Real-time analysis of myocardial contractility.
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Blood Pressure Determination↗
Biomedical subjects
W R Brody
Publications and source records attributed to W R Brody.
Changes in vein grafts following aorto-coronary bypass induced by pressure and ischemia.
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Animals↗
Histologic fate of the venous coronary artery bypass in dogs.
The histologic fate of venous grafts used for coronary artery bypass has been observed with light and electron microscopy in dogs. Endothelial damage and thrombosis were chiefly limited to the first postoperative week. The muscular media uniformly suffered extensive necrosis and inflammatory cell infiltration during the first week. Its smooth muscle cells either hypertrophied, died or underwent apparent fibroblastic transformation, with eventual fibrous replacement, to a variable degree, of the vein wall. Vascular wall ischemia due to interruption of vasa vasorum during transplantation appears to initiate these medial changes. Much more slowly, intimal thickening by myointimal cells and collagen may reduce the graft lumen to a variable extent.
Animals↗
Visual and tactile tracking with step commands. NASA CR-623.
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Data Display↗
Digital subtraction angiography in the evaluation of neoplasms.
Intravenous and intraarterial DSA studies were performed in patients being evaluated for possible neoplastic disease. DSA studies were obtained of the head, neck, chest, abdomen and extremities to evaluate the potential use of this technique in the cancer patient's workup. The results of this study suggest that many cancer patients can have the extent of tumor involvement defined using intravenous digital subtraction angiography. However, due to the number of false negative examinations, this study should not be relied upon as the only screening procedure. The current best application of DSA appears to be its use in conjunction with intraarterial injections as a faster and more economical alternative to angiography and in following up these neoplasms with intravenous DSA after appropriate therapy to evaluate possible recurrence or metastatic spread. Hybrid subtraction techniques and/or the development of new contrast media may greatly facilitate the use of intravenous DSA in conjunction with cancer diagnosis.
Abdominal Neoplasms↗
Intravenous angiography using scanned projection radiography: preliminary investigation of a new method.
The use of digital subtraction techniques combined with fluoroscopy has rekindled interest in arteriography using intranvenous injections of contrast media. A new method is proposed for intravenous angiography in which an x-ray source and xenon detector array from a computed tomographic (CT) scanner are used to scan a region of interest to produce projection image. In order to provide adequate visualization of small concentrations of iodine in blood vessels, a subtraction scheme is used to remove the contribution from overlapping soft tissue and bone. Initial experiments with a temporal subtraction algorithm on phantoms have demonstrated the ability to image simulated blood vessels of 1.7-mm diameter containing dilute diatrizoate with an iodine concentration of 3.7 mg/cc, at an exposure of less than 100 mR. Vascular structures 5-8 mm in diameter have been imaged in dogs with iodine concentrations of less than 37 mg/cc using temporal subtraction. Principal advantages of the method over other film or fluoroscopic subtraction techniques are: 1) wide dynamic range an low noise of the (CT) detectors, providing excellent iodine sensitivity; 2) high scatter rejection; and 3) efficient utilization of x-ray dose.
Angiography↗
A quantitative in vivo comparison of six contrast agents by digital subtraction angiography.
Digital subtraction angiography (DSA) technology can now visualize many significant arterial structures from intravenous injections of contrast media. Image quality of these DSA studies is related to contrast agent enhancement. This study compares contrast agents of differing iodine concentration, viscosity, and osmolarity. A technique is described that utilizes a scanned projection digital radiographic system to compare quantitatively degrees of intra-arterial opacification after the administration of six intravenous contrast agents: iothalamate (at four different concentrations and in combinations with two different cations), diatrizoate, and ioxaglate. The quantitative arterial enhancement was compared in dogs utilizing an extra-period latin-square multiple change-over clinical trial design. The contrast agents span a range of organically bound iodine from 282 mg I/ml. When rate and volume of contrast agent injected are held constant, intra-arterial opacification is directly a function of the iodine concentration (mg I/ml) of the agent injected, while osmolarity and viscosity have no effect on opacification. These studies support the use of agents with high iodine concentration for maximum vascular visualization.
Angiography↗
An experimental evaluation of central vs. peripheral injection for intravenous digital subtraction angiography (IV-DSA).
At a given radiation dosage and field of view, five variables are under meaningful control for intravenous digital subtraction angiography (IV-DSA): concentration and quantity of contrast media injected, volume of injectate, rate of injection, and site of injection. Some controversy exists regarding the selection of a central vs. a peripheral injection site for IV-DSA. This study determined the influence of the site of injection on the peak and width of the arterial time-concentration curve produced by contrast media. Using a noninvasive, in vivo, quantitative x-ray measurement method, 36 separate injections (10 ml of ioxaglate at 8 ml/sec) were administered into the cephalic vein, subclavian vein, and main pulmonary artery in dogs. Injection sites were varied using a Latin-square experimental design. Cardiac output, central blood volume and the peak and width of the contrast media time-concentration curves were measured. The average peak enhancement was greatest for the pulmonary artery injection site. Normalizing peak and width values to make the pulmonary artery values 100%, the average peak values for injections into the subclavian vein and cephalic vein were 93% and 56%, and the average widths were 141% and 163%, respectively. These data support the use of a more central injection site for optimizing IV-DSA examinations.
Angiography↗
Some useful concepts of matched filtering in intravenous digital subtraction angiography.
Using computer calculations and assumed contrast bolus curves, several aspects of the application of temporal integration methods and matched filtering to intravenous digital subtraction angiography (IV-DSA) were studied. The topics included the improvement in signal-to-noise ratio (SNR) of the final image provided by simple integration, a comparison of the SNR performance of matched filtering and extensive integration, the degradation of SNR caused by the motion of noniodinated objects and the sensitivity of SNR to variations in DSA bolus dynamics from patient to patient. Additionally the dependence of matched filter SNR on exposure position and duration was both estimated and demonstrated with clinical DSA images. The results indicate that a substantial improvement in SNR can be obtained with only moderate integration increasing to a two X improvement for longer durations. Integration methods are able to withstand moderate durations (2 seconds) of motion and still provide image quality superior to more conventional DSA results.
Angiography↗
Variability of myocardial CT measurements in vivo.
Variability of myocardial CT measurements, as indicated by standard deviations of mean CT numbers from four myocardial regions, was compared in 12-second scans, 3-second scans, and gated end-diastolic and end-systolic images, all from the same 12 seconds of scan data, both without and with radiographic contrast enhancement in experimental animals. There were statistically significant differences (P less than 0.05) in standard deviations of myocardial CT measurements when comparing 3-second and 12-second scans without contrast (10.4 vs. 7.7 CT#s), and 12-second scans without and with contrast (7.7 vs. 11.2 CT#s). Standard deviations of mean myocardial CT measurements were significantly greater (P less than 0.01) in gated images (end-diastolic) when compared with 12-second scans, both without contrast (22.2 vs. 7.7 CT#s) and with contrast (20.2 vs. 11.2 CT#s). In this study variability of myocardial CT measurements increased as scan time decreased, with radiographic contrast enhancement and with gating cardiac images.
Animals↗
Fast minimum variance estimator for limited angle CT image reconstruction.
Many applications of diagnostic cross sectional imaging require that images be reconstructed from a limited number of projections (limited angle). Convolution back projection has been unsuitable in these applications. Methods for reconstruction based on stochastic estimation theory, such as the minimum variance estimator, use a discrete linear measurement model and are suitable for limited angle reconstruction. Unfortunately, the computational requirements of these methods have precluded their use. In this paper, starting from the general minimum variance estimator x = RxyRyy-1y, a computationally efficient (fast) estimator is derived for limited angle reconstruction by choosing Rxy and Ryy in the simplest way consistent with the geometric considerations of data acquisition. Minimum variance has in the past been precluded from use by the large amount of computation required to compute Ryy-1. With the fast estimator, the computation is avoided because Ryy has a particular form that allows factorization of the matrix into a product of matrices, each of which is easily inverted. A demonstration of the estimator for the reconstruction of sharp peaks is provided. Image quality is similar to that obtained with other methods.
Models, Theoretical↗
Regional myocardial flow estimation using computed tomography.
A novel method is presented for estimating regional myocardial blood flow (RMBF) using x-ray computed tomography (CT). Two major setbacks are removed from the existing methods; namely, the requirement for intra-arterial bolus injection of tracer, and the inability to determine regional volumes of tracer distribution when the corresponding partition coefficients are unknown. The mathematical model developed for RMBF estimation combines both the tracer dispersion process and the CT measurement process. Intravenously administered contrast media (tracer) is assumed to be perfectly mixed by the myocardium. Tracer dynamics, as measured by CT (CT#s. vs time curves) in the myocardial regions and in the left ventricular chamber, can then be used to compute cardiac output, regional volumes of tracer distribution, and absolute RMBF. These computations use the zeroth and the first moments of the measured CT#s. vs time curves. Errors due to partial volume effects, and methods for their correction, are analysed. This formulation is readily adapted to existing computed tomographic systems having the capability to produce multiple sequential CT scans.
Coronary Circulation↗
A method for selective tissue and bone visualization using dual energy scanned projection radiography.
Information contained in the x-ray energy spectrum can be used to produce selective radiographic images of bone or soft tissue. A method has been devised to separate bone and soft tissue based upon differences in photoelectric absorption and Compton scattering using an appropriate combination of images obtained with radiographic exposures at 70 KVP and 140 KVP. Since photoelectric absorption is highly dependent upon atomic number, high atomic number materials such as calcium can be easily separated from water density substances. Using a prototype system for line-scanned radiography, selective subtraction of bone or soft-tissue has been implemented. Because this method uses a conventional broad-spectrum x-ray source, it was necessary to develop a nonlinear polynomial approximation to estimate tissue and bone thickness. The model was verified with phantom studies using water and aluminum. The application of this dual-energy bone and soft-tissue separation to chest radiography is demonstrated. This method allows accurate estimation of tissue and bone thickness and should find application to chest radiography for improved lesion detection and for bone mineral assessment.
Animals↗
Generalized image combinations in dual KVP digital radiography.
Dual energy basis decomposition techniques apply to single projection radiographic imaging. The high and low energy images are non-linearly transformed to generate two energy-independent images characterizing the integrated Compton/photoelectric attenuation components. Characteristic linear combinations of these two basis images identify unknown materials, cancel known materials, and generate synthesized monoenergetic images. The problems of intervening materials and material displacement are solved in general for a wide class of clinical imaging tasks. The basis projection angle identifies one from a family of energy selective imaging tasks, and such performance measures as the contrast enhancement factor (CEF) and signal to noise ratio (SNR) are expressed as functions of this angle. Algorithms for the decomposition of high and low energy measurements are compared and experimental images are included.
Computers↗
Noise reduction methods for hybrid subtraction.
In digital subtraction angiography, hybrid subtraction provides selective vessel images free of soft-tissue motion artifacts but with a lower signal-to-noise ratio (SNR) than temporal subtraction images. An image processing method called measurement-dependent filtering has been developed to enhance the SNR of hybrid images without losing resolution or selectivity. Linear combinations of four images consisting of a pre- and postcontrast dual-energy measurement pair form both the hybrid image and a lower noise but less selective vessel image. The noise-reduced image is derived by combining the low-frequency components of the hybrid image with the high-frequency components of the lower noise image in a variety of ways. The results of the filtering method, when tested on both phantom and clinical data, display images with about the same degree of conspicuity as the hybrid image and a SNR approaching that of the temporal image.
Angiography↗
Intraarterial digital subtraction spinal angiography.
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Angiography↗