1,157 research outputs found
Deep Learning using K-space Based Data Augmentation for Automated Cardiac MR Motion Artefact Detection
Quality assessment of medical images is essential for complete automation of
image processing pipelines. For large population studies such as the UK
Biobank, artefacts such as those caused by heart motion are problematic and
manual identification is tedious and time-consuming. Therefore, there is an
urgent need for automatic image quality assessment techniques. In this paper,
we propose a method to automatically detect the presence of motion-related
artefacts in cardiac magnetic resonance (CMR) images. As this is a highly
imbalanced classification problem (due to the high number of good quality
images compared to the low number of images with motion artefacts), we propose
a novel k-space based training data augmentation approach in order to address
this problem. Our method is based on 3D spatio-temporal Convolutional Neural
Networks, and is able to detect 2D+time short axis images with motion artefacts
in less than 1ms. We test our algorithm on a subset of the UK Biobank dataset
consisting of 3465 CMR images and achieve not only high accuracy in detection
of motion artefacts, but also high precision and recall. We compare our
approach to a range of state-of-the-art quality assessment methods.Comment: Accepted for MICCAI2018 Conferenc
Coronary microvascular ischemia in hypertrophic cardiomyopathy - a pixel-wise quantitative cardiovascular magnetic resonance perfusion study.
BACKGROUND: Microvascular dysfunction in HCM has been associated with adverse clinical outcomes. Advances in quantitative cardiovascular magnetic resonance (CMR) perfusion imaging now allow myocardial blood flow to be quantified at the pixel level. We applied these techniques to investigate the spectrum of microvascular dysfunction in hypertrophic cardiomyopathy (HCM) and to explore its relationship with fibrosis and wall thickness. METHODS: CMR perfusion imaging was undertaken during adenosine-induced hyperemia and again at rest in 35 patients together with late gadolinium enhancement (LGE) imaging. Myocardial blood flow (MBF) was quantified on a pixel-by-pixel basis from CMR perfusion images using a Fermi-constrained deconvolution algorithm. Regions-of-interest (ROI) in hypoperfused and hyperemic myocardium were identified from the MBF pixel maps. The myocardium was also divided into 16 AHA segments. RESULTS: Resting MBF was significantly higher in the endocardium than in the epicardium (mean ± SD: 1.25 ± 0.35 ml/g/min versus 1.20 ± 0.35 ml/g/min, P < 0.001), a pattern that reversed with stress (2.00 ± 0.76 ml/g/min versus 2.36 ± 0.83 ml/g/min, P < 0.001). ROI analysis revealed 11 (31%) patients with stress MBF lower than resting values (1.05 ± 0.39 ml/g/min versus 1.22 ± 0.36 ml/g/min, P = 0.021). There was a significant negative association between hyperemic MBF and wall thickness (β = −0.047 ml/g/min per mm, 95% CI: −0.057 to −0.038, P < 0.001) and a significantly lower probability of fibrosis in a segment with increasing hyperemic MBF (odds ratio per ml/g/min: 0.086, 95% CI: 0.078 to 0.095, P = 0.003). CONCLUSIONS: Pixel-wise quantitative CMR perfusion imaging identifies a subgroup of patients with HCM that have localised severe microvascular dysfunction which may give rise to myocardial ischemia
Cateterização simultânea das artérias coronárias no tratamento das oclusões crónicas totais
As oclusões crónicas totais apresentam-se
como um grande desafio para os cardiologistas de intervenção, sendo o seu
tratamento geralmente acompanhado de um
aumento das complicações. É apresentado um argumento para a utilização da cateterização simultânea das artérias coronárias para a melhoria das
caracterÃsticas da lesão e optimização dos
resultados. Oito doentes com oclusões
crónicas totais foram revascularizados
percutaneamente utilizando esta técnica com
sucesso imediato e ausência de complicações
em todos eles
Three-dimensional contrast-enhanced magnetic resonance pulmonary angiography in the study of pulmonary vascular pathology
Objectives: To assess the feasibility of
performing pulmonary angiography using
MRI with contrast enhancement in patients
with pulmonary vascular disease.
Methods: We present our experience in ten
individuals, two controls and eight patients
who underwent the exam after injection of a
gadolinium-based contrast agent on a 1 Tesla
MR scanner using a time-of-flight sequence
and breath-holding during injection of
contrast.
Results: Pathology in the main pulmonary
artery and its major branches was detected
easily while resolution at the segmental and
subsegmental levels was inadequate.
Conclusion: Contrast-enhanced magnetic
resonance pulmonary angiography is feasible
on a 1 Tesla MR scanner for the study of
pathology of the main pulmonary artery and
its major branches, like massive pulmonary
embolism. However its ability to detect and
define distal vessel pathology as found in
chronic thromboembolic pulmonary
hypertension and small pulmonary emboli is
limited
Transferência de doentes crÃticos para cirurgia cardÃaca urgente após colocação de balão intra-aórtico
Introdução, material e métodos: São
apresentados os resultados de um estudo
retrospectivo de todos os exames
hemodinâmicos realizados no nosso Centro,
com o objectivo de avaliar a exequibilidade e segurança de transferência para um centro
cirúrgico, de doentes coronários instáveis,
nos quais foi implantado um balão intra-
-aórtico. No total, foram implantados 62 BIAOs, em outros tantos doentes, dos quais 24 foram transferidos para centros cirúrgicos no centro de Lisboa, numa ambulância, acompanhados de médico, enfermeiro e pessoal paramédico.
Resultados: O grupo de doentes que
necessitou da implantação de BIAO, era
constituÃdo por doentes com angina instável
e com uma anatomia coronária que aconselhava intervenção cirúrgica imediata,
doentes com hipotensão e complicações
mecânicas pós-enfarte, e ainda doentes com
enfarte agudo do miocárdio que não foram
submetidos a trombólise e nos quais a
anatomia coronária desaconselhava intervenção percutânea. Todos os doentes chegaram vivos ao hospital, não se verificando nenhuma instabilidade
hemodinâmicaa e/ou eléctrica durante o
transporte.
Conclusões: O transporte terrestre de doentes necessitando de cirurgia de emergência nos quais foi colocado um BIAO foi fácil e seguro, podendo a prévia colocação deste device contribuir para uma melhoria clÃnica neste subgrupo particularmente grave de doentes
Relationship between cardiac diffusion tensor imaging parameters and anthropometrics in healthy volunteers
Background: In vivo cardiac diffusion tensor imaging (cDTI) is uniquely capable of interrogating laminar myocardial dynamics non-invasively. A comprehensive dataset of quantative parameters and comparison with subject anthropometrics is required.
Methods: cDTI was performed at 3T with a diffusion weighted STEAM sequence. Data was acquired from the mid left ventricle in 43 subjects during the systolic and diastolic pauses. Global and regional values were determined for fractional anisotropy (FA), mean diffusivity (MD), helix angle gradient (HAg, degrees/%depth) and the secondary eigenvector angulation (E2A). Regression analysis was performed between global values and subject anthropometrics.
Results: All cDTI parameters displayed regional heterogeneity. The RR interval had a significant, but clinically small effect on systolic values for FA, HAg and E2A. Male sex and increasing left ventricular end diastolic volume were associated with increased systolic HAg. Diastolic HAg and systolic E2A were both directly related to left ventricular mass and body surface area. There was an inverse relationship between E2A mobility and both age and ejection fraction.
Conclusions: Future interpretations of quantitative cDTI data should take into account anthropometric variations observed with patient age, body surface area and left ventricular measurements. Further work determining the impact of technical factors such as strain and SNR is required
Solução glicosada hipertônica no mesentério e no peritônio de ratos: estudo macroscópico e microscópico
PURPOSE: The objective of the experimental study is to detect the macroscopic and microscopic alterations of the mesenterium and parietal peritoneum when hypertonic glucose aqueous solution 10%-25% is administrated into the peritoneal cavity of the rat. METHODS: 90 Wistar females young rats adults were used weighin between 180-250 g, numbered 1 to 90, establishing unique group and divided in three groups (A, B, C) of 30 animals chosen aleatory manner. 0,9% saline solution was used called control group, or group A, 10% glucose solution named group B, and in the others 30 was used 25% glucose solution named group C, differing in the observation period, (06h, 24h and 48h), but with the same procedure. A midline abdominal wall laparotomy was made and in the animals of the control group was injected 2 ml of a 0,9% saline solution into the peritoneal cavity. After, we made a suture in mass without to include the peritoneum. For the others groups (B, C) the rats received 10% glucose solution and 25% glucose solution injected into the peritoneal cavity respectively. All groups were kept under observation and the results were submitted to statistical analysis by a longitudinal and transversal comparative study. RESULTS: A new surgery was done in 6h, 24h and 48h, and we observed in macroscopic evaluation, the presence of fluid, serous uniforme and rosy all over the cavity. Vascular congestion was present. We dried out 90 fragments of mesenterium and 90 fragments of parietal peritonium bilateral. In the microscopic study, necrosis was not present. For the mesenterium histological study we observed 16 cases (17,8%) unspecific chronic inflammation, 30 cases (33,4%) hiperplasic linfonod, 10 cases (11,1%) high vascular congestion, 6 cases (6,6%) reaction fibrosis and 28 cases (31,1%) no alteration. For the parietal peritonium histological study we observed 6 cases (3,3%) reaction fibrosis and 174 cases (96,7%) no alteration. Giant cell was not present. In the statistical analisys statistic there is no significance between the groups (p>0,05). CONCLUSION: Hypertonic glucose solution and NaCl 0,9% on the mesenterium and parietal peritonium do not produce tissue necrosis in a rat and the inflammation process has the same intensity.OBJETIVO: Investigar as alterações macroscópicas e microscópicas do mesentério e do peritônio parietal quando se administra a solução aquosa de glicose hipertônica a 10% e a 25% na cavidade peritoneal de rato. MÉTODOS: 90 ratos fêmeas (n=90), adultos, Wistar, jovens, com peso variando de 180 a 250 gramas foram divididos em 3 sub-grupos (A, B e C) contendo cada um 30 animais com procedimentos idênticos, diferindo apenas no perÃodo de observação. Os números de 1 a 30 constituem o grupo A ou grupo-controle (NaCl 0,9%), os números de 31 a 60 constituem o grupo B ou grupo-glicose a 10% e os números de 61 a 90 constituem o grupo C ou grupo- glicose a 25%. Realizando-se posteriormente laparotomia com incisão mediana longitudinal de pele a 2 cm abaixo do processo Xiphoideus sterni, estendendo-se por 3 cm caudalmente na linha média ventral. A escolha do procedimento a ser realizado para introdução na cavidade peritoneal de 2 ml de uma solução de cloreto de sódio 0,9% (controle), de glicose hipertônica a 10% e de glicose hipertônica a 25%. Em perÃodos correspondentes à s 6h, 24h e 48h de pós-operatório, os animais de cada grupo foram reoperados, sendo realizada avaliação macroscópica e microscópica além dos registros das alterações histológicas do mesentério e peritônio parietal. RESULTADOS: Na microscopia do mesentério observou-se que 30 animais (33,4%) apresentaram linfonodos hiperplásicos; 6 animais (6,6%) com fibrose reacional; 10 animais (11,1%) com intensa congestão vascular; 16 animais (17,8%) com inflamação crônica inespecÃfica; 28 casos (31,1%) sem alteração. A microscopia do peritônio revelou 6 casos com fibrose reacional (3,3%) 174 casos (96,7%) sem alteração histológica. CONCLUSÃO: As soluções de glicose a 10% e a 25% não causam necrose tecidual quando introduzidas na cavidade peritoneal. O processo reacional inflamatório é de igual intensidade tecidual comparando-se ao uso da solução de NaCl a 0,9%.UNCISAL DepartmentUFAL Morphology Department and Human AnatomyUNIFESP-EPM Surgery DepartmentUNIFESP, EPM, Surgery DepartmentSciEL
Evaluation of the impact of strain correction on the orientation of cardiac diffusion tensors with in vivo and ex vivo porcine hearts
Purpose To evaluate the importance of strain-correcting stimulated echo acquisition mode echo-planar imaging cardiac diffusion tensor imaging. Methods Healthy pigs (n = 11) were successfully scanned with a 3D cine displacement-encoded imaging with stimulated echoes and a monopolar-stimulated echo-planar imaging diffusion tensor imaging sequence at 3 T during diastasis, peak systole, and strain sweet spots in a midventricular short-axis slice. The same diffusion tensor imaging sequence was repeated ex vivo after arresting the hearts in either a relaxed (KCl-induced) or contracted (BaCl2-induced) state. The displacement-encoded imaging with stimulated echoes data were used to strain-correct the in vivo cardiac diffusion tensor imaging in diastole and systole. The orientation of the primary (helix angles) and secondary (E2A) diffusion eigenvectors was compared with and without strain correction and to the strain-free ex vivo data. Results Strain correction reduces systolic E2A significantly when compared without strain correction and ex vivo (median absolute E2A = 34.3° versus E2A = 57.1° (P = 0.01), E2A = 60.5° (P = 0.006), respectively). The systolic distribution of E2A without strain correction is closer to the contracted ex vivo distribution than with strain correction, root mean square deviation of 0.027 versus 0.038. Conclusions The current strain-correction model amplifies the contribution of microscopic strain to diffusion resulting in an overcorrection of E2A. Results show that a new model that considers cellular rearrangement is required
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