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Biomedical subjects

Bob S Hu

Publications and source records attributed to Bob S Hu.

At least 19 recordsLinked to original sources

Single breath-hold whole-heart MRA using variable-density spirals at 3T.

Multislice breath-held coronary imaging techniques conventionally lack the coverage of free-breathing 3D acquisitions but use a considerably shorter acquisition window during the cardiac cycle. This produces images with significantly less motion artifact but a lower signal-to-noise ratio (SNR). By using the extra SNR available at 3 T and undersampling k-space without introducing significant aliasing artifacts, we were able to acquire high-resolution fat-suppressed images of the whole heart in 17 heartbeats (a single breath-hold). The basic pulse sequence consists of a spectral-spatial excitation followed by a variable-density spiral readout. This is combined with real-time localization and a real-time prospective shim correction. Images are reconstructed with the use of gridding, and advanced techniques are used to reduce aliasing artifacts.

Artifacts↗

Rapid cardiac-output measurement with ungated spiral phase contrast.

An ungated spiral phase-contrast (USPC) method was used to measure cardiac output (CO) rapidly and conveniently. The USPC method, which was originally designed for small peripheral vessels, was modified to assess CO by measuring flow in the ascending aorta (AA). The modified USPC used a 12-interleaf spiral trajectory to acquire full-image data every 283 ms with 2-mm spatial resolution. The total scan time was 5 s. For comparison, a triggered real-time (TRT) method was used to indirectly calculate CO by measuring left-ventricular (LV) volume. The USPC and TRT measurements from all normal volunteers agreed. In a patient with patent ductus arteriosus (PDA), high CO was measured with USPC, which agreed well with the invasive cardiac-catheterized measurement. In normal volunteers, CO dropped about 20-30% with Valsalva maneuvering, and increased about 100% after exercise. Continuous 28-s cycling between Valsalva maneuvering and free-breathing showed that USPC can temporally resolve physiological CO changes.

Adult↗

Real-time color-flow CMR in adults with congenital heart disease.

CMR is valuable in the evaluation of congenital heart disease (CHD). Traditional flow imaging sequences involve cardiac and respiratory gating, increasing scan time and susceptibility to arrhythmias. We studied a real-time color-flow CMR system for the detection of flow abnormalities in 13 adults with CHD. All 16 congenital flow abnormalities previously detected by echocardiography were visualized using color-flow CMR, including atrial septal defects (n = 4), ventricular septal defects (n = 9), aortic coarctation (n = 1), Blalock-Taussig shunt (n = 1) and Fontan shunt (n = 1). Real-time color-flow CMR can identify intra- and extra-cardiac flow abnormalities in adults with congenital heart disease.

Adult↗

Noninvasive assessment of coronary vasodilation using magnetic resonance angiography.

OBJECTIVES: The purpose of this study was to investigate the use of coronary magnetic resonance angiography (MRA) for assessing human epicardial coronary artery vasodilation. BACKGROUND: Coronary vasodilation plays a vital role in the human coronary circulation. Previous studies of epicardial coronary vasodilation have used invasive coronary angiography. Coronary MRA may provide an alternative noninvasive method to directly assess changes in coronary size. METHODS: Thirty-two subjects were studied: 12 patients (age 55 +/- 18 years) and 20 healthy subjects (age 34 +/- 4 years). High-resolution multi-slice spiral coronary MRA (in-plane resolution of 0.52 to 0.75 mm) was performed before and after sublingual nitroglycerin (NTG). Quantitative analysis of coronary vasodilation was performed on cross-sectional images of the right coronary artery (RCA). A time-course analysis of coronary vasodilation was performed in a subset of eight subjects for 30 min after NTG. Signal-to-noise ratio was also measured on the in-plane RCA images. RESULTS: Coronary MRA demonstrated a 23% increase in cross-sectional area after NTG (16.9 +/- 7.8 mm2 to 20.8 +/- 8.9 mm2, p <0.0001), with significant vasodilation between 3 and 15 min after NTG on time-course analysis. The MRA measurements had low interobserver variability (< or =5%) and good correlation with X-ray angiography (r=0.98). The magnitude of vasodilation correlated with baseline cross-sectional area (r=0.52, p=0.03) and age (r=0.40, p=0.019). Post-NTG images also demonstrated a 31% improvement in coronary signal-to-noise ratio (p = 0.002). CONCLUSIONS: Nitroglycerin-enhanced coronary MRA can noninvasively measure coronary artery vasodilation and is a promising noninvasive technique to study coronary vasomotor function.

Adult↗

Rapid measurement of renal artery blood flow with ungated spiral phase-contrast MRI.

PURPOSE: To verify the potential of ungated spiral phase-contrast (USPC), which has been shown to provide accurate and reproducible time-averaged measurements of pulsatile flow, for rapid measurement of renal artery blood flow (RABF) in vivo. MATERIALS AND METHODS: The RABF rates of 11 normal human subjects and one patient with renal failure were measured with USPC within six seconds. RESULTS: Rapid USPC scans produced reproducible RABF measurements (SD < or = 9%) that agreed with the normal RABF rates known from the literature. The RABF rates of the patient with renal failure were substantially less (<50-65%) than the normal RABF rates. CONCLUSION: The results demonstrate that it is now possible to obtain rapid and consistent RABF measurements within six seconds with USPC.

Adult↗

High-resolution real-time spiral MRI for guiding vascular interventions in a rabbit model at 1.5 T.

PURPOSE: To study the feasibility of a combined high spatial and temporal resolution real-time spiral MRI sequence for guiding coronary-sized vascular interventions. MATERIALS AND METHODS: Eight New Zealand White rabbits (four normal and four with a surgically-created stenosis in the abdominal aorta) were studied. A real-time interactive spiral MRI sequence combining 1.1 x 1.1 mm(2) in-plane resolution and 189-msec total image acquisition time was used to image all phases of an interventional procedure (i.e., guidewire placement, balloon angioplasty, and stenting) in the rabbit aorta using coronary-sized devices on a 1.5 T MRI system. RESULTS: Real-time spiral MRI identified all rabbit aortic stenoses and provided high-temporal-resolution visualization of guide-wires crossing the stenoses in all animals. Angioplasty balloon dilatation and deployment of coronary-sized copper stents in the rabbit aorta were also successfully imaged by real-time spiral MRI. CONCLUSION: Combining high spatial and temporal resolution with spiral MRI allows real-time MR-guided vascular intervention using coronary-sized devices in a rabbit model. This is a promising approach for guiding coronary interventions.

Animals↗

Spiral balanced steady-state free precession cardiac imaging.

Balanced steady-state free precession (SSFP) sequences are useful in cardiac imaging because they achieve high signal efficiency and excellent blood-myocardium contrast. Spiral imaging enables the efficient acquisition of cardiac images with reduced flow and motion artifacts. Balanced SSFP has been combined with spiral imaging for real-time interactive cardiac MRI. New features of this method to enable scanning in a clinical setting include short, first-moment nulled spiral trajectories and interactive control over the spatial location of banding artifacts (SSFP-specific signal variations). The feasibility of spiral balanced SSFP cardiac imaging at 1.5 T is demonstrated. In observations from over 40 volunteer and patient studies, spiral balanced SSFP imaging shows significantly improved contrast compared to spiral gradient-spoiled imaging, producing better visualization of cardiac function, improved localization, and reduced flow artifacts from blood.

Artifacts↗

Variable-density one-shot Fourier velocity encoding.

In areas of highly pulsatile and turbulent flow, real-time imaging with high temporal, spatial, and velocity resolution is essential. The use of 1D Fourier velocity encoding (FVE) was previously demonstrated for velocity measurement in real time, with fewer effects resulting from off-resonance. The application of variable-density sampling is proposed to improve velocity measurement without a significant increase in readout time or the addition of aliasing artifacts. Two sequence comparisons are presented to improve velocity resolution or increase the velocity field of view (FOV) to unambiguously measure velocities up to 5 m/s without aliasing. The results from a tube flow phantom, a stenosis phantom, and healthy volunteers are presented, along with a comparison of measurements using Doppler ultrasound (US). The studies confirm that variable-density acquisition of kz-kv space improves the velocity resolution and FOV of such data, with the greatest impact on the improvement of FOV to include velocities in stenotic ranges.

Aorta, Abdominal↗

The future of real-time cardiac magnetic resonance imaging.

Dynamic changes in cardiac structure and function are usually examined by real-time imaging techniques such as angiography or echocardiography. MRI has many advantages compared with these established cardiac imaging modalities. However, system hardware and software limitations have limited cardiac MRI to gated acquisitions that are lengthy and often result in failed acquisitions and examinations. Recently, MRI has evolved into a technique capable of imaging dynamic processes in real time. Improvements in hardware, pulse sequences, and image reconstruction algorithms have enabled real-time cardiac MRI with high spatial resolution, high temporal resolution, and various types of image contrast without requiring cardiac gating or breath-holding. This article provides an overview of current capability and highlights key technical and clinical advances. The future prospects of real-time cardiac MRI will depend on 1) the development of techniques that further improve signal to noise ratio, contrast, spatial resolution, and temporal resolution, without introducing artifacts; 2) the development of software infrastructure that facilitates rapid interactive examination; and 3) the development and validation of several new clinical assessments.

Computer Systems↗

Developmental endothelial locus-1 (Del-1), a novel angiogenic protein: its role in ischemia.

BACKGROUND: Developmentally regulated endothelial locus-1 (Del-1) is an extracellular matrix protein that is expressed by endothelial cells during embryological vascular development. We speculated that Del-1 may be reexpressed in ischemia and may be involved in endogenous angiogenesis. METHODS AND RESULTS: Del-1 protein was detected by immunohistochemistry in murine ischemic hindlimb after femoral artery excision. To determine whether exogenous Del-1 would augment angiogenesis in vivo, Del-1 or vehicle was administered for 3 weeks by intramuscular injection of murine ischemic hindlimbs. Angiogenesis was quantified by gadolinium-MRI perfusion and capillary densitometry. We used a disc angiogenesis system (DAS) to characterize the angiogenic response to vehicle (PBS), Del-1, Del-1 mutant (altered RGD domain), Del-1 minor (truncated discoidin-I-like domain), or basic fibroblast growth factor. After 14 days, the discs were extracted and sectioned to quantify vascular growth by morphometry. Endogenous Del-1 protein expression was increased in ischemic hindlimbs. Administration of Del-1 increased hindlimb vascular flow index and capillary density. In the DAS, Del-1 doubled fibrovascular growth, as did basic fibroblast growth factor. However, angiogenesis was not enhanced by the Del-1 mutant or Del-1 minor proteins. CONCLUSIONS: Del-1 is expressed in ischemic tissue. Del-1 stimulates angiogenesis, an effect that is dependent on the RGD motif and a second signaling sequence in the discoidin-I-like domain. Exogenous intramuscular administration of Del-1 significantly enhances angiogenesis in the murine ischemic hindlimb. Del-1 may prove to be a novel therapeutic agent for patients with ischemia.

Angiogenic Proteins↗

Dynamic real-time architecture in magnetic resonance coronary angiography--a prospective clinical trial.

OBJECTIVES: A dynamic real-time (dRT) architecture has been developed to address limitations in magnetic resonance coronary angiography (MRCA). A prospective clinical trial of 45 patients suspected of coronary artery disease was conducted to determine clinical utility of this integrated real-time system. BACKGROUND: Clinical implementation of MRCA is not performed routinely today. However, improved anatomic coverage, image quality, and scan flexibility may enhance its clinical utility. A novel real-time architecture addresses these challenges through instantaneous reconfiguration between real-time (RT) and high-resolution (HR) imaging sequences with dynamic selection of the desired element on a custom-designed receiver coil. METHODS: A total of 45 subjects were recruited consecutively to evaluate scan time, anatomic coverage, image quality, and detection of coronary lesions. Using a modern PC, the dRT switches from RT to gated HR imaging sequence in one repetition time (39 ms). Magnetic resonance imaging (MRI) scanning was performed using a custom-designed coronary coil consisting of two four-inch phase-array circular elements enabled with real-time selection of the desired coil element. RESULTS: All studies were completed in less than 45 minutes and required a mean of 12 breath holds (16 heartbeats). Of the total number of coronary segments, 91% (357/394) were visualized. Excellent or good image quality was achieved in 86% of the segments. Blinded analysis of the coronary arteries revealed sensitivity of 93% and specificity of 88% in the detection of coronary stenoses. CONCLUSIONS: The integrated environment of dRT provides a rapid and flexible scan protocol for MRCA while achieving wide anatomical coverage, high image quality, and reliable detection of coronary stenosis in short scan time.

Adult↗

Spiral magnetic resonance coronary angiography with rapid real-time localization.

A spiral high-resolution coronary artery imaging sequence (SH) interfaced with real-time localization system (RT) has been developed. A clinical study of 40 patients suspected of coronary artery disease (CAD) was conducted. Segmented k-space acquisition techniques have dominated magnetic resonance coronary angiography (MRCA) over the last decade. Although a recent multicenter trial using this technique demonstrated encouraging results, the technique was hampered by low specificity. Spiral k-space acquisition had demonstrated several advantages for MRCA. Therefore, a first clinical trial implementing spiral high-resolution coronary imaging sequence with real-time localization (SH-RT) was performed.A clinical study of 40 patients suspected of CAD undergoing X-ray angiography was conducted to analyze the clinical reliability of this novel imaging system. The SH-RT had been designed to exploit the unique capability of two imaging sequences. The RT allowed a rapid localization of the coronary arteries. Then SH achieved multislice acquisition during a short breath-hold with submillimeter resolution. The MRCA data were analyzed for scan time, anatomic coverage, image quality, and accuracy in detecting CAD. In 40 subjects, SH achieved 0.7 to 0.9 mm resolution with 14-heartbeat breath-holds. Excellent or good image quality was achieved in 78% (263/337) of the coronary segments. Blinded consensus reading among three observers generated sensitivity of 76% and specificity of 91% in the detection of CAD compared with X-ray angiography. The MRCA imaging sequence implementing a novel spiral k-space acquisition technique enabled rapid and reliable imaging of the CAD in submillimeter resolution with short breath-holds.

Adult↗

Triggered real-time MRI and cardiac applications.

Real-time interactive MRI is becoming the method of choice for many cardiac applications. One current limitation of real-time techniques is inaccurate slice registration during free-breathing. A simple "triggered real-time" imaging approach is proposed which enables the acquisition of synchronized and accurately registered real-time movie loops during short breathholds. Initial in vivo results demonstrate application to complete 4D ventricular function assessment and fully resolved flow imaging.

Anatomy↗

Fat-suppressed steady-state free precession imaging using phase detection.

Fully refocused steady-state free precession (SSFP) is a rapid, efficient imaging sequence that can provide diagnostically useful image contrast. In SSFP, the signal is refocused midway between excitation pulses, much like in a spin-echo experiment. However, in SSFP, the phase of the refocused spins alternates for each resonant frequency interval equal to the reciprocal of the sequence repetition time (TR). Appropriate selection of the TR results in a 180 degrees phase difference between lipid and water signals. This phase difference can be used for fat-water separation in SSFP without any increase in scan time. The technique is shown to produce excellent non-contrast-enhanced, flow-independent angiograms of the peripheral vasculature.

Adipose Tissue↗

Rapid quantitation of high-speed flow jets.

Flow jets containing velocities up to 5-7 m/s are common in patients with congenital defects and patients with valvular disease (stenosis and regurgitation). The quantitation of peak velocity and flow volume in these jets is clinically significant but requires specialized imaging sequences. Conventional 2DFT phase contrast sequences require lengthy acquisitions on the order of several minutes. Conventional spiral phase contrast sequences are faster, but are highly corrupted by flow artifacts at these high velocities due to phase dispersion and motion during the excitation and readout. A new prospectively gated method based on spiral phase contrast is presented, which has a sufficiently short measurement interval (<4 ms) to minimize flow artifacts, while achieving high spatial resolution (2 x 2 x 4 mm(3)) to minimize partial volume effects, all within a single breathhold. A complete single-slice phase contrast movie loop with 22 ms true temporal resolution is acquired in one 10-heartbeat breathhold. Simulations indicate that this technique is capable of imaging through-plane jets with velocities up to 10 m/s, and initial studies in aortic stenosis patients show accurate in vivo measurement of peak velocities up to 4.2 m/s (using echocardiography as a reference).

Aortic Valve Stenosis↗

Steady-state sequence synthesis and its application to efficient fat-suppressed imaging.

A new synthesis algorithm, based on the Shinnar-Le Roux (SLR) transform, can be used to generate fully refocused steady-state pulse sequences with arbitrary magnetization profiles as a function of off-resonant precession. This is accomplished by appropriate periodic oscillation of the RF excitation magnitude and phase from echo to echo. The technique is applied to the design of refocused steady-state free precession (SSFP) sequences with flat profiles, providing the opportunity for banding-artifact-free imaging with steady-state contrast. The algorithm is also used to generate refocused-SSFP sequences with an arbitrarily broad region of attenuated signal. These sequences are implemented and applied to the problem of steady-state fat suppression. Preliminary results show signal levels that agree well with theory, and a broad region of suppressed signal at each echo. Total imaging time is kept identical to that of a standard refocused-SSFP experiment through echo equalization and interleaving. 3D images from the leg of a normal volunteer acquired in 44 s demonstrate the applicability of the technique to fat-suppressed imaging.

Adipose Tissue↗

Fast 3D imaging using variable-density spiral trajectories with applications to limb perfusion.

Variable-density k-space sampling using a stack-of-spirals trajectory is proposed for ultra fast 3D imaging. Since most of the energy of an image is concentrated near the k-space origin, a variable-density k-space sampling method can be used to reduce the sampling density in the outer portion of k-space. This significantly reduces scan time while introducing only minor aliasing artifacts from the low-energy, high-spatial-frequency components. A stack-of-spirals trajectory allows control over the density variations in both the k(x)-k(y) plane and the k(z) direction while fast k-space coverage is provided by spiral trajectories in the k(x)-k(y) plane. A variable-density stack-of-spirals trajectory consists of variable-density spirals in each k(x)-k(y) plane that are located in varying density in the k(z) direction. Phantom experiments demonstrate that reasonable image quality is preserved with approximately half the scan time. This technique was then applied to first-pass perfusion imaging of the lower extremities which demands very rapid volume coverage. Using a variable-density stack-of-spirals trajectory, 3D images were acquired at a temporal resolution of 2.8 sec over a large volume with a 2.5 x 2.5 x 8 mm(3) spatial resolution. These images were used to resolve the time-course of muscle intensity following contrast injection.

Contrast Media↗

Magnetic resonance coronary angiography.

Magnetic resonance coronary angiography (MRCA) has witnessed tremendous technical advances over the past decade. Although high-quality images of the coronary arteries have been demonstrated, this imaging modality is not performed routinely today. The fundamental properties of the coronary arteries deterring noninvasive imaging are well known. This article provides an overview of the developmental efforts to overcome these challenges, and highlights key technical and clinical advances. The future prospect of MRCA depends on clinical implementation of the technique. In order to meet this challenge, the following issues must be addressed: contrast- and signal-to-noise ratio, temporal and spatial resolution, and scan protocol.

Coronary Angiography↗