58 research outputs found
Physiological stress during cardiovascular magnetic resonance - handgrip exercise induced hemodynamic effects
Effects of heart valve prostheses on phase contrast flow measurements in Cardiovascular Magnetic Resonance - a phantom study
Background: Cardiovascular Magnetic Resonance is often used to evaluate patients after heart valve replacement. This study systematically analyses the influence of heart valve prostheses on phase contrast measurements in a phantom trial. Methods: Two biological and one mechanical aortic valve prostheses were integrated in a flow phantom. B-0 maps and phase contrast measurements were acquired at a 1.5 T MR scanner using conventional gradient-echo sequences in predefined distances to the prostheses. Results were compared to measurements with a synthetic metal-free aortic valve. Results: The flow results at the level of the prosthesis differed significantly from the reference flow acquired before the level of the prosthesis. The maximum flow miscalculation was 154 ml/s for one of the biological prostheses and 140 ml/s for the mechanical prosthesis. Measurements with the synthetic aortic valve did not show significant deviations. Flow values measured approximately 20 mm distal to the level of the prosthesis agreed with the reference flow for all tested all prostheses. Conclusions: The tested heart valve prostheses lead to a significant deviation of the measured flow rates compared to a reference. A distance of 20 mm was effective in our setting to avoid this influence
Flow measurement by cardiovascular magnetic resonance: a multi-centre multi-vendor study of background phase offset errors that can compromise the accuracy of derived regurgitant or shunt flow measurements
AIMS: Cardiovascular magnetic resonance (CMR) allows non-invasive phase contrast measurements of flow through planes transecting large vessels. However, some clinically valuable applications are highly sensitive to errors caused by small offsets of measured velocities if these are not adequately corrected, for example by the use of static tissue or static phantom correction of the offset error. We studied the severity of uncorrected velocity offset errors across sites and CMR systems.
METHODS AND RESULTS: In a multi-centre, multi-vendor study, breath-hold through-plane retrospectively ECG-gated phase contrast acquisitions, as are used clinically for aortic and pulmonary flow measurement, were applied to static gelatin phantoms in twelve 1.5 T CMR systems, using a velocity encoding range of 150 cm/s. No post-processing corrections of offsets were implemented. The greatest uncorrected velocity offset, taken as an average over a 'great vessel' region (30 mm diameter) located up to 70 mm in-plane distance from the magnet isocenter, ranged from 0.4 cm/s to 4.9 cm/s. It averaged 2.7 cm/s over all the planes and systems. By theoretical calculation, a velocity offset error of 0.6 cm/s (representing just 0.4% of a 150 cm/s velocity encoding range) is barely acceptable, potentially causing about 5% miscalculation of cardiac output and up to 10% error in shunt measurement.
CONCLUSION: In the absence of hardware or software upgrades able to reduce phase offset errors, all the systems tested appeared to require post-acquisition correction to achieve consistently reliable breath-hold measurements of flow. The effectiveness of offset correction software will still need testing with respect to clinical flow acquisitions
Cardiac involvement of the systemic disorder myotonic dystrophy type II - detection by CMR
Acoustic cardiac triggering: a practical solution for synchronization and gating of cardiovascular magnetic resonance at 7 Tesla
<p>Abstract</p> <p>Background</p> <p>To demonstrate the applicability of acoustic cardiac triggering (ACT) for imaging of the heart at ultrahigh magnetic fields (7.0 T) by comparing phonocardiogram, conventional vector electrocardiogram (ECG) and traditional pulse oximetry (POX) triggered 2D CINE acquisitions together with (i) a qualitative image quality analysis, (ii) an assessment of the left ventricular function parameter and (iii) an examination of trigger reliability and trigger detection variance derived from the signal waveforms.</p> <p>Results</p> <p>ECG was susceptible to severe distortions at 7.0 T. POX and ACT provided waveforms free of interferences from electromagnetic fields or from magneto-hydrodynamic effects. Frequent R-wave mis-registration occurred in ECG-triggered acquisitions with a failure rate of up to 30% resulting in cardiac motion induced artifacts. ACT and POX triggering produced images free of cardiac motion artefacts. ECG showed a severe jitter in the R-wave detection. POX also showed a trigger jitter of approximately Δt = 72 ms which is equivalent to two cardiac phases. ACT showed a jitter of approximately Δt = 5 ms only. ECG waveforms revealed a standard deviation for the cardiac trigger offset larger than that observed for ACT or POX waveforms.</p> <p>Image quality assessment showed that ACT substantially improved image quality as compared to ECG (image quality score at end-diastole: ECG = 1.7 ± 0.5, ACT = 2.4 ± 0.5, p = 0.04) while the comparison between ECG vs. POX gated acquisitions showed no significant differences in image quality (image quality score: ECG = 1.7 ± 0.5, POX = 2.0 ± 0.5, p = 0.34).</p> <p>Conclusions</p> <p>The applicability of acoustic triggering for cardiac CINE imaging at 7.0 T was demonstrated. ACT's trigger reliability and fidelity are superior to that of ECG and POX. ACT promises to be beneficial for cardiovascular magnetic resonance at ultra-high field strengths including 7.0 T.</p
Effects of heart valve prostheses on phase contrast flow measurements in Cardiovascular Magnetic Resonance – a phantom study
Variability and homogeneity of cardiovascular magnetic resonance myocardial T2-mapping in volunteers compared to patients with edema
Rapid parametric mapping of the longitudinal relaxation time T1 using two- dimensional variable flip angle Magnetic Resonance Imaging at 1.5 Tesla, 3 Tesla, and 7 Tesla
Die visuelle und damit subjektive Auswertung T1 gewichteter (longitudinale
Relaxationszeit) oder T2 gewichteter (transversale Relaxationszeit)
Schnittbilder gehören zur täglichen klinischen Diagnostik in der kardialen
Magnetresonanztomographie (MRT). Für diese nichtquantitative
Bildgebungsmethoden hängt die Qualität der Diagnostik unter anderem von
Aufnahmeparametern, Gerätekonfiguration, Homogenität des Grundmagnetfeldes
(B0), vom Hochfrequenz-Sendefeld (B1+) sowie von der Erfahrung des Befunders
ab. Die quantitative Erfassung der T1 und T2 Gewebeparameter birgt das
Potential, sich von diesen äußeren Einflüssen unabhängig zu machen.
Typischerweise sind T1 und T2 Akquisitions- und Quantifizierungsmethoden
jedoch zeitaufwendig. Die vorgeschlagenen Techniken erzielen in der Literatur
eine große Bandbreite an Normwerten, vorwiegend aufgrund technischer Hürden,
unzureichenden Modellannahmen, oder physiologischen Einflussfaktoren wie
Herzfrequenz, Hämodynamik als auch kardiale und respiratorische Bewegung. Aus
diesen Gründen wurde in dieser Studie eine schnelle MR Technik entwickelt, die
das Grundmagnetfeld, das HF-Sendefeld und die quantitative Kartierungen der T1
Zeit innerhalb weniger Sekunden ermitteln kann. Die entwickelte Methode wurde
an einem statischen Phantom, sowie an gesunden Probanden im Gehirn bei
magnetischen Feldstärken von 1.5 Tesla, 3 Tesla, und 7 Tesla getestet und
gegen Referenzmessungen validiert. Exemplarisch wurde in Messungen am
Patienten die klinische Anwendbarkeit demonstriert. Ein weiterer Schwerpunkt
dieser Arbeit lag im Entwurf, der Konstruktion und der Evaluierung eines MR-
kompatiblen bewegten Modells einer menschlichen linken Herzkammer. Diese
diente der Ermöglichung standardisierter Messungen in der Präsenz von
kardialer Bewegung und Blutfluss mit dem Ziel, die T1 Kartierung am Herzen zu
ermöglichen und zu verbessern. Zum Zeitpunkt der Studie waren keine Normwerte
für T1 und T2 Werte des Herzmuskels bei 3T vorhanden, sodass zunächst mittels
eines alternativen Ansatzes bei gesunden Probanden Referenzwerte erhoben
wurden. Während Messungen bei 1.5 Tesla und 3 Tesla zur klinischen Routine
gehören, sind Untersuchungen bei 7 Tesla im humanen Bereich gegenwärtig als
experimentell anzusehen. Für die kardiale Bildgebung im magnetischen Hochfeld
(7T) waren zum Zeitpunkt der Entstehung dieser Arbeit notwendige
Hochfrequenzspulen kommerziell nicht erhältlich. Verschiedene Spulenprototypen
wurden deshalb entwickelt und auf die Machbarkeit diagnostischer
Herzbildgebung geprüft und optimiert. Eine weitere Herausforderung im Hochfeld
stellte die Synchronisation der Bildaufnahme mit dem Herzzyklus dar. Die
konventionelle Synchronisationsmethode der Bildakquise mit dem Herzzyklus
durch das Elektrokardiogramm ist in starken Magnetfeldern nicht ohne weiteres
möglich. Die Ursachen wurden im Zuge dieser Arbeit untersucht, alternative
Methoden entwickelt und für Humanuntersuchungen etabliert.Magnetic resonance imaging (MRI) is a non-invasive imaging technique free of
ionizing radiation that allows medical imaging of the human body in any
arbitrary orientation. Visual but subjective evaluations of longitudinal
relaxation time (T1) or transversal relaxation time (T2) weighted images are
commonly used in clinical diagnostics of cardiac MRI. For this non-
quantitative measure, diagnostic quality depends on external influencing
factors such as hardware configuration, sequence parameters, homogeneity of
the static magnetic field (B0) and the radio frequency transmit field (B1+)
and the observer experience. The quantitative determination of T1 and T2 has
the potential to offset these external influences. However, quantification is
typically time consuming and can exceed clinically acceptable scan times.
Different techniques described in the literature show a large scatter of
normal values mainly due to insufficient model assumptions or physiological
factors such as heart rate, hemodynamics, or cardiac and respiratory motion.
For these reasons, this study examines the feasibility of a rapid slice-
selective T1 quantification using variable flip angles (VFA) at magnetic field
strengths of 1.5 Tesla, 3 Tesla, and 7 Tesla. For this purpose, an MR sequence
was developed, which enables measurement of B0, B1+ and T1 in scan times as
short as few seconds. The developed method was validated in a static phantom
as well as in healthy volunteers in the brain and benchmarked against
reference measurements. Exemplarily, the clinical applicability was
demonstrated in patient pilot studies. To allow measurements using this method
in cardiac tissue, an MR compatible dynamic model of a human cardiac left
ventricle was designed, constructed and tested. This setup resembled highly
standardized physiological motion paradigms and dedicated MR signal properties
to allow validation of the sequence in the presence of cardiac motion and
blood flow. As no normal values for myocardium at 3T were available at the
time of this study, reference values were collected in healthy volunteers
using an alternative T1 mapping approach. Furthermore, radio-frequency (RF)
coils necessary for cardiac imaging at high magnetic field strengths (7T) were
not commercially available. Therefore, various multi-channel RF coil
prototypes were developed, investigated, and optimized for diagnostic cardiac
imaging. Another challenge in high magnetic fields was that the
electrocardiogram, which is established at clinical field strengths for
synchronizing the data acquisition with the cardiac cycle, could not be used
due to signal distortions. The cause of these distortions was studied and
alternative approaches for data synchronization were developed and
investigated
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