Displaying all 14 publications

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  1. Baki MM, Menys A, Atkinson D, Bassett P, Morley S, Beale T, et al.
    Eur Radiol, 2017 Feb;27(2):598-606.
    PMID: 27085701 DOI: 10.1007/s00330-016-4341-3
    OBJECTIVE: Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) METHODS: Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC).

    RESULTS: VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44).

    CONCLUSION: Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability.

    KEY POINTS: • Cine-MRI is used to assess vocal folds (VFs) mobility: abduction and adduction. • New quantitative metrics are derived from VF position and abduction potential. • Cine-MRI able to depict the difference between normal and abnormal VF mobility. • Cine-MRI derived quantitative metrics have good repeatability.

    Matched MeSH terms: Magnetic Resonance Imaging, Cine/methods*
  2. Chuah SH, Md Sari NA, Chew BT, Tan LK, Chiam YK, Chan BT, et al.
    Phys Med, 2020 Oct;78:137-149.
    PMID: 33007738 DOI: 10.1016/j.ejmp.2020.08.022
    Differential diagnosis of hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) is clinically challenging but important for treatment management. This study aims to phenotype HHD and HCM in 3D + time domain by using a multiparametric motion-corrected personalized modeling algorithm and cardiac magnetic resonance (CMR). 44 CMR data, including 12 healthy, 16 HHD and 16 HCM cases, were examined. Multiple CMR phenotype data consisting of geometric and dynamic variables were extracted globally and regionally from the models over a full cardiac cycle for comparison against healthy models and clinical reports. Statistical classifications were used to identify the distinctive characteristics and disease subtypes with overlapping functional data, providing insights into the challenges for differential diagnosis of both types of disease. While HCM is characterized by localized extreme hypertrophy of the LV, wall thickening/contraction/strain was found to be normal and in sync, though it was occasionally exaggerated at normotrophic/less severely hypertrophic regions during systole to preserve the overall ejection fraction (EF) and systolic functionality. Additionally, we observed that hypertrophy in HHD could also be localized, although at less extreme conditions (i.e. more concentric). While fibrosis occurs mostly in those HCM cases with aortic obstruction, only minority of HHD patients were found affected by fibrosis. We demonstrate that subgroups of HHD (i.e. preserved and reduced EF: HHDpEF & HHDrEF) have different 3D + time CMR characteristics. While HHDpEF has cardiac functions in normal range, dilation and heart failure are indicated in HHDrEF as reflected by low LV wall thickening/contraction/strain and synchrony, as well as much reduced EF.
    Matched MeSH terms: Magnetic Resonance Imaging, Cine
  3. Bilal M, Shah JA, Qureshi IM, Kadir K
    Int J Biomed Imaging, 2018;2018:7803067.
    PMID: 29610569 DOI: 10.1155/2018/7803067
    Transformed domain sparsity of Magnetic Resonance Imaging (MRI) has recently been used to reduce the acquisition time in conjunction with compressed sensing (CS) theory. Respiratory motion during MR scan results in strong blurring and ghosting artifacts in recovered MR images. To improve the quality of the recovered images, motion needs to be estimated and corrected. In this article, a two-step approach is proposed for the recovery of cardiac MR images in the presence of free breathing motion. In the first step, compressively sampled MR images are recovered by solving an optimization problem using gradient descent algorithm. TheL1-norm based regularizer, used in optimization problem, is approximated by a hyperbolic tangent function. In the second step, a block matching algorithm, known as Adaptive Rood Pattern Search (ARPS), is exploited to estimate and correct respiratory motion among the recovered images. The framework is tested for free breathing simulated andin vivo2D cardiac cine MRI data. Simulation results show improved structural similarity index (SSIM), peak signal-to-noise ratio (PSNR), and mean square error (MSE) with different acceleration factors for the proposed method. Experimental results also provide a comparison betweenk-tFOCUSS with MEMC and the proposed method.
    Matched MeSH terms: Magnetic Resonance Imaging, Cine
  4. Bewersdorf T, Loch A
    Eur Heart J, 2018 11 01;39(41):3750.
    PMID: 30052855 DOI: 10.1093/eurheartj/ehy415
    Matched MeSH terms: Magnetic Resonance Imaging, Cine
  5. Bilgen M
    Australas Phys Eng Sci Med, 2010 Dec;33(4):357-66.
    PMID: 21110236 DOI: 10.1007/s13246-010-0039-z
    Homogenous strain analysis (HSA) was developed to evaluate regional cardiac function using tagged cine magnetic resonance images of heart. Current cardiac applications of HSA are however limited in accurately detecting tag intersections within the myocardial wall, producing consistent triangulation of tag cells throughout the image series and achieving optimal spatial resolution due to the large size of the triangles. To address these issues, this article introduces a harmonic phase (HARP) interference method. In principle, as in the standard HARP analysis, the method uses harmonic phases associated with the two of the four fundamental peaks in the spectrum of a tagged image. However, the phase associated with each peak is wrapped when estimated digitally. This article shows that special combination of wrapped phases results in an image with unique intensity pattern that can be exploited to automatically detect tag intersections and to produce reliable triangulation with regularly organized partitioning of the mesh for HSA. In addition, the method offers new opportunities and freedom for evaluating myocardial function when the power and angle of the complex filtered spectra are mathematically modified prior to computing the phase. For example, the triangular elements can be shifted spatially by changing the angle and/or their sizes can be reduced by changing the power. Interference patterns obtained under a variety of power and angle conditions were presented and specific features observed in the results were explained. Together, the advanced processing capabilities increase the power of HSA by making the analysis less prone to errors from human interactions. It also allows strain measurements at higher spatial resolution and multi-scale, thereby improving the display methods for better interpretation of the analysis results.
    Matched MeSH terms: Magnetic Resonance Imaging, Cine/methods*
  6. Liew YM, McLaughlin RA, Chan BT, Abdul Aziz YF, Chee KH, Ung NM, et al.
    Phys Med Biol, 2015 Apr 7;60(7):2715-33.
    PMID: 25768708 DOI: 10.1088/0031-9155/60/7/2715
    Cine MRI is a clinical reference standard for the quantitative assessment of cardiac function, but reproducibility is confounded by motion artefacts. We explore the feasibility of a motion corrected 3D left ventricle (LV) quantification method, incorporating multislice image registration into the 3D model reconstruction, to improve reproducibility of 3D LV functional quantification. Multi-breath-hold short-axis and radial long-axis images were acquired from 10 patients and 10 healthy subjects. The proposed framework reduced misalignment between slices to subpixel accuracy (2.88 to 1.21 mm), and improved interstudy reproducibility for 5 important clinical functional measures, i.e. end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and 3D-sphericity index, as reflected in a reduction in the sample size required to detect statistically significant cardiac changes: a reduction of 21-66%. Our investigation on the optimum registration parameters, including both cardiac time frames and number of long-axis (LA) slices, suggested that a single time frame is adequate for motion correction whereas integrating more LA slices can improve registration and model reconstruction accuracy for improved functional quantification especially on datasets with severe motion artefacts.
    Matched MeSH terms: Magnetic Resonance Imaging, Cine/methods*
  7. Ang KP, Quek ZQ, Lee CY, Lu HT
    Med J Malaysia, 2019 12;74(6):561-563.
    PMID: 31929492
    The clinical presentation of acute myocarditis is highly variable ranging from no symptoms to cardiogenic shock. Despite considerable progress, it remains a challenge for frontline physicians to discriminate between acute myocarditis and myocardial infarction, especially in the early phase. Our case serves as a reminder that acute presentation of myocarditis could resemble ST elevation myocardial infarction potentially misdirecting the therapeutic decision. The clinical presentation, electrocardiographic and laboratory findings of the patient are not specific enough to distinguish acute myocarditis from myocardial infarction. The gold standard tests such coronary angiography and cardiovascular magnetic resonance (CMR) can reliably differentiate the two entities.
    Matched MeSH terms: Magnetic Resonance Imaging, Cine/methods
  8. Goh CH, Hamzah MR, Kandasamy R, Ghani ARI, Wong SH, Idris Z, et al.
    Med J Malaysia, 2020 11;75(6):666-671.
    PMID: 33219175
    INTRODUCTION: Chiari malformation (CM) is a disorder of mesodermal origin and is commonly associated with syringomyelia. Foramen magnum decompression is the first-line of standard treatment in symptomatic patients with a confirmed radiographic diagnosis. Magnetic resonance (MR) cine allows accurate evaluation of cerebrospinal fluid (CSF) physiology at the craniovertebral junction but often this is under-utilised in Malaysia.

    METHODS: In this series, we looked into nine cases of CM with syringomyelia from clinical and radiological perspective before and after surgery. The radiological parameters were herniated tonsillar length, syrinx: cord ratio, syrinx length and diameter. Flow velocity and morphologic changes in Chiari were illustrated.

    RESULTS: Seven patients showed either reduction in syrinx length, syrinx: cord ratio or both postoperatively. Clinical recovery somewhat varied in motor and sensory symptoms. Four patients gained better functional grade in modified Rankin scale (MRS) while the rest remained similar. The study highlighted the advantage of CSF flow dynamics information over MR anatomical radiographic improvement in addressing the neurologic and functional recovery. We also discussed the practicality of cine sequence in preoperative patient selection, syrinx analysis and postoperative flow evaluation in anticipation of clinical outcome.

    CONCLUSION: Phase-contrast cine MRI is a useful tool dictated by resource availability. We recommend its routine use in preoperative analysis and subsequent observational follow-up after surgery.

    Matched MeSH terms: Magnetic Resonance Imaging, Cine
  9. Arcari L, Hinojar R, Engel J, Freiwald T, Platschek S, Zainal H, et al.
    Int J Cardiol, 2020 05 01;306:102-108.
    PMID: 32169347 DOI: 10.1016/j.ijcard.2020.03.002
    AIMS: Profound left ventricular (LV) hypertrophy with diastolic dysfunction and heart failure is the cardinal manifestation of heart remodelling in chronic kidney disease (CKD). Previous studies related increased T1 mapping values in CKD with diffuse fibrosis. Native T1 is a non-specific readout that may also relate to increased intramyocardial fluid. We examined concomitant T1 and T2 mapping signatures and undertook comparisons with other hypertrophic conditions.

    METHODS: In this prospective multicentre study, consecutive CKD patients (n = 154) undergoing routine clinical cardiac magnetic resonance (CMR) imaging were compared with patients with hypertensive (HTN, n = 163) and hypertrophic cardiomyopathy (HCM, n = 158), and normotensive controls (n = 133).

    RESULTS: Native T1 was significantly higher in all patient groups, whereas native T2 in CKD only (p 

    Matched MeSH terms: Magnetic Resonance Imaging, Cine
  10. Khalid A, Lim E, Chan BT, Abdul Aziz YF, Chee KH, Yap HJ, et al.
    J Magn Reson Imaging, 2019 04;49(4):1006-1019.
    PMID: 30211445 DOI: 10.1002/jmri.26302
    BACKGROUND: Existing clinical diagnostic and assessment methods could be improved to facilitate early detection and treatment of cardiac dysfunction associated with acute myocardial infarction (AMI) to reduce morbidity and mortality.

    PURPOSE: To develop 3D personalized left ventricular (LV) models and thickening assessment framework for assessing regional wall thickening dysfunction and dyssynchrony in AMI patients.

    STUDY TYPE: Retrospective study, diagnostic accuracy.

    SUBJECTS: Forty-four subjects consisting of 15 healthy subjects and 29 AMI patients.

    FIELD STRENGTH/SEQUENCE: 1.5T/steady-state free precession cine MRI scans; LGE MRI scans.

    ASSESSMENT: Quantitative thickening measurements across all cardiac phases were correlated and validated against clinical evaluation of infarct transmurality by an experienced cardiac radiologist based on the American Heart Association (AHA) 17-segment model.

    STATISTICAL TEST: Nonparametric 2-k related sample-based Kruskal-Wallis test; Mann-Whitney U-test; Pearson's correlation coefficient.

    RESULTS: Healthy LV wall segments undergo significant wall thickening (P 50% transmurality) underwent remarkable wall thinning during contraction (thickening index [TI] = 1.46 ± 0.26 mm) as opposed to healthy myocardium (TI = 4.01 ± 1.04 mm). For AMI patients, LV that showed signs of thinning were found to be associated with a significantly higher percentage of dyssynchrony as compared with healthy subjects (dyssynchrony index [DI] = 15.0 ± 5.0% vs. 7.5 ± 2.0%, P 

    Matched MeSH terms: Magnetic Resonance Imaging, Cine*
  11. Haslbauer JD, Lindner S, Valbuena-Lopez S, Zainal H, Zhou H, D'Angelo T, et al.
    Int J Cardiol, 2019 Jan 15;275:179-186.
    PMID: 30360992 DOI: 10.1016/j.ijcard.2018.10.023
    BACKGROUND: Cancer-related treatment is associated with development of heart failure and poor outcome in cancer-survivors. T1 and T2 mapping by cardiovascular magnetic resonance (CMR) may detect myocardial injury due to cancer-related treatment.

    METHODS: Patients receiving cancer-related treatment regimes underwent screening of cardiac involvement with CMR, either within 3 months (early Tx) or >12 months (late Tx) post-treatment. T1 and T2 mapping, cardiac function, strain, ischaemia-testing, scar-imaging and serological cardiac biomarkers were obtained.

    RESULTS: Compared to age/gender matched controls (n = 57), patients (n = 115, age (yrs): median(IQR) 48(28-60), females, n = 60(52%) had reduced left ventricular ejection fraction (LV-EF) and strain, and higher native T1 and T2. The early Tx group (n = 52) had significantly higher native T1, T2 and troponin levels compared to the late Tx group, indicating myocardial inflammation and oedema (p 

    Matched MeSH terms: Magnetic Resonance Imaging, Cine/methods*
  12. Krishnasamy S, Krishna Nair A, Hashim SA, Raja Mokhtar RA
    Interact Cardiovasc Thorac Surg, 2019 12 01;29(6):976-977.
    PMID: 31363757 DOI: 10.1093/icvts/ivz191
    Liposarcoma is the second most common type of soft tissue malignancy in adults. They are malignant tumours with a mesenchymal origin. Mediastinal liposarcoma accounts for <1% of mediastinal tumours and 2% of liposarcoma. We report a patient with mediastinal liposarcoma who presented with cardiac tamponade, 25 years after the initial liposarcoma in the popliteal fossa.
    Matched MeSH terms: Magnetic Resonance Imaging, Cine
  13. Chan BT, Yeoh HK, Liew YM, Dokos S, Al Abed A, Chee KH, et al.
    Coron Artery Dis, 2018 06;29(4):316-324.
    PMID: 29261521 DOI: 10.1097/MCA.0000000000000596
    OBJECTIVE: This study investigated the intraventricular flow dynamics in ischaemic heart disease patients.

    PATIENTS AND METHODS: Fourteen patients with normal ejection fraction and 16 patients with reduced ejection fraction were compared with 20 healthy individuals. Phase-contrast MRI was used to assess intraventricular flow variables and speckle-tracking echocardiography to assess myocardial strain and left ventricular (LV) dyssynchrony. Infarct size was acquired using delayed-enhancement MRI.

    RESULTS: The results obtained showed no significant differences in intraventricular flow variables between the healthy group and the patients with normal ejection fraction group, whereas considerable reductions in kinetic energy (KE) fluctuation index, E' (P<0.001) and vortex KE (P=0.003) were found in the patients with reduced ejection fraction group. In multivariate analysis, only vortex KE and infarct size were significantly related to LV ejection fraction (P<0.001); furthermore, vortex KE was correlated negatively with energy dissipation, energy dissipation index (r=-0.44, P=0.021).

    CONCLUSION: This study highlights that flow energetic indices have limited applicability as early predictors of LV progressive dysfunction, whereas vortex KE could be an alternative to LV performance.

    Matched MeSH terms: Magnetic Resonance Imaging, Cine
  14. Mahmod M, Pal N, Rayner J, Holloway C, Raman B, Dass S, et al.
    J Cardiovasc Magn Reson, 2018 12 24;20(1):88.
    PMID: 30580760 DOI: 10.1186/s12968-018-0511-6
    BACKGROUND: Heart failure (HF) is characterized by altered myocardial substrate metabolism which can lead to myocardial triglyceride accumulation (steatosis) and lipotoxicity. However its role in mild HF with preserved ejection fraction (HFpEF) is uncertain. We measured myocardial triglyceride content (MTG) in HFpEF and assessed its relationships with diastolic function and exercise capacity.

    METHODS: Twenty seven HFpEF (clinical features of HF, left ventricular EF >50%, evidence of mild diastolic dysfunction and evidence of exercise limitation as assessed by cardiopulmonary exercise test) and 14 controls underwent 1H-cardiovascular magnetic resonance spectroscopy (1H-CMRS) to measure MTG (lipid/water, %), 31P-CMRS to measure myocardial energetics (phosphocreatine-to-adenosine triphosphate - PCr/ATP) and feature-tracking cardiovascular magnetic resonance (CMR) imaging for diastolic strain rate.

    RESULTS: When compared to controls, HFpEF had 2.3 fold higher in MTG (1.45 ± 0.25% vs. 0.64 ± 0.16%, p = 0.009) and reduced PCr/ATP (1.60 ± 0.09 vs. 2.00 ± 0.10, p = 0.005). HFpEF had significantly reduced diastolic strain rate and maximal oxygen consumption (VO2 max), which both correlated significantly with elevated MTG and reduced PCr/ATP. On multivariate analyses, MTG was independently associated with diastolic strain rate while diastolic strain rate was independently associated with VO2 max.

    CONCLUSIONS: Myocardial steatosis is pronounced in mild HFpEF, and is independently associated with impaired diastolic strain rate which is itself related to exercise capacity. Steatosis may adversely affect exercise capacity by indirect effect occurring via impairment in diastolic function. As such, myocardial triglyceride may become a potential therapeutic target to treat the increasing number of patients with HFpEF.

    Matched MeSH terms: Magnetic Resonance Imaging, Cine*
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