich, J; Flamm, S.D.; Fogel, M.A.; Friedrich, M.G.; Kim, R. J.; von Knobelsdorff-Brenkenhoff, F.; Kramer, C.M.; Pennell, D. J.; Plein, S; Nagel, E.

    2013-01-01

    With mounting data on its accuracy and prognostic value, cardiovascular magnetic resonance (CMR) is becoming an increasingly important diagnostic tool with growing utility in clinical routine. Given its versatility and wide range of quantitative parameters, however, agreement on specific standards for the interpretation and post-processing of CMR studies is required to ensure consistent quality and reproducibility of CMR reports. This document addresses this need by providing consensus recomm...

  11. Cardiovascular magnetics resonance diagnosis of cystic tumor of the atrioventricular node

    Wang Xuedong

    2009-04-01

    Full Text Available Abstract Late gadolinium enhanced (LGE cardiovascular magnetic resonance (CMR has proven to be the gold standard for viability assessment. LGE CMR is also useful for identifying the nature of cardiac masses or lesions. We report a case of a rare primary cystic tumor of the atrioventricular node, in which CMR proved to be valuable.

  12. Truncus arteriosus with aortic arch interruption: cardiovascular magnetic resonance findings in the unrepaired adult

    Cook Stephen C; Thavendiranathan Paaladinesh; Arruda Janine; Verhaert David; Raman Subha V

    2010-01-01

    Abstract Truncus arteriosus (TA) is a rare congenital condition defined as a single arterial vessel arising from the heart that gives origin to the systemic, pulmonary and coronary circulations. We discuss the unique case of a 28 year-old female patient with unrepaired TA and interruption of the aortic arch who underwent cardiovascular magnetic resonance (CMR).

  13. Cardiovascular magnetic resonance and PET-CT of left atrial paraganglioma

    Ruehm Stefan; Lai Chi; Tomasian Anderanik; Krishnam Mayil S

    2010-01-01

    Abstract Cardiac paragangliomas are among the rarest primary cardiac tumors. We present a case of left atrial paraganglioma in a patient who presented with symptoms and signs of catecholamine excess in which cardiovascular magnetic resonance in multiple orientations and PET-CT played an important role in the diagnosis and tissue characterization.

  14. Cardiovascular magnetics resonance diagnosis of cystic tumor of the atrioventricular node

    Wang Xuedong; Starnes Vaughn; Tran Thao T; Getzen James; Ross Brian D

    2009-01-01

    Abstract Late gadolinium enhanced (LGE) cardiovascular magnetic resonance (CMR) has proven to be the gold standard for viability assessment. LGE CMR is also useful for identifying the nature of cardiac masses or lesions. We report a case of a rare primary cystic tumor of the atrioventricular node, in which CMR proved to be valuable.

  15. Late gadolinium enhancement cardiovascular magnetic resonance in genotyped hypertrophic cardiomyopathy with normal phenotype

    Jassal Davinder S; Soni Reeni; Ariyarajah Vignendra; Strijack Bradford; Greenberg Cheryl R; McGregor Robert; Morris Andrew

    2008-01-01

    Abstract A 35 year-old asymptomatic Caucasian female with a family history of hypertrophic cardiomyopathy (HCM) was referred for cardiologic evaluation. The electrocardiogram and transthoracic echocardiogram were normal. Cardiovascular magnetic resonance (CMR) was performed for further assessment of myocardial function and presence of myocardial scar. CMR showed normal left ventricular systolic size, measurements and function. However, there was extensive, diffuse late gadolinium enhancement ...

  16. Determinants of left ventricular mass in obesity; a cardiovascular magnetic resonance study

    Clarke Kieran

    2009-04-01

    Full Text Available Abstract Background Obesity is linked to increased left ventricular mass, an independent predictor of mortality. As a result of this, understanding the determinants of left ventricular mass in the setting of obesity has both therapeutic and prognostic implications. Using cardiovascular magnetic resonance our goal was to elucidate the main predictors of left ventricular mass in severely obese subjects free of additional cardiovascular risk factors. Methods 38 obese (BMI 37.8 ± 6.9 kg/m2 and 16 normal weight controls subjects, (BMI 21.7 ± 1.8 kg/m2, all without cardiovascular risk factors, underwent cardiovascular magnetic resonance imaging to assess left ventricular mass, left ventricular volumes and visceral fat mass. Left ventricular mass was then compared to serum and anthropometric markers of obesity linked to left ventricular mass, i.e. height, age, blood pressure, total fat mass, visceral fat mass, lean mass, serum leptin and fasting insulin level. Results As expected, obesity was associated with significantly increased left ventricular mass (126 ± 27 vs 90 ± 20 g; p 2 = 0.77. Conclusion The left ventricular hypertrophic response to obesity in the absence of additional cardiovascular risk factors is mainly attributable to increases in lean body mass, LV stroke volume and visceral fat mass. In view of the well documented link between obesity, left ventricular hypertrophy and mortality, these findings have potentially important prognostic and therapeutic implications for primary and secondary prevention.

  17. The 20 year evolution of dobutamine stress cardiovascular magnetic resonance

    Hundley W; Charoenpanichkit Charaslak

    2010-01-01

    Abstract Over the past 20 years, investigators world-wide have developed and utilized dobutamine magnetic resonance stress testing procedures for the purpose of identifying ischemia, viability, and cardiac prognosis. This article traces these developments and reviews the data utilized to substantiate this relatively new noninvasive imaging procedure.

  18. Magnetic Resonance Imaging: A Wealth of Cardiovascular Information

    Shah, Sangeeta; Chryssos, Emanuel D.; Parker, Hugh

    2009-01-01

    Cardiac magnetic resonance imaging is a relatively new noninvasive imaging modality that provides insight into multiple facets of the human myocardium not available by other imaging modalities. This one test allows for the assessment of ventricular and valvular function, ischemic and nonischemic cardiomyopathies, congenital heart disease, and cardiac tumors. It has been coined by many as “one-stop shopping.” As with any imaging modality, it is important to understand not only the indications ...

  19. Cardiovascular magnetic resonance in rheumatology: Current status and recommendations for use.

    Mavrogeni, Sophie I; Kitas, George D; Dimitroulas, Theodoros; Sfikakis, Petros P; Seo, Philip; Gabriel, Sherine; Patel, Amit R; Gargani, Luna; Bombardieri, Stefano; Matucci-Cerinic, Marco; Lombardi, Massimo; Pepe, Alessia; Aletras, Anthony H; Kolovou, Genovefa; Miszalski, Tomasz; van Riel, Piet; Semb, AnneGrete; Gonzalez-Gay, Miguel Angel; Dessein, Patrick; Karpouzas, George; Puntmann, Valentina; Nagel, Eike; Bratis, Konstantinos; Karabela, Georgia; Stavropoulos, Efthymios; Katsifis, Gikas; Koutsogeorgopoulou, Loukia; van Rossum, Albert; Rademakers, Frank; Pohost, Gerald; Lima, Joao A C

    2016-08-15

    Targeted therapies in connective tissue diseases (CTDs) have led to improvements of disease-associated outcomes, but life expectancy remains lower compared to general population due to emerging co-morbidities, particularly due to excess cardiovascular risk. Cardiovascular magnetic resonance (CMR) is a noninvasive imaging technique which can provide detailed information about multiple cardiovascular pathologies without using ionizing radiation. CMR is considered the reference standard for quantitative evaluation of left and right ventricular volumes, mass and function, cardiac tissue characterization and assessment of thoracic vessels; it may also be used for the quantitative assessment of myocardial blood flow with high spatial resolution and for the evaluation of the proximal coronary arteries. These applications are of particular interest in CTDs, because of the potential of serious and variable involvement of the cardiovascular system during their course. The International Consensus Group on CMR in Rheumatology was formed in January 2012 aiming to achieve consensus among CMR and rheumatology experts in developing initial recommendations on the current state-of-the-art use of CMR in CTDs. The present report outlines the recommendations of the participating CMR and rheumatology experts with regards to: (a) indications for use of CMR in rheumatoid arthritis, the spondyloarthropathies, systemic lupus erythematosus, vasculitis of small, medium and large vessels, myositis, sarcoidosis (SRC), and scleroderma (SSc); (b) CMR protocols, terminology for reporting CMR and diagnostic CMR criteria for assessment and quantification of cardiovascular involvement in CTDs; and (c) a research agenda for the further development of this evolving field. PMID:27179903

  20. Cardiovascular magnetic resonance and computed tomography imaging for the assessment of cardiovascular complications of type 2 diabetes mellitus

    Graça, Bruno Miguel Silva Rosa da

    2014-01-01

    Diabetes mellitus is responsible for diverse cardiovascular complications such as increased atherosclerosis in large arteries (carotids, aorta, and femoral arteries) and increased coronary atherosclerosis. A number of noninvasive tests are now available to detect coronary atherosclerotic disease, myocardial dysfunction and myocardial ischemia. The potential of cardiovascular imaging for the assessment of cardiovascular complications of type 2 diabetic patients is an active field of res...

  1. The effects of breath-holding on pulmonary regurgitation measured by cardiovascular magnetic resonance velocity mapping

    Babu-Narayan Sonya V; Johansson Bengt; Kilner Philip J

    2009-01-01

    Abstract Background Pulmonary regurgitation is a common and clinically important residual lesion after repair of tetralogy of Fallot. Cardiovascular magnetic resonance (CMR) phase contrast velocity mapping is widely used for measurement of pulmonary regurgitant fraction. Breath-hold acquisitions, usually acquired during held expiration, are more convenient than the non-breath-hold approach, but we hypothesized that breath-holding might affect the amount of pulmonary regurgitation. Methods For...

  2. Diagnosis and management of ischemic cardiomyopathy: Role of cardiovascular magnetic resonance imaging

    Doesch, Christina; Papavassiliu, Theano

    2014-01-01

    Coronary artery disease (CAD) represents an important cause of mortality. Cardiovascular magnetic resonance (CMR) imaging evolved as an imaging modality that allows the assessment of myocardial function, perfusion, contractile reserve and extent of fibrosis in a single comprehensive exam. This review highlights the role of CMR in the differential diagnosis of acute chest pain by detecting the location of obstructive CAD or necrosis and identifying other conditions like stress cardiomyopathy o...

  3. Analyzing myocardial torsion based on tissue phase mapping cardiovascular magnetic resonance

    Chitiboi, Teodora; Schnell, Susanne; Collins, Jeremy; Carr, James; Chowdhary, Varun; Honarmand, Amir Reza; Hennemuth, Anja; Linsen, Lars; Hahn, Horst K.; Markl, Michael

    2016-01-01

    Background The purpose of this work is to analyze differences in left ventricular torsion between volunteers and patients with non-ischemic cardiomyopathy based on tissue phase mapping (TPM) cardiovascular magnetic resonance (CMR). Methods TPM was performed on 27 patients with non-ischemic cardiomyopathy and 14 normal volunteers. Patients underwent a standard CMR including late gadolinium enhancement (LGE) for the assessment of myocardial scar and ECG-gated cine CMR for global cardiac functio...

  4. Cardiovascular magnetic resonance in the diagnosis of acute heart transplant rejection: a review

    Toma Mustafa; Haykowsky Mark; Thompson Richard; Butler Craig R; Paterson Ian

    2009-01-01

    Abstract Background Screening for organ rejection is a critical component of care for patients who have undergone heart transplantation. Endomyocardial biopsy is the gold standard screening tool, but non-invasive alternatives are needed. Cardiovascular magnetic resonance (CMR) is well suited to provide an alternative to biopsy because of its ability to quantify ventricular function, morphology, and characterize myocardial tissue. CMR is not widely used to screen for heart transplant rejection...

  5. Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance

    Manning Warren J; Agarwal Anupam; O'Halloran T David; Hauser Thomas H; Josephson Mark E; Tsao Connie W; Yeon Susan B

    2008-01-01

    Abstract Background Anatomic atrial enlargement is associated with significant morbidity and mortality. However, atrial enlargement may not correlate with clinical measures such as electrocardiographic (ECG) criteria. Past studies correlating ECG criteria with anatomic measures mainly used inferior M-mode or two-dimensional echocardiographic data. We sought to determine the accuracy of the ECG to predict anatomic atrial enlargement as determined by volumetric cardiovascular magnetic resonance...

  6. Cystic adventitial disease of the popliteal artery: features on 3T cardiovascular magnetic resonance

    Gelabert Hugh

    2008-08-01

    Full Text Available Abstract Cystic adventitial disease (CAD of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst develops in the adventitial layer of the artery. We report the case of a 26-year-old male with CAD of the right popliteal artery diagnosed non-invasively with 3 Tesla cardiovascular magnetic resonance and confirmed on post-operative histopathology.

  7. Simplified post processing of cine DENSE cardiovascular magnetic resonance for quantification of cardiac mechanics

    Suever, Jonathan D.; Wehner, Gregory J.; Haggerty, Christopher M.; Jing, Linyuan; Hamlet, Sean M; Binkley, Cassi M.; Kramer, Sage P.; Mattingly, Andrea C.; Powell, David K.; Bilchick, Kenneth C.; Epstein, Frederick H.; Fornwalt, Brandon K

    2014-01-01

    Background Cardiovascular magnetic resonance using displacement encoding with stimulated echoes (DENSE) is capable of assessing advanced measures of cardiac mechanics such as strain and torsion. A potential hurdle to widespread clinical adoption of DENSE is the time required to manually segment the myocardium during post-processing of the images. To overcome this hurdle, we proposed a radical approach in which only three contours per image slice are required for post-processing (instead of th...

  8. Assessment of pulmonary veins after atrio-pericardial anastomosis by cardiovascular magnetic resonance

    Greenway Steven C; Yoo Shi-Joon; Baliulis Giedrius; Caldarone Christopher; Coles John; Grosse-Wortmann Lars

    2011-01-01

    Abstract Background The atrio-pericardial anastomosis (APA) uses a pericardial pouch to create a large communication between the left atrium and the pulmonary venous contributaries in order to avoid direct suturing of the pulmonary veins during the repair of congenital cardiac malformations. Post-operative imaging is routinely performed by echocardiography but Cardiovascular Magnetic Resonance (CMR) offers excellent anatomical imaging and quantitative information about pulmonary blood flow. W...

  9. Cystic adventitial disease of the popliteal artery: features on 3T cardiovascular magnetic resonance

    Gelabert Hugh; Finn J Paul; Lai Chi; Tomasian Anderanik; Krishnam Mayil S

    2008-01-01

    Abstract Cystic adventitial disease (CAD) of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst develops in the adventitial layer of the artery. We report the case of a 26-year-old male with CAD of the right popliteal artery diagnosed non-invasively with 3 Tesla cardiovascular magnetic resonance and confirmed on post-operative histopathology.

  10. Myocardial first-pass perfusion cardiovascular magnetic resonance: history, theory, and current state of the art

    Axel Leon; Ferreira Pedro; Epstein Frederick H; Nayak Krishna; Raman Subha V; Gerber Bernhard L; Kraitchman Dara L

    2008-01-01

    Abstract In less than two decades, first-pass perfusion cardiovascular magnetic resonance (CMR) has undergone a wide range of changes with the development and availability of improved hardware, software, and contrast agents, in concert with a better understanding of the mechanisms of contrast enhancement. The following review provides a perspective of the historical development of first-pass CMR, the developments in pulse sequence design and contrast agents, the relevant animal models used in...

  11. Recovery of methamphetamine associated cardiomyopathy predicted by late gadolinium enhanced cardiovascular magnetic resonance

    Buonocore Michael; Caputo Gary; Yeo Khung; Lopez Javier E; Schaefer Saul

    2009-01-01

    Abstract Methamphetamine is known to cause a cardiomyopathy which may be reversible with appropriate medical therapy and cessation of use. Late gadolinium enhancement cardiovascular magnetic resonance (CMR) has been shown to identify fibrosis in ischemic and non-ischemic cardiomyopathies. We present a case of severe methamphetamine-associated cardiomyopathy in which cardiac function recovered after 6 months. Evaluation by CMR using late gadolinium enhancement was notable for an absence of enh...

  12. Cardiovascular magnetic resonance in cardiac sarcoidosis with MR conditional pacemaker in situ

    Hausenloy Derek; Harkness Allan; Plant Gordon T; Holdright Diana R; Quarta Giovanni; Hyare Harpreet; Moon James C

    2011-01-01

    Abstract Cardiovascular implantable electronic devices represent important limitations to magnetic resonance imaging (MRI). Recently, MRI-conditional dual chamber pacemakers and leads have become available. We describe a case of a patient with neuro-sarcoidosis presenting with diplopia and hydrocephalus requiring an MRI-conditional programmable ventriculo-peritoneal shunt, who developed complete heart block. In view of the ongoing need for neuro-imaging, MRI-conditional dual chamber pacemaker...

  13. Diagnostic and prognostic value of cardiovascular magnetic resonance in non-ischaemic cardiomyopathies

    Parsai Chirine; O’Hanlon Rory; Prasad Sanjay K; Mohiaddin Raad H

    2012-01-01

    Abstract Cardiovascular Magnetic Resonance (CMR) is recognised as a valuable clinical tool which in a single scan setting can assess ventricular volumes and function, myocardial fibrosis, iron loading, flow quantification, tissue characterisation and myocardial perfusion imaging. The advent of CMR using extrinsic and intrinsic contrast-enhanced protocols for tissue characterisation have dramatically changed the non-invasive work-up of patients with suspected or known cardiomyopathy. Although ...

  14. The Role of Cardiovascular Magnetic Resonance in Pediatric Congenital Heart Disease

    Taylor Andrew M; Hughes Marina L; Ntsinjana Hopewell N

    2011-01-01

    Abstract Cardiovascular magnetic resonance (CMR) has expanded its role in the diagnosis and management of congenital heart disease (CHD) and acquired heart disease in pediatric patients. Ongoing technological advancements in both data acquisition and data presentation have enabled CMR to be integrated into clinical practice with increasing understanding of the advantages and limitations of the technique by pediatric cardiologists and congenital heart surgeons. Importantly, the combination of ...

  15. Cardiovascular assessment of patients with Ullrich-Turner's Syndrome on Doppler echocardiography and magnetic resonance imaging

    Castro Ana Valéria Barros de

    2002-01-01

    Full Text Available OBJECTIVE: To assess the cardiovascular features of Ullrich-Turner's syndrome using echocardiography and magnetic resonance imaging, and to correlate them with the phenotype and karyotype of the patients. The diagnostic concordance between the 2 methods was also assessed. METHODS: Fifteen patients with the syndrome were assessed by echocardiography and magnetic resonance imaging (cardiac chambers, valves, and aorta. Their ages ranged from 10 to 28 (mean of 16.7 years. The karyotype was analyzed in 11 or 25 metaphases of peripheral blood lymphocytes, or both. RESULTS: The most common phenotypic changes were short stature and spontaneous absence of puberal development (100%; 1 patient had a cardiac murmur. The karyotypes detected were as follows: 45,X (n=7, mosaics (n=5, and deletions (n=3. No echocardiographic changes were observed. In regard to magnetic resonance imaging, coarctation and dilation of the aorta were found in 1 patient, and isolated dilation of the aorta was found in 4 patients. CONCLUSION: The frequencies of coarctation and dilation of the aorta detected on magnetic resonance imaging were similar to those reported in the literature (5.5% to 20%, and 6.3% to 29%, respectively. This confirmed the adjuvant role of magnetic resonance imaging to Doppler echocardiography for diagnosing cardiovascular alterations in patients with Ullrich-Turner's syndrome.

  16. Vascular function assessed with cardiovascular magnetic resonance predicts survival in patients with advanced chronic kidney disease

    Steedman Tracey

    2008-08-01

    Full Text Available Abstract Background Increased arterial stiffness is associated with mortality in patients with chronic kidney disease. Cardiovascular magnetic resonance (CMR permits assessment of the central arteries to measure aortic function. Methods We studied the relationship between central haemodynamics and outcome using CMR in 144 chronic kidney disease patients with estimated glomerular filtration rate Results Median follow up after the scan was 24 months. There were no significant differences in aortic distensibilty or aortic volumetric arterial strain between pre-dialysis and dialysis patients. Aortic distensibilty and volumetric arterial strain negatively correlated with age. Aortic distensibilty and volumetric arterial strain were lower in diabetics, patients with ischaemic heart disease and peripheral vascular disease. During follow up there were 20 deaths. Patients who died had lower aortic distensibilty than survivors. In a survival analysis, diabetes, systolic blood pressure and aortic distensibilty were independent predictors of mortality. There were 12 non-fatal cardiovascular events during follow up. Analysing the combined end point of death or a vascular event, diabetes, aortic distensibilty and volumetric arterial strain were predictors of events. Conclusion Deranged vascular function measured with CMR correlates with cardiovascular risk factors and predicts outcome. CMR measures of vascular function are potential targets for interventions to reduce cardiovascular risk.

  17. Cardiac resynchronization therapy guided by late gadolinium-enhancement cardiovascular magnetic resonance

    Smith Russell EA

    2011-06-01

    Full Text Available Abstract Background Myocardial scarring at the LV pacing site leads to incomplete resynchronization and a suboptimal symptomatic response to CRT. We sought to determine whether the use of late gadolinium cardiovascular magnetic resonance (LGE-CMR to guide left ventricular (LV lead deployment influences the long-term outcome of cardiac resynchronization therapy (CRT. Methods 559 patients with heart failure (age 70.4 ± 10.7 yrs [mean ± SD] due to ischemic or non-ischemic cardiomyopathy underwent CRT. Implantations were either guided (+CMR or not guided (-CMR by LGE-CMR prior to implantation. Fluoroscopy and LGE-CMR were used to localize the LV lead tip and and myocardial scarring retrospectively. Clinical events were assessed in three groups: +CMR and pacing scar (+CMR+S; CMR and not pacing scar (+CMR-S, and; LV pacing not guided by CMR (-CMR. Results Over a maximum follow-up of 9.1 yrs, +CMR+S had the highest risk of cardiovascular death (HR: 6.34, cardiovascular death or hospitalizations for heart failure (HR: 5.57 and death from any cause or hospitalizations for major adverse cardiovascular events (HR: 4.74 (all P Conclusions Compared with a conventional implantation approach, the use of LGE-CMR to guide LV lead deployment away from scarred myocardium results in a better clinical outcome after CRT. Pacing scarred myocardium was associated with the worst outcome, in terms of both pump failure and sudden cardiac death.

  18. Unmasking Silent Endothelial Activation in the Cardiovascular System Using Molecular Magnetic Resonance Imaging.

    Belliere, Julie; Martinez de Lizarrondo, Sara; Choudhury, Robin P; Quenault, Aurélien; Le Béhot, Audrey; Delage, Christine; Chauveau, Dominique; Schanstra, Joost P; Bascands, Jean-Loup; Vivien, Denis; Gauberti, Maxime

    2015-01-01

    Endothelial activation is a hallmark of cardiovascular diseases, acting either as a cause or a consequence of organ injury. To date, we lack suitable methods to measure endothelial activation in vivo. In the present study, we developed a magnetic resonance imaging (MRI) method allowing non-invasive endothelial activation mapping in the vasculature of the main organs affected during cardiovascular diseases. In clinically relevant contexts in mice (including systemic inflammation, acute and chronic kidney diseases, diabetes mellitus and normal aging), we provided evidence that this method allows detecting endothelial activation before any clinical manifestation of organ failure in the brain, kidney and heart with an exceptional sensitivity. In particular, we demonstrated that diabetes mellitus induces chronic endothelial cells activation in the kidney and heart. Moreover, aged mice presented activated endothelial cells in the kidneys and the cerebrovasculature. Interestingly, depending on the underlying condition, the temporospatial patterns of endothelial activation in the vascular beds of the cardiovascular system were different. These results demonstrate the feasibility of detecting silent endothelial activation occurring in conditions associated with high cardiovascular risk using molecular MRI. PMID:26379785

  19. Standardized cardiovascular magnetic resonance imaging (CMR protocols, society for cardiovascular magnetic resonance: board of trustees task force on standardized protocols

    Kim Raymond J

    2008-07-01

    Full Text Available Index 1. General techniques 1.1. Stress and safety equipment 1.2. Left ventricular (LV structure and function module 1.3. Right ventricular (RV structure and function module 1.4. Gadolinium dosing module. 1.5. First pass perfusion 1.6. Late gadolinium enhancement (LGE 2. Disease specific protocols 2.1. Ischemic heart disease 2.1.1. Acute myocardial infarction (MI 2.1.2. Chronic ischemic heart disease and viability 2.1.3. Dobutamine stress 2.1.4. Adenosine stress perfusion 2.2. Angiography: 2.2.1. Peripheral magnetic resonance angiography (MRA 2.2.2. Thoracic MRA 2.2.3. Anomalous coronary arteries 2.2.4. Pulmonary vein evaluation 2.3. Other 2.3.1. Non-ischemic cardiomyopathy 2.3.2. Arrhythmogenic right ventricular cardiomyopathy (ARVC 2.3.3. Congenital heart disease 2.3.4. Valvular heart disease 2.3.5. Pericardial disease 2.3.6. Masses

  20. Effect of rosiglitazone on progression of atherosclerosis: insights using 3D carotid cardiovascular magnetic resonance

    Chan Cheuk F

    2009-07-01

    Full Text Available Abstract Background There is recent evidence suggesting that rosiglitazone increases death from cardiovascular causes. We investigated the direct effect of this drug on atheroma using 3D carotid cardiovascular magnetic resonance. Results A randomized, placebo-controlled, double-blind study was performed to evaluate the effect of rosiglitazone treatment on carotid atherosclerosis in subjects with type 2 diabetes and coexisting vascular disease or hypertension. The primary endpoint of the study was the change from baseline to 52 weeks of carotid arterial wall volume, reflecting plaque burden, as measured by carotid cardiovascular magnetic resonance. Rosiglitazone or placebo was allocated to 28 and 29 patients respectively. Patients were managed to have equivalent glycemic control over the study period, but in fact the rosiglitazone group lowered their HbA1c by 0.88% relative to placebo (P 3 and in the rosiglitazone group was 1354 ± 532 mm3. After 52 weeks, the respective volumes were 1134 ± 523 mm3 and 1348 ± 531 mm3. These changes (-12.1 mm3 and -5.7 mm3 in the placebo and rosiglitazone groups, respectively were not statistically significant between groups (P = 0.57. Conclusion Treatment with rosiglitazone over 1 year had no effect on progression of carotid atheroma in patients with type 2 diabetes mellitus compared to placebo.

  1. Cardiovascular magnetic resonance at 3.0T: Current state of the art

    Gharib Ahmed M

    2010-10-01

    Full Text Available Abstract There are advantages to conducting cardiovascular magnetic resonance (CMR studies at a field strength of 3.0 Telsa, including the increase in bulk magnetization, the increase in frequency separation of off-resonance spins, and the increase in T1 of many tissues. However, there are significant challenges to routinely performing CMR at 3.0T, including the reduction in main magnetic field homogeneity, the increase in RF power deposition, and the increase in susceptibility-based artifacts. In this review, we outline the underlying physical effects that occur when imaging at higher fields, examine the practical results these effects have on the CMR applications, and examine methods used to compensate for these effects. Specifically, we will review cine imaging, MR coronary angiography, myocardial perfusion imaging, late gadolinium enhancement, and vascular wall imaging.

  2. Non Hodgkin lymphoma metastasis to the heart detected by cardiovascular magnetic resonance

    Primary and secondary heart tumors are relatively rare occurrences but usually imply significant treatment decisions. The differential diagnosis among these tumors and other masses can sometimes be difficult and require the use of different imaging modalities to establish a confident verdict. Cardiovascular magnetic resonance CMR imaging is a very useful tool in these cases by allowing for the application of different strategies to better delineate masses, heart structures and adjacent tissues. In this case description, we present a woman with shortness of breath and a paracardiac mass showing how CMR can be applied. (author)

  3. Ultrahigh Resolution 3-Dimensional Imaging Project

    National Aeronautics and Space Administration — Southwest Sciences proposes to develop innovative instrumentation for the rapid, 3-dimensional imaging of biological tissues with cellular resolution. Our approach...

  4. Quality assessment of cardiovascular magnetic resonance in the setting of the European CMR registry: description and validation of standardized criteria

    Klinke, Vincenzo; Muzzarelli, Stefano; Lauriers, Nathalie; Locca, Didier; Vincenti, Gabriella; Monney, Pierre; Lu, Christian; Nothnagel, Detlev; Pilz, Guenter; Lombardi, Massimo; van Rossum, Albert C.; Wagner, Anja; Bruder, Oliver; Mahrholdt, Heiko; Schwitter, Juerg

    2013-01-01

    Background: Cardiovascular magnetic resonance (CMR) has become an important diagnostic imaging modality in cardiovascular medicine. However, insufficient image quality may compromise its diagnostic accuracy. We aimed to describe and validate standardized criteria to evaluate a) cine steady-state free precession (SSFP), b) late gadolinium enhancement (LGE), and c) stress first-pass perfusion images. These criteria will serve for quality assessment in the setting of the Euro-CMR registry. Metho...

  5. ECG-based gating in ultra high field cardiovascular magnetic resonance using an independent component analysis approach

    Krug, Johannes W; Rose, Georg; Clifford, Gari D.; Oster, Julien

    2013-01-01

    Background In Cardiovascular Magnetic Resonance (CMR), the synchronization of image acquisition with heart motion is performed in clinical practice by processing the electrocardiogram (ECG). The ECG-based synchronization is well established for MR scanners with magnetic fields up to 3 T. However, this technique is prone to errors in ultra high field environments, e.g. in 7 T MR scanners as used in research applications. The high magnetic fields cause severe magnetohydrodynamic (MHD) effects w...

  6. Teleportation of a 3-dimensional GHZ State

    Cao, Hai-Jing; Wang, Huai-Sheng; Li, Peng-Fei; Song, He-Shan

    2012-05-01

    The process of teleportation of a completely unknown 3-dimensional GHZ state is considered. Three maximally entangled 3-dimensional Bell states function as quantum channel in the scheme. This teleportation scheme can be directly generalized to teleport an unknown d-dimensional GHZ state.

  7. 3-dimensional Griess algebras and Miyamoto involutions

    lam, Ching Hung; Yamauchi, Hiroshi

    2016-01-01

    We consider a series of VOAs generated by 3-dimensional Griess algebras. We will show that these VOAs can be characterized by their 3-dimensional Griess algebras and their structures are uniquely determined. As an application, we will determine the groups generated by the Miyamoto involutions associated to Virasoro vectors of our VOAs.

  8. Cardiac remodeling following percutaneous mitral valve repair - initial results assessed by cardiovascular magnetic resonance imaging

    Radunski, U K; Franzen, O; Barmeyer, A;

    2014-01-01

    PURPOSE: Percutaneous mitral valve repair with the MitraClip device (Abbott Vascular, Redwood City, California, USA) is a novel therapeutic option in patients with mitral regurgitation. This study evaluated the feasibility of cardiac volume measurements by cardiovascular magnetic resonance imaging...... mitral valve repair results in reverse LV but not in RV or LA remodeling. KEY POINTS: • Volume measurements by cardiovascular magnetic resonance imaging are feasible following percutaneous mitral valve repair despite device-related artifacts.• A significant reduction of left ventricular volume was found...... end-systolic (48 [42 - 80] vs. 51 [40 - 81] ml/m(2); p = 0.48), and LA (87 [55 - 124] vs. 92 [48 - 137] ml/m(2); p = 0.20) volume indices between BL and FU. CONCLUSION: CMR enables the assessment of cardiac volumes in patients after MitraClip implantation. Our CMR findings indicate that percutaneous...

  9. Pulmonary Arterial Hypertension: Use of Delayed Contrast-Enhanced Cardiovascular Magnetic Resonance in Risk Assessment

    Pulmonary arterial hypertension is a severe and progressive disease. Its early diagnosis is the greatest clinical challenge. To evaluate the presence and extension of the delayed myocardial contrast-enhanced cardiovascular magnetic resonance, as well as to verify if the percentage of the myocardial fibrosis mass is a severity predictor. Cross-sectional study with 30 patients with pulmonary arterial hypertension of groups I and IV, subjected to clinical, functional and hemodynamic evaluation, and to cardiac magnetic resonance. The mean age of patients was 52 years old, with female predominance (77%). Among the patients, 53% had right ventricular failure at diagnosis, and 90% were in functional class II/III. The mean of the 6-minute walk test was 395m. In hemodynamic study with right catheterism, the mean average pulmonary arterial pressure was 53.3mmHg, of the cardiac index of 2.1L/ min.m2, and median right atrial pressure was 13.5 mmHg. Delayed myocardial contrast enhanced cardiovascular magnetic resonance was found in 28 patients. The mean fibrosis mass was 9.9 g and the median percentage of fibrosis mass was 6.17%. The presence of functional class IV, right ventricular failure at diagnosis, 6-minute walk test < 300 meters and right atrial pressure ≥ 15 mmHg, with cardiac index < 2.0 L/ min.m2, there was a relevant association with the increased percentage of myocardial fibrosis. The percentage of the myocardial fibrosis mass indicates a non-invasive marker with promising perspectives in identifying patients with high risk factors for pulmonary hypertension

  10. Pulmonary Arterial Hypertension: Use of Delayed Contrast-Enhanced Cardiovascular Magnetic Resonance in Risk Assessment

    Bessa, Luiz Gustavo Pignataro, E-mail: lgpignataro@ig.com.br; Junqueira, Flávia Pegado; Bandeira, Marcelo Luiz da Silva; Garcia, Marcelo Iorio; Xavier, Sérgio Salles; Lavall, Guilherme; Torres, Diego; Waetge, Daniel [Hospital Universitário Clementino Fraga Filho, Ilha do Fundão, RJ (Brazil)

    2013-10-15

    Pulmonary arterial hypertension is a severe and progressive disease. Its early diagnosis is the greatest clinical challenge. To evaluate the presence and extension of the delayed myocardial contrast-enhanced cardiovascular magnetic resonance, as well as to verify if the percentage of the myocardial fibrosis mass is a severity predictor. Cross-sectional study with 30 patients with pulmonary arterial hypertension of groups I and IV, subjected to clinical, functional and hemodynamic evaluation, and to cardiac magnetic resonance. The mean age of patients was 52 years old, with female predominance (77%). Among the patients, 53% had right ventricular failure at diagnosis, and 90% were in functional class II/III. The mean of the 6-minute walk test was 395m. In hemodynamic study with right catheterism, the mean average pulmonary arterial pressure was 53.3mmHg, of the cardiac index of 2.1L/ min.m{sup 2}, and median right atrial pressure was 13.5 mmHg. Delayed myocardial contrast enhanced cardiovascular magnetic resonance was found in 28 patients. The mean fibrosis mass was 9.9 g and the median percentage of fibrosis mass was 6.17%. The presence of functional class IV, right ventricular failure at diagnosis, 6-minute walk test < 300 meters and right atrial pressure ≥ 15 mmHg, with cardiac index < 2.0 L/ min.m{sup 2}, there was a relevant association with the increased percentage of myocardial fibrosis. The percentage of the myocardial fibrosis mass indicates a non-invasive marker with promising perspectives in identifying patients with high risk factors for pulmonary hypertension.

  11. Extra-cardiac findings in cardiovascular magnetic resonance: what the imaging cardiologist needs to know.

    Rodrigues, Jonathan C L; Lyen, Stephen M; Loughborough, William; Amadu, Antonio Matteo; Baritussio, Anna; Dastidar, Amardeep Ghosh; Manghat, Nathan E; Bucciarelli-Ducci, Chiara

    2016-01-01

    Cardiovascular magnetic resonance (CMR) is an established non-invasive technique to comprehensively assess cardiovascular structure and function in a variety of acquired and inherited cardiac conditions. A significant amount of the neck, thorax and upper abdomen are imaged at the time of routine clinical CMR, particularly in the initial multi-slice axial and coronal images. The discovery of unsuspected disease at the time of imaging has ethical, financial and medico-legal implications. Extra-cardiac findings at the time of CMR are common, can be important and can change clinical management. Certain patient groups undergoing CMR are at particular risk of important extra-cardiac findings as several of the cardiovascular risk factors for atherosclerosis are also risk factors for malignancy. Furthermore, the presence of certain extra-cardiac findings may contribute to the interpretation of the primary cardiac pathology as some cardiac conditions have multi-systemic extra-cardiac involvement. The aim of this review is to give an overview of the type of extra-cardiac findings that may become apparent on CMR, subdivided by anatomical location. We focus on normal variant anatomy that may mimic disease, common incidental extra-cardiac findings and important imaging signs that help distinguish sinister pathology from benign disease. We also aim to provide a framework to the approach and potential further diagnostic work-up of incidental extra-cardiac findings discovered at the time of CMR. However, it is beyond the scope of this review to discuss and determine the clinical significance of extracardiac findings at CMR. PMID:27156861

  12. Alterations in vascular function in primary aldosteronism: a cardiovascular magnetic resonance imaging study.

    Mark, P B; Boyle, S; Zimmerli, L U; McQuarrie, E P; Delles, C; Freel, E M

    2014-02-01

    Excess aldosterone is associated with increased cardiovascular risk. Aldosterone has a permissive effect on vascular fibrosis. Cardiovascular magnetic resonance imaging (CMR) allows study of vascular function by measuring aortic distensibility. We compared aortic distensibility in primary aldosteronism (PA), essential hypertension (EH) and normal controls and explored the relationship between aortic distensibility and pulse wave velocity (PWV). We studied PA (n=14) and EH (n=33) subjects and age-matched healthy controls (n=17) with CMR, including measurement of aortic distensibility, and measured PWV using applanation tonometry. At recruitment, PA and EH patients had similar blood pressure and left ventricular mass. Subjects with PA had significantly lower aortic distensibility and higher PWV compared with EH and healthy controls. These changes were independent of other factors associated with reduced aortic distensibility, including ageing. There was a significant relationship between increasing aortic stiffness and age in keeping with physical and vascular ageing. As expected, aortic distensibility and PWV were closely correlated. These results demonstrate that PA patients display increased arterial stiffness compared with EH, independent of vascular ageing. The implication is that aldosterone invokes functional impairment of arterial function. The long-term implications of arterial stiffening in aldosterone excess require further study. PMID:23884211

  13. Nuclear magnetic resonance imaging of the cardiovascular system: normal and pathologic findings

    Whole body nuclear magnetic resonance (NMR) imaging of the cardiovascular system was carried out in early clinical trials in 244 volunteers and patients using a 3.5 KGauss (0.35 T) unit. The spin echo technique with multiple imaging parameters was used. Blood vessels were clearly discriminated from solid organs and lesions because little or no intraluminal signal is seen with laminar blood flow at normal velocities, whereas a more intense image is generated by solid organs. Characteristic flow signals were observed in normal patients and were accentuated by varying the imaging parameters. Cardiac chambers were well delineated in some patients on nongated images. In one case, internal topography of the ventricles was exquisitely displayed on a gated image. Intraluminal pathology, such as dissection of the aorta, aneurysms of the aorta and left ventricle, and aortic atheroma, was clearly demonstrated. Patency of coronary arterial bypass grafts was shown. Abnormal flow patterns due to slow or turbulent flow were accentuated on images using the second spin echo. The preliminary experience indicated the considerable potential of NMR imaging in the evaluation of cardiovascular disease

  14. Cardiovascular ultrahigh field magnetic resonance imaging. Challenges, technical solutions and opportunities

    This involves high spatial resolution cardiac imaging with ultrahigh magnetic fields (7 T) and clinically acceptable image quality. Cardiovascular magnetic resonance imaging (MRI) at a field strength of 1.5 T using a spatial resolution of (2 x 2 x 6-8) mm3. Cardiac MRI at ultrahigh field strength makes use of multitransmit/receive radiofrequency (RF) technology and development of novel technology that utilizes the traits of ultrahigh field MRI. Enhanced spatial resolution which is superior by a factor of 6-10 to what can be achieved by current clinical cardiac MRI. The relative spatial resolution (pixels per anatomical structure) comes close to what can be accomplished by current cardiac MRI in small rodents. Feasibility studies demonstrate the gain in spatial resolution at 7.0 T due to the sensitivity advantage inherent to ultrahigh magnetic fields. Please stay tuned and please put further weight behind the solution of the remaining technical problems of cardiac MRI at 7.0 T. (orig.)

  15. Myocardial first-pass perfusion cardiovascular magnetic resonance: history, theory, and current state of the art

    Axel Leon

    2008-04-01

    Full Text Available Abstract In less than two decades, first-pass perfusion cardiovascular magnetic resonance (CMR has undergone a wide range of changes with the development and availability of improved hardware, software, and contrast agents, in concert with a better understanding of the mechanisms of contrast enhancement. The following review provides a perspective of the historical development of first-pass CMR, the developments in pulse sequence design and contrast agents, the relevant animal models used in early preclinical studies, the mechanism of artifacts, the differences between 1.5T and 3T scanning, and the relevant clinical applications and protocols. This comprehensive overview includes a summary of the past clinical performance of first-pass perfusion CMR and current clinical applications using state-of-the-art methodologies.

  16. The Role of Cardiovascular Magnetic Resonance in Pediatric Congenital Heart Disease

    Taylor Andrew M

    2011-09-01

    Full Text Available Abstract Cardiovascular magnetic resonance (CMR has expanded its role in the diagnosis and management of congenital heart disease (CHD and acquired heart disease in pediatric patients. Ongoing technological advancements in both data acquisition and data presentation have enabled CMR to be integrated into clinical practice with increasing understanding of the advantages and limitations of the technique by pediatric cardiologists and congenital heart surgeons. Importantly, the combination of exquisite 3D anatomy with physiological data enables CMR to provide a unique perspective for the management of many patients with CHD. Imaging small children with CHD is challenging, and in this article we will review the technical adjustments, imaging protocols and application of CMR in the pediatric population.

  17. Remote magnetic targeting of iron oxide nanoparticles for cardiovascular diagnosis and therapeutic drug delivery: where are we now?

    Bietenbeck, Michael; Florian, Anca; Faber, Cornelius; Sechtem, Udo; Yilmaz, Ali

    2016-01-01

    Magnetic resonance imaging (MRI) allows for an accurate assessment of both functional and structural cardiac parameters, and thereby appropriate diagnosis and validation of cardiovascular diseases. The diagnostic yield of cardiovascular MRI examinations is often increased by the use of contrast agents that are almost exclusively based on gadolinium compounds. Another clinically approved contrast medium is composed of superparamagnetic iron oxide nanoparticles (IONs). These particles may expand the field of contrast-enhanced cardiovascular MRI as recently shown in clinical studies focusing on acute myocardial infarction (AMI) and atherosclerosis. Furthermore, IONs open up new research opportunities such as remote magnetic drug targeting (MDT). The approach of MDT relies on the coupling of bioactive molecules and magnetic nanoparticles to form an injectable complex. This complex, in turn, can be attracted to and retained at a desired target inside the body with the help of applied magnetic fields. In comparison to common systemic drug applications, MDT techniques promise both higher concentrations at the target site and lower concentrations elsewhere in the body. Moreover, concurrent or subsequent MRI can be used for noninvasive monitoring of drug distribution and successful delivery to the desired organ in vivo. This review does not only illustrate the basic conceptual and biophysical principles of IONs, but also focuses on new research activities and achievements in the cardiovascular field, mainly in the management of AMI. Based on the presentation of successful MDT applications in preclinical models of AMI, novel approaches and the translational potential of MDT are discussed. PMID:27486321

  18. Non Hodgkin lymphoma metastasis to the heart detected by cardiovascular magnetic resonance; Metastasis cardiaca secundaria al linfoma de Hodgkin detectada por la resonancia magnetica cardiovascular

    Martinez, Florange; Morales, Marisela; Pedreanez, Norma, E-mail: martinez.florangel@gmail.com [Hospital Cardiologico Infantil Latinoamericano Dr Gilberto Rodriguez Ochoa, Carcacas (Venezuela, Bolivarian Republic of); Pabon, Luz; Carrillo, Milton [Universidad Central de Venezuela (UCV/HUC), Caracas (Venezuela, Bolivarian Republic of). Instituto de Hematoncologia. Hospital Universitario; Fernandes, Juliano Lara [Universidade de Campinas (UNICAMP), SP (Brazil)

    2009-10-15

    Primary and secondary heart tumors are relatively rare occurrences but usually imply significant treatment decisions. The differential diagnosis among these tumors and other masses can sometimes be difficult and require the use of different imaging modalities to establish a confident verdict. Cardiovascular magnetic resonance CMR imaging is a very useful tool in these cases by allowing for the application of different strategies to better delineate masses, heart structures and adjacent tissues. In this case description, we present a woman with shortness of breath and a paracardiac mass showing how CMR can be applied. (author)

  19. Clinical application of nuclear magnetic resonance imaging (resistive type) on cardiovascular disease

    In order to evaluate the usefulness of Nuclear Magnetic Resonance (NMR) imaging in diagnosing cardiovascular disease, 27 subjects were examined using a 0.1-Tesla resistive type (ASAHI MARK-J). In 10 normal subjects, four cardiac chambers, interventricular septum, aorta, pulmonary vessels and vena cava were clearly identified in NMR imaging. In two patients with old anteroseptal myocardial infarction, anteroseptal wall thinning and left ventricular aneurysm with mural thrombi were demonstrated. In two cases of antrolateral and posterolateral myocardial infarction, however, infarcted areas were not identified in NMR imaging. In one patient with congestive cardiomyopathy, enlarged left ventricle without hypertrophy was recognized. In two patients with hypertrophic obstructive cardiomyopathy, NMR imaging disclosed thickened left ventricular wall associated with its narrowed cavity. A mural thrombus in the right ventricle was distinctly visualized in one patient with cardio-vascular Behcet's disease. In two patients with mitral valve stenosis, enlarged left atrium with a mural thrombus was clearly demonstrated in both cross and longitudinal sections. In three patients with thoratic aortic aneurysm, local dilatation of aorta and mural thrombi were recognized. In four patients with dissecting aortic aneurysm, double channels with an intimal flap in the aorta were visualized in NMR imaging. Mean T1 values and standard deviations of left ventricle, left ventricular wall, and thrombi were 593+-89, 341+-20, 316+-84 msec, respectively. Mean T1 values of thrombi were ordinally shorter than those of left ventricule. But some thrombi which might be expected fresh had longer T1 values. (J.P.N.)

  20. Effects of deep sedation or general anesthesia on cardiac function in mice undergoing cardiovascular magnetic resonance

    Kutschke William

    2009-05-01

    Full Text Available Abstract Background Genetically engineered mouse models of human cardiovascular disease provide an opportunity to understand critical pathophysiological mechanisms. Cardiovascular magnetic resonance (CMR provides precise reproducible assessment of cardiac structure and function, but, in contrast to echocardiography, requires that the animal be immobilized during image acquisition. General anesthetic regimens yield satisfactory images, but have the potential to significantly perturb cardiac function. The purpose of this study was to assess the effects of general anesthesia and a new deep sedation regimen, respectively, on cardiac function in mice as determined by CMR, and to compare them to results obtained in mildly sedated conscious mice by echocardiography. Results In 6 mildly sedated normal conscious mice assessed by echo, heart rate was 615 ± 25 min-1 (mean ± SE and left ventricular ejection fraction (LVEF was 0.94 ± 0.01. In the CMR studies of normal mice, heart rate was slightly lower during deep sedation with morphine/midazolam (583 ± 30 min-1, but the difference was not statistically significant. General anesthesia with 1% inhaled isoflurane significantly depressed heart rate (468 ± 7 min-1, p In mice with ischemic LV failure, ejection fraction measurements were comparable when performed during light sedation, deep sedation, and general anesthesia, respectively. Contrast-to-noise ratios were similar during deep sedation and during general anesthesia, indicating comparable image quality. Left ventricular mass measurements made by CMR during deep sedation were nearly identical to those made during general anesthesia (r2 = 0.99, mean absolute difference Conclusion In mice with normal cardiac function, CMR during deep sedation causes significantly less depression of heart rate and ejection fraction than imaging during general anesthesia with isoflurane. In mice with heart failure, the sedation/anesthesia regimen had no clear impact on

  1. Homological aperiodic tilings of 3-dimensional geometries

    Nowak, Piotr W

    2012-01-01

    We construct the first aperiodic tiles for two amenable 3-dimensional Lie groups: Sol and the Heisenberg group. Our construction relies on the use of higher-dimensional uniformly finite homology. In particular, we settle completely the existence of aperiodic tiles for all of the non-compact geometries of 3-manifolds appearing in the geometrization conjecture.

  2. Properties of 3-dimensional line location models

    Brimberg, Jack; Juel, Henrik; Schöbel, Anita

    2002-01-01

    We consider the problem of locating a line with respect to some existing facilities in 3-dimensional space, such that the sum of weighted distances between the line and the facilities is minimized. Measuring distance using the l\\_p norm is discussed, along with the special cases of Euclidean and...

  3. Assessment of Left Ventricular Structural Remodelling in Patients with Diabetic Cardiomyopathy by Cardiovascular Magnetic Resonance

    Zhang, Xiaochun; Leng, Weiling

    2016-01-01

    Background. Diabetic cardiomyopathy (DCM) is always accompanied with alteration of left ventricular structure and function. The aims of this study were to assess the structural remodelling in patients with DCM by cardiovascular magnetic resonance (CMR) and correlation of structural remodelling with severity of DCM. Methods. Twenty-five patients (53.8 ± 8.8 years, 52.0% males) with DCM and thirty-one normal healthy controls (51.9 ± 13.6 years, 45.2% males) were scanned by CMR cine to assess function and structure of left ventricular. Length of diabetic history and results of cardiac echocardiography (E′, A′, and E′/A′) were also measured. Results. Compared with normal controls group, DCM group was associated with significantly increased ratio of left ventricular mass at end diastole to end-diastolic volume (MVR) (P 0.05). The ratio correlated with both length of diabetic history and echocardiographic Doppler tissue imaging E′ (all P < 0.05). Conclusions. CMR can be a powerful technique to assess LV remodelling, and MVR may be considered as an imaging marker to evaluate the severity of LV remodelling in patients with DCM.

  4. Diagnosis and management of ischemic cardiomyopathy: Role of cardiovascular magnetic resonance imaging.

    Doesch, Christina; Papavassiliu, Theano

    2014-11-26

    Coronary artery disease (CAD) represents an important cause of mortality. Cardiovascular magnetic resonance (CMR) imaging evolved as an imaging modality that allows the assessment of myocardial function, perfusion, contractile reserve and extent of fibrosis in a single comprehensive exam. This review highlights the role of CMR in the differential diagnosis of acute chest pain by detecting the location of obstructive CAD or necrosis and identifying other conditions like stress cardiomyopathy or myocarditis that can present with acute chest pain. Besides, it underlines the prognostic implication of perfusion abnormalities in the setting of acute chest pain. Furthermore, the review addresses the role of CMR to detect significant CAD in patients with stable CAD. It elucidates the accuracy and clinical utility of CMR with respect to other imaging modalities like single-photon emission computed tomography and positron emission tomography. Besides, the prognostic value of CMR stress testing is discussed. Additionally, it summarizes the available CMR techniques to assess myocardial viability and describes algorithm to identify those patient who might profit from revascularization those who should be treated medically. Finally, future promising imaging techniques that will provide further insights into the fundamental disease processes in ischemic cardiomyopathy are discussed. PMID:25429329

  5. Late gadolinium enhancement cardiovascular magnetic resonance predicts clinical worsening in patients with pulmonary hypertension

    Freed Benjamin H

    2012-02-01

    Full Text Available Abstract Background Late gadolinium enhancement (LGE occurs at the right ventricular (RV insertion point (RVIP in patients with pulmonary hypertension (PH and has been shown to correlate with cardiovascular magnetic resonance (CMR derived RV indices. However, the prognostic role of RVIP-LGE and other CMR-derived parameters of RV function are not well established. Our aim was to evaluate the predictive value of contrast-enhanced CMR in patients with PH. Methods RV size, ejection fraction (RVEF, and the presence of RVIP-LGE were determined in 58 patients with PH referred for CMR. All patients underwent right heart catheterization, exercise testing, and N-terminal pro-brain natriuretic peptide (NT-proBNP evaluation; results of which were included in the final analysis if performed within 4 months of the CMR study. Patients were followed for the primary endpoint of time to clinical worsening (death, decompensated right ventricular heart failure, initiation of prostacyclin, or lung transplantation. Results Overall, 40/58 (69% of patients had RVIP-LGE. Patients with RVIP- LGE had larger right ventricular volume index, lower RVEF, and higher mean pulmonary artery pressure (mPAP, all p Conclusions The presence of RVIP-LGE in patients with PH is a marker for more advanced disease and poor prognosis. In addition, this study reveals for the first time that CMR-derived RVEF is an independent non-invasive imaging predictor of adverse outcomes in this patient population.

  6. Structural and functional cardiac changes in myotonic dystrophy type 1: a cardiovascular magnetic resonance study

    Hermans Mieke CE

    2012-07-01

    Full Text Available Abstract Background Myotonic dystrophy type 1 (MD1 is a neuromuscular disorder with potential involvement of the heart and increased risk of sudden death. Considering the importance of cardiomyopathy as a predictor of prognosis, we aimed to systematically evaluate and describe structural and functional cardiac alterations in patients with MD1. Methods Eighty MD1 patients underwent physical examination, electrocardiography (ECG, echocardiography and cardiovascular magnetic resonance (CMR. Blood samples were taken for determination of NT-proBNP plasma levels and CTG repeat length. Results Functional and structural abnormalities were detected in 35 patients (44%. Left ventricular systolic dysfunction was found in 20 cases, left ventricular dilatation in 7 patients, and left ventricular hypertrophy in 6 patients. Myocardial fibrosis was seen in 10 patients (12.5%. In general, patients had low left ventricular mass indexes. Right ventricular involvement was uncommon and only seen together with left ventricular abnormalities. Functional or structural cardiac involvement was associated with age (p = 0.04, male gender (p Conclusions CMR can be useful to detect early structural and functional myocardial abnormalities in patients with MD1. Myocardial involvement is strongly associated with conduction abnormalities, but a normal ECG does not exclude myocardial alterations. These findings lend support to the hypothesis that MD1 patients have a complex cardiac phenotype, including both myocardial and conduction system alteration.

  7. Cardiac magnetic resonance: Impact on diagnosis and management of patients with congenital cardiovascular disease

    Aim: To estimate the clinical impact of cardiac magnetic resonance (CMR) in patients with congenital cardiovascular disease (CCD). Materials and methods: Since 2003, 1.5 T CMR was used at our university hospital to evaluate morphology, cardiac kinetics, aortic and pulmonary flow, and vascular anatomy in patients with CCD. The present study considered a consecutive series of these patients from 2003 to 2006. A paediatric cardiologist judged our reports as expected or unexpected and, secondarily, as not reliable (level 0), describing findings already known (level 1), not changing therapy/suggested lifestyle (level 2), changing therapy/suggested lifestyle (level 3) or changing diagnosis (level 4). Results: CMR reports were judged to be expected in 187/214 (87%) and unexpected in 27/214 (13%). Less than 2% of CMRs were judged as levels 0 or 1, 66% as level 2, and 5% as level 4. During 2005-2006 the clinical impact improved toward higher impact levels (p < 0.001, chi-square test). Conclusions: In patients with CCD, more than one in 10 CMR reports were unexpected to cardiologists and over seven in 10 prompted a change of diagnosis or therapy.

  8. Dilation of the ascending aorta in Turner syndrome - a prospective cardiovascular magnetic resonance study

    Pedersen Erik M

    2011-04-01

    Full Text Available Abstract Background The risk of aortic dissection is 100-fold increased in Turner syndrome (TS. Unfortunately, risk stratification is inadequate due to a lack of insight into the natural course of the syndrome-associated aortopathy. Therefore, this study aimed to prospectively assess aortic dimensions in TS. Methods Eighty adult TS patients were examined twice with a mean follow-up of 2.4 ± 0.4 years, and 67 healthy age and gender-matched controls were examined once. Aortic dimensions were measured at nine predefined positions using 3D, non-contrast and free-breathing cardiovascular magnetic resonance. Transthoracic echocardiography and 24-hour ambulatory blood pressure were also performed. Results At baseline, aortic diameters (body surface area indexed were larger at all positions in TS. Aortic dilation was more prevalent at all positions excluding the distal transverse aortic arch. Aortic diameter increased in the aortic sinus, at the sinotubular junction and in the mid-ascending aorta with growth rates of 0.1 - 0.4 mm/year. Aortic diameters at all other positions were unchanged. The bicuspid aortic valve conferred higher aortic sinus growth rates (p Conclusion A general aortopathy is present in TS with enlargement of the ascending aorta, which is accelerated in the presence of a bicuspid aortic valve.

  9. Advancing Cardiovascular, Neurovascular and Renal Magnetic Resonance Imaging in Small Rodents Using Cryogenic Radiofrequency Coil Technology

    Thoralf eNiendorf

    2015-11-01

    Full Text Available Research in pathologies of the brain, heart and kidney have gained immensely from the plethora of studies that have helped shape new methods in magnetic resonance (MR for characterizing preclinical disease models. Methodical probing into preclinical animal models by MR is invaluable since it allows a careful interpretation and extrapolation of data derived from these models to human disease. In this review we will focus on the applications of cryogenic radiofrequency (RF coils in small animal MR as a means of boosting image quality (e.g. by supporting MR microscopy and making data acquisition more efficient (e.g. by reducing measuring time; both being important constituents for thorough investigational studies on animal models of disease. This review attempts to make the (biomedical imaging, molecular medicine and pharmaceutical communities aware of this productive ferment and its outstanding significance for anatomical and functional MR in small rodents. The goal is to inspire a more intense interdisciplinary collaboration across the fields to further advance and progress non-invasive MR methods that ultimately support thorough (pathophysiological characterization of animal disease models. In this review, current and potential future applications for the RF coil technology in cardiovascular, neurovascular and renal disease will be discussed.

  10. Routine evaluation of left ventricular diastolic function by cardiovascular magnetic resonance: A practical approach

    Vido Diane

    2008-07-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR has excellent capabilities to assess ventricular systolic function. Current clinical scenarios warrant routine evaluation of ventricular diastolic function for complete evaluation, especially in congestive heart failure patients. To our knowledge, no systematic assessment of diastolic function over a range of lusitropy has been performed using CMR. Methods and Results Left ventricular diastolic function was assessed in 31 subjects (10 controls who underwent CMR and compared with Transthoracic echocardiogram (TTE evaluation of mitral valve (MV and pulmonary vein (PV blood flow. Blood flow in the MV and PV were successfully imaged by CMR for all cases (31/31,100% while TTE evaluated flow in all MV (31/31,100% but only 21/31 PV (68% cases. Velocities of MV flow (E and A measured by CMR correlated well with TTE (r = 0.81, p Conclusion We have shown that there is homology between CMR and TTE for the assessment of diastolic inflow over a wide range of conditions, including normal, impaired relaxation and restrictive. There is excellent agreement of quantitative velocity measurements between CMR and TTE. Diastolic blood flow assessment by CMR can be performed in a single scan, with times ranging from 20 sec to 3 min, and we show that there is good indication for applying CMR to assess diastolic conditions, either as an adjunctive test when evaluating systolic function, or even as a primary test when TTE data cannot be obtained.

  11. Myocardial late gadolinium enhancement cardiovascular magnetic resonance in patients with cirrhosis

    Stremmel Wolfgang

    2010-08-01

    Full Text Available Abstract Background Portal hypertension and cardiac alterations previously described as "cirrhotic cardiomyopathy" are known complications of end stage liver disease (ELD. Cardiac failure contributes to morbidity and mortality, particularly after liver transplantation and transjugular intrahepatic portosystemic shunt (TIPS. We sought to identify myocardial tissue characterization and evaluate cardiovascular magnetic resonance (CMR for diagnosis of cardiac impairment. Results Twenty ELD patients underwent CMR for morphological, functional and tissue characterization by late gadolinium enhancement (LGE. Based on extent of LGE, patients were dichotomized into high and low LGE groups and analyzed regarding liver, cardiocirculatory and renal functions. CMR demonstrated hyperdynamic left ventricular function and a patchy pattern of LGE of the myocardium to a variable extent (range 2-62% in all patients. There were no significant differences in Model for End-Stage Liver Disease (MELD, Child-Pugh score or the left ventricular ejection fraction between high and low LGE groups. QTc-interval was prolonged in 25% of the patients. E/A ratio was at the upper limit of norm; no difference between groups. Patients showing high LGE had a higher CI (p Conclusion CMR shows myocardial involvement in patients with ELD resembling appearance of myocarditis. The hyperdynamic circulation in portal hypertension may be an important factor. Larger prospective trials are warranted to confirm the association with severity and outcome of liver disease and to test the predictive power of CMR for patients listed for liver transplantation.

  12. Velocity encoded cardiovascular magnetic resonance to assess left atrial appendage emptying

    Muellerleile Kai

    2012-06-01

    Full Text Available Abstract Background The presence of impaired left atrial appendage (LAA function identifies patients who are prone to thrombus formation in the LAA and therefore being at high risk for subsequent cardioembolic stroke. LAA function is typically assessed by measurements of LAA emptying velocities using transesophageal echocardiography (TEE in clinical routine. This study aimed at evaluating the feasibility of assessing LAA emptying by velocity encoded (VENC cardiovascular magnetic resonance (CMR. Methods This study included 30 patients with sinus rhythm (n = 18 or atrial fibrillation (n = 12. VENC-CMR velocity measurements were performed perpendicular to the orifice of the LAA. Peak velocities were measured of passive diastolic LAA emptying (e-wave in all patients. Peak velocities of active, late-diastolic LAA emptying (a-wave were assessed in patients with sinus rhythm. Correlation and agreement was analyzed between VENC-CMR and TEE measurements of e- and a-wave peak velocities. Results A significant correlation and good agreement was found between VENC-CMR and TEE measurements of maximal e-wave velocities (r = 0.61, P  Conclusions The assessment of active and passive LAA emptying by VENC-CMR is feasible. Further evaluation is required of potential future clinical applications such as risk stratification for cardioembolic stroke.

  13. Diagnosis and management of ischemic cardiomyopathy: Role of cardiovascular magnetic resonance imaging

    Christina; Doesch; Theano; Papavassiliu

    2014-01-01

    Coronary artery disease(CAD) represents an important cause of mortality. Cardiovascular magnetic resonance(CMR) imaging evolved as an imaging modality that allows the assessment of myocardial function, perfusion, contractile reserve and extent of fibrosis in a single comprehensive exam. This review highlights the role of CMR in the differential diagnosis of acute chest pain by detecting the location of obstructive CAD or necrosis and identifying other conditions like stress cardiomyopathy or myocarditis that can present with acute chest pain. Besides, it underlines the prognostic implication of perfusion abnormalities in the setting of acute chest pain. Furthermore, the review addresses the role of CMR to detect significant CAD in patients with stable CAD. It elucidates the accuracy and clinical utility of CMR with respect to other imaging modalitieslike single-photon emission computed tomography and positron emission tomography. Besides, the prognostic value of CMR stress testing is discussed. Additionally, it summarizes the available CMR techniques to assess myocardial viability and describes algorithm to identify those patient who might profit from revascularization those who should be treated medically. Finally, future promising imaging techniques that will provide further insights into the fundamental disease processes in ischemic cardiomyopathy are discussed.

  14. The Emerging Role of Cardiovascular Magnetic Resonance Imaging in the Evaluation of Metabolic Cardiomyopathies.

    Mavrogeni, S; Markousis-Mavrogenis, G; Markussis, V; Kolovou, G

    2015-08-01

    The aim of this review is to discuss the role of Cardiovascular Magnetic Resonance (CMR) in the diagnosis, risk stratification, and follow-up of metabolic cardiomyopathies. The classification of myocardial diseases, proposed by WHO/ISFC task force, distinguished specific cardiomyopathies, caused by metabolic disorders, into 4 types: 1) endocrine disorders, 2) storage or infiltration disorders (amyloidosis, hemochromatosis and familial storage disorders), 3) nutritional disorders (Kwashiorkor, beri-beri, obesity, and alcohol), and 4) diabetic heart. Thyroid disease, pheochromocytoma, and growth hormone excess or deficiency may contribute to usually reversible dilated cardiomyopathy. Glucogen storage diseases can be presented with myopathy, liver, and heart failure. Lysosomal storage diseases can provoke cardiac hypertrophy, mimicking hypertrophic cardiomyopathy and arrhythmias. Hereditary hemochromatosis, an inherited disorder of iron metabolism, leads to tissue iron overload in different organs, including the heart. Cardiac amyloidosis is the result of amyloid deposition in the heart, formed from breakdown of normal or abnormal proteins that leads to increased heart stiffness, restrictive cardiomyopathy, and heart failure. Finally, nutritional disturbances and metabolic diseases, such as Kwashiorkor, beri-beri, obesity, alcohol consumption, and diabetes mellitus may also lead to severe cardiac dysfunction. CMR, through its capability to reliably assess anatomy, function, inflammation, rest-stress myocardial perfusion, myocardial fibrosis, aortic distensibility, iron and/or fat deposition can serve as an excellent tool for early diagnosis of heart involvement, risk stratification, treatment evaluation, and long term follow-up of patients with metabolic cardiomyopathies. PMID:26197853

  15. The role of cardiovascular magnetic resonance in assessment of patients after radical surgical correction of tetralogy of Fallot

    Surgical management of tetralogy of Fallot (TOF) results in residual anatomic and functional abnormalities in majority of patients. Primarily considered as a benign pulmonary regurgitation with the time results in right ventricular overload, loses the compensatory mechanisms and irreversible right ventricular dilatation and dysfunction. Cardiovascular magnetic resonance (CMR) has evolved during the last two decades as the reference standard imaging modality to assess the anatomic and functional changes in patients with repaired TOF. This article reviews the role of CMR to assess the right ventricular function and to evaluate the degree of pulmonary regurgitation and comments some technical aspects, based to our experience. Key words: Tetralogy of Fallot. Cardiovascular Magnetic Resonance. Pulmonary regurgitation. Right ventricular assessment

  16. An isolated perfused pig heart model for the development, validation and translation of novel cardiovascular magnetic resonance techniques

    Perera Divaka; Morton Geraint; Hay Gunnar; Neumann Nicole; Ishida Masaki; Southworth Richard; Grünwald Inga; Chiribiri Amedeo; Schuster Andreas; Schaeffter Tobias; Nagel Eike

    2010-01-01

    Abstract Background Novel cardiovascular magnetic resonance (CMR) techniques and imaging biomarkers are often validated in small animal models or empirically in patients. Direct translation of small animal CMR protocols to humans is rarely possible, while validation in humans is often difficult, slow and occasionally not possible due to ethical considerations. The aim of this study is to overcome these limitations by introducing an MR-compatible, free beating, blood-perfused, isolated pig hea...

  17. Moderate intensity supine exercise causes decreased cardiac volumes and increased outer volume variations: a cardiovascular magnetic resonance study

    Steding-Ehrenborg, Katarina; Jablonowski, Robert; Arvidsson, Per M;

    2013-01-01

    The effects on left and right ventricular (LV, RV) volumes during physical exercise remains controversial. Furthermore, no previous study has investigated the effects of exercise on longitudinal contribution to stroke volume (SV) and the outer volume variation of the heart. The aim of this study ...... was to determine if LV, RV and total heart volumes (THV) as well as cardiac pumping mechanisms change during physical exercise compared to rest using cardiovascular magnetic resonance (CMR)....

  18. Demonstration of value of optimizing ECG triggering for cardiovascular magnetic resonance in patients with congenital heart disease

    Knesewitsch Thomas; Meierhofer Christian; Rieger Henrike; Rößler Jürgen; Frank Michael; Martinoff Stefan; Hess John; Stern Heiko; Fratz Sohrab

    2013-01-01

    Abstract Background Optimal ECG triggering is of paramount importance for correct blood flow quantification during cardiovascular magnetic resonance (CMR). However, optimal ECG triggering and therefore blood flow quantification is impaired in many patients with congenital heart disease (CHD) due to complex QRS patterns. Therefore, a new ECG-trigger algorithm was developed to address triggering problems due to complex QRS patterns. The aim of this study was to test this new ECG-trigger algorit...

  19. Natural history of spontaneous aortic intramural hematoma progression: Six years follow-up with cardiovascular magnetic resonance

    Zhao Lei; Fan Zhanming; Zhang Zhaoqi; Ma Xiaohai; Yu Jing

    2010-01-01

    Abstract We described a 6 years follow-up of a spontaneous aortic intramural hematoma (IMH) with cardiovascular magnetic resonance (CMR) examination. Since multiple factors may play roles in the natural history of IMH, the patient experienced the course of progression, which included hematoma absorption, ulcer-like lesion, aneurysm and limited dissection. The initial and follow-up CMR examination included 3D CE MRA and non-enhanced "bright blood" pulse sequence. The inherent advantage of outs...

  20. Correction of misaligned slices in multi-slice cardiovascular magnetic resonance using slice-to-volume registration

    Hawkes David J; Schnabel Julia A; Netsch Thomas; Pinder Richard J; Chandler Adam G; Hill Derek LG; Razavi Reza

    2008-01-01

    Abstract A popular technique to reduce respiratory motion for cardiovascular magnetic resonance is to perform a multi-slice acquisition in which a patient holds their breath multiple times during the scan. The feasibility of rigid slice-to-volume registration to correct for misalignments of slice stacks in such images due to differing breath-hold positions is explored. Experimental results indicate that slice-to-volume registration can compensate for the typical misalignments expected. Correc...

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

    Klix, Sabrina; Els, Antje; Paul, Katharina; Graessl, Andreas; Oezerdem, Celal; Weinberger, Oliver; Winter, Lukas; Thalhammer, Christof; Huelnhagen, Till; Rieger, Jan; Mehling, Heidrun; Schulz-Menger, Jeanette; Niendorf, Thoralf

    2015-01-01

    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

  2. Myocardial tagging by Cardiovascular Magnetic Resonance: evolution of techniques--pulse sequences, analysis algorithms, and applications

    Ibrahim El-Sayed H

    2011-07-01

    Full Text Available Abstract Cardiovascular magnetic resonance (CMR tagging has been established as an essential technique for measuring regional myocardial function. It allows quantification of local intramyocardial motion measures, e.g. strain and strain rate. The invention of CMR tagging came in the late eighties, where the technique allowed for the first time for visualizing transmural myocardial movement without having to implant physical markers. This new idea opened the door for a series of developments and improvements that continue up to the present time. Different tagging techniques are currently available that are more extensive, improved, and sophisticated than they were twenty years ago. Each of these techniques has different versions for improved resolution, signal-to-noise ratio (SNR, scan time, anatomical coverage, three-dimensional capability, and image quality. The tagging techniques covered in this article can be broadly divided into two main categories: 1 Basic techniques, which include magnetization saturation, spatial modulation of magnetization (SPAMM, delay alternating with nutations for tailored excitation (DANTE, and complementary SPAMM (CSPAMM; and 2 Advanced techniques, which include harmonic phase (HARP, displacement encoding with stimulated echoes (DENSE, and strain encoding (SENC. Although most of these techniques were developed by separate groups and evolved from different backgrounds, they are in fact closely related to each other, and they can be interpreted from more than one perspective. Some of these techniques even followed parallel paths of developments, as illustrated in the article. As each technique has its own advantages, some efforts have been made to combine different techniques together for improved image quality or composite information acquisition. In this review, different developments in pulse sequences and related image processing techniques are described along with the necessities that led to their invention

  3. Measuring aortic pulse wave velocity using high-field cardiovascular magnetic resonance: comparison of techniques

    Shaffer Jean M

    2010-05-01

    Full Text Available Abstract Background The assessment of arterial stiffness is increasingly used for evaluating patients with different cardiovascular diseases as the mechanical properties of major arteries are often altered. Aortic stiffness can be noninvasively estimated by measuring pulse wave velocity (PWV. Several methods have been proposed for measuring PWV using velocity-encoded cardiovascular magnetic resonance (CMR, including transit-time (TT, flow-area (QA, and cross-correlation (XC methods. However, assessment and comparison of these techniques at high field strength has not yet been performed. In this work, the TT, QA, and XC techniques were clinically tested at 3 Tesla and compared to each other. Methods Fifty cardiovascular patients and six volunteers were scanned to acquire the necessary images. The six volunteer scans were performed twice to test inter-scan reproducibility. Patient images were analyzed using the TT, XC, and QA methods to determine PWV. Two observers analyzed the images to determine inter-observer and intra-observer variabilities. The PWV measurements by the three methods were compared to each other to test inter-method variability. To illustrate the importance of PWV using CMR, the degree of aortic stiffness was assessed using PWV and related to LV dysfunction in five patients with diastolic heart failure patients and five matched volunteers. Results The inter-observer and intra-observer variability results showed no bias between the different techniques. The TT and XC results were more reproducible than the QA; the mean (SD inter-observer/intra-observer PWV differences were -0.12(1.3/-0.04(0.4 for TT, 0.2(1.3/0.09(0.9 for XC, and 0.6(1.6/0.2(1.4 m/s for QA methods, respectively. The correlation coefficients (r for the inter-observer/intra-observer comparisons were 0.94/0.99, 0.88/0.94, and 0.83/0.92 for the TT, XC, and QA methods, respectively. The inter-scan reproducibility results showed low variability between the repeated

  4. 3-dimensional shaped aluminium foam sandwiches

    Baumeister, J. [Fraunhofer-Institut fuer Fertigungstechnik und Angewandte Materialforschung, Bremen (Germany); Baumgaertner, F. [Schunk Sintermetalltechnik, Giessen (Germany); Gers, H. [Honsel AG, Meschede (Germany); Seeliger, W. [Wilhelm Karmann GmbH, Osnabrueck (Germany)

    2000-07-01

    3-dimensional shaped sandwich panels with a very high stiffness can be produced in an elegant way by combining aluminium face sheets with an aluminium foam core. For this, a mixture of aluminium powder and a foaming agent is compressed to a semi-finished product of nearly vanishing porosity by extrusion, powder rolling or hot isostatic pressing. The resulting foamable semi-finished aluminium material is roll clad with sheets of conventional sheet or aluminium. As a result a precursor material is obtained consisting of two face sheets which are metallurgically bonded to the foamable core layer. This sandwich precursor material can be shaped into a 3-dimensional part by conventional techniques, e.g. by stamping or deep drawing. In a final step the foamable precursor material is heated up to the melting point of the core layer thus initiating its expansion into the desired 3-dimensional shaped sandwich structure. The porosity of the foamed core layer is in the range from 80-90% so that the integral density of the sandwich structure can be as low as 0,7 g/cm{sup 3}. The sandwich materials combine the low weight and high bending stiffness with the advantages of the face sheets, i.e. the high strength and weldability. The manufacturing process will be described in detail and the material properties will be shown. Current and future possible applications will be outlined as well as concrete parts produced up to date. (orig.)

  5. Gender difference in ventricular response to aortic stenosis: insight from cardiovascular magnetic resonance.

    Joo Myung Lee

    Full Text Available Although left ventricular hypertrophy (LVH and remodeling is associated with cardiac mortality and morbidity, little is known about the impact of gender on the ventricular response in aortic stenosis (AS patients. This study aimed to analyze the differential effect of gender on ventricular remodeling in moderate to severe AS patients.A total of 118 consecutive patients (67±9 years; 63 males with moderate or severe AS (severe 81.4% underwent transthoracic echocardiography and cardiovascular magnetic resonance (CMR within a 1-month period in this two-center prospective registry. The pattern of LV remodeling was assessed using the LV mass index (LVMI and LV remodeling index (LVRI; LV mass/LV end-diastolic volume by CMR. Although there were no differences in AS severity parameters nor baseline characteristics between genders, males showed a significantly higher LVMI (102.6±29.1 g/m2 vs. 86.1±29.2 g/m2, p=0.003 and LVRI (1.1±0.2 vs. 1.0±0.3, p=0.018, regardless of AS severity. The LVMI was significantly associated with aortic valve area (AVA index and valvuloarterial impedance in females, whereas it was not in males, resulting in significant interaction between genders (PInteraction=0.007/0.014 for AVA index/valvuloarterial impedance, respectively. Similarly, the LVRI also showed a significantly different association between male and female subjects with the change in AS severity parameters (PInteraction=0.033/<0.001/0.029 for AVA index/transaortic mean pressure gradient/valvuloarterial impedance, respectively.Males are associated with greater degree of LVH and higher LVRI compared to females at moderate to severe AS. However, females showed a more exaggerated LV remodeling response, with increased severity of AS and hemodynamic loads, than males.

  6. Hemodynamic predictors of aortic dilatation in bicuspid aortic valve by velocity-encoded cardiovascular magnetic resonance

    Ramamurthy Senthil

    2010-01-01

    Full Text Available Abstract Background Congenital Bicuspid Aortic Valve (BAV is a significant risk factor for serious complications including valve dysfunction, aortic dilatation, dissection, and sudden death. Clinical tools for identification and monitoring of BAV patients at high risk for development of aortic dilatation, an early complication, are not available. Methods This paper reports an investigation in 18 pediatric BAV patients and 10 normal controls of links between abnormal blood flow patterns in the ascending aorta and aortic dilatation using velocity-encoded cardiovascular magnetic resonance. Blood flow patterns were quantitatively expressed in the angle between systolic left ventricular outflow and the aortic root channel axis, and also correlated with known biochemical markers of vessel wall disease. Results The data confirm larger ascending aortas in BAV patients than in controls, and show more angled LV outflow in BAV (17.54 ± 0.87 degrees than controls (10.01 ± 1.29 (p = 0.01. Significant correlation of systolic LV outflow jet angles with dilatation was found at different levels of the aorta in BAV patients STJ: r = 0.386 (N = 18, p = 0.048, AAO: r = 0.536 (N = 18, p = 0.022, and stronger correlation was found with patients and controls combined into one population: SOV: r = 0.405 (N = 28, p = 0.033, STJ: r = 0.562 (N = 28, p = 0.002, and AAO r = 0.645 (N = 28, p Conclusions The results of this study provide new insights into the pathophysiological processes underlying aortic dilatation in BAV patients. These results show a possible path towards the development of clinical risk stratification protocols in order to reduce morbidity and mortality for this common congenital heart defect.

  7. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging

    Introduction: Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. Methods: 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. Results: On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B = 0.02, SE = 0.02, p < 0.001). Routine TTE had a sensitivity of 21–24% and a specificity of 95–98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ = 0.91 and κ = 0.96) compared to TTE (κ = 0.74 and κ = 0.53). Conclusion: LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large.

  8. Assessment of atrial septal defects in adults comparing cardiovascular magnetic resonance with transoesophageal echocardiography

    Brown Michael A

    2010-07-01

    Full Text Available Abstract Background Many adult patients with secundum-type atrial septal defects (ASDs are able to have these defects fixed percutaneously. Traditionally, this has involved an assessment of ASD size, geometry and atrial septal margins by transoesophageal echocardiography (TOE prior to percutaneous closure. This is a semi-invasive technique, and all of the information obtained could potentially be obtained by non-invasive cardiovascular magnetic resonance (CMR. We compared the assessment of ASDs in consecutive patients being considered for percutaneous ASD closure using CMR and TOE. Methods Consecutive patients with ASDs diagnosed on transthoracic echocardiography (TTE were invited to undergo both CMR and TOE. Assessment of atrial septal margins, maximal and minimal defect dimensions was performed with both techniques. Analyses between CMR and TOE were made using simple linear regression and Bland Altman Analyses. Results Total CMR scan time was 20 minutes, and comparable to the TOE examination time. A total of 20 patients (M:F = 5:15, mean age 42.8 years ± 15.7 were included in the analyses. There was an excellent agreement between CMR and TOE for estimation of maximum defect size (R = 0.87. The anterior inferior, anterior superior and posterior inferior margins could be assessed in all patients with CMR. The posterior superior margin could not be assessed in only one patient. Furthermore, in 1 patient in whom TOE was unable to be performed, CMR was used to successfully direct percutaneous ASD closure. Conclusions CMR agrees with TOE assessment of ASDs in the work-up for percutaneous closure. Potentially CMR could be used instead of TOE for this purpose.

  9. The effects of breath-holding on pulmonary regurgitation measured by cardiovascular magnetic resonance velocity mapping

    Babu-Narayan Sonya V

    2009-01-01

    Full Text Available Abstract Background Pulmonary regurgitation is a common and clinically important residual lesion after repair of tetralogy of Fallot. Cardiovascular magnetic resonance (CMR phase contrast velocity mapping is widely used for measurement of pulmonary regurgitant fraction. Breath-hold acquisitions, usually acquired during held expiration, are more convenient than the non-breath-hold approach, but we hypothesized that breath-holding might affect the amount of pulmonary regurgitation. Methods Forty-three adult patients with a previous repair of tetralogy of Fallot and residual pulmonary regurgitation were investigated with CMR. In each, pulmonary regurgitant fraction was measured from velocity maps transecting the pulmonary trunk, acquired during held expiration, held inspiration, by non-breath-hold acquisition, and also from the difference of right and left ventricular stroke volume measurements. Results Pulmonary regurgitant fraction was lower when measured by velocity mapping in held expiration compared with held inspiration, non-breath-hold or stroke volume difference (30.8 vs. 37.0, 35.6, 35.4%, p = 0.00017, 0.0035, 0.026. The regurgitant volume was lower in held expiration than in held inspiration (41.9 vs. 48.3, p = 0.0018. Pulmonary forward flow volume was larger during held expiration than during non-breath-hold (132 vs. 124 ml, p = 0.0024. Conclusion Pulmonary regurgitant fraction was significantly lower in held expiration compared with held inspiration, free breathing and stroke volume difference. Altered airway pressure could be a contributory factor. This information is relevant if breath-hold acquisition is to be substituted for non-breath-hold in the investigation of patients with a view to re-intervention.

  10. Cardiac remodeling following percutaneous mitral valve repair. Initial results assessed by cardiovascular magnetic resonance imaging

    Radunski, U.K [University Heart Center, Hamburg (Germany). Cardiology; Franzen, O. [Rigshospitalet, Copenhagen (Denmark). Cardiology; Barmeyer, A. [Klinikum Dortmund (Germany). Kardiologie; and others

    2014-10-15

    Percutaneous mitral valve repair with the MitraClip device (Abbott Vascular, Redwood City, California, USA) is a novel therapeutic option in patients with mitral regurgitation. This study evaluated the feasibility of cardiac volume measurements by cardiovascular magnetic resonance imaging (CMR) to assess reverse myocardial remodeling in patients after MitraClip implantation. 12 patients underwent CMR at baseline (BL) before and at 6 months follow-up (FU) after MitraClip implantation. Cine-CMR was performed in short- and long-axes for the assessment of left ventricular (LV), right ventricular (RV) and left atrial (LA) volumes. Assessment of endocardial contours was not compromised by the device-related artifact. No significant differences in observer variances were observed for LV, RV and LA volume measurements between BL and FU. LV end-diastolic (median 127 [IQR 96-150] vs. 112 [86-150] ml/m{sup 2}; p=0.03) and LV end-systolic (82 [54-91] vs. 69 [48-99] ml/m{sup 2}; p=0.03) volume indices decreased significantly from BL to FU. No significant differences were found for RV end-diastolic (94 [75-103] vs. 99 [77-123] ml/m{sup 2}; p=0.91), RV end-systolic (48 [42-80] vs. 51 [40-81] ml/m{sup 2}; p=0.48), and LA (87 [55-124] vs. 92 [48-137]R ml/m{sup 2}; p=0.20) volume indices between BL and FU. CMR enables the assessment of cardiac volumes in patients after MitraClip implantation. Our CMR findings indicate that percutaneous mitral valve repair results in reverse LV but not in RV or LA remodeling.

  11. Contribution of cardiovascular magnetic resonance in the evaluation of coronary arteries

    Sophie; Mavrogeni; George; Markousis-Mavrogenis; Genovefa; Kolovou

    2014-01-01

    Cardiovascular magnetic resonance(CMR) allows the nonradiating assessment of coronary arteries; to achieve better image quality cardiorespiratory artefacts should be corrected. Coronary MRA(CMRA) at the mo-ment is indicated only for the detection of abnormal coronary origin, coronary artery ectasia and/or aneu-rysms(class Ⅰ indication) and coronary bypass grafts(class Ⅱ indication). CMRA utilisation for coronary ar-tery disease is not yet part of clinical routine. However, the lack of radiation is of special value for the coronary artery evaluation in children and women. CMRA can assess the proximal part of coronary arteries in almost all cases. The best results have been observed in the evaluation of the left anterior descending and the right coronary artery, while the left circumflex, which is lo-cated far away from the coil elements, is frequently im-aged with reduced quality, compared to the other two. Different studies detected an increase in wall thickness of the coronaries in patients with type Ⅰ diabetes and abnormal renal function. Additionally, the non-contrast enhanced T1-weighed images detected the presence of thrombus in acute myocardial infarction. New tech-niques using delayed gadolinium enhanced imaging promise the direct visualization of inflamed plaques in the coronary arteries. The major advantage of CMRis the potential of an integrated protocol offering as-sessment of coronary artery anatomy, cardiac function, inflammation and stress perfusion-fibrosis in the same study, providing an individualized clinical profile of pa-tients with heart disease.

  12. The role of cardiovascular magnetic resonance in candidates for Fontan operation: Proposal of a new Algorithm

    Ait-Ali Lamia

    2011-11-01

    Full Text Available Abstract Background To propose a new diagnostic algorithm for candidates for Fontan and identify those who can skip cardiac catheterization (CC. Methods Forty-four candidates for Fontan (median age 4.8 years, range: 2-29 years were prospectively evaluated by trans-thoracic echocardiography (TTE, Cardiovascular magnetic resonance (CMR and CC. Before CC, according to clinical, echo and CMR findings, patients were divided in two groups: Group I comprised 18 patients deemed suitable for Fontan without requiring CC; group II comprised 26 patients indicated for CC either in order to detect more details, or for interventional procedures. Results In Group I ("CC not required" no unexpected new information affecting surgical planning was provided by CC. Conversely, in Group II new information was provided by CC in three patients (0 vs 11.5%, p = 0.35 and in six an interventional procedure was performed. During CC, minor complications occurred in one patient from Group I and in three from Group II (6 vs 14%, p = 0.7. Radiation Dose-Area product was similar in the two groups (Median 20 Gycm2, range: 5-40 vs 26.5 Gycm2, range: 9-270 p = 0.37. All 18 Group I patients and 19 Group II patients underwent a total cavo-pulmonary anastomosis; in the remaining seven group II patients, four were excluded from Fontan; two are awaiting Fontan; one refused the intervention. Conclusion In this paper we propose a new diagnostic algorithm in a pre-Fontan setting. An accurate non-invasive evaluation comprising TTE and CMR could select patients who can skip CC.

  13. Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance

    Manning Warren J

    2008-01-01

    Full Text Available Abstract Background Anatomic atrial enlargement is associated with significant morbidity and mortality. However, atrial enlargement may not correlate with clinical measures such as electrocardiographic (ECG criteria. Past studies correlating ECG criteria with anatomic measures mainly used inferior M-mode or two-dimensional echocardiographic data. We sought to determine the accuracy of the ECG to predict anatomic atrial enlargement as determined by volumetric cardiovascular magnetic resonance (CMR. Methods ECG criteria for left (LAE and right atrial enlargement (RAE were compared to CMR atrial volume index measurements for 275 consecutive subjects referred for CMR (67% males, 51 ± 14 years. ECG criteria for LAE and RAE were assessed by an expert observer blinded to CMR data. Atrial volume index was computed using the biplane area-length method. Results The prevalence of CMR LAE and RAE was 28% and 11%, respectively, and by any ECG criteria was 82% and 5%, respectively. Though nonspecific, the presence of at least one ECG criteria for LAE was 90% sensitive for CMR LAE. The individual criteria P mitrale, P wave axis 0.04s·mm were 88–99% specific although not sensitive for CMR LAE. ECG was insensitive but 96–100% specific for CMR RAE. Conclusion The presence of at least one ECG criteria for LAE is sensitive but not specific for anatomic LAE. Individual criteria for LAE, including P mitrale, P wave axis 0.04s·mm are highly specific, though not sensitive. ECG is highly specific but insensitive for RAE. Individual ECG P wave changes do not reliably both detect and predict anatomic atrial enlargement.

  14. BOLD cardiovascular magnetic resonance at 3.0 tesla in myocardial ischemia

    Gebker Rolf

    2010-09-01

    Full Text Available Abstract Background The purpose of this study was to determine the ability of Blood Oxygen Level Dependent (BOLD cardiovascular magnetic resonance (CMR to detect stress-inducible myocardial ischemic reactions in the presence of angiographically significant coronary artery disease (CAD. Methods Forty-six patients (34 men; age 65 ± 9 years, with suspected or known coronary artery disease underwent CMR at 3Tesla prior to clinically indicated invasive coronary angiography. BOLD CMR was performed in 3 short axis slices of the heart at rest and during adenosine stress (140 μg/kg/min followed by late gadolinium enhancement (LGE imaging. In all 16 standard myocardial segments, T2* values were derived at rest and under adenosine stress. Quantitative coronary angiography served as the standard of reference and defined normal myocardial segments (i.e. all 16 segments in patients without any CAD, ischemic segments (i.e. supplied by a coronary artery with ≥50% luminal narrowing and non-ischemic segments (i.e. supplied by a non-significantly stenosed coronary artery in patients with significant CAD. Results Coronary angiography demonstrated significant CAD in 23 patients. BOLD CMR at rest revealed significantly lower T2* values for ischemic segments (26.7 ± 11.6 ms compared to normal (31.9 ± 11.9 ms; p Conclusions Rest and stress BOLD CMR at 3Tesla proved feasible and differentiated between ischemic, non-ischemic, and normal myocardial segments in a clinical patient population. BOLD CMR during vasodilator stress identified patients with significant CAD.

  15. Cardiovascular magnetic resonance findings in a pediatric population with isolated left ventricular non-compaction

    Uribe Sergio

    2012-01-01

    Full Text Available Abstract Background Isolated Left Ventricular Non-compaction (LVNC is an uncommon disorder characterized by the presence of increased trabeculations and deep intertrabecular recesses. In adults, it has been found that Ejection Fraction (EF decreases significantly as non-compaction severity increases. In children however, there are a few data describing the relation between anatomical characteristics of LVNC and ventricular function. We aimed to find correlations between morphological features and ventricular performance in children and young adolescents with LVNC using Cardiovascular Magnetic Resonance (CMR. Methods 15 children with LVNC (10 males, mean age 9.7 y.o., range 0.6 - 17 y.o., underwent a CMR scan. Different morphological measures such as the Compacted Myocardial Mass (CMM, Non-Compaction (NC to the Compaction (C distance ratio, Compacted Myocardial Area (CMA and Non-Compacted Myocardial Area (NCMA, distribution of NC, and the assessment of ventricular wall motion abnormalities were performed to investigate correlations with ventricular performance. EF was considered normal over 53%. Results The distribution of non-compaction in children was similar to published adult data with a predilection for apical, mid-inferior and mid-lateral segments. Five patients had systolic dysfunction with decreased EF. The number of affected segments was the strongest predictor of systolic dysfunction, all five patients had greater than 9 affected segments. Basal segments were less commonly affected but they were affected only in these five severe cases. Conclusion The segmental pattern of involvement of non-compaction in children is similar to that seen in adults. Systolic dysfunction in children is closely related to the number of affected segments.

  16. Troponin release following endurance exercise: is inflammation the cause? a cardiovascular magnetic resonance study

    O'Hanlon Rory

    2010-07-01

    Full Text Available Abstract Background The aetiology and clinical significance of troponin release following endurance exercise is unclear but may be due to transient myocardial inflammation. Cardiovascular magnetic resonance (CMR affords us the opportunity to evaluate the presence of myocardial inflammation and focal fibrosis and is the ideal imaging modality to study this hypothesis. We sought to correlate the relationship between acute bouts of ultra endurance exercise leading to cardiac biomarkers elevation and the presence of myocardial inflammation and fibrosis using CMR. Methods 17 recreation athletes (33.5 +/- 6.5 years were studied before and after a marathon run with troponin, NTproBNP, and CMR. Specific imaging parameters to look for inflammation included T2 weighted images, and T1 weighted spin-echo images before and after an intravenous gadolinium-DTPA to detect myocardial hyperemia secondary to inflammation. Late gadolinium imaging was performed (LGE to detect any focal regions of replacement fibrosis. Results Eleven of the 17 participant had elevations of TnI above levels of cut off for myocardial infarction 6 hrs after the marathon (0.075 +/- 0.02, p = 0.007. Left ventricular volumes were reduced post marathon and a small increase in ejection fraction was noted (64+/- 1% pre, 67+/- 1.2% post, P = 0.014. Right ventricular volumes, stroke volume, and ejection fraction were unchanged post marathon. No athlete fulfilled criteria for myocardial inflammation based on current criteria. No regions of focal fibrosis were seen in any of the participants. Conclusion Exercise induced cardiac biomarker release is not associated with any functional changes by CMR or any detectable myocardial inflammation or fibrosis.

  17. Longitudinal strain from velocity encoded cardiovascular magnetic resonance: a validation study

    Heiberg Einar

    2013-01-01

    Full Text Available Abstract Background Regional myocardial function is typically evaluated by visual assessment by experienced users, or by methods requiring substantial post processing time. Visual assessment is subjective and not quantitative. Therefore, the purpose of this study is to develop and validate a simple method to derive quantitative measures of regional wall function from velocity encoded Cardiovascular Magnetic Resonance (CMR, and provide associated normal values for longitudinal strain. Method Both fast field echo (FFE and turbo field echo (TFE velocity encoded CMR images were acquired in three long axis planes in 36 healthy volunteers (13 women, 23 men, age 35±12 years. Strain was also quantified in 10 patients within one week after myocardial infarction. The user manually delineated myocardium in one time frame and strain was calculated as the myocardium was tracked throughout the cardiac cycle using an optimization formulation and mechanical a priori assumptions. A phantom experiment was performed to validate the method with optical tracking of deformation as an independent gold standard. Results There was an excellent agreement between longitudinal strain measured by optical tracking and longitudinal strain measured with TFE velocity encoding. Difference between the two methods was 0.0025 ± 0.085 (ns. Mean global longitudinal strain in the 36 healthy volunteers was −0.18 ± 0.10 (TFE imaging. Intra-observer variability for all segments was 0.00 ± 0.06. Inter-observer variability was −0.02 ± 0.07 (TFE imaging. The intra-observer variability for radial strain was high limiting the applicability of radial strain. Mean longitudinal strain in patients was significantly lower (−0.15± 0.12 compared to healthy volunteers (p Conclusion In conclusion, we have developed and validated a robust and clinically applicable technique that can quantify longitudinal strain and regional myocardial wall function and present the associated normal values

  18. Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance

    Dweck Marc R

    2012-07-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR is the gold standard non-invasive method for determining left ventricular (LV mass and volume but has not been used previously to characterise the LV remodeling response in aortic stenosis. We sought to investigate the degree and patterns of hypertrophy in aortic stenosis using CMR. Methods Patients with moderate or severe aortic stenosis, normal coronary arteries and no other significant valve lesions or cardiomyopathy were scanned by CMR with valve severity assessed by planimetry and velocity mapping. The extent and patterns of hypertrophy were investigated using measurements of the LV mass index, indexed LV volumes and the LV mass/volume ratio. Asymmetric forms of remodeling and hypertrophy were defined by a regional wall thickening ≥13 mm and >1.5-fold the thickness of the opposing myocardial segment. Results Ninety-one patients (61±21 years; 57 male with aortic stenosis (aortic valve area 0.93±0.32cm2 were recruited. The severity of aortic stenosis was unrelated to the degree (r2=0.012, P=0.43 and pattern (P=0.22 of hypertrophy. By univariate analysis, only male sex demonstrated an association with LV mass index (P=0.02. Six patterns of LV adaption were observed: normal ventricular geometry (n=11, concentric remodeling (n=11, asymmetric remodeling (n=11, concentric hypertrophy (n=34, asymmetric hypertrophy (n=14 and LV decompensation (n=10. Asymmetric patterns displayed considerable overlap in appearances (wall thickness 17±2mm with hypertrophic cardiomyopathy. Conclusions We have demonstrated that in patients with moderate and severe aortic stenosis, the pattern of LV adaption and degree of hypertrophy do not closely correlate with the severity of valve narrowing and that asymmetric patterns of wall thickening are common. Trial registration ClinicalTrials.gov Reference Number: NCT00930735

  19. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging

    Delewi, Ronak [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Interuniversity Cardiology Institute of the Netherlands (Netherlands); Nijveldt, Robin [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Hirsch, Alexander [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Marcu, Constantin B.; Robbers, Lourens [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Hassell, Marriela E.C.J.; Bruin, Rianne H.A. de; Vleugels, Jim; Laan, Anja M. van der; Bouma, Berto J. [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Tio, René A. [Thorax Center, University Medical Center Groningen, Groningen (Netherlands); Tijssen, Jan G.P. [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Rossum, Albert C. van [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Zijlstra, Felix [Thorax Center, Department of Cardiology, Erasmus University Medical Center, Rotterdam (Netherlands); Piek, Jan J., E-mail: j.j.piek@amc.uva.nl [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands)

    2012-12-15

    Introduction: Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. Methods: 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. Results: On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B = 0.02, SE = 0.02, p < 0.001). Routine TTE had a sensitivity of 21–24% and a specificity of 95–98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ = 0.91 and κ = 0.96) compared to TTE (κ = 0.74 and κ = 0.53). Conclusion: LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large.

  20. Static magnetic field effect on the arterial baroreflex-mediated control of microcirculation: implications for cardiovascular effects due to environmental magnetic fields.

    Gmitrov, Juraj

    2007-08-01

    Increasing evidence suggests that time-varying and static magnetic fields in the environment might affect the cardiovascular system. To explore the underlying physiology, the effect of static magnetic fields (SMFs) on the carotid baroreflex control of microcirculation was studied. Twenty-four hemodynamic monitorings were performed in rabbits sedated by pentobarbital infusion (5 mg/kg/h) during experiments that lasted 120 min. Mean femoral artery blood pressure, heart rate, and ear lobe skin microcirculatory blood flow, measured by microphotoelectric plethysmogram (MPPG), were simultaneously recorded before and after a 40 min exposure of the sinocarotid baroreceptors to Nd(2)-Fe(14)-B alloy magnets (n = 14) or sham magnets (n = 10, control series). The local SMF field was 350 mT, at the baroreceptors' site. Arterial baroreflex sensitivity (BRS) was estimated from heart rate/blood pressure response to intravenous bolus injections of nitroprusside and phenylephrine. A significant positive correlation was found between the SMF-induced increase in BRS (DeltaBRS = BRS(afterSMF) - BRS(priorSMF)) and the increment in microvascular blood flow (DeltaMPPG = MPPG(afterSMF) - MPPG(priorSMF)) (r = 0.66, p < 0.009). The SMF probably modulated the arterial baroreflex-mediated microcirculatory control. This could represent one possible mechanism how environmental magnetic fields act on the cardiovascular system, and a method how to complexly adjust macro- and microcirculation with potential clinical implementation. PMID:17530271

  1. A New Approach to 3-Dimensional Fields

    agashe, sadanand

    2016-01-01

    A new approach, using the operator "x d/dx + y d/dy + z d/dz", is introduced for studying 3-dimensional scalar and vector fields. The approach uses a property of the operator which is similar to that of the Laplacian operator, but the operator does not seem to have been used before. Also, the operator requires only once-differentiability of the fields. Using it, a number of new formulas are derived and new proofs given for many classical results such as the Helmholtz theorem, the Poisson form...

  2. 3-dimensional defect TQFTs and their tricategories

    Carqueville, Nils; Schaumann, Gregor

    2016-01-01

    We initiate a systematic study of 3-dimensional `defect' topological quantum field theories, that we introduce as symmetric monoidal functors on stratified and decorated bordisms. For every such functor we construct a tricategory with duals, which is the natural categorification of a pivotal bicategory. This captures the algebraic essence of defect TQFTs, and it gives precise meaning to the fusion of line and surface defects as well as their duality operations. As examples, we discuss how Reshetikhin-Turaev and Turaev-Viro theories embed into our framework, and how they can be extended to defect TQFTs.

  3. Determination of Edema in Porcine Coronary Arteries by T2 Weighted Cardiovascular Magnetic Resonance

    Falk Erling

    2011-09-01

    Full Text Available Abstract Background Inflammation plays a pivotal role in all stages of atherosclerosis. Since edema is known to be an integral part of inflammation, a noninvasive technique that can identify edema in the coronary artery wall may provide unique information regarding plaque activity. In this study, we aimed to determine whether edema induced in porcine coronary arteries by balloon injury could be reliably detected by cardiovascular magnetic resonance (CMR using a water sensitive T2-weighted short tau inversion recovery sequence (T2-STIR. We also aimed to compare these results to those of conventional T2-weighted (T2W imaging. Methods Edema was induced in the proximal left anterior descending (LAD coronary artery wall in seven pigs by balloon injury. At baseline, and 1-10 days (average four post injury, the proximal LAD was assessed by water sensitive T2-STIR and conventional T2W sequences in cross-sectional planes. CMR images were matched to histopathology, validated against Evans blue as a marker of increased vessel wall permeability, and correlated with the arterial amount of fibrinogen used as an edema surrogate marker. Results Post injury, the T2-STIR images of the injured LAD vessel wall showed a significant 72%, relative signal intensity (SI increase compared with baseline (p = 0.028. Using a threshold value of SI 7 SD above the average SI of the myocardium, T2-STIR detected edema in the vessel wall (i.e. enhancement with a sensitivity of 100 and a specificity of 71. Twelve out of the 14 (86% T2-STIR images displaying coronary artery wall enhancement also showed Evans blue uptake in the corresponding histology. The relative signal intensity showed a linear correlation with the amount of fibrinogen detected on the corresponding histopathology (ρ = 0.750, p = 0.05. The conventional T2W images did not show significant changes in SI post injury. Conclusion T2-STIR CMR enabled detection of coronary artery wall edema and could therefore be a non

  4. Semi-automatic segmentation of myocardium at risk in T2-weighted cardiovascular magnetic resonance

    Sjögren Jane

    2012-01-01

    Full Text Available Abstract Background T2-weighted cardiovascular magnetic resonance (CMR has been shown to be a promising technique for determination of ischemic myocardium, referred to as myocardium at risk (MaR, after an acute coronary event. Quantification of MaR in T2-weighted CMR has been proposed to be performed by manual delineation or the threshold methods of two standard deviations from remote (2SD, full width half maximum intensity (FWHM or Otsu. However, manual delineation is subjective and threshold methods have inherent limitations related to threshold definition and lack of a priori information about cardiac anatomy and physiology. Therefore, the aim of this study was to develop an automatic segmentation algorithm for quantification of MaR using anatomical a priori information. Methods Forty-seven patients with first-time acute ST-elevation myocardial infarction underwent T2-weighted CMR within 1 week after admission. Endocardial and epicardial borders of the left ventricle, as well as the hyper enhanced MaR regions were manually delineated by experienced observers and used as reference method. A new automatic segmentation algorithm, called Segment MaR, defines the MaR region as the continuous region most probable of being MaR, by estimating the intensities of normal myocardium and MaR with an expectation maximization algorithm and restricting the MaR region by an a priori model of the maximal extent for the user defined culprit artery. The segmentation by Segment MaR was compared against inter observer variability of manual delineation and the threshold methods of 2SD, FWHM and Otsu. Results MaR was 32.9 ± 10.9% of left ventricular mass (LVM when assessed by the reference observer and 31.0 ± 8.8% of LVM assessed by Segment MaR. The bias and correlation was, -1.9 ± 6.4% of LVM, R = 0.81 (p Conclusions There is a good agreement between automatic Segment MaR and manually assessed MaR in T2-weighted CMR. Thus, the proposed algorithm seems to be a

  5. Inter-study reproducibility of cardiovascular magnetic resonance myocardial feature tracking

    Morton Geraint

    2012-06-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance myocardial feature tracking (CMR-FT is a recently described method of post processing routine cine acquisitions which aims to provide quantitative measurements of circumferentially and radially directed ventricular wall strain. Inter-study reproducibility is important for serial assessments however has not been defined for CMR-FT. Methods 16 healthy volunteers were imaged 3 times within a single day. The first examination was performed at 0900 after fasting and was immediately followed by the second. The third, non-fasting scan, was performed at 1400. CMR-FT measures of segmental and global strain parameters were calculated. Left ventricular (LV circumferential and radial strain were determined in the short axis orientation (EccSAX and ErrSAX respectively. LV and right ventricular longitudinal strain and LV radial strain were determined from the 4-chamber orientation (EllLV, EllRV, and ErrLAX respectively. LV volumes and function were also analysed. Inter-study reproducibility and study sample sizes required to demonstrate 5% changes in absolute strain were determined by comparison of the first and second exams. The third exam was used to determine whether diurnal variation affected reproducibility. Results CMR-FT strain analysis inter-study reproducibility was variable. Global strain assessment was more reproducible than segmental analysis. Overall EccSAX was the most reproducible measure of strain: coefficient of variation (CV 38% and 20.3% and intraclass correlation coefficient (ICC 0.68 (0.55-0.78 and 0.7 (0.32-0.89 for segmental and global analysis respectively. The least reproducible segmental measure was EllRV: CV 60% and ICC 0.56 (0.41-0.69 whilst the least reproducible global measure was ErrLAX: CV 33.3% and ICC 0.44 (0–0.77. Variable reproducibility was also reflected in the calculated sample sizes, which ranged from 11 (global EccSAX to 156 subjects (segmental EllRV. The

  6. Cardiovascular magnetic resonance in the diagnosis of acute heart transplant rejection: a review

    Toma Mustafa

    2009-03-01

    Full Text Available Abstract Background Screening for organ rejection is a critical component of care for patients who have undergone heart transplantation. Endomyocardial biopsy is the gold standard screening tool, but non-invasive alternatives are needed. Cardiovascular magnetic resonance (CMR is well suited to provide an alternative to biopsy because of its ability to quantify ventricular function, morphology, and characterize myocardial tissue. CMR is not widely used to screen for heart transplant rejection, despite many trials supporting its use for this indication. This review summarizes the different CMR sequences that can detect heart transplant rejection as well as the strengths and weaknesses of their application. Results T2 quantification by spin echo techniques has been criticized for poor reproducibility, but multiple studies show its utility in screening for rejection. Human and animal data estimate that T2 quantification can diagnose rejection with sensitivities and specificities near 90%. There is also a suggestion that T2 quantification can predict rejection episodes in patients with normal endomyocardial biopsies. T1 quantification has also shown association with biopsy proven rejection in a small number of trials. T1 weighted gadolinium early enhancement appeared promising in animal data, but has had conflicting results in human trials. Late gadolinium enhancement in the diagnosis of rejection has not been evaluated. CMR derived measures of ventricular morphology and systolic function have insufficient sensitivity to diagnose mild to moderate rejection. CMR derived diastolic function can demonstrate abnormalities in allografts compared to native human hearts, but its ability to diagnose rejection has not yet been tested. There is promising animal data on the ability of iron oxide contrast agents to illustrate the changes in vascular permeability and macrophage accumulation seen in rejection. Despite good safety data, these contrast agents have

  7. Cardiovascular magnetic resonance myocardial feature tracking detects quantitative wall motion during dobutamine stress

    Beerbaum Philipp

    2011-10-01

    Full Text Available Abstract Background Dobutamine stress cardiovascular magnetic resonance (DS-CMR is an established tool to assess hibernating myocardium and ischemia. Analysis is typically based on visual assessment with considerable operator dependency. CMR myocardial feature tracking (CMR-FT is a recently introduced technique for tissue voxel motion tracking on standard steady-state free precession (SSFP images to derive circumferential and radial myocardial mechanics. We sought to determine the feasibility and reproducibility of CMR-FT for quantitative wall motion assessment during intermediate dose DS-CMR. Methods 10 healthy subjects were studied at 1.5 Tesla. Myocardial strain parameters were derived from SSFP cine images using dedicated CMR-FT software (Diogenes MRI prototype; Tomtec; Germany. Right ventricular (RV and left ventricular (LV longitudinal strain (EllRV and EllLV and LV long-axis radial strain (ErrLAX were derived from a 4-chamber view at rest. LV short-axis circumferential strain (EccSAX and ErrSAX; LV ejection fraction (EF and volumes were analyzed at rest and during dobutamine stress (10 and 20 μg · kg-1· min-1. Results In all volunteers strain parameters could be derived from the SSFP images at rest and stress. EccSAX values showed significantly increased contraction with DSMR (rest: -24.1 ± 6.7; 10 μg: -32.7 ± 11.4; 20 μg: -39.2 ± 15.2; p SAX increased significantly with dobutamine (rest: 19.6 ± 14.6; 10 μg: 31.8 ± 20.9; 20 μg: 42.4 ± 25.5; p SAX and worst for RV longitudinal strain (EllRV as determined by 95% confidence intervals of the difference. Conclusions CMR-FT reliably detects quantitative wall motion and strain derived from SSFP cine imaging that corresponds to inotropic stimulation. The current implementation may need improvement to reduce observer-induced variance. Within a given CMR lab; this novel technique holds promise of easy and fast quantification of wall mechanics and strain.

  8. Cardiovascular magnetic resonance feature-tracking assessment of myocardial mechanics: Intervendor agreement and considerations regarding reproducibility

    Aim: To assess intervendor agreement of cardiovascular magnetic resonance feature tracking (CMR-FT) and to study the impact of repeated measures on reproducibility. Materials and methods: Ten healthy volunteers underwent cine imaging in short-axis orientation at rest and with dobutamine stimulation (10 and 20 μg/kg/min). All images were analysed three times using two types of software (TomTec, Unterschleissheim, Germany and Circle, cvi42, Calgary, Canada) to assess global left ventricular circumferential (Ecc) and radial (Err) strains and torsion. Differences in intra- and interobserver variability within and between software types were assessed based on single and averaged measurements (two and three repetitions with subsequent averaging of results, respectively) as determined by Bland–Altman analysis, intraclass correlation coefficients (ICC), and coefficient of variation (CoV). Results: Myocardial strains and torsion significantly increased on dobutamine stimulation with both types of software (p<0.05). Resting Ecc and torsion as well as Ecc values during dobutamine stimulation were lower measured with Circle (p<0.05). Intra- and interobserver variability between software types was lowest for Ecc (ICC 0.81 [0.63–0.91], 0.87 [0.72–0.94] and CoV 12.47% and 14.3%, respectively) irrespective of the number of analysis repetitions. Err and torsion showed higher variability that markedly improved for torsion with repeated analyses and to a lesser extent for Err. On an intravendor level TomTec showed better reproducibility for Ecc and torsion and Circle for Err. Conclusions: CMR-FT strain and torsion measurements are subject to considerable intervendor variability, which can be reduced using three analysis repetitions. For both vendors, Ecc qualifies as the most robust parameter with the best agreement, albeit lower Ecc values obtained using Circle, and warrants further investigation of incremental clinical merit. -- Highlights: •This is the first comparison

  9. A dilogarithmic 3-dimensional Ising tetrahedron

    Broadhurst, D J

    1999-01-01

    In 3 dimensions, the Ising model is in the same universality class as unknown analytical nature. In contrast, all single-scale 4-dimensional tetrahedra were reduced, in hep-th/9803091, to special values of exponentially convergent polylogarithms. Combining dispersion relations with the integer-relation finder PSLQ, we find that $C^{Tet}/2^{5/2} = Cl_2(4\\alpha) - Cl_2(2\\alpha)$, with $Cl_2(\\theta):=\\sum_{n>0}\\sin(n\\theta)/n^2$ and 1,000-digit precision and readily yields 50,000 digits of $C^{Tet}$, after transformation to an exponentially convergent sum, akin to those studied in math.CA/9803067. It appears that this 3-dimensional result entails a polylogarithmic ladder beginning with the classical formula for $\\pi/\\sqrt2$, in the manner that 4-dimensional results build on that for $\\pi/\\sqrt3$.

  10. 3-dimensional bioprinting for tissue engineering applications.

    Gu, Bon Kang; Choi, Dong Jin; Park, Sang Jun; Kim, Min Sup; Kang, Chang Mo; Kim, Chun-Ho

    2016-01-01

    The 3-dimensional (3D) printing technologies, referred to as additive manufacturing (AM) or rapid prototyping (RP), have acquired reputation over the past few years for art, architectural modeling, lightweight machines, and tissue engineering applications. Among these applications, tissue engineering field using 3D printing has attracted the attention from many researchers. 3D bioprinting has an advantage in the manufacture of a scaffold for tissue engineering applications, because of rapid-fabrication, high-precision, and customized-production, etc. In this review, we will introduce the principles and the current state of the 3D bioprinting methods. Focusing on some of studies that are being current application for biomedical and tissue engineering fields using printed 3D scaffolds. PMID:27114828

  11. Scientific visualization of 3-dimensional optimized stellarator configurations

    The design techniques and physics analysis of modern stellarator configurations for magnetic fusion research rely heavily on high performance computing and simulation. Stellarators, which are fundamentally 3-dimensional in nature, offer significantly more design flexibility than more symmetric devices such as the tokamak. By varying the outer boundary shape of the plasma, a variety of physics features, such as transport, stability, and heating efficiency can be optimized. Scientific visualization techniques are an important adjunct to this effort as they provide a necessary ergonomic link between the numerical results and the intuition of the human researcher. The authors have developed a variety of visualization techniques for stellarators which both facilitate the design optimization process and allow the physics simulations to be more readily understood

  12. The role of magnetic resonance tomography in the diagnosis of congenital cardiovascular disorders in children and adolescents

    In the presence of congenital cardiovascular diseases magnetic resonance tomography may be used for children of all age groups as a method providing valuable additional clues, if the information obtained by the usual non-invasive techniques is found wanting and the degree of the disease does not warrant angiocardiography. The current uses of mganetic resonance tomography are largely restricted to the major vessels, septal anomalies that are difficult to ascertain and complex lesions associated with organ displacement. Information even superior to that of angiography may be provided by magnetic resonance tomography in carefully selected cases where probing of certain cardiac or vascular sections is impossible or the disease more widely spread to include the bronchi and pulmonary parenchyma. (orig.)

  13. Cardiovascular magnetic resonance evaluation of aortic stenosis severity using single plane measurement of effective orifice area

    Garcia Julio

    2012-04-01

    Full Text Available Abstract Background Transthoracic echocardiography (TTE is the standard method for the evaluation of the severity of aortic stenosis (AS. Valve effective orifice area (EOA measured by the continuity equation is one of the most frequently used stenotic indices. However, TTE measurement of aortic valve EOA is not feasible or not reliable in a significant proportion of patients. Cardiovascular magnetic resonance (CMR has emerged as a non-invasive alternative to evaluate EOA using velocity measurements. The objectives of this study were: 1 to validate a new CMR method using jet shear layer detection (JSLD based on acoustical source term (AST concept to estimate the valve EOA; 2 to introduce a simplified JSLD method not requiring vorticity field derivation. Methods and results We performed an in vitro study where EOA was measured by CMR in 4 fixed stenoses (EOA = 0.48, 1.00, 1.38 and 2.11 cm2 under the same steady flow conditions (4-20 L/min. The in vivo study included eight (8 healthy subjects and 37 patients with mild to severe AS (0.72 cm2 ≤ EOA ≤ 1.71 cm2. All subjects underwent TTE and CMR examinations. EOA was determinated by TTE with the use of continuity equation method (TTECONT. For CMR estimation of EOA, we used 3 methods: 1 Continuity equation (CMRCONT; 2 Shear layer detection (CMRJSLD, which was computed from the velocity field of a single CMR velocity profile at the peak systolic phase; 3 Single plane velocity truncation (CMRSPVT, which is a simplified version of CMRJSLD method. There was a good agreement between the EOAs obtained in vitro by the different CMR methods and the EOA predicted from the potential flow theory. In the in vivo study, there was good correlation and concordance between the EOA measured by the TTECONT method versus those measured by each of the CMR methods: CMRCONT (r = 0.88, CMRJSLD (r = 0.93 and CMRSPVT (r = 0.93. The intra- and inter- observer variability of EOA measurements was 5 ± 5% and 9 ± 5% for

  14. Performance Analysis of 3-Dimensional Turbo Codes

    Rosnes, Eirik

    2011-01-01

    In this work, we consider the minimum distance properties and convergence thresholds of 3-dimensional turbo codes (3D-TCs), recently introduced by Berrou et al.. Here, we consider binary 3D-TCs while the original work of Berrou et al. considered double-binary codes. In the first part of the paper, the minimum distance properties are analyzed from an ensemble perspective, both in the finite-length regime and in the asymptotic case of large block lengths. In particular, we analyze the asymptotic weight distribution of 3D-TCs and show numerically that their typical minimum distance dmin may, depending on the specific parameters, asymptotically grow linearly with the block length, i.e., the 3D-TC ensemble is asymptotically good for some parameters. In the second part of the paper, we derive some useful upper bounds on the dmin when using quadratic permutation polynomial (QPP) interleavers with a quadratic inverse. Furthermore, we give examples of interleaver lengths where an upper bound appears to be tight. The b...

  15. 心血管MRI第二部分--心血管MRI的基本序列和常用技术%Cardiovascular magnetic resonance imaging:Part II--the basic sequences and common techniques of cardiovascular magnetic resonance

    尹刚; 贺光军; 赵世华

    2013-01-01

    This article is the second section. The basic contrast behaviors, sequences, and requirements of cardiovascular magnetic resonance imaging were described in detail. First, three basic fast sequences for CMR imaging and different contrast behaviors were summarized. Second, some common used technique strategies for solving the problems in CMR imaging were presented.%此文为第二部分,着重介绍心血管MRI(CMRI)的基本对比、序列及要求。首先,归纳CMRI的三种基本快速成像序列和图像的对比分类。然后,应对CMRI的技术挑战和难点,讲述CMRI质量控制的常用技术。

  16. Electrocardiographic diagnosis of left ventricular hypertrophy in aortic valve disease: evaluation of ECG criteria by cardiovascular magnetic resonance

    Feuerbach Stefan

    2009-06-01

    Full Text Available Abstract Background Left ventricular hypertrophy (LVH is a hallmark of chronic pressure or volume overload of the left ventricle and is associated with risk of cardiovascular morbidity and mortality. The purpose was to evaluate different electrocardiographic criteria for LVH as determined by cardiovascular magnetic resonance (CMR. Additionally, the effects of concentric and eccentric LVH on depolarization and repolarization were assessed. Methods 120 patients with aortic valve disease and 30 healthy volunteers were analysed. As ECG criteria for LVH, we assessed the Sokolow-Lyon voltage/product, Gubner-Ungerleider voltage, Cornell voltage/product, Perugia-score and Romhilt-Estes score. Results All ECG criteria demonstrated a significant correlation with LV mass and chamber size. The highest predictive values were achieved by the Romhilt-Estes score 4 points with a sensitivity of 86% and specificity of 81%. There was no difference in all ECG criteria between concentric and eccentric LVH. However, the intrinsicoid deflection (V6 37 ± 1.0 ms vs. 43 ± 1.6 ms, p Conclusion By calibration with CMR, a wide range of predictive values was found for the various ECG criteria for LVH with the most favourable results for the Romhilt-Estes score. As electrocardiographic correlate for concentric LVH as compared with eccentric LVH, a shorter intrinsicoid deflection and a significant ST-segment and T-wave depression in the anterolateral leads was noted.

  17. Cardiovascular magnetic resonance imaging assessment of diastolic dysfunction in a population without heart disease: a gender-based study

    Asymptomatic left ventricular (LV) diastolic dysfunction is increasingly recognised as an important diagnosis. Our goal was to study the prevalence and gender differences in subclinical LV diastolic dysfunction, using cardiovascular magnetic resonance imaging (CMR) at 3 T. We prospectively studied 48 volunteers (19 male and 29 female, mean age 49 ± 7 years) with no evidence of cardiovascular disease. We used CMR to measure left atrium (LA) and LV volumes, LV peak filling rate and transmitral flow. The overall prevalence of LV diastolic dysfunction in our cohort varied between 20 % (based on evaluation of LV filing profiles) and 24 % (based on the evaluation of the transmitral flow). The prevalence of diastolic dysfunction was higher in men than in women, independently of the criteria used (P between 0.004 and 0.022). Indexed LV end-diastolic volume, indexed LV stroke volume, indexed LV mass, indexed LA minimum volume and indexed LA maximum volume were significantly greater in men than in women (P < 0.05). All the subjects had LV ejection fractions within the normal range. It is clinically feasible to study diastolic flow and LV filling with CMR. CMR detected diastolic dysfunction in asymptomatic men and women. (orig.)

  18. Dobutamine stress MRI. Part II. Risk stratification with dobutamine cardiovascular magnetic resonance in patients suspected of myocardial ischemia

    The aim of this study was to determine the prognostic value of dobutamine cardiovascular magnetic resonance (CMR) in patients suspected of myocardial ischemia. Clinical data and dobutamine-CMR results were analyzed in 299 consecutive patients. Follow-up data were analyzed in categories of risk levels defined by the history of coronary artery disease and presence of rest wall motion abnormalities (RWMA). Major adverse cardiac events (MACE) as evaluated end points included cardiac death, nonfatal myocardial infarction and clinically indicated coronary revascularization. Follow-up was completed in 214 (99%) patients with a negative dobutamine-CMR study (no signs of inducible myocardial ischemia) with an average of 24 months. The patients with a negative dobutamine-CMR study and RWMA showed a significantly higher annual MACE rate (18%) than the patients without RWMA (0.56%) (P<0.001). Patients without RWMA showed an annual MACE rate of 2% when they had a history of coronary artery disease and <0.1% without a previous coronary event (P<0.001). Dobutamine-CMR showed a positive and negative predictive value of 95 and 93%, respectively. The cardiovascular occurrence-free survival rate was 96.2%. In patients suspected of myocardial ischemia, dobutamine-CMR is able to assess risk levels for coronary events with high accuracy. (orig.)

  19. Early detection of cardiac involvement in Miyoshi myopathy: 2D strain echocardiography and late gadolinium enhancement cardiovascular magnetic resonance

    Kim Byoung

    2010-05-01

    Full Text Available Abstract Background Miyoshi myopathy (MM is an autosomal recessive distal myopathy characterized by early adult onset. Cardiomyopathy is a major clinical manifestation in other muscular dystrophies and an important prognostic factor. Although dysferlin is highly expressed in cardiac muscle, the effect of dysferlin deficiency in cardiac muscle has not been studied. We hypothesized that early myocardial dysfunction could be detected by 2D strain echocardiography and late gadolinium enhancement (LGE cardiovascular magnetic resonance (CMR. Method Five consecutive MM patients (3 male in whom we detected the DYSF gene mutation and age-matched healthy control subjects were included. None of the patients had history of cardiac disease or signs and symptoms of overt heart failure. Patients were studied using 2D strain echocardiography and CMR, with 2D strain being obtained using the Automated Function Imaging technique. Results All patients had preserved left ventricular systolic function. However, segmental Peak Systolic Longitudinal Strain (PSLS was decreased in 3 patients. Global PSLS was significantly lower in patients with MM than in control subjects (p = 0.005. Basal anterior septum, basal inferior septum, mid anterior, and mid inferior septum PSLS were significantly lower in patients with MM than in control subjects (P Conclusions Patients with MM showed subclinical involvement of the heart. 2D strain and LGE are sensitive methods for detecting myocardial dysfunction prior to the development of cardiovascular symptoms. The prognostic significance of these findings warrants further longitudinal follow-up.

  20. Cardiovascular magnetic resonance imaging assessment of diastolic dysfunction in a population without heart disease: a gender-based study

    Graca, Bruno; Donato, Paulo; Caseiro-Alves, Filipe [University of Coimbra, Medical Imaging Department, University Centre Hospitals of Coimbra, Faculty of Medicine, Coimbra (Portugal); Ferreira, Maria Joao [University of Coimbra, Cardiology Department, University Centre Hospitals of Coimbra, Faculty of Medicine, Coimbra (Portugal); Castelo-Branco, Miguel [University of Coimbra, Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, Coimbra (Portugal)

    2014-01-15

    Asymptomatic left ventricular (LV) diastolic dysfunction is increasingly recognised as an important diagnosis. Our goal was to study the prevalence and gender differences in subclinical LV diastolic dysfunction, using cardiovascular magnetic resonance imaging (CMR) at 3 T. We prospectively studied 48 volunteers (19 male and 29 female, mean age 49 ± 7 years) with no evidence of cardiovascular disease. We used CMR to measure left atrium (LA) and LV volumes, LV peak filling rate and transmitral flow. The overall prevalence of LV diastolic dysfunction in our cohort varied between 20 % (based on evaluation of LV filing profiles) and 24 % (based on the evaluation of the transmitral flow). The prevalence of diastolic dysfunction was higher in men than in women, independently of the criteria used (P between 0.004 and 0.022). Indexed LV end-diastolic volume, indexed LV stroke volume, indexed LV mass, indexed LA minimum volume and indexed LA maximum volume were significantly greater in men than in women (P < 0.05). All the subjects had LV ejection fractions within the normal range. It is clinically feasible to study diastolic flow and LV filling with CMR. CMR detected diastolic dysfunction in asymptomatic men and women. (orig.)

  1. Imaging focal and interstitial fibrosis with cardiovascular magnetic resonance in athletes with left ventricular hypertrophy: implications for sporting participation.

    Waterhouse, Deirdre F

    2012-11-01

    Long-term high-intensity physical activity is associated with morphological changes, termed as the \\'athlete\\'s heart\\'. The differentiation of physiological cardiac adaptive changes in response to high-level exercise from pathological changes consistent with an inherited cardiomyopathy is imperative. Cardiovascular magnetic resonance (CMR) imaging allows definition of abnormal processes occurring at the tissue level, including, importantly, myocardial fibrosis. It is therefore vital in accurately making this differentiation. In this review, we will review the role of CMR imaging of fibrosis, and detail CMR characterisation of myocardial fibrosis in various cardiomyopathies, and the implications of fibrosis. Additionally, we will outline advances in imaging fibrosis, in particular T1 mapping. Finally we will address the role of CMR in pre-participation screening.

  2. Myocardial infarct heterogeneity assessment by late gadolinium enhancement cardiovascular magnetic resonance imaging shows predictive value for ventricular arrhythmia development after acute myocardial infarction

    Robbers, Lourens F. H. J.; Delewi, Ronak; Nijveldt, Robin; Hirsch, Alexander; Beek, Aernout M.; Kemme, Michiel J. B.; van Beurden, Yvette; van der Laan, Anja M.; van der Vleuten, Pieter A.; Tio, Rene A.; Zijlstra, Felix; Piek, Jan J.; van Rossum, Albert C.

    2013-01-01

    The aim of this study was to assess the association between the proportions of penumbrauvisualized by late gadolinium enhanced cardiovascular magnetic resonance imaging (LGE-CMR)uafter acute myocardial infarction (AMI) and the prevalence of ventricular tachycardia (VT). One-hundred and sixty-two AMI

  3. Myocardial area at risk and salvage measured by T2-weighted cardiovascular magnetic resonance: reproducibility and comparison of two T2-weighted protocols

    Lønborg, Jacob; Vejlstrup, Niels; Mathiasen, Anders B;

    2011-01-01

    Late gadolinium enhancement (LGE) and T2-weighted cardiovascular magnetic resonance (CMR) provides a means to measure myocardial area at risk (AAR) and salvage. Several T2-weighted CMR sequences are in use, but there is no consensus in terms of which sequence to be the preferred. Therefore, the aim...

  4. 3-dimensional analysis of FELIX brick with hole

    Electromagnetic induction on FELIX brick with a hole has been analyzed with 3-Dimensional EDDYNET computer code. Incorporating loop currents on hexahedral meshes, the 3-Dimensional EDDYNET program solves eddy current problems by a network approach, and provides good accuracy even for coarse meshes. (author)

  5. Gender differences in response to cold pressor test assessed with velocity-encoded cardiovascular magnetic resonance of the coronary sinus

    Moulin Guy

    2011-09-01

    Full Text Available Abstract Background Gender-specific differences in cardiovascular risk are well known, and current evidence supports an existing role of endothelium in these differences. The purpose of this study was to assess non invasively coronary endothelial function in male and female young volunteers by myocardial blood flow (MBF measurement using coronary sinus (CS flow quantification by velocity encoded cine cardiovascular magnetic resonance (CMR at rest and during cold pressor test (CPT. Methods Twenty-four healthy volunteers (12 men, 12 women underwent CMR in a 3 Tesla MR imager. Coronary sinus flow was measured at rest and during CPT using non breath-hold velocity encoded phase contrast cine-CMR. Myocardial function and morphology were acquired using a cine steady-state free precession sequence. Results At baseline, mean MBF was 0.63 ± 0.23 mL·g-1·min-1 in men and 0.79 ± 0.21 mL·g-1·min-1 in women. During CPT, the rate pressure product in men significantly increased by 49 ± 36% (p -1·min-1 (p = 0.0022 and by 0.73 ± 0.43 mL·g-1·min-1 (p = 0.0001, respectively. The increase in MBF was significantly higher in women than in men (p = 0.0012. Conclusion CMR coronary sinus flow quantification for measuring myocardial blood flow revealed a higher response of MBF to CPT in women than in men. This finding may reflect gender differences in endothelial-dependent vasodilatation in these young subjects. This non invasive rest/stress protocol may become helpful to study endothelial function in normal physiology and in physiopathology.

  6. The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study

    Dundon BK

    2014-09-01

    Full Text Available Benjamin K Dundon,1–3 Kim Torpey,3 Adam J Nelson,1 Dennis TL Wong,1,2 Rae F Duncan,1 Ian T Meredith,2 Randall J Faull,1,3 Stephen G Worthley,1,4 Matthew I Worthley1,4 1Cardiology Department, Royal Adelaide Hospital, Central Adelaide Local Health Network, Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia; 2Monash Cardiovascular Research Centre, MonashHEART, Monash Health, Melbourne, Vic, Australia; 3Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia; 4South Australian Health and Medical Research Institute, Adelaide, SA, Australia Aim: Arteriovenous fistula-formation remains critical for the provision of hemodialysis in end-stage renal failure patients. Its creation results in a significant increase in cardiac output, with resultant alterations in cardiac stroke volume, systemic blood flow, and vascular resistance. The impact of fistula-formation on cardiac and vascular structure and function has not yet been evaluated via "gold standard" imaging techniques in the modern era of end-stage renal failure care. Methods: A total of 24 patients with stage 5 chronic kidney disease undergoing fistula-creation were studied in a single-arm pilot study. Cardiovascular magnetic resonance imaging was undertaken at baseline, and prior to and 6 months following fistula-creation. This gold standard imaging modality was used to evaluate, via standard brachial flow-mediated techniques, cardiac structure and function, aortic distensibility, and endothelial function. Results: At follow up, left ventricular ejection fraction remained unchanged, while mean cardiac output increased by 25.0% (P<0.0001. Significant increases in left and right ventricular end-systolic volumes (21% [P=0.014] and 18% [P<0.01], left and right atrial area (11% [P<0.01] and 9% [P<0.01], and left ventricular mass were observed (12.7% increase (P<0.01. Endothelial

  7. In vitro study on the feasibility of magnetic stent hyperthermia for the treatment of cardiovascular restenosis

    LI Li; Wang, Rui; Shi, Huan-Huan; Xie, Le; LI, JING-DING-SHA; KONG, WEI-CHAO; Tang, Jin-Tian; KE, DA-NIAN; ZHAO, LING-YUN

    2013-01-01

    Thermal treatment or hyperthermia has received considerable attention in recent years due to its high efficiency, safety and relatively few side-effects. In this study, we investigated whether it was possible to utilize targeted thermal or instent thermal treatments for the treatment of restenosis following percutaneous transluminal coronary angioplasty (PTCA) through magnetic stent hyperthermia (MSH). A 316L stainless steel stent and rabbit vascular smooth muscle cells (VSMCs) were used in t...

  8. Interaction of magnetic field-cardiovascular system as a potential risk

    SERT, Cemil

    2013-01-01

    Electromagnetic pollution is an unavoidable reality in today’s world and in our lives. There are many different sources of electromagnetic radiation like industrial electrical equipment, electrical appliances, medical instruments, such as magnetic resonance imaging (MRI), high electrical power lines. The first structures sensitive to electromagnetic fields are signal processing structures: Cell surface receptors, ion channels and ion entrance and exit through these channels, Ca+2 across the c...

  9. Ultra-Wideband Sensors for Improved Magnetic Resonance Imaging, Cardiovascular Monitoring and Tumour Diagnostics

    Frank Seifert

    2010-12-01

    Full Text Available The specific advantages of ultra-wideband electromagnetic remote sensing (UWB radar make it a particularly attractive technique for biomedical applications. We partially review our activities in utilizing this novel approach for the benefit of high and ultra-high field magnetic resonance imaging (MRI and other applications, e.g., for intensive care medicine and biomedical research. We could show that our approach is beneficial for applications like motion tracking for high resolution brain imaging due to the non-contact acquisition of involuntary head motions with high spatial resolution, navigation for cardiac MRI due to our interpretation of the detected physiological mechanical contraction of the heart muscle and for MR safety, since we have investigated the influence of high static magnetic fields on myocardial mechanics. From our findings we could conclude, that UWB radar can serve as a navigator technique for high and ultra-high field magnetic resonance imaging and can be beneficial preserving the high resolution capability of this imaging modality. Furthermore it can potentially be used to support standard ECG analysis by complementary information where sole ECG analysis fails. Further analytical investigations have proven the feasibility of this method for intracranial displacements detection and the rendition of a tumour’s contrast agent based perfusion dynamic. Beside these analytical approaches we have carried out FDTD simulations of a complex arrangement mimicking the illumination of a human torso model incorporating the geometry of the antennas applied.

  10. Magnetic resonance angiography

    MRA; Angiography - magnetic resonance ... Kwong RY. Cardiovascular Magnetic Resonance Imaging. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . ...

  11. SU-E-T-145: Effects of Temporary Tachytherapy Inhibition Magnet On MOSFET Dose Measurements of Cardiovascular Implantable Electronic Devices (CIED) in Radiation Therapy Patients

    P, Joshi; Salomons, G; Kerr, A [CCSEO, Kingston General Hospital, Kingston, Ontario (Canada); Department of Oncology, Queen' s University, Kingston, Ontario (Canada); Peters, C; Lalonde, M [CCSEO, Kingston General Hospital, Kingston, Ontario (Canada)

    2014-06-01

    Purpose: To determine the effects of temporary tachytherapy inhibition magnet on MOSFET dose measurements of cardiovascular implantable electronic devices (CIED) in radiation therapy patients. Methods: Infield and peripheral MOSFET dose measurements with 6MV photon beams were performed to evaluate dose to a CIED in the presence of a doughnut shaped temporary tachytherapy inhibition magnet. Infield measurements were done to quantify the effects of the magnetic field alone and shielding by the magnet. MOSFETs were placed inside a 20×20cm{sup 2} field at a depth of 3cm in the isocentre plane in the presence and absence of the magnet. Peripheral dose measurements were done to determine the impact of the magnet on dose to the CIED in a clinical setting. These measurements were performed at the centre, under the rim and half way between a 10×10cm{sup 2} field edge and the magnet with MOSFETS placed at the surface, 0.5cm and 1cm depths in the presence and absence of the magnet. Results: Infield measurements showed that effects of magnetic field on the MOSFET readings were within the 2% MOSFET dose measurement uncertainty; a 20% attenuation of dose under the magnet rim was observed. Peripheral dose measurements at the centre of the magnet show an 8% increase in surface dose and a 6% decrease in dose at 1cm depth. Dose under the magnet rim was reduced by approximately 68%, 45% and 25% for MOSFET placed at 0.0, 0.5 and 1.0cm bolus depths, respectively. Conclusions: The magnetic field has an insignificant effect on MOSFET dose measurements. Dose to the central region of CIED represented by centre of the magnet doughnut increases at the surface, and decreases at depths due to low energy scattering contributions from the magnet. Dose under the magnet rim, representing CIED edges, decreased significantly due to shielding.

  12. 3-dimensional eddy current analysis of a conducting shell of a superconducting generator by using IBIEM

    To ensure reliable operation of superconducting field windings of a superconducting generator it is necessary to screen the field windings from time-varying magnetic fields. An electrothermal shield is used for this screening in order to protect the superconducting material from quench phenomenon. This screening effect is due to the eddy currents in the electrothermal shield. In this paper, these eddy currents in the conducting shell are analyzed numerically by using 3-dimensional indirect boundary integral equation method (IBIEM)

  13. Dobutamine stress MRI. Part I. Safety and feasibility of dobutamine cardiovascular magnetic resonance in patients suspected of myocardial ischemia

    The aim of the study was to evaluate safety and feasibility of dobutamine cardiovascular magnetic resonance (CMR) in patients with proven or suspected coronary artery disease. Dobutamine CMR was evaluated retrospectively in 400 consecutive patients with suspicion of myocardial ischemia. Dobutamine was infused using an incremental protocol up to 40 μg/kg body weight per minute. All anti-anginal medication was stopped 4 days before the CMR study and infusion time of dobutamine was 6 min per stage. Hemodynamic data, CMR findings and side effects were reported. Patients with contraindications to CMR (metallic implants and claustrophobia) were excluded from analysis. Dobutamine CMR was successfully performed in 355 (89%) patients. Forty-five (11%) patients could not be investigated adequately because of non-cardiac side effects in 29 (7%) and cardiac side effects in 16 (4%) patients. Hypotension (1.5%) and arrhythmias (1%) were the most frequent cardiac side effects. One patient developed a severe complication (ventricular fibrillation) at the end of the study. There were no myocardial infarctions or fatal complications of the stress test. The most frequent non-cardiac side effects were nausea, vomiting and claustrophobia. Age >70 years, prior myocardial infarction and rest wall motion abnormalities showed no significant differences with side effects (P>0.05). Dobutamine CMR is safe and feasible in patients with suspicion of myocardial ischemia. (orig.)

  14. Clinical implications of microvascular obstruction and intramyocardial haemorrhage in acute myocardial infarction using cardiovascular magnetic resonance imaging

    Bekkers, Sebastiaan C.A.M.; Smulders, Martijn W.; Waltenberger, Johannes; Gorgels, Anton P.M.; Schalla, Simon [Maastricht University Medical Center, Department of Cardiology, Maastricht (Netherlands); Passos, Valeria Lima [Maastricht University Medical Center, Department of Methodology and Statistics, Maastricht (Netherlands); Leiner, Tim [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands)

    2010-11-15

    To investigate the clinical implications of microvascular obstruction (MVO) and intramyocardial haemorrhage (IMH) in acute myocardial infarction (AMI). Ninety patients with a first AMI undergoing primary percutaneous coronary intervention (PCI) were studied. T2-weighted, cine and late gadolinium-enhanced cardiovascular magnetic resonance imaging was performed at 5 {+-} 2 and 103 {+-} 11 days. Patients were categorised into three groups based on the presence or absence of MVO and IMH. MVO was observed in 54% and IMH in 43% of patients, and correlated significantly (r = 0.8, p < 0.001). Pre-PCI thrombolysis in myocardial infarction 3 flow was only observed in MVO(-)/IMH(-) patients. Infarct size and impairment of systolic function were largest in MVO(+)/IMH(+) patients (n = 39, 23 {+-} 9% and 47 {+-} 7%), smallest in MVO(-)/IMH(-) patients (n = 41, 8 {+-} 8% and 55 {+-} 8%) and intermediate in MVO(+)/IMH(-) patients (n = 10, 16 {+-} 7% and 51 {+-} 6%, p < 0.001). LVEF increased in all three subgroups at follow-up, but remained intermediate in MVO(+)/IMH(-) and was lowest in MVO(+)/IMH(+) patients. Using random intercept model analysis, only infarct size was an independent predictor for adverse LV remodelling. Intramyocardial haemorrhage and microvascular obstruction are strongly related. Pre-PCI TIMI 3 flow is less frequently observed in patients with MVO and IMH. Only infarct size was an independent predictor of LV remodelling. (orig.)

  15. Is there a place for cardiovascular magnetic resonance conditional devices in systemic inflammatory diseases?

    Mavrogeni, Sophie I; Poulos, George; Sfikakis, Petros P; Kitas, George D; Kolovou, Genovefa; Theodorakis, George

    2016-06-01

    Rhythm disturbances and sudden cardiac death (SCD) are important manifestations of cardiac involvement in systemic inflammatory diseases (SID). The commonest events demanding the implantation of a device include ventricular tachycardia and atrioventricular block, mainly diagnosed in sarcoidosis, systemic lupus erythematosus and scleroderma. In SCD, cardiac magnetic resonance (CMR) identified areas of late gadolinium enhancement (LGE) in 71% and provided an arrhythmic substrate in 76%, while during the follow-up, the extent of LGE identified a subgroup at increased risk for future adverse events. CMR has been successfully used for detection of cardiac disease in SID, including myocarditis, coronary, microvascular and valvular disease. Additionally, SIDs have a higher probability to need MRI scanning of other organs, due to their systemic disease. These reasons support the necessity of an MRI conditional device in SIDs. A broad selection of devices, approved for the MRI environment under defined conditions allows the safe and accurate scanning of SID patients. PMID:26878099

  16. In vitro study on the feasibility of magnetic stent hyperthermia for the treatment of cardiovascular restenosis.

    Li, Li; Wang, Rui; Shi, Huan-Huan; Xie, LE; Li, Jing-Ding-Sha; Kong, Wei-Chao; Tang, Jin-Tian; Ke, DA-Nian; Zhao, Ling-Yun

    2013-08-01

    Thermal treatment or hyperthermia has received considerable attention in recent years due to its high efficiency, safety and relatively few side-effects. In this study, we investigated whether it was possible to utilize targeted thermal or instent thermal treatments for the treatment of restenosis following percutaneous transluminal coronary angioplasty (PTCA) through magnetic stent hyperthermia (MSH). A 316L stainless steel stent and rabbit vascular smooth muscle cells (VSMCs) were used in the present study, in which the inductive heating characteristics of the stent under alternative magnetic field (AMF) exposure, as well as the effect of MSH on the proliferation, apoptosis, cell cycle and proliferating cell nuclear antigen (PCNA) expression of the rabbit VSMCs, were evaluated. The results demonstrated that 316L stainless steel coronary stents possess ideal inductive heating characteristics under 300 kHz AMF exposure. The heating properties were shown to be affected by the field intensity of the AMF, as well as the orientation the stent axis. MSH had a significant effect on the proliferation and apoptosis of VSMCs, and the effect was temperature-dependent. While a mild temperature of 43°C demonstrated negligible effects on the growth of VSMCs, MSH treatment above 47°C effectively inhibited the VSMC proliferation and induced apoptosis. Furthermore, a 47°C treatment exhibited a significant and long-term inhibitory effect on VSMC migration. The results strongly suggested that MSH may be potentially applied in the clinic as an alternative approach for the prevention and treatment of restenosis. PMID:24137187

  17. Cardiovascular magnetic resonance of myocardial edema using a short inversion time inversion recovery (STIR) black-blood technique:Diagnostic accuracy of visual and semi-quantitative assessment

    h-Ici Darach O; Ridgway John P; Kuehne Titus; Berger Felix; Plein Sven; Sivananthan Mohan; Messroghli Daniel R

    2012-01-01

    Abstract Background The short inversion time inversion recovery (STIR) black-blood technique has been used to visualize myocardial edema, and thus to differentiate acute from chronic myocardial lesions. However, some cardiovascular magnetic resonance (CMR) groups have reported variable image quality, and hence the diagnostic value of STIR in routine clinical practice has been put into question. The aim of our study was to analyze image quality and diagnostic performance of STIR using a set of...

  18. 7 Tesla (T) human cardiovascular magnetic resonance imaging using FLASH and SSFP to assess cardiac function: validation against 1.5 T and 3 T

    Suttie, J. J.; DelaBarre, L; Pitcher, A.; van de Moortele, P. F.; Dass, S; Snyder, C. J.; Francis, J M; Metzger, G. J.; Weale, P.; Ugurbil, K; Neubauer, S.; Robson, M; Vaughan, T

    2011-01-01

    We report the first comparison of cardiovascular magnetic resonance imaging (CMR) at 1.5 T, 3 T and 7 T field strengths using steady state free precession (SSFP) and fast low angle shot (FLASH) cine sequences. Cardiac volumes and mass measurements were assessed for feasibility, reproducibility and validity at each given field strength using FLASH and SSFP sequences. Ten healthy volunteers underwent retrospectively electrocardiogram (ECG) gated CMR at 1.5 T, 3 T and 7 T using FLASH and SSFP se...

  19. Differences in carotid arterial morphology and composition between individuals with and without obstructive coronary artery disease: A cardiovascular magnetic resonance study

    Takaya Norihide; Oikawa Minako; Yu Wei; Chu Baocheng; Saam Tobias; Hatsukami Thomas S; Espeland Mark A; Chen Haiying; Terry James G; Yuan Chun; Underhill Hunter R; Yarnykh Vasily L; Kraft Robert; Carr J Jeffrey; Maldjian Joseph

    2008-01-01

    Abstract Objective We sought to determine differences with cardiovascular magnetic resonance (CMR) in the morphology and composition of the carotid arteries between individuals with angiographically-defined obstructive coronary artery disease (CAD, ≥ 50% stenosis, cases) and those with angiographically normal coronaries (no lumen irregularities, controls). Methods and results 191 participants (50.3% female; 50.8% CAD cases) were imaged with a multi-sequence, carotid CMR protocol at 1.5T. For ...

  20. Bramwell-Hill modeling for local aortic pulse wave velocity estimation: a validation study with velocity-encoded cardiovascular magnetic resonance and invasive pressure assessment

    Westenberg Jos JM; van Poelgeest Eveline P; Steendijk Paul; Grotenhuis Heynric B; Jukema JW; de Roos Albert

    2012-01-01

    Abstract Background The Bramwell-Hill model describes the relation between vascular wall stiffness expressed in aortic distensibility and the pulse wave velocity (PWV), which is the propagation speed of the systolic pressure wave through the aorta. The main objective of this study was to test the validity of this model locally in the aorta by using PWV-assessments based on in-plane velocity-encoded cardiovascular magnetic resonance (CMR), with invasive pressure measurements serving as the gol...

  1. Anomalous origin of the left circumflex coronary artery from the pulmonary artery. A very rare congenital anomaly in an adult patient diagnosed by cardiovascular magnetic resonance

    Giannitsis Evangelos; Ringwald Gerd; Korosoglou Grigorios; Katus Hugo A

    2008-01-01

    Abstract Here we report for the first time on the diagnostic potential of cardiovascular magnetic resonance (CMR) to delineate the proximal course of an anomalous left circumflex coronary artery (LCX) originating from the right pulmonary artery in an adult patient with no other form of congenital heart disease. The patient was referred to our institution due to exertional chest discomfort. X-Ray coronary angiography showed a normal left anterior descending coronary artery (LAD) and right coro...

  2. 3-Dimensional quantitative detection of nanoparticle content in biological tissue samples after local cancer treatment

    Rahn, Helene, E-mail: helene.rahn@gmail.com [Institute of Fluid Mechanics, Chair of Magnetofluiddynamics, Technische Universitaet Dresden, Dresden 01069 (Germany); Alexiou, Christoph [ENT-Department, Section for Experimental Oncology and Nanomedicine (Else Kröner-Fresenius-Stiftungsprofessur), University Hospital Erlangen, Waldstraße 1, Erlangen 91054 (Germany); Trahms, Lutz [Physikalisch-Technische Bundesanstalt, Abbestraße 2-12, Berlin 10587 (Germany); Odenbach, Stefan [Institute of Fluid Mechanics, Chair of Magnetofluiddynamics, Technische Universitaet Dresden, Dresden 01069 (Germany)

    2014-06-01

    X-ray computed tomography is nowadays used for a wide range of applications in medicine, science and technology. X-ray microcomputed tomography (XµCT) follows the same principles used for conventional medical CT scanners, but improves the spatial resolution to a few micrometers. We present an example of an application of X-ray microtomography, a study of 3-dimensional biodistribution, as along with the quantification of nanoparticle content in tumoral tissue after minimally invasive cancer therapy. One of these minimal invasive cancer treatments is magnetic drug targeting, where the magnetic nanoparticles are used as controllable drug carriers. The quantification is based on a calibration of the XµCT-equipment. The developed calibration procedure of the X-ray-µCT-equipment is based on a phantom system which allows the discrimination between the various gray values of the data set. These phantoms consist of a biological tissue substitute and magnetic nanoparticles. The phantoms have been studied with XµCT and have been examined magnetically. The obtained gray values and nanoparticle concentration lead to a calibration curve. This curve can be applied to tomographic data sets. Accordingly, this calibration enables a voxel-wise assignment of gray values in the digital tomographic data set to nanoparticle content. Thus, the calibration procedure enables a 3-dimensional study of nanoparticle distribution as well as concentration. - Highlights: • Local cancer treatments are promising in reducing negative side effects occurring during conventional chemotherapy. • The nanoparticles play an important role in delivering drugs to the designated area during local cancer treatments as magnetic drug targeting. • We study the nanoparticles distribution in tumor tissue after magnetic drug targeting with X-ray computed tomography. • We achieved a 3-dimensional quantification of the nanoparticles content in tumor tissue out of digital tomographic data.

  3. Cardiac pathologies in female carriers of Duchenne muscular dystrophy assessed by cardiovascular magnetic resonance imaging

    Duchenne muscular dystrophy (DMD) is the most common and severe dystrophinopathy. DMD carriers rarely present with clinical symptoms, but may suffer from cardiac involvement. Because echocardiographic findings are inconsistent and cardiac magnetic resonance imaging (CMRI) data are limited, this study sought to investigate asymptomatic carriers for cardiac abnormalities using CMRI. Fifteen genetically confirmed DMD carriers (age, 32.3 ± 10.2 years) were prospectively examined on a 1.5T MR system. Cine, T2, and late-gadolinium-enhanced (LGE) images were acquired, and were evaluated in consensus by two experienced readers. Left ventricular (LV) parameters were analysed semiautomatically, normalized to BSA. Normalized LV end-diastolic volume was increased in 7 % (73.7 ± 16.8 ml/m2; range, 48-116 ml/m2) and normalized LV end-systolic volume in 20 % (31.5 ± 13.3 ml/m2; range, 15-74 ml/m2). EF was reduced in 33 % (58.4 ± 7.6 %; range, 37-69 %) and normalized LV myocardial mass in 80 % (40.5 ± 6.8 g/m2; range, 31-55 g/m2). In 80 %, regional myocardial thinning was detected in more than one segment. In 13 % and 40 %, apical-lateral accentuation of LV non-compaction was present. LGE was found in 60 % (midmyocardial inferolateral accentuation). Given the high frequency of cardiac pathologies detected by CMRI, regular cardiac risk assessment is advisable for DMD carriers. Besides clinical examination, CMRI is an excellent tool for this purpose. (orig.)

  4. Cardiac pathologies in female carriers of Duchenne muscular dystrophy assessed by cardiovascular magnetic resonance imaging

    Schelhorn, Juliane; Schemuth, Haemi; Nensa, Felix; Nassenstein, Kai; Forsting, Michael; Schlosser, Thomas [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schoenecker, Anne; Neudorf, Ulrich [University Hospital Essen, Department of Pediatric Cardiology, Essen (Germany); Schara, Ulrike [University Hospital Essen, Department of Pediatric Neurology, Essen (Germany)

    2015-10-15

    Duchenne muscular dystrophy (DMD) is the most common and severe dystrophinopathy. DMD carriers rarely present with clinical symptoms, but may suffer from cardiac involvement. Because echocardiographic findings are inconsistent and cardiac magnetic resonance imaging (CMRI) data are limited, this study sought to investigate asymptomatic carriers for cardiac abnormalities using CMRI. Fifteen genetically confirmed DMD carriers (age, 32.3 ± 10.2 years) were prospectively examined on a 1.5T MR system. Cine, T2, and late-gadolinium-enhanced (LGE) images were acquired, and were evaluated in consensus by two experienced readers. Left ventricular (LV) parameters were analysed semiautomatically, normalized to BSA. Normalized LV end-diastolic volume was increased in 7 % (73.7 ± 16.8 ml/m{sup 2}; range, 48-116 ml/m{sup 2}) and normalized LV end-systolic volume in 20 % (31.5 ± 13.3 ml/m{sup 2}; range, 15-74 ml/m{sup 2}). EF was reduced in 33 % (58.4 ± 7.6 %; range, 37-69 %) and normalized LV myocardial mass in 80 % (40.5 ± 6.8 g/m{sup 2}; range, 31-55 g/m{sup 2}). In 80 %, regional myocardial thinning was detected in more than one segment. In 13 % and 40 %, apical-lateral accentuation of LV non-compaction was present. LGE was found in 60 % (midmyocardial inferolateral accentuation). Given the high frequency of cardiac pathologies detected by CMRI, regular cardiac risk assessment is advisable for DMD carriers. Besides clinical examination, CMRI is an excellent tool for this purpose. (orig.)

  5. Towards real-time cardiovascular magnetic resonance guided transarterial CoreValve implantation: in vivo evaluation in swine

    Kahlert Philipp

    2012-03-01

    Full Text Available Abstract Background Real-time cardiovascular magnetic resonance (rtCMR is considered attractive for guiding TAVI. Owing to an unlimited scan plane orientation and an unsurpassed soft-tissue contrast with simultaneous device visualization, rtCMR is presumed to allow safe device navigation and to offer optimal orientation for precise axial positioning. We sought to evaluate the preclinical feasibility of rtCMR-guided transarterial aortic valve implatation (TAVI using the nitinol-based Medtronic CoreValve bioprosthesis. Methods rtCMR-guided transfemoral (n = 2 and transsubclavian (n = 6 TAVI was performed in 8 swine using the original CoreValve prosthesis and a modified, CMR-compatible delivery catheter without ferromagnetic components. Results rtCMR using TrueFISP sequences provided reliable imaging guidance during TAVI, which was successful in 6 swine. One transfemoral attempt failed due to unsuccessful aortic arch passage and one pericardial tamponade with subsequent death occurred as a result of ventricular perforation by the device tip due to an operating error, this complication being detected without delay by rtCMR. rtCMR allowed for a detailed, simultaneous visualization of the delivery system with the mounted stent-valve and the surrounding anatomy, resulting in improved visualization during navigation through the vasculature, passage of the aortic valve, and during placement and deployment of the stent-valve. Post-interventional success could be confirmed using ECG-triggered time-resolved cine-TrueFISP and flow-sensitive phase-contrast sequences. Intended valve position was confirmed by ex-vivo histology. Conclusions Our study shows that rtCMR-guided TAVI using the commercial CoreValve prosthesis in conjunction with a modified delivery system is feasible in swine, allowing improved procedural guidance including immediate detection of complications and direct functional assessment with reduction of radiation and omission of contrast media.

  6. Effect of Papillary Muscles and Trabeculae on Left Ventricular Measurement Using Cardiovascular Magnetic Resonance Imaging in Patients with Hypertrophic Cardiomyopathy

    To evaluate the influence of papillary muscles and trabeculae on left ventricular (LV) cardiovascular magnetic resonance (CMR) analysis using three methods of cavity delineation (classic or modified inclusion methods, and the exclusion method) in patients with hypertrophic cardiomyopathy (HCM). This retrospective study included 20 consecutive HCM patients who underwent 1.5-T CMR imaging with short-axis cine stacks of the entire LV. LV measurements were performed using three different methods of manual cavity delineation of the endocardial and epicardial contours: method A, presumed endocardial boundary as seen on short-axis cine images; method B, including solely the cavity and closely adjacent trabeculae; or method C, excluding papillary muscles and trabeculae. Ascending aorta forward flow was measured as reference for LV-stroke volume (SV). Interobserver reproducibility was assessed using intraclass correlation coefficients. Method A showed larger end-diastole and end-systole volumes (largest percentage differences of 25% and 68%, respectively, p < 0.05), compared with method C. The ejection fraction was 55.7 ± 6.9% for method A, 68.6 ± 8.4% for B, and 71.7 ± 7.0% for C (p < 0.001). Mean mass was also significantly different: 164.6 ± 47.4 g for A, 176.5 ± 50.5 g for B, and 199.6 ± 53.2 g for C (p < 0.001). LV-SV error was largest with method B (p < 0.001). No difference in interobserver agreement was observed (p > 0.05). In HCM patients, LV measurements are strikingly different dependent on whether papillary muscles and trabeculae are included or excluded. Therefore, a consistent method of LV cavity delineation may be crucial during longitudinal follow-up to avoid misinterpretation and erroneous clinical decision-making

  7. The clinical impact of late gadolinium enhancement in Takotsubo cardiomyopathy: serial analysis of cardiovascular magnetic resonance images

    Katoh Hideki

    2011-10-01

    Full Text Available Abstract Background Our study aimed to investigate both the clinical implications of late gadolinium enhancement (LGE by cardiovascular magnetic resonance (CMR and the relation of LGE to clinical findings in patients with Takotsubo cardiomyopathy (TTC. Methods We evaluated 20 consecutive patients (2 men, 18 women; median age, 77 years; interquartile range [IQR] 67-82 years who were admitted to our hospital with the diagnosis of TTC. CMR was performed within 1 week after admission, and follow-up studies were conducted 1.5 and 6 months later. Results In 8 patients, CMR imaging during the sub-acute phase revealed LGE in the area matched with wall motion impairment. Cardiogenic shock was more frequently observed in patients with LGE than in those without LGE (38% vs 0%, p = 0.049. The patients with LGE needed a longer duration for ECG normalization and recovery of wall motion than did those without LGE (median 205 days, IQR [152-363] vs 68 days, [43-145], p = 0.005; 15 days, [10-185] vs 7 days, [4-13], p = 0.030, respectively. In 5 of these 8 patients, LGE disappeared within 45-180 days (170, IQR [56-180] of onset. The patients with LGE remaining in the chronic phase had higher peak creatine kinase levels than did those without LGE (median 307 IU/L, IQR [264-460] vs 202 IU/L, [120-218], p = 0.017. Conclusion LGE by CMR in the sub-acute phase may be associated with the severity and prolonged recovery to normal of clinical findings in TTC.

  8. Myocardial extravascular extracellular volume fraction measurement by gadolinium cardiovascular magnetic resonance in humans: slow infusion versus bolus

    Jones Bobby L

    2011-03-01

    Full Text Available Abstract Background Myocardial extravascular extracellular volume fraction (Ve measures quantify diffuse fibrosis not readily detectable by conventional late gadolinium (Gd enhancement (LGE. Ve measurement requires steady state equilibrium between plasma and interstitial Gd contrast. While a constant infusion produces steady state, it is unclear whether a simple bolus can do the same. Given the relatively slow clearance of Gd, we hypothesized that a bolus technique accurately measures Ve, thus facilitating integration of myocardial fibrosis quantification into cardiovascular magnetic resonance (CMR workflow routines. Assuming equivalence between techniques, we further hypothesized that Ve measures would be reproducible across scans. Methods In 10 volunteers (ages 20-81, median 33 yr, 3 females, we compared serial Ve measures from a single short axis slice from two scans: first, during a constant infusion, and second, 12-50 min after a bolus (0.2 mmol/kg gadoteridol on another day. Steady state during infusion was defined when serial blood and myocardial T1 data varied Results No subject exhibited LGE near the short axis slices where Ve was measured. The Ve range was 19.3-29.2% and 18.4-29.1% by constant infusion and bolus, respectively. In GEE models, serial Ve measures by constant infusion and bolus did not differ significantly (difference = 0.1%, p = 0.38. For both techniques, Ve was strongly related to age (p Conclusion Myocardial Ve can be measured reliably and accurately 12-50 minutes after a simple bolus. Ve measures are also reproducible across CMR scans. Ve estimation can be integrated into CMR workflow easily, which may simplify research applications involving the quantification of myocardial fibrosis.

  9. Regional myocardial function after intracoronary bone marrow cell injection in reperfused anterior wall infarction - a cardiovascular magnetic resonance tagging study

    Arnesen Harald

    2011-03-01

    Full Text Available Abstract Background Trials have brought diverse results of bone marrow stem cell treatment in necrotic myocardium. This substudy from the Autologous Stem Cell Transplantation in Acute Myocardial Infarction trial (ASTAMI explored global and regional myocardial function after intracoronary injection of autologous mononuclear bone marrow cells (mBMC in acute anterior wall myocardial infarction treated with percutaneous coronary intervention. Methods Cardiovascular magnetic resonance (CMR tagging was performed 2-3 weeks and 6 months after revascularization in 15 patients treated with intracoronary stem cell injection (mBMC group and in 13 controls without sham injection. Global and regional left ventricular (LV strain and LV twist were correlated to cine CMR and late gadolinium enhancement (LGE. Results In the control group myocardial function as measured by strain improved for the global LV (6 months: -13.1 ± 2.4 versus 2-3 weeks: -11.9 ± 3.4%, p = 0.014 and for the infarct zone (-11.8 ± 3.0 versus -9.3 ± 4.1%, p = 0.001, and significantly more than in the mBMC group (inter-group p = 0.027 for global strain, respectively p = 0.009 for infarct zone strain. LV infarct mass decreased (35.7 ± 20.4 versus 45.7 ± 29.5 g, p = 0.024, also significantly more pronounced than the mBMC group (inter-group p = 0.034. LV twist was initially low and remained unchanged irrespective of therapy. Conclusions LGE and strain findings quite similarly demonstrate subtle differences between the mBMC and control groups. Intracoronary injection of autologous mBMC did not strengthen regional or global myocardial function in this substudy. Trial registration ClinicalTrials.gov: NCT00199823

  10. Prognostic value at 5 years of microvascular obstruction after acute myocardial infarction assessed by cardiovascular magnetic resonance

    Klug Gert

    2012-07-01

    Full Text Available Abstract Background Early and late microvascular obstruction (MVO assessed by cardiovascular magnetic resonance (CMR are prognostic markers for short-term clinical endpoints after acute ST-elevation myocardial infarction (STEMI. However, there is a lack of studies with long-term follow-up periods (>24 months. Methods STEMI patients reperfused by primary angioplasty (n = 129 underwent MRI at a median of 2 days after the index event. Early MVO was determined on dynamic Gd first-pass images directly after the administration of 0.1 mmol/kg bodyweight Gd-based contrast agent. Furthermore, ejection fraction (EF, %, left ventricular myocardial mass (LVMM and total infarct size (% of LVMM were determined with CMR. Clinical follow-up was conducted after a median of 52 months. The primary endpoint was defined as a composite of death, myocardial re-infarction, stroke, repeat revascularization, recurrence of ischemic symptoms, atrial fibrillation, congestive heart failure and hospitalization. Results Follow-up was completed by 107 patients. 63 pre-defined events occurred during follow-up. Initially, 74 patients showed early MVO. Patients with early MVO had larger infarcts (mean: 24.9 g vs. 15.5 g, p = 0.002 and a lower EF (mean: 39% vs. 46%, p = 0.006. The primary endpoint occurred in 66.2% of patients with MVO and in 42.4% of patients without MVO (p  Conclusion Early MVO, as assessed by first-pass CMR, is an independent long-term prognosticator for morbidity after AMI.

  11. Effect of Papillary Muscles and Trabeculae on Left Ventricular Measurement Using Cardiovascular Magnetic Resonance Imaging in Patients with Hypertrophic Cardiomyopathy

    Park, Eun-Ah; Lee, Whal [Department of Radiology, Cardiovascular Division, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Kim, Hyung-Kwan [Department of Internal Medicine, Cardiovascular Division, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Chung, Jin Wook [Department of Radiology, Cardiovascular Division, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of)

    2015-11-01

    To evaluate the influence of papillary muscles and trabeculae on left ventricular (LV) cardiovascular magnetic resonance (CMR) analysis using three methods of cavity delineation (classic or modified inclusion methods, and the exclusion method) in patients with hypertrophic cardiomyopathy (HCM). This retrospective study included 20 consecutive HCM patients who underwent 1.5-T CMR imaging with short-axis cine stacks of the entire LV. LV measurements were performed using three different methods of manual cavity delineation of the endocardial and epicardial contours: method A, presumed endocardial boundary as seen on short-axis cine images; method B, including solely the cavity and closely adjacent trabeculae; or method C, excluding papillary muscles and trabeculae. Ascending aorta forward flow was measured as reference for LV-stroke volume (SV). Interobserver reproducibility was assessed using intraclass correlation coefficients. Method A showed larger end-diastole and end-systole volumes (largest percentage differences of 25% and 68%, respectively, p < 0.05), compared with method C. The ejection fraction was 55.7 ± 6.9% for method A, 68.6 ± 8.4% for B, and 71.7 ± 7.0% for C (p < 0.001). Mean mass was also significantly different: 164.6 ± 47.4 g for A, 176.5 ± 50.5 g for B, and 199.6 ± 53.2 g for C (p < 0.001). LV-SV error was largest with method B (p < 0.001). No difference in interobserver agreement was observed (p > 0.05). In HCM patients, LV measurements are strikingly different dependent on whether papillary muscles and trabeculae are included or excluded. Therefore, a consistent method of LV cavity delineation may be crucial during longitudinal follow-up to avoid misinterpretation and erroneous clinical decision-making.

  12. Feasibility and initial experience of assessment of mechanical dyssynchrony using cardiovascular magnetic resonance and semi-automatic border detection

    Günther Rolf W

    2008-11-01

    Full Text Available Abstract Background The systolic dyssynchrony index (SDI has been introduced as a measure of mechanical dyssynchrony using three-dimensional echocardiography to select patients who may benefit from cardiac resynchronization therapy (CRT. However, three-dimensional echocardiography may be inadequate in a number of patients with suboptimal acoustic window and no single echocardiographic measure of dyssynchrony has proven to be of value in selecting patients for CRT. Thus, the aim of this study was to determine the value of cardiovascular magnetic resonance (CMR for the assessment of the SDI in patients with reduced LV function as well as in healthy controls using semi-automatic border tracking. Methods We investigated a total of 45 patients including 35 patients (65 ± 8 years with reduced LV function (EF 30 ± 11% and a wide QRS complex as well as 10 control subjects (42 ± 21 years, EF 70 ± 11%. For cine imaging a standard SSFP imaging sequence was used with a temporal resolution of 40 frames per RR-interval. Quantitative analysis was performed off-line using a software prototype for semi-automatic border detection. Global volumes, ejection fraction and the SDI were calculated in each subject. SDI was compared with standard echocardiographic parameters of dyssynchrony. Results The mean SDI differed significantly between patients (14 ± 5% and controls (5 ± 2%, p Conclusion The results of this preliminary study suggest that CMR with semi-automatic border detection may be useful for the assessment of mechanical dyssynchrony in patients with reduced LV function. No trial registration due to recruitment period between October 2004 and November 2006

  13. 3 dimensional volume MR imaging of intratemporal facial nerve

    Seo, Jeong Jin; Kang, Heoung Keun; Kim, Hyun Ju; Kim, Jae Kyu; Jung, Hyun Ung; Moon, Woong Jae [Chonnam University Medical School, Kwangju (Korea, Republic of)

    1994-10-15

    To evaluate the usefulness of 3 dimensional volume MR imaging technique for demonstrating the facial nerves and to describe MR findings in facial palsy patients and evaluate the significance of facial nerve enhancement. We reviewed the MR images of facial nerves obtained with 3 dimensional volume imaging technique before and after intravenous administration of Gadopentetate dimeglumine in 13 cases who had facial paralysis and 33 cases who had no facial palsy. And we analyzed the detectability of ananatomical segments of intratemporal facial nerves and facial nerve enhancement. When the 3 dimensional volume MR images of 46 nerves were analyzed subjectively, the nerve courses of 43(93%) of 46 nerves were effectively demonstrated on 3 dimensional volume MR images. Internal acoustic canal portions and geniculate ganglion of facial nerve were well visualized on axial images and tympanic and mastoid segments were well depicted on oblique sagittal images. 10 of 13 patients(77%) were visibly enhanced along at least one segment of the facial nerve with swelling or thickening, and nerves of 8 of normal 33 cases(24%) were enhanced without thickening or swelling. MR findings of facial nerve parelysis is asymmetrical thickening of facial nerve with contrast enhancement. The 3 dimensional volume MR imaging technique should be a useful study for the evaluation of intratemporal facial nerve disease.

  14. The intra-observer reproducibility of cardiovascular magnetic resonance myocardial feature tracking strain assessment is independent of field strength

    Background: Cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) is a promising novel method for quantification of myocardial wall mechanics from standard steady-state free precession (SSFP) images. We sought to determine whether magnetic field strength affects the intra-observer reproducibility of CMR-FT strain analysis. Methods: We studied 2 groups, each consisting of 10 healthy subjects, at 1.5 T or 3 T Analysis was performed at baseline and after 4 weeks using dedicated CMR-FT prototype software (Tomtec, Germany) to analyze standard SSFP cine images. Right ventricular (RV) and left ventricular (LV) longitudinal strain (EllRV and EllLV) and LV long-axis radial strain (ErrLAX) were derived from the 4-chamber cine, and LV short-axis circumferential and radial strains (EccSAX, ErrSAX) from the short-axis orientation. Strain parameters were assessed together with LV ejection fraction (EF) and volumes. Intra-observer reproducibility was determined by comparing the first and the second analysis in both groups. Results: In all volunteers resting strain parameters were successfully derived from the SSFP images. There was no difference in strain parameters, volumes and EF between field strengths (p > 0.05). In general EccSAX was the most reproducible strain parameter as determined by the coefficient of variation (CV) at 1.5 T (CV 13.3% and 46% global and segmental respectively) and 3 T (CV 17.2% and 31.1% global and segmental respectively). The least reproducible parameter was EllRV (CV 1.5 T 28.7% and 53.2%; 3 T 43.5% and 63.3% global and segmental respectively). Conclusions: CMR-FT results are similar with reasonable intra-observer reproducibility in different groups of volunteers at 1.5 T and 3 T. CMR-FT is a promising novel technique and our data indicate that results might be transferable between field strengths. However there is a considerable amount of segmental variability indicating that further refinements are needed before CMR-FT can be fully

  15. Case report: Completely unroofed coronary sinus with a left superior vena cava draining into the left atrium studied by cardiovascular magnetic resonance

    A persistent left superior vena cava (LSVC) draining through a dilated coronary sinus into the right atrium is a relatively common congenital cardiovascular anomaly. It is readily identified by cardiovascular magnetic resonance (CMR). However, a LSVC draining into the left atrium (LA) and associated with unroofing of the coronary sinus, with resulting interatrial communication, is rare and may have important clinical consequences. As with any large atrial septal defect, it can be associated with a higher than expected incidence of pulmonary arterial hypertension, systemic embolization, and brain abscesses. In this report, we present a case of a completely unroofed coronary sinus with a persistent LSVC draining directly into the LA and illustrate the role of CMR in the diagnosis and evaluation of such anomalies

  16. Cardiovascular risks and brain function: a functional magnetic resonance imaging study of executive function in older adults

    Chuang, Yi-Fang; Eldreth, Dana; Kirk I Erickson; Varma, Vijay; Harris, Gregory; Fried, Linda P.; Rebok, George W.; Tanner, Elizabeth K.; Carlson, Michelle C.

    2013-01-01

    Cardiovascular (CV) risk factors, such as hypertension, diabetes, and hyperlipidemia are associated with cognitive impairment and risk of dementia in older adults. However, the mechanisms linking them are not clear. This study aims to investigate the association between aggregate CV risk, assessed by the Framingham general cardiovascular risk profile, and functional brain activation in a group of community-dwelling older adults. Sixty participants (mean age: 64.6 years) from the Brain Health ...

  17. Differential Cross Section Kinematics for 3-dimensional Transport Codes

    Norbury, John W.; Dick, Frank

    2008-01-01

    In support of the development of 3-dimensional transport codes, this paper derives the relevant relativistic particle kinematic theory. Formulas are given for invariant, spectral and angular distributions in both the lab (spacecraft) and center of momentum frames, for collisions involving 2, 3 and n - body final states.

  18. Controlled teleportation of a 3-dimensional bipartite quantum state

    Cao, Hai-Jing; Chen, Zhong-Hua; Song, He-Shan

    2008-07-01

    A controlled teleportation scheme of an unknown 3-dimensional (3D) two-particle quantum state is proposed, where a 3D Bell state and 3D GHZ state function as the quantum channel. This teleportation scheme can be directly generalized to teleport an unknown d-dimensional bipartite quantum state.

  19. Controlled teleportation of a 3-dimensional bipartite quantum state

    Cao Haijing; Chen Zhonghua [Physics Department, Shanghai University of Electric Power, Shanghai 201300 (China); Song Heshan [Physics Department, Dalian University of Technology, Dalian 116024 (China)], E-mail: 2007000084@shiep.edu.cn

    2008-07-15

    A controlled teleportation scheme of an unknown 3-dimensional (3D) two-particle quantum state is proposed, where a 3D Bell state and 3D GHZ state function as the quantum channel. This teleportation scheme can be directly generalized to teleport an unknown d-dimensional bipartite quantum state.

  20. 2 and 3-dimensional Hamiltonians with Shape Invariance Symmetry

    Jafarizadeh, M. A.; Panahi-Talemi, H.; Faizi, E.

    2000-01-01

    Via a special dimensional reduction, that is, Fourier transforming over one of the coordinates of Casimir operator of su(2) Lie algebra and 4-oscillator Hamiltonian, we have obtained 2 and 3 dimensional Hamiltonian with shape invariance symmetry. Using this symmetry we have obtained their eigenspectrum. In the mean time we show equivalence of shape invariance symmetry and Lie algebraic symmetry of these Hamiltonians.

  1. Diagnostic Accuracy of Adenosine Stress Cardiovascular Magnetic Resonance Following Acute ST-segment Elevation Myocardial Infarction Post Primary Angioplasty

    Wong Dennis TL

    2011-10-01

    Full Text Available Abstract Background Adenosine stress cardiovascular magnetic resonance (CMR has been proven an effective tool in detection of reversible ischemia. Limited evidence is available regarding its accuracy in the setting of acute coronary syndromes, particularly in evaluating the significance of non-culprit vessel ischaemia. Adenosine stress CMR and recent advances in semi-quantitative image analysis may prove effective in this area. We sought to determine the diagnostic accuracy of semi-quantitative versus visual assessment of adenosine stress CMR in detecting ischemia in non-culprit territory vessels early after primary percutaneous coronary intervention (PCI for ST-segment elevation myocardial infarction (STEMI. Methods Patients were prospectively enrolled in a CMR imaging protocol with rest and adenosine stress perfusion, viability and cardiac functional assessment 3 days after successful primary-PCI for STEMI. Three short axis slices each divided into 6 segments on first pass adenosine perfusion were visually and semi-quantitatively analysed. Diagnostic accuracy of both methods was compared with non-culprit territory vessels utilising quantitative coronary angiography (QCA with significant stenosis defined as ≥70%. Results Fifty patients (age 59 ± 12 years admitted with STEMI were evaluated. All subjects tolerated the adenosine stress CMR imaging protocol with no significant complications. The cohort consisted of 41% anterior and 59% non anterior infarctions. There were a total of 100 non-culprit territory vessels, identified on QCA. The diagnostic accuracy of semi-quantitative analysis was 96% with sensitivity of 99%, specificity of 67%, positive predictive value (PPV of 97% and negative predictive value (NPV of 86%. Visual analysis had a diagnostic accuracy of 93% with sensitivity of 96%, specificity of 50%, PPV of 97% and NPV of 43%. Conclusion Adenosine stress CMR allows accurate detection of non-culprit territory stenosis in patients

  2. Myocardial scarring on cardiovascular magnetic resonance in asymptomatic or minimally symptomatic patients with “pure” apical hypertrophic cardiomyopathy

    Kim Kyung-Hee

    2012-07-01

    Full Text Available Abstract Background Late gadolinium enhancement (LGE cardiovascular magnetic resonance (CMR enables state-of-the-art in vivo evaluations of myocardial fibrosis. Although LGE patterns have been well described in asymmetrical septal hypertrophy, conflicting results have been reported regarding the characteristics of LGE in apical hypertrophic cardiomyopathy (ApHCM. This study was undertaken to determine 1 the frequency and distribution of LGE and 2 its prognostic implication in ApHCM. Methods Forty patients with asymptomatic or minimally symptomatic pure ApHCM (age, 60.2 ± 10.4 years, 31 men were prospectively enrolled. LGE images were acquired using the inversion recovery segmented spoiled-gradient echo and phase-sensitive inversion recovery sequence, and analyzed using a 17-segment model. Summing the planimetered LGE areas in all short axis slices yielded the total volume of late enhancement, which was subsequently presented as a proportion of total LV myocardium (% LGE. Results Mean maximal apical wall thickness was 17.9±2.3mm, and mean left ventricular (LV ejection fraction was 67.7 ± 8.0%. All but one patient presented with electrocardiographic negative T wave inversion in anterolateral leads, with a mean maximum negative T wave of 7.2 ± 4.7mm. Nine patients (22.5% had giant negative T waves, defined as the amplitude of ≥10mm, in electrocardiogram. LGE was detected in 130 segments of 30 patients (75.0%, occupying 4.9 ± 5.5% of LV myocardium. LGE was mainly detected at the junction between left and right ventricles in 12 (30% and at the apex in 28 (70%, although LGE-positive areas were widely distributed, and not limited to the apex. Focal LGE at the non-hypertrophic LV segments was found in some ApHCM patients, even without LGE of hypertrophied apical segments. Over the 2-year follow-up, there was no one achieving the study end-point, defined as all-cause death, sudden cardiac death and hospitalization for heart failure

  3. Use of cardiovascular magnetic resonance imaging for TAVR assessment in patients with bioprosthetic aortic valves: Comparison with computed tomography

    Purpose: Transcatheter aortic valve replacement (TAVR) has been successfully used to treat patients with failing aortic bioprostheses. Computed tomography (CT) is the usual method of pre-procedural imaging for TAVR in the native position; however, the optimal modality for valve-in-valve procedures has not been established. CT can assess intracardiac anatomy and is superior to cardiovascular magnetic resonance (CMR) in the assessment of coronary artery disease. However, CMR can provide superior haemodynamic information, does not carry the risk of ionising radiation, and may be performed without contrast in patients with renal insufficiency. In this study, we compared CT and CMR for the evaluation of TAVR in a small cohort of patients with existing aortic bioprostheses. Materials and methods: 21 patients with aortic bioprostheses were prospectively evaluated by CT and CMR, as pre-assessment for TAVR; agreement between measurements of aortic geometries was assessed. Results: 16/21 patients had aortic bioprostheses constructed with a metal ring, and 5/21 patients had a metal strut construction. Patients with metal struts had significant metal-artefact on CMR, which compromised image quality in this region. There was good agreement between CT and CMR measurements of aortic geometry. The mean difference (d) in annulus area-derived diameter was 0.5 mm (95% limits of agreement [L.A] 4.2 mm). There was good agreement between modalities for the cross-sectional area of the sinuses of valsalva (d 0.5 cm2, L.A 1.4 cm2), sinotubular junction (d 0.9 cm2, L.A 1.5 cm2), and ascending aorta (d 0.6 cm2, L.A 1.4 cm2). In patients without metal struts, the left coronary artery height d was 0.7 mm and L.A 2.8 mm. Conclusions: Our analysis shows that CMR and CT measurements of aortic geometry show good agreement, including measurement of annulus size and coronary artery location, and thus provide the necessary anatomical information for valve-in-valve TAVR planning. However, in patients

  4. Development of a universal dual-bolus injection scheme for the quantitative assessment of myocardial perfusion cardiovascular magnetic resonance

    Alfakih Khaled

    2011-05-01

    Full Text Available Abstract Background The dual-bolus protocol enables accurate quantification of myocardial blood flow (MBF by first-pass perfusion cardiovascular magnetic resonance (CMR. However, despite the advantages and increasing demand for the dual-bolus method for accurate quantification of MBF, thus far, it has not been widely used in the field of quantitative perfusion CMR. The main reasons for this are that the setup for the dual-bolus method is complex and requires a state-of-the-art injector and there is also a lack of post processing software. As a solution to one of these problems, we have devised a universal dual-bolus injection scheme for use in a clinical setting. The purpose of this study is to show the setup and feasibility of the universal dual-bolus injection scheme. Methods The universal dual-bolus injection scheme was tested using multiple combinations of different contrast agents, contrast agent dose, power injectors, perfusion sequences, and CMR scanners. This included 3 different contrast agents (Gd-DO3A-butrol, Gd-DTPA and Gd-DOTA, 4 different doses (0.025 mmol/kg, 0.05 mmol/kg, 0.075 mmol/kg and 0.1 mmol/kg, 2 different types of injectors (with and without "pause" function, 5 different sequences (turbo field echo (TFE, balanced TFE, k-space and time (k-t accelerated TFE, k-t accelerated balanced TFE, turbo fast low-angle shot and 3 different CMR scanners from 2 different manufacturers. The relation between the time width of dilute contrast agent bolus curve and cardiac output was obtained to determine the optimal predefined pause duration between dilute and neat contrast agent injection. Results 161 dual-bolus perfusion scans were performed. Three non-injector-related technical errors were observed (1.9%. No injector-related errors were observed. The dual-bolus scheme worked well in all the combinations of parameters if the optimal predefined pause was used. Linear regression analysis showed that the optimal duration for the predefined

  5. Use of cardiovascular magnetic resonance imaging for TAVR assessment in patients with bioprosthetic aortic valves: Comparison with computed tomography

    Quail, Michael A., E-mail: m.quail@ucl.ac.uk [Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science and Great Ormond Street Hospital for Children, London (United Kingdom); Nordmeyer, Johannes [Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin (Germany); Schievano, Silvia [Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science and Great Ormond Street Hospital for Children, London (United Kingdom); Reinthaler, Markus; Mullen, Michael J. [The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London (United Kingdom); Taylor, Andrew M. [Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science and Great Ormond Street Hospital for Children, London (United Kingdom)

    2012-12-15

    Purpose: Transcatheter aortic valve replacement (TAVR) has been successfully used to treat patients with failing aortic bioprostheses. Computed tomography (CT) is the usual method of pre-procedural imaging for TAVR in the native position; however, the optimal modality for valve-in-valve procedures has not been established. CT can assess intracardiac anatomy and is superior to cardiovascular magnetic resonance (CMR) in the assessment of coronary artery disease. However, CMR can provide superior haemodynamic information, does not carry the risk of ionising radiation, and may be performed without contrast in patients with renal insufficiency. In this study, we compared CT and CMR for the evaluation of TAVR in a small cohort of patients with existing aortic bioprostheses. Materials and methods: 21 patients with aortic bioprostheses were prospectively evaluated by CT and CMR, as pre-assessment for TAVR; agreement between measurements of aortic geometries was assessed. Results: 16/21 patients had aortic bioprostheses constructed with a metal ring, and 5/21 patients had a metal strut construction. Patients with metal struts had significant metal-artefact on CMR, which compromised image quality in this region. There was good agreement between CT and CMR measurements of aortic geometry. The mean difference (d) in annulus area-derived diameter was 0.5 mm (95% limits of agreement [L.A] 4.2 mm). There was good agreement between modalities for the cross-sectional area of the sinuses of valsalva (d 0.5 cm{sup 2}, L.A 1.4 cm{sup 2}), sinotubular junction (d 0.9 cm{sup 2}, L.A 1.5 cm{sup 2}), and ascending aorta (d 0.6 cm{sup 2}, L.A 1.4 cm{sup 2}). In patients without metal struts, the left coronary artery height d was 0.7 mm and L.A 2.8 mm. Conclusions: Our analysis shows that CMR and CT measurements of aortic geometry show good agreement, including measurement of annulus size and coronary artery location, and thus provide the necessary anatomical information for valve

  6. Preliminary assessment of cardiac short term safety and efficacy of manganese chloride for cardiovascular magnetic resonance in humans

    Kalaf Jose M

    2011-01-01

    Full Text Available Abstract Background Manganese based agents are intracellular and accumulate inside myocytes allowing for different imaging strategies compared to gadolinium contrasts. While previous agents release manganese very slowly in the circulation, MnCl2 allows for rapid Mn2+ uptake in myocytes, creating a memory effect that can be potentially explored. Data on animal models are very encouraging but the safety and efficacy of this approach in humans has not yet been investigated. Therefore, our objectives were to study the safety and efficacy of a rapid infusion of manganese chloride (MnCl2 for cardiovascular magnetic resonance (CMR in humans. Methods Fifteen healthy volunteers underwent a CMR scan on a 1.5 T scanner. Before the infusion, cardiac function was calculated and images of a short axis mid-ventricular slice were obtained using a 2D and 3D gradient-echo inversion recovery (GRE-IR sequence, a phase-sensitive IR sequence and a single breath-hold segmented IR prepared steady-state precession acquisition for T1 calculations. MnCl2 was infused over three minutes at a total dose of 5 μMol/kg. Immediately after the infusion, and at 15 and 30 minutes later, new images were obtained and cardiac function re-evaluated. Results There was a significant decrease in T1 values compared to baseline, sustained up to 30 minutes after the MnCl2 infusion (pre,839 ± 281 ms; 0 min, 684 ± 99; 15 min, 714 ± 168; 30 min, 706 ± 172, P = 0.003. The 2D and 3D GRE-IR sequence showed the greatest increase in signal-to-noise ratio compared to the other sequences (baseline 6.6 ± 4.2 and 9.7 ± 5.3; 0 min, 11.3 ± 4.1 and 15.0 ± 8.7; 15 min, 10.8 ± 4.0 and 16.9 ± 10.2; 30 min, 10.6 ± 5.2 and 16.5 ± 8.3, P 2 with no major adverse events, despite all reporting transient facial flush. Conclusions In the short term, MnCl2 appears safe for human use. It effectively decreases myocardium T1, maintaining this effect for a relatively long period of time and allowing for the

  7. Sequence optimization to reduce velocity offsets in cardiovascular magnetic resonance volume flow quantification - A multi-vendor study

    Werner Beat

    2011-03-01

    Full Text Available Abstract Purpose Eddy current induced velocity offsets are of concern for accuracy in cardiovascular magnetic resonance (CMR volume flow quantification. However, currently known theoretical aspects of eddy current behavior have not led to effective guidelines for the optimization of flow quantification sequences. This study is aimed at identifying correlations between protocol parameters and the resulting velocity error in clinical CMR flow measurements in a multi-vendor study. Methods Nine 1.5T scanners of three different types/vendors were studied. Measurements were performed on a large stationary phantom. Starting from a clinical breath-hold flow protocol, several protocol parameters were varied. Acquisitions were made in three clinically relevant orientations. Additionally, a time delay between the bipolar gradient and read-out, asymmetric versus symmetric velocity encoding, and gradient amplitude and slew rate were studied in adapted sequences as exploratory measurements beyond the protocol. Image analysis determined the worst-case offset for a typical great-vessel flow measurement. Results The results showed a great variation in offset behavior among scanners (standard deviation among samples of 0.3, 0.4, and 0.9 cm/s for the three different scanner types, even for small changes in the protocol. Considering the absolute values, none of the tested protocol settings consistently reduced the velocity offsets below the critical level of 0.6 cm/s neither for all three orientations nor for all three scanner types. Using multilevel linear model analysis, oblique aortic and pulmonary slices showed systematic higher offsets than the transverse aortic slices (oblique aortic 0.6 cm/s, and pulmonary 1.8 cm/s higher than transverse aortic. The exploratory measurements beyond the protocol yielded some new leads for further sequence development towards reduction of velocity offsets; however those protocols were not always compatible with the time

  8. Role of Perfusion at Rest in the Diagnosis of Myocardial Infarction Using Vasodilator Stress Cardiovascular Magnetic Resonance.

    Patel, Mita B; Mor-Avi, Victor; Kawaji, Keigo; Nathan, Sandeep; Kramer, Christopher M; Lang, Roberto M; Patel, Amit R

    2016-04-01

    In clinical practice, perfusion at rest in vasodilator stress single-photon emission computed tomography is commonly used to confirm myocardial infarction (MI) and ischemia and to rule out artifacts. It is unclear whether perfusion at rest carries similar information in cardiovascular magnetic resonance (CMR). We sought to determine whether chronic MI is associated with abnormal perfusion at rest on CMR. We compared areas of infarct and remote myocardium in 31 patients who underwent vasodilator stress CMR (1.5 T), had MI confirmed by late gadolinium enhancement (LGE scar), and coronary angiography within 6 months. Stress perfusion imaging during gadolinium first pass was followed by reversal with aminophylline (75 to 125 mg), rest perfusion, and LGE imaging. Resting and peak-stress time-intensity curves were used to obtain maximal upslopes (normalized by blood pool upslopes), which were compared between infarcted and remote myocardial regions of interest. At rest, there was no significant difference between the slopes in the regions of interest supplied by arteries with and without stenosis >70% (0.31 ± 0.16 vs 0.26 ± 0.15 1/s), irrespective of LGE scar. However, at peak stress, we found significant differences (0.20 ± 0.11 vs 0.30 ± 0.22 1/s; p <0.05), reflecting the expected stress-induced ischemia. Similarly, at rest, there was no difference between infarcted and remote myocardium (0.27 ± 0.14 vs 0.30 ± 0.17 1/s), irrespective of stenosis, but significant differences were seen during stress (0.21 ± 0.16 vs 0.28 ± 0.18 1/s; p <0.001), reflecting inducible ischemia. In conclusion, abnormalities in myocardial perfusion at rest associated with chronic MI are not reliably detectable on CMR images. Accordingly, unlike single-photon emission computed tomography, normal CMR perfusion at rest should not be used to rule out chronic MI. PMID:26830261

  9. Final infarct size measured by cardiovascular magnetic resonance in patients with ST elevation myocardial infarction predicts long-term clinical outcome

    Lønborg, Jacob Thomsen; Vejlstrup, Niels Grove; Kelbæk, Henning Skov;

    2013-01-01

    prognostic evaluation. To evaluate the prognostic importance of the final infarct size measured by cardiovascular magnetic resonance (CMR) in patients with STEMI. METHODS AND RESULTS: In an observational study the final infarct size was measured by late gadolinium enhancement CMR 3 months after initial...... admission in 309 patients with STEMI. The clinical endpoint was a composite of all-cause mortality and admission for heart failure. During the follow-up period of median 807 days (IQR: 669-1117) 35 events (5 non-cardiac deaths, 3 cardiac deaths, and 27 admissions for heart failure) were recorded. Patients...

  10. Comprehensive assessment of a post-coronary bypass graft patient with cardiovascular magnetic resonance imaging and multi-detector computed tomography

    Pairoj Rerkpattanapipat; Patcharee Paijitprapaporn; Suthipong Jongjirasiri; Jiraporn Laothamatas; Nithi Mahanonda

    2007-01-01

    Coronary bypass graft surgery (CABG) is a revascularization procedure which reduces myocardial ischemia and cardiovascular morbidity and mortality in selected patients; however, up to 40% of saphanous vein grafts may degenerate over 10 years. Although coronary angiography is the gold standard to detect graft patency and native vessel disease, sometimes it is difficult to locate the grafts resulting in increased exposure to radiation and contrast administration. This case highlights the utility of cardiac computerized tomography and magnetic resonance imaging to provide comprehensive noninvasive assessment in a patient post CABG.