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Biomedical subjects

Nael F Osman

Publications and source records attributed to Nael F Osman.

At least 19 recordsLinked to original sources

Artifact-free black-blood cine cardiac imaging in a single breath-hold.

Fast imaging using the STimulated Echo Acquisition Mode (STEAM) sequence can produce cine images of the heart with black-blood contrast. Nevertheless, correction of deformation-related artifacts is required in order to maintain myocardial signal throughout the cardiac cycle. Recent work by our group has eliminated this artifact by combining two STEAM sequences acquired with two different demodulation gradients. Unfortunately, these two STEAM sequences were acquired on two separate breath-holds; thus, scan time doubled. In this work, we present a technique to reduce the total scan time by one half, without sacrificing image quality. The technique is based on interleaving two demodulations within one acquisition in order to obtain quality cine images of the heart in a single breath-hold. The technique was tested on animal models and human subjects, and the impact of interleaved acquisition on image quality was studied using quantitative and qualitative measures.

Animals↗

Effect of long-term cocaine use on regional left ventricular function as determined by magnetic resonance imaging.

This study examined left ventricular (LV) regional midwall circumferential strain by cardiac tagged magnetic resonance imaging in 32 long-term cocaine users and 14 nonusers. Most of the LV segmentations in the cocaine users had less average circumferential strain in the systolic and diastolic phases. The average diastolic strain in 5 ventricular segmentations was significantly less in the cocaine users (p<0.05). In conclusion, long-term cocaine use may be associated with regional LV dysfunction, especially diastolic dysfunction.

Adult↗

Improved myocardial tagging contrast in cine balanced SSFP images.

PURPOSE: To improve the tag persistence throughout the whole cardiac cycle by providing a constant tag-contrast throughout all the cardiac phases when using balanced steady-state free precession (bSSFP) imaging. MATERIALS AND METHODS: The flip angles of the imaging radiofrequency pulses were optimized to compensate for the tagging contrast-to-noise ratio (Tag-CNR) fading at later cardiac phases in bSSFP imaging. Complementary spatial modulation of magnetization (CSPAMM) tagging was implemented to improve the Tag-CNR. Numerical simulations were performed to examine the behavior of the Tag-CNR with the proposed method, and to compare the resulting Tag-CNR with that obtained from the more commonly used spoiled gradient echo (SPGR) imaging. A gel phantom, as well as five healthy human volunteers, were scanned on a 1.5T scanner using bSSFP imaging with and without the proposed technique. The phantom was also scanned with SPGR imaging. RESULTS: With the proposed technique, the Tag-CNR remained almost constant during the whole cardiac cycle. Using bSSFP imaging, the Tag-CNR was about double that of SPGR. CONCLUSION: The tag persistence was significantly improved when the proposed method was applied, with better Tag-CNR during the diastolic cardiac phase. The improved Tag-CNR will support automated tagging analysis and quantification methods.

Adult↗

Real-time imaging of regional myocardial function using fast-SENC.

A technique for fast imaging of regional myocardial function using a spiral acquisition in combination with strain-encoded (SENC) magnetic resonance imaging (MRI) is presented in this paper. This technique, which is termed fast-SENC, enables scan durations as short as a single heartbeat. A reduced field of view (FOV) without foldover artifacts was achieved by localized SENC, which selectively excited the region around the heart. The two images required for SENC imaging (low- and high-tuning) were acquired in an interleaved fashion throughout the cardiac cycle to further shorten the scan time. Regional circumferential contraction and longitudinal shortening of both the left ventricle (LV) and right ventricle (RV) were examined in long- and short-axis views, respectively. The in vivo results obtained from five human subjects and five infarcted dogs are presented. The results of the fast-SENC technique in a single heartbeat acquisition were comparable to those obtained by conventional SENC in a long acquisition time. Therefore, fast-SENC may prove useful for imaging during stress or arrhythmia.

Animals↗

Correction of through-plane deformation artifacts in stimulated echo acquisition mode cardiac imaging.

Attempts to use a stimulated echo acquisition mode (STEAM) in cardiac imaging are impeded by imaging artifacts that result in signal attenuation and nulling of the cardiac tissue. In this work, we present a method to reduce this artifact by acquiring two sets of stimulated echo images with two different demodulations. The resulting two images are combined to recover the signal loss and weighted to compensate for possible deformation-dependent intensity variation. Numerical simulations were used to validate the theory. Also, the proposed correction method was applied to in vivo imaging of normal volunteers (n = 6) and animal models with induced infarction (n = 3). The results show the ability of the method to recover the lost myocardial signal and generate artifact-free black-blood cardiac images.

Animals↗

An integrated system for real-time detection of stiff masses with a single compression.

An integrated system is proposed for real-time imaging of tissue deformation in response to externally applied mechanical compression. The purpose of the system is to noninvasively detect tissue lesions based on their stiffness. The method includes applying external compression to the examined subject and acquiring magnetic resonance strain-encoded images using a real-time pulse sequence. In the proposed system, only a single compression is necessary to obtain a two-dimensional map of tissue deformation in a slice, eliminating the need for a complicated compressing device. The system was built and validated using phantom experiments.

Compressive Strength↗

The effect of intra-aortic balloon counterpulsation on left ventricular functional recovery early after acute myocardial infarction: a randomized experimental magnetic resonance imaging study.

AIMS: We sought to determine whether intra-aortic balloon pump (IABP) counterpulsation improves the recovery of left ventricular (LV) systolic function after reperfused acute myocardial infarction (AMI). METHODS AND RESULTS: Fourteen dogs underwent 90-min coronary artery occlusion followed by reperfusion. Seven animals were randomized to IABP counterpulsation immediately after reperfusion. Tagged, cine, and contrast-enhanced magnetic resonance imaging were used for regional and global LV functional assessment and MI characterization, respectively. Image acquisition was performed at 1 h, 6 h, and 24 h after reperfusion, during which the IABP device was paused. Animals randomized to IABP demonstrated an earlier improvement of LV ejection fraction when compared with controls (25+/-3 vs. 25+/-2% at 1 h, P=0.91; 36+/-3 vs. 26+/-2% at 6 h, P=0.015; and 38+/-3 vs. 35+/-1% at 24 h, P=0.34). Regional functional analyses revealed the same behaviour among non-infarcted risk regions, i.e., earlier circumferential systolic strain improvement in the IABP group than in controls (-5.4+/-0.4 vs. -5.3+/-0.5% at 1 h, P=0.86; -12.1+/-1.0 vs. -6.0+/-0.4% at 6 h, P<0.001; and -13.9+/-1.1% vs. -12.8+/-0.6% at 24 h, P=0.40). Importantly, however, the degree of LV functional recovery 24 h after reperfusion was similar whether IABP counterpulsation was used or not. CONCLUSION: IABP counterpulsation accelerates but does not significantly improve the recovery of LV systolic function after reperfused AMI.

Animals↗

Does subclinical hypothyroidism affect cardiac pump performance? Evidence from a magnetic resonance imaging study.

OBJECTIVES: We sought to assess the effects of subclinical hypothyroidism (SHT) on the cardiac volumes and function. BACKGROUND: The cardiovascular system is one of the principal targets of thyroid hormones. Subclinical hypothyroidism is a common disorder that may represent "early" thyroid failure. METHODS: Thyroid profile was evaluated in 30 females with SHT and 20 matched control subjects. Left ventricular end-diastolic volume (EDV) and end-systolic volume (ESV), stroke volume (SV), cardiac index (CI), and systemic vascular resistance (SVR) were calculated by cardiac magnetic resonance (CMR). Regional greatest systolic lengthening (E1) and greatest systolic shortening (E2) were calculated by tagging CMR. RESULTS: EDV was lower in SHT than in controls (64.3 +/- 8.7 ml/m(2) vs. 81.4 +/- 11.3 ml/m(2), p < 0.001), as well as SV [corrected] (38.9 +/- 7.5 ml/m(2) vs. 52.5 +/- 6.1 ml/m(2), p < 0.001) and CI (2.6 +/- 0.5 l/[min.m(2)] vs. 3.7 +/- 0.4 l/[min.m(2)], p < 0.001). SVR [corrected] was higher in SHT (12.5 +/- 2.5 mm Hg.min/[l.m(2)] vs. 8.6 +/- 1.1 mm Hg.min/[l.m(2)], p = 0.003). The E1 was higher in controls than in SHT at the basal (p = 0.007), equatorial (p = 0.05), and apical (p = 0.008) levels, as well as E2 at the equatorial (p = 0.001) and apical (p = 0.001) levels. All parameters normalized after replacement therapy. A negative correlation between TSH and EDV (p < 0.001), SV (p < 0.001), CI (p < 0.001), and E1 at the apical level (p < 0.001) and a positive correlation between TSH and SVR (p < 0.001) and E2 at the apical level (p < 0.001) were found. CONCLUSIONS: Subclinical hypothyroidism significantly decreased cardiac preload, whereas it increased afterload with a consequent reduction in SV and cardiac output. Replacement therapy fully normalized the hemodynamic alterations.

Adult↗

Quantitative assessment of regional myocardial function with MR-tagging in a multi-center study: interobserver and intraobserver agreement of fast strain analysis with Harmonic Phase (HARP) MRI.

PURPOSE: To assess the reproducibility of Harmonic Phase (HARP) analysis of myocardial MR tagged images acquired in the Multi-Center Study of Atherosclerosis (MESA). METHODS: Using the HARP method, three independent observers performed two separate quantitative strain analyses of myocardial cine MR-tagging images blindly in 24 participants. The images were obtained in four different centers and analyzed at a single core lab. Each study comprised 3 short-axis slices subdivided in 12 segments (24 x 3 x 12 = 864 segments), each with three layers. Normal strains (circumferential [Ecc] and radial [Err]), principal strains (Lambda1, Lambda2), and the angle alpha (between Ecc-Lambda2) were calculated. Intraclass correlation coefficient (R) for peak systolic strains, and all pooled systolic and diastolic strain data were used to determine inter- and intraobserver agreement. Two observers also visually graded study quality. R values were related to the image quality in different myocardial regions and layers. RESULTS: Overall, HARP yielded an excellent inter- and intraobserver agreement for peak systolic strain data (for Ecc, R = 0.84 and 0.89, respectively) and all systolic pooled data (for Ecc, interobserver R = 0.82, intraobserver R = 0.69-0.76). Both inter and intraobserver agreement were lower for diastolic pooled data (R = 0.69 and 0.58-0.62, respectively). There was a direct relationship between image quality and performance of the HARP analysis, with increasing inter- and intraobserver R values in studies with longer tag persistence. Both inter- and intraobserver agreement were better in the anterior and septal myocardial regions, and in the midwall layer. The intraobserver agreement was similar among the three observers. CONCLUSION: Employing the HARP method for quantitative strain analysis of myocardial MR tagged images provides a high inter- and intraobserver agreement. These good results are obtained in case of good to excellent MR image quality.

Aged↗

Fast tracking of cardiac motion using 3D-HARP.

Magnetic resonance (MR) tagging is capable of accurate, noninvasive quantification of regional myocardial function. Routine clinical use, however, is hindered by cumbersome and time-consuming postprocessing procedures. We propose a fast, semiautomatic method for tracking three-dimensional (3-D) cardiac motion from a temporal sequence of short- and long-axis tagged MR images. The new method, called 3-D-HARmonic Phase (3D-HARP), extends the HARP approach, previously described for two-dimensional (2-D) tag analysis, to 3-D. A 3-D material mesh model is built to represent a collection of material points inside the left ventricle (LV) wall at a reference time. Harmonic phase, a material property that is time-invariant, is used to track the motion of the mesh through a cardiac cycle. Various motion-related functional properties of the myocardium, such as circumferential strain and left ventricular twist, are computed from the tracked mesh. The correlation analysis of 3D-HARP and FINDTAGS + Tag Strain(E) Analysis (TEA), which are well-established tag analysis techniques, shows that the regression coefficients of circumferential strain (E(CC)) and twist angle are r2 = 0.8605 and r2 = 0.8645, respectively. The total time required for tracking 3-D cardiac motion is approximately 10 min in a 9 timeframe tagged MRI dataset and has the potential to be much faster.

Algorithms↗

Late systolic onset of regional LV relaxation demonstrated in three-dimensional space by MRI tissue tagging.

Left ventricular (LV) relaxation entails myocardial deformation that induces LV filling. Yet, the precise mechanisms of the earliest changes in tissue properties that characterize myocardial relaxation remain incompletely understood. Ten healthy volunteers (seven males), 25-43 yr, underwent tagged and cine MRI with high temporal resolution (25-35 ms). Normal strains including radial (E(rr)), circumferential (E(cc)), and longitudinal (E(ll)) strains, shear strains including E(cl) (circumferential-longitudinal), E(cr) (circumferential-radial), and E(rl) (radial-longitudinal), and principal strains (E(1), E(2), and E(3)) were calculated using a displacement field-fitting method. Temporal changes in angular strains indicative of shear and torsion release and normal strains were studied during late systole and early relaxation. The onset of individual relaxation strains was heterogeneous relative to LV filling. Shear strains (E(cr), E(rl), and E(cl)) and radial thinning were first to develop. Times of onset of E(cr), E(rl), E(cl), and E(rr) occurred 108, 93, 67, and 73 ms before aortic valve closure, respectively. E(ll), E(cc), and LV volume change commenced significantly later after the onset of diastolic shear strains and radial thinning. The onset of E(cc), E(ll), and LV volume change was noted 38 ms before aortic valve closure (P < or = 0.05 relative to the onset of shear strains and E(rr)). Myocardial relaxation is characterized by a three-dimensional unfolding deformation that includes release of torsion, shear, and radial thinning beginning before aortic valve closure. This unfolding pattern precedes longitudinal and circumferential elongation and may facilitate early diastolic filling.

Adult↗

Comparison between tagged MRI and standard cine MRI for evaluation of left ventricular ejection fraction.

Global left ventricular function is a prognostic indicator and is used to evaluate therapeutical interventions in patients with heart failure. Regional left ventricular function can be determined with tagged MRI. Assessment of global left ventricular function using the tagging data may have additional clinical value without incurring extra scanning time, which is currently a limiting factor in cardiac imaging. Direct determination of end-diastolic volume is not possible with conventional tagged MRI. However, end-systolic volume can be directly measured because myocardium-blood contrast improves through a tagged image series. We investigated the potential of tagged MRI using frequency-domain analysis software to retrospectively track end-diastolic contour from end-systolic contour and subsequently calculate the ejection fraction. Tagged MRI was compared with the standard bright-blood cine MRI in healthy volunteers ( n=20) and patients with previous myocardial infarction ( n=8). Left ventricular ejection fraction derived from tagged MRI is linearly correlated to left ventricular ejection fraction obtained by standard cardiac cine MRI ( y=1.0 x+1.31, r>0.98, p=0.014). In addition, the inter-observer and intra-observer coefficient of variation for left ventricular ejection fraction measurements was low (CV(intra)=0.4%, CV(inter)=1.3%). With tagged MRI, only end-systolic volume needs to be manually determined, and accurate estimation of left ventricular ejection fraction is obtained because end-diastolic and end-systolic volumes are determined using identical anatomical points. Our data indicate that tagged MRI can be used to quantitatively assess both regional and global left ventricular function. Therefore, tagged MRI may be a valuable clinical tool for determining the prognosis and evaluating the effect of therapeutical intervention using a single imaging session in patients with left ventricular dysfunction.

Humans↗

Persistent diastolic dysfunction despite complete systolic functional recovery after reperfused acute myocardial infarction demonstrated by tagged magnetic resonance imaging.

AIMS: This study was designed to characterise both the systolic and diastolic mechanical properties of regions with different degrees of myocardial ischaemic injury after reperfused acute myocardial infarction (AMI). METHODS AND RESULTS: Fourteen dogs underwent 90-min coronary artery occlusion followed by reperfusion. Image acquisition was performed 24 h after reperfusion using three techniques: tagged, first-pass perfusion and delayed-enhancement magnetic resonance imaging (MRI). Systolic circumferential strain and both systolic and diastolic strain rates were calculated in 30 segments/animal. Transmural AMI segments displayed reduced systolic contractility when compared to subendocardial AMI segments (systolic strain = -2.5 +/- 0.5% versus -6.0 +/- 0.9%, P < 0.01 and systolic strain rate = -0.11 +/- 0.12 versus -0.82 +/- 0.16 s(-1), P < 0.01), and both exhibited significant systolic and diastolic dysfunction compared to remote. Moreover, AMI segments presenting with microvascular obstruction ("no-reflow") displayed further compromise of systolic and diastolic regional function (P < 0.05 for both). Importantly, risk region segments only exhibited diastolic impairment (diastolic strain rate = 1.62 +/- 0.14 versus 2.99 +/- 0.13 s(-1), P < 0.001), but not systolic dysfunction compared to remote 24 h after reperfusion. CONCLUSION: Reversibly injured regions can demonstrate persistent diastolic dysfunction despite complete systolic functional recovery after reperfused AMI. Moreover, the presence of no-reflow entails profound systolic and diastolic dysfunction. Finally, tagged magnetic resonance imaging (MRI) strain rate analysis provides detailed mechanical characterisation of regions with different degrees of myocardial ischaemic injury.

Animals↗

Regenerating MR tagged images using harmonic phase (HARP) methods.

Magnetic resonance tagging has proven useful in the visualization and quantification of cardiac motion. Traditionally, tags are designed to have crisp geometric profiles in order to enhance both visualization and detection of tags. Recent image acquisition and analysis methods, however, have been designed to exploit sinusoidal tag profiles. This paper presents a method based on harmonic phase (HARP) concepts to synthesize tag lines that have both crisp profiles and alternative orientations from the original sinusoidal patterns. Results are demonstrated on images acquired with SPAMM, CSPAMM, and fast-HARP pulse sequences.

Algorithms↗

Spatially resolved imaging of myocardial function with strain-encoded MR: comparison with delayed contrast-enhanced MR imaging after myocardial infarction.

Strain-encoded magnetic resonance (MR) imaging was prospectively evaluated for direct imaging of systolic myocardial strain and compared with cross-registered delayed contrast material-enhanced MR imaging in five healthy volunteers and nine patients with infarction. Local contractile performance was decreased in infarcted myocardium versus that in remote and adjacent myocardium (P < .01) and in adjacent versus remote myocardium (P < .05). The extent of dysfunctional myocardium, as assessed with strain-encoded MR imaging, was greater than that of hyperenhancement, as assessed with delayed contrast-enhanced MR imaging (P < .05). Strain values obtained with strain-encoded MR imaging were strongly correlated with those obtained with three-dimensional tagged MR imaging (r = 0.75, P < .001). Strain-encoded MR imaging provides spatially resolved (1.5 x 2.5-mm) imaging and measurement of myocardial strain in humans without the need for postprocessing, which may improve routine comprehensive evaluation of myocardial viability.

Female↗

Quantitative ischemia detection during cardiac magnetic resonance stress testing by use of FastHARP.

BACKGROUND: Because ECG alterations caused by ischemia cannot be reliably detected in the high-field MRI environment, detection of wall motion abnormalities is often used to ensure patient safety during stress testing. However, an experienced observer is needed to detect these abnormalities. In this study, we investigate the use of fast harmonic phase (FastHARP) MRI for the quantitative, operator-independent detection of the onset of ischemia during acute coronary occlusion. METHODS AND RESULTS: Eight mongrel dogs underwent an acute 2-minute closed-chest coronary artery occlusion while continuous FastHARP images were acquired. Full regional wall strain was determined every other heartbeat in a single short-axis imaging slice. After 5 minutes of reperfusion, a second 2-minute ischemic episode was induced during the acquisition of conventional cine wall-motion images. The time at which ECG alterations were observed during the first ischemic period was recorded. The time from occlusion to the detection of ischemia, based on a consensus of 2 blinded observers, was determined for MRI. No significant ischemia was present in 2 animals. In the remaining animals, the onset of ischemia was detected significantly earlier by FastHARP than by cine MRI (9.5+/-5 versus 33+/-14 seconds, P<0.01). HARP ischemia detection preceded ECG changes, on average, by 54 seconds. CONCLUSIONS: The rapid acquisition and detection of induced ischemia with FastHARP MRI shows promise as a nonsubjective method to diagnose significant coronary lesions during MR stress testing.

Animals↗

Detecting stiff masses using strain-encoded (SENC) imaging.

A method is proposed for detecting stiff masses using strain-encoded (SENC) magnetic resonance imaging (MRI). An object of interest is compressed to produce local strain distribution that depends on local elasticity, where intensities correlate with the local through-imaging-plane strain component. Because the strain is lower inside a stiff mass than in the surrounding soft tissue, an intensity contrast in the resulting images would enable direct detection of the mass without postprocessing. The technique was validated by a phantom experiment in which a gel phantom with a stiff region was used. The advantages of the proposed method include short imaging time and uncomplicated postprocessing. However, in its current form the technique does not measure elasticity.

Magnetic Resonance Imaging↗

Real-time imaging of two-dimensional cardiac strain using a harmonic phase magnetic resonance imaging (HARP-MRI) pulse sequence.

The harmonic phase (HARP) method provides automatic and rapid analysis of tagged magnetic resonance (MR) images for quantification and visualization of myocardial strain. In this article, the development and implementation of a pulse sequence that acquires HARP images in real time are described. In this pulse sequence, a CINE sequence of images with 1-1 spatial modulation of magnetization (SPAMM) tags are acquired during each cardiac cycle, alternating between vertical and horizontal tags in successive heartbeats. An incrementing train of imaging RF flip angles is used to compensate for the decay of the harmonic peaks due to both T(1) relaxation and the applied imaging pulses. The magnitude images displaying coarse anatomy are automatically reconstructed and displayed in real time after each heartbeat. HARP strain images are generated offline at a rate of four images per second; real-time processing should be possible with faster algorithms or computers. A comparison of myocardial contractility in non-breath-hold and breath-hold experiments in normal humans is presented.

Adult↗