BackgroundTransthoracic echocardiography (TTE) is the standard method for the evaluation of the severity of aortic stenosis (AS). Valve effective orifice area (EOA) measured by the continuity equation is one of the most frequently used stenotic indices. However, TTE measurement of aortic valve EOA is not feasible or not reliable in a significant proportion of patients. Cardiovascular magnetic resonance (CMR) has emerged as a non-invasive alternative to evaluate EOA using velocity measurements. The objectives of this study were: 1) to validate a new CMR method using jet shear layer detection (JSLD) based on acoustical source term (AST) concept to estimate the valve EOA; 2) to introduce a simplified JSLD method not requiring vorticity field derivation.Methods and resultsWe performed an in vitro study where EOA was measured by CMR in 4 fixed stenoses (EOA = 0.48, 1.00, 1.38 and 2.11 cm2) under the same steady flow conditions (4-20 L/min). The in vivo study included eight (8) healthy subjects and 37 patients with mild to severe AS (0.72 cm2 ≤ EOA ≤ 1.71 cm2). All subjects underwent TTE and CMR examinations. EOA was determinated by TTE with the use of continuity equation method (TTECONT). For CMR estimation of EOA, we used 3 methods: 1) Continuity equation (CMRCONT); 2) Shear layer detection (CMRJSLD), which was computed from the velocity field of a single CMR velocity profile at the peak systolic phase; 3) Single plane velocity truncation (CMRSPVT), which is a simplified version of CMRJSLD method. There was a good agreement between the EOAs obtained in vitro by the different CMR methods and the EOA predicted from the potential flow theory. In the in vivo study, there was good correlation and concordance between the EOA measured by the TTECONT method versus those measured by each of the CMR methods: CMRCONT (r = 0.88), CMRJSLD (r = 0.93) and CMRSPVT (r = 0.93). The intra- and inter- observer variability of EOA measurements was 5 ± 5% and 9 ± 5% for TTECONT, 2 ± 1% and 7 ± 5% for CMRCONT, 7 ± 5% and 8 ± 7% for CMRJSLD, 1 ± 2% and 3 ± 2% for CMRSPVT. When repeating image acquisition, reproducibility of measurements was 10 ± 8% and 12 ± 5% for TTECONT, 9 ± 9% and 8 ± 8% for CMRCONT, 6 ± 5% and 7 ± 4% for CMRJSLD and 3 ± 2% and 2 ± 2% for CMRSPVT.ConclusionThere was an excellent agreement between the EOA estimated by the CMRJSLD or CMRSPVT methods and: 1) the theoretical EOA in vitro, and 2) the TTECONT EOA in vivo. The CMRSPVT method was superior to the TTE and other CMR methods in terms of measurement variability. The novel CMR-based methods proposed in this study may be helpful to corroborate stenosis severity in patients for whom Doppler-echocardiography exam is inconclusive.
Waveguides have been successfully used to generate magnetic resonance images at 7 T with whole-body systems. The bore limits the magnetic resonance signal transmitted because its specific cut-off frequency is greater than the majority of resonant frequencies. This restriction can be overcome by using a parallel-plate waveguide whose cut-off frequency is zero for the transversal electric modes and it can propagate any frequency. To investigate the potential benefits of traveling-wave excitation for whole-body imaging at 3 T, we compare numerical simulations at 1.5 T, 3 T, 7 T, and 9 T via the propagation of the principal mode of a parallel-plate waveguide filled with a cylindrical phantom and two surface coils. B1 mapping was computed and used to investigate the feasibility of the traveling-wave approach at 3T. The point spread function method was used to measure the imager performance for the traveling-wave magnetic resonance imaging experiment. Human leg images were acquired to experimentally validate this approach. The principal mode shows very little variations in the field magnitude along the propagation direction at 3 T when compared to other higher resonant frequencies. The B1 mapping showed that it is possible to conduct experiments using the traveling-wave approach at 128 MHz. The point spread function results showed a good performance of the scanner for these type of experiments. Leg images were obtained with the whole-body birdcage coil and the waveguide with two circular coils for comparison purposes. The simulated and in vivo results correspond very well for both magnetic field and specific absorption rate. A pretty similar performance was observed for the traveling-wave approach and the conventional one. We have demonstrated the feasibility of traveling-wave magnetic for whole-body resonance imaging at 3T, using a parallel-plate waveguide with standard pulse sequences and only one coil array. This extends the use of the waveguide approach to a wider range of resonant frequencies.
A method for commissioning an EGSnrc Monte Carlo simulation of medical linac photon beams through wide-field lateral profiles at moderate depth in a water phantom is presented. Although depth-dose profiles are commonly used for nominal energy determination, our study shows that they are quite insensitive to energy changes below 0.3 MeV (0.6 MeV) for a 6 MV (15 MV) photon beam. Also, the depth-dose profile dependence on beam radius adds an additional uncertainty in their use for tuning nominal energy. Simulated 40 cm x 40 cm lateral profiles at 5 cm depth in a water phantom show greater sensitivity to both nominal energy and radius. Beam parameters could be determined by comparing only these curves with measured data.
Preliminary results suggested that oral-administration of rooster comb extract (RCE) rich in hyaluronic acid (HA) was associated with improved muscle strength. Following these promising results, the objective of the present study was to evaluate the effect of low-fat yoghurt supplemented with RCE rich in HA on muscle function in adults with mild knee pain; a symptom of early osteoarthritis. Participants (n = 40) received low-fat yoghurt (125 mL d(-1)) supplemented with 80 mg d(-1) of RCE and the placebo group (n = 40) consumed the same yoghurt without the RCE, in a randomized, controlled, double-blind, parallel trial over 12 weeks. Using an isokinetic dynamometer (Biodex System 4), RCE consumption, compared to control, increased the affected knee peak torque, total work and mean power at 180° s(-1), at least 11% in men (p < 0.05) with no differences in women. No dietary differences were noted. These results suggest that long-term consumption of low-fat yoghurt supplemented with RCE could be a dietary tool to improve muscle strength in men, associated with possible clinical significance. However, further studies are needed to elucidate reasons for these sex difference responses observed, and may provide further insight into muscle function.
ABSTRACT:The introduction of the ultrafast imaging sequences has renewed the interest in development of RF coils. The theoretical frame of the SNR of MRI coils is a challenge because it requires a deep mathematical background to master the associated concepts. Here, a simpler method is proposed based on Legendre polynomials. This approximation method, together with a quasi-static approach, was used to derive a signal-to-noise ratio expression for a circular-shaped coil. Legendre polynomials were used instead of a weighting function to simplify the vector potential of the power loss, and an SNR formula was then derived. The simplified version of the SNR formula of a circular coil was compared with the weighting function-derived SNR expression using the quasi-static approach. SNR-vs.-depth plots were computed to theoretically compare both SNR formulas. Results showed a strong agreement between SNR values for the circular-shaped coil. This approach can be used as a tool to derive SNR expressions for more complex geometries.
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