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Correctness of multi-detector-row computed tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard  

Energy Technology Data Exchange (ETDEWEB)

The purpose was to compare the findings of multi-detector computed tomography (MDCT) in prosthetic valve disorders using the operative findings as a gold standard. In a 3-year period, we prospectively enrolled 25 patients with 31 prosthetic heart valves. MDCT and transthoracic echocardiography (TTE) were done to evaluate pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) and pseudoaneurysm formation. Patients indicated for surgery received an operation within 1 week. The MDCT findings were compared with the operative findings. One patient with a Bjoerk-Shiley valve could not be evaluated by MDCT due to a severe beam-hardening artifact; thus, the exclusion rate for MDCT was 3.2% (1/31). Prosthetic valve disorders were suspected in 12 patients by either MDCT or TTE. Six patients received an operation that included three redo ...

2009-04-15

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High-Resolution Computed Tomography with Single-Slice Computed Tomography and 16-Channel Multidetector Computed Tomography: A Comparison Regarding Visibility and Motion Artifacts  

International Nuclear Information System (INIS)

Background: High-resolution computed tomography is the image procedure of choice in the evaluation of interstitial lung disease. Multidetector-row computed tomography provides the possibility of simultaneous reconstruction of thin and thick slices from the same raw data, acquired from one single series. Thus, it may be tempting to exclude the step-and-shoot series. Purpose: To compare high-resolution computed tomography (HRCT step-and-shoot) from single-slice CT (SSCT) and 16-channel multidetector CT (MDCT) in terms of visibility and motion artifacts, and to investigate whether thin images reconstructed from helical MDCT are equal to or better than conventional HRCT by SSCT in terms of visibility and motion artifacts. Material and Methods: 20 patients underwent HRCT step-and-shoot by SSCT (SSCT step-and-shoot) and MDCT (MDCT step-and-shoot), and a helical MDCT acquisition ...

2007-11-01

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Treatment of Frozen Shoulder Using Distension Arthrography (Hydrodilatation)  

UK PubMed Central (United Kingdom)

Frozen shoulder (adhesive capsulitis) is a common, painful and disabling condition which is typically slow to resolve. Patients with this condition will be seen in every musculoskeletal practitioner’s...Full Text Available

2004-07-01

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Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT. Correlation with histopathological findings  

International Nuclear Information System (INIS)

Our aim was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma. Thirteen of 30 consecutive patients with hilar cholangiocarcinoma who underwent surgery, excluding 17 patients who underwent biliary drainage or preoperative portal embolization, were retrospectively evaluated. Using MDCT systems of 4 detector rows or 16 detector rows, plain and dynamic contrast-enhanced images of three phases were obtained. Extent of tumor spread and lymph node metastasis were assessed with MDCT and compared with histopathological findings. The Bismuth-Corlette classification of hilar cholangiocarcinoma with MDCT were type I, 1 patient; type IIIa, 3 patients; type IIIb, 4 patients; and type IV, 5 patients; those with histopathological findings were type I, 1 patient; type IIIa, 2 patients; type IIIb, 4 ...

2008-08-01

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Imaging techniques for the injured ankle joint and tarsal bones  

International Nuclear Information System (INIS)

In the case of injuries of the ankle joint, an imaging technique is expected to reveal the state of the bones, ligaments, and articular cartilage. Irrespective of novel imaging techniques, a plain radiography will be made in order to obtain a first picture of the injury. Examples are given, showing that further orientation along the Lauge-Hansen classification scheme of this type of injury helps to completely ascertain the damage to the Articulatio talocruralis. Further examinations applying specific methods such as arthrography will detect possible, isolated syndesmosis ruptures; lesions of the ligaments can also be directly detected by CT or MRT. The articular cartilage and its lesions can be visualized by a combination of CT and arthrography, but are better shown by the completely non-invasive MRT. This latter method also gives insight into pathological processes with the bone. It allows to detect necrotic bone regions and their ...

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Diagnosis for the cancer extension of cholangiocarcinoma. The current status  

International Nuclear Information System (INIS)

Described is the diagnosis for the cancer extension of cholangiocarcinoma by various imaging techniques and processes to support the current surgical procedure based on preoperative biliary drainage. The cancer tends to locally extend horizontally and/or vertically and its diagnosis is important for surgical indication. For the indication, multi-detector raw CT (MDCT) and MR cholangio-pancreatography (MRCP) are useful and particularly, the former can give multi-phase (arterial, portal and delayed) images to reconstruct multiplanar (MPR) and CT angiographic 3D images, which have made the previous invasive examinations like angiography and percutaneous transportal contrasting unnecessary. MDCT and MRCP can almost complete the diagnosis of the extension. The operative procedure is decided dependently on the site of the lesion, and of which diagnosis, whether it is hepatic hilar/on upper bile duct or middle/lower ductal, is different. ...

2010-07-01

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Multidetector Computed Tomography in the Preoperative Workup of Hilar Cholangiocarcinoma  

International Nuclear Information System (INIS)

Hilar cholangiocarcinoma is associated with a dismal prognosis; however, curative resection may offer a chance of cure. Various factors should be considered in the surgical planning for curative resection. These factors include extent of bile duct involvement, relationship between portal vein and tumor involvement, diffuse hepato duodenal ligament infiltration, vascular invasion, lymph node metastasis, peritoneal seeding, and hepatic volume. Using high-quality volume data from multidetector-row computed tomography (MDCT) and adequate postprocessing images, radiologists can provide various types of information, imperative for curative resection of a hilar cholangiocarcinoma. This review illustrates the role of MDCT in the preoperative workup of hilar cholangiocarcinoma.

2009-10-01

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Importance of preoperative imaging with 64-row three-dimensional multidetector computed tomography for safer video-assisted thoracic surgery in lung cancer  

British Library Electronic Table of Contents (United Kingdom)

Purpose Video-assisted thoracic surgery (VATS) has recently been adopted for complicated anatomical lung resections. During these thoracoscopic procedures, surgeons view the operative field on a two-dimensional (2-D) video monitor and cannot palpate the organ directly, thus frequently encountering anatomical difficulties. This study aimed to estimate the usefulness of preoperative three-dimensional (3-D) imaging of thoracic organs. Methods We compared the preoperative 64-row three-dimensional multidetector computed tomography (3DMDCT) findings of lung cancer-affected thoracic organs to the operative findings. Results In comparison to the operative findings, the branches of pulmonary arteries, veins, and bronchi were well defined in the 3D-MDCT images of 27 patients. Conclusion 3D-MDCT imag...

2009-01-01

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Impact of diagnosis by enhanced multidetector-row computed tomography and magnetic resonance imaging for extrahepatic cholangiocarcinoma  

International Nuclear Information System (INIS)

Herein we present an impact of diagnosis by enhanced multidetector-row computed tomography and magnetic resonance imaging for extrahepatic cholangiocarcinoma (ECC). Although the diagnosis against the longitudinal stromal extension and surrounding tissue invasion of ECC by multi detector row CT (MDCT) and MRI was very strict, we could not detect any superficial mucosal spread (SMS). Furthermore, the diagnosis of lymphnode metastasis by MDCT/MRI was miserable. We believe that misdiagnosis of SMS is permissible since positive mucosal but not stromal surgical margin was not a significant factor influencing the postoperative prognosis. However, further advances in imaging diagnosis for ECC is needed. (author)

2009-10-01

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Magnetic resonance imaging in joint diseases  

International Nuclear Information System (INIS)

Magnetic resonance imaging has proven an invaluable method in the diagnosis of joint diseases associated with osteonecrotic, inflammatory, traumatic and degenerative processes. At the clinical level, it has an important role in decisions about the method of treatment and evaluations of the therapeutic success. When the merits of MRT are balanced against those of conventional radiography including tomography and CT, which both ensure better spatial resolution in the visualisation of cortical and spongy bone structures, it becomes quite evident that MRT must not be regarded as an alternative method of imaging but as one that can be used additionally to obtain the most information for the diagnosis of arthropathy. The question as to whether new pulse sequences (snap shots) or invasive techniques like intra-articular injection of paramagnetic substances (MR arthrography) are likely to become routine procedures in the detection of joint diseases using MRT remains to be ...

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Correct diagnosis of vascular encasement and longitudinal extension of hilar cholangiocarcinoma by four-channel multidetector-row computed tomography  

International Nuclear Information System (INIS)

Accurate diagnosis of local invasion of hilar cholangiocarcinomas is challenging due to their small size and the anatomic complexity of the hepatic hilar region. On the other hand, the correct diagnosis of local invasion is essential for assuring the possibility of curative surgery. The purpose of this study was to evaluate the feasibility of four-channel multidetector-row computed tomography (MDCT) in the assessment of vascular and bile duct involvement, by which we could obtain useful information for the surgical management of hilar cholangiocarcinoma. The subjects were 18 patients for whom the extent of tumor invasion was surgically and pathologically confirmed. All patients underwent preoperative multiphasic CT scanning by MDCT. Arterial and portal dominant phases were acquired using a detector configuration of 1.25 mm x 4 mm, and both axial and multiplanar reconstructed images were interpreted. Longitudinal extension was evaluated up to ...

2009-01-01

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Comparison of sclerosing cholangitis with autoimmune pancreatitis and infiltrative extrahepatic cholangiocarcinoma. Multidetector-row computed tomography findings  

International Nuclear Information System (INIS)

The aim of this study was to compare multidetector-row computed tomography (MDCT) findings between cases of sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) and infiltrative extrahepatic cholangiocarcinoma (IEC). We retrospectively assessed MDCT findings from 16 IEC cases and 13 SC-AIP cases. MDCT findings were analyzed with regard to location, length, wall thickness, contour, stricture wall enhancement pattern, proximal duct diameter, and the presence of diffuse concentric thickening in the proximal duct and gallbladder wall thickness. Stricture length, stricture wall thickness, and proximal duct diameter were significantly smaller for SC-AIP than for IEC: 19.3#+-#8.7 vs. 31.8#+-#12.0 mm (P=0.004), 2.1#+-#1.3 vs. 4.1#+-#1.3 mm (P<0.001), and 9.2#+-#3.9 vs. 13.3#+-#5.0 mm (P=0.012), respectively. SC-AIP was correlated with stricture location in both the intrapancreatic and hilar hepatic bile ducts, concentric ...

2010-04-01

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What is the best contrast injection protocol for 64-row multi-detector cardiac computed tomography?  

International Nuclear Information System (INIS)

Objective: To determine the optimal contrast injection protocol for 64-MDCT coronary angiography. Materials and methods: One hundred and fifty consecutive patients scheduled to undergo retrospectively electrocardiographically gated 64-MDCT. Each 30 patients were assigned to use a different contrast protocol: group 1: uniphasic protocol (contrast injection without saline flush); group 2: biphasic protocol (contrast injection with saline flush); group 3A, 3B and 3C: triphasic protocol (contrast media + different saline diluted contrast media + saline flush). Image quality scores and artifacts were compared and evaluated on both transaxial and three-dimensional coronary artery images among each contrast protocol. Results: Among the triphasic protocol groups, group 3A (30%:70% contrast media-saline mixture was used in second phase) used the least contrast media and had the least frequency of streak artifacts, but there were no significant ...

2010-08-01

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Usefulness of Computed Tomography in pre-surgical evaluation of maxillo-facial pathology with rapid prototyping and surgical pre-planning by virtual reality  

International Nuclear Information System (INIS)

Purpose. To validate a protocol for creating virtual models to be used in the construction of solid prototypes useful for the planning-simulation of maxillo-facial surgery, in particular for very complex anatomical and pathologic problems. To optimize communications between the radiology, engineering and surgical laboratories. Methods and materials. We studied 16 patients with different clinical problems of the maxillo-facial district. Exams were performed with multidetector computed tomography (MDCT) and single slice computed tomography (SDCT) with axial scans and collimation of 0.5-2 mm, and reconstruction interval of 1 mm. Subsequently we performed 2D multiplanar reconstructions and 3D volume-rendering reconstructions. We exported the DICOM images to the engineering laboratory, to recognize and isolate the bony structures by software. With these data the solid prototypes were generated using stereolitography. To date, surgery has been preformed on 12 patients ...

2005-11-01

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Multidetector-row helical CT: analysis of time management and workflow  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate time management and workflow for multidetector-row helical CT (MDCT). Time for patient and data handling of at total of 580 patients were evaluated at two different time periods (December 1999, August 2000), each for the following baseline measurements: (a) change of clothes/instruction; (b) patient placement on the CT table/i.v. catheter; (c) CT planning and programming; (d) CT data acquisition; (e) CT data reconstruction; (f) CT data storage/printing. All imaging was performed on a Somatom Volume Zoom (Siemens, Erlangen, Germany). Time measurements summarized for different CT protocols revealed the following: (a) 5:01 min (#+-#2.06 min); (b) 4:36 min (#+-#2.43 min); (c) 4:11 min (#+-#2.55 min); (d) 0:43 min (#+-#0.15 min); (e) 6:59 min (#+-#2.39 min); (f) 09:51 min (#+-#3.51 min). Planning and programming was most time-consuming for CT angiography, whereas chest and abdominal CT needed only 3:26 and 3:30 min, ...

2002-03-01

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Dual energy virtual CT colonoscopy with dual source computed tomography. Initial experience  

International Nuclear Information System (INIS)

Purpose: To describe the technique of DE MDCT colonoscopy and to assess its feasibility. Materials and Methods: 8 patients were scanned with DSCT with a DE scan protocol and dose modulation software. Analysis was performed using dedicated DE software. Prone non-contrast images and DE supine images after contrast injection were obtained. Results: DE colonoscopic images were successfully obtained in 7 patients, but the FOV did not cover all colonic segments in 1 patient, thus resulting in a technical success rate was 87.5%. Streak artifacts were present in the pelvic region in 2 patients. Virtual unenhanced images and iodine map images were obtained for all patients. In 1 patient a polypoid non-enhancing structure was noted on the iodine map, and conventional colonoscopy revealed impacted stool. Enhancing rectal cancer in 1 patient was correctly shown on the iodine map. Iodine maps helped to differentiate stool fragments/retained fluid by the absence of enhancement ...

2009-09-01

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Injuries of the tibio-talar joint and preoperative planning. Verletzungen des oberen Sprunggelenks aus unfallchirurgischer Sicht  

Energy Technology Data Exchange (ETDEWEB)

The treatment of bony, osteochondral, and ligamentous injuries of the tibio-talar requires precise preoperative planning by radiological investigation. This is essential to a correct understanding of the underlying pathology and will allow a proper classification of the injury, which is the basis of treatment. Conventional radiography using anteroposterior and lateral X-rays with comparative views of the noninjured side and, if necessary, rotated spot views and tomography are of high value especially in osteochondral fractures of the talus. Intraoperative control images in both planes after osteosynthesis are mandatory. For evaluation of the postoperative course and severity of arthrosis formation, the classification system of Bargon has proved its worth. In addition, tomography of the tibio-talar joint in two planes is useful especially in tibial pilon fractures, some malleolar fractures, and peripheral talar fractures. In talar fracture dislocations with concomitant compartment ...

1991-12-01

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64-slice multidetector coronary CT angiography: in vitro evaluation of 68 different stents  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to test a large sample of different coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in 64-slice multidetector-row computed tomography (MDCT) in vitro and to provide a catalogue of currently used coronary artery stents when imaged with state-of the-art MDCT. We examined 68 different coronary artery stents (57 stainless steel, four cobalt-chromium, one cobalt-alloy, two nitinol, four tantalum) in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density -70). Stents were imaged in axial orientation with standard parameters: 32x0.6 collimation, pitch 0.24, 680 mAs, 120 kV, rotation time 0.37 s. Four different image reconstructions were obtained with varying convolution kernels and section thicknesses: (1) soft, 0.6 mm, (2) soft, 0.75, (3) medium soft, 0.6, and (4) stent-optimized ...

2006-04-15