• Journal of the Institute of Electronics Engineers of Korea SC
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• v.40 no.5
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• pp.341-349
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• 2003

A real time interactive controller (spectrometer) for magnetic resonance imaging (MRI) system has been developed using high speed digital signal processors (DSP). The controller generates radio frequency (rf) waveforms and audio frequency gradient waveforms and controls multiple receivers for data acquisition. By employing DSPs having high computational power (e.g., TMS320C670l) real time generation of complicated gradient waveforms and interactive control of selection planes are possible, which are important features in real-time imaging of moving organs, e.g., cardiac imaging. The spectrometer was successfully implemented at a 1.5 Tesla whole body MRI system for clinical application. Performance of the spectrometer is verified by various experiments including high- speed imaging such as fast spin echo (FSE) and echo planar imaging (EPI). These high-speed imaging techniques reduce measurement time, however, usually intensify artifact if there is any systematic phase error or jitter in the synchronization between the transmitter, receiver, and gradients.

• Korean Journal of Radiology
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• v.20 no.6
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• pp.976-984
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• 2019

Objective: To establish diagnostic criteria for pulmonary arterial hypertension (PAH) in children by using parameters obtained through noninvasive cardiac computed tomography (CCT). Materials and Methods: We retrospectively measured parameters from CCT images of children from a single institution in a multiple stepwise process. A total of 208 children with mean age of 10.5 years (range: 4 days-18.9 years) were assessed. The variables were classified into three groups: the great arteries; the ventricular walls; and the bilateral ventricular cavities. The relationship between the parameters obtained from the CCT images and mean pulmonary arterial pressure (mPAP) was tested and adjusted by the children's body size. Reference curves for the pulmonary trunk diameter (PTD) and ratio of diameter of pulmonary trunk to ascending aorta (rPTAo) of children with CCT images of normal hearts, adjusted for height, were plotted. Threshold lines were established on the reference curves. Results: PTD and rPTAo on the CCT images were significantly positively correlated with mPAP (r > 0.85, p < 0.01). Height was the body size parameter most correlated with PTD (r = 0.91, p < 0.01) and rPTAo (r = -0.69, p < 0.01). On the basis of the threshold lines on the reference curves, PTD and rPTAo both showed 88.9% sensitivity for PAH diagnosis, with negative predictive values of 93.3% and 92.9%, respectively. Conclusion: PTD and rPTAo measured from CCT images were significantly correlated with mPAP in children. Reference curves and the formula of PTD and rPTAo adjusted for height could be practical for diagnosing PAH in children.

• Journal of Cardiovascular Imaging
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• v.31 no.2
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• pp.71-82
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• 2023

BACKGROUND: Cardiac magnetic resonance fingerprinting (cMRF) enables simultaneous mapping of myocardial T1 and T2 with very short acquisition times. Breathing maneuvers have been utilized as a vasoactive stress test to dynamically characterize myocardial tissue in vivo. We tested the feasibility of sequential, rapid cMRF acquisitions during breathing maneuvers to quantify myocardial T1 and T2 changes. METHODS: We measured T1 and T2 values using conventional T1 and T2-mapping techniques (modified look locker inversion [MOLLI] and T2-prepared balanced-steady state free precession), and a 15 heartbeat (15-hb) and rapid 5-hb cMRF sequence in a phantom and in 9 healthy volunteers. The cMRF_5-hb sequence was also used to dynamically assess T1 and T2 changes over the course of a vasoactive combined breathing maneuver. RESULTS: In healthy volunteers, the mean myocardial T1 of the different mapping methodologies were: MOLLI 1,224 ± 81 ms, cMRF_15-hb 1,359 ± 97 ms, and cMRF_5-hb 1,357 ± 76 ms. The mean myocardial T2 measured with the conventional mapping technique was 41.7 ± 6.7 ms, while for cMRF_15-hb 29.6 ± 5.8 ms and cMRF_5-hb 30.5 ± 5.8 ms. T2 was reduced with vasoconstriction (post-hyperventilation compared to a baseline resting state) (30.15 ± 1.53 ms vs. 27.99 ± 2.07 ms, p = 0.02), while T1 did not change with hyperventilation. During the vasodilatory breath-hold, no significant change of myocardial T1 and T2 was observed. CONCLUSIONS: cMRF_5-hb enables simultaneous mapping of myocardial T1 and T2, and may be used to track dynamic changes of myocardial T1 and T2 during vasoactive combined breathing maneuvers.

• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.26-38
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• 2023

BACKGROUND: Dobutamine and adenosine stress cardiac magnetic resonance (CMR) imaging is relatively contraindicated in patients with moderate to severe aortic valve stenosis (AS). We aimed to determine the safety of dobutamine and adenosine stress CMR in patients with moderate to severe AS. METHODS: In this retrospective study patients with AS who underwent either dobutamine or adenosine stress CMR for exclusion of obstructive coronary artery disease were enrolled. We recorded clinical data, CMR and echocardiography findings, and complications as well as minor symptoms. Patients with AS were compared to matched individuals without AS. RESULTS: A total of 187 patients with AS were identified and compared to age-, gender- and body mass index-matched 187 patients without AS. No severe complications were reported in the study nor the control group. The reported frequency of non-severe complications and minor symptoms were similar between the study and the control groups. Nineteen patients with AS experienced non-severe complications or minor symptoms during dobutamine stress CMR compared to eighteen patients without AS (p = 0.855). One patient with AS and two patients without AS undergoing adenosine stress CMR experienced minor symptoms (p = 0.562). Four examinations were aborted because of chest pain, paroxysmal atrial fibrillation and third-degree atrioventricular block. Inducible ischaemia, prior coronary artery bypass grafting, prior stroke and age were associated with a higher incidence of complications and minor symptoms. CONCLUSIONS: Moderate to severe AS was not associated with complications during CMR stress test. The incidence of non-severe complications and minor symptoms was greater with dobutamine.

• Journal of Chest Surgery
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• v.57 no.4
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• pp.360-368
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• 2024

Background: The left pulmonary artery (LPA) may be kinked and stenotic, especially in tetralogy of Fallot, because of ductal tissue and anterior deviation of the conal septum. If LPA stenosis is not effectively treated during total correction, surgical angioplasty is occasionally performed. However, whether pulmonary artery (PA) angioplasty in adolescents or adults improves perfusion in the ipsilateral lung remains unclear. Methods: This retrospective review enrolled patients who underwent PA angioplasty for LPA stenosis between 2004 and 2019. Among patients who underwent a lung perfusion scan (LPS) or cardiac magnetic resonance imaging (cMRI) pre- and post-pulmonary angioplasty, those aged >13 years with <40% left lung perfusion (p-left) in the pre-angioplasty study were included. Preoperative and postoperative computed tomography, LPS, and cMRI data were collected. The perfusion ratio was analyzed according to the LPA's anatomical characteristics. Results: Seventeen adolescents and 16 adults (≥18 years old) were finally included (median age, 17 years). The most common primary diagnosis was tetralogy of Fallot (87.9%). In all patients, LPA angioplasty was performed concomitantly with right ventricular outflow tract reconstruction. No patients died. Preoperative p-left was not significantly different between adolescents and adults; however, adolescents had significantly higher postoperative p-left than adults. P-left significantly increased in adolescents, but not in adults. Seven patients had significant stenosis (z-score <-2.0) confined only to the proximal LPA and demonstrated significantly increased p-left. Conclusion: PA angioplasty significantly increased ipsilateral lung perfusion in adolescents. If focal stenosis is confined to the proximal LPA, PA angioplasty may improve ipsilateral lung perfusion, regardless of age.

• Journal of Cardiovascular Imaging
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• v.30 no.1
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• pp.50-58
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• 2022

BACKGROUND: Little is known regarding right ventricular (RV) remodeling immediately after Tetralogy of Fallot (TOF) repair. We sought to describe myocardial deformation by cardiac magnetic resonance imaging (CMR) after TOF repair and investigate associations between these parameters and early post-operative outcomes. METHODS: Fifteen infants underwent CMR without sedation as part of a prospective pilot study after undergoing complete TOF repair, prior to hospital discharge. RV deformation (strain) was measured using tissue tracking, in addition to RV ejection fraction (EF), volumes, and pulmonary regurgitant fraction. Pearson correlation coefficients were used to determine associations between both strain and CMR measures/clinical outcomes. RESULTS: Most patients were male (11/15, 73%), with median age at TOF repair 53 days (interquartile range, 13,131). Most patients had pulmonary stenosis (vs. atresia) (11/15, 73%) and 7 (47%) received a transannular patch as part of their repair. RV function was overall preserved with mean RV EF of 62% (standard deviation [SD], 9.8). Peak radial and longitudinal strain were overall diminished (mean ± SD, 33.80 ± 18.30% and -15.50 ± 6.40%, respectively). Longer hospital length of stay after TOF repair was associated with worse RV peak radial ventricular strain (correlation coefficient (r), -0.54; p = 0.04). Greater pulmonary regurgitant fraction was associated with shorter time to peak radial RV strain (r = -0.55, p = 0.03). CONCLUSIONS: In this small study, our findings suggest presence of early decrease in RV strain after TOF repair and its association with hospital stay when changes in EF and RV size are not yet apparent.

• Journal of radiological science and technology
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• v.41 no.6
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• pp.545-552
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• 2018

The purpose of this study was evaluated the relationship between echocardiography and cardiac computed tomography in normal adults by visual assessment, and evaluated the effective doses of cardiac computed tomography. The subjects were 100 normal patients who visited two general hospitals in Chungnam, from January 1 to May 30, 2018. We obtained images by using these modalities and evaluated the wall thickness and internal dimension of the Left Ventricle with visual assessment. To evaluate the appropriateness of the visual evaluation, two evaluators who were trained for one week were measured and the agreement between the evaluators were verified by statistical analysis. The effective doses of computed tomography were evaluated using the dose length product. As a result, there was a high correlation between the two modalities. The agreement between the two visual evaluator were also highly agreed. The mean X-ray dose of the subjects was $11.1{\pm}3.1mSv$. Although the purpose of imaging is somewhat different in the clinical setting, echocardiography could achieve the same results as radiation-invasive computed tomography. It is thought that utilization will become even larger.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.2
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• pp.135-140
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• 2006

Magnetocardiography (MCG) is the measurement and analysis of the magnetic component of the electro-magnetic field of the human heart, usually conducted externally, using extremely sensitive devices such as a Superconducting Quantum Interference Device (SQUID). MCG is a totally noninvasive method, it uses neither radiation nor ultrasonics. The magnetic activity of the heart is registered from outside the thorax. MCG has a very high sensitivity and a high spatial resolution for very a small, local myocardial current. In comparison to the electrical signals measured by an ECG, the magnetic signal does not disturb the boundaries of tissues with different electrical properties. MCG measures the myocardial function rather than describing the morphology. MCG is a relatively new technique that promises good spatial resolution and extremely high temporal resolution, thus complementing other heart activity measurement techniques such as Electrocardiography (ECG). The clinical uses of MCG are in detecting various cardiac disorders including myocardial infarction, ventricular hypertrophy, ventricular conduction defects, Wolff-Parkinson-White (WPW) syndrome, sudden cardiac death and fetal magnetocardiography. Magnetocardiography may be used alone or together with electrcardiography for the measurement of spontaneous or overloaded activity and for research or clinical purposes.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.15 no.2
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• pp.500-521
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• 2021

Echocardiography, an ultrasound scan of the heart, is regarded as the primary physiological test for heart disease diagnoses. How an echocardiogram is interpreted also relies intensively on the determination of the view. Some of such views are identified as standard views because of the presentation and ease of the evaluations of the major cardiac structures of them. However, finding valid cardiac views has traditionally been time-consuming, and a laborious process because medical imaging is interpreted manually by the specialist. Therefore, this study aims to speed up the diagnosis process and reduce diagnostic error by providing an automated identification of standard cardiac views based on deep learning technology. More importantly, based on a brand-new echocardiogram dataset of the Asian race, our research considers and assesses some new neural network architectures driven by action recognition in video. Finally, the research concludes and verifies that these methods aggregating dynamic information will receive a stronger classification effect.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.355-358
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• 2015

Isolated congenital left ventricular diverticulum is a rare cardiac malformation. Here, we report the case of a 33-year-old woman who had suffered from recurrent transient ischemic attacks for 6 years. Preoperative cardiac magnetic resonance imaging and computed tomography angiography revealed a diverticulum near the apex. The diverticulum was successfully obliterated by cardiopulmonary bypass. We suggest that isolated congenital left ventricular diverticulum can be easily corrected with a low surgical risk by patch repair and plication techniques.