Displacement encoding with stimulated echoes (DENSE) encodes myocardial tissue displacement into the phase of the MR image. Cine DENSE allows for rapid quantification of myocardial displacement at multiple cardiac phases through the majority of the cardiac cycle. For practical sensitivities to motion, relatively high displacement encoding frequencies are used and phase wrapping typically occurs. In order to obtain absolute measures of displacement, a two-dimensional (2-D) quality-guided phase unwrapping algorithm was adapted to unwrap both spatially and temporally. Both a fully automated algorithm and a faster semi-automated algorithm are proposed. A method for computing the 2-D trajectories of discrete points in the myocardium as they move through the cardiac cycle is introduced. The error in individual displacement measurements is reduced by fitting a time series to sequential displacement measurements along each trajectory. This improvement is in turn reflected in strain maps, which are derived directly from the trajectories. These methods were validated both in vivo and on a rotating phantom. Further measurements were made to optimize the displacement encoding frequency and to estimate the baseline strain noise both on the phantom and in vivo. The fully automated phase unwrapping algorithm was successful for 767 out of 800 images (95.9%), and the semi-automated algorithm was successful for 786 out of 800 images (98.3%). The accuracy of the tracking algorithm for typical cardiac displacements on a rotating phantom is 0.24 +/- 0.15 mm. The optimal displacement encoding frequency is in the region of 0.1 cycles/mm, and, for 2 scans of 17-s duration, the strain noise after temporal fitting was estimated to be 2.5 +/- 3.0% at end-diastole, 3.1 +/- 3.1% at end-systole, and 5.3 +/- 5.0% in mid-diastole. The improvement in intra-myocardial strain measurements due to temporal fitting is apparent in strain histograms, and also in identifying regions of dysfunctional myocardium in studies of patients with infarcts.
A navigator-gated 3D spiral cine displacement encoding with stimulated echoes (DENSE) pulse sequence for imaging 3D myocardial mechanics was developed. In addition, previously described 2D postprocessing algorithms including phase unwrapping, tissue tracking, and strain tensor calculation for the left ventricle (LV) were extended to 3D. These 3D methods were evaluated in five healthy volunteers, using 2D cine DENSE and historical 3D myocardial tagging as reference standards. With an average scan time of 20.5 6 5.7 min, 3D data sets with a matrix size of 128 3 128 3 22, voxel size of 2.8 3 2.8 3 5.0 mm 3 , and temporal resolution of 32 msec were obtained with displacement encoding in three orthogonal directions. Mean values for end-systolic mid-ventricular mid-wall radial, circumferential, and longitudinal strain were 0.33 6 0.10, 20.17 6 0.02, and 20.16 6 0.02, respectively. Transmural strain gradients were detected in the radial and circumferential directions, reflecting high spatial resolution. Good agreement by linear correlation and Bland-Altman analysis was achieved when comparing normal strains measured by 2D and 3D cine DENSE. Also, the 3D strains, twist, and torsion results obtained by 3D cine DENSE were in good agreement with historical values measured by 3D myocardial tagging. Magn Reson Med 64:1089-1097, 2010. V C 2010 WileyLiss, Inc.Key words: three dimensional; DENSE; myocardial mechanics; cardiac function; stimulated echo; strain Quantitative imaging of myocardial motion and strain is of growing importance. In addition to conventional applications such as ischemia detection (1,2) and evaluation of myocardial mechanics related to cardiac surgery (3-5), newer applications include quantifying mechanical dyssynchrony in heart failure (6,7), and measuring the functional effects of experimental therapies such as stem cells (8). Potential advantages of quantitative methods are that they may improve diagnostic sensitivity and specificity (9), may reduce subjectivity and intraobserver and interobserver variability, and may facilitate statistical comparisons of cardiac function between different experimental groups.While quantitative two-dimensional (2D) imaging is more common than three-dimensional (3D) imaging, motion of the left ventricle (LV) is, in fact, complex and 3D. The myocardial strain tensor has significant components in the radial, circumferential and longitudinal directions, as well as important off-diagonal components, reflecting the 3D contraction, twist, and torsion that are integral to efficient pump function. A technique that is 3D both with respect to spatial coverage and motion measurement is required for a complete assessment of LV motion. Three-dimensional myocardial tagging MRI has previously been used to noninvasively measure the 3D mechanics of the LV in detail (10-13), and these data provide a reference standard against which new methods may be compared. However, strain analysis of 3D tagged MR images is laborious and time consuming due to the need to detect tag lines, rendering th...
While a number of studies have explored the functional neuroanatomy of social anxiety disorder (SAD), data on grey matter integrity are lacking. We conducted structural MRI scans to examine the cortical thickness of grey matter in individuals with SAD. 13 unmedicated adult patients with a primary diagnosis of generalized social anxiety disorder and 13 demographically (age, gender and education) matched healthy controls underwent 3T structural magnetic resonance imaging. Cortical thickness and subcortical volumes were estimated using an automated algorithm (Freesurfer Version 4.5). Compared to controls, social anxiety disorder patients showed significant bilateral cortical thinning in the fusiform and post central regions. Additionally, right hemisphere specific thinning was found in the frontal, temporal, parietal and insular cortices of individuals with social anxiety disorder. Although uncorrected cortical grey matter volumes were significantly lower in individuals with SAD, we did not detect volumetric differences in corrected amygdala, hippocampal or cortical grey matter volumes across study groups. Structural differences in grey matter thickness between SAD patients and controls highlight the diffuse neuroanatomical networks involved in both social anxiety and social behavior. Additional work is needed to investigate the causal mechanisms involved in such structural abnormalities in SAD.
There are few neuropsychological or neuroimaging studies of HIV-positive children with "slow progression". "Slow progressors" are typically defined as children or adolescents who were vertically infected with HIV, but who received no or minimal antiretroviral therapy. We compared 12 asymptomatic HIV-positive children (8 to 12 years) with matched controls on a neuropsychological battery as well as diffusion tensor imaging in a masked region of interest analysis focusing on the corpus callosum, internal capsule and superior longitudinal fasciculus. The "slow progressor" group performed significantly worse than controls on the Wechsler Abbreviated Scale of Intelligence Verbal and Performance IQ scales, and on standardised tests of visuospatial processing, visual memory and executive functioning. "Slow progressors" had lower fractional anisotropy (FA), higher mean diffusivity (MD) and radial diffusivity (RD) in the corpus callosum (p= <0.05), and increased MD in the superior longitudinal fasciculus, compared to controls. A correlation was found between poor performance on a test of executive function and a test of attention with corpus callosum FA, and a test of executive function with lowered FA in the superior longitudinal fasiculus. These data suggest that demyelination as reflected by the increase in RD may be a prominent disease process in paediatric HIV infection.
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