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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
51

MRI image analysis for abdominal and pelvic endometriosis

Chi, Wenjun January 2012 (has links)
Endometriosis is an oestrogen-dependent gynaecological condition defined as the presence of endometrial tissue outside the uterus cavity. The condition is predominantly found in women in their reproductive years, and associated with significant pelvic and abdominal chronic pain and infertility. The disease is believed to affect approximately 33% of women by a recent study. Currently, surgical intervention, often laparoscopic surgery, is the gold standard for diagnosing the disease and it remains an effective and common treatment method for all stages of endometriosis. Magnetic resonance imaging (MRI) of the patient is performed before surgery in order to locate any endometriosis lesions and to determine whether a multidisciplinary surgical team meeting is required. In this dissertation, our goal is to use image processing techniques to aid surgical planning. Specifically, we aim to improve quality of the existing images, and to automatically detect bladder endometriosis lesion in MR images as a form of bladder wall thickening. One of the main problems posed by abdominal MRI is the sparse anisotropic frequency sampling process. As a consequence, the resulting images consist of thick slices and have gaps between those slices. We have devised a method to fuse multi-view MRI consisting of axial/transverse, sagittal and coronal scans, in an attempt to restore an isotropic densely sampled frequency plane of the fused image. In addition, the proposed fusion method is steerable and is able to fuse component images in any orientation. To achieve this, we apply the Riesz transform for image decomposition and reconstruction in the frequency domain, and we propose an adaptive fusion rule to fuse multiple Riesz-components of images in different orientations. The adaptive fusion is parameterised and switches between combining frequency components via the mean and maximum rule, which is effectively a trade-off between smoothing the intrinsically noisy images while retaining the sharp delineation of features. We first validate the method using simulated images, and compare it with another fusion scheme using the discrete wavelet transform. The results show that the proposed method is better in both accuracy and computational time. Improvements of fused clinical images against unfused raw images are also illustrated. For the segmentation of the bladder wall, we investigate the level set approach. While the traditional gradient based feature detection is prone to intensity non-uniformity, we present a novel way to compute phase congruency as a reliable feature representation. In order to avoid the phase wrapping problem with inverse trigonometric functions, we devise a mathematically elegant and efficient way to combine multi-scale image features via geometric algebra. As opposed to the original phase congruency, the proposed method is more robust against noise and hence more suitable for clinical data. To address the practical issues in segmenting the bladder wall, we suggest two coupled level set frameworks to utilise information in two different MRI sequences of the same patients - the T2- and T1-weighted image. The results demonstrate a dramatic decrease in the number of failed segmentations done using a single kind of image. The resulting automated segmentations are finally validated by comparing to manual segmentations done in 2D.
52

Mise en place d'une mesure quantitative du T1 en IRM cardiaque / Development and setting of T1 quantitative measure in cardiac MRI

Poinsignon-Clique, Hélène 13 November 2012 (has links)
La cartographie du temps de relaxation longitudinale T1 est une technique d'IRM quantitative pour caractériser les tissus myocardiques. Plusieurs études ont déjà montré la corrélation entre la mesure de T1 et la présence de fibrose. Celle-ci est souvent observée dans les pathologies cardiaques telles que les cardiomyopathies ou l'infarctus du myocarde. Cependant, l'acquisition d'une carte T1 du coeur reste techniquement difficile. Actuellement, la quantification T1 du myocarde humain est réalisée en apnée à l'aide de séquences 2D qui sont spécifiques aux constructeurs et donc peu disponibles. Afin de pallier aux limitations de ces séquences, nous proposons une méthode basée sur une séquence 3D clinique. Cette technique, utilisant la variation des angles de bascule avec intégration d'une correction B1, a été adaptée pour une utilisation en imagerie cardiaque. Des essais sur fantôme ont permis de sélectionner les paramètres optimaux et de montrer la reproductibilité de la méthode. Puis, une étude sur volontaires sains a permis de valider la méthode en double synchronisation (cardiaque et respiratoire). Enfin, une méthode de reconstruction intégrant des signaux physiologiques de mouvement a également été utilisée afin de faire de la quantification T1 en respiration libre et de diminuer le temps d'acquisition. Les valeurs de T1 myocardique sur volontaires sont comprises entre 1289 ± 66 ms et 1376 ± 43 ms, correspondant aux valeurs de la littérature. Ces travaux ouvrent la voie à l'utilisation de la cartographie T1 chez les patients avec pour objectifs une meilleure caractérisation des pathologies et une meilleure adaptation des stratégies thérapeutiques / T1 mapping is a useful quantitative MR technique for cardiac tissue characterization. Several studies have shown that T1 measurements are correlated with fibrosis, which is observed in cardiac diseases such as cardiomyopathy or myocardial infarction. However, cardiac T1 mapping remains challenging, mainly because of long acquisition times and interference from cardiac and respiratory motions. T1 quantification on the human myocardium is generally performed on breath-hold with 2D specific sequences. Unfortunately these sequences are scanner specific and poorly available for clinical use. To overcome these limitations, we propose a new method based on a 3D clinical sequence. This technique, using a variable flip angle approach that integrates B1 correction, was adapted in cardiac imaging. Phantom tests were used to select the optimal parameters and to show the method reproducibility. Then, the method was validated with a volunteer study using double synchronization (cardiac and respiratory). Moreover, a reconstruction method integrating physiological signals of motion was also used to perform T1 quantification in free breathing and to reduce the total acquisition time. The myocardial T1 values on volunteers ranged between 1289 ± 66 ms and 1376 ± 43 ms, which was in good agreement with previously published works. These studies allow the use of T1 mapping in patients with better characterization of pathologies and a better adaptation to therapeutic strategies
53

Séchage des matériaux de chaussée traités à l’émulsion de bitume / Drying of pavement materials treated with bitumen emulsions

Goavec, Marie 08 October 2018 (has links)
Les matériaux de chaussée dits “à froid”, formés d’un mélange de granulats et d’une émulsion de bitume, constituent une alternative plus économique et respectueuse de l’environnement aux matériaux de chaussée classiques. Cependant, ces mélanges incorporent une quantité significative d’eau, retardant la consolidation du mélange granulaire. L’objectif de cette thèse est de comprendre le déroulement du séchage au sein de l’enrobé, un milieu granulaire poreux saturé en émulsion de bitume, et quel en est l’effet sur sa structure et ses propriétés. Les principaux mécanismes du séchage de milieux poreux simples initialement saturés en eau sont relativement bien connus : celui-ci se déroule selon une longue première période à vitesse constante associée à une désaturation homogène du milieu et durant laquelle environ 90% d’eau est extraite, suivie d’une période à vitesse décroissante. Quelques travaux ont récemment montré que l’on peut largement s’éloigner de ce schéma dès que le fluide interstitiel est plus complexe (solution saline, suspension, gel), du fait du transport et/ou de l’accumulation des composants non-évaporables contenus dans le fluide. Nous avons choisi de décomposer le problème en étudiant d’abord le séchage du fluide complexe seul, autrement dit l’émulsion de bitume (ainsi que des émulsions modèles de silicone afin de mieux comprendre les mécanismes), puis le séchage de cette même émulsion en milieu poreux. Notre travail s’appuie sur le suivi « macroscopique » du séchage (i.e. pesée), et un suivi des caractéristiques internes (distribution de de liquide au sein du matériau) par Imagerie par Résonance Magnétique, qui fournit des informations originales très complètes. Nous montrons ainsi que l’extraction d’eau résultant du séchage d’émulsions modèles de silicone et de bitume seules est essentiellement homogène sur toute l’épaisseur (centimétrique) de l’émulsion, et associée à la compaction et la déformation progressives des gouttes de phase dispersée. Cependant, un gradient de concentration existe près de la surface libre et il s’avère que dans cette zone la coalescence de gouttes de phase dispersée ralentit très fortement le séchage. Nous montrons ensuite que la vitesse de séchage de milieux poreux initialement saturés en émulsion diminue dès le départ et continuellement jusqu’à de très faibles valeurs. La formation et la progression rapide d’un front sec dans le milieu poreux ainsi que l’absence de migration de bitume dans le milieu poreux, observés par IRM, permettent d’expliquer en partie ce phénomène, mais il faut probablement y ajouter les caractéristiques propres du séchage de l’émulsion de bitume, qui contribuent également à ralentir la vitesse d’évaporation / The preparation of cold mix asphalts, composed of aggregates and bitumen emulsion, represent a substantial economic and environmental potential but the presence of water delays the strengthening of the material. Our objective is to understand how the mix dries and how this affects its properties. The drying of pure liquids in simple porous media has been extensively studied : a constant drying rate period as well as a homogeneous distribution of water are observed until 90% of the water has been extracted; afterwards the drying rate decreases. Studies have shown that the drying of complex fluids (ionic solutions, suspensions, gels) is very different due to the transport and/or accumulation of the fluid’s non-vaporizable elements. We chose to study first the drying of the complex fluid i.e. the bitumen emulsion as well as silicone oil emulsions to understand better the drying mechanisms, then the drying of the complex fluid in a porous media. We used Magnetic Resonance Imaging (MRI) to monitor the internal characteristics of our systems. This allowed us to show that water is extracted uniformly over the drying emulsion’s entire thickness ($approx$cm), leading to the progressive droplet compaction and deformation. However, a water concentration gradient forms near the free surface, which ultimately slows the drying as droplets coalesce. We then show that the drying rate of a porous medium initially saturated with emulsion decreases from the beginning of drying. The rapid formation and progression of a dry area in the porous medium and the absence of bitumen transport partly explain this but it is very likely that the bitumen emulsion’s drying characteristics contribute to the decreasing drying rate
54

A longitudinal study of brain structure in the early stages of schizophrenia

Whitford, Thomas James January 2007 (has links)
Doctor of Philosophy (PhD) / Schizophrenia is a severe mental illness that affects approximately 1% of the population worldwide, and which typically has a devastating effect on the lives of its sufferers. The characteristic symptoms of the disease include hallucinations, delusions, disorganized thought and reduced emotional expression. While many of the early theories of schizophrenia focused on its psychosocial foundations, more recent theories have focused on the neurobiological underpinnings of the disease. This thesis has four primary aims: 1) to use magnetic resonance imaging (MRI) to identify the structural brain abnormalities present in patients suffering from their first episode of schizophrenia (FES), 2) to elucidate whether these abnormalities were static or progressive over the first 2-3 years of patients’ illness, 3) to identify the relationship between these neuroanatomical abnormalities and patients’ clinical profile, and 4) to identify the normative relationship between longitudinal changes in neuroanatomy and electrophysiology in healthy participants, and to compare this to the relationship observed between these two indices in patients with FES. The aim of Chapter 2 was to use MRI to identify the neuroanatomical changes that occur over adolescence in healthy participants, and to identify the normative relationship between the neuroanatomical changes and electrophysiological changes associated with healthy periadolescent brain maturation. MRI and electroencephalographic (EEG) scans were acquired from 138 healthy participants between the ages of 10 and 30 years. The MRI scans were segmented into grey matter (GM) and white matter (WM) images, before being parcellated into the frontal, temporal, parietal and occipital lobes. Absolute EEG power was calculated for the slow-wave, alpha and beta frequency bands, for the corresponding cortical regions. The age-related changes in regional tissue volumes and regional EEG power were inferred with a regression model. The results indicated that the healthy participants experienced accelerated GM loss, EEG power loss and WM gain in the frontal and parietal lobes between the ages of 10 and 20 years, which decelerated between the ages of 20 and 30 years. A linear relationship was also observed between the maturational changes in regional GM volumes and EEG power in the frontal and parietal lobes. These results indicate that the periadolescent period is a time of great structural and electrophysiological change in the healthy human brain. The aim of Chapter 3 was to identify the GM abnormalities present in patients with FES, both at the time of their first presentation to mental health services (baseline), and over the first 2-3 years of their illness (follow-up). MRI scans were acquired from 41 patients with FES at baseline, and 47 matched healthy control subjects. Of these participants, 25 FES patients and 26 controls returned 2-3 years later for a follow-up scan. The analysis technique of voxel-based morphometry (VBM) was used in conjunction with the Statistical Parametric Mapping (SPM) software package in order to identify the regions of GM difference between the groups at baseline. The related analysis technique of tensor-based morphometry (TBM) was used to identify subjects’ longitudinal GM change over the follow-up interval. Relative to the healthy controls, the FES patients were observed to exhibit widespread GM reductions in the frontal, parietal and temporal cortices and cerebellum at baseline, as well as more circumscribed regions of GM increase, particularly in the occipital lobe. Furthermore, the FES patients lost considerably more GM over the follow-up interval than the controls, particularly in the parietal and temporal cortices. These results indicate that patients with FES exhibit significant structural brain abnormalities very early in the course of their illness, and that these abnormalities progress over the first few years of their illness. Chapter 4 employed the same methodology to investigate the white matter abnormalities exhibited by the FES subjects relative to the controls, both at baseline and over the follow-up interval. Compared to controls, the FES patients exhibited volumetric WM deficits in the frontal and temporal lobes at baseline, as well as volumetric increases at the fronto-parietal junction bilaterally. Furthermore, the FES patients lost considerably more WM over the follow-up interval than did the controls in the middle and inferior temporal cortex bilaterally. While there is substantial evidence indicating that abnormalities in the maturational processes of myelination play a significant role in the development of WM abnormalities in FES, the observed longitudinal reductions in WM were consistent with the death of a select population of temporal lobe neurons over the follow-up interval. The aim of Chapter 5 was to investigate the clinical correlates of the GM abnormalities exhibited by the FES patients at baseline. The volumes of four distinct cerebral regions where 31 patients with FES exhibited reduced GM volumes relative to 30 matched controls were calculated and correlated with patients’ scores on three primary symptom dimensions: Disorganization, Reality Distortion and Psychomotor Poverty. The results indicated that the greater the degree of atrophy exhibited by the FES patients in three of these four ‘regions-of-reduction’, the less severe their degree of Reality Distortion. These results suggest that an excessive amount of GM atrophy may in fact preclude the formation of hallucinations or highly systematized delusions in patients with FES. The aim of Chapter 6 was to identify the relationship between the longitudinal changes in brain structure and brain electrophysiology exhibited by 19 FES patients over the first 2-3 years of their illness, and to compare it to the normative relationship between the two indices reported in Chapter 2. The methodology employed for the parcellation of the MRI and EEG data was identical to Chapter 2. The results indicated that, in contrast to the healthy controls, the longitudinal reduction in GM volume exhibited by the FES patients was not associated with a corresponding reduction in EEG power in any brain lobe. In contrast, EEG power was observed to be maintained or even to increase over the follow-up interval in these patients. These results were consistent with the FES patients experiencing an abnormal elevation of neural synchrony. Such an abnormality in neural synchrony could potentially form the basis of the dysfunctional neural connectivity that has been widely proposed to underlie the functional deficits present in patients with schizophrenia. The primary aim of Chapter 7 was to assimilate the findings from the preceding empirical chapters with the theoretical framework provided in the literature, into an integrated and testable model of schizophrenia. The model emphasized dysfunctions in brain maturation, specifically in the normative processes of synaptic ‘pruning’ and axonal myelination, as playing a key role in the development of disintegrated neural activity and the subsequent onset of schizophrenic symptoms. The model concluded with the novel proposal that disintegrated neural activity arises from abnormal elevations in the synchrony of synaptic activity in patients with first-episode schizophrenia.
55

Active Staining for In Vivo Magnetic Resonance Microscopy of the Mouse Brain

Howles-Banerji, Gabriel Philip January 2009 (has links)
<p>Mice have become the preferred model system for studying brain function and disease. With the powerful genetic tools available, mouse models can be created to study the underlying molecular basis of neurobiology in vivo. Just as magnetic resonance imaging is the dominant tool for evaluating the human brain, high-resolution MRI--magnetic resonance microscopy (MRM)--is a useful tool for studying the brain of mouse models. However, the need for high spatial resolution limits the signal-to-noise ratio (SNR) of the MRM images. To address this problem, T1-shortening contrast agents can be used, which not only improve the tissue contrast-to-noise ratio (CNR) but also increase SNR by allowing the MR signal to recover faster between pulses. By "actively staining" the tissue with these T1-shortening agents, MRM can be performed with higher resolution, greater contrast, and shorter scan times. In this work, active staining with T1-shortening agents was used to enhance three types of in vivo mouse brain MRM: (1) angiographic imaging of the neurovasculature, (2) anatomical imaging of the brain parenchyma, and (3) functional imaging of neuronal activity.</p> <p></p> <p>For magnetic resonance angiography (MRA) of the mouse, typical contrast agents are not useful because they are quickly cleared by the body and/or extravasate from the blood pool before a high-resolution image can be acquired. To address these limitations, a novel contrast agent--SC-Gd liposomes--has been developed, which is cleared slowly by the body and is too large to extravasate from the blood pool. In this work, MRA protocols were optimized for both the standard technique (time-of-flight contrast) and SC-Gd liposomes. When the blood was stained with SC-Gd liposomes, small vessel CNR improved to 250% that of time-of-flight. The SC-Gd liposomes could also be used to reduce scan time by 75% while still improving CNR by 32%.</p> <p>For MRM of the mouse brain parenchyma, active staining has been used to make dramatic improvements in the imaging of ex vivo specimens. However for in vivo imaging, the blood-brain barrier (BBB) prevents T1-shortening agents from entering the brain parenchyma. In this work, a noninvasive technique was developed for BBB opening with microbubbles and ultrasound (BOMUS). Using BOMUS, the parenchyma of the brain could be actively stained with the T1-shortening contrast agent, Gd-DTPA, and MRM images could be acquired in vivo with unprecedented resolution (52 x 52 x 100 micrometers3) in less than 1 hour.</p> <p>Functional MRI (fMRI), which uses blood oxygen level dependant (BOLD) contrast to detect neuronal activity, has been a revolutionary technique for studying brain function in humans. However, in mice, BOLD contrast has been difficult to detect and thus routine fMRI in mice has not been feasible. An alternative approach for detecting neuronal activity uses manganese (Mn2+). Mn2+ is a T1-shortening agent that can enter depolarized neurons via calcium channels. Thus, Mn2+ is a functional contrast agent with affinity for active neurons. In this work, Mn2+ (administered with the BOMUS technique) was used to map the neuronal response to stimulation of the vibrissae. The resultant activation map showed close agreement to published maps of the posterior-lateral and anterior-medial barrel field of the primary sensory cortex.</p> <p>The use of T1-shortening agents to actively stain tissues of interest--blood, brain parenchyma, or active neurons--will facilitate the use of MRM for studying mouse models of brain development, function, and disease.</p> / Dissertation
56

Permanent Magnet Design And Image Reconstruction Algorithm For Magnetic Resonance Imaging In Inhomogeneous Magnetic Fields

Yigitler, Huseyin 01 September 2006 (has links) (PDF)
Recently, the use of permanent magnets as magnetic field sources in biomedical applications has become widespread. However, usage of permanent magnets in magnetic resonance imaging (MRI) is limited due to their inhomogeneous magnetic field distributions. In this thesis, shape and geometry optimization of a magnet is performed. Moreover, placement of more than one magnet is optimized to obtain desired magnetic field distribution in specific region of space. However, obtained magnetic field distribution can not be used in the conventional MRI image reconstruction techniques. Consequently, an image reconstruction technique for MRI in inhomogeneous magnetic fields is developed. Apart from these, since any reconstruction technique requires signal data, an MRI simulator in inhomogeneous magnetic fields is constructed as a part of this thesis. Obtained results show that the theory developed in this thesis is valid. Consequently, new MRI devices that have permanent magnets as magnetic field sources can be constructed in the future.
57

Das Verhalten von Mikrochips bei magnetresonanztomographischen Untersuchungen

Piesnack, Susann 22 June 2015 (has links) (PDF)
Mikrochips zur Tierkennzeichnung bestehen aus verschiedenen metallischen Materialien. Diese treten in der Magnetresonanztomographie in Wechselwirkung mit den elektromagnetischen Feldern. So verursachen die ferromagnetischen Materialen der Mikrochips gravierende fokale Bildstörungen. Diese Suszeptibilitätsartefakte können die Beurteilbarkeit der Halsregion erheblich einschränken. Ziel der Studie war, den Einfluss des Sequenztyps auf die Größe des Artefakts zu untersuchen und herauszufinden, welche Möglichkeiten zur Artefaktreduktion bei Veränderung bestimmter Sequenzparameter bestehen. Zusätzlich sollte geklärt werden, wie groß der Abstand zwischen Spinalkanal und Mikrochip mindestens sein muss, um spinale Strukturen beurteilen zu können. In das Untersuchungsgut der Studie gingen die Kadaver von 26 Katzen und 2 Hunden ein. An einem 0,5-Tesla-MRT wurde für verschiedene Sequenztypen (SE-Sequenzen, TSE-Sequenzen, GRE-Sequenzen) und Kombinationen modifizierter Sequenzparameter (Echozeit (TE), Voxelgröße, Ausleserichtung) das Ausmaß der Artefakte ermittelt. Berechnet wurde der Flächeninhalt des Artefakts (cm2). Dieser wurde dann als prozentualer Anteil zur Fläche des Halsquerschnitts angegeben. Diese Berechnung erfolgte für alle untersuchten Einstellungen an transversalen Aufnahmen. Eine ergänzende computertomografische Untersuchung dienste dazu, die Distanz zwischen Spinalkanalund Mikrochip zu messen. Die Untersuchungen der Studie haben gezeigt, dass TSE-Sequenzen wegen ihrer geringeren Artefaktanfälligkeit den SE- und GRE-Sequenzen vorgezogen werden sollten. Besonders kleine Artefakte konnten bei einer T1-TSE-Sequenz mit kleiner TE (10 ms) und kleiner Voxelgröße (große Akquisitionsmatrix von 256 x 256 Pixel, kleines Field of View (FOV) von 160 mm, geringe Schichtdicke (ST) von 2 mm) erreicht werden. Durch Anpassung der Kodierrichtung war es möglich, die Form und Richtung des Artefaktes zu beeinflussen. Lag das Zentrum des Mikrochips näher als 19 mm von der Mitte des Wirbelkanals entfernt, ließen sich auch mit dieser optimierten Sequenz die spinalen Strukturen auf Höhe des Mikrochips nicht beurteilen. Die Größe und Form der Suszeptibilitätsartefakte konnten durch die Wahl des Sequenztyps und Modifikation von Sequenzparametern verändert werden. Dies ist besonders bei kleinen Tieren von Bedeutung. Bei diesen kann es aufgrund der geringen Distanz zwischen Mikrochip und Wirbelsäule zur Beeinträchtigung der MR-Bildauswertung kommen. Eine T1-gewichtete TSE-Sequenz mit kleiner Echozeit (10 ms) und kleiner Voxelgröße (Akquisitionsmatrix 256 x 256 Pixel, FOV 160 mm, ST 2 mm) bietet bei 0,5 Tesla das größte Potenzial zur Artefaktreduktion.
58

Real-time Magnetic Resonance Imaging / Echtzeit Magnetresonanztomographie

Zhang, Shuo 28 October 2009 (has links)
No description available.
59

MR-Guided Assessment and Management of Ventricular Tachycardia

Oduneye, Samuel 13 January 2014 (has links)
This thesis describes the electrical and physiological characterization of cardiac tissue with myocardial infarction (MI) responsible for abnormal cardiac rhythms such as ventricular tachycardia (VT), using a newly-developed magnetic resonance imaging (MRI) electrophysiology system. In electrophysiology (EP), radiofrequency (RF) catheter ablation combined with cardioverter-defibrillator implantation is a first-line action to manage ventricular VT. Unfortunately, this therapy is known to have sub-optimal success rates in a large number of patients because of difficulties to accurately identifying the arrhythmic target regions. Currently, characterization of post-MI scars is performed by using catheters to measure electrical signals of the endocardial tissue (electroanatomical mapping), under x-ray fluoroscopy guidance. Prolonged radiation exposure to both the cardiologist and the patient have made the use of MRI extremely attractive; further, unlike x-ray imaging, MRI provides post-MI scars with direct visualization, characterization in three dimensions and the ability to visualize ablation lesions. Although recent research has focused on registration between pre-acquired MR images and electroanatomical maps, a potentially more useful approach is to use real-time MRI to directly locate and characterize potential arrhythmogenic regions during the EP procedure. A real-time MR-guided EP system was developed and validated to perform EP diagnostic procedures, such as mapping and pacing. In a series of animal studies, the system demonstrated the ability to use active catheter tracking and intra-procedural MR imaging to navigate to specific regions in the left ventricle and record intracardiac electrical signals. A study correlating myocardial fibrotic scar detected by multicontrast late enhancement (MCLE) MRI and electroanatomical voltage mapping demonstrated that MRI information (transmurality, tissue classification, and relaxation rate) can accurately predict areas of myocardial fibrosis identified with bipolar voltage mapping. Finally, MCLE-derived gray zone was shown to have a high correspondence to regions with a high proportion of abnormal intracardiac signals. The methods described in this thesis help advance the understanding of infarcted tissue responsible for ventricular tachycardia. Further studies are proposed to perform RF ablation lesions and correlate pre- and post-ablation tissue electrophysiological properties with MRI.
60

MR-Guided Assessment and Management of Ventricular Tachycardia

Oduneye, Samuel 13 January 2014 (has links)
This thesis describes the electrical and physiological characterization of cardiac tissue with myocardial infarction (MI) responsible for abnormal cardiac rhythms such as ventricular tachycardia (VT), using a newly-developed magnetic resonance imaging (MRI) electrophysiology system. In electrophysiology (EP), radiofrequency (RF) catheter ablation combined with cardioverter-defibrillator implantation is a first-line action to manage ventricular VT. Unfortunately, this therapy is known to have sub-optimal success rates in a large number of patients because of difficulties to accurately identifying the arrhythmic target regions. Currently, characterization of post-MI scars is performed by using catheters to measure electrical signals of the endocardial tissue (electroanatomical mapping), under x-ray fluoroscopy guidance. Prolonged radiation exposure to both the cardiologist and the patient have made the use of MRI extremely attractive; further, unlike x-ray imaging, MRI provides post-MI scars with direct visualization, characterization in three dimensions and the ability to visualize ablation lesions. Although recent research has focused on registration between pre-acquired MR images and electroanatomical maps, a potentially more useful approach is to use real-time MRI to directly locate and characterize potential arrhythmogenic regions during the EP procedure. A real-time MR-guided EP system was developed and validated to perform EP diagnostic procedures, such as mapping and pacing. In a series of animal studies, the system demonstrated the ability to use active catheter tracking and intra-procedural MR imaging to navigate to specific regions in the left ventricle and record intracardiac electrical signals. A study correlating myocardial fibrotic scar detected by multicontrast late enhancement (MCLE) MRI and electroanatomical voltage mapping demonstrated that MRI information (transmurality, tissue classification, and relaxation rate) can accurately predict areas of myocardial fibrosis identified with bipolar voltage mapping. Finally, MCLE-derived gray zone was shown to have a high correspondence to regions with a high proportion of abnormal intracardiac signals. The methods described in this thesis help advance the understanding of infarcted tissue responsible for ventricular tachycardia. Further studies are proposed to perform RF ablation lesions and correlate pre- and post-ablation tissue electrophysiological properties with MRI.

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