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Backhaus SJ, Staab W, Steinmetz M, Ritter CO, Lotz J, Hasenfuss G, Kowallick JT, Schuster A. P5284Fully automated quantification of biventricular volumes and function in cardiovascular magnetic resonance: applicability to clinical routine settings. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiovascular magnetic resonance (CMR) represents the clinical gold standard for the assessment of biventricular morphology and function. Since manual post-processing is time-consuming and prone to observer variability, efforts have been directed towards automated volumetric quantification. In this study, we sought to validate the accuracy of a novel approach providing fully automated quantification of biventricular volumes and function in a “real-world” clinical setting.
Methods
Three-hundred CMR examinations were randomly selected from the local data base. Fully automatic quantification of left ventricular (LV) mass, LV and right ventricular (RV) end-diastolic and systolic volumes (EDV/ESV), stroke volume (SV) and ejection fraction (EF) were performed overnight using commercially available software. Parameters were compared to manual assessments. Sub-group analyses were further performed according to image quality, scanner field strength, the presence of implanted aortic valves and repaired Tetralogy of Fallot (ToF).
Results
Biventricular automatic segmentation was feasible in all 300 cases. Overall agreement between fully automated and manually derived LV parameters was good (LV-EF: intra-class correlation coefficient [ICC] 0.95; bias −2.5% [SD 5.9%]), whilst RV agreement was lower (RV-EF: ICC 0.72; bias 5.8% [SD 9.6%]). Lowest agreement was observed in case of severely altered anatomy, e.g. marked RV dilation but normal LV dimensions in repaired ToF (LV parameters ICC 0.73–0.91; RV parameters ICC 0.41–0.94) and/or reduced image quality (LV parameters ICC 0.86–0.95; RV parameters ICC 0.56–0.91), which was more common on 3.0T than on 1.5T.
Conclusions
Fully automated assessment of biventricular morphology and function is robust and accurate in a clinical routine setting with good image quality and can be performed without any user interaction. However, in case of demanding anatomy (e.g. repaired ToF, severe LV hypertrophy) or reduced image quality, quality check and manual re-contouring is still required.
Acknowledgement/Funding
DZHK - German Centre for Cardiovascular Research
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Affiliation(s)
| | - W Staab
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - M Steinmetz
- University Medical Center Göttingen, Department of Pediatric Cardiology and Intensive Care Medicine, Goettingen, Germany
| | - C O Ritter
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - J Lotz
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - G Hasenfuss
- Heart Centre Goettingen, Goettingen, Germany
| | - J T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - A Schuster
- Heart Centre Goettingen, Goettingen, Germany
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Unterberg-Buchwald C, Fasshauer M, Staab W, Steinmetz M, Kowallick J, Ritter CO. P408Unusual case of pericardial effusion. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez109.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Unterberg-Buchwald
- Universitaetsmedizin Goettingen, Dept. of Cardiology and Pneumology, Insitute of Diag. and Interv. Radiology, Goettingen, Germany
| | - M Fasshauer
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - W Staab
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - M Steinmetz
- Universitatesmedizin Goettingen, Dep.t of Pediatric Cardiology and Intensive Care medicine, Goettingen, Germany
| | - J Kowallick
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - C O Ritter
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
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Pinto Dos Santos D, Giese D, Brodehl S, Chon SH, Staab W, Kleinert R, Maintz D, Baeßler B. Medical students' attitude towards artificial intelligence: a multicentre survey. Eur Radiol 2018; 29:1640-1646. [PMID: 29980928 DOI: 10.1007/s00330-018-5601-1] [Citation(s) in RCA: 218] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 05/28/2018] [Accepted: 06/06/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To assess undergraduate medical students' attitudes towards artificial intelligence (AI) in radiology and medicine. MATERIALS AND METHODS A web-based questionnaire was designed using SurveyMonkey, and was sent out to students at three major medical schools. It consisted of various sections aiming to evaluate the students' prior knowledge of AI in radiology and beyond, as well as their attitude towards AI in radiology specifically and in medicine in general. Respondents' anonymity was ensured. RESULTS A total of 263 students (166 female, 94 male, median age 23 years) responded to the questionnaire. Around 52% were aware of the ongoing discussion about AI in radiology and 68% stated that they were unaware of the technologies involved. Respondents agreed that AI could potentially detect pathologies in radiological examinations (83%) but felt that AI would not be able to establish a definite diagnosis (56%). The majority agreed that AI will revolutionise and improve radiology (77% and 86%), while disagreeing with statements that human radiologists will be replaced (83%). Over two-thirds agreed on the need for AI to be included in medical training (71%). In sub-group analyses male and tech-savvy respondents were more confident on the benefits of AI and less fearful of these technologies. CONCLUSION Contrary to anecdotes published in the media, undergraduate medical students do not worry that AI will replace human radiologists, and are aware of the potential applications and implications of AI on radiology and medicine. Radiology should take the lead in educating students about these emerging technologies. KEY POINTS • Medical students are aware of the potential applications and implications of AI in radiology and medicine in general. • Medical students do not worry that the human radiologist or physician will be replaced. • Artificial intelligence should be included in medical training.
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Affiliation(s)
- D Pinto Dos Santos
- Department of Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - D Giese
- Department of Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - S Brodehl
- Department of Informatics, University Mainz, Mainz, Germany
| | - S H Chon
- Department of Surgery, University Hospital Cologne, Cologne, Germany
| | - W Staab
- Department of Radiology, University Hospital Göttingen, Göttingen, Germany
| | - R Kleinert
- Department of Surgery, University Hospital Cologne, Cologne, Germany
| | - D Maintz
- Department of Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - B Baeßler
- Department of Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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Gilbert F, Eden L, Meffert R, Konietschke F, Lotz J, Bauer L, Staab W. Intra- and interobserver reliability of glenoid fracture classifications by Ideberg, Euler and AO. BMC Musculoskelet Disord 2018; 19:89. [PMID: 29580228 PMCID: PMC5870213 DOI: 10.1186/s12891-018-2016-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/21/2018] [Indexed: 01/24/2023] Open
Abstract
Background Representing 3%–5% of shoulder girdle injuries scapula fractures are rare. Furthermore, approximately 1% of scapula fractures are intraarticularfractures of the glenoid fossa. Because of uncertain fracture morphology and limited experience, the treatment of glenoid fossa fractures is difficult. The glenoid fracture classification by Ideberg (1984) and Euler (1996) is still commonly used in literature. In 2013 a new glenoid fracture classification was introduced by the AO. The purpose of this study was to examine the new AO classification in clinical practice in comparison with the classifications by Ideberg and Euler. Methods In total CT images of 84 patients with glenoid fossa fractures from 2005 to 2018 were included. Parasagittal, paracoronary and axial reconstructions were examined according to the classifications of Ideberg, Euler and the AO by 3 investigators (orthopedic surgeon, radiologist, student of medicine) at three individual time settings. Inter- and intraobserver reliability of the three classification systems were ascertained by computing Inter- and Intraclass (ICCs) correlation coefficients using Spearman’s rank correlation coefficient, 95%-confidence intervals as well as F-tests for correlation coefficients. Results Inter- and intraobserver reliability for the AO classification showed a perspicuous coherence (R = 0.74 and R = 0.79). Low to moderate intraobserver reliability for Ideberg (R = 0.46) and Euler classification (R = 0.41) was found. Furthermore, data show a low Interobserver reliability for both Ideberg and Euler classification (R < 0.2). Both the Inter- and Intraclass reliability using AO is significantly higher than those using Ideberg and Euler (p < 0.05). Using the new AO classification, it was possible to find a proper class for every glenoid fossa fracture. On average, according to Euler classification 10 of 84 fractures were not classifiable whereas to Ideberg classification 21 of 84 fractures were not classifiable. Conclusion The new AO classification system introduced 2013 facilitates reliable grading of glenoid fossa fractures with high inter- and intraobserver reliability in 84 patients using CT images. It should possibly be applied in order to enable a valid, reliable and consistent academic description of glenoid fossa fractures. The established classifications by Euler and Ideberg are not capable of providing a similar reliability.
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Affiliation(s)
- F Gilbert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Würzburg, Germany.
| | - L Eden
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Würzburg, Germany
| | - R Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Würzburg, Germany
| | - F Konietschke
- Department of Mathematical Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - J Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - L Bauer
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - W Staab
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
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Schenk L, Hösch O, Schuster A, Kowallick J, Staab W, Kutty S, Otto T, Seehase M, Lotz J, Paul T, Steinmetz M. The Value of the Newly Validated Cardiovascular Magnetic Resonance Derived Total Right/Left Volume Index in the Course of Ebstein Anomaly: A Prospective Long-Term Follow-up Study. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L. Schenk
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - O. Hösch
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - A. Schuster
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
| | - J. Kowallick
- Department of Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - W. Staab
- Department of Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - S. Kutty
- University of Nebraska Medical Center, University of Nebraska Medical Center/ Children's Hospital and Medical Center, Omaha, United States
| | - T. Otto
- Department of Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - M. Seehase
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - J. Lotz
- Department of Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - T. Paul
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - M. Steinmetz
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
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Steinmetz M, Broder M, Kowallick J, Llamata P, Kutty S, Seehase M, Staab W, Unterberg-Buchwald C, Lotz J, Paul T, Hasenfuß G, Schuster A. Atrioventricular Mechanics and Heart Failure in Ebstein's Anomaly—A Cardiovascular Magnetic Resonance Imaging Study. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schuster A, Stahnke VC, Unterberg-Buchwald C, Kowallick JT, Lamata P, Steinmetz M, Kutty S, Fasshauer M, Staab W, Sohns JM, Bigalke B, Ritter C, Hasenfuß G, Beerbaum P, Lotz J. Cardiovascular magnetic resonance feature-tracking assessment of myocardial mechanics: Intervendor agreement and considerations regarding reproducibility. Clin Radiol 2015; 70:989-98. [PMID: 26139384 PMCID: PMC4683162 DOI: 10.1016/j.crad.2015.05.006] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/30/2015] [Accepted: 05/18/2015] [Indexed: 12/31/2022]
Abstract
Aim To assess intervendor agreement of cardiovascular magnetic resonance feature tracking (CMR-FT) and to study the impact of repeated measures on reproducibility. Materials and methods Ten healthy volunteers underwent cine imaging in short-axis orientation at rest and with dobutamine stimulation (10 and 20 μg/kg/min). All images were analysed three times using two types of software (TomTec, Unterschleissheim, Germany and Circle, cvi42, Calgary, Canada) to assess global left ventricular circumferential (Ecc) and radial (Err) strains and torsion. Differences in intra- and interobserver variability within and between software types were assessed based on single and averaged measurements (two and three repetitions with subsequent averaging of results, respectively) as determined by Bland–Altman analysis, intraclass correlation coefficients (ICC), and coefficient of variation (CoV). Results Myocardial strains and torsion significantly increased on dobutamine stimulation with both types of software (p<0.05). Resting Ecc and torsion as well as Ecc values during dobutamine stimulation were lower measured with Circle (p<0.05). Intra- and interobserver variability between software types was lowest for Ecc (ICC 0.81 [0.63–0.91], 0.87 [0.72–0.94] and CoV 12.47% and 14.3%, respectively) irrespective of the number of analysis repetitions. Err and torsion showed higher variability that markedly improved for torsion with repeated analyses and to a lesser extent for Err. On an intravendor level TomTec showed better reproducibility for Ecc and torsion and Circle for Err. Conclusions CMR-FT strain and torsion measurements are subject to considerable intervendor variability, which can be reduced using three analysis repetitions. For both vendors, Ecc qualifies as the most robust parameter with the best agreement, albeit lower Ecc values obtained using Circle, and warrants further investigation of incremental clinical merit. This is the first comparison of two types of CMR-FT software resulting in clinically valuable inter-vendor agreement data. Assessment of myocardial strain and torsion is feasible with both types of software at rest and with dobutamine stimulation. For both vendors, Ecc qualifies as the most robust parameter with the lowest variability.
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Affiliation(s)
- A Schuster
- Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Germany; Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, King's College London, London, UK.
| | - V-C Stahnke
- Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - C Unterberg-Buchwald
- Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Germany; Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - J T Kowallick
- DZHK (German Centre for Cardiovascular Research), Germany; Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - P Lamata
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, King's College London, London, UK; Department of Computer Science, University of Oxford, Oxford, UK
| | - M Steinmetz
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - S Kutty
- Children's Hospital and Medical Center Joint Division of Pediatric Cardiology, University of Nebraska / Creighton University, Omaha, NE, USA
| | - M Fasshauer
- DZHK (German Centre for Cardiovascular Research), Germany; Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - W Staab
- DZHK (German Centre for Cardiovascular Research), Germany; Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - J M Sohns
- DZHK (German Centre for Cardiovascular Research), Germany; Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - B Bigalke
- Department of Cardiology, Campus Benjamin Franklin, Charité Berlin, Hindenburgdamm 30, 12200 Berlin, Germany
| | - C Ritter
- DZHK (German Centre for Cardiovascular Research), Germany; Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - G Hasenfuß
- Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Germany
| | - P Beerbaum
- Department of Paediatric Cardiology, Hannover Medical School, Hannover, Germany
| | - J Lotz
- DZHK (German Centre for Cardiovascular Research), Germany; Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
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Staab W, Fasshauer M, Steinmetz M, Schuster A, Sohns J, Kowallick J, Unterberg-Buchwald C, Ritter C, Lotz J. Cardiac magnetic resonance imaging in pediatric patient's ≤18 years with suspected arrhythmogenic right ventricular cardiomyopathy (ARVC): a correlation to genetics. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Menke J, Sohns J, Staab W, Kahl F. Sonografie-gesteuerte hydrostatische Desinvagination der ileokolischen Invagination bei Kindern: Analyse der Erfolgsrate unter Verwendung der neuen Indizes von Bekdash et al. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hösch O, Sohns J, Nguyen T, Lauerer P, Kowallick J, Unterberg C, Schuster A, Kutty S, Faßhauer M, Staab W, Paul T, Lotz J, Steinmetz M. The Total Right / Left - Volume - Index: A new and simplified CMR measure to evaluate the severity of Ebstein’s anomaly of the tricuspid valve. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1394005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fasshauer M, Joseph AA, Kowallick JT, Unterberg-Buchwald C, Merboldt KD, Voit D, Steinmetz M, Staab W, Schaetz S, Zhang S, Frahm J, Lotz J, Sohns JM. Real-time phase-contrast flow MRI of haemodynamic changes in the ascending aorta and superior vena cava during Mueller manoeuvre. Clin Radiol 2014; 69:1066-71. [PMID: 25060931 DOI: 10.1016/j.crad.2014.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/01/2014] [Accepted: 06/03/2014] [Indexed: 10/25/2022]
Abstract
AIM To evaluate the potential of real-time phase-contrast flow magnetic resonance imaging (MRI) at 40 ms resolution for the simultaneous determination of blood flow in the ascending aorta (AA) and superior vena cava (SVC) in response to reduced intrathoracic pressure (Mueller manoeuvre). MATERIALS AND METHODS Through-plane flow was assessed in 20 healthy young subjects using real-time phase-contrast MRI based on highly undersampled radial fast low-angle shot (FLASH) with image reconstruction by regularized non-linear inversion. Haemodynamic alterations (three repetitions per subject = 60 events) were evaluated during normal breathing (10 s), inhalation with nearly closed epiglottis (10 s), and recovery (20 s). RESULTS Relative to normal breathing and despite interindividual differences, reduced intrathoracic pressure by at least 30 mmHg significantly decreased the initial peak mean velocity (averaged across the lumen) in the AA by -24 ± 9% and increased the velocity in the SVC by +28 ± 25% (p < 0.0001, n = 23 successful events). Respective changes in flow volume per heartbeat were -25 ± 9% in the AA and +49 ± 44% in the SVC (p < 0.0001, n = 23). Flow parameters returned to baseline during sustained pressure reduction, while the heart rate was elevated by 10% (p < 0.0001) after the start (n = 24) and end (n = 17) of the manoeuvre. CONCLUSIONS Real-time flow MRI during low intrathoracic pressure non-invasively revealed quantitative haemodynamic adjustments in both the AA and SVC.
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Affiliation(s)
- M Fasshauer
- Institute for Diagnostic and Interventional Radiology, Heart Centre, University Medical Centre, Georg-August-University Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - A A Joseph
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - J T Kowallick
- Institute for Diagnostic and Interventional Radiology, Heart Centre, University Medical Centre, Georg-August-University Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - C Unterberg-Buchwald
- Institute for Diagnostic and Interventional Radiology, Heart Centre, University Medical Centre, Georg-August-University Göttingen, Germany; Clinic for Cardiology and Pneumology, Heart Centre, University Medical Centre, Georg-August-University Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - K D Merboldt
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - D Voit
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - M Steinmetz
- DZHK, German Centre for Cardiovascular Research, Göttingen, Germany; Clinic for Paediatric Cardiology and Intensive Care Medicine, Heart Centre, University Medical Centre, Georg-August-University Göttingen, Germany
| | - W Staab
- Institute for Diagnostic and Interventional Radiology, Heart Centre, University Medical Centre, Georg-August-University Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - S Schaetz
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - S Zhang
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - J Frahm
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
| | - J Lotz
- Institute for Diagnostic and Interventional Radiology, Heart Centre, University Medical Centre, Georg-August-University Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany.
| | - J M Sohns
- Institute for Diagnostic and Interventional Radiology, Heart Centre, University Medical Centre, Georg-August-University Göttingen, Germany; DZHK, German Centre for Cardiovascular Research, Göttingen, Germany
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Menke J, Sohns JM, Staab W, Seif AHA, Schwarz A. Prospektives Triggern versus retrospektives Gating in der koronaren CT-Angiografie: Meta-Analyse von diagnostischer Genauigkeit, Bildqualität und Strahlendosis. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Menke J, Jan-Martin S, Staab W, Hosseini Ali Seif A, Schwarz A. Prospektives Triggern versus retrospektives Gating in der koronaren CT-Angiografie: Meta-Analyse von diagnostischer Genauigkeit, Bildqualität und Strahlendosiss. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sohns JM, Staab W, Menke J, Bergau L, Dabir D, Schwarz A, Spiro J, Dorencamp M, Harrison JL, Steinmetz M, Sohns C, Lotz J. Vascular and extra-vascular pathologies in magnetic resonance angiography of the thoracic aorta and the origin of the great vessels. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sohns JM, Faßhauer M, Kowallick JT, Joseph A, Unterberg-Buchwald C, Merboldt KD, Voit D, Staab W, Steinmetz M, Schuster A, Zhang S, Frahm J, Lotz J. Simultaneous real-time flow dynamics in the azygos vein and descending aorta during physiological stress. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Staab W, Bergau L, Schuster A, Hinojar R, Dorenkamp M, Obenauer S, Lotz J, Sohns C. Detection of intracardiac masses in patients with coronary artery disease using cardiac magnetic resonance imaging: A comparison with transthoracic echocardiography. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sohns JM, Staab W, Menke J, Spiro JE, Bergau L, Kowallick JT, Schwarz A, Panahi B, Fasshauer M, Dorenkamp M, Sohns C, Lotz J. Clinical assessment of vascular and extra-vascular pathologies in patients undergoing magnetic resonance angiography of the abdomen, pelvis and lower extremities. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Staab W, Sohns C, Zwaka PA, Sohns JM, Schwarz A, Schneider S, Vollmann D, Zabel M, Hasenfuß G, Lotz J. Split-bolus single-phase cardiac multidetector computed tomography for reliable detection of left atrial thrombus: comparison to transesophageal echocardiography. ROFO-FORTSCHR RONTG 2014; 186:1009-15. [PMID: 24729408 DOI: 10.1055/s-0034-1366247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Evaluation of a new cardiac MDCT protocol using a split-bolus contrast injection protocol and single MDCT scan for reliable diagnosis of LA/LAA thrombi in comparison to TEE, optimizing radiation exposure and use of contrast agent. MATERIALS AND METHODS A total of 182 consecutive patients with drug refractory AF scheduled for PVI (62.6 % male, mean age: 64.1 ± 10.2 years) underwent routine diagnostic work including TEE and cardiac MDCT for the evaluation of LA/LAA anatomy and thrombus formation between November 2010 and March 2012. Contrast media injection was split into a pre-bolus of 30 ml and main bolus of 70 ml iodinated contrast agent separated by a short time delay. RESULTS In this study, split-bolus cardiac MDCT identified 14 of 182 patients with filling defects of the LA/LAA. In all of these 14 patients, abnormalities were found in TEE. All 5 of the 14 patients with thrombus formation in cardiac MDCT were confirmed by TEE. CONCLUSION MDCT was 100 % accurate for thrombus, with strong but not perfect overall results for SEC equivalent on MDCT. KEY POINTS • Patients with no filling defect or thrombus in MDCT in the LA/LAA region are unlikely to have thrombus and may undergo PVI without TEE.• Here, the role of an additional TEE in pre-procedural management prior to PVI in patients with AF has to be redefined.• Using a split-bolus injection protocol increases the diagnostic accuracy of thrombus in the LA/LAA region.
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Affiliation(s)
- W Staab
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - C Sohns
- Dept. of Cardiology and Pneumology, Georg-August-University Goettingen, Germany, Goettingen
| | - P A Zwaka
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - J M Sohns
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - A Schwarz
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - S Schneider
- Dept. of Medical Statistics, Georg-August-University Goettingen
| | - D Vollmann
- Dept. of Cardiology and Pneumology, Georg-August-University Goettingen, Germany, Goettingen
| | - M Zabel
- Dept. of Cardiology and Pneumology, Georg-August-University Goettingen, Germany, Goettingen
| | - G Hasenfuß
- Dept. of Cardiology and Pneumology, Georg-August-University Goettingen, Germany, Goettingen
| | - J Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
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Sohns JM, Menke J, Staab W, Spiro J, Fasshauer M, Kowallick JT, Bergau L, Zwaka PA, Unterberg-Buchwald C, Lotz J, Schwarz A. Current role of cardiac and extra-cardiac pathologies in clinically indicated cardiac computed tomography with emphasis on status before pulmonary vein isolation. ROFO-FORTSCHR RONTG 2014; 186:860-7. [PMID: 24648234 DOI: 10.1055/s-0034-1366107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE The aim of this study was to assess the incidence of cardiac and significant extra-cardiac findings in clinical computed tomography of the heart in patients with atrial fibrillation before pulmonary vein isolation (PVI). MATERIALS AND METHODS 224 patients (64 ± 10 years; male 63 %) with atrial fibrillation were examined by cardiac 64-slice multidetector CT before PVI. Extra-cardiac findings were classified as "significant" if they were recommended to additional diagnostics or therapy, and otherwise as "non-significant". Additionally, cardiac findings were documented in detail. RESULTS A total of 724 cardiac findings were identified in 203 patients (91 % of patients). Additionally, a total of 619 extra-cardiac findings were identified in 179 patients (80 % of patients). Among these extra-cardiac findings 196 (32 %) were "significant", and 423 (68 %) were "non-significant". In 2 patients (1 %) a previously unknown malignancy was detected (esophageal cancer and lung cancer, local stage, no metastasis). 203 additional imaging diagnostics followed to clarify the "significant" findings (124 additional CT, costs 38 314.69 US dollars). Overall, there were 3.2 cardiac and 2.8 extra-cardiac findings per patient. Extra-cardiac findings appear significantly more frequently in patients over 60 years old, in smokers and in patients with a history of cardiac findings (p <0.05). CONCLUSION Cardiac CT scans before PVI should be screened for extracardiac incidental findings that could have important clinical implications for each patient.
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Affiliation(s)
- J M Sohns
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - J Menke
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - W Staab
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - J Spiro
- Radiology, University Hospital of Cologne
| | - M Fasshauer
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - J T Kowallick
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - L Bergau
- Cardiology and Pneumology, University Medical Center of Georg-August-University, Goettingen
| | - P A Zwaka
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - C Unterberg-Buchwald
- Cardiology and Pneumology, University Medical Center of Georg-August-University, Goettingen
| | - J Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
| | - A Schwarz
- Institute for Diagnostic and Interventional Radiology, University Medical Center of Georg-August-University, Goettingen
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Lotz J, Sohns JM, Staab W, Unterberg C, Schwarz A, Steinmetz M. Follow-Up nach Therapie. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kowallick JT, Sohns JM, Unterberg-Buchwald C, Schulte C, Staab W, Merboldt KD, Voit D, Zhang S, Joseph AA, Frahm J, Lotz J. Hochauflösende Echtzeit-Cardio-MRT Flussmessung im Vergleich zur Cine Phasenkontrast-Flussmessung. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Staab W, Sohns C, Zwaka PA, Schwarz A, Sohns JM, Lotz J. Monphasisches Doppel-Bolus Kardio-MDCT zur validen Detektion von Thromben im linken Vorhof und Vorhofohr: ein Vergleich zur transösophagealen Echokardiografie. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sohns JM, Menke J, Staab W, Spiro JE, Kowallick JT, Schulte C, Becker O, Zwaka PA, Unterberg-Buchwald C, Lotz J, Schwarz A. Cardiac and extra-cardiac pathologies in patients undergoing clinically indicated cardiac computed tomography. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sohns JM, Schwarz A, Menke J, Staab W, Spiro JE, Kowallick JT, Schulte C, Becker O, Zwaka PA, Lotz J, Unterberg-Buchwald C. Prevalence and clinical relevance of extra-cardiac findings at cardiac magnetic resonance imaging. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sohns JM, Gröschel S, Baudewig J, Becker L, Schmidt-Samoa C, Menke J, Staab W, Lotz J, Dechent A, Kastrup A. Funktionelle MRT mit Negativen BOLD-Signalveränderungen im Primären Somatosensorischen Kortex unter Einluss des Alterns. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sohns JM, Kowallick JT, Unterberg-Buchwald C, Staab W, Joseph A, Merboldt KD, Uecker M, Voit D, Zhang S, Frahm J, Lotz J. Echtzeit-Cardio-MRT-Phasenkontrast-Flussmessungen mit dem Valsalva- und Müllermaneuver als Stresstest. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sohns C, Sohns JM, Bergau L, Sossalla S, Vollmann D, Luthje L, Staab W, Dorenkamp M, Harrison JL, O'Neill MD, Lotz J, Zabel M. Pulmonary vein anatomy predicts freedom from atrial fibrillation using remote magnetic navigation for circumferential pulmonary vein ablation. Europace 2013; 15:1136-42. [DOI: 10.1093/europace/eut059] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sohns JM, Sohns C, Staab W, Vollmann D, Lüthje L, Zwaka PA, Zabel M, Hasenfuß G, Lotz J. Prognostischer Stellenwert der links-atrialen Dimensionen vor Pulmonalvenenisolation bei Patienten mit Vorhofflimmern: Vergleich zwischen Echokardiographie & Multidetektor-Computertomographie (MDCT). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sohns JM, Staab W, Sohns C, Vollmann D, Lüthje L, Zwaka PA, Zabel M, Hasenfuß G, Lotz J. Prognostischer Stellenwert der links-atrialen Dimensionen vor Pulmonalvenenisolation bei Patienten mit Vorhofflimmern: Vergleich zwischen Echokardiografie & Multidetektor-Computertomografie (MDCT). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Kluge G, Sahlmann CO, Kertesz A, Staab W, Seif A, Meller J, Lotz J. PET/CT Diagnostik des fortgeschrittenen Melanoms. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sohns JM, Staab W, Sohns C, Seif A, Streit U, Kertesz A, Zwaka P, Lotz J. Aktueller Stellenwert der Multi-Detektor-Computertomographie bei Patienten mit Mittelgesichtstrauma. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lotz J, Steinmetz M, Staab W, Unterberg C. Kongenitale Herzvitien: Primärdiagnostik: Rolle von CT und MRT. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1278918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
A new approach to the design of field-effect transistor (FET) sensors and the use of these FETs in detecting extracellular electrophysiological recordings is reported. Backside contacts were engineered by deep reactive ion etching and a gas phase boron doping process of the holes using planar diffusion sources. The metal contacts were designed to fit on top of the bonding pads of a standard industrial 22-pin DIL (dual inline) chip carrier. To minimise contact resistance, the metal backside contacts of the chips were electroless plated with gold. The chips were mounted on top of the bonding pads using a standard flip-chip process and a fineplacer unit previously described. Rat embryonic myocytes were cultured on these new devices (effective growth area 6 x 6 mm(2)) in order to confirm their validity in electrophysiological recording.
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Affiliation(s)
- S Ingebrandt
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, D-55128 Mainz, Germany
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Staab W, Gängler P. [Allergic reaction to chlorhexidine gluconate. A case report]. Stomatol DDR 1982; 32:700-3. [PMID: 6963799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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