Liver stiffness measurement can also be used to detect and assess severity of portal hypertension 2 , 3 , in addition to spleen stiffness 4. Multiple studies showed high accuracy of MRE for liver fibrosis detection and stratification with equivalent to higher performance than other noninvasive modalities, including transient elastography and serum markers 5 — 8.
Moreover, MRE provides larger sampling compared to ultrasound US elastography techniques with high repeatability of LS measurements 9 , MRE needs the addition of motion encoding gradients MEGs in order to image the wave propagation and to compute tissue stiffness. In this sequence, the MEGs are usually applied along the z-axis, with the same frequency as the mechanical excitation and are synchronized with it. This allows the advantage to give precise motion encoding. However, in the fractional encoding method, the period of MEGs is chosen to be shorter than the period of mechanical motion.
The expected tradeoff would be less efficient motion encoding due to mismatched frequencies of MEG and mechanical motion, leading to lower SNR on wave images Moreover, there are few published data on fat and iron effects on MRE quality A phantom study was performed using a previously described setup The passive driver was secured on top of the sample and it caused vertical motion on the container.
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The same MRE sequences as those used for the patients were performed. Our local institutional review board approved this study and waived the requirement for informed consent. The indications of liver MRI were: The etiologies of the chronic liver disease were: These cases were not used for final analysis.
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Patients were not required to fast before the exam. All the exams were performed using a 3.
Our liver protocol included the following sequences: Liver MRE sequences were performed after contrast administration For MRE wave generation, a 19 cm-diameter passive acoustic driver was placed on the right side of the abdomen at the level of the xiphoid. Wave imaging was performed using a modified phase contrast gradient echo sequence with motion encoding gradients along z-axis.
For GRE sequence, all 4 slices were acquired in 4 consecutive breath holds at end expiration and for EPI sequence all 4 slices were acquired in a single breath hold. The details of the sequences are presented in Table 1. The timing diagrams of the 2 MRE sequences are presented in Fig. The toggling MEG gradients are shown with dotted lines. The multimodel direct inversion MMDI algorithm, a statistically based direct inversion algorithm, generated automatically stiffness maps from wave images 24 , For the wave images, a single score was given for the 4 slices as follows: For the confidence maps, the quality was scored for each slice: An overall image quality score was computed as the sum of the wave propagation score and the confidence map score for each slice max For wave images, score was based on depth of propagation of waves.
MRE quantitative analysis was performed by a third observer observer 3, --, a radiologist with 3 years of body MRI experience using Osirix software v 5. This observer was not blinded to the nature of the sequence. Free-hand regions of interest ROIs were drawn on the 4 slices using 3 steps.
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LS values and ROI size were extracted. The ROIs were then pasted on the T1-weighted out-of-phase images. Ra Dash Shonna Bedford General Luma Ellie Bradford Krag Soldier 2 Joshua Jones Krag Soldier 3 Shaun Jones Lead Krag Solider Derek Kunzman The Figure Elaine Marie The survival of Echo is at hand. Edit Details Official Sites: Edit Did You Know? To address privacy concerns, the user can delete voice recordings that are currently associated with the user's account, but doing so may degrade the user's experience using voice search. To delete these recordings, the user can visit the Manage My Device page on Amazon.
In May , it was reported that an Echo device had sent a recorded conversation to an acquaintance of a user who did not intend for this to happen.
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Amazon apologized and conjectured that one part of the conversation had been misinterpreted as a command to distribute it. Echo uses an address set in the Alexa companion app when it needs a location. For example, Echo voice services use the user's location to respond to the user's requests for nearby restaurants or stores.
Similarly, Echo uses the user's location to process the user's mapping-related requests and improve the Maps experience. All information collected is subject to the Amazon. Amazon retains digital recordings of users' audio spoken after the "wake up word", and while the audio recordings are subject to demands by law enforcement, government agents, and other entities via subpoena, Amazon publishes some information about the warrants it receives, the subpoenas it receives, and some of the warrant-less demands it receives, allowing customers some indication as to the percentage of illegal demands for customer information it receives.
During the course of the investigation into the November 22, death of Victor Collins in the home of James Andrew Bates in Bentonville, Arkansas , police sought the data stored on the Amazon Echo on the premises as evidence, but were refused by Amazon. Purchasing merchandise in the categories of apparel, shoes, jewelry, and watches is not available. Echo has provided inconsistent responses when asked common questions to which users would expect better answers. From Wikipedia, the free encyclopedia. Amazon Echo The first-generation Amazon Echo.
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