An efficient and fast multi-band focused bioimpedance solution with EIT-based reconstruction for pulmonary embolism assessment: a simulation study from massive to segmental blockage

Author(s):  
Duc Minh Nguyen ◽  
Luong Duong Trong ◽  
Alistair L McEwan

Abstract Objective: Pulmonary embolism (PE) is an acute condition that blocks the perfusion to the lungs and is a common complication of Covid-19. However, PE is often not diagnosed in time, especially in the pandemic time due to complicated diagnosis protocol. In this study, a non-invasive, fast and efficient bioimpedance method with the EIT-based reconstruction approach is proposed to assess the lung perfusion reliably. Approach: Some proposals are presented to improve the sensitivity and accuracy for the bioimpedance method: (1) a new electrode configuration and focused pattern to help study deep changes caused by PE within each lung field separately, (2) a measurement strategy to compensate the effect of different boundary shapes and varied respiratory conditions on the perfusion signals and (3) an estimator to predict the lung perfusion capacity, from which the severity of PE can be assessed. The proposals were tested on the first-time simulation of PE events at different locations and degrees from segmental blockages to massive blockages. Different object boundary shapes and varied respiratory conditions were included in the simulation to represent for different populations in real measurements. Results: The correlation between the estimator and the perfusion was very promising (R = 0.91, errors < 6%). The measurement strategy with the proposed configuration and pattern has helped stabilize the estimator to non-perfusion factors such as the boundary shapes and varied respiration conditions (3-5% errors). Significance: This promising preliminary result has demonstrated the proposed bioimpedance method’s capability and feasibility, and might start a new direction for this application.

2020 ◽  
Vol 71 (2) ◽  
pp. 399-410
Author(s):  
Khaled Abdelghany ◽  
Noha Osman ◽  
Eman Geneidi ◽  
Hala Abou Senna ◽  
Ahmed Nasr ◽  
...  

2020 ◽  
Vol 16 (2) ◽  
pp. 138-152
Author(s):  
Bingren Zhang ◽  
Chu Wang ◽  
Chanchan Shen ◽  
Wei Wang

Background: Responses to external emotional-stimuli or their transitions might help to elucidate the scientific background and assist the clinical management of psychiatric problems, but pure emotional-materials and their utilization at different levels of neurophysiological processing are few. Objective: We aimed to describe the responses at central and peripheral levels in healthy volunteers and psychiatric patients when facing external emotions and their transitions. Methods: Using pictures and sounds with pure emotions of Disgust, Erotica, Fear, Happiness, Neutral, and Sadness or their transitions as stimuli, we have developed a series of non-invasive techniques, i.e., the event-related potentials, functional magnetic resonance imaging, excitatory and inhibitory brainstem reflexes, and polygraph, to assess different levels of neurophysiological responses in different populations. Results: Sample outcomes on various conditions were specific and distinguishable at cortical to peripheral levels in bipolar I and II disorder patients compared to healthy volunteers. Conclusions: Methodologically, designs with these pure emotions and their transitions are applicable, and results per se are specifically interpretable in patients with emotion-related problems.


2020 ◽  
pp. 204589402098404
Author(s):  
Siyi Yuan ◽  
Huaiwu He ◽  
Yun Long ◽  
Yi Chi ◽  
Inéz Frerichs ◽  
...  

Background: Several animal studies have shown that regional lung perfusion could be effectively estimated by the hypertonic saline contrast electrical impedance tomography (EIT) method. Here, we reported an application of this method to dynamically assess regional pulmonary perfusion defect in a patient with acute massive pulmonary embolism. Case presentation: A 68-year-old man experienced sudden dyspnea and cardiac arrest during out-of-bed physical activity on the first day after partial mediastinal tumor resection. Acute pulmonary embolism (PE) was suspected due to acute enlargement of right heart and fixed inferior venous cava measured with bedside ultrasound. The computed tomography pulmonary angiography further confirmed large embolism in both left and right main pulmonary arteries and branches. The regional time impedance curves, which were obtained by a bolus of 10ml 10% NaCl through the central venous catheter, were then analyzed to quantitatively assess regional perfusion. Normal ventilation distribution with massive defects in regional perfusion in both lungs was observed, leading to a ventilation-perfusion mismatch and low oxygenation index (PaO2/FiO2=86 mmHg) at the first day of PE. The anticoagulation was performed with heparin, and the patient’s condition (such as shock, dyspnea, hypoxemia etc.), regional lung perfusion defect and ventilation-perfusion mismatch continuously improved in the following days. Conclusions: This case implies that EIT might have the potential to assess and monitor regional perfusion for rapid diagnosis of fatal PE in clinical practice.


Author(s):  
Shaha Pramod ◽  
Ragi Skanda ◽  
Bhoite Amol ◽  
Tamboli Asif ◽  
Gautama Amol

Introduction: Pulmonary embolism (PE) is the third most common acute heart disease after myocardial infarction and stroke and is a major public health problem. PE is a disease that has high morbidity and mortality, yet it is challenging to obtain a diagnosis. Objective: The study aims to assess the role of MDCT-PA in the diagnosis of pulmonary embolism, and it's associated conditions in suspected cases of pulmonary embolism. Materials and Methods: The study was conducted in the department of radiology in KRISHNA INSTITUTE OF MEDICAL SCIENCES DEEMED TO BE UNIVERSITY situated in KARAD equipped with a 16 slice MDCT scanner (EMOTION) manufactured by Siemens. Results: Through the study period of one and half year and have met the inclusion criteria, a total of 90 consecutive patients who presented with suspicion of PE were referred for MDCT-PA in the department of radio-diagnosis, Krishna Hospital, Karad. A review of all the cases was done, and the results were presented in the form of tables. Conclusion: Multidetector computed tomography pulmonary angiography can be used to confidently diagnose pulmonary embolism in which it is not contraindicated. MDCT-PA is the investigation of choice because it is a rapid, non-invasive study, highly sensitive and specific.


Author(s):  
Jeff M Smit ◽  
Mohammed El Mahdiui ◽  
Michiel A de Graaf ◽  
Arthur JHA Scholte ◽  
Lucia Kroft ◽  
...  

Patients presenting with chronic and acute chest pain constitute a common and important diagnostic challenge. This has increased interest in using computerized tomography for non-invasive visualization of coronary artery disease in patients presenting with acute chest pain to the emergency department, particularly the subset of patients who are suspected of having an acute coronary syndrome, but without typical electrocardiographic changes and with normal troponin levels at presentation. As a result of rapid developments in coronary computerized tomography angiography technology, high diagnostic accuracies for excluding coronary artery disease can be obtained. It has been shown that these patients can be discharged safely. The accuracy for detecting a significant coronary artery stenosis is also high, but the presence of coronary artery atherosclerosis or stenosis does not imply necessarily that the cause of the chest pain is related to coronary artery disease. Moreover, non-invasive detection of coronary artery disease by computerized tomography has been shown to be related with an increased use of subsequent invasive coronary angiography and revascularization, and further studies are needed to define which patients benefit from invasive evaluation following coronary computerized tomography angiography. Conversely, implementation of coronary computerized tomography angiography can significantly reduce the length of hospital stay, with a significant cost reduction. Additionally, computerized tomography is an excellent modality in patients whose symptoms suggest other causes of acute chest pain such as aortic aneurysm, aortic dissection, or pulmonary embolism. Furthermore, acquisition of the coronary arteries, thoracic aorta, and pulmonary arteries in a single computerized tomography examination is feasible, allowing ‘triple rule-out’ (exclusion of aortic dissection, pulmonary embolism, and coronary artery disease). Finally, other applications, such as evaluation of coronary artery plaque composition, myocardial function and perfusion, and non-invasive assessment of fractional flow reserve from coronary computerized tomography angiography, are currently being developed and may also become valuable in the setting of chronic and acute chest pain in the future.


2011 ◽  
Vol 6 (6) ◽  
pp. 521-528 ◽  
Author(s):  
Benilde Cosmi ◽  
Mathilde Nijkeuter ◽  
Massimo Valentino ◽  
Menno V. Huisman ◽  
Libero Barozzi ◽  
...  

2005 ◽  
Vol 105 (1) ◽  
pp. 26-34 ◽  
Author(s):  
J. J. Michiels ◽  
H. Hoogsteden ◽  
P. M. T. Pattynama

2003 ◽  
Vol 18 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Nicholas J. Screaton ◽  
Harvey O. Coxson ◽  
Steve E. Kalloger ◽  
Elisabeth M. Baile ◽  
Yasutaka Nakano ◽  
...  

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