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Sample records for 3-dimensional echocardiography comparison

  1. Accuracy of 3-Dimensional Transoesophageal Echocardiography in Assessment of Prosthetic Mitral Valve Dehiscence with Comparison to Anatomical Specimens

    Martin R. Brown

    2010-01-01

    Full Text Available The evolution of echocardiography from 2-Dimensional Transthoracic Echo through to real time 3-Dimensional Transoesophageal Echo has enabled more accurate visualisation and quantification of valvular disorders especially prosthetic mitral valve paravalvular regurgitation. However, validation of accuracy is rarely confirmed by surgical or post-mortem specimens. We present a case directly comparing different echocardiographic modality images to post mortem specimens in a patient with prosthetic mitral valve paravalvular regurgitation.

  2. Evaluation of left ventricular volumes in patients with congenital heart disease and abnormal left ventricular geometry. Comparison of MRI and transthoracic 3-dimensional echocardiography

    Purpose: To assess the new method of 3-dimensional echocardiography in comparison to the 'gold standard' MRI as to its ability to calculate left ventricular volumes in patients with congenital heart disease. Materials and methods: Eighteen patients between the ages of 3.9 to 37.3 years (mean: 12.8±9.7) with a geometrically abnormal left ventricle were examined using a 1.5 T scanner with a fast gradient-echo sequence (TR=14 ms, TE=2.6-2.9 ms, FOV=300-400 mm, flip angle=20 , matrix=128:256, slice thickness=5 mm, retrospective gating) in multislice-multiphase technique. Transthoracic 3D-echocardiography was performed with a 3.5 MHz transducer and a Tomtec trademark (Munich, Germany) system for 3D reconstruction. Results: Volume calculation was possible in all patients with 3D-echocardiography, but the muscle mass calculation only succeeded in 11 to 18 patients (61%) due to inadequate visualization of the entire myocardium. Comparing MRI and 3D-echocardiography, the correlation was r=0.97 for the end-systolic volumes, r=0.98 for the end-diastolic volumes, r=0.79 for the end-systolic muscle mass and r=0.77 for the end-diastolic muscle mass. The agreement between both methods was considered good for the calculated end-diastolic volumes and sufficient for the calculated end-systolic volumes. The muscle mass calculations showed larger differences especially for the end-systolic mass. Mean intraobserver variability was 18.6% for end-systolic and 8.3% for end-diastolic volumes. Conclusion: In patients with an abnormal left ventricular configuration due to congenital heart disease, the new method of 3D-echocardiography is sufficient for volume calculations in preselected patients. The high intraobserver variability is still a limitation of transthoracic 3D-echocardiography in comparison to MRI. (orig.)

  3. Implementation of new echocardiographic modalities in routine practice in a general hospital – Pocket-size cardiac ultrasound and 3 dimensional echocardiography. Studies on feasibility and diagnostic accuracy

    2015-01-01

    This thesis is based upon the implementation of pocket-size cardiac ultrasound (PCU) among medical students and residents in internal medicine and 3 dimensional echocardiography (3DE) in routine care at a general hospital. The introduction of widely available and handy ultrasound devices has represented a challenge to the medical community as implementation in clinical practice can be made by non-specialists. In view of favorable results from the non-expert use of the larger laptop-sized d...

  4. Diagnostic value of harmonic transthoracic echocardiography in native valve infective endocarditis: comparison with transesophageal echocardiography

    Embil John M

    2007-05-01

    Full Text Available Abstract Background Although echocardiography has been incorporated into the diagnostic algorithm of patients with suspected infective endocarditis (IE, systematic usage in clinical practice remains ill defined. To determine the diagnostic accuracy of detecting vegetations using harmonic transthoracic echocardiography (hTTE as compared to transesophageal echocardiography (TEE in patients with an intermediate likelihood of native valve IE. Methods Between 2004 and 2005, 36 consecutive inpatients with an intermediate likelihood of disease were prospectively evaluated by hTTE and TEE. Results Of 36 patients (21 males with a mean age of 57 ± 15 years, range 32 to 86 years, 19 patients had definite IE by TEE. The sensitivity for the detection of vegetations by hTTE was 84%, specificity of 88%, positive predictive value (PPV of 89% and negative predictive value (NPV of 82%. The association between hTTE and TTE interpretation for the presence and absence of vegetations were high (kappa = 0.90 and 0.85 respectively. Conclusion In patients with an intermediate likelihood of native valve IE, TTE with harmonic imaging provides diagnostic quality images in the majority of cases, has excellent concordance with TEE and should be recommended as the first line test.

  5. Comparison of dobutamine stress echocardiography with exercise reinjection thallium myocardial perfusion scan to detect myocardial cell viability

    A comparison of dobutamine stress echocardiography with exercise reinjection thallium myocardial perfusion scan on known coronary artery disease patients for detection of myocardial cell viability is given

  6. 'P' mitrale and left atrial enlargement: comparison with echocardiography

    This study was carried out to determine the sensitivity and specificity of 'P' Mitrale in diagnosing left atrial enlargement by comparing it with the Gold Standard of echocardiography. The study was carried out at the department of Physiology, Army Medical College, Rawalpindi and department of Cardiology at Armed Forces Institute of Cardiology / National Institute of Heart Diseases. 50 clinically diagnosed cases of left atrial enlargement were included in the study. ECG of the patients was recorded and 'P' Mitrale observed. This was followed by echocardiography and using 2-D echocardiogram as a guideline M-mode recording was obtained and left atrial size was calculated. 'P' Mitrale has a sensitivity of 22.5% and specificity of 100%. The positive and negative predictive value and diagnostic efficacy of the test were also calculated. Sensitivity of ECG is low in detecting left atrial enlargement. However its sensitivity can be increased by combining 'P' Terminal Force in lead V1 and P/P-R ratio to 'P' Mitrale. ECG is however still recommended as a routine investigation because of its cost effectiveness and easy availability. (author)

  7. Myocardial perfusion SPECT for assessment of left ventricular function and volume- comparison with echocardiography

    Objective: The purpose of this study was to evaluate left ventricular volume and function by gated SPECT and comparison of the results with echocardiography. Methods: 65 Consecutive patients (49 male, 16 female; mean age 61+11 years) who underwent both gated 99mTc-MIBI myocardial perfusion SPECT and echocardiography within a 15 days period were included in the study. Exclusion criteria were any change in clinical status between acquisition of the gated SPECT and echocardiography studies, acute myocardial infarction occurring less than 7 days before study, and surgical procedures occurring within 30 days of the study. The clinical diagnosis of each patient was not considered, as this was not relevant to the purpose of the study. The diagnoses were as follows: coronary artery disease (n=46), hypertensive heart disease (n=8), old myocardial infarction (n=5), myocarditis (n=2), and routine medical examination(n=4). A dose of 740 MBq of 99Tcm-sestamibi was administered in resting condition. Gated SPECT images were obtained with ADAC Vertex MCD-AC SPECT system. The raw projection images were reconstructed with filtered back-projection (ramp filter), without attenuation correction. The data, including left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), end-systolic volume (ESV) were obtained using AUTOQUANT software (ADAC corporation). The echocardiography study used its standard techniques. Two nuclear medicine physicians processed the raw images respectively to evaluate internal reproducibility of gated SPECT. In order to compare the results of gated SPECT with echocardiography on different left ventricular volumes, all patients were divided into two groups (EDV90 ml, n=34) based by EDV measurements in echocardiography. Results: The correlation coefficient of LVEF, EDV, ESV between SPECT and echocardiography were 0.77, 0.86 and 0.90 respectively. P0.07). The reproducibility of gated SPECT was excellent. There were no significant differences in LVEF(59

  8. Comparison of 3-dimensional proton-photon dose distribution and evaluation of side effects after radiotherapy

    Poljanc, K

    2000-01-01

    The use of high precision radiation with particles (protons and ions) allows the radiation of tumors near risk organs and immedicable tumors. The aim of this work is the comparison between normal tissue complication probability for craniocerebral tumors of children and youth during simulation of photontherapy and proton therapy. The multivariate analysis gives the possibility to determine the tolerance dose for certain organs.

  9. Myocardial perfusion: Comparison between 99mTc-MIBI scintigraphy and microbubbles- Pesda and Levovist-echocardiography

    Myocardial perfusion scintigraphy has been used for the last 25 years. Recently echocardiography is trying to realize the same kind of test with microbubbles injected intravenously. Aim: Comparison of the results of myocardial perfusion scintigraphy with 99mTc-MIBI and microbubbles - Pesda and Levovist-echocardiography. The nuclear medicine is considered the gold standard. Material and method: We studied 27 patients, 15 male, aging 58+/- 12.5 years with angina unstable or myocardial infarction (19 pts ) and normal (8 pts ). All patients received 740 MBq of 99mTc-MIBI during the echo examination. The SPECT scintigraphies were performed in an ADAC Vertex Plus scintillation camera. The echo were performed in a HDI 3000/5000 ATL, P3-2 transducer, intermittent harmonic image, VHS and 2 independent observers. During the echo examination the patients received Pesda- 2-7 ml/min- and Levovist- 400mg/ml 2-4 min. Results: NM versus Pesda and NM versus Levovist are presented. Concordance 87% (K=0.42). Concordance 89% (K0.57). Conclusion: Despite of the feasibility, echocardiography can detect myocardial perfusion defects with a good concordance of 87-89 % of these cases. The learning curve, the qualitative analysis is jeopardized by fibrotic areas, and the attenuation are problems that they need to solve

  10. Visualization of transcoronary ablation of septal hypertrophy in patients with hypertrophic obstructive cardiomyopathy: a comparison between cardiac MRI, invasive measurements and echocardiography

    Sohns, Christian; Sossalla, Samuel; Schmitto, Jan D; Jacobshagen, Claudius; Raab, Björn; Obenauer, Silvia; Maier, Lars S.

    2010-01-01

    Objective Hypertrophic obstructive cardiomyopathy (HOCM) is treated by surgical myectomy or transcoronary ablation of septal hypertrophy (TASH). The aim of this study was to visualize the feasibility, success and short-term results of TASH on the basis of cardiac MRI (CMR) in comparison with cardiac catheterization and echocardiography. Methods In this in vivo study, nine patients with HOCM were treated with TASH. Patients were evaluated by transthoracic echocardiography, invasive cardiac ang...

  11. Assessment of Left Ventricular Function and Volume in Patients Undergoing 128-Slice Coronary CT Angiography with ECG-Based Maximum Tube Current Modulation: a Comparison with Echocardiography

    To compare multi-detector CT (MDCT) using 128-slice coronary CT angiography (Definition AS+, Siemens Medical Solution, Forchheim, Germany) with ECG-based maximum tube current modulation with echocardiography for the determination of left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), end-systolic volume (ESV), as well as assessing coronary artery image quality and patient radiation dose. Thirty consecutive patients (M:F = 20:10: mean age, 57.9 ± 11.4 years) were referred for MDCT for evaluation of atypical chest pain. EF, EDV and ESV were determined for both MDCT and echocardiography, and the correlation coefficients were assessed. Coronary artery segment subjective image quality (1, excellent: 4, poor) and radiation dose were recorded. Left ventricular EF, EDV, and ESV were calculated by MDCT and echocardiography and the comparison showed a significant correlation with those estimated by echocardiography (p < 0.05). Consistently, the LVEFs calculated by MDCT and echocardiography were not statistically different. However, LV, EDV and ESV from MDCT were statistically higher than those from echocardiography (p < 0.05). The average image quality score of the coronary artery segment was 1.10 and the mean patient radiation dose was 3.99 ± 1.85 mSv. Although LV volume was overestimated by MDCT, MDCT provides comparable results to echocardiography for LVEF and LVV, with a low radiation dose

  12. Cardiac output determined by echocardiography in patients with cirrhosis: comparison with the indicator dilution technique

    Andersen, Ulrik B; Møller, Søren; Bendtsen, Flemming; Henriksen, Jens H

    2003-01-01

    technique (CO(I)). METHODS: Twelve patients with cirrhosis were studied. CO(d) was measured as the spatial mean velocity of the left ventricular outflow tract, multiplied by the cross-sectional area and the heart rate. CO(I) was determined by the standard indicator dilution technique after injection of 125I......BACKGROUND/AIMS: Measurement of cardiac output in hyperkinetic patients with cirrhosis by Doppler echocardiography is increasingly reported, but has not been validated. We have compared simultaneous measurements of cardiac output by Doppler echocardiography (CO(d)) and by the indicator dilution...... with the Doppler technique. CONCLUSION: Doppler measurements of cardiac output in groups of patients with cirrhosis are accurate with respect to the group mean, but marked disagreements of over- and underestimation were seen in individual patients. The reproducibility of the Doppler technique is...

  13. Magnetic resonance pharmacological stress for detecting coronary disease. Comparison with echocardiography

    Stress testing is the cornerstone in the diagnosis of patients with suspected coronary artery disease (CAD). Although exercise ECG remains the primary approach for the detection of ischemia in patients with chest pain syndromes, its sensitivity and specificity is limited and exercise ECG does not provide detailed information about the localisation and extent of CAD. Stress echocardiography has been used for the detection of ischemia for more than a decade and has become an increasingly popular noninvasive method for the detection of CAD. In experienced hands wall motion analysis based on stress echocardiography has proved to be as sensitive and specific for the detection of myocardial ischemia as scintigraphic techniques. Recent technical improvements, namely the availability of ultrafast imaging sequences with a significant reduction of imaging time have initiated several studies which examined the combination of pharmacological stress and magnetic resonance imaging (MRI) for the detection of suspected CAD. The most well developed stress-MRI technique is wall motion imaging during dobutamine stress. This technique is analogous to stress echocardiography, but MRI has the inherent advantages of better resolution, higher reproducibility and true long and short axis imaging with contiguous parallel slices. However, the clinical impact of MRI for the diagnosis of CAD is still low. Further technical developments including real time imaging and a reliable automated quantitative analysis of left ventricular function are required before stress-MRI becomes a serious challenge to stressechocardiography in the clinical arena. Currently, only a few MRI facilities and physicians are dedicated to pharmacological stress testing with MRI and the future clinical impact of this promising technique will depend on its potential to provide information beyond myocardial function including perfusion, metabolism and coronary anatomy in form of a ''one-stop''-shop for the cardiac patient

  14. Myocardial Strain and Strain Rate Imaging: Comparison between Doppler Derived Strain Imaging and Speckle Tracking Echocardiography

    Anita Sadeghpour

    2013-05-01

    Full Text Available Regional myocardial function has been traditionally assessed by visual estimation (1. Echocardiographic strain imaging which is known as deformation imaging, has been emerged as a quantitative technique to accurately estimate regional myocardial function and contractility. Currently, strain imaging has been regarded as a research tool in the most echocardiography laboratories. However, in recent years, strain imaging has gain momentum in daily clinical practice (2. The following two techniques have dominated the research arena of echocardiography: (1 Doppler based tissue velocity measurements, frequently referred to tissue Doppler or myocardial Doppler, and (2 speckle tracking on the basis of displacement measurements (3. Over the past two decades, Tissue Doppler Imaging (TDI and Doppler –derived strain (S and strain rate (SR imaging were introduced to quantify regional myocardial function. However, Doppler–derived strain variables faced criticisms, with regard to the angle dependency, noise interference, and substantial intraobserver and interobserver variability. The angle dependency is the major weakness of Doppler based methodology; however, it has the advantage of online measurements of velocities and time intervals with excellent temporal resolution, which is essential for the assessment of ischemia (4. Speckle-tracking echocardiography (STE or Non Doppler 2D strain echocardiography is a relatively new, largely angle-independent technique that analyzes motion by tracking natural acoustic reflections and interference patterns within an ultrasonic window. The image-processing algorithm tracks elements with approximately 20 to 40 pixels containing stable patterns and are described as ‘‘speckles’’ or ‘‘fingerprints’’. The speckles seen in grayscale B-mode (2D images are tracked consecutively frame to frame (5, 6. Assessment of 2D strain by STE is a semiautomatic method that requires definition of the myocardium

  15. Fetal echocardiography

    USG performed with a high-end machine, using a good cine-loop facility is extremely helpful in the diagnosis of fetal cardiac anomalies. In fetal echocardiography, the four-chamber view and the outflow-tract view are used to diagnose cardiac anomalies. The most important objective during a targeted anomaly scan is to identify those cases that need a dedicated fetal echocardiogram. Associated truncal and chromosomal anomalies need to be identified. This review shows how fetal echocardiography, apart from identifying structural defects in the fetal heart, can be used to look at rhythm abnormalities and other functional aspects of the fetal heart

  16. Comparison of 3-dimensional dose reconstruction system between fluence-based system and dose measurement-guided system.

    Nakaguchi, Yuji; Ono, Takeshi; Onitsuka, Ryota; Maruyama, Masato; Shimohigashi, Yoshinobu; Kai, Yudai

    2016-01-01

    COMPASS system (IBA Dosimetry, Schwarzenbruck, Germany) and ArcCHECK with 3DVH software (Sun Nuclear Corp., Melbourne, FL) are commercial quasi-3-dimensional (3D) dosimetry arrays. Cross-validation to compare them under the same conditions, such as a treatment plan, allows for clear evaluation of such measurement devices. In this study, we evaluated the accuracy of reconstructed dose distributions from the COMPASS system and ArcCHECK with 3DVH software using Monte Carlo simulation (MC) for multi-leaf collimator (MLC) test patterns and clinical VMAT plans. In a phantom study, ArcCHECK 3DVH showed clear differences from COMPASS, measurement and MC due to the detector resolution and the dose reconstruction method. Especially, ArcCHECK 3DVH showed 7% difference from MC for the heterogeneous phantom. ArcCHECK 3DVH only corrects the 3D dose distribution of treatment planning system (TPS) using ArcCHECK measurement, and therefore the accuracy of ArcCHECK 3DVH depends on TPS. In contrast, COMPASS showed good agreement with MC for all cases. However, the COMPASS system requires many complicated installation procedures such as beam modeling, and appropriate commissioning is needed. In terms of clinical cases, there were no large differences for each QA device. The accuracy of the compass and ArcCHECK 3DVH systems for phantoms and clinical cases was compared. Both systems have advantages and disadvantages for clinical use, and consideration of the operating environment is important. The QA system selection is depending on the purpose and workflow in each hospital. PMID:27179708

  17. Radioimmunometric assay of Ventricular natriuretic peptide (BNP) in transplanted human heart. Comparison with echocardiography

    Aim: Natriuretic Peptide type-B (BNP) is a cardiac hormone secreted predominantly from the ventricles and following impaired cardiac function its plasma concentrations are increased. High levels of BNP are detectable in plasma following orthotopic cardiac transplantation. Other studies try to find correlation between BNP and degree of rejection found in the endomyocardial biopsy. In the present, the correlation of BNP with echocardiographic variables that show the status of ventricular function , is studied. Methods: We have compared 108 BNP determinations with its correspondents echocardiography studies (performed the same day). A total of 36 heart transplanted patients (3 women and 33 men) aged 15 to 64 (mean age 51) were studied. BNP was determined using a radioimmunometric assay 'Shionoria BNP Cis' that use a 'sandwich' technique on solid phase. Echocardiography was performed with a Hewlett Packard Sonos 2500 instrument. Systolic function was defined as conserved when left ventricular ejection fraction (LVEF) was more than 55%, and as mildly, moderately or severely impaired when LVEF was 45-55%, 35-45%, or less than 35%, respectively. We have studied the correlation between BNP and: LV systolic function, isovolumetric relaxation time (IRT) , E-wave deceleration time (EDT), shortening fraction (SF) and LV mass. Statistical analysis: Student's t test and Pearson's correlation coefficient. Results: BNP mean of patients with conserved LVEF was 199,76 pg/ml (First group). BNP mean of patients with mildly or moderate impaired LVFE (Second group) was 937 and patients with severely impaired LVEF (Third group) was 1038 pg/ml. There was statistical difference (p<0,001) between means of groups 1-2 (t=4,03, p= 0,01) and 1-3.(t=0.74, p=0,0084) The correlation coefficient of BNP-IRT was -0.34, BNP-EDT was -0.46, BNP-SF was - 0.19 and BNP-M was 0.5. Conclusion: BNP levels of patients with conserved LV systolic function BNP were very significant lower. There is weak but

  18. STRESS ECHOCARDIOGRAPHY

    Salustri, Alessandro

    1994-01-01

    textabstractIn the studies reported in this thesis, stress echocardiography (either with exercise or with pharmacological agents) and myocardial perfusion scintigraphy have been performed in different groups of patients and in different clinical conditions. Some practical aspects on the protocols of echocardiographic tests are briefly reported

  19. Cardiac output by Doppler echocardiography in the premature baboon: Comparison with radiolabeled microspheres

    Pulsed-Doppler echocardiography (PDE) is a useful noninvasive method for determining left ventricular output (LVO). However, despite increasingly widespread use in neonatal intensive care units, validation studies in prematures with cardiopulmonary disease are lacking. The purpose of this study was to compare radiolabeled microsphere (RLM) and PDE measurements of LVO, using the critically ill premature baboon as a model of the human neonate. Twenty-two paired RLM and PDE measurements of LVO were obtained in 14 animals between 3 and 24 h of age. Average PDE LVO was 152 ml/min/kg (range, 40-258 ml/min/kg) compared to 158 ml/min/kg (range, 67-278 ml/min/kg) measured by RLM. Linear regression analysis of the paired measurements showed good correlation with a slope near unity (gamma = 0.94x + 4.20, r = 0.91, SEE = 25.7 ml). The authors conclude that PDE determinations of LVO compare well with those measured by RLM in the premature baboon. PDE appears to provide a valid estimate of LVO and should be useful in human prematures with cardiopulmonary distress

  20. Sedation for transesophageal echocardiography: comparison of propofol, midazolam and midazolam-alfentanil combination

    Huseyin Toman

    2016-02-01

    Full Text Available Aim The administration of trans esophageal echocardiography (TEE may cause nausea, shortness of breath, agitation, emotional distress and pain in patients due to pharyngo-esophageal intubation, which may be partially relieved by sedoanalgesia. The aim of this study was to compare clinical effects of midazolam, midazolam-alfentanil combination and propofol sedation given for sedation and sedoanalgesia to patients with planned diagnostic TEE interventions. Methods This study was prospectively completed with 90 randomized adult patients in ASA risk groups I-II-III. Group M were given 2.5 mg midazolam, group MA were given 1 mg midazolam and 5 μg/kg alfentanil and group P were given 0.5 mg/kg propofol intravenous bolus. If necessary, additional doses were administered. Patients administered with TEE were evaluated in terms of additional dose requirements, Ramsey Sedation Scale (RSS, modified Aldrete Scoring (MAS, recovery time and duration of stay in the hospital. Results In the group P additional dose requirements were greater (p<0.05, as well as the duration of stay in the recovery unit and hospital were shorter (p<0.05. On insertion of the TEE probe, the RSS in the group P was clearly higher than in other groups M and MA (p<0.05. Conclusion During the TEE intervention, the use of propofol, contrary to requirements for additional dose and observation of apnea, appears to be advantageous due to providing more rapid and effective sedation depth without a need of expensive antagonist agents, and allowing early discharge of patients. Additionally, it seems that the use of midazolam combined with alfentanil, is more advantageous comparing to midazolam alone.

  1. [Comparison of the postmortem anatomical study and bidimensional echocardiography in myocardial infarction].

    Esquivel-Avila, J G; Ferrero, L; González, J A; Baez, N; Osornio, A R; Varela, J

    1985-01-01

    We studied 10 patients between the ages of 30 and 69 years, all of whom had suffered myocardial infarction (MI) at least 6 months before they died. Two-dimensional echocardiography (2-D E) and catheterism were done no more than 15 days before death. The location and extension of MI were compared to the segmentary mobility (SM), end diastolic wall thickness (EDWT) and percentage of systolic wall thickening (PSWT) determined by 2-D E, in the 15 segments of the left ventricular wall. We also compared 2-D E and coronariographic findings. There was a good correlation between the location (P less than 0.01) and extension (P less than 0.05) of the necrotic area dyssynergy, specially when the MI was transmural. The postmortem measurement of the wall thickness in each one of the segments had also good correlation with the EDWT as measured with 2-D E (r = 0.926). The EDWT was less in the necrotic segments (8.8 +/- 1.8 mm) than in non affected segments (14.1 +/- 1.9 mm) and this difference was significant (P less than 0.05). The wall was thinnest in segment affected by transmural necrosis. The PSWT was significantly less (P less than 0.01) in necrotic segments (12.1 +/- 3%) than in segments without necrosis (24.1 +/- 4.3%). The alteration of SM correlated with coronary obstructions greater than 75%, specially when it was associated with necrosis. The EDWT was less in necrotic segments with important coronary artery obstruction than in those without necrosis even though vascular narrowing was marked (P less than 0.01). The PSWT was also less in the areas with necrosis when coronary obstruction was severe as well as moderate (11.3 +/- 2.3%) than in segments with coronary obstruction but without necrosis (22.3 +/- 4.2%) and even less than that obtained in cases with neither coronary artery obstruction nor necrotic area (30.1 +/- 2.2%) and the difference is statistically significant (P less than 0.01). The segmentary measurement by 2-D E of the EDWT and the PSWT are useful for

  2. Value of cardiac multislice spiral CT for the assessment of degenerative aortic stenosis: comparison with echocardiography

    Objective: To non-invasively assess the severity of aortic valve stenosis (AS) by the determination of aortic valve calcification (AVC) using multislice spiral computed tomography (MSCT). Materials and Methods: Forty-one consecutive patients (17 male, 24 female, mean age 71.0±7.9 years) with a history of AS and an aortic valve area ≤2 cm2 underwent retrospectively ECG-gated 4-slice MSCT and echocardiography. The AVCs were quantitatively assessed using the score described by Agatston as well as by calculating the calcium mass. The echocardiographically determined aortic valve area (AVA) and the severity of AS according to the ACC/AHA guidelines were compared to the degree of a aortic valve calcifications. Pearson's correlation coefficient, cut-off values, kappa test and F-test with post hoc Boneferroni t-tests were calculated. Results: Calcium scores were significantly higher in patients with severe AS, when compared to mild or moderate AS (p<0.001). In patients suffering from severe AS, the mean Agatston score was 4125.5±1168.9 (calcium mass 904.1±263.3) while in patients with moderate and mild AS the corresponding values were 1596.3±987.0 (319.1±208.3) and 785.9±390.1 (149.1±90.2), respectively. Pearson's correlation coefficients were r-=0.75 for the Agatston score and r=-0.72 for the calcium mass. There was a moderate agreement between severity of AS according to the ACC/AHA guidelines and the degree of AS determined from AVC scores with κ=0.6091 and κ=0.6985, respectively. Conclusion: Severe AS may be differentiated from moderate or mild AS using cardiac MSCT. Extensive calcifications of the aortic valve presenting with an Agatston-Score ≥2824 (calcium mass ≥611) indicate a severe AS and should be taken as an indication for further diagnostic workup. (orig.)

  3. Comparison of contrast enhanced three dimensional echocardiography with MIBI gated SPECT for the evaluation of left ventricular function

    Cosyns Bernard

    2009-06-01

    Full Text Available Abstract Background In clinical practice and in clinical trials, echocardiography and scintigraphy are used the most for the evaluation of global left ejection fraction (LVEF and left ventricular (LV volumes. Actually, poor quality imaging and geometrical assumptions are the main limitations of LVEF measured by echocardiography. Contrast agents and 3D echocardiography are new methods that may alleviate these potential limitations. Methods Therefore we sought to examine the accuracy of contrast 3D echocardiography for the evaluation of LV volumes and LVEF relative to MIBI gated SPECT as an independent reference. In 43 patients addressed for chest pain, contrast 3D echocardiography (RT3DE and MIBI gated SPECT were prospectively performed on the same day. The accuracy and the variability of LV volumes and LVEF measurements were evaluated. Results Due to good endocardial delineation, LV volumes and LVEF measurements by contrast RT3DE were feasible in 99% of the patients. The mean LV end-diastolic volume (LVEDV of the group by scintigraphy was 143 ± 65 mL and was underestimated by triplane contrast RT3DE (128 ± 60 mL; p Conclusion Contrast RT3DE allows an accurate assessment of LVEF compared to the LVEF measured by SPECT, and shows low variability between observers. Although RT3DE triplane provides accurate evaluation of left ventricular function, RT3DE full-volume is superior to triplane modality in patients with suspected coronary artery disease.

  4. 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.

  5. Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy

    Nabavizadeh, Nima, E-mail: nabaviza@ohsu.edu; Simeonova, Anna O.; Waller, Joseph G.; Romer, Jeanna L.; Monaco, Debra L.; Elliott, David A.; Tanyi, James A.; Fuss, Martin; Thomas, Charles R.; Holland, John M.

    2014-10-01

    Volumetric-modulated arc radiotherapy (VMAT) is an iteration of intensity-modulated radiotherapy (IMRT), both of which deliver highly conformal dose distributions. Studies have shown the superiority of VMAT and IMRT in comparison with 3-dimensional conformal radiotherapy (3D-CRT) in planning target volume (PTV) coverage and organs-at-risk (OARs) sparing. This is the first study examining the benefits of VMAT in pancreatic cancer for doses more than 55.8 Gy. A planning study comparing 3D-CRT, IMRT, and VMAT was performed in 20 patients with pancreatic cancer. Treatments were planned for a 25-fraction delivery of 45 Gy to a large field followed by a reduced-volume 8-fraction external beam boost to 59.4 Gy in total. OARs and PTV doses, conformality index (CI) deviations from 1.0, monitor units (MUs) delivered, and isodose volumes were compared. IMRT and VMAT CI deviations from 1.0 for the large-field and the boost plans were equivalent (large field: 0.032 and 0.046, respectively; boost: 0.042 and 0.037, respectively; p > 0.05 for all comparisons). Both IMRT and VMAT CI deviations from 1.0 were statistically superior to 3D-CRT (large field: 0.217, boost: 0.177; p < 0.05 for all comparisons). VMAT showed reduction of the mean dose to the boost PTV (VMAT: 61.4 Gy, IMRT: 62.4 Gy, and 3D-CRT: 62.3 Gy; p < 0.05). The mean number of MUs per fraction was significantly lower for VMAT for both the large-field and the boost plans. VMAT delivery time was less than 3 minutes compared with 8 minutes for IMRT. Although no statistically significant dose reduction to the OARs was identified when comparing VMAT with IMRT, VMAT showed a reduction in the volumes of the 100% isodose line for the large-field plans. Dose escalation to 59.4 Gy in pancreatic cancer is dosimetrically feasible with shorter treatment times, fewer MUs delivered, and comparable CIs for VMAT when compared with IMRT.

  6. Treatment-Related Morbidity in Prostate Cancer: A Comparison of 3-Dimensional Conformal Radiation Therapy With and Without Image Guidance Using Implanted Fiducial Markers

    Singh, Jasmeet, E-mail: drsingh.j@gmail.com [Calvary Mater Newcastle, Newcastle (Australia); Greer, Peter B. [School of Physical and Mathematical Sciences, University of Newcastle, Newcastle (Australia); White, Martin A. [School of Medicine and Public Health, University of Newcastle, Newcastle (Australia); Parker, Joel; Patterson, Jackie [Calvary Mater Newcastle, Newcastle (Australia); Tang, Colin I.; Capp, Anne; Wratten, Christopher; Denham, James W. [Calvary Mater Newcastle, Newcastle (Australia); School of Medicine and Public Health, University of Newcastle, Newcastle (Australia)

    2013-03-15

    Purpose: To estimate the prevalence of rectal and urinary dysfunctional symptoms using image guided radiation therapy (IGRT) with fiducials and magnetic resonance planning for prostate cancer. Methods and Materials: During the implementation stages of IGRT between September 2008 and March 2010, 367 consecutive patients were treated with prostatic irradiation using 3-dimensional conformal radiation therapy with and without IGRT (non-IGRT). In November 2010, these men were asked to report their bowel and bladder symptoms using a postal questionnaire. The proportions of patients with moderate to severe symptoms in these groups were compared using logistic regression models adjusted for tumor and treatment characteristic variables. Results: Of the 282 respondents, the 154 selected for IGRT had higher stage tumors, received higher prescribed doses, and had larger volumes of rectum receiving high dosage than did the 128 selected for non-IGRT. The follow-up duration was 8 to 26 months. Compared with the non-IGRT group, improvement was noted in all dysfunctional rectal symptoms using IGRT. In multivariable analyses, IGRT improved rectal pain (odds ratio [OR] 0.07 [0.009-0.7], P=.02), urgency (OR 0.27 [0.11-0.63], P=<.01), diarrhea (OR 0.009 [0.02-0.35], P<.01), and change in bowel habits (OR 0.18 [0.06-0.52], P<.010). No correlation was observed between rectal symptom levels and dose-volume histogram data. Urinary dysfunctional symptoms were similar in both treatment groups. Conclusions: In comparison with men selected for non-IGRT, a significant reduction of bowel dysfunctional symptoms was confirmed in men selected for IGRT, even though they had larger volumes of rectum treated to higher doses.

  7. Comparison of low-dose dobutamine stress echocardiography and single photon emission computed tomography and delayed contrast MRI in the diagnosis of myocardial viability: Meta-analysis

    identification of viable myocardium, but delayed contrast enhanced MRI showed significant different pooled sensitivity in comparison to low-dose dobutamine stress echocardiography. (authors)

  8. Exact monitoring of aortic diameters in Marfan patients without gadolinium contrast: intraindividual comparison of 2D SSFP imaging with 3D CE-MRA and echocardiography

    To assess whether ECG-gated non-contrast 2D steady-state free precession (SSFP) imaging allows for exact monitoring of aortic diameters in Marfan syndrome (MFS) patients using non-ECG-gated contrast-enhanced 3D magnetic resonance angiography (CE-MRA) and echocardiography for intraindividual comparison. Non-ECG-gated CE-MRA and ECG-gated non-contrast SSFP at 1.5 T were prospectively performed in 50 patients. Two readers measured aortic diameters on para-sagittal images identically aligned with the aortic arch at the sinuses of Valsalva, sinotubular junction, ascending/descending aorta and aortic arch. Image quality was assessed on a three-point scale. Aortic root diameters acquired by echocardiography were used as reference. Intra- and interobserver variances were smaller for SSFP at the sinuses of Valsalva (p = 0.002; p = 0.002) and sinotubular junction (p = 0.014; p = 0.043). Image quality was better in SSFP than in CE-MRA at the sinuses of Valsalva (p < 0.0001), sinotubular junction (p < 0.0001) and ascending aorta (p = 0.02). CE-MRA yielded higher diameters than SSFP at the sinuses of Valsalva (mean bias, 2.5 mm; p < 0.0001), and comparison with echocardiography confirmed a higher bias for CE-MRA (7.2 ± 3.4 mm vs. SSFP, 4.7 ± 2.6 mm). ECG-gated non-contrast 2D SSFP imaging provides superior image quality with higher validity compared to non-ECG-gated contrast-enhanced 3D imaging. Since CE-MRA requires contrast agents with potential adverse effects, non-contrast SSFP imaging is an appropriate alternative for exact and riskless aortic monitoring of MFS patients. (orig.)

  9. Exact monitoring of aortic diameters in Marfan patients without gadolinium contrast: intraindividual comparison of 2D SSFP imaging with 3D CE-MRA and echocardiography

    Veldhoen, Simon [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Bavaria (Germany); University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Behzadi, Cyrus; Derlin, Thorsten; Henes, Frank Oliver; Adam, Gerhard; Bannas, Peter [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Rybczinsky, Meike; Kodolitsch, Yskert von; Sheikhzadeh, Sara [University Medical Center Hamburg-Eppendorf, Department of General and Interventional Cardiology, Hamburg (Germany); Bley, Thorsten Alexander [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Bavaria (Germany)

    2014-10-15

    To assess whether ECG-gated non-contrast 2D steady-state free precession (SSFP) imaging allows for exact monitoring of aortic diameters in Marfan syndrome (MFS) patients using non-ECG-gated contrast-enhanced 3D magnetic resonance angiography (CE-MRA) and echocardiography for intraindividual comparison. Non-ECG-gated CE-MRA and ECG-gated non-contrast SSFP at 1.5 T were prospectively performed in 50 patients. Two readers measured aortic diameters on para-sagittal images identically aligned with the aortic arch at the sinuses of Valsalva, sinotubular junction, ascending/descending aorta and aortic arch. Image quality was assessed on a three-point scale. Aortic root diameters acquired by echocardiography were used as reference. Intra- and interobserver variances were smaller for SSFP at the sinuses of Valsalva (p = 0.002; p = 0.002) and sinotubular junction (p = 0.014; p = 0.043). Image quality was better in SSFP than in CE-MRA at the sinuses of Valsalva (p < 0.0001), sinotubular junction (p < 0.0001) and ascending aorta (p = 0.02). CE-MRA yielded higher diameters than SSFP at the sinuses of Valsalva (mean bias, 2.5 mm; p < 0.0001), and comparison with echocardiography confirmed a higher bias for CE-MRA (7.2 ± 3.4 mm vs. SSFP, 4.7 ± 2.6 mm). ECG-gated non-contrast 2D SSFP imaging provides superior image quality with higher validity compared to non-ECG-gated contrast-enhanced 3D imaging. Since CE-MRA requires contrast agents with potential adverse effects, non-contrast SSFP imaging is an appropriate alternative for exact and riskless aortic monitoring of MFS patients. (orig.)

  10. Evaluation of viability of infarcted myocardium by low dose dobutamine stress echocardiography. Comparison with exercise stress 201Tl myocardial scintigraphy

    Exercise stress 201Tl myocardial single-photon emission computed tomography (SPECT) is recognized to be a excellent method for identifying viability after myocardial infarction, but it is expensive and needs a longer time for data acquisition than echocardiography. We therefore performed this study to evaluate the effectiveness of low dose (5-10 μg/kg/min) dobutamine stress echocardiography (DSE) in 30 patients (61±8 years old: 24 men and 6 women) within 4 weeks after myocardial infarction in identifying viable myocardium, compared to results obtained by SPECT. Defining an akinetic or dyskinetic segment obtained by rest echocardiography as a definite infarct area, altogether 96 segments out of 716 segments were shown to be infarct areas. Of these, 75 (78%) segments were identified as viable by DSE, and 77 (80%) by SPECT. Only 2 segments were shown to be discrepant on DSE and SPECT. Subsequently, the sensitivity, specificity and accuracy rates for DSE were 96%, 100% and 96%, respectively. In conclusion, DSE is as effective and useful as SPECT in the evaluation of viability after myocardial infarction. (author)

  11. 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.

  12. American Society of Echocardiography

    American Society of Echocardiography Join Ase Member Portal Log In Membership Member Portal Log In Join ASE Renew Benefits Rates FASE – Fellow of the American Society of Echocardiography Member Referral Program FAQs Initiatives Advocacy ...

  13. Left ventricular wall thickness in patients with hypertrophic cardiomyopathy: a comparison between cardiac magnetic resonance imaging and echocardiography.

    Corona-Villalobos, Celia P; Sorensen, Lars L; Pozios, Iraklis; Chu, Linda; Eng, John; Abraham, Maria Roselle; Abraham, Theodore P; Kamel, Ihab R; Zimmerman, Stefan L

    2016-06-01

    We assessed whether cardiac MRI (CMR) and echocardiography (echo) have significant differences measuring left ventricular (LV) wall thickness (WT) in hypertrophic cardiomyopathy (HCM) as performed in the clinical routine. Retrospectively identified, clinically diagnosed HCM patients with interventricular-septal (IVS) pattern hypertrophy who underwent CMR and echo within the same day were included. Left Ventricular WT was measured by CMR in two planes and compared to both echo and contrast echo (cecho). 72 subjects, mean age 50.7 ± 16.2 years, 68 % males. Interventricular septal WT by echo and CMR planes showed good to excellent correlation. However, measurements of the postero-lateral wall showed poor correlation. Bland-Altman plots showed greater maximal IVS WT by echo compared to CMR measurement [SAX = 1.7 mm (-5.8, 9.3); LVOT = 1.1 mm (-5.6, 7.8)]. Differences were smaller between cecho and CMR [SAX = 0.8 mm (-9.2, 10.8); LVOT = -0.2 mm (-10.0, 9.6)]. Severity of WT by quartiles showed greater differences between echo and SAX CMR WT compared to cecho. Echocardiography typically measures greater WT than CMR, with the largest differences in moderate to severe hypertrophy. Contrast echocardiography more closely approximates CMR measurements of WT. These findings have potential clinical implications for risk stratification of subjects with HCM. PMID:26896038

  14. Head to Head Comparison of Stress Echocardiography with Exercise Electrocardiography for the Detection of Coronary Artery Stenosis in Women

    Kim, Mi-Na; Kim, Su-A; Kim, Yong-Hyun; Hong, Soon Jun; Park, Seong-Mi; Shin, Mi Seung; Kim, Myung-A; Hong, Kyoung-Soon; Shin, Gil Ja

    2016-01-01

    Background Exercise-stress electrocardiography (ECG) is initially recommended for the diagnosis of coronary artery disease. But its value has been questioned in women because of suboptimal diagnostic accuracy. Stress echocardiography had been reported to have comparable test accuracy in women. But the data comparing the diagnostic accuracy of exercise-stress ECG and stress echocardiography directly are few. The aim of the study was to compare the diagnostic accuracy of exercise-stress ECG and dobutamine stress echocardiography (DSE) in Korean women. Methods 202 consecutive female patients who presented with chest pain in outpatient clinic, and who underwent treadmill exercise test (TET), DSE and coronary angiography were included for the study. The diagnostic accuracy TET and DSE were calculated by the definition of > 50% or > 75% coronary artery stenosis (CAS). Results The sensitivity and specificity were higher with DSE (70.4, 94.6%) than TET (53.7, 73.6%) for detection of > 50% CAS. The higher accuracy of DSE was maintained after exclusion of the patients who could not achieve over 85% age predicted heart rate before ischemia induction. DSE also showed greater diagnostic accuracy than TET by > 75% CAS criteria, and in subsets of patient with intermediate pretest probability. Conclusion In the diagnosis of CAS, DSE showed higher accuracy than TET in female patients who presented with chest pain. As well as the test accuracy, adequate stress was more feasible with DSE than TET. These finding suggests DSE may be used as the first-line diagnostic tool in the detection of CAS in women with chest pain.

  15. Retrospective analysis of quantitative parameters obtained on myocardial perfusion SPECT imaging (ECTB software) in heart failure patients and their comparison with 2D-echocardiography results

    The objectives of the study are to study the quantitative parameters obtained on Gated MPI SPECT on ECTB software in patients of fixed defects on myocardial perfusion imaging and their comparison between individuals showing evidence of hibernating myocardium and patients without any evidence of hibernating myocardium and to do the comparative analysis of quantitative parameters such as LVEF, EDV, ESV and SV obtained in the aforementioned patients on Gated MPI SPECT (ECTB) and 2D ECHOCARDIOGRAPHY. It is concluded that the present findings are consistent with the nature of hibernating myocardium i.e. non-contractile and dysfunctional myocardium. The noticeable difference in the EDV and ESV in category 'SRS 0-10' is indicative of evidence of early diastolic dysfunction in this group of patients. The trends in the LVEF, EDV and ESV are suggestive of deteriorating myocardial function with increasing extent of ischemia. The increase in left ventricular EDV and ESV with increasing ischemia is suggestive of increasing incidence of gross morphological LV cavity dilatation or 'Dilated ischemic cardiomyopathy (DCMP)' in these patients. The quantitative parameters obtained on ECTB software on MPI study shows good correlation with 2D Echocardiography results

  16. Multimodality evaluation of ventricular function: comparison of cardiac magnetic resonance imaging, echocardiography, and planar and SPECT blood pool imaging

    Feiglin, David H.; Krol, Andrzej; Tillapaugh-Fay, Gwen M.; Szeverenyi, Nikolaus M.; Thomas, Frank D.

    2001-05-01

    Fifteen patients underwent resting echocardiography (EC), ECG gated cardiac MR ventriculography (MRV) and blood pool planar and SPECT ventriculography (SPV) sequentially on the same day. In addition, 36 patients had sequential ECG gated blood pool and SPV and 20 normal volunteers, age > 18 years, had sequential ECG gated cardiac MRI performed on both Siemens closed, 1.5T, and open, 0.2T, magnets. Echocardiography was performed using a HP 5500 system equipped with an S4 transducer in 2D mode. MRV at 0.2T and 1.5T used a circular polarized body coil. Nuclear Medicine studies used 25 mCi Tc- 99m labeled red blood cells. Gated planar and SPV were acquired on a dual head Siemens E-Cam system. We have found that MRV affords the most accurate measurement of ventricular function. SPV and MRV provide similar estimations of left ventricular function (LVEF). Further, SPV consistently provides higher LVEF, as compared to the planar data simultaneously acquired. Observed significant differences in intermodality measurements indicate that follow up studies in patients, especially in patients whose management is critically dependent on functional measurement changes, should be monitored by one modality only.

  17. [Value of cine magnetic resonance imaging in the diagnosis and quantification of valvular regurgitation. Comparison with angiography and Doppler echocardiography].

    Germain, P; Baruthio, J; Roul, G; Mossard, J M; Bareiss, P; Wecker, D; Chambron, J; Sacrez, A

    1989-10-01

    Thirty-three patients presenting with regurgitation of the mitral valve (19 cases), tricuspid valve (14 cases) or aortic valve (11 cases) documented by angiography (n = 20) and/or doppler-echocardiography (n = 28) were examined by cine-MRI in order to test this method in valvular regurgitation. Sixteen ECG-synchronized cine-MRI images were acquired by the GRASS technique every 40 ms on appropriate projections, with a resistive 0.28 Tesla Bruker magnet. The semiology of normal and pathological blood flow images at cine-MRI is described. Valvular regurgitations present as "signal void" jets the chronology and spatial extension of which depend on the severity of the lesion. The differential diagnosis with physiological flows is discussed. The diagnostic sensitivity of the method was 29/29 when compared with angiography and 29/33 when compared with doppler-echocardiography (2 cases of 1/4 mitral regurgitation and 2 cases 1/4 tricuspid regurgitation were not visible at cine-MRI). The specificity of this method, as can be judged from 104 patients explored, also seems to be satisfactory. The severity of regurgitation was graded from 1 to 4 with the three methods, on the basis of strict criteria. The differences in grade evaluation exceeded +/- 1 point in only one case of mitral regurgitation which was greatly underestimated by the doppler method as compared with angiography and cine-MRI. Thus, cine-MRI is a reliable method to evaluate valvular regurgitations and their severity. It solves the practical problem raised by non-echogenic patients when catheterization is to be postponed or avoided. PMID:2512868

  18. Dobutamine Stress Echocardiography and Tissue Synchronization Imaging

    Tas, Hakan; Gundogdu, Fuat; Gurlertop, Yekta; Karakelleoglu, Sule

    2008-01-01

    Dobutamine stress echocardiography has emerged as a reliable method for the diagnosis of coronary artery disease and the management of its treatment. Several studies have shown that that this technique works with 80–85% accuracy in comparison with other imaging methods. There are few studies aimed at developing the clinical utility of dobutamine stress echocardiography for the evaluation of normal and abnormal segments that result from dobutamine stress with Tissue Synchronization Imaging.

  19. Is echocardiography a valid tool to screen for left ventricular systolic dysfunction in chronic survivors of acute myocardial infarction? A comparison with radionuclide ventriculography

    Galasko, G I W; S. Basu; Lahiri, A; Senior, R

    2004-01-01

    Objective: To assess the accuracy of echocardiography with Simpson’s apical biplane method in screening for left ventricular systolic dysfunction (LVSD) in patients six months after acute myocardial infarction (AMI) as compared with radionuclide ventriculography by assessing the proportion of clinically significant errors that occur with echocardiography.

  20. Comparison of gated SPECT, echocardiography and cardiac magnetic resonance imaging for the assessment of left ventricular ejection fraction and volumes

    Left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) can be determined non-invasively by two-dimensional echocardiography (ECHO), gated single photon emission computed tomography (GSPECT) and cardiac magnetic resonance imaging (CMRI). This study was designed to analyze the concordance between LVEF, EDV and ESV values derived from ECHO, GSPECT and CMRI. ECHO, GSPECT and CMRI were performed in a group of 21 patients with suspected coronary artery disease. LVEF, EDV and ESV values were calculated. The mean LVEF measured with GSPECT, ECHO and CMRI were 5.9+-17.8%, 55.7+-16.4% and 56.4+-15.7% respectively. The mean EDV measured with GSPECT, ECHO and CMRI were 109.2+-42.4 mL, 127.5+-42.2 mL and 91.1+-38.0 mL, respectively. The mean ESV measured with GSPECT, ECHO and CMRI were 54.2+-41.2 mL, 59.9+-37.6 mL, respectively. The results of liner regression analysis showed very good correlation between LVEF and ESV values derived from GSPECT, ECHO and CMRI (r=0.91, r=0.92, r=0.97 for LVEF and r=0.86, r=0.91, r=0.91 for ESV, P<0.091). Good correlation were found between EDV values obtained from GSPECT, ECHO and CMRI (r=0.71, r=0.68, r=0.73, P<0.01). Agreement between these techniques in LVEF values was also good, but not in LV volumes, according to Bland-Altman plots. This study showed good overall correlations between LVEF, EDV and ESV values derived from GSPECT, ECHO and LVEF obtained from any of these three imaging modalities could be used interchangeably. However, care should be taken in comparing LV volumes. (author)

  1. Evaluation of postoperative pulmonary regurgitation after surgical repair of tetralogy of Fallot: comparison between Doppler echocardiography and MR velocity mapping

    Pulmonary regurgitation is a common finding in patients after correction of tetralogy of Fallot (TOF). Right ventricular impairment and even ventricular arrhythmia have been ascribed to pulmonary valve insufficiency (PI), which is therefore an important issue in follow-up examinations. To compare PI measured by echocardiography (ECHO) with data provided by cardiac MRI (CMR). We studied 54 selected patients (18 female; median age 14.0 years, range 3.8-53.4 years) after surgical correction of TOF. To quantify pulmonary regurgitant fraction (PRF) by CMR, flow velocity mapping was performed. On Doppler ECHO, length, width and localization of regurgitant flow was measured. The severity of PI was categorized as mild, moderate or severe and compared to the data obtained by CMR. On CMR the mean PRF was 29.2 ± 13.4%. Patients with a transannular patch had a significantly higher PRF (39.9 ± 11.6%) than patients with an intact annular ring (23.6 ± 11.4%). Differentiation by Doppler ECHO between the categories mild, moderate and severe PI was confirmed by significant differences in PRF measured by CMR (mild vs. moderate P < 0.04; moderate vs. severe P < 0.014; mild vs. severe P < 0.001). Furthermore, PRF correlated with right ventricular end diastolic volume index (r = 0.45, P < 0.01) and right ventricular end systolic volume index (r = 0.39, P < 0.01). Doppler ECHO can estimate the severity of PI after repair of TOF with acceptable results compared to CMR flow measurement. In univariate analysis there is only a weak influence of PRF on right ventricular volume. (orig.)

  2. Evaluation of postoperative pulmonary regurgitation after surgical repair of tetralogy of Fallot: comparison between Doppler echocardiography and MR velocity mapping

    Grothoff, Matthias; Spors, Birgit; Gutberlet, Matthias [Charite Campus Virchow Klinikum, Department of Radiology and Nuclear Medicine, Berlin (Germany); Abdul-Khaliq, Hasim [Deutsches Herzzentrum, Department of Congenital Heart Disease/Pediatric Cardiology, Berlin (Germany)

    2008-02-15

    Pulmonary regurgitation is a common finding in patients after correction of tetralogy of Fallot (TOF). Right ventricular impairment and even ventricular arrhythmia have been ascribed to pulmonary valve insufficiency (PI), which is therefore an important issue in follow-up examinations. To compare PI measured by echocardiography (ECHO) with data provided by cardiac MRI (CMR). We studied 54 selected patients (18 female; median age 14.0 years, range 3.8-53.4 years) after surgical correction of TOF. To quantify pulmonary regurgitant fraction (PRF) by CMR, flow velocity mapping was performed. On Doppler ECHO, length, width and localization of regurgitant flow was measured. The severity of PI was categorized as mild, moderate or severe and compared to the data obtained by CMR. On CMR the mean PRF was 29.2 {+-} 13.4%. Patients with a transannular patch had a significantly higher PRF (39.9 {+-} 11.6%) than patients with an intact annular ring (23.6 {+-} 11.4%). Differentiation by Doppler ECHO between the categories mild, moderate and severe PI was confirmed by significant differences in PRF measured by CMR (mild vs. moderate P < 0.04; moderate vs. severe P < 0.014; mild vs. severe P < 0.001). Furthermore, PRF correlated with right ventricular end diastolic volume index (r = 0.45, P < 0.01) and right ventricular end systolic volume index (r = 0.39, P < 0.01). Doppler ECHO can estimate the severity of PI after repair of TOF with acceptable results compared to CMR flow measurement. In univariate analysis there is only a weak influence of PRF on right ventricular volume. (orig.)

  3. Cine MRI in functional and morphological examination of the heart after myocardial infarction. Comparison to angiocardiography, two-dimensional echocardiography, radionuclide ventriculography and enzymatical estimation of infarct size

    61 patients (17 women, 44 men, 36-83 years, 32 with anterior, 29 with posterior wall infarction) received Cine-MRI in the true long and short axis of the heart and two-dimensional echocardiography one and 4 weeks post infarction. Two-level angiocardiography (ACG) and radionuclide ventriculography (RNV) were performed 4 weeks p.i. The size of myocardial infarction was determined enzymatically with the CK integral method. Left ventricular volume indices (EDVI, ESVI, SVI), ejection fraction (EF) and infarction weight (IW) were compared. Excellent correlations existed between Cine-MRI in the long and short axis for the volume indices and EF. Between Cine-MRI in the short axis and ACG all correlations were excellent aswell. They were significantly less satisfactory between Cine-MRI and 2DE due to the inhomogeneity of echo quality. Cine-MRI and RNV produced similar EF results (r=0.884), and a comparison of IW in Cine-MRI and CK integral method also showed a good correspondence (r=0.967). (orig./MG)

  4. Pediatric transesophageal echocardiography

    O.F.W. Stümper (Oliver)

    1991-01-01

    textabstractIn face of several limitations of precordial ultrasound investigations in children with congenital heart disease, it was attempted to defme the additional value of pediatric transesophageal echocardiography. Its comparative value, firstly, in the preoperative diagnosis of congenital hear

  5. Echocardiography in Mice

    Gao, Shumin; Ho, David; Vatner, Dorothy E.; Vatner, Stephen F.

    2011-01-01

    Murine models have been utilized with increasing frequency mainly due to availability of genetically engineered models. With advancement in high spatial and temporal resolution, echocardiography is used extensively for the evaluation of cardiovascular function in murine models of cardiovascular disease. This review summarizes the general applications and methods involved in echocardiography used to study mouse models for cardiovascular research, based on 20 years of experience in our laborato...

  6. Analysis of 3-dimensional Hydro-dynamical Model Simulation in the Gulf of Kutch, India and Its Comparison with Satellite Data

    Osawa, T.; Zhao, C.; Kunte, P.D.; Ae, L.S.; Hara, M.; Moriyama, T.

    better investigation for dynamical or eco-system processes in the coastal or enclosed Gulf at the present time. The objective of this study is to simulate dynamical parameters in the Gulf of Kutch using 3D baroclinic numerical model, in order...-dimensional Hydro-dynamical Model Simulation in the Gulf of Kutch, India and Its Comparison with Satellite Data Chaofang Zhao1,2, Pravin D. Kunte1,3, Lee Sung Ae1, Masanao Hara4, Takashi Moriyma5, Takahiro Osawa1 1. Center for Environmental Remote...

  7. Three-dimensional echocardiography

    Presents tips and tricks for beginners and experts Provides educational material for 3D training courses Features comprehensively illustrated cases Includes an accompanying DVD with video clips of all sample cases Three-dimensional echocardiography is the most recent fundamental advancement in echocardiography. Since real-time 3D echocardiography became commercially available in 2002, it has rapidly been accepted in echo labs worldwide. This book covers all clinically relevant aspects of this fascinating new technology, including a comprehensive explanation of its basic principles, practical aspects of clinical application, and detailed descriptions of specific uses in the broad spectrum of clinically important heart disease. The book was written by a group of well-recognized international experts in the field, who have not only been involved in the scientific and clinical evolution of 3D echocardiography since its inception but are also intensively involved in expert training courses. As a result, the clear focus of this book is on the practical application of 3D echocardiography in daily clinical routine with tips and tricks for both beginners and experts, accompanied by more than 150 case examples comprehensively illustrated in more than 800 images and more than 500 videos provided on a DVD. In addition to an in-depth review of the most recent literature on real-time 3D echocardiography, this book represents an invaluable reference work for beginners and expert users of 3D echocardiography. - Tips and tricks for beginners and experts - Educational material for 3D training courses - Comprehensively illustrated cases - DVD with video clips of all sample cases.

  8. Three-dimensional echocardiography

    Buck, Thomas [University Hospital Essen (Germany). West German Heart Center; Franke, Andreas [Klinikum Region Hannover - Klinikum Siloah, Hannover (Germany). Dept. of Cardiology, Angiology and Intensive Care Medicine; Monaghan, Mark J. (eds.) [King' s College Hospital, London (United Kingdom)

    2011-07-01

    Presents tips and tricks for beginners and experts Provides educational material for 3D training courses Features comprehensively illustrated cases Includes an accompanying DVD with video clips of all sample cases Three-dimensional echocardiography is the most recent fundamental advancement in echocardiography. Since real-time 3D echocardiography became commercially available in 2002, it has rapidly been accepted in echo labs worldwide. This book covers all clinically relevant aspects of this fascinating new technology, including a comprehensive explanation of its basic principles, practical aspects of clinical application, and detailed descriptions of specific uses in the broad spectrum of clinically important heart disease. The book was written by a group of well-recognized international experts in the field, who have not only been involved in the scientific and clinical evolution of 3D echocardiography since its inception but are also intensively involved in expert training courses. As a result, the clear focus of this book is on the practical application of 3D echocardiography in daily clinical routine with tips and tricks for both beginners and experts, accompanied by more than 150 case examples comprehensively illustrated in more than 800 images and more than 500 videos provided on a DVD. In addition to an in-depth review of the most recent literature on real-time 3D echocardiography, this book represents an invaluable reference work for beginners and expert users of 3D echocardiography. - Tips and tricks for beginners and experts - Educational material for 3D training courses - Comprehensively illustrated cases - DVD with video clips of all sample cases.

  9. 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

  10. Comparison of cine-MRI and transthoracic echocardiography for the assessment of aortic root diameters in patients with suspected Marfan syndrome

    Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.929), but a statistically significant bias of -1.0 mm (p<0.001). The mean absolute diameter for sinuses of Valsalva obtained by cine-MRI was 32.3 ± 5.8 mm as compared to 33.4 ± 5.4 mm obtained by echocardiography. Interobserver agreement of measurements of the sinuses of Valsalva was higher for cine-MRI than for echocardiography (p=0.029). Despite small, but statistically significant differences in terms of agreement and reproducibility, cine-MRI and echocardiographic measurements of aortic root diameters provide comparable results without a significant clinical difference. Therefore both techniques may be used for monitoring of the aortic root in patients with Marfan syndrome.

  11. Comparison of cine-MRI and transthoracic echocardiography for the assessment of aortic root diameters in patients with suspected Marfan syndrome

    Bannas, P.; Derlin, T.; Yamamura, J.; Lund, G.; Adam, G. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology; Rybczynski, M.; Sheikhzadeh, S.; Kodolitsch, Y. von [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of General and Interventional Cardiology; Groth, M. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Section for Pediatric Radiology

    2015-11-15

    Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.929), but a statistically significant bias of -1.0 mm (p<0.001). The mean absolute diameter for sinuses of Valsalva obtained by cine-MRI was 32.3 ± 5.8 mm as compared to 33.4 ± 5.4 mm obtained by echocardiography. Interobserver agreement of measurements of the sinuses of Valsalva was higher for cine-MRI than for echocardiography (p=0.029). Despite small, but statistically significant differences in terms of agreement and reproducibility, cine-MRI and echocardiographic measurements of aortic root diameters provide comparable results without a significant clinical difference. Therefore both techniques may be used for monitoring of the aortic root in patients with Marfan syndrome.

  12. Training in critical care echocardiography

    Mayo, Paul H

    2011-01-01

    Echocardiography is useful for the diagnosis and management of hemodynamic failure in the intensive care unit so that competence in some elements of echocardiography is a core skill of the critical care specialist. An important issue is how to provide training to intensivists so that they are competent in the field. This article will review issues related to training in critical care echocardiography.

  13. 3D Harmonic Echocardiography:

    M.M. Voormolen

    2007-01-01

    textabstractThree dimensional (3D) echocardiography has recently developed from an experimental technique in the ’90 towards an imaging modality for the daily clinical practice. This dissertation describes the considerations, implementation, validation and clinical application of a unique

  14. Comparison of Gated SPECT Myocardial Perfusion Imaging with Echocardiography for the Measurement of Left Ventricular Volumes and Ejection Fraction in Patients With Severe Heart Failure

    Shojaeifard, Maryam; Ghaedian, Tahereh; Yaghoobi, Nahid; Malek, Hadi; Firoozabadi, Hasan; Bitarafan-Rajabi, Ahmad; Haghjoo, Majid; Amin, Ahmad; Azizian, Nasrin; Rastgou, Feridoon

    2015-01-01

    Background: Gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is known as a feasible tool for the measurement of left ventricular ejection fraction (EF) and volumes, which are of great importance in the management and follow-up of patients with coronary artery diseases. However, considering the technical shortcomings of SPECT in the presence of perfusion defect, the accuracy of this method in heart failure patients is still controversial. Objectives: The aim of the present study was to compare the results from gated SPECT MPI with those from echocardiography in heart failure patients to compare echocardiographically-derived left ventricular dimension and function data to those from gated SPECT MPI in heart failure patients. Patients and Methods: Forty-one patients with severely reduced left ventricular systolic function (EF ≤ 35%) who were referred for gated SPECT MPI were prospectively enrolled. Quantification of EF, end-diastolic volume (EDV), and end-systolic volume (ESV) was performed by using quantitative gated spect (QGS) (QGS, version 0.4, May 2009) and emory cardiac toolbox (ECTb) (ECTb, revision 1.0, copyright 2007) software packages. EF, EDV, and ESV were also measured with two-dimensional echocardiography within 3 days after MPI. Results: A good correlation was found between echocardiographically-derived EF, EDV, and ESV and the values derived using QGS (r = 0.67, r = 0.78, and r = 0.80 for EF, EDV, and ESV, respectively; P < 0.001) and ECTb (r = 0.68, 0.79, and r = 0.80 for EF, EDV, and ESV, respectively; P < 0.001). However, Bland-Altman plots indicated significantly different mean values for EF, 11.4 and 20.9 using QGS and ECTb, respectively, as compared with echocardiography. ECTb-derived EDV was also significantly higher than the EDV measured with echocardiography and QGS. The highest correlation between echocardiography and gated SPECT MPI was found for mean values of ESV different. Conclusions: Gated

  15. Sixty-four-slice multidetector computed tomography for preoperative evaluation of left ventricular function and mass in patients with mitral regurgitation: comparison with magnetic resonance imaging and echocardiography

    Quantitative values of left ventricular (LV) function and muscle mass in patients with mitral regurgitation are independent predictors of cardiac morbidity and mortality. The aim of this study was to prospectively evaluate whether 64-MDCT can assess the LV function in patients with mitral regurgitation with high accuracy when compared with the MRI and echocardiography results. Fifty-one patients with mitral regurgitation underwent retrospectively ECG-gated 64-MDCT, echocardiography, and MRI for assessing the global ventricular function. End-diastolic and end-systolic volume, stroke volume, ejection fraction, and mass were measured on 64-MDCT and echocardiography, and compared with the results measured on MRI which served as the reference standard. Intertechnique agreement was tested by using Pearson's correlation and Bland-Altman analyses. No significant differences were revealed in calculated LV function and mass between the 64-MDCT and MRI (paired t test, p = 0.07-0.53). Pearson's correlation analysis showed the functional parameters and mass correlated closely between the 64-MDCT and MRI (r = 0.89-0.96, p < 0.001). When compared with MRI, echocardiography underestimated the volumetric parameters of LV (paired t test, p = 0.0003-0.004), but significantly overestimated the EF values (p = 0.003), and moderate correlations of functional parameters were obtained (r = 0.78, 0.60, 0.81, and 0.62, respectively). ECG-gated 64-MDCT allows for accurate and reliable assessment of LV function in patients with mitral regurgitation, whereas LV volumes measured by two-dimensional echocardiography were underestimated and the ejection fraction was overestimated when compared with those achieved by using MRI. (orig.)

  16. Ejection fraction and left ventricle volumes estimated by gated SPECT MIBI: Comparison of EF with contrast angiography and 2D echocardiography

    Aim: Assess the accuracy of ejection fraction (EF) estimated by gated SPECT MIBI (gSPM). Left ventricular volumes (LVV) - comparison with normals. Materials and Methods: 29 male patients, mean age 56 years, underwent contrast angiography (CA), 2D echocardiography (2De) and gSPM study. 9 were single vessel disease (VD), 10 double VD, 9 triple VD and 1 normal. 16 patients had history of myocardial infarction (MI). Same day, stress-rest protocol was used, 8 mCi given for stress and 25 mCi at rest. gSPM was performed on a dual head SPECT Camera, 64x64 matrix, 3o/view, 20s/fr , 180o rotation, RAO 45o-LPO 45o. Rest images were gated (8 frames/R-R). Visual assessment and modified Simpson's rule was used for determination of EF by CA and 2De, respectively, and Gaussian myocardial count profile fitting method for gSPM (QGS, Cedars Sinai). Both, automatic(a) and semi-automatic(s) methods of edge detection and LV slice selection were applied on the rest images. EF values calculated by CA, 2De and both (a) and (s) methods of gSPM were correlated (ra and rs, respectively). Student's t test, 2 tailed, was applied. LVVs of this group were compared with 20 normals. Results: The mean EF calculated for all patients by CA was (50.2∫12.7)%, by 2De (51.5±12.6)%, gSPMa (50.1±16.7)% and gSPMs (46.3±15.1)%. The EF data from CA and gSPM correlated well (ra-0.86, rs-0.85, p-0.001) and between 2De and gSPM (ra-0.72, rs-0.70, pef-0.98 and rlvv-0.99). The EF and EDV calculated by gSPM showed a negative correlation (r=-0.69, p<0.001). Conclusion: Despite the presence of severe resting perfusion defects in more than half of the patients, the EF results of gSPM, correlated well with those of CA, and to a lesser extent with 2De. The absolute values of LVV though low, are reproducible. Hence, gSPM can be used as a reliable method for simultaneous estimation of function and perfusion

  17. The comparison of some hemodynamics parameters, obtained by two non-invasive measurement methods - echocardiography and impedance cardiography (HOTMAN System) by patients with systemic hypertension

    SASSMANNOVÁ, Anna

    2007-01-01

    Echocardiography is an investigation of heart via scan. This enables to intend the moving and the locality of heart structures via scan pulse waves which are repulsed with acoustic interfaces. Impedance measuring of the thorax hemodynamics is based on changes of electrical impedance. These changes happen mainly because of the heart function. By its rhytmical function the heart periodically changes the conditions of blood flow through all vessels. By this we can explain periodical changes of i...

  18. Pacing stress echocardiography

    Agrusta Marco; Gligorova Suzana

    2005-01-01

    Abstract Background High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates ...

  19. Pediatric transesophageal echocardiography

    Stümper, Oliver

    1991-01-01

    textabstractIn face of several limitations of precordial ultrasound investigations in children with congenital heart disease, it was attempted to defme the additional value of pediatric transesophageal echocardiography. Its comparative value, firstly, in the preoperative diagnosis of congenital heart disease had to be determined (Chapters 4-8), secondly, its place as an intraoperative monitoring technique in the surgery of congenital heart disease had to be assessed (Chapter 9), and thirdly, ...

  20. Transthoracic Echocardiography in Mice

    Respress, Jonathan L.; Wehrens, Xander H. T.

    2010-01-01

    In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene expression. Transgenic and gene targeting methods can be used to generate mice with altered cardiac size and function,1-3 and as a result, in vivo techniques are needed to evaluate their cardiac phenotype. Transthoracic echocardiography, pulse wave Doppler (PWD), and tissue Doppler imaging (TDI) can be used to provide dimensional measurement...

  1. 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...

  2. 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

  3. Comparison between Doppler echocardiography and hot-film anemometry in measuring the turbulent shear stress downstream of artificial mitral valves: a methodological study

    SUN Yi; LI Rui-jie; LI Gan-niu; LI Bin; WANG Yu; MA Run-wei; YANG Bai-hui

    2013-01-01

    Background Turbulent shear stress (TSS) plays an important role in the research of fluid dynamics of heart valves.This study aimed to perform a quantitative study of TSS downstream of porcine artificial mitral valves in order to verify the correlation of hot-film anemometry (HFA) and Doppler echocardiography combined with computer-aided image analysis for the detection of TSS.Methods A porcine model of mitral valve replacement was established.HFA and Doppler ultrasound techniques were used to directly and indirectly measure TSS-relevant parameters of the artificial mitral valve following different mitral valve replacements:different approaches were used to reserve the subvalvular apparatus of the mitral valve.A correlation analysis was then carried out.Results There was a significant correlation between the HFA and Doppler ultrasound combined with computer-aided image analysis of the TSS at the same time and at the same site.No significant difference was found in the TSS measured by the two methods.Conclusions Compared with HFA,Doppler echocardiography combined with computer-aided image analysis is a safe,non-invasive,and real-time method that enables accurate and quantitative detection of TSS downstream in vivo,objectively reflecting the flow field downstream of the artificial mitral valve.Doppler ultrasound combined with computeraided image analysis can be employed for quantitatively evaluating the downstream hemodynamic performance of the mitral valve.

  4. Utility of brain natriuretic peptide in diagnosis of congestive heart failure and comparison with trans-thoracic echocardiography: a multicenter analysis in south asian and arabian population

    Objective: To evaluate serum Brain Natriuretic Peptide levels (BNP) as a screening test in the diagnosis of congestive heart failure. Study Design: Comparative cross-sectional study. Place and Duration of Study: Prince Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia between December 2010 to January 2012 and Nishtar Hospital, Multan, Pakistan, from February to August 2006. Methodology: A total of 80 patients with clinical diagnosis of Congestive Heart Failure (CHF) underwent measurement of serum BNP and had a trans-thoracic echocardiography to measure Ejection Fraction (EF). The normal limit for serum BNP levels, provided by the manufacturer of the kit was applied as a cut-off value for BNP. EF of > 45% was considered normal. Results: Forty seven patients (94%) had an EF < 45%. BNP levels were elevated in 36 patients (72%). Sensitivity and specificity of BNP was found to be 80% and 66% respectively and accuracy was 80%. Conclusion: BNP measurements as a screening tool for CHF has good sensitivity and accuracy when compared to echocardiography. (author)

  5. [Echocardiography in infirmary].

    Heredia Guerrero, Ericka Nancy

    2007-01-01

    Cardiovascular diseases are the 1st death cause worldwide in the beginning of the third millennium. Due to its high incidence and fatal complications the study of ischaemic cardiopathy had great importance. Echocardiography is an image diagnostic technique, based on the use of ultrasound, applied in the evaluation and recognition of cardiovascular diseases. It is non invasive, harmless, accessible, easy to made and quick to interpret, safe and cheaper than others imaging techniques, its continuous development has allow its use in all cardiology fields. An area where the nursing staff begin their participation in the National Institute of Cardiology "Ignacio Chavez" is the Echocardiography Department where the nurse professional profile must embrace knowledge in different areas, with an active participation in the echocardiographic studies and protocols, optimizing the patient's quality of attention with the use of Nursing Attention Process based in the theory of Dorothea Orem with the aim of standardize and improve the patient's quality of attention along with the interdisciplinary team. PMID:18938734

  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. Prognostic value of echocardiography in 190 patients with chronic congestive heart failure. A comparison with New York Heart Association functional classes and radionuclide ventriculography

    Madsen, B K; Videbaek, R; Stokholm, H; Mortensen, L S; Hansen, J F

    1996-01-01

    Survival in 190 consecutive patients with congestive heart failure, discharged from a general hospital, was studied. Sixteen patients were in New York Heart Association (NYHA) class I, 87 in II, 83 in III and 4 in IV. Median left ventricular ejection fraction (LVEF) from radionuclide ventriculogr......Survival in 190 consecutive patients with congestive heart failure, discharged from a general hospital, was studied. Sixteen patients were in New York Heart Association (NYHA) class I, 87 in II, 83 in III and 4 in IV. Median left ventricular ejection fraction (LVEF) from radionuclide...... classes III and IV survival was 68.9% for wall motion index > or = 1.3 and 39.9% when < 1.3. Addition of LVEF gave further information about survival. This study demonstrates that echocardiography is of great value in determining prognosis in congestive heart failure patients, and that wall motion index...

  9. Head-to-head comparison of dipyridamole, dobutamine and pacing stress echocardiography for the detection of myocardial ischemia in an animal model of coronary artery stenosis

    A. Schmidt

    2001-07-01

    Full Text Available To compare the sensitivity of dipyridamole, dobutamine and pacing stress echocardiography for the detection of myocardial ischemia we produced a physiologically significant stenosis in the left circumflex artery of 14 open-chest dogs (range: 50 to 89% reduction in luminal diameter. In each study, dobutamine (5 to 40 µg kg-1 min-1 in 3-min stages and pacing (20 bpm increments, each 2 min, up to 260 bpm were performed randomly, and then followed by dipyridamole (up to 0.84 mg/kg over 10 min. The positivity of stress echocardiography tests was quantitatively determined by a significant (P<0.05 reduction of or failure to increase absolute and percent systolic wall thickening in the stenotic artery supplied wall, as compared to the opposite wall (areas related to the left anterior descending artery. Systolic and diastolic frozen images were analyzed off-line by two blinded observers in the control and stress conditions. The results showed that 1 the sensitivity of dobutamine, dipyridamole and pacing stress tests was 57, 57 and 36%, respectively; 2 in animals with positive tests, the mean percent change of wall thickening in left ventricular ischemic segments was larger in the pacing (-19 ± 11% and dipyridamole (-18 ± 16% tests as compared to dobutamine (-9 ± 6% (P = 0.05, but a similar mean reduction of wall thickening was observed when this variable was normalized to a control left ventricular segment (area related to the left anterior descending artery (pacing: -16 ± 7%; dipyridamole: -25 ± 16%; dobutamine: -26 ± 10%; not significant, and 3 a significant correlation was observed between magnitude of coronary stenosis and left ventricular segmental dysfunction induced by ischemia in dogs submitted to positive stress tests. We conclude that the dobutamine and dipyridamole stress tests showed identical sensitivities for the detection of myocardial ischemia in this one-vessel disease animal model with a wide range of left circumflex artery

  10. Pacing stress echocardiography

    Agrusta Marco

    2005-12-01

    Full Text Available Abstract Background High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates to assess global left ventricular contractility. Methods The pathophysiologic rationale of pacing stress for noninvasive detection of coronary artery disease is obvious, with the stress determined by a controlled increase in heart rate, which is a major determinant of myocardial oxygen demand, and thereby tachycardia may exceed a fixed coronary flow reserve in the presence of hemodynamically significant coronary artery disease. The use of pacing stress echo to assess left ventricular contractile reserve is less established, but promising. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon. To build the force-frequency relationship, the force is determined at different heart rate steps as the ratio of the systolic pressure (cuff sphygmomanometer/end-systolic volume index (biplane Simpson rule. The heart rate is determined from ECG. Conclusion Two-dimensional echocardiography during pacing is a useful tool in the detection of coronary artery disease. Because of its safety and ease of repeatability noninvasive pacing stress echo can be the first-line stress test in patients with permanent pacemaker. The force-frequency can be defined as up- sloping (normal when the peak stress pacing systolic pressure/end-systolic volume index is higher than baseline and intermediate stress

  11. Important Advances In Technology: Echocardiography

    Nagueh, Sherif F; Quiñones, Miguel A.

    2014-01-01

    Echocardiography has evolved over the past 45 years from a simple M-mode tracing to an array of technologies that include two-dimensional imaging, pulsed and continuous wave spectral Doppler, color flow and tissue Doppler, and transesophageal echocardiography. Together, these modalities provide a comprehensive anatomic and functional evaluation of cardiac chambers and valves, pericardium, and ascending and descending aorta. The switch from analog to digital signal processing revolutionized th...

  12. New digital measurement methods for left ventricular volume using real-time three-dimensional echocardiography: comparison with electromagnetic flow method and magnetic resonance imaging

    Qin, J. J.; Jones, M.; Shiota, T.; Greenberg, N. L.; Firstenberg, M. S.; Tsujino, H.; Zetts, A. D.; Sun, J. P.; Cardon, L. A.; Odabashian, J. A.; Flamm, S. D.; White, R. D.; Panza, J. A.; Thomas, J. D.

    2000-01-01

    AIM: The aim of this study was to investigate the feasibility and accuracy of using symmetrically rotated apical long axis planes for the determination of left ventricular (LV) volumes with real-time three-dimensional echocardiography (3DE). METHODS AND RESULTS: Real-time 3DE was performed in six sheep during 24 haemodynamic conditions with electromagnetic flow measurements (EM), and in 29 patients with magnetic resonance imaging measurements (MRI). LV volumes were calculated by Simpson's rule with five 3DE methods (i.e. apical biplane, four-plane, six-plane, nine-plane (in which the angle between each long axis plane was 90 degrees, 45 degrees, 30 degrees or 20 degrees, respectively) and standard short axis views (SAX)). Real-time 3DE correlated well with EM for LV stroke volumes in animals (r=0.68-0.95) and with MRI for absolute volumes in patients (r-values=0.93-0.98). However, agreement between MRI and apical nine-plane, six-plane, and SAX methods in patients was better than those with apical four-plane and bi-plane methods (mean difference = -15, -18, -13, vs. -31 and -48 ml for end-diastolic volume, respectively, Pmethods of real-time 3DE correlated well with reference standards for calculating LV volumes. Balancing accuracy and required time for these LV volume measurements, the apical six-plane method is recommended for clinical use.

  13. Comparison of transcranial contrast Doppler sonography and transesophageal contrast echocardiography for the detection of patent foramen ovale in young stroke patients.

    Job, F P; Ringelstein, E B; Grafen, Y; Flachskampf, F A; Doherty, C; Stockmanns, A; Hanrath, P

    1994-08-15

    The prevalence of a patent foramen ovale was assessed by simultaneously performing transesophageal contrast echocardiography and transcranial contrast Doppler sonography (TCD) in 137 subjects (mean age 36 years) with stroke of unclarified etiology (n = 41), clarified etiology (n = 33), and in normal subjects (n = 63; mean age 32 years). Patent foramen ovale was found significantly more often in patients with unclarified than clarified strokes or in normal subjects (66% vs 33%, or 43%). Massive paradoxical embolism through a patent foramen ovale, identified by TCD, occurred significantly (p < 0.01) more often in patients with unclarified (64%) than clarified (27%) strokes or in normal subjects (3%). However, minimal shunts were typical in normal subjects (79%). Patent foramen ovale was detected indirectly by TCD when calculated on the basis of transesophageal contrast echocardiographic findings (sensitivity 89%, specificity 92%). Thus, TCD reliably detects paradoxical cerebral embolism through a patent foramen ovale, and provides important additional information for evaluating its clinical relevance by semi-quantification of embolic contrast material. PMID:7914717

  14. Detection of left atrial thrombus in patients with mitral stenosis and atrial fibrillation: retrospective comparison of two-phase computed tomography, transoesophageal echocardiography and surgical findings

    Choi, Bo Hwa; Ko, Sung Min [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Radiology, Research Institute of Medical Science, Seoul (Korea, Republic of); Hwang, Hweung Kon [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiology, Seoul (Korea, Republic of); Song, Meong Gun; Shin, Je Kyoun [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Thoracic surgery, Seoul (Korea, Republic of); Kang, Woon Seok; Kim, Tae-Yop [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Anesthesiology, Seoul (Korea, Republic of)

    2013-11-15

    This retrospective study aims to assess the accuracy of two-phase computed tomography (CT) and transoesophageal echocardiography (TEE) for the detection of left atrial (LA) thrombus in patients with mitral stenosis (MS) and atrial fibrillation (AF), by using intraoperative findings as the reference standard. Preoperative two-phase CT and intraoperative TEE were performed in 106 patients with MS and AF. The ratio (LAA/AA{sub L}) of Hounsfield units (HU) in the LA appendage (LAA) to the ascending aorta (AA) was calculated on the late-phase CT image. LA echodense masses on TEE and LA filling defects on two-phase CT were observed in 29 and 39 patients, respectively. Thirty-five LA thrombi were identified at surgery in 27 patients. Compared with the intraoperative findings, per-patient sensitivity, specificity, positive and negative predictive values of two-phase CT were 100 %, 85 %, 69 % and 100 %, and those by using TEE were 93 %, 95 %, 86 % and 97 % in detecting LAA thrombus. After adopting the cut-off value of 0.5 for the LAA/AA{sub L} HU ratio, the specificity and positive predictive value of two-phase CT were increased to 96 % and 90 %, respectively. Two-phase CT with a cut-off value of LAA/AA{sub L} HU ratio of 0.5 provides high performance for the detection of LAA thrombus. (orig.)

  15. Detection of left atrial thrombus in patients with mitral stenosis and atrial fibrillation: retrospective comparison of two-phase computed tomography, transoesophageal echocardiography and surgical findings

    This retrospective study aims to assess the accuracy of two-phase computed tomography (CT) and transoesophageal echocardiography (TEE) for the detection of left atrial (LA) thrombus in patients with mitral stenosis (MS) and atrial fibrillation (AF), by using intraoperative findings as the reference standard. Preoperative two-phase CT and intraoperative TEE were performed in 106 patients with MS and AF. The ratio (LAA/AAL) of Hounsfield units (HU) in the LA appendage (LAA) to the ascending aorta (AA) was calculated on the late-phase CT image. LA echodense masses on TEE and LA filling defects on two-phase CT were observed in 29 and 39 patients, respectively. Thirty-five LA thrombi were identified at surgery in 27 patients. Compared with the intraoperative findings, per-patient sensitivity, specificity, positive and negative predictive values of two-phase CT were 100 %, 85 %, 69 % and 100 %, and those by using TEE were 93 %, 95 %, 86 % and 97 % in detecting LAA thrombus. After adopting the cut-off value of 0.5 for the LAA/AAL HU ratio, the specificity and positive predictive value of two-phase CT were increased to 96 % and 90 %, respectively. Two-phase CT with a cut-off value of LAA/AAL HU ratio of 0.5 provides high performance for the detection of LAA thrombus. (orig.)

  16. Assessment of left ventricular ejection fraction: comparison of two dimensional echocardiography, cardiac magnetic resonance imaging and 64-row multi-detector computed tomography

    Chee Khoon LIEW; Kui Hian SIM; Rapaee ANNUAR; Tiong Kiam ONG; Sze Piaw CHIN; Tobias Seyfarth; Yean Yip FONG; Wei Ling CHAN; Choon Kiat ANG; Houng Bang LIEW

    2006-01-01

    Objectives To compare left ventricular ejection fraction (LVEF) determined from 64-row multi-detector computed tomography (64-row MDCT) with those determined from two dimensional echocardiography (2D echo) and cardiac magnetic resonance imaging (CMR). Methods Thirty-two patients with coronary artery disease underwent trans-thoracic 2D echo, CMR and contrast-enhanced 64-row MDCT for assessment of LVEF within 48 hours of each other. 64-row MDCT LVEF was derived using the Syngo Circulation software; CMR LVEF was by Area Length Ejection Fraction (ALEF) and Simpson method and 2D echo LVEF by Simpson method.Results The LVEF was 49.13 ± 15.91% by 2D echo, 50.72 ± 16.55% (ALEF method) and 47.65 ± 16.58%(Simpson method) by CMR and 50.00 ± 15.93% by 64-row MDCT. LVEF measurements by 64-row MDCT correlated well with LVEF measured with CMR using either the ALEF method (Pearson correlation r = 0.94, P <0.01) or Simpson method (r = 0.92, P<0.01). It also correlated well with LVEF measured using 2D echo (r = 0.80, P < 0.01). Conclusion LVEF measurements by 64-row MDCT correlated well with LVEF measured by CMR and 2D echo. The correlation between 64-row MDCT and CMR was better than the correlation between 2D echo with CMR. Standard data set from a 64-row MDCT coronary study can be reliably used to calculate the LVEF.

  17. Left Ventricular Stroke Volume Quantification by Contrast EchocardiographyComparison of Linear and Flow-Based Methods to Cardiac Magnetic Resonance

    Dele-Michael, Abiola O.; Fujikura, Kana; Devereux, Richard B; Islam, Fahmida; Hriljac, Ingrid; Wilson, Sean R.; Lin, Fay; Weinsaft, Jonathan W.

    2014-01-01

    Background Echocardiography (echo) quantified LV stroke volume (SV) is widely used to assess systolic performance after acute myocardial infarction (AMI). This study compared two common echo approaches – predicated on flow (Doppler) and linear chamber dimensions (Teichholz) – to volumetric SV and global infarct parameters quantified by cardiac magnetic resonance (CMR). Methods Multimodality imaging was performed as part of a post-AMI registry. For echo, SV was measured by Doppler and Teichholz methods. Cine-CMR was used for volumetric SV and LVEF quantification, and delayed-enhancement CMR for infarct size. Results 142 patients underwent same-day echo and CMR. On echo, mean SV by Teichholz (78±17ml) was slightly higher than Doppler (75±16ml; Δ=3±13ml, p=0.02). Compared to SV on CMR (78±18ml), mean difference by Teichholz (Δ=−0.2±14; p=0.89) was slightly smaller than Doppler (Δ−3±14; p=0.02) but limits of agreement were similar between CMR and echo methods (Teichholz: −28, 27 ml, Doppler: −31, 24ml). For Teichholz, differences with CMR SV were greatest among patients with anteroseptal or lateral wall hypokinesis (p<0.05). For Doppler, differences were associated with aortic valve abnormalities or root dilation (p=0.01). SV by both echo methods decreased stepwise in relation to global LV injury as assessed by CMR-quantified LVEF and infarct size (p<0.01). Conclusions Teichholz and Doppler calculated SV yield similar magnitude of agreement with CMR. Teichholz differences with CMR increase with septal or lateral wall contractile dysfunction, whereas Doppler yields increased offsets in patients with aortic remodeling. PMID:23488864

  18. Contrast echocardiography in Canada: Canadian Cardiovascular Society/Canadian Society of Echocardiography position paper

    Honos, George; Amyot, Robert; Choy, Jonathan; Leong-Poi, Howard; Schnell, Greg; Yu, Eric

    2007-01-01

    As an adjunct to transthoracic, transesophageal and stress echocardiography, contrast echocardiography (CE) improves the diagnostic accuracy of technically suboptimal studies when used in conjunction with harmonic imaging.

  19. The Value of Contrast Echocardiography

    Shannon C. Treiber

    2016-01-01

    Full Text Available Purpose: There is much evidence-based research proving the effectiveness of contrast echocardiography, but there are still questions and concerns about its specific uses. This study tested the effectiveness of contrast echocardiography in defining the left ventricular endocardial border. Methods: From 30 patients, a total of 60 echocardiograms –– 30 with and 30 without use of contrast –– were retrospectively reviewed by four blinded cardiologists with advanced training in echocardiography. No single cardiologist reviewed contrast and noncontrast images of the same patient. Each set of 30 echocardiograms was then studied for wall-motion scoring. Visualization of left ventricular wall segments and a global visualization confidence level of interpretation were recorded. Results: Of all wall segments (N = 510, 91% were visualized in echocardiograms with use of contrast, whereas 75% of the walls were visualized in echocardiograms without contrast (P < 0.001. Of 30 examinations, 17 contrast echocardiograms were read with high confidence compared to 6 without contrast use (P = 0.004. The number of walls visualized with contrast was increased in 18 patients (60%, whereas noncontrast echocardiograms yielded more visualized walls in 6 patients (20%, P = 0.002. Conclusions: This study demonstrates that contrast is valuable to echocardiographic imaging. Its use should be supported throughout echocardiography clinics and encouraged in certain patients for whom resting and stress echocardiography results without contrast often prove uninterpretable.

  20. Assessment of left ventricular parameters in orthotopic heart transplant recipients using dual-source CT and contrast-enhanced echocardiography: Comparison with MRI

    Objectives: To establish the accuracy and reliability of cardiac dual-source CT (DSCT) and two-dimensional contrast-enhanced echocardiography (CE-Echo) in estimating left ventricular (LV) parameters with respect to cardiac magnetic resonance imaging (CMR) as the reference standard. Methods: Twenty-five consecutive heart transplant recipients (20 male, mean age 62.7 ± 10.4 years, mean time since transplantation 8.1 ± 5.9 years) were prospectively recruited. Two blinded readers independently assessed LV ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV) for each patient after manual tracing of the endo- and epicardial contours in DSCT, CE-Echo and CMR cine images. Student's t-test for paired samples for differences, and Bland and Altman plots and Lin's concordance-correlation coefficients (CCC) for agreement were calculated. Results: There was no statistical difference between left ventricular parameters determined by DSCT and CMR. CE-Echo resulted in significant underestimation of left ventricular volumes (mean difference EDV: 15.94 ± 14.19 ml and 17.1 ± 17.06 ml, ESV: 8.5 ± 9.3 and 7.32 ± 9.14 ml with respect to DSCT and CMR), and overestimation of EF compared with the cross-sectional imaging modalities (3.78 ± 8.47% and 2.14 ± 8.35% with respect to DSCT and CMR). Concordance correlation coefficients for LV parameters using DSCT and CMR were higher (CCC ≥ 0.75) than CCC values observed between CE-Echo and DSCT- or CMR-derived data (CCC ≥ 0.54 and CCC ≥ 0.49, respectively). Interobserver agreement was higher for DSCT and CMR values (CCC ≥ 0.72 and CCC ≥ 0.87, respectively). Conclusion: In orthotopic heart transplantation cardiac DSCT allows accurate and reliable estimation of LV parameters compared with CMR, whereas CE-Echo seems to be insufficient to obtain precise measurements.

  1. Assessing acute systemic effects of an inhaled drug with serial echocardiography: a placebo-controlled comparison of inhaled and intravenous dihydroergotamine

    Noveck RJ

    2013-07-01

    that serial echocardiography can be a useful noninvasive means of assessing acute systemic effects.Keywords: dihydroergotamine, intravenous, MAP0004, echocardiogram, echo, inhaled, pulmonary artery systolic pressure

  2. Assessment of left ventricular parameters in orthotopic heart transplant recipients using dual-source CT and contrast-enhanced echocardiography: Comparison with MRI

    Arraiza, Maria, E-mail: arraiza81@gmail.com [Department of Radiology, Clinica Universidad de Navarra, Avenida Pio XII, 36, 31008 Pamplona (Spain); Department of Radiology, Section of Ambulatory Radiology, Complejo Hospitalario de Navarra (Spain); Azcarate, Pedro M., E-mail: pmazcarate@unav.es [Cardiac Imaging Unit, Clinica Universidad de Navarra, Avenida Pio XII, 36, 31008 Pamplona (Spain); Department of Cardiology, Clinica Universidad de Navarra, Avenida Pio XII, 36, 31008 Pamplona (Spain); De Cecco, Carlo Nicola, E-mail: carlodececco@gmail.com [Department of Radiology, Universita' di Roma ' Sapienza' - Ospedale Sant' Andrea (Italy); Viteri, Guillermo, E-mail: gviteri@unav.es [Department of Radiology, Clinica Universidad de Navarra, Avenida Pio XII, 36, 31008 Pamplona (Spain); Simon-Yarza, Isabel, E-mail: msyarza@unav.es [Department of Radiology, Clinica Universidad de Navarra, Avenida Pio XII, 36, 31008 Pamplona (Spain); Hernandez-Estefania, Rafael, E-mail: rhestefania@unav.es [Department of Cardiac Surgery, Clinica Universidad de Navarra, Avenida Pio XII, 36, 31008 Pamplona (Spain); Rabago, Gregorio, E-mail: grabago@unav.es [Department of Cardiac Surgery, Clinica Universidad de Navarra, Avenida Pio XII, 36, 31008 Pamplona (Spain); and others

    2012-11-15

    Objectives: To establish the accuracy and reliability of cardiac dual-source CT (DSCT) and two-dimensional contrast-enhanced echocardiography (CE-Echo) in estimating left ventricular (LV) parameters with respect to cardiac magnetic resonance imaging (CMR) as the reference standard. Methods: Twenty-five consecutive heart transplant recipients (20 male, mean age 62.7 {+-} 10.4 years, mean time since transplantation 8.1 {+-} 5.9 years) were prospectively recruited. Two blinded readers independently assessed LV ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV) for each patient after manual tracing of the endo- and epicardial contours in DSCT, CE-Echo and CMR cine images. Student's t-test for paired samples for differences, and Bland and Altman plots and Lin's concordance-correlation coefficients (CCC) for agreement were calculated. Results: There was no statistical difference between left ventricular parameters determined by DSCT and CMR. CE-Echo resulted in significant underestimation of left ventricular volumes (mean difference EDV: 15.94 {+-} 14.19 ml and 17.1 {+-} 17.06 ml, ESV: 8.5 {+-} 9.3 and 7.32 {+-} 9.14 ml with respect to DSCT and CMR), and overestimation of EF compared with the cross-sectional imaging modalities (3.78 {+-} 8.47% and 2.14 {+-} 8.35% with respect to DSCT and CMR). Concordance correlation coefficients for LV parameters using DSCT and CMR were higher (CCC {>=} 0.75) than CCC values observed between CE-Echo and DSCT- or CMR-derived data (CCC {>=} 0.54 and CCC {>=} 0.49, respectively). Interobserver agreement was higher for DSCT and CMR values (CCC {>=} 0.72 and CCC {>=} 0.87, respectively). Conclusion: In orthotopic heart transplantation cardiac DSCT allows accurate and reliable estimation of LV parameters compared with CMR, whereas CE-Echo seems to be insufficient to obtain precise measurements.

  3. 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.

  4. 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...

  5. Echocardiography in Pregnancy: Part 2.

    Narayanan, Meena; Elkayam, Uri; Naqvi, Tasneem Z

    2016-09-01

    The prevalence of pregnant women with cardiovascular heart disease is increasing. Transthoracic echocardiography is safe during pregnancy, and it is an important diagnostic tool in pregnant women with established heart disease in order to monitor ventricular and valvular anatomy and function. In addition, it can be used to delineate cardiac anatomy in complex congenital heart disease and help stratify maternal risk during pregnancy. This review will focus on the use of echocardiography in the diagnosis and management of pregnant women with common congenital lesions and with prosthetic valves. PMID:27457084

  6. Comparison of gated planar Tc-99m tetrofosmin scintigraphy with radionuclide ventriculography and echocardiography in the evaluation of left ventricular wall motion

    Assessment of ventricular function is an important diagnostic and prognostic tool in coronary heart disease (CHD). The objective of this study was to compare radionuclide ventriculography (RVG), echocardiography (ECHO) and gated planar tetrofosmin myocardial scintigraphy (GPTF) in patients with CHD. Radionuclide ventriculography in left anterior oblique (LAO) and left lateral (LLT) projections was performed in 44 patients. Two days later, rest tetrofosmin perfusion tomoscintigraphy (SPECT) and rest GPTF in RVG identical parameters and projections were acquired. Within the two following days, the patients underwent two-dimensional ECHO. GPTF studies were processed and interpreted in original (non-inverted (NI)-GPTF) and image inverted, RVG like form (I-GPTF). All visual interpretations were evaluated with a semi-quantitative scoring system. Quantitative analysis was performed on parametric images by means of segmental regions of interest. Linear regression and contingency analysis were carried out in overall analysis and on a segmental basis separately by accepting the RVG as the standard for the whole investigation. In overall cine-mode evaluation, NI-GPTF (r=0.77, p<0.001, complete agreement (CA)=84%) was superior to I-GPTF (r=0.73, p<0.001, CA=82%) and ECHO (r=0.39, p<0.001, CA=78%), compared to RVG. On a segmental basis, NI-GPTF showed the best RVG-correlations except for inferoapical, mid-inferior, mid-anterior and anterobasal segments. In visual analysis of functional images, the best RVG-agreement was observed in I-GPTF (r=0.72, p<0.001, CA=77%). On a segmental basis, I-GPTF showed the best RVG-correlations except for posterolateral, mid-inferior, mid-anterior and anterobasal segments. In overall quantitative evaluation, amplitude values in both I-GPTF (r=0.76, p<0.001) and NI-GPTF (r=0.75, p<0.001) studies were well correlated with RVG amplitude. I-GPTF gave the best RVG-correlation of phase (r=0.59, p <0.001). The mean phase and standard deviation RVG

  7. LWR core safety analysis with Areva's 3-dimensional methods

    The quality of the safety analysis strongly affects the confidence in the operational safety of a reactor. To ensure the highest quality, it is essential that the methodology consists of appropriate analysis tools and an extensive validation base. Sophisticated 3-dimensional core models ensure that all physical effects relevant for safety are treated and the results are reliable and conservative. The validation base includes measurement campaigns in test facilities and comparisons of the predictions of steady state and transient measured data gathered from plants during many years of operation. Thus, the core models achieve reliable and comprehensive results for a wide range of applications. As an example an overview of the application experience as well as the validation base of AREVA's 3-dimensional codes is given. The importance and necessity of the comprehensive 3-dimensional methodology is illustrated with examples of a BWR and PWR safety analysis. For BWR transient application the analysis of regional power oscillations is considered and regarding the PWR safety analysis an example referring to fast enthalpy rise and the maximum fuel temperature caused by a rod ejection accident is shown. (orig.)

  8. Assessment of intracardiac masses by transesophageal echocardiography.

    DeVille, J B; Corley, D; Jin, B S; de Castro, C M; Hall, R J; Wilansky, S

    1995-01-01

    Transesophageal echocardiography and 2-dimensional transthoracic echocardiography have proved to be extremely valuable in the diagnosis of cardiac masses. In this report, we review the echocardiographic findings, clinical history, and histopathologic findings in 21 patients with intracardiac masses who underwent transthoracic echocardiography, transesophageal echocardiography, or both, at our institution. Of these patients, 14 had benign masses and 7 had malignant tumors. The potential role o...

  9. 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.)

  10. Constituent Components of Out-of-Field Scatter Dose for 18-MV Intensity Modulated Radiation Therapy Versus 3-Dimensional Conformal Radiation Therapy: A Comparison With 6-MV and Implications for Carcinogenesis

    Purpose: To characterize and compare the components of out-of-field dose for 18-MV intensity modulated radiation therapy (IMRT) versus 3-dimensional conformal radiation therapy (3D-CRT) and their 6-MV counterparts and consider implications for second cancer induction. Methods and Materials: Comparable plans for each technique/energy were delivered to a water phantom with a sloping wall; under full scatter conditions; with field edge abutting but outside the bath to prevent internal/phantom scatter; and with shielding below the linear accelerator head to attenuate head leakage. Neutron measurements were obtained from published studies. Results: Eighteen-megavolt IMRT produces 1.7 times more out-of-field scatter than 18-MV 3D-CRT. In absolute terms, however, differences are just approximately 0.1% of central axis dose. Eighteen-megavolt IMRT reduces internal/patient scatter by 13%, but collimator scatter (C) is 2.6 times greater than 18-MV 3D-CRT. Head leakage (L) is minimal. Increased out-of-field photon scatter from 18-MV IMRT carries out-of-field second cancer risks of approximately 0.2% over and above the 0.4% from 18-MV 3D-CRT. Greater photoneutron dose from 18-MV IMRT may result in further maximal, absolute increased risk to peripheral tissue of approximately 1.2% over 18-MV 3D-CRT. Out-of-field photon scatter remains comparable for the same modality irrespective of beam energy. Machine scatter (C+L) from 18 versus 6 MV is 1.2 times higher for IMRT and 1.8 times for 3D-CRT. It is 4 times higher for 6-MV IMRT versus 3D-CRT. Reduction in internal scatter with 18 MV versus 6 MV is 27% for 3D-CRT and 29% for IMRT. Compared with 6-MV 3D-CRT, 18-MV IMRT increases out-of-field second cancer risk by 0.2% from photons and adds 0.28-2.2% from neutrons. Conclusions: Out-of-field photon dose seems to be independent of beam energy for both techniques. Eighteen-megavolt IMRT increases out-of-field scatter 1.7-fold over 3D-CRT because of greater collimator scatter despite

  11. Echocardiography in the flight program

    Charles, John B.; Bungo, Michael W.; Mulvagh, Sharon L.

    1991-01-01

    Observations on American and Soviet astronauts have documented the association of changes in cardiovascular function during orthostasis with space flight. A basic understanding of the cardiovascular changes occurring in astronauts requires the determination of cardiac output and total peripheral vascular resistance as a minimum. In 1982, we selected ultrasound echocardiography as our means of acquiring this information. Ultrasound offers a quick, non-invasive and accurate means of determining stroke volume which, when combined with the blood pressure and heart rate measurements of the stand test, allows calculation of changes in peripheral vascular resistance, the body's major response to orthostatic stress. The history of echocardiography in the Space Shuttle Program is discussed and the results are briefly presented.

  12. Split-bolus single-phase cardiac multidetector computed tomography for reliable detection of left atrial thrombus. Comparison to transesophageal echocardiography

    Evaluation of a new cardiac MDCT protocol using a split-bolus contrast injection protocol and single MDCT scan for reliable diagnosis of LA/LAA thrombi in comparison to TEE, optimizing radiation exposure and use of contrast agent. A total of 182 consecutive patients with drug refractory AF scheduled for PVI (62.6% male, mean age: 64.1 ± 10.2 years) underwent routine diagnostic work including TEE and cardiac MDCT for the evaluation of LA/LAA anatomy and thrombus formation between November 2010 and March 2012. Contrast media injection was split into a pre-bolus of 30 ml and main bolus of 70 ml iodinated contrast agent separated by a short time delay. In this study, split-bolus cardiac MDCT identified 14 of 182 patients with filling defects of the LA/LAA. In all of these 14 patients, abnormalities were found in TEE. All 5 of the 14 patients with thrombus formation in cardiac MDCT were confirmed by TEE. MDCT was 100% accurate for thrombus, with strong but not perfect overall results for SEC equivalent on MDCT.

  13. Split-bolus single-phase cardiac multidetector computed tomography for reliable detection of left atrial thrombus. Comparison to transesophageal echocardiography

    Staab, W.; Zwaka, P.A.; Sohns, J.M.; Schwarz, A.; Lotz, J. [University Medical Center Goettingen Univ. (Germany). Inst. for Diagnostic and Interventional Radiology; Sohns, C.; Vollmann, D.; Zabel, M.; Hasenfuss, G. [Goettingen Univ. (Germany). Dept. of Cardiology and Pneumology; Schneider, S. [Goettingen Univ. (Germany). Dept. of Medical Statistics

    2014-11-15

    Evaluation of a new cardiac MDCT protocol using a split-bolus contrast injection protocol and single MDCT scan for reliable diagnosis of LA/LAA thrombi in comparison to TEE, optimizing radiation exposure and use of contrast agent. A total of 182 consecutive patients with drug refractory AF scheduled for PVI (62.6% male, mean age: 64.1 ± 10.2 years) underwent routine diagnostic work including TEE and cardiac MDCT for the evaluation of LA/LAA anatomy and thrombus formation between November 2010 and March 2012. Contrast media injection was split into a pre-bolus of 30 ml and main bolus of 70 ml iodinated contrast agent separated by a short time delay. In this study, split-bolus cardiac MDCT identified 14 of 182 patients with filling defects of the LA/LAA. In all of these 14 patients, abnormalities were found in TEE. All 5 of the 14 patients with thrombus formation in cardiac MDCT were confirmed by TEE. MDCT was 100% accurate for thrombus, with strong but not perfect overall results for SEC equivalent on MDCT.

  14. Echocardiography in military oxygen divers.

    Boussuges, Alain; Riera, Florence; Rossi, Pascal; Castagna, Olivier; Galland, François; Blatteau, Jean-Eric

    2007-01-01

    BACKGROUND: Oxygen divers undergo environmental stressors such as immersion, ventilation with scuba, cold exposure, and increased ambient pressure. All of these stressors may be responsible for acute hemodynamic modifications. We hypothesized that repeated hyperbaric hyperoxia exposure induces long-term cardiovascular modifications. METHODS: A Doppler echocardiography was conducted on 20 military oxygen divers (average 12 yr diving experience) and compared with 22 controls. Parameters known t...

  15. 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...

  16. 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.

  17. Assessment of coronary flow reserve by transesophageal echocardiography in cardiac transplant recipients.

    Unger, P; Preumont, N; Vachiéry, J L; Bougard, M; Damhaut, P; Goldman, S; Berkenboom, G

    1998-06-01

    This study investigated the feasibility of dipyridamole Doppler transesophageal echocardiography to assess coronary flow reserve in 26 patients with orthotopic heart transplantation and compared it with positron emission tomography. We found an 85% success rate in obtaining Doppler flow signals in the proximal left anterior descending coronary artery. Our data also showed that the correlation between transesophageal echocardiography and dipyridamole N-13 ammonia positron emission tomography increases when respective resting rate-pressure products are taken into account. However, comparison between the two methods should be made with caution because coronary flow reserve derived from transesophageal echocardiography tends to be higher than that obtained with positron emission tomography. PMID:9657400

  18. 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 $\\pi/\\sqrt3$.

  19. 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

  20. [Real time 3D echocardiography

    Bauer, F.; Shiota, T.; Thomas, J. D.

    2001-01-01

    Three-dimensional representation of the heart is an old concern. Usually, 3D reconstruction of the cardiac mass is made by successive acquisition of 2D sections, the spatial localisation and orientation of which require complex guiding systems. More recently, the concept of volumetric acquisition has been introduced. A matricial emitter-receiver probe complex with parallel data processing provides instantaneous of a pyramidal 64 degrees x 64 degrees volume. The image is restituted in real time and is composed of 3 planes (planes B and C) which can be displaced in all spatial directions at any time during acquisition. The flexibility of this system of acquisition allows volume and mass measurement with greater accuracy and reproducibility, limiting inter-observer variability. Free navigation of the planes of investigation allows reconstruction for qualitative and quantitative analysis of valvular heart disease and other pathologies. Although real time 3D echocardiography is ready for clinical usage, some improvements are still necessary to improve its conviviality. Then real time 3D echocardiography could be the essential tool for understanding, diagnosis and management of patients.

  1. [Doppler echocardiography in endomyocardial fibrosis].

    Tello, R; Cuan, V; Abundes, A; Navarro, J; García Lara, J; Astudillo, R; Ariza, H; Cuan, M

    1994-01-01

    Twelve patients with endomyocardial fibrosis with angiographic and/or histologic corroboration were studied with Doppler echocardiography with the purpose of describing the echocardiographic features and identify the affected sites. The average age was 41 years (range 16 to 59 years), 2 men and 10 women. Three patients (25%) had isolated right ventricular involvement, one patient (8%) left ventricular, 8 patients (66%) both ventricular. Our Doppler echocardiographic findings were: right atrium enlargement (91%), right ventricle outflow dilatation (83%), paradoxical septal motion (83%), left atrial enlargement (33%), mitral and tricuspid valve prolapse (50%), pericardial effusion (41%), mitral regurgitation (75%), tricuspid regurgitation (100%), apex obliteration (50%) and a restrictive type flow pattern (50%). Doppler echocardiography is a useful method for the diagnosis of endomyocardial fibrosis, the finding of normal or small ventricles associated with apex obliteration and enlarged atria, mitral or tricuspid regurgitation and a restrictive type flow pattern are characteristics of this disease. In our population, the isolated or predominantely right ventricular involvement is the most common finding as it represented 83% of the cases. PMID:7979815

  2. Transesophageal echocardiography in NeoChord procedure

    Pittarello Demetrio

    2015-01-01

    Full Text Available Background: Transapical off-pump mitral valve intervention with neochord implantation for degenerative mitral valve disease have been recently introduced in the surgical practice. The procedure is performed under 2D-3D transesophageal echocardiography guidance. Methods: The use of 3D real-time transesophageal echocardiography provides more accurate information than 2D echocardiography only in all the steps of the procedure. In particular 3D echocardiography is mandatory for preoperative assessment of the morphology of the valve, for correct positioning of the neochord on the diseased segment , for the final tensioning of the chordae and for the final evaluation of the surgical result. Result and Conclusion: This article is to outline the technical aspects of the transesophageal echocardiography guidance of the NeoChord procedure showing that the procedure can be performed only with a close and continuous interaction between the anesthesiologist and the cardiac surgeon.

  3. 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...

  4. Comparison of glucose-insulin-thallium-201 infusion single photon emission computed tomography (SPECT), stress-redistribution-reinjection thallium-201 SPECT and low dose dobutamine echocardiography for prediction of reversible dysfunction

    Sakamoto, Hiroki; Kondo, Makoto; Motohiro, Masayuki; Usami, Satoru [Shimada Municipal Hospital, Shizuoka (Japan)

    2001-12-01

    The usefulness of glucose-insulin-thallium-201 (GI-Tl) infusion single photon emission computed tomography (SPECT) in predicting reversible dysfunction has not been evaluated, so the present study recruited 20 patients with regional ischemic dysfunction for investigation. All patients underwent GI-Tl SPECT, post-stress Tl reinjection imaging and low dose dobutamine echocardiography. The diagnostic accuracy of these 3 techniques in predicting functional recovery was evaluated by receiver operating characteristic (ROC) analysis. In segments with functional recovery, regional Tl activities of GI-Tl SPECT were significantly higher than those of reinjection imaging (p<0.05), although there were no significant differences in segments without recovery. The area under the ROC curve for GI-Tl SPECT (0.75{+-}0.06) was greater than that for reinjection imaging (0.68{+-}0.07). The optimal cutoff values to identify viable myocardium were considered to be 55% of peak activity for GI-Tl SPECT and 50% for reinjection imaging. At this cutoff point, the sensitivity and specificity for detection of functional recovery were, respectively, 85% and 61% for GI-Tl SPECT, and 73% and 61% for reinjection imaging. Dobutamine echocardiography had the same sensitivity (85%), but lower specificity (48%) than GI-Tl SPECT. Continuous infusion of GI-Tl solution enhances regional Tl uptake compared with conventional post-stress reinjection imaging. This study suggests that GI-Tl SPECT is superior to reinjection imaging and dobutamine echocardiography in predicting functional recovery after ischemic left ventricular dysfunction. (author)

  5. Comparison of glucose-insulin-thallium-201 infusion single photon emission computed tomography (SPECT), stress-redistribution-reinjection thallium-201 SPECT and low dose dobutamine echocardiography for prediction of reversible dysfunction

    The usefulness of glucose-insulin-thallium-201 (GI-Tl) infusion single photon emission computed tomography (SPECT) in predicting reversible dysfunction has not been evaluated, so the present study recruited 20 patients with regional ischemic dysfunction for investigation. All patients underwent GI-Tl SPECT, post-stress Tl reinjection imaging and low dose dobutamine echocardiography. The diagnostic accuracy of these 3 techniques in predicting functional recovery was evaluated by receiver operating characteristic (ROC) analysis. In segments with functional recovery, regional Tl activities of GI-Tl SPECT were significantly higher than those of reinjection imaging (p<0.05), although there were no significant differences in segments without recovery. The area under the ROC curve for GI-Tl SPECT (0.75±0.06) was greater than that for reinjection imaging (0.68±0.07). The optimal cutoff values to identify viable myocardium were considered to be 55% of peak activity for GI-Tl SPECT and 50% for reinjection imaging. At this cutoff point, the sensitivity and specificity for detection of functional recovery were, respectively, 85% and 61% for GI-Tl SPECT, and 73% and 61% for reinjection imaging. Dobutamine echocardiography had the same sensitivity (85%), but lower specificity (48%) than GI-Tl SPECT. Continuous infusion of GI-Tl solution enhances regional Tl uptake compared with conventional post-stress reinjection imaging. This study suggests that GI-Tl SPECT is superior to reinjection imaging and dobutamine echocardiography in predicting functional recovery after ischemic left ventricular dysfunction. (author)

  6. 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)

  7. PWR core safety analysis with 3-dimensional methods

    Highlights: • An overview of AREVA’s safety analysis codes their coupling is provided. • The validation base and licensing applications of these codes are summarized. • Coupled codes and methods provide improved margins and non-conservative results. • Examples for REA and inadvertent opening of the pressurizer safety valve are given. - Abstract: The main focus of safety analysis is to demonstrate the required safety level of the reactor core. Because of the demanding requirements, the quality of the safety analysis strongly affects the confidence in the operational safety of a reactor. To ensure the highest quality, it is essential that the methodology consists of appropriate analysis tools, an extensive validation base, and last but not least highly educated engineers applying the methodology. The sophisticated 3-dimensional core models applied by AREVA ensure that all physical effects relevant for safety are treated and the results are reliable and conservative. Presently AREVA employs SCIENCE, CASMO/NEMO and CASCADE-3D for pressurized water reactors. These codes are currently being consolidated into the next generation 3D code system ARCADIA®. AREVA continuously extends the validation base, including measurement campaigns in test facilities and comparisons of the predictions of steady state and transient measured data gathered from plants during many years of operation. Thus, the core models provide reliable and comprehensive results for a wide range of applications. For the application of these powerful tools, AREVA is taking benefit of its interdisciplinary know-how and international teamwork. Experienced engineers of different technical backgrounds are working together to ensure an appropriate interpretation of the calculation results, uncertainty analysis, along with continuously maintaining and enhancing the quality of the analysis methodologies. In this paper, an overview of AREVA’s broad application experience as well as the broad validation

  8. Digital echocardiography 2002: now is the time

    Thomas, James D.; Greenberg, Neil L.; Garcia, Mario J.

    2002-01-01

    The ability to acquire echocardiographic images digitally, store and transfer these data using the DICOM standard, and routinely analyze examinations exists today and allows the implementation of a digital echocardiography laboratory. The purpose of this review article is to outline the critical components of a digital echocardiography laboratory, discuss general strategies for implementation, and put forth some of the pitfalls that we have encountered in our own implementation. The major components of the digital laboratory include (1) digital echocardiography machines with network output, (2) a switched high-speed network, (3) a high throughput server with abundant local storage, (4) a reliable low-cost archive, (5) software to manage information, and (6) support mechanisms for software and hardware. Implementation strategies can vary from a complete vendor solution providing all components (hardware, software, support), to a strategy similar to our own where standard computer and networking hardware are used with specialized software for management of image and measurement information.

  9. Three-dimensional echocardiography: the benefits of the additional dimension.

    Lang, Roberto M; Mor-Avi, Victor; Sugeng, Lissa; Nieman, Petra S; Sahn, David J

    2006-11-21

    Over the past 3 decades, echocardiography has become a major diagnostic tool in the arsenal of clinical cardiology for real-time imaging of cardiac dynamics. More and more, cardiologists' decisions are based on images created from ultrasound wave reflections. From the time ultrasound imaging technology provided the first insight into the human heart, our diagnostic capabilities have increased exponentially as a result of our growing knowledge and developing technology. One of the most significant developments of the last decades was the introduction of 3-dimensional (3D) imaging and its evolution from slow and labor-intense off-line reconstruction to real-time volumetric imaging. While continuing its meteoric rise instigated by constant technological refinements and continuing increase in computing power, this tool is guaranteed to be integrated in routine clinical practice. The major proven advantage of this technique is the improvement in the accuracy of the echocardiographic evaluation of cardiac chamber volumes, which is achieved by eliminating the need for geometric modeling and the errors caused by foreshortened views. Another benefit of 3D imaging is the realistic and unique comprehensive views of cardiac valves and congenital abnormalities. In addition, 3D imaging is extremely useful in the intraoperative and postoperative settings because it allows immediate feedback on the effectiveness of surgical interventions. In this article, we review the published reports that have provided the scientific basis for the clinical use of 3D ultrasound imaging of the heart and discuss its potential future applications. PMID:17112995

  10. Echocardiography in the Era of Multimodality Cardiovascular Imaging

    Benoy Nalin Shah

    2013-01-01

    Full Text Available Echocardiography remains the most frequently performed cardiac imaging investigation and is an invaluable tool for detailed and accurate evaluation of cardiac structure and function. Echocardiography, nuclear cardiology, cardiac magnetic resonance imaging, and cardiovascular-computed tomography comprise the subspeciality of cardiovascular imaging, and these techniques are often used together for a multimodality, comprehensive assessment of a number of cardiac diseases. This paper provides the general cardiologist and physician with an overview of state-of-the-art modern echocardiography, summarising established indications as well as highlighting advances in stress echocardiography, three-dimensional echocardiography, deformation imaging, and contrast echocardiography. Strengths and limitations of echocardiography are discussed as well as the growing role of real-time three-dimensional echocardiography in the guidance of structural heart interventions in the cardiac catheter laboratory.

  11. Automated analysis of 3D echocardiography

    Stralen, Marijn van

    2009-01-01

    In this thesis we aim at automating the analysis of 3D echocardiography, mainly targeting the functional analysis of the left ventricle. Manual analysis of these data is cumbersome, time-consuming and is associated with inter-observer and inter-institutional variability. Methods for reconstruction o

  12. Strain Echocardiography in Acute Cardiovascular Diseases.

    Favot, Mark; Courage, Cheryl; Ehrman, Robert; Khait, Lyudmila; Levy, Phillip

    2016-01-01

    Echocardiography has become a critical tool in the evaluation of patients presenting to the emergency department (ED) with acute cardiovascular diseases and undifferentiated cardiopulmonary symptoms. New technological advances allow clinicians to accurately measure left ventricular (LV) strain, a superior marker of LV systolic function compared to traditional measures such as ejection fraction, but most emergency physicians (EPs) are unfamiliar with this method of echocardiographic assessment. This article discusses the application of LV longitudinal strain in the ED and reviews how it has been used in various disease states including acute heart failure, acute coronary syndromes (ACS) and pulmonary embolism. It is important for EPs to understand the utility of technological and software advances in ultrasound and how new methods can build on traditional two-dimensional and Doppler techniques of standard echocardiography. The next step in competency development for EP-performed focused echocardiography is to adopt novel approaches such as strain using speckle-tracking software in the management of patients with acute cardiovascular disease. With the advent of speckle tracking, strain image acquisition and interpretation has become semi-automated making it something that could be routinely added to the sonographic evaluation of patients presenting to the ED with cardiovascular disease. Once strain imaging is adopted by skilled EPs, focused echocardiography can be expanded and more direct, phenotype-driven care may be achievable for ED patients with a variety of conditions including heart failure, ACS and shock. PMID:26823931

  13. Dynamic 3D echocardiography in virtual reality.

    A.E. van den Bosch (Annemien); A.H.J. Koning (Anton); F.J. Meijboom (Folkert); J.S. McGhie (Jackie); M.L. Simoons (Maarten); P.J. van der Spek (Peter); A.J.J.C. Bogers (Ad)

    2005-01-01

    textabstractBACKGROUND: This pilot study was performed to evaluate whether virtual reality is applicable for three-dimensional echocardiography and if three-dimensional echocardiographic 'holograms' have the potential to become a clinically useful tool. METHODS: Three-dimensional echocardiographic d

  14. 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.

  15. Dobutamine stress echocardiography: a review and update

    Gilstrap LG

    2014-04-01

    Full Text Available Lauren Gray Gilstrap,1 R Sacha Bhatia,2 Rory B Weiner,3 David M Dudzinski3 1Division of Cardiology, Brigham and Women's Hospital, Boston, MA, USA; 2Institute for Health Systems Solutions, Women's College Hospital, Toronto, ON, Canada; 3Cardiology Division, Massachusetts General Hospital, Boston, MA, USA Abstract: Stress echocardiography is a noninvasive cardiovascular diagnostic test that provides functional and hemodynamic information in the assessment of a number of cardiac diseases. Performing stress echocardiography with a pharmacologic agent such as dobutamine allows for simulation of increased heart rate and increased myocardial physiologic demands in patients who may be unable to exercise due to musculoskeletal or pulmonary comorbidities. Dobutamine stress echocardiography (DSE, like exercise echocardiography, has found its primary application in ischemic heart disease, with roles in identification of obstructive epicardial coronary artery disease, detection of viable myocardium, and assessment of the efficacy of anti-ischemic medical therapy in patients with known coronary artery disease. DSE features prominently in the evaluation and management of valvular heart disease by helping to assess the effects of mitral and aortic stenoses, as well as a specific use in differentiating true severe valvular aortic stenosis from pseudostenosis that may occur in the setting of left ventricular systolic dysfunction. DSE is generally well tolerated, and its side effects and contraindications generally relate to consequences of excess inotropic and/or chronotropic stimulation of the heart. The aim of this paper is to review the indications, contraindications, advantages, disadvantages, and risks of DSE. Keywords: stress echocardiography, dobutamine, coronary artery disease, myocardial ischemia

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Role of echocardiography in patients with stroke.

    Nakanishi, Koki; Homma, Shunichi

    2016-08-01

    Investigation of potential embolic source is an important diagnostic step in treating patients with ischemic stroke and transient ischemic attack. Cardiogenic embolism has been estimated to be the causative factor in 15-30% of all cases of ischemic stroke. Cardioembolic strokes are generally severe and recurrence and mortality rate high. Various cardiac disorders including atrial fibrillation, ventricular thrombus, valvular heart disease, cardiac tumors, and structural heart defects can cause cardioembolic stroke. Although the aortic arch is not a cardiac structure, it is usually considered under source of cardiac embolism (cardioaortic source) and is reviewed in this article. Echocardiography (both transthoracic and transesophageal) is a widely used and versatile technique that can provide comprehensive information of thromboembolic risk in patients with stroke. This article reviews potential cardiac sources of stroke and discusses the role of echocardiography in clinical practice. PMID:27256218

  1. Three dimensional echocardiography in congenital heart defects

    Shirali Girish

    2008-01-01

    Full Text Available Three dimensional echocardiography (3DE is a new, rapidly evolving modality for cardiac imaging. Important technological advances have heralded an era where practical 3DE scanning is becoming a mainstream modality. We review the modes of 3DE that can be used. The literature has been reviewed for articles that examine the applicability of 3DE to congenital heart defects to visualize anatomy in a spectrum of defects ranging from atrioventricular septal defects to mitral valve abnormalities and Ebstein′s anomaly. The use of 3DE color flow to obtain echocardiographic angiograms is illustrated. The state of the science in quantitating right and left ventricular volumetrics is reviewed. Examples of novel applications including 3DE transesophageal echocardiography and image-guided interventions are provided. We also list the limitations of the technique, and discuss potential future developments in the field.

  2. Modern echocardiography in pediatric right heart assessment

    Kutty, S.

    2016-01-01

    Right heart function is a key determinant of clinical status, prognosis and outcome in a variety of heart diseases, particularly in patients with congenital heart disease. Various non-invasive imaging tools have been used to assess right heart function in the setting of adult heart disease; however there has been little exploration of those modalities in younger patients. Newer imaging techniques, including tissue Doppler imaging, three-dimensional echocardiography and deformation imaging hav...

  3. Echocardiography and genetic counselling in tuberous sclerosis.

    Webb, D W; Thomas, R D; Osborne, J P

    1992-01-01

    OBJECTIVE--To assess echocardiography as an investigation for the detection of occult gene carriers in tuberous sclerosis. PATIENTS--Sixty parents of children with tuberous sclerosis who had been extensively investigated for signs of the disease and 60 age and sex matched controls. PROCEDURE--Blind study by two experienced echocardiographers and blind interpretation of video recordings by an adult cardiologist. SETTING--Cardiology department of a district general hospital. RESULTS--Two parent...

  4. Quantification of aortic valve area at 256-slice computed tomography: Comparison with transesophageal echocardiography and cardiac catheterization in subjects with high-grade aortic valve stenosis prior to percutaneous valve replacement

    Purpose: The purpose of this study was to compare planimetric aortic valve area (AVA) measurements from 256-slice CT to those derived from transesophageal echocardiography (TEE) and cardiac catheterization in high-risk subjects with known high-grade calcified aortic stenosis. Methods and materials: The study included 26 subjects (10 males, mean age: 79 ± 6; range, 61-88 years). All subjects were clinically referred for aortic valve imaging prior to percutaneous aortic valve replacement from April 2008 to March 2009. Two radiologists, blinded to the results of TEE and cardiac catheterization, independently selected the systolic cardiac phase of maximum aortic valve area and independently performed manual CT AVA planimetry for all subjects. Repeated AVA measurements were made to establish CT intra- and interobserver repeatability. In addition, the image quality of the aortic valve was rated by both observers. Aortic valve calcification was also quantified. Results: All 26 subjects had a high-grade aortic valve stenosis (systolic opening area 2) via CT-based planimetry, with a mean AVA of 0.62 ± 0.18. In four subjects, TEE planimetry was precluded due to severe aortic valve calcification, but CT-planimetry was successfully performed with a mean AVA of 0.46 ± 0.23 cm2. Mean aortic valve calcium mass score was 563.8 ± 526.2 mg. Aortic valve area by CT was not correlated with aortic valve calcium mass score. A bias and limits of agreement among CT and TEE, CT and cardiac catheterization, and TEE and cardiac catheterization were -0.07 [-0.37 to 0.24], 0.03 [-0.49 to 0.55], 0.12 [-0.39 to 0.63] cm2, respectively. Differences in AVA among CT and TEE or cardiac catheterization did not differ systematically over the range of measurements and were not correlated with aortic valve calcium mass score. Conclusion: Planimetric aortic valve area measurements from 256-slice CT agree well with those derived from TEE and cardiac catheterization in high-risk subjects with known

  5. Quantification of aortic valve area at 256-slice computed tomography: Comparison with transesophageal echocardiography and cardiac catheterization in subjects with high-grade aortic valve stenosis prior to percutaneous valve replacement

    Klass, Oliver, E-mail: oliver.klass@uniklinik-ulm.de [University Hospital of Ulm, Department of Diagnostic and Interventional Radiology, Steinhoevelstr. 9, 89075 Ulm (Germany); Walker, Matthew J.; Olszewski, Mark E. [Philips Healthcare, CT Clinical Science, Cleveland, OH (United States); Bahner, Johannes; Feuerlein, Sebastian; Hoffmann, Martin H.K.; Lang, Alexandra [University Hospital of Ulm, Department of Diagnostic and Interventional Radiology, Steinhoevelstr. 9, 89075 Ulm (Germany)

    2011-10-15

    Purpose: The purpose of this study was to compare planimetric aortic valve area (AVA) measurements from 256-slice CT to those derived from transesophageal echocardiography (TEE) and cardiac catheterization in high-risk subjects with known high-grade calcified aortic stenosis. Methods and materials: The study included 26 subjects (10 males, mean age: 79 {+-} 6; range, 61-88 years). All subjects were clinically referred for aortic valve imaging prior to percutaneous aortic valve replacement from April 2008 to March 2009. Two radiologists, blinded to the results of TEE and cardiac catheterization, independently selected the systolic cardiac phase of maximum aortic valve area and independently performed manual CT AVA planimetry for all subjects. Repeated AVA measurements were made to establish CT intra- and interobserver repeatability. In addition, the image quality of the aortic valve was rated by both observers. Aortic valve calcification was also quantified. Results: All 26 subjects had a high-grade aortic valve stenosis (systolic opening area <1.0 cm{sup 2}) via CT-based planimetry, with a mean AVA of 0.62 {+-} 0.18. In four subjects, TEE planimetry was precluded due to severe aortic valve calcification, but CT-planimetry was successfully performed with a mean AVA of 0.46 {+-} 0.23 cm{sup 2}. Mean aortic valve calcium mass score was 563.8 {+-} 526.2 mg. Aortic valve area by CT was not correlated with aortic valve calcium mass score. A bias and limits of agreement among CT and TEE, CT and cardiac catheterization, and TEE and cardiac catheterization were -0.07 [-0.37 to 0.24], 0.03 [-0.49 to 0.55], 0.12 [-0.39 to 0.63] cm{sup 2}, respectively. Differences in AVA among CT and TEE or cardiac catheterization did not differ systematically over the range of measurements and were not correlated with aortic valve calcium mass score. Conclusion: Planimetric aortic valve area measurements from 256-slice CT agree well with those derived from TEE and cardiac catheterization in

  6. Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism.

    Sanchez, Olivier; Trinquart, Ludovic; Planquette, Benjamin; Couturaud, Francis; Verschuren, Franck; Caille, Vincent; Meneveau, Nicolas; Pacouret, Gérard; Roy, Pierre-Marie; Righini, Marc; Perrier, Arnaud; Bertoletti, Laurent; Parent, Florence; Lorut, Christine; Meyer, Guy

    2013-09-01

    We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk stratification in comparison to the PESI alone. The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of cardiac troponin I and brain natriuretic peptide. 30-day adverse outcome was defined as death, recurrent PE or shock. 529 patients were included, 25 (4.7%, 95% CI 3.2-6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (p<0.001). In PESI class I-II, the rate of outcome events was significantly higher in patients with abnormal values of biomarkers or right ventricular dilatation. In multivariate analysis, the PESI (class III-IV versus I-II, OR 3.1, 95% CI 1.2-8.3; class V versus I-II, OR 5.5, 95% CI 1.5-25.5 and echocardiography (right ventricular/left ventricular ratio, OR (for an increase of 0.1) 1.3, 95% CI 1.1-1.5) were independent predictors of an adverse outcome. In patients with normotensive PE, biomarkers and echocardiography provided additional prognostic information to the PESI. PMID:23258789

  7. 3-Dimensional reconstruction of fluorescent structures in tardigrades

    Franz BRÜMMER

    2007-09-01

    Full Text Available Tardigrades are microscopic animals, thus brightfield microscopy is a well established method for tardigrade observation. Modern techniques in functional genetics like fluorescence in situ hybridisation or fluorescently labelled expression markers demand high resolution fluorescence microscopy. Nevertheless tardigrades are still considered to be difficult objects for fluorescence techniques as they are covered by an opaque and diffracting cuticle. We show a modern technique of structured light illumination that enables us to acquire thin optical sections and consequently to reconstruct 3-dimensional structures in tardigrades with a high spatial resolution in all 3 dimensions. This technique is evaluated on taxonomically valuable internal as well as external structures of eutardigrades: the bucco-pharyngeal apparatus and the claws. The 3-dimensional reconstructions allow the measurement of distances in all 3 dimensions.

  8. Feasibility of radial and circumferential strain analysis using 2D speckle tracking echocardiography in cats

    Takano, Hiroshi; ISOGAI, Tomomi; Aoki, Takuma; WAKAO, Yoshito; Fujii, Yoko

    2014-01-01

    The purpose of the present study is to investigate the feasibility of strain analysis using speckle tracking echocardiography (STE) in cats and to evaluate STE variables in cats with hypertrophic cardiomyopathy (HCM). Sixteen clinically healthy cats and 17 cats with HCM were used. Radial and circumferential strain and strain rate variables in healthy cats were measured using STE to assess the feasibility. Comparisons of global strain and strain variables between healthy cats and cats with HCM...

  9. Decay vertex reconstruction and 3-dimensional lifetime determination at BESⅢ

    XU Min; HE Kang-Lin; ZHANG Zi-Ping; WANG Yi-Fang; BIAN Jian-Ming; CAO Guo-Fu; CAO Xue-Xiang; CHEN Shen-Jian; DENG Zi-Yan; FU Cheng-Dong; GAO Yuan-Ning; HAN Lei; NAN Shao-Qing; HE Miao; HU Ji-Feng; HU Xiao-Wei; HUANG Bin; HUANG Xing-Tao; JIA Lu-Kui; JI Xiao-Sin; LI Hai-Bo; LI Wei-Dong; LIANG Yu-Wie; LIU Chun-Xiu; LIU Huai-Min; LIU Ying; LIU Yong; LUO Tao; L(U) Qi-Wen; MA Qiu-Mei; MA Xiang; MAO Ya-Jun; MAO Ze-Pu; MO Xiao-Hu; NING Fei-Peng; PING Rong-Gang; QIU Jin-Fa; SONG Wen-Bo; SUN Sheng-Sen; SUN Xiao-Dong; SUN Yong-Zhao; TIAN Hao-Lai; WANG Ji-Ke; WANG Liang-Liang; WEN Shuo-Pin; WU Ling-Hui; WU Zhi; XIE Yu-Guang; YAN Jie; YAN Liang; YAO Jian; YUAN Chang-Zheng; YUAN Ye; ZHANG Chang-Chun; ZHANG Jian-Yong; ZHANG Lei; ZHANG Xue-Yao; ZHANG Yao; ZHENG Yang-Heng; ZHU Yong-Sheng; ZOU Jia-Heng

    2009-01-01

    This paper focuses mainly on the vertex reconstruction of resonance particles with a relatively long lifetime such as KSO, A, as well as on lifetime measurements using a 3-dimensional fit. The kinematic constraints between the production and decay vertices and the decay vertex fitting algorithm based on the least squares method are both presented. Reconstruction efficiencies including experimental resolutions are discussed. The results and systematic errors are calculated based on a Monte Carlo simulation.

  10. Catalytic carbon deposition on 3-dimensional carbon fibre supports

    Thornton, Matthew James

    2005-01-01

    Catalytic carbon deposition reactions, using methane, ethane or synthetic natural gas (1.8 vol. % propane, 6.7 vol. % ethane and balance methane) as the carbon-containing gas feedstock with or without the addition of hydrogen, have been investigated over nickel, cobalt and iron catalysts supported on 3-dimensional carbon fibre supports, using both a horizontal tube furnace and an isothermal, isobaric induction furnace. The transition metal catalysts were prepared by impregnating 3-dimens...

  11. Anti-de Sitter 3-dimensional Gravity with Torsion

    Blagojevic, M; Vasilic, M.

    2004-01-01

    Using the canonical formalism, we study the asymptotic symmetries of the topological 3-dimensional gravity with torsion. In the anti-de Sitter sector, the symmetries are realized by two independent Virasoro algebras with classical central charges. In the simple case of the teleparallel vacuum geometry, the central charges are equal to each other and have the same value as in general relativity, while in the general Riemann-Cartan geometry, they become different.

  12. Temporal, 3-dimensional, cellular anatomy of corneal wound tissue.

    Jester, J V; Petroll, W M; Barry, P. A.; Cavanagh, H D

    1995-01-01

    We have evaluated temporally the 3-dimensional cellular anatomy of corneal wound tissue in the rabbit eye using in vivo tandem scanning confocal microscopy. In vivo microscopic studies showed that corneal fibroblast migrated into the wound as an interconnected cellular meshwork with long, thin, randomly oriented cell processes. Interconnection of fibroblasts was further confirmed by localisation of monoclonal antibodies to connexin 43 which demonstrated prominent staining of putative gap junc...

  13. Invasive 3-Dimensional Organotypic Neoplasia from Multiple Normal Human Epithelia

    Ridky, Todd W.; Chow, Jennifer M.; Wong, David J.; Khavari, Paul A

    2010-01-01

    Refined cancer models are required to assess the burgeoning number of potential targets for cancer therapeutics within a rapid and clinically relevant context. Here we utilize tumor-associated genetic pathways to transform primary human epithelial cells from epidermis, oropharynx, esophagus, and cervix into genetically defined tumors within a human 3-dimensional (3-D) tissue environment incorporating cell-populated stroma and intact basement membrane. These engineered organotypic tissues reca...

  14. GLOBAL STABILITY IN TIME-DELAYED 3-DIMENSIONAL RICHARDS MODEL

    2010-01-01

    We obtain the global attractivity and global asymptotical stability of positive equilibria to a 3-dimensional Richards model with delays. Our results do not depend on the size-asymmetry parameter which measures the degree of the curvature of size-growth among individuals over the entire growth curve, and the shape parameter which affects the shape of model curve. Lastly, we gave a numerical simulation to verify the feasibility of our main results.

  15. Circuit-Switched Gossiping in the 3-Dimensional Torus Networks

    Delmas, Olivier; Pérennes, Stéphane

    1996-01-01

    In this paper we describe, in the case of short messages, an efficient gossiping algorithm for 3-dimensional torus networks (wrap-around or toroidal meshes) that uses synchronous circuit-switched routing. The algorithm is based on a recursive decomposition of a torus. The algorithm requires an optimal number of rounds and a quasi-optimal number of intermediate switch settings to gossip in an $7^i \\times 7^i \\times 7^i$ torus.

  16. The 3-Dimensional Core Model DYN3D

    Mittag, Siegfried; Rohde, Ulrich; Grundmann, Ulrich

    2010-01-01

    Analyzing the safety margins in transients and accidents of nuclear reactors 3-dimensional models of the core were used to avoid conservative assumptions needed for point kinetics or 1-dimensional models. Therefore the 3D code DYN3D has been developed for the analysis of reactivity initiated accidents (RIA) in thermal nuclear reactors. The power distributions are calculated with the help of nodal expansion methods (NEM) for hexagonal and Cartesian geometry. The fuel rod model and the thermohy...

  17. Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

    Tiago Tribolet de Abreu

    2008-03-01

    Full Text Available Tiago Tribolet de Abreu, Sonia Mateus, Cecilia Carreteiro, Jose CorreiaLaboratorio de Ultrasonografia Cardiaca e Neurovascular, Hospital do Espirito Santo-Evora, E. P. E., PortugalBackground: The role of transesophageal echocardiography (TEE in the evaluation of acute stroke patients is still ill-defined. We conducted a prospective observational study to find the prevalence of TEE findings that indicate anticoagulation as beneficial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocardiography (TTE findings.Methods: We prospectively studied all patients referred to our laboratory for TTE and TEE. Patients were excluded if the diagnosis was not acute ischemic stroke or if they had an indication for anticoagulation based on clinical, electrocardiographic, or TTE data. Patients with TEE findings that might indicate anticoagulation as beneficial were identified.Results: A total of 84 patients with acute ischemic stroke and without indication for anticoagulation based on clinical and electrocardiographic or TTE data were included in the study. Findings indicating anticoagulation as beneficial were found in 32.1%: spontaneous echo contrast (1.2%, complex aortic atheroma (27.4%, thrombus (8.3%, and simultaneous patent foramen ovale and atrial septal aneurysm (2.4%.Conclusions: The results of our study show that TEE can have therapy implications in 32.1% of ischemic stroke patients in sinus rhythm and with TTE with no indication for anticoagulation.Keywords: acute ischemic stroke, transesophageal echocardiography, transthoracic echocardiography, therapy

  18. Predicting and measuring fluid responsiveness with echocardiography

    Ashley Miller

    2016-06-01

    Full Text Available Echocardiography is ideally suited to guide fluid resuscitation in critically ill patients. It can be used to assess fluid responsiveness by looking at the left ventricle, aortic outflow, inferior vena cava and right ventricle. Static measurements and dynamic variables based on heart–lung interactions all combine to predict and measure fluid responsiveness and assess response to intravenous fluid esuscitation. Thorough knowledge of these variables, the physiology behind them and the pitfalls in their use allows the echocardiographer to confidently assess these patients and in combination with clinical judgement manage them appropriately.

  19. Measurement of Thrombus Flux Using Transesophageal Echocardiography

    Yamaguchi, Tadashi; Hirai, Kazuki; Aoki, Masami; Miyagi, Jin; Suzuki, Masahiko; Moriya, Hideshige; Hachiya, Hiroyuki

    2006-05-01

    Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are serious problem of total knee replacement (TKR). These diseases may be caused by a thrombus formed during the TKR operation. Therefore, understanding the flow volume of thrombus is important for curing and preventing PTE. In this paper, we tried to understanding the situation of the flow of thrombus by using transesophageal echocardiography movies. We applied the signal processing technique the FSET to extract the anomalous information from ultrasonic echo image. As a result of processing, the time change of the flow volume of thrombus was confirmed.

  20. Measurement of thrombus flux using transesophageal Echocardiography

    Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are serious problem of total knee replacement (TKR). These diseases may be caused by a thrombus formed during the TKR operation. Therefore, understanding the flow volume of thrombus is important for curing and preventing PTE. In this paper, we tried to understanding the situation of the flow of thrombus by using transesophageal echocardiography movies. We applied the signal processing technique the fiber structure extraction technique (FSET) to extract the anomalous information from ultrasonic echo image. As a result of processing, the time change of the flow volume of thrombus was confirmed. (author)

  1. MRI and echocardiography in the diagnosis of cardiac amyloidosis

    Objective: To assess the values of MRI and echocardiography for the diagnosis of cardiac amyloidosis (CA). Methods: Eleven cases with CA proved pathologically performed MRI and echocardiography, the findings were analyzed retrospectively. Results: The characteristic features of cardiac amyloidosis on MRI and echocardiography were: diffuse slight myocardial thickening of the left ventricular wall and interventricular septum (11 cases), slight myocardial thickening of the interatrial septum (5 cases), increased left ventricular mass (7 cases), enlarged left atrium (7 cases), impaired ventricular systolic and diastolic function (10 cases), pleural and pericardial effusions (11 and 9 cases). Echocardiography showed that myocardium was hyperechoic and presented as ground glass with some spotty hyperechoes in 6 cases. MRI revealed a distinct diffuse delayed enhancement of subendocardial and entire myocardium in 8 cases. Conclusion: Doppler echocardiography is the first-choice imaging technique and cardiac magnetic resonance imaging can provide more information for the diagnosis of CA. (authors)

  2. Development of a 3-dimensional seismic isolation floor for computer systems

    In this paper, we investigated the applicability of a seismic isolation floor as a method for protecting computer systems from strong earthquakes, such as computer systems in nuclear power plants. Assuming that the computer system is guaranteed for 250 cm/s2 of input acceleration in the horizontal and vertical directions as the seismic performance, the basic design specification of the seismic isolation floor is considered as follows. Against S1 level earthquakes, the maximum acceleration response of the seismic isolation floor in the horizontal and vertical directions is kept less than 250 cm/s2 to maintain continuous computer operation. Against S2 level earthquakes, the isolation floor allows large horizontal movement and large displacement of the isolation devices to reduce the acceleration response, although it is not guaranteed to be less than 250 cm/s2. By reducing the acceleration response, however, serious damage to the computer systems is reduced, so that they can be restarted after an earthquake. Usually, seismic isolation floor systems permit 2-dimensional (horizontal) isolation. However, in the case of just-under-seated earthquakes, which have large vertical components, the vertical acceleration response of this system is amplified by the lateral vibration of the frame of the isolation floor. Therefore, in this study a 3-dimensional seismic isolation floor, including vertical isolation, was developed. This paper describes 1) the experimental results of the response characteristics of the 3-dimensional seismic isolation floor built as a trial using a 3-dimensional shaking table, and 2) comparison of a 2-dimensional analytical model, for motion in one horizontal direction and the vertical direction, to experimental results. (J.P.N.)

  3. Echocardiography as an indication of continuous-time cardiac quiescence

    Wick, C. A.; Auffermann, W. F.; Shah, A. J.; Inan, O. T.; Bhatti, P. T.; Tridandapani, S.

    2016-07-01

    Cardiac computed tomography (CT) angiography using prospective gating requires that data be acquired during intervals of minimal cardiac motion to obtain diagnostic images of the coronary vessels free of motion artifacts. This work is intended to assess B-mode echocardiography as a continuous-time indication of these quiescent periods to determine if echocardiography can be used as a cost-efficient, non-ionizing modality to develop new prospective gating techniques for cardiac CT. These new prospective gating approaches will not be based on echocardiography itself but on CT-compatible modalities derived from the mechanics of the heart (e.g. seismocardiography and impedance cardiography), unlike the current standard electrocardiogram. To this end, echocardiography and retrospectively-gated CT data were obtained from ten patients with varied cardiac conditions. CT reconstructions were made throughout the cardiac cycle. Motion of the interventricular septum (IVS) was calculated from both echocardiography and CT reconstructions using correlation-based, deviation techniques. The IVS was chosen because it (1) is visible in echocardiography images, whereas the coronary vessels generally are not, and (2) has been shown to be a suitable indicator of cardiac quiescence. Quiescent phases were calculated as the minima of IVS motion and CT volumes were reconstructed for these phases. The diagnostic quality of the CT reconstructions from phases calculated from echocardiography and CT data was graded on a four-point Likert scale by a board-certified radiologist fellowship-trained in cardiothoracic radiology. Using a Wilcoxon signed-rank test, no significant difference in the diagnostic quality of the coronary vessels was found between CT volumes reconstructed from echocardiography- and CT-selected phases. Additionally, there was a correlation of 0.956 between the echocardiography- and CT-selected phases. This initial work suggests that B-mode echocardiography can be used as a

  4. MR imaging of the knee joint with 3-dimensional gradient echo

    Authors considered and discussed whether various lesions of the knee joint can be diagnosed under the MR imaging condition with a pulse sequence of 3-dimensional fourier transformed gradient recalled acquisition in the steady state and what advantages the method has. The apparatus was 1.5T Signa (General Electric) equipped with surface coil for the knee. The consecutive 124 sagittal images of 0.8 mm thickness taken primarily for 3-dimensional reconstruction were processed to give any cross sections of coronary, horizontal, sagittal or further additional ones. Subjects were 243 knees (138 internal derangement and 105 osteoarthritis) whose lesions were confirmed by arthroscope or by arthrostomy after the MR imaging. Comparison of the MR imaging and surgical finding revealed that accuracy, specificity and sensitivity of the present MR imaging method were all >90% for diagnosis of internal derangement of anterior cruciate ligament and meniscus. For osteoarthritis, the method was thought useful for evaluation of the depth of cartilage deficit. (K.H.)

  5. 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

  6. Incorporating interactive 3-dimensional graphics in astronomy research papers

    Barnes, David G

    2007-01-01

    Most research data collections created or used by astronomers are intrinsically multi-dimensional. In contrast, all visual representations of data presented within research papers are exclusively 2-dimensional. We present a resolution of this dichotomy that uses a novel technique for embedding 3-dimensional (3-d) visualisations of astronomy data sets in electronic-format research papers. Our technique uses the latest Adobe Portable Document Format extensions together with a new version of the S2PLOT programming library. The 3-d models can be easily rotated and explored by the reader and, in some cases, modified. We demonstrate example applications of this technique including: 3-d figures exhibiting subtle structure in redshift catalogues, colour-magnitude diagrams and halo merger trees; 3-d isosurface and volume renderings of cosmological simulations; and 3-d models of instructional diagrams and instrument designs.

  7. Protalign: a 3-dimensional protein alignment assessment tool.

    Meads, D; Hansen, M D; Pang, A

    1999-01-01

    Protein fold recognition (sometimes called threading) is the prediction of a protein's 3-dimensional shape based on its similarity to a protein of known structure. Fold predictions are low resolution; that is, no effort is made to rotate the protein's component amino acid side chains into their correct spatial orientations. The goal is simply to recognize the protein family member that most closely resembles the target sequence of unknown structure and to create a sensible alignment of the target to the known structure (i.e., a structure-sequence alignment). To facilitate this type of structure prediction, we have designed a low resolution molecular graphics tool. ProtAlign introduces the ability to interact with and edit alignments directly in the 3-dimensional structure as well as in the usual 2-dimensional layout. It also contains several functions and features to help the user assess areas within the alignment. ProtAlign implements an open pipe architecture to allow other programs to access its molecular graphics capabilities. In addition, it is capable of "driving" other programs. Because amino acid side chain orientation is not relevant in fold recognition, we represent amino acid residues as abstract shapes or glyphs much like Lego (tm) blocks and we borrow techniques from comparative flow visualization using streamlines to provide clean depictions of the entire protein model. By creating a low resolution representation of protein structure, we are able to at least double the amount of information on the screen. At the same time, we create a view that is not as busy as the corresponding representations using traditional high resolution visualization methods which show detailed atomic structure. This eliminates distracting and possibly misleading visual clutter resulting from the mapping of protein alignment information onto a high resolution display of the known structure. This molecular graphics program is implemented in Open GL to facilitate porting to

  8. Advanced quantitative echocardiography in arrhythmogenic right ventricular cardiomyopathy

    Kjaergaard, Jesper; Hastrup Svendsen, Jesper; Sogaard, Peter;

    2007-01-01

    BACKGROUND: Arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) is a regional disease of the RV myocardium with variable degrees of left ventricular involvement. Three-dimensional echocardiography and Doppler tissue imaging (DTI) are new echocardiographic modalities for the evaluation of ...

  9. Intra-cardiac echocardiography in alcohol septal ablation

    Cooper, Robert M; Shahzad, Adeel; Newton, James;

    2015-01-01

    Alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy reduces left ventricular outflow tract gradients. A third of patients do not respond; inaccurate localisation of the iatrogenic infarct can be responsible. Transthoracic echocardiography (TTE) using myocardial contrast can be...

  10. Trans-esophageal echocardiography for tricuspid and pulmonary valves

    Prabhu Mahesh

    2009-01-01

    Full Text Available Transesophageal echocardiography has been shown to provide unique information about cardiac anatomy, function, hemodynamics and blood flow and is relatively easy to perform with a low risk of complications. Echocardiographic evaluation of the tricuspid and pulmonary valves can be achieved with two-dimensional and Doppler imaging. Transesophageal echocardiography of these valves is more challenging because of their complex structure and their relative distance from the esophagus. Two-dimensional echocardiography allows an accurate visualization of the cardiac chambers and valves and their motion during the cardiac cycle. Doppler echocardiography is the most commonly used diagnostic technique for detecting and evaluating valvular regurgitation. The lack of good quality evidence makes it difficult to recommend a validated quantitative approach but expert consensus recommends a clinically useful qualitative approach. This review ennumerates probe placement, recommended cross-sectional views, flow patterns, quantitative equations including the clinical approach to the noninvasive quantification of both stenotic and regurgitant lesions.

  11. Teaching focused echocardiography for rheumatic heart disease screening

    Daniel Engelman

    2015-01-01

    Full Text Available Screening for rheumatic heart disease (RHD requires workers skilled in echocardiography, which typically involves prolonged, specialized training. Task shifting echocardiographic screening to nonexpert health workers may be a solution in settings with limited human resources. An 8-week training program was designed to train health workers without any prior experience in focused echocardiography for RHD screening. Seven health workers participated. At the completion of training, the health workers performed unsupervised echocardiography on 16 volunteer children with known RHD status. A pediatric cardiologist assessed image quality. Participants provided qualitative feedback. The quality of echocardiograms were high at completion of training (55 of 56 were adequate for diagnosis and all cases of RHD were identified. Feedback was strongly positive. Training health workers to perform focused echocardiography for RHD screening is feasible. After systematic testing for accuracy, this training program could be adapted in other settings seeking to expand echocardiographic capabilities.

  12. Teaching focused echocardiography for rheumatic heart disease screening

    Screening for rheumatic heart disease (RHD) requires workers skilled in echocardiography, which typically involves prolonged, specialized training. Task shifting echocardiographic screening to nonexpert health workers may be a solution in settings with limited human resources. An 8-week training program was designed to train health workers without any prior experience in focused echocardiography for RHD screening. Seven health workers participated. At the completion of training, the health workers performed unsupervised echocardiography on 16 volunteer children with known RHD status. A pediatric cardiologist assessed image quality. Participants provided qualitative feedback. The quality of echocardiograms were high at completion of training (55 of 56 were adequate for diagnosis) and all cases of RHD were identified. Feedback was strongly positive. Training health workers to perform focused echocardiography for RHD screening is feasible. After systematic testing for accuracy, this training program could be adapted in other settings seeking to expand echocardiographic capabilities

  13. Trans-esophageal echocardiography for tricuspid and pulmonary valves

    Prabhu Mahesh

    2009-01-01

    Transesophageal echocardiography has been shown to provide unique information about cardiac anatomy, function, hemodynamics and blood flow and is relatively easy to perform with a low risk of complications. Echocardiographic evaluation of the tricuspid and pulmonary valves can be achieved with two-dimensional and Doppler imaging. Transesophageal echocardiography of these valves is more challenging because of their complex structure and their relative distance from the esophagus. Two-dimension...

  14. Prognostic value of dobutamine stress echocardiography in patients with diabetes

    Sozzi, Fabiola; Elhendy, Abdou; Schinkel, Arend; Vourvouri, Eleni; Bax, Jeroen; Sutter, J.; Borghetti, A.; Poldermans, Don; Roelandt, Jos; Domburg, Ron

    2003-01-01

    textabstractOBJECTIVE: The aim of this study was to assess the incremental value of dobutamine stress echocardiography (DSE) for the risk stratification of diabetic patients who are unable to perform an adequate exercise stress test. Exercise capacity is frequently impaired in patients with diabetes. The role of pharmacologic stress echocardiography in the risk stratification of diabetic patients has not been well defined. RESEARCH DESIGN AND METHODS: We studied 396 diabetic patients (mean ag...

  15. [Improved reproducibility of contrast echocardiography by SH U 454. Experimental studies using digital subtraction echocardiography].

    Grube, E; Fritzsch, T

    1986-06-01

    The right heart chambers of 10 animals were contrasted by conventional (NaCl, CO2, H2O2, indocyanine green (ICG), haemaccel) and a newly developed echo-contrast medium (SH U 454) and studied by 2-D echocardiography. By means of digital subtraction echocardiography (DSE) endocardial borders were defined automatically and the results were compared with the manual input of endocardial borders of original and contrast echocardiograms. The area enclosed by these borders served as basis for the calculation of reproducibility (in %) and correlations. The following correlation coefficients (r) and SEE were calculated between the areas defined by the different contrast media and DSE and manually derived borders: r = 0.85, 3.98 cm2 (ICG), and 0.89, 1.00 cm2 (haemaccel). The best calculations were found using SH U 454 in concentrations between 100 and 300 mg/ml. The correlation coefficients were in the range of r = 0.95 and 0.98 with an SEE of 0.21 to 0.56 cm2 between manually and automatically derived contours. Comparing the reproducibility of data between the different evaluation methods we found the following results: manual input of endocardial borders in original echocardiograms 12.3%-16.9%; manual definition of endocardial borders in contrast echocardiograms 2.0% (SH U 454) - 15.7% (CO2); automatic contour finding in original echocardiograms 8.6%-28.9% (mean 21.6%); automatic definition of endocardium by DSE in contrast echocardiograms 7.6% (ICG) - 0.9% (SH U 454, 300 mg/ml). Our results demonstrate that digital subtraction echocardiography is a simple an safe procedure to define endocardial contours if echo contrast media lead to a uniform and homogeneous opacification of the left and right cardiac cavities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3529670

  16. Avoiding transthoracic echocardiography and transesophageal echocardiography for patients with variable body mass indexes in infective endocarditis

    Robert Sogomonian

    2016-04-01

    Full Text Available Background: Echocardiography has been a popular modality used to aid in the diagnosis of infective endocarditis (IE with the modified Duke criteria. We evaluated the necessity between the uses of either a transthoracic echocardiography (TTE or transesophageal echocardiography (TEE in patients with a body mass index (BMI greater than or equal to 25 kg/m2 and less than 25 kg/m2. Methods: A single-centered, retrospective study of 198 patients between 2005 and 2012 diagnosed with IE based on modified Duke criteria. Patients, required to be above age 18, had undergone an echocardiogram study and had blood cultures to be included in the study. Results: Among 198 patients, two echocardiographic groups were evaluated as 158 patients obtained a TTE, 143 obtained a TEE, and 103 overlapped with TEE and TTE. Out of these patients, 167 patients were included in the study as 109 (65% were discovered to have native valve vegetations on TEE and 58 (35% with TTE. TTE findings were compared with TEE results for true negatives and positives to isolate valvular vegetations. Overall sensitivity of TTE was calculated to be 67% with a specificity of 93%. Patients were further divided into two groups with the first group having a BMI ≥25 kg/m2 and the subsequent group with a BMI <25 kg/m2. Patients with a BMI ≥25 kg/m2 who underwent a TTE study had a sensitivity and specificity of 54 and 92%, respectively. On the contrary, patients with a BMI < 25 kg/m2 had a TTE sensitivity and specificity of 78 and 95%, respectively. Conclusions: Patients with a BMI <25 kg/m2 and a negative TTE should refrain from further diagnostic studies, with TEE strong clinical judgment is warranted. Patients with a BMI ≥ 25 kg/m2 may proceed directly to TEE as the initial study, possibly avoiding an additional study with a TTE.

  17. Transoesophageal echocardiography: What a neuroanaesthesiologist should know?

    Minati Choudhury

    2015-01-01

    Full Text Available Transoesophageal echocardiography (TEE is a semi invasive imaging modality rapidly gained credence and popularity in the cardiothoracic centers worldwide by mid 1990s. It has also been found to be useful in some noncardiac surgical procedures, in particular in the management of neurosurgical patients and haemodynamically unstable patients in intensive care units (ICUs. The principal goal of basic transoesophageal echocardiographic examination encompass a broad range of anatomic imaging including the diagnosis of air embolism, causes of haemodynamic instability, ventricular size and function, volume status, and complications from invasive procedures, as well as the clinical impact or etiology of pulmonary dysfunction in ICU. TEE is relatively cheap and semi-invasive, but it should not be used as a stand-alone device but as a tool which provides data in addition to the data acquired from other forms of monitoring. The establishment of TEE in perioperative neuro anaesthetic care though recent, may result in a significant change in the role of the anaesthetsiologist who, using TEE can provide new information which may change the course and the outcome of surgical procedures.

  18. Minimally invasive cardiac surgery and transesophageal echocardiography

    Ajay Kumar Jha

    2014-01-01

    Full Text Available Improved cosmetic appearance, reduced pain and duration of post-operative stay have intensified the popularity of minimally invasive cardiac surgery (MICS; however, the increased risk of stroke remains a concern. In conventional cardiac surgery, surgeons can visualize and feel the cardiac structures directly, which is not possible with MICS. Transesophageal echocardiography (TEE is essential during MICS in detecting problems that require immediate correction. Comprehensive evaluation of the cardiac structures and function helps in the confirmation of not only the definitive diagnosis, but also the success of surgical treatment. Venous and aortic cannulations are not under the direct vision of the surgeon and appropriate positioning of the cannulae is not possible during MICS without the aid of TEE. Intra-operative TEE helps in the navigation of the guide wire and correct placement of the cannulae and allows real-time assessment of valvular pathologies, ventricular filling, ventricular function, intracardiac air, weaning from cardiopulmonary bypass and adequacy of the surgical procedure. Early detection of perioperative complications by TEE potentially enhances the post-operative outcome of patients managed with MICS.

  19. Dynamic 3D echocardiography in virtual reality

    Simoons Maarten L

    2005-12-01

    Full Text Available Abstract Background This pilot study was performed to evaluate whether virtual reality is applicable for three-dimensional echocardiography and if three-dimensional echocardiographic 'holograms' have the potential to become a clinically useful tool. Methods Three-dimensional echocardiographic data sets from 2 normal subjects and from 4 patients with a mitral valve pathological condition were included in the study. The three-dimensional data sets were acquired with the Philips Sonos 7500 echo-system and transferred to the BARCO (Barco N.V., Kortrijk, Belgium I-space. Ten independent observers assessed the 6 three-dimensional data sets with and without mitral valve pathology. After 10 minutes' instruction in the I-Space, all of the observers could use the virtual pointer that is necessary to create cut planes in the hologram. Results The 10 independent observers correctly assessed the normal and pathological mitral valve in the holograms (analysis time approximately 10 minutes. Conclusion this report shows that dynamic holographic imaging of three-dimensional echocardiographic data is feasible. However, the applicability and use-fullness of this technology in clinical practice is still limited.

  20. Usefulness and limitations of transthoracic echocardiography in heart transplantation recipients

    Galderisi Maurizio

    2008-01-01

    Full Text Available Abstract Transthoracic echocardiography is a primary non-invasive modality for investigation of heart transplant recipients. It is a versatile tool which provides comprehensive information about cardiac structure and function. Echocardiographic examinations can be easily performed at the bedside and serially repeated without any patient's discomfort. This review highlights the usefulness of Doppler echocardiography in the assessment of left ventricular and right ventricular systolic and diastolic function, of left ventricular mass, valvular heart disease, pulmonary arterial hypertension and pericardial effusion in heart transplant recipients. The main experiences performed by either standard Doppler echocardiography and new high-tech ultrasound technologies are summarised, pointing out advantages and limitations of the described techniques in diagnosing acute allograft rejection and cardiac graft vasculopathy. Despite the sustained efforts of echocardiographic technique in predicting the biopsy state, endocardial myocardial biopsies are still regarded as the gold standard for detection of acute allograft rejection. Conversely, stress echocardiography is able to identify accurately cardiac graft vasculopathy and has a recognised prognostic in this clinical setting. A normal stress-echo justifies postponement of invasive studies. Another use of transthoracic echocardiography is the monitorisation and the visualisation of the catheter during the performance of endomyocardial biopsy. Bedside stress echocardiography is even useful to select appropriately heart donors with brain death. The ultrasound monitoring is simple and effective for monitoring a safe performance of biopsy procedures.

  1. Echocardiography and cardiac resynchronisation therapy, friends or foes?

    van Everdingen, W M; Schipper, J C; van 't Sant, J; Ramdat Misier, K; Meine, M; Cramer, M J

    2016-01-01

    Echocardiography is used in cardiac resynchronisation therapy (CRT) to assess cardiac function, and in particular left ventricular (LV) volumetric status, and prediction of response. Despite its widespread applicability, LV volumes determined by echocardiography have inherent measurement errors, interobserver and intraobserver variability, and discrepancies with the gold standard magnetic resonance imaging. Echocardiographic predictors of CRT response are based on mechanical dyssynchrony. However, parameters are mainly tested in single-centre studies or lack feasibility. Speckle tracking echocardiography can guide LV lead placement, improving volumetric response and clinical outcome by guiding lead positioning towards the latest contracting segment. Results on optimisation of CRT device settings using echocardiographic indices have so far been rather disappointing, as results suffer from noise. Defining response by echocardiography seems valid, although re-assessment after 6 months is advisable, as patients can show both continuous improvement as well as deterioration after the initial response. Three-dimensional echocardiography is interesting for future implications, as it can determine volume, dyssynchrony and viability in a single recording, although image quality needs to be adequate. Deformation patterns from the septum and the derived parameters are promising, although validation in a multicentre trial is required. We conclude that echocardiography has a pivotal role in CRT, although clinicians should know its shortcomings. PMID:26645707

  2. Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction.

    Koestenberger, Martin; Friedberg, Mark K; Nestaas, Eirik; Michel-Behnke, Ina; Hansmann, Georg

    2016-03-01

    Transthoracic echocardiography (TTE) is the most accessible noninvasive diagnostic procedure for the initial assessment of pediatric pulmonary hypertension (PH). This review focuses on principles and use of TTE to determine morphologic and functional parameters that are also useful for follow-up investigations in pediatric PH patients. A basic echocardiographic study of a patient with PH commonly includes the hemodynamic calculation of the systolic pulmonary artery pressure (PAP), the mean and diastolic PAP, the pulmonary artery acceleration time, and the presence of a pericardial effusion. A more detailed TTE investigation of the right ventricle (RV) includes assessment of its size and function. RV function can be evaluated by RV longitudinal systolic performance (e.g., tricuspid annular plane systolic excursion), the tricuspid regurgitation velocity/right ventricular outflow tract velocity time integral ratio, the fractional area change, tissue Doppler imaging-derived parameters, strain measurements, the systolic-to-diastolic duration ratio, the myocardial performance (Tei) index, the RV/left ventricle (LV) diameter ratio, the LV eccentricity index, determination of an enlarged right atrium and RV size, and RV volume determination by 3-dimensional echocardiography. Here, we discuss the potential use and limitations of TTE techniques in children with PH and/or ventricular dysfunction. We suggest a protocol for TTE assessment of PH and myocardial function that helps to identify PH patients and their response to pharmacotherapy. The outlined protocol focuses on the detailed assessment of the hypertensive RV; RV-LV crosstalk must be analyzed separately in the evaluation of different pathologies that account for pediatric PH. PMID:27162612

  3. The 3-dimensional construction of the Rae craton, central Canada

    Snyder, David B.; Craven, James A.; Pilkington, Mark; Hillier, Michael J.

    2015-10-01

    Reconstruction of the 3-dimensional tectonic assembly of early continents, first as Archean cratons and then Proterozoic shields, remains poorly understood. In this paper, all readily available geophysical and geochemical data are assembled in a 3-D model with the most accurate bedrock geology in order to understand better the geometry of major structures within the Rae craton of central Canada. Analysis of geophysical observations of gravity and seismic wave speed variations revealed several lithospheric-scale discontinuities in physical properties. Where these discontinuities project upward to correlate with mapped upper crustal geological structures, the discontinuities can be interpreted as shear zones. Radiometric dating of xenoliths provides estimates of rock types and ages at depth beneath sparse kimberlite occurrences. These ages can also be correlated to surface rocks. The 3.6-2.6 Ga Rae craton comprises at least three smaller continental terranes, which "cratonized" during a granitic bloom. Cratonization probably represents final differentiation of early crust into a relatively homogeneous, uniformly thin (35-42 km), tonalite-trondhjemite-granodiorite crust with pyroxenite layers near the Moho. The peak thermotectonic event at 1.86-1.7 Ga was associated with the Hudsonian orogeny that assembled several cratons and lesser continental blocks into the Canadian Shield using a number of southeast-dipping megathrusts. This orogeny metasomatized, mineralized, and recrystallized mantle and lower crustal rocks, apparently making them more conductive by introducing or concentrating sulfides or graphite. Little evidence exists of thin slabs similar to modern oceanic lithosphere in this Precambrian construction history whereas underthrusting and wedging of continental lithosphere is inferred from multiple dipping discontinuities.

  4. Development and Validation of a 3-Dimensional CFB Furnace Model

    Vepsäläinen, Arl; Myöhänen, Karl; Hyppäneni, Timo; Leino, Timo; Tourunen, Antti

    At Foster Wheeler, a three-dimensional CFB furnace model is essential part of knowledge development of CFB furnace process regarding solid mixing, combustion, emission formation and heat transfer. Results of laboratory and pilot scale phenomenon research are utilized in development of sub-models. Analyses of field-test results in industrial-scale CFB boilers including furnace profile measurements are simultaneously carried out with development of 3-dimensional process modeling, which provides a chain of knowledge that is utilized as feedback for phenomenon research. Knowledge gathered by model validation studies and up-to-date parameter databases are utilized in performance prediction and design development of CFB boiler furnaces. This paper reports recent development steps related to modeling of combustion and formation of char and volatiles of various fuel types in CFB conditions. Also a new model for predicting the formation of nitrogen oxides is presented. Validation of mixing and combustion parameters for solids and gases are based on test balances at several large-scale CFB boilers combusting coal, peat and bio-fuels. Field-tests including lateral and vertical furnace profile measurements and characterization of solid materials provides a window for characterization of fuel specific mixing and combustion behavior in CFB furnace at different loads and operation conditions. Measured horizontal gas profiles are projection of balance between fuel mixing and reactions at lower part of furnace and are used together with both lateral temperature profiles at bed and upper parts of furnace for determination of solid mixing and combustion model parameters. Modeling of char and volatile based formation of NO profiles is followed by analysis of oxidizing and reducing regions formed due lower furnace design and mixing characteristics of fuel and combustion airs effecting to formation ofNO furnace profile by reduction and volatile-nitrogen reactions. This paper presents

  5. Digital tele-echocardiography: a look inside

    Daniele Giansanti

    2009-12-01

    Full Text Available Digital tele-echocardiography (T-E has the potentiality to allow relevant change in health care organization. The purpose of the paper is to analyze the scientific development around the digital T-E to explore the successful applications and individuate the limits which hamper the routine introduction in the National Health Care System (NHCS. A literature review was carried out by searching for studies from 1988 to 2008. The studies have been investigated according to four crucial issues: a the employment of the digital T-E versus the traditional videotape registrations; b the evolution of the telecommunication network and T-E; c the quality assessment of the images after transmission; d the economical legal and social impact of the T-E. The analysis showed a generalized increased diffusion of the digital T-E thanks to the wonderful development of the information technology. This diffusion was sometimes also accompanied by investigation studies on the diagnostic accuracy and on cost-benefit analysis with special care to the economical and social impact. The study examined some points which need to be improved to allow a better introduction of the T-E in the NHCS as a routine exam. Among these two were the most important. The first was the lacking of an easy and automatic methodology for the image quality assessment alternative to the currently used methods which are highly complex, expensive and needing a long time to be applied. The second was the lacking of a properly designed methodology for the health technology assessment in T-E, the latter, as it is well known is a very complex and heterogeneus system embedding parts from telematics, bioengineering, and medical physics.

  6. FETAL ECHOCARDIOGRAPHY: A STUDY OF CLINICAL OUTCOME

    Rajanish

    2014-01-01

    Full Text Available BACKGROUND : S tructural abnormalities of the heart and great vessels are fairly common congenital lab normalities with the incidenceof8 in 1000 live births. With the advent of real time scanners fetal cardia can atomy can be analyze d echocardiographically. The earlier diagnosis will make an impact on clinical management of fetus with congenital heart disease. It helps intimely triage and optimal management of specific congenital heart disease either structural , functional orarrhythmia . OBJECTIVES : This study was conducted to note the spectrum of congenital heart diseases detected on fetal echo in pregnant mothers referred with high risk for CHD sand to assess the outcome of prenatally detected congenital heart diseases. MATERIAL S AND METHODS : T he study is aprospective descriptive study conducted in a tertiary care pediatric hospital in Mumbai over period of one year . P regnant mothers were referred for fetal echo , where pregnancy was considered as high risk for CHDs due to maternal , fetalfactorsorabnormallevel 1 scan.Fetal echowas performed by a trained pediatric cardiologistat 18 to 20 week of gestation using HP sonos 2000 echocardiographicmachinewith3/3.5 Hz transducer. Cardiac lesionsandoutcome of pregnancy was noted by postnatal follow - up of patients. RESULTS : A total of 170 patients underwent fetal echo , 13 patients have not delivered and 48 were lost to follow - up. Fetal echo was normal in 130(76.4% and abnormalities were detected in 40(23.5%.Structural anomalies were seen in 24(14.1% , arrhythmia in 5(2.9% and functional abnormalities in 11(6.4%.On outcome analysis84 (77.1% arealive , IUD /terminationof pregnancyoccurred in 18(16.5% , neonatal death in 6 (5.5% , infant death in 1 (0.9%. CONCLUSIONS : All ranges of CHDs can be diagnosed by fetal echocardiography . O utcome of prenatally detected complex congenital heart disease is poor ; nonetheless earlier detection provides a n opportunity for early interventions and

  7. Age- and gender-specific reference values for cardiac chamber geometry and function using three-dimensional echocardiography

    Badano, Luigi P.

    2014-01-01

    Background. Three-dimensional echocardiography (3DE) enables a comprehensive, accurate and reproducible quantification of cardiac chamber size and function without any geometric assumption about their shape. Superior accuracy and reproducibility of 3DE over stabdard two-dimensional (2DE) approach for cardiac chamber volume measurements in comparison to cardiac magnetic resonance (CMR) has been well documented in a number of studies. Both the European Association of Cardiovascular Imag...

  8. Comparison of stability of sacroiliac screws in the treatment for unilateral Tile C sacral fractures between different modalities in a 3-dimensional finite element model%三种骶髂螺钉固定方式治疗单侧Tile C型骶骨骨折的稳定性比较

    赵勇; 张树栋; 孙涛; 王丹; 廉伟; 刘永厚; 谭江威; 邹德鑫

    2013-01-01

    Objective To study the stability of sacroiliac screws fixation for the treatment of unilateral vertical sacral fractures in order to provide pratical manipulation and reference for rapid insertion of sacroiliac screws in case of emergency.Methods A 3-dimensional finite element model of Tile C pelvic ring injury (unilateral type Denis Ⅱ fracture of sacrum) was made in a 36 year of a female patient.The unilateral sacral fractures were fixed in 3 types with sacroiliac screws in models respectively.The shift and angle displacement of the central superior surface of sacrum in the case of upright standing on both feet were measured and compared.Results The stability fixation with two sacroiliac screws for double planes of S1 and S2 segments was markedly superior to fixation with one sacroiliac screw for single plane of S1 or S2 segment; The vertical and rotational stability of sacroiliac screw fixation in S2 was superior to that in S1.Conclusions Fixation with two sacroiliac screws for double planes of S1 and S2 segments should be utilized for the fixation in unilateral sacral fractures of Tile C pelvic ring injury as possible.If only one sacroiliac screw is implanted,the fixation in S2 segment is more recommended than that in S1.%目的 对使用骶髂螺钉固定单侧Tile C型骶骨骨折的稳定性进行比较性研究,从而为急诊快速螺钉置入方案的制定提供预案和参考.方法 使用三维有限元方法,建立Tile C型骨盆损伤(右侧骶骨纵行骨折)模型,模拟使用3种骶髂螺钉固定方式进行固定,并在模拟站立位状态下对骨盆后环的竖直稳定性和后旋稳定性进行量化和比较.结果 S1、S2双层面2枚骶髂螺钉固定组合的稳定性明显优于S1或S2的单层面1枚骶髂螺钉;在S2层面1枚骶髂螺钉固定的稳定性优于S1层面.结论 针对Tile C型骨盆损伤的单侧骶骨纵行骨折,要尽可能选择双层面骶髂螺钉固定;如果使用单层面单枚骶髂螺钉固定治疗

  9. What every radiologist should know about paediatric echocardiography

    Congenital heart defects (CHD) occur in less than one percent of all newborns. Echocardiography represents the imaging modality of choice for morphological and functional assessment. In childhood the different CHD types can be diagnosed trustfully and can be performed bedside. In the follow-up of CHD cross sectional imaging plays an important role and therefore it is essential for the radiologist to know the features, challenges and limitations of echocardiography. Within this review article a systematic approach for morphological and functional assessment of the heart will is given along with representative example images. In addition, typical echocardiographic findings in common CHD is presented. In older children, adolescents and grown-ups with CHD (GUCH) echocardiography suffers from limitations – partially due to skeletal deformations and lung emphysema. In particular right ventricular function assessment is not always possible by echocardiography. Therefore strengths and limitations of echocardiography will be discussed the role of cardiac magnetic resonance imaging (cMRI) and cardiac computed tomography (cCT) emphasized

  10. Detection of congenital heart disease by fetal echocardiography

    Objective: The objective of the study was to determine the sensitivity, specificity, accuracy and predictive value of fetal echocardiography in our set up using postnatal echocardiography as gold standard. Study Design: Validation study. Place and Duration of study: This is an ongoing study in the Radiology department of CMH Rawalpindi and Armed Forces Institute of Cardiology (AFIC) Rawalpindi and the data collected from January 2007 to Jan 2012 is presented. Patients and Methods: Two hundred eighty seven patients reported for fetal echocardiography. Two hundred twenty nine patients were subsequently included in the study. These included patients of all ages who reported to the Radiology department of CMH Rawalpindi for fetal echocardiography. Fetal echo was done on Toshiba Aplio with 3.5 MHz probe having Doppler facility. Post natal evaluation was done by a pediatric cardiologist. Results: There were 207 (90.4%) true negative cases, 15 (6.6%) true positive, 2 (0.9%) false positive and 6 (2.2%) false negative cases. The sensitivity, specificity, positive and negative predictive values were 75%, 99%, 88%, 97% respectively. Conclusion: Fetal echocardiography has high specificity, negative predictive values and accuracy and cases diagnosed as normal can reassure the parents about the normal cardiac status of the fetus. (author)

  11. Speckle Tracking Echocardiography of the Right Atrium: The Neglected Chamber.

    Rai, Aitzaz Bin Sultan; Lima, Eduardo; Munir, Farrukh; Faisal Khan, Anum; Waqas, Ahmed; Bughio, Sara; ul Haq, Ehtesham; Attique, Hassan Bin; Rahman, Zia Ur

    2015-11-01

    The right atrium (RA) plays a pivotal role in electromechanical and endocrine regulation of the heart. Its peculiar anatomical features and phasic mechanical function make it distinct from ventricles. Various invasive and noninvasive techniques have been used to elucidate RA structure and function. Of these modalities, echocardiography has distinct advantages over others. Several conventional measures of RA function through echocardiography have been described in the literature, but they are load dependent. A relatively new technique is speckle tracking-derived strain, which is relatively less dependent on loading conditions. Speckle tracking echocardiography tracks acoustic scatters (speckles) of myocardium frame-by-frame to calculate strain or deformation of the myocardium. Speckle tracking echocardiography has been used extensively for strain assessment of the right and left ventricle to detect subtle disease pathology, to gain mechanistic insight, as a marker of ischemic metabolic memory, as an endpoint in clinical trials, and as a functional assessment tool. The RA is a relatively neglected chamber, as it is mostly studied for assessment of atrial mass lesions, for electrophysiological studies, and in animal models for physiological assessment. However, its role in the systolic and diastolic function of the right heart, pulmonary vascular pathology, congenital heart diseases, and combined electromechanical activation phenomena has been less explored or unexplored. Speckle tracking echocardiography is an ideal tool for the assessment of the RA because of its regional and global functional characterization, angle independence, and high temporal resolution. PMID:26418622

  12. What every radiologist should know about paediatric echocardiography

    Sorantin, Erich, E-mail: erich.sorantin@medunigraz.at [Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 34, A-8036 Graz (Austria); Heinzl, Bernd [Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Medical University Graz, Auenbruggerplatz 34, A-8036 Graz (Austria)

    2014-09-15

    Congenital heart defects (CHD) occur in less than one percent of all newborns. Echocardiography represents the imaging modality of choice for morphological and functional assessment. In childhood the different CHD types can be diagnosed trustfully and can be performed bedside. In the follow-up of CHD cross sectional imaging plays an important role and therefore it is essential for the radiologist to know the features, challenges and limitations of echocardiography. Within this review article a systematic approach for morphological and functional assessment of the heart will is given along with representative example images. In addition, typical echocardiographic findings in common CHD is presented. In older children, adolescents and grown-ups with CHD (GUCH) echocardiography suffers from limitations – partially due to skeletal deformations and lung emphysema. In particular right ventricular function assessment is not always possible by echocardiography. Therefore strengths and limitations of echocardiography will be discussed the role of cardiac magnetic resonance imaging (cMRI) and cardiac computed tomography (cCT) emphasized.

  13. Recommendations for terminology and display for doppler echocardiography

    Doppler echocardiography has recently emerged as a major noninvasive technique with many applications in cardiology. To a large extent, this has been based upon a combination of clinical and engineering advances which now make possible the use of quantitative Doppler echocardiography in combination with two-dimensional imaging for measurement of volume flows, transvalve gradients, and other physiologic flow parameters which reflect cardiac function. It was the purpose of this Committee to provide a glossary of terms which could be used in standard fashion for papers and discussions related to Doppler echocardiography. As part of its task, the Committee also undertook an attempt to recommend a standard for display of Doppler information which would be useful, both for manufacturers and for clinicians. The document, therefore, includes: Section I, the Committee's recommendations for Doppler display. Section II, the glossary of Doppler terms, related to engineering and to clinical applications

  14. False Positive Dobutamine Stress Echocardiography Induced by Esmolol

    Ali Hosseinsabet

    2014-03-01

    Full Text Available Dobutamine stress echocardiography is one of the several noninvasive methods for detection of coronary artery disease (1. New regional wall motion abnormalities have been reported in dobutamine stress echocardiograpghy after intravenous beta blocker administration (2, 3 Thus, this method has been recommended for increasing the test sensitivity (4. The sensitivity, specificity, accuracy, and positive and negative predictive values of dobutamin stress echocardiography without beta blocker have been reported to be 84%, 92%, 87%, 95%, and 77%, respectively. Using beta blocker, on the other hand, these measures have been reported as 92%, 89%, 91%, 94%, and 87%, respectively (3. In theory, beta blocker induced false positive dobutamine stress echocardiography can occur (5.

  15. Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

    Sonali S. Somani

    2016-01-01

    Conclusions: Present study shows significant functional changes in the cardiovascular dynamics during pregnancy. Doppler echocardiography provides an excellent noninvasive method for the evaluation and serial analysis of hemodynamic changes. These results will help in distinguishing abnormal echocardiographic changes from the normal physiologic changes of pregnancy. Therefore maternal echocardiography should be introduced into the antenatal management protocol, which will help to identify women at high risk to developing cardiovascular complications and there by early intervention. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 84-89

  16. Association of heart failure hospitalizations with combined electrocardiography and echocardiography criteria for left ventricular hypertrophy

    Gerdts, Eva; Okin, Peter M; Boman, Kurt;

    2012-01-01

    The value of performing echocardiography in hypertensive patients with electrocardiographic left ventricular hypertrophy (LVH) is uncertain.......The value of performing echocardiography in hypertensive patients with electrocardiographic left ventricular hypertrophy (LVH) is uncertain....

  17. Update of the Echocardiography Core Syllabus of the European Association of Cardiovascular Imaging (EACVI).

    Cosyns, Bernard; Garbi, Madalina; Separovic, Jadranka; Pasquet, Agnes; Lancellotti, Patrizio

    2013-01-01

    The update of the Echocardiography Core Syllabus of European Association of Cardiovascular Imaging (EACVI) is now available online. The Echocardiography Core Syllabus enumerates the elements of knowledge to be taught, represents a framework for the development of local training curricula and provides expected learning outcomes to the echocardiography learner.

  18. Screening for pulmonary arteriovenous malformations: contrast echocardiography versus pulse oximetry

    Oxhøj, H; Kjeldsen, A D; Nielsen, G

    2000-01-01

    purpose. The aim of this investigation was to compare pulse oximetry and contrast echocardiography as screening tools for detection of pulmonary arteriovenous malformations. Eighty-five hereditary haemorrhagic telangiectasia (HHT) patients and first-degree relatives identified in a comprehensive study of...

  19. [Real time 3D echocardiography in congenital heart disease].

    Acar, P; Dulac, Y; Taktak, A; Villacèque, M

    2004-05-01

    The introduction of the 3D mode in echocardiography has led to its use in everyday clinical practice. One hundred and fifty real time 3D echocardiographic examinations were performed in 20 foetus, 110 children and 20 adults with various congenital heart lesions (shunts, valvular lesions, aortic diseases). The 4x matricial probe enables the instantaneous acquisition of transthoracic volumes. Four modes of 3D imaging were used: real time, total volume, colour Doppler and biplane. Quantitative measurements were performed at an outlying station. The feasibility of the method in the foetus, the child and the adult was respectively 90%, 99% and 85%. Real time 3D echocardiography did not affect the diagnoses made by standard echocardiography. The 3D imaging gave a more accurate description of atrial septal defects and congenital valvular lesions. Biplane imaging was decisive in the quantitative approach to aortic dilatation of Marfan's syndrome and in segmental analysis of the foetal heart. 3D colour Doppler imaging has been disappointing but the possibilities of volumic quantification of blood flow are very promising. The present limitations of the method are the inadequate resolution in the small child and the absence of quantitative measurement on the echograph. The facility of utilisation of the matricial probe should lead to routine usage of 3D echocardiography as with 2D and the Doppler modes. Its value should be decisive in many congenital cardiac lesions requiring surgery or interventional catheterisation. PMID:15214550

  20. Prognostic value of dobutamine stress echocardiography in patients with diabetes

    F. Sozzi (Fabiola); A. Elhendy (Abdou); A.F.L. Schinkel (Arend); E.C. Vourvouri (Eleni); J.J. Bax (Jeroen); J. de Sutter; A. Borghetti; D. Poldermans (Don); J.R.T.C. Roelandt (Jos); R.T. van Domburg (Ron)

    2003-01-01

    textabstractOBJECTIVE: The aim of this study was to assess the incremental value of dobutamine stress echocardiography (DSE) for the risk stratification of diabetic patients who are unable to perform an adequate exercise stress test. Exercise capacity is frequently impaired in pati

  1. Speckle tracking echocardiography in mature Irish Wolfhound dogs

    Westrup, Ulrik; McEvoy, Fintan

    2013-01-01

    Two-dimensional strain measurements obtained by speckle tracking echocardiography (STE) have been reported in both humans and dogs. Incorporation of this technique into canine clinical practice requires the availability of measurements from clinically normal dogs, ideally of the same breed, taken...

  2. Various approaches to the modelling of large scale 3-dimensional circulation in the Ocean

    Shaji, C.; Bahulayan, N.; Rao, A.D; Dube, S.K.

    In this paper, the three different approaches to the modelling of large scale 3-dimensional flow in the ocean such as the diagnostic, semi-diagnostic (adaptation) and the prognostic are discussed in detail. Three-dimensional solutions are obtained...

  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. The 3-dimensional Einstein-Klein-Gordon system in characteristic numerical relativity

    Barreto, W.; Da Silva, A.; Gomez, R.; Lehner, L.; Rosales, L.; Winicour, J.

    2005-01-01

    We incorporate a massless scalar field into a 3-dimensional code for the characteristic evolution of the gravitational field. The extended 3-dimensional code for the Einstein--Klein--Gordon system is calibrated to be second order convergent. It provides an accurate calculation of the gravitational and scalar radiation at infinity. As an application, we simulate the fully nonlinear evolution of an asymmetric scalar pulse of ingoing radiation propagating toward an interior Schwarzschild black h...

  5. 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...

  6. A comparison of VRML and animation of rotation for teaching 3-dimensional crystal lattice structures

    Sauls, Barbara Lynn

    Chemistry students often have difficulty visualizing abstract concepts of molecules and atoms, which may lead to misconceptions. The three-dimensionality of these structures presents a challenge to educators. Typical methods of teaching include text with two-dimensional graphics and structural models. Improved methods to allow visualization of 3D structures may improve learning of these concepts. This research compared the use of Virtual Reality Modeling Language (VRML) and animation of rotation for teaching three-dimensional structures. VRML allows full control of objects by altering angle, size, rotation, and provides the ability to zoom into and through objects. Animations may only be stopped, restarted and replayed. A web-based lesson teaching basic concepts of crystals, which requires comprehension of their three-dimensional structure was given to 100 freshmen chemistry students. Students were stratified by gender then randomly to one of two lessons, which were identical except for the multimedia method used to show the lattices and unit cells. One method required exploration of the structures using VRML, the other provided animations of the same structures rotating. The students worked through an examination as the lesson progressed. A Welch t' test was used to compare differences between groups. No significant difference in mean achievement was found between the two methods, between genders, or within gender. There was no significant difference in mean total SAT in the animation and VRML group. Total time on task had no significant difference nor did enjoyment of the lesson. Students, however, spent 14% less time maneuvering VRML structures than viewing the animations of rotation. Neither method proved superior for presenting three-dimensional information. The students spent less time maneuvering the VRML structures with no difference in mean score so the use of VRML may be more efficient. The investigator noted some manipulation difficulties using VRML to rotate structures. Some students had difficulty obtaining the correct angle required to properly interpret spatial relationships. This led to frustration and caused some students to quit trying before they could answer questions fully. Even though there were some difficulties, outcomes were not affected. Higher scores, however, may have been achieved had the students been proficient in VRML maneuvering.

  7. Comparison of 1-, 2-, and 3-dimensional modeling of the TFTR for nuclear radiation transport analysis

    The computational models of the TFTR constructed for the radiation transport analysis for the Q approx. 1 demonstration are summarized and reviewed. These models can be characterized by the dimensionality required to describe the geometry, and by the numerical methods of solving the transport equation. Results obtained with these models in the test cell are compared and discussed

  8. Assessment of right ventricular systolic function by tissue Doppler echocardiography

    Kjærgaard, Jesper

    2012-01-01

    right ventricular hemodynamics: pulmonary embolism, Arrhythmogenic right ventricular cardiomyopathy and pulmonary regurgitation, the latter in an animal model. The conclusions of the thesis are: Color tissue Doppler echocardiography accurately measures velocities, SR and strain in vitro. No systematic......This thesis summarizes a series of studies performed in order to assess the clinical usefulness of a novel echocardiographic technology that allows non-invasive assessment of regional right ventricular myocardial velocities and deformation: tissue Doppler echocardiography. While the technology is a...... promising tool for improving our understanding of right ventricular hemodynamics, several aspects of the technology must be evaluated. The accuracy and reproducibility of the technology is evaluated in vitro, and normal values, impact of changes in loading of the right ventricle, response to exercise and...

  9. On-Orbit Prospective Echocardiography on International Space Station

    Hamilton, Douglas R.; Sargsyan, Ashot E.; Martin, David; Garcia, Kathleen M.; Melton, Shannon; Feiverson, Alan; Dulchavsky, Scott A.

    2010-01-01

    A number of echocardiographic research projects and experiments have been flown on almost every space vehicle since 1970, but validation of standard methods and the determination of Space Normal cardiac function has not been reported to date. Advanced Diagnostics in Microgravity (ADUM) -remote guided echocardiographic technique provides a novel and effective approach to on-board assessment of cardiac physiology and structure using a just-in-time training algorithm and real-time remote guidance aboard the International Space Station (ISS). The validation of remotely guided echocardiographic techniques provides the procedures and protocols to perform scientific and clinical echocardiography on the ISS and the Moon. The objectives of this study were: 1.To confirm the ability of non-physician astronaut/cosmonaut crewmembers to perform clinically relevant remotely guided echocardiography using the Human Research Facility on board the ISS. 2.To compare the preflight, postflight and in-flight echocardiographic parameters commonly used in clinical medicine.

  10. Diagnostic Value of Fetal Echocardiography for Congenital Heart Disease

    Zhang, Ya-Fei; Zeng, Xian-Ling; Zhao, En-Fa; Lu, Hong-Wei

    2015-01-01

    Abstract Prenatal diagnosis of fetal congenital heart disease (CHD) has been shown to have a significant effect on prenatal and postnatal management and outcomes. However, the factors influencing the diagnostic accuracy and which pregnant trimester is the most adaptive for fetal heart disease remain uncertain despite of extensive researches. The aim of the present study was to evaluate the accuracy of echocardiography for detecting CHD and potential influence factors. We searched Chinese Biom...

  11. How standard transesophageal echocardiography views change with dextrocardia

    Raut, Monish S.; Arun Maheshwari; Sujay Shad; G Rachna

    2013-01-01

    Dextrocardia with situs inversus is a rare condition. Situs inversus with dextrocardia is also called as "situs inversus totalis". Transesophageal echocardiography (TEE) views in dextrocardia patient are not discussed in the literature. The cardiac position and the cardiac chambers are mirror image of the normal anatomy. Because of this positional change, certain TEE probe and multiplane angle manipulations are required to obtain the recommended views.

  12. How standard transesophageal echocardiography views change with dextrocardia

    Monish S Raut

    2013-01-01

    Full Text Available Dextrocardia with situs inversus is a rare condition. Situs inversus with dextrocardia is also called as "situs inversus totalis". Transesophageal echocardiography (TEE views in dextrocardia patient are not discussed in the literature. The cardiac position and the cardiac chambers are mirror image of the normal anatomy. Because of this positional change, certain TEE probe and multiplane angle manipulations are required to obtain the recommended views.

  13. Non-ischaemic cardiac conditions: role of stress echocardiography

    Chenzbraun, Adrian

    2014-01-01

    Stress echocardiography (SE) has a unique ability for simultaneous assessment of both functional class and exercise-related haemodynamic changes and as such is increasingly recognised for the evaluation of non-coronary artery disease pathologies. Some indications such as valvular heart disease or hypertrophic cardiomyopathy have been well established already, while others such as diastolic exercise testing are emerging of late. This paper addresses the main and best established indications fo...

  14. Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis

    Kim, Moon Young; Baik, Soon Koo; Won, Chan Sik; Park, Hong Jun; Jeon, Hyo Keun; Hong, Hyun Il; Kim, Jae Woo; Kim, Hyun Soo; Kwon, Sang Ok; Kim, Jang Young; Yoo, Byung Su; Lee, Seung Hwan

    2010-01-01

    Background/Aims The blunted ventricular systolic and diastolic contractile responses to physical and pharmacological stress in cirrhosis are termed cirrhotic cardiomyopathy (CCM). CCM has been known to involve multiple defects in the β-adrenergic signaling pathway. The aim of this study was to determine whether cirrhotic patients have blunted cardiac responses to catecholamine stimulation through dobutamine stress echocardiography (DSE). Methods Seventy-one cirrhotic patients with normal left...

  15. Influence of psoriasis on circulatory system function assessed in echocardiography

    Milaniuk, Sylwia; Pietrzak, Aldona; Mosiewicz, Barbara; Mosiewicz, Jerzy; Reich, Kristian

    2015-01-01

    Psoriasis vulgaris is a chronic disease with a multifactorial pathogenesis. It affects about 2–4 % of the population all over the world. In course of psoriatic arthritis, joints’ damages are observed. In patients with psoriasis vulgaris and psoriatic arthritis, there is increased morbidity and mortality caused by cardiovascular diseases observed. The aim of the study is to analyze the echocardiography of patients with psoriasis vulgaris and psoriatic arthritis on the basis of the literature a...

  16. Automated volume measurements in echocardiography by utilizing expert knowledge

    2009-01-01

    Left ventricular (LV) volumes and ejection fraction (EF) are important parameters for diagnosis, prognosis, and treatment planning in patients with heart disease. These parameters are commonly measured by manual tracing in echocardiographic images, a procedure that is time consuming, prone to inter- and intra-observer variability, and require highly trained operators. This is particularly the case in three-dimensional (3D) echocardiography, where the increased amount of data makes manual trac...

  17. Portopulmonary hypertension: Improved detection using CT and echocardiography in combination

    Devaraj, Anand [Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, London (United Kingdom); Loveridge, Robert; Bernal, William; Willars, Christopher; Wendon, Julia A.; Auzinger, Georg [King' s College Hospital NHS Foundation Trust, The Institute of Liver Studies, King' s Health Partners, King' s College London, London (United Kingdom); Bosanac, Diana; Stefanidis, Konstantinos; Desai, Sujal R. [King' s College Hospital NHS Foundation Trust, Department of Radiology, King' s Health Partners, King' s College London, London (United Kingdom)

    2014-10-15

    To establish the relationship between CT signs of pulmonary hypertension and mean pulmonary artery pressure (mPAP) in patients with liver disease, and to determine the additive value of CT in the detection of portopulmonary hypertension in combination with transthoracic echocardiography. Forty-nine patients referred for liver transplantation were retrospectively reviewed. Measured CT signs included the main pulmonary artery/ascending aorta diameter ratio (PA/AA{sub meas}) and the mean left and right main PA diameter (RLPA{sub meas}). Enlargement of the pulmonary artery compared to the ascending aorta was also assessed visually (PA/AA{sub vis}). CT measurements were correlated with right-sided heart catheter-derived mPAP. The ability of PA/AA{sub vis} combined with echocardiogram-derived right ventricular systolic pressure (RVSP) to detect portopulmonary hypertension was tested with ROC analysis. There were moderate correlations between mPAP and both PA/AA{sub meas} and RLPA{sub meas} (r{sub s} = 0.41 and r{sub s} = 0.42, respectively; p < 0.005). Compared to transthoracic echocardiography alone (AUC = 0.59, p = 0.23), a diagnostic algorithm incorporating PA/AA{sub vis} and transthoracic echocardiography-derived RVSP improved the detection of portopulmonary hypertension (AUC = 0.8, p < 0.0001). CT contributes to the non-invasive detection of portopulmonary hypertension when used in a diagnostic algorithm with transthoracic echocardiography. CT may have a role in the pre-liver transplantation triage of patients with portopulmonary hypertension for right-sided heart catheterisation. (orig.)

  18. Role of echocardiography in diagnosis of pulmonary hypertension

    Srbinovska Kostovska Elizabeta

    2013-07-01

    Full Text Available Pulmonary hypertension (PH is a progressive process that leads to right ventricular (RV overload, hypertrophy, dilatation and RV failure. In cases with chronic heart failure, this condition is associated with more severe symptoms and worse outcomes.Transthoracic echocardiography can give several parameters which correlate with right heart haemodynamics, and should be performed in a case of suspected PH. Several parameters are important for estimation of the RV function, which can be reason for poor outcome: right atrial and ventricular dimensions and volumes, functional area changes, tricuspid annular plane systolic excursion (TAPSE, myocardial performance index, infe- rior vena cava size and collapsibility, S velocity estimated by Tissue Doppler Imaging, and additional information obtained from the advance echocardiograpic techniques, like strain, strain rate, three-dimensional echocardiography. Estimation of PH based on Doppler echo- cardiography measurements is not suitable for screening of mild, asymptomatic PH. Echocardiography can be recommended as a screening tool for specific diseases, follow up PH, and assessment when right heart catheterization is indicated.

  19. Portopulmonary hypertension: Improved detection using CT and echocardiography in combination

    To establish the relationship between CT signs of pulmonary hypertension and mean pulmonary artery pressure (mPAP) in patients with liver disease, and to determine the additive value of CT in the detection of portopulmonary hypertension in combination with transthoracic echocardiography. Forty-nine patients referred for liver transplantation were retrospectively reviewed. Measured CT signs included the main pulmonary artery/ascending aorta diameter ratio (PA/AAmeas) and the mean left and right main PA diameter (RLPAmeas). Enlargement of the pulmonary artery compared to the ascending aorta was also assessed visually (PA/AAvis). CT measurements were correlated with right-sided heart catheter-derived mPAP. The ability of PA/AAvis combined with echocardiogram-derived right ventricular systolic pressure (RVSP) to detect portopulmonary hypertension was tested with ROC analysis. There were moderate correlations between mPAP and both PA/AAmeas and RLPAmeas (rs = 0.41 and rs = 0.42, respectively; p vis and transthoracic echocardiography-derived RVSP improved the detection of portopulmonary hypertension (AUC = 0.8, p < 0.0001). CT contributes to the non-invasive detection of portopulmonary hypertension when used in a diagnostic algorithm with transthoracic echocardiography. CT may have a role in the pre-liver transplantation triage of patients with portopulmonary hypertension for right-sided heart catheterisation. (orig.)

  20. Dobutamine stress echocardiography in healthy adult male rats

    Couet Jacques

    2005-10-01

    Full Text Available Abstract Background Dobutamine stress echocardiography is used to investigate a wide variety of heart diseases in humans. Dobutamine stress echocardiography has also been used in animal models of heart disease despite the facts that the normal response of healthy rat hearts to this type of pharmacological stress testing is unknown. This study was performed to assess this normal response. Methods 15 normal adult male Wistar rats were evaluated. Increasing doses of dobutamine were infused intravenously under continuous imaging of the heart by a 12 MHz ultrasound probe. Results Dobutamine stress echocardiography reduced gradually LV diastolic and systolic dimensions. Ejection fraction increased by a mean of +24% vs. baseline. Heart rate increased progressively without reaching a plateau. Changes in LV dimensions and ejection fraction reached a plateau after a mean of 4 minutes at a constant infusion rate. Conclusion DSE can be easily performed in rats. The normal response is an increase in heart rate and ejection fraction and a decrease in LV dimensions. A plateau in echocardiographic measurements is obtained after 4 minutes of a constant infusion rate in most animals.

  1. Quantitative analysis of aortic regurgitation: real-time 3-dimensional and 2-dimensional color Doppler echocardiographic method--a clinical and a chronic animal study

    Shiota, Takahiro; Jones, Michael; Tsujino, Hiroyuki; Qin, Jian Xin; Zetts, Arthur D.; Greenberg, Neil L.; Cardon, Lisa A.; Panza, Julio A.; Thomas, James D.

    2002-01-01

    BACKGROUND: For evaluating patients with aortic regurgitation (AR), regurgitant volumes, left ventricular (LV) stroke volumes (SV), and absolute LV volumes are valuable indices. AIM: The aim of this study was to validate the combination of real-time 3-dimensional echocardiography (3DE) and semiautomated digital color Doppler cardiac flow measurement (ACM) for quantifying absolute LV volumes, LVSV, and AR volumes using an animal model of chronic AR and to investigate its clinical applicability. METHODS: In 8 sheep, a total of 26 hemodynamic states were obtained pharmacologically 20 weeks after the aortic valve noncoronary (n = 4) or right coronary (n = 4) leaflet was incised to produce AR. Reference standard LVSV and AR volume were determined using the electromagnetic flow method (EM). Simultaneous epicardial real-time 3DE studies were performed to obtain LV end-diastolic volumes (LVEDV), end-systolic volumes (LVESV), and LVSV by subtracting LVESV from LVEDV. Simultaneous ACM was performed to obtain LVSV and transmitral flows; AR volume was calculated by subtracting transmitral flow volume from LVSV. In a total of 19 patients with AR, real-time 3DE and ACM were used to obtain LVSVs and these were compared with each other. RESULTS: A strong relationship was found between LVSV derived from EM and those from the real-time 3DE (r = 0.93, P clinically applicable.

  2. Assessment of right ventricular systolic function by tissue Doppler echocardiography.

    Kjærgaard, Jesper

    2012-03-01

    This thesis summarizes a series of studies performed in order to assess the clinical usefulness of a novel echocardiographic technology that allows non-invasive assessment of regional right ventricular myocardial velocities and deformation: tissue Doppler echocardiography. While the technology is a promising tool for improving our understanding of right ventricular hemodynamics, several aspects of the technology must be evaluated. The accuracy and reproducibility of the technology is evaluated in vitro, and normal values, impact of changes in loading of the right ventricle, response to exercise and pharmacological pulmonary vasodilatation is established in normal subjects. The diagnostic and prognostic importance of adding tissue Doppler echocardiography to conventional echocardiographic and clinical parameters was evaluated in studies on patients with diseases associated with different modes of impact on right ventricular hemodynamics: pulmonary embolism, Arrhythmogenic right ventricular cardiomyopathy and pulmonary regurgitation, the latter in an animal model. The conclusions of the thesis are: Color tissue Doppler echocardiography accurately measures velocities, SR and strain in vitro. No systematic bias between ultrasound systems can be found, and accuracy of the measurements is good. However, the reproducibility of measurements in a test-retest design can limit the usefulness of the technology in daily clinical use, as 25% to 80% of change would be needed for the technology to identify a change in individual patients [I]. Normal values of tissue Doppler based measurements of RV regional velocities, SR and strain exist, and apply to both sexes and in all age groups with the exception of slightly decreasing values in strain with increasing age. Increasing preload and afterload changes regional myocardial velocities, but no changes in SR, strain or isovolumic acceleration could be observed [II and III]. Tissue Doppler echocardiography of the RV free wall in non

  3. The 3-Dimensional q-Deformed Harmonic Oscillator and Magic Numbers of Alkali Metal Clusters

    Bonatsos, Dennis; Raychev, P P; Roussev, R P; Terziev, P A; Bonatsos, Dennis

    1999-01-01

    Magic numbers predicted by a 3-dimensional q-deformed harmonic oscillator with Uq(3) > SOq(3) symmetry are compared to experimental data for alkali metal clusters, as well as to theoretical predictions of jellium models, Woods--Saxon and wine bottle potentials, and to the classification scheme using the 3n+l pseudo quantum number. The 3-dimensional q-deformed harmonic oscillator correctly predicts all experimentally observed magic numbers up to 1500 (which is the expected limit of validity for theories based on the filling of electronic shells), thus indicating that Uq(3), which is a nonlinear extension of the U(3) symmetry of the spherical (3-dimensional isotropic) harmonic oscillator, is a good candidate for being the symmetry of systems of alkali metal clusters.

  4. Speckle tracking echocardiography in chronic obstructive pulmonary disease and overlapping obstructive sleep apnea

    Pizarro C

    2016-08-01

    did not significantly vary either in comparison to controls (P=0.07 or throughout the COPD Global Initiative for Chronic Obstructive Lung Disease stages (P=0.49. COPD-OSA overlap solely correlated with nocturnal hypoxemic events, whereas LV performance status was unrelated to coexisting OSA.Conclusion: To conclude, COPD itself seems to be accompanied with decreased LV deformation properties that worsen over COPD severity stages, but do not vary in case of overlapping OSA. Keywords: chronic obstructive pulmonary disease, speckle tracking echocardiography, left ventricular dysfunction, overlap syndrome

  5. A Fortran program (RELAX3D) to solve the 3 dimensional Poisson (Laplace) equation

    RELAX3D is an efficient, user friendly, interactive FORTRAN program which solves the Poisson (Laplace) equation Λ2=p for a general 3 dimensional geometry consisting of Dirichlet and Neumann boundaries approximated to lie on a regular 3 dimensional mesh. The finite difference equations at these nodes are solved using a successive point-iterative over-relaxation method. A menu of commands, supplemented by HELP facility, controls the dynamic loading of the subroutine describing the problem case, the iterations to converge to a solution, and the contour plotting of any desired slices, etc

  6. In-vivo continuous monitoring of mixed venous oxygen saturation by photoacoustic transesophageal echocardiography (Conference Presentation)

    Li, Li; Subramaniam, Balachundhar; Aguirre, Aaron D.; Andrawes, Michael N.; Tearney, Guillermo J.

    2016-02-01

    Mixed venous oxygen saturation (SvO2), measured from pulmonary arteries, is a gold-standard measure of the dynamic balance between the oxygen supply and demand in the body. In critical care, continuous monitoring of SvO2 plays a vital role in early detection of circulatory shock and guiding goal-oriented resuscitation. In current clinical practice, SvO2 is measured by invasive pulmonary artery catheters (PAC), which are associated with a 10% risk of severe complications. To address the unmet clinical need for a non-invasive SvO2 monitor, we are developing a new technology termed photoacoustic transesophageal echocardiography (PA-TEE). PA-TEE integrates transesophageal echocardiography with photoacoustic oximetry, and enables continuous assessment of SvO2 through an esophageal probe that can be inserted into the body in a minimally invasive manner. We have constructed a clinically translatable PA-TEE prototype, which features a mobile OPO laser, a modified ultrasonography console and a dual-modality esophageal probe. Comprised of a rotatable acoustic array detector, a flexible optical fiber bundle and a light-integrating acoustic lens, the oximetric probe has an outer diameter smaller than 15 mm and will be tolerable for most patients. Through custom-made C++/Qt software, our device acquires and displays ultrasonic and photoacoustic images in real time to guide the deployment of the probe. SvO2 is calculated on-line and updated every second. PA-TEE has now been used to evaluate SvO2 in living swine. Our findings show that changing the fraction of oxygen in the inspired gas modulates SvO2 measured by PA-TEE. Statistic comparison between SvO2 measurements from PA-TEE in vivo the gold-standard laboratorial analysis on blood samples drawn from PACs will be presented.

  7. Reliability of quantitative echocardiography in adult sheep and goats

    Hallowell Gayle D

    2012-09-01

    Full Text Available Abstract Background Echocardiography is a non-invasive method for assessment of the ovine and caprine heart. Complete reference ranges for cardiac dimensions and time indices for both species are not currently available and reliability of these measurements has not been evaluated. The objectives for this study are to report reliability, normal cardiac dimensions and time indices in a large group of adult sheep and goats. Fifty-one adult sheep and forty adult goats were recruited. Full echocardiographic examinations were performed in the standing unsedated animal. All animals underwent echocardiography four times in a 72-hour period. Echocardiography was performed three times by one author and once by another. Images were stored and measured offline. Technique and measurement repeatability and reproducibility and any differences due to animal or day were evaluated. Reference ranges (mean ± 2 standard deviations were calculated for both species. Results Majority of the images obtained were of good to excellent quality. Image acquisition was straightforward with 5.4% of animals demonstrating a small scanning window. Reliability was excellent for majority of dimensions and time indices. There was less variation in repeatability when compared with reproducibility and differences were greater for technique than for measurements. Dimensions that were less reliable included those for right ventricular diameter and left ventricular free wall. There were many differences in cardiac dimensions between sheep and goats. Conclusions This study has demonstrated that specific reference ranges are required for these two species. Repeatability and reproducibility were excellent for the majority of cardiac dimensions and time indices suggesting that this technique is reliable and valuable for examination of clinical cases over time and for longitudinal research studies.

  8. Recent advances in echocardiography: strain and strain rate imaging

    Mirea, Oana; Duchenne, Jurgen; Voigt, Jens-Uwe

    2016-01-01

    Deformation imaging by echocardiography is a well-established research tool which has been gaining interest from clinical cardiologists since the introduction of speckle tracking. Post-processing of echo images to analyze deformation has become readily available at the fingertips of the user. New parameters such as global longitudinal strain have been shown to provide added diagnostic value, and ongoing efforts of the imaging societies and industry aimed at harmonizing methods will improve the technique further. This review focuses on recent advances in the field of echocardiographic strain and strain rate imaging, and provides an overview on its current and potential future clinical applications.

  9. Echocardiography for the Assessment of Congenital Heart Defects in Calves.

    Mitchell, Katharyn Jean; Schwarzwald, Colin Claudio

    2016-03-01

    Congenital heart disease should be considered when evaluating calves with chronic respiratory signs, failure to thrive, poor growth, or if a murmur is heard on physical examination. Echocardiography is currently the gold standard for diagnosing congenital heart defects. A wide variety of defects, either alone or in combination with a ventricular septal defect, are possible. A standardized approach using sequential segmental analysis is required to fully appreciate the nature and severity of more complex malformations. The prognosis for survival varies from guarded to poor and depends on the hemodynamic relevance of the defects and the degree of cardiac compensation. PMID:26922111

  10. The Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation

    Elad Anter, MD

    2009-10-01

    Full Text Available Radiofrequency catheter ablation of pulmonary veins has emerged as an effective therapy for patients with symptomatic atrial fibrillation. Advances in real-time intracardiac echocardiography with 2D and Doppler color flow imaging have led to it integration in atrial fibrillation ablation procedures. It allows imaging of the left atrium and pulmonary veins, including identification of anatomic variations. It has an important role in guiding transseptal catheterization, imaging the pulmonary vein ostia, assisting in accurate placement of mapping and ablation catheters, monitoring lesion morphology and flow changes in the ablated pulmonary veins, hence allowing titration of energy delivery. Importantly, it allows instant detection of procedural complications.

  11. Live/real time three-dimensional transesophageal echocardiography.

    Sudhakar, Selvin; Khairnar, Prakash; Nanda, Navin C

    2012-01-01

    Since the advent of matrix array transducer, three-dimensional transesophageal echocardiography has come to frequent clinical use. It has significantly enhanced the communication between the operators and cardiac imagers in the operating room as well as in the cardiac interventional labs. This article reviews the history, technological aspects, and the protocol for acquisition and processing of the data sets. It also discusses its advantages in various clinical scenarios, both in diagnostic and therapeutic situations. It highlights its limitations in the current form and prospects of future development. PMID:23186294

  12. The Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation

    Elad Anter

    2009-10-01

    Full Text Available Radiofrequency catheter ablation of pulmonary veins has emerged as an effective therapy for patients with symptomatic atrial fibrillation. Advances in real-time intracardiac echocardiography with 2D and Doppler color flow imaging have led to its integration in atrial fibrillation ablation procedures. It allows imaging of the left atrium and pulmonary veins, including identification of anatomic variations. It has an important role in guiding transseptal catheterization, imaging the pulmonary vein ostia, assisting in accurate placement of mapping and ablation catheters, monitoring lesion morphology and flow changes in the ablated pulmonary veins, hence allowing titration of energy delivery. Importantly, it allows instant detection of procedural complications.

  13. Intracardiac echocardiography to diagnose pannus formation after aortic valve replacement.

    Yamamoto, Yoshiya; Ohara, Takahiro; Funada, Akira; Takahama, Hiroyuki; Amaki, Makoto; Hasegawa, Takuya; Sugano, Yasuo; Kanzaki, Hideaki; Anzai, Toshihisa

    2016-03-01

    A 66-year-old female, under regular follow-up for 20 years after aortic valve replacement (19-mm Carbomedics), presented dyspnea on effort and hypotension during hemodialysis. A transthoracic echocardiogram showed elevation of transvalvular velocity up to 4 m/s, but the structure around the aortic prosthesis was difficult to observe due to artifacts. Fluoroscopy revealed normal motion of the leaflets of the mechanical valve. Intracardiac echocardiography (ICE) revealed a pannus-like structure in the left ventricular outflow tract. Transesophageal echocardiogram also revealed this structure. ICE can visualize structural abnormalities around a prosthetic valve after cardiac surgery even in patients in whom conventional imaging modalities failed. PMID:26732266

  14. 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

  15. Fast convergence to an invariant measure for non-intersecting 3-dimensional Brownian paths

    Lawler, Gregory F

    2010-01-01

    We consider pairs of 3-dimensional Brownian paths, started at the origin and conditioned to have no intersections after time zero. We show that there exists a unique measure on pairs of paths that is invariant under this conditioning, while improving the previously known rate of convergence to stationarity.

  16. 3-Dimensional Cahn-Hilliard Equation with Concentration Dependent Mobility and Gradient Dependent Potential

    Rui HUANG; Yang CAO

    2011-01-01

    In this paper we investigate the initial boundary value problem of Cahn-Hilliard equation with concentration dependent mobility and gradient dependent potential. By the energy method and the theory of Campanato spaces, we prove the existence and the uniqueness of classical solutions in 3-dimensional space.

  17. Dynamics of large scale 3-dimensional circulation of the Indian Ocean

    Swapna, P.

    One of the main objective of this thesis is to adapt and configure a fully non-linear, primitive equation type, sigma co-ordinate 3-dimensional circulation model for the entire Indian Ocean area which can be run on diagnostic, semi...

  18. Full 3-dimensional digital workflow for multicomponent dental appliances : A proof of concept

    van der Meer, W. Joerd; Vissink, Arjan; Ren, Yijin

    2016-01-01

    BACKGROUND: The authors used a 3-dimensional (3D) printer and a bending robot to produce a multicomponent dental appliance to assess whether 3D digital models of the dentition are applicable for a full digital workflow. METHODS: The authors scanned a volunteer's dentition with an intraoral scanner (

  19. Study of new chaotic flows on a family of 3-dimensional systems with quadratic nonlinearities

    Based on a wider systematic search on a family of 3-dimensional systems with quadratic nonlinearities, three new simple chaotic systems were found. One of them has the unusual feature of having a stable equilibrium point, and it is the simplest one of other chaotic flows with this property. The others have some interesting special properties

  20. 3-dimensional orthodontics visualization system with dental study models and orthopantomograms

    Zhang, Hua; Ong, S. H.; Foong, K. W. C.; Dhar, T.

    2005-04-01

    The aim of this study is to develop a system that provides 3-dimensional visualization of orthodontic treatments. Dental plaster models and corresponding orthopantomogram (dental panoramic tomogram) are first digitized and fed into the system. A semi-auto segmentation technique is applied to the plaster models to detect the dental arches, tooth interstices and gum margins, which are used to extract individual crown models. 3-dimensional representation of roots, generated by deforming generic tooth models with orthopantomogram using radial basis functions, is attached to corresponding crowns to enable visualization of complete teeth. An optional algorithm to close the gaps between deformed roots and actual crowns by using multi-quadratic radial basis functions is also presented, which is capable of generating smooth mesh representation of complete 3-dimensional teeth. User interface is carefully designed to achieve a flexible system with as much user friendliness as possible. Manual calibration and correction is possible throughout the data processing steps to compensate occasional misbehaviors of automatic procedures. By allowing the users to move and re-arrange individual teeth (with their roots) on a full dentition, this orthodontic visualization system provides an easy and accurate way of simulation and planning of orthodontic treatment. Its capability of presenting 3-dimensional root information with only study models and orthopantomogram is especially useful for patients who do not undergo CT scanning, which is not a routine procedure in most orthodontic cases.

  1. 3-Dimensional and Interactive Istanbul University Virtual Laboratory Based on Active Learning Methods

    Ince, Elif; Kirbaslar, Fatma Gulay; Yolcu, Ergun; Aslan, Ayse Esra; Kayacan, Zeynep Cigdem; Alkan Olsson, Johanna; Akbasli, Ayse Ceylan; Aytekin, Mesut; Bauer, Thomas; Charalambis, Dimitris; Gunes, Zeliha Ozsoy; Kandemir, Ceyhan; Sari, Umit; Turkoglu, Suleyman; Yaman, Yavuz; Yolcu, Ozgu

    2014-01-01

    The purpose of this study is to develop a 3-dimensional interactive multi-user and multi-admin IUVIRLAB featuring active learning methods and techniques for university students and to introduce the Virtual Laboratory of Istanbul University and to show effects of IUVIRLAB on students' attitudes on communication skills and IUVIRLAB. Although…

  2. Is nonangiogenesis a novel pathway for cancer progression? A study using 3-dimensional tumour reconstructions

    Adighibe, O; Micklem, K; Campo, L; Ferguson, M.; Harris, A; Pozos, R; Gatter, K; Pezzella, F.

    2006-01-01

    The nonangiogenic lung tumour is characterized by neoplastic cells co-opting the pre-existent vasculature and filling the alveoli space. 3-Dimensional reconstruction of the tumour reveals that this particular tumour progresses without neovascularization and there is no major destruction of the lung's architectural integrity.

  3. On Maximal Surfaces in Certain Non-Flat 3-Dimensional Robertson-Walker Spacetimes

    Romero, Alfonso, E-mail: aromero@ugr.es [Universidad de Granada, Departamento de Geometria y Topologia (Spain); Rubio, Rafael M., E-mail: rmrubio@uco.es [Universidad de Cordoba, Departamento de Matematicas, Campus de Rabanales (Spain)

    2012-09-15

    An upper bound for the integral, on a geodesic disc, of the squared length of the gradient of a distinguished function on any maximal surface in certain non-flat 3-dimensional Robertson-Walker spacetimes is obtained. As an application, a new proof of a known Calabi-Bernstein's theorem is given.

  4. 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)

  5. Role of Intracardiac echocardiography in Atrial Fibrillation Ablation

    Antonio Dello Russo, MD PhD

    2013-04-01

    Full Text Available In the recent years, several new evidences support catheter-based ablation as a treatment modality of atrial fibrillation (AF. Based on a plenty of different applications, intracardiac echocardiography (ICE is now a well-established technology in complex electrophysiological procedures, in particular in AF ablation. ICE contributes to improve the efficacy and safety of such procedures defining the anatomical structures involved in ablation procedures and monitoring in real time possible complications. In particular ICE allows: a correct identification of the endocardial structures; a guidance of transseptal puncture; an assessment of accurate placement of the circular mapping catheter; an indirect evaluation of evolving lesions during radiofrequency (RF energy delivery via visualization of micro and macrobubbles tissue heating; assessment of catheter contact with cardiac tissues. Recently, also the feasibility of the integration of electroanatomical mapping (EAM and intracardiac echocardiography has been demonstrated, combining accurate real time anatomical information with electroanatomical data. As a matter of fact, different techniques and ablation strategies have been developed throughout the years. In the setting of balloon-based ablation systems, recently adopted by an increasing number of centers, ICE might have a role in the choice of appropriate balloon size and to confirm accurate occlusion of pulmonary veins. Furthermore, in the era of minimally fluoroscopic ablation, ICE has successfully provided a contribute in reducing fluoroscopy time. The purpose of this review is to summarize the current applications of ICE in catheter based ablation strategies of atrial fibrillation, focusing-on electronically phased-array ICE.

  6. Healed perivalvular abscess: Incidental finding on transthoracic echocardiography

    Vishnu Datt

    2014-01-01

    Full Text Available A 36-year-old male patient presented with the complaints of palpitations and breathlessness. Preoperative transthoracic echocardiography (TTE revealed a bicuspid aortic valve; severe aortic regurgitation with dilated left ventricle (LV and mild LV systolic dysfunction (ejection fraction 50%. He was scheduled to undergo aortic valve replacement. History was not suggestive of infective endocarditis (IE. Preoperative TTE did not demonstrate any aortic perivalvular abscess. Intraoperative transesophageal echocardiography (TEE examination using the mid-esophageal (ME long-axis view, showed an abscess cavity affecting the aortic valve, which initially was assumed to be a dissection flap, but later confirmed to be an abscess cavity by color Doppler examination. The ME aortic valve short-axis view showed two abscesses; one was at the junction of the non-coronary and left coronary commissure and the other one above the right coronary cusp. Intraoperatively, these findings were confirmed by the surgeons. The case report demonstrates the superiority of TEE over TTE in diagnosing perivalvular abscesses.

  7. ADIPOKINES CONTENT AND ECHOCARDIOGRAPHY INDICATORS OF WOMEN WITH HYPOTHYROIDISM

    I. Yu. Kapralova

    2015-01-01

    Full Text Available Study objective: to study the adipokines content and echocardiography indicators of women with hypothyroidism.Materials and methods. 30 women with hypothyroidism were included into the study with the average age of 55.2 ± 2.2 years old and the duration of disease of 8.53 ± 0.84 years. Anthropometric parameters of all patients were measured. Levels of leptin, resistin, adiponectin were investigated with enzyme multiplied immunoassay. Morphometric parameters of the left ventricle (LV were assessed with echocardiography.Results. The examined patients with hypothyroidism displayed increased concentration of leptin and resistin, as well as decreased concentration of adiponectin. Concentric and eccentric hypertrophy of the left ventricle is revealed in more than half of cases with patients with the hypofunction of the thyroid gland.Conclusion. Evident decreasing of the level of adiponektin and increasing of the level of leptin and resistin was revealed with examined patients on the background of the excessive body weight. Hypertrophy of the left ventricle and diastolic dysfunction of the myocard with its relatively preserved contractile ability was revealed with women that suffer from hypothyroidism. Age, excessive body weight, increasing of arterial blood pressure, and hypoadiponectinemia play a significant role in the left ventricle myocardial remodeling.

  8. Strain Echocardiography Improves Risk Prediction of Ventricular Arrhythmias After Myocardial Infarction

    Haugaa, Kristina H; Grenne, Bjørnar L; Eek, Christian H;

    2013-01-01

    The aim of this study was to test the hypothesis that strain echocardiography might improve arrhythmic risk stratification in patients after myocardial infarction (MI).......The aim of this study was to test the hypothesis that strain echocardiography might improve arrhythmic risk stratification in patients after myocardial infarction (MI)....

  9. UK Cardiology Training in Core Echocardiography Symposium Report: the good the bad and the ugly

    Kydd, Anna; Sohaib, Afzal; Sarwar, Rizwan; Holdsworth, David; Rana, Bushra

    2014-01-01

    Training in core echocardiography skills within the UK has been the focus of considerable discussion following recent national surveys. This article reports the proceedings of a joint meeting held by the British Society of Echocardiography and British Junior Cardiologists' Association. It considers the current issues impacting on high-quality training and presents potential solutions for the future.

  10. The application of 3-dimensional CAT scan reconstruction for maxillofacial deformities

    It has been found very useful to recognize craniofacial deformities 3-dimensionally, and to observe 3-D Cat scan reconstructions that have been performed by others. Thus, starting in 1985, we have developed a 3-D CT system that combines conventional X-ray CAT scan hardware to a 3-Dimensional display software. In this paper we report on our 3-CT system, its basic algorithm, and its basic processes, i.e., the threshold process, the perspective process, the shading process and the display. The mixture shading which we have developed makes 3-D displays clearer and more natural. Also, we have applied our 3-D display to 39 cases of maxillofacial diformities. (author)

  11. Use of 3-dimensional body scans for body-image research.

    Domina, Tanya; Heuberger, Roschelle; MacGillivray, Maureen

    2008-04-01

    This preliminary study explored the use of highly realistic 3-dimensional body-scan images as a potential tool, taking advantage of a much more specific and expanded representation of the entire body. Traditionally, body-image research makes use of various contour drawing scales whose 2-dimensional figures increase proportionately and do not match the shape of many women. The study tested whether body-scanned images (N = 85) could be consistently "matched" to individual figures on a contour drawing scale. Internal consistency and interrater reliability were calculated and high coefficients were observed (alpha = .97, kappa = .80). The potential of utilizing 3-dimensional images either as more realistic somatotypes in contour-rating scales or as a measurement of body-image satisfaction using computer manipulation of a digital image is discussed. PMID:18556919

  12. Conditioned Media From Adipose-Derived Stromal Cells Accelerates Healing in 3-Dimensional Skin Cultures.

    Collawn, Sherry S; Mobley, James A; Banerjee, N Sanjib; Chow, Louise T

    2016-04-01

    Wound healing involves a number of factors that results in the production of a "closed" wound. Studies have shown, in animal models, acceleration of wound healing with the addition of adipose-derived stromal cells (ADSC). The cause for the positive effect which these cells have on wound healing has not been elucidated. We have previously shown that addition of ADSC to the dermal equivalent in 3-dimensional skin cultures accelerates reepithelialization. We now demonstrate that conditioned media (CM) from cultured ADSC produced a similar rate of healing. This result suggests that a feedback from the 3-dimensional epithelial cultures to ADSC was not necessary to effect the accelerated reepithelialization. Mass spectrometry of CM from ADSC and primary human fibroblasts revealed differences in secretomes, some of which might have roles in the accelerating wound healing. Thus, the use of CM has provided some preliminary information on a possible mode of action. PMID:26954733

  13. Manufacture of Near Net Shaped 3- Dimensional Components for Industrial Applications

    Kennedy, David; Brosnan, Donal

    2005-01-01

    The development of near net shape 3-Dimensional products for industrial applications has been one main goal for Manufacturing Industries over the last few decades. Processes such as polymer blow moulding and its various stages of development, glass forming, extrusion, forging, centrifugal and sand casting, bulge forming and vacuum forming are typical processes that have contributed to this development. Current practices centre on Surface coatings, Rapid Prototyping, laser forming and nanotech...

  14. DYNAMICAL CONSISTENCE IN 3-DIMENSIONAL TYPE-K COMPETITIVE LOTKA-VOLTERRA SYSTEM

    2012-01-01

    A 3-dimensional type-K competitive Lotka-Volterra system is considered in this paper. Two discretization schemes are applied to the system with an positive interior fixed point, and two corresponding discrete systems are obtained. By analyzing the local dynamics of the corresponding discrete system near the interior fixed point, it is showed that this system is not dynamically consistent with the continuous counterpart system.

  15. Energy Sources of the Dominant Frequency Dependent 3-dimensional Atmospheric Modes

    Schubert, S.

    1985-01-01

    The energy sources and sinks associated with the zonally asymmetric winter mean flow are investigated as part of an on-going study of atmospheric variability. Distinctly different horizontal structures for the long, intermediate and short time scale atmospheric variations were noted. In previous observations, the 3-dimensional structure of the fluctuations is investigated and the relative roles of barotropic and baroclinic terms are assessed.

  16. BPS operators from the Wilson loop in the 3-dimensional supersymmetric Chern-Simons theory

    Fujita, Mitsutoshi

    2009-01-01

    We consider the small deformation of the pointlike Wilson loop in the 3-dimensional N=6 superconformal Chern-Simons theory. By Taylor expansion of the pointlike Wilson loop in powers of the loop variables, we obtain the BPS operators that correspond to the excited string states of the dual IIA string theory on the pp wave background. The BPS conditions of the Wilson loop constrain both the loop variables and the forms of the operators obtained in the Taylor expansion.

  17. 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)

  18. Left ventricular noncompaction: diagnosis by three-dimensional echocardiography.

    Correia, Emanuel; Santos, Luís Ferreira; Rodrigues, Bruno; Gama, Pedro; Ferreira, Pedro; Nunes, Luis; Pipa, João; Cabral, Costa; Dionísio, Odete; Santos, Oliveira

    2009-11-01

    Left ventricular noncompaction (LVNC) is a rare congenital disease caused by an arrest in normal myocardial embryogenesis, leading to persistence of numerous prominent trabeculations that communicate with the left ventricle. It was first described as a congenital condition affecting children, but several cases have been reported of late presentation. The main clinical manifestations are congestive heart failure, arrhythmias (supraventricular or ventricular) and systemic embolism. We present the case of a 51-year-old patient brought to our emergency department after an episode of symptomatic ventricular flutter requiring electrical cardioversion. Two-dimensional echocardiography with color Doppler suggested the diagnosis and the three-dimensional echocardiogram revealed the deep trabeculations typical of LVNC. PMID:20222350

  19. Application of 3-dimensional digital subtraction technique in the diagnosing and treating malignant esophageal stenosis

    Objective: To evaluate 3-dimensional digital subtraction technique in diagnosing and treating the malignant esophageal stenosis. Methods: After oral administration of contrast media, both two-dimensional and three-dimensional digital subtraction radiography of narrowed segment of esophagus were performed in forty patients with malignant esophageal stenosis caused by advanced esophageal carcinoma. The images obtained from 3-dimensional digital subtraction technique were compared with the images of the same patient's conventional esophageal air-barium double contrast pictures and 2-dimensional digital subtraction pictures. The results were analyzed. Results: Three-dimensional digital subtraction images could well display the position of the malignant esophageal stenosis. On the images the lesion's length could be precisely measured, the lesion's ulcer and perforation shape could be clearly demonstrated, and subtler esophageal fistula could be detected, which was very helpful for accurately localizing the lesion and selecting suitable endo-esophageal stent. Conclusion: The 3-dimensional digital subtraction technique is very useful in diagnosing malignant esophageal stenosis. With the help of the 3D images the lesion can be precisely localized and the suitable esophageal stent can be effectively selected and placed. (authors)

  20. Repeated bedside echocardiography in children with respiratory failure

    Jehlicka Petr

    2011-04-01

    Full Text Available Abstract Background The aim of this study was to verify the benefits and limitations of repeated bedside echocardiographic examinations in children during mechanical ventilation. For the purposes of this study, we selected the data of over a time period from 2006 to 2010. Methods A total of 235 children, average age 3.21 (SD 1.32 years were included into the study and divided into etiopathogenic groups. High-risk groups comprised: Acute lung injury and acute respiratory distress syndrome (ALI/ARDS, return of spontaneous circulation after cardiopulmonary resuscitation (ROSC, bronchopulmonary dysplasia (BPD, cardiomyopathy (CMP and cardiopulmonary disease (CPD. Transthoracic echocardiography was carried out during mechanical ventilation. The following data were collated for statistical evaluation: right and left ventricle myocardial performance indices (RV MPI; LV MPI, left ventricle shortening fraction (SF, cardiac output (CO, and the mitral valve ratio of peak velocity of early wave (E to the peak velocity of active wave (A as E/A ratio. The data was processed after a period of recovery, i.e. one hour after the introduction of invasive lines (time-1 and after 72 hours of comprehensive treatment (time-2. The overall development of parameters over time was compared within groups and between groups using the distribution-free Wilcoxons and two-way ANOVA tests. Results A total of 870 echocardiographic examinations were performed. At time-1 higher average values of RV MPI (0.34, SD 0.01 vs. 0.21, SD 0.01; p Conclusion Echocardiography complements standard monitoring of valuable information regarding cardiac load in real time. Chest excursion during mechanical ventilation does not reduce the quality of the acquired data.

  1. On-Orbit Prospective Echocardiography on International Space Station Crew

    Hamilton, Douglas R.; Sargsyan, Ashot E.; Martin, David S.; Garcia, Kathleen M.; Melton, Shannon L.; Feiveson, Alan; Dulchavsky, Scott A.

    2010-01-01

    Introduction A prospective trial of echocardiography was conducted on of six crewmembers onboard the International Space Station. The main objective was to determine the efficacy of remotely guided tele-echocardiography, including just-in-time e-training methods and determine what "space normal" echocardiographic data is. Methods Each crewmember operator (n=6) had 2-hour preflight training. Baseline echocardiographic data were collected 55 to 167days preflight. Similar equipment was used in each 60-minute in-flight session (mean microgravity exposure - 114 days (34 -- 190)). On Orbit ultrasound operators used an e-learning system within 24h of these sessions. Expert assistance was provided using ultrasound video downlink and two-way voice. Testing was repeated 5 to 16 days after landing. Separate ANOVA was used on each echocardiographic variable (n=33). Within each ANOVA, three tests were made: a) effect of mission phase (preflight, in-flight, post flight); b) effect of echo technician (two technicians independently analyzed the data); c) interaction between mission phase and technician. Results Nine rejections of the null hypothesis (mission phase or technician or both had no effect) were discovered and considered for follow up. Of these, six rejections were for significant technician effects, not as a result of space flight. Three rejections of the null hypothesis (Aortic Valve time velocity integral, Mitral E wave Velocity and heart rate) were attributable to space flight, however determined not to be clinically significant. No rejections were due to the interaction between technician and space flight. Conclusion No consistent clinically significant effects of long-duration space flight were seen in echocardiographic variables of the given group of subjects.

  2. Transesophageal echocardiography in patients with cryptogenic cerebral ischemia

    Dreger Henryk

    2009-03-01

    Full Text Available Abstract Background In about one third of all patients with cerebral ischemia, no definite cause can be identified (cryptogenic stroke. In many patients with initially suspected cryptogenic stroke, however, a cardiogenic etiology can eventually be determined. Hence, the aim of this study was to describe the prevalence of abnormal echocardiographic findings in a large number of these patients. Method Patients with cryptogenic cerebral ischemia (ischemic stroke, IS, and transient ischemic attack, TIA were included. The initial work-up included a neurological examination, EEG, cCT, cMRT, 12-lead ECG, Holter-ECG, Doppler ultrasound of the extracranial arteries, and transthoracic echocardiography. A multiplane transeophageal echocardiography (TEE, including i.v. contrast medium application [Echovist], Valsalva maneuver was performed in all patients Results 702 consecutive patients (380 male, 383 IS, 319 TIA, age 18–90 years were included. In 52.6% of all patients, TEE examination revealed relevant findings. Overall, the most common findings in all patients were: patent foramen ovale (21.7%, previously undiagnosed valvular disease (15.8%, aortic plaques, aortic valve sclerosis, atrial septal aneurysms, regional myocardial dyskinesia, dilated left atrium and atrial septal defects. Older patients (> 55 years, n = 291 and patients with IS had more relevant echocardiographic findings than younger patients or patients with TIA, respectively (p = 0.002, p = 0.003. The prevalence rates of PFO or ASD were higher in younger patients (PFO: 26.8% vs. 18.0%, p = 0.005, ASD: 9.6% vs. 4.9%, p = 0.014. Conclusion A TEE examination in cryptogenic stroke reveals contributing cardiogenic factors in about half of all patients. Younger patients had a higher prevalence of PFO, whereas older patients had more frequently atherosclerotic findings. Therefore, TEE examinations seem indicated in all patients with cryptogenic stroke – irrespective of age – because of

  3. Saline contrast echocardiography for the detection of patent foramen ovale in hypoxia: a validation study using intracardiac echocardiography.

    Fenster, Brett E; Curran-Everett, Douglas; Freeman, Andrew M; Weinberger, Howard D; Kern Buckner, J; Carroll, John D

    2014-04-01

    Although the "3 beat rule" is widely utiized to discriminate patent foramen ovale (PFO)-mediated right-to-left shunt (RTLS) from intrapulmonary RTLS using saline contrast transthoracic echocardiography (SCE), SCE diagnostic performance has yet to be validated using an invasive intracardiac standard. Percutaneous PFO occluder placement was recently shown to ameliorate hypoxia in patients with suspected PFO-mediated RTLS. We evaluated the ability of SCE to predict PFO presence and size using intracardiac echocardiography (ICE) as a gold standard in a hypoxic cohort. Sixty-three hypoxic patients with suspected PFO-mediated RTLS who underwent SCE at rest, with Valsalva maneuver, and with cough prior to ICE were evaluated retrospectively. PFO RTLS was defined by ICE findings including PFO anatomy, RTLS by saline contrast and color Doppler, and probe patency. SCE shunt severity and timing of left heart saline target appearance were compared to the presence of ICE-defined PFO RTLS. Forty-seven patients (75%) met criteria for PFO-mediated RTLS. A 4 beat cutoff for resting SCE provided optimal diagnostic performance for detection of PFO-mediated RTLS with a 71% sensitivity, 94% specificity, and 97% positive predictive value (PPV). Valsalva and cough maneuvers improved sensitivity compared to rest SCE (89% and 80%, respectively). Valsalva SCE shunt severity more accurately predicted PFO size than resting SCE. In contrast to the widely accepted "3 beat rule," resting SCE for the detection of PFO RTLS in a hypoxic population performs optimally using a 4-cycle cutoff with both excellent specificity and PPV. PMID:24138568

  4. Experimental Validation of Plastic Mandible Models Produced by a "Low-Cost" 3-Dimensional Fused Deposition Modeling Printer.

    Maschio, Federico; Pandya, Mirali; Olszewski, Raphael

    2016-01-01

    BACKGROUND The objective of this study was to investigate the accuracy of 3-dimensional (3D) plastic (ABS) models generated using a low-cost 3D fused deposition modelling printer. MATERIAL AND METHODS Two human dry mandibles were scanned with a cone beam computed tomography (CBCT) Accuitomo device. Preprocessing consisted of 3D reconstruction with Maxilim software and STL file repair with Netfabb software. Then, the data were used to print 2 plastic replicas with a low-cost 3D fused deposition modeling printer (Up plus 2®). Two independent observers performed the identification of 26 anatomic landmarks on the 4 mandibles (2 dry and 2 replicas) with a 3D measuring arm. Each observer repeated the identifications 20 times. The comparison between the dry and plastic mandibles was based on 13 distances: 8 distances less than 12 mm and 5 distances greater than 12 mm. RESULTS The mean absolute difference (MAD) was 0.37 mm, and the mean dimensional error (MDE) was 3.76%. The MDE decreased to 0.93% for distances greater than 12 mm CONCLUSIONS Plastic models generated using the low-cost 3D printer UPplus2® provide dimensional accuracies comparable to other well-established rapid prototyping technologies. Validated low-cost 3D printers could represent a step toward the better accessibility of rapid prototyping technologies in the medical field. PMID:27003456

  5. Experimental Validation of Plastic Mandible Models Produced by a “Low-Cost” 3-Dimensional Fused Deposition Modeling Printer

    Maschio, Federico; Pandya, Mirali; Olszewski, Raphael

    2016-01-01

    Background The objective of this study was to investigate the accuracy of 3-dimensional (3D) plastic (ABS) models generated using a low-cost 3D fused deposition modelling printer. Material/Methods Two human dry mandibles were scanned with a cone beam computed tomography (CBCT) Accuitomo device. Preprocessing consisted of 3D reconstruction with Maxilim software and STL file repair with Netfabb software. Then, the data were used to print 2 plastic replicas with a low-cost 3D fused deposition modeling printer (Up plus 2®). Two independent observers performed the identification of 26 anatomic landmarks on the 4 mandibles (2 dry and 2 replicas) with a 3D measuring arm. Each observer repeated the identifications 20 times. The comparison between the dry and plastic mandibles was based on 13 distances: 8 distances less than 12 mm and 5 distances greater than 12 mm. Results The mean absolute difference (MAD) was 0.37 mm, and the mean dimensional error (MDE) was 3.76%. The MDE decreased to 0.93% for distances greater than 12 mm. Conclusions Plastic models generated using the low-cost 3D printer UPplus2® provide dimensional accuracies comparable to other well-established rapid prototyping technologies. Validated low-cost 3D printers could represent a step toward the better accessibility of rapid prototyping technologies in the medical field. PMID:27003456

  6. Stress myocardial perfusion imaging versus echocardiography for the diagnosis and risk stratification of patients with CAD

    Stress myocardial perfusion imaging and stress echocardiography are both noninvasive diagnostic techniques. Both techniques are very valuable for assessment of diagnosis and risk stratification of patients with coronary artery disease, while both have their advantages and disadvantages. The overall sensitivity for diagnosis of coronary artery disease is higher by stress myocardial perfusion imaging than by stress echocardiography, whereas the specificity is slightly higher by the later. With regard to risk stratification of patients with coronary artery disease, stress myocardial perfusion imaging is more valuable than stress echocardiography. A normal stress myocardial perfusion imaging result indicate an exceedingly low risk even in patients with angiographic coronary artery disease

  7. Significance of blood-pool scintigraphy and echocardiography in the investigation of left heart ventricle

    Left ventricular ejection (LVEF) was assessed by both radionuclide ventriculography and echocardiography. The correlation coefficient of 0.74 revealed a just good agreement. It was better in the range of normal than of pathological values. The analysis of regional wall motion performed by echocardiography was not as reliable as by radionuclide ventriculography. The main advantage of echocardiography is its good spatial resolution. Its domain is the diagnostics of pathomorphological changes including valvular disorders. Advantages of radionuclide ventriculography are good temporal resolution, registration of the third dimension, practicability during exercise and as bed side method (nuclear stethoscope). Functional disturbances of both ventricles are its field of application. (orig.)

  8. Significance of blood pool scintigraphy and echocardiography in the investigation of left heart ventricle

    Left ventricular ejection (LVEF) was assessed by both radionuclide ventriculography and echocardiography. The correlation coefficient of 0.74 revealed a just good agreement. It was better in the range of normal than of pathological values. The analysis of regional wall motion performed by echocardiography was not as reliable as by radionuclide ventriculography. The main advantage of echocardiography is its good spatial resolution. Its domain is the diagnosis of pathomorphological changes including valvular disorders. Advantages of radionuclide ventriculography are good temporal resolution, registration of the third dimension practicability during exercise and as bedside method (nuclear stethoscope). Functional disturbances of both ventricles are its field of application. (author)

  9. Targeted neonatal echocardiography services: need for standardized training and quality assurance.

    Finan, Emer

    2014-10-01

    Targeted neonatal echocardiography refers to a focused assessment of myocardial performance and hemodynamics directed by a specific clinical question. It has become the standard of care in many parts of the world, but practice is variable, and there has been a lack of standardized training and evaluation to date. Targeted neonatal echocardiography was first introduced to Canada in 2006. The purpose of this study was to examine the characteristics of targeted neonatal echocardiography practice and training methods in Canadian neonatal intensive care units (NICUs).

  10. DOBUTAMINE STRESS-ECHOCARDIOGRAPHY: POSSIBILITY OF CLINICAL USAGE IN CARDIOLOGY PRACTICE

    M. A. Saidova

    2016-01-01

    Full Text Available Currently stress-echocardiography or so-called burden echocardiography is essential method of patient examination to reveal latent ischemic heart disease (IHD. That is one of the mostly informative non-invasive methods of IHD diagnosis as well as efficacy evaluation of coronary angioplasty, surgical and pharmacological treatments of IHD. Dobutamine usage as a stress-agent at burden echocardiography allows evaluating not only ischemia but a myocardial vitality in post infarction area as well as clarify severity of valve stenosis, pulmonary hypertension and extent of latent obstruction of exhaust duct of the left ventricle. Method possibilities are presented as well as test protocol, main indications and contraindications.