我们感谢博士。雷蒙温斯洛，埃利奥特·麦克维和帕特里克头盔在约翰·霍普金斯大学提供的体外资料 online.This的研究得到美国国立卫生研究院资助R01-HL082729，国家科学基金会的资助CBET-0933029。

1。纤维方向估计<ol><li>正常成人心脏在舒张时获取的结构MRI和DTMRI的图像，分辨率为1毫米3。使用ImageJ，提取心室肌细胞从地图集的结构图像的拟合，为每个短轴切片，封闭样条曲线通过一组标志点，沿心外膜和心内膜切片中的边界（ 图2A和图2B）。执行手动放置标志点为每10 个图像中的切片。获取剩余的片的标志点，通过线性插值手动确定的点，使用MATLAB.Reconstruct地图集的心脏的纤维取向，通过计算在DTMRI图像（ 图2C）的DTs的主特征向量。 </li><li>获取图像病人的心脏舒张使用体内心脏CT或MRI的几何形状。侦察的病人的心脏几何结构的图像同样的方式建立地图集（ 图3A和图3B）。病人图像，应重新采样，重建等之前，在图面的分辨率为1 mm 2。同样地，片的地标手动拾取，且间隔的满分平面插值的数目必须被调整，使得分割病人心脏的图像具有的片厚度为1mm。 </li><li>变形图谱相匹配的病人的心室图像几何图像分为两个步骤。在第一个步骤，执行的仿射变换一组13地标点：左心室（LV）尖，右心室（RV）插入点在该基地的基础上，两个RV插入点之间的中间基地和顶点，和四组的两个点，平均分配在基地RV和LV心外膜的轮廓，中间基地和顶点（ 图4A＆ <strong&gt;，图4B）。在第二步骤中，变形的仿射变换地图集脑室进一步与病人的几何形状相匹配，利用大变形微分同胚度量的映射（LDDMM）（ 图4C）。 </li><li>变形的DTMRI形象重新定位，根据变换矩阵的仿射匹配和形变场的LDDMM转型的图像体素和重新定向的DTS地图集。执行DTs的，使用保存的主方向（PPD）的方法的重新定向。 </li><li>获取患者的估计的纤维取向从变形图集DTMRI映像通过计算主DTs的（ 图5）的特征向量。 </li></ol> 2。估计误差的测量<ol><li>收购前的正常和3个失败的犬心脏的体内的结构性MR和DTMR的图像，分辨率为312.5×312.5×800微米3。在这里，心脏辉应通过射频消融术的左束支3周起搏在210分钟-1在犬产生诱惑。 </li><li>从犬心同样地人类图谱心脏，§1.1中所描述的分部心室。记脑室正常犬的心为心1至6分割，而这些分割失败的犬心脏的心7到9（ 图6）。 </li><li>获得5个不同的估计，心脏的心室纤维方向心2至6图谱（ 图7）。 </li><li>估计纤维的方向，每一个失败的心室心脏图谱（ 图8）。 </li><li> Foreach回的数据点的每个集合中的估计的纤维取向，|θ-θ的 |，其中θc的和θa的的倾斜角估计计算的估计误差D收购纤维取向在这一点上，分别。 </li><li>对于每个集合中的每个数据点的估计的纤维取向，计算由的thevector点积的装置以三维（3D）betweenestimated和获得的纤维方向的锐角。 </li></ol> 3。估计误差的影响模拟测量<ol><li>心脏1，建设六个型号，其中DTMRI获得的纤维方向的心脏1（称为模型1）和五个五的预算纤维方向的数据集（型号为2〜6）的三个衰竭的心脏。几何形状，构造两个心室模型的DTMRI获得的纤维方向和其他的估计纤维方向之一。这里的空间分辨率的模型，计算的平均边缘的啮合长度方面，应该是约600μm。记心脏衰竭模型的模型7日至9 DTMRI获得的纤维，和那些与估计ED纤维10日至12.In型号的机型，使用单畴表示描述的心脏组织，控制方程： </li></ol><img src="/files/ftp_upload/50125/50125eq1.jpg" alt="式（1）" fo:content-width="2.18in" fo:src="/files/ftp_upload/50125/50125eq1highres.jpg" /> 其中，σb是从bidomain电导率张量计算所描述的Potse 等 30的体积导电率张量，V m是跨膜电位; C M是特定的膜电容; 我和离子的跨膜电流的密度，而这又取决于对 V m和一组状态变量μ横跨的membrane.For C M描述的离子通量的动态，使用1μF / cm 2的值。对于σ 我正常犬心脏模型的，使用纵向0.34 S / m和0.06 S / m的，分别的信号和横向的电导率值。 升离子管理者的犬心室肌细胞的格林斯坦的温斯洛离子模型。减少在的犬心脏衰竭心室模型的电导率达30％（ 图9）。 <ol start="2"><li> CARP使用的软件包（CardioSolv，LLC），所有型号的模拟窦性心律。在6个没有机型采用S1-S2起搏协议诱发折返性室性心动过速（VT）。选择S2交付后2秒以获得持续的VT活性S1和S2之间的定时。如果VT不诱导任何S1-S2的定时，降低电导率，高达70％的，直到VT被诱导（ 图10）。 </li><li>对于每个仿真，计算伪心电图通过服用的差异胞外周围心中各向同性浴中的两个点之间的电位的。附近的两个点，将分离的心脏的基础上由18厘米，例如，连接它们的线垂直的平面中的隔垫的基极-顶点，如在图10中示出。对于每一个模拟，估计纤维取向，计算MAD指标作为</li></ol><img src="/files/ftp_upload/50125/50125eq2.jpg" alt="公式2" fo:content-width="2.77in" fo:src="/files/ftp_upload/50125/50125eq2highres.jpg" /> 其中 X是ECG波形的模拟与估计的纤维取向，Y是ECG波形的thecorresponding模拟与获得的纤维取向，X是平均的 X值，Y是Y 值的平均值， 和 n是X的长度和Y。

<ol>
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没有利益冲突的声明。

此研究表明定量正常和失败的心室的心肌纤维取向，在没有DTMRI，可估计出的体内图像，其在心脏电生理学的模拟中使用的几何形状。拟议的方法表明在体内的CT数据，但它也同样适用于在体内 MR图像心室几何，寻址能力直接获取 ​​病人的纤维取向的缺乏。因此，这是心电生理临床应用的个性化车型的发展迈出的重要一步。该方法也可用于具有高分辨率的前体内的<...

<html>的计算方法是成为中心的功能的心脏健康和疾病的认识的进步。国家的最先进的全心脏电生理和机电模型，目前正在研究一个广泛的现象，比如，正常心室传播，心律不齐，除颤， ​​机电耦合，和心脏再同步1。然而，在临床环境中可直接适用的计算方法，它是必要的，该模型是病人的具体的模型， 即必须根据特定的体系结构和病人的病变心脏的电机电性能。这些模型的模拟将帮助医生到达电干预措施，以及预防，高度个性化的决定，从而显着改善心脏健康护理2-4。 内容“&gt;创建逼真的心脏模型需要获得病人的心脏的几何结构和纤维结构。纤维方向确定在心脏的电传导的方向和应变分布，并因此获取这些是必不可少的心脏模型5，6。在医疗成像的最新进展，它是可行的，得到一个病人的心，includingstructural的的重塑，如心肌梗死，高分辨率磁共振成像（MRI）和计算机断层扫描（CT）技术在体内的几何形状，但有没有实用的方法，用于获取一个病人在体心脏的纤维结构体。扩散张量（DT）MRI 7，8，唯一的技术来获得纤维取向的原封未动的心，是不能广泛提供的简要说明在体内，由于一定的局限性9。以前的努力翻译DTMRI到临床可以发现elsewh的ERE 2。虽然方法，如纤维方向的以规则为基础的分配提供的替代品DTMRI，这些方法有一定的的严重限制2，10。因此，收购心肌纤维结构在体内的困难，目前阻碍心脏电生理和机电模拟在临床上的应用。本研究的目的是直接满足这一需求。 我们假设，一个心脏的心室纤维方向可以准确地预测的心脏和几何形状的地图集，该地图集是心脏的几何形状和纤维方向。因此，我们使用的最先进的技术开发一种方法，估计在体内的心肌纤维方向，在正常和失败的犬心室2测试的假设。我们的光纤估计方法的核心思想是利用similarities的纤维方向，相对于几何形状，以近似的纤维结构（目标）心脏的几何信息，请访问不同的心灵。在我们的估计方法的心脏是注册寰椎与目标几何几何大变形微分同胚公制映射（LDDMM）11，和变形寰纤维方向使用保存的主要组成部分（PPD），12。diffeomorphicproperty的地图集确实不是“foldover”本身在变形过程中，从而保留integrityof的解剖结构， 图1示出我们的方法的处理管道的LDDMM担保。的协议文本部分§1描述的各个组成部分的管道，通过展示如何估计，可进行一个例子病人。请参阅相应的部分在图1中的块内的数字根据第§1款的协议文本。 我们评估的表现所提出的方法通过量化的估计误差，测量的心脏电生理这个错误onsimulations的效果，通过计算模拟当地的电激活地图以及伪心电图（伪心电图）。由于不可用人类的心灵，绩效评估进行犬心脏从以往的研究13-15。的估计计算错误由倾斜角16，followingthe的传统的组织学，角的测量是performedon组织被切断的部分，平行的epicardialsurface，手段。由于anglebetween纤维方向与心外膜的切平面generallysmall 17，18，是微不足道的在描述一个fiberdirection完全使用它的倾斜角的信息损失。对于COMPUT报告以前是19，20，和心肌组织的模型的基础上建立的数学方法和实验数据21日至25日，代表憩模拟，基于图像的模型建立。窦性心律模拟复制的激活源于Purkinje神经网络26，室性心动过速，S1-S2起搏协议27。伪心电图，计算28和比较，采用平均绝对偏差（MAD）指标29。

<table border="1"><tbody><tr><td> LDDMM </td><td>约翰·霍普金斯大学</td><td></td><td> <a href="http://cis.jhu.edu/software/lddmm-volume/index.php" target="_blank">http://cis.jhu.edu/software/lddmm-volume/index.php</a> </td></tr><tr><td> MATLAB </td><td> MathWorks公司</td><td> R2011b </td><td> <a href="http://www.mathworks.com/products/matlab/" target="_blank">http://www.mathworks.com/products/matlab/</a> </td></tr><tr><td> ImageJ的</td><td>美国国立卫生研究院</td><td></td><td> <a href="http://rsbweb.nih.gov/ij/" target="_blank">http://rsbweb.nih.gov/ij/</a> </td></tr><tr><td>蜘蛛</td><td> CAE软件解决方案</td><td></td><td> <a href="http://www.meshing.at/Spiderhome/Tarantula.html" target="_blank">http://www.meshing.at/Spiderhome/Tarantula.html</a> </td></tr><tr><td> CARP </td><td> CardioSolv</td><td></td><td> <a href="http://cardiosolv.com/" target="_blank">http://cardiosolv.com/</a> </td></tr><tr><td>犬图像</td><td>约翰·霍普金斯大学</td><td></td><td> <a href="http://www.ccbm.jhu.edu/research/DTMRIDS.php" target="_blank">http://www.ccbm.jhu.edu/research/DTMRIDS.php</a> </td></tr></tbody></table>

patient-specific modeling of the heart: estimation of ventricular fiber orientations

（DYS）的心脏功能，以个性化的心脏治疗的病人，具体的模拟受阻的情况下， 活体成像技术在临床上取得心肌纤维方向。该项目的目标是开发一种方法，，估计心肌纤维方向，从病人的心脏形状的体内图像。准确地表述室的几何形状和纤维方向，分别从重建高分辨率体外结构磁共振（MR）和弥散张量磁共振图像（DT）的一个正常的人的心，简称为寰椎。病人心脏的心室几何提取， 通过半自动的分割， 在体内计算机断层扫描（CT）图像。使用图像转换算法，该地图集心室几何变形相匹配的病人。最后，形变场，以图谱纤维orientat的应用离子，得到的估计病人的纤维取向。评估使用正常和三个六未能犬心纤维估计的准确性。获取和估计的纤维取向的倾斜角之间的平均绝对差为15.4°。模拟计算表明，在窦性心律和室性心动过速的心室激动的地图和伪心电图估计和收购的纤维取向之间没有显着的差异，在临床观察的水平。从该项目获得了新的见解的发展铺平了道路病人具体型号的心脏，可以帮助医生在个性化的诊断和决定有关电的干预。

图11，AC简化的可视化显示的估计以及DTMRI衍生的纤维方向在正常和心脏衰竭。定性检测显示，估计纤维方向一致，与DTMRI衍生的。 D组说明，覆盖的几何形状的心脏，在正常心脏的倾斜角度的误差分布，平均在所有五个估算。面板E在没有心的倾斜角度，心脏1的几何结构上重叠显示的错误的平均分布。请注意，倾斜角在-90°和+90°之间的值，因此，在0°和180°之间的估计误差范围。组件F...

Watch this Scientific Journal Video about Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations at JoVE.com

Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations

估计心室纤维方向，从病人的心脏几何形状的个性化造型的体内图像描述的一种方法。验证的方法进行使用正常和失败的犬心脏表明，有估计和收购的纤维方向在临床观察的水平没有显着差异。

病人的具体建模之心：的心室纤维方向估计

Patient-specific  simulations of heart (dys)function aimed at personalizing cardiac therapy are hampered  by the absence of in vivo imaging technology for ...

patient-specific-modeling-heart-estimation-ventricular-fiber

Research

JoVE Journal

Bioengineering

13.6K 次观看.  Johns Hopkins University. 估计心室纤维方向，从病人的心脏几何形状的个性化造型的体内图像描述的一种方法。验证的方法进行使用正常和失败的犬心脏表明，有估计和收购的纤维方向在临床观察的水平没有显着差异。

视频: Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations

High-resolution Fiber-optic Microendoscopy for in situ Cellular Imaging

Many biological and clinical studies require the longitudinal study and analysis of morphology and function with cellular level resolution. Traditionally, multiple experiments are run in parallel, with individual samples removed from the study at sequential time points for evaluation by light microscopy. Several intravital techniques have been developed, with confocal, multiphoton, and second harmonic microscopy all demonstrating their ability to be used for imaging in situ 1. With these systems, however, the required infrastructure is complex and expensive, involving scanning laser systems and complex light sources. Here we present a protocol for the design and assembly of a high-resolution microendoscope which can be built in a day using off-the-shelf components for under US$5,000. The platform offers flexibility in terms of image resolution, field-of-view, and operating wavelength, and we describe how these parameters can be easily modified to meet the specific needs of the end user.
We and others have explored the use of the high-resolution microendoscope (HRME) in in vitro cell culture 2-5, in excised 6 and living animal tissues 2,5, and in human tissues in vivo 2,7. Users have reported the use of several different fluorescent contrast agents, including proflavine 2-4, benzoporphyrin-derivative monoacid ring A (BPD-MA) 5, and fluoroscein 6,7, all of which have received full, or investigational approval from the FDA for use in human subjects. High-resolution microendoscopy, in the form described here, may appeal to a wide range of researchers working in the basic and clinical sciences. The technique offers an effective and economical approach which complements traditional benchtop microscopy, by enabling the user to perform high-resolution, longitudinal imaging in situ.

High-resolution Fiber-optic Microendoscopy for in situ Cellular Imaging

In many biological and clinical situations it is advantageous to study cellular processes as they evolve in their native microenvironment. Here we describe the assembly and use of a low-cost fiber-optic microscope which can provide real time imaging in cell culture, animal studies, and clinical patient studies.

高分辨率光纤内窥镜为原位细胞成像

Many biological and clinical studies require the longitudinal study and analysis of morphology and function with cellular level resolution.  ...

科研

生物工程

Multiparametric Optical Mapping of the Langendorff-perfused Rabbit Heart

Optical imaging and fluorescent probes have significantly advanced research methodology in the field of cardiac electrophysiology in ways that could not have been accomplished by other approaches1. With the use of the calcium- and voltage-sensitive dyes, optical mapping allows measurement of transmembrane action potentials and calcium transients with high spatial resolution without the physical contact with the tissue. This makes measurements of the cardiac electrical activity possible under many conditions where the use of electrodes is inconvenient or impossible1. For example, optical recordings provide accurate morphological changes of membrane potential during and immediately after stimulation and defibrillation, while conventional electrode techniques suffer from stimulus-induced artifacts during and after stimuli due to electrode polarization1. 
The Langendorff-perfused rabbit heart is one of the most studied models of human heart physiology and pathophysiology. Many types of arrhythmias observed clinically could be recapitulated in the rabbit heart model. It was shown that wave patterns in the rabbit heart during ventricular arrhythmias, determined by effective size of the heart and the wavelength of reentry, are very similar to that in the human heart2. It was also shown that critical aspects of excitation-contraction (EC) coupling in rabbit myocardium, such as the relative contribution of sarcoplasmic reticulum (SR), is very similar to human EC coupling3. Here we present the basic procedures of optical mapping experiments in Langendorff-perfused rabbit hearts, including the Langendorff perfusion system setup, the optical mapping systems setup, the isolation and cannulation of the heart, perfusion and dye-staining of the heart, excitation-contraction uncoupling, and collection of optical signals. These methods could be also applied to the heart from species other than rabbit with adjustments to flow rates, optics, solutions, etc.
Two optical mapping systems are described. The panoramic mapping system is used to map the entire epicardium of the rabbit heart4-7. This system provides a global view of the evolution of reentrant circuits during arrhythmogenesis and defibrillation, and has been used to study the mechanisms of arrhythmias and antiarrhythmia therapy8,9. The dual mapping system is used to map the action potential (AP) and calcium transient (CaT) simultaneously from the same field of view10-13. This approach has enhanced our understanding of the important role of calcium in the electrical alternans and the induction of arrhythmia14-16.

This article describes the basic procedures for conducting optical mapping experiments in the Langendorff-perfused rabbit heart using the panoramic imaging system, and the dual (voltage and calcium) imaging modality.

多参数的Langendorff灌注兔心脏的光学测绘

Optical imaging and fluorescent probes have significantly advanced research methodology in the field of cardiac electrophysiology in ways that could not ...

Targeting Neuronal Fiber Tracts for Deep Brain Stimulation Therapy Using Interactive, Patient-Specific Models

Deep brain stimulation (DBS), which involves insertion of an electrode to deliver stimulation to a localized brain region, is an established therapy for movement disorders and is being applied to a growing number of disorders. Computational modeling has been successfully used to predict the clinical effects of DBS; however, there is a need for novel modeling techniques to keep pace with the growing complexity of DBS devices. These models also need to generate predictions quickly and accurately. The goal of this project is to develop an image processing pipeline to incorporate structural magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) into an interactive, patient specific model to simulate the effects of DBS. A virtual DBS lead can be placed inside of the patient model, along with active contacts and stimulation settings, where changes in lead position or orientation generate a new finite element mesh and solution of the bioelectric field problem in near real-time, a timespan of approximately 10 seconds. This system also enables the simulation of multiple leads in close proximity to allow for current steering by varying anodes and cathodes on different leads. The techniques presented in this paper reduce the burden of generating and using computational models while providing meaningful feedback about the effects of electrode position, electrode design, and stimulation configurations to researchers or clinicians who may not be modeling experts.

The goal of this project is to develop an interactive, patient-specific modeling pipeline to simulate the effects of deep brain stimulation in near real-time and provide meaningful feedback as to how these devices influence neural activity in the brain.

应用交互式、患者特异性模型对神经纤维束进行深部脑刺激治疗的靶向性

Deep brain stimulation (DBS), which involves insertion of an electrode to deliver stimulation to a localized brain region, is an established therapy for ...

Light-sheet Fluorescence Microscopy for the Study of the Murine Heart

Light-sheet fluorescence microscopy has been widely used for rapid image acquisition with a high axial resolution from micrometer to millimeter scale. Traditional light-sheet techniques involve the use of a single illumination beam directed orthogonally at sample tissue. Images of large samples that are produced using a single illumination beam contain stripes or artifacts and suffer from a reduced resolution due to the scattering and absorption of light by the tissue. This study uses a dual-sided illumination beam and a simplified CLARITY optical clearing technique for the murine heart. These techniques allow for deeper imaging by removing lipids from the heart and produce a large field of imaging, greater than 10 x 10 x 10 mm3. As a result, this strategy enables us to quantify the ventricular dimensions, track the cardiac lineage, and localize the spatial distribution of cardiac-specific proteins and ion-channels from the post-natal to adult mouse hearts with sufficient contrast and resolution.

This study uses a dual-sided illumination light-sheet fluorescence microscopy (LSFM) technique combined with optical clearing to study the murine heart.

光片荧光显微术在小鼠心脏研究中的应用

Light-sheet fluorescence microscopy has been widely used for rapid image acquisition with a high axial resolution from micrometer to millimeter scale. ...

Biaxial Mechanical Characterizations of Atrioventricular Heart Valves

Extensive biaxial mechanical testing of the atrioventricular heart valve leaflets can be utilized to derive&#160;optimal parameters used in constitutive models, which provide a mathematical representation of the mechanical function of those structures. This presented biaxial mechanical testing protocol involves (i) tissue acquisition, (ii) the preparation of tissue specimens, (iii) biaxial mechanical testing, and (iv) postprocessing of the acquired data. First, tissue acquisition requires obtaining porcine or ovine hearts from a local Food and Drug Administration-approved abattoir for later dissection to retrieve the valve leaflets. Second, tissue preparation requires using tissue specimen cutters on the leaflet tissue to extract a clear zone for testing. Third, biaxial mechanical testing of the leaflet specimen requires the use of a commercial biaxial mechanical tester, which consists of force-controlled, displacement-controlled, and stress-relaxation testing protocols to characterize the leaflet tissue&#39;s mechanical properties. Finally, post-processing requires the use of data image correlation techniques and force and displacement readings to summarize the tissue&#39;s mechanical behaviors in response to external loading. In general, results from biaxial testing demonstrate that the leaflet tissues yield a nonlinear, anisotropic mechanical response. The presented biaxial testing procedure is advantageous to other methods since the method presented here allows for a more comprehensive characterization of the valve leaflet tissue under one unified testing scheme, as opposed to separate testing protocols on different tissue specimens. The proposed testing method has its limitations in that shear stress is potentially present in the tissue sample. However, any potential shear is presumed negligible.

This protocol involves characterizations of atrioventricular valve leaflets with force-controlled, displacement-controlled, and stress-relaxation biaxial mechanical testing procedures. Results acquired with this protocol can be used for constitutive model development to simulate the mechanical behavior of functioning valves under a finite element simulation framework.

房室心脏瓣膜的双轴力学特性

Extensive biaxial mechanical testing of the atrioventricular heart valve leaflets can be utilized to derive&#160;optimal parameters used in constitutive ...

Optical Imaging of Isolated Murine Ventricular Myocytes

The ability to isolate adult cardiac myocytes has permitted researchers to study a variety of cardiac pathologies at the single cell level. While advances in calcium sensitive dyes have permitted the robust optical recording of single cell calcium dynamics, recording of robust transmembrane optical voltage signals has remained difficult. Arguably, this is because of the low single to noise ratio, phototoxicity, and photobleaching of traditional potentiometric dyes. Therefore, single cell voltage measurements have long been confined to the patch clamp technique which while the gold standard, is technically demanding and low throughput. However, with the development of novel potentiometric dyes, large, fast optical responses to changes in voltage can be obtained with little to no phototoxicity and photobleaching. This protocol describes in detail how to isolate adult murine myocytes which can be used for cellular shortening, calcium, and optical voltage measurements. Specifically, the protocol describes how to use a ratiometric calcium dye, a single-excitation calcium dye, and a single excitation voltage dye. This approach can be used to assess the cardiotoxicity and arrhythmogenicity of various chemical agents. While phototoxicity is still an issue at the single cell level, methodology is discussed on how to reduce it.

We present the methodology for the isolation of murine myocytes and how to obtain voltage or calcium traces simultaneously with sarcomere shortening traces using fluorescence photometry with simultaneous digital cell geometry measurements.

分离的月毛心室肌细胞的光学成像

The ability to isolate adult cardiac myocytes has permitted researchers to study a variety of cardiac pathologies at the single cell level. While advances ...

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Three-dimensional (3D) quantification of the left ventricle (LV) provides significant added value in terms of diagnostic accuracy and precise risk stratification in various cardiac disorders. Recently, 3D echocardiography became available in routine cardiology practice; however, high-quality image acquisition and subsequent analysis have a steep learning curve. The present article aims to guide the reader through a detailed 3D protocol by presenting tips and tricks and also by highlighting the potential pitfalls to facilitate the widespread but technically sound use of this important technique concerning the LV. First and foremost, we show the acquisition of a high-quality 3D dataset with optimal spatial and temporal resolution. Then, we present the analytical steps toward a detailed quantification of the LV by using one of the most widely applied built-in software. We will quantify LV volumes, sphericity, mass and also systolic function by measuring ejection fraction and myocardial deformation (longitudinal and circumferential strain). We will discuss and provide clinical examples about the essential scenarios where the transition from a conventional echocardiographic approach to a 3D-based quantification is highly recommended.

In this article, we provide a step-by-step acquisition and analysis protocol for the volumetric assessment and speckle-tracking analysis of the left ventricle by 3D echocardiography, particularly focusing on practical aspects that maximize the feasibility of this technique.

使用3D超声心动图评估左心室结构和功能

Three-dimensional (3D) quantification of the left ventricle (LV) provides significant added value in terms of diagnostic accuracy and precise risk ...

Patient-Specific Polyvinyl Alcohol Phantom Fabrication with Ultrasound and X-Ray Contrast for Brain Tumor Surgery Planning

Phantoms are essential tools for clinical training, surgical planning and the development of novel medical devices. However, it is challenging to create anatomically accurate head phantoms with realistic brain imaging properties because standard fabrication methods are not optimized to replicate any patient-specific anatomical detail and 3D printing materials are not optimized for imaging properties. In order to test and validate a novel navigation system for use during brain tumor surgery, an anatomically accurate phantom with realistic imaging and mechanical properties was required. Therefore, a phantom was developed using real patient data as input and 3D printing of molds to fabricate a patient-specific head phantom comprising the skull, brain and tumor with both ultrasound and X-ray contrast. The phantom also had mechanical properties that allowed the phantom tissue to be manipulated in a similar manner to how human brain tissue is handled during surgery. The phantom was successfully tested during a surgical simulation in a virtual operating room.
The phantom fabrication method uses commercially available materials and is easy to reproduce. The 3D printing files can be readily shared, and the technique can be adapted to encompass many different types of tumor.

This protocol describes the fabrication of a patient specific skull, brain and tumor phantom. It uses 3D printing to create molds, and polyvinyl alcohol (PVA-c) is used as the tissue mimicking material.

患者特异性聚乙烯酒精幻影制造与超声波和X射线对比脑肿瘤手术规划

Phantoms are essential tools for clinical training, surgical planning and the development of novel medical devices. However, it is challenging to create ...

Evaluating Regional Pulmonary Deposition using Patient-Specific 3D Printed Lung Models

Development of targeted therapies for pulmonary diseases is limited by the availability of preclinical testing methods with the ability to predict regional aerosol delivery. Leveraging 3D printing to generate patient-specific lung models, we outline the design of a high-throughput, in vitro experimental setup for quantifying lobular pulmonary deposition. This system is made with a combination of commercially available and 3D printed components and allows the flow rate through each lobe of the lung to be independently controlled. Delivery of fluorescent aerosols to each lobe is measured using fluorescence microscopy. This protocol has the potential to promote the growth of personalized medicine for respiratory diseases through its ability to model a wide range of patient demographics and disease states. Both the geometry of the 3D printed lung model and the air flow profile setting can be easily modulated to reflect clinical data for patients with varying age, race, and gender. Clinically relevant drug delivery devices, such as the endotracheal tube shown here, can be incorporated into the testing setup to more accurately predict a device&#8217;s capacity to target therapeutic delivery to a diseased region of the lung. The versatility of this experimental setup allows it to be customized to reflect a multitude of inhalation conditions, enhancing the rigor of preclinical therapeutic testing.

We present a high-throughput, in vitro method for quantifying regional pulmonary deposition at the lobe level using CT scan-derived, 3D printed lung models with tunable air flow profiles.

使用患者专用的 3D 打印肺模型评估区域肺沉积

Development of targeted therapies for pulmonary diseases is limited by the availability of preclinical testing methods with the ability to predict ...

Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging

Mouse models have contributed significantly to understanding genetic and physiological factors involved in healthy cardiac function, how perturbations result in pathology, and how myocardial diseases may be treated. Cardiovascular magnetic resonance imaging (CMR) has become an indispensable tool for a comprehensive in vivo assessment of cardiac anatomy and function. This protocol shows detailed measurements of mouse heart left ventricular function, myocardial strain, and hemodynamic forces using 7-Tesla CMR. First, animal preparation and positioning in the scanner are demonstrated. Survey scans are performed for planning imaging slices in various short- and long-axis views. A series of prospective ECG-triggered short-axis (SA) movies (or CINE images) are acquired covering the heart from apex to base, capturing end-systolic and end-diastolic phases. Subsequently, single-slice, retrospectively gated CINE images are acquired in a midventricular SA view, and in 2-, 3-, and 4-chamber views, to be reconstructed into high-temporal resolution CINE images using custom-built and open-source software. CINE images are subsequently analyzed using dedicated CMR image analysis software.
Delineating endomyocardial and epicardial borders in SA end-systolic and end-diastolic CINE images allows for the calculation of end-systolic and end-diastolic volumes, ejection fraction, and cardiac output. The midventricular SA CINE images are delineated for all cardiac time frames to extract a detailed volume-time curve. Its time derivative allows for the calculation of the diastolic function as the ratio of the early filling and atrial contraction waves. Finally, left ventricular endocardial walls in the 2-, 3-, and 4-chamber views are delineated using feature-tracking, from which longitudinal myocardial strain parameters and left ventricular hemodynamic forces are calculated. In conclusion, this protocol provides detailed in vivo quantification of the mouse cardiac parameters, which can be used to study temporal alterations in cardiac function in various mouse models of heart disease.

This study describes a comprehensive cardiovascular magnetic resonance imaging (CMR) protocol to quantify the left ventricular functional parameters of the mouse heart. The protocol describes the acquisition, post-processing, and analysis of the CMR images as well as assessment of different cardiac functional parameters.

通过心血管磁共振成像定量小鼠心脏左心室功能、心肌劳损和血流动力学力

Mouse models have contributed significantly to understanding genetic and physiological factors involved in healthy cardiac function, how perturbations ...