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G B Cranney

Publications and source records attributed to G B Cranney.

23 records · Page 2Linked to original sources

Overview of cardiovascular nuclear magnetic resonance imaging.

Application of NMR technology to the evaluation of the cardiovascular system is still in its infancy. NMR can frequently yield information equivalent to echocardiography or angiography but cost, long imaging times, and lack of portability have discouraged widespread use. To date, NMR has not replaced standard imaging modalities in the evaluation of most cardiovascular disease states, although it appears to have a unique role in the delineation of great vessel pathology, the evaluation of congenital heart disease, and the delineation of cardiac and paracardiac masses. Appearance of tissue and flowing blood and contrast between structures are highly dependent on magnetic field strength and the imaging pulse sequence used. Published comparisons between NMR and other imaging modalities have to be interpreted and extrapolated with caution, and sensitivity and specificity of NMR imaging in different disease entities should be further validated. With technological improvements, shortening of examination times and data processing times and true three-dimensional imaging may be possible in the near future. Ultimately, however, the clinical importance of NMR will depend on the development of unique applications such as examination of regional cardiac metabolism, noninvasive coronary and peripheral angiography, myocardial perfusion imaging, and improved tissue characterization.

Aortic Diseases↗

Doppler echocardiographic determination of aortic valve area using the continuity equation.

The noninvasive measurement of aortic valve area by use of the continuity equation has been proposed as an accurate method for determining the severity of aortic stenosis. In 32 patients (mean age 64 +/- 14 years) with proven aortic stenosis and without significant regurgitation, aortic valve areas derived by the Gorlin equation from cardiac catheterisation data were compared with valve areas calculated from the continuity equation using Doppler echocardiography. There was a close correlation between Doppler and catheter derived aortic valve areas (r = 0.87, SEE = 0.17 cm2). The interobserver error for aortic valve area measurement in 20 patients was 9.0 +/- 6.8%. The specificity of this method for critical aortic stenosis (aortic valve area less than 0.75 cm2) was 73% and the sensitivity 88%. We conclude that in an adult, predominantly elderly population with calcific aortic stenosis, this Doppler echocardiographic method is reproducible and can be used accurately to derive aortic valve area.

Adolescent↗

Semiautomated method for noise reduction and background phase error correction in MR phase velocity data.

Background phase distortion and random noise can adversely affect the quality of magnetic resonance (MR) phase velocity measurements. A semiautomated method has been developed that substantially reduces both effects. To remove the background phase distortion, the following steps were taken: The time standard deviations of the phase velocity images over a cardiac cycle were calculated. Static regions were identified as those in which the standard deviation was low. A flat surface representing an approximation to the background distortion was fitted to the static regions and subtracted from the phase velocity images to give corrected phase images. Random noise was removed by setting to zero those regions in which the standard deviation was high. The technique is demonstrated with a sample set of data in which the in-plane velocities have been measured in an imaging section showing the left ventricular outflow tract of a human left ventricle. The results are presented in vector and contour form, superimposed on the conventional MR angiographic images.

Blood Flow Velocity↗

Three-dimensional reconstruction of the flow in a human left heart by using magnetic resonance phase velocity encoding.

Intraventricular flows have been correlated with disease and are of interest to cardiologists as a possible means of diagnosis. This study extends a method that use magnetic resonance (MR) to measure the three-dimensional nature of these flows. Four coplanar, sagittal MR slices were located that spanned the left ventricle of a healthy human. All three velocity components were measured in each slice and 18 phases were obtained per beat. With use of the MR magnitude images, masks were created to isolate the velocity data within the heart. These data were read into the software package, Data Visualizer, and the data from the four slices were aligned so as to reconstruct the three-dimensional volume of the left ventricle and atrium. By representing the velocity in vectorial form, the three-dimensional intraventricular flow field was visualized. This revealed the presence of one large line vortex in the ventricle during late diastole but a more ordered flow during early diastole and systole. In conclusion, the use of MR velocity acquisition is a suitable method to obtain the complex intraventricular flow fields in humans and may lead to a better understanding of the importance of these flows.

Adult↗

Embolization of a left atrial ball thrombus during transesophageal echocardiography.

We report a case of systemic embolization of a left atrial ball thrombus during transesophageal echocardiography (TEE). A 49-year-old man with rheumatic mitral stenosis and atrial fibrillation underwent TEE to evaluate a transient cerebral ischemic attack. TEE demonstrated a free-floating left atrial thrombus. Disappearance of the thrombus during the study occurred after tachycardia and was associated with acute hemiplegic stroke and an absent radial pulse. The possible mechanism of embolization and the implications for the selection and management of patients undergoing TEE are discussed.

Echocardiography↗