Sweat artifact and respiratory artifact occurring simultaneously in polysomnogram.
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A diagnostic ultrasound method is being developed for measuring surface contact areas at the tibio-femoral interface of a total knee replacement in a non-clinical industrial setting as an engineering design tool. As an initial step towards this, a previous study mathematically predicted the effect of ultrasound beam thickness on contact area measurements at a two-body interface. In the current study, a novel metal-on-polymer acoustic test object was constructed to create circular two-body interfaces of known geometry. The object was ultrasonically imaged, contact areas measured, and the results compared with the theoretical model previously developed.
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UNLABELLED: This study was aimed at assessing and classifying the incidence of Magnetic Resonance Angiography (MRA) artifacts using the 2D and 3D time-of-flight (TOF) technique. MATERIALS AND METHODS: from 300 MRA examinations performed January 1991 through April 1993, we selected the first 10 examinations for each vascular region which exhibited an artifact. Many kinds of artifacts were considered, i.e., hardware, sequence, magnetic susceptibility, patient and maximum intensity projection (MIP) artifacts. A superconductive 1.5-T magnet (Magnetom, Siemens) was used, with 2D and 3D TOF acquisitions. RESULTS: the quantitative analysis of artifact frequency showed that in the intracranial vessels (2D and 3D TOF sequences) the most common artifacts are saturation (30%) and magnetic susceptibility (30%) artifacts. As for neck vessels (3D TOF sequences), turbulence (40%) and lack of inclusion (30%) artifacts are the most common ones. In thoracic vessels (2D TOF sequences), MIP (50%) and ghost (30%) artifacts are the most common ones, while in the abdominal aorta (2D TOF sequences) magnetic susceptibility (20%), voluntary movement (20%), peristalsis (20%) and MIP (20%) artifacts occurred most frequently. Saturation (30%) and respiratory movement (30%) artifacts were the most common ones in the study of the renal arteries (3D TOF sequences), while MIP artifacts prevailed (40%) in the inferior vena cava (2D TOF sequences). Finally, MIP (40%) and patient movement (30%) artifacts were the most frequent ones in the study of the lower limbs (2 TOF sequences). CONCLUSIONS: in 2D and 3D TOF studies, being familiar with artifacts and their physical principles helps avoid image misinterpretation so that, if no technical means can prevent an artifact from occurring, at least it will not become a diagnostic pitfall.
The purpose of this study was to evaluate the presence of chemical-shift artifacts on cranial MR and to illustrate the interrelationship among chemical-shift artifacts, variable acquisition parameters, and field strength. Measurements of chemical-shift artifacts were performed on scans obtained from a volunteer imaged in a 1.5-T General Electric system at bandwidths of 8, 16, and 32 kHz, using a 24-cm field of view and an 8-kHz bandwidth with a 48-cm field of view. Chemical-shift displacements at 8 kHz were 6.6 and 14.2 mm at the respective fields of view. Retrospective review was also performed in 77 cases of cranial MR performed on a 1.4-T Technicare unit for the presence and source of chemical-shift artifact on spin-density and T2-weighted images. Most data reviewed showed no significant interference of chemical-shift artifacts on cranial images. An artifactual subdural fluid collection was a common artifact (n = 30/77). When present, this was due to shift of fat signal from subcutaneous tissues onto the brain in patients younger than 10 years old (n = 4/10) and correlated with the distance between brain and subcutaneous fat of less than the linear value of the chemical shift. When this artifact was present in adults (n = 25/67), it was due to shift of the medullary fat signal across the inner table of the skull. The latter also occurred in one child under 10. Apparent location shifts, consistent with the displacement expected from the chemical-shift artifact, were noted in five of five cases of intracranial lipoma. In one of these, the chemical-shift artifact disguised the presence of a large associated vessel. The method of calculating the linear displacement of chemical-shift artifact is reviewed, and the interrelationship of machine parameters and chemical-shift artifact is illustrated. Chemical-shift artifact increases proportionally with field strength and field of view. Increasing the bandwidth to decrease chemical-shift artifact has a resultant penalty in signal to noise but allows a lower time to echo. A lower time to echo can also be accomplished without increasing the bandwidth if asymmetric sampling is used. Awareness of the relationships among chemical-shift artifacts, acquisition parameters, and field strengths can result in a more tailored examination when the chemical-shift artifact is going to be a significant factor. In addition, interpreter error can be avoided by awareness of these relationships when reviewing images from outside institutions.
OBJECTIVES: The aim of this study was to identify the mechanism and features of artifacts encountered during transesophageal echocardiography of the aorta. BACKGROUND: Artifacts are an important potential limitation of transesophageal echocardiography of the aorta. METHODS: The mechanism of the artifacts was examined by in vitro modeling. The frequency and clinical correlates of artifacts were examined by retrospective review of transesophageal echocardiograms in 36 patients with aortic pathologic lesions. RESULTS: Two classes of artifact were seen: linear artifacts in the ascending aorta, which may mimic intimal flaps, and mirror image artifacts in the transverse and descending thoracic aorta. Linear artifacts in the ascending aorta, seen in 44% of patients, were shown in vitro to be multiple path artifacts caused by reflection of ultrasound within the left atrium. Linear artifacts in the ascending aorta were associated with dilatation of the ascending aorta and were more frequent when the aortic diameter exceeded the left atrial diameter (p < 0.001). The mirror image artifacts of the transverse and descending thoracic aorta give the appearance of a double-barrel aorta and were shown in vitro to be caused by the aorta-lung interface, which acts as a total reflector of ultrasound. Mirror image artifacts were seen in > 80% of patients. Artifacts were equally frequent with the sagittal and transverse imaging planes when biplane transesophageal echocardiography was used. CONCLUSIONS: Artifacts occur frequently during transesophageal echocardiography of the aorta. An understanding of why they occur and the features that distinguish them from true abnormalities should enhance the diagnostic accuracy of transesophageal echocardiography for aortic disease.
PURPOSE: The GDx (Laser Diagnostic Technologies, San Diego, CA) is a scanning laser polarimeter that measures retardation to assess retinal nerve fiber layer thickness in vivo. Eye movements during image acquisition may result in motion artifacts in the GDx image. The aims of this study were to investigate the effect of motion artifacts on the retardation values and to illustrate how motion artifacts can be identified. DESIGN: Observational case series. PARTICIPANTS: Thirty-two normal subjects and 28 glaucoma patients participated. METHODS: We imaged all 60 subjects with the GDx. Images with identified motion artifacts were compared with images without motion artifacts from the same eye and the same session. In 25 cases, the artifact was identified in the superior segment only, and the effect on the superior maximum parameter was calculated. In 26 cases, the artifact was observed in the inferior segment only, and the effect on the inferior maximum parameter was calculated. In nine cases, the artifact was observed superiorly and inferiorly, and the effect on both parameters was calculated. In all 60 cases, the effect on The Number (a summary parameter) was calculated. We also analyzed the groups of glaucoma patients and normal subjects separately. MAIN OUTCOME MEASURES: Superior maximum parameter, inferior maximum parameter, The Number parameters. RESULTS: In general, the identified motion artifacts led to an increase in retardation, reflected by an increase in the superior maximum and inferior maximum parameter by 5.9 micro m and 3.4 micro m, respectively (P < 0.001). The Number decreased by 3.4 with motion artifacts (P = 0.001). The variability of this effect was large. In one case, the motion artifact increased retardation by as much as 28.6 micro m. The effect of motion artifacts was greater in glaucoma patients than in normal subjects. CONCLUSIONS: The identified motion artifacts generally increase retardation values. This increase, however, is highly variable. Therefore, images with such motion artifacts should be viewed with caution or excluded from analysis.
OBJECTIVE: The objective of our study was to evaluate the method for detection and removal of artifacts in evoked potential monitoring described earlier by Cluitmans and colleagues in a clinical setting. METHODS: The method for detection and removal of artifacts by Cluitmans and colleagues is based on the assumption that a sweep of the recorded electroencephalogram (EEG) signal contains artifacts if one or more variables derived from the signal deviates strongly from the normal range of values. Once these normal ranges are defined, all future EEG recordings that are recorded under comparable circumstances can be automatically evaluated for artifacts by tracking when one or more signal variables falls outside the normal range. To assess the performance of this method in a clinical setting, recordings from a learning set were visually evaluated for artifacts. From the empirical distribution functions of the signal variables, the thresholds for automatic detection of artifacts were determined. The auditory evoked potential (AEP) waveforms resulting after automatic screening were compared with the waveforms obtained after visual evaluation of the raw signal combined with manual exclusion of signal periods containing artifacts. RESULTS: The quality of the resulting waveform was improved by our method of automatic detection and removal of artifacts in 97% of partly contaminated recordings. In only 2% of the recordings, automatic screening slightly degraded the resulting waveform. CONCLUSIONS: We conclude that the described method of automatic detection and removal of artifacts in AEP recordings effectively improves the quality of the resulting AEP waveform, without excessive rejection of artifact-free signal periods. The signal variables used in this method seem appropriate for distinguishing artifact-free signal periods from periods containing artifacts for the types of artifact that were studied.
When stimulating muscles, EMG signals recorded in neighboring muscles can be contaminated by stimulus artifacts, and artifact deletion is necessary. We have devised a digital technique for removing stimulus artifacts from rectified EMG recordings in muscles which lie close to a stimulated muscle. This artifact deletion method replaces the rectified EMG during the artifact interval with an estimate of the rectified EMG. Our research requires detection of very small changes in EMG levels. Therefore, the artifact deletion technique described in this paper was designed to leave less than 10 microV of artifact in the rectified EMG post-processing. This technique relies on being able to estimate the artifact duration. Since stimulated muscles have M-waves that can overlap with artifacts, our technique is only appropriate for removing artifacts in muscles which are not being stimulated. Unlike other artifact elimination techniques, our technique does not change the mean value of the rectified EMG, regardless of artifact width. In addition, it provides a more accurate estimate of the rectified EMG during the artifact interval as opposed to sample-and-hold techniques.
PURPOSE: To develop a technique to quantify artifact, and to use it to compare the effectiveness of several approaches to metal artifact reduction, including view angle tilting and increasing the slice select and image bandwidths (BWs), in terms of metal artifact reduction, noise, and blur. MATERIALS AND METHODS: Nonmetallic replicas of two metal implants (stainless steel and titanium/chromium-cobalt femoral prostheses) were fabricated from wax, and MR images were obtained of each component immersed in water. The differences between the images of each metal prosthesis and its wax counterpart were measured. The contributions from noise and blur were isolated, resulting in a measure of the metal artifact. Several off-resonance artifact reduction techniques were assessed in terms of metal artifact reduction capability, as well as signal to noise ratio and blur. RESULTS: Increasing the image BW from +/-16 kHz to +/-64 kHz was found to reduce the artifact by an average of 60%, while employing view angle tilting (VAT) alone was found to reduce the artifact by an average of 63%. The metal artifact reduction sequence (MARS), which combines several susceptibility artifact reduction techniques, resulted in the least amount of image distortion, reducing the artifact by an average of 79%. CONCLUSION: The results indicate that while VAT alone (with an image BW of +/-16 kHz) resulted in the smallest amount of total energy and no reduction in the signal-to-noise ratio compared to a conventional spin-echo pulse sequence, MARS resulted in significantly less artifact and dramatically less blur.
OBJECTIVE: Ultrasound artifacts arising from the lung-wall interface are either vertical (comet-tail artifacts) or horizontal. The significance of these artifacts for the diagnosis of pneumothorax was assessed. DESIGN: Prospective clinical study. SETTING: The medical ICU of a university-affiliated teaching hospital. PATIENTS: We compared 41 complete pneumothoraces with 146 hemithoraces in 73 critically ill patients in which computed tomography showed absence of pneumothorax. MEASUREMENTS: The anterior chest wall was investigated in supine patients using a portable device. The test was defined as positive for complete pneumothorax when only horizontal artifacts were visible, and negative when artifacts arising from the pleural line and spreading up to the edge of the screen (referred to as "comet-tail artifacts") were present. RESULTS: The feasibility was 98%. Ultrasound showed exclusive horizontal artifacts in all 41 analyzable cases of complete pneumothorax. In the pneumothorax-free group, "comet-tail artifacts" were present in 87 cases and exclusive horizontal artifacts in 56. Ultrasound as well as computed tomography showed anterior consolidation or anterior pleural effusion in three cases. Horizontal artifacts had a sensitivity and a negative predictive value of 100% and a specificity of 60% for the diagnosis of pneumothorax. Horizontal artifacts and absent lung sliding, when combined, had a sensitivity and a negative predictive value of 100% and a specificity of 96.5%. CONCLUSIONS: Ultrasound detection of the "comet-tail artifact" at the anterior chest wall allows complete pneumothorax to be discounted.
OBJECTIVE: To quantify image artifact reduction using a new technique (MARS--metal artifact reduction sequence) in vitro. DESIGN: Coronal T1-weighted MR images were obtained through two metal phantoms (titanium/chromium-cobalt and stainless steel femoral prostheses) immersed in water. Comparison of artifact volume was made with images obtained using conventional and modified (MARS) T1-weighted sequences. Signal intensity values outside a range of +/-40% the average signal intensity for water were considered artifact and segmented into low or high signal artifact categories. Considering the arbitrary selection of this threshold value, volumetric calculations of artifact were also evaluated at +/-50%, 60%, 70%, and 80% the mean signal for water. RESULTS: Conventional T1-weighted images produced 87% more low signal artifact and 212% more high signal artifact compared with the MARS modified T1-weighted images of the stainless steel prosthesis. Conventional T1-weighted images of the titanium prosthesis produced 84% more low signal artifact and 211% more high signal artifact than the MARS modified sequence. The level of artifact reduction was essentially uniform for the various threshold levels tested and was greatest at +/-20% the global signal intensity average for water. CONCLUSION: The MARS technique reduces the volume of image signal artifact produced by stainless steel and titanium/chromium-cobalt femoral prostheses on T1-weighted spin-echo images in a tissue phantom model.
PURPOSE: To determine the frequency and type of optical coherence tomography (OCT) fast macular thickness map (FMTM) scan artifacts, and whether these artifacts depend on patient diagnosis, demographics, and ocular therapy. DESIGN: Retrospective observational case series. METHODS: Records from patients who underwent an ophthalmologic evaluation by a member of the Duke University Eye Center vitreoretinal faculty and had an OCT scan produced by the FMTM protocol between July 7, 2003 and July 31, 2003 were reviewed. The relationships between OCT scan artifacts and ocular diagnosis, ocular treatment, and patient demographics were determined. Logistic regression was used to relate OCT scan artifacts simultaneously with ocular diagnosis and treatment. RESULTS: Scans from 171 eyes were analyzed. Retinal scan artifacts, though not observed in normal eyes, were identified frequently in eyes with macular pathology (P = .049). Artifacts were observed in 43.2% of all scans, and of these, an erroneous retinal thickness measurement was obtained in 62.2%. Six types of OCT surface map artifacts were observed. Of these, inner and outer retinal misidentification, degraded image artifact, and "off center" artifact were significantly associated with central thickness calculation errors (P < .001). Neovascular age-related macular degeneration (AMD), full-thickness macular hole, and photodynamic therapy were all associated with increased artifact (P = .002, .022, and <.001, respectively). CONCLUSION: Optical coherence tomography scan artifacts are seen surprisingly frequently, adversely affect retinal thickness measurements in a high proportion of cases, and are diagnosis-dependent. Recognition of these artifacts will improve retinal thickness measurement accuracy, and will prevent faulty treatment decisions that are based on inaccurate retinal thickness measurements.
It is widely accepted in the brain computer interface (BCI) research community that neurological phenomena are the only source of control in any BCI system. Artifacts are undesirable signals that can interfere with neurological phenomena. They may change the characteristics of neurological phenomena or even be mistakenly used as the source of control in BCI systems. Electrooculography (EOG) and electromyography (EMG) artifacts are considered among the most important sources of physiological artifacts in BCI systems. Currently, however, there is no comprehensive review of EMG and EOG artifacts in BCI literature. This paper reviews EOG and EMG artifacts associated with BCI systems and the current methods for dealing with them. More than 250 refereed journal and conference papers are reviewed and categorized based on the type of neurological phenomenon used and the methods employed for handling EOG and EMG artifacts. This study reveals weaknesses in BCI studies related to reporting the methods of handling EMG and EOG artifacts. Most BCI papers do not report whether or not they have considered the presence of EMG and EOG artifacts in the brain signals. Only a small percentage of BCI papers report automated methods for rejection or removal of artifacts in their systems. As the lack of dealing with artifacts may result in the deterioration of the performance of a particular BCI system during practical applications, it is necessary to develop automatic methods to handle artifacts or to design BCI systems whose performance is robust to the presence of artifacts.
The purpose of this paper is to investigate, identify and discuss artifacts and their sources arising in three-dimensional ultrasound (3D US) in clinical practice in order to increase the awareness of clinicians and sonographers with respect to common 3D US artifacts and to use this increased awareness to avoid or reduce the occurrence of misdiagnosis in 3D US studies. Patient 3D US data were acquired using several different scanners and reviewed interactively on the scanner and graphics workstations. Artifacts were catalogued according to artifact origin. Two-dimensional ultrasound (2D US) artifacts were classified whether they were of a B-mode or color/power Doppler origin and their presentation in the original scan planes and the resulting volume re-sliced planes and rendered images was identified. Artifacts unique to 3D US were observed, noted and catalogued on the basis of whether they arose during acquisition, rendering or volume editing operations. Acoustic artifacts identified included drop-out, shadowing, etc. whose presentation depended on the relationship between slice and imaging plane orientation. Color/power Doppler artifacts were related to gain, aliasing, and flash which could add apparent structure or confusion to the volume images. Rendered images also demonstrated artifacts due to shadowing and motion of adjacent structures, cardiac motion or pulsatility of the cardiac septum or vessel walls. Editing artifacts potentially removed important structures. Three-dimensional ultrasound is prone to the same types of artifacts encountered in 2D US imaging plus others unique to volume acquisition and visualization. The consequences of these diagnostically significant artifacts include mimicking of abnormal development, masses, or missing structures thus requiring careful study before reaching a diagnosis.
Proper interpretation of transbronchial biopsies is critical for appropriate patient management. Artifacts in lung tissue acquired during the biopsy procedure or subsequent processing may mimic "true" disease and potentially lead to incorrect diagnoses. In this study the interpretation of various artifacts in transbronchial biopsies will be correlated with the level of pathologist training and experience. Minced 1 to 2 mm fragments of normal lung tissue were processed to produce various tissue artifacts (atelectasis, sponge artifact, or bubble artifact). Seven hematoxylin-eosin-stained slides of various artifacts and three similar-appearing slides from "true" pulmonary diseases (lipoid pneumonia, usual interstitial pneumonia, and foreign body reaction) were evaluated by eight pathologists of different levels of training and experience. Most pathologists were unaware of the various artifacts in transbronchial biopsies and were occasionally able to differentiate them from true disease. Senior faculty frequently identified and correctly diagnosed the true pathology slides; however, they often failed to recognize artifacts. Junior faculty performed the best by correctly identifying the majority of true pathology and dismissed most artifacts. Junior and senior residents described the microscopic changes, but had more difficulty determining the significance of both true pathology and artifacts. Various artifacts in transbronchial biopsy specimens can create diagnostic dilemmas for all pathologists regardless of level of training. The elimination of these artifacts should reduce the possibility of biopsy misinterpretation.