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Biomedical subjects

Raja Muthupillai

Publications and source records attributed to Raja Muthupillai.

At least 19 recordsLinked to original sources

Automatic identification of the left ventricle in cardiac cine-MR images: dual-contrast cluster analysis and scout-geometry approaches.

PURPOSE: To evaluate the technical feasibility of two approaches--dual-contrast (DC) cluster analysis, and scout geometry (SG)--for automatic identification of the left ventricular (LV) cavity in short-axis (SA) cine-MR images. MATERIALS AND METHODS: The DC algorithm uses Fuzzy C-Means (FCM) cluster analysis of SA images from a black-blood double-inversion recovery turbo spin-echo (dual IR TSE) sequence, and bright-blood images from a steady-state free precession (SSFP) sequence. The SG algorithm employs geometric information from scout views (i.e., vertical long-axis (VLA) and four-chamber (4CH) views). Both algorithms incorporate additional geometric continuity constraints along with LV region segmentation to identify the LV. The performance of both algorithms was compared on images of eight healthy volunteers, and the SG algorithm was further evaluated on images of 13 clinical patients. RESULTS: The DC algorithm identified the LV in 89% (72/75 at end-diastole (ED) and 47/59 at end-systole (ES)) of the images from healthy volunteers, compared to 98% (74/75 at ED and 57/59 at ES) by the SG algorithm. Both methods are robust against interslice signal variations and misalignment. The DC method suffers from misregistration between the dual IR TSE and SSFP images near the apex at ES. The SG method identified the LV in 91% (112/122 at ED and 91/102 at ES) of the images from clinical patients. CONCLUSION: The SG method requires no additional scan, is robust and accurate, and performs better than the DC method for automatic identification of the LV.

Adult↗

Utilizing SENSE to reduce scan duration in high-resolution contrast-enhanced renal MR angiography.

PURPOSE: To evaluate the use of sensitivity encoding (SENSE) to reduce scan time and decrease detrimental artifacts arising from motion and bolus profile effects during contrast-enhanced MR angiography (CE-MRA) of the renal arteries (RAs). MATERIALS AND METHODS: A direct comparison of conventional and SENSE (acceleration factor 2) CE-MRA protocols was performed on 20 patients. Each patient underwent both scans. Both protocols achieved the same resolution, but the SENSE protocol was 50% faster and utilized a faster injection than the conventional scan. Three radiologists graded the images for image quality, artifact levels, and reader confidence. RESULTS: While the signal-to-noise ratio (SNR) decreased (26+/-5 vs. 30+/-10; P=0.04) with the SENSE protocol, the image-quality scores for four identified segments of the RAs increased or were unchanged. The largest improvements in image quality occurred in the more distal segments of the RAs. Parenchymal ringing (P=0.005) and RA blurring (P=0.006) were significantly reduced, and there was a trend toward improvement of RA ringing despite the increased injection rate. CONCLUSION: The faster SENSE scan maintained nearly the same SNR (due to faster injection of Gd-chelate), reduced artifact levels, and improved image quality ratings for the distal renal vessels.

Aged↗

Tissue characterization of myocardial infarction using T1rho: influence of contrast dose and time of imaging after contrast administration.

PURPOSE: To determine whether contrast between acutely infarcted and normal myocardia in T1-rho-weighted cine TFE (T1rho-TFE) and delayed-enhancement (DE) images (measured using a metric percent enhancement (PE)) varied with the dose or time of imaging after contrast administration. MATERIALS AND METHODS: Eighteen patients with acute myocardial infarction (AMI) were randomly divided into three groups according to the dose of gadoversetamide (0.1, 0.2, or 0.3 mmol/kg) administered. After contrast administration, T1rho-TFE images were acquired at five and 40 minutes, and DE images were acquired at 10 and 30 minutes. RESULTS: For T1rho-TFE imaging the PE values at 40 minutes were 70+/-14, 98+/-14, and 105+/-41 at 0.1, 0.2, and 0.3 mmol/kg dose levels, which were significantly greater than the corresponding PEs at five minutes after contrast administration (44+/-12, 71+/-14, and 36+/-13). For DE and T1rho-TFE imaging the dose of contrast agent did not significantly affect the PE. However, with DE the PE tended to increase with the dose. At all dose levels, irreversible injury was more conspicuous in T1rho-TFE images acquired at 40 minutes than at five minutes after contrast. CONCLUSION: In T1rho-TFE, acute infarction was more conspicuous in images acquired at a later time point, and the PE did not vary with the contrast dose.

Contrast Media↗

Automated left ventricular segmentation in cardiac MRI.

We present an automated left ventricular (LV) myocardial boundary extraction method. Automatic localization of the LV is achieved using a motion map and an expectation maximization algorithm. The myocardial region is then segmented using an intensity-based fuzzy affinity map and the myocardial contours are extracted by cost minimization through a dynamic programming approach. The results from the automated algorithm compared against the experienced radiologists using Bland and Altman analysis were found to have consistent mean bias of 7% and limits of agreement comparable to the inter-observer variability inherent in the manual method.

Adult↗

SENSE or k-MAG to accelerate free breathing navigator-guided coronary MR angiography.

OBJECTIVE: The purpose of this study was to assess the relative merits of reducing the scanning time of navigator-guided (NAV) coronary MR angiography by including, both independently and in combination, two time-saving strategies: k-space weighted motion-adapted gating (k-MAG) and sensitivity encoding (SENSE, factor = 2). SUBJECTS AND METHODS: Coronary arteries of 21 healthy subjects were imaged with four NAV MR angiography sequences: conventional NAV sequence, NAV with the addition of SENSE, NAV with the addition of k-MAG, and NAV with a combination of SENSE and k-MAG. All imaging parameters including the magnetization preparation schemes, prescribed spatial resolution, and acquisition duration per R-R interval were identical for all techniques. The total scanning time, navigator efficiency, visible length of the coronary artery, and subjective image quality were used as metrics for evaluating the performance of the techniques. RESULTS: The results show that the addition of k-MAG to NAV coronary MR angiography (with or without SENSE) improved scan efficiency and decreased scanning time by an average of 17% without compromising the length of coronary artery visible or the image quality. The addition of SENSE to the NAV technique (with or without k-MAG) reduces the scanning time by an average of 50%. CONCLUSION: While the average image quality of coronary arteries was unaffected by the addition of k-MAG to navigator techniques, there was a slight reduction in image quality scores for the navigator sequence with SENSE. Identification of the proximal coronary arteries was not hampered by the addition of k-MAG, SENSE, or both to the NAV coronary MR angiography sequence.

Adult↗

Fast 3D cine steady-state free precession imaging with sensitivity encoding for assessment of left ventricular function in a single breath-hold.

OBJECTIVE: This study compares single breath-hold 3D cine steady-state free precession (SSFP) MRI using sensitivity encoding (SENSE) with standard 2D cine SSFP imaging in the quantitative evaluation of global left ventricular (LV) function. MATERIALS AND METHODS: The LV function of 22 healthy volunteers and 15 patients was evaluated using a standard 2D SSFP sequence and a 3D SSFP sequence with SENSE at 1.5 T. Ventricular volume, ejection fraction, and LV mass were calculated with each method, and signal-to-noise ratios (SNRs) and myocardium-to-blood contrast-to-noise ratios (CNRs) were measured. Agreement between the two methods was assessed using Bland-Altman analysis, and results were compared using a paired Student's t test (p < 0.05). The local institutional review board approved the study protocol, and all participants gave signed informed consent. The study complied with the Health Insurance Portability and Accountability Act. RESULTS: Both techniques produced similar estimates of ejection fraction (mean bias +/- SD, -1.2% +/- 3.6%) and LV mass (mean bias, +/- SD-1.2 +/- 10.9 g). No significant differences were found in calculated volumes, ejection fraction, or LV mass between the two methods. Acquisition time was reduced by 82%, to a single breath-hold (18 +/- 3 seconds), with the 3D SSFP technique. SNR and CNR were significantly lower with the 3D method than with the standard method. CONCLUSION: Three-dimensional SSFP imaging with SENSE can reduce acquisition time to a single breath-hold and can provide LV function quantification comparable to that obtained with conventional 2D SSFP imaging.

Adult↗

Quantitative assessment of left ventricular function: steady-state free precession MR imaging with or without sensitivity encoding.

Quantitative left ventricular (LV) function was assessed with magnetic resonance imaging in 20 patients by using standard multisection multiphase steady-state free precession (SSFP) imaging and sensitivity encoding (SENSE)-accelerated cine SSFP imaging with identical spatial, contrast, and temporal resolution. The local institutional review board approved the protocol, and all patients gave signed informed consent prior to imaging. The study complied with the Health Insurance Portability and Accountability Act. Results of Bland-Altman analysis showed that both techniques produced similar estimates of LV ejection fraction, LV mass, and blood-to-muscle contrast and demonstrated minimal interobserver variability. The authors showed that it is possible, by combining SENSE with cine SSFP imaging, to reduce acquisition time by 50% without compromising spatial resolution, temporal resolution, or blood-to-muscle contrast-to-noise ratio compared with those achieved by using SSFP imaging without SENSE for quantitative LV function assessment.

Adult↗

Usefulness of real-time navigator magnetic resonance imaging for evaluating coronary artery origins in pediatric patients.

Navigator coronary magnetic resonance imaging (MRI) was evaluated in assessing coronary artery origins in a pediatric and adolescent population. Sixty-five consecutive infants, children, or adolescents (age range 11 days to 21 years) were referred for MRI evaluations to assess coronary artery origins. Coronary artery origins were unambiguously delineated in 62 of 65 patients. In 3 patients, irregular arrhythmias precluded cardiac gating of the magnetic resonance acquisition. Two patients had anomalous coronary artery origins detected. Twenty-six patients required sedation for the studies. Free-breathing 3-dimensional MRI with real-time navigator correction is a robust method for delineating the coronary artery origins in pediatric and adolescent patients.

Adolescent↗

Acute myocardial infarction: tissue characterization with T1rho-weighted MR imaging--initial experience.

Acute myocardial injury was evaluated in 21 patients by using a contrast material-enhanced T1rho-weighted cine turbo field-echo magnetic resonance (MR) imaging sequence and a delayed-enhancement sequence. In 12 of 21 patients, conventional T1-weighted contrast-enhanced cine turbo field-echo MR images were also collected for direct comparison with T1rho-weighted images. Delayed-enhancement technique distinctly characterized irreversible injury (percentage enhancement, 588% +/- 344). With T1rho weighting, percentage enhancement of irreversibly injured myocardium was 68% +/- 41, compared with 23% +/- 24 without T1rho weighting (P <.006). The addition of T1rho weighting to contrast-enhanced cine turbo field-echo MR sequences may offer a new contrast enhancement mechanism for characterization of acutely infarcted myocardium.

Adult↗

Coronary artery magnetic resonance angiography.

Coronary magnetic resonance angiography (coronary MRA) continues to advance rapidly from both a technical and clinical perspective. Coronary MRA has benefited directly from improvements in spatial resolution, contrast definition, and advances in motion correction, which have furthered its routine use in evaluating coronary artery bypass grafts and anomalous coronary arteries. Work in refining the techniques for more accurate identification of coronary artery disease (CAD) continues, with advances in navigator-gated and breath-hold motion correction techniques, novel k-space strategies (e.g., spiral and radial k-space filling), development and application of intravascular contrast agents, and imaging at higher field strengths. Ultimately, these developments may lead to the routine application of coronary MRA as a screening tool for CAD. This article reviews the development of coronary MRA, discusses the requirements and tools necessary for optimal visualization of the coronary arteries, and describes the application of coronary MRA to acquired and congenital CAD.

Coronary Angiography↗

MRI measurement of hepatic magnetic susceptibility-phantom validation and normal subject studies.

A magnetic resonance (MR) imaging method with the potential for assessing hepatic iron overload from measurements of hepatic magnetic susceptibility in vivo is described. Using the blood in the portal and hepatic veins as an internal reference, this technique uses the orientation dependence of signal phase to measure the susceptibility of the liver parenchyma. Computer simulations were done to investigate the requirements on spatial resolution and contrast ratio between the vessels and the background liver tissue for data acquisition. Validation studies were conducted using tube-embedded gel phantoms doped with iron-dextran from 0 to 10 mg Fe/mL to mimic healthy and iron-overloaded livers. The phantom measurements were conducted without motion and flow, under respiration-like oscillatory motion, and with flow. Studies on six normal human subjects demonstrated excellent reproducibility and precision. All images were collected at 1.5 T using a 3D T(1)-weighted turbo field echo sequence for inflow MR angiographies with full flow compensation and capable of cardiac synchronization, navigator gating, and motion correction.

Algorithms↗

Parallel imaging in MR angiography.

The recently developed techniques of parallel imaging with phased array coils are rapidly becoming accepted for magnetic resonance angiography (MRA) applications. This article reviews the various current parallel imaging techniques and their application to MRA. The increased scan efficiency provided by parallel imaging allows increased temporal or spatial resolution, and reduction of artifacts in contrast-enhanced MRA (CE-MRA). Increased temporal resolution in CE-MRA can be used to reduce the need for bolus timing and to provide hemodynamic information helpful for diagnosis. In addition, increased spatial resolution (or volume coverage) can be acquired in a breathhold (eg, in renal CE-MRA), or in otherwise limited clinically acceptable scan durations. The increased scan efficiency provided by parallel imaging has been successfully applied to CE-MRA as well as other MRA techniques such as inflow and phase contrast imaging. The large signal-to-noise ratio available in many MRA techniques lends these acquisitions to increased scan efficiency through parallel imaging.

Contrast Media↗

Application of SENSE in clinical pediatric body MR imaging.

Pediatric body magnetic resonance imaging can be challenging because of the intrinsic physiologic motions from high respiratory and heart rates. Unlike in adults, in preadolescent children, breath holding is often not an available option. In this paper, the authors describe their clinical experience using the recently available parallel imaging technique, sensitivity encoding (SENSE), to improve on the image quality of pediatric body MR examinations. The three major areas described include rapid imaging using SENSE to achieve time-resolved contrast-enhanced MRA, improvement in single-shot turbo spin echo imaging with SENSE, and decreasing respiratory motion artifact with combination of SENSE and multiple signal averages in various pulse sequences. Some practical suggestions of using SENSE in clinical pediatric body MR examinations are highlighted. The addition of SENSE has allowed for improved image quality and more efficient overall MR examinations for pediatric body imaging.

Artifacts↗

Cardiac sarcoidosis detected by delayed-hyperenhancement magnetic resonance imaging.

We report the case of a patient with sarcoidosis and ventricular tachycardia in whom cardiac magnetic resonance imaging provided supportive evidence of cardiac involvement by delineating regions of myocardial inflammation and fibrosis inconsistent with ischemic injury. The identification of cardiac involvement in patients with sarcoidosis is problematic, and the true incidence is unknown. Cardiac magnetic resonance imaging may help establish the actual incidence of cardiac involvement and allow further advances in monitoring and treatment options.

Cardiomyopathies↗

Time-resolved contrast-enhanced magnetic resonance angiography in pediatric patients using sensitivity encoding.

PURPOSE: To evaluate the role of time-resolved contrast-enhanced magnetic resonance angiography (CE-MRA) using sensitivity encoding in imaging the thoraco-abdominal vessels in pediatric patients. MATERIALS AND METHODS: Thoraco-abdominal vessels of 22 pediatric patients (median age = 5 years) were evaluated with a 3D CE-MRA technique in combination with SENSE following a 0.2 mmol/kg injection of Gd-chelate. The acquisition parameters were as follows: TR/TE = 5/1.1 msec; flip angle = 40 degrees; in-plane phase encoding steps were reduced by a factor of 2 using sensitivity encoding (SENSE); 3D volume acquisition was repeated four to eight times consecutively during free breathing (four to eight dynamics) with a mean temporal resolution of 6.8 seconds/dynamic; and mean acquired voxel size = 1.4 x 1.7 x 3.1 mm (reconstructed as 1.4 x 1.4 x 1.55 mm). Arterial-to-venous signal intensity ratios (AVRs) were computed for each dynamic. RESULTS: All images were successfully reconstructed and were of diagnostic quality. The AVRs of prepeak, peak, and postpeak arterial volumes were 1.0 +/- 0.5, 6.1 +/- 3.3, and 1.3 +/-0.9, respectively, indicating good arterial-to-venous separation. The signal-to-noise ratio (SNR) of the peak arterial volume was 41 +/- 26. CONCLUSION: Our results suggest that it is feasible to apply SENSE to a conventional 3D CE-MRA technique in a time-resolved fashion for imaging the thoraco-abdominal vessels in pediatric patients during free breathing.

Abdomen↗

Implications of SENSE MR in routine clinical practice.

Sensitivity encoding (SENSE) uses multiple MRI receive coil elements to encode spatial information in addition to traditional gradient encoding. Requiring less gradient encodings translates into shorter scan times, which is extremely beneficial in many clinical applications. SENSE is available to routine diagnostic imaging for the past 2 years. This paper highlights the use of SENSE with scan time reduction factors up to 6 in contrast-enhanced MRA, routine abdominal imaging, mammography, cardiac and neuro imaging. It is shown that SENSE has opened new horizons in both routine and advanced MR imaging.

Contrast Media↗