Automated Assessment of Blood Flow in the Cardiovascular System Using 4D Flow MRI

Automated Assessment of Blood Flow in the Cardiovascular System Using 4D Flow MRI PDF Author: Mariana Bustamante
Publisher: Linköping University Electronic Press
ISBN: 9176853462
Category :
Languages : en
Pages : 77

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Book Description
Medical image analysis focuses on the extraction of meaningful information from medical images in order to facilitate clinical assessment, diagnostics and treatment. Image processing techniques have gradually become an essential part of the modern health care system, a consequence of the continuous technological improvements and the availability of a variety of medical imaging techniques. Magnetic Resonance Imaging (MRI) is an imaging technique that stands out as non-invasive, highly versatile, and capable of generating high quality images without the use of ionizing radiation. MRI is frequently performed in the clinical setting to assess the morphology and function of the heart and vessels. When focusing on the cardiovascular system, blood flow visualization and quantification is essential in order to fully understand and identify related pathologies. Among the variety of MR techniques available for cardiac imaging, 4D Flow MRI allows for full three-dimensional spatial coverage over time, also including three-directional velocity information. It is a very powerful technique that can be used for retrospective analysis of blood flow dynamics at any location in the acquired volume. In the clinical routine, however, flow analysis is typically done using two-dimensional imaging methods. This can be explained by their shorter acquisition times, higher in-plane spatial resolution and signal-to-noise ratio, and their relatively simpler post-processing requirements when compared to 4D Flow MRI. The extraction of useful knowledge from 4D Flow MR data is especially challenging due to the large amount of information included in these images, and typically requires substantial user interaction. This thesis aims to develop and evaluate techniques that facilitate the post-processing of thoracic 4D Flow MRI by automating the steps necessary to obtain hemodynamic parameters of interest from the data. The proposed methods require little to no user interaction, are fairly quick, make effective use of the information available in the four-dimensional images, and can easily be applied to sizable groups of data.The addition of the proposed techniques to the current pipeline of 4D Flow MRI analysis simplifies and expedites the assessment of these images, thus bringing them closer to the clinical routine. Medicinsk bildanalys fokuserar på extrahering av meningsfull information från medicinska bilder för att underlätta klinisk bedömning, diagnostik, och behandling. Bildbehandlingsteknik har gradvis blivit en viktig del av det moderna sjukvårdsystemet, en följd av de kontinuerliga tekniska förbättringarna och tillgången till en mängd olika medicinska bildtekniker. Magnetic resonanstomografi (MRT) är en bildteknik som är ickeinvasiv, flexibel och kan generera bilder av hög kvalitet utan joniserande strålning. MRT utförs ofta i klinisk miljö för att bedöma anatomi och funktion av hjärtat och blodkärlen. När man fokuserar på hjärt-kärlsystemet är bedömning av blodflödet viktigt för att kunna förstå och identifiera sjukdomar fullt ut. Bland de olika MRT-teknikerna som är tillgängliga för avbildning av hjärtat möjliggör 4D flödes-MRT komplett täckning av hjärtat i tre dimensioner över tid, och med hastighetsinformation i tre riktningar. 4D flödes-MRT är en mycket effektiv metod som kan användas för retrospektiv analys av blodflödesdynamik på vilken position som helst i den avbildade volymen. Till vardags görs dock blodflödesanalysen vanligtvis på bilder tagna med tvådimensionella avbildningsmetoder. Detta kan förklaras av deras kortare insamlingstider, högre spatiella upplösning, bättre signal-brusförhållandet, och att de är relativt enklare att efterbehandla jämfört med 4D flödes-MRT. Utvinningen av användbar information från 4D flödes-MRT-data är väldigt utmanande på grund av den stora mängden information som dessa bilder innehåller och kräver vanligtvis väsentlig användarinteraktion. Denna avhandling syftar till att utveckla och utvärdera metoder som underlättar efterbehandlingen av 4D flödes-MRT genom att automatisera de steg som är nödvändiga för att härleda hemodynamiska parametrarna av intresse från dessa data. De föreslagna metoderna kräver liten eller ingen användarinteraktion, är relativt snabba, använder all information som finns i de fyrdimensionella bilderna, och kan enkelt appliceras på stora datamängder. Tillägget av de i avhandlingen beskrivna metoderna till den nuvarande analysen av 4D flödes-MRT medger en avsevärd förenkling och uppsnabbad utvärdering, vilket gör att den avancerade 4D flödes MRT-tekniken kommer närmare att kunna användas i kliniskt rutinarbete.

Automated Assessment of Blood Flow in the Cardiovascular System Using 4D Flow MRI

Automated Assessment of Blood Flow in the Cardiovascular System Using 4D Flow MRI PDF Author: Mariana Bustamante
Publisher: Linköping University Electronic Press
ISBN: 9176853462
Category :
Languages : en
Pages : 77

Get Book

Book Description
Medical image analysis focuses on the extraction of meaningful information from medical images in order to facilitate clinical assessment, diagnostics and treatment. Image processing techniques have gradually become an essential part of the modern health care system, a consequence of the continuous technological improvements and the availability of a variety of medical imaging techniques. Magnetic Resonance Imaging (MRI) is an imaging technique that stands out as non-invasive, highly versatile, and capable of generating high quality images without the use of ionizing radiation. MRI is frequently performed in the clinical setting to assess the morphology and function of the heart and vessels. When focusing on the cardiovascular system, blood flow visualization and quantification is essential in order to fully understand and identify related pathologies. Among the variety of MR techniques available for cardiac imaging, 4D Flow MRI allows for full three-dimensional spatial coverage over time, also including three-directional velocity information. It is a very powerful technique that can be used for retrospective analysis of blood flow dynamics at any location in the acquired volume. In the clinical routine, however, flow analysis is typically done using two-dimensional imaging methods. This can be explained by their shorter acquisition times, higher in-plane spatial resolution and signal-to-noise ratio, and their relatively simpler post-processing requirements when compared to 4D Flow MRI. The extraction of useful knowledge from 4D Flow MR data is especially challenging due to the large amount of information included in these images, and typically requires substantial user interaction. This thesis aims to develop and evaluate techniques that facilitate the post-processing of thoracic 4D Flow MRI by automating the steps necessary to obtain hemodynamic parameters of interest from the data. The proposed methods require little to no user interaction, are fairly quick, make effective use of the information available in the four-dimensional images, and can easily be applied to sizable groups of data.The addition of the proposed techniques to the current pipeline of 4D Flow MRI analysis simplifies and expedites the assessment of these images, thus bringing them closer to the clinical routine. Medicinsk bildanalys fokuserar på extrahering av meningsfull information från medicinska bilder för att underlätta klinisk bedömning, diagnostik, och behandling. Bildbehandlingsteknik har gradvis blivit en viktig del av det moderna sjukvårdsystemet, en följd av de kontinuerliga tekniska förbättringarna och tillgången till en mängd olika medicinska bildtekniker. Magnetic resonanstomografi (MRT) är en bildteknik som är ickeinvasiv, flexibel och kan generera bilder av hög kvalitet utan joniserande strålning. MRT utförs ofta i klinisk miljö för att bedöma anatomi och funktion av hjärtat och blodkärlen. När man fokuserar på hjärt-kärlsystemet är bedömning av blodflödet viktigt för att kunna förstå och identifiera sjukdomar fullt ut. Bland de olika MRT-teknikerna som är tillgängliga för avbildning av hjärtat möjliggör 4D flödes-MRT komplett täckning av hjärtat i tre dimensioner över tid, och med hastighetsinformation i tre riktningar. 4D flödes-MRT är en mycket effektiv metod som kan användas för retrospektiv analys av blodflödesdynamik på vilken position som helst i den avbildade volymen. Till vardags görs dock blodflödesanalysen vanligtvis på bilder tagna med tvådimensionella avbildningsmetoder. Detta kan förklaras av deras kortare insamlingstider, högre spatiella upplösning, bättre signal-brusförhållandet, och att de är relativt enklare att efterbehandla jämfört med 4D flödes-MRT. Utvinningen av användbar information från 4D flödes-MRT-data är väldigt utmanande på grund av den stora mängden information som dessa bilder innehåller och kräver vanligtvis väsentlig användarinteraktion. Denna avhandling syftar till att utveckla och utvärdera metoder som underlättar efterbehandlingen av 4D flödes-MRT genom att automatisera de steg som är nödvändiga för att härleda hemodynamiska parametrarna av intresse från dessa data. De föreslagna metoderna kräver liten eller ingen användarinteraktion, är relativt snabba, använder all information som finns i de fyrdimensionella bilderna, och kan enkelt appliceras på stora datamängder. Tillägget av de i avhandlingen beskrivna metoderna till den nuvarande analysen av 4D flödes-MRT medger en avsevärd förenkling och uppsnabbad utvärdering, vilket gör att den avancerade 4D flödes MRT-tekniken kommer närmare att kunna användas i kliniskt rutinarbete.

Towards Personalized Models of the Cardiovascular System Using 4D Flow MRI

Towards Personalized Models of the Cardiovascular System Using 4D Flow MRI PDF Author: Belén Casas Garcia
Publisher: Linköping University Electronic Press
ISBN: 9176852172
Category :
Languages : en
Pages : 71

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Book Description
Current diagnostic tools for assessing cardiovascular disease mostly focus on measuring a given biomarker at a specific spatial location where an abnormality is suspected. However, as a result of the dynamic and complex nature of the cardiovascular system, the analysis of isolated biomarkers is generally not sufficient to characterize the pathological mechanisms behind a disease. Model-based approaches that integrate the mechanisms through which different components interact, and present possibilities for system-level analyses, give us a better picture of a patient’s overall health status. One of the main goals of cardiovascular modelling is the development of personalized models based on clinical measurements. Recent years have seen remarkable advances in medical imaging and the use of personalized models is slowly becoming a reality. Modern imaging techniques can provide an unprecedented amount of anatomical and functional information about the heart and vessels. In this context, three-dimensional, three-directional, cine phase-contrast (PC) magnetic resonance imaging (MRI), commonly referred to as 4D Flow MRI, arises as a powerful tool for creating personalized models. 4D Flow MRI enables the measurement of time-resolved velocity information with volumetric coverage. Besides providing a rich dataset within a single acquisition, the technique permits retrospective analysis of the data at any location within the acquired volume. This thesis focuses on improving subject-specific assessment of cardiovascular function through model-based analysis of 4D Flow MRI data. By using computational models, we aimed to provide mechanistic explanations of the underlying physiological processes, derive novel or improved hemodynamic markers, and estimate quantities that typically require invasive measurements. Paper I presents an evaluation of current markers of stenosis severity using advanced models to simulate flow through a stenosis. Paper II presents a framework to personalize a reduced-order, mechanistic model of the cardiovascular system using exclusively non-invasive measurements, including 4D Flow MRI data. The modelling approach can unravel a number of clinically relevant parameters from the input data, including those representing the contraction and relaxation patterns of the left ventricle, and provide estimations of the pressure-volume loop. In Paper III, this framework is applied to study cardiovascular function at rest and during stress conditions, and the capability of the model to infer load-independent measures of heart function based on the imaging data is demonstrated. Paper IV focuses on evaluating the reliability of the model parameters as a step towards translation of the model to the clinic.

Blood flow specific assessment of ventricular function

Blood flow specific assessment of ventricular function PDF Author: Alexandru Grigorescu Fredriksson
Publisher: Linköping University Electronic Press
ISBN: 9176854159
Category :
Languages : en
Pages : 95

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Book Description
The spectrum of cardiovascular diseases is the leading cause of morbidity and mortality globally. Early assessment and treatment of these conditions, acquired as well as congenital, is therefore of paramount importance. The human heart has a great ability to adapt to various hemodynamic conditions by cardiac remodeling. Pathologic cardiac remodeling can occur as a result of cardiovascular disease in an effort to maintain satisfactory cardiac function. With time, cardiac function diminishes leading to disease progression and subsequent heart failure, the end-point of many heart diseases, associated with very poor prognosis. Within the normal cardiac ventricles blood flows in highly organized patterns, and changes in cardiac configuration or function will affect these flow patterns. Conversely, altered flows and pressures can bring about cardiac remodeling. In congenital heart disease, even after corrective surgery, cardiac anatomy and thereby intracardiac blood flow patterns are inherently altered. The clinically most available imaging technique, ultrasound with Doppler, allows only for one-directional flow assessment and is limited by the need of clear examination windows, thus failing to fully assess the complex three-dimensional blood flow within the beating heart. Cardiovascular magnetic resonance imaging (CMR) with phase-contrast has the ability to acquire three-dimensional (3D), three-directional time resolved velocity data (3D + time = 4D flow data) from which visualization and quantification of blood flow patterns over the complete cardiac cycle can be performed. Four functional blood flow components have previously been defined based on the blood route and distribution through the ventricle, where the inflowing blood that passes directly to the outflow is called Direct flow. From these components, various quantitative measures can be derived, such as component volumes and kinetic energy (KE) throughout the cardiac cycle. In addition, the 4D flow technique has the ability to quantify and visualize turbulent flow with increased velocity fluctuations in the heart and vessels, turbulent kinetic energy (TKE). The technique has been developed and evaluated for assessment of left ventricular (LV) blood flow in healthy subjects and in patients with dilated dysfunctional left ventricles, showing significant changes in blood flow patterns and energetics with disease. There is however still no study addressing the gap in the spectrum from the healthy cohorts to patients with moderate to severe left ventricular remodeling. In Paper III, 4D flow CMR was utilized to assess LV blood flow in patients with subtle LV dysfunction, and a shift in blood flow component volumes and KE was seen from the Direct flow to the non-ejecting blood flow components. In patients with both left- and right-sided acquired and congenital heart disease, right ventricular (RV) function is of great prognostic significance, however this ventricle has historically been somewhat overseen. With its complex geometry, advanced physiology and retrosternal location, assessment of the RV is still challenging and the right ventricular blood flow is still incompletely described. In Paper I, the RV blood flow in healthy subjects was assessed, and the proportionally larger Direct flow component was located in the most basal region of the ventricle and possessed higher levels of KE at end-diastole than the other flow components suggesting that this portion of blood was prepared for efficient systolic ejection. In Paper II, the blood flow was assessed in the RV of patients with subtle primary LV disease, and even if conventional echocardiographic or CMR RV parameters did not show any RV dysfunction, alterations of flow patterns suggestive of RV impairment were found in the patients with the more remodeled LVs. With improvements of the cardiovascular health care, including the surgical techniques, the number of adult patients with surgically corrected complex congenital heart diseases increases, one of which is tetralogy of Fallot (ToF). Surgical repair of ToF involves widening of the pulmonary stenosis, which postoperatively may cause pulmonary insufficiency and regurgitation (PR). Disturbed or turbulent flow patterns are rare in the healthy cardiovascular system. With pathological changes, such as valvular insufficiency, increased amounts of TKE have been demonstrated. Turbulence is known to be harmful to organic tissues and could be significant in the development of ventricular remodeling, such as dilation and other complications seen in Fallot patients. In Paper IV, the RV intraventricular TKE levels were assessed in relation to conventional measures of PR. Results showed that RV TKE was increased in ToF patients with PR compared to healthy controls, and that these 4D flow-specific measures related slightly stronger to indices of RV remodeling than the conventional measures of PR. 4D flow CMR analysis of the intracardiac blood flow has the potential of adding to pathophysiological understanding, and thereby provide useful diagnostic information and contribute to optimization of treatment of heart disease at earlier stages before irreversible and clinically noticeable changes occur. The flow specific measures used in this thesis could be utilized to detect these alterations of intracardiac blood flow and could thus act as potential markers of progressing ventricular dysfunction, pathological remodeling or used for risk stratification in adults with early repair tetralogy of Fallot. Visualizations of intracardiac flow patterns could provide useful information to cardiac/thoracic surgeons pre- and post-operatively.

Fast and Accurate 4D Flow MRI for Cardiovascular Blood Flow Assessment

Fast and Accurate 4D Flow MRI for Cardiovascular Blood Flow Assessment PDF Author: Sven Petersson
Publisher:
ISBN: 9789175195063
Category :
Languages : en
Pages :

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Book Description


Improving Assessments of Hemodynamics and Vascular Disease

Improving Assessments of Hemodynamics and Vascular Disease PDF Author: Magnus Ziegler
Publisher: Linköping University Electronic Press
ISBN: 9176850986
Category :
Languages : en
Pages : 64

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Book Description
Blood vessels are more than simple pipes, passively enabling blood to pass through them. Their form and function are dynamic, changing with both aging and disease. This process involves a feedback loop wherein changes to the shape of a blood vessel affect the hemodynamics, causing yet more structural adaptation. This feedback loop is driven in part by the hemodynamic forces generated by the blood flow, and the distribution and strength of these forces appear to play a role in the initiation, progression, severity, and the outcome of vascular diseases. Magnetic Resonance Imaging (MRI) offers a unique platform for investigating both the form and function of the vascular system. The form of the vascular system can be examined using MR-based angiography, to generate detailed geometric analyses, or through quantitative techniques for measuring the composition of the vessel wall and atherosclerotic plaques. To complement these analyses, 4D Flow MRI can be used to quantify the functional aspect of the vascular system, by generating a full time-resolved three-dimensional velocity field that represents the blood flow. This thesis aims to develop and evaluate new methods for assessing vascular disease using novel hemodynamic markers generated from 4D Flow MRI and quantitative MRI data towards the larger goal of a more comprehensive non-invasive examination oriented towards vascular disease. In Paper I, we developed and evaluated techniques to quantify flow stasis in abdominal aortic aneurysms to measure this under-explored aspect of aneurysmal hemodynamics. In Paper II, the distribution and intensity of turbulence in the aorta was quantified in both younger and older men to understand how aging changes this aspect of hemodynamics. A method to quantify the stresses generated by turbulence that act on the vessel wall was developed and evaluated using simulated flow data in Paper III, and in Paper V this method was utilized to examine the wall stresses of the carotid artery. The hemodynamics of vascular disease cannot be uncoupled from the anatomical changes the vessel wall undergoes, and therefore Paper IV developed and evaluated a semi-automatic method for quantifying several aspects of vessel wall composition. These developments, taken together, help generate more valuable information from imaging data, and can be pooled together with other methods to form a more comprehensive non-invasive examination for vascular disease.

Cardiovascular Disability

Cardiovascular Disability PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030915698X
Category : Medical
Languages : en
Pages : 304

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Book Description
The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Cardiovascular Magnetic Resonance Imaging

Cardiovascular Magnetic Resonance Imaging PDF Author: Raymond Y. Kwong
Publisher: Springer
ISBN: 1493988417
Category : Medical
Languages : en
Pages : 473

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Book Description
The significantly updated second edition of this important work provides an up-to-date and comprehensive overview of cardiovascular magnetic resonance imaging (CMR), a rapidly evolving tool for diagnosis and intervention of cardiovascular disease. New and updated chapters focus on recent applications of CMR such as electrophysiological ablative treatment of arrhythmias, targeted molecular MRI, and T1 mapping methods. The book presents a state-of-the-art compilation of expert contributions to the field, each examining normal and pathologic anatomy of the cardiovascular system as assessed by magnetic resonance imaging. Functional techniques such as myocardial perfusion imaging and assessment of flow velocity are emphasized, along with the exciting areas of artherosclerosis plaque imaging and targeted MRI. This cutting-edge volume represents a multi-disciplinary approach to the field, with contributions from experts in cardiology, radiology, physics, engineering, physiology and biochemistry, and offers new directions in noninvasive imaging. The Second Edition of Cardiovascular Magnetic Resonance Imaging is an essential resource for cardiologists and radiologists striving to lead the way into the future of this important field.

Coronary Magnetic Resonance Angiography

Coronary Magnetic Resonance Angiography PDF Author: Andre J. Duerinckx
Publisher: Springer Science & Business Media
ISBN: 0387949593
Category : Medical
Languages : en
Pages : 355

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Book Description
In recent years, there has been increasing interest in the clinical applications of coronary angiography techniques. Coronary MRA can be instrumental in the evaluation of congenital coronary artery anomalies, however, the complexity of advanced MR pulse sequences and strategies may be overwhelming to many. Coronary MR Angiography demystifies the art of coronary MRA by providing a text in plain language with clearly illustrated imaging steps and protocols. Designed to bridge the gap between radiology and cardiology, it is written for physicians and scientists planning to incorporate this technique into their research or practice.

Adult Hydrocephalus

Adult Hydrocephalus PDF Author: Daniele Rigamonti
Publisher: Cambridge University Press
ISBN: 110703177X
Category : Medical
Languages : en
Pages : 331

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Book Description
Provides guidelines for managing this grossly underdiagnosed and undertreated condition, focusing on early detection and timely, effective interventions.

Quantification of Biophysical Parameters in Medical Imaging

Quantification of Biophysical Parameters in Medical Imaging PDF Author: Ingolf Sack
Publisher: Springer
ISBN: 9783031618451
Category : Medical
Languages : en
Pages : 0

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Book Description
The second edition of this book offers six new chapters covering the latest developments in quantitative medical imaging, including artificial intelligence, MRI mapping, sonography, elastography and cardiac CT. All the other existing chapters have been updated and expanded, many with new text and figures, to reflect the rapid translation and advancement of technology in this exciting area of biomedical research. This updated edition presents fundamental knowledge on the imaging quantification of biophysical parameters for clinical diagnostic purposes. Clinical imaging scanners are considered by the authors as physical measurement systems capable of quantifying intrinsic parameters for the representation of the constitution and biophysical properties of tissues in vivo. In one respect, this approach fosters the development of new imaging methods for highly reproducible, system-independent, and quantitative biomarkers. These methods are greatly detailed in the book. Alternatively, this new edition equips the reader with a better understanding of how the physical properties of tissues interact with signal generation in medical imaging, opening up new insights into the complex and fascinating relationship between structure and function in living tissues. This updated edition is of interest to all those who recognize the limitations of clinical diagnosis based primarily on visual inspection of images, and who wish to learn more about the diagnostic potential of quantitative, biophysically-based medical imaging markers, as well as the challenges posed by the scarcity of such markers for next-generation imaging technologies.