Intraoperative 3D TrueVue transesophageal echo imaging in cardiac mass: Bridge between cardiac anesthesiologist and surgeon.
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SUBMITTER: L'Acqua C
PROVIDER: S-EPMC9244262 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:RationalePoint-of-care ultrasound is widely used in patients with cardiac arrest, allowing for diagnosing, monitoring, and prognostication as well as assessing the effectiveness of the chest compressions. However, the detection of intraoperative cardiac arrest by Point-of-care ultrasound was rarely reported.Patient concernsA 21-year-old male with Marfan syndrome which manifested Valsalva sinus aneurysms was admitted for aortic valve replacement. After endotracheal intubation, TEE transducer was inserted to evaluate the cardiac structure and function with different views. Severe aortic valve regurgitation was observed in the mid-esophageal aortic valve long and short axis view.DiagnosisTEE showed that cardiac contraction was nearly stopped, the spontaneous echo contrast was obvious in the left ventricular and hardly any blood was pumped out from the heart despite the ECG showing normal sinus rhythm with HR 61 beats/min. Meanwhile, the IBP was dropped to 50/30 mm Hg.InterventionsChest compressions were started immediately and epinephrine 100 μg was given intravenously. After 30 times of chest compressions, TEE showed that cardiac contractility increased and the stroke volume was improved in the TG SAX view.OutcomesThe patient was discharged 18 days later in a stable condition.LessonsContinuous echocardiography monitoring may be of particular value in forewarning and detecting cardiac arrest in high-risk patients.
| S-EPMC7440279 | biostudies-literature
Project description:PURPOSE:To develop a dual-radiofrequency (RF), dual-echo, 3D ultrashort echo-time (UTE) pulse sequence and bone-selective image reconstruction for rapid high-resolution craniofacial MRI. METHODS:The proposed pulse sequence builds on recently introduced dual-RF UTE imaging. While yielding enhanced bone specificity by exploiting high sensitivity of short T2 signals to variable RF pulse widths, the parent technique exacts a 2-fold scan time penalty relative to standard dual-echo UTE. In the proposed method, the parent sequence's dual-RF scheme was incorporated into dual-echo acquisitions while radial view angles are varied every pulse-to-pulse repetition period. The resulting 4 echoes (2 for each RF) were combined by view-sharing to construct 2 sets of k-space data sets, corresponding to short and long TEs, respectively, leading to a 2-fold increase in imaging efficiency. Furthermore, by exploiting the sparsity of bone signals in echo-difference images, acceleration was achieved by solving a bone-sparsity constrained image reconstruction problem. In vivo studies were performed to evaluate the effectiveness of the proposed acceleration approaches in comparison to the parent method. RESULTS:The proposed technique achieves 1.1-mm isotropic skull imaging in 3 minutes without visual loss of image quality, compared to the parent technique (scan time = 12 minutes). Bone-specific images and corresponding 3D renderings of the skull were found to depict the expected craniofacial anatomy over the entire head. CONCLUSION:The proposed method is able to achieve high-resolution volumetric craniofacial images in a clinically practical imaging time, and thus may prove useful as a potential alternative to computed tomography.
| S-EPMC6414254 | biostudies-literature
Project description:BACKGROUND:Diffusion-weighted imaging (DWI) has shown great value in rectal cancer imaging. However, traditional DWI with echo-planar imaging (DW-EPI) often suffers from geometrical distortions. We applied a three-dimensional diffusion-prepared stimulated-echo turbo spin-echo sequence (DPsti-TSE), allowing geometrically undistorted rectal DWI. We compared DPsti-TSE with DW-EPI for locally advanced rectal cancer DWI. METHODS:For 33 prior-to-treatment patients, DWI images of the rectum were acquired with DPsti-TSE and DW-EPI at 3?T using b-values of 200 and 1000 s/mm2. Two radiologists conducted a blinded scoring of the images considering nine aspects of image quality and anatomical quality. Tumour apparent diffusion coefficient (ADC) and distortions were compared quantitatively. RESULTS:DPsti-TSE scored significantly better than DW-EPI in rectum distortion (p = 0.005) and signal pileup (p = 0.001). DPsti-TSE had better tumour Dice similarity coefficient compared to DW-EPI (0.84 versus 0.80, p = 0.010). Tumour ADC values were higher for DPsti-TSE compared to DW-EPI (1.47 versus 0.86 × 10-3 mm2/s, p < 0.001). Radiologists scored DPsti-TSE significantly lower than DW-EPI on aspects of overall image quality (p = 0.001), sharpness (p < 0.001), quality of fat suppression (p < 0.001), tumour visibility (p = 0.009), tumour conspicuity (p = 0.010) and rectum wall visibility (p = 0.005). CONCLUSIONS:DPsti-TSE provided geometrically less distorted rectal cancer diffusion-weighted images. However, the image quality of DW-EPI over DPsti-TSE was referred on the basis of several image quality criteria. A significant bias in tumour ADC values from DPsti-TSE was present. Further improvements of DPsti-TSE are needed until it can replace DW-EPI.
| S-EPMC7005244 | biostudies-literature
Project description:Background Signal contamination from long T2 water is a major challenge in direct imaging of myelin with MRI. Nulling of the unwanted long T2 signals can be achieved with an inversion recovery (IR) preparation pulse to null long T2 white matter within the brain. The remaining ultrashort T2 signal from myelin can be detected with an ultrashort echo time (UTE) sequence. Purpose To develop patient-specific whole-brain myelin imaging with a three-dimensional double-echo sliding inversion recovery (DESIRE) UTE sequence. Materials and Methods The DESIRE UTE sequence generates a series of IR images with different inversion times during a single scan. The optimal inversion time for nulling long T2 signal is determined by finding minimal signal on the second echo. Myelin images are generated by subtracting the second echo image from the first UTE image. To validate this method, a prospective study was performed in phantoms, cadaveric brain specimens, healthy volunteers, and patients with multiple sclerosis (MS). A total of 20 healthy volunteers (mean age, 40 years ± 13 [standard deviation], 10 women) and 20 patients with MS (mean age, 58 years ± 8; 15 women) who underwent MRI between November 2017 and February 2019 were prospectively included. Analysis of variance was performed to evaluate the signal difference between MS lesions and normal-appearing white matter in patients with MS. Results High signal intensity and corresponding T2* and T1 of the extracted myelin vesicles provided evidence for direct imaging of ultrashort-T2 myelin protons using the UTE sequence. Gadobenate dimeglumine phantoms with a wide range of T1 values were selectively suppressed with DESIRE UTE. In the ex vivo brain study of MS lesions, signal loss was observed in MS lesions and was conformed with histologic analysis. In the human study, there was a significant reduction in normalized signal intensity in MS lesions compared with that in normal-appearing white matter (0.19 ± 0.10 vs 0.76 ± 0.11, respectively; P < .001). Conclusion The double-echo sliding inversion recovery ultrashort echo time sequence can generate whole-brain myelin images specifically with a clinical 3-T scanner. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Port in this issue.
| S-EPMC6996715 | biostudies-literature
Project description:PurposeThree-dimensional fast spin-echo (FSE) sequences commonly use very long echo trains (>64 echoes) and severely reduced refocusing angles. They are increasingly used in brain exams due to high, isotropic resolution and reasonable scan time when using long trains and short interecho spacing. In this study, T2 quantification in 3D FSE is investigated to achieve increased resolution when comparing with established 2D (proton-density dual-echo and multi-echo spin-echo) methods.MethodsThe FSE sequence design was explored to use long echo trains while minimizing T2 fitting error and maintaining typical proton density and T2 -weighted contrasts. Constant and variable flip angle trains were investigated using extended phase graph and Bloch equation simulations. Optimized parameters were analyzed in phantom experiments and validated in vivo in comparison to 2D methods for eight regions of interest in brain, including deep gray-matter structures and white-matter tracts.ResultsPhantom and healthy in vivo brain T2 measurements showed that optimized variable echo-train 3D FSE performs similarly to previous 2D methods, while achieving three-fold-higher slice resolution, evident visually in the 3D T2 maps. Optimization resulted in better T2 fitting and compared well with standard multi-echo spin echo (within the 8-ms confidence limits defined based on Bland-Altman analysis).ConclusionT2 mapping using 3D FSE with long echo trains and variable refocusing angles provides T2 accuracy in agreement with 2D methods with additional high-resolution benefits, allowing isotropic views while avoiding incidental magnetization transfer effects. Consequently, optimized 3D sequences should be considered when choosing T2 mapping methods for high anatomic detail.
| S-EPMC9299830 | biostudies-literature
Project description:Mass spectrometry-based imaging (MSI) has emerged as a promising method for spatial metabolomics in plant science. Several ionisation techniques have shown great potential for the spatially resolved analysis of metabolites in plant tissue. However, limitations in technology and methodology limited the molecular information for irregular 3D surfaces with resolutions on the micrometre scale. Here, we used atmospheric-pressure 3D-surface matrix-assisted laser desorption/ionisation mass spectrometry imaging (3D-surface MALDI MSI) to investigate plant chemical defence at the topographic molecular level for the model system Asclepias curassavica. Upon mechanical damage (simulating herbivore attacks) of native A. curassavica leaves, the surface of the leaves varies up to 700 μm, and cardiac glycosides (cardenolides) and other defence metabolites were exclusively detected in damaged leaf tissue but not in different regions of the same leaf. Our results indicated an increased latex flow rate towards the point of damage leading to an accumulation of defence substances in the affected area. While the concentration of cardiac glycosides showed no differences between 10 and 300 min after wounding, cardiac glycosides decreased after 24 h. The employed autofocusing AP-SMALDI MSI system provides a significant technological advancement for the visualisation of individual molecule species on irregular 3D surfaces such as native plant leaves. Our study demonstrates the enormous potential of this method in the field of plant science including primary metabolism and molecular mechanisms of plant responses to abiotic and biotic stress and symbiotic relationships.
| S-EPMC7943518 | biostudies-literature
Project description:Cor triatriatum is a rare congenital cardiac anomaly. Majority of the cases present in the childhood with an incidence of 0.4%. However, we report a case of cor triatrium sinister with ostium secundum atrial septal defect (ASD) in a 39-year-old female. The intraoperative 3D transesophageal echocardiography (TEE) offers an advantage over 2D TEE in visualizing the interatrial septum and the attachments of the fibromuscular accessory membrane in the left atrium (LA), which could help in surgical decision-making in this patient.
| S-EPMC7559954 | biostudies-literature
Project description: Not available
| S-EPMC7451913 | biostudies-literature
Project description:Quadricuspid aortic valve (QAV) is a rare congenital anomaly frequently associated with other anomalies particularly coronary anomalies. It may be detected on transthoracic or transesophageal echocardiography. We present here a case report of a 27-year-old male patient with a QAV, the valve being regurgitant and requiring aortic valve replacement. It has been reported as isolated case reports in the literature and various theories exist to the development of QAV. The diagnosis requires a high degree of suspicion and a detailed assessment, and if asymptomatic, then patients need to be carefully followed up for the development of aortic regurgitation.
| S-EPMC5791504 | biostudies-literature
Project description:PurposeInversion recovery-based UTE (IR-UTE) sequences have been proposed to directly image myelin with extremely short T2∗ (~0.3 ms). In this study, we demonstrate the feasibility of complex echo subtraction to improve 3D IR-UTE imaging of myelin in white matter of the brain in vivo.MethodsIn IR-UTE imaging, long T2 components in white matter (i.e., water) are suppressed using an adiabatic inversion recovery preparation pulse. Dual echo UTE data acquisition and magnitude echo subtraction are used to suppress the residual white matter and gray matter signals, providing high myelin contrast. Complex echo subtraction may further improve the myelin contrast by reducing the residual long T2 water signal contamination caused by regional T1 variations. To verify the efficacy of the complex subtraction technique, in vivo experiments were performed with 5 non-symptomatic healthy volunteers and 5 multiple sclerosis patients on a 3T clinical MR system. Signal enhancement between the complex subtraction and the magnitude subtraction was introduced to evaluate the improvement.ResultsThe complex subtraction improved myelin contrast over the magnitude subtraction in both healthy and patient groups, with more fine myelin structures being revealed. The foci of the demyelinated lesion were more clearly detected by complex subtraction. An average signal enhancement of up to 135.9% was achieved with the complex subtraction over the magnitude subtraction.ConclusionThe complex echo subtraction improves 3D IR-UTE morphologic imaging of myelin in white matter of the brain.
| S-EPMC6949380 | biostudies-literature