Development of experimental ground truth and quantification of intracranial aneurysm pulsation in a patient

Aneurysm wall motion has been reported to be associated with rupture. However, its quantification with medical imaging is challenging and should be based on experimental ground-truth to avoid misinterpretation of results. In this work a time-resolved CT angiography (4D-CTA) acquisition protocol is proposed to detect the pulsation of intracranial aneurysms with a low radiation dose. To acquire ground-truth data, the accuracy of volume pulsation detection and quantification in a silicone phantom was assessed by applying pressure sinusoidal waves of increasing amplitudes. These experiments were carried out using a test bench that could reproduce pulsatile waveforms similar to those inside the internal carotid arteries of human subjects. 4D-CTA acquisition parameters (mAs, kVp) were then selected to achieve reliable pulsation detection and quantification with the lowest radiation dose achievable. The resulting acquisition protocol was then used to image an anterior communicating artery aneurysm in a human subject. Data reveals that in a simplified in vitro setting 4D-CTA allows for an effective and reproducible method to detect and quantify aneurysm volume pulsation with an inferior limit as low as 3 mm3 and a background noise of 0.5–1 mm3. Aneurysm pulsation can be detected in vivo with a radiation dose approximating 1 mSv.

On resonant nonlinear bubble oscillations

If a bubble were produced with an initial surface distortion, the energy carried by surface modes could be converted to other modes by nonlinear interaction, a conversion that provides a possible mechanism of second generation by bubbles. Longuet-Higgins (1989a,b) has argued that volume pulsation would be excited at twice the frequency of the distortion mode and that the response to such excitation is ‘surprisingly large’ when its frequency is close to the natural resonance frequency of the volumetrical mode. It is shown in this paper that this is feasible only if the driving system is sufficiently energetic to supply the energy involved in those volume pulsations, and that this is not generally the case. In the absence of external sources, the sum of energies in the interacting modes cannot exceed the initial bubble energy; an increase in one mode is always accompanied by a decrease in another. In contrast to any expectation of significant pulsations near resonance, we find that, once modal coupling is admitted, the volumetrical pulsation has very small amplitude in comparison with that of the initial surface distortion. This is because of the constraint of energy, a constraint that becomes more severe once damping is admitted. Our conclusion therefore is that the distortion modes of a bubble are unlikely to be the origin of an acoustically significant bubble response.

Right atrium mediates a vasomotor reflex

To examine the role of right atrial receptors in mediating reflex vascular responses we measured, in cats anesthetized with chloralose/urethan, changes in mean arterial pressure (MAP) in response to volume pulsation of the right atrium (+/- 1 ml, 1 Hz). Changes in MAP were measured 1) with pressure in the carotid arteries normal and vagus nerves intact: right atrial pulsation led to a very small and transient fall in MAP; 2) with pressure in the carotid arteries at 75 mmHg and the vagus nerves intact: right atrial pulsation led to a larger and sustained fall in MAP; 3) with pressure in the carotid arteries at 75 mmHg and the vagus nerves cooled or sectioned bilaterally: right atrial pulsation of the right atrium led only to a very small and transient fall in MAP. These data suggest strongly that signals from right atrial receptors traveling in the vagus nerves mediate a reflex change in MAP that is normally masked by signals from carotid receptors.

Neurons in medullary areas controlling ACTH: atrial input and rostral projections

To examine hindbrain pathways mediating release of adrenocorticotropin (ACTH) in response to hemodynamic changes we tested, in 19 cats (chloralose/urethan), 70 neurons in ACTH-active areas of the medulla for their response to volume pulsation (+/- 1 ml, 1 Hz, 60 s) of the right atrium (RA) or to hemorrhage (3 ml/kg per 30 s), and to electrical stimulation in ACTH-active areas of the dorsal rostral pons (DRP). The activity of 16 neurons was increased (P less than 0.05) by RA. Of these, 6 were driven antidromically from the locus subcoeruleus (LSC), and were located in the lateral solitary nucleus and in posteromedial nucleus intercalatus (NI). The activity of 11 neurons was decreased by RA. Of these, 5 were driven antidromically from LSC and lateral ventral tegmental nucleus and were located in anterolateral NI. No rostral projections were found to more medial sites in DRP. Responses to the first trial of RA were rapid, but slowed and attenuated with repeated trials. Responses to hemorrhage were rapid and in the opposite direction, but did not attenuate. The results suggest that pathways displaying rate sensitivity project from the right atrium via B-receptors to the DRP.

Bubble Trajectories and Equilibrium Levels in Vibrated Liquid Columns

An analysis of bubble behavior in a vertically vibrated liquid column and experimental results of equilibrium level determinations are presented. The analysis avoids the usual approximation of small bubble pulsation and predicts a nonharmonic volume pulsation; it can be used to predict bubble trajectories and equilibrium levels. The vibrational amplitude affects the bubble motion indirectly through its effect on the thermodynamic behavior of the bubble. The experimental results compare favorably with the analysis.