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At least 523 records · Page 29Linked to original sources

A realistic torso model for magnetocardiography.

This paper contains the description of an inhomogeneous, multi-compartmental volume conductor model which is in use in our group. Although initially developed for the study of the ECG, it has been found to serve equally well for simulating the magnetocardiogram (MCG), the forward problem, and as a basis for source analysis of the MCG, the inverse problem. For both problems some illustrative examples are included demonstrating the necessity of using an inhomogeneous volume conductor model of the torso, having realistic--preferably tailored--geometry. A simple inverse procedure, based on correlation techniques, is included for the solution of the problem of source localization when an accurate description of the inhomogeneous volume conductor is available.

Adult↗

Endorectal ultrasound in the preoperative staging of rectal tumors. A learning experience.

The preoperative staging of rectal cancer has important implications for treatment as local therapies become increasingly utilized. Seventy-seven patients underwent preoperative staging using endorectal ultrasonography. All patients had complete pathologic staging and none had preoperative radiotherapy. Depth of invasion of the tumor was accurately predicted in 75 percent of cases in the entire group, with 22 percent overstaged and 3 percent understaged. Accuracy improved greatly over the study period, and in the past six months, 95 percent have been accurately staged for depth of invasion with 5 percent overstaged. Lymph nodes have been properly classified into positive and negative groups in 88 percent of cases in the past year, with a specificity of 90 percent and a sensitivity of 88 percent. Endorectal ultrasound is an accurate preoperative staging modality. Accuracy is improved greatly with increased experience and it has been found that the 5-layer anatomical model facilitates accurate staging. Introduction of the ultrasound probe through a previously placed proctoscope ensures complete scanning of the entire lesion and should be used for the majority of examinations.

Adult↗

In vitro validation of some flow assumptions for the prediction of the pressure distribution during obstructive sleep apnoea.

An adequate description of the pressure distribution exerted by the fluid flow on pharyngeal walls is a first requirement to enhance the understanding, modelling and, consequently, the prediction of airway collapse during obstructive sleep apnoea. From a fluid mechanical point of view, several flow assumptions can be formulated to reduce the governing flow equations. The relevance of some major flow assumptions and the accuracy of the resulting flow description with respect to obstructive sleep apnoea was investigated on a rigid geometrical replica of the pharynx. Special attention was given to the influence of geometrical asymmetry and to the position of the flow separation point. An in vitro experimental and theoretical study of steady pharyngeal fluid flow is presented for different constriction heights and upstream pressures. Pressure and velocity distributions along a rigid in vitro replica of the oro-pharyngeal cavity were compared with different flow predictions based on various assumptions. Fluid flow models were tested for volume flow rates ranging from 5 to 120 1 min(-1) and for minimum apertures between 1.45 and 3.00 mm. Two-dimensional flow models were required and predicted experimental results with an accuracy of 15%. Flow theories classically used in the case of a Starling resistor provided poor agreement.

Air Pressure↗

Detection of alpha electro-encephalogram onset following eye closure using four location-based techniques.

Detection of alpha activity in the electro-encephalogram (EEG) has been used extensively in neurophysiological studies. Previously applied alpha parameterisation techniques, which utilise the amplitude information from a pair of differential electrodes, are often susceptible to interference from artifact signals. This is an issue if the purpose of detecting the change in alpha wave synchronisation is the basis of an environmental control system (ECS). An alternative approach to alpha activity detection is proposed that utilises the information from an array of electrodes on the scalp to estimate the apparent location of alpha activity in the brain. Four methods are described that successfully detect the onset of alpha EEG increase following eye closure by monitoring the apparent location of alpha activity in the head. The methods use Bartlett beamforming, a four-sphere anatomical head model, the MUSIC algorithm and a new 'power vector' technique. Of the methods described, the power vector technique is found to be the most successful. The power vector technique detects the alpha increase associated with eye closure in times that are, on average, 33% lower than previously applied alpha detection methods.

Algorithms↗

Noninvasive characterisation of multiple ventricular events using electrocardiographic imaging.

Distributions of epicardial potentials, calculated from body surface electrocardiograms (ECGs), were investigated to determine if they could enable detection of multiple sites of ventricular activity. An anatomical model of the human ventricular myocardium was used to simulate activation sequences initiated at nine different ventricular pairs of sites. From these sequences, body surface ECGs were simulated at 352 sites on the torso surface and then used to reconstruct epicardial potentials at 202 sites. The criterion for detection of dual ventricular events was the presence of two distinct primary potential minima in the reconstructed epicardial potentials. The shortest distance between the two events in the right ventricle that resulted in the reconstruction of epicardial potential patterns, featuring two minima, was 27 mm; the distance between the two events in the left ventricle was 23 mm. When Gaussian white noise in the simulated body surface potentials was increased from 3 microV to 15 microV and 50 microV, dual events became more difficult to distinguish. Findings indicate that calculated epicardial potentials provide useful visual information about the presence of multiple ventricular events that is not apparent in features of body surface ECGs, and could be particularly helpful in optimising mapping procedures during difficult or unsuccessful radiofrequency ablations of accessory pathways.

Action Potentials↗

Rapid construction of a patient-specific torso model from 3D ultrasound for non-invasive imaging of cardiac electrophysiology.

One of the main limitations in using inverse methods for non-invasively imaging cardiac electrical activity in a clinical setting is the difficulty in readily obtaining high-quality data sets to reconstruct accurately a patient-specific geometric model of the heart and torso. This issue was addressed by investigation into the feasibility of using a pseudo-3D ultrasound system and a hand-held laser scanner to reconstruct such a model. This information was collected in under 20 min prior to a catheter ablation or pacemaker study in the electrophysiology laboratory. Using the models created from these data, different activation field maps were computed using several different inverse methods. These were independently validated by comparison of the earliest site of activation with the physical location of the pacing electrodes, as determined from orthogonal fluoroscopy images. With an estimated average geometric error of approximately 8 mm, it was also possible to reconstruct the site of initial activation to within 17.3 mm and obtain a quantitatively realistic activation sequence. The study demonstrates that it is possible rapidly to construct a geometric model that can then be used non-invasively to reconstruct an activation field map of the heart.

Cardiac Pacing, Artificial↗

A model-based system for assessing ventricular chamber pressure-volume-dimension relationship: regional and global deformation.

A system has been developed for measuring and relating in a non-beating isolated canine left ventricle dynamic changes in chamber pressure, volume, diameter, regional segment length, and wall thickness. The measurement system consists of a pulsatile blood pump whose stroke-volume and frequency can be adjusted selectively. The external pump system is used as a primary means for controlling instantaneous intraventricular volume. The relationship between left ventricular volume change, intraventricular pressure, minor axis diameter, and regional dimensions were studied as a function of pump rate. In addition to the basic constitutive properties, this system provided the means for measuring and comparing regional and global pressure-strain relationship including the effect of strain rate and its relationship to viscoelastic myocardial muscle model. The dynamic relationship between global dimensions and regional dimensions, circumferential segment length, and wall thickness were also investigated. The instantaneous relationship between intraventricular pressure resulting from periodic oscillations of chamber volume, including minor equator diameter, wall thickness, and regional segment dimensions were plotted and fitted to an exponential pressure-strain model, assuming a quasi-static large deformation. The observed difference between global and regional pressure-dimension strain stiffness coefficients can be attributed in part to basic constitutive and geometric considerations and not necessarily to the complex anisotropic or heterogeneous nature of cardiac muscle properties. This methodology provides indices which appropriately characterize the regional and global left ventricular chamber deformation and stiffness.

Animals↗

Contributions to the impedance cardiogram waveform.

We have developed a cylindrically symmetric model with which to study what physiologic variables might contribute to the impedance cardiogram signal. We find the major contributions in this model to be due to dilation of the aorta and carotid arteries, changes in conductivity of blood in these same vessels due to red cell reorientation during flow, changes in the conductivity of the lungs, and changes in heart volume. The calculations suggest that the popular equation used to determine stroke volume from thoracic impedance data is not accurate under all conditions of the circulatory system.

Adult↗

Signal analysis of noninvasive Xenon-133 cerebral blood flow measurements.

An anatomical model in conjunction with experimentally determined absorption data provides a framework to simulate signals as obtained from the noninvasive Xenon-133 cerebral blood flow technique. The contribution of individual tissue compartments to the total signal as well as the effect on the computed results were investigated under normal conditions. The introduction of physiological abnormalities into the model allowed the determination of sensitivity of the technique with respect to size, position, and perfusion level of the lesion. In addition, effects of cross-talk between hemispheres and signal overlap of adjacent detectors were quantified. It was found that the change of externally measured blood flow is proportional to the decrement/increment of flow in the lesion. Contrary to earlier reports, the effects of cross-talk and signal overlap were not found to be serious limitations in identifying lesions.

Animals↗

Sensitivity of CO2 washout to changes in acinar structure in a single-path model of lung airways.

A numerical solution of the convection-diffusion equation with an alveolar source term in a single-path model (SPM) of the lung airways simulates steady state CO2 washout. The SPM is used to examine the effects of independent changes in physiologic and acinar structure parameters on the slope and height of Phase III of the single-breath CO2 washout curve. The parameters investigated include tidal volume, breathing frequency, total cardiac output, pulmonary arterial CO2 tension, functional residual capacity, pulmonary bloodflow distribution, alveolar volume, total acinar airway cross sectional area, and gas-phase molecular diffusivity. Reduced tidal volume causes significant steepening of Phase III, which agrees well with experimental data. Simulations with a fixed frequency and tidal volume show that changes in blood-flow distribution, model airway cross section, and gas diffusivity strongly affect the slope of Phase III while changes in cardiac output and in pulmonary arterial CO2 tension strongly affect the height of Phase III. The paper also discusses differing explanations for the slope of Phase III, including sequential emptying, stratified inhomogeneity, and the issue of asymmetry, in the context of the SPM.

Carbon Dioxide↗

Incremental network analogue model of the coronary artery.

From Newton's equation and the continuity equation, an equivalent analogue circuit model can be derived for each small segment of the coronary arteries. Sapoznikov divided the coronary artery tree into 116 segments. By replacing each segment with its analogue circuit model, a final incremental network model was derived. The model was tested using typical physical parameters under normal conditions, as well as in the presence of coronary artery stenosis. In the case of stenosis, the arteriolar flow with and without autoregulation were compared. The model shows good agreement with the reported effects of stenoses and heart rate on coronary blood flow.

Animals↗