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Three-directional myocardial motion assessed using 3D phase contrast MRI
Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Institutionen för medicin och vård, Centrum för medicinsk bildvetenskap och visualisering. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Institutionen för medicin och vård, Centrum för medicinsk bildvetenskap och visualisering. Linköpings universitet, Hälsouniversitetet.ORCID-id: 0000-0003-1395-8296
Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Institutionen för medicin och vård, Centrum för medicinsk bildvetenskap och visualisering. Linköpings universitet, Hälsouniversitetet.
Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium.
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2004 (Engelska)Ingår i: Journal of Cardiovascular Magnetic Resonance, ISSN 1097-6647, E-ISSN 1532-429X, Vol. 6, nr 3, s. 627-636Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Regional myocardial function is a complex entity consisting of motion in three dimensions (3D). Besides magnetic resonance imaging (MRI), no other noninvasive technique can give a true 3D description of cardiac motion. Using a time‐resolved 3D phase contrast technique, three‐dimensional image volumes containing myocardial velocity data in six normal volunteers were acquired. Coordinates and velocity information were extracted from nine points placed in different myocardial segments in the left ventricle (LV), and decomposed into longitudinal (VL), radial (VR), and circumferential (VC) velocity components. Our findings confirm a longitudinal apex‐to‐base gradient for the LV, with only a small motion of the apex. The mean velocity for VL for all the basal segments was higher compared to the midsegments during systole [3.5 ± 1.2 vs. 2.5 ± 1.7 cm/s (p < 0.01)], early filling [− 6.9 ± 1.8 vs. − 4.9 ± 1.8 cm/s (p < 0.001)], and during atrial contraction [− 2.2 ± 1.4 vs. − 1.6 ± 1.3 cm/s (p < 0.05)]. A similar pattern was observed when comparing velocities from the midsegments to the apex. Radial velocity was higher during early filling in the midportion of the lateral [− 4.9 ± 2.7 vs. − 3.2 ± 1.6 cm/s (p < 0.05)] wall compared to the basal segments, no difference was observed for the septal [− 2.0 ± 1.5 vs. − 0.3 ± 2.5 cm/s (p = 0.15)], anterior [− 5.8 ± 3.3 vs. − 4.0 ± 1.7 cm/s (p = 0.17)], and posterior [− 2.3 ± 2.1 vs. − 2.5 ± 1.0 cm/s (p = 0.78)] walls. When observing the myocardial velocity in a single point and visualizing the movement of the main direction of the velocities in this point as vectors in velocity vector plots like planes, it is clear that myocardial movement is by no means one dimensional. In conclusion, our time‐resolved 3D, phase contrast MRI technique makes it feasible to extract myocardial velocities from anywhere in the myocardium, including all three velocity components without the need for positioning any slices at the time of acquisition.

Ort, förlag, år, upplaga, sidor
2004. Vol. 6, nr 3, s. 627-636
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:liu:diva-24306DOI: 10.1081/JCMR-120038692Lokalt ID: 3929OAI: oai:DiVA.org:liu-24306DiVA, id: diva2:244623
Tillgänglig från: 2009-10-07 Skapad: 2009-10-07 Senast uppdaterad: 2017-12-13
Ingår i avhandling
1. Quantification of cardiovascular flow and motion: aspects of regional myocardial function and flow patterns in the aortic root and the aorta
Öppna denna publikation i ny flik eller fönster >>Quantification of cardiovascular flow and motion: aspects of regional myocardial function and flow patterns in the aortic root and the aorta
2004 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Quantification of cardiovascular flow and motion is essential in the diagnosis, treatment and follow-up of cardiovascular disease. The accuracy and quantification of many imaging methods used in this field have important shortfalls, however, that result from limitations in spatial and temporal dimensions. Improvement in application of these methods requires an in-depth understanding of the technical and perceptual aspects that contribute to errors in their use.

Visual assessment of echocardiographic images for asynchrony in regional myocardial motion during systolic contraction is an example of the need for better definition of limitations. The discernible delay in wall motion improved from 89 ms to 71 ms by allowing side-by-side comparison to normal motion. Clinically important delays are almost certainly missed with current "eyeballing" methods. Different and more quantitative approaches to this problem have been developed. Anatomic M-mode (AMM) assesses motion along an arbitrary line within a two-dimensional (2D) image, and was demonstrably robust in the clinical setting when used with second harmonic imaging at a depth less than 20 cm and with angle correction ofless than 60°. Doppler myocardial (DMI) imaging and strain rate imaging (SRI) were also shown to reliably demonstrate the effects of inotropic stimulation, total and severe ischemia on asynchrony in a closed chest pig model. Quantification of the changes induced by inotropy and total ischemia was possible with both methods, but the effects of stunning were not. Regional myocardial function and cardiovascular flow can also be assessed with time-resolved, three-directional, three-dimensional (3D) velocity data acquired using phase contrast magnetic resonance imaging (PC-MRI). This multidimensional data demonstrated longitudinal velocity gradients along all four walls of the left ventricle, with miuirnal apical longitudinal motion. The 3D velocity vector from single points in the ventricular wall shows that the motion over the cardiac cycle is complex in all dimensions. The flow patterns in the aortic root were also studied using time-resolved 3D PC-MRI in normal volunteers and patients who had undergone aortic-valve sparing surgery using straight Dacron grafts. In normals, vortices appeared in the sinuses of Valsalva in late systole, increased in size with the deceleration of aortic outflow and moved together as the valve closed in early diastole. These normal flow structures have never before been demonstrated in three dimensions in man. In the postoperative patients, lacking both sinuses and sinotubular junction, vortices were not observed.

Many imaging methods can be improved by a critical definition of the limits oftheir reliability. This can prompt the modifications and new methods which allow us to move beyond the original shortcomings and contribute new knowledge regarding the pathophysiology of cardiovascular disease.

Ort, förlag, år, upplaga, sidor
Linköping: Linköpings universitet, 2004. s. 63
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 832
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:liu:diva-24209 (URN)3803 (Lokalt ID)91-7373-804-2 (ISBN)3803 (Arkivnummer)3803 (OAI)
Disputation
2004-02-20, Elsa Brändströmssalen, Universitetssjukhuset, Linköping, 13:00 (Svenska)
Opponent
Tillgänglig från: 2009-10-07 Skapad: 2009-10-07 Senast uppdaterad: 2012-10-29Bibliografiskt granskad

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