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Biomedical subjects

E L Ritman

Publications and source records attributed to E L Ritman.

At least 109 records · Page 6Linked to original sources
PubMed1985

Cardiogenic motion of right lung parenchyma in anesthetized intact dogs.

Cardiogenic motion of the right lung parenchyma (CGLM) was measured in six morphine-pentobarbital-anesthetized dogs (11-16 kg) under conditions of varying paced and spontaneous sinus heart rates. Motion of 1-mm-diameter percutaneously implanted radiopaque lung parenchymal markers were measured using a computer-based biplane video-roentgenographic assembly. Correlation of the amplitudes and phases of marker motions to the R wave of the electrocardiogram (ECG) were determined utilizing a modified fast Fourier transform algorithm. Of initial importance was the observation that CGLM was significantly greater than the variability of repeated measurements. The total amplitudes of motion of the markers (where AT = square root A2X + A2Y + A2Z and AX, AY, AZ are the amplitudes of marker motion along the orthogonal X, Y, and Z body axes) in the right apical, cardiac, and diaphragmatic lobes were 0.025 +/- 0.005 (SE), 0.046 +/- 0.005, and 0.023 +/- 0.025 cm, respectively, (P less than 0.01, cardiac lobe vs. others). The total amplitude of motion observed in the cardiac lobe was equivalent to earlier observations of total amplitude (0.045 +/- 0.004 cm) of marker motion in response to high frequency airway oscillation at a pump stroke volume of 22-26 ml. An analysis of the higher harmonics of marker oscillation suggested that the second harmonic of CGLM is also larger than the variability of our measurements.

Anesthesia, Intravenous↗
PubMed1985

Effect of body orientation on regional lung expansion in dog and sloth.

Recent studies (E.A. Hoffman, J. Appl. Physiol. 59: 468-480, 1985) using fast multisliced X-ray computed tomography have demonstrated a ventral-dorsal gradient of fractional lung air content (3.29% air/cm lung height) in supine dogs and an essentially uniform ventral-dorsal air content distribution in the prone dogs [mean = 66 +/- 0.6% (SE) air content]. Since the prone orientation is the dog's normal body posture, we sought to study an animal whose normal body posture was "opposite" to that of the dog. Four two-toed sloths were scanned in the Dynamic Spatial Reconstructor in the prone and supine postures. A supine fractional air content gradient was demonstrated with a regression equation of y = 2.09x + 74.3 (r = 0.92), where y is percent air content and x is vertical height in the lung, and ventral-dorsal air content distribution in the prone posture was uniform with a mean of 85 +/- 0.4% (SE) air content. The low functional residual capacity lung density in the sloth was attributable to unusually large alveoli. The mean heart volume-to-body weight ratio in the dogs was 16.4 +/- 0.6 (SE) ml/kg and that in the sloth was 7.3 +/- 0.4 (SE) ml/kg. Mean lung volume-to-body weight ratios for dogs and sloths were 57 +/- 7 (SE) and 89 +/- 6 ml/kg, respectively. Of particular interest was the fact that large changes in prone vs. supine rib cage and diaphragm geometry previously found in dogs did not occur in sloths, though significant alterations of ventral and dorsal lung geometry prone vs. supine were demonstrated, and lung shape changes in both dog and sloth are attributable to shifts in the intrathoracic position of mediastinal structures.

Animals↗
PubMed1984

The Dynamic Spatial Reconstructor: investigating congenital heart disease in four dimensions.

The Dynamic Spatial Reconstructor (DSR) is a high-temporal resolution, three-dimensional (3-D) X-ray scanning device based on computed tomography (CT) principles. It was designed for investigation of some problems inherent in current diagnostic imaging techniques, and to allow quantitative studies of cardiovascular structure and function. One of the research protocols in which DSR is currently used involves studying selected pediatric patients with complex congenital heart disease. Initial results show that 3-D dynamic images can be obtained from these patients with minimal invasiveness and that these images may provide useful diagnostic information.

Adolescent↗
PubMed1984

Quantitative analysis of a vascular tree model with the dynamic spatial reconstructor.

The accuracy in determining the three-dimensional anatomy of a vessel network by computed tomography (CT) is evaluated using a glass model of a pulmonary artery. The dynamic spatial reconstructor (DSR), a high temporal resolution, volumetric, roentgenographic, CT scanner, was used to scan the model. The glass of the model had a roentgen attenuation coefficient mu = 0.55 cm-1, which is approximately equivalent to the 20% dilution of contrast medium to be expected in the pulmonary arterial tree following a contrast agent bolus injection of 2 ml/kg in the right atrium. The model was scanned inside a 20 cm diameter Plexiglas cylinder with a 1 cm thick wall (mu congruent to 0.2 cm-1) to simulate the chest wall of a 20 kg dog, and it was filled with potato flakes to simulate lung parenchyma (mu congruent to 0.06 cm-1). In one 0.011 s scan, information for reconstruction of a stack of images of transaxial sections was recorded. Sequential scans were performed to obtain data for either maximum transaxial resolution (14 angles of view every 0.0167 s, 120 parallel slices each 1.8 mm thick) or maximum axial resolution (eight angles of view every 0.0167 s, 240 parallel slices each 0.9 mm thick) reconstructions. Estimated detectable "vessel" size, cross-sectional area, branching angle, and interbranch segment length were determined as a function of imaged slice thickness, orientation of section image, and number of angles of view (i.e., scan duration) used to make images. Retrospective selection of 0.05 s duration scan apertures at sequential 0.5 s intervals was used to simulate a typical, retrospectively gated reconstruction from a DSR scan. Using these reconstructed images, 2 mm diameter "vessels" could be readily detected and their structure quantitated. Comparing direct measurements and DSR estimates, cross-sectional area (SEE = 3 mm2), branching angles (SEE = 2 degrees), and segment length (SEE = 1 mm) all had a correlation coefficient greater than 0.99, and the regression lines showed no significant differences from the lines of identity (p greater than 0.05).

Animals↗
PubMed1984

Three-dimensional dynamic x-ray-computed tomography imaging of stomach motility.

The dynamic spatial reconstructor (DSR), an x-ray-computed, tomography-based imaging machine, scans a cylindrical volume up to 39 cm in transaxial diameter and 21.5 cm in axial height with scan repetition rate up to 60 per second. We applied this technique to three dogs in order to investigate the accuracy with which stomach shape, dimensions, and motility can be measured. Single peristaltic waves of one dog's stomach filled with air and two other dogs' stomachs filled with different volumes of contrast-enhanced semisolid meals (10% Gastrografin) were scanned at 2-s intervals at scan apertures between 0.011- and 1-s duration. On completion of the scan sequence, images of oblique sections perpendicular to the local long axis of the stomach fundus, corpus, and antrum were computed from the DSR scan data. Measurements of differential motion of defined points on the stomach wall surface, propagation velocities, acceleration, and amplitudes of peristalsis as well as gastric volume determinations were made. This approach overcomes problems of superposition and ambiguity inherent in projection imaging. Measurements of the volumes of ingested first meal were accurate to within 1.5% (of the actual volume of solid food introduced into the stomach) using a 0.40-s scan aperture. Wall motion could be detected with an SEE of 1.5 mm (pixel size used was 1.4 mm) using a 0.40-s scan aperture.

Animals↗
PubMed1984

Mass of left ventricular myocardium estimated with dynamic spatial reconstructor.

Using the Dynamic Spatial Reconstructor (DSR), a unique multiple X-ray source, high-repetition-rate CAT scanner, we estimated left ventricular (LV) myocardial volume and chamber volume of eight dogs ranging from 2.5 to 32.5 kg. Dogs were given subcutaneous morphine (3 mg/kg) and anesthetized with intravenous pentobarbital sodium (22 mg/kg). A bolus of 1 ml/kg body wt contrast medium was injected into the superior vena cava and 60/s scans repeated over 7 s were performed. Each 0.0167-s scan generated image data for 120 1.8-mm-thick transverse slices, in the dextro and levo phases of the angiograms. Retrospective reformatting of the scan data was used to generate images of thin slices perpendicular to the aortoapical axis of the LV. The LV muscle and chamber volumes were estimated from their outlines in each imaged slice using a manually operated trackball interfaced to a computer. Values of the LV muscle ranged from 18.0 to 146.8 cm3 by DSR and showed a good correlation with the postmortem values (r = 0.99, y = 0.94x + 4.1). Ratios of volume of the myocardium to chamber volume ranged from 1.19 to 3.10.

Animals↗
PubMed1984

Coronary angiographic examination with the dynamic spatial reconstructor.

The dynamic spatial reconstructor (DSR), a high temporal resolution, three-dimensional roentgenographic, computed tomography scanner, was used to scan the coronary arteries of five dogs. After one injection of contrast medium into the left main coronary artery or into the aortic root of each dog, all major epicardial coronary arteries and the septal artery could be imaged. After selective removal of all nonangiographically enhanced anatomical structures within the three-dimensional images, pseudo three-dimensional displays were generated to show the arteries from all possible views--even the strictly cranial view--so that superposition of arteries could be avoided. The geometric accuracy of the images was evaluated by comparing coronary arterial segment length measured by the DSR with postmortem measurements (r = .99, SEE = 3.12 mm, n = 35) and by measuring the stenosis produced by nine hollow plastic cylinders lodged in coronary arterial lumina via percutaneous catheterization. Three of the plugs had irregular noncircular lumina drilled into them so that the percentage of stenosis seen in some projection images underestimated the severity of stenosis. The DSR overestimated the length of a 3 mm long stenosis by 0.4 +/- 0.5 mm. The percent area reduction caused by the hollow cylinders varied between 53% and 92% and was underestimated by the DSR on the average by 7%. The correlation between DSR measurements and the direct measurements was r = .85 (SEE = 5%, n = 9). The volume of plastic in each plug (average 13.2 mm3), calculated from the length, cross-sectional area, and degree of the stenosis, showed a better correlation (r = .90, SEE = 2 mm3) with the actual plastic volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Subtraction gated computed tomography with the dynamic spatial reconstructor: simultaneous evaluation of left and right heart from single right-sided bolus contrast medium injection.

Three-dimensional (3-D) dynamic computed tomography of the heart with the dynamic spatial reconstructor (DSR) is being used for studies of cardiovascular function. Formerly, continuous infusion of bilateral bolus injections of contrast medium were required to visualize both sides of the heart simultaneously. The DSR was used to circumvent many of the drawbacks of these methods. In anesthetized dogs a bolus of 1 ml/kg body weight contrast medium was injected into the superior vena cava and 60/s scans were performed during the dextro- and levophases of the resulting angiogram. The recorded scan data were used to generate successive volume (3-D) images with a scan aperture time of 0.06 s each. Each scanned cardiac cycle was thus represented by sequential volume images with either the right or left chambers opacified. Matching equal time intervals from the R wave of the electrocardiogram, the volume images of the left heart phase were digitally subtracted (voxel for voxel) from the images of the right heart phase, with all resulting negative voxel values set to zero. Only the contrast enhanced right ventricle (RV) chamber remained in the subtraction images, whose brightness was then scaled to match the brightness of the opacified left ventricle (LV). The modified RV phase images were then added to the LV phase images. The resulting volume images contain equally enhanced LV and RV chambers and can be used for retrospective analysis, including display of static and dynamic oblique planar images. Verification of the accuracy of this technique was made by estimation of LV muscle mass in five dogs. Dynamic spatial reconstructor estimates from subtracted gated images were compared with postmortem measurements. The correlation was 0.999 with a mean discrepancy of 2.3 +/- 0.4% SEM.

Animals↗
PubMed1983

Effect of verapamil on left ventricular function: a randomized, placebo-controlled study.

Verapamil has a negative inotropic action in isolated cardiac muscle. Its effects on left ventricular function were tested in 25 patients with suspected coronary artery disease. A double-blind, randomized, placebo-controlled study design was used. Verapamil (0.2 mg/kg over 10 minutes) significantly lowered mean arterial pressure (from 105 to 89 mm Hg) while increasing the cardiac index (from 2.8 to 3.1 liters/min/m2). No statistically significant effect was seen on heart rate, left ventricular end-diastolic pressure or end-systolic volume index, ejection fraction, peak rates of systolic wall thickening or diastolic wall thinning, or percentage of hemiaxial shortening. However, there was a small increase in the left ventricular end-diastolic volume index (from 94 to 102 ml/m2). Important findings were a reduction in systemic vascular resistance (from 39 to 30 U . m2), an increase in left ventricular end-diastolic volume index consistent with a negative inotropic effect, and no evidence of improved regional wall dynamics in portions of the left ventricular wall considered hypokinetic because of myocardial ischemia.

Cardiac Catheterization↗
PubMed1983

Noninvasive quantitative imaging of shape and volume of lungs.

The Dynamic Spatial Reconstructor (DSR) can be used to determine detailed structure-to-function relationships or organ systems in vivo. A basic index of lung structure (shape and dimensions) is total lung volume. We checked the accuracy with which in vivo lung volumes can be measured by comparing lung volume (air plus tissue) determined by DSR scanning with that determined by excision and water displacement. Six dogs (2.5-26 kg) under morphine-pentobarbital anesthesia were scanned supine or prone at functional residual capacity and/or total lung capacity. With the trachea clamped at the lung volume scanned, a lethal dose of pentobarbital was administered, the lung excised, and its volume determined by water displacement. In vivo scan data were used to reconstruct adjacent 0.9-mm-thick transverse sections over the entire axial extent of the thorax. A three-dimensional surface-detection algorithm was used to generate shaded surface displays of the in situ lungs. The number of voxels (volume picture elements) of known dimensions contained within the three-dimensional image of the lung was summed to estimate total lung volume. Lung volumes calculated from the in vivo images ranged from -3.4 to +2.3% of the lung volume determined in vitro. The mean difference was 1.38 +/- 0.07% (SE). Regression analysis yielded an r value (correlation) of 1.00, a slope of 0.99, and an intercept of -4.35 ml. Multiple lung inflation steps scanned and analyzed in one dog showed similar accuracy. This technique is applicable to subjects with thorax dimensions up to 42 cm in cephalocaudal height and 39 cm in ventrodorsal and transverse diameters.

Animals↗
PubMed1982

Dynamic volume imaging of moving organs.

The Dynamic Spatial Reconstructor system has been developed to dynamically (up to 60/sec) image the entire 3-D volume (up to 240 adjacent 1-mm-thick transverse sections) encompassing moving organs of the body, particularly the heart and lungs, or the circulation in any organ. This capability permits accurate regional and global measurements to be made of the important relationships between structure and function within and among these organs, which in turn facilitates achievement of new insights into the basic physiological processes of these organs, and promises increased sensitivity and specificity in the diagnosis of pathology that affects normal organ function. This article explains the biomedical and technological rationale for development of the DSR, describes the design concepts and practical operation of the system, and presents preliminary results obtained with the system, including initial data from one of the first patient studies.

Animals↗
PubMed1982

Effects of progressive reduction in coronary blood flow on regional and global left ventricular contraction and relaxation during normal and increased afterload: a roentgen videometric study.

The effects of step-wise reduction in left circumflex coronary blood flow on: 1) posteroinferior wall dynamics; 2) normally-perfused anterior wall dynamics; and 3) cavity function were assessed simultaneously by roentgen videometric analysis of left ventricular angiograms in open-chest dogs during normal and increased afterload. At control coronary flow with normal afterload, peak rates of systolic thickening and diastolic thinning of the posteroinferior and anterior walls were similar. Step-wise reduction in circumflex coronary flow resulted in a progressive fall in systolic and diastolic posteroinferior wall dynamics. Increased LV afterload resulted in a decrease in posteroinferior wall dynamics even at control coronary flow, and reduction in flow resulted in even greater deterioration than occurred with normal afterload. The decrease in posteroinferior wall dynamics with reduction in circumflex coronary flow was accompanied by an increase in peak rates of systolic thickening and diastolic thinning of the normally perfused anterior wall. The level of coronary blood flow at which this increase in anterior wall dynamics occurred, varied with LV loading conditions, occurring earlier when afterload was increased. There was no earlier or greater decrease in diastolic than systolic wall dynamics with progressive reduction in coronary flow with either normal or increased afterload. Left ventricular end-diastolic volume, end-diastolic pressure and ejection fraction changed little until coronary blood flow was reduced to 50% of control; by contrast, stroke-work was exquisitely sensitive to changes in coronary flow. There was no correlation between changes in regional and cavity systolic or diastolic function. The delay in onset of LV cavity dysfunction with ischemia may have been partly due to the "compensatory increase" in anterior wall dynamics, counterbalancing the impaired posteroinferior wall dynamics.

Animals↗
PubMed1982

Three-dimensional spatial, density, and temporal resolution of the dynamic spatial reconstructor.

Spatial, density, and temporal resolution of the dynamic spatial reconstructor (DSR), a multiple X-ray source, high speed, computed tomography scanning system, are evaluated. Hole-pair resolution was evaluated in a stationary phantom surrounded with air, 15 cm of water, or 20 cm of water. Temporal resolution was evaluated by rotation of one of the resolution phantoms during the scan, and with a balloon inflated to a known volume and at a known rate to approximate a typical left ventricular chamber volume and filling rate. These studies confirmed that the spatial resolution is essentially the same in the transverse and axial directions, and that retrospective manipulation of the image data is important for maximization of spatial and density resolution in any structure under examination by obtaining a tradeoff with partial-volume and motion-blurring effects. Maximum spatial resolution in the scanned volume was shown, under ideal conditions, to be greater than five hole pairs per centimeter. Under conditions of intravenous injection of contrast agent, the resolution of blood vessels in an experimental animal approximately 25 kg in weight is expected to be on the order of three hole pairs per centimeter; and in an adult human weighting approximately 60 kg, a resolution of about two hole pairs per centimeter is to be expected.

Angiography↗
PubMed1982

Left ventricular performance before and after aortocoronary artery bypass surgery.

Left ventricular performance was studied before and late (mean 12-17 months) after aortocoronary artery bypass surgery by quantitative, computer-based videoangiography. We measured total function (left ventricular ejection fraction, volumes and end-diastolic pressure) at rest (in 60 patients) and before and after exercise (abnormal exercise hemodynamics preoperatively in 32 patients) and regional function (peak rate of systolic wall thickening) at rest (in 60 patients) and before and after administration of nitroglycerin (in 19 patients). Total left ventricular function at rest is usually unchanged postoperatively. Exercise hemodynamics are more sensitive indexes of performance and, if abnormal, usually improve postoperatively if revascularization has been complete and extensive myocardial infarction has not occurred. Regional myocardial function usually improves postoperatively if the bypass graft to the region is patent and has a blood flow of more than 60 ml/min (measured late postoperatively by videodensitometry) and if no previous infarction was present in the region. Myocardial infarction and graft blood flow of 40 ml/min or less are the two main factors that prevent improvement in abnormal regions defined by the regional wall thickening method when bypass grafts are patent. Regions supplied by occluded grafts show decreases in regional function. The preoperative wall-thickening response to administration of nitroglycerin can be used to distinguish ischemia and significant myocardial infarction and to predict the successful response to aortocoronary bypass graft surgery.

Blood Pressure↗
PubMed1980

Evaluation of ischemic heart disease with a prototype volume imaging computed tomographic (CT) scanner: preliminary experiments.

A prototype synchronous volumetric computed tomographic X-ray scanner was used to demonstrate, in individual experiments, the possibility of estimating percent coronary arterial stenosis, regional myocardial blood supply and regional myocardial wall dynamics. Scans were obtained during angiography in intact anesthetized dogs or in an isolated metabolically supported working left ventricular preparation. Percent arterial stenosis was quantitated using the percent change in brightness area product of successive cross-sectional images of contrast agent-filled Tygon tubing sutured to the epicardium. Myocardial blood supply was evaluated by the transmural and circumferential extent and th time rate of change of myocardial opacification during coronary angiography. The regional time rate of change of left ventricular wall thickening during the systolic phase of the cardiac cycle was demonstrated in the isolated ventricle preparation. The recently installed Dynamic Spatial Reconstructor high speed volumetric scanning system will be used to make these measurements from scan data obtained during a single angiogram in man.

Animals↗
PubMed1980

Three-dimensional imaging of heart, lungs, and circulation.

A new imaging device, the dynamic spatial reconstructor (DSR), is described. It differs from commercially available computed tomography scanners in several ways. It images a volume rather than a slice; it images the volume in stop-action to minimize blurring due to motion; and it repeats the scan 60 times per second so that the functional movements of heart muscle and lung tissue and the distribution of roentgen contrast medium in blood can be quantitated in any portion of the body, especially in the heart, great vessels, and lungs. The system is under evaluation as a research tool for physiologic and, ultimately, clinical investigations.

Animals↗