ABSTRACT
PURPOSE: To elucidate the influence of through-plane heart motion on the assessment of aortic regurgitation (AR) severity using phase contrast magnetic resonance imaging (PC-MRI). APPROACH: A patient cohort with chronic AR (n = 34) was examined with PC-MRI. The regurgitant volume (RVol) and fraction (RFrac) were extracted from the PC-MRI data before and after through-plane heart motion correction and was then used for assessment of AR severity. RESULTS: The flow volume errors were strongly correlated to aortic diameter (R = 0.80, p < 0.001) with median (IQR 25%;75%): 16 (14; 17) ml for diameter>40mm, compared with 9 (7; 10) ml for normal aortic size (p < 0.001). RVol and RFrac were underestimated (uncorrected:64 ± 37 ml and 39 ± 17%; corrected:76 ± 37 ml and 44 ± 15%; p < 0.001) and ~ 20% of the patients received lower severity grade without correction. CONCLUSION: Through-plane heart motion introduces relevant flow volume errors, especially in patients with aortic dilatation that may result in underestimation of the severity grade in patients with chronic AR.
Subject(s)
Aortic Valve Insufficiency , Aortic Valve Insufficiency/diagnostic imaging , Humans , Magnetic Resonance Imaging/methods , Severity of Illness IndexABSTRACT
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
ABSTRACT
X-ray free electron lasers (XFELs) create new possibilities for structural studies of biological objects that extend beyond what is possible with synchrotron radiation. Serial femtosecond crystallography has allowed high-resolution structures to be determined from micro-meter sized crystals, whereas single particle coherent X-ray imaging requires development to extend the resolution beyond a few tens of nanometers. Here we describe an intermediate approach: the XFEL imaging of biological assemblies with helical symmetry. We collected X-ray scattering images from samples of microtubules injected across an XFEL beam using a liquid microjet, sorted these images into class averages, merged these data into a diffraction pattern extending to 2 nm resolution, and reconstructed these data into a projection image of the microtubule. Details such as the 4 nm tubulin monomer became visible in this reconstruction. These results illustrate the potential of single-molecule X-ray imaging of biological assembles with helical symmetry at room temperature.
