Paul A. Picot

MRI Measures of Middle Cerebral Artery Diameter in Conscious Humans During Simulated Orthostasis

BACKGROUND AND PURPOSE The relationship between middle cerebral artery (MCA) flow velocity (CFV) and cerebral blood flow (CBF) is uncertain because of unknown vessel diameter response to physiological stimuli. The purpose of this study was to directly examine the effect of a simulated orthostatic stress (lower body negative pressure [LBNP]) as well as increased or decreased end-tidal carbon dioxide partial pressure (P(ET)CO(2)) on MCA diameter and CFV. METHODS Twelve subjects participated in a CO(2) manipulation protocol and/or an LBNP protocol. In the CO(2) manipulation protocol, subjects breathed room air (normocapnia) or 6% inspired CO(2) (hypercapnia), or they hyperventilated to approximately 25 mm Hg P(ET)CO(2) (hypocapnia). In the LBNP protocol, subjects experienced 10 minutes each of -20 and -40 mm Hg lower body suction. CFV and diameter of the MCA were measured by transcranial Doppler and MRI, respectively, during the experimental protocols. RESULTS Compared with normocapnia, hypercapnia produced increases in both P(ET)CO(2) (from 36+/-3 to 40+/-4 mm Hg, P<0.05) and CFV (from 63+/-4 to 80+/-6 cm/s, P<0.001) but did not change MCA diameters (from 2.9+/-0.3 to 2.8+/-0.3 mm). Hypocapnia produced decreases in both P(ET)CO(2) (24+/-2 mm Hg, P<0.005) and CFV (43+/-7 cm/s, P<0.001) compared with normocapnia, with no change in MCA diameters (from 2.9+/-0.3 to 2.9+/-0.4 mm). During -40 mm Hg LBNP, P(ET)CO(2) was not changed, but CFV (55+/-4 cm/s) was reduced from baseline (58+/-4 cm/s, P<0.05), with no change in MCA diameter. CONCLUSIONS Under the conditions of this study, changes in MCA diameter were not detected. Therefore, we conclude that relative changes in CFV were representative of changes in CBF during the physiological stimuli of moderate LBNP or changes in P(ET)CO(2).

A wall-less vessel phantom for Doppler ultrasound studies

Doppler ultrasound flow measurement techniques are often validated using phantoms that simulate the vasculature, surrounding tissue and blood. Many researchers use rubber tubing to mimic blood vessels because of the realistic acoustic impedance, robust physical properties and wide range of available sizes. However, rubber tubing has a very high acoustic attenuation, which may introduce artefacts into the Doppler measurements. We describe the construction of a wall-less vessel phantom that eliminates the highly attenuating wall and reduces impedance mismatches between the vessel lumen and tissue mimic. An agar-based tissue mimic and a blood mimic are described and their acoustic attenuation coefficients and velocities are characterised. The high attenuation of the latex rubber tubing resulted in pronounced shadowing in B-mode images; however, an image of a wall-less vessel phantom did not show any shadowing. We show that the effects of the highly attenuating latex rubber vessels on Doppler amplitude spectra depend on the vessel diameter and ultrasound beam width. In this study, only small differences were observed in spectra obtained from 0.6 cm inside diameter thin-wall latex, thick-wall latex and wall-less vessel phantoms. However, a computer model predicted that the spectrum obtained from a 0.3-cm inside diameter latex-wall vessel would be significantly different than the spectrum obtained from a wall-less vessel phantom, thus resulting in an overestimation of the average fluid velocity. These results suggest that care must be taken to ensure that the Doppler measurements are not distorted by the highly attenuating wall material. In addition, the results show that a wall-less vessel phantom is preferable when measuring flow in small vessels.

Three-dimensional colour Doppler imaging.

We have developed a system to acquire in vivo three-dimensional (3D) colour velocity images of peripheral vasculature. A clinical ultrasound system was modified by mounting the transducer on a motor-driven translation stage, allowing planar ultrasound images to be acquired along a 37 mm long stroke. A 3D velocity image is acquired by digitizing, in synchrony with the cardiac cycle, successive video images as the transducer is moved over the skin surface. 3D images require about 1 min to acquire and 10 min to reconstruct before being viewed interactively. Image acquisition at several points in the cardiac cycle permits a cine-type reconstructed image. Geometrical, temporal and velocity accuracy of the acquisition and reconstruction have been quantified and found not to degrade the image.

A geometrically accurate vascular phantom for comparative studies of x-ray, ultrasound, and magnetic resonance vascular imaging: construction and geometrical verification.

A technique for producing accurate models of vascular segments for use in experiments that assess vessel geometry and flow has been developed and evaluated. The models are compatible with x-ray, ultrasound, and magnetic resonance (MR) imaging systems. In this paper, a model of the human carotid artery bifurcation, is evaluated that has been built using this technique. The phantom consists of a thin-walled polyester-resin replica of the bifurcation through which a blood-mimicking fluid may be circulated. The phantom is surrounded by an agar tissue-mimicking material and a series of fiducial markers. The blood- and tissue-mimicking materials have x-ray, ultrasound, and MR properties similar to blood and tissue; fiducial markers provide a means of aligning images acquired by different modalities. The root-mean-square difference between the inner wall geometry of the constructed model and the desired dimensions was 0.33 mm. Static images were successfully acquired using x-ray, ultrasound, and MR imaging systems, and are free of significant artifacts. Flow images acquired with ultrasound and MR agree qualitatively with each other, and with previously published flow patterns. Volume-flow measurements obtained with ultrasound and MR were within 4.4% of the actual values.

Quantitative volume flow estimation using velocity profiles

The direct measurement of the velocity profile of blood flowing in a vessel yields a volume flow estimate that is more accurate than single-point Doppler ultrasound. A volume flow estimate is made by assuming a circularly symmetric velocity field and integrating the velocity profile measured along a diameter. The many velocity measurements made contribute to higher precision in the integrated velocity estimate. Also, the velocity profile furnishes the functional diameter of the vessel at many points through the cardiac cycle. This algorithm, as implemented on the Philips CVI system, was tested theoretically by numerical modelling, and experimentally with a flow simulator. The effect of beamwidth, vessel size, and measurement position misalignment on the volume flow estimate were studied. Experimental and theoretical results agreed well and showed that the flow estimation algorithm can produce precise and accurate volume flow estimates. The flow estimate is sensitive to the flow angle and is inaccurate by 5% per degree error in the angle. Beamwidths of 1.0 to 1.5 mm are a good match to axial resolution and yield accurate volume flow estimates in vessels over 2 mm in diameter. Larger beamwidths give lower volume flow estimates, but are not as sensitive to misalignment.<<ETX>>

Quantitative investigation of in vitro flow using three-dimensional colour Doppler ultrasound

A quantitative in vitro flow study was performed by using a three-dimensional colour Doppler imaging system. This system was based on a clinical ultrasound instrument with its transducer mounted on a motor-driven translation stage. A vascular and tissue-mimicking phantom containing two wall-less vessels, one normal and another stenotic, was used to quantify the measurement accuracy of the flow velocity and the flow field. Steady state flows, having Reynolds numbers ranging between 460 and 1300, were generated by a computer-controlled positive displacement pump. Effects of the parameter settings of the ultrasound instrument on results of the estimation of flow field were also studied. Experimental results show that our three-dimensional colour Doppler systems velocity accuracy was better than 7% of the Nyquist velocity and its spatial accuracy was better than 0.5 mm. The system showed a good correlation (r = 0.999) between the estimated and the true mean flow velocity, and a good correlation (r = 0.998) between the estimated maximum and the true mean flow velocity. This study is our first step toward validating the measurement of the three-dimensional velocity and wall shear stress distributions by using three-dimensional colour Doppler ultrasound

Two-dimensional time correlation relaxometry of skeletal muscle in vivo at 3 Tesla

A hybrid two‐dimensional relaxometry (2DR) sequence was used to simultaneously measure both the spin‐spin (R2) and spin‐lattice relaxation rates (R1) of skeletal muscle in vivo. The 2DR sequence involved a 180° inversion pulse followed by a variable delay time (30 values from 40 to 7000 ms); a projection presaturation (PP) scheme to localize a 16‐ml cylindrical voxel; and a CPMG sequence (950 even echoes, effective echo spacing = 1.2 ms, equilibrium time = 12 s). The 2DR data were collected at 3.0 Tesla from the flexor digitorum profundus of eight healthy males, 26 ± 2 years old. Analysis was performed with a 2D version of the non‐negative least‐squares algorithm and a one‐way ANOVA. All subjects exhibited at least three spin‐groups (R2 < 200 s−1), designated B, C, and D, with R2 values of 42.7, 26.5, and 8.1 s−1, and fractional volumes of 52, 35, and 7%, respectively. The R1 values of B and C were similar, ≅0.7 s−1, but different from that of D (P < 0.001), which had an R1 of 1.0 s−1. The results suggest that exchange between B and C ranges from 0.7–16.2 s−1, while exchange between either of these spin‐groups with D is slower. If the data are interpreted with a compartment model, in which spin‐groups with short and long R2 values are attributed to extra‐ and intracellular fluid, respectively, the exchange of water across the cell membrane in living skeletal muscle is slow or intermediate relative to both R1 and R2. Magn Reson Med 46:1093–1098, 2001.

Rapid volume flow rate estimation using transverse colour Doppler imaging

A system is described in which the volume flow rate of blood in a vessel is determined using transverse colour Doppler ultrasound imaging. The system measures rapidly the two-dimensional velocity profile of blood flowing through a vessel. By integration of the measured velocity profiles the volume flow rate of blood in the vessel is obtained. The Doppler angle is obtained from the included angle between two imaging planes, and their respective average measured flows. This technique yields instantaneous and average flow rate in real time, and permits long flow recordings to be made and stored digitally. The error is less than 5% over a 8:1 flow rate range.

A modified x‐ray image intensifier with continuously variable field of view: Resolution considerations

A conventional x-ray image intensifier (XRII) has been modified to enable the field of view (FOV) to be varied continuously, by adjusting the potentials at the focusing electrodes. The benefit, to system resolution, from decreasing the FOV has been characterized by measuring the modulation transfer function (MTF) of the XRII coupled to a high-resolution photo-diode array (PDA), at a number of different FOVs achieved either by electronic or optical zooming. Electronic zooming of the XRII from FOV = 24 cm to FOV = 10 cm led to an increase in f0.1 (the frequency at which MTF = 0.1) from 1.41 to 3.05 mm-1, while optical zooming increased f0.1 from 1.41 mm-1 only to 1.88 mm-1. It is proposed that the advantage, with respect to resolution gain, of electronic zooming over optical zooming was realized only when the XRII limits system resolution. The MTF of the XRII coupled to a video camera, with lower resolving power than the PDA, was measured at different FOVs to show that using electronic zooming is only marginally beneficial when the optical detector and the XRII contribute equally to the resolution degradation. However, when a higher-resolution optical detector is used, electronic zooming always yields a greater gain in resolution.

An in‐line optical image translator with applications in x‐ray videography

Many applications in radiography require, or would benefit from, the ability to translate, i.e. move, an optical image in the detector plane. In this paper, we describe the design and characterization of a prism-based optical image translator for insertion into existing XRII-video imaging systems. A pair of prisms rotatable about the optical axis form a very compact in-line optical image translator for installation in the parallel light path between an x-ray image intensifier and its video camera. Rotation of the prisms translates the XRII optical image on the camera target. With the addition of x-ray and light collimators to limit the image to a single video line, x-ray streak images may be acquired. By rotating an object in the x-ray beam during a streak, a complete computed tomography (CT) data set may be acquired. This image translator can translate an image anywhere in the focal plane of a 50-mm-output lens within a 40-mm-diam circle. The prisms have an aperture of 50 mm, permitting an optical speed of F/2 with a 50-mm output lens. The design is insensitive to angular alignment errors. This image translator is achromatic, since the spectral width of the output phosphorus of image intensifiers is sufficient to introduce blurring in a nonacrhomatic design. A prism-based image translator introduces image distortion, since the prisms do not operate at minimum deviation. The distortion is less than 4% over all parts of a typical detector area, and less than 1% in the central region of the image.(ABSTRACT TRUNCATED AT 250 WORDS)