-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE: Assessment and optimization of intermittent pneumatic compression (IPC) devices for prophylaxis of deep vein thrombosis has previously used duplex ultrasound. The aim was to investigate novel magnetic resonance (MR) venous velocity mapping (VM) for IPC research and development. METHODS: Twelve normal subjects were scanned in the supine position using realtime MR VM with sequential foot and calf IPC (120 mmHg) at 1.5 T. Measurements were taken in the popliteal vein at baseline using both cuffs and each cuff individually recording 60 seconds continuously. Temporal resolution was 310 ms per independent image, at 1 × 1 mm spatial resolution. RESULTS: Peak velocity (V(p)) measurements: baseline, V(p) = 2.1 cm/second (range = 1.1-3.5); using both compression cuffs, V(p) = 41.5 cm/second (18.0-58.1); calf cuff alone, V(p) = 40.6 cm/second (18.1-62.2); foot cuff alone, V(p) = 7.9 cm/second (4.2-15.3). Flow volume measurements per compression cycle (F): baseline, F = 2.3 cm(3) (0.5-11.4); both compression cuffs, F = 7.1 cm(3) (2.5-24.6); calf cuff only, F = 7.1 cm(3) (2.4-24.5); foot cuff only, F = 2.6 cm(3) (0.9-10.7). The foot cuff contribution was insignificant when combined with the calf cuff (P < 0.01). The MR venous VM results were similar to those reported elsewhere using ultrasound. CONCLUSION: This novel technique for MR venous VM can measure the realtime variations in venous blood flow during IPC.
Phlebology 12/2011; · 2.07 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A fully automatic and highly efficient free-breathing navigator gated technique, continuously adaptive windowing strategy (CLAWS), is presented. Using a novel and dynamic acquisition strategy that ensures all potential navigator acceptance windows are possible, CLAWS acquires an image with the highest possible efficiency regardless of variations in the respiratory pattern. Unnecessary prolongation of scan durations due to respiratory drift or navigator acceptance window adjustments are avoided. As CLAWS requires no setting of the acceptance window, nor monitoring of the navigator traces during the scan, operator dependence is minimized and ease of use improved. CLAWS was compared against a standard accept/reject algorithm (ARA) and an end-expiratory following ARA (EE-ARA) in 20 healthy subjects and 10 patients (ARA only). The respiratory efficiency was compared against the retrospectively determined best possible respiratory efficiency for each acquisition. On average, the difference between CLAWS scan times and best possible scan times was 0.6% (± 1.3%). For the ARA and EE-ARA techniques, mean differences were 14.4% (± 20.9%) and 32.6 ± 10.9%, respectively. Had the CLAWS algorithm been used with the ARA and EE-ARA traces, mean differences would have been 0.2% (± 1.1%) and 0.5% (± 1.7%), respectively. Image quality was the same for all techniques: respiratory gating, motion artifacts, navigator, and coronary artery imaging.
Magnetic Resonance in Medicine 10/2010; 64(4):1015-26. · 2.96 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: There were 56 articles published in the Journal of Cardiovascular Magnetic Resonance in 2009. The editors were impressed with the high quality of the submissions, of which our acceptance rate was about 40%. In accordance with open-access publishing, the articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. We have therefore chosen to briefly summarise the papers in this article for quick reference for our readers in broad areas of interest, which we feel will be useful to practitioners of cardiovascular magnetic resonance (CMR). In some cases where it is considered useful, the articles are also put into the wider context with a short narrative and recent CMR references. It has been a privilege to serve as the Editor of the JCMR this past year. I hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.
Journal of Cardiovascular Magnetic Resonance 03/2010; 12:15. · 3.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Human right coronary artery (RCA) haemodynamics is investigated using computational fluid dynamics (CFD) based on subject-specific information from magnetic resonance (MR) acquisitions. The dynamically varying vascular geometry is reconstructed from MR images, incorporated in CFD in conjunction with pulsatile flow conditions obtained from MR velocity mapping performed on the same subject. The effects of dynamic vessel motion on instantaneous and cycle-averaged haemodynamic parameters, such as wall shear stress (WSS), time-averaged WSS (TAWSS) and oscillatory shear index (OSI), are examined by comparing an RCA model with a time-varying geometry and those with a static geometry, corresponding to nine different time-points in the cardiac cycle. The results show that the TAWSS is similar for the dynamic and static wall models, both qualitatively and quantitatively (correlation coefficient 0.89-0.95). Conversely, the OSI shows much poorer correlations (correlation coefficient 0.38-0.60), with the best correspondence being observed with the static models constructed from images acquired in late diastole (at t = 0 and 800 ms, the cardiac cycle is 900 ms). These findings suggest that neglecting dynamic motion of the RCA is acceptable if TAWSS is the primary focus but may result in underestimation of haemodynamic parameters related to the oscillatory nature of the blood flow.
The British journal of radiology 01/2009; 82 Spec No 1:S24-32. · 2.11 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A detailed investigation of left ventricle (LV) flow patterns could improve our understanding of the function of the heart and provide further insight into the mechanisms of heart failure. This study presents patient-specific modelling with magnetic resonance imaging (MRI) to investigate LV blood flow patterns in normal subjects. In the study, the prescribed LV wall movements based on the MRI measurements drove the blood flow in and out of the LV in computational fluid dynamics simulation. For the six subjects studied, the simulated LV flow swirls towards the aortic valve and is ejected into the ascending aorta with a vertical flow pattern that follows the left-hand rule. In diastole, the inflow adopts a reasonably straight route (with no significant secondary flow) towards the apex in the rapid filling phase with slight variations in the jet direction between different cases. When the jet reaches about two thirds of the distance from the inflow plane to the apex, the blood flow starts to change direction and swirls towards the apex. In the more slowly filling phase, a centrally located jet is evident with vortices located on both sides of the jet on an anterior-posterior plane that passes through the mitral and aortic valves. In the inferior-superior plane, a main vortex appears for most of the cases in which an anticlockwise vortex appears for three cases and a clockwise vortex occurs for one case. The simulated flow patterns agree well qualitatively with MRI-measured flow fields.
Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine 06/2008; 222(4):475-85. · 1.21 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Combined in vitro experiments and numerical simulations were performed to study flow artifacts in phase contrast (PC) velocity mapping of steady flow through an anatomically realistic aortocoronary bypass graft model. The geometry was obtained through imaging and computational reconstruction of a left anterior descending (LAD) coronary artery of a porcine heart. Simulated images of through-plane velocity were obtained at selected slices of the geometry. These were then compared and contrasted with velocity images of corresponding sites that were obtained from in vitro experiments. The shift and distortion of the measured velocity profile was well predicted by the simulation, while trajectories obtained from particle tracking were shown to be useful in understanding the origins of the flow artifacts that were observed.
Medical Physics 08/2006; 33(7):2621-31. · 2.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To determine, in asymptomatic subjects, the inter-study reproducibility of a three-dimensional (3D) volume selective fast spin echo (FSE) cardiovascular magnetic resonance sequence for the assessment of carotid artery wall volume as a measure of atheroma burden.
Inter-study reproducibility was evaluated in 16 asymptomatic volunteers (10 male, 6 female). Both carotid arteries were scanned twice with a median inter-scan time of 5 days. The images were acquired in cross-section, and the total carotid arterial wall volume (TWV) was calculated by subtraction of the total carotid lumen volume from the total outer carotid vessel volume.
The mean carotid T1-weighted TWV for the first and second scans was 828 and 821 mm(3), respectively (mean difference 7 mm(3), p=0.45). The standard deviation (S.D.) of the differences between the measurements was 38 mm(3) yielding an inter-study coefficient of variation of 4.6%. The time for each study was approximately 30 min. For the longitudinal evaluation of carotid atheroma burden with pharmacological intervention versus placebo, 32 subjects would enable a difference of 38 mm(3) to be detected with a significance level of 5% with 80% power.
Volumetric analysis with carotid CMR in asymptomatic subjects using a 3D volume-selective FSE is time-efficient with good inter-study reproducibility, and is well suited for longitudinal studies of carotid atheroma with reasonable sample sizes.
Atherosclerosis 01/2006; 183(2):361-6. · 3.79 Impact Factor
-
S. J. Vermeersch,
F. P. Glor,
L. A. Crowe,
B. Ariff,
M. Bol,
P. Segers,
A. D. Hughes,
X. Y. Xu,
Thom SMcG, D. N. Firmin,
P. R. Verdonck
Computer Methods in Biomechanics and Biomedical Engineering 09/2005; Supplement(1):279-280. · 0.85 Impact Factor
-
Proc. Intl. Soc. Mag. Reson. Med. 01/2005;
-
[show abstract]
[hide abstract]
ABSTRACT: Atherosclerosis is a major cause of morbidity and mortality. Its apparent link with wall shear stress (WSS) has led to considerable interest in the in vivo estimation of WSS. Determining WSS by combining medical images with computational fluid dynamics (CFD) simulations can be performed both with magnetic resonance imaging (MRI) and three-dimensional ultrasound (3DUS). This study compares predicted 3D flow patterns based on black blood MRI and 3DUS. Velocity fields in the carotid arteries of nine subjects have been reconstructed, and the haemodynamic wall parameters WSS, oscillatory shear index (OSI), WSS gradients (WSSG) and angle gradients (WSSAG) were compared between the two imaging techniques. There was a good qualitative agreement between results derived from MRI and 3DUS (average correlation strength above 0.60). The root mean square error between haemodynamic wall parameters was comparable to the range of the expected variability of each imaging technique (WSS: 0.411 N m(-2); OSI: 0.048; temporal WSSG: 150 N s(-1) m(-2); spatial WSSG: 2.29 N m(-3); WSSAG: 87.6 rad m(-1)). In conclusion, MRI and 3DUS are capable of providing haemodynamic parameters when combined with CFD, and the predictions are in most cases qualitatively and quantitatively similar. The relatively high cost of MRI and continuing improvement in ultrasound favour US to MRI for future haemodynamic studies of superficial arteries.
Physiological Measurement 01/2005; 25(6):1495-509. · 1.68 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The link between atherosclerosis and wall shear stress (WSS) has lead to considerable interest in the in vivo estimation of WSS. Both magnetic resonance imaging (MRI) and three-dimensional ultrasound (3DUS) are capable of providing the anatomical and flow data required for subject-specific computational fluid dynamics (CFD) simulations. This study compares, for the first time, predicted 3D flow patterns based on black blood MRI and 3DUS. Velocity fields in the carotid arteries of nine subjects have been reconstructed, and the haemodynamic wall parameters WSS, oscillatory shear index (OSI), WSS gradients (WSSG) and angle gradients (WSSAG) were computed and compared. There was a good qualitative agreement between results derived from MRI and 3DUS, embodied by a strong linear correlation between the patched representations of the haemodynamic wall parameters. The root-mean-square error between haemodynamic wall parameters was comparable to the range of the expected variability of each imaging technique (WSS: 0.411 N/m; OSI: 0.048; temporal WSSG: 2.29 N/(s.m<sup>2</sup>); spatial WSSG: 150 N/m<sup>3</sup>; WSSAG: 87.6 rad/m). In conclusion, MRI and 3DUS are comparable techniques for combining with CFD in the carotid artery. The relatively high cost of MRI favour 3DUS to MRI for future haemodynamic studies of superficial arteries.
Engineering in Medicine and Biology Society, 2004. IEMBS '04. 26th Annual International Conference of the IEEE; 10/2004
-
[show abstract]
[hide abstract]
ABSTRACT: The relationship between the morphology and blood flow of the Left Ventricle (LV) during myocardial remodelling is complex
and not yet fully understood. Cardiovascular MR (CMR) velocity imaging is a versatile tool for the observation of general
flow patterns in-vivo. More detailed understanding of the coupled relationship between blood flow patterns and myocardial wall motion can be further
enhanced by the combined use of Computational Fluid Dynamics (CFD) and CMR. This permits the generation of comprehensive high-resolution
velocity fields and the assessment of dynamic indices, such as mass transport and wall shear stress, that are important but
cannot be measured directly by using imaging alone. One of the key drawbacks of ventricular flow simulation using CFD is that
it is sensitive to the prescribed inflow boundary conditions. Current research in this area is limited and the extent to which
this affects in-vivo flow simulation is unknown. In this work, we measure this sensitivity as a function of the inflow direction and determine
the limit that is required for accurate ventricular flow simulation. This represents an important step towards the development
of a combined MR/CFD technique for detailed LV flow analysis.
KeywordsCardiovascular Magnetic Resonance-Computational Fluid Dynamics-Left Ventricle Flow-Boundary Condition
09/2004: pages 229-236;
-
[show abstract]
[hide abstract]
ABSTRACT: The link between atherosclerosis and wall shear stress (WSS) has lead to considerable interest in the in vivo estimation of WSS. Both magnetic resonance imaging (MRI) and three-dimensional ultrasound (3DUS) are capable of providing the anatomical and flow data required for subject-specific computational fluid dynamics (CFD) simulations. This study compares, for the first time, predicted 3D flow patterns based on black blood MRI and 3DUS. Velocity fields in the carotid arteries of nine subjects have been reconstructed, and the haemodynamic wall parameters WSS, oscillatory shear index (OSI), WSS gradients (WSSG) and angle gradients (WSSAG) were computed and compared. There was a good qualitative agreement between results derived from MRI and 3DUS, embodied by a strong linear correlation between the patched representations of the haemodynamic wall parameters. The root-mean-square error between haemodynamic wall parameters was comparable to the range of the expected variability of each imaging technique (WSS: 0.411 N/m; OSI: 0.048; temporal WSSG: 2.29 N/(s.m/sup 2/); spatial WSSG: 150 N/m/sup 3/; WSSAG: 87.6 rad/m). In conclusion, MRI and 3DUS are comparable techniques for combining with CFD in the carotid artery. The relatively high cost of MRI favour 3DUS to MRI for future haemodynamic studies of superficial arteries.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2004; 2:1415-8.
-
R H Mohiaddin,
E D Burman,
S K Prasad,
A Varghese,
R S Tan,
S A Collins,
R L Hughes,
P D Gatehouse,
P Jhooti,
D B Longmore,
G Z Yang, D N Firmin,
D J Pennell
[show abstract]
[hide abstract]
ABSTRACT: Aortic atherosclerosis and coronary artery disease (CAD) are closely linked. Early detection of aortic atherosclerosis with the adoption of appropriate preventive measures may therefore help to reduce mortality and morbidity related to CAD. Arterial remodeling, by which the wall adapts to physiological or pathological insults by a change in vessel size, is being increasingly recognized as an important aspect of atherosclerosis. In this prospective longitudinal study we used cardiovascular magnetic resonance (CMR) to detect aortic plaque and to study aortic wall remodeling in asymptomatic subjects.
We recruited 175 healthy volunteers (49 years, 110 men) and documented their cardiovascular risk profile. Each subject underwent echocardiogram (ECG)-gated T1-weighted spin-echo imaging of the infrarenal abdominal aorta at baseline and after 2 years.
Of the 175 subjects who volunteered at baseline, CMR was successful in 174 (99%), with one (0.6%) failure due to claustrophobia. At 2 years, follow-up scanning was performed in 169 subjects (97%). Infrarenal aortic plaque was identified at baseline in nine (5.2%) subjects. This was reconfirmed in all nine (100%) cases at 2-year follow-up. No new cases of infrarenal plaque were identified at follow-up. The signal characteristics of the plaque on the subtracted images of the Dixon method indicate that all plaques were fibrous. In the nine subjects with infrarenal plaque, the total plaque burden increased as assessed by the total wall volume (561 to 677 mm3, p = 0.0063). The total vessel volume also increased (1737 to 1835 mm3, p = 0.031) but there was no change in the total luminal volume (1175 to 1157 mm3, p = 0.29).
Cardiovascular magnetic resonance detects subclinical aortic atherosclerosis, can follow plaque burden over time, and confirms the presence of Glagov remodeling with preservation of the lumen despite progression of plaque. Cardiovascular magnetic resonance is well suited for the longitudinal follow-up of the general population with atherosclerosis, may help in the understanding of the natural history of atherosclerosis, and in particular may help determine factors to retard disease progression at an early stage.
Journal of Cardiovascular Magnetic Resonance 02/2004; 6(2):517-25. · 3.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The combination of computational fluid dynamics (CFD) and magnetic resonance imaging (MRI) offers a promising tool that enables the prediction of blood flow patterns in subject-specific cardiovascular models. The influence of the model geometry on the accuracy of the simulation is well recognized. This paper addresses the impact of different boundary conditions on subject-specific simulations of left ventricular (LV) flow. A novel hybrid method for prescribing effective inflow boundary conditions in the mitral valve plane has been developed. The detailed quantitative results highlight the strengths as well as the potential pitfalls of the approach.
Journal of Biomechanical Engineering 01/2004; 125(6):922-7. · 1.90 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Image-based Computational Fluid Dynamics (CFD) has become a popular tool for the prediction of in vivo flow profiles and hemodynamic wall parameters. Currently, Magnetic Resonance Imaging (MRI) is most widely used for in vivo geometry acquisition. For superficial arteries such as the carotids and the femoral artery, three-dimensional (3-D) extravascular ultrasound (3-DUS) could be a cost-effective alternative to MRI. In this study, nine healthy subjects were scanned both with MRI and 3-DUS. The reconstructed carotid artery geometries for each subject were compared by evaluating cross-sectional areas, centerlines, and carotid nonplanarity. Lumen areas agreed very well between the two different acquisition techniques, whereas centerlines and nonplanarity parameters showed measurable disagreement, possibly due to the different neck and head positions adopted for 3-DUS versus MRI. With the current level of agreement achieved, 3-DUS has the potential to become an inexpensive and fast alternative to MRI for image-based CFD modeling of superficial arteries.
Medical Physics 01/2004; 30(12):3251-61. · 2.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study demonstrates a subject specific approach for simulating blood flow within a left ventricle (LV) by a combined analysis of computational fluid dynamics (CFD) and magnetic resonance imaging (MRI). Time dependent LV morphology and wall movements are measured by 3D multi-slice MRI. The information is then used to build numerical meshes for CFD simulation which provides detailed 3D LV velocity and pressure distributions in the LV cavity. Issues related to mesh generation and the prescription of valvular boundary conditions are also discussed. The predicted flow patterns are compared to that of the published MR measurements, demonstrating the effectiveness of the proposed approach.
Information Technology Applications in Biomedicine, 2003. 4th International IEEE EMBS Special Topic Conference on; 05/2003
-
[show abstract]
[hide abstract]
ABSTRACT: This paper presents an automatic method of correcting non-uniform RF coil response for the classification of body composition using MR imaging. By linear mosaic modelling, the smoothly but non-linearly varying bias field, which modulates tissue intensities within the image, was corrected. The overlapping between adjacent mosaics ensured consistent segmentation of body fat content and the effectiveness of the technique was validated by both phantom and in vivo experiments. Ten whole body composition data sets, each with 39 trans-axial slices, were acquired. Automatic segmentation results using the proposed technique were compared with those from manual delineations. The automatic segmentation method was found to be highly accurate and the mean percentage error between the two methods was less than 1.5%.
MAGMA Magnetic Resonance Materials in Physics Biology and Medicine 04/2002; 14(1):39-44. · 1.88 Impact Factor
-
L J Anderson,
S Holden,
B Davis,
E Prescott,
C C Charrier,
N H Bunce, D N Firmin,
B Wonke,
J Porter,
J M Walker,
D J Pennell
[show abstract]
[hide abstract]
ABSTRACT: To develop and validate a non-invasive method for measuring myocardial iron in order to allow diagnosis and treatment before overt cardiomyopathy and failure develops.
We have developed a new magnetic resonance T2-star (T2*) technique for the measurement of tissue iron, with validation to chemical estimation of iron in patients undergoing liver biopsy. To assess the clinical value of this technique, we subsequently correlated myocardial iron measured by this T2* technique with ventricular function in 106 patients with thalassaemia major. There was a significant, curvilinear, inverse correlation between iron concentration by biopsy and liver T2* (r=0.93, P<0.0001). Inter-study cardiac reproducibility was 5.0%. As myocardial iron increased, there was a progressive decline in ejection fraction (r=0.61, P<0.001). All patients with ventricular dysfunction had a myocardial T2* of <20 ms. There was no significant correlation between myocardial T2* and the conventional parameters of iron status, serum ferritin and liver iron. Multivariate analysis of clinical parameters to predict the requirement for cardiac medication identified myocardial T2* as the most significant variable (odds ratio 0.79, P<0.002).
Myocardial iron deposition can be reproducibly quantified using myocardial T2* and this is the most significant variable for predicting the need for ventricular dysfunction treatment. Myocardial iron content cannot be predicted from serum ferritin or liver iron, and conventional assessments of cardiac function can only detect those with advanced disease. Early intensification of iron chelation therapy, guided by this technique, should reduce mortality from this reversible cardiomyopathy.
European Heart Journal 01/2002; 22(23):2171-9. · 10.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We evaluated free-breathing, prospective navigator-gated, three-dimensional (3D) magnetic resonance coronary angiography (MRCA) with hybrid ordered phase-encoding (HOPE), in the detection of proximal coronary artery stenosis. The coronary arteries were imaged in 46 patients undergoing cardiac catheterization. The mean scan time was 48 minutes. The mean arterial length (mm) visualized was left main stem (LMS) 11.7 (SD 4.5), left anterior descending (LAD) 30.1 (SD 11.1), circumflex (LCx) 15.5 (SD 8.6), and right (RCA) 56.2 (SD 20.8). Twenty-three patients had coronary artery disease with 47 significant stenoses on cardiac catheterization. All LMS were normal on both catheterization and MRCA. MRCA sensitivity was highest for the LAD (89% CI 65%-99%) and RCA (76% CI 50%-93%), but lower for the LCx (50% CI 21%-79%). Specificity ranged from 72%-100%. Improvements in image quality, length of vessel seen, and specific imaging of the LCx are required for MRCA to become an alternative to cardiac catheterization.
Journal of Magnetic Resonance Imaging 01/2002; 14(6):677-84. · 2.70 Impact Factor
