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A Ersahin

Publications and source records attributed to A Ersahin.

7 recordsLinked to original sources

Quantification of volumetric coronary blood flow with dual-energy digital subtraction angiography.

BACKGROUND: As a solution to the well-documented problems associated with visual interpretation of coronary arteriograms, more physiological methods of assessing coronary artery stenosis are being investigated. Volumetric coronary blood flow (BF) can be a valuable aid in the analysis of functional significance of arterial obstruction. METHODS AND RESULTS: The left anterior descending coronary artery (LAD) of 15 anesthetized pigs (40 to 50 kg) was dissected free from the epicardium in its proximal portion, and a transmit-time ultrasound flow probe of the appropriate size was applied. A vascular occluder was positioned distal to the flow probe for flow adjustments. Contrast injections (2 to 4 mL/s for 3 seconds) were made into the left main coronary artery during image acquisition with a motion-immune dual-energy digital subtraction angiography (DE DSA) system. Tissue-suppressed energy-subtracted images were used to generate time-density curves. BF measurements were made in the LAD vascular bed with use of the time-density curve, with consideration that blood was momentarily replaced with contrast during the injection. In 19 comparisons, the mean BF, measured with the use of DE DSA, correlated extremely well with the mean ultrasound flow (DE DSA=0.90 ultrasound+3.10 mL/min, r=.96). Also, contrast injection increased the BF by an average of only 15% during the image-acquisition time interval. CONCLUSIONS: Accurate BF measurements can be made with motion-immune DE DSA. The BF measurements can be completed before the onset of significant changes in BF due to contrast injection. Furthermore, it is possible to make the BF measurements during routine coronary arteriography.

Angiography, Digital Subtraction↗

In-vivo validation of videodensitometric coronary cross-sectional area measurement using dual-energy digital subtraction angiography.

Previous studies indicate that conventional geometric edge detection techniques, used in quantitative coronary arteriography (QCA), have significant limitations in quantitating coronary cross-sectional area of small diameter (D) vessels (D < 1.00 mm) and lesions with complex cross-section. As a solution to this problem, we have previously reported on an in-vitro validation of a videodensitometric technique that quantitates the absolute cross-sectional area including small vessel diameter (D < 1.00 mm) and any complex shape of the vessel cross-section. For in-vivo validation, plastic tubing (5-8 mm long) with different shape complex cross-section with known cross-sectional area (A = 0.8-4.5 mm2) were percutaneously wedged in the coronary arteries of anesthetized pigs (40-50 kg). Contrast material injections (6-10 ml at 2-4 ml/sec) were made into the left main coronary artery during image acquisition using a motion immune dual-energy subtraction technique, where low and high X-ray energy and filtration were switched at 30 Hz. A comparison was made between the actual and measured cross-sectional area using the videodensitometry and edge detection techniques in tissue suppressed energy subtracted images. In eighteen comparisons the videodensitometry technique produced significantly improved results (slope = 0.87, intercept = 0.24 mm2, r = 0.94) when compared to the edge detection technique (slope = 0.42, intercept = 1.99 mm2, r = 0.39). Also, a cylindrical vessel phantom (D = 1.00-4.75 mm) was used to test the ability to calculate and correct for the effect of the out of plane angle of the arterial segment on the cross-sectional area estimation of the videodensitometry technique. After corrections were made for the out of plane angle using two different projections, there was a good correlation between the actual and the measured cross-sectional area using the videodensitometry technique (slope = 0.91, intercept = 0.11 mm2, r = 0.99). These data suggest that it is possible to quantitate absolute cross-sectional area without any assumption regarding the arterial shape using videodensitometry in conjunction with the motion immune dual-energy subtraction technique.

Angiography, Digital Subtraction↗

Absolute phasic blood flow measurement in the brain using digital subtraction angiography.

RATIONALE AND OBJECTIVES: In this study, an angiographic method using first-pass distribution analysis was used for quantification of phasic volumetric blood flow. Studies were conducted in an angiographic perfusion phantom and in an animal model (rabbit) after intraarterial injection of contrast material. METHODS: Digital subtraction angiography and first-pass distribution algorithm were used to assess the absolute volumetric flow rates. The method, based on the conservation of contrast material in successive angiographic images, uses the videodensitometric information in the arterial bed. Measurements were made by summing the pixel values in the region of interest, covering the whole perfusion bed. A contrast pass curve was generated for a sequence of images to obtain instantaneous volumetric flow rates. RESULTS: Instantaneous and mean absolute volumetric flow measurements made in the angiographic perfusion phantom and the common carotid artery of the animal models correlated well with validation measurements made using ultrasound flowprobes. The measured (M) and known (K) flow rates in the carotid artery were related by M = 0.87 K + 2.50 mL/minute (r = 0.96, standard error of the estimate = 3.79 mL/minute, n = 25) and M = 0.92 K - 1.00 mL/minute (r = 0.98, standard error of the estimate = 4.04 mL/minute, n = 38) using the videodensitometric and entrance vessel calibration techniques, respectively. Conclusion. Results demonstrate the potential use of the first-pass distribution method in conjunction with digital subtraction angiography for measuring phasic arterial blood flow in vivo.

Algorithms↗

Absolute cross-sectional area measurements in quantitative coronary arteriography by dual-energy DSA.

Recent studies have emphasized the limitations of conventional coronary angiography. These limitations include the lack of correlation between the severity of coronary stenosis as estimated from coronary angiograms and the actual severity of stenotic lesions measured in postmortem hearts. As a result, attempts have been made to quantitate luminal dimension more precisely. The application of quantitative digital subtraction angiography (DSA) in the assessment of coronary artery lesion dimension has been limited by cardiac and respiratory motion artifacts. We have reported previously on a motion-immune dual-energy (DE) cardiac mode in which kVp and filtration are switched at 30 Hz. To assess the potential advantages of a videodensitometric technique for quantification of absolute vessel cross-sectional area (CSA), three different quantitative coronary arteriography (QCA) algorithms were compared. The three algorithms under comparison were a videodensitometric (V) algorithm, which does not require any geometric assumption for absolute vessel CSA measurement, and videodensitometric (VC) and edge detection (ED) algorithms, which do require the assumption of circular cross-section for CSA measurements. A cylindrical vessel phantom (0.5-4.75 mm in diameter) and a crescentic vessel phantom, producing 25% to 90% area stenosis, were imaged over the chest of a humanoid phantom. The low- and high-energy images were corrected for scatter and veiling glare before energy subtraction. For CSA measurements in crescentic vessel phantoms, the V algorithm produced significantly improved results (slope = 0.87, intercept = 0.51 mm2, r = .95) when compared to the VC (slope = 1.05, intercept = 4.19 mm2, r = .75) and the ED (slope = 1.57, intercept = 5.21 mm2, r = .60) algorithms.

Algorithms↗

Gradient coil design considerations for iron core interventional magnets.

The requirements for access and imaging performance compete in the design of open-concept MR magnets and gradient coils. We conducted a theoretical and experimental investigation of gradient coil design using both solid and laminated pole piece construction to determine whether adequate eddy current control can be obtained without shielded gradient coils while maintaining good patient access and high gradient performance. Eddy currents, gradient characteristics, gradient efficiency, and magnet openness are compared and contrasted for various construction options based on a compact, .27 T iron yoke magnet. The resulting pole pieces and gradient coils have high efficiency for an interventional open-configuration magnet while taking up minimal space between the poles for improved patient access.

Equipment Design↗

Quantification of coronary arterial calcium by dual energy digital subtraction fluoroscopy.

Clinical studies of the heart with fluoroscopy have shown that fluoroscopic visualization of calcium in the coronary arteries is strongly associated with coronary artery disease. However, fluoroscopic detection is limited by its low sensitivity, which is partly due to the interfering background tissue structures and image quantum noise. Moreover, quantification of the absolute amount of calcium in an arterial segment has not been possible. A real-time dual-energy subtraction technique has been investigated as a possible solution to the above problem. In this energy subtraction technique, the kVp and filtration are switched at 30 Hz. In order to assess the potential utility of this videodensitometric technique to quantitate coronary artery calcium, arterial phantoms and excised segments of diseased human arteries were imaged. The low- and high-energy images were corrected for scatter and veiling glare before subtraction. Calcium measurements were made using the tissue-suppressed energy-subtracted images. The estimated calcium phosphate and ashed weights of the calcified arterial segments (N = 20) were highly correlated (slope = 1.04, Intercept = -0.33 mg, r = 0.92).

Calcium↗

Absolute volumetric blood flow measurements using dual-energy digital subtraction angiography.

In recent years, as a solution to the well-documented problems associated with visual interpretation of coronary arteriograms, more physiologic means of assessing coronary artery stenosis are being investigated. Absolute arterial blood flow assessed as a function of time can be a valuable aid in the analysis of functional significance of arterial lesions and obstructions. An absolute volumetric blood flow measurement technique using a motion immune dual-energy subtraction technique is being investigated, where the kVp and filtration are switched at 30 Hz. The low- and high-energy images are corrected for scatter and veiling glare before subtraction. In this technique, the absolute arterial blood flow is calculated by combining the videodensitometric analysis of spatial and temporal aspects concerning the contrast propagation through the arterial bed using tissue suppressed energy subtracted images. The blood flow measurement technique was validated using a pulsatile pump and a flow chamber imaged over a Humanoid chest phantom. A 20-MHz Doppler flow probe was used to validate the measurement of phasic volumetric blood flow. The measured (M) and known (K) mean blood flow for the entrance vessel technique and the videodensitometric calibration technique were related by M = 1.14K - 0.12 ml/s (r2 = 0.98) and M = 1.12K - 0.23 ml/s (r2 = 0.90), respectively. The results indicate that phasic volumetric blood flow can be measured using a CCD camera in conjunction with real time dual-energy subtraction.

Angiography, Digital Subtraction↗