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Bohoran TA, Parke KS, Graham-Brown MPM, Meisuria M, Singh A, Wormleighton J, Adlam D, Gopalan D, Davies MJ, Williams B, Brown M, McCann GP, Giannakidis A. Resource efficient aortic distensibility calculation by end to end spatiotemporal learning of aortic lumen from multicentre multivendor multidisease CMR images. Sci Rep 2023; 13:21794. [PMID: 38066222 PMCID: PMC10709583 DOI: 10.1038/s41598-023-48986-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
Aortic distensibility (AD) is important for the prognosis of multiple cardiovascular diseases. We propose a novel resource-efficient deep learning (DL) model, inspired by the bi-directional ConvLSTM U-Net with densely connected convolutions, to perform end-to-end hierarchical learning of the aorta from cine cardiovascular MRI towards streamlining AD quantification. Unlike current DL aortic segmentation approaches, our pipeline: (i) performs simultaneous spatio-temporal learning of the video input, (ii) combines the feature maps from the encoder and decoder using non-linear functions, and (iii) takes into account the high class imbalance. By using multi-centre multi-vendor data from a highly heterogeneous patient cohort, we demonstrate that the proposed method outperforms the state-of-the-art method in terms of accuracy and at the same time it consumes [Formula: see text] 3.9 times less fuel and generates [Formula: see text] 2.8 less carbon emissions. Our model could provide a valuable tool for exploring genome-wide associations of the AD with the cognitive performance in large-scale biomedical databases. By making energy usage and carbon emissions explicit, the presented work aligns with efforts to keep DL's energy requirements and carbon cost in check. The improved resource efficiency of our pipeline might open up the more systematic DL-powered evaluation of the MRI-derived aortic stiffness.
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Affiliation(s)
- Tuan Aqeel Bohoran
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK
| | - Kelly S Parke
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Matthew P M Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Mitul Meisuria
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Joanne Wormleighton
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - David Adlam
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Deepa Gopalan
- Imperial College London & Cambridge University Hospitals, Cambridge, CB2 0QQ, UK
| | - Melanie J Davies
- Leicester Diabetes Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, LE5 4PW, UK
| | - Bryan Williams
- Institute of Cardiovascular Science, University College London (UCL), National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, WC1E 6DD, UK
| | - Morris Brown
- Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Archontis Giannakidis
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK.
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Zahid AM, Martin B, Collins S, Oshinski JN, Ethier CR. Quantification of arterial, venous, and cerebrospinal fluid flow dynamics by magnetic resonance imaging under simulated micro-gravity conditions: a prospective cohort study. Fluids Barriers CNS 2021; 18:8. [PMID: 33579319 PMCID: PMC7879666 DOI: 10.1186/s12987-021-00238-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 12/24/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Astronauts undergoing long-duration spaceflight are exposed to numerous health risks, including Spaceflight-Associated Neuro-Ocular Syndrome (SANS), a spectrum of ophthalmic changes that can result in permanent loss of visual acuity. The etiology of SANS is not well understood but is thought to involve changes in cerebrovascular flow dynamics in response to microgravity. There is a paucity of knowledge in this area; in particular, cerebrospinal fluid (CSF) flow dynamics have not been well characterized under microgravity conditions. Our study was designed to determine the effect of simulated microgravity (head-down tilt [HDT]) on cerebrovascular flow dynamics. We hypothesized that microgravity conditions simulated by acute HDT would result in increases in CSF pulsatile flow. METHODS In a prospective cohort study, we measured flow in major cerebral arteries, veins, and CSF spaces in fifteen healthy volunteers using phase contrast magnetic resonance (PCMR) before and during 15° HDT. RESULTS We found a decrease in all CSF flow variables [systolic peak flow (p = 0.009), and peak-to-peak pulse amplitude (p = 0.001)]. Cerebral arterial average flow (p = 0.04), systolic peak flow (p = 0.04), and peak-to-peak pulse amplitude (p = 0.02) all also significantly decreased. We additionally found a decrease in average cerebral arterial flow (p = 0.040). Finally, a significant increase in cerebral venous cross-sectional area under HDT (p = 0.005) was also observed. CONCLUSIONS These results collectively demonstrate that acute application of -15° HDT caused a reduction in CSF flow variables (systolic peak flow and peak-to-peak pulse amplitude) which, when coupled with a decrease in average cerebral arterial flow, systolic peak flow, and peak-to-peak pulse amplitude, is consistent with a decrease in cardiac-related pulsatile CSF flow. These results suggest that decreases in cerebral arterial inflow were the principal drivers of decreases in CSF pulsatile flow.
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Affiliation(s)
- Arslan M Zahid
- Emory University School of Medicine, Atlanta, GA, USA. .,University of Chicago, 900 S Clark Street, Apt 1001, Chicago, IL, 60605, USA.
| | - Bryn Martin
- Department of Biological Engineering, University of Idaho, Moscow, Idaho, USA.,Alycone Therapeutics, Lowell, MA, USA
| | - Stephanie Collins
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA
| | - John N Oshinski
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA.,Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - C Ross Ethier
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA
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Hoogeveen ES, Arkink EB, van der Grond J, van Buchem MA, Ferrari MD, Terwindt GM, Kruit MC. MRI evaluation of the relationship between carotid artery endothelial shear stress and brain white matter lesions in migraine. J Cereb Blood Flow Metab 2020; 40:1040-1047. [PMID: 31213163 PMCID: PMC7178149 DOI: 10.1177/0271678x19857810] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Although white matter lesions are frequently detected in migraine patients, underlying mechanisms remain unclear. Low carotid artery endothelial shear stress has been associated with white matter lesions. We aimed to investigate the association between carotid artery endothelial shear stress and white matter lesions in migraine. In 40 elderly migraine patients (n = 29 females, 75 years [SD 3]) and 219 controls (n = 80 females, 74 years [SD 3]) from the PROSPER-MRI study, carotid artery endothelial shear stress was estimated on 1.5 T gradient-echo phase contrast MRI. White matter lesion volumes were calculated from structural MRI scans. Analyses were adjusted for age, sex, cardiovascular risk factors and cardiovascular disease. Migraine patients had lower mean endothelial shear stress compared to controls (0.90 [SD 0.15] vs. 0.98 [SD 0.16] Pa; P = 0.03). The association between mean endothelial shear stress and white matter lesion volume was greater for the migraine group than control group (P for interaction = 0.05). Within the migraine group, white matter lesion volume increased with decreasing endothelial shear stress (β-0.421; P = 0.01). In conclusion, migraine patients had lower endothelial shear stress which was associated with higher white matter lesion volume.
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Affiliation(s)
- Evelien S Hoogeveen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Enrico B Arkink
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark C Kruit
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Shahzad R, Shankar A, Amier R, Nijveldt R, Westenberg JJM, de Roos A, Lelieveldt BPF, van der Geest RJ. Quantification of aortic pulse wave velocity from a population based cohort: a fully automatic method. J Cardiovasc Magn Reson 2019; 21:27. [PMID: 31088480 PMCID: PMC6518670 DOI: 10.1186/s12968-019-0530-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 02/14/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Aortic pulse wave velocity (PWV) is an indicator of aortic stiffness and is used as a predictor of adverse cardiovascular events. PWV can be non-invasively assessed using magnetic resonance imaging (MRI). PWV computation requires two components, the length of the aortic arch and the time taken for the systolic pressure wave to travel through the aortic arch. The aortic length is calculated using a multi-slice 3D scan and the transit time is computed using a 2D velocity encoded MRI (VE) scan. In this study we present and evaluate an automatic method to quantify the aortic pulse wave velocity using a large population-based cohort. METHODS For this study 212 subjects were retrospectively selected from a large multi-center heart-brain connection cohort. For each subject a multi-slice 3D scan of the aorta was acquired in an oblique-sagittal plane and a 2D VE scan acquired in a transverse plane cutting through the proximal ascending and descending aorta. PWV was calculated in three stages: (i) a multi-atlas-based segmentation method was developed to segment the aortic arch from the multi-slice 3D scan and subsequently estimate the length of the proximal aorta, (ii) an algorithm that delineates the proximal ascending and descending aorta from the time-resolved 2D VE scan and subsequently obtains the velocity-time flow curves was also developed, and (iii) automatic methods that can compute the transit time from the velocity-time flow curves were implemented and investigated. Finally the PWV was obtained by combining the aortic length and the transit time. RESULTS Quantitative evaluation with respect to the length of the aortic arch as well as the computed PWV were performend by comparing the results of the novel automatic method to those obtained manually. The mean absolute difference in aortic length obtained automatically as compared to those obtained manually was 3.3 ± 2.8 mm (p < 0.05), the manual inter-observer variability on a subset of 45 scans was 3.4 ± 3.4 mm (p = 0.49). Bland-Altman analysis between the automataic method and the manual methods showed a bias of 0.0 (-5.0,5.0) m/s for the foot-to-foot approach, -0.1 (-1.2, 1.1) and -0.2 (-2.6, 2.1) m/s for the half-max and the cross-correlation methods, respectively. CONCLUSION We proposed and evaluated a fully automatic method to calculate the PWV on a large set of multi-center MRI scans. It was observed that the overall results obtained had very good agreement with manual analysis. Our proposed automatic method would be very beneficial for large population based studies, where manual analysis requires a lot of manpower.
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Affiliation(s)
- Rahil Shahzad
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
| | - Arun Shankar
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
| | - Raquel Amier
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, Amsterdam, 1081 HV The Netherlands
| | - Robin Nijveldt
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, Amsterdam, 1081 HV The Netherlands
| | - Jos J. M. Westenberg
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
| | - Boudewijn P. F. Lelieveldt
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
- Intelligent Systems Department, Delft University of Technology, Van Mourik Broekmanweg 6, Delft, 2628 XE The Netherlands
| | - Rob J. van der Geest
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
| | - on behalf of the Heart Brain Connection study group
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, Amsterdam, 1081 HV The Netherlands
- Intelligent Systems Department, Delft University of Technology, Van Mourik Broekmanweg 6, Delft, 2628 XE The Netherlands
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Dunås T, Wåhlin A, Zarrinkoob L, Malm J, Eklund A. 4D flow MRI—Automatic assessment of blood flow in cerebral arteries. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aae8d1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rayarao G, Biederman RWW, Williams RB, Yamrozik JA, Lombardi R, Doyle M. Improved approach to quantitative cardiac volumetrics using automatic thresholding and manual trimming: a cardiovascular MRI study. J Med Imaging (Bellingham) 2018; 5:014004. [DOI: 10.1117/1.jmi.5.1.014004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 01/17/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Geetha Rayarao
- Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - Robert W. W Biederman
- Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - Ronald B. Williams
- Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - June A. Yamrozik
- Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - Richard Lombardi
- Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - Mark Doyle
- Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania
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Blood-threshold CMR volume analysis of functional univentricular heart. Radiol Med 2018; 123:331-337. [PMID: 29357037 DOI: 10.1007/s11547-017-0851-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To validate a blood-threshold (BT) segmentation software for cardiac magnetic resonance (CMR) cine images in patients with functional univentricular heart (FUH). MATERIALS AND METHODS We evaluated retrospectively 44 FUH patients aged 25 ± 8 years (mean ± standard deviation). For each patient, the epicardial contour of the single ventricle was manually segmented on cine images by two readers and an automated BT algorithm was independently applied to calculate end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and cardiac mass (CM). Aortic flow analysis (AFA) was performed on through-plane images to obtain forward volumes and used as a benchmark. Reproducibility was tested in a subgroup of 24 randomly selected patients. Wilcoxon, Spearman, and Bland-Altman statistics were used. RESULTS No significant difference was found between SV (median 57.7 ml; interquartile range 47.9-75.6) and aortic forward flow (57.4 ml; 48.9-80.4) (p = 0.123), with a high correlation (r = 0.789, p < 0.001). Intra-reader reproducibility was 86% for SV segmentation, and 96% for AFA. Inter-reader reproducibility was 85 and 96%, respectively. CONCLUSION The BT segmentation provided an accurate and reproducible assessment of heart function in FUH patients.
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Codari M, Scarabello M, Secchi F, Sforza C, Baselli G, Sardanelli F. Fully automated contour detection of the ascending aorta in cardiac 2D phase-contrast MRI. Magn Reson Imaging 2017; 47:77-82. [PMID: 29180100 DOI: 10.1016/j.mri.2017.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/15/2017] [Accepted: 11/21/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE In this study we proposed a fully automated method for localizing and segmenting the ascending aortic lumen with phase-contrast magnetic resonance imaging (PC-MRI). MATERIAL AND METHODS Twenty-five phase-contrast series were randomly selected out of a large population dataset of patients whose cardiac MRI examination, performed from September 2008 to October 2013, was unremarkable. The local Ethical Committee approved this retrospective study. The ascending aorta was automatically identified on each phase of the cardiac cycle using a priori knowledge of aortic geometry. The frame that maximized the area, eccentricity, and solidity parameters was chosen for unsupervised initialization. Aortic segmentation was performed on each frame using active contouring without edges techniques. The entire algorithm was developed using Matlab R2016b. To validate the proposed method, the manual segmentation performed by a highly experienced operator was used. Dice similarity coefficient, Bland-Altman analysis, and Pearson's correlation coefficient were used as performance metrics. RESULTS Comparing automated and manual segmentation of the aortic lumen on 714 images, Bland-Altman analysis showed a bias of -6.68mm2, a coefficient of repeatability of 91.22mm2, a mean area measurement of 581.40mm2, and a reproducibility of 85%. Automated and manual segmentation were highly correlated (R=0.98). The Dice similarity coefficient versus the manual reference standard was 94.6±2.1% (mean±standard deviation). CONCLUSION A fully automated and robust method for identification and segmentation of ascending aorta on PC-MRI was developed. Its application on patients with a variety of pathologic conditions is advisable.
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Affiliation(s)
- Marina Codari
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy.
| | - Marco Scarabello
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Francesco Secchi
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, Milan, 20133, Milan, Italy
| | - Giuseppe Baselli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci 32, Milan, 20133, Milan, Italy
| | - Francesco Sardanelli
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy
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Yano Y, Neeland IJ, Ayers C, Peshock R, Berry JD, Lloyd-Jones DM, Greenland P, Mitchell GF, Vongpatanasin W. Hemodynamic and Mechanical Properties of the Proximal Aorta in Young and Middle-Aged Adults With Isolated Systolic Hypertension: The Dallas Heart Study. Hypertension 2017; 70:158-165. [PMID: 28507172 DOI: 10.1161/hypertensionaha.117.09279] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/10/2017] [Accepted: 04/23/2017] [Indexed: 12/12/2022]
Abstract
The aim of this study was to assess characteristic impedance (Zc) of the proximal aorta in young and middle-aged individuals with isolated systolic hypertension (ISH). Zc is an index of aortic stiffness relative to aortic size. In the Dallas Heart Study, 2001 untreated participants 18 to 64 years of age (mean age: 42.3 years; 44% black race) were divided into the following groups based on office blood pressure (BP) measurements: (1) optimal BP (systolic BP [SBP] <120 mm Hg and diastolic BP [DBP] <80 mm Hg; n=837); (2) prehypertension (SBP 120-139 mm Hg and DBP 80-89 mm Hg; n=821); (3) ISH (SBP ≥140 mm Hg and DBP <90 mm Hg; n=121); (4) isolated diastolic hypertension (SBP <140 mm Hg and DBP ≥90 mm Hg; n=44); and (5) systolic-diastolic hypertension (SBP ≥140 mm Hg and DBP ≥90 mm Hg; n=178). Zc, aortic arch pulse wave velocity, and minimum ascending aortic size were quantified using cardiovascular magnetic resonance. In multivariable-adjusted linear models, Zc was highest in the ISH group compared with the optimal BP, isolated diastolic hypertension, or systolic-diastolic hypertension groups (103.2±4.0 versus 68.3±2.1, 75.4±6.0, and 88.9±4.8 dyne*seconds/cm5, respectively; all P<0.05). The Zc-ISH association did not differ by race. Aortic pulse wave velocity was highest in the ISH group compared with the optimal BP, isolated diastolic hypertension, or systolic-diastolic hypertension groups (6.3±0.3 versus 4.3±0.1, 4.4±0.4 and 5.5±0.3 m/s, respectively; all P<0.05), whereas aortic size was similar across groups (all P>0.2). Results were similar in a subgroup of 1551 participants 18 to 49 years of age. In a multiracial population-based sample, we found evidence of a mismatch between proximal aortic stiffness and diameter in young and middle-aged adults with ISH.
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Affiliation(s)
- Yuichiro Yano
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Ian J Neeland
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Colby Ayers
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Ronald Peshock
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Jarett D Berry
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Donald M Lloyd-Jones
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Philip Greenland
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Gary F Mitchell
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Wanpen Vongpatanasin
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., D.M.L.-J., P.G.); Cardiology Division, Department of Internal Medicine (I.J.N., J.D.B., W.V.), Department of Clinical Sciences (C.A.), and Department of Radiology (R.P.), University of Texas Southwestern Medical Center, Dallas; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
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10
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Intra- and inter-reader reproducibility of blood flow measurements on the ascending aorta and pulmonary artery using cardiac magnetic resonance. Radiol Med 2016; 122:179-185. [DOI: 10.1007/s11547-016-0706-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 10/31/2016] [Indexed: 11/24/2022]
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11
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Goel A, Maroules CD, Mitchell GF, Peshock R, Ayers C, McColl R, Vongpatanasin W, King KS. Ethnic Difference in Proximal Aortic Stiffness: An Observation From the Dallas Heart Study. JACC Cardiovasc Imaging 2016; 10:54-61. [PMID: 27838302 DOI: 10.1016/j.jcmg.2016.07.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/25/2016] [Accepted: 07/28/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aims to compare ethnic difference in proximal aortic pulse wave velocity (PWV) and characteristic impedance (Zc). BACKGROUND Increased aortic stiffness is an independent predictor of target organ damage, incident hypertension, and all-cause mortality. However, previous studies have not directly assessed proximal aortic function in Blacks, the ethnic population with disproportionately high risk for incident hypertension and target organ complications. METHODS We evaluated the multiethnic, population-based DHS (Dallas Heart Study) participants (N = 2,544, 54.2% women, 49.7% Black) who underwent cardiac magnetic resonance at 1.5-T. Aortic stiffness and Zc were determined from aortic arch PWV and lumen area measurements. Linear regression was used to evaluate ethnic differences in proximal aortic wall stiffness using aortic arch PWV and Zc as dependent variables with and without adjustment for traditional cardiovascular risk factors. Because cardiac output was significantly higher in Blacks compared to Whites and Hispanics, additional comparisons of PWV and Zc were performed after adjustment for cardiac output and peripheral vascular resistance. RESULTS Compared with Whites, both Blacks and Hispanics had higher levels of aortic arch PWV (4.25, 95% confidence interval [CI]: 4.15 to 4.35 m/s, vs. 4.72, 95% CI: 4.64 to 4.81 m/s, vs. 4.48, 95% CI: 4.33 to 4.63 m/s, respectively, both p < 0.05 vs. White), and Zc (64.9, 95% CI: 63.3 to 66.6 dyne·s/cm5, vs. 75.6, 95% CI: 74.0 to 77.2 dyne·s/cm5, vs. 70.1, 95% CI: 67.6 to 72.8 dyne·s/cm5, respectively, both p < 0.01 vs. White) after adjustment for age, age squared, sex, body mass index, height, mean arterial blood pressure, antihypertensive treatment, heart rate, total cholesterol, diabetes mellitus, and smoking. Compared with Hispanics, Blacks also had higher level of both PWV and Zc (both p < 0.01). Ethnic differences in PWV and Zc persisted after adjustment for cardiac output and peripheral vascular resistance. CONCLUSIONS In a multiethnic population-based-sample, Blacks and Hispanics had higher proximal aortic stiffness compared with Whites independent of blood pressure and relevant risk factors.
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Affiliation(s)
- Akshay Goel
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | | | - Ronald Peshock
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas; Cardiology Division, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Colby Ayers
- Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Roderick McColl
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Wanpen Vongpatanasin
- Cardiology Division, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Kevin S King
- Huntington Medical Research Institutes, Pasadena, California.
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12
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Boye D, Springer O, Wassmer F, Scheidegger S, Remonda L, Berberat J. Effects of contour propagation and background corrections in different MRI flow software packages. Acta Radiol Open 2015; 4:2058460115589124. [PMID: 26346318 PMCID: PMC4548733 DOI: 10.1177/2058460115589124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/07/2015] [Indexed: 11/23/2022] Open
Abstract
Background Velocity-encoded magnetic resonance imaging (VENC-MRI) is a commonly used technique in cardiac examinations. This technique utilizes the phase shift properties of protons moving along a magnetic field gradient. VENC-MRI offers a unique way of measuring the severity of valve regurgitation by directly quantifying the regurgitation flow volume. Purpose To compare flow analysis results of different software programs and to assess the effect of background correction in sample patient cases. Material and Methods A phantom was built out of Polymethyl methacrylate (PMMA) which provides tubes of different diameters. These tubes can be connected to an external water circuit to generate a water flow inside the tubes. Expected absolute flow quantities inside the tubes were determined from preset tube- and flow-parameters. Different flow conditions were measured with a VENC-MRI sequence and the images evaluated using different software packages. In a second step six randomly selected patients showing different degrees of aortic insufficiency were evaluated in clinical terms. Results The contour propagation algorithms used in the software packages performed differently even on static phantom geometry. In terms of clinical evaluation the software packages performed similarly. Enabling background correction or leaving out manual correction of propagated contours changed results for severity of aortic insufficiency. Conclusion Turning on background correction and manual correction of propagated contours in MRI flow volume measurements is strongly recommended.
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Affiliation(s)
- D Boye
- Cantonal Hospital Aarau, Department of Neuroradiology, Aarau, Switzerland
| | - O Springer
- Cantonal Hospital Aarau, Department of Radiology, Aarau, Switzerland
| | - F Wassmer
- Zurich University of Applied Sciences, Institute of Applied Mathematics and Physics, Winterthur, Switzerland
| | - S Scheidegger
- Zurich University of Applied Sciences, Institute of Applied Mathematics and Physics, Winterthur, Switzerland
| | - L Remonda
- Cantonal Hospital Aarau, Department of Neuroradiology, Aarau, Switzerland
| | - J Berberat
- Cantonal Hospital Aarau, Department of Neuroradiology, Aarau, Switzerland
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13
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Babin D, Devos D, Pižurica A, Westenberg J, Vansteenkiste E, Philips W. Robust segmentation methods with an application to aortic pulse wave velocity calculation. Comput Med Imaging Graph 2014; 38:179-89. [PMID: 24405817 DOI: 10.1016/j.compmedimag.2013.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 11/06/2013] [Accepted: 12/09/2013] [Indexed: 10/25/2022]
Abstract
Aortic stiffness has proven to be an important diagnostic and prognostic factor of many cardiovascular diseases, as well as an estimate of overall cardiovascular health. Pulse wave velocity (PWV) represents a good measure of the aortic stiffness, while the aortic distensibility is used as an aortic elasticity index. Obtaining the PWV and the aortic distensibility from magnetic resonance imaging (MRI) data requires diverse segmentation tasks, namely the extraction of the aortic center line and the segmentation of aortic regions, combined with signal processing methods for the analysis of the pulse wave. In our study non-contrasted MRI images of abdomen were used in healthy volunteers (22 data sets) for the sake of non-invasive analysis and contrasted magnetic resonance (MR) images were used for the aortic examination of Marfan syndrome patients (8 data sets). In this research we present a novel robust segmentation technique for the PWV and aortic distensibility calculation as a complete image processing toolbox. We introduce a novel graph-based method for the centerline extraction of a thoraco-abdominal aorta for the length calculation from 3-D MRI data, robust to artifacts and noise. Moreover, we design a new projection-based segmentation method for transverse aortic region delineation in cardiac magnetic resonance (CMR) images which is robust to high presence of artifacts. Finally, we propose a novel method for analysis of velocity curves in order to obtain pulse wave propagation times. In order to validate the proposed method we compare the obtained results with manually determined aortic centerlines and a region segmentation by an expert, while the results of the PWV measurement were compared to a validated software (LUMC, Leiden, the Netherlands). The obtained results show high correctness and effectiveness of our method for the aortic PWV and distensibility calculation.
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Affiliation(s)
- Danilo Babin
- Department of Telecommunications and Information Processing - TELIN-IPI-iMinds, Faculty of Sciences, Ghent University, Sint-Pietersnieuwstraat 41, B-9000 Ghent, Belgium.
| | - Daniel Devos
- Department of Radiology, Cardiovascular MR & CT, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium.
| | - Aleksandra Pižurica
- Department of Telecommunications and Information Processing - TELIN-IPI-iMinds, Faculty of Sciences, Ghent University, Sint-Pietersnieuwstraat 41, B-9000 Ghent, Belgium.
| | - Jos Westenberg
- Department of Radiology, LUMC, Leiden University Medical Center, Albinusedreef 2, 2333 ZA Leiden, The Netherlands.
| | - Ewout Vansteenkiste
- Department of Telecommunications and Information Processing - TELIN-IPI-iMinds, Faculty of Sciences, Ghent University, Sint-Pietersnieuwstraat 41, B-9000 Ghent, Belgium.
| | - Wilfried Philips
- Department of Telecommunications and Information Processing - TELIN-IPI-iMinds, Faculty of Sciences, Ghent University, Sint-Pietersnieuwstraat 41, B-9000 Ghent, Belgium.
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Goel A, McColl R, King KS, Whittemore A, Peshock RM. Fully automated tool to identify the aorta and compute flow using phase-contrast MRI: validation and application in a large population based study. J Magn Reson Imaging 2013; 40:221-8. [PMID: 24115597 DOI: 10.1002/jmri.24338] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 07/16/2013] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To assess if fully automated localization of the aorta can be achieved using phase contrast (PC) MR images. MATERIALS AND METHODS PC cardiac-gated MR images were obtained as part of a large population-based study. A fully automated process using the Hough transform was developed to localize the ascending aorta (AAo) and descending aorta (DAo). The study was designed to validate this technique by determining: (i) its performance in localizing the AAo and DAo; (ii) its accuracy in generating AAo flow volume and DAo flow volume; and (iii) its robustness on studies with pathological abnormalities or imaging artifacts. RESULTS The algorithm was applied successfully on 1884 participants. In the randomly selected 50-study validation set, linear regression shows an excellent correlation between the automated (A) and manual (M) methods for AAo flow (r = 0.99) and DAo flow (r = 0.99). Bland-Altman difference analysis demonstrates strong agreement with minimal bias for: AAo flow (mean difference [A-M] = 0.47 ± 2.53 mL), and DAo flow (mean difference [A-M] = 1.74 ± 2.47 mL). CONCLUSION A robust fully automated tool to localize the aorta and provide flow volume measurements on phase contrast MRI was validated on a large population-based study.
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Affiliation(s)
- Akshay Goel
- Department of Radiology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
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15
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Stankovic Z, Jung B, Collins J, Russe MF, Carr J, Euringer W, Stehlin L, Csatari Z, Strohm PC, Langer M, Markl M. Reproducibility study of four-dimensional flow MRI of arterial and portal venous liver hemodynamics: influence of spatio-temporal resolution. Magn Reson Med 2013; 72:477-84. [PMID: 24018798 DOI: 10.1002/mrm.24939] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 08/01/2013] [Accepted: 08/08/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate influence of variation in spatio-temporal resolution and scan-rescan reproducibility on three-dimensional (3D) visualization and quantification of arterial and portal venous (PV) liver hemodynamics at four-dimensional (4D) flow MRI. METHODS Scan-rescan reproducibility of 3D hemodynamic analysis of the liver was evaluated in 10 healthy volunteers using 4D flow MRI at 3T with three different spatio-temporal resolutions (2.4 × 2.0 × 2.4 mm(3), 61.2 ms; 2.5 × 2.0 × 2.4 mm(3), 81.6 ms; 2.6 × 2.5 × 2.6 mm(3), 80 ms) and thus different total scan times. Qualitative flow analysis used 3D streamlines and time-resolved particle traces. Quantitative evaluation was based on maximum and mean velocities, flow volume, and vessel lumen area in the hepatic arterial and PV systems. RESULTS 4D flow MRI showed good interobserver variability for assessment of arterial and PV liver hemodynamics. 3D flow visualization revealed limitations for the left intrahepatic PV branch. Lower spatio-temporal resolution resulted in underestimation of arterial velocities (mean 15%, P < 0.05). For the PV system, hemodynamic analyses showed significant differences in the velocities for intrahepatic portal vein vessels (P < 0.05). Scan-rescan reproducibility was good except for flow volumes in the arterial system. CONCLUSION 4D flow MRI for assessment of liver hemodynamics can be performed with low interobserver variability and good reproducibility. Higher spatio-temporal resolution is necessary for complete assessment of the hepatic blood flow required for clinical applications.
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Affiliation(s)
- Zoran Stankovic
- Department of Radiology, Northwestern University, Chicago, Illinois, USA; Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA; Department of Diagnostic Radiology and Medical Physics, University Medical Center Freiburg, Freiburg, Germany
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16
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Koerte I, Haberl C, Schmidt M, Pomschar A, Lee S, Rapp P, Steffinger D, Tain RW, Alperin N, Ertl-Wagner B. Inter- and intra-rater reliability of blood and cerebrospinal fluid flow quantification by phase-contrast MRI. J Magn Reson Imaging 2013; 38:655-62. [PMID: 23371821 DOI: 10.1002/jmri.24013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate the intra- and inter-rater reliability of the quantification of blood and CSF flow rates by phase contrast MRI. MATERIALS AND METHODS Blood and CSF flows in the upper cervical region were imaged with velocity-encoded cine-phase contrast using 3T scanners from different manufacturers at two centers. Data of 6 subjects scanned in center A and of 5 subjects in center B were analyzed by six readers at two levels of training. Each data set was analyzed three times in a randomized order for a total of 33 data sets. Intra-class correlation coefficients (ICC) were calculated for the primary measurements of areas and flow rates through the main cervical arteries, veins and the CSF space, and for secondary parameters derived from the individual flow rates. RESULTS ICC ranged from 0.80 to 0.96 for the lumen area and from 0.97 to 0.99 for the volumetric flow rate. The ICC for the derived secondary measures ranged from 0.85 to 0.99. Differences due to operator level of training were not statistically significant. CONCLUSION High intra- and inter-rater reliability of volumetric flow rate measurements is currently achievable across manufacturers and users' skill levels with a pulsatility based automated lumen segmentation.
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Affiliation(s)
- Inga Koerte
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Germany.
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17
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Aortic stiffness in type-1 diabetes mellitus; beware of hypertension. Int J Cardiovasc Imaging 2012; 28:551-4. [PMID: 21442264 PMCID: PMC3326363 DOI: 10.1007/s10554-011-9850-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 03/10/2011] [Indexed: 12/02/2022]
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18
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Westenberg JJM, van Poelgeest EP, Steendijk P, Grotenhuis HB, Jukema JW, de Roos A. Bramwell-Hill modeling for local aortic pulse wave velocity estimation: a validation study with velocity-encoded cardiovascular magnetic resonance and invasive pressure assessment. J Cardiovasc Magn Reson 2012; 14:2. [PMID: 22230116 PMCID: PMC3312851 DOI: 10.1186/1532-429x-14-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 01/09/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Bramwell-Hill model describes the relation between vascular wall stiffness expressed in aortic distensibility and the pulse wave velocity (PWV), which is the propagation speed of the systolic pressure wave through the aorta. The main objective of this study was to test the validity of this model locally in the aorta by using PWV-assessments based on in-plane velocity-encoded cardiovascular magnetic resonance (CMR), with invasive pressure measurements serving as the gold standard. METHODS Seventeen patients (14 male, 3 female, mean age ± standard deviation = 57 ± 9 years) awaiting cardiac catheterization were prospectively included. During catheterization, intra-arterial pressure measurements were obtained in the aorta at multiple locations 5.8 cm apart. PWV was determined regionally over the aortic arch and locally in the proximal descending aorta. Subsequently, patients underwent a CMR examination to measure aortic PWV and aortic distention. Distensibility was determined locally from the aortic distension at the proximal descending aorta and the pulse pressure measured invasively during catheterization and non-invasively from brachial cuff-assessment. PWV was determined regionally in the aortic arch using through-plane and in-plane velocity-encoded CMR, and locally at the proximal descending aorta using in-plane velocity-encoded CMR. Validity of the Bramwell-Hill model was tested by evaluating associations between distensibility and PWV. Also, theoretical PWV was calculated from distensibility measurements and compared with pressure-assessed PWV. RESULTS In-plane velocity-encoded CMR provides stronger correlation (p = 0.02) between CMR and pressure-assessed PWV than through-plane velocity-encoded CMR (r = 0.69 versus r = 0.26), with a non-significant mean error of 0.2 ± 1.6 m/s for in-plane versus a significant (p = 0.006) error of 1.3 ± 1.7 m/s for through-plane velocity-encoded CMR. The Bramwell-Hill model shows a significantly (p = 0.01) stronger association between distensibility and PWV for local assessment (r = 0.8) than for regional assessment (r = 0.7), both for CMR and for pressure-assessed PWV. Theoretical PWV is strongly correlated (r = 0.8) with pressure-assessed PWV, with a statistically significant (p = 0.04) mean underestimation of 0.6 ± 1.1 m/s. This theoretical PWV-estimation is more accurate when invasively-assessed pulse pressure is used instead of brachial cuff-assessment (p = 0.03). CONCLUSIONS CMR with in-plane velocity-encoding is the optimal approach for studying Bramwell-Hill associations between local PWV and aortic distensibility. This approach enables non-invasive estimation of local pulse pressure and distensibility.
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Affiliation(s)
- Jos JM Westenberg
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Paul Steendijk
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Heynric B Grotenhuis
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - JW Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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19
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Markl M, Wallis W, Harloff A. Reproducibility of flow and wall shear stress analysis using flow-sensitive four-dimensional MRI. J Magn Reson Imaging 2011; 33:988-94. [PMID: 21448968 DOI: 10.1002/jmri.22519] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To systematically investigate the scan-rescan reproducibility and observer variability of flow-sensitive four-dimensional (4D) MRI in the aorta for the assessment of blood flow and global and segmental wall shear stress. MATERIALS AND METHODS ECG and respiration-synchronized flow-sensitive 4D MRI data (spatio-temporal resolution = 1.7 × 2.0 × 2.2 mm(3) /40.8 ms) were acquired in 12 healthy volunteers. To analyze scan-rescan variability, flow-sensitive 4D MRI was repeated in 10 volunteers during a second visit. Data analysis included calculation of time-resolved and total flow, peak systolic velocity, and regional and global wall shear stress (WSS) in up to 24 analysis planes distributed along the aorta. RESULTS Scan-rescan, inter-observer, and intra-observer agreement was excellent for the calculation of total flow and peak systolic velocity (mean differences <5% of the average flow parameter). Global WSS demonstrated moderate agreement and increased variability regarding wall shear stress (scan-rescan, inter-observer, and intra-observer agreement; mean differences <10% of the average WSS parameters). The segmental distribution of wall shear stress in the thoracic aorta could reliably be reproduced (r > 0.87; P < 0.001) for different observers and examinations. CONCLUSION Flow-sensitive 4D MRI-based analysis of aortic blood flow can be performed with good reproducibility. Robustness of global and regional WSS quantification was limited, but spatio-temporal WSS distributions could reliably be replicated.
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Affiliation(s)
- Michael Markl
- Department of Radiology - Medical Physics, University Hospital Freiburg, Germany.
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20
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Westenberg JJ, Scholte AJ, Vaskova Z, van der Geest RJ, Groenink M, Labadie G, van den Boogaard PJ, Radonic T, Hilhorst-Hofstee Y, Mulder BJ, Kroft LJ, Reiber JH, de Roos A. Age-related and regional changes of aortic stiffness in the marfan syndrome: Assessment with velocity-encoded MRI. J Magn Reson Imaging 2011; 34:526-31. [DOI: 10.1002/jmri.22646] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 04/07/2011] [Indexed: 11/05/2022] Open
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van der Wall EE, van Velzen JE, de Graaf FR, Jukema JW. Reduction of radiation dose using 80 kV tube voltage: a feasible strategy? Int J Cardiovasc Imaging 2011; 28:425-8. [PMID: 21424152 PMCID: PMC3288370 DOI: 10.1007/s10554-011-9845-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 03/02/2011] [Indexed: 10/25/2022]
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22
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Brandts A, Westenberg JJM, Versluis MJ, Kroft LJM, Smith NB, Webb AG, de Roos A. Quantitative assessment of left ventricular function in humans at 7 T. Magn Reson Med 2011; 64:1471-7. [PMID: 20593368 DOI: 10.1002/mrm.22529] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The purpose of this study was to determine the ability of 7 T cardiac magnetic resonance imaging (MRI) to quantitatively assess left ventricular volumes, mass, and function from cine short-axis series and left ventricular diastolic filling from velocity-encoded MRI in 10 healthy volunteers. As comparative "gold standard," the corresponding measures obtained at 1.5 T were taken. Left ventricular volumes, function, and mass were obtained by manual image segmentation. Trans-mitral flow graphs were obtained from 2D one-directional through-plane velocity-encoded MRI planned at the mitral valve in end-systole. Imaging at 7 T MRI was successful in 80% of the examinations. Assessment of left ventricular volumes, function, and mass at 7 T showed good agreement with 1.5 T (no significant differences between variables describing volumes, function, and mass with intraclass correlation coefficients ranging from 0.77 to 0.96). Trans-mitral stroke volume and the ratio between early and atrial peak filling rate showed strong agreement at both field strengths (no significant differences between stroke volumes and filling ratios with intraclass correlation coefficients 0.92 for stroke volumes and 0.77 for peak filling ratios). In conclusion, this study shows that assessing left ventricular volumes, function, and flow is feasible at 7 T MRI and that standardized MRI protocols provide similar quantitative results when compared with 1.5 T MRI.
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Affiliation(s)
- Anne Brandts
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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23
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Bonekamp D, Degaonkar M, Barker PB. Quantitative cerebral blood flow in dynamic susceptibility contrast MRI using total cerebral flow from phase contrast magnetic resonance angiography. Magn Reson Med 2011; 66:57-66. [PMID: 21287594 DOI: 10.1002/mrm.22776] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Revised: 11/12/2010] [Accepted: 11/24/2010] [Indexed: 11/10/2022]
Abstract
Dynamic susceptibility contrast magnetic resonance imaging during bolus injection of gadolinium contrast agent is commonly used to investigate cerebral hemodynamics. The large majority of clinical applications of dynamic susceptibility contrast magnetic resonance imaging to date have reported relative cerebral blood flow values because of dependence of the result on the accuracy of determining the arterial input function, the robustness of the singular value decomposition algorithm, and others. We propose a calibration approach that directly measures the total (i.e., whole brain) cerebral blood flow in individual subjects using phase contrast magnetic resonance angiography. The method was applied to data from 11 patients with intracranial pathology. The sum of squares variance about the mean (uncorrected: white matter = 105.6, gray matter = 472.2; corrected: white matter = 34.1, gray matter = 99.8) after correction was significantly lower for white matter (P = 0.045) and for gray matter (P = 0.011). However, the mean gray and white matter cerebral blood flow in the contralateral hemisphere were not significantly altered by the correction. The proposed phase contrast magnetic resonance angiography calibration technique appears to be one of the most direct correction schemes available for dynamic susceptibility contrast magnetic resonance imaging cerebral blood flow values and can be performed rapidly, requiring only a few minutes of additional scan time.
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Affiliation(s)
- David Bonekamp
- Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
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van der Wall EE, de Graaf FR, van Velzen JE, Jukema JW, Bax JJ, Schuijf JD. 320-row CT: does beat-to-beat motion of the coronary arteries affect image quality? Int J Cardiovasc Imaging 2011; 28:147-51. [PMID: 21279691 PMCID: PMC3275735 DOI: 10.1007/s10554-010-9794-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Accepted: 12/30/2010] [Indexed: 11/24/2022]
Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - F. R. de Graaf
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. E. van Velzen
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. W. Jukema
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. J. Bax
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. D. Schuijf
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
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van der Wall EE, de Graaf FR, van Velzen JE, Jukema JW, Schuijf JD, Bax JJ. Functional analysis by 64-slice CT scanning: prediction of left ventricular dysfunction together with reduction in radiation exposure? Int J Cardiovasc Imaging 2010; 27:1089-93. [PMID: 21170591 PMCID: PMC3182322 DOI: 10.1007/s10554-010-9771-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 12/08/2010] [Indexed: 11/24/2022]
Affiliation(s)
- E E van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands.
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van der Wall EE, van Velzen JE, de Graaf FR, Jukema JW, Schuijf JD, Bax JJ. 320-row CT scanning: reduction in tube current parallels reduction in radiation exposure? Int J Cardiovasc Imaging 2010; 28:193-7. [PMID: 21136168 PMCID: PMC3275722 DOI: 10.1007/s10554-010-9762-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 11/26/2010] [Indexed: 11/13/2022]
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van der Wall EE, Zeppenfeld K, Bax JJ, Siebelink HM, Schalij MJ. CMR-determined scar volume: predictive for ventricular tachycardias? Int J Cardiovasc Imaging 2010; 27:989-93. [PMID: 21061171 PMCID: PMC3182320 DOI: 10.1007/s10554-010-9744-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 10/27/2010] [Indexed: 11/30/2022]
Abstract
The interesting data reported by Bernhardt et al. strengthen the diagnostic benefit of CMR in patients with ischemic cardiomyopathy. Consequently, the presence, location and size of the CMR-determined scar tissue may be used for better risk stratification in patients with ischemic cardiomyopathy eligible for ICD therapy.
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Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - K. Zeppenfeld
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - J. J. Bax
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - H. M. Siebelink
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - M. J. Schalij
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
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van der Wall EE, Reiber JHC. Assessment of left ventricular function: visual or quantitative? Int J Cardiovasc Imaging 2010; 27:573-7. [PMID: 20981573 PMCID: PMC3101355 DOI: 10.1007/s10554-010-9735-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 10/13/2010] [Indexed: 01/08/2023]
Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - J. H. C. Reiber
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
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Westenberg JJ, de Roos A, Grotenhuis HB, Steendijk P, Hendriksen D, van den Boogaard PJ, van der Geest RJ, Bax JJ, Jukema JW, Reiber JH. Improved aortic pulse wave velocity assessment from multislice two-directional in-plane velocity-encoded magnetic resonance imaging. J Magn Reson Imaging 2010; 32:1086-94. [DOI: 10.1002/jmri.22359] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Herment A, Kachenoura N, Lefort M, Bensalah M, Dogui A, Frouin F, Mousseaux E, De Cesare A. Automated segmentation of the aorta from phase contrast MR images: validation against expert tracing in healthy volunteers and in patients with a dilated aorta. J Magn Reson Imaging 2010; 31:881-8. [PMID: 20373432 DOI: 10.1002/jmri.22124] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To assess if segmentation of the aorta can be accurately achieved using the modulus image of phase contrast (PC) magnetic resonance (MR) acquisitions. MATERIALS AND METHODS PC image sequences containing both the ascending and descending aorta of 52 subjects were acquired using three different MR scanners. An automated segmentation technique, based on a 2D+t deformable surface that takes into account the features of PC aortic images, such as flow-related effects, was developed. The study was designed to: 1) assess the variability of our approach and its robustness to the type of MR scanner, and 2) determine its sensitivity to aortic dilation and its accuracy against an expert manual tracing. RESULTS Interobserver variability in the lumen area was 0.59 +/- 0.92% for the automated approach versus 10.09 +/- 8.29% for manual segmentation. The mean Dice overlap measure was 0.945 +/- 0.014. The method was robust to the aortic size and highly correlated (r = 0.99) with the manual tracing in terms of aortic area and diameter. CONCLUSION A fast and robust automated segmentation of the aortic lumen was developed and successfully tested on images provided by various MR scanners and acquired on healthy volunteers as well as on patients with a dilated aorta.
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Assessment of left ventricular volumes; reliable by gated SPECT? Int J Cardiovasc Imaging 2010; 27:635-8. [PMID: 20924791 PMCID: PMC3101353 DOI: 10.1007/s10554-010-9717-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 09/23/2010] [Indexed: 11/24/2022]
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Shanks M, Siebelink HMJ, Delgado V, van de Veire NRL, Ng ACT, Sieders A, Schuijf JD, Lamb HJ, Ajmone Marsan N, Westenberg JJM, Kroft LJ, de Roos A, Bax JJ. Quantitative assessment of mitral regurgitation: comparison between three-dimensional transesophageal echocardiography and magnetic resonance imaging. Circ Cardiovasc Imaging 2010; 3:694-700. [PMID: 20810848 DOI: 10.1161/circimaging.110.947176] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND quantification of mitral regurgitation severity with 2-dimensional (2D) imaging techniques remains challenging. The present study compared the accuracy of 2D transesophageal echocardiography (TEE) and 3-dimensional (3D) TEE for quantification of mitral regurgitation, using MRI as the reference method. METHODS AND RESULTS two-dimensional and 3D TEE and cardiac MRI were performed in 30 patients with mitral regurgitation. Mitral effective regurgitant orifice area (EROA) and regurgitant volume (Rvol) were estimated with 2D and 3D TEE. With 3D TEE, EROA was calculated using planimetry of the color Doppler flow from en face views and Rvol was derived by multiplying the EROA by the velocity time integral of the regurgitant jet. Finally, using MRI, mitral Rvol was quantified by subtracting the aortic flow volume from left ventricular stroke volume. Compared with 3D TEE, 2D TEE underestimated the EROA by a mean of 0.13 cm(2). In addition, 2D TEE underestimated the Rvol by 21.6% when compared with 3D TEE and by 21.3% when compared with MRI. In contrast, 3D TEE underestimated the Rvol by only 1.2% when compared with MRI. Finally, one third of the patients in grade 1 and ≥50% of the patients in grade 2 and 3, as assessed with 2D TEE, would have been upgraded to a more severe grade, based on the 3D TEE and MRI measurements. CONCLUSIONS quantification of mitral EROA and Rvol with 3D TEE is feasible and accurate as compared with MRI and results in less underestimation of the Rvol as compared with 2D TEE.
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Affiliation(s)
- Miriam Shanks
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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100 kV versus 120 kV: effective reduction in radiation dose? Int J Cardiovasc Imaging 2010; 27:587-91. [PMID: 20809283 PMCID: PMC3101358 DOI: 10.1007/s10554-010-9693-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 08/24/2010] [Indexed: 11/13/2022]
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van der Wall EE, Delgado V, Holman ER, Bax JJ. Speckle tracking: distinction of physiologic from pathologic LVH? Int J Cardiovasc Imaging 2010; 27:101-4. [PMID: 20734233 PMCID: PMC3035794 DOI: 10.1007/s10554-010-9689-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 08/13/2010] [Indexed: 11/03/2022]
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van der Wall EE, Holman ER, Scholte AJ, Bax JJ. Echocardiography in Takotsubo cardiomyopathy; a useful approach? Int J Cardiovasc Imaging 2010; 26:537-40. [PMID: 20390358 PMCID: PMC2868168 DOI: 10.1007/s10554-010-9629-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 04/02/2010] [Indexed: 11/24/2022]
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Brandts A, Roes SD, Doornbos J, Weiss RG, de Roos A, Stuber M, Westenberg JJM. Right coronary artery flow velocity and volume assessment with spiral K-space sampled breathhold velocity-encoded MRI at 3 tesla: accuracy and reproducibility. J Magn Reson Imaging 2010; 31:1215-23. [PMID: 20432359 DOI: 10.1002/jmri.22144] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate accuracy and reproducibility of flow velocity and volume measurements in a phantom and in human coronary arteries using breathhold velocity-encoded (VE) MRI with spiral k-space sampling at 3 Tesla. MATERIALS AND METHODS Flow velocity assessment was performed using VE MRI with spiral k-space sampling. Accuracy of VE MRI was tested in vitro at five constant flow rates. Reproducibility was investigated in 19 healthy subjects (mean age 25.4 +/- 1.2 years, 11 men) by repeated acquisition in the right coronary artery (RCA). RESULTS MRI-measured flow rates correlated strongly with volumetric collection (Pearson correlation r = 0.99; P < 0.01). Due to limited sample resolution, VE MRI overestimated the flow rate by 47% on average when nonconstricted region-of-interest segmentation was used. Using constricted region-of-interest segmentation with lumen size equal to ground-truth luminal size, less than 13% error in flow rate was found. In vivo RCA flow velocity assessment was successful in 82% of the applied studies. High interscan, intra- and inter-observer agreement was found for almost all indices describing coronary flow velocity. Reproducibility for repeated acquisitions varied by less than 16% for peak velocity values and by less than 24% for flow volumes. CONCLUSION 3T breathhold VE MRI with spiral k-space sampling enables accurate and reproducible assessment of RCA flow velocity.
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Affiliation(s)
- Anne Brandts
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
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van der Hulst AE, Westenberg JJM, Kroft LJM, Bax JJ, Blom NA, de Roos A, Roest AAW. Tetralogy of fallot: 3D velocity-encoded MR imaging for evaluation of right ventricular valve flow and diastolic function in patients after correction. Radiology 2010; 256:724-34. [PMID: 20634432 DOI: 10.1148/radiol.10092269] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate three-dimensional (3D) velocity-encoded (VE) magnetic resonance (MR) imaging, as compared with two-dimensional (2D) VE MR imaging, for assessment of pulmonary valve (PV) and tricuspid valve (TV) flow, with planimetry as the reference standard, and to evaluate diastolic function in patients with a corrected tetralogy of Fallot (TOF). MATERIALS AND METHODS Local institutional review board approval was obtained, and patients or their parents gave informed consent. Twenty-five patients with a corrected TOF (12 male, 13 female; mean age, 13.1 years +/- 2.7 [standard deviation]; age range, 8-18 years) and 19 control subjects (12 male, seven female; mean age, 14.1 years +/- 2.4; age range, 8-18 years) underwent planimetric MR imaging, 2D VE MR imaging, and 3D VE MR imaging for TV and PV flow evaluation. For evaluation of diastolic function, PV and TV flow were summated. Data were analyzed by using linear regression analysis, paired and unpaired t testing, and Bland-Altman plots. RESULTS Strong correlations between the 2D VE MR and 3D VE MR measurements of PV flow (for forward flow: r = 0.87, P < .01; for backward flow: r = 0.97, P < .01) were observed. With PV effective flow as a reference, 3D TV effective flow measurements were more accurate than 2D TV effective flow measurements: In patients, the mean 2D TV effective flow versus 2D PV effective flow difference was 17.6 mL +/- 11 (P < .001), and the mean 3D TV effective flow versus 3D PV effective flow difference was -1.2 mL +/- 4.7 (P = .22). Diastolic functional impairment in patients could be detected at 3D VE MR imaging diastolic assessment. CONCLUSION Three-dimensional VE MR imaging is accurate for PV flow assessment and is more accurate than 2D VE MR imaging for TV flow evaluation. Assessment of diastolic function with 3D VE MR imaging can facilitate ongoing research of diastolic dysfunction in patients with a corrected TOF.
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Affiliation(s)
- Annelies E van der Hulst
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, RC, Leiden, The Netherlands
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van der Wall EE, de Graaf FR, van Velzen JE, Jukema JW, Bax JJ, Schuijf JD. IVUS detects more coronary calcifications than MSCT; matter of both resolution and cross-sectional assessment? Int J Cardiovasc Imaging 2010; 27:1011-4. [PMID: 20623370 PMCID: PMC3182328 DOI: 10.1007/s10554-010-9668-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 06/30/2010] [Indexed: 12/02/2022]
Affiliation(s)
- E E van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands.
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Evidence of scar tissue: contra-indication to cardiac resynchronization therapy? Int J Cardiovasc Imaging 2010; 27:59-63. [PMID: 20614190 PMCID: PMC3035785 DOI: 10.1007/s10554-010-9664-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 06/25/2010] [Indexed: 11/06/2022]
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40
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Cardiac magnetic resonance imaging; gatekeeper in suspected CAD? Int J Cardiovasc Imaging 2010; 27:123-6. [PMID: 20571872 PMCID: PMC3035784 DOI: 10.1007/s10554-010-9661-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 06/14/2010] [Indexed: 11/23/2022]
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41
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van der Wall EE, Scholte AJ, Bax JJ. Gated myocardial SPECT imaging; true additional value in AMI? Int J Cardiovasc Imaging 2010; 26:893-6. [PMID: 20532632 PMCID: PMC2991157 DOI: 10.1007/s10554-010-9650-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 05/27/2010] [Indexed: 12/01/2022]
Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - A. J. Scholte
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - J. J. Bax
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
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Use of the anterior-posterior chest diameter in CT: reduction in radiation dose? Int J Cardiovasc Imaging 2010; 26:941-5. [PMID: 20526742 PMCID: PMC2991165 DOI: 10.1007/s10554-010-9647-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Accepted: 05/21/2010] [Indexed: 01/07/2023]
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Evaluation of pulmonary arterial hypertension: invasive or noninvasive? Int J Cardiovasc Imaging 2010; 27:943-5. [PMID: 20473785 PMCID: PMC3182326 DOI: 10.1007/s10554-010-9642-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 05/06/2010] [Indexed: 01/06/2023]
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Cardiac magnetic resonance imaging analysis in STEMI: quantitative or still visual? Int J Cardiovasc Imaging 2010; 27:965-8. [PMID: 20454931 PMCID: PMC3182319 DOI: 10.1007/s10554-010-9638-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 04/24/2010] [Indexed: 12/04/2022]
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van der Wall EE, Scholte AJ, Holman ER, Bax JJ. Stress imaging in patients with diabetes; routine practice? Int J Cardiovasc Imaging 2010; 27:939-42. [PMID: 20454930 PMCID: PMC3182325 DOI: 10.1007/s10554-010-9639-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 04/26/2010] [Indexed: 11/29/2022]
Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - A. J. Scholte
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - E. R. Holman
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - J. J. Bax
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
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Affiliation(s)
| | - M. J. Schalij
- Leiden University Medical Center, Leiden, The Netherlands
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van der Wall EE, van Velzen JE, de Graaf FR, Boogers MM, Schuijf JD, Bax JJ. Increased accuracy in computed tomography coronary angiography; a new body surface area adapted protocol. Int J Cardiovasc Imaging 2010; 26:601-4. [PMID: 20396952 PMCID: PMC2868173 DOI: 10.1007/s10554-010-9628-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 04/02/2010] [Indexed: 11/25/2022]
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van der Wall EE, Siebelink HM, Scholte AJ, Bax JJ. Positron emission tomography; viable tool in patients pre-CABG? Int J Cardiovasc Imaging 2010; 26:661-4. [PMID: 20358291 PMCID: PMC2898113 DOI: 10.1007/s10554-010-9612-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Accepted: 03/05/2010] [Indexed: 11/30/2022]
Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - H. M. Siebelink
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - A. J. Scholte
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
| | - J. J. Bax
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, Netherlands
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Associations between total cerebral blood flow and age related changes of the brain. PLoS One 2010; 5:e9825. [PMID: 20352115 PMCID: PMC2843728 DOI: 10.1371/journal.pone.0009825] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Accepted: 01/17/2010] [Indexed: 11/19/2022] Open
Abstract
Background and Purpose Although total cerebral blood flow (tCBF) is known to be related to age, less is known regarding the associations between tCBF and the morphologic changes of the brain accompanying cerebral aging. The purpose of this study was to investigate whether total cerebral blood flow (tCBF) is related to white matter hyperintensity (WMH) volume and/or cerebral atrophy. Furthermore, we investigate whether tCBF should be expressed in mL/min, as was done in all previous MR studies, or in mL/100 mL/min, which yielded good results in precious SPECT, PET and perfusion MRI studies investigating regional cerebral blood flow. Materials and Methods Patients were included from the nested MRI sub-study of the PROSPER study. Dual fast spin echo and FLAIR images were obtained in all patients. In addition, single slice phase contrast MR angiography was used for flow measurements in the internal carotids and vertebral arteries. tCBF was expressed in both mL/min and mL/100 mL/min. Results We found a significant correlation between tCBF in mL/min and both age (r = −.124; p = p≤.001) and parenchymal volume (r = 0.430; p≤.001). We found no association between tCBF in mL/min and %-atrophy (r = −.077; p = .103) or total WMH volume (r = −.069; p = .148). When tCBF was expressed in mL/100 mL/min the correlation between tCBF and age was no longer found (r = −.001; p = .985). Multivariate regression analyses corrected for age showed a significant correlation between tCBF in mL/100 mL/min and WMH volume (r = −.106; p = .044). No significant association between tCBF in mL/100 mL/min and %-atrophy was found. Conclusion From this study we conclude that, when evaluating tCBF alterations due to various pathologies, tCBF should in mL/100 mL/min instead of mL/min. Furthermore, changes or differences in WMH volume should be accounted for.
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Affiliation(s)
| | - J. J. Bax
- Leiden University Medical Center, Leiden, The Netherlands
| | - J. W. Jukema
- Leiden University Medical Center, Leiden, The Netherlands
| | - M. J. Schalij
- Leiden University Medical Center, Leiden, The Netherlands
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