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Sample records for cardiac mri advances

  1. Advanced Analysis Techniques for Intra-cardiac Flow Evaluation from 4D Flow MRI

    OpenAIRE

    van der Geest, Rob J; Garg, Pankaj

    2016-01-01

    Purpose of the Review Time-resolved 3D velocity-encoded MR imaging with velocity encoding in three directions (4D Flow) has emerged as a novel MR acquisition technique providing detailed information on flow in the cardiovascular system. In contrast to other clinically available imaging techniques such as echo-Doppler, 4D Flow MRI provides the 3D Flow velocity field within a volumetric region of interest over the cardiac cycle. This work reviews the most recent advances in the development and ...

  2. Cardiac MRI in Athletes

    NARCIS (Netherlands)

    Luijkx, T.

    2012-01-01

    Cardiac magnetic resonance imaging (CMR) is often used in athletes to image cardiac anatomy and function and is increasingly requested in the context of screening for pathology that can cause sudden cardiac death (SCD). In this thesis, patterns of cardiac adaptation to sports are investigated with C

  3. MRI of cardiac rhabdomyoma in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Kivelitz, Dietmar E.; Muehler, Matthias [Institut fuer Radiologie, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany); Rake, Annett; Chaoui, Rabih [Klinik fuer Gynaekologie und Geburtshilfe, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany); Scheer, Ianina [Klinik fuer Strahlenheilkunde, Abteilung Paediatrische Radiologie, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany)

    2004-08-01

    Primary cardiac tumors are rarely diagnosed in utero and are usually seen on prenatal echocardiography. Cardiac rhabdomyomata can be associated with tuberous sclerosis. Prenatal MRI can be performed to assess associated malformations. This case report illustrates the ability of fetal MRI to image cardiac rhabdomyata and compares it with prenatal and postnatal echocardiography. (orig.)

  4. Cardiac MRI of the athlete's heart

    NARCIS (Netherlands)

    Prakken, N.H.J.

    2010-01-01

    The increase in pre-participation cardiovascular screening using the Lausanne protocol will ultimately lead to an increased use of cardiac MRI and MDCT in the cardiovascular work-up of athletes. The role of cardiac MRI is well established in the evaluation of cardiomyopathies, myocarditis, aortic st

  5. Cardiac MRI in restrictive cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, A. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Singh Gulati, G., E-mail: gulatigurpreet@rediffmail.com [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Seth, S. [Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Sharma, S. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India)

    2012-02-15

    Restrictive cardiomyopathy (RCM) is a specific group of heart muscle disorders characterized by inadequate ventricular relaxation during diastole. This leads to diastolic dysfunction with relative preservation of systolic function. Although short axis systolic function is usually preserved in RCM, the long axis systolic function may be severely impaired. Confirmation of diagnosis and information regarding aetiology, extent of myocardial damage, and response to treatment requires imaging. Importantly, differentiation from constrictive pericarditis (CCP) is needed, as only the latter is managed surgically. Echocardiography is the initial cardiac imaging technique but cannot reliably suggest a tissue diagnosis; although recent advances, especially tissue Doppler imaging and spectral tracking, have improved its ability to differentiate RCM from CCP. Cardiac catheterization is the reference standard, but is invasive, two-dimensional, and does not aid myocardial characterization. Cardiac magnetic resonance (CMR) is a versatile technique providing anatomical, morphological and functional information. In recent years, it has been shown to provide important information regarding disease mechanisms, and also been found useful to guide treatment, assess its outcome and predict patient prognosis. This review describes the CMR features of RCM, appearances in various diseases, its overall role in patient management, and how it compares with other imaging techniques.

  6. Practical textbook of cardiac CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Tae-Hwan (ed.) [ASAN Medical Center, Seoul (Korea, Republic of). Dept. of Radiology

    2015-04-01

    Guide to the interpretation of cardiac CT and MRI for the purposes of diagnosis, treatment planning, and follow-up. Emphasis on applications in a wide range of real clinical situations. Numerous informative illustrations. Summarizing sections permitting rapid retrieval of information. QR codes allowing access to references, additional figures, and motion pictures from the internet. This up-to-date textbook comprehensively reviews all aspects of cardiac CT and MRI and demonstrates the value of these techniques in clinical practice. A wide range of applications are considered, including imaging of atherosclerotic and non-atherosclerotic coronary artery disease, coronary revascularization, ischemic heart disease, non-ischemic cardiomyopathy, valvular heart disease, cardiac tumors, and pericardial disease. The numerous high-quality images illustrate how to interpret cardiac CT and MRI correctly for the purposes of diagnosis, treatment planning, and follow-up. Helpful summarizing sections in every chapter will facilitate rapid retrieval of information. This book will be of great value to radiologists and cardiologists seeking a reliable guide to the optimal use of cardiac CT and MRI in real clinical situations.

  7. Fast Registration of Cardiac Perfusion MRI

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Larsson, Henrik B. W.

    2003-01-01

    This abstract presents a novel method for registration of cardiac perfusion MRI sequences. By performing complex analyses of variance and clustering in an annotated training set off-line, our method provides real-time segmentation in an on-line setting. This renders the method feasible for live...

  8. Establishing a clinical cardiac MRI service

    International Nuclear Information System (INIS)

    After several years of research development cardiovascular MRI has evolved into a widely accepted clinical tool. It offers important diagnostic and prognostic information for a variety of clinical indications, which include ischaemic heart disease, cardiomyopathies, valvular dysfunction and congenital heart disorders. It is a safe non-invasive technique that employs a variety of imaging sequences optimized for temporal or spatial resolution, tissue-specific contrast, flow quantification or angiography. Cardiac MRI offers specific advantages over conventional imaging techniques for a significant number of patients. The demand for cardiac MRI studies from cardiothoracic surgeons, cardiologists and other referrers is likely to continue to rise with pressure for more widespread local service provision. Setting up a cardiac MRI service requires careful consideration regarding funding issues and how it will be integrated with existing service provision. The purchase of cardiac phased array coils, monitoring equipment and software upgrades must also be considered, as well as the training needs of those involved. The choice of appropriate imaging protocols will be guided by operator experience, clinical indication and equipment capability, and is likely to evolve as the service develops. Post-processing and offline analysis form a significant part of the time taken to report studies and an efficient method of providing quantitative reports is an important requirement. Collaboration between radiologists and cardiologists is needed to develop a successful service and multi-disciplinary meetings are key component of this. This review will explore these issues from our perspective of a new clinical cardiac MRI service operating over its first year in a teaching hospital imaging department

  9. Cardiac MRI of acute coronary syndrome.

    Science.gov (United States)

    Akerem Khan, Shamruz; Khan, Shamruz Akarem; Williamson, Eric E; Foley, Thomas A; Cullen, Ethany L; Young, Phillip M; Araoz, Philip A

    2013-05-01

    Acute coronary syndrome (ACS) is a major cause of morbidity and mortality worldwide. New serological biomarkers, such as troponins, have improved the diagnosis of ACS; however, the diagnosis of ACS can still be difficult as there is marked heterogeneity in its presentation and significant overlap with other disorders presenting with chest pain. Evidence is accumulating that cardiac MRI provides information that can aid the detection and differential diagnosis of ACS, guide clinical decision-making and improve risk-stratification after an event. In this review, we present the relevant cardiac MRI techniques that can be used to detect ACS accurately, provide differential diagnosis, identify the sequelae of ACS, and determine prognostication after ACS. PMID:23668741

  10. Cardiac MRI for myocardial ischemia.

    LENUS (Irish Health Repository)

    Daly, Caroline

    2013-01-01

    Proper assessment of the physiologic impact of coronary artery stenosis on the LV myocardium can affect patient prognosis and treatment decisions. Cardiac magnetic resonance imaging (CMR) assesses myocardial perfusion by imaging the myocardium during a first-pass transit of an intravenous gadolinium bolus, with spatial and temporal resolution substantially higher than nuclear myocardial perfusion imaging. Coupled with late gadolinium enhancement (LGE) imaging for infarction during the same imaging session, CMR with vasodilating stress perfusion imaging can qualitatively and quantitatively assess the myocardial extent of hypoperfusion from coronary stenosis independent of infarcted myocardium. This approach has been validated experimentally, and multiple clinical trials have established its diagnostic robustness when compared to stress single-photon emission computed tomography. In specialized centers, dobutamine stress CMR has been shown to have incremental diagnostic value above stress echocardiography due to its high imaging quality and ability to image the heart with no restriction of imaging window. This paper reviews the technical aspects, diagnostic utility, prognostic values, challenges to clinical adaptation, and future developments of stress CMR imaging.

  11. Advanced flow MRI: emerging techniques and applications.

    Science.gov (United States)

    Markl, M; Schnell, S; Wu, C; Bollache, E; Jarvis, K; Barker, A J; Robinson, J D; Rigsby, C K

    2016-08-01

    Magnetic resonance imaging (MRI) techniques provide non-invasive and non-ionising methods for the highly accurate anatomical depiction of the heart and vessels throughout the cardiac cycle. In addition, the intrinsic sensitivity of MRI to motion offers the unique ability to acquire spatially registered blood flow simultaneously with the morphological data, within a single measurement. In clinical routine, flow MRI is typically accomplished using methods that resolve two spatial dimensions in individual planes and encode the time-resolved velocity in one principal direction, typically oriented perpendicular to the two-dimensional (2D) section. This review describes recently developed advanced MRI flow techniques, which allow for more comprehensive evaluation of blood flow characteristics, such as real-time flow imaging, 2D multiple-venc phase contrast MRI, four-dimensional (4D) flow MRI, quantification of complex haemodynamic properties, and highly accelerated flow imaging. Emerging techniques and novel applications are explored. In addition, applications of these new techniques for the improved evaluation of cardiovascular (aorta, pulmonary arteries, congenital heart disease, atrial fibrillation, coronary arteries) as well as cerebrovascular disease (intra-cranial arteries and veins) are presented. PMID:26944696

  12. Noninvasive Diagnosis of Cardiac Amyloidosis by MRI and Echochardiography

    Institute of Scientific and Technical Information of China (English)

    汪晶; 孔祥泉; 徐海波; 周国锋; 常丹丹; 刘定西; 张丽; 谢明星

    2010-01-01

    This study described the radiological features on echocardiography and MRI specific to cardiac amyloidosis confirmed on biopsy. Eleven cases of biopsy-proven cardiac amyloidosis were retrospectively reviewed in this study. All patients underwent biopsy, cardiac MRI and echocardiography. The main echocardiography and MRI findings were as follows: diffuse ventricular and septum wall thickening, atrial enlargement, pericardial effusion, restricted left ventricular (LV) systolic and diastolic function, characte...

  13. Atrial tumors in cardiac MRI; Vorhoftumoren in der kardialen MRT

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, Nils; Schoth, F.; Guenther, R.W.; Krombach, G. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum RWTH Aachen (Germany); Balzer, J.C.; Neizel, M.; Kuehl, H. [Klinik fuer Kardiologie, Pneumologie und Angiologie, Universitaetsklinikum RWTH Aachen (Germany)

    2009-11-15

    Cardiac magnetic resonance imaging (MRI) is an important tool for the diagnosis of cardiac masses. Various cardiac tumors are predisposed to occurring in atrial structures. The aim of this review article is the description of atrial tumors and their morphological features in MRI. In general, cardiac tumors are rare: approximately 0.001-0.03% in autopsy studies. About 75% of them are benign. The most common cardiac tumor is the myxoma. They are predisposed to occur in the atria and show a characteristically strong hyperintense signal on T2-wieghted images in MRI. In other sequences a heterogeneous pattern reflects its variable histological appearance. Lipomas exhibit a signal behavior identical to fatty tissue with a typical passive movement in cine imaging. Fibroelastomas are the most common tumors of the cardiac valves. Consisting of avascular fibrous tissue, they often present with hypointense signal intensities. Thrombi attached to their surface can cause severe emboli even in small tumors. Amongst primary cardiac malignancies, sarcomas are most common and favor the atria. Secondary malignancies of the heart are far more common than primary ones (20-40 times). In case of known malignancies, approximately 10% of patients develop cardiac metastasis at the end of their disease. Lymphogenic metastases favor the pericardium, while hematogenic spread prefers the myocardium. Since they are not real atrial tumors, thrombi and anatomical structures of the atria have to be differentiated from other pathologies. (orig.)

  14. Predictive Modelling of Cardiac 2D Multi-Slice MRI with Simultaneous Resolution of Cardiac and Respiratory Motion

    DEFF Research Database (Denmark)

    Pedersen, Henrik; Ólafsdóttir, Hildur; Darkner, Sune;

    2009-01-01

    This paper introduces a novel approach to modelling of volumetric cardiac magnetic resonance imaging (MRI) with simultaneous resolution of cardiac and respiratory motion. The major challenge is that the inherent slow nature of MRI prevents obtaining real-time volumetric images of the heart with...... respiratory bellow and a vectorcardiogram, and utilizes a combination of deformation modelling and pixel intensity modelling. We demonstrate that this approach reliably models volumetric cardiac MRI for any combination of cardiac and respiratory phase....

  15. Heart MRI

    Science.gov (United States)

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  16. MRI with cardiac pacing devices – Safety in clinical practice

    International Nuclear Information System (INIS)

    Objectives: The aim of this study was to introduce a single centre “real life” experience of performing MRI examinations in clinical practice on patients with cardiac pacemaker systems. Additionally, we aimed to evaluate the safety of using a dedicated safety protocol for these patients. Materials and methods: We used a 1.5 T MRI scanner to conduct 68 MRI scans of different body regions in patients with pacing systems. Of the cardiac devices, 32% were MR-conditional, whereas the remaining 68% were MR-unsafe. We recorded the functional parameters of the devices prior, immediately after, and approximately one month after the MRI scanning, and compared the device parameters to the baseline values. Results: All MRI examinations were completed safely, and each device could be interrogated normally following the MRI. We observed no changes in the programmed parameters of the devices. For most of the participants, the distributions of the immediate and one-month changes in the device parameters were within 20% of the baseline values, although some changes approached clinically important thresholds. Furthermore, we observed no differences in the variable changes between MR-conditional and MR-unsafe pacing systems, or between scans of the thorax area and other scanned areas. Conclusion: MRI in patients with MR-conditional pacing systems and selected MR-unsafe systems could be performed safely under strict conditions in this study

  17. Role of cardiac MRI in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Erwin Mulia

    2013-02-01

    Full Text Available Mortality in patients with acute myocardial infarction (AMI has decreased significantly and appears to be the result of current reperfusion therapeutic strategies. Reperfusion itself may develop into reperfusion injury. Therefore, management of these patients poses several challenges, such as diagnosing and managing heart failure, identifying persistent or inducible ischaemia, estimating the need for anticoagulation, and assessing overall cardiovascular risk. This case presentation will demonstrate the impact of cardiac magnetic resonance imaging (MRI in the assessment of the pathophysiology of AMI in the current reperfusion era. Cardiac MRI can provide a wide range of clinically useful information which will help clinicians to manage and choose specific therapeutic strategies for AMI patients. (Med J Indones. 2013;22:46-53Keywords: Acute myocardial infarction, cardiac magnetic resonance imaging, reperfusion injury

  18. Automatic assessment of cardiac perfusion MRI

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Stegmann, Mikkel Bille; Larsson, Henrik B.W.

    2004-01-01

    In this paper, a method based on Active Appearance Models (AAM) is applied for automatic registration of myocardial perfusion MRI. A semi-quantitative perfusion assessment of the registered image sequences is presented. This includes the formation of perfusion maps for three parameters; maximum up...

  19. Value of fetal cerebral MRI in sonographically proven cardiac rhabdomyoma

    Energy Technology Data Exchange (ETDEWEB)

    Muehler, Matthias R.; Hamm, Bernd [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Rake, Annett [Charite - Universitaetsmedizin Berlin, Section for Prenatal Medicine, Department of Gynecology and Obstetrics, Berlin (Germany); Schwabe, Michael [Charite - Universitaetsmedizin Berlin, Department of Pathology, Berlin (Germany); Schmidt, Susanne [Charite - Universitaetsmedizin Berlin, Paediatric Radiology, Berlin (Germany); Kivelitz, Dietmar [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Leipzig Heart Center, Department of Radiology, Leipzig (Germany); Chaoui, Rabih [Prenatal Diagnosis and Human Genetics, Berlin (Germany)

    2007-05-15

    Tuberous sclerosis complex (TSC) is an autosomal dominant phakomatosis associated with intracardiac rhabdomyomas. The aim of our study was to examine the value of cerebral MRI in diagnosing TSC in fetuses with intracardiac rhabdomyomas, applying the TSC Consensus Conference (TSCCC) criteria. In a prospective manner six consecutive fetuses with cardiac rhabdomyomas (21-34 weeks' gestation) underwent cerebral MRI. The MRI results were correlated with clinical follow-up at 10-34 months after birth, histology, and genetic data. In five of the six fetuses the diagnosis of TSC was established. In two of five fetuses MRI demonstrated cerebral manifestations of TSC that correlated well with severe epilepsy manifesting during the follow-up period. In another two of five fetuses MRI as well as clinical follow-up were normal. One of five pregnancies was terminated and histology demonstrated microscopically small subependymal nodules not demonstrated by MRI. The results of our study agree with the available literature that fetal MRI is sufficient for the detection of cerebral lesions in TSC and should be better promoted. The TSCCC criteria can also be applied to fetal MRI. (orig.)

  20. Cardiac MRI: A General Overview with Emphasis on Current Use and Indications.

    Science.gov (United States)

    Pfeiffer, Michael P; Biederman, Robert W W

    2015-07-01

    Cardiac magnetic resonance is well-established as a robust modality of cardiovascular imaging, providing superior resolution, infinite imaging planes, and the ability to obtain multiple types of information without ionizing radiation. Limitations imposed by availability, cost effectiveness, and safety prevent universal application. Many general and specialty practitioners do not have routine exposure to Cardiac MRI (CMR). Guidelines for the use of CMR exist, but continue to adapt to advances in techniques and ongoing research. Understanding the basics of CMR acquisition techniques, categories of appropriate use, and pertinent safety information will assist with selecting the best clinical scenarios to consider CMR. PMID:26042886

  1. Visualization and analysis of functional cardiac MRI data

    Science.gov (United States)

    McVeigh, Elliot R.; Guttman, Michael A.; Poon, Eric; Pisupati, Chandrasekhar; Moore, Christopher C.; Zerhouni, Elias A.; Solaiyappan, Meiyappan; Heng, PhengAnn

    1994-05-01

    Rapid analysis of large multi-dimensional data sets is critical for the successful implementation of a comprehensive MR cardiac exam. We have developed a software package for the analysis and visualization of cardiac MR data. The program allows interactive visualization of time and space stacks of MRI data, automatic segmentation of myocardial borders and myocardial tagging patterns, and visualization of functional parameters such a motion, strain, and blood flow, mapped as colors in an interactive dynamic 3D volume rendering of the beating heart.

  2. Cardiac MRI and CT features of inheritable and congenital conditions associated with sudden cardiac death

    Energy Technology Data Exchange (ETDEWEB)

    Sparrow, Patrick; Merchant, Naeem; Provost, Yves; Doyle, Deirdre; Nguyen, Elsie; Paul, Narinder [University Health Network and Mount Sinai Hospital, Division of Cardiothoracic Imaging, Department of Medical Imaging, Toronto, Ontario (Canada)

    2009-02-15

    Cardiac MRI (CMR) and electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) are increasingly important tools in the identification and assessment of cardiac-related disease processes, including those associated with sudden cardiac death (SCD). While the commonest cause of SCD is coronary artery disease (CAD), in patients under 35 years inheritable cardiomyopathies such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy are important aetiologies. CMR in particular offers both accurate delineation of the morphological abnormalities associated with these and other conditions and the possibility for risk stratification for development of ventricular arrhythmias with demonstration of macroscopic scar by delayed enhancement imaging with intravenous gadolinium. (orig.)

  3. Using MRI to calculate cardiac velocity fields

    International Nuclear Information System (INIS)

    This paper describes the use of magnetic resonance imaging to produce quantitative information about heart motion. Motion estimation techniques utilizing convex set projections and simple block shift matching are applied to determine directional and magnitude of heart motion. These methods are tested and compared using simulated motion on a single MMR frame and actual MRI cine data. These simulated motion is in the form of transnational only and linear velocity fields. Motion estimation is performed using image pairs with and without additive noise. Results are given which quantify the effectiveness of the algorithms

  4. Respiratory and cardiac self-gated radial MRI

    OpenAIRE

    Paul, Jan

    2016-01-01

    Motion in cardiac Magnetic Resonance Imaging (MRI) is a major challenge, as it results in artifacts like image blurring if not compensated for. Respiratory motion of the heart can be addressed by acquisitions during breath-hold for scan times shorter than 10–15 seconds. When longer scans are required, only data from end-expiration is used. Determination of the respiratory position is typically achieved via interleaved Respiratory Navigator (RNAV) measurements. Self-Gating (SG) is an alter...

  5. Late gadolinium enhancement and subclinical cardiac dysfunction on cardiac MRI in asymptomatic HIV-positive men

    Directory of Open Access Journals (Sweden)

    A Loy

    2012-11-01

    Full Text Available Background: HIV is associated with an increased risk of cardiovascular disease (CVD and related clinical events. While traditional risk factors play an important role in the pathology of cardiovascular disease, HIV infection and its sequelae of immune activation and inflammation may have significant effects on the myocardium before becoming clinically evident. Cardiac MRI (CMR can be used to detect the pattern of these subclinical changes. This will lead to a better understanding of risk factors contributing to cardiovascular disease prior to it becoming clinically significant in HIV-positive patients. Methods: Prospective cohort study of 127 asymptomatic HIV-positive men on ART compared to 35 matched controls. Baseline demographics, HIV parameters, 12-lead ECG, routine biochemistry, and traditional cardiovascular risk factors were recorded. Images were acquired on a 3T Achieva Philips MRI scanner with 5 channel phase array cardiac coil and weight-based IV gadolinium was given at 0.15 mmol/kg dose with post-contrast inversion recovery imaging after 10 minutes. Results: 6/127 (4.7% of asymptomatic HIV-positive men had late gadolinium enhancement (LGE on MRI verses 1/35 (2.9% in the control group. In 3/6 (50% of cases this was in a classical infarction pattern with subendocardial involvement. 3/6 (50% were consistent with prior myocarditis. There was no significant difference in mean LVEF (66.93% vs 65.18%, LVMI (60.05g/m2 vs 55.94g/m2 or posterolateral wall thickness (8.28 mm and 8.16 mm between cases and controls respectively. There was significantly more diastolic dysfunction, E:A ratio < 1, found in the HIV-positive group, 18% vs 7% of controls (p = 0.037. Framingham risk did not predict either of these outcomes. Conclusions: There is an increased incidence of LGE detected on CMR in this asymptomatic HIV-positive cohort. Two distinct pathological processes were identifed as causing these changes, myocardial infarction and myocarditis

  6. Distilling complexity to advance cardiac tissue engineering

    Science.gov (United States)

    Ogle, Brenda M.; Bursac, Nenad; Domian, Ibrahim; Huang, Ngan F; Menasché, Philippe; Murry, Charles; Pruitt, Beth; Radisic, Milica; Wu, Joseph C; Wu, Sean M; Zhang, Jianyi; Zimmermann, Wolfram-Hubertus; Vunjak-Novakovic, Gordana

    2016-01-01

    The promise of cardiac tissue engineering is in the ability to recapitulate in vitro the functional aspects of healthy heart and disease pathology as well as to design replacement muscle for clinical therapy. Parts of this promise have been realized; others have not. In a meeting of scientists in this field, five central challenges or “big questions” were articulated that, if addressed, could substantially advance the current state-of-the-art in modeling heart disease and realizing heart repair. PMID:27280684

  7. Validation of MRI measurement of cardiac output in the dog: the effects of dobutamine and minoxidil.

    Science.gov (United States)

    Hockings, Paul D; Busza, Albert L; Byrne, Joanne; Patel, Bela; Smart, Sean C; Reid, David G; Lloyd, Heather L; White, Alan; Pointing, Karen; Farnfield, Belinda A; Criado-Gonzalez, Ana; Whelan, Greg A; Taylor, Gemma L; Birmingham, Jeffrey M; Slaughter, Mark R; Osborne, Janette A; Krebs-Brown, Axel; Templeton, David

    2003-01-01

    The use of magnetic resonance imaging (MRI) for the measurement of cardiac output parameters in anesthetized adult male beagle dogs has been validated against a widely accepted thermodilution method. Using a multislice cine gradient echo MRI method to acquire images of the entire heart, left ventricular lumen volumes were measured at systole and diastole in seven animals. Cardiac output correlated well (R 2 = 0.88) with thermodilution measurements made in a parallel manner, both before and during acute stimulation with the inotrope dobutamine. In a chronic study of changes in cardiac morphology and function brought about by the antihypertensive minoxidil, MRI reliably detected the expected increases in stroke volume (28%) and cardiac output (58%) resulting from neural reaction to decreased blood pressure. Left ventricular lumen enlarged as well in response to fluid retention and plasma volume increase. Two in four minoxidil-treated animals also developed clear MRI-visible pericardial effusion. PMID:20021181

  8. Optimization of myocardial nulling in pediatric cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Tham, Edythe B. [Stollery Children' s Hospital, University of Alberta, Department of Pediatrics, Division of Pediatric Cardiology, Edmonton, Alberta (Canada); Hung, Ryan W.; Crawley, Cinzia; Noga, Michelle L. [University of Alberta, Pediatric Radiology, Stollery Children' s Hospital, Edmonton (Canada); Myers, Kimberley A. [Alberta Children' s Hospital, Calgary (Canada)

    2012-04-15

    Current protocols to determine optimal nulling time in late enhancement imaging using adult techniques may not apply to children. To determine the optimal nulling time in anesthetised children, with the hypothesis that this occurs earlier than in adults. Sedated cardiac MRI was performed in 12 children (median age: 12 months, range: 1-60 months). After gadolinium administration, scout images at 2, 3, 4 and 10 min and phase sensitive inversion recovery (PSIR) images from 5 to 10 min were obtained. Signal-to-noise ratio (SNR) and inversion time (TI) were determined. Quality of nulling was assessed according to a grading score by three observers. Data was analysed using linear regression, Kruskal-Wallis and quadratic-weighted kappa statistics. One child with a cardiomyopathy had late enhancement. Good agreement in nulling occurred for scout images at 2 ({kappa} = 0.69) and 3 ({kappa} = 0.66) min and moderate agreement at 4 min ({kappa} = 0.57). Agreement of PSIR images was moderate at 7 min ({kappa} = 0.44) and poor-fair at other times. There were significant correlations between TI and scout time (r = 0.61, P < 0.0001), and SNR and kappa (r = 0.22, P = 0.017). Scout images at 2-4 min can be used to determine the TI with little variability. Image quality for PSIR images was highest at 7 min and SNR optimal at 7-9 min. TI increases with time and should be adjusted frequently during imaging. Thus, nulling times in children differ from nulling times in adults when using standard adult techniques. (orig.)

  9. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2012-02-01

    OBJECTIVE: This article reviews the optimal cardiac MRI sequences for and the spectrum of imaging appearances of cardiac tumors. CONCLUSION: Recent technologic advances in cardiac MRI have resulted in the rapid acquisition of images of the heart with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MRI provides optimal assessment of the location, functional characteristics, and soft-tissue features of cardiac tumors, allowing accurate differentiation of benign and malignant lesions.

  10. Advances in cardiac magnetic resonance imaging of congenital heart disease

    NARCIS (Netherlands)

    Driessen, Mieke M P; Breur, Johannes M. P. J.; Budde, Ricardo P J; van Oorschot, Joep W M; van Kimmenade, Roland R J; Sieswerda, Gertjan Tj.; Meijboom, Folkert J; Leiner, Tim

    2015-01-01

    Due to advances in cardiac surgery, survival of patients with congenital heart disease has increased considerably during the past decades. Many of these patients require repeated cardiovascular magnetic resonance imaging to assess cardiac anatomy and function. In the past decade, technological advan

  11. PET/MRI: Technical challenges and recent advances

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Ho; Choi, Yong; Im, Ki Chun [Molecular Imaging Research and Education Laboratory, Dept. of Electronic Engineering, Sogang University, Seoul (Korea, Republic of)

    2016-03-15

    Integrated positron emission tomography (PET)/magnetic resonance imaging (MRI), which can provide complementary functional and anatomical information about a specific organ or body system at the molecular level, has become a powerful imaging modality to understand the molecular biology details, disease mechanisms, and pharmacokinetics in animals and humans. Although the first experiment on the PET/MRI was performed in the early 1990s, its clinical application was accomplished in recent years because there were various technical challenges in integrating PET and MRI in a single system with minimum mutual interference between PET and MRI. This paper presents the technical challenges and recent advances in combining PET and MRI along with several approaches for improving PET image quality of the PET/MRI hybrid imaging system.

  12. Evaluation of highly accelerated real-time cardiac cine MRI in tachycardia.

    Science.gov (United States)

    Bassett, Elwin C; Kholmovski, Eugene G; Wilson, Brent D; DiBella, Edward V R; Dosdall, Derek J; Ranjan, Ravi; McGann, Christopher J; Kim, Daniel

    2014-02-01

    Electrocardiogram (ECG)-gated breath-hold cine MRI is considered to be the gold standard test for the assessment of cardiac function. However, it may fail in patients with arrhythmia, impaired breath-hold capacity and poor ECG gating. Although ungated real-time cine MRI may mitigate these problems, commercially available real-time cine MRI pulse sequences using parallel imaging typically yield relatively poor spatiotemporal resolution because of their low image acquisition efficiency. As an extension of our previous work, the purpose of this study was to evaluate the diagnostic quality and accuracy of eight-fold-accelerated real-time cine MRI with compressed sensing (CS) for the quantification of cardiac function in tachycardia, where it is challenging for real-time cine MRI to provide sufficient spatiotemporal resolution. We evaluated the performances of eight-fold-accelerated cine MRI with CS, three-fold-accelerated real-time cine MRI with temporal generalized autocalibrating partially parallel acquisitions (TGRAPPA) and ECG-gated breath-hold cine MRI in 21 large animals with tachycardia (mean heart rate, 104 beats per minute) at 3T. For each cine MRI method, two expert readers evaluated the diagnostic quality in four categories (image quality, temporal fidelity of wall motion, artifacts and apparent noise) using a Likert scale (1-5, worst to best). One reader evaluated the left ventricular functional parameters. The diagnostic quality scores were significantly different between the three cine pulse sequences, except for the artifact level between CS and TGRAPPA real-time cine MRI. Both ECG-gated breath-hold cine MRI and eight-fold accelerated real-time cine MRI yielded all four scores of ≥ 3.0 (acceptable), whereas three-fold-accelerated real-time cine MRI yielded all scores below 3.0, except for artifact (3.0). The left ventricular ejection fraction (LVEF) measurements agreed better between ECG-gated cine MRI and eight-fold-accelerated real-time cine MRI

  13. Motion-compensation of Cardiac Perfusion MRI using a Statistical Texture Ensemble

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Larsson, Henrik B. W.

    2003-01-01

    This paper presents a novel method for segmentation of cardiac perfusion MRI. By performing complex analyses of variance and clustering in an annotated training set off-line, the presented method provide real-time segmentation in an on-line setting. This renders the method feasible for e.g. analy......This paper presents a novel method for segmentation of cardiac perfusion MRI. By performing complex analyses of variance and clustering in an annotated training set off-line, the presented method provide real-time segmentation in an on-line setting. This renders the method feasible for e...

  14. Radiotherapy beyond cancer: Target localization in real-time MRI and treatment planning for cardiac radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Ipsen, S. [Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia and Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck 23562 (Germany); Blanck, O.; Rades, D. [Department of Radiation Oncology, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck 23562 (Germany); Oborn, B. [Illawarra Cancer Care Centre (ICCC), Wollongong, New South Wales 2500, Australia and Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, New South Wales 2500 (Australia); Bode, F. [Medical Department II, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck 23562 (Germany); Liney, G. [Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, New South Wales 2170 (Australia); Hunold, P. [Department of Radiology and Nuclear Medicine, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck 23562 (Germany); Schweikard, A. [Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck 23562 (Germany); Keall, P. J., E-mail: paul.keall@sydney.edu.au [Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006 (Australia)

    2014-12-15

    Purpose: Atrial fibrillation (AFib) is the most common cardiac arrhythmia that affects millions of patients world-wide. AFib is usually treated with minimally invasive, time consuming catheter ablation techniques. While recently noninvasive radiosurgery to the pulmonary vein antrum (PVA) in the left atrium has been proposed for AFib treatment, precise target location during treatment is challenging due to complex respiratory and cardiac motion. A MRI linear accelerator (MRI-Linac) could solve the problems of motion tracking and compensation using real-time image guidance. In this study, the authors quantified target motion ranges on cardiac magnetic resonance imaging (MRI) and analyzed the dosimetric benefits of margin reduction assuming real-time motion compensation was applied. Methods: For the imaging study, six human subjects underwent real-time cardiac MRI under free breathing. The target motion was analyzed retrospectively using a template matching algorithm. The planning study was conducted on a CT of an AFib patient with a centrally located esophagus undergoing catheter ablation, representing an ideal case for cardiac radiosurgery. The target definition was similar to the ablation lesions at the PVA created during catheter treatment. Safety margins of 0 mm (perfect tracking) to 8 mm (untracked respiratory motion) were added to the target, defining the planning target volume (PTV). For each margin, a 30 Gy single fraction IMRT plan was generated. Additionally, the influence of 1 and 3 T magnetic fields on the treatment beam delivery was simulated using Monte Carlo calculations to determine the dosimetric impact of MRI guidance for two different Linac positions. Results: Real-time cardiac MRI showed mean respiratory target motion of 10.2 mm (superior–inferior), 2.4 mm (anterior–posterior), and 2 mm (left–right). The planning study showed that increasing safety margins to encompass untracked respiratory motion leads to overlapping structures even in the

  15. Robust segmentation of 4D cardiac MRI-tagged images via spatio-temporal propagation

    Science.gov (United States)

    Qian, Zhen; Huang, Xiaolei; Metaxas, Dimitris N.; Axel, Leon

    2005-04-01

    In this paper we present a robust method for segmenting and tracking cardiac contours and tags in 4D cardiac MRI tagged images via spatio-temporal propagation. Our method is based on two main techniques: the Metamorphs Segmentation for robust boundary estimation, and the tunable Gabor filter bank for tagging lines enhancement, removal and myocardium tracking. We have developed a prototype system based on the integration of these two techniques, and achieved efficient, robust segmentation and tracking with minimal human interaction.

  16. MRI in cardiac sarcoidosis and amyloidosis; MRT bei kardialer Sarkoidose und Amyloidose

    Energy Technology Data Exchange (ETDEWEB)

    Bauner, K.U. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Wintersperger, B. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); University of Toronto, Department of Medical Imaging, Toronto General Hospital, Toronto, ON (Canada)

    2013-01-15

    Sarcoidosis and amyloidosis are both multisystem disorders, which may involve the heart; however, isolated cardiac disease is rare. Diagnosis of cardiac sarcoidosis and amyloidosis is crucial because the patient prognosis is dependent on cardiac involvement and early treatment. Echocardiography is the first line imaging modality in the diagnostic work-up of both diseases, possibly giving hints towards the correct diagnosis. Besides myocardial biopsy and radionuclide studies cardiac magnetic resonance imaging (MRI) is routinely performed in patients suspect of having infiltrative cardiomyopathy. The T1 mapping procedure is currently being evaluated as a new technique for detection and quantification of global myocardial enhancement, as seen in cardiac amyloidosis. Sensitivities and specificities for detection of cardiac sarcoidosis and amyloidosis can be significantly improved by MRI, especially with late gadolinium enhancement (LGE) imaging. In cardiac sarcoidosis the use of LGE is outcome-related while in amyloidosis analysis of T1-mapping may be of prognostic value. If cardiac involvement in sarcoidosis or amyloidosis is suspected cardiac MRI including LGE should be performed for establishing the diagnosis. (orig.) [German] Die Sarkoidose und Amyloidose sind Multisystemerkrankungen, in deren Verlauf es zu einer kardialen Beteiligung kommen kann. Bildgebend wird als primaeres Verfahren die Echokardiographie eingesetzt. Zur weiteren Diagnostik wird neben der Biopsie und nuklearmedizinischen Verfahren v. a. die MRT herangezogen. Als neuere Technik zur Darstellung globaler diffuser Kontrastmittelanreicherungen, wie sie im Rahmen der Amyloidose vorkommen, wird z. Z. das T1-Mapping evaluiert. Durch den Einsatz der MRT, insbesondere des Late-Gadolinium-Enhancements (LGE), koennen die Sensitivitaet und Spezifitaet in der Diagnostik der kardialen Sarkoidose und Amyloidose entscheidend verbessert werden. Bei der Sarkoidose stellt das Vorhandensein eines LGE einen

  17. Locally homogenized and de-noised vector fields for cardiac fiber tracking in DT-MRI images

    Science.gov (United States)

    Akhbardeh, Alireza; Vadakkumpadan, Fijoy; Bayer, Jason; Trayanova, Natalia A.

    2009-02-01

    In this study we develop a methodology to accurately extract and visualize cardiac microstructure from experimental Diffusion Tensor (DT) data. First, a test model was constructed using an image-based model generation technique on Diffusion Tensor Magnetic Resonance Imaging (DT-MRI) data. These images were derived from a dataset having 122x122x500 um3 voxel resolution. De-noising and image enhancement was applied to this high-resolution dataset to clearly define anatomical boundaries within the images. The myocardial tissue was segmented from structural images using edge detection, region growing, and level set thresholding. The primary eigenvector of the diffusion tensor for each voxel, which represents the longitudinal direction of the fiber, was calculated to generate a vector field. Then an advanced locally regularizing nonlinear anisotropic filter, termed Perona-Malik (PEM), was used to regularize this vector field to eliminate imaging artifacts inherent to DT-MRI from volume averaging of the tissue with the surrounding medium. Finally, the vector field was streamlined to visualize fibers within the segmented myocardial tissue to compare the results with unfiltered data. With this technique, we were able to recover locally regularized (homogenized) fibers with a high accuracy by applying the PEM regularization technique, particularly on anatomical surfaces where imaging artifacts were most apparent. This approach not only aides in the visualization of noisy complex 3D vector fields obtained from DT-MRI, but also eliminates volume averaging artifacts to provide a realistic cardiac microstructure for use in electrophysiological modeling studies.

  18. Churg-Strauss Syndrome with Cardiac Involvement: A Case Report with CT and MRI Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seong Joo; Cho, Young Jun; Kim, Keum; Hwang, Cheol Mok; Kim, Dae Ho [Dept. of Radiology, Konyang University College of Medicine, Daegu (Korea, Republic of); Choi, Eu Gene [Dept. of Internal Medicine, Konyang University College of Medicine, Daegu (Korea, Republic of)

    2012-02-15

    This is a case report of Churg-Strauss Syndrome (CSS) associated with cardiac involvement which is demonstrated in chest CT and cardiac MRI (CMR) without specific cardiac symptoms. A 32-year-old woman had a 3-year history of bronchial asthma, chronic sinusitis, and otitis media. The patient had various typical findings of CSS. The patient had no specific cardiac symptoms or signs such as chest pain, palpitations, syncope, or murmur, but she had diffuse low attenuation lesions in the inner wall of the left ventricle (LV) in contrast-enhanced CT. This corresponded to the area of subendocardial hyperenhancement in delayed contrast-enhanced CMR images. She was treated with steroids for 2 months. Follow-up delayed contrast-enhanced CMR of the LV showed a decrease in the size of the subendocardial enhancement area, and she had no symptoms. Therefore, the radiologist and clinician both should pay careful attention to observe possible cardiac involvement in case of CSS.

  19. Motion-compensation of cardiac perfusion MRI using a statistical texture ensemble

    DEFF Research Database (Denmark)

    Stegmann, M.B.; Larsson, H.B.W.

    This paper presents a novel method for segmentation of cardiac perfusion MRI. By performing complex analyses of variance and clustering in an annotated training set off-line, the presented method provides real-time segmentation in an on-line setting. This renders the method feasible for e.g. anal...

  20. Unsupervised motion-compensation of multi-slice cardiac perfusion MRI

    DEFF Research Database (Denmark)

    Stegmann, M.B.; Ólafsdóttir, H; Larsson, H.B.W.

    2005-01-01

    This paper presents a novel method for registration of single and multi-slice cardiac perfusion MRI. Utilising off-line computer intensive analyses of variance and clustering in an annotated training set, the presented method is capable of providing registration without any manual interaction in ...

  1. Compressed sensing reconstruction of cardiac cine MRI using golden angle spiral trajectories

    Science.gov (United States)

    Tolouee, Azar; Alirezaie, Javad; Babyn, Paul

    2015-11-01

    In dynamic cardiac cine Magnetic Resonance Imaging (MRI), the spatiotemporal resolution is limited by the low imaging speed. Compressed sensing (CS) theory has been applied to improve the imaging speed and thus the spatiotemporal resolution. The purpose of this paper is to improve CS reconstruction of under sampled data by exploiting spatiotemporal sparsity and efficient spiral trajectories. We extend k-t sparse algorithm to spiral trajectories to achieve high spatio temporal resolutions in cardiac cine imaging. We have exploited spatiotemporal sparsity of cardiac cine MRI by applying a 2D + time wavelet-Fourier transform. For efficient coverage of k-space, we have used a modified version of multi shot (interleaved) spirals trajectories. In order to reduce incoherent aliasing artifact, we use different random undersampling pattern for each temporal frame. Finally, we have used nonuniform fast Fourier transform (NUFFT) algorithm to reconstruct the image from the non-uniformly acquired samples. The proposed approach was tested in simulated and cardiac cine MRI data. Results show that higher acceleration factors with improved image quality can be obtained with the proposed approach in comparison to the existing state-of-the-art method. The flexibility of the introduced method should allow it to be used not only for the challenging case of cardiac imaging, but also for other patient motion where the patient moves or breathes during acquisition.

  2. Advances in cardiac magnetic resonance imaging of congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Driessen, Mieke M.P. [University of Utrecht, University Medical Center Utrecht, Department of Radiology, PO Box 85500, Utrecht (Netherlands); University of Utrecht, University Medical Center Utrecht, Department of Cardiology, PO Box 85500, Utrecht (Netherlands); The Interuniversity Cardiology Institute of the Netherlands (ICIN) - Netherlands Heart Institute, PO Box 19258, Utrecht (Netherlands); Breur, Johannes M.P.J. [Wilhelmina Children' s Hospital, University Medical Center Utrecht, Department of Pediatric Cardiology, PO Box 85500, Utrecht (Netherlands); Budde, Ricardo P.J.; Oorschot, Joep W.M. van; Leiner, Tim [University of Utrecht, University Medical Center Utrecht, Department of Radiology, PO Box 85500, Utrecht (Netherlands); Kimmenade, Roland R.J. van; Sieswerda, Gertjan Tj [University of Utrecht, University Medical Center Utrecht, Department of Cardiology, PO Box 85500, Utrecht (Netherlands); Meijboom, Folkert J. [University of Utrecht, University Medical Center Utrecht, Department of Cardiology, PO Box 85500, Utrecht (Netherlands); Wilhelmina Children' s Hospital, University Medical Center Utrecht, Department of Pediatric Cardiology, PO Box 85500, Utrecht (Netherlands)

    2015-01-01

    Due to advances in cardiac surgery, survival of patients with congenital heart disease has increased considerably during the past decades. Many of these patients require repeated cardiovascular magnetic resonance imaging to assess cardiac anatomy and function. In the past decade, technological advances have enabled faster and more robust cardiovascular magnetic resonance with improved image quality and spatial as well as temporal resolution. This review aims to provide an overview of advances in cardiovascular magnetic resonance hardware and acquisition techniques relevant to both pediatric and adult patients with congenital heart disease and discusses the techniques used to assess function, anatomy, flow and tissue characterization. (orig.)

  3. Cardiac Toxicity after definitive Radiotherapy of locally advanced NSCLC

    DEFF Research Database (Denmark)

    Schytte, Tine; Hansen, Olfred; Stohlberg-Rohr, Thomine;

    2010-01-01

    report the heart toxicities in locally-regionally advanced NSCLC (LA-NSCLC) patients (pts) treated with RT in our centre.   Methods and material: From 01.01.1995-30.11.2007, 287 pts with LA-NSCLC (stage IIB-IIIB) were treated with RT at our centre with planned dose 60-66 Gy. All RT was applied as 3D RT......    Cardiac Toxicity after definitive Radiotherapy of locally advanced NSCLC Tine Schytte, Olfred Hansen, Thomine Stolberg-Rohr* and Carsten Brink*. Dept. Oncology and Radiophysic Lab.* Odense University Hospital, Denmark   Keyword: Radiotherapy, Locally advanced NSCLC, Cardiac toxicity...

  4. Cardiac metabolism measured noninvasively by hyperpolarized 13C MRI

    DEFF Research Database (Denmark)

    Golman, K.; Petersson, J.S.; Magnusson, P.;

    2008-01-01

    was almost absent (0.2-11%) and the alanine signal was reduced (27-51%). Due to image-folding artifacts the data obtained for lactate were inconclusive. These studies demonstrate that cardiac metabolic imaging with hyperpolarized 1-(13)C-pyruvate is feasible. The changes in concentrations of the...

  5. Highly accelerated real-time cardiac cine MRI using k-t SPARSE-SENSE.

    Science.gov (United States)

    Feng, Li; Srichai, Monvadi B; Lim, Ruth P; Harrison, Alexis; King, Wilson; Adluru, Ganesh; Dibella, Edward V R; Sodickson, Daniel K; Otazo, Ricardo; Kim, Daniel

    2013-07-01

    For patients with impaired breath-hold capacity and/or arrhythmias, real-time cine MRI may be more clinically useful than breath-hold cine MRI. However, commercially available real-time cine MRI methods using parallel imaging typically yield relatively poor spatio-temporal resolution due to their low image acquisition speed. We sought to achieve relatively high spatial resolution (∼2.5 × 2.5 mm(2)) and temporal resolution (∼40 ms), to produce high-quality real-time cine MR images that could be applied clinically for wall motion assessment and measurement of left ventricular function. In this work, we present an eightfold accelerated real-time cardiac cine MRI pulse sequence using a combination of compressed sensing and parallel imaging (k-t SPARSE-SENSE). Compared with reference, breath-hold cine MRI, our eightfold accelerated real-time cine MRI produced significantly worse qualitative grades (1-5 scale), but its image quality and temporal fidelity scores were above 3.0 (adequate) and artifacts and noise scores were below 3.0 (moderate), suggesting that acceptable diagnostic image quality can be achieved. Additionally, both eightfold accelerated real-time cine and breath-hold cine MRI yielded comparable left ventricular function measurements, with coefficient of variation cine MRI with k-t SPARSE-SENSE is a promising modality for rapid imaging of myocardial function.

  6. Left atrial dysfunction in type 2 diabetes mellitus: insights from cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Graca, Bruno; Donato, Paulo; Caseiro-Alves, Filipe [University of Coimbra, Faculty of Medicine, Coimbra (Portugal); Coimbra' s Hospital Centre and University, Medical Imaging Department, Coimbra (Portugal); Joao Ferreira, Maria [University of Coimbra, Faculty of Medicine, Coimbra (Portugal); Coimbra' s Hospital Centre and University, Cardiology Department, Coimbra (Portugal); Gomes, Leonor [University of Coimbra, Faculty of Medicine, Coimbra (Portugal); Coimbra' s Hospital Centre and University, Endocrinology Department, Coimbra (Portugal); Castelo-Branco, Miguel [University of Coimbra, Faculty of Medicine, Coimbra (Portugal)

    2014-11-15

    The left atrium (LA) modulates left ventricular filling through reservoir, conduit and booster pump functions. Only limited data exist on LA involvement in type 2 diabetes mellitus (DM2). This study sought to assess LA function in asymptomatic DM2 with cardiac MRI. We hypothesized that cardiac MRI can detect LA dysfunction in asymptomatic DM2. Forty-five patients with asymptomatic DM2 and 24 normoglycaemic controls were studied. MRI cine imaging was performed to measure LA maximal and minimal volumes. A flow-sensitive phase-contrast gradient-echo sequence was used for flow measurements perpendicular to the orifice of the mitral valve, to quantify active LA stroke volume. LA total, passive and active emptying volumes and fractions were calculated. LA reservoir function, namely LA total ejection fraction, was significantly greater in controls compared to patients with DM2 (62.2 ± 5.2 vs 57.0 ± 7.6 %, P = 0.004). LA passive ejection fraction was also greater in the controls (26.2 ± 9.5 vs 16.1 ± 11.0 %, P < 0.001). Regarding parameters of LA booster pump function, LA active ejection fraction was not significantly different between groups. DM2 was demonstrated to be an independent determinant of LA function. Cardiac MRI enables the detection of LA dysfunction in asymptomatic DM2, characterized by a reduction in LA reservoir and conduit functions. (orig.)

  7. SELDI-TOF-MS Serum Profiling Reveals Predictors of Cardiac MRI Changes in Marathon Runners

    Directory of Open Access Journals (Sweden)

    George D. Wilson

    2012-01-01

    Full Text Available Purpose. To utilize proteomics to discover proteins associated with significant cardiac magnetic resonance imaging (MRI changes in marathon runners. Methods. Serum from 25 runners was analyzed by surface enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS. Proteomic profiles were compared in serum samples obtained prior to the race, at the finish line and within 7 hours after race to identify dynamic proteins correlated with cardiac MRI changes. Results. 693 protein/peptide clusters were identified using two ProteinChip surface chemistries and, of these, 116 were significantly different between the three time points. We identified 7 different patterns of protein expression change within the runners and 5 prerace protein peaks, 16 finish-line protein levels, and 15 postrace proteins which were correlated with significant postrace cardiac MRI changes. Conclusions. This study has identified baseline levels of proteins which may be predictive of risk of significant cardiac damage following a marathon race. Preliminary identification of the significant proteins suggested the involvement of cytokines and other proteins involved in stress and inflammatory response.

  8. Subject specific BOLD fMRI respiratory and cardiac response functions obtained from global signal.

    Science.gov (United States)

    Falahpour, Maryam; Refai, Hazem; Bodurka, Jerzy

    2013-05-15

    Subtle changes in either breathing pattern or cardiac pulse rate alter blood oxygen level dependent functional magnetic resonance imaging signal (BOLD fMRI). This is problematic because such fluctuations could possibly not be related to underlying neuronal activations of interest but instead the source of physiological noise. Several methods have been proposed to eliminate physiological noise in BOLD fMRI data. One such method is to derive a template based on average multi-subject data for respiratory response function (RRF) and cardiac response function (CRF) by simultaneously utilizing an external recording of cardiac and respiratory waveforms with the fMRI. Standard templates can then be used to model, map, and remove respiration and cardiac fluctuations from fMRI data. Utilizing these does not, however, account for intra-subject variations in physiological response. Thus, performing a more individualized approach for single subject physiological noise correction becomes more desirable, especially for clinical purposes. Here we propose a novel approach that employs subject-specific RRF and CRF response functions obtained from the whole brain or brain tissue-specific global signals (GS). Averaging multiple voxels in global signal computation ensures physiological noise dominance over thermal and system noise in even high-spatial-resolution fMRI data, making the GS suitable for deriving robust estimations of both RRF and CRF for individual subjects. Using these individualized response functions instead of standard templates based on multi-subject averages judiciously removes physiological noise from the data, assuming that there is minimal neuronal contribution in the derived individualized filters. Subject-specific physiological response functions obtained from the GS better maps individuals' physiological characteristics.

  9. Preliminary MRI study on hemodynamics after prosthetic cardiac valve implantation

    International Nuclear Information System (INIS)

    Objective: To assess the function of prosthetic valve by magnetic resonance imaging (MRI), and to measure the blood velocity downstream of prosthetic valve and three-dimensional surface profiles so as to provide the original materials for appearance and development of thrombi-embolic complications in the long time follow-up. Methods: Twenty-seven cases with prosthetic aortic valve were examined and the blood velocity was measured by using MRI. The diseased heart valves were replaced with two prosthetic valves in 20 cases, and replaced with single prosthetic valve in 7 cases. The axial velocity components were measured at three positions near the valve including half, one, and two diameter downstream in the ascending aorta. Two and three-dimensional surface profile reconstruction were analyzed by using flow analysis software and Matlab 6.5 software. Results: In 16 cases with prosthetic aortic valve replacement with two leaflets prosthetic valves, the velocity profiles downstream of the valve prosthetic reflecting the valve design was nearly three velocity, jets of the two major orifices and the central slit between the two leaflets. In 4 cases with prosthetic aortic valve replace with Sorin two leaflets prosthetic valve, the velocity profiles downstream was nearly two velocity jets of the two major orifices. In 20 cases replaced with two leaflets prosthetic valves, blood velocity profiles were skewed with highest velocities. Seven cases with single leaflet showed single velocity jets of the major orifices at peak systole. Retrograde velocities occurred in part of the lateral orifice regions in 26 cases. Three-dimensional surface profiles downstream of the prosthetic aortic valve reflected the valve design. The blood velocity profiles with prosthetic aortic valve in the one diameter downstream in the ascending aorta clearly showed the valve design. Conclusion: MRI is a non-invasive, direct, and in-vivo method of choice to assess the valvular function and is the

  10. Unravelling the grey zone : cardiac MRI volume to wall mass ratio to differentiate hypertrophic cardiomyopathy and the athlete's heart

    NARCIS (Netherlands)

    Luijkx, Tim; Cramer, Maarten J.; Buckens, Constantinus F.; Zaidi, Abbas; Rienks, Rienk; Mosterd, Arend; Prakken, Niek H. J.; Dijkman, Barbara; Mali, Willem P. Th M.; Velthuis, Birgitta K.

    2015-01-01

    Background Differentiating physiological left ventricular hypertrophy (LVH) in athletes from pathological hypertrophic cardiomyopathy (HCM) can be challenging. This study assesses the ability of cardiac MRI (CMR) to distinguish between physiological LVH (so-called athlete's heart) and HCM. Methods 4

  11. Pattern-based approach to fetal congenital cardiovascular anomalies using the transverse aortic arch view on prenatal cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Su-Zhen; Zhu, Ming [Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China)

    2015-05-01

    Fetal echocardiography is the imaging modality of choice for prenatal diagnosis of congenital cardiovascular anomalies. However, echocardiography has limitations. Fetal cardiac magnetic resonance imaging (MRI) has the potential to complement US in detecting congenital cardiovascular anomalies. This article draws on our experience; it describes the transverse aortic arch view on fetal cardiac MRI and important clues on an abnormal transverse view at the level of the aortic arch to the diagnosis of fetal congenital cardiovascular anomalies. (orig.)

  12. 核磁共振在缺血性心脏病及心脏功能分析中的新进展%Advances of MRI in Ischemic Heart Disease and Analysis of Cardiac Function

    Institute of Scientific and Technical Information of China (English)

    黄莺; 马依彤

    2003-01-01

    @@ 随着科学技术的发展,心血管疾病的诊断日益完善,仅心血管影像技术就有超声心动图,心肌灌注断层显像(Single photon emission computed tomography,SPECT),X-线计算机断层成像(Computed tomography,CT),核磁共振(Magnetic resonance imaging,MRI)及数字减影血管造影(Digital subtraction angiography,DSA)等.MRI是近十年来用于临床心血管疾病的诊断技术,由于其无创,无辐射,可行多层面,多角度成像,因而较之其他的技术更便利.

  13. Pulmonary arterial dimensions and right ventricular function by cardiac MRI

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of cardiac magnetic resonance imaging (CMRI) for pulmonary arterial hypertension (PAH). Methods: One hundred and thirty patients with PAH confirmed by right cardiac catheterization were examined by CMRI and the results were compared with that of 31 healthy control participants. The main pulmonary artery diameter (MPAD), aortic diameter (AOD), main pulmonary artery diameter/aortic diameter (MPAD/AOD), right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular ejection fraction (RVEF) and right ventricular mass (RVM) were measured. The independent samples t-test was used to compare the PAH group with the control group. The Pearson correlation analysis and linear regression analysis were used to evaluate the relationship between cardiac and arterial measurements and pulmonary arterial pressure (PAP). Results: The MPAD, MPAD/AOD, RVEDV, RVESV, RVM in PAH group [(3.88 ±0.57) cm,1.36 ±0.17,(161.63 ±56.37) ml,(112.61 ±41.46) ml,(82.70 ± 20.73) g, respectively] were increased compared with those in normal control group [(2.74 ±0.31 ) cm, 0.90 ±0.07, (131.31 ± 15.14) ml, (61.33±9.00) ml, (44.39±5.87) g, respectively]. The RVSV and RVEF in PAH group[(49.02 ±19.20) ml, (30.76 ± 5.85 )%, respectively] were decreased compared with those in normal control group [(69.95 ± 9.63 )ml, (53.28 ± 4.14)%, respectively]. The MPAD, MPAD/AOD, RVEDV, RVESV, RVSV, RVEF, RVM were significantly different between PAH patients and control participants (tMPAD=10.82, tMPAD/AOD=14.93, tRVEDV=2.96, tRVESV=6.83, tRVSV=-5.89, tRVEF=-20.22, tRVM=10.12, respectively, P<0.01). There were no significant correlations between MPAD, RVEDV, RVESV, RVSV and PAP (r=0.299 for MPAD, r=0.127 for RVEDV, r=0.278 for RVESV, r=-0.229 for RVSV). Moderate positive correlations were found between MPAD/AOD, RVM and PAP (r=0.702 for MPAD/AOD, r=0.683 for RVM ). A moderate negative correlation was found between

  14. Automated segmentation and reconstruction of patient-specific cardiac anatomy and pathology from in vivo MRI

    International Nuclear Information System (INIS)

    This paper presents an automated method to segment left ventricle (LV) tissues from functional and delayed-enhancement (DE) cardiac magnetic resonance imaging (MRI) scans using a sequential multi-step approach. First, a region of interest (ROI) is computed to create a subvolume around the LV using morphological operations and image arithmetic. From the subvolume, the myocardial contours are automatically delineated using difference of Gaussians (DoG) filters and GSV snakes. These contours are used as a mask to identify pathological tissues, such as fibrosis or scar, within the DE-MRI. The presented automated technique is able to accurately delineate the myocardium and identify the pathological tissue in patient sets. The results were validated by two expert cardiologists, and in one set the automated results are quantitatively and qualitatively compared with expert manual delineation. Furthermore, the method is patient-specific, performed on an entire patient MRI series. Thus, in addition to providing a quick analysis of individual MRI scans, the fully automated segmentation method is used for effectively tagging regions in order to reconstruct computerized patient-specific 3D cardiac models. These models can then be used in electrophysiological studies and surgical strategy planning. (paper)

  15. Motion adaptive patch-based low-rank approach for compressed sensing cardiac cine MRI.

    Science.gov (United States)

    Yoon, Huisu; Kim, Kyung Sang; Kim, Daniel; Bresler, Yoram; Ye, Jong Chul

    2014-11-01

    One of the technical challenges in cine magnetic resonance imaging (MRI) is to reduce the acquisition time to enable the high spatio-temporal resolution imaging of a cardiac volume within a short scan time. Recently, compressed sensing approaches have been investigated extensively for highly accelerated cine MRI by exploiting transform domain sparsity using linear transforms such as wavelets, and Fourier. However, in cardiac cine imaging, the cardiac volume changes significantly between frames, and there often exist abrupt pixel value changes along time. In order to effectively sparsify such temporal variations, it is necessary to exploit temporal redundancy along motion trajectories. This paper introduces a novel patch-based reconstruction method to exploit geometric similarities in the spatio-temporal domain. In particular, we use a low rank constraint for similar patches along motion, based on the observation that rank structures are relatively less sensitive to global intensity changes, but make it easier to capture moving edges. A Nash equilibrium formulation with relaxation is employed to guarantee convergence. Experimental results show that the proposed algorithm clearly reconstructs important anatomical structures in cardiac cine image and provides improved image quality compared to existing state-of-the-art methods such as k-t FOCUSS, k-t SLR, and MASTeR.

  16. Cardiac MRI, How Much can be Performed on a 1.5T Magnet with Basic Cardiac Sequences?

    Directory of Open Access Journals (Sweden)

    Sepideh Sefidbakht*

    2012-05-01

    Full Text Available Background/Objective: To present our first 8-month experience with cardiac MRI (1.5T, Siemens Avanto magnet, Argus viewer spectrum of local referrals and outcomes.Materials and Methods: The population included 24 patients, (five female, 19 male reffered for evaluation of possible arrhythmogenic right ventricular dysplasia (ARVD (11, myocarditis (5, ischemic scar (2 and miscellaneous cases (6 including myocardial cyst, papillary muscle lipoma, straight back syndrome (ruling out absent pericardium, possible pericarditis, Brugada syndrome and one case of later biopsy proven cardiac amyloidosis. Retrorecon, truFisp cine images were obtained in SA, 2 and 4 chamber views. T1 flash images were taken with/ without fat-saturation. T2HASTE and SA STIR images were obtained. Postcontrast delayed enhancement images were taken (PSIR tFla or Trufisp. Dynamic perfusion images were obtained in two cases. For DE images, TI 160-360 was manually selected one image at a time and optimal myocardial nulling was selected visually and subjectively. Results: Out of 11 patients reffered for possible ARVD, four patients showed regional dys/akinesia; with an EF<40% this was considered a major criterion. Three of the mentioned patients as well as two patients without obvious dyskinesia showed delayed RV freewall enhancement. Out of five patients referred with possible myocarditis, three showed patchy subepicardial enhanecement which confirmed the diagnosis, and two showed nonspecific transmural edema and/or enhancement. Ischemic scar was observed in two.Conclusion: Although far less than perfect, the basic MRI sequences provided by many vendors on 1.5T magnets can be helpful in selected cases of cardiac disease when referral to centers with a higher level of expertise and equipment is not feasible.

  17. From the Weinberg Angle to Cardiac MRI a career change

    CERN Document Server

    ten Have, I

    1997-01-01

    In summer 1994 I left particle physics to pursue a career in industry. Now three years later I am working for Philips Medical Systems in the Netherlands. I am responsible, both technically and commercially, for adapting the exist-ingMagnetic Resonance Imaging (MRI) technique for cardiology applications. In this seminar I will talk about the interesting challenges my current position holds for me. I will present the substantial added value of my working experience at CERN: the physics research, working at technological frontiers, the international collaboration, expatriate life. Finally I will also describe what I have done to actively support this career change. Speaker: 1985-1989 Ð University of Nijmegen and CERN - Ph.D. on B0-B0bar mixing, Eurojet, top quark cross-sections, test of the O(as3) QCD matrix element, calculations for future hadron colliders, UA1. 1989-1994 Ð University of Glasgow and CERN - ALEPH - Jet charge studies, measurement of the Weinberg Angle. 1994-1996 Ð Master of Business Administr...

  18. Recent advances in cardiac magnetic resonance.

    Science.gov (United States)

    Greulich, Simon; Arai, Andrew E; Sechtem, Udo; Mahrholdt, Heiko

    2016-01-01

    Cardiac magnetic resonance (CMR) is a non-invasive imaging modality that has rapidly emerged during the last few years and has become a valuable, well-established clinical tool. Beside the evaluation of anatomy and function, CMR has its strengths in providing detailed non-invasive myocardial tissue characterization, for which it is considered the current diagnostic gold standard. Late gadolinium enhancement (LGE), with its capability to detect necrosis and to separate ischemic from non-ischemic cardiomyopathies by distinct LGE patterns, offers unique clinical possibilities. The presence of LGE has also proven to be a good predictor of an adverse outcome in various studies. T2-weighted (T2w) images, which are supposed to identify areas of edema and inflammation, are another CMR approach to tissue characterization. However, T2w images have not held their promise owing to several technical limitations and potential physiological concerns. Newer mapping techniques may overcome some of these limitations: they assess quantitatively myocardial tissue properties in absolute terms and show promising results in studies for characterization of diffuse fibrosis (T1 mapping) and/or inflammatory processes (T2 mapping). However, these techniques are still research tools and are not part of the clinical routine yet. T2* CMR has had significant impact in the management of thalassemia because it is possible to image the amount of iron in the heart and the liver, improving both diagnostic imaging and the management of patients with thalassemia. CMR findings frequently have clinical impact on further patient management, and CMR seems to be cost effective in the clinical routine. PMID:27635240

  19. Dictionary-Driven Ischemia Detection From Cardiac Phase-Resolved Myocardial BOLD MRI at Rest.

    Science.gov (United States)

    Bevilacqua, Marco; Dharmakumar, Rohan; Tsaftaris, Sotirios A

    2016-01-01

    Cardiac Phase-resolved Blood-Oxygen-Level Dependent (CP-BOLD) MRI provides a unique opportunity to image an ongoing ischemia at rest. However, it requires post-processing to evaluate the extent of ischemia. To address this, here we propose an unsupervised ischemia detection (UID) method which relies on the inherent spatio-temporal correlation between oxygenation and wall motion to formalize a joint learning and detection problem based on dictionary decomposition. Considering input data of a single subject, it treats ischemia as an anomaly and iteratively learns dictionaries to represent only normal observations (corresponding to myocardial territories remote to ischemia). Anomaly detection is based on a modified version of One-class Support Vector Machines (OCSVM) to regulate directly the margins by incorporating the dictionary-based representation errors. A measure of ischemic extent (IE) is estimated, reflecting the relative portion of the myocardium affected by ischemia. For visualization purposes an ischemia likelihood map is created by estimating posterior probabilities from the OCSVM outputs, thus obtaining how likely the classification is correct. UID is evaluated on synthetic data and in a 2D CP-BOLD data set from a canine experimental model emulating acute coronary syndromes. Comparing early ischemic territories identified with UID against infarct territories (after several hours of ischemia), we find that IE, as measured by UID, is highly correlated (Pearson's r=0.84) with respect to infarct size. When advances in automated registration and segmentation of CP-BOLD images and full coverage 3D acquisitions become available, we hope that this method can enable pixel-level assessment of ischemia with this truly non-invasive imaging technique.

  20. Current Pharmacological Advances in the Treatment of Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Andry Papastylianou

    2012-01-01

    Full Text Available Cardiac arrest is defined as the sudden cessation of spontaneous ventilation and circulation. Within 15 seconds of cardiac arrest, the patient loses consciousness, electroencephalogram becomes flat after 30 seconds, pupils dilate fully after 60 seconds, and cerebral damage takes place within 90–300 seconds. It is essential to act immediately as irreversible damage can occur in a short time. Cardiopulmonary resuscitation (CPR is an attempt to restore spontaneous circulation through a broad range of interventions which are early defibrillation, high-quality and uninterrupted chest compressions, advanced airway interventions, and pharmacological interventions. Drugs should be considered only after initial shocks have been delivered (when indicated and chest compressions and ventilation have been started. During cardiopulmonary resuscitation, no specific drug therapy has been shown to improve survival to hospital discharge after cardiac arrest, and only few drugs have a proven benefit for short-term survival. This paper reviews current pharmacological treatment of cardiac arrest. There are three groups of drugs relevant to the management of cardiac arrest: vasopressors, antiarrhythmics, and other drugs such as sodium bicarbonate, calcium, magnesium, atropine, fibrinolytic drugs, and corticosteroids.

  1. Hepatoma with cardiac metastasis: An advanced cancer requiring advanced treatment

    Institute of Scientific and Technical Information of China (English)

    Yu-Sheng Lin; Shih-Ming Jung; Feng-Chun Tsai; Chun-Nan Yeh; Tzu-Fang Shiu; Hsueh-Hua Wu; Pyng-Jing Lin; Pao-Hsien Chu

    2007-01-01

    AIM: To investigate the clinical and pathologic findings,and to discuss the pathophysiology of hepatocellular carcinoma with cardiac metastasis.METHODS: Eight hepatoma patients with cardiac metastasis, who were treated by surgical excision from 1993 to 2006, were retrospectively studied. Detailed clinical parameters were analyzed.RESULTS: Of those eight patients, two (25%) were women and six (75%) were men, with the mean age of 50 years (range, 40-70 years). The presentations included: asymptomatic (75%), heart failure (25%), and pulmonary embolism (12.5%). All lesions involved the right atrium, and extended to the lung (12.5%), inferior vena cava (25%), and left atrium (12.5%). The level of tumor marker, alpha-fetal protein, was not correlated with the severity of metastasis or disease prognosis.Moreover, the availably estimated doubling time was less than 3 mo. The pathological findings included variable hemorrhage and necrosis. The survival time following surgery also varied from one month to more than 30 mo.CONCLUSION: Hepatoma metastasis to the heart was detected in all eight patients. This study demonstrates that surgery might help the outcome in such cases.

  2. New cardiac MRI gating method using event-synchronous adaptive digital filter.

    Science.gov (United States)

    Park, Hodong; Park, Youngcheol; Cho, Sungpil; Jang, Bongryoel; Lee, Kyoungjoung

    2009-11-01

    When imaging the heart using MRI, an artefact-free electrocardiograph (ECG) signal is not only important for monitoring the patient's heart activity but also essential for cardiac gating to reduce noise in MR images induced by moving organs. The fundamental problem in conventional ECG is the distortion induced by electromagnetic interference. Here, we propose an adaptive algorithm for the suppression of MR gradient artefacts (MRGAs) in ECG leads of a cardiac MRI gating system. We have modeled MRGAs by assuming a source of strong pulses used for dephasing the MR signal. The modeled MRGAs are rectangular pulse-like signals. We used an event-synchronous adaptive digital filter whose reference signal is synchronous to the gradient peaks of MRI. The event detection processor for the event-synchronous adaptive digital filter was implemented using the phase space method-a sort of topology mapping method-and least-squares acceleration filter. For evaluating the efficiency of the proposed method, the filter was tested using simulation and actual data. The proposed method requires a simple experimental setup that does not require extra hardware connections to obtain the reference signals of adaptive digital filter. The proposed algorithm was more effective than the multichannel approach. PMID:19644754

  3. Advanced Structural and Functional Brain MRI in Multiple Sclerosis.

    Science.gov (United States)

    Giorgio, Antonio; De Stefano, Nicola

    2016-04-01

    Conventional magnetic resonance imaging (MRI) of the central nervous system is crucial for an early and reliable diagnosis and monitoring of patients with multiple sclerosis (MS). Focal white matter (WM) lesions, as detected by MRI, are the pathological hallmark of the disease and show some relation to clinical disability, especially in the long run. Gray matter (GM) involvement is evident from disease onset and includes focal (i.e., cortical lesions) and diffuse pathology (i.e., atrophy). Both accumulate over time and show close relation to physical disability and cognitive impairment. Using advanced quantitative MRI techniques such as magnetization transfer imaging (MTI), diffusion tensor imaging (DTI), proton MR spectroscopy ((1)H-MRS), and iron imaging, subtle MS pathology has been demonstrated from early stages outside focal WM lesions in the form of widespread abnormalities of the normal appearing WM and GM. In addition, studies using functional MRI have demonstrated that brain plasticity is driven by MS pathology, playing adaptive or maladaptive roles to neurologic and cognitive status and explaining, at least in part, the clinicoradiological paradox of MS. PMID:27116723

  4. A 128-Channel Receive-Only Cardiac Coil for Highly Accelerated Cardiac MRI at 3 Tesla

    OpenAIRE

    Schmitt, Melanie; Potthast, Andreas; Sosnovik, David E; Polimeni, Jonathan R; Wiggins, Graham C.; Triantafyllou, Christina; Wald, Lawrence L.

    2008-01-01

    A 128-channel receive-only array coil is described and tested for cardiac imaging at 3T. The coil is closely contoured to the body with a “clam-shell” geometry with 68 posterior and 60 anterior elements, each 75 mm in diameter, and arranged in a continuous overlapped array of hexagonal symmetry to minimize nearest neighbor coupling. Signal-to-noise ratio (SNR) and noise amplification for parallel imaging (G-factor) were evaluated in phantom and volunteer experiments. These results were compar...

  5. The role of 1.5 tesla MRI and anesthetic regimen concerning cardiac analysis in mice with cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Ulrich Grabmaier

    Full Text Available Accurate assessment of left ventricular function in rodent models is essential for the evaluation of new therapeutic approaches for cardiac diseases. In our study, we provide new insights regarding the role of a 1.5 Tesla (T magnetic resonance imaging (MRI device and different anesthetic regimens on data validity. As dedicated small animal MRI and echocardiographic devices are not broadly available, we evaluated whether monitoring cardiac function in small rodents with a clinical 1.5 T MRI device is feasible. On a clinical electrocardiogram (ECG synchronized 1.5 T MRI scanner we therefore studied cardiac function parameters of mice with chronic virus-induced cardiomyopathy. Thus, reduced left ventricular ejection fraction (LVEF could be verified compared to healthy controls. However, our results showed a high variability. First, anesthesia with medetomidine, midazolam and fentanyl (MMF led to depressed cardiac function parameters and more variability than isoflurane gas inhalation anesthesia, especially at high concentrations. Furthermore, calculation of an average ejection fraction value from sequenced scans significantly reduced the variance of the results. To sum up, we introduce the clinical 1.5 T MRI device as a new tool for effective analysis of left ventricular function in mice with cardiomyopathy. Besides, we suggest isoflurane gas inhalation anesthesia at high concentrations for variance reduction and recommend calculation of an average ejection fraction value from multiple sequenced MRI scans to provide valid data and a solid basis for further clinical testing.

  6. Cardiac involvement in Erdheim- Chester disease: MRI findings and literature revision

    International Nuclear Information System (INIS)

    Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis, characterized by the involvement of several organs. The lesions may be skeletal or extra-skeletal: in particular, long bones, skin, lungs, and the cardiovascular and the central nervous systems can be affected. In this report, we describe a case of a 34-year-old man, who came to our observation with symptomatic ECD, for a correct assessment of the degree of cardiac involvement through magnetic resonance imaging (MRI)

  7. Cardiac MRI of ischemic heart disease at 3 T: Potential and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Wieben, Oliver [Department of Radiology, University of Wisconsin, Madison, WI 53792-3252 (United States); Department of Medical Physics, University of Wisconsin, Madison, WI 53792-3252 (United States)], E-mail: owieben@wisc.edu; Francois, Christopher [Department of Radiology, University of Wisconsin, Madison, WI 53792-3252 (United States)], E-mail: cfrancois@uwhealth.org; Reeder, Scott B. [Department of Radiology, University of Wisconsin, Madison, WI 53792-3252 (United States); Department of Medical Physics, University of Wisconsin, Madison, WI 53792-3252 (United States); Department of Biomedical Engineering, University of Wisconsin, Madison, WI 53792-3252 (United States); Department of Medicine, University of Wisconsin, Madison, WI 53792-3252 (United States)], E-mail: sreeder@wisc.edu

    2008-01-15

    Cardiac MRI has become a routinely used imaging modality in the diagnosis of cardiovascular disease and is considered the clinically accepted gold standard modality for the assessment of cardiac function and myocardial viability. In recent years, commercially available clinical scanners with a higher magnetic field strength (3.0 T) and dedicated multi-element coils have become available. The superior signal-to-noise ratio (SNR) of these systems has lead to their rapid acceptance in cranial and musculoskeletal MRI while the adoption of 3.0 T for cardiovascular imaging has been somewhat slower. This review article describes the benefits and pitfalls of magnetic resonance imaging of ischemic heart disease at higher field strengths. The fundamental changes in parameters such as SNR, transversal and longitudinal relaxation times, susceptibility artifacts, RF (B{sub 1}) inhomogeneity, and specific absorption rate are discussed. We also review approaches to avoid compromised image quality such as banding artifacts and inconsistent or suboptimal flip angles. Imaging sequences for the assessment of cardiac function with CINE balanced SSFP imaging and MR tagging, myocardial perfusion, and delayed enhancement and their adjustments for higher field imaging are explained in detail along with several clinical examples. We also explore the use of parallel imaging at 3.0 T to improve cardiac imaging by trading the SNR gain for higher field strengths for acquisition speed with increased coverage or improved spatial and temporal resolution. This approach is particularly useful for dynamic applications that are usually limited to the duration of a single breath-hold.

  8. Cardiac MRI

    Science.gov (United States)

    ... Gadolinium can be used in patients with iodine contrast allergy, but may require pre-medication. It is far ... it is known that the patient has an allergy to the gadolinium contrast, it may still be possible to use it ...

  9. Technical assessment of whole body angiography and cardiac function within a single MRI examination

    International Nuclear Information System (INIS)

    Aim: To evaluate a combined protocol for simultaneous cardiac MRI (CMR) and contrast-enhanced (CE) whole-body MR angiography (WB-MRA) techniques within a single examination. Materials and methods: Asymptomatic volunteers (n = 48) with low-moderate risk of cardiovascular disease (CVD) were recruited. The protocol was divided into four sections: (1) CMR of left ventricle (LV) structure and function; (2) CE-MRA of the head, neck, and thorax followed by the distal lower limbs; (3) CMR LV “late gadolinium enhancement” assessment; and (4) CE-MRA of the abdomen and pelvis followed by the proximal lower limbs. Multiple observers undertook the image analysis. Results: For CMR, the mean ejection fraction (EF) was 67.3 ± 4.8% and mean left ventricular mass (LVM) was 100.3 ± 22.8 g. The intra-observer repeatability for EF ranged from 2.1–4.7% and from 9–12 g for LVM. Interobserver repeatability was 8.1% for EF and 19.1 g for LVM. No LV delayed myocardial enhancement was observed. For WB-MRA, some degree of luminal narrowing or stenosis was seen at 3.6% of the vessel segments (involving n = 29 of 48 volunteers) and interobserver radiological opinion was consistent in 96.7% of 1488 vessel segments assessed. Conclusion: Combined assessment of WB-MRA and CMR can be undertaken within a single examination on a clinical MRI system. The associated analysis techniques are repeatable and may be suitable for larger-scale cardiovascular MRI studies. - Highlights: • We report the use of whole body MR angiography and cardiac MR as a single examination. • Healthy volunteers with elevated cardiovascular disease risk were scanned. • Vessel segments and cardiac function were assessed by Radiologists and Physicists respectively. • The protocol took an average of 51 minutes to complete, and analyses were repeatable. • This combined cardiovascular MRI protocol will be used for better targeting of future interventions

  10. 3D cardiac motion reconstruction from CT data and tagged MRI.

    Science.gov (United States)

    Wang, Xiaoxu; Mihalef, Viorel; Qian, Zhen; Voros, Szilard; Metaxas, Dimitris

    2012-01-01

    In this paper we present a novel method for left ventricle (LV) endocardium motion reconstruction using high resolution CT data and tagged MRI. High resolution CT data provide anatomic details on the LV endocardial surface, such as the papillary muscle and trabeculae carneae. Tagged MRI provides better time resolution. The combination of these two imaging techniques can give us better understanding on left ventricle motion. The high resolution CT images are segmented with mean shift method and generate the LV endocardium mesh. The meshless deformable model built with high resolution endocardium surface from CT data fit to the tagged MRI of the same phase. 3D deformation of the myocardium is computed with the Lagrangian dynamics and local Laplacian deformation. The segmented inner surface of left ventricle is compared with the heart inner surface picture and show high agreement. The papillary muscles are attached to the inner surface with roots. The free wall of the left ventricle inner surface is covered with trabeculae carneae. The deformation of the heart wall and the papillary muscle in the first half of the cardiac cycle is presented. The motion reconstruction results are very close to the live heart video. PMID:23366825

  11. Cardiac MRI. Diagnostic gain of an additional axial SSFP chest sequence for the detection of potentially significant extracardiac findings in the cardiac MRI examination setting

    Energy Technology Data Exchange (ETDEWEB)

    Roller, F.C.; Schneider, C.; Krombach, G.A. [University Hospital Giessen (Germany). Dept. Radiology; Schuhbaeck, A. [University Hospital Giessen (Germany). Dept. Cardiology; Rolf, A. [Kerckhoff Hospital Bad Nauheim (Germany). Dept. Cardiology

    2014-01-15

    Purpose: Cardiac MRI (CMRI) is an effective method for imaging of the heart. The aim of our study was to assess whether an axial chest sequence in addition to the standard CMR examination setting has advantages in the detection of potentially significant extracardiac findings (PSEF). Materials and Methods: 400 consecutive patients were imaged at 1.5 T for clinical reasons. In addition to the standard long and short-axis views, an axial SSFP sequence was obtained covering the thorax from the lung apex to the diaphragm. All sequences were separately evaluated for PSEF. Results: A total of 25 PSEF were diagnosed in 400 patients, including 16 pleural effusions, a pulmonary fibrosis, a spondylodiscitis, ascites, lymphadenopathies, relapse of a mamma carcinoma, growth of adrenal glands metastases and diaphragmatic elevation. All 25 PSEF were detected by reading survey sequences. 24 of the 25 PSEF were detected by the additional SSFP chest sequence as well as the CINE sequences. Conclusion: In our study the additional axial SSFP chest sequence didn't show a benefit in the detection of PSEF. With the survey sequences we were able to detect all PSEF. We conclude that survey images should be assessed for additional findings. (orig.)

  12. Establishment of Pediatric Cardiac Intensive Care Advanced Practice Provider Services.

    Science.gov (United States)

    Gilliland, Jill; Donnellan, Amy; Justice, Lindsey; Moake, Lindy; Mauney, Jennifer; Steadman, Page; Drajpuch, David; Tucker, Dawn; Storey, Jean; Roth, Stephen J; Koch, Josh; Checchia, Paul; Cooper, David S; Staveski, Sandra L

    2016-01-01

    The addition of advanced practice providers (APPs; nurse practitioners and physician assistants) to a pediatric cardiac intensive care unit (PCICU) team is a health care innovation that addresses medical provider shortages while allowing PCICUs to deliver high-quality, cost-effective patient care. APPs, through their consistent clinical presence, effective communication, and facilitation of interdisciplinary collaboration, provide a sustainable solution for the highly specialized needs of PCICU patients. In addition, APPs provide leadership, patient and staff education, facilitate implementation of evidence-based practice and quality improvement initiatives, and the performance of clinical research in the PCICU. This article reviews mechanisms for developing, implementing, and sustaining advance practice services in PCICUs. PMID:26714997

  13. Using learned under-sampling pattern for increasing speed of cardiac cine MRI based on compressive sensing principles

    Science.gov (United States)

    Zamani, Pooria; Kayvanrad, Mohammad; Soltanian-Zadeh, Hamid

    2012-12-01

    This article presents a compressive sensing approach for reducing data acquisition time in cardiac cine magnetic resonance imaging (MRI). In cardiac cine MRI, several images are acquired throughout the cardiac cycle, each of which is reconstructed from the raw data acquired in the Fourier transform domain, traditionally called k-space. In the proposed approach, a majority, e.g., 62.5%, of the k-space lines (trajectories) are acquired at the odd time points and a minority, e.g., 37.5%, of the k-space lines are acquired at the even time points of the cardiac cycle. Optimal data acquisition at the even time points is learned from the data acquired at the odd time points. To this end, statistical features of the k-space data at the odd time points are clustered by fuzzy c-means and the results are considered as the states of Markov chains. The resulting data is used to train hidden Markov models and find their transition matrices. Then, the trajectories corresponding to transition matrices far from an identity matrix are selected for data acquisition. At the end, an iterative thresholding algorithm is used to reconstruct the images from the under-sampled k-space datasets. The proposed approaches for selecting the k-space trajectories and reconstructing the images generate more accurate images compared to alternative methods. The proposed under-sampling approach achieves an acceleration factor of 2 for cardiac cine MRI.

  14. Cardiac Imaging Using Clinical 1.5 T MRI Scanners in a Murine Ischemia/Reperfusion Model

    Directory of Open Access Journals (Sweden)

    Jakob G. J. Voelkl

    2011-01-01

    Full Text Available To perform cardiac imaging in mice without having to invest in expensive dedicated equipment, we adapted a clinical 1.5 Tesla (T magnetic resonance imaging (MRI scanner for use in a murine ischemia/reperfusion model. Phase-sensitive inversion recovery (PSIR sequence facilitated the determination of infarct sizes in vivo by late gadolinium enhancement. Results were compared to histological infarct areas in mice after ischemia/reperfusion procedure with a good correlation (=0.807, <.001. In addition, fractional area change (FAC was assessed with single slice cine MRI and was matched to infarct size (=−0.837 and fractional shortening (FS measured with echocardiography (=0.860; both <.001. Here, we demonstrate the use of clinical 1.5 MRI scanners as a feasible method for basic phenotyping in mice. These widely available scanners are capable of investigating in vivo infarct dimensions as well as assessment of cardiac functional parameters in mice with reasonable throughput.

  15. Unsupervised motion-compensation of multi-slice cardiac perfusion MRI

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Ólafsdóttir, Hildur; Larsson, Henrik B. W.

    2005-01-01

    This paper presents a novel method for registration of single and multi-slice cardiac perfusion MRI. Utilising computer intensive analyses of variance and clustering in an annotated training set off-line, the presented method is capable of providing registration without any manual interaction...... is verified and stabilised using perfusion specific prior models of pose and shape estimated from training data. Qualitative and quantitative validation of the method is carried out using 2000 clinical quality, short-axis, perfusion MR slice images, acquired from ten freely breathing patients with acute...... myocardial infarction. Despite evident perfusion deficits and varying image quality in the limited training set, a leave-one-out cross validation of the method showed a mean point to curve distance of 1.25+/-0.36 pixels for the left and right ventricle combined. We conclude that this learning-based method...

  16. Regional assessment of LV wall in infarcted heart using tagged MRI and cardiac modelling

    International Nuclear Information System (INIS)

    A segmental two-parameter empirical deformable model is proposed for evaluating regional motion abnormality of the left ventricle. Short-axis tagged MRI scans were acquired from 10 healthy subjects and 10 postinfarct patients. Two motion parameters, contraction and rotation, were quantified for each cardiac segment by fitting the proposed model using a non-rigid registration algorithm. The accuracy in motion estimation was compared to a global model approach. Motion parameters extracted from patients were correlated to infarct transmurality assessed with delayed-contrast-enhanced MRI. The proposed segmental model allows markedly improved accuracy in regional motion analysis as compared to the global model for both subject groups (1.22–1.40 mm versus 2.31–2.55 mm error). By end-systole, all healthy segments experienced radial displacement by ∼25–35% of the epicardial radius, whereas the 3 short-axis planes rotated differently (basal: 3.3°; mid:  −1° and apical:  −4.6°) to create a twisting motion. While systolic contraction showed clear correspondence to infarct transmurality, rotation was nonspecific to either infarct location or transmurality but could indicate the presence of functional abnormality. Regional contraction and rotation derived using this model could potentially aid in the assessment of severity of regional dysfunction of infarcted myocardium. (paper)

  17. Myocardial delayed contrast enhancement in patients with arterial hypertension: Initial results of cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Kjel [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: kjel_andersen@web.de; Hennersdorf, Marcus [Department of Cardiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: hennersdorf@med.uni-duesseldorf.de; Cohnen, Mathias [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: cohnen@med.uni-duesseldorf.de; Blondin, Dirk [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: blondin@med.uni-duesseldorf.de; Moedder, Ulrich [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: moedder@uni-duesseldorf.de; Poll, Ludger W. [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: poll@gmx.de

    2009-07-15

    Purpose: In arterial hypertension left ventricular hypertrophy comprises myocyte hypertrophy, interstitial fibrosis and structural alterations of the coronary microcirculation. MRI enables the detection of myocardial fibrosis, infarction and scar tissue by delayed enhancement (DE) after contrast media application. Aim of this study was to investigate patients with arterial hypertension but without known coronary disease or previous myocardial infarction to detect areas of DE. Methods and material: Twenty patients with arterial hypertension with clinical symptoms of myocardial ischemia, but without history of myocardial infarction and normal coronary arteries during coronary angiography were investigated on a 1.0 T superconducting magnet (Gyroscan T10-NT, Intera Release 8.0, Philips). Fast gradient-echo cine sequences and T2-weighted STIR-sequences were acquired. Fifteen minutes after injection of Gadobenate dimeglumine inversion recovery gradient-echo sequences were performed for detection of myocardial DE. Presence or absence of DE on MRI was correlated with clinical data and the results of echocardiography and electrocardiography, respectively. Results: Nine of 20 patients showed DE in the interventricular septum and the anteroseptal left ventricular wall. In 6 patients, DE was localized intramurally and in 3 patients subendocardially. There was a significant correlation between myocardial DE and ST-segment depressions during exercise and between DE and left-ventricular enddiastolic pressure. Patients with intermittent atrial fibrillation showed a myocardial DE more often than patients without atrial fibrillation. Conclusion: In our series, 45% of patients with arterial hypertension showed DE on cardiac MRI. In this clinical setting, delayed enhancement may be due to coronary microangiopathy. The more intramurally localization of DE, however, rather indicates myocardial interstitial fibrosis.

  18. SVM-based classification of LV wall motion in cardiac MRI with the assessment of STE

    Science.gov (United States)

    Mantilla, Juan; Garreau, Mireille; Bellanger, Jean-Jacques; Paredes, José Luis

    2015-01-01

    In this paper, we propose an automated method to classify normal/abnormal wall motion in Left Ventricle (LV) function in cardiac cine-Magnetic Resonance Imaging (MRI), taking as reference, strain information obtained from 2D Speckle Tracking Echocardiography (STE). Without the need of pre-processing and by exploiting all the images acquired during a cardiac cycle, spatio-temporal profiles are extracted from a subset of radial lines from the ventricle centroid to points outside the epicardial border. Classical Support Vector Machines (SVM) are used to classify features extracted from gray levels of the spatio-temporal profile as well as their representations in the Wavelet domain under the assumption that the data may be sparse in that domain. Based on information obtained from radial strain curves in 2D-STE studies, we label all the spatio-temporal profiles that belong to a particular segment as normal if the peak systolic radial strain curve of this segment presents normal kinesis, or abnormal if the peak systolic radial strain curve presents hypokinesis or akinesis. For this study, short-axis cine- MR images are collected from 9 patients with cardiac dyssynchrony for which we have the radial strain tracings at the mid-papilary muscle obtained by 2D STE; and from one control group formed by 9 healthy subjects. The best classification performance is obtained with the gray level information of the spatio-temporal profiles using a RBF kernel with 91.88% of accuracy, 92.75% of sensitivity and 91.52% of specificity.

  19. Importance of Delayed Enhanced Cardiac MRI Imaging in Idiopathic RVOT-VT: Differentiating Mimics Including Early Stage ARVC and Cardiac Sarcoidosis

    Directory of Open Access Journals (Sweden)

    Carlos Macias, MD; Keijiro Nakamura, MD; Roderick Tung, MD; Noel G. Boyle, MD PhD; Kalyanam Shivkumar, MD, PhD and Jason S. Bradfield, MD.

    2014-12-01

    Full Text Available Abstract: A detailed understanding of cardiac anatomy and pathophysiology is necessary to optimize catheter ablation procedural success for patients with symptomatic ventricular tachycardia (VT/premature ventricular contractions (PVCs of outflow tract origin. Comprehensive imaging with cardiac magnetic resonance imaging (cMRI is now at the forefront of procedural planning for complex ventricular arrhythmia ablation for patients with structural heart disease, but is increasingly used in patients with presumed “idiopathic” outflow VT/PVCs as well. cMRI with late gadolinium enhancement (LGE can localize small regions of myocardial scar from previous myocardial infarction, fibrosis from non-ischemic cardiomyopathy, or edema/fibrosis from inflammatory disorders and help define targets for ablation. LGE, in combination with structural assessment, can help differentiate true idiopathic outflow VT/PVCs from those caused by early stage disease secondary to more significant pathology, such as arrhythmogenic right ventricular cardiomyopathy or cardiac sarcoidosis. We review the benefits of cMRI with LGE for patients with VT/PVCs of outflow origin.

  20. Pediatric cardiac MRI: automated left-ventricular volumes and function analysis and effects of manual adjustments

    Energy Technology Data Exchange (ETDEWEB)

    Hammon, Matthias; Janka, Rolf; Dankerl, Peter; Kammerer, Ferdinand J.; Uder, Michael; Rompel, Oliver [University Hospital Erlangen, Department of Radiology, Erlangen (Germany); Gloeckler, Martin; Dittrich, Sven [University Hospital Erlangen, Department of Pediatric Cardiology, Erlangen (Germany)

    2015-05-01

    Cardiac MRI is an accurate and reproducible technique for the assessment of left ventricular volumes and function. The accuracy of automated segmentation and the effects of manual adjustments have not been determined in children. To evaluate automated segmentation and the effects of manual adjustments for left ventricular parameter quantification in pediatric cardiac MR images. Left ventricular parameters were evaluated in 45 children with suspected myocarditis (age 13.4 ± 3.5 years, range 4-17 years) who underwent cardiac MRI. Dedicated software was used to automatically segment and adjust the parameters. Results of end-diastolic volume, end-systolic volume, stroke volume, myocardial mass, and ejection fraction were documented before and after apex/base adjustment and after apex/base/myocardial contour adjustment. The software successfully detected the left ventricle in 42 of 45 (93.3%) children; failures occurred in the smallest and youngest children. Of those 42 children, automatically segmented end-diastolic volume (EDV) was 151 ± 47 ml, and after apex/base adjustment it was 146 ± 45 ml, after apex/base/myocardial contour adjustment 146 ± 45 ml. The corresponding results for end-systolic volume (ESV) were 66 ± 32 ml, 63 ± 29 ml and 64 ± 28 ml; for stroke volume (SV) they were 85 ± 25 ml, 83 ± 23 ml and 83 ± 23 ml; for ejection fracture (EF) they were 57 ± 10%, 58 ± 9% and 58 ± 9%, and for myocardial mass (MM) they were 104 ± 31 g, 95 ± 31 g and 94 ± 30 g. Statistically significant differences were found when comparing the EDV/ESV/MM results, the EF results after apex/base adjustment and after apex/base/myocardial contour adjustment and the SV results (except for comparing the SVs after apex/base adjustment and after apex/base/myocardial contour adjustment). Automated segmentation for the evaluation of left ventricular parameters in pediatric MR images proved to be feasible. Automated segmentation + apex/base adjustment provided clinically

  1. A comparison study of atlas-based 3D cardiac MRI segmentation: global versus global and local transformations

    Science.gov (United States)

    Daryanani, Aditya; Dangi, Shusil; Ben-Zikri, Yehuda Kfir; Linte, Cristian A.

    2016-03-01

    Magnetic Resonance Imaging (MRI) is a standard-of-care imaging modality for cardiac function assessment and guidance of cardiac interventions thanks to its high image quality and lack of exposure to ionizing radiation. Cardiac health parameters such as left ventricular volume, ejection fraction, myocardial mass, thickness, and strain can be assessed by segmenting the heart from cardiac MRI images. Furthermore, the segmented pre-operative anatomical heart models can be used to precisely identify regions of interest to be treated during minimally invasive therapy. Hence, the use of accurate and computationally efficient segmentation techniques is critical, especially for intra-procedural guidance applications that rely on the peri-operative segmentation of subject-specific datasets without delaying the procedure workflow. Atlas-based segmentation incorporates prior knowledge of the anatomy of interest from expertly annotated image datasets. Typically, the ground truth atlas label is propagated to a test image using a combination of global and local registration. The high computational cost of non-rigid registration motivated us to obtain an initial segmentation using global transformations based on an atlas of the left ventricle from a population of patient MRI images and refine it using well developed technique based on graph cuts. Here we quantitatively compare the segmentations obtained from the global and global plus local atlases and refined using graph cut-based techniques with the expert segmentations according to several similarity metrics, including Dice correlation coefficient, Jaccard coefficient, Hausdorff distance, and Mean absolute distance error.

  2. A model-based time-reversal of left ventricular motion improves cardiac motion analysis using tagged MRI data

    Directory of Open Access Journals (Sweden)

    Cook Larry T

    2008-05-01

    Full Text Available Abstract Background Myocardial motion is an important observable for the assessment of heart condition. Accurate estimates of ventricular (LV wall motion are required for quantifying myocardial deformation and assessing local tissue function and viability. Harmonic Phase (HARP analysis was developed for measuring regional LV motion using tagged magnetic resonance imaging (tMRI data. With current computer-aided postprocessing tools including HARP analysis, large motions experienced by myocardial tissue are, however, often intractable to measure. This paper addresses this issue and provides a solution to make such measurements possible. Methods To improve the estimation performance of large cardiac motions while analyzing tMRI data sets, we propose a two-step solution. The first step involves constructing a model to describe average systolic motion of the LV wall within a subject group. The second step involves time-reversal of the model applied as a spatial coordinate transformation to digitally relax the contracted LV wall in the experimental data of a single subject to the beginning of systole. Cardiac tMRI scans were performed on four healthy rats and used for developing the forward LV model. Algorithms were implemented for preprocessing the tMRI data, optimizing the model parameters and performing the HARP analysis. Slices from the midventricular level were then analyzed for all systolic phases. Results The time-reversal operation derived from the LV model accounted for the bulk portion of the myocardial motion, which was the average motion experienced within the overall subject population. In analyzing the individual tMRI data sets, removing this average with the time-reversal operation left small magnitude residual motion unique to the case. This remaining residual portion of the motion was estimated robustly using the HARP analysis. Conclusion Utilizing a combination of the forward LV model and its time reversal improves the performance of

  3. Hypertrophic cardiomyopathy: Cardiac structural and microvascular abnormalities as evaluated with multi-parametric MRI

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yu-Dong, E-mail: njmu_zyd@163.com [Department of Radiology, the First Affiliated Hospital with Nanjing Medical University (China); Li, Meijiao, E-mail: newgljyk@163.com [Department of Radiology, Peking University First Hospital (China); Qi, Liang, E-mail: qiliang1120@126.com [Department of Radiology, the First Affiliated Hospital with Nanjing Medical University (China); Wu, Chen-Jiang, E-mail: njmu_wcj@163.com [Department of Radiology, the First Affiliated Hospital with Nanjing Medical University (China); Wang, Xiaoying, E-mail: cjr.wangxiaoying@vip.163.com [Department of Radiology, Peking University First Hospital (China)

    2015-08-15

    Highlights: • LGE-present HCM had lower K{sup trans}, higher V{sub e} and MTT against LGE-absent HCM and normal group. • LGE-absent had significantly higher V{sub e} and MTT against normal group. • K{sup trans} was not changed between LGE-absent and normal group Microcirculatory dysfunction in HCM closely correlated to structural abnormality. - Abstract: Purpose: To determine the relationship between myocardial structural and microvascular abnormality in hypertrophic cardiomyopathy (HCM) by multi-parametric cardiac MRI. Materials and methods: Twenty-four HCM and eighteen controls were retrospectively included. Left ventricle mass (LVM), LV end-systolic and end-diastolic volume (LVESV, LVEDV), LV ejection fraction (LVEF), and 16-segment wall thickness at ES and ED (SESWT, SEDWT) were assessed with a 2D cine-MRI. Myocardial perfusion (reflected by K{sup trans}), interstitial volume (V{sub e}) and mean transmit time (MTT) were evaluated with a model-dependent dynamic contrast-enhanced MRI. Myocardial fibrosis was assessed with late gadolinium enhancement (LGE) imaging. Results: K{sup trans} was significantly decreased in LGE-present (0.74 ± 0.15 mL/g/min) against LGE-absent (0.55 ± 0.14 mL/g/min, p = 0.030) and normal group (0.81 ± 0.32 mL/g/min, p < 0.001), but was unchanged in LGE-absent against normal group (p > 0.05). V{sub e} and MTT were significantly increased in LGE-present (V{sub e}: 26.7 ± 15.7%; MTT: 28.6 ± 21.3 s) against LGE-absent (37.6 ± 18.3%; 49.8 ± 30.5 s) and normal group (19.7 ± 6.9%; 15.1 ± 3.9 s; all p < 0.001), and were significantly increased in LGE-absent against normal group (p < 0.001). LGE significantly correlated to K{sup trans}, V{sub e}, MTT, and SESWT (ρ = 0.232, −0.247, −0.443, and −0.207, respectively). K{sup trans} negatively correlated to SEDWT and SESWT (ρ = −0.224 and −0.231). V{sub e} and MTT positively correlated to SEDWT (V{sub e}: ρ = 0.223; MTT: ρ = 0.239) and SESWT (V{sub e}: ρ = 0.248; MTT:

  4. Repeatability of cardiac-MRI-measured right ventricular size and function in congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, Rowan; Salem, Yishay [Mount Sinai School of Medicine, Division of Pediatric Cardiology, New York, NY (United States); Shah, Amee; Lai, Wyman W. [Morgan Stanley Children' s Hospital of New York Presbyterian, New York, NY (United States); Nielsen, James C. [Mount Sinai School of Medicine, Division of Pediatric Cardiology, New York, NY (United States); Mount Sinai Children' s Heart Center, Box 1201, New York, NY (United States)

    2011-08-15

    The measurement error for right ventricular (RV) size and function assessed by cardiac MRI (CMRI) in congenital heart disease has not been fully characterized. As CMRI parameters are being increasingly utilized to make clinical decisions, defining error in the clinical setting is critical. This investigation examines the repeatability of CMRI for RV size and function. Forty consecutive people with congenital heart disease involving the RV were retrospectively identified. Contouring of RV volumes was performed by two expert CMRI clinicians. The coefficient of variability and repeatability coefficients were calculated. Repeatability coefficients were multiplied by the mean value for each group studied to define a threshold beyond which measurement error was unlikely to be responsible. The variability for indexed RV end-diastolic volume = 3.2% and 3.3% for intra- and interobserver comparisons, respectively. The repeatability coefficients were 13.2% and 14.9% for intra- and interobserver comparisons, which yielded threshold values of 15.1 ml/m{sup 2} and 20.2 ml/m{sup 2}, respectively. For RV ejection fraction (EF), the repeatability coefficients for intra- and interobserver comparisons were 5.0% and 6.0%, which resulted in threshold values of 2.6 EF% and 3.0 EF%. The threshold values generated can be used during serial assessment of RV size and function. (orig.)

  5. 3-D cardiac MRI in free-breathing newborns and infants: when is respiratory gating necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Seeger, Achim [University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); University Hospital of Tuebingen, Department of Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Krumm, Patrick; Schaefer, Juergen F.; Kramer, Ulrich [University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Hornung, Andreas; Sieverding, Ludger [University Hospital of Tuebingen, Department of Pediatric Cardiology, Tuebingen (Germany)

    2015-09-15

    Newborns and small infants have shallow breathing. To suggest criteria for when respiratory gating is necessary during cardiac MRI in newborns and infants. One-hundred ten data sets of newborns and infants with (n = 92, mean age: 1.9 ± 1.7 [SD] years) and without (n = 18, mean age: 1.6 ± 1.8 [SD] years) navigator gating were analysed retrospectively. The respiratory motion of the right hemidiaphragm was recorded and correlated to age, weight, body surface area and qualitative image quality on a 4-point score. Quantitative image quality assessment was performed (sharpness of the delineation of the ventricular septal wall) as well as a matched-pair comparison between navigator-gated and non-gated data sets. No significant differences were found in overall image quality or in the sharpness of the ventricular septal wall between gated and non-gated scans. A navigator acceptance of >80% was frequently found in patients ages <12 months, body surface area <0.40 m{sup 2}, body weight <10 kg and a size of <80 cm. Sequences without respiratory gating may be used in newborns and small infants, in particular if age <12 months, body surface area <0.40 m{sup 2}, body weight <10 kg and height <80 cm. (orig.)

  6. 3-D cardiac MRI in free-breathing newborns and infants: when is respiratory gating necessary?

    International Nuclear Information System (INIS)

    Newborns and small infants have shallow breathing. To suggest criteria for when respiratory gating is necessary during cardiac MRI in newborns and infants. One-hundred ten data sets of newborns and infants with (n = 92, mean age: 1.9 ± 1.7 [SD] years) and without (n = 18, mean age: 1.6 ± 1.8 [SD] years) navigator gating were analysed retrospectively. The respiratory motion of the right hemidiaphragm was recorded and correlated to age, weight, body surface area and qualitative image quality on a 4-point score. Quantitative image quality assessment was performed (sharpness of the delineation of the ventricular septal wall) as well as a matched-pair comparison between navigator-gated and non-gated data sets. No significant differences were found in overall image quality or in the sharpness of the ventricular septal wall between gated and non-gated scans. A navigator acceptance of >80% was frequently found in patients ages <12 months, body surface area <0.40 m2, body weight <10 kg and a size of <80 cm. Sequences without respiratory gating may be used in newborns and small infants, in particular if age <12 months, body surface area <0.40 m2, body weight <10 kg and height <80 cm. (orig.)

  7. MRI for advanced gastric cancer; Especially for scirrhous cancer of the stomach

    Energy Technology Data Exchange (ETDEWEB)

    Homma, Hisato; Masuko, Eiichi; Saito, Tadanori; Ikeda, Shigeyuki (National Sapporo Hospital (Japan)); Mezawa, Synichi; Betsuyaku, Takashi; Niitsu, Yoshiro

    1993-01-01

    We conducted MRI examinations in 92 patients with advanced gastric cancer and evaluated the clinical potential of MRI for diagnosis of scirrhous cancer of the stomach. The feature of scirrhous cancer of stomach by MRI are: (1) thickened gastric wall, (2) shortening of T1 and T2 values; and (3) clear contrast between the gastric mucosae and cancer areas found in the T1 and T2 weighted images (preservation of the mucosae). MRI for scirrhous cancer of the stomach is thought a useful image diagnosis as an adjunct method to gastric X-ray and gastric endoscopy. (author).

  8. Correlation of CT-based regional cardiac function (SQUEEZ) with myocardial strain calculated from tagged MRI: an experimental study.

    Science.gov (United States)

    Pourmorteza, Amir; Chen, Marcus Y; van der Pals, Jesper; Arai, Andrew E; McVeigh, Elliot R

    2016-05-01

    The objective of this study was to investigate the correlation between local myocardial function estimates from CT and myocardial strain from tagged MRI in the same heart. Accurate detection of regional myocardial dysfunction can be an important finding in the diagnosis of functionally significant coronary artery disease. Tagged MRI is currently a reference standard for noninvasive regional myocardial function analysis; however, it has practical drawbacks. We have developed a CT imaging protocol and automated image analysis algorithm for estimating regional cardiac function from a few heartbeats. This method tracks the motion of the left ventricular (LV) endocardial surface to produce local function maps: we call the method Stretch Quantification of Endocardial Engraved Zones (SQUEEZ). Myocardial infarction was created by ligation of the left anterior descending coronary artery for 2 h followed by reperfusion in canine models. Tagged and cine MRI scans were performed during the reperfusion phase and first-pass contrast enhanced CT scans were acquired. The average delay between the CT and MRI scans was myocardial strain (Ecc) was calculated from the tagged MRI data. The agreement between peak systolic Ecc and SQUEEZ was investigated in 162 segments in the 9 hearts. Linear regression and Bland-Altman analysis was used to assess the correlation between the two metrics of local LV function. The results show good agreement between SQUEEZ and Ecc: (r = 0.71, slope = 0.78, p function. The good agreement between the estimates of local myocardial function obtained from CT SQUEEZ and tagged MRI provides encouragement to investigate the use of SQUEEZ for measuring regional cardiac function at a low clinical dose in humans.

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

    OpenAIRE

    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...

  10. Advanced cardiac imaging in heart failure : from subclinical myocardial dysfunction to therapy optimization

    NARCIS (Netherlands)

    Auger, Dominique

    2014-01-01

    Advanced echocardiographic techniques permit assessment of left ventricular dyssynchrony in overt heart failure patients and provide important prognostic data. These techniques may guide patients’ selection for cardiac resynchronization therapy and device optimization. Global left ventricular longit

  11. The search for neuroimaging biomarkers of Alzheimer's disease with advanced MRI techniques

    Energy Technology Data Exchange (ETDEWEB)

    Li, Tie-Qiang (Karolinska Huddinge - Medical Physics, Stockholm (Sweden)), email: tieqiang.li@karolinska.se; Wahlund, Lars-Olof (Dept. of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm (Sweden))

    2011-02-15

    The aim of this review is to examine the recent literature on using advanced magnetic resonance imaging (MRI) techniques for finding neuroimaging biomarkers that are sensitive to the detection of risks for Alzheimer's disease (AD). Since structural MRI techniques, such as brain structural volumetry and voxel based morphometry (VBM), have been widely used for AD studies and extensively reviewed, we will only briefly touch on the topics of volumetry and morphometry. The focus of the current review is about the more recent developments in the search for AD neuroimaging biomarkers with functional MRI (fMRI), resting-state functional connectivity MRI (fcMRI), diffusion tensor imaging (DTI), arterial spin-labeling (ASL), and magnetic resonance spectroscopy (MRS)

  12. Early assessment of sub-clinical cardiac involvement in systemic sclerosis (SSc) using delayed enhancement cardiac magnetic resonance (CE-MRI)

    Energy Technology Data Exchange (ETDEWEB)

    Di Cesare, Ernesto, E-mail: ernesto.dicesare@cc.univaq.it [Department of Radiology, University of L’Aquila, Via Vetoio 1, 67100 L’Aquila (Italy); Battisti, Sara; Di Sibio, Alessandra [Department of Radiology, University of L’Aquila, Via Vetoio 1, 67100 L’Aquila (Italy); Cipriani, Paola; Giacomelli, Roberto; Liakouli, Vasiliky; Ruscitti, Piero [Rheumatology Clinic, Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila (Italy); Masciocchi, Carlo [Department of Radiology, University of L’Aquila, Via Vetoio 1, 67100 L’Aquila (Italy)

    2013-06-15

    Objectives: Systemic sclerosis heart involvement (SHI) is one of systemic sclerosis (SSc) most frequent complications, both in diffuse (dcSSc) and limited (lcSSc) cutaneous forms of disease. Nowadays, SHI is a major factor decreasing SSc survival rate because, when clinically evident, is associated with 70% of mortality at 5 years. SHI shows different forms, primary and/or secondary. Primary myocardial SHI is characterized by fibrosis. Aim of our study is to assess the presence and pattern of fibrosis as detected by cardiac magnetic resonance (CMR) in systemic sclerosis. Methods: In this study, we used CE-MRI (contrast enhanced-MRI) in 58 female SSc patients. Images were evaluated to obtain functional parameters and to see presence, location and pattern (nodular, linear or diffuse) of myocardial LE, sign of fibrosis. CE-MRI findings were correlated with patients clinical setting. Results: Myocardial fibrosis was detected in 25 of 58 patients (43%). The main finding observed in 16 of these 25 patients was a late enhancement showing a linear pattern, without coronary distribution and sparing the sub-endocardial myocardial layers. A patchy nodular enhancement pattern was observed in 9 patients (36%). Patients with linear pattern presented dcSSc, on the contrary patients with nodular LE displayed the lcSSc form. Conclusions: This study shows that CE-MRI is a reliable technique to detect SHI earlier than other methods. SHI increase passive myocardial stiffness, proportional to collagen deposition degree, leading to cardiac remodelling with possible development of heart failure, even with normal ejection fraction. An early treatment of SHI might improve SSc patients outcome.

  13. The developing role of fetal magnetic resonance imaging in the diagnosis of congenital cardiac anomalies: A systematic review

    International Nuclear Information System (INIS)

    Advances in the fetal magnetic resonance imaging (MRI) over the last few years have resulted in the exploring the use of fetal MRI to detect congenital cardiac anomalies. Early detection of congenital cardiac anomalies can help more appropriately manage the infant's delivery and neonatal management. MRI offers anatomical and functional studies and is a safe adjunct that can help more fully understand a fetus' cardiac anatomy. It is important for the obstetricians and pediatric cardiologists to be aware of the recent advancements in fetal MRI and it's potential utility in diagnosing congenital cardiac anomalies

  14. The developing role of fetal magnetic resonance imaging in the diagnosis of congenital cardiac anomalies: A systematic review

    Directory of Open Access Journals (Sweden)

    Rohit S Loomba

    2011-01-01

    Full Text Available Advances in the fetal magnetic resonance imaging (MRI over the last few years have resulted in the exploring the use of fetal MRI to detect congenital cardiac anomalies. Early detection of congenital cardiac anomalies can help more appropriately manage the infant′s delivery and neonatal management. MRI offers anatomical and functional studies and is a safe adjunct that can help more fully understand a fetus′ cardiac anatomy. It is important for the obstetricians and pediatric cardiologists to be aware of the recent advancements in fetal MRI and it`s potential utility in diagnosing congenital cardiac anomalies.

  15. Meshless deformable models for 3D cardiac motion and strain analysis from tagged MRI.

    Science.gov (United States)

    Wang, Xiaoxu; Chen, Ting; Zhang, Shaoting; Schaerer, Joël; Qian, Zhen; Huh, Suejung; Metaxas, Dimitris; Axel, Leon

    2015-01-01

    Tagged magnetic resonance imaging (TMRI) provides a direct and noninvasive way to visualize the in-wall deformation of the myocardium. Due to the through-plane motion, the tracking of 3D trajectories of the material points and the computation of 3D strain field call for the necessity of building 3D cardiac deformable models. The intersections of three stacks of orthogonal tagging planes are material points in the myocardium. With these intersections as control points, 3D motion can be reconstructed with a novel meshless deformable model (MDM). Volumetric MDMs describe an object as point cloud inside the object boundary and the coordinate of each point can be written in parametric functions. A generic heart mesh is registered on the TMRI with polar decomposition. A 3D MDM is generated and deformed with MR image tagging lines. Volumetric MDMs are deformed by calculating the dynamics function and minimizing the local Laplacian coordinates. The similarity transformation of each point is computed by assuming its neighboring points are making the same transformation. The deformation is computed iteratively until the control points match the target positions in the consecutive image frame. The 3D strain field is computed from the 3D displacement field with moving least squares. We demonstrate that MDMs outperformed the finite element method and the spline method with a numerical phantom. Meshless deformable models can track the trajectory of any material point in the myocardium and compute the 3D strain field of any particular area. The experimental results on in vivo healthy and patient heart MRI show that the MDM can fully recover the myocardium motion in three dimensions. PMID:25157446

  16. Advances in High-Field BOLD fMRI

    Directory of Open Access Journals (Sweden)

    Markus Barth

    2011-11-01

    Full Text Available This review article examines the current state of BOLD fMRI at a high magnetic field strength of 7 Tesla. The following aspects are covered: a short description of the BOLD contrast, spatial and temporal resolution, BOLD sensitivity, localization and spatial specificity, technical challenges as well as an outlook on future developments are given. It is shown that the main technical challenges of performing BOLD fMRI at high magnetic field strengths—namely development of array coils, imaging sequences and parallel imaging reconstruction—have been solved successfully. The combination of these developments has lead to the availability of high-resolution BOLD fMRI protocols that are able to cover the whole brain with a repetition time (TR shorter than 3 s. The structural information available from these high-resolution fMRI images itself is already very detailed, which helps to co-localize structure and function. Potential future applications include whole-brain connectivity analysis on a laminar resolution and single subject examinations.

  17. Cardiac MRI and Transthoracic Echocardiography of Left Ventricular Myocardial Noncompaction in A Patient with Congestive Heart Failure: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eui Min; Byun, Joo Nam [Chosun University Hospital College of Medicine, Gwangju (Korea, Republic of); Kim, Dong Hun [Soonchunhyang University Hospital Bucheon College of Medicine, Bucheon (Korea, Republic of)

    2010-11-15

    We report a case of a 38-year-old male presenting with new-onset dyspnea, that was diagnosed as left ventricular noncompaction by transthoracic echocardiographic and cardiac MR. The tests revealed left ventricular systolic dysfunction with prominent trabeculations associated with deep intertrabecular recesses and an enddiastolic noncompacted to compacted ratio of 2.5 in the whole apical wall and mid-ventricular anterolateral and inferolateral walls. Delayed gadolinium contrast-enhanced MRI revealed subepicardial mid-wall hyperenhancement of the midventricular anteroseptal and inferoseptal walls, which suggested myocardial fibrosis. We review the pathophysiology, clinical characteristics, and diagnostic approach of the left ventricular noncompaction associated with congestive heart failure

  18. Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in locally advanced breast cancer: Relation to response patterns on MRI

    International Nuclear Information System (INIS)

    Background. This study evaluated the accuracy of magnetic resonance imaging (MRI) for estimating residual tumor size after neoadjuvant chemotherapy in patients with locally advanced breast cancer and assessed whether the tumor pattern on MRI after chemotherapy influenced the accuracy of the MRI measurement of the residual tumor size. Patients and methods. Fifty patients who received neoadjuvant chemotherapy with doxorubicin and docetaxel for locally advanced breast cancer were evaluated with MRI before and after chemotherapy. We compared the residual tumor size measured by MRI with the pathologically determined size and investigated the influence of the residual tumor pattern on MRI (shrinkage, nest or rim, and mixed) and pathologic characteristics on the accuracy of the MRI measurement. Results. The correlation coefficient between the residual tumor sizes determined by MRI and by pathology was 0.645. The MRI measurement agreed with the pathologically determined size in 36 patients (72%) and disagreed in 14 patients (28%), overestimating the size in 13 (26%) and underestimating the size in one (2%). Disagreement appeared to be more frequent in the cases showing a nest or rim pattern than in those exhibiting a shrinkage pattern, although this was not statistically significant (p=0.119). Conclusions. MRI is an accurate method for predicting the extent of residual tumor after neoadjuvant chemotherapy; however, it may overestimate the residual disease, especially in cases showing a nest or rim tumor pattern and in those having combined lesions with ductal carcinoma in situ or multiple scattered nodules after neoadjuvant chemotherapy

  19. Technological advances in MRI measurement of brain perfusion.

    Science.gov (United States)

    Duyn, Jeff H; van Gelderen, Peter; Talagala, Lalith; Koretsky, Alan; de Zwart, Jacco A

    2005-12-01

    Measurement of brain perfusion using arterial spin labeling (ASL) or dynamic susceptibility contrast (DSC) based MRI has many potential important clinical applications. However, the clinical application of perfusion MRI has been limited by a number of factors, including a relatively poor spatial resolution, limited volume coverage, and low signal-to-noise ratio (SNR). It is difficult to improve any of these aspects because both ASL and DSC methods require rapid image acquisition. In this report, recent methodological developments are discussed that alleviate some of these limitations and make perfusion MRI more suitable for clinical application. In particular, the availability of high magnetic field strength systems, increased gradient performance, the use of RF coil arrays and parallel imaging, and increasing pulse sequence efficiency allow for increased image acquisition speed and improved SNR. The use of parallel imaging facilitates the trade-off of SNR for increases in spatial resolution. As a demonstration, we obtained DSC and ASL perfusion images at 3.0 T and 7.0 T with multichannel RF coils and parallel imaging, which allowed us to obtain high-quality images with in-plane voxel sizes of 1.5 x 1.5 mm(2). PMID:16267852

  20. Diffusion Weighted MRI as a predictive tool for effect of radiotherapy in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Haack, Søren; Tanderup, Kari; Fokdal, Lars;

    Diffusion weighted MRI has shown great potential in diagnostic cancer imaging and may also have value for monitoring tumor response during radiotherapy. Patients with advanced cervical cancer are treated with external beam radiotherapy followed by brachytherapy. This study evaluates the value of DW......-MRI for predicting outcome of patients with advanced cervical cancer at time of brachytherapy. Volume of hyper-intensity on highly diffusion sensitive images and resulting ADC value for treatment responders and non-responders is compared. The change of ADC and volume of hyper-intensity over time of BT is also...

  1. Pre-operative MRI in heart failure patients scheduled for cardiac resynchronization therapy

    NARCIS (Netherlands)

    Manzke, R.; Lutz, A.; Bornstedt , A.; Binner, L.; Merkle, N.; Gradinger, R..; Hombach, V.; Rasche, V.

    2009-01-01

    Cardiac resynchronization therapy (CRT) aims at improving the pumping function of the heart using bi-ventricular pacing. For the lead implantation procedure, knowledge of the heart function, the relevant anatomy (i.e. coro-nary sinus (CS), great cardiac vein (GCV) and its tributaries) and left ventr

  2. Application of the Karhunen-Loeve transform temporal image filter to reduce noise in real-time cardiac cine MRI

    International Nuclear Information System (INIS)

    Real-time dynamic magnetic resonance imaging (MRI) typically sacrifices the signal-to-noise ratio (SNR) to achieve higher spatial and temporal resolution. Spatial and/or temporal filtering (e.g., low-pass filtering or averaging) of dynamic images improves the SNR at the expense of edge sharpness. We describe the application of a temporal filter for dynamic MR image series based on the Karhunen-Loeve transform (KLT) to remove random noise without blurring stationary or moving edges and requiring no training data. In this paper, we present several properties of this filter and their effects on filter performance, and propose an automatic way to find the filter cutoff based on the autocorrelation of the eigenimages. Numerical simulation and in vivo real-time cardiac cine MR image series spanning multiple cardiac cycles acquired using multi-channel sensitivity-encoded MRI, i.e., parallel imaging, are used to validate and demonstrate these properties. We found that in this application, the noise standard deviation was reduced to 42% of the original with no apparent image blurring by using the proposed filter cutoff. Greater noise reduction can be achieved by increasing the length of the image series. This advantage of KLT filtering provides flexibility in the form of another scan parameter to trade for SNR.

  3. Echocardiography and cardiac MRI in mutation-negative hypertrophic cardiomyopathy in an older patient: a case defining the need for ICD.

    Science.gov (United States)

    Rodriguez, Fatima; Degnan, Kathleen O; Seidman, Christine E; Mangion, Judy R

    2014-08-01

    We report the case of a 67-year-old man with hypertrophic cardiomyopathy who presented for a second opinion about implantable cardio-defibrillator (ICD) placement after a witnessed syncopal episode. Despite his older age, being mutation-negative, and having a maximal septal thickness of 2.2 cm on echocardiography, he demonstrated rapid progression of myocardial fibrosis on cardiac MRI, correlating to ventricular tachyarrhythmias and syncope. We review the role of echocardiography and cardiac MRI in optimizing medical care for such patients who may not otherwise meet criteria for an ICD placement or further interventions. PMID:24816179

  4. Objective evaluation of methods to track motion from clinical cardiac-gated tagged MRI without the use of a gold standard

    Science.gov (United States)

    Parages, Felipe M.; Denney, Thomas S.; Brankov, Jovan G.

    2015-03-01

    Cardiac-gated MRI is widely used for the task of measuring parameters related to heart motion. More specifically, gated tagged MRI is the preferred modality to estimate local deformation (strain) and rotational motion (twist) of myocardial tissue. Many methods have been proposed to estimate cardiac motion from gated MRI sequences. However, when dealing with clinical data, evaluation of these methods is problematic due to the absence of gold-standards for cardiac motion. To overcome that, a linear regression scheme known as regression-without-truth (RWT) was proposed in the past. RWT uses priors to model the distribution of true values, thus enabling us to assess image-analysis algorithms without knowledge of the ground-truth. Furthermore, it allows one to rank methods by means of an objective figure-of-merit γ (i.e. precision). In this work we apply RWT to compare the performance of several gated MRI motion-tracking methods (e.g. non-rigid registration, feature based, harmonic phase) at the task of estimating myocardial strain and left-ventricle (LV) twist, from a population of 18 clinical human cardiac-gated tagged MRI studies.

  5. PET/MRI and PET/CT in advanced gynaecological tumours: initial experience and comparison

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Marcelo A.; Schulthess, Gustav von; Veit-Haibach, Patrick [University Hospital Zurich, Department Medical Radiology, Nuclear Medicine, Zurich (Switzerland); University Hospital Zurich, Department Medical Radiology, Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Zurich, Zurich (Switzerland); Kubik-Huch, Rahel A.; Freiwald-Chilla, Bianka [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); Hauser, Nik [Kantonsspital Baden AG, Department of Gynaecology, Baden (Switzerland); Froehlich, Johannes M. [Guerbet AG, Zurich (Switzerland)

    2015-08-15

    To compare the diagnostic accuracy of PET/MRI and PET/CT for staging and re-staging advanced gynaecological cancer patients as well as identify the potential benefits of each method in such a population. Twenty-six patients with suspicious or proven advanced gynaecological cancer (12 ovarian, seven cervical, one vulvar and four endometrial tumours, one uterine metastasis, and one primary peritoneal cancer) underwent whole-body imaging with a sequential trimodality PET/CT/MR system. Images were analysed regarding primary tumour detection and delineation, loco-regional lymph node staging, and abdominal/extra-abdominal distant metastasis detection (last only by PET/CT). Eighteen (69.2 %) patients underwent PET/MRI for primary staging and eight patients (30.8 %) for re-staging their gynaecological malignancies. For primary tumour delineation, PET/MRI accuracy was statistically superior to PET/CT (p < 0.001). Among the different types of cancer, PET/MRI presented better tumour delineation mainly for cervical (6/7) and endometrial (2/3) cancers. PET/MRI for local evaluation as well as PET/CT for extra-abdominal metastases had therapeutic consequences in three and one patients, respectively. PET/CT detected 12 extra-abdominal distant metastases in 26 patients. PET/MRI is superior to PET/CT for primary tumour delineation. No differences were found in detection of regional lymph node involvement and abdominal metastases detection. (orig.)

  6. Cardiac structure and function during ageing in energetically compromised Guanidinoacetate N-methyltransferase (GAMT-knockout mice – a one year longitudinal MRI study

    Directory of Open Access Journals (Sweden)

    Clarke Kieran

    2008-02-01

    Full Text Available Abstract Background High-resolution magnetic resonance imaging (cine-MRI is well suited for determining global cardiac function longitudinally in genetically or surgically manipulated mice, but in practice it is seldom used to its full potential. In this study, male and female guanidinoacetate N-methyltransferase (GAMT knockout, and wild type littermate mice were subjected to a longitudinal cine-MRI study at four time points over the course of one year. GAMT is an essential enzyme in creatine biosynthesis, such that GAMT deficient mice are entirely creatine-free. Since creatine plays an important role in the buffering and transfer of high-energy phosphate bonds in the heart, it was hypothesized that lack of creatine would be detrimental for resting cardiac performance during ageing. Methods Measurements of cardiac structure (left ventricular mass and volumes and function (ejection fraction, stroke volume, cardiac output were obtained using high-resolution cine-MRI at 9.4 T under isoflurane anaesthesia. Results There were no physiologically significant differences in cardiac function between wild type and GAMT knockout mice at any time point for male or female groups, or for both combined (for example ejection fraction: 6 weeks (KO vs. WT: 70 ± 6% vs. 65 ± 7%; 4 months: 70 ± 6% vs. 62 ± 8%; 8 months: 62 ± 11% vs. 62 ± 6%; 12 months: 61 ± 7% vs. 59 ± 11%, respectively. Conclusion These findings suggest the presence of comprehensive adaptations in the knockout mice that can compensate for a lack of creatine. Furthermore, this study clearly demonstrates the power of cine-MRI for accurate non-invasive, serial cardiac measurements. Cardiac growth curves could easily be defined for each group, in the same set of animals for all time points, providing improved statistical power, and substantially reducing the number of mice required to conduct such a study. This technique should be eminently useful for following changes of cardiac structure and

  7. Cardiac Regeneration using Growth Factors: Advances and Challenges

    Science.gov (United States)

    Rebouças, Juliana de Souza; Santos-Magalhães, Nereide Stela; Formiga, Fabio Rocha

    2016-01-01

    Myocardial infarction is the most significant manifestation of ischemic heart disease and is associated with high morbidity and mortality. Novel strategies targeting at regenerating the injured myocardium have been investigated, including gene therapy, cell therapy, and the use of growth factors. Growth factor therapy has aroused interest in cardiovascular medicine because of the regeneration mechanisms induced by these biomolecules, including angiogenesis, extracellular matrix remodeling, cardiomyocyte proliferation, stem-cell recruitment, and others. Together, these mechanisms promote myocardial repair and improvement of the cardiac function. This review aims to address the strategic role of growth factor therapy in cardiac regeneration, considering its innovative and multifactorial character in myocardial repair after ischemic injury. Different issues will be discussed, with emphasis on the regeneration mechanisms as a potential therapeutic resource mediated by growth factors, and the challenges to make these proteins therapeutically viable in the field of cardiology and regenerative medicine. PMID:27355588

  8. Recent advances in understanding cardiac contractility in health and disease.

    Science.gov (United States)

    MacLeod, Ken T

    2016-01-01

    The aim of this review is to provide the reader with a synopsis of some of the emerging ideas and experimental findings in cardiac physiology and pathophysiology that were published in 2015. To provide context for the non-specialist, a brief summary of cardiac contraction and calcium (Ca) regulation in the heart in health and disease is provided. Thereafter, some recently published articles are introduced that indicate the current thinking on (1) the Ca regulatory pathways modulated by Ca/calmodulin-dependent protein kinase II, (2) the potential influences of nitrosylation by nitric oxide or S-nitrosated proteins, (3) newly observed effects of reactive oxygen species (ROS) on contraction and Ca regulation following myocardial infarction and a possible link with changes in mitochondrial Ca, and (4) the effects of some of these signaling pathways on late Na current and pro-arrhythmic afterdepolarizations as well as the effects of transverse tubule disturbances.

  9. Recent Advances in the Imaging Diagnosis of Hepatocellular Carcinoma: Value of Gadoxetic Acid-Enhanced MRI.

    Science.gov (United States)

    Joo, Ijin; Lee, Jeong Min

    2016-02-01

    Magnetic resonance imaging (MRI) using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DPTA), or gadoxetic acid for short, is a hepatocyte-specific contrast agent which is now increasingly used for the detection and characterization of focal hepatic lesions, particularly in patients at high-risk of developing hepatocellular carcinomas (HCC). In fact, several recent guidelines now recognize gadoxetic acid-enhanced MRI (Gd-EOB-MRI) as the primary diagnostic imaging modality for the noninvasive diagnosis of HCC, although it must be noted that several major guidelines still include only extracellular contrast media-enhanced computed tomography and MRI. The primary merits of Gd-EOB-MRI lie in the fact that it can provide not only dynamic imaging, but also hepatobiliary phase (HBP) imaging which can lead to high lesion-to-liver contrast and give additional information regarding hepatocyte uptake via organic anion transporting polypeptides. This, in turn, allows higher sensitivity in detecting small HCCs and helps provide additional information regarding the multistep process of hepatocarcinogenesis. Indeed, many recent studies have investigated the diagnostic value of Gd-EOB-MRI for early HCCs as well as its role as a potential imaging biomarker in predicting outcome. We herein review the recent advances in the imaging diagnosis of HCCs focusing on the applications of Gd-EOB-MRI and the challenging issues that remain. PMID:26989660

  10. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    Science.gov (United States)

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients.

  11. Would the field of cognitive neuroscience be advanced by sharing functional MRI data?

    Directory of Open Access Journals (Sweden)

    Weissman Daniel H

    2011-04-01

    Full Text Available Abstract During the past two decades, the advent of functional magnetic resonance imaging (fMRI has fundamentally changed our understanding of brain-behavior relationships. However, the data from any one study add only incrementally to the big picture. This fact raises important questions about the dominant practice of performing studies in isolation. To what extent are the findings from any single study reproducible? Are researchers who lack the resources to conduct a fMRI study being needlessly excluded? Is pre-existing fMRI data being used effectively to train new students in the field? Here, we will argue that greater sharing and synthesis of raw fMRI data among researchers would make the answers to all of these questions more favorable to scientific discovery than they are today and that such sharing is an important next step for advancing the field of cognitive neuroscience.

  12. Characterization of respiratory and cardiac motion from electro-anatomical mapping data for improved fusion of MRI to left ventricular electrograms.

    Directory of Open Access Journals (Sweden)

    Sébastien Roujol

    Full Text Available Accurate fusion of late gadolinium enhancement magnetic resonance imaging (MRI and electro-anatomical voltage mapping (EAM is required to evaluate the potential of MRI to identify the substrate of ventricular tachycardia. However, both datasets are not acquired at the same cardiac phase and EAM data is corrupted with respiratory motion limiting the accuracy of current rigid fusion techniques. Knowledge of cardiac and respiratory motion during EAM is thus required to enhance the fusion process. In this study, we propose a novel approach to characterize both cardiac and respiratory motion from EAM data using the temporal evolution of the 3D catheter location recorded from clinical EAM systems. Cardiac and respiratory motion components are extracted from the recorded catheter location using multi-band filters. Filters are calibrated for each EAM point using estimates of heart rate and respiratory rate. The method was first evaluated in numerical simulations using 3D models of cardiac and respiratory motions of the heart generated from real time MRI data acquired in 5 healthy subjects. An accuracy of 0.6-0.7 mm was found for both cardiac and respiratory motion estimates in numerical simulations. Cardiac and respiratory motions were then characterized in 27 patients who underwent LV mapping for treatment of ventricular tachycardia. Mean maximum amplitude of cardiac and respiratory motion was 10.2±2.7 mm (min = 5.5, max = 16.9 and 8.8±2.3 mm (min = 4.3, max = 14.8, respectively. 3D Cardiac and respiratory motions could be estimated from the recorded catheter location and the method does not rely on additional imaging modality such as X-ray fluoroscopy and can be used in conventional electrophysiology laboratory setting.

  13. Cardiac MRI in addition to MR angiography: a longitudinal study in vascular risk patients; Kardiale MRT als Ergaenzung zur MR-Angiografie: Eine longitudinale Studie bei vaskulaeren Risikopatienten

    Energy Technology Data Exchange (ETDEWEB)

    Seeger, A.; Grimm, F.; Fenchel, M.; Kramer, U.; Doering, J.S.; Klumpp, B.; Claussen, C.D.; Miller, S. [Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Scheule, A. [Abt. fuer Herz-, Thorax- und Gefaesschirurgie, Eberhard-Karls-Univ. Tuebingen (Germany); May, A.E. [Abt. fuer Kardiologie, Eberhard-Karls-Univ. Tuebingen (Germany)

    2008-05-15

    Purpose: the aim of the study was to assess the feasibility and additional diagnostic information of cardiac MRI as a supplement to state-of-the-art MR angiography (MRA) in the case of vascular risk patients. Therefore, the prevalence of delayed myocardial enhancement (DE) was determined in patients suffering from peripheral artery disease (PAD) and a clinical follow-up was evaluated after 2 years. Materials and method: 87 consecutive patients (ages 66 {+-} 10 years, 67 males) with symptomatic peripheral arterial occlusive disease (n = 68) or abdominal aortic aneurysm (n = 19) were examined using delayed cardiac enhancement (DE) within the clinical indication of MRA at a 1.5T system. A follow-up examination was carried out two years later (24 months {+-} 4 months) with regards to cardiac events (cardiac death, myocardial infarction or acute coronary syndrome, heart insufficiency, coronary revascularization). Results: in total, 40/87 patients had myocardial infarctions shown in MRI (46%). In 25 patients (29%), the myocardial infarction was already known, while in 15 patients (17%) an occult progressing infarction was diagnosed (38% of the myocardial infarcts). Follow-up data was able to be obtained after 2 years for 82 patients. 15 patients had a major cardiac event during the follow-up period, and 10 (67%) of them already showed DE in the MRI. In the group with occult progressing infarctions, cardiac events occurred in 40% (6/15 patients, cardiac death n = 1, ischemia n = 4, heart insufficiency n = 1, bypass n = 1), in patients with known infarction in 17% (4/23 patients, cardiac death n = 1, ischemia n = 3, bypass n = 2) and in 11% of patients without myocardial scars (5/44 patients, cardiac death n = 1, ischemia n = 2, heart insufficiency n = 2). (orig.)

  14. [18F]-fluoro-l-thymidine PET and advanced MRI for preoperative grading of gliomas

    Directory of Open Access Journals (Sweden)

    S. Collet

    2015-01-01

    Conclusion: Whereas advanced MRI parameters give indications for the grading of gliomas, the addition of [18F]-FLT-PET could be of interest for the accurate preoperative classification of diffuse gliomas, particularly for identification of doubtful grade III and IV gliomas.

  15. Functional cardiac MRI for assessment of aortic valve disease; Aortenklappenstenose im MRT mit Dynamik und 3D

    Energy Technology Data Exchange (ETDEWEB)

    Sagmeister, F.; Ritter, C.; Machann, W.; Koestler, H.; Hahn, D.; Beer, M. [Universitaetsklinikum Wuerzburg, Institut fuer Roentgendiagnostik, Wuerzburg (Germany); Herrmann, S.; Voelker, W.; Weidemann, F. [Universitaetsklinikum Wuerzburg, Medizinische Klinik I, Wuerzburg (Germany)

    2010-06-15

    Aortic valve disease shows a rising incidence with the increasing mean age of Western populations. The detection of hemodynamic parameters, which transcends the mere assessment of valve morphology, has an important future potential concerning classification of the severity of disease. MRI allows a non-invasive and a spatially flexible view of the aortic valve and the adjacent anatomic region, left ventricular outflow tract (LVOT) and ascending aorta. Moreover, the technique allows the determination of functional hemodynamic parameters, such as flow velocities and effective orifice areas. The new approach of a serial systolic planimetry velocity-encoded MRI sequence (VENC-MRI) facilitates the sizing of blood-filled cardiac structures with the registration of changes in magnitude during systole. Additionally, the subvalvular VENC-MRI measurements improve the clinically important exact determination of the LVOT area with respect to its specific eccentric configuration and its systolic deformity. (orig.) [German] Erworbene Erkrankungen der Aortenklappe wie die Aortenklappenstenose zeigen mit zunehmender Alterungstendenz unserer Gesellschaft eine ansteigende Inzidenz. Die Erfassung ueber die reine Klappenmorphologie hinausgehender haemodynamischer Parameter hat ein wichtiges zukuenftiges Potenzial zur Schweregradeinschaetzung. Die MRT erlaubt eine nichtinvasive und raeumlich flexible Darstellung der Aortenklappe sowie ihrer benachbarten anatomischen Strukturen (linksventrikulaerer Ausflusstrakt/LVOT, Aorta ascendens). Darueber hinaus ist eine Bestimmung funktioneller haemodynamischer Parameter wie Flussgeschwindigkeiten und effektiven Oeffnungsflaechen (EOeF) moeglich. Der neue Ansatz einer seriellen Planimetrie geschwindigkeitskodierter MRT-Sequenzen (Velocity-encoding- [VENC-]MRT) erlaubt die Groessenbestimmung flussdurchstroemter kardialer Strukturen und die Aufzeichnung ihrer dynamischen Groessenveraenderung waehrend der Systole. Zusaetzlich ermoeglicht die

  16. Combined respiratory and cardiac triggering improves blood pool contrast-enhanced pediatric cardiovascular MRI

    Energy Technology Data Exchange (ETDEWEB)

    Vasanawala, Shreyas S.; Newman, Beverley [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Chan, Frandics P. [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Alley, Marcus T. [Stanford University School of Medicine, Lucas MRS Center, Department of Radiology, Stanford, CA (United States)

    2011-12-15

    Contrast-enhanced cardiac MRA suffers from cardiac motion artifacts and often requires a breath-hold. This work develops and evaluates a blood pool contrast-enhanced combined respiratory- and ECG-triggered MRA method. An SPGR sequence was modified to enable combined cardiac and respiratory triggering on a 1.5-T scanner. Twenty-three consecutive children referred for pediatric heart disease receiving gadofosveset were recruited in HIPAA-compliant fashion with IRB approval and informed consent. Children underwent standard non-triggered contrast-enhanced MRA with or without suspended respiration. Additionally, a free-breathing-triggered MRA was acquired. Triggered and non-triggered studies were presented in blinded random order independently to two radiologists twice. Anatomical structure delineation was graded for each triggered and non-triggered acquisition and the visual quality on triggered MRA was compared directly to that on non-triggered MRA. Triggered images received higher scores from each radiologist for all anatomical structures on each of the two reading sessions (Wilcoxon rank sum test, P < 0.05). In direct comparison, triggered images were preferred over non-triggered images for delineating cardiac structures, with most comparisons reaching statistical significance (binomial test, P < 0.05). Combined cardiac and respiratory triggering, enabled by a blood pool contrast agent, improves delineation of most anatomical structures in pediatric cardiovascular MRA. (orig.)

  17. Neuroimaging of pediatric brain tumors: from basic to advanced magnetic resonance imaging (MRI).

    Science.gov (United States)

    Panigrahy, Ashok; Blüml, Stefan

    2009-11-01

    In this review, the basic magnetic resonance concepts used in the imaging approach of a pediatric brain tumor are described with respect to different factors including understanding the significance of the patient's age. Also discussed are other factors directly related to the magnetic resonance scan itself including evaluating the location of the tumor, determining if the lesion is extra-axial or intra-axial, and evaluating the contrast characteristics of the lesion. Of note, there are key imaging features of pediatric brain tumors, which can give information about the cellularity of the lesion, which can then be confirmed with advanced magnetic resonance imaging (MRI) techniques. The second part of this review will provide an overview of the major advanced MRI techniques used in pediatric imaging, particularly, magnetic resonance diffusion, magnetic resonance spectroscopy, and magnetic resonance perfusion. The last part of the review will provide more specific information about the use of advanced magnetic resonance techniques in the evaluation of pediatric brain tumors.

  18. Detection of pathological areas and estimation of viability parameters in late-enhancement cardiac MRI

    OpenAIRE

    Breeuwer Marcel; Hautvast Gilion; Mory Benoît; Ciofolo-Veit Cybele; Elagouni Khaoula

    2010-01-01

    International audience We propose a novel fully automatic method to detect and quantify pathological areas in late-enhancement cardiac MR images. The electronic version of this abstract is the complete one and can be found online at: http://jcmr-online.com/content/12/S1/P167

  19. Phenotyping of left and right ventricular function in mouse models of compensated hypertrophy and heart failure with cardiac MRI.

    Directory of Open Access Journals (Sweden)

    Bastiaan J van Nierop

    Full Text Available BACKGROUND: Left ventricular (LV and right ventricular (RV function have an important impact on symptom occurrence, disease progression and exercise tolerance in pressure overload-induced heart failure, but particularly RV functional changes are not well described in the relevant aortic banding mouse model. Therefore, we quantified time-dependent alterations in the ventricular morphology and function in two models of hypertrophy and heart failure and we studied the relationship between RV and LV function during the transition from hypertrophy to heart failure. METHODS: MRI was used to quantify RV and LV function and morphology in healthy (n = 4 and sham operated (n = 3 C57BL/6 mice, and animals with a mild (n = 5 and a severe aortic constriction (n = 10. RESULTS: Mice subjected to a mild constriction showed increased LV mass (P0.05. Animals with a severe constriction progressively developed LV hypertrophy (P<0.001, depressed LVEF (P<0.001, followed by a declining RVEF (P<0.001 and the development of pulmonary remodeling, as compared to controls during a 10-week follow-up. Myocardial strain, as a measure for local cardiac function, decreased in mice with a severe constriction compared to controls (P<0.05. CONCLUSIONS: Relevant changes in mouse RV and LV function following an aortic constriction could be quantified using MRI. The well-controlled models described here open opportunities to assess the added value of new MRI techniques for the diagnosis of heart failure and to study the impact of new therapeutic strategies on disease progression and symptom occurrence.

  20. Wild-Type Transthyretin Cardiac Amyloidosis: Novel Insights From Advanced Imaging.

    Science.gov (United States)

    Narotsky, David L; Castano, Adam; Weinsaft, Jonathan W; Bokhari, Sabahat; Maurer, Mathew S

    2016-09-01

    Amyloidosis is caused by extracellular deposition of abnormal protein fibrils, resulting in destruction of tissue architecture and impairment of organ function. The most common forms of systemic amyloidosis are light-chain and transthyretin-related (ATTR). ATTR can result from an autosomal dominant hereditary transmission of mutated genes in the transthyretin or from a wild-type form of disease (ATTRwt), previously known as senile cardiac amyloidosis. With the aging of the worldwide population, ATTRwt will emerge as the most common type of cardiac amyloidosis that clinicians encounter. Diagnosis of systemic amyloidosis is often delayed, either because of the false assumption that it is a rare disease, or because of misdiagnosis as a result of mistaking it with other conditions. Clinicians must integrate clinical clues from history, physical examination, and common diagnostic tests to raise suspicion for ATTRwt. The historical gold standard for diagnosis of cardiac amyloid is endomyocardial biopsy analysis with pathological distinction of precursor protein type, but this method often results in delayed diagnosis because of the limited availability of expertise to perform and interpret the endomyocardial biopsy specimen. Emerging noninvasive imaging modalities provide easier, accurate screening for ATTRwt. These modalities include advanced echocardiography, using strain imaging and the myocardial contraction fraction; nuclear scintigraphy, which can differentiate between ATTR and light-chain cardiac amyloid; and cardiac magnetic resonance imaging, using extracellular volume measurement, late gadolinium enhancement, and distinct T1 mapping. These novel approaches reveal insights into the prevalence, clinical course, morphological effects, and prognosis of ATTRwt. PMID:27568874

  1. Cardiac MRI in a Patient with Coincident Left Ventricular Non-Compaction and Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Zahra Alizadeh-Sani

    2011-12-01

    Full Text Available Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy that affects both children and adults. Since the clinical manifestations are not sufficient to establish diagnosis, echocardiography is the diagnostic tool that makes it possible to document ventricular non-compaction and establish prognostic factors. We report a 47-year-old woman with a history of dilated cardiomyopathy with unknown etiology. Echocardiography showed mild left ventricular enlargement with severe systolic dysfunction (EF = 20-25%. According to cardiac magnetic resonance imaging findings non-compaction left ventricle with hypertrophic cardiomyopathy was considered, and right ventricular septal biopsy was recommended. Right ventricular endomyocardial biopsy showed moderate hypertrophy of cardiac myocytes with foci of myocytolysis and moderate interstitial fibrosis. No evidence of infiltrative deposition was seen.

  2. Recurrent Fully Convolutional Neural Networks for Multi-slice MRI Cardiac Segmentation

    OpenAIRE

    Poudel, Rudra P K; Lamata, Pablo; Montana, Giovanni

    2016-01-01

    In cardiac magnetic resonance imaging, fully-automatic segmentation of the heart enables precise structural and functional measurements to be taken, e.g. from short-axis MR images of the left-ventricle. In this work we propose a recurrent fully-convolutional network (RFCN) that learns image representations from the full stack of 2D slices and has the ability to leverage inter-slice spatial dependences through internal memory units. RFCN combines anatomical detection and segmentation into a si...

  3. Advances in Functional and Structural Imaging of the Human Lung Using Proton MRI

    OpenAIRE

    Miller, G. Wilson; Mugler, John P.; Sá, Rui C.; Altes, Talissa A.; Prisk, G. Kim; Hopkins, Susan R.

    2014-01-01

    The field of proton lung MRI is advancing on a variety of fronts. In the realm of functional imaging, it is now possible to use arterial spin labeling (ASL) and oxygen-enhanced imaging techniques to quantify regional perfusion and ventilation, respectively, in standard units of measure. By combining these techniques into a single scan, it is also possible to quantify the local ventilation-perfusion ratio, which is the most important determinant of gas-exchange efficiency in the lung. To demon...

  4. Recent Advancements in Diffusion MRI for Investigating Cortical Development after Preterm Birth – Potential and Pitfalls

    Directory of Open Access Journals (Sweden)

    Jeroen eDudink

    2015-01-01

    Full Text Available Preterm infants are born during a critical period of brain maturation, in which even subtle events can result in substantial behavioral, motor and cognitive deficits, as well as psychiatric diseases. Recent evidence shows that the main source for these devastating disabilities is not necessarily white matter damage but could also be disruptions of cortical microstructure. Animal studies showed how moderate hypoxic-ischemic conditions did not result in significant neuronal loss in the developing brain, but did cause significantly impaired dendritic growth and synapse formation alongside a disturbed development of neuronal connectivity as measured using diffusion magnetic resonance imaging (dMRI. When using more advanced acquisition settings such as high-angular resolution diffusion imaging, more advanced reconstruction methods can be applied to investigate the cortical microstructure with higher levels of detail. Recent advances in dMRI acquisition and anlysis have great potential to contribute to a better understanding of neuronal connectivity impairment in preterm birth. We will review the current understanding of abnormal preterm cortical development, novel approaches in dMRI, and the pitfalls in scanning vulnerable preterm infants.

  5. MO-A-BRD-08: Radiosurgery Beyond Cancer: Real-Time Target Localization and Treatment Planning for Cardiac Radiosurgery Under MRI Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Ipsen, S [University of Luebeck, Luebeck, SH (Germany); University of Sydney, Camperdown (Australia); Blanck, O [CyberKnife Zentrum Norddeutschland, Guestrow, MV (Germany); Oborn, B [Illawarra Cancer Care Centre, Wollongong, NSW (Australia); Bode, F [Medical Clinic II, Section for Electrophysiology, UKSH, Luebeck, SH (Germany); Liney, G [Ingham Institute for Applied Medical Research, Liverpool, NSW (United Kingdom); Keall, P [University of Sydney, Camperdown (Australia)

    2014-06-15

    Purpose: Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting >2.5M Americans and >4.5M Europeans. AF is usually treated with minimally-invasive, time consuming catheter ablation techniques. Radiosurgery of the pulmonary veins (PV) has been proposed for AF treatment, however is challenging due to the complex respiratory and cardiac motion patterns. We hypothesize that an MRI-linac could solve the difficult real-time targeting and adaptation problem. In this study we quantified target motion ranges on cardiac MRI and analyzed the dosimetric benefits of margin reduction assuming real-time MRI tracking was applied. Methods: For the motion study, four human subjects underwent real-time cardiac MRI under free breathing. The target motion on coronal and axial cine planes was analyzed using a template matching algorithm. For the planning study, an ablation line at each PV antrum was defined as target on an AF patient scheduled for catheter ablation. Various safety margins ranging from 0mm (perfect tracking) to 8mm (untracked motion) were added to the target defining the PTV. 30Gy single fraction IMRT plans were then generated. Finally, the influence of a 1T magnetic field on treatment beam delivery was calculated using the Geant4 Monte Carlo algorithm to simulate the dosimetric impact of MRI guidance. Results: The motion study showed the mean respiratory motion of the target area on MRI was 8.4mm (SI), 1.7mm (AP) and 0.3mm (LR). Cardiac motion was small (<2mm). The planning study showed that with increasing safety margins to encompass untracked motion, dose tolerances for OARs such as the esophagus and airways were exceeded by >100%. The magnetic field had little impact on the dose distribution. Conclusion: Our results indicate that real-time MRI tracking of the PVs seems feasible. Accurate image guidance for high-dose AF radiosurgery is essential since safety margins covering untracked target motion will result in unacceptable treatment plans.

  6. Assessment of Liver Fibrosis Using Fast Strain-Encoded (FSENC) MRI Driven by Inherent Cardiac Motion

    Science.gov (United States)

    Harouni, Ahmed A.; Gharib, Ahmed M.; Osman, Nael F.; Morse, Caryn; Heller, Theo; Abd-Elmoniem, Khaled Z.

    2014-01-01

    Purpose An external driver-free MRI method for assessment of liver fibrosis offers a promising non-invasive tool for diagnosis and monitoring of liver disease. Lately, the heart’s intrinsic motion and MR tagging have been utilized for the quantification of liver strain. However, MR tagging requires multiple breath-hold acquisitions and substantial post-processing. This work proposes a fast strain-encoded (FSENC) MRI methodology to measure the peak strain (Sp) in the liver’s left lobe, which is in close proximity and caudal to the heart. Additionally, a new method is introduced to measure heart-induced shear wave velocity (SWV) inside the liver. Methods Phantom and in-vivo experiments (11 healthy subjects, and 11 patients with liver fibrosis) were conducted. Reproducibility experiments were performed in seven healthy subjects. Results Peak liver strain Sp significantly decreased in fibrotic liver compared healthy liver (6.46%±2.27% vs. 12.49%±1.76%, P<0.05). Heart-induced SWV significantly increased in patients compared to healthy subjects (0.15±0.04 m/s vs. 0.63±0.32 m/s, P<0.05). Reproducibility analysis yielded no significant difference in Sp (P=0.47) or SWV (P=0.56). Conclusion Accelerated external driver-free noninvasive assessment of left liver lobe strain and shear wave velocity is feasible using strain-encoded MRI. The two measures significantly separate healthy subjects from patients with fibrotic liver. PMID:25081734

  7. Study progress of cardiac MRI technology in assessment of myocardial viability after myocardial infarction

    International Nuclear Information System (INIS)

    Acute myocardial infarction (AMI) is one of the most common diseases that cause disability and death around the world. Correctly and effectively assessing the myocardial viability after myocardial infarction can reduce the disabled rate and mortality rate. At present, many methods could be used to assess myocardial viability. The cardiac magnetic resonance imaging (CMR) technology has a lot of advantages compared to other methods. In this paper, we reviewed the research progress of CMR in assessment of myocardial viability after myocardial infarction, and compared CMR with other technologies. (authors)

  8. HW 01-3 CARDIAC AND VASCULAR MRI IN HYPERTENSION EVALUATION.

    Science.gov (United States)

    Lee, Sang-Chol

    2016-09-01

    Chronic hypertension can result in deleterious effects on various vascular organs including the heart and vessels. Cardiovascular magnetic resonance (CMR) has the unique advantage of the ability to assess ventricular volumes and function, valvular abnormalities, vascular pathology, myocardial perfusion and tissue characterization with high accuracy and reproducibility and also avoid the risk of radiation. As this is the case, CMR seems to be an ideal method for comprehensive assessment of patients with systemic hypertension.In the heart itself, left ventricular hypertrophy with myocardial fibrosis and diastolic or systolic dysfunction of the left ventricle are all important consequences of systemic hypertension that can lead to increased morbidity and mortality. In addition, increased risk of coronary artery disease is another critical end-result of chronic hypertension. CMR can be utilized to assess all of these consequences using cine-MRI, late Gadolinium enhancement, tagging, and myocardial perfusion imaging.In the arteries, atheromatous plaque and aneurysm formation with the possibility of wall dissection or formation of intramural hematomas are important end-results of longstanding uncontrolled hypertension. With vascular MRI, all of these findings are assessable readily and accurately. Currently, newer techniques such as 4-D flow imaging of the aortic blood flow is being studied for use in understanding the mechanics of blood flow damaging the vessels. Another aspect of vascular MRI that is highly anticipated is the evaluation of pulsed wave velocity. With accurate measurement of vascular flow within any part of the body, and also precise measurement of the distance between various points of the aorta, the propagation velocities of the blood can be assessed with CMR and can be utilized to evaluate the effects of increased central blood pressure, instead of various assumptions using peripheral blood pressure for evaluation of PWV. In addition, evaluation of

  9. A combined deep-learning and deformable-model approach to fully automatic segmentation of the left ventricle in cardiac MRI.

    Science.gov (United States)

    Avendi, M R; Kheradvar, Arash; Jafarkhani, Hamid

    2016-05-01

    Segmentation of the left ventricle (LV) from cardiac magnetic resonance imaging (MRI) datasets is an essential step for calculation of clinical indices such as ventricular volume and ejection fraction. In this work, we employ deep learning algorithms combined with deformable models to develop and evaluate a fully automatic LV segmentation tool from short-axis cardiac MRI datasets. The method employs deep learning algorithms to learn the segmentation task from the ground true data. Convolutional networks are employed to automatically detect the LV chamber in MRI dataset. Stacked autoencoders are used to infer the LV shape. The inferred shape is incorporated into deformable models to improve the accuracy and robustness of the segmentation. We validated our method using 45 cardiac MR datasets from the MICCAI 2009 LV segmentation challenge and showed that it outperforms the state-of-the art methods. Excellent agreement with the ground truth was achieved. Validation metrics, percentage of good contours, Dice metric, average perpendicular distance and conformity, were computed as 96.69%, 0.94, 1.81 mm and 0.86, versus those of 79.2-95.62%, 0.87-0.9, 1.76-2.97 mm and 0.67-0.78, obtained by other methods, respectively.

  10. A combined deep-learning and deformable-model approach to fully automatic segmentation of the left ventricle in cardiac MRI.

    Science.gov (United States)

    Avendi, M R; Kheradvar, Arash; Jafarkhani, Hamid

    2016-05-01

    Segmentation of the left ventricle (LV) from cardiac magnetic resonance imaging (MRI) datasets is an essential step for calculation of clinical indices such as ventricular volume and ejection fraction. In this work, we employ deep learning algorithms combined with deformable models to develop and evaluate a fully automatic LV segmentation tool from short-axis cardiac MRI datasets. The method employs deep learning algorithms to learn the segmentation task from the ground true data. Convolutional networks are employed to automatically detect the LV chamber in MRI dataset. Stacked autoencoders are used to infer the LV shape. The inferred shape is incorporated into deformable models to improve the accuracy and robustness of the segmentation. We validated our method using 45 cardiac MR datasets from the MICCAI 2009 LV segmentation challenge and showed that it outperforms the state-of-the art methods. Excellent agreement with the ground truth was achieved. Validation metrics, percentage of good contours, Dice metric, average perpendicular distance and conformity, were computed as 96.69%, 0.94, 1.81 mm and 0.86, versus those of 79.2-95.62%, 0.87-0.9, 1.76-2.97 mm and 0.67-0.78, obtained by other methods, respectively. PMID:26917105

  11. Highly accelerated cardiac cine parallel MRI using low-rank matrix completion and partial separability model

    Science.gov (United States)

    Lyu, Jingyuan; Nakarmi, Ukash; Zhang, Chaoyi; Ying, Leslie

    2016-05-01

    This paper presents a new approach to highly accelerated dynamic parallel MRI using low rank matrix completion, partial separability (PS) model. In data acquisition, k-space data is moderately randomly undersampled at the center kspace navigator locations, but highly undersampled at the outer k-space for each temporal frame. In reconstruction, the navigator data is reconstructed from undersampled data using structured low-rank matrix completion. After all the unacquired navigator data is estimated, the partial separable model is used to obtain partial k-t data. Then the parallel imaging method is used to acquire the entire dynamic image series from highly undersampled data. The proposed method has shown to achieve high quality reconstructions with reduction factors up to 31, and temporal resolution of 29ms, when the conventional PS method fails.

  12. Safe use of MRI in people with cardiac implantable electronic devices.

    Science.gov (United States)

    Lowe, Martin D; Plummer, Christopher J; Manisty, Charlotte H; Linker, Nicholas J

    2015-12-01

    MR scanning in patients with cardiac implantable electronic devices (CIEDs) was formerly felt to be contraindicated, but an increasing number of patients have an implanted MR conditional device, allowing them to safely undergo MR scanning, provided the manufacturer's guidance is adhered to. In addition, some patients with non-MR conditional devices may undergo MR scanning if no other imaging modality is deemed suitable and there is a clear clinical indication for scanning which outweighs the potential risk. The following guidance has been formulated by the British Heart Rhythm Society and endorsed by the British Cardiovascular Society and others. It describes protocols that should be followed for patients with CIEDs undergoing MR scanning. The recommendations, principles and conclusions are supported by the Royal College of Radiologists. PMID:26420818

  13. Surface-length index: a novel index for rapid detection of right ventricles with abnormal ejection fraction using cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Bonnemains, Laurent; Mandry, Damien; Felblinger, Jacques; Marie, Pierre-Yves [CHU Nancy, Departments of Cardiology and Medical Imaging and INSERM (IADI U947, CICIT 801 and U684), Vandoeuvre les nancy (France); Universite de Lorraine, Vandoeuvre les nancy (France); Menini, Anne; Vuissoz, Pierre-Andre [CHU Nancy, Departments of Cardiology and Medical Imaging and INSERM (IADI U947, CICIT 801 and U684), Vandoeuvre les nancy (France); Stos, Bertrand [Marie Lannelongue Chirurgical Centre, Le Plessis-Robinson (France)

    2013-09-15

    To validate a new index, the surface-length index (SLI) based on area change in a short-axis view and length reduction in the horizontal long-axis view, which is used to quickly (<1 min) detect right ventricles with an abnormal ejection fraction (EF) during a cardiac MRI examination. SLI can be used to avoid a complete delineation of the endocardial contours of normal right ventricles. Sixty patients (group A) were retrospectively included to calibrate the SLI formula by optimisation of the area under the ROC curves and SLI thresholds were chosen to obtain 100 % sensitivity. Another 340 patients (group B) were prospectively recruited to test SLI's capacity to detect right ventricles (RVs) with an abnormal EF (<0.5). The appropriate threshold to obtain 100 % sensitivity in group A was 0.58. In group B, with the 0.58 threshold, SLI yielded a sensitivity of 100 % and specificity of 51 %. SLI would have saved 35 % of the RV studies in our population, without inducing any diagnostic error. SLI and EF correlation was good (r {sup 2} = 0.64). SLI combines two simple RV measures, and brings significant improvement in post-processing efficiency by preselecting RVs that require a complete study. (orig.)

  14. A robust automated left ventricle region of interest localization technique using a cardiac cine MRI atlas

    Science.gov (United States)

    Ben-Zikri, Yehuda Kfir; Linte, Cristian A.

    2016-03-01

    Region of interest detection is a precursor to many medical image processing and analysis applications, including segmentation, registration and other image manipulation techniques. The optimal region of interest is often selected manually, based on empirical knowledge and features of the image dataset. However, if inconsistently identified, the selected region of interest may greatly affect the subsequent image analysis or interpretation steps, in turn leading to incomplete assessment during computer-aided diagnosis or incomplete visualization or identification of the surgical targets, if employed in the context of pre-procedural planning or image-guided interventions. Therefore, the need for robust, accurate and computationally efficient region of interest localization techniques is prevalent in many modern computer-assisted diagnosis and therapy applications. Here we propose a fully automated, robust, a priori learning-based approach that provides reliable estimates of the left and right ventricle features from cine cardiac MR images. The proposed approach leverages the temporal frame-to-frame motion extracted across a range of short axis left ventricle slice images with small training set generated from les than 10% of the population. This approach is based on histogram of oriented gradients features weighted by local intensities to first identify an initial region of interest depicting the left and right ventricles that exhibits the greatest extent of cardiac motion. This region is correlated with the homologous region that belongs to the training dataset that best matches the test image using feature vector correlation techniques. Lastly, the optimal left ventricle region of interest of the test image is identified based on the correlation of known ground truth segmentations associated with the training dataset deemed closest to the test image. The proposed approach was tested on a population of 100 patient datasets and was validated against the ground truth

  15. Usefulness of breath-hold cardiac cine MR imaging with a middle field MRI system

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kentaro; Sato, Kiyoto; Aono, Masaki; Inoshita, Kenji; Utsumi, Naoko [Kagawa Inoshita Hospital, Ohnohara (Japan)

    1999-07-01

    To assess the accuracy of contrast-enhanced, single breath-hold cine MR imaging in calculating left ventricular volume and ejection fraction, we compared MR measurements with those obtained by using cine ventriculography in 60 patients. Fast cine MR images were acquired with a middle field MR system (0.5 T). A breath-hold single slice multi-phase fast gradient-echo (Fast Card) sequence was used to obtain fast cine MR images with the following parameters; TR of 16 ms, TE of 3 ms, flip angle of 30 degree, matrix elements of 256 x 128, view per segment of 6, field of view of 350 x 260 mm and one excitation. Left ventricular end-diastolic volume and ejection fraction obtained with contrast-enhanced Fast Card correlated well with those obtained with cine ventriculography (end-diastolic volume, y=1.00x+14.0, r=0.904, p<0.001; ejection fraction, y=0.961x+2.8, r=0.936, p<0.001). Our results show that contrast enhanced breath-hold cardiac cine MR imaging on horizontal long-axis view using a middle field MR system is an accurate method for evaluating left ventricular volume and ejection fraction. (author)

  16. Important advances in technology and unique applications related to cardiac magnetic resonance imaging.

    Science.gov (United States)

    Ghosn, Mohamad G; Shah, Dipan J

    2014-01-01

    Cardiac magnetic resonance has become a well-established imaging modality and is considered the gold standard for myocardial tissue viability assessment and ventricular volumes quantification. Recent technological hardware and software advancements in magnetic resonance imaging technology have allowed the development of new methods that can improve clinical cardiovascular diagnosis and prognosis. The advent of a new generation of higher magnetic field scanners can be beneficial to various clinical applications. Also, the development of faster acquisition techniques have allowed mapping of the magnetic relaxation properties T1, T2, and T2* in the myocardium that can be used to quantify myocardial diffuse fibrosis, determine the presence of edema or inflammation, and measure iron within the myocardium, respectively. Another recent major advancement in CMR has been the introduction of three-dimension (3D) phase contrast imaging, also known as 4D flow. The following review discusses key advances in cardiac magnetic resonance technology and their potential to improve clinical cardiovascular diagnosis and outcomes.

  17. Quantifying the effect of tissue deformation on diffusion-weighted MRI: a mathematical model and an efficient simulation framework applied to cardiac diffusion imaging

    Science.gov (United States)

    Mekkaoui, Imen; Moulin, Kevin; Croisille, Pierre; Pousin, Jerome; Viallon, Magalie

    2016-08-01

    Cardiac motion presents a major challenge in diffusion weighted MRI, often leading to large signal losses that necessitate repeated measurements. The diffusion process in the myocardium is difficult to investigate because of the unqualified sensitivity of diffusion measurements to cardiac motion. A rigorous mathematical formalism is introduced to quantify the effect of tissue motion in diffusion imaging. The presented mathematical model, based on the Bloch-Torrey equations, takes into account deformations according to the laws of continuum mechanics. Approximating this mathematical model by using finite elements method, numerical simulations can predict the sensitivity of the diffusion signal to cardiac motion. Different diffusion encoding schemes are considered and the diffusion weighted MR signals, computed numerically, are compared to available results in literature. Our numerical model can identify the existence of two time points in the cardiac cycle, at which the diffusion is unaffected by myocardial strain and cardiac motion. Of course, these time points depend on the type of diffusion encoding scheme. Our numerical results also show that the motion sensitivity of the diffusion sequence can be reduced by using either spin echo technique with acceleration motion compensation diffusion gradients or stimulated echo acquisition mode with unipolar and bipolar diffusion gradients.

  18. Quantifying the effect of tissue deformation on diffusion-weighted MRI: a mathematical model and an efficient simulation framework applied to cardiac diffusion imaging.

    Science.gov (United States)

    Mekkaoui, Imen; Moulin, Kevin; Croisille, Pierre; Pousin, Jerome; Viallon, Magalie

    2016-08-01

    Cardiac motion presents a major challenge in diffusion weighted MRI, often leading to large signal losses that necessitate repeated measurements. The diffusion process in the myocardium is difficult to investigate because of the unqualified sensitivity of diffusion measurements to cardiac motion. A rigorous mathematical formalism is introduced to quantify the effect of tissue motion in diffusion imaging. The presented mathematical model, based on the Bloch-Torrey equations, takes into account deformations according to the laws of continuum mechanics. Approximating this mathematical model by using finite elements method, numerical simulations can predict the sensitivity of the diffusion signal to cardiac motion. Different diffusion encoding schemes are considered and the diffusion weighted MR signals, computed numerically, are compared to available results in literature. Our numerical model can identify the existence of two time points in the cardiac cycle, at which the diffusion is unaffected by myocardial strain and cardiac motion. Of course, these time points depend on the type of diffusion encoding scheme. Our numerical results also show that the motion sensitivity of the diffusion sequence can be reduced by using either spin echo technique with acceleration motion compensation diffusion gradients or stimulated echo acquisition mode with unipolar and bipolar diffusion gradients. PMID:27385441

  19. Is cardiac MRI an effective test for arrhythmogenic right ventricular cardiomyopathy diagnosis?

    Institute of Scientific and Technical Information of China (English)

    Santhi; Chellamuthu; Alyson; M; Smith; Steven; M; Thomas; Catherine; Hill; Peter; W; G; Brown; Abdallah; Al-Mohammad

    2014-01-01

    AIM:To evaluate the referrals with suspected arrhythmogenic right ventricular cardiomyopathy(ARVC)and compare cardiac MR(cMR)findings against clinical diagnosis.METHODS:A retrospective analysis of 114(age range16 to 83,males 55%and females 45%)patients referred for cMR with a suspected diagnosis of ARVC between May 2006 and February 2010 was performed after obtaining institutional approval for service evaluation.Reasons for referral including clinical symptoms and family history of sudden death,electrocardiogram and echo abnormalities,cMR findings,final clinical diagnosis and information about clinical management were obtained.The results of cMR were classified as major,minor,non-specific or negative depending on both functional and tissue characterisation and the cMR results were compared against the final clinical diagnosis.RESULTS:The most common reasons for referral included arrhythmias(30%)and a family history of sudden death(20%).Of the total cohort of 114 patients:4 patients(4%)had major cMR findings for ARVC,13patients(11%)had minor cMR findings,2 patients had non-specific cMR findings relating to the right ventricle and 95 patients had a negative cMR.Of the 4 patients who had major cMR findings,3(75%)had a positive clinical diagnosis.In contrast,of the 13 patients who had minor cMR findings,only 2(15%)had a positive clinical diagnosis.Out of the 95 negative patients,clinical details were available for 81 patients and none of them had ARVC.Excluding the 14 patients with no clinical data and final diagnosis,the sensitivity of the test was 100%,specificity 87%,positive predictive value29%and the negative predictive value 100%.CONCLUSION:CMR is a useful tool for ARVC evaluation because of the high negative predictive value as the outcome has a significant impact on the clinical decision-making.

  20. MR-based attenuation correction for cardiac FDG PET on a hybrid PET/MRI scanner: comparison with standard CT attenuation correction

    Energy Technology Data Exchange (ETDEWEB)

    Vontobel, Jan; Liga, Riccardo; Possner, Mathias; Clerc, Olivier F.; Mikulicic, Fran; Veit-Haibach, Patrick; Voert, Edwin E.G.W. ter; Fuchs, Tobias A.; Stehli, Julia; Pazhenkottil, Aju P.; Benz, Dominik C.; Graeni, Christoph; Gaemperli, Oliver; Herzog, Bernhard; Buechel, Ronny R.; Kaufmann, Philipp A. [University Hospital Zurich, Department of Nuclear Medicine, Zurich (Switzerland)

    2015-09-15

    The aim of this study was to evaluate the feasibility of attenuation correction (AC) for cardiac {sup 18}F-labelled fluorodeoxyglucose (FDG) positron emission tomography (PET) using MR-based attenuation maps. We included 23 patients with no known cardiac history undergoing whole-body FDG PET/CT imaging for oncological indications on a PET/CT scanner using time-of-flight (TOF) and subsequent whole-body PET/MR imaging on an investigational hybrid PET/MRI scanner. Data sets from PET/MRI (with and without TOF) were reconstructed using MR AC and semi-quantitative segmental (20-segment model) myocardial tracer uptake (per cent of maximum) and compared to PET/CT which was reconstructed using CT AC and served as standard of reference. Excellent correlations were found for regional uptake values between PET/CT and PET/MRI with TOF (n = 460 segments in 23 patients; r = 0.913; p < 0.0001) with narrow Bland-Altman limits of agreement (-8.5 to +12.6 %). Correlation coefficients were slightly lower between PET/CT and PET/MRI without TOF (n = 460 segments in 23 patients; r = 0.851; p < 0.0001) with broader Bland-Altman limits of agreement (-12.5 to +15.0 %). PET/MRI with and without TOF showed minimal underestimation of tracer uptake (-2.08 and -1.29 %, respectively), compared to PET/CT. Relative myocardial FDG uptake obtained from MR-based attenuation corrected FDG PET is highly comparable to standard CT-based attenuation corrected FDG PET, suggesting interchangeability of both AC techniques. (orig.)

  1. Accelerated dynamic cardiac MRI exploiting sparse-Kalman-smoother self-calibration and reconstruction (k  -  t SPARKS).

    Science.gov (United States)

    Park, Suhyung; Park, Jaeseok

    2015-05-01

    Accelerated dynamic MRI, which exploits spatiotemporal redundancies in k  -  t space and coil dimension, has been widely used to reduce the number of signal encoding and thus increase imaging efficiency with minimal loss of image quality. Nonetheless, particularly in cardiac MRI it still suffers from artifacts and amplified noise in the presence of time-drifting coil sensitivity due to relative motion between coil and subject (e.g. free breathing). Furthermore, a substantial number of additional calibrating signals is to be acquired to warrant accurate calibration of coil sensitivity. In this work, we propose a novel, accelerated dynamic cardiac MRI with sparse-Kalman-smoother self-calibration and reconstruction (k  -  t SPARKS), which is robust to time-varying coil sensitivity even with a small number of calibrating signals. The proposed k  -  t SPARKS incorporates Kalman-smoother self-calibration in k  -  t space and sparse signal recovery in x  -   f space into a single optimization problem, leading to iterative, joint estimation of time-varying convolution kernels and missing signals in k  -  t space. In the Kalman-smoother calibration, motion-induced uncertainties over the entire time frames were included in modeling state transition while a coil-dependent noise statistic in describing measurement process. The sparse signal recovery iteratively alternates with the self-calibration to tackle the ill-conditioning problem potentially resulting from insufficient calibrating signals. Simulations and experiments were performed using both the proposed and conventional methods for comparison, revealing that the proposed k  -  t SPARKS yields higher signal-to-error ratio and superior temporal fidelity in both breath-hold and free-breathing cardiac applications over all reduction factors.

  2. Diagnosis of Acute Global Myocarditis Using Cardiac MRI with Quantitative T1 and T2 Mapping: Case Report and Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chul Hwan [Department of Radiology and Research Institute of Radiological Science, Yonsei University Health System, Seoul 135-720 (Korea, Republic of); Choi, Eui-Young [Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720 (Korea, Republic of); Greiser, Andreas [Healthcare Sector, Siemens AG, Erlangen D-91052 (Germany); Paek, Mun Young [Siemens Ltd., Seoul 120-837 (Korea, Republic of); Hwang, Sung Ho; Kim, Tae Hoon [Department of Radiology and Research Institute of Radiological Science, Yonsei University Health System, Seoul 135-720 (Korea, Republic of)

    2013-07-01

    The diagnosis of myocarditis can be challenging given that symptoms, clinical exam findings, electrocardiogram results, biomarkers, and echocardiogram results are often non-specific. Endocardial biopsy is an established method for diagnosing myocarditis, but carries the risk of complications and false negative results. Cardiac magnetic resonance imaging (MRI) has become the primary non-invasive imaging tool in patients with suspected myocarditis. Myocarditis can be diagnosed by using three tissue markers including edema, hyperemia/capillary leak, and necrosis/fibrosis. The interpretation of cardiac MR findings can be confusing, especially when the myocardium is diffusely involved. Using T1 and T2 maps, the diagnosis of myocarditis can be made even in cases of global myocarditis with the help of quantitative analysis. We herein describe a case of acute global myocarditis which was diagnosed by using quantitative T1 and T2 mapping.

  3. Free-Breathing 3D Imaging of Right Ventricular Structure and Function Using Respiratory and Cardiac Self-Gated Cine MRI

    OpenAIRE

    Yanchun Zhu; Jing Liu; Jonathan Weinsaft; Pascal Spincemaille; Nguyen, Thanh D.; Prince, Martin R.; Shanglian Bao; Yaoqin Xie; Yi Wang

    2015-01-01

    Providing a movie of the beating heart in a single prescribed plane, cine MRI has been widely used in clinical cardiac diagnosis, especially in the left ventricle (LV). Right ventricular (RV) morphology and function are also important for the diagnosis of cardiopulmonary diseases and serve as predictors for the long term outcome. The purpose of this study is to develop a self-gated free-breathing 3D imaging method for RV quantification and to evaluate its performance by comparing it with brea...

  4. Imaging technique and current status of valvular heart disease using cardiac MRI; Untersuchungstechniken und Stellenwert der MRT bei der Diagnostik von Herzklappenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Lotz, J.; Sohns, J.M. [Universitaetsmedizin Goettingen, Georg-August-Universitaet, Institut fuer Diagnostische und Interventionelle Radiologie, Goettingen (Germany)

    2013-10-15

    The main indications for cardiac magnetic resonance imaging (MRI) in the evaluation of valvular heart disease are pathologies of the aortic and pulmonary valve. For mitral and tricuspid valve pathologies MRI is not the first line modality as these are usually well visualized by echocardiography. The advantages of MRI in valvular heart disease are a high reliability in the evaluation of ventricular volumes and function as well as the assessment of the perivalvular arterial or atrial structures. This reliability and the limitless access to any imaging plane partially compensates for the lower temporal and spatial resolution in comparison to echocardiography. In patients with congenital heart disease, cardiac MRI is established as a valuable diagnostic tool in daily clinical management, especially for the evaluation of pulmonary valve defects. Nevertheless, echocardiography remains the first-line diagnostic imaging tool for the foreseeable future. (orig.) [German] Die Untersuchung der Herzklappen in der MRT umfasst derzeit v. a. die Aorten- und Pulmonalisklappe. Pathologien der atrioventrikulaeren Klappen bilden demgegenueber nur selten die zentrale Fragestellung einer kardialen MRT-Untersuchung, da diese normalerweise einer echokardiographischen Untersuchung gut zugaenglich sind. Die Staerke der MRT ist die hohe Zuverlaessigkeit, mit der neben der Klappenmorphologie und -funktion die Funktionsparameter des jeweiligen Ventrikels und die Morphologie der nachgeschalteten Arterien bestimmt werden koennen. Dadurch kann die MRT die prinzipielle Schwaeche in der Orts- und Zeitaufloesung gegenueber der Echokardiographie teilweise kompensieren. Bei Patienten mit kongenitalen Herzvitien ist die MRT-basierte Klappendiagnostik fester Bestandteil des klinischen Managements. Das gilt besonders fuer die Evaluation der Pulmonalisklappe. Die Echokardiographie bleibt absehbar die Modalitaet der ersten Wahl fuer die Klappendiagnostik am Herzen. (orig.)

  5. Advanced MRI techniques of the fetal brain; Zukunftsweisende MRT-Techniken des fetalen Gehirns

    Energy Technology Data Exchange (ETDEWEB)

    Schoepf, V.; Dittrich, E.; Berger-Kulemann, V.; Kasprian, G.; Kollndorfer, K.; Prayer, D. [Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2013-02-15

    Evaluation of the normal and pathological fetal brain. Magnetic resonance imaging (MRI). Advanced MRI of the fetal brain. Diffusion tensor imaging (DTI) is used in clinical practice, all other methods are used at a research level. Serving as standard methods in the future. Combined structural and functional data for all gestational ages will allow more specific insight into the developmental processes of the fetal brain. This gain of information will help provide a common understanding of complex spatial and temporal procedures of early morphological features and their impact on cognitive and sensory abilities. (orig.) [German] Evaluierung des gesunden bzw. pathologischen fetalen Gehirns. Die Magnetresonanztomographie. Zukunftsweisende Techniken in der MRT-Bildgebung des fetalen Gehirns. Die Diffusionstensorbildgebung (DTI) befindet sich bereits in der klinischen Anwendung, alle anderen Methoden sind bisher noch als experimentell zu werten. Auf dem Weg zur Etablierung als Standardverfahren. Eine kombinierte Verarbeitung funktioneller und struktureller Daten, modelliert fuer jede Schwangerschaftswoche, wird es zukuenftig ermoeglichen, anhand dieser fusionierten Informationen einen praezisen Einblick in den Entwicklungsprozess des Gehirns zu erlangen. Diese Erkenntnisse und Ergebnisse werden entscheidend zur Klaerung des zeitlichen Verlaufs und des komplexen Aufbaus frueher morphologischer Auffaelligkeiten beitragen sowie deren Einfluss auf kognitive und sensorische Faehigkeiten aufzeigen. (orig.)

  6. Modelling Cardiac Signal as a Confound in EEG-fMRI and its Application in Focal Epilepsy

    DEFF Research Database (Denmark)

    Liston, Adam David; Salek-Haddadi, Afraim; Hamandi, Khalid;

    2005-01-01

    effects to be modelled, as effects of no interest. Our model is based on an over-complete basis set covering a linear relationship between cardiac-related MR signal and the phase of the cardiac cycle or time after pulse (TAP). This method showed that, on average, 24.6 +/- 10.9% of grey matter voxels...... contained significant cardiac effects and 22.3 +/- 24.1% of those voxels exhibiting significantly IED-correlated BOLD signal also contained significant cardiac effects. We quantified the improvement of the TAP model over the original model, without cardiac effects, by evaluating changes in efficiency......, with respect to estimating the contrast of the effects of interest. Over voxels containing significant, cardiac-related signal, efficiency was improved by 18.5 +/- 4.8%. Over the remaining voxels, no improvement was demonstrated. This suggests that, while improving sensitivity in particular regions...

  7. Modelling cardiac signal as a confound in EEG-fMRI and its application in focal epilepsy studies

    DEFF Research Database (Denmark)

    Liston, A. D.; Ellegaard Lund, Torben; Salek-Haddadi, A;

    2006-01-01

    effects to be modelled, as effects of no interest. Our model is based on an over-complete basis set covering a linear relationship between cardiac-related MR signal and the phase of the cardiac cycle or time after pulse (TAP). This method showed that, on average, 24.6 +/- 10.9% of grey matter voxels...... contained significant cardiac effects and 22.3 +/- 24.1% of those voxels exhibiting significantly IED-correlated BOLD signal also contained significant cardiac effects. We quantified the improvement of the TAP model over the original model, without cardiac effects, by evaluating changes in efficiency......, with respect to estimating the contrast of the effects of interest. Over voxels containing significant, cardiac-related signal, efficiency was improved by 18.5 +/- 4.8%. Over the remaining voxels, no improvement was demonstrated. This suggests that, while improving sensitivity in particular regions...

  8. Clinical advances on Cardiac Insuffiency Avances clínicos en insuficiencia cardiaca

    Directory of Open Access Journals (Sweden)

    Gerardo Rivero González

    2007-06-01

    Full Text Available Cardiac insuffiency is a complex clinical syndrome which constitutes a common final path to get in by the majority of the cardiac diseases. Studies based on the communitarian surveys shows that from 30 to 40 % of the patients decease within the first year of the diagnosis. The rest of the patients (from 60 to 70 % die within the 5 years after being diagnosed. For this reason it has been called as the ¨cancer of cardiology¨. The objective of this article is to update the advances reached in the clinical and therapeutic aspects of this important syndrome.

    La insuficiencia cardiaca es un síndrome clínico complejo que constituye una vía final común a la que van a llegar la mayoría de las enfermedades cardiacas. Los estudios basados en encuestas comunitarias muestran que entre el 30 – 40 % de los pacientes mueren dentro del primer año del diagnóstico y el 60 – 70 % dentro de los 5 años, por lo que ha sido denominada, como el ¨cáncer de la cardiología¨. El objetivo de este artículo consiste en actualizar los avances alcanzados en los aspectos clínicos y terapéuticos de este importante síndrome.

  9. Cardiac CT and cardiac MRI - competitive or complementary for nuclear cardiology; Kardio-CT und Kardio-MR - konkurrierend oder komplementaer zur Nuklearkardiologie?

    Energy Technology Data Exchange (ETDEWEB)

    Moshage, W. [Medizinische Abt. (Kardiologie, Angiologie, Pneumologie, Intensivmedizin), Klinikum Traunstein (Germany)

    2004-09-01

    In summary, cardiac computed tomography (CT) and cardiac magnetic resonance (MR) are two different technologies with distinct imaging properties that gain increasing importance in clinical cardiology. Even though images may look similar, the areas of application of CT and MR are quite different. Clinical applications of cardiac CT focus on on-invasive imaging of the coronary arteries. In this respect, the higher spatial resolution of cardiac CT constitutes a significant advantage as compared to MR and clinical results are superior. Clinical applications of cardiac MR, next to morphologic imaging of the heart, are most frequently found in the context of intra-and pericardial masses, complex congenital anomalies, and the assessment of left ventricular function (dobutamine) and perfusion (adenosine) under stress. The evaluation of the size and localization of myocardial necrosis, scars, and fibrosis gains increasing importance, for example in the workup of myocardial infarction, but also myocarditis and cardiomyopathies. In this respect, magnetic resonance imaging partly constitutes an alternative to nuclear medicine methods. Due to the lack of ionizing radiation and a relatively high spatial resolution, an increase of MR diagnostic procedures at the expense of nuclear medicine can be expected. (orig.)

  10. Recent Advances on Pathophysiology, Diagnostic and Therapeutic Insights in Cardiac Dysfunction Induced by Antineoplastic Drugs

    Directory of Open Access Journals (Sweden)

    Marilisa Molinaro

    2015-01-01

    Full Text Available Along with the improvement of survival after cancer, cardiotoxicity due to antineoplastic treatments has emerged as a clinically relevant problem. Potential cardiovascular toxicities due to anticancer agents include QT prolongation and arrhythmias, myocardial ischemia and infarction, hypertension and/or thromboembolism, left ventricular (LV dysfunction, and heart failure (HF. The latter is variable in severity, may be reversible or irreversible, and can occur soon after or as a delayed consequence of anticancer treatments. In the last decade recent advances have emerged in clinical and pathophysiological aspects of LV dysfunction induced by the most widely used anticancer drugs. In particular, early, sensitive markers of cardiac dysfunction that can predict this form of cardiomyopathy before ejection fraction (EF is reduced are becoming increasingly important, along with novel therapeutic and cardioprotective strategies, in the attempt of protecting cardiooncologic patients from the development of congestive heart failure.

  11. Improved myocardial strain measured by strain-encoded magnetic resonance imaging in a patient with cardiac sarcoidosis.

    Science.gov (United States)

    Nakano, Shintaro; Kimura, Fumiko; Osman, Nael; Sugi, Keiki; Tanno, Jun; Uchida, Yoshitaka; Shiono, Ayako; Senbonmatsu, Takaaki; Nishimura, Shigeyuki

    2013-11-01

    A woman aged 64 years with cardiac sarcoidosis responded favourably to corticosteroid therapy in terms of recovered longitudinal myocardial strain, as evaluated by strain-encoded magnetic resonance imaging (SENC-MRI). In contrast, circumferential myocardial strain and late gadolinium enhancement demonstrated minimal improvement, suggesting relatively advanced pathology of the myocardial middle layer. We propose SENC-MRI as a marker of disease at an early stage of cardiac sarcoidosis.

  12. Advances in functional and structural imaging of the human lung using proton MRI.

    Science.gov (United States)

    Miller, G Wilson; Mugler, John P; Sá, Rui C; Altes, Talissa A; Prisk, G Kim; Hopkins, Susan R

    2014-12-01

    The field of proton lung MRI is advancing on a variety of fronts. In the realm of functional imaging, it is now possible to use arterial spin labeling (ASL) and oxygen-enhanced imaging techniques to quantify regional perfusion and ventilation, respectively, in standard units of measurement. By combining these techniques into a single scan, it is also possible to quantify the local ventilation-perfusion ratio, which is the most important determinant of gas-exchange efficiency in the lung. To demonstrate potential for accurate and meaningful measurements of lung function, this technique was used to study gravitational gradients of ventilation, perfusion, and ventilation-perfusion ratio in healthy subjects, yielding quantitative results consistent with expected regional variations. Such techniques can also be applied in the time domain, providing new tools for studying temporal dynamics of lung function. Temporal ASL measurements showed increased spatial-temporal heterogeneity of pulmonary blood flow in healthy subjects exposed to hypoxia, suggesting sensitivity to active control mechanisms such as hypoxic pulmonary vasoconstriction, and illustrating that to fully examine the factors that govern lung function it is necessary to consider temporal as well as spatial variability. Further development to increase spatial coverage and improve robustness would enhance the clinical applicability of these new functional imaging tools. In the realm of structural imaging, pulse sequence techniques such as ultrashort echo-time radial k-space acquisition, ultrafast steady-state free precession, and imaging-based diaphragm triggering can be combined to overcome the significant challenges associated with proton MRI in the lung, enabling high-quality three-dimensional imaging of the whole lung in a clinically reasonable scan time. Images of healthy and cystic fibrosis subjects using these techniques demonstrate substantial promise for non-contrast pulmonary angiography and detailed

  13. Impact of thoracic surgery on cardiac morphology and function in small animal models of heart disease: a cardiac MRI study in rats.

    Directory of Open Access Journals (Sweden)

    Peter Nordbeck

    Full Text Available BACKGROUND: Surgical procedures in small animal models of heart disease might evoke alterations in cardiac morphology and function. The aim of this study was to reveal and quantify such potential artificial early or long term effects in vivo, which might account for a significant bias in basic cardiovascular research, and, therefore, could potentially question the meaning of respective studies. METHODS: Female Wistar rats (n = 6 per group were matched for weight and assorted for sham left coronary artery ligation or control. Cardiac morphology and function was then investigated in vivo by cine magnetic resonance imaging at 7 Tesla 1 and 8 weeks after the surgical procedure. The time course of metabolic and inflammatory blood parameters was determined in addition. RESULTS: Compared to healthy controls, rats after sham surgery showed a lower body weight both 1 week (267.5±10.6 vs. 317.0±11.3 g, n<0.05 and 8 weeks (317.0±21.1 vs. 358.7±22.4 g, n<0.05 after the intervention. Left and right ventricular morphology and function were not different in absolute measures in both groups 1 week after surgery. However, there was a confined difference in several cardiac parameters normalized to the body weight (bw, such as myocardial mass (2.19±0.30/0.83±0.13 vs. 1.85±0.22/0.70±0.07 mg left/right per g bw, p<0.05, or enddiastolic ventricular volume (1.31±0.36/1.21±0.31 vs. 1.14±0.20/1.07±0.17 µl left/right per g bw, p<0.05. Vice versa, after 8 weeks, cardiac masses, volumes, and output showed a trend for lower values in sham operated rats compared to controls in absolute measures (782.2±57.2/260.2±33.2 vs. 805.9±84.8/310.4±48.5 mg, p<0.05 for left/right ventricular mass, but not normalized to body weight. Matching these findings, blood testing revealed only minor inflammatory but prolonged metabolic changes after surgery not related to cardiac disease. CONCLUSION: Cardio-thoracic surgical procedures in experimental myocardial infarction

  14. Fairly direct hit. Advances in imaging of shotgun projectiles in MRI

    Energy Technology Data Exchange (ETDEWEB)

    Eggert, Sebastian [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); University of Zurich, Institute of Forensic Medicine, Zurich (Switzerland); Kubik-Huch, Rahel A.; Peters, Alexander [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); Klarhoefer, Markus [Siemens Healthcare, Zurich (Switzerland); Bolliger, Stephan A.; Thali, Michael J. [University of Zurich, Institute of Forensic Medicine, Zurich (Switzerland); Anderson, Suzanne [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); University of Notre Dame Australia, Radiology, Sydney School of Medicine, Sydney, NSW (Australia); Froehlich, Johannes M. [Federal Institute of Technology, Pharmaceutical Sciences, Zurich (Switzerland)

    2015-09-15

    To investigate the magnetic properties of different types of projectiles and qualify the metal artefact reduction technique for diagnostic and/or forensic MRI. Ten different projectiles embedded in ordnance gelatine blocks underwent an in vitro 1.5-T MR study with seven sequences including a recently developed metal artefact reduction sequence (Advanced WARP) combining VAT (view-angle-tilting) and SEMAC (slice-encoding metal-artefact-correction). Resulting image quality (five-point scale: 1=best; 5=worst) was scored. Quantifiable magnetic characteristics were correlated with qualitative rating of the MR sequences and torque dislodgment. Metal artefact reduction sequence (median: 2.5) significantly (p < 0.001) improves depiction of projectiles in comparison to all other MR pulse sequences (median: 4.75). Images from diamagnetic composed bullets (median: 2) are much less disturbed compared to magnetic attracted ones (median: 5). Correlation (0.623) between deflection angle measurement (ferromagnetic mean 84.2 ; paramagnetic 62 ; diamagnetic mean 0 ) and median qualitative image quality was highly significant (p = 0.027). Torque dislodgement was distinct for elongated magnetic attracted projectiles. Significant improvement of MR imaging of projectiles using metal artefact reduction techniques has important implications for diagnostic/forensic work-up. The correlations between magnetic attraction force, deflection-angle results and image properties demonstrate that the MR safety of projectiles can be estimated with one of these methods. (orig.)

  15. Fairly direct hit. Advances in imaging of shotgun projectiles in MRI

    International Nuclear Information System (INIS)

    To investigate the magnetic properties of different types of projectiles and qualify the metal artefact reduction technique for diagnostic and/or forensic MRI. Ten different projectiles embedded in ordnance gelatine blocks underwent an in vitro 1.5-T MR study with seven sequences including a recently developed metal artefact reduction sequence (Advanced WARP) combining VAT (view-angle-tilting) and SEMAC (slice-encoding metal-artefact-correction). Resulting image quality (five-point scale: 1=best; 5=worst) was scored. Quantifiable magnetic characteristics were correlated with qualitative rating of the MR sequences and torque dislodgment. Metal artefact reduction sequence (median: 2.5) significantly (p < 0.001) improves depiction of projectiles in comparison to all other MR pulse sequences (median: 4.75). Images from diamagnetic composed bullets (median: 2) are much less disturbed compared to magnetic attracted ones (median: 5). Correlation (0.623) between deflection angle measurement (ferromagnetic mean 84.2 ; paramagnetic 62 ; diamagnetic mean 0 ) and median qualitative image quality was highly significant (p = 0.027). Torque dislodgement was distinct for elongated magnetic attracted projectiles. Significant improvement of MR imaging of projectiles using metal artefact reduction techniques has important implications for diagnostic/forensic work-up. The correlations between magnetic attraction force, deflection-angle results and image properties demonstrate that the MR safety of projectiles can be estimated with one of these methods. (orig.)

  16. The OMERACT MRI inflammatory arthritis group: advances and future research priorities

    DEFF Research Database (Denmark)

    Conaghan, Philip G; Bird, Paul; McQueen, Fiona;

    2009-01-01

    The OMERACT magnetic resonance imaging (MRI) in inflammatory arthritis group previously developed the rheumatoid arthritis MRI score (RAMRIS) for use in clinical studies, evaluated the use of extremity MRI, and initiated development of a psoriatic arthritis MRI score (PsAMRIS). At OMERACT 9...... the group looked at clarifications of applying the RAMRIS, and presented data from a study examining how the contrast agent gadolinium affects RAMRIS outcomes. Much of the group's effort has been aimed at the iterative development of its PsA score, and reported exercises examining this score demonstrated...

  17. MRI volumetry for prediction of tumour response to neoadjuvant chemotherapy followed by chemoradiotherapy in locally advanced rectal cancer

    OpenAIRE

    2015-01-01

    Objective: To investigate if MRI-assessed tumour volumetry correlates with histological tumour response to neoadjuvant chemotherapy (NACT) and subsequent chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC). Methods: Data from 69 prospectively enrolled patients with LARC receiving NACT followed by CRT and radical surgery were analysed. Whole-tumour volumes were contoured in T2 weighted MR images obtained pre-treatment (VPRE), after NACT (VNACT) and after the full course of NACT...

  18. Recent Stem Cell Advances: Cord Blood and Induced Pluripotent Stem Cell for Cardiac Regeneration- a Review.

    Science.gov (United States)

    Medhekar, Sheetal Kashinath; Shende, Vikas Suresh; Chincholkar, Anjali Baburao

    2016-05-30

    Stem cells are primitive self renewing undifferentiated cell that can be differentiated into various types of specialized cells like nerve cell, skin cells, muscle cells, intestinal tissue, and blood cells. Stem cells live in bone marrow where they divide to make new blood cells and produces peripheral stem cells in circulation. Under proper environment and in presence of signaling molecules stem cells begin to develop into specialized tissues and organs. These unique characteristics make them very promising entities for regeneration of damaged tissue. Day by day increase in incidence of heart diseases including left ventricular dysfunction, ischemic heart disease (IHD), congestive heart failure (CHF) are the major cause of morbidity and mortality. However infracted tissue cannot regenerate into healthy tissue. Heart transplantation is only the treatment for such patient. Due to limitation of availability of donor for organ transplantation, a focus is made for alternative and effective therapy to treat such condition. In this review we have discussed the new advances in stem cells such as use of cord stem cells and iPSC technology in cardiac repair. Future approach of CB cells was found to be used in tissue repair which is specifically observed for improvement of left ventricular function and myocardial infarction. Here we have also focused on how iPSC technology is used for regeneration of cardiomyocytes and intiating neovascularization in myocardial infarction and also for study of pathophysiology of various degenerative diseases and genetic disease in research field. PMID:27426082

  19. Recent Stem Cell Advances: Cord Blood and Induced Pluripotent Stem Cell for Cardiac Regeneration- a Review.

    Science.gov (United States)

    Medhekar, Sheetal Kashinath; Shende, Vikas Suresh; Chincholkar, Anjali Baburao

    2016-05-30

    Stem cells are primitive self renewing undifferentiated cell that can be differentiated into various types of specialized cells like nerve cell, skin cells, muscle cells, intestinal tissue, and blood cells. Stem cells live in bone marrow where they divide to make new blood cells and produces peripheral stem cells in circulation. Under proper environment and in presence of signaling molecules stem cells begin to develop into specialized tissues and organs. These unique characteristics make them very promising entities for regeneration of damaged tissue. Day by day increase in incidence of heart diseases including left ventricular dysfunction, ischemic heart disease (IHD), congestive heart failure (CHF) are the major cause of morbidity and mortality. However infracted tissue cannot regenerate into healthy tissue. Heart transplantation is only the treatment for such patient. Due to limitation of availability of donor for organ transplantation, a focus is made for alternative and effective therapy to treat such condition. In this review we have discussed the new advances in stem cells such as use of cord stem cells and iPSC technology in cardiac repair. Future approach of CB cells was found to be used in tissue repair which is specifically observed for improvement of left ventricular function and myocardial infarction. Here we have also focused on how iPSC technology is used for regeneration of cardiomyocytes and intiating neovascularization in myocardial infarction and also for study of pathophysiology of various degenerative diseases and genetic disease in research field.

  20. Comparison of an advanced minimally invasive cardiac output monitoring with a continuous invasive cardiac output monitoring during lung transplantation.

    Science.gov (United States)

    Tomasi, Roland; Prueckner, Stephan; Czerner, Stephan; Schramm, Renè; Preissler, Gerhard; Zwißler, Bernhard; von Dossow-Hanfstingl, Vera

    2016-08-01

    The aim of this study was to compare a continuous non-calibrated left heart cardiac index (CI) measurement by arterial waveform analysis (FloTrac(®)/Vigileo(®)) with a continuous calibrated right heart CI measurement by pulmonary artery thermodilution (CCOmbo-PAC(®)/Vigilance II(®)) for hemodynamic monitoring during lung transplantation. CI was measured simultaneously by both techniques in 13 consecutive lung transplants (n = 4 single-lung transplants, n = 9 sequential double-lung transplants) at distinct time points perioperatively. Linear regression analysis and Bland-Altman analysis with percentage error calculation were used for statistical comparison of CI measurements by both techniques. In this study the FloTrac(®) system underestimated the CI in comparison with the continuous pulmonary arterial thermodilution (p waveform and continuous pulmonary artery thermodilution are, therefore, not interchangeable during these complex operations.

  1. Recent advances in image reconstruction, coil sensitivity calibration, and coil array design for SMASH and generalized parallel MRI.

    Science.gov (United States)

    Sodickson, Daniel K; McKenzie, Charles A; Ohliger, Michael A; Yeh, Ernest N; Price, Mark D

    2002-01-01

    Parallel magnetic resonance imaging (MRI) techniques use spatial information from arrays of radiofrequency (RF) detector coils to accelerate imaging. A number of parallel MRI techniques have been described in recent years, and numerous clinical applications are currently being explored. The advent of practical parallel imaging presents various challenges for image reconstruction and RF system design. Recent advances in tailored SiMultaneous Acquisition of Spatial Harmonics (SMASH) image reconstructions are summarized. These advances enable robust SMASH imaging in arbitrary image planes with a wide range of coil array geometries. A generalized formalism is described which may be used to understand the relations between SMASH and SENSE, to derive typical implementations of each as special cases, and to form hybrid techniques combining some of the advantages of both. Accurate knowledge of coil sensitivities is crucial for parallel MRI, and errors in calibration represent one of the most common and the most pernicious sources of error in parallel image reconstructions. As one example, motion of the patient and/or the coil array between the sensitivity reference scan and the accelerated acquisition can lead to calibration errors and reconstruction artifacts. Self-calibrating parallel MRI approaches that address this problem by eliminating the need for external sensitivity references are reviewed. The ultimate achievable signal-to-noise ratio (SNR) for parallel MRI studies is closely tied to the geometry and sensitivity patterns of the coil arrays used for spatial encoding. Several parallel imaging array designs that depart from the traditional model of overlapped adjacent loop elements are described. PMID:11755091

  2. Comparison of total variation with a motion estimation based compressed sensing approach for self-gated cardiac cine MRI in small animal studies.

    Directory of Open Access Journals (Sweden)

    Juan F P J Abascal

    Full Text Available PURPOSE: Compressed sensing (CS has been widely applied to prospective cardiac cine MRI. The aim of this work is to study the benefits obtained by including motion estimation in the CS framework for small-animal retrospective cardiac cine. METHODS: We propose a novel B-spline-based compressed sensing method (SPLICS that includes motion estimation and generalizes previous spatiotemporal total variation (ST-TV methods by taking into account motion between frames. In addition, we assess the effect of an optimum weighting between spatial and temporal sparsity to further improve results. Both methods were implemented using the efficient Split Bregman methodology and were evaluated on rat data comparing animals with myocardial infarction with controls for several acceleration factors. RESULTS: ST-TV with optimum selection of the weighting sparsity parameter led to results similar to those of SPLICS; ST-TV with large relative temporal sparsity led to temporal blurring effects. However, SPLICS always properly corrected temporal blurring, independently of the weighting parameter. At acceleration factors of 15, SPLICS did not distort temporal intensity information but led to some artefacts and slight over-smoothing. At an acceleration factor of 7, images were reconstructed without significant loss of quality. CONCLUSION: We have validated SPLICS for retrospective cardiac cine in small animal, achieving high acceleration factors. In addition, we have shown that motion modelling may not be essential for retrospective cine and that similar results can be obtained by using ST-TV provided that an optimum selection of the spatiotemporal sparsity weighting parameter is performed.

  3. Fetal Electrocardiogram (fECG) Gated MRI

    OpenAIRE

    Paley, Martyn N.J.; Morris, Janet E.; Debbie Jarvis; Griffiths, Paul D.

    2013-01-01

    We have developed a Magnetic Resonance Imaging (MRI)-compatible system to enable gating of a scanner to the heartbeat of a foetus for cardiac, umbilical cord flow and other possible imaging applications. We performed radiofrequency safety testing prior to a fetal electrocardiogram (fECG) gated imaging study in pregnant volunteers (n = 3). A compact monitoring device with advanced software capable of reliably detecting both the maternal electrocardiogram (mECG) and fECG simultaneously was modi...

  4. Cardiac imaging. A multimodality approach

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, Manfred [Johannes Gutenberg University Hospital, Mainz (Germany); Erbel, Raimund [University Hospital Essen (Germany). Dept. of Cardiology; Kreitner, Karl-Friedrich [Johannes Gutenberg University Hospital, Mainz (Germany). Clinic and Polyclinic for Diagnostic and Interventional Radiology; Barkhausen, Joerg (eds.) [University Hospital Schleswig-Holstein, Luebeck (Germany). Dept. of Radiology and Nuclear Medicine

    2009-07-01

    An excellent atlas on modern diagnostic imaging of the heart Written by an interdisciplinary team of experts, Cardiac Imaging: A Multimodality Approach features an in-depth introduction to all current imaging modalities for the diagnostic assessment of the heart as well as a clinical overview of cardiac diseases and main indications for cardiac imaging. With a particular emphasis on CT and MRI, the first part of the atlas also covers conventional radiography, echocardiography, angiography and nuclear medicine imaging. Leading specialists demonstrate the latest advances in the field, and compare the strengths and weaknesses of each modality. The book's second part features clinical chapters on heart defects, endocarditis, coronary heart disease, cardiomyopathies, myocarditis, cardiac tumors, pericardial diseases, pulmonary vascular diseases, and diseases of the thoracic aorta. The authors address anatomy, pathophysiology, and clinical features, and evaluate the various diagnostic options. Key features: - Highly regarded experts in cardiology and radiology off er image-based teaching of the latest techniques - Readers learn how to decide which modality to use for which indication - Visually highlighted tables and essential points allow for easy navigation through the text - More than 600 outstanding images show up-to-date technology and current imaging protocols Cardiac Imaging: A Multimodality Approach is a must-have desk reference for cardiologists and radiologists in practice, as well as a study guide for residents in both fields. It will also appeal to cardiac surgeons, general practitioners, and medical physicists with a special interest in imaging of the heart. (orig.)

  5. Application Progress of MRI in Diagnosis of Cardiac Mitral Valve Diseases%磁共振在心脏二尖瓣病变诊断中的应用进展

    Institute of Scientific and Technical Information of China (English)

    耿德海; 吴丽娜

    2015-01-01

    本文从心脏二尖瓣磁共振研究方法、正常解剖的磁共振表现、二尖瓣血流动力特征及心肌改变、二尖瓣膜病磁共振表现4个方面介绍心脏二尖瓣病变磁共振诊断的临床价值。%The clinical effectiveness of application of MRI (Magnetic Resonance Imaging) in diagnosis of cardiac mitral valve diseases was introduced in this paper from aspects of the MRI research method, the MRI manifestations of the normal anatomy, the blood lfow dynamics features and myocardial changes of mitral valves, as well as the MRI manifestations of mitral valve diseases.

  6. Pulmonary hyperpolarized noble gas MRI: Recent advances and perspectives in clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Zaiyi [Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States); Department of Radiology, Guangdong General Hospital Guangdong Academy of Medical Sciences (China); Araki, Tetsuro, E-mail: taraki@partners.org [Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States); Okajima, Yuka [Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States); Albert, Mitchell [Hyperpolarized Gas MRI Laboratory, Thunder Bay Regional Research Institute, Lakehead University (Canada); Hatabu, Hiroto [Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States)

    2014-07-15

    The invention of hyperpolarized (HP) noble gas MRI using helium-3 ({sup 3}He) or xenon-129 ({sup 129}Xe) has provided a new method to evaluate lung function. Using HP {sup 3}He or {sup 129}Xe for inhalation into the lung air spaces as an MRI contrast agent significantly increases MR signal and makes pulmonary ventilation imaging feasible. This review focuses on important aspects of pulmonary HP noble gas MRI, including the following: (1) functional imaging types, (2) applications for major pulmonary diseases, (3) safety considerations, and (4) future directions. Although it is still challenging to use pulmonary HP noble gas MRI clinically, the technology offers promise for the investigation of the microstructure and function of the lungs.

  7. Can course format influence the performance of students in an advanced cardiac life support (ACLS program?

    Directory of Open Access Journals (Sweden)

    F.D. Garrido

    2011-01-01

    Full Text Available Advanced cardiac life support (ACLS is a problem-based course that employs simulation techniques to teach the standard management techniques of cardiovascular emergencies. Its structure is periodically revised according to new versions of the American Heart Association guidelines. Since it was introduced in Brazil in 1996, the ACLS has been through two conceptual and structural changes. Detailed documented reports on the effect of these changes on student performance are limited. The objective of the present study was to evaluate the effect of conceptual and structural changes of the course on student ACLS performance at a Brazilian training center. This was a retrospective study of 3266 students divided into two groups according to the teaching model: Model 1 (N = 1181; 1999-2003 and Model 2 (N = 2085; 2003-2007. Model 2 increased practical skill activities to 75% of the total versus 60% in Model 1. Furthermore, the teaching material provided to the students before the course was more objective than that used for Model 1. Scores greater than 85% in the theoretical evaluation and approval in the evaluation of practice by the instructor were considered to be a positive outcome. Multiple logistic regression was used to adjust for potential confounders (specialty, residency, study time, opportunity to enhance practical skills during the course and location where the course was given. Compared to Model 1, Model 2 presented odds ratios (OR indicating better performance in the theoretical (OR = 1.34; 95%CI = 1.10-1.64, practical (OR = 1.19; 95%CI = 0.90-1.57, and combined (OR = 1.38; 95%CI = 1.13-1.68 outcomes. Increasing the time devoted to practical skills did not improve the performance of ACLS students.

  8. Collaborative effects of bystander-initiated cardiopulmonary resuscitation and prehospital advanced cardiac life support by physicians on survival of out-of-hospital cardiac arrest: a nationwide population-based observational study

    OpenAIRE

    Yasunaga, Hideo; Horiguchi, Hiromasa; Tanabe, Seizan; Akahane, Manabu; OGAWA, Toshio; Koike, Soichi; Imamura, Tomoaki

    2010-01-01

    Introduction There are inconsistent data about the effectiveness of prehospital physician-staffed advanced cardiac life support (ACLS) on the outcomes of out-of-hospital cardiac arrest (OHCA). Furthermore, the relative importance of bystander-initiated cardiopulmonary resuscitation (BCPR) and ACLS and the effectiveness of their combination have not been clearly demonstrated. Methods Using a prospective, nationwide, population-based registry of all OHCA patients in Japan, we enrolled 95,072 pa...

  9. Early MRI response monitoring of patients with advanced hepatocellular carcinoma under treatment with the multikinase inhibitor sorafenib

    Directory of Open Access Journals (Sweden)

    Gregor Michael

    2009-06-01

    Full Text Available Abstract Background New therapeutic principles in clinical oncology require the adjustment of response criteria to govern therapy decisions. For advanced hepatocellular carcinoma (HCC a new era has recently begun by the approval of the multikinase inhibitor sorafenib. As a unique feature, HCC usually develops in a diseased liver and current imaging technologies employing classical response criteria have not been prospectively evaluated for this new treatment. Methods MRI signal patterns were assessed in 21 advanced HCC patients receiving sorafenib. MRI was performed at baseline and in short-term intervals thereafter. Signal changes under therapy on T1WI, T2WI and post-gadolinium images including necrosis volume and its ratio to the entire tumor volume were compared to baseline imaging. To assess the association between the categorical variables, Fisher's exact tests were applied for a statistical analysis. Survey time ranged from 2–65 weeks, and a total of 39 target lesions were evaluated. Results Signal abnormalities during sorafenib therapy were disclosed by T1WI and T2WI in 15/21 patients. The predominant tumor signal change was hyperintensity on both T1WI and T2WI. Interestingly, most patients developed MRI signal changes within 4 weeks of therapy; in contrast, two non-responders did not show any signal alteration at follow-up. Under therapy, 16/21 patients presented with new or progressive necrosis, whereas 7 patients achieved temporarily >75% tumor necrosis under sorafenib. Significantly associated MRI variables were increase in T1WI signal and tumor necrosis (p = 0.017 as well as increase of tumor necrosis with an elevated ratio of necrotic to vital tumor areas (p = 0.002. Remarkably, some (3/13 of the patients developing necrotic tumor areas showed a relevant (>20% increase in tumor volume, which should be considered in the assessment of imaging studies. Conclusion As sorafenib induces early intralesional necrosis with profound changes

  10. Advances in exploring the role of microRNAs in the pathogenesis, diagnosis and therapy of cardiac diseases in China.

    Science.gov (United States)

    Pan, Z W; Lu, Y J; Yang, B F

    2015-12-01

    Cardiovascular disease has become the most serious health threat and represents the major cause of morbidity and mortality in China, as in other industrialized nations. During the past few decades, China's economic boom has tremendously improved people's standard of living but has also changed their lifestyle, increasing the prevalence of cardiovascular disease, the so-called 'disease of modern civilization'. This new trend has attracted a significant amount of research. Many of the studies conducted by Chinese investigators are orientated towards understanding the molecular mechanisms of cardiovascular disease. At the molecular level, the long-standing consensus is that cardiovascular disease is associated with a sequence mutation (genetic anomaly) and expression deregulation (epigenetic disorder) of protein-coding genes. However, new research data have established the non-protein-coding genes microRNAs (miRNAs) as a central regulator of the pathogenesis of cardiac disease and a potential new therapeutic target for cardiovascular disease. These small non-coding RNAs have also been subjected to extensive, rigorous investigations by Chinese researchers. Over the years, a large body of studies on miRNAs in cardiovascular disease has been conducted by Chinese investigators, yielding fruitful research results and a better understanding of miRNAs as a new level of molecular mechanisms for the pathogenesis of cardiac disease. In this review, we briefly summarize the current status of research in the field of miRNAs and cardiovascular disease in China, highlighting the advances made in elucidating the role of miRNAs in various cardiac conditions, including cardiac arrhythmia, myocardial ischaemia, cardiac hypertrophy and heart failure. We have also examined the potential of miRNAs as novel diagnostic biomarkers and therapeutic targets. PMID:25393505

  11. Accelerated acquisition of tagged MRI for cardiac motion correction in simultaneous PET-MR: Phantom and patient studies

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Chuan, E-mail: chuan.huang@stonybrookmedicine.edu [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115 (United States); Departments of Radiology, Psychiatry, Stony Brook Medicine, Stony Brook, New York 11794 (United States); Petibon, Yoann [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Ouyang, Jinsong; El Fakhri, Georges [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Department of Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 and Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115 (United States); Reese, Timothy G. [Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115 and Martinos Center for Biomedical Imaging, Charlestown, Massachusetts 02129 (United States); Ahlman, Mark A.; Bluemke, David A. [Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland 20892 (United States)

    2015-02-15

    Purpose: Degradation of image quality caused by cardiac and respiratory motions hampers the diagnostic quality of cardiac PET. It has been shown that improved diagnostic accuracy of myocardial defect can be achieved by tagged MR (tMR) based PET motion correction using simultaneous PET-MR. However, one major hurdle for the adoption of tMR-based PET motion correction in the PET-MR routine is the long acquisition time needed for the collection of fully sampled tMR data. In this work, the authors propose an accelerated tMR acquisition strategy using parallel imaging and/or compressed sensing and assess the impact on the tMR-based motion corrected PET using phantom and patient data. Methods: Fully sampled tMR data were acquired simultaneously with PET list-mode data on two simultaneous PET-MR scanners for a cardiac phantom and a patient. Parallel imaging and compressed sensing were retrospectively performed by GRAPPA and kt-FOCUSS algorithms with various acceleration factors. Motion fields were estimated using nonrigid B-spline image registration from both the accelerated and fully sampled tMR images. The motion fields were incorporated into a motion corrected ordered subset expectation maximization reconstruction algorithm with motion-dependent attenuation correction. Results: Although tMR acceleration introduced image artifacts into the tMR images for both phantom and patient data, motion corrected PET images yielded similar image quality as those obtained using the fully sampled tMR images for low to moderate acceleration factors (<4). Quantitative analysis of myocardial defect contrast over ten independent noise realizations showed similar results. It was further observed that although the image quality of the motion corrected PET images deteriorates for high acceleration factors, the images were still superior to the images reconstructed without motion correction. Conclusions: Accelerated tMR images obtained with more than 4 times acceleration can still provide

  12. Myocardial perfusion imaging for predicting cardiac events in Japanese patients with advanced chronic kidney disease: 1-year interim report of the J-ACCESS 3 investigation

    Energy Technology Data Exchange (ETDEWEB)

    Joki, Nobuhiko; Hase, Hiroki [Toho University Ohashi Medical Center, Department of Nephrology, Tokyo (Japan); Kawano, Yuhei; Nakamura, Satoko [National Cerebral and Cardiovascular Center, Division of Hypertension and Nephrology, Osaka (Japan); Nakajima, Kenichi [Kanazawa University Hospital, Department of Nuclear Medicine, Kanazawa (Japan); Hatta, Tsuguru [Hatta Medical Office of Internal Medicine, Kyoto (Japan); Nishimura, Shigeyuki [Saitama Medical University International Medical Center, Saitama (Japan); Moroi, Masao [Toho University Ohashi Medical Center, Department of Cardiology, Tokyo (Japan); Nakagawa, Susumu [Saiseikai Central Hospital, Department of Cardiology, Tokyo (Japan); Kasai, Tokuo [Tokyo Medical University Hachioji Medical Center, Tokyo (Japan); Kusuoka, Hideo [Osaka National Hospital, Osaka (Japan); Takeishi, Yasuchika [Fukushima Medical University, Department of Cardiology and Hematology, Fukushima (Japan); Momose, Mitsuru [Tokyo Women' s Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo (Japan); Takehana, Kazuya [Kansai Medical University, Department of Cardiology, Osaka (Japan); Nanasato, Mamoru [Cardiovascular Center, Nagoya Daini Red Cross Hospital, Nagoya (Japan); Yoda, Shunichi [Nihon University Itabashi Hospital, Department of Cardiology, Tokyo (Japan); Nishina, Hidetaka [Tsukuba Medical Center Hospital, Department of Cardiology, Tsukuba (Japan); Matsumoto, Naoya [Suruga-dai Nihon University Hospital, Department of Cardiology, Tokyo (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto (Japan)

    2014-09-15

    Whether myocardial perfusion imaging (MPI) can predict cardiac events in patients with advanced conservative chronic kidney disease (CKD) remains unclear. The present multicenter prospective cohort study aimed to clarify the ability of MPI to predict cardiac events in 529 patients with CKD and estimated glomerular filtration rates (eGFR) < 50 ml/min per 1.73{sup 2} without a definitive diagnosis of coronary artery disease. All patients were assessed by stress-rest MPI with {sup 99m}Tc-tetrofosmin and analyzed using summed defect scores and QGS software. Cardiac events were analyzed 1 year after registration. Myocardial perfusion abnormalities defined as summed stress score (SSS) ≥4 and ≥8 were identified in 19 and 7 % of patients, respectively. At the end of the 1-year follow-up, 33 (6.2 %) cardiac events had occurred that included cardiac death, sudden death, nonfatal myocardial infarction, and hospitalization due to heart failure. The event-free rates at that time were 0.95, 0.90, and 0.81 for groups with SSS 0-3, 4-7, and ≥8, respectively (p = 0.0009). Thus, patients with abnormal SSS had a higher incidence of cardiac events. Multivariate Cox regression analysis showed that SSS significantly impacts the prediction of cardiac events independently of eGFR and left ventricular ejection fraction. MPI would be useful to stratify patients with advanced conservative CKD who are at high risk of cardiac events without adversely affecting damaged kidneys. (orig.)

  13. How Can Nanotechnology Help to Repair the Body? Advances in Cardiac, Skin, Bone, Cartilage and Nerve Tissue Regeneration

    Directory of Open Access Journals (Sweden)

    Juan Antonio Marchal

    2013-03-01

    Full Text Available Nanotechnologists have become involved in regenerative medicine via creation of biomaterials and nanostructures with potential clinical implications. Their aim is to develop systems that can mimic, reinforce or even create in vivo tissue repair strategies. In fact, in the last decade, important advances in the field of tissue engineering, cell therapy and cell delivery have already been achieved. In this review, we will delve into the latest research advances and discuss whether cell and/or tissue repair devices are a possibility. Focusing on the application of nanotechnology in tissue engineering research, this review highlights recent advances in the application of nano-engineered scaffolds designed to replace or restore the followed tissues: (i skin; (ii cartilage; (iii bone; (iv nerve; and (v cardiac.

  14. Cardiac metabolism and function in patients with Multiple Sclerosis: a combined {sup 31}P-MR-spectroscopy and MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Beer, M.; Sandstede, J.; Buchner, S.; Krug, A.; Koestler, H.; Pabst, T.; Kenn, W.; Hahn, D. [Wuerzburg Univ. (Germany). Inst. fuer Roentgendiagnostik; Weillbach, F.; Toyka, K.V.; Gold, R. [Wuerzburg Univ. (Germany). Neurologische Klinik; Spindler, M.; Ertl, G. [Wuerzburg Univ. (Germany). Medizinische Klinik; Landschuetz, W.; Kienlin, M. von [Wuerzburg Univ. (Germany). V. Physikalisches Inst.

    2001-05-01

    14/15 patients with MS could be included in the study, as the MRS examination of one patient had to be excluded from analysis due to movement during the examination. Using chemical shift imaging (CSI) and AMARES, phosphocreatine (PCr) to adenosine triphosphate (ATP) ratios, characterizing myocardial high-energy phosphate metabolism, were determined. Additionally, absolute concentrations of PCr and ATP were calculated by SLOOP (spatial localization with optimal pointspread function). Analysis of functional changes was performed by Cine-MRI. 14 healthy volunteers matched for age and gender served as control. Results: A significant decrease of absolute PCr concentration was observed in patients with MS compared to matched volunteers (p<0.05), whereas ATP concentrations showed no significant changes (p = 0.27). Metabolite ratios calculated by SLOOP or AMARES showed a tendency to be reduced in patients, however, did not reach significance (p = 0.08, SLOOP; p = 0.47, AMARES). Using volunteers' mean values {+-} 2 x SD as cut off value revealed PCr changes in 5 of 14 patients, whereas only 2 also had pathologic PCr/ATP ratios. Functional analysis by MRI depicted depressed left ventricular ejection fraction in 4 patients. (orig.) [German] 14/15 Patienten konnten in die Studie eingeschlossen werden, da die MRS Untersuchung eines Patienten infolge von Bewegungsartefakten von der Datenanalyse ausgeschlossen werden musste. Als Index des myokardialen Energiestoffwechsels wurde zum einen das Phosphokreatin (PCr) zu Adenosintriphosphat (ATP) Verhaeltnis mittels 3D-chemical shift imaging (CSI) und konventioneller Fouriertransformation (AMARES) bestimmt. Zusaetzlich wurden die Absolutkonzentrationen von PCr und ATP mit Hilfe des SLOOP-Verfahrens (spatial localization with optimal pointspread function) berechnet. Morphologische wie funktionelle Veraenderungen wurden mittels MRI erfasst. 14 gesunde Probanden gematcht fuer Alter und Geschlecht bildeten eine Kontrollgruppe

  15. Advances of blood oxygen-level dependent MRI in muscular system

    International Nuclear Information System (INIS)

    BOLD-fMRI has been applied to muscular system to observe muscular pathophysiological change after performing a task and show the characteristics of muscle perfusion. This paper mainly introduces the scanning sequence, common tasking methods, such as cuff compression, excise, oxygen and drug, etc. It also introduces clinical study of perfusion reserve of muscular tissue with abnormal blood vessels. (authors)

  16. Optimization of Free-Breathing Whole-Heart 3D Cardiac MRI at 3Tesla to Identify Coronary Vein Anatomy and to Compare with Multi-Detector Computed Tomography

    Science.gov (United States)

    Ibrahim, Wael G.; El Khouli, Riham H.; Abd-Elmoniem, Khaled Z.; Matta, Jatin Raj; McAreavey, Dorothea; Gharib, Ahmed M

    2014-01-01

    Objective This study optimizes use of 3T MRI to delineate coronary venous anatomy, and compares 3T MRI with MDCT measurements. Methods The study population included 37 consecutive subjects (22 men, 19-71 years). Whole-heart contrast-enhanced MRI images at 3T were acquired using segmented k-space gradient echo with inversion recovery prepared technique. MDCT images were obtained using nonionic iodinated contrast. Results The coronary sinus, and great cardiac, posterior interventricular, and anterior interventricular veins were visualized in 100% of cases by both MRI and MDCT. Detection of the posterior vein of left ventricle and left marginal vein by MRI was 97% and 81% respectively. Bland Altman plots showed agreement in ostial diameter measured by both modalities with correlation coefficients ranging 0.5-0.76. Vein length and distances also agreed closely. Conclusion Free-breathing whole-heart 3D MRI at 3T provides high spatial resolution images and could offer an alternative imaging technique instead of MDCT scans. PMID:24983436

  17. Recent advances in animal and human pluripotent stem cell modeling of cardiac laminopathy.

    Science.gov (United States)

    Lee, Yee-Ki; Jiang, Yu; Ran, Xin-Ru; Lau, Yee-Man; Ng, Kwong-Man; Lai, Wing-Hon Kevin; Siu, Chung-Wah; Tse, Hung-Fat

    2016-01-01

    Laminopathy is a disease closely related to deficiency of the nuclear matrix protein lamin A/C or failure in prelamin A processing, and leads to accumulation of the misfold protein causing progeria. The resultant disrupted lamin function is highly associated with abnormal nuclear architecture, cell senescence, apoptosis, and unstable genome integrity. To date, the effects of loss in nuclear integrity on the susceptible organ, striated muscle, have been commonly associated with muscular dystrophy, dilated cardiac myopathy (DCM), and conduction defeats, but have not been studied intensively. In this review, we aim to summarize recent breakthroughs in an in vivo laminopathy model and in vitro study using patient-specific human induced pluripotent stem cells (iPSCs) that reproduce the pathophysiological phenotype for further drug screening. We describe several in-vivo transgenic mouse models to elucidate the effects of Lmna H222P, N195K mutations, and LMNA knockout on cardiac function, in terms of hemodynamic and electrical signal propagation; certain strategies targeted on stress-related MAPK are mentioned. We will also discuss human iPSC cardiomyocytes serving as a platform to reveal the underlying mechanisms, such as the altered mechanical sensation in electrical coupling of the heart conduction system and ion channel alternation in relation to altered nuclear architecture, and furthermore to enable screening of drugs that can attenuate this cardiac premature aging phenotype by inhibition of prelamin misfolding and oxidative stress, and also enhancement of autophagy protein clearance and cardiac-protective microRNA.

  18. MRS: a noninvasive window into cardiac metabolism.

    Science.gov (United States)

    van Ewijk, Petronella A; Schrauwen-Hinderling, Vera B; Bekkers, Sebastiaan C A M; Glatz, Jan F C; Wildberger, Joachim E; Kooi, M Eline

    2015-07-01

    A well-functioning heart requires a constant supply of a balanced mixture of nutrients to be used for the production of adequate amounts of adenosine triphosphate, which is the main energy source for most cellular functions. Defects in cardiac energy metabolism are linked to several myocardial disorders. MRS can be used to study in vivo changes in cardiac metabolism noninvasively. MR techniques allow repeated measurements, so that disease progression and the response to treatment or to a lifestyle intervention can be monitored. It has also been shown that MRS can predict clinical heart failure and death. This article focuses on in vivo MRS to assess cardiac metabolism in humans and experimental animals, as experimental animals are often used to investigate the mechanisms underlying the development of metabolic diseases. Various MR techniques, such as cardiac (31) P-MRS, (1) H-MRS, hyperpolarized (13) C-MRS and Dixon MRI, are described. A short overview of current and emerging applications is given. Cardiac MRS is a promising technique for the investigation of the relationship between cardiac metabolism and cardiac disease. However, further optimization of scan time and signal-to-noise ratio is required before broad clinical application. In this respect, the ongoing development of advanced shimming algorithms, radiofrequency pulses, pulse sequences, (multichannel) detection coils, the use of hyperpolarized nuclei and scanning at higher magnetic field strengths offer future perspective for clinical applications of MRS. PMID:26010681

  19. Cardiac MRI assessed left ventricular hypertrophy in differentiating hypertensive heart disease from hypertrophic cardiomyopathy attributable to a sarcomeric gene mutation

    Energy Technology Data Exchange (ETDEWEB)

    Sipola, Petri [Kuopio University Hospital, Department of Clinical Radiology, Kuopio (Finland); University of Eastern Finland, Institute of Clinical Medicine, Faculty of Health Sciences, Kuopio (Finland); Magga, Jarkko; Peuhkurinen, Keijo [Kuopio University Hospital, Department of Medicine, Kuopio (Finland); Husso, Minna [Kuopio University Hospital, Department of Clinical Radiology, Kuopio (Finland); Jaeaeskelaeinen, Pertti; Kuusisto, Johanna [Kuopio University Hospital, Department of Medicine, Kuopio (Finland); Kuopio University Hospital, Heart Center, P.O. Box 1777, Kuopio (Finland)

    2011-07-15

    To evaluate the value of cardiac magnetic resonance imaging (CMRI)-assessed left ventricular hypertrophy (LVH) in differentiating between hypertensive heart disease and hypertrophic cardiomyopathy (HCM). 95 unselected subjects with mild-to-moderate hypertension, 24 patients with HCM attributable to the D175N mutation of the {alpha}-tropomyosin gene and 17 control subjects were studied by cine CMRI. Left ventricular (LV) quantitative and qualitative characteristics were evaluated. LV maximal end-diastolic wall thickness, wall thickness-to-LV volume ratio, end-diastolic septum thickness and septum-to-lateral wall thickness ratio were useful measures for differentiating between LVH due to hypertension and HCM. The most accurate measure for identifying patients with HCM was the LV maximal wall thickness {>=}17 mm, with a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 90%, 93%, 86%, 95% and 91%, respectively. LV maximal wall thickness in the anterior wall, or regional bulging in left ventricular wall was found only in patients with HCM. LV mass index was not discriminant between patients with HCM and those with LVH due to hypertension. LV maximal thickness measured by CMRI is the best anatomical parameter in differentiating between LVH due to mild-to-moderate hypertension and HCM attributable to a sarcomeric mutation. CMRI assessment of location and quality of LVH is also of value in differential diagnosis. (orig.)

  20. Algorithm for quantifying advanced carotid artery atherosclerosis in humans using MRI and active contours

    Science.gov (United States)

    Adams, Gareth; Vick, G. W., III; Bordelon, Cassius; Insull, William; Morrisett, Joel

    2002-05-01

    A new algorithm for measuring carotid artery volumes and estimating atherosclerotic plaque volumes from MRI images has been developed and validated using pressure-perfusion-fixed cadaveric carotid arteries. Our method uses an active contour algorithm with the generalized gradient vector field force as the external force to localize the boundaries of the artery on each MRI cross-section. Plaque volume is estimated by an automated algorithm based on estimating the normal wall thickness for each branch of the carotid. Triplicate volume measurements were performed by a single observer on thirty-eight pairs of cadaveric carotid arteries. The coefficient of variance (COV) was used to quantify measurement reproducibility. Aggregate volumes were computed for nine contiguous slices bounding the carotid bifurcation. The median (mean +/- SD) COV for the 76 aggregate arterial volumes was 0.93% (1.47% +/- 1.52%) for the lumen volume, 0.95% (1.06% +/- 0.67%) for the total artery volume, and 4.69% (5.39% +/- 3.97%) for the plaque volume. These results indicate that our algorithm provides repeatable measures of arterial volumes and a repeatable estimate of plaque volume of cadaveric carotid specimens through analysis of MRI images. The algorithm also significantly decreases the amount of time necessary to generate these measurements.

  1. Recent advances in understanding cardiac contractility in health and disease [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    Ken T. MacLeod

    2016-07-01

    Full Text Available The aim of this review is to provide the reader with a synopsis of some of the emerging ideas and experimental findings in cardiac physiology and pathophysiology that were published in 2015. To provide context for the non-specialist, a brief summary of cardiac contraction and calcium (Ca regulation in the heart in health and disease is provided. Thereafter, some recently published articles are introduced that indicate the current thinking on (1 the Ca regulatory pathways modulated by Ca/calmodulin-dependent protein kinase II, (2 the potential influences of nitrosylation by nitric oxide or S-nitrosated proteins, (3 newly observed effects of reactive oxygen species (ROS on contraction and Ca regulation following myocardial infarction and a possible link with changes in mitochondrial Ca, and (4 the effects of some of these signaling pathways on late Na current and pro-arrhythmic afterdepolarizations as well as the effects of transverse tubule disturbances.

  2. Single breath hold 3D cardiac cine MRI using kat-ARC: preliminary results at 1.5T.

    Science.gov (United States)

    Jeong, Daniel; Schiebler, Mark L; Lai, Peng; Wang, Kang; Vigen, Karl K; François, Christopher J

    2015-04-01

    Validation of a new single breath-hold, three-dimensional, cine balanced steady-state free precession (3D cine bSSFP) cardiac magnetic resonance (CMR) sequence for left ventricular function. CMR examinations were performed on fifteen patients and three healthy volunteers on a clinical 1.5T scanner using a two-dimensional (2D) cine balanced SSFP CMR sequence (2D cine bSSFP) followed by an investigational 3D cine bSSFP pulse sequence acquired within a single breath hold. Left ventricular end diastolic volume (LVEDV), end systolic volume (LVESV), ejection fraction (LVEF), and myocardial mass were independently segmented on a workstation by two experienced radiologists. Blood pool to myocardial contrast was evaluated in consensus using a Likert scale. Bland-Altman analysis was used to compare these quantitative and nominal measurements for the two sequences. The average acquisition time was significantly shorter for the 3D cine bSSFP than for 2D cine bSSFP (0.36 ± 0.03 vs. 8.5 ± 2.3 min) p = 0.0002. Bland-Altman analyses [bias and (limits of agreement)] of the data derived from these two methods revealed that the LVEF 0.9% (-4.7, 6.4), LVEDV 4.9 ml (-23.0, 32.8), LVESV -0.2 ml (-22.4, 21.9), and myocardial mass -0.4 g (-23.8, 23.0) were not significantly different. There was excellent intraclass correlation for intra-observer variability (0.981, 0.989, 0.997, 0.985) and inter-observer variability (0.903, 0.954, 0.970, 0.842) for LVEF, LVEDV, LVESV, and myocardial mass respectively. 3D cine bSSFP allows for accurate single breath-hold volumetric cine CMR which enables substantial improvements in scanner time efficiency without sacrificing diagnostic accuracy.

  3. The advances of cardiac resynchronization therapy%心脏同步化治疗进展

    Institute of Scientific and Technical Information of China (English)

    杨兴生; 孙静平; JM.Felner

    2010-01-01

    @@ Heart failure(HF)currently affects over 5 million Americans,with approximately 500 000 new cases diagnosed each year,with 5-year mortality rates approaching 50%.This is the most common cause of hospitalization in patients older than 65 years-old~([1]). There is overwhelming evidence from prospective randomized controlled trials that provides support for cardiac resynchronization therapy(CRT)in patients with symptomatic heart failure and ventricular dyssynchrony.

  4. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Kanwalpreet Sodhi

    2011-01-01

    Full Text Available Background: Guidelines on performing cardiopulmonary resuscitation (CPR have been published from time to time, and formal training programs are conducted based on these guidelines. Very few data are available in world literature highlighting the impact of these trainings on CPR outcome. Aim: The aim of our study was to evaluate the impact of the American Heart Association (AHA-certified basic life support (BLS and advanced cardiac life support (ACLS provider course on the outcomes of CPR in our hospital. Materials and Methods : An AHA-certified BLS and ACLS provider training programme was conducted in our hospital in the first week of October 2009, in which all doctors in the code blue team and intensive care units were given training. The retrospective study was performed over an 18-month period. All in-hospital adult cardiac arrest victims in the pre-BLS/ACLS training period (January 2009 to September 2009 and the post-BLS/ACLS training period (October 2009 to June 2010 were included in the study. We compared the outcomes of CPR between these two study periods. Results: There were a total of 627 in-hospital cardiac arrests, 284 during the pre-BLS/ACLS training period and 343 during the post-BLS/ACLS training period. In the pre-BLS/ACLS training period, 52 patients (18.3% had return of spontaneous circulation, compared with 97 patients (28.3% in the post-BLS/ACLS training period (P < 0.005. Survival to hospital discharge was also significantly higher in the post-BLS/ACLS training period (67 patients, 69.1% than in the pre-BLS/ACLS training period (12 patients, 23.1% (P < 0.0001. Conclusion : Formal certified BLS and ACLS training of healthcare professionals leads to definitive improvement in the outcome of CPR.

  5. Right-sided cardiac function in healthy volunteers measured by first-pass radionuclide ventriculography and gated blood-pool SPECT: comparison with cine MRI

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Lebech, Anne-Mette; Hesse, Birger;

    2005-01-01

    and breath-hold cine MRI performed according to standard protocols. RESULTS: Normal ranges for RV ejection fraction (RVEF) defined as mean +/- 2SD were 0.49-0.72, 0.44-0.66 and 0.40-0.69 when measured by MRI, FP and GBPS respectively. Bland-Altman analysis showed a mean difference (bias) between MRI and FP...

  6. Cross-modality assessment and planning for pulmonary trunk treatment using CT and MRI imaging.

    Science.gov (United States)

    Vitanovski, Dime; Tsymbal, Alexey; Ionasec, Razvan Ioan; Georgescu, Bogdan; Hubert, Martin; Taylor, Andrew; Schievano, Silvia; Zhou, Shaohua Kevin; Hornegger, Joachim; Comaniciu, Dorin

    2010-01-01

    Congenital heart defect is the primary cause of death in newborns, due to typically complex malformation of the cardiac system. The pulmonary valve and trunk are often affected and require complex clinical management and in most cases surgical or interventional treatment. While minimal invasive methods are emerging, non-invasive imaging-based assessment tools become crucial components in the clinical setting. For advanced evaluation and therapy planning purposes, cardiac Computed Tomography (CT) and cardiac Magnetic Resonance Imaging (cMRI) are important non-invasive investigation techniques with complementary properties. Although, characterized by high temporal resolution, cMRI does not cover the full motion of the pulmonary trunk. The sparse cMRI data acquired in this context include only one 3D scan of the heart in the end-diastolic phase and two 2D planes (long and short axes) over the whole cardiac cycle. In this paper we present a cross-modality framework for the evaluation of the pulmonary trunk, which combines the advantages of both, cardiac CT and cMRI. A patient-specific model is estimated from both modalities using hierarchical learning-based techniques. The pulmonary trunk model is exploited within a novel dynamic regression-based reconstruction to infer the incomplete cMRI temporal information. Extensive experiments performed on 72 cardiac CT and 74 cMRI sequences demonstrated the average speed of 110 seconds and accuracy of 1.4mm for the proposed approach. To the best of our knowledge this is the first dynamic model of the pulmonary trunk and right ventricle outflow track estimated from sparse 4D cMRI data. PMID:20879263

  7. Response evaluation after chemoradiotherapy for advanced nodal disease in head and neck cancer using diffusion-weighted MRI and 18F-FDG-PET-CT

    NARCIS (Netherlands)

    C.S. Schouten; P. de Graaf; F.M. Alberts; O.S. Hoekstra; E.F.I. Comans; E. Bloemena; B.I. Witte; E. Sanchez; C.R. Leemans; J.A. Castelijns; R. de Bree

    2015-01-01

    Objectives Evaluation of accuracy and interobserver variation of diffusion-weighted magnetic resonance imaging (DW-MRI) and 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDGPET-CT) to detect residual lymph node metastases after chemoradiotherapy (CRT) in advanced stage

  8. Response evaluation after chemoradiotherapy for advanced nodal disease in head and neck cancer using diffusion-weighted MRI and 18F-FDG-PET-CT

    NARCIS (Netherlands)

    Schouten, C.S.; Graaf, P. de; Alberts, F.M.; Hoekstra, O.S.; Comans, E.F.; Bloemena, E.; Witte, B.I.; Sanchez, E.; Leemans, C.R.; Castelijns, J.A.; Bree, R. de

    2015-01-01

    OBJECTIVES: Evaluation of accuracy and interobserver variation of diffusion-weighted magnetic resonance imaging (DW-MRI) and 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDGPET-CT) to detect residual lymph node metastases after chemoradiotherapy (CRT) in advanced stag

  9. BASIC PRINCIPLES AND CONCEPTS UNDERLYING RECENT ADVANCES IN MRI OF THE DEVELOPING BRAIN

    OpenAIRE

    Panigrahy, Ashok; Borzage, Matthew; Blüml, Stefan

    2010-01-01

    Over the last decade, magnetic resonance imaging has become an essential tool in the evaluation of both in vivo human brain development and perinatal brain injury. Recent technology including MR compatible neonatal incubators, neonatal head coils, advanced MR pulse sequences and 3T field strength magnets allow high quality MR imaging studies to be performed on sick neonates. This article will review basic principles and concepts underlying recent advances in MR spectroscopy, diffusion, perfus...

  10. Effect of simulation on knowledge of advanced cardiac life support, knowledge retention, and confidence of nursing students in Jordan.

    Science.gov (United States)

    Tawalbeh, Loai I; Tubaishat, Ahmad

    2014-01-01

    This study examined the effect of simulation on nursing students' knowledge of advanced cardiac life support (ACLS), knowledge retention, and confidence in applying ACLS skills. An experimental, randomized controlled (pretest-posttest) design was used. The experimental group (n = 40) attended an ACLS simulation scenario, a 4-hour PowerPoint presentation, and demonstration on a static manikin, whereas the control group (n = 42) attended the PowerPoint presentation and a demonstration only. A paired t test indicated that posttest mean knowledge of ACLS and confidence was higher in both groups. The experimental group showed higher knowledge of ACLS and higher confidence in applying ACLS, compared with the control group. Traditional training involving PowerPoint presentation and demonstration on a static manikin is an effective teaching strategy; however, simulation is significantly more effective than traditional training in helping to improve nursing students' knowledge acquisition, knowledge retention, and confidence about ACLS.

  11. Impact of advanced MRI techniques for the diagnosis of dementia: comparison with PET

    DEFF Research Database (Denmark)

    Steffensen, Elena; Prakash, Vineet; Vestergård, Karsten;

    of cerebral blood flow (CBF) and also of white matter damage may be used to support the diagnosis and characterization of dementia and is of special important interest for the detection of changes in the early stages of the disease. Purpose: To investigate whether perfusion MRI with CBF maps combined....../left asymmetry of CBF for different lobes for patients in comparison with controls. Five of the patients had prominent asymmetry in both frontal and temporal lobes, 4 in parietal lobes, 4 were found normal and 5 patients were difficult to classify. In 9 out of 11 patients PET confirms findings: 3 patient...... with suspected Alzheimer's disease (AD); 4 with suspected frontotemporal dementia (FTD), and 2 were found normal. Mean FA and ADC values in cingulum and in CC for the patient group compared with controls are presented in Table 1. ADC values in CC were higher comparing with controls and higher for patients...

  12. Advanced glycation end products accelerate ischemia/reperfusion injury through receptor of advanced end product/nitrative thioredoxin inactivation in cardiac microvascular endothelial cells.

    Science.gov (United States)

    Liu, Yi; Ma, Yanzhuo; Wang, Rutao; Xia, Chenhai; Zhang, Rongqing; Lian, Kun; Luan, Ronghua; Sun, Lu; Yang, Lu; Lau, Wayne B; Wang, Haichang; Tao, Ling

    2011-10-01

    The advanced glycation end products (AGEs) are associated with increased cardiac endothelial injury. However, no causative link has been established between increased AGEs and enhanced endothelial injury after ischemia/reperfusion. More importantly, the molecular mechanisms by which AGEs may increase endothelial injury remain unknown. Adult rat cardiac microvascular endothelial cells (CMECs) were isolated and incubated with AGE-modified bovine serum albumin (BSA) or BSA. After AGE-BSA or BSA preculture, CMECs were subjected to simulated ischemia (SI)/reperfusion (R). AGE-BSA increased SI/R injury as evidenced by enhanced lactate dehydrogenase release and caspase-3 activity. Moreover, AGE-BSA significantly increased SI/R-induced oxidative/nitrative stress in CMECs (as measured by increased inducible nitric oxide synthase expression, total nitric oxide production, superoxide generation, and peroxynitrite formation) and increased SI/R-induced nitrative inactivation of thioredoxin-1 (Trx-1), an essential cytoprotective molecule. Supplementation of EUK134 (peroxynitrite decomposition catalyst), human Trx-1, or soluble receptor of advanced end product (sRAGE) (a RAGE decoy) in AGE-BSA precultured cells attenuated SI/R-induced oxidative/nitrative stress, reduced SI/R-induced Trx-1 nitration, preserved Trx-1 activity, and reduced SI/R injury. Our results demonstrated that AGEs may increase SI/R-induced endothelial injury by increasing oxidative/nitrative injury and subsequent nitrative inactivation of Trx-1. Interventions blocking RAGE signaling or restoring Trx activity may be novel therapies to mitigate endothelial ischemia/reperfusion injury in the diabetic population.

  13. Locally advanced rectal cancer: is diffusion weighted MRI helpful for the identification of complete responders (ypT0N0) after neoadjuvant chemoradiation therapy?

    International Nuclear Information System (INIS)

    To determine retrospectively the additional value of DWI-MRI toT2-MRI for predicting complete response (ypT0N0 = CR) after chemoradiation-therapy (CRT) in locally advanced rectal cancer. Seventy locally advanced rectal cancer patients underwent CRT followed by restaging MRI and resection. Two readers with different experience levels independently scored T2 images for CR and, in a second reading, combined T2 and DWI. A 5-point confidence-level score was used to generate ROC curves. Areas under the ROC curves (AUC) and interobserver agreement were compared for both readings. Histology served as reference standard. The interobserver agreement increased after addition of DWI from 0.35 to 0.58 but the AUC improved only for the experienced reader (0.77 to 0.89, p = 0.005 vs. 0.74 to 0.70, p > 0.05). Sensitivity and NPV improved from 20-30 % to 40-70 %, respectively 88 % to 91-95 %. Specificity and PPV improved only for the experienced reader (87 to 93 % respectively 27 to 63 %). Adding DWI to T2-MRI improves consistency between readers and has potential to improve readers' accuracy dependent on his/her experience. DWI could be of additional value, particularly in ruling out CR (high NPV), but considering the sub-optimal PPV one should be cautious about relying solely on MRI for the clinical decision to offer a wait-and-see strategy. (orig.)

  14. Locally advanced rectal cancer: is diffusion weighted MRI helpful for the identification of complete responders (ypT0N0) after neoadjuvant chemoradiation therapy?

    Energy Technology Data Exchange (ETDEWEB)

    Sassen, S.; Booij, M. de; Vliegen, R. [Atrium Medical Center Parkstad, Department of Radiology, P.O. Box 4446, Heerlen (Netherlands); Sosef, M. [Atrium Medical Center Parkstad, Department of General Surgery, P.O. Box 4446, Heerlen (Netherlands); Berendsen, R. [Atrium Medical Center Parkstad, Department of Clinical Physics, P.O. Box 4446, Heerlen (Netherlands); Lammering, G. [MAASTRO Clinic, Department of Radiation Oncology, P.O. Box 3035, Maastricht (Netherlands); Clarijs, R. [Atrium Medical Center Parkstad, Department of Pathology, P.O. Box 4446, Heerlen (Netherlands); Bakker, M. [Atrium Medical Center Parkstad, Department of Gastroenterology and Hepatology, P.O. Box 4446, Heerlen (Netherlands); Beets-Tan, R. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); Warmerdam, F. [Atrium Medical Center Parkstad, Department of Internal Medicine/Oncology, P.O. Box 4446, Heerlen (Netherlands)

    2013-12-15

    To determine retrospectively the additional value of DWI-MRI toT2-MRI for predicting complete response (ypT0N0 = CR) after chemoradiation-therapy (CRT) in locally advanced rectal cancer. Seventy locally advanced rectal cancer patients underwent CRT followed by restaging MRI and resection. Two readers with different experience levels independently scored T2 images for CR and, in a second reading, combined T2 and DWI. A 5-point confidence-level score was used to generate ROC curves. Areas under the ROC curves (AUC) and interobserver agreement were compared for both readings. Histology served as reference standard. The interobserver agreement increased after addition of DWI from 0.35 to 0.58 but the AUC improved only for the experienced reader (0.77 to 0.89, p = 0.005 vs. 0.74 to 0.70, p > 0.05). Sensitivity and NPV improved from 20-30 % to 40-70 %, respectively 88 % to 91-95 %. Specificity and PPV improved only for the experienced reader (87 to 93 % respectively 27 to 63 %). Adding DWI to T2-MRI improves consistency between readers and has potential to improve readers' accuracy dependent on his/her experience. DWI could be of additional value, particularly in ruling out CR (high NPV), but considering the sub-optimal PPV one should be cautious about relying solely on MRI for the clinical decision to offer a wait-and-see strategy. (orig.)

  15. Research on the cardiac MRI in the diagnosis and treatment of unstable angina%核磁共振在不稳定型心绞痛诊治中的应用价值

    Institute of Scientific and Technical Information of China (English)

    李鹏; 亓燕

    2014-01-01

    Objective:To investigate the cardiac magnetic resonance technique in the diagnosis and treatment of unstable angina application value. Methods:The hospital diagnosed patients with unstable angina as research subjects, were given coronary angiography in patients (CAG) examination, ECG, echocardiography and cardiac MRI examination, recording the results and statistical analysis. Results:Cardiac MRI for>90%stenos is detected heart rate, and coronary angiography (CAG) showed no significant difference (x2=3.257, P>0.05), for0.05);cardiac MRI for cardiac function and cardiac structure determination is better than conventional echocardiography. Conclusion: Cardiac MRI technology to more accurately reflect changes in cardiac structure and function of the stenos is and effort ischemia detection rate with conventional inspection methods have better consistency.%目的:探讨核磁共振技术在不稳定心绞痛诊治中的应用价值。方法:选取经莱芜市人民医院确诊的不稳定心绞痛患者40例,分别给予冠状动脉造影(CAG)、心电图、超声心电图及心脏核磁共振检查,并对结果进行统计学分析。结果:核磁共振在心脏狭窄>90%的检出率高,与CAG间差异无统计学意义(x2=3.257,P>0.05),对<90%的狭窄检出率低,与CAG检查结果间差异有统计学意义(x2=17.267,x2=25.714;P<0.05);核磁共振对心脏狭窄程度高的患者的心肌缺血检出率高,与心电图检出率差异明显,有统计学意义(x2=4.65,P<0.05),但总检出率间差异不明显,无统计学意义(x2=0.251,P>0.05);核磁共振对于心功能及心脏结构的测定效果优于传统的超声心动图。结论:核磁共振技术能更准确的反应心脏结构和功能改变,对狭窄和心机缺血的检出率与传统检查方法有较好一致性。

  16. "The state of the heart": Recent advances in engineering human cardiac tissue from pluripotent stem cells.

    Science.gov (United States)

    Sirabella, Dario; Cimetta, Elisa; Vunjak-Novakovic, Gordana

    2015-08-01

    The pressing need for effective cell therapy for the heart has led to the investigation of suitable cell sources for tissue replacement. In recent years, human pluripotent stem cell research expanded tremendously, in particular since the derivation of human-induced pluripotent stem cells. In parallel, bioengineering technologies have led to novel approaches for in vitro cell culture. The combination of these two fields holds potential for in vitro generation of high-fidelity heart tissue, both for basic research and for therapeutic applications. However, this new multidisciplinary science is still at an early stage. Many questions need to be answered and improvements need to be made before clinical applications become a reality. Here we discuss the current status of human stem cell differentiation into cardiomyocytes and the combined use of bioengineering approaches for cardiac tissue formation and maturation in developmental studies, disease modeling, drug testing, and regenerative medicine.

  17. Brain MRI in Parkinson's disease

    NARCIS (Netherlands)

    Meijer, F.J.A.; Goraj, B.M.

    2014-01-01

    In this review article, conventional brain MRI and advanced MRI techniques in Parkinson`s disease (PD) are discussed, with emphasis on clinical relevance. Conventional brain MRI sequences generally demonstrate limited abnormalities specific for PD and in clinical practice brain MRI is mainly used to

  18. Assessment of the right ventricular function in patients with chronic obstructive pulmonary disease and cor pulmonale using cardiac 64-slice spiral CT comparing with 1.7 T MRI

    International Nuclear Information System (INIS)

    Objective: To assess the right ventricular function in patients with moderate to severe chronic obstructive pulmonary disease (COPD) and eor pulmonale using cardiac 64 MSCT comparing with MRI. Methods: Forty-six patients with COPD determined by pulmonary function test (PFT) were prospectively studied. According to the Global Initiative for COPD classification, the COPD patients were divided into three groups depending on the severity of the disease: mild COPD (16 cases), moderate COPD (16 cases) and severe COPD (14 cases). Twenty age-matched subjects were included as the controls. The RV function was assessed by 64-MSCT and 1.5 T cardiac MRI in all four groups. Pearson correlation analysis was used to evaluate the relationship between the right ventricular ejection fraction (RVEF), myocardial mass (MM) and the PFT results in COPD patients. AP value of less than 0.05 was considered statistically significant. End-diastolic volume (EDV), end-systolic volume (ESV), RVEF and MM on MSCT were compared with that on MRI using Pearson correlation analysis. Bland-Airman plot was used to evaluate the correlation between MSCT and MRI. Results: The RVEF was (51.6 ± 5.6)% in mild COPD, (49.8 ± 6.0)% in moderate COPD, (39.4 ± 7.2)% in severe COPD, and (53 ± 5.9)% in controls, respectively. The MM was (44.5 ± 5.4) g in mild COPD, (49.6 ± 5.0) g in moderate COPD, (57.1 ± 3.4) g in severe COPD, and (40.8 ± 3.9) g in controls, respectively. The EDV was (139.9 ± 25.0), (130.2 ± 21.2), (107.6 ± 18.4) and (149.2 ± 27.9) ml, the SV was (72.1 ± 16.1), (64.3 ± 11.0), (42.5 ± 16.5) and (77.0 ± 11.7) ml in four groups, respectively. The values of RVEF and RVEDV were significantly lower in severe COPD than that in mild COPD, moderate COPD and controls (FRVEF=143, FRVEDV=38.07, PRVEF= 1.03, FEDV=3.22, FEFV=0.44, FSV=2.77, P>0.05). The MM of the RV was significantly different between controls and the other three groups (F=66.34, P<0.01). All parameters of the RV function on

  19. Imaging the DNA Alkylator Melphalan by CEST MRI: An Advanced Approach to Theranostics.

    Science.gov (United States)

    Ngen, Ethel J; Bar-Shir, Amnon; Jablonska, Anna; Liu, Guanshu; Song, Xiaolei; Ansari, Roxana; Bulte, Jeff W M; Janowski, Miroslaw; Pearl, Monica; Walczak, Piotr; Gilad, Assaf A

    2016-09-01

    Brain tumors are among the most lethal types of tumors. Therapeutic response variability and failure in patients have been attributed to several factors, including inadequate drug delivery to tumors due to the blood-brain barrier (BBB). Consequently, drug delivery strategies are being developed for the local and targeted delivery of drugs to brain tumors. These drug delivery strategies could benefit from new approaches to monitor the delivery of drugs to tumors. Here, we evaluated the feasibility of imaging 4-[bis(2-chloroethyl)amino]-l-phenylalanine (melphalan), a clinically used DNA alkylating agent, using chemical exchange saturation transfer magnetic resonance imaging (CEST MRI), for theranostic applications. We evaluated the physicochemical parameters that affect melphalan's CEST contrast and demonstrated the feasibility of imaging the unmodified drug by saturating its exchangeable amine protons. Melphalan generated a CEST signal despite its reactivity in an aqueous milieu. The maximum CEST signal was observed at pH 6.2. This CEST contrast trend was then used to monitor therapeutic responses to melphalan in vitro. Upon cell death, the decrease in cellular pH from ∼7.4 to ∼6.4 caused an amplification of the melphalan CEST signal. This is contrary to what has been reported for other CEST contrast agents used for imaging cell death, where a decrease in the cellular pH following cell death results in a decrease in the CEST signal. Ultimately, this method could be used to noninvasively monitor melphalan delivery to brain tumors and also to validate therapeutic responses to melphalan clinically. PMID:27398883

  20. Advanced Imaging of Chiari 1 Malformations.

    Science.gov (United States)

    Fakhri, Akbar; Shah, Manish N; Goyal, Manu S

    2015-10-01

    Type I Chiari malformations are congenital deformities involving cerebellar tonsillar herniation downward through the foramen magnum. Structurally, greater than 5 mm of tonsillar descent in adults and more than 6 mm in children is consistent with type I Chiari malformations. However, the radiographic severity of the tonsillar descent does not always correlate well with the clinical symptomatology. Advanced imaging can help clinically correlate imaging to symptoms. Specifically, cerebrospinal fluid (CSF) flow abnormalities are seen in patients with type I Chiari malformation. Advanced MRI involving cardiac-gated and phase-contrast MRI affords a view of such CSF flow abnormalities. PMID:26408061

  1. What advances in microscopy are required for combined MRI and optical functional brain imaging? (Conference Presentation)

    Science.gov (United States)

    Kleinfeld, David

    2016-03-01

    This overview talk will focus on forward-looking scientific needs and physical limits to images of neuronal processes. The challenge in nervous systems is that the basic unit for "switching" events in the nervous system occurs on the one micrometer scale of synaptic spines, while computations involve communication between individual neurons across the full expanse of cortex, which is ten millimeters for mouse cortex. I will address hoped-for advances in optical microscopy, within the context of existing and proposed contrast mechanisms of neuronal function, that span the four orders of magnitude of length scales for neuronal processing

  2. MRI for Assessing Response to Neoadjuvant Therapy in Locally Advanced Rectal Cancer Using DCE-MR and DW-MR Data Sets: A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Mario Petrillo

    2015-01-01

    Full Text Available To evaluate MRI for neoadjuvant therapy response assessment in locally advanced rectal cancer (LARC using dynamic contrast enhanced-MRI (DCE-MRI and diffusion weighted imaging (DWI, we have compared magnetic resonance volumetry based on DCE-MRI (V(DCE and on DWI (V(DWI scans with conventional T2-weighted volumetry (V(C in LARC patients after neoadjuvant therapy. Twenty-nine patients with LARC underwent MR examination before and after neoadjuvant therapy. A manual segmentation was performed on DCE-MR postcontrast images, on DWI (b-value 800 s/mm2, and on conventional T2-weighted images by two radiologists. DCE-MRI, DWI, and T2-weigthed volumetric changes before and after treatment were evaluated. Nonparametric sample tests, interobserver agreement, and receiver operating characteristic curve (ROC were performed. Diagnostic performance linked to DCE-MRI volumetric change was superior to T2-w and DW-MRI volumetric changes performance (specificity 86%, sensitivity 93%, and accuracy 93%. Area Under ROC (AUC of V(DCE was greater than AUCs of V(C and V(DWI resulting in an increase of 15.6% and 11.1%, respectively. Interobserver agreement between two radiologists was 0.977, 0.864, and 0.756 for V(C, V(DCE, and V(DWI, respectively. V(DCE seems to be a promising tool for therapy response assessment in LARC. Further studies on large series of patients are needed to refine technique and evaluate its potential value.

  3. Gender Disparities Across the Spectrum of Advanced Cardiac Therapies: Real or Imagined?

    Science.gov (United States)

    Bogaev, Roberta C

    2016-11-01

    Cardiovascular disease has been responsible for more deaths in women than in men each year since 1985. This review discusses federal laws that have influenced the inclusion of women in research and reporting sex-specific differences, then addresses gender differences and gender disparities in four areas of clinical cardiovascular medicine: coronary heart disease, valvular heart disease, electrophysiology, and heart failure. The prevalence of disease in women is highlighted, the clinical characteristics of women at the time of referral for advanced therapies are reviewed, and the clinical outcomes of women are discussed. With the emergence of new technology such as smaller devices and less invasive procedures, more women are being referred for advanced therapies. However, a gap in awareness and diagnosis remains, contributing to later referrals for women. Women who do undergo advanced therapies often have more comorbidities and worse outcomes than men. A call is made to increase awareness, educate healthcare providers, and report more sex-specific data to resolve these gender disparities. PMID:27628294

  4. Impact of increasing levels of advanced iterative reconstruction on image quality in low-dose cardiac CT angiography

    International Nuclear Information System (INIS)

    Purpose: To investigate the effects of an advanced iterative reconstruction (IR) technique on subjective and objective image quality (IQ) in low-dose cardiac CT angiography (CCTA). Materials and Methods: 30 datasets of prospectively triggered 'step-and-shoot' CCTA scans acquired on a 256-slice CT scanner with optimized exposure settings were processed on a prototype IR system using filtered back-projection (FBP) and 4 levels of advanced IR (iDose4, Philips) providing incremental rates of IR (level 2, 4, 6, 7). In addition, the effects of different reconstruction kernels (semi-smooth [CB], standard with edge-enhancement [XCB]) and a 'multi-resolution' feature [MR] to preserve the noise power spectrum were evaluated resulting in a total of n = 480 image sets. Contrast-to-noise ratios (CNR) were computed from regions of interest at 9 coronary locations. The subjective IQ was rated on a 4-point-scale with 'classic' image appearance and noise-related artifacts as main criteria. Results: At an effective dose of 1.7 ± 0.7 mSv, the CNR significantly improved with every increasing level of IR (range: 14.2-27.8; p < 0.001) with the best objective IQ at the highest level of IR (level 7). The subjective IQ, however, was rated best at the medium level of IR (level 4) with minimal artifacts and a more 'classic' image appearance when compared to higher IR levels. The XCB kernel provided better subjective ratings than CB (p < 0.05) and the MR feature further increased the IQ at a high level of IR. Conclusion: The objective IQ of low-dose CCTA progressively improves with an increasing level of IR. The best subjective IQ, however, is reached at medium levels of IR combined with an edge-enhancing kernel allowing for preservation of a 'classic' image appearance suggesting application in the clinical routine. (orig.)

  5. Functional and morphological findings in early and advanced stages of HIV infection: A comparison of 99mTc-HMPAO SPECT with CT and MRI studies

    International Nuclear Information System (INIS)

    In fourty patients at early and advanced stages of HIV infection (Water-Reed stages I-VI) regional cerebral blood flow was determined by 99mTc-HMPAO SPECT, comparing the results with CT and MRI findings. All patients with HIV encephalopathy (AIDS dementia complex) had pathologic SPECT results (multilocular, patchy uptake defects), but also in earlier and even earliest stages of HIV infection positive SPECT findings were observed. Compared to functional SPECT imaging, morphologically orientated method (CT, MRI) were insensitive in detecting HIV-induced foci: More than 50% of the patients with pathologic SPECT findings had negative CT or MRI scans. Most patients in advanced Walter Reed stages had neurological abnormalities accompanied by positive SPECT. Subtle alterations of HMPAO uptake were observed even in a few cases of early HIV infection without neurological CNS symptoms. The data presented suggest that HMPAO SPECT is highly sensitive in the detection of altered brain perfusion not only in advanced but also early stages of HIV infection. Changes in regional cerebral blood flow are presented before noticeable structural defects may be observed. (orig./MG)

  6. Cardiac tumours in children

    Directory of Open Access Journals (Sweden)

    Parsons Jonathan M

    2007-03-01

    Full Text Available Abstract Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT and Magnetic Resonance Imaging (MRI of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor.

  7. Cancer treatment-related cardiac toxicity: prevention, assessment and management.

    Science.gov (United States)

    Fanous, Ibrahim; Dillon, Patrick

    2016-08-01

    Cancer therapies, especially anthracyclines and monoclonal antibodies, have been linked with increased rates of cardiotoxicity. The development of some cardiac side effects happens over several months, and changes in ejection fraction can be detected long before permanent damage or disability occurs. Advanced heart failure could be averted with better and earlier detection. Methodologies for early detection of cardiac changes include stress echocardiograms, cardiac velocity measurements, radionuclide imaging, cardiac MRI and several potential biomarkers. Many agents have been described for prophylaxis of cardiac events precipitated by cancer therapy. Prophylactic use of beta-blockers and ACE inhibitors may be considered for use with trastuzumab in breast cancer as tolerated. Recovery of cardiac function is possible early after the injury from a cancer therapy. Late complications for coronary artery disease, hypertension and arrhythmia are underappreciated. Treatments for severe cancer therapy-related cardiac complications follow the existing paradigms for congestive heart failure and coronary artery disease, although outcomes for cancer patients differ from outcomes for non-cancer patients. PMID:27372782

  8. Translocation and cleavage of myocardial dystrophin as a common pathway to advanced heart failure: A scheme for the progression of cardiac dysfunction

    OpenAIRE

    Toyo-Oka, Teruhiko; Kawada, Tomie; Nakata, Jumi; Xie, Han; Urabe, Masashi; Masui, Fujiko; Ebisawa, Takashi; Tezuka, Asaki; Iwasawa, Kuniaki; Nakajima, Toshiaki; Uehara, Yoshio; Kumagai, Hiroyuki; Kostin, Sawa; Schaper, Jutta; Nakazawa, Mikio

    2004-01-01

    Advanced heart failure (HF) is the leading cause of death in developed countries. The mechanism underlying the progression of cardiac dysfunction needs to be clarified to establish approaches to prevention or treatment. Here, using TO-2 hamsters with hereditary dilated cardiomyopathy, we show age-dependent cleavage and translocation of myocardial dystrophin (Dys) from the sarcolemma (SL) to the myoplasm, increased SL permeability in situ, and a close relationship between the loss of Dys and h...

  9. Advanced Cardiac Resuscitation Evaluation (ACRE: A randomised single-blind controlled trial of peer-led vs. expert-led advanced resuscitation training

    Directory of Open Access Journals (Sweden)

    Hughes Thomas C

    2010-01-01

    statistics showed that the difference of 15% meant that it was possible that the expert-led teaching was 20% better at generating students with High Passes. Conclusions The key elements of advanced cardiac resuscitation can be safely and effectively taught to medical students in small groups by peer-instructors who have undergone basic medical education training.

  10. Adaptation of the modified Bouc–Wen model to compensate for hysteresis in respiratory motion for the list-mode binning of cardiac SPECT and PET acquisitions: Testing using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dasari, Paul K. R.; Shazeeb, Mohammed Salman [Department of Radiology, Division of Nuclear Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 and Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts 01609 (United States); Könik, Arda; Lindsay, Clifford; Mukherjee, Joyeeta M.; Johnson, Karen L.; King, Michael A., E-mail: Michael.King@umassmed.edu [Department of Radiology, Division of Nuclear Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 (United States)

    2014-11-01

    Purpose: Binning list-mode acquisitions as a function of a surrogate signal related to respiration has been employed to reduce the impact of respiratory motion on image quality in cardiac emission tomography (SPECT and PET). Inherent in amplitude binning is the assumption that there is a monotonic relationship between the amplitude of the surrogate signal and respiratory motion of the heart. This assumption is not valid in the presence of hysteresis when heart motion exhibits a different relationship with the surrogate during inspiration and expiration. The purpose of this study was to investigate the novel approach of using the Bouc–Wen (BW) model to provide a signal accounting for hysteresis when binning list-mode data with the goal of thereby improving motion correction. The study is based on the authors’ previous observations that hysteresis between chest and abdomen markers was indicative of hysteresis between abdomen markers and the internal motion of the heart. Methods: In 19 healthy volunteers, they determined the internal motion of the heart and diaphragm in the superior–inferior direction during free breathing using MRI navigators. A visual tracking system (VTS) synchronized with MRI acquisition tracked the anterior–posterior motions of external markers placed on the chest and abdomen. These data were employed to develop and test the Bouc–Wen model by inputting the VTS derived chest and abdomen motions into it and using the resulting output signals as surrogates for cardiac motion. The data of the volunteers were divided into training and testing sets. The training set was used to obtain initial values for the model parameters for all of the volunteers in the set, and for set members based on whether they were or were not classified as exhibiting hysteresis using a metric derived from the markers. These initial parameters were then employed with the testing set to estimate output signals. Pearson’s linear correlation coefficient between the

  11. First experience of simultaneous PET/MRI for the early detection of cardiac involvement in patients with Anderson-Fabry disease

    Energy Technology Data Exchange (ETDEWEB)

    Nappi, Carmela; Altiero, Michele; Imbriaco, Massimo; Giudice, Caterina Anna; Spinelli, Letizia; Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Nicolai, Emanuele; Aiello, Marco; Diomiaiuti, Claudio Tommaso [IRCCS SDN, Naples (Italy); Pisani, Antonio [University Federico II, Department of Public Health, Naples (Italy)

    2015-03-26

    Anderson-Fabry disease (AFD) is an X-linked lysosomal storage disorder associated with severe multiorgan dysfunction and premature death. Early diagnosis and treatment strategies play a key role in patient outcome. We investigated the potential role of hybrid PET/MR imaging in the assessment of early cardiac involvement in AFD patients. Thirteen AFD patients without cardiac symptoms and with normal left ventricular function underwent simultaneous cardiac PET/MR imaging after administration of {sup 18}F-FDG. Cardiac FDG uptake was quantified by measuring the standardized uptake value in 17 myocardial segments in each subject. The coefficient of variation (COV, i.e. the standard deviation divided by the average) of the uptake of the 17 segments was calculated as an index of heterogeneity in the heart. Six patients exhibited focal late gadolinium enhancement (LGE) indicating intramyocardial fibrosis, and four of these also had positive short inversion time inversion recovery (STIR) sequences. All patients with LGE and positive STIR MR images showed focal FDG uptake in the corresponding myocardial segments indicating inflammation. Of the seven patients with negative LGE and STIR images, five showed homogeneous FDG cardiac uptake and two showed heterogeneous FDG uptake. The COV was significantly greater in patients with focal FDG uptake (0.25 ± 0.02) than in those without (0.14 ± 0.07, p < 0.01). PET/MR imaging is clinically feasible for the early detection of cardiac involvement in patients with AFD. Further studies evaluating the role of hybrid PET/MR imaging in management of the disease in larger patient populations are warranted. (orig.)

  12. First experience of simultaneous PET/MRI for the early detection of cardiac involvement in patients with Anderson-Fabry disease

    International Nuclear Information System (INIS)

    Anderson-Fabry disease (AFD) is an X-linked lysosomal storage disorder associated with severe multiorgan dysfunction and premature death. Early diagnosis and treatment strategies play a key role in patient outcome. We investigated the potential role of hybrid PET/MR imaging in the assessment of early cardiac involvement in AFD patients. Thirteen AFD patients without cardiac symptoms and with normal left ventricular function underwent simultaneous cardiac PET/MR imaging after administration of 18F-FDG. Cardiac FDG uptake was quantified by measuring the standardized uptake value in 17 myocardial segments in each subject. The coefficient of variation (COV, i.e. the standard deviation divided by the average) of the uptake of the 17 segments was calculated as an index of heterogeneity in the heart. Six patients exhibited focal late gadolinium enhancement (LGE) indicating intramyocardial fibrosis, and four of these also had positive short inversion time inversion recovery (STIR) sequences. All patients with LGE and positive STIR MR images showed focal FDG uptake in the corresponding myocardial segments indicating inflammation. Of the seven patients with negative LGE and STIR images, five showed homogeneous FDG cardiac uptake and two showed heterogeneous FDG uptake. The COV was significantly greater in patients with focal FDG uptake (0.25 ± 0.02) than in those without (0.14 ± 0.07, p < 0.01). PET/MR imaging is clinically feasible for the early detection of cardiac involvement in patients with AFD. Further studies evaluating the role of hybrid PET/MR imaging in management of the disease in larger patient populations are warranted. (orig.)

  13. Cardiac carcinoid: tricuspid delayed hyperenhancement on cardiac 64-slice multidetector CT and magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Martos, R

    2012-02-01

    INTRODUCTION: Carcinoid heart disease is a rare condition in adults. Its diagnosis can be easily missed in a patient presenting to a primary care setting. We revised the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing this condition. MATERIALS AND METHODS: We studied a 65-year-old patient with carcinoid heart disease and right heart failure using transthoracic Doppler-echocardiogram, cardiac MDCT and MRI. Cardiac echocardiogram revealed marked thickening and retraction of the tricuspid leaflets with dilated right atrium and ventricle. Cardiac MDCT and MRI demonstrated fixation and retraction of the tricuspid leaflets with delayed contrast hyperenhancement of the tricuspid annulus. CONCLUSION: This case demonstrates fascinating imaging findings of cardiac carcinoid disease and highlights the increasing utility of contrast-enhanced MRI and cardiac MDCT in the diagnosis of this interesting condition.

  14. 胎儿及婴幼儿结节性硬化症伴有心脏横纹肌瘤的MRI表现%MRI findings of tuberous sclerosis complex combined with cardiac rhabdomyomas in fetuses and infants

    Institute of Scientific and Technical Information of China (English)

    周莺; 孙爱敏; 董素贞; 邵虹; 潘慧红; 林毅; 朱铭

    2014-01-01

    目的 分析胎儿及婴幼儿结节性硬化症(TSC)合并心脏横纹肌瘤(CRs)的影像表现,以提高对该病的认识.方法 回顾性分析2006年6月至2013年11月经MRI诊断的9例婴幼儿和4例胎儿TSC伴有CRs的临床和影像资料,总结其影像特征.所有胎儿及婴幼儿均接受颅脑和心脏MR平扫,9例婴幼儿还进行MR增强检查.结果 9例TSC患儿在头颅MRI上具有特征性的侧脑室室管膜下及双侧大脑皮层和皮层下多发异常结节信号.室管膜下结节在常规自旋回波T1WI表现为等或略低信号,T2WI为稍高或稍低信号.皮层及皮层下结节T1WI表现为低或者高信号,T2WI上为低或者高信号.增强后有不同程度强化.9例CRs患儿中,单发病灶3例、多发6例.心脏增强扫描CRs表现为室间隔、心室流出道或房室游离壁类圆形实质性占位,自旋回波T1WI及T2WI、平衡稳态快速梯度回波(B-TFE)序列均呈类似于心肌的等信号,增强后无或者轻度强化.4例胎儿快速序列MRI显示颅内双侧室管膜下多发小结节,T1WI呈等或稍高信号,单次激发快速自旋回波(SSTSE)或平衡稳态快速梯度回波(B-FFE)序列上呈等高或者低信号.心房或者心室内CRsB-FFE序列和SSTSE序列呈等或稍高圆形信号.结论 MRI在TSC合并CRs的颅内和心脏病灶的检出方面均具有独特的优势.MRI技术的发展可以提高本病诊断的及时性及准确性.%Objective To improve the understanding,the incidence and imaging findings of tuberous sclerosis complex (TSC) combined with cardiac rhabdomyomas (CRs) in fetuses and infants.Methods The imaging findings of 9 infants with TSC combined with CRs and 4 fetuses with TSC combined with CRs from our hospital between June,2006 and November,2013 were retrospectively reviewed.Results The brain MRI of 9 with TSC combined with CRs showed bilateral subependy-mal nodules,subcortical white matter and cortical tubers.Subependymal nodules were isointense or hypointense

  15. Diagnosis and treatment of cardiac sarcoidosis.

    Science.gov (United States)

    Kusano, Kengo F; Satomi, Kazuhiro

    2016-02-01

    Sarcoidosis is a systemic granulomatous disease of unknown aetiology. The frequency of cardiac involvement (cardiac sarcoidosis (CS)) varies in the different geographical regions, but it has been reported that it is an absolutely important prognostic factor in this disease. Complete atrioventricular block is the most common, and ventricular tachycardia/ventricular fibrillation the second most common arrhythmia in this disease, both of which are associated with cardiac sudden death. Diagnosing CS is sometimes difficult because of the non-specific ECG and echocardiographic findings, and CS is sometimes misdiagnosed as dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy or an idiopathic ventricular aneurysm, and therefore, endomyocardial biopsy is important, but has a low sensitivity. Another problem is the recognition of isolated types of CS. Recently, MRI and (18)F-fluorodeoxyglucose positron emission tomography have been demonstrated to be useful tools for the non-invasive diagnosis of CS as well as therapeutic evaluation tools, but are still unsatisfactory. Treatment of CS is usually done by corticosteroid therapy to control inflammation, prevent fibrosis and protect from any deterioration of the cardiac function, but the long-term outcome is still in debate. Despite the advancement of non-pharmacological approaches for CS (pacing, defibrillators and catheter ablation) to improve the prognosis, there are still many issues remaining to resolve diagnosing and managing CS. Here, we attempt a review of the clinical evidence, with special focus on the current understanding of this disease and showing the current strategies and remaining problems of diagnosing and managing CS. PMID:26643814

  16. Rationale and design of the Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research Trial (MANTICORE 101 - Breast: a randomized, placebo-controlled trial to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer using cardiac MRI

    Directory of Open Access Journals (Sweden)

    Ezekowitz Justin

    2011-07-01

    Full Text Available Abstract Background MANTICORE 101 - Breast (Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research is a randomized trial to determine if conventional heart failure pharmacotherapy (angiotensin converting enzyme inhibitor or beta-blocker can prevent trastuzumab-mediated left ventricular remodeling, measured with cardiac MRI, among patients with HER2+ early breast cancer. Methods/Design One hundred and fifty-nine patients with histologically confirmed HER2+ breast cancer will be enrolled in a parallel 3-arm, randomized, placebo controlled, double-blind design. After baseline assessments, participants will be randomized in a 1:1:1 ratio to an angiotensin-converting enzyme inhibitor (perindopril, beta-blocker (bisoprolol, or placebo. Participants will receive drug or placebo for 1 year beginning 7 days before trastuzumab therapy. Dosages for all groups will be systematically up-titrated, as tolerated, at 1 week intervals for a total of 3 weeks. The primary objective of this randomized clinical trial is to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer, as measured by 12 month change in left ventricular end-diastolic volume using cardiac MRI. Secondary objectives include 1 determine the evolution of left ventricular remodeling on cardiac MRI in patients with HER2+ early breast cancer, 2 understand the mechanism of trastuzumab mediated cardiac toxicity by assessing for the presence of myocardial injury and apoptosis on serum biomarkers and cardiac MRI, and 3 correlate cardiac biomarkers of myocyte injury and extra-cellular matrix remodeling with left ventricular remodeling on cardiac MRI in patients with HER2+ early breast cancer. Discussion Cardiac toxicity as a result of cancer therapies is now recognized as a significant health problem of increasing prevalence. To our knowledge, MANTICORE will be the first

  17. Cardiac cine MRI: Comparison of 1.5 T, non-enhanced 3.0 T and blood pool enhanced 3.0 T imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gerretsen, S.C.; Versluis, B.; Bekkers, S.C.A.M. [Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands); Leiner, T. [Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands)], E-mail: leiner@rad.unimaas.nl

    2008-01-15

    Introduction: Cardiac cine imaging using balanced steady state free precession sequences (bSSFP) suffers from artefacts at 3.0 T. We compared bSSFP cardiac cine imaging at 1.5 T with gradient echo imaging at 3.0 T with and without a blood pool contrast agent. Materials and methods: Eleven patients referred for cardiac cine imaging underwent imaging at 1.5 T and 3.0 T. At 3.0 T images were acquired before and after administration of 0.03 mmol/kg gadofosveset. Blood pool signal-to-noise ratio (SNR), temporal variations in SNR, ejection fraction and myocardial mass were compared. Subjective image quality was scored on a four-point scale. Results: Blood pool SNR increased with more than 75% at 3.0 T compared to 1.5 T (p < 0.001); after contrast administration at 3.0 T SNR increased with 139% (p < 0.001). However, variations in blood pool SNR at 3.0 T were nearly three times as high versus those at 1.5 T in the absence of contrast medium (p < 0.001); after contrast administration this was reduced to approximately a factor 1.4 (p = 0.21). Saturation artefacts led to significant overestimation of ejection fraction in the absence of contrast administration (1.5 T: 44.7 {+-} 3.1 vs. 3.0 T: 50.7 {+-} 4.2 [p = 0.04] vs. 3.0 T post contrast: 43.4 {+-} 2.9 [p = 0.55]). Subjective image quality was highest for 1.5 T (2.8 {+-} 0.3), and lowest for non-enhanced 3.0 T (1.7 {+-} 0.6; p = 0.006). Conclusions: GRE cardiac cine imaging at 3.0 T after injection of the blood pool agent gadofosveset leads to improved objective and subjective cardiac cine image quality at 3.0 T and to the same conclusions regarding cardiac ejection fraction compared to bSSFP imaging at 1.5 T.

  18. Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy

    International Nuclear Information System (INIS)

    To assess whether DCE-MRI pharmacokinetic (PK) parameters obtained before and during chemotherapy can predict pathological complete response (pCR) differently for different breast cancer groups. Eighty-four patients who received neoadjuvant chemotherapy for locally advanced breast cancer were retrospectively included. All patients underwent two DCE-MRI examinations, one before (EX1) and one during treatment (EX2). Tumours were classified into different breast cancer groups, namely triple negative (TNBC), HER2+ and ER+/HER2-, and compared with the whole population (WP). PK parameters Ktrans and Ve were extracted using a two-compartment Tofts model. At EX1, Ktrans predicted pCR for WP and TNBC. At EX2, maximum diameter (Dmax) predicted pCR for WP and ER+/HER2-. Both PK parameters predicted pCR in WP and TNBC and only Ktrans for the HER2+. pCR was predicted from relative difference (EX1 - EX2)/EX1 of Dmax and both PK parameters in the WP group and only for Ve in the TNBC group. No PK parameter could predict response for ER+/HER-. ROC comparison between WP and breast cancer groups showed higher but not statistically significant values for TNBC for the prediction of pCR Quantitative DCE-MRI can better predict pCR after neoadjuvant treatment for TNBC but not for the ER+/HER2- group. (orig.)

  19. Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Drisis, Stylianos; Stathopoulos, Konstantinos; Chao, Shih-Li; Lemort, Marc [Institute Jules Bordet, Radiology Department, Brussels (Belgium); Metens, Thierry [Erasme University Hospital, Radiology Department, Brussels (Belgium); Ignatiadis, Michael [Institute Jules Bordet, Oncology Department, Brussels (Belgium)

    2016-05-15

    To assess whether DCE-MRI pharmacokinetic (PK) parameters obtained before and during chemotherapy can predict pathological complete response (pCR) differently for different breast cancer groups. Eighty-four patients who received neoadjuvant chemotherapy for locally advanced breast cancer were retrospectively included. All patients underwent two DCE-MRI examinations, one before (EX1) and one during treatment (EX2). Tumours were classified into different breast cancer groups, namely triple negative (TNBC), HER2+ and ER+/HER2-, and compared with the whole population (WP). PK parameters Ktrans and Ve were extracted using a two-compartment Tofts model. At EX1, Ktrans predicted pCR for WP and TNBC. At EX2, maximum diameter (Dmax) predicted pCR for WP and ER+/HER2-. Both PK parameters predicted pCR in WP and TNBC and only Ktrans for the HER2+. pCR was predicted from relative difference (EX1 - EX2)/EX1 of Dmax and both PK parameters in the WP group and only for Ve in the TNBC group. No PK parameter could predict response for ER+/HER-. ROC comparison between WP and breast cancer groups showed higher but not statistically significant values for TNBC for the prediction of pCR Quantitative DCE-MRI can better predict pCR after neoadjuvant treatment for TNBC but not for the ER+/HER2- group. (orig.)

  20. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United State

    OpenAIRE

    Boysen-Osborn, Megan; Anderson, Craig L.; Navarro, Roman; Yanuck, Justin; Strom, Suzanne; McCoy, Christopher E.; Youm, Julie; Ypma-Wong, Mary Frances; Langdorf, Mark I.

    2016-01-01

    Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8...

  1. Tailored RF Pulse Modulation for RF Refocussed Variable Flip Angle MRI

    Science.gov (United States)

    Shah, Ajit S.; Ortendahl, Douglas A.; Carlson, Joseph W.; Kramer, David M.; Crooks, Larry E.

    1989-05-01

    Advances in Magnetice Resonance Imaging (MRI) techniques have recently made MRI the imaging modality of choice for many applications of clinical imaging. MRI provides the diagnosing clinician a non-invasive method for obtaining soft tissue differentiation with sub-millimeter resolution. Clinical MRI techniques include 3-dimensional imaging, spectroscopic imaging, arterial angiography and cardiac imaging. One MRI technique which has recently gained popularity is a class of protocols known as variable/partial flip angle MRI. Partial flip angle MRI techniques are useful because of their ability to vary contrast between tissues and/or maintain a particular level of contrast with a reduction in acquisition time [1]. Variable flip angle techniques differ from conventional MRI protocols in that the initial RF excitation/rotation pulse is not constrained to a 90 degree rotation of the longitudinal magnetization. Instead, the initial excitation flip angle is calculated to provide improved contrast between two tissues and/or maximize the intensity of a particular tissue. For tissues with reduced TR/T1 ratios, variable flip angle techniques may also be used to increase the image signal to noise within a localized region.

  2. Automatic classification of scar tissue in late gadolinium enhancement cardiac MRI for the assessment of left-atrial wall injury after radiofrequency ablation

    Science.gov (United States)

    Perry, Daniel; Morris, Alan; Burgon, Nathan; McGann, Christopher; MacLeod, Robert; Cates, Joshua

    2012-03-01

    Radiofrequency ablation is a promising procedure for treating atrial fibrillation (AF) that relies on accurate lesion delivery in the left atrial (LA) wall for success. Late Gadolinium Enhancement MRI (LGE MRI) at three months post-ablation has proven effective for noninvasive assessment of the location and extent of scar formation, which are important factors for predicting patient outcome and planning of redo ablation procedures. We have developed an algorithm for automatic classification in LGE MRI of scar tissue in the LA wall and have evaluated accuracy and consistency compared to manual scar classifications by expert observers. Our approach clusters voxels based on normalized intensity and was chosen through a systematic comparison of the performance of multivariate clustering on many combinations of image texture. Algorithm performance was determined by overlap with ground truth, using multiple overlap measures, and the accuracy of the estimation of the total amount of scar in the LA. Ground truth was determined using the STAPLE algorithm, which produces a probabilistic estimate of the true scar classification from multiple expert manual segmentations. Evaluation of the ground truth data set was based on both inter- and intra-observer agreement, with variation among expert classifiers indicating the difficulty of scar classification for a given a dataset. Our proposed automatic scar classification algorithm performs well for both scar localization and estimation of scar volume: for ground truth datasets considered easy, variability from the ground truth was low; for those considered difficult, variability from ground truth was on par with the variability across experts.

  3. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  4. Chest MRI

    Science.gov (United States)

    Nuclear magnetic resonance - chest; Magnetic resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI ... healthy enough to filter the contrast. During the MRI, the person who operates the machine will watch ...

  5. Fetal Electrocardiogram (fECG Gated MRI

    Directory of Open Access Journals (Sweden)

    Martyn N.J. Paley

    2013-08-01

    Full Text Available We have developed a Magnetic Resonance Imaging (MRI-compatible system to enable gating of a scanner to the heartbeat of a foetus for cardiac, umbilical cord flow and other possible imaging applications. We performed radiofrequency safety testing prior to a fetal electrocardiogram (fECG gated imaging study in pregnant volunteers (n = 3. A compact monitoring device with advanced software capable of reliably detecting both the maternal electrocardiogram (mECG and fECG simultaneously was modified by the manufacturer (Monica Healthcare, Nottingham, UK to provide an external TTL trigger signal from the detected fECG which could be used to trigger a standard 1.5 T MR (GE Healthcare, Milwaukee, WI, USA gating system with suitable attenuation. The MR scanner was tested by triggering rapidly during image acquisition at a typical fetal heart rate (123 beats per minute using a simulated fECG waveform fed into the gating system. Gated MR images were also acquired from volunteers who were attending for a repeat fetal Central Nervous System (CNS examination using an additional rapid cardiac imaging sequence triggered from the measured fECG. No adverse safety effects were encountered. This is the first time fECG gating has been used with MRI and opens up a range of new possibilities to study a developing foetus.

  6. MRI of cardiovascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Kastler, Bruno [Centre Hospitalier Univ. Jean Minjoz, Besancon (France); Universite de Franche-Comte, Besancon (FR). Lab. I4S (Health, Innovation, Intervention, Imaging, Engineering); Centre Hospitalier Sherbrooke Univ., PQ (Canada). Dept. of Radiology

    2011-07-01

    MRI is a non-invasive and non-ionizing imaging modality that is perfectly suited for the diagnosis and follow-up of both pediatric and adult congenital heart disease. It provides a large field of view and has the unique ability to depict complex cardiac and vascular anatomy and to measure cardiac function and flow within one examination. MRI is the ideal complement to echocardiography whenever the information provided by the latter is limited. This book has been conceived as a self-teaching manual that will assist qualified radiologists, cardiologists, and pediatricians, as well as those in training. It is richly illustrated with numerous images and drawings that cover all usual and most unusual anomalies. The principal author, Professor Bruno Kastler, is head of radiology at Besancon University Hospital, France and is board certified in both radiology and cardiology. (orig.)

  7. Advanced on MRI in rheumatoid arthritis%类风湿性关节炎的MRI研究进展

    Institute of Scientific and Technical Information of China (English)

    孟俊; 杨汉丰; 杜勇; 黄亚勇; 李兵

    2012-01-01

    传统X线平片、CT及超声在早期诊断类风湿性关节炎(RA)方面存在一定局限性.MRI已成为目前早期诊断RA、判断病情及监测疗效的主要方法之一.本文就近年来MRI诊断RA方面的应用现状进行综述.%Traditional X-ray, CT and ultrasound have some limitations in early diagnosis of rheumatoid arthritis (RA). MRI has become one of the most important methods in the early diagnosis, determining the condition and monitoring the efficacy of RA. Recent applications of MRI in RA were reviewed in this article.

  8. MRI and low back pain

    Science.gov (United States)

    Backache - MRI; Low back pain - MRI; Lumbar pain - MRI; Back strain - MRI; Lumbar radiculopathy - MRI; Herniated intervertebral disk - MRI; Prolapsed intervertebral disk - MRI; Slipped disk - MRI; Ruptured ...

  9. The role of advanced imaging techniques in cystic fibrosis follow-up: is there a place for MRI?

    Energy Technology Data Exchange (ETDEWEB)

    Puderbach, Michael; Eichinger, Monika [German Cancer Research Center (DKFZ), Department of Radiology, Heidelberg (Germany)

    2010-06-15

    Cystic fibrosis (CF) lung disease is caused by mutations in the CFTR-gene and remains one of the most frequent lethal inherited diseases in the Caucasian population. Given the progress in CF therapy and the consecutive improvement in prognosis, monitoring of disease progression and effectiveness of therapeutic interventions with repeated imaging of the CF lung plays an increasingly important role. So far, the chest radiograph has been the most widely used imaging modality to monitor morphological changes in the CF lung. CT is the gold standard for assessment of morphological changes of airways and lung parenchyma. Considering the necessity of life-long repeated imaging studies, the cumulative radiation doses reached with CT is problematic for CF patients. A sensitive, non-invasive and quantitative technique without radiation exposure is warranted for monitoring of disease activity. In previous studies, MRI proved to be comparable to CT regarding the detection of morphological changes in the CF lung without using ionising radiation. Furthermore, MRI was shown to be superior to CT regarding assessment of functional changes of the lung. This review presents the typical morphological and functional MR imaging findings with respect to MR-based follow-up of CF lung disease. MRI offers a variety of techniques for morphological and functional imaging of the CF lung. Using this radiation free technique short- and long-term follow-up studies are possible enabling an individualised guidance of the therapy. (orig.)

  10. The role of advanced imaging techniques in cystic fibrosis follow-up: is there a place for MRI?

    International Nuclear Information System (INIS)

    Cystic fibrosis (CF) lung disease is caused by mutations in the CFTR-gene and remains one of the most frequent lethal inherited diseases in the Caucasian population. Given the progress in CF therapy and the consecutive improvement in prognosis, monitoring of disease progression and effectiveness of therapeutic interventions with repeated imaging of the CF lung plays an increasingly important role. So far, the chest radiograph has been the most widely used imaging modality to monitor morphological changes in the CF lung. CT is the gold standard for assessment of morphological changes of airways and lung parenchyma. Considering the necessity of life-long repeated imaging studies, the cumulative radiation doses reached with CT is problematic for CF patients. A sensitive, non-invasive and quantitative technique without radiation exposure is warranted for monitoring of disease activity. In previous studies, MRI proved to be comparable to CT regarding the detection of morphological changes in the CF lung without using ionising radiation. Furthermore, MRI was shown to be superior to CT regarding assessment of functional changes of the lung. This review presents the typical morphological and functional MR imaging findings with respect to MR-based follow-up of CF lung disease. MRI offers a variety of techniques for morphological and functional imaging of the CF lung. Using this radiation free technique short- and long-term follow-up studies are possible enabling an individualised guidance of the therapy. (orig.)

  11. DCE-MRI Perfusion and Permeability Parameters as predictors of tumor response to CCRT in Patients with locally advanced NSCLC

    Science.gov (United States)

    Tao, Xiuli; Wang, Lvhua; Hui, Zhouguang; Liu, Li; Ye, Feng; Song, Ying; Tang, Yu; Men, Yu; Lambrou, Tryphon; Su, Zihua; Xu, Xiao; Ouyang, Han; Wu, Ning

    2016-01-01

    In this prospective study, 36 patients with stage III non-small cell lung cancers (NSCLC), who underwent dynamic contrast-enhanced MRI (DCE-MRI) before concurrent chemo-radiotherapy (CCRT) were enrolled. Pharmacokinetic analysis was carried out after non-rigid motion registration. The perfusion parameters [including Blood Flow (BF), Blood Volume (BV), Mean Transit Time (MTT)] and permeability parameters [including endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume (Ve), fractional plasma volume (Vp)] were calculated, and their relationship with tumor regression was evaluated. The value of these parameters on predicting responders were calculated by receiver operating characteristic (ROC) curve. Multivariate logistic regression analysis was conducted to find the independent variables. Tumor regression rate is negatively correlated with Ve and its standard variation Ve_SD and positively correlated with Ktrans and Kep. Significant differences between responders and non-responders existed in Ktrans, Kep, Ve, Ve_SD, MTT, BV_SD and MTT_SD (P < 0.05). ROC indicated that Ve < 0.24 gave the largest area under curve of 0.865 to predict responders. Multivariate logistic regression analysis also showed Ve was a significant predictor. Baseline perfusion and permeability parameters calculated from DCE-MRI were seen to be a viable tool for predicting the early treatment response after CCRT of NSCLC. PMID:27762331

  12. Comparison of three multichannel transmit/receive radiofrequency coil configurations for anatomic and functional cardiac MRI at 7.0T: implications for clinical imaging

    International Nuclear Information System (INIS)

    To implement, examine, and compare three multichannel transmit/receive coil configurations for cardiovascular MR (CMR) at 7T. Three radiofrequency transmit-receive (TX/RX) coils with 4-, 8-, and 16-coil elements were used. Ten healthy volunteers (seven males, age 28 ± 4 years) underwent CMR at 7T. For all three RX/TX coils, 2D CINE FLASH images of the heart were acquired. Cardiac chamber quantification, signal-to-noise ratio (SNR) analysis, parallel imaging performance assessment, and image quality scoring were performed. Mean total examination time was 29 ± 5 min. All images obtained with the 8- and 16-channel coils were diagnostic. No significant difference in ejection fraction (EF) (P > 0.09) or left ventricular mass (LVM) (P > 0.31) was observed between the coils. The 8- and 16-channel arrays yielded a higher mean SNR in the septum versus the 4-channel coil. The lowest geometry factors were found for the 16-channel coil (mean ± SD 2.3 ± 0.5 for R = 4). Image quality was rated significantly higher (P < 0.04) for the 16-channel coil versus the 8- and 4-channel coils. All three coil configurations are suitable for CMR at 7.0T under routine circumstances. A larger number of coil elements enhances image quality and parallel imaging performance but does not impact the accuracy of cardiac chamber quantification. (orig.)

  13. Comparison of three multichannel transmit/receive radiofrequency coil configurations for anatomic and functional cardiac MRI at 7.0T: implications for clinical imaging

    Energy Technology Data Exchange (ETDEWEB)

    Winter, Lukas; Graessl, Andreas; Hezel, Fabian; Thalhammer, Christof [Max-Delbrueck Center for Molecular Medicine, Berlin Ultrahigh Field Facility, Berlin (Germany); Kellman, Peter [National Institutes of Health/NHLBI, Laboratory of Cardiac Energetics, Bethesda, MD (United States); Renz, Wolfgang [Max-Delbrueck Center for Molecular Medicine, Berlin Ultrahigh Field Facility, Berlin (Germany); Siemens Healthcare, Erlangen (Germany); Knobelsdorff-Brenkenhoff, Florian von; Schulz-Menger, Jeanette [Max-Delbrueck Center for Molecular Medicine, Berlin Ultrahigh Field Facility, Berlin (Germany); HELIOS Klinikum Berlin-Buch, Department of Cardiology and Nephrology, Berlin (Germany); Charite Medical Faculty and the Max-Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Berlin (Germany); Tkachenko, Valeriy [Charite Medical Faculty and the Max-Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Berlin (Germany); Niendorf, Thoralf [Max-Delbrueck Center for Molecular Medicine, Berlin Ultrahigh Field Facility, Berlin (Germany); Charite Medical Faculty and the Max-Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Berlin (Germany)

    2012-10-15

    To implement, examine, and compare three multichannel transmit/receive coil configurations for cardiovascular MR (CMR) at 7T. Three radiofrequency transmit-receive (TX/RX) coils with 4-, 8-, and 16-coil elements were used. Ten healthy volunteers (seven males, age 28 {+-} 4 years) underwent CMR at 7T. For all three RX/TX coils, 2D CINE FLASH images of the heart were acquired. Cardiac chamber quantification, signal-to-noise ratio (SNR) analysis, parallel imaging performance assessment, and image quality scoring were performed. Mean total examination time was 29 {+-} 5 min. All images obtained with the 8- and 16-channel coils were diagnostic. No significant difference in ejection fraction (EF) (P > 0.09) or left ventricular mass (LVM) (P > 0.31) was observed between the coils. The 8- and 16-channel arrays yielded a higher mean SNR in the septum versus the 4-channel coil. The lowest geometry factors were found for the 16-channel coil (mean {+-} SD 2.3 {+-} 0.5 for R = 4). Image quality was rated significantly higher (P < 0.04) for the 16-channel coil versus the 8- and 4-channel coils. All three coil configurations are suitable for CMR at 7.0T under routine circumstances. A larger number of coil elements enhances image quality and parallel imaging performance but does not impact the accuracy of cardiac chamber quantification. (orig.)

  14. Advanced life support therapy and on out-of-hospital cardiac arrest patients: Applying signal processing and pattern recognition methods

    Directory of Open Access Journals (Sweden)

    Trygve Eftestøl

    2005-10-01

    Full Text Available In the US alone, several hundred thousands die of sudden cardiac arrests each year. Basic life support defined as chest compressions and ventilations and early defibrillation are the only factors proven to increase the survival of patients with out-of-hospital cardiac arrest, and are key elements in the chain of survival defined by the American Heart Association. The current cardiopulmonary resuscitation guidelines treat all patients the same, but studies show need for more individualiza- tion of treatment. This review will focus on ideas on how to strengthen the weak parts of the chain of survival including the ability to measure the effects of therapy, improve time efficiency, and optimize the sequence and quality of the various components of cardiopulmonary resuscitation.

  15. Whole-heart cine MRI in a single breath-hold. A compressed sensing accelerated 3D acquisition technique for assessment of cardiac function

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to perform functional MR imaging of the whole heart in a single breath-hold using an undersampled 3 D trajectory for data acquisition in combination with compressed sensing for image reconstruction. Materials and Methods: Measurements were performed using an SSFP sequence on a 3 T whole-body system equipped with a 32-channel body array coil. A 3 D radial stack-of-stars sampling scheme was utilized enabling efficient undersampling of the k-space and thereby accelerating data acquisition. Compressed sensing was applied for the reconstruction of the missing data. A validation study was performed based on a fully sampled dataset acquired by standard Cartesian cine imaging of 2 D slices on a healthy volunteer. The results were investigated with regard to systematic errors and resolution losses possibly introduced by the developed reconstruction. Subsequently, the proposed technique was applied for in-vivo functional cardiac imaging of the whole heart in a single breath-hold of 27 s. The developed technique was tested on three healthy volunteers to examine its reproducibility. Results: By means of the results of the simulation (temporal resolution: 47 ms, spatial resolution: 1.4 x 1.4 x 8 mm, 3 D image matrix: 208 x 208 x 10), an overall acceleration factor of 10 has been found where the compressed sensing reconstructed image series shows only very low systematic errors and a slight in-plane resolution loss of 15 %. The results of the in-vivo study (temporal resolution: 40.5 ms, spatial resolution: 2.1 x 2.1 x 8 mm, 3 D image matrix: 224 x 224 x 12) performed with an acceleration factor of 10.7 confirm the overall good image quality of the presented technique for undersampled acquisitions. Conclusion: The combination of 3 D radial data acquisition and model-based compressed sensing reconstruction allows high acceleration factors enabling cardiac functional imaging of the whole heart within only one breath-hold. The image quality in the

  16. 静息态磁共振成像在脑瘫患儿中的研究进展%Advances of functional MRI in cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    魏云霞; 魏军良; 张仙海; 赵海

    2013-01-01

    脑功能磁共振成像(functional magnetic resonance imaging,fMRI)能在活体人脑定位各功能脑区,研究脑的功能连接.本文基于静息态的应用模式,自局部脑区功能活动、脑区之间的功能连接及脑功能网络层面,综述了脑功能磁共振成像在脑性瘫痪患儿发病机制、诊断、治疗及预后等方面的临床研究现状.今后需要进行多学科、多方法相结合的综合研究,探索脑性瘫痪患儿特异的功能影像学标记,为疾病的早期发现、早期干预及预后判断等提供客观和直观的影像学依据.%Brain functional magnetic imaging (fMRI) can help loctate the functional areas in human brian,and study the functional connectivity between the brain regions.Based on the modes of the resting state,the present review summarized clinical advances of fMRI in the pathogenesis,diagnosis,treatment and prognosis of cerebral palsy to the brain function network.Future researches need to combine multi-methods and to cooperate with multi-disciplines to explore specific neuroimaging markers in the cerebral palsy.Thus,imaging technique may eventally be used to help with early detection,early intervention and prognosis judgement.

  17. Application of advanced machine learning methods on resting-state fMRI network for identification of mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Khazaee, Ali; Ebrahimzadeh, Ata; Babajani-Feremi, Abbas

    2016-09-01

    The study of brain networks by resting-state functional magnetic resonance imaging (rs-fMRI) is a promising method for identifying patients with dementia from healthy controls (HC). Using graph theory, different aspects of the brain network can be efficiently characterized by calculating measures of integration and segregation. In this study, we combined a graph theoretical approach with advanced machine learning methods to study the brain network in 89 patients with mild cognitive impairment (MCI), 34 patients with Alzheimer's disease (AD), and 45 age-matched HC. The rs-fMRI connectivity matrix was constructed using a brain parcellation based on a 264 putative functional areas. Using the optimal features extracted from the graph measures, we were able to accurately classify three groups (i.e., HC, MCI, and AD) with accuracy of 88.4 %. We also investigated performance of our proposed method for a binary classification of a group (e.g., MCI) from two other groups (e.g., HC and AD). The classification accuracies for identifying HC from AD and MCI, AD from HC and MCI, and MCI from HC and AD, were 87.3, 97.5, and 72.0 %, respectively. In addition, results based on the parcellation of 264 regions were compared to that of the automated anatomical labeling atlas (AAL), consisted of 90 regions. The accuracy of classification of three groups using AAL was degraded to 83.2 %. Our results show that combining the graph measures with the machine learning approach, on the basis of the rs-fMRI connectivity analysis, may assist in diagnosis of AD and MCI.

  18. Role of MRI in Assessing Fetus Cardiac Abnormalities%胎儿心脏畸形磁共振成像诊断

    Institute of Scientific and Technical Information of China (English)

    朱铭; 董素贞

    2009-01-01

    近年来,胎儿磁共振成像(MRI)在评价胎儿畸形方而逐渐成为超声的一种有效的补充检查手段.但胎儿的不断运动和无法使用门控限制了胎心脏畸形的MRI诊断.两维快速稳态进动(FIESTA)等序列对胎儿心脏可提供对比较好的图像.本文介绍我们使用两维快速稳态进动(FIESTA)等序列作胎儿心脏MRl诊断的初步经验,并客观评估胎儿心脏MRI的临床应用价值.

  19. 前列腺癌MRI诊断技术研究进展%Advances in MRI diagnosis of prostate cancer

    Institute of Scientific and Technical Information of China (English)

    张龙敏; 刘爱连

    2014-01-01

    前列腺癌是世界上第二常见的男性恶性肿瘤,我国前列腺癌的发病率亦呈逐年上升趋势.MRI有着良好的软组织分辨率及多方位成像优势,能较好地显示前列腺的解剖结构及相邻的组织结构,随着MRI技术的不断发展,其对前列腺癌的诊断发挥着越来越重要的作用.该文从前列腺癌MRI常规序列的影像表现着手,对各种功能MRI在前列腺癌的诊断和鉴别诊断中的应用进行了详细地论述,如MR灌注加权成像、MR波谱、MR扩散加权成像、MR扩散张量成像、体素内不相干运动扩散加权成像、MR磁敏感加权成像等,介绍了功能MRI相对于常规扫描的优势及其所能提供的更多的影像学资料,通过系列半定量和定量数据,能进一步提供前列腺癌的血流灌注、水分子扩散、微循环状态、物质代谢及生化成分变化等信息.%Prostate cancer is the second most common cancer in the world,and the incidence of prostate cancer in China shows an upward trend.MRI has high soft tissue resolution and mnulti-dimensional imaging advantages,and it can better show the anatomy of the prostate and adjacent tissue structures.With the development of MR technique,it plays a more and more important role in prostate cancer diagnosis.This review starts from the imaging performance of routine MRI sequence of prostate cancer,and a variety of functional MRI applications in the diagnosis and differential diagnosis of prostate cancer are described in detail,such as MR perfusion-weighted imaging,MR spectroscopy,MR diffusion-weighted imaging,MR diffusion tensor imaging,intravoxel incoherent motion diffusion-weighted imaging,MR susceptibility-weighted imaging.Meanwhile this review introduces that functional MRI has more advantages and can provide more image information than routine MRI sequence.According to a series of semi-quantitative and quantitative data,functional MRI can further provide the blood perfusion of prostate cancer

  20. 胶质瘤的MR影像学研究进展%Advances in Research of MRI on the Gliomas

    Institute of Scientific and Technical Information of China (English)

    廖丹玲; 梁碧玲

    2006-01-01

    胶质瘤是颅内最常见的原发性肿瘤.近年来,随着影像学技术的进步,胶质瘤的诊断由既往单纯形态学水平,深入到分子水平.本文介绍MR灌注成像(perfusion weighted imaging,PWI)、磁共振弥散加权成像(diffusion weighted imaging,DWI)与弥散张量成像(diffusion tensor imaging,DTI)、磁共振波谱(magnetic resonance spectroscopy,MRS)、功能磁共振(functional MRI,fMRI)等新技术在胶质瘤诊断上的应用.这些新的进展对于胶质瘤的诊断与鉴别诊断,明确肿瘤级别,疗效监测及判断预后等具有重要意义.

  1. Research advances in cardiac stem cells%心脏干细胞的研究与进展

    Institute of Scientific and Technical Information of China (English)

    杨文玲; 赵晓辉

    2011-01-01

    背景:大量研究证明,哺乳动物心脏中存在心脏自身干细胞,参与心脏的自我更新和内源性修复.目的:就心脏干细胞的来源、分类、特征及心脏病治疗等方面进行综述.方法:由第一作者应用计算机检索PubMed数据库2000-01/2010-12有关心脏干细胞的来源、分化、特征及其在心肌再生方面的文章,检索词为"Cardiac stem cell",包括临床研究和基础研究,排除重复研究和Meta 分析,共保留32篇文献进行综述.结果与结论:心脏干细胞是一类存在于心脏组织内能够自我更新及克隆增殖的干细胞,它能够分化为心肌细胞、内皮细胞,参与心脏损伤修复,改善心功能.现已能够通过体外分离培养扩增后移植入动物心脏内,为下一步在临床上应用于人体打下了基础.但成体心脏干细胞自身的稳态平衡和动态变化,及其向心脏功能细胞分化需经历哪些具体过程,有哪些影响因素及如何调控等还不太清楚,需要继续研究以进一步证实.%BACKGROUND: A large amount of studies have demonstrated that stem cells in the heart of mammal participate in heart self-renewal and endogenous repair.OBJECTIVE: To summarize the source, classification, features of cardiac stem cells and application in heart disease. METHODS: A computer-based online search of PubMed database was performed for articles published between January 2000 and December 2010 related to the source, classification, features of cardiac stem cells and its effects on myocardial regeneration with key words "cardiac stem cell". Clinical studies and basic studies were all included. Repetitive studies and Meta analysis were excluded. Finally, 32 articles were included.RESULTS AND CONCLUSION: Cardiac stem cell is a type of stem cells in the heart, with properties of self-renewal and cloning proliferation. It can differentiate into cardiomyocyte and endothelial cell and plays a role in heart injury repair to improve heart function

  2. An update on technical and methodological aspects for cardiac PET applications.

    Science.gov (United States)

    Presotto, Luca; Busnardo, Elena; Gianolli, Luigi; Bettinardi, Valentino

    2016-12-01

    Positron emission tomography (PET) is indicated for a large number of cardiac diseases: perfusion and viability studies are commonly used to evaluate coronary artery disease; PET can also be used to assess sarcoidosis and endocarditis, as well as to investigate amyloidosis. Furthermore, a hot topic for research is plaque characterization. Most of these studies are technically very challenging. High count rates and short acquisition times characterize perfusion scans while very small targets have to be imaged in inflammation/infection and plaques examinations. Furthermore, cardiac PET suffers from respiratory and cardiac motion blur. Each type of studies has specific requirements from the technical and methodological point of view, thus PET systems with overall high performances are required. Furthermore, in the era of hybrid PET/computed tomography (CT) and PET/Magnetic Resonance Imaging (MRI) systems, the combination of complementary functional and anatomical information can be used to improve diagnosis and prognosis. Moreover, PET images can be qualitatively and quantitatively improved exploiting information from the other modality, using advanced algorithms. In this review we will report the latest technological and methodological innovations for PET cardiac applications, with particular reference to the state of the art of the hybrid PET/CT and PET/MRI. We will also report the most recent advancements in software, from reconstruction algorithms to image processing and analysis programs. PMID:27611711

  3. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... types of clips used for brain aneurysms some types of metal coils placed within blood vessels nearly all cardiac defibrillators and pacemakers You ... called MR angiography (MRA) provides detailed images of blood vessels in the ... the opening of certain types of MRI machines. The presence of an implant ...

  4. Blocked-micropores, surface functionalized, bio-compatible and silica-coated iron oxide nanocomposites as advanced MRI contrast agent

    Energy Technology Data Exchange (ETDEWEB)

    Darbandi, Masih, E-mail: masih.darbandi@uni-due.de [Vanderbilt University, Department of Physics and Vanderbilt Institute of Nanoscale Science and Engineering (VINSE) (United States); Laurent, Sophie [University of Mons, Department of General, Organic and Biomedical Chemistry NMR and Molecular Imaging Laboratory (Belgium); Busch, Martin [University of Duisburg-Essen, Nanoparticle Process Technology, Faculty of Engineering and Center for Nanointegration Duisburg-Essen (CeNIDE) (Germany); Li Zian [University of Duisburg-Essen, Faculty of Physics and Center for Nanointegration Duisburg-Essen (CeNIDE) (Germany); Yuan Ying; Krueger, Michael [University of Freiburg, Department of Microsystems Engineering and Freiburg Materials Research Centre (Germany); Farle, Michael [University of Duisburg-Essen, Faculty of Physics and Center for Nanointegration Duisburg-Essen (CeNIDE) (Germany); Winterer, Markus [University of Duisburg-Essen, Nanoparticle Process Technology, Faculty of Engineering and Center for Nanointegration Duisburg-Essen (CeNIDE) (Germany); Vander Elst, Luce; Muller, Robert N. [University of Mons, Department of General, Organic and Biomedical Chemistry NMR and Molecular Imaging Laboratory (Belgium); Wende, Heiko [University of Duisburg-Essen, Faculty of Physics and Center for Nanointegration Duisburg-Essen (CeNIDE) (Germany)

    2013-05-15

    Biocompatible magnetic nanoparticles have been found promising in several biomedical applications for tagging, imaging, sensing and separation in recent years. In this article, a systematic study of the design and development of surface-modification schemes for silica-coated iron oxide nanoparticles (IONP) via a one-pot, in situ method at room temperature is presented. Silica-coated IONP were prepared in a water-in-oil microemulsion, and subsequently the surface was modified via addition of organosilane reagents to the microemulsion system. The structure and the morphology of the as synthesized nanoparticles have been investigated by means of transmission electron microscopy (TEM) and measurement of N{sub 2} adsorption-desorption. Electron diffraction and high-resolution transmission electron microscopic (TEM) images of the nanoparticles showed the highly crystalline nature of the IONP structures. Nitrogen adsorption indicates microporous and blocked-microporous structures for the silica-coated and amine functionalized silica-coated IONP, respectively which could prove less cytotoxicity of the functionalized final product. Besides, the colloidal stability of the final product and the presence of the modified functional groups on top of surface layer have been proven by zeta-potential measurements. Owing to the benefit from the inner IONP core and the hydrophilic silica shell, the as-synthesized nanocomposites were exploited as an MRI contrast enhancement agent. Relaxometric results prove that the surface functionalized IONP have also signal enhancement properties. These surface functionalized nanocomposites are not only potential candidates for highly efficient contrast agents for MRI, but could also be used as ultrasensitive biological-magnetic labels, because they are in nanoscale size, having magnetic properties, blocked-microporous and are well dispersible in biological environment.

  5. 心脏性猝死的研究进展%Advances in research of cardiac sudden death

    Institute of Scientific and Technical Information of China (English)

    王晓芳; 吴素芬

    2007-01-01

    @@ 1 心脏性猝死的定义 心脏性猝死(Sudden cardiac death,SCD)严重地威胁生命,已引起广泛的重视.SCD是指由于心脏原因引起的,无法预测的自然死亡.从突然出现症状到死亡时间有不同规定,美国心肺血液病研究所定为24 h;世界卫生组织定为6 h.大多数心脏病学者认为从猝死的突发性及意外性而言,主张发病后1 h死亡者为猝死[1].

  6. MRI Scans

    Science.gov (United States)

    Magnetic resonance imaging (MRI) uses a large magnet and radio waves to look at organs and structures inside your body. Health care professionals use MRI scans to diagnose a variety of conditions, from ...

  7. Unveiling nonischemic cardiomyopathies with cardiac magnetic resonance.

    Science.gov (United States)

    Aggarwal, Niti R; Peterson, Tyler J; Young, Phillip M; Araoz, Philip A; Glockner, James; Mankad, Sunil V; Williamson, Eric E

    2014-02-01

    Cardiomyopathy is defined as a heterogeneous group of myocardial disorders with mechanical or electrical dysfunction. Identification of the etiology is important for accurate diagnosis, treatment and prognosis, but continues to be challenging. The ability of cardiac MRI to non-invasively obtain 3D-images of unparalleled resolution without radiation exposure and to provide tissue characterization gives it a distinct advantage over any other diagnostic tool used for evaluation of cardiomyopathies. Cardiac MRI can accurately visualize cardiac morphology and function and also help identify myocardial edema, infiltration and fibrosis. It has emerged as an important diagnostic and prognostic tool in tertiary care centers for work up of patients with non-ischemic cardiomyopathies. This review covers the role of cardiac MRI in evaluation of nonischemic cardiomyopathies, particularly in the context of other diagnostic and prognostic imaging modalities. PMID:24417294

  8. Burkitt’s Lymphoma Presented as Advanced Ovarian Cancer without Evidence of Lymphadenopathy: CT and MRI Findings

    OpenAIRE

    Lucia Manganaro; Silvia Bernardo; Maria Eleonora Sergi; Paolo Sollazzo; Valeria Vinci; Alessandra De Grazia; Anna Clerico; Maria Giovanna Mollace; Matteo Saldari

    2013-01-01

    Burkitt's lymphoma is a rare non-Hodgkin's lymphoma which can occasionally involve the ovary and may cause confusion for the clinician since its presentation might mimic other much more frequent tumors. We present a case of a 23-year-old woman with sporadic Burkitt’s lymphoma presented as advanced ovarian cancer with bilateral ovarian masses, peritoneal carcinomatosis, ascites, and marked elevation of CA-125. Liver involvement and atypical bone lesions, such as the cranial vault and the ili...

  9. Advanced echocardiography and cardiac magnetic resonance in congenital heart disease : insights in right ventricular mechanics and clinical implications

    NARCIS (Netherlands)

    Hulst, Anna Elisabeth van der

    2011-01-01

    The thesis provides new insights into advanced echocardiographic and magnetic resonance imaging techniques for comprehensive mechanical assessment of the right ventricle in healthy children and in pediatric patients with right ventricular dysfunction. It is shown that the right ventricle does not co

  10. Cardiac arrest

    Science.gov (United States)

    ... Article.jsp. Accessed June 16, 2014. Myerburg RJ, Castellanos A. Approach to cardiac arrest and life-threatening ... PA: Elsevier Saunders; 2011:chap 63. Myerburg RJ, Castellanos A. Cardiac arrest and audden aardiac death. In: ...

  11. Research advance on airway management of patients with cardiac arrest%心搏骤停患者气道管理的研究进展

    Institute of Scientific and Technical Information of China (English)

    李瑞萍; 薛富善; 刘高谱; 孙超; 杨桂珍

    2015-01-01

    Background Recent discoveries surrounding the physiology of cardiac arrest have turned the ABC mnemonic around.Objective This review will focus on issues regarding airway management in patients with cardiac arrest.Content The main contents include the paradigm shifts in emergency airway management, airway management methods, ventilatory management strategies, etc.It is specially emphasized that the initial goal of emergency airway management is the provision of effective ventilation, and can be achieved with a bag-valve-mask (BVM) or supraglottic airway device in the first few minutes of resuscitation.The deployment of an advanced airway should be deferred until the completion of 3 chest compression cycles.Furthermore, the goals of ventilator support of the resuscitated patients include the need to use the lowest possiblepositive end expiratory pressure (PEEP) while carefully titrating inspiratory oxygen concernation to avoid hyperoxia.Trend Paradigm shifts by the understanding of cardiac arrest physiology have resulted in changes to overall management strategies of the resuscitated patients.It is hopeful that these changes would improve the outcomes of patients resuscitated from cardiac arrest.%背景 对心搏骤停的生理研究已经使人们对气道(airway)、呼吸(breathing)和循环(circulation)即ABC复苏三步骤的顺序进行了调整. 目的 综述心搏骤停患者的气道管理问题. 内容 包括紧急气道管理模式的转变、气道管理的方法和通气管理策略等.特别强调紧急气道管理的最初目标是保证有效通气.在复苏的最初几分钟内,应用简易呼吸囊-面罩(bag-valve-mask,BVM)或声门上气道装置即足以达到此目标,高级气道管理应推迟至3个胸部按压循环后实施.再者,复苏患者通气支持的目标是应用尽可能低的呼气末正压通气(positive end expiratory pressure,PEEP),同时调定吸入氧浓度避免高氧. 趋向 心搏骤停生理研究产生的治疗模式

  12. MRI-detectable polymeric micelles incorporating platinum anticancer drugs enhance survival in an advanced hepatocellular carcinoma model

    Directory of Open Access Journals (Sweden)

    Vinh NQ

    2015-06-01

    Full Text Available Nguyen Quoc Vinh,1 Shigeyuki Naka,1 Horacio Cabral,2 Hiroyuki Murayama,1 Sachiko Kaida,1 Kazunori Kataoka,2 Shigehiro Morikawa,3 Tohru Tani4 1Department of Surgery, Shiga University of Medical Science, Shiga, Japan; 2Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan; 3Department of Nursing, Shiga University of Medical Science, Shiga, Japan; 4Biomedical Innovation Center, Shiga University of Medical Science, Shiga, Japan Abstract: Hepatocellular carcinoma (HCC is one of the most intractable and lethal cancers; most cases are diagnosed at advanced stages with underlying liver dysfunction and are frequently resistant to conventional chemotherapy and radiotherapy. The development of tumor-targeting systems may improve treatment outcomes. Nanomedicine platforms are of particular interest for enhancing chemotherapeutic efficiency, and they include polymeric micelles, which enable targeting of multiple drugs to solid tumors, including imaging and therapeutic agents. This allows concurrent diagnosis, targeting strategy validation, and efficacy assessment. We used polymeric micelles containing the T1-weighted magnetic resonance imaging contrast agent gadolinium-diethylenetriaminpentaacetic acid (Gd-DTPA and the parent complex of the anticancer drug oxaliplatin [(1,2-diaminocyclohexaneplatinum(II (DACHPt] for simultaneous imaging and therapy in an orthotopic rat model of HCC. The Gd-DTPA/DACHPt-loaded micelles were injected into the hepatic artery, and magnetic resonance imaging performance and antitumor activity against HCC, as well as adverse drug reactions were assessed. After a single administration, the micelles achieved strong and specific tumor contrast enhancement, induced high levels of tumor apoptosis, and significantly suppressed tumor size and growth. Moreover, the micelles did not induce severe adverse reactions and significantly improved survival outcomes in comparison to oxaliplatin or

  13. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United States

    Directory of Open Access Journals (Sweden)

    Megan Boysen-Osborn

    2016-02-01

    Full Text Available Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS taught in flipped classroom/team-based Learning (FC/TBL vs. lecture-based (LB control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015, compared to 3 classes in LB (2012-14 format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours, and 20 (12 lecture, simulation 8 hours in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14 or podcast (2015 as was testing: 50 multiple-choice questions (MCQ, 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015. Two of 3 tests (MCQ and fill-in improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4 to 95.1% (92.8, 96.7, P=0.0001. For the fill-in test: 94.1% for LB (89.6, 97.2 to 96.6% for FC/TBL (92.4, 99.20 P=0.0001. For MC: 88% for LB (84, 92 to 90% for FC/TBL (86, 94, P=0.0002. For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%, and 2 or 3 components (8.1% vs. 3.2%, P=0.006. Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%. Conclusion: A FC/TBL format for ACLS marginally improved written test results.

  14. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United State

    Science.gov (United States)

    2016-01-01

    Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8 hours) in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14) or podcast (2015) as was testing: 50 multiple-choice questions (MCQ), 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015). Two of 3 tests (MCQ and fill-in) improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4) to 95.1% (92.8, 96.7, P=0.0001). For the fill-in test: 94.1% for LB (89.6, 97.2) to 96.6% for FC/TBL (92.4, 99.20 P=0.0001). For MC: 88% for LB (84, 92) to 90% for FC/TBL (86, 94, P=0.0002). For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%), and 2 or 3 components (8.1% vs. 3.2%, P=0.006). Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%). Conclusion: A FC/TBL format for ACLS marginally improved written test results. PMID:26893399

  15. A ventricular assist device as a bridge to recovery, decision making, or transplantation in patients with advanced cardiac failure.

    Science.gov (United States)

    Neragi-Miandoab, Siyamek

    2012-10-01

    Despite many advances in the management of patients with heart failure, acute cardiogenic shock and progressive congestive heart failure remain serious problems with dismal prognoses. Both temporary and permanent mechanical support has been gaining wide clinical application in this patient population. Although mechanical circulatory support technology is rapidly evolving, this approach is associated with multiple issues such as the optimal duration of temporary support, ideal timing to bridge these patients to a long-term device, and selection of the right device for the right patient. The currently available devices are categorized into two major groups: temporary and long-term devices (including destination therapy). Heart failure is a dynamic condition, and the therapeutic approach may need to be modified depending on the patient's condition. Furthermore, the patient's preexisting morbidity, age, socioeconomic status, and family support are confounding factors that need to be considered when making such decisions. Clinical trials including prospective studies, as well as meticulous analysis of existing data, may help develop universal guidelines to select the right device. This manuscript will review the most widely used ventricular assist devices. PMID:22814623

  16. 心脏MRI的应用现状与新技术进展%The current status and technical advances in cardiac MRI

    Institute of Scientific and Technical Information of China (English)

    张兆琪; 徐磊

    2013-01-01

    在过去的20年间,心脏MRI技术飞速发展.目前心脏MRI能可靠地获得心血管的形态、功能、灌注及心肌活性等综合信息.其对血流动力学、代谢及冠状动脉的研究也逐渐兴起,当前的研究从解剖和功能逐步深入到细胞和分子水平.MRI无电离辐射,具有多方位和多参数成像及可重复性高等优势.已越来越广泛地应用于心血管疾病的诊断、治疗决策和预后评价中.作者就心脏MRI的应用现状及新技术的进展进行简要介绍.

  17. Automated Segmentation of Cardiac Magnetic Resonance Images

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Nilsson, Jens Chr.; Grønning, Bjørn A.

    2001-01-01

    Magnetic resonance imaging (MRI) has been shown to be an accurate and precise technique to assess cardiac volumes and function in a non-invasive manner and is generally considered to be the current gold-standard for cardiac imaging [1]. Measurement of ventricular volumes, muscle mass and function...... is based on determination of the left-ventricular endocardial and epicardial borders. Since manual border detection is laborious, automated segmentation is highly desirable as a fast, objective and reproducible alternative. Automated segmentation will thus enhance comparability between and within cardiac...... studies and increase accuracy by allowing acquisition of thinner MRI-slices. This abstract demonstrates that statistical models of shape and appearance, namely the deformable models: Active Appearance Models, can successfully segment cardiac MRIs....

  18. Cardiac Malpositions

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Shi Joon; Im, Chung Gie; Yeon, Kyung Mo; Hasn, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus and 3 cases had levocardia with situs inversus. 2. There was no genuine exception to visceroatrial concordance rule. 3. Associated cardiac malpositions were variable and complex with a tendency of high association of transposition and double outlet varieties with dextrocardia in situs solitus and levocardia in situs inversus. Only one in 6 cases of dextrocardia with situs inversus had pure transposition. 4. In two cases associated pulmonary atresia was found at surgery which was not predicted by angiocardiography. 5. Because many of the associated complex lesions can be corrected surgically provided the diagnosis is accurate, the selective biplane angiocardiography with or without cineradiography is essential.

  19. 3 T MRI in paediatrics: Challenges and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Dagia, Charuta [Department of Medical Imaging, Royal Children' s Hospital and Murdoch Childrens Research Institute, Flemington Road, Parkville 3052 (Australia); Ditchfield, Michael [Department of Medical Imaging, Royal Children' s Hospital and Murdoch Childrens Research Institute, Flemington Road, Parkville 3052 (Australia)], E-mail: michael.ditchfield@rch.org.au

    2008-11-15

    3 T MRI is being increasingly performed for clinical purposes in paediatrics, primarily because of the potential to improve spatial and temporal resolution - these can assist in overcoming the unique anatomic, physiologic and behavioural challenges of imaging children. The increased spatial resolution improves the capacity to image small patients; with particular reference to smaller structures such as the inner ear, brachial plexus, biliary system and the vascular system. The challenges inherent to imaging at high field strength remain pertinent especially, the altered T1 contrast, artefacts (susceptibility, chemical shift and B1 inhomogeneity) and safety issues, including specific absorption rate - several of these are circumvented due to software and hardware advances, or by trade off of some of the increased signal. The above mentioned challenges also create opportunities at 3 T, with improvement in MR angiography, arterial spin labelling, functional MRI, susceptibility weighted imaging, and MR spectroscopy - all of which have distinctive applications in paediatrics. Whole body imaging also becomes more practical because of the capacity for faster scans. 3 T MRI has the potential to image all the systems in paediatrics. However, neonatal brain and paediatric spine imaging have specific challenges at 3 T. Several factors also limit cardiac imaging at present. Further improvements in coil technology and newer sequences may help overcome the challenges that remain.

  20. 3 T MRI in paediatrics: Challenges and clinical applications

    International Nuclear Information System (INIS)

    3 T MRI is being increasingly performed for clinical purposes in paediatrics, primarily because of the potential to improve spatial and temporal resolution - these can assist in overcoming the unique anatomic, physiologic and behavioural challenges of imaging children. The increased spatial resolution improves the capacity to image small patients; with particular reference to smaller structures such as the inner ear, brachial plexus, biliary system and the vascular system. The challenges inherent to imaging at high field strength remain pertinent especially, the altered T1 contrast, artefacts (susceptibility, chemical shift and B1 inhomogeneity) and safety issues, including specific absorption rate - several of these are circumvented due to software and hardware advances, or by trade off of some of the increased signal. The above mentioned challenges also create opportunities at 3 T, with improvement in MR angiography, arterial spin labelling, functional MRI, susceptibility weighted imaging, and MR spectroscopy - all of which have distinctive applications in paediatrics. Whole body imaging also becomes more practical because of the capacity for faster scans. 3 T MRI has the potential to image all the systems in paediatrics. However, neonatal brain and paediatric spine imaging have specific challenges at 3 T. Several factors also limit cardiac imaging at present. Further improvements in coil technology and newer sequences may help overcome the challenges that remain

  1. Advances in Research on Pathogenesis of PRKAG2 Cardiac Syndrome%PRKAG2心脏综合征发病机制研究进展

    Institute of Scientific and Technical Information of China (English)

    叶忠; 张必利

    2012-01-01

    PRKAG2心脏综合征是一种由于编码单磷酸腺苷激活蛋白激酶γ2亚基的PRKAG2基因遗传性缺陷导致的罕见的常染色体显性遗传病,它的典型表现为:心室预激、进展性传导系统疾病和心脏肥大.虽然PRKAG2心脏综合征的临床表现与肥厚型心肌病、预激综合征相似,但它们在发病机制上却存在着本质的差别,PRKAG2心脏综合征是一种心脏代谢性疾病.现就近年来对PRKAG2心脏综合征发病机制的研究做一综述.%The PRKAC2 cardiac syndrome is an unusual autosomal dominant disease caused by the PRKAG2 genetic defect. This gene encodes the gamma-2 regulatory subunit of AMP-activated protein kinase. PRKAG2 cardiac syndrome is a cardiac metabolic disease. This article reviews recent research regarding the pathogenesis of PRKAG2. PRKAG2 cardiac syndrome is characterized by ventricular preex-citation,progressive conduction system disease,and cardiac hypertrophy. Although the clinical phenotype of the PRKAG2 cardiac syndrome is similar to hypertrophic cardiomyopathy and Wolff-Parkinson-White syndrom, there is essential distinction on the pathogenesis among them. The PRKAG2 cardiac syndrome is a cardiac metabolic disease. This article reviews current research on the pathogenesis of the PRKAG2 cardiac syndrome.

  2. Gadolinium-DTPA enhanced MRI in myocardial infarction

    International Nuclear Information System (INIS)

    This thesis focuses on one aspect of cardiac magnetic resonance imaging (MRI) for noninvasive screening of ischemic heart disease: the identification and quantification of acutely infarcted myocardium using gadolineum-diethylene triamine pentaacetic acid (Gd-DTPA) enhanced T1-weighted MRI in a clinical and experimental setting. (author). 296 refs.; 34 figs.; 4 tabs

  3. Use of MRI: Multiple ways to enhance electrophysiology procedures

    NARCIS (Netherlands)

    Smink, J.; Weiss, S.; Wiethoff, A.; Gijsbers, G.

    2011-01-01

    This white paper summarizes the various ways in which MR may improve cardiac electrophysiology procedures of both types, catheter ablation and cardiac resynchronization therapy. The report gives an overview of how applications do or may benefit from pre-, post- and evenintra-operative MRI, focussin

  4. Pediatric MRI

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  5. Cardiac perioperative complications in noncardiac surgery

    Directory of Open Access Journals (Sweden)

    Radovanović Dragana

    2008-01-01

    Full Text Available Anesthesiologists are confronted with an increasing population of patients undergoing noncardiac surgery who are at risk for cardiac complications in the perioperative period. Perioperative cardiac complications are responsible for significant mortality and morbidity. The aim of the present study was to determine the incidence of perioperative (operative and postoperative cardiac complications and correlations between the incidence of perioperative cardiac complications and type of surgical procedure, age, presence of concurrent diseases. A total of 100 patients with cardiac diseases undergoing noncardiac surgery were included in the prospective study (Group A 50 patients undergoing intraperitoneal surgery and Group B 50 patients undergoing breast and thyroid surgery. The patients were followed up during the perioperative period and after surgery until leaving hospital to assess the occurrence of cardiac events. Cardiac complications (systemic arterial hypertension, systemic arterial hypotension, abnormalities of cardiac conduction and cardiac rhythm, perioperative myocardial ischemia and acute myocardial infarction occurred in 64% of the patients. One of the 100 patients (1% had postoperative myocardial infarction which was fatal. Systemic arterial hypertension occurred in 57% of patients intraoperatively and 33% postoperatively, abnormalities of cardiac rhythm in 31% of patients intraoperatively and 17% postoperatively, perioperative myocardial ischemia in 23% of patients intraoperatively and 11% of postoperatively. The most often cardiac complications were systemic arterial hypertension, abnormalities of cardiac rhythm and perioperative myocardial ischemia. Factors independently associated with the incidence of cardiac complications included the type of surgical procedure, advanced age, duration of anaesthesia and surgery, abnormal preoperative electrocardiogram, abnormal preoperative chest radiography and diabetes.

  6. Fetal and maternal manifestations of tuberous sclerosis complex: Value of fetal MRI.

    Science.gov (United States)

    Goel, Reema; Aggarwal, Nishant; Lemmon, Monica E; Bosemani, Thangamadhan

    2016-02-01

    Tuberous sclerosis complex (TSC) is a genetic disorder characterized by benign hamartomas in various organ systems of the body. Prenatal screening of fetuses of mothers affected with TSC using ultrasonography (US) may detect cardiac lesions. Fetal US is not sensitive for evaluation of the brain. We describe brain MRI findings in a fetus with cardiac rhabdomyomas identified on prenatal screening US. Postnatal brain MRI at 5 days of age demonstrated fetal MRI findings without significant added information. Fetal MRI is the imaging modality of choice for evaluation of cerebral manifestations of TSC. Maternal manifestations of TSC in the abdomen or pelvis may also be demonstrated on fetal MRI. PMID:26838171

  7. A unique pattern of delayed enhancement of a large cardiac fibroma on magnetic resonance imaging.

    Science.gov (United States)

    El Yaman, Malek M; Vos, Jeffrey A; Gustafson, Robert A

    2015-06-01

    MRI is a valuable noninvasive tool that helps in predicting the type of cardiac tumors and guiding management decisions. Several reports have described the appearance of cardiac fibromas on MRI, which typically show hyperenhancement on myocardial delayed enhancement (MDE) imaging, with or without a dark core. This report demonstrates the unique appearance of a large solitary ventricular septal cardiac fibroma in a 5-month-old patient on MDE imaging, with two discrete dark cores, each surrounded by a hyperenhancing pseudocapsule.

  8. Epigenetic regulation in cardiac fibrosis

    Institute of Scientific and Technical Information of China (English)

    Li-Ming; Yu; Yong; Xu

    2015-01-01

    Cardiac fibrosis represents an adoptive response in the heart exposed to various stress cues. While resolution of the fibrogenic response heralds normalization of heart function, persistent fibrogenesis is usually associated with progressive loss of heart function and eventually heart failure. Cardiac fibrosis is regulated by a myriad of factors that converge on the transcription of genes encoding extracellular matrix proteins, a process the epigenetic machinery plays a pivotal role. In this minireview, we summarize recent advances regarding the epigenetic regulation of cardiac fibrosis focusing on the role of histone and DNA modifications and non-coding RNAs.

  9. Integration of DCE-MRI and DW-MRI Quantitative Parameters for Breast Lesion Classification

    Directory of Open Access Journals (Sweden)

    Roberta Fusco

    2015-01-01

    Full Text Available Objective. The purpose of our study was to evaluate the diagnostic value of an imaging protocol combining dynamic contrast-enhanced MRI (DCE-MRI and diffusion-weighted MRI (DW-MRI in patients with suspicious breast lesions. Materials and Methods. A total of 31 breast lesions (15 malignant and 16 benign proved by histological examination in 26 female patients were included in this study. For both DCE-MRI and DW-MRI model free and model based parameters were computed pixel by pixel on manually segmented ROIs. Statistical procedures included conventional linear analysis and more advanced techniques for classification of lesions in benign and malignant. Results. Our findings indicated no strong correlation between DCE-MRI and DW-MRI parameters. Results of classification analysis show that combining of DCE parameters or DW-MRI parameter, in comparison of single feature, does not yield a dramatic improvement of sensitivity and specificity of the two techniques alone. The best performance was obtained considering a full combination of all features. Moreover, the classification results combining all features are dominated by DCE-MRI features alone. Conclusion. The combination of DWI and DCE-MRI does not show a potential to dramatically increase the sensitivity and specificity of breast MRI. DCE-MRI alone gave the same performance as in combination with DW-MRI.

  10. Cardiac rehabilitation

    Science.gov (United States)

    ... attack or other heart problem. You might consider cardiac rehab if you have had: Heart attack Coronary heart disease (CHD) Heart failure Angina (chest pain) Heart or heart valve surgery Heart transplant Procedures such as angioplasty and stenting In some ...

  11. MRI-conditional pacemakers: current perspectives

    Directory of Open Access Journals (Sweden)

    Ferreira AM

    2014-05-01

    Full Text Available António M Ferreira,1,2 Francisco Costa,2 António Tralhão,2 Hugo Marques,3 Nuno Cardim,1 Pedro Adragão1,2 1Cardiology Department, Hospital da Luz, 2Cardiology Department, Hospital Santa Cruz- CHLO, 3Radiology Department, Hospital da Luz, Lisbon, Portugal Abstract: Use of both magnetic resonance imaging (MRI and pacing devices has undergone remarkable growth in recent years, and it is estimated that the majority of patients with pacemakers will need an MRI during their lifetime. These investigations will generally be denied due to the potentially dangerous interactions between cardiac devices and the magnetic fields and radiofrequency energy used in MRI. Despite the increasing reports of uneventful scanning in selected patients with conventional pacemakers under close surveillance, MRI is still contraindicated in those circumstances and cannot be considered a routine procedure. These limitations prompted a series of modifications in generator and lead engineering, designed to minimize interactions that could compromise device function and patient safety. The resulting MRI-conditional pacemakers were first introduced in 2008 and the clinical experience gathered so far supports their safety in the MRI environment if certain conditions are fulfilled. With this technology, new questions and controversies arise regarding patient selection, clinical impact, and cost-effectiveness. In this review, we discuss the potential risks of MRI in patients with electronic cardiac devices and present updated information regarding the features of MRI-conditional pacemakers and the clinical experience with currently available models. Finally, we provide some guidance on how to scan patients who have these devices and discuss future directions in the field. Keywords: pacemakers, magnetic resonance imaging, MRI, MRI-conditional devices, safety

  12. Inherited cardiac disease

    Directory of Open Access Journals (Sweden)

    Philippe Charron

    2012-06-01

    Full Text Available Major advances have been achieved over the two last decades in the field of genetic cardiovascular diseases, not only through increased recognition and understanding of underlying molecular defects but also through rapid translation of knowledge into clinical practice. Genetic counseling and organization of cardiac family screening has become part of the medical management of these diseases, and these should be performed systematically unless an acquired cause has been diagnosed...

  13. Accelerating Dynamic Cardiac MR Imaging Using Structured Sparse Representation

    Directory of Open Access Journals (Sweden)

    Nian Cai

    2013-01-01

    Full Text Available Compressed sensing (CS has produced promising results on dynamic cardiac MR imaging by exploiting the sparsity in image series. In this paper, we propose a new method to improve the CS reconstruction for dynamic cardiac MRI based on the theory of structured sparse representation. The proposed method user the PCA subdictionaries for adaptive sparse representation and suppresses the sparse coding noise to obtain good reconstructions. An accelerated iterative shrinkage algorithm is used to solve the optimization problem and achieve a fast convergence rate. Experimental results demonstrate that the proposed method improves the reconstruction quality of dynamic cardiac cine MRI over the state-of-the-art CS method.

  14. Portable MRI

    Energy Technology Data Exchange (ETDEWEB)

    Espy, Michelle A. [Los Alamos National Laboratory

    2012-06-29

    This project proposes to: (1) provide the power of MRI to situations where it presently isn't available; (2) perform the engineering required to move from lab to a functional prototype; and (3) leverage significant existing infrastructure and capability in ultra-low field MRI. The reasons for doing this: (1) MRI is the most powerful tool for imaging soft-tissue (e.g. brain); (2) Billions don't have access due to cost or safety issues; (3) metal will heat/move in high magnetic fields; (4) Millions of cases of traumatic brain injury in US alone; (5) even more of non-traumatic brain injury; (6) (e.g. stroke, infection, chemical exposure); (7) Need for early diagnostic; (8) 'Signature' wound of recent conflicts; (9) 22% of injuries; (10) Implications for post-traumatic stress disorder; and (11) chronic traumatic encephalopathy.

  15. MRI Artifacts

    Directory of Open Access Journals (Sweden)

    Abed Al Nasser Assi

    2009-12-01

    Full Text Available   "nMagnetic resonance imaging (MRI has become more and more frequently used in medical imaging diagnostic in recent years. Radiologists and technicians working at these systems are relatively often confronted with image artifacts related to the radiowave with strong magnetic in the scanner. Many artifacts may be corrected or modulated through an understanding of their cause. This requires familiarity with scanner design; theory of operation; and image acquisition. The purpose of this review article is to present the most relevant artifacts that arise in MRI scanner, to provide some physical background on the formation of artifacts, and to suggest strategies to reduce or avoid these artifacts. The most frequent artifacts that can occur during MRI scanning are Motion related artifacts; Para-magnetic artifacts; Phase Wrap artifacts; Frequency artifacts; Susceptibility artifacts; Clipping artefact; Chemical Shift artifact and "Zebra" artefact .    "n  

  16. MRI Safety during Pregnancy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z MRI Safety During Pregnancy Magnetic resonance imaging (MRI) Illness ... during the exam? Contrast material MRI during pregnancy Magnetic resonance imaging (MRI) If you are pregnant and your doctor ...

  17. Fetal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, D.; Brugger, P.C. [University Hospital of Vienna (Austria). Division of Neuroradiology

    2004-07-01

    New, ultrafast sequences have made it possible to obtain MR images of the fetus without maternal sedation or immobilization of the fetus itself. While fetal MRI began as an adjunct to ultrasound, it has now been shown that MRI can provide additional information that may change prognosis, the management of pregnancy, or the treatment of the newborn child. It is of particular value in the assessment of malformations of the central nervous system. The steady development and adaptation of MR-sequences to the needs of fetal imaging has led to new indications that can support prognostic and therapeutic decisions. (orig.)

  18. Hepato-cardiac disorders

    Institute of Scientific and Technical Information of China (English)

    Yasser; Mahrous; Fouad; Reem; Yehia

    2014-01-01

    Understanding the mutual relationship between the liver and the heart is important for both hepatologists and cardiologists. Hepato-cardiac diseases can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. Differential diagnoses of liver injury are extremely important in a cardiologist’s clinical practice calling for collaboration between cardiologists and hepatologists due to the many other diseases that can affect the liver and mimic haemodynamic injury. Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to the improvement of all cardiac changes and the reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both the liver and the heart concomitantly including congenital, metabolic and inflammatory diseases as well as alcoholism. This review highlights these hepatocardiac diseases

  19. MRI zoo

    DEFF Research Database (Denmark)

    Laustsen, Christoffer

    The basic idea was to use MRI to produce a sequence of 3D gray scale image slices of various animals, subsequentlyimaged with a clinical CT system. For this purpose, these animals were used: toad, lungfish, python snake and a horseshoe crab. Each animal was sacrificed according to standard proced...

  20. Fetal MRI

    International Nuclear Information System (INIS)

    Ultrasonography is the method of choice for prenatal malformation screening, but it does not always provide sufficient information for correct diagnosis or adequate abnormality evaluation. Fetal MRI is increasingly being used to complete sonographic findings. It was initially used for evaluation of cerebral abnormalities but is increasingly being applied to other fetal areas. In vivo investigation of fetal brain maturation has been enhanced by MRI. An adequate analysis of fetal chest and abdomen can be achieved with fast T2-, T1-weighted and diffusion-weighted imaging (DWI). The advantages include the great field of view and the excellent soft tissue contrast. This allows correct diagnosis of congenital diaphragmatic hernia and evaluation of the consequences on pulmonary growth. Other pulmonary malformations, such as cystic adenomatoid malformation, sequestration and brochogenic cysts, can also be easily identified. Renal position can be quickly determined using DWI sequences and renal agenesia can be easily diagnosed with only one sequence. Prenatal MRI is virtually as effective as postnatal examination, dispenses with transport of a potentially very ill newborn, and provides logistic advantages. Therefore, prenatal MRI is useful for adequate postnatal treatment of newborns with malformations. (orig.)

  1. Quantitative Myocardial Perfusion with Dynamic Contrast-Enhanced Imaging in MRI and CT: Theoretical Models and Current Implementation

    Directory of Open Access Journals (Sweden)

    G. J. Pelgrim

    2016-01-01

    Full Text Available Technological advances in magnetic resonance imaging (MRI and computed tomography (CT, including higher spatial and temporal resolution, have made the prospect of performing absolute myocardial perfusion quantification possible, previously only achievable with positron emission tomography (PET. This could facilitate integration of myocardial perfusion biomarkers into the current workup for coronary artery disease (CAD, as MRI and CT systems are more widely available than PET scanners. Cardiac PET scanning remains expensive and is restricted by the requirement of a nearby cyclotron. Clinical evidence is needed to demonstrate that MRI and CT have similar accuracy for myocardial perfusion quantification as PET. However, lack of standardization of acquisition protocols and tracer kinetic model selection complicates comparison between different studies and modalities. The aim of this overview is to provide insight into the different tracer kinetic models for quantitative myocardial perfusion analysis and to address typical implementation issues in MRI and CT. We compare different models based on their theoretical derivations and present the respective consequences for MRI and CT acquisition parameters, highlighting the interplay between tracer kinetic modeling and acquisition settings.

  2. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  3. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  4. Prognostic value of cardiovascular MRI in diabetics

    International Nuclear Information System (INIS)

    Despite an increased cardiovascular risk in patients with diabetes mellitus they are a heterogeneous population with very different individual manifestation of diseases; therefore, a profound stratification is recommended. Clinical examinations and blood biomarkers are typically used in diabetic patients to determine the risk for developing cardio-cerebrovascular events. Cardiac as well as whole-body magnetic resonance imaging (MRI) including cardiovascular sequences are established methods for clinical diagnostics. Their significance in predicting the outcome and the corresponding risk stratification for patients with diabetes is becoming increasingly more important based on recent study results. Late gadolinium enhancement (LGE) in cardiac MRI detects silent myocardial ischemia in up to 30 % of diabetic patients, which is associated with a hazard ratio of 3-6 for cardiovascular events. Regional left ventricular wall motion abnormalities and decreased ejection fraction also have a prognostic value in diabetics. Based on whole-body MRI, the vessel score as well as carotid artery stenosis have been evaluated as additional predictors for cardio-cerebrovascular events. The MRI-based predictors have independent and incremental prognostic value beyond traditional risk stratification for cardio-cerebrovascular events; however, only the comprehensive assessment of whole-body MRI including angiography allows the identification of patients who remain free of cardio-cerebrovascular events over a period of 6 years. Cardiac MRI, particularly the detection of LGE, can be recommended for risk stratification of patients with diabetes mellitus. The clinical relevance of the added prognostic value of whole-body MRI needs to be clarified in further studies. (orig.)

  5. Sodium MRI in human heart: a review.

    Science.gov (United States)

    Bottomley, Paul A

    2016-02-01

    This paper offers a critical review of the properties, methods and potential clinical application of sodium ((23)Na) MRI in human heart. Because the tissue sodium concentration (TSC) in heart is about ~40 µmol/g wet weight, and the (23)Na gyromagnetic ratio and sensitivity are respectively about one-quarter and one-11th of that of hydrogen ((1)H), the signal-to-noise ratio of (23)Na MRI in the heart is about one-6000th of that of conventional cardiac (1)H MRI. In addition, as a quadrupolar nucleus, (23)Na exhibits ultra-short and multi-component relaxation behavior (T1 ~ 30 ms; T2 ~ 0.5-4 ms and 12-20 ms), which requires fast, specialized, ultra-short echo-time MRI sequences, especially for quantifying TSC. Cardiac (23)Na MRI studies from 1.5 to 7 T measure a volume-weighted sum of intra- and extra-cellular components present at cytosolic concentrations of 10-15 mM and 135-150 mM in healthy tissue, respectively, at a spatial resolution of about 0.1-1 ml in 10 min or so. Currently, intra- and extra-cellular sodium cannot be unambiguously resolved without the use of potentially toxic shift reagents. Nevertheless, increases in TSC attributable to an influx of intra-cellular sodium and/or increased extra-cellular volume have been demonstrated in human myocardial infarction consistent with prior animal studies, and arguably might also be seen in future studies of ischemia and cardiomyopathies--especially those involving defects in sodium transport. While technical implementation remains a hurdle, a central question for clinical use is whether cardiac (23)Na MRI can deliver useful information unobtainable by other more convenient methods, including (1)H MRI.

  6. Non-cardiac findings on coronary computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc; Schnapauff, Dirk; Teige, Florian; Hamm, Bernd [Charite-Universitaetsmedizin Berlin, Humboldt-Universitaet zu Berlin, Department of Radiology, Chariteplatz 1, P.O. Box 10098, Berlin (Germany)

    2007-08-15

    Both multislice computed tomography (CT) and magnetic resonance imaging (MRI) are emerging as methods to detect coronary artery stenoses and assess cardiac function and morphology. Non-cardiac structures are also amenable to assessment by these non-invasive tests. We investigated the rate of significant and insignificant non-cardiac findings using CT and MRI. A total of 108 consecutive patients suspected of having coronary artery disease and without contraindications to CT and MRI were included in this study. Significant non-cardiac findings were defined as findings that required additional clinical or radiological follow-up. CT and MR images were read independently in a blinded fashion. CT yielded five significant non-cardiac findings in five patients (5%). These included a pulmonary embolism, large pleural effusions, sarcoid, a large hiatal hernia, and a pulmonary nodule (>1.0 cm). Two of these significant non-cardiac findings were also seen on MRI (pleural effusions and sarcoid, 2%). Insignificant non-cardiac findings were more frequent than significant findings on both CT (n = 11, 10%) and MRI (n = 7, 6%). Incidental non-cardiac findings on CT and MRI of the coronary arteries are common, which is why images should be analyzed by radiologists to ensure that important findings are not missed and unnecessary follow-up examinations are avoided. (orig.)

  7. A computational framework for the statistical analysis of cardiac diffusion tensors: application to a small database of canine hearts.

    Science.gov (United States)

    Peyrat, Jean-Marc; Sermesant, Maxime; Pennec, Xavier; Delingette, Hervé; Xu, Chenyang; McVeigh, Elliot R; Ayache, Nicholas

    2007-11-01

    We propose a unified computational framework to build a statistical atlas of the cardiac fiber architecture from diffusion tensor magnetic resonance images (DT-MRIs). We apply this framework to a small database of nine ex vivo canine hearts. An average cardiac fiber architecture and a measure of its variability are computed using most recent advances in diffusion tensor statistics. This statistical analysis confirms the already established good stability of the fiber orientations and a higher variability of the laminar sheet orientations within a given species. The statistical comparison between the canine atlas and a standard human cardiac DT-MRI shows a better stability of the fiber orientations than their laminar sheet orientations between the two species. The proposed computational framework can be applied to larger databases of cardiac DT-MRIs from various species to better establish intraspecies and interspecies statistics on the anatomical structure of cardiac fibers. This information will be useful to guide the adjustment of average fiber models onto specific patients from in vivo anatomical imaging modalities.

  8. Cardiac CT angiography in children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Siripornpitak, Suvipaporn, E-mail: ssiripornpitak@yahoo.com [Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Pornkul, Ratanaporn [Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Khowsathit, Pongsak [Pediatric Cardiac Unit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Layangool, Thanarat; Promphan, Worakan [Pediatric Cardiology Unit, Queen Sirikit National Institute of Child Health, Bangkok (Thailand); Pongpanich, Boonchob [Pediatric Cardiac Unit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand)

    2013-07-15

    Cardiac imaging plays an important role in both congenital and acquired heart diseases. Cardiac computed tomography (angiography) cCT(A) is a non-invasive, increasingly popular, complementary modality to echocardiography in evaluation of congenital heart diseases (CHD) in children. Despite radiation exposure, cCT(A) is now commonly used for evaluation of the complex CHD, giving information of both intra-cardiac and extra-cardiac anatomy, coronary arteries, and vascular structures. This review article will focus on the fundamentals and essentials for performing cCT(A) in children, including radiation dose awareness, basic techniques, and strengths and weaknesses of cCT(A) compared with cardiac magnetic resonance imaging (cMRI), and applications. The limitations of this modality will also be discussed, including the CHD for which cMRI may be substituted.

  9. Robot-assisted cardiac surgery.

    Science.gov (United States)

    Ishikawa, Norihiko; Watanabe, Go

    2015-01-01

    Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB), and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. Robot-assisted cardiac surgery as minimally invasive cardiac surgery is reviewed. PMID:26134073

  10. State of the Art in Cardiac Hybrid Technology: PET/MR

    OpenAIRE

    Nappi, Carmela; El Fakhri, Georges

    2013-01-01

    Simultaneous PET/MRI is an emerging technique combining two powerful imaging modalities in a single device. The wide variety of available tracers for perfusion and metabolic studies and the high sensitivity of positron emission tomography (PET) combined with the high spatial resolution and soft tissue contrast of magnetic resonance imaging (MRI) in depicting cardiac morphology and function as well as MRI's absence of ionizing radiation makes PET/MRI very attractive to radiologists and clinici...

  11. [Cardiac amyloidosis].

    Science.gov (United States)

    Hoyer, Caroline; Angermann, Christiane E; Knop, Stefan; Ertl, Georg; Störk, Stefan

    2008-03-15

    Amyloidoses are a heterogeneous group of multisystem disorders, which are characterized by an extracellular deposition of amyloid fibrils. Typically affected are the heart, liver, kidneys, and nervous system. More than half of the patients die due to cardiac involvement. Clinical signs of cardiac amyloidosis are edema of the lower limbs, hepatomegaly, ascites and elevated jugular vein pressure, frequently in combination with dyspnea. There can also be chest pain, probably due to microvessel disease. Dysfunction of the autonomous nervous system or arrhythmias may cause low blood pressure, dizziness, or recurrent syncope. The AL amyloidosis caused by the deposition of immunoglobulin light chains is the most common form. It can be performed by monoclonal gammopathy. The desirable treatment therapy consists of high-dose melphalan therapy twice followed by autologous stem cell transplantation. Due to the high peritransplantation mortality, selection of appropriate patients is mandatory. The ATTR amyloidosis is an autosomal dominant disorder caused by the amyloidogenic form of transthyretin, a plasmaprotein that is synthesized in the liver. Therefore, liver transplantation is the only curative therapy. The symptomatic treatment of cardiac amyloidosis is based on the current guidelines for chronic heart failure according to the patient's New York Heart Association (NYHA) state. Further types of amyloidosis with possible cardiac involvement comprise the senile systemic amyloidosis caused by the wild-type transthyretin, secondary amyloidosis after chronic systemic inflammation, and the beta(2)-microglobulin amyloidosis after long-term dialysis treatment. PMID:18344065

  12. SU-E-P-10: Imaging in the Cardiac Catheterization Lab - Technologies and Clinical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Fetterly, K [Mayo Clinic, Rochester, MN (United States)

    2014-06-01

    Purpose: Diagnosis and treatment of cardiovascular disease in the cardiac catheterization laboratory is often aided by a multitude of imaging technologies. The purpose of this work is to highlight the contributions to patient care offered by the various imaging systems used during cardiovascular interventional procedures. Methods: Imaging technologies used in the cardiac catheterization lab were characterized by their fundamental technology and by the clinical applications for which they are used. Whether the modality is external to the patient, intravascular, or intracavity was specified. Specific clinical procedures for which multiple modalities are routinely used will be highlighted. Results: X-ray imaging modalities include fluoroscopy/angiography and angiography CT. Ultrasound imaging is performed with external, trans-esophageal echocardiography (TEE), and intravascular (IVUS) transducers. Intravascular infrared optical coherence tomography (IVOCT) is used to assess vessel endothelium. Relatively large (>0.5 mm) anatomical structures are imaged with x-ray and ultrasound. IVUS and IVOCT provide high resolution images of vessel walls. Cardiac CT and MRI images are used to plan complex cardiovascular interventions. Advanced applications are used to spatially and temporally merge images from different technologies. Diagnosis and treatment of coronary artery disease frequently utilizes angiography and intra-vascular imaging, and treatment of complex structural heart conditions routinely includes use of multiple imaging modalities. Conclusion: There are several imaging modalities which are routinely used in the cardiac catheterization laboratory to diagnose and treat both coronary artery and structural heart disease. Multiple modalities are frequently used to enhance the quality and safety of procedures. The cardiac catheterization laboratory includes many opportunities for medical physicists to contribute substantially toward advancing patient care.

  13. Battlefield MRI

    Energy Technology Data Exchange (ETDEWEB)

    Espy, Michelle [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-06-01

    Magnetic Resonance Imaging is the best method for non-invasive imaging of soft tissue anatomy, saving countless lives each year. It is regarded as the gold standard for diagnosis of mild to moderate traumatic brain injuries. Furthermore, conventional MRI relies on very high, fixed strength magnetic fields (> 1.5 T) with parts-per-million homogeneity, which requires very large and expensive magnets.

  14. MRI of the pulmonary parenchyma

    International Nuclear Information System (INIS)

    Imaging of the pulmonary parenchyma represents a unique challenge for MRI. Limited signal is caused by low proton density, susceptibility artifacts, and physiological motion (cardiac pulsation, respiration). Recently, further improvements in MRI techniques have widened the potential for investigations of pulmonary parenchymal disease. These include very short echo times, ultrafast turbo-spin-echo acquisitions, projection reconstruction technique, breathhold imaging, ECG triggering, contrast agents (perfusion imaging, aerosols), sodium imaging, hyperpolarized noble gas imaging, and oxygen enhancement. By using widely available techniques, MRI is helpful in the assessment of (a) acute alveolitic processes in chronic infiltrative lung disease, (b) detection and characterization of pulmonary nodules, (c) detection, characterization, and follow-up of pneumonia, (d) differentiation of obstructive atelectasis from non-obstructive atelectasis and infarctions, and (e) measurements of lung water content. Chronic bronchitis, bronchiectasis, and emphysema are not readily assessable by routine MRI techniques. More sophisticated techniques are under investigation for MR imaging of pulmonary ventilation and perfusion. They represent the beginning of functional MR imaging of the lung which will be established in the future. (orig.)

  15. MRI of the pulmonary parenchyma

    Energy Technology Data Exchange (ETDEWEB)

    Kauczor, H.U.; Kreitner, K.F. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie

    1999-07-01

    Imaging of the pulmonary parenchyma represents a unique challenge for MRI. Limited signal is caused by low proton density, susceptibility artifacts, and physiological motion (cardiac pulsation, respiration). Recently, further improvements in MRI techniques have widened the potential for investigations of pulmonary parenchymal disease. These include very short echo times, ultrafast turbo-spin-echo acquisitions, projection reconstruction technique, breathhold imaging, ECG triggering, contrast agents (perfusion imaging, aerosols), sodium imaging, hyperpolarized noble gas imaging, and oxygen enhancement. By using widely available techniques, MRI is helpful in the assessment of (a) acute alveolitic processes in chronic infiltrative lung disease, (b) detection and characterization of pulmonary nodules, (c) detection, characterization, and follow-up of pneumonia, (d) differentiation of obstructive atelectasis from non-obstructive atelectasis and infarctions, and (e) measurements of lung water content. Chronic bronchitis, bronchiectasis, and emphysema are not readily assessable by routine MRI techniques. More sophisticated techniques are under investigation for MR imaging of pulmonary ventilation and perfusion. They represent the beginning of functional MR imaging of the lung which will be established in the future. (orig.)

  16. Characterisation of peripartum cardiomyopathy by cardiac magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mouquet, Frederic; Groote, Pascal de; Bouabdallaoui, Nadia; Dagorn, Joel; Lamblin, Nicolas; Bauters, Christophe [Pole de Cardiologie et Maladies Vasculaires, CHRU Lille et Universite Lille 2, Lille Cedex (France); Lions, Christophe; Willoteaux, Serge; Beregi, Jean Paul [Radiologie et Imagerie Cardiovasculaire, CHRU Lille et Universite Lille 2, Lille Cedex (France); Deruelle, Philippe [Gynecologie-Maternite, CHRU Lille et Universite Lille 2, Lille Cedex (France)

    2008-12-15

    Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure. Only half of the patients recover normal cardiac function. We assessed the usefulness of magnetic resonance imaging (MRI) and late enhancement imaging to detect myocardial fibrosis in order to predict cardiac function recovery in patients with peripartum cardiomyopathy. Among a consecutive series of 1,037 patients referred for heart failure treatment or prognostic evaluation between 1999 and 2006, eight women had confirmed PPCM. They all underwent echocardiography and cardiac MRI for assessment of left ventricular anatomy, systolic function and detection of myocardial fibrosis through late enhancement imaging. Mean ({+-} SD) baseline left ventricular ejection fraction (LVEF) was 28 {+-} 4%. After a follow-up of 50 {+-} 9 months, half the patients recovered normal cardiac function (LVEF = 58 {+-} 4%) and four did not (LVEF = 35 {+-} 6%). None of the eight patients exhibited abnormal myocardial late enhancement. No difference in MRI characteristics was observed between the two groups. Patients with PPCM do not exhibit a specific cardiac MRI pattern and particularly no myocardial late enhancement. It suggests that myocardial fibrosis does not play a major role in the limitation of cardiac function recovery after PPCM. (orig.)

  17. Molecular therapies for cardiac arrhythmias

    NARCIS (Netherlands)

    G.J.J. Boink

    2013-01-01

    Despite the ongoing advances in pharmacology, devices and surgical approaches to treat heart rhythm disturbances, arrhythmias are still a significant cause of death and morbidity. With the introduction of gene and cell therapy, new avenues have arrived for the local modulation of cardiac disease. Th

  18. The combination of FDG PET and dynamic contrast-enhanced MRI improves the prediction of disease-free survival in patients with advanced breast cancer after the first cycle of neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ilhan; Kim, Byung II; Choi, Chang Woon; Lim, Sang Moo [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Nuclear Medicine, Korea Cancer Center Hospital, 75 Nowongil, Nowon Gu, Seoul (Korea, Republic of); Korea Institute of Radiological and Medical Sciences (KIRAMS), Molecular Imaging Research Center, Seoul (Korea, Republic of); Noh, Woo Chul; Kim, Hyun-Ah; Kim, Eun-Kyu [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Surgery, Korea Cancer Center Hospital, Seoul (Korea, Republic of); Park, Jihyun; Byun, Byung Hyun [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Nuclear Medicine, Korea Cancer Center Hospital, 75 Nowongil, Nowon Gu, Seoul (Korea, Republic of); Park, Ji Ae; Kim, Kyeong Min [Korea Institute of Radiological and Medical Sciences (KIRAMS), Molecular Imaging Research Center, Seoul (Korea, Republic of); Park, Ko Woon [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of); Lee, Seung Sook [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Pathology, Korea Cancer Center Hospital, Seoul (Korea, Republic of); You, Eun Young [Gachon University School of Medicine and Science, Department of Radiology, Gil Hospital, Incheon (Korea, Republic of)

    2014-10-15

    The aim of this study was to investigate the potential of FDG PET/CT and MRI in predicting disease-free survival (DFS) after neoadjuvant chemotherapy (NAC) and surgery in patients with advanced breast cancer. The analysis included 54 women with advanced breast cancer. All patients received three cycles of NAC, underwent curative surgery, and then received three cycles of additional chemotherapy. Before and after the first cycle of NAC, all patients underwent sequential PET/CT and MRI. All patients were analysed using a diverse range of parameters. including maximal standardized uptake value (SUV), percent change in SUV (ΔSUV), initial slope of the enhancement curve (MRslope), apparent diffusion coefficient (ADC), tumour size, change in MRslope (ΔMRslope), change in ADC (ΔADC), change in tumour size (Δsize) and other clinicopathological parameters. The relationships between covariates and DFS after surgery were analysed using the Kaplan-Meier method and the multivariate Cox proportional hazards model. Time-dependent receiver operating characteristic curves were used to determine the optimal cut-off values of imaging parameters for DFS. Of the 54 patients, 13 (24 %) experienced recurrence at a median follow-up of 38 months (range 25 - 45 months). Univariate and multivariate analyses showed that a lesser decline in SUV, a lesser decline in MRslope, a lesser increase in ADC, and ER negativity were significantly associated with a poorer DFS (P = 0.0006, ΔSUV threshold -41 %; P = 0.0016, ΔMRslope threshold -6 %; P = 0.011, ΔADC threshold 11 %; and P = 0.0086, ER status, respectively). Patients with a combination of ΔSUV >-41 % and ΔMRslope >-6 % showed a significantly higher recurrence rate (77.8 %) than the remaining of patients (13.3 %, P < 0.0001). Functional parameters of both FDG PET and MRI after the first cycle of NAC are useful for predicting DFS in patients with advanced breast cancer. This approach could lead to an improvement in patient care because

  19. Evaluation of apical subtype of hypertrophic cardiomyopathy using cardiac magnetic resonance imaging with gadolinium enhancement.

    Science.gov (United States)

    Kebed, Kalie Y; Al Adham, Raed I; Bishu, Kalkidan; Askew, J Wells; Klarich, Kyle W; Araoz, Philip A; Foley, Thomas A; Glockner, James F; Nishimura, Rick A; Anavekar, Nandan S

    2014-09-01

    Apical hypertrophic cardiomyopathy (HC) is an uncommon variant of HC. We sought to characterize cardiac magnetic resonance imaging (MRI) findings among apical HC patients. This was a retrospective review of consecutive patients with a diagnosis of apical HC who underwent cardiac MRI examinations at the Mayo Clinic (Rochester, MN) from August 1999 to October 2011. Clinical and demographic data at the time of cardiac MRI study were abstracted. Cardiac MRI study and 2-dimensional echocardiograms performed within 6 months of the cardiac MRI were reviewed; 96 patients with apical HC underwent cardiac MRI examinations. LV end-diastolic and end-systolic volumes were 130.7 ± 39.1 ml and 44.2 ± 20.9 ml, respectively. Maximum LV thickness was 19 ± 5 mm. Hypertrophy extended beyond the apex into other segments in 57 (59.4%) patients. Obstructive physiology was seen in 12 (12.5%) and was more common in the mixed apical phenotype than the pure apical (19.3 vs 2.6%, p = 0.02). Apical pouches were noted in 39 (40.6%) patients. Late gadolinium enhancement (LGE) was present in 70 (74.5%) patients. LGE was associated with severe symptoms and increased maximal LV wall thickness. In conclusion, cardiac MRI is well suited for studying the apical form of HC because of difficulty imaging the cardiac apex with standard echocardiography. Cardiac MRI is uniquely suited to delineate the presence or absence of an apical pouch and abnormal myocardial LGE that may have implications in the natural history of apical HM. In particular, the presence of abnormal LGE is associated with clinical symptoms and increased wall thickness. PMID:25037678

  20. Cardiac rhabdomyosarcoma

    OpenAIRE

    Chlumský, Jaromír; Holá, Dana; Hlaváček, Karel; Michal, Michal; Švec, Alexander; Špatenka, Jaroslav; Dušek, Jan

    2001-01-01

    Cardiac sarcoma is a very rare neoplasm and is difficult to diagnose. The case of a 51-year-old man with a left atrial tumour, locally recurrent three months after its surgical removal, is presented. Computed tomography showed metastatic spread to the lung parenchyma. On revised histology, the mass extirpated was a sarcoma. Because of the metastatic spread, further therapy was symptomatic only; the patient died 15 months after the first manifestation of his problems. Immunohistochemical stain...

  1. Spinal cord motion. Influence of respiration and cardiac cycle

    Energy Technology Data Exchange (ETDEWEB)

    Winklhofer, S. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; University Hospital Zurich (Switzerland). Inst. of Diagnostic and Interventional Radiology; Schoth, F. [RWTH Aachen University Hospital (Germany). Dept. of Diagnostic Radiology; Stolzmann, P. [University Hospital Zurich (Switzerland). Inst. of Diagnostic and Interventional Radiology; Krings, T. [Toronto Western Hospital, ON (Canada). Div. of Neuroradiology; Mull, M.; Wiesmann, M. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; Stracke, C.P. [RWTH Aachen University Hospital (Germany). Dept. of Neuroradiology; Alfried-Krupp-Hospital, Essen (Germany). Dept. of Neuroradiology

    2014-11-15

    To assess physiological spinal cord motion during the cardiac cycle compared with the influence of respiration based on magnetic resonance imaging (MRI) measurements. Anterior-posterior spinal cord motion within the spinal canal was assessed in 16 healthy volunteers (median age, 25 years) by cardiac-triggered and cardiac-gated gradient echo pulse sequence MRI. Image acquisition was performed during breath-holding, normal breathing, and forced breathing. Normal spinal cord motion values were computed using descriptive statistics. Breathing-dependent differences were assessed using the Wilcoxon signed-rank test and compared with the cardiac-based cord motion. A normal value table was set up for the spinal cord motion of each vertebral cervico-thoracic-lumbar segment. Significant differences in cord motion were found between cardiac-based motion while breath-holding and the two breathing modalities (P < 0.01 each). Spinal cord motion was found to be highest during forced breathing, with a maximum in the lower cervical spinal segments (C5; mean, 2.1 mm ± 1.17). Image acquisition during breath-holding revealed the lowest motion. MRI permits the demonstration and evaluation of cardiac and respiration-dependent spinal cord motion within the spinal canal from the cervical to lumbar segments. Breathing conditions have a considerably greater impact than cardiac activity on spinal cord motion.

  2. What Is Chest MRI?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Chest MRI? Chest MRI (magnetic resonance imaging) is a safe, noninvasive test. "Noninvasive" means that ... your chest wall, heart, and blood vessels. Chest MRI uses radio waves, magnets, and a computer to ...

  3. Breast MRI scan

    Science.gov (United States)

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... your stomach on a narrow table with your breasts hanging down into cushioned openings. The table slides ...

  4. MRI (Magnetic Resonance Imaging)

    Science.gov (United States)

    ... Procedures Medical Imaging MRI (Magnetic Resonance Imaging) MRI (Magnetic Resonance Imaging) Share Tweet Linkedin Pin it More sharing options ... 8 MB) Also available in Other Language versions . Magnetic Resonance Imaging (MRI) is a medical imaging procedure for making ...

  5. Postmortem cardiac imaging in fetuses and children

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Andrew M. [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiorespiratory Division, Level 7, Old Nurses Home, London (United Kingdom); UCL Institute of Cardiovascular Science, London (United Kingdom); Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); UCL Institute of Cardiovascular Science, London (United Kingdom); Sebire, Neil J. [UCL Institute of Cardiovascular Science, London (United Kingdom); Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Histopathology, London (United Kingdom)

    2015-04-01

    Fetal and pediatric cardiac autopsies have a crucial role in the counseling of parents with regard to both the cause of death of their child and the implications of such findings for future pregnancies, as well as for quality assurance of antenatal screening programs and antemortem diagnostic procedures. Postmortem imaging allows an opportunity to investigate the heart in situ prior to dissection, and both postmortem CT and postmortem MRI have shown excellent accuracy in detecting the majority of clinically significant cardiac lesions in the perinatal and pediatric population. As less-invasive autopsy becomes increasingly popular, clinical guidelines for maximal diagnostic yield in specific circumstances can be developed. (orig.)

  6. Recent Advances in Nuclear Cardiology.

    Science.gov (United States)

    Lee, Won Woo

    2016-09-01

    Nuclear cardiology is one of the major fields of nuclear medicine practice. Myocardial perfusion studies using single-photon emission computed tomography (SPECT) have played a crucial role in the management of coronary artery diseases. Positron emission tomography (PET) has also been considered an important tool for the assessment of myocardial viability and perfusion. However, the recent development of computed tomography (CT)/magnetic resonance imaging (MRI) technologies and growing concerns about the radiation exposure of patients remain serious challenges for nuclear cardiology. In response to these challenges, remarkable achievements and improvements are currently in progress in the field of myocardial perfusion imaging regarding the applicable software and hardware. Additionally, myocardial perfusion positron emission tomography (PET) is receiving increasing attention owing to its unique capability of absolute myocardial blood flow estimation. An F-18-labeled perfusion agent for PET is under clinical trial with promising interim results. The applications of F-18 fluorodeoxyglucose (FDG) and F-18 sodium fluoride (NaF) to cardiovascular diseases have revealed details on the basic pathophysiology of ischemic heart diseases. PET/MRI seems to be particularly promising for nuclear cardiology in the future. Restrictive diseases, such as cardiac sarcoidosis and amyloidosis, are effectively evaluated using a variety of nuclear imaging tools. Considering these advances, the current challenges of nuclear cardiology will become opportunities if more collaborative efforts are devoted to this exciting field of nuclear medicine. PMID:27540423

  7. Magnetic Resonance Imaging (MRI)

    Science.gov (United States)

    ... How Can I Help a Friend Who Cuts? Magnetic Resonance Imaging (MRI) KidsHealth > For Teens > Magnetic Resonance Imaging (MRI) Print A A A Text Size What's ... Exam Safety Getting Your Results What Is MRI? Magnetic resonance imaging (MRI) is a type of safe, painless testing ...

  8. Value of MRI in predicting sudden cardiac death in patients with ischemic cardiomyopathy%MRI预测缺血性心肌病患者并发心源性猝死的价值

    Institute of Scientific and Technical Information of China (English)

    林长坚; 金奇; 吴立群

    2011-01-01

    @@ 冠心病是心源性猝死(sudden cardiac death,SCD)者最常见的病因,所占百分率可达80%[1].由冠心病导致心肌瘢痕形成的缺血性心肌病患者,其SCD发生率明显升高[2-3].射血分数降低是此类患者发生SCD的重要预测因子,但该指标仍缺乏较高的特异度及灵敏度[4].目前,SCD的预测主要围绕心肌电不稳定机制展开,包括T波电交替、心率振荡和心率变异性等[5].但对于缺血性心肌病患者产生心肌电不稳定的病理基质,如心肌瘢痕、瘢痕边缘区的检测,同样能提供有效的预测价值.近年来迅速发展的心脏磁共振(cardiac magnetic resonance,CMR)技术具有很高的组织分辨率和无创性等优点,可显示缺血性心肌病患者的心肌瘢痕及瘢痕边缘区,有助于SCD的危险分层及预测.

  9. Diffusion MRI

    Science.gov (United States)

    Fukuyama, Hidenao

    Recent advances of magnetic resonance imaging have been described, especially stressed on the diffusion sequences. We have recently applied the diffusion sequence to functional brain imaging, and found the appropriate results. In addition to the neurosciences fields, diffusion weighted images have improved the accuracies of clinical diagnosis depending upon magnetic resonance images in stroke as well as inflammations.

  10. Magnetic resonance imaging of congenital cardiac abnormalities

    International Nuclear Information System (INIS)

    Magnetic resonance imaging will not replace echocardiography as the simplest and most definitive method of establishing a noninvasive diagnosis in young patients with congenital cardiac malformations, nor will it replace radionuclide angiography for relatively noninvasive detection and quantitation of cardiac shunts. Magnetic resonance imaging is a complementary noninvasive imaging procedure that can answer some questions left in doubt by echocardiography (mainly extracardiac artery and vein assessments) or radionuclide angiography and used as a preferred follow-up imaging method in certain clinical circumstances. In addition, MRI can be a first-line modality for cardiovascular imaging in older patients in whom adequate echo windows are not available. Angiocardiography remains necessary to provide vital physiological data, i.e., chamber pressures, shunt volumes, oxygen saturations, and pulmonary vascular resistance; however, MRI could negate some follow-up catheterizations in appropriate clinical circumstances. High-resolution proton MRI tomography should ultimately permit the accurate evaluation of ventricular volumes, myocardial mass, and the assessment of regional wall motion and ejection fractions. Paramagnetic substances such as manganese ion may ultimately provide a basis for myocardial perfusion imaging. The potential for MRI evaluation of tissue characterization, noninvasive blood-flow measurements, and myocardial metabolism assessment in intriguing and awaits clinical evaluation

  11. [Advanced resuscitation of adults

    DEFF Research Database (Denmark)

    Lippert, F.K.; Lauritsen, T.L.; Torp-Pedersen, C.

    2008-01-01

    International and European Resuscitation Council (ERC) Guidelines for Resuscitation 2005 implicate major changes in resuscitation, including new universal treatment algorithms. This brief summary of Guidelines 2005 for advanced resuscitation of adult cardiac arrest victims is based upon the ERC...

  12. Nanomaterials for Cardiac Tissue Engineering Application

    Institute of Scientific and Technical Information of China (English)

    Yachen Zhang; Yong Tang; Ying Wang; Liying Zhang

    2011-01-01

    In recent years, the emerging cardiac tissue engineering provides a new therapeutic method for heart diseases. And in the tissue engineering, the scaffold material which can mimic the structure of the extracellular matrix properly is a key factor. The rapid expansion of nano-scaffolds during the past ten years has led to new perspectives and advances in biomedical research as well as in clinical practice. Here we search articles published in recent years extensively on cardiac tissue engineering scaffold materials and nanotechnology. And we review the traditional scaffold materials and the advances of the nano-scaffolds in cardiac tissue engineering. A thorough understanding of the nano-scaffolds would enable us to better exploit technologies to research the ideal scaffold material, and promote the cardiac tissue engineering using in the clinical practice as soon as possible.

  13. MANAGEMENT OF ALLOSENSITIZED CARDIAC TRANSPLANT CANDIDATES

    OpenAIRE

    Velez, Mauricio; Johnson, Maryl R.

    2009-01-01

    Cardiac transplantation remains the best treatment in advanced heart failure patients with a high risk of death. However, an inadequate supply of donor hearts decreases the likelihood of transplantation for many patients. Ventricular assist devices (VAD) are being increasingly used as a bridge to transplant in patients who may not survive long enough to receive a heart. This expansion in VAD use has been associated with increasing rates of allosensitization in cardiac transplant candidates. A...

  14. Cardiac and Respiratory Disease in Aged Horses.

    Science.gov (United States)

    Marr, Celia M

    2016-08-01

    Respiratory and cardiac diseases are common in older horses. Advancing age is a specific risk factor for cardiac murmurs and these are more likely in males and small horses. Airway inflammation is the most common respiratory diagnosis. Recurrent airway obstruction can lead to irreversible structural change and bronchiectasis; with chronic hypoxia, right heart dysfunction and failure can develop. Valvular heart disease most often affects the aortic and/or the mitral valve. Management of comorbidity is an essential element of the therapeutic approach to cardiac and respiratory disease in older equids.

  15. Non cardiopatic and cardiopatic beta thalassaemic patients: quantitative and qualitative cardiac iron deposition evaluation with MRI; Pazienti {beta} talassemici non cardiopatici e cardiopatici: valutazione quantitativa e qualitativa del deposito di ferro cardiaco con RM

    Energy Technology Data Exchange (ETDEWEB)

    Macarini, Luca; Marini, Stefania; Scardapane, Arnaldo [Bari Univ., Bari (Italy). DIMIMP-Sezione di Diagnostica per Immagini; Pietrapertosa, Anna [Bari Univ., Bari (Italy). MIDIM-Cattedra di Ematologia II; Ettore, Giovanni Carlo [Foggia Univ., Foggia (Italy). Cattedra di Radiologia

    2005-02-01

    Purpose: Cardiomyopathy is one of the major complications of {beta} thalassaemia major as a result of transfusion iron overload. The aim of our study is to evaluate with MR if there is any difference of iron deposition signal intensity (SI) or distribution between non-cardiopatic and cardiopatic thalassaemic patients in order to establish if there is a relationship between cardiopathy and iron deposition. Materials and methods: We studied 20 patients affected by {beta} thalassaemia major, of whom 10 cardiopatic and 10 non-cardiopatic, and 10 healthy volunteers as control group. Serum ferritin and left ventricular ejection fraction were calculated in thalassaemic patients. All patients were examinated using a 1.5 MR unit with ECG-gated GE cine-MR T2*-weighted, SE T1-weighted and GE T2*-weighted sequences. In all cases, using an adequate ROI, the myocardial and skeletal muscle signal intensity (SI), the myocardial/skeletal muscle signal intensity radio (SIR) and the SI average of the myocardium and skeletal muscle were calculated for every study group. The qualitative evaluation of iron deposition distribution was independently performed by three radiologists who analysed the extension, the site and the morphology of iron deposition on the MR images and reported their observations on the basis of a four-level rating scale: 0 (absent), 1 (limited), 2 (partial), 3 (widespread deposition). The results of quantitative and qualitative evaluation were analysed with statistical tests. Results: Cardiac iron deposition was found in 8/10 non-cardiopatic thalassaemic patients and in all cardiopatic thalassaemic patients. We noticed a significant SI difference (p>0.05) between the healthy volunteer control group and the thalassaemic patients with iron deposition, but no significant SI difference in iron deposition between non-cardiopatic thalassaemic patients in the areas evaluated. The qualitative evaluation revealed a different distribution of iron deposition between the two

  16. Physics of Cardiac Arrhythmogenesis

    Science.gov (United States)

    Karma, Alain

    2013-04-01

    A normal heartbeat is orchestrated by the stable propagation of an excitation wave that produces an orderly contraction. In contrast, wave turbulence in the ventricles, clinically known as ventricular fibrillation (VF), stops the heart from pumping and is lethal without prompt defibrillation. I review experimental, computational, and theoretical studies that have shed light on complex dynamical phenomena linked to the initiation, maintenance, and control of wave turbulence. I first discuss advances made to understand the precursor state to a reentrant arrhythmia where the refractory period of cardiac tissue becomes spatiotemporally disordered; this is known as an arrhythmogenic tissue substrate. I describe observed patterns of transmembrane voltage and intracellular calcium signaling that can contribute to this substrate, and symmetry breaking instabilities to explain their formation. I then survey mechanisms of wave turbulence and discuss novel methods that exploit electrical pacing stimuli to control precursor patterns and low-energy pulsed electric fields to control turbulence.

  17. A low cost DICOM review station for cardiac surgery

    NARCIS (Netherlands)

    Gerritsen, MG; Dijk, WA; Waterbolk, TW; Mook, PH; van der Velde, W; van der Putten, N; Dassen, WRM; Baljon, MH; Murray, A; Swiryn, S

    1998-01-01

    A low-cost PC based DICOM multi modality review station for cardiac surgery has been developed for use during Minimally Invasive Coronary Surgery. This system is a Windows 95 networked PC for review of DICOM coronary catheterization, ultrasound and MRI cine's stored at a departmental image server. F

  18. Temperature Management After Cardiac Arrest: An Advisory Statement by the Advanced Life Support Task Force of the International Liaison Committee on Resuscitation and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.

    Science.gov (United States)

    Donnino, Michael W; Andersen, Lars W; Berg, Katherine M; Reynolds, Joshua C; Nolan, Jerry P; Morley, Peter T; Lang, Eddy; Cocchi, Michael N; Xanthos, Theodoros; Callaway, Clifton W; Soar, Jasmeet

    2016-01-01

    For more than a decade, mild induced hypothermia (32 °C-34 °C) has been standard of care for patients remaining comatose after resuscitation from out-of-hospital cardiac arrest with an initial shockable rhythm, and this has been extrapolated to survivors of cardiac arrest with initially nonshockable rhythms and to patients with in-hospital cardiac arrest. Two randomized trials published in 2002 reported a survival and neurological benefit with mild induced hypothermia. One recent randomized trial reported similar outcomes in patients treated with targeted temperature management at either 33 °C or 36 °C. In response to these new data, the International Liaison Committee on Resuscitation Advanced Life Support Task Force performed a systematic review to evaluate 3 key questions: (1) Should mild induced hypothermia (or some form of targeted temperature management) be used in comatose post-cardiac arrest patients? (2) If used, what is the ideal timing of the intervention? (3) If used, what is the ideal duration of the intervention? The task force used Grading of Recommendations Assessment, Development and Evaluation methodology to assess and summarize the evidence and to provide a consensus on science statement and treatment recommendations. The task force recommends targeted temperature management for adults with out-of-hospital cardiac arrest with an initial shockable rhythm at a constant temperature between 32 °C and 36 °C for at least 24 hours. Similar suggestions are made for out-of-hospital cardiac arrest with a nonshockable rhythm and in-hospital cardiac arrest. The task force recommends against prehospital cooling with rapid infusion of large volumes of cold intravenous fluid. Additional and specific recommendations are provided in the document.

  19. Temperature Management After Cardiac Arrest: An Advisory Statement by the Advanced Life Support Task Force of the International Liaison Committee on Resuscitation and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.

    Science.gov (United States)

    Donnino, Michael W; Andersen, Lars W; Berg, Katherine M; Reynolds, Joshua C; Nolan, Jerry P; Morley, Peter T; Lang, Eddy; Cocchi, Michael N; Xanthos, Theodoros; Callaway, Clifton W; Soar, Jasmeet

    2016-01-01

    For more than a decade, mild induced hypothermia (32 °C-34 °C) has been standard of care for patients remaining comatose after resuscitation from out-of-hospital cardiac arrest with an initial shockable rhythm, and this has been extrapolated to survivors of cardiac arrest with initially nonshockable rhythms and to patients with in-hospital cardiac arrest. Two randomized trials published in 2002 reported a survival and neurological benefit with mild induced hypothermia. One recent randomized trial reported similar outcomes in patients treated with targeted temperature management at either 33 °C or 36 °C. In response to these new data, the International Liaison Committee on Resuscitation Advanced Life Support Task Force performed a systematic review to evaluate 3 key questions: (1) Should mild induced hypothermia (or some form of targeted temperature management) be used in comatose post-cardiac arrest patients? (2) If used, what is the ideal timing of the intervention? (3) If used, what is the ideal duration of the intervention? The task force used Grading of Recommendations Assessment, Development and Evaluation methodology to assess and summarize the evidence and to provide a consensus on science statement and treatment recommendations. The task force recommends targeted temperature management for adults with out-of-hospital cardiac arrest with an initial shockable rhythm at a constant temperature between 32 °C and 36 °C for at least 24 hours. Similar suggestions are made for out-of-hospital cardiac arrest with a nonshockable rhythm and in-hospital cardiac arrest. The task force recommends against prehospital cooling with rapid infusion of large volumes of cold intravenous fluid. Additional and specific recommendations are provided in the document. PMID:26449873

  20. Magnetic Resonance Imaging (MRI) Safety

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) Safety What is MRI and how does ... What is MRI and how does it work? Magnetic resonance imaging, or MRI, is a way of obtaining very ...

  1. Cardiac perception and cardiac control. A review.

    Science.gov (United States)

    Carroll, D

    1977-12-01

    The evidence regarding specific cardiac perception and discrimination, and its relationship to voluntary cardiac control, is critically reviewed. Studies are considered in three sections, depending on the method used to assess cardiac perception: questionnaire assessment, discrimination procedures, and heartbeat tracking. The heartbeat tracking procedure would appear to suffer least from interpretative difficulties. Recommendations are made regarding the style of analysis used to assess heartbeat perception in such tracking tasks. PMID:348240

  2. Evaluation of cardiac structures and function in hypertrophic cardiomyopathy with magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To assess the capability of magnetic resonance imaging(MRI)in evaluating the cardiac structures and function in the hypertrophic cardiomyopathy(HCM).Methods:Fourteen healthy volunteers and eighteen cases with HCM verified by history,clinical presentation,electrocardiogram and echocardiography(ECG)were performed with MRI.The myocardial thickness of interventricular septum at the basal segment and that of posterolateral free wall of the left ventricle(LV)were measured.Some indexes for evaluating cardiac function were measured using ARGUS auto-quantitative program.Resuits:The myocardial thickness of septum at the basal segment had significant difference between the HCM patients and the healthy volunteers.There was no significant difference between MRI and ECG in examining end-diastolic volume,ejection fraction of the LV.Conclusion:MRI can fully provide more information on the abnormalities of cardiac anatomy and function;thus,it is of great value in clinical application.

  3. Abdominal MRI scan

    Science.gov (United States)

    Nuclear magnetic resonance - abdomen; NMR - abdomen; Magnetic resonance imaging - abdomen; MRI of the abdomen ... spread. This is called staging. MRI avoids the dangers of angiography , such as too much radiation exposure ...

  4. MRI of the Chest

    Science.gov (United States)

    ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... over time. top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging ...

  5. Interventional MRI: update

    Energy Technology Data Exchange (ETDEWEB)

    Lufkin, R.B. [Department of Radiology, University of California Los Angeles, School of Medicine, 10 833 Le Comte Avenue, Los Angeles, CA 90024-1721 (United States); Gronemeyer, D.H.W.; Seibel, R.M.M. [Institute of Diagnostic and Interventional Radiology, Medical Computerscience, University Witten/Herdecke (Germany)

    1997-12-31

    Interventional MRI is in its early stages of development. Nevertheless, the design of new interventional MRI scanners that allow maximum direct access to the patient combined with the development of new interventional MRI pulse sequences and localization systems, means that the archetypal operating rooms of the 21st century may well contain dedicated interventional MRI units for combined radiological and surgical procedures. The present article looks at the state of interventional MRI today and looks ahead to what may be forthcoming in the not-too-distant future. After briefly discussing the instrumentation necessary for practical interventional MRI, the article will go on to describe a number of different approaches to, and clinical applications for, interventional MRI. The use of MRI in guiding and controlling tumor ablation, aspiration cytology and surgical biopsy of different body parts is described. (orig.) With 13 figs., 1 tab., 114 refs.

  6. Cardiac MRI in children and adolescents who have undergone surgical repair of right-sided congenital heart disease. Automated left ventricular volumes and function analysis and effects of different manual adjustments

    Energy Technology Data Exchange (ETDEWEB)

    Rompel, O.; Janka, R.; May, M.S.; Lell, M.M.; Uder, M.; Hammon, M. [University Hospital Erlangen (Germany). Dept. of Radiology; Gloeckler, M.; Dittrich, S. [University Hospital Erlangen (Germany). Dept. of Pediatric Cardiology; Cesnjevar, R. [University Hospital Erlangen (Germany). Dept. of Pediatric Cardiac Surgery

    2015-12-15

    To evaluate automated segmentation and the effects of different manual adjustments regarding left ventricular parameter quantification in cardiac magnetic resonance (MR) data on children and adolescents who have undergone surgical repair of right-sided congenital heart disease (CHD). Dedicated software (syngo.via, Siemens AG) was used to automatically segment and/or manually adjust the end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), myocardial mass (MM) and ejection fraction (EF) before/after manual apex/base adjustment (ADJ-step 1) and after manual apex/base/myocardial contour adjustment (ADJ-step 2; reference standard). MR data of 40 patients (13.1 ± 3.1y, 4-17y) with repaired CHD with decreased pulmonary blood flow (CHD-DPBF) were evaluated. Intra- and inter-rater reliability was determined for 10 randomly selected patients. The software correctly detected the left ventricle in 38/40 (95 %) patients. EDV after automated segmentation: 119.1 ± 44.0ml; after ADJ-step 1: 115.8 ± 39.5 ml; after ADJ-step 2: 116.2 ± 39.4 ml. The corresponding results for ESV were 52.0 ± 18.5/49.6 ± 16.9/49.7 ± 16.4 ml; for SV 67.1 ± 28.5/66.2 ± 25.4/66.5 ± 25.5 ml; for EF 55.5 ± 7.3/56.7 ± 6.6/56.7 ± 6.3%; for MM 83.7 ± 35.9/76.2 ± 28.3/74.6 ± 27.2 g. Significant differences were found for ESV/MM/EF comparing the automated segmentation results with these after ADJ-step 1 and ADJ-step 2. No significant differences were found when comparing all results of ADJ-step 1 and ADJ-step 2 or when comparing EDV/SV results. Intra- and inter-rater reliability was excellent. The mean time effort was 63.4 ± 6.9 s for the automated segmentation, 74.2 ± 8.9 s for ADJ-step 1 and 269.5 ± 39.4 s for ADJ-step 2. Automated left ventricular volumes and function analysis in children and adolescents with surgically treated CHD proved to be feasible with excellent intra- and inter-rater reliability. Automated segmentation with manual apex/base adjustment provided

  7. Cardiac MRI in children and adolescents who have undergone surgical repair of right-sided congenital heart disease. Automated left ventricular volumes and function analysis and effects of different manual adjustments

    International Nuclear Information System (INIS)

    To evaluate automated segmentation and the effects of different manual adjustments regarding left ventricular parameter quantification in cardiac magnetic resonance (MR) data on children and adolescents who have undergone surgical repair of right-sided congenital heart disease (CHD). Dedicated software (syngo.via, Siemens AG) was used to automatically segment and/or manually adjust the end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), myocardial mass (MM) and ejection fraction (EF) before/after manual apex/base adjustment (ADJ-step 1) and after manual apex/base/myocardial contour adjustment (ADJ-step 2; reference standard). MR data of 40 patients (13.1 ± 3.1y, 4-17y) with repaired CHD with decreased pulmonary blood flow (CHD-DPBF) were evaluated. Intra- and inter-rater reliability was determined for 10 randomly selected patients. The software correctly detected the left ventricle in 38/40 (95 %) patients. EDV after automated segmentation: 119.1 ± 44.0ml; after ADJ-step 1: 115.8 ± 39.5 ml; after ADJ-step 2: 116.2 ± 39.4 ml. The corresponding results for ESV were 52.0 ± 18.5/49.6 ± 16.9/49.7 ± 16.4 ml; for SV 67.1 ± 28.5/66.2 ± 25.4/66.5 ± 25.5 ml; for EF 55.5 ± 7.3/56.7 ± 6.6/56.7 ± 6.3%; for MM 83.7 ± 35.9/76.2 ± 28.3/74.6 ± 27.2 g. Significant differences were found for ESV/MM/EF comparing the automated segmentation results with these after ADJ-step 1 and ADJ-step 2. No significant differences were found when comparing all results of ADJ-step 1 and ADJ-step 2 or when comparing EDV/SV results. Intra- and inter-rater reliability was excellent. The mean time effort was 63.4 ± 6.9 s for the automated segmentation, 74.2 ± 8.9 s for ADJ-step 1 and 269.5 ± 39.4 s for ADJ-step 2. Automated left ventricular volumes and function analysis in children and adolescents with surgically treated CHD proved to be feasible with excellent intra- and inter-rater reliability. Automated segmentation with manual apex/base adjustment provided

  8. Minimally Invasive Cardiac Surgery: Transapical Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Ming Li

    2012-01-01

    Full Text Available Minimally invasive cardiac surgery is less traumatic and therefore leads to quicker recovery. With the assistance of engineering technologies on devices, imaging, and robotics, in conjunction with surgical technique, minimally invasive cardiac surgery will improve clinical outcomes and expand the cohort of patients that can be treated. We used transapical aortic valve implantation as an example to demonstrate that minimally invasive cardiac surgery can be implemented with the integration of surgical techniques and engineering technologies. Feasibility studies and long-term evaluation results prove that transapical aortic valve implantation under MRI guidance is feasible and practical. We are investigating an MRI compatible robotic surgical system to further assist the surgeon to precisely deliver aortic valve prostheses via a transapical approach. Ex vivo experimentation results indicate that a robotic system can also be employed in in vivo models.

  9. Neuromuscular blockade in cardiac surgery: An update for clinicians

    OpenAIRE

    Hemmerling Thomas; Russo Gianluca; Bracco David

    2008-01-01

    There have been great advancements in cardiac surgery over the last two decades; the widespread use of off-pump aortocoronary bypass surgery, minimally invasive cardiac surgery, and robotic surgery have also changed the face of cardiac anaesthesia. The concept of "Fast-track anaesthesia" demands the use of nondepolarising neuromuscular blocking drugs with short duration of action, combining the ability to provide (if necessary) sufficiently profound neuromuscular blockade during surgery and i...

  10. Recommendations for real-time speech MRI.

    Science.gov (United States)

    Lingala, Sajan Goud; Sutton, Brad P; Miquel, Marc E; Nayak, Krishna S

    2016-01-01

    Real-time magnetic resonance imaging (RT-MRI) is being increasingly used for speech and vocal production research studies. Several imaging protocols have emerged based on advances in RT-MRI acquisition, reconstruction, and audio-processing methods. This review summarizes the state-of-the-art, discusses technical considerations, and provides specific guidance for new groups entering this field. We provide recommendations for performing RT-MRI of the upper airway. This is a consensus statement stemming from the ISMRM-endorsed Speech MRI summit held in Los Angeles, February 2014. A major unmet need identified at the summit was the need for consensus on protocols that can be easily adapted by researchers equipped with conventional MRI systems. To this end, we provide a discussion of tradeoffs in RT-MRI in terms of acquisition requirements, a priori assumptions, artifacts, computational load, and performance for different speech tasks. We provide four recommended protocols and identify appropriate acquisition and reconstruction tools. We list pointers to open-source software that facilitate implementation. We conclude by discussing current open challenges in the methodological aspects of RT-MRI of speech. PMID:26174802

  11. Recommendations for Real-Time Speech MRI

    Science.gov (United States)

    Lingala, Sajan Goud; Sutton, Brad P.; Miquel, Marc E.; Nayak, Krishna S.

    2016-01-01

    Real-time magnetic resonance imaging (RT-MRI) is being increasingly used for speech and vocal production research studies. Several imaging protocols have emerged based on advances in RT-MRI acquisition, reconstruction, and audio-processing methods. This review summarizes the state-of-the-art, discusses technical considerations, and provides specific guidance for new groups entering this field. We provide recommendations for performing RT-MRI of the upper airway. This is a consensus statement stemming from the ISMRM-endorsed Speech MRI summit held in Los Angeles, February 2014. A major unmet need identified at the summit was the need for consensus on protocols that can be easily adapted by researchers equipped with conventional MRI systems. To this end, we provide a discussion of tradeoffs in RT-MRI in terms of acquisition requirements, a priori assumptions, artifacts, computational load, and performance for different speech tasks. We provide four recommended protocols and identify appropriate acquisition and reconstruction tools. We list pointers to open-source software that facilitate implementation. We conclude by discussing current open challenges in the methodological aspects of RT-MRI of speech. PMID:26174802

  12. Getting an MRI

    Medline Plus

    Full Text Available ... Skating Crushes What's a Booger? Getting an MRI (Video) KidsHealth > For Kids > Getting an MRI (Video) Print A A A Text Size en español Obtención de una resonancia magnética, RM (video) An MRI (magnetic resonance imaging) scan creates detailed ...

  13. Getting an MRI

    Science.gov (United States)

    ... Snowboarding, Skating Crushes What's a Booger? Getting an MRI (Video) KidsHealth > For Kids > Getting an MRI (Video) Print A A A Text Size en ... Obtención de una resonancia magnética, RM (video) An MRI (magnetic resonance imaging) scan creates detailed pictures of ...

  14. Getting an MRI

    Medline Plus

    Full Text Available ... Snowboarding, Skating Crushes What's a Booger? Getting an MRI (Video) KidsHealth > For Kids > Getting an MRI (Video) Print A A A Text Size en ... Obtención de una resonancia magnética, RM (video) An MRI (magnetic resonance imaging) scan creates detailed pictures of ...

  15. MRI in acute poliomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Kornreich, L. [Imaging Department, The Schneider Children`s Medical Centre of Israel, Kaplan Street, Petah Tiqva 49202 (Israel)]|[Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Dagan, O. [The Intensive Care Unit, The Schneider Children`s Medical Centre of Israel, Beilinson Medical Campus, Petah Tiqva (Israel)]|[Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Grunebaum, M. [Imaging Department, The Schneider Children`s Medical Centre of Israel, Kaplan Street, Petah Tiqva 49202 (Israel)]|[Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    1996-05-01

    MRI can be used in the diagnosis of anterior horn infection and for assessing the extent of disease. There are no specific MRI signs to differentiate between the various possible pathogens. This is demonstrated in the present case of poliomyelitis, in which MRI of the spine played an important role in establishing the diagnosis. (orig.). With 1 fig.

  16. fMRI Neuroinformatics

    DEFF Research Database (Denmark)

    Nielsen, Finn Årup; Christensen, Mark Schram; Madsen, Kristoffer M.;

    2006-01-01

    Functional magnetic resonance imaging (fMRI) generates vast amounts of data. The handling, processing, and analysis of fMRI data would be inconceivable without computer-based methods. fMRI neuroinformatics is concerned with research, development, and operation of these methods. Reconstruction...

  17. Dynamic MRI CSF imaging

    International Nuclear Information System (INIS)

    Full text: Understanding of the cerebrospinal fluid (CSF) flow physiological and anatomical substrate underwent the revolutionary process during the last one hundred years, resulting with the theory of what we call today the 'bulk' flow. Due to almost incredible technological advance we experienced a prominent clinical and experimental advance in the field of CSF creation, flow, and absorption that have brought the 'bulk' flow theory partly under question. There are still a large number of uncertainties in our truly understanding of basic CSF flow physiology, but also pathology, that are persistently present, requesting further and ever more advanced investigation in order to provide the most adequate diagnosis for the benefit of the patient. It is my strong believe that the diagnostic reality nowadays is that we are still facing the major lack of understanding how is CSF actually created, what are the CSF pathways trough the intracranial and extracranial spaces, and finally where and how does CSF got absorbed. This certainly opens the space for numerous different theories pretending to give correct explanation of CSF physiological behavior. On the other hand, a proper and valuable technique which would provide us with the wanted information may still not be available at the present time. Therefore, as the radiologists examining the patients with CSF flow disorders, we are constantly challenged by the number of questions in an attempt to achieve the relevant and overall, accurate diagnostic information on the type of the CSF flow disorder, in order to facilitate the planning of the better individually optimized neurosurgical treatment. Though MRI, with mostly used phase-contrast but also technically older maximum dephasing techniques allows dynamic CSF flow visualization introducing us into the field of CSF hydrodynamics disorder diagnostics, we should face the fact that in the routine radiological examination with currently available and most dedicated

  18. Advanced MRI increases the diagnostic accuracy of recurrent glioblastoma: Single institution thresholds and validation of MR spectroscopy and diffusion weighted MR imaging

    Directory of Open Access Journals (Sweden)

    Tomas Kazda

    2016-01-01

    Full Text Available The accurate identification of glioblastoma progression remains an unmet clinical need. The aim of this prospective single-institutional study is to determine and validate thresholds for the main metabolite concentrations obtained by MR spectroscopy (MRS and the values of the apparent diffusion coefficient (ADC to enable distinguishing tumor recurrence from pseudoprogression. Thirty-nine patients after the standard treatment of a glioblastoma underwent advanced imaging by MRS and ADC at the time of suspected recurrence — median time to progression was 6.7 months. The highest significant sensitivity and specificity to call the glioblastoma recurrence was observed for the total choline (tCho to total N-acetylaspartate (tNAA concentration ratio with the threshold ≥1.3 (sensitivity 100.0% and specificity 94.7%. The ADCmean value higher than 1313 × 10−6 mm2/s was associated with the pseudoprogression (sensitivity 98.3%, specificity 100.0%. The combination of MRS focused on the tCho/tNAA concentration ratio and the ADCmean value represents imaging methods applicable to early non-invasive differentiation between a glioblastoma recurrence and a pseudoprogression. However, the institutional definition and validation of thresholds for differential diagnostics is needed for the elimination of setup errors before implementation of these multimodal imaging techniques into clinical practice, as well as into clinical trials.

  19. Sudden cardiac death risk stratification.

    Science.gov (United States)

    Deyell, Marc W; Krahn, Andrew D; Goldberger, Jeffrey J

    2015-06-01

    Arrhythmic sudden cardiac death (SCD) may be caused by ventricular tachycardia/fibrillation or pulseless electric activity/asystole. Effective risk stratification to identify patients at risk of arrhythmic SCD is essential for targeting our healthcare and research resources to tackle this important public health issue. Although our understanding of SCD because of pulseless electric activity/asystole is growing, the overwhelming majority of research in risk stratification has focused on SCD-ventricular tachycardia/ventricular fibrillation. This review focuses on existing and novel risk stratification tools for SCD-ventricular tachycardia/ventricular fibrillation. For patients with left ventricular dysfunction or myocardial infarction, advances in imaging, measures of cardiac autonomic function, and measures of repolarization have shown considerable promise in refining risk. Yet the majority of SCD-ventricular tachycardia/ventricular fibrillation occurs in patients without known cardiac disease. Biomarkers and novel imaging techniques may provide further risk stratification in the general population beyond traditional risk stratification for coronary artery disease alone. Despite these advances, significant challenges in risk stratification remain that must be overcome before a meaningful impact on SCD can be realized.

  20. Cardiac resynchronization therapy in a patient with amyloid cardiomyopathy.

    Science.gov (United States)

    Zizek, David; Cvijić, Marta; Zupan, Igor

    2013-06-01

    Cardiac involvement in systemic light chain amyloidosis carries poor prognosis. Amyloid deposition in the myocardium can alter regional left ventricular contraction and cause dyssynchrony. Cardiac resynchronization therapy (CRT) is an effective treatment strategy for patients with advanced heart failure and echocardiographic dyssynchrony. We report a clinical and echocardiographic response of a patient with amyloid cardiomyopathy, treated with a combination of chemotherapy and CRT.

  1. Technological Solutions for Cardiac Surgery in the Elderly

    OpenAIRE

    Rony-Reuven Nir; Gil Bolotin

    2013-01-01

    The current review addresses contemporary technological advances in cardiac surgery performed on octogenarian patients, namely off-pump coronary artery bypass grafting (CABG), proximal anastomosis device, routine use of intraoperative epiaortic ultrasound, proximal anastomosis without clamping, transcatheter aortic valve implantation (TAVI), and brain protection during cardiac surgery.

  2. Optimized cardiac resynchronization therapy in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    NIU Hong-xia; HUA Wei; ZHANG Shu; SUN Xin; CHEN Ke-ping; WANG Fang-zheng; CHEN Xin

    2007-01-01

    @@ Heart failure was a major and increasing public health problem, with an almost "epidemic increase in the number of patients.1 Despite recent advances in pharmacotherapy, the prognosis remains poor. Cardiac resynchronization therapy (CRT), by pacing right and left ventricles, has been proved to improve symptoms and reduce mortality for heart failure patients with cardiac dyssynchrony.

  3. Cardiac sympathetic neuronal imaging using PET

    Energy Technology Data Exchange (ETDEWEB)

    Lautamaeki, Riikka; Tipre, Dnyanesh [Johns Hopkins University, Division of Nuclear Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Bengel, Frank M. [Johns Hopkins University, Division of Nuclear Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Cardiovascular Nuclear Medicine, Baltimore, MD (United States)

    2007-06-15

    Balance of the autonomic nervous system is essential for adequate cardiac performance, and alterations seem to play a key role in the development and progression of various cardiac diseases. PET imaging of the cardiac autonomic nervous system has advanced extensively in recent years, and multiple pre- and postsynaptic tracers have been introduced. The high spatial and temporal resolution of PET enables noninvasive quantification of neurophysiologic processes at the tissue level. Ligands for catecholamine receptors, along with radiolabeled catecholamines and catecholamine analogs, have been applied to determine involvement of sympathetic dysinnervation at different stages of heart diseases such as ischemia, heart failure, and arrhythmia. This review summarizes the recent findings in neurocardiological PET imaging. Experimental studies with several radioligands and clinical findings in cardiac dysautonomias are discussed. (orig.)

  4. Leadless Cardiac Pacemakers: Back to the Future.

    Science.gov (United States)

    Miller, Marc A; Neuzil, Petr; Dukkipati, Srinivas R; Reddy, Vivek Y

    2015-09-01

    Despite significant advances in battery longevity, lead performance, and programming features since the first implanted permanent pacemaker was developed, the basic design of cardiac pacemakers has remained relatively unchanged over the past 50 years. Because of inherent limitations in their design, conventional (transvenous) pacemakers are prone to multiple potential short- and long-term complications. Accordingly, there has been intense interest in a system able to provide the symptomatic and potentially lifesaving therapies of cardiac pacemakers while mitigating many of the risks associated with their weakest link-the transvenous lead. Leadless cardiac pacing represents the future of cardiac pacing systems, similar to the transition that occurred from the use of epicardial pacing systems to the familiar transvenous systems of today. This review summarizes the current evidence and potential benefits of leadless pacing systems, which are either commercially available (in Europe) or under clinical investigation. PMID:26337997

  5. Cardiac sodium channelopathies

    NARCIS (Netherlands)

    A.S. Amin; A. Asghari-Roodsari; H.L. Tan

    2010-01-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (I-Na) during phase 0 of the cardiac action potential. The importance of I-Na for normal cardiac electrical activity is reflected by the high incidence of

  6. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  7. Pharmacological MRI (phMRI) of the Human Central Nervous System.

    Science.gov (United States)

    Lanfermann, H; Schindler, C; Jordan, J; Krug, N; Raab, P

    2015-10-01

    Pharmacological magnetic resonance imaging (phMRI) of the central nervous system (CNS) addresses the increasing demands in the biopharma industry for new methods that can accurately predict, as early as possible, whether novel CNS agents will be effective and safe. Imaging of physiological and molecular-level function can provide a more direct measure of a drug mechanism of action, enabling more predictive measures of drug activity. The availability of phMRI of the nervous system within the professional infrastructure of the Clinical Research Center (CRC) Hannover as proof of concept center ensures that advances in basic science progress swiftly into benefits for patients. Advanced standardized MRI techniques including quantitative MRI, kurtosis determination, functional MRI, and spectroscopic imaging of the entire brain are necessary for phMRI. As a result, MR scanners will evolve into high-precision measuring instruments for assessment of desirable and undesirable effects of drugs as the basic precondition for individually tailored therapy. The CRC's Imaging Unit with high-end large-scale equipment will allow the following unique opportunities: for example, identification of MR-based biomarkers to assess the effect of drugs (surrogate parameters), establishment of normal levels and reference ranges for MRI-based biomarkers, evaluation of the most relevant MRI sequences for drug monitoring in outpatient care. Another very important prerequisite for phMRI is the MHH Core Facility as the scientific and operational study unit of the CRC partner Hannover Medical School. This unit is responsible for the study coordination, conduction, complete study logistics, administration, and application of the quality assurance system based on required industry standards.

  8. The value of cardiac genetic testing.

    Science.gov (United States)

    Ingles, Jodie; Semsarian, Christopher

    2014-08-01

    Genetic testing is an important and necessary aspect of the management of families with cardiac genetic conditions. Commercial genetic tests are available for most cardiac genetic diseases, and increasing uptake amongst patients has contributed to a vastly improved knowledge of the genetic basis of these diseases. The incredible advances in genetic technologies have translated to faster, more comprehensive, and inexpensive commercial genetic tests and has completely changed the landscape of commercial genetic testing in recent years. While there are enormous challenges, mostly relating to interpretation of variants, the value of a genetic diagnosis should not be underestimated. In almost all cases, the single greatest utility is for the predictive genetic testing of family members. This review will describe the value of cardiac genetic testing in the current climate of rapid genetic advancements.

  9. MRI for the evaluation of pectus excavatum

    Energy Technology Data Exchange (ETDEWEB)

    Marcovici, Peter A. [University of California, San Diego, Department of Radiology, San Diego, CA (United States); LoSasso, Barry E. [Children' s Hospital and Health Center, Department of Surgery, San Diego, CA (United States); Kruk, Peter; Dwek, Jerry R. [Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States)

    2011-06-15

    Pectus excavatum, the most common congenital deformity of the anterior chest wall, is both a cosmetic and functional abnormality. The degree of abnormal chest wall deformity determines its functional effect, particularly its cardiac and pulmonary impact. Although CT scanning is the most widely used cross-sectional imaging technique used to measure the Haller index, the radiation exposure is reason to seek other alternatives. At our institution, we have introduced a rapid MRI technique for this purpose, which utilizes a single-axial 2-D FIESTA acquisition. (orig.)

  10. Imaging pitfalls, normal anatomy, and anatomical variants that can simulate disease on cardiac imaging as demonstrated on multidetector computed tomography

    International Nuclear Information System (INIS)

    Advances in computed tomography have led to continuous improvement in cardiac imaging. Dedicated postprocessing capabilities, faster scan times, and cardiac gating methods reveal details of normal cardiac anatomy and anatomic variants that can mimic pathologic conditions. This article will review normal cardiac anatomy and variants that can mimic disease. Radiologists should be familiar with normal cardiac anatomy and anatomic variants to avoid misinterpretation of normal findings for pathologic processes

  11. High-resolution functional MRI of the human amygdala at 7 T

    International Nuclear Information System (INIS)

    Functional magnetic resonance imaging (fMRI) has become the primary non-invasive method for investigating the human brain function. With an increasing number of ultra-high field MR systems worldwide possibilities of higher spatial and temporal resolution in combination with increased sensitivity and specificity are expected to advance detailed imaging of distinct cortical brain areas and subcortical structures. One target region of particular importance to applications in psychiatry and psychology is the amygdala. However, ultra-high field magnetic resonance imaging of these ventral brain regions is a challenging endeavor that requires particular methodological considerations. Ventral brain areas are particularly prone to signal losses arising from strong magnetic field inhomogeneities along susceptibility borders. In addition, physiological artifacts from respiration and cardiac action cause considerable fluctuations in the MR signal. Here we show that, despite these challenges, fMRI data from the amygdala may be obtained with high temporal and spatial resolution combined with increased signal-to-noise ratio. Maps of neural activation during a facial emotion discrimination paradigm at 7 T are presented and clearly show the gain in percental signal change compared to 3 T results, demonstrating the potential benefits of ultra-high field functional MR imaging also in ventral brain areas

  12. High-resolution functional MRI of the human amygdala at 7 T

    Energy Technology Data Exchange (ETDEWEB)

    Sladky, Ronald, E-mail: ronald.sladky@meduniwien.ac.at [MR Centre of Excellence, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna (Austria); Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Baldinger, Pia; Kranz, Georg S. [Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Tröstl, Jasmin [MR Centre of Excellence, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna (Austria); Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Höflich, Anna; Lanzenberger, Rupert [Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Moser, Ewald [MR Centre of Excellence, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna (Austria); Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Windischberger, Christian, E-mail: christian.windischberger@meduniwien.ac.at [MR Centre of Excellence, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna (Austria); Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria)

    2013-05-15

    Functional magnetic resonance imaging (fMRI) has become the primary non-invasive method for investigating the human brain function. With an increasing number of ultra-high field MR systems worldwide possibilities of higher spatial and temporal resolution in combination with increased sensitivity and specificity are expected to advance detailed imaging of distinct cortical brain areas and subcortical structures. One target region of particular importance to applications in psychiatry and psychology is the amygdala. However, ultra-high field magnetic resonance imaging of these ventral brain regions is a challenging endeavor that requires particular methodological considerations. Ventral brain areas are particularly prone to signal losses arising from strong magnetic field inhomogeneities along susceptibility borders. In addition, physiological artifacts from respiration and cardiac action cause considerable fluctuations in the MR signal. Here we show that, despite these challenges, fMRI data from the amygdala may be obtained with high temporal and spatial resolution combined with increased signal-to-noise ratio. Maps of neural activation during a facial emotion discrimination paradigm at 7 T are presented and clearly show the gain in percental signal change compared to 3 T results, demonstrating the potential benefits of ultra-high field functional MR imaging also in ventral brain areas.

  13. MRI in psychiatry

    Energy Technology Data Exchange (ETDEWEB)

    Mulert, Christoph [UKE, Hamburg (Germany). Psychiatry Neuroimaging Branch; Shenton, Martha E. (ed.) [Harvard Medical School, Boston, MA (United States). Dept. of Psychiatry and Radiology

    2014-07-01

    This is the first comprehensive textbook on the use of MRI in psychiatry covering imaging techniques, brain systems and a review of findings in different psychiatric disorders. The book is divided into three sections, the first of which covers in detail all the major MRI-based methodological approaches available today, including fMRI, EEG-fMRI, DTI, and MR spectroscopy. In addition, the role of MRI in imaging genetics and combined brain stimulation and imaging is carefully explained. The second section provides an overview of the different brain systems that are relevant for psychiatric disorders, including the systems for perception, emotion, cognition, and reward. The final part of the book presents the MRI findings that are obtained in all the major psychiatric disorders using the previously discussed techniques. Numerous carefully chosen images support the informative text, making this an ideal reference work for all practitioners and trainees with an interest in this flourishing field.

  14. High frame rate retrospectively triggered Cine MRI for assessment of murine diastolic function.

    Science.gov (United States)

    Coolen, Bram F; Abdurrachim, Desiree; Motaal, Abdallah G; Nicolay, Klaas; Prompers, Jeanine J; Strijkers, Gustav J

    2013-03-01

    To assess left ventricular (LV) diastolic function in mice with Cine MRI, a high frame rate (>60 frames per cardiac cycle) is required. For conventional electrocardiography-triggered Cine MRI, the frame rate is inversely proportional to the pulse repetition time (TR). However, TR cannot be lowered at will to increase the frame rate because of gradient hardware, spatial resolution, and signal-to-noise limitations. To overcome these limitations associated with electrocardiography-triggered Cine MRI, in this paper, we introduce a retrospectively triggered Cine MRI protocol capable of producing high-resolution high frame rate Cine MRI of the mouse heart for addressing left ventricular diastolic function. Simulations were performed to investigate the influence of MRI sequence parameters and the k-space filling trajectory in relation to the desired number of frames per cardiac cycle. An optimized protocol was applied in vivo and compared with electrocardiography-triggered Cine for which a high-frame rate could only be achieved by several interleaved acquisitions. Retrospective high frame rate Cine MRI proved superior to the interleaved electrocardiography-triggered protocols. High spatial-resolution Cine movies with frames rates up to 80 frames per cardiac cycle were obtained in 25 min. Analysis of left ventricular filling rate curves allowed accurate determination of early and late filling rates and revealed subtle impairments in left ventricular diastolic function of diabetic mice in comparison with nondiabetic mice.

  15. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head ... limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is ...

  16. Cine magnetic resonance imaging for evaluation of cardiac structure and flow dynamics in congenital heart disease

    International Nuclear Information System (INIS)

    Cine magnetic resonance imaging (Cine MRI) was performed in 20 patients aged 19 days to 13 years (mean 4.0 years), who had congenital heart disease confirmed at echocardiography or angiography. Prior to cine MRI, gated MRI was performed to evaluate for cardiac structure. Cine MRI was demonstrated by fast low fip angle shot imaging technique with a 30deg flip angle, 15 msec echo time, 30-40 msec pulse repetition time, and 128 x 128 acquisition matrix. Abnormalities of cardiac structure were extremely well defined in all patients by gated MRI. Intracardiac or intravascular blood flow were visualized in 17 (85%) of 20 patients by cine MRI. Left to right shunt flow through ventricular septal defect, atrial septal defect, and endocardial cushion defect were visualized with low signal intensity area. Low intensity jets flow through the site of re-coarctation of the aorta were also visualized. However, the good recording of cine MRI was not obtained because of artifacts in 3 of 20 patients (15%) who had severe congestive heart failure or respiratory arrhythmia. Gated MRI provides excellent visualization of fine structure, and cine MRI can provide high spatial resolution imaging of flow dynamic in a variety of congenital heart disease, noninvasively. (author)

  17. MRI brain imaging.

    Science.gov (United States)

    Skinner, Sarah

    2013-11-01

    General practitioners (GPs) are expected to be allowed to request MRI scans for adults for selected clinically appropriate indications from November 2013 as part of the expansion of Medicare-funded MRI services announced by the Federal Government in 2011. This article aims to give a brief overview of MRI brain imaging relevant to GPs, which will facilitate explanation of scan findings and management planning with their patients. Basic imaging techniques, common findings and terminology are presented using some illustrative case examples.

  18. Cardiac stress MR imaging with dobutamine

    Energy Technology Data Exchange (ETDEWEB)

    Strach, K.; Meyer, C.; Schild, H.; Sommer, T. [University of Bonn, Department of Radiology, Bonn (Germany)

    2006-12-15

    Stress testing for detection of ischemia-induced wall-motion abnormalities has become a mainstay for noninvasive diagnosis and risk stratification of patients with suspected coronary artery disease (CAD). Recent technical developments in magnetic resonance imaging (MRI), including the adoption of balanced steady-state free precession (b-SSFP) sequences - preferentially in combination with parallel imaging techniques - have led to a significant reduction of imaging time and improved patient safety. The stress protocol includes application of high-dose dobutamine (up to 40 {mu}g/kg/min) combined with fractionated atropine (up to a maximal dose of 1.0 mg). High-dose dobutamine stress MRI revealed good sensitivity (83-96%) and specificity (80-100%) for detection of significant CAD. Myocardial tagging methods have been shown to further increase sensitivity for CAD detection. Severe complications (sustained tachycardia, ventricular fibrillation, myocardial infarction, cardiogenic shock) are rare but may be expected in 0.1-0.3% of patients. Dobutamine stress MRI has emerged as a reliable and safe clinical alternative for noninvasive assessment of CAD. New pulse sequences, such as real-time imaging, might obviate the need for breath holding and electrocardiogram (ECG) triggering in patients with severe dyspnoea and cardiac arrhythmias, which may further improve the clinical impact and acceptance of stress MRI in the future. (orig.)

  19. Diffusion and perfusion MRI of the lung and mediastinum

    Energy Technology Data Exchange (ETDEWEB)

    Henzler, Thomas, E-mail: Thomas.Henzler@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University (Germany); Schmid-Bindert, Gerald [Interdisciplinary Thoracic Oncology, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University (Germany); Schoenberg, Stefan O.; Fink, Christian [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University (Germany)

    2010-12-15

    With ongoing technical improvements such as multichannel MRI, systems with powerful gradients as well as the development of innovative pulse sequence techniques implementing parallel imaging, MRI has now entered the stage of a radiation-free alternative to computed tomography (CT) for chest imaging in clinical practice. Whereas in the past MRI of the lung was focused on morphological aspects, current MRI techniques also enable functional imaging of the lung allowing for a comprehensive assessment of lung disease in a single MRI exam. Perfusion imaging can be used for the visualization of regional pulmonary perfusion in patients with different lung diseases such as lung cancer, chronic obstructive lung disease, pulmonary embolism or for the prediction of postoperative lung function in lung cancer patients. Over the past years diffusion-weighted MR imaging (DW-MRI) of the thorax has become feasible with a significant reduction of the acquisition time, thus minimizing artifacts from respiratory and cardiac motion. In chest imaging, DW-MRI has been mainly suggested for the characterization of lung cancer, lymph nodes and pulmonary metastases. In this review article recent MR perfusion and diffusion techniques of the lung and mediastinum as well as their clinical applications are reviewed.

  20. Diffusion and perfusion MRI of the lung and mediastinum.

    Science.gov (United States)

    Henzler, Thomas; Schmid-Bindert, Gerald; Schoenberg, Stefan O; Fink, Christian

    2010-12-01

    With ongoing technical improvements such as multichannel MRI, systems with powerful gradients as well as the development of innovative pulse sequence techniques implementing parallel imaging, MRI has now entered the stage of a radiation-free alternative to computed tomography (CT) for chest imaging in clinical practice. Whereas in the past MRI of the lung was focused on morphological aspects, current MRI techniques also enable functional imaging of the lung allowing for a comprehensive assessment of lung disease in a single MRI exam. Perfusion imaging can be used for the visualization of regional pulmonary perfusion in patients with different lung diseases such as lung cancer, chronic obstructive lung disease, pulmonary embolism or for the prediction of postoperative lung function in lung cancer patients. Over the past years diffusion-weighted MR imaging (DW-MRI) of the thorax has become feasible with a significant reduction of the acquisition time, thus minimizing artifacts from respiratory and cardiac motion. In chest imaging, DW-MRI has been mainly suggested for the characterization of lung cancer, lymph nodes and pulmonary metastases. In this review article recent MR perfusion and diffusion techniques of the lung and mediastinum as well as their clinical applications are reviewed. PMID:20627435

  1. Diffusion and perfusion MRI of the lung and mediastinum

    International Nuclear Information System (INIS)

    With ongoing technical improvements such as multichannel MRI, systems with powerful gradients as well as the development of innovative pulse sequence techniques implementing parallel imaging, MRI has now entered the stage of a radiation-free alternative to computed tomography (CT) for chest imaging in clinical practice. Whereas in the past MRI of the lung was focused on morphological aspects, current MRI techniques also enable functional imaging of the lung allowing for a comprehensive assessment of lung disease in a single MRI exam. Perfusion imaging can be used for the visualization of regional pulmonary perfusion in patients with different lung diseases such as lung cancer, chronic obstructive lung disease, pulmonary embolism or for the prediction of postoperative lung function in lung cancer patients. Over the past years diffusion-weighted MR imaging (DW-MRI) of the thorax has become feasible with a significant reduction of the acquisition time, thus minimizing artifacts from respiratory and cardiac motion. In chest imaging, DW-MRI has been mainly suggested for the characterization of lung cancer, lymph nodes and pulmonary metastases. In this review article recent MR perfusion and diffusion techniques of the lung and mediastinum as well as their clinical applications are reviewed.

  2. Tumor disease and associated congenital abnormalities on prenatal MRI

    International Nuclear Information System (INIS)

    Objective: Fetal tumors can have a devastating effect on the fetus, and may occur in association with congenital malformations. In view of the increasing role of fetal magnetic resonance imaging (MRI) as an adjunct to prenatal ultrasonography (US), we sought to demonstrate the visualization of fetal tumors, with regard to congenital abnormalities, on MRI. Materials and methods: This retrospective study included 18 fetuses with tumors depicted on fetal MRI after suspicious US findings. An MRI standard protocol was used to diagnose tumors judged as benign or malignant. All organ systems were assessed for tumor-related complications and other congenital malformations. Available US results and histopathology were compared with MRI. Results: There were 13/18 (72.2%) benign and 5/18 (27.8%) malignant tumors diagnosed: a cerebral primitive neuroectodermal tumor in 1/18, head–neck teratomas in 4/18; ventricular rhabdomyomas in 4/18; a cardiac teratoma in 1/18; a hepatoblastoma in 1/18; neuroblastomas in 2/18; a cystic hemorrhagic adrenal hyperplasia in 1/18; a pelvic leiomyoma in 1/18; sacrococcygeal teratomas in 3/18. Tumor-related complications were present in 13/18 (72.2%) cases; other congenital abnormalities in 3/18 (16.7%). MRI diagnosis and histology were concordant in 8/11 (72.7%) cases. In 6/12 (50%) cases, US and MRI diagnoses were concordant, and, in 6/12 (50%) cases, additional MRI findings changed the US diagnosis. Conclusion: Our MRI results demonstrate the visualization of fetal tumors, with frequently encountered tumor-related complications, and other exceptional congenital abnormalities, which may provide important information for perinatal management. Compared to prenatal US, MRI may add important findings in certain cases.

  3. MRI assessment program

    International Nuclear Information System (INIS)

    Usage, cost and efficacy data from the MRI Assessment Program to 30 March 1988 is presented, as a continuation of an earlier analysis. Analysis has been performed on data from 8565 examinations relating to 7997 patients at 4 hospitals. MRI was used mainly for examination of the head and spine. Some details of the follow up studies being conducted on selected patients and disease categories are given. A consensus statement is included which summaries the view of the Technical Committee on the potential applications of MRI in Australia. The MRI unit quench incident at Royal Adelaide Hospital is described. Refs., 10 figs., tabs

  4. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  5. Cardiovascular MRI in congenital heart disease. An imaging atlas

    Energy Technology Data Exchange (ETDEWEB)

    Sridharan, Shankar; Price, Gemma; Tann, Oliver; Hughes, Marina; Muthurangu, Vivek; Taylor, Andrew M. [UCL Institute of Child Health and Great Ormond Street Hospital for Children, London (United Kingdom). Centre for Cardiovascular MR

    2010-07-01

    This new and unique clinical resource offers rapid access to high-quality images covering a broad spectrum of paediatric and adult cardiac pathologies visualized using MRI and CT. Key images of each condition and a clear interpretation of their MR appearances allow for greater understanding of the pathology. Focus is given to the planning of imaging planes, techniques and sequences to obtain the best images and improve MR assessment. This text would benefit all health professionals involved in imaging congenital cardiac disease. (orig.)

  6. Cardiac magnetic resonance imaging in children

    Energy Technology Data Exchange (ETDEWEB)

    Helbing, Willem A. [Erasmus Medical Centre - Sophia Children' s Hospital, Department of Radiology, Rotterdam (Netherlands); Department of Paediatrics (Division of Cardiology), Sp-2.429, P.O. Box 2060, CB, Rotterdam (Netherlands); Ouhlous, Mohamed [Erasmus Medical Centre - Sophia Children' s Hospital, Department of Radiology, Rotterdam (Netherlands)

    2015-01-01

    MRI is an important additional tool in the diagnostic work-up of children with congenital heart disease. This review aims to summarise the role MRI has in this patient population. Echocardiography remains the main diagnostic tool in congenital heart disease. In specific situations, MRI is used for anatomical imaging of congenital heart disease. This includes detailed assessment of intracardiac anatomy with 2-D and 3-D sequences. MRI is particularly useful for assessment of retrosternal structures in the heart and for imaging large vessel anatomy. Functional assessment includes assessment of ventricular function using 2-D cine techniques. Of particular interest in congenital heart disease is assessment of right and single ventricular function. Two-dimensional and newer 3-D techniques to quantify flow in these patients are or will soon become an integral part of quantification of shunt size, valve function and complex flow patterns in large vessels. More advanced uses of MRI include imaging of cardiovascular function during stress and tissue characterisation of the myocardium. Techniques used for this purpose need further validation before they can become part of the daily routine of MRI assessment of congenital heart disease. (orig.)

  7. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... medically necessary. MRI may not always distinguish between cancer tissue and fluid, known as edema . MRI typically ...

  8. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  9. Historical perspectives of cardiac electrophysiology.

    Science.gov (United States)

    Lüderitz, Berndt

    2009-01-01

    The diagnosis and treatment of clinical electrophysiology has a long and fascinating history. From earliest times, no clinical symptom impressed the patient (and the physician) more than an irregular heart beat. Although ancient Chinese pulse theory laid the foundation for the study of arrhythmias and clinical electrophysiology in the 5th century BC, the most significant breakthrough in the identification and treatment of cardiac arrhythmias first occurred in this century. In the last decades, our knowledge of electrophysiology and pharmacology has increased exponentially. The enormous clinical significance of cardiac rhythm disturbances has favored these advances. On the one hand, patients live longer and thus are more likely to experience arrhythmias. On the other hand, circulatory problems of the cardiac vessels have increased enormously, and this has been identified as the primary cause of cardiac rhythm disorders. Coronary heart disease has become not just the most significant disease of all, based on the statistics for cause of death. Arrhythmias are the main complication of ischemic heart disease, and they have been directly linked to the frequently arrhythmogenic sudden death syndrome, which is now presumed to be an avoidable "electrical accident" of the heart. A retrospective look--often charming in its own right--may not only make it easier to sort through the copious details of this field and so become oriented in this universe of important and less important facts: it may also provide the observer with a chronological vantage point from which to view the subject. The study of clinical electrophysiology is no dry compendium of facts and figures, but rather a dynamic field of study evolving out of the competition between various ideas, intentions and theories. PMID:19196616

  10. MRI of Listeria rhombencephalitis

    International Nuclear Information System (INIS)

    A case of Listeria rhombencephalitis in a patient, who was evaluated by MRI, is reported. MRI shows areas of high signal intensity on T2-weighted images in the rhombencephalon and confirmed the clinical diagnosis of a brainstem affection by Listeria monocytogenes. (orig.)

  11. Getting an MRI

    Medline Plus

    Full Text Available ... School Butterflies? Read This Chloe & Nurb Meet The Brain (Movie) Quiz: Do You Need a Flu Shot? Got Homework? Here's Help White House Lunch Recipes Getting an MRI (Video) KidsHealth > For Kids > Getting an MRI (Video) ...

  12. Getting an MRI

    Medline Plus

    Full Text Available ... Dictionary of Medical Words En Español What Other Kids Are Reading Movie: Digestive System Winter Sports: Sledding, ... a Booger? Getting an MRI (Video) KidsHealth > For Kids > Getting an MRI (Video) Print A A A ...

  13. Play the MRI Game

    Science.gov (United States)

    ... Play MRI the Magnetic Miracle Game About the game In the MRI imaging technique, strong magnets and radio waves are used for getting images of inner organs made of soft tissue, compared to X-ray imaging where you get images of hard tissue, ...

  14. MRI of atherosclerose

    NARCIS (Netherlands)

    te Boekhorst, B.C.M.

    2010-01-01

    This thesis is aimed at visualization of atherosclerotic plaques with MRI. Noninvasive screening for subclinical atherosclerosis as well as detection of high-risk atherosclerotic plaque in an established population of cardiovascular patients is important for patient management. Anatomical MRI utiliz

  15. Automatic Characterization of Myocardial Perfusion in Contrast Enhanced MRI

    Science.gov (United States)

    Positano, Vincenzo; Santarelli, Maria Filomena; Landini, Luigi

    2003-12-01

    The use of contrast medium in cardiac MRI allows joining the high-resolution anatomical information provided by standard magnetic resonance with functional information obtained by means of the perfusion of contrast agent in myocardial tissues. The current approach to perfusion MRI characterization is the qualitative one, based on visual inspection of images. Moving to quantitative analysis requires extraction of numerical indices of myocardium perfusion by analysis of time/intensity curves related to the area of interest. The main problem in quantitative image sequence analysis is the heart movement, mainly due to patient respiration. We propose an automatic procedure based on image registration, segmentation of the myocardium, and extraction and analysis of time/intensity curves. The procedure requires a minimal user interaction, is robust with respect to the user input, and allows effective characterization of myocardial perfusion. The algorithm was tested on cardiac MR images acquired from voluntaries and in clinical routine.

  16. The emerging role of cardiovascular MRI for suspected cardioembolic stroke

    International Nuclear Information System (INIS)

    Stroke is a leading cause of morbidity and long-term disability worldwide and is often the result of embolic material from the heart or proximal aorta. These are referred to as cardioembolic sources of stroke. The investigation of patients with suspected cardioembolic stroke has traditionally been the mainstay of echocardiography. Cardiac magnetic resonance imaging (MRI) is a powerful imaging technique that has rapidly evolved over the last decade and is playing an ever increasing role in clinical cardiovascular imaging. This review of the literature aims to furnish the reader with an understanding of the role of cardiac MRI across the spectrum of causes of cardioembolic sources of stroke by providing the reader with an overview of the indications, technical considerations, a proposed imaging algorithm, and capabilities of this technology with selected illustrated examples of disease entities.

  17. DENSE: Displacement Encoding with Stimulated Echoes in Cardiac Functional MRI

    Science.gov (United States)

    Aletras, Anthony H.; Ding, Shujun; Balaban, Robert S.; Wen, Han

    1999-03-01

    Displacement encoding with stimulated echoes (DENSE) was developed for high-resolution myocardial displacement mapping. Pixel phase is modulated by myocardial displacement and data spatial resolution is limited only by pixel size. 2D displacement vector maps were generated for the systolic action in canines with 0.94 × 1.9 mm nominal in-plane resolution and 2.3 mm/π displacement encoding. A radial strain of 0.208 was measured across the free left ventricular wall over 105 ms during systole. DENSE displacement maps require small first-order gradient moments for encoding. DENSE magnitude images exhibit black-blood contrast which allows for better myocardial definition and reduced motion-related artifacts.

  18. Image analysis methods for tagged MRI cardiac studies

    Science.gov (United States)

    Guttman, Michael A.; Prince, Jerry L.

    1990-07-01

    Tracking of magnetic resonance (MR) tags in myocardial tissue promises to be an effective tool in the assessment of myocardial motion. The amount of data acquired is very large and the measurements are numerous and must be precise requiring automated tracking methods. We describe a hierarchy of image processing steps that estimate both the endocardial and epicardial boundaries of the left ventricle and also estimate the spines of radial tags that emanate outward from the left ventricular cavity. The first stage determines the position of the myocardial boundaries for each of 128 rays emanating from the origin. To counter the deleterious effects of noise and the presence of the tags when determining the boundary positions we use nonlinear filtering concepts from mathematical morphology together with a prion knowledge related to boundary smoothness to improve the estimates. The second stage estimates the tag spines by matching a template in a direction orthogonal to the expected tag direction. We show results on tagged images and discuss further research directions. 1.

  19. OPTIMAL MULTI-CHANNEL TIME-SEQUENTIAL ACQUISITION IN DYNAMIC MRI WITH PARALLEL COILS

    OpenAIRE

    Sharif, Behzad; Bresler, Yoram

    2006-01-01

    Magnetic resonance imaging with parallel coils is commonly used as a method to speed up the acquisition by exploiting spatial encoding. Another, distinct acceleration method is spatio-temporal modeling with adaptive acquisition, which has been previously proposed for dynamic cardiac MRI with a single coil. We propose an optimal acquisition scheme for parallel dynamic MRI combining the two methods. It provides accelerations up to the product of the individual accelerations. The proposed scheme...

  20. Detection of an occult transclival cerebrospinal fluid fistula by CT and MRI

    International Nuclear Information System (INIS)

    We describe an unusual occult transclival cerebrospinal fluid (CSF) fistula to the sphenoid sinus demonstrated by MRI. CT was performed because of a posterior cerebral infarct caused by cardiac arrhythmia. Axial sections showed fluid in the sphenoid sinus. High-resolution scans revealed a bony defect 3 mm in diameter of the posterior wall of the sphenoid sinus, and MRI showed a transclival CSF fistula. This occult lesion was confirmed by surgery and duraplasty was successfully performed via an endonasal approach. (orig.)

  1. Validation of SPAMM Tagged MRI Based Measurement of 3D Soft Tissue Deformation

    OpenAIRE

    Kevin M. Moerman; Sprengers, Andre M. J.; Ciaran K. Simms; Lamerichs, Rolf M.; Stoker, Jaap; Aart J. Nederveen

    2016-01-01

    This study presents and validates a novel (non-ECG-triggered) MRI sequence based on SPAtial Modulation of the Magnetization (SPAMM) to non-invasively measure 3D (quasi-static) soft tissue deformations using only six acquisitions (three static and three indentations). In current SPAMM tagged MRI approaches data is typically constructed from many repeated motion cycles. This has so far restricted its application to the measurement of highly repeatable and periodic movements (e.g. cardiac deform...

  2. Exploring fMRI Data for Periodic Signal Components

    DEFF Research Database (Denmark)

    Hansen, Lars Kai; Nielsen, Finn Årup; Larsen, Jan

    2002-01-01

    We use a Bayesian framework to detect periodic components in fMRI data. The resulting detector is sensitive to periodic components with a flexible number of harmonics and with arbitrary amplitude and phases of the harmonics. It is possible to detect the correct number of harmonics in periodic sig...... signals even if the fundamental frequency is beyond the Nyquist frequency. We apply the signal detector to locate regions that are highly affected by periodic physiological artifacts, such as cardiac pulsation....

  3. State of the Art in Cardiac Hybrid Technology: PET/MR

    Science.gov (United States)

    Nappi, Carmela; El Fakhri, Georges

    2013-01-01

    Simultaneous PET/MRI is an emerging technique combining two powerful imaging modalities in a single device. The wide variety of available tracers for perfusion and metabolic studies and the high sensitivity of positron emission tomography (PET) combined with the high spatial resolution and soft tissue contrast of magnetic resonance imaging (MRI) in depicting cardiac morphology and function as well as MRI's absence of ionizing radiation makes PET/MRI very attractive to radiologists and clinicians. Nevertheless, PET/MR scientific and clinical promise is to be considered in the context of numerous technical challenges that hinder its use in the clinical setting. For example, in order for a PET system to work correctly within an MR field, major changes are required to the photon detection chain such as the elimination of photomultiplier tubes, etc. Another significant limitation of PET/MRI is the lack of an electron density map (as is the case with PET-CT) that can be readily obtained from MRI (the latter measures proton not electron density) and used to correct PET data for attenuation. Moreover, as with PET-CT, cardiac and respiratory motions cause image degradations that affect image quality and accuracy both in static and dynamic PET imaging. As a result, overcoming these (and other) technical limitations is a very active area of research both in academic institutions as well as industry. In this paper, we review recent literature on cardiac PET/MRI, present the state-of-the-art of this technology, and explore promising preclinical and clinical cardiac applications where PET/MRI could play a substantial role. PMID:24073295

  4. Assessment of congenital heart disease (CHD): Is there a role for fetal magnetic resonance imaging (MRI)?

    Energy Technology Data Exchange (ETDEWEB)

    Manganaro, L. [Department of Radiological Sciences, UMBERTO I Hospital, SAPIENZA University of Rome, Viale del Policlinico 155, 00161 Rome (Italy); Savelli, S. [Department of Radiological Sciences, UMBERTO I Hospital, SAPIENZA University of Rome, Viale del Policlinico 155, 00161 Rome (Italy)], E-mail: sarasavelli@hotmail.it; Di Maurizio, M.; Perrone, A.; Francioso, A.; La Barbera, L.; Totaro, P.; Fierro, F.; Tomei, A.; Coratella, F. [Department of Radiological Sciences, UMBERTO I Hospital, SAPIENZA University of Rome, Viale del Policlinico 155, 00161 Rome (Italy); Giancotti, A. [Department of Gynaecological Sciences, UMBERTO I Hospital, SAPIENZA University of Rome, Viale del Policlinico 155, 00161 Rome (Italy); Ballesio, L. [Department of Radiological Sciences, UMBERTO I Hospital, SAPIENZA University of Rome, Viale del Policlinico 155, 00161 Rome (Italy); Ventriglia, F. [Department of Pediatric Cardiology, UMBERTO I Hospital, SAPIENZA University of Rome, Viale del Policlinico 155, 00161 Rome (Italy)

    2009-10-15

    Purpose: To review our experience with fetal magnetic resonance imaging (MRI) to evaluate congenital heart disease (CHD). Methods: We performed fetal MRI in 32 fetuses with an echocardiographically assessed CHD. Both direct and indirect signs of CHD were investigated. Direct signs considered were: morpho-volumetric abnormalities of the heart; malrotations; ventricular and atrial septal defects; anomalies of the origin, size and course of the great arteries. Indirect signs considered were: difficulty to recognize a 'normal' anatomical structures in the reference projections; increase of the vascular size before a stenosis; hypertrophy of the papillary muscles; cardiomegaly and pericardial effusion. All MRI findings were compared with postnatal or autoptic findings. Results: MRI allowed the CHD to be visualised by direct signs in 17 fetuses, indirect signs in 5 and both direct and indirect signs in 9 fetuses, excluding the prenatal echocardiographic suspect of hypoplastic left heart syndrome in 1 fetus. Postnatal echocardiograms or autoptic findings confirmed a normal heart in 1 fetus and CHD in 31 fetuses including a single cardiac anomaly or syndrome in 19 fetuses, 2 associated cardiac abnormalities in 11 and 3 cardiac anomalies in 1 fetus. However, in 2 fetuses MRI detected a ventricular septal defect successively disclosed by gold standard. Conclusions: MRI is a promising method for further assessment of the cardiovascular pathologies diagnosed by echocardiography, and may be a valuable tool in assessing associated extracardiac anomalies.

  5. Valvular heart disease: what does cardiovascular MRI add?

    Energy Technology Data Exchange (ETDEWEB)

    Masci, Pier G.; Dymarkowski, Steven; Bogaert, Jan [Gasthuisberg University Hospital, Department of Radiology, Leuven (Belgium)

    2008-02-15

    Although ischemic heart disease remains the leading cause of cardiac-related morbidity and mortality in the industrialized countries, a growing number of mainly elderly patients will experience a problem of valvular heart disease (VHD), often requiring surgical intervention at some stage. Doppler-echocardiography is the most popular imaging modality used in the evaluation of this disease entity. It encompasses, however, some non-negligible constraints which may hamper the quality and thus the interpretation of the exam. Cardiac catheterization has been considered for a long time the reference technique in this field, however, this technique is invasive and considered far from optimal. Cardiovascular magnetic resonance imaging (MRI) is already considered an established diagnostic method for studying ventricular dimensions, function and mass. With improvement of MRI soft- and hardware, the assessment of cardiac valve function has also turned out to be fast, accurate and reproducible. This review focuses on the usefulness of MRI in the diagnosis and management of VHD, pointing out its added value in comparison with more conventional diagnostic means. (orig.)

  6. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  7. Fetal Brain MRI

    Directory of Open Access Journals (Sweden)

    Ahmad Tahmasebpour

    2010-05-01

    Full Text Available MRI is a useful supplement to ultrasonography for the assessment of fetal brain malformations. Superior soft tissue contrast and the ability to depict sulcation and myelination are the strengths of MRI. Subtle or inconclusive ultrasonography abnormalities can be confirmed or ruled out by MRI. In some cases, additional findings detected with MRI often help in arriving at a definitive diagnosis, which is necessary for parental counseling and for guiding management. Fast T2W sequences form the basis of fetal MRI. There have been no reports of deleterious effects of MRI on the fetus. A few case examples are presented to illustrate the advantages of MRI. "nThe database comprises MR images of a total of 26 fetuses (gestational age 22-23 weeks reformed be-cause of suspected abnormalities due to ultrasonic findings, family history or maternal illness and scanned on a 1.5T MR system using single-shot fast spin echo "SSFSE, HASTE" T2 sequence, slice thick-ness 3mm, no gap. "HASTE=fourier acquisition single shotturbospinecho". In the normal fetus the ventricular size or volume did not vary with the gestational age but cerebral and cerebellar volumes increase during the same period "Grossman et al." Diagnostic accuracy is about 48%. "OB/GYN news, Chicago". Today it is not necessary to use sedatives or muscle relaxants to control fetal movement "ultra-fast MRI techniques". Modified technique for 50% reduction in the time necessary to take MRI images of the fetal brain is dedicated by Kianosh Hosseinzadeh, by using a line of reference through the eyes "AJR 2005"."nOur fetuses are 22-23 weeks in gestational age, 26 in number and we found agenesis of corpus callosum, hydrocephaly, holoprosencephaly, mega-cisterna magna, occipital meningocele, Arnold Chiari malformation type 1, Dandy Walker syndrome and lissencephaly

  8. Explaining MRI examinations DVD

    International Nuclear Information System (INIS)

    When conducting MRI examinations, there are various things to be careful of. There is often stress related to the MRI examinations, so in order to perform an examination safely and smoothly, sufficient explanation must be given. An explanation of what to do and what not to do during an examination should be outlined in a brochure given to patients before the examination. There may be many patients who have misgivings about their MRI examinations, so to reduce their anxiousness and deepen their understanding of MRI examinations and to improve the safety and effiency of MRI examinations,; we created a DVD about MRI examinations. We gathered MRI-related safety information and instructions, and assessed the effect that the information might have on patients. We started a workgroup for a project to plan and record a video according to the Storyboard. When editing, we reviewed the length of each segment, the amount of information on screen, and the overall length of the DVD. We discussed the issue within the workgroup and had hospital approval. It was possible for us to complete it without depending on the supplier and the cost was kept to a minimum. Finally, we decided on a viewing location. We asked a hospital volunteers to see a complete DVD and we evaluated their responses by questionnaires. As the result, their understanding and anxieties related to MRI examinations were alleviated, as expected. Their anxiety seemed to be eased. Patients also seemed to have a deeper understanding of MRI examinations having seen an examination being conducted. (author)

  9. MRI dynamic range and its compatibility with signal transmission media

    Science.gov (United States)

    Gabr, Refaat E.; Schär, Michael; Edelstein, Arthur D.; Kraitchman, Dara L.; Bottomley, Paul A.; Edelstein, William A.

    2009-06-01

    As the number of MRI phased array coil elements grows, interactions among cables connecting them to the system receiver become increasingly problematic. Fiber optic or wireless links would reduce electromagnetic interference, but their dynamic range (DR) is generally less than that of coaxial cables. Raw MRI signals, however, have a large DR because of the high signal amplitude near the center of k-space. Here, we study DR in MRI in order to determine the compatibility of MRI multicoil imaging with non-coaxial cable signal transmission. Since raw signal data are routinely discarded, we have developed an improved method for estimating the DR of MRI signals from conventional magnitude images. Our results indicate that the DR of typical surface coil signals at 3 T for human subjects is less than 88 dB, even for three-dimensional acquisition protocols. Cardiac and spine coil arrays had a maximum DR of less than 75 dB and head coil arrays less than 88 dB. The DR derived from magnitude images is in good agreement with that measured from raw data. The results suggest that current analog fiber optic links, with a spurious-free DR of 60-70 dB at 500 kHz bandwidth, are not by themselves adequate for transmitting MRI data from volume or array coils with DR ˜90 dB. However, combining analog links with signal compression might make non-coaxial cable signal transmission viable.

  10. PET/MRI in Oncological Imaging: State of the Art.

    Science.gov (United States)

    Bashir, Usman; Mallia, Andrew; Stirling, James; Joemon, John; MacKewn, Jane; Charles-Edwards, Geoff; Goh, Vicky; Cook, Gary J

    2015-01-01

    Positron emission tomography (PET) combined with magnetic resonance imaging (MRI) is a hybrid technology which has recently gained interest as a potential cancer imaging tool. Compared with CT, MRI is advantageous due to its lack of ionizing radiation, superior soft-tissue contrast resolution, and wider range of acquisition sequences. Several studies have shown PET/MRI to be equivalent to PET/CT in most oncological applications, possibly superior in certain body parts, e.g., head and neck, pelvis, and in certain situations, e.g., cancer recurrence. This review will update the readers on recent advances in PET/MRI technology and review key literature, while highlighting the strengths and weaknesses of PET/MRI in cancer imaging. PMID:26854157

  11. PET/MRI in Oncological Imaging: State of the Art

    Directory of Open Access Journals (Sweden)

    Usman Bashir

    2015-07-01

    Full Text Available Positron emission tomography (PET combined with magnetic resonance imaging (MRI is a hybrid technology which has recently gained interest as a potential cancer imaging tool. Compared with CT, MRI is advantageous due to its lack of ionizing radiation, superior soft-tissue contrast resolution, and wider range of acquisition sequences. Several studies have shown PET/MRI to be equivalent to PET/CT in most oncological applications, possibly superior in certain body parts, e.g., head and neck, pelvis, and in certain situations, e.g., cancer recurrence. This review will update the readers on recent advances in PET/MRI technology and review key literature, while highlighting the strengths and weaknesses of PET/MRI in cancer imaging.

  12. MRI in perianal fistulae

    International Nuclear Information System (INIS)

    MRI has become the method of choice for evaluating perianal fistulae due to its ability to display the anatomy of the sphincter muscles orthogonally, with good contrast resolution. In this article we give an outline of the classification of perianal fistulae and present a pictorial assay of sphincter anatomy and the MRI findings in perianal fistulae. This study is based on a retrospective analysis of 43 patients with a clinical diagnosis of perianal fistula. MRI revealed a total of 44 fistulae in 35 patients; eight patients had only perianal sinuses

  13. MRI of brachial plexopathies

    Energy Technology Data Exchange (ETDEWEB)

    Sureka, J. [Department of Radiology, Christian Medical College, Vellore (India)], E-mail: drjyoticmch@rediffmail.com; Cherian, R.A.; Alexander, M.; Thomas, B.P. [Department of Radiology, Christian Medical College, Vellore (India)

    2009-02-15

    Magnetic resonance imaging (MRI) has become the primary imaging technique in the evaluation of brachial plexus pathology, and plays an important role in the identification, localization, and characterization of the cause. Improvements in MRI technique have helped in detecting changes in the signal intensity of nerves, subtle enhancement, and in detecting perineural pathology, thereby refining the differential diagnosis. The present review of the visualization of brachial plexus abnormalities using MRI is based on a review of 26 cases. The causes include trauma and a spectrum of non-traumatic causes, such as acute idiopathic/viral plexitis, metastases, immune-mediated plexitis, and mass lesions compressing the brachial plexus.

  14. MRI in perianal fistulae

    Directory of Open Access Journals (Sweden)

    Khera Pushpinder

    2010-01-01

    Full Text Available MRI has become the method of choice for evaluating perianal fistulae due to its ability to display the anatomy of the sphincter muscles orthogonally, with good contrast resolution. In this article we give an outline of the classification of perianal fistulae and present a pictorial assay of sphincter anatomy and the MRI findings in perianal fistulae. This study is based on a retrospective analysis of 43 patients with a clinical diagnosis of perianal fistula. MRI revealed a total of 44 fistulae in 35 patients; eight patients had only perianal sinuses.

  15. Cardiac-induced physiologic noise in tissue is a direct observation of cardiac-induced fluctuations.

    Science.gov (United States)

    Bhattacharyya, Pallab K; Lowe, Mark J

    2004-01-01

    Recent studies have shown that in certain cases, cardiac and respiratory rate fluctuations in BOLD-weighted MRI time courses may be an artifact unique to rapid sampled acquisitions and may not be present in longer repetition-time acquisitions. The implication of this is that, in these cases, cardiac and respiratory rate fluctuations are not aliased into data that undersample these effects and do not affect the resulting time course measurements. In this study, we show that these cases are specific to regions of large cerebrospinal fluid content and are not generally true for gray matter regions of the brain. We demonstrate that in many brain regions of interest, these fluctuations are directly observed as BOLD fluctuations and thus will affect measurements that undersample these effects.

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  17. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  18. Quality assurance in functional MRI

    DEFF Research Database (Denmark)

    Liu, Thomas T; Glover, Gary H; Mueller, Bryon A;

    2015-01-01

    Over the past 20 years, functional magnetic resonance imaging (fMRI) has ben- efited greatly from improvements in MRI hardware and software. At the same time, fMRI researchers have pushed the technical limits of MRI systems and greatly in- fluenced the development of state-of-the-art systems. Min...

  19. Biomimetic material strategies for cardiac tissue engineering

    International Nuclear Information System (INIS)

    Cardiovascular disease precedes many serious complications including myocardial infarction (MI) and it remains a major problem for the global community. Adult mammalian heart has limited ability to regenerate and compensate for the loss of cardiomyocytes. Restoration of cardiac function by replacement of diseased myocardium with functional cardiomyocytes is an intriguing strategy because it offers a potential cure for MI. Biomaterials are fabricated in nanometer scale dimensions by combining the chemical, biological, mechanical and electrical aspects of material for potential tissue engineering (TE) applications. Synthetic polymers offer advantageous in their ability to tailor the mechanical properties, and natural polymers offer cell recognition sites necessary for cell, adhesion and proliferation. Cardiac tissue engineering (TE) aim for the development of a bioengineered construct that can provide physical support to the damaged cardiac tissue by replacing certain functions of the damaged extracellular matrix and prevent adverse cardiac remodeling and dysfunction after MI. Electrospun nanofibers are applied as heart muscle patches, while hydrogels serve as a platform for controlled delivery of growth factors, prevent mechanical complications and assist in cell recruitment. This article reviews the applications of different natural and synthetic polymeric materials utilized as cardiac patches, injectables or 3D constructs for cardiac TE. Smart organization of nanoscale assemblies with synergistic approaches of utilizing nanofibers and hydrogels could further advance the field of cardiac tissue engineering. Rapid innovations in biomedical engineering and cell biology will bring about new insights in the development of optimal scaffolds and methods to create tissue constructs with relevant contractile properties and electrical integration to replace or substitute the diseased myocardium.

  20. Biomimetic material strategies for cardiac tissue engineering

    Energy Technology Data Exchange (ETDEWEB)

    Prabhakaran, Molamma P., E-mail: nnimpp@nus.edu.sg [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore); Venugopal, J. [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore); Kai, Dan [NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore (Singapore); Ramakrishna, Seeram [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore)

    2011-04-08

    Cardiovascular disease precedes many serious complications including myocardial infarction (MI) and it remains a major problem for the global community. Adult mammalian heart has limited ability to regenerate and compensate for the loss of cardiomyocytes. Restoration of cardiac function by replacement of diseased myocardium with functional cardiomyocytes is an intriguing strategy because it offers a potential cure for MI. Biomaterials are fabricated in nanometer scale dimensions by combining the chemical, biological, mechanical and electrical aspects of material for potential tissue engineering (TE) applications. Synthetic polymers offer advantageous in their ability to tailor the mechanical properties, and natural polymers offer cell recognition sites necessary for cell, adhesion and proliferation. Cardiac tissue engineering (TE) aim for the development of a bioengineered construct that can provide physical support to the damaged cardiac tissue by replacing certain functions of the damaged extracellular matrix and prevent adverse cardiac remodeling and dysfunction after MI. Electrospun nanofibers are applied as heart muscle patches, while hydrogels serve as a platform for controlled delivery of growth factors, prevent mechanical complications and assist in cell recruitment. This article reviews the applications of different natural and synthetic polymeric materials utilized as cardiac patches, injectables or 3D constructs for cardiac TE. Smart organization of nanoscale assemblies with synergistic approaches of utilizing nanofibers and hydrogels could further advance the field of cardiac tissue engineering. Rapid innovations in biomedical engineering and cell biology will bring about new insights in the development of optimal scaffolds and methods to create tissue constructs with relevant contractile properties and electrical integration to replace or substitute the diseased myocardium.

  1. Imaging of the pituitary: Recent advances

    Directory of Open Access Journals (Sweden)

    Vikas Chaudhary

    2011-01-01

    Full Text Available Pituitary lesions, albeit relatively infrequent, can significantly alter the quality of life. This article highlights the role of advanced imaging modalities in evaluating pituitary-hypothalamic axis lesions. Magnetic resonance imaging (MRI is the examination of choice for evaluating hypothalamic-pituitary-related endocrine diseases. Advanced MR techniques discussed in this article include dynamic contrast-enhanced MRI, 3T MRI, magnetization transfer (MT imaging, diffusion-weighted imaging (DWI, proton MR spectroscopy, fluorine-18 fluorodeoxyglucose-positron emission tomography, single-photon emission computed tomography, intraoperative MRI, and intraoperative real-time ultrasonography.

  2. [Cardiac evaluation before non-cardiac surgery].

    Science.gov (United States)

    Menzenbach, Jan; Boehm, Olaf

    2016-07-01

    Before non-cardiac surgery, evaluation of cardiac function is no frequent part of surgical treatment. European societies of anesthesiology and cardiology published consensus-guidelines in 2014 to present a reasonable approach for preoperative evaluation. This paper intends to differentiate the composite of perioperative risk and to display the guidelines methodical approach to handle it. Features to identify patients at risk from an ageing population with comorbidities, are the classification of surgical risk, functional capacity and risk indices. Application of diagnostic means, should be used adjusted to this risk estimation. Cardiac biomarkers are useful to discover risk of complications or mortality, that cannot be assessed by clinical signs. After preoperative optimization and perioperative cardiac protection, the observation of the postoperative period remains, to prohibit complications or even death. In consideration of limited resources of intensive care department, postoperative ward rounds beyond intensive care units are considered to be an appropriate instrument to avoid or recognize complications early to reduce postoperative mortality. PMID:27479258

  3. Future perspectives for intraoperative MRI.

    Science.gov (United States)

    Jolesz, Ferenc A

    2005-01-01

    MRI-guided neurosurgery not only represents a technical challenge but a transformation from conventional hand-eye coordination to interactive navigational operations. In the future, multimodality-based images will be merged into a single model, in which anatomy and pathologic changes are at once distinguished and integrated into the same intuitive framework. The long-term goals of improving surgical procedures and attendant outcomes, reducing costs, and achieving broad use can be achieved with a three-pronged approach: 1. Improving the presentation of preoperative and real-time intraoperative image information 2. Integrating imaging and treatment-related technology into therapy delivery systems 3. Testing the clinical utility of image guidance in surgery The recent focus in technology development is on improving our ability to understand and apply medical images and imaging systems. Areas of active research include image processing, model-based image analysis, model deformation, real-time registration, real-time 3D (so-called "four-dimensional") imaging, and the integration and presentation of image and sensing information in the operating room. Key elements of the technical matrix also include visualization and display platforms and related software for information and display, model-based image understanding, the use of computing clusters to speed computation (ie, algorithms with partitioned computation to optimize performance), and advanced devices and systems for 3D device tracking (navigation). Current clinical applications are successfully incorporating real-time and/or continuously up-dated image-based information for direct intra-operative visualization. In addition to using traditional imaging systems during surgery, we foresee optimized use of molecular marker technology, direct measures of tissue characterization (ie, optical measurements and/or imaging), and integration of the next generation of surgical and therapy devices (including image

  4. MRI of myelitis

    OpenAIRE

    Hodel, J.; Outteryck, O; Jissendi, P; Zins, M.; Leclerc, X; Pruvo, J P

    2012-01-01

    The diagnosis of myelitis relies on MRI. The purpose of this review is to describe the imaging findings in patients with myelitis through clinical cases. MR findings in Multiple Sclerosis, Neuromyelitis Optica and others Transverse Myelitis are highlighted.

  5. MRI of the shoulder

    International Nuclear Information System (INIS)

    Magnetic resonance imaging has become available at a time in which shoulder pathology is more frequently seen. It is a noninvasive procedure that does not use ionizing radiation. It provides detailed visualization of soft-tissue structures that is not possible with other imaging modalities. Though not as widely available as conventional radiographs or computed tomography scanning, the number of MRI units worldwide is increasing steadily. The main features of the present book are as follows: The physical basis of Magnetic Resonance Imaging (MRI), normal shoulder anatomy and MRI, diagnosis of shoulder disorders, MRI of patients with shoulder pain or instability, case studies as well as treatment of shoulder disorders. (orig./MG) With 145 figs

  6. Out-of-Hospital Cardiac Arrest in Denmark

    DEFF Research Database (Denmark)

    Wissenberg Jørgensen, Mads

    challenges, due to the victim’s physical location, which brings an inherent risk of delay (or altogether absence) of recognition and treatment of cardiac arrest. A low frequency of bystander cardiopulmonary resuscitation and low 30-day survival after out-of-hospital cardiac arrest were identified nearly ten......BACK COVER TEXT Cardiac arrest is an emergency medical condition characterized by the cessation of cardiac mechanical activity; without immediate and decisive treatment, a victim’s chances of survival are minimal. Out-of-hospital cardiac arrest is a particular arrest subgroup that poses additional...... years ago in Denmark. These findings led to several national initiatives to strengthen bystander resuscitation attempts and advance care. Despite these nationwide efforts, it was unknown prior to this project whether these efforts resulted in changes in resuscitation attempts by bystanders and changes...

  7. MRI of the Coronary vasculature: Imaging the Lumen, Wall and Beyond

    Science.gov (United States)

    Lin, Kai; Carr, James C.

    2015-01-01

    The characteristics of coronary artery disease (CAD) are gradual thickening of the coronary walls and narrowing of the vascular lumen due to the built-up of atherosclerosis plaques. Those morphological changes can be noninvasively detected by coronary MRI/MRA. In addition, functional changes, such as coronary wall distensibility and flow changes may also be evaluated with MRI. However, the application of current MRI/MRA techniques is limited in clinical practice due to several adverse technical and physiological factors, such as cardiac motion and respiratory motion. Many technical innovations have been adopted to address those problems from multiple aspects. PMID:25726999

  8. MRI of intracranial calcifications

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jin Wha; Chang, Kee Hyun; Park, Jung Mi; Han, Moon Hee; Han, Man Chung; Kim, Chu Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1988-12-15

    Recently computed tomography(CT) has been rapidly replaced by magnetic resonance imaging (MRI) in diagnosis of majority of intracranial diseases. But MRI still has some limitation, one of which is its inferiority in detecting calcification. MRI of intracranial calcification has been known to be variable in signal intensity. We retrospectively analyzed the MRI of 26 patients with intracranial calcified lesions in order to evaluate the MR intensity of calcification and to assess the capability of MRI in detecting calcification in various intracranial lesions. All the MRI were obtained using routine T1-and T2-weighted spin eco pulse sequences on 2.0T superconducting system. The 26 patients consisted of 13 brain tumors (4 oligodendrogliomas, 2 craniopharyngiomas, 2 astrocytomas, 1 gem cell tumor, 1 medulloblastoma, 1 ependympma, and pathologically unconfirmed 2 cases), 11 infectious diseases (1 paragonimiasis, 1 sparganosis, 2 cysticercosis, 3 tuberculosis, and 4 unknown cases), and 2 undetermined pathologies. Eighty-two percent (9/11) of infections disease, and 50% (1/2) of undetermined group showed signal diminution or signal void on both T1-and T2-weighted image (T1W1, T2W1). Twenty-four percent (3/13) of brain tumors showed signal diminution on both T1W1 and T2W1. In 46% (6/13) and 61% (8/13) of brain tumors the signal intensities were isointense on T1W1 and T1W1, respectively. Unexpectedly, 3 oligodendrogliomas showed high signal intensity on T1W1, two of which showed com plexed signal intensity mixed with high, iso, and low signal intensities on T2W1. In remained cases (18% (2/11) of infectious diseases and 50% (1/2) of undetermined group) the signal intensities were mixed. With simultaneous review of CT and MRI in each case, the calcification (at least one in cases showing multiple ones) was identifiable on MRI in 62% (8/13) of rumors, 82% (9/11) of infectious diseases, and 100% (2/2) in undetermined group. In 36% (4/11) of infectious diseases, fewer number of

  9. MRI of plantar fasciitis

    Energy Technology Data Exchange (ETDEWEB)

    Roger, B.; Grenier, P. [Service de Radiologie Polyvalente Diagnostique et Interventionelle, Hopital de la Pitie, 83, boulevard de l`Hopital, F-75651 Paris Cedex 13 (France)

    1997-12-01

    At present, MRI is the only imaging method that can precisely visualize lesions of the superficial plantar aponeurosis, whether they be musculoaponeurositides, enthesopathies or tears, and whether they be acute or chronic, with or without complications. By its direct visualization of the lesion, MRI enables an accurate assessment of the injury to be made and thereby better orients the therapeutic strategy. (orig.) With 11 figs., 15 refs.

  10. MRI of the penis

    OpenAIRE

    Kirkham, A

    2012-01-01

    MRI of the penis is an expensive test that is not always superior to clinical examination or ultrasound. However, it shows many of the important structures, and in particular the combination of tumescence from intracavernosal alprostadil, and high-resolution T2 sequences show the glans, corpora and the tunica albuginea well. In this paper we summarise the radiological anatomy and discuss the indications for MRI. For penile cancer, it may be useful in cases where the local stage is not apparen...

  11. High-resolution MRI: in vivo histology?

    OpenAIRE

    Bridge, Holly; Clare, Stuart

    2005-01-01

    For centuries scientists have been fascinated with the question of how the brain works. Investigators have looked at both where different functions are localized and how the anatomical microstructure varies across the brain surface. Here we discuss how advances in magnetic resonance imaging (MRI) have allowed in vivo visualization of the fine structure of the brain that was previously only visible in post-mortem brains. We present data showing the correspondence between definitions of the pri...

  12. Posttraumatic pseudolipoma: MRI appearances

    International Nuclear Information System (INIS)

    The goal of this study was to describe the MRI characteristics of posttraumatic pseudolipomas. Ten patients with previous history of blunt trauma or local surgery were investigated with MRI at the level of their deformity. The etiology was blunt trauma in eight patients and postoperative trauma in two. For all patients medical documentation, in the form of clinical history and physical examination, confirmed that a visible hematoma was present acutely at the same location following the injury and that the contour deformity subsequently appeared. All patients underwent liposuction. Preoperative bilateral MRI examinations were performed on all patients. The mean clinical follow-up was 17.8 months. MRI examinations were interpreted in consensus by two experienced musculoskeletal radiologists with attention to fatty extension (subcutaneous fatty thickness and anatomical extension), asymmetry compared with the asymptomatic side, the presence or absence of fibrous septae or nonfatty components, and patterns of contrast enhancement. Ten posttraumatic pseudolipomas were identified. Clinically, they showed as subcutaneous masses with the consistency of normal adipose tissue. Their locations were the abdomen (n=1), hip (n=1), the upper thigh (n=6), the knee (n=1), and the ankle (n=1). On MRI examinations, using the contralateral side as a control, pseudolipomas appeared as focal fatty masses without a capsule or contrast enhancement. Posttraumatic pseudolipomas may develop at a site of blunt trauma or surgical procedures often antedated by a soft tissue hematoma. Characteristic MRI findings are unencapsulated subcutaneous fatty masses without contrast enhancement. (orig.)

  13. Posttraumatic pseudolipoma: MRI appearances

    Energy Technology Data Exchange (ETDEWEB)

    Theumann, N.; Abdelmoumene, A.; Wintermark, M.; Schnyder, P.; Gailloud, M.C.; Resnick, D. [CHUV, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland)

    2005-09-01

    The goal of this study was to describe the MRI characteristics of posttraumatic pseudolipomas. Ten patients with previous history of blunt trauma or local surgery were investigated with MRI at the level of their deformity. The etiology was blunt trauma in eight patients and postoperative trauma in two. For all patients medical documentation, in the form of clinical history and physical examination, confirmed that a visible hematoma was present acutely at the same location following the injury and that the contour deformity subsequently appeared. All patients underwent liposuction. Preoperative bilateral MRI examinations were performed on all patients. The mean clinical follow-up was 17.8 months. MRI examinations were interpreted in consensus by two experienced musculoskeletal radiologists with attention to fatty extension (subcutaneous fatty thickness and anatomical extension), asymmetry compared with the asymptomatic side, the presence or absence of fibrous septae or nonfatty components, and patterns of contrast enhancement. Ten posttraumatic pseudolipomas were identified. Clinically, they showed as subcutaneous masses with the consistency of normal adipose tissue. Their locations were the abdomen (n=1), hip (n=1), the upper thigh (n=6), the knee (n=1), and the ankle (n=1). On MRI examinations, using the contralateral side as a control, pseudolipomas appeared as focal fatty masses without a capsule or contrast enhancement. Posttraumatic pseudolipomas may develop at a site of blunt trauma or surgical procedures often antedated by a soft tissue hematoma. Characteristic MRI findings are unencapsulated subcutaneous fatty masses without contrast enhancement. (orig.)

  14. Cardiac metabolism and arrhythmias

    OpenAIRE

    Barth, Andreas S.; Tomaselli, Gordon F.

    2009-01-01

    Sudden cardiac death remains a leading cause of mortality in the Western world, accounting for up to 20% of all deaths in the U.S.1, 2 The major causes of sudden cardiac death in adults age 35 and older are coronary artery disease (70–80%) and dilated cardiomyopathy (10–15%).3 At the molecular level, a wide variety of mechanisms contribute to arrhythmias that cause sudden cardiac death, ranging from genetic predisposition (rare mutations and common polymorphisms in ion channels and structural...

  15. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O;

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  16. Magnetic resonance imaging (MRI): A review of genetic damage investigations.

    Science.gov (United States)

    Vijayalaxmi; Fatahi, Mahsa; Speck, Oliver

    2015-01-01

    Magnetic resonance imaging (MRI) is a powerful, non-invasive diagnostic medical imaging technique widely used to acquire detailed information about anatomy and function of different organs in the body, in both health and disease. It utilizes electromagnetic fields of three different frequency bands: static magnetic field (SMF), time-varying gradient magnetic fields (GMF) in the kHz range and pulsed radiofrequency fields (RF) in the MHz range. There have been some investigations examining the extent of genetic damage following exposure of bacterial and human cells to all three frequency bands of electromagnetic fields, as used during MRI: the rationale for these studies is the well documented evidence of positive correlation between significantly increased genetic damage and carcinogenesis. Overall, the published data were not sufficiently informative and useful because of the small sample size, inappropriate comparison of experimental groups, etc. Besides, when an increased damage was observed in MRI-exposed cells, the fate of such lesions was not further explored from multiple 'down-stream' events. This review provides: (i) information on the basic principles used in MRI technology, (ii) detailed experimental protocols, results and critical comments on the genetic damage investigations thus far conducted using MRI equipment and, (iii) a discussion on several gaps in knowledge in the current scientific literature on MRI. Comprehensive, international, multi-centered collaborative studies, using a common and widely used MRI exposure protocol (cardiac or brain scan) incorporating several genetic/epigenetic damage end-points as well as epidemiological investigations, in large number of individuals/patients are warranted to reduce and perhaps, eliminate uncertainties raised in genetic damage investigations in cells exposed in vitro and in vivo to MRI.

  17. Clinical experiences of delayed contrast enhancement with cardiac computed tomography: case series

    Directory of Open Access Journals (Sweden)

    Sidhu Manavjot S

    2013-01-01

    Full Text Available Abstract Background Myocardial delayed enhancement (MDE by gadolinium-enhanced cardiac MRI is well established for myocardial scar assessment in ischemic and non-ischemic heart disease. The role of MDE by cardiac CT (CT-MDE is not yet defined. Findings We reviewed all clinical cases of CT-MDE at a tertiary referral center to present the cases as a case series. All clinical cardiac CT exams which utilized CT-MDE imaging between January 1, 2005 and October 1, 2010 were collected as a series and their findings were also compared with available myocardial imaging to assess for myocardial abnormalities, including echocardiography (wall motion, morphology, cardiac MRI (delayed enhancement, morphology, SPECT MPI (perfusion defects. 5,860 clinical cardiac CT exams were performed during the study period. CT-MDE was obtained in 18 patients and was reported to be present in 9 patients. The indications for CT-MDE included ischemic and non-ischemic heart diseases. In segments positive for CT-MDE, there was excellent agreement of CT with other modalities: echocardiography (n=8 demonstrated abnormal morphology and wall motion (k=1.0 and k=0.82 respectively; prior MRI (n=2 demonstrated abnormal delayed enhancement (MR-MDE (k=1.0; SPECT MPI (n=1 demonstrated fixed perfusion defects (k=1.0. In the subset of patients without CT-MDE, no abnormal segments were identified by echocardiography (n=8, MRI (n=1 and nuclear MPI (n=0. Conclusions CT-MDE was performed in rare clinical situations. The indications included both ischemic and non-ischemic heart disease and there was an excellent agreement between CT-MDE and abnormal myocardium by echocardiography, cardiac MRI, and nuclear MPI.

  18. Clinical experiences of delayed contrast enhancement with cardiac computed tomography: case series

    OpenAIRE

    Sidhu Manavjot S; Ghoshhajra Brian B; Uthamalingam Shanmugam; Kilcullen Niamh; Engel Leif-Christopher; Medina Hector M; Venkatesh Vikram; Vorasettakarnkij Yongkasem; Hoffmann Udo; Cury Ricardo C; Abbara Suhny; Brady Thomas J

    2013-01-01

    Abstract Background Myocardial delayed enhancement (MDE) by gadolinium-enhanced cardiac MRI is well established for myocardial scar assessment in ischemic and non-ischemic heart disease. The role of MDE by cardiac CT (CT-MDE) is not yet defined. Findings We reviewed all clinical cases of CT-MDE at a tertiary referral center to present the cases as a case series. All clinical cardiac CT exams which utilized CT-MDE imaging between January 1, 2005 and October 1, 2010 were collected as a series a...

  19. Ischemic Hepatitis as the Presenting Manifestation of Cardiac Amyloidosis

    Directory of Open Access Journals (Sweden)

    Chelsey A. Petz MD

    2014-11-01

    Full Text Available An abrupt elevation in aminotransferases without clear etiology may be attributed to hypoxic hepatitis. Underlying cardiac dysfunction, an important clinical clue, is often overlooked as a cause of hypoxic hepatitis, and understanding the interdependence of the heart and liver is crucial in making this diagnosis. Causes of cardiac dysfunction may include any of many different diagnoses; infiltrative heart disease is a rare cause of cardiac dysfunction, with amyloidosis being the most common among this category of pathologies. More advanced imaging techniques have improved the ability to diagnose infiltrative heart disease, thus allowing quicker diagnosis of conditions such as amyloidosis.

  20. Cardiac Risk Assessment

    Science.gov (United States)

    ... to assess cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring ... LDL-C but does not respond to typical strategies to lower LDL-C such as diet, exercise, ...

  1. Sudden Cardiac Arrest

    Science.gov (United States)

    ... Heart Risk Factors & Prevention Heart Diseases & Disorders Atrial Fibrillation (AFib) Sudden Cardiac Arrest (SCA) SCA: Who's At Risk? Prevention of SCA What Causes SCA? SCA Awareness Atrial Flutter Heart Block Heart Failure Sick Sinus Syndrome Substances & Heart Rhythm Disorders Symptoms & ...

  2. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;

    2012-01-01

    to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  3. Fetal MRI: obstetrical and neurological perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Gressens, Pierre [INSERM E 9935 and Service de Neurologie Pediatrique, Hopital Robert Debre, 48 Blvd Serurier, 75019, Paris (France); Luton, Dominique [Maternity Department, Hopital Robert Debre, Paris (France)

    2004-09-01

    Despite major advances in the understanding and in the genetics of several diseases of the developing brain, early prediction of the neurological prognosis of brain abnormality discovered in utero or of white matter damage discovered in a preterm neonate remains particularly difficult. Advances in prenatal diagnosis and the increased rate of survival of extremely preterm infants who are at higher risk of developing white matter damage underline the critical and urgent need for reliable predictive techniques. New imaging techniques such as diffusion-weighted imaging, magnetic resonance spectroscopy or functional MRI applied to the fetus represent promising tools in this perspective. (orig.)

  4. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  5. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  6. Cardiac rehabilitation in Germany.

    Science.gov (United States)

    Karoff, Marthin; Held, Klaus; Bjarnason-Wehrens, Birna

    2007-02-01

    The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers. Cardiac rehabilitation has predominantly been offered as an inpatient service, but has recently been complemented by outpatient services. A general agreement on the different indications for offering these two services has yet to be reached. Cardiac rehabilitation is mainly offered after an acute cardiac event and bypass surgery. It is also indicated in severe heart failure and special cases of percutaneous coronary intervention. Most patients are men (>65%) and the age at which events occur is increasing. The benefits obtained during the 3-4 weeks after an acute event, and confirmed in numerous studies, are often later lost under 'usual care' conditions. Many attempts have been made by rehabilitation institutions to improve this deficit by providing intensive aftercare. One instrument set up to achieve this is the nationwide institution currently comprising more than 6000 heart groups with approximately 120000 outpatients. After coronary artery bypass grafting or acute coronary syndrome cardiac rehabilitation can usually be started within 10 days. The multidisciplinary rehabilitation team consists of cardiologists, psychologists, exercise therapists, social workers, nutritionists and nurses. The positive effects of cardiac rehabilitation are also important economically, for example, for the improvement of secondary prevention and vocational integration. PMID:17301623

  7. Cardiac tumours in infancy

    OpenAIRE

    Yadava, O.P.

    2012-01-01

    Cardiac tumours in infancy are rare and are mostly benign with rhabdomyomas, fibromas and teratomas accounting for the majority. The presentation depends on size and location of the mass as they tend to cause cavity obstruction or arrhythmias. Most rhabdomyomas tend to regress spontaneously but fibromas and teratomas generally require surgical intervention for severe haemodynamic or arrhythmic complications. Other relatively rare cardiac tumours too are discussed along with an Indian perspect...

  8. Infected cardiac hydatid cyst

    OpenAIRE

    Ceviz, M; Becit, N; Kocak, H.

    2001-01-01

    A 24 year old woman presented with chest pain and palpitation. The presence of a semisolid mass—an echinococcal cyst or tumour—in the left ventricular apex was diagnosed by echocardiography, computed tomography, and magnetic resonance imaging. The infected cyst was seen at surgery. The cyst was removed successfully by using cardiopulmonary bypass with cross clamp.


Keywords: cardiac hydatid cyst; infected cardiac hydatid cyst

  9. The incidence of sudden cardiac death in athletes

    Directory of Open Access Journals (Sweden)

    Popović Dejana

    2006-01-01

    Full Text Available Introduction. Despite remarkable advances in medicine and sports, sudden cardiac death remains a significant problem. Incidence of sudden cardiac death. The incidence of sudden cardiac death varies in different studies and there are no systematic data about it. It varies in different types of sports, with age and sex. Sudden cardiac death and physical activity. Many changes in cardiac morphology and function represent an adaptive response to physical activity. As a result, the heart undergoes profound morphologic, functional and electro-physiological alterations. But as there are different kinds of physical activities, the degree of these morphological changes is highly variable. It is needless to say how important it is to know which changes in the heart due to physical activity are normal, and when they are pathological. Considering the results of many studies, the main cause of sudden cardiac death is hypertrophic cardiomiopathy. Conclusion. It is very important to distinguish physiological changes of the heart due to physical activity, and pathological changes due to some cardiac diseases. That is why, clear recommendations on intensity, type, duration and frequency of physical training in every sports discipline are necessary. That is the only way to decrease the incidence of sudden cardiac death in athletes. .

  10. [Technologies for cardiac valve prostheses].

    Science.gov (United States)

    Nakano, Kiyoharu

    2009-07-01

    To show the technological development of cardiac valve prostheses, a historical review of both mechanical and biological valve prostheses and a current overview of modern cardiac valve devices are provided. Scince the 1st implantation of Starr-Edwards ball valve in 1960, both mechanical and biological valve prostheses have advanced. The valve design, the material of the leaflet and the hausing of mechanical prostheses have improved. Currently, the majority of the mechanical prostheses are bileaflet tilting disc valves made of pyrolytic carbon, which is antithromboembolic. However, anticoagulation therapy with warfarin is still required. As for the bioprostheses, although the fixation and anti-mineralization methods of the tissues improved, the durability of these valves is still limited. For the material of the current biological valves, the porcine aortic valve or bovine pericardium are used. The tissues are fixed by non-pressure or low-pressure method in glutaraldehyde solution. A stented and non-stented valves are available. Epoch-making events in this field are the implantation of new bioprosthetic valves using tissue engineering methods and the development of the transcatheter valve replacement therapies.

  11. MRI evaluation of end-organ damage in diabetes and hypertension

    NARCIS (Netherlands)

    Elderen, Saskia Gerdina Cornelia van

    2010-01-01

    Our studies have shown MRI assessed aortic stiffness being an integrated marker of cardiac function, cerebral small vessel disease and atrophy, as well as of renal function in type1 diabetes mellitus patients. Aortic stiffness already in normal range is related to end-organ damage in type1 diabetes

  12. GPU accelerated iterative SENSE reconstruction of radial phase encoded whole-heart MRI

    DEFF Research Database (Denmark)

    Sørensen, Thomas Sangild; Prieto, Claudia; Atkinson, David;

    2010-01-01

    Isotropic whole-heart imaging has become an important protocol in simplifying cardiac MRI. The acquisition time can however be a prohibiting factor. To reduce acquisition times a 3D scheme combining Cartesian sampling in the readout direction with radial sampling in the phase encoding plane was r...

  13. Auto-Segmentation of Bone in MRI-only Based Radiotherapy Using Ultra Short Echo Time

    DEFF Research Database (Denmark)

    Edmund, J. M.; Kjer, Hans Martin; Hansen, R. H.

    2012-01-01

    ). Materials and Methods: A cutaway from the front leg of a calf including the knee-joint was used as a phantom. The MR images were acquired on a 3.0-T MRI scanner (Philips Achieva) using a cardiac coil to cover the entire phantom. The UTE sequence applies two different echo times, TE1 and TE2, which were 0...

  14. Cardiac applications of optogenetics.

    Science.gov (United States)

    Ambrosi, Christina M; Klimas, Aleksandra; Yu, Jinzhu; Entcheva, Emilia

    2014-08-01

    In complex multicellular systems, such as the brain or the heart, the ability to selectively perturb and observe the response of individual components at the cellular level and with millisecond resolution in time, is essential for mechanistic understanding of function. Optogenetics uses genetic encoding of light sensitivity (by the expression of microbial opsins) to provide such capabilities for manipulation, recording, and control by light with cell specificity and high spatiotemporal resolution. As an optical approach, it is inherently scalable for remote and parallel interrogation of biological function at the tissue level; with implantable miniaturized devices, the technique is uniquely suitable for in vivo tracking of function, as illustrated by numerous applications in the brain. Its expansion into the cardiac area has been slow. Here, using examples from published research and original data, we focus on optogenetics applications to cardiac electrophysiology, specifically dealing with the ability to manipulate membrane voltage by light with implications for cardiac pacing, cardioversion, cell communication, and arrhythmia research, in general. We discuss gene and cell delivery methods of inscribing light sensitivity in cardiac tissue, functionality of the light-sensitive ion channels within different types of cardiac cells, utility in probing electrical coupling between different cell types, approaches and design solutions to all-optical electrophysiology by the combination of optogenetic sensors and actuators, and specific challenges in moving towards in vivo cardiac optogenetics.

  15. Advances of quantitative dynamic contrast-enhanced MRI in head and neck neoplasms%定量动态增强MRI在头颈部肿瘤中的研究进展

    Institute of Scientific and Technical Information of China (English)

    闫铄; 夏爽(审校)

    2014-01-01

    The dynamic contrast-enhanced MRI (DCE-MRI) images were generated according to the signal changes aroused by the different perfusion and permeability of micro-molecule contrast agents in tissues. The common T 1WI sequences include volumetric interpolated breathhold examination (VIBE), liver acquisition with volume acceleration (LAVA), time-resolved angiography with interleaved stochastic trajectories (TWIST). The qualitative, semi-quantitative and quantitative conclusions could be drawn after the post-processing of the original DCE-MRI images. Among them, the quantitative analysis was conducted according to different parameters, and then was applied in the diagnosis, differentiate diagnosis, and the classification of tumors and tumors’ therapeutic evaluations. In this review we summarized the applications of the quantitative DCE-MRI in the head and neck neoplasms.%动态增强MRI基于小分子对比剂在灌注程度和渗透性不同的组织中分布不同而引起信号变化进行成像,常用T1WI扫描序列如快速三维容积内插屏气检查(VIBE)、肝脏快速容积采集(LAVA)序列、时间分辨随机轨道成像(TWIST)。这些序列各有优缺点。动态对比增强MR(DCE-MRI)原始图像经过后处理,可以进行定性、半定量、定量分析。定量分析根据不同的参数值,对肿瘤进行诊断、鉴别诊断,肿瘤分级及疗效评价等。就定量DCE-MRI在头颈部肿瘤中的应用进展进行综述。

  16. Value of prenatal MRI in early evaluation of fetal central nervous system anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Keiichi [Kugayama Hospital, Tokyo (Japan); Nakamura, Masanao; Hino, Ken [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine] [and others

    2002-08-01

    Advances in technology and the need for accurate prenatal diagnoses have produced great improvements in fetal diagnosis by MRI. However, there are still many problems with diagnosis of central nervous system (CNS) anomalies using MRI (e.g., time of diagnosis, factors limiting diagnostic ability. Fifteen cases referred to our clinic from 1992 to 2001 and examined using intrauterine ultrasound, prenatal MRI and postnatal MRI were reviewed retrospectively. All clinical records and findings from prenatal MRI, postnatal MRI and ultrasound were reviewed. Prenatal MRI was found to be equal in diagnostic power to ultrasound and postnatal MRI in 10 of the 15 cases. In the remaining 5 fetuses, the findings of prenatal MRI were not the same to those of prenatal ultrasound and postnatal MRI. Our goal was to determine the value of prenatal MRI in diagnosis of fetal CNS anomalies, to ascertain how this information might be used for counseling, and to assess its impact on pregnancy management. Prenatal MRI provided useful information for support personnel (e.g., physicians, nurses, caseworkers, religious advisers). (author)

  17. Diagnostic performance of cardiac imaging methods to diagnose ischaemia-causing coronary artery disease when directly compared with fractional flow reserve as a reference standard

    DEFF Research Database (Denmark)

    Danad, Ibrahim; Szymonifka, Jackie; Twisk, Jos W R;

    2016-01-01

    -vessel specificity was highest for MRI (85%, 79-89), FFRCT (78%: 78-81), and SPECT (75%: 69-80), whereas ICA (66%: 64-68) and CCTA (58%: 55-61) yielded a lower specificity. CONCLUSIONS: In this meta-analysis comparing cardiac imaging methods directly to FFR, MRI had the highest performance for diagnosis of ischaemia-causing......), and cardiac magnetic resonance (MRI) imaging when directly compared with an FFR reference standard. METHOD AND RESULTS: PubMed and Web of Knowledge were searched for investigations published between 1 January 2002 and 28 February 2015. Studies performing FFR in at least 75% of coronary vessels...

  18. MRI of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Kauczor, Hans-Ulrich (ed.) [University Clinic Heidelberg (Germany). Diagnostic and Interventional Radiology

    2009-07-01

    For a long time, only chest X-ray and CT were used to image lung structure, while nuclear medicine was employed to assess lung function. During the past decade significant developments have been achieved in the field of magnetic resonance imaging (MRI), enabling MRI to enter the clinical arena of chest imaging. Standard protocols can now be implemented on up-to-date scanners, allowing MRI to be used as a first-line imaging modality for various lung diseases, including cystic fibrosis, pulmonary hypertension and even lung cancer. The diagnostic benefits stem from the ability of MRI to visualize changes in lung structure while simultaneously imaging different aspects of lung function, such as perfusion, respiratory motion, ventilation and gas exchange. On this basis, novel quantitative surrogates for lung function can be obtained. This book provides a comprehensive overview of how to use MRI for imaging of lung disease. Special emphasis is placed on benign diseases requiring regular monitoring, given that it is patients with these diseases who derive the greatest benefit from the avoidance of ionizing radiation. (orig.)

  19. MRI in Japanese encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, S. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Radiology; Misra, U.K. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Neurology; Kalita, J. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Neurology; Salwani, V. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Radiology; Gupta, R.K. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Radiology; Gujral, R. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Radiology

    1997-03-01

    We document the MRI features in seven patients with Japanese encephalitis. MRI was carried out on a 1.5 T system within 10-60 days of onset. In all the patients MRI revealed bilateral thalamic lesions, haemorrhagic in five. Signal changes were present in the cerebrum in four patients, the midbrain and cerebellum in three each, the pons in two and the basal ganglia in one. The lesions were haemorrhagic in three of the four patients with lesions in the cortex, two of the three with lesions in the midbrain and cerebellum, but the pontine lesions were haemorrhagic in both patients. Spinal cord involvement was seen in one of the three patients who underwent MRI. In two patients MRI was repeated 3 years after the onset, showing marked reduction in abnormal signal; and all the lesions gave low signal on both T1- and T2-weighted images. Bilateral thalamic involvement, especially haemorrhagic, may be considered characteristic of Japanese encephalitis, especially in endemic areas. (orig.)

  20. MRI of the lung

    International Nuclear Information System (INIS)

    For a long time, only chest X-ray and CT were used to image lung structure, while nuclear medicine was employed to assess lung function. During the past decade significant developments have been achieved in the field of magnetic resonance imaging (MRI), enabling MRI to enter the clinical arena of chest imaging. Standard protocols can now be implemented on up-to-date scanners, allowing MRI to be used as a first-line imaging modality for various lung diseases, including cystic fibrosis, pulmonary hypertension and even lung cancer. The diagnostic benefits stem from the ability of MRI to visualize changes in lung structure while simultaneously imaging different aspects of lung function, such as perfusion, respiratory motion, ventilation and gas exchange. On this basis, novel quantitative surrogates for lung function can be obtained. This book provides a comprehensive overview of how to use MRI for imaging of lung disease. Special emphasis is placed on benign diseases requiring regular monitoring, given that it is patients with these diseases who derive the greatest benefit from the avoidance of ionizing radiation. (orig.)

  1. Clinical study on the adriamycin induced cardiomyopathy using the cardiac magnetic resonance imaging. Total dose and cardiac dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Kyoko; Teraoka, Kunihiko; Hirano, Masaharu [Tokyo Medical Coll. (Japan)

    2001-05-01

    We studied cardiac functional disorders caused by Adoriamycin using gadolinium (Gd) contrast cine MRI. Forty-eight patients were given ACT (31 men and 17 women; mean age, 52{+-}15 years). First, the relationship between dose and the left ventricular volume, cardiac function, left ventricular cardiac mass and localized wall motion were examined in all patients. Patients given a total dose of 300 mg/m{sup 2} or higher were assigned to the high dose group and those given doses under 300 mg/m{sup 2} to the low dose group. The same parameters were studied in both groups and compared. A 1.5-Tesla superconductive MRI was used for all studies. Cine images of the long and short axes at the papillary muscle level were obtained by ECG R-wave synchronized Gd contrast cine MRI. Left ventricular volume and cardiac function were analyzed using the long-axis cine images and the wall thickness in diastole and systole was measured at each site using the short-axis cine images. The percentage of wall thickness was calculated at each site. The mean ACT dose was 273.3{+-}218.2 mg/m{sup 2}. In all patients the total dose directly correlated with ESVI and inversely correlated with the ejection fraction (EF). In the high dose group, the total dose and EF were inversely correlated, but no significant differences were observed in the low dose group. In the high dose group, the ESVI was significantly greater and the SVI and EF were more significantly reduced than in the low dose group. In the high dose group, the thickness of the anterior, lateral and posterior walls, excluding the septum, was significantly lower than in the low dose group. However, changes in wall thickness were not significantly different between the groups. Gd contrast cine MRI was useful in examining cardiac functional disorders caused by anthracyclines. The total dose of anthracycline correlated directly with the ESVI, and inversely with the EF. A total dose of 300 mg/m{sup 2} appeared to be the borderline dose beyond

  2. Multifocal non-Hodgkin lymphoma in an infant with cardiac involvement: whole-body MR imaging

    International Nuclear Information System (INIS)

    Non-Hodgkin lymphoma (NHL) is rare in infancy, and we present a case of aggressive NHL of T-cell lineage in an infant with multifocal bone, cardiac, mediastinal nodal, paranasal sinus, calvarial, and soft-tissue deposits on presentation that were detected on whole-body MRI. (orig.)

  3. On the Procedures for the Demonstration of the RF Safety of Active and Passive Implants in MRI Environments

    Institute of Scientific and Technical Information of China (English)

    Eugenia CABOT; Maria CABANES-SEMPERE; Niels KUSTER

    2016-01-01

    As a diagnostic method, magnetic resonance imaging (MRI) is not allowed to be used in patients with medical implants, including both active implants (such as cardiac deifbrillators or deep brain stimulators) and passive implants (such as orthopedics implants and support). MRI imaging scanning can produce magnetic ifelds, which will produce concentrated electromagnetic induction on metal edges of the implants, such as electrodes. The magnetic ifeld can also signiifcantly increase the temperature of surrounding tissues. Besides, the currents and voltage produced by active implants when exposed to MRI scanning can lead to damage and malfunction of pulse generators. Therefore, patients with medical implants cannot receive MRI as a diagnostic method. This safety protocol prevents a large group of patients from receiving MRI diagnosis. This leads to the conclusion that the safety evaluation of implants under MRI environment requires the combination of accurate data analysis and experimental techniques so as to establish the standard testing program.

  4. Real time dynamic MRI by exploiting spatial and temporal sparsity.

    Science.gov (United States)

    Chen, Chen; Li, Yeqing; Axel, Leon; Huang, Junzhou

    2016-05-01

    Online imaging requires that the reconstruction of current frame only depends on the previous frames, and real time imaging is the desired case. In this work, we propose a novel scheme for real time dynamic magnetic resonance imaging (dMRI) reconstruction. Different from previous methods, the reconstructions of the second frame to the last frame are independent in our scheme, which only require the first frame as the reference image. Therefore, this scheme can be naturally implemented in parallel. After the first frame is reconstructed, all the later frames can be processed as soon as the k-space data are acquired. As an extension of the conventional spatial total variation, a new online model called dynamic total variation is used to exploit the sparsity on both spatial and temporal domains in dMRI. In real time dMRI, each frame is required to be reconstructed very fast. We then design a novel reweighted least squares algorithm to solve the challenging problem. Motivated by the special structure of partial Fourier transform in sparse MRI, this algorithm is accelerated by the preconditioned conjugate gradient descent method. The proposed method is compared with 4 state-of-the-art online and offline methods on two in-vivo cardiac dMRI datasets. The experimental results show that our method significantly outperforms previous online methods, and is comparable to the offline methods in terms of reconstruction accuracy. PMID:26578303

  5. An integrated platform for image-guided cardiac resynchronization therapy

    Science.gov (United States)

    Ma, Ying Liang; Shetty, Anoop K.; Duckett, Simon; Etyngier, Patrick; Gijsbers, Geert; Bullens, Roland; Schaeffter, Tobias; Razavi, Reza; Rinaldi, Christopher A.; Rhode, Kawal S.

    2012-05-01

    Cardiac resynchronization therapy (CRT) is an effective procedure for patients with heart failure but 30% of patients do not respond. This may be due to sub-optimal placement of the left ventricular (LV) lead. It is hypothesized that the use of cardiac anatomy, myocardial scar distribution and dyssynchrony information, derived from cardiac magnetic resonance imaging (MRI), may improve outcome by guiding the physician for optimal LV lead positioning. Whole heart MR data can be processed to yield detailed anatomical models including the coronary veins. Cine MR data can be used to measure the motion of the LV to determine which regions are late-activating. Finally, delayed Gadolinium enhancement imaging can be used to detect regions of scarring. This paper presents a complete platform for the guidance of CRT using pre-procedural MR data combined with live x-ray fluoroscopy. The platform was used for 21 patients undergoing CRT in a standard catheterization laboratory. The patients underwent cardiac MRI prior to their procedure. For each patient, a MRI-derived cardiac model, showing the LV lead targets, was registered to x-ray fluoroscopy using multiple views of a catheter looped in the right atrium. Registration was maintained throughout the procedure by a combination of C-arm/x-ray table tracking and respiratory motion compensation. Validation of the registration between the three-dimensional (3D) roadmap and the 2D x-ray images was performed using balloon occlusion coronary venograms. A 2D registration error of 1.2 ± 0.7 mm was achieved. In addition, a novel navigation technique was developed, called Cardiac Unfold, where an entire cardiac chamber is unfolded from 3D to 2D along with all relevant anatomical and functional information and coupled to real-time device detection. This allowed more intuitive navigation as the entire 3D scene was displayed simultaneously on a 2D plot. The accuracy of the unfold navigation was assessed off-line using 13 patient data sets

  6. Intraoperative MRI in pediatric brain tumors

    International Nuclear Information System (INIS)

    Intraoperative magnetic resonance imaging (iMRI) has emerged as an important tool in guiding the surgical management of children with brain tumors. Recent advances have allowed utilization of high field strength systems, including 3-tesla MRI, resulting in diagnostic-quality scans that can be performed while the child is on the operating table. By providing information about the possible presence of residual tumor, it allows the neurosurgeon to both identify and resect any remaining tumor that is thought to be safely accessible. By fusing the newly obtained images with the surgical guidance software, the images have the added value of aiding in navigation to any residual tumor. This is important because parenchyma often shifts during surgery. It also gives the neurosurgeon insight into whether any immediate postoperative complications have occurred. If any complications have occurred, the child is already in the operating room and precious minutes lost in transport and communications are saved. In this article we review the three main approaches to an iMRI system design. We discuss the possible roles for iMRI during intraoperative planning and provide guidance to help radiologists and neurosurgeons alike in the collaborative management of these children. (orig.)

  7. Intraoperative MRI in pediatric brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Choudhri, Asim F. [Le Bonheur Children' s Hospital, Department of Radiology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Siddiqui, Adeel [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Klimo, Paul; Boop, Frederick A. [University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Semmes-Murphey Neurologic and Spine Institute, Memphis, TN (United States); St. Jude Children' s Hospital, Division of Neurosurgery, Department of Surgery, Memphis, TN (United States)

    2015-09-15

    Intraoperative magnetic resonance imaging (iMRI) has emerged as an important tool in guiding the surgical management of children with brain tumors. Recent advances have allowed utilization of high field strength systems, including 3-tesla MRI, resulting in diagnostic-quality scans that can be performed while the child is on the operating table. By providing information about the possible presence of residual tumor, it allows the neurosurgeon to both identify and resect any remaining tumor that is thought to be safely accessible. By fusing the newly obtained images with the surgical guidance software, the images have the added value of aiding in navigation to any residual tumor. This is important because parenchyma often shifts during surgery. It also gives the neurosurgeon insight into whether any immediate postoperative complications have occurred. If any complications have occurred, the child is already in the operating room and precious minutes lost in transport and communications are saved. In this article we review the three main approaches to an iMRI system design. We discuss the possible roles for iMRI during intraoperative planning and provide guidance to help radiologists and neurosurgeons alike in the collaborative management of these children. (orig.)

  8. Toward microendoscopy-inspired cardiac optogenetics in vivo: technical overview and perspective

    Science.gov (United States)

    Klimas, Aleksandra; Entcheva, Emilia

    2014-08-01

    The ability to perform precise, spatially localized actuation and measurements of electrical activity in the heart is crucial in understanding cardiac electrophysiology and devising new therapeutic solutions for control of cardiac arrhythmias. Current cardiac imaging techniques (i.e. optical mapping) employ voltage- or calcium-sensitive fluorescent dyes to visualize the electrical signal propagation through cardiac syncytium in vitro or in situ with very high-spatiotemporal resolution. The extension of optogenetics into the cardiac field, where cardiac tissue is genetically altered to express light-sensitive ion channels allowing electrical activity to be elicited or suppressed in a precise cell-specific way, has opened the possibility for all-optical interrogation of cardiac electrophysiology. In vivo application of cardiac optogenetics faces multiple challenges and necessitates suitable optical systems employing fiber optics to actuate and sense electrical signals. In this technical perspective, we present a compendium of clinically relevant access routes to different parts of the cardiac electrical conduction system based on currently employed catheter imaging systems and determine the quantitative size constraints for endoscopic cardiac optogenetics. We discuss the relevant technical advancements in microendoscopy, cardiac imaging, and optogenetics and outline the strategies for combining them to create a portable, miniaturized fiber-based system for all-optical interrogation of cardiac electrophysiology in vivo.

  9. CARDIAC FUNCTION AND IRON CHELATION IN THALASSEMIA MAJOR AND INTERMEDIA: A REVIEW OF THE UNDERLYING PATHOPHYSIOLOGY AND APPROACH TO CHELATION MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Athanasios Aessopos

    2009-07-01

    Full Text Available Heart disease is the leading cause of mortality and one of the main causes of morbidity in beta-thalassemia. Patients with homozygous thalassemia may have either a severe phenotype which is usually transfusion dependent or a milder form that is thalassemia intermedia.  The two main factors that determine cardiac disease in homozygous β thalassemia are the high output state that results from chronic tissue hypoxia, hypoxia-induced compensatory reactions and iron overload.  The high output state playing a major role in thalassaemia intermedia and the iron load being more significant in the major form. Arrhythmias, vascular involvement that leads to an increased pulmonary vascular resistance and an increased systemic vascular stiffness and valvular abnormalities also contribute to the cardiac dysfunction in varying degrees according to the severity of the phenotype.  Endocrine abnormalities, infections, renal function and medications can also play a role in the overall cardiac function.  For thalassaemia major, regular and adequate blood transfusions and iron chelation therapy are the mainstays of management. The approach to thalassaemia intermedia, today, is aimed at monitoring for complications and initiating, timely, regular transfusions and/or iron chelation therapy.  Once the patients are on transfusions, then they should be managed in the same way as the thalassaemia major patients.  If cardiac manifestations of dysfunction are present in either form of thalassaemia, high pre transfusion Hb levels need to be maintained in order to reduce cardiac output and appropriate intensive chelation therapy needs to be instituted.  In general recommendations on chelation, today, are usually made according to the Cardiac Magnetic Resonance findings, if available.  With the advances in the latter technology and the ability to tailor chelation therapy according to the MRI findings as well as the availability of three iron chelators, together with

  10. MRI of oriental cholangiohepatitis

    Energy Technology Data Exchange (ETDEWEB)

    Wani, N.A., E-mail: ahmad77chinar@gmail.co [Department of Radiodiagnosis and Imaging, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar (India); Robbani, I.; Kosar, T. [Department of Radiodiagnosis and Imaging, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar (India)

    2011-02-15

    Oriental cholangiohepatitis (OCH) also called recurrent pyogenic cholangitis is characterized by intrahepatic duct calculi, strictures, and recurrent infections. In turn cholangitis can result in multiple hepatic abscesses, further biliary strictures, and in severe cases, progressive hepatic parenchymal destruction, cirrhosis, and portal hypertension. Magnetic resonance cholangiopancreatography (MRCP) and conventional T1-weighted (T1 W) and T2-weighted (T2 W) magnetic resonance imaging (MRI) findings have been described in patients with OCH. MRCP findings include duct dilation, strictures, and calculi. MRCP can help to localize the diseased ducts and determine the severity of involvement. T1 and T2 W sequences reveal the parenchymal changes of atrophy, abscess formation, and portal hypertension in addition to calculi. Post-treatment changes are also well depicted using MRI. Comprehensive, non-invasive assessment is achieved by using conventional MRI and MRCP in OCH providing a roadmap for endoscopic or surgical management.

  11. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI-guided prostate biopsy uses imaging ... Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI-guided prostate biopsies are performed ...

  12. SU-E-J-192: Verification of 4D-MRI Internal Target Volume Using Cine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lafata, K; Czito, B; Palta, M; Bashir, M; Yin, F; Cai, J [Duke University Medical Center, Durham, NC (United States)

    2014-06-01

    Purpose: To investigate the accuracy of 4D-MRI in determining the Internal Target Volume (ITV) used in radiation oncology treatment planning of liver cancers. Cine MRI is used as the standard baseline in establishing the feasibility and accuracy of 4D-MRI tumor motion within the liver. Methods: IRB approval was obtained for this retrospective study. Analysis was performed on MR images from four patients receiving external beam radiation therapy for liver cancer at our institution. Eligible patients received both Cine and 4D-MRI scans before treatment. Cine images were acquired sagittally in real time at a slice bisecting the tumor, while 4D images were acquired volumetrically. Cine MR DICOM headers were manipulated such that each respiratory frame was assigned a unique slice location. This approach permitted the treatment planning system (Eclipse, Varian Medical Systems) to recognize a complete respiratory cycle as a “volume”, where the gross tumor was contoured temporally. Software was developed to calculate the union of all frame contours in the structure set, resulting in the corresponding plane of the ITV projecting through the middle of the tumor, defined as the Internal Target Area (ITA). This was repeated for 4D-MRI, at the corresponding slice location, allowing a direct comparison of ITAs obtained from each modality. Results: Four patients have been analyzed. ITAs contoured from 4D-MRI correlate with contours from Cine MRI. The mean error of 4D values relative to Cine values is 7.67 +/− 2.55 %. No single ITA contoured from 4D-MRI demonstrated more than 10.5 % error compared to its Cine MRI counterpart. Conclusion: Motion management is a significant aspect of treatment planning within dynamic environments such as the liver, where diaphragmatic and cardiac activity influence plan accuracy. This small pilot study suggests that 4D-MRI based ITA measurements agree with Cine MRI based measurements, an important step towards clinical implementation. NIH 1R21

  13. Introduction to Interventional MRI

    Institute of Scientific and Technical Information of China (English)

    Jarmo Ruohonen; William G.Bradley; Jr.MD

    2002-01-01

    An increasing number of interventional procedures are done under imaging guidance. These include biopsies, drainages and injections. Likewise, imaging guidance and monitoring have enabled the use of sophisticated techniques for minimally invasive therapy of tumors. Since MRI provides the best tissue contrast and lesion sensitivity,the use of MR-guided procedures (MRGP) is quickly gaining momentum. Special hardware and software solutions have been developed that allow more efficient interventional use of the MR scanner.This introduction summarizes the basic concepts of interventional MRI and outlines some of the applications of today and tomorrow.

  14. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... medically necessary. MRI may not always distinguish between cancer tissue and fluid, known as edema . MRI typically ... Brain Tumors Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association top ...

  15. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... have this exam in the first trimester of pregnancy unless the potential benefit from the MRI exam ... See the Safety page for more information about pregnancy and MRI. If you have claustrophobia (fear of ...

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... claustrophobia. Newer open MRI units provide very high quality images for many types of exams; however, older ... MRI units may not provide this same image quality. Certain types of exams cannot be performed using ...

  17. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... MRI an invaluable tool in early diagnosis and evaluation of many conditions, including tumors. MRI enables the ... physicians with expertise in several radiologic areas. Outside links: For the convenience of our users, RadiologyInfo .org ...

  18. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging technique that ... than 30 minutes from the onset of symptoms. Risks The MRI examination poses almost no risk to ...

  19. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) ... conditions such as: brain tumors stroke infections developmental anomalies hydrocephalus — dilatation of fluid spaces within the brain ( ...

  20. Magnetic Resonance Imaging (MRI) -- Head

    Science.gov (United States)

    ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... over time. top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging ...

  1. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose and treat medical ... CD. Currently, MRI is the most sensitive imaging test of the head (particularly the brain) in routine ...

  2. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... items, which can distort MRI images removable dental work pens, pocket knives and eyeglasses body piercings In most cases, an MRI exam is safe for patients with metal implants, except for a ...

  3. Detecting regional changes in myocardial contraction patterns using MRI

    Science.gov (United States)

    Sanchez-Ortiz, Gerardo I.; Chandrashekara, Raghavendra; Rhode, Kawal S.; Razavi, Reza; Hill, Derek L. G.; Rueckert, Daniel

    2004-04-01

    Measuring changes in cardiac motion patterns can assist in diagnosing the onset of arrhythmia and ischaemia and in the follow-up of treatment. This work presents a methodology for measuring such motion changes from MR images. Non-rigid registration is used to track cardiac motion in a sequence of 3D tagged MR images. We use a cylindrical coordinate system to subdivide the myocardium into smaller anatomically meaningful regions and to express motion derived measurements such as displacement and strain for each myocardial region during the cardiac cycle. In the first experiment we have evaluated the proposed methods using synthetic image sequences where the ground truth was available. These images were generated using a cardiac motion simulator for tagged MRI. Normal and abnormal motion fields were produced by modifying parameters in a small region of the myocardium. In the second experiment we have acquired two separate tagged MR image sequences from five healthy volunteers. Both acquisitions have been carried out without moving the volunteer inside the scanner, thus avoiding potential misregistration errors due to subject motion between scans. In addition, one of volunteers was subjected to stress during one of the scans. In the final experiment we acquired tagged MR images from a patient with super-ventricular tachyarrhythmia, before and after radio frequency ablation. The image acquisition and catheter intervention were performed with a combined X-ray and MRI system. Detection results were correct on synthetic data and no region was incorrectly classified as having significant changes in the repetition studies. Significant changes in motion pattern were measured in the stress and ablation studies. Furthermore, results seem to corroborate that the ablation regularised cardiac contraction.

  4. The role of tissue engineering and biomaterials in cardiac regenerative medicine

    OpenAIRE

    Zhao, Yimu; Feric, Nicole T.; Thavandiran, Nimalan; Nunes, Sara S.; Radisic, Milica

    2014-01-01

    In recent years, the development of three-dimensional engineered heart tissue (EHT) has made large strides forward due to advances in stem cell biology, materials science, pre-vascularization strategies and nanotechnology. As a result, the role of tissue engineering in cardiac regenerative medicine has become multi-faceted as new applications become feasible. Cardiac tissue engineering has long been established to have the potential to partially or fully restore cardiac function following car...

  5. Cine-MRI swallowing evaluation after tongue reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Hartl, Dana M. [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dmhartl@aol.com; Kolb, Frederic; Bretagne, Evelyne [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Bidault, Francois; Sigal, Robert [Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)

    2010-01-15

    Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

  6. Longitudinal monitoring of cardiac siderosis using cardiovascular magnetic resonance T2* in patients with thalassemia major on various chelation regimens: a 6-year study.

    Science.gov (United States)

    Ambati, Srikanth R; Randolph, Rachel E; Mennitt, Kevin; Kleinert, Dorothy A; Weinsaft, Jonathan W; Giardina, Patricia J

    2013-08-01

    Cardiovascular magnetic resonance (CMR) and hepatic magnetic resonance imaging (MRI) have become reliable noninvasive tools to monitor iron excess in thalassemia major (TM) patients. However, long-term studies are lacking. We reviewed CMR and hepatic MRI T2* imaging on 54 TM patients who had three or more annual measurements. They were managed on various chelation regimens. Patients were grouped according to their degree of cardiac siderosis: severe (T2*, cardiac siderosis (T2*, >20 msec). We looked at the change in cardiac T2*, liver iron concentration (LIC) and left ventricular ejection fraction (LVEF) at years 3 and 5. In patients with severe cardiac siderosis, cardiac T2* (mean ± SD) improved from 6.9 ± 1.6 at baseline to 13.6 ± 10.0 by year 5, mean ΔT2* = 6.7 (P = 0.04). Change in cardiac T2* at year 3 was not significant in the severe group. Patients with mild to moderate cardiac siderosis had mean cardiac T2* of 14.6 ± 2.9 at baseline which improved to 26.3 ± 9.5 by year 3, mean ΔT2* =  1.7 (P = 0.01). At baseline, median LICs (mg/g dry weight) in patients with severe, mild-moderate, and no cardiac siderosis were 3.6, 2.8, and 3.3, whereas LVEFs (mean ± SD) (%) were 56.3 ± 10.1, 60 ± 5, and 66 ± 7.6, respectively. No significant correlation was noted between Δ cardiac T2* and Δ LIC, Δ cardiac T2*, and Δ LVEF at years 3 and 5. Throughout the observation period, patients with no cardiac siderosis maintained their cardiac T2* above 20 msec. The majority of patients with cardiac siderosis improve cardiac T2* over time with optimal chelation.

  7. Less Confusion in Diffusion MRI

    NARCIS (Netherlands)

    Tax, C.M.W.

    2016-01-01

    With its unique ability to investigate tissue architecture and microstructure in vivo, diffusion MRI (dMRI) has gained tremendous interest and the society has been continuously triggered to develop novel dMRI image analysis approaches. With the overwhelming amount of strategies currently available i

  8. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging technique that does not involve exposure to ionizing radiation. MRI can help physicians evaluate the structures of the brain and can also provide functional information (fMRI) in selected cases. MR images of ...

  9. Nanowires and Electrical Stimulation Synergistically Improve Functions of hiPSC Cardiac Spheroids.

    Science.gov (United States)

    Richards, Dylan J; Tan, Yu; Coyle, Robert; Li, Yang; Xu, Ruoyu; Yeung, Nelson; Parker, Arran; Menick, Donald R; Tian, Bozhi; Mei, Ying

    2016-07-13

    The advancement of human induced pluripotent stem-cell-derived cardiomyocyte (hiPSC-CM) technology has shown promising potential to provide a patient-specific, regenerative cell therapy strategy to treat cardiovascular disease. Despite the progress, the unspecific, underdeveloped phenotype of hiPSC-CMs has shown arrhythmogenic risk and limited functional improvements after transplantation. To address this, tissue engineering strategies have utilized both exogenous and endogenous stimuli to accelerate the development of hiPSC-CMs. Exogenous electrical stimulation provides a biomimetic pacemaker-like stimuli that has been shown to advance the electrical properties of tissue engineered cardiac constructs. Recently, we demonstrated that the incorporation of electrically conductive silicon nanowires to hiPSC cardiac spheroids led to advanced structural and functional development of hiPSC-CMs by improving the endogenous electrical microenvironment. Here, we reasoned that the enhanced endogenous electrical microenvironment of nanowired hiPSC cardiac spheroids would synergize with exogenous electrical stimulation to further advance the functional development of nanowired hiPSC cardiac spheroids. For the first time, we report that the combination of nanowires and electrical stimulation enhanced cell-cell junction formation, improved development of contractile machinery, and led to a significant decrease in the spontaneous beat rate of hiPSC cardiac spheroids. The advancements made here address critical challenges for the use of hiPSC-CMs in cardiac developmental and translational research and provide an advanced cell delivery vehicle for the next generation of cardiac repair.

  10. Motion analysis of both ventricles using tagged MRI

    Science.gov (United States)

    Ozturk, Cengizhan; McVeigh, Elliot R.

    2000-04-01

    Although several methods exist for the analysis of tagged MRI images of the left ventricle (LV), analysis of the right ventricle (RV) remains challenging due to its complex anatomy and significant through plane motion. We present here preliminary results of our new motion analysis method, both for RV and LV, in healthy human volunteers. In this method, following standard myocardial and tag segmentation of cardiac gated cine tagged MR images; a 4D B-spline based parametric motion field was computed for a volume of interest encompassing both ventricles. Using this motion field, 3D displacements and strains were calculated on the RV and LV. We observed that for both chambers the circumferential strain (Ecc) decreased with a constant rate throughout systole. The systolic strain rate displayed spatial similarity not only for the LV but also for the RV. For RV free wall, mean systolic Ecc was -0.19 +/- 0.05 with an average coefficient of variability of 20%. The 4D B-spline based motion analysis technique for tagged MRI yields compatible results for the LV and gives consistent circumferential strain measures for the RV free wall. Tagged MRI based RV mechanical analysis can be used along with LV results for a more complete cardiac evaluation.

  11. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  12. Nonconventional MRI and microstructural cerebral changes in multiple sclerosis

    DEFF Research Database (Denmark)

    Enzinger, Christian; Barkhof, Frederik; Ciccarelli, Olga;

    2015-01-01

    MRI has become the most important paraclinical tool for diagnosing and monitoring patients with multiple sclerosis (MS). However, conventional MRI sequences are largely nonspecific in the pathology they reveal, and only provide a limited view of the complex morphological changes associated with MS....... Nonconventional MRI techniques, such as magnetization transfer imaging (MTI), diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI) promise to complement existing techniques by revealing more-specific information on microstructural tissue changes. Past years have witnessed dramatic advances...... in the acquisition and analysis of such imaging data, and numerous studies have used these tools to probe tissue alterations associated with MS. Other MRI-based techniques-such as myelin-water imaging, (23)Na imaging, magnetic resonance elastography and magnetic resonance perfusion imaging-might also...

  13. The cardiac anxiety questionnaire: cross-validation among cardiac inpatients

    NARCIS (Netherlands)

    Beek, M.H. van; Oude Voshaar, R.C.; Deelen, F.M. van; Balkom, A.J. van; Pop, G.A.; Speckens, A.E.

    2012-01-01

    OBJECTIVE: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  14. THE CARDIAC ANXIETY QUESTIONNAIRE : CROSS-VALIDATION AMONG CARDIAC INPATIENTS

    NARCIS (Netherlands)

    van Beek, M. H. C. T.; Voshaar, R. C. Oude; van Deelen, F. M.; van Balkom, A. J. L. M.; Pop, G.; Speckens, A. E. M.

    2012-01-01

    Objective: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  15. MRI of intact plants

    NARCIS (Netherlands)

    As, van H.; Scheenen, T.; Vergeldt, F.J.

    2009-01-01

    Nuclear magnetic resonance imaging (MRI) is a non-destructive and non-invasive technique that can be used to acquire two- or even three-dimensional images of intact plants. The information within the images can be manipulated and used to study the dynamics of plant water relations and water transpor

  16. Fetal MRI; Fetales MRT

    Energy Technology Data Exchange (ETDEWEB)

    Blondin, D. [Inst. fuer Diagn. Radiologie, Uniklinikum Duesseldorf (Germany); Turowski, B. [Inst. fuer Diagn. Radiologie, Neuroradiologie, Uniklinikum Duesseldorf (Germany); Schaper, J. [Inst. fuer Diagn. Radiologie, Kinderradiologie, Uniklinikum Duesseldorf (Germany)

    2007-02-15

    Ultrasonography is the method of choice for prenatal malformation screening, but it does not always provide sufficient information for correct diagnosis or adequate abnormality evaluation. Fetal MRI is increasingly being used to complete sonographic findings. It was initially used for evaluation of cerebral abnormalities but is increasingly being applied to other fetal areas. In vivo investigation of fetal brain maturation has been enhanced by MRI. An adequate analysis of fetal chest and abdomen can be achieved with fast T2-, T1-weighted and diffusion-weighted imaging (DWI). The advantages include the great field of view and the excellent soft tissue contrast. This allows correct diagnosis of congenital diaphragmatic hernia and evaluation of the consequences on pulmonary growth. Other pulmonary malformations, such as cystic adenomatoid malformation, sequestration and brochogenic cysts, can also be easily identified. Renal position can be quickly determined using DWI sequences and renal agenesia can be easily diagnosed with only one sequence. Prenatal MRI is virtually as effective as postnatal examination, dispenses with transport of a potentially very ill newborn, and provides logistic advantages. Therefore, prenatal MRI is useful for adequate postnatal treatment of newborns with malformations. (orig.)

  17. MRI of intact plants.

    NARCIS (Netherlands)

    As, H. van; Scheenen, T.W.J.; Vergeldt, F.J.

    2009-01-01

    Nuclear magnetic resonance imaging (MRI) is a non-destructive and non-invasive technique that can be used to acquire two- or even three-dimensional images of intact plants. The information within the images can be manipulated and used to study the dynamics of plant water relations and water transpor

  18. MRI and interventions

    Institute of Scientific and Technical Information of China (English)

    Roberto Blanco Sequeiros

    2002-01-01

    @@ Interventional radiology was started not long after the discovery of X - rays. Interventions started as image guided biopsies and angiographies early this century, later emerged computed tomography (CT) and ultrasound-guided interventions in the 1970s and ultimately the magnetic resonance imaging(MRI) guided interventions at the 1980s.

  19. Combined PET/MRI

    DEFF Research Database (Denmark)

    Bailey, D. L.; Pichler, B. J.; Gückel, B.;

    2015-01-01

    February 23 to 27, 2015. Specifically, we summarise the three days of invited presentations from active researchers in this and associated fields augmented by round table discussions and dialogue boards with specific topics. These include the use of PET/MRI in cardiovascular disease, paediatrics, oncology......, the conclusion of last year's meeting "the real work has just started" still holds true....

  20. Visualization of a Small Ventricular Septal Defect at First-pass Contrast-enhanced Cardiac Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Francesco Secchi

    2013-01-01

    Full Text Available Ventricular septal defect (VSD is a congenital heart disease that accounts for up to 40% of all congenital cardiac malformations. VSD is a connection between right and left ventricle, through the ventricular septum. Echocardiography and magnetic resonance imaging (MRI help identify this entity. This case presents a 12-year-old male diagnosed with a small muscular apical VSD of 3 mm in diameter, at echocardiography. Cardiac MRI using first-pass perfusion sequence, combining the right plane of acquisition with a short bolus of contrast material, clearly confirmed the presence of VSD.

  1. Giant Cardiac Cavernous Hemangioma.

    Science.gov (United States)

    Unger, Eric; Costic, Joseph; Laub, Glenn

    2015-07-01

    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  2. Perioperative management of cardiac disease.

    Science.gov (United States)

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S

    2014-01-01

    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  3. High-quality breast MRI.

    Science.gov (United States)

    Hendrick, R Edward

    2014-05-01

    Breast magnetic resonance imaging (MRI) demands the competing factors of high spatial resolution, good temporal resolution, high signal-to-noise ratios, and complete bilateral breast coverage. Achieving these competing factors requires modern MRI equipment with high magnetic field strength and homogeneity, high maximum gradient strength with short rise times, dedicated multichannel bilateral breast coils with prone patient positioning, and 3D (volume) gradient-echo MRI pulse sequences with short TR, short TE, high spatial resolution, and reasonably short acquisition times. This article discusses the equipment and pulse sequences needed to achieve high-quality breast MRI and summarizes requirements of the ACR Breast MRI Accreditation Program. PMID:24792656

  4. Multimodal Registration of gated cardiac PET, CT and MR sequences

    International Nuclear Information System (INIS)

    The research described in this manuscript deals with the multimodal registration of cardiac images from Magnetic Resonance Imaging (MRI), Position Emission Tomography (PET) and Computerized Tomography (CT). All these modalities are gated to the Electrocardiogram (ECG) and provide information to evaluate cardiac function, and to diagnose and to follow-up cardiovascular pathologies. PET imaging allows the evaluation of ventricular function and MRI is a gold standard for the study of the left ventricular function. The goal of our registration process is to merge functional (from PET) and anatomical images (from CT and MRI). Our process is adapted to the modalities used and is divided in two steps: (i) a global rigid 3-dimensional model-based ICP (Iterative Closest Point) registration between CT and MR data and (ii) an iconic 2-dimensional registration based on Free Form Deformations and Mutual Information. This last step presents an original contribution by using a composite image of CT (which presents epicardic contours) and PET (where endocardic contours are partially visible) data to make mutual information more accurate in representing the similarity with the MR data. To speed up the whole process, we also present a transformation initialization scheme using displacement field obtained form MR data only. The obtained results have been evaluated by experts. (author)

  5. Development of a postgraduate interventional cardiac nursing curriculum.

    Science.gov (United States)

    Currey, Judy; White, Kevin; Rolley, John; Oldland, Elizabeth; Driscoll, Andrea

    2015-11-01

    Interventional cardiology practices have advanced immensely in the last two decades, but the educational preparation of the workforce in cardiac catheter laboratories has not seen commensurate changes. Although on-the-job training has sufficed in the past, recognition of this workforce as a specialty practice domain now demands specialist educational preparation. The aim of this paper is to present the development of an interventional cardiac nursing curriculum nested within a Master of Nursing Practice in Australia. International and national health educational principles, teaching and learning theories and professional frameworks and philosophies are foundational to the program designed for interventional cardiac specialist nurses. These broader health, educational and professional underpinnings will be described to illustrate their application to the program's theoretical and clinical components. Situating interventional cardiac nursing within a Master's degree program at University provides nurses with the opportunities to develop high level critical thinking and problem solving knowledge and skills. PMID:25687694

  6. MRI texture heterogeneity in the optic nerve predicts visual recovery after acute optic neuritis

    Directory of Open Access Journals (Sweden)

    Yunyan Zhang

    2014-01-01

    Conclusions: Tissue heterogeneity may be a potential measure of functional outcome in ON patients and advanced analysis of the texture in standard MRI could provide insights into mechanisms of injury and recovery in patients with similar disorders.

  7. Risk stratification for sudden cardiac death.

    Science.gov (United States)

    Sabir, Ian N; Usher-Smith, Juliet A; Huang, Christopher L-H; Grace, Andrew A

    2008-01-01

    Recent advances in pharmacological and device-based therapies have provided a range of management options for patients at risk of sudden cardiac death (SCD). Since all such interventions come with their attendant risks, however, stratification procedures aimed at identifying those who stand to benefit overall have gained a new degree of importance. This review assesses the value of risk stratification measures currently available in clinical practice, as well as of others that may soon enter the market. Parameters that may be obtained only by performing invasive cardiac catheterisation procedures are considered separately from those that may be derived using more readily available non-invasive techniques. It is concluded that effective stratification is likely to require the use of composite parameters and that invasive procedures might only be justified in specific sub-groups of patients. PMID:19351522

  8. Interplay between cardiac function and heart development.

    Science.gov (United States)

    Andrés-Delgado, Laura; Mercader, Nadia

    2016-07-01

    Mechanotransduction refers to the conversion of mechanical forces into biochemical or electrical signals that initiate structural and functional remodeling in cells and tissues. The heart is a kinetic organ whose form changes considerably during development and disease. This requires cardiomyocytes to be mechanically durable and able to mount coordinated responses to a variety of environmental signals on different time scales, including cardiac pressure loading and electrical and hemodynamic forces. During physiological growth, myocytes, endocardial and epicardial cells have to adaptively remodel to these mechanical forces. Here we review some of the recent advances in the understanding of how mechanical forces influence cardiac development, with a focus on fluid flow forces. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

  9. The cardiac malpositions.

    Science.gov (United States)

    Perloff, Joseph K

    2011-11-01

    Dextrocardia was known in the 17th century and was 1 of the first congenital malformations of the heart to be recognized. Fifty years elapsed before Matthew Baillie published his account of complete transposition in a human of the thoracic and abdominal viscera to the opposite side from what is natural. In 1858, Thomas Peacock stated that "the heart may be congenitally misplaced in various ways, occupying either an unusual position within the thorax, or being situated external to that cavity." In 1915, Maude Abbott described ectopia cordis, and Richard Paltauf's remarkable illustrations distinguished the various types of dextrocardia. In 1928, the first useful classification of the cardiac malpositions was proposed, and in 1966, Elliott et al's radiologic classification set the stage for clinical recognition. The first section of this review deals with the 3 basic cardiac malpositions in the presence of bilateral asymmetry. The second section deals with cardiac malpositions in the presence of bilateral left-sidedness or right-sidedness. Previous publications on cardiac malpositions are replete with an arcane vocabulary that confounds rather than clarifies. Even if the terms themselves are understood, inherent complexity weighs against clarity. This review was designed as a guided tour of an unfamiliar subject.

  10. Cardiac effects of vasopressin.

    Science.gov (United States)

    Pelletier, Jean-Sébastien; Dicken, Bryan; Bigam, David; Cheung, Po-Yin

    2014-07-01

    Vasopressin is an essential hormone involved in the maintenance of cardiovascular homeostasis. It has been in use therapeutically for many decades, with an emphasis on its vasoconstrictive and antidiuretic properties. However, this hormone has a ubiquitous influence and has specific effects on the heart. Although difficult to separate from its powerful vascular effects in the clinical setting, a better understanding of vasopressin's direct cardiac effects could lead to its more effective clinical use for a variety of shock states by maximizing its therapeutic benefit. The cardiac-specific effects of vasopressin are complex and require further elucidation. Complicating our understanding include the various receptors and secondary messengers involved in vasopressin's effects, which may lead to various results based on differing doses and varying environmental conditions. Thus, there have been contradictory reports on vasopressin's action on the coronary vasculature and on its effect on inotropy. However, beneficial results have been found and warrant further study to expand the potential therapeutic role of vasopressin. This review outlines the effect of vasopressin on the coronary vasculature, cardiac contractility, and on hypertrophy and cardioprotection. These cardiac-specific effects of vasopressin represent an interesting area for further study for potentially important therapeutic benefits. PMID:24621650

  11. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...

  12. Cardiac pacemaker power sources

    International Nuclear Information System (INIS)

    A review of chemical and radioisotope batteries used in cardiac pacemakers is presented. The battery systems are examined in terms of longevity, reliability, cost, size and shape, energy density, weight, internal resistance versus time, end-of-life voltage, chemical compatibility, and potential failure mechanisms

  13. Advance in the study of prognostication of neurological outcome in comatose survivors from cardiac arrest%心搏骤停后昏迷患者神经功能预后评估的研究进展

    Institute of Scientific and Technical Information of China (English)

    王淦楠; 张劲松

    2016-01-01

    心肺复苏后昏迷患者早期神经功能预后评估作为心搏骤停(CA)后管理的重要组成部分,具有显著的临床意义.本文从神经系统检查、脑电图、诱发电位、神经影像学及血清生物标志物等方面,结合亚低温治疗对神经功能评估的影响,综述了CA后昏迷患者神经功能预后评估的研究进展.%Early prognostication of neurological outcome in comatose survives after cardiopulmonary resuscitation,an essential component of post-cardiac arrest care is significantly meaningful in both clinical and economic fields.From the perspectives of predictors based on neurological examination,electroencephalogram,evoked potentials,neuroimaging and blood biomarkers and taking advantage of therapeutic hypothermia into consideration,this article reviews the development in evaluation of neurological outcome in comatose survives after cardiac arrest.

  14. Cardiac motion compensation and resolution modeling in simultaneous PET-MR: a cardiac lesion detection study

    Science.gov (United States)

    Petibon, Y.; Ouyang, J.; Zhu, X.; Huang, C.; Reese, T. G.; Chun, S. Y.; Li, Q.; El Fakhri, G.

    2013-04-01

    Cardiac motion and partial volume effects (PVE) are two of the main causes of image degradation in cardiac PET. Motion generates artifacts and blurring while PVE lead to erroneous myocardial activity measurements. Newly available simultaneous PET-MR scanners offer new possibilities in cardiac imaging as MRI can assess wall contractility while collecting PET perfusion data. In this perspective, we develop a list-mode iterative reconstruction framework incorporating both tagged-MR derived non-rigid myocardial wall motion and position dependent detector point spread function (PSF) directly into the PET system matrix. In this manner, our algorithm performs both motion ‘deblurring’ and PSF deconvolution while reconstructing images with all available PET counts. The proposed methods are evaluated in a beating non-rigid cardiac phantom whose hot myocardial compartment contains small transmural and non-transmural cold defects. In order to accelerate imaging time, we investigate collecting full and half k-space tagged MR data to obtain tagged volumes that are registered using non-rigid B-spline registration to yield wall motion information. Our experimental results show that tagged-MR based motion correction yielded an improvement in defect/myocardium contrast recovery of 34-206% as compared to motion uncorrected studies. Likewise, lesion detectability improved by respectively 115-136% and 62-235% with MR-based motion compensation as compared to gating and no motion correction and made it possible to distinguish non-transmural from transmural defects, which has clinical significance given the inherent limitations of current single modality imaging in identifying the amount of residual ischemia. The incorporation of PSF modeling within the framework of MR-based motion compensation significantly improved defect/myocardium contrast recovery (5.1-8.5%, p defect detectability (39-56%, p < 0.01). No statistical difference was found in PET contrast and lesion detectability

  15. Ultrafast MRI in the prenatal diagnosis of Bourneville′s tuberous sclerosis

    Directory of Open Access Journals (Sweden)

    Khanna P

    2005-01-01

    Full Text Available The purpose of this report is to highlight the utility of prenatal MRI as an adjunctive imaging modality in the diagnosis and prognosis of Tuberous Sclerosis (TS (Bourneville′s disease. We report a case of TS detected in utero at 30 weeks gestation. A routine ultrasonography at 26 weeks in a 28-year-old primigravida was followed by an ultrafast MRI examination at 30 weeks gestation. Ultrasound raised the possibility of TS based on the detection of multiple cardiac rhabdomyomas. Fetal MRI, subsequently performed, showed the presence of cortical tubers and subependymal nodules establishing the diagnosis. Fetal MRI in the appropriate clinical setting can be potentially invaluable and can have important prognostic implications.

  16. ICA if fMRI based on a convolutive mixture model

    DEFF Research Database (Denmark)

    Hansen, Lars Kai

    2003-01-01

    Modeling & Analysis Abstract The fMRI signal has many sources: Stimulus induced activation, other brain activations, confounds including several physiological signal components, the most prominent being the cardiac pulsation at about 1 Hz, and breathing induced motion (0.2-1 Hz). Most fMRI data...... scans of fixation, 31 scans of stimulation, and 60 scans of post-stimulus fixation was repeated 10 times (data acquired by Dr. Egill Rostrup, Hvidovre Hospital, DK). Results We apply a model with time lags 0-39*TR (=13sec), requiring 40 mixing coefficient images. In the figure we show the 40 images...... challenge with previous independent component analyses is the convolutive nature of the mixing process in fMRI. In temporal ICA we assume that the measured fMRI response is an instantaneous, spatially varying, mixture of independent time functions. However, the convolutive structure of the hemodynamic...

  17. Functional MRI activation in white matter during the Symbol Digit Modalities Test

    OpenAIRE

    Jodie Reanna Gawryluk; Erin Lindsay Mazerolle; Steven eBeyea; Ryan eD'Arcy

    2014-01-01

    Background: Recent evidence shows that functional magnetic resonance imaging (fMRI) can detect activation in white matter (WM). Such advances have important implications for understanding WM dysfunction. A key step in linking neuroimaging advances to the evaluation of clinical disorders is to examine whether WM activation can be detected at the individual level during clinical tests associated with WM function. We used an adapted Symbol Digit Modalities Test (SDMT) in a 4T fMRI study of healt...

  18. fMRI in Parkinson’s Disease

    DEFF Research Database (Denmark)

    Siebner, Hartwig R.; Herz, Damian

    2013-01-01

    In this chapter we review recent advances in functional magnetic resonance imaging (fMRI) in Parkinson’s disease (PD). Covariance patterns of regional resting-state activity in functional brain networks can be used to distinguish Parkinson patients from healthy controls and might play an important...

  19. Diagnosis of coronary artery disease with dobutamine-stress MRI

    NARCIS (Netherlands)

    Kuijpers, D

    2005-01-01

    Dobutamine-stress cardiovascular magnetic resonance (CMR) is a new diagnostic tool for the non-invasive detection of coronary artery disease. Technological advances in CMR have evolved this technique to an adequate alternative to the standard cardiac stress tests. Its high reproducibility and excell

  20. Diffusion and Perfusion MRI in Acute Cerebral Ischemia

    Institute of Scientific and Technical Information of China (English)

    Tchoyoson CC Lim; Chong-Tin Tan

    2001-01-01

    Reeent advances in magnetic resonance imaging (MRI), in particular diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI), have allowed clinicians to have the ability to differentiate between irreversible cerebral infarction and the potentially reversible ischemic penumbra. This article examines the principles and practice of DWI and PWI. With continued advances in thrombolysis and other therapy for acute cerebral ischemia, neuroimaging is poised to play an increasingly important role in decisionmaking in aeute stroke.