CN100401979C - Cardiac diagnosis using ventricular wall motion and perfusing cardiac MRI imaging and system for cardiac diagnosis - Google Patents
Cardiac diagnosis using ventricular wall motion and perfusing cardiac MRI imaging and system for cardiac diagnosis Download PDFInfo
- Publication number
- CN100401979C CN100401979C CNB038231050A CN03823105A CN100401979C CN 100401979 C CN100401979 C CN 100401979C CN B038231050 A CNB038231050 A CN B038231050A CN 03823105 A CN03823105 A CN 03823105A CN 100401979 C CN100401979 C CN 100401979C
- Authority
- CN
- China
- Prior art keywords
- loop
- cinema loop
- cinema
- mri
- wall motion
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Images
Abstract
A cine display/MRI system (10) includes an MRI acquisition system (11) that may include an MRI control system circuit (12), an MRI pulse excitation system circuit (14) and an MRI signal measurement system circuit (16).
Description
Related application
The application has required the priority of following U.S. Provisional Patent Application: 60/399 of application on July 29th, 2002,60/421,708 of application on October 28th, 275,2002,60/435278 of December in 2002 application on the 23rd, their content is introduced among the application by quoting as proof as a reference at this.
Technical field
The present invention relates to the cardiac diagnosis field, more specifically to the stress test cardiac diagnostics of using nuclear magnetic resonance (MRI) method.
Background technology
Heart is a uninterrupted pumping blood, simultaneously the oxygen of supporting life and the muscle that nutrient is transported to health major organs and tissue.Because this, heart needs a large amount of oxygen and nutrient.Heart receives blood from three main coronary artery.Any one in these tremulous pulsies narrows down or stops up, and the blood and the oxygen that flow to heart will be restricted, and the pumpability of your heart will weaken, and may cause the permanent damage of heart.The heart that is weakened or damage can influence quality of life significantly even cause death.
Coronary artery disease (CAD) is to make to lead to or be in the first cause that the tremulous pulse in the heart narrows down and stops up.It is the first dead origin cause of formation in the U.S..Although in many decades just in the past since the lethal ratio of CAD in steady decline, in the 20-30 in future, because the aging of population, estimate sickness rate that CAD is total and all can significantly rise the mankind's influence cost together with health care.In the U.S., the estimated amount of damage that CAD causes on the output value of health care and forfeiture every year is Da Dao $1000 hundred million.Therefore, the particularly CAD test of the accuracy at coronary heart disease/CAD initial stage is useful can to improve cardiac diagnosis.Following test is more useful: make the doctor can make clear and definite diagnosis and treatment plan, can reduce unnecessary test and in time of staying of operating room and hospital, and can reduce patient's anxiety, do not accommodate risk and/or can estimate therapeutic effect.
In recent years because the development of previous sophisticated day by day cardiac tests and therapy, alleviate or evade the ability that CAD renders a service and be developed." golden standard " that it has been generally acknowledged that cardiac tests is that cardiac catheter is got involved and angiography.It is most commonly used to determine the disease locus and the order of severity of CAD.Yet owing to there is traumatic and potential complexity, the cardiac catheter interventional procedure is the expensive methods that a kind of typical case needs hospitalization.Just use when therefore, the cardiac catheter interventional procedure only produces obvious abnormal results usually when patient carries out other noninvasive diagnostic test such as cardiac stress test.Estimate that the annual cardiac catheter interventional procedure above 1,000,000 that carries out spends hundred million dollars of 30-50.
Cardiac stress test is particular importance aspect evaluate cardiac and coronary artery thereof, this be since when the patient who is in quiescent condition is tested CAD appearance and effectiveness usually be left in the basket.Only by treadmill or by bike the motion heart is loaded, or the patient's that can not carry out actual body motion for various reasons heart used speciality chemical or medicine (medicine causes load), make under the situation that heart loaded thereby produce peak exercise, could in a large amount of crowds, detect the CAD symptom reliably.At present, the most frequently used stress test comprises motion (treadmill) stress test, stress echocardiogram (ultrasonic) and nuclear perfusion stress test.
These three kinds of tests are had nothing in common with each other on complexity, accuracy rate, effectiveness and cost.The ECG exercise stress test be the most extensive effectively and the stress test of using, and the cost that operates is minimum.It depends on the variation of surveying ST section on the heart reflectogram that 12-leads; Its accuracy constantly changes, and produces a large amount of false positives and false-negative result.Therefore, patient will carry out replenishment imaging usually when using Echocardiography and radioactive nucleus scintigraphy to carry out stress test.The complexity of Echocardiography and radioactive nucleus scintigraphy stress test needs it to be operated and assessed by the expert.Typically, a ultrasound technician or the heart expert through training operates a pressure heart reflectogram, examines perfusion stress test together and possess the technician and the heart expert of operation radiosiotope qualification or radiate the expert.In order to be diagnosed accurately, need the cardiologist to assess the result of two test records.Typically, the cardiologist is based on patient's health and understanding and its clinical judgment of medical history are selected to test.Each test all has inaccuracy to a certain degree.Echocardiography has the fault rate near 10-15%, and this moment, diagnosis can't be carried out.May stop the obstacle of capturing diagnostic qualitative picture can cause such fault rate.The tissue that thoracic surgery is impaired, body fat and the example that obtains the obstacle that the lung of excessive oxygen comes to this unusually in the lung that patient is too much.For various reasons, the test of pressure Echocardiography also can produce a large amount of false negative result.The nuclear perfusion stress test is extremely sensitive, and easily produces same a large amount of false positive results.
The load Echocardiography above 1,300,000 that carries out every year is tested the fault rate with 10-15%, has promptly carried out surpassing 100,000,000 dollars of unnecessary or insecure load Echocardiography tests every year potentially.The fault rate of this stress echo test has caused the known nuclear perfusion stress test quantity that possesses the altofrequency false positive results to rise.One time the false positive cardiac stress test may increase the number of times of expensive and unnecessary cardiac catheter interventional procedure and relevant therewith essential hospitalization and the anxiety that has increased patient, discomfort, and increased medical-risk.A large amount of false negative result of load Echocardiography may increase the heart onset risk and because the undiscovered heavier CAD danger of dying suddenly, and/or have reduced in early days the CAD stage successful possibility of intervention earlier.
Therefore, cardiac diagnosis need reduce cost, increases accuracy rate and/or increase effective stress test.
Summary of the invention
Embodiments of the invention are provided for showing method, system and/or the computer program of heart of patient information.A plurality of MRI cinema loop (cine loop) of heart of patient are to obtain under a plurality of hearts rate and under the load level of materia medica and/or motion generation.Described a plurality of cinema loop comprises the wall motion cine loops of images of wall motion frame and the perfusion image of at least one cardiac position.Wall motion cine loops and perfusion cine loops show simultaneously.
Among some embodiment, perfusion image is about the cinema loop of heart at least one position perfusion image at least.Further among the embodiment, perfusion image is that heart strengthens the perfusion image of (MDE) in the myocardial delayed of a position.
Among the special embodiment of the present invention, by adjusting described a plurality of MRI cinema loop to be provided at the compensation cinema loop that possesses same number of frames in each MRI cinema loop.Furtherly, described a plurality of MRI cinema loop can obtain when patient is carried out stress test.Also can by the MRI cinema loop that shows be assessed whether determine myocardial ischemia, or based on the myocardial viability of the cinema loop of described demonstration.
In yet another embodiment of the present invention, at the load derivant or the quantity of motion of single dosage, show a plurality of cinema loop of the diverse location relevant simultaneously with heart of patient.Also can show a plurality of cinema loop simultaneously at the dosage of different load revulsive with the corresponding single position of heart of patient.
In the further embodiment of the present invention, described a plurality of MRI cinema loop remove from least one described a plurality of MRI cinema loop by the increase frame and/or frame and regulate.Frame can join in each MRI cinema loop and/or from wherein removing, thereby makes the MRI cinema loop of all demonstrations possess identical frame number.Further, the frame of increase can obtain by the frame that repeats a MRI cinema loop.The frame of adding or removing can be evenly distributed in whole M RI cinema loop.
In an alternative embodiment of the invention, make conventional part coordination mutually in respective frame and the heart of patient circulation in described a plurality of wall motion MRI cine loops each by the compensation wall motion MRI cine loops.Like this, frame in the different cinema loop may the corresponding different persistent period, yet, the same percentage time that each frame can corresponding cardiac cycle.
Furtherly, the persistent period that described a plurality of MRI cinema loop also can show by at least one the frame of adjusting in a plurality of MRI cinema loop obtains adjusting, thereby each MRI cinema loop possesses common total persistent period.
In an alternative embodiment of the invention, show patient's heart information by a plurality of MRI cinema loop of obtaining heart of patient under a plurality of hearts rate, described a plurality of cinema loop comprise the cinema loop that contains the images of wall motion frame.Also obtain the perfusion image of at least one position of heart.Wall motion cine loops and at least one perfusion image show simultaneously.
Among some embodiment of the present invention, perfusion image provides a plurality of perfusion images of cine loop of perfusion images.In this case, come displays of wall motion cinema loop and at least one perfusion image simultaneously by while displays of wall motion cinema loop and at least one cine loop of perfusion images.
In an alternative embodiment of the invention, perfusion image is a myocardial delayed enhancement perfusion image.
In an alternative embodiment of the invention, provide the user interface of MRI Imaging Evaluation.User interface can show on display device, and comprises that the zone of a plurality of cinema loop of the MRI image that at least one is arranged to show the heart chamber wall motion and at least one are configured to show the zone of at least one MRI image of heart perfusion.At least one cinema loop of heart perfusion MRI image can be arranged to be shown in the zone that is configured to be shown at least one MRI image of heart perfusion.Further, a plurality of cinema loop of described heart chamber wall motion MRI image can be each other and and at least one cinema loop of heart perfusion MRI image synchronous.And, the cinema loop of at least one be recorded to heart perfusion MRI image of a plurality of cinema loop of described heart chamber wall motion MRI image.
As is known to the person skilled in the art, by means of of the present invention open, embodiments of the invention may be provided in method, system and/or computer program.
Description of drawings
Fig. 1 is the module map according to a MRI system of the embodiment of the invention.
Fig. 2 is the module map according to the data handling system of the embodiment of the invention.
Fig. 3 is a more detailed module map of MRI cinema loop display system according to the embodiment of the invention.
Fig. 4 is the flow chart that is used to illustrate embodiment of the invention operation.
Fig. 5 is the screen interception figure of an exemplary cinema loop display.
Fig. 6 is the flow chart that is used to illustrate the further embodiment operation of the present invention.
The specific embodiment
Hereinafter with reference to the present invention of accompanying drawing more detailed description, in the accompanying drawing explicit declaration embodiments of the invention.Yet the present invention not should be understood to only limit to given embodiment here, and provides these embodiment so that scope of invention to be described in detail and completely, and makes those skilled in the art fully understand scope of the present invention.
As is known to the person skilled in the art, the present invention can show as method, system and computer program.Therefore, the present invention can be the embodiment of hardware fully, and complete software implementation example or the embodiment that software and hardware is combined all is commonly referred to as " circuit " or " module " here.Further, the present invention can show as based on possessing computer that the computer of imprinting in media can the recognizer code and can discern the computer program of storage medium.Any computer readable medium all can adopt, and comprises hard disk, CD-ROM, and optical storage apparatus is supported the transmission medium of the Internet or LAN, perhaps magnetic storage apparatus such as those.
The computer program code of carrying out the present invention's operation can be write into by such as Java@, in the object of determining towards program language of Smalltalk or C++.But, carry out the also available common program language of computer program code of the present invention's operation and write as " C " program language.Concrete film display system can use interaction data language (IDL) program that the suitable cinema loop of using in embodiments of the present invention is provided.Program code can be fully on the subscriber computer, part on subscriber computer, as the stand alone software bag, part is on subscriber computer, part is being carried out on remote computer on the remote computer or fully.In one scheme of back, remote computer can link to each other with user's computer by Local Area Network or wide area network (WAN), and perhaps this connection can be carried out (for example, by using the Internet of Internet server) by outer computer.Further, subscriber computer, remote computer or both can be attached in other system such as the MRI system together.
Following with reference to the flow process key-drawing and/or according to the method for the embodiment of the invention, the module map of device (system) and computer program illustrates the present invention.The module in each module in the known procedures key-drawing and/or module map and the flow process key-drawing and/or the associating of module map can be carried out by computer program instructions.These computer program instructions can be input in the processor of general purpose computer, special-purpose computer or other sequencing data processing equipment and start the machine, and produce the method that is used for carrying out the function/action of stipulating in the module of flow process and/or module map thereby carry out this instruction by computer processor or other sequencing data processing equipment.
These computer program instructions also can be stored in the computer-readable memory that vectoring computer or other data processing equipment that stylizes work in a particular manner, thereby are stored in the product that instruction in the computer-readable memory produces the instruction method of the function/action that comprises the module regulation of carrying out in flow process and/or the module map.
Computer program instructions also can be loaded into computer or other sequencing data processing equipment, to produce a series of operating procedures that can be performed in computer or other programs device, produce the processing that computer is carried out with this, thereby the instruction of carrying out is provided for carrying out the step of the function/action of the module regulation in flow process and/or the module map in computer or other programs device.
Embodiments of the invention provide the cardiac diagnosis of not only adopting the wall motion MRI cine loops of patient's heart beating but also adopting perfusion image.Perfusion image can be MRI cine loop of perfusion images and/or single image, for example strengthens the image that is provided by myocardial delayed.Locular wall MRI cinema loop can from the time go up with through adjusting the different hearts rate of the heart rate that causes with compensation as load, and so the different heart circulation patterns and/or the cinema loop of persistent period that cause synchronous.Cardiac diagnosis go up synchronous MRI cinema loop by the evaluation time and stand patient's the perfusion image of stress test and the MRI cinema loop in one or all carry out.This assessment can produce relevant Screening test that patient suffers from the CAD probability.
Fig. 1 has described an example system 10 according to the embodiment of the invention.As shown in Figure 1, a film demonstration/MRI system 10 comprises a MRI acquisition system 11 that can comprise 12, one MRI pulse excitations of a MRI control system circuit circuit system 14 and a MRI Signal Measurement System circuit 16.MRI control system circuit 12 is controlled the operation of MRI acquisition system 11 to obtain and MRI is provided image in patient's a cardiac cycle.MRI control system circuit 12 also can make up the image that obtains and it is transferred to work station 20 or other such data handling system, with further analysis and/or demonstration.Work station 20 can be organized in the MRI group or away from MRI.By controlling described MRI pulse excitation circuit system 14 and described MRI Signal Measurement System circuit 16 obtains the MRI signal that heart of patient MRI image is provided.
For example, the MRI image can obtain by using the sectional k-intervening sequence of fast gradient echo.Can be provided for confirming the end-systolic appropriate time resolution of the heart (13-65 millisecond) by adjusting described k-space segmentation, and heart end-systole frame typically has minimum left ventricle (LV) chamber size.Can utilize Image Sharing between the frame that obtains, to provide intermediate frame.Following table provides the example in the whole k-space segmentation of different heart rate downward modulations.
| Heart rate (jump/minute) | Every section number of views | Temporal resolution (millisecond) | Breath holding time (second) |
| ＜55 | 10 | 65 | 10 |
| 55-65 | 8 | 52 | 13-11 |
| 65-95 | 6 | 39 | 15-10 |
| 95-125 | 4 | 26 | 15-12 |
| 125-170 | 2 | 13 | 23-17 |
What can select is, can use other highlighted outstanding LV cardiac muscle to thicken or lax MRI technology is obtained image.
The dabbling MRI image of ventricular wall motion and cinema loop frame can comprise and heart of patient diverse location place and the heart of patient corresponding image of different time (being that cinema loop can be recorded in other cinema loop) in the cycle.For example, image can comprise the section such as basic minor axis, major axis, middle minor axis and sharp minor axis, four chambeies and the section of two chambeies.In the specific embodiment, the picture position of the optional prestige of selecting a time is to provide LV images of wall motion.Further, image can be from the different periods of patient's stress test, for example, under baseline or resting heart rate and/or different heart rate, and/or adopt various dose such as under dobutamine and the atropinic load derivant.
Myocardial perfusion imaging will be when tranquillization and under load (pharmacology or motion), obtain behind paramagnetic contrast medium (for example containing gadolinium) or the sensitive agent (for example containing ferrum oxide or dysprosium) giving, perhaps adopt the combination technique that does not give contrast agent, for example use the cardiac image of the dependence blood oxygenated water flat (BOLD) of T2 preparatory pulse sequence or 3 dimension T2 weighting sequences.The heart wall perfusion image that obtains can be the image that is derived from single position in the heart area of repeatedly successive heartbeat.Perfusion image can also be produced with showing to provide with the heart wall motion MRI cinema loop of compensation correlation time compares the cinema loop of tool by same number of frames.
Such as by the GE medical system, Siemens, the Philips, Varian, Bruker, the routine MRI system that Marconi and Toshiba provide can be used to be provided at the MRI picture frame of the expectation of collecting between the patient's heart beat period that stands stress test, the embodiment described herein according to the present invention, these picture frames can be through time bias and demonstration, and/or carries out biophysics or biophysiology anomaly analysis, thereby carries out cardiac diagnosis.
Although Fig. 1 has described an exemplary cinematic demonstration/MRI system, and specifically being divided in this and being described with regard to its function and/or operation, but as is known to the person skilled in the art,, also can use other the function and/or the division of operation according to instruction of the present invention.For example, MRI control system circuit 12 can make up with MRI pulse excitation circuit system 14 or MRI Signal Measurement System circuit 16.Therefore, the present invention should not be understood that to be limited in the concrete structure or the division of MRI function/operation, and can comprise any function/operating structure or division that can realize describing operation here.
What Fig. 2 described is the one exemplary embodiment that is applicable to the data handling system 230 that work station 20 and/or MRI control system circuit 12 are provided according to an embodiment of the invention.Typically, data handling system 230 comprises the input equipment 232 such as keyboard or mouse, display 234 and with the memorizer 236 of processor 238 swap datas.Data handling system 230 can further comprise the I/O FPDP 246 of speaker 244 and same and processor 238 swap datas.FPDP 246 is used in Data transmission between data handling system 230 and another computer system or the network.These parts can be can be configured to the conventional components that work is described in place like this as what use in many routine data processing systems.
Fig. 3 describes the module map of the data handling system embodiment of system, method and/or computer program according to an embodiment of the invention.Processor 238 is by address/data bus 348 and memorizer 236 swap datas.Processor 238 can be any commercialization or custom microprocessor.To carry out all systems of memory device of the data of data handling system 230 functions be representative to memorizer 236 to comprise software and being used to.Memorizer 236 includes but not limited to following type: cache memory, ROM, PROM, EPROM, EEPROM, flash memory, SRAM and DRAM.
As shown in Figure 3, memorizer 236 can comprise multiclass software and/or be used in the data of data handling system 230: operating system 352; Application program 354; I/O (I/O) device driver 358 and data 356.As is known to the person skilled in the art, operating system 352 can be any operating system of using with data handling system that accommodates, for example OS/2 of International Business Machine Corporation (IBM), AIX or system 390, the Armonk of Microsoft, NY, Windows95, Windows98, Windows2000, WindowsNT or WindowsXP, and Redmond, WA, Unix or Linux.Operating system can be arranged to support connect based on TCP/IP or other similar network communication protocol.Described I/O equipment 358 typically comprises by application program 354 by operating system 352 visits, with store the software program that 236 parts are communicated by letter such as I/O FPDP 246 and some.Application program 354 is illustrated by the program of carrying out data handling system 230 various features, and preferably includes support at least one application according to the operation of the embodiment of the invention.At last, static state and dynamic data that on behalf of application program 354, data 356 use, operating system 354, I/O device drives 358 and other reside in software program in the memorizer 236.
Further as shown in Figure 3, application program 354 can comprise a cinema loop processing application 360.Cinema loop is handled application 360 can carry out operation as described herein, this is operating as last synchronous MRI image cinema loop of time, the demonstration time is gone up the synchronous heart chamber wall motion MRI image and/or the cinema loop of heart wall perfusion image, and/or show assessment to the time synchronized cinema loop of MRI image.Shown in the embodiment of Fig. 3, the data division 356 of memorizer 236 can comprise the MRI view data 362 that contains ventricular wall motion and perfusion MRI image cinema loop.
Although for example use 360 and describe the present invention but as is known to the person skilled in the art, also can adopt other to benefit from the configuration of the present invention's instruction with reference in Fig. 3, handling for the cinema loop of application program.For example, cinema loop processing application 360 also can be combined with other this type of logical partitioning of operating system 352, described I/O device driver 358 or data handling system 230.Therefore, the present invention is not interpreted as and only limits to setting shown in Figure 3, anyly can carry out operation arrangement as described herein and includes in the scope of the invention.
Fig. 4 has described the operation according to certain embodiments of the invention.As shown in Figure 4, patient is carried out stress test (module 400) and during stress test, gather ventricular wall motion and the dabbling MRI image (module 402) of representing heart of patient.The stress test of any kind that can carry out when described stress test can be collection MRI image.A specific embodiment of MRI stress test is induced stress test for using such as dobutamine or analog biochemistry.Carry out stress test those skilled in the art are known, therefore here be not described.
The perfusion image of gathering can be gathered the perfusion image of " at first passing through " immediately after giving with contrast agent.In this case, perfusion image can be the cinema loop of image, thereby the perfusion of contrast agent can be by cine loop images spike or monitoring.Perfusion cine loop images can be a plurality of perfusion cine loop images of heart different parts.These cinema loop can be by the wall motion cine loops image recording, thus perfusion cine loops and wall motion cine loops correspondence position much at one.For example, perfusion cine loops can be the cinema loop of three minor axis wall motion cine loops of three correspondences.Therefore, perfusion image can gathered on the identical plane by heart with the minor axis images of wall motion.
That can select is, or except producing cine loop of perfusion images, also can provides myocardial delayed to strengthen (MDE).Among the MDE, give with contrast agent for example after gadolinium DPTA20 minute, its part is infiltrated (downright bad) tissue and will become bright (therefore, being delayed enhancing) of gangrene.These images can be in the cinema loop mode, and with independent image mode collection, and record (in the same slice position) corresponding perfusion and/or images of wall motion.MDE is the perfusion of another kind of form, that is to say, it is the perfusion of slough, that is, the perfusion of at first passing through is living tissue perfusion.Therefore, perfusion image may comprise the independent image such as MDE image and/or image cinema loop.Above-mentioned one of them or both all can together show with images of wall motion.
To the MRI images of wall motion of the load derivant of the cinema loop of the heart beating that can be provided at the heart diverse location and/or various dose by time synchronized, and set up the number of perfusion image, so that each cinema loop possesses the MRI image or the frame of similar number, thereby each cinema loop can be shown the identical time (module 404).Therefore, for example, perfusion cine loops can show and synchronous with wall motion cine loops by itself and images of wall motion are circulated with same speed.Perfusion cine loops synchronously also can be by increasing frame number, reduce frame number or adjust the demonstration time as described herein and realize.Wall motion cine loops also can be synchronous with cardiac cycle, makes each cinema loop begin at the same section of cardiac cycle.
The wall motion cine loops of compensation and the cinema loop of perfusion image and/or perfusion image for example can show for work station, and can assess to determine patient's heart physiological state (module 406) to both.Such assessment for example can be by showing several or all next given positions of dosage ventricular wall motion and perfusion cine loops and/or show that cinema loop several or all positions are carried out under a certain given dose.Can assess by showing near the image that obtains in real time.In addition or alternatively, can show a MDE image or a plurality of MDE image with wall motion cine loops.The cinema loop and/or the image that show can be assessed by physiologist, to determine the physiological status of heart.So really, usual practice determines that as comprising whether CAD exists the variation of CAD seriousness, the effect of cardiac treatment system etc.Whether for example, perfusion image can compare with images of wall motion, corresponding with impaired ventricular wall motion zone to determine the perfusion zone of reducing, thereby determines further whether blood vessel stops up.
Such operation can repeat, the obtained and compensation up to the MRI image of desired locations (module 408) and expected load grade (module 410), as described here.Therefore, if gather more view (module 408), then proceed to gather the operation of other MRI image (module 402).If assess other load level (module 410), then proceed other stress test (module 400).
Have been found that, the cinesync loop makes physiologist evaluate cardiac physiology more effectively in time, and can not produce tangible artifact and/or distortion by time synchronizing, and these artifacts and/or distortion meeting make information fuzzy or the error message that causes invalid assessment are provided.Further find, the cinema loop time synchronized has improved the effectiveness of MRI cinema loop assessment, because it allows the heart movement under the visually more different hearts rate of physiologist while, wherein heart movement demonstration of its same position in cardiac cycle is synchronous.Therefore, the image of each demonstration accounts for the time of ratio much at one in heart beating.Therefore, can directly more different hearts rate under the difference of sections' wall motion, to survey existing of disease.As discussed above, have been found that time synchronizing as described herein can avoid producing inaccurate, artifact or other may hinder the demonstration of the distortion of evaluation process.Furtherly, evaluation process can be carried out with sufficient real-time mode, thereby can make physiologist utilize the MRI cinema loop to monitor stress test when carrying out stress test.Such monitoring is all practical in carrying out stress test and based on the stress test result patient status being assessed.By such permission direct cinema loop information of more different heart rate datas simultaneously is provided, physiologist can be determined the heart of patient physiological status fast, thus adjustment test parameters and/or avoid injuring patient.
In some cases, when for example in the stress test overall process, having tranquillization heart chamber wall dyskinesia, or exist under the situation of concentric left ventricular hypertrophy, the ventricular wall motion assessment is not enough to determine ischemia.Because like this, to heart perfusion and/or postpone to strengthen and the association evaluation of film ventricular wall motion can improve discriminating person and determines unconspicuous heart necrosis or ischemic ability when assessment ventricular wall motion separately.
Among another further embodiment of the present invention, the employing image processing techniques can the automatic or automanual assessment of carrying out cinema loop.Owing to adopt the public part in the corresponding cardiac cycle of onesize data equipment and the respective frame in the data equipment, thereby the time synchronized of cinema loop helps so automatic assessment.For example, the parts of images in cinema loop or the cinema loop can compare or reference mutually, thus the deviation of outstanding baseline cinema loop.Therefore, for example, baseline wall motion cine loop can with the various dose cinema loop relatively and show difference, and/or with threshold ratio, so that the assessment of indication and/or heart physiological to be provided.These differences also can with the cinema loop of perfusion cine loops or the same area relatively, and compare with low perfusion zone and unusual ventricular wall motion zone.Since much at one time in the corresponding cardiac cycle in the position in each cinema loop, thus the frame of the similar position of different cinema loop can directly compare mutually, thereby relatively becoming of this cinema loop may and/or be simplified.
For example, comprise more also that automatically the different cinema loop of record are to baseline loops.Such record can be undertaken by adopting normal mode identification and/or alignment technique, thereby partly each of the corresponding pixel of cinema loop or cinema loop is associated with approximately uniform physiological location in the patient body.In the specific embodiment, relatively can be 3 dimensions (x, y, t), 4 dimensions (x, y, z, t) and/or 5 dimensions (x, y, z, t, dosage).
Can pass through the multiimage, increase or reduce the pictorial display time and/or from cinema loop, remove image and come cinema loop is compensated.Cinema loop can realize time synchronized by image or frame that similar number in each ring is provided.Therefore, the heart beating of each demonstration of patient can show that the heart rate when the identical time cycle is obtained cinema loop is irrelevant.Have than the loop of multiframe and can remove frame, and the loop with less frame can increase frame.Frame can increase by the frame in repeating to encircle.Frame also can increase by the virtual manner that increases the time that frame shows.The increase of this frame in fact to the storage demand than the circulation in the physics repeating frame to lack.The frame that increases or remove can be distributed in the whole loop, or preferred average basically being distributed in the whole loop.Further, cinema loop can with the heart of patient cycle synchronisation, thereby each cinema loop begins in the approximately uniform part of cardiac cycle.Making the technology of MRI cinema loop and heart of patient cycle synchronisation is known to those skilled in the art, does not therefore discuss at this.
In specific embodiments of the invention, cinema loop shows in real time.Among all the other embodiment, cinema loop is near showing in real time.To the patient's that stands stress test cinema loop so in real time or can be by allowing to carry out rapid analysis and monitoring near real-time demonstration to stress test, thereby can avoid injury to patient, thereby provide safe stress test.In other embodiments, the demonstration of cinema loop is provided by storage information, and can carry out " off-line " operation.This off-line analysis is suitable for cinema loop analysis detailed or more consuming time.Further, the transmission of data acquisition, picture construction and/or cine loop images can be overlapped, thereby reduce the tangible propagation delay time between image acquisition and the demonstration.
Fig. 5 is the screen interception figure according to the cinema loop display 500 of embodiments of the invention.As shown in Figure 5, a plurality of cinema loop 502 show simultaneously.Cinema loop is time synchronized as mentioned above, and comprises displays of wall motion and perfusion information.As shown in Figure 5, wall motion cine loops, the perfusion cine loops of passing through first and MDE image all can show simultaneously.Among Fig. 5, baseline wall motion cine loop 502, the first dosage wall motion cine loops 504, peak dose wall motion cine loops 506, recover wall motion cine loops 508, first by perfusion cine loops 510 and delayed enchancement images 512 as described herely show simultaneously.
Fig. 6 describes is operation according to the further embodiment of the present invention.As shown in Figure 6, can import and reduce the cinema loop parent map, and/or regulate contrast, brightness, γ or other display level (module 600) of basic cine loop images by obtaining the user.Reduce and/or the grade adjustment can propagate in the basic cinema loop remaining image automatically and propagate into other demonstration or stored cine loops (module 604) in.Therefore, the doctor can adjust the demonstration of cine loop images rapidly and needn't adjust each sub-picture and/or one loop.Alternatively, reduction and/or class information can be stored and be associated with cinema loop.Cinema loop for example can be stored on hard disk or other storage medium, and after recover, for showing and/or analyzing.Stored cine loops is shown by reduction and/or the class information with automatic application subsequently.
Although the embodiment of the invention at first is described near real-time assessment with reference to the MRI image, known to by means of those skilled in the art of the disclosure of invention, the assessment of MRI image also can be carried out at " off-line " or after than long stagnation.For example, previous MRI image can show and compare with current MRI image, with the condition improved of having determined whether to have taken place in ventricular wall motion and/or perfusion to cause owing to therapeutic process.Therefore, the present invention assesses the MRI cine loop images after should not be construed as and only limiting to gather immediately.
Preamble has been described the present invention but not as restriction of the present invention.Although exemplary embodiments more of the present invention are described, those skilled in the art know under the situation that does not substantially depart from novel teachings of the present invention and advantage of the present invention easily can carry out many modifications in these exemplary embodiments.Therefore, all such modifications are included within the scope of the present invention that limits as claims.
Claims (17)
1. method that shows heart of patient information comprises:
Obtain a plurality of MRI cinema loop of heart of patient under a plurality of hearts rate, these a plurality of cinema loop comprise that the cinema loop that contains the images of wall motion frame comprises the cinema loop of at least one cardiac position place multiframe perfusion image with at least one; And
While displays of wall motion cinema loop and at least one perfusion cine loops.
2. the method for claim 1 further is included in the wall motion cine loops of demonstration and/or the perfusion cine loops and adjusts frame number, makes the frame that the wall motion cine loops that shows and perfusion cine loops possess equal number.
3. the method for claim 1 wherein obtains a plurality of MRI cinema loop and is included in and gathers a plurality of MRI cinema loop when patient implemented stress test.
4. the method for claim 1, wherein the cinema loop of Xian Shiing provides with coronary artery disease and whether has relevant viewdata.
5. the method for claim 1, the wherein said demonstration simultaneously comprises a plurality of cinema loop that show simultaneously for the diverse location relevant with heart of patient of single dose load derivant.
6. the method for claim 1, the wherein said demonstration simultaneously comprises a plurality of cinema loop that show simultaneously for the single position relevant with heart of patient of various dose load derivant.
7. method as claimed in claim 2, wherein said adjustment comprise that increasing frame removes frame to the wall motion cine loops of at least one demonstration or perfusion cine loops and/or from the wall motion cine loops or the perfusion cine loops of at least one demonstration.
8. method as claimed in claim 7, wherein said increase frame comprises the frame of repetition MRI cinema loop.
9. method as claimed in claim 7 wherein, increases the cinema loop of frame to a demonstration or removes frame from the cinema loop of a demonstration and make the frame that increases or remove be distributed on basically the cinema loop of a demonstration.
10. the method for claim 1, wherein wall motion MRI cine loops is compensated, thereby make in described a plurality of wall motion MRI cine loops the public part of the corresponding heart of patient circulation of frame of the correspondence in each.
11. the method for claim 1 is wherein adjusted described a plurality of MRI cinema loop and is comprised at least one display cycle of adjusting described a plurality of MRI cinema loop, thereby makes each MRI cinema loop possess common total cycle.
12. method as claimed in claim 11, wherein controlled frame of cycle is distributed in the MRI cinema loop of whole adjustment.
13. a system that shows heart of patient information comprises:
Be used for obtaining under a plurality of hearts rate the device of a plurality of MRI cinema loop of heart of patient, wherein a plurality of cinema loop comprise that the cinema loop that contains the images of wall motion frame comprises the cinema loop of the multiframe perfusion image at least one cardiac position place with at least one; And
The device of while displays of wall motion cinema loop and at least one perfusion cine loops.
14. an equipment that is used to show heart of patient information comprises:
Be configured to be able to obtain under a plurality of hearts rate the device of a plurality of MRI cinema loop of heart of patient, wherein a plurality of cinema loop comprise that the cinema loop that contains the images of wall motion frame comprises the cinema loop of the multiframe perfusion image at least one cardiac position place with at least one; And
Be configured to be able to the device of while displays of wall motion cinema loop and at least one perfusion cine loops.
15. a method that shows heart of patient information comprises:
Obtain a plurality of MRI cinema loop of heart of patient under a plurality of hearts rate, described a plurality of cinema loop comprise the cinema loop that contains the images of wall motion frame;
Obtain at least one perfusion image at least one cardiac position place; And
While displays of wall motion cinema loop and at least one perfusion image.
16. method as claimed in claim 15, wherein at least one perfusion image is used to provide the cinema loop of perfusion image, and wherein while displays of wall motion cinema loop and at least one perfusion image comprise the cinema loop of while displays of wall motion cinema loop and at least one perfusion image.
17. method as claimed in claim 15, at least one perfusion image wherein comprises myocardial delayed enhancement perfusion image.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US39927502P | 2002-07-29 | 2002-07-29 | |
| US60/399,275 | 2002-07-29 | ||
| US60/421,708 | 2002-10-28 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1713851A CN1713851A (en) | 2005-12-28 |
| CN100401979C true CN100401979C (en) | 2008-07-16 |
Family
ID=35719180
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB038231050A Expired - Fee Related CN100401979C (en) | 2002-07-29 | 2003-07-28 | Cardiac diagnosis using ventricular wall motion and perfusing cardiac MRI imaging and system for cardiac diagnosis |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN100401979C (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP3866176A1 (en) * | 2020-02-17 | 2021-08-18 | Siemens Healthcare GmbH | Machine-based risk prediction for peri-procedural myocardial infarction or complication from medical data |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5111820A (en) * | 1990-11-02 | 1992-05-12 | The Trustees Of The University Of Pennsylvania | System and method for magnetic resonance imaging of 3-dimensional heart wall motion with spatial modulation of magnetization |
| CN1116077A (en) * | 1994-08-04 | 1996-02-07 | 深圳安科高技术有限公司 | Phase speed measuring method of magnetic resonance presentation |
| CN1228014A (en) * | 1996-07-30 | 1999-09-08 | 伊塔马医药(C.M)1997有限公司 | Method and apparatus for non-invasive detection of medical conditions by monitoring peripheral arterial tone |
| CN1310356A (en) * | 2000-02-22 | 2001-08-29 | 株式会社根本杏林堂 | Display apparatus for medical laminogram |
-
2003
- 2003-07-28 CN CNB038231050A patent/CN100401979C/en not_active Expired - Fee Related
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5111820A (en) * | 1990-11-02 | 1992-05-12 | The Trustees Of The University Of Pennsylvania | System and method for magnetic resonance imaging of 3-dimensional heart wall motion with spatial modulation of magnetization |
| CN1116077A (en) * | 1994-08-04 | 1996-02-07 | 深圳安科高技术有限公司 | Phase speed measuring method of magnetic resonance presentation |
| CN1228014A (en) * | 1996-07-30 | 1999-09-08 | 伊塔马医药(C.M)1997有限公司 | Method and apparatus for non-invasive detection of medical conditions by monitoring peripheral arterial tone |
| CN1310356A (en) * | 2000-02-22 | 2001-08-29 | 株式会社根本杏林堂 | Display apparatus for medical laminogram |
Also Published As
| Publication number | Publication date |
|---|---|
| CN1713851A (en) | 2005-12-28 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| JP5364044B2 (en) | Cardiac diagnosis using MRI imaging of wall motion and cardiac blood flow and system for cardiac diagnosis | |
| Chuang et al. | Importance of imaging method over imaging modality in noninvasive determination of left ventricular volumes and ejection fraction: assessment by two-and three-dimensional echocardiography and magnetic resonance imaging | |
| JP2005515809A (en) | Method and apparatus for evaluating contrast agent uptake based on derived parametric images | |
| Mendelsohn et al. | Signatures of memory: brain coactivations during retrieval distinguish correct from incorrect recollection | |
| Ryd et al. | Utility of fetal cardiovascular magnetic resonance for prenatal diagnosis of complex congenital heart defects | |
| US11872019B2 (en) | MRI-derived strain-based measurements and related image data acquisitions, image data processing, patient evaluations and monitoring methods and systems | |
| Friedman et al. | Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children | |
| Bustamante et al. | Using deep learning to emulate the use of an external contrast agent in cardiovascular 4D flow MRI | |
| Rizi et al. | Thallium-201 myocardial scintigraphy: a critical comparison of seven-pinhole tomography and conventional planar imaging | |
| Groth et al. | Improved agreement between experienced and inexperienced observers using a standardized evaluation protocol for cardiac volumetry and infarct size measurement | |
| CN100401979C (en) | Cardiac diagnosis using ventricular wall motion and perfusing cardiac MRI imaging and system for cardiac diagnosis | |
| US8494611B2 (en) | Cardiac diagnostics using time compensated stress test cardiac MRI imaging and systems for cardiac diagnostics | |
| Miller et al. | Hemodynamic response and safety of vasodilator stress cardiovascular magnetic resonance in patients with permanent pacemakers or implantable cardioverter‐defibrillators | |
| Helbing et al. | Recommendations from the Association for European Paediatric Cardiology for training in congenital cardiovascular magnetic resonance imaging | |
| Yoshida et al. | Ferumoxytol-enhanced 4D multiphase, steady-state imaging with magnetic resonance in congenital heart disease: ventricular volume and function across 2D and 3D software platforms | |
| Vollbrecht et al. | Fetal Cardiac MRI Using Doppler US Gating: Emerging Technology and Clinical Implications | |
| Duerinckx | Cardiac MRI for clinicians: an overview | |
| Kappanayil | Advanced Cardiac Imaging: Computed Tomography and Magnetic Resonance Imaging | |
| Zhong et al. | CVIA The Current Practice of Cardiac Magnetic Resonance Imaging for Congenital Heart Disease in Asia: A Survey to Promote Future Practice | |
| CN113643285A (en) | Myocardial bulls-eye diagram analysis method, system and medium based on artificial neural network | |
| JPH10286244A (en) | Device for estimating bio-action current source | |
| JPS6090537A (en) | X-ray diagnostic apparatus | |
| Broberg | Indications for Cardiac Magnetic Resonance Imaging in Adult Congenital Heart Disease | |
| Schuster | Validation of Quantitative Myocardial Perfusion Magnetic Resonance Imaging | |
| Gutteling | Towards quantitative cardiac imaging |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| CF01 | Termination of patent right due to non-payment of annual fee | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20080716 Termination date: 20200728 |