A Novel Tool for a Challenging Disease: Stasis Leg Ulcers Assessed Using QFlow in Triggered Angiography Noncontrast Enhanced Magnetic Resonance Imaging

Imaging characteristics of stasis leg ulcers (SLUs) are not easily demonstrated through existing diagnostic tools. Early diagnosis and treatment are crucial. This pilot study was conducted to assess the quantitative flow (QFlow) in triggered angiography noncontrast enhanced (TRANCE) magnetic resonance imaging (MRI) to identify the hemodynamics of victims with stasis leg ulcers (SLUs). This study included 33 patients with SLUs and 14 healthy controls (HC). The 33 patients with SLUs were divided into a reflux (15 patients) and a nonreflux group (18 patients). QFlow was done in the reflux, the nonreflux, and the HC. The stroke volume (SV), forward flow volume (FFV), absolute flow volume (AFV), mean flow (MF), and mean velocity (MV) were higher in the reflux than in the HC group in most segments, namely the external iliac vein (EIV), popliteal vein (PV), and great saphenous vein (GSV) (SV, p = 0.008; FFV, p = 0.008; absolute stroke volume (ASV), p = 0.008; MF, p = 0.002; MV, p = 0.009). No differences in the QFlow patterns were found in the GSV segment between the nonreflux group and the HC. Excellent performance in discriminating SLU with superficial venous reflux was reported for SV in the EIV and the PV (area under the curve (AUC) = 0.851 and 0.872), FFV in the EIV and PV (AUC = 0.854 and 0.869), ASV in the EIV and PV (AUC = 0.848 and 0.881), and MF in the EIV and PV (AUC = 0.866 and 0.868). The cutoff levels of SV/FFV/ASV/MF in the EIV/FV/PV/GSV for discriminating the SLU with superficial venous reflux were identified (p < 0.005). In conclusion, SLUs present different QFlow patterns by different etiology. The QFlow parameters of all vessel segments were higher in the morbid limbs of the reflux group than HC. The GSV segment of the nonreflux group displayed a pattern like the HC.

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Stasis Leg Ulcers: Venous System Revises by Triggered Angiography Non-Contrast-Enhanced Sequence Magnetic Resonance Imaging

Diagnostics ◽

10.3390/diagnostics10090707 ◽

2020 ◽

Vol 10 (9) ◽

pp. 707

Author(s):

Chien-Wei Chen ◽

Yuan-Hsi Tseng ◽

Min Yi Wong ◽

Chao-Ming Wu ◽

Bor-Shyh Lin ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Stroke Volume ◽

Venous Occlusion ◽

Leg Ulcers ◽

Flow Volume ◽

Resonance Imaging ◽

Mean Velocity ◽

Contrast Enhanced ◽

Valvular Insufficiency

Objectives: The distribution of venous pathology in stasis leg ulcers is unclear. The main reason for this uncertainty is the lack of objective diagnostic tools. To fill this gap, we assessed the effectiveness of triggered angiography non-contrast-enhanced (TRANCE)-magnetic resonance imaging (MRI) in determining the venous status of patients with stasis leg ulcers. Methods: This prospective observational study included the data of 23 patients with stasis leg ulcers who underwent TRANCE-MRI between April 2017 and May 2020; the data were retrospectively analyzed. TRANCE MRI utilizes differences in vascular signal intensity during the cardiac cycle for subsequent image subtraction, providing not only a venogram but also an arteriogram without the use of contrast agents or radiation. Results: TRANCE MRI revealed that the stasis leg ulcers of nine of the 23 patients could be attributed to valvular insufficiency and venous occlusion (including deep venous thrombosis [DVT], May–Thurner syndrome, and other external compression). Moreover, TRANCE MRI demonstrated no venous pathology in five patients (21.7%). We analyzed TRANCE MRI hemodynamic parameters, namely stroke volume, forward flow volume, backward flow volume, regurgitant fraction, absolute volume, mean flux, stroke distance, and mean velocity, in the external iliac vein, femoral vein, popliteal vein, and great saphenous vein (GSV) in three of the patients with valvular insufficiency and three of those with venous occlusion. We found that the mean velocity and stroke volume in the GSV was higher than that in the popliteal vein in all patients with venous valvular insufficiency. Conclusions: Stasis leg ulcers may have no underlying venous disease and could be confirmed by TRANCE-MRI. TRANCE MRI has good Interrater reliability between Duplex study in greater saphenous venous insufficiency. It also potentially surpasses existing diagnostic modalities in terms of distinguishable hemodynamic figures. Accordingly, TRANCE-MRI is a safe and useful tool for examining stasis leg ulcers and is extensively applied currently.

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Radiomics and Magnetic Resonance Imaging of Rectal Cancer: From Engineering to Clinical Practice

Diagnostics ◽

10.3390/diagnostics11050756 ◽

2021 ◽

Vol 11 (5) ◽

pp. 756

Author(s):

Francesca Coppola ◽

Valentina Giannini ◽

Michela Gabelloni ◽

Jovana Panic ◽

Arianna Defeudis ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Rectal Cancer ◽

Magnetic Resonance ◽

Accuracy Assessment ◽

Unmet Need ◽

Quantitative Information ◽

Added Value ◽

Diagnostic Tools ◽

Resonance Imaging ◽

Cross Sectional

While cross-sectional imaging has seen continuous progress and plays an undiscussed pivotal role in the diagnostic management and treatment planning of patients with rectal cancer, a largely unmet need remains for improved staging accuracy, assessment of treatment response and prediction of individual patient outcome. Moreover, the increasing availability of target therapies has called for developing reliable diagnostic tools for identifying potential responders and optimizing overall treatment strategy on a personalized basis. Radiomics has emerged as a promising, still fully evolving research topic, which could harness the power of modern computer technology to generate quantitative information from imaging datasets based on advanced data-driven biomathematical models, potentially providing an added value to conventional imaging for improved patient management. The present study aimed to illustrate the contribution that current radiomics methods applied to magnetic resonance imaging can offer to managing patients with rectal cancer.

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P613Cardiac magnetic resonance imaging derived left ventricular mechanical function in patients with atrial fibrillation and left atrial low voltage zones

European Heart Journal ◽

10.1093/eurheartj/ehz747.0222 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S Ulbrich ◽

R S Schoenbauer ◽

B Kirstein ◽

J Tomala ◽

Y Huo ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Atrial Fibrillation ◽

Magnetic Resonance ◽

Stroke Volume ◽

Left Atrial ◽

Low Voltage ◽

Left Ventricular ◽

Left Ventricular Stroke Volume ◽

Resonance Imaging ◽

Ventricular Filling

Abstract Background The relation of left atrial low voltage zones (LVZ) to left ventricular function in patients undergoing pulmonary vein isolation (PVI) is not known. Objective To explore the relationship of left atrial low voltage zones (LVZ) on left ventricular function in patients with atrial fibrillation. Methods From June to Nov. 2018, 107 (mean age 67y, 70 men, 73 persistent AF) consecutive patients with symptomatic AF underwent a PVI with LVZ mapping. Before PVI the left ventricular ejection fraction (EF) and stroke volume (SV) were measured by cardiac magnetic resonance imaging (CMR). From feature-tracking of CMR-cine images left ventricular global, systolic and diastolic longitudinal strains (GLS), circumferential strains (GCS) and radial strains (GRS) were calculated. Results Of 59 patients CMR scanning in sinus rhythm was performed, LVZ were present in 24 patients. LVEF was significantly lower in patients with left atrial LVZ (62±9% vs. 55±15%) (p=0,03). Left ventricular stroke volume was significantly decreased by the extent of LVZ (94±23 vs. 72±21ml), (p=0,03). The left ventricular diastolic strains during ventricular filling (caused by atrial contraction) of GLS (r=−0,52), GCS (r=−0,65) and GRS (r=−0,65) were highly signifcantly correlated to the occurence and extent of LVZ (each p<0,001 respectively). The only systolic ventricular strain was GLS, which decreased (r=−0,3, p=0,03) by the occurance of atrial low voltage. Conclusion The active, atrial part of diastolic left ventricular filling properties is impaired by the occurrence and extent of left atrial LVZ. In patients with left atrial LVZ the left ventricular stroke volume and ejection fraction is decreased already in sinus rhythm. It seems possible that atrial mechanical dysfunction and presence of atrial low voltage maybe predicted by LV diastolic strain analysis.

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Correlation between Echocardiography and MRI in Volumetric Analysis of Dilated Cardiomyopathy - A Cross-Sectional Study from Puttaparthi, Andhra Pradesh

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/265 ◽

2021 ◽

Vol 8 (19) ◽

pp. 1391-1396

Author(s):

Kushal Singh ◽

Anshita Singh ◽

Piyush Piyush

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Stroke Volume ◽

Dilated Cardiomyopathy ◽

Cardiac Mri ◽

Andhra Pradesh ◽

Cross Sectional Study ◽

Sectional Study ◽

Resonance Imaging ◽

Cross Sectional

BACKGROUND Echocardiography is considered as a traditional approach to clinically study dilated cardiomyopathy. Because of poor apical visibility, however, volumetric calculations are difficult to ascertain. In calculating left ventricle volumes and ejection fractions, magnetic resonance (MR) imaging has shown to be more accurate than echocardiography. Due to conflicting literature, the present study was conducted to diagnose dilated cardiomyopathy using 2 D - echocardiography and correlate these echocardiographic findings with magnetic resonance imaging (MRI). METHODS This observational cross-sectional study was conducted in the Department of Radio-diagnosis and Imaging, Sri Sathya Sai Institute of Higher Medical sciences, Puttaparthi, Andhra Pradesh, Pin 515134. The study group consisted of consecutive patients who had clinical suspicion of dilated cardiomyopathy. A total of 40 patients underwent both 2 D - echo and cardiac MRI on the same day. All patients underwent 2 - D echo which was performed at the frame rate of 40 - 80 frames per second in the left lateral decubitus position to obtain standard 2, 3, and 4 chambers as well as short axis views (GE Vingmed Vivid 7 Dimensions, Horton, Norway: 2.5 MHz transducer). MRI was performed on a 1.5 T scanner (Mangnetom Aera, Siemens, Erlangen, Germany). For patient monitoring and cardiac synchronization, 3 - lead electrocardiography was used. RESULTS In the present study, in comparison to reference standard (cardiac MRI), 2 D - echocardiography showed significant and systematic underestimation of enddiastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV). Good correlation between 2 D - echo and cardiac MRI was noted for end-diastolic volume (r = 0.89), stroke volume (r = 0.60) and ejection fraction (r = 0.75). CONCLUSIONS In summary, magnetic resonance imaging is an accurate, non-invasive, safe and advanced modality for evaluation of global left ventricular function and myocardial scarring. 2 D - echocardiography can be used for screening of the patients with clinically suspected dilated cardiac myopathy (DCM) and their follow up. KEYWORDS Echocardiography, MRI, Cardiomyopathy

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Is Aqueductal Stroke Volume, Measured with Cine Phase-contrast Magnetic Resonance Imaging Scans Useful in Predicting Outcome of Shunt Surgery in Suspected Normal Pressure Hydrocephalus?

Neurosurgery ◽

10.1227/01.neu.0000315863.32544.eb ◽

2008 ◽

Vol 63 (6) ◽

pp. E1209-E1209 ◽

Cited By ~ 8

Author(s):

Antonio Scollato ◽

Pasquale Gallina ◽

Nicola Di Lorenzo ◽

Gautam Bahl

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Stroke Volume ◽

Phase Contrast ◽

Normal Pressure ◽

Shunt Surgery ◽

Resonance Imaging ◽

Contrast Magnetic Resonance ◽

Predicting Outcome ◽

Cine Phase Contrast

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Dynamics of xylem and phloem sap flow in an outdoor zelkova tree visualized by magnetic resonance imaging

Tree Physiology ◽

10.1093/treephys/tpz120 ◽

2019 ◽

Vol 40 (3) ◽

pp. 290-304

Author(s):

Yasuhiko Terada ◽

Yusuke Horikawa ◽

Akiyoshi Nagata ◽

Katsumi Kose ◽

Kenji Fukuda

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Cross Section ◽

Sap Flow ◽

Diurnal Changes ◽

Flow Volume ◽

Resonance Imaging ◽

Flow Measurements ◽

Phloem Sap ◽

Xylem Flow

Abstract Xylem and phloem sap flows in an intact, young Japanese zelkova tree (Zelkova serrata (Thunb.) Makino) growing outdoors were measured using magnetic resonance imaging (MRI). Two propagator-based sequences were developed for q-space imaging: pulse field gradient (PFG) with spin echo (PFG-SE) and stimulated echo (PFG-STE), which were used for xylem and phloem flow measurements, respectively. The data evaluation methods were improved to image fast xylem flow and slow phloem flow. Measurements were taken every 2–3 h for several consecutive days in August 2016, and diurnal changes in xylem and phloem sap flows in a cross-section of the trunk were quantified at a resolution of 1 mm2. During the day, apparent xylem flow volume exhibited a typical diurnal pattern following a vapor pressure deficit. The velocity mapping of xylem sap flow across the trunk cross section revealed that the greatest flow volume was found in current-year earlywood that had differentiated in April–May. The combined xylem flow in the 1- and 2-year-old annual rings also contributed to one-third of total sap flow. In the phloem, downward sap flow did not exhibit diurnal changes. This novel application of MRI in visualization of xylem and phloem sap flow by MRI is a promising tool for in vivo study of water transport in mature trees.

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