34 results on '"Malgorzata Polacin"'
Search Results
2. Quantitative evaluation of aortic valve regurgitation in 4D flow cardiac magnetic resonance: at which level should we measure?
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Malgorzata Polacin, Julia Geiger, Barbara Burkhardt, Fraser M. Callaghan, Emanuela Valsangiacomo, and Christian Kellenberger
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Cardiac magnetic resonance ,4D flow ,Aortic regurgitation ,Medical technology ,R855-855.5 - Abstract
Abstract Purpose To find the best level to measure aortic flow for quantification of aortic regurgitation (AR) in 4D flow CMR. Methods In 27 congenital heart disease patients with AR (67% male, 31 ± 16 years) two blinded observers measured antegrade, retrograde, net aortic flow volumes and regurgitant fractions at 6 levels in 4D flow: (1) below the aortic valve (AV), (2) at the AV, (3) at the aortic sinus, (4) at the sinotubular junction, (5) at the level of the pulmonary arteries (PA) and (6) below the brachiocephalic trunk. 2D phase contrast (2DPC) sequences were acquired at the level of PA. All patients received prior transthoracic echocardiography (TTE) with AR severity grading according to a recommended multiparametric approach. Results After assigning 2DPC measurements into AR grading, agreement between TTE AR grading and 2DPC was good (κ = 0.88). In 4D flow, antegrade flow was similar between the six levels (p = 0.87). Net flow was higher at level 1–2 than at levels 3–6 (p
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- 2022
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3. Segmental strain for scar detection in acute myocardial infarcts and in follow-up exams using non-contrast CMR cine sequences
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Malgorzata Polacin, Mihaly Karolyi, Matthias Eberhard, Ioannis Matziris, Hatem Alkadhi, Sebastian Kozerke, and Robert Manka
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Cardiac magnetic resonance ,Acute myocardial infarction ,Ischemic heart disease ,Feature tracking ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background The purpose of the study was to investigate feasibility of infarct detection in segmental strain derived from non-contrast cardiac magnetic resonance (CMR) cine sequences in patients with acute myocardial infarction (AMI) and in follow-up (FU) exams. Methods 57 patients with AMI (mean age 61 ± 12 years, CMR 2.8 ± 2 days after infarction) were retrospectively included, FU exams were available in 32 patients (35 ± 14 days after first CMR). 43 patients with normal CMR (54 ± 11 years) served as controls. Dedicated software (Segment CMR, Medviso) was used to calculate global and segmental strain derived from cine sequences. Cine short axis stacks and segmental circumferential strain calculations of every patient and control were presented to two blinded readers in random order, who were advised to identify potentially infarcted segments, blinded to LGE and clinical information. Results Impaired global strain was measured in AMI patients compared to controls (global peak circumferential strain [GPCS] p = 0.01; global peak longitudinal strain [GPLS] p = 0.04; global peak radial strain [GPRS] p = 0.01). In both imaging time points, mean segmental peak circumferential strain [SPCS] was impaired in infarcted tissue compared to remote segments (AMI: p = 0.03, FU: p = 0.02). SPCS values in infarcted segments were similar between AMI and FU (p = 0.8). In SPCS calculations, 141 from 189 acutely infarcted segments were accurately detected (74.6%), visual evaluation of correlating cine images detected 43.4% infarcts. In FU, 80% infarcted segments (91/114 segments) were detected in SPCS and 51.8% by visual evaluation of correlating short axis cine images (p = 0.01). Conclusion Segmental circumferential strain derived from routinely acquired native cine sequences detects nearly 75% of acute infarcts and 80% of infarcts in subacute follow-up CMR, significantly more than visual evaluation of correlating cine images alone. Acute infarcts may display only subtle impairment of wall motion and no obvious wall thinning, thus SPCS calculation might be helpful for scar detection in patients with acute infarcts, when LGE images are not available.
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- 2022
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4. Cardiovascular magnetic resonance imaging of functional and microstructural changes of the heart in a longitudinal pig model of acute to chronic myocardial infarction
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Christian T. Stoeck, Constantin von Deuster, Maximilian Fuetterer, Malgorzata Polacin, Conny F. Waschkies, Robbert J. H. van Gorkum, Mareike Kron, Thea Fleischmann, Nikola Cesarovic, Miriam Weisskopf, and Sebastian Kozerke
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Chronic myocardial infarction ,Microstructural CMR ,Functional CMR ,CMR Relaxometry ,T2 mapping ,T1 mapping ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background We examined the dynamic response of the myocardium to infarction in a longitudinal porcine study using relaxometry, functional as well as diffusion cardiovascular magnetic resonance (CMR). We sought to compare non contrast CMR methods like relaxometry and in-vivo diffusion to contrast enhanced imaging and investigate the link of microstructural and functional changes in the acute and chronically infarcted heart. Methods CMR was performed on five myocardial infarction pigs and four healthy controls. In the infarction group, measurements were obtained 2 weeks before 90 min occlusion of the left circumflex artery, 6 days after ischemia and at 5 as well as 9 weeks as chronic follow-up. The timing of measurements was replicated in the control cohort. Imaging consisted of functional cine imaging, 3D tagging, T2 mapping, native as well as gadolinium enhanced T1 mapping, cardiac diffusion tensor imaging, and late gadolinium enhancement imaging. Results Native T1, extracellular volume (ECV) and mean diffusivity (MD) were significantly elevated in the infarcted region while fractional anisotropy (FA) was significantly reduced. During the transition from acute to chronic stages, native T1 presented minor changes ( 23% for MD and > 27% for FA) during follow-up compared to relaxometry (T1 17–18%/T2 10–20%). Conclusion During chronic follow-up after myocardial infarction, cardiac diffusion tensor imaging provides a higher sensitivity for mapping microstructural alterations when compared to non-contrast enhanced relaxometry with the added benefit of providing directional tensor information to assess remodelling of myocyte aggregate orientations, which cannot be otherwise assessed.
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- 2021
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5. Parametric mapping CMR for the measurement of inflammatory reactions of the pericardium
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Robert Manka, Mareike Gastl, Hatem Alkadhi, Alexander Gotschy, Malgorzata Polacin, Sebastian Kozerke, Justyna M Sokolska, and Jochen von Spiczak Brzezinski
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2022
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6. Impact of Photon Counting Detector CT Derived Virtual Monoenergetic Images on the Diagnosis of Pulmonary Embolism
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Tetyana Yalynska, Malgorzata Polacin, Thomas Frauenfelder, and Katharina Martini
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computed tomography ,photon-counting ,pulmonary embolism ,image processing ,quality evaluation ,virtual monoenergetic image ,Medicine (General) ,R5-920 - Abstract
Purpose: To assess the impact of virtual-monoenergetic-image (VMI) energies on the diagnosis of pulmonary embolism (PE) in photon-counting-detector computed-tomography (PCD-CT). Methods: Eighty patients (median age 60.4 years) with suspected PE were retrospectively included. Scans were performed on PCD-CT in the multi-energy mode at 120 kV. VMIs from 40–70 keV in 10 keV intervals were reconstructed. CT-attenuation was measured in the pulmonary trunk and the main branches of the pulmonary artery. Signal-to-noise (SNR) ratio was calculated. Two radiologists evaluated subjective-image-quality (noise, vessel-attenuation and sharpness; five-point-Likert-scale, non-diagnostic–excellent), the presence of hardening artefacts and presence/visibility of PE. Results: Signal was highest at the lowest evaluated VMI (40 keV; 1053.50 HU); image noise was lowest at the highest VMI (70 keV; 15.60 HU). Highest SNR was achieved at the lowest VMI (p < 0.05). Inter-reader-agreement for subjective analysis was fair to excellent (k = 0.373–1.000; p < 0.001). Scores for vessel-attenuation and sharpness were highest at 40 keV (both:5, range 4/3–5; k = 1.000); scores for image-noise were highest at 70 keV (4, range 3–5). The highest number of hardening artifacts were reported at 40 keV (n = 22; 28%). PE-visualization was rated best at 50 keV (4.7; range 4–5) and decreased with increasing VMI-energy (r = −0.558; p < 0.001). Conclusions: While SNR was best at 40 keV, subjective PE visibility was rated highest at 50 keV, potentially owing to the lower image noise and hardening artefacts.
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- 2022
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7. Cardiovascular magnetic resonance T2* mapping for structural alterations in hypertrophic cardiomyopathy
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Mareike Gastl, Alexander Gotschy, Jochen von Spiczak, Malgorzata Polacin, Florian Bönner, Christiane Gruner, Malte Kelm, Frank Ruschitzka, Hatem Alkadhi, Sebastian Kozerke, and Robert Manka
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Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Purpose: Hypertrophic cardiomyopathy (HCM) is characterized by a heterogeneous morphology and variable prognosis. A mismatch between left ventricular mass (LVM) and microvascular circulation with corresponding relative ischemia has been implicated to cause myocardial replacement fibrosis that deteriorates prognosis. Besides parametric T1 mapping, Cardiovascular Magnetic Resonance (CMR) T2* mapping is able to identify ischemia as well as fibrosis in cardiac and extracardiac diseases. Therefore, we aimed to investigate the value of T2* mapping to characterize structural alterations in patients with HCM. Methods: CMR was performed on a 1.5 T MR imaging system (Achieva, Philips, Best, Netherlands) using a 5-channel coil in patients with HCM (n = 103, 50.6 ± 16.4 years) and in age- and gender-matched controls (n = 20, 44.8 ± 16.9 years). T2* mapping (1 midventricular short axis slice) was acquired in addition to late gadolinium enhancement (LGE). T2* values were compared between patients with HCM and controls as well as between HCM patients with- and without fibrosis. Results: HCM patients showed significantly decreased T2* values compared to controls (26.2 ± 4.6 vs. 31.3 ± 4.3 ms, p
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- 2019
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8. Cardiovascular magnetic resonance T2* mapping for the assessment of cardiovascular events in hypertrophic cardiomyopathy
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Robert Manka, Mareike Gastl, Hatem Alkadhi, Christiane Gruner, Karin Labucay, Alexander Gotschy, Jochen Von Spiczak, Malgorzata Polacin, Florian Boenner, Malte Kelm, Frank Ruschitzka, and Sebastian Kozerke
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundHypertrophic cardiomyopathy (HCM) is associated with an increased risk of adverse cardiac events. Beyond classic risk factors, relative myocardial ischaemia and succeeding myocardial alterations, which can be detected using either contrast agents or parametric mapping in cardiovascular magnetic resonance (CMR) imaging, have shown an impact on outcome in HCM. CMR may help to risk stratify using parametric T2* mapping. Therefore, the aim of the present study was to evaluate the association of T2* values or fibrosis with cardiovascular events in HCM.MethodsThe relationship between T2* with supraventricular, ventricular arrhythmia or heart failure was retrospectively assessed in 91 patients with HCM referred for CMR on a 1.5T MR imaging system. Fibrosis as a reference was added to the model. Patients were subdivided into groups according to T2* value quartiles.Results47 patients experienced an event of ventricular arrhythmia, 25 of atrial fibrillation/flutter and 17 of heart failure. T2*≤28.7 ms yielded no association with ventricular events in the whole HCM cohort. T2* of non-obstructive HCM showed a significant association with ventricular events in univariate analysis, but not in multivariate analysis. For the combined endpoint of arrhythmic events, there was already an association for the whole HCM cohort, but again only in univariate analyses. Fibrosis stayed the strongest predictor in all analyses. There was no association for T2* and fibrosis with heart failure.ConclusionsDecreased T2* values by CMR only provide a small association with arrhythmic events in HCM, especially in non-obstructive HCM. No information is added for heart failure.
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- 2020
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9. RadAdapt: Radiology Report Summarization via Lightweight Domain Adaptation of Large Language Models.
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Dave Van Veen, Cara Van Uden, Maayane Attias, Anuj Pareek, Christian Bluethgen, Malgorzata Polacin, Wah Chiu, Jean-Benoit Delbrouck, Juan Manuel Zambrano Chaves, Curtis P. Langlotz, Akshay Chaudhari, and John M. Pauly
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- 2023
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10. Exploring the Versatility of Zero-Shot CLIP for Interstitial Lung Disease Classification.
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Cara Van Uden, Christian Bluethgen, Maayane Attias, Malgorzata Polacin, Haiwei Henry Guo, Neha Simha, Rishi Raj, and Curtis P. Langlotz
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- 2023
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11. Clinical Text Summarization: Adapting Large Language Models Can Outperform Human Experts.
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Dave Van Veen, Cara Van Uden, Louis Blankemeier, Jean-Benoit Delbrouck, Asad Aali, Christian Bluethgen, Anuj Pareek, Malgorzata Polacin, William Collins, Neera Ahuja, Curtis P. Langlotz, Jason Hom, Sergios Gatidis, John M. Pauly, and Akshay S. Chaudhari
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- 2023
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12. RoentGen: Vision-Language Foundation Model for Chest X-ray Generation.
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Pierre J. Chambon, Christian Bluethgen, Jean-Benoit Delbrouck, Rogier van der Sluijs, Malgorzata Polacin, Juan Manuel Zambrano Chaves, Tanishq Mathew Abraham, Shivanshu Purohit, Curtis P. Langlotz, and Akshay Chaudhari
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- 2022
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13. Routine early postoperative computed tomography angiography after coronary artery bypass surgery: clinical value and management implications
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Tobias Gloor, Robert Manka, Matthias Eberhard, Mihály Károlyi, Martin O Schmiady, Vedran Savic, Paul R. Vogt, Hatem Alkadhi, Malgorzata Polacin, André Plass, and University of Zurich
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Computed Tomography Angiography ,Pleural effusion ,610 Medicine & health ,Coronary Angiography ,Coronary artery bypass surgery ,medicine ,Humans ,Coronary Artery Bypass ,Thrombus ,Vascular Patency ,Aged ,Computed tomography angiography ,medicine.diagnostic_test ,10042 Clinic for Diagnostic and Interventional Radiology ,business.industry ,Graft Occlusion, Vascular ,General Medicine ,medicine.disease ,10020 Clinic for Cardiac Surgery ,Pulmonary embolism ,Surgery ,Stenosis ,medicine.anatomical_structure ,Pneumothorax ,10209 Clinic for Cardiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
OBJECTIVES Computed tomography angiography (CTA) is broadly used for long-term follow-up of graft patency after coronary artery bypass graft surgery (CABG). However, its clinical value in the early postoperative setting has not been established yet. We evaluated the benefit of adding CTA to the routine clinical work-up after CABG on patient management. METHODS A total of 305 consecutive patients (269 males, median age 68 years) underwent CABG and postoperative CTA with a median of 6 days after surgery. Graft patency and additional imaging findings were assessed and their influence on diagnosis and clinical management was evaluated. RESULTS Graft occlusion or high-grade stenosis was found in 15% of the patients. Additional findings were reported in 44% of the patients, including pericardial (2%) and pleural effusion (27%), large pneumothorax (11%), pulmonary infection (4%), cardiac or vascular thrombus (2%), pulmonary embolism (2%), sternal dehiscence (1%) and additional incidental findings requiring follow-up (6%). CT findings initiated new diagnostic and/or therapeutic measures in 15% of the patients, 47% of those with diseased grafts and 19% of patients with non-graft-related findings. No adverse events related to CTA were documented. CONCLUSIONS Early routine postoperative assessment of CABG with CTA reveals both cardiac and non-cardiac findings with a high frequency, affecting clinical management in a substantial proportion of patients.
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- 2021
14. Accuracy of dynamic three-dimensional magnetic resonance perfusion imaging for the detection of coronary artery disease in patients with reduced ejection fraction
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Alexander Gotschy, Cosima Jahnke, Sven Plein, Sandra Hamada, Rolf Gebker, Frank Ruschitzka, Nikolaus Marx, Malgorzata Polacin, Sebastian Kozerke, Thomas F. Lüscher, Michael Frick, Hatem Alkadhi, Robert Manka, Sabrina Oebel, Ingo Paetsch, Jochen von Spiczak, and Frank Enseleit
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medicine.medical_specialty ,Ejection fraction ,Radiological and Ultrasound Technology ,business.industry ,Medicine (miscellaneous) ,030204 cardiovascular system & hematology ,medicine.disease ,3. Good health ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Cardiac magnetic resonance perfusion imaging ,Heart failure ,Late gadolinium enhancement ,Magnetic resonance perfusion imaging ,Internal medicine ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,In patient ,business - Abstract
BackgroundTo assess the accuracy of 3D cardiovascular magnetic resonance (CMR) perfusion imaging for the detection of coronary artery disease (CAD) against fractional flow reserve (FFR) and quantitative coronary angiography (QCA) in patients with reduced ejection fraction (EF).MethodsOut of 447 patients who underwent 3D CMR perfusion imaging (at 1.5 and 3.0 T under adenosine stress and at rest) at 5 European centers, 86 cases with an EF ≤50% were identified (mean age 64 ± 11 yrs, 80% male). Significant CAD was defined as a FFR value 50%. 86 individuals matched for age, gender and major cardiovascular risk factors, were chosen as the control group.ResultsThe prevalence of CAD defined by FFR (50%), P = 0.4). In relation to FFR, 3D perfusion imaging yielded a sensitivity of 84.5% (95% CI 76.0–90.4) and specificity of 77.3% (95% CI 66.7–85.3). The sensitivity of perfusion imaging was higher in patients with an EF≤50% (90.2 vs. 78.3%, P = 0.1) whereas specificity showed the reverse (62.9 vs. 90.0%, P = 0.005) The diagnostic accuracy was comparable in both subgroups (AUC 79.1 vs. 83.7%, P = 0.25). According to QCA, the prevalence of CAD was 78 vs. 72% (P = 0.4). Perfusion imaging yielded a sensitivity and specificity of 82.1 vs. 62.9%, P = 0.01 and 79.0 vs. 95.8%, P = 0.09 respectively with a high diagnostic accuracy in both subgroups (AUC 82.0 vs. 80.5%).Conclusion3D-CMR perfusion imaging yields a high sensitivity and diagnostic accuracy with regards to the detection of significant CAD irrespective of left ventricular (LV) systolic function.
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- 2021
15. Segmental strain analysis for the detection of chronic ischemic scars in non-contrast cardiac MRI cine images
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Alexander Gotschy, Bettina Baessler, Matthias Eberhard, Hatem Alkadhi, Mihály Károlyi, Sebastian Kozerke, Malgorzata Polacin, Robert Manka, and University of Zurich
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Adult ,Male ,Science ,Cardiology ,Myocardial Ischemia ,Scars ,Magnetic Resonance Imaging, Cine ,Strain (injury) ,610 Medicine & health ,030204 cardiovascular system & hematology ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Cicatrix ,0302 clinical medicine ,Text mining ,Medical research ,Cardiac magnetic resonance imaging ,Medicine ,Humans ,Myocardial infarction ,cardiovascular diseases ,Aged ,Multidisciplinary ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,10042 Clinic for Diagnostic and Interventional Radiology ,Gold standard (test) ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,10209 Clinic for Cardiology ,cardiovascular system ,Female ,medicine.symptom ,business ,Nuclear medicine ,Radial stress - Abstract
Cardiac magnetic resonance imaging (MRI) with late gadolinium enhancement (LGE) is considered the gold standard for scar detection after myocardial infarction. In times of increasing skepticism about gadolinium depositions in brain tissue and contraindications of gadolinium administration in some patient groups, tissue strain-based techniques for detecting ischemic scars should be further developed as part of clinical protocols. Therefore, the objective of the present work was to investigate whether segmental strain is noticeably affected in chronic infarcts and thus can be potentially used for infarct detection based on routinely acquired non-contrast cine images in patients with known coronary artery disease (CAD). Forty-six patients with known CAD and chronic scars in LGE images (5 female, mean age 52 ± 19 years) and 24 gender- and age-matched controls with normal cardiac MRI (2 female, mean age 47 ± 13 years) were retrospectively enrolled. Global (global peak circumferential [GPCS], global peak longitudinal [GPLS], global peak radial strain [GPRS]) and segmental (segmental peak circumferential [SPCS], segmental peak longitudinal [SPLS], segmental peak radial strain [SPRS]) strain parameters were calculated from standard non-contrast balanced SSFP cine sequences using commercially available software (Segment CMR, Medviso, Sweden). Visual wall motion assessment of short axis cine images as well as segmental circumferential strain calculations (endo-/epicardially contoured short axis cine and resulting polar plot strain map) of every patient and control were presented in random order to two independent blinded readers, which should localize potentially infarcted segments in those datasets blinded to LGE images and patient information. Global strain values were impaired in patients compared to controls (GPCS p = 0.02; GPLS p = 0.04; GPRS p = 0.01). Patients with preserved ejection fraction showed also impeded GPCS compared to healthy individuals (p = 0.04). In patients, mean SPCS was significantly impaired in subendocardially (− 5.4% ± 2) and in transmurally infarcted segments (− 1.2% ± 3) compared to remote myocardium (− 12.9% ± 3, p = 0.02 and 0.03, respectively). ROC analysis revealed an optimal cut-off value for SPCS for discriminating infarcted from remote myocardium of − 7.2% with a sensitivity of 89.4% and specificity of 85.7%. Mean SPRS was impeded in transmurally infarcted segments (15.9% ± 6) compared to SPRS of remote myocardium (31.4% ± 5; p = 0.02). The optimal cut-off value for SPRS for discriminating scar tissue from remote myocardium was 16.6% with a sensitivity of 83.3% and specificity of 76.5%. 80.3% of all in LGE infarcted segments (118/147) were correctly localized in segmental circumferential strain calculations based on non-contrast cine images compared to 53.7% (79/147) of infarcted segments detected by visual wall motion assessment (p > 0.01). Global strain parameters are impaired in patients with chronic infarcts compared to controls. Mean SPCS and SPRS in scar tissue is impeded compared to remote myocardium in infarcts patients. Blinded to LGE images, two readers correctly localized 80% of infarcted segments in segmental circumferential strain calculations based on non-contrast cine images, in contrast to only 54% of infarcted segments detected due to wall motion abnormalities in visual wall motion assessment. Analysis of segmental circumferential strain shows a promising method for detection of chronic scars in routinely acquired, non-contrast cine images for patients who cannot receive or decline gadolinium., Scientific Reports, 11 (1), ISSN:2045-2322
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- 2021
16. Segmental strain for scar detection in acute myocardial infarcts and in follow-up exams using non-contrast CMR cine sequences
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Ioannis Matziris, Hatem Alkadhi, Robert Manka, Sebastian Kozerke, Mihály Károlyi, Malgorzata Polacin, Matthias Eberhard, and University of Zurich
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Magnetic Resonance Spectroscopy ,Cardiac magnetic resonance ,Ischemic heart disease ,media_common.quotation_subject ,Acute myocardial infarction ,Feature tracking ,Myocardial Infarction ,Magnetic Resonance Imaging, Cine ,610 Medicine & health ,Ventricular Function, Left ,Cicatrix ,Humans ,Medicine ,Contrast (vision) ,cardiovascular diseases ,Aged ,Retrospective Studies ,media_common ,Strain (chemistry) ,business.industry ,10042 Clinic for Diagnostic and Interventional Radiology ,Myocardium ,Middle Aged ,cardiovascular system ,10209 Clinic for Cardiology ,Nuclear medicine ,business ,Cardiology and Cardiovascular Medicine ,Follow-Up Studies - Abstract
Background The purpose of the study was to investigate feasibility of infarct detection in segmental strain derived from non-contrast cardiac magnetic resonance (CMR) cine sequences in patients with acute myocardial infarction (AMI) and in follow-up (FU) exams. Methods 57 patients with AMI (mean age 61 ± 12 years, CMR 2.8 ± 2 days after infarction) were retrospectively included, FU exams were available in 32 patients (35 ± 14 days after first CMR). 43 patients with normal CMR (54 ± 11 years) served as controls. Dedicated software (Segment CMR, Medviso) was used to calculate global and segmental strain derived from cine sequences. Cine short axis stacks and segmental circumferential strain calculations of every patient and control were presented to two blinded readers in random order, who were advised to identify potentially infarcted segments, blinded to LGE and clinical information. Results Impaired global strain was measured in AMI patients compared to controls (global peak circumferential strain [GPCS] p = 0.01; global peak longitudinal strain [GPLS] p = 0.04; global peak radial strain [GPRS] p = 0.01). In both imaging time points, mean segmental peak circumferential strain [SPCS] was impaired in infarcted tissue compared to remote segments (AMI: p = 0.03, FU: p = 0.02). SPCS values in infarcted segments were similar between AMI and FU (p = 0.8). In SPCS calculations, 141 from 189 acutely infarcted segments were accurately detected (74.6%), visual evaluation of correlating cine images detected 43.4% infarcts. In FU, 80% infarcted segments (91/114 segments) were detected in SPCS and 51.8% by visual evaluation of correlating short axis cine images (p = 0.01). Conclusion Segmental circumferential strain derived from routinely acquired native cine sequences detects nearly 75% of acute infarcts and 80% of infarcts in subacute follow-up CMR, significantly more than visual evaluation of correlating cine images alone. Acute infarcts may display only subtle impairment of wall motion and no obvious wall thinning, thus SPCS calculation might be helpful for scar detection in patients with acute infarcts, when LGE images are not available., BMC Cardiovasular Disorders, 22, ISSN:1471-2261
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- 2022
17. Free-breathing motion-informed locally low-rank quantitative 3D myocardial perfusion imaging
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Tobias Hoh, Valery Vishnevskiy, Malgorzata Polacin, Robert Manka, Maximilian Fuetterer, and Sebastian Kozerke
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Motion ,Adenosine ,Coronary Circulation ,Respiration ,Myocardial Perfusion Imaging ,Humans ,Radiology, Nuclear Medicine and imaging ,Magnetic Resonance Imaging - Abstract
To propose respiratory motion-informed locally low-rank reconstruction (MI-LLR) for robust free-breathing single-bolus quantitative 3D myocardial perfusion CMR imaging. Simulation and in-vivo results are compared to locally low-rank (LLR) and compressed sensing reconstructions (CS) for reference.Data were acquired using a 3D Cartesian pseudo-spiral in-out k-t undersampling scheme (R = 10) and reconstructed using MI-LLR, which encompasses two stages. In the first stage, approximate displacement fields are derived from an initial LLR reconstruction to feed a motion-compensated reference system to a second reconstruction stage, which reduces the rank of the inverse problem. For comparison, data were also reconstructed with LLR and frame-by-frame CS using wavelets as sparsifying transform (Improved uniformity of MBF maps with reduced local variations was achieved with MI-LLR. For rest and stress, intra-volunteer variation of absolute and relative MBF was lower in MI-LLR (±0.17 mL/g/min [26%] and ±1.07 mL/g/min [33%]) versus LLR (±0.19 mL/g/min [28%] and ±1.22 mL/g/min [36%]) and versusThe combination of pseudo-spiral Cartesian undersampling and dual-stage MI-LLR reconstruction improves free-breathing quantitative 3D myocardial perfusion CMR imaging under rest and stress condition.
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- 2022
18. First Performance Evaluation of an Artificial Intelligence-Based Computer-Aided Detection System for Pulmonary Nodule Evaluation in Dual-Source Photon-Counting Detector CT at Different Low-Dose Levels
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Bernhard Schmidt, Hatem Alkadhi, André Euler, Michael Messerli, Christian Blüthgen, Thomas Frauenfelder, Malgorzata Polacin, Lisa Jungblut, Katharina Martini, and University of Zurich
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Photons ,business.industry ,Image quality ,Computers ,Phantoms, Imaging ,10042 Clinic for Diagnostic and Interventional Radiology ,Low dose ,Detector ,610 Medicine & health ,General Medicine ,10181 Clinic for Nuclear Medicine ,Computer aided detection ,Artificial Intelligence ,Pulmonary nodule ,Image noise ,Medicine ,Dual source ,Radiology, Nuclear Medicine and imaging ,Artificial intelligence ,business ,Tomography, X-Ray Computed ,Photon counting detector - Abstract
OBJECTIVE The aim of this study was to evaluate the image quality (IQ) and performance of an artificial intelligence (AI)-based computer-aided detection (CAD) system in photon-counting detector computed tomography (PCD-CT) for pulmonary nodule evaluation at different low-dose levels. MATERIALS AND METHODS An anthropomorphic chest-phantom containing 14 pulmonary nodules of different sizes (range, 3-12 mm) was imaged on a PCD-CT and on a conventional energy-integrating detector CT (EID-CT). Scans were performed with each of the 3 vendor-specific scanning modes (QuantumPlus [Q+], Quantum [Q], and High Resolution [HR]) at decreasing matched radiation dose levels (volume computed tomography dose index ranging from 1.79 to 0.31 mGy) by adapting IQ levels from 30 to 5. Image noise was measured manually in the chest wall at 8 different locations. Subjective IQ was evaluated by 2 readers in consensus. Nodule detection and volumetry were performed using a commercially available AI-CAD system. RESULTS Subjective IQ was superior in PCD-CT compared with EID-CT (P 0.05) and superior in the HR-mode (PCD 55.8 ± 11.7 HU vs EID 74.8 ± 5.4 HU; P = 0.01). High resolution showed the lowest image noise values among PCD modes (P = 0.01). Overall, the AI-CAD system delivered comparable results for lung nodule detection and volumetry between PCD- and dose-matched EID-CT (P = 0.08-1.00), with a mean sensitivity of 95% for PCD-CT and of 86% for dose-matched EID-CT in the lowest evaluated dose level (IQ5). Q+ and Q-mode showed higher false-positive rates than EID-CT at lower-dose levels (IQ10 and IQ5). The HR-mode showed a sensitivity of 100% with a false-positive rate of 1 even at the lowest evaluated dose level (IQ5; CDTIvol, 0.41 mGy). CONCLUSIONS Photon-counting detector CT was superior to dose-matched EID-CT in subjective IQ while showing comparable to lower objective image noise. Fully automatized AI-aided nodule detection and volumetry are feasible in PCD-CT, but attention has to be paid to false-positive findings.
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- 2022
19. Three-dimensional Whole-Heart Cardiac MRI Sequence for Measuring Trabeculation in Left Ventricular Noncompaction
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Malgorzata Polacin, Mihály Károlyi, Verena Wilzeck, Matthias Eberhard, Alexander Gotschy, Hatem Alkadhi, Sebastian Kozerke, Robert Manka, University of Zurich, and Manka, Robert
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Technical Development ,10042 Clinic for Diagnostic and Interventional Radiology ,10209 Clinic for Cardiology ,2741 Radiology, Nuclear Medicine and Imaging ,Radiology, Nuclear Medicine and imaging ,610 Medicine & health - Abstract
PURPOSE: To compare three-dimensional (3D) whole-heart MRI with isotropic submillimeter resolution with standard two-dimensional (2D) cine MRI in measuring the bilayered myocardium in left ventricular noncompaction (LVNC). MATERIALS AND METHODS: Twenty-four patients with LVNC (mean age, 42 years ± 16 [SD]) were retrospectively enrolled between October 2011 and July 2020. Compacted myocardium (CM) and noncompacted myocardium (NCM) were measured in long axis (Petersen approach) and short axis (Jacquier approach) at 3D whole-heart and 2D cine MRI by two independent readers. Image quality (1 = excellent, 2 = adequate, 3 = nondiagnostic), considering discrimination between NCM and CM and CM and adjacent tissue, was evaluated. Pearson, Spearman, and intraclass correlation tests were used as statistical tests. RESULTS: In long-axis measurements, the correlation between both sequences was moderate to strong for CM (Pearson, 0.66–0.79; Spearman, 0.61–0.68) and strong to very strong for NCM (Pearson, 0.90–0.97; Spearman, 0.77–0.91). Intraclass correlation coefficient (ICC) in 3D whole-heart MRI was 0.90 (95% CI: 0.78, 0.95) for CM and 0.94 (95% CI: 0.84, 0.97) for NCM, while ICC in 2D cine MRI was 0.77 (95% CI: 0.55, 0.89) for CM and 0.87 (95% CI: 0.72, 0.94) for NCM. Short-axis CM and NCM measurements had a strong to very strong correlation between both sequences (Pearson, 0.86–0.98; Spearman, 0.82–0.98). ICC in 3D whole-heart MRI was 0.96 (95% CI: 0.94, 0.99) for CM and 0.98 (95% CI: 0.97, 0.99) for NCM, while ICC in 2D cine MRI was 0.82 (95% CI: 0.63, 0.92) for CM and 0.87 (95% CI: 0.72, 0.94) for NCM. 3D whole-heart MRI demonstrated higher image quality than did 2D cine MRI (P < .001). CONCLUSION: 3D whole-heart MRI revealed higher image quality, with better structure discrimination and interobserver agreement in LVNC measurements, compared with standard 2D cine images. Keywords: MR Imaging, Cardiac, Cardiovascular Magnetic Resonance, Left Ventricular Noncompaction, Free-breathing Imaging Technique Supplemental material is available for this article. © RSNA, 2022 See also the commentary by Jensen and Petersen in this issue.
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- 2022
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20. Photon-counting computed tomography for the diagnosis of myocardial infarction with non-obstructive coronary artery disease
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Malgorzata Polacin, Christian Templin, Robert Manka, Hatem Alkadhi, University of Zurich, and Polacin, Malgorzata
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10042 Clinic for Diagnostic and Interventional Radiology ,10209 Clinic for Cardiology ,610 Medicine & health ,Cardiology and Cardiovascular Medicine ,2705 Cardiology and Cardiovascular Medicine - Published
- 2022
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21. Segmental Strain for Myocardial Scar Detection in Acute Infarcts and Follow-Up CMR Using Non-Contrast Cine Images
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Alexander Gotschy, Mihály Károlyi, Sebastian Kozerke, Matthias Eberhard, Malgorzata Polacin, Ioannis Matziris, Hatem Alkadhi, and Robert Manka
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Text mining ,business.industry ,media_common.quotation_subject ,cardiovascular system ,Medicine ,Contrast (vision) ,Strain (injury) ,cardiovascular diseases ,business ,Acute infarcts ,medicine.disease ,Nuclear medicine ,media_common - Abstract
Aims Scar tissue from myocardial infarction is best visualized with cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE). Gadolinium-free alternatives for detection of myocardial scars are limited. This study investigated the feasibility of myocardial scar detection in acute infarcts and follow-up CMR using non-contrast cine images. Methods Fifty-seven patients with acute infarcts (15 female, mean age 61 ± 12 years, CMR 2.8 ± 2 days after infarction) were retrospectively evaluated with follow-up CMR exams available in thirty-two patients (9 female, 35 ± 14 days after infarction). Twenty-eight patients with normal CMR scans (2 female, mean age 47 ± 8 years) served as controls. Global and segmental strain parameters (global peak circumferential [GPCS], global peak longitudinal [GPLS], global peak radial strain [GPRS], segmental peak circumferential [SPCS], segmental peak longitudinal [SPLS], and segmental peak radial strain [SPRS]) were calculated from standard non-contrast balanced SSFP cine sequences using commercially available software (Segment CMR, Medviso, Sweden). Visual assessment of wall motion abnormalities on short axis cine images, as well as segmental circumferential strain calculations (endo-/epicardially contoured short axis cine and resulting polar plot strain map) of every patient (acute imaging and follow-up CMR) and control were presented for two blinded readers in random order, who were advised to localize potentially infarcted segments, blinded to LGE images and clinical information.Results While global strain values were impaired in patients with acute infarcts compared to controls (GPCS p= 0.01; GPLS p= 0.04; GPRS p= 0.01), global strain was similar between first CMR and follow-up imaging in the subgroup of 32 patients (GPCS p= 0.7; GPLS p=0.8; GPRS p=0.2). In acute infarcts and in follow-up CMR, patients had reduced mean SPCS in infarcted segments compared to remote myocardium (acute p= 0.03, follow-up exams p= 0.02). SPCS values in infarcted areas were similar in acute infarcts and in follow-up exams (p=0.8). In acute infarcts 74.6% of all in LGE infarcted segments (141/189) were correctly localized in polar plot strain maps compared to 44.4% (84/189) of infarcted segments detected by visual wall motion assessment only (p < 0.01). In follow-up exams, 81.5% of all in LGE infarcted segments (93/114 segments) were correctly localized in polar plot strain maps compared to 51.8% (59/114) of infarcted segments detected by visual wall motion assessment (p < 0.01).Conclusion Segmental circumferential strain derived from routinely acquired cine sequences detects nearly 75% acute infarcts and about 80% of infarcts in follow-up CMR and can potentially be used for scar identification based on non-contrast cine images, when gadolinium cant not be applied or LGE images are not available.
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- 2021
22. Value of cardiac magnetic resonance imaging derived spectral myocardial strain pattern for non-invasive diagnosis of myocarditis
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Malgorzata Polacin, P. Lurz, Matthias Gutberlet, Robert Manka, Hatem Alkadhi, Karin Klingel, Christian Luecke, Fabian Christopher Laqua, Bettina Baessler, and Holger Thiele
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Cardiac function curve ,Ejection fraction ,Myocarditis ,medicine.diagnostic_test ,business.industry ,Non invasive ,General Medicine ,medicine.disease ,Nuclear magnetic resonance ,Cardiac magnetic resonance imaging ,Myocardial strain ,Medical imaging ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Diagnostic radiologic examination - Abstract
Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Society of Radiology European Institute for Biomedical Imaging Research Background Traditionally, cardiac function is quantified by measures of peak excursion, for example ejection fraction. However, myocardial strain estimation from cine- cardiac MRI allows quantification of cardiac motion over the whole heart cycle. We propose a spectral decomposition of the strain curves applying Discrete Fourier transformation (DFT). Purpose To evaluate a potential additive diagnostic value of spectral temporal strain curve quantification for non-invasive diagnosis of myocarditis using cardiac MRI. Methods In the single-center prospective study patients with suspected myocarditis underwent comprehensive cardiac MRI followed by biventricular endomyocardial biopsy (EMB) between 2012 and 2014. DFT was applied to myocardial strain curves extracted from cine-Images. As reference model, a L1- and L2-penalized logistic regression model using global native T1 time, T2 time and presence of late-gadolinium enhancement was trained to predict EMB results and compared to two models which additionally include three orders of DFT coefficients and ejection fraction, respectively. Predictive performance was evaluated in a tournament-leave-pair-out cross-validation approach with a bootstrap correction for testing of multiple hyperparameter configurations. Results Out of 100 patients (28 % female, median age 40 [IQR 32 to 56) years) with acute symptom-onset ( Conclusions Discrimination of myocarditis from similar clinical presentations remains challenging. The results support incremental discriminatory value of DFT-decomposed myocardial strain for non-invasive diagnosis of myocarditis. Future research should address the value of the spectral decomposition of cardiac motion trajectories in larger samples and different disease entities.
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- 2021
23. Reproducibility of aortic valve calcification scoring with computed tomography – An interplatform analysis
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Fabian Morsbach, Hatem Alkadhi, Francesco Maisano, Thi Dan Linh Nguyen-Kim, Malgorzata Polacin, Felix C. Tanner, Matthias Eberhard, Ricarda Hinzpeter, Fabian Nietlispach, Eberhard, M, Hinzpeter, R, Polacin, M, Morsbach, F, Maisano, F, Nietlispach, F, Nguyen-Kim, Tdl, Tanner, Fc, Alkadhi, H, and University of Zurich
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Male ,Aortic Stenosis Computed tomography Reproducibility of results Transcatheter aortic valve replacement ,610 Medicine & health ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Spearman's rank correlation coefficient ,2705 Cardiology and Cardiovascular Medicine ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Linear regression ,medicine ,2741 Radiology, Nuclear Medicine and Imaging ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,Aged, 80 and over ,Observer Variation ,10042 Clinic for Diagnostic and Interventional Radiology ,business.industry ,Calcinosis ,Reproducibility of Results ,Regression analysis ,Aortic Valve Stenosis ,medicine.disease ,10020 Clinic for Cardiac Surgery ,Exact test ,Stenosis ,Aortic Valve ,10209 Clinic for Cardiology ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Aortic valve calcification ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,Agatston score ,Nuclear medicine ,business ,Software ,Kappa - Abstract
Background To investigate whether aortic valve calcification (AVC) scoring performed with different workstation platforms generates comparable and thus software-independent results. Methods In this IRB-approved retrospective study, we included 100 consecutive patients with symptomatic aortic stenosis undergoing CT prior to transcatheter aortic valve implantation. Two independent observers performed AVC scoring on non-enhanced images with commercially available software platforms of four vendors (GE, Philips, Siemens, 3mensio). Gender-specific Agatston score cut-off values were applied according to current recommendations to assign patients to different likelihood categories of aortic stenosis (unlikely to very likely). Comparative analysis of Agatston scores between the four platforms were performed by using Kruskal-Wallis analysis, Spearman rank correlation, linear regression analysis, and Bland-Altman analysis. Differences in category assignment were compared using Fisher's exact test and Cohen's kappa. Results For both observers, each workstation platform produced slightly different numeric AVC Agatston scores, however, without statistical significance (p = 0.96 and p = 0.98). Excellent correlation was found between platforms, with r = 0.991–0.996 (Spearman) and r2 = 0.981–0.992 (regression analysis) for both observers. Bland-Altman analyses revealed small mean differences with narrow limits of agreement between platforms (mean differences: 6 ± 128 to 100 ± 179), for inter-observer (mean differences: 1 ± 43 to 12 ± 70), and intra-observer variability (mean differences: 9 ± 42 to 20 ± 96). Observer 1 assigned 11 (kappa: 0.85–0.97) and observer 2 assigned 10 patients (kappa: 0.88–0.95) to different likelihood groups of severe aortic stenosis with at least one platform. Overall, there was no significant difference of likelihood assignment between platforms (p = 0.98 and p = 1.0, respectively). Conclusion While absolute values differ slightly, common commercially available software platforms produce comparable results for AVC scoring, which indicates software-independence of the method.
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- 2019
24. Cardiovascular magnetic resonance T2* mapping for structural alterations in hypertrophic cardiomyopathy
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Christiane Gruner, Frank Ruschitzka, Sebastian Kozerke, Hatem Alkadhi, Florian Bönner, Mareike Gastl, Malgorzata Polacin, Robert Manka, Alexander Gotschy, Jochen von Spiczak, Malte Kelm, University of Zurich, and Gastl, Mareike
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lcsh:Medical physics. Medical radiology. Nuclear medicine ,medicine.medical_specialty ,T2 mapping ,lcsh:R895-920 ,Ischemia ,610 Medicine & health ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Internal medicine ,medicine ,Late gadolinium enhancement ,2741 Radiology, Nuclear Medicine and Imaging ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,CMR ,ComputingMethodologies_COMPUTERGRAPHICS ,medicine.diagnostic_test ,business.industry ,10042 Clinic for Diagnostic and Interventional Radiology ,Hypertrophic cardiomyopathy ,Magnetic resonance imaging ,medicine.disease ,030220 oncology & carcinogenesis ,T2* mapping ,Cardiology ,10209 Clinic for Cardiology ,cardiovascular system ,Myocardial fibrosis ,business - Abstract
Graphical abstract, Highlights • HCM patients exhibited significantly decreased T2* values compared to controls. • Within HCM patients, those with myocardial fibrosis presented with decreased T2* values. • T2* provided good diagnostic accuracy to diagnose HCM with fibrosis. • T2* may add information for identifying a higher risk sub-group of HCM patients., Purpose Hypertrophic cardiomyopathy (HCM) is characterized by a heterogeneous morphology and variable prognosis. A mismatch between left ventricular mass (LVM) and microvascular circulation with corresponding relative ischemia has been implicated to cause myocardial replacement fibrosis that deteriorates prognosis. Besides parametric T1 mapping, Cardiovascular Magnetic Resonance (CMR) T2* mapping is able to identify ischemia as well as fibrosis in cardiac and extracardiac diseases. Therefore, we aimed to investigate the value of T2* mapping to characterize structural alterations in patients with HCM. Methods CMR was performed on a 1.5 T MR imaging system (Achieva, Philips, Best, Netherlands) using a 5-channel coil in patients with HCM (n = 103, 50.6 ± 16.4 years) and in age- and gender-matched controls (n = 20, 44.8 ± 16.9 years). T2* mapping (1 midventricular short axis slice) was acquired in addition to late gadolinium enhancement (LGE). T2* values were compared between patients with HCM and controls as well as between HCM patients with- and without fibrosis. Results HCM patients showed significantly decreased T2* values compared to controls (26.2 ± 4.6 vs. 31.3 ± 4.3 ms, p
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- 2019
25. Comparison of 3D and 2D late gadolinium enhancement magnetic resonance imaging in patients with acute and chronic myocarditis
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Mihály Károlyi, Christian Blüthgen, Hatem Alkadhi, Robert Manka, Malgorzata Polacin, Bettina Baessler, Sebastian Kozerke, Mareike Gastl, Matthias Eberhard, Ioannis Kapos, J von Spiczak, University of Zurich, and Manka, R
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Male ,Cardiac imaging ,Magnetic resonance imaging ,Late Gadolinium Enhancement ,Myocarditis ,Contrast Media ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Observer Variation ,medicine.diagnostic_test ,10042 Clinic for Diagnostic and Interventional Radiology ,Middle Aged ,Acute Disease ,10209 Clinic for Cardiology ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Adult ,medicine.medical_specialty ,Adolescent ,Magnetic Resonance Imaging, Cine ,610 Medicine & health ,2705 Cardiology and Cardiovascular Medicine ,03 medical and health sciences ,Young Adult ,Imaging, Three-Dimensional ,Predictive Value of Tests ,Internal medicine ,medicine ,Organometallic Compounds ,2741 Radiology, Nuclear Medicine and Imaging ,Late gadolinium enhancement ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,Aged ,Retrospective Studies ,Original Paper ,Chronic myocarditis ,business.industry ,Myocardium ,Reproducibility of Results ,medicine.disease ,Fibrosis ,Acute myocarditis ,Chronic Disease ,Myocardial fibrosis ,business - Abstract
We compared a fast, single breath-hold three dimensional LGE sequence (3D LGE) with an established two dimensional multi breath-hold sequence (2D LGE) and evaluated image quality and the amount of myocardial fibrosis in patients with acute and chronic myocarditis. 3D LGE and 2D LGE (both spatial resolution 1.5 x 1.5 mm(2), slice-thickness 8 mm, field of view 350 x 350 mm(2)) were acquired in 25 patients with acute myocarditis (mean age 40 +/- 18 years, 7 female) and 27 patients with chronic myocarditis (mean age 44 +/- 22 years, 9 female) on a 1.5 T MR system. Image quality was evaluated by two independent, blinded readers using a 5-point Likert scale. Total myocardial mass, fibrotic mass and total fibrotic tissue percentage were quantified for both sequences in both groups. There was no significant difference in image quality between 3D und 2D acquisitions in patients with acute (p = 0.8) and chronic (p = 0.5) myocarditis. No significant differences between 3D and 2D acquisitions could be shown for myocardial mass (acute p = 0.2; chronic p = 0.3), fibrous tissue mass (acute p = 0.7; chronic p = 0.1) and total fibrous percentage (acute p = 0.4 and chronic p = 0.2). Inter-observer agreement was substantial to almost perfect. Acquisition time was significantly shorter for 3D LGE (24 +/- 5 s) as compared to 2D LGE (350 +/- 58 s, p < 0.001). In patients with acute and chronic myocarditis 3D LGE imaging shows equal diagnostic quality compared to standard 2D LGE imaging but with significantly reduced acquisition time., The International Journal of Cardiovascular Imaging, 37 (1), ISSN:0167-9899, ISSN:1569-5794, ISSN:1573-0743
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- 2021
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26. Analysis of Segmental Strain for the Detection of Chronic Ischemic Scars in Non-Contrast Cardiac MRI Cine Images: A Feasibility Study
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Matthias Eberhard, Bettina Baessler, Alexander Gotschy, Sebastian K, Mihály Károlyi, Malgorzata Polacin, Hatem Alkadhi, and Robert Manka
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business.industry ,media_common.quotation_subject ,Scars ,Strain (injury) ,medicine.disease ,Text mining ,cardiovascular system ,medicine ,Contrast (vision) ,cardiovascular diseases ,medicine.symptom ,business ,Nuclear medicine ,media_common - Abstract
Aims Cardiac magnetic resonance imaging (MRI) with late gadolinium enhancement (LGE) is considered the gold standard for scar detection after myocardial infarction. In times of increasing skepticism about gadolinium depositions in brain tissue and contraindications of gadolinium administration in some patient groups, tissue strain-based techniques for detecting ischemic scars should be further developed as part of clinical protocols. Therefore, the objective of the present work was to investigate the feasibility of scar detection in segmental strain calculations based on routinely acquired non-contrast cine images in patients with chronic infarcts.Methods Forty-six patients with chronic infarcts and scar tissue in LGE images (5 female, mean age 52 ± 19 years) and 24 gender- and age- matched healthy controls (2 female, mean age 47 ± 13 years) were included. Global (global peak circumferential [GPCS], global peak longitudinal [GPLS], global peak radial strain [GPRS]) and segmental (segmental peak circumferential [SPCS], segmental peak longitudinal [SPLS], segmental peak radial strain [SPRS]) strain parameters were calculated from standard balanced SSFP cine sequences using commercially available software (Segment CMR, Medviso, Sweden). Two independent blinded readers localized potentially infarcted segments in segmental circumferential strain calculations (endo-/epicardially contoured short axis cine and resulting polar plot strain map) and by visual wall motion assessment of cine images. Results Global strain values were reduced in patients compared to controls (GPCS p= 0.02; GPLS p= 0.04; GPRS p= 0.01). Patients with preserved ejection fraction showed also reduced GPCS compared to healthy individuals (p=0.04). In patients, mean SPCS was significantly impaired in subendocardially (- 5,4% +/- 2) and in transmurally infarcted segments (- 1,2% ± 3) compared to remote myocardium (-12,9% +/- 3, p= 0.02 and 0.03, respectively). ROC analysis revealed an optimal cut- off value for SPCS for discriminating infarcted from remote myocardium of - 7,2 % with a sensitivity of 89,4 % and specificity of 85,7%. Mean SPRS was impeded in transmurally infarcted segments (15,9 % +/- 6) compared to SPRS of remote myocardium (31,4% +/- 5; p= 0.02). The optimal cut-off value for SPRS for discriminating scar tissue from remote myocardium was 16,6% with a sensitivity of 83,3% and specificity of 76,5%. 80.3 % of all in LGE infarcted segments (118/147) were correctly localized in segmental circumferential strain calculations based on non-contrast cine images compared to 53.7% (79/147) of infarcted segments detected by visual wall motion assessment (p > 0.01). Conclusion Global strain parameters are impaired in patients with chronic infarcts compared to healthy individuals. Mean SPCS and SPRS in scar tissue is impeded compared to remote myocardium in infarcts patients. Blinded to LGE images, two readers correctly localized 80% of infarcted segments in segmental circumferential strain calculations based on non-contrast cine images, in contrast to only 54% of infarcted segments detected by visual wall motion assessment. Analysis of segmental circumferential strain shows a promising alternative for scar detection based on routinely acquired, non-contrast cine images for patients who cannot receive or decline gadolinium.
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- 2020
27. Myocardial edema in COVID-19 on cardiac MRI
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Mihály Károlyi, Frank Ruschitzka, Hatem Alkadhi, Reto A. Schuepbach, Annelies S. Zinkernagel, Johannes Nemeth, Malgorzata Polacin, Peter Steiger, Mandeep R. Mehra, Erik W. Holy, Robert Manka, University of Zurich, and Manka, Robert
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,2747 Transplantation ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Myocardial edema ,610 Medicine & health ,2705 Cardiology and Cardiovascular Medicine ,10234 Clinic for Infectious Diseases ,Internal medicine ,Edema ,medicine ,Transplantation ,medicine.diagnostic_test ,business.industry ,10042 Clinic for Diagnostic and Interventional Radiology ,Magnetic resonance imaging ,2746 Surgery ,2740 Pulmonary and Respiratory Medicine ,Cardiology ,10209 Clinic for Cardiology ,Surgery ,medicine.symptom ,10023 Institute of Intensive Care Medicine ,business ,Cardiology and Cardiovascular Medicine ,Coronavirus Infections - Published
- 2020
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28. Novel Magnetic Resonance Late Gadolinium Enhancement With Fixed Short Inversion Time in Ischemic Myocardial Scars
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Robert Manka, Matthias Eberhard, Ioannis Kapos, Alexander Gotschy, Jochen von Spiczak, Sebastian Kozerke, Mareike Gastl, Hatem Alkadhi, Malgorzata Polacin, Lucas Weber, University of Zurich, and Manka, Robert
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Male ,medicine.medical_specialty ,Scar tissue ,Myocardial Infarction ,Scars ,Contrast Media ,Magnetic Resonance Imaging, Cine ,Inversion Time ,Gadolinium ,610 Medicine & health ,Inversion recovery ,030218 nuclear medicine & medical imaging ,Breath Holding ,03 medical and health sciences ,Cicatrix ,0302 clinical medicine ,Imaging, Three-Dimensional ,Internal medicine ,Medicine ,Late gadolinium enhancement ,Humans ,2741 Radiology, Nuclear Medicine and Imaging ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Myocardial infarction ,Endocardium ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,10042 Clinic for Diagnostic and Interventional Radiology ,Reproducibility of Results ,Magnetic resonance imaging ,Heart ,General Medicine ,Middle Aged ,medicine.disease ,embryonic structures ,Cardiology ,10209 Clinic for Cardiology ,Female ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Aims: Late gadolinium enhancement (LGE) visualizes scar tissue after myocardial infarction. However, in clinically used LGE sequences, subendocardial infarcts can be missed due to low contrast between blood pool and subendocardium. The purpose of his study was to compare scar visibility in a novel 3-dimensional (3D) single breath-hold inversion recovery sequence with fixed, short inversion time (TI = 100 milliseconds) (short LGE) and standard 3D LGE imaging with individually adjusted TI (LGE). Methods: Short LGE and LGE (both sequences with the same settings: spatial resolution, 1.2 × 1.2 mm; slice thickness, 8 mm; field of view, 350 × 350 mm; single breath-hold) were acquired in 64 patients with previous MI (13 female; mean age, 57 ± 19 years) at 1.5 T. Inversion time was set to 100 milliseconds in short LGE and adjusted individually in LGE according to the Look-Locker sequence. Two independent readers evaluated 1088 segments (17-segment model), identified infarcted segments, and categorized scar visibility (5 = excellent, 1 = poor scar visibility) and scar transmurality (4 = transmural, 0 = no scar) using a 5-point Likert scale. Signal intensity ratios between short LGE and LGE for scar and blood pool, for scar and remote myocardium, and for remote myocardium and blood pool were calculated. Results: Short LGE showed 197 infarcted segments out of 1088 (18.1%); LGE revealed 191 segments (17.6%). Short LGE with dark scar and bright blood pool demonstrated better overall scar visibility, especially in subendocardially infarcted segments compared with LGE (4.2 vs 3.0, 5 = excellent visibility; P = 0.01). Signal intensity ratios for short LGE relative to LGE were 1.42 for scar/blood pool, 0.8 for scar/remote myocardium, and 0.22 for remote myocardium/blood.Overall transmurality was not rated higher in short LGE compared with LGE (P = 0.8). More fibrous tissue and total fibrous percentage (P = 0.04) were measured in short LGE compared with LGE, whereas myocardial mass was not significantly different (P = 0.5). Acquisition time was similar between short LGE and LGE (26 ± 4 seconds vs 25 ± 9 seconds, P = 0.7). Conclusions: Short LGE is a fast, single breath-hold 3D LGE sequence with no need for myocardial nulling due to fixed inversion time with improved scar visibility, especially in subendocardial infarcts.
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- 2020
29. Cardiovascular magnetic resonance T2* mapping for the assessment of cardiovascular events in hypertrophic cardiomyopathy
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Frank Ruschitzka, Christiane Gruner, Karin Labucay, Robert Manka, Jochen von Spiczak, Alexander Gotschy, Malte Kelm, Florian Boenner, Malgorzata Polacin, Hatem Alkadhi, Mareike Gastl, Sebastian Kozerke, University of Zurich, and Gastl, Mareike
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Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,myocardial ischaemia and infarction (IHD) ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Ventricular hypertrophy ,Fibrosis ,Risk Factors ,Univariate analysis ,medicine.diagnostic_test ,10042 Clinic for Diagnostic and Interventional Radiology ,Hypertrophic cardiomyopathy ,Atrial fibrillation ,Middle Aged ,Prognosis ,Cohort ,Cardiology ,cardiovascular system ,Disease Progression ,10209 Clinic for Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,arrhythmias ,MRI ,Adult ,medicine.medical_specialty ,Magnetic Resonance Imaging, Cine ,610 Medicine & health ,macromolecular substances ,2705 Cardiology and Cardiovascular Medicine ,03 medical and health sciences ,Troponin T ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Heart Failure and Cardiomyopathies ,Aged ,Retrospective Studies ,Heart Failure ,business.industry ,Myocardium ,Magnetic resonance imaging ,Arrhythmias, Cardiac ,Cardiomyopathy, Hypertrophic ,medicine.disease ,lcsh:RC666-701 ,Heart failure ,ventricular hypertrophy ,myocardial fibrosis ,business ,Biomarkers - Abstract
Background Hypertrophic cardiomyopathy (HCM) is associated with an increased risk of adverse cardiac events. Beyond classic risk factors, relative myocardial ischaemia and succeeding myocardial alterations, which can be detected using either contrast agents or parametric mapping in cardiovascular magnetic resonance (CMR) imaging, have shown an impact on outcome in HCM. CMR may help to risk stratify using parametric T2* mapping. Therefore, the aim of the present study was to evaluate the association of T2* values or fibrosis with cardiovascular events in HCM. Methods The relationship between T2* with supraventricular, ventricular arrhythmia or heart failure was retrospectively assessed in 91 patients with HCM referred for CMR on a 1.5T MR imaging system. Fibrosis as a reference was added to the model. Patients were subdivided into groups according to T2* value quartiles. Results 47 patients experienced an event of ventricular arrhythmia, 25 of atrial fibrillation/flutter and 17 of heart failure. T2*≤28.7 ms yielded no association with ventricular events in the whole HCM cohort. T2* of non-obstructive HCM showed a significant association with ventricular events in univariate analysis, but not in multivariate analysis. For the combined endpoint of arrhythmic events, there was already an association for the whole HCM cohort, but again only in univariate analyses. Fibrosis stayed the strongest predictor in all analyses. There was no association for T2* and fibrosis with heart failure. Conclusions Decreased T2* values by CMR only provide a small association with arrhythmic events in HCM, especially in non-obstructive HCM. No information is added for heart failure., Open Heart, 7 (1)
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- 2020
30. Elevated Cardiac Troponin T in Patients With Skeletal Myopathies
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Stefan Quasthoff, Martin Asslaber, Hubert Scharnagl, Andrea Berghold, Benjamin Dieplinger, Malgorzata Polacin, Peter P. Rainer, Ruth Birner-Gruenberger, Dieter H. Szolar, Meinrad Beer, Johannes Schmid, Roman Radl, Tatjana Stojakovic, Johannes Mair, Josepha S. Binder, and Laura Liesinger
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medicine.medical_specialty ,macromolecular substances ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Troponin complex ,Cardiac magnetic resonance imaging ,Internal medicine ,Troponin I ,medicine ,Myopathy ,medicine.diagnostic_test ,biology ,Troponin T ,business.industry ,Skeletal muscle ,Troponin ,medicine.anatomical_structure ,cardiovascular system ,biology.protein ,Cardiology ,Creatine kinase ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background Cardiac troponins are often elevated in patients with skeletal muscle disease who have no evidence of cardiac disease. Objectives The goal of this study was to characterize cardiac troponin concentrations in patients with myopathies and derive insights regarding the source of elevated troponin T measurements. Methods Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) concentrations were determined by using high sensitivity assays in 74 patients with hereditary and acquired skeletal myopathies. Patients underwent comprehensive cardiac evaluation, including 12-lead electrocardiogram, 24-h electrocardiogram, cardiac magnetic resonance imaging, and coronary artery computed tomography. cTnT and cTnI protein expression was determined in skeletal muscle samples of 9 patients and in control tissues derived from autopsy using antibodies that are used in commercial assays. Relevant Western blot bands were subjected to liquid chromatography tandem mass spectrometry for protein identification. Results Levels of cTnT (median: 24 ng/l; interquartile range: 11 to 54 ng/l) were elevated (>14 ng/l) in 68.9% of patients; cTnI was elevated (>26 ng/l) in 4.1% of patients. Serum cTnT levels significantly correlated with creatine kinase and myoglobin (r = 0.679 and 0.786, respectively; both p Conclusions Measured cTnT concentrations were chronically elevated in the majority of patients with skeletal myopathies, whereas cTnI elevation was rare. Our data indicate that cross-reaction of the cTnT immunoassay with skeletal muscle troponin isoforms was the likely cause.
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- 2018
31. 3D whole heart imaging in severe funnel chest and non-compaction cardiomyopathy
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Sebastian Kozerke, Malgorzata Polacin, Hatem Alkadhi, Patric Biaggi, Robert Manka, University of Zurich, and Polacin, Malgorzata
- Subjects
medicine.medical_specialty ,Funnel Chest ,medicine.diagnostic_test ,10042 Clinic for Diagnostic and Interventional Radiology ,business.industry ,MEDLINE ,Cardiomyopathy ,610 Medicine & health ,Magnetic resonance imaging ,medicine.disease ,2705 Cardiology and Cardiovascular Medicine ,Text mining ,Predictive value of tests ,Internal medicine ,Severity of illness ,10209 Clinic for Cardiology ,medicine ,Cardiology ,2741 Radiology, Nuclear Medicine and Imaging ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Images in CV Applications ,Cardiac imaging - Published
- 2020
32. P459Inflammatory reactions of the pericardium as measured with parametric mapping CMR
- Author
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Hatem Alkadhi, Justyna M. Sokolska, Sebastian Kozerke, Mareike Gastl, Robert Manka, and Malgorzata Polacin
- Subjects
medicine.anatomical_structure ,business.industry ,medicine ,Pericardium ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Cardiology and Cardiovascular Medicine ,business ,Parametric statistics ,Biomedical engineering - Published
- 2019
33. Determinants of myocardial function characterized by CMR-derived strain parameters in left ventricular non-compaction cardiomyopathy
- Author
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Malgorzata Polacin, Hatem Alkadhi, Alexander Gotschy, Valery Vishnevskiy, Sebastian Kozerke, Dominik C. Meyer, Robert Manka, Mareike Gastl, Justyna M. Sokolska, Felix C. Tanner, University of Zurich, and Manka, Robert
- Subjects
Adult ,Male ,medicine.medical_specialty ,Rotation ,Heart Ventricles ,Cardiomyopathy ,lcsh:Medicine ,Magnetic Resonance Imaging, Cine ,610 Medicine & health ,Heart failure ,030204 cardiovascular system & hematology ,Asymptomatic ,Ventricular Function, Left ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Prospective Studies ,lcsh:Science ,Prospective cohort study ,1000 Multidisciplinary ,Multidisciplinary ,Ejection fraction ,medicine.diagnostic_test ,10042 Clinic for Diagnostic and Interventional Radiology ,business.industry ,lcsh:R ,Magnetic resonance imaging ,Steady-state free precession imaging ,Strain rate ,Middle Aged ,medicine.disease ,Echocardiography ,Case-Control Studies ,10209 Clinic for Cardiology ,Cardiology ,lcsh:Q ,Female ,medicine.symptom ,business ,Cardiomyopathies - Abstract
Clinical presentation of left ventricular non-compaction cardiomyopathy (LVNC) can be heterogeneous from asymptomatic expression to congestive heart failure. Deformation indices assessed by cardiovascular magnetic resonance (CMR) can determine subclinical alterations of myocardial function and have been reported to be more sensitive to functional changes than ejection fraction. The objective of the present study was to investigate the determinants of myocardial deformation indices in patients with LVNC. Twenty patients with LVNC (44.7 ± 14.0 years) and twenty age- and gender-matched controls (49.1 ± 12.4 years) underwent functional CMR imaging using an ECG-triggered steady state-free-precession sequence (SSFP). Deformation indices derived with a feature tracking algorithm were calculated including end-systolic global longitudinal strain (GLS), circumferential strain (GCS), longitudinal and circumferential strain rate (SRll and SRcc). Twist and rotation were determined using an in-house developed post-processing pipeline. Global deformation indices (GLS, GCS, SRll and SRcc) were significantly lower in patients with LVNC compared to healthy controls (all, p, Scientific Reports, 9 (1), ISSN:2045-2322
- Published
- 2019
- Full Text
- View/download PDF
34. Hypoplastisches Linksherzsyndrom beim adulten Patienten mit Heterotaxie
- Author
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Meinrad Beer, Malgorzata Polacin, and Horst Brunner
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Heterotaxy Syndrome ,business.industry ,medicine ,Cardiac Imaging Techniques ,Radiology, Nuclear Medicine and imaging ,Magnetic resonance imaging ,Radiology ,Differential diagnosis ,medicine.disease ,business ,Hypoplastic left heart syndrome - Published
- 2017
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