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206


Faster Diffusion-weighted MR Imaging of Cardiac Microstructure

Axel, Leon
PMID: 28218885
ISSN: 1527-1315
CID: 2459832

Optimal topological cycles and their application in cardiac trabeculae restoration

Wu, P; Chen, C; Wang, Y; Zhang, S; Yuan, C; Qian, Z; Metaxas, D; Axel, L
In cardiac image analysis, it is important yet challenging to reconstruct the trabeculae, namely, fine muscle columns whose ends are attached to the ventricular walls. To extract these fine structures, traditional image segmentation methods are insufficient. In this paper, we propose a novel method to jointly detect salient topological handles and compute the optimal representations of them. The detected handles are considered hypothetical trabeculae structures. They are further screened using a classifier and are then included in the final segmentation.We show in experiments the significance of our contribution compared with previous standard segmentation methods without topological priors, as well as with previous topological method in which non-optimal representations of topological handles are used
SCOPUS:85020551569
ISSN: 0302-9743
CID: 2626262

Use of self-gated radial cardiovascular magnetic resonance to detect and classify arrhythmias (atrial fibrillation and premature ventricular contraction)

Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Feng, Li; Axel, Leon
BACKGROUND: Arrhythmia can significantly alter the image quality of cardiovascular magnetic resonance (CMR); automatic detection and sorting of the most frequent types of arrhythmias during the CMR acquisition could potentially improve image quality. New CMR techniques, such as non-Cartesian CMR, can allow self-gating: from cardiac motion-related signal changes, we can detect cardiac cycles without an electrocardiogram. We can further use this data to obtain a surrogate for RR intervals (valley intervals: VV). Our purpose was to evaluate the feasibility of an automated method for classification of non-arrhythmic (NA) (regular cycles) and arrhythmic patients (A) (irregular cycles), and for sorting of common arrhythmia patterns between atrial fibrillation (AF) and premature ventricular contraction (PVC), using the cardiac motion-related signal obtained during self-gated free-breathing radial cardiac cine CMR with compressed sensing reconstruction (XD-GRASP). METHODS: One hundred eleven patients underwent cardiac XD-GRASP CMR between October 2015 and February 2016; 33 were included for retrospective analysis with the proposed method (6 AF, 8 PVC, 19 NA; by recent ECG). We analyzed the VV, using pooled statistics (histograms) and sequential analysis (Poincare plots), including the median (medVV), the weighted mean (meanVV), the total number of VV values (VVval), and the total range (VVTR) and half range (VVHR) of the cumulative frequency distribution of VV, including the median to half range (medVV/VVHR) and the half range to total range (VVHR/VVTR) ratios. We designed a simple algorithm for using the VV results to differentiate A from NA, and AF from PVC. RESULTS: Between NA and A, meanVV, VVval, VVTR, VVHR, medVV/VVHR and VVHR/VVTR ratios were significantly different (p values = 0.00014, 0.0027, 0.000028, 5x10-9, 0.002, respectively). Between AF and PVC, meanVV, VVval and medVV/VVHR ratio were significantly different (p values = 0.018, 0.007, 0.044, respectively). Using our algorithm, sensitivity, specificity, and accuracy were 93 %, 95 % and 94 % to discriminate between NA and A, and 83 %, 71 %, and 77 % to discriminate between AF and PVC, respectively; areas under the ROC curve were 0.93 and 0.89. CONCLUSIONS: Our study shows we can reliably detect arrhythmias and differentiate AF from PVC, using self-gated cardiac cine XD-GRASP CMR.
PMCID:5123392
PMID: 27884152
ISSN: 1532-429x
CID: 2314522

Dyspnea and Chest Pain in a Young Woman Caused by a Giant Pericardial Lymphohemangioma: Diagnosis and Treatment

Heffron, Sean P; Alviar, Carlos L; Towe, Christopher; Geisler, Benjamin P; Axel, Leon; Galloway, Aubrey C; Skolnick, Adam H
We describe a 21-year-old woman who presented with chest pain and dyspnea on exertion and who was found to have a large pericardial mass. Multimodality imaging was instrumental in narrowing the differential diagnosis and planning surgical treatment, which included coronary artery bypass and right-sided heart reconstruction. The final pathologic diagnosis was lymphohemangioma; to our knowledge, this was the largest cardiac/pericardial vascular tumor ever to be reported in the literature.
PMCID:4993682
PMID: 26961665
ISSN: 1916-7075
CID: 2024392

Stress Cardiac MRI in Women With Myocardial Infarction and Nonobstructive Coronary Artery Disease

Mauricio, Rina; Srichai, Monvadi B; Axel, Leon; Hochman, Judith S; Reynolds, Harmony R
BACKGROUND: In a prospective study, cardiac MRI (CMR) and intravascular ultrasound were performed in women with myocardial infarction (MI) and nonobstructive coronary artery disease (MINOCA). Forty participants underwent adenosine-stress CMR (sCMR). HYPOTHESIS: Abnormal perfusion may co-localize with ischemic late gadolinium enhancement (LGE) and T2-weighted signal hyperintensity (T2+), suggesting microvascular dysfunction contributed to MI. METHODS: Qualitative perfusion analysis was performed by 2 independent readers. Abnormal myocardial perfusion reserve index (MPRI) was defined as global average
PMID: 27459149
ISSN: 1932-8737
CID: 2191502

Cardiovascular magnetic resonance features of mechanical dyssynchrony in patients with left bundle branch block

Revah, Giselle; Wu, Vincent; Huntjens, Peter R; Piekarski, Eve; Chyou, Janice Y; Axel, Leon
Patients with left bundle branch block (LBBB) can exhibit mechanical dyssynchrony which may contribute to heart failure; such patients may benefit from cardiac resynchronization treatment (CRT). While cardiac magnetic resonance imaging (CMR) has become a common part of heart failure work-up, CMR features of mechanical dyssynchrony in patients with LBBB have not been well characterized. This study aims to investigate the potential of CMR to characterize mechanical features of LBBB. CMR examinations from 43 patients with LBBB on their electrocardiogram, but without significant focal structural abnormalities, and from 43 age- and gender-matched normal controls were retrospectively reviewed. The following mechanical features of LBBB were evaluated: septal flash (SF), apical rocking (AR), delayed aortic valve opening measured relative to both end-diastole (AVOED) and pulmonic valve opening (AVOPVO), delayed left-ventricular (LV) free-wall contraction, and curvatures of the septum and LV free-wall. Septal displacement curves were also generated, using feature-tracking techniques. The echocardiographic findings of LBBB were also reviewed in those subjects for whom they were available. LBBB was significantly associated with the presence of SF and AR; within the LBBB group, 79 % had SF and 65 % had AR. Delayed AVOED, AVOPVO, and delayed LV free-wall contraction were significantly associated with LBBB. AVOED and AVOPVO positively correlated with QRS duration and negatively correlated with ejection fraction. Hearts with electrocardiographic evidence of LBBB showed lower septal-to-LV free-wall curvature ratios at end-diastole compared to normal controls. CMR can be used to identify and evaluate mechanical dyssynchrony in patients with LBBB. None of the normal controls showed the mechanical features associated with LBBB. Moreover, not all patients with LBBB showed the same degree of mechanical dyssynchrony, which could have implications for CRT.
PMID: 27306621
ISSN: 1875-8312
CID: 2145192

Accelerated MRI for the assessment of cardiac function

Axel, Leon; Otazo, Ricardo
Heart disease is a worldwide public health problem; assessment of cardiac function is an important part of the diagnosis and management of heart disease. Magnetic resonance imaging (MRI) of the heart can provide clinically useful information on cardiac function, although it is still not routinely used in clinical practice, in part because of limited imaging speed. New accelerated methods for performing cardiovascular MRI (CMR) have the potential to provide both increased imaging speed and robustness to CMR, as well as access to increased functional information. In this review, we will briefly discuss the main methods currently employed to accelerate CMR methods, such as parallel imaging, k-t undersampling and compressed sensing, as well as new approaches that extend the idea of compressed sensing and exploit sparsity to provide richer information of potential use in clinical practice.
PMCID:5257298
PMID: 27033471
ISSN: 1748-880x
CID: 2059282

Real time dynamic MRI by exploiting spatial and temporal sparsity

Chen, Chen; Li, Yeqing; Axel, Leon; Huang, Junzhou
Online imaging requires that the reconstruction of current frame only depends on the previous frames, and real time imaging is the desired case. In this work, we propose a novel scheme for real time dynamic magnetic resonance imaging (dMRI) reconstruction. Different from previous methods, the reconstructions of the second frame to the last frame are independent in our scheme, which only require the first frame as the reference image. Therefore, this scheme can be naturally implemented in parallel. After the first frame is reconstructed, all the later frames can be processed as soon as the k-space data are acquired. As an extension of the conventional spatial total variation, a new online model called dynamic total variation is used to exploit the sparsity on both spatial and temporal domains in dMRI. In real time dMRI, each frame is required to be reconstructed very fast. We then design a novel reweighted least squares algorithm to solve the challenging problem. Motivated by the special structure of partial Fourier transform in sparse MRI, this algorithm is accelerated by the preconditioned conjugate gradient descent method. The proposed method is compared with 4 state-of-the-art online and offline methods on two in-vivo cardiac dMRI datasets. The experimental results show that our method significantly outperforms previous online methods, and is comparable to the offline methods in terms of reconstruction accuracy.
PMID: 26578303
ISSN: 1873-5894
CID: 2040392

The Mitral Valve in Obstructive Hypertrophic Cardiomyopathy: A Test in Context

Sherrid, Mark V; Balaram, Sandhya; Kim, Bette; Axel, Leon; Swistel, Daniel G
Mitral valve abnormalities were not part of modern pathological and clinical descriptions of hypertrophic cardiomyopathy in the 1950s, which focused on left ventricular (LV) hypertrophy and myocyte fiber disarray. Although systolic anterior motion (SAM) of the mitral valve was discovered as the cause of LV outflow tract obstruction in the M-mode echocardiography era, in the 1990s structural abnormalities of the mitral valve became appreciated as contributing to SAM pathophysiology. Hypertrophic cardiomyopathy mitral malformations have been identified at all levels. They occur in the leaflets, usually elongating them, and also in the submitral apparatus, with a wide array of malformations of the papillary muscles and chordae, that can be detected by transthoracic and transesophageal echocardiography and by cardiac magnetic resonance. Because they participate fundamentally in the predisposition to SAM, they have increasingly been repaired surgically. This review critically assesses imaging and measurement of mitral abnormalities and discusses their surgical relief.
PMID: 27081025
ISSN: 1558-3597
CID: 2078502

Clearance systems in the brain-implications for Alzheimer diseaser

Tarasoff-Conway, Jenna M; Carare, Roxana O; Osorio, Ricardo S; Glodzik, Lidia; Butler, Tracy; Fieremans, Els; Axel, Leon; Rusinek, Henry; Nicholson, Charles; Zlokovic, Berislav V; Frangione, Blas; Blennow, Kaj; Menard, Joel; Zetterberg, Henrik; Wisniewski, Thomas; de Leon, Mony J
PMID: 27020556
ISSN: 1759-4766
CID: 2162882