Images in cardiovascular medicine. Continuous cardiac magnetic resonance imaging during untreated ventricular fibrillation.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Maria I Altbach.
Explore the source record for details and available documents.
BACKGROUND: Most out-of-hospital ventricular fibrillation (VF) is prolonged (>5 minutes), and defibrillation from prolonged VF typically results in asystole or pulseless electrical activity. Recent visual epicardial observations in an open-chest, open-pericardium model of swine VF indicate that blood flows from the high-pressure arterial system to the lower-pressure venous system during untreated VF, thereby overdistending the right ventricle and apparently decreasing left ventricular size. Therefore, inadequate left ventricular stroke volume after defibrillation from prolonged VF has been postulated as a major contributor to the development of pulseless rhythms. METHODS AND RESULTS: Ventricular dimensions were determined by MRI for 30 minutes of untreated VF in a closed-chest, closed-pericardium model in 6 swine. Within 1 minute of untreated VF, mean right ventricular volume increased by 29% but did not increase thereafter. During the first 5 minutes of untreated VF, mean left ventricular volume increased by 34%. Between 20 and 30 minutes of VF, stone heart occurred as manifested by dramatic thickening of the myocardium and concomitant substantial decreases in left ventricular volume. CONCLUSIONS: In this closed-chest swine model of VF, substantial right ventricular volume changes occurred early and did not result in smaller left ventricular volumes. The changes in ventricular volumes before the late development of stone heart do not explain why defibrillation from brief duration VF (<5 minutes) typically results in a pulsatile rhythm with return of spontaneous circulation, whereas defibrillation from prolonged VF (5 to 15 minutes) does not.
RAD-GRASE is an MRI sequence that combines radial (RAD) k-space scanning with the gradient and spin-echo (GRASE) technique. RAD-GRASE has the advantages of all radial data acquisition methods in that it can reduce motion sensitivity and correct motion-induced data errors, which can be exploited to achieve high-resolution diffusion-weighted imaging (DWI). One can obtain different types of image contrast, including DWI, T(1), T(2), and T(2)*, in RAD-GRASE by controlling the magnetization preparation and sequence timing. Moreover, because there is oversampling of the low spatial frequencies inherent to radial sequences, partial data reconstruction can be used to achieve multiple forms of image contrast from a single acquired data set, and to generate parametric image maps of equilibrium magnetization, T(2), and T(2) (dagger). The RAD-GRASE technique can also be used to achieve fat-suppressed and/or separated fat and water images by choosing the appropriate timing parameters.
Radial fast spin-echo (radial-FSE) methods enable multishot diffusion-weighted MRI (DWMRI) to be carried out without significant artifacts due to motion and/or susceptibility and can be used to generate DWMRI images with high spatial resolution. In this work, a novel method that allows isotropic diffusion weighting to be obtained in a single radial k-space data set is presented. This is accomplished by altering the direction of diffusion weighting gradients between groups of TR periods, which yield sets of radial lines that possess diffusion weighting sensitive to motion in different directions. By altering the diffusion weighting directions and controlling the view ordering appropriately within the sequence, an effectively isotropic diffusion-weighted image can be obtained within one radial-FSE scan. The order in which radial lines are acquired can also be controlled to yield data sets without significant artifacts due to motion, T(2) decay, and/or diffusion anisotropy.
Radially acquired fast spin-echo data can be processed to obtain T2-weighted images and a T2 map from a single k-space data set. The general approach is to use data at a specific TE (or narrow TE range) in the center of k-space and data at other TE values in the outer part of k-space. With this method high-resolution T2-weighted images and T2 maps are obtained in a time efficient manner. The mixing of TE data, however, introduces errors in the T2-weighted images and T2 maps that affect the accuracy of the T2 estimates. In this work, various k-space data processing methods for reconstructing T2-weighted images and T2 maps from a single radial fast spin-echo k-space data set are analyzed in terms of the accuracy of T2 estimates. The analysis is focused on the effect of image artifacts, object dependency, and noise on the T2 estimates. Results are presented in computer-generated phantoms and in vivo.
In this work we present a new method for the improved detection of lipid infiltration in the heart. The method employs a double-inversion fast spin-echo technique where the acquisition of water- and lipid-suppressed k-space data is alternated between TR periods to produce co-registered lipid and water images from data acquired in a breath hold. The lipid and water images can then be combined to generate a lipid/water image with reduced artifacts due to flow and excellent contrast between lipid and myocardium. The method is demonstrated in ex vivo tissue and in vivo. This novel method may improve the detection of lipid infiltration in the heart in pathologies such as arrhythmogenic right ventricular dysplasia.
Radial MRI sequences are frequently used to obtain images with reduced sensitivity to motion. To decrease imaging time, multiple spin-echo acquisitions can be incorporated into radial sequences. In this case, different radial lines of Fourier data have different TE times and the resulting images can contain streaking artifacts due to T(2) decay. The streaking is not only dependent on the T(2) of the object and the timing of the data acquisition, but also on the order in which radial lines are collected (view order). The view ordering can easily be controlled to minimize artifacts due to T(2) decay as well as motion. Four view-ordering techniques are presented and evaluated for the radial FSE sequence.
PURPOSE: To evaluate a multishot radial fast-spin echo (RAD-FSE) method developed to improve the quality of abdominal T2-weighted imaging as well as the characterization of focal liver lesions. MATERIALS AND METHODS: The RAD-FSE sequence used in this work consisted of a preparatory period followed by a short echo train (ETL = 16). A novel radial k-space trajectory was used to minimize streaking artifacts due to T2 variations and motion. Small diffusion gradients (b = 1.2 mm/s(2)) were used to improve flow suppression. The quality of images obtained with RAD-FSE was compared to multishot 2DFT fast spin-echo (2DFT-FSE) and half-Fourier acquisition single-shot turbo-spin-echo (HASTE) images using data from 16 patients. A postprocessing algorithm was used to generate multiple high-resolution images (at different effective TE values) as well as a T2 map from a single RAD-FSE data set. The T2 maps were used to differentiate malignant from benign lesions for a set of 33 lesions ranging from 0.8-194 cm(3). RESULTS: RAD-FSE produces high-resolution images of the liver in a breath-hold without the motion artifacts of 2DFT-FSE methods, and without the blurriness and loss of small lesion detectability of HASTE. The inclusion of diffusion weighting in RAD-FSE decreases the signal from blood in hepatic vessels, which improves lesion visualization. The T2 values obtained by postprocessing a single RAD-FSE data set can differentiate malignant from benign lesions. The mean T2 values obtained for malignancies, hemangiomas, and cysts are 108 +/- 30 msec, 240 +/- 14 msec, and 572 +/- 334 msec, respectively. CONCLUSION: These results indicate that RAD-FSE produces abdominal images of higher quality than 2DFT-FSE and HASTE. In addition, lesions can be characterized using T2 maps generated from a single RAD-FSE data set.