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Biomedical subjects

Daniela Föll

Publications and source records attributed to Daniela Föll.

5 recordsLinked to original sources

Investigating myocardial motion by MRI using tissue phase mapping.

OBJECTIVE: Velocity-encoded phase contrast magnetic resonance imaging (MRI) provides a tool to quantify regional myocardial wall motion of the entire heart. It allows the acquisition of three-directional velocity vector fields with high spatial resolution that reflect the temporal evolution of myocardial velocities over the cardiac cycle. In contrast to other imaging modalities such as echocardiography left ventricular performance can be assessed without limited anatomical or functional coverage. METHODS: Compared to other techniques that quantify local myocardial contractility (e.g. implanted ultrasonic crystals) by means of regional displacement, phase contrast MRI provides information about local and global left ventricular velocities (i.e. motion) by utilizing the intrinsic motion sensitivity of MRI. The resultant motion components of contraction, expansion, rotation, lengthening, and shortening of the left ventricle are described in high spatial and temporal detail. Phase contrast measurements were performed in 12 healthy volunteers with a respiratory-gated technique in order to achieve a high temporal resolution of 13.8ms to demonstrate the detailed assessment of global and regional myocardial motion. RESULTS: Data revealed details in left ventricular motion patterns that were previously not seen in phase contrast measurements and are only known from echocardiography. For all volunteers, characteristic myocardial motion patterns and locally different radial (i.e. contraction and expansion), rotational (i.e. twisting and untwisting) and longitudinal (i.e. lengthening and shortening) motion components could be detected with high accuracy. CONCLUSIONS: The phase contrast MRI technique for high temporal resolution velocity mapping is therefore very promising for the investigation and better understanding of the myocardial motion in normal subjects and patients with disturbed left ventricular performance and may validate further testing of different models of cardiac structure.

Heart↗

Detailed analysis of myocardial motion in volunteers and patients using high-temporal-resolution MR tissue phase mapping.

PURPOSE: To detect and investigate details in left ventricular (LV) motion patterns with a temporal resolution comparable to that of echocardiography. MATERIAL AND METHODS: To assess global and regional myocardial motion in high temporal detail, respiratory-gated MR phase-contrast measurements with three-directional velocity encoding (venc) were performed in 12 healthy volunteers and two patients with LV hypertrophy in basal, midventricular, and apical locations of the LV with a temporal resolution of 13.8 msec. RESULTS: The volunteer data revealed details in LV motion patterns that were known only from echocardiography. For all volunteers, characteristic myocardial motion patterns, such as triphasic global diastolic expansion, could be detected with high accuracy. One volunteer underwent an additional echocardiographic measurement in order to corroborate the complex motion features as measured by MRI. Patient examinations revealed substantial changes in diastolic function compared to motion patterns in healthy volunteers. CONCLUSION: The proposed high-temporal-resolution velocity-mapping technique provides previously undetectable information on LV performance, and is highly promising for the detection of local and global motion abnormalities in patients with disturbed LV performance, such as diastolic dysfunction.

Adult↗

Magnetic resonance stress tagging in ischemic heart disease.

High-dose dobutamine magnetic resonance stress testing has been shown to be superior to dobutamine stress echocardiography for diagnosis of coronary artery disease (CAD). We determined the feasibility of quantitative myocardial tagging during low- and high-dose dobutamine stress and tested the ability of global systolic and diastolic quantitative parameters to identify patients with significant CAD. Twenty-five patients suspected of having significant CAD were examined with a standard high-dose dobutamine/atropine stress magnetic resonance protocol (1.5-T scanner, Philips). All patients underwent invasive coronary angiography as the standard of reference for the presence (n = 13) or absence (n = 12) of significant CAD. During low-dose dobutamine stress, systolic (circumferential shortening, systolic rotation, and systolic rotation velocity) and diastolic (velocity of circumferential lengthening and diastolic rotation velocity) parameters changed significantly in patients without CAD (all P < 0.05 vs. rest) but not in patients with CAD. Identification of patients without and with CAD during low-dose stress was possible using the diastolic parameter of "time to peak untwist." At high-dose stress, none of the global systolic or diastolic parameters showed the potential to identify the presence of significant CAD. With myocardial tagging, a quantitative analysis of systolic and diastolic function was feasible during low- and high-dose dobutamine stress. In our study, the diastolic parameter of time to peak untwist as assessed during low-dose dobutamine stress was the most promising global parameter for identification of patients with significant CAD. Thus quantitative myocardial tagging may become a tool that reduces the need for high-dose dobutamine stress.

Adrenergic beta-Agonists↗

Myocardial perfusion imaging using OMNISCAN: a dose finding study for visual assessment of stress-induced regional perfusion abnormalities.

BACKGROUND: Different doses of contrast agent are applied for magnetic resonance perfusion studies and mainly semiquantitative approaches have been reported for analysis. We aimed to determine the optimal dose for a visual detection of perfusion defects. METHODS: 49 patients (59+/-8 years; 33 male) scheduled for invasive angiography were examined at stress (0.14 mg adenosine/kg body weight/minute) and rest using a TFE-EPI hybrid sequence (Philips ACS NT; 1.5 T). Patients were assigned to three different dose groups of gadodiamide (0.05, 0.1, and 0.15 mmol/kg body weight) injected as a bolus via a peripheral vein. Visual assessment was used to detect a regional reduction of peak signal intensity or speed of contrast agent inflow at stress in comparison to rest. RESULTS: Prevalence for coronary artery disease was 67%. The highest diagnostic accuracy was reached for a dose of 0.1 mmol gadodiamide/kg body weight (86% p=nonsignificant vs. 0.15 and 0.05 mmol gadodiamide/kg). At this dose, no major artifacts related to the contrast agent were found. CONCLUSIONS: Visual assessment of myocardial perfusion using a high-flow rate contrast agent bolus injection and a TFE-EPI sequence can be best achieved with a dose of gadodiamide 0.1 mmol/kg bodyweight.

Aged↗

Comparison of reconstruction intervals in routine ECG-pulsed 64-row-MSCT coronary angiography in frequency controlled patients.

PURPOSE: In light of the increasing use and acceptance of multislice computed tomography (MSCT) coronary angiography it was the purpose of this study to compare reconstruction intervals used in a routine ECG-pulsed MSCT coronary artery angiography setting with frequency controlled patients. METHODS: Examinations were performed on a Siemens Somatom Sensation 64 scanner with a total of 110 ml of contrast agent and ECG pulsing (interval from 40% to 70%) after oral application of a beta-blocker if the heart rate was higher than 65 bpm. All human subjects were referred for the evaluation of suspected coronary artery disease. Coronary artery segments were evaluated by two experienced radiologists in a consensus reading. A ranking of diagnostic image quality (from 1 (no evaluation possible) to 5 (excellent image quality)) was statistically evaluated by Wilcoxon Signed Rank Test. RESULTS: In 45 patients (30 male, 15 female, age 63.8 +/- 12.1 years) we detected a significant advantage of the 60% reconstruction interval over 40%, 50%, and 70% (for each p < 0.05). In cases of sudden arrhythmia or movement during the scan, additional reconstruction intervals within the ECG-pulsed reconstruction intervals remained necessary for diagnosis. CONCLUSION: In a routine diagnostic setting with frequency controlled patients and ECG pulsing the 60% reconstruction interval can be considered superior for the initial diagnosis in 64-row multislice computed tomography coronary angiography. However, further information can be derived from various reconstruction intervals such as 40% and 70%.

Adult↗