Assessment of carotid atherosclerotic disease using three-dimensional cardiovascular magnetic resonance vessel wall imaging: comparison with digital subtraction angiography.

BACKGROUND:A three-dimensional (3D) cardiovascular magnetic resonance (CMR) vessel wall imaging (VWI) technique based on 3D T1 weighted (T1w) Sampling Perfection with Application-optimized Contrast using different flip angle Evolutions (SPACE) has recently been used as a promising CMR imaging modality for evaluating extra-cranial and intra-cranial vessel walls. However, this technique is yet to be validated against the current diagnostic imaging standard. We therefore aimed to evaluate the diagnostic performance of 3D CMR VWI in characterizing carotid disease using intra-arterial digital subtraction angiography (DSA) as a reference. METHODS:Consecutive patients with at least unilateral > 50% carotid stenosis on ultrasound were scheduled to undergo interventional therapy were invited to participate. The following metrics were measured using 3D CMR VWI and DSA: lumen diameter of the common carotid artery (CCA) and segments C1-C7, stenosis diameter, reference diameter, lesion length, stenosis degree, and ulceration. We assessed the diagnostic sensitivity, specificity, accuracy, and receiver operating characteristic (ROC) curve of 3D CMR VWI, and used Cohen's kappa, the intraclass correlation coefficient (ICC), and Bland-Altman analyses to assess the diagnostic agreement between 3D CMR VWI and DSA. RESULTS:The ICC (all ICCs ≥0.96) and Bland-Altman plots indicated excellent inter-reader agreement in all individual morphologic measurements by 3D CMR VWI. Excellent agreement in all individual morphologic measurements were also found between 3D CMR VWI and DSA. In addition, 3D CMR VWI had high sensitivity (98.4, 97.4, 80.0, 100.0%), specificity (100.0, 94.5, 99.1, 98.0%), and Cohen's kappa (0.99, 0.89, 0.84, 0.96) for detecting stenosis > 50%, stenosis > 70%, ulceration, and total occlusion, respectively, using DSA as the standard. The AUC of 3D CMR VWI for predicting stenosis > 50 and > 70% were 0.998 and 0.999, respectively. CONCLUSIONS:The 3D CMR VWI technique enables accurate diagnosis and luminal feature assessment of carotid artery atherosclerosis, suggesting that this imaging modality may be useful for routine imaging workups and provide comprehensive information for both the vessel wall and lumen

Automated tracking of a passive endomyocardial stiletto catheter with dephased FLAPS MRI: a feasibility study

Automated tracking of a passive stiletto catheter for regenerative myocardial therapy under the MR environment may improve the accuracy ofthe procedure. We report successful implementation of automated computer-assisted tracking for this purpose in a controlled phantom study

Brain MRI Super Resolution Using 3D Deep Densely Connected Neural Networks

Magnetic resonance image (MRI) in high spatial resolution provides detailed anatomical information and is often necessary for accurate quantitative analysis. However, high spatial resolution typically comes at the expense of longer scan time, less spatial coverage, and lower signal to noise ratio (SNR). Single Image Super-Resolution (SISR), a technique aimed to restore high-resolution (HR) details from one single low-resolution (LR) input image, has been improved dramatically by recent breakthroughs in deep learning. In this paper, we introduce a new neural network architecture, 3D Densely Connected Super-Resolution Networks (DCSRN) to restore HR features of structural brain MR images. Through experiments on a dataset with 1,113 subjects, we demonstrate that our network outperforms bicubic interpolation as well as other deep learning methods in restoring 4x resolution-reduced images.Comment: Accepted by ISBI'1

Coronary MRA

Coronary X‐ray angiography is the gold standard for coronary artery imaging, but is an invasive procedure, with a minor risk of potentially serious complications in addition to the drawback of exposure to ionizing radiation. Coronary magnetic resonance angiography (MRA) is a noninvasive method of imaging the coronary arteries, with no known adverse effects. In addition to morphologic evaluation of coronary artery disease with coronary MRA, cardiac MRI offers exciting possibilities to study the functional significance of coronary artery disease in the same setting. Three widely used coronary MRA approaches are presented‐‐two free‐breathing navigator‐gated methods, and a breath‐hold method. Although the positive predictive value of coronary MRA for detecting stenoses remains lower than that of X‐ray angiography, coronary MRA can reliably detect anomalous origins of coronary arteries, and has a high negative predictive value for stenoses. In conclusion, coronary MRA is a promising tool to study coronary artery disease.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145393/1/cpmia1105.pd

Automated tracking of a passive intramyocardial needle with off-resonance MRI: a feasibility study

Direct intramyocardial therapies aimed at treating myocardial regions affected by severe ischemia may benefit from CMR-guided interventional procedures. Although interventional MR approaches using active devices are considered to be the method of choice, potential tissue heating and altered mechanical properties are some of their limitations. Methods that have the capacity to visualize MR-compatible passive devices may overcome many of these obstacles. Recently, an off-resonance-based real-time positive contrast method (FLAPS) was used to visualize the passage of an intramyocardial needle (PIN) through the aorta and into the heart of swine [1,2]. We envision this procedure may benefit from computer assisted strategies that track the needle's location throughout the MR procedure. However, the feasibility of real-time automated tracking of a PIN has not been established

Contrast-free detection of myocardial fibrosis in hypertrophic cardiomyopathy patients with diffusion-weighted cardiovascular magnetic resonance.

BackgroundsPrevious studies have shown that diffusion-weighted cardiovascular magnetic resonance (DW-CMR) is highly sensitive to replacement fibrosis of chronic myocardial infarction. Despite this sensitivity to myocardial infarction, DW-CMR has not been established as a method to detect diffuse myocardial fibrosis. We propose the application of a recently developed DW-CMR technique to detect diffuse myocardial fibrosis in hypertrophic cardiomyopathy (HCM) patients and compare its performance with established CMR techniques.MethodsHCM patients (N = 23) were recruited and scanned with the following protocol: standard morphological localizers, DW-CMR, extracellular volume (ECV) CMR, and late gadolinium enhanced (LGE) imaging for reference. Apparent diffusion coefficient (ADC) and ECV maps were segmented into 6 American Heart Association (AHA) segments. Positive regions for myocardial fibrosis were defined as: ADC > 2.0 μm(2)/ms and ECV > 30%. Fibrotic and non-fibrotic mean ADC and ECV values were compared as well as ADC-derived and ECV-derived fibrosis burden. In addition, fibrosis regional detection was compared between ADC and ECV calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) using ECV as the gold-standard reference.ResultsADC (2.4 ± 0.2 μm(2)/ms) of fibrotic regions (ADC > 2.0 μm(2)/ms) was significantly (p < 0.01) higher than ADC (1.5 ± 0.2 μm(2)/ms) of non-fibrotic regions. Similarly, ECV (35 ± 4%) of fibrotic regions (ECV > 30%) was significantly (p < 0.01) higher than ECV (26 ± 2%) of non-fibrotic regions. In fibrotic regions defined by ECV, ADC (2.2 ± 0.3 μm(2)/ms) was again significantly (p < 0.05) higher than ADC (1.6 ± 0.3 μm(2)/ms) of non-fibrotic regions. In fibrotic regions defined by ADC criterion, ECV (34 ± 5%) was significantly (p < 0.01) higher than ECV (28 ± 3%) in non-fibrotic regions. ADC-derived and ECV-derived fibrosis burdens were in substantial agreement (intra-class correlation = 0.83). Regional detection between ADC and ECV of diffuse fibrosis yielded substantial agreement (κ = 0.66) with high sensitivity, specificity, PPV, NPV, and accuracy (0.80, 0.85, 0.81, 0.85, and 0.83, respectively).ConclusionDW-CMR is sensitive to diffuse myocardial fibrosis and is capable of characterizing the extent of fibrosis in HCM patients

Magnetic resonance multitasking for motion-resolved quantitative cardiovascular imaging.

Quantitative cardiovascular magnetic resonance (CMR) imaging can be used to characterize fibrosis, oedema, ischaemia, inflammation and other disease conditions. However, the need to reduce artefacts arising from body motion through a combination of electrocardiography (ECG) control, respiration control, and contrast-weighting selection makes CMR exams lengthy. Here, we show that physiological motions and other dynamic processes can be conceptualized as multiple time dimensions that can be resolved via low-rank tensor imaging, allowing for motion-resolved quantitative imaging with up to four time dimensions. This continuous-acquisition approach, which we name cardiovascular MR multitasking, captures - rather than avoids - motion, relaxation and other dynamics to efficiently perform quantitative CMR without the use of ECG triggering or breath holds. We demonstrate that CMR multitasking allows for T1 mapping, T1-T2 mapping and time-resolved T1 mapping of myocardial perfusion without ECG information and/or in free-breathing conditions. CMR multitasking may provide a foundation for the development of setup-free CMR imaging for the quantitative evaluation of cardiovascular health

Antibacterial activity of the crude extract of Chinese green tea (Camellia sinensis) on Listeria monocytogenes

The antibacterial activity of the methanol and aqueous extract of Camellia sinensis on Listeria monocytogenes were investigated using agar-gel diffusion, paper disk diffusion and microbroth dilution techniques. The results obtained showed that methanol and water extract exhibitedantibacterial activities against L. monocytogenes. The leaf extract produced inhibition zone ranging from 10.0 – 20.1 mm against the test bacteria. The methanol extracts of the test plant produces largerzones of inhibition against the bacteria than the water extract. The minimum inhibitory concentration (MIC) for the methanol and water leaf extract was 0.26 and 0.68 mg/ml, respectively