Multidrug-resistant tuberculosis in prison inmates, Azerbaijan.

In a tuberculosis (TB) program in the Central Penitentiary Hospital of Azerbaijan, we analyzed 65 isolates of Mycobacterium tuberculosis by IS6110-based restriction fragment-length polymorphism (RFLP) and spoligotyping. From 11 clusters associated with 33 patients, 31 isolates had an IS6110-based banding pattern characteristic of the Beijing genotype of M. tuberculosis. In addition, 15 M. tuberculosis isolates with similar RFLP patterns constituted a single group by spoligotyping, matching the Beijing genotype. Multidrug resistance, always involving isoniazid and rifampin, was seen in 34 (52.3%) of 65 isolates, with 28 belonging to the Beijing genotype

p-type delta-doped layers in silicon: structural and electronic properties

We report on the properties of p-type delta-doped layers prepared in molecular beam epitaxy-Si by growth interruption and evaporation of elemental B. Secondary-ion mass spectrometry measurements at several primary ion energies have been used to show that the full width at half maximum is ~2 nm. Hall measurements confirm that the layers are completely activated at 300 K with a mobility of 30±5 cm2/V s for a carrier density of (9±2)×1012 cm−2. At temperatures below 70 K nonmetallic behavior is observed which we have attributed to conduction between impurity states. It is concluded that the critical acceptor separation for the Mott metal-insulator transition in this system is significantly less than the value found in uniformly doped Si:B

Motion and eddy current-induced signal dephasing in in vivo cardiac DTI

ISSN:0740-3194ISSN:1522-259

Synthetically trained convolutional neural networks for improved tensor estimation from free-breathing cardiac DTI

Cardiac diffusion tensor imaging (cDTI) provides invaluable information about the state of myocardial microstructure. For further clinical dissemination, free-breathing acquisitions are desired, which however require image registration prior to tensor estimation. Due to the varying contrast and the intrinsically low signal-to-noise ratio (SNR), registration is very challenging and thus can introduce additional errors in the tensor estimation. In the work at hand it is hypothesized, that by incorporating spatial information and physiologically plausible priors into the fitting algorithm, the robustness of diffusion tensor estimation can be improved. To this end, we present a parameterized pipeline to generate synthetic data, that captures the statistics including spatial correlations of diffusion tensors and motion of the heart. The synthetic data is used to train a residual convolutional neural network (CNN) to estimate diffusion tensors from unregistered in-vivo cDTI data. Using in-silico data, the synthetically trained CNN is demonstrated to yield increased tensor estimation accuracy and precision when compared to conventional registration followed by least squares fitting. The network outputs fewer outliers especially at the myocardial borders. In-vivo feasibility using data from five healthy subjects demonstrates the utility of the synthetically trained network. The in-vivo results predicted by the synthetically trained CNN are found to be consistent with the registered least-squares estimates while showing fewer outliers and reduced noise. Even in low SNR regimes, the network results in robust tensor estimation, enabling scan time reduction by reduced-average acquisition in-vivo. Finally, to investigate the network's capability of discriminating between healthy and lesioned tissue, the in-vivo data was artificially augmented showing preserved classification of tissue states based on diffusion metrics.ISSN:0895-611

Motion and eddy current–induced signal dephasing in in vivo cardiac DTI

Purpose To address motion in cardiac DWI, stimulated‐echo acquisition mode (STEAM) and second‐order motion‐compensated spin‐echo (SE) sequences have been proposed. Despite applying motion‐compensation strategies, residual motion can cause misleading signal attenuation. The purpose of this study is to estimate the motion‐induced error in both sequences by analysis of image phase. Methods Diffusion‐weighted motion‐compensated SE sequences and STEAM imaging was applied in vivo with diffusion encoding along 3 orthogonal directions. A b‐value range of 100 to 600 s/mm2 and trigger delays of 25%, 50%, and 75% of end systole and middiastole were used. Eddy‐current contributions were obtained from phantom measurements. After computation of motion‐induced phase maps, the amount of signal dephasing was computed from phase gradients, and the resulting errors in diffusion tensor parameters were calculated. Results Motion‐induced dephasing from the STEAM sequence showed less dependency on the b‐value and no dependency on the heart phase, whereas SE imaging performed best at 75% end systole followed by 50% end systole and middiastole. For a typical experimental setting, errors of 3.3%/3.0% mean diffusivity, 4.9%/4.8% fractional anisotropy, 2.9º/3.2º helix angulation, 0.8º/0.7º transverse angulation, and 9.9º/10.0º sheet angulation (SE/STEAM) were calculated. Conclusion Image phase contains valuable information regarding uncompensated motion and eddy currents in cardiac DTI. Although the trigger delay window for SE is narrower compared with the STEAM‐based approach, imaging in both systole and diastole is feasible and both sequences perform similarly if the trigger delays are selected carefully with SE

Analysis and correction of off‐resonance artifacts in echo‐planar cardiac diffusion tensor imaging

Purpose Cardiac diffusion tensor imaging using EPI readout is prone to image distortions in the presence of field inhomogeneities. In this work, a framework to analyze and correct image distortions in cardiac diffusion tensor imaging is presented. Methods A multi‐coil reconstruction framework was implemented to enable field map‐based off‐resonance correction. Numerical simulations were used to examine reconstruction performance for EPI phase‐encode directions blip up‐down and down‐up for different degrees of off‐resonance gradients and varying field map resolution. The impact of coil encoding was analyzed using the g‐factor and normalized RMSE. Finally, the proposed method was tested on free‐breathing in vivo cardiac diffusion tensor imaging data acquired in healthy subjects at 3 Tesla. Results Depending on the local field map gradient strength and polarity and the selected phase‐encode direction, field inhomogeneities lead to either local spatial compression or stretching with standard image reconstruction. Although spatial compression results in loss of image resolution upon field map‐based reconstruction, spatial stretching can be recovered once multiple receive coils are utilized. Multi‐coil reconstruction was found to reduce the normalized RMSE from 34.3% to 8.1% for image compression, and 33.6% to 1.8% for image stretching, with resulting average g‐factors 14.7 ± 2.9 and 1.2 ± 0.1, respectively. In vivo, multi‐coil field map‐based reconstruction yielded improved alignment of angle maps with anatomical cine data. Conclusion Multi‐coil, field map‐based image reconstruction for echo‐planar cardiac diffusion tensor imaging allows accurate image reconstruction provided that the phase‐encode direction and polarity is chosen to principally align with the direction and polarity of the prominent gradients of field inhomogeneities

Characterizing cardiac involvement in amyloidosis using cardiovascular magnetic resonance diffusion tensor imaging

BACKGROUND In-vivo cardiovascular magnetic resonance (CMR) diffusion tensor imaging (DTI) allows imaging of alterations of cardiac fiber architecture in diseased hearts. Cardiac amyloidosis (CA) causes myocardial infiltration of misfolded proteins with unknown consequences for myocardial microstructure. This study applied CMR DTI in CA to assess microstructural alterations and their consequences for myocardial function compared to healthy controls. METHODS Ten patients with CA (8 AL, 2 ATTR) and ten healthy controls were studied using a diffusion-weighed second-order motion-compensated spin-echo sequence at 1.5 T. Additionally, left ventricular morphology, ejection fraction, strain and native T1 values were obtained in all subjects. In CA patients, T1 mapping was repeated after the administration of gadolinium for extracellular volume fraction (ECV) calculation. CMR DTI analysis was performed to yield the scalar diffusion metrics mean diffusivity (MD) and fractional anisotropy (FA) as well as the characteristics of myofiber orientation including helix, transverse and E2A sheet angle (HA, TA, E2A). RESULTS MD and FA were found to be significantly different between CA patients and healthy controls (MD 1.77 ± 0.17 10 vs 1.41 ± 0.07 10 mm/s, p <  0.001; FA 0.25 ± 0.04 vs 0.35 ± 0.03, p <  0.001). MD demonstrated an excellent correlation with native T1 (r = 0.908, p <  0.001) while FA showed a significant correlation with ECV in the CA population (r = - 0.851, p <  0.002). HA exhibited a more circumferential orientation of myofibers in CA patients, in conjunction with a higher TA standard deviation and a higher absolute E2A sheet angle. The transmural HA slope was found to be strongly correlated with the global longitudinal strain (r = 0.921, p < 0.001). CONCLUSION CMR DTI reveals significant alterations of scalar diffusion metrics in CA patients versus healthy controls. Elevated MD and lower FA values indicate myocardial disarray with higher diffusion in CA that correlates well with native T1 and ECV measures. In CA patients, CMR DTI showed pronounced circumferential orientation of the myofibers, which may provide the rationale for the reduction of global longitudinal strain that occurs in amyloidosis patients. Accordingly, CMR DTI captures specific features of amyloid infiltration, which provides a deeper understanding of the microstructural consequences of CA

Cardiovascular magnetic resonance imaging of functional and microstructural changes of the heart in a longitudinal pig model of acute to chronic myocardial infarction

Background We examined the dynamic response of the myocardium to infarction in a longitudinal porcine study using relaxometry, functional as well as diffusion cardiovascular magnetic resonance (CMR). We sought to compare non contrast CMR methods like relaxometry and in-vivo diffusion to contrast enhanced imaging and investigate the link of microstructural and functional changes in the acute and chronically infarcted heart. Methods CMR was performed on five myocardial infarction pigs and four healthy controls. In the infarction group, measurements were obtained 2 weeks before 90 min occlusion of the left circumflex artery, 6 days after ischemia and at 5 as well as 9 weeks as chronic follow-up. The timing of measurements was replicated in the control cohort. Imaging consisted of functional cine imaging, 3D tagging, T2 mapping, native as well as gadolinium enhanced T1 mapping, cardiac diffusion tensor imaging, and late gadolinium enhancement imaging. Results Native T1, extracellular volume (ECV) and mean diffusivity (MD) were significantly elevated in the infarcted region while fractional anisotropy (FA) was significantly reduced. During the transition from acute to chronic stages, native T1 presented minor changes ( 23% for MD and > 27% for FA) during follow-up compared to relaxometry (T1 17–18%/T2 10–20%). Conclusion During chronic follow-up after myocardial infarction, cardiac diffusion tensor imaging provides a higher sensitivity for mapping microstructural alterations when compared to non-contrast enhanced relaxometry with the added benefit of providing directional tensor information to assess remodelling of myocyte aggregate orientations, which cannot be otherwise assessed.ISSN:1097-6647ISSN:1532-429