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Biomedical subjects

D Saloner

Publications and source records attributed to D Saloner.

At least 19 recordsLinked to original sources
PubMed2000

Influence of stenosis morphology on flow through severely stenotic vessels: implications for plaque rupture.

Flow patterns and flow-related stresses contribute to the characterization of health risks, particularly the risk of plaque rupture, posed by a particular atherosclerotic stenosis. Blood flow in the presence of significant plaque deposits is investigated, and the influence of factors such as stenosis morphology and surface irregularity is evaluated. Solutions for three-dimensional, unsteady flow in these stenotic vessels are obtained for an incompressible, Newtonian fluid. The equations of motion are solved numerically using a finite volume formulation. The resulting flow patterns and shear and normal stresses are interpreted with respect to diagnostic implications, including the possibility of plaque rupture. The inadequacy of "percent stenosis" to characterize the risks posed by a particular plaque is demonstrated. Surface irregularity, stenosis aspect ratio, and the shape of the pulsatile waveform all have considerable influence on the flow field and on the stresses on the plaque. A measure of surface irregularity or plaque symmetry, in particular, may complement percent stenosis in diagnosing the risk of plaque rupture.

Arteriosclerosis↗
PubMed1999

Flow and motion.

An understanding of the underlying mechanisms that produce motion-related signal artifacts is useful in designing strategies to reduce or eliminate those effects. These strategies also provide the tools necessary to explore qualitatively and quantitatively a broad range of phenomena associated with flow and motion in the body. Advances in postprocessing methods and scanner hardware will help in the development of important new diagnostic tools.

Artifacts↗
PubMed1998

Determinants of image appearance in contrast-enhanced magnetic resonance angiography. A review.

The use of contrast agents in magnetic resonance (MR) studies of vascular pathology has permitted the exploration of regions that were heretofore poorly evaluated with conventional magnetic resonance angiography (MRA). An important feature of contrast-enhanced MRA (CE-MRA) is the very short acquisition times that are possible. The determination of the parameters to be used in a CE-MRA study rests on an understanding of the dynamics of the passage of the injected contrast agent and the response of the magnetization to the parameters of the MR imaging sequence. An overview of this interaction is presented.

Contrast Media↗
PubMed1996

Calculation of the magnetization distribution for fluid flow in curved vessels.

The signal intensity in magnetic resonance angiography (MRA) images reflects both morphological and flow-related features of vascular anatomy. A thorough understanding of MRA, therefore, demands a careful analysis of flow-related effects. Computational fluid dynamics (CFD) methods are very powerful in determining flow patterns in 3D tortuous vessels for both steady and unsteady flow. Previous simulations of MRA images calculated the magnetization of flowing blood by tracking particles as they moved along flow streamlines that had been determined by a CFD calculation. This manuscript describes MRA simulations that use CFD calculations to determine magnetization variation at a fixed point and, therefore, do not require streamline tracking to calculate the distribution of magnetization in flowing fluids. This method inherently accounts for uniform particle density, avoids problems associated with tracking particles close to the wall, and is well-suited to modeling pulsatile flow.

Blood Flow Velocity↗
PubMed1996

Central intraluminal saturation stripe on MR angiograms of curved vessels: simulation, phantom, and clinical analysis.

PURPOSE: To investigate the appearance of reduced signal intensity in the center of blood vessels on magnetic resonance (MR) angiograms that can mimic intraluminal thrombus. MATERIALS AND METHODS: Simulations and phantom studies were performed to analyze MR angiogram appearance distal to a pronounced curve. RESULTS: Saturation effects substantially lower the signal strength in the center of the vessel relative to that at the vessel periphery. These effects appeared even though the flow was well ordered and laminar. In curved geometries, secondary flow patterns produced counter-rotating vortices, which moved the fastest-moving particles to the outside of the curve and folded the slow-moving particles to the center of the vessel. CONCLUSION: Imaging parameter choices that reduce saturation, such as acquisition of a two-dimensional section transverse to the vessel and through the questionable region, effectively eliminate the central hypointensity effect in vivo.

Adult↗
PubMed1995

Assessment of carotid artery stenosis by ultrasonography, conventional angiography, and magnetic resonance angiography: correlation with ex vivo measurement of plaque stenosis.

PURPOSE: Several studies have investigated the correlation between Doppler ultrasonography (DUS), angiography (CA), and magnetic resonance angiography (MRA) in the evaluation of stenosis of the carotid bifurcation. However, these studies suffer from the lack of a true control-the lesion itself-and therefore conclusions about the diagnostic accuracy of each method remain relative. To determine the absolute accuracy of these modalities, we have prospectively studied lesion size with DUS, MRA, and CA in 28 patients undergoing 31 elective carotid endarterectomies and compared the percent of carotid stenosis determined by each technique to the carotid atheroma resected en bloc. METHODS: All patients were evaluated by each modality within 1 month before the thromboendarterectomy. With DUS, stenosis size was determined by standard flow criteria. For angiography and MRA, stenosis was defined as residual lumenal diameter/estimated normal arterial diameter (European Carotid Surgery Trial criteria). At surgery the carotid atheroma was removed en bloc in all patients. Patients in whom the lesion could not be removed successfully without damage were excluded from the study. Stenosis of the atheroma was determined ex vivo with high-resolution (0.03 mm3) magnetic resonance and confirmed by acrylic injection of the specimen under pressure and measurement of the atheroma wall and lumen. RESULTS: The measurements of the ex vivo stenosis by high-resolution magnetic resonance imaging correlated closely with the size of stenosis determined by the acrylic specimen casts (r = 0.92). By ex vivo measurement, the lesions were placed in the following size categories: 40% to 59% stenosis (n = 2), 60% to 79% stenosis (n = 6), 80% to 89% stenosis (n = 7), and 90% to 99% stenosis (n = 16). CONCLUSIONS: In general, the correlation of measurements of ex vivo stenosis with all modalities was good in these severely diseased arteries, although it was better for DUS (r = 0.80; p < 0.001) and MRA (r = 0.76; p < 0.001) than for CA (r = 0.56; p < 0.05).

Aged↗
PubMed1995

The AAPM/RSNA physics tutorial for residents. An introduction to MR angiography.

This article provides an overview of the basic principles of magnetic resonance (MR) angiography. The parameters in MR imaging manipulated to generate high contrast between flowing nuclei and stationary tissue are discussed. Two primary strategies are used: time-of-flight (TOF) MR angiography, which creates differences in magnetization magnitude between flowing and stationary nuclei, and phase-contrast MR angiography, which induces changes in the spatial orientation, or phase, of flowing nuclei relative to stationary nuclei. The end result of an MR angiographic study is typically a three-dimensional data set composed of either sequential two-dimensional sections or true three-dimensional data. Two-dimensional TOF methods are sensitive to slow flow and are valuable for differentiating between slow flow and occlusion. Three-dimensional TOF methods have better resolution and are more useful in imaging tortuous vessels. Phase-contrast MR angiography can be effectively used to avoid problems of magnetization saturation that occur in three-dimensional TOF studies and to eliminate signal from high-intensity stationary material such as blood products, which may appear bright and mimic flow signal in TOF studies. Careful use of postprocessing tools aids in the assessment of vascular abnormalities once the MR angiographic data have been acquired.

Angiography↗
PubMed1994

MR imaging of flow through tortuous vessels: a numerical simulation.

A novel computer simulation technique is presented that allows the calculation of images from Magnetic Resonance Angiography (MRA) studies of blood flow in realistic curving and branching two-dimensional vessel geometries. Fluid dynamic calculations provide flow streamlines through curved or branching vessels. MR simulations generate images for specific MR pulse sequence parameters. Simulations of steady flow in carotid bifurcation and carotid siphon geometries as imaged by a standard, flow-compensated, spoiled gradient echo sequence illustrate the major features seen in clinical time of flight MRA studies. The simulations provide insight into a number of artifacts encountered in MRA such as displacement artifacts, signal pile-up, truncation artifacts, and intravoxel phase dispersion.

Algorithms↗
PubMed1994

MRA studies of arterial stenosis: improvements by diastolic acquisition.

Cardiac-phase-specific data acquisition is used to reduce signal loss in MR Angiography resulting from disturbed flow. RF pulses are delivered continuously throughout the cardiac cycle, but incrementation of phase-encoding gradients and data storage are enabled only during the chosen part of the cycle. Studies in a stenotic pulsatile flow phantom demonstrate that poststenotic signal loss is primarily determined by the mean flow velocity, and is not appreciably affected by acceleration or deceleration of the mean flow rate. The signal loss is least in diastole. In vivo studies in patients with carotid artery disease show that data acquisition in diastole reduces the apparent degree and extent of carotid bifurcation stenosis and provides a crisper definition of the vascular lumen. The additional time required for cardiac-phase-specific acquisition can be reduced by gating only the lower-order phase-encoding lines while retaining acceptable image quality.

Blood Flow Velocity↗
PubMed1994

High speed bolus tagging: time resolved velocity quantification of pulsatile flow in a single breath hold.

We have implemented a high speed method for cardiac-triggered blood velocity quantification within a single breath hold on a conventional MR system. The method, based on bolus tagging, was tested using a pulsatile flow phantom and evaluated in vivo. The image acquisition time was reduced by a factor of N by acquiring N phase encode lines per bolus tag application. The clarity of the flow tag was found to vary with how k-space was covered during data collection. The technique was optimized and multiple bolus tag images were obtained throughout the cardiac cycle within a single breathold.

Aorta, Thoracic↗
PubMed1994

Measurement of internal carotid artery stenosis from source MR angiograms.

PURPOSE: To determine whether interpretation of internal carotid artery (ICA) stenosis from source partitions is more accurate than interpretation from maximum-intensity projections (MIPs) from three-dimensional (3D) time-of-flight (TOF) magnetic resonance (MR) angiography. MATERIALS AND METHODS: The percentage of diameter ICA stenosis was measured on source images and MIPs from sagittal (n = 150) and transverse (n = 140) 3D TOF MR angiography. Measurements were compared with those from conventional angiography. RESULTS: Sensitivity and specificity for distinguishing 70%-99% stenosis were 96% and 78%, respectively, for sagittal MIPs, 88% and 90% for sagittal source images, 92% and 86% for transverse MIPs, and 92% and 95% for transverse source images. Areas under the receiver operating characteristic curves statistically significantly increased (P < .05) with interpretation from source images. Complete loss of intravascular signal was not encountered on source partitions except within a greater than 85% stenosis. CONCLUSION: Interpretation of source partitions rather than MIPs reduces the tendency for overestimation of stenosis with MR angiography and improves the specificity for discriminating 70%-99% stenosis.

Aged↗
PubMed1992

Evaluation of myocardial perfusion abnormalities with gadolinium-enhanced snapshot MR imaging in humans. Work in progress.

To determine whether myocardial perfusion abnormalities could be detected in patients with coronary artery disease by means of contrast material-enhanced magnetic resonance (MR) images, a snapshot imaging technique was used in six patients with coronary artery disease and four healthy subjects in conjunction with pharmacologic stress (dipyridamole infusion) and bolus injection of gadopentetate dimeglumine. MR images from all patients and healthy subjects were quantitatively analyzed to define spatial changes in signal intensity after administration of dipyridamole and gadopentetate dimeglumine. The resultant findings were compared with findings on thallium-201 scintigrams obtained after administration of dipyridamole and on coronary arteriograms in all patients. Nine myocardial regions supplied by stenosed arteries showed diminished levels of signal intensity after infusion of the contrast agent compared with those of normally perfused regions. These findings were in agreement with those obtained with T1-201 scintigraphy (in eight of nine regions) and arteriography. Thus, contrast-enhanced high-speed MR imaging with use of dipyridamole enabled detection of regional perfusion abnormalities in humans.

Adult↗
PubMed1992

Magnetic resonance angiography of the carotid artery combining two- and three-dimensional acquisitions.

To assess the agreement between magnetic resonance angiography and conventional angiography in the evaluation of carotid stenosis, 61 carotid arteries of 40 patients were studied by combined two- and three-dimensional magnetic resonance angiography and conventional angiography. Stenosis of the internal carotid artery was categorized as mild, moderate, severe, critical, or complete occlusion. In 42 arteries, the degree of stenosis according to magnetic resonance angiography correlated exactly to that found by conventional angiography. In the remaining 19 carotid arteries, the magnetic resonance angiographic measurement of stenosis differed from the conventional angiographic measurement by only one size category. The Spearman rank correlation coefficient was 0.95 (p < 0.001). This study showed that by combining information from two- and three-dimensional magnetic resonance angiographic studies and making use of the advantages of each method, magnetic resonance angiography was comparable to conventional angiography in determining carotid stenosis. Magnetic resonance angiography tended to demonstrate a higher level of stenosis when there was a discrepancy. These data demonstrate that magnetic resonance angiography is a steadily improving technology. Although additional studies need to be done, it seems clear that magnetic resonance angiography will be an imaging modality comparable in accuracy to conventional angiography.

Aged↗
PubMed1991

Color Doppler artifact from metallic carotid clamp.

The presence of mirror artifacts in color Doppler has been noted by others. In that report, the artifact arose from scattering at the smooth vessel wall and appeared as signal outside the lumen of the vessel, but with no change in flow direction. As experience increases, recognition of the artifacts of color Doppler will lead to a better understanding and more precise evaluation. This case shows that a band of metal around the carotid artery causes registration errors in color-coded Doppler, and perhaps other metal foreign bodies in the soft tissues have similar potential. The specific appearance of the artifact will depend sensitively on the geometrical configuration of the metal body itself and on its orientation relative to the surrounding anatomy and the ultrasound probe. Appropriate placement of the transducer will reduce such artifact.

Artifacts↗
PubMed1991

Noninvasive evaluation of cerebral ischemia. Trends for the 1990s.

A number of diagnostic tools have been developed over the past decade that facilitate the noninvasive evaluation of cerebral ischemia. From duplex Doppler ultrasound to xenon computed tomography and magnetic resonance angiography, a greater trend toward combining both anatomic and function information is anticipated. The methodology, limitations, and current clinical applications of these three diverse techniques, with emphasis on xenon computed tomography and magnetic resonance angiography, are discussed. Both xenon computed tomography and magnetic resonance angiography can be performed on current systems with minimal hardware and software modifications. As a result, standard anatomic and structural imaging can be supplemented with diverse information such as quantitative brain perfusion without and with flow challenging as well as flow mapping and velocity imaging, which approximates conventional x-ray angiography.

Brain↗
PubMed1990

Flow velocity quantitation using inversion tagging.

A method for quantitating flow velocities is presented. The technique tags multiple boli of magnetization in transit across a thick selection slab using rf inversion pulses. Results in phantoms and in vivo demonstrate that the method is robust and can provide velocity determinations in tortuous vessels.

Blood Flow Velocity↗