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Lindström, Lena
Publications (9 of 9) Show all publications
Andersson, C., Kihlberg, J., Ebbers, T., Lindström, L., Carlhäll, C. & Engvall, J. (2016). Phase-contrast MRI volume flow - a comparison of breath held and navigator based acquisitions. BMC Medical Imaging, 16(26)
Open this publication in new window or tab >>Phase-contrast MRI volume flow - a comparison of breath held and navigator based acquisitions
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2016 (English)In: BMC Medical Imaging, ISSN 1471-2342, E-ISSN 1471-2342, Vol. 16, no 26Article in journal (Refereed) Published
Abstract [en]

Background: Magnetic Resonance Imaging (MRI) 2D phase-contrast flow measurement has been regarded as the gold standard in blood flow measurements and can be performed with free breathing or breath held techniques. We hypothesized that the accuracy of flow measurements obtained with segmented phase-contrast during breath holding, and in particular higher number of k-space segments, would be non-inferior compared to navigator phase-contrast. Volumes obtained from anatomic segmentation of cine MRI and Doppler echocardiography were used for additional reference. Methods: Forty patients, five women and 35 men, mean age 65 years (range 53-80), were randomly selected and consented to the study. All underwent EKG-gated cardiac MRI including breath hold cine, navigator based free-breathing phase-contrast MRI and breath hold phase-contrast MRI using k-space segmentation factors 3 and 5, as well as transthoracic echocardiography within 2 days. Results: In navigator based free-breathing phase-contrast flow, mean stroke volume and cardiac output were 79.7 +/- 17.1 ml and 5071 +/- 1192 ml/min, respectively. The duration of the acquisition was 50 +/- 6 s. With k-space segmentation factor 3, the corresponding values were 77.7 ml +/- 17.5 ml and 4979 +/- 1211 ml/min (p = 0.15 vs navigator). The duration of the breath hold was 17 +/- 2 s. K-space segmentation factor 5 gave mean stroke volume 77.9 +/- 16.4 ml, cardiac output 5142 +/- 1197 ml/min (p = 0.33 vs navigator), and breath hold time 11 +/- 1 s. Anatomical segmentation of cine gave mean stroke volume and cardiac output 91.2 +/- 20.8 ml and 5963 +/- 1452 ml/min, respectively. Echocardiography was reliable in 20 of the 40 patients. The mean diameter of the left ventricular outflow tract was 20.7 +/- 1.5 mm, stroke volume 78.3 ml +/- 15.2 ml and cardiac output 5164 +/- 1249 ml/min. Conclusions: In forty consecutive patients with coronary heart disease, breath holding and segmented k-space sampling techniques for phase-contrast flow produced stroke volumes and cardiac outputs similar to those obtained with free-breathing navigator based phase-contrast MRI, using less time. The values obtained agreed fairly well with Doppler echocardiography while there was a larger difference when compared with anatomical volume determinations using SSFP (steady state free precession) cine MRI.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Phase-contrast flow; Magnetic resonance imaging; Segmentation; 2D Doppler echocardiography
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-127432 (URN)10.1186/s12880-016-0128-x (DOI)000372901200001 ()27021353 (PubMedID)
Note

Funding Agencies|Swedish Heart and Lung Foundation [20120449, 20140398]; Region of Ostergotland [281281]; European Union FP 7 [223615]; Medical Research Council of Southeast Sweden [88731, 157921]

Available from: 2016-05-01 Created: 2016-04-26 Last updated: 2018-03-20Bibliographically approved
Maret, E., Brudin, L., Lindström, L., Nylander, E., Ohlsson, J. L. & Engvall, J. (2008). Computer-assisted determination of left ventricular endocardial borders reduces variability in the echocardiographic assessment of ejection fraction. Cardiovascular Ultrasound, 6(55)
Open this publication in new window or tab >>Computer-assisted determination of left ventricular endocardial borders reduces variability in the echocardiographic assessment of ejection fraction
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2008 (English)In: Cardiovascular Ultrasound, ISSN 1476-7120, E-ISSN 1476-7120, Vol. 6, no 55Article in journal (Refereed) Published
Abstract [en]

Background: Left ventricular size and function are important prognostic factors in heart disease. Their measurement is the most frequent reason for sending patients to the echo lab. These measurements have important implications for therapy but are sensitive to the skill of the operator. Earlier automated echo-based methods have not become widely used. The aim of our study was to evaluate an automatic echocardiographic method (with manual correction if needed) for determining left ventricular ejection fraction (LVEF) based on an active appearance model of the left ventricle (syngo (R) AutoEF, Siemens Medical Solutions). Comparisons were made with manual planimetry (manual Simpson), visual assessment and automatically determined LVEF from quantitative myocardial gated single photon emission computed tomography (SPECT).

Methods: 60 consecutive patients referred for myocardial perfusion imaging (MPI) were included in the study. Two-dimensional echocardiography was performed within one hour of MPI at rest. Image quality did not constitute an exclusion criterion. Analysis was performed by five experienced observers and by two novices.

Results: LVEF (%), end-diastolic and end-systolic volume/BSA (ml/m(2)) were for uncorrected AutoEF 54 +/- 10, 51 +/- 16, 24 +/- 13, for corrected AutoEF 53 +/- 10, 53 +/- 18, 26 +/- 14, for manual Simpson 51 +/- 11, 56 +/- 20, 28 +/- 15, and for MPI 52 +/- 12, 67 +/- 26, 35 +/- 23. The required time for analysis was significantly different for all four echocardiographic methods and was for uncorrected AutoEF 79 +/- 5 s, for corrected AutoEF 159 +/- 46 s, for manual Simpson 177 +/- 66 s, and for visual assessment 33 +/- 14 s. Compared with the expert manual Simpson, limits of agreement for novice corrected AutoEF was lower than for novice manual Simpson (0.8 +/- 10.5 vs. -3.2 +/- 11.4 LVEF percentage points). Calculated for experts and with LVEF (%) categorized into < 30, 30-44, 45-54 and >= 55, kappa measure of agreement was moderate (0.44-0.53) for all method comparisons (uncorrected AutoEF not evaluated).

Conclusion: Corrected AutoEF reduces the variation in measurements compared with manual planimetry, without increasing the time required. The method seems especially suited for unexperienced readers.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16221 (URN)10.1186/1476-7120-6-55 (DOI)
Available from: 2009-02-19 Created: 2009-01-09 Last updated: 2017-12-14Bibliographically approved
Åström Aneq, M., Lindström, L. & Nylander, E. (2008). Long-term follow-up in arrhythmogenic right ventricular cardiomyopathy using Tissue Doppler Imaging. Scandinavian Cardiovascular Journal, 42(6), 368-374
Open this publication in new window or tab >>Long-term follow-up in arrhythmogenic right ventricular cardiomyopathy using Tissue Doppler Imaging
2008 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 42, no 6, p. 368-374Article in journal (Refereed) Published
Abstract [en]

Aim: To study patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and describe different echocardiographic parameters and their change over time during almost 10 years follow-up period.

Methods: Fifteen patients (9 male, 6 female), aged 22-58 years (mean 40) with a diagnosis of ARVC, were followed up for a period of 6-10 years (mean 8.7). Twelve-lead and a signal- averaged ECG was recorded. Tricuspid and mitral annular motion and tissue Doppler imaging were registered by echocardiography. Wall motion score index (WMSI) was calculated for the left and right ventricles.

Results: We registered significant reduction in systolic tissue velocity on right ventricle free wall between the first and last investigations: 7-17cm/s (mean 11.8) to 4-15 (mean 9.1), p=0.005. WMSI increased by at least 0.2 in 10/14 patients for the right and in 8/15 patients for the left ventricle. A decrease in velocity time integral for the left ventricular outflow was observed (16-30 to 13-21, p=0.009).

Conclusion: ARVC is a progressive disease with individual variation. Left ventricular involvement may occur early in the disease. Tissue Doppler imaging is a useful tool to follow-up right ventricular abnormalities.

Keywords
Arrhythmogenic right ventricular cardiomyopathy, Doppler tissue imaging, progression, right ventricular function
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16180 (URN)10.1080/14017430802372384 (DOI)
Available from: 2009-01-09 Created: 2009-01-09 Last updated: 2017-12-14
Lindström, L. (2007). Höger kammares ekokardiografiska anatomi och funktion (den bortglömda kammaren Hur och varför skall högerkammarfunktionen bedömas?). In: IX Svenska Kardiovaskulära vårmötet,2007.
Open this publication in new window or tab >>Höger kammares ekokardiografiska anatomi och funktion (den bortglömda kammaren Hur och varför skall högerkammarfunktionen bedömas?)
2007 (Swedish)In: IX Svenska Kardiovaskulära vårmötet,2007, 2007Conference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-40397 (URN)53201 (Local ID)53201 (Archive number)53201 (OAI)
Available from: 2009-10-10 Created: 2009-10-10
Lindström, L., Nylander, E., Larsson, H. & Wranne, B. (2005). Left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy: A scintigraphic and echocardiographic study. Clinical Physiology and Functional Imaging, 25(3), 171-177
Open this publication in new window or tab >>Left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy: A scintigraphic and echocardiographic study
2005 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 25, no 3, p. 171-177Article in journal (Refereed) Published
Abstract [en]

Background:  Left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy (ARVC) is a common finding in autopsy studies. In clinical studies using myocardial scintigraphy, MRI and echocardiography, contradictory results have been reported. In this study, we therefore investigated a group of 15 patients with ARVC using thallium-201 (Tl) single-photon emission tomography (SPECT) and echocardiography including assessment of mitral annular motion with M-mode and pulsed tissue Doppler.

Methods:  Exercise and rest Tl-201 SPECT were performed in 15 patients with ARVC. The time from diagnosis of the disease varied from less than 1–16 years. All patients fulfilled the established diagnostic criteria for ARVC. An echocardiographic examination, including assessment of left and right ventricular motion and measurements of the mitral annulus motion with M-mode and pulsed tissue Doppler was performed in the patients and in 25 normal subjects.

Results:  Tl-201 uptake defects in the left ventricular myocardium were present in all except one patient (93%). The uptake defects were predominantly located to the anteroseptal and basal posterior segments. Wall motion abnormalities were seen in the same segments, and in addition to this, in the septal area. In line with this, the total amplitude and the peak systolic velocity of mitral annular motion at the septal point were significantly decreased in the patients compared with the control group.

Conclusions:  Our data show that left ventricular involvement is common in ARVC. Tl-201 SPECT and echocardiographic abnormalities were seen not only in patients with long-lasting symptoms but also in asymptomatic patients and in those with short duration of symptoms.

Keywords
annular motion, pulsed tissue Doppler, T1-201 scintigraphy, wall motion abnormalities
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28426 (URN)10.1111/j.1475-097X.2005.00607.x (DOI)13565 (Local ID)13565 (Archive number)13565 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
Carlhäll, C., Lindström, L., Wranne, B. & Nylander, E. (2001). Atrioventricular plane displacement correlates closely to circulatory dimensions but not to ejection fraction in normal subjects. Journal of the American College of Cardiology, 37(2)
Open this publication in new window or tab >>Atrioventricular plane displacement correlates closely to circulatory dimensions but not to ejection fraction in normal subjects
2001 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 37, no 2, p. 388A-388AConference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-49360 (URN)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
Lindström, L. (2000). Annular Motion: Assessment of Cardiac Function using Echocardiography and Magnetic Resonance Imaging. (Doctoral dissertation). Linköping: Linköpings universitet
Open this publication in new window or tab >>Annular Motion: Assessment of Cardiac Function using Echocardiography and Magnetic Resonance Imaging
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis concentrates on the assessment of cardiac function, both systolic and diastolic using variables originating from the longitudinal motion of the heart using both established and novel non-invasive imaging techniques. We developed a new magnetic resonance imaging (MRI) technique that creates an M-mode MRI image, analogous to the one used in echocardiography and enables quantitative assessment of cardiac motion. The MRI M-mode method was compared with M-mode echocardiography in a phantom study, by measuring mitral and tricuspid annular motion in 20 normal subjects, and in a study of right ventricular function in 17 patients after coronary artery bypass surgery. The agreement between M-mode MRI and Mmode echocardiography was good. However, the amplitudes were somewhat higher measured by MRI, probably because of less angle error in the MRI calculation, furthermore the lower resolution in the MRI image may have contributed.

Pulsed tissue Doppler, a recently developed Doppler modality that gives the possibility of recording instantaneous annular /or myocardial velocities on-line, was used to obtain reference values of mitral and tricuspid annular motion in 27 normal subjects of different ages. Diastolic left ventricular function was assessed in 15 patients with systemic hypertension and in 10 patients with moderate to severe aortic stenosis. Furthermore, pulsed tissue Doppler was used in the evaluation of right and left ventricular function in 15 patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).

The mitral and tricuspid annular velocity pattern in normal subjects is characterised by three major components: asystolic (SA) velocity, an early (EA) diastolic velocity, and a late (AA) diastolic velocity. In normal young subjects, the EA-peak velocity was highest; with increasing age, the EA-peak velocity decreases and the AA-peak velocity increases, with similar changes in both the mitral and tricuspid annular velocity pattern. In patients with left ventricular hypertrophy the EA/AA-ratio was significantly decreased compared with age- match normal subjects. Comparing ARVC patients with normal subjects the tricuspid annular EA-peak velocity was significantly decreased as well as the lateral SA-peak velocity. Our result indicates that abnormal diastolic tricuspid annular velocity pattern may be an early sign of right ventricular myocardial dysfunction in patients with ARVC. The septal mitral annular SA-peak velocity was significantly decreased in ARVC patients compared to the controls. This in accordance with subjective analysis of echocardiographic wall motion and T1-201 SPECT that showed left ventricular abnormalities in 93% of the patients predominantly located in the anteroseptal and posteroseptal segments.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. p. 56
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 620
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27516 (URN)12172 (Local ID)91-7219-577-0 (ISBN)12172 (Archive number)12172 (OAI)
Public defence
2000-03-24, Berzeliussalen, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-08-02Bibliographically approved
Wilkenshoff, U. M., Sovany, A., Wigström, L., Olstad, B., Lindström, L., Engvall, J., . . . Sutherland, G. R. (1998). Regional mean systolic myocardial velocity estimation by real-time color Doppler Myocardial Imaging: A new technique for quantifying regional systolic function. Journal of the American Society of Echocardiography, 11(7), 683-692
Open this publication in new window or tab >>Regional mean systolic myocardial velocity estimation by real-time color Doppler Myocardial Imaging: A new technique for quantifying regional systolic function
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1998 (English)In: Journal of the American Society of Echocardiography, ISSN 0894-7317, E-ISSN 1097-6795, Vol. 11, no 7, p. 683-692Article in journal (Refereed) Published
Abstract [en]

A new color Doppler myocardial imaging (CDMI) system with high spatial and temporal resolution and novel postprocessing modalities has been developed that could allow quantifiable stress echocardiography. The purpose of this study was to determine whether regional myocardial systolic velocities could be accurately and reproducibly measured both at rest and during bicycle ergometry by using CDMI. Thirty normal subjects were examined with CDMI at rest, and peak mean systolic myocardial velocities (MSV) were measured for 34 predetermined left ventricular myocardial segments. Interobserver variability and intraobserver variability were established for all segments. Submaximal bicycle ergometry was performed in 20 normal subjects by using standardized weight-related increases in workload. MSV were measured at each step of exercise for 16 left ventricular stress echo segments. At rest, a base-apex gradient in regional MSV was recorded with highest longitudinal shortening velocities at the base. A similar pattern was noted for circumferential shortening MSV. Measurements were predictable and highly reproducible with low interobserver and intraobserver variability for 26 of 34 segments. Reproducibility was poor for basal anteroseptal segments in all views and mid anterior, anteroseptal, and septal segments in the short-axis views. During exercise, mid and basal segments of all walls showed a significant increase of MSV between each workload step and for apical segments between alternate steps. The resting base-apex velocity gradient observed at rest remained in all walls throughout ergometry. Thus a CDMI system with improved spatial and temporal resolution and postprocessing analysis modalities provided reproducible and accurate quantification of segmental left ventricular circumferential and longitudinal contraction both at rest and during exercise.

National Category
Medical Laboratory and Measurements Technologies
Identifiers
urn:nbn:se:liu:diva-67491 (URN)10.1053/je.1998.v11.a90584 (DOI)
Available from: 2011-04-14 Created: 2011-04-14 Last updated: 2017-12-11
Wigström, L., Lindström, L., Sjöqvist, L., Thuomas, K. Å. & Wranne, B. (1995). M-mode magnetic resonance imaging: a new modality for assessing cardiac function. Clinical Physiology, 15(4), 397-407
Open this publication in new window or tab >>M-mode magnetic resonance imaging: a new modality for assessing cardiac function
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1995 (English)In: Clinical Physiology, ISSN 0144-5979, E-ISSN 1365-2281, Vol. 15, no 4, p. 397-407Article in journal (Refereed) Published
Abstract [en]

Magnetic resonance imaging (MRI) studies of the heart have been used for some years, but there are few tools available to quantify cardiac motion. A method has been developed that creates an M-mode MRI image, analogous to the one used in echocardiography, to display motion along a line as a function of time. The M-mode image is created from MRI images acquired with an ordinary gradient echo cine sequence. In a cinematographic display of the images, a cursor line can be positioned in order to determine the orientation of the measurement. A resampling algorithm then calculates the appearance of the M-mode image along the cursor line. The MRI method has been compared to echocardiographic M-mode in a phantom study and by measuring mitral and tricuspid annulus motion in 20 normal subjects. The phantom study showed no significant differences between MRI and echocardiographic M-mode measurements (difference mm). The annulus motion exhibits a similar pattern using both methods and the measured amplitudes are in close agreement. M-mode MRI provides similar information to echocardiography, but the cursor line can be placed arbitrarily within the image plane and the method is thus not limited to certain acoustic windows. This makes M-mode MRI a promising technique for assessing cardiac motion.

Keywords
cardiac motion, heart, image processing, MRI, M-mode
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-79469 (URN)10.1111/j.1475-097X.1995.tb00529.x (DOI)
Available from: 2012-08-02 Created: 2012-08-02 Last updated: 2017-12-07Bibliographically approved
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