1
|
Guo Y, Du GQ, Xue JY, Xia R, Wang YH. A novel myocardium segmentation approach based on neutrosophic active contour model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2017; 142:109-116. [PMID: 28325439 DOI: 10.1016/j.cmpb.2017.02.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 02/09/2017] [Accepted: 02/15/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Automatic delineation of the myocardium in echocardiography can assist radiologists to diagnosis heart problems. However, it is still challenging to distinguish myocardium from other tissue due to a low signal-to-noise ratio, low contrast, vague boundary, and speckle noise. The purpose of this study is to automatically detect myocardium region in left ventricle myocardial contrast echocardiography (LVMCE) images to help radiologists' diagnosis and further measurement on infarction size. METHODS The LVMCE image is firstly mapped into neutrosophic similarity (NS) domain using the intensity and homogeneity features. Then, a neutrosophic active contour model (NACM) is proposed and the energy function is defined by the NS values. Finally, the ventricle is detected using the curve evolving results. The ventricle's boundary is identified as the endocardium. To speed up the evolution procedure and increase the detection accuracy, a clustering algorithm is employed to obtain the initial ventricle region. The curve evolution procedure in NACM is utilized again to obtain the epicardium, where the initial contour uses the detected endocardium and the anatomy knowledge on the thickness of the myocardium. RESULTS Echocardiographic studies are performed on 10 male Sprague-Dawley rats using a Vivid 7 system including 5 normal cases and 5 rats with myocardial infarction. The myocardium boundaries manually outlined by an experienced radiologist are used as the reference standard for the performance evaluation. Two metrics, Hdist and AvgDist, are employed to evaluate the detection results. The NACM method was compared with those from the eliminated particle swarm optimization (EPSO) and active contour model without edges (ACMWE) methods. The mean and standard deviation of the Hdist and AvgDist on endocardium are 6.83 ± 1.12mm and 0.79 ± 0.28mm using EPSO method, 7.12 ± 0.98mm and 0.82 ± 0.32mm using ACMWE method, and 4.55 ± 0.9mm and 0.58 ± 0.18mm using NACM method, respectively. The improvement on epicardium is much more significant, and two metrics are decreased from 7.45 ± 1.24mm, and 1.47 ± 0.34mm using EPSO method, and 8.21±0.43mm, and 1.73±0.47mm using ACMWE method, to 4.94 ± 0.82mm, and 0.84 ± 0.22mm using NACM method, respectively. CONCLUSIONS The proposed method can automatically detect myocardium accurately, and is helpful for clinical therapeutics to measure myocardial perfusion and infarct size.
Collapse
Affiliation(s)
- Yanhui Guo
- Department of Computer Science, University of Illinois at Springfield, Springfield, IL USA.
| | - Guo-Qing Du
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jing-Yi Xue
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Rong Xia
- Oracle Corporation, Westminster, CO, USA
| | - Yu-Hang Wang
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
2
|
Guarini G, Kiyooka T, Ohanyan V, Pung YF, Marzilli M, Chen YR, Chen CL, Kang PT, Hardwick JP, Kolz CL, Yin L, Wilson GL, Shokolenko I, Dobson JG, Fenton R, Chilian WM. Impaired coronary metabolic dilation in the metabolic syndrome is linked to mitochondrial dysfunction and mitochondrial DNA damage. Basic Res Cardiol 2016; 111:29. [PMID: 27040114 DOI: 10.1007/s00395-016-0547-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 03/09/2016] [Indexed: 12/11/2022]
Abstract
Mitochondrial dysfunction in obesity and diabetes can be caused by excessive production of free radicals, which can damage mitochondrial DNA. Because mitochondrial DNA plays a key role in the production of ATP necessary for cardiac work, we hypothesized that mitochondrial dysfunction, induced by mitochondrial DNA damage, uncouples coronary blood flow from cardiac work. Myocardial blood flow (contrast echocardiography) was measured in Zucker lean (ZLN) and obese fatty (ZOF) rats during increased cardiac metabolism (product of heart rate and arterial pressure, i.v. norepinephrine). In ZLN increased metabolism augmented coronary blood flow, but in ZOF metabolic hyperemia was attenuated. Mitochondrial respiration was impaired and ROS production was greater in ZOF than ZLN. These were associated with mitochondrial DNA (mtDNA) damage in ZOF. To determine if coronary metabolic dilation, the hyperemic response induced by heightened cardiac metabolism, is linked to mitochondrial function we introduced recombinant proteins (intravenously or intraperitoneally) in ZLN and ZOF to fragment or repair mtDNA, respectively. Repair of mtDNA damage restored mitochondrial function and metabolic dilation, and reduced ROS production in ZOF; whereas induction of mtDNA damage in ZLN reduced mitochondrial function, increased ROS production, and attenuated metabolic dilation. Adequate metabolic dilation was also associated with the extracellular release of ADP, ATP, and H2O2 by cardiac myocytes; whereas myocytes from rats with impaired dilation released only H2O2. In conclusion, our results suggest that mitochondrial function plays a seminal role in connecting myocardial blood flow to metabolism, and integrity of mtDNA is central to this process.
Collapse
Affiliation(s)
- Giacinta Guarini
- Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
| | - Takahiko Kiyooka
- Division of Cardiology, Tokai University Oiso Hospital, Oiso, Japan
| | - Vahagn Ohanyan
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
| | - Yuh Fen Pung
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
- Department of Biomedical Science, University of Nottingham, Semenyih, Malaysia
| | - Mario Marzilli
- Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | - Yeong Renn Chen
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
| | - Chwen Lih Chen
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
| | - Patrick T Kang
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
| | - James P Hardwick
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
| | - Christopher L Kolz
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
| | - Liya Yin
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
| | - Glenn L Wilson
- Department of Cell Biology and Neuroscience, University of South Alabama, Mobile, USA
| | - Inna Shokolenko
- Department of Biomedical Sciences, University of South Alabama, Mobile, USA
| | - James G Dobson
- Department of Microbiology and Physiological Systems, University of Massachusetts, Boston, USA
| | - Richard Fenton
- Department of Microbiology and Physiological Systems, University of Massachusetts, Boston, USA
| | - William M Chilian
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA.
| |
Collapse
|
3
|
Du GQ, Xue JY, Guo Y, Chen S, Du P, Wu Y, Wang YH, Zong LQ, Tian JW. Measurement of myocardial perfusion and infarction size using computer-aided diagnosis system for myocardial contrast echocardiography. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:2466-2477. [PMID: 26048775 DOI: 10.1016/j.ultrasmedbio.2015.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 02/19/2015] [Accepted: 04/21/2015] [Indexed: 06/04/2023]
Abstract
Proper evaluation of myocardial microvascular perfusion and assessment of infarct size is critical for clinicians. We have developed a novel computer-aided diagnosis (CAD) approach for myocardial contrast echocardiography (MCE) to measure myocardial perfusion and infarct size. Rabbits underwent 15 min of coronary occlusion followed by reperfusion (group I, n = 15) or 60 min of coronary occlusion followed by reperfusion (group II, n = 15). Myocardial contrast echocardiography was performed before and 7 d after ischemia/reperfusion, and images were analyzed with the CAD system on the basis of eliminating particle swarm optimization clustering analysis. The myocardium was quickly and accurately detected using contrast-enhanced images, myocardial perfusion was quantitatively calibrated and a color-coded map calibrated by contrast intensity and automatically produced by the CAD system was used to outline the infarction region. Calibrated contrast intensity was significantly lower in infarct regions than in non-infarct regions, allowing differentiation of abnormal and normal myocardial perfusion. Receiver operating characteristic curve analysis documented that -54-pixel contrast intensity was an optimal cutoff point for the identification of infarcted myocardium with a sensitivity of 95.45% and specificity of 87.50%. Infarct sizes obtained using myocardial perfusion defect analysis of original contrast images and the contrast intensity-based color-coded map in computerized images were compared with infarct sizes measured using triphenyltetrazolium chloride staining. Use of the proposed CAD approach provided observers with more information. The infarct sizes obtained with myocardial perfusion defect analysis, the contrast intensity-based color-coded map and triphenyltetrazolium chloride staining were 23.72 ± 8.41%, 21.77 ± 7.8% and 18.21 ± 4.40% (% left ventricle) respectively (p > 0.05), indicating that computerized myocardial contrast echocardiography can accurately measure infarct size. On the basis of the results, we believe the CAD method can quickly and automatically measure myocardial perfusion and infarct size and will, it is hoped, be very helpful in clinical therapeutics.
Collapse
Affiliation(s)
- Guo-Qing Du
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jing-Yi Xue
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yanhui Guo
- School of Science, St. Thomas University, Miami Gardens, Florida, USA
| | - Shuang Chen
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Pei Du
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yan Wu
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yu-Hang Wang
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Li-Qiu Zong
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jia-Wei Tian
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
| |
Collapse
|
4
|
Bishop CV, Molskness TA, Xu F, Belcik JT, Lindner JR, Slayden OD, Stouffer RL. Quantification of dynamic changes to blood volume and vascular flow in the primate corpus luteum during the menstrual cycle. J Med Primatol 2014; 43:445-54. [PMID: 24948037 DOI: 10.1111/jmp.12132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 01/28/2023]
Abstract
BACKGROUND The objective of the current study was to determine changes to vascular parameters of nonhuman primate dominant ovarian structures by dynamic contrast-enhanced ultrasound (DCE-US). MATERIALS AND METHODS Dynamic contrast-enhanced ultrasound with intravenous microbubble infusion was performed on the rhesus macaque ovary bearing the pre-ovulatory follicle and corpus luteum (CL) sequentially during the natural luteal phase (n = 8) and GnRH antagonist (antide)-induced luteal regression (n = 6). RESULTS Changes in luteal blood volume (BV) and vascular flow (VF) were observed between stages of the luteal phase Luteal BV was highest in early stage CL, before decreasing 2.5-fold in late stage CL (P < 0.06); in contrast, luteal VF peaked at mid luteal stage (P < 0.01). Two females identified with luteal insufficiency trended toward lower peak BV, compared to typical CLs. Another female was identified with a luteal cyst on the contralateral ovary, and a CL that regressed before P levels declined. After 72 hours of antide exposure, BV was reduced 2.3-fold (P = 0.03). CONCLUSIONS DCE-US provides a sensitive, non-invasive measurement of the dynamics of blood volume and flow in dominant ovarian structures.
Collapse
Affiliation(s)
- Cecily V Bishop
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
| | | | | | | | | | | | | |
Collapse
|
5
|
Abstract
It is now possible to perform myocardial contrast echocardiography at the bedside with an intravenous injection of commercially available contrast media. Although myocardial contrast echocardiography is a sensitive method for the detection of coronary stenosis and myocardial viability, its diagnosis has relied largely on the subjective interpretation of regional perfusion by experienced clinicians. Thus, quantification of myocardial contrast echocardiography data and displaying comprehensive images have been necessary for its routine application. In this review, new methods for quantifying or displaying myocardial contrast echocardiography parameters will be introduced: firstly, parametric imaging that displays the parameters of myocardial blood volume, blood flow velocity and myocardial blood flow separately; and secondly, color-coded maps of myocardial blood volume established from one myocardial contrast echocardiography image. These quantitative techniques can provide comprehensive and easy-to-understand images, although the quality of the baseline image remains a critical factor.
Collapse
Affiliation(s)
- Hiroshi Ito
- Sakurabashi Watanabe Hospital, Division of Cardiology, Kita-ku, Osaka 530-0001, Japan.
| |
Collapse
|
6
|
Tang MX, Mulvana H, Gauthier T, Lim AKP, Cosgrove DO, Eckersley RJ, Stride E. Quantitative contrast-enhanced ultrasound imaging: a review of sources of variability. Interface Focus 2011; 1:520-39. [PMID: 22866229 PMCID: PMC3262271 DOI: 10.1098/rsfs.2011.0026] [Citation(s) in RCA: 184] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 04/26/2011] [Indexed: 12/14/2022] Open
Abstract
Ultrasound provides a valuable tool for medical diagnosis offering real-time imaging with excellent spatial resolution and low cost. The advent of microbubble contrast agents has provided the additional ability to obtain essential quantitative information relating to tissue vascularity, tissue perfusion and even endothelial wall function. This technique has shown great promise for diagnosis and monitoring in a wide range of clinical conditions such as cardiovascular diseases and cancer, with considerable potential benefits in terms of patient care. A key challenge of this technique, however, is the existence of significant variations in the imaging results, and the lack of understanding regarding their origin. The aim of this paper is to review the potential sources of variability in the quantification of tissue perfusion based on microbubble contrast-enhanced ultrasound images. These are divided into the following three categories: (i) factors relating to the scanner setting, which include transmission power, transmission focal depth, dynamic range, signal gain and transmission frequency, (ii) factors relating to the patient, which include body physical differences, physiological interaction of body with bubbles, propagation and attenuation through tissue, and tissue motion, and (iii) factors relating to the microbubbles, which include the type of bubbles and their stability, preparation and injection and dosage. It has been shown that the factors in all the three categories can significantly affect the imaging results and contribute to the variations observed. How these factors influence quantitative imaging is explained and possible methods for reducing such variations are discussed.
Collapse
Affiliation(s)
- M.-X. Tang
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - H. Mulvana
- Imaging Sciences Department, Faculty of Medicine, Imperial College London, London W12 0HS, UK
| | - T. Gauthier
- Department of Experimental Medicine and Toxicology, Hammersmith Hospital, Imperial College London, London W12 0NN, UK
| | - A. K. P. Lim
- Hammersmith Hospital, MRC Clinical Sciences Centre, Faculty of Medicine, Imperial College London, London W12 0NN, UK
| | - D. O. Cosgrove
- Imaging Sciences Department, Faculty of Medicine, Imperial College London, London W12 0HS, UK
| | - R. J. Eckersley
- Imaging Sciences Department, Faculty of Medicine, Imperial College London, London W12 0HS, UK
| | - E. Stride
- Department Mechanical Engineering, University College London, London WC1E 7JE, UK
| |
Collapse
|
7
|
Mor-Avi V, Koch R, Holper EM, Goonewardena S, Coon PD, Min JK, Fedson S, Ward RP, Lang RM. Value of vasodilator stress myocardial contrast echocardiography and magnetic resonance imaging for the differential diagnosis of ischemic versus nonischemic cardiomyopathy. J Am Soc Echocardiogr 2008; 21:425-32. [PMID: 18187290 DOI: 10.1016/j.echo.2007.10.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Noninvasive differentiation of ischemic versus nonischemic cardiomyopathy (CM) remains challenging because of the low specificity of imaging-based tests in these patients. We hypothesized that myocardial contrast echocardiography (MCE) and cardiac magnetic resonance (CMR), combined with vasodilator stress, could provide accurate alternatives for determining the cause of CM. METHODS To allow side-by-side comparisons between these techniques with coronary angiography as a reference, we studied 16 patients referred for coronary angiography after abnormal nuclear perfusion studies. Both MCE and CMR images were acquired within 48 hours with infusion of adenosine. MCE included flash-echo imaging during intravenous infusion of echocardiographic contrast solution. CMR included gadolinium injections for first-pass perfusion and delayed enhancement imaging. MCE and CMR images were reviewed by experienced investigators, blinded to the findings of the other modality and angiography. For each technique, each myocardial segment was classified as normal or abnormal. Sensitivity and specificity of each technique were calculated against the angiography reference. These calculations were also performed using a perfusion territory as a unit of analysis. RESULTS Six of 16 patients had normal coronary arteries, and three patients had stenosis < 50%. By using this threshold for abnormal perfusion, segment-by-segment comparisons with angiography resulted in sensitivity of 0.88, 0.61, and 0.71 and specificity of 0.74, 0.86, and 0.94 for CMR perfusion, delayed enhancement scans, and MCE sequences, respectively. Using stenosis > 70% as a threshold resulted in a small decrease in both sensitivity and specificity (0.02-0.04) for all three techniques. Analysis of the ability of these techniques to detect an abnormality in at least one perfusion territory yielded sensitivity of 1.00, 1.00, and 0.86 and specificity of 0.78, 0.78, and 0.89, correspondingly, which were threshold-independent. CONCLUSIONS Both CMR and MCE perfusion imaging may be used to differentiate between ischemic and nonischemic CM. These emerging diagnostic tools may prove useful in strategizing treatment in these patients and thus avoiding unnecessary invasive procedures.
Collapse
|
8
|
Yoshifuku S, Chen S, McMahon EM, Yoshikawa A, Sengupta P, Korinek J, Belohlavek M. Parametric harmonic-to-fundamental ratio contrast echocardiography: a novel approach to identification and accurate measurement of left ventricular area under variable levels of ultrasound signal attenuation. ULTRASONICS 2007; 46:109-18. [PMID: 17276474 PMCID: PMC2034328 DOI: 10.1016/j.ultras.2006.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Revised: 12/08/2006] [Accepted: 12/12/2006] [Indexed: 05/13/2023]
Abstract
OBJECTIVES We introduced a harmonic-to-fundamental ratio (HFR) of the radiofrequency (RF) signals that reduces confounding effects of attenuation. We studied whether HFR analysis of RF signals received from contrast microbubbles allows accurate measurement of the left ventricular (LV) cavity area under varying levels of attenuation. BACKGROUND Attenuation is a fundamental problem in ultrasound imaging and limits the use of clinical echocardiography. METHODS RF data from short axis systolic and diastolic scans were obtained from 14 open-chest dogs following left-atrial bolus of Optison. Attenuation was induced by interposed silicone pads calibrated to induce 7dB or 14dB reductions of the backscattered RF signal. RF images were reconstructed from the RF signals, HFR values calculated for each image pixel for 0dB, 7dB and 14dB attenuation conditions, and LV area obtained by summation of "LV cavity pixels". A reference LV cavity area was obtained from endocardial border tracings in enhanced scans by experts. RESULTS Correlation of the HFR-defined and reference areas at systole was R=0.95, R=0.94, and R=0.91 for 0dB, 7dB and 14dB levels of attenuation, respectively, and at diastole was R=0.95 for 0dB, 7dB and 14dB levels of attenuation. The mean difference from both systolic and diastolic values was <1.45 cm(2) (i.e. negligible) in all attenuation settings. CONCLUSION Our novel HFR method supports precise measurement of the LV cavity area in contrast images with simulated high attenuation of ultrasound signals.
Collapse
Affiliation(s)
- Shiro Yoshifuku
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Shigao Chen
- Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Eileen M. McMahon
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Akiko Yoshikawa
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Partho Sengupta
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Josef Korinek
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Marek Belohlavek
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| |
Collapse
|
9
|
Abstract
One of the most intriguing developments in ultrasound imaging of the heart was the use of contrast media to assess myocardial perfusion, which sparked tremendous interest and over the years generated a significant body of research. Although most published work has been based on the use of contrast for 2D perfusion imaging, there are a few recent studies aimed at exploring the idea of 3D assessment of myocardial perfusion, which has the potential to overcome many of the limitations of the 2D methodology. We provide a brief overview of the 2D work that provided the scientific basis for the emerging 3D methodology and discuss the unique features and promises as well as the challenges posed by this novel approach.
Collapse
Affiliation(s)
- Victor Mor-Avi
- The Cardiac Imaging Center, Department of Medicine, University of Chicago MC5084, 5841 S. Maryland Avenue, Chicago, IL 60637, USA.
| | | |
Collapse
|
10
|
Kaandorp TAM, Lamb HJ, Viergever EP, Poldermans D, Boersma E, van der Wall EE, de Roos A, Bax JJ. Scar tissue on contrast-enhanced MRI predicts left ventricular remodelling after acute infarction. Heart 2007; 93:375-6. [PMID: 17322518 PMCID: PMC1861431 DOI: 10.1136/hrt.2006.097675] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Trindade MLZH, Caldas MA, Tsutsui JM, Rosario MA, Rochitte CE, Nicolau JC, Ramires JAF, Mathias W. Determination of size and transmural extent of acute myocardial infarction by real-time myocardial perfusion echocardiography: a comparison with magnetic resonance imaging. J Am Soc Echocardiogr 2007; 20:126-35. [PMID: 17275697 DOI: 10.1016/j.echo.2006.08.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The exact determination of acute myocardial infarction (AMI) extent is still a challenging issue. Quantitative myocardial perfusion echocardiography (MPE) with parametric imaging (PI) and gray scale (GS) has been shown to accurately measure infarcted area in animals, but not in human beings. We sought to validate MPE quantification of transmural extent and size of AMI using magnetic resonance imaging (MRI) as a gold standard. METHODS Twenty patients (12 men, 64 +/- 13 years) underwent MPE and MRI between the second and fifth day post-AMI. Infarct area and location, number of involved segments, and transmural extent in each segment were determined by PI using beta value and GS. Results were compared with late enhanced MRI. RESULTS There was 99% agreement between both methods regarding the segmental location. The correlation between infarct area by MRI and GS was 0.82 (P < .001) whereas MRI and beta PI was 0.92 (P < .001). The correlation between transmural extent by MRI and GS was 0.77 (P < .001), and between MRI and beta PI was 0.93 (P < .001). CONCLUSION There was a good correlation between MPE, in special beta PI, with MRI in measuring infarcted area and its transmural extent in patients with AMI.
Collapse
Affiliation(s)
- Maria L Z H Trindade
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Abstract
Over the past three decades, echocardiography has become a major diagnostic tool in the arsenal of clinical cardiology for real-time imaging of cardiac dynamics. More and more, cardiologists' decisions are based on images created from ultrasound wave reflections. From the time ultrasound imaging technology provided the first insight into a human heart, our diagnostic capabilities have increased exponentially as a result of our growing knowledge and developing technologies. One of the most intriguing developments that brought about a decade-long combination of expectations and disappointments was the introduction of echocardiographic contrast agents. Despite repeated waves of controversy regarding the readiness of this technology for clinical use, it has overcome multiple hurdles and currently provides useful clinical information that helps cardiologists to diagnose heart disease accurately. Since the initial reports on the use of ultrasound contrast media such as agitated saline or renografin, the major advances in the field of contrast echocardiography have included (1) the development of stable perfluorocarbon-filled microbubbles, frequently referred to as second-generation contrast agents; and (2) the development of contrast-targeted nonlinear imaging modes, such as harmonic imaging, pulse inversion, and power modulation, which allow consistent real-time visualization of these agents. These contrast agents in conjunction with the new imaging technology constitute powerful tools that improve our ability to evaluate left ventricular function and myocardial perfusion, and allow differential diagnosis of thrombi and intravascular masses. In this manuscript, we briefly review some of the literature that has provided the scientific basis for the use of echocardiographic contrast agents in the context of these important variables.
Collapse
Affiliation(s)
- Roberto M Lang
- Cardiac Imaging Center, Department of Medicine, University of Chicago Medical Center, Illinois, USA.
| | | |
Collapse
|
13
|
Main ML, Hannen MN, Kusnetzky LL, Martin JL, Coggins TR, Lanza P, Morris BA, Magalski A, Jones PG. Myocardial Contrast Echocardiographic Estimates of Infarct Size Predict Likelihood of Left Ventricular Remodeling After Acute Anterior Wall Myocardial Infarction. J Am Soc Echocardiogr 2006; 19:64-70. [PMID: 16423671 DOI: 10.1016/j.echo.2005.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2005] [Indexed: 11/23/2022]
Abstract
OBJECTIVES We sought to determine the utility of myocardial contrast echocardiography (MCE) in predicting left ventricular (LV) remodeling (LVR) in patients with a recent anterior wall myocardial infarction and residual regional LV akinesis. BACKGROUND Although recent studies have shown that MCE predicts recovery of regional and global LV systolic function after myocardial infarction, the relationship between myocardial perfusion patterns and likelihood of subsequent LVR has not been extensively studied. METHODS In all, 50 patients (mean age 62 years) underwent contrast-enhanced echocardiography for determination of LV volumes and ejection fraction, and MCE, 2 days after admission, with follow-up contrast-enhanced echocardiography 6 months later. LVR was defined as greater than 15% increase in LV end-diastolic volume index at follow-up. RESULTS LVR occurred in 19 patients (38%) (group 1), with stable LV volumes in 31 patients (62%) (group 2). Routine clinical and angiographic variables did not differ between groups 1 and 2. Both transmural extent of infarction and number of abnormally perfused myocardial segments (assessed by MCE) predicted LVR. LVR occurred in 55% of patients with transmural perfusion defects, and was less common in those with subendocardial perfusion defects or normal perfusion (31% and 21%, respectively). The mean percent increase in LV size was significantly greater for transmural infarcts (15 +/- 7%) versus subendocardial infarcts or normal perfusion (-1 +/- 8 and 8 +/- 8, respectively). When more than 5 myocardial segments were abnormally perfused, remodeling always occurred and was extensive. CONCLUSIONS MCE markers of infarct size are useful in predicting subsequent risk of LVR after myocardial infarction. Routine performance of MCE studies in select patients early after infarction may be helpful in further refining risk stratification.
Collapse
Affiliation(s)
- Michael L Main
- Mid America Heart Institute, Kansas City, Missouri, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Bodí V, Sanchís J, Losada A, García D, Núñez J, Pellicer M, Millet J, Chorro FJ, Llácer À. Estudio de la perfusión coronaria postinfarto mediante análisis cuantitativo de la ecocardiografía miocárdica con inyección de contraste por vía intravenosa. Rev Esp Cardiol 2005. [DOI: 10.1157/13071887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
15
|
Affiliation(s)
- Arthur E Weyman
- Cardiac Ultrasound Laboratory, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
| |
Collapse
|
16
|
Demaria AN, Ben-Yehuda O, Berman D, Feld GK, Greenberg BH, Knoke JD, Knowlton KU, Lew WYW, Narula J, Sahn D, Tsimikas S. Highlights of the year in JACC2004. J Am Coll Cardiol 2005; 45:137-53. [PMID: 15629388 DOI: 10.1016/j.jacc.2004.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Accepted: 11/15/2004] [Indexed: 11/16/2022]
Affiliation(s)
- Anthony N Demaria
- Cardiology Division, University of California-San Diego, San Diego, California
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|