26 research outputs found
Echocardiography
The book "Echocardiography - New Techniques" brings worldwide contributions from highly acclaimed clinical and imaging science investigators, and representatives from academic medical centers. Each chapter is designed and written to be accessible to those with a basic knowledge of echocardiography. Additionally, the chapters are meant to be stimulating and educational to the experts and investigators in the field of echocardiography. This book is aimed primarily at cardiology fellows on their basic echocardiography rotation, fellows in general internal medicine, radiology and emergency medicine, and experts in the arena of echocardiography. Over the last few decades, the rate of technological advancements has developed dramatically, resulting in new techniques and improved echocardiographic imaging. The authors of this book focused on presenting the most advanced techniques useful in today's research and in daily clinical practice. These advanced techniques are utilized in the detection of different cardiac pathologies in patients, in contributing to their clinical decision, as well as follow-up and outcome predictions. In addition to the advanced techniques covered, this book expounds upon several special pathologies with respect to the functions of echocardiography
Post formation processing of cardiac ultrasound data for enhancing image quality and diagnostic value
Cardiovascular diseases (CVDs) constitute a leading cause of death, including premature
death, in the developed world. The early diagnosis and treatment of CVDs is therefore of
great importance. Modern imaging modalities enable the quantification and analysis of the
cardiovascular system and provide researchers and clinicians with valuable tools for the
diagnosis and treatment of CVDs. In particular, echocardiography offers a number of
advantages, compared to other imaging modalities, making it a prevalent tool for assessing
cardiac morphology and function. However, cardiac ultrasound images can suffer from a
range of artifacts reducing their image quality and diagnostic value. As a result, there is great
interest in the development of processing techniques that address such limitations.
This thesis introduces and quantitatively evaluates four methods that enhance clinical cardiac
ultrasound data by utilising information which until now has been predominantly
disregarded. All methods introduced in this thesis utilise multiple partially uncorrelated
instances of a cardiac cycle in order to acquire the information required to suppress or
enhance certain image features. No filtering out of information is performed at any stage
throughout the processing. This constitutes the main differentiation to previous data
enhancement approaches which tend to filter out information based on some static or
adaptive selection criteria.
The first two image enhancement methods utilise spatial averaging of partially uncorrelated
data acquired through a single acoustic window. More precisely, Temporal Compounding
enhances cardiac ultrasound data by averaging partially uncorrelated instances of the imaged
structure acquired over a number of consecutive cardiac cycles. An extension to the notion of
spatial compounding of cardiac ultrasound data is 3D-to-2D Compounding, which presents a
novel image enhancement method by acquiring and compounding spatially adjacent (along
the elevation plane), partially uncorrelated, 2D slices of the heart extracted as a thin angular
sub-sector of a volumetric pyramid scan. Data enhancement introduced by both approaches
includes the substantial suppression of tissue speckle and cavity noise. Furthermore, by
averaging decorrelated instances of the same cardiac structure, both compounding methods
can enhance tissue structures, which are masked out by high levels of noise and shadowing,
increasing their corresponding tissue/cavity detectability.
The third novel data enhancement approach, referred as Dynamic Histogram Based Intensity
Mapping (DHBIM), investigates the temporal variations within image histograms of
consecutive frames in order to (i) identify any unutilised/underutilised intensity levels and
(ii) derive the tissue/cavity intensity threshold within the processed frame sequence.
Piecewise intensity mapping is then used to enhance cardiac ultrasound data. DHBIM
introduces cavity noise suppression, enhancement of tissue speckle information as well as
considerable increase in tissue/cavity contrast and detectability.
A data acquisition and analysis protocol for integrating the dynamic intensity mapping along
with spatial compounding methods is also investigated. The linear integration of DHBIM and
Temporal Compounding forms the fourth and final implemented method, which is also
quantitatively assessed. By taking advantage of the benefits and compensating for the
limitations of each individual method, the integrated method suppresses cavity noise and
tissue speckle while enhancing tissue/cavity contrast as well as the delineation of cardiac
tissue boundaries even when heavily corrupted by cardiac ultrasound artifacts.
Finally, a novel protocol for the quantitative assessment of the effect of each data
enhancement method on image quality and diagnostic value is employed. This enables the
quantitative evaluation of each method as well as the comparison between individual
methods using clinical data from 32 patients. Image quality is assessed using a range of
quantitative measures such as signal-to-noise ratio, tissue/cavity contrast and detectability
index. Diagnostic value is assessed through variations in the repeatability level of routine
clinical measurements performed on patient cardiac ultrasound scans by two experienced
echocardiographers. Commonly used clinical measures such as the wall thickness of the
Interventricular Septum (IVS) and the Left Ventricle Posterior Wall (LVPW) as well as the
cavity diameter of the Left Ventricle (LVID) and Left Atrium (LAD) are employed for
assessing diagnostic value
Three-dimensional echocardiography: an accurate technique for cardiac quantification
Cardiac ultrasound has become the dominant imaging technology in clinical cardiology.
Two-dimensional echocardiography (2DE) gained widespread use and allows rapid and
comprehensive evaluation of anatomy and function by providing tomographic cardiac views
recorded from transthoracic (TIE) or transesophageal (TEE) acoustic windows. However, the
diagnosis of a cardiac disorder is based on a mental spatial reconstruction process of these
views into their correct geometry. This process is not always easy and accurate particularly in
complex congenital heart disease and in patients with coronary artery disease and distorted
ventricles. Three-dimensional echocardiography (3DE) obviates these limitations and is able
to provide more accurate quantitative and qualitative information in complex disorders. The
first attempt to obtain 3DE images for cardiac diagnosis and quantification started two
decades ago. These were computed from a series of nonparallel echocardiographic images
using either an articulated device or an acoustic ranging technique using multiple spark gaps
for spatial registration. However, this approach was tedious and time consuming. In addition,
cycle selection, border digitizing and tracing together with the computer analysis would take
several days. With the revolutionary advances in the computer technology, 3DE acquisition is
considerably shortened with optimal spatial and temporal registration by using computer
controlled transducer systems.
Approaches to 3DE are:
• Random acquisition with external reference (mechanical, acoustic and electromagnetic).
• Predetermined acquisition with internal reference (linear, fan like and rotational).
• Real time acquisition (pyramidal volumetric scan).
Real time volumetric scan is by definition the ideal technique for 3DE. Initial results are
promising, but further improvement in image quality is needed for routine clinical
application.
In practice the most commonly used methods arc the random acquisition and the
predetennined rotational acquisition technique