An automatic cerebellum extraction method in T1-weighted brain MR images using an active contour model with a shape prior

Purpose

The objective of this paper was to automatically segment the cerebellum from T1-weighted human brain magnetic resonance (MR) images.

Materials and Methods

The proposed method constructs a cerebellum template using five sets of 3-T MR imaging (MRI) data, which are used to determine the initial position and the shape prior of the cerebellum for the active contour model. Our formulation includes the active contour model with shape prior, which thereby maintains the shape of the template. The proposed active contour model is sequentially applied to sagittal-, coronal- and transverse-view images. To evaluate the proposed method, it is applied to BrainWeb data and a 3-T MRI data set and compared with FreeSurfer with respect to performance assessment metrics.

Results

The segmented cerebellum was compared with the results from FreeSurfer. Using the manually segmented cerebellum as reference, we measured the average Jaccard coefficients of the proposed method, which were 0.882 and 0.885 for the BrainWeb data and 3-T MRI data set, respectively.

Conclusion

We presented the active contour model with shape prior for extracting the cerebellum from T1-weighted brain MR images. The proposed method yielded a robust and accurate segmentation result.     

Micrometer-sized iron oxide particle labeling of mesenchymal stem cells for magnetic resonance imaging-based monitoring of cartilage tissue engineering

Purpose

To examine mesenchymal stem cell (MSC) labeling with micrometer-sized iron oxide particles (MPIOs) for magnetic resonance imaging (MRI)-based tracking and its application to monitoring articular cartilage regeneration.

Methods

Rabbit MSCs were labeled using commercial MPIOs. In vitro MRI was performed with gradient echo (GRE) and spin echo (SE) sequences at 3T and quantitatively characterized using line profile and region of interest analysis. Ex vivo MRI of hydrogel-encapsulated labeled MSCs implanted within a bovine knee was performed with spoiled GRE (SPGR) and T_1ρ sequences. Fluorescence microscopy, labeling efficiency, and chondrogenesis of MPIO-labeled cells were also examined.

Results

MPIO labeling results in efficient contrast uptake and signal loss that can be visualized and quantitatively characterized via MRI. SPGR imaging of implanted cells results in ex vivo detection within native tissue, and T_1ρ imaging is unaffected by the presence of labeled cells immediately following implantation. MPIO labeling does not affect quantitative glycosaminoglycan production during chondrogenesis, but iron aggregation hinders extracellular matrix visualization. This aggregation may result from excess unincorporated particles following labeling and is an issue that necessitates further investigation.

Conclusion

This study demonstrates the promise of MPIO labeling for monitoring cartilage regeneration and highlights its potential in the development of cell-based tissue engineering strategies.     

Dual-high-frequency ultrasound excitation on microbubble destruction volume

Objective and motivation

The goal of this work was to test experimentally that exposing air bubbles or ultrasound contrast agents in water to amplitude modulated wave allows control of inertial cavitation affected volume and hence could limit the undesirable bioeffects.

Methods

Focused transducer operating at the center frequency of 10 MHz and having about 65% fractional bandwidth was excited by 3 μs 8.5 and 11.5 MHz tone-bursts to produce 3 MHz envelope signal. The 3 MHz frequency was selected because it corresponds to the resonance frequency of the microbubbles used in the experiment. Another 5 MHz transducer was used as a receiver to produce B-mode image. Peak negative acoustic pressure was adjusted in the range from 0.5 to 3.5 MPa. The spectrum amplitudes obtained from the imaging of SonoVue^TM contrast agent when using the envelope and a separate 3 MHz transducer were compared to determine their cross-section at the - 6 dB level.

Results

The conventional 3 MHz tone-burst excitation resulted in the region of interest (ROI) cross-section of 2.47 mm while amplitude modulated, dual-frequency excitation with difference frequency of 3 MHz produced cross-section equal to 1.2 mm.

Conclusion

These results corroborate our hypothesis that, in addition to the considerably higher penetration depth of dual-frequency excitation due to the lower attenuation at 3 MHz than that at 8.5 and 11.5 MHz, the sample volume of dual-frequency excitation is also smaller than that of linear 3-MHz method for more spatially confined destruction of microbubbles.     

Effects of therapeutic pulsed ultrasound and dimethylsulfoxide phonophoresis on oxidative stress parameters after injury induced by eccentric exercise

Introduction

The aim of the study was to evaluate the effects of TPU together with DMSO on oxidative stress parameters after eccentric exercise.

Methods

Thirty and six animals were divided in control; eccentric exercise (EE); EE + saline gel 0.9%; EE + TPU 0.8 W/cm²; EE + DMSO gel; EE + TPU + DMSO gel and submitted to one 90-min downhill run (1.0 km h⁻¹). TPU was used 2, 12, 24, 46 h after exercise session and 48 h after the animals were killed and the gastrocnemius muscles were surgically removed. Production of superoxide anion, creatine kinase (CK) levels, lipoperoxidation, carbonylation, and antioxidants enzymes were analyzed.

Results

Showed that TPU and gel-DMSO improved muscle healing. Moreover, superoxide anion production, TBARS level and protein carbonyls levels, superoxide dismutase and catalase activity were all decreased in the group TPU plus gel-DMSO.

Discussion

Our results show that DMSO is effective in the reduction of the muscular lesion and in the oxidative stress after eccentric exercise only when used with TPU.     

Application of multivariate analysis of TOF-SIMS spectra for studying the effect of high glucose intake on aortic lipid profile

Aim

To study the effect of long-term glucose feeding on aortic lipid composition by using the time of flight-secondary ion mass spectrometry (TOF-SIMS).

Method

Rats were divided into two groups, drinking water with or without 10% glucose from birth to 6 months of age. The aortic wall was dissected out, high-pressure frozen, freeze-fractured, freeze-dried and analyzed by TOF-SIMS using a Bismuth cluster ion source. Surface spectra were taken from standardized regions of the vessel wall.

Results

Different peaks, such as cholesterol, fatty acids (FAs) and diacylglycerols (DAGs), were identified by the principal component analysis as carries of variance between two groups. These peaks were then compared by conventional t-test. Our data showed that the intensity of cholesterol, but not FAs and DAGs, was significantly decreased in the glucose-drinking rat. Moreover, the long-term glucose intake changed ratios between different FAs in the aorta.

Conclusion

The long-term glucose intake led to decreased cholesterol intensity in the aortic wall and this effect was revealed through a global analytical approach with objective selection of significant variables.     

Susceptibility weighted imaging in detecting hemorrhage in acute cervical spinal cord injury

Background and Purpose

Susceptibility weighted imaging (SWI) is sensitive to deoxyhemoglobin and blood products such as hemosiderin in detecting microbleeds in the brain. However, there are no studies on SWI in the spine cord injury so far. The purpose of this study was to evaluate the role of SWI in detecting hemorrhage in acute cervical spinal cord injury (SCI).

Materials and Methods

Twenty-three patients with a history of acute cervical spine trauma were studied. High-resolution SWI, gradient-echo (GRE) T2* weighted-image (T2*WI) and conventional magnetic resonance imaging (MRI) were performed on all patients within 15 days of the onset of injury. On the basis of the MRI findings, the patients were classified into four patterns: normal cord, spinal cord edema, spinal cord contusion and spinal cord hemorrhage. Quantitative analysis was performed by calculating and comparing the signal ratio of the hemorrhage to normal spinal cord on the same slice of T2*WI and SWI. All patients were clinically evaluated in follow-up. Twenty volunteers were also scanned as a control group.

Results

Out of 23 patients with a history of acute cervical spine trauma, 4 patients showed normal spinal cord on both conventional MRI and SWI, 8 had only spinal cord edema and 5 had contusion on conventional MRI, but SWI showed hemorrhage in 2 of the 5 patients with spinal contusion on conventional MRI; the other 6 patients had intraspinal hemorrhage on conventional MRI, and SWI proved hemorrhage in all these 6 patients. There was a significant difference between the signal ratios of hemorrhage to normal tissue on T2*WI and SWI (Z=2.34, P=.02).

Conclusion

Susceptibility weighted imaging is more sensitive than conventional MRI in detecting hemorrhage in acute cervical SCI. This technique could prove to be a useful tool in the routine evaluation of cervical SCI patients.     

Paradoxical high signal intensity of hepatocellular carcinoma in the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI: initial experience

Purpose

To describe the paradoxical high signal intensity of hepatocellular carcinoma (HCC) in the hepatobiliary phase on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI).

Materials and Methods

A database search was performed to identify cases of HCC that showed unusual prolonged enhancement in the hepatobiliary phase of Gd-EOB-DTPA MRI. All patients received 3.0-T liver MRI including precontrast T1-weighted images, T2-weighted images and a post Gd-EOB-DTPA-enhanced dynamic study. The signal intensity of HCC was measured at pre-enhanced, arterial, portal, delayed and hepatobiliary phase using regions of interest. Radiologic and pathologic correlation was performed for the paradoxically prolonged enhancing portion of HCC in the hepatobiliary phase.

Results

Four patients (all male, age range 44-70; mean 57.5 years) were included in this study. All patients showed HCC lesions that were low signal intensity (SI) on T1-WI, high SI on T2-WI, enhanced in arterial phase, and washed-out in delayed phase. All cases showed paradoxically high SI in hepatobiliary phase, which was unusual for HCC. Pathologically, they were all diagnosed as well-differentiated HCC with prominent cytoplasm and a bile secreting appearance.

Conclusion

HCC may demonstrate the prolonged high signal intensity at the hepatobiliary phase on Gd-EOB-DTPA enhanced MRI. These HCCs tended to be highly differentiated and to have prominent bile secretion.     

Effect of dual-frequency clutter suppression in harmonic Doppler detection

Background

High-frequency Doppler imaging is highly potential for detection of blood flow in microcirculation. In a swept-scan system, however, the spectral broadening of tissue clutter limits the detectability of low-velocity flow signal. Conventionally, the scanning speed of transducer has to be reduced to alleviate the clutter interference but at the cost of imaging frame rate. For example, the blood velocity of 0.5 mm/s becomes detectable only with a scanning speed lower than 1 mm/s. In this study, an alternative method is examined by suppressing the clutter magnitude to reduce the interference to flow signal without sacrificing scanning speed.

Methods

The method of third harmonic (3f₀) transmit phasing can suppress the tissue harmonic clutter by transmitting at the fundamental and the additional 3f₀ frequencies to achieve mutual cancellation between the frequency-sum and the frequency-difference components of the second harmonic signal. With 3f₀ transmit phasing, the cut-off frequency of wall filtering can be reduced to preserve low-velocity flow without compromising the frame rate.

Results

Our results indicate that the 3f₀ transmit phasing effectively reduces the harmonic clutter magnitude and thus improves the flow signal-to-clutter ratio. Compared to the conventional counterpart, the clutter-suppressed color flow and power Doppler images show fewer clutter artifacts and is capable of detecting more low-velocity flow of microbubbles. The resultant color-pixel-density also improves with clutter suppression.

Conclusion

For the swept-scan high-frequency (>20 MHz) system, 3f₀ transmit phasing is capable of providing effective clutter suppression. With the same achievable scanning speed, the resultant Doppler image has higher sensitivity for low-velocity flow and is less susceptible to clutter artifacts.     

In vivo SNR in DENSE MRI; temporal and regional effects of field strength, receiver coil sensitivity and flip angle strategies

Aim

The influences on the signal-to-noise ratio (SNR) of Displacement ENcoding with Stimulated Echoes (DENSE) MRI of field strength, receiver coil sensitivity and choice of flip angle strategy have been previously investigated individually. In this study, all of these parameters have been investigated in the same setting, and a mutual comparison of their impact on SNR is presented.

Materials and methods

Ten healthy volunteers were imaged in a 1.5 T and a 3 T MRI system, using standard five- or six-channel cardiac coils as well as 32-channel coils, with four different excitation patterns. Variation of spatial coil sensitivity was assessed by regional SNR analysis.

Results

SNR ranging from 2.8 to 30.5 was found depending on the combination of excitation patterns, coil sensitivity and field strength. The SNR at 3 T was 53±26% higher than at 1.5 T (P<.001), whereas spatial differences of 59±26% were found in the ventricle (P<.001). Thirty-two-channel coils provided 52±29% higher SNR compared to standard five- or six-channel coils (P<.001). A fixed flip angle strategy provided an excess of 50% higher SNR in half of the imaged cardiac cycle compared to a sweeping flip angle strategy, and a single-phase acquisition provided a sixfold increase of SNR compared to a cine acquisition.

Conclusion

The effect of field strength and receiver coil sensitivity influences the SNR with the same order of magnitude, whereas flip angle strategy can have a larger effect on SNR. Thus, careful choice of imaging hardware in combination with adaptation of the acquisition protocol is crucial in order to realize sufficient SNR in DENSE MRI.     

Parametric harmonic-to-fundamental ratio contrast echocardiography: a novel approach to identification and accurate measurement of left ventricular area under variable levels of ultrasound signal attenuation

Objectives

We introduced a harmonic-to-fundamental ratio (HFR) of the radiofrequency (RF) signals that reduces confounding effects of attenuation. We studied whether HFR analysis of RF signals received from contrast microbubbles allows accurate measurement of the left ventricular (LV) cavity area under varying levels of attenuation.

Background

Attenuation is a fundamental problem in ultrasound imaging and limits the use of clinical echocardiography.

Methods

RF data from short axis systolic and diastolic scans were obtained from 14 open-chest dogs following left-atrial bolus of Optison. Attenuation was induced by interposed silicone pads calibrated to induce 7 dB or 14 dB reductions of the backscattered RF signal. RF images were reconstructed from the RF signals, HFR values calculated for each image pixel for 0 dB, 7 dB and 14 dB attenuation conditions, and LV area obtained by summation of “LV cavity pixels”. A reference LV cavity area was obtained from endocardial border tracings in enhanced scans by experts.

Results

Correlation of the HFR-defined and reference areas at systole was R = 0.95, R = 0.94, and R = 0.91 for 0 dB, 7 dB and 14 dB levels of attenuation, respectively, and at diastole was R = 0.95 for 0 dB, 7 dB and 14 dB levels of attenuation. The mean difference from both systolic and diastolic values was <1.45 cm² (i.e. negligible) in all attenuation settings.

Conclusion

Our novel HFR method supports precise measurement of the LV cavity area in contrast images with simulated high attenuation of ultrasound signals.     

Vibro-acoustography imaging of permanent prostate brachytherapy seeds in an excised human prostate - Preliminary results and technical feasibility

Objective:

The objective in this work is to investigate the feasibility of using a new imaging tool called vibro-acoustography (VA) as a means of permanent prostate brachytherapy (PPB) seed localization to facilitate post-implant dosimetry (PID).

Methods and materials:

Twelve OncoSeed (standard) and eleven EchoSeed (echogenic) dummy seeds were implanted in a human cadaver prostate. Seventeen seeds remained after radical retropubic prostatectomy. VA imaging was conducted on the prostate that was cast in a gel phantom and placed in a tank of degassed water. 2-D magnitude and phase VA image slices were obtained at different depths within the prostate showing location and orientation of the seeds.

Results:

VA demonstrates that twelve of seventeen (71%) seeds implanted were visible in the VA image, and the remainder were obscured by intra-prostatic calcifications. Moreover, it is shown here that VA is capable of imaging and locating PPB seeds within the prostate independent of seed orientation, and the resulting images are speckle free.

Conclusion:

The results presented in this research show that VA allows seed detection within a human prostate regardless of their orientation, as well as imaging intra-prostatic calcifications.     

A general dual-bolus approach for quantitative DCE-MRI

Purpose

To present a dual-bolus technique for quantitative dynamic contrast-enhanced MRI (DCE-MRI) and show that it can give an arterial input function (AIF) measurement equivalent to that from a single-bolus protocol.

Methods

Five rabbits were imaged using a dual-bolus technique applicable for high-resolution DCE-MRI, incorporating a time resolved imaging of contrast kinetics (TRICKS) sequence for rapid temporal sampling. AIFs were measured from both the low-dose prebolus and the high-dose main bolus in the abdominal aorta. In one animal, TRICKS and fast spoiled gradient echo (FSPGR) acquisitions were compared.

Results

The scaled prebolus AIF was shown to match the main bolus AIF, with 95% confidence intervals overlapping for fits of gamma-variate functions to the first pass and linear fits to the washout phase, with the exception of one case. The AIFs measured using TRICKS and FSPGR were shown to be equivalent in one animal.

Conclusion

The proposed technique can capture even the rapid circulation kinetics in the rabbit aorta, and the scaled prebolus AIF is equivalent to the AIF from a high-dose injection. This allows separate measurements of the AIF and tissue uptake curves, meaning that each curve can then be acquired using a protocol tailored to its specific requirements.     

Quantitative assessment of mobile protein levels in human knee synovial fluid: feasibility of chemical exchange saturation transfer (proteinCEST) MRI of osteoarthritis

Purpose

To establish the feasibility of chemical exchange saturation transfer (proteinCEST) MRI in the differentiation of osteoarthritis (OA) knee joints from non-OA joints by detecting mobile protein and peptide levels in synovial fluid by determining their relative distribution.

Materials and Methods

A total of 25 knees in 11 men and 12 women with knee injuries were imaged using whole knee joint proteinCEST MRI sequence at 3 T. The joint synovial fluid was segmented and the asymmetric magnetization transfer ratio at 3.5 ppm MTR_asym (3.5 ppm) was calculated to assess protein content in the synovial fluid. The 85th percentile of synovial fluid MTR_asym (3.5 ppm) distribution profile was compared using the independent Student's t test. The diagnostic performance of the 85th percentile of synovial fluid MTR_asym (3.5 ppm) in differentiating OA and non-OA knee joints was evaluated.

Results

The 85th percentile of synovial fluid MTR_asym (3.5 ppm) in knee joints with OA was 8.6%±3.4% and significantly higher than that in the knee joints without OA (6.3%±1.4%, P<.05). A knee joint with an 85th percentile of synovial fluid MTR_asym (3.5 ppm) greater than 7.7% was considered to be an OA knee joint. With the threshold, the sensitivity, specificity and overall accuracy for differentiating knee joints with OA from the joints without OA were 54% (7/13), 92% (11/12) and 72% (18/25), respectively.

Conclusion

proteinCEST MRI appears feasible as a quantitative methodology to determine mobile protein levels in synovial fluid and identify patterns characteristic for OA disease.     

Direct laser light enhancement of susceptibility of bacteria to gentamicin antibiotic

Objectives

To test the effect of pulsed (Q-switched) and continuous wave (CW) laser light at wavelength of 532 nm on the viability of free-living stationary phase bacteria with and without gentamicin (an antibiotic) treatment.

Methods

Free living stationary phase gram negative bacteria (Pseudomonas aeruginosa strain PAO1) was immersed in Luria Broth (LB) solution and exposed to Q-switched and CW lasers with and without the addition of the antibiotic gentamicin. Cell viability was determined at different time points.

Results

Laser treatment alone did not reduce cell viability compared to untreated control and the gentamicin treatment alone only resulted in a 0.5 log reduction in the viable count for P. aeruginosa. The combined laser and gentamicin treatment, however, resulted in a synergistic effect and viability was reduced by 8 logs for P. aeruginosa PAO1.

Conclusions

Combination of laser light with gentamicin shows an improved efficacy against P. aeruginosa.     

Fractal dimension of 40 MHz intravascular ultrasound radio frequency signals

Objective

Fully automatic tissue characterization in intravascular ultrasound systems is still a challenge for the researchers. The present work aims to evaluate the feasibility of using the Higuchi fractal dimension of intravascular ultrasound radio frequency signals as a feature for tissue characterization.

Methods

Fractal dimension images are generated based on the radio frequency signals obtained using mechanically rotating 40 MHz intravascular ultrasound catheter (Atlantis SR Plus, Boston Scientific, USA) and compared with the corresponding correlation images.

Conclusion

An inverse relation between the fractal dimension images and the correlation images was revealed indicating that the hard or slow moving tissues in the correlation image usually have low fractal dimension and vice-versa. Thus, the present study suggests that fractal dimension images may be used as a feature for intravascular ultrasound tissue characterization and present better resolution then the correlation images.     

Characterization of ultrasound-mediated destruction of drug-loaded microbubbles using an improved in vitro model

Introduction

Ultrasound mediated destruction of microbubbles (MBs) has become a promising tool for site specific drug and gene delivery. One of the most important properties of drug-loaded MBs is their destructibility by ultrasound. Therefore, the aim of this study was to establish a new in vitro model that allows evaluation of the kinetics of ultrasound-mediated MB destruction at near physiological conditions.In this work, a newly developed drug-loaded MB formulation was compared with unloaded MBs in order to assess the influence of drug-loading on their acoustic destructibility. Furthermore, drug-loaded MBs were compared to acoustically active lipospheres (AALs), comprising an additional layer of triacetin, as well as to a marketed MB contrast agent (SonoVue^®, Bracco Diagnostics, USA), used as standard.

Methods

MBs with phospholipid monolayer shells were produced by mechanical agitation of liposomal dispersions and octafluoropropane gas. AALs were accordingly produced by agitation of phospholipid-stabilized aqueous triacetin microemulsions with gas.The in vitro experimental setup for acoustic destructibility testing comprised a membrane cell, pressurized and brought to 37 °C in order to imitate human blood pressure and body temperature. The optimized egg-like cell shape provided optimal flow conditions and a minimized dead volume.Ultrasound with frequencies of 1 and 3 MHz and intensities, varying from 1 to 4 W/cm², was applied through a silicone membrane window to the cell. MB size distribution and concentration were measured by light blockage in equal time intervals during the sonication.

Results

The optimized in vitro setup demonstrated differences in the ultrasound destructibility of the MB formulations used. The fastest decay upon ultrasound exposure was found for SonoVue^®. Unloaded and drug-loaded MBs appeared to be comparably destructible to SonoVue^®. AALs were about 4.5-fold more stable than SonoVue^®. MB destructibility was also found to depend on particle diameter, corresponding to theoretical models described in the literature.

Conclusion

The optimized in vitro setup has rendered a fast and reliable laboratory tool for characterization of MB formulations.     

Detection of small intrahepatic metastases of hepatocellular carcinomas using diffusion-weighted imaging: comparison with conventional dynamic MRI

Purpose

The purpose of our study was to compare diffusion-weighted MR imaging (DWI) with conventional dynamic MRI in terms of the assessment of small intrahepatic metastases from hepatocellular carcinoma (HCC).

Materials and Methods

In 24 patients with multifocal, small (≤2 cm) intrahepatic metastatic foci of advanced HCC, a total of 134 lesions (≤1 cm, n=81; >1 cm, n=53) were subjected to a comparative analysis of hepatic MRI including static and gadopentetate dimeglumine-enhanced dynamic imaging, and DWI using a single-shot spin-echo echo-planar MRI (b values=50, 400 and 800 s/mm²), by two independent reviewers.

Results

A larger number of the lesions were detected and diagnosed as intrahepatic metastases on DWI [Reviewer 1, 121 (90%); Reviewer 2, 117 (87%)] than on dynamic imaging [Reviewer 1, 107 (80%); Reviewer 2, 105 (78%)] (P<.05). For the 81 smaller lesions (≤1 cm), DWI was able to detect more lesions than dynamic imaging [Reviewer 1, 68 (84%) vs. 56 (69%), P=.008; Reviewer 2, 65 (80%) vs. 55 (68%), P=.031], but there was no statistically significant difference between the two image sets for larger (>1 cm) lesions.

Conclusion

Due to its higher detection rate of subcentimeter lesions, DWI could be considered complementary to dynamic MRI in the diagnosis of intrahepatic metastases of HCCs.     

Quantification of myocardial viability distribution with Gd(DTPA) bolus-enhanced, signal intensity-based percent infarct mapping

Introduction

A substantial, common shortcoming of the currently used semiautomated techniques for the quantification of myocardial infarct with delayed enhancement magnetic resonance imaging is the assumption that the whole myocardial slab that corresponds to the hyperenhanced tomographic area is 100% nonviable. This assumption is, however, incorrect. To resolve this conflict, we have recently proposed the signal intensity percent-infarct mapping method and validated it in an ex vivo, canine experiment. The purpose of the current study has been the validation of the signal intensity percent-infarct mapping method in vivo, using a porcine model of reperfused myocardial infarct.

Methods

In swines (n=6), reperfused myocardial infarct was generated occluding for 90 min by an angioplasty balloon either the left anterior descending or the left circumflex coronary artery. To obtain DE images, Gd(DTPA) enhanced inversion-recovery fast gradient-echo acquisitions were carried out on day 28 after myocardial infarction. Scanning started 15 min after intravenous injection of 0.2 mmol/kg Gd(DTPA). At the end of the MRI session, the animal was sacrificed and 2,3,5-triphenyltetrazolium chloride staining was used to validate the existence and to determine the accurate size of the myocardial infarct. Tissue samples were taken and stained with hematoxylin-eosin and Masson's trichrome for histological assessment of the infarct and the periinfarct zone. The signal intensity percent-infarct mapping data were compared with corresponding data from the delayed enhancement images analyzed with SI_remote+2S.D. thresholding, and with corresponding triphenyltetrazolium-chloride staining data using Friedman's repeated measure analysis of variance on ranks.

Results

The infarct volume determined by the triphenyltetrazolium chloride, SI_remote+2S.D. and signal intensity percent-infarct mapping methods was 3.04 ml [2.74, 3.45], 13.62 ml [9.06, 18.45] and 4.27 ml [3.45, 6.33], respectively. Median infarct volume determined by SI_remote+2S.D. significantly differed from that determined by triphenyltetrazolium chloride (P<.05). The Bland-Altman overall bias was 12.49% of the volume of the left ventricle. Median infarct volume determined by signal intensity percent-infarct mapping, however, did not differ significantly (NS) from that obtained by triphenyltetrazolium chloride. Signal intensity percent-infarct mapping yielded only a 1.99% Bland-Altman overall bias of the left ventricular volume.

Conclusions

This in vivo study in the porcine reperfused myocardial infarct model demonstrates that signal intensity percent-infarct mapping is a highly accurate method for the determination of the extent of myocardial infarct. MRI images for signal intensity percent-infarct mapping are obtained with the pulse sequence of conventional delayed enhancement imaging and are acquired within clinically acceptable scanning time. This makes signal intensity percent-infarct mapping a practical method for clinical implementation.     

Acoustic Radiation Force Impulse-Imaging for the evaluation of the thyroid gland: a limited patient feasibility study

Purpose

Real-time tissue elastography, a qualitative elastography method, has shown promising results in the diagnostic work up of thyroid nodules. However, to our knowledge no study has evaluated a quantitative elastography method in the thyroid gland. The present study is a feasibility study evaluating Acoustic Radiation Force Impulse-Imaging, a novel quantitative elastography method in the thyroid gland.

Methods

ARFI-imaging involves the mechanical excitation of tissue using short-duration acoustic pulses to generate localized displacements in tissue. The displacements induce a lateral shear-wave propagation which is tracked using multiple laterally positioned ultrasound “tracking“ beams. Inclusion criteria were: thyroid nodules ?1 cm, non-functioning or hypo-functioning on radionuclide scanning, and cytological/histological assessment of thyroid nodule as reference method. All patients received conventional ultrasound, and examination of the thyroid gland including Power Doppler Ultrasound using a 9 MHz linear transducer, in addition real-time elastography (RTE) was performed at 9 MHz frequency and ARFI-imaging was performed at 4 MHz using Siemens (ACUSON S2000) B-mode-ARFI combination transducer.

Results

Sixty nodules in 55 patients were analyzed. Three nodules were papillary carcinoma. The stiffer the tissue the faster the shear wave propagates. The results obtained indicated that the shear wave velocity in thyroid lobes ranged between 0.5 and 4.9 m/s. The median velocity of ARFI-imaging in the healthy nodule-free thyroid gland, as well as in benign and malignant thyroid nodules was 1.98 m/s (range: 1.20-3.63 m/s), 2.02 m/s (range: 0.92-3.97 m/s), and 4.30 m/s (range: 2.40-4.50 m/s), respectively. While no significant difference in median velocity was found between healthy thyroid tissue and benign thyroid nodules, a significant difference was found between malignant thyroid nodules on the one hand and healthy thyroid tissue (p = 0.018) or benign thyroid nodules (p = 0.014) on the other hand. Specificity of ARFI-imaging for the differentiation of benign and malignant thyroid nodules was comparable with RTE (91-95%).

Conclusions

ARFI can be performed in the thyroid tissue with reliable results.     

Third harmonic transmit phasing for SNR improvement in tissue harmonic imaging with Golay-encoded excitation

Background

Ultrasound tissue harmonic signal generally provides superior image quality as compared to the linear signal. However, since the generation of the tissue harmonic signal is based on finite amplitude distortion of the propagating waveform, the penetration and the sensitivity in tissue harmonic imaging are markedly limited because of the low signal-to-noise ratio (SNR).

Methods

The method of third harmonic (3f₀) transmit phasing can improve the tissue harmonic SNR by transmitting at both the fundamental (2.25 MHz) and the 3f₀ (6.75 MHz) frequencies to achieve mutual enhancement between the frequency-sum and the frequency-difference components of the second harmonic signal. To further increase the SNR without excessive transmit pressure, coded excitation can be incorporated in 3f₀ transmit phasing to boost the tissue harmonic generation.

Results

Our analyses indicate that the phase-encoded Golay excitation is suitable in 3f₀ transmit phasing due to its superior transmit bandwidth efficiency. The resultant frequency-sum and frequency-difference components of tissue harmonic signal can be simultaneously Golay-encoded for SNR improvement. The increase of the main-lobe signal with the Golay excitation in 3f₀ transmit phasing are consistent between the tissue harmonic measurements and the simulations. B-mode images of the speckle generating phantom also demonstrate the increases of tissue harmonic SNR for about 11 dB without noticeable compression artifacts.

Conclusion

For tissue harmonic imaging in combination with the 3f₀ transmit phasing method, the Golay excitation can provide further SNR improvement. Meanwhile, the axial resolution can be effectively restored by pulse compression while the lateral resolution remains unchanged.