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41.
  • Bonzon, Jerome, et al. (författare)
  • Rigor mortis at the myocardium investigated by post-mortem magnetic resonance imaging
  • 2015
  • Ingår i: Forensic Science International. - : ELSEVIER IRELAND LTD. - 0379-0738 .- 1872-6283. ; 257, s. 93-97
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Post-mortem cardiac MR exams present with different contraction appearances of the left ventricle in cardiac short axis images. It was hypothesized that the grade of post-mortem contraction may be related to the post-mortem interval (PMI) or cause of death and a phenomenon caused by internal rigor mortis that may give further insights in the circumstances of death. Method and materials: The cardiac contraction grade was investigated in 71 post-mortem cardiac MR exams (mean age at death 52 y, range 12-89 y; 48 males, 23 females). In cardiac short axis images the left ventricular lumen volume as well as the left ventricular myocardial volume were assessed by manual segmentation. The quotient of both (LVQ) represents the grade of myocardial contraction. LVQ was correlated to the PMI, sex, age, cardiac weight, body mass and height, cause of death and pericardial tamponade when present. In cardiac causes of death a separate correlation was investigated for acute myocardial infarction cases and arrhythmic deaths. Results: LVQ values ranged from 1.99 (maximum dilatation) to 42.91 (maximum contraction) with a mean of 15.13. LVQ decreased slightly with increasing PMI, however without significant correlation. Pericardial tamponade positively correlated with higher LVQ values. Variables such as sex, age, body mass and height, cardiac weight and cause of death did not correlate with LVQ values. There was no difference in LVQ values for myocardial infarction without tamponade and arrhythmic deaths. Conclusion: Based on the observation in our investigated cases, the phenomenon of post-mortem myocardial contraction cannot be explained by the influence of the investigated variables, except for pericardial tamponade cases. Further research addressing post-mortem myocardial contraction has to focus on other, less obvious factors, which may influence the early post-mortem phase too. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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42.
  • Booij, Ronald, et al. (författare)
  • Assessment of visibility of bone structures in the wrist using normal and half of the radiation dose with photon-counting detector CT
  • 2023
  • Ingår i: European Journal of Radiology. - : ELSEVIER IRELAND LTD. - 0720-048X .- 1872-7727. ; 159
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To quantitatively and qualitatively assess the visibility of bone structures in the wrist on photon-counting detector computed tomography (PCD-CT) images compared to state-of-the-art energy-integrating de-tector CT (EID-CT).Method: Four human cadaveric wrist specimens were scanned with EID-CT and PCD-CT at identical CTDIvolof 12.2 mGy and with 6.1 mGy (half dose PCD-CT). Axial images were reconstructed using the thinnest possible slice thickness, i.e. 0.4 mm on EID-CT and 0.2 mm on PCD-CT, with the largest image matrix size possible using reconstruction kernels optimized for bone (EID-CT: Ur68, PCD-CT: Br92). Quantitative evaluation was performed to determine contrast-noise ratio (CNR) of bone/ fat, cortical and trabecular sharpness. An observer study using visual grading characteristics (VGC) analysis was performed by six observers to assess the visibility of nutrient canals, trabecular architecture, cortical bone and the general image quality.Results: At equal dose, images obtained with PCD-CT had 39 +/- 6 % lower CNR (p = 0.001), 71 +/- 57 % higher trabecular sharpness in the radius (p = 0.02) and 42 +/- 8 % (p < 0.05) sharper cortical edges than those obtained with EID-CT. This was confirmed by VGC analysis showing a superior visibility of nutrient canals, trabeculae and cortical bone area under the curve (AUC) > 0.89) for PCD-CT, even at half dose.Conclusions: Despite a lower CNR and increased noise, the trabecular and cortical sharpness were twofold higher with PCD-CT. Visual grading analysis demonstrated superior visibility of cortical bone, trabeculae, nutrient canals and an overall improved image quality with PCD-CT over EID-CT. At half dose, PCD-CT also yielded superior image quality, both in quantitative measures and as evaluated by radiologists.
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44.
  • Brismar, Torkel, et al. (författare)
  • Liver Vessel Enhancement by Gd-BOPTA and Gc-EOB-DTPA – a Comparison in Healthy Volunteers.
  • 2009
  • Ingår i: Acta Radiologica. - : Informa Healthcare. - 0284-1851 .- 1600-0455. ; 50:7, s. 709-715
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A thorough understanding of magnetic resonance (MR) contrast media dynamics makes it possible to choose the optimal contrast media for each investigation. Differences in visualizing hepatobiliary function between Gd-BOPTA and Gd-EOB-DTPA have previously been demonstrated, but less has been published regarding differences in liver vessel visualization.Purpose: To compare the liver vessel and liver parenchymal enhancement dynamics of Gd-BOPTA (MultiHance®) and Gd-EOB-DTPA (Primovist®). Material and Methods: The signal intensity of the liver parenchyma, the common hepatic artery, the middle hepatic vein, and a segmental branch of the right portal vein, was obtained in 10 healthy volunteers before contrast media administration, during arterial and portal venous phases, and 10, 20, 30, 40 and 130 minutes after intravenous contrast medium injection, but due to scanner limitations not during the hepatic venous phase. Results: Maximum enhancement of liver parenchyma was observed from the portal venous phase until 130 minutes after Gd-BOPTA administration and from 10 minutes to 40 minutes after Gd-EOB-DTPA. There was no difference in maximum enhancement of liver parenchyma between the two contrast media. When using Gd-BOPTA, the vascular contrast enhancement was still apparent 40 minutes after injection, but had vanished 10 minutes after Gd-EOB-DTPA injection. The maximum difference in signal intensity between the vessels and the liver parenchyma was significantly greater with Gd-BOPTA than with Gd-EOB-DTPA (p<0.0001). Conclusion: At the dosage used in this study Gd-BOPTA yields higher maximum enhancement of the hepatic artery, portal vein and middle hepatic vein during the arterial and the portal venous phase and during the delayed phases than Gd-EOB-DTPA does, whereas there is no difference in liver parenchymal enhancement between the two contrast agents.
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45.
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46.
  • Burza, Matthias, et al. (författare)
  • Hollow microspheres as targets for staged laser-driven proton acceleration
  • 2011
  • Ingår i: New Journal of Physics. - : Institute of Physics Publishing (IOPP). - 1367-2630. ; 13, s. 013030-
  • Tidskriftsartikel (refereegranskat)abstract
    • A coated hollow core microsphere is introduced as a novel targetin ultra-intense laser–matter interaction experiments. In particular, it facilitates staged laser-driven proton acceleration by combining conventional target normal sheath acceleration (TNSA), power recycling of hot laterally spreading electrons and staging in a very simple and cheap target geometry. During TNSA of protons from one area of the sphere surface, laterally spreading hot electrons form a charge wave. Due to the spherical geometry, this wave refocuses on the opposite side of the sphere, where an opening has been laser micromachined.This leads to a strong transient charge separation field being set up there, which can post-accelerate those TNSA protons passing through the hole at the right time. Experimentally, the feasibility of using such targets is demonstrated. A redistribution is encountered in the experimental proton energy spectra, as predicted by particle-in-cell simulations and attributed to transient fields set up by oscillating currents on the sphere surface.
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47.
  • Burza, Matthias, et al. (författare)
  • Laser wakefield acceleration using wire produced double density ramps
  • 2013
  • Ingår i: Physical Review Special Topics. Accelerators and Beams. - 1098-4402. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • A novel approach to implement and control electron injection into the accelerating phase of a laser wakefield accelerator is presented. It utilizes a wire, which is introduced into the flow of a supersonic gas jet creating shock waves and three regions of differing plasma electron density. If tailored appropriately, the laser plasma interaction takes place in three stages: Laser self-compression, electron injection, and acceleration in the second plasma wave period. Compared to self-injection by wave breaking of a nonlinear plasma wave in a constant density plasma, this scheme increases beam charge by up to 1 order of magnitude in the quasimonoenergetic regime. Electron acceleration in the second plasma wave period reduces electron beam divergence by approximate to 25%, and the localized injection at the density downramps results in spectra with less than a few percent relative spread. DOI: 10.1103/PhysRevSTAB.16.011301
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48.
  • Bäck, Sophia, et al. (författare)
  • Assessment of transmitral and left atrial appendage flow rate from cardiac 4D-CT
  • 2023
  • Ingår i: Communications Medicine. - : Springer Nature. - 2730-664X. ; 3:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Plain language summaryAssessing the blood flow inside the heart is important in diagnosis and treatment of various cardiovascular diseases, such as atrial fibrillation or heart failure. We developed a method to accurately track the motion of the heart walls over the course of a heartbeat in three-dimensional Computed Tomography (CT) images. Based on the motion, we calculated the amount of blood passing through the mitral valve and the left atrial appendage orifice, which are markers used in the diagnostic of heart failure and assessment of stroke risk in atrial fibrillation. The results agreed well with measurements from 4D flow MRI, an imaging technique that measures blood velocities. Our method could broaden the use of CT and make additional exams redundant. It can even be used to calculate the blood flow inside the heart. BackgroundCardiac time-resolved CT (4D-CT) acquisitions provide high quality anatomical images of the heart. However, some cardiac diseases require assessment of blood flow in the heart. Diastolic dysfunction, for instance, is diagnosed by measuring the flow through the mitral valve (MV), while in atrial fibrillation, the flow through the left atrial appendage (LAA) indicates the risk for thrombus formation. Accurate validated techniques to extract this information from 4D-CT have been lacking, however.MethodsTo measure the flow rate though the MV and the LAA from 4D-CT, we developed a motion tracking algorithm that performs a nonrigid deformation of the surface separating the blood pool from the myocardium. To improve the tracking of the LAA, this region was deformed separately from the left atrium and left ventricle. We compared the CT based flow with 4D flow and short axis MRI data from the same individual in 9 patients.ResultsFor the mitral valve flow, good agreement was found for the time span between the early and late diastolic peak flow (bias: <0.1 s). The ventricular stroke volume is similar compared to short-axis MRI (bias 3 ml). There are larger differences in the diastolic peak flow rates, with a larger bias for the early flow rate than the late flow rate. The peak LAA outflow rate measured with both modalities matches well (bias: -6 ml/s).ConclusionsOverall, the developed algorithm provides accurate tracking of dynamic cardiac geometries resulting in similar flow rates at the MV and LAA compared to 4D flow MRI. Back et al. describe a motion tracking algorithm to measure the flow rate through the mitral valve (MV) and the left atrial appendage (LAA) from 4D-CT data. The developed algorithm provided accurate tracking of dynamic cardiac geometries resulting in similar flow rates at the MV and LAA to those measured by 4D flow MRI.
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49.
  • Bäck, Sophia, et al. (författare)
  • Comprehensive left atrial flow component analysis reveals abnormal flow patterns in paroxysmal atrial fibrillation
  • 2024
  • Ingår i: American Journal of Physiology. Heart and Circulatory Physiology. - : AMER PHYSIOLOGICAL SOC. - 0363-6135 .- 1522-1539. ; 326:3, s. H511-H521
  • Tidskriftsartikel (refereegranskat)abstract
    • Left atrial (LA) blood flow plays an important role in diseases such as atrial fibrillation (AF) and atrial cardiomyopathy since alterations in the blood flow might lead to thrombus formation and stroke. Using traditional techniques, such as echocardiography, atrial flow velocities can be measured at the pulmonary veins and the mitral valve, but a comprehensive understanding of the three-dimensional atrial flow field is missing. Previously, ventricular flow has been analyzed using flow component analysis, revealing new insights into ventricular flow and function. Thus, the aim of this project was to develop a comprehensive flow component analysis method for the LA and explore its utility in 21 patients with paroxysmal atrial fibrillation compared with a control group of 8 participants. The flow field was derived from time-resolved CT acquired during sinus rhythm using computational fluid dynamics. Flow components were computed from particle tracking. We identified six atrial flow components: conduit, reservoir, delayed ejection, retained inflow, residual volume, and pulmonary vein backflow. It was shown that conduit flow, defined as blood entering and leaving the LA within the same diastolic phase, exists in most subjects. Although the volume of conduit and reservoir is similar in patients with paroxysmal AF in sinus rhythm and controls, the volume of the other components is increased in paroxysmal AF. Comprehensive quantification of LA flow using flow component analysis makes atrial blood flow quantifiable, thus facilitating investigation of mechanisms underlying atrial dysfunction and can increase understanding of atrial blood flow in disease progression and stroke risk. NEW & NOTEWORTHY We developed a new comprehensive approach to atrial blood component analysis that includes both conduit flow and residual volume and compared the flow components of atrial fibrillation (AF) patients in sinus rhythm with controls. Conduit and reservoir flow were similar between the groups, whereas components with longer residence time in the left atrium were increased in the AF group. This could add to the pathophysiological understanding of atrial diseases and possibly clinical management.
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50.
  • Bäck, Sophia, et al. (författare)
  • Elevated atrial blood stasis in paroxysmal atrial fibrillation during sinus rhythm: a patient-specific computational fluid dynamics study
  • 2023
  • Ingår i: Frontiers in Cardiovascular Medicine. - : FRONTIERS MEDIA SA. - 2297-055X. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Atrial fibrillation (AF) is associated with an increased risk of stroke, often caused by thrombi that form in the left atrium (LA), and especially in the left atrial appendage (LAA). The underlying mechanism is not fully understood but is thought to be related to stagnant blood flow, which might be present despite sinus rhythm. However, measuring blood flow and stasis in the LAA is challenging due to its small size and low velocities. We aimed to compare the blood flow and stasis in the left atrium of paroxysmal AF patients with controls using computational fluid dynamics (CFD) simulations.Methods : The CFD simulations were based on time-resolved computed tomography including the patient-specific cardiac motion. The pipeline allowed for analysis of 21 patients with paroxysmal AF and 8 controls. Stasis was estimated by computing the blood residence time.Results and Discussion: Residence time was elevated in the AF group (p < 0.001). Linear regression analysis revealed that stasis was strongest associated with LA ejection ratio (p < 0.001, R-2 = 0.68) and the ratio of LA volume and left ventricular stroke volume (p < 0.001, R-2 = 0.81). Stroke risk due to LA thrombi could already be elevated in AF patients during sinus rhythm. In the future, patient specific CFD simulations may add to the assessment of this risk and support diagnosis and treatment.
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