• Title/Summary/Keyword: Cardiac MR

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Complete Recovery of Perfusion Abnormalities in a Cardiac Arrest Patient Treated with Hypothermia: Results of Cerebral Perfusion MR Imaging

  • Kim, Min Jeong;Park, Yae Won;Lim, Soo Mee
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.56-60
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    • 2018
  • Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.

The preprocessing effect using K-means clustering and merging algorithms in cardiac left ventricle segmentation

  • Cho, Ik-Hwan;Do, Ki-Bum;Oh, Jung-Su;Song, In-Chan;Chang, Kee-Hyun;Jeong, Dong-Seok
    • Proceedings of the KSMRM Conference
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    • 2002.11a
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    • pp.126-126
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    • 2002
  • Purpose: For quantitative analysis of the cardiac diseases, it is necessary to segment the left-ventricle(LV) in MR cardiac images. Snake or active contour model has been used to segment LV boundary. In using these models, however, the contour of the LV may not converge to the desirable one because the contour may fall into local minimum value due to image artifact in inner region of the LV Therefore, in this paper, we propose the new preprocessing method using K-means clustering and merging algorithms that can improve the performance of the active contour model.

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Dilated Cardiomyopathy in Acromegaly: a Case Report with Cardiac MR Findings

  • Kim, Min Seon;Choi, Hye Won;Seo, Yoon Seok;Lee, Whal;Park, Eun Ah
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.4
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    • pp.395-400
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    • 2019
  • Acromegaly is a rare endocrine disorder caused by excessive secretion of the growth hormone. There is a wide range of clinical manifestations from somatic symptoms to respiratory or cardiac failure. Among them, cardiovascular involvement is a leading cause of morbidity and mortality. There are relatively few cases reporting cardiac magnetic resonance imaging (CMR) findings of cardiomyopathy in patients with acromegaly. Thus, we report a case of acromegaly showing dilated cardiomyopathy focusing on the findings of CMR.

Minimizing MR Gradient Artefacts on ECG Signals for Cardiac Gating based on an Adaptive Digital Filter (적응 디지털 필터 기반의 MRI Cardiac Gating을 위한 심전도 신호의 MR Gradient 잡음 최소화 방법)

  • Park, Ho-Dong;Jang, Bong-Ryeol;Lee, Kyoung-Joung
    • Proceedings of the IEEK Conference
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    • 2006.06a
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    • pp.817-818
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    • 2006
  • In Magnetic Resonance Imaging(MRI), the QRS complex of ECG is used as a trigger signal for MRI scan. But, gradient and RF(radio frequency) artifacts which are caused to static and dynamic field in MRI scanner cause interference in the ECG. Also, the signal shape of theses artifacts can be similar to the QRS-complex, causing possible misinterpretation during patient monitoring and false gating of the MRI. In case of using general FIR or IIR band-pass filters for minimizing the artifacts, artifact-reduction-ratio is not excellent. So, an adaptive real-time digital filter is proposed for reduction of noise by gradient and RF(radio frequency) artifacts. The proposed filter for MRI-Gating is based on the noise-canceller with NLMS(Normalized Least Mean Square) algorithm. The reference signals of the adaptive noise canceller are a combination of the noisy three channel ECG signals. In conclusions, the proposed method showed the acceptable quality of ECG signal with sufficient SNR for gating the MRI and possibility of real time implementation.

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Echocardiographic Findings after Mitral Valve Replacement (승모판막치환수술 전후 심장초음파 소견의 변화에 관한 연구)

  • 이상진
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.656-663
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    • 1994
  • Evaluation of heart function is of importance in assessing the results of valvular heart surgery. Information on volume and functional change of heart chamber can be obtained by cardiac catheterization and echocardiography. We studied 41 patients with mitral stenosis[MS] and 23 patients with mitral regurgitation[MR] using M-mode echocardiography before and after mitral valve replacement[MVR] at Pusan Paik Hospital. Preoperative cardiac catheterization was available in 56 cases, and the results were obtained as follows. 1. In patients with MS, preoperative average LV end-diastolic dimension[EDD] and end-systolic dimension[ESD] were remained within normal range, but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative and postoperative LV ejection fraction[EF] were remained within the normal range and no significant change[P>0.05]. The preoperative left atrial dimension[LAD] was enlarged considerably above normal[P<0.01], but was significantly decreased after surgery[P<0.001]. The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05]. 2. In patients with MR, preoperative average end-diastolic dimension[EDD] and end-systolic dimension[ESD] were significantly greater than normal[P<005], but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative LV ejection fraction[EF] and fractional shortening[FS] were within normal range, and no significant change after surgery[P>0.05].The preoperative left atrial dimension[LAD] was enlarged considerably above normal [P<0.01], but was significantly decreased after surgery[P<0.001].The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05].

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Design of ECG/PPG Gating System in MRI Environment (MRI용 심전도/혈류 게이팅 시스템 설계)

  • Jang, Bong-Ryeol;Park, Ho-Dong;Lee, Kyoung-Joung
    • Journal of Biomedical Engineering Research
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    • v.28 no.1
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    • pp.132-138
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    • 2007
  • MR(magnetic resonance) image of moving organ such as heart shows serious distortion of MR image due to motion itself. To eliminate motion artifacts, MRI(magnetic resonance imaging) scan sequences requires a trigger pulse like ECG(electro-cardiography) R-wave. ECG-gating using cardiac cycle synchronizes the MRI sequence acquisition to the R-wave in order to eliminate image motion artifacts. In this paper, we designed ECG/PPG(photo-plethysmography) gating system which is for eliminating motion artifacts due to moving organ. This system uses nonmagnetic carbon electrodes, lead wire and shield case for minimizing RF(radio-frequency) pulse and gradient effect. Also, we developed a ECG circuit for preventing saturation by magnetic field and a finger plethysmography sensor using optic fiber. And then, gating pulse is generated by adaptive filtering based on NLMS(normalized least mean square) algorithm. To evaluate the developed system, we measured and compared MR imaging of heart and neck with and without ECG/PPG gating system. As a result, we could get a clean image to be used in clinically. In conclusion, the designed ECG/PPG gating system could be useful method when we get MR imaging of moving organ like a heart.

Magnetic Resonance Angiographic Evaluation as a Screening Test for Patients who are Scheduled for Cardiac Surgery (심장수술 대상자에서 선별 검사로서 두경부 MRA)

  • Suh, Jong-Hui;Choi, Si-Young;Kim, Yong-Hwan
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.718-723
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    • 2008
  • Background: The advances in surgical techniques, anesthesia management, perfusion methodology and postoperative intensive care have markedly decreased the mortality and cardiac morbidity of patients who undergo heart surgery over the past 2 decades. Nevertheless, it is well recognized that cardiac surgery carries a substantial risk for central nervous system complications. This study was conducted to evaluate the prevalence of subclinical cerebrovascular lesions in the head and neck by performing magnetic resonance angiography (MRA), and we investigated the clinical course of patients who had abnormal lesion seen on head and neck MRA. Material and Method: The subjects were 107 patients (71 men and 36 women ranging in age from 21 to 83 years) who were scheduled for cardiac surgery under nonemergency conditions between October 2005 and June 2008. Informed consent was obtained before the MRA. The carotid arteries, intracranial arteries and brain parenchyme were examined for subclinical cerebrovascular lesions by performing MRA. We reviewed the patients' medical records and MR findings to evaluate the prevalence of neurologically high risk patients and their clinical course. Result: The overall prevalence of neurologically high risk patients was 15.7% (17 patients). Among these patients, 11 patients had ischemic heart disease and 6 patients had valvular heart disease. Only 2 patients had a history of cerebrovascular disease. The clinical courses of 14 patients (13.1%) were changed according to their MRI findings. Conclusion: The prevalence of subclinical cerebrovascular disease in patients who were scheduled for cardiac surgery was higher than was expected. MR angiography was of value to identify these patients.

Clinical Usefulness of Phase-Contrast Cine MRI Evaluation in Patients with Cervical Myelopathy (경추 척수병증 환자에 있어서 Phase-Contrast Cine MRI 평가의 임상적 유용성)

  • Lim, Jeong-Hwan;Song, Jun-Hyeok;Shin, Kyu-Man;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1634-1641
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    • 2000
  • Objective : The cerebrospinal fluid(CSF) pulsates within the craniospinal axis in response to rhythmic cerebral blood volume variation during the cardiac cycle. The aim of this study is to characterize the normal and abnormal CSF flow and its waveforms in the cervical spinal subarachnoid space. Methods : The magnetic resonance(MR) images were obtained with 1.5 T(GE Signa, GE Medical Systems, Milwaukee, USA) unit using the 2 dimensional cine PC(phase contrast) sequence with cardiac gating and gradient recalled echo imaging. This pulse sequence yielded 16 quantitative flow-encoded images per cardiac cycle. Sagittal and axial images of the cervical spinal CSF space were obtained, and target sites were analyzed for characteristic CSF flow (TR=50ms, TE=12.5-15ms). The region of interest(ROI) was 1mm 3 in volume. Twenty six persons were included in this study : 10 healthy volunteers and 16 patients with cervical myelopathy. The post-operative cine MR study were also done in five patients. Results : The normal CSF pulsation dynamics in the cervical spine showed discrete systolic and diastolic components. The CSF flow revealed a sine wave pattern, in which the systolic phase was shorter than the diastolic phase(ratio=2 : 3). The patient group revealed decreased amplitudes of the CSF flow and irregularly distored flow waves. The systolic phase was elongated in the ROI above the stenotic level, whereas the diastolic phase was lengthened below the level. In the postoperative images, the abnormal pattern and amplitude were found to be corrected. Conclusion : From these results, the authors believe that the CSF flow study provides valuable informations regarding the extent of cervical stenosis and may be useful for the surgical planning and post-operative evaluation.

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Successful mitral repair in dogs by mitral annuloplasty using Hegar dilator: two case reports

  • Lee, Won-Jong;Kim, Junyoung;Moon, Chang-Hwan;Eom, TaeHeum;Son, DongJu;Lee, Seungmin;Lee, Haebeom;Jeong, Seong-Mok;Kim, Dae-Hyun
    • Journal of Veterinary Science
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    • v.23 no.1
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    • pp.11.1-11.10
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    • 2022
  • Mitral regurgitation (MR) is the most common heart disease in small-breed dogs. Mitral repair, which comprise artificial chorda tendineae implantation and mitral annuloplasty, has become the mainstay of treatment in the veterinary field. We report on two small dogs who underwent mitral repair surgery for MR. A Hegar dilator was used during mitral annuloplasty for accurate and reproducible surgery. In both cases, mitral regurgitant flow almost disappeared after surgery, and clinical signs improved. The treatment regimen was terminated 3 months after the surgery. We concluded that using a Hegar dilator may facilitate mitral valve repair surgery.