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At least 91 records · Page 5Linked to original sources

The digital computer in medical imaging: a critical review.

The present use of computers in radiology is reviewed. The major functions of a fully digital radiology department are described as (a) control and management, (b) image acquisition, (c) image distribution, (d) image interpretation, (e) image redisplay, and (f) image archiving. In addition, the benefits of a fully digital department and the problems that must be solved before it can be achieved are discussed.

Computers↗

Noninvasive quantitation of blood flow turbulence in patients with aortic valve disease using online digital computer analysis of Doppler velocity data.

Previous experimental studies have demonstrated that aortic valve disease is associated with significant downstream turbulence (T). In this study, we developed a noninvasive method on the basis of Doppler velocity recording for quantitating aortic blood flow T in patients with aortic valve disease. The instantaneous blood velocity at a point in the aorta is equal to the sum of a mean periodic velocity component with a random or turbulent velocity component. According to the ensemble average method, time mean absolute T intensity is the root-mean-square value of turbulent velocity averaged over time and T is better quantitated by the relative T intensity (TIr), which is the ratio of absolute T intensity to the ensemble average velocity averaged over time. We computed TIr in 18 patients with mild to severe aortic stenosis and in 13 healthy volunteers from instantaneous modal velocities of 70 cycle length-matched heart beats recorded in the proximal part of the descending aorta by pulsed Doppler using an ultrasound system with an output port for online digital data transfer into a microcomputer. TIr was greater in patients with aortic valve disease (18.4 +/- 5.1%, range 11.2%-28.9%) than in control patients (7.9 +/- 1.9%, range 4.8%-9.8%; P =.0001). In patients with aortic valve disease, TIr was better linearly related to the ratio of postvalvular aorta to valvular orifice cross-sectional areas (r = 0.89, P =.0001) than to other parameters of valve restriction: transvalvular pressure gradient (r = 0.78, P =.0001); valve area (r = -0.56, P =.01); and valve resistance (r = 0.72, P =.0002). Thus, T that can be computed noninvasively from direct digital transfer of Doppler velocity data appears to be linearly related to indices of aortic valve restriction. Our data support the concept of the postvalvular aorta to valvular orifice cross-sectional areas ratio as a new important hemodynamic parameter in patients with aortic valve disease.

Adult↗

Quantitative coronary arteriography: estimation of dimensions, hemodynamic resistance, and atheroma mass of coronary artery lesions using the arteriogram and digital computation.

More accurate characterization of coronary artery lesions is needed for evaluation of short and long-term interventions in coronary disease. A method of segmental artery analysis has been developed to maximize the information obtained from coronary arteriograms. Coronary lesions are traced from two projected, perpendicular, 35 mm cineangiographic views and transmetted, in digital form, to a PDP 11/45 computer. Magnification and distortion of the image are compensated for in order to determine the actual vessel profiles, using the catheter and its location as a scaling device. The two views are matched; a spatial representation of the vessel centerline is constructed mathematically; and orthogonal vessel diameters are computed at increments along this centerline. Assuming an elliptical lumen, the absolute and percentage reduction in diameter and cross-sectional area in the stenosis are computed. More complex functions (integrated atheroma mass, Poiseuille resistance, and orifice resistance) are then calculated. The accuracy and variability of the different steps involved in lesion analysis have been determined. Dimensional accuracies of +/- 150 microns (SD) are feasible. Examples are given of patients with Prinzmetal's angina and with progressive coronary disease.

Adult↗

Determination of the existence of hinge movements of the temporomandibular joint during normal opening by Cine-MRI and computer digital addition.

PURPOSE: The purpose of the first phase of this two-part investigation was to determine if the opening motion of the mandible could be illustrated and described using a dynamic imaging method. The purpose of the second phase of the investigation was to determine if a center of rotation would be discovered. MATERIALS AND METHODS: Five volunteer subjects, 2 female and 3 male, whose temporomandibular joints had previously been determined to be asymptomatic, were examined by magnetic resonance imaging (MRI) during opening from a standardized position. The serial static images were reconstructed by the MRI's computer in "cine mode" to simulate dynamic motion, similar to a motion picture. For the second phase, each patient's series of static images were digitally added and manipulated by a computer graphics program to locate the center of hinge motion. RESULTS: After reviewing the animated images recorded on videotape, three independent dentist observers confirmed that the opening movement of the mandible was initially rotational, followed by translation within the glenoid fossa. A center of rotation was calculated to be in the anatomic center of the condylar head of all of the subjects in this study. CONCLUSIONS: This study showed that opening dynamics of the mandibular condyle could be studied by cine-MRI and that an opening hinge axis appears to be located in the anatomic center of the condylar head.

Biomechanical Phenomena↗

On-line cardiac output by digital computer.

Many devices for fast cardiac output calculations employ special assumptions and departures from the Stewart-Hamilton method. These assumptions and departures can cause substantial errors. This publication describes an on-line computer system for evaluating dye-dilution curves according to the classical Stewart-Hamilton method. Dilution curves are smoothed, using a digital filter to eliminate heartbeat noise. Recirculation is removed using the constant ratio property of exponentials. The quality of the curves is evaluated by determining the length of the base line, the extent and the fit to an exponential downslope, and a figure of merit based on the five tanks-in-series model. Dilution curves, the logarithmic form, and the exponential ratios are displayed on a CRT for visual checks. Comparison of cardiac outputs obtained by this on-line system with results obtained by hand calculations showed a mean difference of 150 ml. Repeated evaluation of one electronically simulated dye curve resulted in SD = 10 ml for computer results and SD = 200 ml for hand calculations.

Animals↗

Animated visualization of a high resolution color three dimensional digital computer model of the whole human head.

The interactive visualization of animated images through a computerized three dimensional (3D) full color model of an unstained cadaveric human head is presented. Serial full color images were taken of the blockface of a cryomicrotomed frozen human head every 200 microns. From this series of images a three dimensional digital model with a resultant pixel resolution of 200 microns3 was created on a UNIX workstation. Using this database, resampled images were computed along orthogonal axes and written sequentially to a write-once-read-many times (WORM) videodisc unit. Playback of this customized videodisc dataset provides animations of the digitally reconstructed slices and 3D reconstructed surface models. An interactive interface to the animated sequences is provided through a PC based tutorial package. This tutorial program is able to access videodisc frames to display animations and labeled still images in a software window to illustrate various neuroanatomic topics. The technique of animation as applied to this high resolution 3D model provides insight into complex spatial relationships and has great potential in research and as a teaching tool in the neurosciences.

Brain↗

Determination of the most appropriate velocity threshold for applying hemispheric flow convergence equations to calculate flow rate: selected according to the transorifice pressure gradient. Digital computer analysis of the Doppler color flow convergence region.

BACKGROUND: While flow convergence methods have been promising for calculating volume flows from color Doppler images, it appears that the velocity threshold used and the transorifice pressure gradient dramatically influence the accuracy of application of the simple hemispheric flow convergence equation for calculation of flow rate. The present in vitro study was performed to determine whether the value of velocity threshold at which the shape of proximal isovelocity surface best fits given shape assumptions with different orifice sizes and flow rates is predictable as a function independent of orifice size from clinically measurable peak velocity or transorifice pressure gradient information. METHODS AND RESULTS: In an in vitro model built to facilitate ultrasound imaging, steady flow was driven through circular discrete orifices with diameters of 3.8, 5.5, and 10 mm. Flow rates ranged from 2.88 to 8.28 L/min with corresponding driving pressure gradients from 14 to 263 mm Hg. At each flow rate, Doppler color-encoded M-mode images through the center of the flow convergence region were obtained and transferred into the microcomputer (Macintosh IIci) in their original digital format. Then, the continuous wave Doppler traces of maximal velocity through the orifice were derived for the calculation of driving pressure gradient. Direct numerical spatial velocity measurements were obtained from the digital color encoded M-mode velocities with computer software. For each flow rate, we could calculate flow volume from any number of velocity distance combinations with a number of assumptions and use the results to assess expected flow convergence shape based on a priori knowledge of the progression from oblate hemispheroid to hemisphere to prolate hemispheroid changes observed previously. Our results showed that for a given ratio of calculated flow rate to actual flow rate (0.7 and 1), the velocity threshold that could be used for the calculation of flow rate with a hemispheric flow convergence equation correlated well with the pressure gradient for a given orifice size, and the differences in velocity threshold that could be used this way among different orifice sizes once they were adjusted for the covariate pressure gradients were not statistically significant (P = .79 for ratio = 0.7, and P = .81 for ratio = 1). CONCLUSIONS: Our present study provides an orifice size-independent quantitative method that can be used to select the most suitable velocity threshold for applying a simple hemispheric flow convergence equation based on clinically predictable pressure gradients ranging from 40 to 200 mm Hg, and it offers a correction factor that can be applied to the hemispheric flow convergence equation when the pressure gradient is less than 40 mm Hg.

Blood Flow Velocity↗

Digital computer analysis of M-scan echocardiograms.

In the past few years, echocardiography has emerged as a useful noninvasive clinical tool in cardiac diagnosis. Conventional methods for analyzing echocardiographic data involve time consuming and tedious manual techniques for measuring various distances and computing cardiac parameters of interest. This paper describes a useful method for automating the analysis of M scan echocardiograms both for routine clinical work as well as for special research oriented ultrasonic cardiac studies. Using a GRAF/PEN digitizer interfaced to a PDP-11 minicomputer system, relevant points of the ventricular and mitral valve interfaces, R-R intervals, and time and distance calibration points are entered from hard copies of M scan echocardiograms. The computer then determines all the parameters of interest such as left ventricular (LV) diameters, LV volumes, LV mass, ejection fraction, stroke volume, cardiac output, septal and posterior wall dynamics, as well as such mitral valve (MV) parameters as opening/closing velocities, excursions, and areas subtended by both MV leaflets. The data and results are stored on disc or tape and a report of the results is immediately available from a printer for incorporation into the patient's record file.

Diagnosis, Computer-Assisted↗